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Home My WebLink About3151 Airway Ave - Building PermitsPERMIT TYPE: B COMBO Sub Type: COM -ALT PERMIT NUMBER: BC15-00965 STATUS: FINALED DATE ISSUED: 11/10/2015 ISSUED BY: CK JOB ADDRESS: 3151 P001 AIRWAY AV CM Suite/Unit: P001 APN: 93894071 Zoning: Vicinity: Primary Occ: Const Type: V -B SO. FT: 0 Valuation: $1,500.00 SCOPE OF WORK: LEGALIZE DEMO OF NON-BEARING WALLS. ADDITIONAL PERMITS MAYBE REQUIRED PENDING FIELD INSPECTION. REF: C15-0842 OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS CALIFORNIA %PROPERTY RESERVE I Unit: 10 E SO TEMPLE ST #400 Phone: City/State/Zip: BRUCE CHRISTENSEN APPLICANT: JOSEPH BLAINE JARVIES Unit: Phone: 714-609-2038 CONTRACTOR: Phone: Cell: ARCHITECT: ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund Waste Hauling Per Project Fees TOTAL FEES: **Refer to fee receipts for all fees paid for project City/State/zZip: HELENDALE, CA Address: Unit: City/State: License No. License No. $0.00 $54.00 $0.00 $0.00 $0.00 $0.00 $0.50 $1.00 $0.00 $55.50 License No. Address: %SOUTHERN Address: PO BOX 479 ZipCode PHONE: PHONE: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays- 9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day PERMIT TYPE: B COMBO Sub Type: COM -ALT JOB ADDRESS: 3151 M003 AIRWAY AV CM APN: 93894068 Zoning: Vicinity: Const Type: V -B SQ. FT: 3364 PERMIT NUMBER: BC19-00641 STATUS: FINALED DATE ISSUED: 09/11/2019 ISSUED BY: Suite/Unit: M003 Primary Occ: Valuation: $151,380.00 SCOPE OF WORK: COMMERCIAL T.I., FOR NEW TENANT, ' INSIGHT VISION CENTER OPTOMETRY" INTERIOR NON-BEARING OFFICE PARTITION WALLS IN EXISTING SUITE, ACCESSIBILITY UPGRADES TO EXISTING RESTROOMS. FIXTURE COUNT: MECH- (2) VENT FANS. ELEC- (75) LIGHTS, (75) OUTLETS, (28) SWITCHES. PLMG- (1) EA. BAR SINK, COMMERCIAL SINK, (2) EA. SINK, TOILETS, (5) FLOOR SINKS. OWNER: PROPERTY RESERVE INC Address: PO BOX 22036 Unit: Phone: City/State/Zip: SAN DIEGO CA APPLICANT: BARNES, KEVIN Unit: Phone: 626-524-1793 City/State/zZip: SOUTH PASADENA, CA CONTRACTOR: A - PLUS TEC CONSTRUCTION CO License No. 826593 Phone: 626 833 8873 Address: 14721 FOXWOOD RDUnit: Cell: City/State: CHINO HILLS, CA ARCHITECT: KEVIN BARNES PHON E:626-524-1793 ENGINEER: COMBINATION PERMIT FEE SUMMARY License No. Building Plan Check: $1,288.40 Building Fees: $1,982.15 Electrical Fees: $268.92 Mechanical Fees: $58.14 Plumbing Fees: $200.85 SMIP Residential: $0.00 SMIP Commercial: $42.39 Bldg Std Admin Fund $7.00 Waste Hauling Per Project Fees $0.00 TOTAL FEES: $3,946.96 "Refer to fee receipts for all fees paid for project Address: 517 INDIANA CT ZipCode 91709 License No.0 32454 PHONE: IHOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 I Monday thru Friday -7:00 am thru 7:00 pm. Saturdays -9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: PERMIT NUMBER: BC15-00003 PERMIT TYPE: B COMBO STATUS: FINALED Sub Type: COM -ALT DATE ISSUED: 03/20/2015 ISSUED BY: DAS JOB ADDRESS: 3151 J002 AIRWAY AV CM Suite/Unit: J002 APN: 93894021 Zoning: , Vicinity: Primary Occ: Const Type: V -B SO. FT: 0 SCOPE OF WORK: SUITE J002 FOR VALERIE LAM O.D CONTYRUCT PARTION WALLS 2 WASHBASINS 15 LIGHTS. 3/31/15- PLUMBING: ADD (1) WATER HEATER. OWNER: JAY TWO Phone: 714-540-5568 APPLICANT: ANTHONY TANG Unit: Phone: 714-234-5945 CONTRACTOR: N T CONSTRUCTION Phone: 714-234-5945 Cell: ARCHITECT: ENGINEER: DONALD INMAN PHONE:714-521-0554 COMBINATION PERMIT FEE SUMMARY Address: City/State/Zip: BRUCE CHRISTENSEN City/State/zZip: Valuation: $55,000.00 %PROPERTY RESERVE I Unit: License No. 872604 Address: 1191 N KNOLLWOOD CIRCLEUnit: City/State: ANAHEIM, CA License No. Building Plan Check: $441.19 Building Fees: $678.75 Electrical Fees: $40.00 Mechanical Fees: $0.00 Plumbing Fees: $52.90 SMIP Residential: $0.00 SMIP Commercial: $15.40 Bldg Std Admin Fund $3.00 Waste Hauling Per Project Fees $0.00 TOTAL FEES: $1,231.24 **Refer to fee receipts for all fees paid for project Address: ZipCode 92683 PHONE: License No. 11888 HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays- 9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Day. Independence Day, Labor Day, Thanksgiving Day and Christmas Day PERMIT TYPE: B COMBO Sub Type: COM -ALT JOB ADDRESS: 3151 G003 AIRWAY AV CM APN: 93894061 Zoning: Vicinity: Const Type: V -B SQ. FT: 32 PERMIT NUMBER: BC19-00747 STATUS: FINALED DATE ISSUED: 10/24/2019 ISSUED BY: CAC Suite/Unit: G003 Primary Occ: Valuation: $4,000.00 SCOPE OF WORK: CREATE 2 NEW OFFICES OUT OF EXISTING OPEN OFFICE SPACE. SCOPE INCLUDES (3) NEW WALLS AND (2) DOORS. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS CALIFORNIA %PROPERTY RESERVE I Unit: 10 E SO TEMPLE ST #400 Phone: City/State/Zip: BRUCE CHRISTENSEN APPLICANT: GARY MAXWELL WESTWINDS LN Phone: 949-632-6018 CONTRACTOR: OC BUILDERS Phone: 714 -553 - Cell: ARCHITECT: GARY MAXWELL PHONE:949-632-6018 ENGINEER: COMBINATION PERMIT FEE SUMMARY Building Plan Check: Building Fees: Electrical Fees: Mechanical Fees: Plumbing Fees: SMIP Residential: SMIP Commercial: Bldg Std Admin Fund Waste Hauling Per Project Fees TOTAL FEES: "Refer to fee receipts for all fees paid for project Unit: City/State/zZip: HUNTINGTON BEACH, CA License No. 986363 Address: 8131 INDIANAPOLIS AVEUnit: City/State: HB. CA License No. $98.94 $152.21 $0.00 $0.00 $0.00 $0.00 $1.12 $1.00 $0.00 $260.88 Address: %SOUTHERN Address: 19722 4732 ZipCode 92646 License No.C13785 PHONE: HOURS FOR CONSTRUCTION ACTIVITY: EFFECTIVE 3/18/2010 - PER CMMC Sec. 13-279 Monday thru Friday - 7:00 am thru 7:00 pm. Saturdays- 9:00 am thru 6:00 pm. Prohibited all hours - Sundays and the following Federal holidays: New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Christmas Day oe OWNER STERN PACIrIC DATE 11/2,/8_ JOB ADDRESS 3151 Aixwav Avenue. Bldg_ R BUILDING PERM11 NO rTnev ' GENERAL CONTRACTOR DESCRIPTION of WORK CymToprr ial Ti',d-*ng AP No. 427-291-Q3 1h u 09 TRACT FIRE ZONE VALUE S 183,156, INSPECTIONS Si na ire DMe TYPE GROUP ZONE M GAIL SUBCONTRACTOR P Dote ` 5 ED Number Siann3ore Gas WATER Plum ROUGH PLUMBING �VTljj sc PROP, SWR, LINE Q HOUSE LGN, _ .. -•7. J.f,p SPRINKLING SYSTEM - 79607 MISL: LLANEOULon S^.3^ �� •-a.J HOUGH �ff.6TING AND AIR CONDITIONING Jp� TEMPORARI SERVICE OR POLE U�f10ERG Rp JHO POWER �i AUGH WIRING 0'j L- tx, - id- Hooting and V ML TRENCHES FORMS STEEL fie INF. Vr FLOOR SYSTEM BOND BEAM 0 STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING - 1N [-] OUT PLASTER, 9ROWN COAT STRUCTURA4, FINAL HEATING, VENT., REFRIG., ANO A.C., FINAL $• 7. PLUMBING. FINAL AND GAS TEST Ll_fir _ fI ELECTRIC, FINAL BUILDING, FINAL '- SPECIAL REQUIREMENTS UT141 TY NOTIFIED, GAS ELECT. OCCUPANCY CMF 0486.46 (BU 4) HOLD FOR SPECIAL REOUIRFAAFMT*, 51043 G -n 94B8 -GB [BV 4; HOLD FOR SPECIAL REQUIREMENTS 51642 OWN] JOB, GENI AP N SpI SOIL GAS W ATEI ROUGE PROP. SPRIN MISL; FrDU^all TEMPO ENE TREgG FL0011 BOND I SHEAT FRAMI LATHIJ PLAST STRUC H I;AT tl PLDME 3LECT BU I—LD I SPECIj UTILIT vccu CMF OWNER 6ES= PACIFIC: FIAIA}?4VlA-fn. RATE 11 /77/R[1 OWNER OWNER W99rEM PACIFIC F DATE 11 So JOB ADDRESS 3151 rlirm . C BUILDING PERMIT NO. 51044 GENERAL CONTRACTOR J. a son Co. DESCRIPTION of WORK Qggp2tnia1 &dLdir AP NO. 427-291-03 thru_ 09 _ . TRACT FIRE ZONE VALUE $ 182.678.00 INSPECTIONS ISN—t—f Dote IITYPE GROUP ZONE _ GAILSUBCONTRACTOR I55 GAS ote ►[ulR6ar Si naT rt WATER Plum6in ROUGH PLUMBING - fes! t' _ J PROP, SWA, LINE r! HOUSE CON, ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE 11NOERGROUND 0 POWER ROUAH WIRING f'jVLX I TRENCHES Llff FORMS STEEL REINF. k. Atin. and Vent. %11 FLOOR SYSTEM BONG BEAM M STEEL REINFORCE SHEATHING =�- FRAME AND FLASH IN � LATHING — IN OUT PLASTER, BROWN COAT STRUCTURAL. FINAL HEATING, WENT., REFRiG. AND A. C., FINAL, %• PLUMBING, FINAL AND GAS TEST y ELECTRIC, FINAL BUILOING, FINAL / •• SPECIAL REQUIREMENTS r UTILITY NOTIF LEO, GAS M ELECT. rl OCCUPAN Y CMP 04 8r,46 (eLI4) RE ENTS 51044 IWH ER TniF;S'I+mi ppmT TC F Imrym, DATE LATER uMB+ SUBCONTRACTOR OU6H HEATING AND AIR CONDITIONINGS EMPORARY SERVICE OR POLE HDERGROUHD E] POWER ❑ Ou6n wIRIHc RENCneS FORMS STEEL REIRF, Heau LOOR SYSTEM G OND BEAM STEEL REINFORCE HEAT "IK � � -' 7 RAME AND FLASHING - t ATHING — IN F1 0 LASTER, BROWN COAT TRUCTUAAL. FINAL EATIHO, WENT., IIEFRIG. AND A,C., FINAL 'f'j• 7.' q LUM9IRG_ FINAL AND GAS TEST LECTRIC, FINAL _ uILDIHG, FINAL PECIAL REOUIRENIEHTS f 54 1 7-2-so3 CF 0486.46 [BV 0 HOLD Fa FZ SPECIAL REQUIREMEN.M.... _ 51Q45 h1 OWNER DATE � � 11 2i sa P FIC FiI3ANCIAL JOB ADDRESS 3151 Aisww Bldg. _H BUILDING PERMIT NO. 51050 GENERAL CONTRACTOR 3_ Donald Clsnn C DESCRIPTION of WORK amial BuLidt}a AP No. 427-291-05 thru 09 TRACT FIRE ZONE VALU S 1 2 4' INSPECTIONS Sl nolure pose TYPE GfiOUP ZONE CL SOIL SUBCONTRACTORP n— S IS Number Si nururs GAS WATER umbirka ROUGH PLUMBING r — f? PROP. HE 0 HOUSE CON. LJII 11 p '_S{ SPRINNLIHG SYSTEM II (! MISCELLANEDHS y or ROUGH HEATING AND AIR CONOITIONINE y TEMPORARY SERVICE OR POLE UNDERGROUND ( POWER T7 8J✓� ...� ROUGH WIRING Meati and Venr TRENCHES FORMS TEEL R'EINF. FLOOR SYSTEM BOND BEAM F STEEL REINFORCE SHEATHING FRAME AND FLASHINGSR&F , $ LATHING —IN OUT PLASTER, BROWN COAT ST;OCTURAL, FIN).L HEATING. VENT., REFHIG. IHO R.C., FINAL 1T" PLUMBING, FIMAL ANO GAS TEST ELECTRIC, FINAL Q_ Q6 BUILDIkG. FIMAL 7.93, SPECIAL REQUIREMENTS UTILITY MOTIF IED, GAS ELECY. OCCUPANCY .. CMF 0796-46 IOU 4) HOLD FOR SPECIAL REQUIREMENTS 51050 OWNER WESrEr4j p; JOB ADDRESS 3151 Aa u� nary 7nT_nz +T..... no TRACT RATE BUILD' -3 PERMIT NO. 51051 04 WORK e - arcxal BuildinCf VAL I .Ii 247.353.00 ``moiINE INSPECT IONS Si nmuro C1olc TYPE GROUP SUBCONTRACTOR PjfA{TS lute Number Si nature SOIL GAS WATER P"1 ROUGH PLUMBING v a PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AHO ALR CONDITIONING G - TEMPORARY SERVICE OR POLE UHOERGROUNO cs POWER QJ L ROUGH WIRING TRENCHES OR.MS STEEL REIXF. FLOOR SYSTEM or Hestina aed VM BOND BEAM ©_ STEEL REINFORCE SHEATHING �^ _ FRAME AND FLASHLN 5 -- LATHING -- IN OUT - PLRSTER, BROWN CDAT STRIk TUFIAL, FINAL ING. VENT., REFRIG. RH71 D A.C., FINALZ %'" _� .1 Elacirl-c— a PLUMBING. FlHAL AHO GAS TEST 7� ELECTRIC, FINAL BUILDING, FINAL SPECIAL REQUIREMENTS UTILITY NOTIFIED. GAS ELECT, 'Z OCCUPANCY CMF0485464Q1+41 . "01r) FnR coEC[At REOUIREAAENTIZ 51051 OWNER F j PACIFIC DATE 5/18/81 JOBADDRESS 3151—R1 Ait'umir nimniw 1,1 .. _ —_l 01111 NIL— r,rn.. r — GENERAL CONTRACTOR DE RIPTION of WORI( 'y°i- AP No, 427-291.-08 LOT I INSPECTIONS 30PL TRACT 51 nelure FIRE Dot. ZONE VALUE; TYPE GROUP SUBCONTRACTOR PERMITS Date Plumbfn ra ZDNE Number Si GAS ;:ATE AOUGX PL UNrg ING PROP, SWR" LIN( - HOUSE CON. �] SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND ASR CON01710MING TEMPORARY SERVICE OR POLE UHDERGBOUHB 7 POWER ROUGH WIRING " N.erf Rnd Vont. TRENCHES FORMS STEEL REINF" FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING = IH OUT PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND R.C., FINAL Y C_ - 'a PLUMBING" FINAL Alm GAS TE5T ELECTRIC, FINAL BUILDING. FINAL [� rS 7.`a �• SPECIAL REQUIREMENT UTILITY NOTIFIED" GAS ELECT. OCCUPANCY CMF pq 86-g6 (BL14] 51875 OWNER DATE AP No. 427-291-08 COT_ Pct 7 TRACT FIRE ZONE VA! OF I , r`nnn nn� INSPECTIONS SOIL GAs ROUTER Si nature D-ra TYPE GROUP ZONE SUoCONTRACTOR Oe}e Number SI .tura Pl. bin R011GR PL JMBlNG PROP, SWR. LINEMOUSE CON. 1 SPRlNKL IMG SYSTEM — MISCELLANCOUS POUGN HEATINt ANO AIR CONB17to"I HG TEMPORARY SERVICE PR POLE UMOERGROUHO3 POWER 0 ROUGH WIRING '7r N.nfln cmd V. T. !TRENCHES Lj FORMS STEEL REIHF. IFLOOR SYSTEM BOH❑ 9EAM STEL RCOHFORCE --� j SHEATHING FRAME ANO FLASHIN ILAT HING —IN=OOT PLASTER, BROWN COAT STRUCTURAL, F.NAL _ -- �--I HEATIHG. VENT., REFRIG. ANO A.C., FINAL PLUMBING. FI.YAL AND GAS TEST --- ELECTRIC, FINAL BUILDING. FINAL S_P$CIAL REQUIREMENTS! UTILITY MOTIF IED, GAS` ELECT. OCCUPANCY — CMF/ , CA 9&46 (6U4) 51876 COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOK 4200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BU LD ING ADDRESS OWNER OWNER OR / .E..\ TENANT �/ J r lJ MAILING_ i ? lig //7n APPLICATION F0M'TRUCTURWLPERMIT�,E...`� ' R EIV BY PERMIT N2— 510 3 9 A.P. NO.�� BUILDING211101 ADDRESS UNIT OR SPACE NO. �A� _ R� rr ✓�� TR.NO. LOT BLK. O/ %��r 7 �Nr O J(r[ CITY, NECL CNSTRUGTIO O NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER BRANCH OWNS ADDRESS VALUE ARCHITE �% TE �QT� US DO OF ENGIN /Y ADDRESS l �� ZONE TYPE GROUP CONTRACTOR D - APPROVED BY DATE ADDRESS TEL. CITY NO. STATE CITY APPROVED SETBACKS LIC. NO. LIC. NO. SIZE NO. OF SLDGS. (FROM CJL STREET) OF LOT NOW ON LOT F ONT FT, USE OF EXISTING BLDG, >E f/j� W Separate permits are required for L. SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APPROVED I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violatlon of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. the State of Californ usiness and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, andsuc licenses are i full force and effect, oral THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: _1111 am exempt f m th rovision of at f Cal ornia Business VALUATION PERMIT FEE $ 1,47 and Proiessi de, Division ap PLAN CHECK $ Signature of Per;ittee o0c) X g (/ / / Authorized AgeOt Date i TOTAL PA1 D I. 1 a LU H a o_ J a } J IZ LU CL 0 IZ CL Z w _H W (L [r D 0 } U) t�} i— COSTA MESA BUILDING—SAFETY DEPARTMENT P. ( IOX IZOQ Costa Iftsa, California CONTRACTOR Address City Zip Code Stale License No. Class. City License No. Tei. No. NUMBER TYPE OF FIXTURE OR ITEM FEE Bathtub Laundry Tub or Tray Automatic Washing Machine j, Sink, Bar Sink, Kitchen Wash Basin (Lavatory) Water Closet (Toilet) Drinking Fountains Floor Drains Interceptors f'/ Floor Servile Dunwasner Garage Disposal Water Softener Water Heater and Vent Gras System ... Outlets/. Roof [gains Water Piping Alterat' n Backflow Prevente Lawn Sprinklers es or Nan -R Property Sewe ... Feet House Sewer jtonnection Cesspool, S06tic Tank CMF 0450-46 b -Total us TOri'AL FEE TRACT NO, RECD. BY LOT NO DATE ISSUED BUILDING USE tsuntatng Address Owner Mail Address Cit yfr Tel. No. i 1/hereby acknowledge `lhat =l have read this application and state that the above is correct and agree to comply with all City Ordinances and Stite Laws regulating plumbing. 1 cerfifyfthaf (•possess the above valid State of California classi- / fication or,l am the legal owner of the residential property de- scribed above. r ; I cerlify'thaf 1 have obtained a permit from the State Division of Industrial Safety for excavations, other than swimming pools, five feet deep or deeper and into which a person is required to descend. 'y signarure of Permiltee INSPECTION RECORD APPROVALS INSPECTOR DATE Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA PERMIT NO, 1 TRACT NO. LOT NO. BLDG. NO. r� 6124- Sy2E3/82 81S.75 TU ..CONSTRUCTION PERMIT 36,S:-0-- CN Project Address ' l �� TYPE OF CONSTRUCTION . 1. , Owner LZ hone ❑ NEW ' ❑ ADD ❑ ALTERATION 4 -Address Z20 '❑ REPAIR ❑ CONVERSION ❑DEMOLISH ZONING Arch/Eng, - License No. ❑ OTHER REGULATIONS i DESCRIPTION OF WORK A.P. \ Address-, - -ZONE 'PLNTyGOp. REF. $ ' Contracto - C 4 - Phones{ (o7-Ci7, TYPE OF PERMIT- SETBAING . PROPEkTDY LINE- -AddfesS �,`� :� L it �] ❑ GRADING. ❑ FOUNDATION - ❑ STRUCTURAL CK C T. S1, YARD - LICE=NSED CONTRACTOR DECLARATION _ -. '1 hereby that I licensed Charter 9 ❑TENANT ELECTRICAL ❑PLUMBING ❑MECHANICA W - _ affirm am under provisions of (com- mencing with section 7000) of Division 3 -of the and ❑ OTHER. RIIGH7 -Business Professions Cdde, Cd license is In ll t CI eff t. PROJECT - ' REAR YARD ATO P/L) ,License Class tens o. "r� DESCRIPTION PKG. SPACE'REQ. PROVIDED f 0 . SQ. FT. - Date Signatur - - _ 1 STREET WIDTH PARK FEE $ - _ �'�'fkKERS' COMPENSATION DECLARATION 4" . that 1 OCCUPANCY CONSTRUCTION TYPE ZONING APPROVED BY DATE - - r,areby affirm have a certificate of consent to self -Insure ora VALUATION + ZONE ''ificate of Workers' Compensatltln insurance, or a -certified copy .H - `SPECIAL CONDITIONS: thereof (Section 3800,�ab.t.). r GRADING CU. YDS. ACRES Policy No•ZN41.�i d5C Company' - - - ❑_Cerfified copy, is hereby furnished. ._ - - REMARKS:,i. Q .-. Certified copy is filed with the city Building Division, �l EXEMPTION FROM WORKERS' COMPENSATION DECLARATION AIL S - !�'[ + (This section need not be completed if the,permit,is for one hundred I $100) or lesslj. , ,I.certify that In the Performance of the work for which permit is _this Issued, I shall not employ any person in any manner So as to become PLUMBING PLA N CHECK , ELECTRICAL PLAN'CHECK subject, to the Workers' Compensation LawS.of California.'_. INU GAHA ,' 1 - BATHTUBS SHOWERS* - .Date Signature ,} NOTICE: If atter making this declaration, you should becomesubject -TOILETS, URINALS '-' '+ " --- GENERATOR- '0-1`KW -- - 1-10 KW- TRANSFORMER td the Workers' COrnp¢nsatlon provisions of the Labor Code, you must forthwith comply with Such provisions or this permit shat! be deemed LAVATORIES OOUBL'E CAVS - - z ` APPLIANCE 10-50 KW + KW - (d i� V revoked, _ . _ k _ _ _ _ _ _ ',CONSTRUCTION LENDING AGENCY �• KIT. SINKS- - - '- -' DISHWASHERS- - 7 -' - _ MOTORS - -� 0-1 HP" -1-101-1p* - -- + 4 hereby affirm that there is a construction lending agency for the Per- SERVICE SINKS SUMPS - - - - .J,+ - 4(jNC. SOLAR} •_ _;a_50 HPC ---50•+ HP -� - formance of the work for which this permit is issued (Section 3097 j Civ. C.). -' -- FLOOR'SINKS - FL-OOR•DRAINS , FIXTURES- --'OUTLETS-- SWITCHES - - Lender's Name ! _ ,Lender's Address DRINKING FOUNTAINS ' -` , _ - GASTUBESIGNS ---' �- -- - - - - - - + - OWNER BUIL•DER'DECLARATION RIFIERS "- - INTERCEPTORS CLA +' {POLE LIGHTS- LIGHTS - 1 hereby affirm that I am exempt from the Contractor's License Law for ' the following- reason {Section 7031:5 -Business and Professions Code:- -SWIMMING POOL - -' P TRAP - •-^� -�- - Any city or county which requires a permit to construct, alter, 'POLES METERED SUB +^^ rove, demolish or repair any structure, prior to its issuance, also re- �;es the apf_licant for to file a signed statement that he WATER SERV ICE -ALTERATION PANELS ' MAIN SUB - - - ;_ such permit -;E"ensed pursuant to the provisions of the Contra clor's^L'Icense-Law - - GAS SERVICE OUTLETS -�,, -*SERVICE - - - -AMP --• '.'?iapter 9 (commencing with Section 7000) of Division 3 of the Business -and Professions Code) or that he is exempt therefrom and the- WATER -HEATERS BTU OUTPUT - _ basis for the alleged exemption. Any violation of Section 7031.5 by any applicant- for -a permit subjects the applicant -to a civil penalty --SEWER CONNECTIONS' r of not more than five hundred dollars ($500). ❑ I, as owner •of -the' property, -or--my- employees witWwages aS'their SOLAR TANK --COLLECTORS- sole,compensation„will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS.- _ [ - -ISSUE FEE-, Contractor's License taw does -not apply to an owner of a property who builds or improves thereon, and who does such worlAimself or _ ._ _ - - ISSUE FEE -• APPLICATION APPROVED BY- - - - - - - - DATE - through. his own employees, provided that such improvements are not intended or offered for sale. It, however, the building or Improvement MECHANICAL PLAN CHECK T ) - SUMMARY OF FENS is sold within one year of completion, the owner will have the burden• of proving he did not build of improve for the purpose of -sale). -- 6UILDING •- - -- - - --� -- - - - - -• -- ❑ 1, as •owner- of- the- -am - exclusively contracting with HEATING SYSTEM 0.100,000 BTU -' -+' - - - PERMIT S SMIP--r ;S, �• - property, licensed contractors tq construct the project (Section 7044, Business AND DUCTING ` '+ 100,000BTU � -•--- •^ ---- - �- ••�- -- - r PLAN CHECK $ PERMIT -- - 1 and-Rofessions Code: The Contractor's Llcensa Law does.not apply to-• an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU + _ _ ISSUANCE , PLUMBING $ C tracts from-suchFprojects-with a contractor(s) Iicesned. pursuant to -SYSTEM » + - _ GRADING,' S Q� the Contractor's License Law). �” -"er'Section 100,000 + BTU - I PLAN CHECK L$t ,,,, ~ .S. •i \ ❑ I am ei empt'undB. & P. C. for this- - - B ""- BOILERS TLJ .$• %� ` " { . - reason• - - -_ MICROFILM $ ,PLANELECTRICAL�CHECK $ - + ry Date Owner SYSTEM REPAIR, ALTERATION r. TOTAL FEE $' MECHANICAL $ • • +( v I hereby Clave read this application and State that the above EXHAUST SYSTEM MULTIPLE - LESS AD- inforrnat' recta- I -agree to 'comply with all city and county PLAN CHECK $ VANCE PC r� ortlin es and stat ws elat g to Construction, and hereby authorize ,.Preentatives -Of- t ; cit to enter upon the above mentioned V prop y for, ins Ses. Signatur Date 2 at �gZ FINAL FEE $.�,+�L_ Drivers' License or S - - S - ISSUE -FEE- Z7'- "F 2 65-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # J_ 3 (S0 Date Inspector POOL & SPA -r-- r APPROVALS Permii Date -, Inspector is t . 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location. 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding Y ; 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE _ 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pi e, 0 Undr rn,.Test- - 9. Water Pipe-Undrgrn 51 • Backwash Lines P-Tra ❑ ndr rri 10. Structural Floor System 52. APPROVAL TO DECK ' _.11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final ' 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - - 14. Rough Electric -Conduit t - 56. -Electrical-Final w 15. Rough Electric -Wiring - - 57. Solar System -Final 16.- Rough Heating & Air Conditioning encing &.Access Approval 17' Ducts in Structure' - _ APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test' - - - _ _. = 20' Roof. Framing 21. Roof Sheathing NOTES: " r 22. Frame and Flashing - 23. Insulation 24. Lathing & Siding - - - 251. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Finale- - 28; Final Electric 29: Final Heating & Air Conditioning - 30. Final Gas Pipe -Test - 31'. Final'Plumbing 32. Water Service -Final - 33. Gas Service -Final 34. Solar Domestic -Final 4, 35. Landscape Sprinkling System 36. Sound Atterivation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed - 40. Electric Release to Edison a 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date • .N 1_- •I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA' MESA PERMIT NO. Q TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT 9 Z16 Owner C��(/11 f '� '* - Phone7) /L b iol Address ,aft Ve✓ (� CUL Arch/Eng.MAIL - ,4 S"/v License Noo%Q Address Contractor I Phone Address /Ne LICENSED CONTRACTOR ECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 700D) of Division 3 of the Business and Professions Code and my license is in full force nd of License Class License Nor, Date Signature _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy vbreof (Section 3800, Lab. C.). dicy No. Company Ll Certified copy is hereby furnished. ❑ Certified copy Is tiled with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if the permit is for one hundred $100) or less). 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. - Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the Per. formance of the work for which t Is per it Is is ed (Section 3097 Civ. C.). Lender's Name :Ote40- Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License taw f7"`3pter 9 (commencing with Section 7000) of Division 3 of the less and Processions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by - 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. (Section 7044, Business and Professions Code: The Contractor's License taw does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of Proving he did not build or improve for the purpose of sale). Cl- I, as owner of the property, am exclusively contractingwith licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant- to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason — — —— -- Date Owner I hereby certify that I have read this application and state that the above Information is correct. i agree t comply with all city and ounty ordinances and st ws relatlzT.- f_—J1-r1rlvers' construc "on, and hereby out rite representatly is city nter up the' above menti ned property r 12 e I R License or SS White -Building; Canary -Applicant; Pink-Accountln TYPE OF CONN TRUCTION El NE 100 ❑ ALTERATION ❑l REPAIR El CONVERSION El DEMOLISH 2-0-T HERCZ I DESCRIPTION O VW0RK A.P. i ZONE TYPE OF PERMIT ❑ GRADING . ❑ FOUNDATION ❑ STRUCTURAL � ❑-I TENANT El ELECTRICAL ❑PLUMBING ❑MECHAI 62 -ETHER - - PROJECT DESCRIPTION SQ. FT. OCCUPANC ONSTRUCTION TYPE._ VALUATION Zae2Q'r ZONE GRADING CU. YOS. ACRES REMARKS: - Lr 7 _ 4 - �► .a-. 2177 8/63/81 29037 TL ZONING REGULATIONS REAR YARD (TO P/L) PKG. SPACE R EQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PLNG. REF. =)r- 101 PROVIDED PARK FEE $ - prod -Assessor PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0.1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KWT50 + KW KIT. SINKS DISHWASHERS - MOTORS 0-1 HP 1-10 HP SERVICE SINKS SUMPS {iNG. SOLAR) 10-50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS - INTERCEPTORS CLARIFIERS POLE LIGHTS ' SWIMMING POOL PTRAP' 'POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE - AMP WATER -HEATERS - ST0OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE: —.?— MECHANICAL PLAN CHECK '� SUMMARY OF FEES HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMTP S �tl AND DUCTING • 100,000 + BTU .PLAN CHECK $� PERMIT r ' ISSUANCE $ REFRIGERATION 0-1 00,000 BTU 1,+', y�I't 'PLUMBING �� 5 SYSTEM GRADING $ 100,000 + BTU PLAN CHECK S BOILERS BTU ELECTRICAL $ $ MICROFILM 5 SYSTEM REPAIR, ALTERATION PLAN CHECK S TOTAL FEES EXHAUST SYSTEM MULTIPLE MECHANICAL 5LESS AD - PLAN CHECK $ VANCE PC 5 _ - FINAL FEE S is SUE FEE prod -Assessor APPROVALS CONSTRUCTION AND PLANNING Permit # Date Inspector POOL 8& SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil PiPe,Undrgrn 44. Steel Reinforcement 3. - Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit=Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, 0 Undr rn, Test 9. Water Pir)e-Undrgrn 51. Backwash Lines P-Tral2, 0 Undr rn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12.. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating &.Air Conditioning b8. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31, Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. 35. Solar Domestic -Final Landscape Sprinkling System . y 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date r t Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERM T NO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT _ / 3/Q project Address / f TYPE OF CONSTRUCTION ' ❑ NEW ❑ ADD ❑ ALTERATION E-1 REPAIR EJ CONVERSION El DEMOLISH ❑ OTHER DESCRIPTION OFwnRK .�l ✓ Owner ACf k+ Phone Address�t Arch/Eng. AfJ License No. Address D L 4. ,tA N+ Contractor -127%g j( 10&QWPhdne__r J Y021CCXTYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC ❑-OTHER PROJECT DESCRIPTION " SQ. F.T. Address j L./e>- COffYj'/L[-eYA• LICENSED -CONTRACTOR DFCLAIRATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 Of the Business and Professions Code, and y license Is In full force nd effe t. License Class Licen e o G Date �7-ar Signature WORKERSCOMPENSATION DECLARATION _ 'OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure ora" certificate of- Workers' Compensation Insurar_a certified copy ncee,� '+ereof (Section 3800, Lab, C.). VALUATION ZONE ' GRADING CU. YDS. ACRES Ilcy No. Company J Certified. copy is hereby furnlshe'd. - - _ ❑ Certified copy is filed with the city Building Division. 'REMARKS: ' ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be completed if the permit is for. one hundred I -10 -HP - + HP ' ($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.Californla._ _ PLUMBING ,{ ,-PLAN CHECK BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject TOILETS URINALS - - to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS ' revoked. CONSTRUCTION LENDING AGENCY _ KIT. SINKS DISHWASHERS' ' I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 Civ. C.). »' f Lender's Name SERVICE SINKS ,SUMPS FtOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS ' Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS the following reason (Section -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 re- quires the applicant for such permit to file a signed statement that he SWIMMING"POOL - P'TRAP -" - - WATER SERVICE ALTERATION `4 GAS SERV ICE OUTLETS ' is licensed pursuant to the provisions of the Contractor's -License Caw" (r'hapter 9 (commencing with Section 7000) of Division 3 of the - WATER HEATERS' BTU OUTPUT- less and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS '"- 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 SOLAR TANK • COLLECTORS "- sole compensation, will do the work, and the structure is not intended SOLAR PIPING SYS. or Offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does,not.apply to an owner of a property ISSUE FEE { who builds or improves thereon, and who does Such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK intended or offered for sale. If, however, the building or improvement is sold within one year, of completion, the owner -will have the burden HEATING SYSTEM 0-100,000_ BTU - AND DUCTING - - - '- 100,000 + BTU of proving he did not build or improve for the purpose of sale). ElI, as owner of 'the, property, am exclusively- contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: -The -Contractor's License Law does not apply to REFRIGERATION 0.100,000 BTU SYSTEM' 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts 'from such 'projects' with a contractor(s) iicesned pursuant to the Contractor's License Law). ❑ I am exempt under Section - B. & P. C. for this - BOILERS BTU reason - i Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above information is correct, l agree to comply with all city and county ordinances and state laws relatl�6 to construction, and hereby authorize representatl this city/t ante upon the above mentioned propert Signature $ VANCE PC $ _��}}} Drivers' License or SS ISSUE FEE CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor F •� OCT 7 1981, ZONING REGULATI A.P. !ONE 510E WD '- LET E Y R RIGHT REAR YARD (TO P/L) PKG. SPACE R EQ. PRO V I DED STREET WIDTH - PARK FEE $ - ;ZONING APPROVED BY DATE SPECIAL CONDITIONS: ISSUE FEE ELECTRICAL DATE - PLAN 'CHECK. ` SCJ- FT. - - - - - .- GENERATOR' - -` TRANSFORMER APPLIANCE 0-1 KW 1.10 KW -- ' ' MOTORS - ,(INC. SOLAR) 0-1 HP - 10-50 HP_50 I -10 -HP - + HP ' FIXTURES OUTLETS SWITCHES - PLAN CHECK GAS TUBE SIGNS PERMIT -1 POLE LIGHTS` ISSUANCE - $ POLES - METERED SUB ' TPANELS MAIN SUB GRADING S SERVICE "' - _ - • "^ AMP' ' • ELECTRICAL $ _ MICROFILM'$ ISSUE FEE APPLICATION APPROVED BY DATE - SU MARY OF FEES - =BUILDING• - /• / .PERMIT $ SMIP �$ T PLAN CHECK $. f0�'_O� PERMIT -1 ISSUANCE - $ PLUMBING $ GRADING S .PLAN CHECK $ - -- • ELECTRICAL $ _ MICROFILM'$ PLAN CHECK $ - TOTAL FEE $ -MECHANICAL" $ i r' _ LESS AD. PLAN CHECK $ VANCE PC $ _��}}} . - - FINAL FEE $ CONST U�17OI Alu�p° RLi�4N11VG4 �. e # Date Pert # �) APPROVAL mi .f Inspector POOL &SPA ` Date Inspector APPROVALS Permit # 1. Tem;o;Vrq Electrical Service or:Pole 43. Pool & Equipment Location 2. Soil Pipe= [irgrn _ 44. Steel Reinforcement 3. Electrical Conduii•,fUtility,=fUndrg ti'I 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47, Rough Plumbing & Pressure Test " 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7, Footings 49. Electrical Conduit-Undr rn -8. , Foundation 50. Gas Pipe, ❑ Undr rn, Test 9.. Water Pipe-Undrgrn• 51. Backwash Lines P -Trap,❑ UndrQrn ' 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 63: - Backwash & Receptor -Final 12. Street Sewer Connection 54- Heater & Vent -Final .13. Rough Plumbing 55, Plumbing Systern.- Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval .17, Ducts .in Structure 5 APPROVED FOR PLASTERING 18.. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe=Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22.- Frame and Flashing •23. Insulation _ 24: Lathing & Siding _ 25., Drywall Nailing .26. Plaster Brown Coat 27. -Electrical Power Meter -Fina! 2B. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System - stem -36. 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date -------•r.-a"punting; Goldenrod -Assessor 2207 2/17/B2 - - 23.00 TL ANfCA inheA to fill in all spaces W11 -1 7717-y border lines and sign all appropriate declarations. rApplicant CI COSTMESA PERMIT NO. TRACT NO, LOT -NO. BLDG. NO. I CONSTRUCTION PERMIT 473 T BUILLPNG- �RO1EIf vV Lt t Address -3 r l UPI --,A M esh TYPE OF CONSTRUCTION Tr .b� o KJ- �1_y A�' Phone ❑•NEW ❑ AD[) ❑ ALTERATION - ss -3 r ,� 1 ft.1'. ' -L6fTA MPS. - ❑ REPAIR C1 CONVERSION' ❑DEMOLISH SI OE YA ng.-- -License No. - - [�-OTHERAssDESCRIPTION rAdd OF WORKctorx.i �- A Phonew{y/7 REAPr�YARD (TQ P/L)' TYPE OF P£RM1Tss 2 i Cj ` -A PO f-/`}�� ❑.GRADiNG-',.,,f ❑ FOUNDATION -❑ STRUCTURALiED-CONTRACTOR DECLARATION - ❑TENANT I[7'ELECTRICAL ❑PLUMBING ❑MECHy STREET WIDTH ` " PARK FEE affirm th;,t I am licensed under provisions of Charter 9 (Com- -with section 7000) . Divislon- 3 of Business and ❑ OTHER _ of -the Professions Cod � ,�ante�d my license is In full force and effect. License - = Liy� No �G� j�- PROJECT DESCRIPTION ass�S.G, nse • 17 � � �,. Signature '�'1�R1 - _ - - KE S' C6MPENSATION DECLARATION f/ _• � •OCCUPANCY '- CONSTRUCTION TYPE eby affirm that I have a Certificate of consent to Self -Insure or. a VALUATION ZONE certificate of Workers' -Compensation Insurance,. -or a certlffed'copy thereof (Se ti�r 3B q0��ab. .). [i ifUk - Q � GRADING CU.,YDS. _ ACRES lacy No: Compariy .SSI - Certified copy is hereby furnished.- _ - ._ - • - L REMARKSo ., ❑ Certified copy is filed with the city Building Division. Y . FT- EXEMPTION FROM WORKERS -COMPENSATION DECLARATION - - - - (This section need not -be completed. if the permit fs-for one hundred (5100) or less). r (TRANSFORMER I e.,tlfy. that in the perfOrmance of the work for which this permit is APPLIANCE- - 10-50 KW__, 50 +-KW - - - Issued, I shall not -employ any person in any. mariner so as t4 become PLUMBING -- - PLAN CHECK -•,MOTORS- subject -to the Workers' Compensation laws of California._' _ _ Date Signature r BATHTUBS- SHOWERS ' NOTICE: if after making this declaration, you should become subjectETS .. -,URINALS ' FIXTURES- -- OUTLETS- -SW(�6:i-fEs -- - to the Workers' Cornpensation provisions of the Labor Code,•you must forthwith comply with such Provisions or this permit shall be deemedATORIES DOUBLi LAVS- ` revoked. CONSTRUCTION LENDING AGENCYI SfNK$ - OfSHWASHERS hereby affirm that there is a construction lending agency for the per.ICE SINKS SUMPS' - Cr formance of the work for which this permit is issued (Section 3097 r Civ: C.).--- -`- -' - `- --- - - '�" FLOOR$iNKS-- - FLOOR -DRAINS Lander'_s Name ?PANELS - MAIN--_-- - -5U9 - - _ Lender's Address -DRiNKING'FOUNTAINS-- #SERVICE-_ ---AMP OWNER BUILDER DECLARATiON I hereby.affirm that I am exempt from the Contractor's License Law for LARIFIER$ INTERCEPTORS ' CLARIFIERS- + the the' following reason -(Section 7031.5 Business and Professions Code: - SWIMMING POOL P TRAP ` - city or County which requires a permit to COnstrUCt, alter, we, demolish or -repair -any structure, -prior to -its issuance, also re- WATER SERVICE ALTERAT)ON. the ap,l)cant for such Permit to file a signed statement that he - jAPPL-ICATION-APPROVED BY-- - - _ DATE -ensed'RursuantAO the provisions of the Contractor's License law Alusiness GAS SERV ICE - - T' OUTLETS " - - hapter 9 (commencing with Section 7000) of Division 3 of the and Professions Code) or that he Is exempt therefrom and the WATER -HEATERS -' BTU OUTPUT - - basis for the alleged exemption, Any violation of Section 7031.5 by -:BUILDING any -applicant for a -permit subjects -the -applicant to a civil -penalty SEWER CONNECT ONS - j of not more,than five hundred dollars ($500). ❑ I as -owner of the -property, or my employees with wages as their SOLAR'TANK - -"' -COLLECTORS- sole compensation,, will d0 the work, and the structure is not Intended -ISSUANCE � g' $ -- -� - - - -� n - or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. rh• { GRApING_ S �' Contractor's ,License Law does not apply_ to an owner of a property � Who builds or improves thereon, and who does such work himself or 'ISSUE•FEE - - - through_ his own employees, -provided that such Improvements are not jr - r,? ELECTRICAL' $ $ intended or offered for sale. If, however, the building or improvement'- _ _ MECHANICAL PLAN CHECK T— MICROFILM'S - is Sold _within -one-year of completion, the owner will have the burden i of proving he did not build or improve for the purpose of sale). - C1 with ❑ SYSTEM 0-100,000 BTU I,• as owner of -'the -property, •am -exclusively- contracting iicenseu contractors to construct the project (Section 7044, Business AND DUCTING" -- -�- - -• 100,000 + BTU and,Professions Code: The Contractor's -License -Law does.not apply to. -MECHANICAL ^ $ - an owner Of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU ' tracts• from -such -projects-with-a�-contractor(s) licesned_pursuant. to. •SYSTEM - - - - r - the ContraCtor's License Law). 1o0,000�'+ gTU ❑--I am -exempt under'Section'- — �B. 8-P: C: for this'1301LER5 BTU reason _ _ _ - - Oate Owner SYSTEM REPAiR,ALTERATION 1 hereby certify that f have read this application and state that the above EXHAUST SYSTEM MULTIPLE information is correct. -I agree to comply with 'all -city and County ordinances and state laws relating to construction, and hereby authorize mpresentatives f -t is" City 'to -enter upon the above' Mt ned property Insp TIO pies. -for Q+C1.e � ��} -2 I� �- Signature mate �r "��nsc ar SS -- - - - - - ISSUE FEE -------•r.-a"punting; Goldenrod -Assessor 2207 2/17/B2 - - 23.00 TL ANfCA A. P.- - - ,ZONE - - - -" -' .PLNG.. R�E�F.p� T BUILLPNG- �RO1EIf vV Lt SET AC ST. NE 7 ID YARD -- - - - - SI OE YA 1 RiGHT REAPr�YARD (TQ P/L)' PKG. SPACE REQ.' PRDViOF-D STREET WIDTH ` " PARK FEE _ [ZONING APPROVED i3Y" DATE- - " - -SPECIAL CONDiTIONS:- ELECTRICAL FT- -.G ENERATOR 0 -1 -KW- "- -1=10 KW�J." (TRANSFORMER APPLIANCE- - 10-50 KW__, 50 +-KW - - - -•,MOTORS- - 0-1 HP--1.10'HP' - - ^- __ .(INC. SOLAR) .�10-50-HP 50 + HPC FIXTURES- -- OUTLETS- -SW(�6:i-fEs -- - 'GAS TUBE SIGNS --- - - -- -' - - - - ---- ;POLE LIGHTS' j Cr iPOLE$ -METERED_- SUB ?PANELS - MAIN--_-- - -5U9 - - •I 1 - - #SERVICE-_ ---AMP - - + - - jAPPL-ICATION-APPROVED BY-- - - _ DATE ' F SUMMARYOF,FEE5 - -:BUILDING rPERMfT $ SMIP, $ , PLAN CHECK $ -- - PERMIT.t z.. -rjr - - -ISSUANCE � g' $ -- -� - - - -� n - rh• { GRApING_ S �' � ,PLAN CHECK- 3 _,, .� r jr - r,? ELECTRICAL' $ $ MICROFILM'S - i PLAN CHECK ' TOTAL FEE -MECHANICAL ^ $ - LESS AD - 'PLAN CHECK `$' - - - - VANCE'PC FINAL FEE b CONSTRUCTION AND PLANNING APPROVALS Permit # r Date Inspector POOL & SPA -, APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrn 45. Forms - - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plunibing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation. - `' 50. Gas Pipe, ❑ Undr rn, Test 9.. Water Pipe-Undrgrn 51. Backwash Lines P-Tra _U 1 ndr rn - 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer. Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer.Connection 54. Heater & Vent-Final - 13. Rough Plumbing -55. Plumbing System - Enal 14. Rough Electric-Conduit •56: ` Electrical-Final 15. Rough Electric-Wiring 57: Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21. Roof Sheathing. NOTES: 22. Frame and Flashing - 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final-/&-$ 28. Final Electric 29. Final Heating & Air Conditioning- 30, Final,Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final- 34. Solar Domestic-Final'''' 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed t 40. Electric Release .to Edison 41. Gas Release to Southern California Gas Co. t 42. CERTIFICATE OF OCCUPANCY No Date __ 4 Hr.v• �q'•'w•nn'rn'att-a„_ within heavy border lines and sign all appropriate declarations- CITY OF COSTA MESA PE 1T NO. y' TRACT NO, LOT NO. ' BLDG. NO. - - CONSTRUCTION PERMIT - s'� ' TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAiR-Q;CONVERSION ❑DEMOLISH VV 1947 IP/PQ/FVk• �Z(!v�}� TL Project Address. Owner hone Address ;� l.f ❑ OTHER �-�- ZONING REGULATIONS Arch/Eng. Uicen No. DESCRIPTION OF W RK - _ i4'P' ZONE PLNG. REF. Address - - Contractor" Phone TYPE OF PERMIT ❑ GRAOING' ❑ FOUNDATION -❑ STRUCTURAL .❑ TENANT ❑ ELECTRICAL •❑PLUMBING ❑MECHANIC SETBACK C ST- SIDE YARD LSEDF YARD uI pINC XROPYW LINE - Address -- LICENSED CONTRACTgR ECLARAT ON that I of Charter 9 AlI hereby affirm am licensed under provisions (com- section 7000) of Division 3 of the Business ' and 1. s � OTHER RIGHT mencing with Professions Code, and my license Is in full force and effect. J REAR -YARD (TO PJL) �' PROJECT DESCRIPTION Llcerise Class icense No PKG, SPACE RECD. PROVIDED - f Oate �z^-Signature r--.. - SQ. -FT.' STREET WIDTH - PARK FEE- L _ '*rORK£RS' C MP£NSATION DECLARAi'f N -OCCUPANCY-.;.,—CONSTRUCTION _TYPE _ u ZONING APPROVED BY - DATE 'ereby affirm that 1 have a Certificate of consent to self -insure or a 'VALUATION b ZONE Rt - tificate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS- 1 ereof Sectio 3840, Lab. C.). ! ( 1 ING CU. YDS, ACRES Policy No. r— 29 7--L• Company •� I4Wr, A f, _ .d Certified Copy Is hereby furnished. _ - RKS? • R'Certified copy is filed with the cityBuilding Division. EXEMPTION FROM WORKERS'' COMPENSATION DECLARATION -(This section-need,not be completed if tho permit IS for one hundred[$100) ors)-( certifythat In the performance'of the work for which this permit is Issued, I shalt not;empioy any person in any manner so as to becomeBING', PLAN CHECK ELECTRICAL PLAN CHECK Subject to.the Workers' Compensation Laws of California. _ TUBS SHOWERS -NOTICE: Date Signature If after making this declaration, you shoWd become subjectTS , URINALS' - FKIT.SINKS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must comply with such provisions or this permit Shall be deemedTORIES DOUBLE LAYS - - TRANSFORMER,forthwith -APPLIANCE •• 10-50 KW -50 + KW revoked,_CONSTRUCTION.LENDING AGENCY INKS DISHWASHERS -MOTORS 0.1 HP 1-10 HP•I hereby affirm that there IS a construction lending agency for the per -ICE $INKS SUMPS - - (INC. SOLAR) 10-50 HP50.+ HPformance of the work for which this permit is Issued (Section 3097 R SINKS FLOOR DRAINS FIXTURES - OUTLETS SWITCHESLender's Civ, C.). - NameLender's ING FOUNTAINS - - GAS-TUBE•SIGNSOWNER'SUILDER Address CEPTORS CLARIFIERS - POLE LIGHTSI DECLARATION - - hereby affirm that I am exempt from the Contractor's License Law forthe-follow)ng POOL PTRAP •- POLES METERED -SUB reason (Section --7031,5 Business and Professions Code:MING Any City or county which requires a permit to construct, alter, WATER SERVICE ALTERATION ' PANELS- MAIN SUB Improve; demolish or repair any structure, prior to its issuance; also re- res the applicant for such permit to file a signed statement that he - - +•-� GAS SERVICE OUTLETS -SERVICE - - AMP• - - ensed pursuant to -the -provisions of the Contractor's License Law pier 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS' BTU OUTPUT - - - - - -- •- - Iness`and Pro4essions Code) or that he is exempt therefrom and the I for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - " - -� '-- •- •'� - - - applicant for a -permit subjects the applicant to -a civil penalty not more than five hundred dollars ($5DD). SOLAR TANK' COLLECTORS ' ❑ I, as- owner 'of the property,_or my employees with wages as their' sole compensation, will the work, and the structure is not intended SOLAR PIPING SYS. - •• - ISSUE ISSUE FEE -do or offered for sale. (Section 7044, Business and Professions Cotlea The License Law does not apply to an owner of a property_ ISSUE FEE -- APPLICATION APPROVED BY - ;DAT 2 L who builds or improves tflereo», and who does sut11 work himself or. through his own employees,. provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF,FEES intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will nave the burden BUILDING - •' of proving he did not build or improve for the purpose of safe). FtERTING SYSTEM 0-100,000 87U - - . PERMIT E �LSt..�?S� - SM1P- ❑ I, as owner of the property, am exclusively.. contracting with AND DUCTING ,_ _ • .• ��+ } licensed contractors to construct the ro'ect Section 7044, Business p I ( 100,000 +BTU PLAN CHECK S i-sly✓� PERMIT t and -Professions Code: The Contractor's License. Law,does not apply to .. -. ISSUANCE'. $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S, -T •GRADING tracts from such projects with a.contractor(s) lic¢soed pursuant to SYSTEM - - _ .__._ _ , �$ the Contractor's License Law). 100,000 + BTU PLAN CHECK.- S ❑ I am'exempt'under Section B..& P.•C. for thisi BOILERS BTU ELECTRICAL S $ reason- - - - -, - - - -- - PLAN CHECK S' - MICROFILM.$ Date Owner SYSTEM REPAIR, ALTERATION FEE MECHANICAL $TOTAL -$ I hereby certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE 1 LESS AD- ,4 information is correct. I agree 'to comply with all city and County PLAN CHECK $ _ VANCE PC S ordinances and state laws relating to construction, and hereby authorize -� representatives f'-tbls Clly to enter upon The above mentioned property f_or i pe ti n pup s. _ - - - OZ Signature Date ' n - - FINAL FEE $ Drivers' License or SS ISSUE FEE •' - - "' - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod-ASsessor CONSTRUCTION AND PLANNI" APPROVALS Permit # L_:ZtrXL Date Inspector POOL &SPA --.- Da te Inspector APPROVALS Permit -Temporary Electrical Service or Pole 43. ' Pool & EquipmentLocation— -2.- - Soil Pipe-Undrgrn 44. Steel Reinforcement 3: Electrical Conduit Utility-Undrgrn 45.- Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5_ Steel Reinforce.. 47. Rough Plumbing &Pressure Test 6. Electrical UFER Grn. 48. APPROVAL TO COVER -GUNITE 7. Footings. 49. Electrical Conduit-Undrqrn 8. -Foundation- 50. Gas Pipe, El Undrgrn, Test 9. Water Pipe-Undrgrn- 51. Backwash Lines, P-Traj5-, ❑Undrgrn 10. Structural Floor System 52. APPROVAL30 DECK -11.-.Property-Sewer Line.& House Connection 53.- Backwash & Recepnor-Firial 12. Street Sewer. Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, PlumbLa System - Fi6a( 14. Rough Electric-Conduit -56r--Electrical-Final 15. Rough Electric -Wiring 57-.-- Solar System -Final 16.- Rough -Heating &-Air Conditioning" - b8. Fencing & Access Approval -1.7-- - Ducts; in Structure 59. APPROVED FOR PLASTERING 18. Ducts, -Ventilating 60. POOL/SPkSYSTEMS FINAL' 19. Gas Pipe -Rough & Test 20--- Roof Framing 21. Roof Sheathing NOTES, 22. Frame and Flash' Ing 23.- Insulation - f 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29, Final Heating &,Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32., Water Service -Final Gas Service -Final 34, Solar Domestic -Final 35.-'-Landsca e Sprinkling Sistern'- 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY N6 Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TR) NO. LOT-NO:r BLDG: NO. ' CONSTRUCTION PERMIT g • S�'-t"� '� a TYPE OF CONSTRUCTION Project Address 3ae Owners Pon ❑ NEW- ❑"ADD ❑ AL`TERATION -" -Address V f—r. ❑ REPAIR ❑ ONVERSION ❑DEMOLISH I9�}C} .I p G - _ ZONING REGULATIONS Arch/Eng. Licen a No. A.P. # OESCRIPTION OF WORK Address _•. ._ - _ _ -- _ - ._ r. _ _ . � _ ZONE _. - PLNTG.. REF.. '; - -• - ContractOr Phone _ TYPE OF PERMIT. SETBACK NGC/L ST. PRO F-WRNLNE • Address - C�❑.GRADING - ❑ FOUNDATION ❑ STRUCTURAL •-• LIDE YARD EF LICENSED CONTRACTOR bFECLARATION. = (]-TENANT ELECTRICAL.❑PLUMBING,❑MECHANiCA SIDE I hereby affirm that I am licensed under provisions of Charter 9 (corn- 7000) --of Division 3 of and' QFOT.FiER RIGHT M mencing with section -the -Business license is In full force REAR YARD (TO PJL) ' Profession$ Code,, and my and effect., - . PROJECT DESCRIPTION'PKG. License Cl as "cense o - =� SPACE REQ. PROVIDED t Signature Date Sit SQ. FT. � � `• - � STREET WIDTI-I - PARK FEE - - �..-ZQ� •WORKERS' CO PENSATION DECLARATI rm ave a certificate of consent to self -insure or a OCCUPANCY"' CONSTRUCTION TYPE - ;'ZONE ZONING APPROVED BY - - -- OATEN - \ VALUATION -certificate of Workers' Compensation Insurance, -or -a certified copy V •- - SPEC IAL CONDITIONS: "' "-'- ' thereof (Sec n 3.8QO.Lab. C.)• I O GRADING_ CU. YDS. ACRES 1� Policy No. Company - - -- - --• _ f -❑ Certified copy is hereby furnished. _-._ _�, _ _ _ .. - _ - REMARKS:. .^,• Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION .(This.section need. not be completed if the permit is for one hundred ($100) or less). 4 .l certify that in the, performanceofthe work for which this permit is Issued, I shall not employ any person In any manner so as -to -become PLUMBING, - PLAN CHECK--' - • -ELECTRICAL - - -PLAN-CHECK-- - - .subject to the Workers' Compensation Laws of California. ,__• _ • .• - BATHTUBS SHOWERS ` " ' - - -- Date Signature NOTICE: If after making this declaration, you should become; subject TOILETS- .- URINALS •- - - -• - -GENERATOR, 0-1 KW- --1-10 KW - - -- to the Workers' Compensation provisions of the Labor Code,'you must TRANSFORMER .•; forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS - - - APPLIANCE- 10-50 KW_50+.KW -revoked. KIT. SINKS -DISHWASHERS• -- -MOTORS 0-1-Hp-=-----1-10-Hp CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS:--., + SUMPS - - - - - •... . (INC. SOLAR) 10-50,HP 50.+•HP_ formance of the work for which this permit IS issued (Section 3097 -CIv. C.).' .f 'I i1 -� - "" "' FLOOR SINKS 'FLOOR -DRAINS -FIXTURES - OUTLETS • SWITCHES•-- Lender's Name /IT ,Lender's Address 'DRINKING -FOUNTAINS -• - -- -- •- -•_ 'OWNER'BUILDER DECLARATION INTERCEPTORS--CL'ARIFIERS - • i POLE LIGHTS•' - - -- --- �� - - ---» I hereby affirm that I am exempt from.the Contractor's License Law for -the"tollowing-reason (Section 7031.5 -Business and -Professions Code: • •SWIMMING POOL'--- P TRAP•-- - -"' -POLES " ' ' METERED"" ""SUB Any city or county which requires a permit to Construct, alter, 'improve, demollsh•or repair any structure; prior to•it$ issuance,-also.re- WATER SERVICE ALTERATION- " ' PANELS --- -MAIN SUB ' - - -• ' -- quires the applicant for such permit to file a signed statement that he - -Is-licensed pursuant to the pro visions -of -the Contractor's -License Law- GAS'SERVICE OUTLETS-' - -SERVICE - --- ---•- AMP' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the UTPUT WATER HEATERS BTU OUTPUT- basis for the alleged exemption. Any violation of Section 7031.5 by basis ' ,any applicant - for a permit subjects -the, applicant to, a•civil•penalty '•'SEWER"CONNECTIONS' n''" -•-'-• - •- - - --•- -- - - - -- ---- - of not more than five hundred dollars ($500). ' ❑ 1, as owner of the property, or my'employees with wages as their' SOLAR TANK" - - _ - COLLECTORS, - — - - - - -•--- --- - •• --. - - - - .-. sole.compensation,,will do the work, and the structure is not intended , or offered for sale. (Section 7044, Business and-Professions_Code:'The SOLAR PIPING SYS: - ISSUE FEE • ----- - - - - Contractor's -License Law does not apply to_an owner of a property who builds or improves thereon, acid who does such work himself or ISSUE FEE - -- '" - ' - ' APPLICATION APPRO_ _ ' VED BY- GATE�pi PO z through his own employees, provided -that such improvements are not intended or offered for sale. If, however, the building or improvement' "MECHANICAL FLAN'CHECK -^ SUMMARY OF•'FEES_ y - is sold within one .year of completion, the owner will have the burden of proving he did not build or improve 'for the purpose of sale)." . - -- - - -• - - -, t, , •, ` BUILOING-- '- ':._ SD. Or °❑'I, -as owner -of the property, am -exclusively, contracting with licensed contractors to construct the project (Section 7044, Business HEATING SYSTEM 0-100,0.00 BTU AND DUCTING' -- -- - •�--- •-•-•- - 100,000 + BTU PERMIT g ••SNIP' $ - -• - -- �t' PLA N-GHECK $ PERMIT ,. and Professions Code: The -Contractor's License Law doe$•not•apply to . _, _ _ _. _-., - _ _ ___ .._ ISSUANCE`.,.$,, " an owner of property who builds or improves thereon, and who can- REFRIGERATION 0-100,000 BTU PLUMBING S ,&- -'� �Er contractoe(s) Iicesned_pursuant_to- �-SYSTEM-• -- '` - . L_. _ _ 100,000+ BTU - '� _ _• _ _ GRADING PLAN the Contractor's License Law). •❑'I } _ _ CHECK -,S am exempt'under Section -' B. &-P: C.'for this.- ^-� - ;-• BOILERS BTU - - - _-. "�EL•ECTRICAL-'-$' "- r — - - - - - - .. .» SYSTEM REPgIR,ALTERATION " • • 1, .. , MICROFILM $' -`PLAN CHECK- - S- - - -- - - Owner TOTAL`FEE S' certify that,l have read this application and state that the above EXHAUST SYSTEM MULTIPLE ^MECHANICAL-$•- •.. - - • M LESS AO- • r tion Is cor"rest. I agree to comply with all city and 'County" - PLAN CHECK-• $ - VANCE PC $�- - -- ces and state laws relating to construction, and hereby authorize License '• .. ,� , tatives f • this -city' to enter upon the' above mentioned for spe o_n rp s._ _ ? QZ FEE re DaterFINAL $+ License or S ISSUE FEE• - - -,• CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNI APPROVALS Permit # Date Inspector POOL - Date Inspector APPROVALS Y Permit #` _ - 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location - 2. SoilPipe-Undrgrn _ 44.Stqel Reinforcement - - -" --3. Electrical Conduit Utility-Undrgrn _ - _ 45. Forms -4. Electrical-Conduit-Undrgrn _ - - 46._ Electrical Bonding 5. Steel ein orce _ _ , 47. . Rough Plumbin • &.Pressure Test ... - - - - 6..- Electrical UFER Grn _ _ 48, APPROVAL TO COVER -GUN rTE' ' - -'- _7. Footings_ _ 49. Electrical Conduit-Undr rn ' 8. Foundation 50., Gas Pipe, ❑ Undr rn, Test 9: Water-Pipe-Undrgrn- 51. Backwash Lines P-Tra- ndr rn " 10. - Structural Floor System 52. _ APPROVAL TO DECK` - 11. � - Property Sewertine & House Connection._ Backwash & Receptor -Final 12.- Street Sewer Connection.- - _ : _ . _ _' 54. Heater &'Vent -Final • 13. Rough Plumbing -- _ . _ - - 14. Rough Electric -Conduit 56.- Electrical -Final- - 15. Rough Electric -Wring - -57. Solar System -Final 16. Rough Heating & Air -Conditioning 158. Fencing & Access Approval 17; Ducis in Structure . - - ? APPROVED FOR PLASTERING -18. Ducts, Ventilating- 60.. POOL/SPA SYSTEMS FINAL , 19. Gas Pipe -Rough & T6st .. - - -20: Roof Framing-- - --- - - - 21. Roof Sheathin NOTES: ; - - 22. - Frame and, Fiashin - - - 23. Insulation 24. Lathing & Siding .. _ {- 25.- Drywall Nailing „ 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28._. Final Electric - - - - 29:- Final Heating & Air Conditioning- onditioning 30. 30. -Final Gas Pipe -Test 31, Final Plumbing _ i 32.. Water Service,Final - 33. Gas Service -Final - 34. Solar Domestic -Final 35. ' 'Landscape 5 rinklin S to '1- 36. Sound Attenuation 37, Handicap Regulations 38. FINAL STRUCTURE & BUILDING - �} 39. Special Requirements Completed 40. Electric Release to Edison 41- Gas Release to Southern California Gas Co. 42. ` CERTIFICATE OF OCCUPANCY �No Date • CITY OF COSTA MESA BUILDING DIVISION } 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754.5626 PERMIT NUMBER. B08-00213 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93894001 DATE ISSUED: 07/17/2008 ISSUED BY: CAC JOB ADDRESS: 3151 A AIRWAY AV CM Suite/UniV . :" A Vicinity: BLD A y z Squares: 0 " -Valuation; $17,627.00 SCOPE OF WORK: TEAT? OFF'WOOD SHAKE INSTALL 1-15 L13 FELT AND CLASS A 40 YEAR COMP. SHINGLES OWNER: CORP OF THE.PRESibING.BISHOP CHURCH OF LDS Address: %DON TON ASSOCIATES %PROPERTY,,RESERVE IN,. Unit: 10 E SO TEMPLE ST #400 PHONE: {F t' CitylStatelZip: BRUCE CHRISTENSEN APPLICANT: DUKE HANSEN -" u Address: 260 E ALTON AVE Unit: PHONE: 714-557-7,440 _ .. City/State/Zip: SANTA ANA,'CA CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON. AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA, CA 92707 CELL: ARCHITECT: i License No. _ PHONE; " ENGINEER: =ti ` ` =r' License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroo( Permit Feb: Reinspection Fee:'$O:OI) ;. TOTAL FEES- r $293.25- , NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE R. INSPECTION TYPE QAR INTMAL6 CODE f !K$PECTION INTMAL6 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocIVRetaining 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 BuildinglOccupancy P/If O WORKERS' COMPENSATION DECLARATIO hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. ❑ 1 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: Carrier: (?hes wdvn need not 6e c>, T#eted I rhe pem+a its valuedal one hundred doaars ($100) or less.) Policy Number: ❑ 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's Signature Date 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 DOLLARS ($100,000), IN ADDITION 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 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. Lic. # Class # Contrattor's Signature Date CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction tending 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 rile 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 Dale 3057-46(3!07) r Owner ID verified by dAR .nse. ❑ Yes ❑ 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, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No 8. (If yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I'certify that under perialty'ol"pedury the information given above is correct. I agree to comply with all state law_ s 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 stale 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) And/or Authorized Applicant Date Date CMF 0865.46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. - -•�^ CITY.Of,:COSTA MESA'PEr�T N hrV-1IMd TRACT NO. LOT NO. BLDG. NO. ' IONS-TRUCTION PERMIT %Q t TYPE OF CONSTRUCTION ❑ NEW ❑ ADD, ❑ ALTERATIONr yr— ❑REPAIR El CONVERSION ❑DEMOLISH J4 OTHER ; ;14 163.43 ZONING REGULATIONS Project Address ' Owner Picone .-Address Arch/Eng. License No: DESCRIPTION OF WORK TYPE OF PERMIT ` ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL )FTENANT ❑ELECTRICAL ❑PLUMBING ❑MECHANICA A P � ZONE LIEF YARD SETBACK C/l.T gIp EYRD — - PLNG. REF. Toe I ING PROPERTY I E Address Contracto r hone Address ' LICENSED CONTRACTOR DECLARA ION I hereby affirm that I am licensed under of Charter 9 provisions (cam- mencing with section 7000) of Division 3 of the Business and ❑ DTHER '- RIGHT Professions Code, and my license I$ In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION_ License Class License No. PKG. SPACE REQ. b IE Date _ Signature - SQ. FT. STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY CONST UCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a ZONING APPROVED BY DATE !- v certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE - thereof (Section 3800, Lab. C.). GRADING CU. Yp .ACRES SPECIAL CONDITIONS: Policy No. - Company - - - - - - - Certified copy is hereby furnished. REMARKS: rtlfled copy Is filed with the city Building Division. IPTION FROM WORKERS' COMPENSATION DECLARATION ` (I ... s section need not be completed if the permit is for One hundred ' N($100) or lessl. certify that In the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become PLUMBING: PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS DWELLING Date Signature TOILETS URINALS - GENERATOR 0-1 KW 1.10 KW NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provision$ of the Labor Code, you must TRANSFDRMER LAVATORIES DOUBLE LAVS forthwith comply with such provisions or this permit shall be deemed "APPLIANCE 10-50 KW_50 + KW revoked. KIT. SINKS DISHWASHERS - MOTORS '0-1 HP I.10 HP ' CONSTRUCTION LENDING AGENCY SERVIGE SINKS =• SUMPS -, I hereby affirm that there Is a construction lending agency for the per- (INC. SOLAR) 10.20 HP_ 50 + HP - foimance oflthe woeV for'.which,4hls-permit Is issued (Section 3097, `' - - _ Civ.'C.). Lender4s Name,` FLOOR SINKS FLOOR DRAINS _. . 'FIXTURES OUTLETS . SWITCHES Leader's -Address L. + DRINKING FOUNTAINS ~ GAS TUBE SIGNS OWNER BUILDER DECLARATION) ' t- I hereby affirm that I am exempt 'frorii the'+Contractor's License Law for INTER - t C \r CEPT•ORS. CLARIFIERS �� r+ • R ti �� - POLE LIGHTS the following reason (Section r7031.5 Business and Professions Code: SWIMMING -POOL' r PTRAP " ` - POLES METERED SUB Any city or county which requiresNa .perrnit to Construct;, alter„ Improve, demolish or repair,any structure; prior to Its Issuance; also ro- quires the appHCant for such permltJd%flle'a signed statement that he WATER SERVICE r� ALTERATION PANELS MAIN SUB Is licensed pursuant to the provisions of the'Contractor's-License Law GAS SERVICE OUTLETS SERVICE AMP - - `Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Processions Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a Civil penalty of,_not more than five hundred dollars ($500). SOLAR TANK COLLECTORS r`� ,,; as owner of the property, or my employees with_ wages as their �:omponsation, will do the work, and the structure is not intended 6 Uffered for sale. 7044, Business and Professions Code: The ISSUE FEE ' (Section Contractor'sLicense Law does not apply to an owner of a property SOLAR PIPING SYS. ISSUE FEE APPLICATION APPROVED BY r� who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will,have the burden of proving he did not build or improve for the purpose of sale). BUILDINGO ql El I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ � licensed contractors to Construct the project (Section 7044, Business AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ REFRIGERATION 0-100,000 BTU an owner of property who builds or Improves thereon, and who con- PLUMBING $ tracts from such pro' is with a contractors) Ilcesned pursuant td- SYSTEM - GRADING $ the Contractor's Lice se w). 100,000 + BTU PLAN CHECK $ E]I am exempt unde Se Eion B. & P. C. for thisBOILERS $ BTU ELECTRICAL $ reason" PLAN CHECK $ MICROFILM_ $ Date caner SYSTEM REPAE R, ALTERATION TOTAL FEE S - MECHANICAL $ I hereby artilyth I h e re d this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- informat on is cor ct. I a ee to Comply with all City and county PLAN CHECK $ - VANCE PC $ _ " ordinanc r n9 to construction, and hereby authorize represen as of t er upon the above rr�� entioned- property in c I /� 163, Signatur Date I FINAL FEE S Drivers' License or :rISSUE FEE - CMF 0865.46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA - APPROVALS Permit_# �; •• - Date Inspector• 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44.. Steel Reinforcement 3. Electrical Conduit Utility•Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE-' 7. Footings 49. Electrical Conduit-Undr rn - 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Tra ❑ ndr rn' 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection '53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning 5B. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21, Roof Sheathin NOTES: ti S'r�. �� 22. Frame and Flashin Ko ,, 6 g 23. Insulation . T- cl 24. Lathing & Sidingc2rlollofv /- 4ev Qw 407 iv -:W7c 25. Drywall Nailing 70e -d p g2 4 26. Plaster Brown Coat. y g 27. Electrical Power Meter -Final g B 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing .32. Water Service -Final ` 33. Gas Service -Final 34. Solar Domestic -Final 36. ' Landscape Sprinkling S stern 36. Sound Attenuation .. 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42., CERTIFICATE OF OCCUPANCY Nb Date 'Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ,OF • CITY COSTA MESA PERMIT NO. /I TRACT NO, LOT NO. BLDG. NO. CONSTRUCTION PERMIT—o�o�p�`f ~` 0239 ' 1105/82 8.00 ,TL Project Address 77 TYPE OF CONSTRUCTION - ' ' � - (`� Owner E GPhone ❑ NEW '❑ ADD - ❑ ALTERATION es 1 `Address - ❑-REPAIR ❑CONVERSION ❑DEMOLISH 'Arch/En ❑ OTHER ZONING REGULATIONS , . g License No. A.P. _ Address' _ DESCRIPTION OF WORK' - - ` ,r I ZONE P,!_NG. REF.-* , l Contractor`^L czPhone S 7) TYPE OF PERMIT �� - - To BUI�ING PROPE Y LINE Address - - ❑ GRADING' ' ❑ FOUNDATION' -EI STRUU CTRAL SETBACK C T. Y ARD , LICENSED -CONTRACTOR DECLARATION- - - ❑TENANT ❑ ELECTRICAL ❑PL'UMBING (]MECHgNICA gI E YA - 7 I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) 'of Division - 3 'of the, Business and r :� ❑ OTHER ^ RIGHT - Professions Code, a d my license Is In full force and effect, REAR YARD (TO P/L) �� r - PROJECT DESCRIPTION. + ~ License Class i n e "_ PKG. SPACE REQ. PROVIDED •�' Date I " .+S--$2 Signature • SQ. FT, - _ WORKERS' COMPENSATION -DECLARATION- • - -• - t� -- OCCUPANCY '� _ CONSTRUCTION TYPE ,STREET WIDTH PARK FEES I hereby affirm that I havo a certificate of consent to self -Insure ora VALUATION fir' ZONE ZONING APPROVED BYC)ATF, i certificate 'of -Workers' Compensation Insurance, ora certified -copy -Z - thereof (Section 3800, Lab. C.). - � GRADING�CU.'.YDS. ACRES SPECIAL CONOITIONS: , �• ' .y No. Company ertffied copy is hereby furnished., - - - --- REMARKS: Certified_ copy Is flied with the city Building Division. )•.. ;. , ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if-the-permit_Is for one hundred (($100) - - _ _ •_„ _ _ _ '•1 , r �' or less)) i certify that.)n the'perfarmance of the work for whlch.this permit Is _ - Issued, I shall not employ any person In any manner so as to becomerBATHTUBS _ BING PLAN CHECK ELECTRICAL PLAN CHECK subject to -the Workers Compensation.Laws of California.-Uvv _ _ ___ Date Signature ' SHOWERSFTSO. NOTICE: if after making this declaration, you should become.subjectETS' UR1N4L5 GENERATOR 0-1 KW 1-i0 KW to the Workers' Compensation provisions of the Labor Code, you must _ TRANSFORMER 1 -- forthwith comply with such provisions or this permit shall be deemed TORIES DOUBLE LAYS APPLIANCE '10-5D Kw_—: - revoked. _ CONSTRUCTION LENDING AGENCY SINKS '� DISI�iWASHERS - - MOTORS - 0-1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS -. ; SUMPS- - (INC: SOLAR) 10-50 HP_ 50 + HP i formance of the work_ for which this permit is issued (Section 3097 Civ. C.): - _ Lender's—Name. _ FLOOR SINKS u FLOOR DRAINS FIXTURES OUTLETS SWITCHES r „' Lender's Address _ ORINKING FOUNTAINS _ GAS TUBE SIGNS - - OWNERBUILDERDECLARATION-'--- - I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS - CLARIFIERS 1 POLE LIGHTS —171U775-1-71=1 the following reason (Section' 7031,5 Business and 'Professions Code: SWIMMING POOL P TRAP '� �. - 10 M f' Any. city or County which requires a permit to construct, alter, POLES METERED SUB improve, demolish or repair any structure; prior to its Issuance, also re- WATER SERVICE ALTERATION PANELS MAIN ' "SUB quires the ap,.licant for such permit to file a signed statement that he - 'SERVICE- �. is' licensed pursuant'to the provisions of the Contractor's License Law __ _ GAS SERVICE OUTLETS - �•' '".4 - - AMP` - (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and -Professions-Code) or that he is -exempt therefrom and the WATER HEATERS BTU OUTPUT - r for the alleged exemption. Any violation of Section 7031.5 by applicant for 'a" permit' subjects the applicant to a civil•penalty- SEWER CONNECTIONS _ _ mora than five hundred dollars ($500) _ �- t V i, as owner of the property, or my employees with wages as their _ _ SOLAR TANK COLLECTORS - sole compensation, will do the work, and the structure is not.lntentled or offered for sale. (Section 7044, Business and Professions Code: The - SOLAR PIPING SYS. ' ISSUE FEE Contractor's License Law does not apply to an owner of a property - - -- - who builds or Improves thereon, and who does such work himself or - - ISSUE FEE - - APPLICATION"APPROVED BY - DATE ' through his -own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within_one year of comoletion,.the owner will -have the burden of proving he did not build or Improve for the purpose of sale►, ❑"1','as• of^�the -am'exctusively contracting HEATING SYSTEM 0-1DD,000 BTU r _ _ BUILDING _,PERMIT $ - 'SMIP:•. E ` Owner Property;with AND DUCTING �� - �- - - ` ' licensed contractors to construct the project (Section 7044, Business 100,000 + BTU 'PLAN CHECK S PERMIT - and Professions Code: The Contractor's License Law does not apply to - _ ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - tracts from-such"projects-with-a contractor(s)'Ilcesned-pursuant to SYSTEM ^ - t- - - GRADING $ the Contractor's License Law). 100,000!+ BTU PLAN CHECK $. v ' ❑ 1 am exempt uncia' Section' '- B. & P. C. for this Et ECTRICAL $ O4 $ -� reason ' - ._. BOILERS BTU PLAN CHECK $ MICROFILM E - Date— - - Owner •- -- - -- SYSTEM REPAIR, ALTERATION -- - - TOTAL FEE.$ - MECHAN€CAL�•$ , I hereby.certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ _ - -$ LESS'AD- information Is 'correct, I agree to comply with all city and county _ PLAN CHECK - _ VANCE PC $_ ordinance$ and state la 5 relating,to const tion, and hereby authorize representativas f t cif t nter Pon the above mentioned property for spa p� Signature Date_ S FINAL FEE- $ lip Drivers' Licenso or SS ISSUE FEE - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA - Y -- Date Inspector APPROVALS .-:.Permit.# 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -- 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. •Electrical Conduit Utility-Undrgrn 45. Forms, J 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - - 5. Steel Reinforce 47. Rough Plumbing & Pressure Test - - - _6. '_Electrical UFER Grn 48. APPROVAL TO COVER -GUN ITE - 7. Footings 49. Electrical Conduit-Undr rn a 8.• - Foundation _ 50. J Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,ndr rn - - - 10. Structural -Floor System 52. -. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12._ Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing _ - - 14. Rough Electric -Conduit - •56. Electrical -Final ' 15. - Rough -Electric -Wiring - - - -57. Solar System -Final 16. Rough Heating & Air Conditioning. 58. Fencing & Access Approval 17.1 Ducts in Structure 59. APPROVED FOR PLASTERING ' 18. - Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test _ _ .20. Roof Framing - 21. Roof Sheathing - -._,. _ , _..- ...... NOTES: 22: Frame and -Flashing 23. - Insulation _ 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat i 27. Electrical Power Meter -Final ' 28: '.-Final .Electric 1 29.. Final Heating & Air.Conditioning 30.. Final Gas Pipe -Test 31. _ Final Plumbing i 32! _Water Service -Final 33. Gas.Service-Final 34. Solar Domestic -Final " 35. Landscape Sprinkling System 36. Sound Attenuation , 37. Handicap Regulations _ 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No.-....-_ Date 4 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OP COSTA MESAPE MET NO. TRACT NO. LOT NO. BLDG. NO. CONS`�RUCTION PERMIT - JyCod Project Address ' 2Wa, —Zb o TYPE OF CONSTRUCTION Ovune C-5 Phan ❑ NEW ❑ ADD ❑ ALTERATION Address S of -y, G `�, ❑ REPAIR ❑ CONVERSION'❑DEMOLISH Arch/Eng. License No. ❑ OTHER - Address DESCRIPTION OF -WORK 2 7,1 745 F/ Contractor-5-A-eJ ; AC, G Phone*S . ,,2j TYPE OF PERMIT. Addresses -%O 4'`/L ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACT R DECLARATION 1:1 TENANT C3 ELECTRICAL ❑PLUMBING ❑MECHANI, I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of ;Division 3 of the Business and ;Division'[:] OTHER Professions Code, andRy license is- In full force and effect. �- License Class 0 License NO- 44I PROTECT DESCRIPTION Date - Signature_ SCI. FT' WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent t0 self -Insure or a VALUATION ZONE -tficate of Workers' Compensation Insurance, or a -certified copy of (Section 3800, Lab. C.). - - GRADING CU. YDS. ACRES ty No. Company Certified copy is hereby furnished. - i REMARKS: ❑ Certified copy is filed with the -city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred (510 01 or less}. ! f 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 Californla.- PLUMBING PLAN CHECK BATHTUBS SHOWERS Date Signature -- _. TOILETS URINALS NOTICE: If after making this declaration, you Should become Subject to the Worker$' Compensation provisions of the Labor Code, you must forthwith comply with such provision$ Or this permit shall be deemed LAVATORIES DOUBLE LAYS revoked. KIT. SINKS DISHWASHERS CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a Construction lending agency for the per- formance.of the work for which this permit Is Issued, (Section 3097 SERV ICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS Civ. C.). Lender's Name DRINKING FOUNTAINS Lender's_ Address R OWNEBUILDER DECLARATION I hereby affirm.[hat i am exempt fro m.the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such.permit to file a Signed Statement that -he INTERCEPTORS CLARIFIERS SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS is licensed pursuant to the provisions of the Contractor's License Law vter 9 (commencing with Section 7000) of Division 3 of the ess and Professions Code) or that he is exempt therefrom and the .,for the.alleged exemption. -Any violation of Section 7031.5 by WATER HEATERS BTU OUTPUT SEWER CONNECTIONS ai y 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 SOLAR TANK COLLECTORS Sole compensation, will do the work, and the structure is not Intended PLAN CHECK SOLAR PIPING SYS. or offered for Sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE who builds or improves thereon, and who does Such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or improvement Is sold within'One year Of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to Construct the project. (Sectlon 7044, Business and Professions Code: The Contractor's License Law does not apply to HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU an. owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason Date Owner ' SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances ands Id relatip o construction, and hereby authorize reprasenta P i cit ter upon the above cottoned property• n Slgnatur A to s ' L c 3 / Driverse or SS ISSUE FEE CMF 0865-46 Wnite-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 9539 12/15/8I: ZONING REGULATIONS A.P. 99L ZONE REAR YARD (TO P/L) PKG. SPACE RECD. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: 7,00 TL! PLNTTG,, RttE��F.pp� PROgRLPY'NLGINE PROVIDED PARK FEE $ DATE e e - ELECTRICAL PLAN CHECK GENERATOR 0-1 KW - TRANSFORMER - APPLIANCE 10.50 KW -50 1-10 KW - + KW MOTORS (INC. SOLAR) 0.1 HP 10.50 HFL_- 1.10 HP 50 + HP — .'FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS S SMIP POLE LIGHTS PLAN CHECK $ PANELS MAIN , SUB SERVICE AMP r r ISSUE FEE APPLICATION APPROVED BY DATE FINAL FEE S G 4 SUMMARY OF. FEES BUILDING PERMIT S SMIP E' PLAN CHECK $ PERMIT ISSUANCE S� PLUMBING $ GRADING $ PLAN CHECK $ ELECTRICAL $ �- MICROFILM $ H PLAN CECK TOTAL FEE $ MECHANICA LESS AD- • PLAN CHECK E t VANCE PC S FINAL FEE S G 4 CONSTRUCTION AND PLAN INP APPROVALS Permit # Date Inspector POOL & SPA . APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool &EquipmentLacatia_n ~' ~ 2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn \�. �- 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test r 6. Electrical UFER Grn 48, APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrgrn 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing Plumbing System - Fowil 14. -.55, Rough Electric -Conduit '56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning Q encing & Access Approval 17. Ducts in Structure . APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning EAT 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System -,-36.. Sound Attenuation 37.- Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison. '_ , ` I 41. Gas Release to Southern" Califorpia Gas Co. 42. CERTIFICATE OF OCCUPANCY I Date i Applicant to fill in all spaces within heavy border lines and. sign all appropriate declarations. CITY QF COSTA MESA PERMITdO. +1. . R NO. _-7 N B DG. NO. CONSTRUCTION PERMIT iy g-3 Project Address f 1 4./� TYPE OF CONSTRUCTI ON Owner r Phohe ❑ NEW ❑ ADD LTERATION Atldress e)(/l moi✓ ❑REPAIR ❑CDNION" ❑DEMOLISH Arch/Eng. Q� License No. El OTHER Address - DESCRIPTION OF WORK - Contractor Phone Address LICENSED CONTRACTOR 13ECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) Of Division 3 of the Business and Professions Code, a my license is In full force ffec Licens lass License N'N Date _ Signature 'WORKE S' COMPENSATION DECLARATION -I hereby affirm that I have 9 certlficate of Consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy `thereof (Section 3800, Lab. C.). "•aicy No. Company ',ertifted copy fs hereby furnished. 'ertified copy Is filed with the city Building Division. -AEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred (E100� or less). I cert fy that n the performance of the work for which this permit is issued, I shall not employ any parson In any manner so as to become subject to the Workers Componsation Laws of California. Date Signature NOTICE: If after making thlI declaration, you should become subject to the Workers' Compensation provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for wnlCh this ped it is Issued (Section 3097 ,Civ. C.).'- Lender's Leaders Address14:0 .-W f.,,& TM( -Act OWNER BUILDER DECLARATION, I herebyy affirm that I am exempt Irom.the Contractor's License Law for the fotlowing reason (Section 7031.5 Business and Professions Cotle: Any city or county which.requires a permit to Construct, alter, Improve, demolish or repair anY structure, prior to its Issuance, also re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Low (Chapter 9 (commencing with Section 7000)_ of Division 3 of, the Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption.; Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty 3t more than five hundred dollars ($500). ., 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or through his 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 conlPletion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). El 1. as owner of the prope.rty, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Cont(actor's License Law does not apply to an owner of property who blillds or Improves thereon, and who can. tracts from such projects with a Contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C, for this reason Date Owner 1 hereby certify that I have read this application and state that the above information Is correct. I agree to com ly with all city and county ordinances and state laws relating to co ruction, an hereby authorize representatives of y to eft upon th bovC. mentioned Property for I a p r sey. ��/ ' Signature O� _ -2G 9 9 Drivers' License or SS :9p TYPE OF PERMIT - ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL NANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC ❑ OTHER PROJECT DESCRIPTION SQ. FT. I ]4�— OCCUPANCY - STRUCTION TYPE VALUATION �ZONE GRADING -CU: YOS. -ACRES 4442 ZONING REGULATIONS REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED E SPECIAL CONDITIO f REMARKS:14 - i Ft PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW -50 1-10 KW + KW LAVATORIES DOUBLE LAVS KIT. SINKS DISHWASHERS MOTORS (INC. SOLAR) 0-1 HP 10-50 HP 1-10 HP 50 + HP + SERVICE SINKS SUMPS FLOOR SINK S•; �• FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING'F�OUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIEPS�;= tT'� f�' \� POLE LIGHTS SWIMMING POOL P TRAP CONS I ROC I 10m POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS 'SERVICE AMP WATER HEATERS BTU OUTPUT - SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE rl MECHANICAL PLAN CHECK SUMMARY BUILDING $ PERMIT . ,5`O 233� �^ J � �}+� PLAN CHECK $.�1�[_! PLUMBING $ PLAN CHECK $ ELECTRICAL $ PLAN CHECK $ MECHANICAL $ PLAN CHECK si• + i OF FEES SNIP Z Z - - � y PERMIT 155UANCE S GRADING $ S MICROFILM E FEE S? LESS AD. VAN EPC $ FINAL FEE $ ''1_ HEATING SYSTEM. 0-100,000 BTU AND DUCTING 100,000 +, BTU REFRIGERATION 0.100,000 BTU SYSTEM 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION _TOTAL EXHAUST SYSTEM MULTIPLE ISSUE FEE�- CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor I CONSTRUCTION AND PLANNINGQ �I APPROVALS Permit # / l Date Inspector POOL & SPA •, APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pale 43. Pool & Equipment Location ' 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNIT'E _ 7. Footings 49. Electrical Conduit-Undr rn B. Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-TraQ, ID Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK • - 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing , 14. Rough Electric-Conduit '56. Electrical-Final 15. Rough Electric-Wiring- 57. _ Solar System-Final 16. Rough Pleating & Air Conditioning _ � • '� � � •- Fpncing.&.Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. - POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test 20:- Roof Framing 21. Roof-Sheathing NOTES: 22. Frame and Flashing f 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final- Plumbing 32. Water Service-Final • 33. Gas Service-Final 34, Solar Domestic-Final 35. Landsca e Sprinkling System 36. Sound Attenuation ; 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING !� 39. Special Requirements Completed 40. .Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF_QCC �` _�_ ate Y e - U,FLO' C' � - - T H fr W CL O 0 H COSTA MESA BUILDING—SAFETY DEPARTMENT C/P P.O. BOX 1200 Costa Mesa, California *to &x/20/81 1 1000 TL COntrac Cor _S's_^IT,1�j A` M �J TRACT N0. LOT NO. Permit634 N' Address _5_C0(CC0 ',J . PO LO�Q-A BUILDING USE Of f,GU DATE ISSUED 9—/7-8/ CityS' nIi /C -,J Zip Code 9-L,7� State License No. Class. C - 7-7J BUILDING _ ADOREss JS l 4j j± j� ! C -4--1. Z- City License No./SZ (O NO. ITEM Tel. Noss EACH -- FEES l�L COSTA MESA,CALIFORNI! FAU, Wall, or Gray. Furn. Incl. Ducts and Vents to 100-000 BTU � OWNER :J7 j, c> MAIL 1� v ADDRESS GCS„ f��1CC'L�I aver 100,000 BTU , .,. y CITY'��' TEL. NO. Vent (if not incl. above) y i hereby ackno ledge that I have read this application andrstetelthat the above is correct and agree to comply ,'x44 aliyCity Ordinances and State Laws regulating Heat - �ing, Ventilating, Refrigeration and Air -Conditioning. I certify that I possess the above valid State of Calif - omia classification or I am the legal owner of the single family residential property described above. Signature of Permittee Suspended Heater �- Alter or Replace Appliance C �� • ver eat a gas piping t -r1 �f51 BOILERS OR COMPRESSORS Y 3 H,P. or less Over 3 H.F. to 15 H, P. F '`�( .1 �1 Bathroom Vent F"an—Sin le Duct' / REMARKS: Kitchen.�� y' Ventilatin L Hood VD' Meial_,F,ire,Places ICBO # AGA # APPROVALS INSPECTOR DATE Misc- Butts Underground Butts in Structure Ducts Ventilating Heating — Rough Hoods iftn Check Refrigeration Lines Pressure Test Reinspection Fee Air-Cond. Final Ventilating Final Sub -Total Q` Y Heating Final Processing Fee Refrigeration Final Final Gas Test TOTAL FEES E! �`- Utility Co. Notified CMF 0449-46 BLDG. PERMIT NO. W H Q ❑ J Q } J cc W CL. O cc CL Z W H cc W 0. O } tJ) 2 H COSTA MESA BUILDING—SAFETY DEPARTMENT P.O. BOX 1200 Costa Mesa, California 9505 Ii /I 9/91 I9e36 TL' CMF 0313-46, rev. 7/75 BLDG. PERMIT NO. For items not listed refer to Fee Schedule NO. TRACT NO. L RECD BY _, LIZ,0v LOT NO. SUED BUILDING USE �O!Fomta ¢ jal BUILDING ADDRESS 31.51 A Suite � ELECTRICIAN ��3r1 Electr:LC. I11C. _ ADDRESS lO$$5 K31ffiT1a RiVlex Rd. r Lh'ait S CITY 7E1, No. 540`_'7773 n ValleY . STATE LICENSE NO. 323$05 CLASS. C-10 — CITY LICENSE. NO. 23fi81 No. ITEM EACH PIIS COSTA MESA, CALIFORNIA _'ry4 % r Dwelling, Sq, Ft. $ NEAREST CROSS ST. 20 Garage, 5q. Ft. First 20 Outlets, each 25 5 QQ OWNER Western Pacific FL118T�9_ MAIL %]MI �'+ r ADDRESS 40 Outlets, Additional .12 4 $0 .3JLD.LOLLA. Ce CITY nada ca ' TEL, NO. 20 First 20 Pictures, each 25 5 00 t HEREBY ACXNOWLEDGE THAT I HAVE READ THIS APPtr. CATION ANO.STATE THAT THE ABOVE IS CORRECT AND AGREE ALL CITY ORDINANCES AND STATE LAWS REG- ULATING ELECTRICAL WIRING. � I CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF CALIFORNIA CLASSIFICATION OR 1 AM THE LEGAL OWNER OF THE SINGLE FAMILY RESIDE IAL PROPE TY DESCRIBED ABOVE. PERMIure of / �it/1ir PERMITTEE�- 13 Fixtures, Additional '71.560 12 -70f&MPLY'WITH Dryer /� SI L Fansignat L+ Heater 'S � Oven, Domestic) NO. ITIM EACH PEES Pole, Cons trucftn c� Sign d 1 Trans. 2.00 Range, DornefTransformers KW MIsc. �� Generators KW Motors {Sea Schedule) HP HP HP tal Fees APPROVALS Meters, e0. IMSPECTOI DATE LE k Permit Fee 3 UND CONDUIT f:::-- t— {/:L jg 'if Sub -Total Fees 19:361: f ER Total Fees . NOTIFIED CMF 0313-46, rev. 7/75 BLDG. PERMIT NO. For items not listed refer to Fee Schedule Applicant to fill in aft spaces within heavy border lines and sign all appropriate declarations CITY, OF -COSTA MESA PERMIT NO. TRACT NO. LOT NO, NO. JCONSTRUCTION PERMIT ie-/ [BLDG. TYPE OF CONSTRUCTION ❑ NEW 0 ADA ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS' t Address �� /¢ — a Phone ss ng, License No. DESCRIPTION OF WORK A,P. =ZONE ss rAd OF PERMIT ❑ GRADING ❑ FOUNDATION- ❑ STRUCTURAL PINGOp. SET AC LST.PRp ID YARD 9RUEF. IeWYI Lss ctor ,s, �� P�Q.S Ph6ne7 GZ7�.TYPE Z 2 Z EL L ED GONTRACTOA DECLARA ION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA y affirm thatIam licensed under provisions of Charter 9 {Corn- Rti�HtYARD Rg with section 7000) of Division 3 of the Business and ❑ OTHER ions Code, and y license is In lull f r and effect. REAR YARD (TO P/L) / PROJECT DESCRIPTION License lass en PKG. SPACE REQ, PROVIDED Date Signature5Q. FT. STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECRA ION OCCUPANCY CONSTRUCTION TYPE t hereby affirm that I have a certificate of co nt 0lf4nsure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insura a, o a certifled copy thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: '=cy No. Company 'ertlfied Copy is hereby furnished. REMARKS: zertif€ed copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION'DECLARATION (This section need not be completed if the permit Is for one hundred 5$100] or less. certify that n the performance.of,tho work for which this perm' i4 PLRN CHECK TRICAL PLAN CHECK ' Issued, I shalt not employ any person to any mannor so as to bet me subject to the Workers' Compensation Laws of California. THTUBS SHOWERS Date Signature TOILETS URINALS GENERATOR 0-1 KW 1.10 KW ' NOTICE: if after making this declaration, you should become Subject to the Workers' Compensation provisions Of the Labor Code, you must TRANSFORMER forthwith comply with Such provisions Or this permit Shall be deemed LAVATORIES DOUBLE LAV5 APPLIANCE 10-50 KW_50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS, 0-1 HP I-10 HP CONSTRUCTION LENDING AGENCY L hereby affirm that there is a Construction lending agency for the per- SERVICE SINKS SUMPS (INC, SOLAR) 10-50 HPL_ 50 + HP - formance of the work for which this permit is issued (Section 3097 Civ. C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION 4 hereby affirm that I am exempt from the Contrattor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason (Section 7031.5 BusinesS and Professions Code:SWIMMING POOL P TRAP Any city or county which requires a permit to Construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit t0 file d signed Statement that he 15 'licensed pursuant to the provisions of the Contractor's License Law GAS5ERVtCE OUTLETS SERVICE AMP (Chapter 4 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ' Business and Professions Code) or that he Is exempt therefrom and the h--15 for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the aPpftcant to a civil penalty A more than five hundred dollars (5500). SOLAR TANK COLLECTORS L- 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 SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Lary does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own eMPIOyeeS, provided that Such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. if, however, the building or Improvement is Sold within one year o1 comp)etion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). El HEATING SYSTEM 0-IDOODD T , BTU BUILDING PERMIT 3 SMIP $ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to con{struct the project Section 7044, Business 100,000 +TU B PLAN CHECK S PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING 3 -- tracts from such projects with a contractor(s) liCesned pursuant to SYSTEM GRADING E the Contractor's License Law). 100,000 + BTU PLAN CHECK 3 Cl 4 am exempt under section B. & P. C. for this 801 LERS BTU ELECTRICAL 3 �Ll-• - _ b ieason PLAN CHECK $ MICROFILM $ Date Ownar SYSTEM REPAIR, ALTERATION TOTAL FEE 3 I hereby certify that I and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD - information is torr omply with ail city angcounty PLAN CHECK S___^_� VANCEPC 3_ordinances Wreadplication antl s a Ionstruction, and hereby ' represents er upon the above property for Signature FINAL FEE 3 Drivers' Lice a or 55 ISSUE FEE - CMF 0865.46 White -Bu din nary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA ' APPROVALS Permit'# Date Inspector. 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electriril Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9, Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. 1Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final .At 28. Final Electric 29, Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31..: Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Serinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - Applicant to fill in all spaces within heavy border Iines and sign ail appropriate declarations CITY, QF.COSTA MESA PERMIT NO. E-557 TRACT NO. LOT NO. BLDG. NO. •CdNSTftUCTION PERMIT Project Address Ms 2 YPE OF CONSTRUCTION Owner P � Phone C3NEW ❑ ADD IKALTERATION Address Yji+ t C3 REPAIR ❑CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER Address DESCRIPTION OF WORK Addresses J, Q LICENSED CONTRACTOFt DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 70001 of Division 3 of the Business and Professions Code,nd my license Is In full force and effect. License Clas License No. Date Signature _ WORKERS' COMPENSATION D ATION I hereby affirm that I have a Certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a`Ce�rtified copy thereof (SgctlonS O�L Company �•_'AQ A#L-b--- Icy Ne GG]] S :ertltled copy I$ hereby furnished. Certified Copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be completed if the permit is for One hundred ($100) or less. I Certify that n the perfoirhance of the work for which this permit 15 Issued, I shall not employ any person in any manner so as t0 become subject t0 the Workers Compensation Laws of California. Date Signature NOTICE; If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked, CONSTRUCTION LENDING AGENCY I hereby affirm that there Ig a construction lending agency for the per- formanCe of the work for which this permit is issued (Section 3097 Civ. C.). F.� - r� a: •� Lenper's Name Lender's Address;' OWNER BUILbER DECLAgATION' r ' I hereby affTfm that I am exeunpt.from the Conlractor'SACicense 1]agv, fo5 the following reason,(Sectign 7031.5 Business and Professions Code: Any city arcounty, whi¢h,requlres ai permit , b Construct, alter, improve, demolish or repair-any_Structure, prior�to its issuance, also re- quires the applicant for'.such permlt t0 fjlaa signedlsiatemeht�that he I$ licensed pursuant to the provisions of the Contractor's -License Law (Chapter 9 (commencing With Section 7000) of Division 3 of the Business and Professions Cdde) or that he is exempt therefrom and the for the alleged exemption, Any violation of Section 7031.5 by 3 - -applicant for a permit subjects the applicant to a civil penalty r'ot more than five hundred dollars ($500), oI, 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. (Section 7044, Business and Profession$ Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the buildingdr improvement Is sold within one year of cgmptetion, the owner will have the burden of proving he did not build or Improve for the purpose of sate). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to congtrucl the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from Such projects with a Contractor($) licesned pursuant to the Contractor's License Law), ❑lam exempt under Section B. & P. C. for this reason Date owner - t hereby certify that I have read this application and state that the above information is correct. I agree to Comply with all city and county ordinances and state laws relbtingto coni uctIon. and hereby authorize rep( of t s city to onto on the above mentioned pro rty for i n pgrposes. . x t Slgnatur Date" Drivers' Limos CMF 0865.46 TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT to ELECTRICAL ❑PLUMBING ❑MECHAN ❑ OTHER PROJECT DESCRIPTION SO. FT, OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: 3549 Ft/ Ia/R! ZONING REGULATIONS A.P. :P ELECTRICAL ZONE PLNTG.. SETBACK C/L ST. gUREF..9P PROPEIRTpY LINE Effi YARD SYSTEM RIIGA RD HTT URINALS DOUBLE LAVS REAR YARD (TO P/L) 0-1 KW 10-50 KW PKG. SPACE RCC. PROVIDED STREET WIDTH PARK FEE S ZONING APPROVED BY DATE SPECIAL CONDITIONS: FLOOR DRAINS PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS REFRIGERATION 0-100,000 BTU_ SYSTEM TOILETS URINALS DOUBLE LAVS GENERATOR APPLIANCEMER TRANSFOLAVATORIES 0-1 KW 10-50 KW 1.10 KW 50 + KW KIT. SINKS SERVICE SINKS DISHWASHERS SUMPS MOTORS (INC. SOLAR) 0-1 HP 10.50 HPL -50 1-10 HP + HP FLOOR SINKS FLOOR DRAINS FIXTURES ,1/ OUTLET S'z SWITCHES Fj Q DRI&KING,FOUNTAINS GAS TUBE SIGNS GRADING INTERCEPT6RS1, •.-,N CLARIFIERS POLE LIGHTS SSWIfNMING-POOL. ,WATER P TRAP POLI LES METERED SUB SERVICE .�� ALTERATION PANELS MAIN SUB GAS SERVICE %OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT S SEWER CONNECTIONS LESS AD - SOLAR TANK COLLECTORS VANCE PC s -- SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU_ AND DUCTING 100,000 + BTU _ REFRIGERATION 0-100,000 BTU_ SYSTEM E SMIP 100,000'+ BTU_ BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE or SS � ISSUE FEE Whlte-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor FINAL_ SUMMARY OF FEES BUILDING PERMIT E SMIP 5 PLAN CHECK $ PERMIT ISSUANCE S PLUMBING $ ' GRADING $ PLAN CHECK $_13 ELECTRICAL Ste! /--rr..rryy--��4 T E MICROFILM S PLAN CHECK $ TOTAL FEE $ MECHANICAL S LESS AD - PLAN CHECK $ VANCE PC s -- FINAL FEE S ,w CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA L ._ APPROVALS Permit # Date Inspector. 1 f 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-U-nUr-grn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel einorce 47. Rough Plumbing & Preis6fe'Test 6. Electrical UFER Grn 48. APPROVAL TO COVER -GUNITE ' 7. Footings 49. EledtFical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ ndr rn 'f 10. Structural Floor System 52. APPROVAL TO DECK y. 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing Systern - Final 21 < 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. - Solar System -Final 16. Rough Heating & Air Conditioning bti. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof ShNathin NOTES: 22. Frame and Flashing ,23. Insulation r; _ ^ 24. Lathing & Siding re o 25. Drywall Nailing S 26. Plaster Brown Coat w; 27. Electrical Power Meter -Final Q-eg 7 28. Final Electric 1pC� 29. Final Ideating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing - 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern Cafifornia Gas Co. 42. ' CERTIFICATE OF OCCUPANCY No, .___- Date T -! If J r,:- i Applicant to fill In all spaces within heavy border lines and -sign all appropriate declarations. CITY'OF C09TA MESA PE MIT NO.TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT — r1/_/ P-1-1 AAA—. _ - _ . . . TYPE OF CONSTRUCTION ❑ NEW - ❑ ADD ❑ ALTERATION Address rwaynqtnMpcaC1 REPAIR El CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK Arch/Eng. " - License No. 'Address Contractor _ Phon TYPE OF PERMIT - ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT C1 ELECTRICAL ❑PLUMBING ❑MECHANI Address LICENSED CONTRACTOR p! CLARATiO I hereby affirm that I am licensed under provisions of Charter 9 (com- BATHTUBS SHOWERS menCing with section 7000) of 'Division 3 of -the Business and _ ❑ OTHER Professions Code, and myllcense in full force and effect. LAVATORIES DOUBLE LAVS License ass L 40 D7 t�r— PROJECT DESCRIPTION Date Signature SQ. FT. WOR ERS COMPENSATION LARA N OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure or a VALUATION ZONE 41ficate of Workers' Compensation Insurance, or a certified copy INTERCEPTORS CLARIFIERS fof f'Company BEAVER GRADING CU. S. ACRES GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT - �Cortlfied COPY •is•hereby furnished, -- REMARKS: Certified copy is filed With the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 0 ((This section need not bd Completed ifthepermit I$ for one hundred _ PROVIDED,~. f$1)D) or less). I JCertify that In the performance -of ttic .work ,for.which this permit Is Issued, I shall not employ any person in any manner So as to become subject tothe Workers .Compensation. Laws of, California._ w. PARK FEE,$- ' PLUMBING PLAN CHECK BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TOILETS URINALS - LAVATORIES DOUBLE LAVS revoked. KIT. SINKS DISHWASHERS CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a Construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 Civ. C.). - - Lender's Name, SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING -FOUNTAINS Lender's Address OWNER SUILDE ARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 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 re= quire$ the applicant for sUCh permit to file a signed statement that he is licensed pursuant to -the provisions of -the Contractor's License Law- r•";".,3pter 9 (commencing with Section -7000) of Division 3 of the gess and Professlons Code) or that`he is exempt therefrom and the r`%'for the alleged exemption. Any violation of Section 7031.5 by w!" applicant for a permit subjects the applicant to'a Civil penalty of not more than five _hundred dollars {$500►. ❑ I, asowner 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. (Section 7044, Business and Professions Code: The Contractor's License Law does -not apply -to -an owner of a property INTERCEPTORS CLARIFIERS SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT - SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE Who builds or Improves thereon, and who does such work himself or through his own employes, provided that suCh Improvements are not Intended or offered for sale. If, however, the building or Improvement is sold witnin one year of completion, the owner will have the burden of proving he did not nuild or improve for the purpose of sale). ❑ I, as owner of -the property,- am' -exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Profession$ Code:' The Contractor's"LIcense'Law does not apply to MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU an owner of property who builds or improves thereon, and who con. tracts from such projects with a contractor(s)- licesned pursuant to the Contractor's License Low). ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason - - Date- Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE - 1 -hereby certify that I have read this application and state that the above informat io rrect. I agree to comply with all city and county ortlinances a aw r at to Construction, and hereby authorize representat!ves O enter upon the above entloned property fo �pecti pj1rposes. � ISSUE FEE Slgnatur e Drlvers' ' ense or SS I';MF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ZONING REGULATIONS A -P,: 41 ..15 H/cL-'/61 ZONE PLNG. REF. qP. RIGHT - REAR YARD (TO P/L) 0 PKG. SPACE IiEQ._ _ PROVIDED,~. STREET WIDTH PARK FEE,$- ' ZONING APPROVED BY DATE SPECIAL CONDITIONS: PLAN CHECK $ PERMIT ISSUANCE $ PLUMBING $ ,ELECTRICAL PLAN CHECK tJVVLI_I_fNU GAR AGE `. GENERATOR 0.1 KW ,TRANSFORMER APPLIANCE 10-50 KW_50 1-1D KW + KW MOTORS 0-1 HP =(INC. SOLAR) 10-50 HP - 1-10 HP 50•+ HP FIXTURES OUTLETS - SWITCHES' GAS TUBE SIGNS ' PLAN CHECK POLE LIGHTS POLES _ METERED SUB ,PANEL'S- MAIN SUB - SERVICE - AMP ' q I 1. ISSUE FEE APPLICATION APPROVED BY - - DATE SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT ISSUANCE $ PLUMBING $ GRADING S PLAN CHECK $ ELECTRICAL S $ MICROFILM $ PLAN CHECK MECHANICAL $ S �70drOTAL FEE $ ze LESS AD - PLAN CHECK $ VANCE PC FINAL FEE $ q I 1. CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA - APPROVALS Permit # Date Inspectot - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Coriduit•Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51, Backwash Lines P -Trap,❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing Sy5jeca - Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts, in Structure 5T APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame arid Flashing _ 23. Insulation- nsulation-•24. .24. Lathing &•Siding 25. Drywall Nailing •• ' 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric - 29. Final Heating & Air Conditioning /µ-- I' j+! s J 30. Final Gas Pipe -Test " 31. Final Plumbing •0 /a -C 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System -36. -Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to -Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, ` CrTY OF i''OST-A MESA P IT TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT n4 �� -1 5697 1U12' -)1'6R ' - Id AJ. 19 TL ZONING REGULATIONS A.P.41 0.0-7 1 ZONE PLN77G.. RItFF. rf BUILD] NG SETBACK L ST. PROPEIR IN NE SgIDp YARD R LRIEI GF H T REAR YARD (TO P/L) PKG. SPACE RED. P OViDED STREET WIDTH %.PARK FEE $ ZONING APPROVED BY ( DATE SPECIAL CONDITIONS: C1ONDITIONS:y IiT� issued, I shall not employ any'person in any manner so as to'become subject to the Workers Compensation taws of California. PLUMBING Proect-Aadress C iN, TYPE OF CONSTRUCTION' . t 1:1 NEW -E3 ADO, ❑ ALTERATION 1:1 REPAIR ED CO VERSION QDEMOLISH OER r ElTH DESCRIPTION OF WORK_ OwnerPhone Address- ` Arch/Eng. icense No, Address �r r' SO Fr _ _ Contractor Phone - - TYPE OF PERMIT - C3 FOUNDATION- '❑ STRUCTURAL ' TENANT ❑ ELECTRICAL ❑PLUMBING EIMECHANiCAL AddressC3GRADING-•. AR -LICENSED CONTRACTOR DE LATI I hereby affirm that I am licensed under provisions of Charter 9 (tom-: . 90THER' mencing with section 7000) of Division 3 Of the Business and ' Professions Code, and my license is In full force and effect. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this Permit is Issued (Section 3097 Civ. C.). - - Lender's Name - PROJECT DESCRIPTION License Clas Ll nae o ;(INC. SOLAR) Date Signature SQ. FT' WORKERS' cofAPENSATION DECLARAT,1 "OCCUPANCY ONSTRUCTION TYPE . I hereby affirm that I have a certificate of consent to sell -Insure or a - i certificate of Workers' Compensation Insurance, or a -certified copy VALUATION -21, ,ZONE thereof fSec n 800 C.). Q ADING CU: YOS. ACRES Policy Nd. Company ��ertltied copy Is hereby furnished, - REMARKS: ,� 9 - - �3 - , lL Certified copy is filed with the city Building Division. 6/ -X - _XEMPTION-FROM WORKERS" COMPENSATION DECLARATION (This section need not be Completed if the permit Is for one hundred -^;• - _ i (5100) or less). I certify that In the performance of the work for which this permit I$ 5697 1U12' -)1'6R ' - Id AJ. 19 TL ZONING REGULATIONS A.P.41 0.0-7 1 ZONE PLN77G.. RItFF. rf BUILD] NG SETBACK L ST. PROPEIR IN NE SgIDp YARD R LRIEI GF H T REAR YARD (TO P/L) PKG. SPACE RED. P OViDED STREET WIDTH %.PARK FEE $ ZONING APPROVED BY ( DATE SPECIAL CONDITIONS: C1ONDITIONS:y IiT� issued, I shall not employ any'person in any manner so as to'become subject to the Workers Compensation taws of California. PLUMBING PLAN CHECK ELECTRICAL PLAN'CHECK - BATHTUBS- -SHOWERS - SEWER CONNECTIONS— �" • - -� • - ' r' SO Fr ,Date Signature TOILETS LAVATORIES URINALS DOUBLE LAVS GENERATOR 'TRANSFORMER APPLIANCE 1 -10 -KW 0-1 KW - - 1-10 KW 10.50 KW -50 + KW NOTICE: If after making this declaration, you should b6come,subject to the Workers' Compensation provisions of the Labor Code, you must to Comply with such provisions or this permit shall be deemed revoked. KIT. SINKS- - DISHWASHERS" r 'MOTORS- 0.1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this Permit is Issued (Section 3097 Civ. C.). - - Lender's Name SERVICE SINKS SUMPS - ;(INC. SOLAR) 10.50 HP___ _50 + HP -- FLOOR SINKS - FLCbKDRAINS FIXTURES - OUTLETS SWITCHES Lender's Address - DRINKING FOUNTAINS' - i GAS TUBE SIGNS OWNER BUILDER DECLARATION - - - I hereb affirm that I am ex m t f INTERCEPTORS -CLARIFIERS - POLE LIGHTS - ' Y e p rom the Contractor s License Law for the. following reason:(Section .7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair anystructure, prior -to -its issuance, also re- quires the ap, licant for such permit to file a signed statement that hg SWIMMING POOL-- PTRAP' -' - -- - --WATER'SERVICE ALTERATION' Is licensed pursuant to the provisions of the Contractor's License- Law Chapter 9 (commencing with Section 7000) of Division 3 Of the GAS SERVICE- ` - - OUTLETS - -- -WATER -HEATERS " BTU, OUTPUT-- - '1 uslness and ProiesSlons Code) or that he is.exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any for for a permit subjects. the applicant to a. civil ..Penalty not more than five hundred dollars ($500). SEWER CONNECTIONS— �" • - -� • - ' • SOLAR TANK 'COLLECTORS - , as owner of the property, or my employees with wages as their corn pensation, will do the work, and the structure is not Intended SOLAR PIPING SYS,- ' ' i - - - -' or offered for sale, (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he' -did not -build or improve for the purpose of 'sale). El I,- as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code., The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts -from such projects-wltth, a_contractor(s)..Ilcesned-,pursuant to the Contractor's License Law). 'ISSUE FEE -MECHANICAL - PLAN CHECK HEATING SYSTEM TO -100,000_ BTU -AND DUCTING - - - - �- - 100,000 + BTU _ REFRIGERATION 0.100,000 BTU SYSTEM. - -- 100,000 + BTU C3I am exempt under -Section B. & P. C: for this BOILERS BTU reason ' SYSTEM REPAIR, ALTERATION _ Date Owner EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above information is Correct. I agree to comply with all city and county ordinances and stale laws relating to construction, and hereby authorize representatives of this city to enter upon the above mentioned property for . spec n r s. -- - Signature _ GRADING- S Drlvprs' I ;rpncp nr [ ISSUE FEE GMF 0865-46 White -Building, Canary -Applicant; Pink -Accounting., Goldenrod -Assessor _-- - - POLES ..�_.�.. METERED -SUB - PANELS PANELS - - "MAIN 7- SUB SERVICE -' T AMP ISSUE FEE _ APPLICATION APPROVED BY-- •' DATE Z SUMMARY OF FEES BUILDING , / rPERMIT $ O` - SM 'SMIP„ _ 'PLAN CHECK $S.-�2- PERMIT. ISSUANCE ---S PLUMBING $ _ GRADING- S PLAN CHECK S' ELECTRICAL S. S PLAN CHECK E MICROFILM S. MECHANICAL E TOTAL FEE b PLAN CHECK $ t LESS AD- VANCEPC S_iy FINAL FEE s Z/ Y� - CONSTRUCTION AND PLANNINGPOOL APPROVALS Permit + �',5.3% Date Inspector & SPA-. _ • APPROVALS Permit # Date Inspector, 1. Temporary Electrical Service or Pole ~ 43. Pool & Equipment Location 2. Soil Pipe- n rgrn 44. Steel Reinforcement 3. Electrical Conduit_Qtility-Undigrn 45. Forms - - 4., Electrical Conduit-Undrgrn 46. Electrical Bondiin - " 5. Steel etn orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE ' ' 7.Footings._49. Electrical Conduit-Undr rn .8. Foundation , , «, 50.. Gas Pi , ❑ Undr rn, Test 9. Water Pipe-Undigrn 51. Backwash 0nes. E-Tra6_ -Ej Undf4rn'- 10. -Structural Floor System 52. - AI'P.ROVAL TO DECK 11. .'Ptoperty Sewer Linq & House Connection 53.- -Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final ^- - 13.. 14. Rough Plumbing Rough Electric -Conduit :56. - Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning =Fencing & Access Approval 17. Ducts in StructureAPPROVED FOR PLASTERING 18. Ducts, Ventilating. 61). POOL/SPA SYSTEMS FINAL , 19. Gas Pipe -Rough &Test 20. -Roof Framing _ 21. Roof Sheathing- 'NOTES: 22. Frame and Flashing .. _ 23. Insulation - - , 24. Lathin & Sidincr- lfl 25. Drywall Nailing�Z- 26'. Plaster Brown Coat 27. Electrical Power Meter -Final -28. Final Electric - - -- - _ - 29. Final Heating & Air Conditioning ,_.30. Final Gas Pipe -Test - 31. Final Plumbing. 32. Water Service-F,ina1 _. 33.. "Gas Service -Final ' - 34. -Solar Domestic -Final ' • `~ ' �. 35: •Landsca S rinklin stem': 36. Sound Attenuation - -- - -- 37. Handicap Regulations - '• 38. FINAL STRUCTURE & BUILDING 511 39, Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY • 'No✓ - Date - - •- Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ' CITY OF COSTA MESAP IT N °"'-- -3qa TO. NO. LOT NO.' BLDG. NO, ^ CONSTRUCTION PERMIT A: 9B6G'JD/pg/6p k- 16e2� ;TL Prpject Address /Sl iQw+ -��Q - ._TYPJE OF CONSTRUCTION , Owner yf o�sJ .+lrw.c� X ,.Phone KNEW•, El ADD 1:3 ALTERATION , Address- - - - ❑ REPAIR ❑CONVERSION ❑DEMOLISH ,( - Arch/Eng. - License No. 0-OTHER' -ZONING REGULATIONS �+ ORK DESCRIPTION OF-WORK AP .. Address -- - w ZONE PLNG. REF.:#-- : ` Contractor /� ,rh! ��Tqi� Phone(�JV-ijc TYPE OF'PERMIT; ' B BiJILDING OPERTY L•INC ' Address 1 7-- rfw t4✓e C.4W/F10 ' " [:].GRADING FOUNDATION ❑ STRUCTURAL -SETBACK ST. YARD LICENSED CQNTRACT R DECLARATION I hereby affirm thO I am licensed under Charter 9 ❑ TENANT. ELECTRICAL ❑PLUMBING ❑M$CHANICA SIDE YARD- -} ' provisions of (corn-. mencing with Section 7000) of Division - 3 of the Business and ❑ OTHER " RIGHT Professions Code, nd my license is In full force and effec LI �, License Class jqe PROJECT DE QRIPTION -REAR YARD (TO P/ L) - o. Date SignatureC- a!'Q.. J O SQ. -FT. ,# PKC. SPACE REQ. PROVIDED STREET WIDTH - PARK FEE $ yVORKE S' C MPENSATION LARATION..._. _ ' OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self-Insure or a, VALUATION ZONE ZONING APPROVED.f3Y DATE certificate-of Workers' Compensation Insurance, orja-certified copy - thereof ctl n 80 i � b GRADING'CU.YDS. ACRES SPECIALCONDETIONS: icy N( mpany� O•rirr._u.' Certified copy Is hereby furnished.. _ ,-REMARKS:.'_- LJ Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION- (This section need not be completed if the permit Is for one hundred '. 1 ($100) or less). - r - -,• ... - - - - - - ^ 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 becomeNG PLUMBING.--, ;` ' '-PLAN CHECK "' � ELECTRICAL- PLAN'CHECK. ' subject to the Workers' Compensation-Laws of California. -" _ _ Dale Signature _ _ - SHOWERS LI NOTICE: If after making this declaration, you should become subjectLETS.•' -_ .• URINALS'GENERATOR'S D.1`KW 1-10 KWto the Workers' Compensation .provisions of the Labor Code, you must !TRANSFORMER forthwith comply with such provisions or this permit shall be deemedATORIES DOUBLE'LAVS- •^_ APPLIANCE "' 10-50 KW .; 50 + KW - -' revoked. _- CONSTRUCTION LENDING AGENCY Y � KIT.-SINKS '-" DISHWASHERS - - ""MOTORS '0-1 HP '1.10-H6:` I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - .�-SUMPS""', - - '(INC. SOLAR) - ,10-50 HP.,: • •50 + HPC -•• - .formance of the work for which this permis Issued (Section 3097 it Civ. C.). - FLOOR'SINKS' FLOOR'ORAINS; f` FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address DRINKING FOUNTAINS .jY - GAS TUBE SIGNS'-" '- '"' - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for `INTERCEPTORS Y' .CLARIFIERS - 'POLE LIGHTS- -' "` ` - _• - ' the following reason (Section 7031.5 Business and -professions Code: SWIMMING 'POOL- -"- PTRAP-"' �•• - r - - POLES - METERED J Any city or county which requires a permit to construct, alter, improve, improve, demolish-or repair any Structure, prior to its issuance; also re- WATER SERVICE `ALTERATION - - -' SUB -'MAIN- - SUB - - quires the ap, licant for such permit to file a signed statement that he r' -PANELS - Is licensed pursuant to the provisions of-the Contractor's License Law GAS SERVICE- OUTLETS -SERVICE' AMP DU (Chapter 9 (commencing with Section 7000) of Division 3 of the gsiness and Professions Code) or that he is exempt therefrom and the WATEWHEATERS' _ '-'BTU'OUTPUT' -- - - - - ' y •• • " _,;3 for the alleged exemption, Any violation of Section 7031.5 by • applicant for a permit subjects the applicant to a- civil penalty SEWER CONNECTIONS '-" - •• - -- .aot more than five hundred dollars ($500). U 1, as owner of the property, or my'employees with wages as their SOLAR TANK' COLLECTORS"" - - -` - -, ', " sole compensation, will do the work, and the structure is not Intended or offered for sale, (Section 7044, Business and Professions Code: The" SOLAR PIPING SYS. ISSUE FEE - Q' Contractor's License Law does not apply to an owner of a property - who builds or improves thereon, and who does such work himself or _ _ _ ISSUE FEE ",, �- '.APPLICATION APPROVED BY - - - - DATE - through his-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 will have the burden MECHANICAL PLAN CHECK c SUMMARY OF FEES •- -,, . �L•, of-proving he did not build or improve - for the purpose of sale).HEATING - •'BUILOING' '� --' -- - ��• - '•- EJ I.' as owner of the -property,-am -exclusively contracting with SYSTEM 0-100,000.BTU _ AND DUCTING _•PERMIT $ `- SMIP. - $, - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to--- - ISSUANCE .•,S r an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - tracts-from such projects with a contractor(s)-licesned-Pursuant to SYSTEM -- GRADING $ the Contractor's License Law). 100,000 + BTU 'PLAN CHECK $ t _ El1 am exempt under Section B. & P. C. for this BOILERS BTU $ ELECTRICAL S } reason - MICROFILM, $ PLAN CHECK' '$ - "' ' Dale Owner SYSTEM REPAIR, ALTERATION � TOTAL FEE $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $' MECHANICAL - - LESS AD- , Information is correct. I agree to Comply with all city'and' county , _ CHECK - S VANCE PC $ - ordinances and state laws relating to construction, and hereby authorize 'of-this 9 representatives city to enter upon 'the above mentioned property fpr .i pectl pnr oses - - 6 Signature �. �� ti- FINAL FEE s - Drivers' icense or SS ISSUE FEE - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor 15, CONSTRUCTION AND PLANNING E r• _', APPROVALS Permit �• S 0 Date Inspector POOL & SPA' ; APPROVALS Permit # Date Inspector . 16. 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location 17. 2. Soil ipe n rgrn 44. Steel Reinforcement ' 18. 3. Iectrical Conduit Utility-Undrgrn 45. Forms 19. Gas Pipe -Rough &Test _ 4. Electrical Conduit-Undrgrn , 46. Electrical Bonding T' Roof Sheathin 5. Steel em orce 47. Rough Plumbing & Pressure Test 23. 6. Electrical UFER Grn _ 48. APPROVAL TO COVER-GUNITE - s; 24. 7. Footings 49. Electrical Conduit-Undr rn 25. .8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 26. 9. Water Pipe-Undrgrn , Backwash LinesP-ra- 27. 40. Structural Floor System 52. APPROVAL TO DECK 28. '+final Electric ' 11. Property Sewer Line & House Connection 53, Backwash & Receptor -Final 12, Street Sewer Connection 54• Heater & Vent -Final - - 13. Rough Plumbing 55Plumbing Syggm 400al- " 14. Rough Electric -Conduit - :56. Electrical -Final ' 1 15, Rough Electric -Wiring _ - - -57. Soler System -Final ` 16. Rough Heating & Air Conditioning - Fencing .& Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING';,. 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test _ 20. Roof Framing 21; Roof Sheathin NOTES.: 22. - Frame and Flashing 23. Insulatiori• w- 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. '+final Electric ' 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test _31. Final Plumbing 132. --Water Service -Final 33. GasService-Final 34, Solar Domestic -Final ' 35. Landscape Serinkling System 36. Sound Attenuation , - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 1 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. , 42. CERTIFICATE OF OCCUPANCY • I No Date '" COST, P.Q. ^!G -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT A NIESA, CALIFORNIA 92626 7� R RECEIVE PERiNIT For Applicant to Fill in Completely — Use Ink Only BUILDING A,P. NO, ag 2r 9 03 -� ADDRESS OWNER OR TENANT Western Pacific Financial BVILDIN ADDRESS MAILING C Q ,r, na son O. ADDRESS 18003 JiC ar�C Blvd Ste UNIT N SPACE NO. . M. �i BLK. CITY Irvine Ca 92714 No 540-260 74-391 Parcel 1 CONSTRUCTI ' ' NEW ADD ALTER REPAIR MOVING DEMOLISH LENGES western Pac f c ria X BRANCW OWNER Western Pacific Financia C ADDRESS Sanie rVA UE US $/�Q�S AON RENGI£EER Hales -Lan Ston TEL�47_�5�2 ADDRESS 777 S. Main, Orange, Ca. II ZONE TYPE J� GRdUP M �� CONTRACTOR J. Donald Olson Co APPROVED BY DATE ADDRESS 15003 Sky2ark Blvd., Ste .33 CITY Irvine Ca. 92714 Nd540-2606 2 5h uc No. 333969 APPROVED SETBACKS LIC. NO. SIZE NO. OF BLDG& IFROM C/L STREET) OF LOT NOW ON LOT 0 RONT FT. USE OF Vacant Land EXISTING BLDG. Separate permits are required for L. SIDE electric, plumbing and heating work: RE FT. USE OF BUILDING AND WORK TO BE PERFORMED PLAAAING ACTION Construct office building shell r j DATE APPROVED 5 712 S.F. APPROVEDply //— How -OR SPECIAL REQUIREMENT:1 I hereby acknowledge that I have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation of the workman's compensation laws of the State of California. I hereby certify that I prop rly licensed as contractor under SO. FT. the State of Califof Busine and Professio C ision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and th such I nses are In fulland of act, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from a visions theSta aflforni usiness end Professions e, Division 3 Chapte VALUATION PERMIT FEE 3 Signature Permittee PLAN CHECK S r�1L sl� �/ I. >0 TAX S o r IV Authorized Agent Date a TOTAL PAID 5 7� R I 4 11100! Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. _ s'�,�• ' Y OF COSTA MESA PERMIT NO. TRACT NO. t:OT NO. BL'D NO. CONSTRUCTION PERMIT �- � . ' " ��: 9909 10)L3-9'/62 14.50 TL Project Address I.♦�. TYPE OF CONSTRUCTION � Owner r) A AdP one ' y ❑NEW ❑ADD ❑ ALTERATION'- Address ❑REPAIR ❑ CONVERSION,r❑DEMOLISH ❑ OTHER ZONING REGULATIONS Arch/Eng. License No. -� Address DESCRIPTIONOFWORK A P ZONE "PLNG. REF. - . CorltrBctor1 Phone 7�`[( tJV`J J T i - YPE OF PERMIT. -, B N BUILDING:' ,- •' PROPERTY LINE ' Add;•ess' ' C4 -P4Lk"14 XA14HCJ0)❑;GRADING'• ':❑ FOUNDATION ❑ STRUCTURAL SETBAC L ST. SIDE YARD FT Y LICENSED CONTRACTOR DECLARATION-. ❑lTENANT,❑ ELECTRICAL_• ❑PLUMBING El MECHANICAL SIDE YA - I hereby affirm thWt• I am Licensed under provisions of Charter 9 (com- ' RIGHT mencing with section 7000) of Divlslon 3 of the Business and •❑ OTHER Professions Code% and my license is In full force and effect. REAR YARD (TO P/L) 0 y42 17 PROJECT DESCRIPTION - License Class �- is a PKC, SPACE REQ. PROVIDED Sq. FT. Date �tTri __ Signature • STREET WIDTH PARK FEE $ ,WORKERS' COMPENSATION DE LARATION OCCUPANY CONSTRUCTION TYPE C ' I hereby affirm that I have a certificate of consent to sett-Ensure or,a ' ;ficate Workers' Compensation Insurance, VALUATION ZONE ZONING APPROVED BY ,DATE "�•_, of or a certified copy SPECIAL CONDITIONS: ,of (Section 3800, tab, C.). GRADING CU. YDS- ACRES .,cy No.' _-. Company. - -• - -• -- - - - - -. - V ❑ Certified copy Is hereby furnished.._ - __ ❑ Certified copy is filed with the city Building Division. REMARKS: - - 7 7 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 7- - - - (This section need not be completed if the permit,is for one hundred - f. - `- ($100) or less). I certify that in the' performance of the work for which this=permit is issued, 1 shalt not employ any person in any man r so as to ecome PLUMBING.' .; ,.y PLAN CHECK _ ELECTRICAL _ PLAN CHECK -- subjec to a kers' Compensatto rni _ _ _ BATHTUBS - 'SHOWERS _ Date` SignatureAGIE- ., NOTICE: If after making this declaration, you should tree me subjectFKIT.-.SINKS ILETS - + URINALS `•• :GENERATDR - •p=1 KW 1.10=KW'' to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER -- � - _ • - - forthwith comply with such provisions or this permit shall be deemed'VATORIES _ •. DOUBLE LAVS '" APPLIANCE 10-50 KW�50+ KW, revoked. _ _• CONSTRUCTION LENDING AGENCY Y _ DISHWASHERS -' 'MOTORS ' 0-1 HP _ 1-10 HPIhereby affirm that there is a construction lending'agency for the per-RVICE SINKS SUMPS ,(INC, SOLAR) 10-50 HP'50 + HPformance of the work for which this permit is issued (Section 3097Civ, ,� Lentler.'s-Name er,' OOR SINKS •FLOOR DRAINS FIXTURES•'• OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS "`j -GAS TUBE SIGNS - i. _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for - INTERCEPTORS CLARIFIERS ,POLE LIGHTS ' the following reason (Section 7031.5 Business and Professions CoderSWIMMING POOL " P TRAP - Any city or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE- ALTERATION PANELS MAIN SUB improve, demolish or repair any structure; prior to its issuance,also re- quires the ap,,Iicant for such permit to file a signed statement that he GAS SERVICE •OUTLETS • SERVICE "--` - .• AMP - Is licensed pursuant to the provisions of the Contractor's License Law pier 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - iess"and Pro=fessions Code),or that he is exempt therefrom and the - for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS.of any applicant for a permit subjects the applicant to a civil penalty- not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ 1, as owner of the property,-or my employees with wages as their sole compensation,_ will do the work, and the.structure is not intended _ _ SOLAR PIPING SYS.. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License, Law does not apply to an owner_of a property _. -- - . ISSUE FEE APPLICATION APPROVED BY-'•'DAT,E - . who builds or improves thereon, and who does such work himself or. through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK FEES' intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden SUMMARY OF ; of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING "' PERMIT $ - SMIP;$ ❑ 1, as owner of -the property, am exclusively contracting with AND DUCTING - _. - " - - '-- - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT', ireason' and- Professions Code: -The Contractor's LEcense'Law does not apply to - - ' -• -ISSUANCE $ an owner of property who builds or irnproves thereon; and who con. REFRIGERATION 0-100,000 BTU PLUMBING $ , 'S_ ' tracts from-such projects with a contractor(s). Iicesned-pursuant to SYSTEM - - - -GRADING the Contractor's License Law), 100,000 + BTU PLAN CHECK $ - Q ❑ I am exempt under Section - - B`& P. C. for this BOILERS BTU ELECTRICAL $ $ SYSTEM REPAIR, ALTERATION MICROFILM $:• PLAN CHECK $ , ' Date Owner -'TOT,AL FEE $_' -1f• I hereby certify that I have read this application and state that the above XHAUST SYSTEM MULTIPLE MECHANICAL $ LE55 A - LESS AD- information is correct. I agree to comply -with' all city and county - PL'AN'CHECK $ _ S.- +� ordinances and state laws relating to construction, and hereby authorize __ - .- representatives representatives of this c' y to enter upon the above mentioned - • property f ee4•ian o I Signature Date �� y� - FINAL FEE $ Drivers' License or SS ISSUE FEE ,� d❑ - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # � Date Inspector POOL & SPA ; AP,permit # ; . - Date Inspector PROVALS 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location.- ocation. - - - 2. Soi ipe n rgrn 4. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbin '& Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7, Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn - 51.� Backwash Lines P -Trap- ❑ Urfdorri 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection' 53. Backwash &,Recefor-Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing "55. Piumbong-Systern - Final 14. Rough Electric -Conduit - :56. Electrical -Final 15. Rough Electric -Wring' - 57. Solar System -Final 16. Rough Heating & Air ConditioningFencing &Access Approval 17. Ducts in Structure_ 59. APPROVED FOR PLASTERING " 16. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL " 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame -and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final - 28. Final -Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32: Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. LandscapeSp6inkling System r i 36. Sound Attenuation i 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison ;` < _' 41. Gas Release to Southern Califofnla Gas Co. 42. - CERTIFICATE OF OCCUPANCY -No Date _ _ - City of Costa Mesa j1 Building Safety Department I CERTIFICATE OF OCCUPANCY . . P.O. Box 1200 Costa Mesa, California t The Building located at }`I 3151 I'dii-ray -weenie '1[A-2 has been inspected and f6 44und to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 �G Occupancy. II r Use of Building lnterL Altarat ops Legal Description 42l-1_�l (See reverse side for Metes and Bounds) .,H-5394 B- 99 E-2224 M-634 Building Permit No — '42,4 Electrical Permit No. -P-5390 Plumbing Permit No. 11-761 Number of apartments —fi— and/or guest rooms —0— ISSUED TO: I� Building Official r / Shearscm American E cornss t,17. E. Clmd for V. C. Nowton, Bui3.din�- -Divisio Date Q1Y'r This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. ,� w Form BU 34 Rev. 11/70 l I City of Costa Mesa Building Safety DepartmentCERTIFICATE O F i! O C C U P A N C Y3257 P.O. Box 1200 Costa Mesa, California The Building located at Wtnrn,r3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group ..3--2 OCcUpancy Use of Building rrwM r•.rc�ial Offir-P!'i1?lc3inrr — Tnf�rinr 10tj:-rni-irinei Legal Description A.P. �-A27--2141-0r, (See reverse side for Metes end Bounds) Building`Permit No. L'� c;— -=—Elecfrical Permit'No�'-L7=*LW�-2-2 Plumbing-Permit:No. �LLL'� Number of apartments and/or guest rooms ISSUED TO: Building Official by * r -rf; �rj t ' �ACiFIC Fr'A'L, 4T Victor C. Date Jarrn»^ ! �'F. 1 S'R2. This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C.I. Form BU 34 Rev. 11/70 ADDRESS OFBWLDM: 3151 AIRWAY AV UMT. A CITY OF COSTA MESA -- BUILDING PERMIT - OnE1TSNUE IFWL ww! EXECUTIVE GUILD PERM NO: B 075187 ADDRESS: 3151 AIRWAY AV PERMIT N $ 075187 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA, CA 92626 APPL.MMUNGADORESS: CONSTRUCTION TYP : -N PERMIT TYPE: STR PURPOSE: OTH AKWECTORENMEER: LIC. NO.: JOB DESCRIPTION : T/OFF AND REROOF AIR COND WELL W/CAP SHE SQ FT; 426 ARCH. OR EN4'S ADDRESS: UHT: CLAIM VALUE: 426.00 CALL -VALUE: 426.00 GROUP OCC: B--2 / CONTRACTOITSNAME' CUSTOM ROOFING INC (714)997-7108 coNTRACTDITSMAIDMI 10952 GLEN ROBIN LN COMMENTS: PARTIAL RE -ROOF AT AIR COND WELLS ' Awns& ORANGE CA uc.No.: 670866 *** * *it•it• �E�E ******* * * �Eir_it****** . 92669 • UNIT: Z 0 N I N G R E Q U I R E M E N T S LICENSED CONTRACTORS DECLARATION: i hereby affirm undo perafty, of perjury that I am licermed under provisions of Chapter s S E T B A C K S (oommancintg with Section 7000) d Division 3 of the Busineea snd Profasorns Code, y n scee is in f td affect. .- CITY LIC. ND,: �IC.CLUB: C3 6 ------------- MAIN' BUILDING ----------- --_----_--- ACCESSORY BUILD-ING�--- � ------ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: f i. FT IN �nale: Cont�— LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: k FT; IN — JWNER BUILDER DECLARATION: I hereby allium under penalty of perjury that I am exempt from the Contramsrs License Law for the ' following reawn (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to muit uct, after, improve, PARKING REQ : P R O V : PARCEL: 00000000 Z N E : REF NO : demolish, or repel any structure. prior to as issuance, also requires the applicant for such permit to file a signed awamam ts� he or she PLANNING NOTES > is licensed pursuant to the provisions d the Contractors License Lew [Cheplr 9 (commencing with Section 7000) of Division 3 d the Busineea and Professions Code[ or that he or she is exempt therefrom and the baro 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 155001). > �^ iE iF iF iF iF * iF iF * iF iF iF ?'F *"�F ?'F ?'F ?'F ?'F ?'F ?'F ?'F ?'F ?'F ?'F ?'F * * ?'F it it iE iE iE �F �(• �(• iE iE �E iF iF iE ?'F ?'F iE �E iE �E iE * iE iE �E iE iE 1(• iE iE iF ❑ 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 D E V E' •In O P M E N T S E R V I C E S R E Q U I R E M E N T S or offered for sale (Section 7044, Business snd Professions Code: The Contractors License Law does not apply to an owner d property , who builds or improves thereon. and who does such work himself or herself or thrash he or her own employees. provided that such impnovermaxs are not intended or offered for sale. a, however, the building or improvement is sold within one yew of oomptelion, the ZONING APPROVED B Y, DATE: owner -budder will have the burden d proving he or she did not build or improve for the purpose d sate)- ❑ 1. as oween of the prop". am exclusively contracting with LioeFsed contractors ro construct the proied (Section 7044, Business and Professions Code: The ContractorsLicense Law does d builds improves BUILDING APPROVED BY DATE : not apply to an owner piopana y who there . arid who L� cordrecb for such protects with it o0mredor(s) licensed pursuant to the Contractors License Law). /. ❑ I am exempt under Section: B. a P.C., for this reason: AP PL ICAT ION: ISSUED BY ; DATE: Date Owner.LEGALIZATION-:N f F E E S U M M .A R Y STRUCTURAL SEGMENT:Y I do hereby certify that I ern aware d end understand the requirements of California Heafth rd Safety Cafe Sections 25505, 2553:1, two ' 2553x, and that i awry tuiure building oaufpsnr will I will not (circle one) need to oxmpiy with said slate codes and the requirements for a permit far construction or rnOdifir�ion from the Ai uta i yTiranagrrwt fisrip. Residruial o�xgtnrGan appfeatir® are exempt from these BLDGM T PLUMBING ELECTRIC MECHANIC FIRE SM I P / R E S-�' GRADING provisions. PERMIT 1 . 00 c Data: Applirar,t: d SMIP/NON' RES PLAN 500 , WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following dedwations: ISSUE FEE ❑ 1 have and will maintain a certificate of consent to self-insum for workers' compensation, as provided for by Section 3700 d the labor BUILDING -DIV - > PERMIT ISSUE PLAN -CHECK' �� TOTAL PAID D U E Code, for the performance of the work for which this permit i9 issued. "vrsurance. TOTALS — — — — > 15.50 0.00 0.00 15.50 15.50 . I have and will mdntm workers' Oompemeetiom m required by Section 3700 of the Labor Code, for the perfamems d the .00 work for which this permit is issued. My workers' compensation insurance carrier and poke number are: Carrier: STATE FUND EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: - 15.50 OVER/SHORT: .00 Pol"ryNumlaer: 01/01/96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/_TOT GRADING PLAN -CHECK I (This sadion Food nor be comptated l the permt is for one hundred domm JS1001 or fess) 15.00 " _ .50 /- ❑ I certify that in the performance d the work for which the permit is eared. I shall not em cry person in any m so as to s / become subject to the workers' compensation Laws d California. end spree °hall become workers' 3E *)( iE )( )( )( )( iF iF )( iE iF iF iF iE iE iF iF iE iF iF iF iF iF iF iF iE iE iF iF iF iF iF iF iF iF iF iF iF * iF �E �E �E !E iE iE iE iE �F �F iE iE iE *)( iF iE iE �F �F �F �F �F �F �F i6 iE iE iE IE iE iE iE `on'p!e``mati°m novmsrona d '- ion 3700 of the Labs n cOmpty I N D I V I D U A L F E E T$ R E A K D O W N l Dale: I• ~ r � — L Appfcam: / Warning_ Feature m *scum workers' compsrurlon ewsrays Is unlawful, and shall aetDleCt an'srtlploysr ro crWrial peltaltlsa and TYPE QTY D E S C R I P T I 0 N UNIT COST TOTAL COST drill fines rpt to one hundred thousand dollar (Sy0QOW1 In addldon to the coat of compsnsatfor4 damages as povtdad for In Section 3706 of the Labor Code, Interest, and anorn afees. SFC 426 REROOF BY VALUE COMMERCIAL N037.ONE 1.00 426.00 CONSTRUCTION LENDING AGENCY: I hereby affirm under parially, of perjry that there is a construction lending agency for the _ END OF F E E S e " performance of the .cork for which the parmi is issued (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: i } I certify that I have reed this appframion and dale that the above irdamation is correct. I agree to comply with aft dry and oaunty ordimenccss end state laws miming to building axrstrrrGion and hereby eithor¢e repreeematives of the city to enter upon the above-mremionad property for inspection purposes. R I T Z E - atria Date:' Signature oratty - {515146 .y J Y `— -WP) While -Build ng b Safety, Gere nRk Canary-Appicam: Pink -Revenue; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector �� ;SPA 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. Stee! Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE ` 7. Footings _ 58, Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd.. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System `'r 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 - Finati - 14, Rough Plumbing �'h 65, Electrical -f=inal 15, Rough Electrical -Conduit v 66. Solar Sysiem•FinaJ 16. Rough Electric Wiring 67. Fencing & Access Appro4al 17. Rough Wiring Sign 68. APPROVED FQR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT -APPROVALS. Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure _ 1 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test - 72. Underground Flush -T 2Q noor rramfng I j 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil L5. Roof Sheathing `��'� 74. Overhead Hydro : �. Dry Chemical fctructurall & Monocoat 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL - r 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 SO N 4, • 36. Hood -or Canopy 37. Final Factory Fireplace 38. Final Plumbing �-V�vr �1- 1YYYY (r0 -elf-C 5 r 39. Water Service -Final r 40. Gas Service -Final 41. Solar Domestic -Final 42, Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation . '. ,. Handicap Regulations 47. FINAL STRUCTURfn.t LOVG 48. FINAL $ y 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa is Development Services Department. Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 33-51 XTRWAY AMM' SUITE 0B--1- has 13-1has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building OFFICE Legal Description 427-291-14 (See reverse side for Metes and Bounds) Building Permit No I=QARti Electrical Permit No. F•'+-•Zf 0OR Plumbing Permit No. Mechanical Permit No. M-1 AA47 Number of apartments 1. and/or guest rooms ISSUED TO: Building Official 6r AK 6_��•!G sw-ARsojN/A—rqrTCA R 19000 2MACARTHUR, 1OWPOi T BFACU, CA. Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premi and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 Ie) U.B.C. CMF 1015-46 rev. 1/83 white . Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Building Safety Department . P.O. Box 1240 Costa Mesa California 7 1 CERTIFICATE i OF OCCUPANCY 31.85 . i The Building located at '!7S1 Mr. ,—y B+?j has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicablei thereto I fora Group R-2 Occupancy. j Use of Building_ r!=1"'� ��'� "' WZ-1-a Legal Descriptioh A_ A. "x.27-241-33 (See reverse side for Metes and Bounds) Building Permit No "-..'�^!t�) Electrical Permit No.T—�2311'2—r-252 Plumbing Permit No. Number of apartments and/or guest rooms ISSUED TO: Building Official by V. C. J.Z,-jte: -1_ Date 12,_1 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the pre`rnis+ tr Building Official of the City of Costa Mesa under Sec. 306 Ie) U.B.C. Form BU 34 Rev. 11/10 I andiSHALL NOT BE removed except by the k City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY P.O. Box 1200 i.tip 3 1 8'3 Costa Mesa, California The Building located at'a1S1 n4-m-mir tainyrntr+ Fhiii- has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group T3-2 Occupancy. Use o f Building 'ilartani- Ymrn^rrctr±rro—Int — Offic1 Legal Description A. P_ M.77-291-13 (See reverse side for Metes and Bounds) Building Permit No A—'1anf1 Electrical Permit No)C=!7til/T=_Agr'7 Plumbing Permit No. r-�^�Pr,1 E-3847 Number of apartments -A— and/or guest rooms —n— ISSUED TO: Building Official by arco�/ �xicaai �mm � V. Cl ay D pian Diz=tDY Date This Certificate of Occupancy SHALL BE posted in a conspicuous place an the premises andrSHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.G. Form BU 34 Rev. 11/70 . slCC6 1. ;;• City of Costa Mesa: Building Safety Department C E R -T I F1 C A T• E O F OCCUPANCY �rc P.O. Box 1200 z ti, i- 3461 Costa Mesa; California ` The -Building locate{ at ' 3151 AirwaV A -M -nue ?I B-1: ' has been inspected and found to comply with the provision's of all City of Costa Mesa Ordinances applicable thereto for a Group P --)i Occupancy. �f Use of Building C` rrial - Tnt••pricir hi i-, rt at-inn�; Legal Description 7k,"'_il-tkd,)'7-)(,1-nF_n4 f1'7-nR (See reverse side for Meted and Bounds) - ---Building-Permit-Nlectrical,P.e�mit_No.-• '�'��4 Plumbing_Pecmit No. 11 Number of apartments -I)- and/or guest rooms -n- ISSUED TO: s Building Official,' ` by' .G�.-�/ �r WF�,ZERN _PATIFIC FITS .WCE 91 Vi:Ctor C., Ne tM-Direc. on ElUi.ldi ng Divisi= Date Sezo'tnrber 22. 1981 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT -BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 ie1 U.B.C. K 'Form BU 34 Rev. 11/70 i, d r f CITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 - Fax(714)754-4856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER B08-00206 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93894027 DATE ISSUED: 07/10/2008 ISSUED BY: YH JOB ADDRESS: 3151 B AIRWAYAV,CM. r'Sijite/Unit: -B Vicinity: BLDG- B - Squares: 0 = •Valuation: : $19,363.00 SCOPE OF WORK: REROOF-'SEAR OFFEXISTINGWOOD SHAKE, REPAIR SHTG AS NEEDED, ,INSTALC1: LAYER OF 15# FELT & 83 SQR'S OF 40 YR. CLASS A COMP. SHINGLES- 4:12 PITCH ROOF, *` OWNER: CORP OF THE PRESIDING'BISHOP CHURCH OF LDS "', Address: r %STORSTAD; KIMBERLEY E %PROPERTY RESERVE,-;. vY''' �' • Unit: 10 E SO TEMPLE ST #400 J PHONE: E 15. - .` ,E, ;City/StatelZip: BRUCE CHRISTENSENi. ;t r.. - APPLICANT: HANSEN_DUKE f F Address: N6646636 PHONE: - - CitylStatelZip: CONTRACTOR: ROSS AND BARROWS INC r License No. 327802 Address: 260 E ALTON AVEUnit; PHONE: 714-557-7440 City/State/Zip: SANTA ANA; CAs ' , 92707 CELL: ARCHITECT: , License No. PHONE:; ,= ENGINEER: License No. ='PHONE: FEE SUMMARY Reroof Plan Check: -$0.00'TU r 83 Reroof Permit Fee: $321 25 ,• a :�' Reinspection Fee: $0.00 'Ai } TOTALFEES $321.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CDDE t, INREcnaNTYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re -Roof 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition DATE INTRIALS CODER I115PECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildinglOccupancy g� INTMALs WORKERS' COMPENSATION DECLARATION§ I hereby affirm under penalty of perjury one of the fallowing declarations:. , ❑ 1 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. 2I 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: Carrier. (This section need not be compleled of ft penng is valued at onehundreddollars (3100) or less) P�y.Number: ❑ 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 tabo Code, I s II fo with comply with these provisions. i- Applicant's Signature IDate 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 DOLLARS ($100,000), IN ADDITION 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 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. Lic Class:#_ -G7 Contraclor's ignature Date CONSTRUCTION LENDING AGENCY: ❑ 1 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 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 ($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 3057-46 (3/07) Date Owner ID verified by drive rise. ❑ Yes ❑ No w. .. Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): , r 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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. s 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. ignature o! L er(sJ CAndlo('AuthorizedApplicant Date (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cEMILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Status: ISSUED Suite: B003 Applied: 08122/2006 Vicinity: Issued: 09/1112006 Primary Oa: B Eat<501 Office/ Bar<50 Type of Construction: V -N Parcel Number: 93894027 Zoning: Applicant: VEITH, GARY Address: 2822 WALNUT AVE STE E Phone: 714-734-6074 ISSUED BY: TUSTIN, CA _ Zip: 92780 owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE 10 E SO TEMPLE ST #400 Phone: BRUCE CHRISTENSEN Zip: 84133-1122 Contractor: M A NOURSE, INC. ; Address: 2882 WALNUT AV SUITE E '" Phone: 714-734-6074 ' TUSTIN, CA , Zip: 92780 License: 617556 Arch : GLESS, ARIC Eng: Address: 4931 BIRCH ST Address: Phone: 949-852-0585 Phone: NEWPORT BEACH, CA Zip: 92660 License: C11855 License: SCOPE OF PERMIT 2,168 S.F. INTERIOR TENANT IMPROVEMENT FOR "JFA INC" IN UNIT B003, WORK TO INCLUDE: ADD INTERIOR, NON -LOAD BEARING WALLS, DOORS, FINISHES TO CREATE ADDITIONAL OFFICES ELECTRICAL AND PLUMBING. FEE SUMMARY Plan Check: $120.54 - Calc Valuation: $64,000.00 Permit: .SMTP Res: SMIP Com: Other: Inspection: Total: $741.75 $0.00 $13.44 $0.00 $0.00 $875.73 SETBACKS MAIN STRUCTURE Front ; 0- 0 ACCESSORY Front 0-0 PARKING Existing: 0 Rear • 0- 0 Rear 0-0 Required: 0 PLANNING & ZONING Left 0-0 Leis 0-0 Proposed: 0 Claim Valuation.- Rear aluation: Right 0- 0 Right 0-'0 i ,/ $64,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12.21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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) 7545626 2446-0 (6=) DECLARAT16NS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to sell -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' co ensantion Ins rants ca and polic number ere: 1 Ca _ - � 1 1 T� r 1✓ _ Foltty.Number I .� Z 3 �p Z (7 G f~� settlor read not be completed if the permit is valued of ore hundred dollars ($100) or less.} ~' I Certify that in the performance o! the work for which this permit is Issued, i shall not employ any person in any manner so es to become subJect to the workers' Compensation laws of California, and agree that 1! I Should bac subJect to the workers' Compensation provisions of Section 37 0 of th shot Code, I shall forthwith comply,with tthese provisions E� Ap c t.Signat ure 4Q dt I Q to Date: WARNING: FAILURE TO SECURE RKERS' COMPENSATION COVERAGE IS UNLAWFUL AND Sr•tALL SUBJECT AN EMPLOYER TO CRIMINAL P(NAL-nd AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,OD0), IN ADDITION 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 underprovJsio s o C t 9 {commencing with Section 7000) of Division 3,of �the.Business and ofessions Code, and my license Is in full force and effect. 06-4f—")((fly (( �A 118`41 &-s-$ # 16_1111 Contractor s Signature: Dat, `� 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 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 ($500).): ❑ I, as owner of the properly, 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 Licenso Law does not apply to an owner of property who builds or Improves theroon, 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 drivor's license. ❑ Yes ❑ No Driver's License No, Expires: Verification of Ownership by (typo 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 then thirty-six (38) 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? ❑ 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 then 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 ❑ 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 quantiry 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). .....................................l--.............................................................. .......................................................................,........................................................................................................................................ 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 Q 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. ................................................... - ............................................................................................................................. _....... ................................................ 1111... ......... _... 4 If an RMPP is prosentiy required, has Section 25534 of the California Health and Safety Code been fully Complied with? ❑ Yes ❑ No ........................................... ---•--...--•-----....................................... .....................--....................................... --•..................... ...................................................................................................................... 5 Does Or will the applicant or present or future building occupant require for the work which is the subject of this a ptication a Eermit for such construction or modification from the South Coast Air Quality Management District or from any other air potJutlon control district or agency? tl Yes (J No (Section £5850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .........--..............................................................................................................................................................................................................................•---............................. .....-* ............................................................................... B Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). m ....................._.................................. ...._.............................................................................._.._...................:............................ -••--....................... ........ ......h�..n.L....................... _.................... 7 If a Permit from tha South Coast Air Quality Management District or other air pollution control district or agency is required for the workwhich s the subject of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No ..................................----------------......................................................................................................................................................................-•---------......................................................................................... 8 pt yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I cartify 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. A Signature 01 er(s) ' rate ��— FAnd ,er uthorized Applicant— X rrQste�-- CODE t. INSPECTION TYPE INTRIALS CODE! INSPECTION TYPE 2M fNTITIALS 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Black/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 �� 6 0-0- - (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.c9-ftCTRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite No 8003 Vicinity: UNIT 8003 Parcel Nunmber: 93894027 Applicant: THOMPSON, RICHARD Address: 1401 N BATAVIA STE 112 Phone: 714-288-8120 ORANGE, CA Zip 92867-3504 Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE FEE SUMMARY 10 E SO TEMPLE ST #400 Phone: BRUCE CHRISTENSEN, Zip: 84133-1122 Contractor: i THOMPSON ELECTRICAL CONSTRUCTION Address: 1401 N BATAVIA Temp Dist System / Lighting STE 112 Phone: 714-288-8120 Temp service test ORANGE, CA Zip: 92867-3504 Busway 1100 ft $0.00 License: 360849 ISSUED BY: Status: ISSUED Applied: 0 911 1 2 006 Issued: 09/112006 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Caiifornia.statute and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automaticalty expire and become void if work is not commenced within 180 days, 1 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) 7545628 244846 (&W) SCOPE OF PERMIT ELECTRICAL PERMIT FOR2,168 S.F. INTERIOR TENANT IMPROVEMENT FOR "JFA INC" IN UNIT B003. REF#: B06-01423 WORK TO INCLUDE: 5 LIGHT FIXTS, 17 OUTLETS, 8 SWITCHES AND 1 SERVICE TO 200A. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System / Lighting $0.00 0 Temp service test KOO Busway 1100 ft $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 I Spa $0.00 0 ................up to 10 kva/kw $0.00 0 Lighting Fixts $5.50 5 .........up to 50 kvalkw MOO 0 Recept Outlets $18.70 17 .................up to 100 kvalkw $0,00 01 Switches $8.80 8 ..................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 $30,50 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 1hp $0.00 0 Circus (mech ride or lights) $0.00 0 Motors to 10hp MOO 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 $87.00 Intermed Pole $0.00 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Caiifornia.statute and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automaticalty expire and become void if work is not commenced within 180 days, 1 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) 7545628 244846 (&W) 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 1199 permit is issued. ❑ 1 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 work8rs' ro pe on Insu nce carder and policy number are: `� o -Carrier �;�a .r - -_- [Zr d �3 .T- (This.sactlon need not be comptated ff the perrnif Is valued of one hundred dollars (3100) or less.) ❑ 1 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 p _y Applicant Si�nature: �Ofl[e: fx_Q Ir WAF,iNW FAILURE TO SECURE WORKERS' ENSATION COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLI.ARE (5100,000), IN ADDMON TO THE COST OF OOMPENSATICN, DAMAGES AS PROMDED FOR IN SECTION 37011 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Secilon 7000) o1 DMsion.3 of the•Business and Professions Code, and my license is In tuft .force end effect tic, a - -sz cias9 «3 (0- -,/a _Contrac oes.Signature: 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). Lenders Name: Lender's Address: Signature: Date: OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I em 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 cxvll 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 Corte: 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 contrector(s) license pursuant to the Contractors License Laws.). ❑ i em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Vedlication of Ownership by (type of document, I.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby canity that no excavation five (5) or more feet in depth Into which a person is required to descend, will be made In connactlon 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, An 2, Sec. 341, Tide B, Califomla 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? ❑ Yes ❑ No (Section 25505 of the California Health end 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 fool of compressed gas at standard temperature find pressure). _ _.................... — .......... - _ ----....._._..._—.................._._................................................................—..---- - 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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 aapp_ _plicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? [3 Yes 1:1No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation, certification and riling with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application aermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes 8 No (Section 115850.2 of the California Government Code requires that the requested Information be fumished on applications for non-residential building permits). ........................... __._................................... ..........._...._......................................._...................................****'*'*...........**.................;4 ................... .....-..........__—......... _.. -- 8 Will any part of the facility to be constructed under [his permit be within 1000 feet from the outer boundarias of a school? ❑ Yes ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). .................. I ....................................... .............................................. ....................................................... ... ............................. ........................... ........................................................... .._- ......... __ .........---- 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 dlsdosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8 (If 'fres", 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 stale 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. Si re Of Legal Owner(s) Date r Authorized Applicant =_ r`Date-� C00E A, INSPECTION TYPE I2AIE INTiTIA CODE INSPECTIONTYPE 2&B, RITITIA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof a 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Fina! Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final BulldinglOccupancy (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesa.e5tsUMBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite No B003 Vicinity: UNIT 8003 Status: ISSUED Applied: 09/12/2006 Issued: 09112/2006 Parcel Nunmber: 93894027 Applicant: WHITNEY, LANCE ISSUED BY: Address: 3295 GRAPEVINE ST J�- _ �� Ph ne-_f 957-685-7300 MIRA LOMA, CAS 1 �Zip:l 91752 Owner: CORPOF'THE PRESIDING $/SHOP C_H_URCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY_ RESERVE, G10�E SO TEMPLE ST #40�-- �� 1?ne: /� BRUCE CHRISTENSENv Zip: 84133-11i2 Contractor: ACADEMY,,MECHANICAL /n Address: 3295 GRAPEVINE ST Phone: f 951-685-7300 if? MIRA L'OMA, CA ( Zip: 91752 ,,:License:.457040," oo FEE SUMMARY, 1 '�A � � � �', II AMT �_ �L j� ti r � �'ANIT ��'� �. � �� AMT ISSUE FEE $23.50 Laundry Tub,/ Washer $0.00 0, Sump Pump f f' $0.00; 0 Backflow.irrigation �, $0.00 0 Landscape Irrigation _.----$0;00 i' 0 Swimming Pool ��'� J $0.00 "0 Backflow Preventer �1'ti,� $0.00 0 P -Trap $0.00 0 Trap Primer i - , $0.001', "o Bathtub ` $0.00 0-) Pressure Regulator <$0:00 0 Urinal ; -$0.00 ' 0 Clarifigr,System \ ` $0.00 0 Process Piping (per loft) -$0.00 _J-.0 Vacuum Brkr,Bkflow(1-4) _.$0.00 r' 0 Connect'(Ice,Soda,etc) \ 50.00 0 Receptors $0.00 0 Vacuum Brki Bkflow(5+)� $0.00 0 Dental Units ` �• \$0.00 01 Septic Tank t,�. t'2^ ' $0.00 0 Wash Basing' t, $0.00 0 Dishwasher $9.80 1 Sewer Cap16i Demo "...50.00 0 Wash Basin Set � ; /$0.00 0 Drain, Floor \ 50.00 0, SewJ Conned o $0.00; �,� 0 Waste.and Vent System / 1$9.80 1 Drain, Rainwater $O:00 `� 0j . _ Sewer Private Line ° $0.00 } 0 .;? ; _. Water Close! (Toilet) 1$0.00 0 Drain, Roof " $0.00 \0� �" `:`r 'Shower '.:� �c , , ' ` �� r �+% �� o _ $0.00' O r r" '�>' Water Heater/ vent /50.00 0 Drinking Fountav\ $0.00 �0 ;Sink; bar �" p�I $0.00 0 J�,Water Piping (Inst or Rep:) $9.80 i Expansion Tank ��\ �$D.00� pig _Sink, commercial , , $0.00 0 ! VIIa1er, Rd -pi pe,; %� $0.00 0 Gas Earthquake Valve �$O.00r 0��\ Sink, Floor " $0.00 0 - �WaterSe`rvice' / % $0.00 0 Gas {1 4 outlets) ��$0.00 ��il Sink; kitchen ` $29.40 _3.-= Water Softener// $0.00 0 Gas (Over 4 outlets) $0.00 C Sinii;aervioe/mop ;=_ -$0:00_: -0 \�OTHER� /�� $0.00 Gas Repipe <$0.00 o Spa (priv`ate)� $0.00 0-1 tVlOt ATIQNj $0.00 Gas Service $0:00 0 C 'Spa (public) $0.00_"' r0 ,-) PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.000 r I c�1 --. i i REINSPECTION $0.00 0 Interceptors (Sand Auto) $0.00 i;� ,,,,TOTAL: CALCULATED FEES: $82.30 COMMENTS l-SPECIAL'CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days, or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: to 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 SCOPE OF PERMIT--�"_ % 'PLUMBING PERMIT FOR 2,168 S.F. INTERIOR TENANT IMPROVEMENT FOR_"JFA�INC" IN UNIT 8003./ / REF#: B06-01423 I WORK TO INCLUDE: 1 DISHWASHER iKITCHEN•SINKS 1 WASTE AND VENT SYST, 1 WATER- \ PIPING (INST OR REP).'_= 1! �✓ 11 ,+ ; ; Ii 1 �+ �.: �l� 1; , f FEE SUMMARY, 1 '�A � � � �', II AMT �_ �L j� ti r � �'ANIT ��'� �. � �� AMT ISSUE FEE $23.50 Laundry Tub,/ Washer $0.00 0, Sump Pump f f' $0.00; 0 Backflow.irrigation �, $0.00 0 Landscape Irrigation _.----$0;00 i' 0 Swimming Pool ��'� J $0.00 "0 Backflow Preventer �1'ti,� $0.00 0 P -Trap $0.00 0 Trap Primer i - , $0.001', "o Bathtub ` $0.00 0-) Pressure Regulator <$0:00 0 Urinal ; -$0.00 ' 0 Clarifigr,System \ ` $0.00 0 Process Piping (per loft) -$0.00 _J-.0 Vacuum Brkr,Bkflow(1-4) _.$0.00 r' 0 Connect'(Ice,Soda,etc) \ 50.00 0 Receptors $0.00 0 Vacuum Brki Bkflow(5+)� $0.00 0 Dental Units ` �• \$0.00 01 Septic Tank t,�. t'2^ ' $0.00 0 Wash Basing' t, $0.00 0 Dishwasher $9.80 1 Sewer Cap16i Demo "...50.00 0 Wash Basin Set � ; /$0.00 0 Drain, Floor \ 50.00 0, SewJ Conned o $0.00; �,� 0 Waste.and Vent System / 1$9.80 1 Drain, Rainwater $O:00 `� 0j . _ Sewer Private Line ° $0.00 } 0 .;? ; _. Water Close! (Toilet) 1$0.00 0 Drain, Roof " $0.00 \0� �" `:`r 'Shower '.:� �c , , ' ` �� r �+% �� o _ $0.00' O r r" '�>' Water Heater/ vent /50.00 0 Drinking Fountav\ $0.00 �0 ;Sink; bar �" p�I $0.00 0 J�,Water Piping (Inst or Rep:) $9.80 i Expansion Tank ��\ �$D.00� pig _Sink, commercial , , $0.00 0 ! VIIa1er, Rd -pi pe,; %� $0.00 0 Gas Earthquake Valve �$O.00r 0��\ Sink, Floor " $0.00 0 - �WaterSe`rvice' / % $0.00 0 Gas {1 4 outlets) ��$0.00 ��il Sink; kitchen ` $29.40 _3.-= Water Softener// $0.00 0 Gas (Over 4 outlets) $0.00 C Sinii;aervioe/mop ;=_ -$0:00_: -0 \�OTHER� /�� $0.00 Gas Repipe <$0.00 o Spa (priv`ate)� $0.00 0-1 tVlOt ATIQNj $0.00 Gas Service $0:00 0 C 'Spa (public) $0.00_"' r0 ,-) PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.000 r I c�1 --. i i REINSPECTION $0.00 0 Interceptors (Sand Auto) $0.00 i;� ,,,,TOTAL: CALCULATED FEES: $82.30 COMMENTS l-SPECIAL'CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days, or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: to 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 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following dedaredons: ❑ 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 perrNt Is issued. ❑ 1 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 perrnil is Issued. .r"Myworkers' coon ensalfon lnsurqfioe carrier and policy number are: -Cartier, , Pdlcy Number. ' pie sac on need no be if a pe is valued atone hundred ddlars (S100) or less.) ' ❑ I cardfy that in the perfo co of the work for w lch th rmit Is Issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws o1 Calitomi and agree the d e subject to the workers compensation provisions d Section 3700 0} the Labor Code, I shaA forthwith comply with those provls Appll -n 8lgneture: Dater WARNING: FAILURE TO SECU OFiKERS' COMP TION CONERA�LSLAWFUL AND SHALL SUEJECT AN EMPLOYER TO CRIAeNAL PENALTIES AND CIVIL FINES UP TOONE HUNDRED THOUSAND DOL ARE ($100, IN ADDMON TO THE COST Of CAMP, DAMAGES AS PROVIDED FOR IN SECTION 9706 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licanVp under pro sions o1 Chapter 9 (commencing with Section 7000) of Division 3 o1_the Business and P ofesslons Code, and my license is In full force and effect... Uc. 0 - . CC lase M_ Contractors Signature: ' Date: CONSTRUCTION LEN G AGENCY: ❑ I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued. (Sec. 3D97, Civil Code). Lenders 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 Profsssicns Code: Any dty 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 penally of not more than five hundred dollars ($5500).): ❑ 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. 11, 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 Lew does not apply to an owner of property who builds or Improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ 1 em exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Fires: Verification of Ownership by (type of document, i.e. - property tax big or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby ceMly that no excavation five (5) or more feel 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, of demolilicn or dismantling thereof, will be more than thirty-six (36) feet high. (Chap, 32, Grp 2, Art 2, Sec. 341, Tltle 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? ❑ 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with some excep(ions, requires registration with the Costa Mesa Fire Department by each business which at arty one lime 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 loot of compressed gas at standard temperature and pressure). _ _............... -- ---- ................................. 3 Does Boor will th❑e applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? No (Section 25534 of the California Health and Safety Code provides that the Costa Mese Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required 10 register acutely hazardous materiels with the Fire Department. 4 If an RMPP Is presently required, has Section 25534 of the California Health and Safety Coda been fully compiled with? No _................................._........................................................................................................................................................................._.................—_.........._—...._... 5 Does ar will the applicant or present or future building occupant require for the work which Is the subject of this a pticatlon a edit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes jf No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residentlal building permits). 6 Wiii any part of the fadiily Io be r onstntcied under this permit be within 1000 feet tram the outer boundaries of a schod7 Yes ❑ No (if "yes'. the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code). 7 It apermit 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 prescried by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8 (If 'yes', attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I oertity 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: Dale: 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. Sign eget ner(e) Dal A/� /Z C. -AftCFrAuthorize cant --Date MW INSPECTION TYPE l Af1ID6Lli CODE R INSPECTION TYPE PAM mmm 16 lAr Fixed System Final Fire Prevention 206 Final Mechanical 5 1266 Pool Spa Final 208 Final Plumbing rl> 200 Final Re -Root 210 Final Electrical 201 Final Block(Retalning 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 (714) 754-5273 • Fax (714) 754-4856 • www,ci,costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Address: 3151 AIRWAY AV Suite No 8003 Vicinity: B003 Parcel Nunmber: 93894027 Applicant: LANCE WHITNEY Address: 3295 GRAPEVINE ST MIRA LOMA, CA Phone: 951-685-7300 Zip: 91752 ISSUED BY: Status: ISSUED Applied: 10/3112006 Issued: 10/31/2006 Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE. 10 E SO TEMPLE ST #400 Phone: f . BRUCE CHRISTENSEN Zip: 84133-1122 ' Contractor: ACADEMY MECHANICAL J Address: 3295 GRAPEVINE ST Phone: 951-685-7300 MIRA LOMA, CA Zip: 91752 License: 457040 SCOPE OF PERMIT REF B06-01423 1 FLOOR SINK 2 WASH BASINS 2 TOILETS 1 WATER HEATER NOTICE: The work authorized try this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of ISO 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) 7545626 2446-4s (6=) \\ FEE SUMMARY AMT QTY AMT., -QTY ....- AMT OTY ISSUE FEE $23.50 Laundry Tub/ Washer - "$0.00 10 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 .4 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P -Trap $0.00 :07�• Trap Primer $0.00 0 Bathtub $0.00 0 Pressure Regulator $0.00 0, Urinal $0.00 0 Clarifier, System $0.00 0 Process Piping (per 10 ft) _-.$0.00 ../','O',�_ Vacuum Brkr Bkflow(1-4): $0.00 0 Connect (Ice,Soda,etc) $0.00 0 Receptors = $0.00 ; .i0'= "°� Vacuum Brkr 8kilow(5+) ; '$0.00 0 Dental Units $0.00 0 Septic Tank $0.00 �`0 Wash Basin $19.60 2 Dishwasher $0.00 0 Sewer Cap for Demo $0:00 0 Wash Basin Set' $0.00 0 Drain, Floor $0.00 0 Sewer Connect $0.00, 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 0 Sewer Private Line $0.00 '0 Water Closet (Toilet) $19.60 2 Drain, Roof $0.00 0 Shower $0.00 0 Water Heater I vent $12.30 1 Drinking Fountain $0.00 0 Sink, bar WOO 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re -pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $9:80,,._ 1 Water Service $0.00 0 Gas (1-4 outlets) $0.00.; .• 0 Sink,•kilchen $0.00"„0 Watei,Softener• $0.00 0 Gas (Over 4 outlets) $0.00.' 0 t - Sink, service/mop $0.00 ;0. " "+r;'� 'OTHER' $0.00 Gas Repipe $0.00 01 Spa (private) $0.00 0� � VIOLATION $0.00 Gas Service 50.00 '0 Spa (public) $0.00 0 - PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 'REINSPECTION $0.00 0 Interceptors (Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $34,80 COMMENTS 1 SPECIAL CONDITIONS NOTICE: The work authorized try this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of ISO 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) 7545626 2446-4s (6=) \\ DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following dedarations: ❑ I have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the tabor 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. r_—__:; My workers' am ejn?anon Ins ran a carrier and policy number are: n� CafrQrr: _ /0v MGr muN ber: Ul[' '(71ii ss Bction need not be completed if the permit is valued at one hundred dollars ($100) or fess.) ❑ I certify that in the performance of the work foywhict>lhis permit Is issued, I shall not employ any person in any manner so as to become s bject to the workers' compensation laws of Califwland agree t ho d become subject to the workers' compensation provisions of Section 37 of I Labor Code, I shall forthwith comply with these provi ' S. Applicart-Slgnature: Defe:_ 71 r l 'WARNING: FAILURE TO SE ORKERV COMPENSAT1pN COV GE 1S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL NAL S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ( 51 J, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 0E THE LA R CO E, INTEREST, AND ATTORNEY S FEES, LICENSED CO ACTORS DECLARATION: I hereby affirm that I am licensed under rovis'o of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full for,e.and act.:Cie. N see LM' Contractors.STgnature:Date: !:!® .. — CONSTRUCTION LENDI AGENCY: ❑ I hereby affirm that there is a construction lending agency fort performance of the work for which this permit is issued. (Sec. 3097, Civil Code). Lenders 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 (Seo. 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).): ❑ 1, es 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 Lew does not apply to an owner of property who builds or improves thereon, and who contracts far 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 ❑ No Drivers Licanse 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: 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? ❑ 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). ............-----...._._.__....._..---.—._—_......_._...------------- I ............... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the Cel3lomle. 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 and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. _....................._......................._................................._......._.._..................................._.................................__................................................................................... ........................ _............... _._._......_............ PP 4 If an RMis presently required, hes Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ............................................................... ....................-._..... .... ---._..................................... .—-................................................................_..............._................ _.............. _............... .—.............. 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of thisa plication aEEermit for such construction or modification from the South Coast Air ouality Management District or from any other air pollution control district or agency? a Yes LJ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). .......... .........................................................................................................................................------.................................:.................................................................... .......................................................................................... fi Wilt any part of the facility So be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No (it'yee, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ................................................................................................................................................................................................:..................................."............................................................................................................................. 7 I1 a permit from the South Coast Air Ouality 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? ❑ Yes ❑ No .. .............. ........................................................................................................................ --....................... ........................................................................................................................................ -- ...................... 8 (If jtes", 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 Costs Mesa to enter upon the abovo-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 — Date Z 22 14 And/Or Authorized App n to CODE 0 INJEWfON I= DATE IKMALS CODE a INSPECTION TYPINTITLA 1616ed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 2101 Final Electrical 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 SuildinglOccupancy O W t— Q J Q } J W a O Ix CL Z W 2 LU a Ix COSTA MESA BUILDING—SAFETY DEPARTMENT P. 0. 80X iZOG Sef3 S 3a ��47/22/81 7.0,. TL Costa Mesa, California ki TRACT N0. it NO ' /� ContractorS��Tf C—a A LOT NO. Address SSI, i BUILDING USE DATE ISSUED City ,5_ , /4 l_r.{Q,4Zip Code g z-7 ti � L 4/ State License No. �4 Class. —`� BUILDING 22;� DDRESS 1.9'1 A•fr2:ra,4 .4 ✓e LAC- ..J AC e COSTA MESA, CALIFORNIA, Ro City License No. O I--r�in � NO. ITEM NO. Tel. Ho. EACH —3C FEES FAU, Wall, Or Gray. Furn. Incl. Ducts and Vents to 100 000 BTU Y s' OWNER MAIL ADDRESS C(1 UO Over 100,000 BTU r CITY�TEL, NO. Vent (if not incl. above) �s y I hereby ackno ledge that I have read this application XE andr tate that the above is correct and agree to comply tw th'all'rCity Ordinances and State Laws regulating Heat - ing, Ventilating, Refrigeration and Air -Conditioning. I certify that I possess the above valid State of Calif - ornia classification or I am the legal owner of the single family residential property described above. Signature of Permittee Suspended Heater Alter or Replace Appliance Over 10 feet of gas piping BOILERS OR COMPRESSORS +' 3 H.P. or less Ck \ `�' Over 3 HY, to 15 H.P. 55 Bathroom Vent Fan—Sin Ie,DUCt REMARKS: _Kitchen 1� lL' Ventlfating. HOOd �jd ^J T //Y� kk Met'al.iFirO Places !! {{�j�j�ICBO �•` '04 4b 9"-4- �s1r11o%aE-[`pIr" # AGA # APPROVALS INSPECTOR DATEMise IDucts cts Undergroundcts in Structure Ventilating ating —Rough ods Plan Check Refrigeration Lines Pressure Test Reinspection Fee -Gond. Final ntilating Final Sub•Total JA ating Final.Processing Fee �frigeration Final nal Gas Test TOTAL FEES ility Co. Notified CMF 0449-46 _ BLDG. PERMIT NO. COSTA MESA BUILDING -SAFETY DEPARTMENT 'APPLICATION FaWrliUCTURAl PERMIP- . A2 TLf P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 RECEIVED Y PERMIT For Applicant to Fill in Completely — Use Ink Only BUILDING A.F. NO. ADDRESS OWNER Orj_7esterR Pacific Financial TENANT w BUILOING ADDRESS/0I ie_ MAILING C O na Olson O � UNIT N SPACE NO. ADDRESS X9�6iD. BLK. TEL. s 41 79-3Parcel 1 CITY r e a 2 NO. -2 NEW A00 ALTER REPAIR MOVING DEMOLISH _ RU LLEENDER�ON Western Pacific Financia X BRANCH DWNEFWestern Pacific Financial i ADDRESS (Same) VALUE ARCHITECTHales-Lan Ston US a/� �Q NEL547-086 OR ENGINEER ADDRESS 777 S. Main Orange Ca. ZONE TYPE GROUP CONTRACTOR J. Donald Olson Co. APPROVED BY DATE ADDRESS 18003 Skypark Blvd., Ste .B CITY Irvine, Ca. 92714 WEND -2606 �� 4f' �Zv� LjS .Fi STATE CITY APPROVED SETBACKS LIC. NO. 333969 LIC. NO. SIZE ND. OF BLDGS. O (FROM C/LSTREET) 12. OF LOT NOW ON LOT RONT FT. Q 4 USE OF EXISTING BLDG. Vacant Land R- SIDE v] FSeparate permits are required for L. SID FT electric, plumbing and heating work: REA FT. i' USE OF BUILDING AND WORK TO 13E PERFORMED PLANNING ACTION Q aConstruct office building shell -� 7 -/3d DATE >> 6343 S.F. APPROVE // _ tIOLD FOR SPECIAL REQUIREib hN i w 1 hereby acknowledge that I have reed this application and state pOH, that the above information Is correct and agrae to Comply with Q. all laws regulating building construction, and I shall not employ ? z any person in violation of the workman's compensation laws of o LQ the State of California. 3 1 hereby certify that II licensed as a contractor under SO. FT, a the State of California Busirte n rofesslons Code, piv sion 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that suse re In full for fe I ch lic or THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the pro" or of the S a of al rnia siness VALUATION PERMIT FEE $ to and Professions Code, D' s 3, Chapt 9. Signature of PLAN CHECK S ^� c) Permittee or 1 _ $ %831 S 6 TAX a U Authorized Agent Date , r �` TOTAL PAID za 7 COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 7 RECEIVED EIYf PERMIT 4AA For Applicant to Fill in Completely — Use Ink Only J 1 BUILDINGBld . J-1 per City A.P. NO. 27 � 2 -PI (y��nES I u ADDRESS3 151—HI OWNER OR BUILDING ADDRESS SI — IYLf%Qr Vem TENANT Western Pacific /� UNIT OR MAILING SPACE NO. ADDRESS 1601 Dove St. Newport Beach ZJR.NO LOT BILK. j CITY NOL ]52-7670 G NEW Apo ALT R REPAIR MOVING OEMOLISH CONSTRUCTION LENDER Western BRANCH Same OWNER G T�r� DlC J� f C ADDS ESS VALUE USE �jK.•L- I stf OPO ARCHITECT TEL, OR ENGINEER547-0869 4LL— V ADDRESS777 1; Main Suite 101), Orqngp ZONE TYPE GROUP APPROVED DATE CONTRACTOR BY ADDRESS 18003 Sky Park Circ. ll TEL. CITY Irvine NO. 540-2606 STATE CITY APPROV D SETBJjr LIC. No. 333969 LIC. NO. 22707 SZE NO. OF BLDGS. I (FROM C/L ST EET) LOT NOW ON LOT ONT FT. USE OF EXISTING BLDG. Separate permits are required for L. SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE Commercial — Tenant 1MproygMenr.,9APPROVED APPR VED 1 GO LJQ I hereby acknowledge that 1 have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. i — I hereby certify that I am properly licensed as a contractor under SQ. FT J 0 / the State of California Business and Profession$ Code, Olvlslon 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY., am exempt from the provisions of the State of California Business VALUATION PERMIT FEE S S end Profa$sions Coda [vision 3, Chapte 9. PLAN CHECK S ,8 Signature bf Permittee �� S /f40 00 TAX $ or Authorized Agent Date _ TOTAL PAID s 37 TL. rn i 0 to N D m W q M M a f u i COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING J-3 per city ADDRESS 3151 Airway, C.M. B-3 Rer Rlan OWNER OR TFNANT Financial APPLICATION FOR STRUCTURAL PERMIT 1, RECEIVED Ila PEftlbl 1 1117 -L 3�1 50 71,. A. P. NO. U BUILDINGd1. ADDRESS � V MAILING T OR SPACE ADDRESS 1601. Dove St NO. TR.NO. LOT BLK. TEL. clTv Newport Beach Ca. No. 752-7670 ' NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER West rPacific Financial — BRANCH OWNER ADDRESS Same , VALVE 7 ARCHITECT TEL. USE P�lrti , $�! OR ENGINEER No. ADDRESS 2ON TYPa_: GROUP 'r 2— APPROVED CONTRACTOR he J Donald Olson Company By DATE ADDRESS 18003 Sk Park Blvd. Suite B TEL. CITY Irvine NO -540-2606 STATE CITY APPROVED SETBACKS LIC. NO. 333969 LIC. NO. 22707 SIZE NO. OF BLDGS. (FROM CIL STREET} OF LOT NOW ON LO-rRONT. T USE OF EXISTING BLDG. T. Separate permits are required For L. SIDE electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE Tenant Improvements APPROVED APPROVED Ry I hereby acknowledge that I have read this application and state that the above Information to correct and agree to comply with all laws regulating building construction, and I shall not employ IYr any person in violation of the workman's compensation laws of the State of California. /' FT. I hereby certify that I am properly licensed as a contractor and v0� the State of California Business and Professions Code, Division 3, THE -AMOUNT SHOWN UNDER V LUATION IS FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION PERMIT FEE E and Professions Co Ion 3, Ch pter 9. Signature of- PLAN CHECK S Permittee37/ TAX $ or �Td/ Authorized Agent Date - �"--` - -- - ---- n' TOTAL PAID $� IJ f o, wi N J m_ q rn M M 0 LL i U t Applicant to fill in all spaces within hea CITY OF COSTA MESA 'PIT NO. _ COI�`STRIbCTION P.ERWT ie -3]f Project Address %t A Owner Phone Address v� .1 +5_ — Arch/Eng. License No. to Address ` ContractoAknni; r% h IQ L4r Phone Address `` LICENSED CONTRACTOR DECLARATION v 1 her affirm that I am licensed under provisions of Charter 9 (cam- mencing with section 7000) of -Division 3 of- the Business and Profession$ Code; and my license IS In full force and effect. r License Class — License No. Date Signature WORKERS' OMPENSATION DECLARATION ape affirm that I have a Certificate of consent to self -insure or a certificate of Workers' Compensation -Insurance, or a certified copy thereof (Section 3890, Lab. C.). / licy No company 1T 84!3 ei ` t7 Certified copy.is hereby furnished. LJ Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100) or less). , 1. Certify that In the performance of the work for which this permit is issued, t shall not employ any person in any manner so a5 to became subjeci�o the Workers' Compensathon�ew;}of �f2� Date (� Signature �� / [�' NOTICE: if after making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 Civ -C.): Lender's Name, Lender's Address ' OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason- (Section 7031.5 Business --and Professions Code: Any city or county which requires a permit to construct, alter, }III 'Improve, demotlsh-or repair any structure, prior to Its issuance, also re- quires the ap;.licant for Such permit to file a signed statement that he ts' licensed'pursuant to the provisions of the -Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Pusine55 and Professions Code) or that he is exempt therefrom and -the I for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant -to a civil penalty ,iot more than five hundred dollars ($500). [, 1, a$ owner of the property, or my employees withwagbs as their sole compensation, -will do the work, and the structure is not intended. or offered for sale. (Section 704a, Business and Professions Code: The Contractor's License Law does not apply to an owner of -a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not Intended or offered for sate. if, however, the building or Improvement is sold within one year of completion, the owner will have the burden I, of proving he did not build or improve for the purpose of sale). ❑ I, a5 owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Bu1ne$s I antlProfessionsCode: The Contractor's License -Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such -projects with a -contractors) •licesnod pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason - Date Owner — I hereby Certify that i have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state ws relating con ruction, and hereby authorize representative$ f is city t me upon the 'above mentioned ,property, for sp i rp s Signature ate border lines and sign all appropriate declarations. TRACT NO. LOT NO. B.7G,NOi TYPE OF•CONSTRUCTION(' ❑ NEW ❑-APD 1:1ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRACING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICAL ❑ OTHER r PROJECT•DESCRIPTION Sp, FT, OCCUPANCY CONSTRUCTION TYPE - VALUATION ZONE GRADING CU. YDS. ACRES .REMARKS: f Q PLUMBING 'PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAVS KIT. SINKS DISHWASHERS SERVICE SINKS +• SUMPS ' FLOOR SINKS' 4,'FLOOR DRAINS •DRINKING FOUNTAINS �INTERC$PTOR5 -� "'r CLARIFIERS SWIMMING POOL' PTRAP - WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. r. ISSUE FEE PERMIT MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU 100,000 + BTU REFRIGERATION SYSTEM 0-100,000 BTU 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE Drivers' License or SS ISSUE FEE i CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 7087 6/09/62 36.76 iTL: REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ DATE ' , SUB ZONING REGULATIONS A.P, 0 - AMP - ZONE PLNG. :f SETBACK Cf( -.p gRttE,,1fF, §T. �ROPEIRTpYNLINE ENT YARD iWDE MOTORS"' (INC. SOLAR). YARD RIGHT 1-10 HP 50 + HP REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ DATE ' PANELS MAIN SUB ELECTRICAL 'PLAN CHECK - AMP - GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW_ 1-101KW 50 + KW MOTORS"' (INC. SOLAR). 0-1 HP --" 10-50 HP 1-10 HP 50 + HP FIXTURES OUTLETS' SWITCHES - GASTUBE SIGNS ' APPLICATION APPROVED BY - DATE POCE'LIGHTS' ` -BUILDING - PERMIT PANELS MAIN SUB SERVICE - AMP - ISSUE FEE ' ' APPLICATION APPROVED BY - DATE SUMMARY OF FEES -BUILDING - PERMIT _ E SMIP S I PLAN CHECK $ PERMIT ISSUANCE $ PLUMBING $ I - GRADING. $ PLAN CHECK S i - ELECTRICAL s $ PLAN CHECK E MICROFILM_ $ TOTAL FEE $ i MECHANICAL $ '- LESS AD- PLAN CHECK $ VANCE PC S _ - - FINAL_FEE $ CONSTRUCTION AND PLANNING APPROVALS Permit # E- 7 Date - Inspector POOL &SQA APPROVALS Permi!'#. J� ° ~pate Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4.. Electrical Conduit-Undrgrn. 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE- } 7. Footings 49. Electrical Conduit-Undr rn i 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines -P -Trap. ❑ ' ndr rn - ,-10;-. Structural Floor'System 52. APPROVALTO DECK 11. Property Sewer Line &•House Connection 53. Backwash & Receptor -Final .12. Street Sewer Connection, 54. Heater & Vent -Final 13. Rough Plumbing_ 14. Rough Electric -Conduit :56.- Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts, in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing - NOTES: 22. ..Frameand Flashing 23.- Ii solation 24. Lathing & Siding 6 -OLZ 25. Drywall Nailing = - 26. Plaster Brown Coat - 27. Electrical Power Meter -Final 28. Final Electric .-yp -47 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32:- Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. "' �• ' CERTIFICATE OF OCCUPANCY No. Date - . -. . ... t- - 110 Applicant to fill in all spaces within heavy border tines and sign all appropriate declarations. CITY OF COSTA MESA F PER IT NO TRACT NO. LOT NO. B DG. N COW(RUCTiON PERMIT f' y Project Address -!51151 NWM 9- SU iTeS 5-n0_--3 TYPE OF CONSTRUCTION Owner *>. ()•LjL •"" Phone NEW it ADD ❑ ALTERATION I'"{.......U......�� r Address 1i0 REPAIR ❑ CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER DESCRIPTION OF WORK Address _ Contractor Ph6rleqJ9-&11 TYPE OF PERMIT - - Address ❑ GRADING. ❑ FOUNOATIDN ❑'STRUCTURAL ;LICENSED CONTRACTOR DECLARATION - ❑ TENANT ❑ ELECTRICAL ❑PLUMBING•%MECHANIC l hereby affirm thzt I am licensed under provisions of Charter 9 (com- 'with 3 i. , ❑ menCing section 7000) of Olvision of the Business -and Professions Cade, andmy ;teens is in full t ca an` OTHER e Q PROJECT DESCRIPTIONµ . License Class 1 i serf A I S9i32 I , - . I ' Date Signature , .WORKERS' COMPENSATION DECLARATION J5 OCCUPANCY ' CONSTRUCTION TYPE I hereby affirm that I have a certificate of Consent to self -insure or a VALUATION ZONE certificate -of Workers' Compensation- Ins ranee, ora ertifled'copy -" Q�•�a, - thereofCo CU `YDS. t ACRES �'1fil�/� Company r E(w_9 C � ertified copy,is hereby furnished. - _ _ :.: 'ARKS: ELECTRICAL $ ALJ Certified copy is filed with the city Building Division, $ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION(T.his MICROFILM section. need -not be completed if the permit is for one.hundred($100) MECHANICAL $ �l. ba or less).;Icertify_that,in PLAN CHECK $ the.performance.of the work for which this_permit isissued, rGDING Ishall not employ any person in any manner so as tobecomeMBING i•:,Jgd --PLAN CHECKsubject to theWorkers'Compensation, taws of California.Date 1 Signature HTUBS SHOWERS ;NOTICE: It after making this declaration• you should become subjectLETS _ (• ,� URINAL'SLtothe Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemedATORIES DOUBLELAVS _ - _ • --- _ _ -_ -� ,revoked. LENDING AGENCY __'CONSTRUCTIDN SINKS DISHWASHERS " - il hereby affirm that there is a Construction lending agency for the per- SERVICE SINKS - ' �' SUMPS - - - -' - formance of the work for which this permit Is Issued (Section 3097 lClv:'C.)'. "- - -- - - FLOOR SINKS FLOOR DRAINS .Lender's Name ;Lender's Address r DRINKING FOUNTAINS OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS ' the fotlowing-reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP r Any city or county which requires a permit to Construct, alter, improve.-demollsh or repair any structure, prior to Its'Issuance, also re- WATER SERVICE ALTERATION- ' quires the ap}licant for such permit to file a signed statement that he is Ilcensed'pur$uant'to the provisions of the Contractor's- License -Law GAS SERVICE OUTLETS (Chapter 9 (commencing with Section 7000) of Division 3 of the IY••t[ness and -Professions Code) or that he is exempt therefrom and the WATER HEATERS' BTU OUTPUT '. - for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the'applicant to a civil penalty SEWER CONNECTIONS -,at more than five hundred dollars ($500). ❑ I. as owner at the property, or my employees with wages as their SOLAR TANK COLLECTORS - sole compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. i 'Contractor's License Law does not apply to an_owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE •i through his awn employees, provided•that Such improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK is sold within one year of completion, the owner will have the burden � of proving he did not build or improve for the purpose of -sale). [3.1, -as the with HEATING SYSTEM 0-100,000 BTU owner of property, -am exCluSively contracting AND DUCTING licensed contractors to construct the project (Section 7044, BUSIness 100,000 + BTU and-ProfesSions Code: The Contractor's License Law does not apply to ' an owner of property who builds or improves thereon, and who Con- REFRIGERATION 0-100,00D BTU tracts from such projectswitha contfactor(s) licesned pursuant to SYSTEM ,the Contractor's License Law), 100,000+ BTU ❑ I am iixempt under Section B.-& P. C.'for this BOILERS BTU reason- - - p SYSTEM REPAIR, ALTERATION ODd Date Owner I hereby certify that I have this application and state that the above EXHAUST SYSTEM MULTIPLE _read information is correct. I agree to comply with all city and county , ordinances an state laws relat' g to construction, and hereby authorize representativ s of th city enter upon the above mentioned property fo pu s. �v l. ,r A r0� Signature O ISSUE FEE 3 Drivers' License or SS =,P CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 2854 71.1.5/82 11).-00 T[, ZONING REGULATIONS PAP_0 �PLNG.. REF,pp� C T. PROPET GINE AftD " kL SID I EHTYA - • - - -- R. REAR YARD (TO P/L) �• PKG:SPAC£ REO. PROVIDED STREET WIDTH• PARK FEE s - { ZONING APPROVED BY DATE SPECI'AL'CONDITIONS: - - ELECTRICAL PLAN CHECK GENERATOR 0-1 KW 1-10 KCW- TRANSFORMER APPLIANCE - 10.50 KW_50-+ KW' n MOTORS 0-1 HP - 1-10 HP' (INC: SOLAR)- 10-50 HP 50 + HP FIXTURES OUTLETS'- -SWITCHES GAS TUBE SIGNS POLE LIGHTS 'POLES METERED SUB ',PANELS MAIN SUB SERVICE AMP - ti , FINAL FEE $1-]sd�P_ ISSUE FEE APPLICATION -APPROVED BY DAT - SUMMARY OF FEES BUILDING PERMIT $ SMTP $ PLAN CHECK S PERMIT ISSUANCE s PLUMBING $ GRADING $ PLAN -CHECK $ ELECTRICAL $ $ 'PLAN CHECK S MICROFILM $ MECHANICAL $ �l. ba TOTAL FEE S PLAN CHECK $ LESS AD- VANCE PC' $ _ FINAL FEE $1-]sd�P_ CONSTRUCTION AND PLANNING Date APPROVALS Permit =# Inspector` POOL & SPA ` '• " _ .,, Daje , _ APPROVALS F Permit'#' "" Inspector 1. _Temporary Electrical Service or Pale 43. Pool & Equipment Location - . SoilPipe-Undrgrn _ 44. Steel Reinforcement ' .3. Electrical Conduit Utility-Undrgrn 45. Forms, 4. Electrical Conduit=Undrgrn _ 46. Electrical Bonding t e e7rem orce 47. Rough Plumbing & Pressure'Test 6. Electrical UFER Grn 48. APPROVAL TO COVER'GUNITE t "''• "' �' "' 7. Footings ' ' 49. Electrical Conduit-Undr rn 8. .Foundation S0. Gas Pipe, ❑ Undr rn, Test .9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra` .❑ Wri&grn 10.. Structural Floor System 52. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final ' 12. Street Sewer Conni 0on _ _ 54. Heater & Vent-Final 13. Rough Plumbing - SICM 14. Rough Electric-Conduit :56:- Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning'Fencing &Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilati g 60. _ POOL/SPA SYSTEMS FINAL ' 19. Gas Pipe-Rough &'rest 20. Roof, Fra mi ng 21. Roof Sheathing- --- - NOTES: 22'. Frame and Flashin _ 23. Insulation 24. Lathing & Siding- 25. Drywall Nailing " 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric - - 29. Final Heating & Air Conditioning j - 30. Final Gas Pipe-Test t 31.. Final Plumbing 32. -Water Service-Final 33'. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling S stem 36. Sound Attenuation 37. Handicap Regulations x ' 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release tp Edison -1 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY 'i, , No _ Date Applicant to f111 in all spaces wnnm heavy-buiarr•nne. no•stgn-all appropriate declarations. � CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. - 7047 6%08/62 322.19 Tl. CON94fRUCTION PERMIT 3 r 3 $ CQ - - Project A ;dress3151 Airway Avp_. B2&3 C M_ TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION caner h n American Ex reSSPhon-5752-767 -Address 1601 Dove Newport -Beach ❑ REPAIR [:]CONVERSION ❑DEMOLISH_ ZONING REGULATIONS [:]OTHER tenant improvement Arch/Eng. Tom Moon & Assoc. License No. C-5180 DA.P. '' OF WORK ZONE GLS PLNG. REF.'S Address 2234 New ort Blvd.,ESCRIPTION Newport Beach Contractor - JDO Company Phone 540-264 TYPE OF PERMIT -BUILDING Ilv LIN Address 3151',Airwa E -1. -Costa Mesa ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SIQSET�YC RQ -ST. O LWI LICENSED CONTRACTOR DECLARATION that I am licensed of Charter 9 I Cid TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA E YA RD ' I hereby affirm under provisions (com- mencing with section 7000) of Division 3 of the Business and RIGHT ❑ D7HER Professions Code, and my license Is In full force and effect. REAR YARD ( O P/L) PROJECT DESCRIPTION _ License Class -License No _ _ 4038PKG. SPACE REd, PROVIDED Date_ 618 /82 -------Signature ,s SC FT. ` _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a OCCUPANCY {Rp}N(Sg[�TRUCTION_ TYPE ZONING WIQTk-I PARK FEE $. «VALUATION ~�W.00 ZONE ZONING APPROVED BY OAT certificate of -Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS: - _ thereof (Se on 3 0 C.). :' • GRADING,CU. YDS. ACRES Pnllcy No. , _.Company - .ertifled copy is.hereby furnished. REMARKS:. :ertlfied copy is filed with the city Building Division. EXEMPTION FROM WORKERS'?COMPENSATtON DECLARATION - W!2 (7hls section need not be completed if the permit Is for one hundred (5100) or less}. O ` I certify in the performance of the work for which this permit Is -that issued, i shall not employ any person in any mariner so as to become PLUMBING ,.yam---., --••-=PLAN"CHECK-'- --' ELECTRICAL PLAN CHECK' .subject to the Workers Compensation Laws of_Callfornia:'-' _ BATHTUBS SHOWERS'Q.' °gateSignature NOTICE: If after making this declaration, you should become subject TOILETS- URINALS GENERATOR - 0.1 KW 1.10. KW to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TRANSFORMER LAVATORIES DOUBLE LAYS" _ APPLIANCE 10-50 KW 50 + KW -- ' revoked. CONSTRUCTION LENDING AGENCY KIT.'SINKS -' "'- DISHWASHERS' MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICESINKS -- SUMPS - - (INC. SOLAR) -10-50,1-!P 50-+ HP r _ formance of the work for .which.this permit Is issued (Section 3097 FLOOR SINKS FLOOR DRAINS - FIXTURES - OUTLETS SWITCHES ' Cl V. C.).-- - Lender's Name - _ 'DRINKIN Lender's Adtlress oVe , porteac __' G FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS w POLE LIGHTS - OWNER BUILDER DECLARATION 1 herebyy affirm that I am exempt from.the Contractor's License Law for SWIMMING POOL P TRAP 'POLES 'METERED SUB the following reason (Section 7031.5 Business -and Professions Code: Any city or county which requires a permit to Construct, alter, WATER.SERVICE ALTERATION PANELS MAIN- SUB ` �"• - ' Improve, demolish or repair any structure, prior to its -issuance, also re- the,applicant for such to a -signed statement that'he quires permit -file is licensed pursuant to the provisions of.the Contractor's License Levi (TAS.SERVICE OVTt_ETS SERVICE - AMP - - ~ ,((Chapter - 9 (Commencing with Section, 7000) df, Division 3?of the, Business and -Professions Coo) or that he IS exempt therefrom and the -HEATERS basis for the.alieged'exemption. Any violation of Section +7031.5 by; WATER BTU OUTPUT SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty ot,more than -five hundred dollars ($500). v1 s ti -SOLAR TANK COLLECTORS - -- - ' ., as owner -of the property, or my employees with wages as their, Sole compensation, will do the work, and the structure is not Intended - ISSUE FEE SOLAR PIPING SYS. - or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE - APPLICATION APPROVED BY� DATE 2 through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEE Intended or offered for sale. If, however, the building or Improvement s sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT �A $ _�A. — SMIP $ �c I, • as owner of the property, am exclusively contracting with AND DUCTING •licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN C EC PERMIT 'and Professions Code: The Contractor's License law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) llcesned pursuant to SYSTEM _ GRADING $ the Contractor's License Law). 100,000 + BTU I PLAN CHECK $ ❑ l am exempt under Section B. &'P. C. for thisBOILERS BTU ELECTRICAL $ - $ '_ reason - -MICROFILM $ PLAN CHECK $'- Dale Owner SYSTEM REPAIR, ALTERATION TOTAL FEES I hereby certify that I have read this application and state that the above MECHANICAL $ EXHAUST SYSTEM MULTIPLE LESS'AD- Information is correct. l agree to comply with all city and county PLAN CHECK $ VANCE PC $ _ ordinances and state laws relating to c Struction, and hereby authorize - 'representatives this ity t e upon the above ' -V ~' , ;Joned property for -f Ctl urp FINAL FEE $ Signature ISSUE FEE Drivers' License or SS CMF o865.46 White -Building, Canary -Applicant; Pink -Accounting; GoldenrOd-Assessor CONSTSUCTION AND PLANNING �r APPROVALS Permit # 0 Date Inspector POOL & SPA: APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe- ndrgrn 44. Steel Reinforcement 3. Electrical nduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn -- 46. - Electrical Bonding 5. Steel ein orce _ 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. . Foundation 50. Gas Pipe, ❑ Undr rn, Test 9, Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ Undr rn- 10. Structural Floor System 52. 'APPROVAL TO DECK 11. Property Sewer'Line &-House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing , -55, Plumbing System - Final 14. Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-Wiring - - 57. Solar System-Final 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts in Structure -99-- APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA.SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21. Roof Sheathing NOTE S:.� - -, 22. Frame and Flashing fat{ PE. 23. Insulation me 24. Lathing & Siding --_ 25. Drywall Nailing 26. Plaster Brown Coat f 27. Electrical power Meter-Final // 471-17912- 8"128. 28. Final Electric k u T a'%'c� v� Dnp p 29. Final Heating & Air Conditioningr Bio Pc*c� OL c,,' V.W 30. Final Gas Pipe-Test [ r C ►- _ -o�c ��f X�� i ` 31. Final Plumbing r ,� 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final '.35. • Landscape Sprinkling-System . 36. Sound Attenuation,. r r 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ,�� 39. Special Requirements Completed 40.. .Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CEFj7IFIATE 1rfJAPANCY No ll�ess GG !! Date Q l _ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 'CITY OF COSTA MESA P MIT NO. COIF +TRUCTION P-ERMIT ip- 3e &3. ` TRACT NO. LOT NO: BLDG. NO. TYPE OF CONSTRUCTION' ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION fD DEMOLISH- ❑OTHER ' DESCRIPTION OF WORK - TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL APLUMBING ❑MECHANICAL 1 Project Address 3I •-Z 4- 8 3 j Owner OCA--� Phone W08P' IRT~ (GINE , Address '3 J./ ]" ArChlEng,- License No. + � - Address ll Contractor Pfione PROVIDED Address \ LICENSED CONTRACTOR DECLARATION 1 hereby affirm thit t am licensed under provisions of Charter 9 (COM- mencling with section 7000)- Of Division 3 of the ' Business and (] OTHER - Professions Catle, and my license is in full force and effect. PROJECT rDESCRIPTION .. License CIaS$ License o. Date �=Y�© Signature SQ' FT' WORKERS' COMPENSATION AECLAR I OCCUPANCY CONSTRUCTION TYPE. 1 hereby affirm that I have a certificate consent to self -Insure Or a certificate of Workers' Compensation Insurance, Or a certified cop, VALUATION ZONE thereof (Section Lab. C.), c ,)Iicy No_y2_i �t3800, !2 I Company -. •� �� J Certified copy is hereby furnished. - JZ_Certifled copy Is filed with the'city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION GRADING CU. YDS. ACRES - -'-REMARKS: 1 - IThis section need -not be compieted if the permit Is for one hundred , ($100) or less). MECHANICAL I certify that -in -the performance ,of the work for which -this permit.is Issued, I shall not employ any person in any manner s0 as to become- subject to the Workers_ CcmpenSation•Laws of California. Date Signature _ (PLUMBING= : PLAN CHECK BATHTUBS SHOWERS _ _ 'TOILETS , URINALS NOTICE: If after, making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit $hail be deemed �. LAVATORIES DOUBLE LAVS -revoked. - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASERS H SERVICE SINKS. SUMPS - 1 hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS Civ. C.). Lender's Name DRINKING FOUNTAIN r[- Lender's Address OWNER BUILDER OECLARAYION - I hereby affirm_ that I_am exempt from the Contractor's License Law for the following reason (Section 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 re- .quires the api iicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law IyChapter 9- (commencing with Section 7000) of Division 3 of the Ruslness and Professions Code) ' -or that he is exempt therefrom and the -is for the alleged exemption.Any violation of Section 7031,5 by applicant -for a permit sulljects the applicant to a civil penalty not more than five_hundred dollars INTERCEPTORS CLARIFIERS - SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT r SEWER CONNECTIONS - d` SOLAR TANK COLLEC OR - 1, as owner of the property, or my employees with wages as their~ le compensation, will -do -the Work, and the structure isnot-intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property SOLAR PIPING SYS. ISSUE FEE who builds or improves thereon. and who does such work himself or through his -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 will have the burden of proving he did not build or improve for the purpose of sale). '❑ i --as Owner- Of the-'propefty, am exclusively-contractingwith- licensed contractors to construct the project (Section 7044, eusiness and 'Professions' The'Contractor's License Law does not apply to an owner o1 property who builds or improves thereon, and who con- 'tracts' from such- projects with a -contractors) Iicesned pursuant to' the Contractor's License Law), ❑ 1 am exempt under Section B. & P. C. for this MECHANICAL PLAN CHECK HEATING SYSTEM _ 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU +` f'• .,%- fir• BOILERS BTU reason Date - - --Own __—_- - - _ _ _SYSTEM REPAIR, ALTERATION SYSTEM MULTIPLE_ I.hereby,cert_ify that I have read this application and state.that the above[!,HAUST lnformation is correct. I agree to comply with all City and county ordinances and state.laws relating.to•construCtion, and hereby authorize epresentatives is y ter upon the above mentioned Opert� specti pi e _ ature Date ~rs' License r S SSUE'FEE - - - - 65-46 White -Building; nary pp Icon ; Pink -Accounting; Goldenrod -Assessor 7149 6/10182 ELECTRICAL . PLAN CHECK , 9.00 TL. -GENERATOR- 0-1 KW ZONING REGULATIONS A.P. 1W - '- - ZONE PLNG.. REF. SETBACK CIL ST. W08P' IRT~ (GINE , Lg�pFTYARD �RIFFGHTA I 1-30 HP {INC. SOLAR)- REAR YARD (TO P/L) t PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE _$ ZONING APPROVED BY DATE SPECIAL CONDITIONS: $ ELECTRICAL . PLAN CHECK , 9.00 TL. -GENERATOR- 0-1 KW 1-10 KW TRANSFORMER - '- - - - APPLIANCE 10-50 KW..�_50 + KW MOTORS 0.1 HP 1-30 HP {INC. SOLAR)- 10c50 -HP 50 + HP ' FIXTURES OUTLETS SWITCHES „ GAS TUBE SIGNS GRADING $ POLE LIGHTS $ POLES METERED SUB PANELS MAIN 1_ ,. SUB SERVICE-� . . . AMP ISSUE FEE - • - I APPLICATION APPROVED BY- _ '' DATE - FINAL FEE $-f—C-0 SUMMARY OF FEES BUILDING - '- - - - PERMIT__ _ $ SMIP _S ' PLAN CHECK_ $PERMIT 1 p ISSUANCE $ PLUMBING $ GRADING $ PLAN CHECK"' $ ELECTRICAL $ S MICROFILM $ PLAN CHECK $ , TOTAL FEE $ MECHANICAL $ PLAN CHECK $ - LESS AD- VANC E PC _ $ _• FINAL FEE $-f—C-0 CONSTRUCTION AND PLANNING APPROVALS Permit # ?J Date inspector POOL & SPA ). APPROVALS Permit # , Date - Ensp� tor_. 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - -� 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn 45. .Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding Steel ein once 47. Rough Plumbing &-Pressure Test. 6: Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn _ 8. Foundation 50, Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51.. Backwash Lines P-Tra ' '0-' ndr rn - - 10. Structural Floor System 52. APPROVAL TO DECK ' 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. " Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing --55. ng System - nal 14. Rough Electric -Conduit - :56. lectrical-Final 15. Rough Electric -Wiring - -57. Solar System -Final = 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts, in Structure -79-- APPROVED FOR PLASTERING 16. Ducts, Ventilating 60. POO LISPA SYSTEMS F INA L 19. Gas'Pipe-Rough'& Test ,• ' _ 20. Roof -Framing 21. Roof Sheathing NOTES: - - _ r , *�_ �'• 22. Frame and Flashin .23. Insulation 24. Lathing & Siding �` ? t. l' 7-1 -25. Drywall Nailing 26. Plaster Brown Coat - -' 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbingz- 32. Water Service -Final 33, Gas Service -Final 34. Solar Domestic -Final " 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING -- .� 39. Special Requirements Completed 40, Electric Release to Edison - " -01 41. Gas Release to,Southern California Gas -'Co. 42. .3_ CERTIFICATE OF OCCUPANCY .No. Date _ . d , � o Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA- PERMIT NO, TRACT NO: LOT NO. BLDG. NO. 43 %� J�82 B�QO TL O,NSIQUCTION PERMIT a2 -3 - • _ . Project Address - _e TVPE OF CONSTRUCTION �� _ ' '� _ -�'• Owner 4P 12 QoPhone ❑ NEW ❑ ADD ❑ ALTERATION Address - ❑-REPAIR ❑ CONVERSION ❑OEMOLISH t ❑ o7HER't+ ZONING REGULATIONS Arch/Eng, License No. P_ AddressA I AL OESCRIPTION OF'WORK - �- add ZONE PLNG. REF Co acts - Phone - -- - 7YPE.OF PERMIT.., I - •�:p BtJI $IfVG-._ - PLOP Y dress -' "❑'G R AOING,�,'❑ FOUNDATION • ❑-STRUCTURAL-- SETBACK L T. ID YARf7 - - -LINE LICENSED,CONTRACTOR DH 'ARATION I licensed under Charter 9 ❑.TENANT�BELECTR%ICA(. ❑PLUMBING ❑MECHANICA SIEpFEYA 'RIGHT - - I hereby affirm that am provisions of (Com-,, -with- sectlon 7000) of Division -3 -Of the -Business and _ is E]OTHER mencing , Professions Code, antl my license Is In full force and effect. _ REAR YARD (TO P/L) _ .-_. . _. PROJECT -DESCRIPTION License GI s _ L ense O '' SQ. FT. ' ' i l PKG.SPACE REQ. -' PROVIDED Date Signature`` _. _ _ STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATI OCCUAANCY CONSTRUCTION TYPE ZONING APPROVED.BV i I hereby affirm that I have a certificate of Consent to self -Insure ora �S, VALUATION ZONE Certificate of Workers'- Compensation-.)nsuranCe,-Or a-certitietl' copy �' SPECIAL CONDITIONS: ��reof Section 3800, Lab. C.). ( .,GRADING CU. YDS. ACRES :y'No. - _'Company•- ��/ertltied copy (s.hereby furnished. _ - _ REMARKS: L IE Certified copy is tiled with the city Building Division. - EXEMPTION'FROM WORKERS' COMPENSATIONDECLARATION -' -- --- -- -- - - `— -- '(This section need not be. Completed_if_the permit_is for one hundred -- - -L_ $100) or less )y ) — S 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 PLUMBING PLAN CHECK -. '- "'ELECTRICAL AVC" PLAN CHECK' sublect,to.the Workers' Compensation Laws of_Cdlif_ornia,' "-_z I- - :'r'i.iA "-f`-' -' "' ` _ BATHTUBS SHOWERS ' _ - - - Date Signature , making this declaration, you should becoe•subject NOTICE: If after mm -TOILETS • •- „ir URINAL'S - GENERATOR- 0.1' -KW 1_10;_kW - to the Workers' Compensation provisions of the Labor Code, -you must forthwith Comply with such provisions or this permit shall be deemed .- LAVATORIES DOUBLE LAVS jTRANSFORMER ,..• , APPLIANCE -10.50-KW_.;;-_50 + KW -- _ revoked., CONSTRUCTION LENDING AGENCY "KIT. SINKS' ` ---DISHWASHERS- - ,MOTORS- - 0-1 HP 1-10 HP. - - T- I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS :; ---- �- SUMPS '�� (INC., SOLAR)„ -_10 -50 -HP 50-+ HP " formance of the work for which this permit Is issued (Section 3097 1� - CivC.). - ' '- —' - - - -' - - - _ : Name FLOOR SINKS—` FLOOR -DRAINS " ''FIXTURES - OUTLETS- SWITCHES' i !Lender's _ _ _ _ _ _ _ Lender's Address - __.. DRINKING FOUNTAINS' "^ - '" 'Y "- - GAS TUBE SIGNS-- „ . - - - - - - - - I , CLARIFIERS -I _ "�POLELIGHTS '- - --• - OWNER'BUILDER'DECLARATION-~INTERCEPTORS •I , herebyy affirm that l am exempt from the Contractor's License Law for Professions SWIMMING POOL- P TRAP POLES METERED SUB the -lot owing reason (Section •7031.5• Business and Code:- Any city or County which requires a permit to construct, alter, improve, demolish or•repair•any structure, prior to its issuance; also re- - + - WATER'SERVICE ALTERATION', - -- t' PANELS - MAIN -• - SUB - - - .quires the ap;llcant for such permit to fife a signed statement that he GAS SERVICE' OUTLETS ;'[ '. - ' -.SERVICE - - - AMP- - is licensed pursuant to the provisions of the- Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - -- - - r- -iness and Professions Code) or that•he is exempt therefrom and the • for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS -` '-'- - -�- •• ---- - -- - applicant for a -permit -subjects the applicant to -a -civil penalty ' L" not more than five hundred dollars ($500). ' SOLAR TANK COLLECTORS' -- , - �- --•- - -- - •••--- - - •- - •'- -'r - ❑ I, as owner of 'tho property, oCrny employees with -wages as their 1 sole compensation, will do the work'and the structure is not intended _ _ _ _SOCPIPING SYS. ISSUE FEE - - or offered for sale. (Section 7044, Business and'Professions'Code: The Contractor's License Law does not apply.to an -owner of a property, who builds or improves thereon, and who does such work himself or q --ISSUE FEE _ --- ---- - - •{ T APPLICATiON•APPROVED By-'- - - �� •DATE -- •- through his Own employees, provided that such Improvements are not + MECHANICAL PLAN CHECK - _ ( - SUMMARY pF FEES _ intended or offered for sale. If, houve�er, the building or Improvement- is sold .within one year of completion, the owner will have the burden - - BUILDING - • - -- +� --- -- of proving he did not build or improve for the purpose Of sale). HEATING SYSTEM 0-100,000 BTU PERMIT S _IP S ❑ I,- as -owner -of the property,-am•-exclusively..contraCting-with_ to the 7044, Business AND DUCTING - i -- �� 100,000 BTU - ' -'-' - •• -'-- - =- licensed contractors construct project (Section iPLAN CHECK $ PERMIT, ` and Professions Code:, The Contractor's License Law does -not apply to an owner of property who builds or improves thereon, and wno Con- REFRIGERATION 0-100,000 BTU , PLUMBING $~ ISSUANCE E ,.r - ) tracts from -such projects with-a-contractor(s) licesned .pursuant to - SYSTEM -- - - -- — -- _ GRADING $7 the Contractor's License Law). 100,000,+ BTU , PLAN CHECK ❑-I am exempt under Section - B. &-P.'C: for this BOILERS BTU ELECTRICAL reason - PLAN CHECK E - - MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION •TOTAL' FEE $ I hereby certify_that I have read this application and Slate that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ - 0 _ _- - LESS AD - information is correct. I agree -to -comply with all city and -county .. PLAN CHECK $ - -- - vANCE PC -$_ - ordinances and state laws relating to construction, and hereby authorize •- . - representatives f this* city to enter -upon the above enti ned property for spec i n pur os _ FINAL FEE $ Signature Date _a� Drivers' License or SS ISSUE FEE _ _ -Assessor CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION'AND PLANNING APPROVALS Permit 5L Date Inspector POOL & SPA APPROVALS Permit:#' Date Inspecto"r 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location, - 2. Soil Pipe-Undrgrn• 44. Steel Reinforcement 3. Electrical Conduit Utility ndrgrn _ • _ . 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - b. Steel Reinforce , . 47. Rough'Plunibing & Pressure Test 6._ Electrical UFER Grn 48. APPROVALTO COVER-GUNITE - -- 7. Footings 49. Electrical Conduit-Undr rn 8.- Foundation _ _ _ 50: . Gas Pipe;-❑ Undr rn, Test 9.. Water Pipe-Undrgr.n _.. _ _ 51. Backwash Lines P-Tra ` ❑ ndrrn' -` 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line -&.House Connection 53. Backwash & Rece tor-Final' 12. Street Sewer Connection " ' " ' 54. Heater & Vent-Final 13. Rough.Plumbing _ { 14. Rough Electric-Conduit - -' •56- Electrical-Final 15, Rough Electric-Wiring - - -57. Solar System-Final . 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval ' 17. Ducts in Structure - _ 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. _ POOL/SPA SYSTEMS FINA I:' ' 19. Gas Pipe-Rough & Test 20. - Roof-Framing 21. Roof'Sheathin - - NOTES: 22.- Frame and Flashing- - _ ' _ 23. Insulation ' - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28: Final Electric L 29. Final Heating & Air Conditioning ' 30. Final Gas Pipe-Test 31. Final Plumbing ` 32. Water Service-Final - 33. Gas Service-Final. L 34. Solar Domestic-Final` 35. Landscape Sprinkling System 36. Sound Attenuation 37, Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special- Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date I Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ;CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. f CONSTRUCTION PERMIT � .zS.z)- 1 1 a. Project Address� TYPE OF CONSTRUCTION ElNEW ❑ ADD ElALTERATION ❑ REPAIR- ❑ CONVERSION' ❑DEMOLISH LJ OTHER OESCRIPTION OF WORK Owner1132 enia tV Phone Address Arch/Eng. License No. Addresstr - nctor - Phone TYPE OF,PERMIT ❑ GRADING C1FOUNOATION '❑ STRUCTURAL E]TENAN-r ELECTRICAL ❑PLUMBING ❑MECHANIC, e s yr L, -LICENSED CONTRACTOR DEtCARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- menCing -with section- -7000) of . Division- 3 -of the Business and - -❑ OTHER Professions Code, an my license Is In full force and effect. PROJECT DESCRIPTION License Cl ss LIC so N - L Date Sig nature - SQ. FT. WORKERS' OMPENSATION DECLARATIO - - - .. _ OCCUPANCY CONSTRUCTION TYPE, _ I hereby affirm that I have a Certtf€Cate Of consent to self -Insure or a Certificate of Workers' -Compensation Insurance, or a certified Copy - VALUATION' I ZONE -� thereof (Section 3800, Lab. C.). GRADING.CU.•YDS. ACRES ^ 'icy No. Company-'- - kertlfied copy is -hereby turnished. - - REMARKS:' - Certified copy is filed with the city Building Division, EXEMPTION FROM -WORKERS' COMPENSATION DECLARATION -' ' - (This. section need not be Completed.if the permit is for one hundred - - (5100) or less)- I- I Certify•that In the performance of the work for which this permit Is Issued, 1 shall not employ any person in any manner so a$ to-beCome - * • - _ -PLUMBING, - �. PLAN -CHECK subject to the WorkerS'-Compensatioq Laws of California. BATHTUBS ' SHOWERS Date iSignature ` NOTICE: If after making this declaration, you should become subiect TOILETS URINALS to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES OOUBL'E LAVS - revoked. CONSTRUCTION LENDING AGENCY - KIT. SINKS - DISHWASHERS -` SERVICE SINKS 'SUMPS I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 `FLOOR SINKS -' FLOOR DRAINS Clv. C.). ^- -^' Lender's Name DRINKING FOUNTAINS " _ Lender's Address _ y OWNER BUILDER DECLARATION-- I hereby affirm that I -am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS ' SWIMMING POOL - P TRAP MOTORS 0.1 HP"' - I40 HP the following reason (Section -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 re- Quires the applicant for such permit to file a signed Statement that he WATER SERVICE ALTERATION - ' �- GAS SERVICE OUTLETS - Is licensed pursuant to the -provisions of•the Contractor's License taw Chapter 9 (commencing with Section 7000) of Division 3 of the rfuless and Professions Code) or that he is exempt therefrom and the cnfor the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS' BTU OUTPUT I SEWERCONNECTIONS )FIXTURES-- OUTLETS applicant for a permit subjects the -applicant -to a-civilpenalty ?t more than five hundred dollars (5500). -SOLAR TANK COLLECTORS GAS TUBE SIGNS - Lu 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 _ SOLAR PIPING SYS. or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or Improve for the purpose of sale). ❑ 1, as owner of -the --properly, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: -The -Contractor's, License -Law does not apply to ISSUE FEE - •� - MECHANICAL PLAN CHECK HEATING SYSTEM 0.100,000 BTU AND DUCTING - 100,000. BTU REFRIGERATION 0-100,000 BTU an owner of property who builds or improves thereon, and who con- AMP tracts- from. such. projects with a contractor(s) Ilcesned pursuant to the Contractor's License Law). SYSTEM 100,000 + BTU ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason - Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and State that the above Information is correct. I agree to compiy with all 'city'andcodnty , -- - DATE ordinances and state laws relating to construction, and hereby authorize ' representatives of this city to enter upon the 'above enti ned property for i ectlo ur O _ ISSUE FEE - SUMMARY OF FEES Signature Date Drivers' License or SS ad BUILDING - +PERMIT CMF 0865-45 White -Building-, Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 3144 7/19/82 B.00 TL L ' ZONING REGULATIONS A. P. r r , ZONE PLNBUILDING TG... BRtE}FL.p� LINT SETBAC S . PROPEIRTY YARD - - - g1 RIIGH7A REAR YARD (TO P/L) r i PKG,SPACE REO. ' PROVIDED STREET WIDTH PARK FEE S ZONING APPROVEBY D h DATE ' SPECIAL CONDITIONS: - r ELECTRICAL - PLAN CHECK SQ- FT- -SO- FT - :GENERATOR 4-1 KW 1-i0 KW F - TRANSFORMER APPLIANCE 10.50 KW_50 + KW - - MOTORS 0.1 HP"' - I40 HP s• - ((iNC. 50LAR) 10-50 HP_ 50+ HP )FIXTURES-- OUTLETS SWITCHES GAS TUBE SIGNS - .POLE LIGHTS POLES METERED SUB ,PANELS MAIN SUB - SERVICE AMP ISSUE FEE APPLICATION -APPROVED BY -- - DATE SUMMARY OF FEES BUILDING - +PERMIT S - SMIP S - PLAN CHECK S PERMIT - - ISSUANCE --S PLUMBING S. GRADING S 'PLANCHECK S ELECTRICAL S S MICROFILM '§ t ' PLAN CHECK '§'- TOTAL FEE $ ' MECHANICAL §' -- - LESS AD- 7 PLAN CHECK S VANCEPC S- r FINAL FEE S CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA Date inspector APPROVALS Permit # Date Insp9ctor" 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location i2. Soil Pipe-Undrqn, •44. Steel Reinforcement ` -3. ,Electrical Conduit Utility-Undrgrn 45. Forms -- 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding ' Steel a+n orce 47. Rough Plumbing & Pressure Test + 6. Electrical UFER Grn 46. APPROVAL TO COVER-GUNITE ' 7. + Footings49. Electrical Conduit•Undr rn B. Foundation 50. . Gas Pipe, ❑ Undr rn; Test i 9. Water Pipe:Undrgrn 51. Backwash Lines P -Trap.❑ Undrcirn J 10. Structural Floor System 52. APPROVAL TO DECK - 11. . Property Sewer Line &.House Connection 53. Backwash & Receptor -Final'. 12. _Street Sewer Connection ' 54. Heater & Vent -Final 13. Rough Plumbing - - 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electrio-Wiiing - 57. Solar System -Final - 16. Rough Heating & Air Conditioning - b8. Fencing &-Access Approval -17. Ducts, in.Strueture APPROVED FOR PLASTERING 18.' 19. 20: Ducts, Ventilatirlg Gas Pipe -Rough &Test Roof Framing - 60. _ . POOL/SPA SYSTEMS FINAL 21. 22; Roof Sheathing Frame and Flashin NOTES: 23: Insulation -, 24. Lathing & Siding 25. Drywall Nailing 26: Plaster Brown Coat 27. - Electrical Power Meter -Final 7`2 o _ 'L 28. Final Electric - 29, Final Heating &-Air Conditioning . 30. Final Gas Pipe -Test - 31, Final Plumbing - 32. Water Service -Final .33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkfing System 36. Sound Attenuation 37. Handicap Regulations - 36. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42, CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT N �� TRACT NO. LOT NO. I BLDG. NO. -CONStRUCTION PERMIT TYPE OF CONSTRUCTION 08727/23/0I I 7a9 XNEW ❑ ADD ❑ ALTERATION ❑ REPAIR•❑CONVERSION El DEMOLISH ZONING REGULATIONS ❑ OTHER Project Address Owner Phone Address Arch/Eng. License No DESCRIPTION OF WORK A.P. =0 ZONE PLNG. REF. :4k I Address Contractor AV G Phone TYPE OF PERMIT BUILDINGpp ggtt��f�p INC SET AC ROPERTY LINE ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL 10 YARD ❑ TENANT K ELECTRICAL' ❑PLUMBING ❑MECHANICA WIIGE Y - I Addressrr—ax LICENSED CONTRACTOR DECLARATION I licensed of Charter 9 I hereby offirm that am under provisions (com- with Section 7000) of Division 3 of the Business and RHT ❑ OTHER men cing Professions Code, and my license Is in full force and effect. P REAR YARD (TOL ) PROJECT DESCRIPTION License ss 3=T License No PKG. SPACE REQ. PROVIDED Date Signature Sq. FT, STREET WIDTH PARK FEE S WORK RS' COMPENSATION DE A ATION OCCUPANCY CONSTRUCTION TYPE DATE I hereby affirm that I have a certif a of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY certificate of Workers' Compensation Insurance, or a certified copy thereof (Se on 3800, C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: PolicyNo.C�L�I—��ompanY /e;1?RA1. ertified copy is hereby furnished. REMARKS: - - Certified copy is filed with the city Building Division. ,MPTION FROM WORKERS' COMPENSATION DECLARATION ,s Section need not be completed if the permit IS for one hundred _ _ _ .• } _ - - , or less). " �a100) certlify that ]n the performance of the work for which this permit Is _ Issued,I spall not employ any person in any manner as to ,become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject t e rkers .Compensa n ws of- Califo BATHTUBS SHOWERS Date Signature TOILETS URINALS GENERATOR 0_1 KW 1-10 KW TRANSFORMER NOTICEL if after making this tlecla you Should become subject of to the Workers' Compensation provisions the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW -50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HA 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC. SOLAR) 10.50 HP 50 + HP - formance of the work for which this permit Is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURESUTLETS SWITCHES AW Cl v. C.). Lender's Name DRINKING FOUNTAINS GAS TUBE SIGNS Lender's Address INTERCEPTORS CLARIFIERS POLE LIGHTS 1 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 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 re- the applicant for such to fife a signed statement that he WATER SERVICE ALTERATION PANELS MAIN SUB ' quires permit Is licensed pursuant to the provisions of the Contractor's License Law GAS SERV ICE OUTLETS 'SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS - as owner o1 the property, or my employees with wages as their romvensatlon, will do the work, and the structure is not Intended SOLAR PIPING SYS. ISSUE FEE ' rfered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does sucn work himself or APPLICATION APPROVED BY DATE? ISSUE FEE �� through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. if, however, the building or improvement iS sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT BUILDING E SMTP S ❑ % as owner of the property, am exclusively Contracting with _ AND QUOTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S PERMIT and Professlons'Code: The Contractor's License Law does not apply to ISSUANCE E an owner ofproperty who builds or 4mproveS thereon, and who can- REFRIGERATION 0-100,000 BTU PLUMBING S tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING E the Contractor's License Law). 100.000 + BTU PLAN CHECK $— ❑ 1 am exempt under Section B. & P. C. for this C1 BOILERS BTU ELECTRICAL 5 reason MICRpFiLM-E PLAN CHECK S Pate Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD- fon is correct. I agree to comply with all city and county iLSigna!ur�e PLAN CHECK E VANCE PC $ s and state laws relating to construction, and hereby authorize tives Of this City to enter upon the above mentioned for Inspect n purpose + G 23 FINAL FEE 5 a icense or 5 ISSUE FEE - -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43, Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement .3. Electrical Conduit Utility-Undrgrn 45, Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough PlumbinQ & Pressure Test 6. Electrical UFER Grn 48, APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. hough Plumbing 55, Plumbing System - Final- 14. Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-Wiring C 1 57'.• Solar System-Final 16. Rough Heating & Air Conditioning bu. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22.. -Frame and Flashing 23. Insulation ow 24. Lathing & Siding - 4 C C, 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29, Final Heating & Air Conditioning. 30. Final Gas Pipe-Test 31. . Final Plumbing 32. -Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35, Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY , -No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY QPCOSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. �7L'�= CT. 91X311:1 c7nrJ1 CONSTRUCTION PERMIT I Project Address S / Alh C? TYPE OF CONSTRUCTION , Owner Phone C] [I ❑ / j'r NEW ADO ALTERATION i Address Owe lw,4r-4 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH LJOTHER ZONING REGULATIONS Arch/Eng. �. per„ License No Itf Address �y 1/- A DESCRIPTION OF WORK A.P. 9P S' . ZONE PLNG. REF. � Contractor Q� Ph6n!& iPTYPE OF PERMIT BUILDING pp ggt�11l DING" PROPETY LINE Address NM� / W ( ! Ne ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBACK C L ST. SIDE YARD LICENSED CONTRACTC01k 15ECLARATION ❑ TENANT 1-1ELECTRICAL ❑PLUMBING ❑MECMANICA _ I hereby affirm that I am licensed under provisions Of Charter 9 (com• SEDF A RD RIGHT mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, a my license Is In full forceec REAR YARD (TO P/L) PROJECT DESCRIPTION � License Class - License No. PKG. SPACE REQ. PROVIDED � - Date Signature _ SQ. FT, ' � - STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE _ I .hereby affirm that I have a certificate of consent to self -insure or a VALUATION' ZONE ZONING APPROVED BY DATE certiflwte of Workers' Compensation Insurance, of a certifled copy - thereof (Section 3800, Lab. C.). GRADING GU. YDS. ACRES SPECIAL CONDITIONS: - Policy No. Company - t (� Certified copy IS hereby furnished. REMARKS:.- - - - - 12 Certified copy.i$ filed with the city Building Division._ _ --``� - r,_.. LMPTION FROM WORKERS' COMPENSATION DECLARATION ' t nis section need not be compteted if the permit is for one hundred -_-- ($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-aSA6 become _ _ PLUMBING'. PLAN CHECK ELECTRICAL PLAN CHECK -. subject to the Workers' Compensation L-aws`of California. - - . Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS �. URINALS GENERATOR 0-1 KW - - 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must _ TRANSFORMER . - . forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS 'APPLIANCE 10-50 KW -50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT, SINKS DISHWASHERS MOTORS 0-1 HP 1.10 HP I hereby affirm that there IS a construction Ie Ing agency for the per- SERVICE SINKS SUMPS r ". (INC. SOLAR) 10-50 HP 50 + HP •? of the work for which thi rrrli issuCtl (Se[tion 3047 [� y M1 _ Civ.formance Civ. C.). FLOOR SINKS FLOOR ORAINS FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address �'RINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the, Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS ` SWIMMING POOL P TRAP the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to Construct, alter, POLES METERED SUB ' WATER SERVICE ALTERATION PANELS MAIN SUB ' Improve, demolish or repair any structure, prior to it4 issuance, also re- quires the applicant for -such permit to file.a signed statement that he GAS SERVICE OUTLETS SERVICE AMP, 0 Is licensed Pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Pro4essions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031,5 by SEWER CONNECTIONS - any applicant for a permit subjects the applicant to a civil penalty ` not more than five hundred dollars ($500). SOLAR TANK COLLECTORS - _ , , as owner of the property, or my employees with wages as their compensation, will do the work, and the structure is not Intended SOLAR PIPING SYS. t ISSUE FEE QD ' or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply -to an owrier of a'property ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL, PLAN CHECK - SUMMARY OF FEES ' _. intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the'owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ contracting with HEATING SYSTEM 0-100,000 BTU BUILDING , PERMIT 5 SMIP $ I, as owner of the property, am exclusively AND DUCTING ` licensed contractors.to construct the project (Section 7044, Business _ 100,000 + BTU PLAN CHECK S PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or_improves thereon, and who con., REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projeCts with a contractor(s) llce4ned pursuant to SYSTEM' _ GRADING $ - the Contractor's License Law). 100,000 +BTU t PLAN CHECK S ❑ I am exempt untler Section d_ & P. C. for this BOILERS BTU !ELECTRICAL $ ' 6 0 reason _ PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ MECHANICAL $ I hereby Certifytflat-I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - LESS AD- - - - Information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC S ordinances andstate lating to Co ruction, nd hereby authorize - .. representatives ity to ent upon t above mentioned property t S , �• /C((jj{{ .3�Y,)f/ - Oa FINAL FEE $ Signature Drivers' License or SS � ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA ' APPROVALS Permit # Date - Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location- 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER•GUNITE 7. Footings 49, Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing -3 -H 55- Plumbing System - Final 14. Rough Electric -Conduit _ -56. Electrical -Final 15, Rough Electric -Wiring - \ 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60, POOL/SPA SYSTEMS FINAL 21, 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24, Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heatin & Air Conditioning 3 30, Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service-rinai 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 9• 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - , ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. t CfTY OF COSTA MESA PER IT NO. TRACT NO. I� 6�• � BLDG. NO. - •ZONSTRUCTION PERMIT > ��•3 — TYCONSTRUCTION 1 P''" EW ❑ ADD ❑ ALTERATION ❑ REPAIR C1 CONVERSION El DEMOLISH ElOTHER l;tt:��' ire � ; ZONING REGULATIONS Project Address Owner J Donald Phone 7 Addressr Arch/Eng. License No. DESCRIPTION OF WORK A.P. �f Address ZONE PLNG. RUEF.. � Contractor _ Phdne OTYPE OF PERMIT ❑GRADING ❑ FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL LUMBING ❑MECHANICA SBUILDING ETBACK ST. I YARD S D ARD �ROPEIRTDYNGNE Address LICENSED CO TRACTOR DE L&R 00N 1 hereby affirm that I am licensed of Charter 9 {tom- under provisions mending with section 7000) of Division 3 Of the BuslnOSS and ❑ OTHER RIIGHT Code, 'and my license is in full force and effect. REAR YARD (TO P/L) .Professions PROJECT DESCRIPTION License Class License No. 141 PKG. SPACE REQ. PROVIDED Date Signature SQ. FT. WORKERS' COMPENSATION DECL ATION OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE $ I hereby affirm that I have a Certificate of consent to self -insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation insurance, or a certified copy thereof (Section 800, Lab. C.). GRADING CU. YOS. ACRES SPECIAL CONDITIONS: Policy No.P92bil Company 7 irb-ni '{'.h Na ti n na 1 ❑ Certified copy Is hereby furnished. Y REMARKS:' IN Certified copy Is filed with the city Building Division. 'MPTION FROM WORKERS' COMPENSATION DECLARATION ' section need not be completed if the permit is for one hundred ~ ` 00 or lessj. 1certify that In the performance of the work for which thispermitis PLUMAING PLAN CHECK ELECTRICAL- PLAN CHECK - Issued, I shall not employ any person in any manner so as to become Subject to the Workers Compensation ,Laws of. California. BATHTUBS SHOWERSLQ OILETS -URINALS/t+G J GENERATOR UARAU - D -i KW 1-10 KW Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' COmpensatian provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions Or this permit Shall be doemed LAVATORIES DOUBLE LAVS J APPLIANCE 10.50 KW_:'_�50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a Construction lendingagency for the per- SERV ICE SINKS SUMPS (INC. SOLAR) 10.50 HP • 50 + HP' formance of the work for which this permit Is issued (Section 3047 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS -SWITCHES ' Civ. C.). - Lender's Name _ Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt fromtheContractor's License Law for the following reason (Section 7031.5 Business and Professions Code: INTERCEPTORS CLARIFIERS POLE LIGHTS ' SWIMMING POOL PTRAP POLES METERED SUB Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve. demolish or repair any structure, prior to Its issuance,a ISO re- quires the applicant for such permit t0 file a signed Statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions Of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT BuSinesS and Profe$Sions Code) or'that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by ` SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS F' ' as owner of the property, or my employees with wages as their :ompensation, will do the work, and the structure is not intended SOLAR PIPING SYS. ISSUE FEE fered for Sale. (Section 7044, Business and Professions Code: The C—tractor's Llcense.Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or Improves thereon, and who tloes Such work himself or through his own employees, provided that Such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ contracting with HEATING SYSTEM D-100,000 BTU BUILDING PERMIT $ J SMIP $ 1, as owner of the property, am exclusively AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to r+� ISSUANCE $ an ownerfspropprojects whobuilds improves thereon.ando REFRIGERATION 0-100,000 BTU ' PLUMBING $ - is r cf pursuant 1) SYSTEM GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $_ $ reason SYSTEM REPAIR,ALTERATION PLAN CHECK $ MICROFILM $ TOTAL FEE!t Date Owner - MECHANICAL $ 1 hereby certify that I have read this application and state that the above EXHAUST- SYSTEM MULTIPLE LESS AD information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC S -_- ordinances and state laws relating tv co ruction, and hereby authorize representatives of this city to ent p rl the above mentioned - for InSp J� 5L11g,na..1urevrs' FINAL FEE 5 [property_ License orF ISSUE FEE -Assessor CMF 0865-46 White -Building; Canary -Applicant; pink -Accounting; Goldenrod 0 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 1 ti SoilPipe-Undrgrn 44. Steel Reinforcement "- - 3. Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn " " 46. Electrical Bonding5. , Steel em orce 47. Rough Plumbing & Pressure Test �-- - -- - 6. Electrical UFER Grn _ 48. _ APPROVAL TO COVER -GUN ITE - - 7. Footings 49, Eiectrical Conduit-Undr rn B. Foundation 50. Gas , Pi e p Undr rn, Test 9. Water. Pi pe-Undrgrn 51., Backwash Lines P-Tra ❑ Undrcirn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash &-Receptor-Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough, Plumbing 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System-Final- ystem-Final-16.. -16.. Rough Heating & Air Conditioning b8. encing,& Access Approval 17: Ducts in Structure 5 APPROVED'FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rqugh &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. ' Insulation 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing Lal L 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape 5prinkling SprinklingSystem ' 36. Sound Attenuation 37, Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date T Applicant to fill In all spaces within heavy border tines and sign all appropriate declarations. CITY OF,'COSTA MESA P MIT TRACT NO. LOT ND. NO. 1 0316 7/ami 273oO3 TV CONSTRUCTION PERMIT !BLDG. - - _ r Project Address • ' _ _ r.WayAVpTYPE OF CONSTRUCTION _ Owner Westegn Pacif ic Fin.hones 752-7 76kNEW ❑ ADO ALTERATION Address 1601 Dove Newport Beach ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 13 OTHER ZONING REGULATIONS Arch/Eng. Hales -Langston License No. 010899 7 7 S Main Orange DESCRIPTION OF WORK A.P.-P- , ZONE PLNG. F. z# tor J. Donald Olson Co. Phone 540-26 YPEOFPERMIT SETBACK gg PROPEII�TI LGNE ❑GRADING ❑ FOUNDATION ❑ STRUCTURAL T. 51 YARD LRII rAdde7 D CONTRACTOR DECLARATION that I am licensed under of Charter 9 'X1 TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC YARD Eaffirm provisions (com- with section 7000) Of Division 3 Of the Business and ❑ OTHER HTs Code, and my license Is in full force and effect. REAR YARD O P/L) 9 q PROJECT DESCRIPTION ta.s ]3 license No. 2305 PKC. SPACE REO. PROVIDED Date Signature 54: FT. STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY ONSTRUCTION TYPE I hereby affirm that I have a Certificate of consent to self -Insure or a VALUATION+ p��ZONE ZONING APPROVED C DA certificate Of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C.). _ GRADING CU. YDS. ACRES SPECIAL CONDITION y NO. Company We _ rtlfied copy is hereby furnished. REMARKS: +rtified copy Is filed with the city Building Division. - NPTION FROM WORKERS' COMPENSATION DECLARATION (I ws section need not be completed -If the permit is for one hundred $1001 or less II certiiry that in the performance Of the work for which this permit Is Issued, ! shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK' subject to the Workers Compensation Laws of California. Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should became subject TOILETS URINALS GENERATOR 0-1 KW 1-10'KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER - forthwlth comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS , (INC. SOLAR) 10.50 HP 50 + HP formance of the work for which this permit Is issued (Section 3097 Lender's Name Western Pacific Financial Len FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES ' Lender's Address 1tin1 nnl;Q Si- bJprannrf- Rrh DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt froMAhe Contractor's LICenSe Law for INTERCEPTORS CLARIFIERS POLE LIGHTS POOL P TRAP the following reason (Section 7031.5 Business and Professions COtlo:SWIMMING Any city or county which requires a•permit,to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB Impprove, demolish or repalr any structure, prior to its Issuance, also re- quires the applicant for suCh permit to file a signed Statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Of Division 3 Of the WATER HEATERS BTU OUTPUT Business and Professlons Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penally c„1,e29t more than five hundred dollars ($500). SOLAR TANK COLLECTORS as owner of the property, or my employees with wages as their .'�',�x"�compensation, will do the work, and the structure Is not Intended of offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE � r'ZC! who builds or Improves thereon, and who does such work himself or Q through his own employees, provided that such improvements are not MECHANICALPLAN CHECK - SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden of provinghe did not build or improve for the purpose of sale). HEATING SYSTEM 0.100,000 BTU - PERMIT BUILDING S 1b ❑ I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business AND DUCTING ., 100,000 + BTU SMIP• $ PLAN CHECK $-ZQA-.4?i PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds Or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contrattor(s) licesned pursuant to SYSTEM GRADING S the Contractor's License Law). 100,000 + BTU PLAN CHECK 5 ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reason PLAN CHECK S MICROFILM-$ - _ Owner SYSTEM REPAIR, ALTERATION « MECHANICAL TOTAL FEE certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE S LESS AD - ion is Correct. I agree to comply with all city and county PLAN CHECK •$VANCEPC S Lhereby es and state laws relating to construction, and hereby authorizeatives ofcityton upon t above mentioned for t pu FINAL FEE $License to _ Or SS ISSUE FEE CMF 0865-46 White-Bullding; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor -- — -. CONSTRUCTION AND PLANNING - APPROVALS Permit # `� S Date Inspector.. POOL & SPA APPROVALS Permit # Date' lospector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe -Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45, Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce . 47. Rough Plumbing & Pressure Test '6. Electrical UF$R Grn 1.48. APPROVAL TO COVER-GUNITE 7. Footings 49! ' Electrical Conduit-Undr rn B. Foundatibn 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -T ap. ❑ n r r 10. Structural Floor System - 52.' -APPROVAL TO DECK 11. Property,Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connectibn - 54. Heater & Vent -Final 13.` Rough Plumbing - - 14." 'Rough Electric -Conduit -56.. Electrical -Final 15. - - Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60, POOL/SPA SYSTEMS FINAL 19, Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathin NOTES: 22. Frame and F18hin - - ,.,Z _g' y] S 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27, Electrical Power Meter -Final ' 28. Final -Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35.. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPAN No L` Date z —/ Applicant to fill in all Spaces except those within heavy border lines and sign all appropriate declarations. Lt•2 ) 1 i2/ I ft/ .j . I r a / +W l I 0 CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address ` ., fir Applicant's Mailing Address 3--fl/f Owner's Name -:U__D+ UyL S phone � L Address Arch/Eng. License No. Address Contractor's Phone Address (mailing) 3 td A City License No. _Q2f4'_-C LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license'is in f III for a and effect. f.Jcerise Class — ea' ,DateSignature �, Z2 WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self4nsure or a certificate of Workers' Compensation -Insurance, or a certified copy thereof (Section 3800, Lab. C.) I PolICy No. Company ❑Certified copy is hereby furnished. ' fi?RCertlfied copy Is filed with the city building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION -(Thissection need not be completed If the permit is for one hundred (5100) 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. Date Signature NOTICE: If,'after making this declaration, you, should become subject to the. Workers' Compensation provisions of the Labor Code, you must forthwith comply with, such provisions. or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ofthe work for which. this permit Is issued (Section 3097 Civ. C.) Lender's Name Lender's ,Address __ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the'ContraCtor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or aunty which requires a permit to construct, alter, improve, demolish or repair y structure, prior to its.issuance, also requires the applicant for such permit J file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3- of the Business and Professions Code) or that he/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 •� enalty of not mare than five hundred dollars ($500). 1, -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 (Section 7044, Business and Professional Code. The Contractor's 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 employees, provided that such improvements are not intended or offered for saleIf, however, the building or improvement Is sold within one year of com- pletion, the owner wlll'have'the burden of proving he/she did not build or im- ' rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- ' 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 - builds or improves thereon,,and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner - I, hereby certify that 1 have read this application, and state that the above Information is correct. I agree to comply with ail city and county ordinances ' and state laws relating to bull Ing O tru ion, and hereby authorize repre- sentatives of this city, to' er above-mentioned property for Inspectionpur 62r/r Signature ' Date Drivers' Lice i or SS PERMIT NO. TRACT NO. LOT NO. B DG. /DD lv TYPE OF CONSTRUCTION NEW ADD ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK 77Z B REPAIR - . A.P.gls 1.Zone Main Building: Accessory Building: Z TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL ❑ IOTHER ROJECT DESCRIPTION SQ. FT. OCCUPANCY CON STRUCTION TYPE VALUATION S ZONE GRADING CU.YDS. ACRES T Front O N B A Rear I N C Right G K $ Left e R E Ping. Ref, # Park.Fees $ Q U Remarks: Parking Req./Providid I Use of Building: R E M E N S PLUMBING FEES Planning Notes: Sar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap ELECTRICAL FEES Bathtubs Sewer Connection �. Automatic Washer Construction P_oI_eSub. Transformer ❑ 15-50 KW ❑ 50+ KW Clarifiers Solar Collectors Dishwasher Solar Piping _ Cooking Unit Miter 0 u to 100 amps Drinking Fountains Solar Tank Dishwasher Meter ❑over 100 amps Floor Drains. Swimming Pool w/Spa T Dryers ❑Gas ❑Electric Sub Panel Floor Sinks Urinal Fan Motors 00.1 HP 01 i4 8 Gas Service Outlets Watir Closet F.A.U. Inc. Solar C1 9-15 HP Ell 6-15+ Interceptors Water Heater Fixtures i Microwave Kitchen Sink Water Service Device Boxes Pole Light Lavatories Outlets -Range P—Trap Switches Sign Roof Drains Garbage Disposal • Standing Sections Generator ❑0-5 KW 05-15 KW Trash Compactor Reinspection. Fee $25 Issue Fee $ 3 Reinspection Fee $261 Issue Fee $ 3 - MECHANICAL FEES PUBLIC SERVICES RE4UIREMEfdTS: Zoning Approved By Application Approved By Application Iisued By Date ' Date Date Boiler Hood or Type I ❑ Canopy Type I I El, Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU 0100,000 BTU Duct - ventilating BUILd NG PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES I $ SMIP $ $ PERMIT - $ ISSUANCES $ $ ENERGY P.C. $ $ GRADING $ $MICROFILM $ $ _L!2 TOTAL FEE $ $ 1� Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. BI t. ICB0 Heating System & Ducting ❑0.100,000 BTU DI 00,000 BT - V P Z t Reinspection Fee$25 Issue Fee $ 3 CMF 0865.46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor- a ,CONSTRUCTION AND PLANNING APPROVALS Permit # ' Gd V)L.& Date, Inspector SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Polel 52. Pool & Equipment Location 12. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electfical•Condui Utility' Undrgrnd.` ' 54. Forms. 1 4. Electrical' Conduit-U6drgrnd. y + 55. Electrical Bonding y , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical )JEER Grnd, `' 57. APPROVAL TO COVER-GUNITE F 7. FFootings 58. Electrical Conduit-Undrgrnd. 8. Foundation ) 59. Gas Pipe, ❑ Undrgrnd:, Test 4. 9. Water Pipe-Undrgrnd, • 4 60. Backwash Lines, P -Trap, ❑ Undrgmd. f 10., Structural Floor SystQm 61. APPROVAL TO DECK 11. Property Sewer Line $i House Conn"eLion 62. Backwash & Receptor -Final 12..Sewe ,Pp 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 �F 16. Rough Electric Wiring 67. Fencing& Access Approval 17. Rough Wiring Sigri- 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL •y '/ 19. Rough Heating & Air Conditioning p3 FIRE DEPT, REQUIREMENT APPROVALS IPermit # *= 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro " 22. Ducts, Ventilating `• 71. Product Piping ❑ Gas, ❑ Oil 23, Gas Pipe -Rough & Test 72. Underground Flush 24, Roo# Framing 73. Undergrnd.'Storage Tank ❑ Gas ❑ 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 4$ 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 _ 47. FINAL STRUCTURE & BUILDING 48, Special Requirements Completed 49. Electric Release to Eclison 50. Gas Release to Southern California Gas Co 1 F 51. CERTIFICATE OF OCCUPANCY No. Date rtified copy is hereby furnished. • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Accessory Building: 'CI` y 01F. COSTA MESA," FP M[T NO. TRACT NO. LOT NO. BLDG. NO. Park.Fees $ 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 ds to become Subject to tie Workers'. Compensation Laws of California. CONSTRUCTION PERMIT ; . - 6'o O 1 Dryers ❑Gas' ❑Electric DateSignature ' NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Urinal Fan Project Address i W TYPE OF CONSTRUCTION NEW ADD ALTERATION ri REPAIR - F.A.U. Interceptors Water Heater Applicant's MailingAgdres�sa� awl v ❑ CONVERSION ❑ DEMOLISH ❑ OTHER, A,P.4h Lender's Name Owner's Name`_""'�� r%C� Phon �'� DESCRIPTION OF WORK S Main Building: Switches C E _ Generator ❑0.5 KVV 05-15 K Address ti�%SRL`/ TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T FfOnt 7031.5 by any applicant for. a permit subjects the applicant to a civil r enalt of net more than five hundred dollars ($500 Arch/Eng. License No. ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear Address, ❑ OTHER 1 A Right W �'P� +[r S Contractor's Nam Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY -1 C K _ —w Address (mailing)�� ` �'� ff'"' �� `J� �� CONSTRUCTION.TYPE VALUATION$ S Left - eft.Address(mailing) '\. City License No. ZONE GRADING CU.YDS. ACRES Ping, Ref. # \ LICENSED CONTRACTOR DECLARATION 'under Remarks: Parking Req./Provided I herebyfaffirm that I am licensed provisionsof Charter 9 (commencing 7Ith-section 7000) of Division 3' of the Business and Professions Code, $�Ginformation Use of Building: my license is in full forc@ and effect. ucense la C/ U Lie No. PLUMBING FEES Planning Notes: Date Signature Bal' Sink $hOWerS PLAN CHECK WORKE S' C MPENSATION DE LARATION D 8 MIsentatives I hereby affirm that I have a certificate of consent to self -insure or a certificate Backflow Preventer Service Sink I of Workers' Compensation Insurance. -or a certified copy thereof (Section— "00' 3800, Lab. r —o' �� Backflow Sewer Cap Signaturse to !� � -e— Policy No. Company _ _ rtified copy is hereby furnished. Zone Accessory Building: Z O N N G E Q U 1 R E M E T Clarifiers ( Solar Collectors Construction Pole Sub, -EXEM IO FROM WORKERS' C PENSRTION-DECLARATION (This section need not be completed If the permit Is for one hundred (£100) or D"tshwasher Solar Piping. Park.Fees $ 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 ds to become Subject to tie Workers'. Compensation Laws of California. - , Drinking •Fountains Solar Tank - 1 Dryers ❑Gas' ❑Electric rtified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Cer i c filed with the city B I ng D (]ate Applicant ►'�r Clarifiers ( Solar Collectors Construction Pole Sub, -EXEM IO FROM WORKERS' C PENSRTION-DECLARATION (This section need not be completed If the permit Is for one hundred (£100) or D"tshwasher Solar Piping. Cooking Unit g 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 ds to become Subject to tie Workers'. Compensation Laws of California. - , Drinking •Fountains Solar Tank Dishwasher , Floor Drains Swimming Pool w/Spa Dryers ❑Gas' ❑Electric DateSignature ' NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Urinal Fan Workers' Compensation provisions -of the Labor Code, you must forthwith - comply with, such provisions or this permit shall_ be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issueq .(Section 3097 Civ. CJ" Gas Service -Outlets' Water Closets - F.A.U. Interceptors Water Heater Fixtures Kitchen Sink t Water'.Service - Device Boxes . Lender's Name lender's Address - OWNER BUILDER DECLARATION t hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section. 7031,5' Business and Professional, Code: Any city or , Lavatories - 7 Outlets 22— P—Trap P Switches .county which requires a permit to construct, alter improve, demolish or repair ,any structure, prior to Its issuance, also requires tyre applicant for such permit to file a -signed statement that he/she is licensed pursuant to'the provisions of Roof Orains - Garbage Disposal _ Generator ❑0.5 KVV 05-15 K theContractor's License Law (Chapter 9 (commencing•with Section 7000) of Division 3 of the -Business and Professions Code) Or that he/she Is exempt therefrom and the basis for the alleged exemption. Any violation of Section Reinspection Feb $25 Issue Fee . - $ 3 7031.5 by any applicant for. a permit subjects the applicant to a civil r enalt of net more than five hundred dollars ($500 ELECTRICAL Transformer 0 15.50 KW ❑ 50 + KIN Meter ❑up to, 100 amps" Meter Dover 100 amps Sub Panel Motors.❑0-1 HP ❑1'h - 8 Inc. Solar ❑9-15 HP 016-15+ Microvvave Pole Light Range Sign Standing Sections ' W Trash Compactor Y )• I, as owner of. the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 )slue Fee compensation, will do the work, and the structure is not intended or offered FEES for sale. (section 7044, Business and' Professional Code: The Contractor's PUBLIC'SERVICES REQUIREMENTS: License Law does not apply to an•owner of a Property'who'builds or improvesBoiler ' Hood or Type 1 ❑ thereon, and who'does such work himself/herself or through his or.her own -Zoning Approved By employees, provided that such improvements are not Intended or offered for Canopy Type 11 ❑ sale. If, however, the building or Improvement Is $old within one year of com- Duct - Under Ground Application Approved By pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). t Duct - Structural Refrigeration Systerrt Application Issued By-_ �l— LJ 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: Duct - Ventilating ❑0 100,000 BTU ❑100,ODD BTU SUMMARY OF FEES -The Contractor's -License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMLF tractor(s) license pursuant to the Contractor's License Law). i Section PLAN CHECK $ PE❑ am exempt under e. & P. C. for this reason Firepl/Fact. BEL. ICBO # ISDate PLUMBING S Owner i Heating System & Ducting PLAN CHECK $ ENI hereby certify that I have read this application and state that -the above ❑0-100,000 BTU (]1DD,DDDBT ELECTRICAL $�Ginformation is correct. I agree to comply with ail city and county ordinancesantl state laws relating to building construction, and hereby authorize repre- PLAN CHECK $inspection D 8 MIsentatives of this city to ent r up0 the above-mentioned prop t r pur � s. I Signaturse to !� � MECHANICAL TO U Reinspection Fee $25' Issue Fee $ 3 PLAN CHECK $ r Drivers' L ense or SS � /� CMF 0865-46 rev. -7/83 White - Building; Canary - Appticant; Pink - Accounting; Goldenrod - Assessor - r CONSTRUCTION AND PLANI`vING = APPROVALS Permit #�S Date Inspector - POOL & SPA APPROVALS Permit # Date Inspector • 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.JElectrical Conduit Utility-Undrgrnd, 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd, 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. -Water Pipe-Undrgrnd.- 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10 -Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final- eceptor-Final12. 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 Rough Electric Wiring / 67. Fencing & Access Approval 17.' Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar CeilingJ< d Cj 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 1 71. Product Piping ❑ Gas 0 Oil 21 Gas Pipe -Rough & Test ' 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ 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/fig Notes: 34. Final Heating & Air Conditioning ur 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric, Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY P.O. Box 1200 Costa Mesa, California The Building located at 3151 Airw&v Avmua f---) has been inspected'and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-9 Occupancy. Use of Building Tn}arirrr- Legal Description A!/P! *427-241-1.1 ISee reiierse side for Metes and Bounds) Building Permit No IRWD-9c;Q1 Electrical Permit No.1MP-9SAI Plumbing Permit No. f Number of apartments —a— and/or guest rooms —0-r ISSUED TO: Building Official /� ,4— b`y !�� C. ��1r.�-�1i.., Be J. Jahn on Victor C. Buil�1��]g� Division Dirc�ctoPa Date /,Z7 �AP�/ L I y -Z— This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU 34 Rev. 11/70 l� CITY OF COSTA MESA BUILDING DIVISION r 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us t: " FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: E08-00097 PERMIT TYPE ELEC STATUS: ISSUED APN. 93894008 DATE ISSUED: 03/19/2008 ISSUED BY: JOB ADDRESS: 3151 C001 AIRWAY AV CM Suite/Unit: C001 Vicinity: ROOF TOP - UNIT C1. SCOPE OF WORK: REPLACE DISCONNECT BOX FOR HVAC REPLACEMENT. REF: M08-00036 CHANGE OUT HVAC ON ROOF TOP WITH SAME SIZE/WEIGHT UNIT. INSPECTOR TO VERIFY A/C UNIT FULLY SCREENED BY ROOF CUT-OUT PRIOR TO FINAL INSP. OWNER: PROPERTY RESERVE INC Address: 3151 AIRWAY AVE C-1 Unit: PHONE: City/State/Zip: . COSTA MESA, CA 92626 APPLICANT: MILLER, DUSTIN PHONE: 714 826-5119 CONTRACTOR: SONSHINE PLUMBING INC -DIAL ONE Address: 10537 DALE AVEUnit: PHONE: 714-523-9219 City/State: STANTON, CA ZipCode: 92626 ELECTRICAL PERMIT FEES Electrical Plan Check Fee: $0.00 Electrical Permit Fee: $28.25 Reinspection Fee $0.00 TOTAL FEES $28.25 Address: Unit: City/State/zZip: License No. 550716 CELL: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE 0• IKSPEcnortTYPE L7 INUU CODE I INSPECTION TYPE DATE INTITIALS 1816 Fixed System Final Fire Prevention 208 Final Mechanical 1268 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 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildinglOccupancy WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of pgrjury one of the following declarations: ❑ 1 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, fpr the performance of the work for which this permit is issued. My workers' compensation Insurance carrier and policy number are: } f_ j Lamer: S� r { eP � wv l�!�, h IM'.A 1111 VA V1 Ce- Cu1&Gi (This sed+on need nor be mrnplot d rhe permit is valued at ono hundred dollars (E IGO) or fess.) Polley Number: lis('Do L2 7iPol ❑ 1 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 th ,, 13p r Code, I shall forthwith comply with these provisions. Applicant'signature LJ Date 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 DOLLARS ($100,000), IN ADDITION 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 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. O Lic. # -71( n Class G 1(0 C Contractors Sipnalure '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: 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 and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects thr: applicant to a civil penalty of not more than rive hundred dollars (5500).): ❑ 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 10 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 contractort License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ lam exempt under sec. Business and Professions Code for this reason: Signature 305746 (3107) Date Owner ID verified by driver's licb.. _. ❑ 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. Applicant's Signature Dale 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? ❑ 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? ❑ Yes ❑ 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 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 wilh? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ 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 Qualily 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? ❑ Yes ❑ No 8. (It "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. Si nature :;241'a2 Date G�_�3 _9 , d� And/or Authon¢ pplicant V Date T CITY OF COSTA MESA o "? 9 BUILDING DIVISION i 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa-ca-us ` FOR INSPECTIONS CALL: (714) 754-5626 I PERMIT NUMBER: M08-00036 PERMIT TYPE MECH STATUS: ISSUED APN: 93894008 DATE ISSUED: 03/1912008 ISSUED BY: JOB ADDRESS: 3151 C001 AIRWAY AV CM SelitelUnit: C001 Vicinity: ROOFTOP SQ. FT: 0 SCOPE OF WORK: CHANGE OUT HVAC PACKAGE ON ROOF TOP WITH SAME SIZEMIEIGHT.UNIT. INSPECTOR TO VARIFY AIC UNIT FULLY SCREENED BY ROOF CUT-OUT PRIOR TO FINAL OWNER: PROPERTY RESERVE INC Address: 3151 AIRWAY AVE C-1 Unit: PHONE: City/State/Zip: COSTA MESA, CA 92626 APPLICANT: MILLER, DUSTIN Address: Unit: PHONE: 714 826-5119 Cily/State/zZip: CONTRACTOR: SONSHINE PLUMBING INC -DIAL ONE License No. 550716 Address: 10537 DALE AVEUnit: PHONE: 714-523-9219 City/State: STANTON, CA ZipCode: 92626 CELL: MECHANICAL PERMIT FEE SUMMARY MECH ITEM FEE: $38.20 PLAN CHECK FEE: $0.00 INVESTIGATION FEE: $0,00 - REINSPECTION FEE: $0,00. TOTAL FEES: $38.20 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE I INSPECTION TYPE DAFT INTMAL CODE I INSPECTION TYPELD.AATE IN TIAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical )b_- Q 1266 Pool Spa Finat 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 Final Sign 222 Final Site 204 Final Demolition 250 Final BuildinglOccupancy I WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintein 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: SS Carrier: 2A � w* t?e,&i� J,10 JA 1u S J VA 01-6 E Vld (The section need nor be I the perm) o Valued at one hur,&ed dollars ($100) Or k1s.) ,,Policy Number:(,20(213 022, certify that in the performance of the work for which this permit is ssued, 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 f rthwith comply with these provisio s. Appi�—Carks re V Date 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 DOLLARS ($100,000), IN ADDITION 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 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. /! l Class #- L� r] Contract 's Signa um to 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 (5500),): ❑ L, 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 blritding 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.). ❑ 1, 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 Profession8 Code for this reason: Signature 9057-46 (3107) Owner ID verified by driver's lic. [:]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, Iafsework, 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. Appiicant's 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? ❑ 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? ❑ Yes ❑ 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 Catifomia 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 42303 of the Catifomia 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? ❑ Yes ❑ 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 Date /�� 1 V �? i�j `'� And/or 4u2vofiz piwnt - Date COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING ADDRESS °TOR ENAWestern Pacific Financial MAILING rtq_j._Pona1a Olson Go. APPLICATION Fg,3�TgygjV- PERM1T42he 79 % RECEIVEf3BY PERMIT,.,, w �/I A.P. NO. IY2.r7,_9/BUILD NG ADDRESS ADDRESSS UNIT OR SPACE NO. i Dv 11 O. r.M. k16T BLK. CITY Irvine Ca. 92714 NOL540-260- `D�qI T'lestern Pacific Financial NEW App ALTER REPAIR MOVING DEMOLISH LE'NDER'S NDE BRANCH OWNER. Western Pacific FinancLal (Sante) ADDRESS VALUE ARCHITECT TE OR ENGINEER Hale s - a s t - ^ USE s o� ADDRESS 777 S. Main, Orange, Ca. ZONE TYPE GROUP CONTRACTOR J • Donald Olson Co. BYPROVED DATE ADDRESS 18003 Skypark Blvd , Ste . B Nct40-2606 '� S 2Z1 g CITY Irvine Ca. 92714 -2-57a sic No. 833969 APPROVED SETBACKS LIC. NO. SIZE NO. OF BLDGS. (FROM CIL S7REETI OF LOT NOW ON LOT Q FRONT FT. USE OF Vacant Land EXISTING BLDG SIDE M Al' Separate permits are required for L. SLDE FT. electric, plumbing and heating work.. RE FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Construct office building shell 9-13o DATE APPROVED 6343 S ,F . APPROVED _' JQATF �G HOLD FOR SPECIAL REQUIREMENT` I hereby acknowledge that I hove read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shell not employ any person in violation of the workman's compensation laws of the State of California. 1 hereby certify that I am pr y licensed as a contractor under SQ. FT. the State of California Bus esa nd Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, andZzuchcan s are In full force end t, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt froer sof the ata of lif la usinessVALUATION and Professions n 3, Cho 9. PERMIT FEE s Signature of Permittee s lQQe� Q PLAN CHECK S 89 G7U f TAX S42 or Authorized Agent Date TOTAL PAID 72 i Dv 11 ' Abplicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ,CITYO,F COtTA MgR [PIERMIT NO. TRACT NO. LOT NO: BLDG. O. - ICONSTRUCTIO- 101.2J f Project Address S AA Jf C -?---r 3 TYPE OF CONSTRUCTION ©NEW ❑ADD ❑ALTERATION ❑ REPAIR ❑ CONVERSION'❑DEMOLISH OTHERArchlEng_tt�]�rLicense DESCRIPTION OF WORK ,Owner OPhone 6q „,0;! 4Address'95 -3 �Gftd- CIE No. �S� Address a )b2 OVL;F Contractorli i�i�g Phone &q5?,4)!2 TYPE OF PERMIT, ❑ GRADING „❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT �'�`L"ECTRICAL (PLUMBING -❑MECHANIC ( :Address LICENSED CONTRACTOR DECLARATION; I hereby affirm thi.t, I am licensed under provisions of Charter 9 (com- mancing with section 7000) of DIvIsIon -3 of the Business and Professions Code, anI my license is In full force aid�ifpct. S oZ f19�D I (� OTHER - PROJECT DESCRIPTION' _ _ i* License C3 s i s o ^ate gnature I RKERS' COMPENSATION DIZC ATION- - •reby affirm that I have a certificate of consent to sett -insure or a ,etificate`of-Workers' Compensdtion InsuranCe, -or a certified copy thereof (SectGto Lab. C.). f e Policy No. , f, --CortlPanY r 4tQ ou S.�S S-- - r SCI. FT, 1 OCCUPANCY�CO STRUCTION TYPE VALUATIONrZONE - - GRADING CU. YDS. ACRES - • • - - - - •• - • - - -REMARKS: ' '-' • - ---- - I]•Certified copy -i$ hereby•furnished: - - — --- - - -• -4 ❑ Certified copy Is filed with the tity Building Division. _ EXEMPTION FROM WORKERS'-COMPENSATION-DECLARATION- (This- section -need not -be completed.if the permit is for -one -hundred 1$100) or less). + .certify that in thetperformance of the -work for which_this.perm1t.15 Issued, I shall not employ any person in any manner so as to become subject.to the Workers' Compensation Laws of. California. - . - Date Signature I _ _ _ _•_.,-_ _, -�N., _ _ .�._ �. _ __ .. �- PLUMBING •: PLAN CHECK __ BATHTUBS SHOWERS - NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you forthwith comply with such provisions or this permit shall be deemed TOILETS `,•f )?,URINALS - LAVATORIES DOUBLE LAVS_ revoked. -- •! _ _ . ' - __ _. - _ ._ CONSTRUCTION LENDING AGtNCY _-- -- KIT. SINKS DISHWASHERS' SINKS SUMPS I hereby affirm that there is a Cogstruction lending agency for the per -SERVICE formance of the work for which this permit is issued 30_97 FLOOR SINKS FLOOR DRAINS _(Sec_tion Civ.'C.). - Lender's Name Lender's Address DRINKING FOUNTAINS - INTERCEPTORS CLARIFIERS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the' follow+ng rea$on`(Section -7031.5-Business and -Professions Code: Any city or county which requires a permit to construct, alter, reprove, demolish or repair any structure, prior'to its Issuance; also're- ires the ap;.licant for such perrttit to file a signed statement that he licensed pursuant -to the provisions of the Contractor's LICense Law' ,Chapter 9 (Commencing with $ectlon 7000) of Division 3 of the Business and Professions Code) or that he 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). SWIMMING POOL P'TRAP WATER SERVICE ALTERATION— " GAS SERVICE OUTLETS _ 'WATER'FIEATERS - ^ BTU�OUTPUT -- - --- SEWER CONNECTIONS - - - _ SOLAR TANK COLLECTORS j ❑ I, as owner of the property, qr my employees with wages as their- sole compensation, will do the work, and the structure )$.not Intended, or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does-nbt apply -to an owner, of a property who builds or improves thereon, and who does such work himself or through his own. employees,. provided that. such.improvements are not intended or offered for sale. If, h9wever, the building or improvement is.soid.within one year of -Completion, theowner will have the burden , of proving he did not build or improve for the purpose of sale). (3-l; -as -owner-of-tne- property; am exclusively contracting with licensed contractors to construct the project (Section 7044, -Business and 'Professions Code: The'Contractor's License Law does not apply to - an owner of property who builds or improve$ thereon, and who con- tracts'from such projects with 'a contractor(s) licesned Pursuant -to the Contractor's_ License Law). SOLAR PIPING SYS. ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,0.00 BTU --AND DUCTING 100,000,+ BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000+ BTU El am exempt under'SeCHGA _ B. & P. C. for this I BOILERS BTU reason- ` SYSTEM REPAIR, ALTERATION Date - Owner- - _ _ EXHAUST SYSTEM MULTIPLE _ I hereby certify that I have read.this application and.state that the above Information Is correct. I agree to comply with all city and county ordinances and state laws,relatfn to construction, and hereby authorize_ representativ f this enter upon the above mentioned property . in c p ey,... - ISSUE FEE - - - -- -- - T Signature _ Date - _ r• ` Drivers' Lic a or 55I CMF 0865-46 White -Building; Canary•Applicant; Pink -Accounting; Goldenrod -Assessor 4597 4/14/88 13.00 'TU ING REGULATIONS A.P. - ZONE PLN•�G.. gRtE�1F.p SEpTBACK C T. PROPEIR MINE JJI Ste YARD _. .. RIIGHT REAR YARD (TO P/L) _ SPACREQ. POVIDED-„_ PKG. E R I I STREET WIDTH PARK FEE S ZONING APPROVED BY - r DATE SPECIAL CONDITIONS: _ELECTRICAL PCAN-CI�ECK - SO" FT. _ -GENERATOR '- 0-1 KWL ]-10;KW TRANSFORMER X50 _-+-KW APPLIANCE'-10.50'KW�- I MOTORS--- 0.1 HP" 1.10•HP` _4- -.(INC. SOLAR)-- -10.50 HP_ -x-50 + HP FIXTURES- -OUTLETS- SWITCHES- -GAS'TUBE SIGNS IGNS'"POLE -POLELIGHTS ---` - I POLES METERED UB PANELS'- "- MAIN' SUB SERVICE-'_- - - AMP - 1 -ISSUE FEE 'APPLICATION APPROVED BY -' -- - DATE -- - _ j SUMMARY OF, FEES, ^ - + ,BUILDING` - PERMIT_ $ �' r SMIP•�- $•• ; .- _ - - rPLAN CHECK E PERMIT '• ; +. ; - r_ - --$ -� ISSUANCE $• •- 'PLUMBING -':GRADING. 'S PLAN CHECK J ELECTRICAL S � - •• S y � - I t. MICROFILM E. • 1PLAN-CHECK $ - - -I TOTAL FEE $'' ) •IMECHANICAL'S' { I. - •" - . ' I t t• _ - LESS AD- PL'AN'CHECK' E - - - VANCE PC - $_ •ice' " • � - + k _ FINAL FEE $ Y CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL`& SPA. APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. -Electrical Conduit Utility-Undrgrn_ 45. Forms 4. Electrical Conduit-Undrgrn_ _ 46. Electrical Bonding 5. Steel ein_orce 47. Rough Plumbing & Pressure test 6. Electrical, LIFER Grn 48. APPROVAL TO COVER -GUN ITE - 7, Footings 49. Electrical Conduit-Undr rn -8. Foundation. 50. Gas Pie ❑ Undr rn Test -9. .Water Pipe;Undrgrn. , + 51. Backwash Lines P -Trap,❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53:^ -Backwash & Receptor -Final .12. . Street Sewer -Connection _' 54. Heater & Vent -Final 13. Rough Plumbing- - - 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final 16. Rough Heating & Air Conditioning _787-encing & Access Approval 17, Ducts in Structure- 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating -60. POOL/SPA SYSTEMS FINAL 19.' Gas Pipe -Rough &Test 20. -Roof Framing 21. Roof Sheathing 22. Frame and FlashingNOTES: 23. Insulation 24. Lathing & Siding - - 25. Drywali Nailing ; 26. Plaster Brown Coat T 27. Electrical Power Meter -Final / 28. Final Electric 29. Final Heating & Air Conditioning _ 30. Final Gas Pipe -Test 31. Final Plumbing ` '32. Water Service -Final 33. Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release. to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY -No Date Applicant to fill In all spaces wMklin heavq, border lines and sign all appropriate declarations. • CITY-OF COSTA MESA -- PE IT NO. - - -TRACT NO, LOT NO. , B�DG. NO. - - 2545' 2/26782 23.56 TL ' CONSTRUCTION PERMIT �3 - r. . , - ;' 1 Project-Address f�! ,� ,S 1 r r +tea TYPE OF CONRUCTION -r _ r $ , -11?ADD El ALTERATION Owner o +iso1'1 s oC, one '❑ NEW -L Address _ _ _ ❑ REPAIR ❑ CONVERSION ❑DEMOLISH y i ` ❑ OTHER. ZONING REGULATIONS Arch/Eng. 7 T S oriJt nbprdy icense No. DESCRIPTION OF WORK 19t1fJ&kA-.P. 9F -Address- T 4/1 S ZONE- PLN7G. RUE FI: .- i ry I-Contractor E dor' ' b Q Phone $-0 -T PI OF PER - - BUILDING- - pROPEIRTOYNLGINE Address ' " SETBACK C sT. �» E� % - C '� ❑ Gf24DING FOUNDATION -❑•STRUCTURAL - , Si E YARD -- f LICENSED-CONTRACTOR DECLARA ON r ❑ TENANT ELECTRICAL .❑PLUMBING-❑MECHANtCA SIDFE-YA II hereby affirm that I am licensed sunder provi5lons of Charter '9,(com- RIGHT - 'mencing•-with, section.-7000). ,of, , Division 3 of the Business, and ❑ OTHER _- ,Professions Code, land my license is In full force an effect. REAR YARD (TO P/L) f - - =-za S4 J' PROJECT DESCRIPTION'r _ . _ _ _ License Class - Licen o' J PKG. SPACE-REQ.- 'PROVIDED" z'-2611 Sa,'F.T. , , Date` r" Signature. _ " - - - ORKERS- COMPENSATION DECLARATION STREET WIDTH PARK FEE $ OCCUPANCY' CONSTRUCTION TYPE ereby affirm that I have a certificate of Con Se to self-insure,or a ZONING APPROVED'HY - DATE - -,VALUATION-' - - - ZONE=_ ~� •� •' + ti -ficate of Workers' Compensation .Insurance. or- a.certllled,copy. _ _ _ _ _ _.,r_ ��.__ eof (Section 3800, tab, C.). IGRADING�CU. YDS. ACRES SPECIAL CONDITIONS: Policy-No.- - - - - Company- - -- - - - - _ Lk- - - - - _ _ - '❑ Certified copy Whereby furnished. _ _ _ _ _ - REMARKS:-;,�+_ +' 1 _ _ _ _ _ _ _ _ Z. _ l❑ Certified copy is tiled with the city Building Division.- (EXEMPTION -FROMWORKERS'-COMPENSATION DECLARATION'•-��'- �{{This section need not be completetl if the permit Is for one hundred i � _ J + •''' !: ,_ ' , :{$100) or'IesS}. - - - - - - ._.- _ ;_. r.. �; - -- - - - - fr• .. '.!._. _ - - - _. - II Certify that n the performance of the work for which this ermlt Is Ty - ; Sal 1 shall not emQloy any person in'any"manner o as t - ecoMe PLUMBING -PLAN CHECK - ELECTRICAL PLAN CHECK. subject to the Workers _Compensation La of ",or r ' iDateSignature BATHTUBS -" -SHOWERS ` - - - - - ;NOTICE: If after making this declaration, you should b subjectI-FEOOR ,TOILETS - URINALS--- i- - 'GENERATOR- 0.1 KW 1-10'KW- to the Workers' Com P.nsatI.n provisions of the Labor C d ou must' TRANSFORMER forthwith comply with such provisions or this permit s li be deemedLAVATORIES DOUBLE LAYS -- - -- - - - •APPLIANCE - 10-50•KW�50 + KW revoketl,_ _ } __ KIT. SINKS - DISHWASHERS.- -,MOTORS•- ,CONSTRUCTION LENDING AGENCY - 0 1 HP-_1-10 HP,I hereby affirm that there is a construction lending agenty for the per•SERVICE SINKS.,, -ter ISUMPS-' -- - - •--- - _ -(INC..SOLAR)- .10-50HP --50.+-HP.formance of the work for which this permit is issuetl Section 3097 Iciv. C.).- SINKS "FL'OOR"DRAINS' -- - fFIXTURES S'G 'OUTLETS SWITCHES- Lender's Address ' DRINKING-FOUNTAIN$ :GAS TUBE SIGNS - --- •--- - - -• - - - � OWNER BUILDER-DECLARATION--•- -INTERCEPTORS - CLARIFIERS - '-1 7PDLE LIGHTS - --- - I hereby affirm that I am exempt from the Contractor's License Law for _ •-- - �T f. _-�, iii the-fol lowing. reason (Section -7031.5-Business and.Professions Code: SWIMMING POOL •- P-TRAP �- - - -- - Any city or county which requires a permit to Construct, alter, �r POLES METERED SUB-, t improve-•demolish-or-repair•any-structure,, prior to-its Issuance, also re- - WATER SERVICE- ALTERATION- - -r-� PANELS --- -'-'MAIN -- SUB - - - - quires the applicant for such permit to tiie a signed statement that he ` t 'tensed pursuant-to•the-provisions•of.the Contractor's License Law -GAS SERVICE OU�TL'"- ETS 1' :', - SERVICE - -- -AARP-• -pter 9 (commencing with Section 7000) of Division 3 of the _ _ - - + _ Hess and Professions•Cocfe)-or-that-he.is exempt therefrom.and the WATER HEATERS - -BTU-OUTPUT - - -= -�- =- '-- -- - - - - - - - - - r,a>Is for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects- the -applicant to a- civil. penalty-'SEWERCONNECTIONS `-�•'- -- - --•� -- - -- - -- --- of not more than five hundred dollars ($500). '0-1-as"owner of'the-property, or my employees with wages as their -SOLAR TANK- COLLECTORS- - - - - -- - - - - - - - - F sole compensation, will do the work, and the structure Is not intended or'offered-for'Sale. (Section 7044,-BuSiness and Professlons-Code:'The" - SOLAR-PIp1NG SYS. "" _ ;,- --' - - - ISSUE FEE - - - - --- - Contractor's License Law does not apply to an owner of a property - who-builds or'improves thereon,-and who does Such work-'himself'or - -'ISSUE-FEE - -" ' j�'- "' • `-` ' }APPLICATION APPROVED-BY. - - --- • - - -DATE - - - through his own employees, provided that such improvements are not Int6nded'or'offered for sale. It,-however, the build ing-or'improve ment -MECHANICAL PLAN CHECK .�_ _ •` T-SUMMARY OF FEES is sold within one year of completlon, the owner will have the burden r ;• .1, ,, - ' „e r ofproving'-he tlid- not •'build' or improve' for the purpose of sale): - - - -- 'BUILDING --- - - --- --- HEATING SYSTEM 0.100,00♦) BTU -. ^ _ 1PERMIT - _ _$ ^ _ - _ 5MIP i $• _ -••-�- ❑-l,_as-owner_-of the property, am exclusively contracting-,with -AND DUCTING 1,^ -- I `=n'' licensed contractors to construct the project (Section 7044, Business 100,000'+ BTU -� iiPLAN CHECK E PERMIT. and.Professions Code: The, Contractor.'s .License: Law does not apply to _ F, _ _ _ _ I 'i' 4 , •r' an owner of property who builds or improves thereon, antl who con- - ISSVANCE-$ a REFRIGERATION 0-100,000 BTU PLUMBING $ ^ i tracts-from such.projects with_a contractors) licesned, pursuant to___ _ e {"--' ti' t i -SYSTEM-- _._ ___ _ _. - _ GRADING the Contractor's License Law). 1)0,000. BTU PLAN CHECK $ ❑-I'am,exempt under•Se.ction - -- B. &P., C: for,this BOILERS BTU '- ELECTRICAL "$ i PLAN CHECK E ^• - 'MICROFItJVI'S"" Date Owner SYSTEM REPAIR, ALTERATION _ - 7 .J TOTAL FEE S•' 1 1 herebycertify that 1 have read this a MECHANICAL •$- - - j y application and state that the above EXHAUST SYSTEM MULTIPLE • LESS AD InIormation-is-correct: I-agree to-comply-with allCity and county .,PL-AN CHECK 5 ''VANCE PC- $_ ordinances and state YaJ.", lating to construction, and hereby authorize representatives of thit -enter •upon-^the-the-above-- - - ° '• -• •• •' C property fpr i pec op s. + r•..1� 1 �•��- - FINAL FEE $� $fgnalure ISSUE FEE Drivers' License of SS 0865-46 White•Buildiag; nary-Applican ; In -Accounting; Goldenrod-Assessor CONSTRUCTION AND PLANNINGPOOL APPROVALS Permit #alLi Date ,; InspectoFJ & SPA ` APPROVALS s. Permit'# l �� ,' Date Inspector 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location _ Soil ipe:Undrgrr� - :7. 44. Steel Reinforcement - - - 3...Electrical,Conduit.Utility-Undrgrn.,- + _ 45. • Forms _ - 4. Electrical. Conduit-Undrgrn _ _ k_ ;_ 46. Electrical-Bonding - - _Steel Reinforce ._ F 47. Rough Plumbin '& Pressure Test-- - - _6. --Electrical -UF.ER Grn - _ 48. APPROVAL TO COVER-GUNiTE 7. Footings__ > 49. Electrical Conduit-Undr iri' = r ---8...- Foundation. __ _"_. _ _ 50.x, Gas Pipe, ❑ Undr rn,Test 9. -_ Water- Pipe-Undrg'rn 51., Backwash Lines P-Tra- ndF4rn • 10. Structural.Floor System 52. _M -APPROVAL TO DECK 11. Property Sewer Line &.House:Connection _ _ 53.- Backwash & Receptor-Final 12._.-Street. Sewer Connection .. _ . _ 54. Heater'&'Vent-Final ` .13..- .Rough-Plumbing _ -55. Plumbing S�ite Einal 14. Rough Electric-ConduitTY "`" '-' '56. -Electrical-Final 15. Rough Electric-Wiring - 57. Solar System-Final 16 Rough Heating & Air Conditioning = ----Fencing &.Access Approval -17'. Ducts, in Structure - - . AP.PROVED..FOR PLASTERING 18. Ducts, Ventilating 60.- POOL/SPA SYSTEMS F.INA'Lr;'.�� 19: Gas Pipe-Rough $i Test ` - - 20: --Roof Framing 21. Roof'Slieathin --- ---- NOTES: 22. -Frame and Fkashin - _ . 23. • Insulatiori_. " - 24:-Lathing.&-Siding 25. -Drywall-Nailing 26.. Piaster Brown Coat 27. Electrical Power Meter-Final - It b ' 28. Final Electric - • - - - - 29. Finan Heating & Air Conditioning - ` - - -- - - 30. Final;Gas Pipe-T@st - - - - 31:,- Final,Plumbing - _ _ Li 32. -Water Service-Final - - - - - - - 33:- Gas Service-Final - 34. Solar Domestic-Final '' ' ' Lw~ 35. Landscape Sprinkling System - 36. Sound Attenuation 1 37. Handicap, Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed"' ^ _ } 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. , ,42. -CERTIFICATE OF OCCUPANCY -No. Date .� l Applicant to fill in all spaces within heavybortler IineS and sign all appropriate declarations. CITY,0C�+�TA MESA r P�ggMET TRACT NO. LOT NO. BLDG. NO. 'CONSTRUCTION PERMIT PM ZS`�3 gm 53 —1 SUMMARY OF FEES Project Address 3j j W.,9 FVL16 L'2 TYPE OF CONSTRUCTION PERMIT Owner 13,j.)CAkSO4 Phone603 ©NEW ❑ADD ALTERATION S PERMIT 'Address �5'U� eftT-5C017rr ± 7 NG1Gy, © REPAIR .❑ CONVERSION ❑DEMOLISH. PLUMBING Arch/Eng. . IODD sro evibav icense No. C-� C3 OTHER _ GRADING S Address a (p2 POM04A A Cj DESCRIPTION OF WORK �%6�� C ELECTRICAL WRRI16H 1� T Y - R � . � l�1Y Mme/✓%$ MICROFILM $ Contractor 4er & Phone 04SIM13 TYPE OF PERMIT MECHANICAL Address `�) Fp E, ZQ ell ,.,.., �� ❑GRADING,- ❑ FOUNDAT,[I..O,,//N' L`TSTRU�C�URAL $ LESS AD- '' •r - VANCE PC $_ LICENSED -CONTRACTOR DECLARATION ❑ TENANT LGPLUM81NG L�3MECHAN I hereby affirm that t am licensed under provisions of Charter 9 (com- 3 t ❑ mencing with section, 7000) of Division of the Business and Professions Code, and my license is in full force and gftec[. license lass 13 s lS OTHER - PROJECT DE GRIP ON _ SQ..FT. � 70 Date �' CI a Signature WORKERS' COMPENSATION DEC RATION OCCUPANC : CZjVSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure at VALUATION 70r ' ZONE ELECTRICAL PLAN CHECK certificate of Workers' Compensation Insurance, -or a -certified- copy - .. thereof (Se Lab. C.). fAi�Df`4-r �f45twomet GRADING CU.'YDS. ACRES GENERATOR 0.1 KW' ' 1.30 KW TRANSFORMER APPLIANCE 10-50 KW-�--50 + KW Policy No. r,' '� --Company IQ ❑ Certified copy Is hereby furnished. - — r"RCertlfied REMARKS: copy is filed with the city Building Division. FIXTURES OUTLET SWITCHES -MPTION FROM WORKERS' COMPENSATION DECLARATION Q�Eo%• �� ds section need not be completed if the -permit is for one hundred �, .� '� ! i$100) or less)j. (.certify that in the performance of the work.for which this permit Is Issued, ! shall not employ any person in any manner so as to become PLUMBINGµ PLAN CHECK subject to the Workers' Compensation Laws of California.. Date Signature) BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS ,+ .. URINALS' - to the Workers' Compensation provisions of the Labor Code, you must forthwith comply:with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS -' .revoked. CONSTRUCTION LENDING AGENCY KIT, SINKS OISHWASHERS I hereby affirm that there Is a construction lending agency for the per- SERV ICE SINKS'- SUMPS formanCe+of ,the work far %- h�ch.thls permit. is issue (Section 3097, `- APPLICATION APPROVED BY Civ. C.). ` - L _ A I FLOOR SINKS FLOOR DRAINS I:-ender'S Nam¢,.:, - C c 4' Lender's Address 1, DRiNKING'FOUNTAINS OWNER BUILDER DECLARATION- -- - "'" -- I hereby affirm that I am exempt -from the Contractor's,License Law for IER- S INTERCEPTORS„." CLARIFS the following -reason (Section 7031.5 "Business and ProfesSions Code: SWIMMING POOL ' P TRAP Any city or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to its Issuance, also re- quires the api.licant for such permit to file a signed statement that he WATER SERVICE 1 - ALTERATION is 'licensed pursuant to the provision$ of the Contractor's License Law GAS SERVICE OUTLETS (Chapter 9 (commencing with Section 7000) of Division 3 of the 'Business and Professions Code) or that he"is exempt therefrom and the -WATER HEATERS y - BTU OUTPUT I - basis for the alleged exemption. Any violation of Section 7031.5 by any applicantfor-a' permit subjects the applicant to a' civil penalty SEWER CONNECTIONS o_f not more than five hundred dollars ($500). 1 1, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS,--'-, compensation, will do the work, and the structure is not Intended Offered for sale. (SeCtlon 7044, Business and Professions Code: The SOLAR PIPING SYS. ?' Contractor's License Law does not apply to an owner of -a property who builds or improves thereon, and who does such work himself or ISSUE FEE .through his own employees, provided that.such improvements -are not Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK is sold. within one year of completion, the. owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0.100,000 BTU 0.1, as owner -of the property, am. exclusively contracting with AND DUCTING-- licensed contractors to construct the project (Section 7044, Business 100,006-+ BTU and- Profession$ -Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU tracts -from such projects with a contractor(s) licesned- pursuant - to SYSTEM - - - •-- - " the Contractor's License Law) • 100,000 +BTU 'I am exempt under Section' B.-& P. C. for this BOILERS BTU reason-- - - - reas SYSTEM REPAIR, ALTERATI ON Owner— wner DatLEn'- .certify that I have read this application and state that the above I EXHAUST SYSTEM MULTIPLE on is correct. I agree to comply with all city and county and state laws relating to construction, and hereby authorize VC%i5/lr p1✓L ative of t 's city en r upon the above mentioned �'•``~ f 1 o Y P - -K � ISSUE FEE Lite or SS CMF 0965-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor .1728 , 2/05/82, .424.34 TL SUMMARY OF FEES ZONING REGULATIONS � 3 PERMIT — PLAN CHECK S PERMIT PLNG.. P ISSUANCE $ PLUMBING gREF..pp=ST. ROP�IRTYLINE GRADING S _ - $ ELECTRICAL WRRI16H 1� T Y - R MICROFILM $ REAR YARD (TO P/L) S - - _ . MECHANICAL PKG. SPACE REQ. C9i45 PROVID PLAN'CHECK $ LESS AD- '' •r - VANCE PC $_ STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE 2 K V SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK GENERATOR 0.1 KW' ' 1.30 KW TRANSFORMER APPLIANCE 10-50 KW-�--50 + KW -' IQ MOTORS 0:1 HP - 1-10 HP .(INC. SOLAR) 10-50 HP - 50 + HP ' FIXTURES OUTLET SWITCHES GAS'TUBE SIGNS - - - POLE LIGHTS" POLES METERED SUB'. ' )� 'PANELS MAIN SUB + - SERVICE - - " - AMP- MP-ISSUE ISSUEFEE QRS APPLICATION APPROVED BY Zea T _ FINAL -FEE, SZ3o' k1 SUMMARY OF FEES BUILDING � 3 PERMIT S SMIP $ 96, 4D PLAN CHECK S PERMIT ISSUANCE $ PLUMBING S GRADING S PLAN CHECK $ ELECTRICAL $ $ MICROFILM $ PLAN CHECK S - - _ . MECHANICAL TOTAL FEE'$ E �Qr' - PLAN'CHECK $ LESS AD- '' •r - VANCE PC $_ Zea T _ FINAL -FEE, SZ3o' k1 CONSTRUCTION AND PLANNING APPROVALS Permit #��S� Date Inspector POOL & SPA- ''. - Date Inspector APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn i 71,f 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4.. Electrical Conduit-Undrgrn 46. Electrical Bonding ' 5. Steel ein arca 47. Rough Plumbing & Pressure Test - - - - 6. , Electrical U ER Grn ,' 48. APPROVAL TO COVER-GUNITE- - 7. Footings.- 49. Electrical Conduit-Undr rn 8. foundation. 50. Gas Pipe,. ❑ Undr rn, Test _ 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap,0n1cY r ° 10. Structural Floor System 52. ---APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final _ 12. Street Sewer Connection _ _ 54. Heater & Vent -Final 13. Rough Plumbing _ / �7 - 14. Rough Electric -Conduit -- - ~ •56.- Electrical -Final 15. Rough Electric Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning 2� Fencing &Access Approval 17. Ducts, in Structure 59• APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 60. POOL/SPA SYSTEMS FINAL ` 19. Gas Pipe -Rough & Test _ __ 20. Roof Framing 21. Roof Sheathing- Y -- ` - - NOTES: S 4� �- 22. Frame and Plashing . _ _ . -Z _ 23. insulation '' 24. Lathing & Siding 25. Drywall Nailing Rf-) 3 - -2- 26. 26. Plaster Browri.Cbat =' 27. Electrical Pgwer Meter -Final' 28. Final Electric --29. Final Heating& Air Conditioning _ _ - Y -30. Final Gas Pipe -Test 31, Final Plumbing _ 32. Water Service -Final - 33: Gas Service -Final 34.. Solar Domestic -Final 35. Landscape rinklin S aSem 36. Sound Attenuation' �' ' r•" . " 37. Handicap Regulatioris, 38. FINAL STRUCTURE & BUILDING if 39. Special Requirements Completed 40, Electric Release to Edison - 41. Gas Release to Southern'Celifornia Gas Co. 42. CERTIFICATE OF OCCUPANCY No. �� S Date l �Z ' L�� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. C,4 GF GOSTA MES', ►. PERMIT NO. TRACT NO. LOT NO. gq!eO-NO. CONSTRUCTION _PEFSIV�I Project Ad ress C TTY//JPE OF CONSTRUCTION Owner 1 t]� NEW ❑ ADD ❑ ALTERATION Address �. REPAIR ❑CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER ' DESCRIPTION,OF WORK Address VYLJ4141v - - Contractor Pho TYPE OF PERMIT ' -Address -' - - _ ❑ GRADING ❑-FOUNDATION STRUCTURAL LICENSED CQ TRACTOR. DECLARATION, r' { ❑ TENANTELECTRICAL• ❑PLUMBiNGMECWAN 1 licensed of Charter 9 . 1 hereby affirm th«t am under provisions (cpm- mencing with section 7000) of 'Oivlslon 3 of the Business and ❑•OTHER Professions Code, and my license Is In full force and effect.. •PROJECTOE•CRIPTION - '- License Class - License No. rr•�� Date " ' 'Signature - ' V WORKERS' COMPENSATION DECLARATION. _ OCCUPANCY -CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATIONS • V%7S' _•TONE certificate -of -•Workers' -Compensation Insurance, or a certified Copy—,r thereof (Section 3800, Lab. C.). ' GRADING -CU.. YDS. ACR Oollcy No. -- -Company - - 1�,Certified copy..Is.hereby_furnishetl,- _ ., REMARKSi_ + J Certified Copy is filed with the city Building Division. EXEMPTION -FROM -WORKERS' COMPENSATtON-DECLARATION - - -• - "- - - ---• •-�- -- - - (Thls-section need not be completed if the permit is for one hundred - - I ($100) or-iess). for this is I Certify that in the performance of the work which permit Issued. I shall not employ any person in any manner so 'as to•become PLUMBING,�PLAN'CHECK--- subject, to. the Workers' Compensation Laws of_California. '_ _ i.Date ) Signature BATHTUBS- SHOWERS NOTICE: If after making this declaration, you should become subject, TOILETS, - , •URINALS''•---'~'- to the Workers' Compensation provisions of the Labor Code, you must' ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS -- - 1 revoked, _ - -- -KIT,'SINKS - DISHWASHERS'' CONSTRUCTION LENDING AGENCY 1 hereby affirm that there IS a Construction lending agency for the per- SERVICE SINKS .4 ^ ,SUMPS- - - .I , formance of the work for which this permit Is issued (Section 3097 r • Civ, C.). - - -- - — 'FLOOR: SINKS - FLOOWOkAINS�-` L'onder's Name ' r Lander'S Address, DRINKING'FOUNTAINS OWNER BUILDER DECLARATION I herebyINTERCEPTORS CLARIFIERS affirm that l am exempt from the Contractor's License Law for Professions Code: the following reason (Section -7031,5 Business. and SWIMMING POOL"-- -P TRAP Any city or county which requires a permit to Construct, alter, imrove- demolish -or repair any structure, prior to Its issuance, also re- WATER SERVICE A'L'TERATION- ' qu the ap{ licant for such to file a signed statement that he res permit is licensed pursuant to -the provisions of the Contractor's License Law• GAS SERV ICE "- OUTLETS - Qt (Chapter 9 (commencing with Section 7000) of Division 3 of the Professions that he Is therefrom the- t- Business -and Code) or exempt and WATER HEATERS' BTU OUTPUT i s. for the alleged exemption. Any violation of Section 7031,5 by I 2ppllcant for a permit -subjects the applicant to a civil penalty SEWER CONNECTIONSI more than five hundred dollars (5500).owner*of the property; •'SOLAR TANK - - COLLECTORSwill do the work, antl the structure is not Intended rthrough r offered for sale. (Section 7044, Business and -Professions Cade: The SOLARPIPING SYS. IIontractor's License Law tloes notapply to an owner of a propertyho builds or improves thereon, and who tloes such work-himself'or ISSUE FEE. d his. own amployees,.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 will have the burden MECHANICAL PLAN CHECK ' of proving he did not build or Improve for the purpose of' sale). HEATING SYSTEM 0-100,000 BTU ❑ 1, as owner .of. the property, am exclusively .contracting with_ AND DUCTING - - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU and'Professions Code: The Contractor's Licanse.Law dI f apply to an owner of properly who builds Or improve who con- REFRIGERATION 0-100,000 BTU tracts from Stich projects ,with a contra srSuant to SYSTEMthe Contractor's License Law).100,000 + BTU ❑ I am exempt under Section .C. forlhis BOILERS BTU reason Date Own SYSTEM REPAiR,ALTE RATION I hereby Certifythat ve re appiicati n and state that the above EXHAUST SYSTEM ` MULTIPLE Informatl0n is ect.'I a comply with all unty ordinances an itla ela . Ig t Lb t ction, and hereb au prize representatly f- cit to ant on the 'above a oned property for i . n P qlii SJg;.,V Date Drlvers' License or SS y)t - ISSUE FEE - - - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor G8B9 6/21182 382.26 TL' ZONING REGULATIONS R.P. =P' - ZONE GL PLNTTG, REF. LINE y SETBACK-C16PROPEII�TY YARD - - - SIDp IC 11 RIEIGFHTARU REAR YARD (TO PILI , PKG.-SPACE REQ. PROVIDED STREET WIDTH PARK FEE 5. ' ZONING APPROVED'BY ' DAT ' SPECIAL CONDITIONS: -ELECTRICAL - 'PLAN CHECK - I GENERATOR - 0 -1 -KW - -1'•10 KW 'TRANSFORMER ' +APPLIANCE 10-50 KW--:,-50-„KW -n = = `MOTORS- - 0=1 HP ' -1=10 HP :(INC. SOLAR) 10-50 Hp -- 50 + HP _= ''FI%TURES' OUTLETSSWITCHES” 1 -GAS TUBE SIGNS-- ;POL'E'LIGHTS .I POLES METERED .SUB PANELS MAIN' -" -SUB SERVICE - - - -AMP- - - ISSUE FEE — �-• - APPLICATIDN APPROVED BY - DATE jai Qt SUMMARY OF. FEES -BUILDING - - • - •, PERMIT $Q SMTP• $�.-� PLAN CHECK $ PERMIT' I ISSUANCE $ PLUMBING $ GRADING 'E PLAN CHECK $ •; �, r ELECTRICAL$_14-11-'rJ $ MICROFILM S PLAWCHECK $ -� '1"OTAL'FEEs :, d MECHANICAL* - ' 4 6 '0 •LESS AO - PL -AN CHECK $ - VANCE PC- $ _ FINAL FEE S CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector 'FOOL & SPA APPROVALS Permit 4#. Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil ipe-Undrgrn 44, Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - - - - - b. Z)teel Reintorce 47. Rough Plumbing & Pressure Test" - 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50, Gas Pie ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undr r 10. Structural Floor System 52. • APPROVAL TO DECK 11. Property Sewer Line &'House'Connection 53.. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit "" •56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure PLO59. APPROVED FOR PLASTERING , 18. Ducts, Ventilating - 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashin D5 CC 23. 'Insulation - - C -Z- 6`3 46 z- -7` i 24. Lathin -& Siding 25. Orywall Nailing 26. Plaster Brown Coat 27. - Electrical Power Meter -Final - 28. Final Electric (�- 29. Final Heating & Air Conditioning C ` 30. Final Gas Pipe -Test 31. Final Plumbing 32. - Water Service -Final • • 33, - Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System `- 36. Sound Attenuation 37. Handicap Regulations ' 38. FINAL STRUCTURE & BUILDING , .. 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF, -COSTA MESA - PEPJWT NO,' 1 TRACT NO. - LOT NO,. JBLDG.T0. CONSTRUCTION PERMIT f - I ( Project Address%4f0WJ0:%TYPE OF CONSTRUCTION Owne Phon 1q14 ❑NEW C1 ADD ❑ ALTERATION 6813 6404/82 T REGULATIONS A.P. IF ZONE PLNG. REF. 71' Mill - Tn .. u r fL Nr] 28.00 TL: REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED — STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: ELECTRICAL - PLAN CHECK 1. - GENERATOR TRANSFORMER APPLIANCE " Address my 1 ❑ REPAIR -❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' _ DESCRIPTION OF WORK - "MOTORS SOLAR) Arch/Eng. License No. 1-10 HP , 50 + HP Address _ OUTLETS ContractoCqA,5dJdC Ph6n6 rTYPE OF PERMIT ` ❑ GRADING ❑ FOUNDATION- -'❑ STRUCTURAL TENANT ELECTRICAL ❑PLUMBING ❑MECHANI< PERMIT Address - "' LICENSED CONTRACTOR DECLARATION❑ I hereby affirm thzt I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license is In full force and effect, PROJECT DESCRIPTION— ESCRIPTION License License Class License No. PANELS Date Signature SQ. FT. WORKERS' COMPENSATION DECLARATION ,OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure or,a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.)- VALUATION ZONE GRADING CU.-YOS.ACRES Policy No Company $ . REMARKS: - _ _- • ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need .not be completed if the permit Is for one hundred . (x100) or Iess). PL CHECK' 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 _ PLUMBING PLAN CJ#ffC&e> subject to.the Workers' Compensation Laws of California. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply; with such provisions or this permit shall be deemed BATHTUBS TOILETS UR3lNALS LAVATORI DOUOLE A revoked. CONSTRUCTION LENDING AGENCY KIT. S tSHlh SHERS i! iC SI KS S MPS I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 RAI L OR SINK "I' RVR'Alfl Civ, C.). Lender's Name D I I,a FOUNTAINS ,� t]• -- Lender's Address iN RC�PTORS IERS' OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for MING PO L RAP " the following reason•(Section 7031.5 Business and- Professions Code:SWI Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to Its issuance; also re- quires the apfl9cant for such permit to file a signed statement that he WAT ALTERATION " GAS S E OUTLETS Is licensed pursuant to"the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS - BTU OUTPUT- - - Business and Professions Code) or that he is exempt therefrom and the hasiS for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS ny applicant for a permit subjects the applicant to a civil penalty f not more than five hundred dollars ($500). I as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS compensation, will do the work, and the structure is not intended SOLAR PIPING SYS. or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a propertywho ISSUE FEE builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or improvernenl is sold within one year of completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTU ANDDUCTING 100,000 + BTU of proving he did not build or improve for the purpose of Sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to REFRIGERATION '0-100,000 BTU an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) Ilcesned pursuant to the Contractor's License Law). SYSTEM - - - 100,000 + BTU ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU reason — Date Ow SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I-herebycertifyt ave rea s app cation and state that the above information correct. I to co ply with all city and county ordinances d state law to nstruction, and hereby aut orize representa i s of cit r upon the above a Toned ,property If ect n _ - , ISSUE FEE F 'ignature - rT__ s' License or SS -Assessor 865-46 White -Building: Canary -Applicant; Pink -Accounting: Goldenrod hkil 6813 6404/82 T REGULATIONS A.P. IF ZONE PLNG. REF. 71' Mill - Tn .. u r fL Nr] 28.00 TL: REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED — STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: ELECTRICAL - PLAN CHECK 1. - GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW -50 1-10,KW + KW ' "MOTORS SOLAR) 0-1 HP 10-50 HP 1-10 HP , 50 + HP FIXTURES OUTLETS SWITCHES ' GAS TUBE SIGNS PERMIT $ POLE LIGHTS PLAN CHECK S POLES METERED SUB PANELS MAIN- SUB ' SERVICE AMP ISSUE FEE 1 IdDd APPLICATION APPROVED BY ( SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK S PERMIT ISSUANCE S PLUMBING $ ' GRADING $ PLAN CHECK $ i ELECTRICAL S�"00 -$ -AN MICROFILM.$ PL CHECK' $ TOTAL FEE $ MECHANICAL' "$ AD- PLAN'CHECK $LESS - VANCE PC $ _ • r FINAL FEE $ !'Oy CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA, % � APPROVALS Permit #' Date Inspector 1. Temporary Electrical Service or Pole 43. 'Pool & Equipment'Cocation -- 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms -- 4. Electrical Conduit-Undrgrn 46. Electrical Bonding. 5. Steel ein orce 47, Rough Plumt in & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tral2. ❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection , 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing Plumbing System - Fi�al 14, Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-wring - - 57. Solar System-Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60, POOL/SPA SYSTEMS FINAL .19. Gas Pipe-Rough'& Test 20. Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat _ - 27. Electrical Power Meter-Final 28. Final Electric - - •29. 'Final Heating & Air Conditioning. 30. Final Gas Pipe-Test 31. Final.Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date J Applicant to fill in all spaces within heavy border lines and sign ail appropriate declarations, CITY'OF COSTA MESA PERMIT NO. TRACT NO; LOT NO:- BLDG. N7. -- - - - CONST -TION PERMIT 3 %� - 6392'' 5/26/82''' 8.00 %1 Project Address W' C� ai TYPE OF CONSTRUCTION Owner Phone �/' eEW ❑App ❑ALTERATION' _ -- Address ❑ REPAIR ❑ CONVERSION, ❑DEMOLISH C1 OTHER 'ZONING REGULATIONS -Arch/Eng • - License No: P= C -' -F - DESCRIPTION'OF WORK ' A.P. VE Address - ZONE PLNG. REF: Contractor - Phone (. r TYPE OF PERMITBUILDINGoo PtV� LpING SETBACK - �ROBgPERTY LINE r Address , Cl GRADING , ❑ FOUNDATION --El STRUCTURAL 51 YARD--- ARD-- 3 LICENSED CONTRACTOR DECLARATION. _ _ LICENSED ❑•-TENANT ELECTRICAL ❑PLUMBING •❑MECHANIC- L •�' T T I hereby affirm thr,t I am licensed under provisions of Charter 9 (com- -section--7000) = [IOTHER•-- RIIGHY s i mencing with of ; Dlvislon 3 of -the Business -and Professions Code, and my license is in full force and effect, - 'REAR YARD�(TO-P/Lj ' '` _ ' PROJECT DESCRIPTION-__ -.PROJECT License Class Li cense No -.Sq. •>� PKG;-SPACE REQ. PROVIDE_ D ; Date • - - ' Signature _ FT::...� - - _ - _i- - _ . _ .-- STREET WIDTH PARK FEE,$- -� - - ' WORKERS' COMPENSATION pECLARATEON hereby affirm that I have a certificate of consent to self -insure or OCCUPANCY'' UCTION TYPE CONSTR VALUATION ZONE - ZONING APPROVED BY At D i ' c certificate of Workers' -Compensation Insurance, or a certified copy - - - - -�. - -^-• - - -- thereof (Section 3800, Lab. C.). GRAD ING CU. YOS. ACRES SPECIAL CONDITIONS Policy No. Company - -- - - -- - - - - -- Certified copy 15-hereby_furnished. - _- _ _ _ .' KS: ❑ Certified copy Is -filed with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be Completed if-the,permlt,is for one hundred_{$100yor less),IIcertify that In the-performance.of the work(or which this permit ifissued, ! shall not employ any person in any manner so as to becomeNG-, PLAN CHECK`ELECTRICAL -PLAN CHECKsubject to the Worker$'.Compensation.Laws of -California.' ' FBATHTUBS Date Signature BS SHOWERSSO. F�LINUNOTICE: If after making this declaration, you should become subjectS.w r URINALS"-- i� - 'j GENERATOR 0-1KW 1-10 KWtothe TRANSFORMERforthwith Workers' Compensation provisions of the Labor Cotle, yumu comply with such provisions or this permit Shall be deemedORIES OOUBLE LAVS "`- `+-'- - - APPLIANCE- - "'-10-50-KW_50 + KWrevoked.._KS LENDING AGENCY ' '� DISHWASHERS- `� "�' ' MOTORS ^'pa"HP' •1-10 HP -,CONSTRUCTION I hereby affirm that there is a construction lending agency for the per -E SINKS- ti SUMPS-- 0"0"C-'SOLAR)--10-50-HPL ---50 + Ho"., Jormance of the work for which this permit is issued (Section 3097 icl ^ ,Lender's Name, FLOOR SINKS-- FLOOR'DRAINS ^ FIXTURES - -OUTLETS' - SWITCHES - _ .Lender's Address DRINKING FOUNTAINS �' - - ,-"`-' '.GAS -TUBE SIGNS` --� - -- '- - - • --- OWNER BUILDER'DECLARATION- I hereby affirm that I am exempt from the Contractor's License Law for - w INTERCEPTORS CLARIFIERS - POLE'L'IGHTS`" r the'following reason'(Sectton 7031.5,Business antl Professions Cotle:- Any city or County which requires a permit to construct, alter, SWIMMING POOL --P'TRAP - POLES METERED SUS^ improve, demolish Or repair any.structure, prior to its issuance, also re- - WATER -SERVICE ALTERATION- -� -- `-- - , PANELS -" --MAIN -- ' '-' SUB quires the ap; licant for such permit to file a signed statement that he is'lieensed"puTSuant to the provlsionVOf the'Contractor'S-LIcenSe Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the " - - -- GAS SERVICE OUTLETS �' - (SERVICE -' -� AMP ! .( Business and Professlons Code) or -that he Is exempt, therefrom and the WATER HEATERS - - BTU OUTPUT' •$is for the alleged exemption. Any violation of Section 7031.5 by - applicant 'for -a permit- subjects' the applicant to 'a -civil penalty SEWER'CONNECTIONS - -' ' " '- �- - "'- ` -' • ' - -- -^• - -- " - -- - • - -•-- - - - ,-^- i not more than five hundred dollars ($500). i : �• ,A", as owner of the property, or my employees with wages as their 'SOLAR -TANK-'- '"' COLLECTORS ' jsole-compensation, will do the.work,.and the Structure is riot -Intended . or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. r ^{ T - 'ISSUE -FEE' Contractor's License Law. does not.apply_to an owner, of a property_ { who builds or improves thereon, and who does such work himself or ; ..� -w - ISSUE FEE w 'APPLICATION APPROVED f3Y" DATE — through .his-own.employees, providetl_that.such_improvements-are not , • I intended or offered for sale. it, nowever, the building or improvement is,sold with, n.one year-of.completion,.the-owner will have burden MECHANICAL PLAN CHECK SUMMAY OF FEES R +r ),•( �,� •� - ) _the of proving he did not build or improve for the purpose of sale),' ❑-I- as owner -of the property, am -exclusively ContraCtingL with HEATING SYSTEM 0-100,600 BTU AND -DUCTING - - -'-�j--'" '- L� -- -- ,BUILDING- -- -- -• - -• - -- - --- PERMIT s tSMIP-;-,$ --- - -- - ___ -•_ - _ _ ,,; - -. _ -_-_ licensed contractors to construct the project (Section 7044, Business 100,000 + BTU j PLAN CHECK $ PERMIT ' and-ProfeSSions•Code: The- Contractor's -License law does not apply to- - --- --- --- - -ISSUANCE $ - an owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,600 BTU PLUMBING $T - - , tracts -from- such, projects with a contractorIs)-licesned pursuant to -SYSTEM-^^ I• - - — -� - - GRADING_ $ the Contractor's License Law). 160,000 + BTU I 'PLAN CHECK .$ " +r U , - , Rt•,; ❑ i am exempt under'Section - " - B. 8. P. C. -for this BOILERS BTU- ELECTRICAL $ ' reason' — -- PUAN'CHECK S._ . i-- MICROFILM $'' be - Date Own SYSTEM REPAIR,ALTERA�'ION (TOTAL FEE $ �I hereby certify that a read th- Iicatio and state that the aboveLEXHAUST SYSTEM MULTIPLE MECHANICAL- $' , ir"-�'r,• "!-LESS AD. ' information is t. l agr omt) ith all city and county -on, iPLAN CHECK $ •• VANCE'PG $_ ` ordinances and ate laws r to onstr and hereby authorize , y ,, ' representative ! this to the above mentioned • - - o property_for,-t i. P pup _ 21 i Signature Date •� r , --.. ._ - FINAL FEE ate._--„•.__ _ Drivers' Licunse or SS ISSUE FEE CMF 0865•-16 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING t APPROVALS Permit # Date Inspector POOL & SPA - APPROVALS Permit # Date C Inspector 1. Temporary Electrical Service or Pole 43. Pooi & Equipment Location F - SoilPipe-Undrgrn_ 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn _ 45., Forms - 4... Electrical Conduit-Undrgrn_ 46. Electrical Bonding_5. - _ tee ein orce_ 47. Rough Plumbin & Pressure Test - 6. Electrical UFER Grn _ _ 48. APPROVAL TO COVER-GUNITE - - 7. Footings__ _ 49. Electrical Conduit-Undr rn > ' - B. Foundation ' 50. , ,Gas Pipe, ❑Undr gin, Test -9. Water Pipe- Undrgrn _ _ _' 51. Backwash Lines P-Tra `E] Undrcirn - '- 10. Structural Floor System 52. APPROVAL TO DECK - 11.. Property Sewer Line &-House Connection 53. Backwash & Receptor -Final 12._ . Street Sewer -Connection _ 54. Heater & Vent -Final 13. Rough Plumbing _ _ _ - , 14. Rough Electric -Conduit -' - - - :56.- -Electrical-Final 15. Rough Electric -Wiring - - -- 57. Solar System -Final ` `16. -Rough Heating &-Air Conditioning= 58. Fencing.& Access Approval t •17., - Ducts -in Structure:- APPROVED FOR PLASTERING - 18.- Ducts, Ventilating _ 60. POOL/SPA SYSTEMS FINAL- INAL-20. ,rl 19.' Gas Pipe -Rough& Test _ _ 20.Roof Framing. - 21. Roof'Sheathin NOTES: 22.- Frame -a- nd Flashin - 23. Insulation 24. Lathing & Siding _ , - 25. Drywali Nailing - - _- .26. Plaster Brown Coat r - 27. - Electrical Power Meter -Final- C. 28: --Final Electric - ` - 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31 Final Plumbing 32. Water.Service-Final 33. Gas Service -Final 34. Solar Domestic -,Final 35. Landscape Sprinkling System 36. Sound Attenuation - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING i 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co'. 42. CERTIFICATE OF OCCUPANCY No� Date 4 PROJECT ADDRESS: 31 5 1 A I RWAY AV UNIT: C— 3 OWNER'S NAME: BEVERLY JOHNSON AODRESS:1338 SANTIAGO DR NEWPORT BEACH ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: TONY HODAK CONSTRUCTION (310)862-6984 ADDRESS: 12 7 21 OR I Z AB A AV DOWNEY CA 90242 LICENSED CONTRACTOR 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 farce and effec CITY LIC.: STATE LICA 7 4 0 2 �cuss:B Date: ��Signature: —WORKERS' COMPENSATION DECLARATION: I hereby affirm o1 consent to sell -insure or a certificate of workers' Compel n urin .� r pil' opy thereof (Section 3800. Lab 1� `4LICY NOD.?f 1 1 7 EXP. DATE: 1/31 /94 XMPANY:S TATE L-1 Certified copy is hereby furnished. t Certified copy is filed with the city Bldln Division Date: 3-5--5 Applicant: ` EXEMPTION FROM WORXERS' COMPENSATION DECLARATION: (This erg not be completed if the permit is for one hundred {S1001 of less). I cern:y that in the performance of the work for which this permit is issued, I shall not employ arty person in any manner so as to become subject to the Workers' Compensation Laws of Calilornia. Date: Signature: NOTICE: Lt, alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or [tis perp it shall be deemed revoked. J 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 {Section 3097, Civ. Q. LENDER: ADDRESS: OWNER BUILDER DECLARATIDW I hereby affirm that I am exempt from the Contractors' Stale License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance. also requires the applicant lot such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 {commencing with Section 700D) of Division 3 of the Business and Professions Code) or that he/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 (5500)• I, as owner of the property or my employees with wages as their sale compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselllhersell or through his or her own employees, provided that such improvements are not intended or offered for sale. IL however the building or improvement is sold within one year of completion, the owner will have the burden of praying he/she did not build or improve for the purpose o1 sale). I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project {Section 7D44, Business 0 and Professions Code: The Contractors' State License Law does not apply loan owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their worker's Compensation insurance should be provided to me. 0 I am exempt under Section; 8. 8 P. C. for this reason: Date: .''Owner I do hereby certify that I am aware of and understand the requirements o1 California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wilpwill not (circle ane) need to comply with said state codes and the requirements for a permit for coni lion or modification from the Au slay Management District. Residemial construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is Correct. I agree to comply with all city and county ordinances and state Laws relating to building Construction and hereby authorize representatives of i city nter upon the above-mentioned property ler inspection purposes. Date: �� Signature: Driver's License or Social Security 1641-46 While—Building: Green—Code Enforcement: Canary—Applicant; Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT N0: B 061277 PLAN CHECK N0; 00764-93 S YEhm NU: b Ub.LL -ll N bill Ivt CONSTRUCTION TYPE; V—N PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION CONSTRUCT WALL TO CREATE CLOSET SQ FT: 2,500 CLAIM VALUE; 2,500,00 CALC—VALUE; 2,500,00 GROUP UCC: B-2 / COMMENTS: CREATE WALL TO SEPARATE C2 & C3 SUITES, NO OTHER WORN AUTHORISED �- �• * �• �• �• �- �-�• �• �• �- �- ic- ic- * * * �-* � �- >f-�c-�- �- �- �-�- �- � N� �• �- � �• �• �- �-�• K� �• �c� �• � �--K• � � x ->E• �- x� �c• �t• �• ic• �-�• � �• �- >F +E �c• � �• * �• �• �• }c- }c-+t•+t• � �• >f �• Z O N I N G S E T B A C K S R E Q U I R E M E N T S MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ• PROV• PARCEL: 42729114 ZNE; CL REF NO; PLANNING N TES> MINOR INT. ALT TO AN EXISTING INDUSTRIAL CONDO BUILDING, a i 7 txt I• ! •lk •lk !E ll- lE lE lE !F !k •lk •k }E !E }E }E iE lE i(- iE lE IE •lk 3I- if if !I' •Ik * •k * * * 1F lE }E ll- }E iE iE iE lE lE iE }E lE ll- iE lE It 3t }E IE iE � iE * � }E iE lE •lk �!• !E iE # iE iE il• K 3(- if !f � •Ir: >k * * * if D E V E L O P M E N T S E R V I C E S R E Q U I R E M E .N "T S ZONING APPROVED BY'_,-` ; SCC DATE: S3 BUILDING APPROVED BY,: DATE: a• APPLICATION ISSUED..BY: f IDA= DATE: IF iE #E * IE iE * * }E }E lE lE lE * if il* * * iE * }E -ME * * !F 1E •If •If if }F }E • is it - �t r iE ie !F !I' * !F iE iE if• #E }E !E !E !E •lk * il• * if• iE � }E ![• iE lE •lk il• il�I- # •Ik if if * * }E !E 1( !E * iE iE iE iE #E iE lE TI i'C IE'�I- if * * iE i(- lE lE * iF * iE 3{• iI- !(• }F iE �f* � !E 94 #E �t * #(• IF }E iE iE iE LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE' 1SMIP/RES. GRADING PERMIT 54.00 SM I P /NON—RES PLAN 35.10 l . .53 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL C,J PAID DUE TOTALS-----> 54.53 0,00 35,10 89,63 89,63 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 89.'63 OVER/,SHORT; 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT/. GRADING PLAN—CHECK 54.00 r'� 35. 10 � � if }F 1F il• * * #E iE iE lE lE •Ik * * 1F iE iE !E iE iE ![• ![• �(- •Ik ll- •Ik •Ik il• i(- .53,_ * * lE !t i(- iE * * iE !f}E iE •Yf° }E �lE !(••}:�F * #(• lK- iE �F i� lE il• �(• * iE �F if-�f- •If •If �!• �{!E �(ll- iE iE 1F iE -II• iE iE * if IND I VI D U A L,• F E E� B�, R E A" K. D O W N TYPE QTY D E S C R I P T I O N—r V UNIT COST TOTAL COST r SFC 2500 ALTER BY VALUE COMMERCIAL NO.ZONE/ 1,00 2,500,00 END OF FEES a i 7 txt I• ! CONSTRUCTION AND PLANNLNG� APPROVALS Permit # Date Inspector I & SPA APPROVALS Permit # Date Inspector 1, Temporary Electrical Service'ar Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility -Undrgrrid. 54. Forms 4. Electrical Conduit-Undrgrnd. 55, Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 1 6, Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ll Undrgrnd., Test 9, Water Pipe•Undrgrnd, 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62, Backwash & Receptor -Final 12. Sewer Cap 63. Htfater & Vent -Final 13, Root Drains 64, Plfimbing System - Final 14. Rough Plumbing 15. Rough Electrical -Conduit 65, Elbctrical-Final 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17, Rough Wiring Sign 68. APPROVED FOR PLASTERING 1B. Rough Electrical -T Bar Ceiling 69. POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23, Gas Pipe -Rough & Test 72, Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil I 25. Root Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding $ r�l af! Y , 75, pry Chernical wl 76, Dry Standpipe 77. FIXED SYSTEM FINAL 29. Insulation I i 78. FIRE PREV, FINAL 30. Drywall Nailing f HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ! l 79. FINAL INSPECTION 32. Electrical Power Meter -Final 33. Final Electric I 80. FOOD CERTIFICATE ISSUED I Notes: /•K�/ I J I I ' A i 4 jhQ, I t �ftoo k ✓ ' 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 i 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations s JI/7v� 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date ,i 1_�I PROJECT ADDRESS: 3151 AIRWAY AV DNIT: C— 3 OWNER'S NAME: BEVERLY JOHNSON ADDRESS: 1 3 3 8 SANTIAGO DR NEWPORT BEACH ARCHIENGINEER: REG.ND.: ADDRESS: UNIT: PERMITTEE: TONY HODAX CONSTRUCTION (310)862-6984 ADDRESS: 12721 OR I Z AB A AV DOWNEY CA 90242 LICENSED CONTRACTOR DECLARATION: i hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of nivision 3 of the Business and Professions Code. and my license is in full force and effe t. CITY LIC.: STATE LIC.:4 7 4 0 2 8 CLASS: B Date: S i? Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that h v ace 'cote of consent to self -insure or a certificate of Workers' Compensation n ur nc°. r roti apy thereof (Section 3800, ab. C POLICY NO.: r — EXP. DATE: O / 3 1/ 9 4 f COMPANY:STATE ❑ Certified copy is hereby furnished. 14J Certified copy is filed with the city Building Divisr . f Dale: — SGS 3 Applican EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: [This sectilUneedbe completed if the permit is for one hundred ($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 tine Workers' Compensation Laws of California. Date: Signature: } NOTICE: IL alter making this declafation, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions orlihis permit shall be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' Slate License Law for the following reason )Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business arid Professions Code) or that helshe 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 properly or my employees with wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State LicenSe Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himselilherself 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 will have the burden of proving helshe did not build or improve for the purpose of sale) - I, as owner of the property, am eKclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contracter(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: 8. & P. C. for this reason: Dale: Owner, I do hereby certify that I am aware of and understand the requirements of California_ Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Al I hereby certily that I have read this application and state that the above information is correct, I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this cit to enter upon the above-mentioned property for inspection. purposes f --\ , /f _ V Date: _2 1' 1 ' Driver's License or Social Security v: 1641-46 White—Budding: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: E 061278 PLAN CHECK NO: N PERM NO: E 0b12' I GOVT; N SUPP: CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION : CONSTRUCT WALL TO CREATE CLOSET SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: CREATE WALL TO SEPARATE C2 & C3 SUITES RE:4B61277 BE � � � * � BE � � BE BE BE � � � � � � � BE BE BE -FE �- ►� ►� �- � * * BE x- BE K- * � ►� BE Bt• * * BE K• x-� -►E -x- � � x x -x• Ik r� a�• Is-�s--n- �c• Ik * * x• �c- x- ac• �c x- * +c• �ca'f* �c• �c- * � �c- Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING----_•---- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING RE • PROV: PARCEL: 42729114 ZNE: REF NO: PLANNING N TES> > BE BE BE BE BE BE K- iE BE BE BE * BE BE BE BE BE BE BE BE BE BE BE BE BE iE iE BE BE K- BE * * K- BE BE BE BE BE BE BF K- BE B(- BE .K. BE BE i( BF BE BE iE * BF BF BE BE BE BF BETE BE BE BF BE BE BE BE BE BE BE BE BE iE IE i[• BE BE D E V E L O P M E N T S E.R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE; APPLICATION ISSUED BY- ` DATE: 3 BE BE BE BF BF BF K BE BE Bt BE BE BE B( BE BE BE Bt BE BE BE BE BE BE BE BE K. BE BE BE BE B( �i i�Klit, tv Jiv ?v k BE -IE BE BE IE BE BE BE BE BE BE BE K• BE BE ?E BE BE iE BE BE BE BE BE .K. * BE BE BE BE iE BE BE BE BE BE'BE �E BE BE � BE B{ BE BE B(• K1E BE !E BE BE BE }E BE BE BE 3( BE BE BE BE * BE BE BE BE .� i( )E #E BE BE #E BE BE B{• *• B(• iE if LEGALIZATION:N FX E, S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 33.75 50% SMIP/NDN—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN --CHECK TOTAL PAID DUE TOTALS ---- > 33.75 15.00 0.00 48, 75 48,75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 48,75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 48,75 BE BE BE BE BE BE iE BE BE BE BE BE BF BE -IE BF BE BE BE BE BE BF BE BE BE if• BE BE BE BE BE BE BE BE BE BE #E BE BE BE BE BE � BE #E BE BE BE BE BE If BE iE BE BE BE BE -1E iE K• i(• BE BE BE BE iE BE BE BF Bf• BE BE BF BE BE BE iE BE BE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 RECEPT/OUTLET 1 ST 20 EA, ,75 ,75 ELE 3 MISC CONDUIT NOT LISTED RE? PERMIT 11.00 33,00 END OF FEE CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA 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 56. Electrical Conduit-Undrgrnd. & Foundation _ 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, © 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 �,' r 64. Plumbing System - Final 14. Rough Plumbing 65, Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final i 16. Rough Electric Wiring 67. Fencing & Access Approval C 17. Rough Wiring Sign B 9 9 68, APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL(SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace -21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73: Undergrnd. Storage Tank ❑ Gas ID 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 I 76, FIRE PREY. FINAL 30, Drywall Nailing ; HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat C 79;. FINAL INSPECTION 32. Electrical Power Meter-Final 33. Final Electric 34. Final Heating & Air Conditioning j G. FOOD CERTIFICATE ISSUED 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace I I 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41, Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irri4ation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co i 51, CERTIFICATE OF OCCUPANCY No. Date Ap i - CITIY OF COSTA MESA -, C_r3NSTR UCTION PERMIT Prgject,4dfi-ess '7 t 1 moi/ Ux) IT i Applicant's Mailing Address Qr oho x _.I c c Owner's Name " JQ64LJSCa�J _Phone Address 3 t.Tl Q VLAU' 4 Arch/Eng. f rob>75T067r;i:wJ AQm%0P-%%*lticense No. Address ;2.1(.=- Pom L &, Ave—' Co --r&• M355a Contractor's Name..s�A�ts� �.C�S71.t�h-s. Phone 18-1191� Address (mailing) O � —CT City License No. 30 S \� LICENSED CONTRACTOR DECLARATION 1 vp 1 hereby affirm that I am licensed under provisions of Cha 9 rn' 1, Ing U\Q with section 7000) of Division 3 of the usiness d fess Code, and my license is In tui force and effect. F License Cl a s 444 gw�A bate Z u Signature ORKERS' COMPENSATION DECLARATI nereby affirm that I have a certificate of consent t0 Self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. c�_s' Policy No. ` ��e`s� Comp y �� t i'1-% ❑ Certified copy is hereby furnished, I.�Certi ed c : filed with the city Sion. pate Applican EXEM I FROM WORKERS' COMPEN ATI N DECLAR TION - (This section need not be completed It the permit Is for one hundred ($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. DateSignature NOTICE: If,'after making this declaration, you should become subject to the Workers' Compensation provisions of the labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. 'C.) Lender's Name M Lender's Address OWNER BUILDER DECLARATION I hereby affirm that i am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 -� file a signed statement that he/she Is licensed pursuant to the provisions of e Contractor's License Law (Chapter 9 (commencing with Section 7000) of ,;vision 3 of the Business and Professions Code) or that he/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 enatty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as thoir sole compensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such, improvements are not intended or offered for Sale. If, however, the building or Improvement is, sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License law). ❑ 1 am exempt under Section A B. r9 P. C. for this reason Date Owner I hereby certify that I have rea information Is correc I agree and state laws rel to but sentatives of chi Inspection purp Signature Drivers' License or SS � CMF 0865-46 rev. 7/83 d state that the above and county ordinances hereby authorize rgpre- entloned .oropertl/ for, pllcant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. BLDG. NO. Meter ❑up'to 100 amps $ Meter Dover 100 amps $ TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR $ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - - A.P. # DESCRIPTION OF WORK OprtJCE Me4J4.04..r 1 LlPA_0V�Lcl�tJ� $ Microwave S Main Building: $ Range $ TYPE OF PERMITr LJ GRADING FOUNDATION STRUCTURAL T Front 1:1 TENANT U ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Trash Compactor $ ❑ -OTHER A' Rear PROJECT DESCRIPTION Scat. rT. OCCUPANCY C K Right CONSTRUCTION TYPE VALUATION S S I Left ZONE GRADING CU. YDS. 'ACRES Ping, Ref, # Remarks: 0— Parking Req./Provided Use of Building: t PLUMBING FEES Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers ; Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets, Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee . I $25 Boiler ' i Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑0-100,000 BTU ❑100,000 BT IReinspectign Fee t; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer,Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service IIssue Fee MECHANICAL Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System ❑0.100,000 BTU 0100,000 BTU System Repair/Alteration $25 I I Issue Fee • . E Automatic Washer Construction Pole Sub, Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes 2 Outlets Switches Garbage Disposal Generator ❑0.5 KW 05.15 KW 49.69 -2.A2&/34 Zone Accessory Building: I Park. -Fees $ a.1 b FL 1ICAL FEES Transformer ❑ 15-50 KW El50 + KW Meter ❑up'to 100 amps $ Meter Dover 100 amps $ Sub Panel $ `Motors 00-1 HP ❑l -S .Inc.Solar 09-15 HP ❑16-15+ $ Microwave < Pale Light $ Range $ Sign 3 Standing Sections $ Trash Compactor $ $ 3 Reinspection Fee 1 $251 Issue Fee $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By nate Application Approved By Date ' Application Issued By r Dat $ 3 Z O N I N G R E Q U I R E M E N T S . .SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ _2_ GRADING $ PLAN CHECK $ //,.70 MICROFILM $ MECHANICAL $ TOTAL FEE $ �d PLAN CHECK $ i)O .�DSTRUCTION AND PLANNING E APFROVALS Permit # �� Date Inspector Pt & SPA ' APPROVALS Permit # Date Inspector 1.;7emporary Electrical Service or Pole- ` 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. r 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 !f 6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER-GUNITE �s " 7. 'Footings J 58. Electrical Conduit-Undrgrnd. � c: 8. Foundation 4 _ 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd.�%t, '� r • } 60. Backwash Lines, P Trap, ❑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 l 13.. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing 65, Electrical -Fina! 15. Rough Electricai-Conduit 66. Solar System -Final 1`6. Rough Electric Wiring Z 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 APPROVALS Permit # 20. Rough Factory Fireptace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating_ 71. Product Piping ❑ Gas ❑ Oil 23•. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing r 73, Undergrnd. Storage Tank ❑ Gas C1 Oil 25':rRoof 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 �r - 35. Final Gas Pipe -Test 36. Hood or Canopy S 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 4t , Sound Attenuation a 46, Handicap Regulations 47, FINAL STRUCTURE & BUILDING 48, Special Requirements Completed 49. Electric Release to Edison ; 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA ;: FEF1 NQ. TRACT AVO. LOT NO. BL . CON4TRUCTION PERMITProject Address' _ ��` �+�� >C l F CONSTRUCTION NEW ADD ALTERATION REPAIR Applicant's Mailing Address. C_r/� ONVERSION ❑ DEMOLISH ❑ OTHER A.P, q)6 Owner's Name `1 Noi}OneCRIPTI NOF WORK Address - 5 ! BAI<515iEYLtJce /!1l s' Arch/Eng. License No. Address Contractor's Nam �'�/�N! f Phone z Cif d0 Address (mailing) -1 p 44&15- ` City'LicPnse No.,i— LICENSED CONTRACTOR DECLARATION (:hereby affirm that I am licensed under provisions of Charter 9 (commencing With section 7000) of Division 3 of the Business and Professions Code, and my license is .13 7 l LlcensGs D Signature !Q&- zz:• i ORKERS' COMPENSATION DECLARATION iereby affirm that I have a certificate of consent to self insure or a certificate of Workers' 'Compensation- Insurance, or a' certified copy thereof (Section 3800, Lab. C.) Policy No. Company T� ,Certified copy is hereby furnished. 1 Certified copy is filed with the city Building Division, Date Applicant EXEMPTION FROM WORKERS', COMPENSATION DECLARATION - (Thissection need not be completed if the permit is for one hundred ($100) or less}, I certify,that in the perfprmance of the work for which this permit Is'isSued I Mail not employ any person in any manner so as to become subject to'the ' Workers', Compensation. Laws of California. Date Signature NOTICE: if, after making this declaration, you should become subject to the Workers' Compehsation provisions of the Labor Code, you -must forthwith comply with such provisions. or this permit - shall be deemed revoked. 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. (Section 3097 CIv. C.) Lender's Namn ' Lender's Address t OWNER BUILDER DECLARATION I hereby, affirm that I am exempt from the Contractor's Lleense Law for4he following reason (Section 7031.5. Business and Professional 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 ,3 file a signed statement that he/she Is licensed pursuant to the provisions of a Contractor's License Law (Chapter 9 (commencing with Section 7000) of vision, 3 -of the Business and Professions Code), or that he/she Is exempt _.,erofrom 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 , ' malty of not more than five hundred dollars ($500)., I, as owner of the property or my employee$ with wages as their sole , Compensation, will do the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code:. The Contractor's 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 awn employees, provided that such improvements are not Jntended or offered for sale, If, however, the building or Improvement is sold within one year of com- pletion, the owner wlll'have the burden of proving he/she did not build or im. Eve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con• J 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 builds or Improves thereon, -and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that f have read this application and stale that the above information is correct. I agree to Comply with ali'ctty and County ordinances and state laws relatin q b ilding conStruCtion, and hereby authorize repre- sentatives of thi o enter upon the above-mentioned property for inspection pur Signature bate OEX C a �J C p S Main Building: Garbage Disposal Stand i ng'Sectio ns TYPE,OF PERMIT GRADING FOUNDATION STRUCTURAL Generator ❑0-5 KW 115-15 KW Trash Compactor T Front ED TENANT •❑ EL CTgiC LP❑�JpLUMBING�ME6HANICAL B A Rear F91OTHER Q�y �1��1Q+C $ 3 PUBLIC SERVICES REQUIREMENTS: C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY K CONSTRUCTION TYPE ZONE' GRADING VALUATION CU.YDS. ACRES S Left Ping. Ref. # Remarks: SUMMARY OF FEES Parking Req,/Provided i • SMIP $ Use of Building: Planning Notes: PLUMBING FEES Bar Sink Backflow Preventer Backflow Irrigation Bathtubs a Clarifiers Dishwasher Drinking Fountains i Floor Qrainsi, �. Floor Sinks Gas Service Outlets( - Interceptors Kitchen Sink Lavatories c P—Trap Roof Drain Reinspection 'Fee ; $25 �l M Boiler _ Duct'- Under Ground r Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. 81t. ICBG # - Heating System & Ducting ❑o-loo,000BTU ©100,000 BT - Reinspection Fee $25 Drivers':License or 55 � • CMF 0865-46 rev: 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap ' Sewer Connection Solar Collectors Solar Piping, Solar Tank Swimming POO( w/Spa • Urinal Water Closet - Water Heater Water Service I .. I Issue Fee . Hood or Type I : ❑ ' "- Canopy Type II ❑ Refrigeration System ' 110-100,000 BTU 11100,000 BTU System Repair/Alteration Issue Fee $ 3 FEES $ 3 r- 5042 5042 2/29/84 '3a 2L, T; IZone Accessory Building: I Park.Fees $ '-' Automatic Washer Construction Pole Sub. Cooking Unit •'% Dishwasher Dryers ❑Gas. ❑Electric Fan _ F.A.U. i Fixtures Device Boxes ' Outlets ELECTRICAL 'Transformer El 15.50 KW ❑ 50+KW Meter' ❑up to 100 amps -- Meter Clover 100 amps I'Sub Panel Motors ❑0.1 HP D.1.A - B i Inc. Solar 09-15 HP ❑16-15+ I Microwave Pole Light Range Z O N I N G R E U • U 1 R E M E - N T Switches Sign Garbage Disposal Stand i ng'Sectio ns r Generator ❑0-5 KW 115-15 KW Trash Compactor Reinspection Fee $25 : Issue Fee $ 3 PUBLIC SERVICES REQUIREMENTS: Zoning Approved By into Application Approved By I Date Application Issued By Dat SUMMARY OF FEES BUILdING PERMIT $ • SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ Ott MECHANICAL $ TOTAL FEE $ PLAN CHECK $ -CONSTRUCTION AND PLANNING 'l -%APPROVALS Permit # Date Inspector PO SPA 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. ElectricaliConduit;Uricfr'grnd. 55. Electrical Bonding 5. Steel Reinforcement's 56. Rough Plumbing & Pressure Test 6.. Electrical LIFER Grid. �,!• 57. APPROVAL TO COVER-GUNITE � 7. Footings' =� S�, �� 58. Electrical Conduit-Undrgrnd. 8.� Foundation �' % r s. 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undi "'n'd.60. 4 Backwash Lines, P -Trap, ❑ Undrgrnd. 10:'Structural'Floor System 61. APPROVAL -TO DECK 11,1 Property Sewer Line & House Connection fit. Backwash &Receptor -Final 2.! Sewer Cap - 63. Heater & Vent -Final �y 13. Roof Drains 64. Plumbing System •Final 14.. Roubh Plumbi6g 65. Electrical -Final 15. Rough Etectrical-Conduit• 66. Solar System -Final ,16. Rough Electric.iWiring 67: Fencing & Access Approval ' 1;7. Rough Wiring Sign 68. APPROVED FOR PLASTERING ,18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL -19. Rough`Heating & Air Conditioningcf $ gJ FIRE DEPT, REQUIREMENT APPROVALS Permit # T 20. Rough.Factory, Fireplace 21. Ducts, in Structure 70. Underground Hydro 22..Ducts,1Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing �, 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil i 25. Roof Sheathing •' 74. Overhead Hydro 26. T -Bar Ce ilingStructural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28: Lathing & Siding s 77. FIXED SYSTEM FINAL - 29.. Insulation 78. FIRE PREY. FINAL 30: Drywall'Nailing HEALTH DEPT. REQUIREMENT I� 31. Piaster 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 Prev, nter 43. Backflow Irrigation 44. Landscape lrripation System . i 45. Sound Attenuation , 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING i 48. Special Requirements Completed 49. Electric Release to Edison < < f 50. Gas Release to Southern California Gas Co = 51. CERTIFICATE: OF OCCUPANCY No. Date ,�� ; _� rV of Costa Mesa dafety Department P.O. Box 1200 Costa Mesa, California The Building located at i CERTIFICATE. OF OCCUPANCY J151 Ai-yv',1V Drj-V--. Suite D~2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group F?--� __Occupancy. Use of.Building .r .1-. t]£F: Ar�irirn Trt-%rinY2If•1rari.rv) Legal Description_ls,_ri. iel!:7-74i--1? /See reverse side for Mates and Bounds! / l Building Permit No,_ �/ %p -1_S tl Electrical Permit No.�% 1a � Plumbing Permit No.•B/c/. 1t�9 NumI ber of apartments and/or guest �room s -4)— ISSUED TO: Building Official y by n PTUTOT I Vier IAC. z evton-Director Building Uivi: j. D. pL,0„ COYMM j' Date Jativa- v 15. 15$2 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except, �by the Building Official of the City of Costa -Mesa under Sec.'306 (e) U.B.C. Form BU 34 Rev. 21/70j} CC2 L%� 5t!' rL�`'L-i /fJ C �ti� y City of Costa+Mesa {� di Building Safety Department CERTIFICATE O,F OCCUPANCY �' G P.O. Box 1200 Costa Mesa, California p The Building located at 3131 dn—rdv has been inspected and found to comply with the provision's of all City of Costa Mesa Ordinances applicable thereto I{ for a Group `'i --.i Occupancy. ! IM Use of Building Tnt-kn-ricer Alter-ratiaiiL, Legal Description 427-191-1.3 (See reverse side for Metes and Bounds) E-3372 P-3247 Building Permit No RFi7-7x47 Electrical Permit No.JI i01-1-2g�l Plumbing Permit No. +�-,-2992 1i Number of apartments 4—(1—a1. guest rooms —0— i Il ISSUED TO: Building Official rti by Tandem Pror -exties Vel C'., Newton ,'fir ding Division 0��Ct0r jj Dated/��Z . This Certificate of Occupancy SHALL BE posted in a conspicuous plaice on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU 34 Rev. 11/70 I, CITY OF COSTA MESA �• �; 1 BUILDING DIVISION }` 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 Www.ci.costa-mesa.ca.us �.� FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. B08-00196 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 93894039 DATE ISSUED: 07103/2008 ISSUED BY: RMD JOB ADDRESS: 3151 D AIRWAY AV. CM Suit 6Whit`.Y'-". D Vicinity: ROOF Squares: 6500 Valuation:$14,178.00 SCOPE OF WORK: REROOF COMMERCIAL BUILDING. TEAR OFF (E) ROOF MATERIALS; INSTALL 1 LAYER OF 15# FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR CLASS "A" FIBERGLASS SHINGLES GAF, APPROX 5600 SF. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: %MOSIER FAMILY LLC %PROPERTY RESERVE INC Unit: 10 E SO TEMPLE'ST#400 PHONE: r City/State/Zip: BRUCE CHRISTENSEN ' I" _ APPLICANT: HANSEN, DUKE Address: 260 E ALTON AVE Unit: PHONE: 714-$57-74401 CitylStatelZip: SANTA ANA, CA CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA, CA 92707._ - - CELL: ARCHITECT: , ;' License No. _ .PHONE:, ENGINEER; License No. PHONE: FEE SUMMARY Reroof Plan Check: x$0;00 Reroof Permit Fee: $251:25 - Reinspection Fee, $0.00 TOTAL FEES $251.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable nodes, 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. CODE 1. INSPE02Ht(jaE Qm 1NTMAL5 CODE f INSEgOON TYPE 2&A INTTML 1910 Fixed System Final Fire Prevention 206 Final Mechanical 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 0 WORKERS' TION DECLARATION,_ I hereby affirm u natty of perjury one of the following declarations: ❑ 1 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: Carrier. (This section need not be Wrnpreted if the perm4 is valued alone hundred dollars (S 100) or less,) Pol cr y Number: ❑ 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 beco ject to the workers' compensation provisions of Section 3700 of the abor C de, I sha o with comply with these provisions. 7 Applicant's Sign lure D le 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 DOLLARS ($100,000), IN ADDITION 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 l 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. - Lic: # a_-'? ora Class # '-' -ContractorsSignature Dare 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 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 ($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 sate.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cade: 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($) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature 305746 43/07) Date Owner ID verified by drifcense. ❑ Yes ❑ Na Driver's License No. Verification of Ownership by (type of document, Le I Expires: - 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 B, 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. Applicant's 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (if yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No 8. (If yes", attach certificate of compliance,from the appropriate air pollution control officer). CERTIFICATE'OF COMPLIANCE: I certify that under penaltyof perjury the information given above is correct. 1 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. // ignalure b gal Owner(s) —row --- And/or Authorized Applicant Date Z r. to �d w 3288 i i !21./BO 321. l 3 Tic' COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Wx� RECEIVEWY PERMIT �o For Applicant to FBI in Completely — Use Ink Only BUILDING A.P. NO. L t p� �� D9 ADDRESS OWNER OR ILDING ADDRESS �c '� TENANT Western Pacific Financial r MAILING C o J. one son Go. UNIT OR SPACE NO. ADDRESSBlvd,�� BLK. CITY Irvine Ca. 92714 TEL NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER Western Pacific Financia X BRANCH OWNER Western Pacific Financia ADDRESS Same VALUE�`� ARCHITECTTEL ORENGINEER Hales -Lan Ston 5 -086 USE / 777 S. Main, Orange, Ca. ADDRESS ZONE TYPE GROUP TC�iS CONTRACTOR J. Donald Olson o . .,f BYPROVED DATE ADDRESS18003 Skypark Blvd., Ste.B 0. 2s3 20 3, S CITY Irvine, Ca. 92714 ;0$40-2606 STATE NO. 333969 sic NO. APPROVED SETBACKS SIZE NO. OF BLOGS. (FROM C/L STREET) OF LOT NOW ON r RONT FT. USE OF EXISTING BLDG. Vacant Land Separate permits are required for L SIDE FT. electric, plumbing and heating work. NT. EARINP USE OF BUILDING AND WORK TO BE PERFORMED PLANNkJG ACTION Construct office building shell O APPROVED Q 4033 S.F. • APPROVED 0DATE /D-�t,9t.4 HOLD FOR SPECIAL REQVJREMENT-` hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. the State of California Busln nd Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such a ses are in full for an ct, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the p vi ns of the tate o rni usiness and Professions Cod 1 Ion 3, Cha ter 9. VALUATION PERMIT FEE $ Signature o PLAN CHECK S Permittee j 5 rG/ 1 SQ• �— TAX $ or �•o ��`� + Authorized Agent Date TOTAL PAI D Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY QF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. PERMIT 1-7 CokSTRUCTION r��a2 TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION '❑-REPAIR- ❑ CONVERSION ❑DEMOLISHcK/Eng.- 0187 II04i62' 8.00 ' ject Address = S ner _ Phone S6- S7 — / - rAddress--31,51- (I'rt/A ❑ OTHER ,ZONING REGULATIONS -Z ( SE / t License No. Z �t OF WORKA.P.dress ZONE PLNG. REF. =JF ' A�DESCRIPTION •ir0� —/�}' /L� V//Ir (A Contractor' v �'L n Phone SY - lJYr�/ TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL ❑ TENANT ELECTRICAL []PLUMBING DMECHAIC11. - SETBAC ID YARD 5I E YA - ro gt�ILDING -; PROPERTY LINE - Address fe-/� ��% z f/1L 'LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter-9•(com- 7000) Division -3 the Business and ❑ OTHER RIGHT mencing with section of of Professions Code, and my license is In full force and effect. REAR YARD (TO P/L) PROJECT dESCRIPTION License Class Ucense No. t PKG. SPACE REQ. PROVIDED Date -- ----, g.. . -re. - - - - SQ_ FT. - STREET WIDTH PARK FEE $ , WORKERS''COMPENSATION DECLARATION -OCCUPANCY- CONSTRUCTION TYPE ` I hereby affirm that I have a certificate of consent to self -Insure or a .VALUATION ZONE ZONINGAPPROVEDBY DATE certificate' of Workers' Compensation Insurance, -Or -a certified copy -- SPECIAL CONDITIONS: thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES .- Policy No. Company REMARKS: g> _ 4•�� - ❑ Certified copy Is hereby furnished. - - - �Certlfied copy Is filed with the city Building Division. r r' /EXEMPTION FROM WORKERS' COMPENSAITION DECLARATION - (This section need not_be-completed -If the permit.is for one hundred _ ($100) or lessl. - 1. certify that.ln the performance of -the wor.k for which this permit IS issued, I shall -not employ any person In any manner so as to become PLUMBING . PLAN CHECK ELECTRICAL PLAN CHECK -subject to-the�Workers' Compensation.Laws of California. BATHTUBS SHOWERS ___- Date Signature NOTICE: if after making this declaration, you should become subject TOILETS _ URINALS GENERATOR 0-1 KW TRANSFORMER 1.10 KW s to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed _ _ _ LAVATORIES DOUBLE LAVS ' APPLIANCE 10-50 KW�:50 + KW- r :: revoked.- - _ - -- CONSTRUCTION LENDING AGENCY - KIT. SINKS DISHWASHERS MOTORS 0-1 HP -- - - 1 -10 -HP 1 hereby affirm that there is a construction lending agency for the per- SERVICE SINKS': SUMPS - ` " - -'" (INC. -SOLAR) - 10>50 -HP _ 50 -HP_-_ - - - formance of the work for which this permit is issued (Section 3.097 -- FLOOR SINKS FLOOR ORAINS FIXTURES' -OUTLETS SWITCHES---' - Civ. C.). — Lender's •P 1d� - r-IMO-AaA04 _ r �a2w _ _Nam�SL!�e,S��- Lender's Address ��-T7AP A,T /3Fg1(l DRINKING FOUNTAINS i1 -GAS TUBE SIGNS - - INTERCEPTORS CLARIFIERS POLE -LIGHTS OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P�TRAp POLES METERED SUB^ 'the foriowing-reason (Section 7031.5 -Business and Professions Code: Any city or county which re4uires a permit to construct, alter, WATER SERVICE ALTERATIONi - r-�-- PANELS MAIN :SUB* 'improve, demolish or repair any structure, prior to its Issuance, also re- quires the apti_licant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE ��';; � !p AMP ' is licensed pursuant to the provfsions'of the -Contractor's -License Caw (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT -•` '- - Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by _ SEWER CONNECTIONS - -any-'applicant- for a permit subjects the-applicantto a civil'penalty of not more than five hundred dollars ($500). 'SOLAR TANK •• COLLECTORS-• •' '• •'ISSUE - -- ❑__ _ 1' as owner of the property, or my employees with wages as trieir- .sole compensation, will do the work, and the_str.ucture is not intended SOLAR PIPING SYS_ FEE - '�•, or offered for sale. (Section 7044, Business and Professions Code: The, •Contractorts License-Law_does not apply to .an owner of a,property who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED'BY DATE ` _ through-his.own-employees, provided that,such.improvements are -not . MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale_ If, however, the building or improvement -is .sold .within one year of completion, the owner will have the burden - `BUILDING' _ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM_ 0-100,000 BTU PERMIT $ �-'� SMIP S El I, -as- owner- of the -property, am exclusively contracting -with AND_ DUCTING - - `I _ _ T • " licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT, and Profess I ons- Code: The Contractor's License Law does not apply to ---- - - -- - - - - -ISSUANCE an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ r. •• r„ - f - "tracts -from such -projects with a contractor(s)-iicesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK 1 S. ❑ 1 am exempt under Section B.'& P. C. for this BOILERS BTU ELECTRICAL $:� - - $ w "reason- - _ _ _ - _ _ _ _ SYSTEM REPAIR, ALTERATION_. _. _ � �� •!� y PLAN CHECK $ MICROFILM-$ { Date- - - Owner _ • - MECHANICAL $ - _ + TOTAL FEE $* 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ r " ' '' � LESS'AD �'-' information is correct. I agree to comply with all city and county _ _' _ 'PLAN CHECK'" $ - �- " ` --" VANCE PC S _ - -- ordina state laws relating to construction, and hereby authorize r sentatives of this cit upon the above en onetl� •. .property fa a ose - -- _ / �� FINAL FEE $ a SI- - -- Drivers' L _ icense or $S 'ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink-Accountingi Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # ' POOL & SPA + - Date I nspector _ Date I nspe�tor APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn _ _ 45. Forms 4, Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47.' Rough Plumbing & Pressure Test 6, Electrical LIFER Gr; 48, APPROVAL TO COVER-GUNITE' - 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ Undr rn 10. Structural Floor System 52. APPROVAL TO DECK 11, Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection _ _ 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit 56, Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8l. Fencing & Access Approval 17. Ducts in Structure _59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60, POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding = 25.. Drywall Nailing. -.- 26. Plaster Brown Coat 27. Electrical Power Meter -Final LG. 28.- Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. ' -Water Service -Final 33. Gas Service -Final ' 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison • 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date �I 9601 10/27/62 ZONING REGULATIQNS A. P. =P ...... __ ZDNE PLNG.'REF, REAR YARD (TO P/L) PKG.SPA CE REQ. STREET WIDTH ZONING APPROVED -BY SPECIAL CONDITIONS: 19.00 TL l .. PROVIDED PARK FEE $ DATE ELECTRICAL PLAN CHECK'. Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. � CITY OF COSTA MESA, PERI IT NO. TRACT NO. LDT {VO. H DG. NO. 0.1 KW .. 1-10 .KW .- -10-50 KW;.�50 + KW ONSTRUCTION PERMIT L-� — Y•37 -Z r j 1 -10 -HP ' -50 + HP ddress Cot; N (y6 TYPE OF CONSTRUirTION ❑ NEW ❑ ADD ALTERATION REPAIR ❑ CONVERSION ❑DEMOLISH --❑.OTHER DESCRIPTION OF WORK 'SWITCHES p < • hone F SMTP , E ' 1p� [,•.1�,❑ VAh $ . ZLicense No. _POLES 1 - Q%etsn v6R CM 'PANELS Contractor 5 9Q,- kQA Cby TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANTLECTRICAL ❑PLUMBING ❑MECHANICF SERVICE Address S� _ P S N1J'1', LICENSED CONTRACTOR DECLARATION - GRADING $— I hereby affirm tht.t I -am licensed under provisions of Charter 9 (com- mencing with section 7000) of ' Division 3 of the Business and ❑ OTH£R " Professions Code and my license^ In full forte and effect. Licenl`s Class L n - PROJECT DESCRIPTION $ Date '..kms Signature SQ. FT. _ - WORKERS' COMPENSATION DECLARATION - - - OCCUPANCY CONSTRUCTION TYPE MICROFILM $_ '1 hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation In mnc, sect ed py .thereof ( 7" d'� b' - VALUATION ZONE GRADING CU. YDS. ACRES - Policy N mpan ❑ Certified copy is hereby furnished. .�%i} �' — a!f�%Q Certified copy is filed with the city Building Division. RE ARKS: _ _ _"log EMPTIDN FROM WORKERS' COMPENSATION DECLARATION . ' ' (This section need not be completed if the permit Is for one hundred • LESS AD-' ($100)-or-•Iessl. . 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 $ PLUMBING _. PLAN CHECK subject to the Workers' Compensation Laws of California. - BATHTUBS SHOWERS Date Signature TOILETS URINALS NOTICE: -If after making this declaration, you should became subject to the Workers' Compensation prd4lslons of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed 'LAVATORIES DOUBLE LAVS - revoked. CDNSTRUCTION LENDING AGENCY KIT, SINKS DISHWASHERS , SERVICE SINKS SUMPS - ' 'I hereby affirm that there is a construction lending agency for the per- 'Jormance of the work for hich this permit, is Issued (Section 3097 Civ. C.)', ��\ h ILC [^ ,Lender's Name FLDOR-SINKS .FLOOR DRAINS ' DRINKING FOUNTAINS Lender's Address ,OWNER BUILDER DECLARATION - - �- - 'l hereby affirm that I am exempt from the, Contractor's License Law for INTERCEPTORS CLARIFIERS SWIMMING -POOL' P TRAP' - the following reason (Section 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 re- quires the ap, Iicant for such permit to file a signed statement that he WATER SERVICE • - ALTERATION GAS SERVICE OUTLETS is licensed pursuant to the provisions of the Contractor's License law (Chapter 9(commencing with Section 7000) of Division 3 of the 'WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS i. any applicant for a permit Subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SDLAR TANK COLLECTORS - ❑ 1, as -owner of the property, or my employees with wages'as their sole compensation, will do the work, and -the structure is noLintended SOLAR PIPING SYS. - - or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property _ ISSUE FEE who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK - intended or otfered,for,sale. If, however, the building or improvement Is sold within one year of completion, the owner•will have the burden of proving he did not build or improve for the purpose Of sale). ❑ I, as owner Of the property, am exclusively contracting • with licensed contractors to Construct the project (Section 7044, BuSinesS and Professions Code: The Contractor's License Law does not apply to HEATING SYSTEM 0-100,000 BTU ANDDUCTING ' 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM - - 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from Such projects with a contraCtor(s) licesned pursuant to the Contractor's License Law).. ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason Date Owner SYSTEM REPAIR, ALTERATION ' EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above information. is correct. I agree t0 Comply with at$ city and county ordinances an sta ws retWgtnstri ction, and hereby authorize representatives t is c1r upon the above mentionedproperty,for p i nt ISSUE FEE Signature Drivers' Lice Se or SS -Assessor CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod 9601 10/27/62 ZONING REGULATIQNS A. P. =P ...... __ ZDNE PLNG.'REF, REAR YARD (TO P/L) PKG.SPA CE REQ. STREET WIDTH ZONING APPROVED -BY SPECIAL CONDITIONS: 19.00 TL l .. PROVIDED PARK FEE $ DATE ELECTRICAL PLAN CHECK'. 5Q- FFT_ � Q GENERATOR' ,TRANSFORMER APPLIANCE - 0.1 KW .. 1-10 .KW .- -10-50 KW;.�50 + KW 'MOTORS ' (INC.'SOLAR) 021 HP 10-50 HP 1 -10 -HP ' -50 + HP FIXTURES 'OUTLETS 'SWITCHES GAS TUBE -SIGNS ' SMTP , E .POLE LIGHTS $ PERMIT. _POLES METERED_ $UB_ ~ 'PANELS MAIN, - SUB SERVICE AMP- - GRADING $— PLAN CHECK E " ISSUE FEE" � Q APPLICATION 'APPROVED BY DATE - SUMMARY OF FEES BUILDING - PERMIT .$ SMTP , E PLAN CHECK $ PERMIT. ISSUANCE $— PLUMBING $ _ • - GRADING $— PLAN CHECK E " $ ELECTRICAL $, r _ " MICROFILM $_ PLAN CHECK $ TOTAL FEE S 'MECHANICAL $ . ' ' • LESS AD-' PLAN CHECK $ _ - VANCE PC FINAL FEE $ _ f!i S! CONSTRUCTION AND PLANNING APPROVALS Permit #7r Date Inspector POOL & SPA APPROVALS Permit # Date tnspetti5r 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location " '-- Soil Pipe-Undrgrn 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn 45. Forms - -- - 4. Electrical Conduit-Undrgrn 46. • Electrical Bonding - 5. Steel Reintorce 47. Rough Plumbing & Pressure -Test - - -- 6. Electrical LIFER Grn 48. APPROVALTO COVER-GUNITE---- - - - 7. Footings 49. Eleciricai Conduit-Undr rn 8. Foundation 50. Gas Pi ,. ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Tray.L3 UndrqrW ' 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final z• � 13. Rough Plumbing 14. Rough Electric -Conduit :56. _ Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning W. Fencii7g_& Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathin 22. Frame arid FlashingNOTES: 23. Insulation - - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. --Electrical Power Meter -Final 75- '28. "Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing -32. --Water Service -Final 33. Gas Service -Final 34. Solar Domestic -F=inal 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF;OSTA MESA PER O. TRACT'NO. LOT NO. G. NO. t. CON.O'RUCTION PER IT -/ S r i'I 9:157 ,12i07ia,i; a.aa T� _ ,j proi,cr Address TYPE OF CONSTRUCTION, �- AS _ _ owner - Phone ❑ NEW ❑ ADO ❑ ALTERATION' - Address -- -' '' ❑REPAIR ❑ CONVERSION -❑DEMOLISH ZONING REGULATIONS- ,l Arch/En g. j License No. ❑ OTHER- DESCRIPTION•OF WORK A. P. :P _ Address - J• ZONE PLNG. REF. 9_ Contractor u one -� YPE OFTERMIT s, D - Tp "MLpING PROPERTY LINE Address t� m ❑ GRADING, ,❑ FOUNDATION ❑'STRUCTURAL` SETBACK L ST. IOE YARD - LICENSED CONTRACTOR' DECLARATION - that I licensed of Charter.9 O TENANT ❑•ELECTRICAL ]PLUMBING ❑MECHANICA SIEDE Y - '' I here by_affirm am under provisions (com- mencing with- section' 7000) of Division 3 of 'the 'Business antl I - ❑ OTHER- • - - RIGHT ProfeSsions Code; n_d my license is in full force and effec + r. ;• REAR YARD (TO P/L) ��``rr'' '' PROJECT DESCRIPTION �~ License Class cense o./�Q r PKC. SPACE REQ. r'PROVIDED Date ' Signature SD. FT. - -~ STREET WIDTH PARK FEE $ y -WORKERS. COMPEN5ATIOTV-DE AR TIO OCCUPANCY;-, CONSTRUCTION TYPE. I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY 4t DATE certificate of Workers' Compensation Insurance, or a certifi copy _thereof Section 3800, Lab. C.). Ful )il _ ., 'GRADING CV. JDs. ACRES SPECIAL CONDITIONS - f Policy No. Company-JlTT1G' Policy - - - - ; r• - - - - _ -, ;--- •- ; ❑Certified copy is hereby furnished. --- - - --�1»�-• ` REMA- RKSc" c� g. +_�'� ertified copy is filed with the City Building Division. - ' EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION- ( -This -section - need - not be completed -if the permit Is -for -one hundred -' ($100) or less. a I certify. that-}n.the-performance;of the work_for-which this.permit_i5 issued, I shall not employ any person in any manner so'as to -become •.,PLUMBING -_ PLAN CHECK ELECTRICAL PLAN,CHECK r. -subject to4he Workers Compensation Laws of.�iifornla.-- _ , _ UVVLLLING „ Date Signature' BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become. subject TOILETS,, (,,;J URINALS - GENERATOR 0-1 KW M1-10 KW �; to the Workers' Compensation provisions of the Labor)Code, you must forthwith comply with such provisions or this permit -Shall be deemed _ _ _ _ LAVATORIES D,OUBf4E LAVS� 1 TRANSFORMERM APPLIANCE'S 10=50 KW,•:50 - ^•• +'KW ;' - '"__ f •. -revoked.•--- -' --_ - . - --- -- . - - .. -. - - .-- - - SKIT. CONSTRUCTION LENDING AGENCY _ SINKS DISHWASHERS ._ _ MOTORS 0-1 HP 1-10 HP- " j t hereby affirm that there is a Construction lending agency for the per -(INC: SERVICE SINK •t,Cj�`rSU SOLAR)•- 10-50'FIP - 50 + HP_ - •� - formance of the _work _for which this permit is issued (Section 3_097 Civ. C.)- FLOOR SINKS -- FLOOR DRAINS •' Fix- - - OUTLETS SWITCHES - _ -Lender.'s Name. _ Lender's Address _ _ _ ~DRINKING FOUNTAINS - GA5'TUBE-SIGNS OWNER BUILDER DECLARATION - INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031'.5'-Buslness'and Professions Code:- _ -' _ - Any city, or county _which reouires a permit to construct, alter, SWIMMING POOL P+TRAP" �+ POLES METERED SUB improve, emolish or repair any structure, prior to Its Issuance, also re= d WATER SERVICE ALTERATION PANELS- MAIN SUB quires the apd }licant for such permit to file a signed statement that he f _. a+.. te a• .tie J is licensepursuant'to' the provisions of the Contractor's- License Law' GAS SERVICE OUTLETS SERVICE - '" AMP -7----- ` (fChapter_ 9. (commencing with Section 7000) of Division 3 of the business and Professions Code) or that'he Is exempt therefrom'and the' -BTU " basis for the alleged exemption. Any violation of Section 7031.5 by any applicant`for a permit'subjects the applicant to'a civil penalty WATER HEATERS OUTPUT - - SEWER CONNECTIONS T �__- - - _• - _� - _ of not more than five hundred dollars ($500). 1 ❑ 1, as owner of the property, or my employees with wages 3s their' _ -� SOLAR TANK COLLECTORS' sole- compensation, willdo the work, and the structure is not intended_ or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE 1 - Contractor's -License Law does not apply to an.owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY ` through his -own - employees, -provided that -such improvements are not. intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES, -is sold within one year of completion,.the owner will have. the burden_ of proving he did not build or improve for the purpose of sate), HEATING SYSTEM 0-100,00_0 BTU _ _ _ _ BUILDING - "" PERMIT $ ` •' - -' I SMTP S ❑'-I',' as -owner of -the property, am exclusively contracting with- -AND DUCTING - —-------y�i'- - ' licensed contractors to construct the project (Section 7044, Business 100,000 + gTU PLAN CHECK S PERMIT •- ;; , 'and" Professions- Codee'The Contractor's License Law does not apply to - - - ISSUANCE S ' '-- an owner of property who builds or improves thereon, and who con- "tract$ from such -projects with" a contractor(s) Ilcesned• -to REFRIGERATION 0-100,000 BTU -. _ . . }--- PLUMBING $ ,f, r -+ pursuant SYSTEM'- 100,000 +BTU - PLAN CHECK, r - -� GRADING $ [' the Contractor's License Law). f $ „ -, r 1 ❑ I am exempt 6nder'5ection B. &'P. C. for this BOILERS •- ELECTRICAL $ • S 1� reason" ` „BTU PLAN CHECK $ MICROFILM S �• I SYSTEM REPAIR, ALTERATION -Date ----� -- -=-Owner- - - -- - - - - - -- TOTAL' FEE $. .I.hereby certify that-I,have read,this applicatlon.and.state,that the above _ EXHAUST SYSTEM _ MULT_IPLE _ MECHANICAL 3 PLAN CHECK'-$ _LESS AD_ information is correct, 1 agree to comply with -all city and county VANCE PC $_ I ,ordinance5.and state Iaws.relating-to construction, and hereby authorize- representatives of 't i5 Cit to enter upon the above mentioned 'o properly _t r_-insp _p os S. Signature ate � .: +r' FINAL FEE _ _ . Drivers' Li se 55 -ISSUE FEE - EE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CMF CONSTRUCTION AND PLANNING - APPROVALS Permit + Date POOL & SPA Inspector APPROVALS . VT it Date 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms A.- Electrical Conduit-Undrgrn 46. Electrical Bonding tee l Reinforce 47. Rough Plumbing'&'Pre's§tire Test 6. Electrical LIFER Grn 48. APPROVAL TO COVIFIRGUNITP-1 -7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation 50, Gas Pipe, 1:1 Undrqrn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-TFa5,-ET6,_ndrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater& Vent -Final 13. Rough Plumbing 55, Plumbing System - Fin`l� 14. Rough Electric -Conduit 56.' -Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning W Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. 19. -20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60, POOL/SPA SYSTEMS FINAL 21'. 22. Roof Sheathing Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE& BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date r. % -+ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. NITY OF COSTA MESA" PE MIT NO. / TRACT NO: LOT NO. _SLDQ; NO. CONSTRUCTION PERMIT 31IG� LT/ ,, .. "a {' - • " t Project Address 31 D TYPE OF CONSTRUC,T---,,I,O//ff��LL + _ •�"� ; ' ' OWner ' p y"_ ), Phone - - ❑ NEW ❑'ADD ;ZT�ERATION - -- 4499 A/1.2/62 Address ~' -- -❑REPAIR ❑CONVERSION-❑DEMOLISH Vr: _ ,.• L e- ZONING REGULATIONS Arch/Eng: f License Na. - ❑ OTHER'f - A.P. ,.. •. DES C IPTION OF WORK - I ; A'ddresS - - --- - --• - • . --- _ -_- - _ ...._..- ` - . ,-ZINE PL'_NG. REF. _. r I `^,11 -ContYaC(Or Phone t� EP G A & 70 ` TYPE OF PERMIT -' -- -- _� B TO BUILDING OP RTY LINE ' PR E „_ - _ Address -• _ r, SL}� rs ,.�A j, DECLARATION = "..== •❑.GRADING ..�❑ FOUNDATIDJV ❑STRUCTURAL ❑ SETBAC L S LIDE YARD - s• I LICENSED-CONTRACTOR - 9,(com-, ❑.-TENANT ELECTRICAL PLUMBING-❑MECHANICA SI YA RIGWT r I hereby affirm tht.t I am licensed under provisions of Charter -7000)--of Division -•of -the Business- and •--E]-OTHER: ) - F'. -- - ) - - -- - - -• - - -- S mencing with- section Professions Code, 'and y license is II force and effect. 1 REAR YARD (TO P/L) . ` - _ _. __ rr ,License I ss nse No aPROJECT.DESCRIPTION'- - 1 # _ "PKC. SPACE REq. ``PROVIDED ` _ -Signature ` _ ,• r Sq._FT. I Date ; { �' ,STREET WlOTH - , PARK FEE•$i-,,,;"-� r. '.WORKERS' COMPENSATION CLARATION � -- - -- - - 'OCCUPANCY CONSTRUCTION TYPE a 'ZONING APPROV EO BY— c preb affirm that 1 have a certificate of consent to self-insure,or a. Y , VALUATION'_' ZONE n+-tDAi'E ificate-of Workers'-Compensation Insurance,-or-a-certifle =copy - • _ -- - - -� 4 ' - 'SPECIRL CONDITIONS: _ - reof (Section 3800, Lab, C.). ' GRADINGfCU. YDS. ACRES ' Policy No. -Company -❑•Certified copy is•hereby-furnished.-- _._) Division. REMARKS:=''>•�':_.� _ ;'._,,._., f..�-.__�. - - ..-._- _ ._.-_ _ _ _ _ _ -. _ _- __ ertified copy is filed with the city Building •� ` - - - EXEMPTION-FROM WORKERS'-COMPENSATION DECLARATION ' (This.section.need. hot be completed if the permit is for ,one hundred - _ r _ --, _ _ _ - »_ - _ __ - .. - ) _ . --_- • . ,_.-,, �-,.. _ ` __• :�� _' _' ($100) or less). ._�' ! certify-that in the.performance of the work for which this permit Is _ - .l -`"" - issued, I shall not employ any person in any manner so as to-b,c PLUMBING �t 2LAN CHECK ',ELECTRICAL - PLAN CHECK' t subject to the Workers' Compensation taws of,.California.,_ .. _,•��__ -_-- �..... - � •-- 'Date - -° ' 5i9nature -r _ - - BATHTUBS SHOWERS'-"" "" - - -- NOTICE: If after making this declaration, you should become subject ;TOILETS. ., • • ,-;�,URENALS" - �" - ;GENERATOR-- 0-1 KW 1-10 KW '�' I to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE-CANS" �" - jTRANSFORMER • �.) KW- ,APPLIANCE-•-""'•10-50•KW;_50 + KVJ- - , f revoked. CONSTRUCTION LENDING AGENCY _ .. - -'KIT SINKS-"' ""DISHWASHERS" -- j' -- - - -� - '4MOTORS -� -0°1 HP 1=10 HP-- _ -• - - - - - • I hereby affirm that there Is a construction lending agency for the per- ,-•.- ' ---• SERVICE SINKS a ;'k it++;SUMPS """' �' 3_ • (INC. SOLAR)-.. 1 10-50 HP - 50•+�HP'--- ---� �- formance of the work for which this permit is issued (Section 3097 Civ,-C:). -' ""' - - - ______-r -._- -•... -------- ,Lender's Name FLUOR SINKS �- _FLOOR'DRAINS �i ;FIXTURES'-'"- -- OUTLETS -SWITCHES '• r !� `.Lender's DRINKING FOUNTAINS � ` - " "' '- ^GAS TUBE�SIGNS -- "---' '"" - - - -- - '-' Address INTERCEPTORS CLARIF IERS- )• ';PDLELIGHTS'r' •'"4' `" OWNER BUILDER DECUARATION I hereby affirm that I am exempt from the Contractor's License Law for '-SWIMMINGPOOL. �" PTRAP-" "" •' i^- - ON - - -- -� -,:- -•- POLES METERED- •SUB the"following'reason-(Sectio n-7031.5-Buslness and-Professions Code: Any city or county which requires a permit to construct, alter, improve; repair any structure; to-its-Issuance,-aISO re-- "ALTERATION -- PANELS demolish-or prior WATER SERVICE P-Ares the ap,.licant for such permit to file a signed statement that he Tensed-Dursuant'to-the'provisions"of-the'Contractor's-License, Law GASSERVICE - »•- OUTLETS». _ ^- - }SERVICE- __ -'- -- -'^^ `w- --AMP•- - .pter 9 (commencing with Section 7000) of Division 3 of the --WATER-HEATERS -' BTU OUTPUT - I mess'and`Pro4essiORs,Codo)'Or-that-he'is exempttherefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by --SEWER'CONNECTIONS'"_--,, -"' - ___,-_„ __�.. __ _ . _ • ».� __ __ w _ J - any applicant•"for a permit subjects-the-applicant to-a-civil penalty of not more than five hundred dollars ($500). SOLAR-TANK ` 'COL`LECTORS'- - ❑ I, as owner of the pvopeiky, or`my empl`a ees Wifh wge=aa`s their sole.compensation, will.do_the work, and the_structure,is-not intended. - SOLAR PIPING SYS. --•ISSUE-' ' -'- '� FEE '•�-- ----_-- -_ _ _ _.. or offered for sale. (Section 7044, Business and Professions Code: The 1 Contractor's .Lice nse_.Law_does-not.apply, to an, owner -of a property Himself or who builds or improves thereon, and who does such work H { _ -� » _,,,,�,•„• ISSUE FEE U - - (� _ ,� JAPPLICATION'APPROVED BY -•-- -- - -- - -DATE— - through-his own .cmployees,.provided that.such-improvements.are.not # MECHANICAL PLAN CHECK _ ._ �_t _ _ _ - •___ _ w SUMMARY _ _ OF FEE -, -1T=��_oe' __-� _ -+-' intended or offered for sale. If, however, the building or improvement` is.sold_within„one,yearOf. completion, the, owner. willave_ _ of he did not build or improve for the. purpose 6f., sale). _ BUILDING---` --'-= ,$••- - .l proving I. •as -owner of-the- property, am-exclusively - contracting- with HEATING SYSTEM 0-100,000 BTU - "AND DUCTING - 'PERMIT _ $• `- .? ,�• SMIP__ _ - -- _ licensed contractors to construct the project (Section 7044, Business 100,000,+BTU PLAN CHECK $ , PERMIT - 7 ' F r and, Professions, Code! The Contractor's License Law does-not apply to- •.-• - --- - ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU 'PLUMBING $� tf„�+ 11., ,- .,rLI, GRADING tracts from-such •projects-with a contractor(s)-licesned -pursuant to. the Contractor's License Law). SYSTEM -- -- . -- -•r -- • - -- 100,004,+ BTU - - t - - -- 'PLAN CHECK L$ ^ • - t -_ _L ❑'l'a`m exempt'undei Section"r-L= -'-B7&-P.-C. for this BOILERS BTV } ELECTRICPL $ ” �" _M -� $ - 'MiCF2DFiLlvll$'"•• e 1�k reason` _ __ _ - _ - - t SYSTEM REPAIR, ALTERATION i "'PLAN'CHECK -$ t -TOTAL$ •_;' - Date Owner , 'MECHANICAL"'$ 7 -_ _ _FEE 1 hereby certif"ve this_application and state that the above EXHAUST SYSTEM MULTIPLE id-. + CESS AD-information ie to comply with all city and county PLAN�CHECK-$- - - --•- -- VANCEPCordinancesanq,to constructio__n and hereby uth'rf,-; representativeto enter-"uponthe-above ent' hed" Iproperty-for.oses.-_,�,FINAL FEESignature Date C= icen .ISSUE FEEDriver -Assessor CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod CONSTRUCTION AND PLANNI G Date Inspector APPROVALS Permit # POOL &SPA ` �� .APPROVALS Permit,#' •. Date Inspector �. y .. � 1: _Temporary Electrical Service or Pole - 43. Pool & Equipment Location 2. SoilPipe-Undrgrn _ , 44. Steel Reinforcement 73. _Electrical.ConduitUtility-Undrgrn 45. Forms. .4. _Electrical Conduit-Undrgrn 46: Electrical Bondin 5. Steel em orce 47. Rough Plumbin ` & Pressure Test 6. Electrica]_UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn' = B. Foundation _ 50... Gas Pipe, ❑ Undr fn, Test 9. WaWrr PipezUndrgin 51. Backwash Lines P Tra D' ndr rn'- 10. ructurai Floor -System _ 52.. APPROVAL TO DECK H11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final " 12. _Street Sewer Connection. 54. Heater & Vent -Final, - 13. _ .Rough Plumbing f 14.- Rough Electric -Conduit - - - •56.• -Electrical-Final - 15. Rough Electric -Wiring Solar -System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval • 17. Ducts in Structure ; APPROVED FOR PLASTERING 18: 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test- _ Roof_Framing• -- - _ 60. POOL/SPA SYSTEMS FINAL + 21. 22. Roof Sheathing Frame and Flashing _ _.._ _ - ~ NOTES: 23. Insulation 24. Lathing & Siding - - - - - - - •-25.-Drywall,Nailing - 26. Plaster Brown Coat - 27. Electrical -Power Meter -Final 28.- Final Electric. - -- ` Y 29. -- Final, Heating & Air Conditioning_ , 30. FinaliGas-Pipe-Test _ 31' - FinaltPlumbing 32.-- -Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System ' 36. Sound Attenuation ' 37. Handicap Regulations f 38. FINAL STRUCTURE & BUI LDING - - 39. Special Requirements Completed -' 40. Electric Release,to Edison 41. Gas Release to Southern California Gas Co. I 42. CERTIFICATE OF OCCUPANCY No Date a a� • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITyY OF COSTA MESAP RMIT lyj3./ TRACT N0. LOT NO, [BLDG, NO. CONSTRUCTION PERMIT o) YYPE OF CONSTRUC?T,�ION ❑ NEW ❑ ADD QkALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER . 1 ., '..` 0074 12/30/61 .7-00 TL,, ZONING REGULATIONS Project Address _ Owner i Phone Address Arch/Eng. License No. DESCRIPTION OF WORK _!YM TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ElELECTRICAL ❑PLUMBING I&MECHANICAL A.P.TIA 9P ZONE PLNTTG.. gREFLLp:r SET DI PRt�P�112TYN' LINE I YARD RD Address r Phon Contractor IX 4 Address Q t LICENSED CONTRACTOR DECLARATION 9 I hereby affirm that I am licensed under provisions of Charter (com- 7000) of Division 3 Of the Business and ❑ OTHER RIIppGMTYA mencing with section Professions Code and licanse Is In full force and a c REAR YARD (TO P/L) i� License lass Uc sI PROJECT DESCRIPTION �KG.SPACE REQ. PROVIDED a Date � Signature Q FT SQ. - STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DE L RA i OCCUPANCY CONSTRUCTION TYPE. ZONING APPROVED BY DATE I hereby affirm that I have a Certificate of consent to self -Insure Or a VALUATION ZONE rtlflcat0 of Workers' Compensation Insurance, or a certtTled copy SPECIAL CONDITIONS: _ o,��ereof (Sect on 0, C.). 'i GRADING CU. YDS. ACRES IV r"AO IICy No. � Company E& - - ❑ Certified Copy is hereby furnished. - REMARKS: 1 Certified copy Is filed with the city Building Division. ! XEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred .. ' Or I 14 I cerci the performance of the work for which this permit, is certify thatat Issued, I shall not employ any person In any manner s0 as t0 become PLUMBING PLAN CHECK -ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS - UWELLINUKA Date Signature TOILETS URINALS GENERATOR 0.1 KW 1.10 KW NOTICE: It after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS TRANSFORMER APPLIANCE 10-50 KW�50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction fending agency for the per- forman Ce of the work for which this permit is Issued (Section 3097 SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name DRINKING FOUNTAINS GAS TUBE SIGNS _ Lender's Address INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I herebyy affirm that 1 am exempt from the Contractor's License law for the following reason (Section 7031.5 Business and Professions Code: IK Any city or county which requires a permit to Construct, alter, SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish Or repair any structure, prior to Its issuance, also re- quires the applicant for Such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP - licensed Pursuant to the provisions of the Contractor's License Law _ apter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ,•siness antl Professions Code) or that he is exempt therefrom and the is for the alleged exemption. Any violation Of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a -civil penalty of not more than five hundred dollars (S500). SOLAR TANK COLLECTORS ❑ 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 SOLAR PIPING SYS, ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or - ISSUE FEE APPLICATION APPROVED BY DATE # through his Own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES S intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden BUILDING of proving he tlkd not build or improve for the purpose of sake). HEATING SYSTEM 0.100,000 BTU PERMIT 3 SMIP S' ❑ I,'as owner of the property, am exCIUslvely contracting with AND DUCTING licensed contractors to Construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK b PERMIT and Professions Codet The Contractor's License Law does not apply to ISSUANCE S an owner Of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) IICesned pursuant t0 SYSTEMGRADING $ the Contractor's License Law). 100,DOD +BTU PLAN CHECK S ❑ I am exempt under Section B. b P. C. for this BOILERS BTU ELECTRICAL $ S MICROFILM $ reason Date Owner SYSTEM REPAIR, ALTERATION PLAN CHECK $ ____� MECHANICAL $ TOTAL FEE S 1 hereby -certify that 1 have read this application and State that the above EXHAUST SYSTEM MULTIPLE LESS AD - information Is COrr¢Ct. I agree to comply with all city and County � PLAN CHECK $ VANCEP PC $ ordinances and state laws relating to Construction, and hereby authorize represents s nto on above mentioned - propertyi r � �_ FEE S FINAL Sigure ISSUE FEE 3 Drivers' License or S � -Assessor - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNINGpp APPROVALS Permit # O Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra . ❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK s 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing " 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wring 57. Solar System -Final 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 1B. Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19. Gas Pips -Rough &Test 20, Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28, Final Electric 29. Final Heating & Air Conditioning 7 Y 30, Final Gas Pipe -Test 31, Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERT IPICATE OF OCCUPANCY No _ --- Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations.' 3475 3/1 �/62 271.47 + + 'Q�COSTA 16iL5i PERMIT NO.' TRACT NO. LOT NO. -,NO. CONSTRU&ION PERMIT i�.f Z 92 Q - 1?�ojecf,Ati cess I j� 71 : L : TYPE OF CONSTRUCTION Ownert�J t $ Phone 9 • _ ❑ NEW ❑ ADD ALTERATION Address -j__J1 4;� G, 0.1 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH - -Arch/Eng. -'❑ OTHER ZONING REGULATIONS Itt.i ZAS License No. �• oYj$ A.P. y� _' I { CIL , .• ° Address C �- - &-r,L-� Lf ✓%'h. DESCRIPTION OF WORK - - - '_� - - -• - - - , - ' -OZONE GI L-� _ -. PLNG` R_EF.: .,_�- - --- - + Contractor's -41 Phone -0100 TYP.BbF PERMIT, - BUILDING- Tp B ILDING -- IAddress /� Lj,.j �f �Lr+'I t ❑+GR DING ❑-'FOUNDATION (STRU��C//TURAL SETBACK L T.� PROPERTY LINE -.SIDE YARD ;: •- -- - ! LFT LICENSED CONTRACTOR DECLARA 1 N- i hereby affirm that I am licensed under of Charter 9 {Com- ENANT WEL-ECTR�ICAL ❑PLUMBING 0eN1ECHANICA YARD- provisions mon cing with section- 7000) of Division 3 of the- Business and. � ) - ❑ OTHER RIGHT Professions Code, and my license is in full force and effect., _ REAR YARD (TO P/L) ti lass ` ?�Z3GZ'' PROJECT DESCRIPTION _ _ _ +PKG. ` -� - - - -+ License ¢nse I Z -- SO..FT. too.; SPACE REQ. ,IDED Date 22 1 2 Signature ,1 WORKERS' COMPENSATION•UECLARATI - I hereby affirm that I have a certificate of consent to self -insure or a ��j '-OCCUPANCY�F� CONSTRUCTION TYPE, _- �/J+�//+�f �Q' , 'VALUATION ZONE•i - - - _ STREET WIDTH - ZONING APPROVED'BY OAT certificate of Workers' Compensation Insurance, or a certified copy 1aiL _ SPECIAL CONDITIONS 'j thereof (Section 3800, Lab. C.). G CU. YDS. ACRES o. - .. _ Company.. y No.- - copy is hereby furnished. - -^ _ __. copy KS:""'Jfertified copy Is flled with the city Building Division.XEMPTION FROM WORKERS' COMPENSATION -DECLARATION"' This-section.need_ not be_cOmpieted.if-the permit.is.fOr One hundred(510+1) or less). t -I -certify that in,the performance-of-the_work.for which -this permitis FKIT.SINKS Issuetl, I shall not employ any person in any manner so as to becomeNG1 - ;-PLAN'CHECK - —' ELECTRICALT `� "-PL'AN CHECK':subject-to the Workers' Compensation Laws of.CaIifornIa.'.'_ _ _Date Signature BS SHOWERS" !SQ.FT_ NOTICE: It atter making this decldratlOn, you should beCome subjectS , {�• -URINALS' -� " ^- -GENERATOR `- 0:1'KW'tothe TRANSFORMERforthwith Workers' Compensation provisions of the Labor Code, you must comply with such provisions or this permit shall be deemedRIES DOOBLE-LAVS- ' ' "[APPLIANCE 10-50 KW -50 + KWrevoked._-. ._ ._ _ _ _ _1 _.� _. _�. ._ __^CONSTRUCTION LENDING AGENCY KS - - - -" -- DISHWASHERS'-- r, MOTORS - - - 0-1 HP -1-10 HP- I hereby affirm that there is a construction lendingagency for the per- g y .T- -- - - SERVICE SINKS SUMPS"' ,[INC. SOLAR10-50 ) - -HP -- 50 +.HP formance of the work for which thl permit is issued (Section 3097 , - ; Civ. C.). - .,.� - ti r�, .� __ mW �1-� jjp e -,o r� _ FLOOR SINKS' FLOOR DRAINS �� - _. FIXTURES''- OUTLET B'SWITCHES'`T 'Z t4 Lender's Name T _ ^^-7--^^ _ Lender's Address ORINKING FOUNTAINS"" """""' - 'tGAS-TUBE'SIGNS, -- - -- i OWNER BUILDER DECLARATION - I hereby affirm that 1 am exempt from the Contractor's License Law for 'INTERCEPTORS CLARIFIERS , - - *POUE-LIGHTS-- - the' following -reason, (Section- 7031.5 Business- and Professions Code: Any City or.eounty. which requires- a permit to, construct, .alter„ SWIMMING. POOL' -. �- "P TRAP ^-- '" " "" = POLES METERED - SUB -_--- .� - I Improve- demolish or repair any structure, prlor'to its Issuance, also re -WATER SERVICE -_i '-,ALTERATION PANELS - MAIN - quires the ap�licant for such permit to file a signed Statement that'he' -< _ Is licensed-pursuant'to_ the-provislons'of the Contractor's License Caw - GAS•SERVICE- (_ 0UTLETS- SERVICE -^' ^ -- -•M••-- -•AMP- - - -- - --- (Chapter 9 (commencing with Section 7000) of Division 3 of the -WATER'HEATERS - ` j Business and Professions Code) or that he is'exempt therefrom and the - BTU_'OUTPUT tlsis for the alleged exemption. Any violation of Section 7031.5 by - - • _ - '•`�E;`;-appElWnt fora permit subjects the applicant to -a civil penalty �t more than five hundred dollars ($500). SEWER CONNECTIONS' -' '- -- ' -- �- - •' - - -- -�-- - - ------ - -- -- - .;.:'.+, as owner of the property, or -my employees witH wages A their SOLAR TANK -' - -COLLECTORS - - - ---' + - -� `^• -^-- •- - - - - •• - --- - sole compensation, -will db the -work, and the structure is not Intended _ or offered for sale, (Section 7044, Business and Professions Code: The _ _ __ _ SOLAR PIPING SYS. - __.. -- ISSUE FEE Contractor..s License Law does -not apply -,to -an -owner of a property who builds or improves thereon, and who does such wark himself Or ISSUE FEE -,i ... - •,APPLICATIOMAPPROVED-BY - - DATE ' , through his.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'will have the burden MECHANICAL PLAN CHECK r J - SUMMARY OF,fEES _ r"- T: - •+ of proving he did not build or improve for the purpose of sale).HEATING ❑•1, the, -am contracting with SYSTEM 0-100,000 BTU - - BUILDING - •��p - •PERMIT S ,SMTPti5- as owner of. property, exclusively licensed contractors to construct the project {Section 7044, Business -Code: Contractor's does not apply to ANppUCTING "' +--� •- 100,000 +BTU -- - -- - - ' PLAN CHEC5 PERMIT •• r .-.y7 ;•+ K 'ISSUANCE and Professions The License Law an Owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU I E PLUMBING 5 tracts -from -such projects with a contractor (s) •licesned•-pursuant to the Contractor's License Law). ❑ I am exempt under Section - - ': C. for this B.& P SYSTEM 100,000 i BTU 'GRADING , �4 y ' PLAN C1-IECK 5 ` •,, - S t EL'ECTRICAu $ BOILERS BTU _ reason- --- - - -- - - --- - - - - - moi• MICROFILM _ S -'PLAN'CHECK- S -� -- - - - - - - --- Date. Owner ld SYSTEM REPAIR, ALTERATION N.' GO•,'OTAL'FEE_5 '_ MECHANICAL -•S - 1 hereby certify that I have r this application and State that the above EXHAUST SYSTEM ULTIPLE < ;. /•-LESS 4D- AD - Information is c ect. I ree-to comply with -all city and county to hereby ,l f % • _ PLAN CHECK 5 VAN VRNCE PC 5 �� ordinances and a s acing construction, and authorize enter _ _ -, , + `'y representative t s ty t upon the above en oned' property f_or i p I Purp es. _ f J J<, �1��, :� + �\ ♦t ,t,.� ` % t1 l • - FINAL'FEE $.;»._... Signature ate + ISSUE FEE - • .a DO icense or SS CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNINip APPROVALS Permit # - L d Date Inspector POOL•& SPA APPROVALS Permit # Date In;pectpr 1. _ Temporary Electrical Service or Pole 43. Pool &Equipment Location 2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45: Forms .4. Electrical.Conduit-Undrgrn 46. Electrical Bonding _ teeReinforce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn, 48. APPROVAL TO COVER-GUNITE 7.-Footings 49. Electrical Conduit-Undr rn 8. Foundation 50.., Gas Pipe,- El Undr rn, Test � 9. --Water Pipe-Undrgrn.51. Backwash Lines P-Trap.EJ' ndr rn - - 10. ,.Structural Floor System . 52. -APPROVAL TO DECK - - -- - ' 11. ..Property. Sewer Line & House -Connection 53. . Backwash & Receptor-Final 12.. Street Sewer. Connection_ 54. Heater & Vent-Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-Wiring 57. -Solar System-Final 16. Rough Heating & Air Conditioning - encing &.Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof-Framing- v 21. Roof Sheathing- ' NOTES: 22. Frame and Flashing JL .L 23. 'Insulation-j,�-r ?�- . 24. Lathing & Siding a a►. r� b �! o �i�- ' 25. Drywall Nailing . L,- 26: Plaster Brown Coat y 27: Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning -� 30. Final Gas Pipe-Test 31.. Final Plumbing i 32.• -Water Service-Final 33. Gas Service-Final- 34. Solar Domestic-Final 35. 'Landscape Sprinkling System . 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE-& BUILDING 39. Special Requirements Completed " 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY 'No -�3-J 7 Date,-29 jL f?_'�Q P&� t Applicant to fill in all spaces within heavy border lines and TRACT NO, CITY OF COSTA MESA MIT NO. CUNSTR'UCTiQN PERMIT �'�© Project Address Owners CiAar / vT-,l7A�✓(s�CT one Address ,31sS / A/rl�✓A Arch/En9,6:,(,J,Sef7z_ 41,4_1 -AC License No, Address% ,2i//dle � /V - Address 2 C E S•v//Z Z'�✓�ni.� LICENSED CON RACTOR DECLA ATION ! hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Cla;s.�Z- I - -- - -ri1 -dl Icen"jo.222l22 WORKERS' COMPENS-AM04-CDECLARATION / I,.Ilereby affirm that I have a certificate of consent o self -Insure a ^ Ticate of Workers' Compensation Insurance, or a certified copy .i {Section 3800, Lab. C.J. P�°,icy No. Company ❑1�y Certified copy is hereby furnished. MLCertified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section -need not -be completed if the permit Is for one hundred (5100) or less . Iethat n the performance ofthework for which ihls.permit Is Issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, Date Signature NOTICE: 11 after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance, of the work for which this permit is Issued (Section 309] Lender)'S'Name ' 1� !-/�y�i�G''✓` ®�li�'iC �i.✓,�rk�/ L--C/P/ [� Lender's Addres/-- J OWNER BUILDER DECLARATION } `\ I hereby affirm that,l am exempt from.the Contractor's License Law for the following reason (Section 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 re- quireS thejapplicaBt for!spch permiCto file a signed statement that he.. I..,41censed pursuant to the provisions of the Contractor's License Law `cpter 9 (commencing with Section 7000) of Division 3 of the '-less and Professions Code) or that he is exempt therefrom and the H for Lhe,alleged exemption, Any violatlun•'of-Section-7031:5.1iy any appllcanl fora permit subjects the appliEant to a civilypenalty 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 vdork,,and the -structure isnot Intended - or offered for sale. (Section 7044; Business and Professions Code: The Contractor's License Law'.d'Oes not apply..to an owner of a property who builds or"*improves't hereon, and who -does such work himself or through his 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 will have the burden of proving he did not build%or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) lice$ned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this �1 reason Date - Owner - I hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city county ordinances and state laws relating to construction, a her ze representdti s of th s cit to nter �spon t n i d all appropr)a7e•aeclaratfons.7- LOT NO. •BLDG. NO. r 9080�(�iUa%61 324x02 TL, TYPE OF CONSTRUCTIO ❑ NEW ❑ ADD ALTERATION ❑ REPAIR ❑ CONVERSION C1 DEMOLISH ❑ OTHER DESCRIPTION OF WORK /Al T'L€QI etV A L7rc::t1d r/ d5,L TYPE OF PERMIT �.,� ❑ GRADING ❑ FOUNDAT,I�O!/+y tl/STRUCTURAL ❑ TENANT ELECTRICAL IfQPLUMBING ❑MECHANIC ❑ OTHER PROJECT DESCRIPTION !FT. f UPAN CYj ONSTRUCTALUATION �- �Q�i � ZONE GRADING CU. YDS. ACRES REMARKS: --*fes I J. 0_ PLUMBING,, PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAVS KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS FLOOR SINKS _ FLOOR DRAINS ,DRINKING FOUNTAINS r INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP WATER SERVICE1 - -ALTERATION GAS SERVICE OUTLETS WATER HEATERS,__,_ _ BTU OUTPUT SEWER CONNECTIONS . SOLAR TANK •- t COLLECTORS GRADING $ ISSUE FEE $ MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU 100,000+ BTU REFRIGERATION SYSTEM 0-100,000 BTU 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE Drivers' License or SS ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ZONING REGULATIONS A. P. Z`7 i — /3 ZONE �— PLNG. REF. =P REAR YARD (TO P/L) PKG, SPACE REO. STREET WIDTH ZONING APPROVED B\ SPECIAL CONDITIONS: ELECTRICAL PROVIDED U 1 / PARK FEE $ - DATE e 0-1 HP 10-50 HP - 1.10'HP = 50 + HP FIXTURES53 OUTLETW PLAN CHECK I GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW _ 1-10 KW -50 + KW _ ' MOTORS (INC. SOLAR) 0-1 HP 10-50 HP - 1.10'HP = 50 + HP FIXTURES53 OUTLETW SWITCHES GAS TUBE SIGNS OAT F � T ' POLE LIGHTS BUILDING - PANEL'S MAIN SUB SERVICE - AMP ISSUE FEE94 LDad APPLICATION APPROVED BYKf OAT F � T SUMMARY OF FEES BUILDING /79. 5-46 Q 'PERMIT s SMTP $ PLAN CHECK sl 6.67 PERMIT PLUMBING $ � ISSUANCE $ GRADING $ PLAN CHECK $ ELECTRICAL $$ PLAN CHEC K /011 1 $ MICROFILM $ MECHANICAL 5 TOTAL FEE $ PL'F1N�CHECK LESS AO- $ VANCE PC : sr� } FINAL+FEE $ f- CONSTRUCTION AND PLANNI G APPROVALS Permit # ~� A? Date Inspector POOL & SPA APPROVALS Permit # 1 - Date IhsppctorT 1. Temporary Electrical Service or Pale, 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3, Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit•Undrgrn• 46. Electrical Bonding b. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7, Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrarn 10. Structural Floor System 52. APPROVAL TO DECK •11, ' Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54.. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric-Wiring57. I Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing S 12 _3r 23. Insulation 24. Lathing & Siding - T-. 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric r 29. Final Heating & Air 30. Final Gas Pipe- est 31. Final Plumbing r % 32. Water Service -Final 33. ' Gas Service -Final �'!r 34. Solar Domestic -Final 35. Landscape Serinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUI-LDING ► 5 l ,i 39. Special Requirements Complated 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. 'CERTIFICATE OF OCCUPANCY Date �+ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. carr -OSTA MESA CONSTRU TION PERM T PERMIT NO. TRACT N . LOT NO. UNIT NO. f Z 9 S,7 i Rv r+V paFz PAR / D- _2 Project Address f S r tr�I J_ (� W_V U� u Applicant's Mailing Ad ess 3 ) nS _1. ® _I _ Owner's Name BQn1G� l:lUlAlrl Phone Address 3151 i/! -- Arch/Eng, k k Si - L,l�ilense No. i_ 113 I Address%DD-zoi Contractor's Nam ' Phone Address (mailing) ISI - a City License No.�3z Za LICENSED CONTRACTOR DECLARATION f hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in f I force and effect. n��/ License ass - Llc e 7 [d le Signature )R KERS' COMPENSATION DEC RATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workeis' Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C.) Policy No. Company BCertified copy is hereby furnished, , Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100) or less) - I certify that in the performance of tate w rl for which this permit is issued, I shall not employ any person In any man so as to, bAcome subject to the Workers' yp1n i n Laws of Californi Date Signature NOTICE: I , after m !ting ,this declaration, ou she a subject to the Workers' Compensation -provisions of the Labor Code, you must forthwith comply with such •provisions or this permit shall be deemed revoked. 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 (Section 3097 - Civ- C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that f am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code:.Any city or county which requires a permit to construct, alter, Improve, demolish or repair •ty structure, prior to. its issuance, also requires the applicant for such permit file a signed statement that he/she Is licensed pursuant to the provisions of ,e Contractor's License Law (Chapter 9 (commencing with Section'7000) of 01 Vision 3 of the Business and Professions Code) or that he/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 malty of not more than five hundred dollars (5500). 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 forsale ,(Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such worts himSolf/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 com- pletion, the owner will have the burden of proving he/she did not build or Im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Cen- tractorsto construct the project(Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a Con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof off their Worker's. Compensation insurance Should be provided to me, ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner 1 hereby cerQor information I and state law sentatives of inspection p Signature Drivers' Licen this aDPI often antl state that the above 'm h all city and county ordinances tl n, and he eby ut ho rize repre- roperty for �,°F_ TYPE OF CONSTRUCTION L1 NEW I )rJ At REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. 4, q27— — zjIl— 1 -DESCRIPTION OF WORKIUSE OF BLDG. TQ �-A. I-� SUMMARY OF FEES BUILDING PERMIT $ S Main Building: PLAN CHECK E SD .-3X PERMIT TYPE OF PERMIT GRADING LJ FOUNDATION 9 STRUCTURAL T Front ISSUANCE TENANT ElELECTRICAL ❑ PLUMBING ❑ MECHANICAL $ Rear r NTT ❑ OTHER A LP . _0 I PROJECT DESCRIPTION SO. FT, OCCUPA47 C Right CONSTRUCTION TYPE VALUATION 5 S Left ZONE. GRADING CU. YDS. ACRES Ping, Ref. # Remarks: Planning Notes: TCAs R tQT ; `PC#- Sar -six} -1-0 PLUMBING FEES Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks` Gas Service Outlets Interceptors Kitchen Sink P -Trap Roof,Drains Reinspection Fee S15 Boiler Duct - Under Ground Duct - Structural Duct • Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO '* Heating System & Ducting ❑0-100,000 BTU C-) 100.000 SIT Reinspection Fee 1 $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar -Collectors Solar Piping ' Solar Tank Swimming Pool vv/Spa w Water Closet -Water Heater Water Service. Auto -Wash Laundry Trays �i Issue Fee MECHANICAL Hood or Type ❑ Canopy Typell ❑ Refrigeration System 00.100,000 BTU, 0100,000 BTU System Repair/Alteration Fire Dampers Registers Issue Fee S 3 FEES S 3 Automatic Washer' Construction Pale Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures I'.i' Zone C 4 - Accessory Building: A c�TE2Art`r o n Parking Req./Provided �gL/ 5ft f Nov Fla u_srs NEw OV7YrnGS Mair ELECTRICAL Device Boxes D Outlets Switches Garbage Disposal Generator 130-5 KW 05-15 KW Transformer ❑ 15-50 KW ❑ 50 + KW Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel Motors ❑0.1 HP ❑1 h - B Inc.Solai 09-15 HP 016.15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor FEES Z O N I N G R E O M T S I I Reinspection Fee I $15 I I Issue Fee I S 3 I I -DEVELOPMENT SERVICES REQUIR Zoning Approved By Building Approved By Application Issued By' PLAN CHECK 50% $ J _ 60 MICROFILM MECHANICAL S f ` 00 TOTAL FEE PLAN CHECK 25% $ !7 S SUMMARY OF FEES BUILDING PERMIT $ 310-00 SMIP PLAN CHECK $ SD .-3X PERMIT PLUMBING S. ISSUANCE PLAN CHECK 25% $ 0.5 ENERGY P.C. ELECTRICAL $ LP . _0 GRADING PLAN CHECK 50% $ J _ 60 MICROFILM MECHANICAL S f ` 00 TOTAL FEE PLAN CHECK 25% $ !7 S CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA 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 LIFER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, ❑ 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 l 14. Rough Plumbing 45. Electrical -Final 15. Rough Electrical-Conduit66. Solar System -Final el 16. Rough Electric Wirin 46. 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 APPROVALS Permit # _ 20. Rough Factory Fireplace 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T -Bar Ceiling (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 8�1�01� HEALTH DEPT. REQUIREMENT 31. Piaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERT CATE ISSUED 33. Final Electric ,. Notes: 34. Final Heating &Air Conditioning 3lgq (D t O I 35. Final Gas Pipe -Test 7� Dom LacwlAa 36. Hood or Canopy l L 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Date F Il Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CON TR CTION eERMIT Project Address D 14--!) Applicant's Mailing Address Owner's Name nA, fJ e310 q t )IN,„-Phoneti Address a,,—) /I- } ArchlEng. License No. —C � Address U L A Contractor's Nam /��, l�l1~1 S Phone Address (mailing) +31 �? Pf l�"-J� City License No. 211-9 LICHNSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 o the Business and Professions Code, and my license is in full fort nd effect. �/ License I ss ns }• -ate Z Signature WORKERS' COM EN5ATION DE RATION I hereby affirm that i have a Certificate of consent to selfynsure or a cortlficato -,f Workers' Compensation Insurance, or a certified copy thereof (Section 300, Lab. C.) olicy No. Company eCertified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit Is for one hundred ($100) or less). I certify that In the performance of the worr for whit s permit is Issuetl. I shall not employ any person In any m so come subject to the Workers' m ' a on taws Of Califor Date Signature n NOTICE: If, after rriaking this declaration,ou s u ecome subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction fending agency for the performance ofthe work for which this permit Is issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License taw for the following reason {Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Coda) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil laity of not more than five huntlred dollars (S500). -1 I, as owner of the property or my employees with wages as their $olo Compensation, will do the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professional Cotle: The Contractor's 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 employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is sold within one year of com- pletion,'the owner will have the burden of proving he/she did not build or im- prove for the purpose of safe). ❑ I, as owner of the property, am exclusively contracting with licensed con. 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 builds or improves thereon, and who contracts for such projects with a can- tractor(s) license pursuant to the Contractor's License Law), I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section S. & P. C. for this reason Date I hereby certify thi information is corre4 and state laws relati sentatives of this c inspection purposes. Signature Drivers' License or S — Owner I have read this I agreeto Com I building r, s 4Eenteron TRACT LO7 NO. PERM T NO NO. Service Sink UNIT NO. Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collector Dishwasher Solar Pi Drinking Fountains S Tank TYPE OF CONSTRUCTION LJ NEW LJ ADD LZALTERATION LJ REPAIR Floor;Sinks' Urinal ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Water Closet A.P. 46 Water Heater DESCRIPTION OF WORKIUSE OF BLDG. Water Service Lavatorie Auto -Wash P -Trap Laundry Trays Rbof'Diains S Main Building: E TYPE OF PERMITGRADING FOUNDATION STRUCTURAL T Front ❑ TENANT_LFCTRICAL ❑ PLUMBING ❑ MECHANICAL B ❑ OTHER A Rear PROJECT DESCRIPTION SQ. FT. OCCUPANCY C K Right CONSTRUCTION TYPE VALUATION S S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: l �iJ _f�7 Ve _ C-r-aq19'7 Planning Notes: iplication and state that the above with all ity and County Ordinances u tl hereby authorize repre- ove-mentfoned property for FEES Bar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collector Dishwasher Solar Pi Drinking Fountains S Tank Floor Drains 01Swimming Pool w/Spa Floor;Sinks' Urinal Gas Service Outle Water Closet Interceptors Water Heater Kitchen Sink Water Service Lavatorie Auto -Wash P -Trap Laundry Trays Rbof'Diains Reinspection Fee 1 $15 Boiler Duct • Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO + Heating System & Ducting E-10-1100,000 BTU ❑10 OBT Reinspection Fee 1 $15 CMF 0865.46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee 5 3 MECHANICAL FEES Hood or . Type 1 ❑ Canopy Type 11 ❑ Refrigeration 5 m ❑0-100, BTU ❑100,000 BTU S m Repair/Alteration Fire Dampers Registers Issue Fee 1 $ 3 Zone Accessory Building: Z O N I N G R Perking Req./Provided E 4 M T S ELECTRICAL Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Q Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW ❑5-15 KW Transformer ❑ 15.50 KW ❑ 50+KW Meter ❑up to 100 amps Meter El over 100 amps Sub Panel Motors ❑0-1 HP ❑1;5-8 Inc. Solar ❑9-15 HP 016-15+ Microwave Pole Light Range Sign Standing Sections Trash Compactor FEES I I Reinspection Pee ' I $15 1 I Issue Fee I S 3 I I DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Date ES SUMMARY"OF' BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ _ ES SMTP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING S MICROFILM S TOTAL FEE S CONSTRUCTION AND -PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Scif Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE, 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 6. Solar System -Final 16. Rough Electric Wiring g Fencing & Access Approval 17. Rough Wiring Sign F68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling . POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # _ 20., Rough Factory Fireplace 21, Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas [:]Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73: Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and f=lashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78.. FIRE PREY, FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32, Electrical Power Meter -Final 0. 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 '•r 38. Final Plumbing 39: Water Service -Final •40. Gas Service -Final ' 41. Solar Domestic -Final .r ,42.' 'Backflow Preventer 43 J -Backflow Irrigation 4A' Landscape Irrigation System >'45"Sound Attenuation 46. Handicap Regulations -,, 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed _ 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _ City of Costa Mesa 11 4` I Building Safety Departmentil h CERTIFICATE' OF O CJIC U P A N C Y �+ P.O. Box 1200 it A — 60 Costa Mesa, California 3151 x i n%ra Avenue -Build r-1,.' The Building located at Y 4 has been inspected and found,to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto t' for a Group p-2 Occupancy. Use of Building r -'Lal.- Interior Alterations _-- Legal Description A.:?. 0427-291-05 (See reverse side for Metes and Bounds) Building Permit No If 3/E-467 Electrical Permit No—E-4571 Plumbing Permit No. ji Number of apartments "0— and/or guest rooms —0— g is ISSUED TO: I; Building Official by �WPOPT =S-IctTl Victor C. Ne�rrtpn-Dixevd�hr Buildin+a Divici,a*z Date SepI:knber 22, 1961 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the`City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU'34 Rev, 11/74 ;11 CITY OF COSTA MESA BUILDING DIVISION i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL. (714) 754-5626 PERMIT NUMBER: B08-00132 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93894040 DATE ISSUED: 0412312008 ISSUED BY: JOB ADDRESS:_ 3151 AIRWAY AV CM SuitelUnit: Vicinity: BLDG.I1 s Squares: 0 J Valuation: $24,392.00 SCOPE OF WORK: REROOF: Y/O WOOD SHAKE ROOF, REPLACE WITH 110 SQR'S OPCLASS X`40 YR. GAF FIBERGLASS SHINGLES 8 15# FELT. ROOF PITCH: 4:12 , BLDG. I GREEN ROOF INSTALLATION PER ES LEGACY REPORT #ER -5546 OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: %' ?' %SOUTHERN CALIFORNIA %PROPERT;Y RESERVE,I - ; . Unit: 10 E SO TEMPLE ST #400 t PHONE: City/State/Zip: BRUCE CHRISTENSEN?, APPLICANT: HANSEN, DUKE Address: N6646636 Unit: PHONE: City/Stale/Zip: CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: - PHONE:, 714-557-7440- City/State/Zip- SANTA ANA, CA 92747 CELL; ARCHITECT: License No. PHONE: ENGINEER; License No., PHONE: FEE SUMMARY Reroof Plan Check: $0.00 ` Reroof Permit Fee: $391.25 Reinspection Fee: $0.00 ti NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE 1. INSPECTION TYPEpl�T NI TMALS CODEC INSPECP4X�YP� Q�7fi LM771UtL5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final - 208 Final Plumbing 200 Final Re -Roof Q iP 210 Fina! Electrical 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 WORIKERS' CgMPENSATION DECLARATION. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, fog the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Cection 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: / J Carrier: vYr� 7e 1111-1 w (rho secfbn need not be cvmpfeied d the permit is vahred ai one hundred dollars (S f 00) or less.) Policy Number: c❑. 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 y or Code, I hall forthwith comply with these provisions. Appllcant's5ignature / 'Date 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 DOLLARS ($100,000), IN ADDITION 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 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. Class.# Convactor s Signature Date CONSTRUCTION LENDING AGENCY: ❑ 1 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 penalty of perjury that 1 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 sate. 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 sate.). ❑ 11 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 3057-46 (W7) Date Owner 1D verified by dri% ce. a Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property lax 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 6, 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, Applicanl's 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? ❑ 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 rile a registration form for acutely hazardous materials? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Ouality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for nonresidential 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 ❑ No (if "yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No 8. (If -yes", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: l certify that under penalty of perjury the information given above is correct. 1 agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature Date CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: 1 certify under penalty of perjury that I have read this application and slate 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 o gal Owners) ndlor,AuthO ized Applicant Date Date I i ` 7 CITY OF COSTA MESA - BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 Fax (714) 754-4856 www.ci.costa-m2sa-ca.us F t FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B08-00218 PERMIT TYPE B ROOF2 _ STATUS: ISSUED APN: 93894028 DATE ISSUED: 07/23/2008 -ISSUED BY: GAG JOB ADDRESS: 3151 E AIRWAY -AV CM Suite/Unit: ` E Vicinity: Squares: 0 Valuation: $18,868.00 SCOPE OF WORK: TIOFF WOOD SHAKE INSTALL 1-15LB FELT AND 40 YEAR COMP. SHINGLES CLASS. _ OWNER: CORP OF THE ,PRESIDING BISHOP CHURCH OF LDS Address: %DOMANI CORP %PROPERTY RESERVE INC..- Unit: 10 E SO TEMPLE ST #400 PHONE: - .,City/State/Zip: BRUCE CHRISTENSEN APPLICANT: DUKE HANSEN� Address: 260 E"ALTON`AVE h Unit: PHONE: 714-557-7440. City/State/Zip: SANTA ANA; CA CONTRACTOR: ROSS AND BARROWS INC _ License No. :• 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA', CA 92707 - CELL: ARCHITECT: License No. PHONE:, ENGINEER: License No. _ PHONE:' FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: $307.25 Reinspection Fee: $0.00' TOTAL FEES $307,25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. Faifure to obtain inspections and final approval will result in the expiration of this permit. Ql4PE L INSPECTION TYPE 2&U 114TMALS C_OOE a INSINCTION TYPE D LNIM 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 2x18 Final Plumbing 200 Final Re Roof jy� 3 210 Final Eledriral 201 Final BlocIdRetaining Well !�P 4 212 Final Fire Prevention 202 Final Faclory Fin: Plane 220 Final Planning Approval 203 Final Sign 222 Final Site 2U Final Demolition 250 Final Buildingioccupancy 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 ec ion 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy Znu C r:Vc/ % T �'[J 4 (Tho seLtkin need nor be compfered d fhe perrn# is valued of one hundred dollars ($100) or less_) Pol; ber: b Z S}�3f �—o 0 g ❑ 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 bec51b subject to the workers' compensation provisions of Section 3700 of t Cade, I sh �rthwiih comply with these provisions. 3 �S- Applicant's Agnature Dale 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 DOLLARS (S100,000), IN ADDITION 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and m e is in full force and effect. is Signature CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the worts 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 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 ($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.). ❑ l,` 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 (hereon, 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 Dale 3057.46 (3107) Owner ID verified by drivt. _ ..cense. ❑ Yes ❑ 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: ❑ 1 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. Applicant's 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 I iDvmer(s Andlor Au z d Applicant Date a,2z3 e", to W F- a } J cc W 0- 0 cc CL Z W 2 cc W D- oc oc O } Cli 2 H COSTA MESA OUILDINC—SAFETY OEPARTMENT P.O. BOX 1200 Costa Mesa, California TRACT N0. -153 � N° IMM or It �y ! ^ r �f Contractor 51;7/17-,,A- , 0 /T � LOT NO. 5:;4A17 -,,A -e, Address ?_60 4E� „D e& -7ZI:) 3� 7rBUILDING USE DATE ISSUED Citys ,� Zip Code a 7aa S'/ .I c� I � State License No./'t J t.% Class. C — -Z�d BUILDING K ADOREss31�;/iZLv �Q ire`" %3L�C'• L� y COSTA MESA, CALiFDRNI�, City License No. O L6 41 Tel. Tfo. IC. _gr Np, ITEM EAC+I FEES FAU, Wall, or Gray. Furn.Incl.Ducts and OWNER �f Y Vents to 100,000 8TU MAIL over 100,000 BTU ADDRESS ,� 6Y CITY111 �. TEL. N0. Vent (if not incl. above) IV l here y acknowledge that i have read this application and'statejthat the above is correct and agree to comply Suspended Neater Alter or Replace Appliance , 'Zwthl a ll�Gity Ordinances and State Laws regulating Heat- ', tng, Ventilating, Refrigeration and Air -Conditioning. ver 16 reet O gas piping fid j' I certify that I possess the above valid State of Calif - BOILERS OR COMPRESSORS omia classification or I am the legal owner of the single family residential property described above. � j� -1Y 3 H.P. or less � Signature of ` ver to 15 N.P. ]y Permittee Bathroom Vent F'an—Sin le Duct' REMARKS: Kitchen1C y - VantiIatin Hood 1 1(` h _ Matal,�Fire•Places ICBG + AGA + APPROVALS INSPECTOR DATE Mist Ducts Underground Oa Ducts in Structure Ducts Ventilating DA#A C—A 7 Heating — Rough P' Hoods Refrigeration Lines Pian Check Pressure Test Reinspection Fee Air -Gond. Final Ventilating Final Sub -Total Heating Final / Processing Fee O U Refrigeration Final Final Gas Test TOTAL FEES `�`� Utility Co. Notified CMF 0449-46 BLDG. PERMIT NO. a %� C+ COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FORNTRUCTURAL PERMI1410. 18 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 • . A" ►L' RECEIVEOPY PERMIT �.+ cant to Fill in Completely — Use Ink Only FOR A.P. NO. -- aq� -- 03- oq BUILDING ADDRESS astern Pacific Financial ,3/r�4i2 I MAILING C/O . Donaldsoon UNIT OR ACE NO. ADDRESS S Ste S TEL ]�-39i Parcel 1 BLK. �/� CITY Irvine Ca 92714 No 540-260 c°'E'R 7lc�estern Pacific Financial NEW I ADD ALTER IREPAIR IMOVINGIDEMOILISH LENNDDER X BRANCI-1 OWNEFWestern Pacific Financial ADDRESS Same VALUE ARCHITECT Hales -Langston TEL547-086 USE S/ 71'11,1333, `j OR ENGINEER r / ADDRESS 777 S. Main.,Orange, Ca. ZONE �/ TYPE GROUP CONTRACTOR J. Donald Olson Co. BYPROVED DATE 18003 Skypark Blvd., Ste B eZ S7 - • C'� ADDRESS , TE CITY Irvine Ca. 92714 NO` 540-2606 APPROVED SETBACKS LIC ivO. 333969 LICNO. SIZE NO. OF BLDG& S (FROM C/L STREET) OF LOT NOW ON LOT QFRONT FT. USE OF Vacant Land EXISTING BLDG Separate perrnits are required for L SIE T. electric, plumbing and heating work: RE FT. USE OF BUILDING AND WORK TO BE PERFORMED PLAMINGCTION Construct office buildingshell r - AP ROVED 6040 S.F. APPROVED _nAJE HOLD FOR SPECIAL REQ MENT% I hereby acknowledge that I have road this application and state that the above information li correct and agree to comply with all laws regulating building construction, and I shall not employ any parson In violation of the workman's compensation laws Of the State of California. I hereby certify that Iam pr y licensed as a contractor under SO. FT. the State of California Bus ass d Professions de, Di on 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such ee s are in full f ee n f , or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from the pr v its Of the St Ca rnia iness and Professions Code, tslon 3, Chapt 9 VALUATION PERMIT FEE S my PLAN CHECK 3 S Signature of Permittee '1 S 7.710 •� TAX S or Authorized Agent Date TOTAL PAID ►L' Applicant to fill in all spaces within heavy border lines and. sign all appropriate declarations. CITY Of COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. VONWROCTION PERMIT Project Address Aur C. Owher r.. Phone Address I f /? / 1 7i iQ A)P..,Aa 'r AL; License No. Address ,nJ St. 00a -G Contractor AJ�r �� 5�� PhoneSC/ Address LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code,d my license Is In full force t Llcens Class A License No. Data Signature _ WORKERS' COMPENSATION DECLARATION •reby affirm that i have a certificate of consent to self -insure or a ` ;ticate of Workers' Compensation Insurance, or a Certified copy eof (Section 3800, Lab. C.). . Policy No. Company ❑ Certified copy is hereby furnished. ❑ Certified copy is flied with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred {$100) or le 1. " 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. Date Signature - NOTICE: If after making this declaration, you should become subject tothe Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. formance of the work for which this permit is issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from,the Contractor's License law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a -'permit t0 construct, alter, improve, demolish or repair any structure, prior to Its Issuance,also re. Fres the applicant for such permit to file_a signed statement that he ,.ensed pursuant to the provisions of the Contractor's License Law Ater 9 (commencing with Section 7000) of Division 3 of the ness and Pro{essions Code) or that he 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 ($500). ❑ I, as owner of the property, or my employees with wages as their sole Compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply -to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not Intended or offered for sale. if, however, the building or Improvement I$ sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con. tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that 1 have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and s relating;o Construction, and hereby authorize represent s is cit t enter up the above mentioned propert for sp Ion r ses. Signature e Drivers' License or SS TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC ❑ OTHER PROJECT DESCRIPTIO14 SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: ±2_71r ZONE 4673 9/CE/21 )NTNG REGULATIONS PLNG.. ggRUUppEF..* �ROPEIRTVNLIN REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ T B.—,1L PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS NU ; TOILETS URINALS GENERATOR 0-1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW,50 + KW KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP SERVICESINKS SUMPS (INC.SOLAR) 10-50 HI? 50+HP 'FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT , SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. IS'TfE FEE f ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDINGPERMIT HEATING SYSTEM 0 100,000 BTU $ SMIP E ' AND OUCTING 100,000 + BTU_ PLAN CHECK $ PERMIT ISSUANCE $ REFRIGERATION 0-100,000 BTU PLUMBING $ SYSTEM GRADING S 100,000 +BTU PLAN CHECK E BOILERS BTU �_ ELECTRICAL S $ MICROFILM $ SYSTEM REPAIR, ALTERATION I i]' T11 PLAN CHECK $ MECHANICAL $ TOTAL FEE S EXHAUST SYSTEM MULTIPLE LESS AO - PLAN CHECK $ VANCE PC $ FINAL FEE $ O ISSUE FEE -'"--White-Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA - .e Date Inspector APPROVALS Permit # Date. Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -T a12, ❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash.& Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit -56. Electrical -Final -15. Rough Electric -Wiring 57. Solar System -Final 16. Rough. Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing' 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24, Lathing & Siding 25. Drywall Nailing 26, Plaster Brown Coat 27. Electrical Power Meter -Final 28. -Final Electric 1 29. ' Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison ,41. Gas Release to Southern California Gas Co. ` 42. CERTIFICATE OF OCCUPANCY No Date --MR" Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. +±yC 911L3181. �{� j�a - sora♦ Ti _ CITY OF COSTA MESA PERPW NO TRACT NO. LOT NO. BLDG. NO. r GCONS'TRUCTION PERMIT rrDjeCl mooress r L/•kf ' C,/61k TYPE OF CONSTRUCTION Owner 7y ,~1 Phone. ❑ NEW ❑ ADD ❑ ALTERATION Address 3ZC4 Jri— /✓e ❑REPAIR El CONVERSION C1 DEMOLISH Arch/Eng: ❑ OTHER DESCRIPTION OF WORK Address j QXA1tf,1 cP_ 0-1 KW Contractor Phone YPE OF PERMIT ❑GRADING ❑ FOUNDATION El$7RUGTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAN Address%✓e LICENSED CONTRAC70R QfECCARATION I, hereby affirm that I arts licensed under provisions of Charter 9 (com- - mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, an my license is in full force an f c subject to the Workers Compensation Laws of California. SHOWERS PROJECT DESCRIPTION License Class License No. NOTICE: If after making this declaration, you should become subjectURINALS Date Signature SQ. FT. ' RKERS' COMPENSATION DECLARATION - OCCUPANCY CONSTRUCTION TYPE, reby affirm that I pave a certificate of consent to self -insure or a VALUATION ZONE �firate of Workers' Compensation Insurance, or a certified copy FLOOR SINKS FLOOR DRAINS thereof (Section 3800, Lab. C.). GRADING CU: YDS. ACRES Policy No. Company 0-1 KW ❑ Certified copy Is herepy furnished. ❑ Certified copy is tiled with the city. Building Division. _ 0 r- EXEMPTION FROM WORKERS' COMPENSATION DECLARATION2,0 (This section need not tfe completid if the permit is for one hundred - [$100) or Iess). fI certify that In the performance of the work for which tnls permit Is Issued, I shall not employ any person in any manner so as to become MOTORS ' PLAN CHECK - RH subject to the Workers Compensation Laws of California. SHOWERS Date Signature 50 + HP NOTICE: If after making this declaration, you should become subjectURINALS to the Workers' Compensation provisions of the Labor Cotle, you must forthwith comply with such provisions or this permit Shall be deemedIES DOUBLELAYS revoked, - - - - CONSTRUCTION LENDING AGENCY DISHWASHERS = SUMPS Ihereby affirm that there Is a construction lending agency for the per -INKS lormance.ot the work for whlCh chis per it is sued (Section. 3097 Civ, C.). � C Lender's -Name FLOOR SINKS FLOOR DRAINS KINKING FOUNTAINS Lender's Address OWNER BUILDER DECI-ARATION I herebmwfliirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city .or County which requires a permit to construct, alter, INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP WATER SERVICE ALTERATION ^,+prove, demolish or repair any structure, prior to its issuance, also re- k�Z-es the applicant for such permit.to file -a signed. statement that he V,•.,,..ensed pursuant to the provisions of the Contractor's License Law :fapter 9 (commencing with Section 7000) of Division 3 of the business and Professions Code) or that he is exempt therefrom and the basis .for the alleged -exemption. Any. violation of .Section 7031.5 by GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollar$ ($500). - SOLAR TANK COLLECTORS ❑ I. as owner of the property, or my employees witn wages as their sole compensation, will'do the work, and the structure is not intended SOLAR PIPING SYS. ' or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply'to an owner of a property ISSUE FEE who builds or improves thereon, and who does Such work himself or through his own employees, provided that•such-improvements are not MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or Improvement IS Sold within one year of completion,- the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ nI, as owner of the property, am exclusively contracting with licesed contractors to Construct the project (Section 7044, Business and Professions Cotle: The Contractor's License Law does not apply to HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION_ 0-100,000 BTU an -owner -of property.who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License I.aw). _ SYSTEM 100,000 + BTU ❑ I am exempt under Section S. & P. C. for this _ BOILERS. BTU reason Date owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I herebycertifytnat i have read this application and state that the above Information is correct. I agree to comply with all city and county , ordinances and stat Ia s relating to construction, and hereby authorize representative city On r upon' the above mentioned property fo a onpur ses - - �/ - ISSUE FEE r r Signature Drivers' License or SS =,p GMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor A.P. 1F ZONE ZONING REGULATIONS PLNG. REF. =h� rp BU1L INC PROPERTY LINE it REAR YARD (TO P/L) PKG.SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED' PARK FEE S DATE ELECTRICAL PLAN.CHECK.' GENERATOR 0-1 KW 1-10 KW TRANSFORMER APPLIANCE 10-50 KW 50 + KW MOTORS 0-1 "P 1.10 HP SOLAR) 10-50 HP 50 + HP t(INC. ISSUANCE FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS 'POLE LIGHTS GRADING S PANELS MAIN .,SUB SERVICE AMP ISSUE FEE APPLICATION APPROVED BY M®M 0�0 N�1 =tee FINAL FEE S Of, 00 SUMMARY OF FEES- " BUILDING PERMIT $ SMIP $ RLAN CHECK $ PERMIT ISSUANCE S PLUMBING E GRADING S •_ ,PLAN CHECK ELECTRICAL S S 2150 $ - MICROFILM S - PLAN CHECK S TOTAL FEE S MECHANICAL , S - LESS AD- PLAN CHECK S VANCE,PC S FINAL FEE S Of, 00 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # ' Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment -Location ` 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER -GUN ITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning W. 7-en-cing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation r 24. Lathing & Siding ` 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final - (� 28. Final Electric A- E-:9'1 i 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42, CERTIFICATE OF OCCUPANCY No Date , Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY JJF COSTA MESA `T� l '7-T TRACT NO. LOT NO. SLOG. NO. CONSITIUCTION PERMIT L/p Project Address j,4 y Owner Phone Address Arch/Eng. License No. Address Contractor Phone Address i}d trV LICENSED CONT A R DECLARATION I hereby affirm that ! am licensed untler provisions of Charter 9 (com- mencing with section 7000) of Division 3 O he usiness and Professions Code, and 9y_ license i In f rce ayp a feet. License Clas �O U e o. Date Signature WORKERS' COMPENSATION DEC ARATIO `ereby affirm that I have a certificate of coAjWnt t0 self -insure or a Ificate of Workers' Compensation Insurance, Or a certified copy :eof (Section 3800, Lab. C.). Policy No, Company�J- �- - - '❑ Certified copy is hereby furnished. 13'Certifled copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION �This section need not be completed if the permit Is for one hundred $0) or less). cert[[fy that n. 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.. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. _. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a Construction lending agency for the per. formance of the work for which this permit is Issued (Section 3097 Civ. C.). - Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions -Code - Any city or county which requires a permit to construct, alter, At improve, domolish or repair any structure, prior to Its Issuance, also re- `-j`p quires the applicant for such permit to file a signed statement that he s; ensed pursuant to the provisions of the Contractor's License Law eater 9 (Commencing with Section 7000) of Division 3 of the b�v�i" ass and Professions Code) or that he Is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant t0 a civil penalty of not more than five hundred dollars ($500). ❑ I, as Owner of the properly, or my employees with wages as their Sola compensation, will do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner -of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who COn- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason - Date - Owner I hereby Certify Oat I. have r0ge this application and,state that the above Information Is orrect. ! to comply with all City and.county ordinances arl tate law t g construction, and hereby authorize representativ of Cho//enter upon the above mentioned pro ae rtv -Uf tlinect o 5. — r -I Drly ' License or CMF 0\65-46 4 TYPE OF CONSTRUCTION E]E,NEW A00 ❑ ALTERATION ❑ REPAIR ❑ CONVERSION E] DEMOLISH ❑ OTHER DESCRIPTION OF WORK QLA—Z.2OAZE TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL El TENANT ❑ ELECTRICAL ❑PLUMBING L7M/ECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY"—CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: 2402 8/04/81 12.00 Th ZONING REGULATION A.P. 99h ZONE PLNG. REF. :P HT REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE E ZONING APPROVED BY DATE SPECIAL CONDITIONS: ISSUE FEE - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor FINAL FEE S� _I PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-14 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW -50 + KW KIT. SINKS - DISHWASHERS MOTORS - 0-1 HP 1-14 HP SERV ICE SINKS SUMPS (INC. SOLAR) 10-50 HPL -50 + HP - FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - DRINKING FOUNTAINS + GAS 'TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING HEATING SYSTEM 0-140,000 STU PERMIT S SMIP S AND DUCTING 100,000 + BTU PLAN CHECK S PERMIT ,��,'] ISSUANCE S REFRIGERATION 0-100,000 BTU PLUMBING E.i1SL SYSTEM GRADING S 100,000 + BTU PLAN CHECK S BOILERS BTU ELECTRICAL E S MICROFILM S SYSTEM REPAIR, ALTERATION PLAN CHECK $ TOTAL FEE S MECHANICAL $ E AUST SYSTEM MULTIPLE LESS AD- - _ PLAN CHECK S VANCEPC ISSUE FEE - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor FINAL FEE S� _I CONSTRUCTION AND PLANNING APPROVALS Permit # bate Inspector POOL & SPAS N ` APPROVALS \ -Permit # Date Inspectpr 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe -Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn .8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11, Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing I 14. Rough Electric -Conduit -:56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final 16. Rough Heating & Air Conditioning58. Fencing &Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOLISPA SYSTEMS F INAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning a 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and, sign all appropriate declarations. CITE OF -COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. v CONSTRUCTION PERMIT 79 V roject Address % TYPE OF CONSTRUCTION Owner Phone KNEW ❑ ADD ❑ ALTERATION Address ❑ REPAIR ❑ CONVERSION ❑OEMOLISH ❑ OTHER ZONING REGULATIONS Arch/Eng.License No. DESCRIPTION OF WORK A. P. � Address - - - ZONE PLNG. REF. y¢ Contractor Ph6n AJ,/c C� i - TYPE OF PERMIT 1 I NG Tp L P PRO�ERTY LINE Address , ❑ GRADING - El FOUNDATION ❑ STRUCTURAL SETBACK LST. ID YARD LICENSED CONTRACTOR DECLARATION I hereby that I am licensed Charter 9 ❑ TENANT J&ELECTRICAL ❑PLUMBING [_1MECHN%-%L WIDE YARD affirm under provisions of (com- mencing- with section 7000) of Division 3 of the Business and ❑OTHER RIGHT Professions Code, and my ilcense is in full force and effect. REAR YARD (TO P/L) �` 10 '�'�y PROJECT DESCRIPTION - License Class LILcense No. PKG. SPACE EQ. RSTREET PROVIOED l Date Signature SQFT.. . , .WORKERS' COMPENSATION DEC6kOAilON SA VLI OCCUPANCY CONSTRUCTION TYPE WIDTH PARK FEE S reby affirm that I have a certificate of consent to self -insure or VALUATION ZONE ZONING APPROVED BY DATE ficate of Workers' Compensation Insurance, or a certified copy - — .eof (Sectiogn 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No d2 r►/�'i-/. Ildr, Company - EAJ2� -r/2 S- ❑ Certified copy is hereby furnished. REMARKS: '5Z d "I I ID Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not be completed if -the permit is for one hundred -- (f5100) or lessl1. - - I. certlfy-that }n the,.performance of the.work for which this permit is issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. Date Signature BATHTUBS SHOWERS SO -FT MOTICE: if after making this declaration, you should become Subject TOILETS URINALS GENERATOR'- 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed _ LAVATORIES DOUBLE LAVS- APPLIANCE 10.50 KW_50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP --1-10 H,P I. hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 + Civ. C.). - - FLOOR SINKS FLOOR DRAINS FIXTURES -OUTLET SWITCHES Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that l am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS ' the following reason (Section '7031.5 Business and Professions Cotler SWIMMING POOL P TRAP - - Any city or county which requires a permit to construct, alter, -POLES METERED SUB Improve, demolish or repair any structure, prior to Its issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB .,res the applicant for such permit to file a signed statement that he ,.ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP pter 9 (commencing with Section 7000) of Division 3 of the mess and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the' applicant to -a civil •penalty SEWER CONNECTIONS of not more than five hundred dollars ($500)• IDI, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work, and the structure is not intended or offered for Sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's. License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE ` APPLICATION APPROVED BY L,?� DATE through his.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 will have the burden MECHANICAL PLAN CHECK SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). ❑ I, the -exclusively HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMIP S as owner of property, am contracting with AND'DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ ' tracts from Such projects with a contractor(s) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL S reason PLAN CHECK- $ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION tom, TOTAL FEE $ a MECHANICAL -S I I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- Information is correct. I agree to comply with all city and county PLAN CHECK - S - VANCE PC s ordinances and state laws relating to construction, and hereby authorize _ representatives of this city to enter upon the above mentioned property for inspection purposes. 7 - Signature Oate FINAL FEE $ Drivers' License or SS ISSUE FEE CMF 0865-46 White -Building: Canary -Applicant; Pink -Accounting; Goldenrod -Assessor COIVS —a APpR0V.4 TRUCrION AN S Dp AN 1 • Tem NTNG Soil porary Electric Permit` ipe-Un a! Sery _ �Electr; . _ drgrn Ice or A ._ S F" gs -n g• Wa er PrtrOn 70, pe 11 Structural FUndrgrn 12 Property S °or /stern 13, Street Se Wer Line & 14 Rough S1 plumb+COnnectio °use Connectio. 15 u 9h ectr• n 16 Ro gh cle rc r]duit 17 ROU Ne ctric•Wirin p gh arin g acts g & Air 1$' Ducts ,n Structure Conditions 19, Ga . Ventilati ng 2 � Roof prafi Rugh gr -rest Roof 22. Fr Sheathin 23. insU ae and Flash,n 24. tion 25. Lathin Dr & Sidin 26 Plastervvall Nailing g 27. Elect.carovvn Coat 29. Final Electpcwer Meter_Final 30 nal 1-leatin Gas 3 7' Final lP Pip &eptr Conditioning 2 Waterrobin 33' GasService final 34. SoI Service.Final lar D 35. ornestic 36. �ndsca Fina! Sound e S rinklin 37, Nand? Attenuation S stern 9. FIXq S7.Regulations Speci RUC -'U 410 Electric Requiremen�E & BUlLD/IVG 42 Gas Re/ ea Retase to Edi on Aleted 0 No RTIF'CAT OF0CC Califol E UPA/VCy Gas Co. Date Date inspector APPRovgLS POOL & SP q 3, Po 1 0l ~� 44' Ste Equipme per it 45' ForrnsRein f °rcemerti t °ca tion 6. Electr r 4 7' R°ugh p 1 $onding 8' APpRO lurnbin & Pr - 4g• 1Eie vA � TO CO ensure Te ctrl Con ER 50 Gas pl. r 1 duit-U dGUNpqst " rn 53 APPRO v+nes ncIr p Trn Test sh qL a 54 Backwash & -O DECK n r rn -I Neare Rece 5 r & vent-Fin for -penal 6 57Electrical- Fin Solar Syste a! - eneing & Aina! AAPRO c e v ss q ppr ED FOR p oval POOL/SPq SYS LASTERl1VG _ 7 -EMS FINAL NorEs: lnspecror _ 77, ' Applloant to fill la all spaces within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA PFjig(IITti1TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT �j�J 47_13 31,11.11,1 fie.. _ Project Address "S r t✓ f.0 �d 3 TYPE OF CONSTRUCTION Owner J J> o P one 2Q— ❑ NEW ❑ ADD ❑ ALTERATION Address j_ ❑ REPAIR ❑ CONVERSION El DEMOLISH ❑ OTHER ZONING REGULATIONS Arch/Eng. .w License No. DESCRIPTION OF WORK C;L9n A.P.:f Address ZONE PLNG. REF, z# Contractor Ow ne,r Phone TYPE OF PERMIT BUILDING TTpp gg�! IL(�,ppING PROPERTY Address wr� �// ❑ GRADING ❑ FOUNDATION LS STRUCTURAL SETBACK C T. SIDE YARD LINE LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING Elmizcwumml, SIE Y ARD I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Divide of the us s and El OTHER RIGHT Professions Code, and my license i n full f r d effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class„off U PKG. SPACE REQ. PROVIDED Date C?—/��! Signature SQ. FT. WORKERS' COMPENSATION DE ARATIO OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE $ I hereby affirm that I have a certificate ofr, sent to self-in ure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation 11 Ce, or a certified copy t reof (Section 3800, lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: y No. Company .ertified copy is hereby furnished. REMARKS: NCertified copy is filed with the City Building Division. EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit IS for one hundred {$100 or leu1. I cert ty that n the performance of the work for which this permit IS Issued, I Shall not employ any person In any manner s0 as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers' Compensation lraw$ Of California. Date Signature __ __ BATHTUBS SHOWERS UVYLILLINU GARAGE NOTICE: if after making this declaration, You should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions Of the Labor Code, you must TRANSFORMER forthwith comply with such provision$ or this permit shall be deemed LAVATORIES ODUBLE LAVS APPLIANCE 10.50 KW_r50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there IS a construction ending agency for the per. SERVICE SINKS SUMPS {INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued.(Section 3097 Civ. C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP Any city or county which requires a permit to construct, after, POLES METERED SUB improve, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a Signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE 1 AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the ^ •cIness and Professions Code) or that he IS exempt therefrom and the WATER HEATERS BTU OUTPUT for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a Civil penalty SEWER CONNECTIONS not more than five hundred dollars ($500). ' ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORSI I Sole compensation, will do the work, and the structure is not Intended L or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS.ISSUE FEE ,APPLICATION Contractor's License Law does not apply to an owner of a property - who builds or Improves thereon, and who does such work himself or ISSUE FEE APPROVED BY DATE through his own employees, provided that sucn improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one-year of completion, the owner will have the burden MECHANICAL PLAN CHECK SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING /O� OD •�f'� C3 I. as owner of the property, aM exclusively contracting with AND AND DUCTING PERMIT S SMIP $ - licensed Contractors to construct the project (Section 7444, BUS 100,o00 + BTU*+ , .PLAN CHECK S b, .S Q PERMIT and Professions Code: The Contractor'$ License Law does not apply to _ ISSUANCE $ an-owner of property who builds or improves thereon, and'who con- REFRIGERATION 0.100,000 BTU 1 ~ -'PLUMBING $ - ' tracts from such projects with a contractor($) IICe$ned pursuant to SYSTEM ' •- - - GRADING $ the Contractor's License Law). 100,000 +BTU ” �` - s PLAN CHECK $ + ❑ I am exempt under Section B. & P. C. for thi$ BOILERS BTU ELECTRICAL $ $ reason SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ Date O e _ MECHANICAL $ - TOTAL FEE $ I hereby certify that I h ere d this ap icat and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- information Is corre . 1 ree o ith all city and county PLAN CHECK $ VANCE PC $ ordinances and stat aw$ elatin to ru ion, and hereby authorize representatives o t ' cit to u the above en ioned property to in on r p S. /' ' DO Signature / 41p/r/8 FINAL FEE $ r Drivers' Licen or SS ISSUE FEE ,� CMF 0865-46 White-Building; Canary-Appticant; Pink-Accounting; Goldenrod; ssessor CONSTRUCTION AND PLANNING • APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Irtispector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45.• Forms 4. Electrical Conduit-Undrgrn ,= 46. Electrical Bonding 57 tee ein orce47: Rough Plumbing &Pressure Test = 6. Electrical LIFER Grn - 4$.' APPROVAL TO COVER-GUNITE 7• Footings 49.- Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Tray,❑ undrorn 10. Structural Floor System 52. ' 'APPROVAL TO DECK 11. Property Sewer Line & house Connection 53. 'Bdckwash & Receptor -Final 12. Street Sewer Connection 54. Heater & VenLFinal• 13. Rough Plumbing stem - . 14. ' Rough Electric -Conduit •56:.. Electrical -Final:." ' 15. Rough Electric -Wiring 57, Solar System -Final 16. (lough Heating & Air Conditioning 58.. encing & A±ccess Approval 17. Ducts, in Structure' Y- APPROVED F"R PLASTERING 18. .Ducts,Ventilatinq' 60:• .. - POOL/SPA SYSTEMS FINAL . 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing- NOTES: 22. 'Frame and Flashing 23. Insulation 24. Lathing & Siding = Y 25, Drywall Nailing "; _ • ' _ r . 26. Plaster Brown Coat 27. Electrical Power Meter -Final - - C, 28. Final Electric- ;� ' '• 29. Final Heating & Air Conditioning - 30. Final Gas Pipe -Test 31. • -Final Plumbing - 32. Water Service -Final - - 33. Gas Service -Final - 34. Solar Domestic -Final 35:'• Landscape S rinklin System.-,-, 36. Sound Attenuation'Arl 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co., 42. CERTIFICATE OF OCCUPANCY No Date PROJECT ADDRESS: 3151 AIRWAY AV UNIT: E-2 OWNER'S NAME: MARK VAK IL I ADDRESS 3151 AIRWAY AV #E-2 COSTA MESA CA 92626 ARCHIENGINEER: (714)557-7771 REG.NO.: ADDRESS: UNIT: PERMITTEE: MARK VAKILI (714)5'57-7771 ADDRESS: 3151 AIRWAY AV COSTA MESA CA 92626 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIG.: STATE LIC.: CLASS: Date: Signature: WORKERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800. Lab. C). POLICY NO.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. .ate: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATIDW {This section need not be completed it the permit is for one hundred {5100) or less). I certify that in the performance of the work for which this permit is issued, 1 shah not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: 11. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby allirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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 helshe is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codel or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 71131.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). 1, 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 ollered for sale (Section 7044, Business and Professional Code: The Contractors' Stale License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himsehlherself 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 will have the burden of proving he/she did not build or improve for the purpose of sale). 1, as owner of the property, am exclusive) contracting with licensed contractors to construct the project (Section 7044, Business Eland Professions Code: The Contractors' Mate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. l� I am exempt under Section: B P 7 0 4 4 B. 8 P. C. S+Y for tnls reason, OWNER Hate: AONTRACTING I/ Owner:6��I I do hereby certify that I am aware of and understand the requirements of California. Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection u(rpjoses. Date 2- / $ ` Signatul_1-114— Driver's License or Social Security 0: 164146 White—Buddinq: Pink—Revenue, Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 05555 PERMIT NO; B 055551 PLAN CHECK NO; 05215-91 S GOVT; N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE; STR PURPOSE; ALT JOB DESCRIPTION. ; INSTALL ONE 4'X8' SKYLIGHT SQ FT; 500 CLAIM VALUE; 500.00 CALC--VALUE; 500.00 GROUP OCC; B-2 / COMMENTS; 'Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------- MAIN BUILDING ----------- --------- ACCESSORY BUILDING --------- FRNT;FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARKING REQ• - . PROV; PARCEL: 42729105 ZNE: REF NO; PLANNING NOTES> • 1 D E V E L O P M E N T S E R V I C E S R E Q -U I R E M E N:;T S ZONING APPROVED BY DATE; BUILDING APPROVED- BY ; DATE; APPLICATION ISSUED BY,; DATE; ilif•il�titil�FiF#FiFil�ifiFiFif*iE�liFil�k iFiF1E�*1E 1E**� ib*' ilii•itil�lit�*iFitflFit•iEiFifitiE.ieiEiE�litiE�it•it•�iFitiEiE�F*i�it• �E�t iliE*it*�11Eit i[•*�iF**#(#(iF**#(iF�t�****��lEi6��tit*iFiF*� - LEGALIZATION;N F fi E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG" -PMT. PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT .15,00 = SMIP/NON—RES PLAN 9.75 .50 ISSUE FEE BUILDING—DIV—>: PERMIT ISSUE PLAN—CHECK :TOTAL PAID DUE TOTALS----> 15.50 0.00 9,75 •25,25 25.25 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 25,25 OVER/SHOAT: .00 BLDG PMT.PLUMBING.ELECTRIC MECHANIC FIRE• SMIP/TOT GRADING PLAN—CHECK 15.00. ,50 9,75 **1E*****iF*iF*iF**1E*1E****1EiF1E1Eit•*****#f•�FiFiFiFit•iF�*�#f•#f•�F"iFiFiFiFi6 XE9E�#(�1F�Fi6�1FXEiF1F��iFiFiFit•iF�F*�Fit•it•#f•** IN D I V I D U A L F E E B R -E A K D 0 W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST. SFC 500 ALTER BY VALUE COMMERCIAL NOZONE 1,00 END OF FEES 01 :TO DATE. 1r1o91 TrNE: 24:'7 500,00 CONSTRUCTION AND PLANNING POOL 'A APPROVALS Permit # Date APPROVALS Inspector APPROVALS Permit # Date Inspector- Temporary Electrical Service or Pole 52. Pool & Equipment Location 2S Soi€ Pipe-Undrgrnd. 53. Steel Reinforcement a3 ,61 � al Condq-tj.' klity-Undrgrnd. 54. Forms - - 4. ECtCviical Conduit•UFidrgrnd. 55. Electrical Bonding 1cRinforceilenti 56. Rough Plumbing &Pressure Telt' �6 ElBctri�al UFER"Grrrd, 57. APPROVAL"TO COVER-GUNJTE tT ' �-7. �ootiiic� 58. Electrical Conduit-Undrgrnd. _ >8. 'Foundation > 59. Gas Pipe, ❑ Undrgrnd., Test c 9. -Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgtnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line"'& House Connection 62, Backwash & Receptor -Final <t, 12. S.0,6r Cap 4, 63. Heater & Vent -Final 13. Roof Drains ^ 64. Plumbing System - Final 14. Rough Plumbingd,. 65. Electrical -Final 15, Rough Electrical -Conduit 66, Solar System -Final 16, Rough Electric'wiring 67. Fencing & Access Approval ' `i17. 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 APPROVAL-S-10(Peroiit 20. Rough Factory Fireplace '• = ' -D "' ` 21.'Ducts, in -Structure ... * r - 0. Undergrraund-,•iykdto S 22. Duv, Ventilvinyy ik •�? Z* 1, Products rpirig ©'Gas ❑f ii r 23. Gas Pipe -Rough &'Test l _ . rt „ y Qom• ; 72. Undergr" and Flush=-, •c ,.+ 24.:AootFraming'- 7 r =73.'1Undergrnd7Stora*e Tank ❑ Gas ❑ Oil' 25. Roof_Sheathin g � a �. ,� _.. 74,tOuerhead Hydra s _ ;.. � 26.;t -Bar. Ceiling (Structural) & f onocoat 'U �j �] * ••' 75.=Ury Chemical h 27.,'Fra me and Flashing t�, A 9 �� S -r '� " - U ,t..., w " 76.' Dry Standpipe ;2$. Lath ng & Siding ScL , r �: 77.' FIXED SYSTEM F}E\€AL _ '29. Insulation - - * 1/ t=' 78.4FIRE PREY. FINAL *30. Drywall Nailing ,a I �.� r. L ' HEALTHIDEPT.FREQUfRE-HENT 31, Plaster B�own.Coat" oc I '" tt w 79. -'FINAL Ws� , , ,,ECT14 Y �32.-Electrica€ Power Meter. -,Final `-`- •. v i i +. ;80, FOOD CERjT�ATE ISSUED 33. F. iniT EI¢btric� _' I t`Notes: =:y ; f ',34. •Final, Heating & Air,Conditionirtgti " y ' , x •, f .� - 5 i r 35. ,Final Ga Pipe -Test Y` z,36. Hodd or -Canopy •J t i itl I;' X -t• 37. Final Faeiory Fireptaed `38. S inatPlumbing 739.4atist Service -Final i :� '• �' T JT , 40. Gas Service -Fina€ ° V4 K 41. ,solar Domestir-Final r42. Backflow Preventer 43. Backflow Irrigation $4. Landscd a Irrigatiop Systems ``„.� ,. A5. Sound AttenOation- ''� - ! L - ' • -+ '� w v tc - M' _: ��„'• r f X46, -Handicap 'Regulations ' x 47. FINAL STRUCTURE & BUl'tDING ?��• r . 48. -FINAL PLANNING; •r I � i •� !- r• 49. Eleci�ic Release to Edison I as elease to Southern California Gas Co I t •'51. CERTIFICATE OF)O000PANCY' a ,T No. Dite A_ppllcant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT, NO. BLTREPAIR CONSTRUCTION PERMIT Applicant's Mailing Address Jib!Al rVaay. NVe • b CIS' �' " TYPE OF CONSTRUCTION NEW ADD. ALTERATION - - 31b1 Airiial Ave. bldg. B-1Costa t'ifes ❑ CONVERSION "❑ DEMOLISH ❑ OTHERT - -• - -' Project Address Owner's Name t �� rSOi) �11;1er Cdn CX re ns J��J %Li�V DESCRIPTION OF WORK _Till"pr'ior •Tii(IPrr19c2(rent GR UL' T ' Address 190OU �•iaCkthgr , Ne1�r'pori: Peach _ TYPE OF PERMIT GRADING FOUNDATION STRUCTUR 27�-Z A.W �' 1 ZONE G ArchlEng. '- Oiri i.a�ij}7 License No. I 7 C xJ TENANT ❑ELECTRICAL ❑PLUMBING ❑MECHANICAL. REF, q(E- : ,, ,"- ;, BUILDING Address, ._:ul li• l*iaj�1 Jl.. irvtne _ - C�',•OTHER _ ILDING " J. Uo alti C1 sun i. 540-260 Contractor's Name - �11 Q • _Phone PROJECT DESCRIPTION SQ. FT, OCCUPANCYE Y INE REAR YARD (TO P/L) " : v " [.1' a, CONSTRUCTION TYPE VgLUATION $ 1i1A %SIDE _ YARD RIGHT SI DE YARDmailing) 0: �' 7 d ZONA GRADINGCU,YDS. IACRF7q PACE REQ- PROVIDED License No; L`10ENSED CONTRACTOR DECLARATION Remarks: ET WIDTH 'PARK FEE $I,hereby'afflrm that I.am Ilcensed,under provisionsOf Charter.9 (commencing_with section 7000) Of Division 3 of the Business and Professions Code, and AL CONDITIONS: A, my license, Is In full force and effect. 3J� � Rcense (�1-5s _' ense { I PLUMBING .+ ' Data Slgnature 1 c ; Bar Sink ; Sewer Cap ELECTRICAL WORKERS' COMPENSATION DECLARATION I. 1 -hereby affirm that.I have a certificate of consen .to self insure or a certificateAutomatic - Backflow Preventer Sewer Connection I Washer +Meter ❑over tW amps . of Workers' Compensation Insurance,or a certified{ copy thereof (Section , t . �. . _, Construction Pole ' Panel ' 3600, Lab. C [] I L29%�t Fairmont i Backflow Irrigation Solar Collectors-. - .Sub Policy No. - company Certified COPY Is hereby furnished. ( Bafhtubs Solar PipingCooking Unit Sub Pole + �, Cert d y, filed with the city,Sul ng i on, Clarifiers Solar Tank Dishwasher Motors 00-1 HP ❑ 1 K$ i ate V Applicant EXEMPTION,F ROM WORKERS' COMPENSATI DECLARA DN Dryers []Gas ❑Electric Inc.Solar ❑9-15 HP ❑16-15+ Dishwrasher Swimming Pool w/Spa This section need not be completed if the permit for one hur, ad ($100} or less). 1 certify that In the performance of the work for,whlch this permll is Issuetl I Drinking Fountains Urinal Fan Microwave shall not employ any person in any manner so as to become subject to tare Workers', Compensation, Laws of California.' 1 + Floor Drains - Water Closet F.A.U. 'Pole Li ht g Date Slgnature NOTICE: It, after making this declaration, you should become subject to the i• Floor Sinks- f Weter•Heater, Fixtures Range g Workers' Compensation provisions of the Labor Code, you must.forthwith, comply with, such provisionsor ' this tpermit 'shall be deamed' revoked., } 'y ; Ga's Service outlets • Water, Service ; l Device Boxes Sign' CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the' performance, Interceptors Outlets Standing Sections , Of the ,work for i. `ch this permit Is ;Issued (Section -3097 Civ. C:) 1•ander's Nam + ` ` Kitchen Sink' � j Switches . Trash Compactor ; - _ -_ r _ Lender's Address: OWNER BUILDER DECLARATION 1. Lavatories.N ; Garbage Disposal I hereby;afflrm that I am exempt from the! Contractor's: License Law for the ' `•dlowing Section Professional Code: Any P—Trap, Generator 00-5 KW ❑5-15 KW reason'( -7031.5 Business and city o� +nty which requires a permit to construct, after, Improve, demolish or,►epai■ '} Trarisfarmer ©(5-50 KW _ structure; prior to its'IsSuance„also requires the applicant for such permit file a signed statement that he/she Is licensed pursuant to the provisions of + Roof Drains ' y ' ' ❑50+ KW ' + the Contractor's. License Law,(Chapter 9 (commencing with Section 7000) of I -• j ; Reinspectidn'F ' $15 �Rainspection Fee $15' Division 13• of the Business and Professions Code)"or• that', ha she, is exempt therefrom the. basis for the alleged of, Section Showers l - M Meter ❑up to 100'amps -Issue Fee! 3 and exemption:-Any,vi0la�ion• for•aIpermit- ( i , .7,Q31;5 by: any appiicant subjects the -applicant to a” civil r ��a,na��y Of not more than five hundred dollars ($500). ! _ Service Sirik+ ;- Issue Fee $ 3 -_.. Zoning Approved By Date t`] I, as'owner of the property nr my employees with wages as their sole eompensatlon will.'do the work', and -the structure.is not Intended or offered for sale'(Sectfon 7044, Business' anti, Professional. Code., Thai Contractor's MECHANICAL Application Approved By ata License Law does not apply to an owner of a property"who builds or Improves I BoilEr : Refrigeration System Application Issued 8y �' DataIfIl thereon, and who does such work nlmself/herself or through his or her own employees, provided that such Improvements are,not Intended or offered for is putt -'Under Ground ; I ❑0100,0008TU ❑100,000 BTU i , 1 . sale, If, however, the building or Improvement sold within one year of com- ) pietion, the owner will have the burden of proving he/she did not build or lm- for the purpose of safe}. I B31, 1 t t SUMMARv BUILDING PERMIT $? OF FEES ; { ' �n SMIP i $ ' - Duct - Structural System Repair/Alteration 1, as owner Of the property, am exclusively contrai:ting.with licensed con- Duct_ I PLAN / ; rCv tractors to construct the project (Section 7044, Bug{ness and Professions Code: 1. Ventilating. ,. - _ _ CHECK' $ - PERMIT 1 ' The,Contractor's License Law does not apply to an owner of property who . builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑' , ' PLUMBING $ 1 ) ISSUANCE ' $ ' tractor(s) license pursuant to the Contractor's License Law). 'PLAN GRADING $ ❑ I am exempt under Sectlon B. & P. C. for this reason I FirepllFact, Blt, iCBO # j CHECK $ , f ' ELECTRICAL $ i $ Date Ownerj I _ t Heating System & Ducting 1 PLAN $ ' MICROFILM + $ -1-hereby certify -that -h -have -read this -application and - state that the above• ; - 00-100;000 BTU X100,000 - v ^ ' CHECK S j Information Is correct. I agree to comply with all city and county ordinances I •MECHAN+ICAL $ TOTAL -FEE: $ I and state laws rola ng .to building construction,'and hereby authorize repre- ?food Or 7 Type f ❑' Sentatives of ;thl ity t anter the above-mentioned property for Inspection purp r �- , Canopy T e It ❑' k Reinspection Fee t $15 + PLAN CHECK' l $ LESS ADVANCED Pc Signature Data +11!<�i/•%l $ .,9 Drivers' License or SS c Registers i I Issue Fee 3 7 , FINAL FEE ? _ $6 J CMF 0665-46 rev. 12/82 White - Building; Canary - Appilcant; Pink - Accounting; Goldenrod - Assessor l r7 0CQN$TRUCTIONrAND`PGANNIN[; a a "'t m~ ' r SPA C, a" = m �ApPROVALS Permit #� [ +Date r r ,Inspector -•L'& - gP,PROVALS, : Permit_# r' Date In`s ector p r, ,1� Temporary Elect Eical Service or�Pole '52., Pool &.Equ'iprrtent Location i - I ;- ! 2` Soil Pipe-Uhd {grad = ,53° Steel Reinforcement ` m' 1 v r r 3t EIectrica'1 Conduit Utiliiv' -Un(Tr grnd� - F r -54: o ms ' 4= Electrical Conduit-Uhdrgr.Add- n' -c Electrical.Boncling. .•�- _4 '-y� I r ! -i i a t`c: ? 3, : 5: Steel Reinforcement I � i .- r'�ry �� i �� ;"56.t Rough Plumbing-& Pressure Test ; c �; Electrical OFER Grnd, 57'- 0136VA6-f6.60VER-&UNITE 7. Footings i "58. rid uit-Undrarnd. I , _Electrical'Co r 8. Fo+unciatiori r y �.t N 59. Gas'Piper❑ Ustclsgrrid if 9. Water Pipe-Uridrg'rnd. o G a - F G x;60. Backwash Lines, . Trap, ❑'Undrgrnd. Jt n r 10. Structure! Floor SyLtem t= o 61. APPROVA_L.TO.DEGK I r �i 11, Property Sewe'r Line &lHo`use`Cgnnection- r , �. _ 0 f 62. BackvdasK &�.Recepior-Final t ~` 12. Sewer Cap 63. Heater &:Vent -Final - .L 13. 'Roof 'Dratins , , � r ` "'am Fihal . gyst`T 14. Rough Plurimbing j ` u i c ° + i "65. Electrical=Final r - ` ;r -15: -:Rough -Electrical -Conduit .,--� . ,! -.. � I ! "' t. -F -; - - ! t66. Solar(Sysfem-Final- I - 11r 1, i 16.- 67.)'Fencing &`Access Approval'' a " ,[ rml - , r t,'i7. Rou h Wiriri :Si nF •`? ! :' j I�'-' ( 9 9 9 = + -_ - APPROVES FOR'PLQSTERING .68.' t r l .a : s s' , I b 18,.nRaugh Electrical T,Ba'�;Ceilingi 69.! POO USPASYSTEMS_F,INAL I> 19. iRough, Heating &Air Conditioning ( FIRE DEPT fREQUIREMENT APPROVALS! } Permit'# ?0.,!Rough Factory Fireplace' �{ I t I j 21. 'Ducts; in Structure ! I i 1 ( 70.1 Underground Hydro I 1 X22. ,Duc#s, Ventilating o -71 Product Piping ❑ Gas D Oil • �. 23. ,Gas!Pipe'Rough & Test �(P i{- �- -! (� ,v- I f 72.' Underground Flush 4 24. ;Roof Framing, tm � I _ 73.' Undergrrid. Storage Tank'❑ Gas•. ❑ Oil + r i " 25. !Roof Sheathin is I g j ( to j I •� 3 , I ;7,4. OverFiead Hydro t ,., r ! I� - i � 26. T -Bar Ceiling (Structural), & MonocoV i =,1 '' =75.' Dr Chemical ` :r r - �,ly ,rr r7 27. Frame and Flashin _ ( = g t j !76.1 Dry Standpipe + I 28. hything 8& Siding!i] i77.; FIXED SYST�M.FMAL 1 •f X29. Jlnsulation r, ^ rs '� a j i i i� ; } ! { i78.' FIRE PREY. FINAL ; ! 30. IDry+nrall Nall .: ! ^' i iy II i 1 t !Notes• I( 31. ,Plaster Brown Coat : I 32. tElectricaI Power Meter Final I r tl 33, iFinal Electric_ ; r ;�.A _ -reg 34. Final Heating &PAir'I Conditioning I, ,rl.. -1 i 35. Final Gas` Pipe=Testi n! t 36. Hood or, by :� `� j ni I• t f t i i ,• i j€ 37. Final Factpr.y'Pireglace Final Piurri�iirS 38.„� l 4 39. Water Service-Fitnalki- 40. Gas S�vice-Fina1"T t: 41. Solar Domestic -Final ,I t.-... D - tl .• , 42. Backflow Pre1ver;) er T Irrigation i I 43. Backflt t ]ow • ! __ <I ! t , ,: r 44. Landscape I�r_igation-System- w 1. t„ 45. Sound Attenuation I n !I E z• � „ ,i r =r ! �` i- I r S j I 1 �•� f i G I 1+ _ s 46. Handigap. Regulations If I 47. FINAL' STRUCTURE & 'LJl DfNG, 'I 48. Special Requirements Completed 49. Electric Release to Edison '.- € ��- f- ` + i f_ 4--1 -r_ 1 .-i_ - - _#•__ _ __ r 59. Gas Release to Southern California Gas EQ 51. CERTIFICATE10FI OCCUPANCY I I ' + No, '3 Date 91 "�,.r .:�.+... .ny r :.i..� .y ,.r...�� ' � . �,. f l> >. 1. rad tr,r"F.,,4�!,r+*^•i^' ..y. P'i't.Y.IT'� -"� %¢�w�,J � ?!' ti'�.r.riv ,�N �;s '�KT-'—�`.�...ti, Ci -Y OF COSTA MI ;A Development Service0pivision of Building and Safety CERTIFICATE"SOF OCCUPANCY This certificate is issued pursuant to the`requireme is of the Uniform Building Code, Section 308 adopted by the City of Costa Mesa certifies that at the time of its issuance the building structure herein below described was inspected and approved for occupancy as follows: Building Address 3151` Airway Av. Ste_ F103 Bldg. Permit Number B06-01034 Use Dentist (1,870 s£) Group HP Type of Construction ` V H` ' ` 1F�Yrxe r Owner of Building Corp of the Presidin,g,SBishoP Tenant or chlirchOr c o orstad,, fifinberley E. roper y ese ve Address 1n p- gn,3tl, ;.�'.Prnpi°P St_rP.Pt_ _ galt Lake Cit, BUILDING OFFICIAL-Kharlh Q.Nguyen C.B.O.' ," Date 11 Use Zone l?u-IC°HE G L I F F v/DT 10/16/ REQUIRED TO BE POSTED IN A CONSPICOUS PLACE MP ITOH, DDS City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000159 ision P. 0, Box 1200 Costa Mesa, California The Building located at V # has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto �i for a Group B-2 Occupancy. Use of Bi►ildingtF. CXA- taXatj-Or1S —Office Legal Description 238-94-029 'a. iSee reverse side for Metes and SGundsl � f� Buildin Permit No 7 Electrical Permit NO,T�,-,6939 g Plumbing Permit No. -- Mechanical Permit No, M�-Ftl355 - Number of apartments —0— ... and/or guest rooms "'8" ISSUED TO, Shearson/American mss Building Official _/l e 1 i l � by � r 1601 DoveStreet-#200, Nit Beach, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premise_ end SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e} U.B.C. CMF 1015-46 rev. 1/83 white - Owner; Canary - Numerical Fife; Pink • Bidg. Permit File 1\ w City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. Building Safety Division L J �+ -= Ji P- O- Box 1200 Costa Mesa, California The Building located at 3151 A,JXWav Avemle W-207 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Fj,.-2 __Occupancy. Use of Building tx-x t-- 4 - Off' m Legal Description 938-94-032 {See reverse side for Metes and Bounds) Building Permit No- A -691G Electrical Permit No. R-ACIA1 Plumbing Permit No. Mechanical Permit No. I+-6932 Number of apartments -0-`j� and/or guest rooms "0- ISSUED TO: Building Official D/ Slleaacson/Wneri= Express 1601 Dave Stmt #200, Newport Basch, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the pre 1m sessrand SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. C - CMF CMF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File vs 4 y ' .i. - Y fY. ' �Q „r - .I •r - -- 4 .4 a }'<,' City of'.Costa Mesa Building safety Department ;• C RT FF ICA T E O F O CC U P RC Y i �3 35 5 i P.O. Box 1200 1 z.: Costa Mesa; California III The Building located at 31. 1 flirt" rv"A'Kn-rnta.'.lIii"6a R-11 f1 -;, o ,a «Y ..e' .� has been inspected and found -to coralI ply with-tli'e provisions of all City of Costa Mesa Ordinances'applicable•thereto for a'Group< R—?. Occupancy. Useo f. B u i l d i ri g Ir terior*' AlteAtiaris ` -'• Office �iL �t�.<42,41 - phi,' -.1c �91•.t)'' ��Ci�- �� Legal Description: `427291.-1.3 (See reverse side for Metes and Bounds) P-4931. Build ing'Perrriit.No !° B-4926 11 Electrical Permit No. ,'E44977 Plumbing Permit'No.'` .M=4993' Number of apartments r-0-^ and/or guest rooms • '� r O j Building Official ISSUED.T • �• - W .L - • X• I •' ny- ' by ll �'4.: � r 'C�W(LMI /Jl'� �E • 'rI? • t Si -i n-Am-ri an � Cid Ncia� n, Boi Division Direr r _c_t - a= Date/ i' This Certificate of Occupancy SHALE, BE posted, in a conspicuous place ori the premises and SHAL!_ NOT.BE removed except by the.. Auilding Official of the City of Costa Mesaunder Sec. 306 (e} U.B.C..'' j!I` Form BU 34 Rev..iino it ✓ I! 4 Ilk City of Costa Mesa r. Development Services Department CERTIFICATE OF OCCUPANCY NO. Building Safety Division 0 0 0 b s o P. O. Box 1200 Costa Mesa, California The Building located at 3151 AirMy Aver= OF -205 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto r for a Group B-2 Occupancy. Use of Building IntoXior Alterations - Office Legal Description 427`291-14 0 (See reverse side for Metes and Bounds) Building Permit No 8--7866 Electrical Permit No. -E-7875 Plumbing Permit No. V I Mechanical Permit No. M-7961 Number of apartments —0— and/or guest rooms —0— ISSUED TO: EXecutive Gmld - JWA 11 3151 Aitzaay Avenue $E-1, Costa Mesa, CA Building OOffficc by This Certificate of Occupancy SHALL BE posted in a conspicuous place on the Building Official of the City of Costa Mesa under Sec. 307 {ej U.B.C. ✓ CMF 1015-46 rev. 1/83 white - Owner; Canary - (Numerical File; Pink • Bldg. Permit File V SHALL NOT BE removed except by the : ' f . �-r ' M -- . ` •,l ' tf ? ip �' • Ea . • N.•j4 a�'f'• �• 1V .<�'k� _ -� �' > 'H,{fF �',', i -• � 1. , ,. . .., i , ,. _ .�.y _ .. - F,3 . City of Costa Mesa .; ' ..'•, ''.• a' - Develo men' Services De artmeni ` y- f- ' ^ ` r p n CER,TIF•ICAT:E` DF OCCUPANCY No. ��= ' '.Building Safety Division y 4' p P. O. Box 1200 �. Costa Mesa; California.. The Building located at 3151.AixMya ;#9 204 r ' ha ybeen�inspected and found to comply with the provisions oI"If. 'II�City,of Costa Mesa Ordinances appiicab'le thereto_ for",a Gr•aup B�2 Occupancy� 17 + Use , o f'Building i4 lnttL ior' Albs 1ti chs' l_ Off1C@ Legal Description '427-291-14 !�'.�+ f t `+ V „`► � S + ISee reverse side for Metes and Boundsl {: Bu Iding Permit No b-8662 T Electrical PermitcNo: E-8702. Plumbing Permit No. Mechanical Permit No: NI--8689 _ Number of apartments' ""0" and/or guest rooms"^ ' iSSUEo.r;o;::;.`::,,Building Official by 14000. NfarAkL nor N� Beach, Date This Certificate of Occupancy SHALL BE posted,,in a conspicuoui place on the premises and SHALL NOT BE removed except by the'I. Building Official of the City of-Costa Mesa under Sec. 307'W-U.B.C: ; CMF IDIS-46 rev. I/83 •U White - Owner; Canary =Numerics! File; Pink - Bidg.'P e�rmit File n. s ' 1, ! ♦ -' 1-� , it . r ' �.. City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY go P.O. $ox 1200 Costa Mesa, California The Building located at 3151-AiryayAyangis; 42 119 has been inspected and found to comply with the provisions of all City..of Costa Mesa Ordinances applicable thereto is� for a Group Occupancy. li { Use of Building VTtericw_ Alt exatimi Legal Description • (See reverse side for Metes and Bounds), Building Permit No B-5668Electrical Permit No. �j- ':7a 4 Plumbing Permit No.�`� Number of apartments r' - and/lir guest rooms _n_ ISSUED TO: r. Building Official " by Ali. a•�w-�t� .. 1 : '�.rj�� • Srrrar�Jl�fCx1t]�8�` --- Date IV,, . Ya• L This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.I3E removed except by the Building Official of"the City of Costa Mesa under Sec. 306 (e) U.B.C. !; Form BU 34 Rev. 11/70 .�r ' City of Gosta Mesa Development Services Department t� Building Safety Division P. 0. Box 1200 j Costa Mesa, California CERTIFICATE OF OCCUPANCY No. 000002 The Building located at =. .r Avenue StiitE F-206 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-'2 Occupancy. Use of Building Interior Alterations - Office Legal Description 427-291-14 ISee reverse side for Metes and Bounds) E-5887 Building Permit No B-5802 Electrical Permit No. E-5863 Plumbing Permit No. P-6092 Mechanical Permit No. NI -5897 Number of apartments --0— and/or guest rooms —0— ISSUED TO: Shearson American Exoress Building 0 ficial by This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File (-' •' •, ;h; a fir„ � P "'�'i�'#��rd� f�T;•+'%i'T'",-jy 'i `� — ;�' .. `��_ ,J 1 P.1 lit 1 4 ,.� ^ c• r,_ • la- a . 1 1 -1 'b i .4~ •• t.• '' "City of Costa Mesa Building Safety Department- P ti - C E R T'I ;F I C AT E nO F-;'=O,C`C U -.P A N C{Y, 712 -3,i 4:�' P.O. Bak 1200• "r +� y - i.•4 •1a f.-�1. S� vii w Yi� F - , • ' �. CostaMesaaCalifornia'• ;The.i3uilding',located.at' 3151.E Wj� .#I'-105 _ _ 'has been inspected and found to comply with th'e>provisions.of all City'of Costa Mesa Ordinances applicable thereto for. aGroup $-2 1° Occupa n`cy, t Use,of Building. _.:`Intexior,Alte' BItLOI7a Legal"Descr.iption 1.-T^•r291�-2'' ii f 4 ' t (See reverse side for Metes and Bounds) �. ,µ..t f: .j < , E-138$5 • '14-4992- ., „E l � Building Permit No ; $-4754 •' Electrical�iiPermit No. E-4$50 Plumbing Permit No.- P-4794 - Number of apartments :0and' /or guest room's -0--' .:; JSSUEDiTO:. • _ _. t" ';,.Building Official �: Shearson=Az�ean ,kcarss .° f` V Y, E. ewt ,r° ilc3'DqDivi s� �nf?irtor= .; Date s� This,Certificate of Occupancy -SHALL BE ;posted in a:canspicuous place on the premises and SHALL NOTBEremoved except by thea. , ,Building Official:of the City of Casts Mesa funder Sec. 3k (e) U.B:C. r _ 'a v.' �:Form•9U,34'Retl/i0 'e,'`'- 'r-. 1! :'o si •,r7i �. _ 1• *16 -W :c '��. f1i1�, 6G � - - .'et•. .r. .,r i�T�° :, y' „ �w 1t,` - .- � ni71�v �� "•� l i � "� : , • t � _ j?. �'�7 4�' �r' '��' ".'*I �'„�' .1.. S �d fr • >. �. '4,...r' ... r v .. kl,�. �.'Is• .. -. •.zeal 6 7.. 1 - Ie .,, .2 -.- . r .. .. • l .,. City of Costa Mesa Development Services Department Building Safety division CERTIFICATE OF OCCUPANCY No. ff j r U � � �+ , P, O. Box 1200 Costa Mesa, California The Building located at 3151 Aixway Avenue #F-100 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building Legal Description Interior Alterations — Offirce 427-991-1.3 ISee reverse side for Metes and Bounds? E-3726 Building Permit No 8-3698 Electrical Permit No. E-3856 Plumbing Permit No. P-3721 Mechanical Permit No, M" 3699 Number of apartments —B— and/or guest rooms —a ISSUED TO: BuildingOfficial ShearSCrVAWa-Xican EKpreas by 1601 Dove Street, _NewMrt Beach, CA Date This Certificate of - Occupancy SHALL BE posted in a conspicuous place on the premises and'(SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. GMF 1015-46 rev, 1/83 White - Owner; Canary - Numerical File; Pink- Bldg. Permit File City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 0 0 0 2 3 1 P. O. Box 1200 Costa Mesa, California The Building located at 31,10 Ajy &Vp=p has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a GYoup R-7 Occupancy. Use of Building Tn n+Jor Alt-arat;rnsa nffjC_%R Legal Description A77 -941-11A {See reverse side for Metes and Bounc!0 Building'Permit No_ B-86 I Electrical Permit No. E-8699 Plumbing Permit No. Mechanical Permit No. M_9r%.q; Number of apartments —D^ and/or guest rooms —0— ISSUED-TO: Shaarann /Atnera.C�n Building Official A/( by ,� C� /&Gc-� r L Ma Ar,f-hm.-N�%nn= Beach. 9A ficate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the fficial of the City of Costa Mesa under Sec. 307 (e} U.B.C. a6 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg, Permit File City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 0 Building Safety Division v L P, 0. Box 1200 Costa Mesa, CaWorma The Building located at 37.51 Airway Ayalaug 0E--203 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group A --a Occupancy. Use of Building Tnf-orier A1fAratinnq -- Qf_f cR Legal Description 427-2.91-14 _ IN (See reverse side for Metes and Bounds) Building Permit No l--8663 Electrical Permit No. F-8701 Plumbing Permit No Mechanical Permit No. M— RR Number of apartments . —0"' and/tor guest rooms —Q— ISSU>=D T0: Building 0 ictal C-kp 3.90i1[l Mar-Arttnir,_ NFafacat't Keach, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White • Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa •' Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. (, 1r �, _ S J q P.O. Box 1200 Costa Mesa, California The Building located at 3151 M;Wpty Avenue OF -202 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use o f'B u i l d i n g Interior Alterations - Offi.oe Legal Description 427--291-14 t� [See reverse side for Metes and Bounds) l t Building Permit No A—R60—Electrical Permit No. E-8700 Plumbing Permit No. Mechanical Permit No. M-8687 Number of apartments -0- and/or guest rooms -0— ISSUED TO: - Building Official 5lLearsorvIffrxi can Ex ess by i 190011-2"ecArthur, Newmostr Beach. CA . Rate '3 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premisesand SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File CITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 - Fax (714) 754-4856 - www.ci.costa-mesa.ca.us 1- � FOR INSPECTIONS CALL: (714) 754-5626 0'�"°� PERMIT NUMBER: B09-00321 PERMIT TYPE B_ROOF2 APN: 93894027 JOB ADDRESS: 3151 F AIRWAY AV CM Vicinity: BUILDING F Squares: 6000 STATUS: ISSUED DATE ISSUED: 12/18/2009 ISSUED BY: Suite/Unit: F Valuation: $20,400.00 SCOPE OF WORK: TEAR OFF (E) ROOF MATERIALS AND REROOF WITH 1 LAYER OF 15# FELT AND A 40 YEAR ASPHALT SHINGLE ON A 6:12 PITCHED ROOF COMMERCIAL BUILDING, APPROX 60 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED, OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: STORSTAD, KIMBERLEY E PROPERTY RESERVE~ Unit: 10 E SO TEMPLE ST #400 PHONE: City/State/Zip: BRUCE CHRISTENSEN APPLICANT: HANSEN, DUKE PHONE: 714-557-7440 CONTRACTOR: ROSS AND BARROWS INC Address: 260 E ALTON AVEUnit: City/State/Zip: SANTA ANA, CA 92707 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $335.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $336.25 Address: 260 E ALTON AVE Unit: : City/State/Zip: SANTA ANA, CA License No. - 327802 PHONE: 714-557-7440 CELL: License No. PHONE: License No. PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE P. INSPECTION TYPE DATE iNTMALS CODE NN INSPECTION TYPE DAT INTITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining 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 Buildingloccupancy 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 workers' compensation Insurance carrier and policy number are: /� � 1 Ca e 7 % 7 T C/' `1 (Thd wagon need not be complered dine perrne is vabed alone hundred doears ($ too) or less ) Pcflcy Number: 00 2 57S `) q 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 theL r ode, I shall hwith comply with these provisions. L Z&v ppiicanrs Signature Date C�__ WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1$ UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION 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 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. LiCtass.#= Lr -i ContraGo[SSign�tuse ^ = = 11' • Da 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 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 4icense 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 ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, WILL DO THE WORK, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors 4icense Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for Sale. If, however, the building or improvement is sold within one year of Completion, the owner -builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Profession$ 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature Dale '1057-46 (3107) Owner ID verified by drivense. ❑ Yes [INo 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: ❑ 1 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, An 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. Applicant's Signature Division of lndusirial Safety Permit Number: Date 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? ❑ 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? ❑ Yes ❑ 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 acutety 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 and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department, 4. )f an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 I Owners) Date Authpnzed A45plicant _ _ Date_ Job Address: 3151 AIRWAY AV Status: ISSUED 0 Suite: Applied: 02/09/2007 Vicinity: EAST STAIRWAY OF BLDG F Issued: 02/09/2007 Primary Occ: Type of Construction: V -N Parcel Number: TPNO07003 Zoning: Applicant: JON HASTINGS ' Address: 34145 PACIFIC COAST HIGHWAY UNIT 520 Phone:949-292-3567 DANA POINT „ Zip: 92629- ISSUED BY: Owner: CORP OF THE,PRESIDING BISHOP CHURCH OF LDS' / Address JOHN WAYNE EXECUTIVEr G'-UILD OWNERS ASSN COSTA MESA, CAS ` Phone:; 714 540.5568 _ " 3151"AIRWAY,AV'SUITE•Ki01 Zip: ,92626,. 1 Contractor JON'HASTINGS'CONSTRUCTION INC Addre1ss:/34145 PACIFIC COAST HIGHWAY %,•/ �UNlT 520 �� !� Phone: 949-292-3567 / \ DANA POINT/ � Zi ' 92629/,�License: 392715 \ Arch :�, �.�� Eng: Address: %fir/ Address: Phone:1 Phone: ' �- � �,%i � ` �. pis •._ � I � �, , r /Zip: - _Licenser 10 ! ' /.',. ` License: SCOPE OF PERMIT BUILDING F : , � %� _ ,� , -.1 REPAIR EXISTING EXTERIOR STAIRS ON•THE EAST SIDE OF BUILDING F. WORK TO INCLUDE REMOVING ROTTED STAIR STRINGERS AND REPLACE "WITH;EXACT SAME MATERIAL AND DESIGN. � FEE SUMMARY Plan Check' $0.00 �- - - - -- - I Calc Valuation: $3,750.00 Permit:, $97.25 �� ,..� Claim Valuation: $3,750.00 SMIPReS: .l $0.00 SMIP Com: $0.79 Outer:'. $0.00__ v Inspection: $0.00 .Total: $98.04 - 'PL'ANNING &ZONING SETBACKS MAIN STRUCTURE Front 0;0 t. Rear" 0- D Lett 0-0 Right D- D ACCESSORY', Front 0-0. Rear' �0-0 Left 0-0 _"Right. 0-0 ✓, . PARKING \\` Existing. 0'eaui�ed:--0 _ Proposed:- NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-26, § 1, 12-21-92) 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) 7545626 244646 (6N6) 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 io self -Insure for workers' compensation, as provided for by section 3700 of the labor Code, for the performance o1 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 worke penseiion Ins once carrier and policy number are: ter' ^- Cardifl. _ - �r G --- - - __ PgGcy,Number. t_�_ 2 '0 S (This secflon need not be Completed it the permit is valued at one hundred dollars ($100) or less,) ' �" = ❑ 1 certify that in the perfarmance 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 Califomla, and agree that if I should become subject to the workers' compensation provisions of Section 37DO of the Labor Code, I shell forthwith comply with those ions. , Applicant Signature:, -AQDataT� D�] WARNING: FAILURE TO SECU ORKERS' COMPEN TION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am lice. ed under p sions o1 Chapter 9 (commencing with Section 7000) of Division 3 of the Busiriffs and Professions Code, and my license is in full force and effect. LIC: 0 �� l CCU t i, Contractor's Signature;--^ Date r a C CONSTRUCTION LENDING AGENCY: ❑ 1 hereby affirm that there is a construction lending agency for the performance o1 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 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 (cvmmandng 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 (S5DO).): ❑ 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 Drivels License No. Expires: Verification of Ownership by (type of document, i.e. - property lax 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) foot high. (Chap. 3.2, Grp 2, Art 2, See. 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: Data: 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? ❑ 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? ❑ Yes ❑ No (Section 25533 01 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 foot 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 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? ❑ Yes ❑ No ............... ................_.__........................................'o"*r fu"'t,u.'r- ........'l -d -i........ C* C- 'u"p"'......................___...............__.....................................,i'e".......'f'"I'..................,---....._............._..._..."'r-*........................._._......i-o' ......................1'o" ... 5 Does or will the applicant or present or future building occupant require Tor the work which is the subject of this a plication a r, m- for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IJ Yes l� No (Section 65850.2 of the Califomla Government Code requires that the requested information be fumishad on applications for non-residential building permits). _ ._..... _..._........ _.._....................................................................... ............._.... _........._.. _..............-,............................. - ..................... , .- - - .._.............................................................................. 6 Will any part of the facility fo be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ Mo (if 'lyes', the facility must moot the requirement of Sections 25534 and 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 Callfomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _......._ ......... - ------ - -------.... - .................. 8 (If fres", 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. 1 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 penatty 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. S' natur g I Owner($) PaaleJ J1q An Or Authoriltidl Applicant G e CODE I• WELgIlOriun QAM ISS SCOFF! INSPECTION TYPE 12 -pa INTITIA 1616 Fixed System Final Fire Prevention 206 Final Mechanical 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 Piece 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final BuildinglOccupancy S (714) 754-5273 - Fax (714) 754-4856 - www,cl.costa-mesa.c43iUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 DANA POINT, CA _ _ _ Zip_ : ---92629 Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE f \\\\ 10 E SO TEMPLE'5T #400 Phone: BRUCE CHRISTENSEN Zip: -84133-1122/ T \ \\ Contractor. jrJON S HASTINGS, Address: 34145 PACIFIC.COAST HIGHWAY UNIT 520 /� Phone: 949-292-3567 DARA POINT �� xip: 92629,, %% License: 392715 �� c� A11 ' /Arch :;' TERRY;'CHARLES Eng: Address:\ 20 TRUMAN ST Address: SUITE 101, Phone: 949-552-7400 Z- ;Phone: 1RVINE!CA" Zip: ,92620%' License: C1165 _• License: = ' SCOPE OF PERMIT 1,87,0 S.F. INTERIOR TENANT IMPROVEMENT FOR "KOUICHI CLIFF ITOH, DDS" IN UNIT F103. DOCTOR IS SOLE PRACTITIONER WITH TWO STAFF MEMBERS AND TREATS PATIENTS ON A ONE-TO-ONE BASIS ONLY. AS,A RESULT; ONLY 3-4 PARKING SPACES ARE REQUIRED FORTHISUSE ANDA MCUP.IS NOT REQUIRED. - / f �rti r� Vii• _ FEE'SUMMARY- Plan Check:' .$133.05 Calc Valuation: $75;Ooo.00 ` Permit: ' $818.75 Claim Valuation: $ 5,aao.tio' .1 7 SMIP Res: $0.00 c_ j_ SMIP Co: $15.75 Corn" Other: $0.00 Inspection: $0.00 PLANNING &ZONING SETBACKS A v\, �. _. Job Address: 3151 AIRWAY AV �� {p ?if' Status: ISSUED Suite: F103 Applied: 06272006 Vicinity: ' Left 0-0 Right zO� 0 Issued: 07/25/2006 Primary Occ: B Eat<501 Office/ Bar<50 Type of Construction: V N Parcel Number: 93894027 Zoning: Applicant: JON HASTINGS Address: 34145 PACIFIC COAST HIGHWAY Phone: 949-292-3567 ISSUED B DANA POINT, CA _ _ _ Zip_ : ---92629 Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE f \\\\ 10 E SO TEMPLE'5T #400 Phone: BRUCE CHRISTENSEN Zip: -84133-1122/ T \ \\ Contractor. jrJON S HASTINGS, Address: 34145 PACIFIC.COAST HIGHWAY UNIT 520 /� Phone: 949-292-3567 DARA POINT �� xip: 92629,, %% License: 392715 �� c� A11 ' /Arch :;' TERRY;'CHARLES Eng: Address:\ 20 TRUMAN ST Address: SUITE 101, Phone: 949-552-7400 Z- ;Phone: 1RVINE!CA" Zip: ,92620%' License: C1165 _• License: = ' SCOPE OF PERMIT 1,87,0 S.F. INTERIOR TENANT IMPROVEMENT FOR "KOUICHI CLIFF ITOH, DDS" IN UNIT F103. DOCTOR IS SOLE PRACTITIONER WITH TWO STAFF MEMBERS AND TREATS PATIENTS ON A ONE-TO-ONE BASIS ONLY. AS,A RESULT; ONLY 3-4 PARKING SPACES ARE REQUIRED FORTHISUSE ANDA MCUP.IS NOT REQUIRED. - / f �rti r� Vii• _ FEE'SUMMARY- Plan Check:' .$133.05 Calc Valuation: $75;Ooo.00 ` Permit: ' $818.75 Claim Valuation: $ 5,aao.tio' .1 7 SMIP Res: $0.00 c_ j_ SMIP Co: $15.75 Corn" Other: $0.00 Inspection: $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: to 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) 7645626 244&4e tsWl PLANNING &ZONING SETBACKS A v\, �. _. -=: , / MAIN STRUCTURE Front 0- 0., Rear 0-0- Left 0-'6 "- Rightjja'0 1� �; ACCESSORY' \ Front 6.0 Ream 0- 0 ' Left 0-0 Right zO� 0 PARKING '�Existi a: '` 0 ' ;�, Rea uired.-_10 _ Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: to 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) 7645626 244&4e tsWl DECLARATIONS WORKERS' COMPENSATIO_ N DECLARATION: I hereby affirm under penalty, of perjury one o1 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 workers'tco_ pensa�tio"n �Insurance carrier and policy number are: I r O `Carri9[ S TCL t -t r✓V� Poflcy Number. ^ IJ I Ifliiissec Ion need not be completed if the permit 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 I a r Code, I shall forthwith comply with these p S. ��,�� f (r.Applicant 5lgrhature:-0 h1��1W�4Cilf,'4117� b to i WARNNG:"FAJL'URE TO SECURE &&KERW COMPENSA ON COVERAGE IS UNLAWFUL AND SWILL SUBJECT AN EMPLOYER TO CRIheNAL PENALTIES AND CIVIL FINES UP O ONE HUNDRED I(X AND DDU ARE ($100,000), IN ADDITION O THE CAST OF COMPENSATION. DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I horeby.affirm.that I am Ilcens d under proylsions of Chapter 9 (commandng with Section 7000) of Division 3 of.the Busine�s,and Professions Code, and my license is in full faits and ,affect..Lic 10-f M a-) 1 `j CCI M �j _Contractors SEgnature:_ Da_ 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. (Sot. 3097, Civil Code). Lender's 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, altar, improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to Ole a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Lew (Chapter 9 (commencing with Sectlon 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 ddiers (5500).): ❑ I, as owner of the property, or my employees with wages as their ads compensation, WALL DO THE WORK, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Lew 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 sdd 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.). ' ❑ 1, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Data: Owner lD verified by driver's license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Ice. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cerIlfy that no excavation five (5) or more toot In depth Into which a person is required to descand, will be made in connection with work authorized by this permit, and that no building structure, scaffolding, faisswork, or demolition or dismantling thereof, will be more than thlrty-six (38) 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? ❑ Yes ❑ No (Section 25505 Of the California Health and Safety Coda 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 then 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 Ole a registration form for acutely hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, wlth acme 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 gaJkms, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or Mil the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? 13 Y03 ❑ 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? ❑Yes ❑ No _.................... ----.�_............. _._..... _... 5 Does or will the applicant or present or future building occupant require for the work which As the subject of this application a reit for such construction or modification from the South Coast Air Quality Management District or from arty other air pollution control district or agency? U Yas UNo (Sadlon 65850.2 of the Califomia Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any pari of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if yes', the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). �7 It 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 boon made? ❑ 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 wlth 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 wlth all state laws and dry ordinances rolating to building oonstruction, and authorize representatives of the CAry of Costa Masa 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. IgnalWAJDI LegalOwner(s) a Date (AndlOr AI lflz,d Applicant -.-Date CeeE f• INSPECTION INTI'mL,4 CODE ( INSPECTION_TYPE 20 INITIAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Rnal 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Sullding/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa '&TR[CAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite No F103 Vicinity: Parcel Nunmber: 93894027 Applicant: ROWE, MICHAEL Address: 625 W KATELLA AVE SUITE 26 ORANGE, CA Phone: 714-639-6110 Zip 92867 Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE 10 E SO TEMPLE ST #400 Phone: BRUCE CHRISTENSEN Zip: 84133-1122 Contractor: ROWE ELECTRIC INC Address: 625 W KATELLA AVE SUITE 26 Phone: 714-639-6110 ORANGE, CA Zip: 92867 License: 850357 SCOPE OF PERMIT ISSUED BY: Status: ISSUED Applied: 08/21/2006 Issued: 08/21/2006 1,870 S.F. INTERIOR TENANT IMPROVEMENT FOR "KOUICHI CLIFF ITOH, DDS" IN UNIT F103, REF.: B06-01034. ELECTRICAL TO INCLUDE: 64 LIGHT FIXTURES, 37 OUTLETS, 28 SWITCHES, 17 NON-RESIDENTIAL APPLIANCES (DEDICATED CIRCUITS), 1 SERVICE TO 200 AMPS AND 1 SUB PANEL TO 200 AMPS. FEE SUMMARY Quantity ISSUE FEE $23.50 - . - Temp Dist System I Lighting Temp service test $0.00 Busway /100 ft Res. a/c package 50.00 Standing Section New Res (1-2 units) $0.00 0 New Res (3+units) $0.00 0 Pool I Spa $0.00 0 Lighting Fixts $54.12 64 Recept Outlets $34.41 37 Switches $27.84 28 Non Res Appl $80.75 17 Res Appl $0,000,' s Low Volt Wiring System I Ckt Service to 200a:` ; $30.50 ; ; 1 Service to 10006 $0.00,.' 0 ' Service over 1000a $0:00 "0- Motors to 1 hp $0.00`• 0 Motors to 10hp $0.00 0 Motors to 50hp 50.00; , •0 Motors to 100hp '$0.00. 0. Motors over 100hp $0.00 0 Communication drops $0.00 0- . Sub panel to 200a $30.50 •_1 Pole Light Pkg $0.00 0_ Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 FEE SUMMARY Quantity - . - Temp Dist System I Lighting 50.00 0 Busway /100 ft $0.00 0 Standing Section $0.00 0 Misc Electrical Equipment 50.00 0 Transformers up to 1 kvalkw $0.00 0 ..............:.up to 10 kvalkw $0.00 0 ..................up to 50 kvalkw $0.00 110 .................up to 100 kvalkw $0.00 0 ..................over 100 kvalkw $0.00 0 Low Voltage Equipment $0.00. 0 Low Volt Wiring System I Ckt $0.00 0 Misc. Conduit $0.00 0 Misc. Conductor " ;S0.00' ," 0 Circus (gen or ride) $0.00 '10 Circus (mech ride or lights) $0.00 ' 0 Christmas Tree Stand $0.00 0 Fireworks Stand $0.00 0 Other Electrical Fee 50.00 Investigation Fee 50.00 Plan Check Fee Reinspection Fee $0.00 TOTAL CALCULATED FEES 5281.62 COMMENTS 1 SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: to order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained: Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2448-4e (M) i WORKERS' COMPENSATION DECLARATION: I hereby afllrm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate o1 consent to sell -Insure far workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the krk for which this permit Is issued. ,myworkers, ave and will maintain workers' Compensation Insurance, as required by sectlon 3700 of the Labor Code, for the performance of iho work for which this permit is Issued, o omp Ballon Insurance carrier and policy number are: G`aJmer ,,� 1 mr?� 6L 1 7 7 _4049 -section need not be completed if the permit is valued at one hundred dollars ($ f Oo) or less.) ❑ 1 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 Ca la, and roe that If I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these ro PY. P 1�' ' J +Appllcant Signature: u L'L Date T .� ?/1 d �O _WARMNG: FAJLy RE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN E CRIMINAL PENALTIES AND CIVIL FlraES UP TO ONE HUNDRED THOUSAND DOLLARE (5100,000), IN ADDITION TO THE COST OF OpMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3768 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hero`ce and e by attimLitlal-Lam licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of be -Business and Professions Code, and my license is In full 'Torffect. Llc. a S 7 Class a` 5 L I a _ .- Contractor ,_ s Signature: �_ .L u� Date: Z{ f 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 ($50D).): ❑ 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 of 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.). ❑ 1, 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 conlractor(s) license pursuant to the Contractors License Laws.), ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature: Dale: Owner ID verified by drivers license. ❑ Yes ❑ No Drivers License No. Expires: Verification of Ownership by (type of document, Le. - properly 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, talsowork, 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, Calilomia 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: pate: 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? ❑ Yes ❑ No (Section 2$505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled with the Costa Mesa Fire Deportment 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 toot 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 ❑ No (Section 25533 of the California Health and Safely 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 o1 acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel 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, certificalion and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materiels with the Fire Department. ............ ..---................................................................. ........__r ............................ _................................--............................................._........................_...—...-----............... _._..-............ ... 4 11 an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? [I .Yes ❑ No ..— ... _............................ ............................ ...—...... ............ ..........._..................__..._-........................................-....._ _._ ............_..........-..----.................. __..............._ .._... S Does or will the applicant or present or future building occupant require for the work which is the subject of this a pliration a rmit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes j No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). ....._ _ ...---._.................................. .--..__........... .............. ..............................................._.................-..........-_.—........................-.................. 6 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (It yes', the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No _ __............._— _.- _....._._ - _..._... _ .........._ ........... -_... _ _ ................. _... 8 (If yes-, attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penally of perjury the information given above is correct. I agree to comply with all slate laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Data: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I cavity 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 abov"ascribed property for Inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. 411 nature Of r(ryri ,5), ) �I F, pate { And/Or Authorized Applicant'--_ CODE P. INSPECT10141YPE QAIE �iN1�4S.. SQQF�E INSPECTION TYPE pS1€~� LMLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 -Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRelaining 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 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.cPfUMBING PERMIT 77 FAIR iJHIVt, GV51A Mt, -3A, GA 52152b Job Address: 3151 AIRWAY AV Status: ISSUED Suite No F103 Applied: 08/21/2006 issued: 08121 /2008 Vicinity: UNIT F103 Parcel Nunmber: 93894027 Applicant: GECK, JOHN ISSUED BY: Address: 14141 DENISE DRIVE Phone: 714-890-6370 WESTMINSTER, CA Zip: 92683 Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE 10 E SO TEMPLE ST #400 Phone: BRUCE CHRISTENSEN Zip: 84133-1122 Contractor: L JS PLUMBING Address: 14141 DENISE DRIVE Phone: 714-890-6370 WESTMINSTE, CA Zip: 92683 License: 850790 SCOPE OF PERMIT PLUMBING PERMIT FOR A 1,870 S.F. INTERIOR TENANT IMPROVEMENT FOR "KOUICHI CLIFF ITOH, DDS" IN UNIT F103. REF#: B06-01034 WORK TO INCLUDE -.3 DENTAL UNITS, 1 BAR SINK, 1 COMMERCIAL SINK, 1 FLOOR SINK, 1 KITCHEN SINK, 1 SUMP PUMP. QTY FEE SUMMARY AMT ISSUE FEE S23.50 Backflow irrigation 50.00 Backflow Preventer $0.00 Bathtub $0.00 Clarifier System SO.00 Connect (Ice,Soda,etc) SO.00 Dental Units 529.40 Dishwasher 50.00 Orain, Floor 50.00 Drain, Rainwater 50.00 Drain, Roof 50.00 Drinking Fountain 50.00 F-xpansion Tank S0.00 Gas Earthquake Valve 50.00 Gas (1-4 outlets) $0.00 Gas (Over 4 outlets) $0.00 Gas Repipe 50.00 Gas Service SO.00 Interceptors (Grease, Oil) S0.00 interceptors (Sand Auto) S0.00 QTY FEE SUMMARY AMT QTY. AMT QTY Laundry Tub / Washer 50.00 0 Sump Pump 59.80 1 Landscape Irrigation •$0.00 0 Swimming Pool 50.00 0 P -Trap 50.00 0 Trap Primer $0.00 0 Pressure Regulator $0.00 0 Urinal $0.00 0 Process Piping (per 10 ft) $0.00 0 Vacuum Brkr,Bkflow(14) 50.00 0 Receptors $0.00 0 Vacuum Brkr Bkftow(5+) $0.00 0 Septic Tank 50.00 0 Wash Basin $0.00 0 Sewer Cap for Demo S0.00 0 Wash Basin Set $0.00 0 Sewer Connect S0,0D 0 Waste and Vent System 50.00 D Sewer Private Line 50.00 0 Water Closet (Toilet) '$0,00 0 Shower 50.00 0 Water Heater 1 vent $0.00 0 Sink, bar 59.80 1 Water Piping (Inst or Rep.) $0.00 0 Sink, commercial S19.60 2 Water Re -pipe S0.00 0 Sink, Floor $9.80 1 Water Service $0.00 0 Sink, kitchen $9.80 1 Water Softener $0.00 01 Sink, service/mop $0.00 0 OTHER $0.00 Spa (private) $0.00 0 VIOLATION S0,00 Spa (public) $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 0 TOTAL CALCULATED PEES: $111.70 COMMENTS ! SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calif is statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. IN5PECTIONS: 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) 7545626 N 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 Cade, for the performance of the work for which this permit is issued. ❑ t 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: Carrier Policy Number: (fhfs section need not be completed if the permit is valued at one hundred dollars ($100) or lass.) _(3te-1,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' ppnsation laws of Caliicmla, nd agree that if I s Id become aubJect to the workers' Compensation provisions of Section 3700 of lha,,LallbotPoda, I shall forthwith compty with these p App1i ignature:r_ = Datg;_ d `WARNING;;: FAILURE TO SE WORKERS' COMPENSATION COVERAGE IS UNLAriFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND &L FINES UP TO ONE HUNDRED .TFIOVSAr+Ip DC>1.LARE fEt00,00f1j, tN ADDITION TO THE 0057 DF CONWENSATION, OANNOES AS PROVIDED r -0R IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 oLthe_Businessa d Proles Ions Code, and my license is in full force and'effect. 0—c—#Class ti G 3 c o Conlractrra Slgn� :, 64.AdL. 61 (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). 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. 70 31.5, Business and Professions Code: Any dry or county which requires a permit to construct, alter, improve, domolish, 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 70DO) of Division 3 of the Business and Professions Code) or that he or rho 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 sore compensation, WILL DO THE WORK, and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contrectore 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 Lew 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: Data: 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 dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation tire (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 dlvtsion. 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? ❑ 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 businoss 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 ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mese 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). _.._ ..... ....._— .................a.. ......................._._............ _.................................................. -_-._._...-................................... ....................... ................ 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 ❑ N DSection 25534 of the Califomia Health and Safety Code provides [hat the Costa Mesa Fire Department may require the preparation, certification and filing with the Fire epartment of an RMPP by businesses which ere required to register acutely hazardous materials with the Fire Department. — �- 4 If an RMPP Is prosently required, has Section 25534 of the California Health and SatetyCode been fully complied with? ❑ Yes ❑ No _ _................. _..—.._...................... ......................— .................. _._........ . _ _ -____........m.......-..._._...----- ..... ...w................. 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a�armll for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ No (Section 85850.2 of the California Govemment Code requires Ihel 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? Elves— ❑ No (It 'fres", the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If apermit 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? ❑ Yes ❑ 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 confect. I agree to comply with all stale laws and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the above-described pro tori tion pigposes. agree not to occupy or allow occupancy of any building authorized by this permit til 1, al inspection. m �60 D Signature OfLegalOwner(s) Date 1Z - — — L AndlOr Authorized Applicant [ Date 1 CODE INSPECTION IYPE 2&M INTITIA CODE[ INSPECTION1NTITIAl*$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical Q 1266 Pod Spa Final 208 Final Plumbing R 9 _LL 200 Final Re -Root 210 Final Electrical 201 Final Block/Retaining Wail 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Silo 204 Final Demolition 250 Final Building/Occupancy I A 17 (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca-us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT .lob Address: 3151 AIRWAY AV Suite No F103 Vicinity: SUITE F103 Parcel Number: 93894027 Status: ISSUED Applied: 09/14/2006 Issued: 0911412006 ISSUED BY: Applicant: HASTINGS, JON Quantity, Address: - 0 Inst FAU <100 k BTU $0.00 Phone: 949-292-3567, Inst FAU >100 k BTU $0.00 Zip, Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS, Address:- %STORSTAD, KIMBERLEY E %PROPERTY RESERVE .. $0.00 10 E SO TEMPLE ST #400 Phone: $0.00 BRUCE CHRISTENSEN, Zip: 84133-1122 • Contractor: JON'S HASTINGS Gas Piping Address: 34145 PACIFIC COAST HIGHWAY Factory Fireplace $0.00 UNIT 520' Phone: 949-292-3567 $0.00 DANA POINT Zip: 92629 License: 392715 _ SCOPE OF PERMIT 1,870 S.F. INTERIOR TENANT IMPROVEMENT FOR "KOUICHI CLIFF ITOH, DDS" IN UNIT F103. REF: 606-01034 2 OEPAIRIALT COOLING/HEAT ` FEE SUMMARY Quantity Repair/ Alt Absorbtion Unit $0.00 Quantity, ISSUE FEE $23.50 0 Inst FAU <100 k BTU $0.00 0 Inst FAU >100 k BTU $0.00 0 Repair / Alt CoolinglHeat $27.40 2 - Inst / Rep. Recess Wall Htr $0.00 0 Refrig Sys <100 k BTU $0.00 0 Refrig Sys >100 k BTU $0.00 0 Gas Piping $0.00 0 Factory Fireplace $0.00 0 Hood w/Meth Exhaust $0.00 0 VAV Box $0.00 0 Vent Fan 1 Single Duct $0.00 0 Appliance $0.00 0 Fire Dampers $0.00 0 Smoke Dampers $0.00 0 Inst or Relocate Appl Vent $0.00- 0 Air Handlers < 10000cfm $0.00 0 Air Handlers > 10000cfm $0.00 0 Floor Furnace $0.00- 0 Floor or Suspend Heater $0.00 0 -- Reinspection Fee $0.00 Quantity Repair/ Alt Absorbtion Unit $0.00 0 Repair/ Alt Refrigeration Unit $0.00 0 Ventillation System $0.00 0 Evaporative Cooler $0.00 0 Commercial Incinerator $0.00 0 Domestic Incinerator $0.00 0 Compressors 1 Absorption Systems Up to 3 hp 1100 k BTU '$0.00 0 3 To 15 hp / 500 k BTU $0.00 0 15 To 30 hp 11,000 k BTU $0.00 10 30 To 50 hp 11,750 k BTU , $0.00 0 Over 50 hp 1 Over 1,750 BTU $0.00 -0 Boilers Up to 3 hp $0.00 '0 3 To 15 hp $0.00 0 15 to 30 hp '$0.00 0 30 to 50 hp 10.00 0 Over 50 hp $0.00 0 Other Mechanical Fee ; Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $50.90 COMMENTS ! SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 1Q-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. i INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 24413 46 (&W) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: r' ❑ 1 have and will maintain a certificate of consent to self -Insure, for workers' compensatlon, as provided for by section 3700 of the labor Code, for the performance of the work for which this permit is Issued. ❑-1 have and will maintain workers' compensation insurance, as required by section 3700 of the Labor Code. for the performance of the work for which etas permit is Issued. _ My yvo mpensation Insurance carrier and policy are: et�� ro Carrier, - ncdl Paicy'Number. -_ /as need not be completed if the permit is valued of erre hundred daflars ($f 00) or fess,) ❑ 1 cenity 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 pr P Applicant Signature:__ ��Dale..�t �� WARNING: FAILURE -TO SECURE RS' OQIrtPENSATION E IS UNLAWFUL AND SHALL SLM3IECT AN EMF_E_0YER TO CRIM]NAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (6100,000), I ADDITION TO THE DOST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: h I hereby affirm that I am licenj under provisions of Chapter 9 (commencing with Section 7000) o1 Division 3 of the Business and Professions Code, and my license is In full force.and effectl. p C1 D"1 _lass p. Contractor's Signature: Dale: CONSTRUCTION LENDING AGENCY: ❑ 1 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, oiler, Improve, demolish, or repair any structure, prior to its Issuance, also requires the applicant for such permit to Ii1e a Signed statement that he or she is licensed pursuant to the provisions of Ahe 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 try any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ 1, as owner of the property, or my employees with wages as their solo 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 safe. It, 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 ❑ No Drivers license No. Expires: Verif166flon 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: Divislon 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Masa 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). _........—_.............................................. ._ ...... _ _.......... —.............. _—................. I ................ ....... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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 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 (',ode bean fully complied with? ❑Yes ❑ No ......................... ...................... _—.._....... _..— ............_...—..................----............... ..........................................._...._..._....... _............. _ __ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication a�ermlt for such construction or modification from the South Coast Air Quality Management District or from any other air pollution Control district or agency? jJ Yes LJ 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 feat from the out boundaries of a school? ❑ Yes ❑ Np (If yes", the facility must meet the requirement o1 Sections 25534 and 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 Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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 COMPLJANCE AND AUTHORIZATION OF ENTRY: I carVy 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 rotating 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. I atu al-Owner(s) ! Dale L— — — And/Or Authod# Applicant Date C90E 1. INSPECTION TYPE DAIS INTMAL4 CODE S INSPECTION i7QE am 1616 Fixed System Final Fire Proventlon 206 Final Mechanical 1266 Pool Spa Final 20a 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 3291 11/2E/80 1172937 TL COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT J P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 to ro 0 LL U BY PERMIT For Applicant to Fill in Completely -- Use Ink Only BUILDING a ! — dc3� a ADDRESS _' OWNER D TENANT 'western Pacific Financial. IN VILOING S I�414((f MAILING Do na Sq n C ADDRESS �fe BCITY PEED O. O�Sk ar VC[ Not'40-260IWAb1 Parcel 1 r P1 9W ELK. Irvine Ca. 92714 ADO ALTER REPAIR MOVING DEMOLISH CONSTRUCT Pacific FinancialBRANCH(Same) LENDERNstern Western Pacific Financi ADDRESS VALUE C USE $ ff tARCHITECT7 * TE p dale$—Lan store •47"0062 ORENGINEE 6— ADDREss 777 S. Main orange, Ca. ZONE TYPE GROUP CONTRACTOR J. Donald Olson Co. BVAPPROVED DATE /J ADDRESS 180/�03 Skypark Blvd., Ste .B CITY Irvine Ca. 92714 No�40-2606 eL, 72-9 NO. APPROVED SETBACKS LIC. 333969 LIC. NO. SIZEND. OF BLOC'S.. (FROM (FROM C/L STREET) OF LOT NOW ON LOT O FRONT FT. USE of Vacant Land ExtsrlNG BLDG. Separate permits are required for L. SIDE F electric, plumbing and heating work. REAIJU FT. USE OF BUILDING AND WORK TO BE PERFORMED PLA NG ACTION Construct office building shell DATE VED 253480 S.F. - Two Story APPROVEDRY + , QATF _C2Qr O HOLD FOR SPECIAL REOUIREMENT�- - 7 I hereby acknowledge that I have read this application and state that the above Information is correct and agree to comply with oil laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws Of the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. 'ss and Professions Code, Division 3, the State oZthatrlsas THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, ees are In full rce a ct, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exemptnsofthe Ste Ca ornlauslness VALUATION PERMIT FEE $ 1741, and Profess3, Signare o PLAN CHECK 3 Permofttea $ 7?1 g2y-� TAx $ Authorized Agent Date TOTAL PAID $ to ro 0 LL U 7_� Applicant to fill in all spaces within heavy border lines and sign all aplOpriate declarations, lj CITY OF COSTA MESA PE IT NO. TRACT NO. LOT NO. BLDG NO. CONSTRUCTION PERMIT — 7s /::w !" �. 3151 Airwa F-105 Costa Mesa TYPE OF CONSTRUCTION Phone PROPEIRTYNLINE ❑NEW ❑ ADD ❑ ALTERATION SINKS DISHWASHERS ❑REPAIR ❑CONVERSION ❑DEMOLISH S REAR YARD (TO P/L) ❑OTHER interinss DESCRIPTION OF WORK n 9 SSOC. License No, rAddress 17779 Main 11�� ctor D one540-26 TYPEOF PERMIT s DATE /! + ❑ GRADING '❑ FOUNDATION ❑ STRUCTURAL ®TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC ❑OTHER PROJECT DESCRIPTION nC SQ, FT.— _505 �. OCCUPANCYj�.. CnOf�J�ZRUCTION TYPE V -N 6 ED CONTRACTOR DECLARATION - affirm that I am licensed under provisions Of Charter 9 (com- with section 7000) of Division 3 Of the Business and Professions Code, and my license Is In full force n ct. License Class B c nsa 96'? Oate 7/30/82 3 Signature WORKERS' COMPENSAT10!` -D EC L�A`RAT 194 WATER HEATERS BTU OUTPUT - I hereby affirm that!-have•a certificate of nsent to self -Insure or a VALUATION %1 []U SOLAR TANK COLLECTORS ^-rtificate of Workers'—CompenSatlon Insurance, Pr a certified copy reof (Se 'OVE b!C.). �A�R p � icy No. •Ci Company --- ZONE GRADING CU. YDS. ACRES REMARKS: MECHANICAL PLAN CHECK LJ Certified copy Is hereby furnished. Certified copy is filed with the city Building Division. AV99a an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned- pursuant to the Contractor's License Law). ❑ I am exempt under Section S. & P. C. for this EXEMPTION FROM'WORKERS' COMPENSATION DECLARATION LJ 7443 9/10/82 1 1 3.5� % ZONING REGULA'T'IONS A.P. 9r- Z �. ZONE G�. PLNTTG.. REF.:P. SETBACK L T. PROPEIRTYNLINE SIDE YARD SINKS DISHWASHERS RIGHT I hereby affirm that there is a construction lending agency for the per-ERVICE formance of the work for which this permit is issued (Section 3097 REAR YARD (TO P/L) Civ. C.).None Lender's Name PKG. SPACE REQ. ,PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE /! + SPECIALCDNDITIONS� GAS SERVICE OUTLETS (This section need not be completed If the permit is for one hundred ($1001 or iess). ' — I certify -that In the•performance of the work for Which this permit Is, issued, ! shall not employ any person In any manner so as to become ' PLUMBING PLAN CHECK"' ELECTRICAL subject to the Workers'- Compensation Laws of Califor.nla. 0-1 KW 10-50 KW -50 Date Signature ___ ATHTUBS SHOWERS _ URINALS NOTICE: If after making this declaration, you should become subjectOILETS to the Workers' Compensation provisions of the Latlor Code, you mustforthwith Comply with such provisions Or this permit shall be deemedAVATORIES DOUBLELAVS [IT. revoked.CONSTRUCTION SINKS DISHWASHERS LENDING AGENCY I hereby affirm that there is a construction lending agency for the per-ERVICE formance of the work for which this permit is issued (Section 3097 SINKS SUMPS Civ. C.).None Lender's Name FLOOR SINKS FLOOR DRAINS. DRINKING FOUNTAINS Lender's Address OWNER BUILDER DECLARATION 1•hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031,5 Business and Professions Code: Any city or county which requires a permit t0 construct, alter, improve, demolish or repair any structure, prior to its issuance, aiSo re- quires the applicant forsuch permit to file a signed Statement that he is licensed pursuant to the"provislons of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the INTERCEPTORS CLARIFIERS SWIMMING POOL P TRAP _ WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT - easiness and Professions Code) or that he is exempt therefrom and the ISIS for the alleged exemption. Any violation of Section 7031,5 by .ny applicant for a permit subjects the applicant t0 a civil penalty of not more than five hundred dollars ($500)._ 1-1i, 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an oWner of a property _ SEWER CONNECTIONS SOLAR TANK COLLECTORS _ SOLAR PIPING SYS. - ISSUE FEE who builds or improves thereon, and who does such work himself or through his Own employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). E] I, as owner- of the property; 'am exclusively contracting with - licensed contractors to construct the project (Section 7044, Business and 'Professions Code: The Contractor's License Law does not apply to MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0.100,000 BTU SYSTEM 100,000 +BTU'' an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned- pursuant to the Contractor's License Law). ❑ I am exempt under Section S. & P. C. for this BOILERS BTU 1 reason SYSTEM REPAIR, ALTERATION Date -- - Dwner _ _ _ - EXHAUST SYSTEM MULTIPLE I hereby Certify that I have read this application and state that the.above Information Is correct, I agree to comply with all City and county ordinances and st a laws relating to con uction, and hereby au h0r'z0 representatives this Ity to t pan the above me do ed��Ci1; property for ec s t ; Signature Date Drivers' License or SS ISSUE FEE -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod PLAN CHECK ,GENERATOR -TRANSFORMER APPLIANCE 0-1 KW 10-50 KW -50 1-10 KW + KW .MOTORS (INC. SOLAR) 0-1 HP 10-50 HP 1-10 HP ' 50 + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS PERMIT $ --L/�.=W SMIP $ POLE LIGHTS PERMIT, ' PANELS MAIN - SUB SERVICE AMP ISSUE FEE APPLICATION APPROVED BY DATE SlJj�71Y OF FEES - BUILDING - '' ��ff L+ PERMIT $ --L/�.=W SMIP $ PLAN CHECK $ PERMIT, ' ISSUANCE $ PLUMBING $ GRADING $— PLAN CHECK $ ELECTRICAL . s + I_.""' ;�1 MICROFILM $ PLAN CHECK S _,ME6a' C r ' MECH,�NICAL $� TOTAL FEE $ LESS AD- PLAN CHECK $ VANCE PC $ _._�.._. • �� \ ��r�'� .� - FINAL+FEE$,% CONSTRUCTION AND PLANNING APPROVALS Permit # �i y Date Inspector -- ' POOL & SPA `, { APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrlcal Conduit Utihty,[)ndrgm 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding5. r Steel ein orce 47. Rough Plumbing & Pressure Test - r 6. Electrical UFER-Grn ry 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn • 51. Backwash Lines P -Trap.❑ Undr rn 10. Structural Floor System 52. APPROVAL TO DECK -11.' i Property Sewer -Line & House Connection 53. Backwash & Receptor -Final 12.. Street Sewer Connection 54. Heater & Vent -Final . 13. Rough. Plumbing e[n 14. Rough Electric -Conduit -56. Electrical -Final . 15. Rough Electric -Wiring 57. Solar Systerri-Fina! 16. Rough Heating & Air Conditioning bb. Fencing & Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. POOLISPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing f NOTES: 23. Insulation 24. Lathing & Siding 25, Drywall Nailing q 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29, Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final. Plumbing 32._ Water Service -Final „ 33.x' Gas Service -f=inal , 34. Solar Domestic -Final --35: 'Landscape S rinklin System'-" 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 4 39. Special Requirements Completed •140. Electric Release to Edison 416AZESCAQ 41. Gas Release to Southern California Gas 42. CERTIFICATE OF OCCUPANCY .No Date !�wS��d Applicant to fill in all F.COSTA MESA PE.VIT N( 'RUCTION PERMIT r .. Ad � within heavy border lines and sign all appropriate declarations. J* I - TRACT NO, I LOT NO. • BLDG. NO. ' .vies n GMF 0865-46 White-Bultding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 7606 9/13/92 ZONING REGULATIONS A.P. 9 ZONE PLNG. REF. it 20.00 TL r ' NE REAR YARD (TO P/L) resL.IAIZ/0,2 TYPE OF CONSTRUCTION Nner Phone STREET WIDTH ❑ NEW ❑ ADD• ❑ ALTERATtON ZONING APPROVED BY ❑ REPAIR ❑ CQNVERSION DEMOLISHEng,_ � - - OTHERess. DESCRIPTION OF W A. L;Addrew License No. MOTORS 011 HP TYPE OF PERMIT " ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL Contractor L Phone Address C j 41 LICENSED CO TRACTOR DECLARA ON I hereby affirm that`( am licensed under provisions Of Charter 9 (com- mencingg with section 7000) of Division 3 of -the Business and + HP ❑ TENANT ❑ ELECTRICAL PLUMBING ❑MECHANIC ❑ OTHER Professions Code, and my license Is In full force and effect. License Class C_ - -3 Lice a o. Date Signature PROJECT DESCRIPTION ' - " - - - - - WORKERS' COMPENSATION DECLAION OCCUPANCY' CONSTRUCTION_ TYPE SWITCHES I hereby affirm that I have a certificate Of . nser f to selfansure Or a certificate of Workers' Compensation.Insurance, Or a certified copy VALUATION ZONE thereof (Se 800 Lab. C.). GRADING CU. YOS.-ACRES POLE LIGHTS Company Cad, �� - - :REMARKS: POLES -ertified copy is hereby furnished._ Certified copy Is flled•with the city Building Division. SU y r EXEMPTION FROM WORKERS' COMPENSATION -DECLARATION MAIN (Thissettlor, need not be completed if the permit is for one hundred r . [5100) or less}. -- - - - - I Certify that In the performance of the work for which this permit Is issued, d shall not employ any person in -any manner so as to become subject to the Workers' Compensation Laws Of Calltornia. PLUMBING "' PLAN CHECK - TUBS SHOWER E Date Signature - NOTICE: If after making this declaration, you should become subjectTS to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemedTORIES revoked. URINALS- DOUBLE LAYS FKIT.SINKS - DISHWASHERS - CONSTRUCTION'CENDING AGENCY ' ISSUE FEE I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 SERVICE SINKS SUMPS' < Civ. C.). �- - Lender's Name -FLOOR SINKS FLOOR DRAINS " DRINKING FOUNTAINS Lender's Address ' OWNER BUILDER DECLARATION_ I hereby affirm that 1 am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he SWIMMING POOL P TRAP -WATER SERVICE ALTERATION' SMIP E Is,llconsed pursuant to, the provisions of the Contractor's Ueen$e Law (Chapter 9 (commencing with Section 7000) of Division 3 of the GAS SERVICE' - OUTLETS Business and Professions Code) or that - he Is eXempt therefrom and the basi- for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS BTU OUTPUT a� piicant for a permit subjects, the applicant to a clvll .penalty If more than five hundred dollars ($500)• L _ " owner of the property, or my employees -with wages as their SEWER CONNECTIONS SOLAR TANK COLLECTORS PLUMBING 5 sole compensation, will do the work, and the structure is not Intended SOLAR PIPING SYS. or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law doe$ not apply to an owner of a property ISSUE FEE who builds -or improves thereon, and who does such work himself Or through his own employees, provided that such improvements are not -MECHANICAL' PLAN CHECK Intended or offered for sale. If, however, the building or Improvement s sold within one year of completion, the owner will have the burden ELECTRICAL $ of proving he did -not build or Improve for the purpose of sale). ❑ I, as owner Of the property, am exclusively _contracting with licensed cohtractorS to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to HEATING SYSTEM 0400,000 BTU AND DUCTING - - 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM ' 100,000 + BTU PLAN CHECK $ an'ownerof property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). . MICRDFILM.$ ❑ 1 am exempt under Section B. 6 P. C. for this BOILERS BTU reaso n SYSTEM REPAIR. ALTERATION PLAN CHECK .$ Date _ Owner EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above i information is correct, I agree to comply with all city and county ordinances and state laws r rating to construction, and hereby authorize representative thisy to rater upon the above mentioned propert spec u s ' ' Signature to Drivers' Licens o S � ISSUE FEE GMF 0865-46 White-Bultding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 7606 9/13/92 ZONING REGULATIONS A.P. 9 ZONE PLNG. REF. it 20.00 TL r ' NE REAR YARD (TO P/L) 0.1 KW PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE E ZONING APPROVED BY DATE SPECIAL CONOITIONS: - - ME r ELECTRICAL PLAN Ci IECK - Q GENERATOR 0.1 KW 1-10 KW i . _TRANSFORMER APPLIANCE 10-50 KW -50 _ + KW MOTORS 011 HP 1.10 HP - .(INC. SOLAR) 10-50 1-1P50 + HP FIXTURES - -OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS - POLES METERED SU y r - "PANELS MAIN SUB SERVICE - AMP ISSUE FEE f ), APPLICATION APPROVED BY DATE , SUMMARY OF FEES BUILDING PERMIT S SMIP E PLAN CHECK_ E PERMIT ' A ISSUANCE S - PLUMBING 5 - GRADING; $ PLAN CHECK S ELECTRICAL $ $. PLAN CHECK $ . MICRDFILM.$ - MECHANICAL $ TOTAL FEE $ PLAN CHECK .$ LESS AD- VANCE PC $ i d4 ' ' FINAL FEE E Date Inspector CONSTRUCTION AND PLANNING APPROVALS Permit # 1. Temporary Electrical Service or Pole ' . Soil Pipe-Undrgrn _ 3. Electrical Conduit Utility-Undrgrn 4. Electrical Conduit-Undrgrn 5. Steel ein orce 6. Electrical UFER Grn ' 7. Footings 8. Foundation 9. Water Pipe-Undrgrn 10. Structural Floor System 11. Property Sevrer Line & House'Connection 12. Street Sewer Connection 13. Rough Plumbing 14. Rough Electric -Conduit 15. Rough Electric -Wiring 57.` "Solar System -Final 16. Rough Heating & Air Conditioning 17. Ducts in Structure , 18. Ducts, Ventilating --19-.APPROVED FOR PLASTERING 19. Gas Pipe -Rough & Test a 1 20. Roof -Framing 21. Roof Sheathin 22. Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power -Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic- Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No Date Date Inspector POOL & SPA,' Date Inspector APPROVALS - Permit # .. . -. 43. Pool & Equipment Location ' 44. Steel Reinforcement _ 45. Forms 1 .•46. ';.Electrical Boniiinig 47. Rough Plumbing & Pressare'Te3t 4B. APPROVAL TO COVER -GUN IT E' '' , , _ . , • _ - .•`�, _ ' 49. Electrical Conduit-Undr rn 50. Gas Pipe, ❑ Undr rn, Test 51. Backwash .Lines P -Trap, ❑ Qridrjrn , 52. APPROVAL TO DECK 53. Backwash & Receptor -Final 54. Heater & Vent-Final55. t Plumbing System - Final i -56:Electrical-Final ` 57.` "Solar System -Final W. Fencing &.Access Approval , _ --19-.APPROVED FOR PLASTERING a 1 - 60. POOL/SPA SYSTEMS FINAL NOTES: Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA I PERMIT NO. I TRACT NO. t LOT NO. I BLDG. NO. CONSTRUCTION PERMIT Project Address G, i A)dle�tn.. Owner N 0 C Address 1,5:+' 65 TYPE OF CONSTRUCTION /Y Phone ❑ NEW ❑ ADD El ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER DESCRIPTION OF WORK Address -� - _ _ BUILDING SETBACK L ST. PROP��RLPY LI Ni- Contractor Ph6n15Z.i TYPE.OF PERMIT Address ❑GRADING ❑ FOUNDATION ❑ STRUCTURAL TENANT -❑ ELECTRICAL ❑PLUMBINGMECHANICP LICENSED CONTRACTQFI DECLARAT&ON 0 I hereby affirm th:.t I am licensed under provisions of Charter 4 (com- mencing with section 7000) of Division 3 of -the Business- and ❑OTHER Professions Code, kind y Ilcens is In full force and effect. Ir37 PROJECT DESCRIPTION ° ,License Class en N Date i 7� `- Signature + . SO. FT: -- ^'bRKERS' COMPENSATION DECLARATI -- - - OCCUPANCY CONSTRUCTION TYPE ereby affirm that I have a certificate of consent to self -ins tiflcate of Workers'- Compensation I uran e - or a t, f, cl .,,ereof (Sectlo380 Lab. C.). { Policy,No n fo Company ure ora[LAVATORIES VALUATION ZONE , GRADING Cu. YDS. ACRES REMARKS: - - - I] Certified copy Is hereby furnishea,. -- =- •• 5, Certified copy Is filed with the city Building Division. - EXEMPTION FROM WORKERS'•COMPENSATION DECLARATION '(This section need.not be completed If the permit is for one hundred,- - _ ($100) or less), - l -certify that in the -performance of the work for which this permit is .GENERATOR 0-1 Kw TRANSFORMER_ ,APPLIANCE 10-50 KW Issued, I shall not employ any person in any manner so as to becomePLUMBING PLAN CHECK subject to the Workers' Compensatibn Laws of„California.' BATHTUBS SHOWERS Date Signature 0 URINALS NOTICE: If after making this declaration, you should become subjectTOILETS to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed - DOUBLE LAYS 'CONSTRUCTION LENDING AGENCY - KIT. SINKS DISHWASHERS I'hereby affirm that there is a construction lending agency for the per'- -formance of the work for which this permit Is Issued (Section 3097 SERVICE SINKS - SUMPS L FLOOR SINKS FOOR DRAINS Clv.•C.). " " . - " - �' •Lender's Name DRINKING FOUNTAINS Lender's Address _ OWNER BUILDER'DECLARATION - • - I herebyy affirm that I am exempt from the Contractor's License Law for the foll0wing'reason (Section 7031:5 Buslness'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 re- 'ulres the ap, licant for such permit to file a signed statement that he INTERCEPTORS CLARIFIERS ' SWIMMING POOL PTRAP ' WATER SERVICE ALTERATION GAS SERVICE OUTLETS licensed pursuant to'the provisions of the Contractor's License Law chapter 9 (commencing with Section 7000) of Division 3 of the justness and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of- Section 7031.5 by WATER HEATERS .BTU OUTPUT y - _ SEWER CONNECTIONS any applicant' for 'a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS , ❑ 1, as owner of the property, or my empfoyee5 with wages as their sole compensation, will do the wor.k, and the structure is.not intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License -Law does -not apply to an owner of a.property SOLAR PIPING SYS. ISSUE FEE who builds or improves thereon, and who does such work himself or through. his own employees, provided that such improvements. are not MECHANICAL PLAN CHECK Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTU - ANDDUCTING 100,000 + BTU of proving he aid not build or improve for the purpose of sale). ❑ I, as• -owner -of the property, am -exclusively contracting with licensed contractors t0 construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such -projects with a- contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. 19 P. C. for this BOILERS BTU reason Date --Owner - _ SYSTEM REPAIR, ALTERATION. EXHAUST SYSTEM MULTIPLE 'I hereby Certify that l have read this application and state that the above Information is correct. 1 agree to comply with all City and county ordinances and state laws relating to Construction, and hereby authorize representatives f this ty a er upon the above mentioned property for i pectlon rp es Signature t Orlve'rs' License or SS - t ISSUE FEE CMF 0865-46 Wnite-Building; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor 8367 9/28/02 11.0d TL IING REGULATIONS A.P, 2 ZONE PLNTTG.. RttEF. � BUILDING SETBACK L ST. PROP��RLPY LI Ni- LIEF YARD ----- -- --- SIDE YARD�• RIGHT REAR YARD (TOP/L) SUMMARY OF.FEES''- PKG. SPACE REQ. PROVIDED 'STREET WIDTH 7 PARK FEE S ZONING APPROVED BY DATE SPECIAL CONDITIONS: •' $ ; SMIP s• 'PLAN CHECK S ELECTRICAL PLAN CHECK" SO. FT. .GENERATOR 0-1 Kw TRANSFORMER_ ,APPLIANCE 10-50 KW 140 KW -50 + KW MOTORS 64-H;3-- '(INC. SOLAR) • • '10-50 HP 1-10 HP 50 + HP -FIXTURES m OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS _ POLES METERED -SUB PANELS MAIN 'Sub - ,SERVICE 'AMP s •••' _ ' 'ELECTRICAL E ISSUE FEE APPLICATION APPROVED BY DATE SUMMARY OF.FEES''- . •BUILDING -- _ PERMIT $ ; SMIP s• 'PLAN CHECK S ' PERMLT ISSUANCE S =PLUMBING E _ GRADING $•— .PLAN CHECK s •••' _ ' 'ELECTRICAL E $' PLAN CHECK E MICROFILM $ •• Q TOTAL FEE S MECHANICAL E '..-� PLAN CHECK $ - LESS AD- VANCE PC .� s _ yy Gx> FINAL FEE 13. Rough Plumbing SyggCa- - -- --- - - - - 14. CONSTRUCTION AND PLANNING '.-� _ - Date Llnspator APPROVALS Permit # ( POOL & SPA ,' ' . - • • pate tr - Inspector APPROVALS ''P,ermit # - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Loc'a'tion -'-- 2. Soil Pipe-Undrgrn 44. Steel Reinforcement - --- - -` '-' - 3. Electrical Conduit Utility-Undrgrn _ 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding- - 5. Steel Reinforce 47. Rough Plumbing & Pressure Test - - 6. Electrical UFER Grn 48. APPROVAL•TO COVE-R-GUNtTE-- 7. Footings r'• 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51.= Backwash Lines P-Trarrfl 10. Structural Floor System 52. APPROVAL TO DECK _ "'I - 11. Property Sewer Line & House Connection 53. No Backwash & Rece for -Final 12. Street Sewer Connection 54.- Heater & Vent -Final = 13. Rough Plumbing SyggCa- - -- --- - - - - 14. Rough Electric -Conduit =" 56:'= Electrical -Final - y' 15. Rough Electric-Wirinq 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING M. Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding. 25. Drywall Nailing 26. Plaster Brown Coat• -..- 1/. LIectrical Power Meter -Final ' 28. Final Electric 29. Final Heating & Air Conditioning r 30. Final Gas'Pipe-Test 31. Final Plumbing 32. Water Service -Final ' 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 1 36. Sound Attenuation i 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - y 39. Special Requirements Completed - a 40. Electric Release to Edison y 41. Gas Release to Southern California Gas'Co. ' 42. CERTIFICATE OF OCCUPANCY _ No Date t , _ _ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. 'NOT-1- COI�SMiCTION PERMIT �,57� 0_S • Project Address / w^,i bra T�YP�E OF CONSTRUCTION �. ' 78 1 2' 9/ 1 7/82 246'56 . Tl, vnt Phone-- R NEW ❑ ADD ` []'ALTERATION LM ✓= - , Address p i�oVP �$ ❑ REPAIR ❑ CONVERSION ODEMOLIS 6r C1 OTHER ZONING REGULATIONS Arch/Eng. _ _ License No.. R.P. Address DESCRIPTION OF WORK ZONE PLNG.-REF. =jf , 1 Contractor �j;tJl�L�tiJ ' Phone ice- TYPE OF PERMIT= TpgU'�pINC PROPERTY L1 NE Address,/da 0 00-k ❑GRADING,,.,, • ❑ FOUNDATION ❑ STRUCTURAL' SETBACK Y RD SIEP LICENSED CONTRACTOR DECLARATION TENA T 'ELECTRICAL ❑PLUMBING ❑MECHANIC ❑ N@ 1St I hereby affirm that am licensed under provisions of Chaiter 9 (com'- Y RIGHT ,i mencing with sectldn 7000)_ of Division 3 of, the Business and. _ ❑.OTHER Professions Code and my ilcense is In full for and effect, PROTECT DESCRIPTION•. REAR YARD (TO P/L) , Licen •C ass• ucen _ - PKG. SPACE REQ. PROVIDED, Date 1_' Signature SQ. FT. &:Q - `' STREET WIDTH PARK FEE $ WOR ER COMPENSATION D RATION OCCUPANCY CONSTRUCTUON,TYPE I hereby•affirm that I have a E flcate of corisent to self -Insure or ZONING APPROVED BY ., f , ;� DATE certificate of Workers' Compen.tlon Insurance, gr a_ certified! COPY VALUATION ZONE Hereof (Section*3 Ld . C.). icy No. 1: / S COmpanY' dl _ .c.. / _ -ea- GRADING CU. YDS. ACRES - - - SPECIAL CONDITIONS; tlfied copy Is hereby furnished. REMARKS:- Certified'copy Is filed with the city Building Division, 6XEMPTION..FROM.WORKERS' COMPENSATION DECLARATION -- ((This section need not be completed If the permit is for one hundred - '- or less. - - 4$100) cert((fy that n the performance of the work for which this permit Is issued,I shall -not -employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. _ - Date Signature ` BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS �_ iURINALS GENERATOR TRANSFORMER 0-1 KW 1-10 KW Labor t0 the Workers' Compensation provisions of the Labor Code, you must' forthwith comply with such provisions or this permit shall be deemed _ LAVATORIES DOUBLE'L'AVS "" , - . APPLIANCE 10-50 KW_:_5o + KW , J revoked. CONSTRUCTION' LENDING AGENCY -, KIT --SINKS DISHWASHERS - MOTORS'— p-1 HP - , 1-10 HP 1 , I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HR___: 50 +'HP formance of the work for which this permit is issued (Section 3097 Civ- C.)_" __ _ - - Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS/ SWITCHES �" Lander's Address DRINKING FOUNTAINS w "" GAS TUBE SIGNS _ _ a -'INTERCEPTORS CLARIFIERS POLE LIGHTS ' OWNER BUILDER DECLARATION Ihe affirm that I am exempt from.the Contractor's License Law for SWIMMING PDOL `PTRAP r POLES METERED SUB the following.reason(Section-7031.5 Business and,Professlons Code: Any city or county which requlres a permit to construct, alter, WATER SERVICE AL'TER'ATION ` - PANELS MAIN •' �. SUB improve, demolish"or repair any struCture,.prior to its Issuance, also.re- the applicant for such to file a Signed statement that he quires permit Is licensed pursuant t0 the provisions of the Contractor's -License Law ' GAS SERVICE ' OUTLETS - - i SERVICE - �d AMP, Chapter 9 (commencing with Section 7000) of Division 3 of the (Chapter WATER HEATERS STU OUTPUT _ and"Profess'ions Code) or. that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER -CONNECTIONS T -' -� - •" - A,,,�' appllwnl for a permit subjects the applicant-.ta a civil penalty.. ,i,V'hot more than five hundred dollars ($500). SOLAR TANK COLLECTORS r` 1 ❑ 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 SOLAR PIPING SYS. - - -ISSUE FEE Or offered for -sale. (Section 7.044, Business and -Professions -Code: The , Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not _ MECHANICAL PLAN'CHECK SUMMARY OF FEES_ intended or offered for sale. if, -however, the -building or Improvement is sold within one of completion, the Owner will have the burden year of proving he did not -build -or Improve for -the purpose of sale). ❑ the contracting with HEATING SYSTEM 0-100,000 BTU ,•_ BUILDING PERMIT $ SMIP_ $ ' 1, as owner of property, "am exclusively the 7044, Business AND DUCTING licensed contractors to construct project (Section and Professions Code: The Contractor's License Law does.not apply to 100,000 +',BTU~ PLAN CHECK S PERMIT ISSUANCE $ an owner -of- property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) Ilcesned, pursuant to SYSTEM - - GRADING -S the Contractor's License Law).-- 100,000 + BTU PLAN CHECK $ 1 ❑ 1 am exempt under Section B. &-P• C. -for this- BOILERS BTU (_ ELECTRICAL $ J L�/j $• reason _ PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIRALTERATION , - TOTAL FEE S. I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ - LESS AD - Information is correct. I .agree to comply with -ail city and county PLAN CHECK $ VANCE,PC S ordinances and state laws relating to construction, and hereby authorize representatives.of thls ity,to enter .upon the above mentioned property for spectiose p L - _L S Signature �f O - FINALFEE S Drivers' icerlSe or SS 9F ISSUE FEE a -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector" POOL & SPA APPROVALS' _ Permits#1\`�;'�' - �� • -. :" ' Date- " Ihspgtor 1. Temporary Electrical Service or Pole '- 43. Pool & Equipment Location -r , �\ 2.- Soil Pipe-Undrgrn 44. Steel Reinforcement' `- - - 3. Electrical Conduit Utility-Undrgrn _ ___45.. Forms 4. Electrical Conduit-Undrgrn -46. Electrical Bonding 5. Steel em orce 47. Rougii Plumbin� & Pressure Test. ..-i, - Nn . r r r k 6. Electrical UFER Grn 48. , APP90VAL TO COVER -GUN ITE J ' -' 7. Footings 49. Electrical Conduit-Undr rri ` 8. Foundation 50. . Gas Pipe; ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,_ ❑.Undr rn� Cti N? 10. Structural Floor System 52.•. APPROVAL TO DECK '� \F ^' 11. Property Sewer Line & House Connection - 53. Backwash & Rece for=Fina! �• 12. Street Sewer Connection _. 54. Heater & Vent -Final ,_ _, ,1.1 ,•,._,-:, �, f -r7. �C i:N� .13. Rough Plumbing `� T - - 14. Rough Electric -Conduit - - - - •56. Electrical+inal 15. ' Rough Electric -Wiring - - C: - - 57.- Solar System - Final -16. - _Rough Heating & Air Conditioning 5B. -. Fencing &.Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60.. - - - -. .POOL/SPA.SYSTEMS FINAL - 19. Gas Pipe -Rough & Test _ _ .. _ 20. Roof Framing. - 21 Roof Sheathin -NOTES: 22. Frame and Fiashin " ' _ ` _ _ _ 23.' Insulation,, 24. ' Lathing & Siding 25. Drywall Nailing 26.. Plaster Brown Coat- oat 27. 27. 28. Electrical Power Meter -Final Final Electric 29. Final Heating & Air Conditioning - 30. Final Gas Pipe -Test - W 31. Final Plumbing 32. -•Water Service -Final - - '33. Gas Service -Final ' 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation w 37. Handicap Redulations - 38. FINAL STRUCTURE & BUILDING - .. 39. Special Requirements Completed "- 40. Electric Release to Edison '41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY .-NO- Date ti Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 79111 9/20/82 6,00 CITY OF COSTA MESA P MIT.N 8� TRACT NO. LOT NO. BLDG. NO. - G`ONSTFiUCZION PERMIT P roject Address /S �fA�,%� TYPE OF CONSTRUCTION r .Owners S -Phone <EW [J ADD ❑ALTERATION Address AIIP—I& r ❑ REPAIR ❑ CONVERSION C1 DEMOLISH El ZONING REGULATIONS Arch/Eng. License No. . Ik p P' Address DESCRIPTION OF WORK - ZONE PLNG. REF. = Contractor F� w((�,� L� r� i+ir Phone ! 1-• TYPE OF PERMIT Io etJl L ING _ Address {/r lie - [moncing - ❑ GRADING , ❑ FOUNDATION- ❑ STRUCTURAL SETBACK C ST. SIDE YARD rROPERTY LINE ICENSED CONTRACTO DECLARATION that licensed Charter 9 ❑ TENANT LECTRICAL ❑PLUMBING ❑MECHANICA E YAR WillaHT ` hereby affirm I am under provisions of (cam- section 7000) of Division 3 of the Business and ❑ OTHER. with _ Professions Cc 6, and my license is In full force andeff t. _ REAR YARD (TO PtL) 3 � PROJECT DESCRIPTION Licen CI ss Li ns o. SQ. FT. PKG. SPACE REQ. PROVIDED Date144t-2=W Signature ^'�� _� STREET WIDTH PARK FEE § WOR RS' OMPESATION D LARATION OCCUPANCY CONSTRUCTION TYPE ZONING APPROVED BY DATE -geby affirm that t have a c(KifiCate of consent to self-insure pr a VALUATION ZONE ficate of Workers' Compensation Insurance, or, a certified c pY- eof (Se on 0, L� C.). fE / V" — WdSL 3 Q2rrr+ti GRADING CU. YDS. ACRES SPECIAL CONDITIONS: POIicY No. .Company s— _ _ ❑ rtifled copy is hereby furnished. REMA RKS Eertltled copy is filed with the city Building Division. E?�IPTION FROM-WORKERS' COMPENSATION DECLARATION This section need not be completed if the permit Is for one hundred J or less). S$100) 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 sub)ect to the Workers Compensation Laws of California, $' 1 • PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS UVVLLLINU_ -tilARALit- Date Sfgneture NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW- 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS TRANSFORMER APPLIANCE 10-50 KW�50-+'KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 FIP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS {INC. SOLAR) 10-50 HP- 50 + HP .3 formance of the work for which this permit is Issued (Section 3097 Civ, C•)•_ Lender's Name FLOOR StNKS-- FLOOR DRAINS " FIXTURES OUTLETS SWITCHES Lender'sAddress - DRINKING FOUNTAINS , - GAS'TUBE SIGNS _ INTERCEPTORS CLARIFIERS POLE LIGHTS _ OWNFR BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P TRAP POLES METERED SUB. the following reason (Section 7031.5 Business and Professions Code:. Any' city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS- MAIN SUB - improve, demollsh or reWT any structure, prior-to.its Issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE "OUTLETS SERVICE AMP r i• tensed pursuant to the provisions of.the Contractor's License Law I ter 9 (Commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT' ' L ess and Professions Code) or that he is exempt therefrom.and the basrs for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ` any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK- COLLECTORS _ ❑ 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 _ SOLAR'PIPING'SYS- - - , ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property - ISSUE FEE APPLICATION APPROVED BY DATE ,. Who builds Of improves thereon, and who does RSCh work himsell Or throuah his own employees, provided that such improvements are not - MECHANICAL PLAN CHECK SUMMARY OF FEES ' Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden - of prPving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $- SMTP $ ❑ 1, as owner of the properly, am exclusively contracting with AN D DUCTING _ licensed Contractors to construct the pro)oct (Section 7044, Business 100,000 + BTU ?LAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner ofproperty who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) iicesned pursuant to SYSTEM ,- GRADING' $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑, I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ `� $ reason- PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ 1 heret)Y certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $_^�—� - - LESS AD. - inforrrlation is correct. -1 agree to comply with all City and County PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction, and hereby authorizerepresentatives of this C y enter upon the above mentioned property for n ectlo ses. - -- , - - f'C•• �i/../ FINAL FEE $.�— Slgnature to Drivers' icen$e or SS qr-l�`�— ISSUE FEE T-El _ CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor TI. CONSTRUCTION AND PLANNING APPROVALS Permit Date r Inspector�,,;Date POOL & SPA APPROVALS Permit �� -'•.` „ Inspeetof ; t�-' = 1Z' - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn , 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5 ----Steel Reinforce 47. Rough Plurnbiih4 & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit=Undo rn S. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water pipe-Undrgrn 51. Backwash Lines P-Tra '❑ ridr rn -';Z- 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Ficial 12. Street Sewer Connection -54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit 5$. ' Electridal-Final 15. Rough Electric -Wiring 57: Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. hoof Framing 21. Roof Sheathing 22. 'Frame and FlashingNOTES: 23, Insulation 24. Lathing & Siding 25. Drywall Nailing 26.. Plaster Brown Coat .27. Electrical Power Meter -Final ' `28. Final Electric e X29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing -32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Wndscape Sprinklinq System 36. Sound Attenuation _ 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY -- NorDate Applicant to fill in all spaces within heavy border lines and ftn'alt appropriate declarations. r CITY-DF COSTA MESA -PERMIT NO.4 TRACT NO. LOT NO. BLDG: NO. J o I j % j E�'I +� I+ltr I a%e 1} T{ - ' CONSTRUCTION PERMIT 13 04 Ot Project Address f' k Lu ke A TYPE OF CONSTRUCTION d, , 4 Owner e e Phone []NEW ❑ ADD ❑ ALTERATION U, ' Address D f1 / 4. ❑REPAIR' ❑CONVERSION ❑DEMOLISH, ' Arch/Eng. TOA01icensa No. ❑ OTHER ZONING REGULATIONS A,P - @ " DESCRIPTNOF WORK Address f1/ y/ C ZONE ' �� PLNG. REF.:#' Contractor -T DG Q a r Phe^ G•� TYPE OF PERMIT - TToo gg ILLDDING LINE Address ❑ GRADING ❑ FOUNDATION -❑ STRUCTURAL- SETBACKPROP�RTY YARD LICENSED -c6NIrAACTOA DE LARATIO - 9 ❑ TENANT ❑ ELECTRICAL ❑PLUMBING EIMECHANICAL EF SIDE YARD I hereby affirm that I am licensed under provisions of Charter (corn-. 7000) - Division of the. Business and' ,. ❑,OTHER RIGHT mencing with section of -3 PCode, a my license is In full force and effect. / ). REAR YARD (TOPLrofessions PROJECT DESCRIP ION License Cles ense "" "' • - PKG. SPACE REQ. PROVIDED SQ. FT. Date Sk9nature � STREET WIDTH - ;,'PARK FEE;$', WORKERS' C MPENSATION DEC LARATI to OCCUPANCY ONSTRUCTION TYPE ZONING APPROVED BY �~� DATrE/3o I hereby affirm that I have a certlficate of consent Sel -insure or a VALUATIONZONE .7rtificate of Workers' Compensation Insurance, or a certified copyQ�g SPECIAL CONDITIONS: _ eof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES No. ' Company---.L---- - - - - - - - } L':I Gertifled copy Is hereby furnished. - REMARKS: �� s• -. - _ _ _ - - _ .. - ❑ Certified copy Is filed with the city Building Divlsion. , I EXEMPTION FROM WORKERS' COMPENSATIONDECLARATION - - (This section need not be completed if the permit is for one hundred -- - �-S _,1•-� G • �` _ ,_ _ I - .•f, - ($100) or 1e$51. .certify that )n the performance of the work for which this permit is S issued,'I shall not employ any person in any manner so'as to become • P,LUMBING ;.,r1 -,'PLAN CHECK-' r ELECTRICAL— PLAN CHECK- - S• t subject_ o the Workers Compensation Laws of Californla. - _ BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject Z TOILETS, URINALS - ^ GENERATOR - 0-1-KW TRANSFORMER 1-10 KW _ .. - j,,; •� w to the Workers' Compensation provisions of the Labor Code, you must- forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs - •- ••^ - APPLIANCE- -- 10-50 KW, ,, 50 + KW revoked. _ . _- CONSTRUCTION LENDING AGENCY ^ KIT. SINKS - �° DISHWASHERS MOTORS 0-1 HP I '1-10 HP - r I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS ^ - -- -- (INC. SOLAR) .10-50-HP 50 +-HP formance of the work for which this permit is issued (Section 3097 Civ C.)." bender's Name Al FLOOR SINKS' FLOOR DRAINS- - 'FIXTURES- OUTLETS SWITCHES - - -+ Londer's Address - _ DRINKING FOUNTAINS' GAS TUBE SIGNS - - -• -� 1 INTERCEPTORS 'CLARIFIERS -POLE LIGHTS - - - OWNER'BUILDER DECLARATION-POLE hhereby affirm that I am exempt from the Contractor's License Law for - SWIMMING POOL - -' P TRAP- - - -- -- .- i POLES - METERED-` SUB ; the following reason (Section •7031.5 Business and -Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION— -- -PANELS-- MAIN- SUB improve,- demolish or repair any structure, prior to its-issuance. also re- quires the applicant for such permit to file a signed statement that he SERVICE OUTLETS' "' - SERVICE - •-- --- - - - AMP - - j is licensed pursuant to the'provislons of the Contractor's License LawGRS - (r oter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - f ess-and-Professions Code) or that he-is exempt therefrormand the or the alleged exemption. Any Violation of Section 7031.5 by SEWER CONNECTIONS '- - •• - •- •• •-^- - - ---- - - - - a. ,pplkcant- for a permit subjects-the- applicant to a civil penalty- of not more than five hundred dollars ($500). '-SOLAR TANK -COLLECTORS-- COLLECTORS- _ ❑ 1, as owneF of the property, ormy employees-with wages as their sole compensation,.wlll do the work, and the structure is not intended sole -SOLAR PIPING SYS.- - '- -• - ' - - ISSUE FEE - -• - - - or offered for sale. (Section 7044, Business and Professions Code: The Contractorls License Law. does not apply to, an- owner of a property who builds or improves thereon, and who does such work himself or _ - _•_ I _ ISSUE'FEE APPLICATION APPROVED BY QATEf2 through hls.own employees,_provided that such IMPToverpents are not MECHANICAL - PLAN CHECK T SUMMARY OF.FEES- intended or offered for sale. If, however, the building or Improvement is sold•within one year of completion, the owner will have the burden of provinghe did not build or Improve for the purpose of sale . p ) HEATING SYSTEM 0-100.000 BTU , - BUILDING �s�. _• s �� ❑• I, -as owner- of the property, am-exclusively contracting with AND'DUCTING •'- - �••-••-� PERMIT E - - --- - - - - • SNIP $ -: - - i licensed contractors to construct the project (Section 7044, Business 300,000 +BTU PLAN CHECK $ PERMIT, r and Professions Code! The-Contractor's- License Lawdoesnot apply to -' -. - - • - ._-ISSUANCE ` $ _ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to *SYSTEM -•• .- r -- - GRADING_ $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ r• E3, I am exempt under Section ' B. & P. C. for this gOIL$RS BTU ELECTRICAL' $ $ reason - - - - - _. - .' - _� _ - '_ _ pLANCHECK -$ _ MICROFItAv $ Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE $ I hereby certify that I have read this application and state that the above 'and EXHAUST SYSTEM MULTIPLELESS MECHANICAL- $ - PLAN CHECK'--'s AD- Information is correct, i agree to comply with all city county ordinances and state laws relating to construction, and hereby authorize VANCE PC $ representatives f this city to nter upon the above mentioned property for ' pe n pu o _ _ _ • -' • - a4 Signature �� _ FINAL FEE, S Drivers' License or 5 E FEE ISSU--- - -- - - - - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date - Inspector ••:' POOL & SPA Y APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole_ 43. Pool & Equipment Location ` •`r r • ` - r..2.- _Soil PipewUndrgrq _ _ _ _. _ --WT-Steal Reinforcement. - - - - -- - 3. Electrical Conduit UtFlity-Undrgw__ __ - _ 45.- Forms - - - - - 4. -- Electrical. Conduit-Undrgrn_ 46._ Electrical Bonding _ - tee em orce ' -.; _ _ k� 47. Rough Plumbing & FOressiure Test 6. Electrical UFER Grn _- 48. APPROVAL TO COVERT,UNITE 7... Footings _ _ _ + 49. Electrical Conduit-Undr rn B. Foundation - _..: _ _ _ _ _ 50: . Gas Pipe,C} Undr rn, Test - 9. Water Pipe•Undrgrn- _ _ _ _ _ _ i 51, ackwash Lines, P•Tr'a `' Q LLndqrn 10. Structural Floor System - 52. >-APP1tOVAi.TO DECK 1'1.- Property Sewer Line &."Houte Connection's _ __ _ 61'• Backwash & Recefor-Final 12. - Street Sewer -Connection - .._� - - "_ - -' sc - 54, Heater & Vent=Final , .-.13. -Rough plumbing---' _ �; s _ c= - PjLfmbihg Systerh- - - - - - _ 14. Rough Electric Conduit ;56. Electrical --Final 15. Rough Electric -Wiring ( - - - - -- -'-57:- -Solar System -Final f 16.- Rough Heating &Air Conditioning . __ Fencing:&fAccess.Approval t ` 17:',- Ducts�in Structure - - -' - - - _ __ __ " ' APPROVED- FOR,eLASTERING `--IS:--Ducts,Ventilating --{ -- - - - -- - -- _ 60, _ POOL/SPA SYSTEMS FINAL -'_ 1•vvr 1 - -- -- t• 1 ; ! 19.11 Gas Pipe=Rough"&'Test �-20: Roof -Framing =" _ _ ----- --.- }-- - - -- ' 21., Roof Sheathin .. _ t.__ NOTES: _` v ,: } t_„• ,,._ . , ,� .,. -22 -- - - - - -� : - -Freme-and-Flashin �- is-- 4 r23Insulation "rt' -�-✓ - - - -_ -- -� �.� i 24:+ Lathing & Siding- _ _ - - 25J Drywall -Nailing 26. Plaster Brown Coat - - - --- - - _ •t _ --i - - _ K -27.-,-- Electrical Power Meter -Final 28'- final -Electric - - - - ---- - - - - .- - - _ - - -- -' - - ` •" , �^ f , < _'. 1 '29. Final Heating & Air Conditioning f-30+- Final Gas -Pipe -Test --- - - - - - -- �- - -- _ �: • ,, .. � ; w f ,' -31:'--Final -Plumbing -- .�-,32.L Water,'Service-Final, -- 33: -"Gas -Service -Final-- = = 4: lar Domestic -Final . 3*5.- Landscape 5 rinklin System ' ' r _ _ , ", 4 c, , .; • _� 36. Sound Attenuation -- ' ' ' I -- - -- - - , , •, _ f. r 37. _ Handicap Regulations j 38. FINAL STRUCTURE & BUILDING - ., j 39. Special Requirements Completed - !%40:' 'Electric,Release to Edison , } •' y - 41 • Gas Release to Southern California Gas Co. r 42. CERTIFICAT OF OCCUPANCYI No' _. 7 Date 3 - -1 ✓�� i - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY Or- COSTA MESA PERMI TRACT NO. LOT NO. BLDG- NO. CONSTRUCTION PtRM17 I i 5. ±;'f^ i T,. Project Address 15 /h'Gl D TYPE OF CONSTRUCTION .. , Owner A ,� N7,F.tirG. w El NEW El ADD El ALTERATION //PPhonee Address 57. /fit' o A., ! ❑ REPAIR ❑ CONVERSION.❑DEMOLISH _ V Arch/Eng. License No. - ❑ OTHER ZONING REGULATIONS A p if ' r�7�5 DESCRIPTION OF WORK Address ZONE PLNG- REF. # _ Contractor N(��r rlrc rc Phone' TYPE OF PERMIT TTpp ggtt��tLLppl G PROPERTYINE ` 'i Address y �% LCa..p /� d� /w.�J ❑GRADING ❑ FOUNDATION ❑STRUCTURAL SETBACK YARD LICENSED CONTRACTOR DECLARATION -❑ TENANT ❑ ELECTRICAL'❑PLUMBING OMECHA-41CI-kL SID 1 hereby affirm that I am licensed under provisions of Charter 9 (com- • _ RIGHT ,. mencing with section 7000) of Division 3 of the Business and ❑ OTHER and It nse is in full force d of ectt_ Professions Co .-7i REAR YARD (TO P/L) . Q L PROJECT DESCRIPTION. L[cense CIa s Lic s v + PKG. SPACE REQ. PROVIDED Date Signature SQ.FT. -_ STREET WIDTH - PARK FEES 7RK R COMPENSATION CLARATION - OCCUPANCY CONSTRUCTION TYPE, ZONING APPROVED BY DATE ereby affirm that I have a 6irtificate of consent to self4nsure or a VALUATIONZONE rtlficate of Workers' Compgnsatlon Insurance, or -a Certified copy SPECIALCONDITIONS: ' �' thereof (Se n 33S y��11��J /I ' GRADING CU. YDS. ACRES • Policy fVoaanY l.�M�'►-LJ/i6�-Owe _ _ - _- - _ - --- - _- ❑ Certified copy is hereby furnished. REMARKS: ertified copy.is filed with the city Building Division. MPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if.the permit Is for one hundred _ [E'Doi) or less) , f certify that In the performance ofthe work for which this permit is Issued, I snail not employ any person in any manner so as to become _ PLUMBING PLAN CHECK- - _ ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California, .. _ _ _ . -. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subject' TO_ ILETS,• _ .�,` • ' URINALS-• GENERATOR- 0-1 KW '_ 1-1O'KW to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS -- " TRANSFORMER APPLIANCE 10-50 KW -z--50 + KW i revoked, :-- - +- - - -- - »- -- - KIT. SINKS r 'DISHWASHERS "'` MOTORS"' '0-1HP 1=10 HP - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- -<-; SUMPS'-' ' r � - (INC. SOLAR),.,- .10-50 HP 50•+.HP•, for this is Issued 3097 SERV ICE SINKS • r formance of the work which -permit. (Section_ Civ. C.). Lender's_Name FLOOR SINKS FLOOR DRAINS' ' FlXTURESa OUTLETS' SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS- ' INTERCEPTORS CLARIFIERS POLE LIGHTS w - OWNER'BUILDER DECLARATION 1 -hereby affirm that I am exempt from -the Contractor's License Law for Professions Code: + SWIMMING POOL P TRAP "' " " TOIT POLES METERED SUB the following reason' (Section 7031:5' Business and f Any- city ar county which requires a permit to construct, alter, WATER SERVICE ALTERATION ` "PANELS " ' ' MAIN. - SUB rove, demolish or repair any'SEructure; prior to its Issuance, also re- the applicant for such permit to file a signed statement that he _ GAS SERVICE OUTLETS ; SERVICE AMP =� sensed pursuant to the provisions of the Contractor's License Law 9 Section 7000) Division 3 of the apter (commencing with of Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS STU'OUTPUT 'SEWER CONNECTIONS - - "--� - - - - any appliran! for a permit subjects -the applicant to a civil penally of not more than five hundred dollars SOLAR TANK COLLECTORS ❑ 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 - �•- SOLAR PIPING SYS. ISSUE FEE- -- ' or offered for sale. (Section 7044, Business and Professions Code; The Contractor's License Law, does not apply to an owner of a property who builds or improves thereon, and who does such work himself or _ _ .._ - •• ISSUE FEE APPLICATION APPROVED'BY •- - PATE ' through his own employees, provided. that such improvements are not , A MECHANICAL PLN CHECK _ _ SUMMARY OF FEES f Intended or offered for sale. If, however, the building or Improvement Is sold within one year completion, the owner will have the burden - BUILDING J r •-_ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT SMTP - -$ - ❑ 1, as owner of the property` -am exclusively contracting with AND DUCTING' - _5 _ _ - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT , and Professions Code; The Contractor's License- Law does not apply to ` ISSUANCE S an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ •�- ' tracts from such projects with a contractor(s) licesned pursuant to SYSTEM` ---'1 '- - - - . -GRADING 5 the Contractor's License Law)- 100,000 + BTU PLAN CHECK S " ❑ 1 am exempt under Sectio ri B. & P. C. for this BOILERS BTU ELECTRICAL $ reason - PLAN CHECK' E MICROFILM $ SYSTEM REPAIR, ALTERATION _ -• TOTAL FEE E Date Owner - _ _ MECHANICAL $ ' Thereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE • LESS AD - Information Is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction, and hereby authorize - representatives of this -ty epter upon the above mentioned property for ctio as¢S/j .. ,- �_./r Signature e FINAL FEE $ Drivers' LXense or SS ISSUE FEE -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit Date �. Inspector FOOL &SPA � r• APPROVALS Permit # 4 - Date In -Spector 1. Temporary Electrical Service or Pole 43; Pool &Equipment Location --�.- -' -- - - 2. Soil ipgn . Steel Reinforcement 3..__, lectrical•Conduit Utility,;Undrgrn _ 45. Forms - - - - ,--4.-. Electrical Conduit--Undrgrn _ 46. _._Electrical Bonding5. _ _ _ 47. Rou h'Plumbin`& Pressure -Test 6.. Electrical LIFER Grn a 48. 'APPROVAL: TO COVER -GUN ITE; • _ 7.ootings _ w� ;_ _ 49. Electrical Conduit-Undr rn ' B. Foundation r ' SO.,-, Gas Pipe, ❑,Undr rn j Test s 9. . Water Pipe:Undrgrn _ 51. Backwash Lines ra ' ❑ ndr rri : -10.. Structural Floor_System _b 52. APPROVALTO DECK _11. __Property.Sewe'r Line & House Connection - 53. Backwash.& Receptor -Final 12.. Street..Sewer_Connection r ' - _. _- 54. - Heater & Vent -Final ,.. 13. _Rough Plumbing _ _ 14. Rough Electric -Conduit i` -- - -- - -- -•-56:--Electrical-Final 15. Rough Electric -Wiring -- ___ __ .._. __ _ _ -57 __Solar -System -Final 16.-- Rough Heating &-Air Conditioning - - -. -Fencing & Access Approval �17. Ducts in Structure_': APPROVED FOR PLASTERING -18.• Ducts; -Ventilating - -:,1. _ - . _ _ _ ? _ .t _ 1 -_ : ---- •--- - ' - . ' .', _ _ --- - _ _ `;�• `POOL/SPA SYSTEMS FINAL -'�l1J1M♦rl - _ _ _- v . _ - J_ -,". -',1L ,i •'', .. +! 19. Gas Pipe -Rough &Te"st-- " ' �r 1, ', i - .'_ _t__ _ ,l1 . , ._ -J. � 4�.J dJ��. 20. Roof -Framing- --�- ._ - _- _ _ , - -� - 21. Roof Shea&n - - -- -' = r 22. Frame`ar d Flashin 23.-1- Insulation"ti-_-- _•t - - • - - - !-1., ' �,. - - - ��_ r� N_t-. L - 24. Lathiri & Sidin9 - .. + 1- i, .!, - .25. _Drywall. Nailing-- •� - .. • . 26. Plaster Brown Coat " ' - - - 27.'_ Electrical Power'Meter.-Final. 282 Final Electric- -29.;-• Final Heating•& Air Conditioning.-..- a� . - - - - 30.x --Final Gas Pipe -Test- - _ -J. ''• ` " _ f 31., Final Plumbing 32. Water Service -Final - t 33: -Gas Service -Final- j . 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 1 ' - 38. FINAL STRUCTURE&•BUILDING -- 39. Special Requirements Completed 40. Etectric Release -to Edison ' - - 41. Gas Release to Southern California Gas Co. T 42. CERTIFICATE OF OCCUPANCY Ar 'No ' Date I +- ! .,.,- -- .• '. (E1001 or Fess). - I cart(tty that In the performance ofthework 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 Catifornia. Date, ' - , Signature PLUMBING - t PLAN CHECK -- BATHTUBS SHOWERS T OILETS URINALS Applicant to fill in all spates within heavy border tines and sign all appropriate declarations. ,tothe Workers' Compensation provisions of the Labor Code, you must comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LAVS revoked. •-. - '. - CONSTRUCTION LENDING AGENCY ;•CITY OF 'COSTAVESA - PERMIT NO. TRACT NO. ... LC`T NO. BLDG. NO. _ _ DRINKING FOUNTAINS 7n' - - "(L -OWNER BUILDER DECLARATION .1hereby affirm that -I am exempt from the Contractor's License Law for the following reason (Section 7031:5 Business and Professions Cotle: 'Any' city' or county which requires a permit to construct, alter, #'•nprove, demolish or repair any'structure, prior to its Issuance, also re- = i,_ fres the ap, lirant for guch permit to file a signed statement that he . CONSTRUCTION OERMIT WATER SERVICE' ALTERATION ' GAS -SERVICE OUTLETS licensed pursuant t0 the provisions of the Contractor's License Law "hapter 9 (commencing with Section 7000) of Division 3.of the Business and Pra(essions Code) or that he is exempt therefrom antl the basis for the alfeged-exemption. Any violation of Section .70 1.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). WATER HEATER BTU OUTP ' SEWER CONNECTIONS - - 13 k 6 l �1� baa I SoGI� sole compensation, will (to the work, and the structure Is not intended dress �t L✓ ��p TYPE OF CONSTRUCTION Contractor's License LaW does not apply to an owner of a property ` -- + who builds or impruves,thereon, and who tloes such work himself or through his own employees, provided that such improvements are not intended or offered for Sale. If, however, the building or Improvement Is sold within one year 4f completion, the'owner will have the burdenof proving he did not build or improve for the purpose of sale). ❑ I_ as owner -of the property, am exclusively contracting with ticensed contractors to construct the project (Section 7044, Business and' Professions -Code: The Contractor's License Law tloes not apply to yrpr� 6, eS k-26015 ❑ NEW ❑ ADD ❑ ALTERATION REFRIGERATION 0.100,000 BTU SYSTEM - - - 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am•exempt under Section S. S P. C. for this BOILERS BTU / - y)� a4 ❑REPAIR ❑CONVERSION ❑DEMOLISH EXHAUST SYSTEM MULTIPLE_ .I hereby certify that I havereadthis application -and state that the above information is correct. I agree to comply with all city and county License No. r'.Address OTHER ZONING REGULATIONS , PLAN CHECK $ A PDESCRIPTION ISSUE FEE t -Assessor OF WORK MICROFILM S PLAN CHECK $ ' " TOTAL FEE E MECHANICAL. $ � ZONE PLNG. REF.:ff PLAN CHECK $LESS AD- -VANCEPC S_ L' v fj Phon 6t%- ��j TYPE OF PERMIT El GRADING ❑ FOUNDA�10 ❑STRUCTURAL ' SBUILDINGErBACK C L ST. ��OP�IRTYNLNE" - - - � �r -�� - IpF YARD \ LICENSED CONTRACTOR D£CLA ATION - hereby th&t I ani 9 ❑ TENANT ❑ ELECTRICAL JIS�LUMBING ❑MECHANICA � SID£Y - ' I affirm ticensed under provisions of Charter (com- with section 7000) :Division 3 of the Business and � ❑ OTHER RIGHT mencing of Professions Code, and my license is In full force andeff ct. CJ, REAR YARD (TO P/L) PROJECT DESCRIPTION �. K _ -- License Class '• Licens N " - PKG, SPACE REQ. PROVIDED- ROVIDE=D Date •� (2.� 2, f SignatuYe 'C' SQ; FT. - •� 'STREET ';jVORKERS' COMPENSATION 0ECLARAT ON OCCUPANCY CONSTRUCTION TYPE _ WIDTH PARK FEE 3 herebyaffirm that I have a certificat consent to self -Insure of a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation -Insuranc or a certified copy thereof (Sectl 380 aYi� } - - • -- • , ACRES SPECIAL CONDITIONS: .. .. - , _ .GL /1 Policy No. �V SrGYIf; 233A J GRADING CU. YDS. w - - - Company ❑ Certified Copy is heref3v furnished. - -- , . , REMARKS: - ✓1 c'r' / _ - - - .- (E1001 or Fess). - I cart(tty that In the performance ofthework 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 Catifornia. Date, ' - , Signature PLUMBING - t PLAN CHECK -- BATHTUBS SHOWERS T OILETS URINALS making this declaration, you should become subject NOTICE: If after m ,to ,tothe Workers' Compensation provisions of the Labor Code, you must comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LAVS revoked. •-. - '. - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS SERV ICE SINKSSUMPS ' 1 hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOORbRAtNS ' Civ. C.). Lender's Name - - ---..• _ _ DRINKING FOUNTAINS 7n' _ _ Lender's Address — _ __ _ _ _ _ - _ ___ INTERCEPTORS CLARIFIERS -OWNER BUILDER DECLARATION .1hereby affirm that -I am exempt from the Contractor's License Law for the following reason (Section 7031:5 Business and Professions Cotle: 'Any' city' or county which requires a permit to construct, alter, #'•nprove, demolish or repair any'structure, prior to its Issuance, also re- = i,_ fres the ap, lirant for guch permit to file a signed statement that he SWIMMING POOL PTRAP WATER SERVICE' ALTERATION ' GAS -SERVICE OUTLETS licensed pursuant t0 the provisions of the Contractor's License Law "hapter 9 (commencing with Section 7000) of Division 3.of the Business and Pra(essions Code) or that he is exempt therefrom antl the basis for the alfeged-exemption. Any violation of Section .70 1.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). WATER HEATER BTU OUTP ' SEWER CONNECTIONS - - SOLAR TANK COLLECTORS ` ❑ I,.as owner of the property, or my employees with wages as their sole compensation, will (to the work, and the structure Is not intended SOLAR PIPING 5Y8. or offered for sale. (Section 7044, Business and Professions Code: The l Contractor's License LaW does not apply to an owner of a property ISSUE FEE who builds or impruves,thereon, and who tloes such work himself or through his own employees, provided that such improvements are not intended or offered for Sale. If, however, the building or Improvement Is sold within one year 4f completion, the'owner will have the burdenof proving he did not build or improve for the purpose of sale). ❑ I_ as owner -of the property, am exclusively contracting with ticensed contractors to construct the project (Section 7044, Business and' Professions -Code: The Contractor's License Law tloes not apply to MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU ' REFRIGERATION 0.100,000 BTU SYSTEM - - - 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am•exempt under Section S. S P. C. for this BOILERS BTU reason Da-gwner t SYSTEM R EPAI R, ALTERATION EXHAUST SYSTEM MULTIPLE_ .I hereby certify that I havereadthis application -and state that the above information is correct. I agree to comply with all city and county PLUMBING S!>� ordinances and state Iaw2 relating to construction, and hereby authorize representatives Of city o e ler upon the above mentioned property for ctia Signature ^�'�� , PLAN CHECK $ Drivers' License Or Vj ISSUE FEE t -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod ELECTRICAL PLAN CHECK 'SQ. -ET, SM El - GENERATOR 0-1'KW - 1-10 KW TRANSFORMER APPLIANCE. •'" 10-50 KW'_50 +-KW-_:,, - .:MOTORS 0-1 HP 1 -10 -HP (INC, SOLAR) 10-50 HP 50 + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS - POLE LIGHTS u LJ POLES METERED SUB - PANELS MAIN _ SUB ' SERVICE -AMP = - ISSUE FEE APPLICATION APPROVED BY r DATE - SUMMARY OF FEES i BUILDING PERMIT $ SMIP $ - PLAN CHECK $ ERMIT ISSUANCE - S PLUMBING S!>� GRADING. E PLAN CHECK $ ELECTRICAL $ V $ MICROFILM S PLAN CHECK $ ' " TOTAL FEE E MECHANICAL. $ � - PLAN CHECK $LESS AD- -VANCEPC S_ 1 • FINAL FEE S_/15 CONSTRUCTION AND PLANNINGc APPROVALS Permit # ` Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1._ Temporary Electrical Service or Pole -44. 43. Pool & Equipment Location-- 2. Soil Pipe-Undrgrn Steel Reinforcement - - - - -- 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee . ein orce 47. Rough Plumbin� & Pressure Test - -- - -� 6.. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE=-- 7. Footings 49. Electrical Conduit-Undr rn e 8. Foundation50. ~ - Gas -Pipe, 1:1Undr rn Test 9. _ Water Pipe-Undrgrn ~- 51. Backwash Lines P ra _. ❑ ' ri n 10. Structural. Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. - Backwash & Receptor -Final .12.- _ Street Sewer Connection 54. - Heater & Vent -Final ,. 13. . Rough Plumbing _ -''' " 14. Rough Electric -Conduit •-56. •-Electrical-Final 15. Rough Electric-Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning - encing.& Access Approval, 17. Ducts in Structure ► APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 60.. FOOL/SPA SYSTEMS FINAL ' 19. Gas Pipe -Rough &Test __ _ 20. Roof Framing 21. Roof Sheathing-- : NOTES: 22. Frame and Flashing- 23. ' Insultion 24. Lathing &Siding 25. Drywall Nailing - -26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final'Gas Pipe -Test 31: Final Plumbing 32. Water Service -Final ! ' 33.- Gas Service -Final 34. Solar Domestic -Final s 35. Landscape Sprinkling System ' 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE &-BUILDING - 39. Special Requirements Completed 4 l - 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. - J 42. CERTIFICATE OF OCCUPANCYNo Date r f. Y Applicant to (ill in all spaces within heavy border lines and sign all appropriate declarations, (43jyQ 3�jjl:�t i �,IoJQ �� • r CITY OF COSTA MESA PERMIT TRACT NO. LOT NO. NO. r. � i CONSTRUCTION PERMIT A4 J'BLDG. * ' Project Address j-1 t, -/P EZ07 TYPE OF CONSTRUCTION 4 Owmar TTD 57 ol dc). Phone 0 NEW ❑ ADD ❑ ALTERATION •• - '- a. t' -, Address 3 S� �4/� - ❑.REPAIR ❑ CONVERSION (--]DEMOLISH ❑ OTHER ZONING REGULATIONS . l Arch/Eng, License No. A.P. _ 1 Address DESCRIPTION OF WORK ZONE PLNG.REF„r• Contractor _ /(�Z' PhoneG',:�0' YPE OF PERMIT BL�IL$ING WON u Address3Z111- / - G,!/' 1 C1 GRADING ❑ FOUNDATION ❑ STRUCTURAL - SETBACKCLST. SIDE VRRl7 OP '• •�' LICENSED CONTRACTOR DECLARATION _ 9 -❑ TENANT ❑-ELECTRICAL ❑ PLUM BING.MECHAN[CA LgEpFYARD .-. 3 hereby affirm th:.t I am licensed under provisions of Charter (com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER RIIGHT Professions Code, a dmy license is in full force and e e Q REAR YARD (TO P/L) �j^ PROJECT DESCRIPTION. 'PROVIDED' License Class e N PKG. SPACE REQ. w 9 Date r Signature Sia. FT. - _ WORKERS' COMPENSATION DECLARATION. - - _ OCCUPANCY _ CONSTRUCTID_ N.TYPE 'VALUATION STREET WIDTH ZONING APPROVED - PARK.FEE,$ _ - DATE �,i hereby affirm that I have a certificate of consent to self -insure or a ZONE -BY ZertlflCate of Workers' Compensation Insurance, or a. certified copy. _ _ - ,:hereof (Section 3800, Lab. C.). GRADING CU. YOS. ACRES SPECIAL CONOITIONS: Policy No. CdnipanY ❑ Certified copy is'hereby furnished. - - _ REMARKS: '❑ Certified copy is•filed with the city Building Division. 'EXEMPTION FROM WORKERS' COMPENSATION -DECLARATION •� ;(This section need not be Completed if the permit is for one hundred _ _ - ($100) or less). - - I certify that in the.performance of the work for which this permit is - issued. I shall not employ any person in any r so to come 'PLUMBING. -,.PL•AN CHECK ELECTRICAL' PLAN CHECK... x' subject the Wor ars' Compensation rn• •_ •' _ SHOWERS" DateUWLULINU Signature r ,NOTICE: If after making this declaration, you should be me subject_ TOILETS,- •' URINALS - - ”' GENERATOR 0.1 KW 'TRANSFORMER 1-10 KW - to the Workers' Compensation provisions of the Labor C de, you must 'forthwith comply with such provisions or this permit shall be deemed 'revoked. LAVATORIES DOUBLE L -AVS - APPLIANCE 10-50 KW��50 +!KW. - t , . 'CONSTRUCTION LENDING AGENCY KIT. SINKS OIS iWASHERS 4MOTORS 0-1 HP' 1.10 HP•-•' Ihereby affirm that there Is a construction lending agency.for the per- SERVICE SINKS SUMPS - (INC. SOLAR) 10-50 HPL_50 +'Wp �'• - S iormance of the work for which this permit Is issued (Section 3097 Cl V. C.). - - - Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - iLender's ,tender's- Address 'L _ DRINKING FOUNTAINS' GAS TUBE SIGNS `- INTERCEPTORS CLARIFIERS 'POLE•LIGI-TS` OWNERBUILDERDECLARATION I hereby affirm that I am exempt from the Contractor's License taw for SWIMMING POOL' 'P TRAP' `" ' • ' POLES METERED "' SUB the following reason (Section 7031.5 Business and_Profession$ Code: •� Any city or county which requires a permii to construct, alter, , WATER SERVICE ALTERATION' PANELS MAIN SUB Improve. demolish or repair any;structure, prior'to Its issuance, also re- quires the a;5, Ilcant for such permit to file a signed Statement that he GAS SERV ICE OUTLETS SERVICE MP- AMP.-. ;yalcensed pursuant to the provistons'of the Contractor's License Law ,.=iapter 9 (commencing with Section 7000) of Division 3 of the ',.,,iapter WATER HEATERS BTU OUTPUT " '4: Iness and Professions Code) or that he is exempt therefrom and the oasls for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS' - _ '' any applicant for a permit subjects the applicant to a civil penalty •• of not more than five hundred dollars (5500). ) SOLAR TANK COLLECTORS wa "• ❑ I, as owner of the property, or my, employees -with wages as their f sole Compensation, will do the work, and the structure is not intended SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property _ ISSUE FEE APPLICATION APPROVED BY - - DATE - who -builds or improves thereon, and who does such work himself or through his,own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES - Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden `$ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTUPERMIT BUILDING •SNIP; El I, as -owner of the property, am exclusively contracting with AND DUCTING -' ' - -.— !fr licensed contractors to construct the project (Section 7044, Business 100,000,+BTU PLAN CHECK S .PERMIT _ 'V and. Professions Code: The Contractor's License Law does not apply to - ISSUANCE-- $ �1. an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S • ? _ tJ tract$ from such projects with a contractor(s)vlicesned pursuant to SYSTEM - l - _ _ 'GRADING S l Q the Contractor's License Law), 100,000 + U BT PLAN CHECK S'�.-.. j" I am exempt under Section B. &P. C. for this BOILERS Ty ELV. ECTRICAL S $ reason - PLAN -CHECK $- MICROFILM $�_. J Date Owner SYSTEM REPAtR,ALTERATION TOTAL FEE E MECHANICAL'S I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE PLAN CHECK .$ LESS AD- }'• AD - Information is correct. I agree to comply with all city and county laws to hereby VANCE PC- C ordinancesr ating construction, and authorize Q ordinances and state S� representatives of to r upon the above mentioned d e� AI property for acct rho r 2 r2��-� /C -S: FINAL FEE Signature Da[e �•' •` -- Drivers' License or SS -ISSUE FEE-- -' •- -3� - - . +� -Assessor �' CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING i APPROVALS Permit # ,5 Date Inspector POOL & SPA- APPROVALS Permit # T Date y� Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn,• 46. Electrical Bonding_ 5. Steel em orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER -GUN ITE 7. Footings 49. Electrical Conduit•Undr rn 8. Foundation 50.., Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P-Trari. 0 Uriftin 10. . Structural Floor System. 52. APPROVAL TO DECK -" _ 11.' Property Sewer Line & House Connection 53. Backwash & Reoe for -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13, Rough Plumbing 14. Rough Electric -Conduit '156. `Electrical -Final 15: Rough ElectHe Wijing 57. Solar System -Final 16, Rough Heating & Aiif. Conditioning 53. Fencing & Access.Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20: Roof Fr-amirig 21. Roof Sheaihin - ' NOTES: 22. Frame and Flashing _ '23. Insulation - ,24. Lathing & Siding "25? Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final - 26. Final Electric 29: Final Heating & Air Conditioning 30. Final Gas Pipe -Test - 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscme Sprinkling System 36. Sound Attenuation ^ 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. A2. 1 CERTIFICATE OF OCCUPANCY 'No- Date - • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY,OF COSTA MESA PMIT �� l TRACT NO. LOT NO. BLDG. ,- 011 STRUCTION_PERMIT z'- [/� fr+lj UfJ owner s'J•rt'�1�,j(".,/ sftfpQyC-s rnone ) Address /06d/ Z:�),,•o $7— A7&•- "c Arch/Eng, License No. Address Contractor�/�irJ ��. j �a. c Rhdne�-�?�rtys1 Address .)/1 L — a-4 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of- the Business and Professions Cade; and my license Is in full forCand effect License Cla s C/v Lice ri No � Date Signature _ WORK RS' MPENSATION DE LARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensdtlon Insurance, or a certified copy `Ihereof (Se9 3800EiSJ�3 ,.J_ab. C.). policy No. ' Company— L_�, CtLWIecl copy Is.hereby furnished. L!'I;ertifled copy IS flied with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not -be completed if the permit is for one hundred $100) or less}. cert((fy that n the performance Of the work for which this permit is issued, loth shall not employ any pe son in any manner So as to become, subject to th0 Worker$' Compensation Laws of California. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked. CONSTRUCTION LENDING AG9NCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 Civ. C.). Lender's Name Lender's Address 'OWNER BUILDER DECL'A'RATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 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 re- quires the appllcant for such permit to file a signed statement that he Is licensed pursuant'to-the provisions of, the Contractor's License Law, ^hapter 9 (commencing with Section 7000) of Division 3 of the Ines$ and Professions Code) or that he is exempt therefrom and the_ i for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit-subjeCts the applicant -to a civil penalty of not more than five hundred dollars ($500)• Il 1, as owner of the property, or my -employees with wages as their ,sole compensation, will do.the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Profession$ Code: The Contractor's License, Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or. through his 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: -The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such projects -with a contractor(s) liCesned pursuant -to the Contractor's License Law), ' ❑-I am exempt under Section' "'B. V P: C. for this reason _ - --- - - --- - Date. Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and county _ordinances and state laws relating to Construction, and hereby authorize representatives of thiscit to nter, upon the above mentioned - property for pec rpo ; Signature 11LLLL��^�^^^ yj TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL © TENANT XELECTRiCAL ❑PLUMBING ❑MECHANIC. © OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY - CONSTRUCTION TYPE VALUATION _ ZONE GRADING CU. YDS. ACRES REMARKS: -. PLUMBING PLAN CHECK BATHTUBS- SHOWERS TOILETS URINALS ` LAVATORIES DOUBLE LAVS KIT. SINKS --"-- f DISHWASHERS SERVICE SINKS , T, SUMPS FLOOR SINKS FLOOR DRAINS - DRINKING FOUNTAINS INTERCEPTORS CL:ARIFiERS' ' - SWIMMING POOL '" '" P TRAP" - - WATER SERVICE ALTERATION'-- GAS SERV ICE OUTLETS - - WATER HEATERS-- BTU OUTPUT - SEWER CONNECTIONS ` SOLAR TANK' 'COLLECTORS ' SOLAR PIPING SYS. - ISSUE FEE ` MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0.100,000 BTU 100,000 +BTU REFRIGERATION SYSTEM - ' ' 0-100,000 BTU 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE DrivISSUE FEE- ers' License or SS - CMF 0865.46 White-Buitding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 2 122 12 3 / a2 ZONING REGULATIONS A.P. :# ZONE PLNTG.. REF. :P BUILDING SETBACK C/L ST. pR OgPLI♦TY LINE SID TYARD LLRI GENERATOR -0-1 TRANSFORMER APPLIANCE II GFF H T ' 1-10 KW 50 + KW -- REAR YARD (TO P[L) :0.1 HP' 10.50 HP PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: POLE LIGHTS ELECTRICAL PLAN CHECK - . - ISSUE FEE- GENERATOR -0-1 TRANSFORMER APPLIANCE KW - 10-50 KW, 1-10 KW 50 + KW -- MOTORS - (INC. SOLAR) - :0.1 HP' 10.50 HP 1-10 HP '- 50 + HP - - - FIXTURES - OUTLETS SWITCHES- - GAS'TUBE'SIGNS' -- - POLE LIGHTS .GRADING . $ PLAN CHECK'S ELECTRICAL r O'er• •• POLES METERED SUB. PANELS -MAIN SUB - SERVICE �wAMP . - ISSUE FEE- ' APPLICATION APPROVED BY DATE SUMMARY OF FEES 'BUILDING- - - - - PERMIT g SMTP, Ste^ PLAN CHECK' $ -PERMIT. ISSUANCE' $ PLUMBING $;+ - .GRADING . $ PLAN CHECK'S ELECTRICAL r O'er• •• is -' - PLAN -CHECK $ - MICROFILM;_$ -• 4 ;' TOTAL',FEE $ + MECHANICAL $ _ LESS AD- PL -AN CHECK-- $ ' VANCE'PC •$ ' I r - FINAL FEE 16 CONSTRUCTION AND PLANNING Date APPROVALS Permit # `:+ InspectorDale POOL & SPA APPROVALS Permit,# i- .. Inspector 1. Temporary Electrical Service or Pale 43. Pool &Equipment; Location 2. Soil' ipe-Un rgrn 44. Steel Reinforcement 3. -Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46.. Electrical Bonding .. 5. Steel em orce 47. Rough Plumbing &Pressure test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUN ITE 7. Footings 49. Electrical Conduit-Undr rn ..8, . Foundation 50. Gas Pipe, ❑ Undr-rn, Test, • , 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑•Un`dr rn - - 10. Structural Floor System 52. APPROVAL TO DECK _ 11. Property Sewer Line & House Connection 53. . Backwash & Receptor-Final 12. Street Sewer Connection L 54. Heater &Vent-Final 13. Rough Plumbing . 14. Rough Electric-Conduit -' - +. -,� -.•56, Electrical-Final 15. Rough Electric-Wiring _ - 4 57. -Solar System=Final 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts; in Structure APPROVED_ FOR PLASTERING -18. ' Ducts, Ventilating. _ 19. Gas Pipe-Rough &Test 20. Roof• Frarning 60.. POOLISPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashin _ NOTES: .. 23. Insulation _ 24. Lathing & Siding 25. Drywall Nailing - - -26. Plaster Brown Coat 27,,-, Electrical Power Meter-Final' 28: Lzl Final Electric 29. Final Heating & Air Conditioning 30. . Final Gas Pipe-Test _31... Final Plumbing " 32.--` Water Service-Final - - -- .--- _ .• ` 33, Gas Service-Final - 34. Solar Domestic-Fin-al 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations -- - 38. FINAL. STRUCTURE &-BUILQI(VG 39. Special. Requirements Completed 40. Electric, Release to Edison ' 41. Gas Release to Southern California Gas Co.1" 42. QERTIFICATE OF OCCUPANCY Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations, ' CITY OF COSTA MESA'___ -' - T µ PERMIT NO. TRACT NO. LOT NO. BLDG. 1 �1a i1 � l -";+ _- GON5TRUCTION PERMIT i = 4" !Applicant's Mailin Address 5 1 sway _ '; f Os a "lesa'- TYPE O_FCONSTRUCTION NEw ADD' ALi- RATiON' REPAIRh�ojectAdaress 151 Airway. -204; Xosta "Hess ❑}GONVERSION ❑ DEMOLISH ❑OTHERt Shearson%Al�jeri can Expre�,, '955-7200 • DESCRIPTION OF wORK tenant]mlpr-ovemen.t-o9FlciF one i •. `' I G REG L 1 SAddres: •s' =19000 4i iiacArthur- 8th f.I Newport ;kach6TOm TYPE OF PERMIT- GRADING FOUNDATION D STRUCTURAL' ' 2, f 29 V V ZONE' ��I-1 Carle OSASSOC. Arch/Eng. License No. ®iTENAiVT ❑ELECTRICAL ❑;PLUMBING ❑MECHANICAL' .» e is :BUILDINGAdd1.ress '17779•F. Naln .St: Irvine I E ❑•,OTHER r^.) I '' n t I NGI_ :REAR YARD (TO P/L)540-2606. r Contractor's Name- J: -Donal d-U� SOn Phone 'PROJECT DESCRiPTIION; SO. FT. • - OCCUPANCY ' LINE' 31 1tAirwa -1, Costa Mg sa l Address (mailing) y CONSTRUCTION TYPE • VALUATION $ ! YARD RIGHT SIDE YARD, , ;• " �;� 1 License No. ZONj �� 1 GRADING CU. pKG.SPACE REQ. I PROVIDED I ) __ L10EHlSEO CONTRACTOR OECL'ARATIONi 1 I y { Remarks: I 1 J 3 S Y 6�_ . { STREET WIDTH ; _ PARK FEE-$ i : I=, 1:hereby,affirm that'l.ain licensed under provisions of Charter.9 (commencing i with sectlon 7000) of Division 3 of the Business and Professions Code, and ��/ d� �/ �, v ' SPECIAL CONDITIONS: #+ my license IS in full ffoOrce and!effect• L'(cense I s I cense o. 39b9 ? PLUMBING - i I late I Signature ' i Bar Sink t Sewer Cap f , ELECTRICAL i WORKERS' COMPENSATION DiCLARATIO ! ! hereby.afflrm that.l.have a•certiflcate of.conse to,setf-Insure o-a.cl3rtlilcate - -- I Backflow•Preventer - Sewer Connection'--- - -j - --• - Automatic Washer + Meter Dover 100 amps -- _ of Workers' Compensation Insurance, or a certified' Copy thereof (Section ' • Construction Pole t Sub Pane(` 3800, Lab. C.) 1 { 1 ! $ackflow Irrigation ' S Solar. Collectors l �`7 Policy No. Fr �T-I Company a Certlfled copy Is hereby furnished. Bul Bathtubs -. Solar Piping' i 1.1 1 Cooking Unit i Y Sub Pole ` 'I. i , r i Llj Cert(ep,ypp [ tiled with the city g D Applicant , Clarifiers 1 I Solar Tank ; Dishwasher i ! Motors ❑0-1 HP Q 1'h 8 k _ _ ;-EXEMPTION;FROMWORKERS' COM ENSATld ECLARAT! N _. !-Dishwasher i _ _ SwimmingPool,w/Spa', j 1 _ Dryers ❑Gas:DElectric "","' 11nc:Sola�t❑9-15 HP'❑,16-15+" (This section need not be completed if the permit Is or one huntlre ( i ooyor t lin , __ • i Fan ,Microwave } ! I clesertify tthat the performance of the work for which this permit is issued 1 Drinking Fountains i Urinal i �; �; i i Nw i i t shall: not' employ any person in any manner so 'as to become subject. to tie ! Workers', Compensation, Laws California., ! • Floor Drains I { Water Closet; ; 1 F,A.U. ! I ' ' 1 'Pole Li ht I ! 'Lighi f s f of { { , Signature l { ' NOTICE. -if, after making this declaration; you should become subject to the ;1 { - 1 I ,� Fixtures y r Water.Heate�, - --, ---� - --•�- - -- - - - - __i . n m 'Range 1 _ _. 9 -i w_ j 1 _ +_ ~`� - F160r Sinks -�• - - ... Workers" Compensation, provislons.of the Labor. Code,.you,.must. -forthwith comply ,withl such .provisions` -or ,, thls:'permlt •shall be ;deemed revoked: - _ Gas ServlCe' Outlets 1. -` ; r� Water Service r . i " i Device Boxes (` t , Sign = r ; 1 CONSTRUCTION: LENDING AGENCY I hereby affirm that there is a conitructlon lending agency for the performance 1 ( I interceFtors : �: - - ., [ r- ' r ! I Outlets I i , Standing Sections E { of the work for wits this; permit is issued .(Section 3097; Civ: C.): Lender's• Name. I�fhtr. ' 4._ , - t. r. - -„ } - - —' i - , Kitchen Sink; " - r s - s . - ,G Switches 1 Trash Compactor 1 'Z I Lender's' 'Address = OWNER•BUILOER DECLARATION -1 2' ' w t { i - I Lavatoriesu r� I , _ Gariiage Disposal 1 i I hereby(affirm that I am -exempt from the,Contiactor's, License Law for the ' 1 p -Trap! ' i p; `. * `: i i r" ' , Generator; ❑0;5 KW 05-15 KIN 1 following reason (Sect ion'7031:5 Business and ProfesslonalfCode: Any city or ; ' ounty which requires a permit to construct', alter, Improve, demolish,or,repalr -r structure' prior to its,lssuance, also requires the applicant for such permit' r , - _ t _ Transformer ❑ 15-50 KW • 1 ' I { - ., = I .W Roof.,Drains C• - 4 a - i I > !-„,-file a signed statement that he/she Is licensed pursuant to the provisions of Contract or's: Ucen se Liiw;(Chapter.9 (commencing with 'Section 7000) of r. 1 i-- L ( r , _ �, ' ❑50 + KW ! 1 } ( Reinspection Foe vision ,3 -of the:Business and' Professions' Code) 'or that he//she'-is}exempt the,basis,for the Any ;r n Showers (T 1-;. r, i T Reinspeetian,F- $15 Met9_r ❑up to 100 amps 1 $ 3. therefrom and alleged exemption: violation•of,Section 7031;5 by )any applicant for a permit -subjects .the' applicant to, a- civil of not more than five hundred dollars ($500): I' %: j. ,r Y t _ - e , : Service Sink' , Issue Fee - i'ing $ 3enalty Issue Fee Apprcired Bylt I,`as owner of thelproperty orlmy employees.wlth wageslas their sole 1 ' T compensation wlll:do the work, andthe.structure is not intended or offered sale:(Sec{!on 7044, Business, and Professional -Cade: The Contractor's _ MECHANICAL i _ r - i ! lication Approved Byafor —��83 License Law does not apply to`an owner of a property.who builds or Improves ( 1 Boiler �' { Refrigeration System ,hration Issued B 1 y I • Data r��thereon,;and who'does'such work.himself/herself or through his or her own l employees, provided that such•Improvements are(not Intended or offered for + i f ❑10Q000.BTU,sale. If, however, the building or Improvement Is sold within one year of com- ! the owneriwill have burden of he/she did not build or im- Duct Under Ground !!❑0100OOOBTU , , { Irove S MARY OF FEESpletlon, � ,the proving for'the purpose of sale), i( _ = t i Duct - Structural i I I System RepairlAlte'ration 1. I ;BUILDING PERMIT $r _11-11 SMIP } $ I I, as owner of the property, am exciuslveiy contracting withilicensed con- ( j ..tractors SO COnStrlfCt,the.prOleCt_ $ectlOn_7044„Business and,Proie551ons Code, ,,,, Duct_- Ventilatin ( I _ _ 8..,_ �_,...._ �._ : i _j I �4 -�_ _-.;. _ � ' i -1 JPLAN CHECK $ PERMIT , 1 � , The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- i tractor(s) Il cense pursuant to the Contractor's License Law): i Exhaust System ❑ Multiple ❑; , { I 1 1 I i I (PLUMBING $. F ISSUANCE ; $ ! t 1 1 : I 1 ❑lam exempt under Section i B. & P. C. for this reason 1 Firepl/FaCt. Bit. ICBG 1 i PLAN CHECK i $ 1 GRADING $ { ( 1 i ; 4 'ELECTRICAL' $ ! l $ 4 ' Date. ' i Owner] f H-ating�System & Ducting I i ©a100;OOO.BTIi ❑100,000B # i' + } I I !PLAN CHECK . $ I ( { MICROFILM $ t Thereby. certify that -I have read this application�and-state tliat-the-abava information ls-correct, I agree to comply with, all city and county ordinances - -- 3 +. -- •+� -;� - �' --( i I I 1 : , TOTAL FEE $ and, state laws rel Ing to building co structiart,tand hereby authorize repro- i sentatives of ! thl clty• en r n the above-mentioned property .for Hood or Type I ❑ 1 I y Reiagpectian Fees $15 MECHANICAL $ I' ! i ! PLAN CHECK $ i t v I I LESS 1 I Inspection purpo S. + I- Canopy' T e 11 ❑ I , ADVANCED PC '• $ } Signature Date 18/24/83 1 1 3 Drlvers' Llcense orSS I ' 1 r 1 g Register k ( Issue Fee I $ 3 — - t i FINAL FEE; $ CMF 0865-46 rev, 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor *�,CONSTRUCTION,AND-PL,A!V IN r �'I x' :''. �:'' ^o= P `& SPA, _7_<<" r �� , ',-.-APPROVALS f; Permit ¢= Date .Inspector - --'AP.PROVA!S Permit•#6" + Date Inspector. 1, Temporary Electrical Service or,Pole . " 52. Pool &Equipment Location •• [ - f` ri - . r - - 2' Soil Pipe-Undrgrnd. � ' 53' Steel Re-inforcement - 3t Electrical Conduit Utility-Undrgrnd. 54.s Forms r 4: Electrical Conduit-Undrgrnd. ;r / ` - : 55. Electrical'Bonding c 5? Steel Reinforcement 56. Rough Plumbing .& Pressure Test � 6: s = - �y ,Electrical LIFER Grnd.j ;, j - ' y _ . 57.; APPROVAL TO COVER GUNITE , ' 7. Footings' y 68.iectrical Conduit=Undrarnri_ - B. Foundation '59. Gas Pipe,' -d Undrgrnd ;Test` 9. Water` Pipe-Undrgrnd. l t ,, �� r - _ '60. BackwasFi Lines, P_Trap, ❑ Undrgrnd. ' : •. - 10. Structural Floor System �r .61. APPROVAL TO -DECK 11. Property Sewer Line &:House�Connection 62. Backwash &Receptor Final 1 12, Sewer Cap ' ! r - $3. Heater & ;Vent -Final ^ 13. Roof Drains F i r 64. Plumbing;Systern - Final - 14. Rough Plumbing [ = # ` •65. Electrical -Final %n ' 15. 'RougITElectrical-Conduit-,-i-;, i "'� "'j r- 7 -66. S3Iar�Syst:em 9x167. 1RR6u h Electric Wirin , c ?1:6: l g - ,• - -_-4 Fencing& Access;Approval - ,• - - __ ,1r7'. Nbugh Wiring Sign'- - ' ., l , I i j j6$.' APPROVED FOR PLASTERING - 181;Rough'Electrical:TrBar Ceiling, r: I :_ I �'.. v ;69.� POOL/SPA SYSTEMS FIINAL �RoughJHeating &IQir Conditioning { I - DEPT. REQUIREMENT { i+ 'FIRE APPROVALS O ; Permit 20. -Rough:Faetory Fireplace ,�` ` ! i i 21. Ducts, in Strda tuie•' "F �` �� f 170. Underground Hydro ' 224 "Duc"ts, Ventilating'-; '+ i� I I 71.1Product Piping ❑Gas ❑Oil i I r23. iGas'Pipe'-Rough & 'Fest ' 3 ' f 1 r i72. Underground Flush 1 - , _I _ i 24., Roof Framing s ` j �' i 3 I E _ s73: Undergrnd. Storage Tank ❑ Gas ❑ Oil f.� _ s . 25. Roof Sheathing ? t i �: ;' 74: Overhead Hydro i :-26. T -Bar Ceiling (Structural), &'Nlonocoat' ! - ' 75. Dry Chemical h r r`-27: Frame and Flashing 1 ;76- Dry Standpipe 28" thing & Siding � ',77: FIXED SYSTEM FINAL ; 29.' Insulation i ,1 FIRE PREV. FINAL s ,78' 30: Dry wall Nailing l r f ' b=5 q Notes:` r 31 ~'Plaster Brown Coat, i }J32. Electtical Power Meter -Final ' 33. Final Electric i " 34'. FinalYHeating &';Air Conditioning I � ti c 35. Final Gas Pipe-fest 36. Hood or'Canopy r r i s i 37. Final Factory Fireplace , T . I • , v 38. Final Plumbing! r c 39. Water-,Se'rvice-Final ' ' , s , 1•'� s I � I 1 , I ! 40. Gas Service -Final - 41. Solar Domestic -Final 42. Backflow Preventer - -y - - - - - 43. Backflow Irrigation 44. Landscape IrrigatiomSystemj 45, Sound Attenuations 46. Handicap Regulation's i ' I I I 47. FINAL STRUCTUfRE,& BUILDING, 5 1. «� �• ; 48, Special Requirements Completed "• 4 ' , - r , , 49. Electric Release 'toIEdi son 50. Gas Release to Southern California Gas Ca i 51. CERTIFICATE'OF OCCUPANCY _T_ No rs Date r - - - CITY OF COSTA MESA CONSTRUCTION PERK IT Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - PERMIT MD.. r 1 TRACT NO. I LOT NO.- -1 BLDG. NO. Project Address- _ ('/v t -J Applicant's MailingAddrress �%/1 '� L !w PALkinid POwner's Name r0r ._Phone Address Arch/Eng. License No. Address , Contractor's Name�149`N�v vhf — A'C—& ' Phone o 644 Address Imailingl City License No. LICENSED CONTRACTOR DECLARATION ' I hereby affirm that 1 am licensed under provision$ of,Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In f Il f and effect. Licens las tn ens /� Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section , 3800, lab, C.) Policy No. Company eCertified copy is hereby furnished. , Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this ermlt is'issued, I shall not employ any person in any manner a o bec subj to the Workers'10pM? rys�tiQrs� aws of CaII! Date , ( i (Signature NOTICE: If,'atter making this declaration, you should become ject to -Workers' Compensation provisions of the Labor Code, you Aust forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION 1 hereby, affirm that I am exempt from the Contractor's License Law for the following reason -(Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish.or repair •ny structure, prior to Its issuance, also requires the,applicant for such permit • file a signed statement that he/she is licensed pursuant to the provisions of e Contractor's License Law (Chapter 9 (commencing with Section 7000) of - .rivision 3 of the Business and Professions Code) or that he/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 enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License law does not apply to an ownor of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of com- pletion, the owner will have ,the burden of proving he/she did not build or im- �yve for the purpose of sale). L� I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's Ucen$e law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that I have read this application and state that the above information is -correct. i agree to comply with all city and county ordinances and state laws relating to b Iding co structlon, and hereby authorize repre- ' sentative$ of this city. t er th above-mentioned property for inspection _ Gam/ Signature Dater 42 Drivers' Lic nse or SS Reinspection Fee $25 GMF 0865-46.rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 5483 9/12/83 Zone Accessory Building: Park.Fees $ Bar Sink Showers $ TYPE OF CONSTRUCTION LJ NEW LJ ADD ❑ CONVERSIONy ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK LJ ALTER TION LJ REPAIR A.P. # S T B A C K S Main Building:' TYPE OF PERMIT GRADING 11 FOUNDATION ElSTRUCTURAL ❑ TENANT ❑ ELECTRICAL: ❑ PLUMBING ❑ MECHANICAL ❑ ,OTHER Front Rear PROJECT DESCRIPTION SQ. FT. CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. OCCUPANCY $ ACRES Right Left Ping. Ref. # Remarks: 421 $ Parking Req./Provided Meter ❑up to, 100 amps Drinking Fountains Use of Building: PLUMBING FEES Planning Notes: 5483 9/12/83 Zone Accessory Building: Park.Fees $ Bar Sink Showers $ SMIP $ Backflow Preventer Backflow Irrigation Service Sink Sewer Cap PERMIT ELECTRICAL Bathtubs Sewer Connection $ Automatic Washer Construction Pole Sub, Transformer El15 50 KW ❑ 50+ KW Clarifiers Solar Collectors Dishwasher l Solar Piping $ Cooking Unit Meter ❑up to, 100 amps Drinking Fountains Solar Tank Dishwasher Meter ❑over 100 amps Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Floor Sinks Urinal Fan Motors ❑0-1 HP ❑ 11/2 - 8 Gas Service Outlets Water Closet F.A.U. Inc.Solar 139-15 HP ❑16.15+ Interceptors Water Heater Fixtures, Microwave Kitchen Sink - Water Service Device Boxes 'Pole Light Lavatories Outlets .. Range P—Trap Switches Sign Roof:Drams Garbage Disposal Standing Sections J Generator ❑0.5 KW 1-15-15 KW Trash Compactor ' Reinspection Fee $25 issue Fee S 3 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bft. ICBO # Heating System & Ducting ❑ 0.100,000 BTU ❑ 100,000 ST Al O ,N N G R E Q U I R E ;M 'E A 'T FEES M■ ©0 WE M® M■ M■ M■ -■ WE O■ -' ` ' Reinspection Fee $25 1 Issue Fee $ 3 MECHANICAL FEES Hood or Typel ❑ PUBLIC SERVICES REQUIREMENTS: Canopy Type 11 ❑ 4 Zoning Appirovod By Date Application.Approved By Date �s i- '7 Refrigeration System ❑0.100,000 BTU 0100,000BTU System Repair/Alteration Issue Fee $ 3 BUILDING ^PERMIT PLAN CHECK PLUMBING PLAN CHECK r ELECTRICAL PLAN CHECK MECHANICAL r" PLAN CHECK' SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ $ 4 ENERGY P.C. $ $ GRADING $ $ MICROFI LM $ ! $ $ TOTAL FEE $ `^ CONSTRUCTION AND PLA NIN APPROVALS Permit #� Date Inspector L & SPA APPROVALS Permit # Date Inspector 1 .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 LIFER Grnd. - s 57. APPROVAL TO COVER-GUNITE - ' 7. Footings 58.. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, O Undrgrnd., Test , 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System r 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 177. 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 APPROVALS Permit # `-20. Rough Factory Fireplace 21. Ducts, in Structure 1 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23, Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 9. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79, FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED I 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 i 43. Backflow Irrigation w 44. ,Landscape Irrigation System 45, Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY, No. AZ2 3 2- Date Applicant to fill in all spaces except those within heavy border lines and S!w all appropriate declarations. • * CITY OF COSTA MESA I PERMIT NO. TiiACT NO. LOT NO. } B DG, • ODNST'RUCT•ION PERMIT -7 D ;2L � - ' Cooking Unit Meter up to 100 amps - r — less): I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank Project Address i icJ d TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR shall, not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California.l Date Signature Floor Drains Swimming Pool w/Spa i 2D rr♦♦ ❑ CONVERSION DEMOLISH ❑ OTHER Fan, I Motors ❑0-1 HPe<'/— 8 Duct- Under Ground Applicant's Mailing Address iY� :❑ A.P. Refrigeration System Owner's Name Phon (j _� DESCRIPTION OF WORK S Main Building: I hereby affirm that there is a construction lending agency for the performance of the work .for ,which this permit is issued ,(Section 3097 Clv. C.) AddressW TYPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL T Front _ Lavatories Outlets f Range Arg/Eng.' License No. ❑' TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Garbage Disposal Standing Sections Firepl/Fact.Blt. ICBO # Address' ❑ •OTHER ', A Rear the Contractor's License Law (Chapter 9(commencing with Section 7000) of -Division, 3 .of the Business and Professions Code) or that he/she 1s exempt W� iC� A - - Contractor's Nam Phone PROJECT DESCRiPTiON SQ.'FT, OCCUPANCY C K Right Address (mailing) D ^e V CONSTRUCTION TYPE VALUATION $ S Left! 1 City ;License No. ZONE GRADING CU.YOS. ACRES - Ping. Ref.+ i PLAN CHECK $ LICENSED CONTRACTOR DECLARATION ' Remarks: Parking Req./Provided I -hereby affirm that I, am licensed under provisions of Charter 9 (commencing , with section 7000) of Division 3 of the Business and Professions Code, a Use of Building: my license is in full force and'effect, r License is Li c Z PLUMBING FEES Planning Notes: DatetdZ .�� Signature ' /L✓ 7 y Bar Sink t Showers WORKERS' COMPENSATION DE9(ARATION ' I hereby affirm that I have a certificate of consent to self -insure or a certificate Backflow Preventer Service Sink -of Workers' Compensation Insurance,.or a certified copy thereof (Section �• 3800, Lab. C. 7/ 1' } g Backfiow lift ation Sewer Cap " Policy No.,�(__�_. Compa�ny!_T-e zone -- , Accessory Building: Park. Fees S i ELECTRICAL FEES Z O N I N G R E O U I R E M E N T S Q4 : rtified co is hereby furnished, . r� Copy Cer ' 1 op Neal with the city Bttlfdr g Divi�}6ji. /' Date ,j Applicant--om f/ -t i`r�� Bathtubs ,) - Sewer Connection Automatic Washer -Transformer © 15-50 KW - ❑ 50+ KW Construction Pole_ Sub. �„ J " Glarifieis rti Solar Collectors EXEM ION' ROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed if the permlt,is for one hundred ($100) or -' DIShWasher` Solar Piping P g - ' Cooking Unit Meter up to 100 amps - less): I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Solar Tank Dishwasher Meier Dover 100 amps ; ' Boiler - shall, not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California.l Date Signature Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel Floor Sinks Urinal Fan, I Motors ❑0-1 HPe<'/— 8 Duct- Under Ground NOTICE: If,'after making this declaration, you should become subject to the Workers' Compensation provisions of'the-Lab 0r Code, you -must forthwith j7' Gas Service -Outlets ,Water.Closet F.A.U. Inc. Solar 09.15 HP El 16-15+ Refrigeration System comply with Such provisions or this. permit, Shall be deemed revoked. CONSTRUCTION -LENDING AGENCY Interceptors Water Heater - Fixtures •1 /�, Microwave ' ❑0-100,000 BTU ❑100,000 $TU - , I hereby affirm that there is a construction lending agency for the performance of the work .for ,which this permit is issued ,(Section 3097 Clv. C.) 7 Kitchen Sink Water Service r Device Boxes , Pole Light Lender's Name- - - _ Lender's Address _ OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the 'oliowing reason (Section 7031,5 Business and Professional; Code: Any city or runty which requires a permit,to construct, alter, improve, demolish or repair _ Lavatories Outlets f Range P—Trap _ Switches a Sign Roof Drains - Garbage Disposal Standing Sections Firepl/Fact.Blt. ICBO # ry structure, prior to its Issuance, also requires the applicant for such permit o file a signed statement that he/she is licensed pursuant to the provisions of I Generator 00-5 KW ❑5.15 KW Trash Compactor Date OwnerI - 1 here certify that I have re his application acid state that the above infor tion is correct. �1 agree 't comply with all city and'county ordinances.. and state laws relating -to buil ng construction; and hereby authorize repre- sentatives of thi city to en above-mentioned proper y f Inspection purp sn Signature �`-�` the Contractor's License Law (Chapter 9(commencing with Section 7000) of -Division, 3 .of the Business and Professions Code) or that he/she 1s exempt Z O N I N G R E O U I R E M E N T S ,therefrom and the basis for the alleged exemption. Any violation of Section 7031,5 by any- applicant form permit. subjects the, applicant to a civil 9 enaity of not more than five hundred dollars ($500). • I, as owner of the; property employees with wages as their 'sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code:' The Contractor's License Law does not apply to an owner of a property, who bu€Idsor improves thereon, and 'who'does such work himself/herself or through his or her own employees, provided thatsuch improvements are not intended or offered for sale. If, however, the builcling or improvement Is,sold within one year of Com- pletion, the owner will have'the burden of proving he/she did not build or im- move for the purpose of sale). Reinspettion'Fee $25. Issue Fee �.3 Reinspection Fee 1 $25 Issue Fee $-3 L MECHANICAL FEES Boiler - •- Hood or. Type i ❑ Canopy Type I I ❑ PUBLIC SERVICES REQUIREMENTS: Zoning Approved By ate Application Approved By Date Application Issued By r f Dat l3 Duct- Under Ground Duct - Structural Refrigeration System LJ I, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does -not apply to an.owner of property who . builds or improves thereon, and who contracts for such projects with a con- tractor($) license pursuant to the Contractor's License Law), { ❑"I am,exempt under Sect€on & C. for this reason ❑0-100,000 BTU ❑100,000 $TU - , Duct - Ventilating SUMMARY OF FEES BUILDING PERMIT $ 5M[P PLAN CHECK $ + PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. ' $ ELECTRICAL $ 9'3 GRADING i $ ' PLAN CHECK $ r MICROFILM $ 7 MECHANICAL $ TOTAL FEE $ Exhaust System El Multiple ❑ System Repa€r/Alteration - Firepl/Fact.Blt. ICBO # I Date OwnerI - 1 here certify that I have re his application acid state that the above infor tion is correct. �1 agree 't comply with all city and'county ordinances.. and state laws relating -to buil ng construction; and hereby authorize repre- sentatives of thi city to en above-mentioned proper y f Inspection purp sn Signature �`-�` . Heating System & Ducting ❑0.100,000 BTU ❑100,000BTJ -- - - - - -- - - 1 - - - _ _ i i I i r 1 Drivers' L' nse yr SS I Reinspection Fee , $25' Issue Fee $ 3 PLAN CHECK $ CMF 886-46 iev. -7/83 - White -'Building; Canary - Appllcant;•Pink - Accounting; Goldenrod - Assessor. ��_o " CONSTRUCTION AND PLANNING APPROVALS Permit # g�p�= • Date Inspector jOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole r 52. Pool & Equipment Location l 2: "soil Pipe-llndrgrnd. 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 LIFER Grnd. +` 57. APPROVAL TO COVER-GUNITE } 7. Footings ' 4 58. Electrical Conduit-Undrgrnd. i 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9' Water"Pipe,Undrg'rnd, 60. Backwash Lines, P_ -Trap, ❑ Undrgrnd. 10.1Structural 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 Plurnbing ' 65. Electrical -Final 15. Rough Electrical -Conduit ' , 66. Solar System -Final 16. Rough Electric Wiring Q� - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR'PLASTERING 18. Rough Electrical -T Bar Ceiling $ g e 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. ,Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping I] Gas ❑ Oil 23, Gas Pipe -Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank I] Gas ❑ Oil 25. Roof Sheathing i 74. Overhead Hydro 26. T -Bar Ceiling (Structur"al) & Monocoat 75, Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 130. Drywall Nailing HEALTH DEPT: REQUIREMENT •31. Plaster Brown Coat 79. FINAL INSPECTION :32.. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric rf Notes: 34. Final Heating & Air Conditioning. 35, Final Gas Pipe -Test - r 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 t 43. Backflow Irrigation , 44. ,Landscape Irrigation System 45. Sound Attenuation ! 46. Handicap Regulations , 47. FINAL STRUCTURE &BUILDING ' 48. Special Requirements Completed 49, Electric Ralease to Edison 50. Gas Release to Southern Califoenia'GasCo 51. CERTIFICATE OF OCCUPANCY No. Date Q Applicant to fill In all spaces except those within heavy_ border lines and_slgn all appropriate declarations. ,ZY OF COSTA MESA ' I PE MIT NO. TFj(><CT NO. LOT NO. BLD CONSTRUCTION PERMIT.�[�►'1 /5c� ! /�,q,Q, f Applicant's Mailing Address rw4 ' t- Costa 'ieSa TYPE OF CONSTRUCTION. KJ NEW 0 ADD LJ ALTERATION LJ REPAIR PrajectAddress �15i rkvav i; CO$La �eSa ❑CONVERSION ❑ DEMO H q O HER 71cip.I=_r-205, EX@Cuti Ve {alit � I 06 DESCRIPTION OF WORK enaill, Ill roveClen lr -y4 -Phone Owner's Name (i— - -�-'-� - ' IG YARD' Address M51 Airwa�-CostaMesa" Arch/Eng: I Oill (,allil7OS-'�Y Assocf1: ____License No. YIP�EIOF PERMIT GRADING ❑ ELECTRICAL FOUNDATION STRUC ❑ PLUMBING ❑ Addiess 17779-I- 1 aln. Jt: Irvine YJ TENANT ❑OTHER MECHANIC Contractor's Name J. ' bolo( U=Olson Phone 540-2600 PROJECT DESCRIPTION. SQ.�T- 1J6;? - OCCUPANCY - -- Address Irnailing) 31.51 Ai rVjav'Ave • _E-1; _COSt:d__ PJe$a CONSTRUCTION TYP _- _ VALUATION $ 20 475. Uu License No. __ ZONj= GRADING CU.YDS. -ACR1=5 LICENSED CONTRACTOR DECLARATION Remarks: » JIV 'J'` .H,7941 Fixtures. I Hereby affirin that ].am licensed under provisions Of Charter -9 (commencing $ $ Device Boxes i with section 7000) of Division 3i of the Business and Professions Code, and ELECTRICAL Outlets my license Is In full force and effect. �y Switches Ucense CI s rise N 3969 ! PLUMBING _ Date Signature WORKERS' COMPENSATION DECLARATION i Bar Sink Sewer Cap , I hereby affirm that l have a certificate of consent self Insure or a certificate Backflow Preventer Sewer Connection' Of Workers' Compensation Insurance,' or a cortlfied' copy thereof (Section $75 _ 3600, Lab. C.) r F->��S Cal rfllOflt Backflow Irrigation Solar Collectors _ - _L Policy No Company FINAL FEE' 1 $ .73 Certltled copy Is hereby furnished.Bathtubs ' Solar Piping Certlf is filed with the city 6 n9 fon. Clarifiers Solar Tank Date//� Applicant EXEMPTION°FROM WORKERS' CO NSATI O LARAT N (This section need not be completed If the permit or. one hundred ($100) or Dishwasher Swimming POOL vv/Spa Iess). I certify that In th0 performance of the work for which this permit is issued I so as to become subject. to the Drinking Fountains - 9 Urinal _, shall not employ any person In any manner Workers', Compensation• Laws of i California., Floor Drains Water Closet Date ( signature NOTICE: If, after'making this declaration, you should become subject to -the-, F(oorSinks'•--' �-- 1 -,- - Water Heater Workers'i Compensation provisions lot the Libor Code,lyou•must forthwith comply with, such provisionsjorFthis perrnit,shalli be deemed revoked.; t? Gas Service` Outlets' Water -Service CONSTRUCTION'LENDING AGENCY • I hereby affirm that there is a`constructlon fending agency for the performance Interceptors of the ,work for w�1 ; this permit Is Issued • (Section .3097 Civ. C.) l l _ ` Landers' Name'' ni I Kitclien Sink t Lender's Atltlress • ^ __ _ + L OWNERFBUILDER DECLARATION `� r .1 + _ I ;- Lavatories • , - .'. _' + ; ' I hereby affirm that I am exempt from the Contractor's License Law for the.' following Professional1COde: Any P--Tre P reason(Section';7031.5 ,Business and City, or, county which requires a permit;to construct, Biter improve; demolishlor,repair ' any structure; prior to its'Issuanco,-also requires tNe applicant -for such permit- , to I r Roof Drains' 4, to file a signed statement that he/she is licensed pursuant the,provislons of. he Contractor's L(cense Law {Chapter 9 (coinmencIng with Section 7000) of- r.A .*kion :3 of the Business and Professions Code)' or, that he//she Is exempt the; basis for the Any violat{on'of.Section Showers R@inspection, Fee $15 r. �1,:refrom"and alleged exemption. by any applicant for a permit supjects,the applicant to a civil nalty of not more than five hundred dollars (3500)• i , I' t Service Sink Issue Fee $ H 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 ' " F MECHANICAL 1 ' for sale (Secfion 7044', Business and' Professional Code: The. Contractor's License Law does not apply to'an owner of a property who builds or Improves I - Boller. Refrigeration System thereon,;and who does. such work himself/herself or through his or her own aro Intended for t r employees, provided that such improvements not or offered sale. If, however, the building or improvement is sold within one year of trim- ' Duct= Under Ground ' ❑0:100,0006TU ❑100,000 BTU at 'a the Owner;wilI have the burden of prpving he/she did not build or im- rove for the purpose Of -sale}. - Duct Structural ) ; System Repair/Alteration I.as owner of the property, am exclusively contracting'wlthylicansed con-1 trdctorsto construct.the.projoct (Sectio n.7044,.Business.antlProfesslons code: The Contractor's License law does not apply to an owner of property who -:. Duct_ Ventilating_ builds or Improves thereon, and who contracts for such projects with a Con- I Exhaust System ❑ Multiple ❑ tractor(,) license pursuant to the Contractor's License L. i ❑ I am exempt under Section I B. & P. C. for this reason - Firepi/Fact. Bit. ICBO I } Date ` 1 Owner ' r Heating System & Ducting i I herebyy`'certlfy'that-I have'read this apptlGation-'and state that -the above lnformatlon Is 1 to all city and county ordinances `' ! • ❑a100,000BTU-❑100,000BT 1 - -- .-� - - - correct. agree comply w{trti and,state laws ret Ing to building c tructlon,land hereby authorize repre- Hood or T Type I ❑. { i sentative5 of j thi ,city enc the above-mentioned property for 1 , Cane T I I ❑" i R@Ifl3jleCtiOn.Fe@l $15 Inspection Dllrp i `. r• I I ' Dat@ d�2ts�33 e r Signature I i t 1 � Registers ; Issue Fee Drivers' License orj55 r CMF 0865-46 rev. 12/62 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor A. P. 4-— PLNG. REF. -0 LEFT SIDE YARD If`) PKG. SPACE REQ. �— STREET WIDTH SPECIAL CONDITIONS: - -, 167E - ZONING RE ULATIONS , ZONE !' BUILDING .Meter ❑over 100 amps REAR YARD (TO P/L) F " ' IG YARD' f� PROVIDED l 'Sub Pole PARK FEE $ , Motors ❑0-1 HP Eli,/2-8 $t- 0 Dryers ❑Gas ❑Electric InC.S6lar'0945 HP .❑16.15+ I , ELECTRICAL !' Automatic Washer .Meter ❑over 100 amps r Construction Pole Sub Panel f� Cooking Unit o l 'Sub Pole t ,yMMARY OF FEES ; Dishwasher Motors ❑0-1 HP Eli,/2-8 $t- 0 Dryers ❑Gas ❑Electric InC.S6lar'0945 HP .❑16.15+ tPLAN CHECK Fan r :Microwave ; Y F.A.U. Pole Light ISSUANCE i Fixtures. Range $ $ Device Boxes i 'Sign. ELECTRICAL Outlets Standing Sections �y Switches Trash Compactor ! Garbage Disposal _ MECHANICAL $ i Generator El 0-5 KW El 5-15 KW $ 'PLAN CHECK ' Transformer ❑ 15.50 KW 050+ KYV' 1 'Reinspeclion Fee $75 Meter ❑up to 100 amps I I ;Issue Fee' 1$ 3. Zoning Approved By 44Date FINAL FEE' I , Application Approved By 14 —fat@ Application Issued By i -—Data t ,yMMARY OF FEES ; ( l•' BUILDING PERMIT $t- 0 SMIP $ tPLAN CHECK $ 2 3, 10 PERMIT ISSUANCE i $ ; 1 PLUMBING r :PLAN CHECK = $ $ GRADING r ' $ ELECTRICAL $ $ PLAN CHECK $ { s MICROFILM $ MECHANICAL $ i TOTAL FEE' $ 'PLAN CHECK ' $ i' + , LESS !• r ADVANCED PC $ I I r 1 t FINAL FEE' 1 $ .73 A : CONSTRUC714NAND#PLANIN a F - zAPPROVALS Ptiermit #` ?Inspector ' - APPROVALS,Permit# TDate' :Inspector R 3�- Temporary Electricai Service or Pole ^'' . , o "' .152:, Pool & Equipment Location; N 2' Soil ripe-Undrgrnd: 1' f ' = i. _ �' 53.; Steel Reinforcement _ '- I r - 3? Electrical Conduit Utilitv-Ll idrg�nd.i• l 54:: Forms. ' r w t � k _ r. 4' Electrical Conduit-Undrgrnd'. _ `r' ,� : 55: Electrical-Bohding 7- i 5y' Steel Reinforcement '� I ` s;� - - 56. Rough Plumbing& Pressure Test _ , r 6: Electrical UFER Grnd. r> �' r - , 57.• APPROVAL TO COVE R-GUNITE r, 7. Footings - 58.` ElectricalcCoriduit Undror�rl. '- - 8. Foundation j - 59. Gas Pipe, iJ Undrgrnd.; Test r 9. Water Pipe Undrgrnd.y ' . - s - " i '60. Backwash'. Lines, P -Trap, 0 Undrgrnd. f 10. Structural Floor System °' �� V.61. APPROVAL TO -DECK 11. Property. Sewer Line & Housetonnection 62. Backwash& Receptor Final _ 12. Sewer Cap t , r�,. 63. Heater &Vent FineF. 13. Roof Drains ,'64. PlumbingSystem Final c 14. Rough Plumbing ! - z - 65. 6eictrical=Final-t i ` -f ! T ~M "; j -66. Solar System-Fi,n`al - r15.�Rough'Electrical-Conduit`Tr-rt ' _ h ElectricWirin9 . r4" Fn-i�16�Rop - 7,. ecng &:Access+Aiiproval -- - } a } � _ -�17"YRou h Wirin Si n ` } 9 { g g r •, " I I ; I f i . 1 � 68.IAOPROVED FOR PLASTERING ,a , I . 1 k' 18!`tRoughElectrical T -Bar Ceiling# " I = I 4 I c. !69.j POOL/SPASYSTEM'S FINAL 19. Rough'Heating & Air Conditioning j _ , , , FIRE DEPT. REQUIREMENT- ; APPROVALS I t Permit# u 20. tRough. Factory Ffreplace'�S I i 21. Ducts, in 5tcu4ture ; '} F. 1 € 70., Underground Hydro - 22' Duct's, Ventilating I A• g - 1 I { � � 3[:]Gas` 71. Product Piping [] Oil , I ; K _ 23� Gas Pipe Rough & Test ` �� ' `- i - 72. Underground Flush. = _ 24:!'Roof Fr1aming, s _ �r ,., -. 73. Undergrnd. Storage Tank D Gas ❑Oil ' 25: Roof Sheathing ; , " ; - ` " ; "! 74. Overhead Hydro ,. - •ir I .-2 6: T Bar Ceiling (5tructurall+& Monocoat` , ,`j.�Z �' 75.; Dry Chemical :27''Frame and Flashing_'Mi'.' # 76., Dry Standpipe } 28' Lathing &-Sidings i ;l , i j I f X77.; FIXED SYSTEM'F'INAL ' :lnsulation -_ `, r 1 '' r } I I; r � � � � 178.; FIRE PREV. FINAL -- 30,. Drywall Pj3il�tlg } j f '� ;3 °SNotes: ; I i - F Plester'BrQwn Coat 32.;,Electrical Power Meter -Final s l t I t 33. lh'al-Electric 34. Final Pleating &iAir Conditioning t 35. Final Gas Pi,pe,Test 36. Hood or Canopy 37. Final Factory F=ireplace= 38. Final Plumbing inal• 39. Water Service -I --� 40. Gas Service -Final"' !; i • , �, , 41. Solar Domestic -Final 42. Backflow` Preventer 43. Backflow Irrigation 44. Landscape Irri ' 1 - - gation�System 45. Soundl Attenuation Imo, r. 46. Handicap Regulations 1 e. 47. FINAL S�RUdURE & BUILDING 46. Special Requirerrmerits Completed , .. 49. Electric keleaseito Edison 50. Gas Release to Southern California Gas Co I t t , i - ' '� • �'' , 51. CERTIFICATEIOF,OCCUPANCY Date : No. tc/qf� GIT'Y OF, A MESA mlupr`RUCTION PERMIT N Applicant to fill in all spaces except those within heavy border lines and Sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO., BLRG. 2 71I4/B3' j6*00 TI ZONE BUILDING REAR YARD ITO P/L) RIGHT SIDE YARD ' PROVIDED l PARK FEE.$ ELECTRICAL Meter ❑aver 101) amps Sub Panel + ; Sub Pole l Motors 00-1 HIP 1 h-8 tric Inc,3olar;09-15 HP 016.15+ !Microwave Pole Light _ .Range Sign ° I r .Standing Sections Lender's, Name - qp�cant's Mailing Address ' ` " '" " r TYPE OF CONSTRUC710N LJ NEW iJ ADD i_ I ALTERATION LJ REPAIR Switches Address , t"C�p ❑ CONVERSION 11 DEMOLISH ❑OTHER -Owner's Ptlject I Name L hone DESCRIPTION OF WORK Garbage Disposal Address ��SI`��~ - TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL' A. P,� P-T�- Generator E10-5 KW 136-15 KIN Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECOANICAL following reason (Section'7031.5 Business and Professional Code: Any city or Address PLNG. REF.: f— ❑. -OT H E R PROPERTYTO ILONGNE PROJECT DESCRIPTION, SQ. FT. OCCUPANCY Contractor's Name' ='Vc1 ""' — -,Phone 63a _ Address (nailing) i�QA/r- 1.- 97 .1- CONSTRUCTION TYPE VALUATION $ LEFT SIDE YARD License No. r C - ZONE GRAOING CU.YDS. ACRES PKG. SPACE REQ. ' any structure, prior to Its issuance,'also requires the applicant for such permit ,kj1c► LICENSED CONTRACTOR DECLARATION Remarks: STREET WIDTH I hereby affirm that 1 am licensed under provisions of Charter 9 (cominencinq to file a signed statement that he/she Is licensed pursuant to the provisions of the ' with section 7000) of Division 3 of the Business and Professions Code, and SPECIAL CONDITIONS: Dein ctitln spa my license Is In f fo a d effect. , ''� y Contractor's License Law:(Chapter 9 (commencing with Sectlon-7000) of 4sion 3^of the Business Professions Code)' that' he/she_.Is 1 h Ucen Class ---� - -- - --may Ice Date � Signature / 42 PLUMBING ; Bar Sink Sewer Cap and, or exempt refrom and the, basis for the alleged exemption. -Any violation of Section WORKERS' COMPENSATION DECLARATION - - . Meter Cup to 100.amps •I hereby affirm that I have a certificate of consent to self -insure or a certificateBackflow • Preventer Sewer Connection Automatic Washer 31,5 by any applicant fora • permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). of Workers' Compensation Insurance,, or a certified copy thereof (Section . Construction Pole + 3800, Lab • Ci) Backflow Irrigation Solar Collectors I; is'owner of the property or my employees with wages as tAeir sole compensation will do the work, and •the structure Is not intended or offered for -(Sec Ion 7044, Professional Certifled copy is hereby furnished. Cooking Unit Bathtubs Solar Piping 1 ata Cer�l�ed w,!&f with the city, �`r r. I Dishwasher Clarifiers Solar Tank Boiler t Date / L, Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLA TION , Dishwasher Swimming Pool w/spa < - Dryers ❑Gas ❑Ile Date (Thls section need not be completed If the permit Is for, one hundred ($100) or less). r i 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 to become subject. to the , � Fan i Drinking Fountains Urinal - Duct = Under Ground ! ,as Workers' Compensation Laws of California. i ( - - F.A.U. Floor Drains I p Water Closet' Dati Signature NOTICE -.-If, after making this declaration, you should -become subject -to the Fixtures. FIOtlr Sinks - , Water Heaters - r System Repair/AlterationBUILDING Workers' Compensation provisions ,of the Labor Code, you must ,forthwith comply with such provisions •or -this .permit 'Shall be deemed revoked., ! Gas Service Outlets r • Water.Service .� , -Device Boxes $ ' CONSTRUCTION (LENDING AGENCY I I hereby affirm that there Is a,constructlon•lending agencydor the performance, Outlets 'a Interceptors i u. I �J of the work for which- this, permit Is issued (Section ;3097 Civ. C:). ' PERMIT 2 71I4/B3' j6*00 TI ZONE BUILDING REAR YARD ITO P/L) RIGHT SIDE YARD ' PROVIDED l PARK FEE.$ ELECTRICAL Meter ❑aver 101) amps Sub Panel + ; Sub Pole l Motors 00-1 HIP 1 h-8 tric Inc,3olar;09-15 HP 016.15+ !Microwave Pole Light _ .Range Sign ° I r .Standing Sections Lender's, Name - Kitchan'Sink - ' r Switches Trash_ Compactor ; Lender's Address OWNER,BU1LOER i^ Lavatories; Garbage Disposal DECLARATION' c I hereby affirm that I am'exempt from the Contractor's License Law for the P-T�- Generator E10-5 KW 136-15 KIN following reason (Section'7031.5 Business and Professional Code: Any city or p county which requires a permit to construct, alter. Improve, demolish or repair Transformer 1:115-50 KW r ' any structure, prior to Its issuance,'also requires the applicant for such permit Roof Drains i i to file a signed statement that he/she Is licensed pursuant to the provisions of the ' P ❑50+ KW Dein ctitln spa Fee $15' Contractor's License Law:(Chapter 9 (commencing with Sectlon-7000) of 4sion 3^of the Business Professions Code)' that' he/she_.Is r• a - , - Showers - Reinspection • Fee I $15 and, or exempt refrom and the, basis for the alleged exemption. -Any violation of Section z Meter Cup to 100.amps $ 3 i 31,5 by any applicant fora • permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). S Service Sink Issue Fee $ 9 _ -. • Zoning Approved By Issue Fee. _ Date I I; is'owner of the property or my employees with wages as tAeir sole compensation will do the work, and •the structure Is not intended or offered for -(Sec Ion 7044, Professional + MECHANICAL Application Approved By ata sale Business and Code: -The Contractor's License Law does not apply to'an owner of a -property who builds or Improves ; Boiler t Refrigeration System Application issued By Date thereon„and who does, such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for Duct = Under Ground ! ❑0 100,000 BTU ❑ 100,000 BTU' i sale. If, however, the building or Improvement Is sold within one year,of com- ' p[etion, the owner wilt have the burden of proving he/she did not build or Im- rove for the purpose of sale). � + Duct -Structural r System Repair/AlterationBUILDING SUMMARY PERMIT $. OF FEES SMTP $ ' I, as owner of the property, am exclusively contracting ,with -licensed con- tractorsto construct the,project (Section.7044. Business and Professions Code: Duct- Ventilating _.._._ - _ u. I �J f PLAN CHECK, $ PERMIT d The Contractor's License Law oes not apply to an owner of property who-, I ISSUANCE $ . builds or improves, thereon, and who contracts for such projects with a con- tractor(s) license to the Exhaust System ❑ Multiple ❑' IV g r PLUMBING $ pursuant Contractor's License Law). I ) ,le. GRADING $ Elm i�aexempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO ! PLAN CHECK $ S Heating'System & Ducting ELECTRICAL r $ ' $ Date Owner I- hereby certify that -I have read this application -and state that the above •r (]0-100,000 BTU-❑l00;000BT PLAN CHECK' ! $ 1 MICROFILM $ ' Inform is correct. I agree to comply with au city antl county ordinances I and state laws relating to b Ing construction, and hereby authorize repre- Hood ❑ ; ^� �, MECHANICAL $ TOTAL FEE. $ ' sentatives of this city ter' o the above-mentionedproperty for or Type I Ceno ❑ Reinspection Fee, $75 PLAN CHECK $ LESS Inspection p p Type II ADVANCED PC $ ! E Signature' ; I Drivers' Lice or SS Registers Iswe Fee $ 3 ) FINAL FEE $ Goldenrod - Assessor CMF 0865-46 rev, 12/82 White - Building; Canary - Applicant; Pink - Accounting; ' `= -"L-'3:' � i, '� `; j "� 4, _POOL PA : r ' °COf"rfRUCTION.AND-PL'ANNING' [ G ROVALS Permit # =Date ;! nspectoi c : . _ G• ` - APPROVALS, Date r Inspector _Permit.# 1' tern orar Electrical Service or.Pol`e t' c T�t - p Y ' f �r as �Tcy 3 £ - 52-; Pool & Equ,ipment Location - - i u 2i Soil Pipe-"V,drgrnd. _ 4 ,� U'. •{ , ,- �a 'y� r53 Steel Reinforcement !_ t 37 Electtical Condui00tiI ftV;Undrgrn�i:' a '54. 'Forms --� _ '? 4 Ectrical Conduit-nrgrndr +o 5. cakb6nding 5' Steel Reinfarcemen_h, r o' ` = c 56.• Rough Plumbing•& Pressure Test 6.;EtectiicaI "FER Grnd", u ' n �: -y X57:' APPROVAL -TO COVER-GUNITE ' r' 7. FooTings ` s ?' �' _ = I ;58: ElectricahCOriduit'UndrOrnrj,- r _ 8. Foundation ;�ri�;7, - ij '4r' ' . { 1-59. Gas Pipe' L3 Undrd nd_, Test 9. Vater.-PipeiUndrgrntl. fr'� `'s `�-, '' r�64. Backwash Lines❑ Undrgrnd, `• 1' ,"P-Trap, I j 10.. Structural FIo`or System 61. APPROVAL TO DECK •= ' C 11. Property Sewer Linc & House Connection ` = e 62. Backwash &Receptor Final ' 12. Seviw4i Cap' s'r '• 1F �' ti ' j ; $3. Heater &'Vent Final _ t 1 13. 'R,; ;Drains ' i - f 64. P.lumbing;System Final' X 14i Rough Plumbing. �; r ` ` = I ° ' ` 65. Electrical -Final = ` '--15�-Rough-Electrical=Condui# - -f6., Solar System -Final -' 1111.6,Rough-ElectricjWiring ` t, ,'I'r I �'i '�� 1 �$7'1 Fencing &Access Approval I I , 1`17. ;fiough"Wiring'Sidn;" ;� + . I - I � 68.r APPROVED FOR -PLASTERING L I I . 1 i �1B. ,Rough�EIectridal^T.Bar, Ceiling;69.1 #'OOLJSRA SYSTEMS:FINAL t fk 19. Roughs Heating &'Airtonditioning r _ '` t ' I FIRE DEPT, REQUIREMENT- y .� �7 _ { 1 APPROVALS' Permit # ough~Factor'y Fireplace ' " ' I 4 I I I `I 21. 'bucfsjn Structure 70.' Urider1ground Hydro , i i_ ',Ducts, Ventilating = i „ j ;r f li Product Piping CJ Gas ❑ Oil L22. i ;71. 11 3. ;Gas Pipe -Rough & Test r� -� {I I 72• Underground Flush' 1s A .•� -24. Roof Framing-, ' i + ,+', ; - s ti i { 73.} Undergrnd. Storage Tank ❑ Gas _0 Oil' s I _ ' 25. Roof Sheathing I } i+j, 74.; Overhead Hydro r , I• I t Bar Ceiiin {Structuralil& Mono'cor r j ?J at I = I + - '' i ' 75. Dry Chemical I ;Frame and Flashing' k ! { 76.; Dry Standpipe r,27. { 1 { I I s u 28• irLathing &Siding; r; ,, 1 { 1� i e I 1 I ;77.' FIXED SYSTEM.FINAL x_29. alnsuiation FIRE PREV., FINAL 178.! r.1 4 3t3:�Drywalll Nailing ti 11 j I f f ;Noiesc; 4 31. Plaster Brown Coat - rP 32.'E_:ct'ricai'Power Meter;Final 33.•Finai-Electric 34. Final Heating & Air Conditioning 35. Final Gas Pi {'e -lest 36. Hood or Canopy`' 37. Final Factory Fireplace. 38. Final Plu'mbi'ng'j {I 39. Water SefVlce-Final= 40. Gas Service -Final s 41. Solar Domestic-Final .1 } t i _ 42. BackflowtPreventen 43. Backflows Irriq ation @r.• { .1 I x_ It• , I Ir; 1 I I I I r+l =t { 44. Landscape Irri gation�System 'Wf r_ -e 45. Soundil Attenuation �, r• 46. Handicap Regulations �' l I t g r r 1- I r- 47. FINAL STRfJCTURE & BjUILDING {.- 48. Special Requirements Completed I • i it r t 49. Electric Release -,to Edison' I 1 I 50. Gas Release to Souther=n California Gas GO 51. CERTIFICATE OFJOCCUPANCY _ I-__-_- .- No. �� I I Date I L .. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF'COSTA MESA t- ; ' PERMIj NO. - ' TRACT NO. ti LOT.IVO., B CONS'TRUCTiON PERMIT , S • . _ s j s ,' 1g25' :706/03 �' I' :34-351 TL 1#ppiicant'sMeiling dress TYPE .OFCQNSTRUCTION IVEw ADD ALTERATION REPAIR•_ t �y Project Address c''Xi � fT%k L_ Z_ rPhorte� ❑CONVERSION ❑DEMO OTHER, ' Owner's'Nama �S�[ ��%s;� � r'� ,�- DESCRIPTION OF WORK L� r INCEGU • Address aj�r�tw/ �r� - TYPE OF PERNi1T GRADING FOUNDATION STRUCTURAL ' A. P. 20NE t rch/Eng. - LicenNo. Ase ❑ TENANT ELECTRICAL ❑PLUMBING ❑ ME=GHANICAL -PLNG. REF..+ BUILDISGTOANG 1 Address' - ❑'OTHER ' PROJECT DESCRIPTIONS SQ: FT. ' '—OCCUPANCY, TO BUILDING PROPERTY INE - STI r REAR YARD (TO P/L) , _ Clrrr -ee '6 Z I�L Contractor's Nem hone �/ Address (mailing) -Z = �iF'dNd� �!ltJ� CONSTRUCTION TYPE - _ VALUATION $ LEFT SIDE YARD RIGHT SIDE YARp License No. ZONE GRADING CU. YDS. ACRE PKG. SPACE REQ. PROVIDED i Remarks: STREET WIDTH PARK FEE $ , LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I. am licensed under provisions of Charter-9 (commencing ' with section 7000) of Division 3 of the Business and Professlons Code,pd SPECIAL CONDITIONS: my license_Is In full farce d'effect. J r` I %dJ I1Jcans@�I No PLUMBING ' Date % Signature Bar Sink Sewer Cap ELECTRICAL WORK RS' OMPENSATION D LARATION , k hereby affirm that.l have a Certificate of consent to self-insure or a certificate Backflow Preventer _ Seliver Connection Automatic Washer Meter over 10.0 amps of Workers' Compensation Insurance,' Dr a certified copy thereof (Section 3800, Lab. C r+ .r " " Backflow Irrigation - Solar Collectors i Construction Pole Sub Panel Pol�Cy, No. Company e��4'^^� ❑ tlfled copy Is hereby furnished. Bathtubs - Solar Pipingtt Cooking Unit 'Sub Pole y d with the city-Buil n Ivlslo . , Dishwasher 'Motors ❑0.1 HP few pate Applicant 1"`�-� Clarifiers Soler Tank _� EXEM ION' ROM WORKERS' CO ENSATION DECLARATION Dishwasher a Swimming Pool w/spa Dr ers' L]Gas ❑Electric y Inc,Solar ❑9-,15 FiP ❑16-15+ (This section need not be completed If the permit Is for one hundred ($100) or less). : I certify .,that in the performance of the work for which this permit Is Issued I shall riot employ any In any manner soto become subject to the ` , Drinking Fountains Urinal i f• Fan Microwave f ! ' person .as Workers', Compensation. Laws of California. Floor Drains - -- Water Closet_ F.A.U. - Pole Light I Date ' Signature _ __ NOTICE: If, atter making this tleclaration, you should become subject to the Floor Sinks - Water Heater - _ _ Fixtures ; Range.- �_ •_� _.•, , y t Workers'.Compensation provisions of the Labor Code, you must forthwith. comply ,with such provlstonr'or this permit 'shall be deemed revoked. Gas Service .Outlets Water Service Device Boxes Sign CONSTRUCTION;LENDING AGENCY Outlets I hereby affirm that there Is alcanstruction lending agency for the performances 1 Interceptors s Standing Sections 1 j of the work for which: this permit -Is issued (Section .3097 Ctv: C.): Switches , Lender's; Name, ' ' ' Kitchen Sink' _ y' Trash Compactor S p / Lenaer'5' Address • .` - Lavatories. ' ' Garbage Disposal ; OWNER,BUILDER 13ECLARATION t hereby,affirm that I am exeripNfrom the'Contractor's'Llcense Law for the r 1 Generator. 00-5 KW ❑5-15 KW ; following reason. (Section 7031.5 Business and Profession a l; Code: Any city or P—Trap; ,county which requires a permit-to construct, alter. Improve, demolish or-repair Transformer ❑ 15-50 KW any structure,' prior to Its -issuance,, also requires the appllcant•for such permit -• Roof Drains i to file a signed statement that he/she Is licensed ursuant to the provisions of Contractor's License Law (Chapter.9 (Commencing with Sectfom7000) of L. , = ' 05V+ KW` ! } 1Reinspection Fee $15: =' ision 3 of. the .Business and Professions Codec or. that he/she. Is'exempt - ) Showers ; Reinspect!on.Fee ; $15 t :efrom and the basis for the alleged exemption.-Any viola ion'of Section Meter p to i00amps Q Issue Fee $ 3- O t X1.5 by any applicant fora per mlt_subjects the applicant to a civil 7 Service Sink Issue Fee I $ 3 _ enalty of not more than five hundred.dollars ($500): 1. "as sole ' ) I Zoning Approved By Date I; .owner of) the .property or my employees .with wages'as their I ! compensation' wlllldo the work, and- the structure is not Intended or offered for sale :(Sec{Ion 7044, Business and Professional- Code: • The - Contractor's _. MECHANICAL Application Approved $ ate d License Law does not apply to an owner of a property who builds or Improves thereon„and who doeszsuch work himself/herself or through his or her own _ Boiler _ r Refrigeration System t: ; Application Issued By Date � --,9 employees, provided that such improvements arelnot Intended or offered for Duct Under-Ground 00io0,000BTU ❑100,000BTU l sale, if, however, the building or Improvement Is sold within one year'of com- SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Me for the purpose of sale)'. S Duct - Structural } System RepairlAlteratiori BUILDING PERMIT $, _ SMIP $ i I, as owner of the property, am exclusively contratting:with:licensed con- , tractors to construct the project .tSection 7444, Business and Profession$ Code:. Res Duct.- Ventilating PLAN CHECK $' ' PERMIT 1 The Contractor's License Law not apply to an owner of property why 1 builds or improve$ thereon, and who contracts for such projects with a con. y Exhaust System ❑ Multiple ©' ( PLUMBING $ ISSUANCE $ tractor(s) license pursuant to the Contractor's License Law). ) =s T� GRADING $ ❑ I am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit, ICBG ; 'PLAN CHECK i $ ��, Heating.System & Ducting , I ELECTRICAL $ ;L 9 + $ } c MICROFILM $ ' Date l Owner i ' hereby-certlfy that I have read this applicatlon-and state -the -the above 1 ❑0 400,000 BTU ❑100,00OBT PLAN CHECK $ II n Is correct. I agree to comply with all city-and county ordinances andistate laws relating to building construCtion,;and hereby authorize repre- s i 1 $, TOTAL FEE' ( $ ; l sentatives of Ithis =City to a on t e above-mentioned pro arty or } Hood Or T e I ❑' . yP ) tt 4 Rainspectiori Fee $15 1MECHANICAL PLAN CHECK LESS i s Inspection purpo s i/p�l�/' Canopy! Type I I ❑' ; $ ADVANCEDPC $ Signature to-S / t i Registers E i Issue Fee $ 3 i ' Drivers' LI Ce or SS , , FINAL FEE $ CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor E o6dN5-r UCTION,AIVD PL';ANNINpu f- - �` = x; ^i .Inspector; POO! `' Date inspector, APPROVALS ,, Permif#. �i0ate f._ {- ,; �APP.ROVALS-. 'Permit•# � 37 :'Tempr orary..,f+Electrjcal ServicAe or=_Polex52 Poo- l &-Eguipmetnt Location ! . 1 - ,v 2'Sbil'Pi a ndr rnd�' S. 'An t+ c - :53Steel Rei.nforce-m. ent : 1 3: Electrical ConduiI Hilt v,Undrgrnrh" " - : _ 54t'.'Forinsm . ., I t 1 -4. Eleairical 6onduit Und'rgrh =�i ' is ''' • '`" `` J?`= :55�'Electrical Bonding. '.Y, -•s ! •, r, :k 'f; 1,/,. C •�; 1=D' _ _ 5. Steel,Reinforcement;�r =.;' 56. Rough Plumbing & Pressure -Test s: Electrical t}FER Gr,"nd'I d 4- i, i_ �?� r - ° c57r` APPROVAL'TO:COVER-GUNITE TO, COVER Footings 1 i r -� y - 5e 'Electrical- Conduit-Undrarnri• ,. Irf; f' • f:�1' [ ,i.^a i r-�; Usk B. Foundatif 1 t �1 �,, a• 59. Gas Pipe❑ Undrgrnd'.; Test= -_ f �-r` :, w 9. Water Pipe'Undrgrri`d. V ' - ' I: 1760. Backwash Lines, P 0 Undrgrnd. _ ;; _ -Trap, 10. St fcctural Floor Sys't i � �__ `" 1 61. APPROVAL TO -DECK PrdpI'ry Sewer Line &` HouseFCon'n''ection� 11. t e62. Backwash'8CReceptor-Final Q , l ,�•_ y ? 12. Sewed Ca Heater & Vent -Final s V� �, ..'63. 13. RooflD :64. Plum6in63System Final'_ gains z r i 14. 'Rough'Plumbing i, w� `,-=� i65.Electrical=Final' - } .• ,' '15:Rough'Electrical=Conduit 166, Solar�System=Final :.16 ,Rough-EIediric•Wirjng, ! oft �67-: Feii66 & Access:Approval i7i. Rou6li'Wiring.Sign _ S AT { I a i _ •T ;68• APPROVED' FOR PLASTERING ' + F T )[ U C 1 ough Electrical-T.$ar Ceiling 169. POOL/SPA SYSTEMS FINAL ~� 119.,lRough'Heating &f Air'Conditioning = , FIRE DEPT.[REQUIREMENT APPROVALS; 'Permit # 20t Rough Factory Fireplace 21. Ducts, in Structures 1111. r i 170.+ Underground Hydro j 4, "22.Ducts, f M t'ir� i 1 71.' Product Piping F1 Gas ❑ OilJI { .Ventilating ! i !r iP 23. /Gas:Pi .e -Rau h & Test }} iio I - 1� I - I ,72• ; Undound Flush ergrfi ,meg E k = Framing #z 73.' Un erg' d. St rageTank,0Gas ❑ Oil i 25.'Roof Sheathing 1s ; I�q ;„ ! . , " _ 7'4 Overhead Hydro y {' _ 'T_ --Bar Ceiling {Structural}, & Monocoat " T I : 75. Dry Chemical - 27. Frame end "FlashingX76., Dry Standpipe i 128. k`atliing & Siding ;, i ;', I: ; [ i 1 I .77.• FIXED SYSTEM I 1 !1 I 29. ;Insulation s + 4 r f j 178. FIRE PREY. F -I NAL { Drywall Nailing E' Notes: ; -30. ; > ji I l i i 31. tPlaster Brovirn Coat 2 �31 Electrical'Power Meter! -Final F 33. ,Final Electric .-. , . i 1 { ,1. 34. F nal�Heating &Wr Conditioning • i ai;Gas Pist 35. Fin pe -Te' u 36. HooAr i Canopy'�_ '�r1��1?I G . 1 37. Final Factory Fireplace l = i 38. Ficial Plumbing 39. Water Service -Finals 40. Gas Service -Final �• u i i t i � t I i i ! - S , �i 41. Solar Domestic -Final i i {{�� _� } �_ .-1 `- �� - -- .• �. ' ' �5- ';; 42. Backflow Preventers I [ t 43, Backflow Irrigation 44. Landscape Itiigation�$ystem ^i. { { i +1 �� j j r S S I r1 45. Sound `Attenuation p } Q � � � � I !' I j cl 1 'i '•1 � � � c I 46. Handicap Regulation`s `' I [ ; { I' 1 47. FINAL STRUCTURE & BU"ILDiNG 48. Special Requirements Completed jr ! : ! 49. Electric Releaselto Edison{ 1 1 -� 'J • 50. Gas Release to Southern California Gas Co 51. CERTiFICATE'OF,OCCUPANC,Y No. s' :+ l k 4 Date � I :[ i j Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PEg(VIIT N TRACT NO. LOT NO. BLDG. NO. I CONSTRUC ION PERMIT i�J[ Q !gill Proj�^ 3151 -Airway Ave. F-206 Costa M S-BYPE OF CONSTRUCTION Owner Gynrocc Phone 79;9 -70;711 ❑ NEW ❑ ADD ❑ ALTERATION Address 1601 UOVe , Newport Beacn Arch/Eng. Tom Campos License No, Address 17779 "f" Main St. Irvine Contractor JDO Cowanv ez-x ;Ph ne 540-260 Address 3151 Airway Ave. E-1. Costa Mesa -LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, band my license Is In full force9e�fEct. License Class a nse o. s�. pate f Vii] f R7 Signature _ 'KERS' COMPENSATION DECLARAT10 k eby affirm "that I have a certificate of consent to self -insure or a c...,ficate of Workers' Compensation Insurance, Or a Certified copy thereof (Section -3800, Lab. C.). _ Policy No. Company ❑ Certified copy Is hereby furnished.' Certified Copy is filed 'with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if the permit is for one hundred {$100) or less I certify that in -the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to became subject to the Workers Compensation Laws of California. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - - - CONSTRUCTION LENDING AGENCY .1 hereby affirm that there Is a construction lending agency for tho per- formance of the work for which tnis permit Is Issued (Section 3097 Civ. C.). N/A Lender's Name ` - — Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code, Any City. or county which requires a permit to construct, atter, Ir -we. demolish or repair any structure, prior to Its Issuance, also ra. C the applicant for Such permit to file a signed statement that he L 1sed pursuant to the provisions of the Contractor's License Law LC+.+pter 9 (commencing with Section 7000) of Division 3 of the Business and Processions Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not 'apply to an owner of a properly who build$ or improves thereon, and who does Such work himself Or through his 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 wilt have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an Owner of property who bulldS.or Improves thereon, and who con- tracts from such projects with a contractor($) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. d, P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives af thi city to.0,enter upon the above mentioned property for Ippecuon pu p9"e. 11/29/82 Signature 41-9 �- r�'"^ - - - - Date Drivers' License r cc ❑ REPAIR ❑ CONVERSION ❑DEMOL'ISH ❑ OTHER leant ... _ eme t - 2,,732 .DESCRIPTION OF WORK corridor 1250 s/f TYPE OF PERMIT ❑GRADING ' ❑ FOUNDATION ❑ STRUCTURAL OTENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHA ❑ OTHER PROJECTp%PIPTION SQ. FT. jj CCUPANCYt�jy(j - / OVALUATION�5 !6. ZONE N TYPE GRADING CU. YDS. ACRES 175G 12/15/1ry ZONING REGULATIONS A.P. +# ZONE REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED B` SPECIAL CONDITIONS: PLNG. REF. :ir- PROVIDED PARK FEE $ 319.13 REMARKS: e� COLLECTORS PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS ISSUE FEE TOILETS LAVATORIES URINALS DOUBLE LAVS GENERATOR TRANSFORMER 'APPLIANCE 0-1 KW 10-50 KW -50 1-10 KW + KW KIT. SINKS SERVICE SINKS DISHWASHERS SUMPS MOTORS , S (INC. SOLAR) 0-1 Hp 10-50 HP 1-10 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS' 0.100,000 BTU GAS TUBE SIGNS $ -31.3,0 SMIP INTERCEPTORS CLARIFIERE POLE LIGHTS SWIMMING POOL, PTRAP �' POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE $ AMP WATER HEATERS BTU OUTPUT $ _- Jt SEWER CONNECTIONS I 1 SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DA7Er /� MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING 3 HEATING SYSTEM 0.100,000 BTU PERMIT $ -31.3,0 SMIP $ AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT ISSUANCE $ REFRIGERATION 0-100,000 BTU PLUMBING $ _- Jt SYSTEM GRADING $ 100,000 + BTU PLAN CHECK $ $ BOILERS BTU ELECTRICAL $ MICROFILM $ PLAN CHECK $ SYSTEM REPAIR, ALTERATION TOTAL FEE $� MECHANICAL $ EXHAUST SYSTEM MULTIPLE ' -LESS AD - PLAN CHECK $ VANCE PC $ ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor odlm;aAV*Z FINAL FEE $ O/AIV 6i, r, 9�� 317,/3 CONSTRUCTION AND PLANNIN APPROVALS Permit # * Date Inspector. %• _ _- PQOL & SPA .Date �a Inspector APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44- 'Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - 5. Steel Heinforce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation " 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ ndr rn 10. Structural Floor System 52. APPROVAL TO DECK 11. ' Property Sewer Line.& House Connection 53. Backwash & Rece for -Final 12. Street Sewer Connection r 54. Heater & Vent -Final ' 13. Rough Plumbing - 14. Rough Electric -Conduit _ 56. Electrical -Final 15. Rough Electric -Wiring 57.. Solar System -Final 16. Rough Heating & Air Conditioning 5H. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL _ . 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing . -L, -21 23.- Insulation 24. Lathing & Siding 25. Drywall Nailing I-.�(• } 26. Plaster Brown Coat - 27, Electrical Power Meter -Final r 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System ' 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 1_35- 5-7 39. Special Requirements Completed 40, Electric Release to Edison 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - CL CITY OF COSTA MESA P &4WT NO. TRACT NO. LOT NO, BL G. NO. -2121. 121231-32 dal] CbNSTRMTION PERMIT .-- Project Address a/ly/ `QjR6u C6 TYPE OF CONSTRUCTION Owner S%'p,03dAl ��y� rt Phone ❑•NEW ❑ ADD ❑ ALTERATION {� Address (yam/ C71 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH / ZONING REGULATIONS Arch/Eng. - License No. 1:1OTHER DESCRIPTION OF WORK A,P, i' Address - ZONE PLNG. REF. 41 Contractor /CJ :/m y -, rt Phone3��j L. TYPE OF PERMIT BUILDING Tp BUILDi(�G ' / Address/ 2 7� �L 121411�.,�, ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBACK C S:[, YARD PROPERTY LINE LICENSED CONTRACT R DECLARATION ��I ❑ TENANT�ELECTRICAL ❑PLUMBING ❑MECHANICArREE E YARD WIDE I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and \\\\\\ ❑ OTHER - .. Professions Code, and my license is In full force and effect R YARD (TO P/L) �� a-3 •PROJECT DESCRIPTION License Cl s LI c ns o. . SPACE REQ. PROVIDED / SQ. FT. Date Signature t ET WIDTH PARK FEE $ CORKERS' COMPENSRTION D CLARATION- OCCUPANCY ' CONSTRUC710N TYPE ' ereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE ;Ificate of Workers' Compensation Insurance, or a certifiied copy .erect (Seelig 3p SOLab. C.). � GRApING CU. YDS. ACRES SPECIAL CONDITIONS: - � Policy No. -Company T - Ce�fled copy Is hereby furnished. REMARKS: �❑-, 10-1 entified copy is filed with the'city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION +' (This.section need not be completed .if the Permit is for one hundred _ (5100) 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 _ PLUMBING PLAN CHECK ELECTRIGAL. 'PLAN CHECK subject to the Workers' Compensation Laws of California. - > BATHTUBS SHOWERSLJVVLLL - ' Date Signature NOTICE: If after making this tleclaratlon, you should become subject TOILETS URINALS -" - GENERATOR 0-1 KW - '1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - APPLIANCE 10-50 KW„50 + KW. revoked, _ CONSTRUCTION LENDING AGENCY _ KIT. SINKS DiSHWASHERS' MOTORS 0-1 HP' 1.10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - - - (INC. SOLAR) -- 10-50 HP - 50 + HP- formance of the work for which this permit Is issued (Section 3097 Civ. C-)' - Lender's Name FLOOR SINKS "FLOOR DRAINS - ' FIXTURES -- OUTLETS- SWITCHES Lender's Address DRINKING FOUNTAINS - ^ GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE'LIGHTS- - _ - '•• - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL - P TRAP '-' - '- POLES METERED - SUB the'following reason '(Section 7031.5 Business and 'Professions Code: Any city or county which requires a permit to construct, alter, ' WATER SERVICE ALTERATION'"' ° 1 `PANELS. MAIN ',.SUB Improve, demolish 'or'repair'any structure, prior to Its issuance, also re-- es the applicant for Such permit to file a signed statement that he SERVICE OUTLETS SERVICE ,OQAMP tensed pursuant to'the provisions of the Contractor's License•Law-"GAS AXer 9 (Commencing with Section 7000) of Division 3 of the ' WATER -HEATERS -BTU OUTPUT"'" iness'and Profe$Sic,nS^Code)'or'that -he-is exempt therefrom and the- basis for the alleged exemption. Any violation of Section 7031.5 by SEWER -CONNECTIONS Y+ 'any -applicant -for a permit subjects the applicantto-acivil penalty of not more than five hundred dollar$ ($500), SOLAR TANK— "� COL'LECTORS -' -' _ -"- '-" - "-'-- "' �-• '-^- - - -- -� �• ❑ 1, aS owner of [he propertyor my employees with wages as their .sole.compensation,.will do.the work, and the structure is not intended SOLAR PIPING SYS. - ,.._ ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor'License Law .does not apply to an.owner-_of..a property - - -- - ISSUE FEE' -; 'AppLICATION'APPROVED BY - -DATE - - who build OL improves thereon, and who does Such work himself or through his own employees, provided that. such improvements are not, MECHANICAL PLAN CHECK SUMMARY•OF FEES intended or offered for sale. If, however, the building or improvement is sold within one year of, Completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTU of proving he did not build or improve for the purpose of sale),• -BUILDING •- - ” � PERMIT $ - - - •� •- -SMIP• •., $ 1, as owner of the property; am exclusively contfacting with AND DUCTING • _ licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S PERMIT - and Professions' Code: The Contractor's License Law does not apply to - - -ISSUANCE $ REFRIGERATION 0-100,0.00 BTU an owner of property who builds or Improves thereon, and who con. PLUMBING S ' tracts from such projects with -a contractor{s) Iicesned pursuant to • -SYSTEM - GRADING. $ the Contractor's License Law). ❑' I exempt Section B. a P. C. for this 100,000 + BTU PLAN CHECK )$ S; BOILERS BTU am under ELECTRICAL $ reason ., ' ' PLAN CHECK $ MICROFILM Date Owner SYSTEM REPAIR, ALTERATION 'MECHANICAL' TOTAL FEE $ $ . .- - 1 hereby certify that I have read this application and state that the above EXHAUST SYSTEM_ MULTIPLE LESS AD- information is correct. t agree to comply with all city and county • PL•AN'CHECK S - VANC£ PC • S' ordinances and state laws relating to construction and hereby author_izg upon _ •; r .. - , representatives of this city to enter tie above mentio etl property ,for pectY poses. - J pr. aQ 6 FINAL FEE S e� Signature Drivers' cense or SS �= ISSUE FEE -Assessor CMF 0865-46 White -Building, Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA' \ - APPROVALS Permit # � De�e� Inspector 1. Temporary Electrical Service or Pole � 43. Pool &Equipment Location., 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee em orce 47. Rough Plumbing& Pfessure Test 6. Electrical LIFER Gm 48. APPROVAL TO COVER-GUNITE 7. Footings _ 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Und rn,-Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.Q Qdrcim 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer .Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55-- Plumbing Syslem - Final 14. Rough Electric -Conduit - •56. -f-lectrical-Final �. 15. Rough Electric -Wiring - 57. Solar Systbm-Final 16. Rough Heating & Air Conditioning 5B. Fencing & Access Approval 17. Ducts in Structure--IT.-APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19, Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22• Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat 27. Electrical Power Meter -Final _ t 28. -'Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31., Final Plumbing 32. ,-,Water Service -Final 33, Gas Service -Final - 34. Solar Domestic -Final 35. LandscapeSprinkling System 36. Sound Attenuation 37. Handicap Regulations _- 38. FINAL STRUCTURE &•BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT N TRACT NO, LOT NO, •BLDG. NO. r CONSTRUGTION PERMIT �- �� ddress�5� A� Q TYPE OF CONSTRUCTION ' / , Wr _I;FjPone ❑ NEW ❑ ADD ❑ ALTERATION / %/ ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 4J ZONING REGULATIONS `. License No. ❑ OTHER PAdd 1� DESCRIPTION OF WORK A.P. ZONE PLNG. REF. � - J 1or L Phon TYPE OF PERMIT BUILDI ILpIryGSET PROPERTY LINE ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL ACKC I YARD D CONTRACTO DECLARATION I hereby that I licensed 9 ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHANIC 5 ARD affirm am under provisions of Charter (com- menCing with section 7000) of Division 3 of the Business and ❑ OTHER RII�HT Profosslons Code, nd my license is in full force and effect. REAR YARD (TO P/LI PROJECT DESCRIPTION Licens Cl s Lice e oc37 PKG. SPACE R EQ, PROVIDED - Date �� Signature - SQ, FT. STREET WIDTH PARK FEES WOR RS' MPENSATION DE LARATION" OCCUPANCY r� CONSTRUCTION TYPE ZONING APPROVED BY DATE I hereby affirm that I have a certificate of consent to sell -insure or a VALUATION• ZONE " Certificate of Workers' Compensation Insurance, or a -certified copy thereof (Secti 38 C.).SPECIAL •GRADING CU: YDS. —'ACRES CONDITIONS: - Policy No. 'Combany` T"`-f"T,-t"� `•' -� - - (;Wtifled copy is hereby furnished. - REMARKS*�„�•' b - -- Ed`Certified copy Is filed with the city Building Division. - ' EXEMPTION FROM WORKERS, COMPENSATION DECLARATION - - - - - - This section need .not be completed If the permit is for one hundred ($100) or less. .certify that in the performance of the work for which this Permit is _ Issued, I shall not employ any par;on In any manner so as to become- _ PLUMBING PLAN CHECK- ELECTRICAL PLAN CHECK- HECKsubject subjectto the Workers Compensation Laws.of California. Date Signature BATHTUBS SHOWERS NOTICE: If after making this deClAration, you should become subject •TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provislons of the Labor Code, you must TRANSFORMER forthwith Comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50 + KW revoked. _ CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP - I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - . - (INC. SOLAR) 10-50 HP 50 -HP formance of the work for which this permit is issued (Section 3097 Civ. C.). `, 1 FLOO_R SINKS FLOOR DRAINS FIXTURES,3J OUTLETS SWITCHES <3 Lender's -Name Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS - - -OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt frgm the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason '(Section 7031.5 Business and Professions Code: SWIMMING POOL_ P'TRAP ' POLES METERED SUB Any city or county which requires a permit -to construct, atter, improve,'demollSh or repair any structure, prior to its Issuance; also re- WATER SERVICE ALTERATION PANELS MAIN SUB _ quires the applicant for such permit to file a signed statement that he c licensed pursuant to the provisions of the Contractor's License law- GAS SERVICE OUTLETS SERVICE AMP 9 (commencing with Section 7000) of Division 3 of the khapter siness and Processions Code) or that he IS exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil penalty '- SEWER -CONNECTIONS of not more than five hundred dollars ($500), ❑ I, as owner of the property, or my employees with wages -as their' SOLAR TANK COLLECTORS sole Compensation, will do the work, and the structure is not Intended or offered for Sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. t ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or - iSSUE FEE ' APPLICATION APPROVED BY, DATE through his own -employees, provided that such Improvements are not , intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK_ _ SUMMARY OF FEES Is sold,within one year of completion, the owner will have the burden . Of proving he tlld not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT S SMIP $ ❑ 1, as owner --Of 'the property, am exCluSively contracting with AND DUCTING - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S PERMIT ,S and'Professions Code: 'The Contractor's License Law does not apply to - ISSUANCE an owner of property who builds or Improves thereon, and who con- -such REFRIGERATION 0.100,000 BTU PLUMBING 5 ' tracts from projects with a contractor(s) ilcesned pursuant to -SYSTEM - - - - GRADING S the Contractor's License Lawl. 100,000 +BTU PLAN CHECK S ❑ I am exempt under Section• B.'& P. C. for this ELECTRICAL S - - '— BOILERS BTU MICROFILM E reason PLAN CHECK 5� - - - Date Owner SYSTEM REPAIR, ALTERATION TO7AL'FE 3 E ' _ _ _ I hereby certify that,l have.read this application and State that the above EXHAUST SYSTEM - MULTIPLE MECHANICAL S LESS AD= information is correct, I agree to comply with all city and county PLAN CHECK S VANCE PC S - - ordinances and state laws,relating,to construction, and hereby_ authorize representatives of this cit to ter on the above mentioned property_for•'ns Action" /1 _ _ _ • FINAL FEE E. Signature - Drivers' Anse or SS =ht FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; GOldenrod-Assessor W% CONSTRUCTION AND PLANNING APPROVALS Permit # -� �$(-� Date - Inspector POOL & SPA 1 . Date _ Inspector APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn • 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45, Forms 4.. Electrical Conduit-Undrgrn 46. Electrical Bonding -Steel Reinforce 47. Rough Plumbin & Pressure Test - f .6. _Electrical LIFER Grn_ 48. APPROVAL TO COVER-GUNITE •''• '•"' -• • •`• 7. Footings 49, Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rri, Test 9.. Water Pipe-Undrgrn, 51. Backwash Lines P -Trap.❑ Mr rn 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection- 54. Heater & Vent -Final 3. _Rough Plumbing ygem 14. Rough Electric -Conduit r -56. Electrical -Final 15. Rough Electric -Wiring _g - C_ 57. Solar System -Final -16. " Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure ,, . APPROVED FOR PLASTERING 1$, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough &Test- 20. _Roof Framing 21. , Roof Sli hin v . NOTES: 22., _..Frame and Flashing _ 23. Insulation- 24. Lathing &-Siding - .25. . Drywall.Nailing 26. - Plaster Brown -Coat 27.-..=.Electricai`Power Meter -Final 28. Final -Electric -- r 4-6 C. 29, Final Heating & Air Conditioning_ 30. Final Gas Pipe -Test 31. Final Plumbing "32. --Water Service -Final -33. • Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42, CERTIFICATE OF OCCUPANCY No Date .t rApplicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY Ot COSTA MESA PE MIT NO. TRACT NO. LOT NO, BLDG. NO. CONSTRUCTION PERMIT - SIP TRANSFORMER APPLIANCE Project Address k U)q4 — TYPE OF CONSTRUCTION MOTORS Owner D.1 e" Phone ❑ NEW ❑ ADD �sALTERATION (INC. SOLAR) - Address S LZIA)�l ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 'FIXTURES Arch/Eng. License No. ❑ OTHER GAS TUBE SIGNS DESCRIPTION OF WORK Address POLES METERED ! Contractor �]c/1i tr y�r l Phone O-Y/ YPE OF PERMIT MAIN Address L p N'! b�.a ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ECHAN I hereby affirm that I am licensed under provisions of Charter 9 (com- 3 the ❑ mencing with Section 7000) of Division of Business and Professions Coogla d my license Is in f 1 foxcaW�)tect OTHER, pROdECT DESCRIPTIQN License C11 �— LIc N ISSUE FEE �� Date SignatureSQ. FT. - - DAT WORKERS' COMPENSATION D LARATION OCCUPANCY CONSTRUCTION TYPE BUILDING - weby affirm that I have a certificate of consent to self -insure ora VALUATION ZONE PERMIT $ ffleate of Workers' Compensation Insurance, or -a certified copy _ PLAN CHECK s ,reof (Section 3800, Lab. C.). - GRADING CU. YOS. ACRES Policy No. Company ' PLUMBING S ❑ Certified copy is hereby furnished. - REMARKS: ❑ Certified copy is filed with the city Building Division. . PLAN CHECK $ EXEMPTION FROM WORKERS' COMPENSATION'DECLARATION23 - ' ELECTRICAL $ (This. section need not be completed if the permit is for one hundred - s ($100) or less). MICROFILM s PLAN CHECK $- MECHANICAL $ I Certify that In the performance of the work for which this permit IS TOTAL -TEE $ ' Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK PLAN CHECK $ SubjeL tot a Wo Jc rS' Compensation Rrn _ - VANCE PC" S Date fgnature BATHTUBS SHOWERS NOTICE: If after making this decaration, you should beco4e subject TOILETS r URINALS to the Workers' Compensation provisions of the Labor Code, you must Forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs" revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS I hereby affirm that there is a construction lending agency for the per- SERV ICE SINKS SUMPS•'- formance of the work for which this permit is Issued (Section 3097 Cl v.' C.). _ `" "" FLOOR SINKS FLOOR DRAINS Lender's Name Lender's Address - DRINKING FOUNTAINS - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for -INTERCEPTORS CLARIFIERS the following reason '(Section ^7031.5 Business and Professions Code: SWIMMING POOL ' P TRAP- Any city or County which requires a permit to construct, alter, Improve, demolish or repalr'any structure; prior to Its Issuance, also re- WATER SERVICE '—ALTERATION -'—'res the applicant for such permit to file a Signed Statement that he tensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS ipter 9 (commencing with Section 7000) of Division 3 of the mess and ProWesslons Code) or that he Is exempt therefrom and the WATER HEATERS' BTU OUTi. PUT basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for -a permit SUbjeCtS-the applicant to a civil penally _ SEWER CONNECTIONS of not more than five hundred dollars (5500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK "COLLECTORS Sole Compensation, will do the work, and, the structure isnot Intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractors License Law does not apply to an owner of a property - who builds or improves thereon, and who does such work himself or ISSUE FEE ,through his own employees, provided that such. Improvements are not Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK is sold within one year of.completion, the owner will have the burden of proving he did not build or Improve for the purpose of Sale). HEATING SYSTEM 0-100,000 BTU ❑-f, as owner -of- the property, am exclusively -contracting with- AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU i and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from -Such projects with a contractor(s) licesned pursuant to SYSTEM the Contractor's Ucense Law). 100,00.0+ BTU ❑ I -a m exempt under Section B. & P. C. fol this BOILERS BTU reason' ' Date Owner SYSTEM REPAIR, ALTERATION i hereby certify.that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE information is correct. I agree to comply with all city and county ordinances and State laws relating to construction, and hereby authorize /� C representatives_ of this - ity o en r upo the above mentioned �Q� property f s.aR _ 16 Signature Date _ Drivers ' License or SS ISSUE F E 3 CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ZONING REGULATIONS A.P. lill" ZONE PLNG. REF. zAL REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: ry 1 9 �.J, - ELECTRICAL PLAN CHECK SO- FT- S!- FT -- — GENERATOR 0.1 KW 1-10 KW TRANSFORMER APPLIANCE 10-50 KW 50 + KW MOTORS ' 0-1 HP 1.10 HP (INC. SOLAR) - 10-50 HP 50 + F -1P 'FIXTURES OUTLETS" SWITCHES ' GAS TUBE SIGNS -POLE LIGHTS' - -- POLES METERED SUB PANELS MAIN '.SUB - - '- SERVICE 'AMP'-•~ ISSUE FEE APPLICATION APPROVED BY- DAT SUMMARY OF -FEES, 1 , BUILDING - •- - PERMIT $ - SMTP, - s,' PLAN CHECK s ISSUANCE 5 PLUMBING S GRADING' $ PLAN CHECK $ ELECTRICAL $ - s MICROFILM s PLAN CHECK $- MECHANICAL $ Q_ � _L`_ TOTAL -TEE $ ' LESS AD- ' PLAN CHECK $ _ - VANCE PC" S FINAL FEE $� CONSTRUCTION AND PLANNING APPROVALS Permit # '.S Date Inspector POOL & SPAv' APPROVALS Permit # ` -+Date. . _ Inspector r- 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location _ 2. SoilPipe-Undrgrn . 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding_ 5. Steel ein orce 47. Rough Pfumbing &'Pressure Test. _ 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50, Gas Pipe, ❑ Undrilm, Test 9. Water Pi a-Undr rn 51. Backwash Lines Tra0 ndr rn" ' --- 10. Structural Floor System 52. APPROVAL TO DECK '- 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection - 54. Heater & Vent -Final .13. Rough Plumbing " 14. Rough Electric -Conduit - '•-5&. Electrical -Final 15. Rough Electric -Wiring "57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure . APPROVED FOR PLASTERING _ 18. -Ducts,-Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof -Framing 21. Roof Sheathing NOTES: 22. Frame arid Tlashin 23. -Insulation- 24.- Lathing & Siding 25. Drywall Nailing 26. Plaster- Brown Coat 27. Electrical.Power Meter -Final- - 28. Final Electric -- - - _ 29. - Final Heating & Air Conditioning ' 30. Final Gas Pipe -Test 31. Final Plumbing -32. Water Service=Final - :33.- -Gas Service -F{naJ' -- 34. Solar Domestic -Final 35. Landscape Sprinklino System . 36. Sound Attenuation r 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release. to Edison. 41, Gas Release to Southern California Gas Co. 42. CERTIFICA'T'E OF OCCUPANCY Date "e Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declaration$. ' CiTY OF COSTA MESA - PCRAT NO. NO. LOT NO. BCONSTRUCTION PERMIT�© �Z[TRACT Applicant's Mailing Address TYPE OF CONSTRUCTION NEW - ADD ALTERATION RJR �1 Project Address _RJ�/ 4PA cu'4Y r 20 ❑ CONVERSION ❑ DEMOLISH OTHER tlJ Owner's Neme +7JraQy -- j� Phone d i��' DESCRIPTION OF WORK ZONING T.— Address' TYPE OF PERMIT GRADING{' FOUNDATION STRUCTURALA. P, ZONE \ Arch/Eng. `' License No.' ! + ❑ TENANT [JELECTRICAL y� PLUMBING ❑ MECHANICAL X. Pi -NG. REF. •H, - { +, BUILDING le ` Address 1 Contractor's Nam �Q Seri hone q6 O ❑,BOTHER PROJECT DESCRIPTION Sa. FT. TO BUILDING SFTBAC REAR YARD (TO P/L) '- OCCUPANCY _ Address Ifnailin Y.37I j o� 'fra^.c r-;,4" &y1YIfa i , CONSTRUCTION TYPE_ — VALUATIONS 'LEFT .. SIDE YARD I r RIGHT SIDE YARD ' G 0� 3 GRADINGCU.YOS. ACRESPKG,SPACE REQ. ' PROVIDED License No. __ LICENSED CONTRACTOR DECLARATION r Remarks: $ Q I STREET WIDTH I PARK FEE S I hereby'affirm that -I -am licensed under provisions of'Charter,9 (commencing , with section 7000) of Division 3 of the Business and Professions Code, and Z! SPECIAL CONDITIONS: license is in fut(forcg�ntl effect. t iC 3 (� ' 3 `V ✓ 6' J f ; ' PLUMBING ense Cla, s; Lic se '�_ f� Signature' Date COMPENSATION , '# BarSmk �U it�-a!LiJflc, Sewer Cap ELECTRICAL ; WORKERS' DECLAR T N 1-hereby,afflrnl.that I have a certificate.of.` n8ent,t0 self Insure or.a Certificate Backflow Preventer --. - - Sewer Connection - - --f-- Automatic Washer _ _ _ . _ _ _ Met¢r over 100_ amps i +; ; _ _ _ _ of Workers' Compensation Insurance, or a certified, copy thereof {Section r ' !. Construction Pole > Suty Panel 3800, Lab. G ll f s�lg Backflow Irrigation Solar Collectors )- Policy No. g Company fig Cr3�yl�s Certifled copy Is hereby furnished, ? Bathtubs s Solar Piping r CookingUnit i ' Sub Pole } Certlfled copy IS filed with the city Building Dlvlslon, I Dishwasher ; i Motors �0-1 HP ©134$ Date r Applicant t k Clarifiers I Solar Tank 1 ! EXEMPTION; FROM NIORKERS' COMPENSATION DECLARATION — i ( Dishwasher + - Swimming Pool w/Spa Dryers ❑Gas'" ❑Electric' "--, 116C.Solar+❑9-.15 HP ❑16.15+ 1 4 r (Thissection need not be completed If the permit is for,one hundred (=100) or + less}: + + Fan! iMicrowave i + t certlfy1that in the performince of the work for which this permit is issued I shall; not employ any in any manner so las to become subject. to tare I Drinking Fountains Urinal 1 t t ;Pole person Workers', Compensation, Laws of California.: ( I FIOOr Drains j - Water Closet; i F.A.U. ` # •Light Date Signature, • NOTICE: If, after •making�this -declaration, you -should become -subject to the , -' Floor Sinks. - • __ .t -ri _ Water.Heater,- Fixtures - ` { iRange ' .• : - _ Workers', Compensation provisionsof,the Labor. Code, you ,must forthwith , comply with! such provlsions„or this, Permit shall_ be;deemed revoked. E ,_ Gas Service r :Outlets t ,Water. Service DiB Device Boxes ,, ; Sign' i + CONSTRUCTION LENDING 'AGENCY` , _' Outlets I hereby affirm that there is a constructlon,lending agency for the performance 'work Interceptors .,c r' Standing Sections of the for, which this permit'is-issued (Section 3097 Civ. C:) Lenders Name - '• F { - � !.' :. t Kltchen�Sink'; t # � i , i Switches ' i , ' , .Trash Compactor ! ; Ladder's Addressr✓ OWNER BUILDER DECLARATION + r, t Lavatories,, -" , , - - _ r Garbage Disposal j ereby afflrm.lhit I am -exempt', from the Contractor's License Law for the reason, •7031.5 'Business and Professional Code: Any I P - Generator. 130.5 KW ❑5-15 KW pwing (Section city or ' { -Trap rty which' requires a permit.to construct, alter Improve, demolish or repair y structure; prior to Its 'issuance,.also requires the appticant for such permit Roof D'ra(nS• Transformer 1:115-50 KW i ' -,to file a'signed statement that he/she is licensed pursuant to the'provisions Of Lha Contractor's License Law (Chapler'9 (commencing with Section 7000} of , I ❑5l} + KW' Reinspaction Fee !Division .3, -of the,Business'and Professions Code) or that he/sheds exempt I therefrom the, basis for the Any'vloration Sectionf Showers • i , ,ry Reinspection, Feel $15 deter ❑up to 100 amps $ 3 and alleged exemption. of. ' - •a ' ' issue Fee 'penalty7031,5 by,any applicant for- a permitCsubjects the applicant to a civil of not more than five hundred dollars (y500).. •- Service Sink Issue Fee = 3 Zoning Apprbtied By 1 Date ' r, as owner of the 1 property or my emPloyee5 with wages.! as their sole compensation, will, do the work, and the structure, Is not intended or offered for sale r(Sechon-7044'. Business; and Professional Code:, The Contractor's :. ,'; MECHANICAL Application Approved By ,' ---- — nate License Law does not apply to an owner of a property;who builds or Improves '.who'does'such Bpil2r - Refrigeration System I r Application isiued By Date — thereon;,and work himself/herself or through his or. her own employees, provided that such improvements are not intentled or ot[ered `tor r , Duct - Under Ground ❑0-..100;000 BTU ❑ 100,000 BTU' I , sale. If, however, the building or Improvement is sold within one year of Com- y ' ; SUMMARY OF FEES' platten, the owner'wlll have .the burden of proving he/she did not build or Im- rove fo_r the purpose of sale). , Duct - Structural System Repair/Alteration BUILDING PERMIT $ _ SMTP $ .; I, as owner of the pioDerty, am exclusively contractEng,with licensed con- + ' ' tractors to construct the project_�Section 7044, Business and Protasslons Coda: •The COntrattar'S License Law pas not apply tp an owner of property who _ Duct -;Ventilating PLAN CHECK r $ PERMIT + CIOISSUANCE ' $ builds or improves thereon, and'who contracts far such projects with a con- Exhaust System ElMultiple ❑ , PLUMBING $ r , tractors} license pursr:ani to the Contractor's License Law}. ❑ I,am exempt antler Section B. & P, C. for this reason FirepllFect; Bit. ICBG PLAN CHECK $ GRADING $ I ! Heating System &Ducting + ; } ELECTRICAL ' $ ° $ MICROFILM $. Date Owner, i --I hereby- certify- •that'I hare read -this application and,state-that, the above- - El 0-100,000 BTU•❑100,0008 4 • - - -- - - - �) �! + PLAN CHECK, $ 1 ' , Information Is correct, I agree to comply with all city and county Ordinances t ! , $� i TOTAL -FEE, $ and'.state laws relating to building construction,, and hereby authorize repre- sentatives of -this • to erste, p0 the above-mentioned properly for Inspection P _IJ r Ho' Or Typ9 I ❑ ' Canopy T e II ❑• + I Reirrspaetipn Feel , $15 .,MECHANICAL PLAN CHECK $ LE55 f ADVANCED JJ��/��s� QQ � Signature' Date— I ; PC $ i Drivers' License or,5 I ! i Registers , l Issue Fee I $ 3 # + I FINAL FEE: $ CMF 0865-46 rev- 12/82 White - Building; Canary - Applicant; Pink - Accouniing; Goldenrod - Assessor a 1 ct C3CONSTRUCTION ANDPi?ANNI. 7- d 0L-& SPA APPROVALS Permif#= " - Dste 'Inspector _ < < APPROVALS Permits# - Data Inspector A .1. Temporary, Electrical Service orJ_Pole'; Pool &Equipment Location - - - r• 2;Soil Pipe-Qndrgrnd`.� . '53' Steel Reinforcement � r _ w 1 �• ., . f s Y .'Forms'3. - r 4. Electrical Conduit-Undrgrnd. ' 4 _ ? 55:� Electrical, Bonding - R `RougFi 5: Steel.Reinforcement n I_ c c u - �: r: i56. Plumbing &Pressure Test 1 '6: Electricil LIFER L t : L� 57;' APPROVATO�COVER GUNITE tGrnd.+ I 7. Footings I Conduit-Undrarr,rl. - I + ♦ f -Electrical- B. Foundation j - ` = 59. -Gas Pipe;,❑. Undrgrnd.-, Test 9. -Water Pi a-Undr rn = p g d. c } 60. Backwash Lines, P -Trap, ❑ Undrgrnd. s 10. Structural Floor Systerh �: n 61. APPROVAL TO DECK - i 1, Sewer Lina &,House=Connection; -_ I :i2. Backwash & Receptor -Final - tProperty Bio 12. Sewer Cap i • _ t �- 63. Heater &Vent Final 13. tRoof'Drains i64. Plumbing System Final 14. Rough Plumbing = _ - :165. Electrical -Final - 15.''Rough Electrical:Conduin-. " { '� " 1 - i 766. Solar System.Final l_-"'_7 _� 4'-1.6:'R&ugh Electric Wiring _ is ! � r� 'T71 s r X67. Fencing &Access Approval `17. Rouo-Wiririg Signa ' ° ' . _ •' _ { ; i • 68. APPROVED FOR PLASTERING V1 B. ; Rou Il .Electrilal-T Bauer Ceiling i . { E { [ 169. POOL/SPA SYSTEMS FINAL 1 1 19. Rough,Heating &?Air.Conditioning !, ! i - ( I ! FIRE DEPT. REQUIREMENT f APPROVALS Permit 20. kough;Factory Fireplace i ; f' 21: LDucts jn Structure '. ' 'r • + i �; I { 1 70 ` Underground Hydro 22.'Ducts, Ventilating . 4 ' ! i { {71 ` Product Piping 0 Gas ❑ Oil •_23.,GasfPipe-Rough & Test l I' , i l T t I I_ 72! Underground Flush i 24. Roof Framing, ,73. Undergrnd. Storage.Tank ❑ Gas. ❑Oil 4 , + 25. Roof,Sheathin'g - ' , - ; . ` 74. Overhead Hydro = T Bar Ceiling [Structuralj, Monacoat i I _ ` i ` 45. 26. & ; �, Dry Chemical 27. Frame and'Flashing, 76- Dry Standpipe t 28.,JL thing & Siding' �:i n f �: i + 1 ! 77. FIXED SYSTEM FINAL 29. Insulation' _ .. - , f i I j 78. FIRE PREV. FINAL -30. Drywall Nailing ' ; ' �' }+ ' Notes-' 31.4Plaster Brown Coat - 1 ' 32. Electrical Power Meter -Final 33. rFinal .Electric 34, Final Heating & Air Conditioning 35. Final Gas Pipe=Test 36. Hood oQ,anoPY-'; 37. Final Factory Fireptacey 36. Fina[ Pfdrnbingi t 39. Water'Ser'vice-Final 40. Gas Service -Final } I } + ? } + t + s 41. Solar Domestic -Final , 42. BackflowPreventer' L 43. Backflow leiigatiori 44. Landscape Irrigation Sytitemi ;e+ ; ! 45. Sound tAttenuation % , ` { f 46. Handicap Regulations t 47,- FINAL STRUCTURE & BUILDING4{ f I I I 48. Special Requirements Completed + , 49. Electric Retease to!Edisoni 50. Gas Release to Southern California Gas Co 51. CERTIFICATE,OF OCCUPANCY No if Date -r + - Applicant to fill in all spaces whin heavy border lines and sign all appropriate declarations. PON COSTA MESA PE IT NO. TRACT NO. LOT NO. NO. RUCTION PERMIT -,41 c) Project Address Airway venue Suite F110 TYPE OF CONSTRUCTION Owner earson-American Ex re Mona ❑ NEW ❑ ADD II ALTERATION ,jIlcy No, Company I Certified copy Is hereby furnished. tA Certlfled copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectionneed not be completed if the permit Is for one hundred {$100 or less. f cert fy that n 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. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a Construction lending agency for the per- formance of the work for which this permit IS issued (Section 3097 Civ. C.). NONE Lender's Name Lender's Address OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the 's for the alleged exemption. Any vlolatlOn of Section 7031.5 by aPPllcent for a permit subjects the applicant to a civil penalty .ot more than_five hundred dollars ($500). LJ 1, as owner of the property, or my employees with wages as their sole compensation, wilt do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Profession$ Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date - er I hereby certify that I ve ad this appli io d state that the above Information is Corr agree co p wi all city and county ordinances and sta I relating to c st cti , and hereby authorize representatives is city o e r po the above mentioned property .for i coon r o jO Signature ate ` Drivers' Lice a or SS REMARKS: p— 2 - Address 1601 Dove Street ❑ REPAIR ❑ CONVERSION ❑DEMOLISH 0-100,000 BTU, ❑OTHER Arch/Eng. Tom Campos $ Assoc.LicenseNo. PLAN CHECK ESCRIPT ON OF WORK Tenant mprovement office 'Address 17779 Main "F" lrvine CA. 92 Contract9p JDO Company Phone 540-ZbUv TYPE OF PERMIT AddreV3151 Airway Avenue Bldg. DOUBLE LAVS a❑ GRADING ❑ FOUNDATION E7 STRUCTURAL ❑ TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANIC, [3 OTHER PROJECT DESCRIPTION SO. FT. 505 OCCUPANCY�CONSTRUCTION TYPE N VALUATION (2291Q ZONE GRADING CU. YDS. ACRES LICESED CONTRACTOR DECLARATION I her, affirm that I am licensed under provisions of Charter 9 (com- mon ng with section 7000) of Division 3 of the Business and Pro ssions Cod and my license is In full force and effect. L ense Class -1 License No. � ate 841 Signature _ WDRKERS' COMPENSATION DECLARATIDN - I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a Certified copy thereof (Sectio1pq3dj�Pb. C.).Fairmont Ins. Co. ,jIlcy No, Company I Certified copy Is hereby furnished. tA Certlfled copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectionneed not be completed if the permit Is for one hundred {$100 or less. f cert fy that n 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. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a Construction lending agency for the per- formance of the work for which this permit IS issued (Section 3097 Civ. C.). NONE Lender's Name Lender's Address OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the 's for the alleged exemption. Any vlolatlOn of Section 7031.5 by aPPllcent for a permit subjects the applicant to a civil penalty .ot more than_five hundred dollars ($500). LJ 1, as owner of the property, or my employees with wages as their sole compensation, wilt do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Profession$ Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date - er I hereby certify that I ve ad this appli io d state that the above Information is Corr agree co p wi all city and county ordinances and sta I relating to c st cti , and hereby authorize representatives is city o e r po the above mentioned property .for i coon r o jO Signature ate ` Drivers' Lice a or SS REMARKS: p— 2 - PLAN CHECK HEATING SYSTEM 0-100,000 BTU, AND DUCTING PLUMBING PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAVS KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS, - FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS SUB INTERCEPTORS CLARIFIERS SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS' BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU, AND DUCTING 1-10 HP + HP " FIXTURES 100,000 + BTU_ REFRIGERATION 0.100,000 BTU— SYSTEM 100,000 + BTU' - BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE CMF 0865.46 White-BuildinV Canary -Applicant; Pink -Accounting; Goldenrod -Assessor -� 6I 39 9/23/62 535.7E , TL. ZONING REGULATIONS A.P. zf -12.7 -- = I— ZONE te-- / PLN -G. REF. :P REAR YARD (TO P/L) /� t PKG. SPACE REO. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY�� DATE SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK " GENERATOR TRANSFORMER APPLIANCE 0.1 KW 10-50 KW -50 1.10 KW + KW MOTORS (INC. SOLAR) 0-1 HP 10-50 HR. -50 1-10 HP + HP " FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS GRADING -$ POLES- METERED SUB PANELS- - MAIN SUB SERVICE AMP - $ TOTAL FEE $, ISSUE FEE APPLICATION APPROVED DATE/��L BUILDING SUMMARY OF FEES it ! !' I PERMIT $ $MIP $,_� PLAN CHECK PLUMBING S ERMIT ISSUANCE $ $ GRADING -$ PLAN CHECK ELECTRICAL $ $ $ ,PLAN CHECK $ MICROFILM $ ,MECHANICAL $ TOTAL FEE $, PLAN CHECK LESS AD - S VANCE PC S FINAL`FEE $ APPROVALS CONSTRUCTION AND PLANNING-~OOL Permit # rtP Date, Inspector & _' • PSPA APPROVALS Permit # ; Date Inspector 1. Temporary Electrical Service or Pole 43, Pool & Equipment Location 2. SoilPipe-Undrgrn.. 44. Steel Reinforcement .3.. •Electrical Conduit Utilify•Uadrgrrr _ - 45. Forms f 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee eln orce 47. Rough_Plurnbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50, Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-TraI2, ❑ Undrarn 10. Structural Floor.System 52. APPROVAL TO DECK 11 z-".Property.Sewer 'Nine & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection _ 54. Heater & Vent -Final 13. Rough Plumbing _ Final 14. Rough Electric -Conduit .•56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flash ing , 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat AA0 j5 f 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33: Gas Service -Final 34. Solar Domestic -Final 35.-- Landscape Sprinkling System 36. Sound Attenuation �• 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING -4kSR Y * 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. . CERTIFICATE OF OCCUPANCY No - 3,5 Date 2 i `�' Applicant to fill InII spat thin heavy border lines and sign all appropriate declarations. J• .,CityOF COSTA MESA. -F'7,� 7 1 TRACT NO. -- LOT NO- " :BL G. N,' CONSTRUCTION PERMIT �a - lO 8161 9/23/82 r ZONING REGULATIONS 29.00 TL :A.P. :P roject Address �t7 TYPE OF CONSTRUCTION SACK C/L ST. wners 1 Phone 5-D-26" - ❑ NEW- ❑ AOD =❑-ALTERATION f _ ddress �)s- �i2 r -� - L 10 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH -'VL7 ,�TfIgR �L�0�� Mp'y rcWEng. _' _ _ LicenseNo,.__ \ i 'r� DESCRIPTION OF WORK_e7"oi`�ect - TYPE OF PERMIT. =� -❑ GRADING © FOUNDATION 0 STRUCTURAL ' ❑_TENANT ©ELECTRICAL'WMBING ❑MECHANIC Address Contractor(Z_U - _ Phone 6' _ a$ Address ` SCh ? LICENSED CONTRACTOR DECLARATION DATE I hereby affirm that'd arii licensed under proWilons of Charter 9 (com- mencing with section 7000)- of Division 3 of the Business and Professlons-'Code; and my license is in- full force and effects Ucense Class Ucen a No. G Date � "'g Z Signature WORKERS' COMPENSATION DECLAR ON ❑ OTHER PROJECT DESCRIPTION - SQ. FT. OCCUPANCY ' ' ' CONSTRUCTION TYPE PLAN CHECK I hereby affirm that -i have a certificate of consent to self -Insure ora certificate of Workers' Compensation Insurance, or ,a certified copy VALUATION ZONE - .- thereof (Ion 3800 b. G•)• Policy No. s Lat Company S > - Czr , GRADING CU. YOS: ACRES - - - - - ELECTRICAL PLAN CHECK ' 7 Certified copy Is hereby furnished, �^ Certified copy Is filed with the city Building Oivlsion. REMARKS: _ (� Z GENERATOR 0_1 KW TRANSFORMER APPLIANCE 10-50 KW_50 1-10 KW + KW EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 1-10 HP 50 + HP (This section need not be completed if the permit Is for one nundred SWITCHES t GAS TUBE SIGNS (3100! or less!. I Cert(fy that )n the performance of the work for which this permit Is issued, I Shall not employ arty person In any manner so as to become subject to the Workers' Compensation Laws Of California. POLE LIbHTS PLUMBING PLAN CHECK BATHTUBS SHOWERS SUB. Data Signature SUB NOTICE: If after making this declaration, you Should become subject TOILETS URINALS Z - $ to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with Such provisions or this permit shall be deemed LAVATORIES I DOUBLE LAYS -P,- revoked. ' CONSTRUCTION LENDING AGENCY -KIT. SINKS DISHWASHERS I hereby affirm that there IS a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 SERVICE SINKS SUMPS - Civ. C.). Lender's Name ' FLOOR'SINKS -FLOOR DRAINS DRINKING FOUNTAINS-' Lender's Address OWNER BUILDER DECLARATION. i hereby affirm that I am exempt from.the Contractor's License taw for the following reason (Section 7031.5.13usiness 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 re- qua resthe applicant for such permit to file a signed statement that he INTERCEPTORS CLARIFIERS SWIMMING -POOL P TRAP WATER SERVICE -ALTERATION -' Is'licensed pursuant to trio provisions of the.Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Professions Code) Or• that he is exempt therefrom and the_ Business basis for the alleged exemption. Any violation of Section 7031.5 by the b a' ippticant for a permit subjects the applicant to a civil penalty t more than five hundred dollars ($500). GAS SERVICE -OUTLETS WATER, HEATERS -' BTU OUTPUT - lvd - SEWER CONNECTIONS-- - -SOLAR TANK COLLECTORS L. , 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 offeredfor sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License taw does not apply to an owner of a property ISSUE FEE - - who builds -or Improves thereon, and- who does such work himself'or through his own employees, provided that such improvements are not Intended or offered for- sale. - It. however, the building or improvement Is sold within one year of corrrpletlon, the owner will have the burden MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU --AND-DUCTING- ' ' - - - - 100,000 +`BTU of proving he did not build or -Improve -.for -the purpose of sale). 11I, as owner of the property, am exclusively contracting. with licensed contractors to construct the project, (Section 7044, Businoss and Professions Code: The Contractor's License Law does not apply_to REFRIGERATION 0-100,000 BTU _ SYSTEM - 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the'Contractor's License Law). ❑ I,am exempt under section B. & P. C. for this BOILERS BTU reason Date _ Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and State that the above information is correct- 1 agree to Comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives of this cii to en er upon the -above mentioned property for io Signatu c to Drivers' License o ISSUE FEE- CMF 0865.46 White -Building; Cana ry-Appiicant; Pink -Accounting; Goldenrod -Assessor 8161 9/23/82 r ZONING REGULATIONS 29.00 TL :A.P. :P ZONE 'PLNG7gUiLDING SACK C/L ST. gRlE�F.p�� XROPEW II NE t!PFFt YARD _ o RIIGHT REAR YARD TO P/L) PKG. SPACE REQ. PROVIDED .STREET WIDTH PARK FEE $ ZONING APPROVED BY- DATE SPECIAL CONDITIONS: SMIP!-' $, PLAN CHECK $ PERMIT ISSUANCE 3 ELECTRICAL PLAN CHECK ' SQ FT. SCJ. FT. - GENERATOR 0_1 KW TRANSFORMER APPLIANCE 10-50 KW_50 1-10 KW + KW MOTORS 0-1 HP (INC. SOLAR) - -10-50 HP 1-10 HP 50 + HP FIXTURES OUTLETS SWITCHES t GAS TUBE SIGNS $ POLE LIbHTS PLAN CHECK POLES METERED SUB. PANELS MAIN SUB SERVICE' AMP. , $ LESS AD- VANCE PC S FINAL FEE 3 ~ ISSUE FEE APPLICATION APPROVED BY DATE. - SUMMARY_ OF FEES BUILDING - PERMIT. - $ SMIP!-' $, PLAN CHECK $ PERMIT ISSUANCE 3 PLUMBING $ -GRADING '3 PLAN CHECK $ ELECTRICAL $ $ PLAN CHECK g _MICROFILM E MECHANICAL $ - -TOTAL FEE $ PLAN CHECK $ LESS AD- VANCE PC S FINAL FEE 3 ~ CONSTRUCTION AND PLANNING APPROVALS Permit Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location— 2. l Sol -ipe-Undrgrn 44. Steel Reinforcem6nt, 3. Electrical Conduit Utility-Undrgrn -_x 45.. Forms 4. Electrical Conduit-Undrgrn 46, - Electrical -Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undrgrn 8. Foundation SO. Gas Pipe, [I Undrgrn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P -Trap. E] Undr-grn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Finat 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing ..55. Plijinbing System - Einal 14. Rough Electric -Conduit -56. -E-tectrical-Final 15. -Rough Electric -Wring 57.- Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gag Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathipg NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. - Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final{ 33, Gas Service -Final 34. Solar Domestic -Final 35, Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In aft spaces within heavy border lines and sign all appropriate declarations. CITY QFC COSTA MESA PERMIT Q.� a TRACT NO. LOT NO. BLDG. NO. �r 1 CONSTRUCTION PERMIT iG JJ i Project Address C,,7, TYP OF CONSTRUCTION ' Owner + Phone. NEW ❑ ADD' ❑ ALTERATION Address 1:1 REPAIR ❑ N ❑ ,COVERSION DEMOLISH Arch/Eng,_ ._ _ License No. ❑ OTHER DESCRIPTION OF WORK Address REMARKS: Contractor xAtiJ{4/p• '6 z r Ph6ne s/ L TYPE OF PERMIT , ❑ GRADING © FOUNDATION— 0 STRUCTURAL ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHAI Address 2 v Qra4 AIIss LICENSED CONTRACTOW DECLARATION 1. hereby affirm that I am licensed under provisions of Charter 9 (com- '' `` mencing with section 7000) of Division 3 of the Business: and ❑ OTHER Professions Code and my license is in full force and effeq!!. 1.10 HP 7 - J.- PROJECT DESCRIPTION ' ucens CI ss e No .. Date? --Signature SQ, FT. WORK RS' C MPENSATION D CLARAT10N OCCUPANCY CONSTRUCTION TYPE I hereby affirm' that I have a c tiflcate of consent to self -insure ora VALUATION, ZONE certificate of Workers' Compe atlon Insurance, or a certified copy FLOORSINKS FLOOR DRAINS- - thereof (Ser.Lion 3800, Lab. C.). / , GRADING CU. YOS• ACRES Policy No. " Compan; f3"'•� �•' `-^c tlfied copy Is hereby furnished. REMARKS: 1Certified copy Is filed with the city Building Division. TRANSFORMER - `1 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION. gThis section need not be completed if the permit Is for one hundred 10-50 KW_ ($100) or less). - - MOTORS I certify that n the performance of the work for which this permit is 1.10 HP 7 - Issued, i shall not employ any person in any manner so as to become PLUMBING PLAN CHECK Subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS - Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TOILETS URINALS - ' LAVATORIES DOUBLE L -AVS revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS 1 hereby affirm that there IS a construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 SERVICE SINKS SUMPS FLOORSINKS FLOOR DRAINS- - Civ C.). - Lender's Name DR1NKiNG FOUNTAINS ' Lender's Address - r ' OWNER BUILDER DECLARATION =:1 I hereby affirm that t am exempt from.the Contractor's License Law for the following reason (Section 7031.5 BUSInes$ and Professions Code: Any 'city or county- which requires a permit to construct, alter, 'INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP Improve, demolish or repair any structure, prior to Its.issuance, also re-. quires the applicant for such permit to file a signed Statement that he Is licensed pursuant to the -provisions of the Contractor's License -Law. (Chapter 9 (commencing with -Section 7000) of Division 3 of the WATER SERVICE ALTERATION _ GAS SERVICE OUTLETS WATER HEATERS - BTU OUTPUT -' business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS r applicant for a permit subjects- the -applicant to a civil penalty_ t more than five hundred dollars ($500). SOLAR TANK COLLECTORS ' L, , as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended SOLAR PIPING'SYS.- or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE who builds or improves thereon, and who does such work himself'or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK intended or offered for sale. If, however, -the building or Improvement • Is Sold within one year of completion, the owner will have the burden of proving he did- not -build or improve for the purpose of sale). © 1, as owner of the properly, am exclusively contracting with licensed' contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to HEATING SYSTEM 0-100,000 BTU AND DUCTING 100.000+ BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU an owner of property who bullds or Improves thereon, and who con- tracts from such projects with a contractors) licesned pursuant to the Contractor's License Law), © I am exempt under Section B. & P. C. for this BOILERS BTU GRADING $ reason Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that 1 have read this application and state that the above Information is correct. I agree to comply with ail city and county ordinances and state laws relating to construction, and hereby authorize representatives of this city to enter upon the above mentioned property for s tionp Signature Drivers' LLense or SS 4 / !! ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod•AssesSor '8299 9/27/8 ZONING REGULATIONS' A.P. # ZONE PLNG. REF. :P REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE S ZONING APPROVED BY DATE SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK , GENERATOR 0-1 KW 1-10 Kw TRANSFORMER PANELS _ APPLIANCE 10-50 KW_ 50+ KW , MOTORS 0-1 HP- 1.10 HP 7 - (INC. SOLAR) 10-50 HP 50 + HP FIXTURES(/ �— OUTLETS 'SWITCHES GAS TUBE SIGNS POLE LIGHTS' -35.16 TL •I POLES r.w. METERED SUB PANELS MAIN SVB r SERVICE O AMP eo�-. ISSUE FEE APPLICATION APPROVED BY DATE i SUMMARY OF FEES BUILDING PERMIT S SMIP $ PLAN CHECK $PERMIT ' -ISSUANCE E PLUMBING S GRADING $ PLAN CHECK E ELECTRICAL a ZUZ414 E PLAN CHECK $ MICROFILM 5 MECHANICAL S - TOTAL FEE $ PLAN CHECK E LESS AD- VANCE PC $ FINAL FEE E� ' ti 1 CONSTRUCTION AND PLANNING � �1�� APPROVALS Permit # .l 4 7 Date Inspector POOL & SPA APPROVALS Permit # Y Date-- Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . Soil Pipe-Undrgrn - i , ...: 44. Steel Reinforcement ` 3. Electrical Conduit Utility-Undrgrn _ , _ -45. Forms 4. Electrical Conduit-Undrgrn 46. .Electrical Bonding " 5. Steel ein orce ' 47. Rough Plumbing & Pressure Test ` 6. 'Electrical UFER Urn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn' J' 8. Foundation 50... Gas Pipe-, ❑ Undr rn, Test . 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ' ❑ Undrrn 10. Structural Floor System 52. APPROVAL TO DECK ? 11, Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55.' Plumbing Sy5tem - Final 14. Rough Electric -Conduit - - •56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning ots. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test _ 20. Roof.Framing 21. Roof Sheathing NOTES: 22. ' Frame and Flashing _ _. -23., Insi.11ation 24. Lathing & Siding 25. Drywall Nailing _ 26. Plaster Brown Coat T 27. Electrical Power Meter -Final ' 28. Fi4l Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test .31. Final Plumbing _ 32. Water -Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation _- 37. Handicap Regulations ' •38. FINAL STRUCTURE & BUILDING • 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ^CITY OF COSTA MESA PERMIT NP. TRACT NO. LOT NO. BLDG. NO. St7. FT. ISSUE FEE -� CONSTRUCTION PERMIT C7 Address � C> TYPE OF CONSTRUCTION Phone ❑ NEW ❑ ADD ❑ ALTERATION s ❑ REPAIR ❑CONVERSION ❑DEMOLISH ng. License No. ❑ OTHER MA'd DESCRIPTION OF WORK scto PERMIT _ - Ph neTYPE OF PERMIT s ©GRADING © FOUNDATION ❑STRUCTURAL ED CONTRACTOR ECLARATIO Q TENANT ❑ ELECTRICAL ❑PLUMBINGMECHANIC aTilrm thLt 1 amf)tansed under pro SIonS of Charter 9 (com- with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my Ileans is in full fortand cif I. PROJECT DESCRIPTION License Class b is s o. Date q Signature -11 SQ. FT. _ WORKERS' COMPENSATION DE&ARATObN OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a Certificate of conserilt to sZEN VALUATION ZONE c--•tflCate of Workers' Compensation 1 rant r a , f (Se tion 3800 b. C.). GRADING_ CU. YDS. ACRES vi 4 =j No. Company + i Certi(letl copy is hereby furnished. -REMARKS: - !t ertified copy is filed with the city Building Division. MICROFILM s ! I�MPTION FROM WORKERS' -COMPENSATION DECLARATION' - fff '{This section.need not be Completed if the permit is for one hund ed 1($100) MECHANICAL or less). f 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 PLUMBING PLAN CHECK subject to the Workers Compensation -Laws of California. PLAN CHECK Date Signature • BATHTUBS SHOWERS _ 1 NOTICE: If after making th1S declaration, you should become subject TOILETS' 0 URINALS tothe Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS fl- hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS ,formance of the work for which this permit Is issued (Section 3097 ' `Civ. C.). • - _ FLOOR SINKS FLOOR DRAINS Lender's Name - _antler's Address DRINKING FOUNTAINS ' 7WNER BUILDER DECLARATION • hereby affirm that I am exempt from the Contractor's License taw for INTERCEPTORS CLARIFIERS he following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL PTRAP i ny city or county which requires a permit to Construct, alter, - 1„)provo, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE ALTERATION sires the ap, 11cant for such permit to file a signed statement that he ' V, lice nsed'pursuant'to the provisions of the Contractor's License law GAS SERVICE. OUTLETS 9 (commencing with Section 7000) of Division 3 of the u:z� Professlons Code) or that he is exempt therefrom and the 1 as�• the alleged exemption, Any violation of Section 7031.5 by WATER HEATERS BTU 7 OUTPUT'� •1 ay wpllCant tar a permit Subjects the applicant' to d Civil penalty _ SEWER CONNECTIONS t f not more than five hundred dollars ($500). -a-s- 1 3 , a5 owner of the property, or my employees'with wages as their SOLAR TANK - COLLECTORS He will do the work, and the structure isnot Intended _ _ i offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ontractor's License Law does not apply to an -owner of a property , ho builds or Improves thereon, and who does such work himself or ISSUE FEE trough -his own employees, provided that such Improvements are not - tended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK ;sold within one year of completion, the owner will have the burden proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU V1 1, as owner of the property, am exclusively contracting with AND DUCTING I / } sensed contractors to construct the project (Section 7044, Business 100,000 +BTU i o+ id Professions Code: The Contractor's License Law does not apply to I owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU acts from such projects with a Contractor(s) IlCesned pursuant to SYSTEM le Contractor's License Law). 100,000 + BTU .. ) I am exempt under Section B. E1 P. C. for this i ason BOILERS BTU etc Owner SYSTEM REPAIR, ALTERATION • hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE iformatlon is correct. I agree to comply with all city and county ;di nances an tate laws relati g to construction, and hereby authorize presentative of t s y enter upon the above mentioned io_ perty for lnspectl n s. gnature 'rivers' License or SS ISSUE FEE 8368 9/28/82 ZONING REGULATIONS A, P. 9F ZONE PLNG. REF. 7P REAR YARD (TO P/L) PKG. SPACE R E4. PROVIDED STREET WIDTH PARK FEE S ZONING APPROVED BY DATE< SPECIAL CONDITIONS: 19.0')- TL ELECTRICAL PLAN CHECK St7. FT. ISSUE FEE GENERATOR TRANSFORMER APPLIANCE 0-1 KW ,1-10 KW 10-50 KW_ 50 + KW MOTORS (INC. SOLAR) 0-1 HP - 10-50 HP ~ 1-10 HP 50 + HP FIXTURES OUTLETS SWITCHES ' GAS TUBE SIGNS - POLE LIGHTS PERMIT _ - s w PANELS MAIN' SUB . SERVICE AMP FINAL FEE S.._��-�_ IAF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 4—z- ISSUE FEE APPLICATION APPROVED BY- DATE SUMMARY OF FEES :•' BUILDING - PERMIT _ - s w -SMTP � S .PLAN CHECK $ PERMIT ISSUANCE S PLUMBING $ GRADING $� PLAN CHECK S , ELECTRICAL $ s PLAN CHECK - $ MICROFILM s TOTAL FEE S MECHANICAL $ _ '- LESSAD-. PLAN CHECK s _ VAN VgNCE-PC S FINAL FEE S.._��-�_ IAF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 4—z- CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA _ APPROVALS Permit # -Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. Soil ipe n rgrn • Steel Reinforcement - 3. lectrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding Steel ein orce 47. Rough Plumbing & Pressure Tact 6. Electrical OF -Grn 48. APPROVALTO COVER-GUNITE - - 7. Footings 49. Electrical Conduit•Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rnr.Test 9. Water Pipe-Undrgrn 51. Backwash Lines P ra •- ❑ r '- 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash &.Rece for -Final t 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - 14. Rough Electric•Conduit - - 56: . Electrical -Final _ 15. Rou h Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 5U. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Hoof Framing 21, Roof Sheathing NOTES: 22. Frame and Flashing 23: Insulation 24. Lathin2 & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical -Power Meter -Final - 28. Final Electric 29. 30. Final Heating & Air Conditioning Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final ti 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System ; 36. Sound Attenuation r au 37. Handicap Regulations- 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No._. Date L 6380 5/26/82 ZONING REGULATIONS ' A.P. fit 1'�.� ...,� i -•.L� ZONE L� /-,PLNG. REF. REAR YARD (TO P/+-) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY 'SPECIAL CONDITIONS: r PROVIDED PARK FEE $ DATE 378.60 Tit ELECTRICAL Applicant to fill in ail spaces within heavy border lines and Pgn all appropriate declarations. PLAN CHECK - - 'CIT.Y" OF COSTA MESA PE MIT NO. TRACT NO. y�,QQTNO. BLDG. NO. .5 SMIP $ RI �:ONST�CTlO.� PERMIT 173 1-10 KW + KW " Project Address 3151 F-100 Ai rway Ave. C M. TYPE OF CONSTRUCTION 1-10 HP 50 + HP (d NEW El ID ALTERATION Owner Phone SWITCHES ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Address _ ❑ OTHER DESCRIPTION OF WORK tenant improvemen! Arch/Eng, Tom Campos & Assoc. License No. Address n �� _ nIrvine UUU Contractor J . Donald 01 Son Ph6ne 5j40-25 TYPE OF PERMIT Address ' ❑GRADING ❑ FOUNDATION ❑ STRUCTURAL " LESS AD- ` VANCE PC $ IN TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAI LICENSED CONTRACTOR DECLARATION rhereby affirm that I am licensed under provisions of Charter 9 (com- encing with section 7000)' of Division 3 of the Business and O'OTHER Professions Coci and my license is In full force and effect. License Class V License No. 393999 Date Signature PROJECT DESCRIPTION - SQ, FT.��//�� a� 'ORKERS' COMPENSATION -DECLARATION - '" OCCUPANCY ONSTR CT.ION.TYPE hereby affirm that I have a certificate of consent to self -Insure or a -artifieate of Workers' Compensation Insurance; or -a certified copy VALU , ONE thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES Policy No. Company ' - REMARKS: - �"Jr~ Z-_3 ' (] Certified copy Is -hereby furnlshed: - Certified copy Is filed with the city Building Division. r EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section -need not be completed if -the -permit -Is for one hundred ($1003 or less). F 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 - 1 - ' = PLUMBING. ' .,PLAN CHECK subject to the Workers Compensation Laws of California.- - - - BATHTUBS SHOWERS Date Signature NOTICE: If atter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TOILETS ;i'; 4URINALS LAVATORIES DOUBLE LAYS - revoked. - - - - - - - CONSTRUCTION LENDING AGENCY •- - - - KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS I hereby affirm that there is a construction lending agency for the per- formanCe of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS civ. cShearson/American Express Langer's"Name DRINKING FOUNTAINS Lender's Address 7601 Dove St- - NPwnf)rt RParh INTERCEPTORS CLARIFIERS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the-Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or -County ,which requires a permittoconstruct, alter, -orove, demolish or repair any structure, prior to Its issuance, also re-' es the applicant for such permit to file a signed statement that he tensed pursuant to the provisions of the Contractor's License Law .napter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he' is exempt therefrom and the' basis for the alleged exemption, Any violation of Section 70.31.5 by any applicant for a permit subjects the applicant to'a civil penalty of not more than five hundred dollars (5500). SWIMMING POOL P TRAP ' WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS " SOLAR TANK COLLECTORS ❑ 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply to an owner of a property- ISSUE FEE r who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden HEATING SYSTEM 0.100,000 BTU AND DUCTING 100,000 + BTU of proving he did not build or improve for the purpose of sale). 0 I, as owner of the property, am 'exclusively contracting with licensedcontractors to construct the project (Section 7044, Business and Professions Code: -The Contractor's License Law does not apply to REFRIGERATION 0-100,000 BTU an owner ofproperty who builds or improves thereon, and who con- tracts from such projects with a contractor(s) Ilcesned pursuant to the Contractor's License Law). SYSTEM -" 100,000 + BTU ❑ 1 am exempt under Section B. 8. P. C. for this BOILERS BTU reason - reasOwner Date SYSTEM, REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I"hereby Certify that I have read this application and state that the above Information Is correct, I agree to comply with all city and county ordinances and state laws relating to construction, and hereby a thorize representatives this City to enter upon the above nti ed Property for pect ih pur. o - •� -� - ISSUE FEE Signature Date Drivers' License or SS jg CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor L 6380 5/26/82 ZONING REGULATIONS ' A.P. fit 1'�.� ...,� i -•.L� ZONE L� /-,PLNG. REF. REAR YARD (TO P/+-) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY 'SPECIAL CONDITIONS: r PROVIDED PARK FEE $ DATE 378.60 Tit ELECTRICAL — PLAN CHECK - - 'SO, FT. PERMIT $ .5 SMIP $ GENERATOR TRANSFORMER APPLIANCE 0-1 KW I0-50_KW_50 1-10 KW + KW " MOTORS .(INC. SOLAR) 0.1 HP' 10-50 HP 1-10 HP 50 + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS ELECTRICAL $ _ POLE'LIGHTS _ MICROFILM $ PLAN CHECK' $ RUC 1 1 UN "$ TOTAL FEE $" .PANELS- MAIN SUB SERVICE - AMP ISSUE FEE APPLICATION APPROVED BY DA om INMM EM IN Es SUMMARY OF FEES . . BUILDING 7-q.6,0 PERMIT $ .5 SMIP $ PLAN CHECK $MIT ISSUANCE$ J PLUMBING $ GRADING $ 'PLAN CHECK $ ' ELECTRICAL $ $ MICROFILM $ PLAN CHECK' $ "$ TOTAL FEE $" MECHANICAL PLAN CHECK' " S " LESS AD- ` VANCE PC $ �IFINALF.EE $ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector 1 \- POOL & SPA APPROVALS , Permit # 1. Date's rispector 1. Temporary Electrical Service or Pale 43. Pool & Equipment Location 2. SorlPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit'Utility-Undrgrn ti 45. Forms 4. Electrical Conduit•Undrgrn' - _ 46. Electrical Bonding 5. Steel ern ores 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn ; r 48. APPROVALTO COVER-GUNITE 7. Footings 49, Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK -11., - Property Sewer Line& House Connection 53: Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing55. Plumbing System - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57' Solar System -Final, 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 16. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 3 . 23. Insulation 24. Lathing & Siding 25. Drywall Nailing -g. 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31, Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. . CERTIFICATE OF OCCUPANCY No D% Dateg: K Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA' PER IT NO. CONSTRUCTION PERMITF 3I0 9 9 TRACT NO. LOT NO. BLDG. NO: &— 63/9, • ... C rjIOL6I�72. 23e00 'T�•; . . ,, ct Address 1%461 b1i . � TYPE OF CONSTRUCTION X. I r`er � {�CaiA_S&l..aPhone 'KNEW ❑ADD - ❑ALTERATION ess -A + • '❑ REPAIR .❑ CONVER_SION ❑DEMOLISH/Eng, ❑ OTHER_ ZONING REGULATIONS'ress - License No. DESCRIPTION,OF WORKP'P''F6ZONE fAdd PLNG.. RULEF.�ractorS�;FE1� CJ JPhon �� TYPE OF PERMIT LDVNLGINE ress M CONTRACTOR DECLARATION. - ` -'❑ GRADING ❑ FOUNDATION ---❑•ST CTURAL- ❑ TENANT ❑ ❑PLUMBINGECHANICA SETBRCK C ST I YARDNSED PROP _ by affirm that I am licensed under provisions of Charter 9 Com- - ELECTRICAL. Sl EYA ing with section 7000) of Division -3- Of••Lhe Business and ❑OTHERsions RIGHT Code, and my license is In full force and effect. REAR YARD (TO•P/L)PROJECT se Clas Dcense*Nb, DESCRIPTION PKG. SPACE REO.' - - PROVIDED - -_-- Date • y s 'Signature" _ J SQ. FT. r� STREETWIDTH - ' PARK FEE-,$"-•`};'""'- WORKERS' COMPENSATION DECLARATION _ OCCUPANCY -'' CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure or a - VALUATION ZONE -i Y `ZONING APPROVED BY- -- - -DATE ^-•- -- 'Certificate Of Workers' Compensation Iurance, or-certif'ed copy thereof (Section 3 0 b. C,). I GRADING CU. YDS, ACRES SPECIACCONDITIONS:-"" -- - 1 Polley No. Company FFiM+i� _ --_ - ---- -- 1 '❑ Certified copy Is hereby furnished.. REMARKS: t Certified copy isiflled with the city Building Division. EX MPTION FROM WORKERS' �COMPENSATION'DECLARATION ;(Thls.sectlon need not be completed If_the-,permit_IS f_or-one hundred ;' 1"t ($100) or less). - - - -- - - - - - I cert(fy 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,bec`me ' PLUMBING a - PLAN CHECK - - ELECTRICAL- . ubject.to the Workers' Compensation Laws of California._ _ - _ Date ) Signature -I- BATHTUBS SHOWERS"SO. FT.- - NOTICE: If after making this declaration, you should become subject TOILETS , ,. URINALS - •- - - 'GENERATOR 0.1 KW•_ TRANSFORMER -1-10 KW - -- - to the Workers' Compensation provisions of the Labor Code, you must r 'ifothwlth comply with such provisions or this permit shall be deemed LAVATORIES DOUBL•'E•LAVS. -- - •- • - -- APPLIANCE - 10 -50 -KW 50 + KW._,- -- 'CONSTRUCTION LENDING AGENCY KIT.'SINKS-' - '-' DISHWASHERS -: +- - - ~MOTORS — 0.1 HP- 1-10 HP 'I hereby affirm that there is a construction lendingagency for the per- g y - . �_ _ _ SERVICE SINKS rel SUMPS - f - _ _ _ '. INC. SOLAR ( ) 10-50.HP ril, 50.+NP. _ 'formance of the work for which this permit is Issued (Section 3097 'Civ. C.):' - -- - • - - — (L.ender_S Name FLOOR SINKS - FLOOR DRAINS " - ;FIXTURES OUTLETS SWITCHES - i _ 'Lender's Address DRINKING FOUNTAINS -' ' -^-- - ,GASTUBESIGNS ---- .- -�-' - r ,OWNER'BUILDER'DECLARATION INTERCEPTORS CLARIFIERS -p' - POLE LIGHTS- ---»•--- -- - - -- l hereby affirm that I am exempt from.tfie Contractor's License Law for , SWIMMING POOL -- -P-TRAP -_ 7 — _ POLES ME=TERED'- "the following reason -(Section, 7031.5 Business and Professions -Code: lAny city or county which requires a permit to construct, alter, l WATER'SERV ICE- ALTERATION- PANELS MAIN - nprove; demolish•or repair any structure, prior to its Issuance, -also re- uires the api-licant for such permit to file a signed statement that he - - 'GAS SERV ICE OUTLETS SERVICE - - - - AMP -• - -licensed pursuant to the -provisions of -the Contractor's License -Law i3Chapter 9 (commencing with Section 7000) Of Division 3 of the uslness and Professions •Code)•or that he is exempt—therefrom—and—the- 'BTU basis for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS 017TP17T-- SEWER CONNECTIONS - _, - �- - t - --� - - -- - -- - - - •- - •- _ - - 'any-apoticant for a permit- subjects the- applicant -to a -civil -penalty ;of,not more than.11ve hundred dollars ($500), SOLAR'TANK- - COLLECTORS "' ---- - --•- �- -� - ---•----- - . •_- -- _ - -.- ` 10 I, as owner of the property, or my employees with wages -as their 1 sole compensation, will.do the work, and the structure is not intended SOLAR PIPING SVS: -- - J- '^- #- - ISSUE FEE - -- - - • - - - -- -••-- •- for offered for Sale. (Section 7044, Buslness and Professions Code: The !Contractor's License. Law does not apply to an owner of a property -_- - _ "_-- _ 'ISSUE FEE - - APPLICATION APPROVED BY _ DATE-� -*_ - - who builds or improves thereon, and who does such work himself or .through his own employees„ provided that such improvements are not _ _ _ _ _ _ MECHANICAL PLAN CHECK ' "-' I - - - SUMMARY�OF FEES '` !intended or offered for sale. If, however, the buitding or improvement is sold within one year of .completion, the Owner will have the burden 'of -the f BUILOING- -"-„• '__. •'.: ': - - - - HEATING SYSTEM 0.100`000 BTU ,- proving he did not build or improve for purpose of sale). ❑ -..... _” PERMIT $ ____ _ _; -''.�• , I - as owner, -of the- property, am exclusively -contracting-with - - AND DUCTING�'l i ) •''_ - I licensed contractors to construct the project Section 7044, Business ( 100,000;+ BTU I PLAN CHECK $ PERMIT, R antl Professions Code: The Contractor's - Lice rise. La w• does not apply to _ ISSUANCE $ {' REFRIGERATION 0-100,000 BTU Zan owner Of property who builds or improves thereon, antl who con- PLUMBING $ .tracts from such protects with Ilcesned pursuant to. SYSTEM -- - - - - - - - a - "§ GRADING- $ the Contractor's License Law). ,❑ 1 am exempt -under Section- "- - --" 6: & P. C: for this " 100,000•+ BTU PLAN CHECK ` i ELECTRICAL' $ - _ - - i - -, • $ V• .' BOI LERS BTU lred SOn - -- -- - . --. _ ••• ;.. :ai:MICROFILM.5 k " • ,-' _ _ - , SYSTEM RE -PAI R, ALTERATION Date Owner PLAN CHECK . S - o MECHANICAL,S- TOTAL FEE $ ' EXHAUST SYSTEM AZ MULTIPLE r I hereby certifyth av read thi licatio fid state that the above "' f„ ,- ~* , LESS A LESS AD- _ information is rr t. -agree com ith-all city and county PLAN CHECK $ VANCE -PC '$ Ordinances a state S ret g to ructio hereby allthoriZC ,representa - es of IS c bove mentioned property or - • '- w• FINAL FEE $ Slgnatur are ISSUE FEE _ Drivers' nse or SS CMF Oa65.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit =*.g Date Inspector POOL & SPA APPROVALS -.Permit 4#•Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. _&611 Pipe-Undrgrn 44. Steel Reinforcement .-3. Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure test. 6. Electrical UFER Grn 48. APPROVAL TO COVER=GUNITE 7. Footings 49. Electrical Conduit-Undrqrn 8. Foundation 50. Gas Pipe, El Undrgrn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines. P -Trap.- Cj Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater &-Vent-Final 13. Rough Plumbing 55.'- PlumbLagjustern - Fi . n; . i . I 14. Rough Electric -Conduit •56.' 'Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning- Fencing & Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POO L/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing. NOTES: 22. Frame and Flashing 23. insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31'. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation t. J 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison --,.- 41. Gas Release to Southern California Gas Co. 42'. ,CERTIFICATE OF OCCUPANCY 'No Date "— Applicant to fill in all spaces within heavy border lines and sign all appropriate -declarations. CITY OF COSTA MESA PERLM IT NO. TRACT NO, LOT NO. BLDG. N CONSTRUCTION PERMIT P -t37 -7I _ ; rro)eci Acroress Gr/ f-� Ofd TYPE OF CONSTRUCTION Owner S Phone" ❑ NEW ❑ ADD ❑ ALTERATION Address - �❑REPAIR ❑ CONVER ION ❑.DEMOLISH 'Arch/Eng- License No. isi OTHER Address - OESCRIPTIONOF WORK + - 1r Contractor' -,- Phone 1,Y O TYPE OF PERMIT Address '71 ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL - i. LICENSED CONTRACTOR DECLARATION ' ' - ❑ TENANT' ❑ ELECTRICAL WPLUMBING -❑MECHANICA I hereby affirm th&t I am licensed under provisions of Charter 9 (tort- j - mencing with section -7000) Of Division 3 of the Business and ❑ OTHER 64,47 5427./52 52.50 TL ZONING REGULATIONS' -' A.P. i)r ZONE - PLNTTG.. ggRttE��F..ppi SETBACK C/L ST. PROPEIRT.YNLG Nt I YARD - - - -- S _ -r kll Hi Professions Code, jantl my lirense is In full force and effect.. REAR YARD (TO P/L) -- - PROJECT DESCRIPTION: License Class C Lice No. 6 - _ - ; PKC. SPACE'REQ. A- --7-G_ $ SQ..FT.' - nate�Signatur `- -- - •-^� -�- - - - - flRKERS' COMPENSATION DECLAR ON. r OCCUPANCY "` COIVSTR_ UCTIO_N T_YP_E {STREET WIDTH hereby affirm that I have a certificate consent to self -insure or, a I ZONING' APPROVED BY certificate of Workers' •Compensation - Insurance, -or- a certified copy' -VALUATION- _ - ZONE --- _ thereof (Section 3800, Lab. C.). , / ,GRADING CU. YDS. ACRES �I� 75PEC1'AL CONDITIONS: -_---' Policy No. _` - Company �'l`i4 - ❑ Certified copy Is hereby. furnished. _ _ _ • it- i REMARKS: a s ' ` �- Certlfled copy Is filed with the city Building Division. � XEMPTION-FROM'WORKERS'-COMPENSATION DECLARATION '-' �--•� - - -- - (This_section -need not be completed if,tha permlt_is_for one hundred •_ •, �•� ($100) or less). I certify that In the performance of.othe work for which this permit Is issued, I shall not employ any person in any manner sas to become subject to the Workers. Compens0tio n-Laws,of California.6'. • _ -_ Date Signature _ - .�.i' PLUMBING. . - , -PLgN'CHECK " _ BATHTUBS-""'" SHOWERS TotLEZS,• .57 r r _URINALS- -•--- - - - - f ^-- NOTICE: If after making this declaration, you shouid become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked-_ i . -_ .:.. _ _ - - _ - CONSTRUCTION LENDING AGENCY LAVATORIES DOUBLE LAVS KIT: SINKS' - ---DISHWASHERS -' - - SERVICE SINKS -,. r' SUMP5 ' - - _ - - •- I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 FLOOR SINKS--"` FLOOR DRAINS -2 - Civ. C:). Lender's Name_ DRINKING'FOUNTAIN5-` l _.S -( - fl Lender's Address- T --_•._ OWNER BUILDER -DECLARATION I hereby affirm that f am exempt from the Contractor's License Law for the following reason (Section 7031.5 -Business and -Professions Code: Any city or county which requires a permit to construct, alter, INTERCEPTORS CLARIFIERS' SWIMMING POOL `---- - P'TRAP------••�- -�- - - - "PROVIDED - - - PARK -FEE_$;--" - DAT E- - ,rove, demolish or repair any •Structure, prior to its issuance, also re-- es trio ap�iicant for such perfnit to file a signed statement that he f PANEL'S` - MAIN- --- :SUB- - _ - - - i ',SERVICE- - - - - AMP - .censed pursuant to the -provisions of- the Contractors -License Law lk.:hapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS"� - BTU'OUTPUT t�-; - -!Rig-� - -- -- - - - - - --- - ?ELECTRICAL - - PLAN CHECK - ' - - - SOLAR TANK- - --COLLECTORS-"' i- - - ---••'-- �-- ---• .- - -- - - - -. _ ❑ 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. (Section 7044, Business and Professions Code: The- COntrattor,s License Law does not apply to an owner of a property m who builds or improves thereon, and who does such work himself or SOLAR PIPING"SYS. _ _ ISSUE FEE -- - ilia GENERATOR 0=1 KW ,TRANSFORMER -'1=10 KW _, ;, r' APPLIANCE - 10-50 KW_.;_50 + KW - ,I.•.,,1 - - - r -)MOTORS 0.1 -HP - -1-10 HPC- - - SYSTEM REPAIR, ALTERATION (INC. SOLAR) 10-SO.HP 50 +, HP' 7 ISSUE FEE - '- rFIXTURES- OUTLETS -- SWITCHES ---- GAS TUBE SIGNS- ;POLE LIGHTS TPOLES METERED`— -SUB- , ,rove, demolish or repair any •Structure, prior to its issuance, also re-- es trio ap�iicant for such perfnit to file a signed statement that he WATER SERVICE---AL'TERATION' PANEL'S` - MAIN- --- :SUB- - _ - - - GAS SERVICE ' '- -OQTLETS_ - - s ',SERVICE- - - - - AMP - .censed pursuant to the -provisions of- the Contractors -License Law lk.:hapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS"� - BTU'OUTPUT t�-; - -!Rig-� - -- -- - - - - - --- - Business and-Pro4eSsions Code) or,that-he is exempt therefrom and the. basis for the alleged exemption. Any violation of Section 7031.5 by' -SEWER CONNECTIONS" '" „ " _ -�- " ••�- - ' ----•------ - - �_ - -. _ _. _ ' ' _' - any -applicant for a- permit- subjects -the -applicant to -a civil -penalty- of not more than five hundred dollars ($500). - SOLAR TANK- - --COLLECTORS-"' i- - - ---••'-- �-- ---• .- - -- - - - -. _ ❑ I; as owner of -the property, or my employees with wages'as their" Sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The- COntrattor,s License Law does not apply to an owner of a property m who builds or improves thereon, and who does such work himself or SOLAR PIPING"SYS. _ _ ISSUE FEE -- - ilia ISSUE FEE 'APPLICATION APPROVED BY =- DATE•-• -- - through -his own, employees, proVided.that such improvements are not intended or offered for sale. If, however, the building or improvement is. sold within one year of completion, the owner will have the burden of proving he did not build or improve for thepurposeof sale).- as owner of the property, am exclusively- contracting. with_ licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's. License Law does not apply to. an owner of property who builds or improves thereon, and who Con- tracts -from-suCh project$ with a contractor(s) .Ilcesned-pursuant to- the Contractor's License Law). Ell am exempt under'SectionB. &'P.C.'forthis reason- - - _ MECHANICAL PLAN CHECK r - - - - ; SUMMARY OF FEES ,,, ,•- w 'BUILDINGEI-P, PERMIT $ _ ; SMTP, S' _ ,PLAN CHECK -S r,PERMtT r - , ISSUANCE'-_$ •PLUMBING S- t'� ..�-,.t� _ GR'ADING'- 5 ' � PLAN CHECK -,$- ;ELECTRICAL -'s PLAN CHECK 'S - ~, ` MICROFILM S �,e . _ _ _. _- _ f + I TOTAL FEE S ' MECHANICAL $ -• _ _ i LE55'RD-• - 'PLANCHECK'--s•-VAS'AD-NCE 3_ I '•S �+ - • _ - _ FINAL FEE $ - ' - - - - -- -- - -- -� - HEATING SYSTEM 0-100,000 BTU - AND DUCTING - - - -- - - --- 100,000'+ BTU ..� REFRIGERATION 0-100,00b BTU SYSTEM- _ ---- -^� _- 100,000 + BTU BOILERS BTU - Date Owner I hereby certify that I have road this application and state that the above information is correct. I agree to comply with all city and -county ordinances and state laws relating to construction, and hereby authorize representatives "1"this-' ity o enter upon the above mentioned property nspec o u s rZ Signatue ^ate Drivers' Licans SS SYSTEM REPAIR, ALTERATION f EXHAUST SYSTEM MULTIPLE t: .e -I ISSUE FEE - '- CMF 0865.46 White-Buiiding; Canary-Appticant; Pink -Accounting; Goldenrod -Assessor ' CONSTRUCTION AND'PLAN APPROVALS Permit # NI7a Date inspector POOL & SPA APPROVALS Permit # Date inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe-Un rgrn , _ --73-Electrical 44. Steel Reinforcement Conduit Utility-Undrgrn 45. Forms 4. ..Electrical Conduit-Undrgrn. __- 46.. .Electrical Bonding - - b. tee em orce•. 47. Rough Plumbing & Pressure -Test- 6.-__Efectrical_UFER Grn- 48. APPROVAL TO COVER-GUNiTE 7. - Footings 49. Electrical Conduit-Undr r'n B. Foundation _ . _ ___ _. 50. Gas Pipe, ❑ Undr r'n, Test - -9.- Water-Pipe-Undigrn _- - j, 51. Backwash Lines • P Ira ❑ ndr rn 10._ -Structural Fldor System 52. APPROVALTO DECK - 11. Property Sewer Line & House Connection 53, Backwash& Receptor -Final t 12. Street Sewer Connection-_ " ' _ . - - - - - -54. Heater & Vent -Final _.13._ Rough Plumbing 55 - 14. Rough Electric -Conduit ► - - r- -,-56.-- Electrical -Final•.- t 15. Rough Electric -Wiring 157: Solar System -Final 16, - Rough Heating &'Air Conditioning - - - - - encing & Access Approval -i7, Ducts in Structure --59.- APPROVED FO,R PLASTERING -18,- Ducts, Ventilating �! 60. POOL/SPA SYSTEMS FINAL` 19! Gas Pipe -Rough -&'Test - 1 ` '_ 20: Roof Framing - -� 21, Roof'Sheathin NOTES: 22. Frame and Flashin _ _ 23. Insulation -- - - - . 24• Lathing & Siding 25. Drywall Nailing- ailing 26. 26. Plaster Brown Coat - - - - - 27. Electrical Power Meter -Final - - - f 28. Final Electric - - 29'. Final Heating & Air Conditioning - -' • ' 30. Final'Gas Pipe -Test - - -- - - - 31:. - Final Plumbing 32. Water Service -Finale 33. :=Gas Service -Final - - - 34• Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation - 37. HandicapRegulations- 38. FINAL STRUCTURE & BUILDING 39• Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42• CERTIFICATE OF OCCUPANCY - No. Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. I' CITY OF COSTA MESA PE.QMIT NO. - -' TRACT NO. LOT NO. SLOG. NO. CONSTRUCTION PERMIT, I , /Or3 Project Address �.S /41 Ce1+it U 4 Owner ,C �[rctia �+as Phone( Address V� sT ,.J 4 r Arch/Eng. License No. 1 Address Contractor I¢tVl�lf.. £ ver Phrine",.)'�'Z Address ,; LICENSED CONTRACTOft DECLARATION I hereby affirm that i am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3. of the Business and Professions Code, and my license is In full forte n ]ef Cte License Class % I icevft-Uo. r DateSignature �`�-- - I R ER -CO PENSATION ARATION rereby affirm that I have a c6ftificate of consent to self-Insure,or a CrtifiCate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C-)• r� Policy NoC AG- 74 T.Y_'� ' Company ❑CoMillied copy is hereby furnished. E'certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if the_permit is for one hundred ($100) or less). I Certify that In the performance of the work for which this permit Is Issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California. Date Signature' NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked- CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 Civ; -C.). Lender's iv:C.)- Lender's Name Lender's Address - OWNER BUILDER DECLARATtDN - - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section -7031.5 Business and Professions Code: Any city or county which requires a permit to Construct, alter, -'-+prove, demolish or repair any structure, prior to -its Issuance, also Te- res the ap},Ilcant for such permit to file a signed statement that he Icensed pursuant to the provisions of the -Contractor's. License Law napier 9 (commencing with Section 7000) of Division 3 of the f3usine$s and Pro{essions Code) or that he 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 ($500). ❑ I, as owner of the property, or -my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale, (Section 7044, Business -and Professions Code: The .Contractor's License Law does not apply- to an owner of a property who build$ or Improves thereon, and who does such work himself or ,through his own employees,, provided that such improvements are not intended or offered for sale. If, howeder, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such projects• with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section -"B. & P. C. for this reason - - Date Owner — I hereby certify that I have read this application and state that the above information Is correct- I agree to comply with -all city and county ordinances and state laws relating to construction, and hereby authorize 1'representativeS' of this -city -to enter upon the- above mentioned property for I Deet pos _ t+ p Signature _ Date T G TYfi3OF CONSTRUCTION { INC-1ADD C1ALTERATION %' ❑ REPAIR C-1CONVERSION❑DEMOLISH ' j ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING FOUNDATION E]STRUCTURAL ❑ TENANT Lel-ELECTRICAL ❑PLUMBING ❑MECHAN ❑ OTHER PROJECT �DESCRIPTION SQ. FT. �lC'`f-. - - - OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE , GRADING CU.,YOS. , ACRES REMARKS: 7132 6/09/62 6,00 fl.� ZONING REGULATIONS A.P.:# ZONE _PLNG. REF. 9 - REAR YARD (TO P/L) - PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: ISSUE FEF - Drivers' cense or SS t#E i i CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor PLUMBING PLAN CHECK ELECTRICAL CHECK - BATHTUBS SHOWERS - GSQA_PLAN TOILETS URINALS GENERATOR 0.1 KW 1.10 KW TRANSFORMER LAVATORIES DOUBLELAVS - APPLIANCE 10.50 KW=50+KW - -- KIT- SINKS DISHWASHERS MOTORS - 0-1 HP 1.10 HP - SERVICE SINKS SUMPS - - (INC. SOLAR) 10.50 HP 50 + HP - FLOOR SINKS - FLOOR DRAINS FIXTURES ' OUTLETS SWITCHES DRINKINGFOUNTAINS- GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS - s. SWIMMING POOL-'- "-' ' PiTRAP — - =7175 1 1019 POLES METERED 5U6 WATER SERVICE ALTERATION PANELS -MAIN SUB GAS SERVICE OUTLETS -Z' } SERVICE- ZaQ AMP WATER HEATERS BTU OUTPUT - -- - - - - - - SEWER CONNECTIONS - SOLAR TANK COLLECTORS - SOLAR PIPING SYS- -ISSUE FEE O ISSUE FEE - APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING - HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT ISSUANCE E REFRIGERATION 0-100,000 BTU PLUMBING $ SYSTEM GRADING $ 100,000 +BTU PLAN CHECK $ BOILERS BTU ELECTRICAL $ `�� $ MICROFILM $ SYSTEM REPAIR, ALTERATION PLAN CHECK $ - '$ MECHANICAL $-- TOTAL FEE EXHAUST SYSTEM MULTIPLE LESS AD - PLAN -CHECK $ VANCE PC $ _ FINAL FEE $ ISSUE FEF - Drivers' cense or SS t#E i i CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # 1, Date Inspector POOL & SPA �• APPROVALS :` ' a�,'�Permit.# { r < <� a ltiDate„, Inspector 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location. 2. SoilPipe-Undrgrn 44. Steel Reinforcement `•-� ' '' '�` 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. . Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings _ 49. Electrical Conduit•Undr rn 8. Foundation 50. . Gas Pi pe, .9. -Water Pipe-Undrgrn 51. 'Backw'ash Lines P-Tra �'[J' Qndr r.n`• _110. . Structural Floor System 52. APPROVAL TO DECK ice. 4 ;' v -11. Property,Sewer Line & House Connection 53. Backwash & Receptor-Final 12. ..Street Sewer Connection 54. Heater & Vent-Final, ;, 13. Rough Plumbing -, 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring 57,c•tSolar System-Final 16. Rough Heating & Air Conditioning "' '= encing & Access Approval, 17, Ducts in Structure 59. APPROVED'FOR PLASTERING 18: Ducts,-Ventilating _ 60.. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing - 21. Roof-Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing , 26. Plaster Brown Coat 27,. Electrical Power Meter-Final - 28. Final Electric J A 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37, Handicap Regulations 38. FINAL STRUCTURE &,BUILDING 39. Speciaf .Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - PII�T NO. - TRACT NO. LOT NO. B G -NO. - - -' Ca*,V-rWUCTION PERMIT !' 3 .Z6 D� 6465 5/27/82 44.28 TU Project Address f w Q TYPE OF CONSTRUCTION +. - ' 3 OWner� _ + Phone �/N EW ❑ ADD - ❑ ALTERATION Address• / + AZe:je• 6! ❑ REPAIR ❑ CONVERSION' ❑DEMOLISH 'ZONING usr ' ElOT.HER'"4 REGULATIONS Arch/Eng. License No. - A.P. - DESCRIPTION OF WORK ' Address ; _ ., r _. - 'ZONE P,LNG. REF, 9L. ' Contractor' �-�;- Phone' ; i TYPE OF PERMIT.+ t.' BUILDING-{ 'SETBACK p BtJi ING PROPERTY LINE c -Address a. „o Cyr« ❑ GRAOING FOUNDATION. ❑ STRUCTURAL- I YARD - } ` 1 LICENSED -CONTRA TOR_DECLARATION 4 _ _ - _ ❑TENANT �ECTRICAL--❑PLUMBING-❑MECHANICA 51 g Y - , l \ ,I hereby affirm that I am licensed under provisions of Charter 9 (Com- r , - RIGHT ,• mancing with section 7000) -of Division -3. of- the Business and ❑ OTHER 17 EAR YARD T P ( O /L) ' Professions Code, and my license is in full fore and effect. - S'�^Z+� J ;' PROJECT DESCRIP,ON _ .. -- - , '- License Class cen a No ` SQ. FT. .1 t�7((�� PKG. SPACE REQ. PROVIDED, -, - '+afe Signature -. - - STkEET WIDTH- PARK'FEE.$- -,.- - , 4 )OR ERS' OMPENSATION D LARATION-- _ __ _ .00CUPANCY• CONSTRUCTION TYPE -ZONING APPROVED BY D - AT1= ,ereby affirm that I have a ce ffiCate of consent to self -insure or a r ' ZONE _ r -ertificate of Workers' Compensation -insurance. or a certified -copy ,VALUATION - - �>- - --- SPECIAL CONDITIONSc ' thereof (Section 3800, lab. C.). GRADING Cu. YDS. ACRES Policy No. Company` - - - - - - --- - --- ----- - ---.�--,•�- -, -. .r ❑ frertifjed copy is hereby furnished. _ - - REMARKS::;''. LXCertified copy is filed with the city Building Division. EXEMPTION'FROM WORKERS' COMPENSATION'OECL'ARATION - - - (This section need not be completed If -the permit -is for one -hundred__ ($100) or less). t 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 PLUMBING Tqq -` i PLAN CHECK-"- -' s' - '" 'ELECTRICAL "• LAHECK subject to the Workers' Compensation Laws -of California,' `SHOWERS- { �_ r _ - _ BATHTUBS " - - Date Signature 'NOTICE: If after making this declaration, you should become subject TOILETS � .1, -URINALS ^-' - �" - • GENERATOR - ---0-1 KW TRANSFORMER '1.10 KW to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS-` - APPLIANCE 10-50 KWT50•+ KW - - revoked. - - ° _ i _ _ .� � CONSTRUCTION LENDING AGENCY -�. _ , KIT. SINKS '� - - 'DISHWASHERS MOTORS 0-1-1-11>"---- 1-10 HP - �,r c -I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS I-, )i,,SUMPS -' `- """'r-` - (INC. SOLAR) -..10 -50 -HP 50 + HP_ formance of the work for which this permit is Issued (Section 3047 lCivc C.). - - - - - - - - - - - ' - - ' FL"OOR'SINKS• _ ' FL•QOR'DRAINS-' -+ - ',FIXTURES OUTLETS SWiTCMES ci Lender's Name - _ �"-'-" _ " ILcnder's Address DRINKING`FOUN7AIN5 �` " -IGAS TUBE -SIGNS -� - --- - OWNER BUILDER•DECL•ARATION"INTERCEPTORS` CLARIFIERS `- POLE LIGHTS - - - I hereby affirm that I am exempt from the Contractor's License Law for the7lollowing reason (Section -7033,5 Business and Professions -Code: -SWIMMING POOL"" - P'TRAP- - - - t-�- - - - -- POLES METERED- `SUB Any city or county which requires a permit to construct, alter, ,rove, demolish or repair -any structure, prior -to its issuance, also re- WATER'SERV ICE" •`"" -ALTERATION ,PANELS •• � -- - MAIN SUB 00.1 as the ap,.lir..ant for such permit to file a signed statement that he - -censed-pursuant to the provisions of the Contractor's - License •LawG'ASSERV ICE" OC1TL ETS "- --- - - ' _ - -SERVICE - -•- _ - QO AMP Oa `chapter 9 (commencing with Section 7000) of Division 3 of the Professions -that he is lhereffom-and the '- - _ � i Buslness and Cade) or exempt WATEWHEATERS ` BTU OUTPUT I - - - - - - - - _ basis for the alleged exemption. Any violation of Section 7031.5 by any •applicant for a -permit subjects the,applicantto a civil Penalty. •'SEWER CONNECTIONS- I - -"' } ` T - •'' - - " - - - - of not more than five hundred dollars (5500). ❑ 1, as owner of the property; or limy employees with wages as"thelr SOLAR TANK' _ COLLECTORS' sole compensation, will do the work, and the structure Is not intended or offered for sale. (Section 7044', Business and Professions Code: The SOLPiR PIPING SYS._ ' ` ISSUE FEE - - _ -- Contractor's License.Law does not apply .to an owner of a property- who builds or Improves thereon, and who does such work himself or - _ - ISSUE FEE -- 'APPLiCATIONAPPROVEDBY - - - (TATE ' through his own employees, provided that such Improvements are not intended or offered for sale. It, however, the building or improvement MECHANICAL PLAN CHECK a SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale): _ , BUILDING• --- - --- , - -- •.-- --_-•� - ❑ I,- as -owner of the -property, am -exclusively contracting with HEATING SYSTEM 0-100,00.0 BTU AND DUCTING PERMIT E SMTP.. E - ' - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU ( PLAN CHECK b PERMIT . + ��' and Professions. Code: -The Contractor.'s•License Law -does not apply -to - - ' _ _ _. ISSUANCE - E an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S GRADING { RADING tracts from such projects with a-contraCtor(S) licesned. pursuant- to - - - - - -- SYSTEM" 100,000 t - PLAN I the Contractor's License law}. + BTU CHECK S ❑ 1 am exempt under'Section " - ---B. &'P. C: for this BOILERS BTUr _ ELECTRICAL 1 _ _ _ reason - - PLAN CHECK -S - - MICROFILM E SYSTEM REPAIR, ALTERATION TOTAL FEE E ' f Data Dwner MECHANICAL I hereby Certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _- •LESS AD - information Is correct'. I "agree to comply -with -ail' city and county PLAN CHECK $ - - VANCE PC $ -• _ ordinances and state laws relating to construction, and hereby authorize representatives of hi3,city to enter upon the above mentioned property f r In tTpfi py/(3psesr y� (L� �-•�-, {//6 - - - 4• FINAL FEE $ �•YL t Signal Ure Date V� -ISSUE FEE Drivers' icenso or SS CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor • CONSTRUCTION AND PLANNING Date Inspector APPROVALS Permit # POOL & SPA .. :` r , = J° APPROVALS ; Permit.#`• ... .-y_ Date Inspector 1. Electrical Service or Pole _ 43. Pool & Equipment Location-- . _Temporary Soll Pipe-Undrgrn 44- Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn 45.• Forms - 4. Electrical Conduit-Undrgrn _. Y 46... _Electrical Bonding - 5._ tee _ ern orce 47. Rough Plumbin• & Pressu�e"Test - "' A � '_-6. _ Electrical UF,ER Grn 48. APPROVAL TO COVER-GUNITE 7. _-Footings_ _ 49. Electrical Conduit-Undr rn -8. -Foundation. . ' _ _ _ _ 50.., Gas Pipe, 0 Undr rn, Test, 9. - Water Pipe-Undrgrn 51. 'Backwash Lines P -Trap,❑ ' n it rn 10._ Structural Floor System _ c 52. , APPROVAL TO DECK- ECK 11. 11. Property'Sewbr line & House Connection'__ 53, Backwash & Receptor -Final • N4 .12. • Street Sewer Connection 54. Heater &•Vent -Final 13. _ Rough Plumbing - e[D-- - 14. Rough Electric -Conduit 56. --Electrical-Final t 15. Rough Electric -Wiring -57. --Solar System -Final 16. Rough Heating & Air Conditioning bd, _ Fencing & Access.Approval 17; Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, -Ventilating. 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe -Rough & Test` - _ - 20. Roof Framing 21 • Roof Shealhin - - - - NOTES: - 22: •Frame and Flashing -- _ 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. • Plaster Brown Coat - 27. Electrical Power Meter -Final - 28: Final Electric 29'. Final.Heating & Air Conditioning - 30: Final Gas Pipe -Test - 31... Final Plumbing 32.- Water Service -Final - -- -' 33. Gas Service -Final - 34. Solar Domestic-r-inal 35. Landscape SPrinkling System y 36. Sound Attenuation 37. Handicap Regulations - = 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No'* Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OFCOSTA MESA' I3 PE Ni TRACT NO. LOT NO. - •BLDG.- . CONSTRUCTION PERMIT. 20 C7 ' Applicant's Mailing Address ` l'1 SfirPE OF CONSTAUCT10N , NEW ADD ALTERATION: REPAIR I� Project Adifrass •3151 Airway Fv . 0 e Costa' Mesa ❑CONVERSION ❑ DEnnOLISH 13 OTHER Owner's Name : ShearsoOkperi can' Lxpres OAe • y55 -%ZOO DESCRIPTION OF WORK "r ZONING ULA ^ I Address' HacA'thur 8th F1'.. Newport Bch. TYPE OF PERMIT ` GRADING FOUNDATION 'STRUCTURAL d A. P: 2 'S Z9 I : ZONE-- + ;. ,19070 ,� �' A_rchlEng,- Tom' Can, pi ASSOC_. License i ®TENANT• ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Pli REF. = BUILDING+ , Address �'%%% hiajn St. r Irvine ❑'-OOTHER , - 90 I ; _ TO BUILDING REAR YARD (TO P/L) Contractor' Nam hone 540-2b05 PROJECT DESCRIPTION' SQ: FT,_ 1126 OCCUPANCY P INE Address (mailing) 3151 Airway Ave'. E-1 s Costa- �,Iesa CONSTRUCTION TYPF__ V� -- VALUATION $ 15 890.00 LEFT SIDE YARD - RIGHT SIDE YARD ZONi GRADING _ -r CU. YDS.- ;ACRES KG. SPACE REQ. PROVIDED , t- a License No. -P __ LICENSED CDNTRACTOR DECLARATION Remarks: �; S ' STREET WIDTH _ PARK FEE $ ];hereby affirm that I am licensed under provisions of Charter. g (commencing ` with section 7000) of Division 3 of the Business and Professions Code, and F6 95� 5'6 �G l I SPECIAL CONDITIONS: my Ilcense'is In f4i and,offect. d; 33969 = ' r ' license CI s cense o PLUMBING Date Signature ' Bar Sink Sewer Cap ELECTRICAL „- WORKERS' COMPENSATION DEC RATIO I hereby.afflrm that I have a certificate of consen to self -Insure or a.certificate Automatic Washer - Mater ❑Over 10b amps I b1r _ r Backflow Preventer Sewer Connection of Workers' Compensation tnsurance,', or a certified copy thereof (Section Construction Pole Sub Panel, 3800, Lab, C.) + ��i?t Backflow Irrigation Solar Collectors :r licy No. Company �� T Certified copy Is hereby furnlslied- Bathtubs - - - Solar Piping Cooking Unit Sub Pole ,i L4 Corti f 4�,5p j filed with the city.Bui g Clarifiers I Soler Tank I Dishwasher Motors ❑0-1 HP 01%-8 r Datee%L4%-5-- ---Applicant EXEMP710N FROM WORKERS' COMP NSATION CLARATI Dryers ❑Gas ❑Electric Inc.Salar ❑9-i5 HP'❑16-15+ Dishwasher Swimming Pool w/Spa ' {This section need not be completed if the permit is f one hundred 5100) or Fan less) ; I certify that in the performance of the work for which this permit is issued I i Drinkin Fountains 9 Urinal 1 _ Microwave 'Pole 1 shall -not employ any person In any manner so as to become subject, to the, - F.A.U. Light Workers' Compensation, Laws of California. Floor Drains, Water Closet Date Signature -NOTICE.- If, after riiaking this declaration, -you should become subject to the Floor Sinks - - Water Heater Fixtures r Range Workers'. Compensation provisions of the Labor, Coda, you must forthwith comply with such provisions or this, permit shall_ be deemed revoked. Gas Service Outlets Water Service 4 Device Boxes Sign e CONSTRUCTION LENDING AGENCY I hereby affirm that there is a'constructlon lending agency for the performance , . Interceptors * � ', Outlets Standing Sections i of the ,work for, �y(�I� this_ permit is , Issuod (Section 3097 Civ. C.) _ Switches Trash Com I�nder's, Name.�S�)l Kitchen.Sink P actor Lender's Address; .7 11 r GarbegeDisposal t OWNER'BUILOER DECLARATION E 1 hereby affirm that I am exempt from the; Contractor's. License Law for the' 'pries,. Generator ❑0-5 KW ❑5-15 KW ' following reason (Section 7031.5 Business and Professional Code: Any city or 1 P -Trap - - 'county which requires a permit to construct, alter Improve; demolish or,repair to its'lssuance, the I Transformer El 15-50 KW , • any structure; prior also requires applicant'for such permit, -to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's. License Law (Chapter 9 (commencing'with'Section 7000) of ' ; Roof Drains ❑5U + KW I lReinspection Fee I $15 -, I o 1 Division i3 of the ,Business and-, Professions Code) or, that he/she Js' exempt ' therefrom and the basis for the alleged exemption: -Any violation' of Section - Showers + `- Reinspection+Fee $15 Meter ❑up to i00 amps , Elssue Fee' ' ` $ 3 7031:5 by- any applicant for- a permit' subjects. the applicant to a civil '-anal[ ? ` Service Sink t Issue Fee $ 3 Y of not more than five hundred dollars ($500). r. 1 Zoning Approved By Date - l,• as lowner off the property oi,m'y employees with wages, as their sole Is intended , _ MECHANICAL ' 9-�- npensation will+do the work, and the structure not or offered 7044, Business Professional Coda: • The, Contractor's �• - I �. ! Application Approved By ate �r sale-(SecEion and; r License Law does not apply to an owner of a property who builds or Improves l Boiler r, Refrigeration System Application Issued By + i—'if.aP3 - Date thereon,.and work who does' himself/hersolf or through his or her own + ' intended - [ ❑100,000 - ., employyees, provided that such Improvements are -not or offered for building improvement Is sold + Duct Under G�Ound CG100,0008TU BTU sale. lf, however, the or within one yEarof com- pletfon, the owner will have tha burden of proving he/she did not build or im- rove for the purpose of sale}, , I, as owner of the property, am exclusively contracting`wlth•IEcensed con- SUMMARY OF FEES + ' 'BUILDING PERMIT ${��Sd SMIP $ G , Q 1 Duct - Structural i System Repair/Alteration tractorsta construct the project (Section 7044, Business and Professions Code: • Law does _ Duct _- Ventilating- -_; _- _ + PLAN CHECK $ t PERMIT The Contractor's License not apply to an owner of property who builds or Improves thereon, and 'who contracts for such projact. with a con- ExhaustSyStem ❑ Multiple t , ' ( ,PLUMBING ' I $ { ISSUANCE $ [ractor(s) license pursuant to the Contractor's License Law). i ❑ 1'am Section P. I [ CHECK $, GRADING $ t exempt unser B. & C. for this reason i Firepl/Fact. Bit. ICSO i i I ,PLAN i Heating�System & Ducting ' i ELECTRICAL $ + ' $ + Date Owner '-I -hereby: certify that E,hare-read•this•appllcati0n arid state that the above -� ❑0.100,000 BTU•❑100,0008T - [ - - �• - � -' - PLAN CHECK' ' $ MICROFILM $ Information 15 correct, I agree to comply with all city -and county ordinances s S ;MECHANICAL $. TOTAL'FEIi $ ' and, state laws rola[ to building constructlon,land hereby authorize Pre- ; Hood or Type I ❑ + ; E I LESS 1 I Se of {this y, t enter • u on above-mentioned property for ins action Pu i os r p p 1 { Canopy, T ' e I1 ❑' i Reinspection Fee; $15 •PLAN CHECK' + $� t ADVANCED PC $ ' Signature Date 74 /83 1 Drivers' License or;55 ' Registers E Issue Fee $ 3 FINAL FEE ; $ - VIF 0865-46 rev. 12/82 W1 Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor T -` UCTION�ANQ,'PLAN INC; � _ � :��..c�OL,& SI r 19QNSTF -APPROVALS ' Per"mit# �`' rDate rl`nspector r " " - - _ ;APPROVALS` =Permit# Date Inspector r , , Li- Temporary Electrical Service orPole i `• o ? �52:i Pool & Equipmerii Location iSoil Pipe Undrgrnd, t 1 n X53 Steel Reinfarce'nient I 3: Electrics! Conduit Utility Undrgrnd. Forms+ '4' Electrical Conduit Undrgrnd: ML i �'r} �' : i55� Electrical•Bonding 5: Stee}`Reinforcement # '- �? c- 56.• Rough 'Plumbing:& Pressure Test - 6: Electrical OFER•GrAd.E a' J Y c'� 57. APPROVAL TO COVER-GUNITE' 7. Footings58 Electrical: Conduit• n rn - U• dra �l. , 8, Foundation ' i -.'� r 59. Gas PiperO-:Undrgrnd. Test'- b, ; �' 9. Water Pipe-Undrgrnd.F .`r � 60. Backwash Lines, P -Trap,•❑ Undrgrnd.. t 10. St'•rucPral Floor System : g ' 61. APPROVAL TOL-DECK 11. Property Sewer Line &:House-Conn`ection` 'h ` �rCr.= - =62. Backwash' k Receptoi Final r 12. Sewer Cap' 63. Heater &"Vent -Final ' 13. RooflDrains s ' „� 64. Plumbing;Syste,rri,;F_inal s 14. Rough Plumbing I - C = -65. Electrical Final - inal-15rRough-Electrical 15"' Rbugh-ElectricalConduit �, IIT�F i -! 66.,-S61ar;System Filial - - , .416.-i:Rou h -Electric Wirin 9 g I c. r , - -67, Fencing &Access Approval Rough Wiririg,Signi: i68. APPROVED FOR PLASTERING ' 18: 'Rough_Electricai;T,Bar. Ceiling` ;Ij !i : l _ 69.• POOL/SPA SYSTEMS FINAL j gli Heating &+Air Conditioning FIRE DEPT.'REQUIREMENT= , t' f APPROVALS' Permit',+{ 20. Rough"Factor`y Fir lace '11 f I _ ; i } I ; r 21. ;Ducts uin Strui turev j70. Underground Hydro 22. Ducts, Ventilating,` i n I �� i i 1 I .71 ] Product Piping ❑ Gas C3OiI 1 1r:23. Gas�Pipe-Rough & Test a i"' i� ;rTi l - I 72. Underground Flushl ' I y24_'Roof Framing 4 '� ; !�' I, 173•` Undergrnd. Storage Tank'E] Gas C].Oil , I 25 Roof Sheathing ` +''• l ,t" tj I ; l - r i i74. O4erhead Hydro n' ' 26.;T -Bar Ceiling'{Structural}, &",Monocoat-{ 75. Dry Chemical 2T.',i=rame and'Flashing' i ' ' E I 76.3 Dr,y Standpipe s - I 28:�'Lathing & Sidings '77. FIXED SYSTEM -FINAL ' 29.:Insulation �7W FIRE P14EV. FINAL Nailing {Notes: 1;30.16rywall -!i9.i Brown Coat- { .r31:•fka-ster i I 1 l l i 32. Electrical Power Meter, Final y 33. final Electric � i ! I { � i � ,"-j"•�I_ _li ��_ ��. _J_ .1• �1._ 34. Final Heating &:Air Conditioning i► 1 ' 4,14 1 , 35. Final Gas Pip,6rest I I ni t' r I I I I r) } 6 { 36. Hood or`CanoPY 37. Final Factory Fireplaces I 38. Final Plumbing I v i } I 1 39. Water Service Final. 40. Gas Service -Final i 41. Solar Domestic-�inak 42. Backflows Rrevente 43. Backflow Irrigation, T c i'tern 44. Landscape Irrw7gatio�n-System 1i J.•} f.. 7 , 45. Sound Attenvatiori 46- Handicap. Regulations 47. FINAL STRUCTURE & BUILDING k :� 48, Special Requirer'nents Completed I i '` •'� ' 49, Electric Release�to Edison 50. Gas Release to Southern California Gas Co JSSi i + I l i + , • r' i i h 51. CERTIF!CATE{OFiOCCUPANCY No- CAU;V 2 3/ 1 Date i I• { I i{ r "CITY,OF COSTA MESA CONSTRUCTION PERMIT Appilcant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PEPYITTRACT N0. LOT NO. BLD; llCCaa// , Project Address t TYPE OF CONSTRUCTION ILJ NEW LJ ADD LJ ALTERATION REPAIR Applicant's Mailing Address 3 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. 916 1117- p r-) rz DESCRIPTION OF WORK Owner's Name_ i ---Phone Address 31� gyp' Arch/Eng. License No, Address Contractor's Named ��""' `p�n� Phoned�� q� Address (mailing) _ ��1� /7 ('j4 `� AL'--� — r" Jd W -7 City L'icnnse No. LICENSED CONTRACTOR DECLARATION I hereby affirm that iam licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in f orce a3)d effect./Zr_ U c e n CI_ass — Li se `f Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that l have a certificate of consent to self -insure or a Certificate of Workers' Compensation Insurance, or a certified, copy thereof (Section. 3800, Lab. C.) I olicy No. Company Certified copy is hereby furnished. Certified copy Is filed with the city Building Division. Date Applicant .EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less 1. I certify that In the performance of the work for wh!ppthis permitIs issued I shall not employ any person in any manners as bete t) ct to tke Warkers'�omgepsati� a s of Ca)ifor Date //ll Signature NOTICE: If,'after making this declare tip you should become ject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked, 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License taw for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, atter, improve, demolish or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 'snalty of not more than five hundred dollars ($500). 1 I, as owner of the property or my employees with wages as their sole .ompensation, will do the work, antl the structure is not Intandad or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is sold within one year of Com- pletion, the owner. will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License law). ❑ 1 am exempt under Section B, & P. C. for this reason Date Owner, 1 hereby certify that 1 have read this application and state that the above information 1S Correct. I agree to Comply with -all city and county ordinances antl-state laws relating to b lding co truCtl n, and hereby authorize repre- sentatives of thisSLY'�� o inter t above-mentloned property for inspection pyipele� - Signature / r P Date T �J Drivers' License or SS :5P Bar Sink Backflow Ptevenier Backflow Irrigation Rathtuhs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service ' Outlets, Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee I $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt, ICBO 9P - Heating Heating System & Ducting ❑ 0-100,000 BTU Ell w000 BT Reinspection Fee '1 $25 CMF 0865-46 rev. 7/83 White - Building; -Canary - APPIIcant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping - Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee ECHANICAL Hood or Type I ❑ Canopy Type Ili ❑ Refrigeration System 00.100,000 BTU ❑100,000 BTU System Repok/Alteratiop Issue Fee 5493 9/ 1 2/TIZ I a Zone Accessory Building: Park.Fees $ S Main Building: Washer Transformer ❑ 15-50 KW Construction Pole Sub, El 50+KW JfIAutomatic ISSUANCE Cooking Unit Meter ❑up to 100 amps ENERGY P.C. TYPE OF PERMIT GRADING ❑ TENANT ❑ ELECTRICAL ❑ OTHER El FOUNDATION. 0 STRUCTURAL ❑ PLUMBING ❑ MECHANICAL Dryers ❑Gas ❑Electric Sub Panel T B A Front Rear PROJECT DESCRIPTION SQ. FT. CONSTRUCTION TYPE ZONE GRADING - OCCUPANCY VALUATIONS CU.YDS. ACRES Fixtures' i•'' Microwave C K S Right Left r Outlets Range Ping. Ref. 546 Remarks: Generator 06-5 KW 1-15.15 KW Trash Compactor Parking Req,/Provided Reinspection Fee $25 Issue Fee FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By _ Date — Application Approved By Date, Application Issued By. Date_; Use of Building: Planning'Notes: PLUMBING FEES Bar Sink Backflow Ptevenier Backflow Irrigation Rathtuhs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service ' Outlets, Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee I $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt, ICBO 9P - Heating Heating System & Ducting ❑ 0-100,000 BTU Ell w000 BT Reinspection Fee '1 $25 CMF 0865-46 rev. 7/83 White - Building; -Canary - APPIIcant; Pink - Accounting; Goldenrod - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping - Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee ECHANICAL Hood or Type I ❑ Canopy Type Ili ❑ Refrigeration System 00.100,000 BTU ❑100,000 BTU System Repok/Alteratiop Issue Fee 5493 9/ 1 2/TIZ I a Zone Accessory Building: Park.Fees $ SUMMARY OF FEES u .8UILDING'PERMIT 1 PLAN CHECK PLUMBING PLAN CHECK _ ELECTRICAL PLAN CHECK MECHANICAL $ 3 PLAN.CHECK $ ELECTRICAL $ Washer Transformer ❑ 15-50 KW Construction Pole Sub, El 50+KW JfIAutomatic ISSUANCE Cooking Unit Meter ❑up to 100 amps ENERGY P.C. Dishwasher Meter ❑over 100 amps GRADING Dryers ❑Gas ❑Electric Sub Panel MICROFILM Fan Motors 110-1 HP ❑ 1)4 - 8 TOTAL FEE f F.A.U. Inc. Solar 09-15 HP El 16-15+ Fixtures' i•'' Microwave Device 8oxes„ Pole Light r Outlets Range Switches, Sign Garbage Disposal Standing Sections Generator 06-5 KW 1-15.15 KW Trash Compactor S 3 Reinspection Fee $25 Issue Fee FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By _ Date — Application Approved By Date, Application Issued By. Date_; SUMMARY OF FEES u .8UILDING'PERMIT 1 PLAN CHECK PLUMBING PLAN CHECK _ ELECTRICAL PLAN CHECK MECHANICAL $ 3 PLAN.CHECK $ SM P $ PERMIT $ ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE FEES $ 3 Z O N I N G R E Q U I R E E N T • CCNSTRUCTION AND PLANN G APPROVALS Permit # �O Date Inspector POOL &. 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 58. Electrical Conduit-Undrgrnd, 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 Electricai-T Bar Ceiling 69. POOLISPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oit 23. Gas Pipe Rough & TeSt 72. Underground Flush 1 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro , 26. T -Bar Ceiling {Structural] &-Monocoat 75. Dry Chemical r 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 �,r• 33. Final Electric Notes: f+ 34.-Final:l�eat�Ag�&karir'C,nsadetianirtg Y ` 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 01 .40 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43, Backflow Irrigation `1 U 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL§TRUCTURE & BUILDING 4B. Special Requirements Completed 49, Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date ! �, Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. QITY-OF COSTA MESA ' CONNTRUCTION PERMIT Project Address Applicant's Mail Owner's Name Address Arch/Eng. License No. Address Contractor's Nam �P Phone�2_ Address (mailing),��GZ /��`��`n 2`'•e City License No. LICENSED CONTRACTOR DECLARATION I hereby' affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Profession$ Code, apt my license Is In full rt and effect. Licens las . Llc a 4� Date Signature WORK S' C MPENSATION D LARATION - I hereby affirm that I have a certificate of consent to self -insure or a certificate ' ,f Workers' Compensation Insurance, or a certified copy-thereoff (Section Lab 8lic No. / 7� Policy No. (�� Company rtified copy Is hereby furnished. Certjfi i with the city B I g DI Ilk Date Applicant EXEMPTI N F OM WORKERSCO PEN SATION'DECLARATION (This section need not be completetl ' the permit Is for one hundred ($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.' . Date Signature NOTICE: If, -after making this declaration, you should become subject to the Workers' Compensation provisions of 'the Labor Code, you must forthwith comply with, such provisions or this -permit, shall be deemed revoked. 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 (Section 3097 Civ, C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the fallowing reason (Section 7031.5.Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt •herefrom 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 analty of not more than five hundred dollars ($500). 1] 1, 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to antowner of a property who builds or improves thereon, and who does such work himself/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 com- pletion, the owner will have+the burden of proving he/she did not build or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con. tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License taw does notapplyto an owner of property -who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner. I herebycertify that I have read this application and state that the above Information is correct -1 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 e r n the above-mentioned�erty Inspection put u Signatre e Drivers' - ense or SS c# 11 !CMF 086C_46 rev' 7/83 PERMIT NO. TRACT NO. LOT NO. BLQ � TYPE OF CONSTRUCTION LJ NEW= ADD ALTERATION- U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK • - ^' 0'-7 n r' ^ A.P. # - Zone' - , S Main Building: Accessory Building:- Z TYPE OF PERMITGRADING FOUNDATION STRUCTURAL 1:1TENANT LEGT,RICAL ❑ PLUMBING ❑ MECHANICAL •• ❑, ,OTH E RA PROJECT DESCRIPTION, Sq' FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES T Front - O N B Rear N C Right G S Left E Ping. Ref. Park,Fees $ Q U Remarks: Parking Req./Provided (epUse of Building: R E M E N T S PLUMBING FEES Planning Notes: ' I Bar Sink Showers Backflow Preventer Service Sink' Backflow Irrigation Sewer Cap �' / ELECTRICAL FEES Bathtubs ^, _ Sewer Connection Automatic Washer Construction Pole Sub. Transformer ❑ 15'50 KW ❑ 50 +KW Clarifiers ,; Solar Collectors ' 'I Dishwasher t Solar Piping Cooking Unit :Meter ❑up to 100 amps Drinking Fountains Solar Tank Dishwasher Meter ❑over 100 amps Floor Drains Swimming Pool w/Spa Dryers ❑Gas ©Electric Sub Panel Floor Sinks Urinal Fan _ Motors ❑0-1 HP Gas Service Outlets Water Closet F.A.U. Inc.Solar ❑9.15 HP 016-15+ Interceptors Water Heater Fixtures Q Microwave Kitchen Sink Water Service Device Boxes Pole Light Lavatories Outlets 2 0 Range 14 86 P--�Trap Switches I 0 Sign � d Roof Drains Garbage Disposal Standing Sections Generator 00-5 KW ❑5-15 KW Trash Compactor ' Reinspection Fee $25 Issue Fee $ 3 Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By !� • 0*f Data r1 /3 ate_ Boiler Hood or T Ype I ❑ Canopy Type 11 ❑ Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU ❑100,000 BTU Duct - Ventilating BUILDING PERMIT PLAN CHECK PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ $ PERMITPLUMBING $ ISSUANCE S. $ ENERGY P.C. $ $ _v� GRADING $ $ 10,SS. MICROFILM $ $ TOTAL FEE $ 3 6S $ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact Blt. ICBG # I Heating System & Ducting ❑0-100,000 BTU E] 160,000 B7 - - - - - i Reinspection Fee $25 Issue Fee $ 3 to - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - - - CONSTRUCTION AND PLANK APPROVALS Permit# (,,�� Date Inspector POOL , .'A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool &' Equipment Location �. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd: 54. Forms 4. Electrical Conduit=Undrgrnd. r 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. +• 8. Foundation 59. Gas Pipe, ❑ -Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11., Property Sewer Line & House Connection 62, Backwash & Receptor -Final r 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. RougNPlumbing 65. Electrical -Final 15. Rough Electrical -Conduit - 66. Solar System -Final 16. Rough Electric Wiring / 42 67. Fencing &Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling4 ag Ci IO 69. POOL/SPA SYSTEMS F INAL 19, Rough Heating & Air Conditioning F FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. FINAL ;30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Piaster 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.-Laridscape.lrrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 46. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY' No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. • CITX,OF COSTA MESA , -` r . - -- -- - PERMIT Nq 'TRACT NO. LOT NO. BLDG. 5376- 9/10H/L+3 r I F9a /'c'; ;T!. y _ CONSTRUCTION PERMIT g(v �►� -2c�� - + ' Applicant's MailingAdd_ress a arYPE OFCONSTRUCTION NEW ADD ALTERATION 'REPAIR 3151 Airway Ave. F-202-„-- Costa Mesa 0 CONVERSION E] DEMOLISH ❑ OTHER + + (� u0 Project Address, Shearson/Aneri can Ewe's hone ' 955-7200 DESCRIPTION OF WORK tpnhatJimprovertient r' r• -ZONING REGULATIONS Owner's Name 1 1 A.ddress' 19060 AaCArthur 8th Fl.', iNewport- Seach -TYPE OF PERMIT• GRADING' FOUNDATION STRUCTURAL A. P.'fw Z1.�Z9-'y^1 + ZONE Lr' - -'•i� , Asch/En SOI)) Cam OS' & Assoc.__License No. TENANT= ❑,ELECTRICAL ❑ PLUMBING ❑.MECHANICAL }' BUILDING, 1 .SE-rBACIC - address. 17779 -F fYiain St., Irvine - — ----._ ❑',OTHER ' r + TO.BUILOING - C41 S1_ , REAR YARD (TO P/Ll Contractor's Nam •i '�0ndl d '61 son CO . nacre 56 -2065 PROJECT DESCRIPTION SQ.' FT. ' OCCUPANCY - P Y LINE _ 151-,Airwa- F-1. Costa--Hesa-__+_ Address imeiling} y CON STRUCTION TYPE V -N t VALUATION$ •17.445_inn LEFT SIDEYgRD IGHTSIDEYARD + ZONJE GRADINGCU.YDS.. ACRES + i PKG.SP,ACEREQ. r PROVIDED _ + ; License No, j + LICENSED CON__TRACTOR DECLARATION I Remar6:3 5 t , _- STREET WIDTH , r t PARK FEE.$ I lr• ; 1•hereby affirm that I am licensed under provisions of charter•9 (commencing + with -section 7000) of Division 3 of the Business and Professions Cotle, and ' - C 1 -cda� ` 1 SPECIAL CONDITIONS: my license is in full'f rce and effect. ( 1 + License CI s en i 2 j PLUMBING I ate Signature ) gar Sink ; i Sewer Cap" ELECTRICAL 1 ' )RKERS' COMPENSATION DEC RATION •-nereby-affirm that I have a certificate of consent:to.self4nsure or a certificate, _� - Automatic Washer +Meter ❑Over 100 amps .-• Baekflotnr'Preventer - -^ Sewer Connection'- -- - - •- of Workers' Compensation Insurance,' or a certified, copy thereof (Section Construction Pole Sub Panel - 3800, tib. C:) i _..r • Backflow Irrigation Solar Collectors Policy No. -a 7 ComZpan IIiWQ - -.r-- —KI l furnished• j, Bathtubs - . Solar Piping Cooking Unit Sub Pole . + ®Certified copy Is hereby Certtfke�rspp tied with the clty.BuO b! G`f� I Clisrifiers i Solar Tank I Dishwasher Motors ❑0-1 HP ❑ 1 K$ , r Date Applicant EXEMPTION FROM WORKERS' COMP SATION CLARATION Dishwasher , i Swimming POoI wlSpa + Dryers- ❑Gas;-E1Electric--_.. +-' 'Inc:Solar;❑9-15 HP ❑16-15+"- T' (This section need not be Completed If the permit is f ,one hundred ( 00} or less} e Fan l i ( Microwave 1 certify that in the performance of the work for which this permit is Issued I Drinking FOuntaids , Urinal I shalt, not' employ any person in any manner so ,as to become subject to tke t F.A.U. ` ! 1 Pole,Light Workers' Componsation.Laws of California. Floor Drains j I Water Closet i Date' I9nature t- NOTICE' If, after making this declaration, you should become subject to=the Floor•Sinks . - _� . _ ;, - Water Heater.. _ . _ Fixtures ! -- _- ;Ran I Workers'; Compensation provisions,of the Labor Code, you must forthwith ' comply with: such 'provls(ons•;or , this'.permlt shall be deemed, revoked:, :, I Gas Service Outlets Water Service DiBakes , evce + ' 'Sign, g I I CONSTRUCTION, LENDING AGENCY I hereby affirm that there is a',construction Io i Ing agency for the' performance, • Is ' 3097 Civ: C.); Interceptors ti ' - 1 i z Outlets ; Standing Sections ' ! of the work for whicr s; permlt .issued .(Section ( Lender's Name' i� Kitchen�Sinkl �- F _ ,y J' Switches j Trash Compactor t Lender's Address OWNER'BUILOER D£CCARATION' ' r I I r { Lavatories„ Garbage Disposal 1 hereby;afflrm that I am exemptlfrom the!Contractor's.License Law for the 1 - i . Generatof ❑0.5 KW ❑5-15 KW 1 following reason, (Section 7031.5 Business and Professional Code: Any city or + I ?-Trap i + C_ I county which' requires a permit -to construct, alter Improve, demolish or repair 1 structure; prior to its issuance, -also requires the appllaant for such permit , .-, Roof drainss. I - Transformer ❑ 15-50 KW T ; `�:; file a signed statement'thal he/she is licensed pursuant to the provisions or ;- ;' i + I ❑5U + KW { i ; !Reinspection Fee $15 ;,,u Contractor's License Law (Chapter 9 (commencing with Section 7000) of vision 3 of the'Business'and Professions' Code)*or that he/sheds exempt 'therefrom + t Showers , - , t- Reinspeetr�oajFee 815 Meter ❑up to 100 amps � $ 3 : and the' basis for ,the alleged exemptlon.- Any_vlolation=of, Section Issue Fee ,7031:5 by ,any applicant for a permit subjects the -applicant to a civil anally of not more than five hundred dollars ($500)- _ Service Sink Issue Fee , $ a Zonin A cored By g Approved I Data o I, as owner of the -property or my employees with wages as their Sole j Compensation' will -do the work; and the Structure Is not Intended or offered - I I MECHANICAL 1 Application Approved By 1 • Date for sale .(Seci'lon 7044', Business' and, Professional Code:. The Contractor's r, i i "' j Aeirigeration System + 1 G p License Law does not apply to an owner of a property who builds or Improves q goiter '• Application Issued By , ' Date thereon, and who does; Such work:tilniself/herself or through his or her own employees, provided that such Improvements are not intended or offered for If, however, the building or improvement Is sold within ono of com- • Duct = Under`Ground 1 i ! ❑0.100, 00BTU ❑100,000 BTU' t SUMMARY OF FEES sale. year + pietlon, the owner'wlll have the burden of proving he/she dtd not bulltl or im- roveforthe of sale). 1 ) Dtect Structural I System Repair%Alteration { } PERMIT $ SMIP $ `' purpose } !, as owner of the property, am exclusively contracting'w3th,l3censad con- I 7044,.Buslness Code:. I-, i i Duct_- Ventilating•^i i I + i ,BUILDING PLAN CHECK. $ PERMIT tractars.to construct the.prolect (Section and•Protessipns The Contractor's License law does not apply to an owner of property who I__ _ _ , i l ISSUANCE $ hullds or Improves thereon, and who contracts for such projects with a con -Exhaust System ❑ Multiple ❑' i + 'PLUMBING s I j tractors} license pursuant to the Contractor's License Law).. + PLAN CHECK. $ GRADING! I $ ❑ Fam exempt udder Section B. & P. C. for this reason ' I I Fii'epl/Fact. Blt. ICSO j I I 1 F $ 1 (ELECTRICAL( $ ( ) Date 1 Owner i ' 'i hereby -certify -that �IX have read �this' application -and State that the above - - -•• i- Heating System & Ducting ! 1 ❑0-100,000 BTU El 1601060 ? : I I ; PLAN CHECK' ! $ , i MICROFILM I $ I ) -- - --- � - .,--.-i information Is correct. I agree to comply with all city and county ordinances t ,--- ' + I MECHANICAL $ I TOTAL+FEE, i $ and state laws relat" ,to building construction„and hereby authorize repre. sentattl of'thigy, to enter the above-mentioned property .for 1 Hood pi T vipe I ❑� ❑ i Reinspection Feel $15 PLAN CHECK $ I j LE55lnspectton , purpo,,Cana 1 Date (8/24/83Dryers' T a I I 1 ADVANCED PCSignature 1 ' Registers i ' Issue Fee S 8 ' I } i i FINAL FEE. t $ 1 License or55 CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor h? 'C,Ol STRUCTION A�ND�PL' IN ' PC 3e SPA = =* 'APPROVALS n Permif-# `Date Inspector APPROVALS'-., Permit Date I n"spector .1; Temporiiry Electrical Service or Pole ; , ;, 52. Paal &.Egui'pment Location r t n i� 2? Soil Pipe Undr'grnd: fl, i c , ' ' V 1 - 53 'Steel Reinforcement - 3' Electrical Conduii Utility.Undrgrnti. c 54. Forms - V - `? 4' Electrical Conduit-Undrgrnd. `r y ' onding 55- Electrical Bonding- 5: 5: Stael,Reinforcement �'. . „ 'i ;� `; 56. Rough Plumbing & Pressure Test 6: Electricai UFER Grnd. '" 57. APPROVAL TO,COVER-GUNITE. 7. Footings 11 5$. Electrical Conduit-Undrornd - B. F0'undation y - _ s -� ° _ 59. Gas Pipe, L1: Undrgrnd., Test _ , 9. Water Pipe-Undrgrnd. { ,R ' ! , 60. Backwash''Lines, P -Trap, ❑ Undrgrnd.• 10. Structural Floor System ,� 61. APPROVAL TO DECK 11. Property Sewer Line &jHouse'ConnE'Qion ' 62. Backwash & Receptor -Final - I 12. Sewer Cap ' r '' - ` '63. Heater &Vent-Firial L, r i 13.' i RoofDrains , ( �� _ t 64. Plumbing:System -Final• - 14. 'Rough Plumbing' - 65. Electrical -Final 715r'RougFi Electrical=Conduit ; "� '' ' i i 66•�S61ar Sysfetii Final I , �16.'Rough.ElectricWiring• i - I-' - '- 'A - _ >" _. � n in Ac es r v I :67:' Fe c g &; c s App o a , 17: ;Rough Wiring Sign'_' ' r gPPROVED FOR.PLASTERING 1 - , i 1$..RougFi Electrical.T Bar Ceiling+ 'i+ I l } ,� l 69: POOL/SPA SYSTEMS FINAL ' 19. RoughHeating & Air`Corrditioning I ^ ; , FIRE DEPT.,REQUIREMENT - ,r APPROVALS I Permit # 1 x ! 20. Rooughc Farctory Fireplace ' i !r la I , I } 21.'Ducts; in Structure; ` ,I I i70. Underground Hydro Q22: Ducts, ,Venailating `,� ; , F 1 i 71j Product Piping ❑ Gas 0 Oil I i L.23.,,Gas Pipe -Rough & Test I . ' I i 72. Underground Flush !=24. i Roof Framing• �' ; t - '73: Undergrnd. Storage Tank'❑,Gas.'❑ Oil ! 25.;'RoofSheathing 74. Overhead Hydro K. r, -26: T -Bar Ceiling r(Structural)t& Monocoof �`). 75. Dry Chemical -. , .27, ,Frame and -Flashing' _ +,' `S �l '76, Dry Standpipe t 28.NLathing & Siding, �, rs 77. FIXED SYSTEM FINAL . 29.'fnsulit ion" s' ; p 1 1 76' FIRE PREV. FINAL n t , 30:,brywalI Nailing! D .� Notes: I y i -- 3V. 1Plaster'Brown Coati 32. Electrical Power Meter-Ftinal I _ j+ s 33.' Final Electric 1 I I 1 1 34. Final Heating&•Air Conditioning 35. Final Gas Pipe=Test 36. Hood or;Canopy.' r_ 37, Final Factory F1ireplace a 3$. Final Plumbing] - 39. Water;Skice-Final 40. Gas Service -Final 41. Solarbomestic�FinaI Vi 1 , 42. Backflow PPeyentef I ' 43. Backflow Irrigation • ' I i� - ' ' ` l ' 44. Landscape Irrigafi6n7System' 45. Sound -Attenuation 'I 1 i �f !• 1 3 t 46, Handicap Regulations' 1 47. FINALSTRUCTURE-& BUI'LDING 4$. Special Requirements!Completed 49. Electric'Release toi Edison I I _ _ _ . _ _ ' I _ _ I i - ' 50. Gas Releaselto Southern California Gas Co'''I 51. CERTIFICATE OF OCCUPANCY I No. 'dDpZ3!! Date �G Ji __ - -' ": , F CI;Y OF COSTA MESA CONSTRUCTION PERMIT Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Is PE MIT O TRACT NO LOT NO BLD Project Address f 2 1 f- '-t/ --f Applicant's Mailing Address Owner's Name :3-,4D, 0, Phone Address Arch/Eng. License No. Address Contractor's Name ��yyM ` /tL Pho/tney� Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION 1 hereby'affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. 1.icen yCla C- r U Ice o. y 1 rte ^l 'signature .oORK£RS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section _ 3800, Lab. C.) Policy No. Company Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed it the permit Is for one hundred ($100) or less). 1 certify that in the performance of the work for whit this p rmit is Issued I shall not employ any person In any manner So' s t eco bj t to the Worker ' �T}A�nsati ws of Calif Date ' r Signature NOTICE: If, after.making this detlaratio you should becomes jet o Workers' Compensation provisions of the Labor Code, you rrKist forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 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.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031,5 Business and Professional Code: Any city or county which requires a permit to Construct, alter, improve, demolish or repair ny structure, prior to its issuance, also requires the applicant for such permit i file'a signed statement that he/she Is licensed pursuant to the provisions of he Contractor's License taw (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 erialty 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 (Section 7044, Business and Professional Code: The Contractor's License taw 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 employyees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Buslnoss and Professions Code: The Contractor's License taw does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date f Owner' I hereby certify that I have read this application and State that the above information is correct. I agree to comply with all city and county ordinances and -state laws relating t building construction, and hereby authorize repre- sentatives of this ci en o he above-mentioned property for inspection Signature Date Drivers' License or SS :P C3 �� T�(PEOFCONSTRUCTION 0 NEW El ADD LJ ALTERATION REPAIR �[dJ} ❑ CONVERSION ❑ DEMOLISH ❑ OTHER- DESCRIPT)ON OF WORK " TYPE OF PERMIT GRADING, FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SO. FT. OCCUPANCY I CONSTRUCTION TYPE VALUATION S ZONE//f� GRADING CU.YDS: ACRES Remarks: 10 9/_ Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee Outlets $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIL ICBO # Heating System & Ducting C].0-100,000 BTU ❑ 100,000 BT PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Soler Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Issue Fee MECHANICAL Hood or Type I . ❑ Canopy Type 11 ❑ Refrigeration System 130-100,000 BTU 13100,000 BTU System Repair/Alteration Reinspection Fee I $25 I I Issue Fee CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; pink - Accounting; Goldenrod - Assessor FEES A.P. # S Main Building: E T Front B Rear A C Right K S Left Ping. Ref. # Parking Req./Provided Use of Building: Planning Notes: 5491 9/ 1 i2/;;j Zone Accessory Building: Park.Fees $ ELECTRICAL Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ©Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW 135.15 KW S 3 FEES Reinspection Fee Transformer ❑ 15-50 KW ❑ 50 + KW Meter Chip to 100 amps Meter ❑over 100 amps Sub Panel Motors ❑0.1 HP 01 A - B Inc.Soler El 9-15 HP 016-15+ Microwave Pole Light Range Standing Sections Trash Compactor $25 1 Issue Fee I o/ E Q U I R' fE` M �E N •S FEES S 3 PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved Byate Application Issued By Dat SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ �2r 5Z PLAN CHECK $ ENERGY P.C. S ELECTRICAL $ GRADING $ PLAN CHECK $.y MICROFILM $ °E"'TOTAL MECHANICAL $ FEE $ S 3 PLAN CHECK $ 1 CONSTRUCTION AND PLAN INi ' APPROVALS Permit # Q ` Date Inspector- JL & SPA = APPROVALS Permit # Date Inspector ' 1', Temporary Electrica[.Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, 53; Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding '5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57, APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation -59. 'Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 66. APPROVED FOR PLASTERING 18. Rough Electrical -T gar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # •20. Rough Factory Fir@place 21. Ducts, in Structure ' 70. Underground Hydra 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush , , 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical i. 27. Frame and Flashing 76. Dry Standpipe f' 26. Lathing & Siding 77. -FIXED SYSTEM FINAL it 29, Insulation 78. FIRE.PREV. FINAL f , 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79, FINAL INSPECTION ;. 32. Electrical Power Moter-Final 80. FOOD CERTIFICATE ISSUED ' t 33. Final Electric Notes: .34. Final Heating.& Air --Conditioning 35. Final Gas Pipejest 36. Hood or Canopy 37. Final Factory Fireplace 36, Final Plumbing r 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer '} - i 43. Backflow Irrigation 44. ,Landscape Irrigation System t 0 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48, Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co l r 51. CERTIFICATE OF OCCUPANCY No. ddQ 2 Ad Date %/ `; e r CITY 0000STA MESA CONSTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PFRMIT Nn I TRACT NO. I LOT NO. I BLD Project Address na /S Applicant's Mailing Address, C -e wC Owner's Name ZyT.4,<3&V OS- 21"fC-;L— Phon ' 2 ei Address Arch/Eng. License No. Address / Contractor's Nama __ /�%uKf f:" _ F,�Tt/C Phnn st�U�J L Address (mailing) ZS2 City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license.is In f r a t. Q kens- se N to Signature .ifORK S' COMPENSATION D CLARATION r I hereby affirm that I have a Certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a -certified copy thereof (Section 3800, Lab. , ,( Policy No.Company ified copy Is hereby furnished. e i opy is filed with the city BuiDivis" bate Applicant EXEMIP41ON FROM WORKERS' CO ENSATION DECLARATION (This section need not be completed If the permit is for one hundred ($100) or - less). I certify that in the performance of the work for which this permit Is Issued 1 shall not employ any person In any manner so as to become subject to tike Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you shouid become subject to the Workers' --Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section,3097 Civ. C.) Lender's Namn Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License taw for the following reason (Section 7031.5 Business and Professional Code: Any city or 'ounty which requires a permit to construct, alter, improve, demolish or repair y structure, prior to its issuance, also requires the applicant for such permit file asigned statement that he/she Is licensed pursuant to the provisions of ie Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division. 3- of the Business and Professions Code).or that he/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 enalty 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 (Sectlon 7044, Business and Professional Code: The Contractor's 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 employees, provided that such Improvements are not intended or offered for sale. It, however, the building or Improvement is sold within one year of Com- pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Con- 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 builds or improves thereon, and who Contracts for such projects with a Con- tractors) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason .E - S-?oo TYPE OF CONSTRUCTION NE ZO Z J ADD L-3 ALTERATION LJ,REPAIR CONVERSION DEMOLISH u OTHER A.P. 996 DESCRIPTION OF WORK ". S Main Building: ELECTRICAL TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Transformer El15-50 KW ❑ 50 + KW ❑ OTHER A Rear C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY iC a, CONSTRUCTION TYPE VALUATION $ S Left ZONE { GRADING CU.YDS. ACRES Ping. Ref. Remarks: Parking Req./Provided Sub Panel Use of Building: PLUMBING FEES Planning Notes: I i Bar Sink Backflow Preventer Backflow Irrigation Bathtubs } Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee Outlets $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Date Owner Heating System & Ducting I hereby certify that I have read this application and state that the above 00-100,000 BTU ❑ 100,000 BT information Is Correct I agree to comply with all cityand count ordinances - and state laws relating to building construction, and hereby authorize repre- sentatives of this' city t0 nter upon the above-mentioned pro rty for inspection pur ses. C� Signature ate ` Reinspection Fee $25 Drivers' LI nse or 55 �F CMF 0865.46 rev. 7/83 White - Building; -Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - - Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water. Closet Water Heater Water Service Issue Fee Hood or Type I C]Canopy Typell ❑ Refrigeration System 00-100,000 BTU ❑ 100,000 System Repair/Alteration Issue Fee K'49 L;, T„ zone . Accessory Building: Z O N I N • G R ' E Park'.Fees $ O U I R E M E ". N i ELECTRICAL T S FEES ' Automatic Washer Construction Pole Sub. Transformer El15-50 KW ❑ 50 + KW 4_ , Cooking Unit Meter "Pto 100 amps S Q a, Dishwasher Meter Clover IDOamps Dryers ❑Gas ❑Electric Sub Panel Fan Motors 00.1 HP i/ - 8a) F.A.U. Inc. Solar 09-15 HP 1:116.15+ Fixtures Microwave 36 r Device Boxes Pole Light Outlets f Range 3 O � Switches f 5L 6 Sign L�( Garbage Disposal Standing Sections Generator 1:10-5 KW 1:15-15 KW Trash Compactor $ 3 Reinspection Fee $25 Issue Fee $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By — Date Date _-,,Q_r NI -1— -- -- Date 5'/i3 F3 - BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY $ $ $ $ENERGY $ $ �r $ $ OF FEES SMIP $ PERMIT ISSUANCE $ P.C. $ 0 GRADING S MICROFILM $ TOTAL FEE $ <3(;ti $ 3 �_4 CONSTRUCTION AND PLANNING . APPROVALS Permit #-��C I Date Inspector )L & SPA APPROVALS Permit # Date Inspector - ' 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53, Steel Reinforcement 3. Electrical Conddit Utility-Undrgrnd. 54, Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test i 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe Undrgrnd: 60. Backwash Lines, P -Trap, ❑ 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 t 65. Electrical -Final 15. Rough Electrical -Conduit r 66. Solar System -Final 16. Rough Electric Wiring 9 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 1$. Rough Electrical -T Bar Ceiling (► 1L 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping © Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 2B. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL ,r30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 'T 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No, Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER IT TRACT NO. LOT NO. BLDG. NO.- .GONSTRUCTION PERMIT- tLCI: I FINAL it . Meter_ Clover 100 amps T t Applicant's Mailing Address - =-,sfa' ' S*YPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION REPAIR Costa Mesa ❑ CONVERSION 1:1 DEMOLISH ❑'OTHER Project Address - -Airway -F-203, I y,3151- Ownei's Name Shea-rsln/Ailierican _CxpreS hone 955-7200 DESCRIPTION OF WORK TP_I)ant TnnrnVPMPnt ^T Address 19000, tMacArtbUr• 8th fl .. ' NeWport Beach = TYPE OF PERMIT 0 GRADING ' FOUNOATION STRUCTURAL " AfchlEng,-Tom Camps & Assoc . Llcense No. ❑ TENANT ❑ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Address 17779 F &ii) St..- Irvine ❑,•OTHER , Contractor's Nam hone 540-2006 PROJECT DESCRIPTION SO_ET. � ' OCCUPANCY - Address {mailing} 3.IS .iraiay `L-1, CDS td t'(eSd - CONST RUCTION TYPE V -N t VALUATION$ 19.700.00 License No. ZONE_ GRADING CU. YDS. I ACRES LICENSED CONTRACTOR DECLARATION i i Remarks: ' Trash Compactor j heieby;afflrm that I am licensed under provisions of Charter 9 (commencing Garbage Disposal j 'A section 7000) of Division 3 of the Business and Professions Code. and Generator 00.5 KW 05.15 KVV i yticense Is In fu _force and effect. Q Y LL Ucense C a E150 KW I PLUMBING , Date Signature 1 Bar Sink Sewer Cap WORKERS' COMPENSATION DECLARATION ' Data ' .-I hereby affirm that I have a certificate bf consent to Salfdnsure or a,certlfiwte _ . Backflow Preventer-- - SewerConnection- of Workers' Compensation Insurance,. or a certified copy thereof (Section t I _ 3800, tib. C.1 ^- �, Backflow Irrigation Solar Collectors Policy No. � = T' Company J2! •S� r SMJP - - ® Certified copy Is hereby furnished. Bathtubs i i , Solar Piping Date�rtlfled,cppy i$.flled wiatApthe aney Build DI tt55I/ LL''••hkI/ bb33 Clarifiers # Solar Tank ' i - I EXEMPTION*ROM WORKERS' cOMPE TION CLARATIOV100). (Thissection need not be completed If the permit is f one hundred ( 100) or Dishtnrasher Swimmin Pool w/Spa --� g less) i l certify that in the performance Of the work for which this permit Is Issued I Drinking Fountains - Urinal shall not employ any person in anymanner so as to become subject to the MICROFILM I ! $ Workers'. Compensation' Laws of CaHtornia.I % Floor Drains' Water Closet ; Date Signature I � NOTICE: If,"after -making this declaration, you should became subject to -the Floor Sinks -Water Heater - - - - - Workers' Compensation provlslons of the Labor Code, you must forthwith comply 'with such provlslons 'or this permit shall be deemed. revoked. ' Gas Service +_ Outlets Water Service CONSTRUCTION LENDING AGENCY : I hereby Affirm that there Is a,construction lending agency for the performance• Interceptors ' , t of the lwork for, jQ� this; permit is Issued _(Section 3097 Civ. C.). _ Lender's' Namer'^ 1 Kitchen�5ink I , 1 I Lender's! Address NNER'BUILDER DECLARATION _ , Lavatories,' I , ireby'afflrin that ! am exempt from thojContraitor's'License Law for the reason,(SectIOn-7031.5 Business Professional Code: Any p—Tre ' ; P, ; .towing antl city or county which requires a permit to construct, alter improve, demolish ;or•ropaii 1 any structure; prior to Its Issuance,,also requlros the appllcant.for such permit to file a signed statement'that he/she is licensed pursuant to the provisions of w Roof Drains', the Contractor's License Law•(Chapter 9 (commencing wlth'Sectlon 7000) of 'Division 3 -of the Business and Professions Coda) or that! he/she. is exempt �- Showers f,: Reinspection Fee $15 therefrom -and the basis for the alleged exemption, -Any violation of Section 7031;5 b r any applicant for,a permit subjects the applicant to a civil enalty b not more than five hundred dollars ($500): I 1 Service Sink lane Fee $ 3 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 Z f MECHANICAL for sato'(Seclion 7044, Business' and' Professional Code: The Contractor's ; License Law does not apply to an pwn0r of a property who builds or Improves Bpiler: , + Refrigeration System thereon„and who does such work himself/herself or through his or her own employyees, provided that such improvements areinot Intentlod er offered for ' sale. I}, howerar, the bu[Iding 0 improvement Is sold I 30100,000BTU 0100,000BTU + Duct Under Ground ' within 0ne,year of con- 000tha owner will have the burden of proving he/she did not build or Im- ' I rove for the purpose of sale)- t , Duct -Structural ( system flepairlAlteratian I.as owner of the property, am exclusively cenlracting.wllh l)cen9ed con- � "tractors to. construct the projact (Section 7044, Buslno_ and Prof.ssl-ns Cade:. The Contractor's U— so Law does to , Duct- Ventilatin 9 I _ not apply an ewnor of property who builds or improves thereon, and who contracts for such projects with a con. I Exhaust System ❑ Multiple ❑ . tractor{s) license pursuant to the Contractor's License Law), ❑ I am exempt under Section B. & P. C. for this reason Fii'epl/Fact. Bit. ICBO # + + Date i Owner, Heating System & Ducting , I hereby certify that-!' have-read-thti application -and -state that the -above- i ❑0-100,000'STU ❑100,000 Information IS correct, I agree to comply with all city. and county ordinances and state laws rel ng to building construction, and hereby authorize reore- -ity.t Hood or Type I ❑ , ' sentatives Ong Inspection + enter. p the above-mentioned property forH!F� Can I T D. Reinspection Fee I $15 pure I I ell Signature Date -8/24/83 Drivers' License 0"55 ' gisters Issue Fee $ 3 r CMF 0855-46 rev. 12/82 White -Building; Canary -Applicant; Pink -Accounting; Goidenrotl - Assessor 2.03 A.P.4k l.�Z-I L'�►� PLNG. REF, -0 TO BUILDING PROPERTY INE LE FT SIDE YARD PKG•SP.ACE REO. STREET WIDTH SPECIAL CONDITIONS: 5377 9/06/93 « ZQNING REGULATIONS - - ir ZONE C� �+ BUILOING REAR YARD (TO P/L) . RIGHT SIDE YARD PROVIDED TAR FEE $ ' tLCI: I FINAL it Automatic Washer -,i _ Meter_ Clover 100 amps T t Construction Pole Sub Panel' Cooking Unit I Sub Pole I , F Dishwasher Motors 00-1 HP C1 135$ Dryers ❑Gas' ❑Electric .Inc.Solar 09.15 NP ❑16-15t { �, Fan Microwave �' i F.A.U. i 'Pole Light Fixtures 1 rw Flange - - - Device Device Boxes Sign Outlets ' Standing Sections i r Switches Trash Compactor j Garbage Disposal j Generator 00.5 KW 05.15 KVV i Transfornier ❑ 15.50 KIN E150 KW I Reinspection Fee $15 Meter E3 up to 100 ampsIlssua Fee' $ 3 Zoning Approved By ' Data ' } Application Approved By :Jarmo Date L 6 T a Application Issued BY t I 4 I ! I SUMMARY OF FEES I ' i I �'� 'BUILDING PERMIT $ •S� r SMJP $ PLAN CHECK $j PERMIT : -PLUMBING $' + ISSUANCE $ ? PLAN CHECK $ GRADING $ 'ELECTRICAL i 3 t S ' PLAN CHECK! i $ MICROFILM I ! $ MECHANICAL $ TOTACFEE, ' $ I � «PLAN CHECK; $I ADVANCED'PC S ,—` ' FINAL FEE $ = '- �CONSTRUCTiON AND PLAN, POOL & SPA --Date' =APPROVALS Permit # Date Inspector -P APPROVALS ermit # Irisp(ktor 1 r , . . Tempor`ary,Electrical Service or Pole .: 52: Pool &.Equipment Location r "} 2t ISoil Pipe-Undrgrnd.R53.' Steel Reinforcement :r 1 Electrical Conduit Utility-Undrgrnd: 54. Forins A; Electrical Conduit-UndrgrndP 55. Electrical Bonding 5. Steel Reinforcement ; ` 56. Rough PEuinbing &Pressure Test 6: ;Electrical LIFER Grnd. I , - 57. APPROVAL TO COVER-GUNITE 7. 'Footi.ng; {� /' ` 58. Electrical. Conduit-Undrarn.i. r 8. Foundation ^ �' 4'•' `_ 59. Gas Pipe, ❑vUndrgrnd., Test 9. Water Pipe-,Undrgrnd. _ ,� .# 60. Backwash Lines, -P -Trap, ❑ Undrgrnd. 10. Structural Floor System. .61. APPROVAL TO -DECK 11. Property Sewer Line" & House Connection 62• Backwash''& Receptor Final 12, Sewer Cap r 63. 1 -)eater &Vent -Final 13, Roof Drains - i + i - 64. Plumbing System.- Final 14. FRough Plumbing 65. Electrical=Final `15Rough Electrical -Conduit , i -T- 66. Solar System -Final 16. Rough Ele7iric,Wiri�ngz 67. Fencing &'Access Approval _17. Wiritig`Signt�68,I APPROVED FOR PLASTERING �Rougti 16., Rough Electrical;T Bar Ceilings 69.i PODL/5PA SYSTEMS FINAL y 19.',Rough'He4ting &'Air Conditioning FIRE DEPT. REQUIREMENT _ APPROVALS Permit# " �0.lfiRoughfactory Fireplace i 21. Ducts, in Structure, [ ''I i 70. Underground Hydro ` 22: Ducts, Ventilating p I '{ ' i 71.' Product Piping ❑ Gas C7 Oil `-23. 'Gas Pipe -Rough & Test I 72. Underground Flush r -24' Roof Framing, ` t 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing , 74. Overhead Hydro 26: +T -Bar Ceiling (Structural),& Monocoat S_ ,a?�� 75. Dry Chemical 27:l Frameand'Flashing i .�� :� 76.; Dry Standpipe _ 28.'Lathing&'Siding i 477.. FIXED SYSTEM FINAL 29.E Insulation 78. FIRE PREV. FINAL 30rbr'ywall NailingIlls �� Notes: 31'. -.'Plaster Brown Coat i r . .r 32. Electrical Power Meter -Final r ) < 33. Final Electric 34. Final Heating &,Airl Conditioning 35. Final Gas Pipe=Test t c3 36. Hood or;Canopy. . •• I' _ 37. Final Factoiy Fireplace- L 38. Final Plumbing 1 i - 39. Water Service -Final ,• - 40. Gas ServicelFinal j 41. Solar Domestic -Final ` 42. Backflow Preventer 43. Backflow Irrigation Z - 44. Landscape Irrigation System 45. Sound, Attenuation _ _ 46. Handicap Regulations" i r ' 47. FINAL STRUCTURE &BUILDING A, 48. Special Requirements Completed i I 49. Electric Release,to Edison, 50. Gas Release to Southern California Gds Co 51, CERTIFICATE OF OCCUPANCY G '�?.35K ' j e _ l No Date f CITY,OF COSTA MESA CONSTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NQ, - , — TRACT NO, I LOT NO. I BLD Project Address It Applicant's Mailing Address oyr �, �/a�� 41 Owner's Name = _6 hone Address 3/f/ Arch/Eng.. License No. Address Contractor's Name- -- U� — -Phone 411 Address(mailing),r,! l �p 64L -J107 #4 p4Z T City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Lith section 7000) of Division 3 of the Business and Professions Code, and i,y license Is In fyU^orW 4qd effect. License Class SCJ ns f Oa te Signature WORKERS' COMPENSATION DECLARATION 00, I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C.) Policy No. Company eCertified copy Is hereby furnished. Certified copy Is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred (5100) or less). I certify that in the performance of the work for whit his permit is Issued, I shall not employ any person in any manne eco je to the Workers' ,Fpm� satioLLLaws of Calif Date 1 1� Signature NOTICE: If, after making this declaration, you should become srt ect to the - Workers' Compensation provisions of the Labor Coda, you midt forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Cly. C.) Lender's Namn Lender's Address -WNER BUILDER DECLARATION iereby affirm that I am exempt from the Contractor's License taw for the Bowing reason (Section 7031.5 Business and Professional 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 fiie a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of trio Business and Professions Code) or that he/she is exempt therefrom and the basis for the allegedexemption. Any violation of Secllon 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their solo 'compensation, will do the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License taw does not apply to an owner of a property who bullds or improves thereon, and who does such work hlmself/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 com- pletion, the owner will have the burden of proving he/she did not build or Im- rove fOr the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Coda: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who Contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ k am exempt under Section B. & P. C. for this reason Date Owner; I hereby certify that I have read this application and state that the above Information is correct. I agree to -comply with all city and county ordinances and state laws relating to buildin c nstruction, and hereby authorize repre. sentatives of; this c' nt n e above-mentioned property for Inspection p7 Signature ataC> Drivers' License or SS TYPE OF CONSTRUCTION L1 NEW LJ ADD LJ ALTERATION 0 REPAIR Backflow Preventer Backflow Irrigation ��NVERSION 1:1DEMOLISH ❑ OTHER Bathtubs A.P. # 015fC OF WORK Solar Collectors Dishwasher- Solar Piping, - Drinking Fountains Solar Tank S Main Building: Floor Sinks Urinal Gas ServiceOutlets Water Closet TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ELECTRICAL Roof Drains GRADING $ Rear ❑ -OTHER $ $ A $ $ PLAN CHECK C RightK PROTECT DESCRIPTION SQ. FT. OCCUPANCY N STRUCTION TYPE VALUATION $ 777ZO___NE g Left GRAOING CU.YDS- ACRES Ping. Ref. 9W Remarks: Parking Req./Provided Use of Building: PLUMBING FEES Planning Notes: i Bar Sink Showers Backflow Preventer Backflow Irrigation Service Sink Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher- Solar Piping, - Drinking Fountains Solar Tank Floor Drains Swimming Pool w/Spa Floor Sinks Urinal Gas ServiceOutlets Water Closet Interceptors Water Heater Kitchen Sink Water Service Lavatories $ P -Trap ELECTRICAL Roof Drains GRADING Reinspection'Fee I $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ElMultiple ❑ Firepl/Fact. Blt, ICBO # A Heating System & Ducting ❑0-100,000 BTU ❑100,=BT Reinspection Fee -Accounting; Goldenrod -Assessor Issue Fee MECHANICAL Hood or Type I ❑ Canopy Type !I ❑ Refrigeration System 00•100,000BTU D100,000BTU System Repair/Alteration �Jo,0 I Automatic washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A•U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 Kw ❑5•1 $25 I I issue Fee I $ 3 11� 7S SUMMARY OF FEES BUILDING PERMIT $ 5MlP $ PLAN CHECK $ PERMIT ; PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. 3 Zane Accessory Building: Park. Fees $ , ELECTRICAL Transformer ❑ 15-50 Kw ❑ so + Kw - Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel Motors [30-1 HP❑lh-8 Inc.Solar ❑9-15 HP 016.15+ Microwave Pole Light Range Sign Standing Sections Trash 5 Kw Z O N I Compactor FEES $ 3 FEES Reinspection Fee $25 issue Fee $ 3 PUBLIC SERVICESREDUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By - - Data N G R E O U I R E M E N T 51490 9/12/7 CMF 0865-46 rev. 7/83 White -Building; Canary -Applicant; Pink $ , ELECTRICAL $ GRADING $ PLAN CHECK MECHANICAL ' $ $ MICROFILM � TOTAL FEE $ $ PLAN CHECK � $ ' CONSTRUCTION AND PLA iv G �l APPROVALS Permit # 6 Date Inspector POOL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pale 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement f 3. Electrical Conduit Utiiity-Undrgrnd. 54. Forms 4. Electrical. Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7.- Footings 58. Electrical Conduit-Undrgrnd. 8' Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 i 68. APPROVED,FOR PLASTERING -18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace orFIRE DEPT. REQUIREMENT .11 APPROVALS Permit # 21. Ducts, in Structure i 70. Underground Hydra 22. Ducts, Ventilating 71, Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72, Underground Flush f,? 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil r 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power M@ter-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 i 43. Backflow Irrigation 44. .Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requiremerhts Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co t: 51. CERTIFICATE OF OCCUPANCY No. Date i; t_ ;X, '#C1TV OF COSTA MESA, CONSTRUCTION PERMIT I Project Address W� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. I TRACT NO. I LOT NO. SJDG. NO. Applicant's Mailing ddrajss�, 4Z Owner's Nam* --'-7 �*�� /��5"`'— Pho Address Arch/Eng. License No. Address' A 7�-- ;r� 14 Contractor's Nam f� ..' 'r ! hon. Address (mailing) City,License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, ago - my license Is in full foEe a effec st. ty _UcenCl C.. Lice e N o Date Signature WORK RS' C MPENSATION DE RATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sect4on Lab. C Policy NodT Company tri h: Ce copy is hereby furnished. er i cgpy d with the city �E[NSATION ding DIv Date = - Applicant EXEM ION F OM WORKERS' C DECLARATION (This se tion need not be completed f the permit Is for one hundred ($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. Date Signature NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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, (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for the ,slowing reason (Section 7031.5 Business and Professional Code; Any city or _ounty 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code).or that he/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 Enalty 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- ove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to.the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Bar Sink Showers Backflow Preventer Service Sink Backflow'Iriigation Sewer Cap TYPE OF CONSTRUCTION 0 NEW 0 ADD ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK • LJ ALTERATION LJ REPAIR A.P. # S T 13 A C KLeft $ Main Building: TYPE OF PERMIT lel GRADING El FOUNDATION. STRUCTURAL ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ 'OTHER Front Rear PROJECT DESCRIPTION SQ. FT. CON 57RUCTION.TYPE VALUATION ZONE GRADING CU. YDS. OCCUPANCY $ 'ACRES Right urinal Ping. Ref. # Remarks: Interceptors Parking Req./Provided Kitchen Sink Water Service Use of Building: PLUMBING FEES Planning Notes: Bar Sink Showers Backflow Preventer Service Sink Backflow'Iriigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher' Solar Piping Drinking Fountains Solar Tank Floor Draii sl Swimming Pool w/Spa Floor Sinks urinal Gas Service Outlets Water Closet Interceptors Water Heater Kitchen Sink Water Service Lavatories $ P—Trap $ Roof Drains Reinspection Fee $25 I I Issue Fee Boiler Duct': Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIt. ICBO:� Date Owner Heating System & Ducting I hereby certify that I have read this application and state that the above ❑ Cl, 106,0008TU ❑100,00087 Information is correct. I agree to comply with all city -and county ordinances and state laws relating to buildin construction, and hereby authorize repre- sentatives of t s• city to ent u the a ova -mentioned • ro t i Inspection purp ' Signature to//.z 6 Drivers' Li rise or 55 W Reinspection Fee $25 CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type I ❑ Canopy Type II ❑ Refrigeration System 110-100,000 8TU 0 100,000 BTU System Repair/Alteration 5548 9118/83 Zone Accessory Building: Park.Fees $ S 3 Reinspection Fee $25 1 Issue Fee, FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By—_ � r Issue Fee ' S 3 Z O N I N G R E U _ I R E M E N T' FEES Mm -■ ■E ME OE mm - ELECTRICAL SUMMARY OF FEES Automatic Washer Transformer 1:115 50 KW Construction Pale Sub. 0 50 + KW e $ Cooking Unit Meter 1o100 amps $ Dishwasher Meter Cover 100 amps $ Dryers ❑Gas ❑Electric Sub Panel Fan Motors ❑0-1 HP - $(� $ F.A.U. Inc. Solar ❑9-15 HP 016-15+ $ Fixtures Q Microwave $ Device Boxes Pole'Light $ Outlets �(, �6 Range $ Switches Sign $ Garbage Disposal Standing Sections $ Generator ❑0-5 KW D5-15 KW Trash Compactor S 3 Reinspection Fee $25 1 Issue Fee, FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By—_ � r Issue Fee ' S 3 Z O N I N G R E U _ I R E M E N T' FEES Mm -■ ■E ME OE mm - SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ 41 —3 GRADING $ PLAN CHECK $ O r MICROFILM $ �/ MECHANICAL $ TOTAL FEE $ PLAN CHECK $ ' CONSTRUCTION AND PLANNING - APPROVALS Permit # Date. ' Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52, Pool 8i Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3.-Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding r 5. Steel Reinforcement r 56. Rough Plumbing & Pressure Test i 6: Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. `Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, D 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 i 64. Plumbing System •Final ' 14. Rough Plumhing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring , ; �i, 67. Fencing & Access Approval 17. Rough Wiring Sign 66. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24, Roof Framing "' 73. Undergrnd. Storage Tank D Gas ❑ 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 LAZ 80. FOOD CERTIFICATE ISSUED 33, Final Electric Notes: 34. Final Heating & Air Conditioning T 35. Final Gas Pipe-Test 36. Hood or Canopy 37, Final Factory Fireplace , 38. Final Plumbing ; 39. Water Service-Final 40. Gas Service•Pinal 41. Solar Domestic-Final ' 42. Backflow Prevente'r 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48, Special Requirements Completed 49, Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY' No.� Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CIT7193F COSTA MESAl _ PERNf(INO. TRACT NO. LOT.NO..13LOG. NO. PONSTRUCTION PERMIT = r Applicant's Mailing Address . TYPE OF CONSTRUCTION ' NEW U ADD U ALTERATION REPAIR s ` ,4 - ❑CONVERSION ❑ DEMOLISH ❑ OTHER• Project Address r+ Owner's Name - • hone _ DESCRIPTION OF WORK therefrom •and the basis for the alleged exemptlon.•Any,viola ion of; Sectionry 7031:5 by'•any applicant for a: permlt'.subjects'the applicant to at civil Address. �� ' G r - TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL A. P. 4f5 ZONE anally of not more than five hundred dollars (SS00): ' �: .r 1 '+ Service Sink I i Arch/Eng., License No.. �,IS! TENANT ❑ ELECTRICAL XPLUMBING ❑ MECHANICAL+ PLNG. REF. BUILDING • pterion, the owner�wlll have the burden of proving he/she did not buiitl or Im- rove for the purpose of Sala). - i •� 1 I 1 l Address 1 -[];-OTHER compensation' will do the work, and -the structuress not intehded or offered '-+r 70 BUILDING I MECHANICAL I + i 4,•.. ' sale 1(Sediort 7044 Business' and' Professional - Code: The Contractor's j •ense Law does not apply to'an owner of a property who builds or Improves _. . I REAR YARD ITO P/L) , Contractors Nam -� ____Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY reon,}antl who ,does such work himself /herself or through his or her own { $ PERMIT - Address lmeiling) ' CONSTRUCTION TYPE VALUATION S LEFT SIDE YARD I j RIGHT'SIDE YARD r ~ I ) ZONE + GRAD NG CU. YDS, IACFiES--'-- ' PKG. SPACE REG. a 1 j PROVIDED " l $ Lie "so - / __ LICENSE1 CONTRACTOR DECLARATION i -9 Remarks: �e k �, -a;"�gs ' STREET WIDTH PARK FEE S Firepl/Fact, Bit, ICBO # Chereby;affirrn that Pam licensed under provisions of Charter (commencing . �+ - l 1 t with section 7000) of Division T of the Business and Professions Code, and r r l I SPECIAL CONDITIONS: i i my license is in tull fort nd street. + ' $ t t I MICROFILM $ $ ' License lass ' 1 c { 1 ( can No - I ( ' PLUMBING r - - --�.- —y E r SPLAN CHECK' Date r ' Signature ' 1 Bar Sink 3 i Sevuer Cap r ELECTRICAL ! WORKERS' OMP£NSATION DECLARATIO .1.hereby. affirm that.l.have.a certificate. of-consent-to,self�nsure or. a.CertlflCate _ r -r 1 _ � Automatic Washer-: _- - z -Meter -, Over 1097 amps!^__ $ _..} t --.1-- ' . __1 --r - Backflow Preventer - -- SenRr Connection $ r of workers' Compensatlon Insurance,' -or a certified; copy thereof (Section sentatives of thl 'city' to enter u o the above-mentioned ropert ,for p Construction Pole'. Sub Panel' $15 3804, Lab. C.) , , I t j f , i Backflow Irrigation Solar Cal lectors ; ! . I I f Inspection pure 9. Slgnature Date �3 Policy No. ' t Company i i I , - Pi CookingUnit I Pole ) ADVANCED PC $ A Certlfletl copy Is hereby furnished. Be htuhs I } 1 Solar In p @ ' j l +Sub yJ Certified copy is filed with the city Building Division. ) { ! r { i 1 Clarifiers I Solar Tank ? Dishwasher r „ s , -Motors D0-1 HP ❑ 1',y$ ' ate _ _Applicant _ _ _I XEMPTIONjFROM WORKERS' COMPENSATION DECLARATION ' y I t + DFysrs ❑Gas ❑E`lectric` "� '1 Inc.Soterl 9-,15 HP^❑16-15+ ' Dishwasher ( + ! Swimming Pool w/Spa ; I (Thissectlon need not be completed if the permit is for,one hundred ($100) or , [ less):. , j , ICartify:that in the performance of the work for which this permit Is ISSued I - Drinking Fountains 1 Urinal ! 1 Fans Microwave { i I shall: not employ any person in any manner so as to become subjectto the ; Workers', Compensation, Laws California, 3 Floor Drains ) I l S F.A.U. I' `�f t Pole,Lighi I { I of I Ddte _ t �Ignature ! NOTICE: 1f,•after makirlg•thirdeclaratlon, you should become subject•to the i I Water poser , Fixtures r i t 1 t r-.. • 'Device i _. 'flange -� I -:- Floor Sinks -( - - -�--- - • Water Heater - -- - - - — • - Workers'. Compensation provisions,_of the Labor Code, you must forthwith, comply with, SUCK provislons:'or this,,permit:shall be:deemed revoked-, :' Gas Service'. { Outlets =_ r 1 ;- W_ iter Service "� _ Boxes ! 4 Sign; CONSTRUCTION: LENDING AGENCY- t • , j + Outlets + 1 i F• + I hereby affirm that there is a;construction lending agency for the performanu, ' 'work Interceptors I i ;, I Standing Sections of the for, which this; permit is Issued (Section 3097 Civ: C:) - Lender's! !Name_ - ` i r r '• Kitchen!Sink' l + - ; ' Switches i r Trash Com actor + { p , I J :, r• + Londer's, Address • 1 I .I Garbage Disposal ! ' L -11 .; . OWN_EWBUIt_DEA DECLARATION_ ti a^• ! , I 1 hereby�afflrm that 1 am exempt from tha,Contractor's License Law for the r t } ._ , Generator; E]015KW ❑5-15 KW following reason (Section 7031.5 Business and Professional. Code: Any city or P -Trap ounty which requiras a permlt to:construct, alter improve, demolish or repair a y structure, prior to its issuance,;also requires t�re•appllcant•for such ppermlt - ROOF Drains• ' t Transformer ❑ 15-50 KIN ' 1 file a signed statement That he/she is licensed pursuant to the: provisions of i he ilea Law:(Chapter 9 ', _ - ' - ❑5U + KW , I + ,Reinspection Fee $15 actor's.License (commencing+wlth;Saction.7000} of + pivlsfon'3 of the',Buslness and. Prpfessions'Code)''orlthat,he/she is'exampt , I , r Showers Rainspection'Fe9' $15 + I M ❑ 1 therefrom •and the basis for the alleged exemptlon.•Any,viola ion of; Sectionry 7031:5 by'•any applicant for a: permlt'.subjects'the applicant to at civil i ` J - r '• $ 3 eter up to t00amp$ r t (slue Fee, _ anally of not more than five hundred dollars (SS00): ' �: .r 1 '+ Service Sink I i _ 1 Issue Fee Zoning Approved By 'Gate l,'asjowner of. the :property or'my employees with wages, as then sole + • pterion, the owner�wlll have the burden of proving he/she did not buiitl or Im- rove for the purpose of Sala). - i •� 1 I 1 l ! ' compensation' will do the work, and -the structuress not intehded or offered '-+r I •� _ i I MECHANICAL I + Application Approved By I ate sale 1(Sediort 7044 Business' and' Professional - Code: The Contractor's j •ense Law does not apply to'an owner of a property who builds or Improves � , $ I Boiler r ! , 1, as owner oT the property, am exclusively contracting,with'Ifcensad con- I tractorsSo.construct the project (Section 7044, Buslness,and.Profasslons Cade: , Refrigeration System i r _ Application isiued 8y reon,}antl who ,does such work himself /herself or through his or her own { $ PERMIT i t The Contractor's Cleanse Law does not apply to an Owner of property who1 builds or Improves thereon, and who contracts for such projects with a con- Exhaust System E)Multipte ❑' eta MINE �IY.. ,ployees, provided that such improvements are not Intended or offered for sale. If, However, the building or improvement Is sold within one year of tom- I Duct=Under Ground , ❑0100,000BTU ❑100,000BTU ; SUMMARY OF FEES • pterion, the owner�wlll have the burden of proving he/she did not buiitl or Im- rove for the purpose of Sala). - i •� 1 I 1 l , Duct - Structural I � System Repair/Alteratiorii � � ;BUILDING PERMIT ( i SMTP � , $ I , 1, as owner oT the property, am exclusively contracting,with'Ifcensad con- I tractorsSo.construct the project (Section 7044, Buslness,and.Profasslons Cade: , Duct Ventilating. :_ _ ,- v _ ' PLAN CHECK- $ PERMIT i t The Contractor's Cleanse Law does not apply to an Owner of property who1 builds or Improves thereon, and who contracts for such projects with a con- Exhaust System E)Multipte ❑' PLUMBING j $' 7` ISSUANCE ' l $ tractor(5) license pursuant to the Contractor's LJ cense taw): t ; j $ GRADING $ _ ❑ I -am exempt un or Section B. 6 P. C. for this reason Firepl/Fact, Bit, ICBO # PLANCHECK 1 t r r l Heating,System & Ducting i ELECTRICAL• ) ! $ t t I MICROFILM $ $ ' Date Owner' ° '-1-hereby certify -that I have read this application.and-state-that-the above -r• " ❑0.100,000.BTU-❑100,0006 r - - --�.- —y E r SPLAN CHECK' $ ( + I information is correct, I agree to comply with all city and county ordinances , and, state laws relatin to buildingconstruction, and hereby authorize repre- i ! t f t MECHANICAL # $ ) r TOTAL•FEEi I , $ r sentatives of thl 'city' to enter u o the above-mentioned ropert ,for p Ho Or Type I ❑! I ; i Reirrspactiori Foe, $15 ; PLAN CHECK , ; t = L� i r 1 1 t Inspection pure 9. Slgnature Date �3 Canopy" Type -11 ❑' $ ADVANCED PC $ ' Drivers' License or S5 Registers 1 ISSrIe Fee + $ 3 i ( FINAL FEE I O Q $ ' r r 1 [ GMF 0865-46 rev, 12/E2 White - Bufiding; Canary - Applicant; Pink - Accaunting; Goldenrod - Assessor - 1-tONSTRUCTION,ANgPL'•ANNIINQ r' �r sc� �- - = -_! "' POOL-& SPA 7 _r YAPPROVALS �, Permit #= L' : x t o :Date �Insp"ei:ta APPROVALS Permit # Date Inspector '•: [•1 E " 'n. r v r„� .. y•,� a �� .O i. I, . r,- ¢ _ ti- - ;f- jTemporary Electrlical Service orzPoleN = '• n iiQ " 52:' Pool &`Equiprrient Location 2: Isoil'Pipe-Undrgrnd:_ `' 1„ o I - y`' r--- 53� Steel Reinforcekrent - I 1 •3!.Electr'ical Conduit Utility-Undrgrnd. sL '_` ' y= '54.4 Forms i y v 4Electr,ica�! Cbnduii Undrgr't�d� = F ' I i = ' �- :55`. Eleotrica[.13'6 idirig 7 E - - -5: Steel Reinforcement r ' S b ,` -a _ .;: ".. -� • - - _ Rough Plumbing'& Pressure,Test' - E 1 , ,,, ,56. 7-7 6. jElect'ricaI INFER Grnd. j °� # �- ; ` r ��- 57: APPROVAL' TO'COVER�UNITE r 7. Fdot ngs i i ! i aI :58: bectrica)'Conduit-Undrarri l.. 8. Foundation r j 59. Gas Pipe, -.0 Undrgrnd:, Test _ 9.'Water Pi'pe-Undrgrnd. ; y ° .i a r` 60. Backwash Lines,'PuTrap, ❑ Undigrnd. 10. Structural P16 -or System _ c ti ( r 61. APPROVAL TOiDECK 11. Property Sewer Line &;Ho Connection] I : 'c 62.:Backwash & Receptor Final -"use , 12. Sewer Cap I 1 + r ' - ; ri 63. Heater & Vent -Final, 13. Roof'Drains Plumbing System Final 14. Rough Plumbing ( `- it I ' - - 65. Electricaf=Final= ` 15: - -TE- (-- �� - r--- -t66.- SolanSystem-Final �Rough'Electrical=Conduit 16. Rough Electrie Wiring :, i F ;t-`" c: ` 7r 1? j67 + Fencing & Access Approval - r _ 17. Rough Wi�ing'Sign m 1 J �,` �. f .ri c ` , t 6B r APPROVED FOR PLASTERING ? c ! ' 18..•Rbugli Electrical _T'Bay, Ceilings (+� i (- 1 t ( POOL/SPA SYSTEMS FINAL = ' k6g•, 19. `Roup Heating &,AirLConditionirtg ( t" FIRE DEPT.'REQUIREMENT {l c. i APPROVALS Permit # 20. Rough Firepkace (:tl 1i ' j ( I I iFactocy 1 21. D'ucts,.in Structure,. 70- Ulidergrouod Hydro � � , J422.'Dua.s, Ventilating'_ i t k + i i + � } Product Piping ❑Gas ❑Oil ' - I - , 171. I >.23. Ges Pi 6-11 h&Test l; T -t - r-- 72- .' Underground g. round Flush,ou �r 24. Roof Framing; ' n ;� 1 a �l2` I 1 (�� t n u i - ; 73.1 Undergrnd. Storage Tank' ❑ Gas ❑ Oil i 1 I Oto t 25. IRoo'f Sheathing i f �� 1�ca ! ` i w j : E (- i T ; '74. Overhead Hydra 26.'T -Bar Ceiling (Structural)4 Monocoa -- j �.I" 1 i !75.1 Dry Chemical 27. ;Frame and Flashing' 1; ; ( j } 76., Dry Standpipe 1 li I 1 28. �6thing & Siding! n ! ( f �) #, 1 w 4 ` { :77-� FIXED SYSTEM FINAL 29. Insulation t [ f �� ( I 1 '78: FIRE PR EV. FINAL ! I; , f '-30. Drywall Nailing j j; ( I ( Notes: i -'31.'Plaster Brown Coat- I X32. `Electrical•Power Meter Final ii 33. 'Final Electric I j_, _� r W ,34. `._.iT Final Heating & Air Conditioning ► } I I I ' 35. Final Gas PipeTestr( D J'l�(u�� 36. Hood or •Cariopy?>, i ' s i r ? f+ 1 r11 t 37. Final Factor FireP lace T 1 0� . _e,. 1 38. Final Plumbing I f I I= I I ! + ' 39. Water Service -Final 40. Gas Service Final 41. Solar Domestic Final ! 42. Backflow P,reventer 43. Backflow, Irrigation) ` i I ( t;iz 44. Landscape Wigation'SYstem 45.• Sound 46. Handicap' Regulation`s i rc j Ic i r I ' I �� I •: .•. I 47. FINAL STRUCTURE & BUTILDI,NG 48. Special Requirements Completed 49. Electric Releasejto �Edi'san) 50. Gas Release to Southern Caliliornia Gas Co ( M F i i ' i •� ., 51. CERTIFICATEtOFtOCCUPANCY ; t -i-44--t_-- No r r Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. "CONSTRUCTION PERMIT C—Ca A. P. -0 ZONE PLNG. REF. 906 BUILDING T13BUILDING eftP Y t Applicant's Mailing Address TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR PKG. SPACE REO. PROVIDED ❑ CONVERSION ❑ DEMOLISH ❑ OTHER SPECIAL CONDITIONS! Project Addresss3A,57 DESCRIPTION OF WORK r Zoning Approved By Owner's Name e'�p'�� !�� /Cq.. Phones 04 Automatic Washer Meter Clover 100 amps Construction Pole Address TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL Sub Pole Arch/Eng, License No. 1:1 TENANT ELECTRICAL 1:1 PLUMBING 1:1 MECHANICAL 'Inc.Solar ❑9-15 HP 016-15+ i Fan ❑ OTHER F.A.U. Pole 'Light Address _ Contractor's Nem r c� hone 2- • PROJECT DESCRIPTION SQ. FT. OCCUPANCY 'Sion Address (mailing) ha/al ,� �" - /L{.d CONST RUCTION TYPE VALUATION S PLAN CHECK $ GRADING ZONj2 GRADING CU.YDS. ACRES- -- - License No. ELECTRICAL $ __ LICENSED CONTRACTOR DECLARATION Remarks.,7 $ ; MECHANICAL $ I hereby affirm that I am licensed under provisions of Charter 9 (commencing $ PLAN CHECK $ LESS ADVANCED PC With section 7000) of Division 3 of the Business and Professions Code, and FINAL FEE $ my license Is In ful farce antl effect. O,p7 3 (� /CJ 23 PLUMBING license 1 s Ll o. late - Signature Bar Sink Sewer Cap H- K RS' doMPENSATION D LARATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate Backflow Preventer Sewer Connection of Workers' Compensation Insurance, or a certified copy thereon action 3800, Lab. C.} r �, `� / Backflow Irrigation Solar_ Collectors No. r (J y Company k-Y, tifled copy Is hereby furnished.Bathtubs Solar Piping"ftifley with the city Bui g Divj� c/ c�--�'a1�-' Clarifiers Solar Tank Date Applicant - EXEM ION FROM WORKERS' CO101ENSATION DECLARATION Dishwasher Swimming Pool w/Spa (This section need not be completed the permit Is for one hundred (3100) or less), i I certify that in the performance of the work for which this permit Is issued I become to tke ' Drinking Fountains Urinal shall not employ any person in any manner so as to subject Workers'. Compensation Laws of California. Floor Drains , Water Closet DateSignature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Water Heater - — Workers' Compensation provisions of the Labor. Code, you must forthwith comply with' such provisions or this permit shall be deemed, revoked. Gas Service. Outlets 'Water Service CONSTRUCTION'LENDING AGENCY I hereby $fflrm that there is a construction lending agency for the performanw l Interceptors of the work for which- this permit Is issued (Section 3097 Civ. C.) - Lender's Name Kitchen Sink Lender's' Address Lavatories. i ` OWNER BUILDER DECLARATION I hereby affirm that I am exempt'from the Contractor's License L.aw for the P_Tra p following reason (Section'7031.5 Business and Professional Code: Any city or county which requires a permit to construct, attar Improve, demolish or repair ,ny structure, prior to its,issuance, also requires tiro applicant for such permit Roof Drains _ ^I(ie a signed statement that he/she Is licensed pursuant to the provisions of e Contractor's Uounse Law,(Chapter 9 (commencing with Section 7000) of Showers Rein (tion Fee $15 sPe Jivlsion 3 of the Business and Professions Code) or that•he/she-Is exempt therefrom and the, basis for the alleged exemption. -Any violatlon'of Section 7031.5 by any applicant for a • permit subjects the applicant to a civil Service Sink Issue Fee -' $ 3 Mnaltu y 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 MECHANICAL for sate (Se[�Ion 7044, Business. and Professional, Code: The Contractor's License Law does not apply to an owner of a property who builds or improves Boil er r Refrigeration System ' thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not Intended or offered for ' ❑0.100,000 BTU ❑ 100,000 BTU Duct -Under Ground sale. If, however, the building or Improvement is sold within one year of com- pletion, the owner'will have the burden of proving he/she did not build or lm• for the purpose of sale}. Duct -Structural System Repair/Alteration {J 1, as owner of the property, am exclusively contracting with licensed con- I traetorsto construct the project (Section 7044,.Business and Professlons.Code: Duct %Ventilating The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ tractor(s) license pursuant to the Contractor's License Law). El I'am exempt under Section B. 11 P. C. for this reason Firepl/Fact• Bit. ICSO 90: t Heating'System & Ducting Date Owner, I •hereby certify that li have read this application and state that the above ❑0-100,000 BTU Ell 00.000 - - - information Is correct. I agree to comply with all city and county ordinances and state laws relating •to building construction, and hereby authorize repre- Hood or T sentatives of this city to n po the above-nentioned prop rty f r inspection , p3, se Canopy Typo 1l 13pure Rainspliction Fee $15 Signature ate v Registers Issue Fee $ 3 Drivers' License nse or SS CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 71554 41 utivels AkF1 Standing Sections REGULATIONSZONING A. P. -0 ZONE PLNG. REF. 906 BUILDING T13BUILDING eftP Y t REAR YARD (TO P/L) LEFT SIDE YARD RIGHT SIDE YARD PKG. SPACE REO. PROVIDED STREET WIDTH PARK FEE S SPECIAL CONDITIONS! Meteroirup to 100'amps Issue Fee, r Zoning Approved By ELECTRICAL Automatic Washer Meter Clover 100 amps Construction Pole Sub Panel Cooking Unit Sub Pole Dishwasher Motors ❑0.1 HP ❑1K$ Dryers ❑Gas ElElectric 'Inc.Solar ❑9-15 HP 016-15+ i Fan ,Microwave F.A.U. Pole 'Light J Fixtures Range eD Device Boxes 'Sion 41 utivels AkF1 Standing Sections t C) Switches Trash Compactor Garbage Disposal Generator ❑0-5 KW 05.15 KW Transformer ❑ 15.50 KW 05U + KW Reinspection Fee $15, Meteroirup to 100'amps Issue Fee, $ 3 Zoning Approved By Date Application Approved By nate `' Application Issued By V Date SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE , $ PLAN CHECK $ GRADING $ "Zp $ ELECTRICAL $ PLAN CHECK' $ �.� MICROFILM $ ; MECHANICAL $ TOTAL FEE $ PLAN CHECK $ LESS ADVANCED PC $ FINAL FEE $ yCONSTRUCTION•AND-PL'A61NING%, .�' u - • r "�- ' ,Date ,.. ^' i nspector n - - _ -,PC _& SPA• _ ' - e = _ "- `E. Date 'Ins ectoi > '-APPROVALS Permit # �3 . APPROVALS ''Permit# p- rt,. Tempn. orary Electrical Service o'r.Pole. ��• ;� o "� '52: Pool &:Equipment Location .. - r - nS Soil Pipe-Undrgrnd: - . f ° f ` - 53`' Steel Reinforcement L' , 3 Electrical Conduit Utility Undrgrr�rl. ` y ;54.: Forms 1 , 4' Electrical Conduit-Undrgrricl r ' ',r. 55� Electrical. Bonding 5: Steet'Re'inforcement�. :. ! 56.. Rough Ptu'mbing-& Pressure Test 'I ' n s '6: :El6drical LIFER Gr' d' ` �' •'- : ;�•- - 57. APPROVAL,TO COVER-GUNITE 7. Footings t ; j' �. : r I 58'. Electrical Conduit-Undrarnj 8. Foundatiori + _ ► - - :59. Gas Pipe; Undrgrnd. Testi 9. Water Pipe-Undrgrnd. r60. Backwash Line'P-Trap, ❑ Undrgrnd. f J' 10. Structural Floor System "' j 61. APPROVAL -TO DECK i r 11. Property Sewer Line &House Connection.. 62. Backwash &'Receptor Final . 12. Sewer Cap �! ) ;� ": ; 63. Heater &" -Final It ,Vent 13. Roof Drains=* 64, Plumbing System- Final- - - 14. Plumbing' -N-;' ! -'-� '65. Electrical` -Final ,Rough ', 16. IRougF� Electfical-Conduit { I - F - i ,66.�'Solar System -Final i - - , f - i . 4, Er � "i 6. Rough Electric Wiring "t = '='n B7?"Fencing &:Access.Approval, _ , `17. iRougFiyWiring Sign'l68-. APPROVED FOR PLASTERING I I 18. IRough-Electrical T'Bar Ceillinn'g ! '' ` I' 69.: POOL/SPA SYSTEMS*FINAL' ! i i i c 19. Heating &,Air Condi tinning '; : ?.. ! 1 I FIRE DEPT.IREQUIREMENT ,fi0ugti APPROVALS Permit # ! 20. -Rough Factory Fireplace ,�.. A ' I + j 21..+PuctsAi ,n Structure? '' ,�` I s; I !70. Underground Hydro , ic22. !Ducts, (Ventilating . �+ t, i 71.1 Product Piping ❑ Gas ❑ Oil F23. Gas Pipe -Rough & Test `-, ± ' 1_ � s 72.' Underground Flush - t I _ c. 1 :24. Roof Framing ! '+_ ,, ' v , 1 ti ? 3 { Undergrnd.5torage Tank ❑Gas ❑Oil n , r - 173 25. Roaf SheAtliing ! ,;�, t 74. Overhead Hydro - -26. T -Bar Ceiling (Structural), & Mongcoat I ! ! 75 `Dry Chemical _ r,27, Frame and'Flashing i 1 '761 Dry Standpipe { 28.�ILathing & Siding' I ; ' t �77.� FIXED SYSTEM FINAL 29.. Insulation` 'I i Itt i E78! FIRE PREV. FINAL 530. Drywall !Nailing Notes: 1 , 1 i.31'.�Plaster+Brown Coat' r3�.; ElectricallPower Meter-Firial +''33_..FinaI Electric ` - 34. Final HegtingVAir Conditioning i I ; i�. + 4 t I 35. Final Gas Pipe_Test 36. Hood orkrCanopy nr'Ftipla37. Fina! 1 i?' F� + 38. Final Pl 'rnbingt 4 l i ;` I; i 1 c "• y 39. Water Servic6-Final t 40. Gas S&vice-Final I I C + I 41. SolarDomestic Fir. I 1 -ri42. Backflow Prevehter 43. BackflIrrigation ation 44. Landscape Irrigat'sor System; 45. Sound :Attenuation 46. Handicap Regulations 47. FINALSTRU16TUREJ&BUILDING i = 48. Special Requirements Completed 49. Electric Release tolEd'isori i 50. Gas Release,to Southern CaliforniaGasCo 51. CERTIF,ICATEiOF, OCCUPANCY No. I: I Date Applicant to fill in all spaces except those within heavy border fines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT Applicant's Mailing Address 31'7%ZF ld 1-�ti1[hllu _�,JiU� Project Address '� �'� . Owner's Name rkLlhone _, �O � AddressA C� � Arch/Eng. License No. Address Contractor's Name hone 30 Uy, Address (mailing► License No. _ 355��.� LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my Ilcense is In full forco and effect. C License Clas �" U a N Date Signature WORKERS' COMPENSATlqP DEC RATI N I hereby affirm that i h certificate of conse self -Insure or a cert of Workers' Com tion Insurance, o ertlfled copy the action 3800, tab. C Uro Policy N Company JtC B fad Copy is hereb rnished. irtifiad 0 Is f with the city v ion o Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred (SI 00) 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 manners s t atom s jact to iiia 'tl Worker aws of Calan 4e /� Date Ignature /� NOTICE: If, after rn ng this declaratl n, you,ou becomes act Workers' Compensationprovisions of the Labor Code, you, must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY , I hereby affirm that there is a construction fending agency for the performance of the work for; which this permit Is Issued (Section 3097 Civ. C.) Lender's Name Lender's 'Address OWNER BUILDER DECLARATION, ' I hereby affirm that 1 am exempt from the Contractor's License Law for the , following reason. (Section- 7031.5 Business and Professional Code: Any city or county which requires a parmlt-to construct, alter improve, demolish or repair ,any structure, prior to Its Issuance, also requires the applicant for such permit Jto file a signed statement that he/she Is licensed pursuant to the provisions of ' the Contractor's•Ucense law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 malty of not more than five hundred dollars ($500). 1, •as owner of the property or my employees with wages as their sots compensation will do the work, and the structure is not Intended or offered for sale , (Secilon 7044, Business and' Professional Code: The Contractor's License Law does not apply to'an owner of a property who builds or Improves thereon, and ,who does such, work himsetf/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 com- pletion, the owner will have the burden of proving he/she did not build or im- �TOVO foY, the purpose of sale). (� I, as Owner of the property, am exclusively contracting with licensed con- tractorito construct the.project[Section 7044, Business and Professions Code: The Contractor's License taw does not apply to an owner of property who builds or Improves, thereon, and who contracts for such projects with a con• tractor(s) license pursuant to the Contractor's License Law), ❑ I am exempt under Section B. t1 P. C. for this reason Date Owner I hereby certify -that I have read this application and state that the above 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 toer u n he above-mentioned property for Inspection purer ��P Data Signature Drivers' U6ense or SS z# P"OF CONSTRUCTION Lj NE ❑ CONVERSION ❑ DEMOLISH DESCRIPTION OF WORK J ADD LI ALTERATION LJ REPAIR OTHER TYPE OF PERMIT GRADING1:1 FOUNDAT O 1:1STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING aLMECHANICAL ❑ BOTHER , PROJECT DESCRIPTION SQ. FT. OCCUPANCY W%CON STRUCTION TYPE VALUATION $' ZONJE GRADING CU.YDS. ACRES Remarks: Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO 9f6 Heating System & Ducting E10.100,000.8TU 0100,0000T or Type] u. Registers CMF 0865.46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Herngeratron System 00-100,000BTU ❑ 100,000 BTU System Repair/Alteratio Reinspection Fee Issue Fee A. P. -0- PLNG. REF, 90 TO BUILDING PROPERTY LINE LEFTS] DE YARD PKG. SPACE REO. l STREET WIDTH SPECIAL CONDITIONS: Automatic Washer.. Construction Pole /' Cooking Unit r Dishwasher Dryers ❑Gas ❑Electric Fan f : F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW 05-15 KW Transformer ❑ 15.50 KW 050 -f KW G I N ZONE BUIL_raDING Cif C11 S 'r REAR YARD (TO P/L) RIGHTSIDE YARD PROViOED PARK FEE $ ELECTRICAL ,Meter Dover 100 amps Sub Panel Sub Pole Motors 00-1 HP ❑ 1 K-8 - Inc.Solar 119-15 HP 11 116.115+7 Microwave Pole Light Range Sign Standing Sections Trash Compactor , Reinspection Fee vis Meter ❑up to 100 amps I 1 Issue Fee Zoning roved By ^ - Date Application Approved By I ate Application Issued By Date PLUMBING Bar Sink Sewer Cap Backflow Preventer Sewer Connection Backflow Irrigation Solar Collectors Bathtubs Soler Piping Clarifiers Solar Tank Dishwasher Swimming Pool w/Spa Drinking Fountains Urinal Floor Drains Water Closet _ Floor Sinks Water Heater Gas Service Outlets Water Service . Interceptors " Kitchen Sink $ Lavatories $ P_Trap {_ Roof Drains $ 1 ' r Showers Reinspection Fee $15 - Service Sink, Issue Fee $ 3 $ 3 MECHANICAL Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO 9f6 Heating System & Ducting E10.100,000.8TU 0100,0000T or Type] u. Registers CMF 0865.46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Herngeratron System 00-100,000BTU ❑ 100,000 BTU System Repair/Alteratio Reinspection Fee Issue Fee A. P. -0- PLNG. REF, 90 TO BUILDING PROPERTY LINE LEFTS] DE YARD PKG. SPACE REO. l STREET WIDTH SPECIAL CONDITIONS: Automatic Washer.. Construction Pole /' Cooking Unit r Dishwasher Dryers ❑Gas ❑Electric Fan f : F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW 05-15 KW Transformer ❑ 15.50 KW 050 -f KW G I N ZONE BUIL_raDING Cif C11 S 'r REAR YARD (TO P/L) RIGHTSIDE YARD PROViOED PARK FEE $ ELECTRICAL ,Meter Dover 100 amps Sub Panel Sub Pole Motors 00-1 HP ❑ 1 K-8 - Inc.Solar 119-15 HP 11 116.115+7 Microwave Pole Light Range Sign Standing Sections Trash Compactor , Reinspection Fee vis Meter ❑up to 100 amps I 1 Issue Fee Zoning roved By ^ - Date Application Approved By I ate Application Issued By Date SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $, ISSUANCE' S PLAN CHECK $ GRADING $ ELECTRICAL $ $ PLAN CHECK $ MICROFILM $ -MECHANICAL $ TOTAL FEE. $ 1 ' $15 PLAN CHECK $ SS gDVANCED PC $ $ 3 FINAL FEE 1 $ r l :? CrvO{VSTRUCTION AND PLA NI ti `` .,'�r: Date ,, - - Inspector •,-. ,7 POOL&SPA c _ - _ - Date C ' Inspector r ,-s4PPROVALS ,_ Permit #2%, ,APPROVALS .. Permit # ., < - T 1• Temporary Electrical Service or,P61e - 3 -- _: =� 52' Pool &:Equipment Location + 2! Soil Pipe-Undrgrnd: ! _ i* , , ' 53; Steel Reinforcement 3` Electrical Conduit Util&t -Undrgrnd. �� - 54.= Forms �? 4. Electrical Conduit Undrgrnd: _ 55= Electrical Bonding 5: Steel Reinf6rcement56. Rough Plumbing.& Pressure Test 6. Electrical'UFER Gind.4 � - 57: APPROVAL'. TO`COVER-GUNITE 7. Footings ' ` _` I` 58. Eledtrical,Conduit-Undrarnri.- 8. Foundation 59. Gas Pipe, '❑'Undrgrnd:, Test n 9. Water Pipe-Undrgrnd. _ 1 ' 60. Backwash Lines, 0 -trap, ❑ Undrgrnd. , 10. Structural Floor System ; -61. APPROVAL TO DECK 11. Property Sewer Line & House Conriettion r 62. Backwash &, Rec'e'ptor -Final 12. Sewer Cap. --• x'63. Heater & Vent -Final. 13. Roof' -Drains { ! -• ° ,+ t ;64. Plumbin S stem . Final " 14. Rough Plumbing' 1-65. Electrical -Final- + "-15-. Rough Electrical -Conduit _r__�- '66 Solar System Final , Rough-Elegtric Wiring' 1 • . , -'- • _ , 67., Fencing &Access Approval �- _.... Rough Wiring.5ign:: "' 68.` APPROVED FOR PLASTERING . y ugh -E 1,8�Rolectricalj;Bar, Ceiling, ` -' - , ;' �'' 69. POOUSPA SYSTEMS FINAL - U 4 , 11)r)Rough•Heating & Air Conditioning l ' FIRE DEPT. �REQUIREMENT- , APPROVALS; ! Permit # , 20)%Rough Factory Fireplace ' 1 ` 21. 'Ducfs,,in Stiucture I 70.i Underground Hydro { -22. `Duct's, Ventilaiing w Lam' '71.Product Piping ❑ Gas O Oil I, J - i 4 ".23. Gas:PiP a-Rough & Test ,n� -; � _ , _ i .-�_ - - _-� -- -72., Underground Flush - • - - - � t,1tf •-._ .. . "N. 'Roof Framin , 9' : ? l ' U6dergrri Storage Tank ❑ Gas ❑ Oil �/ , , ` ,7.3.' 25. hoof Sheathing i J fel, l t 74•, Overhead Hydro 4 Yrr r26. T-BarCeiling (Structural}. & Monocoat' i _ I 75. Dry Chemical • 27. Frame and Dashing _ ` 76.' Dry Standpipe r� w 28. "Lathing & Siding r -, , I i I 77.; FIXED SYSTEM FINAL 29. , 78. FIREPREV. FINAL,lnsulatiot �` _r ! ''-C brywall Nailing ' +Notes•! ; i I 't'Z Plaster Brown Coat12r- ,. •Electrical Power MeterrFinal ii ► + ` i V L A 33. 'Final Electric t& 34. Final HeatingAir Conditioning 35. Fina! Gas. Pipe=Tek - i - 36. Hood or Canopy' . i - .. - - �• 1 ' , 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final i'. f . 40. Gas Service -f=inal i j; I E L 41, Solar Domestic -Final 42. Backflows' Preventers ! r !n R -- r- - - 43. Backflow Irrigation' T ' ' 44. Landscape Irrigation -System 45. Sound Attenuation 46. Hand icaplRegulations I 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed 49. Electric Reiease'to Edison; 50. Gas Release to Southern California Gas Co 40 51. CERTIFICATE OF;OCCUPANCY d ;. !_'. _}� }_ ! _ _ '. iL, + 10 No l , Date j I j _ CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor • _ - _ �« Applicant to fill in all spaces except those within heavy border lines and sign all apgrop_riate declarations. CITY OF COSTA MESA! CONSTRUCT.IoWPERMIT , . �. P IT ys�v c • 7 T NO. TRACT NO.L20 L � . ApplicanVs Mailing Address ' w - TYPE OF CONSTRUCTION• EW ADD', ALTERATION .RProjectAddren 3151' Airwa F -208' Costa' Mesa• ❑ coNVERsioN ❑DEMOLISH ❑ OTHER Expres�le 7552-76'!0 DESCRIPTION OF WORK tpnanf �mnrnypmPrltShearson%American I G ULATI Address 1601 Dove- X200', Newport BeachtYPE TOlil Calllp05 & ASSOC._LicenseNo. OF PERMIT GRADING' FOUNOATION STRUCTURALA. P•+ �� ZONEArch/Eng.- TENANT• ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL IR PLNG. RE F.51� " 'BUILDING•Address ' 17779 7' Main St._,• Irvine - ❑;OTHER TOBUILDING�i6-,,: Contractor'sName: J'• � Donald OlSon CD. 540-2606 - PROJECT DESCRIPTION' SQ. F ' r OCCUPANCCY PR PE Y I E •REARY OP/L) 3151 A3rwayAyi. E-I-,'Costa Mesa CONSTRUCTION TYPE.t VALUATION$ 25,920LEFT �'Address(mailing) SIDE YARD IG El'ARD1tZONj= License No'. " GRADINGCU,YDS. ACRESPKG.SPACElREQ. , PROVIDE }' LICENSEDCONTRACTOR DECLARATION _ Remarks: +�'J.9S r�G5 $•� �i WIDTH RK FEE.$ I + I,hereby affirm that 1 am licensed under provisions of Charter.9 (commencing P�STREET _ a Mwith section 7000) of Division 3, of the Business and Professions Code, and 6 85 _617Y SPECIAL CONDITIONS: ) my license is in f I force and effect, r ' `333969 00 License C s - License No. 3J ' ' l PLUMBING `ate Signature Bar Sink Sevvar Cap ELECTRICAL 1 iORKERS' COMPENSATION DECLARATION .-I hereby affirm that.l have a certificate of consent to self-Insure ora, certificate _ Backflow Preventer - _- _ ' _ Sevver Connection ' _ Automatic Washer ' _ Meter El over 100 amps of Workers' Compensation Insurance, or a certified. copy thereof (Section 3800, Lab, C' t Y' 7 % , , ; Backflow Irrigation Solar Collectors_ i Construction Pole Sub Panel' t ° ? i� f Policy No. �l ' `'� [- ComPar,Y �F- 1}'It=-/`�iC.�1►' j i ,• - ® Certified copy Is hereby furnislied. ? Bathtub's _ Solar Piping r ! Cooking Unit i -Sub Pole f Certlfl co Is flied with the city But ng isio Date Appllca-it Clarifiers Solar Tank Dishwasher Y .Motors ❑0-1 HP Q1'h-8 ; - EXEM IO ,FROM WORKERS' COMPENSAT DECLAR TION (Thissection need not be completed if the permit-Is for one hundred (5100) or , Dishwasher i $wimmin POOI w1Spa g-.. Dryers ❑Gas ❑Electric Inc.Solar ❑9-15 HP x.16-15+ less): i , l I cartlfy'that in the performance of the work foriwhich this permit is issued I ' shall• not employ any in any manner so as to become subject, to the Drinking Fptintairis Urinal �• � Fan ; Microwave } ' 'Pole person Workers' Compensation, Laws of California.; • , I 1 ! Floor Drains. i - - Water -Closet • F.A.U. ' Light g i 1 Data Ignature NOTICE: If.-after making this declaration, you should'rbecome subject to the , Floor Sinks -- r-- ' - -Water Heater - - Fixtures -- - iRange Workers' Compensation, provisions the Labor' Code„you must forthwith, comply :with, such provisions or _this 'permit shall be deemed revoked: Gas Service ;Outlets . - +. Wate�Service� - Device Boxes Sign 4 CONSTRUCTION LENDING AGENCY ' ' I hereby affirm that there is a'construction lending agericy.for the performance' Interceptors - Outlets ' Standing Sections of the work for 7gCh„ thlst permit is i issued :(Section 3097' Clv_” C-) Lender's Name. N ^ - -1 Kitchen'Sink' = ' Switches i Trash Compactor I _ Lender's -Address - 1 ;, 3 - _ ~ Garbage bisposal I �, 1 Lavatories, n - OWNER BUILDER DECLARATION j I herebyjaffirm that t am exempt'from the;Contractor's License Law for the following 7031:5 Business and,Professional Cade: Any city n , r '. P� Trap1 = U' , , �: ` ! Generator"❑0-'5 KW ❑5.15KW 1: reason. (Section or 'county which requires a per mibto construct; alter, Improve; demolIsh:or, repaIr r - I i Transformer ❑15.54 KIM , _• I l I I r-- •' i• g'._,A ,prior to Itsassuance, also requires the applicant for such permit y structure' i T ROof'Drains,, _ ( _ � � f. ., Ile awned statement: that he/she, Is licensed pursuant to the, provisions. of -Contractor's License Law:{Chapter 9 (commenting wlth:5ectlon-7000) of i II 1- i - i ReinspectionlFae # $15 ❑5V + KW: : 1 } 1 t Reinspection Fee t ibision 13-of. the ,Business' andi Professions- Code) or that) he/she Is exempt therefrom -and the, basis for the alleged exemption. Any, violation of. Section t Showers r, ! �_ 's t" ,' Meter ❑up to 100amps I Issue Fee $ 3 t 7,031-5 by•any applicant for•'a permit subjects the -applicant toa: dull anally of not more than flue hundred dollars (500). %� i f. i I 1 i ;, 1 Service Sink ! i r r'• t f '' Issue Fee $ 3, Zoning Approved try y Date I ,.,as towner of'the'property or''my employees with wages las their sole compensation' wlll!do the work; a_nd,the structure Is not Intended or offered I , j MECHANICAL' � I �' �. Application Approved ey y , sate ' for sale' {Secilon 7044, Business and Professional, Code: 'The, Cont ractor's License Law does not apply to an owner of a property who builds or Improves _ � _ Boiler. t Refrigeration System � , , Application hued By 1 t� r 1 Date thereon„and who does such' work himself/herself or through his or her own employees, provided that such Improvements are;riot intended or offered for ) ! DUCt =Under Ground ' i ❑0 100,000 BTU ❑ 100,000 BTU - ' sate. If, however, the bUltdln ar imRrovement is sold within one:year of Com- pletfon, the owner'wlll have he burden of proving he/she did not build or im• t = - f I i + , SUMMARY OF FEES s ; 17. rove for the purpose of sale) . { , ! as Duct Structural, System RepairlAlteratiori BUILDING PERMIT $ _ OD i SMIP , I $ I, owner Of the property, am exUusively tontracting'wlth,licensed con- _tractors to construct the protect.(Sectlan.7044,,Business and.Professions Code: The Contractor's License Law ddoes not apply to an owner of property who , -4 Duct - Ventilating „-: „'_ „_ ? _ , , _ r -. E PLAN CHECK; � V 1 PERMIT ; j (. i t i builds or ,Improves, thereon, and wtto contracts far such projects with a con- { Exhaust System ❑ Multiple ❑ i !PLUMBING I $' ISSUANCE $ l , tractor{s) license pursuant to the Contrattor"s License Law). , ❑ 1"am exempt under Section B,C. for this reason ss 1 , Firepl/Fact. bit. ICBO # j PLAN CHECK { i GRADING $ ' 4 Heating'System & Ducting 'ELECTRICAL, $ t l ) $ MICROFILM $ Date Owner ' -1-hereby-certify-that--I have-read this appiicatio'n-and state-that'the,-above �- 00.100,000:BTU❑100,woB -- - _ - PLAN CHECK. $ ! information Is correct. I agree-to comply with all city: and county ordinances and state laws relating to building COnstruction,'and hereby authorize repre- ; ,-- MECHANICAL i $j i • TOTAL,FEE, $ ! HOOd or Type I ❑' sentatives of chi city to a ter pon the above-mentioned property for Data Signal purp s, e :3/15 83 Cal T ell ❑' Reinspection Fee �• $15' PLAN CHECK $ 1 LESS i 1 I , i I ADVANCED; P(3 t $ y Drivers' License or SS t Re isters g ! 1 Issue Fee ( �$,3 e ! , I ! ' FINAL FEE , $ CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor r t?CONSTI UCTION AND PL'A ING] }- -' ; APPROVALS l?erinit,4# :' 'c - `x- :.Date = = - Inspector ; _ - ' ` c : , P( & SPA _ _ � "APPROYALS. Permit•# - -: Date _ Inspector . =i. 1 1'. Temporary Electrical Service or.Poie - _ Pool &-Equipment Location' 0 t n - 'Soil n .52: - 2 Pipe-Undrgrnd:' n i F _ '' J• t . - 53 Steel Reinforcement ; _ 3: Electrical Conduit Utility Undrgrnd. 54. Forms = ' � 1 � - 4. Electrics! Conduit Undrgrnd. 55. Electrical Bonding _ 5: Steel +Reinfarcementn �; ' ri ' '1. c ` ,�; s •- '56 - Rough Plumbing &Pressure Test . :' 6. Electrical LIFER Grnd. °^ `i 577 i,PPROVAL=TO COVER-GUNITE=• =� 7. Footing s { w; 58 Electrical'Conduit Undra>noi._ 'f I ti• i B. Foundation { ` o < 59. Gas Pipe; O,Undrgrnd ;Test l 9. Water Pipe-Undrgrnd. _ :60. Backwash Lines, P -Trap, ❑Undrgrnd.- 10. Structural Floor System 61. APP,ROVAL.TO'DECK 11. Property Sewer Line &,House'Connection fit. Backwash &'Receptor Final 12. Sewer Cap- " 63. Heater, &. Vent -Final { , 13. Roof'Drains 64. Plumbing;5ystem Final 14. Rough Plumbing I G '65, Electrical -Final J " I. 15-iRough Electrical=Conduit-tj-" ,� -' _1 y i-��j '66. SolarjSystem-Final l ` 16.r Rough Electric.Wiring I f_ l�: -r ; i' �" $7- Fencing &Access Approval' T` 17. Rough Wiring"Sign 68. APPROVED FOR PLASTERING 18"Rough Electrical•T;Bar Ceiiing,' gg•i POOUSPA SYSTEMS -FINAL 19.'?Rough Heating &'Air Conditioning i . ± ^ i : FIRE DEPT. REQUIREMENT- ; APPROVALS Permit'# 'l 20. +Rough_Factory Fireplace, i I , i + 21. Ducts, in Str`.ucture i k ij ii i t i I # 1 70. Underground hydro - '_22"'Ducts, Ventilating �.- f ( i 71.' Product Piping 0 Gas ❑Oil i .,23: 'Ga•s�Pipe-Rough & Test Q i ; _ r- i 72.' Underground Flush' + i .i'm 24''Roof Framing , 73, Undergrnd. Storage Tank•:O Gas ❑'Oil i+ 2 heathing y ! it„ !ir I s ' Overhead Hydro ' �o� F i & onocoat° ! 6. T�Bar Ceiling (Structural]M �/��`S3 �8' ryi, ; 75., Dry Chemical 27. Frame i _ { , pry Standpipe 28. & Siding r ii 77.E FIXED SYSTEM FINAL 4Lathing c 4 29. Insulation `78. FIRE PR EV FINAL f30..Drywall Nailing i 'i I t i i 1 s Nates:; t -311.,'laster-Brown Coati 32: Electrical Power Meter -Final 33._ Final Electric { tv ! �• ' ! I _ 34. Final Heating &{Air, Conditioning { r 35. Final Gas PipeJest' '_, i Ir I t•`i i 36. Hood or Canopy. , n i ni 37. Final Fact&ry Fireplace:r + 11 E_; 38. Final Plumbing bt I 39. Water Wvice-Final' 44. Gas Service -Final <_ } 1! t 41. Solar Domestic -Final r. 42. Backflow Preventer, 43. 8acki ow Irrigation % : { i iry{ i.V :I _ r� 1 I'r� 44. Landscape lrrigation'System 45. Sound Attenuation 4 1 46. an i� f r 47. FINAL STRUCTURE&BUILDING 48. Special Requirements , mp e e 1 i 49. Electric Release to Edison] i 50. Gas Release to Southerin California Gas Co 1 51. CERTI FICATE OF;OCCUPANCY No.! �' I 'Date L 'F- p Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY eF COSTA MESA' PER IT O. TRACT NO; LOT N0. BLD 'CONSTRUCTION PERMIT � i� 931 a (�1PECIAL Applicant's Mailing Address OFCONSTRUCTION NEW ADD ALTERATION REPProject Address �-�CONVERSION ❑ DEMOLISH ❑ OTHEROwner's Nam' t�• Sfy Phoneme (Yc� DESCRIPTION OF WORK Z 1 U IAddress 31S'/ /�'l�ie �t/i4 Y A/C. 6Q174TYPE OF PERMIT GRADING1:1 FOUNDATION STRUCTURAL P.46 ZONE Arch/Eng. License No, ❑ TENANT ❑ELECTRICAL ❑.PLUMBING MECHANICALNG.REF.-O BUILDING Address, ❑,OTHER O BUILDINGContractor's Name?yw l�, --0,2Z Phon �y1C �q PROJECT DESCRIPTION S0. FT. OCCUPANCYPROPE Y 1 E REAR YARD (TO P/L) Address (mailing) eF. DAL"A 1D y CONSTRUCTION TYPE= VALUATION $ FT SIDE YARD RIGHT SIDE YARD License No. C-2 C%ZON9 GRADINGCU.YDS.' ACRE{KG.SPACEREQ. PROVIDED LICENSEDCONTRACTOR DECLARATION Remarks: REET WIDTH PARK FEE $ 1hereby,affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and CONDITIONS: my license is In f for aeffect. cense Class ' — o. �7� 'ate —64i Signature WORKERS' COMPENSATION DEC RATION I hereby affirm that I have a certificate o_ f consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) ' Policy No. Company ' Certified copy is hereby furnished. Cartifled copy IS filed with the city Building Division. E Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for.one hundred ($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' s t eco ubject. to lire Worker : ?TI Laws of Cal Date .?TI La NOTICE: If, after making this declarat on, you should became bJect to the Workers' Compensation' provisions,of the Labor Code, .you ust ,forthwith comply ,with such provisions !or this -permit •shall be .deemed revoked, - CONSTRUCTION LENDING AGENCY ' # I hereby affirm that there Is a con_ struction•lending agency for the'performance of the work for which: this permit is 'Issued (Section 3097' Civ: C.) Lender's. Name-' r Lender's Address ' i Lavatories OWNER BUILDER DECLARATION i I hereby affirm that I am'exempt from the; Contractor's License law for the p—Trap following reason .(Section 7031.5 Business and Professional Code: Any city or p ,.ounty which requires a permit to construct, alter, Improve, demolish or repair ny structure, prior to Its Issuance, also requires the applicant for such permit RoofDrains o file a signed statement that he/she Is licensed pursuant to the provisions of ' the Contractor's License law (Chapter 9 (commencing with Section 7000) of - $16 Division,3 of the Business and Professions Code) 'or that he/she, Is exempt Showers Reinspection Fee 1 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 = enalty of not more than five hundred dollars ($500). Service Sink , Issue Fee $ 3 1, as owner of, the `Property or' my employees with wages as their sole MECHANICAL compensation will -do the work, and the structure Is not Intended or offered for sale (Sec{ion 7044, Business and' Professional Code;: The Contractor's __q 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 employees, prov[ded that such Improvements are not Intended or offered for sale. If, however, the bUlltling or Improvement Is sold within one year of Com- pletlon, the ownar;wlll hav0 the burden of proving he/she did not build or Im- -1 rove for the purpose of sale}• �} i, as owner of the property, am exeluslvely contracting with�licensad con- tractars to Construct the Project (Sect]on 7044, t3uslness and Processions Code: i. The Contractor's. License Law does not apply to an owner of property who j1� builds or Improves thereon, and who contracts for such protects with a con- ; ; tractor(s) license pursuant to the Contractor's License Law), i ' ❑ 1 am exempt under Section I B, & P. C. for this reason Re Date Owner, 'I hereby certify that -I have read this application and state that tlie-abuve Informatlon 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 r u the above-mentioned property for v Inspection our �].� Signature Date227---- Drivers' Lice se or SS � Boiler - - Refrigeration System � , Duct -Under Ground ❑0-100,00013TU ❑100,000 BTU ' Duct -Structural ' S System Repair/Alteration � Duct -Ventilating Exhaust System ❑ Multiple ©, Fjrep1lFect, Bit. ICBG # � 1 Heating System &Ducting - El 0.100,000 BTU ❑100,000BT- Hood or Type I ❑' Reinspection Fee S75 Caro T e k I ❑ Registers ' PLUMBING Bar Sink Sevrer Cap' Backflow Preventer - Sewer Connection Backflow Irrigation Solar Collectors Bathtubs Solar Piping ' Glorifiers - Solar Tank Dishwasher Swimming Pool wlSpa Drinking Fountains Urinal Floor Drains Water Closet ' Floor Sinks -Water. Heater. � r - ' Gas Service, Outlets '•Water Service Interceptors Kitchen'Sink' Range ' ' I SUMMARY OF FEES t I BUILDING PERMIT � r SMTP $ , PLAN CHECK $, PERMIT • � ISSUANCE $ F PLUMBING $ i GRADING $ PLAN CHECK $ , ELECTRICAL $ � $ � > MICROFILM $ PLAN CHECK $ I TO,TAL.FEE: MECHANICAL $ � 'PLAN CHECK $ S . LESS ELECTRICAL ' Automatic Washer Meter over 100 amps ' Construction Pole Sub Panel. I Cooking Unit Sub Pole ' '. Dishwasher 'Motor ❑0-1 HP ❑1'f,� -. dryers ❑Gas, ❑Electric,jnc.Solar ❑9-15 HP 'El 16-15+ Fan' , Microwave , F.A.U. ,Pole Light Fixtures _ Range ' Device Boxes Sign Outlets Standing Sections i � issue Fee Switches Trash Compactor $ ' Garbage Disposal ' Generator 04-5 KW 13 5-15 KW Transformer 015-5OKW ❑5U + KW +Reinspection Fee .Issue $16 Meter ❑up to 100 amps - Fee ` $ 3 Zoning Approved By t Application Approved By Application Issued BY ' Date � Date ' � Date Accounting; Goldenrod -Assessor f issue Fee $ 3 ADVANCED PC Accounting; Goldenrod -Assessor f i ai• CMF 0865-46 rev. 12/82 White -Building; Canary -Applicant; Pink - ADVANCED PC $ ' FINAL FEE. $ i ai• CMF 0865-46 rev. 12/82 White -Building; Canary -Applicant; Pink - UT 16h';AND-PUANNI ING C P�le Ins actor' F,jL,& SPA Date, S Permit, . �APPOVALS Permit # R ,spectorPRVM T' Temporary Electrical Service or;PoI6 52, Pool &'EqYipme'nt Location 2) S6il Pipe'Uhclrgrnd',-. i- '��3Steel Reinforcement 31 El;ctr'ca) CoConduitd,UtiIitv!0ndrg_rnd. 54.1 Forms 4 ElectricalConduit n onduit-Uhqrgrqd� , 5 5- Electrica'l-bonding 1 0; Steel 56., Rough Plumbing &'Pre�ssure Test r i >7d. 1 nd.1 E ecfrica1 UFER Gr 57' APPROVAL TO'C6VE R -G UNITE 7. Footil Pgs 1 58' Electrical'Conduit-Undrarnrl. B. Nup'fatiok 4 1' '159 "ipe,'O-,Ijndrgrnd-, Test Gas? 9. 1l iter, Pipe-Undrgrnd. Eb. tiackwasl� Lines', P_-Tial3i, El Undrgrnd. 10, Structural Fl6or System 61. APPROVAL TO'DECK 11, 1P ooerty'��wer Line HouserCZnnection- 62. Backwash & Receptor -Final 12. Sewer Cap,; eater "0.H " e 0. H_ater &-Vent-Final Dr! ii 13. R an Plumb.ing.System - Final r.14. f�4. R -h,Plumbing 9 65. ElectricalwFinal' ...'N - 15'.`_Ro,uqh Electeical'Conduit-,-- r --r, 66- Sbla-FISystern-F inal �_16.-jRo,jghElefftricAirin Wiring, -1 -Ac- a 67 Fenci6gF� cess Approval iRough Wirl:ng'.Sign 68.1 APPROVED FOR PLASTERING 18. 69., POOL/SPA SYSTEMS FINAL NAL r. 19. . R , o Ltg h' . Hea1ing &Air;Conditio r nin6 I 'FIRE DEPT.,REQUIREMENT APPROVALS'. Permit 20. Nj6ugh-Factoty Fir;-Piace:. 21 E�6cts,ln Structure,, d Hydro 170.! Underground Lj J ,22. Ducts, Ve'nFila-ting T, I �1711.' Product Piping 0 Gas 11011 _s' -Rough & Test F23. :Gas ip 1 172,1 Underground Flush 24. No'of Framing I I !73.) U n1cler'grrid. Storage Tank. 0 Gas 00il 25. IROf Sheathing ir j :74.. Oyerhead Hydrb 26. T'Bar Ceiling (Structural), & Monacoat* Dry Chemical 1, j 27. Frame and Ft�shing' # 76.1 Dry Standpipe I 28. Lathing ing & Sidi I ng; 77.1 FIXED SYSTEM FINAL 29. Insulation X78. FIRE PREV. FINAL =30. Drywall Nailing Notes, 31. Plaster Brown Coat t 32. ElwriLl Power Meter -Final . . . . . . 3.3.: -Final Electric ji I ------ 34. Final Heating &'Air C6nditioning s 35. Finala"Pipe_-Test.4-,,, 36.Hood or'Canopy V 37. Final Factory Fireplace .. 38. Final Plumbing 39. WaterlSefivicf- Final ------------ 40. Gas Service-Finil 41. Solar W"rnestic-Final 1 42. Backflow Pre'venter 43. BackfjRw Irrigation r i 101 W 44. Landscape lrrigati&System t I L 45. Sound Attenuation - f 46, Handicap Regulations 4 V 47. FINAL S'TRUCTURE& BUILDING i t I 48. Special Require' ents Completed Iv j t I 49. Electric ReldaSetOjEdi,'son; k, 50. Gas Release to Southern California Ga's Co 1 51. CERTIFICATE OF, OCCUPANCY No. Date - --k- __- L. Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Crt;reP COSTA MESA 1• PERMIT NO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMITL� —ZONING REQULATIONS ZONE Applicant's Mailing Address -TYPE OF CONSTRUCTION ErNEW ADD LJ ALTERATION U REPAIR 'REAR YARD (TO P/L) �Sl w 4', r ❑ CONVERSION 1:1 DEMOLISH 1:1 OTHER PROVIDED Project Address Owner's Name t FSC)w Pq� Phone DESCRIPTION OF WORK SPECIAL CONDITIONS: ISSUANCE 1 $ /5/; $ ELECTRICAL Automatic Washer Address TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ' uO Arch/Eng. f License No. ❑TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Motors 00-1 HP O1'/. -B j < Address ❑OTHER Fan ' f _ ;Contractor's Nam fil �� one '� PROJECT DESCRIPTION SO. FT. ' OCCUPANCY Range 1 o Address (mailin 4)2 �A, a CONSTRUCTION TYPE VALUATION $ Standing Sections t '401 Switches l ZONE GRADING CU,YDS. 'ACRES - f i t l License No. FINAL FEE' Transformer E]115 -5O KIN 1351.)+ KW Reinspection Fee t $15 i __ LICENSED CONTRACTOA DECLARATION Remarks: r Zoning Approved By Application Approved By Application Issued By Data Date { ate Z I hereby affirm that I -am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code„and my license Is in tui 0 and effect. I �� {�� d ' License Cl ss pe PLUMBING =o. • 'te 7 Signature Bar Sink Sewer Cap .ORK RS' C MPENSATION D L4RATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate _ - Backflow Preventer - - - - Sewer -Connection' --- - i of Workers' Compensation Insurance, or a certified' copy thpreoL,(Sectio 3800, Lab. C.) 1 Policy No. ° J/4 '._.--.. Company M - 0u'. Backflow Irrigation Solar Collectors ��{{y, -�rtlfietl copy is hereby furnished. f Bathtubs Solar Piping I Certlflod copy is filed with the city,Bulitling Division. ' { I i Clarifiers Solar Tank Date Applicant _ EXEMPTION,F ROM WORKERS' COMPENSATION DECLARATION Dishwasher Swimming Pool w/Spa { (This section need not be completed If the permit is forgone hundred ($100), or lecertify ,that In the performance of the work for (which this permit Is issued I Drinking Fountains 1 Urinal i I shall' not employ any person In any manner so 'as to become subjectto the - - Workers' Compensation, Laws of California, h t Floor Drains i Water Closet Date Signature I I '' NOTICEi•If, after making-thls•declaratlon,-you should become subject -to -the ^t Floor Sinks ._ . , _ . }_ __. i ? - _Water. Heater +, Workers', Compensation provisions of the Labor Code, you.must,forthwith, ; 'provisions this,be deemed, rei_ioketl:; x} Gas ' ;_ Service comply wlths such or: permit rshall { Service, .Outlets :Water CONSTRUCTION' LENDING AGENCY I hereby affirm that there is a'construction•lendind agency for the performance: Interceptors I of the work for, which„ this' permit -;Is •issued :(Section c3097, Civ. C:); Lender's Name " Kitchen'Sink f l Lender's' 'Address 1i OWNER BUILDER DECLARATION- j '. F ;' •- �; ' Lavatories ` I hereby affirmthatI am exemptlfrom the -Contractor's -License Law for the , following reason, (Section:7031,5 Business and Professional Code: Any city or P -Trap f county which requires a permit to construct, alter improve, demolish or.repair + ,ny structure, prior to its.issuance,'also requires t6wplicant for such permit _ Roof Drains a file a signed statement'that he/she is licensed pursuant to the•provisions of + he Contract or's•License Law (Chapter 9 (commencing with Section 7000) of Division 31 of the Business and Professions Code) or� that he/she; is, exempt - = Showers r Reinspection Fee $15 therefrom and the basis for the alleged exemptlonrAny vlolafion=of Section s7031.5 by_any applicant for;`a permit subjects -the -applicant to a civil ` Service Sink' Issue Fee •' j 3 enalty of not more than flue hundred dollars ($500). i i I, as towner of the i property of my emplayees•vvlth wages as their sole i compensation will: do the work, and theatructure Is not intended or Offered _. , ,-, 1 _ MECHANICAL for sale,(Sectlon 7044, Business and Professional. Code: The` Contractor's License Law does not apply to an owner of a property, who', builds or Improves Boiler= ; Refrigeration System thereon, and who 'does. such work filmself/herself or through his or her own [hat improvements are not Intended or offered forr ' • I ❑0-10G,0006TU 0100,000BTU employyees, provided such sale. If, however, the building ar improvement IS Sold within one year of com- Duct - Under Gfound , + pletlon, the ownerlwlll have the burden of prov[ng he/she did not build or im- t I Duct - Structural System Re_ pair/Alteration 1 pr�ove for the purpose of sale). i r U I, as owner of the property, am exclusively contracting"with`.Ilcensed con- i tractors to construct the project (Section 7044, Business,and Professions Code: a- ; Duct_- Ventilating.__, I , The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ ti tractors) license pursuant to the Contractor's License Law): ' ❑ I'am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. (CBO } i Date ` Owner. I Heating System & Ducting I hereby certify that l have read this application and state that -the above- - r - ❑0-100,000 BTU-❑100,000BT' informatl is correct. l agree to comply with all city and county ordinances t and state laws relating :to building construction, and ,hereby authorize repre-r f� Hood or Type I ❑ } Fee' $15 sentatives of; this -city to en"uponabove-mentioned pro arty inspection pur % [i t Canopy Tipe 11 ❑ Reinspection O Signature 'SS ' Registers 1 Issue Fee $ 3 7655 4/2E'7193 Dr: vers LI nse or CMF 0865-46 rev. 12/62 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - — - —ZONING REQULATIONS A. P. -"4# ZONE PLNG, REF. 4 BUILDING TO BUILDING PROPERTY INE 'REAR YARD (TO P/L) LEFT SIDE YARD RIGHT SI DE YARD PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE $ SPECIAL CONDITIONS: ISSUANCE 1 $ r $ ELECTRICAL Automatic Washer -Meter Clover 100 amps Construction Pole Sub Panel. i Cooking Unit Sub Pole Dishwasher I Motors 00-1 HP O1'/. -B j < Dryers ❑Gas ' ❑Electric Inc.Soler 09-15 HP ED) 16=15+ i Fan ' Microwave 1 ; F.A.U. Pole.Light I j Fixtures I Range 1 o Device Boxes :Sign: i I ` Outlets Standing Sections t '401 Switches l Trash Compactor S Garbage Dispo3al f i t l Generator` 00-5 KW 135-15 KW FINAL FEE' Transformer E]115 -5O KIN 1351.)+ KW Reinspection Fee t $15 i Meter UKptolooamps rlssue Fee : ' '$ 3 Zoning Approved By Application Approved By Application Issued By Data Date { ate Z Dr: vers LI nse or CMF 0865-46 rev. 12/62 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - — - SUMMARY OF FEES F I 'BUILDING PERMIT $ SMIP $ ,PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE 1 $ PLAN CHECK' } $ GRADING I I t $ ' ' 'ELECTRICAL $ �/ o b $ ' I PLAN CHECK $ .� $p MICROFILM $ 1 MECHANICAL $ TOTAL FEE t $ = t PLAN CHECK $ LESS i i ADVANCED PC $ ' F I FINAL FEE' $� Dr: vers LI nse or CMF 0865-46 rev. 12/62 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - — - ?C(lSTRUCTIQN�AND'`,PicA�1191lN ' 7I4: n� .� `.'� i' "r_:, Pt._ -'&SPA - r. AfT 6VALS Permit # iDate'� 'p Inspector APPROVALS c Permit.# Date -Inspector. ! 1:i7emporary Electrical Service or`Ro_ ke" ;�" ` %�O " 'S2r pool &:Equipment Location a f'r i i l 1, r I 1! I ♦- r T L r ... �' 2c !Soil Pipe=Undrgrnd. - I -e 53.`; Steel Reinforcement'' it �z 3� Ele'ctri&aI Conduit•Utility Urldrgr d" ' �; - 54:�-Forms 3 4; Electr;icak Conduit tJndrg�rid: `55: Electrical,Bonding , 5:; SteellReinfarcement,�l ''� `." "'", >_ ; _�`� �'_ 56_ Rough Plumbing"& Pressure`Test� , .l G' 16. El'Parical'OF•ER Grnd.� i,!} r U = ;57:' APPROVAL TO[COVE R-GUNITE: " . ,. r ; ? 7. Foat ngsc'.58~ Electrical Conduit-Undrarnd. B. i,�1 'I ry'-_ .' r - o 1 =59. GasPipeA3 Urid'rgr9 Test !Founds'lo8in _ 9. Wafer Pipe Uridrgrnci. j u - } •,60. Backwash'Lines; P;Trap, C7 Undi grnd. ' i [ r E • _ :r 10. !Structural Floor System I j` `l Y; T i ! .61. APPROVAL TO'DECK = _ 11. Property Sewer Eine &:House'Connection' ' '- `- ',62. Backwash ekecepfor•Final: 12. ewer'Ca I ;� , •<<' o ' '63. Heater & Vent -Fina!_ y i : F �r I r Roof Drain's ' 6. Plumt13. Final ! 14, IRougl%Plumbing i, I ! ' = "fi5. Electrical -Final' �� % • _ ` ` �' U { $X-1 RFough-Electrical:Cond`uit`j i �,{ -T �"j` F " `" �� ",66,r Solar'System-Final's - '`" "" ' - -_T } �16, �, r :� t ; j �� ;',a(} C 187.. 176cing &Access Approval r' i.Rough•EIectric•Wiring , 7.gRough"Wiring:Sign,_ -� { �IY €' f APPROVED FOR PLASTERING r 4 I I r 1, ;68." ougli Elecfr ca(.TiBa'r Ceiling �€ k `�; i 169 POOL/SPA SYSTEMS FINAL c 19 I'Rough'Heating & Air :FIRE DE?T_IREQUIREMENT' APPROVALSPermit =I#- 1 20. Rough Factory Fir�pIace /�{I `I i k i ! 21.,'IDucts;_in Structure �� Il� 21 .:'Ibu&s;_in ! i { 170:' Underground Hydro 1 `C.22.; Ducts, Ventilating 71.'Product Piping ❑Gas ❑Oil a ! !i,23. [Gas=Pipe-Rough & Test }72) Underground Flush. a.. r. 24.ilRoof Framing: ' f [' -, ' 173i Undergrnd. Storage Tank ❑Gas ❑Oil 1 ; r, I 11 inrr, i tk'i n , rt [ ;j= , 25. Roof Sheafhi6g i Ic„ l i _ ' I ` i74! Overhead Hydro I YStructure! �, - '�26."T Ber Ceiliri ."& Mo '' " g [ 1 nocoat' I F "' t' [. t '' ' '75: Dry Chemical ` , s Fame and F11shing 76! Dry Standpipe .r27. , 28. ntkiing &,Siding ? :; ' I ii '771 FIXED SYSTEM FINAL j } r i i '`I Y , i s' } k I I ; 178i F,I RE PREY. F1NAL _29.,;lnsulation� ?30.'Drywall Nailing r j ' I 4i f I i Notes Il 1 X31. Plaster, Brown Coat! 32.. Electrical Power Meter Fina[ j 1 i Fina! Electric _33. 34. Fina! Heating.& Air Conditioning 1_ 35. Final Gas Pipe. -Test'' 36. Hoodiorjnopy';; Q i nl y i? ,r l 37. Final'Fa'kory 'F,ii-e p lace 38. Final.Plumb'ing. 39. Water Service -Fina! - 40. Gas S rv'lce,Final 41. Solar;D'Omestic'Final I 1 t 42. Backflow PreventerQ 43. Backflow Irrigation t F 44. Landscape Irrigation Systems ! 45. Sound_Attenuation' i 1 u} s ,. 46• Handicap Regulations: -; 47, FINAL & BUILDINGS rSTRUCTURE 48. Special Requirements}Completeq 49. Electt icRelease to Edison_L _j __' } I t `-_'• i 50, Gas Release to California GasiCo Southern 51, CER TIF,ICATEOF OCCUPANCY r'. ' i 1 _� t_ _ i ��'�` No. 1 l :Date "WE __Applirant_to fill in all"spaces except those within heavy border lines and sign all appropriate declarations.- _ EI�YF CUST_A MESA 1 _ PE MIT NO TRACT NO. LOT NO._ BLD CONSTRUCTION PERMIT J. E_1 —�O '' ' Mesa; 7581'.A/21/63.r, 1 17.5.) Ti_ Applicant's Mailing Address TYPE OF CONSTRUCTION'• NEW ADD, . ALTERATION _REPAIR Project Address 31 1 AJ sway Lie . F-�� _Sc��a- ��esa ❑ CONVERSION ❑ DEMOLISH ❑ QTHER Owrier's'Neme Shearson/American Exorr%ne_ 702-7,,75 DESCRIP710NOFwORK tenant' x[11 rovernen <�,:o, 22 ZONING-REGULATIONS Address' TYPE OF PERMIT, GRADING^ FOUNDATION ''STRUCTURAL' A. P?# 1J �O .z ZONE ArchrEng. TOn1.' Campos &; AsSOC. License No.. EX TENANT ❑ ELECTRtCAL EI-PLUMBING ❑ MECHANICAL r c BUILDING - _ 779. "F" Plain Irvine PLNG.RE1..# nT r Address ❑,-OTHER I _ I TO BUILDING . REAR YARD ISO P/L)- ' ! Contractors Name ' J • DOnal d Ol son Co _Phone ; 540-2608, PROJECT DESCRIPTION' 5q. F OCCUPANCY PROPERTY INE 3151: Ai rwa E'-1 Costa"P�esa CONSTRUCTION TYPE "� VALUATION $ ' 15 ; O60 OO-_-_' LEFT SIDE YARD SIDE YARD Address (mailing) zoN)` _ GRADING CU. YDS.- ACRES PKG. SPACE REQ. PROVI D License N6. i r M LICENSED CONTRACTOR DECLARATION ; Remarks: :�'�}( - rte '7 S 77 STREET WIDTH i ARK FEE $ h J I. hereby' affirm that I am licensed under provisions of'Charter•9 (commencing y (� with section 7000) of Division 3 of the Business and Professions Code, and 1 7-6`fh{j /y4 q3 SPECIAL CONDITIONS: I " Y my license Is In ful orce and effect. �' �-7 �• `� � 3 V - ansec�s cans -333989 PLUMBING e 3 1 Signature f ..ORKERS' COMPENSATION DECLARATIO Bar Sink Sewer Cap ; ELECTRICAL I f� • I hereby affirm that I have a certificate of consent t0 self-insure or a certificate- Backflow Preventer Sewer Connection Automatic Washer Meter .❑over-10i3 amps 1 of Workers' Compensatlon Insurance, or i certlfled copy thereof (Section , Construction Pole -Sub Panel I 3800, Lab. C.) Backflow Irrigation Solar Collectors' Polley No. � Company ±�a IRA40A JT - ; Certified copy is hereby furnished. 1 I , ! Bathtubs Solar Piping _ Cooking Unit Sub Pale ' ' ® Cert i 1 cop Is filed with the city., In vislo i I Dishwasher MDte7r5 !]0-1 HP ❑i'r4$ + Date Applicant _ _ Clarifiers Solar Tank - FXEMPTION OM WORKERS',COMPENSATt DECLAR ION Dishwasher Swimming Pool w/Spa 1 Dryers ❑Gas ❑Electric Inc.Solar ❑9 15 HP El 16-15+ (This section need not be completed If the permit for.ona hun red ($100j or g less).. t I Ur. Fan' 'Microwave ' I certify,that In the performance of the work for wNch this permit is issued I Drinking Fountains l Urinal i, I shall• not employ any person In any manner so as to become subject. to the - - y, , F.A.U. ,Pole Light Workers'I Compensatlon: Laws of California. Floor Drains r f {Nater Closet 9 Date -Ibnature Workers',NOTE Come nsatloafter ln gProlvlsionsdeclaration; the Labor ou should becou must. forthwith. - +, Fixtures Ran e t me subject to the' ';' -' Floor Sinks � - - -- •- -• ; - Water•Heater-- �; - -^ -. - - - - - - - 9 Code, yo - w . Device Boxes } Sign comply with; such ,provisions_ '• or ,this permit - stlall. be deemed revoked` , Gas Service Outlets ' .Water.Service t+, l CONSTRUCTION LENDING I hereby affirm that there Is a.constructiomlending agencyifor the,perfarmance + Interceptors ; "i I y, - i Outlets l Standing Sections of the work for, pit Ahr this. permit Is , Issued ' (Section ,3097: Civ. C:), Lend6r'sl Name 'rI r Kitchen Sink' _ Switches • Trash Compactor 1 ' Lender's) Address'+ I t r , . I w �, Garbage Disposal ( ' OWNER BUILDER DECLARATION + + 1 i ;: Lavatories„ i I i_k. I hereby affirm that I am-exampt from the'Contractor's License Law for the'P,-Trap , Generator ❑0-5 KIN ❑5-15 KW ; following reason=(Section 7031.5 Bus[ness and. Professional Cotle: Any city or ; 1 , rr, -c}unty which requires a permit'to construct, alter Improve, demolish Ior"repair - Trarisformer 1 ' structure; prior to Its issuance, also requires tho applicant-for such permit Roof Drains ❑15 50 KW `ra Contractor's License Law.(Chstatement that apterShe is licensed 9 (commenc ng with Sectiursuant to on.7400} ofrovisions f r ©50+ KWi { t Reinspection Fee Division 3'of the,Business'and Professions Code), or that he/she•:is exempt Showers ''•• Reinspection'Fee' $15, $75 ' therefrom-and the basis for the alleged exemption.-Any vlolatlon'of;Section Meter C1 up to 100 amps tissue Fee 703L5 byxany applicant for alpermit subjects the applicant to a-civll { F enalty of not more than five hundred dollars ($540}• + ! Service Sink Issue Fee s �1 $ 3.y ; t — e i , Zoning Approved By Date t 1,'as'oivner of theipraparty or my employees with wa9es'as their sole compensation' will:do the work, antl the .structure Is not intended or offered , MECHANICAL ; �, a ; Application Approved By r Date for solei{Sec{Ion 7044; Business antl;Professional Code:'The:Contractor's f License Law does not apply to an owner of a propaYty.who builds or improves Bailer 1 Refrigeration 5ysteril ' ' I thereon„and who doss such work himself/herself Ar through his or her own .:^ '+ ; - 'Application Issued ey ` Date ;employees, provldetl that such Improvements are"riot Intended or offered for ❑0.100000 BTU ❑100,000BTU sale. If, however, the building or improvement Is sold within one'year of com- Duct - Under,Ground , I i s SUMMARY OF FEES pletlon, the owner will have the burden of proving Pe/she did not build or Im- r s rove for the purpose of sale): t i ( I Duct-Structural System Repair/Alteration_ 1 BUILDING PERMIT $ '/ i SG SMIP $ I, as owner of the property, am exclusively contract Ing. with; IIcensed con- 1 i tractorsto.construct the,project fSectlon-7044,. Business and Professions.Cods: _ i_ Duct --Ventilating _ _ _ _ , . _ _r _ _ 1 _. F,. PLAN CHECK; r $' PERMIT The Contractor's License Law does not apply to an owner of property who + ! 1 ISSUANCE : $ ) builds or improves thereon,-and who contracts for such projects with a con- •� Exhaust System ❑ Mu ltipEe ❑ ; ,� PLUMBING $ tractor(s) license pursuant to the Contractor's Llcen9e Law): i { GRADING '' $ ❑ I am exempt under Section--= --- l - e. & P. C. for this reason 1 Fi�epl/Fact. Bit. ICBO # r l PLAN CHECK $ I ELECTRICAL; t $' 1 $ Date I Owner' ! I Heating'Sys4m & Ducting.' I $ t t _ I MICROFILM I herebyy certify that I, have' read this'-application "and state that^ttie above ❑0 100,000'BTU ❑100,0006 " r PLAN CHECK $' 1 informatipn Is correct, I agree to comply with all city,and county ordinances + r i ; f�„ { I TOTAL-FEE- .l $ and' state laws relating to buliding construction,, and hereby authorize repre- j 1 Hood or T � MECHANICAL' $ � 1 sentatives of I thi ,city! to anter f pan the above-mentioned property ,for Type I ❑ inspection pure es. i } i ; Cano Type II ❑ i I Reirlspection'Fee, i $15 PLAN CHECK' $3 ; LESS i slgriature ADVANCED PC $ Drlvers' Llcerise or SS Registers - i Issue Fee I ,' $ 3 I ; FINAL : ( $ CMF 0865-46 rev, 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -Assessor C C` NST RLIPMON AND',PLAN- _NG CO S:. F SPA- -D -11 -, 4#' �_f q7 7 L��' Q, 'APPROVALS Permit.#- bite .16 speictor' - . APPROVALS. Date Iriikctoir� rToe, 52 Pool &-EqU ip prt Lecati0n 2'S�il Pipe-Uhdrg-ndl 53Steel Reinforcementorcement 5` El6ctrica'1,6nd,it' Uti[iiv-bn flcIrgrnd. F'or�ps*'l - �54;! 4-. E19ctrical Conduit-Undrgrnd) '55-. Electrical B6ndin r §te;eI_Reir.40�r6ment L -,K, - Ore' 56%. Rough Plumbing,& ssure. Test 6- Elect ic Electrical LIFER Grnd., !�.7,.._ APPROVA,LITO COVER -GIUINIITE, 7. Footings -iM.' 1 Elec I trical:CordUit-Undrarnrl.'- 8. Fdun�latior� 3� I U L -59. Giis Pipej] ndrgrnd-, Ust 3� t 9. Water Pi e-bnrdrgrnd. 60. Back%iash'. Lines, P-Trap,'D -Undrgrnd. 10, Structural Floor System61. APPROVAL -TO bkK ;L - - - 11. Pro pertV. Se'wer Line & House Connection ;6�2. Pa ckwa s h'& - Rece 0o r - F i pa I 12. Sewer Cap e -Final' 53. Heater & Vent 13. Roof Drains 1 ':64. Plumbing- ystem- 14. Rough Plumbing f T '.-65. Eleclrical=Final F1 5-. - Rough,EtectricallConduit F; T _,66_,`sol� r Sstem-Final -I 1'�l 6.Wo-u_qh,EIect_rjc Wirihgl A 8 Cry+ F: --f- 4- _J 7', F ricing �,Access Approva 1Z U ',;I A R'OughWirin"g Sig -p N P' R V LA�S�TER I NG AP RO Ejp F611 �8 . ;_1k.R'0'ug h, Elect" ic�ai I"LT C�k l'i ng 0 T f C '6-9�.tPOOL/SPA SYSTEMS -FINAL Z L !1 Af 'k6ubWHeaiing & Air Conditic)tn_ing" I';1 'FIRE 6E�T. REQ'UIREMENTr'_�L "RO A /ALS Permit'+--L- '�ujh Fireplace 20- R ,Fa�torV, Fi jpl e! 21. [�jcts,`in StFuctureN 7-.1 Unldergro�und Hydro 0 Q Ducts, :,?4 Duct Ventil6fing 71 'Prq'duct P'ipi'ng El Gas Oil ii,� �SOipe,-Iio"�gh &'Ti ;i_''Un7dergro'und q.,G e T_ 72.; Flush r j aming-, �3.: Udderg rnd. Sto*e Tank O.Gas, 010il 4 25-' Roof Sheathin'g' 4.1 Overhead Hydro 26. T -Bar C'eiling' {Str6cturalii &'Mo'n"opoal t Dry Chemical ,,27, Frame and Flashing 76. Dry Standpipe 128. 1athing & Siding 77. FIXED ' 'Y 'T EM I N A L S 429. nsulkion '7 8. FI!RE.PREV. FINAL p 30. D' '!tl' Nailing D-5, es otes' 'Not 'N !Yv�� : ,.'31. Plastec-Brown Coat I. --r _T --f--i F~- -'- - -. - 32. Electrical Power Miiter-Final,., 1� 33. Final Electric AL V. (Vv C. 34. Final Heating &,Air ConditioninR 35. Final qas;Pip'e!'72,esi'I P, 36. Hood or UORY 37. Final Factory Fi�reiola6e! z�r7 38. Final Plumbing g 39. Water Sei,v`ice-Finalj 40. Gas Service Final ra V, I 41. Solar D'ffie�iic-Final' 1 .,o,. ;. : I '. -,I I r - 1. j- - -I- -- - "_::Pre'ven�terj J"] 42. Backf Ion --4-4 - 43. Backfl IrH*ion' 9vy 44. Landscape Irrigation em I System 'Z' 45. Sound 'Alteiniva�ion < 46. Hand ica'p�'!Regu fahioh"* 47.- FINA� Si R101 C' GAE B 61 LD I NG j 48. Speciai!,Requirer�ents Completed) 49. Electric Release to Edison I 4 A I T 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF!OCCUPANCY No. Von 151-1. Date 1_7 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000175 P. O. Box 1200 Costa Mesa, California The Building located at _ 3151 Airway Avemle #M-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building Inteslcw Altexat nm — Offiae Legal Description 427-291--12 " I ISee reverse side for Metes and Bounds) Building Permit No, R-7154 Electrical Permit No. Fr7195 Plumbing Permit No. P-7165 Mechanical Permit No. Number of apartments and/or guest rooms ISSUED T0: Building Official Shearson/American ExaresIs by 1601 Dove St., #200. Newport BeEch Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on&e prem-sesfand SHALL NOT BE removed except by the ,This Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services bepartment Building Safety Division P. O. Box 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY No. O0`,-1181 The Building located at 3151 Airway Avenue,. Unit M3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group - 92 Occupancy. Use of Building ' Office Legal Description 427-291-15 (See reverse side for Metes and Boundo Building Permit No A461.32 _ .__Electrical Permit No - Mechanical Permit No, Number of apartments lumbing Permit No, and/or guest rooms ISSUED TO: Building Official ,rnnn« e: rns 4-z Oranae Comaanv 3151 Airway Ave.. Ste. K101 by -- Costa Mesa, CA 92626 ' Date September 4,, 1990 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. t� CMF 1015-46 rev, 1/83 white -Owner; Canary - Numerical File;'Pink - Bldg. Permit File f City of Costa Mesa Development Services Department Building Safety Division ',C E R T I F I,C A T E OF OCCUPANCY NO. P. O. Box 1200 Costa Mesa, California The Building located at 3151 Airmay Avenue M-3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto ii for a Group Occupancy. Use of Building Interior Alteration - Office Legal Description 938-94048 (See reverse side for Metes and Bounds) Building Permit No. G13467 d Electrical Permit No, G13467 Plumbing Permit No G13467 Mechanical Permit No. G13467 Number of apartments —0 and/or guest rooms —0 t ,�dJ � ISSUED TO: Building Official . Gtail�e Consultants 3151 Airway Av; E-1 C.M. by Ave411 Date oz -0 This Certificate of Occupancy SHALL BE posted in a conspicuous place on theRremises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec, 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Building safety Department CERT I F;1 C A T E' O F OCCUPANCY t= 13,0. Box 1200 Costa Mesa, California The Building located at 3i1 uiyay �NVZ1= CM --1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group n1_2 Occupancy. Use of Buildinginr.�L3%1�'A71 Legal Description 427-291-12 (See reverse side for Metes and Bounds) - ,;, f�5888 �2-•�C�S Building Permit No 11A• -167n Electrical Permit No. 'Sf 74 Plumbing Permit No. Number of -apartments t and/or guest rooms -0— ISSUED T0: Building Official by ci..•XnVft-ren V. C. WS -A onr,'Butildinj OiviC3ral uaxez..-t — Date :t- E`i i F } This Certificate of Occupancy SHALL BE posted in a,conspicuous place on the premises and SHALL NOT.BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU 34 Rev,,21/70 ,;_ ` NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE t. INSP WON TYPE 1616 CITY OF COSTA MESA 1266 BUILDING DIVISION 200 Final Re -Roof } 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci,costa-mesa.ca.us t- FOR INSPECTIONS CALL: (714) 754-5626 203 PERMIT NUMBER BC07-00075 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: COM—ALT DATE ISSUED: 08/20/2007 ISSUED BY: RMD JOB ADDRESS: 3151 M002 AIRWAY AV CM Suite/Unit: M002 ` APN: 93894067 Zoning: Vicinity: M2 ERIC A PROUTY, DM Primary Occ: Const Type: SO. FT: 1534 Valuation: $75,000.00 SCOPE OF WORK: 1534 SO FT TENANT IMPROVEMENT FOR "ERIC A PROUTY, DMD," DENTAL OFFICE, IN UNIT M2. ELECTRICAL AND PLUMBING WORK ALSO INCLUDED. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF L_DS Address: SOUTHERN CALIFORNIA PROPERTY RESERVE I Unit: 10 E SO TEMPLE ST 400 Phone: i CitylStatelZip: BRUCE CHRISTENSEN APPLICANT: HASTINGS, JON Address: Unit: Phone: 949-292-3567 CitylStatelzZip: , CONTRACTOR: JON HASTINGS CONSTRUCTION INC License No. 392715 Phone: 949-292-3567 Address: 34145 PACIFIC COAST HIGHWAYUnit: UNIT 520 Cell: - CitylState: DANA POINT ZipCode 92629 ARCHITECT: TERRY, CHARLES License No.C11658- ,- PHONE:949-552-7400 ENGINEER: License No. PHONE: COMBINTATION PERMIT FEE SUMMARY Building Pian Check: $133.05 Building Fees: $818.75 Electrical Fees: $327.60 Mechanical Fees: $0.00 Plumbing Fees: $141.10 SMIP Residential: $0.00 SMIP Commercial: $15.75 TOTAL FEES: $1,436.25 "Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE t. INSP WON TYPE 1616 Fined System Final Fire Prevention 1266 Pool Spa Final 200 Final Re -Roof 201 Final BlocidRefaining wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition PLTE IM ALS CODER IRSPE TION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuiidinglOccupancy xTITIA �s alt&L 7 WORKERS' COMPENSATION DECLARATION: 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. ❑ 1 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 Cermit is issued. My workers' compensation Insurance carrier and policy number are: kk�__ Carrieir �'TIL� FU�L (7h6 section need not be onmpfeted rf the permd is ,.atued alone hundred dollars fi 100) or fess.) policy.Num—Wr: l8 3 Q. S 13 ❑ 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 de, I shall forthwith comply with these provisions. c Obf o&- arlb.nt s Sgnat Date.___ -_r_-_-2 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'$ 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. SI -11 � r V 10 _ Contractors Sigmlur C ^ow --�_ 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 Cade). Lender's Name: Lender's Address: Signature Date OWNER -BUILDER DECLARATIONS: I hereby affirm that under penalty of perJ'ury 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 rile 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 (S500).): ❑ 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 appy 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature 3067-46 (3rp7) Date Okmer ID verified by drive. Driver's License No. ue. ❑ Yes ❑ 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, 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. Applicant's 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 Pian for emergency response to release or threatened release of a hazardous material? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? [:]Yes ❑ No (Section 85850.2 of the California Government Code requires that the requested information be furnished on applications for ran -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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No S. (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 slate 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. Sig Lure of Legal Owner(s) D to b 0A L__A dl r Authorized Appl`ca ate_ �_ CITY OF COSTA MESA BUILDING DIVISION - r 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 7544856 • www.ci.costa-mesa.ca.us 1r - `'. FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00145 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 93894033 _ DATE ISSUED: 0810512009 ISSUED BY: kjb JOB ADDRESS: 3151 M AIRWAY AV CM SuitelUnit: M Vicinity: BUILDING N ROOF Squares: 7500 Valuation: $19,893.00 „ SCOPE OF WORK: REROOF BUILDING "M". TEAR OFF (E) ROOF MATERIALS, INSTALL i LAYER OF 15 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 75 SQUARES, REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: J. WAYNE EXECUTIVE Address: 34145 PACIFIC COAST HWY Unit: PHONE: 949-42MS37 City/State/Zip: DANA POINT, CA APPLICANT: HANSEN, DUKE Address: N6646636 Unit:,•�:,� PHONE: City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: •i 714-557-7440 - City/State/Zip: SANTA ANA, CA 92707 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $321.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $322.25 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE I, INMcnoN TYPE DATE INTITIAL CODE S INsrecTloN rrPDAFT INmtAL 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final� 208 Final Plumbing 8 Z 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining 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 BuildinglOccupancy a WORKERS' COMPENSATION DECLARATION: I hereby affirm under penally of perjury one of the following declarations: ❑ 1 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. ❑ 1 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 Insura ce carrier and policy �number �are, zt_-_ f 'Cd`yFTt ' (This section need nor be mmpfeted d the permt is valued al one hundmd dollars (S 100) a fess.) um er:2,9 ❑ 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 Section 3700 of Ihata6o Code, I sha orthwith comply with these provisi C � 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 DOLLARS ($100,000), IN ADDITION 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 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. n e CONSTRUCTION LENDING AGENCY: ❑ 1 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 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 (5500),): ❑ 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature Date 3057-d6 (307) 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 We (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. Applicant's 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? ❑ 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? []Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 slate 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. SignaG (LegalONmer(s) '`?� Applicant to 1111 in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA ER�yITT NO. TRACT NO. LOT NO. SLO . NO. F;/ •CONSTRUCTION PERMIT llffJJ PKG. SPAC E REQ. Project Address 3151 Airway, Costa Mesa, Ca. TYPE OF CONSTRUCTION Owner J. Donald Obon Phone — 60�4EW ❑ ADO ❑ ALTERATION ^yr �f�J Address 18003 Skypark, Irvine, Ca. ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER Address DESCRIPTION OF WORK Contractor Leaverton-Beck, InC. - Ph6ne979-356 TYPE OF PERMIT Address 1 721 Hale- , Irvine, Ca. 92714 .❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICALS UMBING ©MECHA I hereby affirm that I am licensed under provisions of Charter 9 (com- 1-10 KW + KW mencing with section 7000) of Oivislon 3 of the Business -and ❑ OTHER Professions CodeCrSl my license is In full tnrcpgn6p+ffect. {{77 li y ``JJ PROJECT DESCRIPTIONLicense Class License No Date /11 -til Signature �� SQ. FT. WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE, I hereby affirm that 1 have a certificate of consent to calf -Insure ora ALUATION ZONE- + VALUATION—ZONE- certificate of Workers' Compensation Insurance, Ora certified copy -SUB thereof (Sects n 3800, (_ab, C.). thereof GRAOING CU. YDS. ACRES POliCY No. -Company %PTii ♦-}'t 'i1t-ifltlal . '.ert1fled c0 is hereby furnished.- -- _ ,.'.,- copy Y REMARKS: _ copy is filed with the City Building Division. S TOTAL FEE M-"`."ertifled MPTION FROM WORKERS' COMPENSATION DECLARATION PLAN CHECK (This section need not be -completed if.the permit is for -one hundred $ _ (;100) or less). FINAL FEE` (.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 +`PLUMBING •; PLAN CHECK subject to the Workers Compensation Laws of.California. Date Signature BATHTUBS SHOWERS NOTICE: It after makh19 this declaration, you should become subject .TOILETS - URINALS - to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions Or this permit shall be deemed LAVATORIES DOUBLE_ LAYS " revoked. - CONSTRUCTION LENDING AGENCY KIT. SINKS OISHWASHERS 1 hereby affirm that there is a construction tending agency for the per- SERVICE SINKS SUMPS " formance of the work for which this permit Is issued_ (Section 3.097 CIV. C.), L.ender'sName _ FLOOR SINK$ FLOOR DRAINS _ Lender's Address DRINKING FOUNTAINS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL- P TRAP Any city or County which requires a permit to construct, alter, Improve, demolish or repair any structure, prior'to Its Issuance, also re- MATER SERVICE ALTERATION quires the applicant for such Permit to file a Signed statement that he Is licensed pursuant to the'provlslons of the Contractor's' License Law "GAS SERV ICE OUTLETS (Chapter 9 (commencing •with Section 7000) Of Division 3 of the business and Pro4ession4 Code) or -that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT' basis far the alleged exemption. Any violation of Section 7031.5 by a• applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS i I more than five hundred dollars (S500). L as owner of the Property, or my employees with wages as their SOLAR TANK COLLECTORS - _ sole compensation, will do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The S. Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such_improve ments are not Intended or offered for sale. If, however, the building Or Improvement MECHANICAL PLAN CHECK Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). C1 HEATING SYSTEM 0-100,000 BTU I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors t0 construct the project (Section 7044, Business 100,000 + BTU and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from such projects with a contractor(s) liceSned pursuant to SYSTEM the Contractor's License Law). 100,000+ BTU ❑ i am exempt under Sgction B. & P. C. for this BOILERS BTU reason ___ reasOwner SYSTEM REPAIR. ALTERA-fl ON I hereby certify.that I have read this application and state that the above- EXHAUST SYSTEM MULTIPLE information is correct. 1 agree to comply with all city and county ordinances and state Iaw5 relating to construction, and hereby authorize representatives this city t0 enter upon the above mentioned property for.' spectiOn p 'L - . Signatur Drivers' License or SS :r -- ISSUE FEE GMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1 6768 10/13/81 1 i6'000 ! T ZONING REGULATIONS A.P. 9r- r ZONE PLNG: REF. =P RIGHT + REAR YARO (TO P/L) PKG. SPAC E REQ. PROVIDED STREET WIDTH PARK FEE S ZONING APPROVED BY DATE SPECIAL CONDITIONS: SUMMARY OF FEES •, BUILDING PERMIT ELECTRICAL PLAN CHECK $ PLAN CHECK GENERATOR 0-1 KW - TRANSFORMER APPLIANCE 10-50 KW�__50 1-10 KW + KW MOTORS 0-1 HP (INC. SOLAR) •10-50 HP 1.10 HP 50 + HP - FIXTURES OUTLETS SWITCHES - GAS TUBE SIGNS ' POLE'LIGHTS GRADING POLES METERED SUB PANELS - MAIN -SUB - - SERVICE '- - AMP ' ISSUE FEE ' APPLICATION APPROVED BY DATE SUMMARY OF FEES •, BUILDING PERMIT S ;SMTP $ PLAN CHECK $ PERMIT ISSUANCE 5 - PLUMBING E ' GRADING $ PLAN CHECK $ ELECTRICAL S $ PLAN CHECK- S - MICROFILM S MECHANICAL S TOTAL FEE S PLAN CHECK LESS AD - $ VANCE PC $ _ FINAL FEE` CONSTRUCTION AND PLANNING rmlt APPROVAL$ JGNF1Nn1P`.4"# I Date Inspector POOL & SPA APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location Soil ipe- ndrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee e- orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footinqs 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.0 Undrarn 10. Structural Floor System - 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection "y_ 1 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing Svst�m - Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 5B. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof. Framing 21: Roof Sheathing (VOTES: 22. Frame and Flashing 23. Insulation 24. Lathin &.Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 36. FINAL_ STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA 717 O. 71 TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT e�LS !{ M rro)ect Aaaress 3151 Airway, Costa Mesa CA Owner JD0 Qmnany Phon Address 3151 AirWAV, Costa Mesa CA 92626 Arch/Eng. License No. ` Address ContrnctorLeaver ton—Beck Inc. Phone 979-356 Address a Aye, , Irvine CA 92714 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions Of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, aOt(6my.license Is in full force and License ass CC ii }cen�0 No 1i Date �� y Signature 0_J WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation insurance, or a certified copy thereof cy No.�t��3�4Q ff C.). Company Great American :ertified copy Is hereby furnished. kr_PXertifled copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if the permit is for one hundred ($100` or le ssl- 1 certify that In the performance of the work for which this permit is issued, I shalt Fiat employ any person to any manner so as to become subject to the Workers Compensation Laws of California. pate Signature NOTICE: If after making thisdeclaration, you should become subject to the Workers' Compensation provisions of the Labor Coda, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the Per- formance Of. the work for which this vermlt Is Issued (Section 3097 Civ. C.). L-ender's Name L.ender'S Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's. License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which- requires a permit to construct, alter, Irnrrove, demolish or repair any structure, prior to its Issuance, also ro- quifres the applicant for such permit to file a signed Statement that he is licensed pursuant to the provisions of the Contractor's License Law 8 Chapter 9 (commencing with Section 7000) of Division 3 of the u1"ess and Professions Code) or that he is exempt therefrOm and the P for the alleged exemption. Any violation of Section 7031.5 by �ppllcant for a permit subjects the applicant to a civil penalty �t 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an'owner of a properly who builds or improves thereon, and who does sucn work himself or tt+rnugh his 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as Owner of the property, am exclusively contracting with Ilrensed contractors to construct the project (Section .7044. Business and Professions Code: The Contractor's License Law does not apply to arr owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) Ilcesnod pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. d, P. C. for this reason Date Owner I nereby certify that I have read this application and State that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representati this CRY to_e+t�t/,r rpon the above mentioned property o s ecllon `purp0¢s. AIT _ „ TYPe OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑OEMOLISIi ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION Q STRUCTURAL ❑ TENANT ❑ ELECT RICALOLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: t, 3570 7/21/82 ZONING REGULATIONS A.P. : ZONE PLNG. AEF. gr - REAR YARD (TO P(L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED By SPECIAL CONDITIONS: PROVIDED PARK FEE $ DATE 54.00 TL PLUMBING- ' PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_ 50 + KW KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP SERVICE SINKS SUMPS (INC. SOLAR)' l0-50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARI IERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GASSERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS f SOLAR TANK COLLECTORS*. SOLAR PIPING SYS, 61 1.0 ISSUE FEE ISSUE FEE Pyj APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF_FEES. HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ SMTP AND DUCTING DUCTING 100,000 + BTU PLAN CHECK % PERMIT REFRIGERATION 0-100,000 BTU PLUMBING E ISSUANCE E SYSTEM GRADING E 100,000,+ BTU PLAN CHECK $ BOILERS BTU_ ELECTRICAL E $ PLAN CHECK $ MICROFILM S SYSTEM REPAIR, ALTERATION I MECHANICAL E TOTAL FEE 5 EXHAUST SYSTEM MULTIPLE J LESS AD- PLAN CHECK E VANCE PC r E Signet ur Oflvers' License or SS � ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink-AccOunting; Goldenrod -Assessor FINAL FEE $�� CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit=* Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44- Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8, Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51, Backwash Lines 15 -Trap. ❑ Undrqrn 10. Structural Floor System 52. APPROVAL. TO DECK 11. Property Sewer Line & House Connection 53, Backwash & Receptor -Final . . 12. Street Sewer Connection 54, Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit •56, Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning 1513. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19' Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat ` 27. Electrical Power Meter -Final 28. Final Electric 29: Final Heating & Air Conditioning , 30. Final Gas Pipe -Test 31. Final Plumbing Wk4l U's. I 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. -' 42. CERTIFICATE OF OCCUPANCY No Date CMF 0865-46 White -Building; Cana ry-Appikant; Pink -Accounting; Goldenrod -Assessor SApplicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CIT1hOF COSTA MESA P RMIT NO. TRACT-NO. L T NO. , BLDG. NO. - - CONSTRUCTION PERMIT /f' b' '. Project Addres j► OF CONSTRUCTION ` ` 61 4I 5/2(]/2 3I.Oa TLI Owner SQN - Phone - AEW ❑ADD ❑ALTERATION �• - - ;- . -"Address ` �`j'•' + r PAkR CONVERSION ❑DEMOLISH- ❑ OTHER ZONING REGULATIONS 1 Arch/Eng. License NO. DESCRIPTION OF WORK P. AddressN£ PLNG_REF:•-COntracto Phon TYPE OFPERMIT- - -- .- - �BUILDINGE Address- e- rTBACK ❑'GRADING-' 0 FOUNDATION D STRUCTUD C T. OPERTY LINE.+ YARDLICENSED CONTRACTO DECLARATI "❑:TENANT❑.ELECTRICAL ❑PLUMBING EDEYA J hereby affirm th;h I am licensed under ions of Cha co 7000) On_ of- th d - ❑OTHER' '" ° ' GHTmencinq.with section of. Siness Professions Code, d my lice is I full a and ect. PROJECT DESCRIPTION 3HANIC AR'YARO (TO P/t;)Lkcens Class - LIC e' - — - -G.SPACE-REQ, - PROVIDEDDat •SQ. FT + Signa re '' PARK FEE5t CLARA ON CUPANCY CONSTRUCTION TYPEREETWIDTlt hereby affirm that I have a ertiflcate of consent to self-kns a „ ZONE ,NING-APPROVED-BY DATEVALUATION ,Cert[fiCate.ot Worker5'_Compensation Ins nca, or_a cerlf}le :copy _ - -_ ,,, ,thereof(Seyt�Qn aa„Lab. }_GRAD(NGCU.YDS. ACRES ECIAL CONDITIONS:NOJ- CompanS -� C - .ified coPy Is hereby furnished. Division. REMARKS:_ __ �_ __ _ _ _ __ ertlfied copy Is flied with the cltyBuilding •1 EXEMPTION FROM WORKERS' COMPENSATION DECLARATION- (This section need not be completed if the permit IS for one hundred ($100) or less). . --I- Ycertify - certifythat 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 PLUMBING, PLAN CHECK. �s �� -- ELECTRICALPE-AN CHECK subject to the Workers Compensation Laws of California.* + - _ ,- Date Signature- f - BATHTUBS__ _ ' - SHOWERS' ' ' 1 Ffl- NOTICE: If after makingthis declaration, you should becomesubject y -must TOILETS, ...URINALS - - - -GENERATOR - 0-1 KW - 1-10 KW - ; to the Workers' Compensation provisions o1 the Labor Code, you or this shall be deemed LAVATORIES DOUBLE LAVS - - - TRANSFORMER - � - .forthwith comply with such provlslons permit revoketl. CONSTRUCTION LENDING AGENCY - "^ KIT. SINKS - - DiSHWASNERS- APPLIANCE MOTORS -• --0-1-HP 1=10'HP j 1 hereby affirm that there Is a construction lending agency for the per• SERVICE SINKS SUMPS y•- - - - A(tNC. SOLAR) -_ 10-50 HPL--,:- 50 +.HP' formanco of the work for which this permit is issued (Section 3097 , y Civ.. _). Lnder's Name Lende FLOOR SINK' '" 'FLOOR DRAINS- S - -FIXTURES OUTLETS -�SWITCHES -' Leridei's Address - -- - ' DRINKING FOUNTAINS - -r - GAS TUBE SIGNS - -- • - - - - — 1 `OWNER 13UILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for i INTERCEPTORS - - CLARIFIERS' "-' •� - -POLE LIGHTS •^-- W •- the following reason (Section ,7031.5 13usiness and Professions -code: 'Any city or county which requires a permit to construct, alter, "•1 SWIMMINGPOOL - P TRAP„ -, I POLES METERED-� •SUB• - improve, demolish. or repair any.structure, prior_to,Its Issuance,.aiso.re- WATER SERVICE, ALTERATION PANELS -MAIN - SUB - - quires the apklicant for such permit to file a signed statement that he _ T -GAS SERVICE OULETS - �SERVICE AMP- Is licensed. pursuant-to.the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) Of Division 3 of the + WATER HEATERS BTUOUTPU7�- -•- - - - - - BBusiness and. Professions .Code) or that., he-is exempt-therefrom and the ISIS for the'alleged exemption. Any yidtation of Section 7031.5 by SEWER CONNECTIONSmor-- - - - - - •- -� - - .. _ _ __ _ - - W _ r a. permitsubjects tne 0 pliCant to.a. civlltpenalty vnotapplicant .) tha ed s ($5 -SOLAR TANK - -COL'LECTORS - • - --- ----- -- - Ll t, as-owner of the, property, or-my employees with wages as their sole compensation, will do the work, and the structure is not intended - I - SOLAR PIPING SYS. - ' - - • ISSUE FEE - -- - -• - - - - - - ,-DATE or offered-for sate_ (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE -- _ -- - - '"'� - APPLICATION APPROVED-BY- - - -- - who -bukids'or•lmproves't hereon, and -Who does such-work himself'or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHEC4C SUMMARY OF FEES' Intended-or offered for sale.-If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden J of proving' he -did -not build, or. improve-for the purpose of sale). -BUILDING - - - -- • --• --- - - __ - , .. _ _. _ - _ - NO SYSTEM 0.100,000 - - - BTU • •-• -- HEATI : ❑ 1, owner_ of the, property, am exclusively contracting with AND OUCTiNG-w - - - PERMIT = SMIP $ licensed contractors construct the project (Section 7044, Business ]00,000+ BTU 1 (PLAN CHECK PERMIT s and. Professions Code:: The ContractorLicense Law does.not apply to and. ISSUANCE $ ISSUANCE REFRIGERATfON 0.100,000 BTU n v an owner of property who builds or irnproves thereon, and who con- tracts from with. a Contractor($) IiCeSned to PLM UBING $ -such projects .pursuant the Contractor's License Law). -SYSTEM 100,000 + BTU - GRADING $' PLAN CHECK •s ter. ❑ 1 am,exempt under Section.,_ B. & P. C. for this ELECTRICAL- - S BOILERS BTU reason. T Date Owner MICROFILM $ PLAN CHECK - S - -- - - �- TOg AL FEE S - r , , _ - -- -- SYSTEM REPAIR, ALTERATION 1� _ MECHANICAL .$ - -- - I herebycertifyth read this a on d state that the above EXHAUST SYSTEM MULTIPLE ti' 'LESS AD- Informalon-irrect agree onjP h all city and county - PLAN CHECK- $ VANCE PC $•� ordinances slat s rola tO COnf Ion, and hereby authorize represent ves -p Is-E to •upon •the above mentioned propert for peal + l _ - ISSUE FEE FINAL FEESigat $ ALL •"" Dri ars Drivecense or SS � - ' - •-' - - CMF 0865-46 White -Building; Cana ry-Appikant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING �� \ APPROVALS '``1i' Pelr`mit�# Date Inspector POOL & SPA gPPROVALS -, �t`P.e�mif#'� ' r , ,i DC�e1,C C Inspector :�` 1 ,,� 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location • , �, �r ,-, ?r r 2. SoilPipe-Undrgrn 44. Steel Reinforcement x 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & 6. Electrical UFER Grn ,f 48. APPROVAL TO COVEGUNITE R- '��'`" V" 7. Footings / \ 49. Electrical Conduit-Uridr rn 8._ Foundation .. 50. Gas Pipe, ❑ Undr rn,,Test; 4 r .9. Water Pipe-Undrgrn 51. Backwash Lines P-T-ra -O_ r dr r 10. Structural Floor System 52. . APPROVAL TO -DECK " - 11. Property Sewer Line & House. Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final *\ \ 13. Rough Plumbing _ 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 57: -Solar System -Final 16. Rough Heating &Air Con 'tioning encing &Access Approval 17. .18. Ducts in Structure Ducts, Ventilating 59. APPROVED FOR PLASTERING 60. POO L/SPA SYST E MS F I NA L 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing- NOTES: 22. Frame and Flashing _ _ 23. Insulation = 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter,Final - 28. Final Electric 29. Final'Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33, Gas Service -Final 34. Solar Domestic -Final 35. Landsca e S rinklin S stem - 3V Sound Attenuation 37. Handicap Regulations ' •, ` 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY Noy Date 5 ` - 61 1,5 5/20/B2 33.46 TU ZONING REGULATIONS Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. + _ �Cl'rY PF COSTA MESA � PERMIT NO. �. ",CONSTRUCTION PERMIT 3Z TRACT NO. - LOT -NO. BLDG NO. AC T. Project Address 1 IZuj TYPE OF CONSTRUCTION , $ ' Ovune i ,x [. 43hon!2V2,-767,00 NEW ❑ ADD ❑ ALTERATION PKG. SPACE REQ. Address - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ! I ❑ OTHER DESCRIPTION OF WORK Arch/Eng. License No. Address d COntractOrv Phori(,A% ZOO TYPE OF PERMIT' j ❑ GRADING •. El FOUNDATION ❑STRUCTURAL . Address -7•� �' \ \ ❑TENANT ELECTRICAL'❑PLUMBING ❑MECHANIC ClOTHER _ PROJECTDESCRIPTION SQ. FT. , - LICENSED CONTRACTOR DECLARATION I hereby affirm th:,l I am licensed under provisions of Charter 9 (Com- moncing with Sectlon 7000) of Division 3 of the Business and Professions Code, and my Ilcen in fu for d„e1f t. License Class l► —Ito Li se �� Date S^ LO "' 8Z Signature r WORKERS' COMPENSATION OECLAF6TION OCCUPANCY CONSTRUCTION TYPE MICROFILM I hereby affirm that I have a certificate of consent to self -Insure or d certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE, S thereof (Section 3800, La ,). + GRADING CU. YDS. ACRES - TOTAL FEE 'POIICY No"VC�f--��—Company �r��iLN.L �Certified copy is hereby furnished. --• -� - - - - - - REMARKS: - L - - PANELS MAIN Certified copy is filed with the city Building Division. LESS AD - SERVICE EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be completed if the permit is for one hundred ►. T;AGL _ •S$100) or less)). I I-cert,fy that in the performance of the work for which this permit is Issued, 1 shall not employ any person in any manner so as to _become _ PLUMBING PLAN CHECK subject to the Workers' Compensation -Laws of California. BATHTUBS SHOWERS Dale Signature - NOTICE: If after making this declaration, you Should become Subject tothe Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed TOILETS + URINALS LAVATORIES DOUBLE LAYS DATE revoked.-- - - - - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS SINKS SUMPS I hereby affirm that there is a construction lending agency for the per - forof the work.for which this permit Is issued (Section 3097 mance FLOOR SINKS ? , +� ;FLOOR DRAINS Civ. C.). �� , - 1 Lender's -Name DRINKING FOUNTAINS Lender's Address INTERCEPTORS CLARIFIERS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the fallowing reason (Section 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 re- qulres the ap;.licant_for such permit to file a signed statement that he SWIMMING POOL P TRAP 1 WATER SERVICE ALTERATION t - GAS SERVICE OUTLETS 1s licensed pursuant to the provisions of the Contractor's License Law' (Chapter 9 (commencing with Section 7000), of Division 3 of the. WATER HEATERS BTU OUTPUT e Business and Professions Code) or that he Is exmpt therefrom and the hasls for the alleged _exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS iy applicant for a permit subjects the applicant to a civil penalty r not.more.than five hundred dollars ($500). SOLAR TANK COLLECTORS '1:]. 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. (Section 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or SOLAR PIPING SYS. ISSUE FEE through his 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑-I," as owner ofL the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- MECHANICAL PLAN CHECK HEATING SYSTEM 0.100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0.100,000 BTU tracts from such projects with a contractor(s) IlceSned pursuant to the Contractor's License Law).100,000 SYSTEM + BTU JElI am exempt under Section B. a P. C. for this - BOILERS BTU ea'sori Date - Owner- - - SYSTEM REPAIR, ALTERATION .EXHAUST SYSTEM MULTIPLE . I hereby certify that 1 -have read this application and -state that the above informs ' rrect. I agree to comply with all city and county ordin ccs and sta la reEating construction, and hereby.authorizo- repres ntatives of t city t enter � pon the above mentioned props - fo •ins pur s• -- Slgnatur Date Drivers' License or 55 V� ISSUE FEE -Assessor GMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod 61 1,5 5/20/B2 33.46 TU ZONING REGULATIONS A.P. + _ ONE ZBUILDI PLNTTOPEIG.. REF- 5PSET AC T. PRkTYNLINE SSI p YARD R11 G YARDT $ ' REAR YARD (TO P/L) = PERMIT PKG. SPACE REQ. PROVIDED - STREET WIDTH 4 PARK FEES .• ZONING APPROVED BY 1 UAI'L - 'SPECIAL CONDITIONS: PERMIT E .•-SMIP $ ' PLAN CHECK = PERMIT - ISSUANCE S ELECTRICAL PLAN CHECK $ So- FT. -• GENERATOR 0-1 KW TRANSFORMER APPLIANCE 10.50 KW,50 1-10 KW + KW " MOTORS 0-1 HP (INC: SOLAR) 10.50 HP_50.+ I-10 HP HP r FIXTURES OUTLETS SWITCHES MICROFILM GAS TUBE SIGNS PLAN CHECK S POLE LIGHTS - - TOTAL FEE POLES METERED SUB S PANELS MAIN SUB LESS AD - SERVICE AMP $ VANCE•PC T;AGL _ ISSUE FEE APPLICATION APPROVED BY - DATE FINAL FEE $z! �• SUMMARY OF FEES ' BUILDING PERMIT E .•-SMIP $ ' PLAN CHECK = PERMIT - ISSUANCE S PLUMBING $ GRADING S PLAN CHECK S ELECTRICAL $a -a.' MICROFILM $ PLAN CHECK S - TOTAL FEE $ MECHANICAL S LESS AD - PLAN CHECK $ VANCE•PC $ _ FINAL FEE $z! �• CONSTRUCTION AND PLANNING APPROVALS Permit # f- _' �O Date Inspector POOL & SPA APPROVALS Permit,# P% Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment 'Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. _Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee em orce 47. Rough Plumbing &'Pres'sure,Testy. 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE•3 ' �� • a' ~' ' ` + 7. Footings 49. ElectHcal Conduit-Undr rn B. _ Foundation 50. Gas.Pi e, ❑ Undr rn,,Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra - 0 Undrqr'n 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final _12.__ Street Sewer Connection f 54. Heater & Vent -Final 13. Rough Plumbing - 14. Rough Electric -Conduit •56..• Electrical -Final 15. -Roiugh'Electric-Wiring E c J 57. -Solar System:Final 16. Rough Heating & Air Conditioning _Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING ' 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20, Roof Framing - 21. Roof Sheathing NOTES;. 22. Frame and Flashing .23. Insulation ns Z 24. Lathing & Siding _ 25. Drywall Nailing 26. Plaster Brown Coat 27. "Electrical Power Meter -Final -� 28. Final Electric 29. Final Heating & Air Conditioning 3D. Final Gas Pipe -Test 31. Final Plumbing 32. _Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co.' ' - 42• CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY. OF COSTA MESA PERMIT NO. I TRACT NO. LOT NO. -BLDG NO. CONSTRUCTION PERMIT L1V1_11 { V V" 114. Owner PrnPhone Address Arch/Eng. Hajes—I angston License No. C 01022 Address 777 S.- Main 105 Orange, Ca. Contractor The 'J. Donald 01 son CO.Phone 540-260 Address 3151 -E Airway Ave: Costa Mesa LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of- the Business and Professions Code and my license Is in full force and effect. License Class A License No. 333969 - Date Signature _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section D,�Lra� b. Cr -1[ Policy No. -1 - - , ffi d �+mpany Fai,.rWO)lt 10Surance lfled copy is hereby furnished. Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if. the permit Is for one hundred S$100) or less), 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. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which_this permit Is issued (Section 3097. Civ' Lender's Western Pacific Financial Corp. Lentler's Name Lender's Address 1Sn1 nf1Vp Sirppta Newport Bch, OWNER BUILDER DECLARATION ' I hereby affirm that 1 am exempt from -the Contractor's License Law for the following reason (Section 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 re- quires the appllrant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the usiness and Professions Code) or that he IS exempt therefrom and the ��Sls for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). .-j 1, 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. (Section 7044, Business and Professions Code; The Contractor's License Law does not apply to an owner of -a property. who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intondcdor offered for sale. If, however, the building or Improvement is sold within one year of completlon, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively- contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts -from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason-' Date- 1. ate 1. hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city and County ordinances and state laws•relaIPXconstruction, and hereby authorize representativ is city nter u theabove mentioned property ct" _ it � Signature, Drivers' License or IS �p J: c.r I ::I '.'1 '] — 3 q 11 pc, I a TYPE OF CONSTRUCTION 1 ISI NEW ❑ ADD ❑ ALTERATION Play -Check # 51442 ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS DESCRIPTION OF WORK Commercial A'P' 9 — 5 Office Condominium ZONE GL PLNG.. RIE�F,,pgp -! TYPE OF PERMIT � j� 1:1GRADING -FOUNDATION 6 SETBACK OBk-F�RY' LINE W STRUCTURAL 1fp YARD r'O je ci 1:1❑ ❑ TENANT ELECTRICAL PLUMBING ❑ MECHANIC ❑ OTHER 1 . }MIGHT Ian1 REAR YARD (TO P/L) PROJECT DESCRIPTION PKG. SPACE REQ, ;2 15 PROVIDED 30 SQ. FT. STREET WIDTH PARK FEE $ OCCUPANC !01`CONSTRUCTtON TYPE 5 N- 248- ZONING APPROVED BY KG DATE a3_81 VALUATION$212 NE .q_ GRADING CU. YDS. ACRES ' SPECIAL CONDITIONS: ' dULD R SPECIAb'REQUIREMENTS REMARKS: - C -- 1 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP SERVICE SINKS SUMPS (INC. SOLAR) - • 10-50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING 725.50 14,86 HEATING SYSTEM_ 0-100,000 BTU PERMIT $ SMIP $ AND DUCTING 100',000.+ BTU PLAN CHECK $ PERMIT ISSUANCE $ REFRIGERATION 0-100,000 BTU PLUMBING $ SYSTEM GRADING $ 100,000 + BTU PLAN CHECK $ BOILERS BTU ELECTRICAL $ $ PLAN CHECK $ MICROFILM $ SYSTEM REPAIR, ALTERATION TOTAL FEE $ MECHANICAL 5 EXHAUST SYSTEM MULTIPLE:d LESS AD= PLAN CHECK $ VANCE PC $ _ ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor FINAL FEE s740. -16 CONSTRUCTION AND PLANNING APPROVALS Permit # - 611,1% Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2, SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4, . Electrical. Conduit- Undrgrn 46. Electrical Bonding 5. tee ein orce 47.� Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings Q I 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe•Undrgrn 51. Backwash Lines P -Trap,❑ Undrqrn 10, Structural Floor System 52. APPROVAL TO DECK 11, 'Property Sewer tirie3& House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit 56: Electrical -Final 15. Rough Electric-Wirin 57. Solar System -Final 16. Rough Heating _& Air Conditioning--SU-.Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof SheathingL ) S NOTES: 22. Frame and Flashin 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date 5 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAPE MIT NO. TRACT NO. - LOT NO. BL N9 CONSTRUCTION PERMIT A/% Project Address 5/ AUR 1<,A TYPE OF CONSTRUCTION J Owner J •, f W Phone 11 NEW El ADD 0 ALTERATION G. Address- p�� L."d _❑ REPAIR _❑CONVERSION El DEMOLISH L Arch/Eng. License N0. ❑ OTHER DESCRIPTION OF WORK Address OF PERMIT ' ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING XMECHAN ContractorPhone Address - LICENSED CONTRACTOR DECLARATION I hereby affirm that.I am licensed under provisions Of Charter 9 (com- ❑ mencing with section 7000) of Division 3 of the Business and OTHER 'Professions Co e, 'and my license is In full force and /PJ�tect. _ y r PROJECT DESCRIPTION License lass lc e 'r /�- - SQ -•FT: - Date Slgnature - KIT. SINKS DISHWASHERS ' WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure Or a VALUATION ZONE Compensation Insurance, or a certified copy " tcertificatef(Section 3800, Lab. C.) i- GRADING CU. YDS- ACRES r No. Company WATER SERVICE ALTERATION - REMARKS: L_ ertified copy is hereby furnished. EI Certified Copy is filed with the city Building Division. _ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be Completed If the permit Is for one hundred $100) or less)- ICertify that In the performance of the work for which this permit -is Issued, I shall not employ any person in any,�nesto become subject tt W rs Compensation fDate Slgnature2�7A _� - PLUMBING'' PLAN -CHECK BATHTUBS SHOWERS TOILETS URINALS NOTICE: it after making this declaration, you should ecome subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed . LAVATORIES DOUBLE LAVS '- revoked. _ CONSTRUCTION LENDING AGENCY - - KIT. SINKS DISHWASHERS ' SERVICE SINKS SUMPS ' I hereby affirm that there is a construction lending agency for the per- for mance of the. work for which this permit Is issued (Section 3097 SINKS FLOOR DRAINS Civ- C.I.FLOOR ,Lender.'s Name DRINKING FOUNTAINS - Lender's Address INTERCEPTORS CLARIFIERS - OWNER BUILOER-DECLARATION affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code-- the Any city or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its Issuance, also re- quires the ap, lirant for such permit to file a signed statement that he Is licensed'Dursuant to the provisions of the Contractor's License Law (Chapter •9 (commencing with Section 7000) of Division 3 of the ,siness and Professions'Code) or that he is exempt therefrom and the - is for the alleged exemption. Any violation of Section 7031.5 by SWIMMING POOL - P TRAP WATER SERVICE ALTERATION - GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS ' applicant for- a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ 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 _ SOLAR PIPING SYS. - or offered for sale.'(Section 7044, Business and Professions Code: The Contractor's License law does not apply to an owner of a property ISSUE FEE who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL - PLAN CHECK Intended or offered for sale. If, however, the building or improvement Is sold within one year of Completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTU AND DUCTING - 100,000 + BTU of proving he did not build or improve for the purpose of sale). ❑ I, -as owner of .the property, am exclusively- contracting with licensed contractors to construct the project (Section 7044; Business and Professions Code: The Contractor's License law does not apply to REFRIGERATION 0-100,000 BTU an owner of property who builds or improves thereon, and who con- tracts from such projects with.a contraCtor(s) licesned pursuant to. the Contractor's License Law). SYSTEM - 100,000 + BTU ❑ I am'exempt under Section B. & P. C. for this BOILERS -al" reason Date Owner - - SYSTEM REPAIR,ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and stale that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize /,9 5 representatives of this y t ter upon the above' mentioned property for ur //', —_y Slgnature ate l ISSUE FEE Drivers' License or SS CMF 0865-46 White-Bullding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ZONING REGULATIONS A.P. 9F E ZONE PLNBUILDING TTG.. REF. $ . 11 PROPEIRTYNL NE I SETBACK CIL ST. -- 'REAR YARD (TO P/L) PKG. SPACE REQ. ' PROVIDED STREET WIDTH PARK FEE S -ZONING APPROVED BY DATE SPECIAL CONDITIONS: s ELECTRICAL- - PLAN CHECK . GENERATOR-, ••-• 0-1 KW TRANSFORMER 1-10 KW APPLIANCE 10-50 KW -50 + KW a MOTORS • •, - 0-1 HP 1-10 HP (INC. SOLAR) , 10-50 HP 50 + HP " FIXTURES OUTLETS SWITCkLS':',!: GAS -TUBE SIGNS POLE LIGHTS POLES' "METERED' SUB - -PANELS - MAIN SUB _ -SERVICE AMP. ' -ISSUE FEE - 'APPLICATION APPROVED BY _ - -- • DATE - I SUMMARY OF FEES • BUILDING - - --• - ' PERMIT $ _ .SMIP 'PLAN CHECK $ PER_ ISSUANCE-MIS PLUMBING $ • GRADING , $ PLAN CHECK S - ,+ iELECTRICAL $ S ' PLAN CHECK S MICROFILM $ MECHANICAL SIF ".-"•-- TOTAL FEE $ /& �,f� PLAN CHECK, $� J LESS AD• - VANCE PC- $_—_" FINAL FEE S_ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPAS APPROVALS '. Permii # 4ate Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location " 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46.. Electrical Bonding_ Steel ein orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48.. APPROVAL TO COVER-GUNITE " 7, Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test -9. - Water Pipe-Undrgrn 51. Backwash Lines P-Trap.❑"ndr rn - - 10. Structural Floor System 52. _ APPROVAL TO DECK- 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection . 54: Heater & Vent-Final 13, Rough Plumbing 55.', elUmbing System - Final 14. Rough Electric-Conduit - " °56.- 'Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final -' 16. Rough Heating & Air"Conditioning �y513. Fencing &Access Approval 17. Ducts in Structure =, --W.-APPROVED FOR PLASTERING, " • 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL ' 19. Gas Pipe-Rough & Test' - - - - 20. Roof Framing - - 21' Roof Sheathing- - - NOTES: 22. Frame and Flashing - 23. nsulation Insulation- 24. 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. -Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning - - 30. Final Gas Pipe-Test - 31. Final Plumbing 32. Water Service-Final _ 33. Gas Service-Final ' 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation - --- - ` 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. ompleted Special Requirements Completed- 40. 40. Electric Release-to Edison, 41. Gas Release to Southern California'Gas Co. . ,42. CERTIFICATE OF OCCUPANCY \No f Date ' - - . _ L • Applirant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITI OF CESTA MESA, PE IT Nq_ TRACT IVO. LOT NO. BLDS;. N - CONSTRUCTION PERMIT t/c� Project Address �,��, TYPE OF CONSTRUCTION Y• ~ • 11.H7 I P/ 7 I / 82 " .._ 0 40 ' T OwnA.Lys, ;-a Phone L-IriEw ❑ ADD` ❑ ALTERATION - ��• Address�� e ST /(ilgu C1 REPAIR [:]CONVERSION ODEMOLISH { ZONING REGULATIONS, Arch/Eng. License No. ❑ OTHER . A P � + DESCRIPTION OF.WORK • Address ZONE - PLNG. REF. -t VIS HT REAR YARD (TO P/L') • ' -Contractor �r¢ i(ilC ,h r.� �r Phan L TYPE OF PERMIT Address Q1� �p ��p /SftiQ /ccro ❑GRADING - CyFOU1VDRTION ❑ STRUCTURAL 1 - LICENSED' CONTRACTOR DECLARATION 7 ❑ TENANT. LECTRICAL ❑PLUMBING ❑MECHANIC I hereby affirm that .I am licensed under provisions of Charter 9 (com- 7000) Division 3 the ❑ mencing with section of of Business and OTHER y Professions Code, ntl my license is In full force �tlt�t PROJECT DESCRIPTION Llcense Class Lice - Data � Signature �°-• - 'SQ. FT, _ � - • - _ WORKE S' OMPENSATION LARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a rtlflcate of consent to self -Insure or a VALUATION ZONE certificate of Workers' Compensation Insurance, or i copy _ _ %certified thereof (Se do 00, Lab. C.). GRADING CU. YDS. ACRES ! _ Policy No. Company °sy • 1. - r] Certified copy is.hereby furnished. _ REMARKS:. O �'°'Certified copy is filed with the city Building Division_ = `x.'1EMPTION FROM WORKERS' COMPENSATION DECLARATION r This section need -not be completed if thepermit is for one hundred _ _. ($100) or less . 1n 1 certify that the performance of the work for which this permlt is _ Issued, I shall not employ any person in any manner so as to become -PLUMBING PLAN CHECK subject to the Workers' Compensation Laws of California. BATHTUBS` " 'SHOWERS ' Date Signature - NOTICE: If after making this declaration, you Should become subject TOILETS - - URINALS - to the Workers' Compensation provisions of the Labor Code, you must VATORIES DOUBLE LAYS forthwith comply with such provisions or this permit shall be deemed ' revoked, CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS 1 1 hereby affirm that there I$ a Construction lending agency for the per- SERVICE SINKS SUMPS - -• formance of the work for which this permit 1$ I$sutd (Section 3097 Civ. C.)• FLOOR'SINKS - -'FLOOR DRAINS-" ' Lender,'s Name L'ender's Address DRINKING FOUNTAINS'" OWNER BUILDER DECLARATION INTERCEPTORS "' CLARIFIERS ' i hereby affirm that I am exempt from.the Contractor's License taw for r the following reason (Section 7031:5 Business and -professions Code: SWIMMING POOL P TRAP Any City or county which require$ a permit to construct, alter, • Improve, demolish or repair any structure, prior to itg issuance, also re- WATER SERVICE' ALTERATION' - quires the.applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GASSERVICE OUTLETS' BChapter 9 (Commencing with Section 7000) of Division 3 of the usiness and Professions Code) or that -he is exempt therefrom and the WATER HEATERS BTU;OUTPUT 't basi$ for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant t0 -a civil penalty- SEWER CONNECTIONS if not more than five hundred dollars ($500). 1 1, as owner of the' property; or mg employee$ with wages as their ' SOLAR TANK COLLECTORS ^� ' ,ole compensation, will dothework,, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The' SOLAR PIPING SYS. Contractor's- Licen$e Law does not apply to an owrier of a property who builds r improves thereon, and who does such work himself or -ISSUE FEE ' o through his own employees, provided that such, improvements are not J Intended or offered for sale. If, however, the bulldin or Improvement MECHANICAL PLAN CHECK - - i$ Sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). - Y - - - HEATING SYSTEM 0-100,000 BTU ❑L I,%as'owner- of --the property, am exclusively, contracting with AND DUCTING w•- licensed contractors to construct the project (Section 7044, Business 100,000 + BTU and Contractor's Code: The Contracto's License Law does not apply to an, owner Of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from such -projects wlthL a contractors) llcetned.pursuant to SYSTEM -T. - the Contractor's License Law),100,000!'BTU (� 1 am exempt'under'Section - B. & P• C: for this_ BOILERS BTU' reason - Date Owner SYSTEM REPAIR, ALTERATION I hereby certify that I have read this application and stete that the above EXHAUST SYSTEM MULTIPLE is correct. 1 -agree to Comply with all city and county dinances and state laws relating to construction, and hereby authorize LInformation presentatives of this ente- upon "the dbove mentionedoperty for _irlgpectio r $es. ��gnature nice. L�^� e Orivers' Cense or 55 ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor VIS HT REAR YARD (TO P/L') • ' " PKG. SPACE REQ: "` —PROVIDED - STREETWIDTF& - '" -;PARK-FEES-.. •_ - -ZONING APPROVED BY DATE - rt SPECIAL CONDITIONS: '-ELECTRICAL- '-' PLAN CHECK--- SQ- FT - GENERATOR 0.1 KW 1-10 KW' TRANSFORMER APPLIANCE— - 10.50-KW_50 +-KW MOTORS 2-' 0-1 HP =- 1.10 HP-- - = (INC. SOLAR) _ . 10.50 HP 50 + HP e FIXTURES OUTLETS• ITCHES •Q GAS TUBE SIGNS - • - - . POLE LIGHTS 'POLES METE ED SUB PANELS- MAIN- - SUB - SERVICE----- - -.. -AMP-' - - ISSUE FEE - • - _ _ APPLICATION APPROVED BY. DATE, 1 SUMMARY OF FEES BUILDING ---S PERMIT $_T _SMIP�• ^^•` - PLAN CHECK $ PERMIT -- ' ISSUANCE '_E'' PLUMBING $ 'GRADING S __ -PLAN CHECK-•$-�7-7 • •'- - � •' ,1 - ELECTRICAL' SQ " '" $ • MICRO3 .FILM 'PLAN CHECK E"- - TOTAL FEE'E MECHANICAL $ - - ' !LESS AD- _ PLAN CHECK 8 VANCE PC Ey'/— + FINAL FEE Ste' 4 CONSTRUCTION AND PLANNING APPROVALS Permit # Date {Inspector POOL & SPA APPROVALS• r PerrhR4 Date_-� Inspector 1._, Temporary_ Electrical Service or Pole 43. Poo! &Equipment Location Y - - - - ._ _ Pipe-n rgrn . Steel Reinforcement 3.- Electrical Conduit. Nlity-Undrgrn .. _ 45:' Forms - - - 4. - Electrical Conduit-Undrgrn . �_ - , . _ _ _46. Electrical .Bonding - - - ._ Steel. Reinforce' _.. - _ 47. Rou h Plumbin &Pressure Test y; "�� -A. . 6. -.Electrical.UFER,Grn._ - 48.. APPROVAL TO COVER -GUN ITE . 7. - . ootings .__ _ 49. Efectricaf.Conduit-Undr rn --8. Foundation—- - _'- _ . �.' 50. ,Gas Pi ❑Undr rn, Test - 9. - Water- Pipe•Undrgrn 51. Backwash Line P ca ❑ n r`rn' 10. -Structural Floor System_ r- a 52. - APPROVAL TO DECK 1.1.- Property Sewer-Line.&.House Connection _ _ _ _ _ 53-- Backwash & Receptor-Final ` 12. - Street Sewer Connection - ' _ ' - ' _ _'-- - --- - - 54: Healer &Vent Final 13. -Rough.Plumbing_ .._ _ - 14. Rough Electric Conduit - =56: Electrical-Final - 15. Rough Electric-Wiring z .-57.-- Solar System-Final 't-16.-. Rough•Heating &-Aie Conditioning = - _ --- - - - encing & Access Approval 17.+- Ducts-in Structure ., --,� ti- r .r= t- - _y--.._ APPROVED FOR PLASTERING . •., 18.i Ducts, Ventilating---- _60. _POOL/SPA.SYSTEMS FINAL 19. Gas Pipe-Rough.&'Test •- r- _ 20. Roof-Framing-- oof•Framing- 21., 21. Roof Shea-thin NOTES,422. , Frame and Flashin f 23: Insuiatioir'- 24.' Lathing- &•Siding 25. Drywall Nailing 26. Plaster Brown Coat - 27.'- Electrical Power-Meter-Final ` 28.r Final Electric---- lectric-----29.' -29? Final Heating & Air Conditioning- -- - - -- -' - r --- --- - - - - r 30. Final Gas-Pipe-Test 1 31.' -Final Plumbing , 32: Water Service-Final - - _ =- - •- ' - -_-- r . , 31--Gas-Service-Final- 3. -Gas•Service-Final-34. 34. Solar Domestic-Final 35: Landscape S rinklin System 36. Sound Attenuation 1 37. Handicap-Regulations 38. FINAL STRUCTURE &.BUILDING 1 39, Special Requirements Completed ► ' 40. Electric -Release to Edison 41. Gas Release to Southern California Gas Co. ' + 42. CERTIFICATE OF OCCUPANCY No` ,�� H�I - Date ... 2123 12/23/83 ZONING REGULATIONS- ..A.P. 59� ZONE PLNG. REF. = REAR YARD (TO P/ L) PKG. SPACE REQ, PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE ^ SPECIAL CONDITIONS: Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 'CITY- OF. COSTA.MESAPITS$ TRACT NO. LOT NO. BLDG. NO. - DIN L SO_ FT. CONSTRUCT_ ION PERMIT C �'✓ 8 TYPE OF CONSTRUCTION r ❑ NEW ❑ ADD ❑ ALTERATION ' ❑ REPAIR [I CONVERSION ❑DEMOLISH ❑OTHER DESCRIPTION OF WORK GENERATOR 0-1 KW- Project Address S' 14r `?J/ TRANSFORMER R Owners-p,�r��jC1 `Jj„r �- Phone - - -t' Address 4�l+° ,; 10-50 KW;50 Arch/Eng. License rfo. MOTORS - Address 1-10 HP' Contractor �jQ�FJ �,�? oc C Pho 04 )--TYPEC)FPERMI T ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL ❑TENANT ELECTRICAL ❑PLUMBING ❑MECHANICA 50+HP' Address ,,Z� de ty LICENSED CONTRACTOR DECLARATION SWITCHES I hereby affirm that I am licensed under provisions of Charter ,9•(com- mencing with section 7000) of Division 3 of the Business and' Professions Code a my license is In full fort feyt License Class �,Lice l J ❑ OTHER PROJECT OESCRIP.TION 'POLE LIGHTS Date Signature SQ. FT. POLES METERED WORK S' MPENSATION CLARATION .. ..00CUPANCY CONSTRUCTION TYPE SUB SERVICE- I hereby affirm that I have a dertificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE thereof (Sec' 3 b. C.). ' ,GRADING CU. YDS. ACRES Policy No. Company ARKS: Certlf' copy iS Hereby -furnished. - - - APPLICATION•APPROVED BY ertified copy is filed with the -city Building Division. -sz 74(This SUMMARY OF,FEES• EMPTION FROM WORKERS"COMPENSATION DECLARATION -- _ section need not be completed if the permit -is for one hundred$100) PERMIT _ $ f SMIP, '$ or less). I Certify that in the performancelof the work for which this permit is,issued, I shall not employ any person m any manner soas to becomeMBING subject to the Workers' Compensation .Laws of California.Date SignatureHTUBS ••PERMIT..- PLAN'CHECK F'K,T' - SHOWERSNOTICE: PLUMBING $ •, - URINALStothe - •' ' If after making this declaration, you should become subjectLETS- Workers' Compensation provisions of the Labor Code, you mustforthwith comply with such provisions or this permit Shall be deemedATORIES DOUBLE LAVS"'"revoked.CONSTRUCTION a. LENDING AGENCY SINKS' DISHWASHERS - SERVICE SINKS SUMPS'" I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS 77- ` CHECK $ Civ. C.). Lender's Name DRINKING FOUNTAINS -- ' �� •' -- - '- ' _ Lender's Address - '-INTERCEPTORS-' CLARIFIERS �-- ,TOTAL OWNER BUILDER DECLARATION "•` J I hereby affirm that I am exempt from the Contractor's License Law for 'SWIMMING POOL PTRAP _ LESSAD- PLAN CHECK.$ the following -reason (Section 7031.5 -Business and Professions Code: Any city or county which requires a permit to construct, alter, -improve; demollsh'or repair any structure, prior to Its issuance, also re= quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of -the Contractor's License -Law (Chapter 9 (commencing with Section 7000) of Division 3 of the 'Business'and Pro4esslons Code)'or that he Is exempt therefrom•and the basis for the alleged exemption. Any violation of Section 7031.5 by -WATER SERVICE ALTERATION -. _ -"GAS SERVICE _ OUTLETS - t WATER HEATERS"" - BTO OUTPUT - SEWER CONNECTIONS'"- ,if anyapplicantfor a permit subjects 'the applicant, to a, civil penalty- not more than five hundred dollars ($500). SOLAR TANK - ` ` COLLECTORS- �- 1, as owner 'of thi'property, or my employee$ With wages as their. ;ole compensation,.will do the work, and,the structure isnot intended- _. SOLAR PIPING SYS. or offered for sale. (Section 7044, Business and Professions Code: The -Contractor's. License .Law -does ,not. apply to an owner_of. a property, ISSUE FEE t who buildsor improves thereon, and who does such work himself or through-his.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 will have_the burden of proving he did not build or improve for the purpose of sale). -0 I,• as owner of the property, am exclusively contracting- with licensed contractors to construct the project (Section 7044, Business MECHANICAL PLAN CHECK _ HEATING SYSTEM 0-100,000 BTU -AND DUCTING' - - 100,000 + BTU - r 'and' Professions Code: The Contractor's License, Law does -not apply to - REFRIGERATION 0-100,000 BTU SYSTEM -- 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such projects with -a contractor(s) licesned -pursuant to the Contractor's License Law). .I I am exempt under Section B. & P. C. for this- BOILERS BTU -reason - '' •Date -- - Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read, this, application and state that the above information is correct. I agreto comply with all 'city and county ordinances and state laws relating to construction, and hereby authorize representatives of this' y enc upon the above mentioned property for i ectio ses. Signature 75f Drivers' cense'or S5 ISSUE FEE - -Assessor CMF 0865-46 White- ui mg; nary- pp scan Pink—Accounting; Goldenrod ... 2123 12/23/83 ZONING REGULATIONS- ..A.P. 59� ZONE PLNG. REF. = REAR YARD (TO P/ L) PKG. SPACE REQ, PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE ^ SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK DIN L SO_ FT. GENERATOR 0-1 KW- 1-10 KW - TRANSFORMER R - -t' APPLIANCE 10-50 KW;50 + KW' -- - MOTORS - 0-1 HP 1-10 HP' (INC.SOLAR) 10-50 HP 50+HP' FIXTURES -'- OUTLETS SWITCHES GAS TUSE'SIGNS- 'POLE LIGHTS POLES METERED SUB PANELS MAIN SUB SERVICE- MP - OG ISSUE FEE APPLICATION•APPROVED BY -^^ - - ---'- DATE - - •^ SUMMARY OF,FEES• BUILDING -- _ _ •-- _ PERMIT _ $ f SMIP, '$ PLAN CHECK_ S ••PERMIT..- - _ ISSUANCE -.'i PLUMBING $ - •' ' GRADING PLAN CHECK $' a. 5 — $ ELECTRICAL $ "PL -AN MICROFI[1v_f'-$" -' CHECK $ -' FEE.s.' MECHANICAL $ �-- ,TOTAL _ LESSAD- PLAN CHECK.$ - VANCE PC $� -' -. _ •, FINAL FEE $ v •�/� 16. Rough Heating & Air Conditioning Fencing & Access Approval CONSTRUCTION AND PLANNING ti Date Inspectoe APPROVALS Permit # POOL & SPA - Date Inspector APPROVALS Perthit #. •. 18. - Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 1. Temporary Electrical Service or Pole43. Pool &Equipment Location -..L (VI 21. Roof Sheathing_ NOTES: 2. SoilPipe-Undrgrn 44. Steel Reinforcement- einforcement 24. Lathing & Siding 3. Electrical Conduit Utility•Undrgrn 3. 45. Forms - 26. Plaster Brown Coat 4. - Electrical Conduit-Undrgrn 46. Electrical Bonding L� . 28.• -,Final Electric __ _. _ 5. Steel ein orce 47. Rough Plumbing &'Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER.GUNITE-' 7. Footings 49. Electrical Conduit-Undr rn B. Foundation _ 50. • Gas Pipe, ❑ Undr rn, Test - - 9. ..Water Pipe-Undrgrn 51. Backwash fines P -Trate ��E] tjtdrirn • 10. Structural Floor System - _ 52:. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit •56. ,Eleptrigi-Final 15. Rouqh Etectric-Wirinq - - 5 e 57: -Solar Sysfem-Fina{ 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts, in Structure . APPROVED FOR PLASTERING 18. - Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe=Rough & Test __ 20. Roof Framing 21. Roof Sheathing_ NOTES: 22.- Frame and Flashing _ 23. Insulation 24. Lathing & Siding 25. Drywall Nailing - 26. Plaster Brown Coat .._27. Electrical Power Meter -Final . 28.• -,Final Electric __ _. _ - 29. Fina! Heating & Air Conditioning 30. . Final Gas Pipe -Test • 31. Final Plumbing 32. 'Water Service -Final _ :33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 36. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed' 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42, CERTIFICATE OF OCCUPANCY No Date I-Ilkti Applicant to fill In all spaces within heavy border lines .`sign Ar!appropria ade (tions. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG: NO. ' CONSTRUCTION PERMIT' -- SG D • 153-- A"2 4►- _t Project Address 3161 11-1 " Ai rwa - Ave., C 'M . TYPE OF CONSTRUCTION r OwnBr EX r SS Phone 752-767 ❑ NEW ❑ ADD G ALTERATION Address ,D e Newport Beach ❑ REPAIR ❑ CONVERSION LJ DEMOLISH Arch/Eng. Tom Campos & 'Assoc.License'No. ' ❑ OTHER Tenant ImPLOYMeI'd Address 17779 "P Main Irvine • OESCRIPTION OF WORK Contractor J. Donald Olson Co. Phone 540-2605 TYPE OF PERMIT Address "E-1" Airwa Costa Mesa GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION TENANT ❑ ELECTRICAL ❑PLUMBING DMECHAN I hereby affirm that I am licensed under provisions of Charter 9 (com- ❑ mencing with section 7000) of Division 3 of the BusinaSS and Professions Code, and my license Is In full force and effect.969 R OTHER PROJECT DESCRIPTION License Class se N SO. FT. 1515 Date 111124,82 Signature WORKERS' COMPENSATION DECLX-R4FIOV OCCUPANCY - ON TRUCTION TYPELZ •1 hereby affirm that t have a certificate of Consent to self-nsure or a VALUATION ZONE certificate of Workers' Compensation - Insurance, Or a certifled copy $ ►sem. thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES Policy No. Company PERMIT s Certlfled copy Is hereby furnished, -REMARKS: G :ertifled copy Is filed with the city Building Division. PLUMBING -�EMPTION FROM WORKERS' COMPENSATION DECLARATION ^ 1z•- 11 -12 - (This ((Thls section -need not be completed If the permit Is for one hundred 6 - {$100) Or less].'" i( cert[[fy that n the performance of the work for which this permit Is' _ Issued 1 shall not employ any person any anner so as,to,become subject to e W k1 Compensation ws Ilfa i PLUMBING PLAN CHECK &r Date Signature BATHTUBS SHOWERS NOTICE: If ter making this declaration, Y should bec a subject Workers' Compensation Labor Code, TOILETS URINALS to the provisions of a you must forthwith comply with such provisions or this permit Shall be deemed _. LAVATORIES DOUBLE LAVS revoked. - - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS I hereby affirm that there Is a construction lending agency for the per- form nee of the work for which this permit Is Issued ( action 3097 SERVICE SINKS SUMPS Cl V. C.). NZA FLOOR SINKS FLOOR DRAINS Lender's Name Lender's Address DRINKING FOUNTAINS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP Any city or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to Its Issuance, also re- the for to file a signed statement that he WATER SERVICE ALTERATION quires applicant such permit Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS (Chapter 9 (commencing with Section 7000) of Dlvlslon 3 of the he Is therefrom the Business and Pro4essions Code) or that exempt and Section 7031.5 by WATER HEATERS BTU OUTPUT basis for the alleged exemption, .Any. violatlon of ,ny for subjects the applicant to a civil _ applicant a permit penalty not more than .five hundred dollars ($500). SEWER CONNECTIONS I, as owner of the property, or my employees with wages as their sole compensatlon, will do the work, and the structure is not Intended SOLAR TANK COLLECTORS or offered for sale. (Section'7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Lew does not apply to an owner of a.property who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own em loyees, provided that such Improvements are not Pf, Intended or offered for sale. however, the building or Improvement Is of completion, the owner will have the burden MECHANICAL PLAN CHECK sola withln One year of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU ❑ 1, as owner of the property, am exclusively contracting with the 7044, Business AND DUCTING - 100,000+ BTU licensed contractors to Construct project (Section and Professions Coda: The Contractor's License Law does not apply t0 an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from such projects wlth--a contractor(s) Ilcesned pursuant to SYSTEM ' the Contractor's License Law). 100,000 + STU ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason SYSTEM REPAIR, ALTERATION Date Owner I hereby certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE Information is correct. i agree to comply with all city antl county and st laws relating to and hereby authorize ordinances construction representatives this city to to upon the above mentioned property for act ur o 1'1�12�82 Signature ateL:� ISSUE FEE soor Drivers' Licensr SS CMF 0865-46 White-Buliding; Canary-Appticant; P1nk-Accounting; Goldenrod -Assessor A.P. 01 ZONE 1170 12/01/B2 . 4, . . , - NG REGULATIONS PLNG.. gREF! p-0 ROP RTY ,J REAR YARD -(TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE -$ ELECTRICAL PLAN CHECK GENERATOR 0-1 KW 1-10 KW — .TRANSFORM ER MAIN SUB APPLIANCE 10.50 KW -50 + KW — MOTORS 0.1 HP - 1-10 HP (INC. SOLAR) 10.50 HP: --50 + HP _ FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS ISSUE FEE POLE LIGHTS- APPLICATION APPROVED BY DATE FINAL FEE $ METERED SUB PANELS MAIN SUB SERVICE- AMP ISSUE FEE APPLICATION APPROVED BY DATE SUMMARY OF FEES BUILDING PERMIT $ ►sem. SMIP S PLAN CHECK s PERMIT s ISSUANCE S PLUMBING $ r GRADING- S lir PLAN CHECK ELECTRICAL $ $ PLAN CHECK $' MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK $ LESS AD- ' VANCE PC $ FINAL FEE $ !1 CONSTRUCTION AND PLANNING APPROVALS Permit #Date Inspector POOL & SP -A• - APPROVALS - Permit # Date Inspector. 1. Temporary Electrical Service or Pole 43 Pool & Equipment Location . SoilPipe-Undrgrn 1 44. Steel Reinforcement - 3. Electrical Cond+rit{ tihty: Undrgrn _. _ 45. Forms 4. Electrical Conduit-Undrgrn - _ _ 46. Electrical Bonding Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER.Grn 48.' APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation _ ' 7R 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn - 10. Structural Floor System 52. ' APPROVAL TO DECK Property Sewer'-[Jrie &-House'Connection 53 \E3 kwash & Receptor-Final- ece tor-Final•12. 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit f •56. 'Electrical -Final 15. Rough Electric Wiring - - 57. Solar System -Final ` 16. -Rough Heating•& Air Conditioning Fencing &Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 2� S 23. Insulation IT 24. Lathing & Siding 25, Drywall Nailing 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33.' Gas Service=Fina I 34. Solar Domestic -Final 35.'landscape S rinklin `S stem'_ 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 3 ' 39•. Special Requirements Completed -40.-- ' Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42.' CERTIFICATE OF OCCUPANCY No _` Date - r, Applicant to fill in all spaces within heavy border lines and slg%kil apP—Priate declarations. CITY OF G(osTA %*iESA - P R tl�QNO. TRACT NO: LOT NO. BLDG. NO.,��` CONSTRUCTION PERMIT' TYPE OF CONSTRUCTION ❑ NEW '❑ ADD ' ❑ ALTERATION ❑ REPAIR ❑ CONVERSION -E1 DEMOLISH* - Ou 50ry{ ' u Project Address .9 7" stJ /Ji Owner ZtJ22Eadk, 55-Phcin.6-,/4j Address y` 4c/ _� OTHER k ZONING REGULATIONS"." l Arch/Eng. - License No. DESCRIPTION OF WORK OF PERMIT- ❑ GRADING -❑ FOUNDATION ❑ STRUCTURAL- ❑ TENANT ❑ ELECTRICAL LUMBING ❑MECHANICA A.P. j ZONE PLNG. REF. BUILDING PR BUILDING ' SETBACK G LST, OPERTY LINE ' .SIDE YARD - LWIDFE YAR Address Contractor ' ' L! C PhiineqeKey7aTYPE Address - LICENSED CONTRACTOR DECLAMATION I hereby affirm thLt I am-Ilcensed under of Charter 9 (com- provisions 'mencing with section 7000) of Division 3 of -the Business and 'k: 0 OTHER. RIGHT Professions Code, ntl license Is in full force and effect. REAR YARD (TO P/L) /111LLL r� PROJECT DESCRIPTION License Gass ` Lice a _ PKG. SPACE REQ, 'PROVIDED, Date/A-6-TZ, E`� Signature , ` _. \ SQ. FT. ' _ , STREET WIDTH . PARK FEE WORKERS' COMPENSATION DECLA ION OCCUPANCY CONSTRUCTION TYPE ,$ 1 -hereby' -affirm that i have a certifies of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY 1 DATE certificate of Workers' Compensation Insurance, or a certified copy -GRADING CU. YDS. ACRES' SPECIAL CONDITIONS: thereof (Se ti 0 b. � �%�Mi✓- Policy,No, C�7pany$�/sr. r ':ertified copy Is hereby furnished. REMARKS: 76 _ ertified copy is filed with the city Building Division. - - -dMPTIO,N FROM WORKERS' COMPENSATION DECLARATION -� I (This section need not be completed if the permit is for one hundred •- - "` - (($100) or less), - T > (_certify that In the performance of the work for which this permit is issued, 1 shall not employ any'person in any manner so as to become'FKIT.SINKS- BING - PLAN CHECK - ELECTRICAL PLAN,CHECK to the Workers' Compensation Laws of California, _ _ TUBS SHOWERS _subject Dale Signature NOTICE: If after making this declaration, you should become subjectETS , �r URINALS GENERATOR 0-1 KW 1-10 KW -to the Workers' Compensation proviSions of the Labor Code, -You must TRANSFORMER forthwith comply with Such provisions or this permit shall be deemedATORIES DOUBLE LAVS' "- - - .APPLIANCE 10-50 KW;„50 + KW - revoked,,,. DISHWASHERS •- MOTORS - 0-1 HP 1-10 HP - _ _ _ CONSTRUCTION LENDING AGENCY .. I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS - SUMPS - •(INC. 50 LA R) - 10-50 HP 50 + HP •'- - '-- formance of the work for which this permit is issued (Section 3097 - - FLOOR SINKS "'•'FLOOR DRAINS - '- ,FIXTURES "OUTLETS' SWITCHES 'Civ. C-): •- - - - ; .Lender's Name DRINKING FOUNTAINSrD _ GAS TUBE SIGNS - Lender'S,Address - GLARIFlERS - '•POLE LIGHTS - •- - ' OWNER BUILDER DECLARATIONINTERCEPTORS I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section -7031.5 -Business and -Professions Coder SWIMMING POOL P TRAP ^ POLES METERED r - SUB Any city' or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to its issuance, also re- 'ap;'licant'for WATER SERVICE ALTERATION 'PANELS MAIN SUB quires the such permit to file a Signed statement that he - GAS SERVICE- -OUTLETS ' ' SERVICE AMP is Iicensed•pursuant to the -.provisions of the Contractor's- License Law 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT v BChapter usiness and ProfesSions Code) or that he is exempt therefrom and the basis for the'alleged exemption. Any violation of Section 7031.5 by -_ SEWER'CONNECTIONS - -• •- - -- any applicant for -a -permit- subjects the applicant -to -a civil penalty not more than five hundred dollars ($500), - - - - SOLAR TANK COLLECTORS 'I;.aS owner of'the property, or my employees with wages as their- _ole compensation, will do the work, and the structure is not intended _ SOLAR PIPING SYS. "ISSUE FEE - • or offered for sale., (Section 7044, Business and Professions Code: The License Law does not apply to an owner of a property - ISSUE FEE - ` APPLICATION APPROVED BY < DATE' .Contractor's who builds or improves thereon, and who does such work himself or •through his own employees,, provided that such improvements are not MECHANICAL PLAN CHECK SUN[MARY OF:FEES ' ,intended or offered for Sale. If, however, the -building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose" of sale)'. E) - - HEATING SYSTEM. 0 100,000 BTU BUILDING ..PERMIT - � $ • SMIP�' •' -I, -I, as owner of the property, am exclusively contracting with AND DU _ _ _ - - licensed contractors to construct the project (Section 7044, Business 100,000 +BTU 'PLAN CHECK $ PERMIT and Professions Code:. The Contractor's License Law does not apply to ISSUANCE .$` an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU .'PLUMBING $ - tracts from.such projects with a contractor(s) licesned pursuant to SYSTEM - - - -- - GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK S ❑ I am exempt under Section B. &.P. C. for'this m 4$ $ BOILERS BTU ELECTRICAL reason--- - -- - -PLAN CHECK= $ MICROFILMS$ _ Date. Owner SYSTEM REPAIR,ALTERAT,ION ' TOTALFEE I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE .MECHANICAL, $ - LESS AD - information is correct. I agree 'to comply with- all 'city an county `PLAN CHECK $- - VANCE PC $ ordinances and state laws relating to construction, and hereby authorize t representatives of this 'ci -,enter upon the above mentioned property f inspecti n' r e ? - _ /Z E'` z FINAL FEE $ Signature oto Drivers' License 5 ISSUE FEE - -• --. �--- T1 CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN APPROVALS Permit #�?�f Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn Z 44. Steel Reinforcement J. Electrical Conduit Utility-Undrgrn 45. Forms - 4. Electrical Conduit-Undrgrn 46. Electrical Bonding_ ' - 5. Steel Reinforce 47. Rough Pluinbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn; Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ nd" r'n -10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line.& House Connection 53. Backwash & Receptor -Final -•12. Street Sewer Connection _ 54. Heater & Vent -Final 13. Rough Plumbing `'!- " 14. Rough Electric -Conduit 156. --Electrical-Final-- 15. Rough Electric -Wiring 57. Solar System -Final 16: Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts in Structure • APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. P00 L/SPA SYSTEMS F INAL 19. Gas Pipe -Rough '& Test - - - 20. Roof Framing 21. Roof Sheathing- - - _NOTES_ 22. Frame and Flashing ' - 23. Insulation - - 24. Lathing & Siding - - 25. Drywall Nailing Al2ySAA9 26. Plaster Brown Coat 27. - . Electrical Power Meter -Final - - 28. Final Electric - - - 29. Final'Heating & Air Conditioning - - - 30. --Final Gas Pipe -Test 31. Final Plumbing -32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Serinkling System 36. Sound Attenuation _ 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 1 42. CERTIFICATE OF OCCUPANCY - - No Date - - ' Applicant to fill In all spaces except those within heavy border lines and sign All appropriate declarations. CITY OF COSTA MESA 0 I NO + TRACT NO. LOT NO. L i I I , CONSTRUCTION PERMIT - . . . ' - , , . Q . ' - �. Applicant's Mailing Address - FPE. OF CONSTRUCTION NEW - ADO ALTERATION REPAIR s � - CONVERSION ❑ DEMOLISH ❑ OTHERPro}act Address Name S Ona- SCRIPTION OF WORKOwner'! ) Address. - Arch/Eng, License No. TYPE OF PERMIT ,GRADING FOUNDATION STRUCTURAL .❑ .PLUMBING ❑•MECHANICAL A. P. �' - ZONE ,CT�3T TENANT ELECTRICAL PLNG. REF. qt�� ti -BUILDING I t ) Address. ❑,OTHER TO BUILDING Contractor's Nam '' � hone '-'SY4 ��• ' PROJECT DESCRIPTION. SQ. FT. ' ' OCCUPANCY PE Y INE REAR YARD (TO P/L) ^�I 3/SL= /ffRt.)A_N �/ �' ,,�y}} Address'(meiling} -- r.L'�A lJf�� 'CONSTRUCTION TYP VALUATION $ - LEFT SIDE YARD RIGHT SIDE YARD Licenw No. ' J ZONjE i ry GRADINGCU.YDS: s ACRES r PKG.SPACE'REd. . PROVIDED LICENSED CONTRACTOR DECLARATION t < ! Remarks: L i "STREET WIDTH I _ PARK FEE $ -� I hereby affirm that l am licensed under provisions Df,Charter,9 (commencing I + r with section 7000) of Division X oT the Business and Professions Code, antl # .- + ! SPECIAL CONDITIONS: my license Is In full } ce antl effect, , i ! ` r , ' PLUMBING License Cl ss 1 ense a. [ Date Signature g 1 Bar Sink v Sewer Cap ! ) � ! ELECTRICAL WORKERS' COMPENSATION DEGLAAATION I,hereby affirm that I have a certificate.of,consent,to,self insure or a certificate._]_ I _ gal kflow Preirentar -' { -Sewer Connection - i~ -. - �-- Automatic Washer '._� : Meter over 100.emps _ Workers' Compensation Insurance,;or a ternfled,•Copy thereof (Section 00, Lab, C,) ! l + ' frA - f. • I Backflow Irrigation I - Saler Collectors I f ' I Construction Pole'' Sub Panel• i I r e}.�licy No. ' Company I i ' ' Certifled copy is hereby furnished. t r } 1 ! ! Bathtubs 1 ! , Solar Piping i Cooking Unit !Sub Pole Certified copy is filed with the city Building Divlslon, ! I ! t I , , ; Clarifiers ! Solar Tank , Dishwasher "• t Motors ❑0-1 HP 011 Y,$ r Date _ t APPltcant I + EXEMPTION -FROM WORKERS' COMPENSATION DECLARATION �I _ be If Is for I . � i I `Dryers'❑Cosi 1]Electric "'+ ' I 'Inc.501ar ❑9-15 FIP ❑16-15+ r Dishwasher ; f swimming Pool w/Spa • Y (Thissection need not completed the permit one hundred ($100) or less),. ) 1 , I certify,that in the performance of the work for which this permit is issued 1 ( 1 Drinking Fountains Urinal i r Fan ( ; r Microwave ! , r shall not employ any person In any manner so'as to ,become subject, to the ,, F.A,iI. :Polo Li ht j g 4 Workers'; Compensation, Laws of California. = Floor Drains ; ; yYater Closet'_ j + : r Date- ' signature (-NOTICE: If, after makln this dectaratfon, ou shoWQ become Subject to the • ' 9 Y 3 Floor Sinks •. • - ` -- �. Water Heater.. _ _ �_- • , ?�__ Fixtures r Workers' Compensation provislons.of the Labor" Code, you most forthwith comply with such ,provisions or ,this, permit shall be 'deemed; revoked. , _T" _ ;. ' I �; Gas Sarvica', .r Outlets r • ' Water• Service _ r ( -j , Device Boxes a ! , Si n; ! ' '. $ i CONSTRUCTION I LENDING AGENCY I hereby affirm that there Is a- const ructIon, lendIng agency for the' erformarice, p j the for which this. As •issued 3097,' CIV: i It ' r ,. interceptors , I -, , ,, _ I Outlets I r r ; ( 'Stantling Sections r I ;i . , ,� of work permit (Section C.} • • E + Lender's Name � KitchenSinkj r t 1 ; •< � Switches i Trash Com actor f P 1 Lender's Address I �• t _ 1' ) ' = _ _ Garbage Disposal I ' L"avatories,-: `' i { OWNER BUILOER DECLARATION ? + I hereby, affirm that t am exempt from tha'Contraclar's'_LFcanse Law for the fpllowing Professlonal . , �. , Generator. ❑0-5 KW ❑5.15 KW + p-Tra :,; P. ' reason (Section -7031.5 Business and Code: Any city or county which requires a permit to construct, alter Improve, demolish or repalr any structure, prior to its issuance, also requires the applicant for such permit. , Transformer 015.50 KW r I I Raof,Drains , ' - ) •�" to file a signed statement, that he/she Is licensed pursuant to the•PrpVlslons of = the Contractor's. License Law (Chapter 9 (commencing with Section 7000) of _ "' _ • '- ` - { - ," Reinspectlon•Fee $15 ❑51)+ KW' r , + 'Reinipeetion Fee ! $15 t Division +3• -of the Business and. Professions Coda) -or' that. he//she Is. exempt therefrom and the basis for the alleged exemption. Any violation of,Section Showers ,: l ; �' r Meter ❑up to 100 amps', + $ 7031,5 by any applicant for. a. permit subjects 'the L applicant to a-civili lenalty of not more than five hundred dollars ($500). ; . ,- �' : Service Sink' I Issue Fee ' ' , } $ S Issue Fee' 3 Zoning Approved By r ; Date ❑ I, as;own;r of; thelproperly or my employees with wages'as their sole — L f r compensation will'do the work, and,the structure' Is not intended or offered I Professional ! 7 _ "_ I r., MECHANICAL' ! + i 1 Application Approved By 1 , D t at@ + for sale •(Secflon 7044; Business. and Code:: The r Contractor's License law does not apply town owner of a property.who builds or Improves Boiler I # # { Refrigeration System I_: Application Issued $y ! _ Date "`— ' (?3— ` thereon, land who does:such work himself/herself or through his or her own ! employees, providod that such4mDrovements are not Intended or offered for = r" t ❑0.100,000 BTU ❑ 100,000 BTU - ti Duct'- UnderjGround sale. If however, the building or Improvement Is sold within one yaar.•Of com- I platlet,, the owner will have the burden of proving he/she did not build or Im- j l ; SUMMARY 1 i OF FEES I ( t ! ! 1 rove for,the purpose of. sale)'. t t t is , Duct - Structural L t ( System flepalr/Alteration > e r , s r BUILDING PERMIT $ I SMTP I 1, owner of the property, am exclusively contracting1with, licensed ccon- tract_orsto construct the'project Section 7044, Business and Profasslons Code-' apply _ I Duct - Ventilating l - . T tPLAN CHECK; s $' r PERMIT t The Contractor's Lli:ense Law does not to an owner of property who i builds or. Improves thereon, and who contracts for such projects with a con- Exhaust ❑ Multiple ❑I ! ! �-r PLUMBING i $ ; ISSUANCE $ t System s ToZ—; i tractor(s) license pursuant to the Contractor's License Law), } ❑ I'am exempt under Section B. 6 P. C. for this reason Firepl/Fact, Bit, ICBO c + PLAN CHECK $' # GRADING $ , ' , :ELECTRICAL 1 $ ; + r $ MICROFILM $ 1 Heating'System & Ducting r j I r i ' i ' Date ' t Owner :-L-hereby+certify•that I have read this-applicatlon and•state•that the above �• - DO-t00,00OFBTU0100,000 _ { y' r_-� f ;PLAN CHECK' $ ' r r b Information is correct. I agree to comply wlth all city, and county ordinances , and state taws relating to building construction, and hereby authorize repro i + sentatives oT'th city• to enter -upon the above mentioned pr party/ for i I : Hood or Type I ❑ i ! ( ! + Reinspection Fee•, $15 j MECHANICAL $ + I + ? r TO. FEE, $ r i ' Inspection pure es, 1 j t D to //1/�{rT ono T a II ❑. f = I ' ]PLAN CHECKS $I I , ADVA{4CED PC {' $ t r i Signature c i s prlvers' License or'SS _ I Registers i } r Issue Fee I I l t , $ 3 i. r F a + FINAL FEE i $ CMF 0865-4( rev. 12/82 - White - Bullding; Canary - APPEicarlt; Pink - Accounting; Goldenrod - Assessor ra C) ",CONSTRUCTION AND-PL'ANNING `} �- ¢ , rr..r _ t7 - n _FOOL_&,rA -- - - �• : .� _ ... - - - - ,1 > _APPROVALS ' Permit# ri _ x �`Date� �Inspector _ _ APPROVALS Permits# Date Inspector. I ti ra �• n c +S •. ••1 I c � _ . }Temporary Electrical Service or�Pole , p - �'• ; c ? - ; ;52:' 'Pool &'Equipment Location _ v2. i a -Undo rnd:. - _, ``' ' o Soil PP 9 - � � - k ` � � � 53` - f Steel'Rein orcement !- �. , _ 3. Electrical Conduit Utility.Undrgrnri} + bt = 54� Forms i a C• , . 4, Electrical Conduit-Undrgrnd.' y =' L : = 55. Electrical: Bonding F 5: Steel'Reinforcement,Rough Plumbing &Pressure Test j +Electrical LIFER Grnd. =� i �'';" o 57•_ APPROVAL•TO COVER-GUNITE. `8• 7. Footings ' ; "y ¢' ° a 1 58. Electrical Conduit Undrornrl.. 1 f S. Fqundatiori t 5 : - c `59. Gas Pipe, (]'Undrgrnd., Test , C 9. Watet Pipe-Undrgrnd. 60. Backwash Lines, -Trap, C'Undrgrnd.' 10. Struotyral h6or System 1PropertV .61. APPROVAL TO DECK 11. Sewer Line &(House Conndction_ i I 1 I i a r 62. Backwash &Receptor Final _ n 12. Cap o 63. Heater & Vent•Finai, �SeMre{ 13. IR Drains t i l; c I' ti I a 64. Plumbing -System - Final 14. Plurimbin Rough ` g g • ' � - - 65. Electrical -Final ` =15: Rough Electrical -Conduit', -7- - r-� X66.` Solar System Final =Rough•, Electric Wiring, ., I �` ^�, • .-� :�fc - -'," ;'r ;67: Eencirig &Access Approval'' , I _ Rougs�Wiring :Sign' i 1, I �- f ` 1 68.' APPROVED FOR PLASTERING = i I _ 1$. Rough Electrical 7'Bar Ceiling 69: POOLISPA SYSTEMS FINAL 19.,R66'gl 'Heating & Air Conditioning k e + i FIRE DEPT..REGUIREM>ENT t APPROVALS ° Permit # 20.�;'Rough�Fa'ctory Fireplace i� ' I a r ! ' 21. ;Ducts, in Structure*, 70: Underground Hydro ;u22" (Ducts, Ventilating ,_ = T �€ ` 71. Product Piping 0 Gas 0 Oil }23. Gas -Rough & Test ' �� {' T-1 1721 Underground Flush, - 1, 24.'Roof Framing 173: Undergrnd.StorageTank 13 Gas 0 Oil 25. Roof Sheathing i „! +1 I 74:, Overhead Hydro -26. T -Bar Ceiling (Structura1) & ll+on000at' s, " , '75. Dry Chemical 27. ,Frame and Flashing ; ! �; i 76.1 Dry Standpipe , 28.I,L,athing & Siding' ' ' I + , 4 �; # 177> FIXED SYSTEM. FINAL. r 29.';lh,sulation , j ', ; 1 t j 78: FIRE PREV. FINAL T'30. 'Drywall Nailing t + !; i Notes I` ' I ^31. Plaster Brown Coat , i_ 1 I 32.'Electrical Power Meter•Final 33.;Final Electric 1 34. Final Heating*& Air Conditioning I I r 35. Final Gas Pipe -Test I L ': j It c t i �•: r - ' ` I . ±. 36. Hood or"Canopy 37. Final Factory Fireplaces ' �J; i� ' ! fl 7 38. Final Plumbing' 1 1 39. Water;Sei vice -Final 1 I I 1 i 1 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer i ! Ont 43. Backflovv, Irrigation 44. Landscape Irrigation j l!n, J � ' L r , ;,- .System , 1 45. Soun&.Attenuation 46. Handicap Regulations' 47. FINAL STRUCTURE & BUILDING ' - 1 48. Special Requirements Completed 49, Electric Release;to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY !I ! = ' T --�- No u f, Date 11 f t- ' Y _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. STA MESA j VCOTiRUCTION PERMIT N0._ P—i16 TRACT NO. LO7 NO.I - PERMIT. k - r. I : �:�i Be }d •:5/1'7%83.` 1: 24X11 ;TL Applicant's Mailing Address1 Ltc NAL sarP TYPE'OFCONSTRUCTION: NEW AD'o ALTER_ProjeCtAddress S r1CL� ❑CONVERSION❑ DEMOLISH ❑ OTHER11} u'c G- i Name X " ° honee l DESCRIPTION OFWORK ,lt!a%%;/ i✓C/TeLC- '[1 vqOwner's AddressTypEOFPERMIT GRADING�i'FOUNDATION I L O STA. P:t 20NEArchlEng. r License NO. TENANT ❑ELECTRICAL PLUMBING ❑;MECHpLNG F BUILDINGAddress REF ,, r❑'OTHER Contractor's Nam hone ".3 / - PRWECT DESCRIPTION SQ. FT, OCCLEFT 70 BUILDINGREAR LINE YARD (TO P/L) - r� Address.(malling)LX}�/�� c[-r -�- CONSTRUCTIONTYP VALUATIONZONJ~ 510E YARD RIGHT SFDE YARD License No. _ GRADING CU.VDS. PKG. SPACE REQ. PROVIDED LICENSED CONTRACTOR DECLARATION Remark-1 7' CC;c STREET WIDTH PARK FEE $ I hereby affirm that I! am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and SPECIAL CONDITIONS: my license Is in full force and,effW. License Class 1 Lic se No.;7 �1 MZ ' PLUMBING . date SSL:-1 - Signature _ CAIA•t 1 e_- —. .' .. Bar Sink I Sewer Cap ELECTRICAL )RKERS' COMPENSATION D p! .A .areby affirm.that I have a certificate of consent to sell-Insure or a certificate-, 'Workers' Automatic Washer Meter El over, 100 amps _ Backflow Preventer -• - ;. - Sewer Connection of Compensation Insurance„ or a certified copy thereof (Section • 3800, C.) Construction Pole Sub Panel, Lab. Backflow Irrigation Solar Collectors + - POiicy No. Company Certified copy is hereby furnished. .' f Bathtubs Solar Piping Cooking Unit Sub Pole ; Certified copy Is filed with the city Building Division. 1,•, { Clarifiers Solar Tank Dishwasher Motors E10-1 HP ©i%$ pate Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Drysrs ❑Gas ❑Electric Inc.Solar. 9-15 HP ❑1615+ ❑ Dishwasher I Swimming Pool w/Spa (This section need not be completed If the permit Is for one hundred (3100) or-,' less). +. �' Fart I certify that in the performance of the work for which this permit Is issued' I / Drinking Fountains ! , Urinal 1 i Microwave shall, not employ•any person In an manger so to bec me subject. to the ,' any 5� i" Corr�ens4tlon Laws Callfornl 4 / //- Floor - F.A.U. r I "Pole Light 1 i Workers'- of '` Drains Water Closet - Date L_ I Signature/.�[� NOTICE: if,-after-making this declaration, ou should' become subject to the �: - f' FIOOr Sinks - -Water_ Heater;- - I c _ . Fixtures .,.. -Range 4-- Workers'. Compensation provisions of the Labor Code, you must forthwith. • ' comply with, such provisions_ =or this ,permit tshall be 'deemed revoked.. - Gas Service ;Outtets . - Water Service Device Boxes Sign J CONSTRUCTION, LENDING AGENCY t i Outlets I hereby affirm that there Is a construction -lending agericyefor the'performance+ I Interceptors _ t^ ) i, 1 „ 3 ' y )Standing Sections of the work for' which- th3 rmit is •Issued -(Section 3097, Civ. C;' ' _s " Switches:' _ Lender's Name- tie - Kitchen Sirik r ,. /^ i ; Trash Compactor t G m actA p Lender's Address " I T 1 OWNEWBUILDER DECLARATION' - _ - r r�= Lavatories, „ , `' r I r, ' Garbage'Disposal i I I hereby;aff0n that f am exempt: from the'Contractor's.Llcense Law for the i' Generator 00 KW ❑5-15 KW following reason:(Section 7031.5 Business antl Professional Code: Any city or r j P-Tr8p' - _ s .. j ,• } 3 county which requires a permit to construct, alter Improve, demollsh'or'repair any structure; prior to its Issuance,'also requires the applicant for such permit Roof Dfains' }' r '• 'S - ' f Transformer Eli 5 50 KW j i 1 '� file a signed statementthdt he/she 15 11Cen5ed pursuant to theprovislons of Contractor's'Llcensa L�w;(Chapter 9 (tommencing'with Section.7000) of _ I t` I. 1 { ❑5t)f KW3 :Reinspection Fee , $15 vision .3 of the 'Business' and Professlonsl Cada) or that, he//she' Is' exempt ereirom and the:basls for the alleged exemptionrAny vlolatfon of Section Showers '• _ •" ". ` r Reinspection,FGo Meter Cup to 100 { 7031:5 by any applicant for;.a!permit supJects the applicant to a'civil Service Sink l i - Fee $ 3' amps - .. Issue Fee" $ 3 w enalty of not more than five hundred dollars (x500). r. i � _ f i ( Issue Zoning Approved By f Date y 1 I,•as owner of;theiproperty or my employees. with wages',as their sole compensatlon' willldo the work; and the.structure.is not intended or offered i for sale (Sec Ion 7044; Business and Professional Code: The, Contractor's ; r , 1 4 MECHANICAL Application Approved By Date , License Law does not apply to'an owner of a property who builds or Improves } thereon,,and ,who doesisuch work hlmseif/herself or through his or her own Boiler '' ` '�' Refrigeration System Application Issued By - !bate i employees, provided that such -improvements are,not Intended or offered for j safe. If, however, the bulldin or improvement is sold within one'year of com- Oucf =Under Ground ❑0-100,000 BTU ❑ 100,000 BTU i —" - --r--^ - go, SUMMARY OF FEES l I p'a"0n, the owner will have he burden of proving he/she did not build or !m- rove for the purpose Of sale), J ` Duct -Structural System Repair/Alteration BUILDING PERMIT $ ) SMIP $ as owner of the property, am exclusively contracting �wlth'licensad con- _tractorsto construct the project,(Section 7044, Business and Professlons.Code: _ Duct - Ventilating-- '_ ._ ' __�_ . - PLAN CHECK $ F PERMIT The Contractor's L'Icense Law as not apply to an owner Ot property who builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ l pp PLUMBING $� ISSUANCE $ tractor(sy license pursuant to the Contractor's License Law); ❑ I am exempt under Section B, b P. C. for this reason ' Firepl/Fact, Bit. ICBO # PLAN CHECK $ ,D o GRADING $ { I ELECTRICAL $ $ t t Heating ;System & Ducting F _ Date Owner, ' I - hereby••certify that -1' have••read this application and -state that the above - ❑0=100,006;BTU ❑100,000BT `,--- - - -{ PLAN CHECK $ MICROFILM $ r Information is correct. I agree to comply with all city and County ordinances � MECHANICAL $ t TOTAL FEE: $ andrstate laws relating -to fuillging construction,'and hereby authorize repre- sentatives of his 'city 1 e ter, • uJan the above-mentioned ro ert for E P P Hood or Type I ❑ Reinspection Fee t$!5 ' ' 3 LESS Inspection our ose5. ' lL�1yC✓l ��-P� l 1 Date 5: GanO T e I I ❑ PLAN CHECK $ ADVANCED PC $ Signature S Drivers( Li nse or SS f Registers Issue Fee $ 3 , �� oe FINAL FEE 1 $ �� CMF 0865-46 rev. 12/82 White -Building; Canary - Apptltant; PI k - Accounting; Goldenrod - Assessor - CQNSTRUCTION;AND:PLAN 72 POI SPA : ` ' + •' = _ ': `Date + .IAPPROVALS B Permii•*`' C Inspector ` •' - ;P'AP.PROVALS_ - ermit,# Date Inspector c ;1•. Tempor`ary,;Electricai Service or Pole `3 Eguipent omLo,c.a#ionr; E rl C s I c 2: lSoil Pipe Undrgrnd;] 7P`'r83 3:' Steel Reinforcerrierit 3: Electrical Conduit Utility-6ndrgrnd. _ 1.. _ - �54 Forms c _ _ t - + 4: Electrical Conduit-Undrgrnd _ , 55=� EtectrihalBonding r l 1 1' C -' - p 5: Steel ;Reinforcement n _ ' �,' - ! 56. Rough plumbing &Pressure Test , 6.Elecfrical•LIFER Grnd.� s a `'� • ;� ` ;', APP,ROVAL'TO.COVER-GUNITE + • ; •57 _ . 7. FootingsLstr IL Conduit.'UMrcrnri. ; B. Founda6orf59. Gas Pip ed Uridrgrnil: Test 1 - - ,- 9. Water Pipe-Undrgrnd: `60. Backwash Lin es;,P-Trap,_EJ Undrgrnd. 10. Structural Floor Sysiem - `3 ;,61. APPROVAL.TO-DECK " - - _L 11. Property Sewer Line.&1 House -Connection K� � ,-62 Backwash&'Receptor,-Final - r 12. Sewe'r Cap g f ia� 63. Heater, &:Vent -Final r 13. Roof'Drgins ;•yFi4. Plumbing Systein',Final 14. Rough'Plumbing ' ! - 1 65. Electrical -Fina!` - f 15:j Rough Electrical=Conduit- �" - 66TSolarrSystem-Final - -' -- -T R ,� x'16.Rough-ElectrielWirln9, } I -' m ; _; 1 - + �'��. 67. Fencing &•Access Approval' � 1 - } _17. 'Rough-Wiring;Sign - ry I } _ ; I ` I '_ ' I 68.E APPROVED FOR PLASTERING I •-' - - 4.1- - � ri Vit F 1 18.. R,ough:Electrical.T;BaT:SCeilingl 1 69.1 POOL/SPASYSTEMS:FINAL !` 19.•R66gh Heating &'Air Conditioning FIRE DEPT. REQUIREMENT: APPROVALS Permit',# ,I 20. 'R6uihLFactorV Fireplace; I i' l i I E., r, I 11 I t t a 21. DOM'in Structures I ' ;' i j I 70. Underground Hydro }t22. Ducts; Venkilat'ing ,� 4' i I i I I X71 J Product Piping 0 Gas D Oil 1 nr23. Gas�Pipe-Rough & Test !I� l; �� j �i 1 X72.' Underground Flush ` { �t24. 'Roof Framing,) { 1 5 ., • ' 1 ' { + I,p I - 73.; Under rnd. Stora a Tank'0 Gas- ❑ Oil ! _ r 25. Roof Sheathing 3 t, • 1 € 1 ' ' ' ; 74.a Overhead Hydro 11-26. Ceiling (Structural} & Monocoat- {''`'I r 75.� Dry Chemical fT-"Bar i 1 , >�27..Frame and Flashing I r I '• 76.; Dry Standpipe r a I r 1 28. Lathing & Siding l r 1 f i{ 77•i FIXED SYSTEM.FINAL t i 1 1 r 1 f 29_ 1�sulatiori I 1 I 178.E FIRE PR�EV. FINAL i i _30. Drywall Na'iiingt �1 I 'Noes: r l l I _a .'31. Plaster Brown Coat i �', _ I f �1. _ '1 dp31 I r32. Electrical Power Meier -Final i T 1 .{ I ? �' 1 . •� _ 33. Final Electric 34. Final Heating &IAir, Conditioning 35. Final Gas"Pipe=Ye'stl ' h V 36. Hood or Canopy-;) ; 1 i i c �- , I t 1 a l J 1'tI it I 37. Final Factory Fire,.-place I 38. Final P.iumbing I , ' 39. Water Service -Final` 1. 1 I i 40, Gas Service-Finarl� 1 1 I I { i { } { 41. Solar Dotitiestic-Final 1 j ll I- 4_4-�_ ! --I 42. Backflow,,Pre'venter I ~�I 1 r' 43. Backflow, Wigatian 44. Landscape Irrigatiiin;System - 45. Soundi; Attenuation l 46. Handica. !.iRAulations, 1' 1 f d f 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Con4pleted' ! - I 1 49. Electric Release to Edison l r I _ ;_ -� j_- _ . _ •1_ _ ; __ , ; I , {I +1 1 + I r � r t 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY , �_ }{ �! Date # -E_ T No. Applicant to fill In all spaces except those within heavy border lines and sign ail approoriate_deeiarations. CITY PF COSTA MESA i PERMIT NO TRACT NO. LOT NO. BL CONSTRUCTION PERMIT7f Applicant's Mailing AddressTYPE OF CONSTRUCTION NEWADD ALTERATIO ".REPAIR Project Address �r r1 4-y;a J `/ ' Z ❑ CONVERSION El DEMOLISH' 0 OTHER �• L+ Owner's Name ^t' ©, zr�s� _Phone DESCRIPTION OF WORK r PLUMBING ' Sewer Cap Sewer Connection' Solar Collectors Solar Piping Solar Tank _ Swimming Pool w/Spa . Urinal Water Closet -Water -Heater Water.Service r Reinspection' Fee $15 I Issue Fee $ 3 0a1o0,000BTU ❑100,00013TU] System Repair/Alteration 'I i r Reinspection Fee 1 $15 fIssue Fee $ 3 SPECIAL CONDITIONS: E AutomaticWasher ....?. Construction Pole Cooking Unit Dishwasher Dryers ❑Gas, ❑Electric Fan F,A.U. Fixtures " Device Boxes O t "20NE .- r BUILDING Arle Sr-rR C 41 Si REAR YARD (TO P/L)-' RIGHT SIDE YARD + PROVIDED ` PARK FEE $ ' ELECTRICAL Meter. Eloveriotiam,ps, _ 'I Sub Panel Sub Pole ; 'Motors 00-1 HP El 1%-8 I Inc.Solar 09-15HP ❑16-15+ Microwave ; Pole Light 'Range . Sign' ; ut ets iI Standing Sections I 1. Switches . Trash Compactor Garbage Disposal Generator ❑0-5 KW ❑5-15 KW i k Transformer ❑15-50 KW { ❑5U+ KW I 'Reinspection Fee $15' Meter El up to 100 amps Issue Fee l ' $ 3. Zoning Approved By s Date t Application Approver! By Date I 1 �- Application Issued By ! Date Address ,21Ii OnYtZ t`- X C6 VZl9-PV f I TYPE OF PERMIT IJ GRADING 0 FOUNDAT12M. Li STRUCTURAL A. P. ,W my license is In f I fa a and affect. License Class io License No. 3s��g nate Signature IRKERS' COMPENSATION DECLARATION GRADING Arch/Eng. License No. ❑ TENANT 1:1ELECTRICAL ❑ PLUMBING',9SMECHANICAL 4 areby affirm that I have a certlflcate of consent to selfinsure or a certlfirate of Workers' Compensation Insurance, or a certified! copy thereof (Section PLNG. REF. # ELECTRICAL' Address Bathtubs ' ❑,,OTHER Certlfl with the city B pa eA Applicant Giarifiers TO BUIDING` axil PTION FROM WORKERS' C P NSATION DECLARATI need not be completed if the permit Is for,one hundr ($100) or rese): + ' I certify ,that In the performance of the work for.whlch this permit Is issued I shalt not employ any person In any manner so 'as to become subject. to the Workers' Compensation laws of California. Contractor's Nam �vi'f"� honest -^?1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY PR P> TY INE Workers' Compensation provisions of the labor Code, you must forthwith i comply 'with! such provisionsror this permit shall be deemed revoked.' Address (meiling) / c � C � np`G�'i-� -'�� CONSTRUCTION TYPE VALUATION $L LEFT SIDE YARD I hereby affirm that there is a construction lending agencrifor theperformance of the work for which this permit Is .Issued -(Section :3097 Civ. C.) - License No. C^ ZDNJr GRADING CU. YDS. ACRES PKG. SPACE REQ. { LICENSED CONTRACTOR DECLARATION Remarks; Contractor's License Law (Chapter 9 (commencinglwith,Section.7000) of I lsion 3 -of the Business and Professions Code)' or that he/she _ Is exempt erefrom and thel basis for the alleged exemption. -Any- vtolaflon of Section 7031:5 by any applicant for , a . permit subjects . the -applicant to' a- civil realty of not more than five hundred dollars ($500)' ' ' k STREET WIDTH PLUMBING ' Sewer Cap Sewer Connection' Solar Collectors Solar Piping Solar Tank _ Swimming Pool w/Spa . Urinal Water Closet -Water -Heater Water.Service r Reinspection' Fee $15 I Issue Fee $ 3 0a1o0,000BTU ❑100,00013TU] System Repair/Alteration 'I i r Reinspection Fee 1 $15 fIssue Fee $ 3 SPECIAL CONDITIONS: E AutomaticWasher ....?. Construction Pole Cooking Unit Dishwasher Dryers ❑Gas, ❑Electric Fan F,A.U. Fixtures " Device Boxes O t "20NE .- r BUILDING Arle Sr-rR C 41 Si REAR YARD (TO P/L)-' RIGHT SIDE YARD + PROVIDED ` PARK FEE $ ' ELECTRICAL Meter. Eloveriotiam,ps, _ 'I Sub Panel Sub Pole ; 'Motors 00-1 HP El 1%-8 I Inc.Solar 09-15HP ❑16-15+ Microwave ; Pole Light 'Range . Sign' ; ut ets iI Standing Sections I 1. Switches . Trash Compactor Garbage Disposal Generator ❑0-5 KW ❑5-15 KW i k Transformer ❑15-50 KW { ❑5U+ KW I 'Reinspection Fee $15' Meter El up to 100 amps Issue Fee l ' $ 3. Zoning Approved By s Date t Application Approver! By Date I 1 �- Application Issued By ! Date ,•hereby affirm that',am licensed under provisions of Charter 9[Commencing SU AI 1BUILDING PERMIT with section 7000) of Division 3 of the Business and Professions Code, and + f ` my license is In f I fa a and affect. License Class io License No. 3s��g nate Signature IRKERS' COMPENSATION DECLARATION GRADING .PLUMBING Bar Sink Backflow Preventer PLAN CHECK areby affirm that I have a certlflcate of consent to selfinsure or a certlfirate of Workers' Compensation Insurance, or a certified! copy thereof (Section Backflow Irrigation t ELECTRICAL' 3300, Lab,c _ Policy No. ! Gia --!- Company/ Certified copy copy Is hereby furnlshed. ' Bathtubs ' PLAN CHECKi Certlfl with the city B pa eA Applicant Giarifiers MECHANICAL ' axil PTION FROM WORKERS' C P NSATION DECLARATI need not be completed if the permit Is for,one hundr ($100) or rese): + ' I certify ,that In the performance of the work for.whlch this permit Is issued I shalt not employ any person In any manner so 'as to become subject. to the Workers' Compensation laws of California. Dishwasher{Thissectlon Drinking Fountains 9 Floor Drains Date tignature - �. I i NOTICE: If, after making this declaration, -you shou,d`become subject to the- Floor Sinks Workers' Compensation provisions of the labor Code, you must forthwith i comply 'with! such provisionsror this permit shall be deemed revoked.' Gas Service` Outlets CONSTRUCTION, LENDING AGENCY • Interceptors I hereby affirm that there is a construction lending agencrifor theperformance of the work for which this permit Is .Issued -(Section :3097 Civ. C.) - Kitchen Sink :- Lender's Name It.Ander's Address (OWNER BUILDER UECt-ARATION. , - I hereby'affirm that I am exempt from the'Cohtr0ctor's License Law for t" ' I following reason (Section 7031.5 Business and Professional 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' file asigned statement that he/she is licensed pursuant to the provisions of lavatories :n p_Tra _ _ • P, Roof Drains' -• - Showers Contractor's License Law (Chapter 9 (commencinglwith,Section.7000) of I lsion 3 -of the Business and Professions Code)' or that he/she _ Is exempt erefrom and thel basis for the alleged exemption. -Any- vtolaflon of Section 7031:5 by any applicant for , a . permit subjects . the -applicant to' a- civil realty of not more than five hundred dollars ($500)' ' ' k Service Sink 1, as owner of the property or:my employees with wages.'as their sole - t compensation' will'do the work; and the structure is not Intended or offered for sale (Sec(lon -7044, Business, and Professional Code: i The' Contractor's y License Law does not apply to:an owner of a property who builds or improves • thereon,!and who does, such work himself/herself or through his or her own employees, provided that such Improvements are'not Intended or offered for ! ' sate. If, however, the building or improvement Is sold within one year,of eom- pletion, the owner will have the burden of proving he/she did not build or Im- � Q,r.,ove for the purpose ofl Sale), k t - i , � ; LJ I, as owner of the property, am exclusively contracting!wlth licensed con- ' tractprsSo construct the,project,(Section 7044,.Business and. Professions. Code: .. Boiler `•_ Duct =Under Ground , . f , ', Dutt -Structural ! Duct- Ventilating The Contractor's License taw does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law): j ❑ 1•am exempt under Section B. & P. C. for this reason Exhaust System ❑ Multiple ❑ - Firepl/Fact, Blt. ICBO # Date Owner _ -1•hereby certify that 11 -have read this appiication-and state'that ttie above Information is correct. I agree to comply with all city and county ordinances andstate tves to s relating ttoEbl ngconstt ctl n_an her by, authorize repre- ; property for , Inspection Signature Date Drivers' Llcense or 55 91' Heating System & Ducting ❑O-100,000,BTU'❑100,000$TL Hood or Type I ❑' CanO . Type II ❑• Registers CMF 0865-46 rev. 12/92 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING ' Sewer Cap Sewer Connection' Solar Collectors Solar Piping Solar Tank _ Swimming Pool w/Spa . Urinal Water Closet -Water -Heater Water.Service r Reinspection' Fee $15 I Issue Fee $ 3 0a1o0,000BTU ❑100,00013TU] System Repair/Alteration 'I i r Reinspection Fee 1 $15 fIssue Fee $ 3 SPECIAL CONDITIONS: E AutomaticWasher ....?. Construction Pole Cooking Unit Dishwasher Dryers ❑Gas, ❑Electric Fan F,A.U. Fixtures " Device Boxes O t "20NE .- r BUILDING Arle Sr-rR C 41 Si REAR YARD (TO P/L)-' RIGHT SIDE YARD + PROVIDED ` PARK FEE $ ' ELECTRICAL Meter. Eloveriotiam,ps, _ 'I Sub Panel Sub Pole ; 'Motors 00-1 HP El 1%-8 I Inc.Solar 09-15HP ❑16-15+ Microwave ; Pole Light 'Range . Sign' ; ut ets iI Standing Sections I 1. Switches . Trash Compactor Garbage Disposal Generator ❑0-5 KW ❑5-15 KW i k Transformer ❑15-50 KW { ❑5U+ KW I 'Reinspection Fee $15' Meter El up to 100 amps Issue Fee l ' $ 3. Zoning Approved By s Date t Application Approver! By Date I 1 �- Application Issued By ! Date OF FEES ! SU AI 1BUILDING PERMIT $ + ,PLAN CHECK' $ GRADING .PLUMBING $ $ PLAN CHECK $ k ELECTRICAL' $ PLAN CHECKi $ + FINAL FEE, MECHANICAL ' $ CIP PLAN CHECK' • $. t OF FEES ? Sm IP $ f r I PERMIT + ISSUANCE $ GRADING $ 4 $ MICROFILM $ ' TOTAL FEE, $ LESS i ADVANCED PC $ + FINAL FEE, $ j `C "CONSTRUCTION-AND PLANNING -PO( SPA .�/��• r Date r P APPROVALS `, L7_ Inspector . - . APPROVALS' Permit Date Inspector >=- Permit_# ; t1: Tempoiary,Electrical Service or Pole _ „ n, T t .'52� Pool &'Equipment Location � •• r• t - l2- Soil Pipe'Undrgrnd: 1 �; ,, .' 53:' Steel Reinforcement ! r +3: Electrical Conduit Utility=Undrgrnd. ! ? = _ 54.i Forms - Z 4• Electrical Conduit-U t �, 55� Electrical Bonding ; c[ 5. Steel Reinforcement ` : , e ` ; ° ;,56. Rough Plumbing &Pressure, Test L ` 6: Electrics! UFER Grnd., 57.' APPROVAL TO•COVER•GUNITE - 7, Footings - �* Y z=. = s 58� EledtricalcCpnduit lJndrarnii. ; S. Foundation ' � {_ - ~ ' 59. Gas Pipe,tq. ggdrgrnd., Test 9. Water' Pipe-Undrgrnd.`1 ` _ F` _ Backw'ash'Lines', P-Trap, ❑ Undrg�nd.= 7 10, Structural Floor System a ` ' .61. APPROVAL�TO;DECK - G _ r 11. Propertj Sewer Line & House Conriection ' +*. 5r' 62. Backwasfi'&.Receptor-Final . 12. Sewer Cap - 63. Heater &Vent Filial " i r 13. Roof-Drains - i ;h 4 , �� j :;64, Plumbing'System Final F 14. Rough Plumbing - ! y 65. Electrica&inal 1Rough Electrical=Conduit ;'� - - `- - - "" 'T'� 66.�.Solar;System Final -� � , _1.6! Rough�Electr is Wiring r ; ; !-' - -;'- ; �- _ 167 4 Fencing &Access Approval . l '17. Rough'Wiring Signr I ' l,'� t - i - ' I W. APPROVED FOR PLASTERING a , +J 18., Rough Electrical'-7 Bad Ceil.ing� '69. POOL/SPA SYSTEMS FINAL 19: Ro ug h'Heat i n g &,Ai r Conditioning �' r FIRE DEPT. REQUIREMENT APPROVA'LS3 �Permiti# �0. Rough Factory Fireplace I �, 4 I I, 21, Ducts, in Structure 1 j I' I '70.r Underground Hydro 22, Ducts, Ventilating # ;! V i ' ! { I ; r 71. Product Piping ❑ Gas ❑ Oil ' 23. Gas'Pipe Rough &Test ,� ;� I I I 92.t Underground Flush r r X24, Roof Framing'' G t i I n j' ' - > 73.E Uridergrrid. Storage Tank ❑•Gas. ❑ Oil I; 25, Roof Sheathing r' ' i" - - 74.i Overhead Hydro * ` 26. rt-Bar Ceiling (Structural). &~Monocoat : I 75. Dry Chemical 27. Frame and Flashing I + 1 76. Drly Standpipe 28. Lathing & Siding i I' i I ; _ ' ,77. FIXED SYSTEM FINAL 29. Insulation , j II ,78. FIRE PREV. FINAL 30. Dry4va11 Nailing i ? INoies:� 31. Plaster Brown Coat _� i r., ~ i 32, (Electrical Power Meier-Final � r 33. Final Electric 34.-Final Heating &Air Conditioning 35. Final Gas Pipe-Test r _ 36. Hood or Canopyu,� I r + r- I 37. Final Factory Fireplace- , t l 38. Final Plumbing 39. Water Service-Filial ' F i I l t a• ' 40. Gas Service-Final 41. Solar Domestic-Final f ti - 1 - I -4- - - - � - - ------•" - -. - 42. 42. Backflow Preventer' ,r ; 43. Backflow Irrigation; ,• i I 44. Landscape Irrigation System ,,•? - ' ; ( l �' .G + I .., I I ` + 45. Sound'- Attenuation = ` ,� . ' I I ; i ` • i i i I i l j I ' : I '` I I 46. Handicap Regulations T r r I I 1 ,_ .i f' j ; �, rl _ �. I' + 1 -, i 47.- FINAL' STRUCTURE & BUiE� DING 48. Special Requirements Completed] 49. Electric Release to Edison ! ]_ '1 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOF;OCCUPANCY No ! f Date Applicant to fill in all spaces except those within heavy_ border lines and sign all appropriate declarations. �r CITY'OF COSTA MESA, ' t i T I PE IT,N - I TRACT NO. LOT NO. ; , BLD - C�NST UCTION PERMIT , _ ! I . ��- -> g �' ' . '7 . �T' 57 3 =3 , - l R , i`.9 ' r 89330..20 T Applicant's Mallin Address-�� T'YPE,OF CONSTRUCTION,_ NEW ADD ALTERATION; REPJRT //Q '��` :, + CONVERSION •'❑ DEMOL ❑ THER Project Address 1 _ DESCRIPTION OF WORK ed `� ��' l I F w"-"" 1Owner'$'Name �p"dso? �� c-� phone lOs_ '�ZONI GREG L`'ATI iHAddressTYPE OF PERMIT IGRADING. FOUNDATION STRUCT.URALA. P. ZONEArch/Eng: License NO. • ❑ TENANT ELECTRICAL .❑°PLUMBING• ❑ MECHANICAL •BUILDING Address ' ❑ gTHER r PLNG. REF. qW:iT ' 1 + t i PROPERTY1DNE E 1 - i :A EAR YARD (TO P/L) Contractor's Nam R�k1 i«isJ '�r'c r hone �� PROJECT DESCRIPTION SQ. FT. - 'OCCUPANCY ' Addr" �{meiling)��aZ '�� d""e /9`'�: ��/�<c%a CONSTRUCTION TYPE VALUATION , LEFT SIDE YARD j RIGHTSIpE YARD License No. _ b�, ZON)= GRADING CU, YDS. ,ACRF1 _ PKG. SPACE REG. PROVIDED y ` LICENSED CONTRACTOR DECLARATION Remarks: 1 STREET WIDTH ,PARK FEE'i - , - i.`r thereby affirm that i am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, a SPECIAL CONDITIONS: \' m license:is In full r and effect. I Licen ss' l e N /-�� J' PLUMBING I + ted Signature ° Bar Sink ' Sewer Cap I ELECTRICAL 4 \ IRK RS COMPENSATION CLARATION ; _.,Hereby affirm that Lhave a certificate of.consent to soli insuie.or a certificate _ Automatic Washer_ Meter,.❑over 100 amps, , of Workers' Compensatlori r Insurance„ or a certified copy thereof (Section Backflow Preventer Sewer Connection 3800, Lab. Backflow Irri tion Construction Pole Sub Panel: �. ga Solar Collectors 1 1 /(jO J4 Policy No.�� Y / • Company �/K f' yw w� U`" I Bathtubs Solar Pi Cooking Unit :Sub Pole ' t ❑ C_'ertiHed copy Is heraby'furnished, r �y 1 PIn9 I rt e p i;lifed with the clty,8 ng Oi dna i Dishwasher Motors 00-1 HP Date d 3 Applicant , ham-- { Clarifiers y Solar Tank S EXEM IONiFROM WORKERS' CO PENSATION DECLARATION Dryers ❑Gas ❑Electric Inc.Solar, ❑9-15 HP ❑16 15+ + (Thissection need not be completed I the permit Is fortune hundred ($100) or ) Dishwasher ! + ! Swimming POOI w/Spa lessp: ^. ? i Fan . �p Microwave i. I certify that In the performance of the work for'whlch this permit Is Issued I Drinking Fountains ) Urine( 1riR. shall, not. employ any person In any manner so 'as to become subjecttothe , _ _ Workers' Compensatlom Laws of GaHfornia, t f F.A .U. Pole Light ! i i Floor Drains Water Closet F Date Signature -- - _ y- fixtures _ _ 'Range-_ NOTICE:-If,•after making this declaration, you should: become -subject to the Floor Sinks '- — --Water-Heaters- ; - - 9 _ Workers'; Compensation provisions.of the Labor Code,.you.must forthwith Device Boxes Sign I j� comply .with ' such provisions 'or ,this 'permit ishai! be ,deemed. revoked; GasSer�icj, 'Outlets4 Wa#-rYSErvicB --s , '}- CONSTRUCTION ,LENDING -AGENCY • I hereby affirm that there is a�construCtion.iendin aeric ,for the performance• 1 Interceptors - 4 - ! I f Outlets ! ' + + + ' 9 g Y I-- �, € �� r- .? j, =r • Standing Sections , + of the work far, which ,this; perrnit >is tissued (Section 3097' Civ. C:,, - Switches Lender's• Name ' = _ Trash Compactor + w, Kitchen Sink I i i i P -Dander's Address ' ' . 4� + •Y , - --• - _ - OWNER BUILDER DECLARATION' C i , , - r - Lavatories Garbage Disposal ` ) I hereby affirm that I am exemptlfrom the' Can tracto'r's; License Law for the ,•' I m Generator, ❑0.5 KW ❑5 15 KW following reason , (Sect Ion, 7031:5 Business and Professional Code: Any city or P -Trap t : r; j _ - _ ! I } 'county which l requires a permit.to construct', alter, Improve; demolish or,repair - Transformer ©15.50 KIN structure, prior t0 Its issuance, also requires the applicant'for such permit? 1 i ROOf Drains i' + I j 1 file_a signed statementahat he/she is licensed pursuant to the"provisions of ' fF I El 56 KW; , Contractor's'Llcense l aw'(Chapter,9 (commenc[ngiwith Section,7000) of 1 = = 1 �` k 4°. i + 'Reinspeotion_Fee I $95' aivision (3 -of, the Business' and. Professions] Cade)'ori that' he/she'-is.exempt , - Showers rC , '"{ 1 Rein5pectioniFee $15 therefrom -and the basis for the alleged exemption. Any. violation ofiSection Mater p to 100 amp-. 6(J 1,7031.5 by,,any, applicant for a'permit:5ub)ects 'the -applicant to a clnl! + i f= r 1 v i 1 ,issue Fed I '$ 3. nenaity of not more than five hundred dollars ($500). _ s Service Sink T ,. 1 - '? i. Issue Fee i $ 3 I LJ r i i "� Zoning Approved E: Date ' I,'"es ;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 r, I '` ' I MECHANICAL' l i. i Application Approved ey Date for saleLawdlon 7044, Business and.'Professionalpropel Code:: The, Contractor's - � { y License Law does not apply to'an owner of a property who builds or improves Boiler + i F'' Refrigeration System I r I i I thereon,,and who '.does Such'work himself/herself or through his or her own , : + Application issued By r Date .employees, providd that such Improvements are,not intended or offered for ❑4.100,ODOBTU ❑100,000 BTU sale. If, however, the bulldin or Improvement Is sold within oneiyear of com- Duct - Under,Ground , i s I i r + { ` ; SUMMARY OF FEES pletion, the owner'wlll have the burden of proving he/she did not build or Im- i , rove for the urpose of sale). + ; Duct -Structural System Re air/Alteratiori . ? I { p 3 :BUILDING PERMIT $f ; SMTP $ i I, as owner of the property, am exclusively contracting with licensed con. I l + tractors to construct the project -(Section 7444, Business and .Professions.Code:. ,. Duct _Ventilating- PLAN CHECK' $ PERMIT The Contractor's License Law does not apply to an owner of property who ! i ! ISSUANCE $ i builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ ` 'PLUMBING $ J ?.tractor(s) license pursuant to the Contractor's License Law).k � } I ; + PLAN CHECK-' $ GRADING ,$ ' ' ❑ fam exempt under Section- } — B. & P. C. for this reason Firepi/Fact. Bit. ICSO # i { r Date' Owner s Heating System &Ducting i !• ELECTRICAL $ $ _ MICROFILM' r l-herebyecertify.,that -I �hava read ^this' application - and -state that the -above -,J. ' ❑b-ioo,000,BTU'❑100,000 _. PLAN CHECK' $ information Is Correct. I agree to comply with all City. and county -ordinances i - I - + • ~ + ,- r TOTACFEE'' and state laws relating to building construct: hereby authorize repre- , I MECHANICAL $' )' $ Sentatives of )this tcltylto me rupon the above-mentioned prop sty or Hood Oi Type I ❑r ! I •, ; t• - + p Reins ction Fee $'15 i LESS Inspection purp s I ///J� ; Date 0 i Cano s •T - e iI ❑:' `- , {PLAN CHECK ! $i ! i l ADVANCED PC 2 $ I I Signature I Y- ' /� f Registers i i Issue Fee l $ 3 i r I Drivers' L191'rise ar SS i a , I , i FINAL FEE i ! $ I f CMF 0865-46 rev. 12/82 White-- Buiiding; Canary - Applicant; Pink - Accountingi Goldenrod - Assessor r? �CONSTFiUCTION;AND;PEA I1(NING� 'e - " "" s v.$l-'_{' :' `.Date n_ v�;ry(, _&S _ �- `'` -.'� ', " =' a > c APPROVALS Permit,# �" ` �'Inspectbr r:- t t ', Mermito [ �' pate Inspector ,:, i; r7�'n „t' i` -�.iQ; i, ,I yAPPROVALS; •..yam �scr .� "•a M Te`mporary€Electr,ical Service 52: `P" I .E ui ment cati ri n 2+ ,'Soil Pipe Undr`grnd i f ��'� r i`r , ;533 Ste el 'Reinfiarcement- xv j•• p.-. ` I Ro . , I'•' fa L w l , f1 _ >= -, N ! - Li - ..W� '- '�tiAr C ' 'Q I r'.f. , �, y-!• "7 S •v rr L!- 3! E!`ect_rical Conduit-Utility-Uncirr,rrid g .^`•- • _,fir � :'-i lr+ - �-�1 .� Forms -+ _ - . _•' I,V� -.� ' ,•i. ` ��€ Y• - 1 S4% - ,' r. <- i G l' T 7 : , ��• i. i '4' Electrical Conduit Undrgr'nd'. _ y ; , f 3.' � 6:, r ding " - ;t; i55..'Etectrical 5: Sjeel,Reinforcement �f�, wRough �Plumbing'$i'Pre`ssure Test �, !, 6: Electrical LIFER Gi nd'-� � ,� `-' f ; Vis' �: 57' APPROVAL TO C011ER GUNITE� + I 7. Footings I I i € `- a ' 1j <;'Electrical'Co,rid'uit=lJndrarnri: L� _' _ 3 1 I ! vi r" :� 3- E ,i �.i• �' .. { - r r c- i -' ! I !��'! 1 8. Fourida#ion ! N'L ? rv,1`...r_°--r n �' ; tt''n_ ' 59. GaslPipe?P] Undrgrnd ; Test= i Fy G •a - ' .7 I ,4 !• 3l 9. Water Pi"pe Undr !rnd p 9 ? ' f .:.r_ - ' ; X60. Sackwash'Lines,,P. Trap, l] Undrgrnd. ! , , i ,€ �'� -C 10. Structural Floor System " S '! "� 4AfPPR01/AL°TO-DECK �T ,'tel' X61. 11. Property" Sewer Line 80jhlouse`'Connection __ +` _ = 7`, ; 62. 8ackwasl &Receptor .� ._) . 12. Se; erl Cap } ; '!I i c }i ' I C° - "63. Heater &Vent -Final 13. RooflDrains I ! n ! i� :64. Plumbing System, ,Final r r ! { 14, Rough Plumbing 65. Electrical=Final I € =75--Rough-Electrical:Conduit� -'-q- r�#- -F"TT-'TT ! �-- T i� �^ � �66.}'Solar'Sysiem i3 L I_ I 1 # I llu1'6.i"Rough,Elecfric Wirjng, ` i; w r_ i �3 ' n "67. Fencing &;Access�Approval. n - �� - i , .�. I I ''`17. ;Plough Wiring�Sign - = •. €, €; ; _ I �; j U ; I ' ;68J APPROVED FOR'PLASTERING � _ r � I •,r '� 0' i s• 98:"�RoughElectrical;T;Bar,Ceiling,� I• j , f i .. � i� o',I ..._ i N ! :• � 4: l69.POOL/SPASYSTEMS-FINAL E- Rough''Heating &iAirtonditibning €i { '.i i i } j jFIREDEPT.jREQUIREMENT� I r. �01RoughJFactory Fireplace, `i Fye i J_ ! ! �` ! l I I s APPROVALS' € Permit# I fhf ♦1 Imo. r4 `. {t i I I I ! I 1 I I i ! �' 1 •� ii 21. ;Ducts,•in Structure- ', �f l �! t i l i76. -Underground Hydro - i f = II 22. Ducts, Ventilating ! ;I ,? t !r- fL} ! ! ! 171.! Product Piping ❑ Gas ❑ Oil ! 1�-J �i - 1 Ef 1 ' ' i , l rr ,1 1 Kl Rough & Test �, l •' -1 _-. M. ._-_• __i. "- Underground Flush - ,!r23. ;Gas'P.ipe c24. Roof.Framingr ��i ry ° +'� t� i tits r Its € 1, 173. Undergrnd.StorageTank''❑'Gas_❑Oil: l 25. (Roof Sheatliirlg ` ` �" �ii ! �. ! l ` £ f _ f ; X74. Overhead Hydro I -26. l7 Bar Ceiling 'Structurat)i 81 Nfonocoa#� ! l --z I :y € , ' �75.� Dry Chemical - 27, ,Frame:anlj Flashing i76.1 Dr,y Standpipe 28. Lathing & Siding i " a Iii 1 ; �, 177. FIIXED SYSTEM FINAL.. € t j ! -03 ` l 3 3 178 FIRE PREV. FINAL X29.lrisulation �. Ey } €Ll - --,F W l ' I 1 �'1 I S� � L- S , 1 { 30. brywali Nailing 1 ! M1 # I l I ` 7 I l r i • !Nates:; ( ' } ! ! € 1 € k �31-: iPlaster:Brown Coat i ; i ! -32.Power Meter -Final ;Electrical I , 33. Final Electric r 34. Final -Heating &,'Air• Cond t oning ii Is- L s " ' I ; �l Y s, ri - In ri 7 �� I � I !� 1 ti 35. Final GasjPipe-Test' `�' f7 C „ ! ' 1 ; I!- - Y» i L3 O ! I l . 36. Hood or Ga no{ �I p'Ic�'3 li 37. Final Factory Fi(eplace n 38, Final lumbi ig 39. Water Service-Fi�nali E 40. Gas Service -Final i l - t li ! 41. Solar Domestic-Final-il 42, Backflow; Preventer, 43. Back ,or fl * Irrigation rr{ A '' y i` - •'f , "{ � JQ ' 1 "' 44. Landscape Irr-igation ;System l }:� �: o I ." � c -' I I 3 � a l ' i ; •f - 45. Sound'!' P j t ; a : r Attenuation T ,., �,' � ° j 1 1' J 1 t { � � 7, 1 � ¢ { ! �' •�- -� . 46. Handicap; Regulations i _ € 47. FINAL 9t RUCTURE & BUILDING 48. Special Requirements Completed l a '' j l l ! 3 .• L I i'±; 49, Electric Releas4lo Edison ► ! ��i_ . T I _ It :L L L i 2 .,� 7 50. Gas Release to Southern California GasCb , l •• ,( Le , L L I 1 7 = 51. CERTIFICATE OF}}IOCCUPANCY ,�y,u.,E�oFio�o} No- I{ I � I _ Date I � ; � S s " ! 1 e;.�l <� � , ; f I ..7(- L f �. 1 i if' y r ! ('. r �t - �'l' , !.'�-�--- i -•-'i ,, s € , I e. 1 '�" _._ifs-�-.r .>- .: - T� ..,....,.>,...r.,��....7..--•ti.- i�� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ' , r CITY,OF COSTA MESA ,PERMIT NO. TRACT NO. LOT NO. B CQNSTRA1ICTION PERMIT 13-715-4 /53 .. .- - . , :. �, , . ''8� 4.! 5/ I -6/F}3 165.12' TL Applicant's Mailing Address. Jibl- 1 rwdY Ave.. E - F, os a ' PE,oF CONSTRUCTION NEW ADt7 ALTERATION REPAIR Projectiddrass 3151 Airway Ave.' M -L_,_ Qostd Mesa _ ❑ CONVERSION ❑ DEMOLI Interior H ❑OTHER s Shearson Amer'.1ca17_ Ex��+one p__ ��dZONWG DESCRIPTION OF WORK tenant' improvement Owner's Name REGULATIONS Xddress 1fiQ1 UOVe Suite'200. Newport Beach TYPE OF PERMIT El GRADING ElFOUNDATION STRUCTURAL A. P. 46 2-- ZONE I A.ch/Eng. Tom Campus_& Assoc Licensa No. � . ®.TENANT ❑'ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BUILDING' . 17779-F Main Set. Address +a IrVlYje. Ca . ❑ OTHER DING TO BUILDING' TO BUILDING - Contractor's Name � 1 _ DQnal� C}1 snn Co- Phone 540-26 6 PROJECT DESCRIPTION Sri FT 1543 OCCUPANCY � REAR YARD (TO P/L) , rr Addrasslmaiiing) :151 Airway Ave. E -1, -Costa Mesa � CONSTRUCTION TYPE- VALUATION $ 23 145. aC - >, LEFT SIDE YARD RI T D - ! ZON)= GRADING CU. YDS. ACRES PKG. SPACE REQ. V Ed` License No, i __ LICENSED CONTRACTOR DECLARATIONRemarks: �Ci STREET WIDTH FEE $ i hereby affirm that 1. am licensed under provisions of Charter 9 (commencing i f I with section 7000) of Division 3 of the Business and Professions Code, and �� ,,r P 7/C 5- �x-L� SPECIAL CONDITIONS: {� my license is In full Orta and'affect. 333969 ; I:.Icense c a�In PLUMBING I f ^ate • Signature ( Bar Sink Sewer Cap •, ELECTRICAL iRKER5' COMPENSATION DECLA areby afflrm.that l have,a certificate -Insura,ora.certlficate _ BBckflOw Praventer Sewer Connection_ - Automatic Washer __ _ + �+ Meter Dover.100 amps 1 ' of Workers' Compensation insurance, or a certified��ppppy thereof (Section 3800, Lab. C.} " / r' g �� Backflow Irrigation Solar Collectors' / Construction Pale Sub Panel , j Policy I" company. --i o 1�(�{vwi , i Certified copy is hereby furnished• I Bathtubs _ Solar Piping I Cooking Unit Sub Pole ' ; 1 is filed with the clty,Buf g n,Z7 i Clarifiers Solar Tank : Dishwasher , Motors E10-1 HP ❑1'/4-B ' DateCer Applicant EXEMPTION •FROM WORKERS' COMPENSATIO ECLARATI Dishwasher Swimming'Pooi,wlSpa ' ` Dryers ❑cies ❑Electric Inc.Solar ❑9-15 HP ❑16-15+ (ThIS section neetl not be completetl If the permit i r one hundre ($100) or , ' less). I_ I Certify that In the performance of the work for which this permit is issued I Drinking Fountains Urinal , .. ' , Fan Microwave r 1 ' ' i shall, not employ any person In anyy manner so as to become subject, to the Workers', Compensation Laws of California. Floor Drains - n Water Closet f'r F,A,U. Pole Light , Date �Egnature NOTICE: If, after making this declaration, you should become subject to -the ,, Fixtures Range Floor Sinks Water. Heater - • - `_. Workers' Compensation provisions of the Labor Code, you must forthwith, + Device Boxes Sign comply with such provisions or this permit shall be deemed ►evoked:• Gas Service Outlets Water Service CONSTRUCTION LENDING AGENCY Outlets i I hereby afflrm that there is a construction, lending agency for the performance Interceptors Standing Sections of the rwork forNwhlch this permit is Issued (Section 3097 Civ. C.). Switches Lender's Name/1hi1 -- Kitchen Sink Trash Compactor , Lender's Address } OWNER`SUILDER DECLARATION Lavatories , Garbage Disposal } I hereby -affirm that I am exempt from the:Cdntrattor's'Llcense Law for thely—Tr8 Generator 130-5 KW E15-15 KW following reason -(Section -7031•.5 Business and Professional Code: Any city or p i� county which requires a permit to construct, alter Improve, demolish or,repair_ Transformer E115-50 KW any structure, prior to Its issuance, also requires the applicant for such permit <=;file a signed statement that he/she Is licensed pursuant to the provisions of I Contractor's License Law (Chapter 9 (commencing with -Sect lon-7000) of f^"'ision Roof Drains ❑5� + Kw 'Reinspection Fee + $t5 - Showers + = 1 ReiriMme im-Fee ' $15 3 of the Business and Professions Code)` or; that, he/she. is exempt "24';efrom and the' basis for the alleged exemption. Any viol a�ion•of Section - _ I Meter ❑up to 100 amps 3 , 7031.5 by. any applicant for' a parmlt:.subjetts the applicant to a- civil r penalty of not more than five hundred dollars ($500): I ertiployees'with Se rvi11 � a Sink _ u Y ISsue FeB $ 3 lSSu9 FB9' -r Zoning Approved By _ Date LJ 1; as owner of: the .property or' my wages as their sole the Is intended J '_ , MECHANICAL i } // Val.— y, 16 6 compensation wlll,dd work, and the structure not or offered for sale I(Sec{ion 7044, Business; and Professional. Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves Application Approved By ate 's ' C Refrigeration System thereon, 'doessuch himself/herself or through his her goiter .• ' Application Issued By , _ Date D and who work or own ! employees, provided that such Improvements are, Intended or offered for Duct-- Under Ground ❑0•,100,000 BTU ❑100,000 BTU I t ! sale. If, however, the building or Improvement is sold within ono yea com• f pletion, the owrterwlll have the burden of proving he/she did not buffo or Im- + t S M ARY OF FEES �r� �_54 1 ! id Duct - - System Re rove for the Purpose of sale . P ), I -Structural r P air/Alteration BUILDING PERMIT $; SMlP $ ;— qC --�t— I as owner of the property am exclusively contracting'.wEth,licensed con- 1 s . Code: Duct - Ventilating �' _� PLAN CHECK $ PERMIT The Contractor's License Law does not apply to or' owner of property who b.11as or Improves thereon, and who contracts for such projects with aeon- 11 Exhaust System ❑ Multiple 0 j iPLUMBING $ ISSUANCE ! $ ' I 1 tractors) license pursuant to the Contractor's License L. r PLAN CHECK, I $' GRADING $ i ❑ I am exempt untler Section B. a4 P. C. for this reason I 1 Firepl/Fact. Bit. 1CB0 ; i Heating:System & Ducting ' I ELECTRICAL' $; i $ MICROFILM ' I Date Oivner1I 1- �I hereby. certify that- I. have read this appjlcatiort and state that the -above- ❑0.100;0{)0 BTU-0100;000BT - , -- - •-• �•- •PLAN CHECK' $ TOTAL'FEE Information Is correct. I agree to comply with all city and County ordinances , I MECHANICAL $� I $ and'state laws relating to building constructlon,;and hereby authorize repre- Hood or Type ! ❑ � , LESS i ; r sentatives of -th city, to nt upon the above-mentioned propert for Y Inspection Canopy. Type II ❑ ! Reinspection FeB ; 1 $15 PLAN CHECK $; ' Pur es. ( Signature ' Date "5/4/83_ -T j r ADVANCEO PC $ ; 11 Drivers' License or 5 .Reg Issue Fee ! $ 3 1 , 1 r FINAL FEE' $ !� ' CMF 0865.46 rev, 12/82 White - Building'; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor tiCONSTRUCTION AND PLAN ING'. SPA •, �: •: = r Rate -APPROVALS n Permit'#- _ - [ t nspactor y -,APPROVALS Permit:# ` Date Inspector ,� Temporary !Electrical Service or Pole . " 52 }Pool & Equipment Location' - ` I - r L'V'1! ISoil Pipe-Undrgrnd`••' _� V �o° I i - - ; ` ` 4 �, �' = 53� Steel Reinforcement _ , 3: Electrical Conduit Utility Undrgrnd- Forms '4.• Electrical Conduit-Undrgrnd' - .i- c c ~ ' t U = ' , ;55:. Electrical -Bonding. , ? try i • n f, - c •v 5� Steel IReinfarcement } i n a ' `. ± Q = = a _ 56. Rough Piu'mbing.& Pressure Test `6. Electrical UFER Grind.' 57: APPROVAL -TO COVER-GUNITE 1 �- 7. Footings i a.a Y �t ti .� �' ' '58: Electrical Conduit•Undrarn�. .r , ' S. Foundatiari �J r .' ' �� ' ` ' Lam[ 9. Gas:Pipe,L-0-Un � 9: Water Pipe Undrgrnd. - 60. Backwash'Lides; P -Trap, O-Undrgrnd. 10, Structural Floor System 61. APPROVAL TQD_ ECK '' 11. Property Sewer Line &:House`Connection; 62. Backwash &-Receptor-Final',_ _ ' _ 12. Sewer Cap �'° I' ° Jr 63, Heater & Vent -Final r'S ♦ 4 13. 'Roof Drains i I ! t5 : ?+ ' r *64, Plumbin!,System, Finale, I s I y i r 14. Rough Plumbing I `_ - 65. Electrical-Final=� 715, Rough Electrical=Conduit .I- '� ; ?'� -; "�-I -� �r"T 66: -Solar Syste"m=Final- 16.:,Rough Electric Wiring, 67a Fencing_&Access A ppiovaI - sRough Wiiirig Sign? 4r I '• ^ ', i i r -, _ 1 ! `: -' 68.' APPROVED FOR PLASTERING ' x;17,. 18. Rough_Electrical=T Bar Ceiiingf , r ; e '69.1 ROOL/SPA SYSTEMS FINAL r j , 19. TRough-Heating & Air.Conditioriing ` FIRE DEPT. REQUIREMENT', !Rough , APPROVALS. Permit # r 20. Factory Fireplace z�l }. 4 f i 21. Ducts,,in Structure • f ' �� !I j + I ! r70.i Underground Hydro X22, Ducts, Ventilating Via. i' r { ` ^i� I� , i I I I t71. Product Piping ❑ Gas ❑ Oil I i i 23. 'Gas'.Pipe Rough & Test i �72.I Undergrounu Flush I ; _ t'-'24. Roof Framing I , ' ;�` f,,, ; r i i . F C • • J3.' Unde'rgrnd. Storage Tank.O Gas _❑ Oil ; 25. Roof Sheathing ; 74, Overhead Hydro 1 I 26. T -Bar Ceiling {structural}. & ondcoat ! �'S (c�l'1_ ;75. Dry Chemical - r. 27. Frame and Fla'shiiFg r r: F' I � r76., Dry Standpipe v I 28. '•Lathing &Siding' ' o I' 11 =I l 177.i FIXED SYSTEM FINAL f r r _ 29._alnsulatio+i 7$! FIRE PREV. FINAL I i. 30: Drywall NailingNotes:• ' r 31. Plaster Brown Coat h'32_ ElecfricaI'Power Meter -Final 33. Final Electric t S I r { 34. Final Heating &'Air Conditioning - i 35. Final Gas Pipe -Test 36. Hood or;Canopy r d 37. Final Factory Fireplace i '� = 38. Final Plumbing 39. Water Service -Final 40. Gas Ser vice -Final I I F I 11 I r i i i i 41. Solar bo' mestic-Final I �' r --r_ 42. Backflow Preveriter 43. Backflow Irrigation -' rr 44. Landscape Irrigation -System' 45. Sound 'Attenuation ;, F �' '` �' ( , _ -• 46. Handicap Regulations '; 47. FINAL STRUCTURE & BUILDING'' 48. Special Requirements Completed 't w I ± t I 1 F I 49. Electric Release,to Edisonl 1 i 1 1 50. Gas Release to Southern California Gas CA 51. CERTIFICATE;OFOCCUPANC• r_ No I-OG'iT___i bate n ,� _r`._I_ ' �• - ;� _' _ _ _ ` PROJECT'ADDRESS: 3151—AIRWAY AV UNIT: M 3 OWNER'S NAME: ORANGE CO, ADDRESS: 715.1` AIRWAY KIN COSTA MESA CA .7.2626 '. (714)755=6525 ARCH/ENGINEER: IGNAC'IO J. VILLAR'lA REG.ND.:C11.461 ADgiRESS: 2174'9-• BIRCH HILL: DR. UNIT: DIAMOND BAR CA 9 1;76 5 PERMITTEE: R, 14 . ST'ANHOP E (21.3)660-,2620 ADDRESS: 24'40 CRYSTAL ST. 1.. A.' CA -90039 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section ' 700D) of Division 3 of the Business.and Professions Code, and my lice a is in full force and effect.' CITY LIC.: 0 4 9 9 5 9. STATE uc.:1. 2 7 6 4 9 clAaa: B Date: Signatu : WORKERS' COMPENSATION p CUtRATION: I here y affirm that I have a ce ificwe of consent to self -insure or a certificate of Workers' Compensation �p aqr� a r� ti e�eof (Section 3800, Lab. ) I POLICY NO.: `w 5e HIV 1 y` EXP. DATE: �1 / 2 9 /j9 1 ' OMPANY• KANSAS CITY..-,. FIR Certified copy is hereby furnished. YJ Certified copy is filedJrrith the city Building Division. Date: Z=1 U Applica x EXEMPTION FROM WORKERS' COMPENSATION OEC ON: (This section need not be completed it the permit is tot one hundred (S1 DD) or less). Icertity 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. I Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ADDRESS:' OWNER BUILDER DECLARATIf]N: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance, also'requires the applicant for such permit to file a signed statement that helshe is licensed pursuant to the provisions of the Contractors' State License Law {Chapter 9 (commencing with Section 70110) of Division 3 of the Business and Professions Code) or that he/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 mom than Sive hundred dollars ($500). 1, as owner at the property or; my employees .with wages as their sole compensation, will do the work,. and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: 'The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himseN7herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business F-1andProfessions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor($) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be, Tided to me. ❑ I am exempt under Section: S. & P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wi l/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to urger upon the above-mentioned property for inspection purposes, Date: Z ` s` 90 Sionaturi Driver's License or Social Security 1841-46 While—buildino; Green—Code Enforcement; Canary—Applicant: Pink—Revenue; Goldenrod—Assessor CITY OF -COSTA MESA `=' BUILDING PERMIT PERM 1,10: "H 0"461:32 PERMIT NO: B .'046132 GOVT: N SUPP; 1�1 CONSTRUCTION TYPE: 5--N PERMIT. TYPE: ' STR : ,i ''PURPOSE: ADD JOB ; DESCRIPTION I14TERIOR ALT. (O1� E'ICES) so .FT e • , ] 8 , 500 CLAIM VALUE::, CALC--VAL<UE : IS, 5oo , UU' � GROUP • t]CC r B -2-- I % COMMENTS ;. { i'E •}F iE iE iE iE iE iE �E iE iE # iE �E �E �E � i! jt• iI- iI- i! iE .N iE �E iE # �E •}E # # 9E 3E iE •1E iE dE fE ji iE # iE i(ic- iE iE iE .� iE •ME 1'E iE iE iE •1E # i(• it- it- iE iE iE iE iE •ME * # �E * -lE -lE �f -lE -lE iE 1E ie x Z O N I N G R'E Q U I R E M E N T S S E T B A OK S --- -- -- MAIN BUILDING; ----••------- ------- - — ACCESSORY BUILDIN_ G. — ----- FRNT: F1 IN REAR- FT IN FRNT:' FT IN REAR: CT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CI. REF NO,: PLANNING NO'TES> INTERIOR ALTERATIONS FOR C.O. OF ORANGE (JW AIRPORT -ADMIN.) > IN EX . COMM.. -BLDG.. - � # 9E # � �r- �r- >E * +t ;{ # ►E �E �r- �- � # +t- # �E i'E # +t- +t- �r- �r- # � fE fE �E # * +t- x,* �.* hk x• � +t- rr•-lE ?E +t- �E iE # D E V E L O :P.M E N •T S E R V I C E: S R F Q U I R£ M E N T S. ZONING APPROVED 13Y _ :-., � DATE: `:?A e BUILDING APPROVED BY--.-' � _ _ _ � DATE. APPLICATION ISSUED ,;Ifi'. DATE- - oZ -X ft # # iE iE 3E -lE * * iE * ?E # -1E 3E # it # �E.•�--rr fE 4E # # # �¢ i� dE # # # # # 9E .yr 3E # * iE �f- �F •>F - E # •1E frF x- -1E iE -1E i� # iE �E:* �E �E �E iE iE,dE -1E 1E •1E dE �E �E �(• 9E !E * •)E � 1E iE LEGAL RATION : N �F E E: S U M A R Y. , STRUCTURAL ' SEGMENT . Y ' BLDG PMT VLUMSINGELECTRIC MECHANIC F`-IIt.E SMTP'/RES GRADING PERMIT 198.00 _ SM-1'€'VNON--RFS PLAN ' 12 8 .•'70 _ 2.78 ISSUE FEE IBUI:LD-ING-'DIV,DIV- > PERMIT ISSUE PLAN --CHECK ,' TOTALy i PAID t DUE TOTALS—; ---> 200.78 0.00 -128.70 � 329 •48' 5329-�48 .0,0 REVENUE DIVISION] TOTALS > COLLECTED-,:, 200,.78' COVER/SHORT': .00) - BLDG IJMT PLOMBING ELECTRIC MECHANIC. ^F• -RE - SM.T.13VTO,' ,GRADING PLAM—CHECK 198.00 ;. ;2.78' iE * iE Tf iE iE iE 1E rE rE iE, rE . iE �E R. iE # iE fE iE ±E 3r K iE i( iE # # iE iE }E' }C iE # iE iE iE # * )` ♦f 1E E iE 1( �1 }F # )F}F �E * *..t(# iF iE'E 3E 1E 3E 1E f tF # iE TE ik * iE )E iE lE ?6 rY 1E,1E I N D I V I. D U A' L' F lE EL'B R E A Ir'. D O W Nth - .TYPE I QTY D E S C' R I P x -I. O :N -,r UNI'F? COST TOTAL. COST � 18,500,00 SFC 18500- ALTER BY. VALUE CUNIMERCIAI;,�, r.NIC�ZONI; " '_1 .OU ,� • END OF FF -ES ' e tj f 01 00054204-00054205 DATE:.02/15/90 TIME: PLAN' f'H•ECIC NO; U24.70 -9U S TOT 200,18 14:16 CONSTRUCTION AND PLANNING, APPROVALS Permit # Date Inspector PO SPA APPROVALS Permit # r Date Inspector y , Temporary Electrical Service or Pole 52. Pool & Equipment Location I 2• Soil Pipe-Undrgrnd. j • 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit•Undrgrnd. o, A 55. Electrical Bonding 5' Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. f 57• APPROVAL TO COVER•GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. 8. Foundation 59, Gas Pipe, ❑ Undrgrnd„ Test ; 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. Structural Floor System 3' 61, APPROVAL TO DECK 11. Property Sewer Line & HouWConnection r - 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. Ro'ugh'Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating ; 71. Product Piping 0Gas 000 23, Gas Pipe -Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas 000 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 ^r�`�{-''. HEALTH DEPT. REQUIREMENT 31. Plaster -Brown Coat I ; 3 '+ `i 79. FINAL INSPECTION 32. Electrical Power Meter -Final d' 80. FOOD CERTIFICATE ISSUED 33. Final Electric f "�,; Notes: 34, Final Heating & Air Conditioning- -� 35. Final Gas Pipe -Test 36, Hood or Canopy y 37- Final Factory Fireplace pnw 1A&0%Gr1AAY 38. Final Plumbing 39: Water Service -Final ,/• _ 40. Gas Service -Final �f �- 41. Solar Domestic -Final s 0, 7. 42. Backflow Preventer 43. Backflow Irrigation f .l 44. Landscape Irriqation System _. a 45. Sound Attenuation1�0� /ZZA 46. handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. ` Date PROJECT ADDRESS: 3151 AIRWAY AV UNIT: M 3 OWNER'S NAME: ORANGE CO. ADDRESS: 3151 AIRWAY K101 COSTA MESA CA 92626 (714)755-6525 ARCNIENGINEER: IGNAC I O J. V I LLARTA REG -NO.: 0 1 1 4 6 1 ADDRESS: 21749 BIRCH HILL DR. UNIT: DIAMOND BAR CA 91765 PERMITTEE: SUNGLO ELECTRIC (818).814-2877 ADDRESS: 14180 LIVE OAK AV J BALDWIN PARK CA 91706 LICENSED CONTRACTOR 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 Ilcense Is In full force and elle CITY LiC.: 0 5 0 7 5 6 STATE uc.: 4 3 2 014 CLASS: C1 0 Date: —p---% Signature: WORKERS' COMPENSATIOq[N DECLARATION: I herebyaffirm that I have a certificate of n o - re or a certificate of Workers' POLICY NO.: W6aeb ,i �cRrtgjed copy thereof (Section 38M, P. E b. C)� / O 1 / 9 0 COMPANY: CNA INSURANCE C 1 ❑ Certified copy is hereby furnished. Certified copy is fded with the my B Jate: I/ Applicant, t EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This ' need not be completed if the permit is for one hundred ($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. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: t 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). LENDER: ADDRESS: f OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State Liunse Law (Chapter 9 (commencing with Section 7DDO) of Division 3 of the Business and Professions Code) or that he/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 We hundred dollars ($500). I, as owner of the property or my employees whh wages as their sole compensation, will do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Cordractors' State License Law does not appy to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for We. If, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License taw aces not appy to an owner of properly who builds or improves thereon and who contracts for such projects cith a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Comperrsvion insurance should be provided to me. ❑ I am exempt under Section: B. b P. C. for this reason: Date: Owner: I do hereby certity that I am aware of and understand the requirements of Catifomia Heahh and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant willtwill not (circle one) need to comply with said state Codes and the requirements for a permit for construction or modification from the Air iality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certity that I have read this application and state that the above ordinances and state laws relating to building construction and hereby auM property for Inspection purposes. Date: 0 Signature: Driver's License or Social Security N: is corn to comply with an city and county s a to comp upon the above -me anti lj�rted 184148 White—Building; Green—Cade Enforcement; Canary—Applicant; Pink—Revenue; Goldenrod—Assesvor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 047655 PERMIT NO: E 047655 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; 5—N PERMIT TYPE; ELE PURPOSE: ADD JOB DESCRIPTION : INTERIOR ALT. (OFFICES), REFER TO#B46132 SQ FT: CLAIM VALUE: CALC--VALUE: GROUP OCC: B-2 / COMMENTS: Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ------------ ---------- ACCESSORY BUILDING --------- FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING N TES> 7 il•'lf'lf * 9f 9f * 9f * Tl• * 9f iE 9f iE iE �f 9f 9f iE iE'lf iE iE iE'lf'lf'lf * 9f * * * * * * 9f 9f iE TE if iE TE iE i4'lf i4'lf iE i4'lf iE'lf iE iE iE i4 i4 iE ii iE 9f 9f 'lt iE'lt'lt'lt'lt * * ii if if i[• iE �f iE iE D E V E L O P M E N T S E -,R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: 'lt if if jE * ii * * * ii jE ii ii iE iE iE ii ii ii iE iE'lt iE jE 9k 9k 9k jE jE iE iE iE 9f 9f 'lf'lf'lf 9f 9f 9f 9f 9f * 9f * 9f iE iE iE iE ?rf 9f 9f iE iE'lf if iE if'lf if 9k jE 9k 9k jE 9k 9k 9k ?rf 9f jE iE if if iE i[• if if'lf if iE iE'lf iE iE iE ?rf 9f * � iE iE iE Tl• * iE iE iE iE'lt i4 i4 i4 * ii * ii � * * * ii LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT G.-75 .'50% SMIP/NON—RES PLAN ISSUE FEE 15:0,9' BUILDING—DIV—> PERMIT ISSUE 'PL'ANTCHECK TOTAL PAID DUE TOTALS ---- > 6.75 15.00 0,00 21.75 21.75 ,00 REVENUE DIVISION TOTALS--> . COLLECTED: 21.75 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK. 21.75 i4 * iE iE iE i4 i4 i4 ii ii iE iE iE i4 i4 iE iE TE iE iE i4 i4 i4 iE i4 i4 if i4 iE iE * * iE * iE * * ii iE iE iE ii iE ii iE'lt'lt iE i1• if if ii 9k jE if if iE 9k 9k iE'lf'lf * * Tl• * iE iE iE iE i4 i4'lt i4 if iE Tt'lf'lf I N D I V I D U A L- F E E B R E A K D O•W N TYPE QTY D E S C R I P T I O -N UNIT COST TOTAL COST ELE 2 RECEPT/OUTLET 1 ST 20 EA. .75 1.50 ELE 7 RECEPT/SWITCH 1 ST 20 EA, n1990 5,25 END OF FEES Jf1 CITY OF COSTA MESA CONSTRUCTION AND PLANNING APPROVALS Permit # f Date Inspector POOL A APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole : 52, Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 1, 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 URER Grnd. 57, APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8, Foundation 59. Gas Pipe, ❑ Undrgrnd., Test , 9. Water Pipe-Undrgrnd. r 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ` f 62. Backwash $c Receptor -Final 12. Sewer Cap _ .. 4 63. -Heater & Vent -Final 13. Roof Drains ". n 64. Plumbing System - Final 14, Rough Plumbing , s 65. Electrical -Final 15. Rough Electrlcal,Conduit Solar System -Final 16. Rough Electric Wiring 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 APPROVALS, _ Permit # 20. Rough Factory Fireplace 21. Ducts, in -Structure 70. Underground Hydro 22. Ducts, Ventilating - -.71. Product Piping O Gas ❑ Oil 23. -Gas Pipe -Rough & Test - - ' '72. Underground Flush 24. Roof Framing 73. ' Undergrnd. Storage Tank ❑ Gas O Oil 25, Roof Sheathing 74: Overhead Hydro _ 26. T -Bay 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 Biown,Coat - . -79. "FINAL INSPECTION - 32. Electrical Power Meter -Final 80: OD CE lFICATE ISSUED _ '_33: Final Electric ` otes, 34, Finai 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 r 41. Solar Domestic -Final + • _ 42. Backflow Preventer 43. Backflow Irrigation , 44. Landscape Irrigation System _ 45. Sound Attenuation - .46. Handicap Regulations 47.' FrIIVAL STRUCTURE & BUILDING - L 48. FINAL PLANNING 49.' Electric Release to Edison 50. Gas Release to Southern California Gas Co _ 51. CERTIFICATE OF OCCUPANCY No._ Date J PROJECT ADDRESS: 3151 AIRWAY AV UNIT: M 3 OWNER'S NAME: ORANGE CO. ADDRESS: 3151 AIRWAY K101 COSTA MESA CA 92626 (714)755-6525 ARCHIENGINEER: I G NAC I O J. V I L LARTA REG.NO.: C 114 6 1 ADDRESS:..21749 BIRCH HILL DR. UNIT: DIAMOND BAR CA 91765 PERMITTEE: WESTCO AIR COND (714)594-8621 ADDRESS: 384 S LEMON AV WALNUT CA 91789 LICENSED CONTRACTOR 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. CITY us.: 050758 STATE LIC.: 5 357 9 cu :.0 Date: — _C Signatur WORKERS' COMPENSATION DECLARATIO I hereby a ' that ave a certificate of consent to s insure or a cerificato of Workers' Compensation InnsC cq c tjTipIf copy thereof (Section 3600, Lab. POLICY N9.: y§ II II P. DATE: 87 / 01 / 9 0 COMPANY: REPUBLIC INDEMN ❑ Certified copiy is hereby furnished. [( Certified copy's filed with the city Building Division. ate: _1� 1 .f j Applican EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: ITIlls section need not be completed if 0 rnrtt is far one hundred (SIOD) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any erson in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. C). , LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair arty structure, prior to its issuance, also requires the applicant for such permit to fife a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law {Chapter 9 {commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant -fora,permit-subjects theapplicantto a.civil penalty of not:more-than five hundred dollars ($500).- 1, 5500)..—I, as owner of the property or my empployees with wages as their sole compensation, will do the work, and the El structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State 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 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 will have the burden of proving heJshe did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business LJ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects Lith a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compens-Cdon Insurance should be provided to me. ❑ I am exempt under Section: B. & P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Heath and Safety Cade Sections 25505, 25533, and 25534 and that I or any future building occupant wiIVWIl not (circle one) need to campy with said state codes and the requirements for a permit for construction or'modification from the Air Ouality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above -men ed propelon rposes. Date:forin p ti_�l U ( Signatur Driver's License or Social Security N: 1641-46 White—Building; Green—Code Enforcement: Canary—Applicant; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM}NO; M , 047691 PERMIT NO: M 047691 PLAN CHECK NO: N GOVT.: N SUPP: N CONSTRUCTION TYPE; 5—N PERMIT TYPE: MEC PURPOSE: ADD JOB DESCRIPTION ; INTERIOR ALT. (OFFICES),REFER TO #B46132 SQ FT: ; CI;AIMVALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: Z O N I N G R E Q U I R E M E N T S + S E T. B A C K S --------- --- MAIN BUILDING -.------------------- ACCESSORY BUILDING - ------------ FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN - PARKING REQ• PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING N TES> �!- if �!- if if if �!- �!- iE iE �(- i[• iE iE iE ir• �(- if if �(- i(- i[• if i(- �k fit• �k i[• i(- i[• i(- i[• �k fit• if il•,il•,i� if- il• i[• i[• i[• i[• iE i[• iE if iE iE �(- i4 if if �!- iE iE if if �!- �!- if * �(- * ir• iE iE �!- if- if- �(- �(- iE if- if- if- if- D E V E L O P M E N T S E R, -,%F I C E S R E Q U I R E M E N T S t ZONING APPROVED BY DATE: BUILDING APPROVED BY r DATE: APPLICATION ISSUED BY: �`! DATE: �(- if- j4 �(- �(- �(- if- if- if- if- 9E if- �f- * * if- iE iE iE iE i[• iE iE if- if- if- if- if- i(- i(- i(- iE �(• if- * i(- * i[• �(- 3E �(- �(- d[• if if iE if jk if �f- iE iE iE �f- iE iE iE iE iE �(- iE iE i[• iE iE �(- iE �(- if �f- if if if if �(- if �f- iE iE iE iE iE iE if jE iE iE �(- if �f- �f- �E dt if i[• �f- * * �E iE �E if- iE iE if- LEGALIZATION:N t F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/RES GRADING PERMIT 9.00 25% SMTP/NON-RES PLAN = -- _ h t = _ . -. -- _ _ . - - -ISSUE -FEE— - T 15.00 ' BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 9,00. 15:00 0,00 24,00 24.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 24,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/,TOT GRADING PLAN -CHECK 24.00 �f- il• it• dt �- �- �- it iE fit- i[• i[• iE +E iE i[• dt dt � � i(• � � * ik'lt x- ir• x- x- x- �t Ill• 3E 3E ?'[• * * * �(- �(- * * ik 3E 3E 3E �E �E dt fit• 3E 3E �(- * * 3E 3E ir- dt it it if- i(- i[• �E iE �E -)(- iE iE it at• dt i[• * * if- if - I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 1 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9.00 l 9.00 END OF FEES, 01 00062934-00062834 TI`IT 24.80 DATE: 06/11/90 TIME: 04:44 r r1 CONSTRUCTION AND PLANNING APPROVALS Permit # � Date _ Inspector POOL t k APPROVALS Permit # Date Inspector �� 1. -Temporary Electrical Service or Pole - - 52. Pool & Equipment Location - 2, Soil. Pipe- Undrgr nd.. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Und"rgrnd, _ 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. -Steel Reinforcement 56. Rough Plumbing & Pressure Test 6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58, Electrical Conduit•Undrgrnd. B. Foundation z 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 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 APPROVALS -Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating ; 71. Product -Piping ❑Gas 0 Oil 23. -Gas Pipe -Rough & Test -: 72. Underground Flush 24. Roof Framing .73. _Undergrnd. Storage Tank ❑ Gas ❑ Oii 25. Roof Sheathing y 74. Overhead Hydro'_ 26, T -Bar Ceiling (Structural) &-Monocoat _ 75. Dry Chemical 27, Frame and Flashing 76. Dry Standpipe ; 28. Lathing & Siding , 77.J FIXED SYSTEM FINAL 29. Insulation 78._FIRE PREY. 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 = i 41. Solar Domestic -Final 42, Backflow Preventer ; 43. Backflow Irrigation 44. Landscape Irrigation System 'r -45: Sound Attenuation 46.• Handicap Regulations _47. FINAL STRUCTURE & BUILDING 48, FINAL PLANNING 49: Electric Release to Edison 50. Gas Release to Southern California Gas Go _ 51. CERTIFICATE OF'OCCUPANCY No. Date Applicant to fill in all spaces except those wittiin heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA �. CONSTRUC-TION PERMIT Project Address• l rwd ve .b1dq. M-3, ' Applicant's Mailing Address 3151 Airway Ave. E-1 C.M.' yr Guildhouse Consultants Phone 540-2606 Owner's Name _ Address 3151 Airway Ave. E-1, Costa Mesa Arch/Eng. Tom Campos & Assoc. License No. Addressl7 79 'T' Main Irvine Ca. Contractor's Name SCO CiampdTly Phone 540-2606 Address (mailing) 3151 AirwayAve. E=1 Costa Mesa City License No. _ LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licehsed under provlslons of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. 333969 { License 1 Ss • icen Date 1 Signature -'ORKERS' COMPENSATION DECLARATI 7` ereby affirm that 1 have a certificate of consent to self -insure or a certificate Workers' CompensationInsurance, or' a certified copy thereof (Section., 3800, Lab. Policy No. Company - "...Fairmont Certified••��copf led copy Is herebwlthrnishef'ing the city Bu J 'cion. rDate�1�l�— Applicant EXEMPTION FROM WORKERS' COMP SAT DECLARATI (This section need not be completed if the perml ilr one hundre ($100) or! less). ; I certify that in the performance of the work for which this permit is,Issued, I' shall not em toy- ny person in any mann so as to become ubject to the Workers' G➢ pen o Laws of California Date: I Signature NOTICEafte ma Ing this declaration, you sh I ecome,su ct to the Workers' Compensation provisions of the Labor de, you mu forthwith comply with' such provisions, or this permit' shall be, deemed revoked. CONSTRUCTION' LENDING, AGENCY - z ` I hereby affirm that there is aiCOnstruction lending agency for the performance of the work for v.Itllpq this' permit is Issued (Section 3097, Civ. C:)� Lender's. Name Lender's Address' OWNER BUILDER DECLARATION' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031,5 Business and Professional Code: Any city or .county which requires a permit to construct, alter, Improve, demolish Or.repair any structure; prior to its issuance, also-requiresthe•applfcant for such permit to file a'signed statement that he/she is licensed pursuant to the provisions of `he Contractor's License Law (Chapter 9 (commencing with Section 7000) of vision'3 of the,Business and Professions Code) or thathe/she is exempt arefrom 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). 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such Improvements are not Intended -Or offered for sale. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im-, rove for the purpose of sale). ' I, as owner of the property, am exclusively contracting with licensed Con- 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 builds or improves thereon,'dnd who contracts for such projects with a can- , tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section S. & P. C. for this reason Date Owner I hereby ify that I have read this application and state that the above Informationcertis correct: 1 agree to comply with all city and County ordinances and •state laws relating to building construction, and hereby authorize repre- sentatives of t City to e e on the above-mentioned property for inspection Our es Si9natuie Date 5/15/84 G Reinspection,,Fee $25 Issue Fee $ 3 ._ TYPE OFCONSTRUUCTION NEW ADD ALTERATI nLJ-REPAIR ❑ CONVERSION ❑'FEMOLISH ❑ OTHERA.P.# ('_ C DESCRIPTION OF WORK _ tenant improvement SUMMAF.LY OF FEES s ' BUILDING PERMIT $ Z�• SMIP $ 3 PLAN CHECK ZS�$� - :+fZ'3 T PERMIT !PLUMBING $" 'J�/�r�� ISSUANCE $ . PLAN CHECK S. ENERGY P.C. $ ELECTRWAL •-S' D _ GRADING $ -PLAN CHECK $ ZZ.gQ MICROFILM $ MECHANICAL $ TOTAL FEE $ 4s?�'L� PLAN CHECK $ o S Main Building:, TYPE OF PERMIT GRADING LJ FOUNDATION 0 STRUCTURAL T Front ® TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER - A - B-2 C Right PROJECT DESCRIPTION SQ. FT.2992 'OCCUPANCY CONSTRUCTION TYPE_... V -N VALUATION $ 44,RRn - n S Left - ZONE GRADING CU. YD5. ACRES Ping. Ref. + Remarks: Y- — S Parking RecidProvided Use of Building: PLUMBING FEES Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs _ Clarifiers } Drinking Fountains Floor Drains Floor Sinks Gas Service' ' Outlets Interceptors Kitchen Sink Lavatories P -Trap Rpof Drains, Reinspection Fee Showers Service Sink . Sewer Cap Sewer Connection' Solar Collectors Solar Piping Solar Tank"_ Swimming Poohw/Spa Urinal 2 Water Closet' ' 1 Water Heater, Water Service 'S25 Issue Fee Boiler _ Duct- Under Ground Duct - Structural Duct- Ventilating Exhaust System 0' Multiple ❑ Firepl/Fact. Bit, ICBO # Heating System & Ducting ❑ G- 100,000 BT ❑ 1 oo,000 BT Drivers' License or SS I Reinspect ion 'Fee $25 CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod -'Assessor 7-1 Automatic Washer Construction Pole Sub, Cooking Unit r r` fel Dishwasher Dryers ❑Gas ❑Electric Fan _ F.A.U. ,y , Fixtures 1- DAice'8oxes, 2L Outlets ` Garbage Disposal - , Generator ❑0-55W ❑5-15 Hood or Type I. ❑ Canopy Type 11' ❑ Refrigeration System 1:30.100,000 BTU ❑ 100,000 BTU System Repair/Alteration Issue Fee 1279 5/30/gp Zone L Accessory Building: Z O N - 1 N G R E Park. Fees $ O U R E M E T ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+ KW Meter ❑up to 1001am0s' Meter 5?over 100 amps ' ,Sub Panel 4 / Motors 00.1 HPVI., 831r lnc.Solar ❑9-15 HP ❑16-151 • Microwave Pole Light Range Sign— Standing ign—Standing Sections N Trash Compactor FEES MIN �= $ 3 r_ Reinspection,,Fee $25 Issue Fee $ 3 FEES OUI E ENTS: PUBLIC SERVICES RK� Zoning'Appro4ed'By ' ' at. �_ Application Approved By- Date�-- Application issued By _ Date SUMMAF.LY OF FEES s ' BUILDING PERMIT $ Z�• SMIP $ 3 PLAN CHECK ZS�$� - :+fZ'3 T PERMIT !PLUMBING $" 'J�/�r�� ISSUANCE $ . PLAN CHECK S. ENERGY P.C. $ ELECTRWAL •-S' D _ GRADING $ -PLAN CHECK $ ZZ.gQ MICROFILM $ MECHANICAL $ TOTAL FEE $ 4s?�'L� PLAN CHECK $ $ 3 J. f t CONSTRUCTION AND PLANNING APPROVALS Permit # _ Date Inspector. POG SPA. APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool &Equipment Location �2, Soil'Pipe Undrgrnd. LfD „' 53., Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd, ,, .. 54. Forms Electrical Conduit-Undrgrnd.: f '° _ (� 55'. Electrical Bonding : IF4. -5. Steel Reinforcement - 56. Rough 'Plumbing & Pressure Test 6. Electrical UFER Grnd. , ,57. -APPROVAL TO COVER-GUNITE 7., Footings 58. Electrical Conduit-Undrgrnd. ' 8. Foundation 59., Gas Pipe; ❑ Undrgrnd.,.Test 9. Water Pipe-Undrgrnd. �,�/�,r LV ' 60.'Backwash Lines, P -Trap, ❑'Undrgrnd. ' 10. Structural Floor System 61, APPROVACTO DECK 11.• Property Sewer Line & House Connection l 62. Backwash '& Receptor -Final 12, Sewer Cap 4 63. Heater & Vent -Final 13. Roof Drains 64...Plumbing System - Final 14. Rough Plumbing 611,1%y ( (J 65. 'ElectHcaI-Final ' 15. Rough Electrical -Conduit r 66. Solar System -Final 16.1 Rough Electric Wiring G ' 67. Fencing & Access Approval 17, Rough Wiring Sign _ 68. -APPROVED FOR PLASTERING 1$:• Rough Electrical -T Bar Ceiling 69, POO [:/SPA SYSTEMS FINAL 19. Rough Heating & Air C tt' ' (,gyp FIRE -DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Dpcts, in Structure i 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping' ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test ' 72. Underground Flush 24• Roof Framing } 73. -Undergrnd. Storage Tank ❑ Gas ❑ Oil 25, Roof Sheathing 74, Overhead Hydro 26. T -Sar Ceiling (Structural) & Monocoat �� 45. Dry Chemical 27. Frame and Flashing D��n�`- *IE�k (Q1� 76. Dry Standpipe, 28. Lathing & Siding' C'. ' 77. FIXED SYSTEM FINAL 29.E Insulation 78. FIRE PREV. FINAL ' 30. Drywall Nailing ' HEALTH DEPT.'REQUIREMENT 31:'Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final ) ` G 80. FOOD -CERTIFICATE ISSUED 33. Final Electric .i�6 �� + Notes: 34. Final Heating & Air Conditioning- 35. Final.Gas'Pipe-Test 1 36. Hgod or Canopy JP 37. Final.Factory Fireplace 38. Final Plumbing! L190 39. Water Service -Final r 40. Gas Service -Final , 41. Solar Domestic -Final 42, Backflow Pre venter r. JVl 43. Backflow Irrigation 44. ,Landscape Irrigation System' t ! 45. Sound Attenuation c ! • I .y , 46. Handicap Regulations' _ 47. FIN4LSTRUCTURE & BUILDING f3 f r 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ( r + E• 51. CERTIFICATE OF OCCUPANCY No.. Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE O E OCCUPANCY No. 031015 P- O. Box 1200 Costa Mesa. California The Building located at 3151 Amway Avenues #Nl & 2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building Legal Description Offices 427-291-15 (See reverse side for Metes and Bounds) Building Permit No BP16529 Electrical Permit No. E16544 Plumbing Permit No. 13P16529 Mechanical Permit No. 6805 Number of apartments 0 and/or guest rooms 0 ISSUED TO: BuildingOfficialAo. C!4:z4'4 Jds7 / Gtilildlau.-A-- rensix1tanta- 3151 Airway Avanue, #El, ODsta Mesa, CA _ Date This Certificate of Occupancy SHALL- BE posted in a conspicuous place on the,premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File 1 1 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 3151 AIRWAY AVENUE UNIT N-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group H-2 Occupancy. Use of Building T.I. "UNIGLOBEPW TO GQ TRAVEL" Legal Description 427-291-15 (See reverse side for Metes and Bounds? Building Permit No B66434 Electrical Permit No, E66467 Plumbing Permit No, P66532 Mechanical Permit No. Number of apartments and/or guest rooms ISSUED TO: Building Official TOW C'fleBACA JMIKA ENTERPRISES 1851 W. VISTA BAY #262 by VISTA CA 92083 Date ,TiJ[,Y 14, 1994 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink • Bldg. Permit File i� City of Costa Mesa Development Services Department ' Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 3151 Airway Ave, Bldg. N Ste. #1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. Use of Building Office Legal Description 427-291-15 ISee reverse side for Metes and Bounds) Building Permit NO B52643 Mechanical Permit No lectrical Permit N o, E52782 Number of apartments Plumbing Permit No.P52728 and/or guest rooms ISSUED TO: Building Official Tonv C' De Baca California Federal Bank 3151 Airway Ave. #F--108 by Costa Mesa, CA 92626 Date August 14, 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White -Owner; Canary • Numerical File; Pink - Bldg, Permit File CITY OF COSTA MESA ' F BUILDING DIVISION h77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00138 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93894036 DATE ISSUED: 07130/2009 ISSUED BY: RMD JOB ADDRESS: 3151 N AIRWAY AV CM SuitelUtiit:, .. N Vicinity: BUILDING N ROOF Squares: 0 Valuation: $17,300.00 SCOPE OF WORK: REROOF BUILDING "N". TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 15 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 70 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED, OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: CALIFORNIA %PROPERTY, RESERVE I Unit: 10 E SO TEMPLE ST #400 PHONE:.'City/State/Zip: BRUCE CHRISTENSEN APPLICANT: HANSEN, DUKE Address: N6646636 PHONE: CitylState/Zip; CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557-7440 CitylStatelZip: SANTA ANA, CA 92707 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $293.25 . Reinspection Fee; $0.00 Bldg Std Admin Fund $1.00 - TOTAL FEES $294.25 %SOUTHERN Unit: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. WDF I• INSPECTION TYPE DATE INi1ilAL5 CODE /INSPEC_,� T10x rrP DATE, INTn1ALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final !p� 206 Final Plumbing 200 Final Re -Roof — �Q-1 210 Final Electrical 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 WORKERS' COMPENSATION DECLARATION: i 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. qr 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: % Carrier: rs7��q,r (This seri bn need not be can�p7etediflhe pend u valued at one hundred "ars (S100) or fess.) Policy, Number. (%C22 f S' Z O b ❑ 1 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 bec subject to the workers' compensation provisions of Section 3700 of e,lihie Labo Code, I sh ft orthwith comply with these provisions. Applicant's Sigsdlure - Date 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 DOLLARS ($100,000), IN ADDITION 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 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. Li c,' Class # 7l 3n/� 9 tractor s Sign lure al 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 Dale 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 ($500).): ❑ 1. as owner of the property, or my employees with wages as their sole compensation, WILL 00 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.). ❑ 1, 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 3057-46 (3107) 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-buitder, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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 feel 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 ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If 'fres". 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? ❑ Yes ❑ 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 LegalOwner(s) Date ,AnWor Aulhorrzed Applicant Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA- PE iT NO. TRACT NO. LOT NO. BLDG. NO. ' ,CONSTRUCTION PERMIT TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION _REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER61159 - _ ZONING REGULATIONS Project Address 5 Airway, Costa Mesa, Ca. Owner J. Dona O On Phone 540--260 Address 18003 Sk rk, Irvine, Ca. Arch/Eng. - License No. DESCRIPTION OF WORK 0714781 A.P.� _ �lae�Q ZONE PLNG. REF. gr Address Contractor I,eaverton-Beck, IC. Phoneg79-356 TYPE OF PERMIT ❑ GRADING El FOUNDATION El STRUCTURAL TENANT- ❑ ELECTRICAL 1 LUM13ING ❑MECHANICA SETSAC ST. IDE YARD — Wll�E yARD oogguul��pplNG �ROPERTY LINE Address 16721 Hale, Irvine, Ca. 92714 LICENSED CONTRACTOR DECLARATION❑ hereby that I licensed Charter 9 (com- I affirm am under provisions of with section 7000) of Division 3 of the Business and ❑ OTHER ( HT mencing Professions Coda, yjr}d6 my license Is In full force�arldggfject. C i 9 - PROJECT DESCRIPTION REAR YARD (TO P/L) License Clas ocense J b PKG. SPACE REQ, PROVIDED Date _ Signature � � � SQ. FT. + STREET WIDTH - PARK FEE $ ' WORKERS' COMPENSATION DECLARATION - OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure ora 1• VALUATION' ZONE ZONING -APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy _ - thereof (Sectlon 800 b. C.). GRADING,CU. YDS. ACRES SPECIAL CONDITIONS: PoilCy No. 1'Af Company?iI212 i�af innal - - -- ertified copy is hereby_furnlshed. _ _ REMARKS: rtified copy is filed with the city Building Division. EXEMPTION FROM'WORKERS' COMPENSATION DECLARATION - "" - — - - - - (This section need not be completed if the permit is for, one hundred ($100) or less). I cert fy that -in the performance of the-work,for which this_perihit Is issued, I shall not employ any person in any manner so as to become PLUMBING - PLAN CHECK' ELECTRICAL - PLAN CHECK. subject to the Workers Compensation Laws of.Californla._ _ BATHTUBS SHOWERS UVYt SO- FT - Date Signature TOILETS- URINALS - GENERATOR -0-1 KW 1-10 KW NOTICE. If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code,'you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS -' - APPLIANCE 10-50 KW___50 + KW - revoked._ - KIT. SINKS 'DISHWASHERS MOTORS 0-1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS +SUMPS (INC. -SOLAR) 10-50 HP - 50 +-HP formance of the work for which this permit Is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES ` Civ. C.). - Lender's Name Lender's Address i DRINKING FOUNTAINS GASTUBE'SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for 'SWIMMING POOL P'TRAP POLES METERED - - SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE- A0—ERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior to Its Issuance, also re- quires the applicant for such permit to file a signed statement that he 1 - "GAS SERV ICE OUTLETS - - SERVICE AMP ^ Is licensed pursuant to the provisions of the Contractor's License Law 9 (commencing with Section 7000) of Division 3 of the -WATER HEATERS- -BTU OUTPUT -- 13Chapter uslness and Professions Code) -or that he Is exempt'therefrom and the hasls for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - v applicant 'for a'permlt subjects the applicant to a civil penalty' not more than five hundred dollars ($500). SOLAR'TANK COLLECTORS - 1, as owner of the property, or my employees with wages as their sole compensation, will do.the work, and the structure Is not Intended S; ISSUE FEE - or offered for sale. (Section 7044, Business and Professions Code: The Contractor's .License Law does not apply to an owner of a Property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK ` SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner -will have the burden ., of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT S SMIP $ © I, as owner of -the 'property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to 100,000 + BTU PLAN CHECK E / PERMIT , ISSUANCE an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU ,. 1/ PLUMBING S �r2 �� $ tracts from such•projeets with a contractor(s) Ilcesned•pursuant to SYSTEM GRADING $ the Contractor's License Law), 100,000 + BTU .PLAN CHECK S El I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL S $ ' reason PLAN CHECK '$ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE S- MECHANICAL $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ LESS AD - Information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC s _ ordinances and state laws relating to construction, and hereby authorize representative if this city t enter upon the above mentioned property f r s ectp ion our se = L.IC.(C-I�- / FINAL FEE Signatur _$ Drivers' License or SS � ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor A7 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Un.d.rgrn.. ,• , 44. Steel Reinforcement =T ou Electrical Cdnduit'UtiliWUndrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test .9. Water Pipe-Undrgrn 51.- Backwash Lines. P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection La. 53. Backwash & Rece for -Final 12.. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 5B. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Serinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40, Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, C( MESA _ AMINO, TRACT NO. LOT -NO. BLDCp. NO. UCTION PERMIT (/� O�]L. F N Project Address S' - 2W - C7..TYPE OF CONSTRUCTION OWne �� hbrlc sZ ❑NEW ❑ADD ❑ALTERATION til ❑ REPAIR ❑ CONVERSION 13 DEMOLISH rl ❑ OTHER DESCRIPTION OF WORK -- Address - Arch/Eng, License No. Address - - - _, 'Contracto , 0 � 4 C Ph6na&VOYO-20 TYPE OF PERMIT_, ❑ GRAOING ❑ FOUNDATION ❑ STRUCTURAL ` ❑ TENANTELECTRICAL ❑PLUMBING- ❑ MECHANIC Address '� l [ e LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing 'with section 7000) of Division 3 of the Business and rProfessions Code, -1a I�,ense--tsyn dull for eff ct. , • , ❑OTHER PROJECT DESCRIPTION. _ i .License Class _.� ( J i(cense Date' -;'•O —9WZ Slgnatur ..r SQ. FT. WORKERS' COMPENSATION DECLARATION _ OCCUPANCY CONSTRUCTION TYPE it hereby affirm that I have a certificate of consent to self -insure or a -certificate of Workers' Compensation Insurance, or a Certified copy VALUATION ZONE _ thereof (Section 3800, La y. OV.). 'k,licy No I+JC%I - IJJ• 1�"lµ•�Irrri C:n.r GRADING.CU. YDS. ACRES _ ,Certified copy is hereby furnished. - - , _ _ .. _,. rCertlfled copy Is,filed with the•city Building Division. REMARKS: ' SO �r EXEMPTION FROM WORKERS' COMPENSATION -DECLARATION ,(Thls section need not be.completed if the permit is for one hundred [$100) or IcSSI. ! + Certify_that in the performance of the work for which this permlt IS Issued, I shall not employ any person in any manner so as to become subject-to.the.Workers Compensation Laws of ,California. - * -. - -7-T 777-7- - s , PLUMBING- 'PLAN'CHECK BATHTUBS SHOWERS Date Signature 'NOTICE: If after making this declaration, you should become subject TOILETS f -URINALS - Jo the Workers' Compensation provisions of the Labor Code ; you must' 'forthwith comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LAYS ,revoked. _ ., f .-. CONSTRUCTION LENDING AGENCY -KIT: SINKS' 'DISHWASHERS SERVICE SINKS•t ,-, .-SUMPS"' 'I hereby affirm that there IS a construction lending agency for the per- �formance of the work for which this permit Is Issued (Section 3097 FLOOR SINKS _ >rLOOR DRAINS '`�'� t• ` _ - Lender's Name DRINKING FOUNTAINS_:- - :Lender's Address -' - -INTERCEPTDRS CLARIFIERS— OWNER BUILDER DECLARATION -- - I hereby affirm that I am exempt from the Contractor's License Law for - SWIMMING POOLP TRAP the following reason (Section 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 re- quires the api.lirant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License'Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and,,ProfesSions Code) or -that -he is exempt -therefrom and the h-sls for the alleged exemption. Any violation of Section 7031.5 by WATER SERVICE ' ALTERATION " GAS SERVICE - WATER HEATERS-- BTU OUTPUT* SEWER CONNECTIONS" "•, - " -` applicant for a permit subjects the applicant -to a -civil penalty of more than five hundred dollars ($500). SOLAR TANK- " - ' 'COLLECTORS - �- - - 1, as owner -of the property, or my employees with wages as their sole_compensation, will do the ,work, and the structure is not intended + - SOLAR PIPING SYS. - or offered for sale. (Section 7044, Business and Professions Code: The ,Contractor's _License Law does not apply to an owner of a property � ISSUE FEE if who builds or improves thereon, and who does such work himself or through nis own -employees, provided that such improvements are not 'intended or offered for sale. If, however, the building or improvement is sold. within one year of completion, the owner will have the burden _ MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000'+ BTU t :of proving ne did not bund or improve for the purpose of sale): ,❑ I, as --owner of -the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to REFRIGERATION 0-100,000 BTU 'an owner of property who builds or improves thereon, and who con- tracts from such -projects •with a contractor(s) llcesned pursuant to the Contractor's License taw). SYSTEM - 100,000 + BTU +� ❑ 1 am exempt under Section' - -B."& P. C: for this BOILERS Bib Y - reason— eason Date. Owner Date SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ' 11 hereby Certifythat I have read this a t_ application and state that the above in f0g reci. 1 agree to ;omply'with all city and county ortlintes and sta s relat 9 to construction, and hereby authorize reprnta[i�es'�df 'ci to enter' upon' the above mentionedprofor i 0 poses. Signature Date Drivers' License or SS _ - ry -fSSUE-FEE - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 6116 5/20182 27.25 , ZONING REGULATIONS A.P, =jP ZONE PLNG. REF• !f SETBACK -Q�1. ST. PROPEIRTY LINE. I51YARD - T REAR YARD (TO P/L) PKG,'SPACE REQ. PROVIDED' STREET WIDTH PARK FEE -$ ` ZONING APPROVED BY DATE _ 'SPECIAL CONDITIONS: ELECTRICAL PLAN CHECK, SQ. FT. 5173_ FT_ GENERATOR 0.1 KW 1=10 -KW ' TRANSFORMER + APPLIANCE -10-50 KW,- 50 +-KW- - -- - - jMOTORS- - 0.1 -HP -'"-- 1-10 HPC i(INC..SOLAR). _ 10.50 HP - 50.+ HP -- FIXTURES" OUTLETS jSWITCHES71 ) ,GAS TUBE SIGNS - - POLE'LIGHTS - - If POLES METERED SUB' 1 :PANELS •-- MAIN : jSUB SERVICE"-- AMP1 - ISSUE -FEE • - -• - - - - - r -tAPPLiCATION-APPROVED BY- - - - '-DATE SUMMA RYOF,FEES } 'BUILDING - 'PERMIT 5 ' SMIP • $ 'PLAN CHECK $ ryPERMIT , ISSUANCE '$ fiPLUMBING - S T_ i GRADING' $' PLAN CHECK $' ELECTRICAL $ 2 $ 'MICROFILM $- PLAN CHECK- E - -' TOTAL FEES MECHANICAL: $ - � _ • i ,LESS AD- PLAN CHECK $ VANCE PC - FINAL FEE TL CONSTRUCTION'AND PCANNING Permit # �4Date Inspector POOL& SPAS t #� Date.'% Inspector _1rAPPROVALS T 1. Temporary Electrical Service or Pole 43. Pool & Equipment•Locaiion t�' '' �"'"- 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms - 4.. Electrical Conduit•Undrgrn 46. Electrical Bonding - 5. Steel Reintorce - •• 47. Rough Plumbing &'Pressu're'Test 6.._ Electrical UFER G_ rn _ 48. APPROVALTO COVER=G(J 1TE 7. _ Footings 49. Electrical Conduit-Undr rn -_8.- Foundation 50. Gas Pipe, ❑Undr rn, Test 9, ..Water Pipe-Undrgrn ` ' 51. Backwash Lines P-Tra" ❑ ' n- rA 10._. Structural ,lb"or System 52, APPROVAL TO DECK 1.1. Property Sewer,Line & House Connection.. -53. Backwash & Rece for -Final _12._ Street Sewer Connection - - - 54. Heater & Vent -Final y ' 13. Rough Plumbing _ _ _ - - 14. Rough Electric -Conduit 56:" •Electrical -Final 15. Rough Electric -Wiring ./ :g t 57: Solar System -Final - _ 16.- Rough Heating & Air -Conditioning 58• . encing & Access Approval 17. Ducts, -in Structure = ,rt- - APPROVED FOR PLASTERING 18. Ducts, Ventilating- 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe=Rough & Test - ' -20. Roof Framing 21. Roof'SheatFiin - - _- - NOTES -:-,L t 22. Frame and Flashing - _-. - _ -23'. Insulation 24. Lathing & Siding 25. Drywall Nailing. ,• 26. -Plaster Brown Coat ,- 27: Electrical Power Meter -Final - -28- Final. Electric- lectric 29'L 29'L Final -Heating & Air Conditioning---,- I _ 30. Final'Gas Pipe -Test - -i 31'. Final'Plumbing __ _ ► ' 32. Water Service -Final - -33.- .Gas Service -Final - 34. Solar Domestic -Final 35. Lands ca e Spriinkling SprinklingSystem 36. Sound Attenuation + 37. Handicap_Regulations 38. FINAL STRUCTURE & BUILDING 39. Special ,Requ'€rements Completed - - 40. Electric Release to Edison s 41. Gas Release to Southern California Gas Co. ` 42, s CERTIF ICATE OF OCCUPANCY No. Date i C Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER T N � ��. CONSTRUCTION PERMIT TRACT NO. LOT NO.I-BLDG.NC. 35%I 7/21 /82 t 240 TL• - • -•• - .. _ _ _.. Project Address 315. Airway, Costa Mesa CA TYPE OF CONSTRUCTION - OwnerJDO'CompanyPhone —260 0 NEW ❑ ADD ❑ ALTERATION Address3151 Airway. Costa Mesa CA 92626 El REPAIR ❑ CONVERSION ❑OEMDCISH ❑ ZONING REGULATIONS Arch/Eng. License No. OTHER Address ' DESCRIPTIDN OF WORK A.P. P0 ZONE PLNG. REF. =)F Contractor Leaverton-Beck Inc. Phone 9'79-356 TYPE OF PERMIT SET ACK �RQPEIE7TY L NE Address n .92714 ❑ GRADING ❑_FOUNDATION ❑ STRUCTURAL I YARD LICENSED CONTRACTOR DECLARATION ❑,TENANT ❑ ELECTRICAL LUMBING ❑MECHANIC 5I y ARD I hereby affirm that I am licensed under provisions of Charter 9,(com- RIGHT mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license Is In full force anil effect. REAR YARD (TO P/L) C36 19 969 PROJECT DESCRIPTION Lleonse [ass License No PKG. SPACE REQ. PROVIDED " pate -�� Signature SQ. FT. WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE E I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (s�c(]Qr) a8D01lph. c.). Great Amer lean - (( 33UU��JJZZUU 1 ' GRADING CU. YDS.. ACRES SPECIAL CONDITIONS: Ilcy No. Company Certified copy Is hereby furnished. REMARKS: -.Certified copy,is filed with the city Building OiviSlon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - This section need not be completed If the permit is for one hundred - ($100) or less). f 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws of California. Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration,you should become subject TOILETS URINALS GENERATOR 0.1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER ' forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW 50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) ' 10-50 HP ' 50 + HP formance of the work for which this permit is Issued (Section 3097 Cl V. C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS a . OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason (Section 7031.5 Business and Professions Code:SWIMMING POOL P TRAP Any city. or county which requires a permit to construct, alter, POLES METERED SUB r Improve, demolish or repair any structure, prior to its Issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB ' quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Buslness and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT F r -is for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to 'a civil penalty SEWER CONNECTIONS �t of more than five hundred dollars ($500). L! 1, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. f.{J ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does Such work himself or ISSUE FEE 3 APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ 1, the am exclusively contracting with HEATING SYSTEM 0-100000 BTU , BUILDING PERMIT 5 SMIP S as owner of property, licensed contractors to construct the project- (Section 7044, Business AND DUCTING 100,000 + BTU PLAN CHECK $A, I PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a ContraCtor(s) Iicesned pursuant to SYSTEM GRADING $• the Contractor's License Law). - - 100,000 + BTU_ PLAN CHECK S s ❑ lam exempt under Section B. & P. C. for this BOILERS BTU 'ELECTRICAL $ S reason PLAN CHECK S MICROFILM S SYSTEM REPAIR, ALTERATION Date Owner MECHANICAL E TOTAL FEE S I hereby certify that -I have read this application and stale that the above EXHAUST SYSTEM - MULTIPLE LESS AD - Information is correct. I agree to comply with ail city and county PLAN CHECK S VANCE PC S ordinances and sta a laws relating to construction, and hereby authorize representatives this city to e t r upon the above mentioned property I p t purp - �� fL FINAL FEE S Signatur Drivers' License or SS ISSUE FEE - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNI APPROVALS Permit # Date Inspector POOL & SPA'. APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47, Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undr rn 8. Foundation 50'. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Liries P-Tra ❑ Undrcirn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection- 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - -- - 14. Rough Electric -Conduit •56. Electrical -Fina! -15. Rough -Electric -Wiring ' 57. Solar System -Final _ 16. Rough Heating & Air Conditioning SH. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL -'- 19. Gas Pipe -Rough &Test 20. Roof•Framing 21. Roof,Sheathin NOTES: 22. Frame and Flashing 23. Insulation 24, Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28, Final Electric 29: Final,Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 7- 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic Final 35. Landsea e Sprinkling System 36. Sound Attenuation ' 37. Hand icap,Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date r PS -3 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY OF COSTA -MESA 'PEIT NO. - TRACT NO. OT NO. BLDG. NO. CONSTRUCTION PERMIT 6140 5/20/82 23.00 TU Project Addres/� •r r/ �1�� 2, E OF CONSTRUCTION NEW 13ADD ElALTERATION r, - Owner rPhone Address &Ra r, ❑ EPA'IR ❑ CONVERStON ❑DEMOLISH_ 13 OTHER ' DESCRIPTION OF WORK - ZONING REGULATIONS - A.P. - ZONE ^ PLNG. REF. Arch/Eng. License No. Address Contractor Phone %• TYPE OF'PERMIT ' SET AC T. GRAdING ❑ FOUNDATION ❑ ST CTU RAL IDE YARD_ /❑ TENANT ❑ ELECTRICAL ❑PLUMBING ECHAN[CA SIDE YARD - I HT - ❑OTHER �ROPEIRTY G - LINE " _ + - "-- 4ddr ' LJ l) LICENSED CONTRACTOR DECLARATI '"' hereby, I affirm that I am licensed and ions of Char co mencing- with section -7000) -of +On Of the siness - Professions Code, and my lice• iso I full f a d C PROJECT DESCRIPTION' REAR YARD (TO P/L) License Class Llc crse Igna r WORKERS' COMPENSATIO CLARA N_ I hereby affirm that I have a ertificate of consent to self4ns�.�_�VALUATION certificate of Workers' Compensation ins onto, or -a cerlifi -hereof (Se n 800 tji .�. f �d �% lky No. Company L/� �5-�s-/J_5 • 5;Mfiecl copy Whereby furnished.. __ ILYCerti(led copy Is.filed with the city Building Olvision. _ - - i - : FT: CUPANCY CONSTRUCTION TYPE ZONE .GRADING CU. YDS. ACRES REMARKS: _ I Oat , --- .- ^ - - PKG. SPACE REQ. - -- STREET WIDTH - ZONING APPROVED BY SPECIAL CONDITIONS: - --- + PROVIDED PARKFEE S DATE _ - - -- F _ EXEMPTION FROM WORKERS"COMPENSATION DECLARATION - + (This section need not be completed_lf the_permit is for one hundred (5100) or leu). * - t certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner s0 as'to become subject t0 the Workers Compensation Laws of California. • ' PLUMBING - • PLAN CHECK - - - + - ELECTRICAL - ' --- PLAN CHECK - -BATHTUBS SHOWERS - ' i ' _ _ pate Signature NOTICE: If after making this tleClaratlon, yOu should become subject, .to the Workers' Compensation provisions of the Labor Code, you'must forthwith comply with such provisions or this permit shall be deemedATORIES -TOILETS,. URINALS — -- - DOUBL-E-LAVS - - -- GENERATOR 0 -1 -KW- TRANSFORMER APPLIANCE - 10-50 KW_' 1-10,KW _... 50 + KW CONSTRUCTION LENDING AGENCY ~' SINKS - - ^' --DISHWASHERS--• --� - MOTORS 0-1 HP1-10 HP.J hereby affirm that there is a construction lending agency for the per -ICE formance of the work for which this permit is issued (Section 3097 SINKS ,-SUMPS •- ••� - _- _ (INC. SOLAR) _ ;0;50 HP 50 + HP `FLOOR SINKS FL'OOR-ORAINS - - •FIXTURES-- --OUTLETS. .SWITCHES_ (Lentle.). Name T -Lender's Address -� DRINKING FOUNTAINS -..-GAS TUBE.SIGNS __ �_ t -. OWNER 'BUILDER DECLARATION -Y' -- --- I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORSCLARIFIERS POLE LIGHTS _ - - - - -' - the'following reason (Section 7431.5 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 re. 'quires the ap; llcant for such permit to file a signed statement that he - SWIMMING POOL -P TRAP - POLES' `' METERED SUB -WATER SERVICE - -ALTERATION - -- PANELS - MAIN-_ SUB - -GAS SERVICE'-- OVTLETS -•- - - SERVICE AMP'S' t •'- - ds'licensed pursuant to the provisions of the Contractor's License Law ,LChapter 9 (commencing with Section 7000) of Division 3 of the "WATER HEATERS - BTU OUTPUT- -- -- - - usiness and-Professions•Code) or that he is exempt therefrom and the- cis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS-. _ ^ _ . '7— ;.' _ '_ _ 1 no five runthundsubjects s (5500)the licant-t0 a Civil penalty, ,,j I. as -owner Sf-the property, or myemployceS Mth`wages as their .sole compensation, will do the work, and the structure is not Intended or offered for sale.'(Sectlon 7044• Business and Professions Code: The lContractor_s. License -Law does not apply to an owner of a property iwho builds or improves thereon, and who does such work himself or through his own -employees. providedthatsuch improvements are not intended or offered for sale. If, however, the building or improvement ,)s sold.within one year of, Completion the owner will have the burden 'of proving he did not build or Improve fog the purpose of sale). Q I, as- owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon• and who con- tracts from such projects -with a •contractor(s)-licesned- pursuant. toSYSTEM the Contractor's License Law). '❑ I am'exempt under Section - B. -&'P. C. for this SOLAR TANK --• COLLECTORS SOLAR PIPING SYS.- -'" _ - - -- - - - ISSUE FEE - APPLICATION APPROVED BY_ - ISSUE FEE ' ' - �� - -- - - DATE ' + MECHANICAL PEAR CHECK (M __, SUMMARY OF FEES �' L -BUILDING_ HEATING SYSTEM 0-100,000 BTU PERMIT 5SMIP $ AND"OUCTING �Q _ + 100,000 + BTU PLAN CHECK 5 - ' PERMIT . « _ _ _ _ _ 'ISSUANCE ' $ REFRIGERATION 0-100,000 BTU PLUMBING $ - mGRADING $' 100,000 + BTU PLAN CHECK BOILERS BTU ELECTRICAL •S ! r , - �$ 'reason - • Date Owner _ I hereby certi at I ve read t applicat' and slate that the above Informatio is c r I a to Co with all City and County -Ordinan ands laws ting struction, and hereby authorize ,repres atl ' of thl en a 'above mentioned prop Y Signa Drivers' License or SS - - - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE PLAN CHECK , MECHANICAL $ � u r PLAN CHECK MICROFILM $ - - - - •TOl"AL FEE $ LESS AD- vANCE PC S _ ' FINAL FEE S ��. eb CMF 0665.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod-AsSeSSOr Z r CONSTRUCTIONANDPLANNING APPROVALS Permit y - �� Date Inspector- � POOL &SPA APPROVALS f' _kPermitt#' Date Inspector 1. Temporary Electrical Service or Pale 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms ' 4. Electrical Conduit-Undrgrn 46, Electrical Bonding, . 5. Steel em orce _ 47. Rou h'Plumbing &P'ressu're Test 6. Electrical UFER Grn 48. APPROVAL TO COVER=GUNITE"'z-, 7. -Footings 49. Electrical Conduit-Undr rn 8. Foundation -- 50. Gas Pipe, ❑ Undr rn •Test. 9. Water, Pipe-Undrgrn 51. Backwash Lines P-Tra P.- O' r drg'rn 10. Structural Floor System 52. APPRpVALTO DI=CK r i 11. Property Sewer Line &.House Connection 53. Backwash & Receptor -'trial 12. Street Sewer Connection54. Heater & Vent -Final , Z , -. : ,i: •. 13. Rough Plumbing 55- Plumbing System - F a nal - 14. Rough Electric -Conduit :56.. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing - 21 • Roof Sheathing NOTES: 22. Frame and Flashing 23• Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final, Heating & Air Conditioning 30. Fina i. Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System '=- 36. "Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No Date _ , Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. 5786 19/wt3/e CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. . BLDG NO. CONSTRUCTION PERMIT .6 / f e2— -'7R , 1 a N TYPE OF CONSTRUCTION - Z] NEW ❑ ADD ❑ ALTERATION Pian Check # 51442 ❑ REPAIR ❑CONVERSION ❑DEMOLISH ZONING REGULATIONS ❑ OTHER Project Address 3151-N Airway Avenue, Costa Mesa Owner Western Pacific Financial Phone752-7670 Address 1601 Dove Street New ort Bch. Ga. n Arch/Eng. Hales License NO. C-010899 -Langston DESCRIPTION OF WORK Commercial A.P: Address 777 S. Main #105 Orange, Ca. Office Condominiums ZONE L PLNG. � ^ -7 '-130 Contractor The J . Donald Olson Co .Phone 540-260 ggREF. G TYPE OF PERMIT SETBACKT. �ROPERT Y INE ❑GRADING FOUNDATION (J STRUCTURAL I YARD fit' ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC E YARD Address -#.!51-E 51-E AZ rwa Avenue Costa Mesa CA LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- 70001 Division - RIGHT W, ❑ Mencing with section of 3 of the Business and Professions Coda, and m license Is In full force an a fact. RY n License Class u License No. 3 9 7 OTHER REAR YARD (TO P/L) PROJECT IPTION MT PKG. SPACE REQ. � PROVIDED [� - Date Signature SQ. FT. N B-2 STREET WIDTH PARK FEE S WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a OCCUPANCY CONSTrR�(U}CTION TYPE 185 887 ZONING APPROVED BY I DAT Y certificate of Workers' Compensation Insurance, or a certified copy _ VALUATION •",'ONE thereof {Se do 0, C �—f4 GRADING CU. YDS. AGREE SPECIAL CONDITIONS: ` -iicy No. -M -�^mpany Fairmont Ins ureanc Q�E1� : ert(fied copy I$ hereby furnished. REMARKS: 0 1.5 % Certifled copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred or less. 1E100� Cert fy that n the performance of the work for which this permit is Issued I shall not employ any person in any manner so as to becomePLUMBING subject to the Workers Compensation Laws of California. PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS DatO Signature TOILETS URINALS GENERATOR 0-1 KW 1-10 KW NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1.10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP _-50 + HP for mance of th ort for w Ich th per ( Is issued eclion 3097. an FLOOR SINKS FLOOR DRAINS FIXTURES , OUTLETS SWITCHES Civ. ides ern Kaci Vi c �i nand a I Lender's Name Lender's Address157- 0Ve Street, a DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I nereby affirm that I am exempt from the Contractor's License Lew for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to Construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior to Its Issuance, also re- quires.the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and ProfesSions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty -1t more than five hundred dollars ($500). SOLAR TANK COLLECTORS LJ 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 SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property improves does such g/ APPLICATION APPROVED BY DATE Z who builds or thereon, and who work himself or through his own employees, provided that such Improvements are not ISSUE FEE MECHANICAL PLAN CHECK SUMMARY OF FEES ' intended or offered for Sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ the am exclusively contracting with HEATING SYSTEM 0-100,000 BTU BUfLOING ��8 �r� SMTP S 13-�� PERMIT E" tn�Z.l2r�s7t�.sls/g�L-w. I, as owner of property, AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK *42!7: L►L PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Lew). 100,000 + BTU PLAN CHECK S ' ❑ I am exempt under Section B. 6 P. C. for this BOILERS BTU ELECTRICAL S $ reason MICROFILM $ SYSTEM REPAIR, ALTERATION PLAN CHECK $ O Date Owner MECHANICAL-$ TOTAL FEE S I hereby certify that 1 have read this application and state that the above EXHAUST SYSTEM - -MULTIPLE - LESS AD - information Is correct. i agree to comply with all city and county PLAN CHECK $ VANCE PC S ordinances and State laws relating to construction, and hereby authorize representati hiS cl y gnter u the above mentioned property o ctl n urs G� G7 FINAL FEE S 6 1-01 Signature - Drivers' License or SS ISSUE FEE - -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # a' Date inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical-Conduit�Utility-Undrgrn 45. Forms 4... Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel ein orce 47.• Rou h Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 5 iO-IS-q t '49. Electrical'Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ n r rn 10. Structural Floor System 52. APPROVAL TO DECK " 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12, Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit •56. Electrical+inal . 15. Rough Electric -Wiring- - 57. Solar System -Final = 16. Rough Heating & Air Conditioning W Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SQA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing•• - NOTES:aj�7jnAe-Oki 22. Frame and Flashing 141-W 23. Insulation I-,_ 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation - 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA CONSTRUCTION PERMIT Applicant's Mailing Address 3151, Airway Ave.. E-1 , C.tA, Owner's Name Gui 1 dhouse Consultants Phone540-2606 Address 3151 Airway Ave; F-1 Costa Mesa Arch/Eng. llatteo Mardi nl License No. 06291 Address 926 Town & Country Rd ' Contractor's Name J.:' •_ Donald• Olson Phone540-2606 Address (mailing) 3T51 Airway Ave., C-1 , Costa Mesd City LiCPnse No. 22707 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full f rc and effect. { Licens a Li r se No Date Signature WORKERS' COMPENSATION DVCLARATION 1 hereby'affirm that I have a certificate of consent to selfansure or a certificate of Workers' Compensation Insurance, or a certified, copy thereof (Secticn, 3800, Lab. C.) C n 'icy No. - F-2974 company' F17 rlMOnt _ _-- Certified coppy IIss hereby furnished. ' DateelliIF/U�j•_filedwiittPpis city iltlI 9'Division EX£IiAPTION:FROM.WORKERS'C PENSATION-DECLARATION (This suction need'not be compteted'if the permit is for one hundred ($100) or, 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.' •� Date Signature NOTICE: if, after making this declaration, you should become subject to the Workers'- Compensation provislons'of the Labor Code, you must forthwith comply with such provisions - or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performance of the work for wMichn this permit Is Issued (Section 3097 Civ, C.). Lender's Name' i 2% Lender's Address _ OWNER BUILDER DECLARATION y I hereby affirm that I am exempt from the Contractor's License Law for the following reason(Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section, 7000) of 'Division 3_of the Business and Professions Code) or that he/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 ($504). I, as owner of the property or, my employees with wages as thelr sole mpensation, will do the work, and the structure I$ not intended or offered or sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement is Sold within one year of com- pletion, the owner will'have'the burden of proving he/she did not build or im- rove for the purpose of sale). I, a, owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). ❑ .1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above i information Is correct. I agree to comply with all CI y and county ordinances and state laws relating -to building construction; hereby authorize repre- sentatives of hIS city' to e r n [ ab e -mentioned property far Inspection p 5 11/16/84 Signature ti• Date Drivers' Lficense or SS z 3640 i PineiRh C1;.nZ_ X7 PERMIT NO. T ACT NO: OT NO. BLDG. TYPE OF CONSTRUCTION Fl NEW ADD I I ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK.tnteri or Improvement qL A•P 2 X3 i - 15Zone• CL S Main Building: Accessory Building: TYPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL ® TENANT ❑ ELECTRICAL ,❑ PLUMBING [],MECHANICAL ' •❑ OTHER PROJECT DESCRIPTION Sq. FT. 5610 OCCUPANCYp - CONSTRUCTION TYPE 'VALUATION$ 84,150.00 ZONE GRADING CU.YDS. ' ACRES E T Front 1.� t4 1.0 B A .Rear - L C . Right $ Left IS Ping. Ref. # Park,Fees $ ,4Remarks: ` C; 7 _ 1" Parking Req./Provided Use of Building: PLUMBING . FEES Planning Notes: Bar Sink Showers p Backflow Preventer ServiceSink ' Backflow Irrigation Sewer Cap = ELECTRICAL ", FEES Bathtubs Sewer Connection Automatic Washer ' Construction Pole Sub. Transformer ❑ 15 50 ICW El 50 + KW ClarifiersSolar Collectors. Dishwasher Solar'Piping Cooking Unit - Meter 06 to 100anips Drinking Fountains Solar Tank ; - Dishwasher Meter El over 100 amps Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel " Floor Sinks Urinal eg 9 69 Fan Motors 1:10-1 HP, ❑1 i4 - 8 Gas Service, `Outlets -Water Closet v F.A.U. inc. Solar ❑9-i 5 HP ❑ 16-15+ Interceptors r Water Heater pd Fixtures 'Microwave Kitchen Sink Water.Service Device Boxes Pole Light Lavatories Outlets Range P—Trap - Switches Sign Roof Drains - ' y Garbage Disposal Standing Sections Generator ❑0.5 KW 05-15 KW Trash Compactor Reinspection Fee $25 Issue Fee , $ 3 Reinspection Fee $25 i Issue Fee' S 3 MECHANIC_ ALFEES PUBLIC SERVICES RE U1REM NTS: Zoning Approved By ate Application Approved By - t Data Application Issued By Data I Z' e Boiler Hood or Type I ❑ Canopy Type I I El, Duct - Under Ground Duct - Structural Refrigeration System f0-100,000 BTU ❑100,000 BTU Duct - Ventilating BUILDING PERMIT PLAN CHECK PLUMBING ( PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES S SMIP S $ PERMIT $ • ISSUANCE $ $ Q ENERGY P.C. $. $ GRADING S $ MICROFILM $ S TOTAL FEE S $ _ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Blt. ICBO # Heating System & Ducting E] 0-100,000 BTU I] 100,000 BTLJ -•- Reinspection Fee $25 Issue Fee S 3 CMF 0865.46 rev. 7/83' White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - ASSeSSor AtONSTRUCTION AND PLANNING APPROVALS Permit #' Date Inspector. �- POOL & S. APPROVALS Permit # Date Inspector •i:-Amporary Electrical Service or Pole 52. -Pool & Equipment Location 2. Soil Pipe-Undrgrnd. I2�1Z, jj C,1 53. Steel Reinforcement- 3.� Electrical Conduit Utility-Undrgrnd. 54. Forms A. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding 175. Steel Reinforcement - " 56. Rough Plumbing & Pressure Test '6•' Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7.; Footings 58. Electrical Conduit-Undrgrnd. 8. Foundationc, (Z// �� 59.' Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. fZI(2�}Uf (,�j 60. ,Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap63. 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 F'OR PLASTERING 18. Rough Electrical-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &,Air Corditioning FIRE DEPT. REQUIREMENT APPROVALS , Permit # 20: Rough Factory Fireplace t 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test • 7.2. Underground Flush 24. Roof Framing _ ' - 73. Undergrnd. Storage Tank 0 Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat i 75.' Dry Chemical 27. Frame and Flashing (7 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. 1risulation 78. FIRE PREY. FINAL .30, Drywall Nailing 1�1 HEALTH DEPT.-REQUIREMENT 31. Plaster Brown Coat 79. F1NAL'INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ;n ELc Cr 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test t , 36. Hood br Canopy 37, Final Factory Fireplace 38. FinaIrPlumbing 39. Water Service-Final 40. Gas Service-Finale 41. Solar Domestic-Final _ 42. Backflow Preventer ; 43, Backflow Irrigation , , 44. Landscape Irrigation System , 45. Sound Attenuation 46. Handicap. Regulations 47, FINAL STRUCTURE & BUILDING 48. Special Requirements-Completed ■49. Electric Release to Edison - - - 50. Gas Release tolsouthern California Gas Co a 51. CERTIFICATE OF OCCUPANC �j No. r f> / Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Ct I I r, COSTA MESrA CONT I n UCTiA0N PER IT PERMIT NO, TRACT NO. LOT NO. UNIT NO. Project Address aAT(2- uvAl AJ ' Applicant's Mailing Address I Owner's Name 3D —Phone Address ArchlEng. License No. Address3q,//.tel Contractor's Name /-r�U�J�� ` , Phone J 30 Address (Mailing) q,�� .�—Za L�jPQLZ-y704 JO U 1!9�P41 ICity License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing ` with section 7000) of Division 3 of the Business and Professions Code, and my license is in fyll,for n effect. \ License Clap L1 j Date Signature IIS WORKERS' COMPENSATION DECLARATION V\ I hereby affirm that I have a certificate of consent to self -i sure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) _ �l i Nicy No G/7�d 3 73 5 Company - Certified copy is hereby furnished. Certifie!Ccop (tjCd with the city I, 1 9 Dlvision. Date—,�' l - Applicant yL�' "'��e EXEMPTION FROM WORKERS'COMPENSATION DECLARATION /! (This section need not be completed if the permit Is for One hundred ($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. Date Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ, C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior t0 its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 enalty of not more than five hundred dollars ($500)• 1, as owner of the property. or my employees with wages as their sole :ompensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is Sold within one year of com- ptetion, the owner wiii,have the burden of proving he/she did not build or im- prove for the purpose of sale). ❑ Y, as owner of the property, am exclusively Contracting with licensed con- 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 - builds or improves thereon, and who contracts for such projects with a con- tractors) license oursuarlt*to.the Contractors License Law). I am aware that proof of their Worker's Compensation insurance Should be provided to me. ❑ 1 am exempt under Section B. & P, C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and County ordinances and state laws relating toilding construction, and hereby authorize repre- sentatives of this cit pon the above-mentioned property for inspection p Signature ante Date Drivers' License or SS -# -116Od TYPE OF CONSTRUCTION. LJ NEw LJ ADD ^ALTERATION LJ REPAIR 1:1CONVERSION 1:1DEMOLISH ❑ OTHER A.P. DESCRIPTION OF WORK/USE OF BLDG. 5 Main Buildi TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT El ELECTRICAL ❑ PLUMBING1�J- MECHANICAL B Rear ❑ OTHER A C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY K " CONSTRUCTION TYPE VALUATION S S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: R A — j/„, `�__7- 9 Planning Notes: FEES Bar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Clarifiers Solar Collectors Dishwasher Solar Piping Drinking Fountains Solar Tank Floor Drains Swimming Paol w/Spa' Floor Sinks Urinal Gas Service Outlets Water Closet interceptors Water Heater Kitchen Sink Water Service Lavatories Auto -Wash P—Trap Laundry Trays Roof Drains Reinspection Fee , $15 Boiler . Duct - Under Ground c Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ 0.100,000 BTU Eli oo,000 BTI, Reinspection Fee 1 $15 L.� CMF 0865-46, rev. 10184 ' White - Building; Canary - Applicant; Plnk - Accounting; Goldenrod - Assessor Issue Fee Hood or Type I ❑ Canopy Type I1 ❑ Refrigeration System ❑0.100,000 BTU ❑ 100,000 BTU System Repair/Alteration Fire Dampers Registers Issue Fee 4909 1/03/85 I r Zone Accessory Building: Parking Req./Provided 5 LL* .'..r TL ELECTRICAL FEES Automatic Washer Construction Pale Sub. Transformer- ❑ 15-50 KW 50 + KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter Dover 100 amps Dryers ❑Gas []Electric Sub Panel Fan Motors ❑0-1 HP ❑ 115 - B F.A.U- Inc. Solar 09-15 HP El 16-15+ Fixtures Microwave Device Boxes Pale Light Outlets Range Switches Sign Garbage Disposal , Standing Sections Generator El 0-5 KW El 5-15 KW Trash Compactor t Z O N I N G R E O M T S $ 3 Reinspection Fee $15 Issue Fee $ 3 FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By n Application Issued By ! 1. 7/1A Date Date Dat BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ SUMMARY OF FEES d j I SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ $ 3 -CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POOL&� .► 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. " .8. Foundation 59" Gas Pipe, ❑ Undrgrnd., Test Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 �%Zi��- �) FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -.Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydra 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 ' 47• FINAL STRUCTURE & BUILDING 48. Special Requirements Completed , 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co i ' 51- CERTIFICATE OF OCCUPANCY No. Date _ I `4 0 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. .IT1hOF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT No, _P,ojece.Address .� / // N Z Applicant's Mailing Address «,� Z. T✓e �Ni.�t] Owner's Name Phone Address r�'"" —_ % Arch/Eng, License No. Address Contractor's Name if 4 A- eA _ ��'err r � Phone Address (mailing) � /� Z f• City License No. LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter'9 (commencing with section 7000) of Division 3 of the Business and Professions Code, ani my license is in full ford and effect. Ucense ClLi s o. L7J Date ass y Signature WORKE S' OMPENSATION P66CARATION I hereby affirm that t1ficate of consent to self -insure or a certificate of Workers' Compensation Insuranc or a certified copy thereof (Section, 3800, Lab. C.) Policy No. taC� L�ompany sem"^ `r f tried copy is hereby furnished. ilrCfit d with the city B er�ified Id' g Divl Date Applicant EXEMPT ONe AOM WORKERS' PENSATION DECLARATION (This section need not be complete ' the permit is for one hundred ($100) or I certify -that In the performance f the work for which this permit I$ Issued I shall' not' -'employ any person in any manner so as to become subject to the Workers' Compensation;tfawS of California. Date Signature 'NOTICE- if, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply 'with such provisions or this permit shall be deemed revoked. CONSTRUCTION -LENDING AGENCY_- . I hereby affirm that there Is a constructio6riending agency for the performance ofthe work for which this permit is issued (Section 3097 Civ. C.) Lender's Name Lender's Addre$s OWNER BUILDER DECLARATION - t hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with, Section 7000) of Division 3 of the Business and Professions Code) or that he/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 ,� enaIty 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 or sale (Section 7044, Business and Professional Code:' The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work'hImseIf/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 com- pletion, the owner will have'the burden of proving he/she did not build or im- ' EEfor the purpose of sale), I, as owner of theproperty, am exclusively contracting with licensed con- '. tractarsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or -improves thereon, and who contracts for such projects with a c0n- tractor(s) license pursuarit'tn'the Contractor's License Law). I am aware that proof o their Worker's Compensation Insurance should be provided to -me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to but ing Construction, and hereby authorize repre- sentatives of 's ity to r the above-mentioned prop inspectlon pu o s �/ n, Signature e Drivers' License or SS 4k TYPE OF CONSTRUCTION L.�-aEW LJ ADD LJ ALTERATION LJ REPAIR, ❑ CONVERSION ❑ DEMDLISH ❑ OTHER A.P. DESCRIPTION OF WORK/USE OF BLDG. S Main Building: E TYPE OF PERMIT �� GRADING" ❑ FOUNDATION STRUCTURAL T Front 1:1rr77�--� TENANT Il�ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Rear [:],OTHER PROJECT DESCRIPTION SQ. FT, OCCUPANCY C Right K Left CONSTRUCTION TYPE VALUATION $ $ ZONE GRADING CU. YDS. ACRES Ping, Ref. # Remarks: -72Q— //"r, ? Planning Notes: Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑0-i00,000 BTU 01100,00013T Reinspection Fee I $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant. Pink - Accounting; Goldenrod - Assessor Refrigeration System 00.100,000 BTU 0100,000 BTU System Repair/Alteration Fire Dampers Registers Issue Fee 1 $ 3 3668 12/07/64 1 I Zone Accessory Building: Parking Req./Provided ELECTRICAL Automatic Washes - Trensftirmer ❑ 15-50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit 'Meter ❑up to 100amps Dishwasher Meter ver 100 amps Dryers ❑Gas ❑Electric =2 Sub Panel Fan Motors ❑0-1 HP 8 F.A.U. r Inc. Solar ❑9-15 HP 1116-15+ Fixtures Microwave - T Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal ; Standing Sections Generator ❑0-5 KW ❑5-15 KW Trash Compactor 4;2090 TL Z O N I N G R E Q M T S IReinspection Fee PLUMBING FEES Bar Sink Showers Backflow Preventer Service Sink Backflow'Irrigation i Sewer Cap Bathtubs '-` Sewer Connection Clarifiers Solar Collectors Dishwasher Solar Piping ; Drinking Fountains Solar Tank = Floor Drains. Swimming Pool w/Spa Floor Sinks Urinal - Gas Service 1 'Outlefs WaterCloset Interceptors, Water Heater Kitchen Sink ; Water Service Lavatories Auto -Wash P --•Trap r. - -Laundry Trays Roof Drains - $ PLAN CHECK Reinspection Fee PERMIT S15 Issue Fee $ 3 MECHANICAL FEES $ Boiler $ Hood or Type I ❑ Canopy Type IIS ❑ '7 $ ENERGY P.C. $ ELECTRICAL Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑0-i00,000 BTU 01100,00013T Reinspection Fee I $15 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant. Pink - Accounting; Goldenrod - Assessor Refrigeration System 00.100,000 BTU 0100,000 BTU System Repair/Alteration Fire Dampers Registers Issue Fee 1 $ 3 3668 12/07/64 1 I Zone Accessory Building: Parking Req./Provided ELECTRICAL Automatic Washes - Trensftirmer ❑ 15-50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit 'Meter ❑up to 100amps Dishwasher Meter ver 100 amps Dryers ❑Gas ❑Electric =2 Sub Panel Fan Motors ❑0-1 HP 8 F.A.U. r Inc. Solar ❑9-15 HP 1116-15+ Fixtures Microwave - T Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal ; Standing Sections Generator ❑0-5 KW ❑5-15 KW Trash Compactor 4;2090 TL Z O N I N G R E Q M T S IReinspection Fee $15 I -Issue Fee I $ 3 ` DEVELOPMENT SERVICES REQUIREMENTS:, Zoning Approved By Date Building Approved By Date Application Issued By - r�S(/Ch' Dat �- SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ _�- 1 -�0�3 GRADING $ PLAN CHECK 50% $ °S0^ MICROFILM $ MECHANICAL $ TOTAL FEE $��D PLAN CHECK 25% $ 0 r� ONSTRUCTION AND PLANNING u' APPROVALS Permit # Oat inspector POOL & SIP,., APPROVALS Permit # Date lnspeGtnr y 1, Temporary Electrical Service or Pole*' �� 52. Pool•& Equipment Location 2. Soil Pipe.Undrgrnd. .1 � 53. Steel Reinforcement f� -3.Electr+ical Conduii.Utility-Undrgrnd. Y 54. Forms 4 -Electrical Conduit-Undrgrnd. ,♦ ` 55. Electrical Bonding 5;,5teel Reinforcement 56. Rough Plumbing & Pressure Test t` fi-Electrical UFER'.Grnd: ��` y �� 57. APPROVAL TO COVER•GUNITE 7t''Footing� s ` 56. Electrical Conduit-Undrgrnd. 4� 8.; Foundation y \ 59. Gas Pipe, 13 Undrgrnd., Test 9. Water Pipe-Undrgrnd. .f f ,y �� 60. Backwash Lines, P -Trap, ❑ Undrgrnd, 10.yStructurai Floor System �fi� 61. APPROVAL TO DECK •11, Property Sewer Line & House Connection i !` 62. Backwash & Receptor -Final 12!Sewer Cap �� t 63. Heater & Vent -Final 13 -,.Roof Drains f � a lv • 64. Plumbing System - Final r� . 01 14.4.Raugh Plumbing r 65. Electrical -Final 15. Rough Electrical --Conduit 66. Solar System-Firial 16. 1Rough Electric Wiring ! 67. Fencing &-Access Approval 17. Rough Wiring Sign 66. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling �' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. -Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Duets, Ventilating 71, Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-6ar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 76. FIRE PREY. 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 47, FINAL STRUCTURE & BUILDING 48, Special Requirements Completed' 49. Electric Release to Edison t 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date IRWAY AV PROJECT WNER'SNAMEADDRESS: JODIKAAENTERPRISES UNIT: N2 OWNER'S 1851 W. VISTA BAY# 262 ADDRESS: VISTA CA ., 92083 619) 945-9070 i ARCHIENGINEER; TERRY ARCHITECTS REO.NO.: C-11658 ADDRESS: 18022 COWAN UNIT: 2 01—D IRVINE CA 92714 PERMITTEE: JOHN S HASTINGS (714)633-6286 ADDRESS: 630 W PALM AV 31 ORANGE CA 92668 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Oivisi n 3 of I�PBusiness and Profe ins Code. and my license is in lull force and effect. CITY LEC.: f 5c� y�rTA uc.: 2715 C B�,�,f �a etet Signature: tr h "�^�� WORKERS' COMPENSATION DECLARATION: I hereby atfirm t I ave a cettificate of cpnsenftaSelf-insure or a certificate of Workers' Compensation Rene_ 9 VU010®ps]ttYN(Section 3B . Lab. 61 /01/95 POLICY NO.: STATE FUND EXP. DATE: COMPANY: } El Certified copy is hereby furnished. U Certified copyisfiled with the city Building Division. DateMPTIUN — — � Applicant: u` 1� FROM WORKERS' COMPENSATION DECLARATION: (� an need not be completed if t4penin is to one hundred (5100) or Iesssj- I certify that in the performance of the work for which alis permit is issued. I shall no: employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, Date: Signature: NOTICE: If, after making this declaration, you should become subject to the workers' Compensation provisions.of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. I 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 (Sectiori 3097, Civ- C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractors' State License Law for the following reason {Section 7031,5 Business and Professional Code: Any city of 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/she is licensed pursuant 10 the provisions o1 the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe 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 live hundred dollars (5500), 1, as owner of tee property or my emvvloyees with wages as their sole compensation, will do the work, and the 13 structure is not intended or offered far sale (Sec:on 7044, Business and Professional Code; The Contractors' State License Law does nut apply to an owner of a property who builds or improves thereon, and who does such work hlmseltlherself or through his at her rnm employees. provided that such improvements are not intended or offered for sale. 11, however the building or improvement is sold within one year o: Completion, the owner will have the burden o1 proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business Eland Professions Code: The Contractors' State License Law does not apply to an owner of propewho builds or improves thereon and who contract$ for such projects with a contractorrtys) license pursuant to Contractors' Slate License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. d P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any luture building occupant wiNwill not (circle one► need to comply with said state codes and the requirements for a permit for consuuciion or modification from the Air Quakily Management District. Residential Construction applications are exempt from these provisions. Date: Applicant: I hereby certlty that I have read this application and state that the above information is correct. I agree to campy with all city and county ordinances and state laws relating to building construction and hereby authorize represeniatives of this city to enter upon the above-mendoned property for inspection purposes. AM914n Driver's License or Social Security n: 1641-46 Where—Budding; Green—Code Enforcement; Canary—Applicant: Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 066532 PLAN CHECK NO: N CONSTRUCTION TYPE: V—NR PERMIT TYPE; PLU JOB DESCRIPTION ; INTERIOR TENANT IMPROVEMENTS CLAIM VALUE: CALC—VALUE: PURPOSE: OTH SQ FT: GROUP OCC: B-2 / COMMENTS: FOR " UNIGLOBE TRAVEL " / RE: B66434 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQQ• PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING NOTES> > 1E ![• 1f 1f if if 1f 1f if 1f � iE !E i[• i[• � if iE !E ![• ![• ![• !f 1f � !f if iE � � � � � � if if if iE iE iE � � if if if if if 1t � iE i[• � iE iE i[• i[• i[• 1t if 1t if iE iE i[• iE !t• iE if !f � ![• iE � � � � ![• !f !f D E V E L O P M E N T S E R V I C E Sr R E Q U I R E M E N T S ZONING APPROVED BY : DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE; ![• ![• ![• 1f 1f if 1f if 1f � � � 1F 1F i[• 1F iE iE 9E >>f t>E * � iF iF * � �t'!f if i[• � if �F �F ![• �(- if * 1f 1f 1f 1f 1f 1f !E ![• ![• 1f if 1f ![• !f !f !f 1t• 1t• * 1F iE 1F ![• 1t• if 1t• * if iE 1F iE 1F iE * * is * iE � * 1F � � � * 1F 1F 9E 9E * * * * * !E !E !E !E 9E * 1E 1E 1E 1E * * 1f �F LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 28.00 25t SMIP/NON—RES PLAN ISSUE FEE 20,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 28.00 20.00 0.00 48.00 48.00 .00 REVENUE DIVISION TOTALS —> COLLECTED: 48.00 OVER/SHORT: .00 BLDG PMT PLUMBING, ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 48.00 TYPE _ _QTY PLU 2 PLU 2 I N D I V I D U A L F -E E B R E A K D O W N D E S C R I P T I O N WASH BASIN WATER CLOSET (TOILET) END OF FEES UNIT COST 7.00 7.00 TOTAL COST 14.00 14.00 01 00157670-00157670 T CET 48.00 DATE: 03/24/74 TIME: 15:58 COrvSTRIJOHON AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undr rnd, w 53. Steel Reinforcement i''ecutastifity•iJntirgrryd' 54. Forms :~,4�1ectri+C�_�itbrtdrgrntf, O�-� 55. Electrical Bonding s 5.'i$teei�orq:iar4ent �� 56. Rough Plumbing & Pressure Test ier�e+= F�Grnd. n, .4 57. APPFtOVAL TO COVER-GUNtTE a Foots rE 58, Electrical Condult•Undrgrnd. �r�flund0on ti> 59. Gas Pipe, 0 Undrgrnd., Test -ft7�• td3*+boater Pipe-Undrgrnd. 60, Backwash Lines, P -Trap, ❑ Undrgrnd. 10, Structural Floor System 61, APPROVAL TO DECK 11v Property Server Line & Ho:use Correction 62. Backwash & Fteceptor•Final ,r - 12, Sewer Cap a, 63. Heater & Vent -Final 13. Roof drains,- u 64. Plumbing System - Final 14. Rough Plumbfng "' 65. Electrical -Final 15. Rough tFlectriOI-Conduit �L= �r 66. Solar System -Final ; 16, Rough IElectriejWiring 67. Fencing & Access Approval 17. Rough''ryng,S46 68, APPROVED FOR PLASTERING 18. Rough El trifxai T Bar Ceiling 69. POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT !% :APPf30V L'S� P�7nit# 20i7R gh(1;actQryr#replace �h? hr's r Q 21 If,;, slan Stxuct e . `;E N r: ; 70, - IPAN _ 22. Dumts, V.enGlati*g I 3S a •y 6 .- ; 71, Produeil ing as L Oil Y rT1 23;)G "Pipe•R ggh di yfest cC =, `" 72. UnderFr�Orjd F�4 L 1 r, F L.., k,%v 24� Ro-f Fga rn'V6 :-• r� -H �, O . Y' } , 73u Undergrrs�I. Sto ��c Tank*❑ Gas 00i1" 25. R f S eathin 9 {r v "i:., r 7 Overhead Flydra� , 26T-B�r Ceiling (S�urturall &opocoat x ra ^�+ 791' Dry Chemical 'y 27YFr�meand Flas 'oTt7d-OE m Dry Stare * s w 1 �x l-.Mco t w ;2$:' Laking.& Siding -,x . -i x z •• �i w 77W FIXED S �aTEiCll: i^VA T 29. Insulat n = I 78i;4FlRE PFEV. FIN;9L * r ,r t > 30. Drytiva ;Nailing r; ! s _ _ .,ME•ALTI<I1DEP3`.,REQUIREMENT 31. Plaster ro+vn ; y 71: •NAL'IFtECTbN V e - s. t, Y 324- Electrigl Power Mgtn.Fina� ct �' � ,80tr; FOOD CER IFFI ATE ISSUED (0 33 Fll E3ectrLb ` + •;� '" ", s - r -r 1 •� # .r + 11 *7 til 34,1FZI i gEptir�&&iiCbgiitidrung��--_Z. 35mFiraal G� Pe •Tes& f / T i `• f �`' r 36 Hood at,Canopyro r• � t to -3 a r _ '-+37,DFir55l Factory FiFeq]acre_ 38. Final P!Vmbing �,�; I •• _ C: J� R Gy -- _�_ r V X39. Walir Service -Finale - 0'40. Gas Service-Fina!.t _ r-, CTI L 3 k{ * y x 41. Solar Domestic -Final , , a C3 �427-Backflow Prevented E r I .t `� 'l { 43. Backflow lrggatiorr �' S S * i' '"44. Landscape . igatigft System] n :+. * -- cu r1 . f: ,; �45CjSaund '4ttenuatio�i -"I, �-Tr- 746�"Handick5 Requlati, ins C f }rr,` 47Z�Fi _AL STRUCTURE & BLRLDING 48 FOAL PLAONINd it y it ✓. .-,49;, Eld',c-tric Release to Fdison x �- c50 Release to Sou�hern Cal' ori Gas Co . TIFICATE OFrOCCUP , NCY No. Date PROJECT ADDRESS: 3151 AIRWAY AV OMIT: N 2 OWNER'S NAME:O Y,K G14 L r-rnYtll_-�-lv5 ADDRESS: 1851 W. VISTA BAY# 262 VISTA CA,, 92083 619) 945-9070 ARCHIENGINEER: TERRY ARCHITECTS REG.li C— 1 1 6 5 8 ADDRESS: 18022 COWAN UNIT: 201—D IRVINE CA 92714 PERMITTEE: JOHN S HASTINGS (714)633-6286 ADDRESS: 630 W PALM AV 31 ORANGE CA 92668 LICENSED CONTRACTOR 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. IC.: ST TE LIC.: 392715 C 5: $ 2at r Signature'_ ERS' COMPENSATION DECLARATIDW I hereby aftum have a certificate of conse to self -insure or a Certificate of Workers' Compensation1 e I�jsu a ce.{�}�e py { of (Section 3600. Lab. C . POLICY NO.: L 4 EXP. DATE: 1 / 01 / 9 5 COMPANY: STATE FUND erhfied copy is hereby furnished. izr Certified copy�y isfiledwith the city Building Division, Applicant: XEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Th coon need not be complete f the permii is lot one hundred (5100) or less}. I certify that in the performance of the work [or which this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compersation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 5097, Civ. C! LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law tot the following reason (Section 7031.5 Business and Professional Code: Any city o: 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/she is licensed pursuant to the provisions of the Conlraclars' State License Law (Chapter 9 (commencing with Section 70DO) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5540►. I, as owner of the properly or my employees with wages as their sole compensation, will do the work, andthe ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State 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 employees, provided that such improvements are not intended or offered for sale. ll, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale►. I, as owner of the property, am exclusively contracting with licensed contractors to construct the project {Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors► license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section; S. & P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505. 255M. and 25534 and that I or any future building occupant willlwili not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned i fm inspechon purposes. 1-e :23_(&_0 Signature: _Drf4er's License or Social Security O 1541.45 while—Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor C TY OF COSTA MESA -- BUILDING PERMIT PERM NO: B 066435 PERMIT NO: B 066434 PLAN CHECK NO: 00691-94 A GOVT: N SUPP; N CONSTRUCTION TYPE: V --NR PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION INTERIOR TENANT IMPROVEMENTS SQ FT: 20,000 CLAIM VALUE: 20,000.00 CALC-VALUE: 20,000.00 GROUP OCC: B--2 / COMMENTS: FOR " UNIGLOBEWAY TO GO TRAVEL " Z O N'I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING,---------- ------------ ACCESSORY BUILDING--------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PLANNING NOTES> INTERIOR ALTERATION TO AN EXISTING OFFICE. > f� D E V E L O P M E N-, -T SERVICES R E Q U I R E M E N'J-' -S ZONING APPROVED BYE qtr-:�- DATE: BUILDING APPROVED BY _ DATE;�- APPLICATION ISSUED•BY: r�rrt DATE: IF �!- �!- 1E iE � i(- fF'1E ie #� iE ir- iE iF iE � if �; irt'lE 1E iE iF iE iF'iF ii * ii ic-.� -IF � 1<ii 1E * iI- ic- * iE * * 1F * * * yE iF'1E �!- ir- ir- iF �!- � 1F 1F * iF ii ic- ic- iE ic- ->E * iE * iE * i(• 1I- iE *'lE iF LEGALIZATION:N F E E S.0 M M A R Y /}l, ('STRUCTURAL SEGMENT;Y 1; � tom• ,!- ' BLDG PMT PLUMBING ELECTRIC. MEGHANdC %- t I 1 EI, SMIP/RES GRADING PERMIT 207.00 f r� ;� �SMIP /NON --RES PLAN 33.64 4 , 20 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN; --CHECK TOTALS �� ''r PAID DUE TOTALS-----> 211.20 0.00 'f' 33. 1 24:41. 8,4 j 244 .84 .00 REVENUE DIVISION TOTALS--> COLLEC-TED: r, '2'211 !�20 � JV?ER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC r _^.� � ��/�'C3T GRADING PLAN -CHECK 207.00 t 4 };z0 1F �F ii ii ii � ii iF i(- iE ii ii i(- iE � i(- i[iF iE iE iE iE 1E iE iE 1E � * iF * iF iE �E iE AF �E �EyE iF 9F iE � * it. jF � * it iE iE if �� iF iF i�, �E iE 9F �E 9F iE fE iE iE iF -If iF it aF � iE iE aF �E iE I N D I V I D U A L F E E; B R E A;DfO W N TYPE QTY D E S C R I P T I O'N" w {7 �'UllIT COST TOTAL COST SFC 20000 ALTER BY VALUE COMMS- CJAL • ; iVOZONE / ,` - 1.00 20,000,00 END, OF, FEES MAR 994 `. it CITY 0 A MESA CONSTRUCTION AND PLANNING APPROVAL'S Permit # Date Inspector POOL PA APPROVALS Permit #_1 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. (tough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVE R-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 8, Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60, Backwash Lines, P•Trap, ❑ 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, POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas O Oil 23, Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas 11100 25. Roof Sheathing 74. Overhead Hydro 26. T.Bar Ceiling (Structural) & Monocoat 27, Frame and Flashing /�� 75. Dry Chemical 76. Dry Standpipe 28. Lathing & Siding 77, FIXED SYSTEM FINAL 29. Insulation 30. Drywall Nailing SC -r_ -f-o-�e ! 78, FIRE PREY. FINAL HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: -�r�+C 1 C-4�� '! 34. Final Heating & Air Conditioningan 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 - ► �j�j�/" .42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System r" = 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING �y " 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Go 51. CERTIFICATE OF OCCUPANCY No. Date r=► ADDRESS: 3151 AIRWAY AV UNIT: N 1 OWNER•SNAME: CALIFORNIA FEDERAL BANK ADDRESS: 3151 AIRWAY AV #F-108 COSTA MESA CA 92626- (714)540-2606 ARCHIENGINEER: DARYL MALMBERGASSO. REG.NO.: C-9082 ADDRESS: 2600 MICHELSON UNIT: 1550 IRVINE CA 92715 PERMITTEE: JOHNSTON 6 ASSOC (714)632-3462 ADDRESS: 1035 ARMONDO ST F ANAHEIM CA 92806 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Procession ode. and my license is in lull force and effect. CITY LIC.: 0 515 7 STATE LIC.: 9 3 CLA B�% Date: Y5ignature: —. - — _ 'J-- WORKERS' ��(OMP��€NSATION DECLARATION: I hereby affirm that I ha a certificate of consent to self -ins or a certificate of workers' Compensation t Oo+r ay4 —liejc y Cheroot [Section 3800. ab. POLICY N EXP. DATE: 1 / 0 1 / 9 2 COMPANY: STATE FUNDr,��yr 1 Certified Copy is hereby furnished. L¢ ertified y is filed with the y ing of on. ate: 3 Applic EREMPTI N FR M WORMERS' COMPENSATION DECLARATION: (This s n need not be completed A the permit I ane hundred ($11x1) or less). I certify that in the performance of the work for which this permit i slued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: ff, after making this declaration, you should become subject to the workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. Q. LENOER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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 life a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) o1 Division 3 of the Business and Professions Code) oz that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7035.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). - 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 oliered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner oi.a property who builds or improves thereon, and who does such work himselflhersel: 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 will have the burden of proving he/she did not build or improve [or the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proal of their worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. S P. C. Ior this reason: CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 052643 PLAN CHECK NO: 02310-91 S CONSTRUCTION TYPE: PERMIT TYPE: STR JOB DESCRIPTION : COMMERCIAL T.I. (OFFICES) PERM NO: B 05264 GOVT: N SUPP: N PURPOSE: ALT SQ FT: 7,000 CLAIM VALUE: 7,000,00 CALC-VALUE: 7,000,00 GROUP OCC: B-2 / COMMENTS: Z O N I N G S E T B A C K S R E Q U I R E M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PLANNING NOTES> PROPOSED 100 SQ.FT. T.I. TO EXISTING OFFICE BLDG, > ��*'1F'1F'1F1FfF�F*�F�F�F�F�F�3E��}F'1F3E�}F'1F*'1F'1F3E3E3E***********�F3E�3E�F*�F3E****iF�4'1F**if if ifiE*�FiE�if*if*1F**if if if D E V E L O P M E N T S E R V I C E S R E Q U I R E M E__N- T S ZONING APPROVED BY q,77 DATE: BUILDING APPROVED BY DATE:, APPLICATION ISSUED BY: DATE:' LEGALIZATION:N F E E S U M M A R Y STRUCTPRAL/SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP%RES GRADING PERMIT 90.00 PLAN 58.50 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTALS ---- > 91.47 0.00 58.50 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 90.00 TYPE Date: Owner: I SFC I do hereby certify that I am aware of and understand the requirements of California Health and Safely Code Sections 25505, 2553 permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from and 1 25534 and that I or any lulure building occupant wilYwill not (circle one) need to comply with said slate codes and the requirements for a 111 t fr m these provisions. Dale: Applicant: I herehy certify That I have read this application d Stale That the above information is correct. I agree to Comply with all City ordinances and state laws relating to building cc truction and hereby authorize repro t sof Chi y to enter upon the abo properly lar7insppeecttioninpurposes. Date: �� Signator Dr'iver's License or Social Security d: 154l,46 Whne—Bwldmg: Green—Code Enlorcemenl: Canary—Applicant: Pink—Revenue; Goldenrod—Assessor SMIP/NON-RES 1.47 TOTAL PAID DUE 149.97 149.97 •00 149,97 OVER/SHORT•00 FIRE SMIP/TOT GRADING PLAN -CHECK 1.47, 58.50 I.N D I V I D U A L F E E B R E A K D O W N QTY D E S C R I P T I O N UNIT COST TOTAL COST 7000 ALTER BY VALUE COMMERCIAL NOZONE 1.00 7,000.00 END OF FEES DATE: V7/G3i9i Ti:rE: fvrw' ' 50 4 3 fermVv 01 &7G;1''eA1- C09l" 2 71a :5.�; r DATE2 07i6319''. TXE: i''c- CONSTRUCTION AND PLANNING POC%pA APPROVALS Permit # 111 Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical ServiV6 or"Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - s :X ti. 53. Steel Reinforcement `&-Ekec`£ C - o�[t� U�tiIity-UKdrgrnd',- 54. Forms h,_ter, r. _.t¢. QPrtta�,vit�Ligtdrgrnd. t 55. Electrical Bonding 5+5. S�el�fle€ rc~ '-''� 56. Rough Plumbing & Pressure Test r,i�1.21 s ectrjq FQFE9 rnd. 57. APPROVAL TO COVER GUNiTE � Footings-' c.. 'w, rr: Z• 58. Electrical Conduit-Undrgrnd. .. cr 4'8~i=oundaisb u `'� , I 59. Gas Pipe, ❑ Undrgrnd., Test r Water Pipe-Undrgrnd. f 60. Backwash Lines, P -Trap, ❑ Undrgrnd. �: / l_gVStructural Floor System 14 - 61. APPROVAL TO DECK Property Seuagr Lute,& HQse�Conr�ction 62. Backwash & Receptor -Final 12. Sewer Cap ! o, ar 63. Heater & Vent -Final r 13. Roof Drains4. `f .Y f. 64. Plumbing System - Final 14. Rough Plumb's 65. Electrical -Fina! 15. Rough �Pectrir-b•Conduit f 66. Solar System -Final l- 16. Rough Efectria. iring . 67. Fencing &Access Approval `�17. Rough Wue 5i�j�i 68. APPROVED FOR PLASTERING 18. Rough Elottrictil-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Cond+tinning FIRE DEPT. REQUIREMENT rAPPRgV, i,� �C Permit # - I 20.a Roc h story areplace t� r} '_ w Q x 2170 u2is, i Stcdct��, :� •5 n, -i -. r . V �--,rr r �. ;Qnd HVdro ifi : t .. • -, 5 x - I� * . X70. ,U,,d� x 22. JD u ts, �{i nti atir�g , r. : - � d, : - r� .71. ProducF"�ing tAGbs Q'Oil 23t -'Gas Pip ==Rough &fest r `: 72. Underg%p`1d Fitr�1a k 24Rogf Flaming ;, _ " L' ti StorageTank:❑Gasr❑ �3i1 _4 , .73mUndergrrtti. ., ' 25. Roof Slveathin 9 v =' x ' �74�ver.h�ad`�lydro:=" F �+ ld ;j: 26FT• r Ceiling (Strutural) &�_Aonocoat-7 1 �.w r. :r 75:' Dry Chemical T -• .. :� , 27 =Frame and Flashin ~y C * • o'' y 76- ry-SianQj be O� -• ,r r ^ v cti r..� , lit v S •' L t .i tv L� �28.i. Lathing; -$e Siding �� -3 ;_; a,n, �• x ;E77;, J'.i Y 't 'Y - Sl FIXED SY•STEMBNAI� J k 29. Insulatiph 7 FIRE PREY. FINALtZ i Drywalfi-Naming i HEALTWDEPt REQUIRiiUIENT -,30. X31. Plaster B"rowP Coat` E , 79�FINAL I 2'EMON Y - T `32,,. Electri3 PAer Metg Finaf�,g80,nFOOD CIFIFI£E I$SUED'' 33QFll Electricx `• �- .r Y r' Names: I . '7'34- Heatin•j& A,-ZFgL0itiori�ri$. Lr'.,' 4` �.1 T rS S 35: Fi,; l Gas Pips, -Tests - ter+ x + x ^' ''.1 .r axCanopy t: lr36:--H01 it 4 -37CFinal Factory Fireplace `'38"Fir�J Plumbing -, =!39K,Wa`ner Service -Final; t l O sinal -40"'-Gas Service, " ( ca tey r s' . mKL ' t'" �.t:; Y rr ! '►' u3! CA.,fti Y Y s'41: Solar Domes9ic-Firia� 1 ., , "42•' -'Backflow Preventei«n' '` I �'TE 43. Backflow IrUgation Xi--: A. C r « 44. Landsca igatign 5yste '9` " a '' '' r� r. ` ' O +- ,f'�7 X48; -'Sound 'Atterjuation •-r�, p -C [ i --v - Wo. t>;� - '-�:46`-"Handicap Requlatians �. 47, FINAL STRJ,ICTAE & BQfLDING` +48cl; INAL PLANNING r-49._ E4ariCkelease to:Ed'ison a .: u ► _ " ' 150t Gas to Sou hern CaliforniaGas Co " .. t= `�"14x rRel_s'ase [ � 1-51. C>rRTIFICATEOFrOCCUP4NCY 7 T ;,:G �� . __3 No. Date or AIRWAYY AV �ly v' Ivv uN1r: N2 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 06646-1 VK ENTERPRISES 1 W. VISTA BAY# 262 PERMIT NO: E 066467 PLAN CHECK NO: N GOVT: N SUPP: N TA CA., 92083 519? 945-9070 CHlENGINEER: REG.NO.: • ADDRESS: UNIT: PERMITTEE: ROW E ELECTRIC (714)639-6110 ADDRESS: 760 N. MAIN ST ORANGE CA 92668 LICENSE% CONTRACTOR 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 lull force and effect. CITY LIC.: f� ST E LIC.: 4 5 910 6 C :C-10 te: 3 _� Signat 1WpR (ERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insu_[aM or a llfie copy thereof (Section 3800, Lab. 81/01/95 . POLICY NO.: 1 [� 618 l — � 4 EXP. DATE: 81 / 01 / 9 5 COMPANY: STATE FUND Certified copy is hereby furnished. © Certified copy is filedith l fly Building Division. ate: —I App, nt: MPTION FROM WORKERSCOMPENSATION DECLARATION: (This section need not be completed it the permit is for ane hundred (5100) 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. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must lorthwnth comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097. Civ. C). t LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 70315 Business and Professional Cade: Any city of 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/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 (S500). 1. 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 (Section 7044, Business and Professional Cade: The Contractors' State 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 employees. provided that such improvements are not intended or offered for Sale. 11, however the building or improvement is sold wilhin one year of completion. the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7D44, Business ❑ and Professions Cade: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proal of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Seclien: B. 8 P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California, Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wiltrwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential Construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state taws relating to building construction and hereby authorize represent Iry 1 this city [Denier upon the above-mentioned propert fu, mspe hon purpos s. ��: Dale: _ Signature: -17111er's License or Social Security K: 1641.46 While—Building: Green—Cade Entorcement; Canary—Applicant; Pink—Revenue: Goldenrod—Assessor CONSTRUCTION TYPE: V—NR PERMIT TYPE: ELE JOB DESCRIPTION : INTERIOR TENANT IMPROVEMENTS CLAIM VALUE: CALC—VALUE: PURPOSE: ALT SQ FT: GROUP OCC: B-2 / COMMENTS: REF: B-66434 * ic- �- * *-x--x--x--x- * �-►r--►r- � -►r- � * * -x--x- � � � -x--K--K--K- ��- �c-•r� �- �- �c- �c- �c- �x- �r �r �c- �r *-►r--►r--K- � -K- � * �e �- �c--x- � �c- �c- *-►r--x- �r �r-x--x--x- �- # -x--x- �c- # -rr � �c- # * � # # Z O N I N G R E Q U I R E M E N T S S E T B A C K S MAIN BUILDING ------------ ---------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: REE' NO:, PLANNING NOTES> �lE �lE iE # �lE * * * iE iE iE # iE iE iF 'rf iF �F iF iF iF ir. iF �lE '1F �lE '1F �{- -)(- �lE �lE # '1F ir'* iE # it * '}� -K- iE iE if if iE if ie it it if -If- * jE �lE iE * # iF * * iF }F �f• * * * * ik -lt if -K- * �lE it �lE iF # iF D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: _ APPLICATION ISSUED BY: .' DATE: � �lE # # �lE ? F * * iF iF # iE iF ir• iF iE iE iF iF 9E it• iE if• a �� i� - � t x ?(• # -)E -}(• iE iF ie iE iF � �� F3F��. iE iE iE it• iF iE �F * if• 'rE'rE iF ,til• # �lE �lE iE 3F �(' -It- iF iE iF i(• i(• iE iF iF iE iE it iE if iF iF iF it # iF # lE 3F iE -It- ii iF iF iF * # iF # if• iF -1k # # iF iF * -1E iF iE iF iF -H• �F iF ,F # if• iF r- �E if• # iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING PERMIT PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE TOTALS ---- > 24.00 15.00 ELECTRIC MECHANIC FIRE SMIP/RES GRADING 24,00 50% SMIP/NON—RES 15.00 PLAN—CHECK TOTAL PAID DUE 0.00 39,00 39.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 39,00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC EIRE SMIP/TOT GRADING PLAN—CHECK 39.00 iF 9E �F �F iE i(- 9E 'rf 'rf iF iF iF iF iF iF if• iE ik iF iF lE iF i(- iF iF -1k -1k iF ik # # iE �F * iF iF iF if• iF if• iF I'F I'F iF ? F iF i(- iE iE * -1E -lE iF IE }t•'1E ik iF iF if• -Ik if• if• if• iF iF if• iF iF iF iF ? F -1(- }F * -1E -lE }t• iF I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 3 FIXTURES, LIGHTING 1 ST 20 EA. ,75 2.25 ELE 13 RECEPT/OUTLET 1 ST 20 EA. .75 9.75 ELE 8 RECEPT/SWITCH 1 ST 20 EA. ,75 6,00 ELE 2 MOTOR/POWR APPARATUS 0.0 — 1.0 HP 3.00 6,00 END OF FEES 01 00157402-00157402 T Ci T 39.00 DATE: 03/1$/94 TIME: 09:37 CTIQ-N`AND PLANNING •o Permit # Date Inspector POO ;PAA: APPROVALS Permit # Date-- Inspector orary Electrical Service or Pole 52. Pool & Equipment Location Pipe-Undrgrnd. JL4711ect,ical 53. Steel Reinforcement ectrical Conduit Utility Undrgrnd. 54, Forms Conduit-Undrgrnd. 55, Electrics! Bonding 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd, 57. APPROVAL TO COVER-GUNiTE 7. Footings ' 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60, Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 3 i 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 Flectrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21, Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. 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 34, Final Heating & Air Conditioning T r Notes, 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 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date �TADDRESS: 3151 AIRWAY AV UNIT: N1 OWNER'S NAME: CALIFORNIA FEDERAL BANK ADDRESS: 3151 AIRWAY AV #F-108 COSTA MESA CA 92626 ARCHIENGI"EER: (714)540-2606 REG.NO,: DARYL MALMBERGASSO. C -?R82 ADDRESS: 2600 MICHELSON " .1550 IRVINE CA 92715 PERMITTEE: WILSON PLUMBING CO., INC. (714)692-0381 ADDRESS: 29370 VIA LENARDO YORBA LINDA CA 92687 LICENSED CONTRACTOR 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. CITY LIC.: 052565 STATE LIC.: 4 9 8 7 9 9 C ' C3 Date: — 9 / Signature: WDRXERS' CO PENS T1oH DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a cerufied copy thereof (Section 3800. Lab. Q. PoLlcy "o.: N6002411 C EXP, DATE: 11 / 10 /91 COMPANY: CA INDEMNITY ❑ Certified copy is hereby furnished. [X certified copy is filed with 1 cny 8 ildingg Division. Applicant: /r EXEMPTION FROM WDRNERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred (3100) or less). I certily 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. Date: Signature: NOTICE: 11. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction tending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I.am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, atter, improve, demolish, or repair any structure. prior to its issuance, also requires the applicant for such permit to file a signed statement that helshe is licensed pursuant to the previsions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe 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). ❑ 1. 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 (Section 7044, Business and Professional Code: The Contractors' Stale License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himselflherself 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 will have the burden of piovirlp helshe did not build or improve for the purpose of sale). 1, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a conlracter(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Sections B. & P. C. for this reason: CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: P 052728 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: PLU JOB DESCRIPTION : COMMERCIAL T.I. (OFFICES) CLAIM VALUE: CALC-VALUE: PERM NO: P 052728 GOVT: N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: B-2 / COMMENTS: RE: B52643 PRIMARY BLDG. PERMIT. Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING NOTES> > D E V E L O P M E N T S E R V I C E S:=_ R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : -111 DATE: APPLICATION ISSUED BY: raN DATE: 1D. �F * �F Tt �F i4 iE 1E �F TF TF TF TF TF TF iE iE iE iE iE TF iE TF �F iE TF �F St �F �F �' 1F lf it -IF iE � Tt iF iF TI- �f lf 9F'l(• * iF Tf St TF iE �F �F St St �F �F �F �F �F if �F St * if iE iE � TF i4 * iE * �F i(• �[• iE Tt LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMB4INGG ELECTRIC MECHANIC FIRE SMIP/RES GRADING 00 �5% SMIP/NON-RES PLAN ISSUE FEE 3.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS-----> 4.00 3.00 0,00 7.00 7,00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 7,00 OVER/SHORT•00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 7.00 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale, Owner: PLU I do hereby certify that I am aware of and understand the requirements of Caldornia,Heallh and Safety Code Sections 25505, 25533, and PLU 25534 and that I or any future building occupant willlwill not (circle one) need to comply with said stale codes and the requirements for a permit for construction or modification from the Air Quality Management District. Residential construction applications are exempt Irem these provisions. Date: Applicant: I hereby certify that I have read this appiica6on and state that the above information is correct. I agree to comply with all city and courtly ws and slate laws relating to building construction and hereby authorize representatives of this city io ertter.upon the above-mentioned lot inspection purposes. Daze: Date: �% /.9/10/ rp� ,L�osqSignature: ~ y Driver's Licens(or Social Security a: 1641.46 While—Building: Green— ry—Applicant; Pink—Revenue; Gordenrod—Assessor 1 SINK KITCHEN 1 WATER HEATER AND/OR VENT END OF FEES 2.00 2.00 2.00 2.00 ('1 =01zr`-CLflYlM I'` 7, IsLf� DATES Ua '1�I,1 r I` r CONSTRUCTION AND PLANNING POO , APPROVALS Permit # Date Inspector 7'A APPROVALS Permit # Date 1'nspector ''� 1, Temporary Electrical Service o_Pole 52. Pool & Equipment Location . 2, Soil Pipe-Undrgrnd. r 53. Steel Reinforcement `3. �lec'ric`alrrJradUil�Uilllty Uhdrgrnd.�� 54.'Forms .4• Elentr.ieef:Cbnduit=Uridrgrnd. 55. Electrical Bonding $:.Stec Rf'n�torcement } 56. Baugh Plumbing & Pressure Test T a ... E .y z6; Eiectrical'UFEF�Grad. c_ e 57. APPROVAL TO COVER-GUNITE `7: ootir3gs_�; '� '' 58. Electrical Conduit-Undrgrnd. 87 FoundaW! ;� _T 59. Gas Pipe, 13 Undrgrnd., Test 9:. Water Pip-Und[gmd. ~% 60. Backwash Lines, P -Trap, 0 Undrgrnd. t, 10!.Structural Floor:System - 61. APPROVAL TO DECK If, Property Sewt!r Line & Hoosd Connection 62. Backwash & Receptor -Final � 12. Sewer Cap y 1/'63. Heater &Vent -Final 13. Roof Drains:, c J 64. Plumbing System - Final 14. Rough Pluml '16 `' ` 65. Electrical -Final /+ 15. Rough Electrical: -Conduit ; 66. Solar System -Final 16. Rough ETectri Wiring 67. Fencing & Access Approval 717. Rough Wirtpg Sign 68, APPROVED FOR PLASTERING 1$. Rough Eletirfricai T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE'DEPT. REQUIREMENT J J {�PPROVALS':u Perrrlit # ' 20:TRorh Factory Fi?�place i �" * rec - a! . in,5truct„ , .-0,Uergotncl:Hydro21.'_Ducs, a 22. Ducts, Vt3ntil4tinj'� = r�r Y x=71. ProducfP+ping OGQs EI -Oil 23,':Ga5-Pips=Rou6h V' est 72. Undergro�n� Flu`shF 24,_RoCf Ftaming ti ; �� y[7 :� - C i 73.�Jndergrnd:Storage"fank 13 Gas DOsi • , -r w - ,� 25. Roof Sheathing <] { 4.�Overhead �Iydro4 ' 26. T -bar Ceiling (Structural) &:Monocoat X :L l[t' - �: Chemical a 75.x � � a ,-Dry 27.6Trame and Flashing: ? �, • ` 76: Dry Standp{fie s„ ` , T 28 -`Lathing S& Siding- Y _�= r x r 77. FIXED SYSTENCFJNAL- �29. Insulation s Y - '' i r ; 78�;: FIRE PREV. FINAL •� j IP 2N t •i- 30. Drywall Nailing HEALTH -DEPT. REQUIREMENT _31. Plaster Browa Coit, Y x ' 1FfId'ALiW8P_ECTION - --y, , r79 -32.7ElectricaEPower 8ileter,•Fina1 *, 4,' }. rBO..:FOOD CERTIFICATE ISSUED Electric. r '� ' Notes: �33.�i_rraJ r ) -34,-Fin5l Hating:& Rir.Conditioning:, r `•' .. �; S �- _-`K .► 35.1rFinaI Gas Pipe -Test - - I t' " `" .' N, 'k {•` S,= _06. 1-logd or[CanopY •�� , ir, - ,z -Final Factory Fireptac6 `1 {' -37. �B. Fingl Plumbing rU .... : , U i'-��j I Cti (1!F�' +- i• „' 39. Water Service -Final* i `y x ,-.AO. Gas Service Final ;; ,[• ;t,.r,, ,3 l ar< ' r >'41. Solar Domestic -Final:. ~42 58ackflow Preventers 43. Backflow lrrjgatiori{- * C - -- -44. Landscapei-tri i U-1 u; Rat oil Syste% - r:r r- �. >45 =Sound Atterivatiort + s .'' c • -X ' "-:- t?:.r ri46:,Pandirap Regulations C"r e. X 47.�FINAL STRUCTURE & BUI.LDING 48W"Fll` Al_ PLA`NNINd- .n _49.. Electric Release to Edison w ; 50. Gas -Release to Southern Catifarnia Gas Co :'51. CER•TIFICATEOF„OCCUPANCI( No. Date �TADDRESS: 3151 AIRWAY AV UNIT: N1 OWNER'S NAME: CALIFORNIA FEDERAL BANK ADDRESS: 3151 AIRWAY AV #F-108 COSTA MESA CA 92626 (714)540-2606 ARCHIENGINEER: DARYL MALMBERGASSO. REG.NO.: C-9082 ADDRESS: 2600 MICHELSON UNIT: 1550 IRVINE CA 92715 PERMITTEE: JANNING ELECTRIC (714)830-9668 ADDRESS: 23141 LA CADENA Q LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: i hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 70001 of Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: 052 // 109 n STATE LIC.: 5 37271 C 10 Date: 77/�� 7�_,_.; .--- Signature: — WORKERS' COMPENSATION DECLARATION: I horeby affirm that I have a cert) nate o! consent to self-ip ure or a certificate of Workers' Compensation Insurance. or a certified copy thereof iSection 3800, Lab. C . POLICY NO.: 80015645 EXP. DATE: 2/01/92 COMPANY: FAIRMONT aerCertified copy is hereby furnished. [X Certilied copy is filed with the city Building Divisia . ate: —'/�^� q l Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (Thus section need completed it the per tis for one hundred ($100) or less). k certify that in the performance of the work lot which this permit is issued, I shah not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration. you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby alfirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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 life a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Slate License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 (5500). 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 safe (Section 7044. Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselllherself or through his of her own employees, provided that such improvements are not intended or offered for sale. A, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). 1, as owner o1 the property, am exclusively contracting with licensed contractors to construct the project iSection 7044, Business ❑ and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who contracts for Such projects with a conlractor(s) license pursuant to the Contractors' State License Law), I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. Cr lot this reason: Date: Owner: I do hereby certify that I am aware of and undersland the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant willlwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or maddication from the Air Duality Management District. Residential construction applications are exempt Irom these provisions. Date: Applicant: I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and slate laws retating to building construction and hereby authori a representatives of this city to en er upon the above-mentioned property for inspection purposes Date: ��{ Signature: Driver's License or Social Security •: 1641.46 White--Duildmg; Green—Cade Enforcement; Canary—Applicant: Pmk—Revenue; Goldenrod—Awessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: E 052782 PLAN CHECK NO: N CONSTRUCTION TYPE: PERMIT TYPE: ELE JOB DESCRIPTION : COMMERCIAL T.I. (OFFICES) CLAIM VALUE: CALC-VALUE: PERM NO: E 05278 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B-2 / COMMENTS: REF: B52643 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------- ---------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: REF NO; PLANNING NCITES> 7 iEdE�1E*iEiEiE*iEiliEiE�IF�E�E*****�*��*�**it•*******iE*i!***9E*iE****�***�*it•**iE**�iE*mit•**IFit•it•�it• D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: '7 iE iE iE it• it• .� * iE * if it iE it it• it iF it it * iE it TF * * * it• � it it it• * iF il• ik * iE * iE iIiF iF iE iF iF iF iF iF if iF iE iF � iE � * � iF � iF iF � iE * iF � iE � iF � * it iF � * * * iF iF iE iE iE iE iE iE * � * iE * it iE it• it it it it * iF i(• * iE iF � � #(� iF iE #(• LEGALIZATION:N F E E S U M M A R Y— STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 15 75 PLAN tot SMIP/NON-RES ' ISSUE FEE 15.00 BUILDING -DIV-> PERMIT ISSUE ,PLAN -CHECK TOTAL PAID DUE TOTALS----> 15.75 15.00 0.00 30,75 30,75 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 30.75 OVER/SHORT;00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 30,75 * * iE * * * iE * * iE it• * * iE iE �(• � * iE * iE iE iE * * * iE i(• iE iE iIiE iE iE iE ii• iF if iE iE iE if if if if iE iE iE iE it• iF * * it it it• it• it iE it• it• ik it it it iF iE it i(• iE i(• iF � � � iE iE iE iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 8 FIXTURES LIGHTING 1 ST 20 EA, ,75 6,00 ELE 10 RECEPT/06TLET 1 ST 20 EA. .75 7.50 ELE 3 RECEPT/SWITCH 1 ST 20 EA, ,75 2,25 END OF FEES V/ •=I. dull^!'V�^.. Jj .1t IC �T` �_ � , Adb CONSTRUCTION AND PLANNING Date Inspector POO�r'A Date Inspector APPROVALS Permit # APPROVALS Permit # 1. Temporary Electrical ServWe pr Pole 52, -Pool & Equipment Location a4 1 2. Soil Pipe-Undrgrnd. L Ll 53. Steel Reinforcement Cie6fjcif Cor ddit tlility-Undrgrnd` 54. Forms 4, Eieetrical,Gon[iuit-tidrgrnd. 55. Electrical Bonding -.,SNegReihftircemen�.. 56. Rough Plumbing & Pressure Test u ;.6•'El&cujcof {l1=R,G;rtd. 57. APPROVAL TO COVER-GUNITE '-'7. FootingsS r 58. Electrical Conduit-Undrgrnd. �. . r. B.'Foundat oq �; 59. Gas Pipe, ❑ Undrgrnd., Test 9.. -Water Pipe•Undrgrnd. ",r 60. Backwash Lines, P -Trap, ❑ Undrgrnd• 2 1.0 Structural Floor System ; `" IO. -Structural 61, APPROVAL TO DECK - ' 1 Property Sewer Line& House Con tion S 62, Backwash &Receptor -Final • . 12. Sewer Cap i 63. Heater & Vent -Final 13. Roof Drains, 64. Plumbing System - Final 14. Rough Plumbing L - ' 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough ElectriaWiring 67. Fencing & Access Approval '17, Rough %l Ing Sign' 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT rAPPROVALS : _Permit # Y 20;rRoi gh Factory Firaplace s.,+ .! � _ f eY t 1 'i ly Y - '' i• _ 21' Duets, i n.Str*ct e" w " 170, Ohder4fqw4 Hydro •. r 22' Ducts, V&ntzlating r -71. Product Piping UtGas 60il I r e 23�Gas Pipe Rough -72, UndergroI+np Flgsp; 24., 8oC-0 Framing .,11" C, • .i ve 573.• Undergrnd.. StoraquTank�D Gas' ❑ 011r_ 25. Ropf 5iathing _ ' ` Z '74.- Overhead Hydro r 26` -T -gar Ceiling (Sti"tural) &Wonocoat 1 .� 75.�Dry Chemical u ' 27'; -Frame and Flashing.. x .4 76• -Dry Standplee ? City of Costa Mesa Development Services Department Building Safety Division P. O. Box 1200 Costa Mesa, California The Building located at CERTIFICATE OF OCCUPANCY 3151 AIR•.rAY AVF VLM BUILDING P-3 No. 000432 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group E$__2 Occupancy. Use of Building CFFI(M Legal Description 938-940-73 (See reverse side for Metes and Bounds) Building Permit No G -125$-i Electrical Permit No. G-12585 Plumbing Permit No. G-12383 Mechanical Permit No. Number of apartments �] and/or guest rooms r) !C ISSUED TO: Building Official ZVe � GUILAI MSE OONSULTAN S 3151 AM -JAY AVE. 4F,1, CC]=' -TSA, cam. Date /."2 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 {e} U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File: Pink - Bldg, Permit File City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000559 P. O. Box 1200 Costa Mesa, California The Building located at 3151 A -U:5? 1Y P--2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group S-2 Occupancy. Use of Building CIF'ICE Legal Description 938-940-72 (See reverse side for Metes and Bounds) Building Permit No 613892 Electrical Permit No. 613892 Plumbing Permit No. 613892 92 Mechanical Permit No. 6138 Number of apartments and/or guest rooms ISSUED TO: GUILDHOUSE CONSULTANTS 3151 AITMY E-1 C.M. CALIF Building Official by This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises&drill SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White • Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. P. O. Box 1200 Costa Mesa, California The Building located at 3151 AingAV'aula 0P-1 . has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group H=2 Occupancy. Use of Building Tnb-rich AjtE4Mtj0j9 — Office Legal Description 427-291—I2., 14 (See reverse side for Metes and Bounds) Building Permit No, R-7801 Electrical Permit No. F-71131 Plumbing Permit No. P--7825 Mechanical Permit No. M-7960 Number of apartments ISSUED TO: Building Of, Fir-t1t^iva it1i IA—JTAA PbAFtp TT b�/ 3151 Airway Avemie OE --1 Costa Nara CA This Certificate of Occupancy SHALL BE posted in a conspicuous place on the Building Official of the City of Costa Mesa under Sec. 307 {e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink • Bldg. Permit File `0— _ and/or, guest rooms —0— icial^l`-lf and SHALL NOT BE removed except by the CITY OF COSTA MESA o BUILDING DIVISION r 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us r �. FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00204 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42729115 DATE ISSUED: 0911712009 ISSUED BY: BJK JOB ADDRESS: 3151 P AIRWAY AV CM ' Suite/Lihit: P Vicinity: BUILDING L ROOF Squares: 9400 Valuation: $24,006.00 SCOPE OF WORK: REROOF BUILDING 'P': TEAR OFF EXISTING WOOD SHAKE ROOF, INSTALL 1 LAYER OF 15 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 94 SQUARES, REPAIR AND REPLACE SHEATHING AS NEEDED, OWNER: SUNBELT CONSTRUCTION Address: 4501'E LA PALMA AV Unit: SUITE 200 PHONE: City/State/Zip: ANAHEIM CA APPLICANT: HANSEN, DUKE Address: N6646636 Unit: PHONE: City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC Address: 260 E ALTON AVEUnit: City/State/Zip: SANTA ANA, CA 92707 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund TOTAL FEES $0.00 $391.25 50.00 S1.00 $392.25 License No. 327802 PHONE: 714-557-7440 CELL: License No. PHONE: License No. PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. aC DE f, INSPEcnon TYPE DAF NI TMAL5 CODE II INSPECMN,M DATE INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1286 Pool Spa Final208 Final Plumbing 200 Final Re -Root ! )"D, 210 Final Electrical 201 Final BlocklRetaining 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 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. r�34 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: Carrier: �7�� i P� �U f TW Ilealon need not be oampleled d the perrnr is valued atone hundred dollars (S 7 rap) orfess.) Policy Number: 1/0 7 L L2 - Z a 0 1?1 ❑ 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 or Code, I hall forthwith comply with these provisions. y 4li�/y5P pplii ds Signature Date 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 DOLLARS ($100,000), IN ADDITION 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 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. Class.#. Coniractor Signature_ -Da etet '— 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 Dale 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, after, 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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature Date 3067-46 (3107) Owner ID verified by driver z, rlcense. ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e, - properly 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, Pit 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Duality 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? ❑ Yes ❑ No 8. (If 'yes", attach cerlificale 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, gnature of al Owneris) Dale And/or Authorize Apptrcanl_ Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. P'C� Y OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. [BLDG.NO. ' CONSTRUCTION PERMIT15111.3 5j --1q - 3I-ki, R Project AddressAirwayAvenue Costa Mes TYPE OF CONSTRUCTION 6J, OwnerWpqtern Phone NEW ❑ADO 13 ALTERATION PLAN CHECK #51442 Address ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS Arch/Eng, Hales—LangstQnLicense No. C-0 0899 — DESCRIPTION OF WORK A P a Address ZONE L PLNG. REF. 9r- Contractor The J. Donald Olson CO.Phone 540-2SQ TYPE OF PERMIT SET ACK Tp ptJ! ING PROPERTY LINE Address _ ,yy,, ❑ GRADING ❑ FOUNDATION 91 STRUCTURAL C T. S DYARD LICENSED CONTRACTOR 10ECLARATION I hereby that I licensed Charter 9 ❑ TENANT ❑ ELECTRICAL ❑PLUMBING [:)MECHANICAL5t E YRD affirm am under provisions of (com- mencing with section 7000) of Division 3 of the Business and [:1OTHER RIGHT ' Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) License Class R License No. i33g6q PROJECT IPTION Ff9F PKG. SPACE REQ. �j PROVIDED _ Date Signature SQ. FT. 5 N $-2 STREET WIDTH PARK FEE S WORKERS' COMPENSATION OECLARATION OCCUPANCYdo CONSTRUCTION TYPE I herebyaffirm that 1 have a certificate of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY DATE .3— certificate of Workers' Compensation Insurance, or a certified copy thereof { tl 0, �' Fairmont Insurance GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No. Company 1-199irtified copy is hereby furnished. ARKS: �' 3 Certified copy is filed with the city Building Division, • :f,XEMPTION FROM WORKERS' COMPENSATION DECLARATION +. his section need not be completed if the permit Is for one hundred 1061 or less). -•'cert fy that n the performance of the work for which this permit 15 issuetl, I shall not employ any person in any manner so as to becomeBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws of California. [BATHTUBS Date Signature SHOWERSNOTICE: If after making this declaration, you should become subjectETS URINALS GENERATOR 0.1 KW 1-10 KW totheWorkers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemedATORIES DOUBLE LAYS APPLIANCE 10-50 KW50 + KW revoked. CONSTRUCTION LENDING AGENCY SINKS DISHWASHERS,j MOTORS 0-1 HP1-10 HP I hereby_affirm.lhat.toere is a-construction.lending agency'for the pereIC_E SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP formance ofAhe work foi'which'this'permlt'isfissued (Section 3097 Civ. C.), Lender's Name Western .Pacific _Financial Corp. FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address 1601 Dove Street, NPwp„Qrt RCF)-- DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS ' SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to Its Issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ' Business and Professions Code) or that he is exempt therefrom and trio basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ' any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ I. as owner of the property, or my employees with wages as their " compensation, will do the work, and the structure is not Intended SOLAR PIPING SYS. ISSUE FEE fered for sale. (Section 7044, Business and Professions Code; The actor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE v__ bullds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK - SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement S Sold within One year of Completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0.100,000 BTU PERMIT G E 5n SMIP $ El I, as owner of the property, am exclusively contracting with AND DUCTING -goo_ licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK E PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of properly ,who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING_ $ tracts from such projects with a contractor(s) IlceSned pursuant to SYSTEM GRADING $ the Contractor's License Law), 100,000 + BTU PLAN CHECK E ❑ I am exempt under Section 8. & P. C. for this BOILERS BTU ELECTRICAL $ $ reason _ SYSTEM REPAIR, ALTERATION PLAN CHECK $ ' MICROFILM $ _ Date Owner MECHANICAL E TOTAL FEE S I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD. information correct. I agree to comply with all city and county PLAN CHECK E VANCE PC $ ordinances and state laws relating to construction, and hereby authorize representatives t Is city to enter upap the above mentioned property f ion pLa-1 cnr� FI NAL FEE S R�g - ilt7 Signature Driver$' License or SS ISSUE FEE - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit Date inspector Tom' POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn -51 46. Electrical Bonding 5. tee r-, force 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings _ f , g 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Fina? 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14• Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57• Solar System -Final 16. Rough Heating & Air Conditioning 55. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19, Gas Pipe:Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: „ . . 22. Frame and Flashing 23. Insulation C Q 24. Lathing _& Siding �. 25, Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gay Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40, Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERNO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT I Project Address 3151 Airway, Costa Mesa Ca. TYPE OF CONSTRUCTION OwnerDonaldPhone _ ❑ ADD ❑ ALTERATION Address 7L3 eE5VEW REPAIR ❑ CONVERSION ❑ DEMOLISH 6770 ! O/ 13/61 j6e130 TU 'ZONING'REGULATIONS " =Arch/Eng, License No. ❑ OTHER DESCRIPTION OF WORK A P Address _ ZONE PLNG. REF. 41 Contractor er O —Beck INC Ph6ne979— TYPE OF PERMIT Address" '❑ GRADING , ❑ FOUNDATION ❑ STRUCTURAL - SE SETBACK C L ST. SIDF YARD pROpElt�TVNLINE ' LICENSED CONTRACTOR DECLARATION ❑ TENANT ElELECTRICAL/PLUMBING ❑MECHANICA tSIEEDg I hereby affirm that I am licensed under provisions of Charter 9 (com- YA RIGHT mencing with section 7000) of Divislon 3 of the Business and ❑ OTHER Professions Code, and my license is in full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License Nom PKG. SPACE REQ. PROVIDED Data Signature .Cli[:.cr//� 5Q. FT. STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY -'CONSTRUCTION TYPE I hereby affirm that I have a Certificate of Consent to self-insure or a VALUATION ZONE' APPROVED ZONING APPROVED BY DATE Certificate of Workers' Compensation Insurance, or- a-certified -copy - - thereof (Section C }- 1f4. Zenith National GRADING CU. YDS. ACRES SPECIAL Policy Na. Company 0Certified copy Is hereby furnished. _ :REMARKS: rET-Gertlfied copy Is flied with the city Building Division. EXEMPTION' FROM WORKERS' COMPENSATIONDECLARATIONsect Ion. Ion. need-not be completed If the permit.is fo( one hundred tCP 00) or less}. I. ertify that n the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as -to ,become "PLUMBING PLAN CHECK ELECTRICAL PLAN subject to the Workers Compensation Laws of California.' _ ' '. _ Date Signature BATHTUBS SHOWERS 119 G NOTICE: If after r&king this declaration, you should become subject TOILETS URINALS GENERATOR 0.1 KW 1.1to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER ICHECK forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAYS APPLIANCE 10-50 KW50 revoked.CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP-1-1I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50•HP 50 formance of the work for which this permit is Issued (Section 3097 Civ, C.). — - Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt fromtheContractor's License Law for POOL PTRAP the following reason (Section 7031.5 Business and Professions Code:SWIMMING Any city or county which requires a permit to construct, alter, .POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB impprove, demolish or repair any structure, prior to its Issuance, also re- the applicant for Such to file a signed statement that he quires permit Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE'- AMP {Chapter 9 (Commencing with Section 7000) of Division 3 of the _ WATER HEATERS BTU OUTPUT Business and Professions Code) or that he IS exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by "SEWER CONNECTIONS - - any applicant for a permit subjects the-applicant to a Civil penalty' of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ I, as owner of the property, or my employees with wages as their Sola compensation, will do the work, and the structure is not intended _ri L• ISSUE FEE o• fired for sale. (Section 7044, Business and Professions Code: TheS• C ctor's License Law does not apply to an owner of a property ISSUE FEE r APPLICATION APPROVED BY DATE w., juilds or improves thereon, and who does such work himself or through his own employees, provided that $uCh improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement is Sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-lOD,000 BTU BUILDING PERMIT $ - SMIP $ ❑ I, as owner of the property, aexclusively contracting with m licensed Contractors to construct the project (Section 7044, Business -AND DUCTING 100,000 + BTU ' and Professions Code: The Contractor's License Law does not apply to PLAN CHECK $ PERMIT ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts, from such projects with a•contractor(s) licenned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,D00 + BTU PLAN CHECK $ ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reason PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ MECHANICAL $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- Information IS correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC - $ _ ordinances and state laws relating to construction, and hereby authorize representatives of this city to enter upon the above mentionedproperty f�, spectidn SIg atu e[J�t" 44&A. po na_ro ,f - FINAL FEE $ Drivers' License or SS V� ISSUE FEE' CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector �_Pa:;Temporary ElectticajEService�or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER_ Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap. El Undrqrn 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final -12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbin(i System - Final 14. Rough Electric -Conduit '56. Electrical -Final 15. Rough Electric -Wring 57. Solar System -Final ' 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing- NOTES: 22. Frame and Flashing 23. Insulation - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31, Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Serinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date �_ + Applicant to fill in all spaces within heavy border lines and sign all ap, ridte declarations. TY OF COSTA MESA PE IT NO TRACT NO. - LO O. BLDG. NO. - - -- - CONSTRUCTION PERMIT �r dress 3151 Airwa Bldg �] �] 1 TYPE OF CONSTRUCTION ; ~. -; 6139 5/220/82 355*00 TL' P�`D. Olson - Phone EW ❑ ADD ❑ ALTERATION -' Q- F-Addres3151.Airwa Ave. _ ❑REPAIR• ❑ CONVERSION ❑DEMOLISH, ❑ OTHER t ZONING REGULATIONS"',,,{, e License No. N 1 DESCRIPTION OF WORK A•P, r ` Address ZONE - - - ,PLNG. REF. ' V ContractOrSifeyja -Heat ing. - Phone 921- PE OF PERMIT.,_ _ _,BUILDING_ SETBACK �ROepl l $ f11GINE Addr Imperial HW Santa Fe PQ GRADING -- ❑ FOUNDATtON - ❑ ST UCTURAL' ST. I YARD LICENSED CONTRACTOR DECLARATION O n5 c0 ❑.T.ENANT_ ❑ ELECT.RICAL-❑PLUMBING ECHANtCA I {nY - - - - - I hereby affirm that I am 11Censed under of Char mencing with section 700 ion_ the sines$ . • ❑OTHER RIGHT _of ,_ _of Professions Code an my lice is full a t. �-�O . PROJECT DESCRIPTION REAR YARO (TO P/L) •' .. - Llcense'Class� LIC - " " PKG, SPACE REQ. _ PROVIDED- - J - _ SQ: FT: r ^ Data '� Signat r WORKERS' COM_ PENSATIO CLARAT N • _ -- - •-- CUPANCY CONSTRUCTION TYPE _ -� ' r STREET WIDTH PARK FEE $t4 ! 'I hereby affirm that�l have a certificate of consent to self-ins a ' VALUATION ZONE ZONING APPROVED.BY - Y+ - DATE -- - .- of Workers' Con1P(n$dtion, Insurance, or a Certifle ,copy ,certificate thereof (Sec C.)• °8 Haines Ins. IING,CU. YDS_- ACRES LSPECIAL CONDITIONS: Policy o.- -Company , . ❑ rtlfied copy is hereby furnished. ARKS:_ S: Certified copy Is filed'witn the c1ty Building Division: , ,EMPTION FROM WORKERS' COMPENSATION OECLARATION-his section need not be completed if the permit is for one hundred($100) or less):i certify that in the performance of the work for which this permit is f_R Issued, I shall not employ any person in any manner so as•t0becomeBING , �., ,, ,PL'AN CHECK ,' •,ELECTRICAL PLAN CHECK.-subject to the Workers' Compensation Laws of California. ' I --Date Signature TUBS SHOWERS-4 - NOTICE: Ifafter making this declaration, you should become subjectETS !, URINALS- - --- -GENERATOR-- 0.1 KW 1.10 KWtothe Workers' Compensation provisions of the Labor Code,-you must forthwith comply with such provisions or this permit shall be deemedATORIES DOUBL-E-LAVS•' - -- - TRANSFORMER :APPLIANCE J 10-50•KW_50 + KW revoked. CONSTRUCTION LENDINCa AGENCY`" •� -SINKS - KIT. - DISHWASHERS - MOTORSHP-1L10- r - 0-1 FIP ' I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - SUMPS -' - -r (INC. 40LAR)a - 10-50 HP-- 50 + HP- formanCe of the work for Which this permit is Issued (Section 3097 .• I s. ��- c• { C14. C.).__ �_- _ __ ..,_ - - FLOORSINKS - -FLOOR DRAINSi" Lender's Name FIXTURES OUTLETS" SWITCHES �;• _," -:r Lender's'Address- � - - - DRINKING-FOUNTAINS" '",. �`+'- w GAS TUBE SIGNS - f r - - + , OWNER BUILDER DECLARATION F hereby affirm that I am exemPt from the Contractor's License Law for 'INTERCEPTORS - CLARIFIERS `- - --POLE LIGHTS - the foliowing•reason (Section 7031.5. Business -and Profession$ Code: . SWIMMING POOL - P TRAIP- - - - Any city or county which requires a permit to construct, alter, POLES METERED SUB e• WATER-SERVICE - -' ALTERATION- - 'PANELS- --MAIN '-' SUB- - - - - - improve, demolish-or repalr_dny. structure, prior to.its issuance,.also re-- qulres the applicant for such permit to file a signed Statement that he J~ -s SERVICE-"-- - 'OUTLETS- - - "SERVICE- '- - -- ' ' AMP" J is licensed pursuant.to the.provisions.of the. Contra ctor_'s.Lice rise hwGA5 Chapter 9 (commencing with Section 7000) of Division 3 of the that, he iS,exempt - - WATER HEATERS BTU; OUTPUT ' - - usiness and Professions Code) or therefrom.and.th¢ basis for the alleged exemption. Any violation of Section 7031.5 by any_applIca nt-forte a-permit ,SubJects the applicant to, a .Civil _.penalty. SEWER-CONNECTIONS of not more than five hundred dollars ($504). - l • -SOL-AR TANK- - - - - COLLECTORS- Y - _._. as owner-of-the property, or my�employee$ with wages as their �f !ompensation, will do tMe work, and the structure is not intended �- fr SOUAR-PIPING SYS. - ISSUE FEE O• ffered-for sale. (Section-7044,-Business and-Professions-CodevThe Contractor's License Law does not apply to an owner of a property i -- ISSUE FEE .{ '-� - -f "- - -APPLICATION APPROVED BY - - -' DATE- who builds or improves thereon,'and'who does such•work himsetf'or - through his own employees, provided that such improvements are not 'MECHANICAL PLAN CHECK - SUMMARY OF,FEES intendedor offered for sale,•If; however,-the building or improvement is sold within one year of Completion, the owner will have the burden of proving he did not- build-or improve for the purpose of-sate). • ❑TI, - - HEATING SYSTEM 0-100,000 BTU - BUILDING- - -- - - PERMIT $ - • -- - - �•^ •• .' SMTP E - as owner of the prOP¢rty, am exclusively - contracting with ANO DUCTING - - -- - -- . - - - -- - -- - -- - -- - -- - ricensdd- contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to _+_ - - w$ ISSUANCE- S an owner of property who puilds or Improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING �•. „ly c. Tracts from such projects.'with_a_contractor(s)_Ilcesned pursuant to SYSTEM _ _ +' _ 100,000 _ 3 ' _ - .GRADING _$ the Contractor's License L`aw). ❑ 4 am exempt under-Sectio B. & P.•C. for this + BTU - - -$ BOILERS BTU C�' PLAN CHECK- $ ELECTRICAL 5 - _ y ' reason - Date_ D_wner _ _ SHSTEMREPAIR, ALTERATION _ PLAN CHECK $ MICROFILM $- TOTAL'FEE $" _ _ _ _ MECHANICAL $ - - _. - I hereby cer[ifytha ead this ap n a state that the above EXHAUST SYSTEM MULTIPLE ..- LESS AD- + information is ect,- agree-t mpty all- City and county PLAN CHECK $ VANCE PC. $ _ _ r ordinances a State relati o constr on, and hereby authorize - representa ' es of is cit 0 e - Pon -the above mentioned -- -- - , property Or i ctio �j 7 - 5-13-82- FINAL FEE SlgnaIur ISSUE FEE zv ,fid Drivers' nse or SS CMF 0865.46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor APPROVALS CONSTRUCTION AND PLANNING 1--4*'` �, r,;,, Permit # Date inspector �j� POOL & SPA ti , APPROVALS r•Permit# ° »� ' ;i Date .� : Inspector 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bondin - 5. Steel Reinforce _ 47. Rough Plumbin & Pressure Test. 6. Electrical LIFER Grn ,f 48. APPROVAL TO CCtVER.GCIN'ITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test-: 9. Water Pipe-Undrgrn 51. Backwash Lines . -Tra ❑ ndr rn 10.. Structural Floor System 52. APPROVAL TO`DECK' 11. Property Sewer .Line & House Connection 53. Backwash & Rece toi'-Final 12. Street Sewer Connection 54. Heater &Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit •56.' Electrical -Final 15. Rough Electric -Wiring 57.- Solar System -Final 16. Rough Heating &•Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure . APPROVED FOR PLASTERING 16. 19. 20. Ducts, Ventilating Gas Pipe-Rough'&Test - Roof Framing - 60. POOL/SPA SYSTEMS FINAL 21; 22. Roof Sheathing Frame and Flashing _ NOTES: 23: -Insulation - 24. Lathing & Siding ' 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test - 31. Final Plumbing 32. Water Service -Final 33.. Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling System .36.;7,Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison r 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY Date _ Applicant to tilt in all spaces within heavy border lines and sign all appropriate declarations. 101TY -OF COSTA MESA - - - pEg IT O TRACT NO. -I- LOT -NO. - BLV) NO. CONSTRUCTION PERMIT 3 e - rrojeci muu,-c» =vAl—K 1 W {�/� TYPE OF CONSTRUCTION ` Owne cLca �� L hone -7�. ❑NEW ❑ADD ❑ ALTERATION l O Address ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER Address - - DESCRIPTION OF WORK Contractor Neb.C.rl R Phon-grr1_ Zp OTYPE OF PERMIT t Address LAA a ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHAf I hereby affirm th7.t I am licensed under provisions of Charter 9 (com- 7000) of 3 ❑ mencing -with -section Division of the Business and Professions Code, a d my lice se Is In II f d eE t• - OTHER PROJECT DESCRIPTION License Class cen o� Signature Date Signature SQ' - WORKERS' COMPNSATION D£CLARAT.ION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE Certificate of -Workers' Compensation Insurance, or a Certified copy - - _, _ _ , ereof ( c(iq'.1 3 00, Labe/C.). cW� t• o GRADING CU.,YDS. ACRES lacy No4J n Company -TOILETS , 1 -URINALS' - Certified copy iS,hereby furnished, ertifted copy Is filed with the city Building Division. -REMARKS:, .S ,j. Q (r LAVATORIES DOUBLE LAVS - 6117 5/20/62 ZONING REGULATIONS A.P. it ZONE PLNG. REF, jF 34.50 TU • RIIGHTARD XEMPTION FROM WORKERS' COMPENSATION DECLARATION^ - PANELS (This Section need not be completed if the permitis for one hundred •_ STREET WIDTH S$1001 or less). _ _ _ 'DATE -- Certify that In the performance of the work for which this permit is ^ Issued, I Shall not employ any person in any mannersoa5 to 'become PLUMBING- ;� PLAN'CHECK- _ subject to the Workers' Compensation Laws of Califdrnta.' • ,ELECTRICAL PLAN CHECK _ Date Signature BATHTUBS' 'SHOWERS _ GENERATOR- 0-1' KW - :TRANSFORMER :APPLIANCE 10-50 KW_50 NOTICE: If after making this declaration, you should became subject- to the Workers' Compensation provisions Of the Labor Code, you must -TOILETS , 1 -URINALS' - '1-10 HP - - t 50 + HP forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - ' revoked. POLE LIGHTS - COPISTRUCTION LENDING AGENCY -KIT, SINKS DISHWASHERS. $ I hereby that there IS a construction lending agency for the per- SERVICE SINKS SUMPS $ formance of the work for which this permit is issued (Section 3097 of Civ. C.). - r - - - FLOOR SINKS' F,I_OOR DRAINS - $ Lender'$ Name ' `� ` DRINKING"F`OUNTAINS "" (PLAN CHECK Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am Oxern from the Contractor's License Law for INTERCEPTORS CLARIFIERS .ELECTRICAL the fol lowing •reason (Section 7031,5 -Business andProfessions Code: SWIMMING POOL- P TRAP Any city or county which reaulre5 a permit to construct, alter, MICROFILM $ PLAN CHECK improve, demolish or repair -any structure, prior -to its Issuance, also re- the api.licant for Such permit to file a signed statement that he - WATER SERVICE 'ALTERATION " MECHANICAL quires Is•licenSed-pursuant to the-provi$lanS of the Contractor's License Law 'G'AS SERVICE OUTLETS' 'PLAN (i'hapter 9 (commencing with Stiction 7000) of Division 3 of the , CHECK -iess and Pro4ession5 Code) Or -that he Is exempt therefrom and -the. WATER HEATERS BTU OUTPUT_ .for the alleged exemption. Pny violation of Section 7031,5 by FINAL FEE $� applicant for a permit subjects the applicant t0 a civil penalty SEWER CONNECTIONS' - -' ofnot more than five hundred dollars (5500). PI, as owner of the property,'or my employeeS with wages a5 their SOLAR -TANK COLLECTORS ole Compensation, will do the work, and the structure is not intended or'offered for sale. (Section 7044; Business and Professions Code: The' SOLAR'PIPING'SYS: Contractor's License Law does not apply to an owner of a property who buiIds or Improves thereon, -and who does such work himself or ISSUE FEE - (; through his own employees, proviged that Such improvements are not Intended or offered for sale. If,'hovyever, the building or Improvement Is sold within one year of completion, the owner will have the burden MECHANICAL PLAN CHECK of proving he did not build 'or'lmprova for the purpose of sale). HEATING SYSTEM 0-100,000 BTU ❑ 1, -as owner -of the property,.am exclusively -contracting with AND DUCTING-- licensedcontractors to construct the project (Section 7044, Business 100,000, BTU and Professions Code: The Contractor's LFcense Law does notapplyto an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0.100,000 BTU tracts ,from -such projects -with .a contractor(s) IiceSned pursuant to- _ SYSTEM --- - the Contractor's License Law). i00,0001+ BTU ❑ I am -exempt under Section' - - - B. & P. C. -for this _ 1 ' reason BOILERS BTU Date Owner SYSTEM REPAIR, ALTERATION V \ I hereby certify that 1 have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ 1 !VA Informs correct. I 'agree-ta comply with -all city and county prdln ces and s la 'eag tb construction, and hereby authorize repres tatives of cit to -ent€r upon [ne above mentioned -- proper for on s_ Signature Drivers' License or 55 ISSUE FEE . CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 6117 5/20/62 ZONING REGULATIONS A.P. it ZONE PLNG. REF, jF 34.50 TU • RIIGHTARD METERED REAR YARD (TO P/L) PANELS PKG. SPACE REQ. PROVIDED STREET WIDTH PARK- FEE $ - .ZONING APPROVED BY 'DATE -- SPECIAL CONDITIONS: ^ , I ';t .moi ,ELECTRICAL PLAN CHECK UWLLLeNU SO- FTso k__ GENERATOR- 0-1' KW - :TRANSFORMER :APPLIANCE 10-50 KW_50 1.10 KW I v + KW - MOTORS--- -0.1 HP' (INC. SOLAR) 10.50 Hp_- - '1-10 HP - - t 50 + HP FIXTURE OUTLETS -SWITCHES ,GAS TUBE SIGNS - SUMMARY OF, FEES ' POLE LIGHTS - .POLES METERED .SUB PANELS MAIN - - SUB' - SERVICE - AMP Lip ISSUE FEE- - -- ' - APPLICATION APPROVED BY DATE -- - SUMMARY OF, FEES ' BUILDING ^- - -- PERMIT $ SMTP S. ' PLAN CHECK $ PERMIT ISSUANCE $ PLUMBING $ GRADING' .$ (PLAN CHECK $ $ .ELECTRICAL s� MICROFILM $ PLAN CHECK $ MECHANICAL $ __ _ TOTAL- FEE $- - 'PLAN LESS AD- CHECK $ VANCE PC S_ FINAL FEE $� CONSTRUCTION AND PLANNING '�+'t ^�* ` l;; ..3�0 Date APPROVALS Permit # �} Inspector POOL & SPA / ate y r Inspector APPROVALS Permit # ' 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location .2. - Soil Pipe. Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test . 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49, Electrical Conduit-Undr rn 8. Foundation _ 50. Gas Pie ❑ Undr rn, Test • 4 �- 9. Water Pipe-Undrgrn, 51. Backwash Lines P -Trap,❑ Un ' 10. Structural Floor System . 52. _ { APPROVAL TO DECK • .11. Property Sewer -Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing._ - _ ' 14. Rough Electric -Conduit - 56. Electrical -Final 15. Rough Electric -Wiring (- 57:- Solar System -Final 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts in Structure APPROVED FOR.PLASTERING 18. Ducts, Ventilating _. - 60. ___ POOL/SPA SYSTEMS FINAL } 19.,-- Gas Pipe -Rough & Test' - "- - _ _ - - -- 20. Roof Framing 21. Roof Sheathing- - NOTES: 22. Frame and Flashing'- - - _ 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing 26. Piaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning _ 30. Final Gas Pipe -Test 31' -Final,Plumbing _ 32: Water Service -Final 33. - Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System + 36. Sound Attenuation 37. Handicap Regulations 36. FINAL STRUCTURE & BUILDING L 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. Date heavy border PLUMBING PLAN CHECK subject to the Workers Compensation Laws of California. ' Applicant to fill In all spaces within CITY OF COSTA MESA P MIT NOTRACT lines and sign all appropriate declarations. NO. LOT NO. ffG. NO. 3572 , 7/2i/82 CONSTRUCTiON PERMIT LAVATORIES DOUBLE LAYS revoked, - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS I hereby affirm that there Is a construction lending agency for the par- formance of -the work for which this permit is issued (Section 3097 FLOOR SINKS 3 FLOOR DRAINS Civ. C.). Lender's Name Protect Address TYPE OF CONSTRUCTION OWNER BUILDER DECLARATION I hereby affirm that i.am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS Owner Phone_ JDQ Company _q 4 ❑ NEW * El ADD ❑ ALTERATION Q !� WATER SERVICE ALTERATION GAS SERVICE OUTLETS Address - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ,ny applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS— CA 92626 ❑ OTHER ZONING REGULATIONS Arch/Eng. License No. Contractor's License Law -does not apply to an owner of -a property ISSUE FEE who builds or improves thereon, and who does such work himself or Address II DESCRIPTION OF WORK A.P. ZONE PLNG. REF. _P ContractorLedverton-Beck, Inc. Phdne 979-356 1 TYPE OF PERMIT BTwaTpg uILppINC PROPERPOG Address16721 Hale Ave. Irvine CA" 92714 ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBACK T. SI YARD t hereby certify that I have read this application and state that the above LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under of Charter 9 (com- ❑ TENANT ❑ ELECTRiCALALUMBING EIMECHPANKIAL WII E Y provisions mencing with section 7000) of Division 3 of the Business and El OTHER RIGHT PLAN CHECKAD- Professions Code, -and my license is In full force and effect. VANCEP PC $ G� REAR YARD (TO PJL) C36 191969 PROJECT DESCRIPTION License lass License o. 2 -r SQ' FT' PKG. SPACE REQ. PROVIDED Date%- -f-` Signature_ WORKERS' COMPENSATfON DECLARATION OCCUPANCY - CONSTRUCTION TYPE STREET WIDTH PARK FEE S I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified Copy thereof (SBi`�015o3fiq Job, c.). Great American Policy No. ij UJJ,•-L� Company - GRADING CU. YDS• ACRES SPECIAL CONDITIONS: ' ❑ Certified copy Whereby furnished. - REMARKS: r Certified copy is flled with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 3 Z t4-' (This section need not be completed if the permit is for one hundred - - - E100) or less . certify that n the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK subject to the Workers Compensation Laws of California. BATHTUBS SHOWERS Date Signature TOILETS URINALS NOTICE. If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS revoked, - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS I hereby affirm that there Is a construction lending agency for the par- formance of -the work for which this permit is issued (Section 3097 FLOOR SINKS 3 FLOOR DRAINS Civ. C.). Lender's Name DRINKING FOUNTAINS 3 Lender's Address OWNER BUILDER DECLARATION I hereby affirm that i.am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS SWIMMING POOL P TRAP the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of .Division 3 of the Business and Processions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5,by WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS ,ny applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS— 1, as owner of the property, or my employees with wages as their .ole compensation, will do the work, and the structure is not Intended SOLAR PIPING SYS. or offered for We. (Section 7044, Business and Professions Code: The Contractor's License Law -does not apply to an owner of -a property ISSUE FEE who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not intended or offered for sale. It, however, the building or improvement is sotd'withln one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively Contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to MECHANICAL PLAN CHECK HEATING SYSTEM 0.100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0.100,000 BTU SYSTEM 100,000+ BTU an owner of property who.builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the COntractor's License Law). ❑ 1 am exempt under Section B.& P. C. for this BOILERS BTU reason Date Owner SYSTEM REPAIR, ALTERATION - EXHAUST SYSTEM MULTIPLE t hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and st to laws relating t onstruction, and hereby authorize representatives this city to enter pon the above mentioned property for ec ourp Signator ISSUE FEE Drivers' License or SS CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ELECTRICAL PLAN CHECK GENERATOR 0-1 KW 1-10 KW,� TRANSFORMER APPLIANCE 10-50 KW -50 + KW MOTORS 0-1 HP 1.10 HP �— (INC. SOLAR) 10-50-1-113 50 + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS PLAN CHECKAmwe POLE LIGHTS PANELS MAIN SUB SERVICE AMP - ,51 r..00 TIS i A ISSUE FEE 61-0 APPLICATION APPROVED BY 3 DATE SUMMARY OF FEES' BUILDING PERMIT S SMIP _ S PLAN CHECKAmwe PERMIT ISSUANCE $ PLUMBING $ GRADING $ PLAN CHECK $ ELECTRICAL $ $ MICROFILM S PLAN CHECK $ TOTAL FEE 3 MECHANICAL S LESS PLAN CHECKAD- E VANCEP PC $ G� FINAL FEE S CONSTRUCTION AND PLANNI '7 APPROVALS Permit # .) 1 Date ' Inspector POOL & SPA Date Inspector APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding _ 5. Steel em orce, • 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8.' Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines 'P-Tra ❑ ndr rn' 10. Structural -Floor System 52. APPROVAL TO DECK - -- 11. Property Sewer Line & House'Connection _ 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final '• 13. Rough Plumbing ystem{' - 14, Rough Electric -Conduit 56. Electrical=Final 15. - Rough Electric-Wirin - 57. Solar System -Final s 16. " Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. - POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing n. _ - NOTES: 22. Frame and Flashing 23. Insulation - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing Le,rA '2- 32: Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinklinq S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40, Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. - Date - `--P-1 �v ^^F aOSTA ME t1VSTR6CTIQN PERMIT Project Address 31bi AirwaY AVe. blaq. p-3, Applicant's Mailing Address 3151 Airway Ave. E-1, C.M. owners NameGui l dhouse Consul tants Phone 540-2606 . Address A — 0 td Mesa Arch/Eng. Tom Ca s & Assoc, License No. Address 17779!'F" Contractor's Name, J • Donald Olson Phone 540-'2606 \Address(mailing) 3151 Airway Ave. E-1, Costa Mesa \ City.Licrnse No. LICENSED CONTRACTOR DECLARATION I �\ I hereby affirm that I am licensed under provisions of Charter 9 (commencing \\ with section 7000) of Division 3 of the Business and Professions Code, and ^ my license is In full f rc�j and effect. , f \ Ucense C ss 1 ice ns N 333969 ^ate 4 Signature ad �RKERS' COMPENSATION DECLARAT.IO ,ereby,affirm that I have a certificate of consent to self -insure or a certificate of 'Workers' Compensation insurance, or a certified copy thereof (Section Policy No.. -T-2974 % Company -`Fairmont Certified Copy_is hereby furnished. + i� Cert l(ieypy4is tiled with the city guild g sten. ' Date ��FF OO Applicant EXEMPTION FROM -WO RKERS',COMPENSATI DECLRRA ON (This sectlon need,not be completed if the permit i or one hundr d ($100) oil less). f . 1 certify that In the performance of the work for, which this permit Is issued, I- shan not employ any person In any manner so as;to become subject to the' Workers' Compensation Laws of California. Date 'Signature ' NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this ,permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY 1 hereby affirm that there Is a construction lending agency for the performance of the work for I.`� yah this permit Is issued (Section 3047 Civ. C.) ' Lender's Name Lender's Address OWNER BUILDER 5ECLARATION I hereby, affirm that I am exempt from the Contractor's License Law for the following reason {Section 7031.5 Business and Professional Code: Any city or county which requires a permit to Construct, alter,'Improve, demolish or,repalr . any structure, prior to its issuance, also requires the applicant for such permit `9 file a signed statement that he/she is licensed pursuant to the provisions of ,a 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 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 enalty 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- Eve for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed Con- t 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 builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ i am exempt under Section B. & P. C. for this reason Date Owner I herebycertify that I have read this application and state that the above ' information is correct. I agree to comply with all city and county ordinances and - state taws relating to building construction, and hereby authorize repre- sentatives of t is city to to pan the above-mentioned property for those within h vy border lines and sign all appropriate declarations. 12- S 5 p /`41S DI P�4R. i. -L5 Sewer Cap TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Sewer Connection 1:1 CONVERSION' El DEMOLISH ❑ OTHER A.P. 0 DESCRIPTION OF WORK interior improvement Solar Piping Sub Panel I �� Solar Tank 'r� S Main Building: w•.» E , TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ® TENANT El ELECTRICAL 13❑ PLUMBING MECHANICAL B Sign ❑ ,OTHER A Rear PROJECT DESCRIPTION SG. FT. 2�712 OCCUPANCY B-2 C Right CONSTRUCTION TYPE VALUATION $40,500.00 - S Left - ZONE GRADING CU,YDS, ACRES Ping. Ref. # Remarks; Lf 1 Parking Req./Provided Dat Use of Building: PLUMBING �,• FEES Planning Notes: SMIP $ PERMIT f Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers _ Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee 'I $25 Showers z Service Sink Transformer ❑ 15-50'KW Sewer Cap ❑ 50+KW_le5ub• • Sewer Connection f r. Solar Collectors Meter over 100 amps,'. -7 1 Solar Piping Sub Panel I �� Solar Tank 'r� r Swimming'Pool,w/Spa ' w•.» Urinal -" , 2 Water Closet Pole Light Water Heater Range Water Service Sign Garbage Oisposal Standing Sections Generator 00-5 KW ❑5-15 KW Trash Compactor Z Reinspection Fee$25 Issue Fee ' $ 3 MECHANICAL FEES Boiler Hood or Type I El Duct - Under Ground Canopy Type 11 ❑ Duct - Structural Refrigeration System Duct Ventilating ❑0-100,000 BTU ❑ 100,000 BTUDO Exhaust System ❑ Multiple El system Repair/Alteration Firepl/Fact.'Blt. ICBO # Heating System & Ducting ❑0-100,000 BTU 0100,000 BT inspectlon pur ses 4 3 84 Signature Date�8 Reinspection Fee Drivers' License or SS CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $25 Issue Fee ] $ 3 ' ' •8392 4/ I.1 /,8� Zane Accessory Building: YZA Park. Fees $ : t GQ� 1[150.59 Tl, + Q U N Y j ELECTRICAL FEES ^ ' Automatic Washer_ Transformer ❑ 15-50'KW Construe{ion Po ❑ 50+KW_le5ub• • Cooking Unit - Meter ❑up to -100 amps - Dishwasher Meter over 100 amps,'. -7 1 Dryers ❑Gas []Electric Sub Panel I �� _ Fan Motors ❑0-1 HP 1'/ - 840 F.A.U. Inc. Solar 09.15 HP 016-15+ `� �6 Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Oisposal Standing Sections Generator 00-5 KW ❑5-15 KW Trash Compactor Reinspection Fee$25 Issue Fee $ 3 - PUBLIC SERVICES RECO}QIIRREMENTTS: r/ Zoning Approved By Date Application Approved By Date Application Issued By Dat BUILDING PERMIT S�1� RY_OF FEES L't�'ua� 2 $ PLAN CHECK�5h SMIP $ PERMIT PLUMBING cQ _ ~ ISSUANCE $ PLAN CHECK $,4r ENERGY P.C. $ ELECTRICAL �Sja�Q�_ GRADING $ r PLAN CHECK I—"CFO FILM $ MECHANICAL $ 9® TOTAL FEE $ s Q S PLAN CHECK $_ CQNSTRUCTION AND PLANNING APPROVALS Permit # :Date Inspector PC & SPA APPROVALS Permit # Date Inspector I 1', -Temporary Electrical Service or Pole 52.' Pool & Equipment Location 2. Soil Pipe-Undrgrnd. Lill( 53. Steel Reinforcement �. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd: ` 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical LIFER Grnd. - 57. APPROVAL TO COVER-GUNITE 7. Footings 58. 'Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd.y +fljLf f" 60. Backwash Lines, P -Trap, ❑.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 Plumbingy/x7d�j( ef} 65. Electrical -Final 15. 'Rough Electrical -Conduit i 66. Solar System -Final 16. Rough Electric Wiring P, 1-1-S 67, Fencing"& Access Approval 17. Rough Wiring Sign' 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling' . 5� y (,+' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit# 20, "Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. -Ducts, Ventilating 71. Product Piping El Gas ❑Oil 2s. Gas Pipe -Rough & Test- , . 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural)_&,Monocoat s Zy� G� 75. Dry Chemical 27. Frame and Flashing p�"IA� 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing 5 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 , �j��[� CA) 35. Final Gas Pipe -Test 36. Hood or Canopy 37• Final Factory Fireplace 38. Firial Plumbing �"� LSD 39. Water Service -,Final 40. Gais Service -Final 41. Solar Domestic, Final 4 42. Backflow Preventer = �✓ ' '' 43. Backflow Irrigation , 4 I� 44..Landscape Irrigation System ,. 45. Sound Attenuation 46. ! andicap Regulations 47. FINAL STRUCTURE & BUILDING 48, Special Requirements Completed ' 49. Electric Release to Edison 50. Gas Release to -Southern California Gas Co 51. CERTIFICATE OF OCCUPANC No. z- Date ° �, • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY dP COSTA MESAC NSTRUCTJON PERMIT Project Address 3 1,21 T r✓� _ Applicant's Mailing Address }} Owner's Name D Phone Address Arch/Eng. License No. Address Contractor's Nam hone Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION ' 1 -hereby affirm that Tam licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. �Jcense Class ' License No. Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sectlon 3800, Lab: C.) - Policy No. - Company eCertified copy is hereby furnished. i 1 ` Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for•one hundred ($100) or I car tlfy,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.' Data Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with Such provisions or -this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's, Name Lender's Address __' OWNER BUILDER DECLARATION , ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 Statementrthat he/she is licensed pursuant to the provisions of .the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division, 3 of the Business and Professions Code) or that he/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 enalty of not more than five hundred dollars ($500). - ' I, as owner of the property or my employees with wages as tneir sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/nerself orthrough his or ner 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 com- pletion, the owner will have the burden of proving he%she did not build or Im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with.a con- tractor(s) license pursuant•to the"Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ f am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application. and state that the above information is correct. I agree to comply with all city and county ordinances and state laws elating to building construction, and hereby authorize repre- sentatives of is city to enter?2n e aboy-mentioned pro erty for Inspect'; p p se . Signature Date Drivers' CMF 086 PTT TRACT NO. LOT NO. UNIT NO., 6pr0� 8/09/04 ' I Se�Ci i! TYPE OF CONSTRUCTION NEW ADO ALTERATION' ❑ CONVERSION .❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. REPAIR A.P. # Zone S Main Building: Accessory Building: TYPE OF PERMIT LJ GRADING FOUNDATION :❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ •OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES 1 E T Front Z O B A Rear N C - Right N K S Left ' G Ping. Ret. # � Parking Req./Provided } E Remarks: Planning Notes: M ' T S. PLUMBING* FEES Bar Sink Showers ELECTRICAL FEES Backflow Preventer -Service Sink --- — Automatic, Washer Construction Pole.Sub. _ Transformer ❑ 15-50 KW, - r ❑5D+KW � I .- - - Backfiow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit .' Meter ❑�' p to 100 amps Clarifiers Solar Collectors Dishwasher Meter Cover 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel ' Drinking Fountains Floor Drains, Solar Tank Swimming Pool w/Spa Fen F•A:U. Motors 13 0-1 HP 01%-8 Inc. Solar ❑9-I5 HP Ell 6-15+ Floor Sinks Urinal Fixtures Microwave Gas Service -Outlets+ Water Closet' - Device Boxes Pole Light Interceptors Water Heater Outlets i Range Kitchen Sink Water Service Switches Sign Lavatories ' ' ', Garbage Disposal -'Standing Sections I P=Trap` Generator ❑0.5 KW 05-15 KW Trash Compactor Hoof Drains Reinspection Fee $15 issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 Boiler Duct - Under Ground MECHANICAL Hood or Type I ❑ Canopy Type I I El FEES DEVELOPMENT SERVICES Approved By Building Building Approved By , Application Issued By REQUIREMENTS: Date Date Oate,B� oSUMMARY Duct - Structural Refrigeration System ❑0.100,000 BTU 0100,000 BTU Duct - Ventilating BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50%, MECHANICAL PLAN CHECK 25% OF FEES S SMIP $ $ PERMIT $ !' S -+� ISSUANCE $ $ ENERGY P.C. $ $ $ S MICROFILM $ $ TOTAL FEE $ $ (s'oo Exhaust System ❑ Multiple © System Repair/Alteration Firep1lFact..Blt. ICBG # Heating System & ducting 00-100,000 BTU E-1 100,000 BTGRADING Reinspection Fe_71 e $15 Issue Fee $ 3 rev. 4/04 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor M CONSTRUCTION AND PLANNING APPROVALS ., Permit Date InspectorAPPROVALS r'OOL & SPA 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - v 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe-Undrgrnd% r _ 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10._Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line &.House Connection 62. Backwash & Receptor -Final 112, 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 16. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 y 37. Final Factory Fireplace 38. Final Plumbing 41100vt 610 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 47. FINAL STRUCTURE & BUILDING 48. Sbecial Requirements Completed 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Cb 51. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. • C141,Y 6,.COSTA MESA COi .MCt ON PERM' T ' Project Address.-4.Jl2s rtl-I-way -nvc. uluy. r -r- _ Applicant'* Mailing Address 3151 1 rWa Ave . E-1, C.M. Owner's Name Gui 1 dhouse COnsUl tants Phone�5 Q---2.6.6 Address 3151 Airway Ave.E-1,-Costa Mesa A:rrh/Eng. License No. C-6291 Address . 926 Town A Country, Orange Contractor's Name J Donald son Phone 540-2606 Address (mai Iing) 3.151 Airway Ave. E-1, Costa Mesa_ City License No. LICENSED CONTRACTOR DECLARATION I-herebyaffirm that 1, am licensed under provisions of Charter 9 (commencing with section 7080) of Division 3 of the Business and Professions Code, and my license is In fulforce and effect, Icense Class _-4-lice, 33969 1te Signature WORKERS' COMPENSATION DECLARATIO I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a Certified copy thereof (Section 3800, Lab. C,>F_2974 ,~Fairmont r Policy No. Company - Certified copy, is hereby furnished. r Certifi f� uisled with the city Bu in is slo Date ��,�T .Applicant EXEMPTION FROM WORKERS' COMPENSAT ..DECLAR ION {This section need not be completed it the permit is'for one hu dred {y100y & less). F' 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. Date Signature NOTICE: If,'after making this declaration, you should become subject to the Workers" Compensation provisions of the Labor Code-, you'must forthwith comply with such provisions or this. permit shall be - deemed revoked. CONSTRUCTION LENDING AGENCY - I hereby affirm that there Is a construction lending agency for the performance of the !work for whKyAthls permit Is issued (Section 3097 CIv. C.) Lender's Names 1+1/11 _ Lender's Address - OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional, Code: Any city or aunty which requires a permit to construct, alter, Improve, demolish or repair V structure, prior to its Issuance, also requires the applicant for such permit file'a signed statement that he/she is licensed pursuant to the provisions of 1e Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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). ' LJ 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves 1 thereon, and who does such work himself/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 com- pletion, the owner will have the burden of proving he/she did not build or Im- Q�rove for the purpose of sale). LJ 1, as owner of the property, am exclusively contracting with licensed Con- 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 builds or improves thereon, and who Contracts for such projects with a Con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section a. & P. C. for this reason Date Owner - 1 hereby certify that 1 have read this application and state that the above information Is correct. I agree'to comply with all City and county ordinances and statelaws rel ting to building construction, and hereby authorize repre- sentatives of th city to to pon the above-mentioned property -for inspection purp 6�20�84 Signature Date Drivers' 'License or Ssa EV: PERMIT NO. �RACT NO. �OT NO. . BLD i53- r Z �— TYPE'OFCORISTRUCTION NEW ADD 1 1 ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK . Interior Improvements 3(5z 6/tD8�34 D 4�G. �0 A.P. � '� Zone '� - S Main Building: Accessory Building: Z TYPE'OF PERMIT GRADING. FOUNDATION STRUCTURAL ® TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ ,OTHER 21 Q2 OCCUPANCY - PROJECT DESCRIPTION SQ. VN CONSTRUCTION TYPE vN _ _ VALUATION $ sS30-n0 ZONE GRADING CU.YDS: ACRES E T Front O 111 B A Rear I- N K sight , �R• g Left E Ping. Ref. + Park.Fees $• Q U Remarks: 4.. Parking Req./Provided I Use of Building: R "E 'M :N S PLUMBING FEES Planning Notes: Bar Sink Showers Backflow Preventer Service Sink 1 Backflow Irrigation Sewer Cap '' ELECTRICAL FEES Ci Bathtubs Sewer Connection Automatic Washer' Construction Pale Sub. Transformer El 15-50 KW El 50 + KW Clarifiers _ % • Solar Collectors " Dishwasher - Solar Piping �' Cooking Unit ' Meter 216p to 100 amps 1 Drinking Fountains . Solar Tank n t Dishwasher Meter ❑over 100 amps ' Floor Drains. Swimming Pool W/Spa Dryers ❑Gas e.❑Electric 'Sub Panel Floor Sinks Urinal /L Fan. F.A.U.l Motors ❑0-1 HP %. -.8 s.S Inc.Solar 09-15 HP 1:316.15+ Gas Service -Outlets I Z Water Closet l /� Interceptors - _ Water Heater FixtuiesF� Microwave „ Kitchen Sink Water Service -. ' O DeviceiBoxes Outlets Pole- Light Range %G , $i Lavatories P -Trap. Switches+ Sign Roof Drains - r GarbagePisposat Standing:'Sections Generator ❑0-5 KW ❑5.15 KW. Trash Compactor Reinspection Fee * $25 Issue Fee $ r3' e Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES PUBLIC SERVICES R C)UIREMENTS: Zoning Approved 8y L C Date Application pproved By Date Applicationisspat Boiler s Hood or Type I+ ❑ Canopy Type tl ❑ 1 Duct - Under Ground Duct - Structural Refrigeration System ❑0 100,000 BTU 010d,000BTU 17 Duct -Ventilating BUILDING PERMIT $r��.__2 PUAN'CHECK�9S� $ / L", , PLUMBING --f •� �1 $ ' '/ .'7 PLAN CHECK, �^ $ ELECTRICAL. yl $ ' .PLAN CHECK �$ MECHrANICAL s $ PLAN -CHECK' $ SUMMARY OF FEES 'el SMTP $ 3� PERMIT , ISSUANCE g. ENERGY P.C. $ GRADING $ �� , MICROFILM $ TOTALFEE $Sr�`�--'-Et!Z � ��q/ Exhaust System 0 Multiple ❑ System Repair/Alteration Firepi/Fact. Blt. ICBO # Heating System & Ducting ❑0 100,000 BTU ❑100,000 BT • Reinspection Fee $25 Issue File $ 3 CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor `w- CONSTRUCTION AND PLANNINh-- `t • APPROVALS Permit # Date Inspector - i L & SPA APPROVALS Permit # Date Inspector .. Temporary Electrical Service or Pole 52.. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �_ (�Z�,��(,� 53. Steel Reinforcement +' ..Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56- Rough Plumbing & Pressure Test 6.' Electrical LIFER Grnd. 57. APPROVAL TO. COVER-GUNITE 7'. Footings 58. Electrical Conduit-Undrgrnd. B.' Foundation 59. Gas Pipe, 0 Undrgrnd., Test 13. Water Pipe-Undrgrnd, 6,Z.liK GZO 60. Backwash Lines, P -Trap, ❑ 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 7 a e 6161i 65. Electrical -Final 15, Rough Electrical -Conduit 66. Solar System -Final 16~ Rough Electric Wiring �f 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 Cortditioning i FIRE DEPT- REQUIREMENT APPROVALS , Permit # .20. Rough Factory F=ireplace ,., 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating sy' 71. Product Piping CD Gas ❑ Oil 23. Gas Pipe -Rough & Test' t 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing r - 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: Dryvjall Nailing HEALTH DEPT,.REQUIREMENT 31, Plaster Brown Coat 1. 79. FINAL INSPECTION '32. Electrical Power Meter -Final! i BO.. FOOD:CERTIFICATE ISSUED 33. Final Electric t Notes: -- 34• Final Heating & Air Conditioning 84 a -r 4dArci 35. Final Gas Pipe -Test ` 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing BI�� 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 47. FINAL STRUCTURE & BUILDING? Zb 2) S , 48. Special Requirernents'Completecl 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51 • CERTIFICATE OF OCCUPANCY No.. �,�9 Date _ Applicant to fill In all spaces except those within heavy border lines and sign all a • CITY OF COSTA MESA' PE IT Np _ TRACT NO. LOT NO. CONSTRUCTION PERMIT declarations. ar Applicant's Mailing r � TYPE OF CONSTRUCTION- NEW -ADD ❑ ALTERATION LJ REPAIR Lloens"1 ; . Nq,Q!++ +-V oats ' �' signature - �•�� WORK RS COMPENSATION DE RATION I Project Address /' Backflow Preventer (— Sewer Connection' 1:1CONVERSION DEMOLISH 1:1OTHER I hereby affirm that Lhave a certificate of consent to self -Insure or a certlficate - of Workers' Compensation Insurance,lor a certified copy thereof (Section 3800, Lab.�( r Policy No.�� ` 7 Company ❑ , tined copy is hereby furnished. r Cert led with the city. Bui9fl,n ivl n N i r`+ Oate Applicant . _ - Backflow Irrigation Solar Collectors ` I �' f C) 'lZe Phona�d,� DESCRIPTION OF WORK E)(E_MF#fION if ROM WORKERS' COMPENSATION DECLARATION (Thisseepon need not be completed If the permit is for, one hundred ($100) or I {� `"O ` Owner's Ns _ v� , Address �� W _ Standing Sections I certify that in the performance of the work for which this permit Is Issued I , shalt not employ any person in any manner so as to become subjectto the Workers', Compensation, Laws of California., ; p x + Floor Drains Water Closet TYPE OF PERMIT�� El / GRADING FOUNDATION STRUCTURAL Date Signature NOTICE: If, after making this declaration, you should become subject to the Arch/Eng.. License No. ❑ TENANT t� ELECTRICAL ED -PLUMBING ❑ MECHANICAL t. Address Issue Fee I ❑- o-rHE R Date - Intercepters IgICilv Contractor's Name __ r�7 c. i ___ Phnna -" •�! PROJECT DESCRIPTION SQ. FT. —,OCCUPANCY \ AddrBSSimailinngl �Q47;, /�Ct�OrIO /��" �'^ t:r CONSTRUCTION TYPE __ VALUATION $ PERMIT License Na. r•*r%Z ___. _ ZONJ= GRADINGCU.YDS. - ACRES_ Remarks: 0 ELECTRICAL' $ LICENSED CONTRACTOR DECLARATION PLAN CHECK' $ Thereby affirm that I am licensed under provisions of,Chartei 9 (commeneirLg Ith ti 7000 f Di I. 3 f th 8 i d Pr f i -! TOTAL•FEE ,PLAN CHECK i $' LESS r ADVANCED.PC I w sec on ) o vs on o a us nese an o ass ons Code, d my Ilcense'is in full f Ce effect. •r PLUMBING -ounty which'requires a permit to construct', alter Improve, demolish or repair y structure, prior to its,issuance,'also requlres the applicant for such ppermit, file a signed statement that he/she Is licensed pursuant to the provisions of ne Contractor's License Law'(Chapter 9 {commencing with Section 7000} of'•. Division ',3 of the Business and Professlons Code) `ori that, he/she is exempt I therefrom and thel basis for the alleged exemption. Any. violation of'Section 7031.5 by, any applicant for- a ; permit.: subjects the -applicant to a. civil i penalty of riot more than five hundred dollars ($500). ! -' 1 Ll I,' as )owner of .the property or' my employees with v altos as their sole compensation' wili'do the work; and.the structure, is not Intended or offered for sale i(Seciion 7044; Business, and I Professional, Code. The Contractor's I License Law does not apply to'an owner of a property -who builds or improves thereon, and who does such' work hErriself/herself or through his or her own employees, provided that such improvements are.npt Intended or offered for❑0,100ppOBTU sale. If, however, the building or Improvement Is sold within one;year of Com- Epletlon, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting withilicensed con- tractors to,construct-theiprojoct(Section 7044„Business and Professions Code:___ The Contractor's License Law does not apply to an owner of property who builds or Improves; thereon, and who contracts for such projects with a COn- Lloens"1 ; . Nq,Q!++ +-V oats ' �' signature - �•�� WORK RS COMPENSATION DE RATION I Bar Sink Sewer Cap - Backflow Preventer (— Sewer Connection' _ 1 ' MECHANICAL l Boller i i Refrigeration System ❑i00,000BTU Duct: Under Ground l l I hereby affirm that Lhave a certificate of consent to self -Insure or a certlficate - of Workers' Compensation Insurance,lor a certified copy thereof (Section 3800, Lab.�( r Policy No.�� ` 7 Company ❑ , tined copy is hereby furnished. r Cert led with the city. Bui9fl,n ivl n N i r`+ Oate Applicant . _ - Backflow Irrigation Solar Collectors ` Bathtubs Solar Piping Clarifiers '• t Sotar Tank _ Range.,- E)(E_MF#fION if ROM WORKERS' COMPENSATION DECLARATION (Thisseepon need not be completed If the permit is for, one hundred ($100) or I Dishwasher Swimming Pool w/Spa Drinking Fountains I Urinal ' Standing Sections I certify that in the performance of the work for which this permit Is Issued I , shalt not employ any person in any manner so as to become subjectto the Workers', Compensation, Laws of California., ; p x + Floor Drains Water Closet Garbage Disposal Date Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks - t.- Water Heater - Transformer ❑ 15-50 KW Workers', Compensation' provislons,of the Labor Cotle, you must.forthwFth c Gas Service I `Outlets Water Service t. comply with; such provisions or this. permit 'shall be 'deemed revoked, Issue Fee I CONSTRUCTION LENDING_ AGENCY Date - Intercepters I ±Date _ I hereby affirm that there Is a construction tending agency for the performance, of the work for which this. permit is issued ,(Section 3097 Civ: C.); en Sink, Lender's= Name'"iCitch_ ,BUILDING PERMIT $ 'Lender's Address,' OWNER'BUILDER DECLARATION j ' " _ , p I herb 'afflr th t l t'fr' th C t t LI L f th Lavatories I N tractor(s) license pursuant to the Contractor's License Law}. 1 } \1 ❑ I,am exempt under Section ' B. 3 P. C. for this reason Firepl/Fact. Bit. ICBG # Date• Owner' i f Heating'System & ducting = 1 i hereby certify that 1 have read this,appilcation and state that the above-! ❑0-1100,000;13TU 0100,000 BTL information Is correct. I agree to comply with all city and county ordinances and -state laws relating to building construct hereby authorize repre- Hood or sentatives of't lty is c'to en uppro o the above-mentioned pert for Type I ❑y inspection ,u_lb Cann : Type 11 ❑• Signature I Date �+ , Drivers' Ll nse or SS Registers CMF 0865-46 rev. 12/82 White - Bullding; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Rainspection Fee Issue Fee r- . A. P. #; PLNG. REF. # LEFT SIDE YARD PKG. SPACE REQ. STREET WIDTH ' SPECIAL CONDITIONS: 1.678 7/05/133 - BUILDING S`,ETR A!`K f /l CT REAR YARD (TO P/L) RIGHTSIDEYARD ' PROVIDED PARK FEES , k Automatic Washer _ _ Meter, 25aver 100 amps:. _- l , Construction Pole following rea on;(Seetlons7031 5 Business and Professional Code: Any city or a P—Trap; l' a -ounty which'requires a permit to construct', alter Improve, demolish or repair y structure, prior to its,issuance,'also requlres the applicant for such ppermit, file a signed statement that he/she Is licensed pursuant to the provisions of ne Contractor's License Law'(Chapter 9 {commencing with Section 7000} of'•. Division ',3 of the Business and Professlons Code) `ori that, he/she is exempt I therefrom and thel basis for the alleged exemption. Any. violation of'Section 7031.5 by, any applicant for- a ; permit.: subjects the -applicant to a. civil i penalty of riot more than five hundred dollars ($500). ! -' 1 Ll I,' as )owner of .the property or' my employees with v altos as their sole compensation' wili'do the work; and.the structure, is not Intended or offered for sale i(Seciion 7044; Business, and I Professional, Code. The Contractor's I License Law does not apply to'an owner of a property -who builds or improves thereon, and who does such' work hErriself/herself or through his or her own employees, provided that such improvements are.npt Intended or offered for❑0,100ppOBTU sale. If, however, the building or Improvement Is sold within one;year of Com- Epletlon, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting withilicensed con- tractors to,construct-theiprojoct(Section 7044„Business and Professions Code:___ The Contractor's License Law does not apply to an owner of property who builds or Improves; thereon, and who contracts for such projects with a COn- Roof Drains I _ 1 ShovJers " _ '' ReinspectiorrFee I Service Sink Issue Fee , _ 1 ' MECHANICAL l Boller i i Refrigeration System ❑i00,000BTU Duct: Under Ground l l Microwave duct - Structural I System Repair/Alteration _, Duct ;Ventilating Range.,- ExhaustSystem❑ Multiple ❑ , N tractor(s) license pursuant to the Contractor's License Law}. 1 } \1 ❑ I,am exempt under Section ' B. 3 P. C. for this reason Firepl/Fact. Bit. ICBG # Date• Owner' i f Heating'System & ducting = 1 i hereby certify that 1 have read this,appilcation and state that the above-! ❑0-1100,000;13TU 0100,000 BTL information Is correct. I agree to comply with all city and county ordinances and -state laws relating to building construct hereby authorize repre- Hood or sentatives of't lty is c'to en uppro o the above-mentioned pert for Type I ❑y inspection ,u_lb Cann : Type 11 ❑• Signature I Date �+ , Drivers' Ll nse or SS Registers CMF 0865-46 rev. 12/82 White - Bullding; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Rainspection Fee Issue Fee r- . A. P. #; PLNG. REF. # LEFT SIDE YARD PKG. SPACE REQ. STREET WIDTH ' SPECIAL CONDITIONS: 1.678 7/05/133 - BUILDING S`,ETR A!`K f /l CT REAR YARD (TO P/L) RIGHTSIDEYARD ' PROVIDED PARK FEES , k Automatic Washer _ _ Meter, 25aver 100 amps:. _- l , Construction Pole Sub Panel: dpy 1 Cooking Unit Sub Pole ; Dishwasher Motors ❑0.1 HP X1 Dryers ❑Gas. ❑Electric •inc.Solar'09-1514P I Fan Microwave F.A.U. r r 'Pole Light , i Fixtures _l _ , c Range.,- Device Boxes Sign Outlets Standing Sections Switches Trash Compactor Garbage Disposal Generator El 0-5 KW El 5-15 KW Transformer ❑ 15-50 KW 050+KW iReinspection t. Meter ❑up to 100.amps Issue Fee I Zoning Approved By Date - Application Approved By I ±Date _ Application Issued By Date _ SUMMARY OF FEES ,BUILDING PERMIT $ SMIP PLAN CHECK V PERMIT 'PLUMBING $ ISSUANCE . ,PLAN CHECK; $; GRADING , ELECTRICAL' $ PLAN CHECK' $ , MICROFILM MECHANICAL $ TOTAL•FEE ,PLAN CHECK i $' LESS r ADVANCED.PC f FINAL FEE' 65.25 TL E?'" CONSTRUCTION, 11ND;Pi ANN'ING� Cjv - t� . -,..,- `E7t 1 } 6 E �'t fi 'Inspector I , L.& SPA _��'�r ' - 'Date ° nspector - Y SAPPROVALS Permit # - =3' cDate , c x Y I n - _ APPROVALS- Permit'# 'N I - n h� r m r- i'� - ty Yn G +✓'Y -,i •i .r �%,; �psv - .J, vt; + n" i e`mporaryjElect jical Service lir Pol- ' rl ` ° ' ; r�i' 'n. 0 ? t . n s52' -Pool &`Equipment Location fi"" ^f e i .� - i'r- w2l .Soil Pipe-Undrgrnd:- `�"T t� �`; ; "t y •53: Steel Reinforcem"ent 4'� rical'Concluilt ICJtiMt tlndrgrn�rl. i S i -1?T � ��C j' 54:i Forms T - -r � - C �- ;1 r3 4: E(ectrfCaFl-Conduit;Vndrgrbd'. ' '55c'Efectricai Boncling'".'" Ir 1 �I _tI i I r IIs. rNa n ti r. ��3 ^° 5: Ste'el'Rein1orcement I�'SI � i = L t56. Rouges�Plumbing.& Pressure Test'. r NZ 6: Electrical, tOFER Grnd�,. t A� # fa• " y ^ �'L 57• APP ROVi4L TO C01/ER UNITE, - �' -, •� E , _ 7. ootiing9 , GF C F , a ,! 58. electrical Condbit-Un`drar.d. - I o. i'y; � B. Flaundatiori ,� ' ' -1 . ; . Gas,Pipe, ❑ LJncfrgrnd.; Test t r'I I ,,59. J y 9. Water Pi` a-Undr rn'd k Y - p g I "' r - l r y - - . z t Backwash Lines; P Trap, C] Undrgrnd. �r t t = ,f! = �Y ''j X60. 10.. Structural Flo Qr System � 'ti o # Z. s " z 61. APPROVALrTO-DECK C ` l _ 11, Property Sewer Liner&'House Corrnectiotr l', ° �: n 62. Backwash' &Jiecep#or Final ,s l a _ - 12. Se'we! Ca'p. l 'i ` E "pi i ° s r 'B3. Heater �4 n € 13. Roofipxains , ? - o "64. Plumbing System Final I _• # I fl 14. Rough Plumbing It ' I �., - y ' 65. Eiectrical-Final" - r E r'15�iRough-Electrical=Conduit , -T -"i �ri' �� # 66.E Solar System=Final - 1 I I. aM.'lRough Electric Wirings ; n o� 17 67.i Fencing &Access Approval = ' - I 7,•tifiougWiring;Sign�68., APPROVED EOR PLASTERING 4 - ls Ij]8.tRou'g Idctrilal7,TBar,Ceiiing =j f` `I; I ' `,'''�4 :69.�P.00L/SPASYSTEMS-FIINAL ^i 19:�RpughHeating &{Air Conditioning ('- j I l ' ; ,FIRE DEPT.'REQUIREMENT APPROVALS g Permit 20. Ft�pugh, Factory Fireplace; I i 1Ducts,=irl 21. St1 uctur`e v. `; !j i 70.5 Underground Hydro I if r , E;.22. (Ibmou"ds, Vi elnf�ila�tin9 s 1:_lI'3 f� i I iI l 1'7 1i Pro'duct Pipi,ng ❑ Gas ❑ Oil 1 .I r I I 23. Gas�Pi le-Rou h 8i Test a } I' r ---T {� p1 9, ! �_- "' 'Y I � I -� -i- _ �; Underground Flush';+ I I . f iii 172.1 ! 1. I-_ ;- I I 7 IiY. � =24. Roof Framing, E �I I : j .a r� „i I u i : i , I i I ' {73. Undergrnd. Storage Tank' ❑leas ;❑ Oi ij ; 1 , I # I i II n 25. rRoof Sheat6i-g r :, a' t ' ' j , I 74.; Ove Hydro I , I _ jib r , ,_ _ _+_ ! .I r#iead I1-26. T Bar Ceiling (Structural}, & Monocoar { : l V. i �' [-- t ;;' 7E•' Dry Chemical - �' I - 7 - r- Cr� lr-� I - 1 { 1 4 ,I f1 i 3-• ' 1 {�27. 'Frame and Flashing , I� ,_ 76. Dr'y Standpipe ; I I C i 1 28.',�Gthiing&!-Sidingl ' i ji _ j 77.E FIXEDSYSTEMFINAL ,. _ rz 11 ilnsuiatiori 1 ';78.i FIRE: PREV. FINAL ,DO. 0ryvyalI Wai Applicant to fill In all spaces except those within heavy border lines and sign all appropriate deelaratlom. CITY OFCOSTA MESA CONSTRUCTION PE Applicait's Mailing Er X TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION L) REPAIR �.Address 11 11 DEMOLISH ED OTHER Project Address r� �C'��`�/ CONVERSION RIGHTSIDE YARD Owner's P Name — � Phone— DESCRIPTION OF WORK Motors 00.1 HP ❑1'b-8 Address Address TYPE,OF PERMIT GRADING FOUNOATION 0 STRUCTURAL Arch/Eng. -,_„ —License No. ❑ TENANT. ❑ ELECTRICAL PLUMBING ❑ MECHANICAL Address- ❑ OTHER Fixtures !t Contractor's Nam.1/,q AF hone ' �f3 PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address (mailing) a, CONSTRUCTION TYPE VALUATION $ License No. ZONE: GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Remarks: I hereby affirm that i am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and �'•, l; my Ilcense is In fuit f rca a d ?Oct. r/ Ucense C ss License No a PLUMBING Sts Date Signature f Bar Sink Sewer Cap ' WOR RS COMPENSATION C RATION Issue Fee - - I hereby affirm that 1 have a cert fi of Confent to selfansure or a certificate Backflow Presenter Sewer Connection of Workers' COmpensatton Ins Ce, or a certified Copy thereof (Section- r ate _ 3800, Lab. 0ILI Backflow Irrigation Solar Collectors Policy No. Company Certified copy, is hereby furnlshatl. B Bathtubs Solar Piping Ce I!ie p is�yed with the city 11 in9 Division. • $ ,PLAN CHECK } $ f r Date , Tf_ Applicant I Jr A Clarifiers Solar Tank EXEMPTION,FROM WORKERS' C SATION DECLARATION fThissection need not be completed t perrnit Is for one huntlred ($100) or„ Dishwasher Swimming Pool w/spa S fess): ! . I certify that In -the performance of the work for which this permit Is Issued�I Drinking Fountains Urinal_ _ shall, not employ'any person In any manner so as to become subject. to this- - ' Workers' Compensation Laws of California. rL Floor Drains Water Closet Al Date - - - clgnature $ MECHANICAL $ NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Water Heater - - Workers' Compensationprovisions of the Labor Code, you must forthwith , S comply with such provisions or this • perrnit shall be deemed revoked. , rias Service Outlets Water Service � CONSTRUCTION LENDING AGENCY $L-- 1 hereby affirm that there is a Construction lenping agency for the'performance Interceptors of the ;work for' which' this permit Is, l5sued (Section 3097 Civ: C.) , Lender's' Name Kitchen Sink Lender's 'Address OWNERrBU1LOER DECLARATION LBvatoriesr I hereby affirm that I am exempt from the: Contractor's- License Law for the l_ - following reason (Section 7031.5 Business and Professlonal'COde: Any city or county which requires a permit to construct, alter improve, demolish or repair my structure, prior to its Issuance, also requires the applicant for such permit Roof Drains is file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 70001 of Division 3' of the Business and Professions rode) Or that he she Is exempt therefrom and the'basis for the altegod exemptlon.'Any vlolallon of Section Showers Reinspection Fee 51$ 7031.5 by'any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars (1500), Service Sink issue Fee S 3 1• as'owner of the'property or my employees with wages a$ their sole compensation will do the work, and the structure Is not Intended or offered for sale'(SecfiOn 7044, Business' and Professional Code: The Contractor's r i MECHANICAL License Law does not apply to an owner of a property who builds or Improves Boiler Refrigeration System thereon, and who does such work himself/herself Or through his or her own employees, provided that such'Improvaments are not Intended or offored for 20.100=OBTU 2100,0008TU sale. If, however, the building or improvement is sold within one year of cpm- DuCi=Under'Ground p]etlon, the owner will Have the burden of prOWng he/she did not build Or Im- rove for the purpose of sale). - I, as owner of the property, am exclusively contracting with licensed con- duct -Structural System Repair/Alteration 1 tractors to construct ttle,projett iSection 7044, Business and Professions Code: Duct -Ventilating The COnLraCtOf'S License Law does not apply to an owner oT property who builds or Improves thereon, and who contracts Tor such projects with a con- Exhaust System ❑ Multiple ❑ tractor(s)license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P, C. for this reason Firepl/Fact, Bit. ICBG 516 Date Owner __ _ Heating System & Ducting I -hereby-certify that- I' have read this application, and state that the above' ❑4100,000 BTU ❑100,000 - r information is correct. I agree to comply with all city. and county Ordinances + ' and'state laws relati g to building Construction, and hereby authorize repro- Hood Of Type ! ❑ sentatives of this • y to enter a above mentioned pro rt for 1 yp Reinspection Fee 515. inspection purpose Canopy. Type I1 ❑1 Signiture Date Drivers' Licen o SS Registers l )fie Fee 5 3 ' r CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 1669 7/05/83 A. P.gW ZONE PLNG. REF. -0 BUILDING eGreACX rri a TO BUILDING PROPERTY LINE REAR YARD (TO P/L) LEFT SIDE YARD RIGHTSIDE YARD PKG. SPACE REO. PROVIDED STREET WIDTH PARK FEE $ ' SPECIAL CONDITIONS: I 27.0J TL Automatic Washer, Meter LJover 100 amps Construction Pale Sub Panel Cooking Unit Sub Pole Dishwasher Motors 00.1 HP ❑1'b-8 Dryers El Gas ❑Electric Inc Solar ❑9-15 HP ❑16.15+ Fan t` Microwave F.A,U. i Pole Light Fixtures !t Range - Device Boxes Sign .t Outlets f Standing Sections Switches Trash Compactor Garbage Disposal Ggnerator 110.5 KW 05-15 KW �'•, l; Transformer ©15-50 KW 050.+ KW Reinspection Fee Sts Meter ❑up to 100 amps Issue Fee S 3 Zoning Approvod By -I Date Appton Approved By r ate Apptication issued By Date "r SUMMARY OF FEES .r BUILDING PERMIT , $: SMtP $ ,PLAN CHECK } $ f r I PERMIT PLUMBING $.1-- ISSUANCE fGRArDING $ — $ PLAN CHECK $�r ' ,ELECTRICAL :$ $ PLAN CHECK �' ' $ MICROFILM $ MECHANICAL $ TOTAL FEE $ f PLAN CHECK ' $ LESS ADVANCED PC S .. FINAL FEE $L-- ' = �COf�IS'TRUCTION A'ND;PL'AN ING' ` ' t = - ." L ' ' - - 1 `o i F`' L &SPA ry r J I - a :APPROVALS Permit #- - 3 •'Date -inspector. �: , ' ' - ,. APPROVALS ti _ Permit #- Date Inspector �i Temporary cat Serv46V orcPole' % N' �. �,` ` .F :`.52�', Pool &'t' uipment Location' - r) iEiectr4 ` N;'� 2? Soil Pipe-U!ndrgrrid ° ' H f�- k y 53` Steel Reinforcement = i C- �Y" 1. t 3! rnr.trteil Conduit UfliUndg Forms - - - ; r -:Electrical " 4- Elec rical Conduit n"drgarid- glect 55:'Eri C8 I B_ondin 3 .;A : 5=•5teei Reinforceme"nf''- '' `' ti A -`� "t r -.2 56. Rough Plumbing 8i Pressure Test 2' , .. 6'• -Electrical UFER Grnd " { F'_ r r Y : 57-'A'PPROVAL TO"COVER-GUNITE 7: Footings [ ` 'r'� F' r It Q r %,:''. = 58r Electrical Co nduit•Undrarnri. 8. 'Foundation 17l ^,-, G ' W _ - 3 59. Gas Pipe,.❑;Undrgrnd.; Test a, I I F u 7 1 9.'WA7 Pipe-Undrgrnd. 6[]. Beckwash'•i.ines, PTrap, ❑ Undrgrnd. •� 10.'Stru`ctura1Floor System - s ;, r, r 61. APPROVAL TO,DEC1< t y �, , 11, Property Sewer Ling &; House C3nn>iction _ " : 62. Backwash'&Receptor-Final 5.. Sewer Cdp ^� r ' `; i r - .+ 63. Heater &_Vent -Final 13-Roof'D rain; `i z' - K ? n 64. Plumbing System Final 14. Rough Plumbing ' 1 'ri : r '65. Electrical' incl - 15`.tRough lect�ricaf ConduitT{ -T-- jr-7T -�-'i ' -g6. Solar System Final .,� jb.-'Rough;-,Ele&Jc Wiring ; � ppova�7.EeAl - Ifi m I • i _- n L N t' r - ' +`17, 0ough`1Niri' Sign? s j I� .�; ? r k ; - l 66.�,4PP,ROVED FOR PLASTERING - R'OughElecriglyT:BarsCei�ing� �' ��-� ( ,' ' ' gg,;P000SPASYSTEMS FINAL - _ _ 19. Rouh`Heating & Air bonckioning 1, = 1- I , FIRE DEPT. REQUIREMENT h' '-9 I , APPROVALS _ Permit # 20. Rough Factory Fireplace) } 4 I 4 Ducts, in $Tucture 70.; Underground Hydro1(21, DuctsVenr tng- r s 13 Oil.22. t 71.1 Product Piping 13 Ga , 23. Gas Pipe -Rough & - �estl �. F ;f_ I. i.-0?2.1 Underground FlFush' _� f r24. Roof. Framin .16 ku ' ti ? , I - ; . 7.3. { Uridergrntd. Storage Tank ❑ Gas ❑ Oil' I 25, Roof Sheatljin'I > i N" ,� M [ I F. t ` ^ f 74. Overhead' Hydro { 4 _ 26 'Bad Ceiling {Structural};& Monocoat` - i = f'� s." I ' 75.!Dry Chemical «- I 27. Frame and Flashing i ` I E ; ' 76. Dry Standpipe ' 28. jLathing 84 Siding : o ! E ; j I 1 77. FIXED SYSTEM FINAL R I _ 1129. lrisulatiori r- i !� I l j 1 1 78. FI°RE'PRIEV. FINAL , 30. Drywall NailingINotes: [ 31. Plaster Brown Coat . j i 32. Eiectrical Power Meter3Fina[ j Z1 ,- ! ! i G 1� 'rl �-A 1 133. Fin 'Electric 34. Final Heating W'AirlConditioning 35. Final Gas'pit 36. Hood or no, py- M F 1 , 37. FinalFactory Fireplace �, z r 38. Final Plumbing 39. Water 5ewice-Finali 1t I ! i l I ♦i a, 40. Gas Service -Fina [ 1 41. Solar[omestic-Fina! 42. Backflow Preventers 43. Back 1:1411i4igationt �L ,C ' t - I _ I 44. Landscape Irrigation System e, , 1 45, Sound, Attenuation) 46. HandiQlRegulations !, 11 ' 47. FINAL•ST1,RUCTURE & BUILDING 48. Special Requirements Completed) l i" ` 49. Electric +j]'elease to Edison i 50, Gas Release to Southern California Gas Cn 51. CERTIFICATE OFOCCUPANCY.r No. kl I 1 i Date el on Applicant to fill In all spaces except L CITY OF COSTA MESA CONSTRUCTION PERMIT Appliceriell Mailing Addrtiss C�� Project Address Owner's Named K""Khone Address ' Ib CtiJid ArchlEng. License No, Address Contractor's Name A� �a'"s /d f phone 3�' q �( Address (mailing) ', 9 L', [ b Je ALS 41AMidj�,� License No. _ __ i� J) LICENSED CONTRACTOR DECLARATION t hereby'affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professlons Code, and my license Is Inf or a effect. License ass ~ can*N Datta Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified c py thereof (Sqction 3800, Lab, C. Policy No` �iU%3 R� _ Company iCertified copy Is hereby furnished. Car d c r is filed with the city B ' is ta Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATIQA (This section need not be completed If the permit is for one hundre ($100) Or I less). " j 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. ' Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions' -Or this permit ,shall be 'deemed revoked. 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 (Section 3097 Civ. C.), Lender's, Name Lender's Address OWNER BUILOBR DECLARATION I hereby affirm that I am exempt'from the Contractor's License Law for the following reason -(Section 7031,5 Business and Professional Code: Any city or' -ounty which requires a permit to construct, alter Improve, demolish or repair ry structure, prior to its Issuance, also requires the"applicant for such permit file a signed statement that he/she Is licensed pursuant t0 the provisions of , the Contractor's License Law (Chapter 9 (commencing.with Section 7004) of Division 3 of the Business and Professions Code) or that he/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 enalty of not more than five hundred dollars (4500). 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 (Sac iIon 7044, Business and Professional Code: Tho Contractor's 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 employees, provided that such improvements are.not Intended or offered for sale, If, however, the building or Improvement is sold within one year of com- pletion, the Owner will have the burden Of proving he/she did not build or im- rove for the purpose of sale). I, as Owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that 1 have read this application and state that the above information is correct. 1 agree to comply with all city and county ordinances and state taws relating to bull�Coictl,and hereby authorize repre- sentatives of ;this ova -mentioned pyperly for Inspection ✓J /`•I Signature Date within heavy border lines and sign all appropriate declarations. CT NO. I LOT NO. I BLDG. . TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ BOTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY ..) CONSTRUCTION TYPE - VALUATION S ZONE GRADING CU.YDS. ACRES Remarki: & f7 ^ Bar Sink Backflow Preventer Backflow Irriga[ion Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains F' , Floor Sinks -. Gas Service + Outlets Interceptors Kitchen Sink Lavatories P: Trep Roof Drains PLUMBING Sewer Cap Sewer- Connection Solar Collectors Solar Piping ' Solar Tank Swimming Pool w/Spa Urinal Water Closet' Water Heater Water Service Showers Reinspection Fee $15 Service Sink Issue Fee $ 3 Boiler Duct - Under Ground Duct - Structural Duct -Ventilating Exhaust System ❑ Multiple F irepl/Fact, Bit. ICBO 9W Heating System & Ducting El 0.100,000 BTU E] 100,000 Hood or Type 1 ❑ Drivers' L Registers CMF 0865-46 rev. 12182 White - Building, Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 110.100,0008TU ❑100,000BTU System Repair/Alteration I Reinspection Fee I Issue Fee 2L'i G 7/14/83 A. P. Ok ZONE PLNG. REF. 506 BUILDING PROPERTY I REAR YARD (TO P/L) LEFT SIDE YARD RIGHT SIDE YARD PKG. SPACE REO. PROVIDED STREET WIDTH PARK FEE S SPECIAL CONDITIONS: Automatic Washer Meter 14over 100 amps Construction Pole Sub Panel ' Cooking Unit Sub Pole Dishwasher Motors 130-1 HP ❑ 134-8 Dryers ❑Gas ❑Electric Inc.Soler 09-15 HP 1:116-15+ Fan Microwave 'r F.A.U. Pole Light Fixtures Range Device Boxes Sign, Outlets Standing Sections Switches Trash Compactor Garbage Disposal Generator ❑0-5 KW 05.15 KW Transformer 1:115-50 KW ❑5U+ KW. Reinspection Fee Meter ❑up to 100 amps Issue Fee Zoning Approved By Application Approved By Application Issued By —, Date Date _ _Date BUILDING PERMIT $ / PLAN CHECK PLUMBING PLAN CHECK ` '.ELECTRICAL' PLAN CHECK MECHANICAL PLAN CHECK $ $ $ $ $ $ S � i ADVANCED PC $ J $15 $ 3 Y OF FEES SMIP PERMIT ISSUANCE GRADING 4'La0 '. T ®■ M■ M■ =. OE —. M■ _. Imm MICROFILM $ TOTAL FEE $ LESS ADVANCED PC $ J FINAL FEE $� CONSTRUCTION AND PLANNING lt'c •. T` ,: t• ~ "� L & SPA ,' • j. 'gpp.Rpi/ALS - Permit. # Date Inspector: - APPROVALS --.Permit+ Date Inspector; !r ,7:',Temporary ;IElectrical Service or Pole ,- C `52.; Pool & Equipment Location 2> "Soil Pipe-Undrgrnd. - - - _ ;• ' . 53 Steel Reinforcement ; I tIectAc'al.Cduit U'tiiit�- rgr onUndnd arms FF - r s 4. Electrical Conduit-Ondr,grnd: 1 - ;' i 55. Electrical Banding 5. Steel Reinforcement , o , , 56.• Rough Plumbing & Pressure Test 6. Electrics! UFER Gr'rid. o 57:' APPROVAL TO COVER-GUNITE f 5 7. Footings t I y ' t 5' 58. Electrical Coriduit-Undrarnrl. .• r . 8.' FouRdkion, "' f = -59. Gas Pipe,'C- Undrgrnd., Test 9.'Water,1Pi0e-Undrgrnd.,a, ' ! 80. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. structural Floor System 61. APPROVAL TO DECK r 11, Property Sewer Line & House Con eciion ; i i 62. Backwash{& Receptor Final 12. ewer Cap �, • y ' f_ 63. Heater & Vent -Final I 13. Roof Drains . ! ' _ =64. Piumbin g -System. Final , �. { 14.,Flough Plumbing i ` 65. Electrical, -Final -- r 15. F�ough' Electrical Conduit' I T - ' - _66'Solar System -Final ' 16., ough. Electric Wiring- , ' t ' _ _'67.= Fencing & Access Approval 17. R6dghi,Wir,irig'Sijn . ` �{ { - j 68. APPROVED FOR PLASTERING ' 18. !FfoughElectricalff,,Bar &Mngf IP f I 69. SYSTEMS FINAL _ i .000SPA 19.'Rough Heating &,Air,Conditidning i .f� F FIRE DEPT, REQUIREMENT, APPROVALS' I Permit'# ?0. Rough Factory Fireplace, ' i ll 21. bucts,-in Structure r'" ! { I 70.- Underground Hydro h 22. Ducts, Ventilating i ' i 71.; Product Piping D Gas ❑ Oil h'23. Gas Pipe -Rough & Test , U ! 72.1 Underground Flush' '24. Roof Framing'' I - ' � � .73., Undergrrid. Storage Tank D Gas ❑Oil � �� 25. 9 'Roof Sheathing I � ; t , I _ 74." Overhead Hydro ' 26. T -Bar Ceiling (Structuralj. & Monocoat - I 75. Dry Chemical . K• 27. Frame and Flashing t i 76. Dry Standpipe I 28. 'Lathing' &'Siding 1 '. 77. FIXED SYSTEM FINAL 29. Insulation =, r i `, I, 4 i I 178. FIRE PREV. FINAL {x=30: Nailing { I ;No'tes: ,Drywall i i' r I 31. ;Plaster Brown Coat^- { 32. -Electrical Power Meter -Final ' 1 , 33. -Final Electric i { 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test t - - 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing t 39. Water Service -Final, 1 ' 40. Gas Service -Final 41. Solar b6iestic-Final „ _,_� __ • _ _ 42. Backflow Preventer, !• L _ _. 43. Backflow- Irrigation c fit, 44. Landscape Irrigation System 45. Sound"'Attenuation r 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING I 1 48. Special Requirements Completed 49. Electric Aelease to Edison. 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOF-OCCUPANCY I No i Date ' Applicant CITY OF COSTA MESA. to fill In all spaces except those within heavyporder_lines and sign all appropriate declarations.,- ` � • P IT NO.. TRACT NO. LOT.NO B D � CONSTRUCTION PERMIT P OF CONSTRUCTION NEW ADD ALTERATION REPAIR 1:1 - ` Q `jQQ ^ �+ + / Applicant's Mailing Address ' J i'rwa ' Ve ' 05t a, i =r�irtiray 3151 Ave..P-1,Costa i1'lesa _ Project Address - - LJ CONVERSION . DEMOLISH ❑ OT1iER• - ii!J� f++V� # 7 {iTr�-:R� -Gut 1 G-JWA Phase ohb, 646-2606 Owner's Name '% h DESCRIPTION OF WORK - ella�lt' tlii��rl)yeriler�:�- r ,XECU�Jye_ Address3151l - C05i a Mesa I G E U TYPE OF. PERMIT GRADING FOUNDATION STRUCTURAL I A. P.*'/ -/9'7- '—� % zoNE CITY OF C05Tr } r Arch/Eng.. I Ofji_ uai-fl"s ut Assoc. License No,' r C1 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL PLNG. REF. #' BUILDING r • i TT Address' 1777r) -.;F: tial n St. s Iry ne i ❑, OTHER PROJECT DESCRIPTION, SQ,, 2913 - _ TO BUILDING PR 1 TY INE � k ' � � REAR YPii6 (TO Pi L) � S oi�a1 d Olson_ Co. ' 540-260 Phone .-_' Contractor's Name- - C •I Address,(mailingl 3151• Airway MO. .E-•1, .Costa Iiesa; -ET. OCCUPA,qNCY. C 0 N ST RUCTI ON, TYPE V-� _.� VALUATION$44�600.0� LEFT SIDE YARD RIGHT.SIDEYARD + r _ License No. ZO,Njr �GRADINGCu.YOS. ACRES PKG. SPACE ,REQ. ? PROVIDED - _ --- - ----- CICENSEO CONTRACTOR DECLARATION .t Remarks: ��LLE+� �€ p / �E• S C STREET WIDTH - PARK FEE $ - I'hereby affirm that 1 am licensed under provisions of Charter -9 (commencing r with section 70001 of Division 3 of the Business and Professions Code, and Qy8 �7�' �� 22 D i SPECIAL CONDITIONS: my,license is in full force and effect. ; _ - 1 ! d`- .onse ! e ' � PLUMBING i • .te rU Signature � { Dee DE�LAoRA19 jlOw ELECTRICAL IM hereby affirmO that I.haveT onse -.to self insured a•certlncate--' , gac fBar Preventer "'" SBWer Connection Automatic Washer ' -_ _ Oer�1008mps 1 Y of Workers' Compensation Insurance, or a'certifiedl copy thereof (Section 3800, Lab. C,y t Z�IS , i Backflow Irrigation 1 Solar Collectors - Construction Pole Sub Panel ` r ' f dlrCtlOnt• Policy No. Company Certified copy is hereby furnished- Bathtubs Solar Piping , r CookingUnit ;Sub Pole CerYii}� q is filed with the clty.Bulld _ L` . Clarifiers Solar Tank I!- Dish Washer I Motors 00-1 HP El 114.8 Dat e. -�/ _L_ Applicant%PIP EXEMPTION,FROM WORKERS',COMPENSATI N ECLARATI _ _ Dishwasher Swimming Pool w�Spa �, - Dryers ❑Gas ❑Electric i Inc.Solar ❑9 15 HP,❑16-15+ '1 (This section need not be completed If the permit is ,one hundre ($100) or less): J 1 F -^, I I certify,that In the performance of the work for. which this permit Is issued I , I Drinking Fountains Urinal Fan Microwave f t shalt not employ any person In any manner so,'as to become subject. to tyre I { - F.A.U. Pole Light Workers' Compensation- Laws of California.- g Floor Drains Water Closet ' F• + Date -Signature NOTICE': if, after making thts-declaration; you -should become'subject to the - Floor Sinks- - - - -Water Heater- - - Fixtures " ' Range- i' e- ; • -' -_" - `I - " - Workers' Compensation provisions of the Labor Code,.yourmust forthwith comply ,wlthl such ,provisions'tor -thispermit ►Shalt be [deemed revoked. '; Gas Service' ' lOuttets • - + . Water service - '. Device Boxes Sign CONSTRUCTION LENDING AGENCY' I ' Outlets " I hereby affirm that there is a,construction lending agency for the performance ' Interceptors '. ' Standing Sections 1 of the work for-; y4�ich ;this_ Aermit Is issued _(Section ,.3097 Civ. C.)' , Iti!'A; : ,-. ,- 1 Switches f Lender's Name __E-� _ _ Kitchen Sink .� Trash compactor Lender's! Address i - u -t _' { _ - - OWNER'BUILOER DEC�RRATION ( ' i ; _ - • _ E - r.- Lavatories `• - ( l Garbage Disposal f , I hereby.'affirm that I a'm' exempt from the'Contractor's, License Law for the _ P -Trap' Generator. ❑0-5 KW ❑5-15 KW f C (lowing reason (Section 7031'.5 Business and Professional Code: Any city or � inty which requires a per mlt'ta:construct, alter, Improve,' demolish or4epalr ,' 1 Transformer ❑15-50 KW a t K structure; prior to Its, issuance„also requires the applicant.for such permit * i1e a signed statement that he/she is licensed pursuant to the provisions of k Roof'Drains - ; ❑5U+ f f e Cont ractor'S'License "w;(Chapter.9 (commencing with Section 7000) of KW; iReinspeetion Fee i $15' i Division 3 of the Business and Profession$, Code) or, that; he/she is exempt therefrom -and the:basls for the alleged exemptlori:-Any_violation of,Section Rein Showers ' Spection Fee ' $15 Meter ❑up to 1001amps - Issue Fee. ( '$ 3 7031.5 by -any applicant for a I permit' subjects Lthe applicant to a_ civil penalty of not more than five hundred dollars ($500). ) -' ° Service Sink ` Issue Fee $ 3 Zoning Approved By _ t pate Ll 1, `as (owner of. the ,property or'' my employees.. with wages as their sole i compensation will,do th6 work, and,the structure -Is not Intended or offered + `• , MECHANICAL r + Application Approved By ' L + ate for sale (Secilon 7044, Business' and , Professional Cade: The, Contractor's License Law does not apply to'an owner of a property who builds or improves c Boiler - Refrigeration System /�� •%3 thereon,;and who doesfsUCh work himself/herself at through his or her own i employ ees, provided that Such Improvements arelnot Intended or offared for sale. If, however, the building or Improvement !s sold wlthln vne;year of Com- ; ; - ❑0.100 ooBTU ❑100,000BTU Duct : Under,Ground. I 0 Application Issued By - --'- T ; i pate pletlon, the owner,wlll helve the burden of proving he/she did not build or Im- rove for the purposeot,sale); - y Duct - Structural System Repair/Alteration ( 1 BUILDING PERMIT $ SUMMARY OF FEES i /f 4��s_O SMTP $ I, as owner of the properEy, am exclusively contracting�with'licensed con- 7044,.Business.and•.Professions t_ I- Duct • Ventilating,- ? j tractors to construct thelprolect.(Section Code:- The Contractor's License Law ddoes not apply to an Owner of property who _ r __ _' _. _ - ; _' -_ ! ,PLAN CHECK# $t i PERMIT I 1 i `builds or, improves'therePn, and who contracts for such projects with a con- I tractors} license pursuant to the Contractor's License Law}. , , ( Exhaust System ❑ Multiple ❑ (PLUMBING $j ? i ; ISSUANCE ; $ • ❑ I:am exempt under Section - B. & P. C. for this reason , FirepIlFaCt. Bit. (CBO # r i 1 I -PLAN CHECK; I GRADING � Heating system &Ducting t I 00-100;000;BTU 0100,0006 - - - `f ;ELECTRICAL i $f PLAN CHECK + MICROFILM $ Date i Owner j _ 1 l hereby; have read -this, that- the -above certify-that•t: application-antl State 1 ' information is correct. 1 agree to comply with all cltyiand county ordinances I and .state laws relating t0 building c nstruction,'and hereby authoriXe repre- t I ( - r or Type I ❑' t jMECHANICAL j $ i [ TOTAL FEES ' I j I sentdtive$ of thl ,city i o en r n the above-mentioned property for rnspectlon par es, ? i 1aro n i I Reins coon Fee' $15 r T e it ❑ !PLAN CHECK' $' ( ? r LESS } nature i Date 1]��3 41Hood e ; $ ADVANCED'PCOrl,rers't Icenie or SS + ; r egisters 1 ; i Issue Fee ! ! $ 3 ; i 3 I I 310 FINAL FEE 1 $ r_ '`F 0865-46 rev. 12/82 White - Building; Canary^Applicant; Pink - Accounting; Goldenrod - Assessor �= �CONSTRUC710N ANR;PL•A INS ° ` = «� r. ? L•-& SPA APPROVA LS Permit # r s <Date r f l nspector . C " ` APP#tOVALS -Permit # _ Date '" _ Inspector nj T 1. `remporary Electric$i Service or Pole I -S, :52. Pool &Equipment Location.- c'a 2: Soil Pipe-Undrgrnd: '+ c ' ry `. ' 4 ' 53 Steel Reinforcement H s.. . I Electrical Conduit Utility -06 rgrnd. 54 Forms J F V 4- Electrical Conduit-Undrgrnd rL F• '55 Electrical Bonding , rt 1 r. .- 5: Steel Reinforcement `, r . 56.; Roughs Plumbing& Pressure Test T - 6. Electrical UFER Grnd. r ' 57-' APPROVAUTO,COVER-GUNITE 7. Footings 5$. Conit rard, it duUndn r .Electrical = , - a 8. Foundation = - _ 59. Gas Pipe ,:❑_Undrgrnd., Test 9. Water, Pi a-Undr rnd, �' I P 9, c � '�•� - .• ,60. Backwash'Lines',P-Trap,`❑ Undrgrnd. = ' 10. Structural Floor System ? T ^ : �61. APPROVAL TO DECK ,.tr _ , 11. Property Sewer Line& Ho*use'C6nnection,62. Backwash'& Receptor Final _.. 12. Sewer Cap I ` ' , I I f. 63. Heater & Vent -Final, ' ' 13. Roof Drains 64. Plumbing, System Final , 14, Rough Plumbing _•� I' " - "65. Electrical=Final -15:�Rough Electrical=Conduit-{ - - j- _fi6.j Solar System -Final 1 I X16. Rough Electric.Wiring ,^ y - , ;` c'-� `, �. a: 67.1 Fencing & Acces's.Approval r - '! J--� 7 .17. Rough`Wiring Sign 68. APPROVED FOR -PLASTERING ; R �r. -1.,8.. Rough-Elect�ical=TBar,Ceifing ° ? I'` 69 -# POO L•/SPA SYSTEMS FINAL I „ r I I 19.=Rough Heating & Air Conditioning -, ; FIRE DEPT. REQUIREMENT 1 APPROVALS Permit # '• 20: "Rou h Factory p Fire lacei fti g l 1 l ' i II i I� 21 Ducts, in Structurer I # ! l I 70,E Underground Hydro; i + t •r 1 I I 1 4r22; Ducts, Ventilating _ F, i r i F 71. Product Piping ❑ Gas ❑ Oil ; , �Y'23. Gas Pipe -Rough & Testi rli, 72., Underground Flush �� y•24. Roof, Framing I I - ,. E . `, ; _, f I 73., Undergrnd. Storage Tank ❑ Gas El 01 f t , 25. Roof Sheathing ' i ` I L f r - + 74.1 Overhead, Hydro ". ;126. T -Bar Ceiling (Structural),. & Monocoat J ; l ; -. 75.Dry Chemical - 27, and Flashing I ; ls`S ' ! 76. pry Standpipe rFrame ' 28. Lathing & Siding I 77., FIXED SYSTEMiFINAL 1 4 29. Insulation 78. FI'RE•PREV. FINAL I 30. Drywall Nailing '_� Notes:) r s k31'. Piaster Brown Coat 1I -� - - - -r i, + I { 132. Electrical Power MeiertFinai t r 1 1133. Final'Electric 34. Final Heating &lAirlConditioning! - 35. Final Gas,!:Pipe=TesfI N I ,� l !I I ,• 1 - i , 36. Hood or Canopyt''� 37. Final Factory'Fire lace 38. Final P,lurnbing 39. Water Service -Fin al 40. Gas Service -Final � � 4 � ,' 1 � f � I ' ' • , 41. Solar Domestic -Final 42. BackflowlPreventer{ 43. Backflow.Irrigation l 44. Landscape Irrigation System jI 'nl ' - i ' "' ', � ° - { i u• � I •C I 45:�5ound".Attenuaiion' c; 1; I _ I T' f 46. Handicap Regulations' l t •47: FINAL STRUCTURE & BUILD ING 48. Special Requirernenis Completed - - 49. Electric Release to Edison 50. Gast Release #o Southern California Gas Co 1 51, CERTIFICATE OF OCCUPANCY No. �Gi�j ..� -� Date r ADDMh ofBUILDw 3151 AIRWAY AV 0MRRNA11EIF0101 : EXECUTIVE GUILD Aomss: 3151 AIRWAY AV COSTA MESA, CA 92626 APP►. IUILING ADDRESS: ARCHrrECT GR ENGINEER: ARCH. OR ENG.'S ADDRESS: UNIT: P I CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 075206 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR VIC.NO.; JOB DESCRIPTION : T/OFF AND REROOF A/C WELL W/CAP SHEET UNIT: CLAIM VALUE: 426.00 CALC—VALUE: 426,00 COMACTOR'SNAYE: CUSTOM ROOFING INC t714)997-7108 coNmAcmwsYuum 10952 GLEN ROBIN LN ADOIIEss: ORANGE CA LIc No.; 670866 92669 uwt: LICENSED CONTRACTORS DECLARATION; I hereby offsm under penally of per[tay no f am Ifomned under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Btanass and Professions Code. and my Roane is in full fame and eft CITY LIC. No.: LIC. CLASS: C 3 4) 6 7 0 Date: �( C � Con 'NER BUILDER DECLARATION: I hereby affirm under panty of perjury that I am exempt from the Contractors License Law for the Fwng reason (Semon 7031.5 Business and Professions Coda: Arry city or aunty which requires a parrs to construct, alter, improve, . mdish, or repair any structure, prior torts issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pureusnl to the Provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) d Division 3 d the Business and Professions Coda[ or Ihat he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any appkanl for a permit vubjeas the applicant to a ova penalty of not more than five hundred dollen [s5Don, ❑ I. as owner of the property or my ampbyeas with wages as their sale compernsation, will do the work, and the structure is not handed or offered for sale (Section 7044, Business and Profesaons Cade; The Contractors License Lew dons not apply to an owner of property who buids or improves lheneon, and who does such work himself or herself or through his or her own employees. provided that such improvements are rat tntanded or offered for sale. 1, howev[c. the budding or improvement is sold within one year d completion, the owner -builder will have the burden of proving he or she did nor Ixdld or improve for the purpose of ode). ❑ I, as owner of the propert,. am exdioively oontrenitg with licensed contractors to eonsmid the project (Section 7o44. Business and Professions Code: fl+e Gortractan License Law does nor sopry to an owner of property who builds or improves thereon aro who contracts for acrd projects with a rmfrector(s) licensed purouam to the Contractors License taw). ❑ I am exempt under Section: S. 6 P.C., far this reason: Date: owner, I do hereby certify that I am aware d and understand the requiremanls d California Fleahh and Salary Code Ssaions 25505, 25573, and 25534, and that I or any future building occupant will / will not (circla one) need to comply with said slate codes and the requirements for e pend for oorstruaion orrnodificatior MxnthoAi rr F�arial; sera District. Residrsnd mmnndi n apfimtiorsam axempr from ll 0 Proviso". Dalai Applicard: WORKER'S COMPENSATION DECLARATION: i hereby affirm tinder penally of peritay one d the bIrwvg dedmatims: ❑ I have and will maintain a certificate d consent to seffinwro for workers' cormpenaation, as provided for by Section 3700 of the Labor Code. for the psrorinaece of the work for which this permit is issued. I have mid will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this pernil Is issued. My workers'$ I AT ion E FUNcarrier D ■row policy number are: EXPIRE S Carver: Policy Number. 01/01/96 (This section need mol be compktad if the parse is lar one hundred dollars [$7001 or lass.) ❑I Dandy that in the performance d the work for which this permit is issued, I shell not employ any person in ashy man er so as to bacoree sanbject to the worker' oorrWersation lairs d California. and agree i Ebd workers' compensation prarivos of Section 3700 of the labor Cotictshoill.1prthwith Date: Applicanr: WarrrMg: Failure to aacrlre wonlsrs' rorr>psrrastlon coverage Is unlit 'W, and shall subliect an rrVoyar to afrfraf priahl" and civil ffrw Lip to arra horldred thousand dolfara (SIM DWI ki addition to the cost of compenaatkA darragaa as provMad for In Section 37176 of the tabor Coale, Infersaf, and attorney's foss. CONSTRUCTION LENDING AGENCY: I hereby affirm under parry of perjsy that there is a construction landing agency for the performance of the work for which the permit is issued (Section 3097, Civ. C), LENDER'S NAME: LENDER'S ADDRESS: I certify that I heve read this appl"cation and sane that the above information in correct. I agree to comply with dl dry and county ordinances and state laws rotating to building constnrdion ard hereby authorize representdivee of this dry to ardor upon the above-mentioned property for inspection pkapeeee. p ON I T Z E r Daze: OwneRAge p rasa (5151ae.WP) While -Building A Safety; Greeri_Fle; Canary -Applicant; Pink -Revenue; Goldenrod-Meessor PERM NO: B 075206 GOVT: N SUPP: N PURPOSE: OTH SQ FT: 426 GROUP OCC: B-2 / COMMENTS: PARTIAL RE—ROOF AT AIR COND WELLS Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- ---------- — ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN DEFT: FT IN RGHT: FT IN PARKING RE • PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING N 'TES> > �E****iEiEiEiEiE**�iE*iE�iEiE**iE*iE**?+EiE***iEiE?+E?+E?+E�iE��iEiE?+E?+EiE��E�(-iEiEiE�E**iE�EiEiE�EiEi(-iEi(-iEiE?+E 1(-iEiElElElEdE�EiE*iEiE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 15.00 PLAN SMIP/NON—RES ISSUE FEE .50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 15.50 0.00 0.00 15,50 15.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 15.50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 15.00 .50 I N D I V I D U A L' -F E E B R E A K D O W N : TYPE QTY D E S C R I P T I.0 NUNIT COST TOTAL COST SFC 426 REROOF BY VALUE COMMERCIAL NOZONE 1,00 426,00 END 'OF FEES a %ONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector F &SPA 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. hough Plumbing & Pressure Test 6•• Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. d 8. Foundation 59. Gas Pipe, ❑ Urtdrgrnd., Tast 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P_ -Trap, ❑ 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 -Filial r 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing .65. Electrical -Final 15, Rough Electrical -Conduit or, 66. Solar System -Final 16. hough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. hough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT , APPROVALS Permit 20. Hough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71, Product Piping ❑ Gas C� Oil 23, Gas Pipe -Rough & Test _ 72, Underground F.[ush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas 00d 25. Roof Sheathing - 74. Overhead Hydro,, r 26. T -Bar Ceiling (Structural) & Moriocoat 75, Dry Chemical , 27. Frame and Flashing 76. Dry Standpipe Y F 28. Lathing & Siding 77.• FIXED SYSTEM FINAL 29. Insulation _ 78. FIRE PREV. FINAL 30. Drywall Nailing ;. -HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat r 79. FINAL INSPECTION 32. Electrical Power Meter -Final ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34. Final Heating & Air Conditioning / Notes:�47A pL 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Firnal.Factory Fireplace 38. Final Plumbing 39. Water Service•Final r .40. Gas Service -Final 41. Solar Domestic -Final. 42, Backflow Preventer 43. Backflow Irrigation , 44• Landscape irrigation System 45. Sound Attenuation 46. Handicap Regulations - 47• FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49, Electric Release to Edison ; 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa ReveBui ding Safety Diivisionment CERTIFICATE OF OCCUPANCY No. 0 C r 0 P. O, Box 1200 Costa Mesa, California The Building located at 3151 Airway Ave Unit Q has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B 2 Occupancy. Use of Building Office Legal Description 42729114 iSee reverse side for Metes and Bounds) B 50399 E 50539 Building Permit No Electrical Permit No. Plumbing Permit No. Mechanical Permit No. Number of apartments and/or guest rooms ISSUED TO: Building Official Tony C,DE Baca Cushman&Wakefield Of CA 3151 Airway Ave Unit Q by evJb= /..444 Date March 8, 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical Fife; Pink - $Idg. Permit File V City of Costa Mesa Development Services department CERTIFICATE OF OCCUPANCY No. Q �s Building Safety Division P. O. Box 1200 Costa Mesa, California The Building located at 3151 AIMAY LUM 0-1,2 & 3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B—Z __Occupancy. Use of Building DICES Legal Description 938-940-74,75e76 _ {See reverse side for Metes and Bounds} Building Permit No. BP -13667 Electrical Permit No. E-13734 Plumbing Permit No.AP-13667_ Mechanical Permit No. M-14?IA Number of apartments and/or quest rooms ISSUED TO: Building Official ,e,_A/, r GUnDHOUSE C NL9IMTANTS by C— 3151 ATi&AY AVE. OE -1. COSTA A'1FSA r cA, r % 1 L' / Date rI `J This Certificate of Occupancy SHALL BE posted in a conspicuous place on the promises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 Ile) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File ` CITY OF COSTA MESA o BUILDING DIVISION re 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 •f=ax (714) 754-4856 - www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER:B08-00093 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 93894036 DATE ISSUED: 03/14/2008 ISSUED BY: RMD JOB ADDRESS: 3151 Q AIRWAY -AV -CM _.-SuitelUnit:.. Q Vicinity: ROOF` Squares: 7300 Valuation: $16,503.00 SCOPE OF WORK: PART IAL'REROOF.ON:BUILDING "Q", PITCHED AREA ONLY, TEAR:OFF'(E) ROOF MATERIALS, INSTALL f LAYER OF 15# FELT ON A 4:12 OR GREATER PITCHED ROOF AND REROOF WITH 40 YEAR„F.IBERGALSS::, SHINGLES, "CLASS A A�f�” ON A, COMMERCIAL BUILDING, APPROX 73 SQURES. REPAIR AND REPLACE SHEATHING AS NEE DED.'COMPLY:WITH""T-24 COOL ROOF STANDARDS FOR COMMERCIAL BUILDINGS" IF REQUIRED, OWNER: CORP OF THE PRESIDING BISHOP.CHU"RCH OF LDS ` - Address:., „ %SOUTHERN CALIFORNIA %PROPERTY RESERVE,I Unit: 10 E'SOTEMPLE ST,#406 PHONE: City/State/Zip: BRUCE CHRISTENSEN 3 , APPLICANT: HANSEN, DUKE I ; Address:, N6646636- Unit: PHONE: 714-557-7442 N' CitylStatelZip: .= CONTRACTOR: ROSS AND BARROWSfNC -License'No. _j .327802 Address: 260 E ALTON AVEUnit: PHONE: - - 714-567-7440 City/State/Zip: SANTA ANA, CA . 92707"` CELL:. �I ARCHITECT: License No:, PHONE: ENGINEER: y ;License.No:? PHONE: FEE SUMMARY Reroof Plan Check: x$0.00•. Reroof Permit Fee: $279.25 Reinspection Fee: $0.00��r NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE t. INSPECTION TYPE DATE INTRIALS CODS f INSPEC4011 TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 2�P 210 Final Electrical 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 WORKERS' COMPENSATION DECLARATIL I hereby affirm under penalty of perl'ury 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 Workers' compensation Insurance carrier and policy C___ err-areC' Carrier: ✓/ % �U (This section need ncf be wrnpleled d the permit is valued at one hundred dMars (31 POJ or fess.} PolicyNumber: _/ D 0- ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in tiny 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 or ode, I shall rthwith comply with these provisions. Applicant's Signature GOate r' 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 DOLLARS ($100,000), IN ADDITION 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 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. Llc. ~S KO '-L— Class L� Contractor's Signature Dale CONSTRUCTION LENDING AGENCY: ❑ 1 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 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 ani 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 3057-46 (3/071 Date Owner ID verified by o, , s licb.-_ ❑ Yes ❑ No Driver's License No. Expires: Verification of Ownership by (type of document, i.e. - property lax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safely 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 ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 Dale CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penatty 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. ignature of LL I Owner(si Dale �\ Authonz Applicant —Dale— Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ' STA MESA PERMIT NO. TRACT NO. - ^LOT•NO.', " •BL NO. ONSTRUCTION PERMIT (V Project Address - S% ►'L C'L TYPE OF CONSTRUCTION 6.1. ! 8 ' ' 5/2Q/82 33.49 T� Owner'-, Phone`?'>?- p ❑ New ❑ ADD' ❑ ALTERATION - - y Address t, ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS - Arch/Eng. License No. A.P' 41 1Address \ ' DESCRIPTION OF WORK ZONE PLNG. REF.- , + ,'� 4 LC• Phone -, ,TYPEOFPERMIT 'SE I �vN1GINE P-A �g+f `. ❑ GRADING, -❑ FOUNDATION ❑ STRUCTURAL C IDE YARD CONTRACTOR-DECLARATION 9 ❑TENANT ELECTRICAL ❑PLUMBING ❑MECHANICA WIIOEYAirm that I am licensed under provisions of Charter (com- ith section 7000) 3 of the Business and ❑ OTHER' RIGHT of' vision Code, land my ense In full f d ff t., C 4 �_ l 'PROJECT DESCRIPTION REAR YARO'(TO P/L) " License Class ens ` " �' _ PKG. SPACE REQ. -PROVIDED - - • �OiZ {Date s� -Signature SQ. FT. _ _ _ �-• -STREET WIDTH - -•- PARK FEES - - - ,WORKERS' COMPENSATION DECLARATION _'OCCUPANCY - CONSTRUCTION TYPE ZONING APPROVED BY DATE 11 hereby affirm that I have a certificate of consent t0 self-insure ora .VALUATION ZONE certificate- of Workers' Compensation Insurance, or a certtfled copy ,thereof (`S CtIt 3 00 Lat1,C.). GRADING CU.,YDS.~ ACRES SPECIAL CONDITIONS: ; Policy NO""j1Off ComPany_W ` A� y A41- ays..-� Q.Certlfled copy Whereby furnished. _ REMARKS: L i copy Is filed with the city Building Division. (;!NCertlfled EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This.seCtlOn need.not_be completed if the permit is for one hundred - 7. ,•,• ' .: lir'. i :•�; rs ,7 " ,•y-' •il ($100) or leIn. ertify that n the performance of the work for which this permit is ed, I shall not employ any person in any manner so as to becomeFISATHTUBS-- MBING , :� ,j. PL-AN CHECK - -- tELECTRICAL -- • - PLAN CHECK.- ject to the Workers'_Compensatlon Laws of California. • _• " �` SFIOWERS -' - ';NOTICE: I Date Signature If after making this declaration,you should becomesubjectLETS_ u -- URINALS - - ,GENERATOR 0-1 KW-- 1-10 KW"-;"-";. the Workers' Compensation provisions Of the Labor Code, you must TRANSFORMER Ito comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS -- - 4APPL1ANCE -- 10-50 KW_50 + KW revoked.. -r. _L___ _-_ _ _` , _ .. _- -- .-_-. _ ;CONSTRUCTION LENDING AGENCY ''KIT. SINKS DISHWASHERS- -MOTORS -- -0-1 HP--- 1-lO HP 11 hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS"- '(INC..SOLAR)--_ 10-50,HP 50 +.HP. ;' formance of the work for which this permit is issued (Section 3097 Cfv: C.): - - - Lender's Name- "'FLOOR SINKS "FLOOR DRAINS -1' - FIXTURE OUTLETS-1 -SWITCHES iLender's Address DRINKING'FOUNTAINS- "' GAS TUBE SIGNS. ---- - - -- • - _ OWNER 9UILDER'DECLARATION '- INTERCEPTORS - CLARIFIERS IGHTS- -- •• -POLE LIGHTS- - - - --- - - - 1 hereby affirm that I am exempt from the Contractor's License Law for -• the-following'reaSon-(Section 7431,5 Business, and Professions Code: the-following Any city or county which requires a permit to construct, alter, -SWIMMING POOL - PTRAP - - POLES-- METERED SUB Improve, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE -"- -ALTERATION- - ,' PANELS MAIN --•SUB gwres the ap;.licant for such permit to file a signed statement that he � Is lleensed'pursuant•to'the provisions of the-Contractor'$-License Law -GAS SERVICE OUTLETS -.rL' - SERVICE - - - - AMP '" r (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the- - WATER HEATERS- BTU OUTPUT - `s i Gjw - r - - •-- basis for the alleged exemption. Any violation of Section 7031,5 by the applicant to a civil - any applicant-for a- permit- subjects penalty of not more than five hundred dollars ($500). SEWER CONNECTIONS- r ,E]'I,. is owner of tlie-property, or my'empioyees with wages-as their SOLAR TANK' " sole Compensation,_ will do the work, and the structure is not Intended dor 7044, auslness and Professions Code: The T._ SOLAR PIPING ISSUE FEE - - - - - ^- - - �• or offered sale. (Section Contractor's License Law does not to an owner of a property SYS. '. ,apply 25`a builds or improves thereon, and who does such work himself-or- "ISSUE FEE - -- APPLICATION APPROVED BY -- DATE _ - - - - - ;p3�^gh his own employees, provided that such improvements are not fed or offered for sale. If, however, the building or improvement i':jd of completion, the owner will have the burden MECHANICAL PLAN CHECK - FEES SUMMARY OF „ within one year of proving he did not build Or improve for the purpose of sale). - - -- HEATING SYSTEM 0-100,000 BTU } BUILDING_- PERMIT 5 SMTP $ - it ,❑ I, as owner of the-property, am exclusively contracting .wh _ AND DUCTING- - -100,000 _ _ __ _ + _ licensed contractors to construct the project (Section 7044, Business Professions Code: The Contractor's License Law does not apply.to + BTU- PLAN CHECK 5 PERMIT �$ and an owner of property who builds or improves thereon, and who con- _ REFRIGERATION 0-100,000 BTU _ _ - PLUMBING ^ $ ISSUANCE' �_'_ tracts from -such -projects with a contractor(s) llcesnetl pursuant_to Contractor's License Law). ,SYSTEM 100,000„+ BTU- PIAN CHECK$ GR'ADING the ❑ 'I am exempt under Section” B. & P. C. for this rM ELECTRICAL' '$ -- BOI LERS BTU reason, ICROFILM 5 ' IZIi Date Owner SYSTEM REPAIR, ALTERATION PLRN CHECK • $ -- - TOTRi FEE $ V '1 hereby certify that I have read this application and state that the above - EXHAUST SYSTEM MULTIPLE MECHANICAL $ .y _ LESS AD- + 16format' recti` agree comply with all city and county ordina as and stat relati o C4onstruction, and hereby authorize ij PLAN CHECK $ - VANCE PC E- r0prese tatives' of -t city enr' upon the above mentioned- , propert for insp on p es, Signature Date FINAL FEE ; Drivers' License or SS # ISSUE FEE •- - - - -` - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor CONSTRUCTION AND PLANNING APPROVALS Permit,# G Date Inspector POOL & SPA• APPROVALS Permit .# ' ! Date Inspector 1. .- Temporary Electrical Service or Pole P Y 43. Pool &Equipment Location T` . SoilPipe-Undrgrn 44. Steel Reinforcement " ' l 3. Electrical Conduit Utility-Undrgrn 45, Forms 4. _ Electrical Conduit-Undrgrn _ 46. Electrical Bonding " -- -5. SteelRein.force _ 47. Rough Plumbing & Pressure -Test 6. Electrical UFER Grn_ 48. APPROVAL TO COVER'GUNITE'" 7. Footings 49. Electrical Conduit-Undr rn - 8. Foundation - _ __ _ _ .y 50. Gas Pipe, ❑ Undr rn,rTest.• -9.- Water, Pipe-Undrgrn- _ _ __ _ 51. Backwash Lines P-Tra 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53.. Backwash & Receptor -Final 12. - Street Sewer. Connection _ '.' --54.- Heater & Vent -Final 13. Rough Plumbing _ ' 14. Rough Electric -Conduit f 1 F56.' Electrical -Final 15. Rough Electric -Wiring j5N_e[� 6,e a10- - L 57.- Solar System -Final 16: Rough Heating & Air Conditioning • - F encing & Access Approval 17.- Ducts, in Structure - . APPROVED FOR PLASTERING F 18. Ducts, Ventilating 60. -POOL/SPA SYSTEMS FINAL 19. Gas Pipb- Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashin - _ - �- ._ . 23. -Insulation 24. Lathing & Siding �- - 25. Drywall Nailing - - 26: Plaster Brown Coat 27. 01 Electrical Power Meter -Final -' 28. Final.Electric r 29. Final'Heating & Air Conditioning - - - 30-. Final,Gas Pipe -Test -31. -Final Plumbing 32. Water Service -Final - - - 33. Gas'Service-Final - - - 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36. Sound Attenuation - 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release. to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No: Date 1 1 . 4 1 - -.., Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAPER IT NO TRACT NO, -BLDG. N9. C CONSTRUCTION PERMIT Wr 3J IND. 6136 ' 5/20482 3i.00 TV . Project Addres � 4 T.„YPE�F CONSTRUCTION Owner d ., Olson Phone @ANEW ID ADD OE 'ALTRATiON Address - -3151-Airway Ave - hj.REP'.vAR ❑ CONVERSION ❑DEMOLISH. y E]'OtHER ZONING REGULATIONS' Arch/Eng: -License No. - - A'P-*Address DESCRIPTION OF WORK f '- ' - ' ZONE'- PLNG. REF. grContractor' - Phone 3� YPE OF:PERMIT -_- TpB ILp1 G PROPRTY LINE'Address "� -' - rSETBACK ❑GRADING-•Q�FOUNDATiON ❑ STRUCTU C T. IpE YARD - - JA LICENSED C NTRACTO DECLARATIOEF OIj-TENANT' th:.t I licensed Ion$ Cha ❑-ELECT•RICAL. ❑PLUMBING r ECHANkSIDE YA RDI hereby affirm am under of co mencing' with section 7000} of on of ih siness d r f ❑OTHER RIGHT :! Professions Cotle, �nrlty tic Is 1 fa andct. PROJECT DESCRIPTION'License REAR YARp (TO P/L{ Class Lie e PKG. SPACE REQ.- -PROVIOED 'Date - Signa r - SQ..FT:_ . r-,. -- - rr,�, CUPANCY- CONSTRUCTION TYPE •--'-•^ r STREET WIDTH -- - - { PARK FEE $ :. WORKERS' COMPENSATIO CLARA . ON-. . _ _ . .I hereby affirm that I have a certificate of consent to salf-in r a, VALUATION ' ZONE y- ZONING APPROVED BY - -• DATE -- certificate Of Workers' Compensation Insurance,-or-a cert{f{ copy 'thereof (i b. C.). GRADING-CU. YOS. ACRES - SPECIAL CONDITIONS: - --'- -- .Policy L U "' Company Haines- I�t��_ -- - - �❑ ifcopy is!herebyLfurnished. _ _ •,.- .� _ _ _ .. _' REMARKS: , a" _ �r _ .t. Certified copy is filed with the city Building Division. q EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - �-,js. section, need .` of be completed if, the. permit Is for one hundred z�30) or less).- - iE;rtrfy that in,the performance of _the work for which this permit is bed I shall not employ any person In any manner so as to become' -PLUMBING ,.PLAN CHECK _. •'ELECTRIC_ AL - - PLAN-CHECK - Subjed to the.Workers'_Compensation Laws of_California.' w BATHTUBS SHOWERS '' • ' = --- - - IDate Signature !NOTICE: If atter making this declaration, you should become subject 't0 TOILETS,) ft ,f =y -URINALS, - - - ; -- - 'GENERATOR. - - 0.1 KW ITRANSFORMER 1-10 KW - the Workers' Compensation provisions of the Labor Code; you must •;forthwith comply with Such provi5ion5 or this permit Shall be deemed LAVATORIES DOUBLE LAVS -• --• -- 4APPL-IANCE - .-10.50.KW_50 + ,revoked. ' _ _ _ _ _ 'CONSTRUCTION LENDING AGENCY KIT: SINKS- DISHWASHERS - - - {•MOTORS 0.1 HP 1-1D HP 'I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS SUMPS -.. _..,�_ - - ,(INC.,SOLAR)` _ 10.50 HP 50 + HP formance of the work for which this permit is Issued (Section 3097 ;Civ. C:}, - ' "" -"' !Lender's Name -FLOOR SINKS " - ` ' --FLOOR DRAINS-- ' r PFIXTURES OUTLETS - -SWITCHES - - ! _ ILender's Address - DRINKING'FOUNTAINS - -- - - --- - ,GAS-TUBE.SIGNS__ __ _ _,._ �•-' 'OWNER BUIL13ER DECLARATION- - "` --'- - 11 hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS `- CLARIFIERS - - - POLE LIGHTS - •- - _ - r'_ -' .� ' -SWIMMING POOL PT,RAP - - POLES-'- 'METERED ` SUB- the-'following reason (Section 7031.5-Business and-Professions Code: 'Any city or county which requires a permit to construct, alter, WATER-SERVICE ' '{ALTERATION - - '.PANELS - MAIN improve, demolish or repair any structure,- prior to•Its issuance, also re- the api licant for Such to file a signed statement that he qulres permit its Iicensed'Dursuant to the-provlsions-of the•Contractor's-License Law' GAS SERVICE OUTLETS - 'SERVICE- ..- _ - ___ - �: 'AMP - ,(Chapter 9 (commencing with Section 70001 of Division 3 of the ` -WATER HEATERS----- BTU OUTPUT - - - • '- .. __ ' _ _ . ' Business and'ProfeS$ion$ Code) or that he is-exempt therefrom and the I basis for the alleged exemption. Any violation of Section 7031.5 by-"- SEWERCONNECTIONS any'appllcant-for-a -permit-subjects` ttie•applicant-to-a civil penalty- 'of not more than five hundred dollars ($500). -SOLAR TANK - - -' - COLLECTORS ` 10'i, as owner of the propJiy, a`r my-employees with•wages"a5 their sole compensation,_wih do-the work, and the structure isnot intended SOLAR PIPING SYS:' - - y ISSUE FEE offered for sale. {Section 7044, Business and Professions Code: The t'ractor's. License Law-does.not apply to an owner of a property '• builds or improves thereon, and who does such work himself Or _ _ _� _ - - -'*- - .�APPLJCAT1ON.APPROVED BY ISSUE FEE' , �_ _ _ __UATE_ -' i .Augh his own employees, provided that such improvements are not jig._ _ MECHANICAL -PLAN CHECK r SUMMA•RY,OF FEES'of Intended cr offered for sale, If, however, the building-or improvement is sold within one year of completion, the owner will nave the burden r .} proving he did not build or improve for the purpose of sale). "❑ -•owner -of the am HEATING SYSTEM 0-10p,000BTL; BUiLOING_- PERMIT $ SMI " , $ !, as property, exclusively -contracting -with_ licensed contractor$ to Construct the project (Section 7044, Business ^ANO DUCTING - _ _ 100,000;+ BTU '_PLAN CHECK $ �- - PERMIT' and'Professions Code: The Contractor's License Law does not apply-to an owner of property who builds or improves thereon, and who con- from to. from REFRIGERATION 0-100,000 BTU �- _ ,_ PLUMBING $• - ISSUANCE--$- _ tracts such projects with a contractor(s) •ilcesned-pursuant• the Contractor'$ License Law). SYSTEM - 100,0004+ BTU PLAN CHECK $ +❑ I am exempt under Section - - _ _ -B.'& P.'C.'for this BOILERS BTV ELECTRICAL' $ $ ------- -- (reason' -- - - - _ )Date - Owner - -- . . . _ SYSTEM REPAIR, ALTERATION T { PLAN CHECK-$ MICROFILM $- TOTAL FEE $ '1 herebycertif tha read this a I d state that the above Y pp � EXHAUST SYSTEM MULTIPLE MECHANICAL $� information is ect. agree t ply, w i all city and county -PLANCHECK $ VANCE-PC $_ ordinances stat I s relati const! n, and hereby authorize , represent es p s ci o en on 'the above mentioned propert for, ect11 u - 5-1 �, h^ J-8 5ignat Drivers ense or SS ISSUE FEE �• _ FINAL FEE $ CMF-0865-46 White-Building; Canary- licant; Pink-Accounting; Goldenrod-Assessor a � i CONSTRUCTIOAND PLANNING N Date APPROVALS Permit # � \=;t Inspector I FOOL & SPA' . ' APPROVALS Permit 5f- Date Inspector I. Temporary Electrical Service or Pole 43, Pool &Equipment Location 2. SoilPipe-Undrgrn 44• Steel Reinforcement J. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing.& Pressure Test 6. Electrical LIFER Grn _ '� 48. APPROVAL TO COVER-GUNITE=- -'c • - "-`-' ,,- . 7. Footings 49. Electrical Conduit-Undr rrt 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test .., 9.- -Water Pipe-Undrgrn - 51. Backwash Lines P-Tra' - ndr rn.- ' 10. Structural Floor System 52. .APPROVAL TO DECK_ 11. -Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection - .. 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit :56., Electrical -Final - 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 16. 19. -20. Ducts, Ventilating Gas Pipe -Rough &Test Roof framing 60.. POOL/SPA SYSTEMS FINAL 21. 221• Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power -Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Fina! Gas Pipe -Test s 31. Final Plumbing 32. Water Service+inal 33. Gas Service -Final 34, Solar Domestic -Final 35, Landscape Sprinkling System 36,) !Sound Attenuation 37, Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison 1 <_ 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY NoDate Applicant to fill In all Space$ within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA iT TRACT NO. LOT NO. -BLDG. NO. 3573 7/21./82 51.0,00 [_F_� CONSTRUCTION PERMIT I Q ri' Project Address 1 Airway, Costa Mesa CA TYPE OF CONSTRUCTION Owner .7M CnmpanW Phone 540-260 ❑ NEW 0 ADD ❑ ALTERATION Q Address 3151 Airway,Costa Mesa,' CA 92626 -❑ REPAIR C1 CONVERSION ❑DEMOLISH �f f J ❑ OTHER ZONING REGULATIONS Arch/Eng. License No. 1DESCRIPTION OF WORK A.P. Address ZONE PLNG. REF. -P Contractor Leaverton-Beck, Inc. Phone 979-356 TYPE OF PERMIT �Rpp ��pplLIG Address 16721 Hale Ave. Irvine CA 92714 ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBAC T . 1 YARD Oggtt��IPERTPNE LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under of Charter 9 (com- C1 TENANT 13 ELECTRICAL aLUMBING ❑MECHANICA WII E YRD provisions mencing with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code, and my license is in full force and effect. REAR YARD (TO P/L) + C36 191969 PROJECT DESCRIPTION License ass nse No. PKG. SPACE REQ. PROVIDED 2 �� SQ,FT • SQ - Date Signature STREET WIDTH PARK FEE S WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTfON TYPE 'I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800 Lab. C.}. GRADING CU. YDS. ACRES SPECIAL CONDITIONS: PolicyNo.�3092d�1 Company Great American - ❑ Certified copy is hereby furnished. REMARKS:-- 1 ified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION jl"' ` !This section need not be completed if the permit is for one hundred J,- - - - - ', ,,,T00) or lessi. rtify that n the performance of the work for which this permit Is Od, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws of California. Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0.1 KW1-1D KW Io the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10.50 KW_50 + KW revoked, CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1.10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. -SOLAR) 10.50 HP 50 + HP formance of the work for which this permit Is Issued (Section 3097 Civ. C.). Lender's Name FLOOR SINKS FLOOR DRAINS JC(% FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLAIWFIERS POLE LIGHTS ' I hereby affirm that I am exempt from.the Contractor's License Law for SWIMMING POOL PTRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Cade: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to Its Issuance, also re- quire$ the applicant for. such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of .the WATER HEATERS BTU OUTPUT Business and Profession$ Code) or that he is exempt therefrom and the basis for the alleged exemption. Any -violation of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)- SOLAR TANK COLLECTORS 0 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 SOLAR PIPING SYS. % ' (� �L_0 ISSUE FEE %pffered for safe. (Section 7044, Business and Professions Code: The d'".factor's License Law does not apply to an owner of-aproperty ISSUE FEE 1-0 APPLICATION APPROVED BY DATE s,,buElds or improves thereon, and who does Such work himself or 1` ugh his own -employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement IS sold within one year of completion, the owner will have the burden - , of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING , PERMIT 5 SMIP S ❑ I, as owner of the property,am exclusive! contracting with Y AND DUCTING licensed contractors to construct the {Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT s Lice and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's license Law}, 100,000 + BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ - $- reason PLAN CHECK $ MIC ROFI LM 'S Date Owner - SYSTEM REPAIR, ALTERATION - - TOTAL FEE $ MECHANICAL $ • 1 hereby certify that I have read this application and state that the above EXHAUST.SYSTEM MULTIPLE -. LESS AD- Information IS correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction, and hereby authorize representatives 9q this city ent up n the above mentioned - propert r ection p $e f Z FINAL FEE $ Signet a Drivers' License or SS 0 ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING_POOL APPROVALS Permit # Date Inspector & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7, Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrorn 10. Structural Floor System 52, APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing (( - JL7 �55- Plumbing System - Final 14. Rough Electric -Conduit + 56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning . ' Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19'. Gas Pipe -Rough &Test 20, Roof Framing 21. Roof Sheathing NOTES. 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing - 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar'Domestic-Final 35. Landscape S rinklin S stem ' 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed t 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date t Applicant to fill In all spaces within heavy border lines and sign all appropriate declaration%.. CITY OF COS* ME$A PE IT NO• TRAGI NO. LOT NO. BLDG. NO, CONSTRUCTION PERMIT Q Project Address -4153 Ai rura Costa bae--a TYPE OF CONSTRUCTION�. - - 6_7.71 I�/13/BI 6.00 owner'Phone _ � NEW Cl ADD El ALTERATION - Address ❑ REPAIR ❑ CONVERSION ❑DFmOLIS1i ❑ OTHER ZONING REGULATIONS Arch/Eng. License No. DESCRIPTION OF WORK A.P. rp Address ZONE PLNTG.. REF..p� Contractor — Phon — TYPE OF PERMIT BUILDING - Address ❑ GRADING ❑ FOUNDATION ❑ STRUCTURALtPKG. SETBAc C sT. DE YARD PROHP'lF3'TY LANE LICENSED CONTRACTOR DECL RATION I hereby affirm that I am licensed under Of Charter 9 (Com- ❑ TENANT ❑ £LECTRICALLUMBlNG ❑MECHANICRD DFFE YA provisions mgncing with section 7000) of Division 3 of the Business and ❑ OTHER GHT PrOfesslons Code, and my Ilcense IS In full force and effect. AR YARD (TO P/L) PROJECT DESCRIPTION License Clad License No.� SPACE REQ. PROVIDED DateSQ. FT. REET WIDTH PARK FEE S WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a Certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation insurance, Or a certified -copy r thtireof (S9ctlooft8W Lab. C.). 7p�i National rY�L�L1lVq�i GRADING CU. YOS• ACRES SPECIAL CON DfTIONS: Policy No. Company"" ertlfled copyIs hereby turnisned. REMARKS:ertified copy Is filed with the city Building Division- PC MPTION FROM WORKERS' COMPENSATION DECLARATION 11 (This Section need not be completed If the permit 15 for one hundred _ 00 or less.that�. _ . h ermit Is for iso I '`�tlf shall themploy any persperformance on n any manerwork as{to b come S eU to the Workers. Compensation Laws of California, PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK - Date Signature BATHTUBS SHOWERS' CAMAGE SO- f NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with Such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE' 10-50 KW..; -50 + KW revoked. _ CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hareby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP 50 + HP - formance of the work for which this permit Is issued (Section 3097 Civ. C.). - Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES' •- OUTLETS - SWITCHES Ler+der'sAddress DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP Any city or County which requires a permit to Construct, alter, POLES METERED SUB - - WATER SERVICE ALTERATION - - PANELS - MAIN - SUB improve, dem011Sh'or repair any structure, prior to Its Issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provision$ of'thd Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - Business and Pfofesslons Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Sectlon 7091,5 by SEWER CONNECTIONS -" any applicant for a permit subjects the applicant to a civil penalty of riot more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ 1, as owner of trip property, or my employees withwages as their $ola compensation, will do the work, and the structure is not Intended ISSUE ISSUE FEE of Offered for sate. (Section 7044, Business and Professions Code; The 'ractor'S License Law does nOt apply t0 an Owner of a property - ISSUE FEE AP APPLICATION APPROVED BY GATE builds or Improves thereon, and who does such work himself or agh his own employees, provided that such Improvements aro not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for Sale, it, however, the building or improvement Is sold within one year of completion, the owner will have the burden of proving he did not build Or Improve for the purpose of sale). HEATING SYSTEM 0.100,000 BTU BUILDING PERMIT $ - SMIP S ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S — - PERMIT and Professions Code: The Contractor's Ucense Law does not apply to ISSUANCE S an owner of property who builds Or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING S tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - - - GRADING S the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑ 1 am exempt under Section B. 8•P, C. for this BOILERS BTU ELECTRICAL $ $ reason - PLAN CHECK- E MICROFILM S-------- Date � - Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ 1 hereby certify that I have road this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD- Information is correct. I agree to comply with all City and county PLAN CHECK $ VANCE PC S _ ordinances and State laws relating t construction, and hereby authorize repreS¢ntatives f this city t enjer .Pon the above mentioned property or ,s ection •purp s• / Signature_ � �� FINAL FEE S ` DNvers' License Or SS ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod-ASsessor TL; CONSTRUCTION AND PLANNIN APPROVALS '.%,\�.!\;; IPe'rniit3# - Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2.SoifPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility•Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit -56. Electrical-Final 15. Rough Electric-Wiring - - 57. Solar System-Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOLISPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test 20. ' Roof Framing 21. Rpof Sheathin NOTES. 22. Frame and Flashing 23. fntulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29, Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing _-i 32. Water Service-Final 33, Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY Na Date a wL. P� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA NO. TRACT NO. LOT NO. BL9NO.CONSTRUCTION FPERMIT PERMIT �� ,�-7q� 3q (� d't i�'' 9/C�'16, 7GrProject Address 5 — Alrwd Avenue Costa Mes TYPE OF CONSTRUCTION aIn Check #51442 Owner Phone V NEW ❑ ADO ❑ ALTERATIAddress ch" ❑ REPAIR ❑CONVERSION ❑D Arch/Eng.Hales— Langton License No. C-010899 ❑ OTHER ZONING REGULATIONS Address Ca. DESCRIPTION OF WORK A. P. — 0 Office Condominiums r ZONE L PLNG. REF. 'PZE 7 - [3d Contractor Donald Olson Com 540-260 TYPE OF PERMIT 'rr ggU�J1L pING PROPERTY Address Costa Mesa ❑GRADING ❑ FOUNDATION p1 STRUCTURAL SET AC 1 YARD r LINE 2( C2. ed LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed Charter 9 ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC S E [ �t�U under provisions of (com- moncing with section 7000) of Division 3 of the Business and ❑ OTHER RIIGHT Professions Code, and my license I$ In full force and effect- REAR YARD (TO P/L) R 33396.o PROJECT DESCRIPTION 1 ie Class License No. i.....-'_. 6499 PKG. SPACE REO, PROVIDED O D__- Signature WORKERS' COMPENSATION DECLARATION Sq. FT. OCCUPANCY +CONSTRUCTION TYPE — STREET WIDTH PARK FEE $ I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION 15 7b7 ZONE ZONING APPROVED BY DAT �� certificate of Workers' Compensation Insurance, or a certified copy •`+reof (Sestl�yl3'H o -MI � c'. Fairmont InsuranC �� 77 l V V GRADING CU. YDS. ACRES SPECIAL CONDITIONS: :y No. 1 11'`tf CompanytIQ i.l VfENTQ ertified copy is hereby furnished. REMARKS: Gf ALA �kertifled Copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section need not be completed if the permit i5 for one huntlred ('100t?for leu). tt cery that in the performance of the work for which this permit is issued, 1 shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject t0 the Workers Compensation Laws of California. DateSignature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs APPLIANCE 10.50 KW�50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP I hereby affirm that there Is a construction•iending agency .for the per. SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP_ 50 + HP formance'of1the work for•which this permit IS issued (Section%3097 Civ. C.). ute Lender's Name c. rn Pacific Financial Corp::..- FLOOR SINKS FLOOR DRAINS , FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS ebyy affirm that I am exempt from.the Contractor's License Law for lollowing reason (Section 7031.5 Business antl Professions Code: city or County which requires a permit to Construct, alter, SWIMMING POOL P TRAP POLES METERED SUB improve, demolish or repair any Structure, prior to Its issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for -such permit to file a signed Statement that he is licensed pursuant to the provisions of the Contractor's License Law 9GAS 9 (commencing with Section 7000) of Division 3 of the SERVICE OUTLETS SERVICE AMP ,haptor '^ess and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT b or the alleged exemption. Any violation Of Section 7031.5 by a pplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS " of ...it more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work; and the structure Is not Intended or offered for sate. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE " Contractor's License Law does not apply to an owner of a propertyb/ who builds or improve$ thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE through his 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 will have the burden MECHANICAL PLAN CHECK SUMMARY OF FEES of proving he did _not build or improve for the purpose of sale), El SYSTEM 0-100,000 BTU BUILDING 33.00 PERMIT s SMIP E 15.10 I, as owner of the property, am exclusively contracting with 1, licensed contractors t0 construct the plOjeCt (Section 7044, Business AND DUCTI10,000 + TU - NG 0 B PLAN CHECK $ ' PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE s an owner of property who builds or Improve$ thereon, and who con. REFRIGERATION 0-100,000 BTU PLUMBING s tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING S the Contractor's License Law). 100,000 + BTU PLAN CHECK E ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ s reason SYSTEM REPAIR, ALTERATION PLANCHECK $ MICROFILM 5 O Date Owner MECHANICAL $ TOTAL FEE s i hereby certify that I have react this application and State that the above EXHAUST SYSTEM MULTIPLE LESS AD - Information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC s ordinances and sta ws relating to construction, and hereby authorl4e re pre s citYy t enter u the above mentioned property r �y1r Signature G� 6 7A 7r1 FINAL FEE yJ�� lU.� Drivers' License or SS 91k ISSUE FEE -- CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor __ CONSTRUCTION AND PLANNING APPROVALS Permit # JI Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe n rgrn 44. Steel Reinforcement 3. Electrical Mnduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings �] 1p , y �,.'3 1 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.❑ Undrgrn 10. Structural Floor System 52. _APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 14, Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-Wiring - 57. Solar,System-Final 16. _ Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts in Structure . APPROVED.FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashin 5.3» 8 NOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 's -Lc!.. 26. Piaster Brown Coat 27, Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation -" 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No:_ Date PROJECT ADDRESS: 3151 AIRWAY AV UNIT: Q OWNER'SNAME: CUSHMAN S WAKEFIELD OF CA ADDRESS: 2100 MAIN ST #100 IRVINE, CA 92714 (714)474-4004 ARCHIENGINEER: DARYL MALMBERG ASSO. REG -NO.: NONE ADDRESS: 2600 MICHELSON UNIT: IRVINE CA 92715 PERMITTEE: JOHNSTON C J I CHA (714)632-3462 ADDRESS: 1035 ARMONDO ST F ANAHEIM CA 92806 LICENSED CONTRACTOR DECLARATION: I hereby alfirm 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 lorce and effect, CITY LIC.: 051557 q STATE LIC.: 5 5192 C Date: WORKERS' CO PENSAfION DECLARATION: I hereby affirm that I lade a certificate 01 consent to sell•insllr a certificate of Workers' Compensation ynsprycq 4r A Wrtifi j Upy thereof (Section 380D, Lab. fll / 0 1 / g 1 P I LICY NO 1SA 1sT 1ATJJ 9E t3 7FU 7ND EXP, DATE: v 'OMPANy: Certified copy is hereby furnished. N Certified Copy is filed with the cityJuilding Divisi n. Date: 0 Applicant: EXEMPTION�AOM WO XR ERS' COMPENSATION DECLARATION: (This section d not be completed if She permit is for red J$1 00) or less). I certify that in the perfOrmance of the work for which this permit is issue , I shag not employ arty person in an nner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation previsions of the Labor Code. you must IortMnth comply with such provisions or this permit shall be deemed revoked. CONSTRD{TION LENDING AGENCY: I hereby affirm that there is a construction tending agency for the performance of the work for which this permit is issued (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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 t0 tire a signed statement that he/she is licensed pursuant to the provisioas of the Contractors' Slate License Law (Chapter 9 (commenting with Section 7000) of Division 3 of the Business and Prolessions Code) or that he/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 (5500), I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the 0 structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselflherse4 or through his or her own employees, provided that such improvements are not intended or oNered for safe. If, however the building or improvement is Sold within one year of completion, the owner will have the burden of proving he/she did not build or improve 'lor the purpose of sale). I, as owner of the property. am exclusively contracting with licensed contractors to construct the protect [Section 7044, Business ❑' and Prolessians Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a Contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. I am exempt under Section: B. & P. C. Irir this reason: Dale: Owner. I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that 1 or any lalure building occupant will/will not {cirtte one) need to comply with said state codes and the requirements for a permit for constrdctitirl Or modification from the Air Quality Management District. Residential construction applications are exempt Iron these provisions Date: Applicant: I hereby certify that I have read flus application and state that the above information is correct. I agree to comply with ail city and ordinances and state laws relating to building construction and hereby authpnze repo /nt/ta/ttiiives of this city to enter upon thea e•me property/ rinSpeclietri N 1 I9 d Driver's LicCnse or Social Security 1641.46 While—Building: Green—Code Enforcement. Canary—Applicant; Pink—Revenue; Goldenrod --Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05039 PERMIT NO: B 050399 PLAN CHECK NO: 07140-90 A GOVT: N SUPP: N CONSTRUCTION TYPE: 5—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION COMMERCIAL T.I. (OFFICES) SQ FT: 6,000 CLAIM VALUE: 6,000.00 CALL—VALUE: 6,000.00 GROUP OCC: B-2 / COMMENTS: "HAPPY HOLIDAYS!" FROM COSTA MESA ►E��N�►E��-�•�•��•�•�-��-��•��•�•�•ic-�•ic-ic-ic•�•*�c•�•��*��►T�•►T�-�-��-�•�--��I�N�-��•��-�r�•��I�+E��-�•�-�r•��T+� Z 0 N I N GS E R T E B Q A U C I K R S E M E N T S — MAIN BUILDING ----------- --------- ACCESSORY BUILDING --------- — -- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42729114 ZNE: CL REF NO: PLANNING N TES> TENANT IMPROVEMENT TO AN EX. 6500 INDUSTRIAL BLDG #F 3F TF 1E � 3F iE It 3F 3F TF iE � 3F #F TC 3F TF * 3F iE !f i(• iE iF iE #E iE 1E iF �(- #E iF #E iE iF TF #E 3F iF i(- iF iE iF iF iF iE 1E iF iF iF DE IF iF iF !E 1f iF iE t'F iE * 1R it TF 3F iE iF #E �(• 1E !f !f iF iF �• �F !E �F D E V E L O P M E N T S E R/ V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; - BUILDING APPROVED BY ; DATE: r APPLICATION ISSU Y. DATE:— _z_ iF iE � � aE iE• i(• it iE �E iE iE IE iE EE Et• EE �F Tt• •1( T(• i(- i`t• � !( tt iF iF �( it TF iF iF iF iF iF iF iF 1f !f 1f iF iF iF iE � iF iF iF iF iF iF iF iF iF �F iF iF iF �F �F iF �(• �F #t• iF iE iF iE it iF it .� TE #E #t• iE• �(• iF iE #E iE Et• �(• iF !E � TE 9f * }F �- �- iF 3E.�(• it � � iF !E t'F If t'F * .N. t'F t'F LEGALIZATION:N F E E U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING CTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 81.00 SMTP,/NON—RES PLAN 13,16 ,90 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> . 81.90 0.00 13,16 95.06 95.06 .00 REVENUE DIVISION TOTALS—> COLLECTED: 81.90 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 81.00 ,90 �F � iF iF iF iF � iF iF iF � iF 14 TE #E t'F iE iE iE iE t'F � iF �(• iF * iF j(• j(• j(• j(• iF TF j(• � T(• TE iE iE iE iE 14 iE iE iE i(• IF i(• i(• �E iE 3F 3F iE i4 �E IF 3F if iE iE iE )E i4 if iF TE aR �(• TE ?4 TE 1E � iF iF !(iF � I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 6000 ALTER BY VALUE COMMERCIAL NOZONE 1,00 6,000.00 END OF FEES CONSTRUCTION AND PLANNING- APPROVALS Permit # Date Inspector PG i SPA APPROVALS Permit # Date 1 Inspector 1, Temporary Electrical Service or•Pole 52. Pool & Equipment Location f 2. Soil Pipe-Urdrgrnd. 53. Steel Reinforcement 3. Elect�icaICCon'duit 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 - r i 58. Electrical Conduit-Undrgrnd, 8. Foundation t 59. Gas Pipe, ❑ Undrgrnd., Test i 9.7 -Water Pipe-Undrgrnd. , 60. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. Structural Floor System ;.i' '� 61. APPROVAL TO DECK f 11. Property Sewer Line & House Connection 62. Backwash &Receptor -Final 1.2. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains J 64. Plumbing System - Final 14, Rough Plumbing 65. Elettrical•Final , 15. Rough Electrical -Conduit :t , , r 66. Solar System Final 4 16. Rough Electric Wiring '' 67. Fencing & Access Approval v 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 APPROVALS ---Permit # _ 20r Rough Factory Fireplace S 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating } 71. Product'Piping ❑ Gas ❑ Oil 23: Gas Pipe -Rough & Test 72. Underground Flush _ t 24., Roof Framing �' 73: Undergrnd. Storage Tank 0 Gas ❑ Oil 25. Roof Sheathing Z, 747.Overhead'Hydro 26, T -Bar Ceiling IStructurall & Monocoat 75.' Dry Chemical 27. Frame and Fr,lashind L; _ f 76. Dry Standpipe 28. Lathing-& Stding:r - - 77. FIXED SYSTEM FINAL 429. Insulation r - �, 7B. FIRE PREV. FINAL 30, Drywall Nailing- �k` ,1 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat;' lJ „ 79.' FINAL INSPECTION 32. Electrical Power Meter-Final�' 1 '� - 80. -FOOD CERTIFICATE ISSUED 33.."Final Electric �,� j l` )votes: 34. Final Heating & Air. Conditioning 35.1.Final Gas Pipe -Test, 36: Hood or Canopy_ ! I ►� ; �` iUJ 37. Final Factory Fireplace 3B._ Final Plumbing- - 39. Water Service -Final E 40. Gas Service -Final 41. ---Solar Domestic -Finales I 42. Backflow Preventers ' 43. Backflow Irrigation 44. Landscape Irrigation System ..45. Sound Attenuation 46. Handicap Rsgulations 47. FINAL STRUCTURE & BUILDING {/ 48. FINAL PLANNING 49. Electric Release to Edison -50. Gas Release to Southern California Gas Co i t i- 51. CERTIFICATE OF OCCUPANCY No Date ,kORCf ADDRESS: 3151 AIRWAY AV UNIT: Q OWNER'S NAME: CUSHMAN 6 WAKEFIELD OF CA ADDRESS: 2100 MAIN ST #1'100 IRVINE, CA 92714 (714)474-4004 ARCHIEN ADORE DARYL MALMB ERG ASSO , REG.ND.: NO q9: ADDRESS: 2600 MICHELSON PERMITTEE: IRVINE CA 92715 ADOREss: JANNING ELECTRIC INC. ( 714) 8309668 23141 LA CADENA LAGUNA HILLS CA 92653 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with section 7000) o1 Division 3 of the Business and Professions Code, and my license is in full force and effect. CITY LIC.: 052109 STATE LIC.: 5 3 7 2 7 cLAss: C Date: ��1A Signature: _ WORKERS' COMPENSATION DECLARATION: Ii a t I have a certificate o sent to seli-insure or a certificate of Workers' Compensation Insurance, at a certified copy thereof (Section 800, Lab. C). 'DLICY No.: WC N 8 0 015 0 3 6 EXP. DATE: 02/01/91. COMPANY: FAIRMONT W Certified copy is hereby furnished. ElCertified copy is filed with the city Building Division. I Date: - `S - a t Applican� EXEMPTION FROM WORKERS' COMPENSATION OECLARA1f is section need not be compleled'd the permit is lot one hundred (SIOC) 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. Date: Signature: NOTICE: It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must Ionhwith comply with such provisions or this permit shall be deemed revoked, 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 (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city at 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 helshe is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 7 structure is not intended or offered tot sale (Section 7044, Business and Professional Code: The Contractors' State 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 employees, provided that such improvements are not intended or offered lot sale. If, however the building or improvement is sold within one year of completion- the owner will have the burden of proving he/she did not build or improve for the purpose of sale). I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7D44, Business Eland Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who Contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: f do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant wiNwill not (circle ane) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state lava relaling to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property lar inspection purposes. Dale: _,=151 " `ti Signature` �1* Driver's License or Social Security P. 1641-46 White—Building; Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: E 050539 PLAN CHECK NO: N CONSTRUCTION TYPE: 5-N PERMIT TYPE: ELE JOB DESCRIPTION : COMMERCIAL T.I. (OFFICES) CLAIM VALUE: CALC-VALUE: PERM NO: E 05053 GOVT: N SUPP: N PURPOSE: ALT SQ'FT: GROUP OCC: B-2 / COMMENTS: REF B50399 iE iii• it iE �E �E � �• -IE �E iF dF � � * iF it• ii• � iF �E �E •lE it• it• it• it• it• it• it• #E iF it• �E -1F it• it• it• �E +E iF it• �E iF it• iF # iF �E iF 9(• 9(• ,x #E +E * +E f(• IF •}(• !<• iE 3k •lE iE �[ �E iE �E * � it ![ � iii• iE � it � Z O N I N G S E T B A C K. S R E Q U I R E M. E N T S --- MAIN 'BUILDING ----------- ----------- ACCESSORY BUILDING ------ - FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729114 ZNE: , REF NO: PLANNING NOTES> > •lE •lE � �E •lE •lE � •lE if• if• * if• iIif• iIif• �E if• �- � 9E -IE -IE �E'lE'lE iE -IE �E ir; it•'lE'lE �E -IE * iE -IE it -IE -IE iE � �E �E �E iF * �E �E IF * •lE 9E'lE'lE �E if• �(• �- !E �b ir; 9(• iE if• if• � � if• iF �E iE df iE �4 �E � � D E V E L O P M E N T S E•R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY• r DATE,• -IE iE IE �E iF -IE iE �E iE �E if• if EE iF * if• �- * �- if• !E * iE ib �F if• if• if• �- �E -1F �E �E �E � �E � � iE iE iE �E -IE iE �E iE � iE iF � -lf -1F 3F 1F iE 3F �E 3F iE •1f �F � •1F ik �I• !E 3f•'r4• �f• #E �E •1E •1E �E �E iE �(- �E •1E � •lE iE �E fE �E iE iE iE � �E -IE iE -IE it• � �e iE �E iF �E LEGALIZATION:N F E EI U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECT IC MECHANIC FIRE SMIP/RES GRADING PERMIT 4 .75 50% SMIP/NON-RES PLAN ISSUE FEE 15.00 BUILDING -•DIV->' PERMIT ISSUE LAN -CHECK TOTAL PAID DUE TOTALS-----> ' 4 2.75 15.00 0.00 57.75 57.75 1.00 REVENUE DIVISION TOTALS--> COLLECTED: 57.75 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 57.75 �i- if• * iE 9E iE 3E .�. BE iE >E � � iE -IE �E dF iE � � iE •1E -1F -1F �E dF dF iE � if * iE -1F iF iF � -IE iE iE iE iF iE iF � � -IE iE i4 if• � � i4 � iE iE iE iE � iE iF �[• � �E � fE iE * iE it• it• * 3+: EF � * iE iE �E •1E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 27 FIXTURES LIGHTING 1 ST 20 EA, ,75 20.25 ELE 22 RECEPT/OQTLET 1 ST 20 EA. .75 16,50 ELE 8 RECEPT/SWITCH 1 ST 20 EA, ,75 6,00 END OF FEES 01 GOL7770C-00107"�702z 1'0- .5 7 DATE: Ot/.09/91 LK -WL CONSTRUCTION AND PLANNING APPROVALS _Permit # Date Inspector f - & SPA 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 71, Footings r. 58. Electrical Conduit Undrgrnd. 8, .Foundation r 59. Gas Pipe, ❑ Undrgrnd•, Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 Ele'ctrieal•Conduit I 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 APPRQVALS' Permit # - 20, Rough Factory Fireplace 21 . `Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating Y 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground. Flush - 24. Roof Framing ' 73. Undergrnd, Storage'Tank 0 Gas ❑ Oil ' 25. Roof Sheathing - - y r 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat - 75. -Dry Chemical 27. Frame and Flashing l 76. Dry Standpipe 28. Lathing & Siding .. i 77. FIXED SYSTEM FINAL •29. Insulation 7B. -FIRE PREY, FINAL a 30. Drywall Nailing E t HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 9.'FINAL INSPECTION 32. Electrical Power Meter -Final ,, ! I E 80. FOOD CERTIFICATE ISSUED 33. Final Electric, Jjlql 117, Notes: ; 34. Final Heating & Air Conditioning I _ , 35. Final Gas Pipe -Test - 36. Hood or Canopy I �. !i 37. Final Factory Fireplace I I I 38. Final Plumbing 39. Water Service -Final - i ) 40. Gas Service -Final ' 41. Solar Domestic -Final 42. Backflow Preventer' f , 43. Backflow Irrigation 44. Landscape Irrigation System - 45. Sound Attenuation 46, Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING f` . 49, Electric Release to Edison I ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ! ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 2176 6/13/84 A; PP.. %r1 TI ' CITY"OF COSTA MESA PERMIT NO. TRACT NO. LDT D. i3LDNo.- - - -• �- - - - . CONMOCTION PERMIT Project Address 3151 AirwaYAve. Costa. Resia TYPE OF CONSTRUCTION A NEW 1 1 .ADD I_ALTERATION- REPAIR • ` 3151 Airway -Ave. E-1 C.M. ❑ CONVERSION ❑ DEMOLISH ❑ OTHER P. ._ Zone A Applicant's Mailing Address e ten nt. 1 r ment Owner's -GUlldhouse CQnSUIt�ant.S _Phone, 54O_2606 DESCRIPTION OF WORK S Main Building: Accessory Building: Z _Name O Address; 3151 Airway AVe., I -Z s Costa MESA -- TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front N Maeo Nardi d. License No. _C•-6291 ArchlEn tt g. -- ®TENANT ❑ELECTRICAL ❑ PLUML3ING� El B. + :I' - 926 n'& Ciaunfr %- Orange_ OTHER A Rear N Address{ .10 _E1 - Right .G �) COntrecfor's Name -1- 0final d -Ol son `Phone' 540 26 6 PROJECT DESCRIPTION SQ. FT. 6499OCCUPANCY - K ' 3151 Ai rwd A+Je _ F-1 COStd P_5d Address,{mailing}-_�-��( s CONSTRUCTION TYPE VALUATION $ g Left, E Q + a City -License No. r ZONE GRADING CU.YDS. ACRES ' I Pln . fief, # g Park. Fees $ Q I 1 LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided _ U ! herei.by affirm that [, am licensed under provisions of Charter 9 (commencing' - . wltl+ section 7000) of Division 3 of the Business and Professions Code, and' ' Use of 8uiWing: ':E my Iicense,is in full f ce and effect. q� D I 333969 License Class ens N _ PLUMBING FEES Planning' Notes: _ Dat e+ 6113184 signature 11 1A E 1 ' • NSATIpN Bar Sink 4 Bar Showers ,T WORKERs_TrTCOT LA- hereby affirm that I have a certificate of consent to self -insure or a certificate Backflow Preventer Seivice Sink' Workers' Compensation Insurance, or a certified copy thereof (Section 800, Lab, c.y []7 i I•;. ' + Uiii rmont Backflow Irrigation 9 Sewer Ca C� p • s ELECTRICAL .%' FEES +! - Policy Ni. .277 Company copy'is hereby furnished. Bathtubs f $ewer Connection Automatic Washer Transformer El 15.50.KW 1�Certified ( Cortlf �j, 4r� �,s filed with the city Bui g DJXL Clarifiers �. Solar Collectors,` Construction Pole'`Sub. ❑ 50 -KW Date/ 1,�0� Applicant _ EXEMPTION FROM WORKERS' COMPENSATION ECLARAT N - (This section need not be completed if the permit Is for one hundr ($100) or _ _ 1 Dishwasher _- _ - -. 'Solar Piping- - Cooking Unit' -" . Meter ❑Up to •i 00 amps' less). . , I certify that performance of the work for which this permit is Issuetl,•I- ! Drinking Founiajris ( - + solar Tank �i Dishwasher "" 'Meter ❑over, 100 ampsl I r r ,in'the shall not employ any person In any manner so,as'to become subject to the Workers't Compensation Laws of Calitornia. Floor Drains' swimming Pool 'W/Spa ' Dryers ❑Gas, Electric , 'Sub Panel f• _ Date Signature NOTICE: if, after making this declaration, you should become subject to the FIOOr Sinks ' ' i 1 Urinal - ` - CD Farr Motors ID 0-1 HP ❑1'A - 8 l �_ Workers' -Compensation provisions of -the Labor Code, you must forthwith - ' , comply ,with such provisions or this ,permit shall be deemed revoked. Gas Service Outlets 3 Water Closet, t 'F.A.U. Inc. El 9-15 HP C3 16-15+ CONSTRUCTION, LENDING AGENCY, ) - I hereby affirm that there is a construction lending agency for the performance Interceptors , Water Heater i Fixtures ! _ Microwave I of the work for whieh/Rhis permit is,issued ,(Section 3097 Civ, C.) 11I Ilii - Lender's Name - Kitchen Sink Water Service �Dvice Boxes Pole Lig Lender's 'Address OWNER BUILDER DECLARATION •- - - .2 Lavatories r Outlets s Range r I hereby affirm that ( am exempt from the Contractor's License Law for the I P -Trap following reason (Section 7031.5 -Business and Professional Code: Any city or - - s Switches Sign 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 .Roof Drains - l r' / =•t Garbage Disposal Standing Sections Ito file a•signed statement.that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of : ' Generator E10-5 KW ❑5 15 KW Trash Compactor .rAvlsion 3 of the Business and Professions Code) -or that he/she .is exempt 'erefrom and the basis for the alleged exemption. Any violation of Section - 1 131:5 by any applicant for a' permit subjects the- applicant to a civil ,malty of not more than five hundred dollars ($500). Reins ction.Fee Pe $25, Issue Fee $ 3 _ ❑ I, owner of the property or Amy employees with wages a5 their sole Reinspection Fee p $25 Issue Fee t $ 3 n compensation, will do the work, and the structure is not Intended or offered � MECHANICAL -- � FEES for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to'an'owner of a property who builds or Improves Boiler - Hood or Type [ ❑ r - - PUBLIC SERVICES RE�UI MENT thereon, and 'who does such work himself/herself or through his or her own - t - Canopy Type I I ❑ - Zoning Approved By _ - Date employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- Duct -Under Ground Application Approved By pletion, the owner. wit[ have *the burden of proving he/she did not build or im-•'- rove for the purpose of sale). Duct - Structural Refrigeration System Application -Issued By. ¢ Data 3 I, as owner of the property, am exclusively contracting with licensed con- tractorstoconstruct the project (Section 7044, Business and Professions Code-. Duct - Ventilating ❑0 100,000 eTU ❑100,000 BTU �r r' ^T r-,-- - SUMMARY OF FEES -The Contractor's License -Law does -not apply.to an owner of property who builds or improves thereon, and who contracts for such projects with a ton- , Exhaust System ❑ Multiple ❑ _ - _ - _ System Repair/Alteration - BUILDING.PERMIT i 5 ��'Z-_-�� SMIP $ tractor(s) license pursuant to the Contractor's License Law). PLAN C)1ECK �>b $ PERMIT ' ❑ I am�exenipt under Section B. & P. C. for this reason Firepl/Fact. Blt. ICBO .•rte 1 Z(, (� ISSUANCE $ PLUMB.ING S Date Owner: ' Heating System & Ducting ' PLAN CHECK $ 4',S�• ENERGY P.C. $ I I hereby certify that I have read this application and state that the above ❑0.100,000 BTU ❑100,000BT ELECTRICAL $ GRADING $ ' information is correct: I -agree to comply with all city and -county ordinances and, state laws relating to building construction, and 'hereby authorize repre- - _ PLAN CHECK { $ l MICROFILM $ city t ant the above-mentioned property for sentatives ofAPI , i inspectldn puS. 6113/84 Date_ MECHANICAL $ TOTAL FEE $ Signature Driders"Lice SS I I Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ i ) CMF 0865-46 rev. 7/83 White -Building; Canary - Applicant; Pink -'Accounting; Goldenrod.- Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # �C6 Date Inspector POOL SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2: Soil Pipe Undrgrnd. CZ9 53. Steel Reinforcement 3. F`ectrical Conduit Utility-Undrgrnd. • ' 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. , 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd.,, (yl��l�1� (,,i•o 60. Backwash Lines, P -Trap, ❑ 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test- - 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. %hoof -Sheathing 74, Overhead Hydra 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemicai 27. Frame and Flashing _ $i i!Cr A 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREY. FINAL 30. Drywall Nailing b rc HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: (,1191e,( 'tot Orwoy, LF4 34. Final Heating & Air Conditioning r 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace �s 38. Final Plumbing f (� 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42, Backflow Preventer i 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations 47. FINAL STRUCTURE &•BUILDING 3 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, �8l Date �T d Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations," 'CIT'Y'OF COSTA MESA CONSTRUCTION PERM PERMINO. TRACT NO. LOT NO. UNIT NO. Backflow Preventer Project Address ATP,/ Automatic Washer - 1 Construction Pole Sub. Transformer 15-50 KW - — - 0 50 + KW Backflow Irrigation Sewer Cap Bathtubs Cooking Unit . Meter ❑up to 100 amps /� YjL7/�VIYPE OF CONSTRUCTION NEW LJ AD_DT,�RATION LJ REPAIR Applicant's Mailing Address�Zjj, :37 D0 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER r( A.P. # Owner's Name V Phone l �� DESCRIPTION OF WORK/USE OF BLDG. Dryers ❑Gas ❑Electric Main Building: Address Solar Tank � FanMotors Arch/Eng. License No, TYPE OF PERMIT GRADING FOUNDATIOOjN�( ❑ STRUCTURAL T Front F,A.U, ❑ TENANT ❑ ELECTRICAL ❑PLUMBING JL!„I MECHANICAL B Rear Address Contractor's Nam �'�k Phone tJ��5 ❑ OTHER / C Gas Service Outlets Right �. PROJECT DESCRIPTION SQ. FT. OCCUPANCY Pole Light Interceptors, Water Heater Address (mailing) r 27kZ6 CONSTRUCTION TYPE VALUATION $ S Left City License No. ZONE GRADING CU.YDS. .ACRES P Ref. # LICENSED CONTRACTOR DECLARATION Lavatories I hereby affirm that I am licensed under provisions of Charter 9 (commencing �1 yy Remarks: o �+7 , Z Ianng. Planning Notes: with section 7000) of Division 3 of the Business and Professions Code, and my license is in u{f fp C effect, License las r �7 Date Signature WORKERS' COMPENSATION DECLARA N ,hereby affirm that I have a certificate of consent to self -insure or a certificate If Workers' Compensation Insurance„or-a certified, copy. thereof_(Section 3800, Lab. C.) o 'cy No- Company ertified copy is hereby furnished. 'Cert�1-t7�ed y is filed with the city B 1$0 Dale •�'� Applica EXEMPTION FROM WORKERs''C N ESA N D cLAR ION ed not be (This section necompleted if the permit is for one,h dred ($100) or less). I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to,the Workers' Compensation Laws of California.' , Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith - comply with such provision$ or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name , Lender's Address . OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is Licensed pursuant to the provisions df the Contractor's License Law (Chapter 9(commencing with Sectinn 7000) of Division 3 of the Business and Professions Code) or that he/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 enalty of not more than five hundred dollars ($500). 1, 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 of, for sale (Section 7044, Business and Professional Cade: The Contractor's 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 , employees, provided that such improvements are not Intended or offered for safe. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale), I,,as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for -such projects with a con- , troctor(s) license pursuant'to'the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner, I hereby certify that I have read this application and state that the above Information is correct, ,I agree to comply with ail city and county ordinances and state laws relating t - ildin nstruction, and hereby authorize repre- sentatives of this cit ent p'on he above-mentioned property - for Inspection pu Signature to/ Drivers' Li ens° S jr '4965 7/27/54 =.e Accessory Building: ' Parking Req.YProvided Z O N ' I N G R E 4 M T S. CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING FEES ELECTRICAL FEES Bar Sink Showers Backflow Preventer Service Sink - Automatic Washer - 1 Construction Pole Sub. Transformer 15-50 KW - — - 0 50 + KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit . Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter ❑over 100 amps Dishwasher = Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank FanMotors 00 1 HP O1 % 8 Floor Drains Swimming Pool w/Spa F,A.U, Inc. Solar El 9-15 HP 016-15+ Floor Sinks - Urinal - .-- Fixtures Microwave - Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors, Water Heater Outlets Range I Kitchen Sink Water Service Switches Sign Lavatories Garbage Disposal 'Standing Sections P—Trap' Generator 00-5 KW 1:15-15 KW Trash Compactor Roof Drains I Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES SERVICES REQUIREMENTS: Zoning Zoning Approved By Date Building Approved By Date Application Issued By. Dat Boiler Hood or Type I El Canopy Type I I ❑ Duct - Under Ground Duct - Structural Refrigeration System ❑x-100,000 BTU 0100,000BTU i 00 4ffbuct - Ventilating BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK .25% SUMMARY OF FEES --- $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ GRADING $ $ , $ MICROFILM $ $ 32- 00 TOTAL FEE $ _-'-_i- 2_ $ -7. 2-�5- Exhaust System ❑ Multiple 0 System Repair/Alteration Firep1lFact.Blt.IG60# SL.Lf 75aa Heating System & Ducting 00-100,000 BTU 11100,000BT Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING APPROVALS Permit Date Inspector POOk- a SPA 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. Electiical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITF 7., Footings 58, Electrical Conduit-Undrgrnd. '. 8. Foundation 59. Gas Pipe, D Undrgrnd., Test 9.- Water Pipe-Undrgrnd. j 60. Backwash Lines, P -Trap, D Undrgrnd. 10. Structural Flgor 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 1$, Rough ElectricalT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20: Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑ Gas D Oil 23, Gas Pipe -Rough & Test 72. Underground Flush ' 24. Roof Framing 73. Undergrnd. Storage Tank D Gas D 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: 1 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 �47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co c 51. CERTIFICATE OF OCCUPANCY. No{ Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ',ai'TY QF COSTA M/E-�S-A CONSTRUCTION PERMIT PE,(3MIT N.O• , TRACT NO. LOT NO. UNIT NO. Project Addre3s Applicant's Maiin Add Owner's Namey `, —Phon _a"-4 Addressj!7 Arch/Eng. — License No. Address " Contractor's Nam eL��- lE_Phone Address (mailing) City License_ No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, ar.Ld my license is In full ce and effect. , License CI ss No. Date — Signature WOR RS' OMPENSATION DE ARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate Of Workers'_, �ioy or a certified, �c�o�py th reot (Section 3800, Lab. l b '_C.1.J��_ C'.pir Policy No.Company,^ �rtified copy is hereby furnished. L7 Cer 'fie I with the city Buii Diviygp + DateCM Applicant—oo ��//�� J�•�^-�''' _EX EM ION F OM ORKERS' CONyYENSATION DECLARATION (This section need nat be completed if the permit is for one hundred ($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, Date Signature NOTICE: If, after making this declaration, you should become subject to the workers' Compensation provisions of the Labor Code, you must fortnwith comply with such ,provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/She Is licensed pursuant to the provisions of the Contractor's'License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the 13usiness and Professions Code) or that he/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 enalty of not more than five hundred dollars ($500). I, as owrier of the property or my employees with wages as their sale compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner,of a property who builds or improves thereon, and who Aocs such work himself/herself or through his or her own employees, provldeQ that such improvements are not intended or offered for sale. If, however, the building or improvement is said within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant'to'the Contractor'S License Law). I am aware that Proof Of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date _ Owner I hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentativeAcense city to a on S.helabove-mentionetl yrop rty for Inspection Signaturate Drivers'S 2524 6/20/84 717.65 TI, TYPE OF CONSTRUCTION 'L�NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. FEES Reinspection Fee $15 Issue Fee $ 3 A.P. # Zone Hood 0-r Type I ❑ Canopy Type II ❑ S Main Building: Accessary Building: TYPE OF PERMIT GRADING 11 FOUNDATION ID STRUCTURAL ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHAN4CAL [:],OTHER E T Front OF FEES BUILDING PERMIT S SMIP S PLAN CHECK $ PERMIT PLUMBING - $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P,C. S ELECTRICAL $4i `ti GRADING $ PLAN CHECK 50% S ZZ ,SS MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ Z O B A Rear N I PROJECT DESCRIPTION SQ, FT. OCCUPANCY CONSTRUCTION TYPE VALUATION g ZONE GRADING CU.YDS. ACRES C Right N S1 Left R Ping. Ref. # Parking Req./Provided E Remarks: L2 142 :7Planning Notes: O M T S. PLUMBING FEES Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50 + KW , Backflow Irrigation Sewer Ca 9 P Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher i Meter ®�er 100 amp s�Q a Dishwasher Solar Piping Dr ers Dryers ❑Gas ❑ElectricISub'Panel ' QQ Drinking Fountains Solar Tank Fan + Motors ❑0-1 HP /z 8 C� Floor Drains Swimming Pool w/Spa F,A;U. Inc. Solar ❑9:15 HP Ell 6 15+ Floor Sinks Urinal 57�Fixtures -Microwave r� Gas Service Outlets Water Closet Device Boxes Pale Light Interceptors, -Water HeaterL J'sOutlets Range a c( Kitchen Sink 'Water Service Switches Sign Lavatories Garbage Disposal 'Standing Suctions P --Trap Generator 00.5 KW El 5-15 KW Trash Compactor Roof Drains ' I- Reinspection Fee I ' $15 I I - Issue Fee I $ 3 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System E3 Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting E] 0-100,000 BTU ❑ 100,000 BT Reinspection Fee { $15 CMF 0865-46, rev, 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor MECHANICAL FEES Reinspection Fee $15 Issue Fee $ 3 Hood 0-r Type I ❑ Canopy Type II ❑ DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Application Issued By L 7"fA Dat Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTUSUMMARY OF FEES BUILDING PERMIT S SMIP S PLAN CHECK $ PERMIT PLUMBING - $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P,C. S ELECTRICAL $4i `ti GRADING $ PLAN CHECK 50% S ZZ ,SS MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ System Repair/Alteration Issue Fee $ 3 CONSTRUCTION* AND PLANNING Permit # 7tePOOL& Inspector SPAAPPROVALS APPROVALS PermitDate Inspector 1. Temporary Electrical Service or Poll 52. Pool & Equipment Location fir 2..Soil IPfp`e Undrgrnd. �o �� '� 53. Steel Reinforcement 3.:�lectrical ConduiUtility Undrgr,ndr t - L 54. Forms 4.. Electr'ical,Condui�Und grnd. (�Z 55. Electrical Bonding � 5 ;Stec l Reinforcement 56. Rough Plumbing & Pressure Test' r1i 6. ElectricalllFER,Grnd. 57. APPROVAL TO COVER-GUNITE -7,1Fo6tingst 1<1 "Y !/'f 58. Electrical Conduit-Undrgrnd, BFouridation 59. Gas Pipe, ❑ Undrgrnd., Test gt' Water Pipe-Undrgrnd. + i 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Ploor System 61. APPROVAL TO DECK 'r 11. Pr`�perty Sewer Line & House Co� ection '. �� 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof. Drains 64. Plumbing System - Final / 14. Rough Plumbingw� f 65. Electrical -Final 15. Rough Electrical -Conduit- 66. Solar System -Final - 16. Rough Electric Wiring �6 ) 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 Heatigg &Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23./Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 2B. Lathing & Siding 77. FIXED SYSTEM FINAL 29. insulation 78. FIRE PREY, 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 �- = ltiaG4j 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 r 45. Sound Attenuation P ? 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date l I PROJECT ADDRESS: 3151 AIRWAY AV UNIT: Q OWNER'S NAME: CUSHMAN & WAKEFIELD OF CA ADDRESS: 333 S. AN I TA DR 91050 ORANGE, CA 92668-3320 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: AIR TEC (714)549-1698 ADDRESS: 1606 E CARSON ST 100 CARSON CA 90745 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Businessand Professions Code, and my iicense is in lull farce and effect. CITY LIC.: 3. 5 /7 E LIC.:42065 J /� CLASS: C 2 Date: `'i ( Signalur— / —G WORKERS' C041PENSA40N DECLARATION: I hereby affirm that I have a certificate of consent to sell -insure or a certificate of Workers' Compensation} c . tried py thereof (Section 3800. Lab. POLICY Na.: ^ 1 r� EXP. OATS: 2 / 0 1 / 9 1 )OMPANY: SUPERIOR Certified co is her furnished. ❑ Certifiedcopy is .ed wi the city Buildin�ivi Date: Applicant: EXEMPTION OM RKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred {3100) or less♦, I certify Min the performance o1 the work for which this permit is issued, I shall not employ any person in any manner so as to become subiect to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If, alter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance at the work for which this permit is issued )Section 3097, Civ, C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the lollowing reason )Section 7031.5 Business and Professional Code: Any city at 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/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 )commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 [S5D0). 1. as owner of the property or my employees with wages as their sole compensation, win do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a properly who builds or improves thereon, and who does such work himself/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 will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon .and who Contracts for such projects with a contractor(g) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should he provided to me. ❑ I am exempt under Section. B. 8 P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California.Heallh and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will/will not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from theAuAu Quality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and stale that the above information is correct. I agree to comply with all city and county ordinances and slate laws rell to building construction and hereauthorize representatives of this city to enter upon the ab o -mentioned property far nspec n purpo ss. Iu �/ Date: _ �� v Signature Driver's Lease or So al Security a. 1641.45 while—Budoing: Green—Code Enlorcemenr, CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M otloj PERMIT NO: M 050379 PLAN CHECK NO: N b CONSTRUCTION TYPE: PERMIT TYPE: MEC PURPOSE: ALT JOB DESCRIPTION ; SYSTEM REPAIR/ALTERATION SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: SYSTEM REPAIR/ALTERATION ��•x•****->E*�-►�->4-�•>E•K•�-�•��•>4.>4*��-��-->4�*��-*�•��•�-�-�•�-��*�••>F�-•��-*�•�•***+E*•lE*•rE•lE+E�••x•*�•>f•rc•-�•��.��•�� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 00000000 ZNE: REF NO: PLANNING N TES> > iF •1t• iF •1t• iF iF {t[• iF �4 if #E #E .N. •K• #E #E iE iE iF #E #E iE #E #F iE #E #E #E #E #E #E #E #E #E #E #E iE.#E, #F iF iE iE •If• iE � iF iE 3f •YE iF •>F 9F •>E �F iE #F iE iF it iE iE it it iF )E * it• iE #F it- iE i(• TE i(• •lE •>E If D E V E L O P M E N T S E R'V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY.; DATE: I APPLICATION ISSUED BY: DATE: 1-2 _/ iE iE �{• iE iE iE iE 9F iF iI- it iF •1t• {'E iF it 1r:• iE iE lE it iE�F "'i�fF�ii�•�iii€i� 3F�i�iF�F3F'�'�i• iFi�'i�"i�i� •lE iF {'F TE it i4 it •iF iE iE ii• it• IF iE iE iF 9F i[ iE iE iE >f iE Irt #F K• 1f iE iE K• #F iE trt If * iE iE iE iE #F iE iE it iF ib #F it it #F it it it Tr iE iF iF lE If If it TE iF if if• N #F trt #F i! i! >E if #f iE iE #F #F it I* tf tf iE iE 14 tf iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 27,00 25% SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 27.00 15.00 0.00 42.00 42.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 42.00 OVER/SHORT: •00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 42.00 if• iF iF If �F #F iF i4 iF iE iE iE iF iE it wF E(- it wF it if• wF •1F it 9t 9t it it it it iE iF iF #F #F iF IF iE iF �F it• iF it• * iF 9t 9t iE * iF •K• •K• it• #F iE � iN IE it• 1(• it• X• •YE it• IE iE 1E it wF wF fit• wF iE wF * iE iE �F iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 3 REPAIR/ALT COOLING UNIT/SYS W/CNTLS 9,00 27.00 END SOF FEES 2 1 ' JAN 02 DEC 2 61990, CITY E) CiO.SU. N: -...i i CONSTRUCTION AND PLANNING Date APPROVALS Permit # inspector . 0� SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole. 52. Pool & Equipment Location 2- Soil.Pipe-Undrgrnd. 53, Steel Reinforcement ,3. 'Ele6trical Conduit-Utility-Undrgrnd. 54. Forms 4,••Electrical Conduit-Undrgrnd, c 55- Electrical Bonding 5. Steel Reinforcement `' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 1 •- 57. APPROVAL TO COVER-GUNtTE 7: Footings 58. Electrical Conduit-Undrgrnd. B..Foundation 59. Gas Pipe, O Undrgrnd., Test 1 J 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House -Connection 62• Backwash & Receptor -Final ,- 12. Sewer Cap r„ „ 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 J 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 APPROVALS- Permit # ' 20:' Rough Factory Fireplace .r, s 21, Ducts, in Structure �' .70. Underground Hydro 22. Ducts, Ventilating - -. 71. Product Piping 0 Gas ❑'Oit 23. Gas Pipe` -Rough & Test .72, Underground Flush 24; -Roof Framing = X73.' Undergrnd'. Storage Tank ❑ Gas ❑ Oil 25, Roof Sheathing 74. Overhead Hydro 26, T -Bar Ceiling (Structural) &-Monocoat ,• = + 75. ,Dry Chemical - - 27• Frame and Flashing r 76. Dry Standpipe x ' 28,' Lathing& Siding` r } 1 77: FIXED SYSTEM FINAL '29. Insulation 78. FIRE PREV. FINAL • 30, Drywall Nailing i i ->> HEALTH DEPT. REQUIREMENT .-31. Plaster Brown Coat; , ,.79".' FINAL INSPECTION - J 32, Electrical Power Meter -Final 80-. FOOD CERTIFICATE ISSUED ^33. Final Electric'Notes: �. r 34. Final Heating & Air. Conditioning;�= Q �:c_s_: 35. Final Ga's Pipe -Test ' I j. '�• :• .36 Flood or -Canopy ,• _ ., - I I l _' , 37. Final Factory Fireplaces 38, Final Plumbing � t 39. Water Service -Final t ` 40, Gas Service -Final a 41. Solar Domestic -Final I ' 42. Backflow Preventer• _ 43. Backflow Irrigation _ 44• Landscape Irrigation System ,45.. Sound Attenuation 46.• Handicap Regulations - ,.'I 47• FINAL STRUCTURE & BUILDING 48.'FINALPLANNING ' T •1 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co ! 51. CERTIFICATE OrOCCUPANCY No. Date City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 00 0 609 P. O. Box 1200 Costa Mesa, California The Building located at _3131 A WAY AW. SUITE i;k 1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building OPVTl F; Legal Description 427-231-1i ISee reverse side for Metes and Bounds] Building Permit No4 ('y—lQ)dI Electrical Permit No. s^ 1d'J[L1 Plumbing Permit No.�`o-14241 Mechanical Permit No. AI Number of apartrrients ands/orr guest rooms ISSUED TO: Building Officialy�G/tom GUILDHDi1SE c>�vsuLTaNTs 3151 A:[ --;5W AVE. #E-1, OOSTA MESA, CA. ,..., — Date This Certificate of Occupancy SHALL BE posted in a conspicuous place ori the,premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. Building Safety Division P. O. Box 1200 Costa Mesa, California The Building located at—�31.t I_.' n., t1L'":"'•� has been inspected and found to comply withithe provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building 'r_A_==4 Legal Description A-)-7.._ 0 1A (See reverse side for Metes and Bounds) 10140 Building Permit No ,ra„n Electrical Permit No. 1n7An Plumbing Permit No, r)—inir;Q Mechanical Permit No. Number of apartments ^ and/or guest rooms— ISSUED TO: BuildingOff'cial l' , A1” _ ,&I C7anstiltants !� �- 31SI Airway Avenue, El, Costa i+R>rsa, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White . Owner; Canary - Numerical File; Pink - Bldg. Permit File CITY OF COSTA MESA BUILDIMG DIVISION t i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00096 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 93894027 DATE ISSUED: 06/04/2009 - ISSUED BY: CAC JOB ADDRESS: 3151 R AlRWAY'AV,CM _Suite/Unit::, R Vicinity: Squares: 0 _ .. Valuation:" $.14,721.00 SCOPE OF WORK: TEAR OFF,WOOD,SHAKE:AND INSTALL 1 15LB FELT AND 40 YEAR,COMP. SHINGLES.FOR 60 SQ, SLOPE 4:12 OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS` Address: ° ,%nSTORSTAD, KIMBERLEY E %PROPERTY -RESERVE ' Unit: 10 E SO TEMPLE ST #400 PHONE: CitylStatelZip: BRUCE CHRISTENSEN' APPLICANT: DUKE HANSON Address: 260 E ALTON AVE _ Unit: PHONE: 714-557-7440 CitylStatelZip: SANTA ANA; CA rt.r,4M10 09 CONTRACTOR: ROSS.AND BARROWS INC License "No. 32.7802 Address: 260 E ALTON AV EUnit: -; PHONE: 714-557-7440 T CitylStatelZip: SANTA ANA, CA .92707 .' ' , CELL:, ARCHITECT: License No. PHONE: - ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 _. Reroof Permit Fee: $251.25= Reinspection Fee:'$0.00• Bldg Std Admin Fund $1.00 .,,;.:.�•,=`� TOTAL FEES $252.25 a. ' e !unit: . 01 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. ,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. CODE p. INSPECTION TYPE DATE I"TIALS CODE 0 INSPECTION TYPE DATE--. _ , g `; INTITIALS ,f616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof L7Zm; 210 Final Electrical 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 BuildinglOccupancy WORKERS' COMPENSATION DECLARATIO : 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 KperTfoance of the work for which this permit is issued. ave and will maintain workers' compensation insurance, as required by 3700 of the Labor Code, for the performance of the work for which this pe t ed. My workers' compensation Insurance carrier and policy mber are: 5, rf T Pi Ui`� (This section need not pe completed if the permit is valued atone hundred dollars (5100) or less.) P 2bert b(.7z at in the performance of the work for which this permit is Wir.ed,el shall not employ any person in any manner 5o as to become subject to the workers' compensation laws of California, and agree that if I should become subject to th@ workers' compensation provisions of Section 3700 of t abo ode, I sh 'th comply with these provisions. RppfrcanP nature to WARNIN . FAILURE TO SECUREWORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION 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 under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and �se is in full force and effect. C� ntractot alure to 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 DI=CLARATIONS: 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 ($500).): ❑ 1, 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, thg 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 WfTH 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 unser sec. Business and Professions Code for this reason: Signature 3057-46 (3107) Date Owner ID verified by drl s license. ElYes ❑ 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, falsewurk, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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 acute)y hazardous materials? []Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 informationgiven is correct. I agree to comply with all state laws and city ordinances relatitig 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. �gnature of I Owners) Dale for Aut o - d Applicant Date CMF 0855-46 White -Building; Canary -Applicant; Plnk-Accounting; Goldenrod -Assessor 'lines Applicant to fill in all spaces within heavy borderand sign all appropriate declarations. ,.CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. -SLOG. NO. CONSTRUCTION PERMIT I R Mr 1:9--7q-__3q1R I Project Address 3151-R Ariway Avenue Costa Mesa TYPE OF CONSTRUCTION Owner Financial Phone 752-767 M NEW ❑ ADD ❑ ALTERATION P1 Check #51442 Address 1601 Dove Street New ort Beach ❑ REPAIR ❑ CONVERSION 1-1 DEMOLISH Arch/Eng-Hales-Langston License No. C-010899 ❑ OTHER ZONING REGULATIONS Address S, Main 105 Oran a Ca, DESCRIPTION OF WORK A.P. Q ZONE G PLNG. REF. :r Contractor The J , Donald Olson CO.Phon�740- 2(706 TYPE OF PERMIT p BtJI LPI NG Pe�RQPERTY Address 3 - Airway Avenue Costa Mesa ❑ GRADING FOUNDATION IX STRUCTURAL SETBAC C SIDE YARD LIN LICENSED CONTRACTOR DECLARATION I hereby that I am licensed under Charter 9 ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA LEFT affirm provisions of (com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER R G RIIGHTA Professions Code, and my license Is In full force and effect, REAR YARD (TO P/L) B PROJECT DESCRIPTION C License ClassT License No..�- 437 _ PKG. SPACE REQ, j PROVIDED Q Date Signature SQ. FT, �� - _ STREET WIDTH PARK FEES WORKERS' COMPENSATION DECLARATION OCCUPANCY —!CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure or a VALUATIO$14S 1 50- 9�ONE ZONING APPROVED BY 11 DATE a3' 1 certificate of Workers' Compensation Insurance, or a certified copy - thereof (Seltio�n0, Fairmont Insurance GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No '" - -`- Company TS ❑ certified copy Is hereby furnished. REMARKS: r,. -Certified copy Is filed with the city Building Division, SMPTiON FROM WORKERS' COMPENSATION DECLARATION £" is section need not be completed If the permit Is for one hundred 100 or or less] f 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. Date Signature BATHTUBS SHOWERS FT- NOTICE.It after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith Comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1.10 HP I hereby affirm that there IS a.Constructlon lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR), 10-50 HP 50 + HP - formance•of the work for which this permit is 'issued (Section 3097 Lender's Western Pacific Financial Lender's Name ` FLOOR'SINKS - ;, FLOOR DRAINS - FIXTURES_ OUTLETS SWITCHES Lender's Address 1601 Dove S. rept a Newport Bch.—DRINKING•FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP UU POLES METERED SUB the following reason (Section 7031,5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its Issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT Business and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031,5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ' as owner of the property, or my employees with wages as their =ompensatlon, will do the work, and the structure is not Intended SOLAR PIPING SYS. ISSUE FEE ,ifered for sale, (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DAT Z / 164 a who builds or improves thereon, and who does Such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, the am exclusivelycontracting HEATING SYSTEM 0-100,000 BTU PERMIT BUILDING $-S.rIR-Qn SMIP S 1r)_ l� as owner of property, with AND DUCTING ' licensed contractors to Construct the project (Sectl0n 7044, Business 100,000 + BTU n PLAN CHECK $ 3 V-- PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ tracts from such projects with a contractor($) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000 + BTU , PLAN CHECK $ ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL s $ reason SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ Date Owner MECHANICAL $ TOTAL FEE $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD - Information is correct. I agree to Comply with 211 City and County PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction, and hereby authorize representatives tt is city to inter upo 'fie above mentioned property fo l�►pos}_ FINAL FEE $ 568.16 Signature Drivers' License or SS 9P _ ISSUE FEE CMF 0855-46 White -Building; Canary -Applicant; Plnk-Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # _ rb- _ Date Inspector POOL & SPA I - APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. - Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing &Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings j yp_j Z. i 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap. ❑ ndr rn 10, Structural Floor System 52.-- APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing Svqtem - Final 14. Rough Electric -Conduit •56. Electrical -Final 15: Rough Electric -Wiring 57. _Solar System -Final 16. Rough Heating & Air Conditioning. W Fencing & Access Approval 17. Ducts in Structure APPROVED. FOR PLASTERING 18. Ducts, Ventiiating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20, Roof Framing 21, Roof Sheathing NOTES: w 22. Frame and Flashing54�L r _ 23. Insulation L - '-bLz_ 24. Lathing & Siding 640 Kz �N S 25. Drywall Nailing 26. Piaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY . No _ Date �j 00 Applicant to fill in all spaces Within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA PERMIT NO, TRACT NO. LOT NO. BLDG. NO. , CONSTRUCTION PERMIT 1}.1%"(1 R Address 18003 Skypark. Irvine Ca. 2 a Z& - Arch/Eng. License No, Address Contractor 'Leaverton—B ck r IT7C. PM5479" 3560 Address 16721 Hale rrvine. Ca. 92714 LICENSES] CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of I.jivi$Ion 3 of the Business and Professions Cade, and my f#sense is In full force and effect. License Cl as 36 License ND Date Sig natur®_~/ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a Certificate of consent to Seif4l+sure or a certificate of Workers` Compensation insurance, or d Certillod copy thereof (Section 3660, Lab. C,). Policy No.—.2223-64 Company- Zenith National Qertified copy Is hereby furnished, . - ` ertifled Copy IS filed with the city Building Olvislpn. CMPTION PROM WORKERS' COMPENSATION DECLARATION ;is Section need not be completed if the permit is for one hundred 4x100j or le f certify thass).t In the performante of the work for wnich this permit is Issued, t Shalt not emftloy any person In any manner sO as tO become subject to the Workers Compensation Laws of California.. Date Signatur¢ NOTICE: If after making this declaration, you Should become, Subject to the Workers' Compensation prov#s#ons of the LabOr Code, you must li forthwith comply with such provisions or this permit shalt be deemed revOked. CON$TRUC-fION LENL7tNG AGEP4CY I hereby affirm that there is a Construction lending agenCyy for the per, formnce of the work for which tills permit is Issuca (Sectlon 3097 Cl v. C,), Lender's Name j Lender's Address i OWNER BUILDER DECLARATION I hereby affirm that I am e%empt from.the Contractor's License Law for I the following reason (Seciibn 7033,5 Business and Professions Code: Any city or county wn#ch requires 4 permit to construct niter, improve, demolish or repair any structure, prior to its issuance, alto re- quires the appiic4nt for such permit to file a signed statement that he Is licensed "rSuant to the provisions of the Contractor's License Law Chapter 9 tcommancing with $'er~tion 7000) of Division 3 of the Usiness and Professions Cade) or that he is exempt therefrom and the basis for the alleged exernmion. Any violation of Section 7031.5 by any applicant for at permit'tubjects the aDPIlrant t4 a civil penalty of not more than five hundred dollars (S540). A 66,as owner of the property, or my employees with wages as their Compensation, will do the work, and the structure is not intended ffered fOr sale. (Section 7044, R4tsinOS3 and Professions Code: The retractor's L(cense Law does not Opply to an owner of 4 property who builds or improves thereon, and who doe& Stich work hirASLlf of tnrougli his own employees, provided that sUCh imorovements are not Intended or offereti for tale. If, however, the building or Improvement Is sofa Within one year of completion, the Owner will have the burden of proving he did not t�ulld or improve for the purpose or SOIL). d I, as owner of the property, am exclusively contracting with #icensed contractors to construct the project (SeCtion 7044, Business and Professlons Code: The Contractor s License taw does'not apply to an owner of property who builds or irnproves thereon, anti who con- tra(;t$ front Such projects with a contractor(;) Iicesned pursuant to the Contractor's License taw). I am exempt under Sectlon B. & P. C. for this reason' Date Owner I hereby Cettify that # have read tR"s5 applicatlon.and state that the above Information IS correct. I agree to comply with ail city and County ordinances and 5 to ilw5 relating to Construction, and hereby authorize representatives ,S`/f tills, city to -O tet[ upon the above mentioned property fort SpKtign put gs TY E OF CONSTRUCTION �' 6772 Q% ,�/$ 6*0�i NEW a ADD ❑ ALTERATfON • T REPAIR ❑ CONVERSION ©DEMOL#SH CI OTHER ZONING REGULATIONS DESCRIPTION OF WORK A.P. 4 -ZONE PLNG. REF. ,i9t TYPE OF PERMIT S �a��t�� GRADING D FOUNOATiON ❑ STRUCTURAL. T• AR INE ri TENANT 0 ELECTR#CALUMBING❑MECHANIC WillYARQ © OTHER HT REAR YARD (TO PfL) PROJECT pEDESCRIPTIONPKG, SPACit REQ. PROVIDED SQ, , FT. FT. ' OCCUPANCY—CONSTRUCTION TYPE STREET WIDTH PARK PEE $ ZONING APPROVED $Y C7ATI- VALUATION—ZONE GRADING CU, YDS, ACRES SPECIAL CONDITIONS: REMARKS: PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK SATHTUt3$ SHOWERS TOILETS URINALS GENERATOR 0.1 KW__ 1.10 Kw TRANSFORMER L,AVATORIe5 DOUBLE LAYSAPPLIANCE 10-50 KW -50 + KW KIT. SINKS DISHWASHERS MOTORS 0.1 HP_1-1U HP SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HIP -50 +-HP FLOOR S#t KS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS w POLE LIGHTS 5WIMMiNaPOOi. PTRAP POLES M TER UB WATER SERVICE ALTERATION PANELS MAIN' SUB GAS SERVICE OUTtXT$ SERVICE AMP WATER HEATERS BTU OUTPUT SEINER CONNECTIONS SOLAR TANK COLLECTORS. / �• fSSUE FEE ISSUE FEE frtrj APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES HEATING SY57EM o-100,000 BTU PERMIT PERMIT yTTTT�� $HtIP I— - -- - AND OUCTiNG AND 100,000 + STU ," PIAN CHECK S -. ._ PERMIT ISSUANCE- S REFRIGERATION 4.100,000 BTU PLUMBING S SYSTEM 100,oOO + BTU PLAN CHECK s GRADING $ BOILERS $TUMICROFILM ELECTRICAL # $ PLAN CHECK S S SYSTEM REPAIR, ALTERATION _. TOTAL FEE $ MECHANICAL 5 _ ' EXHAUST SYSTEM MULTIPLE PLAN CHECK $ - - VANCE PC Signature -fA f 15SUad F$!: Drivers' License or SS � `�• 6 White-Sul;d#ng; Canary-Ape#Icant; Pmts-AcCounting, Goldenrod-AssesSOr FINAL FEE g CONSTRICTION AND PLANNI APPROVALS V" 11 11 P&411) 90i ' r zz Date Inspector POOL & SPA E APPROVALS Permit Date Inspector 1, Temporary Electrical ServiEe or Pole 43. Pool & Equipment Location it ipB n rgrri - 4. Steel Reinforcement 3, Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding tee eisi orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER•GUNITE Footings 49, Electrical Conduit-Undr rn 8, Foundation 50. Gas Pipe, 0 Undr rn, Test 9. Water Pipe-Undrgrn 51. Bac ash Lines, P T r 10. Structural Floor System 52, APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Rece or -Final 12, Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Final - 14. Rough Electric -Conduit - 66. Electrical -Final 15, Rough Electric -Wiring 57, • Solar System -Final 16- Rou h Heating & Air Conditioning -Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL_ 19. Gas Pipe -Rough 8c Test 20. Roof Framing 21, Roof Sheathin 22. Frame and Flashing,NOTES: 23. Insulation 24. Lathin & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28, Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31, Final Plumbing r 32. Water Service -Final 33. Gas Service -Final 34, Solar Domestic -Final 35. Landsca e 5 rinklin 5 stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42, CERTIFICATE OF OCCUPANCY NoDate - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. -7-�" CITY OF COSTA MESA PEgnn,IT No, TRACT NO. LOT O. BLDG. NO. 61.44 5/20/82 _ + 14e00 TI,' ` CONS'TRUCTION PERMIT _.� • ` y Project Address 1151 Airwa Bld R B- 15 TYP OF CONSTRUCTION ' OwnerOn - Phone NEw ElADD ❑ ALTERATION - - Address 3151: Ave _ ❑ REPAIR ❑ CONVERSION ❑DEMOLISH I_ -Airway ❑ OTHER ZONING -REGULATIONS Arch/Eng. License No. A.P. =P Address _ - _ DESCRIPTION OF WORK _ ZONE PLNG. REF• ANG V Contract 6afewa Heating Servibeie TYPE OF PERMIT, - - 'SET TT gguu pp P�OPE�TY LINE + Address Q Imperial H 5 ❑ GRAOiNG ❑ FOUNDATION ❑ STRUCTU L ACK I YARD i LICENSED CONTRACTOR DECLARATION 'I Charter 9• ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ECHANICA gIp YARD hereby affirm that i am licensed under provisions of mencing with. section 7000) of I Divisl f the Bus nd ❑ OTHER F11GHT Professlons Code, and my license I I fort site _ REAR (TO P/L) PROJECT DESCRIPTION Llceds-6fass. cense PKG.'SPACE REQ. PROVIDED.•LL]]Signatu�1:09. r FT. - STREET WIDTH PARK FEE $ WORKERS' COMPENSATIO ARATIt:j OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a fica[e of consent to self-insur VALUATION ZONE i ZONING -APPROVED BY DATE i I certiflcate of Workers' Compensation or a cerlifle -Insurance, thereof (Secti�q Ca. Haines Ins �l� GRADING CU. YDS. ACRES SPECIAL' CONDITIONS: ' Policy No. Company • ❑ ce!tifj9d<opy is hereby furnished. REMARKS: tied copy is filed with the city Building Divislon. - I' `CEMPTION FROM -WORKERS' COMPENSATION DECLARATION "' nis section need not be completed if the permit is for one hundred - - ,,. •'� , ' ,100) or less). _ _ _. _ _ _ _ _ , _ • _ _ _ _ 1 certify that n the performance of the work for which this permit is issued, f shall not employ any person in any -manner so -as to become ' -PLUMBING _, - PLAN -CHECK - — - ELECTRICAL" - PLAN CHECK -, subject to the Workers' Compensation Laws of California, -. " ^; - _ _ a Date Signature BATHTUBS' SHOWERS _ ) NOTICE: If after making this declaration, you should become subject _TOILETS_ 1reG URINALS '- -•-� 'GENERATOR- ' - 0-PKW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must .TRANSFORMER , forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE- 10-50 KW_50 KW- = - 'revoked, CONS� ` LENDING AGENCY -KIT. SINKS DISHWASHERS- MOTORS -- 0-1 HP•- 1-10 HP-____-_"- I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC, SOLAR) 10-50 HP 50 t HP- formance of the work for which this permit Is issued (Section 3097 Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS - SWITCHES Lender's Address '- - - -DRINKING FOUNTAINS ` '' - — GAS TUBE SIGNS - - - OWNER BUILDER -DECLARATION _ I hereby affirm that l am exempt from the Contractor's Llcense Law for INTERCEPTORS CLARIFIERS' - 'POLE LIGHTS - - e SWIMMING POOL - P TRAP + - POLES ' - - METERED SUB the following reason (Section 7031.5 Business antl •Processions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION - - PANELS MAIN SUB - Improve, demolish or repair any structure, prior to its.issuance, also re- quires the ap,licant for Such permit to file a signed statement that he I OUTLETS' - SERVICE _ AMP - Is licensed pursuant to.the provisions Of the Contractor's_ License Law (ChapterSERVICE (Chapter 9 (commencing with Section 7000) Of Division 3 of tht WATER HEATERS -- BTU OUTPUT } business and Pro{essions Code) or that -he is exempt therefrom and the J basis for the alleged exemption. Any violation of Section 7031.5 by .SEWER CONNECTIONS- -- • -- - ' - - - -- -- - -- - any applicant for a.- permit subjects .the applicant to. a ,Civil penalty ' of not more than five hundred dollars ($500). -SOLAR TANK -COLLECTORS n I. as owner of the, Property-, or my employees with -wages as their compensation, will do the work, and the structure is not intended 'SOL'AR PIPING SYS: ISSUE FEE - - - -- - - rffered for sale: -(Section 7044, -Business and Professions Code: The ntractor's License Law does not apply to an owner of a property tivho-bullds or- improves' thereon, and who does such work himself or ISSUE FEE _ -" -- - APPLICATION APPROVED BV - -DATE through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES ^ r =r r intended'or offered for sale. If, however, -the building•or Improvement Is sold within one year of completion, the owner will have the burden of proving he did -not build or improve -for the purpose of-sale).liEATINGSYSTEM El the 0-100,000 BTU - BUILDING IPERMIT E SMIP $ I, as owner of property, am exclusively contracting with AND DUCTINGr licensed Contractors to construct the project (Section 7044, Business 100,00-0+. BTU PLAN CHECK S 'PERMIT 21 RNEM ' and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner of property who builds or Improves thereon, and who con- tracts -from such. projeM with a con_tractor(s).11cesned pursuant to tracts REFRIGERATION 0-100,000 BTUJJ - SYSTEM _ ' / 0 PLUMBING Ii— GRADING S the Contractor's License Law). 100,000 + BTU ` PLAN CHECK S I am exempt under Section B. E P. C. for this BOILERS � BTU ELECTRICAL '$ $ r reason.SYSTEM - PLAN CHECK - S •MICROFILM s Date Owner REPAIR,ALTERATION 'MECHANICAL s TOTAL FEE S - - Yhereby certify that r d this appll and tate that the above EXHAUST SYSTEM MULTIPLE LESS AD- informatlon is c ect I r'e t0 ply wit alt City antl courtly PLAN CHECK S - VANCE PC $_ ordinances an ate 1 elatln constr , and hereby authorize , representat( of- city -en on the above mentioned Property f r i n- - _� Signaiurer FINAL FEE S��r 1" l55UE FEE _ � 3 R13r n Drivers' Li se or SS gr- 11 o' CMF 865.46 White-Bullding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor - - CONSTRUCTION AND PLANNING APPROVALS Permit # - ' _-�,•, Date Inspector POOL & SPA APPROVALS ' Permit # �. Date.ti Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location s Pipe-Undrgrn 44, Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding 5. Steel Reinforce 47. r n t Rough Plumbing & Pressure Test - 6. Electrical LIFER Grn 4$. APPROVAL TO COVER GUNITE' t 7. Footings 49. Electrical Conduit-UrrdP rn ..� . 8. Foundation 50. Gas Pipe, ❑ Undr rn,Test .9. Water Pipe-Undrgrn - 51. Backwash Lines R-T a ndr r111• -� 10. Structural Floor System 52. APPROVAL TO D K 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection _ 54.- Heater & Vent-Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric-Conduit y '56.. Electrical-Final 15. Rough Electric-Wiring '57. Solar System-Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe=Rough & Test 20. Roof Framing 21. Roof Sheathin NOTES: -22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Serinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed 40. Electric Release to Edison Lei 41. Gas Release to Southern California Gas Co. 42. } •` CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. tlPrOF COSTA MESA Pi RM IT NO. TRACT NO. LOT NO. - BLD NO. 6119 5/20/82 27•25 TL: ' r CONSTRUCTION PERMIT.. '`� %, fN Project Address?�j S "10.4C, TYPE OF CONSTRUCTION r ? - ( Ovvnerlti}e_cy Phone- .^ (o ❑ NEW _❑ ADD (D ALTERATION AddressS .Cti� ❑ REPAIR '❑ CONVERSION ❑ D♦=MOLISH D ❑ ZONING REGULATIONS ' Arch/Eng. License No. OTHER DESCRIPTION OF WORK A.P. Address - -' ZONE- PLNG.. REF. =)P Contractor e , W - Ph6ne (p 'Zp .TYPE OF PERMIT BUILBSETBACK �ROPUEiRTY LfNE Address e -VL C --P_ ❑ GRADING ❑ FOUNDATION -CI-STRUCTURAL LST. - S" YARD LICENSED CONTRACTOR DECLARATION '❑ TENANT �jELECTRICAL ❑PLUMBING ❑MECHANIC ,,I hereby affirm that I am licensed under provisions of Charter 9 (com- 7000) - I ' 5 p RD ItI1GHTA mencing• with section of Division .3 of the Business and Professions Code, and my ull ce a d eff t. ��-!� y��(� .❑ OT.HER PROJECT DESCRIPTION REAR'YARD-(TO-P/L) License Class en o, 1�-O..�z SQ. FT. ,. _ , - PKG. SPACE REQ. PROVIDED, DaEe Signature _ - F STREET WIDTH FEE $' WORKERS' -COMPENSATION DECLARATIO . _ _ II OCCUPAN_CY CONSTRUCTION TYPE TZONE ,PARK hereby affirm that I have a certificate of consent to self -insure or a VAL'URTION ZONING APPROVEp�BY -- - - - r -' certificate-of.•Workers'-Compensation Insurance, or a certlfied.copy -. _ .� _ _ c thereof (Section 380001 �•r�blF.). GRADINGCU. YDS.- + ACRES _ _ i _ SPECIAL CONDITIONS: Policy No.%&2e_"_> ■II Ob Company LAI f�✓s�Qi l4cM� - - - , '❑ Certified copy_is hereby_furnished. _ _ ._ _ - _ REMARKS: Q ��, IF] Certified copy is.filed with the city Building Division. ' 'EMPTIDN FROM WORKERS' COMPENSATION DECLARATIONFBATHTUBS its section need not•be_comgleted if the permit is for one hundred - �� s �, �' ?• _ �u. ;; , ,-, ,x100) or less). ,tet I Certify, that In the performance of the work for which this permit isissued, 1shall not einploy any person in any"manner so•as to become'BING _ PLAN CHECK' A�� - '--- .ELECTRICAL - 'PLAN CHECKsubject tothe Workers' Compensation Laws of California.' ' - i j _. - -- —SignatureNOTICE: - '' SHOWERS ._ --;Date If after meking this declaration, you should become,subject, +OETS_, URINALS - -- - -?' - - - - GENERATDR - -"0-1 KW 'TRANSFORMER ^,.- I-10 KW I ,to the Workers' Compensation provisions of the tabor Code.you`must' .,forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOOBLE LAV5'- t - -••- . •• 'APPLIANCE 10 -50 -KW_- 50+ KW - ' w __ , ,revoked._. _ __ _ _ _ 'CONSTRUCTION LENDING AGENCY- KIT. SINKS DISHWASHERS -j'-- rMOTORS- ---0-1 HP -L=-1-10 'HP- - - - - 11 hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS - SUMPS " - _ (INC. SOLAR)_ _. 10-50 HP - 50 + HP ' formance of the work for which this permit is issued (Section 3097• r - lCiv. C.).- - •�- '- - �•- - -^ - -' - - _ - - -' Lender's Name ` r - , `'-J "`- FLOOR SINKS e, 'FLCIOR"DRAIN5 - '" FIXTURES - OUTLETS' SWITCHLS - �--- .Lender's Address �. ` DRINKING FOUNTAINS --i"• '- I, - GAS TUBE SIGNS - - 1 'OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for `INTERCEPTORS CL`ARIFlER5 �r - _ jPOLE LIGHTS -- - the following -reason- (Section 7031.5 Business and- Professions Code: Any city or county which requires a permit to construct, alter, SWIMMING POOL P TRAP -^ s - - - _ POLES METERED sue improve --demolish or repair any Structure, prior to its -issuance, also re. quires the applicant for such permit to file a signed statement that he WATER SERVICE ALTERATION r PANELS-- ! -MAIN._ SUB ,is licensed-pursuant-to•the-provisions of the Contractor's License Law GAS SERVICE , --- � OUTLETS- SERV ICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the °- •Business and-Profes$ions Code) or that - he -is exempt therefrom and the • - WATER'HEATERS -BTU OUTPUT-` basis for the alleged exemption. Any violation of Section 7031.5 by any -applicant --fora Permit subjects the applicant -to -a civil penalty SEWER -CONNECTIONS ""' - -'- --- - - -- - -^ -- • ---- - - - - of not more than five hundred dollars ($500)- r {; as`owner of'the' property,"or my employees with wages as"their SOLAR"TANK' -- -COLLECTORS'- compensation,_wil! tlo the work, and the structure is not intentled °"fferetl ' for sale. {fiction 7044, Business and professioris Code: The _ SOEAR PIPING SYS.' ---ISSUE FEE - -- - - --- - 1- itractor's License Law does not apply to_an owner of a property' who builds or improves thereon, and"who does such wSrk himself or- -ISSUE•FEE-- -APPLICATION•APPROVED By- . - - DATE - through -his own employees, providetl 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 will nave the burden _ _ _ MECHANICAL PLAN"CHECFG SUMMARY OF, FEES " of proving he did not build or improve for the purpose of sale)." '❑ i,- the am exclusive) contractin ({EATING SYSTEM 4104,000 BTU BUILDING- - ^ - - -- PERMIT $ - .. . -.J. . . , gMIP ;� . y as owner of property,- y` g .with AND DUCTING --• �- 1 ,$ licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and -Professions Code: The -Contractor's -License Lawdoes not appty.to y �ISSUANGE• $ 2 an owner of property who builds or improves thereon, and who con- tracts from-such--projects-with-a contractor(s) Iicesned. pursuant to. REFRIGERATION- 0-100,060 BTU L- PLUMBING $ I , ' _.the Contractor's License Law). SYSTEM- -1L 100,000: BTU . i , PLAN CHECK- $ - GRADING'. S r , ❑'Iam exempt untlef Section 'B;-& P: G. for this BOILERS- BTU r ELECTRICAL' $ reason - ' ' • •- ---- ' • • - - _ - - _ SYSTEM REPAIR, R, ALTERATION - 'PLAN CHECK- $ .^ MICROFILM' $ ' " Date ._Owner___ MECHANlCAL^$ ;TOTAL FEE $ N - 1 hereby Certify that I have read this application and state that the above ' . --agree` -all EXHAUST SYSTEM MULTIPLE � - .- a„ LESS AO. mformat* ect. I o" comply' with city and County or J% es and state w elaC to construction, and hereby authorize PLAN CHECK $ r _ ; VANCE PC $' - repres ntatives -of cit o"'enter' upon" the above • mentioned proper for n res- .7-0-�j Signature Date S' _ -,' FINAL FEE $_-_„_._�� Drivers' License or SS � - ISSUE FEE • -' - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNINCCG/ APPROVALS Permit Date inspector POOL & SPA - APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn _ 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . + - b. Steel Reinforce 47. Rough Plumbing & Pressure Test - -� 6. Electrical LIFER Grn _ _ -• 48. APPROVAL TO COVER-GUNITE - 7. Footings_ 49. Elect ical Conduit-Undr rn 8. Foundation . .- _ 50. . Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn _ 51. Backwash Lines P -Ira •- EJ Rcfrr 10. Structural Floor, System 52. APPROVAL TO DECK - % 11._- Property Sewer Line & House Connection _ _ 53. Backwash & Receptor -Final ' 12. - Street. Sewer Connection - 54.- Heater & Vent -Final 13., Rough plumbing =55. PIUMbil3a System - Final 14. Rough Electric -Conduit - -' '56. Electrical -Final 15. Rough Electric -Wiring = _C , 57.. Solar System -Final - 16. ' Rough Heating& Air Conditioning - - Fencing & Access Approval 17: Ducts, in Structure 59. APPROVED FOR PLASTERING 18. 19. 19. 20.- Ducts, Ventilating- entilating Gas Pipe -Rough &Test Roof Framing _. .''-60. POOL/SPA SYSTEMS FINAL 21. - 22. Roof Sheathing- Frame and Flashing s - z -- NOTES: 23' Insulation °' 1 24. Lathing & Siding - - - 25. Drywall Nailing 26- Plaster Brown Coat - - 27. Electrical Power Meter -Final 28. Final Electric r 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing - 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic=Finale 35. Lands e Sprinkling System 36. Sound Attenuation -- 37. Handicap Reguiations - + 38. FINAL STRUCTURE & BUILDING - ' 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No _ Date - -. ti APplicant to fill In all spaces within heavy border lines and sign all appropriate declarations. .CITY QF COSTA MESAP ITN TRACT NO. LOT NO. SLOG. NO. CONSTRUCTION PERMIT %- ., R Project Address 3151 AirwaV, Costa Mesar CA TYPE OF CONSTRUCTION OwnerJW Conila;;ny Phone Q NEW. D ADD ❑ ALTERATION Address92626 0 REPAIR ❑ CONVERSION ❑DEMOLISH Arch/Eng. License No. ❑ OTHER DESCRIPTION OF WORK Address PLUMBING PLAN CHECK BATHTUBS SHOWERS Contractor Leaver ton -Beck Inc. Phone '979-356 TYPE OF PERMIT Address A 4 0 GRADING ❑ FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION D TENANT ❑ ELECTRICALLUMBING ❑MECHAN I hereby affirm that I am licensed under provisions of Charter 9 (corn- GAS TUBE SIGNS mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license Is In full force and effect. C35 191969 PROJECT DESCRIPTION Licens-e7 Class c se No. pate 24L(-^ Signature SQ', FT' _ WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE certificate of Workers' Compensation Insurance, or a certified copy DRINKING FOUNTAINS thereof (Section 3800 Lab. C.). GRADING CU. YDS. ACRES Poticy No. PC3O92d11 Company Great American Wocertif led copy Is hereby furnished. REMARKS: l ertified copy Is filed with the city Building Division. fkk',�EMPTION FROM WORKERS' COMPENSATION DECLARATION r ohis section need not be completed if the permit is for one -hundred - i$100j or less). E I certiify that )n the performance of the work for wh4ch. this permit is Issued, Ishall not employ any person In any manner so as to become subject to the Workers Compensation Laws of-Callfornia. Date Signature PLUMBING PLAN CHECK BATHTUBS SHOWERS NOTICE: If after making this declaration, you Should become subject TOILETS URINALS to the Workers' Compensation provisions of the tabor Code, you must 1-10 HP — 50 + HP — forthwith comply with such provisions or this permit shalt be deemed LAVATORIES OOUBLE LAYS revoked. GAS TUBE SIGNS CONSTRUCTION LENDING AGENCY KIT, SINKS DISHWASHERS I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS formance of the work for which this permit Is Issued (Section 3097 GRADING $ Civ, C.). FLOOR SINKS FLOOR DRAINS Lender's Name $ Lender's Address DRINKING FOUNTAINS OWNER BUILDER DECLARATION INTERCEPTORS CLA IFIERS I hereby affirm that I am exempt from.the Contractor's License Law for $ the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP Any city or county which requires a permit to construct, alter, $ VANCE PC E improve, demolish or repair any structure, prior to its Issuance, also re- WATER SERVICE ALTERATION quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged. exemption. Any violation of. Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS of not more than five hundred dollars ($500). as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS' :ompensatlon, will do the work, and the structure is not Intended ffered for sale, (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE ' through his own employees, provided that Such improvements are not Intended or offered for sale, If, however, the building or improvement MECHANICAL PLAN CHECK is Sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU I, as owner of the property, am exclusively contracting with AND DUCTING licensed Contractors to construct the project (Section 7044, Business 100,000 + BTU and Professions Code: The Contractor's License Law does not apply to - an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from such projects with a contractor(s) licesned pursuant to SYSTEM the Contractor's License Law). 100,000 + BTU ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU reason SYSTEM REPAI R, ALTERATION Date Owner I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE information is correct. I agree to comply with all City and county ordinances andst to laws ang to construction, and hereby authorize representatives this citrelti y to ter upon the above mentioned pro rt ec fon .purpg�� %'e co Slgnatu e L Dat ISSUE FEE Drivers' License or SS =JF CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 3574 7%21/82 ZONING REGULATIONS .A --P:11 ZONE REAR YARD (TO P/L) PKG. SPACE REG, STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: ELECTRICAL PLNTG.. REF. 41 PROPgERTY LINE PROVIOEO PARK FEE $ DATE PLAN CHECK GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW_50 1-10 KW _ + KW —, MOTORS .(INC. SOLAR) 0-1 HP 10-50 HP 1-10 HP — 50 + HP — FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS ISSUANCE $ POLE LIGHTS $ PANELS MAIN SUB SERVICE AMP ISSUE FEE' APPLICATION APPROVED BY 42.00 TL DATE SUMMARY OF FEES BU I LDI NG PERMIT $ SMTP $ PLAN CHECK $ PERMIT ISSUANCE $ PLUMBING $ GRADING $ PLAN CHECK S ELECTRICALS $ PLAN CHECK $ MICROFILM $ TOTAL FEE $ MECHANICAL $ LESS PLAN CHECK $ VANCE PC E FINAL FEE $ CONSTRUCTION AND PLANNI G APPROVALS Permit # �iU Date Inspector POOL & SPA' APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation '50: Gas Pipe, ❑ Undr rn;-Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn 7 10. Structural Floor System 52. -APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing - 14. Rough Electric -Conduit .56. Electrical -Final 15: Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning -Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20, Roof Framing 21, Roof Sheathing^ NOTES: 22. Frame and Flashing' 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26, Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final.Heating & Air Conditioning 30, Final Gas Pipe -Test 31. Final Plumbing a„h y 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation F 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA =XONGTRUCTIOWPERMIT Project Address rw Y. Aye. .00c]. A'pplicant's Mailing Address 3151 Airway AVe. Owner's Name GO l dhousg CongilUnsPhone 540-2606 Address 3151 Airway Ave. ' E-1, Costa Mem„_ Arch/Eng.Day Stant ey -License No. C-10559 Address926 Contractor's Name J. Donald b1son Phone 540-2606 Address mailing) --3151 Airway Aye- F-1, Costa Mesa City License No. _ LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fullrtorce and effect. 339fi9 f License Class LS ense Date Signature ,RKERS' COMPENSATION DECLARATIO 'retry affirm that I have a certificate of conse oself-Insurer a Certificate Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.)'F-.2974 'Fairmont Policy No. Company kertified copy is hereby,fuinished. - ertlfic J yqf iS,fjled with the city 6 on. Date � 101j�4 Applicant EXEMPTION FROM WORKERS' COM OECL-ARAT N(This sectjan neetl not be completed ifth�Ne' B for One h1 d ($100) ar 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 tke Workers' Compensation Laws of California. Date Signature NOTICE.: lf,'after making this declaration, you shbuld become Subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit ” Shall be L deemed revoked. CONSTRUCTION LENDINGAGENCY I hereby affirm that there Is a construction lending agency for the performance ofthe work for wNthis permit is issued (Section 3097 Civ. C.) Lender's Name _- Lender's Address OWNER BUI-LDER DECLARATION I hereby. affirm that I am_exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 t� file a.signed statement'that he/she IS licensed pursuant to the provisions of Contractor's License Law (Chapter 9 (commenting with Section 7000) of Sion 3 of the Business and Professions Code) or that he/she Is exempt refrom 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 enalty 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 structur@ is not Intended or offered forsale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered .for sale. If, however, the building or improvement IS Sold within one year of Com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). I, aS owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts fpr such projects with a con- tractors) license pursuant to'the Contractor's License Law), ❑ I am exempt under Section B. & P, C. for this reason Date Owner I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances" and state laws r ating•to building construction, $nd hereby authorize repre- sentatives of t city o erste u the above-mentioned property for inspection pure s. 7/1p/8g Signature ` Date U �e TYP`E OF CONSTRUCTION NEW LJ ADD LJ ALTERATION- LJ_ REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTHERAP. ��^ ^ DESCRIPTION OF WORK inted npnt'�% i�45z_ 4 4 S Main Building: TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front KX TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - A Rear ❑ OTHER PROJECT DESCRIPTION SQ. FT. 2186 OCCUPANCY 62 C Right K CONSTRUCTION TYPE V -N VALUATION $ $ Left ZONE GRADING CU.YDS. ACRES _ PI ng, F ef. # Remarks: Parking Req./Provided Use of Building: PLUMBING Planning Notes: ` �r Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee Showers . Service Sink Sewer Cap ` Seger Connection Solar Collectors. Solar Piping Solar Tank f Swimm ing' Poollw/Spa Urinal Water Closet Water Heater Water Service $25 Issue Fee RAC- UAAl It' AI Boiler Duct,- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple 0 Firepl/Fact.Sit. ICBO4 - Heating System & Ducting ❑0.100,000 BTU ❑100,000BTi Drivers' License or SS Reinspection Fee $25 CMF 0865-46 rev: 7/83 - White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type 0 Canopy , Type 11. ❑ Refrigeration System 00-1100,000BTU ❑100,000 BTU System Repair/Alteration Issue Fee $ 3 5025 ' 7/27/84, 34�o-54 Ti ZonejC Accessory Building: Z 0 N 1 N G R . E ark. Fees $. Q U R E M E T a ELECTRICAL •Automatic FEES - Washer Construction Pole Sub. Transformer ❑ 15-50 KW C150 + KW Cooking Unit r Meter up to 100 amps $ 3 a Dishwasher Meter ❑over 100amps _Date' Dryers ❑Gas ❑Electric i Sub Panel S L, Fan 0-1 HP❑1%-B Motors E30-1 ?,_y� 's F.A.U. Ine.Solar. ❑9-15 HP. 016-15+ SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE iZ> Fixtures Microwave FR Device Boxes Pole Light l Jr 1 Outlets Range 20 Switches. Sign 3 C16Garbage Disposal Stand ingpSections Generator E10-5 KW 13 5-15 KW Trash Compactor Reinspection Fee $25 Issue Fee $ 3 FEES - PUBLIC SERVICES REQUIREMENTS: Zoning Approved By—��{ b�-- Application Approved By Application Issued By .. b _Date' nT Date Dat L a Q BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK $ $ $ $ $ $ $ $ SUMMARY OF FEES 2,06, `��) �`� >'-7� DCS _ jD 4�q,20 _ . j C) t2. SQ_ Z. 3e, SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE $ Z $ $ $ $ $ 347 .S $ 3 COIISTRUCTION AND PLANNING APPROVALS Permit #�� ¢�4f Date • Inspector PO' SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 8J7 -y 6a53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. JAM C." 60.••Backwash Lines, P -Trap, ❑ 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 i1 Z'1 ��-{ ' J 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 i 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating &.Air Conditioning `r tza FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑Gas 13 Oil 23. Gas Pipe -Rough & Test 72. Underground Flush •24. Roof Framing 73. Undergrnd, Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar'Ceiling (Structural) & Monocoat j e 75.. Dry Chemical 21P. Frame and Flashing ; -1) S 76. Dry Standpipe 2f. Lathing & Siding 77. FIXED SYSTEM FINAL r 29. insulation 78. FIRE PREY. FINAL 30. Drywall Nailing 3v HEALTH DEPT. REQUIREMENT I 31. Plaster Brown Coat - - 79. FINAL INSPECTION 32. Electrical Power Meter -Final' 80. FOOD CERTIFICATE ISSUED 33, Final Electric 8 Notes4_C4WW Fak UKDir.B. N -a R=F. LFR 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 I 47. FINAL STRUCTURE & BUILDING b 48. Special Requirements Completed 49. Electrie'Release to Edison - .50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY.' No. Date CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address, _3151 Airway Ave- R-2, Costa Masa Applicant's Mailing Address Owner's Name Glj,i 1 dhnitse Cong(11 to ntSPhone 540-2606 Address 3151 Airway Avp F-1, Costa Mesa om Arch/Eng-,TCos &• A am �. _... License No. Address 17779 "F" Maissoc. n St., Irvine Contractors Nam Qona1 d 1 son ' Phone -5-U-2606 1 Address Imaiiing) 3151 Airway Ave. E-1, Costa Mesa 1 City License No, 022707 LICENSED CONTRACTOR DECLARATION I hereby affirm that -I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the slness and Professions Code, and my license is in full forcband effect 333969 License �+�a $ D cense Date 1 L L Signature WORKERS' COMPENSATION OEC RATIO I hereby affirm that I have a certificate of consent to S61f-insure or a certificate Workers' Compensation Insurance, -or a certified copy thereof (Section you0, ab C')F-2974 + Company Fairmont cy Certified copy is hereby furnlshod. Cert]Fia9�gpy�81ed with the city B in (vision. ate 11 LL LLUU 33 Applicant EXEMPTION FROM WORKERS' COMPENSAT N DECLARAT N (This section need not be completed if the perm is for one hundr d ($100) or toss). 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. Date Signature ' NOTICE: If, after making this declaration, you should become subject to the Workers: Compensation provisions of the labor Code, you must forthwith comply with such provisions or, this permit shall be i deemed revoked. CONSTRUCTION, LENDING AGENCY i I hereby affirm that there is a'construction lending agency f6r the performance of the work ,for ,vii/A this permit . Js Issued (Section 3097 Civ, C.) Lender's Name' _ Lender's Address - OWNER BUILDER DECLARATION - - - I hereby affirm that I am exempt from the Contractor's License taw for the following reason (Section -7031.5 Business and Professional 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 assigned statement that he/she is licensed pursuant to the provisions of the Contract or's'License Law (Chapter 9 (commencing with'Section 7000) of .Division 3 of the Business and Professions Code) or that he/she is exempt lerefronn and the basis for the alleged exemptlow. Any violation of Section 31.5 by any' applicant for a permit subjects the applicant to a civil nalty of not more than five hundred dollars ($500). L1 1, as owner of the property lor'my employees with wages as their sole compensation, will do the work, and the structure Is not Intended or offered for sale (Section 7044, Business and, Professional Code: The Contractor's 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 employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of com- pletlon, the owner will have the burden of proving he/she did not build or im- ffe•for the purpose of sale). L! I, as owner of the property, am exclusively contracting with licensed con- 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 bul Ids or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to'the Contractor's License Law). ❑ I.am exempt under Section B. & P, C. for this reason . Date Owner I hereby certify that I have read this application and state that the above 'information is correct. I agree to Comply -with all city and county ordinances and state laws r ating to building construction, and hereby authorize repre-, sentatives of t city to art r on the above-mentioned property for inspection pur es• 123 1/[\ Signature Date plicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO, I TRACT NO. LOT NO.B 0I/0 p s3-1 PM -.1 '-Z TYPE OF CONSTRUCTION NEw AOD ALTERATION REPAIR, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER,- A P. DESCRIPTION OF WORK Interior ImproXement _ S Main Building: TYPE OF PERMIT GRAOING FOUNDATION ~STRUCTURAL T Front• 91,TENANT ❑ ELECTRICAL ❑ PLUMBING E� MECHANICAL B Rear` ❑ •OTHER A PROJECT DESCRIPTION S•Q OCCUPANCY C Right CONSTRUCTION TYPE__.'6 VALUATION $ 32,790.00_ S Left ZONE GRADING CU.YDS. ACRES Ping, Ref.# Remarks: - M 8-3L Parking Req./Provided PI -0149 - Use of Building: PLUMBING FEES Planning Notes: Bar Sink , Showers Backflow Preventer Service Sink = Backflow Irrigation Sewer Cap - Bathtubs Sewer Connection Clarifiers I Solar Collectors Dishwasher - Solar Piping — Drinking Fountains Solar Tank, Floor Drains- Swimming Pool w/Spa Floor Sinks I Urinal Gas Service Outlets Water,Closet L Interceptors Water Heater Kitchen Sink Water Service Lavatories . P—TPap $ Roof Oirains, , r PLAN CHECK Reinspection Fee � $25' Issue Fee. $ 3 MECHANICAL FEES Boiler $ Hood or Type I ❑ Canopy Type I I ❑ Duct - Under Ground Duct - Structural PLAN CHECK Refrigeration System 00-100,000 BTU 1:1100,000 BTU Duct - Ventilating $ Exhaust System ❑ Multiple ❑ MECHANICAL System Repair/Alteration Fi,rep]/Fact. Bit. IC80 # $ Heating System & Ducting ❑0-100,000 BTU El 100,000 BT $ , Drivers' License or.S Reinspection Fee CMF 0865=46 rev. 7/83 -' -White - Building; Canary - Applicant; Pink - Accounting; Goldenrod_- `Assessor 1111h.- $25 I l Issue Fee I $ 3 y Zone C L Accessory Building: Park. Fees $ ELECTRICAL Automatic Washer Transformer ❑ 15.50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit - ; - Meter ❑up to 100 amps - Dishwasher Meter Dover 100 amps Dryers ❑Gas ❑ElectricSub Panel Fan r Mot6rs ❑0-1 HP ❑ 1% - 8 F,A,,U, Inc. Solar ❑S-15 HP ❑16-15+ Fixtures + .Microwave Device Boxes Pole Light Outlets Range Switches' Garbage Disposal Generator ❑0-5 KW ❑5-15 KW Z O N i' N G R E Q U I E r :M ®® s® M■ �m Stariding Sections I ! Trash Compactor Reinspection Fee $25 1. Issue Fee "A& PUBLIC SERVICES REQUIREMENTS: Zoning Approved BY e��Application Approved By Date/ Application Issued By I Dat SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK i $ 3!� - . �L� PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ ' PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK $ CONSTRUCTION AND PLANNING APPROVALS Permit# Date Inspector POO L 'A 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings Z7 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 APPROVALS Permit # 20. Rough Factory Fireplace 2i, Ducts, in Structure ` 70. Underground Hydra 22. Ducts, Ventilating, . "Gas Pipe -Rough & Test 71. Product Piping ❑ Gas ❑ Oil 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing -. 74. Overhead Hydro 26. T -Bar Ceiling ra & Monocoa -b ] �..7�_ 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding5 fZ>1et"tr 77. FIXED SYSTEM FINAL 29. Insulation Q tv e_xf-L 1tJ�F 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 S 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING JJ� 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY . No, 41 Date 2�'� Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 4 TV OF COSTA -MESA -�- ,- -, _ ___ _--.- PE M!T NO- TRACT NO. LOT NO- BLDG, . -- ONSTRUCTION PERMIT. _ 1 Project Address 1 -Av aG TYPE,OF CONSTRUCTION NEW :LJ ADD- -ALTERATION- -REPAIR- ��f �t.? ! `❑ CONVERSION ❑ DEMOLISH •❑ OTHER' q,P• , z8ne,' I �: Applicant's Mailing Addreis '��7//�ft,,- --s _ O_wner's Name'- GILL,-� �� t-n^��-�?''�honen'�� 'DESCRIPTION -OF WORK{.j-'F'G✓�_�i-�'+^�� J �•� _ fes- S' Main Building: : r, Accessory Building: Z Address s1 rftwr} n -J�.- e �s T:} fNis.a , E _ , O �, T^---- _ TYPE OF PERMIT GRADING- ❑ FOUNDATION STRUCTURAL - T Front' r N ArcI41Eng. *�+��± �tn�rs-License No,TENANT ElELECTRICAL El PLUMBING ❑ MECHANICAL B Rear Address %._� 7�. !'�Lif y / amu: !1� 60THER = 1 A _ - ' N Contractor'sNamP .1 1��. hfSinn ! '` 7iN > PROJECT DESCRIPTION SQ. Fl -r�l g6 T^OCCUPRNCY K Right G Phone -•... CONSTRUCTION TYPE .� - � T VALUATION $ rD�6b Left i _ i. R Address (mailing) _ w %J r S E I ZONE GRADINGCU.YDS. ACRES Pln Ref.dk Park.Fees $ a .C!tvLiceoseNo. � yD7 - - — 9• f U , LICEfVSED CONTRACT0_R DECLARATIONRemarks: - I d 1 , Parking Req./Provided I -hereby, affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and ` _ t Use of Building: E mY license is in full force and effect i _ ' Manning Notes: M License Cl ss Ivens 333 Q(,Zrj _ _ PLUMBING FEES 9 �' E Date Signature I ' - ' WORKS S' COMPENSATION DECLARATI I Bar Sink ! i Showers ! N I I hereby affirm that I have a certificate of consent to self -insure or a certificate Backflow Preventer Service Sink } l I ; 1 g Workers' Compensation -Insurance,,-or-a-certified copy -thereof- Section -r — - ----- -__-_ 1 _ . Do, Lab. C,) } ; y « ! Backflow Irrigation I Sewer Cap ELECTRICAL i i i FEES olicY No. ; �`r`oZ�1 ��% Company G erticied copy is hereby furnished. ! I ; t j Bathtubs ; i I Sewer Connection I i Automatic Washer j iTransforrner 0 15!-50 KW ! i kd^Certl(Ie cop is filed with the'city Bu€ ng v!slonj� ; + I i ! I ❑ 50i+ KW Date ! Applicants +�- i� Clarifiers i ! Solar Collectors Construction Pole_ Sub. -EXEMPT( N F OM WORKERS'}COMPENSAT N DECLARA ON--_' ---,- Diihwa'her-t_ - i` ' - -"$o ar Pi In "'- " - ' - ' (This section need not be completed if the permit Js for one hundred ($100) or p, g Cooking"Unit-' " - - i Meter -❑up -t '-I00,amps"- 1 cert€fy that lin the performance of the work forlwhich this permit islissued, I ' Drinking Fountains j Solar Tank .. € ; 1 Dishwasher ! . ✓ ` ; Meter ❑over 100 amps $ hall' not employ -any person in any manner so as to become subject to `!the , Workers', Compensation' Laws of California. i i Floor Drains' i Swimming Pool w15pa Dryers ❑Gas. ❑Electric i ;Sub Panel Date Signature NOTICE: If,'ifter making this declaration, you should become subject to the I Floor Sinks I Urinal I . I ' ' _ _ Motors 070-1 HP ❑1'h - B l Workers'-Compensation-provisions-oftthe-L".abor-Code,-you must-ferthwith! ', - - -----•1----�-- - - - •----•-- -- --- ` comply with such -provisions or .this permit shall .be deemed revoked. Gas Service rOutlets ! _ I :Water•Closer F.A:U. 'Inc. Solar ;❑9-15 HP El 16-15+ CONSTRUCTIONe LENDINGrAGENCY;; [_ ; ! .` ; �,, I T j r,j 1 - - I hereby affirm that there is a construction lending agency'for the performance i I nterceptors „ ( j Water Heater, ' Fixtures I l S Microwave I I 1 of the ,work 'for whi h t}�t permit�Is' Issued ;(Settionw:3097 Civ. C:) i - - I j Lender's Name- �'� r, _ 1 - - 1 - Kitchen Sink = W - - - _ e Lender's Address' ater,Service D@V€Ce Boxes Pole Light , OWNER BUILDER DECLARATION .h . - 1 u2 _ yatories" _ �' _ I = i _ Outlets Range i ' I hereby, affirm ,that I am.exempt from the COntractvr's.L€cense Law for.the , • . - • ' , - � _ - r following reason' (Section -7031:5 Business and Professional Code:.Any city or I P -Trap, s U l " ` - _ Switches : ' Siguctn l r { onstr ['anynstructure, prior res a to Itslssulan ecalso requires the applicant for such permit sh r ! = I RooYDrams c `. i I �` ! i * Garbo a Disposal Staridin Sections ' j (to file atsignetl statement'that .he/she is licensed pursuant to the provisions of ; 'T' + ' � -' ' - _ g p 1 s g. i '.the Con tract or's'•License Cavi (Chapter 4 (commencing wltn Section 7000} of i ; i w 2 i I _ i v _ � Generator ❑0.5 KW ❑5-15 KW Trash Compactor f } -Divisionl 3•:of t€ie,Business and Professions Code) -or, that he/she,. is exempt = , ; i- j I =� i - I C- p 'herofrom-and the basis for'the alleged exemption'. Any, viol atIon-,of Section I - - } 131:5 by.;any- applicant for; ai permit; subjects -the' applicant -to !a civil ! ! i C malty of'not more than five hundred dollars,($500). i r, I r. I j '4 , iReinSpeCtian-Fee •. $25 �, 1 Issue Feeµ j ❑ rn I;;as{ owner of thel property ior�my nr ployees.wltti wages as their sole I Reinspection Fee I $25 Issue Feei `compensation, will dD the work, and the structure is not Intended or offered I ! I I i = i MECHANICAL FEES for sale! (Section ;7044, Business and Professional Code: The Contractor's License Law does not apply to'an!owner of a propertyiwho!builds or Improves ' I ' ' C� PUBLIC SERVICES REQUIREMENTS: Boller _ I = ! Hood or' Type ! r ❑ ! * i ! i thereon; andlwho)does such work-himself/herself-or,through his or her own - ` r Zoning.Apprdved By ; I Date 1 employyees, provided that such -Improvements are, not Intended or off Canopy Type II ❑ ' � , P If, however, the building or Improvement Is sold within one ear of com- I ; Duct- Under Ground i i I j } y - i Application Approved By I ' Date j �rhet tlpn,the owner willhave the burden of proving he/she did not builtlor�im- i 1 7oveforthepurpose of sale)Duct - Structural ! I Ref iigeration System ( Applirdtion Issued -By _Dat I,as ownerofthepropertymecluivelycontract€ngwith licensed con- , Q0,100,000 8TU ❑100,000 BTU ! ' , r corstoconstrcttheprjectSetion 7044, Bsiness and Profssions Code: Duct -Ventilating i ( I 'SUMMARY OF FEES .Contractora_license_Law_ pes_not.apply-to.an.owner of. property -who_. _ ! ' j } builtls ar improves thereon,Pantl who contracts for such projects with a -can- ! Exhaust System ❑ Multiple ❑i System Repair/Alteration 1 - - 4 i .�,BUI LDING!PERMIT $ SMIP• I $ - tractvr(s) license pursuant to'the Contractor's License Law): '' ! ( ( 1 ' [ , 'PLAN CHECK ; $ ! ' PERMIT l l I ❑U-am'exempt under Section B. & P. C. for this reason Fire I/Fact.,Blt• ICBO;# < s k t s I + 1 l p ! i } ! _ 3, Q ISSUANCE 1$ € ;PLUMBING j $ _ ! ; Date ! € ' ) Owner; ! i Heating System & Ducting i f �' ! ! ENEAGY P.C. $ { PLAN CHECK $ •_��` I hereby certify that I have read this application and state that the above ; 00-100,000 BTU 0100,OOOBT _ F ' ri F GRADING ! $ a r -information-is Correct-l-agree•to'comply with-all-city-and'County- ordinances- - - -T- -- -- rr ELECTRICAL $ and -State laws relatingito building construction; and!hereby authorize repre- € , ; r I ! r MICROFILM ! $ 1 I + sentatives of; this; yr to enter; upo the above-mentioned ,pro erty ,for ' i I I -, PLAN CHECK $ ; Inspection pup ase ! + r / j ' Signature ip I Date ! ) I ! + -�„ •'MECHANICAL $ ITOTAL FEE l $ r Dri'yers'!License orf 55 ) ! t I Reinspection Fee $25j Issue Fee i $ 3 rl �PL'AN CHECK f $ } (CMF-0865.46rev.-7/83• -•-White-,'Building;Canary- Applicant;•Plnk ;Accountirig;Goldenrod--}Assessor- _t- -,CONSTRUCTION AND PLANNING APPROVALS Permit # i7 l Ifoa Date inspector POOL' A 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 4 ` 56. Rough Plumbing & Pressure Test .6' Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings , - 58. Electrical•Conduit-Undrgrnd. ' 8. Fouindation 59. Gas Pipe, 0 Undrgrnd., Test r 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 Etectrical-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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure .70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas 0 Oil 23. Gas Pipe-Rough & Test ,72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tarik ❑ Gas ❑ 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. Piaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric „ I Notes: 34. Final Heating & Air Conditioning x A aViv/ �fwr p , 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 47. FINAL STRUCTURE & BUILDING , 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date z Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6TY WCOSTA MESA PERMIT NO. TRACT NO. LOT NO. BLjj. i� CONSTRUCTION PERMIT nil - . _ '7 C: 2 ]�C P.rvjel Address Appliceiit's Mailin Address kDr o/5� Ovrner's Name Phone *e�__2,40a Address Arch/Eng.. License No. Address A ` Contractor's Nam AIo�jJL/i� �+ 'Phone G3t��9 Address:(mailing)--- 3 g'�-��-'-LA � � GI!!`f � (� City +License No. ' LICENSED CONTRACTOR DECLARATION 1 -hereby affirm that ram licensed under provisions of Charter,9 (comImencing with section 7000) of Division 3 of the Business and Professions Code, and f my ticense is in ff ' for a d.effect. License lass •' Li N �� Date Signature WORKERS' COMPENSATION DECLARATION I hereby,affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation 'Insurance, or a"certified: copy thereof (Section - 3800, tab. C.) Policy No. Company Certified copy Is hereby furnished. r Certifie co is filed with the city E3 1di Division. Date rte' ' - Applicant/=s/l►f/�'N��`� -EXEMPTION FROM WORKERS',COMPENSATION DECLARATION- - (Thissection need not be completed if the permit'is for one hundred ($100) or less). k I certify that 'in the performance of the work for which this permit is Issued, I , shall not employ any person In anymanner so,as to become subject to the Workers' Compensation taws of California.' Date Signature I NOTICE: If 'after making this declaratlgn, you should become subject to the Wo'rliers' Compensation provisions of the Labor'Code,-you must forthwith - comply with, such provisions , or thi; permit Shall be deemed revoked. 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 (Section .3097 Civ. C.) Lender's Name - r Lender's Address; _ - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she i; licensed, pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of -Division 3 of the Business and P(Ofes;ions Code)_ or that he/she is exempt therefrom and the basis for -the alleged exempt lot,. Any violation of Section 7031.5 by any applicant for perMit, subjects the applicant to a civil ,penalty of not more than five hundred dollars ($500). LJ 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 (Section •7044, Business and Professional Code: The Contractor's 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 employees, provided that such •Improvement5 are not intended or offered for sale. If, however, the building or Improvement is sold within one year of Com- pletion, the owner: will 'have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project{Section 7044, Business and Professions Code: The -Contractor's L cense Law does not apply to -an owner of property who buildsor Improves thereon, arid who contracts for such projects with a con- tractors) license pursuant to the Contractor's License taw). ❑'•lam exempt under Section B. & P. C. for this reason Date ' Owner I hereby certify that I have read this application and state that the above 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 c , t nter on he above-mentioned properly -for inspectlon pur 51gnature Date Bar Sink Backflow Preventer- Backflow Irrigation Bathtubs i Clarifiers DisK;vvasher Drinking Fountains , Floor Drains% Floor Sinks,, Gas Service ,Outlets! v Interceptors Kitchen Sink Lavatories ' P -Trap Roof Drains. f Reinspection Fee $25 Boiler - Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIt. ICBO # Heating System & Ducting , ❑¢100,000 BTU ❑ 100,000 BTI Reinspection Fee 5 Drivers'License or SS :P� CMF -0865-46 rev. 7/83 ' White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Amt Showers Service Sink ' Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet ; Water Heater Water Service Zane Accessory Building: r• s . Park. Fees $ Y - ELECTRICAL Automatic Washer Construction Pole Sub. TYPE OF CONSTRUCTION NEW U ADD LJ ALTERATION III REPAIR Cookirig Unit ' `"' rIC CONVERSION ❑ DEMOLISH ❑ O ER ' A.P. # DESCRIPTION OF WORK _L��LLis�S.r- S Main Building: Fan' Motors ❑0-1 HP ❑l%-8 F.A.U. TYPE OF PERMIT El GRADING M FOUNDATI STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING .MECHANICAL Pole Light Rear Range A Sign -❑ ,OTHER C Right PROJECT DESCRIPTION. SQ. FT. OCCUPANCY K CONSTRUCTION TYPE VALUATION $ $ Left ZONE GRADING CU. YDS. ACRES Ping. Ref, # Remarks- - Parking Req./Provided Use of Building: PLUMBING Planning Notes: Bar Sink Backflow Preventer- Backflow Irrigation Bathtubs i Clarifiers DisK;vvasher Drinking Fountains , Floor Drains% Floor Sinks,, Gas Service ,Outlets! v Interceptors Kitchen Sink Lavatories ' P -Trap Roof Drains. f Reinspection Fee $25 Boiler - Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BIt. ICBO # Heating System & Ducting , ❑¢100,000 BTU ❑ 100,000 BTI Reinspection Fee 5 Drivers'License or SS :P� CMF -0865-46 rev. 7/83 ' White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Amt Showers Service Sink ' Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet ; Water Heater Water Service Zane Accessory Building: r• s . Park. Fees $ Y - ELECTRICAL Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 5d+ KW Cookirig Unit ' `"' Meter ❑up to 100 amps ' Dishwasher Meter Dover 100 amps Dryers ❑Gas ❑Electric Sub Panel. Fan' Motors ❑0-1 HP ❑l%-8 F.A.U. Inc. Solar 1:19-15 HP E] 16-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator ❑0-5 KW ❑5-15 KW Trash Compactor I Z O N I N G R E Q U R E M N T FEES � 1 Issue Fee $'3 Reinspection Fee $25 Issue Fee $ 3 1ANICAL FEES PUBLIC SERVICES REQUIREMENTS: Hood ❑ or Type I , Canopy Type I I ❑ Zoning Approved By Date Application Approved By Application Issued BY „� 7 Date +�ate.f Refrigeration System ®0-100,000BTU ❑100,000BTU BUILDING PERMIT r $ PLAN CHECK $ 'SUMMARY OF FEES SMIP. PERMIT . $ System Repair/Alteration --�-� S",,.rG. �r�— =-•�� 3 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK $ $ $ $ ISSUANCE $ , ENERGY'P.C. $ GRADING $ MICROFILM $ MECHANICAL $ TOTAL FEE $ Issue Fee $ 3 PLAN CHECK $ GQNSTRucfION AND PLANNING pPMbVALS `Permit # A I ll �4. � Date Inspector - A POOL & SPA � APPROVALS. Permit # Date Inspector 1 . Temporary Electrical Service or P61e 52,. Pool & Equipment. Location '2. Soil Pipe-Undrgrnd. • s 53. Steel Reinforcement ,_3., Electrical Conduit Utility-Undrgrnd? 54. Forms? 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding '5. Steel Reinforcement r ` - - 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. _ 57. APPROVAL TO COVER-GUNITE 7. Footings .58. Electrical Conduit-Undrgrnd. 8. Foundation '" = 59. Gas Pipe, II Undrgrnd., Test 9.Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 1,7. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT APPROVALS Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas 0 Oil 23. Gas Pipe -Rough & Test 4 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank []Gas I] Oil' 25. Roof Sheathing ;r 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 i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat E i 79, FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 0 33. Final Electric Notes: 34. Final Heating & Air Conditioning, �_ �j►j,�(� 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 r v 47. FINAL STRUCTURE & BUILDING - ! 48. Special Requirements Completed 49. Electric Release to Edison i 50. Gas Release to'Southern California,Gas Co ' 51. CERTIFICATE OF OCCUPANCY' No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - CIYYOF COSTA MESA _ItO'NSTRUCTION PERMIT PERMIT NO- TRACT NO. LOT NO. BLMG. MO.I I c �� ti �., , i u Project Address / f (AS Applicant's Mailing Address �f��A� TYPE OF CONSTRUCTION. NEW F I ADD 'ALTERATION LJ F-1 CONVERSION ❑ DEMOLISH El OTHER REPAIR A.P. # Zone Owner's Name_ r-0/4�.Shc�� r� Phone 9L _� DESCRIPTION OF WORK S Main Building: Accessory Building: Z n u0 Address %S /g IRf�° P OSnni %1P� TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL [:],OTHER PROJECT DESCRIPTION SQ. FT. —OCCUPANCY CONSTRUCTION TYPE VALUATION$ ZONE GRADING CU.YDS. ACRES- - E T Front • O N Arch/Eng. License No. - 13 A Rear N Address. _ _ MN �l.c. U/ Contractor's Nam hone Address(mailing) �2 t .a >?d�q /jJQ /r. e) �a G� % City License No, __- f` V _ � f C Right - G K S Left r R Ping. Ref. # Park, Fees $ Q U Remarks: -�ZZ ! Parking Req./Provided I \with I NDate ' LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing section 7000) of Division 3 of the Business and Professions Code, ar}� my license Is In full fo ce qd effect. ��S Lice I s ) LlCense o Signature WORK S' C MPENSATION DEC RATION I hereby affirm that i have a Certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Use of Building: _ R E PLUMBING ' FEES Planning Notes: M E Bar Sink Showers N BeCkfIOW Preventer Service Sink T S 3800, Lab, -w Policy No. + y Company BackfloIrrigation Sewer Cap ELECTRICAL FEES Bathtubs Sealer Connection - . Automatic Washer a Transformer ❑ 15-50 KW I-II C rtlfied copy Is hereby furnished. L�YCer a goy d with the city B ilding Di Date �" Applicant �� Construction Pole Sub. ❑ 50 + KW Clarifiers Solar Collectors EXEMP ION ROM WORKERS',C PENSATION DECLARATION (This section need not be completed If the permit is for one hundred (E100) or Dishwasher- Solar Piping - - Cooking Unit - Meter C�'a p to 100 amps less). ;" 1 certify that In the performance of the work for which this permit is Issued, I $hail not employ any person In any manner so as to become subject to the Workers' Compensation' laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions_ or this. permit shall ,be deemed revoked. LENDING AGENCY - Drinking FOUnlain5 - Solar Tank Dishwasher Meter Dover 100 amps • ' Floor Drains Swimming Pool vv/Spa Dryers ❑Gas ❑Electric Sub Panel Floor Sinks _ _ Urinal Fan _ - Motors E10-1 HP�1. - S Gas Service Outlets Water Closet; F.A.U. Inc, Solar 09-15 HP 1__116-15+CONSTRUCTION Interceptors .- Water Heater Fixtures Microwave 6 l% I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issuer( (Section 3097 Civ. C.) Lender's Name — -- Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031,5 Business and Professional Code: Any city or county which requires a permit to construct, atter, Improve, demolish or repair ' any structure, prior to Its issuance, also requires the applicant for such permit to flie a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with, Section 7000) of! Division 3 of the Business and Professions Code) or that he/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 ,nnalty of not more than five hundred dollars ($5p0). LJ I, as owner of the' properly .or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Codea The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and Iwho,does such work-hlmself/herself or through his or her ownZoning employees, provided that such improvements are not•intended or offered for sa1e. If, however, the building or Improvement is.to'd within One year of com- pletion, the owner will have the burden of proving he/she did not build or im- ' rove for the purposo of sale), r Kitchen Sink Water Service r� Device Boxes Pole Light Lavatories - - 1 '�p Outlets Range - S �- p—Trap p. -Switches Sign .3 Ile } Roof•DrainS - - Garbage Disposal Standing Sections - + Generator ❑05 KW ❑5-15 KW Trash Compactor Reinspection $25. i Issue Fee- $ 3 s Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES PU6LIC SERVICES REQUIREMENTS: Approved By Application Approved By Application Issued'By'• Data Date 7 f _ Dat' Boiler Hood or Type I ❑ Canopy ' Type II ❑- Duct: Under Ground Duct - Structural Refrigeration System 1, as owner of the property, am exclusively contracting with licensed con• 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 builds or improves thereon, and who contracts Ior such projects with a con- tractors) license pursuant to the Contractor's License Law): © I am exempt under Section B. & P. C. for this reason ❑0 100,000 BTU ❑100,000 BTU Duct - Ventilating % BUILDING PERMIT ,, ` " PLAN CHECK PLUMBING SUMMARY OF FEES r $ SMIP $ $ PERMIT $ ,ISSUANCE $ _ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepi/Fact. Bit. ICBO _ Date Owner I hereby certify that I have read this application and state that.the above _ - Information is Correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre-k sentatives of this city' t en r, upon the above-mentioned prope y f r Inspection Pur o /.� `7 y Signature 1.�� /o'- (/ Drivers' ense or SS Heating System & Ducting 0&100,000 BTU 11100,000 E3 PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK $ ENERGY P,C. $ $ � GRADING $ $ �J MICROFILM $ $ TOTAL FEE $ $ + k �� ' l _ s - Reinspection Fee Ae $25 Issue•Fee $ 3 CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - '- - •- - - - - - , CONSTRUCTION AND PLANENG ' APPROVALS Permit #� D Date Inspector POOL & SPA APPROVALS Permit # Date Inspector "Ti, Temporary Electrical Service or Pole" 1 52. Pool & Equipment Location , 2., Soil-Pipe-,Undrgrnd. - ;` 53. Steel. Reinforcement 3., Electrical Conduit-Utity-Undrgrnd. 54. Forms- 4'•Electrical Conduit;Undrgrnd. yy� 8 55. Electrical Bonding ' 5. Steel Reinforcement 1 56. Rough Plumbing & Pressure Test 6. Electrical-UFER Grnd. f 57. -APPROVAL TO COVER=GUNITE , 7. Footings { 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. ,Water Pipe-Undrgrnd,` ` �� 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10: Structural Floor System H :' 61. APPROVAL TO DECK 11: Property Sewer Line-& House Connection 62. Backwash"& Receptor -Final 12. Sewer *Gap �� . 63. Heater & Vent -Final 13,, Roof Drains 64. Plumbing System - Final 14.' Rough Plumbing,- 65. Electrical -Final ' 15. Rough Electrical-6nduit 66, Solar System -Final 16: Rough Electric Wiring 1 aQU 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts; in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY, FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final J� 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 i' 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49, Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. _.. •_ . CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. Q (� TRACT NO. LOT NO.' BLD m3051 1/25/8'4 =�' . �I 5;.OQ TL - Project Address TYPE OF CONSTRUCTIONLJ-NEW LJ ADO ALTERATION REPAIR - Applicant's Mailing Address psi A/�Qw..l EICONVERSION .'❑ OEMOLISH ❑ OTHER ' A.P. # . -` Zone . ��'``'' �;� / Owner's Name�.Y'kLS�i��'y� Pc " Phone2S�tz�� DESCRIPTION OF WORK S Main Building: Accessory Building::,; Z Address /,�//��lQ. �-^-� ' JCTI_ Aln-S-3i TYPE OF PERMIT GRADING FOUNDATION ❑.STRUCTURAL' E T : Front ` N Arch/Eng. License No, ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING- ❑ MECHANICAL, B "• Address ❑ OTHER A Rear t r N / � Contractor's Name �I A her" `` ��Tt� PhoneC'��t �/s PROJECT DESCRIPTION SG: FT. OCCUPANCY � C K Right G I '��e X41/ wC Address (mailing) CONSTRUCTION TYPE VALUATION $ S Left - _ E y City License No. ra�T-74 _ _ _ ZONE GRADING CU.YOS: I ACRES Ping: Ref. # Park.Fees $ LICENSED CONTRACTOR DECLARATION I Remarks: • DI� r/ © -Parking Req.IProvided M. U I hereby affirm that I am licensed under provisions of Charter,9 (commencing R with section 7000) of Division 3 of the Business and Professions Cod�nd Use of Building: ", ri E my license! in full for nd effect. License Llce , ; - - PLUMBING f FEES Planning Notes. M ss Date Signature ' � I E '� • WO ATION DERS' COMPENSE RATION Bar Sink , Showers • ' { T hereby affirm that I have a certificate of consent to self -Insure or a certificate Backflow Preve'nter Service Sink 'r ' "'' ` S' t Workers' Compensation Insurance, or a certified copy thereof (Section , ' d00, Lab. ^� �� _; /' Policy No. I�� Companyi�� Backflow Irrigation' Sewer Cap :� ELECTRICAL 4FEES ❑ Cwtffled copy Is hereby furnished. y Bathtubs l Sewer Connection ! Automatic Washer Transformer ❑ 15-50 KW � .� ertif�i��o�� a with the city Bull Ivlsio P� Oate�L !� Applicant Clarifiers Solar Collectors Construction Pole Sub. ❑ 50+ KW EXEM ION F OM WORKERS''CO NSATION DECLARATION (This section need not be completed If he permit Is for, one hundred ($100) or Dishwasher soler Piping ' Cooking Unit Meter ❑up to 100 amps, less): I certify that in the performance of the work for;whlch this permit Is Issued, I Drinkin Fountains 9 solar Tank Dishwasher Meter Dover 100 amps shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California.: Floor Drains Swimming Pool w/Spa l Dryers ❑Gas . ❑Electric Sub Panel Date Signature NOTICE: If,mfter making thirdeclaratlon, you should become subject to the_ FIoOrSinks- - ; -Urinate -� - Fan -' Motors ❑0-1 HP ❑1%z -B t" Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Gas Service' Outlets Water Closet, - F.A.U: Inc. Solar ❑9 15 HP ❑16 15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency, for the performance Interceptors Water Heater Fixtures Microwave of the work . for which this permit is Issued '(Section 3097 Civ. C:) Lender's Name Kitchen Sink - Water Service Device Boxes Pole Light Lender's 'Address OWNER BUILDER DECLARATION' i Lavatories - Outletsi I Range I hereby affirm thit I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or p.Fra p Switches Sign • county which requires a permit to construct, alter, Improve, demolish or,repair , r n any structure, prior to Its issuance, also requires the applicant for such permit Roof Drains i Garbage Disposal Standing Sections -to file a:slgned statement that he/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'iivisjon -of ' Generator ❑0-5 KW 05-15 KW Trash Compactor. 3 the Business and Professions Code) or that he/she is exempt ,refrom and the' basis for the alleged exemption.•Any violation of Section - i 31:5 by any applicant for; - a, permit subjects the applicant to a civil Reinspection Fee $25 �. Issue Fee 3 enalty of not more than five hundred dollars ($500). Reinspection Fee su Fee $ 3 • l,' ast 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 , MECHANICAL FEES for sale' (Section 7044, Business and Professional Code: The Contractor'sRVICES builds Improves REQUIREMENTS: License Law does not apply to an owner of a property who or Boiler Hood or Type I ❑ thereon, and .who does such work himself/herself or through his or her own Canopy Type I I ❑ Zoning Approved By Date emy ees, provided that such improvements are not intended 0r offered for sale. If, however, the building or improvement is sold within one year of Com- Duct - Under Ground Building Approved By Date pletl0f the owner will have the burden of proving he/she did not build or im- ' S shrove for the purpose of sale). LJ is licensed Duct - Structural Refrigeration System Application Issued By Dat I, owner of the property, am exclusively c.ntracting•_Ith con- NaCtorstD Construct the project (Section 7044, Business and Professlons Code: Duct -Ventilating ❑Q100,000 BTU ❑100,000 BTU SUMMARY OF FEES i The Contractor's Ll cense Law does not apply to an owner of property who bultds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP tractor(s) Ikons. pursuant to the Contractor's License Law). PLAN CHECK $, PERMIT ❑ I am exempt under Section B. & P. C, for this reason Firepl/Fact. Bit. ICBG # ISSUANCE $ PLUMBING $ Date Owned Heating System & Ducting PLAN CHECK 25% ENERGY P.C. $ $ I hereby certify that I have read -this application and •state that the above ' ❑0100,000 BTU 0100,000 ELECTRICAL $ %S GRADING $ information Is correct• t agree to comply with all city and county ordinances and state laws relating to b�Idi.onstction and hereby authorize repro- sentativesof t Is tlty; te above -mention for LAN CHECK 50% $MICROFILM $ a ipropert Inspection pur S. �/! MECHANICAL $ TOTAL FEE $� Signature 7 Reinspection Fee `$25, Issue Fee $ 3 . PLAN CHECK 25% - ' $ Drivers' L ense or 55 CMF 0865-46 rev. 12/83 e - u ng; an t; Pink - Accountingl Goldenrod - Assessor + CONSTRUCTION AND PLANNING' r; _POOL A '�s APPROVALS Permit=#_ I ��Dat Inspector APPROVALS. Permit# Date Inspector I 1 Temporary Electrical Service or Pole 52. Pool &Equipment Location v 2) Soil Pipe Undrgrnd r �:• . ',U 53. Steel Reinforcement r r' s - �r 3'� lectrical Conduit Utiri' Indrgrnd:l = �� 54.• Forms � r 47 Electrical Conduit-Und grad. - j' r�' - ` f 55: Electrical Bonding. 5. SteeliReinforcemen{ i-nr1' "+ , =56, Rough Plumbing & PTessiare Test 6= Electri aI+UFER Grrid^;f I ' 57. APPROVALTO COVER-GUNITE 7. Footing"s ''i ' �, 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, ❑.Undrgrnd., TestIlk i 9. Wate�••Pi e;Undr i-na .` p _ g. •� 1' X 60. Backwash; Lines, P -Trap, 0 Undrgrnd. = { , 10. Structural -Floor System , / 61. APPROVAL'T0: DECK r 11. Property Sewer Line & House Connect ion - ; _ 62. Backwash & Receptor -Final Y ! 12. SewerlCap "_! 63. Heater & Vent -Final 13. Roof Drains ' �r"' �!^ 64. Plumbing:System : Final k: 14. Rough Plumbing 65. Electrical -Final 15. -rRough Electrical -Conduit- -' - 66.t Solar System -Fina! _ a 16. Rough Electric Wiring- _-- = i 67. Fencing & Access Approval'- pproval J7. Rough_Wiring Sign; J7. 68.• APPROVED FOR PLASTERING :* 1$. Rou h�Electrical-T Bar Ceiling' g g' I 69. POOL/SPA SYSTEMS i � ' S - 19: Rough Heating & Air Conditioning I ' FIRE DEPT. REQUIREMENT +I APP'ROVALS' Permit# x 20. Rough:Factory Fireplace s < 21. Ducts,ln Structure 70. Underground Hydro I T ".22. Ducts, Ventilating 71. Product Piping ❑ Gas 0 Oil t23. Gas Pipe -Rough & Test r 'r i 72.• Underground Flush; 24. Roof Framing- `- ,. • • ' 73.' Undergrrid. Storage Tank!- ❑ Gas ❑ Oil 25. Roof Sheathing J f^ ,74. Overliead Hydro J 26. T -Bar Ceiling (structural) & Monocoat 75. Dry, -Chemical s - _ 7. and Flashing. Dry Standpipe .76. _ 1 r rFrame 28. 'Lathing &Siding, I -77. FIXED SYSTEM FINAL I I i _ 3 ~78.' 29._Insufation ! FIRE PREV, FINAL i ! -30. Drywall Nailing HEALTH DEPT. REQUIREMENT' i I 31. Plaster Brown Coat ! 79., FINAL INSPECTION i .r 32. Electrical Power Meter -Final 80.' FOOD CERTIFICATE ISSUED X33. Fina! Electric _ _ ,_ LM. 7 Z7~ �U� ;Notes: 34. Final`Heating &'Air'Conditioning 41, ; 35. Final Gas 1Pipe-Test 6 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - 39. Water Service -Final ; a 40. Gas Service -Final 41. Solar Domestic -Fina, 42. Backflow 'Preventeri 43. Backflow Irrigation t 44. ,Landscape Irrigation System 45. Sound Attenuations 46. HandicaplRegulations s 1 + 47. FINAL STRUCTURE & BUILDING! 48. Special Requirements Completed) 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF -'OCCUPANCY - - -- '- ` No. "• ` ,Date,. PROJECT ADDRESS: 3151 AIRWAY AV UNIT: R— 2 AIDDRESS OWNER'SNAME: CALIFORNIA FEDERAL BANK AD: 3151 AIRWAY CM CA 92626 ARCH/ENGINEER: 540-2606 REG.NO.: ADDRESS: UNIT: PERMITTEE: T BOY ER COMPANY ( 714) 6 4 2 — 2 4 31 ADDRESS: 1760 MONROVIA AVE A-20 COSTA MESA CA 92627 LICENSED CONTRACTOR 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 lull force and effect. CITY LIC.:4 7 STATE LIC.: 5 6 6 9 0 s' C 10 Dale: Signature: — WORKE COMP NSATION DECLARATION: I hereby affirm that I have a c �icaleofsent to self -insure or a certificate of workers' Compensation Insurance. or a cerldied copy thereof (Section 3800. Lab. Q. POLICY NO.: EXP, DATE: COMPANY: ❑ Certified copy is hereby famished. © Certified copy is filed with the city Building Division. r Date: Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred {3100) or less)e I certify that in the performance of the work for which this permit is issued. I Shari not employ any person in any mannef so as to become subject So41heV�rkers' Compensation laws of California.ol Date: Signature:� N I! r maks this declaration, you should b cEame subject a Workers' Compensation provisions of the Labor '- Code. you must fort ith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. Q. ; LENDER: t' ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that 1 am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe is exempt therefrom and the basis for the alleged exemption. Any violation o1 Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (5500). f, 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 $or sale (Section 7844, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselflherself or through his or her own employees, provided that such improvements are not intended or offered for safe. Il, however the building or improvement is sold within one year of completion, the owner will have the burden of proving helshe did not build or improve for the purpose of sale). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project {Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon and who Contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby cendy that I am aware of and understand the requirements of Calilornia,Health and Safety Code Sections 2550.5, 25533, and 25534 and that I or any future b0cling occupant will/will not (circle one► need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above inlormation is correct. I agree to comply with all city and county Ordinances and state laws relating fo building construction and hereby authorize representatives of Itis city to enter upon the above-mentioned properly los inspection purposes. -Date: Signature. ZJ/ Driver's Licens Social Secunty w: t64t-46 Whne—Buslding: Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05525` PERMIT NO: E 055255 PLAN CHECK NO: N GOVT; N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE: ALT JOB DESCRIPTION ; T.I. OFFICES SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS • T.I. OFFICES �L %' L'� Ski I r � �• � � � � �c• •># * �-�c �-•x �-�-+i-•>f � +i -•>f •>f •>f � � �-� �+�-+i-+i-+i- � �+�-+i- >E+�--r� r�•>E +e �-�-�-� �-r�+�-•rE *� � � �•+�-�-�-+i-�-�• >E * �-�- a� �- * �-�-x•*•r� �-•� * *�-� Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- ----------- ACCESSORY BUILDING--------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT; FT IN RIGHT: FT IN PARKING RE8: PROV: PARCEL: 42729115 ZNE: REF NO; PLANNING N TES> > D E V E L O P M E N T S E•'•R V I C E S R E Q U I R E M E N T S ZONING APPROVED B,Y DATE: BUILDING APPROVED BY DATE; APPLICATION ISSUED BY- DATE; ->t- �4 �4 -1l- #4 �4 �F 1E 14 j4 �4 �F •1(• �F •14141414 i4 i4 44• {tt #4 �4 -1l- �4 -14 � {tt i4 {'4 i4 i4 iE #F 14 i4 iE iE i4 #F �4 #F i4 {'4 1414 i4 {'4 i4 i4 i4 {'4 i4 i4 * ->t �• •14 i4 �E �4 -1l- iE i4 �4 * i4 i4 �4 �4 iE #F i4 -1l- iE * iE iE i4 1414 i4 -1F i4 -1F #4 #F i4 i4 i4 it it it i4 94 �4.1F i4- i4 it it LEGALIZATION;N F E�EI S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING EL CTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT �' 6.75 50% SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS-----> 6.75 15.00 0.00 21.75 21.75 .00 REVENUE DIVISION TOTALS--> COLLECTED: 21.75 OVER/SHORT; .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 21.75 it4 i4 it4 �F'14 i(- 94 i4 i4 14'14.14.14 14.14 14.14.14 94 14.14.14.14.14 -1l- -1F 94.14 i4 441(• i4 14.141!• •14.14 -14 i4 i4 #4 -14 i4 i4 i4 i4 i4 i4 i4 i4 i4 i4 }4 i4 1414 -1F itt #4.14 -1l- i4 iE 14 iE 141414 i4 i4 #4 i4 i4 it i(- -1t 14.14 i4 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 FIXTURES LIGHTING 1 ST 20 EA, ,75 ELE 5 RECEPT/OQTLET 1 ST 20 EA, ,75 ELE 3 RECEPT/SWITCH 1 ST 20 EA, ,75 END OF FEES .75 3.75 2,25 Cl- CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & . A APPROVALS Permit # Date Inspector 1; Temporary Electrical Service or Pole 52. Poo! & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54, Forms 4. Electrical Condu,t Undrgrnd. 55. Electrical Bonding 5- Steel Rfinforcemeni 56. Rough Plumbing & Pressure Test ,;I electrical LIFER Grr1d, 57. APPROVAL TO COVER-GUNITE 71. Footings 58, Electrical Conduit-Undrgrnd. YtiB: Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9C Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 /�'r�/ ` KAT! ,Q67. 'L Fencing & Access Approval } 8. APPROVED FOR PLASTERING 17. Rough Wiring Sigrf- 18, Rough Electrical•T'Bar Ceiling 19. - Rough Heating & Air Conditioning ,. ' 69. POOL/SPA SYSTEMS FINAL FIRE DEPT, REQUIREMENT APPROVALS- -Permit # 1 20. Rough Factory Fireplace 21.:bucts, in Structure , ,. X70. Undergrpurid "}•Iydry 22. Ducts, Ventilating` .71. ProductRiping DGas ❑Oil 23.'.Gas Pipe -Rough & Test z ' 72. Underground Flush_ - 24. Roof, FramingT t73. Undergrnd: Storage.Tank 0 Gas ❑ Oil 25. Roof Shgething _ r _ 74. Overhead Hydro - 26."T -Bar Ceiling IStructura0 &.Monocoat r 75.,Dry Chemical 27., Frame and Flashing 76. Dry Standpipe y 28. Lathing & Siding'-.-. , 77.-! FIXED SYSTEM. FINAL: .- 29. Insulation - ` 78. FIRE PREY. FINAL + X30. Drywall Nailing "' r, HEALTHJ)EPT. REQUIREMENT 31. Plaster Brown Coat' + Y i 179. -F I NA L I iVPI CTI9N - 32. .Electrical Power Meter -Final �.,.FOOD CERTIFICATE ISSUED 33.'Final Electric - r 34.,Finaj Heating`& Air_Cbnditioning - 35. 'final Gas Pip: -Test' 036. Hood or Canopy 37. -Tinal+Factory Fireplace 38. Final Plumbing -�39. Watai Service -Final- 40, Gas Service -Final ' r; ,41. Solar Domestic -Final 42. 'Backflow Preventer ' 43. Backflow Irrigation- .. F ;44. Landscape irrigation System , y ' , h +:45.'Sound Attenuation 46. Handicap Regulations 47. -FINAL STRUCTURE & BUILDING - [ 48. -FINAL PLANNING' Z49. Electric Release to Edison ti i 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF'OCCUPANCY No. Date .1 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 00044 9 P. O. Box 1200 Costa Mesa, California The Building located at _":1_.9il ATPMV - TT.WT cZ1 1;,_ 7 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group la—? Occupancy. Use of Building OFFICE Legal Description 427-291--15 (See reverse side for Metes and Bounds) Building Permit No, i3-i_n210 Electrical Permit No.F._1f1d34 Plumbing Permit No. V-1.0469 Mechanical Permit No. M -1064F -- Number of apartments and/or guest room ISSUED TO: Buildin fficial 1 MIEDHOUSE OONSULTANTS, LTD. by 3151 AIKWAY AVE. E--1, COMA MASA, CA. - ° ---- Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the�premiswand SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 {e} U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File CITY OF COSTA MESA o p "'� q BUILDING DIVISION 0 F 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00107 PERMIT TYPE B_R00F2 STATUS: ISSUED APN: 93894027 DATE ISSUED: 0611912009 ISSUED BY: RMD JOB ADDRESS: 3151 S AIRWAY AV CM Suite/Unit: S Vicinity: BUILDINGS ROOF Squares: 0 Valuation:. $13,646.00 SCOPE OF WORK: REROOF BUILDING "S". -TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 153 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 70 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED, OWNER: CORP OF THE PRESIDING,BISHOP.CHURCH OF LDS Address: %STORSTAD, KIMBERLEY E %PROPERTY RESERVE Unit: 10 E SO TEMPLE ST #400 PHONE: CitylStatelZip: BRUCE CHRISTENSEN APPLICANT: HANSEN, DUKE Address: N6646636 Unit: PHONE: CitylStatelZip: CONTRACTOR: ROSS AND BARROWS INC License No.. 327802 Address: 260 E ALTON AVEUntt: PHONE: 714-557-7440 CitylStatelZip; SANTA ANA, CA 92707 CELL: ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: Reroof Permit Fee: Reinspection Fee: Bldg Std Admin Fund TOTALFEES License No. License No. $0.00 $237.25 ' $0.00 $1.00 $238.25 PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE N. INSPECTION TYPE DATE INTMALS CODE r INSPECTION TYPE DATE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Fina! 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining Wail 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)Qccupancy 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. t❑ 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: �1 (This section need mol be completed Athe perm# is valued at one hundred dollars (S 100) or less) Polio amber: 19z, Z ;E3�,_ r% — 7-0-0S/ ❑ 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 beco bject to the workers' compensation provisions of Section 3700 of th abor ode, I shal rthWth comply with these provi ions pp1ic0 ,Signature Udte 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 DOLLARS ($100,000), iN ADDITION 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 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. Clas'�# if -5 %X!_ Contractor's Signature ft�tratia+' — 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 iswance, 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 rive 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 3057-46 (3107) Owner ID verified b dri�F's In.ense,Y y ❑ es ❑ 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, wit) 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, Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be riled 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 ❑ 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 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? ❑ Yes ❑ 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 permit 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 ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 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? j] Yes ❑ 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 egal Owner(s) Date Andloi�Aurftnrtz Apprrcanl�,• .: �»- . f��te� �~ Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. •BLDG. O. CdNSTRUCTION PERMIT ///6 5— 7q'3c(1 PGI, a Project Address 3151-S Airway Avenue, Costa Ivies Owner Western Pacific Financlal Phone 757-767 Address 1601 Dove Street Newport Bch.' Arch/Eng. Hal es -Langston License No. C-0 Address 777_ S,' Mains #105, Orange a. ContractorThe J. 'Donald Olson Co. Ph6n()40- Ob Address 3151-E Airway Avenue, Costa esa LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is In fu11 ford d❑ egffact. License Class B License No. JJ6J Date Signature _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Se„Ftign43g�0,11��_G�),^ Policy Ne j1 11 // ll])rr mpany l C rtifietl copy Is hereby furnished. ertifled copy is filed with the city Building Division. .'EMPTION FROM WORKERS' COMPENSATION DECLARATION ,,'his section need not be completed if the permit is for one hundred ($100) or less). I Certify that n the performance Of the work for which this permit is Issued, I $hall not employ any parson in any manner so as to become subject to the Workers Compensation laws of California. Data Signature NOTICE: If after making this declaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lerlding agency for the per- formance of the work for which this permit is issued (Section 3097 Civ. C-)• Western Pacific Financial COr. . Lender's Name Lender's AddressIbUl ova Street, Newplort OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 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 re. quires the applicant for Such permit to file a signed Statement.that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProfeSsions Code) or that he 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 t0 a civil penalty r• not more than five hundred dollars ($500), as owner Of the property, or my employees with wages as their :ompensation, will do the work, and the structure Is not intended �. ,,ffered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does Such work himself or through his 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 will have the burden of proving he did not build or improve for the purpose Of sale). ❑ I, as owner of . the property, am exclusively' contracting with licensed contractors to construct the project (Section 7044, Business andProfessions Code: The Contractor's License Law does not apply to an 0wner of property who builds Or improves thereon, and who con- tracts from such projects with a contractor(S) Ilcesned pursuant t0 the Contractor's License Law). ❑ I am exempt under Section — — B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relat,ng to construction, and hereby authorize propeenfati ttio his Ity to enter pon the above mentioned property acp ;es; signature Drivers' License or SS iA TYPE OF CONSTRUCTION PLA X NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK OMMERICTAI TYPE OF PERMIT�,.� y El GRADING i OUNDATION Ial STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING,❑MECHANI 0 OTHER PROJECT�fgCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE 5 N. R— VALUATION 138 SO9.O9NE GRADING CU. YDS. ACRES REMARKS: 0 �7 ;9- /Z sI CHECK #51442 A.P. :A* ZONE ]NING REGULATIONS 04;�, — OR PLNG. REF:. =# REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ n'f ]` . or l PLUMBING 'PLAN CHECK ELECTRICAL PLAN,CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW_50 + KW KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP ' J SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES , OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN *SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES ' BUILDIN G 540.50 9.72 HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP s AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT ISSUANCE $ REFRIGERATION- 0-100,000 BTU PLUMBING $ SYSTEM GRADING $ 100,00.0 + BTU PLAN CHECK $ BOILERS BTU ELECTRICAL $ $ MICROFILM S SYSTEM REPAIR, ALTERATION PLAN CHECK $ TOTAL FEE MECHANICAL $ EXHAUST.SYSTEM MULTIPLE LESS AO - PLAN CHECK $ VANCEPC $ 550.22 FINAL FEE S ISSUE FEE _ CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # r Date Inspector POOL & SPA r APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2.' SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. ---S=.teel � Electrical Conduit-Undrgrn 46. Electrical Bonding Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,❑ Undrqrn 10. Structural Floor System 52. 'APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection' 54. Heater & Vent-Final 13. Rough Plumbing - 14. Rough Electric-Conduit :56. Electrical-Final. _ -15. Rough Electric-Wiring 57._ Solar System-Final -. 16. .Rough Heating & Air Conditioning 5B. Fencing & Access Approval " 17. Ducts, in Structure . APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe-Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL �- 21. 22. Roof Sheathing Frame and Flashin �`S _}'�� NOTES:r 23. Insulation i- 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 4 33.` Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING I ,(-2-1:2- 2.- y39. 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OP OCCUPANCY No_ Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. ' XITYAqF COSTAMESA' P�E3 IIT' O�t� - TRACT NO: OT O. BLDG. NO. - ' -- -- 6137 _ 5/20/82" _-_ I'9��- T: CONSTRUCTION PERMIT /�/fes Address B , _ - 3j �r S 13 E OF CONSTRUCTION r. � v' s c ^ I' • t -i,.;, ; ()t-' , rirwa 01SQn Phone ! NEW -' ❑ ADD ❑ ALTERATfON _fi�ti ' `D 4 s I 'Airwa Ave - ❑:R PAIR, ❑ CONVERSION. ❑DEMOLISH__ J. I " 'r ❑ .. _ _ »_ ZONING REGULATIONS— ..- ,- _ -- ng,-• License No.- OTHER` rd DESCRIPTION OF WORK1 '}ZONEPL'NG. REF ctor Safewa Heatin Serwiiitse. 'TYPE OF PERMIT = ' ^' B DTpBUIL€,,,}�,„(SETBACK s.f- rS- 6o$ Im eria3 HW Santa-• Fe -S s D"G•RAD�NGt^❑ FOUNDATION --0 STR CTU RAL C LST. PROPERTY LINEz -- itIDE YARD -ED CONTRACTOR.DECCARAT.ION -.,. �ia_ _ '. ❑'TENANT= C]'ELECTRICAL-❑PLUMBING. ECHANICA f affirmthrat I am licensed under Prov' Sof Charter 9 �r.,, x , ”' \\ ❑'OT.HER: RIIGHFAR•with -section 7000) of Oivis the- Bus and Professions Code, and my license In f force d e ec REAR 'YA'RD (TO-P/L)- ,-PROJECT DESCRIPTION• bcen'se Clads - cense " " " ^ ' - FTt( -�- ^— PKG'. SPACE"F2EII:"" PROV I DSD Y Date;c-^ 2 i7 '-Signatur 7-' T-'4Cr - - -'�•K, " , - �-_ _ rOC UPANCY_ C_ONSTRUCT_ION TYPE - tSTREET'WIDTH•--"'"-' y-""PA'RK•FEEI$-•; '--, _- 4 WORKERS' COMPENSATION• ARAT.I _ _ _rte ;I hereby affirm that I have a to ificate of consent to self -insure � r T c? r - - [s RLUAFION ZONE ZONING APPROVED BY -` - - DATE -t.-J-71- certificate of Workers' Compensation -ins u ante, -or a_zertified' i thereof (Sectio. 800 ). L Policy No. f?1N _ - w - - ,GRADING CU-fYDS. ACRES- SPECIAL CONDITIONS: - Company _S_ :a'e - d copy is hereby. furnishid. _- _._______._ ,.,,_. i. P 'ertified is filed the Building Clivision. _REMARKS...29tj`Y:�_ __-_,r . --� �- - - - ` - --� - •' --" - `- -- ' "'- '- -"'"" •-' --^-;• •-__._._ ___ .: copy with city o„ .r +'R- ia. MPTION-FROM WORKERS' COMPENSATION -DECLARATION, - - - - '(This section .need not be -completed if the permit is for one hundred + Wf „ki.- ', ,: •„� ; [$100) or less). : - 7E} .. M � - -"”" �'• -- -- __ _ certifythatin the.performancee -of the work fpr which this permit is issued, I shall not employan er5on in any manner so as to•become + - ; PLUM6ING,�7 �;,r,PLgN CHECK ^�•- �._ "' "ELECTRICAL•'- -� - --- PL -CHECK -'T - subject -to the Workers_Cmpensatlon-Laws of CAliforn_ ia. Date Signature r - _ _ BATHTOBS` - - SHDWERS - ti' -- L _ _ - - 'NOTICE: If after making this declaration, you Should become subject- TOILETS-.. ;rr •,.SUR-INALS-�"y�'''" -�`t• '� --`-IGENERATOR`'�- o-' KW 1 .1'O,KW---------• to the Workers' Compensation provisions of the Labor Code, you must' - TRANSFORMER rir�,,,rr-'•;.t .forthwith comply w_ith'such provisions or this permit shall be deemed LAVATORIES DOl1BL-E-LRVS-- . .-I-- -- ,APPLIANCE-- --•-10-SO�Kw�-SO +, KW.. - CONSTRUCTION LENDING AGENCY a '-KIT-SINKS-'-• -- - �P' HWASFiERS -- ,-- --- MOTORS'-- --- -p-1 HP - -1-10 HP '.'1 h hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS. .^ •' -- -- - I�IV� PS' `W -I - r(INC.,SOLAR)" _10-50.HP 5D.+ HP_ i -'j t` �O€ 1 - .; formance of the work for which this permit is issued (Section 3097 •' ° .Civ. C.):-^•..._,_..._-_�.,.,,.-..f_._ _._ .,_ »-.___..- _ 'FLOOR'S INKS----'"'"°°`"•FLOOR'DRAINS'_ -"'-j �""`----- Lender's Name rFIXTURES-- ^ OUTL-ETS'•-••SWIT6HES=�'---'=-6 - s ,GAS ' - _` •, `_ _ _ _- ._—.___ -"-__'--"_ _" Lender's Address _ DRINKING FOUNTAINS— �� , _"^�"`� ^"?�`-- TUBE•SIGNS -------,----••.- _ ........r 'OWNER BUIL'DER-OECLARATtON - '-4--- -'^^"^' •-'^- �-'-"" License Law for •[ _ INTERCEPTORS """•"' CL'A'RIFIERS'-- ''-`- 'ry' 'POLE-L•IGH75---•^-�---- --- �.-- - .- .._•• I hereby affirm that I am exempt from the ContNiCtor's -the -following reason {Section -7031.5 -Business -and Professions Code:- --SWIMMING POOL-'-- - P'TRAP-•-�- - ^� - -•-'METERED- '•POLES -- "• 'Any city or county which requires a permit to construct, alter, 'WATER -SERVICE ALTERATION - ^ • �- I PANELS �-- MAIN improve, demolish or repair any structure, prior to -its issuance, also re- quires the api-Iicant for such permit to file a signed statement that he 'is'licensed pursuant to the-provisions-of•the Cor€tractor's-License Law --""""" - '""" "`�"'" ---SERVICE-- GAS SERV ICE -- OUTLETS' �. J -----•- --�•-- --- AMP ---•-_ ----_ -.» (Chapter. 9 (commencing with Section 7000) of Division _3 of the € -WATER HEATERS -- BTU,OUTPUT^^--•-• --' ------- �"-;--------•••,-- -- -•- -' "-''' ' - Business•and Processions Code) or that -he -is exempt-therefrom•and=the- basis for the alleged exemption. Any violation of Section 7031.5 by- SEWER 'CONNECT IDNS--^ -- '='_ "- �':- •- -•�-applicant -for-a-•permit subjects -the -applicant to,a-civil-penalty ot more than five hundred dollars ($500),�- as oivrf& of -the property,'or my errrployee9'with'wages'a5'their' SOL'AR,TANK ••y------•COilLECTORS- ---'- ------ - "j- --- - ------•-- -•- - -- - -- '_.,__ s e compensation, will do the work,and the structure is not intended ""SOLAR PIPING'SYS.--'•'-""'• 1: -" """ "- --- -'- �� '-'-ISSUE-FE.E- --•�- --• --_ -- ---�- __. _ 4,.: Pr offered for sale, (Section 7044,-66 siness and'Professions Code: The'" - Contractor's License -Law does not apply to an owner of a property who builds or improves thereon, and who does such such -or J - - "ISSUF'FEE- APPLICATION -APPROVED BY —'_ _ ;':'-DATE-•- 't._. - through-his_own-employees, provided that such improvements are not MECHANICAL PLAN CHECt<- - -�- t - '- SUMMARY OF FEESr intended or offered for sale. If, however, the building br improvement" have the burden is sold within one year of completion, the owner will of proving he did not b«ild or improve for the purpose -of 'sale): =• _ _ - -- - --- - --- _ r--- - -BUILDING ;0 1, as owner --of the- property, am exclusively. contracting -with- HEATING HEATING SYSTEM 0-100,000 BTU �•'- - --• - PERMIT - - _ _$ _ C• SMIF,�.y"F,''.. ,-: N -CHECK licensed contractors to construct the project (Section 7044, Business 100,000 + BTU " ' I PLAN $ .,PERMIT.., - . , •f and Professions -Code: -The Contractor's License•LawAoes.not.apply-to _ _ _ -ISSUANCE- an owner of property -who builds or improves thereon, and who con- tracts -from such -projects"with a-contractor(s).-licesned pursuant toL- REFRIGERATION 0-100,000 BTU f -SYSTEM-.. - - � _ a �' }PLUMBING $r^'-• � :, �-�'��GRADING �'$-' � ear a t the Contractor's Contractor's License Law)._ _ 100',000 +BTU ( !_�._ _ _ PL N CHECK $ _ �� ,, - - -•- - ^-- '$ : r - 0 I am exempt under'Section — B: -&^P. C.'for•this- - - - -- --- --• - --- - -----� BOILERS BTU - -, "�'j •rl^ EL'ECTRICAC-"' reason- - - _ --- - - _. _ _ ' SYSTEM SYSTEM REPAIR, ALTERATION MICROFILM;!g 'I PLAN -CHECK -- Date. Owner 'I _ _ I .TOTAL FEE $ '14 'MECHANICAL. hereby certify th ave ead this ap ion ar state that the above - EXHRUSTSYSTEM MULTIPLE € - � t.• , • .,1 ti LESS AD- ) information i rre t, agree omply all city.and-county 't i IPLAN-CF�ECk $-' --- VANCE•PCa-$-� - - -- - ordinances state s relati o cons on, and hereby authorize _ "ss -above" _ '` )i rte' -"• j representa es o ci t upon the mentioned property or _�- - - . �, ,1' ,?^' r� - - FEE $ / 9.6o i Signatur -- FEE ^FINAL Drivers' License or 55 --ISSUE - -" - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor s f • r'I t • , I CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA �' `: ; i._t_ - stir APPROVALS Date r, Inspector 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location ::��a.. .�:. �• _ 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit.Uridrgrn 46. E=lectrical Bonding 5. Steel ein orce 47. Rough Plumbin` &Pressure Test_ 6. -- Electrical UFER Grn _ �r' 48. APPROVAL TO COVER-GUNITE 7. Footings i 49. E=lectrical Conduit-Undr rn• 8. Foundation - - - 50. Gas Pipe, ❑ Undr rn-,Test 9. -Water Pipe-Undrgrn 51. Backwash Line P -Tia .- ❑' bdr ?ri 10, Structural•Floor System 52, APPROVAL TO DECK 11. - Property Sewer Line & House Connection - 53. . Backwash &•Rete ton -Final ' 12• Street Sewer Connection 54. 'Heater & Vent -Final .13. Rough Plumbing 14. Rough Electric -Conduit :56.7... Electrical -Final 15. Rough Electric -Wiring 57. 'Solar System -Final 16., Rough Heating & Air Conditioning 58. Fencing &Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60, .-POOUSPA SYSTEMS'FINAIL -. 19: Gas Pipe -Rough &Fest 20: Roof -Framing 21. Roof'Sheathin NOTES: -22. Frame and Flashing 23. -Insulation 24: Lathing & Siding - 25! Drywall Nailing 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28. Final Electric 29. f=inal Heating & Air Conditioning - 30. • Final Gas Pipe -Test 31'. Final Plumbing 32. Water Service -Final 33. Gas Service -Final - - 34. Solar Domestic -Final 35. Landscape SpHnkling System ' 36:;7-iS6und Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUI VI,NG - 39. Special Requirements Completed' 40. Electric Release to Edison, 'k.a 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY :� i.�No1 . Date '- - Applicant to fill in all spaces within heavy border tines and sign all appropriate declarations. 3575 7/2i/82 CITY OF COSTA MESA PEB�41IT NO� TRACT NO. L07 NO.' BLDG. NO. �•r -••r - 39.00 _ v CO STRUCTION PERMIT /�-/ T/ •. .. ' Project Address • 3151 Airway, Costa Mesa, CA TYPE OF CONSTRUCTION _ OwnerC'IcmpanyPhone ❑ NEW ❑ ADD. ❑ ALTERATION Address3151-Airway,Megii, CA 92626❑ REPAIR ❑ CONVERSION, ❑DEMOLISH Arch/Eng. License No. ElOTHER ZONING REGULATIONS Address DESCRIPTION OF.WORK A P • ZONE PLNG. REF. -P Contractor LeavertOn-Beck Inc. Phone 979-356 TYPE OF PERMIT BUILSETBDING �ROPTIkTING Y LINE Address Ve • IrViil2 CA Z 14 ❑GRADING ❑ FOUNDATION ❑STRUCTURAL S I YARD LICENSED CONTRACTOR DECLARATION (D TENANT ❑ ELECTRICAL�P.LUMBING OMECHANICA t. SIDE Y _ I hereby affirm that I am licensed under provisions of Charter 9 (corn RIGHT mencing with section 7000) of Division 3 of the Business and "❑ OTHER Professions Cade, a 6my license is in full forcelqct 01fect. PROJECT DESCRIPTION REAR YARD (TO P/L) License lass(; JJ 9PKG. SPACE REQ. 'PROVIDED' Date — Signature SQ. FT. _ WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE s I hereby affirm that I have a certificate Of consent to self-insure ora 1 VALUATION ZONE ZONING APPROVED By DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (SectionC-) GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Cr Policy No. Company_. eat American ertified copy Whereby furnished, REMARKS: Certified copy_is filed with the city. Building Division. :VMPTION FROM WORKERS' COMPENSATION DECLARATION 13 <„•_s sectionneednot be completed If the permit is for one hundred or lessl. IYcert,fy that n the performance of-the work for which this permit is Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ,ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. - Date Signature HTUBS SHOWERS NOTICE. If after making this declaration, you should become subjectETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemedATORIES DOUBLE LAVS FKI APPLIANCE 10-50 KW_50 + KW- revoked. CONSTRUCTION LENDING AGENCY SINKS DISHWASHERS MOTORS 0-1 HP1-10 HP I hereby affirm that there Is a construction lending agency for the per-VICE SINKS SUMPS (INC. 'SOLAR] 10-50 HP 50 + HP formance of-the work. for which this-permit _is Issued. (Section 3097 Civ C-). Lenders Name110 FLOOR SINKSFLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt.from.the Contractor's License Law for INTERCEPTORS CLARI IERS POLE LIGHTS the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL PTRAP Any City. or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to its issuance, also re- WATER SERVICE ALTERATION ANELS MAIN SUB.. quires the applicant for such permit to file a signed statement that he d.P Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS ' SERVICE AMP (Chapter.-9 (commencing with Section -7000) of Division- 3 of the 9Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT basis ,for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS F✓ of not.more than .five hundred dollars.($500). �v P ' as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS <7 f ompensation, will do the work, and the structure Is not intended - fered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. glee ISSUE FEE (,...,(ractor's-License Law does not apply to an owner of a-property who builds or improves thereon, and who does Such work himself or ISSUE FEEAPPLICATION APPROVED BY DATE through his awn 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 will have the burden MECHANICAL PLAN CHECK SUMMARY OF FEES of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ _ SMIP $ (DI, as owner of the property, am exclusively contracting with ANO DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK s PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner ofproperty who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ •00 tracts from such projects with a contractor(s) licesned pursuant to SYSTEM .GRADING the Contractor's License Law).. 100,000 + BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for thisBOILERS BTU ELECTRICAL S - $ - reason PLAN CHECK S MICROFILM $ ' Date Owner - SYSTEM REPAIR, ALTERATION - - TOTAL FEE $ - , MECHANICAL $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE _ LESSAD- information Is Correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances ands to laws relating t construction, and hereby authorize representatives this city t e er upon the above mentioned propert r e ion- pur s 3�r0 D Signatu a FINAL FEE $ Drivers' License or SS ISSUE FEE - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor CONSTRUCTION AND PLANNI APPROVALS Permit # - Date 7 Inspector POOL & SPA' Date Inspector APPROVALS , , Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVi R-GUNITE 7. Footings •' 49. Electrical Conduit-Undr rn . = 8. Foundation -- 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn' 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection , 54. Heater & Vent -Final 13. Rough Plumbing - 14. Rough Electric -Conduit -56:. .Electrical -Final 15, Rough Electric -Wiring 57. Solar System -Final - 16. - Rough Heating & Air Conditioning b8. Fencing & Access Approval 17: Ducts, in Structure 59. APPROVED FOR PLASTERING 18- Ducts, Ventilating 60• POOLISPA SYSTEMS FINAL , 19. Gas Pipe -dough &Test 20. Roof Framing - 21, Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24, Lathing & Siding 25. Drywall Nailing ; 26. Plaster Brown Coat 27. Electrical Power Meter -final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing h. 2, L� 32. Water Service -Final 33, Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date - - Applicant to fill in all space$ within heavy border lines and sign all appropriate declarations, CITY COSTA MESA TRACT NO, e $r73..1.0/.1.3/§.. QF PERMIT NO. CONSTRUCTION PERMIT �� LOT NO. BLOC. NO. I - ' Project'Address 31517irway, Costa _Mesa, Ca. TYPE OF CONSTRUCTION Owner na Son Ph — yl�.[�tEW ❑ ADD - ❑ ALTERATION Address 18003 Skypark, Irvine, Ca. ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑OTHER ZONING REGULATIONS Arch/Eng, License No. A.P'! Address DESCRIPTION OF WORK ZONE ' PLNG.-REF. 9,* Contractor Leaverton-Beck Inc. Ph6ne979-356 TYPE OF PERMIT U Tp V INC' PROPERTY LINE Address 92714 ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SET BAC LSIDE YARD LICENSED CONTRACTOR DECLARATION that I licensed Charter 9 ID TENANT 11ELECTRICA��LUMBING ❑MECHANICA SIEDFE YARD I hereby affirm am under provisions of (com- rnenOng with section 7000) of Division 3 of the Business and ❑.OTHER RIGHT Professions Code, and my license Is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. PKG. SPACE REQ. PROVIDED Date 11229X Signature �— d Z , SQ. FT. STREET PARK FEE 3 WORKERS' COMPENSATION DECLARATION. OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a Certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a.certi{led copy thereof (Se Lab. C.). 2 Zenith National GRADING CU. YDS. ACRES . SPECIAL CONDITIONS: Policy No. Company n Certified copy is hereby furnished. REMARKS:' _ 'ertlfied copy is filed with the City Building Division. :MPTION FROM WORKERS' COMPENSATION DECLARATION (This section needenot be,completed if the permit is for one hundred Ei)o () or less). 1 Cert[fy 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 PLUMBING PLAN CHECK ELECTRICAL _ PLAN CHECK subject to the Workers' Compensation Laws of California. _ _ BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you Should become Subject TOILETS URINALS GENERATOR 0-1 KW 1.10 KW to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed _ LAVATORIES DOUBLE LAVS TRANSFORMER APPLIANCE 10.50'KW_50 + KW revoked. .. _ CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1.10 HP - I hereby affirm that there Is a Construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10.50 WP 50 + WP formance of the work for which this permit is issued (Section 3097 Len Lender's Name FLOOR'SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES _ _ _ Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS ' INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I am exempt fromtheContractor's License Law for SWIMMING POOL' PTRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or County which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demolish'or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE" AMP Is licensed pursuant to the provisions of the -Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT BusineSS-and Professions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER'CONNECTIONS any 'applicant for a permit subjects the applicant to a civil penalty lot more than five hundred dollars ($500). SOLAR TANK COLLECTORS ,. as owner of the property, or my employees with wages as their s compensation, -will do the work, and the structure is not intended p1 -PING -5'I$ �' , ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property it APPLICATION APPROVED BY who builds or improves thereon, and who does such work himself or ISSUE FEE ) DATE through his own employees, provided that Such. improvements are not, MECHANICAL PLAN CHECK - SUMMARY OF FEES, intended or offered for sale. if, however, the building or improvement Is sold within one year of completion, the owner will have the burden BUILDING of proving he did not build or improve for the Purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING ' licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ ' �� tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 +BTU PLAN CHECK $_ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ t MICROFILMS reason SYSTEM REPAIR, ALTERATION PLAN CHECK $ TOTAL FEE S Date Owner MECHANICAL S I hereby certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD= Information is Correct. I agree to comply with all city and county PLAN CHECK S VANCE PC $ _ ordinances and state laws relating to construction, and hereby authorize representatives this city to enter Pon the above mentionpd property ci on p rpo FINAL FEE Signature Drivers' License or SS :P ISSUE FEE -Assessor CMF 0665.46 White -Building; Canary -Applicant; fink -Accounting: Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3.. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - tee em orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7, Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trag, ❑ Undr rn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection j 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater &Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16, Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing 22. Frame and FlashingNOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date L..EMPTION FROM WORKER5 COMPEN5ATION DECLARATION - (This section need not be completed if the permit is for one hundred - l y •• , _ •.; $100) or less),- 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 PLUMBING - PLAN CHECK ELECTRICAL ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. BATHTUBS-- -' SHOWERS - - - - - - + KW NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must ,forthwith comply with such provisions or this permit Shall be deemed 4CITY4F COSTA MESA PERMIT NO TRACT NO. - - BLD NO. - - ,revoked. _ ! _ _ CONSTRUCTION LENDING AGENCY —' KIT. SINKS' "' -a- -DISHWASHERS - '-- - 'CONSTRUCTION PERMI 1--LOT-NO, .I hereby affirm that there is a construction lending agency for the per- formance of ,the work for which this permit is issued (Section 3097 FLOOR SINKS- ' " 'FLOOR DRAINS - Irv, - j -Lender's Name DRINKING -FOUNTAINS - , ''4 'Lender's Address _ [b Project Address — r,VJ TYPE OF CONSTRUCTION f 6120- 5/20/82 29900 TL; _ GAS SERVICE - OUTLETS " — ` V OWneIV,Jesy ' ❑ NEW ❑ ADO ❑ ALTERATION— - •" .. QAddress - F-1 REPAIR EJ CONVERSION EJ DEMOLISH SOLAR 'PIPING_ SYS. - MECHANICAL- $ or offered for sale. (Section 7044, Business-andProfessions Code: The PLAN CHECK ' $' ZONING REGULATIONS r � Arch/Eng, - - License No. ❑ OTHER A.P•: _ _ever,'the'building MECHANICAL PLAN CHECK' HEATING SYSTEM 0-100,006 BTU _ r AND -DUCTING - ---•- - - 100,000 + BTU DESCRIPTION OF WORK REFRIGERATION 0-160,006 BTU T `\m'exempt ClyL.rq,na, tracts from such projects with a contractor(s) licesned. pursuant to ontractor's License Law). - under Section B. & P. C: (or this by Certify that 1 have read this application and state that the above atlo - 'correct. agree to comply with -all city and county -Address - BOILERS BTUOwncr ZONE PLNG. REF.. EXHAUST SYSTEM MULTIPLE . �G (1,`L Phone TYPE OF PERMIT a s an la relatin o construction, and hereby authorize e tative$ oT city ent€r upon the above mentionedrt f r insp onturerS' License or SS l R(� II Y tGINE ISSUE FEE -)-I•e 4 C ❑GRADING ❑ FOUNDATION ©STRUCTURAL SETBBUILACK ST. SIF YARD - "Ad CONTRACTOR DECLARATION 9 ❑ TENANT ELECTRICAL ❑PLUMBINGLL•VAm that I am licensed'under provisions of Charter (CornHTh -section- 7000) of Division 3 of the Business and'.- ❑ OTHER d my license is i full oE�defjf't. REAR YARD TO P/LyCode, ( PROJECT DESCRIPTION. License Class Lice Na• rL '� ' r . — PKG. SPACE REQ.- PROVIDED - ;Date?t"'O: �a'f—Slgnatur ` i SQ. FT. {'' I 4 r STREET WIDTH M PARK FEE $r, WORKERS' COMPENSATION.DECLARAT,10 rOCCUPANCY CONSTRUCTION TYPE I 'I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED BY- DATE certificate of Workers' Compensation Insurance, or a certifled copy thereof {Section •� 0Q L.a C.). � - _ .GRADING CU. YDS.,ACRES SPECIAL CONDITIONS: r � � � Policy Nh�i(, W471 C]Y. - Company !�. TVV 4?,a1_ .a.�-• - - - • • - - --- `' ',ertlfied copy is hereby furnished. REMARKS: S :ertified copy ls'filed with the City Building Division. - L..EMPTION FROM WORKER5 COMPEN5ATION DECLARATION - (This section need not be completed if the permit is for one hundred - l y •• , _ •.; $100) or less),- 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 PLUMBING - PLAN CHECK ELECTRICAL ' PLAN CHECK, GENERATOR- 0-1 KW TRANSFORMER subject_to the Workers Compensation Laws of California. 'pate 1 Signature ' BATHTUBS-- -' SHOWERS - - - - - - + KW NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must ,forthwith comply with such provisions or this permit Shall be deemed -TOILETS-- �� a URINALS - LAVATORIES OOUBLE L•AVS- - - - - ,revoked. _ ! _ _ CONSTRUCTION LENDING AGENCY —' KIT. SINKS' "' -a- -DISHWASHERS - '-- - SERVICE SINKS -1-•, 01SUMPS- -- ! SWITCHES - .I hereby affirm that there is a construction lending agency for the per- formance of ,the work for which this permit is issued (Section 3097 FLOOR SINKS- ' " 'FLOOR DRAINS - { POLE LIGHTS •-••-• - - - - j -Lender's Name DRINKING -FOUNTAINS - _ 'Lender's Address _ INTERCEPTORS CLARIFIERS' - } 'OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and. Professions Code: Any city or county which requires a permit to construct, atter, improve, demolish -or repair any structure, -prior to -its issuance,also re- quires the apl-licant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law '(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions -Code) or -that -he -is exempt therefrom and the- basis for the alleged exemption. Any violation of Section 7031.5 by SWIMMING POOL- --P TRAP ^- -`• WATER SERVICE- ALTERATION- ' _ GAS SERVICE - OUTLETS " — ` V -WATER HEATERS BTU OUTPUT - - SEWER CONNECTIONS-- a^v-applicant for a permit subjects the applicant to -a civil penalty )ol more than five hundred dollars ($50D). SOLAR -TANK - ^- COLLECTORS- „ as owner of the property,'or my'employees with wages -as their a..,e compensation, will do the work, and the structure is not intended SOLAR 'PIPING_ SYS. - MECHANICAL- $ or offered for sale. (Section 7044, Business-andProfessions Code: The PLAN CHECK ' $' Contractor's license Law does not apply to an owner of a property - ISSUE FEE '•`-- '" ,( '" - t FINAL FEE $ who builds`or improves thereon, and 'who does such'work-hlmself or through his own employees, provided that such Improvement$ are not Intended or offered for sale. If, howor Improvement' is sold within one year of completion, the owner will have the burden _ _ever,'the'building MECHANICAL PLAN CHECK' HEATING SYSTEM 0-100,006 BTU _ r AND -DUCTING - ---•- - - 100,000 + BTU of proving he did not build or improve for the purpose of sale).' ❑ 1, as owner of -the property, am exclusively contracting with licensed' contractors to construct the project (Section 7D44, Business and -Professions Code: The Contractor's License,does not apply to an owner of property who builds or improves [hereon, and who con- REFRIGERATION 0-160,006 BTU T `\m'exempt ClyL.rq,na, tracts from such projects with a contractor(s) licesned. pursuant to ontractor's License Law). - under Section B. & P. C: (or this by Certify that 1 have read this application and state that the above atlo - 'correct. agree to comply with -all city and county _SYSTEM. ..�_ 100,000 + BTU BOILERS BTUOwncr SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE a s an la relatin o construction, and hereby authorize e tative$ oT city ent€r upon the above mentionedrt f r insp onturerS' License or SS ISSUE FEE GMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; goldenrod -Assessor PLAN CHECK, GENERATOR- 0-1 KW TRANSFORMER 1=10 KW 'APPLIANCE - 10-50 KW_50 + KW -+ - 0.1 HP- -1-1D HP =MOTORS. - - (INC. SOLAR) -10.50 HP 50 + HP FIXTURESLl - OUTLETS ! SWITCHES - GAS TUBE SIGNS - - - { POLE LIGHTS •-••-• - - - - - - - PANELS j MAIN SUB -- - - 5 SERVICE- - - AMP VL; - - t - ISSUE -FEE- - - - - APPLICATION•APPROVED BY- - DATE- -- R SUMMARY OF; FEES (BUILDING . PERMIT $ SMIP S PLAN CHECK $ PERMIT - _ _ISSUANCE_ S j PLUMBING $ G RAOI`NG $' ' PLAN CHECK' •$ I gy��pp-- ELECTRICAL' $ r, $ MICROFILM $ -PL-AN CHECK $ n TOTAL FEE $ MECHANICAL- $ - - PLAN CHECK ' $' LESS AD- _ VANCE PC $_ - FINAL FEE $ CONSTRUCTION AND PLANNING %.--POOL , ,�.: f .3�jy� Date Inspector APPROVALS Pe'rmit'# & SPAS - - f APPROVALS Permit#f^ •� Date Inspector r., I?' "- 1. Temporary Electrical Service or Pole 43. Pool & Equipment -Location . Soil ipe;,Undrgrn 44. Steel Reinforcement 3.. Electrical.Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding,. - - Steel 47. Rough Plumbing &Pressure Test ' 6. _- Electrical UFER Gm 48. APP,ROVALTO COVER.GUNITE •7. _ Footings _ 49. Electrical Conduit-Undr rn 8. Foundation - . 50: Gas Pipe, 0 Undr rn, Test .-9. -- Water-Pipe-Undrgrn_.. _ 51. Backwash Lines P-Trap.,El nd_r rn • - 10.. Structural Floor'System 52. APPROVALTO,DECK - 11. PropertySewerLine & House Connection _. 53. Backwash & Receptor -Final "' r 12. . Street Sewer Connection _ __ 54. 'Heater .& Vent -Final 13. Rough Plumbing - ` 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring � % 57,: Solar -System -Final T 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING •. 16. Ducts, Ventilating - - - .60._ - - - - POOL/SPA SYSTEMS FINAL , 19. Gas Pipe -Rough &Test- - 2W -Roof -Framing 21: Roof Sheathin� NOTES:. - •. ' ' 22.. Frame and Flashing - - - -- 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing 26. . Piaster Brown Coat- oat 27. 27. 28. Electrical Power Meter -Final ,_` Final Electric - - - 29. Final Heating & Air Conditioning ; 30. Final Gas Pipe -Test 31. -.Final, Plumbing - 32: Water Service -Final f -- - • ` 33. Gas Service -Final - - 34. Solar Domestic -Final ' 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING s 39. Special Requirements Complete 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. . 42. CERTIFICATE OF OCCUPANCY No ° Date Applicant to fill In all spaces except those within hearY border lines and sign all appropriate declarations, CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address / [ Applicant's Mailing Address el— Owner's Owner's Name P ane " Address Arch/Eng. License No. , Address, " Contractor's Name U A WA7W 6&nj Phone �0b Address (mailing) ' City Licpnse No. C7 "7(5 7 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full f e and effect, License I ss Licen 13 '4_6 Data Signature WORKERS' COM ENSATION 0 RATION k.l hereby affirm that t have a certl a of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified -copy thereof (Section .a 3800, Lab. C . _ v Policy No. E- • r Company �� r �'= ai,/l Certified copy is hereby furnished. Certified cepy'i f ed wlth the City B Ing Division. Date I- Li Applicant EXEMPTION FROM WORKERS' COhrP,9NSATION DECLARATION (This section need'not be completed If Me permit is for one hundred ($100) or less) ' r 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. iti - Date Signature NOTICE: If,'after, making this declaration, you should become subject to -the Workers'. Compensation' provisions of the Labor Code,'you must forthwith--� - comply ,with such provisions or ,this permit shall be•deemed revoked, 1- CONSTRUCTION' LENDING AGENCY.- I -• . • 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:) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following ieason-(Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (Commencing wlth,Sectiom7000) of. NIvislon' 3 of the Business and Professions Code) or that fie/she is exempt ierefrom and the basis for'the alleged exemption. Any, violation of Section l 031.5 by any •applicant for a permit, subjects the -applicant to 'a- civil ' enalty of not more than five hundred dollars ($500). - ;� ],,,as owner of the. property or'my employees with wages as their sole.; compensation, will do the work, and the structure Is not Intended or offered ' for sale (Section 7044, Business and Professional Code: The- Contractor's 1 License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not Intended or offered for , sale. If, however, the building or improvement IS SOId within one year of com- pletlon, the owner, will have the burden of proving he/she did not build or')m- ro ve forr the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: .The Contractor's License Law does not apply to an owner of property who. builds or improves thereon, and who Contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). r ❑ I am exempt under Section B. & P. C. for this reason 1 Date Owner, I hereby certify that I have read this application and state that the above Information is correct. I agree to' comply with all city and county ordinance$ and state laws relating,to building construction, and hereby authorize repre- sentatives of this city to entSL upon the above-mentioned property for inspectlon pur es. Signature pate Drivers' Lice(/or SS CMF 0865-46 rev. 7/83 • White - Building; Canary ---Applicant; Pink - Accounting; Goldenrod - Assessor PERMIT NO. TRACT NO. LOT NO. BLDG. NO,_ TY PE OF CONSTRUCTION U NEW LJ ADD LJ ALTERATION -REPAIR ❑ CONVERSION' -1_1 DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT El GRADING El FOUNDATION El STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL • ❑ OTHER' ' PROJECT DESCRIPTION SQ, FT. OCCUPANCY CONSTRUCTION TYPE VALUATION 5 ZONE GRADING CU.YDS. ACRES j Remarks: -. Meter ❑over 100 amps Dryers ❑Gast ❑Electric Sub Panel Fan } i i ,Mota_rs❑0:1 HP Ell %:-B F,A:U.Inc. PLUMBING FEES Bar Sink Showers .. ` Pole Light Backflow Preventer Backflow Irrigation Service Sink Sewer Cap Switches Bathtubs Sewer Connection Standing Sections Clarifiers Solar Collectors Dishwasher 'Solar Piping` ' Issue Fee r $.3 Drinking Fountains Solar Tank Zoning Approved By Floor Drains Swimming Pool w/Spa' i Date Floor Sinks Urinal j SUMMARY OF FEES Gas Service ; ' _Outlets' 'Water Closet; PLAN CHECK $ PERMIT Interceptors- Water Heater PLAN CHECK $ Kitchen Sink Water Service GRADING $ Lavatories MICROFILM $ MECHANICAL $ P --Trap, PLAN CHECK $ Roof Drains, :Reinspection Fee_ $25 Issue Fee $'3 l MECHANICAL i FEES Boiler - - Hood or, Type I ❑ Canopy Type 11 El Duct - Under Ground Duct - Structural Refrigeration System 1:10-100,000 6TU ❑ 100,000 BTU Duct - Ventilating I Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Blt, ICBO,# Heating System & Ducting 1] 0-100,000 BTU ❑ 1 DD,ODD BT Reinspection Fee $25 Issue Fee LL $ 3 A.P. 46 S Main Building: E T Front B Rear. A C R ight 5 Left Ping, Ref. _# Parking Req./Provided Use of Building: Planning,Notes: I 1936 1 /L: Zone- Accessory Building: - r _ t - Park.Fees $ Z O N • 1 N G R E Q U I R E M E ' N T S r ELECTRICAL FEES Automatic Washer- Transformer ❑ 15`50 KW , Construction Pole Sub, ID 50 + KW i Cooking Unit Meter Oup-to 100 amps Dishwasher Meter ❑over 100 amps Dryers ❑Gast ❑Electric Sub Panel Fan } i i ,Mota_rs❑0:1 HP Ell %:-B F,A:U.Inc. Solar ©9-15 HP 016-15+ Fixtures Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal I Standing Sections Generator X0.5 KW 135.15 KW Trash Compactor I t • I , Reinspection Fee $25 Issue Fee r $.3 PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By 'By— Date Application Issued , ► —Date.g SUMMARY OF FEES BUILDING PERMIT $ SM1P $ PLAN CHECK $ PERMIT PLUMBING $ 3 �' ISSUANCE $ PLAN CHECK $ ENERGY•P,C. $ ELECTRICAL , $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK $ CONSTRUCTION AND PLANNING APPROVALS Permit # 7DateInspector POG SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical -Service or Pole. 52. Pool & Equipment Location 2., Soil Pipe_Undrgrnd. :a Steel Reinforcement 3. Electrical ConduitsUtility Undrgrnfi, 54. Forms 4. Electrical'Conduit ,Undrgrnd. f 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test `6. eEl'qct "rical UFER Grnd..: 57. APPROVAL TO COVER-GUNITE 7, Footing`s 58. Electrical Conduit-Undrgrnd. 8.'Fo6ndatibn 59. Gas Pipe, ❑ Undrgrnd., Test 9. .Water Pipe-Undrgrnd. 60, Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural- Floor System 61. APPROVAL TO DECK 11.. Property Sewer Line & House Connection 62. Backwash & Receptor -Final w 12. Sewer Cap 63. Heater & Vent -Final 13 FRoaf Drains 'i, ��`>{` 64. Plumbing System - Final 14. Rough. Plumbing,.', I `2o -.;°Y - 65. Electrical Final } 15. Rough Electrical --Conduit 66. Sola (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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ' [--]Oil 23: Gas Pipe -Rough & Test {.72. -Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. 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 I Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36, Hood or Canopy , 37. Final Factory Fireplace 38. Final Plumbing 2/04 L 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed _ 49. Electric Release to Edison 50. Gas Release to!Southern California Gas Co 51. CERTIFICATE•OF OCCUPANCY No. Date _ I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ' -.:ITS F COSTA MESA J PERMIT NO. TRACT NO. LOT NO. BLDG. CONSTRUCTION PERMIT � - O 4 I4 Prgieet Address / Ir PSI Applicant's Mailing Acl rens ! l �% 's� �F+�/wd Owner's Name �F'�+��``l ��'{T °!' f Phone-ff�- LCC Address Arch/Eng. License No. Address �— Contractor's Nam / ^� Phone JZ Address Iniailing) ��.7 r�7� i�FiNwo /J/+y /. C A//wcr City LicenseNo. I LICENSED CONTRACTOR DECLARATION ! {Ynj I hereby affirm that 1 am licensed under provisions of Charter 9 (Commencing r� with section 7000) of Division 3 of the Business and Professions Code, and 4�} my license is In full for a and effect. ) f License as No. Date Signature WOR ER CO PENSATION DE16LARATION •I hereby affirm that i have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. Policy No. , s T �r Company SC1Cettified copy I$ heraby furnished. ertifie co filetl with the city Bull Divisi n V Date /—` Applicant EXEMPTION FROM WORKERS -CO, ENSATIDN DECLARATION (This section need not be completed illthe permit is for one hundred ($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 tke Workers' Compensation Laws of California. DateSignature NOTICE: If,'after mak—ing this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such previsions or this permit, shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name -- Lender's Address �— OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of _,':?he Contractor's License Law (Chapter 9 (commencing with Section 7000) of 5l'3vision 3 of the Business and Professions Code) or that he/she is exempt efrom 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 enatty of not more than five hundred dollars ($500). 1, as owner of the property ,or my employees with wages as their sole Ft ; compensation, will do the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's. x . 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 employees, provided that such improvements are not Intended or offered for sale_ If, however, the bullding or Improvement is sold within one year of com- ' pletion, the owner will have the burden of proving he/she did not build or Im- Hrove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the protect (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to -an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractors) license purSuar,t ta'the Contractor's License Law). ❑•1 am exempt under Section B. & P. C. for this reason Date — Owner I hereby certify that I have read this application and state that the above 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 ter pon a above-mentioned property for inspection pur /' / /r sSignature Date ZZ f Drivers' L ense or SS 311' �T CMF 0865-46 rev. 7/83 TYPE OF CONSTRUCTION NEW App ALTERATIONFl REPAkR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. # DESCRIPTION OF WORK S Main Building: TYPE OF PERMIT0 GRADING El FOUNDATION LJ STRUCTURAL T Front ❑ TENANT P/� ELECTRICAL- ❑ PLUMBING ❑ MECHANICAL B Rear ❑ -OTHER A PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right K 'CONSTRUCTION TYPE VALUATION $ S I Left -ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: ! p Parking Req./Provided Use of Building: PLUMBING FEES Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $25• Boiler Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBG # Heating System & Ducting E-10-100,000 BTU 0100,0008T Reinspection Fee - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor -- M Showers Service Sink Sewer Cap Sewer Connection Solar Collectors ' Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water. Service Issue Fee Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 1:10 100,000 BTU 0100,00013T System Repair/Alteration $25 Issue Fee L2raf t, Zone Accessory Building: Park. Fees $ 1` Z O N I N G R E Q U I R E E N T ELECTRICAL FEES Automatic Washer I Construction Pole Sub. Transformer ❑ 15.50 KW ❑ 50 + KW H1 Cooking Unit - Meter Mup to 100 amps a F Dishwasher Meter 26ver 100 a - Dryers ❑Gas ❑Electric Sub Panel Q® „f 4 C 19, Fan Motors 00-1 HP Ell %? F.A.U. Inc. Solar ❑9-15 HP 016-15+ Fixtures Microwave os Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator 130-5 KW ❑5-15 KW Trash Compactor $ 3 Reinspection Fee $25 Issue Fee $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By Application Issued By Date Date Dat BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL ' PLAN CHECK $ $ $ $ $ $ $ $ SUMMARY OF FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ I", GRADING $ -Z C7 MICROFILM $ TOTAL FEE $ _ 9O` Td $ 3 r 7. CONSTRUCTION AND PLANNING �. AePROVALSLN - Permit #' Date Inspector POl . Sf;+�� APPROVALS Permit # Date Inspector i.�Temporafiy Electrical Service or Poles 52. Pool &.Equipment Location f 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3 jElect`ica*Conduit�Utility-Undrgrnd. f^ 54. Farms p "Electrical Condui Undrgrnd, �� 55. Electrical Bonding 5 ."S-teel Reiriforcement J ` 56., Rough Plumbing & Pressure Test 6.4Electrical LIFER Grind. 57. APPROVAL TO COWER-GUNITE 09tings �', j;l' 58. Electrical Conduit-Undrgrnd. 8..1 oundation , '�, r 59. Gas Pipe, ❑ Undrgrnd., Test 1 �� 9. Mter'Pi e-Undr'rnd.. P 9 ! -' 60. Backwash Lines, P -Trap, ❑ Undrgrnd. ; 10nStructural Floor System � , 61. APPROVAL TO DECK 11.,,PropertySewer Line & House Connection i 62. Backwash & Receptor -Final 121'Sewei Cap 63. Heater & Vent -Final 13. Roof.Drains f� ti 64. Plumbing System - Final 14. RougPlumbing tti r 65. Electrical -Final �. 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring GJA41 f {9 C °� 67, Fencing & Access Approval 17. Rough Wiring Sign 0 %et d 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace, 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas El Oil 23. Gas Pipe -Rough &.Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. FINAL 30, Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ! 79. FINAL INSPECTION - 32. Electrical Power Meter -Final r-- 80. FOOD CERTIFICATE ISSUED 33. Final Electric (Q ¢ Notes: ` 34. Final Heating & Air Conditigning 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 t r 43. Backflow Irrigation 44..L•andscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric -Release to Edison -' 50. Gas Release to Southern California.Gas Co 51. CERTIFICATE OF OCCUPANCY No. I rt Date �_ �'Ajipl.�a,rr-.v !m•nrn., •r,.___�_ � akrder lines and sign all appropriate declarations. CITY 6 COSTA MESA, j p MIT NO. - TRACT NO. L LOT NO. CONSTRUCTION PERMIT --/D=am/d ',Ph f .3 L ice,+ 54 _ Prdject Address t2A9 1 rwa v Ve • - 3161 Ai AVe M. TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAI Rr ❑ CONVERSION DEMOLITSH El � Applicant's Mailing Address rwa : . -❑ interior jm royemen N A.P. {� ,E.-1. L qC. Owner's Nameaui1dho,use Consultants, Ud-fie. 540-.2606 DESCRIPTION OF WORK S Main Building:' Address 3151 - TY,P-E�IOF PERMIT GRADING 0 FOUNDATION ❑STRUCTURAL T Front Arf; lEng. License No. L� TENANT ❑ ELECTRICAL ❑ PLUMBING- ❑ MECHANICAL B Rear Address 1Z779"E!1 MaAn St., Irvine • 0 OTHER A C Right Contractor's Name _ Donald Olson Co -'Phone 540-2606 R PROJECT DESCRIPTION SQ. FT. '4180 OCCUPA Cy --ri�s �2�/UU• K Gas Service I Outlets Address(inailing) - CONSTRUCTION TYPE VALUATION $ S Left , _ Lender's Address OWNER BUILDER DECLARATION _ ZONE GRADING CU.YDS. 'ACRES Ping. Ref. # _OZ%]n% City LicPnse No. _ _ n - - Roof Drains LICENSED CONTRACTOR DECLARATION Remarks: 4 , Parking Req./Provided '1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and • ! .. �l ' Use Of Building: riy license is In full[{orce and effect. 'cense � 333969 _ I PLUMBING FEES Planning Notes: _ Class � i nae Ni., �te Signature compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and, Professional Code:. The Contractor's Showers Service Sink • ~ Sewer Cap Sewer Connection' I Solar Collector's:`'• Solar'Piping , r� Solar Tank. Swimming Pool w%Spa Urinal Water Closet Water Heater Water Service ^' j s W i Issue Fee k { : $ '3 'MECHANICAL FEE_; Hood or' Type ❑ r ' Canopy 4 Type II' ❑ Refrigeration System • ❑0-100,000 BTU ❑ 140,000 BTU System Repair/Alteration T r Issue Fee ; 3 i Eno Zone. C`:L Accessory Building: " ; Z Nop i NEW Park, Fees NEW INE EL Automatic Washer Construction Pale Sub. , Cooking Unit - Dishwasher Dryers ❑Gas ❑Electric Fan = F.A.U. Fixtures Device Boxes = Outlets Switches Garbage Disposal '- Generator ❑0.5 KW ❑5-15 KW �•'I Reinspection Fee PUBLIC SERVICES REO Zoning Approved By -N .Application Approved By Application Issued By— iCTRICAL i Transformer ❑ ;K 15i50W EJ 50 + •KW Meter ❑up to -100 amps IMeter Dover 100 amps- Sub mpsSub Panel .Motors ❑ 0-1 HP ❑ 1'h - 8 Inc. Solar ❑9-15 HP ❑16-15+ Microwave I i -Pale Light ' Range ' Sign Stariding Sections ' ,Trash Compactor $25 E. Issue Feel k , REMIT� ' �Ll k I BUILDING PERMIT $ .JORKERS' COMPENSATION DECLARATION Bar Sink Backflow Preventer - - PLAN CHECK�C�$ I hereby affirm that I have a certificate of consent o self -insure o a certificate of -Workers' Compensation Insurance, or - a certified' copy -thereof (Section - 3aoo, Lab. 0_2975 'Fairmont Policy _No. Company - Certified copy is hereby furnished. _ Backflow Irrigation Bathtubs $ Cert'f' c py s iletl with the city Buil g Oi ; Date Applicant ' , Clarifiers , Dishwasher $ ,.'.:EXEMPT[(odF OM WORKERS' COMPENSATIOWbJECLARATIO - •- - {This section need not be completed if the permit is one hundred $100) or Drinking Fountains GRADING less). i 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. . Floor Drains PLAN CHECK $ pate Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks i Workers' Compensation provisions of the Labor Code, you -must forthwith comply 'with such provisions or this, permit shall be deemed revoked.- Gas Service I Outlets CONSTRUCTION LENDING 'AGENCY, 7 1- I hereby affirm that there is a' construction lending agency for the performance of the work for whicl�i his permit -.is Issued (Section..3097 Civ. 'C.)• ' Lender's Name lV 11 Interceptors i Kitchen'Sin ' $ _ Lender's Address OWNER BUILDER DECLARATION Lavatories , I hereby affirm that I am exempt from the,Contractor's License Law for the following reason (Section •7031.5 Business and Professional Code: Any city or county which requires a permit'to construct, alter, improve, demolish or repair V structure, prior to its -issuance, also requires the applicant for such permit file a•Signed statement that he/she Is licensed pursuant to the provisions of p-Tra p - - Roof Drains - e Contractor's License Law (Chapter 9 (commencing'with Section 7000) of Division 3 o the Business and Professions Code) or that helshe is exempt therefrom'and the. basis for 'the alleged exemption. Any viola ion of Section E Reinspection -Fee , $25 7031.5 by- any. applicant for a permit subjects the applicant oto a civil = enalty of not more than five hundred dollars ($500). I s 1, as. owner of the property or my 'employeeWith wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and, Professional Code:. The Contractor's License Law does not apply to an owner of a property-who.builds or improves thereon,, and '.who dries such work himself/herselt 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 com- pletion, the owner, will have the burden of proving he/she did not'build or im- rgve.for the purpose of sale). I. as owner of the property, am exclusively cnntractingr with licensed con- ' tractors to construct the projectiSee Ion 7044, Business and Professions Code: -The. Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to.the Contractor's License Law). Boiler Duct •Under Ground ; Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # ❑ ,Cam exempt under Section B. & P. C. for this reason -, i Date Owner I hereby certify that I have read this application and State that the above -information is correct: I agree to comply with all city'and county ordinances and, state laws relating ito building construction, and hereby authorize repre- sentatives of th' city to ' r pon the above-mentioned property for a' t Heating System & Ducting 10 -100,006 BTU Ell 00,000BT - - inspection es. 12/20,83 ' Reinspection Fee $25 Signature Date = _ _ Drivers' License, CMF•0865-46 rev. 7/83 - White - Building; Canary Applicant; Pink - Accounting; Goldenrod - Assessor - - Showers Service Sink • ~ Sewer Cap Sewer Connection' I Solar Collector's:`'• Solar'Piping , r� Solar Tank. Swimming Pool w%Spa Urinal Water Closet Water Heater Water Service ^' j s W i Issue Fee k { : $ '3 'MECHANICAL FEE_; Hood or' Type ❑ r ' Canopy 4 Type II' ❑ Refrigeration System • ❑0-100,000 BTU ❑ 140,000 BTU System Repair/Alteration T r Issue Fee ; 3 i Eno Zone. C`:L Accessory Building: " ; Z Nop i NEW Park, Fees NEW INE EL Automatic Washer Construction Pale Sub. , Cooking Unit - Dishwasher Dryers ❑Gas ❑Electric Fan = F.A.U. Fixtures Device Boxes = Outlets Switches Garbage Disposal '- Generator ❑0.5 KW ❑5-15 KW �•'I Reinspection Fee PUBLIC SERVICES REO Zoning Approved By -N .Application Approved By Application Issued By— iCTRICAL i Transformer ❑ ;K 15i50W EJ 50 + •KW Meter ❑up to -100 amps IMeter Dover 100 amps- Sub mpsSub Panel .Motors ❑ 0-1 HP ❑ 1'h - 8 Inc. Solar ❑9-15 HP ❑16-15+ Microwave I i -Pale Light ' Range ' Sign Stariding Sections ' ,Trash Compactor $25 E. Issue Feel k , REMIT� ' �Ll k I BUILDING PERMIT $ SUMMARY OF FEES `� SMTP. I $ ' 3 Z PLAN CHECK�C�$ PERMIT- I PLUMBING $ ;ISSUANCE $ , PLAN CHECK $ ENERGY P.C, $ ELECTRICAL $ GRADING $ I PLAN CHECK $ MICROFILM $ 2L f MECHANICAL $ TOTAL FEE $ PLAN CHECK $ CONSTRUCTION AND PLANNIN(si APPROVALS Permit # Date Inspector L & SPA 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 r 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding _5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd, 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 1'6. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 35. Roof Sheathing 74. Overhead Hydro 26, T -Bar Ceiling (Structural) & Monocoat S 75. Dry Chemical 7. Frame and Flashing 'E11�rQ „+ 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30, Drywall Nailing .70 HEALTH DEPT. REQUIREMENT 31, Plaster Brown Coat 79. FINAL INSPECTION r32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED "33. Final Electric Notes: Lt� 34. Final Heating & Air Conditioning OV 35. Final Gas Pipe -Test 36. Hood or Canopy � -4 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed ' 49. Electric Release to Edison 50, Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ` Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. X792 134 Tl� ,- CITY OF COSTA"MESA CONSTRUCTION PERMIT, Prd)ecl Address Applicant's Mailing Address _ &;'9 FO1 Owner's Name�� kyr Pone h?��l Address. V5� A;rie-" Arch/Eng.No. . License , Address. Contractor's Name ��' `� Phoneme_-� Address:(mailing);��1� "��►'L��/�f��^7 City License No. JI - L'ICENSE6 CONTRACTOR DECLARATION j i,,hereby:aifirm that,l am licensed under provisions of'Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my Iicense'is in f II f "rce and effect. > i I L'.icense Class � —Li se Oat,^��'y Signature WORKERS' COMPENSATION DECLARATION �l hereby'affirm that i have a certificate of consent to,setf-insure or a certificate 'of "Workers' Compensation' Insuran'ce,'br"a-'certified-copy-thereof"(Section_ 3800, Lab, i {L Policy No. t379, Company INS`46. p� �• �i_' �J *Certified copy -is herehy furnished. 1 { Certified copy is filed with the city Buil Ing,Division. } Date �� 4i ! Applicant �� EXEMPTION'FROM'WORKERS';COMPENSATION DECLARATION' I (This section need not be completed If the permit,is for one hundred ($100) or I certifyfthat in the performance of the work for which this permit is;issued, I ' shall not employ any person•in any manner soyas to become subject to!the Workers' Compensation, Laws of California, Date ' Signature NOTICE:,If,'after making this declar@tlgn,'you should become_ subject, to the Workers' Compensation provisions of ;the Labor Code, you must forthwith comply !with'. such 1'provisions, or ethis ,,permit 1 shall ,bei deemed revoked:. _CONSTRUCTION. L`ENDINGr=AGENCY•, f • , c.� 1 -a ; 't 1 herebyiaffirm that there is a construction lending agency for the performance -of the work for Iwhich, this permitl"Isl issued• (Section 3097 Civ. .C.)' Lender's Name`' i l Lender's Address!. OWNER BUILbER DECLARATION iz.`• �;1 r ' = ` i I he'r+3by, affirm that I am:exempt from the Contractor's License taw for the ! following reason:.(Section,7031h5+Business ind_Professional Code :,Any,cityor .county which requires a permit;td construct,' alter, improve, demolish or;repair Jany structure; prior to its issuance, also requires the applicant for such permit ,to file a,signed statement _that'he/she is licensed pursuant to'the provisions of l he Contractor's'License law (Chapter 9 (commencing with Section 7000) of vision; 3: of the•Business and Professions Code],,or.that he/she is exempt erefrom and the basis for)the alleged exemption. Any -violation -of Section ' /031-5 b;, any -'applicant fora, permit' subjects -the, -applicant to a. Civil i malty of;not more_ than five hundred dollars ($500).; r l_ }. I;: -as: owner 'of the property :or .my,empioyees• w_ itn wages as their sole compensation, will do the work, and the -structure is not intended or offered i for sale: (Section ;7044, Business and: Professional' -Code:; The Contractor's j License Law does not apply to.an;owner'of a property who.builds or improves thereon; and1who(does such work•himself/herself or•through his or!her own employees, provided that such;Improve men ts are not ,intended or offered for sale. If, however, the building or improvement is3sold within one year of com- , pletion, the owner,.wil0havelthe burden of proving he/she did not build or im- T> rove;for the purpose of sale). I, as `owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: •The•Contractor's-License Law does not-apply-to-awowner-of'Property'who-'- bullds or improves thereon, and who contracts for such projects with a con- 1 -tractor(s) license pursuant to the Contractor's License Law),. q t ❑•I am'exerript urider Section B. & P, C. for this reason _ r t Date = Owner;,_ I hereby certify_that.1 have_read- this,application and•state.that the above information is correct. I agree to comply with all city and county ordinances': and -state laws relatinglto buildirig construction, and -hereby authorize repre- sentatives of: this'. city- ent ro the above-mentioned 'property :far Inspection purp Signature Date Z. i Drivers',License or.SS ° III PER IT NO. TRACT NO, LOT NO. i BLDG. NO V TYPE.OF CONSTRUCTION NEW ADD ALTERATION " REPAIR .❑ CONVERSION ❑ DEMOLISH ❑ OTHER" :zL - 'DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING_ ❑ FOUNDATION ❑'STRUCTURAL ❑ TENANT ❑ ELEC'1TRICAL ❑PLMBING MECHANICAL U I ❑ OTHER' PROJECT IDESCRIPTION SQ. F_T OCC'UPANCY' ' :CONSTRUCTION.TYPE 'VALUATION $ ' I ZONE I l S I GRADING CU. YD5. ACRES r Remarks: 1 _ 70 /Q 1 Front t ( i PLUMBING ! 1 FEES Bar Sink Showers _ . Backflow Preventer__.... _,.". r _ Service Sink _._• ` i _, Backfiow irrigation Sewer Cap s Bathtubs Sewer Connection Clarifiers i Solar Collectors ', t Dishwasher•--_'--, Y - ( i - S&IIP�- ariping{-1 Drinking Fourntains Solar Tank i Floor Drains f Swimming Pool w7Spa r ;' Park. Fees $; { �� O U Floor Sinks_; 4 =� _Gas Service `.outlets: } ., Water Closet i w� WC I r Interceptorsc - i Water. Heater kitchen Sink I { Wates Service Lavatories Planning Notes: i M Roof'.O�rairs(' 7 _ r •'r' .ti i - ;;Reinspection-" ee411_1 �'$25� - : - - �7 Issue Fees. ' i ,MECHANICAL ; i ; FEES • Boiler - ' �' Hood or� Type I ❑ Cenopy . Type III ❑ i Duct Under Ground Automatic Washer i t: Duct - Structural El I SO + KWb, t Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTU G s Cooking Unit'"' -_'__. _w__ Duct - Ventilating i i _ Exhaust System ❑ Multiple ❑, Meter ❑'over 100 amps . f System Repair/Alteration y Firepl/Fact.;BIt.ICBO,# l- ;3 Dryers ❑Gas4 ❑Electric t Heating System & Ducting r C _ _Motors ©O-1 HP q1 �_, Do-100,006BITU ❑100,000 BT .._ ............ .__ i Fixtures: i _ .__' .•,.--- • -_ i Device Boxes i Pole Light- . e �: 3 Outlets i `, ; Range Reinspection Fee # $25r Switches i Issue Fee $ 3 1 Garbage Disposal l i StaridingiSections .1 = Generator 1165 KkI 115-15 KW Trash Compactor i CMF 0865-46 ieV.-'7/63 White- Building; Canary - 'ppllcaht; Pink' -"Accounting; Goldenrod A.P. # ; = r Zone I r S Main Building:, w Accessory Building:', _' ' Z T Front t ( N F A Rear . 1 t N C Right G K S Left E 1 Ping. Ref. # Park. Fees $; { �� O U ; Parking Req./Provided l I Use of Building: ,: R ' Planning Notes: i M N S' i ELECTRICAL ;' FEES Automatic Washer !Transformer ❑ 15-50 KW t: - ' "Construction Pole Su El I SO + KWb, t G s Cooking Unit'"' -_'__. _w__ •••- eter❑up tb'100 amps""•,"- '_j_•"-•"" _ w Dishwasher Meter ❑'over 100 amps . f Dryers ❑Gas4 ❑Electric Sub Panel i I F r Fant_„ ..` - _ �_ -4 , _ _Motors ©O-1 HP q1 �_, F.AEU. Inc.Solarp❑915 HP ❑16.151 t•_.._ i Fixtures: i i Microwave i Device Boxes i Pole Light- . e �: 3 Outlets i `, ; Range Switches i ; Sigri x 1 k Garbage Disposal l i StaridingiSections .1 = Generator 1165 KkI 115-15 KW Trash Compactor i Reinspection Feei $25 'Issue Fee' 1 $ 3 PUBLIC SERVICES REOUIREMENTS: ! s Zoning Approved By Date ` Application Approved By Date k 1i Application IssuedlBy , Oar _ t 1 -SUMMARY OF FEES BUILDING PERMIT i. $ SMIPI $ 1 ' PLAN CHECK $ I. PERMIT PLUMBING $ ISSUANCE $ PLAN.CHECK ' $ ENERGYkP.C, i $ ' ELECTRICAL '• $ GRADING $ s PLAN CHECK $ MICROFILM $ - MECHANICAL ' $ �' • �7 • Ate. TOTAL FEE $ PLAN CHECK $ F A' CONSTRUCTION AND PLANNINGPOG • APPROVALS " Permit # Date { Inspector _ SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole,I( v' 52. Pool & Equipment Location i .2. Soil Pipe-Undrgrnd. �+ 53.'Steel Reinforcement ✓^ 3. Electr,.icaLConduitfUtility Undrgrnd,r ' 54. Forms f 4. Electrical Conduit=Undrgrnd. J 55. Electrical Bonding , 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test { ^ 6. Electrical 'UFER Grnd. 57• APPROVAL TO COVER-GUNITE /' 7. Footings •' 58. Electrical Conduit-Undrgrnd, 1 1 8. Foundation r-, 59, .Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe Undrgrnd. t r , 60. Backwash Lines, P -Trap, ❑ Undrgrnd. IO.oEStructLira LFloor System 61. APPROVAL TO DECK 11'.f'Property Sewer Line & House Connection62. Backwash &Receptor -Final 12. Sewer.Cap 63. Heater &Vent Final r 13, Roof Drains h i '; 64, Plumbing System - Final 14, Roug64Plumbing - 65. Electrical -Final 15. Rough Electricak onduit 66. Solar System Final rP 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 . APPROVALS Permit # 20. Rough Factory Fireplace .t 21'. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product.Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25: Roof Sheathing 74. Overhead Hydro 26, T -Bar Ceiling (Structural) &,Monocoat 75. Dry Chemical ; 27. Frame and Flashing , 1 76. Dry Standpipe 28. Lpthing & Siding 77. FIXED SYSTEM FINAL f 29. Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31, Plaster Brown Coat 79. FINAL INSPECTION r32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33: Final Electric Notes: -� 34. Final Heating & Air Conditioning 6(l3(1Y Lar4) 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing r 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements'Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Date City of Costa Mesa Development Services Department Building Safety Division P. O. Box 1200 Costa Mesa, California The Building located at CERTIFICATE OF OCCUPANCY 3151 Airvacy Avmu-- T1 No. GUZa3b has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group H-2 Occupancy. Use of Building Office Legal Description 938-940-81 ISee reverse side for Metes and Bounds) Building Permit No 613701 Electrical Permit No. G13701 Plumbing Permit No. G13701 rUgUbu Mechanical Permit No. C-,13701 Number of apartments 0 anndd//or guest rodoom_s_ � 0 ISSUED TO: Building Official Nick PaMeS 3151 Airway AVenue Tl by Costa Mesa, CA _ %}'� Date /�/ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premiserid SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 le) U.B.C. CMF 1015.46 rev. 1/63 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services Department Building Safety DivisioninionCERTIFICATE OF OCCUPANCY No. 000238 P. O. Box 1200 Costa Mesa, California The Building located at MST Ai_rx�my Arnie 4T-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 5-2 Occupancy. Use o f Building Office - Interior Alterations Legal Description 427-291-12 fSee reverse side for Metes and Bounds), `. I-83$3 Building Permit No B-8232 Electrical Permit No. F-$382 Plumbing Permit No. P-8283 Mechanical Permit No.' —8650 0 Number of apartments —0— and/or guest rooms —0— ISSUED TO: Y '� Builcli^n, Official zi7rbmme Consultants Ltd. by 3151 Airway Avenue #kE-1, Costa Masa, CA T Date . r3 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premi s and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File }— City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000 2081 P. O. Box 1200 Costa Mesa. California The Building located at 3158 Airway Avmmje T-3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B,2 Occupancy. Use of Building Legal Description Office 938-940-83 3 (See reverse side,for Metes and Bounds) Building Permit No, BP -1199 Electrical Permit No. F -12'C156 Plumbing Permit No. i3P—M995 Mechanical Permit No. M-12691 Number of apartments 0 and/or guest rooms ISSUED TO: Building Official // ' /i ( _ Guildhouse Consultants �. �✓ by 3151 Airway Avenue, E-1, Costa Mesa, CA - Date This Certificate of Occupancy SHALL BE posted.in a conspicuous place on the premise and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - owner; Canary - Numerical File; Pink - Bldg. Permit File CITY OF COSTA MESA BUILDING DIVISION r77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www.ci.Costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. 60 0131 PERMIT TYPE B_R00F2 STATUS: ISSUED APN: 93$944$3 DATE ISSUED: 04/23/2008 "' ,ISSUED BY: l..� -•--'.:µ.�-,;.,•,• JOB -ADDRESS: 3151 AlRWAY,.AVVCM`� � SuitelUnit: C.Vlctrnty: BLDG. T Squares: 0 r " = ' Valuation:` $18,651.00 SCOPE OF WORK: REROOF:TIO WOOD SHAKE ROOF, REPLACE WITH 84 SOR'S OF CLASS A 40 YR. GAF FIBERGLASS SHINGLES 8 15# FELT. ; ROOF PITCH: 4:12 GREEN ROOF INSTALLATION PER ES.LEGACY-REPORT #ER -5546 OWNER: CORP OFLTHE PRESIDING BISHOP CHURCH OF LDS Address: %SOUTHERN CALIFORNIA %PROPERTY`RESERVE113 J rrr "'"t ry'� Unit: 10 E SO TEMPLE ST�#400i PHONE: City/State/Zip: BRUCE,CHRISTENSEN s APPLICANT: HANSEN, DUKE !'. ' - - Address: N6646636' Unit: PHONE: c . • CitylStatelZip: CONTRACTOR: ROSS AND BARROWS INC _ _ License.No. 327802 Address. 260 E ALTON'AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA;'CA.r " r�'_92707, 'CELL:' ARCHITECT: License No. PHONE: ENGINEER: _� License No. PHONE: �!.F.S FEE SUMMARY_.. _ Reroof Plan Check: $0.00 „- .25 - „ Reroof Permit Fee: $307� • . . -•. ,. Reinspection Fee: $0.00 �= 5 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No, 92-26, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE I• INSPECi16N SYPE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final 200 Final Re-Roof%2y 201 Final Block/Retaining Wall 202 Final Factory Fire Place 203 Fina15-sgn 204 Final Demolition DATE INTMAL 1 DEI IN$PECTIONTYPE 206 Final Mechanical 206 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final BuildingtOccupancy DAA INTRIALS - a + WORKERS' COMPENSATION DECLARATIO,. I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 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. Ri 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::,, (Carrier: C5 � � 7 (This section need rpt be eomplete7 d the permit is vatued at one hundred daeears ($ 700) or less.) Policy Number. /J_ Z O d 1_f ❑ 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 o Code, Iyell forthwith comply with these provisions. /_,�P�� /� 3 a8' Applirant'45ignature ate 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 DOLLARS ($100,000), IN ADDITION 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 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. Li J Z 7 Class # G _3 ��— Tia 'Contractor's Signature le CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that theta 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'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;penatty6i 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 C)de: 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 3057-06 (3/07) ' Owner ID verified by dr lice L 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, falsewmk, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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 rile a registration form for acutely hazardous materials? ❑ Yes ❑ 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 and fling 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 'f000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 311 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 I Ownerfs) r dlor AuthonZ6d Applicant Date VZ2,:�?4 Date T 9 Aoolicant to fill in all snaces within heavy border lines and Sian all aoorooriate declarations. 6145 5/20/92 35.00 TL• CITY OF COSTA MESA-•- — r PER IT TRACT -NO. - LOT NO, BLDG. NO. CONSTRUCTION PERMIT TYPE OF CONSTRUCTION EW 0 ADD ❑ ALTERATION ❑ REPAIR lffCONVERSIONrElDEMOLISH,- ❑ OTHER _' '• DESCRIPTION OF WORK ! 3" !. f • li : � h -a I ___ r, -ZONING REGULATIONS' ., A P -f- A ZONE' + PLNG.IREF: ' j Proje`crAddress 1 Airway/ Bldg.. TB-111= Owner Phone • AddressAve �. ` Arch/Eng, .^ 1_ License No. _ _ - Address - . - _ . _- _ ,- - '" I Contractor - 5'e�'jeve— 21 -.;- - --•- - - :OF PERMIT ` ❑ GRAbl_G `_ ❑ FOUNDATION -❑ STRUCTURAL ❑ 7ENANT�❑ELECTRICAL!-❑PLUMBING CHANICA �. 0 OTHER. -- OESCREPTION SQ. FT._ - - - J- - UPAN6Y" CONSTRUCTION TYPESTREET - - - - tVAL'UATION - -" ZONE•• ,G RADINGsCU_,Y,DS_ ACRES -. - - -- - BUILDING - - SETBACK L T. Tp BUILDING• -- PROPERTY LINE' r� Address ( SIDE YARD LICENSED CONTRACT R DEC LAR ATI N j of Charte om" I hereby affirm that I am licensed under p;ithe mencing with section _7000) of ;DIY ' _ Hess a Professions Code, land ilcens s ior �;'� -ROJECT Llcense'C s ' �~ 1 ' - ARATI •1 hereby affirm that i have a cer ificate of consent to self -insure certificate. of Workers' Compensation Insurance. or -a certified copy'. thereof (Se C.). r1i1V.7c3L+ TAS. - SiDE-YA w - RIGHT - _ , REAR YARD (TO P/L] PKG'SPACEREO. PROVIDEDSignatur -- WIDTH , . PARK FEEWORKERS„COMPENSATION, ZONING APPROVED BY” 1 DATE' SPECIAL CONDITIONS: ^ •� ' - - - - - Policy No: Company-Haine8 ❑ C [tied copyJ$ hereby_furn+shed. Y _ _ _ _ Certified copy i5 filed with the city ^ Building Division. - • EXEMPTION FROM WORKERS', COMPENSATION DECLARATION 'yThIs Section need not be completed if the permit is for one hundred 100) or -less)." "+ 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 I aws of California. •- • '.n ' ••� • Date - - Signature �.- • �_-- -_- -� - -REMARKS: • 1'tt I m - - - - - - --iE - - -- - -- "• -- �•- _ --PLUMBING ,s ;r{` PLAN CHECK _ _ - .� ' ' ' _ ELECTRICAL " ' ,ti PLAN CHECK- '- BATHTUBS - -' -" SHOWERS•' - -' _ I - - - - -- NOTICE: If after making this declaration, you should becomesu_bject to the Workers' Compensation provisions of the labor Code, ydu must forthwith comply with such provisions or this permit shall be deemed !-TOILETS,,. 1 IURINALS" -'- -� - iGENERATOR----- 0.1 KW- TRANSFORMER APPLIANCE- 10-50•KW___�50+•KW - =• - -- r' LAVATORIES DOUBLE=LAVS^--• - - _e CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance Of the work for which this permit Is issued (Section 3097 -._ 'KIT; SINKS- DISHWASHERS - - -[ _ ._ MOTORS-- RS -' 0 -1 -HP . -m 'I-10 HP" - ___ - .(INC, 50 LA R) -. 1D-50•HP --50•+-HP- •� -s-77717 -• -- -- SERV ICE SINKS ;-,•l �� .SUMPS -� �, - - - -FLOOR SINKS-"-"' '--FLOOR'DRAINS j"' FIXTURES-- OUTL^ETS-'^'SWITCHES"" ^' Civ: C.). -- - • - --- - - --- •- - - - — -- - Lender's Name Lender's -Address DRINKING FOUNTAINS- -'GAS TUBE -SIGNS INTERCEPTORS— --CLARIFIERS - `" -LIGHTS 'OWNER -BUILDER DECLARATION— I hereby affirm that I am exempt from the Contractor's License Law for ^SWIMMING -POOL— - --P-TRAP•-- - ' '!POLES METERED - SUB the follow! ng_ reason (Section 7031.5 BuSiness.and Prafessiuns.Code: Any, City or county .which requires a permit to construct, alter, Improve, demolish or repair any-structure,•prior-to -its,issuance, also re• quires the applicant for such permit to file a signed statement that he --WATER SERVICE `"'ALTERATION -' 'PANELS------- MAIN -SUB -- " - - "- -- GAS SERVICE -.'OUTLETS - -"-' SERVICE- ----AMP - -- is -licensed pursuant to the-provislonsof-the Contractor's License Law- (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and_Professions Code)-or.that,he-is exempt.therefrom and the. basis for the alleged exemption. Any violation of Section 7031.5 byany. -WATER-HEATERS - -BTU-OUTPUT--- -SEWER CONNECTIONS- ^• - ^" � � — - applicant for a -permit subjects the. applicant_to-a-civil..penalty- of ,not more than five hundred dollars ($500). of not --SOLAR TANK— COLLECTORS -- ! as-owner of -the -property, or -my employees•with-wages as -their -le compensation, will do the work, and the structure is not intended -)ffered-for sale.'(Section'7044,-Buslness and'ProfessionsCode:-The SOLAR•PIPING SYS:-`- 'ISSUE-FEE-- itractor's License Law does not apply to an owner of a property- o builds or Improves thereon; and who'doe5 such work himself or through his own employees, provided that such improvements are not ISSUE'FEE - Il' _' "" -- 'APPLICATION APPROVED BY -, DATE---__ - T - MECHANICAL _ PLAN CHECK - -_ SUMMARY OF,FEES _ !*'.•�' E -'• (BUILDING - -- � - PERMIT � $ - SMIP` $: PLAN CHECK. $ PERMIT. 1 _t _ ._ _-- _ . �, - ISSUANCE t- 5 sig' PLUMBING PLAN CHECK $ I C lEL"ECTRICAL_'S I ,. rt+_..,,'•_MICROFILM'$.L• kPLAN'CHECK "3 ' MECHANICAL-$ - " It' ' +�".: i."L'ESS AD. c + r 'PLAN CHECK "$ - VANCE PC- $- „ ,, • I`, �;� , F - , - •' ' ' 2 y� O0 Intended or-offered'for'sale. If, -however, the•building'or improvement is Sold within one year of completion, the owner will have the burden of -proving 'he' did not -build, or -Improve for the -purpose of -Sale).- ❑_i, as.owner of -the .pioperty,.am exclusively -contracting,. with licensed contractors to construct the project (Section 7044, Business and -professions Code: The -Contra ctor'S_License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from.SuCh .projects with -a-contractor (s)-Iicesned pursuant to the Contractor's License Law). ❑ •i am exempt under Section- - - - - - B: & P. C. for this reason Date Owner I hereby certify tha a ead this ap ' ion a state that the above information '^is re agree- t mply all city and county' ordinances a tate relati o cons on, and hereby authorize representat s of s -cit O' a upon t above mentioned Property r f co 513.. - HEATiN4 SYSTEM o-100,000 BTU ANO DUCTING 100,000;+ BTU _ REFRIGERATION 0-100,000 BTU SYSTEM-- 100,000+ BTU BOILERS BTU I - , - _ - - ---- - __ SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE - - - I + -- Sigria[ur Drivers' L nse or SS _ ISSUE FEE - - _ _ _ FINAL FEE 3 " CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor r t r I, ] i ( CONSTRUCTION AND PLANNING APPROVALS Permit # Date �-�.i Inspector l' POOL & SPA R- --t. APPROVALS ermi# ,;iD, ateL . i Inspector �. 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility,Undrgrn 45. Forms. - 4. Electrical Conduit-Undrdrn 46. Electrical Bonding, 5. Steel em orce . 47. Rough Plumbin &Pressure Test _ _ 6. Electrical UFER Grn. - _ 48. APPROVAL TO COVER-GUNITE' 7. Footings 49. Electrical Conduit-Undr'rn 8. Foundation.. 50- Gas Pipe, ❑ Undr rn, Test.---,-. - ' r;• 9. Water Pipe-Undrgrn 51.. Backwash Lines P=Tra ❑ Undr rri"• 10.- . Structural Floor, System .52. APPROVAL TO'•UECI< 11. Property Sewer. Line & House Conneciion 53. Backwash & Receptor -Final 12. Street Sewer. Connection - 54. Heater &. Vent -Fina! :„� : , • . , , 13. Rough Plumbing 55, Plumbing SysteM Final '14. Rough Electric -Conduit '56:" Electrical -Final `` 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 58.• Fencing & Access Approval 17. Ducts, in Structure_ 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL. - 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof SheathingNOTES: 22: Frame and Flashing -23' Insulation = 24. Lathing & Siding - - 25. Drywall Nailing 26. Plaster Brown Coat - 27. Electrical Power Meter -Final 2B: Final Electric - 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Fina! Plumbing 32. Water Service -Final 33.- Gas Service -Final 34. Solar Domestic -Final _ 35. Landscape Sprinkling System r '` 36..-'i! .Sound Attenuation = "- 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison., � ,- 41. Gas Release to Southern California Gas Co. 42. ?lo` CERTIFICATE OF OCCUPANCY ' Date ` ` ; Applicant t0 fill in all spaces ,vlthln heavy boraer•.,,.__._.sign all appropriate declarations. CITY OF COSTA MESAPERMIT NO. TRACT NO. LOT NO. I-BLDG.NO. CONSTRUCTION PERMIT ///7 '7 �39I Gl, a2 Project Address 151-T Airway avenue, LOSta Iviesd TYPE OF CONSTRUCTION Owner Western Pacitic i nand a Phone — k NEW ❑ ADD ❑ ALTERATION Address 1601 Dove Street, Newport Bch-. Arch/Eng. Hal es—Langston License No. — Address 7 'S, Main #105 Oran e, Ca. Contractor The J. Donald Olson COMPhdr,e540-260 Address 3151-E Airway Avenue Costa Mesa LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full for a �gy,ifect, License Class Ucense No 39 6J Date Signature _ WORKERS'COMPENSATION DECLARATION ( hereby affirm that I' have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sectlon 0, Policy No. — — — ompany Fairmont Insuranc ❑ Ce hied copy Is hereby furnished. zertifled copy Is filed with the City Building Division. 4XEMPTION FROM WORKERS' COMPENSATION DECLARATION chis section need not be completed if the permit is for one hundred $1001 or less). 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. Date Signature NOTICE: If after making this declaration, you should become'subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per. formance of the work for which this permit Is issued (Section 3097 Civ. LenWestern der's Pacific Financial Cor . tinder's Name Lender's Address -lbUl _ ova Street, Newpurt OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit t0 Construct, alter, Improve, demolish or repair any structure, prior to its Issuance, also re- quires the applicant for such permit to file a signed statement that he IS licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he 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 ($500). n I, as owner of the property, or my employees with wages as their Compensation, will do the work, and the structure is not intended ,ffered for sale. (Section 7044, Business and Professions Code: The .rlractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not Intended Or Offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). Cl I, as owner of the properly, am exclusively contractingwith licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that l have read this application and state that the above Information is correct. I agree to comply with all city and county ordinanCes and state laws r lett to constr ction, and hereby authorize representativ his ty O enter on the above mentioned property s ctio Signature l��s' py Drivers' License Or SS ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER -- COMMERCIA1 DESCRIPTION OF WORK a Plan heck # 51442 TYPE OF PERMIT,,�� //`` ry� ❑ GRADING t_JYFOUNDATION ly STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAN ❑ OTHER f PROJECT DESCRIPTION SQ. FT. 6661 r} OCCUPANCY CONSTRUCTION TYPE -5 V ALUATIO$ ONE GRADING CU. YDS. ACRES REMARKS. ' PLUMBING PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAVS KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. , ISSUE FEE ELECTRICAL MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU 100,000 +BTU REFRIGERATION SYSTEM 0.100,000 BTU 100,000 +BTU ' BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 0 ZONING REGULATIONS A.P. 11 — 04,-2 r ZONE CIL— PLNG.. 7� SETBACK L ST. gREF..It RO �RkppYNLINE -5 F YARD + KW _ RIIGHTAR v� REAR YARD (TO P/L) (INC. SO BAR) PKG.SPACEREQ. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BYDKrZ r DATE SPECIAL CONDITIONS: ' ELECTRICAL PLAN CHECK GENERATOR 0-1 KW 1-10 KW TRANSFORMER 748.00 _ APPLIANCE 10.50 KW_50 + KW _ MOTORS 0.1 HP 1-10 HP _ (INC. SO BAR) 10-50 HP 50 + HP „ FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS GRADING $ PANELS MAIN SUB SERVICE AMP ISSUE FEE APPLICATION APPROVED BY /f�;+14 i , . —a3 FINAL FEE •$ 763'48 SUMMARY OF FEES BUILDING 748.00 15.48 PERMIT S SMIP $ PLAN CHECK $ PERMIT ISSUANCE $ PLUMBING $ GRADING $ PLAN CHECK $ , ELECTRICAL $ $ MICROFILM $ PLAN CHECK $ TOTAL FEE $ MECHANICAL $ LESS PAN CHECK L $ PC VA CED $ FINAL FEE •$ 763'48 CONSTRUCTION AND PLANNING APPROVALS Permit # i 1 t 7 Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFEF Grn. 48. -APPROVAL TO COVER-GUNITE 7. Footings .l 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51, Backwash Lines P -Trap,❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13, Rough Plumbing 55, Plumbing System - Einal 14. Rough Electric -Conduit :56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final 16. Rough Heating & Air Conditioning M. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathirt �-� NOTES: �_- 22. Frame and Flashin r`7S -k,ts D 23. Insulation i J`Aaj( 7 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Fest 31. Final Plumbing 32. Water Service -Final 33.' Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 3B. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE~ OF OCCUPANCY No Date .,,....�....-.i fill In all spaces within heary border lines and sign all appropriate declarations, ' CITY-OF COSTA MESA PERMIT N TRACT NO. LOT NO. BLDG. Np. CONSTRUCTION PERMIT TYQE OF CONSTRUCTION Gii�i j0fi3/8i ,�eQQ EW ❑ ADD ❑ ALTERATION " ' - ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ZONING REGULATIONS ❑OTHER DESCRIPTION OF WORK A.P. 11 '• ' ZONE PLNG. REF. :P ' t Address mega Ca- Owner SonPhone Address, Arch/Eng. License No, Address ContractorLea�ertnnlk�ck.,- Pharr _3F,6Q TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICALi9jP,1-.UMBING ❑MECHANiCA ❑ OTHER PROJECT DESCRIPTION UU1Lu1rvkx- Tp "O INC SETBACKT. PROPERTY LINE Address E YARD R%E Y RIGHT LICENSED CONTRACTOR DECLARAY I hereby affirm that I am ilconsed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License CI $4 Ucensa/ o REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED Date 10-y-24L Signature •{• s-�_ c I - WORKERS' COMPENSATION OECLARATION I hereby affirm that I have a certificate of consent to self-insure oraVALUATION certificate of Workers' Compensation Insurance, or a certified copy thereof (Se Lab. C.). Policy No.. `�� Company Zen 1h National q Certified copy is hereby furnished. S4. FT. OCCUPANCY CONSTRUCTION TYPE ZONE ' GRADING CU. YDS. ACRES STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: REMARKS: rtIfIed copy Is filed with the city Building Division. �.`--tEMPTION FROM WORKERS' COMPENSATION DECLARATION 'his section need not be completed if the permit is for one hundred. " (8140] or less), f certffy that )n the performance of the work for which this permit Is Issued, I Shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. Date Signature ' BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-10 KW TRANSFORMER APPLIANCE 10-50 KW,50 + KW NOTICE: If after making this declaration, you should become subject t4 the Workers' Compensation provisions of the Labor Code, you must fOrthwllh comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1.10 lip SERVICE 51NKS SUMPS I hereby affirm that there is a construction lending agency for the per- formanCe of the work for which this permit is Issued (Section 3097 Civ C.). L,ender'S Name (INC. SOLAR)- 10-50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES 4ender's Address f DRINKING FOUNTAINS GAS-TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any City or county which requires a permit to Construct, alter, Irrtprovo, demolish or repair any structure, prior to Its issuance, also re- quires the applicant for such permit to filo a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (Commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he Is exompt 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 or not more than five hundred dollars (8500). SWIMMING POOL PTRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE RMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS - SOLAR TANK COLLECTORS as owner of the property, or my employees with wages as their ompensation, will do the work, and the structure is not intended e, offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or �i � ' �Sr o(NAPPLICATION ISSUE FEE ISSUE FEE ix-'C, APPROVED BY OATS through his own employees, provided that such improvements aro not MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING PERMIT $ SMIP f PLAN CHECK $ PERMIT ISSUANCE S-- - _— PLUMBING $ GRADING $ PLAN CHECK 5 intended or offered for sale, It. however, the bUliding or Improvement is sold within one year of completion, the owner will have the burden 4f proving he did not build or Improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to Construct the project (Section 7044, Business And Profession$ Code: The Contractor's License Law does not apply to 4n owner Of property who builds or improves thereon, and who con- tracts from Such project$ with a-contraCtOr(s) licesr)ed pursuant to the Contractor's License Law). HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000;+ BTU ❑ I am exempt under Section B. & P. C. for this reason Date - Owner I hereby certify that I have read this application and state that the above Information is Correct. I agree to comply with all city and county ELECTRICAL $ s PLAN CHECK g MICROFILM $ MECHANICAL E TOTAL FEE 8 LESS AD- PLAN CHECK 5 VANCE PC $ _ BOILERS STU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE Ordinances and state taws relating to construction, and hereby authorize representatives f this city t9.--Crater upon the above mentionetl property for �sp�tlourb4es L' 5ignatu (r /Ll Drivers' License or SS - FINAL FEE S( - ISSUE FEE CMF 01365-46 White-Building; Canary-Applitant; Pink-Accounting; Goldenrod-Assessor {aT CONSTRUCTION AND PLANNING rAPP,ROVALS r a0. (;,1,{�.�i Pe"rirsit#' Date Inspector POOL & SPA ate Inspector APPROVALS Permit # Pate 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn_ 46. Electrical Bonding Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grp 48, APPROVAL TO COVER -GUN ITE 7. Footings 49. Electrical Conduit-Undr rn 8, Foundation 50. Gas Pipe, ❑ Undr rn, Test 9._ Water Pipe-Undrgrn 51. Backwash Lines P-Tra2, 0 Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11, Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Hough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat " 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date i Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAPERS IT NO. TRACT NO. LOT NO, SLOG. NO. CONSTRUCTION PERMIT PP O''.. -P T Project Address 3151 Airway, Costa Mesa CA Owner Phone Address3151 AJCosta Mesa CA 92626 j1 Arch/Eng. License No. I Addres's Coritractor Leaver ton -Beck Inc. Ph6ne 979-356 Address 16721 Hale Am. Irvine CA 92714 LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force apq e'fect. Llcens Class C36 e • o 111969 Oate Signature _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a Certificate of consent to self -Insure or a certificate of Work -tilers' Compensation Insurance, or a certified copy Policy No.0 1TOV �'Rb, C. Company Great American rtified copy Is hereby furnished. - ertffled copy is filed with the city Building Division. NEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($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. Date Signature NOTICE: if after making this declaration, you should become subject to the Workers' Compensation provisions Of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit. is Issued (Section 3097. Cl V. C.). Lender's Name Lender's Address — OWNER BUILDER DECLARATION I herebyy affirm that I am exempt from.the Contractor's License Law for the folk0wing reason (Section 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 re- quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he 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 not -more than five hundred dollars ($500). I, as owner of the property, or my employees with wages as their -lie compensation, will do the work, and the structure is not intended Or Offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself Or through his 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 will have the burden of proving he did not build or Improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively Contractingwith licensed contractors to construct the project (Section 7044, Business and Professions Code. The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). - ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information is Correct. I agree to comply with all city and county ordinances and sta laws relating to nstruction, and hereby authorize representatives� /this city to nter on the above mentioned property Ct n' urp Slgnatu e Drivers' License or SS TYPE OF CONSTRUCTION ❑ NEW ❑ ADO ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK r0 3576 7/21/82 ZONING REGULATIONS A.P. =P ZONE PLNG. REF.: 52.00 ,TLS I TYPE OF PERMIT BUILSETBDING TROPIA?YNLINE ❑ GRADING • ❑ FOUNDATION ❑ STRUCTURAL I YARD ❑ TENANT ❑ ELECTRICALIOI�LUMBING ❑MECHANIC WIGDEHEYARD ❑ OTHER - REAR YARD (TO P/L) PROJECT DESCRIPTION PKG. SPACE REQ. PROVIDED SQ. FT. OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE S ZONING APPROVED BY DATE VALUATION ZONE GRADING CU. YDS., ACRES SPECIAL CONDITIONS: REMARKS: — — PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUE3S SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLELAVS APPLIANCE 10-50 KW_50 + KW KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1.10 HP i' SERVICESINKS SUMPS .(INC. SOLAR) 10-50 HP_50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTION QiO SOLAR TANK COLLECTORS SOLAR PIPING SYS pCV VV ISSUE FEE ISSUE FEE Ole APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP S ' AND DUCTING 100,000 + BTU PLAN CHECK S PERMIT ISSUANCE $ REFRIGERATION 0-100,000 BTU 'PLUMBING S SYSTEM GRADING $ BTU -PLAN CHECK $ BOILERS .100,000,+ BTU ELECTRICAL S $ PLAN CHECK 9— MICROFILM S SYSTEM REPAIR, ALTERATIONTOTAL FEE S EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS - AD - PLAN CHECK $ VANCE PC $ FINAL FEE $ ISSUE FEE - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING1 APPROVALS \ Permit # Hate Inspector POOL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2, SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER -G UNITE 7, Footings '49. Electrical Conduit-Undr rn B. Foundation _ - - 50, Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51, Backwash Lines P -Trap.- ❑ ndr rn 10. Structural Floor System 52. APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 1.ti - i Y55. Plumbing System - Final 14. Rough Electric -Conduit •56. Electrical -Final - 15. Rough Electric-Wirin 57. Solar System -Final 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test_ _ 20. Roof Framing 21: Roof Sheathing- NOTES: 22. Frame and Flashing - 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27: Electrical Power Met@r-Final 28.. . FinalElectric 29. Final Heating & Air Conditioning - 30. Final -Gas Pipe -Test 31. Final Plumbing 32: Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape S riniclin $stem 36. Sound Attenuation ' 37. Handicap Regulations 38. FINAL STRUCTURE= & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date . i i\ %�i` - - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. t�F COSTA MESA - - PERMIT NO. TRACT NO. - t_ -NO. - BLDG. NO. " CONSTRUCTION PERMIT ,3 Project Address3l Sr-- W TYPE OF CONSTRUCTION - 6121 5/20/80 33.50 TL., Owner t Phone 76 ❑ NEW ❑ ADO ❑ ALTERATION ' Q Address AD p �� . ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑OTHER ' ZONING REGULATIONS Arch/Eng. License No. A.P. V1 Address OESCRIPTION OF WORK ZONE PLNG. REF, 191 Contractor t i C C - Ph6ne6Ct(.Jj3V TYPE OF PERMIT' BUILDINGpp t�1 IpING - �20'PV L TY LINE Address 1 ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBAC SIFYARD -- LW11 LICENSED CONTRACTOR DECLARATION horeby that I licensed Charter 9 ❑ TENANT �ELECTRICRL ❑PLUM13ING ❑MECHANIC E YARO I affirm am under provisions of (com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code,`dmy He In ull r REAR YARD (TO P/L) PROJECT DESCRIPTIQN Licens¢ Class ce N01401 PKG. SPACE REQ:- - PROVIDED $Z S4. FT. - f]ate'S~� Slgnatur _ � STREET WIDTH PARK FEE 5 WORKERS: COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of Consent to self -insure or a VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certif�d copy _ -SPECIAL (Section 3 La ). GRADING CU. YDS. ACRES CONDITIONS -.thereof + • ;icy No Company W. A1+N='tiL1(_."_• _ - - - .i'Certified copy Is hereby furnished. REMARKS:.S L. j. Q _ ftCertified copy Is flied with the city Building Division. XEMPTION FROM WORKERS' COMPENSATION DECLARATION • - i - - -• (Thissection need not be completed if the permit Is for one hundred -or - - •) - �- - ca -,,, - _ , > (5100) less)- -49-111 - I certify that In the performance of the work for which this permit is . - i Issued.' I shall not employ any person in any manner so as to become - -PLUMBING PLAN CHECK ELECTRICAL '" - PLAN CHECK'- HECK-subject subjectto the Workers' Compensation of Califor-nia. -Laws Date Signature BATHTUBS SHOWERS - - NOTICE: If after making this declaration, you should become subject TOILETS-,,. URINALS - - - � -GENERATOR - 0.1'KW' 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER for comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LRVS - APPLIANCE 10-50 KW 50 + KW , revoked. y _ CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP,: -1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS-- (INC. SOLAR) 10.50.HP 50 + HP _ formance of the work for which this permit Is issued (Section 3097 f Civ.•C.). - - - -- - - FLOOR SINKS` FLOOR DRAINS FIXTURES OUTLETS SWITCHES - Q Lander's Name 'Land¢r'S Atldre55 - DRINKING FOUNTAINS + - - - - - GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS - - - -` I hareb dt[Irm that 1 dm exempt from the Contractor's License Law for the following reason- (Section 7031.5 BusInOSS and Professions Coda: SWIMMI NG POOL - P TRAP* • - -- - - - - - % Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to Its issuance, also FO' WATER SERVICE ALTERATION PANELS MAIN SUB { quires the apl iicant for such permit to file a signed statement that he �`s r - Is licensed pursuant to the provisions of the Contra Ctor's.License- Law GAS SERVICE' OUTLETS �; T, SERVICE - - - l AMP - [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS- - BTU OUTPUT f• --'s for the alleged exemption. Any violation of Section 7031.5 by G4 applicant for a permit subjects the applicant to -a -civil penalty SEWER CONNECTIONS - -- - •- - — it more than five hundred dollars (5500). i, as'owncr of the property, or my employees with wages as their SOLAR TANK COLLECTORS - - _ - - Sole compensation,- will do the work, and the structure is not Intended or'offered for'sale. (Section 7044,-Business'and Professions Code: Tho SOLAR PIPING SYS. ISSUE FEE i Contractor's License Law does not apply to an owner of a property who -builds or improves thereon, and who does such work himself or ISSUE FEE - I APPLICATION APPROVED BY DATE through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK V ' " SOMMARYQF FEES Is sold within one year of completion, the owner will have the burden - of'proving he- did not build- or'improve for the purpose of Sale). HEATING SYSTEM 0-I00,000 BTU - -.BUILDING - PERMIT S SMlP ❑ I,_as ,Owner. of the property, am -exclusively contracting with AND -DUCTING _ `E _ licensed contractors to construct the project (Section 7044, Business 100,000.+ BTU PLAN CHECK S PERMIT and Professions.Code, The Contractor's License Law does not apply to _ ISSUANCE S ' an owner of property who builds or improves thereon, and who Con- REFRIGERATION 0-100,000 BTU PLUMBING E traCIS -from such -projects with a- contractor(s) licesned pursuant to SYSTEM _ _ 1 'GRADING $ ' the Contractor's License Law). 100,000 + BTU _ _ - PLAN CHECK 5 -' ❑ 1 am exempt under SaCtiOn - - B. &� P. C. for this � `_ ELECTRICAL- $ d - 'S BOILERS BTU _�3:6 MICROFILM $ reason. - PLAN CHECK g Q Date Owner SYSTEM REPAIR, ALTERATION TOTAL' FEE a � I hereby certify that I have read this application and State that the above EXHAUST SYSTEM MULTIPLE MECHANICAL S ' LESS AO- + } information is correct I agree to comply with 'all city and county ELAN CHECK $ VRNCE PC - S _ ordinanc 1 S relat g to Construction, and hereby authorize repress atives-of s city o enter upon -the above mentioned ` prapert for i on S. S Signature Date ' FINAL FEE= S`!L`_ Drivers' License or SS �'. ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # j .� POOL & SPA Date Inspector APPROVALS Permit # ^. Date Inspector '. 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn 45. Forms ' 4.- .Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee em orce 47. Rough Plumbing & Pressure Test - 6. Electrical UF.ER Grn 4$. , APPROVALTO COVER GUNITE f 7. Footings _ 49. Electrical Conduit-Undr rn 8.. Foundation - 50. Gas Pipe, ❑ Undr rn Test - 9. Water Pipe-Undrgrn _ _ 51. Backwash Lines P -Trap.❑ n r` rn • 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & Nouse Connection 53. Backwash & Receptor -Final 12. Street .Sewer Connection _ •54. Heater & Verit•Final .13. Rough Plumbing - ' 14. Rough Electric -Conduit 56. Etectrical-Final- - 't 15. Rough Electric -Wiring C-xe E e-� ri}-. Z '57.. Solar System -Final 16. Rough Heating & Air Conditioning -Fencing & Access Approval 17. Ducts in Structure - APPROVED FOR PLASTERING 18. 19. 20.- Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing -- - 60.- POOL/SPA SYSTEMS FINAL = - 21. 22. Roof Sheathing Frame and Flashing - NOTES: 23. Insulation - - 24. Lathing & Siding - 25. Drywall Nailing - 26. -Plaster Brown Coat 27. -Electrical Power Meter -Final S . 28. Final -"Electric - - - - - 29. Final Heating & Air Conditioning - - 30: Final Gas Pipe -Test - 31. Final Plumbing 32. Water Service -Final - 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations , 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed- ' 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No: Date - _ Applicant to (ill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address T- Appl:cant'sMai t pAddress ��" I�T11�-lAlfS F(tV _ r-s?zo Owner'sfj"me 1�� pAppAE, _ Phone4-;;5,L d� Address Arch/Eng•'TnFi License No. G az �o trracia s N� e_6%Cs7ryJ c � __ -6�.1 Phone y3z ' t7 Address (mailing) :31,5J 61V -61i T=1 City License No. .3 cq- !J G, LiCENSEO CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, artd my license is in full force and effect. 1 1 License Class Ice s No. Date �� /s Signature WORKERS' COMPENSATION D RATION I hereby affirm that I have a C to of consent to self -i ure or a certificate 'of Workers' CompensMion Insurance, or a certified copy thereof (Section 3800, Lab. C.) Policy No. Company Gertlfied copy'is hereby furnished. Certified copy is filed with the city Building Division. Date --.Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection need not be completed If the permit is for one hundred (E100) or_ less) �." ' I certify that in the performance of the work for whlCh this permit Is issued, l-, shall' not employ•any person In any manner soo , as to become sub' ct to the- WorkersCom cation Laws of Californi J Date Signature NOTICE: If, after ma Cing this declar - n you should become s lett to the Workers' Compensation provisions Labor Code, you st forthwith comply with such provisions or this permit shall _be de med revoked. CONSTRUCTION LENDING AGENCY ' I hereby affirm that there Is a construction'lending agency for the performance ofthe work for which this permit Is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am,exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt herefrom 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 �enatty of not more than five hundred dollars ($500). u 1, as owner of the property or my•employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an.owner of a property who. builds or Improves thereon, and who does suchwork-himself/herself or through his or her own employees, provided that such improvements aro not intended or offered for , 'sale. If, however, the building or improvement Is sold within one year of com- plet'eon, the owner will have. the burden of proving he/she did not build or im- rove for the purpose Of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Profession$ Code: The Contractor's License Law does'not apply to an owner of property who builds or improves thereon, and _who contracts for Such projects with a con- tractors) liCense pursuant to'the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that 1 have read this application and state that the above 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 enter upon the Bove -mentioned property for inspection purpo Signature Dateln'7f` Y Drivers' CMF 08i PERMIT NO. ]TRACT NO. G, I 5qIIS- !'/ LOT NO. UNIT NO. !� �4 9 _ 2311 6/15/8y 6RPe711 Y T E OF CONSTRUCTION NEW IJ ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ 0TH R DESCR OF WDRKIUSE OF BLD( A.P. Zone C11— S Main Building: Accessory Building: \ TYPE OF PERMIT GRADING FOUNDATION 0 STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ -OTHER ' PROJECT DESCRIPTION SQ. FT. ID OCCUPAN Y I 00�— CON STRUCTiON TYPE VALUATION $ _/ ZONE GRADING CU.YDS. ACRES T Front Z 0 B A Rear N I C Right N K $ Left G R Ing, Ref. # Park ing'Req./Provided E Remarks: fQ Planning Nates: M T S. ` PLUMBING FEES Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW C1 50+.KW ` .� Backflow Irrigation Sewer Cap Bathtubs Sewer Connection" i' Z Cooking Unit _ Meter El up to 100 amps Clarifiers Solar Collectors, Dishwasher Meter ❑over 100 amps Dishwasher - Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank. Fan+ Motors ❑0-1 HP ❑ 1 r4 - 8 Floor Drains Swimming Pool w1spa ' F.A.U. Inc. Solar 139-15 HP Ell 6-15+ 3 Floor Sinks Urinal Fixtures Microwave Gas Service Dutlets Water Closet4 N' Device Boxes Pole Light + Interceptors j - Water Heater 7— Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Llf CC Garbage Disposal Standing Sections = P—Trap '. - Generator ❑0-5 KW ❑5-15 KW Trash Compactor , Roof Drains ' �`- 2 Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES { DEVELOPMENTSERVIC Zoning 'Approved By��!�- Building°Approved By Apptication Issued By OUI�Rj�M NTS: / Date r S Date / `-;?� Data {� ��2 Boiler Hood or Type I ❑ Canopy Type II El Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTU - Duct - Ventilating .' BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL 'PLAN CHECK 25% SUMMARY OF FEES $ Sg�• SMIP $ S PERMIT $00 ISSUANCE $ S ENERGY P.C. $ $ 27, � GRADING $ $ « (O MICROFILM $ $ I �+� TOTAL FEE $ $ _ 3, .J.--+--� Exhaust System 1:1Multiple ❑ System Repair/Alteration Firepl/Fact- Bit. ICBG # ZDi Heating System & Ducting ❑0-100,000 BTU E]100,000 BTLF Reinspection Fee $15 Issue Fee $ 3 v. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # 7DateInspector POOL .-- SPA APPROVALS' Permit # Date Inspector 1. Tem nary Electrical Service or Pole - 52. Pool & Equipment Location 2. So4I Pipe-Undrgrnd. 4 53. Steel Reinforcement 3. Electrical Conduit'Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 44fG 55. Electrical Bonding 5.• Steel.Reinforcement 56. Rough Plumbing & Pressure Test r 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 56. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, ❑ 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 T1118LI CJF49 65. Ftectrical-Final 15. ,Rough Electrical -Conduit 66. Solar System -Final 16. -Rough Electric Wiring iG 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling , r C 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning vp m Lip FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace ' 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71, Product Piping ❑Gas ❑Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24.E Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 t 77. FIXED SYSTEM FINAL 29. Insulation 71, Vis} Gam„ � 78. FIRE PREY. 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:Tk..T dtt tH Sount1 Cu,,o6-71WJL1(-;FV 34. Final Heating & Air Conditioning �I �� t~�p - oet1 S `-, 35. Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace 36. Final Plumbing 187 8-1 44&3 39. Water Service -Final 40. Gas Service -Final 41. Solar bomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44, ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas•Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spates Mph within heavy border lines and sign all appropriate declarations. CITY of coSYA`m� A CONSTpRJUCTION PERMIT PERM17 NO. TRACT NO. LOT NO. UNIT NO, �l 12�rT T` 153 O I F Project Address PPrtZ Applicant's Mailing Address 3 ( -! AIR—Wk T� Owner's Name i Phone432 3 Address ' Arch/Eng) Aim—T5 License No. �9 Address +30�� Q• Q Contractor's Name 0 4RJ Phone 3 "RSZz 7 Address (mailing) - A a � City License No. 020 LICENSED CONTRACTOR DECLARATION , I herebyaffirm that 'I am licensed under provisions of Charter 9 (commencing With section 7000) of division 3 of the Business and Professions Code, and my license is in full force and effect. Livens Class Li ns e N Date Signature WORKERS' COMPENSATIO EC ARATION V- I hereby affirm that I have a ceFrTlTcate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy- thereof (Section 3800, Lab, C.) Policy No. Company eCertified copy is hereby furnished. . f Certified copy is filed with the city Building Division - Date ' — Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($100) or less), I certify that in the performance of the work for which this permit is issued, I shallnot employ any person in any manner so as to become subject to the Worker o sation I`aws of Calif Date —Signature NOTICE: If, after making ' this declara i, you should becomes b'ect to the Workers' Compensation provisions of the Labor Code, you musT forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION'LENVING -AGENCY 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.) i_ender's Name _. - - Lender's Address OWNER BUILDER DECLARATION I hereby affirm .that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3of the Business and Professions Code) or that he/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 ped nalty of -not more than five hundred dollars ($500).' t ' '7 I. as, owner of the property.or my'employeeS with wages as their sole Dmpensation, will do the work, and the structure isnot intended or offered or sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving tie/she did not build or im- rrove efor the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and ProieSSion5 Code: The Contractor's License L-aw does not apply to an owner of property who builds or improves thereon, and _who contracts for Such projects with a con tractors) license pursuant to'the Contractor's License Law). Iam aware that proof of their Worker's Compensation insurance should be provided to me. ❑ tam exempt under Section B. & P. C. for this reason Date — Owner I hereby certify that I have read this application and state that the above 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 thisiIy to enter up n the a ove-mentioned property for inspection purpo A . _ [r Signature Date TYPE OF CONSTRUCTION El NEW LJ ADD U ALTERATION LJ REPAI R [:]CONVERSION ❑ DEMOLISH �❑ OTHER .� 7� �T' A.P. #. DESCRIPTION OF WORKIUSE OF BLDG. S Main Building: TYPE OF PERMIT El GRADING FOUNDATION ❑STRUCTURAL - T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION SQ. FT. OCCUPANfCY C CONSTRUCTION TYPE VALUATION $ l (i1�� $ Right Left ZONE GRADING CU.YOS. - ACRES Ping. Ref. # Remarks: C-51�'"7 4 Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtub's Clarifiers Dishwasher Drinking Fountains Floor Drains, Floor Sinks Gas Service .Outlets Interceptors Kitchen Sink Lavatories n• P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting 0-100,000 BTU ❑ 100,000 BT Reinspection Fee Drivers' Lice " SS :P CMF 0865-46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor S15 PLUMBING Showers Service Sink Sewer Cap Sevver Connection 3 Solar Collectors Solar Piping Solar Tank Swimming Pool vv/Spa Urinal Water Closet Water Heater -Water Service Issue Fee MECHANICAL Hood or Type I ❑ Can Type I I ❑ Refrigeration System Do-100,00OBTU ❑100,000 BTU System Repair/Alteration Issue Fee 7017 0/24/64- • _ 10.50 "t Zone Accessory Building: Parking Req./Provided Z O N N G R- E- Q M T $ 3 FEES ELECTRICAL Reinspection Fee $15 Issue Fee Automatic Washer - 'Transformer ❑ •15.50 KW Construction Pole Sub. ❑ 50 + KW Cooking Unit Meter ©up to 100 amps Dishwasher Meter Cover 100 amps , SUMMARY OF FEES BUILDING PERMIT $ SMIP PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE PLAN CHECK 25% $ ENERGY P.C. ELECTRICAL $ D GRADING PLAN CHECK 50% S MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ Dryers ❑Gas ❑Electric Sub Panel Fan . Motors E) 0-1 HP Eli % - 8 F.A.U. Inc. Solar ❑9-,15 HP ❑16-15+ Fixtures Microwave- Device Boxes ' Pole Light Outlets Range Switches Sign Garbage Disposal 'Standing Sections Generator OD -5 KW 05-15 KW Trash Compactor Z O N N G R- E- Q M T $ 3 $ 3 Reinspection Fee $15 Issue Fee FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By D. Building Approved By D Application Issued By gyp; , SUMMARY OF FEES BUILDING PERMIT $ SMIP PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE PLAN CHECK 25% $ ENERGY P.C. ELECTRICAL $ D GRADING PLAN CHECK 50% S MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ S 3 Z O N N G R- E- Q M T $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & S. 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 LIFER Grnd. J 57. APPROVAL TO COVER -GUN ITE .7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 APPROVALS Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 47, FINAL STRUCTURE & BUILDING 48, Special Requirements Completed .49. Electric Release to Edison 50: Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date t 1 CITY OF COSTA MESA CONSTRUCTION PERMIT Applicant to till in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT N — TRACT NO. - LOT NO. 6 LUG. QU. r Project Address ~ ZA Applicant's Mailing Address Owner's Name T t D'01 -- - _ Pho a Address -tea ArchlEng. License No. Address Contractor's Name 1`*7 4a 0' PL/U�" 4mr112_—PhonaG L./ Address {mailing) City LIcPnse No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full f ce and effect. License Class C _ f ens -)ate��—�� Signator ORKERS' COMPENSATION DECLARATION nereby affirm that t have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) , Polley No. Company BCertified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($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 'to b e s bject to the Workers' mpen atioVS.gna wof CaEif Date tur NOTICE: If,after makhis declaration, you�shoul beco a subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is.lssued (Section 3097 Civ, C.) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 4o file a signed statement that he/she Is licensed pursuant to the provisions of he Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she Is exempt therefrom and the basis for the allogeel exemption. Any violation of Section 7031,5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). 1, 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 (Section 7044, Business and Professional Code:' The Contractor's 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 emp€o,ees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon,'and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). - ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that I have read this application and state that the above Information Is correct. I agree to comply with all city and county ordinances and -state laws relating to buiDding Const uction, and hereby authorize repre- sentatives of this r u he above-mentioned property for Inspection Dur ate Signature Drivers' Lic nse o4 SS qy CMF 0865-46 rev. 7/83 White-.Building;.Canary - pP scant; Pink - Accounting; Bar Sink Backflow Preventer Bathtubs Clarifiers Dishwasher Drinking Fou Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap . Roof Drains S Reinspection Fee PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outiets Water Closet Water Heater Water Service Pi!v FEES Issue Foe $ 3 MECHANICAL FEES Boiler Hood or Type I ❑ Duct - Under Ground Canopy Type €1 ❑ Duct - Structural Refrigeration System Duct - Ventilating ❑o-100,000 BTU ❑100,000 BTU Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepi/Fact. Bit. €CBO # Heating System & Ducting 11o-1 oo,000 BTU Cl 1 oo,00o i3TL--4 Reinspection Fee Issue Fee $ 3 Planning Notes: 5492 9/12/63 Zane Accessory Building: Park. Fees $ ELECTRICAL Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW ❑5-15 KW Reinspection Fee Transformer ❑ 15.50 KW El 50 + KW Meter ❑up to 100 amps Meter Clover 100 amps Sub Panel Motors 130-1 HP ❑114-8 Inc. Solar ❑9-15 HP El 16-15+ Microwave Pole Light Range Sign Stand ing,Sections Trash Compactor $25 1 Issue Fee PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By— _ Date BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK I MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ PERMIT $ ISSUANCE $ ENERGY P.0 $ GRADING $ MICROFILM $ TOTAL FEE Z O N I N G R E Q U I R E L T FEES $ 3 T I1. - TYPE OF CONSTRUCTION NEW LJ ADO U ALTERATION LJ REPAIR 1,=e;QAVERSION ❑ DEMOLISH ❑ OTHER A.P. 46 DESCRIPTION OF WORT( S Main Building: TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ❑ OTHER A Rear C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY K -r CONSTRUCTION TYPE VALUATION $ S Left •ZONE - GRADING CU, YDS- ,ACRES Ping. Ref. # ' Remarks:S� Parking Req./Provided Use of Building: Bar Sink Backflow Preventer Bathtubs Clarifiers Dishwasher Drinking Fou Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap . Roof Drains S Reinspection Fee PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outiets Water Closet Water Heater Water Service Pi!v FEES Issue Foe $ 3 MECHANICAL FEES Boiler Hood or Type I ❑ Duct - Under Ground Canopy Type €1 ❑ Duct - Structural Refrigeration System Duct - Ventilating ❑o-100,000 BTU ❑100,000 BTU Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepi/Fact. Bit. €CBO # Heating System & Ducting 11o-1 oo,000 BTU Cl 1 oo,00o i3TL--4 Reinspection Fee Issue Fee $ 3 Planning Notes: 5492 9/12/63 Zane Accessory Building: Park. Fees $ ELECTRICAL Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0-5 KW ❑5-15 KW Reinspection Fee Transformer ❑ 15.50 KW El 50 + KW Meter ❑up to 100 amps Meter Clover 100 amps Sub Panel Motors 130-1 HP ❑114-8 Inc. Solar ❑9-15 HP El 16-15+ Microwave Pole Light Range Sign Stand ing,Sections Trash Compactor $25 1 Issue Fee PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By— _ Date BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK I MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ PERMIT $ ISSUANCE $ ENERGY P.0 $ GRADING $ MICROFILM $ TOTAL FEE Z O N I N G R E Q U I R E L T FEES $ 3 T I1. - CONSTRUCTION AND PLANNING - APPROVALSPermit # - 8'(�� Date Inspector PL -- & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole i 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement t 3. Electrical Conduit Utility-Undrgrnd. ' 54• Forms 4. Electrical Conduit-Undrgrnd. 55: Electrical Bonding 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑-Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P-Trap, ❑ 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 APPROVALS Permit # -20• Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating - 71. Product Piping ❑ Gas ❑ Oil r 23. Gas Pipe-Rough & Test r 72. Underground Flush 24, Roof Framing 73. Undergrnd, Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monrocoat 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 Pow@r Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating $i Air Conditioning 35. Final Gas Pipe,Test 36. Hood or Canopy 37. Final Factory lFireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solas Domestic-Final 42. Backflow Preventer r ` 43. Backflow Irrigation 44. Landscape Irrigation System 45, Sound Attenuation 46, Handicap Regulation's 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed r 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY No Date .; Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA II!)ESAPE CONSTRUCTION PERMIT MIT NO. $ $ TRACT NO. LOT NO BLD T Project Address -- 2- Applicant's Mailing Address TYPE OF CONSTRUCTION NEW ADD LTERATION REPAIR ❑' CONVERSION ❑ DEMOLISH ❑ OTHER A.P. Owner's Name Phone Address DESCRIPTION OF WORK S Main Building:. g Accessory Building:- Z O TYPE OF PERMIT GRADING El FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL L�'PL.UMBING D MECHANICAL ❑ OTHER , PROJECT DESCRIPTION SO. FT. OCCUPANCY CON STRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES T Front N Arch/Eng. License No. Address B A Rear I N Right 7Z 3 Contractor's Nam hone_4?,_'� � �r Address (mailing) City License No. K K S Left' R R E Pjng, Ref, Park.Fees $ U U Remarks: Parking Req,/Provided I LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full 1 rce effect. LJcen Cla s t License NO._,T 1� ��/Z Use of Building: R E PLUMBING FEES Planning'Notes: E t Bar Sink Showers (y Date Signature WORK RS' COMPENSATION DEC RATION Backflow Prevunter Service Sink T S I hereby affirm that I have a certificate of consent to Self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Irrigation Sewer Cap` ELECTRICAL FEES 3800, Lab. C.) • , Policy No. Company H Certified copy Is hereby furnished. I Bathtubs ; +?, Sewer Connection Automatic Washer" Transformer ❑ 15-50 KW Certified copy is filed with the city Building Division. Date Applicant Construction Pole Sub. ❑ 50`+ KW Clarifiers Solar Collectors EXEMPTION,FROM WORKERS' COMPENSATION DECLARATION (Thissectlon need not be completed if the permit Is for one hundred ($100) or,- Dishwasher ' Solar Piping - Cooking Unit' Meter ❑up to 100 amps - - Drinking Fountains Solar Tank Dishwasher Meter Dover 100 amps 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 tete,'( Worker ' p soften Laws of Cailfo rf Date � —Signature e NCITIC : If, alter making this declaration, you should be ome subject to the I:pFloor Drains ' t ' Swimming Pool w/Spa Dryers []Gas, DElectric Sub Panel / Floor Sinks Urinal Fan �� Motors E10-1 HP ❑1 56 - 8 Workers' Compensation provisions Of the Labor Code, you must forthwith Comply ,with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet F.A.U. Inc. Solar 09-15 HP 1116-15+ - Interceptors Water Hueter Fixtures Microwave ' 1 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.). Kitchen Sink Water Service Device Boxes Pole Light Lender's Namn Lender's Address OWNER BUILDER DECLARATION R- Lavatories Outlets Range 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, alter, improve, demolish or repair any structure, prior to IIS:iSSuanCe, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the.provisions of the Contractor's License Law (Chapter 9 (commencing with'Section 7000) Of Division 3 Of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation'of Section p -Trap P Switches Sign Roof Drains I Garbage Disposal Standing Sections - Generator ❑0-5 KW ❑5.15 KW Trash Compactor Reins coon Fee pe $25 Issue Fee $ -3 d - 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 (Section 7044, Business and Professional Code: The Contractor's 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 awn empla ees, provided that such improvements are not Intended or offered for Sale. I however, the building or Improvement Is sold within one year of com- Reinspection Fee $25 Issue Fee - $ 3 MECHANICAL -- FEES PUBLIC SERVICES REG.UIREMENTS• Zoning Approved By Date Application Approved y Date Boiler '' Duct - Under Ground Hood Or Type I , ❑ Canopy Type II ❑ , pletlon, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). Application Issued By r DatA Duct -Structural Refrigeration System i, as owner of the property, am exclusively Contracting with licensed con. 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 builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law): ❑ 1 am exempt under Section B. & P. C. for lrt)S reason Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK 4MECHANICAL PLAN CHECK SUMMARY OF FEES S SMTP $ $� PERMIT $ ISSUANCE $ $ ENERGY P.C. $ . $ GRADING $ $ MICROFILM $ $ $ , $Drivers' Exhaust System ElMultiple ElSystem Repair/Alteration FirepI/Fact• BIL ICBO# Date Owner I hereby certify that 1 have read this application and state that the above 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 enter pon the above-mentloned�opertyinspection p ses. SignatureDate,TOTALFEE Lic se or SS Heating System & Ducting F-10-100,000 BTU ❑i00,G00B - f�einspection Fee $25 Issue Fee $ 3 CMF 0865.46 rev" 7/83 wn4re - Building;- Applicant; Pink - Accounting; Goldenrod - Assessor L CONSTRUCTION AND PLANNING APPROVALS Permit # 38 Date Inspector POOL & SPA 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. Footingg 58, Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9.- Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Ffoor 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 . 1 66. Solar System -Fina! Ti 6. 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 APPROVALS Permit # 20. Rough Factory Fireplace 21, Ducts, irh Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas O 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 PREY. 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 01 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • Applicant to fill in all spaces except those wfthip,dwANW border lines and sign all appropriate declarations. '.CITY OF COSTA MESA PE T NO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION PERMIT TYPE OF CONSTRUCTION LJ NEW ADD. LJ ALTERATION DREP AI R CONVERSION ❑ DEMOLISH ❑ OTHER. Motors ❑0-1 HP 131%-8 CVV 1/ Applicant's Mallin dd ass1'7 �1 Project Address ,4 " °2 /z 7--A Inc.Sotar 09-15 HP 16--1 +' noj1A a(SeZON Owner's Na phone DESCRIPTION OF WORK �, 2 Pole Light TYPE OF PERMIT El GRADING LJ FOUNDATION EISTRucTURAL A. P. Address _7L5T,1V1?'kV,4V o2a ArchlEng. License No. - ❑ TENANT X ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ! PLNG. REF.+ ' Address r_ 0, r Contractor's Nam • IQrC�(�i� hone 63V—.1163 -OTHER TO BUILDING PROJECT DESCRIPTION SQ. FT. OCCUPANCY PROPEFIT I E ' Address lrttailing�)f 't GY YOD Drs S CON STRUCT,IDN TYPE VALUATION $ � LEFT SIDE YARD � } ' 1 %^. �, �D C � 1 ' 1 s PKG. SPACE REO. I ' 2DN): GRADING CU. VDS. AC License No. .4%7 7 _ Remarks: Z3Z STREET WIDTH __ LICENSED CONTRACTOR DECLARATION ' I hereby affirm that I am licensed under provisions of Charter 9 (commencing i with settlon 7000) of Division 3 of the Business and Professions Code. and t SPECIAL CONDITIONS: my license is In full f rce and effect a ' I lJcense lass' O. Ice o !- PLUMBING 1. Slgna►ur Bar Sink Sewer Cap aR RS COMPENSATION DEC R ION r + } r hereby affirm that I have,a certificate of consent to-self-Insure.or-a certlfE�ate S ' r� u Automatic Washer Backflow Preyenter - Sewer Connection= : - - -r - - - -e - -� of Workers' Compensatlon Insurance„ or a certified copy thereof (Section Construction Pole 1 3800, Lab. C.) _ ; f �, Sackflow Irrigation Soler Collectors r Policy No. ` Company Certified copy is hereby, fUrnished• ' , } H - - - --- - - Cooking Unit ' , Bathtubs { Soler Piping r Certified copy is filed with the city Building Division. Date'•Applicant_ i + Dishwasher I Clarifiers Solar Tank EXEMPTION ,FROM WORKERS' COMPENSATION DECLARATION'm , Dryers' ❑Gas ' ❑06efric Dishwasher Swimming Pool w/Spa , (This section need not be completed If the permit Is for one hundred ($100) or , Icertify thatin the performance of the ork tar mit Is suetl I mploy any parson in any er a sub) t.to the �ic Worker tion{Laws of Call , ' { an• Drinking Fountains Urinalhaltnt Floor Drains Water Closet + - 3985 ?/ 17/ W3 ZONE _ BUfLDING, - REAR YARD (TO P/L) RIGHT SIDE YARD PROVIDED f PARK FEE $ :i0o6U TE. r • ECTRICAL } :Meter-, _over 100 amps , Sub Panel' Sub Pole , Motors ❑0-1 HP 131%-8 + Inc.Sotar 09-15 HP 16--1 +' --t Microwave t 2 Pole Light Date 5 gnalu. Fixtures_ NOTIC : If, ft r making this declaratlon, u houtd-become subject to the F160,Sinks-•:- • - - - -•Water Heater - -- .-- -- - - .+- .Q : Range _ _ _ Workers' Compensation provisions of the Labor Code,.you must forthwith Device Boxes comply wlth� such provlslons`- or 'this permit shall be deemed revoked. Gas Service. ' •Outlets , - _ water Service I Sign CONSTRUCTION L£NDING-AGENCY Outlets q I hereby affirm that there is a'constructlon lending agency for the performance• Interceptors - /- d Standing Sections of the work for which•- this permit is Issued (Section -30.97' Civ. C.). , fender's Name 1 Kitchen'Sink, 1 Switches l Trash Compactor 2 L.ender's. Address _ _ OWNER�BUILDER DECLARATION' ' r Lavatories ! Garbage Disposal r r 1 hereby affirm that I am-exempt•from the Cont►actor's,Llcense Uw for the „ Generator 130-5 KW 135-15 KIN j following reason (Section 7031.5 Business and Professional Code: Any city or ( P -•Trap county which requires a permit to construct; alter improve, demollsh'or repair Transformer 12115-60 KIN ; _- 1,-4y structure; prior to Its Issuance, also requires 6o applicant for such permit Roof Drains' 's- _ - : ,Jlle a signed statement that he/she is licensed pursuant to the provisions of ❑5U + KW 4;b_:d Contractor's Ucense,Law (Chapter 9 (commenting with Section 7000) of ; ; i , } Reinspection Foe , ;�iivlslon 3 of the ,Business and Professions Code)"or that' ha she is exempt Showers + " I Reinspection Fee $15 therefrom and the basis for the alleged exemption. Any violation of, Section Meter ❑up td 100'emps Issue Fee' $ 3 7031:5 bY- any applicant for a permit -subjects the .applicant to a civil _ anally of not more than five hundred dollars (5500). ! f Service Sink ' i I Issue Fee $ 9 Z r Zoning Approved By Date I'� 1 as owner of the property or my employees with wages as their 5010 7 MECHANICAL # + f { compensation' will do the work, and, the structure Is not Intended or offered , Application Approved By, •Date j for sale �(SecsIon 7044; Business' and 'Professional Code:. The Contractor's - License Law does not apply to.an owner of a property who builds or improves Boiler ' ( Refrigeration Systerit Application Issued By ' Date / T thereon, and who does such work himself/herself or through his or her own r ( 1 r employees, provided that such {mprgvements are not Intended or offored for 100,DOOBTU 0100,ODOBTU (SUMMARY OF FEES ' sale. If, however, the building or Improvement Is sold within ono year of corn- Duct Under Ground I j I platten, the owner will have the burden pf proving he/she did not build or Im- rove for the purpose of sale): ( , ( Duct - Structural 1 I System Repair/Alteration BUILDING PERMIT $ SMIP $ ! I, as owner of the property, am exclusively contracting with licensed ton- pint_- Ventilatin _ tractgrs to construct the project {Section 7044, Business and Professions Coda: g ' _ PLAN CHECK: ' The Contractor's License Law does not apply to an owner of property who $ i PERMIT $ I ! builds or Improves, thereon, and who contracts for such project, with aeon- Exhaust 5y5tem ❑ Multiple ❑' + PLUMBING $, Yractor(s) license pursuant to the Contractor's Ll cense Law), r GRADING $ i ❑ 1 em exempt under Section 8, & P, C. for this reason L Firepl/Fact. Bit, ICBG 5)E IPLAN CHECK, $} I $ I ` ELECTRICAL 1 i Date t f Owner' Heating{System & Ducting } ' + { r , (62 MICROFILM $ I. hereby .certlfy. that i• h ve read -this application and state that -the above r ❑D 100,000 BTU ❑100,0008 - - - PLAN CHECKS Z information rect. 1 a to cLt with I city and county ordinances j l'- I ' TOTAL FEE' $ and "State lata g ifucti and hereby authorize repro- Type I ❑ , MECHANICAL' $ I sentatives y or h bove-man op for j Hood of t ReinspettionlFee; $15 (PLAN CHECK } $1 f LESS i std)' r 1 Canopy' T b e II ❑, 11 + ADVANCED PC , $ inspectlo f�I , f , ) Slgnatur r I , r + 2 Drlv`ers' Ucense or 55 qp. } Registers - , Issue Fee $ 3 ; i FINAL FEE; $ O CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor i ;! CONSTRUCTION AND PL4NNINC -' : r'i_- "- . '- ' •IN &SPA --'x: y APPROVALS Permit #= `Date Inspector ; `APPROVALS Permit'# ' Date Inspector 1. ,Temporary Electrical Service or_Pole V d ` ' � S2. Pool & Equipment Location -- 2..Soi! Pipe,Undrgrnd. ', . V - .. r _ 53: Steel Reinforcement - 3: Electrical Conduit Utilitv-Undrgrnd. - 54. 'Forms 4' Electrical Conduit-Undrgind. _ _ �� 55:'Electrica! Bonding 5. Sieel Reinforcement 56. Rough Plumbing &Pressure Test B. Electrical LIFER Grnd. r :57. APPROVAL TO COVEN-GUNITE ". 7. Footings 58. Electrical CorSduit-Undrarnrl•' B. ,Foundation-' z s ] j r 59. Gas Pipe; ❑ Undrgrnd., Test 9.4ater Pipe-Uridrgrnd. _ - ,4 60. Backwash Lines,•P-Trap, ❑-Undrgrnd. 10. Structural FI&or System �? i - 61. APPROVAL TO DECK 11. ;Property Sewer Line &1H6useConnection-_ - 62. Backwash &Receptor-Fina!•_-. - 12. Sewer Cap ' G C'� 63. Heater &'Vent-Final 13. ,Roof, Drains :64. Plumbing System Final ' 14. lRough Plumbing .. ' 1 - 65. Electricat-Final 15. Rough Electrical= Conduit '- ""-; --_TF-I_ r" " ' ', r' 66. "S616rSysfem-Final- 16. Rough Electric Wiring „ - 9 9 �.7 1- Fencing & Access Approval. - .67. -17..Ro6gh Wiring Sign-_ 'T If I _ 68.' APPROVED FOR PLASTERING 1•8. Rbugh:Efeciricai;'T;Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, RoughHeati.ng'& Air-Conditioning i FIRE DEPT. REQUIREMENT', APPROVALS Permit # 20. "Rough Factory Fireplace , I 21. Ducts, in Structured I li t I ' i ,70: Underground Hydro ,-22. Ducts', Ventilating' I 1 i { 71.1 Product Piping ❑ Gas ❑ 00 23. Gas'Pipe-Rough & Test _ 72.' Underground Flush r 24. 'Roof Framing 73. Undergrrid. Storage Tank ❑ Gash©Oil 25. Roof Sheathings_ 1 - , " 74. Overhead Hydro 26.'T-13ar Ceiling (Structurat), &.Monocoa' O ' 1 1 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe 28. Lathing &Siding :: 1 ' , 77. FIXED SYSTEM FINAL. 29. insulation: 78: FIRE PREV, FINAL -30. Drywall Nailing I Notes: ' 31.. Plaster Brown Coat 32. Electrical'Power Meter-Fina! 33. Final Electric l +; v ; 34. Final Heating &'Air Conditioning 1 - - t _ 35. Final GasPipe=Test 36. Hood or Canopy--,,- anopy-' 37. 37. Final Factory Fireplace= 38. Final Plumbing 39. Water Service-Figal 40. Gas Service-Final f ' 41. Solar Domestic-Final ` r' 42. Backflow Preventer 43. Backflow Irrigation f 1 s 44. Landscape Irrigation System, 45. Sound =Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING'' t 1 l F 48. Special Requirements Completed 1 ' 49. Electric Release to ;Edison' ` i T- 50. Gas Release to Southern California Gas Co 50. I f 51. CERTIFICATEJOF OCCUPANCY No. - - - -s ! Date • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations, ' ,CIT-XOQF COSTA MESA: 7 r - PE IT�VO =JTRACT NO. LOT NO. BJRALA m - CONSTRUCTION PERMIT fV� Applicant's Mailing Address? l' /L1 : rig ' V4 1.—, � ' r TYPE F CONSTRUCTION . NEw ADD ' ALTERATIONProject ' YCONVERSION '❑ DEMOLISHOTrIEROwner's Address Name 'Phone DESCRIPTIO OFwORK _/ �,) G Z f _r1' Addresst •^�r- Arch/Eng, ' - __ License No. i1 I Tj/pE O_F RM1T GRAD1NGµIl•�7lI��FOUNOATIONSTRUCTU. ❑. ❑ ❑ P: TENANT ELECTRICAL l�'PLUMBING MECHANICALLNG. REF, zOAddress Nam hone 5 IL - .'OTHERIO ? PROJECT DESCRIPTION 50. FT, OCCUPANCPE BUILDINGContrectora Y INECONSTRUCTION Address (mailing) TYPE r _' VALUATION $EFT SIDE YARD License No. 9 �(ZONJE f ! GRADING CU. YDS. ACRESKG.SPACE REQ. L'_ICENSED CQNTRRCTOR DECLARATION ` Remarks: .- TREET WIDTH thereby,affirin that 1: am licensed under provisions of Charter,9 (commencing,,with I C sectlon 7000) of Division Tof the Business and Professions Code, and I vPECIAL CONDITIONS: my,licansefis in full fo c and:ef ect.'- CI 3Cv ZrL2 5 "L'_ Licen ss f 7 I Signature I License No. ;� ' PLUMBING 3986 8/1.7/83 3D Ohl . TL ZONING REGULATIONS ZONE - _.BUILDING, 7 REAR YARD (TO P/L] t I RIGHT SIDE YARD { ' = PROVIDED 1 a r 'PARK FEES$ ! i CC s 'm'D( Bar Sink , sewer Cap ! ! I ELECTRICAL f RKE ' COMPENSATION E LARATION " i hereby affirm that I,have,a certificate of, consent to 5elf�nsure.Or,a.certlflcate _ _: Backflow Preventer. —. - --Sewer Connections - + Aut01'natiC Washer �4_ •Me_ter ❑o_ve_r of Workers' Compensation Insurence,l or a certified; copy thereof (Section: Sub Panel - Construction Polefr _ I 3800, Lab. C )"". I ( 1 ' ! t `'' = Backfiow Irrigation Sola_ r_ Collectors 1 e ; 3 1 Poliiiy No. - Company { �t -- • - - Cooking Unit Sub Pole' H certified copy Fs hereby furnished. i I `,i! Bathtubs t $Dior Piping : t { + Certified copy 15 fileC with the city.Bu[Iding Division. , Dishwasher ' Motors C30-1 HP ❑1'fr-B _pate I Applicant I 1 Clarifiers + Solar Tank J EXEMPTION?FROM WORKERS' COMPENSATION DECLARATIONDishwasher _ Swimming Pool wlSpa nDryers ❑Gas- ❑Electric 'Inc.$olar`❑9 15 HP ❑16-15+ r {This section eed•not be completed If the permit Is for. one hundred ($100)r or' ' _ less}. i ' Drjnkin Fountains ! f Urinal ! Fan ( i Microwave I sc.s, tify,that in the performance of the work for.which this permit Is issued 1''... 1, 9 ; I I shall, not employ; any person in any manner so ;as to become subjectto t(te r - r ' ' l I F.A.U. { Pole Li hr Work o satlon+Laws of Califonp{� I F �, Floor Drains, j Water Closet, s� g , pate Signature hl '- •' , - i t i . -NOT CE , a ter making this declaratioyou-should:.be me subject to the.�L - Floor -Sinks r F - —, _rT _Water Heater - , Y••- -'i- • _ _ Fixtures ylr- -�y -'Range.. Workers" ompensatlon prvvlsions.of the Labor, Code„you must forthwith , Comply �wlth; such 'provis10n5`.,or;thls,;perm_ it ishall be deemed' revoked., Gas Service' Outlets l G Water Service . i i Device Boxes Sign' I { ! I CONSTRUCTION'LENDING'+AGENCY 1 ' T •' I hereby affirm that there is a'constructlon lending agency -for the: performance interceptors r - r_ i+,' Outlets Standing Sections ; of t,.e work for, which- this- permit . is ' issued (Section .3097,, Civ: C:), , Lender's Name = ' r ” ' i Kiichen'Sink; ', ,; °' [ ,•' i Switches Trash Compactor 1 ! Lentler's� Address., _ OWNEWBUILDERDECLARATION' lavatories + T C i H 1 Garbage Disposal + ; I here.by!affirin that I am exempt fr8m t6e:6rit`ractor's;Lice. Law for the 1 rl + y + _ ; Generator. ❑0-5 KW El 5-15 KIN F ` following reason (Section' 7031'.5 Business and Professional'Coda: Any city or P -Trap' ) .i. j +• - ' '_ a _ ' + .County whlchi requires a permiCto construct, alter improve; demoiisWor,repair ti i _ _ i , •} I Transformer Ell 5 50 KIN 1, ,y structure, prior to Its'issuance,;also requires the•applicant for such permit, RoofrDrains r • = I , ; .r 1 , w file_ a signed statement that he/she is licensed pursuant to the provisions of _ _ - _ - _ _ _ - I I ❑5U + KW i ' Contractor's:License Law1(Chapter 9 commencing with'Section 7000 of ° : ! C_ 1 I j l } Reinspection Fee $15 ' rision 13 -of the ;Buslness' and, Professions Code)` or' that) he/she'.is ; exempt Showers I i f„ ' ' I Reinspection,'Fee $15; therefrom and the basis for the alleged exeitnptlon, Any violation-of.Section i Meter ❑Lp to 100'amps i Issue Fee' 7031.5 by,'any applicant fora permit subjects :the applicant to a - civil- } i _ enalty of not more than five hundred dollars ($500).1 .� Service Sink y j t Issue Fee �µ $ 3 l r + j Zoning Approved By ! pate I;�as owner of the:property or' -my employees with wageslas their sole compensation willido the work; and,the structure is not intended or offered 1 MECHANICAL i 1 i + I I q Application Approved By ' ata + for sale (Section 7044, Business; and, Professional ,Code:' The, Contractor's ! q , License Law does not apply to?an owner of a property,who buildsor improves Boiler _, i f - Refrigeration System i + { , p thereon, and who does, such work hlrriself/herself or through his or her own ; Appliption Issued By ate employees, provided that such•improvements arelnot Intended or offered for 1 ; ; ❑0-100,OOOBTU ❑100,OOO,BTU $ ale. If however, the building or Improvement is sold within one] ear!of com- ! Duct =Under Ground 1 Y , j SUMMARY OF FEES i I pletlon, the ownerywiil have the burden of proving he/she did not build or Im- ! , t Pr,ove forithe purpose of sale]. ' I f Duct - Structural. System RepairlAiteration BUILDING PERMIT $ SMIP -$ LJ 1, as owner of the property, am exclusively contracting'with licensed con- "tractorsto_construct thelproject (Sectlon 7044, Business and Professions.Code: Duct Ventilating, Y } _ �_ r ;PLAN CHECK $' PERMIT The Contractor's License taw does not apply to an Owner Of property who - �� + s { + ISSUANCE 1 $ ' builds on improved thereon, and who contracts for such projects with a con- I Exhaust, System ❑ Multiple ❑ € PLUMBING tractor{s) license pursuant to the Contractor's License Law),, I i GRADING $ t PLAN CHECK ❑Ilam exempt under Section B. & P. G. for this reason Firepl/Fact. Bit. ICBG # $' =-E ---- Date r Owner' ' i Heating System & Ducting i 1 ELECTRICAL( I $ ! j l $ '' _ PLAN CHECK' $! f MICROFILM 1 $ y I .'I hereby certify that I. have -read thislapplication and state that the above -p- ❑0 100 Ofl0 BTU 0100,OODBT E information Is correct. I agree to comply with an Oty.and county ordinances •' t i I + t l TOTAL,FEEI $- and6state laws relating to building construction, and hereby authorize repre- ;MECHANICAL $I j Hood or Type I ❑ 1 ( ! l ' + ' ' { sentatives of this ;city -to enter upon the above-mentioned prvPerty for Reins actiomFee -$15, LESS 1 Inspection our s, r ) • j Cabo Type I I ❑? + P PLAN CHECK' ! $ + Slgnatura ADVANCED PC $ i j or, l Icense'or'SS Registers } Issue Fee j $ 3' > _ t l I } FINAL FEE , $ CMF 0865-46 rev. 12/82 White - Building, Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - CONSTRUCTION ANIS PLA ING FK & SPA - _ ;,APPROVALS { Permit '# Date Inspector - APPROVALS Permit # Pate ' Inspector . Temporary Electrical Service or Pole ';: = X52. Pool &.Equipment Location ; 2'. Soil Pipe Undrgrnd,_� r 53, Steel Reinforcement , 3. Electrical Conduit Utility Undrgrnd; - „ ° - t 54. Forms 4'. Electrical Conduit-Unclrgrnd. 55: Electrical Bonding' 5. Steel' Reinforcement �•_ _ :; 56. Rough Plumbing & Pressure Test _ y 6- ;EEecfricaLUFER Grnd. 57. APP ROVALTO COVER GUNITE ; 7. Footings , r 56. Electrics! Conduit Undrarnri. . : B. Foundation a L _ ' ` •59. Gas Pipe; D' Uridrgrnd., Test'-_ 9. ,Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap.❑ Undrgrnd.- 10. Structural Floor System ` ;, ' 61. APPROVAL TO DECK 11. Property Sewer Line 8t. House Connection' 6z. Backwash &Receptor Final 12. Sewer Cap f; -63. Heater &-Vent-Final , 13. Roof Drains I - '` 64. Plumbing.System Fina! 14. +Rough Plumbing 65. Electrical -Final' - 15. Rough Electrical -Conduit -t '66, SolarlSysfem-Final n -16.'Rough:Electric.Wiring i r ,, ' , „ :1 67= Fencing &-Access Approval � 17.�RoughrWiriiig'Signt `' r r gg- APPROVED FOR PLASTERING _ 18. Rough Electrical -T Bar Ceiling i + = + { i .69.' POOL/SPA SYSTEMS FINAL " 19. Rough Heating &,Air..Conditioning FIRE DEPT.°REQUIREMENT APPROVALS Permit # ; ?0. Rough.Factory Fireplace i 21. Ducts, in Structure ,1 i 70, Underground Hydro 122. Ducts, Ventilating F I t 71.; Product Piping ❑Gas ❑Oil 23. iGas`Pipe- Rough & Test,: t 72• Underground Flush 24. . Roof Framing 73. Undergrnd. Storage rank ❑ Gas,0 Oil 25. *woof Sheathing � } - = F ' l ; '74, Overhead Hydro i 26.,T-Bar'Ceiling (Structural)i & Monocoat4 ' 75.1 Dry Chemical .27. Prame,and Flashing 76, Dry Standpipe i 26.. Lathing &Siding I , 77. FIXED SYSTEM FINAL. 29. Insulation •. ;: ' 78. FIRE PREY. FINAL - 30. Drywall Nailing I Notes: ' -31. Plaster Brown Coat ; ; 32. Electrical Power Meter -Final 33. Final Electric ' 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or,Canopy:. - n 37. Final Factory Fireplace 38. Final Plumbing s 39. Water,Se'rvice-Final i 40. Gas Service -Final i 41. Solar Domestic -Final ' 1 42. Backflow Preventer 43. Backflow Irrigation + 44. Landscape Irrigation,System ' , 4 J 1 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING I v; 48. Special Requirements Completed ( I 49. Electric Release;to Edison i ,_ _+_ 50. Gas Release to Southern California Gas Co + t 51. CERTIFICATE'OF OCCUPANCYNo- ` Date �O Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. CITY OF COSTA MESA `-CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. BLD . �I/j r g�pS7 Project Address 3757` Applicant's Mailin Add�re'ss �.{/ y�� ' -pL �/ L-�A A Wiih Owner's Name Add I— f/ ` S �T__Phone 5�?6d TYPE OF CONSTRUCTION LJ XPi❑ CONVERSION ❑ DEM OTLIS�H+ DESCRIPTION OF WORK _.!r -.T NEw-,LJ ADD ALTERATION REPAIR ❑ OTHE c �— - „�_- alt ' A.P. �y S Main Building: cry Building: Z Address Arch/Eng. ^ _ _ ._._...License NO. Address T Front �r+ Qf 4 _ N TYPE OF PERMIT GRADING El TENANT ❑ ELECTRICAL ❑ 'OTHER PROJECT DESCRIPTION SQ. FT. CONSTRUCTION TYPE FOUNDATIOON� STRUCTURAL ❑ PLUMBING ICS MECHANICAL / OCCUPANCY VALUATION $ B A Reer 1 N Contractor's Nam ;2A It 4--7�R Phone `ra �jC�lf JIG /V�/"/�] Address (mailing)_ r C Right G S Left R E, Ping. Ref, Park,Fees $ U City License No, LICENSED CONTRACTOR DECLARATION - thereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fu If ce antl effect. License Class � t ns �Z Date i �'"�`��_ Signature WORKERS' COMPENSATION DECLARATIO I hereby,afflrm that I have a certificate of sent to self4risure or a certificate of Workers' Compensation •Insura or -a certified Copy thereof (Section ZONE GRADING - CU.YDS. ACRES Remarks: Parking Req./Provided ( Use of Building: R E PLUMBING � FEES Planning Notes: M E Bar Sink , Showers N Backflow Preventer ,, Service Sink T S 3800, Lab. C.) Backflow Irrigbtio`n Sewer Cap ELECTRICAL FEES Policy No. CompaPy co ereby furnished. ertifl py is fi]ed with the city Building Olvision. Applicant �. .—. —_ Bathtubs Sewer Connectiontce,tifled Automatic Washer Construction Pole Sub. Transformer Q 15.50 KW ❑ 50+KIN Clarifiers Solar Collectors EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for One hundred ($100) or Dishwasher _ Solar Piping p• g Cooking Unit - Meter-❑up•to 100 amps less). I certifythat in the performance of tate worK far w this per It Is Issued I shall not employ any person In any manner so a bec ub t to the Worker C p tion Laws of Cal3fprn' Date _Signature NOTICE: If, after making this declaratl you sh0 Id become ject to Workers' Compensation provisions of the' labor Code, you ust forthwith comply with such provisions, or this permit shall be- tl erred revoked. CONSTRUCTION LENDING ' AGENCY ' Drinking Fountains Solar Tank 3 ,Dishwasher Meter ❑over 100 amps Floor Drains •' Swimming Pool w/Spa '' s Dryers ❑Gas ❑Electric Sub Panel Floor Sinks /,� Urinal Fan Motors ❑0 1 HP ❑1)S,- B Gas Service .Outlets Water Closet + F.A:U. Inc. Soler•09-15 HP 1116-15+ Interceptors Water. Heater - Fixtures Microwave 1 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.) Kitchen Sink Water Service Device Boxes Pole Light Lender's Name Lender's Address OWNER BUILDER DECLARATION - ! hereby affirm that 1 am exempt from the Contractor's License Law for the toliowing' reason (Section 7031.5 Business and Protesslonal Cade: 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 asignod statement that he/she Is licensed pursuant to the provisions of Lavatories - Outlets Range , IP—Trap Switches, Sign - Roof Drains ,' _ Garbage Disposal Standing Sections the Con t raCtor'S LICense Law (Chapter 9 (corrtmencirtg with Section 7000) Of Division 3 of the Business and Professlons Code) -or that he/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 enalty of not more than five hundred dollars ($500). 1 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' (Section 7044, Business and Professional Coca: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who, does such work himself/perself or through his or her own employees, provided that such Improvements are not Intended or offered for sale. If, however, the buildingor Improvement Is sold within one year of com- P ptetionI the Owner se of a le the burden of proving he/she did not build Or im- 1 rove for the purpose of solo), I, as owner of the property, am exclusively contracting with licensed con- ; tractors to Construct the project (Section 7044, Business and Processions Code: The Contractor's License Law does not apply to an owner -of property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor,5 License Law). El am exempt under Section B. & P. C. for this reason ' - Generator ❑0-5 KW ❑5-15 KW Trash Compactor Reir is c pe tion Fee t $25 Issue Feel S 3 Reinspection Fee S25 issue Fee $ 3 MECHANICAL t FEES Boiler Hood or Type I ❑ Canopy py Type II' ❑ Duct - Under Ground PUBLIC SERVICES REQUIREMENTS: Zoning Approved By ate Application Approved By Date t !� Application Issued By / _ Data duct -Structural Refrigeration System Duct -Ventilating ❑0.100,000 BTU ❑100,000 BTU r'} 2 BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ ' $ ENERGY P.C. ' $ $ GRADING $ $ MICROFILM $ $ 19,00 %. Q $ �• a (J TOTALFEE_ $ Exhaust System ❑ Multiple ❑. System Repair/Alteration Firep!/Fact. BIt. ICED # S {p Q Date Owner _ I hereby certify that I have read this application and state that the above information Is correct. I agree to comply with all city and county ordinances and state laws relating•to building construction, and hereby authorize isrepro- Sentatives of th, cit a upon the above-mentioned property for Inspection Signature 6 Data Drlvers' License or SS p Heating System & Ducting �p (� LN5 �P Q �, ❑0-100,000 BTU ❑100,0008 - 4 Reinspection Fee $25 Issue Fee $ 3 'CMF 0865.46 rev. 7/83 White -'Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor _ CONSTRUCTION AND PLANNING APPROVALS Permit # �-�`�� Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 51. 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 LIFER Grnd. 57. APPROVAL TO COVE R-GLIN ITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 124. 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 4 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 APPROVALS Permit # 20. Rough Factory f=ireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts; Ventilating 71, Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 Cbat 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:.Fin'ai-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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date CMF 0865-46 rev. 12%82 White -Building; Canary -Applicant; Plnk - AccounUng; Goldenrod -Assessor T Applicant to fill in all spaces except those.Wlthin hr lines and sign all appropriate declarations. - CITY OF+COSTA MESA. -CONSTRUCTION PERMIT, PEFI IT NO. .,TRACT LOT NO. i BL - ' CP - , Applicant's Mailing Address ' - I'1 hrPE OF CONSTRUCTION - NEW ADD- ALTERATION REPAIR 324' ' 9/f2t:%'3S 2C5s21 . T . T f Aclar = 31 1 �ill^lVcl]I A've. k-�, lOsta l'�e$a ❑ CONVERSION ❑ DEMOLISH ❑ OTJ'iER' Project Gui l shouse Consultants LA640-2606 DESCRIPTION OF WORK Lenant 111�roye)llen 6,,; Owner's Name dna' 'ZONINGREGULATIONS' `T Address - ' Costa 151eSa TYPE OF PERMIT GRADING'- FOUNDATION 'STRUCTURAL ' A. P. �' ZONE G�— `b Arch/Eng:_ 1-Oiil Cafi1005 (t A55oc. License No, ® TENANT ❑.ELECTRICAL ❑ PLUMBING ❑ MECHANICAL �PLNG. AEF. � BUILDING \` _ Address, ' 177_7Si F i ia'I )1' Jt j_a lryi ne • ❑.OTHER TO BUILDING o Contractor's Name J - oonaiA - 01 Son Co. : Phone . -_540-26 6 - PROJECT DESCRIPTION' SQ. Fm - OCCUPA �Y ' �T PROPERTY Y LIN€ REAR YARD (TO P/L) LEFT SIpE YARD _ _ [� -21 hl • Ai hie Ave- F-1. Costa [Jena Address (mailing} - . rPKG.SPACE �f-� VALUATION $ i CONSTRUCTION TYPE _ _ J s ZONJE GRADING CU. YDS. ACRES i SIDE YARD ` � REQ. PROVIpEp License No. _ LICENSED CONTRACTOR DECLARATION Remarks; a STREET WIDTH ' PARK FEE-$ _ I hereby. affirm that -I am Ilcensed under provisions of Charter 9 (commencing j with section 7000) of Division 3 of the Business and Professions Code, and �+� 7� SF-7,U� S'GSD SQ SPECIAL CONDITIONS: - my Ilcense'is In full force and effect. "I ] �� i7 J License lass (tensa , PLUMBING ' to Signature ; Bar Sink Sewer Cap i ELECTRICAL iRKERS' COMPENSATION DECLARATIO I-hereby.affirm that I have a.certificate of consent to self-insure,or a.certlficate -Connection- .- Automatic Washer_ ._ _ - _ (Meter ❑over- i oo amps '_ _ ' - - 4 .j .. BBCkflow Preventer' Sewer of Workers' Comfiensatfon Insurance„ or a certlfledi copy thereof (Section i Construction Pole Sub Panel 3800, Lab. C") + F-2974 Fainilont Backflow Irrigation Soler Collectors I _ _ Policy No. Company Unit Sub Pole r ❑ Certified copy is hereby furnished. Bathtubs Solar PipingCooking � } Lj( Ce f/'�it�j�y is filed with the city,Bui n9 Dishwasher .Motors ❑0-i HP ❑ 1'/r-8 Datelr7� �.i Applicant Clarifiers SDtar Tank 1 _ EXEMPTION,FROM WORKERS' COMP SATIO ECLARATi Dishwasher Swimming Pool w/Spa OryerS ❑Gas ❑Electric _ Inc.Soler ❑9-15 HP ❑16-15+ 1 (Thissectlon need not be completed if the permit i r one hundre ($100) or Fan 1 less). I certify,that in the performance of the work for which this permit Is Issued I Drinking Fountains, Urinal Microwave 1 shall' not employ any person in any manner so as to become subject to the F.A.U. Pole Light 1 I Workers' Compensation Laws of California. i y Floor Drains Water Closet Date signature •' ' NOTICE: If, after making this declaration, you should become subject to the _ - Floor Sinks •' Water Heater Fixtures • _ Range _ _- Workers' Compensation provislons.of the Labor, Code, you must forthwith this be Device Boxes Sign, ' comply with such .provisions or permit I shall deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Service Outlets I hereby affirm that there Is a construction lending agency for the performance Interceptors - i. Standing Sections of the work for vl - this, permit Is issued (Section 3047 Civ._ C.) Switches Lender's Name • L Kitchen Sink - Trash Compactor 'Lender's Addresst OWNER BUILDER DECLARATION' Lavatories" Garbage Disposal ' r ! hereby'affirm that I am exempt, from the Contractor,'s?License Law for the Generator 110-5 KW 115-15 KW 1 following reason -(Section -7031.5 Business and Professional Code; Any city or P -Trap county which'requires a permit tp construct; alter improve, demolish or repair 2;v structure.' prior to Its Issuance, also requires lhe'applicant-for such Roof•Drains Transformer El 15-50 KW permit *z ile a signed statement that he/she is licensed pursuant to the provisions of r , 135U + KW •Rein alien Fee { $15 - Contractor's Law (Chapter 9 (commencing with Section 7000) of �rlsion'3 of the Business and' Professions' Code) or. that he/she Is exempt Showers - Reinspection Fee $15 + therefroril and the" basis for the alleged exemption. Any violation -of Section _ Meter ❑up to 100 amps ISSUe Fee $ 3 j ;7031.5 by- any applicant for a' permit'- subjects the applicant to a' dvil I penally of not more than five. hundred dollars ($500): :. 1 Service Sink Issue Fee $ 3 Zoning Approved By _ Date LJ 1; as'owner oLthe ,property orTmy employees with wages as their sole } MECHANICAL L4- / compensation will: do the work, and the .structure is not Intended or offered for sale'(5echon 7044. Business and, Professional Code: The Contractor's Application Approved By ate ; . License Law does not apply to an owner of a property who builds or Improves Boiler Refrigeration System - + Application Issued By ' ' Bate thereon, and who does; such work himself/herself or through his or her own ' employees, provided that such improvements are.not intended or oif*red for 15 i ❑0.100, 008TU ❑100.000BTU ^ 1 + Duct - Under, Ground. , 1 sale. If, however, the building or Improvement sold within one year of com- pletion, the owner�wfl! have the burden of proving he/she tlId not build or im- rove for, the of sale): SUMMARY OF FEES �� H1 / Duct - Structural - System Repair/Alteration purpose '• I as owner of the property, am excluslvoly contracting'with.licensed con- ' tractorsto-construct the project (Section 7044, Business and Professlons.Coda: does BUELDING PERMIT $ PLAN CHECK $ SMIP _ _aLa PERMIT $ . _ , Duct -Ventilating - The Contractor's Ll cense Law not apply to do owner of property who builds or Improves thereon, and who contracts for such with acon- t ❑ Multiple ❑ i PLUMBING $ ISSUANCE i $ r_ — projects tractor($) license pursuant to the Contractor's License Law).. ❑ exempt ExheusfSystem PLAN CHECK $; GRADING k $ ' I am under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBG i# I _ _ $ Date Owner: HeatingSystem 8r Ducting + ELECTRICAL $ (PLAN MICROFILM $ I- herebyy-certify that -I have -read this application -arid state that the above ; ❑0100;OOOBTU ❑100,000 BT CHECK $I 1 TOTAL FEE $ Information is correct. I agree to comply with all city. and county ordinances i andrstate laws rel ng to building construction, and hereby authorize reps' , Hood of Type 1 ©, i MECHANICAL $ i - sentatives of 51hl it to enter' the above-mentioned pro pert for Y� Y i Caho 1 T II ❑: 1 Reinspection Fee. $15 PLAN CHECKi $ + LESS t Inspection purpo e z + ADVANCED PC 1 $ Slgnature Date i , ' ' Registers 1 Issue Fee $ 3 i i I ` _ Drivers' License or`SS + r FINAL F EE 1' r $ CMF 0865-46 rev. 12%82 White -Building; Canary -Applicant; Plnk - AccounUng; Goldenrod -Assessor CONSTRUCTION AND: PEJE NNING! z ~ Cr -1 0R + ' C. ,, _, PI '&.SPA "., "ti : T' - '}~ -APPROVALS r Permit=#," " -3 } ,`Date I nspector + G• ,. ', ,, APPROVALS; , Permit',# Date I nspector ! � Terngor=aryrElectrical Service dCcl ble 3 X52'.- Pool &=Eguiprrient Ldcatian G - - 2! (Soil Pipe Undrgrnd ' r c ! r - °_ ' ° r `- 53 Steel Reinforcement 3: Electrical Uti lite-Undrgrnd:; _u r. - i54. Forms , "6 Conduit 4 Elect#ical Conduit-Undrgrnd. 3 °' 55 Electrical,Bonclingo' 5: Steel:jReFnforcement:+: x t56. ough:PI6bing'& Press iri`,+est ,F - 6 'Electrics! IJFER�Grnd: Q rh y }� r 57. gPi'ROVAL`TO-COVER GUNITE 7. Footings i ++I i ' i ?' ° i'1 -- T58. Electrical'Corid-ui't Undrornri. _'� - r 1 I i r c, ,E, 8. FLn:iIatiori ' r ; } •, n �� 59. VGaslPipe, CI_Undr'grnd", Test _ F 9. Pipe-Undrgrnd.60. Backwasf 'Lines,tP,Trap, ❑ Urndrgmd.' T. (Water, 10. Structural Floor System ., $, 61. APPROVA�L.TO_DECK 11. Property Sewer Line &House Connection: r i t " 62. Backwash &?Reci3pior-Final. " ! t t s 12, Sewer Cap •j " r ;' r" 63. Heater, &'-Vent-Final t .� _ 13. Roof'Drains I ! p ; ; 64. Plurlmbing Systern Final=` i 1 14, Rough Plumbing ! L� + n I - - 65. Electrical Final _- r '-15.SRou h Electrical:Conduit a -- {I 9 �" "" } Mr } ` - - 66 ~Solar System-Final •, 4-7 "+. ; .• I WW1 it i i I r :16. �Rough,.Elec[ric•Wirng�l67 € Fencing & Access Approval «' 17. Rough`-Wi`ringSig`nF!68• APPROVED >?OR'PL,4STI=RING +tR1ugh7Electrical T;Bar, Ceiling ��;# f t (.- i ° 69.1 POOL/SPA SYSTEMS-FINAL r9 19. Rough Hes#ing &IAir;Conditioning 1 DEPT.; REQUIREMENT-' ,FIRE APPROVALS j Permit 20. -Rough Factory Fireplace + I { 1 _ 21. IDucts,:in Sfructure 1i70. Uridergrountl Hydro k + f a 22..,Ducts, Veniila#ing r �• �;i �E i j { {71•' Product Piping ❑Gas El oil j &Test �; 1j��Ii � 72.Uriderground Flush Aas:Pipe-Rough ` Framing- ! j I + l illi 1+ , I j . v c' ` 1 1;Noof 73., Undergrnd. Storage Tank`,❑ Gas` _❑ Oi! 4 t I oof She2tliing Overhead Hydro + --26. T Bar Ceiling {Structuralj, & Mori'ocoat' j A: I ' �' { ; ' ,75.! Dry Chemical , i Frame and •Flashing. _ 'j� j E + ;76. Dry Standpipe - 1: 4,27. - I 1 } I 28. 'ILathing & Siding' U f j i , s 177.1 FIXED SYSTEM-FINAL zrz + 29. •,Insulation - ', `', Iq l i t•�{i fj j ' j I X78? FIRE PREV. FINAL =i 30. Drywalil Nailing y ; ' i Ik i + r (Notes: j 1 ,I I 1 i t CS G '•�31 "I ster j rown Coat I II { �f T I 1 r 1 , 1 I { i ' 32.,.ElectricallPower Meter, Fina I it t I. I 33.• ;Final Electric_ E 34. Final Heating &Air Conditioning , 35. Final Gas!Pipe=Testi F i I. ' ; f o i`' I' j' ; I �; �i 36. Hood or Canopy_ , I , 1 I 1 ; � 37, Final Factory Fireplace; x ' �'' - i j': ' i I t •`+ ,. '' "M 38. Final Plumbing y, Ir 39. Water Service Final r it 40. Gas Servi6ii -'Final 1 41. Solar Domestic-Final 1 r ( i T �j • 42. Backflow; Preventer` '';' I # ;irr� . , LL(13:, �� 43. Backflow Irrigation' it s" r,•, - :u•c - 44. Landscape,lrrigation;System -nl +i-,`n f ' o ,- I •= t c t r ilk..., a •T L' 1 r t 1 1 -i `.I _ r 45. Sound`'Attenuaiion } I� I '+ '-^, F I a l .- } �, , ;• i w l ; 1 .y r i s _ i - 46. Handicap Regulations' i 3 I I i: ! ° I _ i i " r R' '•. FI NG i s 47,' FINAL STRUCTURE & BUI LONG S I �- 1 ; I 1 t i I I` _,��! ��' 1 48. Special Requirements Completed. i y , z,' 1 C ' { 1 1 I I F i I , i 49. Electric Fieleasejto Edison4 I �� .j__-.-L-; -J-- Y.-;-- ;--- �.L_-_I- I- '-.-4 ~'' 50. Gas Release to Southern California Gas Co r 51, CERTIFICATE OF OCCUPANCY i + I__4 ' No. dt�'a Date r-- - r _ _ Applicant to fill in all spaces except those within heavy border lines and sign ail appropriate declarations. S'CITY COSTA MESA IF PERMIT NO TRACT NO LOT NO. BLDG NO + P60 PERMIT cr Address ' Pe _17 R M7 F4 pfplicant's Mailing Address --�� /C lOwner's Name _0 Phone 201.2 4C Address Arch/Eng. License No. Address Contractor's Nam e✓��6«U "A_ _ Ale Phone Address(mailing► LAP".,'"A 6A14kT'!, City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licenseq under provisions of Charter 9 (commencing \Vl`\ with'section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. fl License Class - L e a Signature � L WORKERS' COMPENSATIQN DECLARATION ' I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. !GL) � Policy No. /-•� ! , — Company Certified copy is hereby furnlshetl. ergJJf, copy is filed with the city Build n w Date �y'"�-y - Applicant EXEMPTION FROM WORKERS' COMPENS TION O LARATION (This section need not be completgd if the permit Is•f one hundred ($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.• DateSignature NOTICE: If.lafter making this detrlaration, you Should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith ' comply with such provisions or this permit shall be deemed revoked. 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 (Sectlon 3097 Civ. C.) Lender's Name T. _ Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit tp 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and professions Code) or that he/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 malty of not more than five hundred dollars ($500). I,• as owner of the property or my employees with wages as their sole compensation will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Coder The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own ampleyees, provided that such irrlprovements are not intended or offered for sale. If, however, the building or Irrjprovement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build Or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con - tractorStp construct the project 1$ection 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con. tractor(s) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section— B. & P. C. for this reason Date Owner I herebyy certify that 1 have read this application and -state that the above-' Informallon Is correct. I agree to comply with all city and county ordinance$ and stale laws relating to building construction, and hereby authorlZe repro- sentatives of this cit ente0 the above-mentioned property for Inspection pur w� Signatur TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - I A,P.:0 DESCRIPTION OF WORK • S Main Building: TYPE OF PERMIT. GRADING`_❑ FOUNDATION STRUCTURAL _ T Front '❑ TENANT ❑ ELECTRICAL ❑ PLUMBING JF11 MECHANICAL A Rear ❑,OT H E R PROJECT DESCRIPTION SQ. FT. OCCUPANCY G Right K CONSTRUCTION TYPE ,T VALUATIONS S. I Left ZONE GRADING CU. YDS. 1 ACRES Ping: Ref. + Remarks: Parking Req./Provided i Use of Building: , PLUMBINGFEES Planning Notes: Bar Sink IShowers Backflow Preventer Service Sink Backflow Irrigation Sewer Cap Bathtubs ? ` Sewer Connection Clarifiers Solar Collectors 1 Dishwasher Solar Piping Drinking Fountains Solar Tank Floor Drains Swimming Pool vv/Spa Floor Sinks Urinal Gas Service Outlets . Water Closet Interceptors Water Heater Kitchen Sink Water Service Lavatories P -Trap Roof Drains -Motors C] 0-1 HP Eh 'A - 8 I Reinspection Fee ' f $25 I Issue Fee III + MECHANICAL Bailer Duct - Under Ground Duct - Structural Duct . Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0.100,000 BTU ❑ 100,000 BTL Drivers' License or 55 Reinspection Fee $25 CMF 0865-46 rev. 12/83 Wh u ng; Ink - Accounting; Goldenrod -Assessor Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 00-100,000 BTU ❑ 100,000 BTU System Repair/Alteration Roz,rictH. -Ala t� Issue Fee ,8016 4/05/Q4 29.0'TL Zone Accessary Building: Z O - N 1 N R E r Park, Fees $ Q U R E • E N T ELECTRICAL FEES Automatic Washer Construction Pole Sub. 1 Transformer ❑ 15.50 KW 50+ KW Cooking Unit Meter ❑up to 100 amps Dishwasher Meter Clover 100 amps Dryers ❑Gas ❑Electric Sub Panel Fan -Motors C] 0-1 HP Eh 'A - 8 1 F.A.U. Inc. Solar ❑g-15 HP ❑ 16-15+ Fixtures Microwave Device Boxes Pale Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator,130-5 KW 05-15 KW Trash Compactor $ 3 ' Reinspection Fee $25 Issue Fee $ 3. FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By Date pate at S gam' 6 BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ S ENERGY P.C. $ $ GRADING $ $ MICROFILM $ $ d`�_7S v TOTAL FEE $ $ i ) 19- 17 $ 3 r CRUCTION AND PL'A NING ':C QVALS - Permit ' � date Inspector POOL & SPA 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 e 7. 'Footings ' 58. Electrical Conduit-Undrgrnd. a 8. Foundation 59. Gas Pipe, ❑ Undrgrnd:, Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, l] 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 1 . 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 L FIRE DEPT. REQUIREMENT APPROVALS Permit # + 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil , 23. Gas Pipe-Rough & Test ' 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dey Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding , 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. 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 f f(Z,3jJc.{ G4W 35. Final Gas Pipe-Test I 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing f 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 I " 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed' 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co 51. CERTIFICATE-OF OCCUPANCY No. Date' - - ' _ 16' Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CPTY OF COSTA MESA _ CO1STFZUCTION PERMIT. 6853' 3/21/84 .. 30. PERMIT NO..TRACT NO. LOT NO. B LOG. No' Project Address - gq .• Applicant's Mailing Address : ��` 1�.2 �� 5^.LitJ]� �'d--�-�P s Owner's Name �• -/_� _Phone �2�D� Address TYPE OF CONSTRUCTION,NEW ADD ALTERATION LJ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK r• � REPAIR A_P_;0 Zone r S. _ Main8uilding: Accessory Building: - TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL' i ❑•TENANT, ELECTRICAL ❑'PLUMBING' ❑-MECHANICAL • ❑ •OTHER f _ PROJECT DESCRIPTION. SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ 'T' Front - -- - = OZ N Aich/Eng, License No. Address B• A• Rear N l Contractor's Namel�� LLjet_a I� P` -- -Phone � l Address (mai Iing) -►�'%f.� �r1s' A-d�+ C �� /t z"r' C Right S S Left r •. R R E Ping. Ref, # Park, Fees $ Q U ��' City License No, LICENSEb CONTRACTOR DECLARATION ZONE GRADINGCU.YDS: _ ACRES - - Remarks: .-^ Parking Req,/Provided / ! hereby affirm that I alicensed under provisions of Charter 9 (commencing with. section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. License Class Li nse No. Date +� �/� Signature WORKERS' COMPENSATION O LARATION _ Use of Building: R E PLUMBING _ FEES Planning Nates: M E Bar Sink Showers N BaCktIOW Preventer - Service Sink - - - S Lhereby affirm that I have a certificate of consent .to self -Insure or a certificate of Workers' Compensation Insurance,. or a certified copy thereof (Section Backflow Irrigation Sewer Cap ELECTRICAL ' FEES 3800, Lab. C1. r Policy No. A d, Company /"/ 1: iA�,. d! /1_ copy is hereby furnished. Eg,:rtified Bathtubs Sewer Connection Automatic Washer Transformer 15-50 KW E)I�.�.Il�rtifled copy IS filed with the city Building D Is" pate �� ?1 4� Applicants++ Construction Pole Sub, ❑ 50+ KW - Clarifiers Solar Collectors EXEMPTION FROM WORKERS' C PECIM NSATION DECLARATION --. (This section need not be completed if the permit Is for one hundred ($100) or Dishwasher Solar Piping Cooking Unit Meter up to 100 amps a Drinking Fountains Solar Tank Dishwasher Meter Clover 100 amps less). ' . I certify that In the performance of the work for which this permit i$ Issued I Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑E$ectric Sub Panel6 shall not employ any person in any manner so as to become subject to tke Workers' Compensation Laws of California. Date Signature NOTICE: If,iafter making this declaration, you should become subject to the-- Workers' Compensation provisions of the Labor Code, you must. forthwith Floor Sinks - - Urinal - FanMotors 00-1 HP 1 '/a - ` g U '` Gas Service Outlets Water Closet F.A,U. Inc. Solar'09-15 HP ❑ 16-15+ comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Interceptors Water HeaterFixtures -23 Microwave a 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.) Kitchen Sink Water Service Device Boxes Pole Light Lender's Name Lender's Address OWNER BUILDER DECLARATION i tes Lavaor L Outlets Range G Q I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of p -Trap p Switches Sign Roof.Drains Garbage Disposal Standing Sections Generator ❑0 5 KW ❑5-15 KW Trash Com actor P the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division •3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section Reinspection Fee , $25 Issue Fee $ 3 7031.5 by any applicant for a permit subjects the applicant to a civil rlenalty of not more than five hundred dollars ($500). I, as owner of the 'property or•my employees with wages as their sale compensation will do the work, and the structure Is not intended or offered for sale(Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale, If, however, the building or Improvement is sold within one year of com- pletion, the owner'will have the burden of proving he/she did not build or Im- rove for the purpose of sale). Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued B_ y Date Date Dat Boiler Hood or . Type I ❑ Canopy Type 11 ❑ i Duct - Under Ground Duct - Structural Refrigeration System 1, as owner of the property, am exclusively contracting with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason 00-100,000 BTU 0100,000BTU Duct - Ventilating SUMMARY BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ ,-3�• -- - OF FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. ' $ �0 GRADING $ Exhaust System 13 Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBG # Date Owner. 1 hereby, certify that I have read -this application and state that the above - information is Correct, I agree to comply with all city and county ordinance$ -- Heating System & Ducting ❑0.160,000 BTU El 100,000 BT .. 1 and state laws relating to building construction, and hereby authorize repre- sentatives of this City to enter upon the above-mentioned property for inspection purses Signature poOate� Drivers' ense or SS 9F PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ MICROFILM $ TOTAL FEE $ G_ Reinspection Fea $25 Issue Fee $ 3 CMF'0865-46 rev. 12/83 W plicant; Pink - Accounting; Goldenrod - Assessor " TL: r 5 low *' GENSTRUCTION;AND PLANNING POOL &SPA L'S X56 Permit-# Date' i; Inspector APPROVALS Permit #. Date : Inspector •APPROVALS _? 1 Temporary Electrical Service or Pole ; _ 52. Pool &Equipment Location - 2. Soil Pipe-Undrgrnd.- ~' 53. Steel Reinforcement , r ' 3.Electrical Conduit UtilityUndrgrnd.• 54. Forms ^ 1. ! 4: Electrical Conduit Usldrgrndj. - `� 55. Electrical Bonding 5: Steel Reinforcement .'• •� , 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.' ,' 57. APPROVAL TO COVER-GUNITE, 7. Footings i 4.; i 58. Electrical Conduit-Undrgrnd, t: , 8. Foundation : ' 59. Gas Pipe, ❑_Undrgrnd., Test _ 9. Water. Pipe-Undrgrnd.'•' 60. Backwash Lines, P -Trap, ❑ Undrgrnd:, , f •' 10. Structural Floor Systemi a 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - of 62. Backwash & Receptor -Final - 12. Sewer Cap' r., 63. Heater & Vent -Final 13. Roof.Drains _ ' a n 64. Plumbing System - Final + 14. Rough -Plumbing 65. Electrical -Final 15'. Rough Electrical=Conduit ' ' i. - 66. Solar System -Final +16. Rough Electric Wiring. + �' 67. Fencing &Access Approval: 17. Rough Wiring Sign - i I 68. APPROVED FOR PLASTERING 1 f • 18. Rough Electrical -T Bar Ceiling, .l 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air,Conditioning - FIRE DEPT. REQUIREMENT I = APPROVALS, Permit # 20. Rough,Factory Fireplace + 21. Ducts,, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71, Product Piping ❑Gas ' ❑Oil 23, Gas Pipe -Rough & Test t 72: Underground Flush' 24, Roof Framing _ 73. Undergrnd. Storage Tank ❑Gas ❑Oil f I 25, ,Roof Sheathing T + 74. Overhead Hydro - 26. T Bar Ceiling (Structural) & Monocoat 1 75. Dry Chemical 27. !Frame and Flashing 76. Dry Standpipe + - 28. Lathing & Siding, 77. FIXED SYSTEM FINAL ' _ 29. Insulation 78. FIRE PREY, FINAL 30. 'Drywall Na ling f HEALTH DEPT. REQUIREMENT 31.;Plaster Brown Coat + 79. FINAL INSPECTION ' 32. .Electrical'Power Meter -Final l} 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating &'Air'Conditio_ning i 35. Final Gas Pipe -Test 36. Hood or -Canopy 1 37. Final Factory Fireplace 38. Final Plumbing f 39. Water Service -Final' 40. Gas Service -Final i t 41. Solar Domestic -Final 42. Backfl'ow�Preventer. _ 43. Backflow Irrigation, 44. Landscape Irrigation System 45. Sound Attenuation t. i f ' + 46. Handicap,Regulations i , 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed ' 49. Eiectrie Release'to Edison, I + r 50. Gas Release to Southern California Gas Co i a 51. CERTIFICATE-OF`OCCUPANCY i- - - - Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. ' CITYOF COSTA MESA r PERM T NO. TRACT NO. LOT NO. BILD 0. Automatic Washer.' - CONSTRUCTION PERMIT • '' �� :�j/ G i R E r r Dishwasher •ProjectAddres5a TrvJa Ve. - Costa Mesa TYPE OF CONSTRUCTION NEW ADO ALTERATION REPAIR' Meter ❑over 100 amps i - f�. Applicant's Mailing Address 3151 Airway Ave- E-1, Costa Me a ❑ CONVERSION ❑ DEMOLISH 1:1OTHER A.P. #o 3 C, Fixtures Owner's Name Grail dhouse Consultants_ phone 540-2606 DESCRIPTION OF: WORK S' Main Building: Pole'Light Address Airway Ave. E-1 Costa Mesa 1:1 E Sign Generator E10-5 KW 05-15 K D6 Assoc. ArchlEng. Tom Campos a Assoc. License No. TYPE PERMIT GRADING FOUNDATION STRUCTURAL B TENANT El ❑PLUMBING C3 MECHANICAL T g F.rpnt . ' . • Address 17779-"F" Main St.. Irvine _ _ ❑ OTHER q Rear Contractor's Name DDO Company Phone 540-2606 — PROJECT DESCRIPTION SQ. FT.- _2503 — OCCUPANCY C Right Address imailing),-3151 irwaX Ave. E'1 0 -Costa Mesa. ' rr11 CONSTRUCTION TYPE VALUATION $ 38,U00.00 g I Left City License No. -LIR a 70 7Z ZONE GRADING CU. YDS. ACRES Ping. Ref. + LICENSED CONTRACTOR DECLARATION ` Remarks: Parking Req./Provided I hereby affirm that'l am licensed under provisions of Charter 9 (commencing with sectlon 7000) of Division 3 of the Business and Professions Code, and r Use of Building: \ —gan my ilcense is in full frc d effect. 33969 License a ense - PLUMBING FEES Planning Notes. Date' Iz1bg Signature \WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to selflnsure ora certificate of Work ors" Compensation Insurance,-, or a certified copy thereof (Section , 3800, Lab. C �- Policy No. -'2974 company Fairmont ❑.Certifletl copy is hereby furnished. �..••' �(Certif•t�7e%%ff??��p}' filed with the city Bu n ion, Date__ _.iI1L[_4�_ --Applicant , ` EXEMPTION FROM WORKERS' COMPENSATI E �DCLARA ON TUN section need not be completed if the permit i or one hundred (5100) 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,asto become subject to the' Workers' Compensation Laws of California. Date Signature NOTICE: If,'after making this declaration, you should become subject to the Workers' Compensation provisions of -the Labor Code, you must forthwith -- comply with such provisions or this -permit shall be deemed revoked. CONSTRUCTION LENDING ,AGENCY 1 hereby affirm that there is a construction lending agency for the performance of the work for v((jiyF� this permit '.is -issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION - ! I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason -(Section 7031.5 Business and Professional, Code; Any city or iounty which requires a permit -to construct, alter, improve, demolish or repair ny structure, prior to its Issuance, also requires the applicant for such permit ' co file a signed statement that he/she Is licensed Pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of 'Division 3 of the Business and Professions Code) or that he/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 malty of not more than five hundred dollars ($500). r 1,•as•owner of the' property 'or:my employees with wages as their sole 1 Compensation will do the work, and the structure is not intended or offered 1 for sale' (Section 7044, Business and Professional Coder The' Contractor's 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 employees, provided thatsuch improvements are not intended or offered,for safe, If, however, the bullding or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects with a con- trntor(s) license pursuant to the Contractor's License taw). ❑ I am exempt under section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county -ordinances and -state taws r lating to building construction, and hereby authorize repre- sentatives of s city to on the above-mentioned property for inspection pu ses. Signature ' Date i / 12 /84 Bar Sink Backflow Preventer Backflow irrigation Bathtubs Clarifiers Dishwastier Drinking Fountains Floor Drains' Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection -Fee Outlets '$25 M Boiler _ Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ F.irepl/Fact, Blt. ICBG # Heating System & Ducting ❑0-100,000BTU El 100,000 BT Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet' Water Heater Water Service Issue Fee 4ANICAL Hood or Type I ❑ , Canopy Type 11 ❑ Refrigeration System ❑0-100,000 BTU 0100,000 System Repair/Alteration Drivers' License or 55 1 Reinspection Fee I $25 Issue Fee I _ 1 6514 3/I13/B1� 2B9.37 TL Zone CL Accessory Building: Z / .O N Automatic Washer.' - !1 Construction Pole Sub. G Cooking Unif".' R E r r Dishwasher Q U Dryers ❑Gas ❑Electric Meter ❑over 100 amps i Fan J i F.A'U. Motors ❑0-1 HP El1'h - 8 C, Fixtures Inc. Solar 09-15 HP 1]16-15+= Device Boxes ' J• Outlets Pole'Light 'Switches Range Garbage Disposal Sign Generator E10-5 KW 05-15 K $ 3 s '' t Reinspection Fee FEES ' . • PUBLIC SERVICES RE IREMEN Zgming Approved By n Application Approved By Application Issued.By $-3 6514 3/I13/B1� 2B9.37 TL Zone CL Accessory Building: Z / .O N N S !1 ' G FEES R E Park.Fees $ Q U ' 3. SFO ENERGY P.C. Meter ❑over 100 amps i ' ( Sub Panel , W S MX�RY OF FEES E / PLAN CHECKoZS0/ $PERMIT N S $ ' ELECTRICAL ;;. FEES Transformer 1l 15-50,kW El50+KW Meter ❑up to 100 amps ' ' 3. SFO ENERGY P.C. Meter ❑over 100 amps i ' ( Sub Panel , GRADING Motors ❑0-1 HP El1'h - 8 Inc. Solar 09-15 HP 1]16-15+= MICROFILM Microwave - Pole'Light TOTAL FEE Range $� Sign ' Standing Sections 1 { Trash Compactor $25 J'Issue Fee $-3 Date �— ._�Date.� v ��Q J BUILDING PERMIT S S MX�RY OF FEES / PLAN CHECKoZS0/ $PERMIT SMIP �,O $ PLUMBING $ISSUANCE $ PLAN CHECK $ ' 3. SFO ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ - MECHANICAL $ TOTAL FEE $ $� $ 3 PLAN CHECK $ ' CQNSTRUCTION AND PLAN INC ' APPRQVALS Permit #'&J/?? Date Insector p SQL & SPA APPROVALS Permit # Date Inspector, ,1.' Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Ondrgrnd. L4W 53. Steel Reinforcement ` 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement : 56. Rough Plumbing & Pressur'e Test 6. Electrical UFER Grnd. 57.• APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation �, 59. Gas Pipe, ❑ U_ndrgrnd., Test ` 9. Water Pipe-Undrgrnd. 3 �/y (�Q 60. Backwash Lines, P -Trap, ❑ Undrgrnd. ?0. Structural'Floor System I , - 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 y! z" 65. Electrical -Final 15.. Rough Electrical -Conduit 66: Solar System -Final -' .1.6. Rough Electric Wiring �- 67. Fencing & Access Approval 17. Rough Wiring Sign ;' 68. -APPROVED FOR PLASTERING 18: Rough Electrical -T Bar Cei`ligg 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ' FIRE DEPT, REQUIREMENT APPROVALS Permit # r 20. Rough Factory Fireplace - 21. Ducts, in Structure ' 70. Underground Hydro 22. Ducts; Ventilating 71'. Product Piping [--)Gas ❑ Oil 2F Gas Pipe -Rough & Test , '•. , 72. Underground Flush 24, Roof Framing t 73. Undergrnd. Storage Tank ❑Gas ❑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 76. 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 l Notes: SAMD OIL.73 Qy as 34. Final Heating & Air Condifionintg 1 CAr ,F tU+ti5 ptt;r VAO'De--1rzSldY Lgo 35. Final Gas Pipe -Test 36. Hood or Canopy i 37. Final Factory Fireplace 38. Final Plumbing} 39. Wafer Service=Final 40. Gal Service-F7n6l 41. Sola'r.Domestic-Final 3 42, Backflow Prevente'r � 43. Backflow Irrigation s ' 44. .Landscape Irrigation System � r 45. Sound Attenuatioif • -1 46. Handicap Regula[ions 47. FINIAL STRUCTURE& BUILDING 48. Special Requirements Completed ; 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co F 51. CERTIFICATE OF OCCUPANCY No'.Date �" - - O GUPANGY Np G T 1 F l GATE O F ..."res applicable thereto r GER Mesa ()td e� & U 2 { GOsta °� Gosta DePartme^t [itY "ices V t ° C)e"eiopm I setSaf ety p i"a �Or' _ ,,zp 1 t 311 G i V �2o Ah the PrOv;ns ° a�ildinq g°x t] G°5 O- Ga °rnia a Mesa iif 3'1 yemP�Y W e 50.0 ( c ed d to cD and foun cY be rn u n has en sP $ 2 pec Pa rt meg$ resa,OdBOUrN l v Group G y1C� erSeSidef°tie perm itSyo for a �Pn lsee re" plumbing s 4 Use of gu'rlding A27-291 12 � uest,rpOm F and for 9 . ° DescrtPtion lectri° cal pet mtt �ti s Legal E er t 3partmant in9 Numb � pffic►al '' guild gulldin9 p ¢,R k. l the E refioaed a-cePt by y�1 permit ND b4 / S aha SVA PX NpT B 5 D -f 0'. Yy sr --�,^� Date / y e oemise ' 15 U a�.rc �r fel ° "-r icu°us Puce °n th OoSp 1b01 a 2p4 f SHA► -L BE 1) Sec 301 ke?,I - S dg' Permit f ile °def i pecuPancV Mesa umerke Gerttiiicate °� the City Ot owner: Sd Thry �. pjjic►at White Bu Ing re" llg3 CMF 1015-66 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 0 0 3 U 8 P. O. Boz 1200 Costa Mesa, California The Building located at 3151 Airway Avenue, Chit 02 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. Use of Building Office Legal Description 427-291-15 iSee reverse side for Motes and Bounds) Building Permit No B 51410 Electrical Permit No. E 51420 Plumbing Permit No. P 51414 Mechanical Permit No. M 51424 Number of apartments and/or guest rooms ISSUED TO: Building Official Tony Me Baca California Fedenal Bank 3151 Airway Ave., G-108 by Costa M--sa, CA 92626 Date April 22, 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 {e} U.B.C. CMF 1015.46 rev. 1/83 White - Owner, Canary - Numerical File; Pink - Bldg. Permit File 4 City of Costa Mesa Deveiopment Services Department CERTIFICATE OF -OCCUPANCY No. 000310 Building Safety Division P, O. Box 1200 Costa Mesa, California The Building located at 'J1fl Airtrat. kirpnilm AFT.3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group a_,) Occupancy. Use of Building Tn4-*rJ�r nff;re Legal Description A97�Q1_1 S (See reverse side for Metes and Bounds) Building Permit No u-0:759 - Electrical Permit No. v-07PR Plumbing Permit No. R-4701 Mechanical Permit No. ^; 9929 Number of apartments ^ and/or guest rooms ISSUED TO: Building Official Ti'�arnr•�.�;err, ri.;,.,t_ 1L�771_T� tb yL11 rl�4 p Date This Certificate of Occupancy SHALL BE posted in a con �z p y p conspicuous place on th�premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under See. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File CITY OF COSTA MESA J o F� BUILDIMO DIVISION >t 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 754-4856 www.ci.costa-mesa.ca.us Ir FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00115 PERMIT TYPE B_R00F2 APN: 93894027 JOB ADDRESS: 3959 U AIRWAY AV CM Vicinity: BUILDING U ROOF Squares: 0 STATUS: ISSUED DATE ISSUED: 07/02/2009 ISSUED BY: RMD Suite/Unit: U Valuation: $17,500.00 SCOPE OF WORK: REROOF BUILDING "U". TEAR OFF (E) ROOF MATERIALS, INSTALL i LAYER OF 15 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 70 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: KIMBERLEY E %PROPERTY RESERVE Unit: 10 E SO TEMPLE ST #400 PHONE: City/Slate/Zip: BRUCE CHRISTENSEN APPLICANT: HANSEN, DUKE Address: N6646636 PHONE: City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA, CA 92707 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $293.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $294.25 %STORSTAD, Unit: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE R. INSPECTION TYPE DAFT iN A D / INNS_P&5116N TYPE DATE IINTMALS 1016 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final BtockJRetaining 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 BuildinglOccupancy 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 workers' compensation Insurance carrier and policy number are: _ %� rr..Carrier- z• �j0� 7` L&1 V__-fTh&sec ion needs nalbecorntedAlha�peermf 4 valued al arra hundred collars (5100) or less.) POID,'Number: CNf�! ❑ 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 st to the wo rs' compensation provisions of Section 3700 of the L I r Cod I shall fo th comply with these provision oat ;� _ 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 DOLLARS (5100,000), IN ADDITION 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 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. , —e-__0 Lim ^–' i Class tf �7 ``Contractor's Signature L:l;�te�`•' rr� 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 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 ($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 wfio 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 3057-d6 (3107) Owner ID verified b 0 drivers license. Yes No Y ❑ 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 rive (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 [hereof, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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? ❑ Yes ❑ 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 and riling 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 Le wner[s) Dale ow a �J Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - t CITY OF COSTA MESA PERMIT NO. TRACT NO;- LOT NO.; B DG. O. - ;CONSTRUCT IO PERMIT '' Project AddressAirway/1317g=.,— TYPE CONSTRUCTION _ 6136 5/24/82 27.00 TLI Owner J 01sOn Phone ❑ADD © ALTERATION } Address 5131 -Airway Ave - ❑ REPAIR- ID -CONVERSION ❑DEMOLISH OTHER ZONING REGULATIONS Arch/Eng. License No. _ - DESCRIPTION OF WORK �' - Address - - ZONE PLNG. REF. =h- Contractor Safeway -Heats Phones 1-- YPEOFPERMIT I BUILDING - pg{�tL(OLI �ROPERTY lJ� Address Iiil erial hW Santa Fe S ©GRApING ❑ FOUNDATION [� STRU�CTUR�A SETBACK ST SI YARD L5IppE LINE - LICENSED CONTRACTOR DECLARAT70 I hereby affirm that I am licensed unde vI ns o! C r 9 :'-❑ TENANT ❑ELECTRICAL ❑PLUMBING-L�itviECHANIC YA RD (ca mencing with section- 7000) at �- slO o! t usines nd ❑'OTHER RIGHT t Professions Code, lice is full rce e e t. r REAR YARD{TO P/L) C-nOmy ROJECT DESCRIPTION. License Class PKG. SPACE -REQ. PROVtDED_, r WORKERS'•COMPENSATION LARATION _ _ i FT. .. OCCVPANGV CONSTRUCTION TYPE '- -FEE'- i STREET WIDTH PARK S ' ' ' -^ 1 ,I hereby affirm that I have a certllltate of consent to self-insur_ ora rVAt_UATION s ZONE ZONING APPROVED BY DATE- - •^ r • certificate of Workers' Compensation Insurance, or a -certified copy _ - SPECIAL CONDITIONS: ' Ahereof ( C.). G�3B�' Ha ines._ Ins.. GRADING CU. YDS. ACRES _ . `Policy No. Company — - - - - - ^� - --' - - - - - - -' - �~ - ._ • - ._-�-• ❑ Certified copy Is herebY•furnished. _ „ . - - --•__ _ -r,. I _REMARKS: • �•,• i. _.•h___�: _. _._., _-.- _ ! i e 7 Certified copy ls!filed with the city Building Division, _ -_ " r ' -XEMPTION'FROM"WORKERS'-COMPENSATION'DECCARATION — r —_ _ -y '- _ "h. (This section need not.be_completed,if the permit is for onehundred ($1001 or less). - - - - - n -.,. - . .- ,Jf- _ -+- - .._- - - - - ` - - •} I certify_thatin the performance of the work for which this permit is issued, I shalt not employ any parson in any manner -so as to -become -PLUMBING • - ;PL'AN CHECK--., ELECTRICAL - PLAN CHECK - subject to the Workers' Compensation laws of California._:,' _ = _ _ _ - • ~ Date Signature BATHTUBS SHOWERS -' ; '' ' "UARAUL SO F1 - ) NOTICE: If atter making this declaration, you should become subject TOILETS -I, +URINALS -- ' '` -- GENERATOR- 0.1 KW -1-1'0 KW - - - to the Workers' Compensation provisions of the Labor Cade, ybu must TRANSFORMER - •forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS -• - APPLIANCE10.50 KW 50 + KW - - revoked. 'CONSTRUCTION LENDING AGENCY - - KIT'SINKS _ ' ' DISHWASHERS " MOTORS --- 0-1 HP 1-10'HP - 11 hereby affirm that there i$ a construction lending agency for the per- SERVICE SINKS •.SVMPS' - " �' - , - - (INC. SOLAR) ]050 HP -� 50 +-HP formance of the work for which this permit Is Issued (Section 3097 f �Civ.-Cl'. ;Lender's Name_ FLOOR -SINKS FLOOR DRAINS - +FIXTURES OUTLETS' SWITCHES - ) _ -• !Lender's Address DRINKING FOUNTAINS -- - y- - . GAS•TUBE SIGNS - - OWNER BUILDER DECLARATION INTERCEPTORS —CLARIFIERS +POLE LIGHTS + I hereby affirm that I am exempt from the Contractor's License Law for - SWIMMING POOL P TRAP'- _ POLES METERED SUB - the -following reason -(Section -7031•-5-8usiness and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION 'PANELS MAIN SUB imrove, demolish or repair any structure, prior to Its -issuance, also re- for file that he qu res the api licant such permit to a signed statement Is licensed pursuant to the provisions of the Contractor's -License Law GAS SERVICE OU,tLETS- _ ' SERVICE` AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Is - WATEWHEATERS "' 'BTU OUTPUT Business and Professions Code) Or that he exempt therefrom and the- basis for theaexemption. Any violation of Section 7031.5 by - SEWER CONNECTIONS -' - - '- - - - - -• - -- any -applicant for a permit subjects the applicant to a -civil -penalty �f not more than five hundred dollars ($500). i SOL'AR'TANK COLLECTORS I,'as Owner of the -property, or mY employees with wages as their ale. compensation. will do the work, and the structure is not intended SOLAR'PIPING SYS. ' 't ' 't ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor.'s License Law does not apply to an_owner of a properly who build$ or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY through his•own employees, provided that such improvements are not f MECHANICAL PLAN CHECK T SUMMARY OF FEES .Intended or offered for sale, If, however, the buliding-or Improvement is sold. within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale).❑ .owner -oh the property, exclusively contracting with HEATING SYSTEM 0-100,000 BTU AND-OUCTING- - + - � BUILDING - -- 'PERMIT S . - - SMIP•? $ - -. f kk d licensed contractors to construct the project {Section 7044, Business pr and Professions Code: The Contractor's -License law does not apply to 100,000.+ BTU PLAN CHECK $ +PERMIT, --A ',ISSUANCE an owner of property who build$ or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU - --- - -� . _ -. (PLUMBING 5 Sa1i� " { tracts, from -such -projects with a contractor(s)-licesned.pursuant to Contractor's License Law). SYSTEM- i 100,000,+ BTU PLAN CHEC k $ }'GRADING. S the 'l am exempt tinder Section - B. & P; C. for this ❑uB.,& ELECTRICAL $ + reason - - — BOILERS BTU - 'PLAN CHECK $ • MICROFILM S ` Date ner SYSTEM SYSTEM REPAIR, ALTERATION ' 1 TOTAL FEE S' I herebyCertif at h e read t pplicati and State that the above 'ag EXHAUST SYSTEM MULTIPLE ,MECHANICAL; E QS-{ � - -• - +LESS AD- Informati0 Cor . I to co with all city and county PLAN CHECK S - VANGE PC - S - •'1 ordinanc nd st aws r i struck d hereby authorize represe five t -„ above mentioned prol?ert + rpose$. Q /] - - - -5-13-8 FINAL FEE S�L• 0 Signatu ISSUE FEE - -• Drivers' License or 55 g -Assessor �CMFOS65-4G White -Building; Canary -Applicant; Pink -Accounting; Goldenrod , CONSTRUCTION AND PLANNINGL APPROVALS �'=ti'� P,rmi it# � Date Inspector �� POOL &SPA - , ' .'•� APPROVALS Peirriit t`� +.•,iDate_�� a Inspector 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location 2. ..SoilPipe-Undrgrn 44. Steel Reinforcement J " 3.. Electrical Conduit Utility-Undrgrn 45, Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em once 47. Rough Plumbing &pressure. Test 6. Electrical UFER Grn~ 46. APPROVAL TO CC+VER-dbNIT 7, Footings 49. Electrical Conduit-Undr rn - - 8. Foundation 50. Gas Pipe, ❑ Undr rn,•Test e 9.. Water Pipe-Undrgrn 51. Backwash Lines''P Tra- ❑ nd-r 7n'~• 10. Structural Floor System 52. APPROVAL TO DECK`S 11. Property Sewer Line & Nouse Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection - - 54. Heater &Vent Final c . 13. Rough Plumbing 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric-Wirin2 57. Solar System -Final 116. Rough Heating & Air Conditioning bti. Fencing & Access Approval 17. 18. 19. 20. Ducts in Structure Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing 60. APPROVED FOR PLASTERING POOL/SPA SYSTEMS FINAL 21. 22: Roof Sheathing- Frame and Flashing !VOTES: " 23. Insulation _ 24. Lathing & Siding 25, Drywall -Nailing 26. Plaster Brown Coat - 27. Electrical Power Meter -Final 26. Final Electric - 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape SprinklinQ System 3&'\Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUI4:DING 39, Special Requirements Completed 40. Electric Release to Edison, , - , 41. Gas Release to Southern Califbr`nia Gas Co. 42. CERTIFICATE OF OCCUPANCY %No' ,__ Date Applicant to fill in all I NFITY OF COSTA MESA r PERMIT NO. CONSTRUCTION PERMIT A ces withrn heavy border lines and sign all appropriate declarations. TRACT NO. LOT NO. I BLDG. NO. 5'-70 - c I , a -11 Ai rwav Avenife. Costa Mes ownerwectern Pacific Finanda J Phone Address Arch/Eng.es-Langston'License No. C-010899 Address Contractor The J. Donl ad Olson Co n 540-260 Address 3151-F Airway Avenue, Costa Mesa LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. License Class —_..B License No. 33969 Date Signature _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a Certificate Of Workers' Compensation Insurance, or a certified copy thereof ( tl 0, _ Polley No. –� -1� Company Fiarrr<ont lnsurane rtlfied Copy is hereby furnished. Certified Copy is filed with the city Building Oivision. `(EMPTION FROM WORKERS' COMPENSATIONDECLARATION Is section need not be Completed If the permit is for one hundred rt or Iasi1. I certify that )n 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. Date Signature NOTICE- If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions Or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a Construction lending agency for the per- formance of the work for which this permit is issued (Section'3097 Civ. C.). Lender's Name Western Pacific - Financial Corp. Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a Signed Statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of piviSion 3 of the gusineSS and Professions Code) or that he 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). ❑ 1, as owner of the property, or my employees with wages as their compensation, will do the work, and the structure Is not Intended 'fared for sale. (Section 7044, Business and Professions Code., The iractor's License Law does not apply to an owner of a property wno builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as owner of the property, amexCluSively contracting with licensed contractors t0 construct the project (Section 7044, Business and Professions Code. The Contractor's License Law does not apply to an owner of property who builds Or improves thereon, and who con- tracts from Such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. 6 P. C. for this reason Date Owner t hereby certify that I have read this application and stale that the above information Is correct. I agree to comply with all city and County ordinances and State laws relating to constr tion, and hereby authorize representativeyef–}his ciwd Xo enter =On the 8bove mentioned property W Signature �!L Drivers' License or SS gril TYPE OF CONSTRUCTION 10 NEW ❑ ADO ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK—MMMFR('.TAI TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION & STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHPJ ❑ OTHER PROJECT 5349 DESCRIPTION SQ. FT. 4 C p OCCUPANCY � NSTRUCTION TYPE 5 N • B VALUATIO Z2.587 ZONE GRADING CU. YDS, ACRES REMARKS. n Check #51442 A.P. -P ZONE '-) _ REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PLNG,, gp RIE�F..91A ---Z� -( XROPEk Y LGNE la pr PROVIDED O PARK FEE § PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS GENERATOR 0-1 KW 1-10 KW ' TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW -50 + KW - KIT. SINKS DISHWASHERS [ MOTORS 0-1 HP 1-10 HP SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP '-50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP CUINZ.IIvim POLESkjt- METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DAT MECHANICAL PLAN CHECK SUMMARY OF FEES HEATING SYSTEM 0-100,000 BTU ' PERMIT BUILDING S 632 00 SMIP s_12.43 AND DUCTING 100,000 + BTU PLAN CHECK §_i4J47M PERMIT ISSUANCE S REFRIGERATION 0-100,000 BTU PLUMBING $ SYSTEM -100,000+BTU GRAOING § PLAN CHECK § BDILERS BTU ELECTRICAL § § SYSTEM REPAIR, ALTERATION PLAN CHECK 5 MICROFILM $ C7 � TOTAL FEE EXHAUST SYSTEM MULTIPLE MECHANICAL S $ PLAN PLAN CHECK § LESS AD - § FINAL FEE § 650.43 ISSUE FEE ,1 CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # i ! f Date 1. Temporary Electrical Service or Pole 2. Soil Pipe-Undrgrn 3. Electrical Conduit. Utility-Undrgrn 4. Electrical Conduit-Undrgrn S. Steel ein orce 6. Electrical UFER Grn 7. Footings 8. Foundation 9. Water Pipe-Undrgrn 10. Structural Floor System 11. Property Sewer Line & House Connection 12. Street Sewer Connection 13. Rough Plumbing 14. Rough Electric -Conduit 15. Rough Electric -Wiring 16. Rough Heating & Air Conditioning 17. Ducts in Structure 18, Ducts, Ventilating 19. Gas Pipe.Rough & Test 20. Roof Framing 21. Roof Sheathing -P- 22. .P22. Frame and Flashin 23. insulation 'S 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e S2rinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No _ Date 53. Backwash & Receptor -Final 54. Heater & Vent -Final 55, Plumbiou System - Final ..•56. Electrical -Final 57. Solar System -Final 58. Fencing & Access Approval APPROVED FOR PLASTERING 60. POOL/SPA SYSTEMS FINAL NOTES: X f? P�.S� Inspector POOL & SPA APPROVALS Permit # Date Inspector 43. Pool & Equipment Location 44. Steel Reinforcement 45. Forms 46, Electrical Bonding 47. Rough Plumbing & Pressure Test 48. APPROVAL TO COVER-GUNITE 49. Electrical Conduit-Undr rn 50. Gas Pipe. ❑ Undrgrn, Test 53. Backwash & Receptor -Final 54. Heater & Vent -Final 55, Plumbiou System - Final ..•56. Electrical -Final 57. Solar System -Final 58. Fencing & Access Approval APPROVED FOR PLASTERING 60. POOL/SPA SYSTEMS FINAL NOTES: X f? P�.S� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. q�'TY-GxF COSTA MESA PERMIT 0. /� TRACT NO. » LOT L NO. B Dr�-rvo. SCONSTRUCTION PERMIT Project Address O t/1� L_TYPE OF CONSTRUCTION Own etJ` CA_& ,1( z• Phone�5- El NEW ADD ALTERATION Address r, j4a- r . -- ❑ REPAIR ❑ CONVERSION DEMOLISH { ArcWEng, - License No. ❑ OTHER O DESCRIPTION OF WORK A.P. :P • Address- - - - - - ZONE - \ \ .-Contractor Ph6ne6gI6 .TYPE OF PERMIT ❑ GRADING - ❑ FOUNDATION ❑ STRUCTURAL Addrfss -7 W t:` STREET WIDTH - ❑ TENANT ELECTRICAL.❑PLUMBING 1]MECHANICA LICENSED CONTRACTOR DECLARATION •-- DATE. I hereby affirm that I am licensed under provisions of Charter 9`(com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER — - - -- •• - '"" Professions Code, and my license In f II force ang effect. License Class ense S'2')y�Z�• e- Date._.... Slgnatur PROJECT DESCRIPTION - SQ. FT. - - - - - COLLECTORS ` _ WORKERS' COMPENSATION DECLARATIO OCCUPANCY CONSTRUCTION TYPE - 'ELECTRICAL- PLAfV CHECK I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' -Compensation .Insurance, or a certifiptl copy r - VALUATION ZONE GENERATOR - 0-1 KW TRANSFORMER APPLIANCE 10-50 KW thereof (Section 3 00, La ,)- f � � J� O shz�'i� GRADING CU. YDS. ACRES 1.10 HP: - .» 50;+- HPI Policy No�2yCf�V�lI Company '�'�G'a`�� - ❑-Certified copy Is hereby furnished. _ ertifled copy is filed with the city Building Division. -XEMPTION-FROM WORKERS', COMPENSATION DECLARATION REMARKS:_ S 4 e- _ - -•- - - ->-• r (This section need not be completed if the permit is for one hundred (5100) or less). -+� i•J `-� POLES- ' - METERED 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 PLUMBING - - PLAN -CHECK -- - - ' SUB '•' subject to the Workers' Compensat on Laws of California.-- � � • .' - � Y BATHTUBS-- SHOWERS Drivers' License 0,SS I, Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must -forthwith comply with such provisions or this permit shall be deemed .revoketl., _ _ _ t _ w - _ _. CONSTRUCTION LENDING AGENCY '• TOILETS �. URINALS -- LAVATORIES DOUBLE LAYS- - KIT. SINKS - •-- DISHWASHERS---- ' -Assessor !I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 ICiv. C.): -- -- -- - - »• - -- - - Lender's Name_ SERVICE SINKS ,•, SUMPS-- -- -- - - - - -FLOOR SINKS - FLOOR DRAINS -- DRINKING FOUNTAINS-- -^ - ^-- --- Lender's Address - - 'OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS "" -CLARIFIERS - SWIMMING POOL- PTRAP - - +- the following reason (Section 7031.5 -Business and Professions Code:. Any city or county which requires a permit to construct, alter, improve, demolish or fepair-any structure, prior to Its issuance, also re- quires the apl.Ilcant for such permit to file a signed statement that heti"•- --WATER-SERVICE ALTERATION - - ,-� GAS SERVICE -- OUTLETS r ' ' • f " is, licensed pursuant -to the provisions of -the Contractor's License -Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER -HEATERS -BTU OUTPUT - - Business and Professions Code) or -that he is exempbthorefrom,and.the 6122 5/20/82 ZONING REGULATIONS PLNG. REF. 9;k 33.25 T4 REAR YARD (TO P/L) - - PKG:SPACEREQ. - - - PROVIDED - STREET WIDTH - - PARK FEE-$• - ZONING APPROVED BY •-- DATE. SPECIAL CONDITIONS- ONDITIONS:'ELECTRICAL •^ - - -- -• — - - -- •• - '"" ' " - SOLAR TANK --- COLLECTORS ` 'ELECTRICAL- PLAfV CHECK SQ: FT_ - - - - - GENERATOR - 0-1 KW TRANSFORMER APPLIANCE 10-50 KW 1x10 KW - 50+ KW'- $MOTORS 0-1 HP - }(INC. SOLAR) - 10-50 HP 1.10 HP: - .» 50;+- HPI FIXTURES' -Z40 OUTLETS SWITCHES - GAS TUBE SIGNS _ r 'POLE LIGHTS - 'APPLICATION APPROVED BY POLES- ' - METERED SUB' - PANELS - --MAIN SUB '•' SERVICE- AMP. 62 n Drivers' License 0,SS I, ISSUE FEE basis for the alleged exemption- Any violation of Section.7031.5 by - - _. . • - 'any applicant for a permit subjects -the applicant to a civil penalty- f not more than five hundred dollars ($500). -SEWER CONNECTIONS •^ - - -- -• — - - -- •• - '"" ' " - SOLAR TANK --- COLLECTORS ` 1'1, as owner of the property, or my employees with wages as their Ile compensation, will do the work, and the structure is not Intended oCoffered for -sale --(Section 7044, Business and Professions Code: The ' SOCAR'PIPING SYS: w $ - - - ISSUE FEE 'Contractor's License Law does not apply to an owner of a property thereon, and'who does such work'hlself or Who builds or Improves m through his his own employees, provided that such Improvements are not ' ISSUE'FEE -"- - _ 1� - - 'APPLICATION APPROVED BY - __� _ _ PATE -MECHANICAL PLAN CHECK �' --- - - - - - HEATING SYSTEM 0-100,000 BTU ; AND DUCTING- - - -- - 10'0,000 +BTU - - - REFRIGERATION 0-100 000 BTU SYSTEM. 100,000 + BTU - ^ ^} SYSTEM REPAIR;ALTERATION - EXHAUST SYSTEM MULTIPLE • - .. _ -` - - f -FEES SUMMARY;OF ` - - - BUILDING _•.� _ _ PERMIT $ ^, SMIPl-- -- - _ _ - _ JL _ $ PLAN CHECK $ -' PERMIT, _ ISSUANCE' $ ' + PLUMBINd $ 'GRADING S PLAN CHECK $ - - - 'i ELECTRICAL $ � � e � - r - MECHAPLAN CHECK $ MICROFILM S ; i TOTAL FEES f NICAL• S LESS AO -11b . - - ' PLAN CHECK- S VANCE PC S _ , FINAL FEE $ 3•a - \ t7� O \ Intended or offered for sale. if, however,'the building'or'improvement- is sold within one year of completion, the owner will have the burden of proving -he- did not build or- improve -for the purpose of sale): ,❑ n as owner of the property,-amstructhe p exclusively contracting -with 'licensed contractors to construct the project (Section 7044, Business ,licensed Professions -Code- The Contractor's License. Law -does not apply to an owner of property who builds or improves thereon, and who Con- .tracts from such projects with -a contractor(s) Jlcesned pursuant. to .the Contractor's License Law)- - is- )❑ I'am exempt antler Section - B. & P, C. forth isBOILERS reason Date Owner 'I hereby certify that I have read this application and state that the above informati • correct '1 agr to comply with all- city and -county ordina s an j s rel gt0 construction, and hereby authorize repres is ci to enter upon the above Propert for i Ion poses. , Signature Date Drivers' License 0,SS I, ISSUE FEE —MF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor f Rough Heating & Air Conditioning - -Fencing rIt CONSTRUCTION AND PLANNING �`-� %ji Date Inspector APPROVALS Permit # r34�� POOL & SPA_ lti Date, Inspector APPROVALS _ Permit•# '� -�" - 1.d-^, Ducts in Structure-. - r APPROVED FOR PLASTERING 1. Temporary Electrical Service or Pole ocation_.y- 43. Pool & Equipment Location'_;' 60. - POOL/SPA-SYSTEMS FINAL " 19. Gas Pipe -Rough &Test _ 2. SoilPipe-Undrgrn _ 44. Steel Reinforcement ' Roof• Sheathin NOTES: 3. Electrical Conduit Utility-Undrgrn 45. Forms Insulation - - - 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding 25. Steel em 4rce _ - 47. Rough Plumbing & Pressure'Test • 26. Plaster Brown Coat - - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - r Electrical Power Meter -Final 7. Footings _ _ _ _ 49. Electrical Conduit-Undr rn 29. --8. Foundation - - = 50. . Gas Pipes 0 Undr rn, Test 9. Water Pipe-Undrgrn - 51. Backwash Lines P-Tra ndr '6 - 10. Structural Floor System 52. APPROVAL TO DECK 1.1. Property Sewer Line & House Connection - -- - 53. Backwash & Receptor -Final 12. Street Sewer Connection = -- • . - - - -54. Heater & Vent -Final 13. Rough Plumbing - . __ _55. Plumbing System - Final 14. Rough Electric -Conduit "- ' -' 56. 'Electrical -Final 15. Roush Electric-Wirina Am clsr 1q 57. "Solar System -Final , 16. Rough Heating & Air Conditioning - -Fencing & Access Approval , 17. Ducts in Structure-. - r APPROVED FOR PLASTERING 18. Ducts,'Ventilating ' 60. - POOL/SPA-SYSTEMS FINAL " 19. Gas Pipe -Rough &Test _ 20. •Roof'Framing t - 21. Roof• Sheathin NOTES: t 22. Frame and Flashing , 23. Insulation - - - 24. Lathing & Siding 25. Drywall Nailing - - 26. Plaster Brown Coat - - 27: Electrical Power Meter -Final 28. Final -Electric 29. Final' Heating & Air Conditioning - - 30. Final Gas Pipe -Test 31'. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic=Final " 35. Landscape Sprinkling System - 36. Sound Atterivation i 37. Handicap Regulations 38. - FINAL STRUCTURE &-BUILDING 39. Special Requirements Completed l _ 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' No Date t_ • � � tee,. _ Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. t CITY'OF COSTA MESA I )E IT NP. TRACT NO. LOT NO. BL U . NO. CONSTRUCTION PERMIT � Phone Sdn— AddressWay, CA 92626 i Arch/Eng. License No. Address COntractorLeaver ton -Beck Inc. Phone 979-366 _ Address LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7o 00) of Division' 3 of the Business and Professions Code, and my license is In full force and effect. License Class C36 U e se N 191969 Date 7 - stfr_�. Slgnatur _ WORKERS' COMPENSATION DECLARATION 1 hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 38 Allb. C.). .Policy No. Company Great AIR1?r'1Cdn ertIfled copy Is hereby furnished. Certified copy Is filed with the city Buitding Division. _ E PTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred ($100) or less). I certify that In the performance Of the work for which this permit is Issued, I shall not employ any person in any manner so a$ to become subject to the Workers Compensation Laws of California. pate Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 Cly. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason {Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, impprove, demolish or repair any structure, prior to Its Issuance, also re- qu]res the applicant for such.permlt to file a slgned.statement that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9. (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he 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). ❑ 1, 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. It, however, the building or improvement Is sold within one year of Completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project, (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who Con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby Certify that l have read this application and state that the above information is correct. I agree to comply with all city and county Ord Ina nces ands laws relating to construction, and hereby authorize representatives this• city t er upon the above mentioned propert,"r ton Pur � ,,), A) — 1. TYPE OF CONSTRUCTION ❑ NEW ❑ ADO ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATI�O1/y ❑ STRUCTURAL ❑TENANT •❑ ELECTRICAL LSd�LUMBING ❑MECHANIC ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING -CU. YDS. ACRES r REMARKS: PLUMBING , PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAVS KIT, SINKS DISHWASHERS SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS.JAW4&',(/ LESS AD - ISSUE FEE $ .VANCE PC $ MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU 100,0 DO + BTU REFRIGERATION SYSTEM 0-100,000 BTU 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE Drivers' License or SS L ISSUE FEE GMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 3577 7/21/82 45.00 TL ZONING REGULATIONS A.P. :P 1-10 KW + KW 1 ZONE PLNTG.. REF..* BUILDING SETBACK T. OUpY II NE - -- — - SpYARD T AHU RiQHT — REAR YARD (TO P/L) PLUMBING PKG.SPACE REQ. PROVIDED STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: PANELS MAIN SUB ELECTRICAL PLAN CHECK GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10.50 KW -50 1-10 KW + KW 1 ;MOTORS (INC. SOLAR) D-1 HP 10.50 HP -50 1-10 HP + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS PLUMBING $ POLE LIGHTS GRADING $ PLAN CHECK POLES METERED SUB PANELS MAIN SUB SERVICE PLAN CHECK AMP ISSUE FEE I APPLICATION APPROVED BY DATE SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK E ERMIT ISSUANCE S PLUMBING $ GRADING $ PLAN CHECK S $ ELECTRICAL S MICROFILM E PLAN CHECK S TOTAL FEE E MECHANICAL E LESS AD - PLAN CHECK $ .VANCE PC $ FINAL FEE $�� ' CONSTRUCTION AND PLANNIN B Date APPROVALS Permit # Inspector i POOL &SPA• , Date Inspector APPROVALS Permit # 1, Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation "50. Gas'Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash-unii-P-Tray, ❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54, Heater & Vent -Final 13. Rough Plumbing (j .• 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric-Wii ring 57. Solar System -Final ' 16. Rough Heating & Air Conditioning 58. - encing & Access Approval 17. Ducts in Structure--W.-APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test + 20. Roof Framing 21. Roof Sheathing NOTES: z 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final - 35. Landsca e Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40, Electric Release to Edison 41. Gas Release to Southern California Gas Co. - 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT Na.RACT NO, LOT NO. BD LG. NO. CONSTRUCTION PERMIT — ��j'� Project Address 3151 Airway, Costa Mesa v• l.JLG.-- V,l,JVll __ 4VV% Address 18003 Skypark, Irvi.ne_, Ca. - 41,V43 Arch/Eng. License No. Address Contractor Ieaverton—Beck, Inc. Ph6ne979-356( Address 16721 Hale, Irvine, Ca. 92719 LICENSED CONTRACTOR DECLARATION n - I hereby affirm that 1 am Ilcensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of tate Business and Professions Code,a my license is In full force and effect. License Class / c Ucense 0. 19 969 Date l�/r`�! - - Signature T __ c WORKERS' COMPENSATION DECLARATION - I hereby affirm that I have a certificate of consent to self-insura or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sectio 3 00A Lab. C.). Policy No.---PL2 -64 - - - Company -Zenith Uati=al ❑ certified copy is hereby -furnished. Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION l This section need not be completed if the permit Is for one hundred y{$100or less)). I cart�fy that )n 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. Oate Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit Is Issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from -the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 o1 the Business and Professions Code) or that he 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). ❑ 1, as owner of the property, or my employees with wages as their .)lo compensation, will do the work, and the structure is not Intended ar offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year o1 Completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to Construct the project {Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) Ilcesnea pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner - I hereby certify that 1 have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and sta laws relating to Construction, and hereby authorize representatives a /this city tinterupo the above mentio property fa i act n Durp6 Signature ` G� Drivers' License or SS :o9L TYPE OF CONSTRUCTION D2<W ❑ ADO ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER OESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL T PLUMBING ❑MECHAf ❑ OTHER PROJECT DESCRIPTION SQ. FT, OCCUPANCY CONSTRUCTION TYPE VALUATION _ ZONE GRADING CU. YDS. ACRES REMARKS: IJ A.P. 41 ZONE 6775 i0/13%8i ZONING REGULATIONS PLNTG.. RtE�FL,p* PROPEIRTY LINE REAR YARD (TO P/L) PKG. SPACE REQ, STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED — PARK FEE $ 6.00 TL PLUMBING, PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWE=RS TOILETS URINALS GENERATOR TRANSFORMER APPLIANCE 0.1 KW 10.50 KW 1-10 KW 50 + KW LAVATORIES OOUBLE LAVS KIT. SINKS DISHWASHERS MOTORS (INC. SOLAR) 0.1 HP 10.50 HP 1-I0 HP 50 + HP SERVICE SINKS 'SUMPS FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS - INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TARP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE - AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS ' ISSUE FEE ISSUE FEE QY,) APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY BUILDING PERMIT $ PLAN CHECK E ��r PLUMBING $_ PLAN CHECK $ ELECTRICAL $ PLAN CHECK g MECHANICAL S PLAN CHECK $ - - OF FEES SMIP $ PERMIT ISSUANCE S GRADING $ $ MICROFILM'S TOTAL FEE S LESS AD- VANCE PC $ [_�/ �ll FINAL FEE HEATING SYSTEM 0.100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0.100,0006TU SYSTEM 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE CMF 0865-46 White-Buliding; Canary -Applicant; Pink -Accounting: Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector Temporary Ele&Qical-Serbi&& Pole 43. Pool & Equipment Location SoilPipe-Undrgrn 44. Steel Reinforcement 3.. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding S. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation. 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection /O -34 -47 53. Backwash & Receptor-Final 12. Street Sewer_ Connection 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring 57, Solar System-Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21, Roof.Sheathing 22. Frame and FlashingNOTES: 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscaiie Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No _ Date 4_ ADVIRESS OF RUILDua: 3151 AIRWAY AV UNIT: MNER'SRAMEIFIOIOWN: SO CAL SUNBELT DEVELOPMEN AmREss: 4501 E LA PALMA #200 ANAHEIM 40 5IM CA 92807 APPL. MAILING ADDRESS: ARCHITECT OR ENGINEER: LIC. NO.: ARCH. OR ENO.'S ADDRESS: UNIT: CON11TOR'SNA1IIEu SOUTHERN CALIF SUNBELT DV (714)777-4411 CONTRACTOWS MAMIN I 4501 EAST LA PALMA ADOREss ANAHEIM 92869 CA L,NO.: 670560 200 uriT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury that I am liereed ands provmone of Chapor 0 (commencing with Section 7000Ld Division a d the Business and Professions Code and my Scat is in full force and aaffect. CITY LIC. NO.: 6977 7 LIC. Cuss: B LIC.N .: 670560 EXP: 05/98 Date: _-7 Contractor• OWNER BUILDER ECLARATION: I hereby affirm under penalty of perjury that I am pt from the Contractors License Law for the following reason (Section 7031.5 Business and Prdasarons Code; Any city or eounyy which requires a permit to construct, alter, improve, demolish, or repair any suuclure, prior to its �—wace. also requires the appliraN for such permit to Se a signed slefenwW thel he or she is licensed pursuant to the previsions of the Comractors License Law (Chapter 8 (commencing with Section 7000) d Division 3 of the 9umness and Professors Code( or this he or she is exempt therefrom and the basis for the alleged exemption. Amy nidation of Section 051.5 by any eppkwd lor a permit subjects the applicant to a civil peraay of not more than two hundred dollars (9.5001 I, as owner of the property or my employees with wages as their sole compensation, wit do the work. and the structure a not insarded or allered for sets (Section 7044. Business and Prolessio m Cade: The Contractors License Law does not apply to an ownerd property who builds or improves thereon. and who does such work himself or herself or thrush his or her own ampbyess. provided that such improvements are not intended or offered for sale. M, however. the building or improvement is said within one year of complsion, the owner -builder will have the burden of proving he or she did not build or improve for the purpose of sats). ❑ I. as owner of the properly. em mdn®rdy contrectng with licensed contractors to conrsrrud Oro project (Section 7044. Business and Professions Code: The C',ontradors license Law does not appy, to an owner of property who builds or improves thereon end who contracts kw atdh prnjeaa wndh a owractor(s) licensed pursuant to the Contractors I Law). ❑ I am examps taller Sedion: B. S P.C.. for this reason: Date: Owner. I do hereby ceniy that I am aware of and understand she requirements d eCatfomia Health end Safety Code Sectors 25.505, 25.'133, and 25531. and that I or arty kdure building occupant wi111 will not (circle one) need to comply wlth said ware codes and the requirements for a permit for corstrucdom or modiff"ion homtheAiva tai y�enegement Dianna. Residssef construction applosiKmam eumpt from these provisions. Date: Appleam! WORKER'S COMPMATION DECLARATION: I hereby affirm under perahy of perjury one of the fallowing daderatcrs: ❑ f here and will mainesih a mulizate of meant to saCminsurg for workers' comperhn m, ea provided for by Sacb m 3700 of the Labor Cods, for the pedamshca of the work for wtkh this permit is Issued. ❑ t have and will eaisain workers' eempersalton Insurance, as required by section 3700 of the Labor Code, for the performance of the work for whin this permit is issued. My workmm' oompensmion insurance comes and policy number ere: Carrier: Pdry Number. re sedi need not be complsad I the parrot m Ar oma AunKbad donna 15100/ or hams) F cor1Cy that in the pedo nance d the work for which thio perm@ is issued. I dell not wnploy any peson in any rneruar so as to became euhject to the workers' compensation low d California, and agree shat it I became subject to the woricars' cern cis inns d Section 3700 d the Labor Code. I wtth compl/ Data: '/ Applicant: Warning. l aero to aachas' workers' eompart"don coverage Is uminrhd, and f trubfec! an aarpfayer nit! penaltlaa and ma civil 0n" tp to ohundred thousand dolka (710(4000), M addition to the crow ail torrlean"donL prvrlded far In Sectfon 3706 of the Labor Code, Intares; and aftomry i fau CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty d perjury that there is a construction WK6 agency for the pedorma d the work for which the permit is issued {Section 30D7, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I certify that 1 have read this application and pate that the above information is to . I agree to comply with a5 city and munty ordnarmm tad etas laws relating to building construction and hereby aulhor" representatives of this city to enter upon the above-mentioned properly for inspection purposes. DONNA SEAL �/PnnN Data: %13h Sig e of OvmarlAgenl/AppY a (5151-48.WP) Whil"ulldlg b Sdety; Groan-ile; Canary-Applicwt; Pink-Flsvontw Cvklenro -ASMes r CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: M 083977 PLAN CHECK NO: N CONSTRUCTION TYPE: V --N PERMIT TYPE: MEC JOB DESCRIPTION : 1534SF OFFICE TI CLAIM VALUE: CALC-VALUE: Mq --coo l PERM NO: M 08337 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B / COMMENTS: "A.B,C." OFFICE TI, RE:#B83975 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93894085 ZNE: REF NO: PLANNING NOTES> �E �E �E �E �E �E * �E �E * �E �E �E �E �E �E * il* * �E �E �E �E ililililililililililililililililililililil44 ill' ill' �[• �E iE ililltl• •1F •1F il* * * �E iE �E iE �E iE ililililililil�E iE �[• il•1F il D E V E L O P M E N T S E R;,V I C E S R E Q U I R E M E N T S ZONING APPROVED BY `� DATE: BUILDING APPROVED BY : ; DATE: APPLICATION ISSUED BY: DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTR'I.0 MECHANIC FIRE SMIP/RES GRADING PERMIT 12.25 25t SMIP/NON—RES PLAN ISSUE FEE 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE TOTALS ---- > 12.25 22,00 0.00 34.25 34.25 .00 REVENUE DIVISION TOTALS--> COLI;ECTED: 34.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 34,.2 5 I N D I V I D U A L' ,.F E E B R E A K D O W N TYPE QTY D E S C R I P T I O.N + UNIT COST TOTAL COST L; MEC 1 REPAIR/ALT COOLINGV UNIT/SYS W/CNTLS 12.25 12.25 END OF FEES 67-38-1997/12:62 PM/134.25 RM1:81-6865939 PERMIT:083977 CONSTRUCTION AND PLANNING POOL F 1 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 y -Electrical Conduit1l��ility-Undrgrnd• 54. Forms c'• 4.'.Electrical ConduittUndrgrnd. 55, Electrical Bonding. 5'.+S'teel Reinforcement. 56. Rough Plumbing & Pressure Test 6 Ecectrical UFER J'rnd. 57. APPROVAL TO COVER-GUNITE u Footings 58. Electrical Conduit-Undrgrnd. 5 Foundation 59. Gas Pipe, ❑ Undrgrnd., Test r;,z.9.-Water Pipe-Undrgrnd. ; 60. Backwash Lines, P•Trap, ❑ Undrgrnd. -10+-Structural Floor•SYstem 61, APPROVAL TO DECK '11. Property Sewer`.L'tne& House Connection 62. Backwash & Receptor -Final 7:12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit -r r 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,Pogg'h F4ctorV F}replacer ? ? L * 11 APPFi01/ACS r P.e•rmit # 4 " •� V 21.'Ducts, in-Strupture `�, "+ 70.-Unde`rgroiirid Hydro ` 22. Ducts, V.Qntil ting 71, Prod ct-Pi'pingrrt3:Gas ID Oil 23."GasrPipe.Rouyh & 7rest ,r ; m ;• +� i -s 72. UndergrdLind Fiulh t 24.=Roof Framing Undergrnd. Storltje Tan ❑ Gas ❑ Oil 25. Roof. Sheathing , 4, 4 - -.v j 7.'4. Overhead Hydro 26.E T Bat Ceiling (Structural) &:lG1on coat Dry Chemical 27.1- range and Flashing; * _ } 76. Dry Standpipe:- .s ;L y 28. Lathing & SidingT { ^• 7• FIXEnYSTE-J�-FINIJ'L- r _ 29. Insulation ,� ' i• j 28. FIRE PREV. RIVAL 30. Drywalt Nailing F. + _ * ; = �H]EALT31 DEPT. REQUIREMENT 31. Piaster fliowp, Coati .r,Y ►:..; 79. FIN A L iN�PECTaON 32, 'Electrical. Power rrleter:Fi�nak' * : ' r 801. FOOD CERTIFIt4TE 1S�UED• 33.. Final. Electric, i hl i Motes531 j : 34, -•Final Heating- & AiriConditionfng- 357Final Gas Pipe -Test { 36. Hood or Canopy jr n In 37. ;final Factory Firepiace- c l. ' X 38. Final Plumbing # - 39. Wafer Service -Finale 40. Gas Service-Finalr;r • i Dom: + 41. Solar Domestic -Find 42.' Backflow Preventer. 7 •1 •1, 43. Backflow Irrigation , � w •44. LandscapeI"_igationSystem -e _: c X wr r - - `45., -Sound A[terivation' -' c - •" ¢ ; �- F- r• t- , •� • -46. Handicap.Fiegulations 47:tFINAL STRUCTURE & BUILDING a 48.'FINAL PLANNING t" r _ Y -49.'-Electric Release to Edison r` 50. -Gas Release to Southern California Gas Co 51., CERTIFICATE OF•OCCUPANCY _ No. _ Date I yi 71 •ONS3OFBttIL0110. 3151 AIRWI AV pM1ERsNw€sFom*. SO CAL SUNP�LT DEVELOPMEN ', tSbDaEss 4501 E LA r 4A #2001. ANAHEIM CA 92807 540-5566 ARCITFUCI OR 09911M. LIG NQ: ARCH. OR f;7Cr S ADDRESS: UNT: CONTAACTOR'S64M- SOUTHERN CALIF SUNBELT DV (714)777-4411 colIMACDOR'SVAIUM 4501 EAST LA PALMA ,,Em ANAHEIM9289 0 CA ,„D.; 6705600 SAiT: LICENSED COWAACTOASo�Do>MURATION: 1 hereby a l'rm under penalty of p�eajW 7hed f am licensed under provisions d ChWw D { b y ! / lit D c cLdAss: $ � arc Nom, o" ! (�3Y � 10 toXP � / 9 8 Cr" LIC_ NO.: Data: Cordredor: OWNER 8 D£R ECLARATION: 1 hereby rdPorn wider pasty d perjury this I ren mcetwo kiss Contractors Licertse Law kollowwQ reason (Sedum 7031,$ Susses and Professions Code: Any eiy or noway whish requiraa a Permit to cortwo-KI. cher, improve, demolish. a repair any stmrtsme, pia to its osuanae. also requires the appkw4 for sudor permit to file a siprm stator"A ihad he or aha is fit wwW pirsuans to IM proKsiaas of the Contraclon License Lew (Chapter 9 (oommsr) irq with Sediau 7000) of Division 3 of the Business and Prdowiana Cade) of them he or she is exempt theoetsom and the basis la mro alleged m is"ien. Any violation d Section 7031.$ by any applicant for a permit subjects the epplirant to a dvB penehy of not more than five hundred doom jSSWD. ❑ r, as owner of the pmperrya my employees with wages as their sole oompernmion, will do the work, and rise structure is not bearded a offated fee gals ISce n 7044, Business and Ptolsaaions Code: Tt*Commado s Ucw%x&La* does mel appy to an owner of properly who beide or itrprv.ws thereon, and who does such work himself or herself or ih mo his or her own emDlave ss, p vMsd that such improrem ms. are sat irasnded errdkrud tot sale. R, however. the building or inprovsm&nr is sold within one year of canipWicn, the owner-buWar will have the burden of poring he or she did no build or improve For the purpose of sale). p 1. as owner or if* pmpmw. am exclu& fy conlra"N with liveried aamhaelore 10ennatruct the pwojeq (Sedion 704A, Bmabress and Pfdessmns Godo: The Gw%md s License Law dose mat eppfy to an owxr d property who builds or inprwes thereon end who centrism For sudor p. leds with a oontractorls) leensed punmaru to the Contradors License Law). Q f am exempt under Section: S. A P.C., for this mason: Date: Owner. I do hereby cadily muel i am aware of and understand Ora maquiremaras of Cafifomis Health and Safely Cada Ssaktm 23605, 255.93, and 25531, and the f or any suture brim m0 aonmem wyl/ will not (circle ate) need to oompty with said state codes and the m*jrwwa fon apermitfor owstructionrexmoditaiiontom the Ar ty.�awgemasDistrict.Reaidwiialaonsfnx0onappirabiorommtarmnghamthese provisions. Dais: Applltbnt: WORKER'S COMPENSATION OECLARATK)N: I hereby ad16m under Penally of pwv " oma of m» kAow6q dedsrakm: ❑ I have and wtlf maintain a caaikcare of consent to 8004rdurq for waken' compensation, as provided for by Bodian 37M of the Labor Cade. tar the performmae of the work for *lith that Parma at musd. Q 1 haus end ori{ meiNaim wakes' oempensaflon mswarm. as required by " ire 3700 d more labor Code, lot it* pedwmwmm of the work for whkh this Permit is issued. fry worker' owperaaiion meurance terrier AM policy rwmber are: Carrier. Poky Number: is &Palom need not bs cvmpierad 7 Ow permit a /err ins hrsrrbad doilm is 00) or her.} Q 1 cerilfy rhal in the performance of the work for which this permit is issued. I efine6 not employ sty person In any manner so as ttr become subject to the worimrs' omvensesion lava d Coldorvs, and euro& miss it 1 ahouW to she wo letn' pompe tion p lions of Season 37D0 or the Labor Code, f shaft lot ' ply wph tissue Data: Applirarc Waminp: Fsliuma ro sewn workers' cornpsrsatlon eoyeraps Is u »whit, and ahsif st16/sot ertp(oyn to rkwtw dr)) firms up m aro hnsdwel rheuw.d dormers 1f1041)ooA In adcllbon to mise cost of carr*wmwNo1R dwomprs ser pvov7dsd fpr Sooffort 3706 of tfte Iwhoe cods, lyderaa; and atiortrey'a fess. CONSTRUCTION LENDING AGENCY: I hereby affirm urea penalty of pw*y that there in a coi rrdiam ko*V eganry For rhe porl,mnw" of the work for whkh this permit n issued 16edion 3087, Cw. C), CITY OF COSTA MESA — BUILDING PERMIT ` �►" 1"�� PERM NO: B 08397 PERMIT NO: B 083975 PLAN CHECK NO: 02718-97 L GOVT: N SUP CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : 1534SF OFFICE TI SQ FT: 4,000 CLAIM VALUE: 4,000.00 CALL—VALUE: 4,000.00 GROUP OCC: B / COMMENTS: "A.B.C." FICE TI �F�E,7E�F�F�F�F�E�F�F�F�E�EiEiE9E�EiE� 9F 9F9F��***iEit9F�**iEit9Fit9Fititititititit�*�F**•>�+:+:��•>�•>��r�r�*�•�•�•�•��*�*•�•�•�* 1 O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILD --------�---------------- ACCESSORY BUILDING --------- FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93894085 ZNE: CL REF NO: PLANNING NOTES> INTERIOR ALTERAT NS (ADD WALLS/DOORS, ETC.) IN EX. SUITE > AT.JOHN WAYNE EXE . GUILD. iF i4 iF iF iF iF * i6 iE iF -iF if 9F i6 iF itis �F iF � �f,iF irk 9E �4 dE if• •1F.it •1F iF dF iF � if' * 9F aF iF 9t• iF iF �F �F iF 9t fit• 9! � iF �1! iF iF 9F if• iF iF ,tf• ,tf• it �1! �9! * * iF * � �,� * •]k •]k � it it 9F it'1F D E V E L O ,'P' -M E N, fT S E R I C E S R E Q U I R E M E- N -.T_ S ZONING APPROVED BY, %L DATE: 3 . BUILDING APPROVED BY': !r DATE:/'--- ,. APPLICATION ISSUEDj•BY: DATE: r; rV�p 9F �,7E iF iF iF �E iF �'1F'1F if if if if �)(• iE �)(• �[•'it * iE 9F 9F 1!'1F'1F'1F'1F i["1F'1F'� •1F iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRSIC-•MECHANIC FIRE SMIP/RES GRADING PERMIT 87.25 —r SMIP/NON—RES PLAN 56.71 _ - r 4 .84 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN CHECK_7% '� TOTAL PAID DUE TOTALS------> 88.09 0.00 y56'.71 244.80 144.80 .00 • r REVENUE DIVISION TOTALS--> COLLECTED.: "".88.09 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC (FIRE SMIP/TOT GRADING PLAN --CHECK 87.25 .84 imE � iE iE iE if if if imE iF iE iE if iE i4 iF iF iE •14 � i4 � i4 i4 � i4 ♦E i4'If � i4 if it iF it it i4 it'it iF iF i4 it �)(• it iF iF it i4 i4 i4 i4 i'F iF �)(• � 9F iF iF it i'F � � i4 i4 i4 i4 i4 i4 i4 i4 9F i4 i4 i["1t•'i+F i4'If I N D I V I D U A L;'"F E E B:j R E A K D O W N TYPE QTY D E S C R I P T I ,Om N: -r UNIT COST TOTAL COST SFC 4000 ALTER BY VALUE COMMERCIAL 'j,,NQZONE 1.00 4,000.00 y' END OF FEES LENDER'S RAVE: ` f LENDER'S AOOAESS: I certify that 1 have reed llmis epg9cetion and ears that the above tnfa[ntetion is versa. !apron to uxngy *itis ed coy and otraiy omtlbmtrra® � �� . erred stars Few relating to buildiup cor�rudmam and hereby ruttha4s reprssemefiros o thea city to weer upon the afw+s•rwdbnW property :orineP`ai0npurptees. DONNA SEAL _ A Prim Name ---�- Date: r 0nalure of t/Conrraga �rt (,••`•-' 15151 46.wp) Whits-$uitdiq S SOW Green-Fow, Ca+tary-AppWxnt: Pink-Raremrs: Goldenrod-Awsimm r 07-38-1997/12:@3 D!!lf88.89 RCPT#;B1-0809940 4 PERMIT: @8397_!5 e e �� X7 4' '' • 'CONSTRUCTION AND PLANNING POOL ?A APPROVALS Permit j# Date • Inspector APPROVALS Permit # Date Inspector �. _, Temporary Electrical Service or Pole' 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement .-Electrical Conduit•Utility-Undrgrnd. 54. Forms 4`c£lectrical Conduit=l7hdrgrnd 55. Electrical Bonding -� 5i -Steel Reinforcement- 56. Rough Plumbing & Pressure Test E• -'Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE 7- Footings <58. Electrical Conduit-Undrgrnd. '-=S. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9.=Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10 -.:Structural Floor'S'ystem 61. APPROVAL TO DECK 11. Property Sewer -Line & House Connection 62, Backwash & Receptor -Final w12. Sewer Cap - .63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing t„ 65. Electrical -Final 15. Rough Electrical -Conduit _ 66. Solar System -Final 16, Rough Electri6'Wi6ng�67. Fencing & Access Approval 17. Rough Wiring Sign ` 68. APPROVED FOR PLASTERING 18. Rough Electrica!•T Bar Ceiling 69, POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVACS�r Permit " 20.7,Pou9'h Factory F�.eplace = ? ;- ;' - 21.i Ducts, inoStr}I3:ture4 .. -� 70: -Undergyurid f Eydro ' 22. Duds, Ventilating k' y.rr 71. Product Piping C�Gas Ll Oil 23,.Gas:.Pipe-Rough & Test �� f [r " •T r 72. Undergftiund Flush_ r 24.. Rods Framing = ' 73. Undergrn Storage Tan El Gas i] Oil 25, Roof Sheathing �. ;, , + �' a 7.4, :Overhead Hydro` + 26.--T-Bat Ceiling (Structural) &"Monocoat 7.5. 'Dry "Chemical -Frame an Flashing - • X f- , 76. IDry Standpipe--'-, 4 _ a 28. Lathing & Sidings' �• " �` »+ ' J " ^s fi 77. FIXE07-ST�IVI;F4I�iPiL e 7 k? - w 29. Insulatign8. ' FIRE PREV. FINAL + 30. Drywall.Nailing _ t ;�6 _� 3�EALTH DEPT: REQUIREMENT 31. Plaster Brown Coat" _ r-+,, , 79. FINAL; NSPEC:: ON Y i= - 32. -.Electrical Power Meter. -Final' '} '• rr 80. FOOD CERTIFICATE ISSUED 33. -.Final Electric Y :r" Eltptes: �[`/ �� . Y� S' i --Il`' _ 34. -Fina-1 Heating & Airx Conditionrtsg: •. , `� 9^ f= : i' ` �v %�-- Iii✓ 35 ''Final Gas Pipe -Test, ' f rrt� T'`" ' ..• 36. ood or Canopy ti; _ . _ r •• a 'i., -� T 37. Final Factory Fireplace- -- • 38. Final Plumbing ;� :.. _ �' '• _ tl' -�-� i✓.�/ •[� 39. -Water Service'Final' 'j 40. -,Gas Service -Final :, <c- -� - x 41. Solar Domesfic•Fin21 x- 42. Backflow Preventers •,-� . ji t - r t 43. Backflow Irrigation C44. Landscape lirigation System. = 1, :_z 7. =45. `Sound Atte6uatio reel -46. Handicap, Regulations 47 --FINAL STRUCTURE & BUfLDING 48. FINAL PLANNING ---49, -.Electric Release to Edison -50.-Gas-Release to Southern California Gas Co y ,;51: CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF etfl wit- 3151 AIRWAY AV UNT: U pMlg3TSMNEtoRaOn'N: SO CAL SUNBELT DEVELOPMEN -ZDRESS: 4501 E LA PALMA #200 ANAHEIM,CA 92807 540--5568 Aim. NAIUM ADDRESS: ! ARCNRTCT OR OMEE.A: LIG NO; ARIL OR Da!S ADORE 3: UNIT: COMMACTO"FI RE: SOUTHERN CALIF SUNBELT DV (71 4 ) 777-4411 CONffIA...... LD 4 501 EAST LA PALMA ADUREss ANAHEIM CA LIG NO_ 670560 92869 alar. 200 LICENSED CONTRACTORS DECLARATION: I hereby affirm under psraty of perjury that I am lice ruaed oder provisions of Chapter 9 (oommenuing with Section 7000) of Division 3 of the Business and Professions Code, end my license is in I'd fora and effect. CITY uc. NO, 0 6� 9y 7 77 ur. CLASS: B Lfc 670560 F' x P•� 01-1/98 Data: � ` 1 ' IR ~% Contract OWNER BUILDER DECLARATION: I hereby affirm m under fury thel I am ermepl from the Contractors. License Law for the fodowing reason (Section 70315 Business and Prof eaaoas Code: Any cky or county wfvdh requires a permit to construct. efts, improve, demolish. or repair any etnnctae, prior to is issuance. also required the applicant for ach Permit to (irk a signed statement that he or she is Wo on sed pursuena to the provisions of the Coni ectors License Law (CClapuer S (wrnmenusng with Seriion 7000) d Dirision 3 d the Business and Professions Code) or that he OF she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7071.5 by any applied I for a perms subjects the apptic ret to a civil ponefly of not more then five hundred dollars [MI). ❑ t, as owner of the property or my employees with wages as their sok compersetlm, wind do the Mork, and the structure is not ssendad or offered for sale ISeclion 7044, Business and Pmfedsicm Code: The Contractaoa License Law does not apply to an owner of propo" who buAds ar impueroee thereon. sof who does such week hnnsell a hers" or through his or hat own emptryess, provided thin each improvements are not irdended ur offeed for as o, 0, however, the building or impromment is" within one year of completion, the owner -builder vA1l have the burden of proving he or she did nal build or improve for the purpose d awe). ❑ I, as owner of the property. am exridiw* cdsroding with licensed oontracsors 10 mrd the Project (Section 704.4, Business and Prdsr®ars Code: The Carrrecton License Law does nal apply to an owner of property who builds a inproves thereon sed who conbaes for such projects with a contractor(s) licensed purauant to the Cordraofurs Lionise Law). ❑ 1 am exempt under Section: B. 6 P,C., for this reason: Date: owner. I do he WN certify mat I am aware of and umderetend the regdromerrs of California Health and Safety Code Sections 2W6, 255M, and 25534, and that I or any turure building oacrmem will / wig not (circle ane) need to oanply with said Bele codes and the requhaments fa e permit for eemetrucuon a modifcation from the Airily WanapensM District. Readsrsiel construction eions am exempi from these Pr Date: Appfran is WORKER'S COMPENSATION DECLARATION: I hereby affirm under penally of perjury one of the following declarations: ❑ I have and will maintain a oertili efe of consent to seeinsure for workers' compensation, as provided for by Sedion 3700 of the Labor Code. for the perlwmernce of We work for which this perm@ if issued. ❑ l have and will mmmar, workm 'compensation a swuncs, as required by Section 3700 of the Labor Code. for the pstbnnenos of the work for n Kiel this permit is issued. My woken' compensation insurance ®vier and policy manber are: Carrier: Policy Numbs: 'ifhls section need no be compered r the vwm;r;a Aar one hundred dopers 15ioul or kiss.) 1t 1 tertdy that in the podamance of the Mork for which this permil is issued, 104 not employ any parson in any mercer so as to become subject to the workers' compo nation we d Califon d agree that it sir t workers, compensation praviaiam of section 3700 of ane Laewn Code. I I hwhh campy \ Dale:�tr Warming: Failure to acture workers' u onitio radon 1 nlawfkrf, and shall sublacf an egploywr to dlrnfnaf penaMq 4rnd civil fin" up to am hundred thwuaarf dollars 010,L000), addtlae to the cost of conipengtlor4 derma sit Provided [ler In Section 7706 of the Labor Code, Udend@4 and attorney's fees. CONSTRUCTION LENDING AGENCY; I hereby affirm under penalty at perjury that Ihse is s evreadnvction lending agency lar the performance oil the work for which this permit is issued (Section 3097. Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I ce,* that I have read this application and state then the above information is correct. I agree to campy with m oly and cowry ordi anoss and stats laws rotating to building cosstrwian and hereby wahome repueserdamm of this city to enter upon the ebwo-mentioned Fop" for inspedion purpDseo. B E N N I E WILLIAMS h n Dene: 7 - (8 9 77, 51.4omp) White-8uildi g a Safety, Graeme: Canary-Applicmmr, Pinks-PleYenue: Goldenrod --Assessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: B 083796 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR JOB DESCRIPTION CLAIM VALUE: : DEMOLITION IN PREP FOR FUTURE TI CALC—VALUE: PERM NO: B 08379[ / GOVT: N SUPP: N PURPOSE: OTH SQ FT: 1,901.00 GROUP OCC: B COMMENTS: "A.B.C.n1 FUTURE OFFICE TI, RE:P.C.2718-97L Z O N I N G R E Q U I R E M E N T S S E T B A C K S 1,901 — MAIN BUILDING ---------- --------- ACCESSORY BUILDING -- — FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93894085 ZNE: REF NO: PLANNING NOTES> > iE iE iE iE i6 iE iE �{ -� iE iE -i(- iE iE iF iF iE iF * iE irk iF iF * it ?E -�F iF it- iE it• iE iF iF iE iE iE iF irk iE it- iE iF iE iE iE iF # if iE l if it- iF ii i4 i4 if � * iE � iE if * iF -1(- iEjfr'� � it- i4 if if if iF ie if 3F D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N^'T.S ZONING APPROVED BY DATE: .' BUILDING APPROVED BY : DATE.: r� APPLICATION ISSUED BY: DATE: iE iE iE iF if iF -IF iE -IF iE -FF iE iE iF iE iE iF iF iE fit- iF if * i{ * * * iE if if �F �E 7t iE if LEGALIZATION: N F E E S U M M A R Y STRUCTiJRAJ,n SEGMENT: Y BLDG PMT PLUMBING ELECTRIC. MECHANIC FIRE SMTCPl E*S GRADING PERMIT 62.25 SMIP/NON--RES PLAN ! .50 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE FEAN—CHECK TOTAL PAID DUE TOTALS ---- > 62.75 0.00 0.00 62.75 62.75 : .00 REVENUE DIVISION TOTALS--> COLLECTED: 62.75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 62.25 'ell .50 r. iE iF iE if if iE if iF iE iF iF if iF iF if iE iF iF iF iF if iF irk it iE iE i4 iE it- iE iE sk iF iF iF iF iF iE � iF iF iF iF if iE it- iE iE i4 }!iE iF iE iF iF iE iE iE ii` iE iE iE iE -FF iF iE �(- iE iE it- #Fit• it- � iF iE iE I N D I V I D U A 1,; F E E B R E A K D O W N TYPE QTY D E S C R I P T I d N UNIT COST TOTAL COST 12 SFC 1901 DEMOLISH BY VALUE COMMERCIAL NOZONE 1.00 1,901.00 OF FEES SEND 17-10-1997/12:20 PHA62.75 RCPT1:11-0019316 PERMIT:083796 CONSTRUCTION AND PLANNING APVROVALS Permit # Date Inspector POOL ,PA APPROVALS Permit # Date t 1 ' Inspector .'Ll. 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. y 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57• APPROVAL TO COVER=GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, O Undrgrnd., Test,, 9, Water Pipe-Undrgrnd. _ 60. Backwash Lines,.P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK r 11. Property Sewer Line & !-louse 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 - i 66. Solar System Fina! - 16. Rough Electric Wiring 67. Fencing & Access Approval 17, Rough Wiring Sign _ 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Cei3ing 69. POOL/SPA SYSTEMS FINAL y 19. Rough Heating & Air Condifioning FIRE DEPT. REQUIREMENT APPROVALS Permit 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas O Oil 23, Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd, Storage Tank 0 Gas O Oil 25, Roof Sheathing 74, Overhead Hydro 26. T-8ar 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 33. Final Electric 34. Final Heating & Air Conditioning 80. FOOD CE/RTIFICATE ISSUED Notes: f f! 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 Irriqation System 45, Sound Attenuation 14 4q, Handicap Regulations 471, FINAL STRUCTURE & BUILDING l" 48. FINAL PLANNING 49. Electric Release to Edison a 50. Gas Release to Southern California Gas Co 511. CERTIFICATE OF OCCUPANCY No. Date ow y • ADDRESS OF, BUILDIM 3151 AIRWAY AV UNIT: OWNWO NAME IF DUNN: SO CAL SUNBELT DEVELOPMEN ADDRESS: 4501 E LA PALMA #200 ANAHEIM CA 92807 540-5569 f APPL . YAJUI 6 A11ORE55: 'ARCHITECT OR ENGINEER: LIC. NO..- ARCH. O.:ARCH. OR EH4'S ADDRESS: UNIT: OWMACTOWSNANE SOUTHERN CALIF SUNBELT DV (714)777-4411 COMACTOWSUMUNO 4501 EAST LA PALMA Aamm, ANAHEIM 92869 CA Lr -No.: 670560 200 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 0 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my linens is in fun force and effed, Crr UC, NO,: 0 6 9 7 7 7 Llc. CLASS: B LIC. No.: 670560- E P: 05/98 Date: -7 cantracta: OWNER BUI DEH ECLARATION: I hereby affirm under penally of perjury that I stn p from the Contractors Lhoeme the fdlowi g reaecn (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to oonaeud, ewer, rn demolish, or repair any structure, prior to its issuance, abo requires the applicant for such permit to fib a signed statement 9w he a she is licensed pursuant to the prw®iom of the Conlrecdors License Law [Chapter 9 (commencing with Section 7000) of Divislon 3 at the.,'. Business and Prolesaiors Code] or that he or she is exempt theralrom and the basis for the alleged exempt on. Any violation of Section 7031.5 by any applicant for a perms srmisds the applicant to a civil perlahy of not mora than firs, hundrod dollars rS500D. ❑ I, as owner at the property or my emplayaes with wages as their sole oompeneation, win do the work, and the stns tura is not intended or offered for sale (Section 7044, Business arid Professions Coda: The Contractors License Law does nol apply to an owner at property who buids or improves thereon, and who does such work himself or herself or through his or her ours amplayam, provided that such impraarnertx era nu intended or offered for sale. lf, however. the, building or :nprovernert in sold within ons yaw at completion, the . owner -builder win have the boder of proving he or she did moil build or improve for the purpose of eeie). ❑ I, as owner dthe property, am exdusively contracting with loaned contractors m mnw ud the projed (Section 7D41, B shove and Professions Gods: The Contractors License Law does not apply to an anxr of property who buitls or improves thereon end who 1 contracts for such pojeaa wt h a comrador(s) licensed pusuant to the Contractors License Lae), r.N J ❑ f am arompt under $edan: B. 8 P.G.. for this reason: • / o h t! • i Date: owner: I -ry •" f I do hereby Camay that I am aware of and understand the requirements of Caliomte Fkam end Safety Code Section 25505, 23533.' end 2553x, and ghat I or any Furse building occupant win 1 wit not (mile one) need an comply with said state codas and Ihs requirements for e permit formstnrction or modiFwionfrom the Ar"MT"I�anegem e t Distria. Resdertd mvlmdarh appliMianaa a exempt from Me** provision. Date: Appk— •+ WORKER'S COMPENSAT10N DECLARATION: I hereby at6ttth under penalty of perjury one of the lo9owing declarations: ❑ I here and *AS maintain a cwWcOo of comms to selfaruma for wsxkasa' bion, as provided for by Section 3700of the Labor Cads, lar the parfonwmca of the work for which this permit is issued. ❑ I have and wil maintain workefa' comparsatm insurance, as regr,Qed by Section 3700 at the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insuranos varier and poky number are: Carver Policy Number, „ median need not be oom„lawd Y the cermi is kr ores hundred ddtars 1SID01 or Ammi l } I certify that in the pedonnemce of the work lar which this permit is issued, I aha11 nor employ any person in any Mannar ee as to become subject to the workers' compensation laws of California, and agree that lf I shouW becion vnbjed to the workers' company ion p of Section 3700 at the Labor Code, I with comply, Dew Dat . 147 Apd�: Wemfng: FRNrrne to secure rsortsn' cortfirrsatlon a Is unlaw'hd, and shagan srmic.) r to cr tmlra! elpruMes rq Yves Lipundre to one hundred thousand dollars f11040001 in addit/on to ft =at ron**ns&Wr% dampp as poise Rbr in Secdon J?X of the Labor Code, Interest surd sffomWa tssa CONSTRUCTION LENDING AGENCY: L hereby affirm under penalty at perjury that there is e corstrurxion lending agency for the performance of the worn for whim thio permit is issued (Seam, 3097, Cir. C). LENDER'S NAME: LENDER'S ADDRESS: 1 certify that I have reed this application and state that the above information is coned. I agree to comply with all dry and musty ordintathom and state lawn Relating to butl.g comtrucion and hereby auLh roe repres infa6vaa at this city to enter upon the above-mentioned prnpatfy "ns' wnv-- DONNA /S EAL Date: __�z & ! (5151 Ae.WP) White -Building d Safely: Breen -Fite; Canary-Applcam: Pink-iavenue; Goldenrod-Assesaa CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 08397 PERMIT NO: E 083976 PLAN CHECK NO: GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION : 1534SF OFFICE TI CLAIM VALUE: CALC—VALUE: SQ FT: GROUP OCC: B / COMMENTS: "A.B.C." OFFICE TI, RE:#B83975 **************************�!�!******�!**�!�!****�!*1f�llfdfr�lIl•*�FII•Il•1f1f1f*Il•Il•Il•Il•Il•****1f�1�11f�l�lIl•�l�llflf Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING -------------- ------------ ACCESSORY BUILDING ---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ(�• PROV: PARCEL: 93894085 ZNE: REF NO: PLANNING NOTES> > k, D E V E L O P M E N T S E -R V I C E S R E Q U I R E M E N T S r ZONING APPROVED BY i DATE: BUILDING APPROVED BY %•' DATE: APPLICATION ISSUED BY; LEGALIZATION:N F PERMIT \\ BLDG PMT PLUMR�i G PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE TOTALS ---- > 20.00 22.00 -+ DATE: 3C Er'EE� S U M M A R Y STRUCTURAL SEGMENT: N ELECTRIC MECHANIC FIRE SMIP/RES GRADING 20.00 501 SMIP/NON—RES 22.00 PLAN—CHECK TOTAL PAID DUE 0.00 42.00 42.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 42.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 42.00 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 15 RECEPT/OUTLET ELE 5 RECEPT/SWITCH P 1 ST 20 EA. 1.00 1 ST 20 EA. 1.00 END OF FEES 15.00 5.00 07-30-1997/12:01 PMA42.00 RCPT0:01-0009938 PERMIT:083976 CONSTRUCTION AND PLANNING ..___ POOL ,, SPA f 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•LIft+lily Uri[lrgrnd, 54. Forms '• 4:`Electricai Condt it-,Undrgrnd. 55. Electrical Bonding J 51 Steel Reinforceuterli4 56. Rough Plumbing & Pressure Test -6'-.-Electrical LIFER Grnd, 57. APPROVAL TO COVER•GUNITE Footings ;rte 58. Electrical Conduit-Undr'grnd. �$; Foundation i, r r./ 59. Gas Pipe, © Undrgrnd., Test Q. Water Pipe•Undqrnd.{ 60. Backwash Lines, P•Trap, ❑ Undrgrnd. -10.5tructural FloorS9stem 61. APPROVAL TO DECK 11. Property Sewer -Line & House -Connection 62. Backwash & Receptor -Final :12. Sewer Cap ,G 63. Heater & Vent -Final '13. Roof Drains 64. Plumbing System 'Final 14. Rough Plumbing, 65. Electrical -Final 15. Rough Electrical-Cb�duit 66. a -lar System -Final 16. Rough Electric Wiring Fencing & Access Approval 17, hough Wiring Sign J 69• PPROVED FOR PLASTERING POOL/SPA SYSTEMS FINAL 18. Rough Efectrica-17 Bar Ceiling? �[ 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT _ - �r1 .n i � F � _ i --•I APPAOVAV Permit -T• 20. TRough Factds F1?e late < "? T 21..Dut`is, in Structure # .. .� fir, '+.t. 70, -Undercfdt�rad Hydro r 22. Ducts, VentifaTin9�; 71. Prod6'2 Piping' as p Oil 23. ;Gas_PiperRou9h 8i t,,est tS t -., ;� i- 72. Undetgrt and Flush F y y. 24. Roof: Framing �� 1 ; �' = _ !. 71 Underg rtd.SWZa Tana ❑Gas 1:16f J. 25. Ro ; 5hea'thing Y; v j yr � 7.4. o , Overhead Hydr,D {: 26. -T-Bar Ceiling (Structural) &11 anocoat u' 7,5. Dry Chwical . 27. Frame and Flashing; . • n$ 76. Dry Sta`ridpipei i[� 28. Lathing.& Sidingsr' FIXED.SYST1 FINl1 _ rF < 29. Insulation -r3+ x r 74. FIRE PREV, FINAL is 5 7�z 30. Drywall'Nailing r t: V HEALT1ID EPT71RE•3UIV111WENT 31. Plaster Brown)Goai 73. FINALS VSPECF}ON 32._Electri6I,Powar t ter=Final ^� i' 1 � p"_" FOOD CERTIn.CA'?'E f3,SS ED 33 -Tina) Elejgtric; rte. , rtes: 34. Final' Heatin8& AirtCtirtditioniajgs .•� e-•7 I' 35..Fina1'Gas Pipe•Te .� I � •� ,' � a 3 r 36. �Iogd or Canopy t - .�0 t iT t 37,gina1 Factory FirepVe.v'J: 38. Final:Plumbing + �.�... �' r ' 39. Watei Service-Final4. 40. Gas Service -Final i ,T•,r, 41. Solar Domestic -Find) x ; <? l' 1 ,! 42. Backflow Preventer,. ;t. :rt -.43. Backflow Irrigation t �i ,44. Landscape i4ioation Systeme ; i C Cil - - ;45.�Sound Attenuation` r -46!t Handicap Regulations 4AIFINAL STRUCTURE & BUI•L•DING L 4&j�FINALPLANNING- _.rf. e r _ 49. _Electric Release to Edison - 1 Z - 5U. Gasj,lelease to Southern Cafifornia Gas Co "+ r =• r t7 51. CERTIFICATE OF OCCUPANCY No. Date c1� ` ADCRESSOFBIIILDDfa 3151 AIRWAY AV uHT: U ONINE1isNAMEIFRIOYIN: SO CAL SUNBELT DEVELOPMEN AODRu&. 4501 E LA PALMA #200 ANAHEIM, CA 92807 540-5568 APPL. MMUNG ADDRESS: ARCHITECT OR ENMEEA: LIC. MD.: ARCIL OR ENG.'S ADDRESS: TMT: CDNrRAcTDIrsmAw• SOUTHERN CALIF SUNBELT DV (714)777-4411 CONTRACT nNAILM6 4 501 EAST LA PALMA ADDREss ANAH E I M CA ur mo, 670560 92869 Dhn, 200 LICENSED CONTRACTORS DECLARATION: I hereby a6im oris pamky d psjury dm i an 6oamed under plowW m d Ch000r 9 (commencirq with Section 7000► of Division 3 of One Buauten and Prdasaiom Code, and my koense is In fug loess and effect. Crry LIC. No.: 9 6 9 7 7 7 uc. uAw: B LIC. No.: 6 0560 E :005/98 Data: Col. or. LARATION: I hereby affirm ender pertly of perjury than I em exempt from Contrarian Lioarns Law f or OWNER BUIjOVDIEfol wn9 reason (Sadon 7031.5 Brous anons d professions Code: Arry rare City or [awry which qre uia permit 10 oomtlud, alter, improve. deondeh, or repair any structure. prior iso is itruanoe, also rerpmes the applimra for such pernW to fie a signed stasoera that he or she is lk mrd purwenl to the prw®rs of the Contractors License law [Chapter 9 (oonunemirD with Section 7000) of Division 3 d the Business and Ftdassors Code[ or that he or she is eurempt Lhi raken and the basis lar the allsped exerVion. Any vidsfion of Seton 7031.5 by any app6mrs far a pans soul i the applicant to a cA pantry of not mom than rive hundred dollars [$500p. ❑ I, as owner d the Property or my goo i0yem with wages as Ilei sole compemaion, w0 do the work and this sanrnra ls not handed or oltared for male (Semon 7044, 8rrmwaa and Professions Code: The Corarodm License se law does not apply to an aanerd property ale hada or ithprove thereon, aid who does such oak mreetl or herself or t rouO hia or her own untioyem, provided that such impcwanerAs are not intended or offered for sale. lf, however, the bualdaq or imprveanas is sold within am yaw of con ion, de owner -budder wig hare the bhrdsh d 1>roiriia he or she did no build or improve for the purpose at safe). ') ❑ I, as owns, of the property. am eafhni.dl' aorntradep with fice sed conbadmrs to cormud the peojed (Section 70"' Bu siraas and Professions Code: The Contractors License Law does nal apply to owner op an owr d property who bdffa or ingaovss thereon and who contracts for such projects with a co frador(s) licanasd pursuant to the Car:tteoton I kens Law). t ,- ❑ I am exempt wider Section: B, A P.C., for this reason: Date: Owner. I do hreb'f certify that I sm aware of and 0 K W d The reparanem d COMOR ie Ffeabh and Sawy Code Sections 2SSOS, 25=, and 25534, and the I or any fora bwldi q oaoupara will / will re (mc6 ale) reed to oornpfy win said state m I and the rspmamats for e piton for construction or mpdificalion hon the Air 5MNj1aas smvrd District. Rmkleruml condnrd'on appirmiws ae aaanpl from these provisions. Dae: Apptiart: WORKER'S COMPENSATION DECLARATION: I herby affam oda pastry d psjury one d the kulfohrI dederatio s: ❑ I have and will maintain a certificale d oDnW910881140.101, for +rarken' oornpsnsaricn. as provided for by Section 3700 d the Labor Code, for the neoformans d the wok for wfi-h Ilia parch is issued. ❑ I hew and wig meiutan workers' compenaelon isutance, as squit by Section 3700 of pts Labor Code, kv the perkrmanos at the work for which this pa nit is issued, Lily workers' mnpe scion insurance caner and policy rumba aa; Carrier: Policy Number: This section need chat be compered! the pamk it Por ars hundred dodo i fS100f or b"j t comity that in the pedom once of the work for which this permit a ' un I shell nal employ any person in any manner so anto becone bled to the workers' conhperhsaon laws of CeEfdnva. and that9 1 .h55C jed to IM worker' compe ion ' ons d Section 3700 of IM Labor Cade, I shall lo7�2�' A1h Date: Apptiaw l Warning "L secure rsoeisrs' conywuafore caresses rs unAmM, and afafr sub an arrploysr to erfnif and c1rlf renes Lip b ora hundred thousand dotAlus (SIDQDW0 In addrrbn m rhe coal of tort, dampsa u pro Sactfon 3706 of tie Labor Code, Irderest and strum y's Tars. CONSTRUCTION LENDING AGENCT: I hereby dlim wider Penalty of po*" that Ihae is ■ conantdion lerdsg epeney far the paoformahce of the work for which the permit is issued (Sed ion 3097. C'nv. C), LENDER'S NAME: LENDER'S ADDRESS: I certify that I have reed this application and male Aha the above Wometon is correct. I ago d m to comply with a9 city aid ordimanoes ad state laves retsin9 to hadn9 cwwnKbcn and hereby aulhome representatives d this rIIy to arta upon the above-mentioned property tarinspo"'or""urpo"as' DONNA REAL (5151 -".WP) Dae: 4� ♦< $alar.• GrearFile: Carry-APpiCaa: Pink4lerm>s: Goldenrod-,Assnnor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: P 083978 PLAN CHECK'NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE; PLU JOB DESCRIPTION ; 1534SF OFFICE TI CLAIM VALUE: CALL—VALUE: PERM NO: P 08397 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B / COMMENTS: "A.B.C." OFFICE TI RE:#B83975 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING---------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN .EAAKING RE • PROV: PARCEL: 93894085 ZNE: REF NO: PLANNING N�TES> > if• if• it * it it * * it it * it it it fa it � � � � * it it * it it it � it � it it it it it it if• it if• if• if• if• if• it it itit it � if• * it * * if• it it * * if• if• if• if• if• � if• � �g it it it it it * it * it it it D E V E L O P M E N T S E R V I C E S"-� "R E Q U I R E M E N T S ZONING APPROVED BY DATE: 8MLDINO AVVROM BY t DATE: r tPPi� LCAT I ON ISSUED BY: 5�1� DATE: 3o * LEGALIZATIONtN Fr E E S U M M A R Y STRUCTURAL SEGMENTtN A" .t I BLDG PMT PLUMBING ELECTRIC?"., MECkAN'tC FIRE SMIP/RES GRADING PERMIT 26225 'F I^ �1, ,; f�. SMIP/N©N-RES PL tot ISSUE FEE 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK;. :. TOTAL PAID DUE TOTALS----> 26,25 22.00 0.00 48.25 48.25 ,00 REVENUE DIVISION TOTALS--> COLLECTED: :48.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC !r FIRE SMIP/TOT GRADING PLAN -CHECK 48.25 it it � * � if• * * * * * it •)F * it * * * * •IE'hl''hl''hl''hl' it hlit lgit it *'ll' * it it *'ll' it it it'hlit lghl91 it it it * hl if• * * � � it * * if• if• fa * * * � � � � � it if• if• �F * * � � if• if• I N D I V I D U A Ll.`�F,£ E 'B'REAKDOWN TYPE QTY D E S C R I P T I O N- ;, UNIT COST TOTAL COST PLU 1 SINK, KITCHEN '' 1 1 8.75 8.75 PLU 1 WATER SERVICE 8.75 8.75 PLU 1 WATER RE -PIPE r r. 8.75 8,75 END; OFy FEES f o rr r - , 07-38-1997/12:63 PMA48.25 ` RCPTM:61-9009941 PERMIT:083978 CONSTRUCTION AND PLANNING- POOL , ..A 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 �j3: Electrical Conduit,Lrtiiity-Undrgrnd. 54. Forms ` 4i'EIectrical ConduittrUiadrgrnd 55. Electrical Bonding r 1•,, ^w lntteel Reinforce men i; 56. Rough Plumbing & Pressure Test V 1 •- L'6 --'Electrical UFER 6s'rnd. ti � - 57, APPROVAL TO COVER-GUNITE 7� Footings ` 58, Electrical Conduit-Undrgrnd. -:8 Foundation -- u 59. Gas Pipe, ❑ Undrgrnd., Test '9. -Water Pipe-Undrgrnd.~ 60: Backwash Lines, P -Trap, ❑ Undrgrnd. :.10, Structural Floor-Svstem 61. APPROVAL. TO DECK 31 . Property Sewer Line & House Connection 62. Backwash & Receptor -Final ,32. Sewer Cap °' 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing, T' 65. Electrical -Final 15. Rough Electrical -Conduit 66- Solar System -Final 16. Rough Electric Wifi 67. Fencing & Access Approval 17. Rough Wiring Sign r 68, APPROVED- FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning ' FIRE DEPT. REQUIREMENTILI y APP AOV LS - Permit 20.^Rough Factor Fi.teplace 21.',Ducts, in�Strp_crur r. -� r. "' -, 70. UndehIj�ound 1'I- 22. DuGVentil2tingw, 73. Produ"ctPng 'Gas L] Oil ts, 23.4Gas Pipe-_3oh &"hest ;,T: R rt C, y :, 5 ~ 72. Underground Ruth t• >• 24, :Roof- Fritming 4',r r' - -'F' � "' - �; � a - 73. Undergrnd, Stc��zge Tank ©Gas ❑ Oil 25. Roof,Sheathing Q l �. rJ 74. Overhead Hydrflr 26, T -Bar, Ceiling (Structural) & TVloitocoat yr - x �' nit 7� Dry Chegtica! i 27.JFraMe and Flashi r 1x } ,. u i 76. Dry Stan[fpipe x = r 28.�Lathing.& Sidingir' 4 r'' -- i 74 FIXED�$yS.T15y r tQ 29, Insulation t. r 7�,.FJRE,PREV, FINAL + ,,.• S �: _ 30. Drywall #NailingEALTH DEPT. REQUIFZEN 31, Plaster Blown Coat { 3 79. FINAL I F�PECT ON ' T KC -n KC 32. �1=1ectrical'.PovVer AReterpFinal � ^� ` �� 8M FOOD CERTIirICATE PSS{JED i+ l It 33. 1=inalkEieGtric., M X Notes: 34.. -Final Heating7& ZrZortditionin= -- - -�3k t 35.:TinaTGas Pipe"• -Test"' - 5 36. 41oo�d or Canopy i re 3 a. t C' 37.'-Fin0l Factory Firep�ce,-.. S t' 01 ! 6 d , c r , 4. ��-,jp�j Com'' 38. Final Plumbing F ^t [ _. 7 Z% _ ". 39. Water Service -Final * t j }< 40. Gas Service -Final * Y 41. Solar Domestic-Fipa# 42. Backflow Prevent er,.r= }, ._ - ! f , f f a _- 43. Backflow lrrigation' I:37 y r 1 :44., Landscape Irtigatio; System:-'- 11 *r, ;t Sound Attenuation` _ :- # �' _ t T - +x ` 4 X46.- 'Hand i cap,RegulatioDs = A + _ zl t: 47'. -FINAL STRi7CTURE & SUrLDING t 48.►FINAL PLANNING!j :49.�Electtic Release to Edison } 50. Gas.Release to Soutbern California Gas Co % ikr 531. CERTI F I CATE OF0CCUPAQ No. Date AIRWAY AV UNIT: U-2 RNIA FEDERAL BANK IRWAY AV G-108 626 06 I'll .: UNIT: 'IING ELECTRIC (714)830-9668 41 LA- CAD£NA Q iGUNA HILLS CA 92653 DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section Ne Business and Professions Code, and my license is in full force and effect. 1014 STATE LIC.: 7 2 71 sLass: C 1 Signature: _ VLI�YND MPENSATtON DECLARATION: I hereby affirm that I have a cert le of consent to self -ins oraworkers' Insurance. or a certified copy thereof (Sechon 3800, Lah. C). 80015645 EXP. DATE: 0 2/ 01 / 9 2 COMPANY: FA I RMON T ❑ Certified copy is hereby furnished. N CC fired copy is filed it the city Building Division. Date: 4 2^ ` — Applicant: EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need ndre completed it the perrrtit is forehundred (S1 O01 or IiI cendy that in the performance of the work for which this permit is issued. I shall not employ any person in arry anner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: It, alter making This declaration, you should become subject td the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of 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/she is licensed pursuant to the provisions o1 the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 {5500). 1, as owner of the property or my employeeswith wages as their sole compensation, will do the work, and she ❑ structure is not intended or oflered for sale {Section 7044. Business and Prolessional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselllherself 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 will have the burden of proving he/she did not build or improve for the purpose of sale). I- as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner I do hereby certify that I am aware of and understand the requirements of Calilornia Health and Safety Code Sections 25505, 25533, and 25534 and that I or any luture building occupant willlwill not (circle one) need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duahty Management District. Residential construction applications are exempt from These provisions. Dale: Applicant: I hereby certify that I have read this applicati nand state that the above information is correct. I agree to comply with all city and county ordinances and slate laws relating to buildin ___ ruction and hereby authorize representatives of this City enler upon the above -menti ed properly for inspection purposes. Date: _Z 4 — j Signature: Driver's License or Social Security 0: 1641-46 While—Building; Green—Code Enforcement. Canary—Applicant: Pink—Revenue; Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO, E _O5179'A'1 PERMIT NO: E 05179'i PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION : T.I. OIFFICES, INSTALL AN ELECT METER SQ :T: CLAIM VALUE: CALL --VALUE : GROUP OCC: B-2 / COMMENTS: REFERENCE. BUILDING PERMIT #B51410 ?¢ 9i •i i(# i4 Ti• 3e 3? }' i(# # # ii iF X * dE * .}4. # # .*. # * * * * Tfr # * # * * # * 3+F •lE # If •t; X_ * If # )f 1& k ii• � �f Ii• #E # * # * k If #F aF # >bf # # �4 Y• # x 3F � >� x Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ------- --------- ACCESSORY BUILDING --------- F'RNT:FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: t3' IN RGHT: FT IN LEFT: FT IN RGHT: FT 7N PARKING REE: PROV: PARCEL: 42729115 ZNF: REF NO: PLANNING N TES> :K # i(,4 i(• 1F aF kiF # .� ?C�4 K• #E k #(• #6 3E tf I<• IC }(- *'k•'}F k * �F # * � � -1[ � # .� 9E N• � # 3i #E if II• #E �• �E # � � -1F #(ai• X• #F 3(# �'. k- # � •4. 1{ #• }= � ii- 3(• ?t # i(eF �-?3E• # ? ?E D E V E L O P M E N T S` E',.'R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: • r BUILDING APPROVED BY DATE.- APPLICATION ATE;APPLICATION ISSUED BY: DATE.�k # # # !{• # # ii i(• IK •IE # # ii- ?(- # # }t• * }- #. * i{- - .. ,Ar. �• ii• *'- * •IE 3t- 3(• � # if x -IF # K;? TE i(• 3if•-Y #F #F iF !f i(• -1f K 3f- iE x� -1f # � # 3+- �E II• # lk af• � 1r � k � �'r iF # 3i � ?F # * i(• � -IF # tE If It # 9F # � � IF;F # # � #(� � .�. iF # I<�I�(• � # •x ii 3S• 14• # �• .s¢ R• t LEGAL I ZATION : N ,F. E E S U M M A R Y STRUCTURAL SEGMENT : N BLDG PMT RLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 18 50 o� SMIP/NON—RES PLAN ISSUE FEE 4,50 BUILDING—DIV--> PERMIT ISSUE PIAN—CHECK TOTAL PAID DUE. TOTALS----> 18.50 4,50 0.00 ,23.00 23,00 ,00 REVENUE DIVISION TOTALS—> COLLECTED: 23.00 OVER/SHORT: ,00 BLDG PMI' PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN—CHECK 23.00 TC # 3F iF iT iE # Xif ��F �: It # N� )f ii• * �ii * * * * •i; # * * #F # ii• }E iC li # if ?f -FF * � * i� #(• # #F # df ii- ,k � # # #E #E � iF # i( 0(• aE i(3F i{ -'f(• +r- iF +:• a(• # # If * * * k ie• i! # I N D I V I D U A L F E E B R E A R D O W N TYPE Qi'Y, D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V & 3ELOW 201 AMP 18,50 18,50 END OF FEES 01 000957.2-00085712 T0T 23.00 DATE: 04/25/91 TIBC: 16:20 Pole ',Iity-Und"tgrnd. .nduit Undrgrnd. 5. StE I Reinforcement Date Inspector POOL & SPA APPROVALS Permit #.-------�---- Date Inspector 1 52, Pool & Equipment Location 53. Steel Reinforcement - 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNiTE 7. Footings 5B. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test I 9. Water Pipe-Undrgrnd. .: 60. Backwash Lines, P -Trap, ❑ 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 j 67. Fencing & Access Approval i 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 APPROVALS Permit # 20, Rough Factory Fireplace 21, Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73, Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. FINAL 30, Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat FINAL INSPECTION 32. Electrical Power Meter -Final FOOD CERTIFICATE ISSUED 33. Final Electric otes: 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 47, FINAL STRUCTURE & BUILDING 48, FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 31 .5 f AIRWAY AV UNIT: U— 2 OWNElhNAME: CALIFORNIA FEDERAL BANK ADDRESS: 3151 AIRWAY AV G-108 CM CA 92626 540--26106 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: JOHNSTON 6 ASSOC (714)632-3462 ADDRESS: 1035 ARMONDO ST F ANAHEIM CA 92806 LICENSED CONTRACTOR DECLARATION: I herelry affirm that I am licensed under provisions of Chapter 9 (comment' g with Section 7COO) of Division 3 of the Business and Prolession5 Code, and my license is in II force and effect. CITY LIC-: 0131 01111110N STATE LIC.: 1 CLA13 Dale:�Signature. ORKERS' COMPENSDECLARATION: I hereby affirm that I e a certificate of consent to self -in su r a certificate of Workers' pmpensation insurances or a certified copy thereof (Section 38 , Lab. Cl. OLICY NO.: 1.11 X 4 8 9— 91 EXP. DATE: 0 1/ 0 1/ 9 1 COMPANY: STATE FUND 0 Certified copy ishereby furnished. [M riffled c Is filed'with the city IIdi Divi ' n. Date: 3,// / 1 Applic� EXEMPTIDN 1`DM WOR ERS' COMPENSATION DECLARATION: {This secti geed not be completed it the permit r one hundred [$1D0) or less} I certify that in the performance of the work for which this permit is is .ed. I shall not employ any per I any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: If. after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a Construction lending agency for the performance et the work for which this permit is issued {Section 3097. Civ, Q. LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Cade: Any city o1 county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its +ssuance, also requires the applicant for such permit to file a signed statement that he/she is.licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 (5500). I, as owner of the property or rry employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law { does not apply to an owner of a property who builds or improves thereon, and who does such work himselflhersell 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 will have the burden of proving he/she did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State license Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a Conlractorls) license pursuant to the Contractors' Stale License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. 0 I am exempt under Section: B. 8 P. C. lof this reason: Dale: Owner I do hereby certify that I am aware of and understand the requirements of Cali:ornia,Healih and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant w Wwill not (circle one) need to comply with said state codes and the requirements for a ` permit for Construction or modification Isom the Air Ouabty Management District. Residential Construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application, state that the above information is correct. I agree t ' o Comply with 0 cand County ordinances and state laws relating to building co [ruction and hereby authorize repres Civ 2 of this.0tv to enter upon the ove-mentioned property for inspe ion our ores. 00 / Date: --3,o Signa[ure: Driver's License or octal Security a: 1641-46 White— Building: Green—Code Enforcement: Canary—Applicant: Pink—Revenue: Goldenrod—Assessor C C C M ;w i X CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 05.14.1 ERMIT NO: B 051410 PLAN CHECK NO: 00910-91 A GOVT: N SUPP: N ONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT OB DESCRIPTION ; T.I. OIFFICES SQ FT: 1,534 LAIM VALUE: 24,000.00 CALL -VALUE: 15,524.08 GROUP OCC.: B-2 / OMMENTS: T.I. OFFICES iE �{ �E iE • •If �f >E �f dE ik iE YE �E lk lk IE * * * * * * •l4 * * * * * iE .x. •IE * V * * if *X * * 9f'k TI- * * * -X * * iE -1E * •}f +F iE iE +F }F iE 9E # 1F FE FE Ic Tf 1F iE }f .N •)E t iw 1K, Z O N I N GS ERrEBQAUCIKRSE M E N T S ----------- ---------- MAIN BUILDING ------------------ ACCESSORY BUILDING --------- RNTFi IN REAR: FT IN FRNT; FT IN REAR: FT IN EFT,: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN RAKING RLQ • PROV: PARCEL: 42729115 ZNE; CL REF NO: LANNING NOTES> 1534 SQ, FT, TI TO AN EXISTING OFFICE COMPLEX, iE �E iE iE �E �E -1F � �E MF TI- J!- iF iF #E''E �E #E �E �E iE * * � iF iE �E iE � iE �(• �E iF-IE •Y. -1E �E rk'lk iE d(• �E iE if iE � iF !E iF # tf tf yE af- iE �F tf +F iE iE iE iE iE � ic'r' }E iE Tc• � � � •1F * * �• �F •lf D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N_T S ONING APPROVED BY S,6c-- DATE: xJ `l 9 UILDING APPROVED BY : DATE: ,PPLICATION ISSUED BY; DATE: ifr �E �E IE � TI- IE •11- iE •11- TI- TI- � #E #E iE � * #E IE #E � * �c #E * * � lE � �E • :t j!- �E -IF * iE if• iE iE -1F N• � iF � 3(• 3F #E #E #E IE #E #E �E IE #E �F � #E #E iE � iE � ih �[- iF � lE +{• � * ih �E IF if TI- �[- -iF * �- •11- •11- � � �{• N• iE �- � �;# �(- if• �F 3F ie * if•� •N- •1F iE � u #E * IE aE � � iF EGALIZATION:N F E E S U M M A R Y STRUCTURAL S.GMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 'ERMIT 171.00 SMIP/NON-RES LAN 27.79 .3.33 SSUE FEE UILDING-DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE 'OTALS-----> 173.33 0,00 27,79 :01.12 201.30 -.18 ,EVENUE DIVISION TOTALS--> COLLECTED: 173,33 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 171.00 2.33 Jt Jt iE 3(• �{ If iE it- � •1t If iE iI- �E -K• �E � iF �; it V.• iE �(• tf � # K• 4E tf ir.• -1F JI- JI- ik il- •1F iE a(• !1• � �( •1t JI- JI- � JI- 3(• il• * k 1(• �- if- * •11- a(• ,x• � iE EE •iF � iE # �F � �(• ii- � K!• � iE -lf ?� � � * •N- I N D I V I D U L F E E B R E A K D O W N YPE QTY D E S C R I P T I O,N UNIT COST TOTAL COST 'FC 1534 OFF -INT, ALTER TYPE V -N -AVER 10,12 i 15,524.08•_ END OF FEES T, J011110 . h _� _4 MAR 19 199, ut OTY of COSTA MESA CONSTRUCTION AND PLANNh-v_ APPROVALS Permit # Date Inspector OL & SPA 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings j 58. Electrical Conduit-Undrgrnd. � 8. Foundation r 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. �.%rR 60. Backwash Lines, P•Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & HouseConnection' �r,, 62. Backwash & Receptor -Final 12, Sewer Cap i 63. Heater & Vent -Final 13. Roof Drains �; �� 64. Plumbing System • Final 14. Rough Plumbing f 65. Electrical -Final ; r' v 15. Rough Electrical -Conduit f ' 'f 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. -Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71, Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. , Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 X79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33, Final Electric ' Notes: 34• Final Heating& Air Conditioning r 35. Final Gas Pipe -Test / 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing y 39. Water Service -Final r ' 7� 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer -- 43. Backflow Irrigation 1,Y - 27 44. Landscape Irrigation System 45. Sound Attenuation ` 46. Handicap Regulations 47.' FINAL STRUCTURE & BUILDING 48.'FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY NoDate PROJECT ADDRESS: 3151 AIRWAY AV OWNEA'SNAME: CALIFORNIA FEDERAL BANK ADDRESS: 3151 AIRWAY AV C-108 CM CA 92626 540-2606 ARCNIENGINEER: ADDRESS: REG.NO.: "NIT: U-2 UNIT: PERMITTEE: WILSON PLUMBING CO. INC. (714)692-0381 ADDRESS: 24370 VIA LENARDO YORBA LINDA CA 92687 LICENSED CONTRACT 0R DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 {commencing with Section 70001 of Division 3 of the Business and Professions Code, and my license is in lull force and effect. CITY LIC.: 0 2 5 6 STATE LIC.: 4 9 8 '] 9 9 u " _3 6 Date: t Signature: _ WORKERS' C MPENSA ION DECLARATION: I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' `ompensation Insurance. or a certified copy thereof (Section 3600, Lab. Cl. •DLICY N6.: EXP. DATE: COMPANY: ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building OMsidn. Dater Applicant: EXEMPTION FROM WORKERS' COMPENSATION OECLARATIOW (This section need not be completed if the permit is for one hundred {5100) or less). I certify that in the performance of the work for which this per is issu I shall not employ any person in any manner so as to become subject to the Workers' Com ensa[ion Laws of California. / Date: Signature: Irf■�/ NOTICE: It, fier mal ng this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you most forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097, Civ. C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct, alter, improve, demolish, or repair any structure. prio: to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that helshe 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 penally of not more than five hundred dollars ($500). I, as owner W 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 (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himsetitherself or through his of her own employees, provided that such improvements are not intended or ohered for sale. Ii, however the building or improvement is sold within one year of completion, the owner will have the burden of proving helshe did not build or improve fur the purpose of sale). I. as owner of the property. am exclusively contracting with licensed contractors to construct the project (Section 7644, Business ❑ and Professions Code: The Contractors' Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractors) license pursuant to the Contractors' State License Law). 1 am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B. 8 P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of CaTdornia,Health and Safety Code Sections 25505, 25533. and 25534 and that I or any future building occupant will will not (circle one) need to comply with said stale codes and the requirements far a permit Sar construction or modification from the Air Duality Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to bmldmg construction and hereby author:. representatives of this city to enter upon the above-mentioned property for in eclion purposes. Date: � 9z Signature: Driver's License or Social Security d: 1641-46 white—Budding, Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05141 • PERMIT NO: P 051.414 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE; PERMIT TYPE: PLU PURPOSE: ALT JOB DESCRIPTION : T.I. OIFFICES SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: B-2 / COMMENTS: REFERENCE BUILDING PERMIT#B51410 i �•*�•��*��•��•�-�-t��t•+E*+E��+Esc+��-��-*�**��•��*****>�***��*�•+Est•��+E+E►t•��•�-�**��-u��• Z O N I N GS M E N T S ERTEBQAUCIKRSE ------------ MAIN BUILDING -------------------- ACCESSORY BUILDING--------•- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REO: PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING NO'TES> } iE iE dE � !E �E iF 9[• 9[• iE iE �{- �{- X• i4 * #F ,7E iE * � �i• #F �f• � �F �F * �F �E �E �E �F'lE �E �F iF �E TE � �• � � iF iE TE �F�i- iF }� iE'14 ,7E ,7E * �: ;F * iE 9E 3Y iF �F iE iE'lE �E �E � iF iE � �E � � �- }: * � D E V E L O P M E N T S E R V I C E Se R E Q U I R E M E N T S ZONING APPROVED BY " DATE: BUILDING APPROVED BY ; DATE: APPLICATION ISSUED BY:DATE: _ it lE i4 rE 94 TE iE iE it �4 !E iR *****ft * TE 3r �!• * }F iE * iE ;F } ic"iEififiE�� ofit•ifiElE+k��(-�-�{'x-iE *x-�[-iE�-��•�� Y: if if TE TEi{'��'u•***��*��l':'?+•�•iF�;!'_��!•iEx+t•iei':i{' �I~•►�_i{'Y K'%!!tif�?4•�:?S'iF#�TE� LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIPJRES GRADING PERMIT 8.00 25% SMIP/NON—RES PLAN ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL' PAID DUE TOTALS ---- > 8,00 3.00 0.00 11,00 11.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 11.00 OVER/SHORT: .00 "BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK 11,00 �E T4 !E iE !E TE iE �{" !E �{- iE.� !{• � #E �{" TE �{- !{• iE TE #E iF TE #E'14 iE iR TE � ?E iR IE k TE � iF ?� * � �(" iE �(" TE � i(- TE % � ib }; � �(" TE TE # iF iF � �F #E TE tf * ,7E iE iE :tie i!• i{- 0!- K- * �F �• iF � * R! I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D'IE S C R I P T I 0 N UNIT COST I TOTAL COST PLU 1 WASH BASIN 2.00 2.00 PLU 1 WATER CLOSET (TOILET) 2.00 00 PLU 2 FLOOR DRAINS 2 ,00 4,00 END OF'FEES t �]1 `106G�rJ5F—CLij6312 T1�:4' CONSTRUCTION AND PLA NNINu 'APPROVALS Permit # Date Inspector jOL & SPA APPROVALS Permit # Date Inspector I . 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 7 58. Electrical Conduit-Undrgrnd. 8. Foundation f f 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe•Undrgrnd, 60. Backwash Lines, P -Trap, 0 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 APPROVALS' • -Permit # 20. Rough Factory Fireplace 21, Ducts, in Structure . 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 000 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,i 79. FINAL 1NSRECTION 32, Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes. 34• Final Heating & Air Conditioning 35. !Final Gas Pipe -Test T 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 Irriqation System 45. Sound Attenuation -46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 3151 AIRWAY AV UNIT: U-2 OWNlNAME: CALIFORNIA FEDERAL BANK ADDRESS: 3151 AIRWAY AV G-108 CM CA 92626 540-2606 ARCHIENGINEll REG.HO.: ADDRESS: UNIT: PERMITTEE: AIR—TEC (213)549-1698 ADDRESS: 1606 EAST CARSON ST CARSON CA 40745 LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 761) of Division 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIC.: 2 STATE LIC.: 4120650. CLASS: C, - 2 Signature: _ — —- — - . 9KER COMPEN ATION DECLARATION: I hereby of ,,, I .I hav a 1Ucate of conse r to elf -insure or a certificate of Workers' .mpensation Insurance. or a certified copy thereof (Section 00, Lab. C). POLICY NO.: WCP — 13 6 91—A EXP. DATE: 0 2 1 0 1/ 4 2 COMPANY: SUPERI( R NAT' 1, ElCenitie copy is h c y fished- ® Certified copy is iled wit the city Build' D' • 'on, Dater Applicant: r_ _ EXEMPTI FROM W KERS' COMPENSATION DECLARATION: (This section need not be completed it the permit is for one hundred ($100) or less). I Certify that in the p rlormance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to Inc Workers' Compensation Laws of California. Date: Signature: NOTICE; It, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code. you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097. Civ. C). LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby allirm that I am exempt from the Contractors' State License Law for the following reason {Section 7031.5 Business and Professional Code: Any city of 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 td file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' Stale License Law (Chapter 9 (commencing with Section 70001 of Division 3 o1 the Business and Professions Code) or that he/she is exempt therefrom and the basis tot the alleged exemption, Any violation of Section 7031.5 by ry applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). 1, 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 (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himsell/herself or through his or her own employees. provided that such improvements are not intended or offered for sale. 11, however the building or improvement is sold within one year of completion, the owner will have the burden of proving he/she did not build or improve for the purpose of sale). 1, as owner o1 the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner dl propertywho builds or improves thereon and who contracts for such projects with a contractor(s) license pursuant to the Contractors' License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. O 1 am exempt under Section: B. & P- C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future building occupant will not (circle one) need to comply with said state codes and the requirements for a permit los construction or modification Irom the Air Oualdy Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct, I agree to comply with all city and county ordinances and s6 a it rel sing to building construction and herein authorize representatives of [his city o enter upon the above-mentioned property terns .coon ur� Date: Signature: Driver's License or Social Security n: 164146 White -•Building; Green—e Enlurcement .nary—Appiieant: Pink—F7evenue; Goldenrod—ASsesSor . CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 051424 PLAN CHECK NO: N CONSTRUCTION TYPE: : T.I. OIFFICES JOB DESCRIPTION CLAIM VALUE: PERMIT TYPE: MEC CALL—VALUE: PERM NO: M 05142 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP'OCC: B-2 / COMMENTS: REFERENCE BUILDING PERMIT #H51410 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING -----•----- --------- ACCESSORY BUILDING--•---_—•-- FRNT: FT IN REAR: FT IN FRNT: -T IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING N TES> iF }I• iF iF iF +F Tf• .� 1F �;r •1F * Tf• #F I[ -MF Tf• #F +F •II• �F iF if• �F iF �F #� �F iF �F iF i1• �F �F �F #F 9E #E itE iF * itE ik ik itE ik •>rE ik � * •Ih iF # * �F !t• # aF TF # TF �C TF � � Tf• Tf• Tf• iP iF � TF � � #F � #� i4 D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: N. •14 •IF'1f �E iF iE �E �i• iE � fi� T(1l� if •)r:• •>f }f• * Tr:- iE iE . aE• * aF �F ]E• ?E iF �• 3E iF #� T4 �F #F #F � ii• ik !F T4 T4 iE *• ?K T4 •Ih #F T(• Irt ik ik •lE ik !E *.!E �• •11• !E �!• ik •>rE � * * * •>rE � � � .. •1F •}E �F• � aF iE TE �F 3F iF #L•'1F kF Tf• TE if• !E �F -kF iF !F iF }F -kF * -MF #F }t• ��,' i>r � � iI• * is T4 * �F'lE LEGALIZATION F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 9200 5% SMIP /NON _RES PIAN ? ISSUE FEE 15,00 ' BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 9.00 15,00 0.00 24.00 24,00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 24.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 24,00 aF �!• •M• ik TF TF •M• dr TF �i• Ti• # * �- * * � * * TF TF TF � TF � TF TF ]E �!- aF * >rt .� aF � iE � * � � TF �{• fit• * * * � iF � •Ih TF �E � ?(• � iE iF #• TF T4 � aE TF 9t aE * * K• � }[• �{• 7E � * #F � �F lE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY MEC 1 D E S C R I P T I O N REPAIR/ALT REFRIG UNIT COST UNIT/SYS W/CNTLS 9.00 END, OF FEES TOTAL COST 4,00 RECEIVED MAR 2 21991 i f5AIR-TFC �i flQDC�?L-4.' ri.r�.�'e�':U ll_- CONSTRUCTION AND PLAN. ; APPROVALS Permit # 1 - Rate Inspector POOL & SPA 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 U F E R Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings r� �- 58. Electrical Conduit-Undrgrnd. 8. Foundation ; `` �; r;._ . r 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System r 61. APPROVAL TO DECK 11. Property Sewer Line'& House Cpnnection '�; 62. Backwash & Receptor -Final 12. Sewer Cap ' 63. Heater & Vent -Final 13. Roof Orains r ` i 64. Plumbing System - Final r 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 APPROVALS • • Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑'Gas ❑;Oil 23. Gas Pipe -Rough & Test 72. Underground Flush- lush24.-Roof 24.-RoofFraming 73.'Undergrnd.Storage Tank ❑Gas ❑Oil 25. Roof Sheathing �74.`Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. -Dry Chemical 27, Frame and Flashing 76, pry 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 �, x Notes: 34. Final Heating & Air Conditioning 35. -Final Gas Pipe -Test .36. Hood or Canopy s 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 1 44. Landscape irrigation System. 45. Sound Attenuation ' 46. Handicap Regulations , 471. FINAL STRUCTURE & BUILDING ' 48. FINAL. PLANNING' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 3151 'AIRWAY AV UNIT: U-2 OWNIR'SNAME: CALIFORNIA FEDERAL BANK. ADDRESS: 3 1 5 1 AIRWAY AV G-108 CM CA 92626 540-2606 ARCHIENGINEER: REG.NO.: ADDRESS: UNIT: PERMITTEE: FANNING ELECTRIC (714)830-9668 ADDRESS: 23141 LA CADENA Q LAGUNA HILLS CA 92653 LICE NSE% CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of pivision 3 of the Business and Professions Code. and my license is in full force and effect. CITY LIG.: 052109 STATE LIC.: 5 3 7 2 7 1CLASS: C 10 mate 3 -J9-9J Signature: _ Q' nse—. f.*OR%ERS' COMPENSATION DECLARATION: I hereby affirm that I have a certificate of con o self.msure or a certificate of Workers' Compensation Insurance. or a certified copy thereof (Section 3800. Lab. C). POLICY NO.: 80015645 EXP, DATE: 0 2/ 01 / 9 2 COMPANY: FAIRMONT ❑ Certified copy is hereby furnished. ® Certified copy is filed with the city Building Division. Date: )! — 91 Applicant: a 406, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION: (This section need not be complete [he permit is for one hundred ($100) or less). certify that in the performance of the work for which this permit is issued, I shall not emplo ny person in any manner so as to become subject to the Workers' Compensation Laws of California. Date: Signature: NOTICE: 11, after making this declaration. you should become subject to the Workers' Compensation provisions o1 the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097. Civ. C), LENDER: ADDRESS: OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors' State License Law for the following reason (Section 7031.5 Business and Professional Code: Any city o1 county which requires a permit to construct, alter, improve, demolish, or repair any structure. prior to its issuance. also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors' State License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Codej or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (S500). I. as owner of the property or my employees with wages as their sole compensation, "$I do the work, and the ❑ structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractors' State License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himselllhersell or through his or her own employees. provided that such improvements are not intended or offered for sale. 11, however the building or improvement is sotd within one year of completion. the owner will have the burden of proving hefshe did not build or improve for the purpose of sale). 1, as owner o1 the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business ❑ and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or impro ms thereon and who contracts for such projects with a contractor{s) license pursuant to the Contractors' State License Lawj. I am aware that proof of their Worker'5 Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B. & P. C. for this reason: Date: Owner: I do hereby certify that I am aware of and understand the requirements of Calitomia.Health and Safety Code Sections 25505, 25533, and 25534 and that I or any future budding occupant willlwill not (circle one) need to comply with said state codes and the requirements 10,a permit lot construction or modification from the Air Ouakly Management District. Residential construction applications are exempt from these provisions. Date: Applicant: I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property farinspectionpurposes. 'Td-te: 3;19... ?/ Signatu Driver's License or Social Security p: 164146 white—Building: Green—Code Enforcement: Canary—Applicani; Pink—Revenue: Goldenrod—Assessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 05142 PERMIT NO: E 051420 PLAN CHUCK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION T.I. OIFFICES SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: REFERENCE BUILDING PERMIT #B51410 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------MAIN — BUILDING•— ---------- .--------- ACCESSORY BUILDING -------- -- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT 1N RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ; PROV: PARCEL; 42.129115 ZNE: REF NO; PLANNING NOTES> y * •�34 �• x• -x +i- 34 •►c• � 34 �x•x• •►c• +i- iE• +c• �• �• � �t x * * x• * * •14 � �• * -x• * +� � * �• �• � �• � �• * �• * �• x•>t ff � � � �.w. � � � � � � �• +r•.x..x. 34.34 x-ri•,�-•>t x• � k � �-�• � �c• D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N .T S ZONING APPROVED BY DATE; BUILDING APPROVED BY 1 DATE; APPLICATION ISSUED BY: DATE; •IE •IE ►4.1I• ►F ►F � •1I• � � ►4 ►4.1I• it � � ►4 34 ►F � ►F 36 * iE 3E 3E IE 3E •IE if !E }� � •lI• iF i4 � •x• it 34 i(• ►t 34 35 � .�. �4 ►t •14 •lI• it• ►t i4 ►t 34 34 it i4 * �( dI• YE iE YE * +� dI• dI.3Yi4 dI• 14 3E 3E * }E 3(• 3F 34 34 dE 3E ►4.� �F � 34 it• ►4 14 341= 3{• a4 •M4 iF it• ii• �4'•x• 34 ii•1(• x• 3F IE � 3E x LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES.. GRADING PERMIT 42.50 ," 50% SMIP/NON;.RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID .' DUE TOTALS ---- > 42,50 15,00 0,00 57.50 57,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 57,50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PbAN—CHECK 57,50 , x- 34 34 34 34 aF iF iF 34 * •14 i614 34 ►F 34 i(• 34 31.3E 14 34 3(• +� 3(• 3F 1414 31.14 IE 14 3E d(• ►F +� •1F ii• 34 }E 3{• .� 3E ►F 3E 34 34 � ►F 34 3E 34 3E 34 * a4 lE-3F if >f 3E a4 �: iE 34 i4 * i(• i4 34,34 ►F d(• �(• iE iF d(• * +r' I N D I V I'D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 11 FIXTURES LIGHTING 1 ST 20 RECEPT/06TLET EA, ,75 8.25 ELE 20 1 ST 20 EA, ,75 15,00 ELE S RECEPT/OUTLET ADDITIONAL EA. .45 2,25 ELE 8 RECEPT/SWITCH 1 ST 20 EA, ,75 r" 6.00 ELE 1 SUB—PANEL 11.00 11.00 ' END OF FEES �1.. Y' 11 I V }J V 'CONSTRUCTION AND PLANNING ;APPROVALS Permit # Date Inspector POOL &SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2-.Soil Pipe-(Jndrgrnd. 53, Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd: - 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7,. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation _ 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P•Trap, ❑ 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 Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS. ' Permit # 20, Rough Factory Fireplace = 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ON 23. -Gas Pipe. Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd, Storage,Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical , 27, Frame and Fiashing" 76. Dry Standpipe , 28. Lathing & Siding- 77. FIXED SYSTEM FINAL 29. Insulation j 78, FIRE PREY. FINAL 30. Drywall Nailing f HEALTH bEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final , FOOD CERTIFICATE ISSUED .33. Final Electric J ` Notes: X34. 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 3 47. FINAL STRUCTURE & BUILDINGZ `&?7 loe 48. FINAL PLANNING 11 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co •51. CERTIFICATE OF OCCUPANCY No. Date r �1 AP01leant-to-fill'In'aII'spaces-exeeept those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA -:P CONSTRUCTION PERMIT RMIT NO. TRAC N . LOT NO. .pQ/Q Applicani3 Mailing Addrerwa v Ave. E77 Costa e a•TYPE 4F CONSTRUCTION 1XI NEW LJ ADD LJ ALTERATION'- U REPAIR ProjectAddress�3151 Airway Ave. U-3, Costa , ❑ CONVERSION .❑ DEMO _ ❑,OTH - CMpesa," Oner's Name .- Executl ve 6ui l d-- _JWA= I Iphone :5'+0-260r� 6 w DESCRIPTION OF WORK in�eri or mprovemen = - REAR YARD (TO P/L) Address' 311 Airway Ave. E-1', Costa Mesa RIGHT SIDE YARD _ 0 Tool & Assoc. TYPE OF PERMIT LJ GRADING FOUNDATION STRUCTURAL Arch/Eng, -Campos LicenseNo.. ,MECANICAL ® TENANT [:],ELECTRICAL ❑PLUMBING ❑ H Address .17779 "P' Main St. Irvine ❑OTHER Contractor's Name' J. Donald Olson -Co.. Phone 540-2606 PROJECT DESCRIPTION' SQ. FT.-- 1879 OCCUPANCY R-2 Address fi-naigng)!3,151-Airwa� Aye.E-1, CQSta Mesa CONSTRUCTION TYPE__ _--__ VALUATION $ 285000 , 00 License Na_. ZONA GRADING CU. YOS: ACRES LICENSED CONTRACTOR DECLARATION '. Remarks: Transformer 015-50 KIN I hereby.affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and 4 ❑50+KW' my license is In full Force and:effect. 333969 D ' Meter ❑up to 100'amps Issue Fee License Clas icens PLUMBING c Dater' Signature ' , , • Bar Sink I Sewer Cap' ' 'ORKERS' COMPENSATION DEC RATIO ` I - -- ereby affirm that.1 have a certificate of. consentto self -insure.or.a certiflcate_.-' • Backflow Preventer Sewer Connection ' Workers' Compensation Insurance, or a certified copy thereof (Section 'BUILDING PERMIT $ 3800, Lab. G. ! Policy No. 1-297`5 Company'' ,Fa i rmont Backflow Irri tion Solar Collectors l - is furnished. �fttfied u Bathtubs Solar Piping iereby gc4oppy the eity.B n i Sion. Clarifiers Solar Tank Data 11 1 a� Applicant $ ; PLAN CHECK ' $ EXEMPTION:FROM WbRKERS' COMPENSATICV4 DE LARATI N (This section need not be completed it the permit IWor one hundred ($100) or Dishwasher Swimming Pool w/Spa less) I certify that in the performance of the work for which this permit is Issued I In to become to the Drinking Fountains Urinal_ shall not employ any person any manner so as subject. Workers' Compensation' Laws of California_ -, • 4Floor Drains Water Closet' Date Signature NOTICE: if, after making this declaration, you should become subject to the Fl&r Sinks - - -Water Heated Workers'. Compensation provisions of the Labor Cotle, you must forthwith comply 'with such provisions or ,. this permit 1 shall be deemed. revoked;• _ Gas Service -Outlets - Water Service : CONSTRUCTION LENDING AGENCY f $ I hereby affirm that there is a construction, lending agency for the performance Interceptors of the work for'yq(� this permit ,is ,Issued (Sect_ion 3. 097 CIv. C.)� Lender's Name L^__ Kitchen Sink Lender's Address OWNER-GUILD_ER DECLARATION J Lavatories. , I hereby affirm that I am'exempt from the: Contractor's License Law for the fol lowing reason' (Section -7031.5 Business and Professional Code: Any city or P -Trey .1 _ county which requires a permitrto construct, alter Improve; demollsh.or repair 1 any structure; prior to Its Issuance, also requires the applicant for such permit, Roof Drains' _ to file a signed statement'that he/she Is licensed pursuant to the provisions of y Contractor's License Law,(Chapter 9 (commencing,with!section.7000) of °- Vision 3, of the Business and= Professions Code)"or that, he/she; Is. exempt Showers j y Reinspection Fee $15 i efrom -and the. basis for the alleged exemption. Any, violation of, Section :131.5 -_a t �- by' any applicant for permit- subjects the applicant to a civil- enalty of not more than five hundred dollars ($500). i I;-as'owner of the iproperty or my employees with wages as their sole Service Sink Issue Fee $ 3 compensation will'do the work, and the structure Is not Intended or offered MECHANICAL for sale (Sec{ion 7044, Business and. Professional Cotler, The Contractor's License Law does not apply to'an owner of a property who builds or Improves Boiler Refrigeration System thereon, and who does; such work hlmself/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 com- a ❑o-i00,00asru ❑100,000 BTU Duct - Under Ground pletion, the owner'will have the burden of proving he/she did not build or im- rove for the purpose of sale)'. I , i c I ' Duct - Structural System Repair/Alteration = I, as owner of the property, am exclusively contracting' with licensed con- , tractorsto.construrt the project (Sectlon.7044, Business and Profasslons.Code:. '_ _ .l_ Duct - Ventilating_,_? ' The Contractor's Ucense Law does not apply to an owner of property who builds or Improves thereon, and who Contracts for such projects with a con- I Exhaust System ❑ Multiple ❑, tractor(s) license pursuant to the Contractor's License Law): ❑ tam exempt under Section B. & P. C. for this reason i Firepl/Felt. Bit. ICBO 4 Date I Owner, i Heating System & Ducting I hereby certify that -1`have- read this application -and state that -the above- E10-1 06,000, BTU ❑100,000 BT - r �'I Information is correct. I agree to comply with all city. and county ordinances f and. statelaws relating t0 building construction, -and hereby authorize repre- ! Hood or Type I ❑' ; sentatives 0f this ityl to ent upon the above-mentioned property for Inspection pure !: I CU' T e II ❑i 1 Reinspection Fee f ! ? $15 Signature Date '11/15/83 Drivers' License or SS it 1 i Registers t ! Issue Fee , $ 3 CMI= 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor A. P. 90 —T ,;� 7- PLNG. REF. 916, LEFT SIDE YARD PKG.SPACE REQ. Uk up STREET WIDTH SPECIAL CONDITIONS: Automatic,Washer Meter Lover 100 amps-. -617 h - ' Construction Pole Sub Panel Cooking Unit Sub Pole 'ZONING REGULATI S Dishwasher - ZONE r BUILDING Inc.Solar.09-15 HP ❑16-15+ REAR YARD (TO P/L) Microwave RIGHT SIDE YARD F.A.U. PROVIDED PARK FEE S Range Device Boxes Sign ELECTRICAL Standing Sections Automatic,Washer Meter Lover 100 amps-. Construction Pole Sub Panel Cooking Unit Sub Pole Dishwasher Motors 00-1 HP ❑1'/,$ Dryers' ❑Gai ❑Electric Inc.Solar.09-15 HP ❑16-15+ Fan Microwave i F.A.U. Pole Light Fixtures Range Device Boxes Sign Outlets Standing Sections ' Switches 'Trash Compactor Garbage Disposal Generator 00-5 KW ❑5-15 KW Transformer 015-50 KIN 4 ❑50+KW' 'Reinspection Fee $15 Meter ❑up to 100'amps Issue Fee ; $ 3 Zoning Approved By Date - Application Approved By Date Application Issued By _ : _ r f�<' � •_ - nate OF FEES 'BUILDING PERMIT $ � �SjU�hPM/A�R,Y LQ�T"! [J SMTP $ %' �D PLAN CHECK/ $; PERMIT I -PLUMBING$ I ISSUANCE $ ; PLAN CHECK ' $ ' GRADING $ ELECTRICAL $ i r $ PLAN CHECK' i $ MICROFILM 1 $ ! MECHANICAL $ s , TOTAL FEEc $ PLAN CHECK. $. I i ? LESS 1 ADVANCED PC t $ ' c i FINAL $ FEE PF 5r� �CON� t a'�, `• `- POO PA ^. r� :�t-,..s `a G - - UCTCON,AND�PLAfVNiNG_, _- 'r `Permit 'f 75 '� 'Dater x �:;s �Insp+3ctor - �� = i J , �^ y Date 'Inspector i APP,ROVAL'S #- -.APPROVALSc- =Permit;# ' }$m'orary;Electriic91 Serviceor_Pole r rw1 - ;9; r4 *� 52� Pool &:Equipment Location �. ;o 6..F M -� t € • � - I. S/ t � i (s '2? iSoil Pipe-Undrgrnd., w' r" F •> �. , w & r ,� 7, C C � I �, _ R, r ; _53:, Steel RetnfoFcem"ent ; I I�, _ 3.` El'ectricat'l Conduit,UtilitylI Undrgrrrri. „' - ` I i' � +• I ° '3 , � i • ' � _ ` • `+: 3 .+ .: r ,^u -: - - i 0 Forms ' _ ' .J i t ,54: 4: EIle ctrical Conduit-Undrgrnd. r %c 55. Electrical•Boricling`'7' 5; Steel ;Reinforcement ; - m L ° = :56:. Rough PQrrT&ng';8c Pressure Test ? ` �i r{ _ ` F 6= fEl'ect'ricel UFER Grnd. ° I -I n a- '- 15T•., A0P.ROV%AL-TO COVER-GUNITE� 7. Footings i •I € !_ I _+ #` r '7 v = I"� n�` ,,58.-'Electrical=Corid i.fif-UndrarM. 8. Foundation 5' I ° S ; si/jgt 59. G2s'Pipe,'b`Uri[Ergrhd., Test 9. Water Pipe Undrgrnd. i ",60. Backwash Lines,:P-Tra`p,.Cl'Und'rgrnd.<< 10. Structural Floor System e # ; l' 61. APPROVAL TO_U,ECK ' n- _ .Q, 11. Property Sewer Line &;Hcuseb6nnection' _ ; Q U' Backwash &_Rete for -Finch ' ' p ;' - ! n ,62. a 12. Sewer Cap X63. Heater & Vent Firial r c 13, Roof;Drain's I n f ) + S i '64. Plumbing:5yste-m Final t 1 1 j 14. Rough Plumbing 4 "65. Electrical -Final= 115: tRoiugh-Electrical'-C6nduit-T---I--' __T �-� __T'g6:iYSola�iSystem-Final- ` •` t - �� ` T "' "° `- -- � � - ' qr a t f 1 ring I z i i' 16. u hr-EleAr-i.c-1Wi = :--�1 ._ A- va67. Fencing'&'Acce_s lInR :I I 17, jRough'Wiring',Sign;� •" ' f( �'tn �'"!' ; i f j 68.+ ,4PRROVED FOR-P,L;4STERING , 18: iRoughTElectrircal-TiBa� Ceiling• 1 1s = ' I u' j' t" �69. POOL/SPA SYSTEMS FINAL I 1 ? c� i , u �, -� r I +' " 19. iFRoa1Neating & Airtonditioning i i ' I :_' y I & I i +FIRE DEPT.JREQUIREMENT:'� • - ' ' APPRQVALS� Permit��- 20. }Rough�Factory Fireplace j j- li li I € 11 7 n a 2"1, Ducts,,in Structure's iI ! I l I i 70.+ Underground Hydro i� Y. �Ructs, Ven#ilating {i� Product Piping D Gas B Oil i ,.23. •�GasnPipe Rough & Test }72.1 Underground Flush ? (Rdof Framing 'Q' ;7$.,t Undergrnd. Storage Tank;'E]'Gas_© Oil i I h ❑� t I i �� I ' f h - ' 5- ,Roof Sheathing j i Ilc? ;(� i , I - l I 74.' Overhead Hydro _ _ I -•-•,-�1 J .n ,� € I 3 .I . i : - ! r. t I C•, - 1 1 - i R-26. iT Bar Ceilil g (Str`uctural) & Moiiocoat' € 31 € v Dry Chemical - .[�-- I 1 ,r". ' 'Fr me and Flashin I ' i r27. a g, ;; € I , i Dry Standpipe : :ice 4 -I r i - + +. r ! �) ! + 176. Y + t IS t I 1 Y '1 1 J 1•" i i r• S 28... Lathing 8i'Sidingi r: {� '�, I ; 3- i. • r F. IXED SYSTEM;FINAL I I .. I )77. t 29.�,Insulation ' `�' I(� } 178: FIRE PR EV. FINAL => � F 1 : ,I n t 3 �Z' • I { 1 I I� I 11 i =30. Dryviraltl Nailing l s!� l ! f �S - I Y (^Y , INotesk + _ 1 1 `B a.tZ I<.aster � t € I II ' 31. (PlCoat i _ > rown -I --r- - - -1 - ,�_ r .'- I_ _.' ._ _'-_ .. - -_ '•-t^- - -1"_-___ - 5 32. 'VectricaI Power Meters Firial ;I i 1 ; 1 ! �- j f i j I t 33. Final Electric 34. Final Heating &:Air Conditioning `l. 35. Final Gas 6e_4est` 36. Hood Eor'Canopy 4' �; =` j t1 r, �• - �- I 37. Final Factory 1 '1-46 Fi'r"eplace!lt, 36. Final Plumbing 39. Water�Service-Final ; -f, 40. Gas Service -Final 41. SolarDj.omestic-FinalAT 42. Backflow Pre' venter ''� 43. Backflow Irrigation 44. Landscape IrrigationSystem; 45. Sounds Atienuatiori I r. i�it '. i - n e 46. Handicap Regulations! - c ' i.• ' .- .y •� r -� I ?I. f, 47. FINAL STRUCTURE & Bi11LDING ' I -�{ t .I I Y 48. Special Req6ire6n'ts Completed 49. Electric Release' Edison 50. Gas Release to Southern California Gas Co 51, CERT;IFICATEOF, OCCUPANCY , s � No�x`n j/:Q Date � 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. G'ITY. QF COSTA MESA �`�_� r P MIT TRACT NO. LOT NO.B CONSTRUCTION PERMJT ;P'! err Tr Project Address TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR [� 'Applicant's Mailing Address. ' L a I j ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# ' Zane // i-Phon DESCRIPTION OF WORK Owner's Name edb - - Sr Main Building: Accessory Building:- Z E O Address TYPE OF PERMIT GRADING .0 FOUNDATION LJ STRUCTURAL T Front N Arch/Eng: License No. ❑ TENANT ❑ ELECTRICAL D. PLUMBING ❑ MECHANICAL B 1 ` `VY ` Address ❑ ,OTHER A Rear N G O G 3{s `� C Right Contractor's Nam S t�'�"+ � hon �dd PROJECT DESCRIPTION Sq. FT. OCCUPANCY R f I� Address (mailing] �T CONSTRUCTION TYPE - VALUATION $ S Left E _ City License No. 7u, ZONE GRAOING CU.YOS- ACRES Ping. Ref. # Park.Fees $ Q U r LICENSED CONTRACTOR DECLARATION Remarks: , Parking Req.lProvided ) I hereby affirm that I am licensed under provisions of Charter 9 (commencing R with section 7000) of Division 3 of the Business and Professions Code, andUse of Building: _ E my license Is in full fo ce and effect. eI 741 �s 7 Planning Nates: M License Class s ens No, y PLUMBING FEES g E 0. to��Zgr�SSlgnature NOR / Bar Sink Showers N KERS' COMPENSATION RATION _ T I hereby affirm that I have a Corti ' ate of consent to self -Insure or a certificate Backflow Preventer Service Sink Jf S of Workers' Compensation Insurance,- or -a certlfled-copy thereof (Sectlor - 3800, Lab. ) `.r L I Backflow Irrigation Sewer Cap " ELECTRICAL FEES Policy No, Compan +F• - Certified copy is hereby furnished, Bathtubs Sewer Connection Automatic Washer Transformer ❑ 15-50 KW Certl IC c y is flled with the cit iltling�iv ❑ 50 + KW nate _� ��] Applicant Clarifiers Solar Collectors Construction PpleSub, EXEMPTION FROM WORKERS' C ENSATION DECLARATION (Thissection need.not be completed - he permit is for one hundred ($300) or Dishwasher - Solar Piping 9 Coo Unit g Meter ❑Up t0 100 amps " { less). I certify that �in-the performance of the work for which this permit is issued, I- Drinking Fountains g Solar Tank Dishwasher Meter Cover 100 amps shall not employ any person in any manner so as to become subject to the ' Workers' Compensation Laws of California. w Floor Drains Swimming Pool w/Spa 'Dryers ❑Gas CElectric Sub Panel pato Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks Urinal .FanMotors ❑0-1 HP C31% - $ ' Workers' Compensation provisions of the Labor Code, you must"forthwith - , - + comply with such provisions or this ,permit I shall be deemed revoked., Gas Service Outlets - Water Closet F.A.U. _40' Inc. Solar ❑9-15 HP ❑ 16.15+ CONSTRUCTION LENDING AGENCY - I hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater. Fixtures �% Microwave of the work for which this permit, is Issued .(Section 3097 Civ. C.) Lender's Name Kitchen Sink 4 Water.5ervice Device Boxes".. 1) 's lPole Light Lender's Address OWNER BUILDER DECLARATION - c Lavatories •-� , s Outlets y� Range I hereby affirm that I am exempt from the Contractor's License Law for the f following reason (Section 7031:5 Business and Professional Code: Any city or P—Trap, p - _• • r �,i• Switches - &ign county which requires a permit'to construct, alter, improve, demolish or repair , I any structure, prior to its issuance, also requires the applicant for such permit _ - Roof Drains _ r Garbage Disposal !Standing Sections 7 file assigned statement that he/she Is licensed pursuant to the provisions of ie Contractor's License Law (Chapter 9 (Commencing with Section 7000) of Generator 00 5 KW Elk -15 KW Trash i -Ivision 3 of the Business and Professions Code). or that he/she is exempt �. Compactor _ P therefrom'and the basis for the alleged exemption. Any. violation of Section 7031.5 by any applicant forra subjects the to a civil , permit •applicant not than five hundred dollars ($500). Reins ction•Fea Pe $25 Issue Fee = $+3 IFmore , , �ryalty of , Reinspeition`Fee $25 Issue Fee $ 3 1, as owner of the property or my employees with wages as their sole MECHANICAL compensation, will do the work, and the -structure Is not intended or offered FEES for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC. SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I ❑ ` , ' - ? , thereon, and who does such work himself/herself or through his or her own intended Canopy Type II ❑ �- Zoning,.Approved By Date employees, provided that such improvements are not or offered,for Duct - Under Ground - sale. If, however, the building or improvement is sold within one year of com• pletion, the owner, will have the burden of proving he/she did not build or im- rove for the purpose of sale). d 7 , , Application'Approved By Application.lssued By Data �' Date Duct - Structural Refrigeration System 1, as Owner of the property, am exclusively contracting'with licensed con- tractors to construct the project {Section 7044, Business and Professions Code: Duct - Ventilating ❑0 100,000 BTU ❑100,000 BTU 1 SUMMARY OF FEES The Contractor's License Law does not apply to an owner of.property who builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration rt' I BUILDING PERMIT- $ SMIP, $ tractor(s) license pursuant to the Contractor's License Law). PLAN ' CHECK $ PERMIT ❑'Lam .exempt under Sectio B. & P. C. for this reason ' Firepl/Fact, Bit, ICBG r , t r''^ '. I �,� ISSUANCE $ - .PLUMBING $ Date / Owner!i Heating System & Ducting !,PLAN+CHECK—) ^ �$ 6 i a I ENERGY P.C. $ 1 hereby certify that I have read this application and state that the above "Is 13 0-100,000 BTU ❑100,000 BT -' - -^ -i �IELECTRICAL $ GRADING $ ' Information correct, 1 agree to, comply with all'city and+caunty ordinances and' state laws relating 'to building construction, and {hereby authorize repre- , • r t i ' ff�' .r PLAN CHECK -T $ , MICROFILM $ ' sentatives of his city, t Iter upon the above-mentioned 'property for t inspection r oses,`� / Signature r � I ' + MECHANICAL, $ TOTAL FEE $1�� Reinspection Fee $25' Issue Fee i $ 3 PLAN CHECK!, $ I Drivers' i rise or,SS � CMF 0865-46 rev. 7/83 • White -Building; Canary -Applicant; Plnk -Accounting; Goldenrod - Assessor _ CONSTRUCTION AND PLING. ` APPROVALS- Permit #AN Date, Inspector K _ & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement Gt --3 :'Electrical Conduit Utility-Undrgrnd./ , 54. Forms 4:-bectrical Conduit=Undrgind, r 55. Electrical Bonding = 5. .Steel Reinforcement; 56. Rough. Plumbing & Pressure Test f ;� 6..`Electrical UFER.Grnd. �- 57. APPROVAL TO COVER-GUNITE 7. Footings _ 58. Electrical. Conduit-Undrgrnd. , 8. "Foundation 3 =� 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd- 60. Backwash Lines, P -Trap, ❑ Undrgrnd. t 10. StiZctural Floor System ;i fit. APPROVAL TO DECK 11 ..,Property Sewer Line &!-louse Connection a - 62. Backwash & Receptbr-Final 12.'Sewer-Cap .,• 63. Heater & Vent -Final 13. Roof•Drains`' - 64. Plumbing System Final •," �114-,,FiaughPiumbing'' 65. Electrical -Final 15.. Rough ectrical-Conduit - 66. Solar SYsteni•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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydra 22. Ducts, Ventilating 71. Product Piping El Gas ❑Oil 23. Gas Pipe -Rough & Test -72.. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY, 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 es: 34. Final Heating & Air Conditipnin %��•S �,�� 35. Final Gas Pipe -Test 36. Hood or, Canopy 37. Final Factory Fireplace Q.QaeZ I- 7�, , 11 38. Final Plumbing 1��$ will 39. Water Service -Final 40. Gas Service -Final Z' -♦ r 41. Solar Domestic -Final F , 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Reiease to Edison - - 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY' . No, Date , / Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. " 0TY'@j;o;OSTA MESA PERMIT NO.TRACT NO. LOT NO. BLDG. GrONS7RUCTION PERMIT 1v —,7 rre?/91• - `� J Projwt Address - �� gnplicant's Mailing Address PAC kh 4 _4 S�- -- �'IO�C' Owner's Name Phone Address Arch/Eng. License No. Address Contractor's Name m4-15 l f-) 427 iLRi Phone "- ' 12 . �— Address (mailing) S A City License No. O c�11- 7 G .2 6 - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my Ilcense,is In full force.and effect, _ License Class~ LI ren 1 } Date Signature NOR ERS' COMPENSATION OECLA'RAT ON' % I hereby affirm that I have a certificate of consent to self -Insure or a certificate 0f'Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. �J /� Policy No. l •� Company " r, �� & (_& Certified copy Is hereby furnished. Certified copy Is filed with the city Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed It the permit Is for one hundred ($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 $o as to become subject to the Workers' Compensation Laws of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such -provisions or this permit shall be deemed revoked. CONSTRUCTION, LENDING AGENCY ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permjt is Issued (Section 3097_ Civ, C,) Lender's Name Lender's Address. OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional'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 r) Iile a signed statement that he/she Is licensed pursuant to the provisions of le Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 enaity of not more than five hundred dollars ($5,00). •1, 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to'the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have rea. information Is correct, I agree to and state laws relating to buildir sentatives of this city�er Signature' Drivers' Licecde or SS� I this application and state that the above comply with all city and county ordinances' g construction, and hereby authorize repre- 1f �nt �abovo -moniionetl property for / Date TYPE OF CONSTRUCTION. LJ NEW: LJ ADD LJ ALTERATION LJ REPAIR jisp CONVERSION ❑ DEMOLISH ❑ OTHER A.P. �� E1 /t/ n t1 A _ r Automatic Washer Y Construction Pole_ Sub, DESCRIPTION OF WORK -7744-109k, $ Main Building: .+ Cooking Unit' TYPE OF PERMIT 0 GRADING FOUNDATION LJ STRUCTURAL. T Front• ❑ TENANT ❑ ELECTRICAL '❑ PLUMBING %MwrMECHANICAL B ❑ OTHER A Rear Fan _ C Right PROJECT DESCRIPTION S4. FT. OCCUPANCY K CONSTRUCTION TYPE VALUATION $ $ Left ZONE GRADINGCU.YDS. ACRES Ping. Ref-# Remarks: Parking Req./Provided Use of Building: PLUMBING FEES Planning Notes: Bar Sink Backflow Preventer Backflow Irrigatiori Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains e* Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P --Trap Roof Drains Reinspection Fee Showers Service Sink Sewer Cap I Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Outlets Water Closet Water Heater Water Service Ate. $25 Boiler Duct - Under Ground Duct - Structurat Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. BA. ICBO + Heating System & Ducting ❑ 0.100,000 BTU ❑ 100,000 BT Reinspection Fee I S25 CMF 0865-46 rev, 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type I ❑ Canopy Type II ❑ Refrigeration System ❑0-100,000 BTU ❑100,000 BTU System Repair/Alteration ' Issue Fee r" e . q Zone AccessoryBuilding: Z O N N G R E Park,Fees $ Q U ` r R E E N T ELECTRICAL FEES r Automatic Washer Y Construction Pole_ Sub, Transformer ❑ 15-50 KW ; 50 + KW .+ Cooking Unit' Meter ❑up to 100 amps Dishwasher Meter ❑over 100 amps Dryers ❑Gas ❑Electric Sub Panel Fan _ Motors 00-1 HP ❑l X 8 �'F.A-U. Inc.Solar'❑9-15 HP 016-15+ Fixtures =Microwave Device Boxes Pole' Light Outlets Range I Switches Sign Garbage Disposal Standing Sections Generator 00-5 KW 05-15 KW Trash Compactor $ 3 Reinspection Fee 1 $25 Issue Fee $ 3 FEES PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By , j Date—1 BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ $ MICROFILM $ $�- TOTAL FEE $ $ $ 3 r� �v i ! . ONsi•R UCTION AND PLANNIN h _ 1 C ,, ,•gci•�13OVALS Permit # �APPROVALS Temporary Electrical Service or Pole Date �. Inspector PL &SPA Permit # 52. Pool &Equipment Location Date Inspector 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement , 3. Electrical Conduit Utility•Undrgrnd. f 54. Forms 4o Electrical Conduit-Undrgrnd, '55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plur'nbing & Pressure Test 6. Electrical UFER Grnd. , 57..APPROVAL TO COVER-GUNITE ' 7, Footings _ = 58. Electrical Conduit-Undrgrnd, 8.' Foundation 59.' Gas Pipe, ❑ Undrgrnd., Test 9,'. Water Pipe-Undrgrnd. 60. Backwash' Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection s 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 e 16.' Rough Electric Wiring 67. Fencing & Access Approval 1 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 APPROVALS . Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating. a 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oii 25, Roof Sheathing 74, Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27" Frame and hashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29, Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Piaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final -Heating & Air Conditioning- `�G 144F 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. 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison ?" 50" Gas Release to Southern California Gas Co ,•_ 51. CERTIFICATE OF OCCUPANCY N� Date 57r I Il' -711-x, `r{er; Zone Accessory Building: Z O N N G R E Park.Fees $ O U R E M E N T Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. (11TY-Of COSTA MESA PERMIT NO. TRACT NO. LOT NO. B - I-XE)NSRUCTION PERMIT Backflow Irrigation + Sewer Cap ELECTRICAL ' FEES Project Address ' TYPE OF CONSTRUCTION 1 1 NEW ADD- ALTERATION D REPAIR Policy No. T��Company~- eCertified copy is hereby_furnlshed. i DateCer 131e �Qp t filed wifh the city B-uil�Jng DI o /` r-, Apptican �� I ❑ ❑ ❑ OTHER Sewer Cronnection] I - Applicant's Mailing Address CONVERSION DEMOLISH A.P. I Clarifiers Solar Collectors l ` Owner's Name Z/JA- �-H Phone ,[ /✓l�Prf^�0+� DESCRIPTION OF WORK 5 Main Building: Solar Piping P g ' Address �_ TYPE OF PERMIT GAADING -❑ FOUNDATION STRUCTURAL E T Front —� 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 Cavils of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of',the Labor Code, you must forthwith comply 'with; such , provisions or this •,permit shall be' deemed revoked. • CONSTRUCTION LENDING AGENCY- +- i r -, I hereby affirm that there is a construction iending agency for the performance of the work for, which, this permit, is Issued,._(SecHon 3097 Civ_ C.), Arch/Eng.' License No. ❑ TENANT ❑ ELECTRICAL• EIPLUMBING ❑ MECHANICAL B t Dishwasher P Address ❑,OTHER A• Rear Fan _ MotOrs ❑0.1 HP 1 i4 - 8 3 ^ - - - - - - - - Contractor's NamP22ri/'1" '��'('��r�/-Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Right �/� Address (mailing) � �+Z+? �l�/��rM raj eS&- . [�I-IIA- 7 CONSTRUCTION TYPE VALUATION $ S Left Pole Light : City License No. ZONE GRADING CU.YDS.ACRES , Ping. Ref. # [ LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided r\ I hereby affirm that I am licensed under provisions of Charter 9 (commencing Switches Sign 3 l \t` with section 7000) of Division 3 of the Business and Profosslons Code, and I Use of Building: \ my license is In/pil force and effect. I wReinspe�ion.Fee i $25' Issue Fee _ 'P r $'3 + _ I License Class License No. Z PLUMBING FEES Planning Notes: 9 I 1 f •pate Signature IVORKERS' COMPBNSATIO ECLARATION Bay Sink Showers 57r I Il' -711-x, `r{er; Zone Accessory Building: Z O N N G R E Park.Fees $ O U R E M E N T I hereby affirm that I have a certificate of consent to self -insure or a certificate of, Workers' Compensation Insurance, or a certified copy thereof (Section Backflow. Preventer I Service Sink 1 -J S , Backflow Irrigation + Sewer Cap ELECTRICAL ' FEES 3800, tab. C. _ Policy No. T��Company~- eCertified copy is hereby_furnlshed. i DateCer 131e �Qp t filed wifh the city B-uil�Jng DI o /` r-, Apptican �� I Bathtubs I. Sewer Cronnection] I - Automatic Washer ' I Construction Pole Sub. Transformer ❑ 15>50 KW ❑ 501+ KW ' I Clarifiers Solar Collectors l WORKERS' C PENSATION DECLARATION EXEMPTIONneed t Is for one hundred {5100) or (This section not be completed if the Perm -it Dishwasher' Solar Piping P g ' Cooking On Meter 120up to; 100 amps - S ^— 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 Cavils of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of',the Labor Code, you must forthwith comply 'with; such , provisions or this •,permit shall be' deemed revoked. • CONSTRUCTION LENDING AGENCY- +- i r -, I hereby affirm that there is a construction iending agency for the performance of the work for, which, this permit, is Issued,._(SecHon 3097 Civ_ C.), Drinking Fountains Solar Tank t Dishwasher P ,Meter Dover 100 amps Floor Drains, Swimming Pool wisps + ' Dryers ❑Gas • ❑E[ectric Sub Panel I Floor Sinks • Urinal Fan _ MotOrs ❑0.1 HP 1 i4 - 8 3 ^ - - - - - - - - Gas Service. 3 -Outlets; Water Closet ) - r� F,A,U.:`•' :Inc. Solar�09-15 HP ❑ 16 15+ .•l - + - Interceptors' r Water Heater I - Fixtures' l Microwave I Kitchen Sinks = Water Service A Device Bpxes Pole Light : Lender's Name Lender's Address ) OWNER BUILDER DECLARATION - -• - I hereby affirm that I am exempt from the Contractor's License L.aw for the following reason (Section 7031.5,Business and Professional Code: Any city or county which requires a permit to construct, alter. Improve, demolish orrepair any structure, prior to its -issuance, also requires the'appllcant for such permit + file arslgned statement that he/she is licensed pursuant to'the provisions of e Contractor's License Law, (Chapter 9'(commencing with Sectlon 7000) of Avision.3 of the Business and Professions Code) or that he//she is exempt7 therefrom and the basis for the alleged exemption, Anyviolation'of Section 7031.5 byIany-applicant for- al permit'subjects Ahe -applicant to 'a civil anally of not more than five hundred dollars.($50Q). I, as owner of, the property or, my employees with wages as their sole compensation, will do the work, and the structure -is not Intended or offered for sale' (Section 7044, Business and, Professional Codev The Contractor's License Law does hot apply to an owner of a property who builds or improves thereon, andiwho,does such work himself/herself or through his or her own employees, provided that such' Improvements are not 'intended or offered for sale. if, however, the building or Improvement Is Sold within one year of com- pletio,, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with ilcensed con- tractorsto construct the project (Section 7044, Business and Profession$ Code: -The Contractor's License -Law does not.apply-to an.owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law), I t ❑•.I am exempt under Section B. & P, C. for this reason -'_ Lavatories-• .. , '� 1 I _ - Outlets - Range �� _ I P -Trap Switches Sign 3 l _ Roof'DrainsGai'bage,Disposal - - + Standing Sections I _ f+• I I f r " Generator 13075 KIN EJ 5-15 KW Trash Compactor I wReinspe�ion.Fee i $25' Issue Fee _ 'P r $'3 + _ I Reinspection Fee $25 Issue Fee $ 3 ;MECHANICAL FEES gpileT '` � Ho ❑ od or Type I ' .-, Canopy Type I! ❑ If SERVICES REQUIREMENTS: PUBLICr' Zoning Approved By ' Date � 1 ; Appliciition Approved By Date Application !'slued By Dat ' zeA EP 1 Duct - Under. Ground I I Duct - Structural Refrigeration System r + ❑4100,000 BTU ❑ 100,000 BTU Duct - Ventilating ,r f{ i� :BUILDING PERMIT $ `L i,PLAN;CHECK $ PLUMBING $ PIAN CHECK $ , l _�' ELECTRICAL $ PLAN;CHEGK $ MECHANICAL $ PLAN CHECK $ SUMMARY OF FEES SMTP $ I PERMIT ISSUANCE $ ENERGY P.C. ' $ r O GRADING $ �, 'O MICROFILM $ TOTAL FEE $ ' _ _ Exhaust System ❑ Multiple ❑ System Repair/Alteration I Firepl/Fact. Blt. ICBO # Date I Owner ) I Hereby certify that I have read this application and state that the above Information is correct. I agree'to comply -with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- $entatives of this. city to enter- upon the above-mentioned property for SignaturDatgi� Inspecti�A� Drivers' Heating System &Ducting I ❑0-100,000BTU ❑1oo,0o0BT - I - i �' Reinspection Fee $25• Issue Fee $ 3 Goldenrod - Assessor - - CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; + CONSTRUCTION AND PLANNING - APPROVALS . Permit # Date Inspector P, .& SPA- APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location r 2.' Soil PW-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduil.Utility•Undrgrnd. 54. Forms � 4. Electrical -Conduit Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6• electrical UFER Grnd, 57, APPROVAL TO COVER-GUNITE 7. -Footings { 58. Electrical Conduit-Undrgrnd. 8. Foundation r 59.. Gas Pipe, ❑ Undrgrnd.; Test 9. 'Water Pipe-Undrgrnd.; � 60. Backwash Lines, P-Trap, ❑ 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 r 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank' ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Coiling (Structural) & Monocoat. 75, Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREY, FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ,31. Plaster Brown Coat • S 79, FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes'. 34. Final Heating & Air Conditioning r•�Z L� 35. Final Gas Pipe-Test C 36. Hood or Canopy i 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 47, FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. - y CITY OF COSTA MESA T PERMIT NQ TRA NO. LOT. NO. B}D orl- t CONSTRUCTION PERMIT ( - j (u/ r ' Applicant's Mailing Address TYPE OF CONSTRUCTION ' NEW ADD- ALTERATION REPAIR 7G39 �l% t g�OJ�; 295+{7FJ + TE. q 3151 -Airway U 2. Costa Mesa' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Project Address Tenant Im �E Owner's Name �_�_ trona 7527670 DESCRIPTION OF WORK rovement= _ —ZONING Address 1601 Dove #200, Ne port each - G Tom Campos a Assoc. TYPE OF PERMIT' GRADING FOUNDATION STRUCTURAL A. P. gl+• 20NE Arch/Eng. License No. ' ® TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL . PLNG. REF. 7W' BUILDING Address _17779 ' "Main, Irvine ❑,OTHER TO BUILDING Uncial d Olson Co.p 540-2605 Contrecfor's Nemli .�]� hone 'PROJECT DESCRIPTION S:L F ' ' OCCUPAI� Y P Y INE REAR (TO P/L) 6 Address (mailing) 3151 Ai rwa�+ Ave. E-1 CO P'1e$a CONSTRUCTION TYPE L U8000 VALUATION $ s LEFT SIDE YARD IDE YA = -Ste } - ZON) + RADINGCU.YDS. ACRES PKG.SPACE 'REQ. i PR License No. ON LICENSED CONTRACTOR DECLARATION ; Remarks; G � �/ 7/s� STREET WIDTH PARK FEE $ I hereby.affirin that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and I SPECIAL CONDITIONS. t7rV �� d73 my Ilcense.ls In ful orce and effect, 1 333959 l P69.�7 �G9A7' C7�4iy --4 Lice", Cla:' Lice PLUMBING 1Y 62 76 MDate ' Signature Bar Sink Sewer Cap,- ELECTRICAL ; b \ WORKERS' COMPENSATION DECLARATIQfA nsure or a certificate t hereby affirm that I have a certificate of consent to self -Insure B ackflow Preventer Sewer Connection -- Automatic Washer Meter El over 100 amps .. . Workers' Compensation Insurance„ or a -certified copy thereof (Section ti Construction Pole Sub Panel 00, Lab. C _ I F�/� ` ,Q� No_ Company /'^ T Backflow Irrigation Solar Collectors - i Ncccirrcop Is hereby furnished. BathtubsSolar pipingtf Cooking Unit Sub Poletifie i o IS filed with the city Bull g DI Clarifiers Solar Tank Dishwasher Motors ❑0 1 HP ❑ Pfr$ r Date Applicant EXEMPTION' ROM WORKERS' COMPENSATIO ECLARATi _ Dryers ❑Gas ❑Electric --' Inc.Sclar ❑9-15 HP ❑16-15+- Dishwasher Swimming Pool w15pa 16 (This section need not be completed (t the permit Is pr one hundre ($100) or iess). �- I certify that In the performance of the work for�whieh'this permit ]s issued I In to become to the k Drinking Fountains , - Urinal Fan Microwave shall- not employ any person any manner so as subject. Workers' Compensatlom Laws California. Floor Drains - _ I F.A.U. pole Light •�' of I Water Closet Date Slgnatiire NOTICE. If; after making thts-dectaration,-you should become subject to the-- Floor Sinks , - Water Heater i ' - Fixtures Range _ Y Workers', Compensation provisions.of the Labor Code,.you-must,forthwith comply with such provisions:" or ' this ,permit . shall be deemed revoked:: ' ) Gas $entice : Outlets Water Service .. t Device Boxes Sign r , ! CONSTRUCTiON'LENDING AGENCY' 1 hereby affirm that there is a construction lending agency for the performance. Interceptors L - Outlets Standing Sections I 1 of the work for _ this; permit Is ; Issued {$action 3097. Civ. C.) , Lend6r'sI Name . 2V KiichemSink' Switches Trash Compactor Lender's Address _ ' .- - .• ! - L '. i. ' Lavatories - Garbage Disposal OWNER BUILDER DECLARATION 1 : 7 I hereby' affirm that I am exempt from the Contractor's•License Law for thep-Tra Generator 00-5 KW ❑5-15 KIN p - following reason. {Section -7031.5 Business and Professional Code; Any city or county which requires a permit -to construct, alter Improve, demolish or repair Transformer ❑ 15-50 KW any structure, prior to Its issuance,.also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains ❑5U+ KW• the Contractor's•L)cense•Law (Chapter 9 (commencing with Section -7000) of Showers - Reinspection Fee $15 Reinspection Fee $75 Dlvislon . 3' of the Business' antl Professions Cade) or that he/she, is exempt and the basis for the alleged exemption. Any.vlola lon of Section Meter ❑up to 100 amps Issue Fee $ 3 ;,-yefrom ,1,5 by any apgllcant for a permit'.subjects .the • applicant to a civil -?' 'lalty of not more than five hundred dollars $500): rr ( K Service Sink 1 i Issue Fee ; 3 ; Zoning Approved By Date _ LJ I,' as owner of- the iproperty or' my employees with wages as their sole compensation will -do the work, a_nd,thestructure Is not intended or offered 1 MECHANICAL I Application Approved By ' Data /�9/�3 ; 7 for sale'(Secflon 7044, Business and, Professlonal Code; The. Contractor's Ll cense Law does not apply to an owner of a property who builds or improves 'does,such ', Boiler- + Refrigeration System 1 Application Issued B PP y - Data ' thereon,land who work himself/herself or through his or her own employees, provided that such' improvements are -not Intended or offered for building improvement Is sold within one of com- t Duct '= Under;Ground ❑0.100 000 BTU ❑ 100,000 BTU ' , I SUMMARY sale. If however, the or year pietlon, the owner'will have the burden of proving he/she did not build or Im- for the - Duct - Structural I System Repair/Alteration n' OF FEES - 2 Z.mD E # ? J rove purpose of sale). , is licensed BUILDING PERMIT $ _ SMTP I $ I owner of the property, am exclusively contracting with con- _tractors to construct.the project (Section 7044, Business and Professions Code. _ _ Duct - Ventilating _ I _. tPLAN CHECK ; $ ; PERMIT The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑: , + PLUMBING $ - ISSUANCE . 4 $ 1 tractor(s) license pursuant to the Contractor's License Law). 1 El PLAN CHECK. $ GRADING ! $ ' l=am exempt under Section B. al. P. C. for this reason Firepl/Fact. Bit. ICBG 9fE , I , Heating System &Ducting ' , ELECTRICAL $ MICROFILM $ $ Date owner 1 hereby certify that -Ir have -read this -application and state'that-the above 00.100,000 BTU 13100,000 BTL ( PLAN CHECK $ I t t Information ls'correct, I agree to comply with all city. and county ordinances r 'MECHANICAL TOTAL FEE ` $ i ' and: state' laws' relating to building construction „and hereby authorize repre- sentatives of this ity enter, the above mentioneq property for 0urpo H6od or Type I ❑' ) I Reinspection Fee $15 t t LESS rt Inspection + i { � f%83 Cano T e 11 ❑ ! PLAN CHECK; $ l 1 ADVANCED PC I $ i signature Dete�%f ' Registers Issue Fee $ 3 r i Drivers' Llcense or S5 , �' FINAL FEE ; $ CMF 0865.46 rev. 12182 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor. / �-CONSTRUCTION AND PLAN 1 G:..:',POOL f = APPROVALS Permit # Date^ _ Inspector r = , APPROVALS Permit;* Date I rispector; r 1. Temporary Electrical Service or- Pole ;,N ' - " '52" Pool. & 'Equipriient' Location' N 2! Soil Pipe-UndrgrndJ s = - u- I r `', i , g 53° Ste eE Reinforcement ' 3' Electrical Conduit Utility-Uridrgrnd.' 54., Forms'„ 1 - m Electrical Conduit-Undrgrnd? c ".; xr �� I 55.' ElectricalcBonding C, -V 5. Ste'el'Reinforceme-nt- ; ' > -`_ �• 56; Rough; Plumbing & Pressure Test , ^; ,; 6. 'Electrical UF Grnd. ' -�. - 57� APPROVAL TO COVER:GUNITE= - 7. Footings; = s" - �'Q '' �: ' 58. Electrical.Conduit Undrornrf-_- c a 8. Foundation Gas Pipe Uridrgrnd:, Test ` 9. Water. Pipe-Undrgrnd. i I c ;; `:� i ;60. Backwash'; Lines, P-Trap, Ll Undrgrnd. 10. Structural Floor System-61. APPROVAL TO DECK 11. Property Sewer Line &'House Connection5 T , 62. Backwash &,Recepfor: Final r 12. Sewer Cap '63. Heater &Vent Final + 13, Roof _ �" o Plurhbing-Syste`m - Final �c (Drains ,64, r 14. Rough Plumbing ! i - :r 45. Electrical`Finel� '15. "Rough Electrical- Conduit i Th I t I ` -1 i 66`, Solar Syss em-Final `^ "1.6_' Rough Electric Wirings „• + f + fR r�, -67• Fencing &=Access Approval - ' 17.. Rough'Wiring Sign'v _ 68. APPROVED FOR PLASTERING ,r ?' - , �rtr - i L ' r t _ a , - - � 1 It 1 " 18.-Rough_ElectricalyT Ba'r:Ceiling ,],- i i ! � i'; I i� I 69.• POOL/SPA SYSTEMS FINAL i r 19: Rough' Heating &Air Conditioning ( j ( ' ( FIRE DEPT. REQUIREMENT APPROVALS, Permit, 1 r q 20. Rough FactoryFireplace) i i y ; ` l 21. Ducts, in Str'.ucture - 1 ` , , •, ' 1 ' 70.t Underground Hydro + I ' _ I• � G22 Ducts, Ventilating I I 1 I ,7i.R Product Piping 0 Gas ❑ Oil �2I-bas Pipe-Rough & Test 72. Underground Flush+ ;,`-24 • Roof Framing; ��, � ! •� '� ;Z 73.. Undetgrrid. Storage Tank ❑Gas. ©Oil r , I a 25 Roof Sheathing !r74.` Overhead Hydro , 1 , ! p 26: 7-Bar Ceiling {Structural}, & Monocoat` " ! ` r 75, Dry Chemical ! z' ;-27. Frame and Flashing „ 76.' Dry Standpipe i ! + .I 28. Uthing &"Siding ,_ r, iF i ' j +77.. FIXED SYSTEM FINAL i 29, insulationi78.. FIRE PREV,. FINAL t -30' Drywall Nailing I , ! i ' I S I ��, !� Notes: i i - Coat., ; _...r- J_, 1 rM31.,PIas#er;Brovvn ,I L32' electrical Power Meter}Final 'I r 33! Final Electric 34. Final Heating &'Air; Co'ndition'ingE u ' t , 1 35. Final Gas Pipe-Test' ,., . �1 s i' : I - - ' , I •_ + I ,. _ :. 36. Hood or Ca'nopy'. 37. Final Facto y Fireplace ' ` I }1 k' i Imo' 38. Final Plumbing CS 39. Water Service-Final, + ( I i Ic I r i 1 i 1 _{ 40. Gas Service-Fina! t 41. Solar Domestic-Final 42. Backflow,Preventer, �; y ! i - -r - 43. Backflow- Irrigations 44. Landscape Irrigation:_System i ' 'T i , i „ j 45. Sound Attenua_tiori 46. Hand icapiRegulatI ns l -' i j I r 47. FINAL) STRUCTURE &-BUILDING ^ f I + I ^ tt t 48. Speciate Requirements Cornpletedl 49. Electric Release to Edison':+ ( I l ' i _ ' ,• I - _ _��__ _' -- - i-- 50. Gas Release to Southern California Gas Co 51. CERTIF[CATEOFIOCCUPANCY _Fi :• No. llCf�jEcs ' Date , CITY OF COSTA MESA CONSTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border lines and sign all approorlate declarations. PE IT NO. TRACT NO. LOT NO. BLU NU IL Applicant's Mailing Address13e1W A-- �� r Project Address -:3 Owner's Name _CZ, Zr s 9 Ly — - phone o- Address 3Z rz:% .Q -$Me r7 'i�-- Arch/Eng,License No. Address Contractor's Nam rr�y ?�;xZ/ ew — QTk hone Address(mailing) ZC�� •!'�!/0 �}�IQ License No. �Sy LICENSED CONTRACTOR DECLARATION I .hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in i frorCAancl effect. Licen lass $e Date Signature WORKERS' COMPE TION D CLARATION by difFrm t have a certlT Of consent to Sure or a Certificate Workers' mpensation rants, or a ter copy thereof (Sectio Poli o. pony 'C ertified c [s hereby fur ad. Ce Ifi S1py i f J wit the city. I Alvis Date 41 Applicant e EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed It the permit Is for one hundred ($100) or less). I } 1 certify that In the performance of the work for whI thls permit is sued ,I shall not employ any person 1n any manner so eco b to lire Workers' Gpmp ti ws of Callforn Date f_?.Signature Vd ':� NOTICE; If, after making this declaratitin, you should become sub ct to Workers' Compensation provisions .of the Labor Code, you must forthwith comply with such prdvlsions or this permit 'shall be deemed revoked, CONSTRUCTION LEF40ING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which- this. permit is issued (Section 3097 Civ. C.) Lender's Name Lender's' Address— OWNER BUILDER DEt i_ARATION I hereby, affirm that I am exempt from the Contractor's License Law for the following reason (Sectign 7031.5 Business and Professional Code: Any city or County which, requires a permit to construct, alter improve, demolish or repair any structure, prior to Its,lssuanCe, also requires tate applicant for such permit to file a signed statement that he/she IS licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of r%lvlsion 3 of the Business and Profession$ Code) or that he/she Isexempt Irefrom and the basis for the alleged exemption. Any violation of Section 31:5 by' any appliCent for a permit. subjects the applicant to a, civil dnalty of not more than five hundred dollars ($500). b 1, as owner of the property Or my employees with wages as their Sole compensation will. do the work, and the structure Is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who doe$�Such work himself/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 com- pletion, the owner will have the burden of proving he/She did not build or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thePeon, and who contraCts tar such project$ with a con- tractor(S) license pursuant to the Contractor's License Law), ❑ 1 am exempt under $action B. & P. C. for this reason Date Owner I hereby certify that-? have read this application and state that the above Information Is correct. I agree to comply with all city and county ordinances and. state laws relating to b (ding construction, and hereby authorize repre- sentatives of this city to r up a Bove -mentioned property for ' fnspectlo Signature Date Drivers' L nse or SS iv I I LL 4-x.1. e P OFCONSTRUCTION NEW LJ ADD LJ ALTERATION U REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT GRADINGFOUNDAT ON STRUCTURAL El TENANT ❑ ELECTRICAL El PLUMBING ><MECHANICAL ❑ BOTHER PROJECT DESCRIPTION SQ. FT, OCCUPANCY' ✓j CON STRUCTION TYPE VALUATION $ ZON)= GRADING CU.YDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers v Dishwasher • ..•k Drinking Fountains Floor Drains' Y Floor Sinks ' Gas Service Outlets Interceptors Kitchen Sink ' Lavatories P—Trap Roof Drains Showers Service Sink VIBING Sewer Cap Sewer Connection' Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater 'Water Service Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46 rev. 12/82 White - Building: Canary - Applicant; Pink - Accounting. Goldenrod - Assessor Meter EJ up to 100 amps Issue Fee 3 Zoning Approved By Date Application Approved By .�Q ate Application Issued BY -- �✓ -- -- -- Date Boiler ` ZONING r I A. P. 0 ZONE PLNG. REF. yY+ BUILDING Arlie TO BUILDING P I YNE REAR YARD ITA P/Ll LEFT SIDE YARD RIGHT SIDE YARD PKG.SPACE REO. PROVIDED STREET WIDTH PARK FEE S SPECIAL CONDITIONS: $ GRADING a ELECTRICAL ELECTRICAL Automatic Washer Meter Clover 100 amps Construction POIe Sub Panel Cooking Unit Sub Pole , Dishwasher Motors 110-1 HP ❑l" ., Dryers ❑Gas ❑Electric Inc.Soler 09-15HP 1116-15+ f Fan' Microwave F,A,U, " Pole Light Fixtures 'Range Device Boxes Sign Outlets Standing Sections Switches Trash Compactor ' Garbage Disposal Reinspection Fee Generator 065 KW 05-15 KW Transformer ❑ 15.50 KW 05U + KW' I Reinspection Fee $15 CMF 0865-46 rev. 12/82 White - Building: Canary - Applicant; Pink - Accounting. Goldenrod - Assessor Meter EJ up to 100 amps Issue Fee 3 Zoning Approved By Date Application Approved By .�Q ate Application Issued BY -- �✓ -- -- -- Date Boiler ` SUMMARY OF FEES Refrigeration System 0O;t00,0006TU ❑i00,000BTU 'BUILDING PERMIT $ SMIP Duct - Under Ground PLAN CHECK Duct - Structural PERMIT System Repair/Alteratioh PLUMBING $ ISSUANCE Duct - Ventilating PLAN CHECK $ GRADING a ELECTRICAL Exhaust System ElMultiple ❑ $ PLAN CHECK $ MICROFILM Firepl/Fact. Bit. ICBD #Heating MECHANICAL $ TOTAL FEELESS $ PLAN CHECK System & Ducting E3().100,000 BTU ❑ 100,000 f '�� ADVANCED PC $ FINAL FEE - Hood or Type I ❑ Canopy TVpe 11 ❑ Reinspection Fee $15 Registers Issue Fee $ 3 CMF 0865-46 rev. 12/82 White - Building: Canary - Applicant; Pink - Accounting. Goldenrod - Assessor Meter EJ up to 100 amps Issue Fee 3 Zoning Approved By Date Application Approved By .�Q ate Application Issued BY -- �✓ -- -- -- Date SUMMARY OF FEES 'BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ GRADING S ELECTRICAL $ $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEELESS $ PLAN CHECK $ f '�� ADVANCED PC $ FINAL FEE - {� CONSTl�l3CTION AND`PLANNING. ' 7 ": �' -POOL-, A _ f Date •si -APPROVALS �; Permit # �O-' r . Inspector _ : r e -APPROVALS Permit # Date Inspector, �a 1. Temporary Electrical Service or.Pole �' '} ? ' •+ -'52:' Pool & Equipment Location - /. 2: Soil Pipe-Undrgrnd: - a �•' :; = 53 J Steel Reinforcement '+ X Electrical Conduit.Uiility-Undrgrnd.. �. - -' - 54 Forms 4. Electrical Conduit-Undrgrnd: - x� +^ :'55: Electrical Bonding _ 5' Steel Reinforcement r / `' - • 56. Rough Plumbing &Pressure Test 1 , . !r 6: `Electrical UFER Grrid. R 1-� !` " 57.' APPROVAI'TO COVER GUNITE r .; - ' 4,- 7. Footings �' .. 58.' Electrical:Conduit Undrarnri.- f ' 8. Foundation Gas Pipe, 0 Undrgrnd:; Test 9. Water Pipe Undrgrnd. r ,60. Backwash Lines, P-Trap, El Undrgrnd. 10. Sductural Floor Sysiem / 61. APPROVAL i0 DECK ' 11, i rgperty. Sewer Line. & 'House Connection, :L 62. Backwash'& Receptor-Final ` y 12. Sewer Cap 63. Heater &Vent-Final 13. Roil Drains - �=Fr7- 64. Plumbing-System - Final - `� �- 14. Rou l4lumbin r 9 9 � i , r''�65. ' Electrical-Final F 15.`.RougFi Elect�icai=Contluit^-- �' 66.Solar System Finaliiou h electric Wirin 1: _ g tr g i + _d-, ? � ' `ri ___�, � 67,. Fencing &AccessApproval1�Raugh Wiring Sign_ 4' = ! ~_ i t `68.1 APPROVED FOR PLASTERING 1T'fRough ElectrirahT Bar` Ceiling _ - 69., POOL/SPA SYSTEMS FINALAough_Heating &.Air Conditioning i { FIRE DEPT.;REOUIREMENT20"'.08u : ; Permit-21. h. Factor Fire laceAPPROVALSg Y P Ducts, in Structure ; { 70.r Underground Hydro ,,22. ;Ducts, Ventilatin � g - LC I � 71.i Product Piping � Gas ❑Oil''1,23. I Pipe-Rough & Test - '!1 T f 3 72. Underground Flush1I24. ,Gas Roof Framing u < i , , 73. Undergrnd. Storage Tank'❑ Gas © Oiln t 25.Roof Sheathing 74.1 Overhead Hydro26. T-Bar Ceiling (Structural) & Monocoat { t'75. Dry Chemical 27. ;Frame and Flashing ' I I { + 76. Dry Standpipe28.Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 3R? Drywall Nailing , ! + Notes' Brown Coat , ,Plaster 3 %EleciricairPower Meter-Final'L� .,'Final Electric , ! 4 Final Pleating &,Air Conditioning35. Final Gas Pipe=T�st36. Hood or Canopy_ 37. Final Factory Firace38. Final PI>{mbing; ! 6 ,{ I ! {139. Water'Service-Final 40. Gas Service-Final41. Solar Doinestic-Final'"k t 42. Backflow Preventer43. Backflow Irrigation44. Landscape Irrigation System'45. Sound Attenuation46. Handicap Regulations47. FINAL STRUCTURE & BUILDING48. Special Requirements Completed 49,Electric Release`to Edison - 7. 1� 50. Gas Release to Southern California Gas Co I + ', i ; • l! 1 I , 51. CERTIFICATE OF, OCCUPANCY �. '._ , _ _ - _� 4 (i,f No. i' L Date 0 C.AOF COSTA MESA CONSTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERM T NQ. � TRACT NO. LOT NO. BuLD- 7 Applicant's MailingAddress t I b� �`��+�'¢ ��, ,� CONSTRUCTION NEW ADD ALTERATION REPAIR Backflow Irrigation 315-/ / A I t 0A AVE- ONVERSION ❑DEMOLISH ❑OTHER r�:F L[ Certlfletl cop 1 Iled wlth the clty.Building Division. Date ZO Applicant EXEMPTION:FROM WORKERS' COMPEN5ATION.DECLARATION (Thls section need.not be completed If the permit Is forgone hundred ($10D) or : Clarifiers Project Address 1 Owner'sName rd`^'V !�N S hone CRIPTION OF WORK 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 tlte' Floor Drains Workers': Compensation Laws of California. Date ISignature NOTICE: If, after making this declaration, you should become subject to the . Floor Sinks - -- Address 3!s l AeMf L AVe l 2" TYPE OF PERMIT GRADINGEl FOUNDATION El STRUCTURAL 0 TENANT ❑ ELECTRICAL ® PLUMBING ❑ MECHANICAL A. P'. , Arch/Eng. License No.,7 Date Owner Interceptors - I hereby certify -that I have read this application and state that the above information is correct. 1 agree to comply =all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter - upon the above-mentioned property for PLNG. REF. Address❑,,OTHER Contractor's Names Y�/ 4, L -co 174_LLA1f31rJEr Phone k 11 PROJECT DESCRIPTION SO. FT, OCCUPANCY TO BUILDING PE Y I E Showers - Address (mailing), Il ail (1-4rrd 110)4L C-19 (,3.6 , CO N STRUCTION TYPE VALUATION $ LEFT SIDE YARD y Q s 8 License No. �� - - -- ZONE GRADING CU. YDS. ACRES E PKG, SPACE RQ. LICENSED CONTRACTOR DECLARATION i Remarks: STREET WIDTH I hereby affirm that I.am licensed under provisions of Cherier 9 (commencing with -section 7000) of Division 3 of the Business and Professions Code, and SPECIAL CONDITIONS: My license Is In full force and effect. z 40Q-7 tl),� .... License Class L Ic se No. Date Li—7-6 -83 Signature . WORKERS' COMPENSATION DEC RATION 0 • - ',ereby affirm that I have a certificate of consent•'to selfanSure or a. certificate Workers' Compeq t sur ceor a c fled' copy thereof (Section`; 00, Lab_ C'.)`�,f�s r�2��10 Policy No Company 01 X10 �hSL�cr Bar Sink Backflow Preventer Backflow Irrigation Bathtubs 1pG, 6rtlfled cop is hereby furnished, j r. L[ Certlfletl cop 1 Iled wlth the clty.Building Division. Date ZO Applicant EXEMPTION:FROM WORKERS' COMPEN5ATION.DECLARATION (Thls section need.not be completed If the permit Is forgone hundred ($10D) or : Clarifiers Dishwasher f Drinking Fountains 9 ' 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 tlte' Floor Drains Workers': Compensation Laws of California. Date ISignature NOTICE: If, after making this declaration, you should become subject to the . Floor Sinks - -- Workers' Compensation provisions of the Labor Code, you must. forthwith Gas Service Outlets comply with such provisions or this permit shall be 'deemed revoked. CONSTRUCTION LENDING AGENCY I 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.) Lender's' Name Lender's Address r OWNER'BUILDER DECLARATIONLavatories Date Owner Interceptors Kitchen Sink: I hereby certify -that I have read this application and state that the above information is correct. 1 agree to comply =all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter - upon the above-mentioned property for I hereby affirm that I am-exempt'from the 'Contractor's License Law for the following reason (Sectlon' 7031.5 Business and Professional Code: Any city or p—Trap p county which requires a permit to, construct, alter Improve, demolish or repair any structure; prior to its Issuance, also requires t6 applicant for such permit - Roof Dfains to file a signed statement that he/she Is licensed pursuant to the provisions of Showers - the Contractor's License Law (Chapter 9 (commencing with Section,7000) of ' tivtslon 3 of the Business and Professions Code)' or that. he/she is exempt •refrom and the basis for the alleged exemption. Any violation of, Section Sirik 31:5 by any applicant for a • permit subjects the applicant to, a- civil bService onalty of not more than five hundred dollars ($500). I I, as .owner of the property or my employees with wages'as their sole compensation willldo the work, and ,the structure is not intended or offered , for sale (Secilon 7044, Business' and' Professional Code: 'The -Contractor's 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 -Meter ©over 100 amps Construction Pole . _ goiter Application Approved By Duct - Under,Ground emploYeel, provided that such improvements are not intended or offered for ' sale. If, however, the building or Improvement is saEd within oneyear of Com- pletion, the owner will have the burden of proving he/she did not build or im- rove far the purptise of sate). w s I, as owner of the property, am exclusively contractIng.with licensed con- tractors to construct the prpJact (Section 7044, Buslness and Professions Code:, Duct - Structural Duct -, Ventilating The Contractor's License law does not apply to an owner of property who 1 builds or Improves. thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's Llcanse Law). ❑ I am exempt untler Section - B. P• C. for this reason i Fixtures '_ Exhaust System ❑ Multiple ❑ t FirepllFaCt, Bit. ICBG # Date Owner Standing Sections Heating System & Ducting ' I hereby certify -that I have read this application and state that the above information is correct. 1 agree to comply =all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter - upon the above-mentioned property for Garbage Disposal ' El 0.100,000 BTU '❑100,000 BTL Generator El 0-5 KW 115-15 KW Hood Or Type I ❑ yp Inspection purposes. Canopy Tyge SignaturaC_ Drivers' Lice or SS � Registers CMF 0865.46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor �IIBENG . Sewer Cap Sewer Connection Solar Collectors , Solar Piping ' Solar Tank Swimming Pool w/Spe Urinal ; Water Closet Water Heater Water Service Reinspection, Fee Issue Fee tAN1GAL Refrigeration System 13 a1100,000 BTU ❑ 100,000 HT U System Repair/Alteration $ 3 Wo 4/21/113 RrrIII GTInhIS - ZONE t BUILDING - SEX.,4CK C11 cr REAR YARD (TO P/L) RIGHT SIDE YARD PROVIDED PARK FEE-$ - Sub Panel Sub Pole %-8 ,Inc.Svlar ❑9-15 HP ❑16-15+ Microwave , Automatic Washer -Meter ©over 100 amps Construction Pole . Cooking Unit ' Application Approved By Dishwasher I Motors E10-10-1 HP ❑ 1 Dryers ❑Gas, ❑Electric I Fan; . . F.A.U. _ :Pole Light Fixtures '_ 'Range Device Boxes Sign Outlets Standing Sections Switches Trash Compactor Garbage Disposal ' PLAN CHECK Generator El 0-5 KW 115-15 KW I. — i GRADING , Transformer ❑15.50 KW 1350+ KW Rainspection Meter ❑up to 100 amps Issue Fee Zoning Approved By • Date Application Approved By Date I Application Issued By - Data SUMMARY OF FEES BUILDING PERMIT $ SMIP PLAN CHECK F $ PERMIT PLUMBING $ ISSUANCE PLAN CHECK $ I. — i GRADING , f ELECTRICAL $ PLAN CHECK $ MICROFILM TOTAL FEE' MECHANICAL $ LE I SS Reinspection Fee $15 PLAN CHECK $ ADVANCED PC Issue Fee $ 3 FINAL FEE .0, TL ME 0 ,'' _ ,, POOL A ''CONSTFIVCTION AND`PLA NINGi _ +_' APPROVALS Permits#= ' ' r7G ,'Date ,Inspector • `.APPROVALS Permit # Date Inspector n 1: Temp"orary Electrical Service ortPole �` _ T' , ' r 52= Pool &Equipment Location .' C1 -2? Soil Pipe-Undrgrnd: s 53. Steel Reinforcement '3+ Electrical Conduit Utility-tJndrgrnrl. I i� _ E "54_ -Forms ' 4 r 4: Electrical Conduit Undlgrrid' �? E:.: 55� Electrical Bonding 5: Steel Reinforcement ; n 1. ` = �' ` �' - 56.- Rough Plumbing & Pressure Test r ' _ 6: 'Elect'rical UFER Grnd. , ` =�= - _ 57. APPROVAL TO COVER-GUNITE 7. Footings ' -; ." `_ . 58. Electrical Conduit•Undrorn:l:_7. 'r 8, Foundation ` f = ° -' '59. Gas!Pipe, ❑ Undrgrnd:, Test _ _ - 9, Water Pipe Urdrgrnd. € _ r ' 60. Backwash Lines, P-Trap, ❑ Undrgrnd. =' , Structural.Floor System = t 61. APPROVLDECK10. '& I 11. Prpperty Sewer Line &'Ho,use Connection` t y62. BackwashReceptor Final 12. Sewer Cap- 63. Heater & Vent-Final 4 !' 13. Roof Drains _ ;'64_ Piumbing,System - Final ' 14. Rough Plumbing ` • < r °65. Electrical-Fina! ' r " 15: Rough-Electrical'-Conduit i - ` ` "'- �{ --," -•66.; Solar,System-Final Wirings I I 1, �' , w I I i -67.; Fencing & Access Approval III16::Rough-Electric 1 17. 'Rough Wining,Sig'nt' n ## + ` ; 68.' APPROVED FOR�PLASTERING i- 18.- Rough.Electrical-T',Bar.Ceiling 4! ; l J' ;' 69.;POOL/SPA SYSTEMS FINAL ` 19.. Rough'Heating &•Air Conditioning ,, I FIRE DEPT,'REOUIREMENT ^ 26. Rough Factory Fireplace, ,, , APPROVALSI Permit # _ i 21. Ducts,•in Structured , � t� � I � t � � I 70. Underground Hydro' , t, J,,22. Qucts, Ven`ilating 1- ii 0 ! 'f � i 1 l { � � 71.! Product Piping ❑ Gas 0 Oil ' 23. Gas Pipe-Rough & Test ' ;I 4; I , 72.' Underground Flush -24. ;Roof 7.3.: Undergrnd. Storage dank ❑Gas. ❑Oil " 25. Roof Shea&n.'g, 74.. Overhead Hydro -26. T-Bar Ceiling (Structural) & Monocoat-T f , f = 1 175.E Dry Chemical 27, Trame and Flashing 76.. Dry Standpipe 28. Lathing & Siding= -- i �l ii ( i I cr I i .77.t FIXED SYSTEM FINAL N - I - •,9.�,lnsulation '478J FIRE PREY, FINAL 30. Drywall Nailing I ; , Notes: , , 31. Plaster Brown Coat 32. Electrical,Power Meter-Finial + +y l 33: 'Final Electric I - 34. Fina! Heating &?Air, Conditioning 1 t, 1 :Air n I 35. Final Gas Pipe=Test' f 36. Hood or Canopy: 37. Final Factory Fireplace i 1 f 38. Final Plumbing a L' l 4, - 39. Water Service-Finali 40. Gas Service-Final 41. Solar Domestic-Final ; r .R _!_ ' 42. Sackf low Preventer. ' 43. Backflow Irrigation ; 4 1! 44. Landscape lrrigation'System 45. Soundi-i�ttenuation 46. Handicap' Regulations it 1 - 47. FINAL STRUCTURE & BUILDING ;i 48. Special R'equireinents Completed t t t 49. Electric Releaselto Edison, I r } 1 _ I 50, Gas Release to Southe to California Gas Co ' 1 I l 51. CERTIFICAT EIOF,0CCUPANCY No. y Date - Applicant -- - - --t to flit in all spaces except those within heavy border lines and sign all appropriate_declaratlons. i. i CIS 17 OF COSTA MESA PER IT NQ i c TRACT NO. LOT NO. BLDG ' 'CONSTRUCTION PERMIT « -- ? ; 1 u-:I 6QJ a Applicant's Melting Address Q'r i �� TYPE;OF CONSTRUCTION'. NEW ADD ALTERATION " _REPAIR':- t Project Address �� I �f " . CONVERSION! ❑ DEMOL.ISH ',❑ OTHER.L Owner's Name 4� rSON !' L+ l� �n�SS _❑ r•DESCAIP?T�ION OF WORK ;S 'ZONINGREGULATIONS - r .- {� "V Addressi~i'✓ Z _TYPE OF.PERMIT GRADING FOUNDATION STRUCTURAL t A. P. 916' M ZONE r: - 7 G �S 7 AvchlEn - n I . i License No. 9-,- ❑ TENANT ❑ ELECTRICAL• E]LPLUMBING. ❑ MECHANICAL PLNG. REF„�16- BUILDING s_ Address; ' l r �7`/ : =❑r OTHER l I TO BUILDING.. PROPERTY ':REAR YARD TO P/L}--- 1 Contractor's Nam hone I y .PROJECT DESCRIPTION. Sq. FT.' OCCUPANCY LINE -LEFT SIDE YARDRIGH' - TSIDE YARD F r Address (Tailing) r CONSTRUCTION TYPE VALUATION $ l_ ' if ZONA GRADING CU. YDS. (ACRES - .PKG.SPACE REO. PROVIDED 1 License No. -- _ -'. ---- LICENSED CONTRACTOR 6ECLARAT(ON + Remarks: ; I ! STREET WIDTH ' t PARK FEE $ Lhereby, affirm that'( am licensed under provislons of charter 9 (commencing 1 r • _ with. section 7000 of _Division 3 of the Business and Profes§Ions Code, and } r- , + SPECIAL CONDITIONS: l ; my license Is in fort a effect, � 1 t LJcen`se Class ' License g , PLUMBING ; 1 - Date?_'~f Signature ' + Bar Sink ; Sewer Cap I ELECTRICAL WORKERS' COMPENSATION D C ATION H ereby affirm that I have a cera ca of consent-taselfansure-or a-certificate a..__ §: ;. Insurance, . Automatic Washer.. '. i •- - - Meter ❑over1100 amps. , _ - Backflow Preventer .. Sewer Connection' "'l Workers' ComTnsatlon or a certlfted copy thereof (Section x"00, Lab. C. ; I L Compan&,-/Q3 � �1�/' ` Backflow Irrigation i Solar Collectors - Construction Pole# ” Sub Panel HCertified copy Is hereby furnlslietl. l I Bathtubs Solar Piping Cooking Unit Sub Pole Certified copy s filed with the city ing Dlvtsl n k r Clarifiers i Solar Tank Dishwasher 1 +"' Motors ❑0-1 HP ❑1'b$ ; Date APpllca } EXEMPTIOMFROM WORKERS'/COWPENSATION DECLARATION- _ w _ Dryers ❑❑ Gas Electric W - - i❑16-15+ nc.$olar ❑9-15 HP ; ; Dishwasher~ Swimming Pool w/Spa (This section need not be complet d the permit is for one hundred ($100) or less(: , Fan r f ` :Microwave I certlfy'that In the performance of the work for which this permit is issued I Drinking Fountains { Urinal "r , ' 1 shall- not employ any person In any manner so;as to become subject. to tie - 1 F.A.U. . ;Pole Light r Workers*, Compensation' Laws of California,, I Floor Drains{ 1 Water Closet, Date Signature . NOTICE: if, 'after making this declaration, you should become subject to the- T' _ - i Floor-Sinks - - -� `` -Water'Heater, `- - - _, Fixtures _ I } , .� Range• t.-_ _, ..-,_;. �. _ _ Workers' Compensation provlsionslof the Labor Code, you must•forthwith• comply with' such _provisions-or this ,permit ;shall be deemed' revoked:. ', Gas Service ';Outlets Water, Service '• ( = Device Boxes Sign; t i CONSTRUCTION ' LENDING AGENCY ' I ? { I hereby affirm that there Is a construction lending agency for the. performance, InterceptoiS , i = a 3 ! Outlets i I 'Standing Sections i t of the 'work for which this, permit Is ;issued -(Section '3097 Clv: C.); i Lender's, Name-' ' '' 4 Kitct en-Sink' I � - ' Switches r 'Trash Compactor -Lander's Address= OWNER'8W LOER L7ECLARATION' ; i Lavatories i s^ W' I _ s" _ Garbage Disposal I hereby affirm that I am exempf from the Contractor's License Law for the i -. , P—Trap, -, 6 Generator ❑0-5 KW ❑5-15 KW S ; ; following reason (Section-7031,5 Business and.Professional:Code: Any city or. r, ; t — i i , E , county which requires a permlt to construct, alter, Improve; demo lish -or.. repair ; any structure, prior to lts,issuance,+also requires the applicant•.for such permit Roof Drains 'r r, Transformer ❑ 15-50 KW j to file a signed statement'that he/she is licensed pursuant to the,provislons of a - ❑5U + KWr 1 i the Contractor's License Law;(Chapter 9 (commencing•wlMsectlon 7000) of 1 Division 13 of the and Professions Code) that; he]she:isiexempt - i -' , Showers ' ;y Reinspection; Fee ( ,Reinspection Fee ' $15' ;Business or, 4 .refrom and Flier basks for the alleged exemption; Any-violattion Section I i i , : y _ Meter ❑up to i00'amps k :Issue Feel 1 $ 3. ! ,3g1'5 by-any applicant for the applicant to a civil R`'7talty of not more than five huntlretl dollars ' { Service Sink i , 1 Issue Fee $ 3' I ; {$500). ; , . -• } L� I as lowner oft the property or' my employees ,with wages, as their sole [ ( ; , . Zoning Approved By Data ' i r 1 compensation wIWdo the work, andlthe.structure.is not lntended or offered for sale -(Sec{Ion 7044; Buslness; and i Professional Code:: The l Contractor's - - ; =_• 1 -. MECHANICAL II App cation Approved By t r ate i, 1 License Law does not apply to'an owner of a property who builds or Improves i does, through own : Boner- j 1 rR i Refrigeration System t ; Application Isstfed BY I Date thereon„and ,who such-work himself/herself _or his or her , employees, provided that such Improvements arelnot Intended or offered for ; • - = I 1 DO-100pOOBTU ❑100,OOOBTU' i sale. If, however, the building or improvement is sold within one'year.of tom- pletion, the owner'witl have the burden of proving he/she did not build or im- + Duct Under•Ground . i + 1 1 f i i ; ' SUMMARY OF FEES prove for the purpose of sale), i ' i "with !licensed ( , Duct - Structural +, ' System Repair/Alteir tion j 'BUILDING PERMIT $ i i 1 SMIP ! $ 1 LJ 1 3s Owner of the property, am exclusively contracting con- tractors to cgnslruCt.[he,project-`Section _7044,.Business and.Professtons Code: _L does to who ._�. ( 1 Duct .Ventilating---4—.__ , I t a _.. _�� -. ._„y 'PLAN CHECK; i $ I ; i ' PERMIT I { The Contractor's license Law not apply an owner of property builds or improves thereon, and who contracts for such projects with a con- ; 1 tractor(s) license pursuant to the Contractor's License Law); I 1 t {' ❑ ( Exhaust System ❑ Multiple ❑' i ( e ' PLUMBING $ s• > (PLAN CHECK $ r i ' ISSUANCE i GRADING I $ f I ; Ilam exempt under Sectio` ` f I B. & P. C. for this reason ( I Firepl/Fact. Bit, ICBG # { _' ; i + 4 f l i I • f Date ' i I I Owner i r t 1 -certify : '�' Heating'System & Ducting ❑0.100,000BTU'❑100,000BT` - i ; i -" "'- -- - ELECTRICAL $ s r I N CHECK P� $ = ; 1$ I MICROFILM $ 1 j hereby l:-have'read'this-application"and"state-ttiat-the"above-' y Is correct. I agree to comply with all city. and county ordinances i ; 1 '. f ! l 1 ; TOTAL FEE. $ { iInformation and.state laws relating to building construction, and hereby authorize repre- ; sentatives of , is Cit to an u n the above-mentioned property for , City;p ' k Hood of Type I ❑ ; ' r i i f Reinspection Feel $15 (MECHANICAL . t $ i r 1 CHECK} $4 i i < inspection pu es, t Date y2 7i Signature S Cano i T e II ❑: l ,PLAN i ! ADVANCED PC $ Drivers' LI en or 55 f r i isters Reg' 3 ' IFie Issue e t $ 3 i a ` } r i FINAL FEE i r$ r CMF 0865-4 rev. 72/82 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor '�-,dONSTqUCTION-,ANWP CANN' ING 'b 'hate 7 1 r� a Date I 'Inspector r i 3� TAPPROVALS -:z Permit nspe ctol APPROVALS 7---P�iMiV,#`: Pz�, Ff0 1'r �1L Temporary. Electrical SbrVA6e T �quip,ment Ldcatiod r,� el 5 Soil oip�-Ury nclrgrnd.� Ic ior _'t `Steel Reinforcement ceme.n i-nduit,Utilitv.Undrgrfirl,! S, I E16tt,,'I-G'a-Co `54., Forms,"- -' 4 4- e rical Conduit-Undrgrn& ".4 i 7 EleGtric'al'Bo' d n ing_ < 6� �te'el 'Rdinf'61`rce6e1 nt'. "'i T�1. Z_ 5, Pl6mU�qA PFe�sUire,�ei� e t"r ca IJFER ijrnd. Electrical 572 APPROV NITEZ f 7. Footings (r Efectrical:Coiriduit-,gridir irt 7- 8. ko'uni'dJ6 n o p T isi ; ,'�O'Qndrbr`n�d-', I i ;7, 9. Mte'rrPiP'e-bnd'rgrnd. C; :t. 'd 60. Backwash, Lines -Trap, ��nd&rn j;; C7 10. St:uctL!Ea( Floor System 61, APPRoVA,-fbbK 7 1 1 11. Pr;6er�. Sevj-e'r Lini& House Cbr)neciion M 62. Backv�,,h.- kReceptor-Final, 12. S40 Cap Ae'aier.& _J6 ,Xe`t'Fin`al., 13. 'RoLf bIrlins" ';64 Plumq bin4,SystOri -,;Final 14. Rough Plumbing i 2 i -65. Electrical;F-inarlP -1 5=Rough-EleclricalConduit7-T- _66-'SblaFSystem-Final _T �i 6., Fi�oughcEleajric ffiri' ng-, r:��- L_ - - __ 7 _sAPp'r04V'al -67...', Fencing �-Access 7! 'i'll 71. 'koug hW r i3g'S idn P68 APPROVED Ecbf R:PLAStE I NG 4 18. Ceiling!69 POOdiS!P,A YSTEMS F INA �L 771 19. W6ug,,h7Heating &,Airboiiditioning I FIRE DEPT. REQUIREMENT.r.- APPROVALS! -Permit'# 1 20.';K6 h -;Factory Fi' Fpi-ce: 11 •tu, -, 7, - _a 2i'D-ucts,'in S-tru'c-tur'e,-i 705. Underground Hydro tt Tj 2. Ducts, Venfila'iing '711. Product Piping 0 Gas 0 Oil �1,2 3. as Apel-li 'h 8; Test ' z F sh 72. Undei U ground "-Roof Framing I J.. 73 jUnd,r"girnd.Sto6ge Tank',.© ;'Gas- n'&jl! J, 25. athirig i Roof Shei 74. Overhead Hydr6 -41 C)IrI 1, -26. -Bar Ceiling (Structural)`, & M'ont,6attl- 75. D,,y qhemjcjj 1 27. 6nd Flashing 3 ) 6.1 D ' Standpipe �y Uthing' j 28. &-Siding i 5 F XED YS,TEM,FiNAL 7 7 S' "Insul'ation, 178, Fl-RE,PREV,. FINAL .�Lg, 30' 'ali l4al �yvv I Ilinb i j Notes: f,-.-31. Pl' �r Brawn Coat B w j Ti F ----F Ast& I i 32. eCt 'ri ca I Power Meter -Final ?t 33.`Final 'Electric 34. Final Heating & Air: Conditioning I 35. Final das"Pipie4isi'l 1-' 1 i V 1� ,I I- lo; A, 365. Hood or Canopy V rl -. , --S I Fireplace.7 37. Final Factory 38. Final Plumbing 39. Water Service-Finall 40. Gas Service -Final 41. Solar Domestic -Final F-+- i 42. BackflO.!,W;Preventer j 1 I L� 43. Backf1bi+v,1111rivioh 11 > ,* , 44. Landsca e r tion�Syst 0 p ern a. 45. Sound Attenuation Ir 46. Handi8a" Regulations': pi 47. FINAL STROCTUR, E & BUILIDING as I: I48. Special. R'equ'irer6in'ts Completed I A3 49. Electric 114eleke'to Edison ', 50. Gas 4else to Southern California Ga's 51. CERTIFICATEOFIOCCUPANCY No- Date -4-_I Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. -CI'PYOF COSTA MESA CONSTRUCTION PERMIT Applicant's Mailing Address Project Address _- Owner's Na �N� 3dw �'��`^`� hone y .24�0� Address Arch/Eng. License No. S Address r/ _ 1 Contractor's Nam N 4' W - i4 q / C hone �O -' /d2-- Address (mailing) 4a12-2- 7' License No. LICENSED CONTRACTOR DECLARATION I hereby affirm tnat I am licensed under provisions of Charter 9 (commencing wlth•section 7000) of Division 3 of the Business and Professions Code, and + my license is in full fo�{e�n effect. License SS CC�- Li n o. 4 Date Signature WORK RS' eOMPENSATION DE RATION + hereby affirm that i have a certificate of consent to self -insure or a certificate Workers' Compensation n- I.7nsurance, or a certified Sopy thereFf (Sot�on 10, Lab. C.) O 5T !'r lM Policy No. - - Company 1 - tifled-copy Is hereby furnished. i Certlfied copy is flied_ with the city Building Division. _Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION (This section need not be completed If the permit Is for one hundred ($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 sous to become subject to the Workers', Compensation' Laws of Callfornla.' Date ' Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions -of the Labor, Code, .you must -forthwith comply jwlth, such ,provisions -or%this permit shall be;deemed revoked.-, CONSTRUCTION'LENDING AGENCY •I 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.) Lender's Name + Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt'from the Cohtrector's License Law fcr'the following reason'(Section•7031-:5 Business and.Professional 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/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (Commencing with Section 7000) of + r)lvislon 3 of the Business and Professions Code) or that he/she_ Is exempt ,refrom and the basis for the alleged exemption. -Any , violation of Section 11.5 by any by for„ -a' permit subjects the applicant to 'a civil .+alty 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- (Section .7044, Business and, Professional Code: The Contractor's i License Law does not apply to an'.owner of a property who builds or Improves i thereon, and who does such work himself/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 com- pletion, the owner will'have the burden of proving he/she did not build or;im- rove for the purpose of sale). ' 0 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon,;and who contracts for such projects with a con- tractors} license pursuant to•the Contractor's License Law). I ❑ 1 am exempt urider Section B, & P. C. for this reason Date Owner 'I hereby certify that I have read this -application and state that the above - information Is correct. I agree to comply with all city and county ordinances and state laws relatinglto building construction, and.hereby authorize repre- sentatives f this dty, to aa;er ypon the above -menti ned ate pr inspection o es. fI T!`�� yi Slgriature TAPE OF CONSTRUCTION LJ NEW L ADD L ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT• LJ GRADING LJ FOUNDATION -J STRUCTURAL ❑ TENANT Ie ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ BOTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONj= 4GRADING CU. YDS. ACRES_ _ Remarks:—�� Lr -7- [ 7 - - Bar Sink Backflow Preventer Backflow Irrigation Bathtubs r Clarifiers Itn i Dish washer ; Drinking Fountains Floor Drains ' Floor Sinks Gas Service, -Outiefs , Interceptors r Kitchen Sink _ Lavatories P -Trap Roof Drains Showers Service Sink r Soiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑' Firepl/Fact. Blt. ICBO+ Heating System & Ducting ❑0.100,000 BTU ❑100,0008Tl Flood or Type 1 ❑ Canopy Type I I I t Drivers" ansa or SS 9PRegisters ' CMF 086546 rev. 12182 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Sewer Cap Sewer Connection'. - Solar Collectors Solar Piping ' Solar Tank ' Swimming Pool vv/Spa Urinal Water Closet;, I Water.Heatef Water Service Reinspection Fee Issue Fee ` S15 S 3 Refrigeration System ❑0.100,000 BTU ❑ 100,000 BTU System Repeir/Alteration I t Reinspection Fee :$15 Issue Fee i $ 3 7653 . 4/2L%63 ZONING UL TI S A. P.'90, ZONE PLNG. REF.. * BUILDING S•FTBerrF O/tSST TO BUILDING_ REAR YARD (TD P/L) PROPERTY LFNE _ LEFT SIDE YARD RIGHT SIDE YARD PKG. SPACE REO. PROVIDED STREET WIDTH PARK FEE $ SPECIAL CONDITIONS: Automatic Washer Meter 9dover 100 amps Construction Pole Sub Panel Cooking Unit Sub Pole Dishwasher ;Motors 00.1 HP 1X,B Dryers ❑Gas ❑Electric Inc.Solar 09 15 HP 016-15 2, Fan Microwave F.A.U. 'Pole Light Fixtures ; I Range t I Device Boxes Sign Outlets Stand ing Sections , Switches Trash Compactor Garbage Disposal $ , Generator ❑0-5 KW 135-15 KIN $ Transformer 1115-50 KW El 50 KW, Reinspection Fee Meter ❑up to 100 amps Issue Fee ' Zoning Approved By Application Approved By IJC Application Issued ByT✓`? Date Date trate 49.20' TL NEE mom MW M■ MW ®■ MOM M■ Mel ♦i M■ + FINAL -FEE SUMMARY OF FEES BUILDING PERMIT $SMIP $) f PLAN CHECK$ PERMIT I PLUMBING $ ISSUANCE $ 1 PLAN CHECK $ GRADING $ , ELECTRICAL $ 5 $ ' PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ , PLAN CHECK $ I LESSAOVANCEO PC I { $ + I + FINAL -FEE ;rCONSTRUGTION AND PLANNING' t ',' -• _ POOL f >+ .;+• j APPROVALS = Permit #� ��1 Q ` Date Inspector ^APPROVALS-.`" Permit # Date Inspector, h J t - i ' 1- Temporary Electrical Service or,Pole'I . ' ; 520 Pool & Equipment Location n ' f 2? SOif Pipe-Undrgrnd. 53.` Steel Reinforcement_ 3? Electrical Conduit16tilitV`Undrgrnri: - 54:4 Forms , S T 4" E11'a'ctrical`Conduit-Undrgrnd:•� ~ ' C ►� • 55: Electrical Bonding a�. 5; Steel Reinforcement .' ; - :., =.e ` 56� Rough P_lumbing.& Pressure Test �'. ' t�N 1 6: Electrical UFER Gind.,• 4 ? ' j- - - 57 APPROVAL TO COVER•GUNITE' 7. Footings,. ?' p• 58. Electrical'Conduit Undrarnd. + B. Foundationc ' : i 59. Gas Pipe;_❑ Undrgrnd.; Test - I . _ /- - „ Z. 9. Water Pipe Undrgrnd. f 60. Backwash Lines, P -Trap, ❑-Undrgrnd. 10. Structural Floor System ; 61. APPROVAL TO DECK r 11. Property Sewer Line & House Connection z - 62. Backwash &Receptor Final 12. Sewer Cap ' r t' 63. Heater & Vent -Final ' 13. Not -Drains -64. Piumbing:System Final- ' f 14. 'Rough.Plumbi'ng '• 65. Electrical -Final' = „ 15.-7'Rough'El'ectri-cal-Conduit7 _ "{" i T----;66. Solar System -Final "16:•rRaugh Elec[ric Wirings ;F� - ", - 67.r Fencing & Access Approval M;i7. Aough'Wiring Sign;' r i - t 68: APPROVED FOR PLASTERING r, r , �, j ; 18.. Rougli_Electrical-T:Bar Ceiling i' _�, ' 69. POOLJSPA SYSTEMS FINAL. ' 19. "l 6u6h�Hea$ing & Air Conditioning -FIRE DEPT. REQUIREMENT r APPROVALS' Permit # 20. Rough Factory Fireplace ' i ! ,� 21. Ducts, in Structure:I _ 70. Underground Hydro i r -22.'Ducts, IVenailating .i71: Product Piping ❑Gas ❑Oil x-23.-Gas=Pipe- Rough & Test "s , t , i X72' Underground Flush + 24. Rtaof Framing.t ^� ��:= +: 4 1 73. Undergrnd. Storage Tank ❑Gas 0 011 ` _25. Roof Sheathing ilc' f 74. Overhead Hydro i -26.'"f Bar Ceiling'(Structural), & Monocoat~ 75. Dry Chemical Frarne and Flashingit 76: Dry Standpipe _27. 28.:, 6thing &"Siding ' '! 77: FIXED SYSTEM FINAL - 29.:1Insulation f " 78: FIRPREV. FINAL 30." Drywall Nailing n ; r I ' Notesl I ' 31..,PlasterlBrAn Coat 32.'IElectrical Power Meter -Final A ' 33., Final Electric b _ i-463 Ct I i ; 34. Final HeatirigE& Air Conditioning 35. Final Gas F?ipe:Test I 36. Hood��or'Cancpy > j' it t _ 37. Final Factory Firiplace 38. Final PlumSing; n r r - 39. Water Service -Final I 40. Gas Service =Final li , 41. Solar Domestic Final _1 42. Backflow Pr'eventer ` La 43. Backflow Irrigation 44. UndswapeIrrigation Systems , W.', ,r 45. Sound!- Attenuation t 46. Handicap Regulations I 47. FINAL'STRUCTURE & BUILDING' 48, Special Requirements Competed a } I 49. Elect'gic Releasb to Edison t i ` I_ , - . _ -_ _ 4 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No, Applicant to fill in all spaces'except those within heavy border Ilnes and sign all appropriate declarations. ..._ CITY OF COSTA MESA IT NO. TRACT NO. LOT NO. BL .. Y . . 47, �' E 6/ �� _ -;� 7 �r o I CONSTRUCTION PERMIT , t . aL ,J� r ,. t Applicant's Will A TYPE OF CON STR CTION NEW ADD • ALTERATION REPAIR _ M Project Address �� U / 7_5 ❑CONVERSION ' ❑ DEMOLISH ❑OTHER / Owner's N �"� �.yfr �` i hon° DESCRIPTION OF WORK me -4 r� ZONING REGULATIONS. Addresser/ '/�74iwa�� ` �,T �� TYPE OF PERMIT GRADING . FOUNDATION STRUCTURAL A. P. 9W ZONE - Arch/Eng, License No., ❑ TENANT ELECTRICAL .❑ PLUMBING ❑ MECHANICAL PLNG. REF. yW' BUILDING, Address, ❑ BOTHER TO BUILDING- ` + � ��, �� Contractor's Nam �� oc T` r hon 2/ PROJECT DESCRIPTION• SQ. i T. OCCUPANCY -PROPERTY INE REAR YARD (TO P/L) rLEFT Address Galling)t��' �"a E' l�V ` CONSTRUCTION TYPE VALUATION $ SIDE YARD , RIGHT SIDE YARD 9�'�3 ' ZONF z GRADING CU.YOS. AC RFS PKG.SPACE REQ. i PROVIDED ' License No. - — - -- LICENSED CONTRACTOR DECLARATION Remarks: STREET WIDTH PARK FEE'$ 1:hereby affirm that I am licensed under provisions of Charter 9 (com'mencing with section 7000) of Division 3 of the Business and Professions Code, SPECIAL CONDITIONS: I my license is in full force and affect. iJcensg Cl ss C lei sl N .1 3 PLUMBING Date- p Signature yy Bar Sink Sewer Cap ELECTRICAL WOR ER COMPENSATION DECLARATIOf! I hereby affirm that I -have a certificate of consent to selfansura Ora certificate - Backflow Presenter Sewer Connection Automatic Washer 1 -. Meter .❑over 100 amps Workers' Compensation Insurance,, nce,, or a certified copy thereof (Section 1 00, Lab. [ / t /?,i 2 Z i Cir a Backflow Irrigation Solar Collectors _ Construction Pole ' Sub Panel G 0 ❑ Icy No. r Y Company Of Certifled-Copy is hereby furnished. Bathtubs i Solar Piping I Cooking Unit i Sub Pole , (� tic fled with the city ulldin�r g��}'� Dishwasher :Motors Do -i HP ❑1'fi$ Date Applicant Clarifiers Solar Tank ,Inc. ' ( hiissection of beecompl ted the one hundred ($100) `- Dishwasher t , Swimming Pool w/Spa , ' Dryers ❑Gas ❑Electric Solar ❑9-15 HP ❑16-15+ , needn li permit IIsrfor or less), I Certify that in the performance of the work for which this permit is issued I . ` Drinking Fountains Urinal f Fan' Microwave i I shall- not employ any person in any manner So as to become subject. to the -- - F.A.U.I i 'Pale Li ht g Workers' Compensation Laws of California. Floor Drains j ! Water Closet ' ! Date 1 Signature NOTICE; If, after -making -this declaration, you should become subject to the Floor Sinks - Water Heater; - Fixtures _ Range- - Workers' Compensation provisions of the Labor Code, you must forthwith, comply with, such provisions or this .'permit shall be 'deemed revoked,• ` Gas Service YOutlets Water Service + ' Device Boxes Sign I CONSTRUCTION 'LENDI NG AGENCY S . . '. I - Ihereby afilrrn that there is a'construction lentling agency for the'performance, interceptors r . Outlets Standing Sections S of the iwork for, which this permit is Issued (Section 3097 Civ. C.); Lender's Name Kitchen Sink' - Switches I t Trash Compactor p Lender's Address. OWNER;SU1LDER DECLARATION'' I _ Lavatories' ' - �' 1 Garbage Disposal y I ( t t I hereby affirm that 1 am'exernpt from the Contractoi's'License taw for the 4031.5 P l Generator E10-5 KW E15-15 KW _ + 1 # following reason (Section Business and Professional'Code. Any city or county which requires a permit to construct, alter Improve, demolish or repair any structure,' prior to Its Issuance, also requires the applicant for such I 1 -Trap Transformer ❑15.50 KW ' I I Roof Draihs ppermit' .to file a signed statement'that he/she is licensed pursuant to the•provlSF.e. of ❑$p+ KW I Fee , $15 ! the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division the Business Professions that is } Showers Reinspection Fee $15 I .Reinspection 13 of and Code) or. he/she exempt •`erefrom and the basis for the alleged exemption., Any of Section Meter ❑up to 100,ampa � ' $ 3 -violation- 11:5 by any applicant for*a permit subjects :the applicant to a civil ally of not more than flue hundred dollars $500. ( ) Service Sink i ' • , I ! r Issue Foe $ 3 issue Fee J Zoning Approved By — Date ,_1 1, as owner of the property or my employees with wages=as their sole compensation wltl' do the work, and the structure Is not intended or offered ; I , ' MECHANICALI Applicetlon Approved By ' ate for sale : (Sec{lon 7044', Business, and • Professional . Code: The' Contract Or Is f 1 License Law does not apply to an owner of a property who builds or improves 1 "does'such goiter i ! - Refrigeration System Application Issued By 1 + ata'�- thereon„and who work himself/herself or through his or her own empioyees, provided that such'improve ments are not Intended or offered for DucC- UndenGround 00-100,OOOBTU ❑100,00013TU ” sale. If, however, the building or Improvement Is sold wlthin one year of com- I l SUMMARY OF FEES ' pletion, the owner -will have the burden of proving he/she did not build or Im- rove for the purpose or sale), r j Duct -Structural 1 System Repair/Alteration + BUILDING PERMIT $ I Slaw 9 $ , 5 I, as owner of the property, am exclusively contracting with,lieensed con- tractors to. construct- the project (Section 7044, Business and Professions Code: ' Duct .Ventiiating I -', �.. •_ PLAN CHECK; $ ! PERMIT I The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑' ' 'PLUMBING $ 3 ISSUANCE $ tractor(s) license pursuant to the Contractor's License Law).; GRADING $ ❑ I am exempt under Sectlon B. & P. C. for this reason Firepl/Fact, Bit. ICSO # I j PLAN $ CHECK + . Heating.System & Ducting ELECTRICAL' $, i $ i Date Owner ! ' ,-1 hereby certify that' I: have read'this application and state that the above' Information Is I to ', ❑0-100;000.BTU ❑10QOOD 1 _ _ - - -' - , - "� PLAN CHECK 1 $ Q MICROFILM , l " i TOTA L FEE $ i i correct. agree comply with all city, and county ordinances hereby , MECHANICAL $' $ and,state laws relating to building construction, and authorize repro- sentatives of ;thl� clty'to a on t above-mentioned proper or ', Inspection Hood or Type I ❑ f Dano T e kl ❑ f ; Rai ction Fee+ ; �� $i5 + PLAN CHECKS $� LESS ; ourp a ;` _T1 i ADVANCED,PC , $ Signature ate Drivers' Lf nse or SS r —,-A- S + Registers __ - Issue Fee ? $ 3 f 1 FINAL FEE l $ CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor �_ �CONSTRUCTION,AND-PCANNING? _ ' _ ; i xr' , -' - p -= 7 v - -_P00 L-9 • _ ~ : , b r�- 'APPROVALS Permit.#= ,Date ` 1'Inspectoi' �';� r' 'y APPROVALS` ;P,ermit:# - Date In`spe-ctor y; Temporary Electrical Service or'Poie�.� a ; ? "� 52 Pool & Equipment Location. + - I •� 2: Soil Pipe! -ter-i- - -� ,ecu.- '- - --- ` - , _Und.rgrnd: _63°Steel Reinforcement e -, 3` Electrical Conduit`Utilitv:Undrgrrnd: �` _' a 3>� 54 Forms'. t _ 4. Electrical Conduit-Undrgrnd'. J . I ' '? ' '' ti ; '� • 55.' Electrical'6anding 5. Steel'Re'inforcemeht I; - ` :°; 1 16 - Rough Pluhibing'& Pressure Test t 6.' Electrical LIFER Grnd� 57;' / PP.ROVL1l=•TO COVER-GUNITE I _ 7. Foot . =Undrarnrl.ngsEectrical Conduit ,r 8. Foundation 1 4.- '59. Gas IPipe,5C7..Undrgrnd:, Test: ' 9. Water Pipe-Undrgrnd.' ;• al - "fi0. BackwashLines;IP-Trap, ElUndrgrnd. 10. Structural,Floor System i ' - tl (,Tt• `p fit. APP.ROVAL:TO OECK 11. Property. Sewet Line & House Connection° I Backwash &:Receptor Final; _ L62. r - 12. SewerrCap'63. .J . I Heater'&�Vent•Final - _ - 13. Roof Drains 1;-64. Plumbing -System Final - - - r 14. Rough -Plumbing r -165. Electrical -Final N ' ` 15'-Rough'Electrical--Conduit- ►'" `- t �-7--' 7- F-' -66.7So�1ef Sys,em Final-!_ : Rough Electric Wiring. �, r 16ing - t,fq; : �� ;- nc+--' - - 67:� Fe &-,,Access: -, r .. 1,M-1� l 1 _ 17, --Rough Wiring:Signf' ; I -' + i _ < , ` gB.1APPRO.VED FOR PLASTERING I _ _ `- J ] I L C t �18. RoughElectrical=T Ba__` Ceil,ingi 69.j POOUSPA SYSTEMS'FINAL I t 19. Rou-h Heat & Air Conditionin g g j I { 1 t ` j FIRE DEPT. REQUIREMENT_ I •a APPROVALS I ; Permit, - y 20. ,Rough, Factory Fireplace 1 ! � I ! i l � I i E 21. Ducts jr, Structure i i ' I 4 I 70. i Underground Hydro Q' 22. Ducts, Ventilating ra k i t { 71.' Product Piping ❑ Gas ❑ Oil _I } = .M. Gas Pipe Rough & Test - a l i 72.�Uriderground FIlush - f - i _ 424. 'hoof Framing ; , 1 ; I �: ifi + - i • t; 73., Undergrnld. Storage Tank'•❑ Gas! ❑ Oil I j 25. Roof Sheathing ` 1' ; n ; I ' I 74.1 Overhead Hydro I 26.+T -Bar Ceiling (Structural),& Mon46oat"Dr'y Chemical 7 27. Frame and Flashing. -n 1' 76.1 Dry Standpipe ;r i E 1 1 , , 28. Lathing & Siding; c i R _ 1 s ; :77. FIXED SYSTEM•FINAL 1 l " 1 . I 78. FINAL29.:Insulation a 30 br wall Nailing ` +' t Y 9 I t ' i i ` I ; Notes: + l + I ;'31.- Plaster Brown Coat 32. Power MeterFinal ' j ; 4 ( r• " L ,Electrical - 1 33."Final Electric {{ _4 ' 34. Final Nesting & IAir Conditioriing - 35. Final GaslP" 'Test { •� , 1 1 ! _ i i T 1 36. Hood or Canopy`'`' 37. Final Factory Fireplace y I a ty 38. Final Plumbing I" t• r i i 39. Water Service -Final+ !' i s I I { t 40. Gas Service -Final r I 41. Solar Domestic -Final 42. Backflow,;Preventer; fJ 43. Backfloklrrigationk - InJ. o Q 44. Landscape Irrigation,System 45. Soundi'Attenuatiori- '' .. - [ t { 1 1 C 46. Handicap Regulations r i 1 0- 1 I �J 1 ' l 1 " 1 : 1; •' i i. •' 1 1' l i - - 1 l I ~ 47. FINALSTRUCTURE & BUILDING ! • I ±; - I ; i j �` I 48. Special" Requireriierits Completed! + •! a I ! # i { k i z , i 49. Electric Release to Edison I I ;�_-,_ fi. �__`__.� _ -_� s r f _ _ •L_ _R_._a 1 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF!OCCUPANCY No. * i1 Date V ; - City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000354 P. 0. Box 1200 Costa Mesa, California The Building located at 3151_ Af1'irdtr_ 71=-tm(m #V1—V2 _ has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 3-2 Occupancy. Use of Building Office Legal Description 427-2q1-1 (See reverse side for Metes and Bounds) Building Permit,No 8179 Electrical Permit No. 6-8179 Plumbing Permit No. B179 L—J1b / l Mechanical Permit Na. 6-8179 Number of apartments 0 and/or guest rooms 0 ISSUED TO: Andrews Petsolem Services 1370 Brea Boulevard, Fullerton CA Building Official V 1. by Date > This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALT_ NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015.45 rev. 1/83 White • owner; Canary - Numerical File; Pink - Bldg. Permit File I aucaim�n I - CITY OF COSTA MESA BUILDING DIVISION 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 7544856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00135 PERMIT TYPE B_R00F2 STATUS: ISSUED APN: 93894027 DATE ISSUED: 07/24/2009 ISSUED BY: RMD JOB ADDRESS: 3151 V AIRWAY AV CM 'Su'ite/Unit: V Vicinity: BUILDING V ROOF Squares: 0 Valuation: $17,608.00 SCOPE OF WORK: REROOF BUILDING 'V'. TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 15 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 70 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: KIMBERLEY E %PROPERTY RESERVE.. Unit: 10 E SO TEMPLE ST #400 PHONE: CitylStatelZip: BRUCE CHRISTENSEN APPLICANT: HANSEN; DUKE Address: N6646636 PHONE: CitylState/Zip: CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA, CA 92707 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No., PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $293.25 Reinspection Fee: $0.00„ Bldg Std Admin Fund $1.00 TOTAL FEES $294.25 %STORSTAD, Unit: : NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE I. INSPECTION TYPE DATE INTMALS CODE I INSPECTION TYPE DATE INTMALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 206 Final Plumbing 200 Final Re -Roof — �p 210 Final Electrical 201 Final BlocIVRetaining 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 WORKERS' COMPENSATION DECLARATION: t 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 Cade, 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' compensationIn urance carrier and policy number are: Carrier:'� (This section need Trot be completed At7 a permd is valued stone hundred doliers ($100) or less,) Policy Number. 9 z O O ❑ 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 beco ubject to the workers' compensation provisions of Section 3700 of th abor ode, I sh I forthwith comply with these provisions. Tz/e Applicant's ignature' Dale 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 DOLLARS ($100,000), IN ADDITION 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 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. /' Lic: 2-12 Z Class # `'_ ontractor's Tignature Dale t 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: Sgnalure 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 ($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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature Oate 305746 (310 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: ❑ 1 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 B, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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? ❑ Yes ❑ 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 and riling 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No B. (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;correctrl 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. Sr nature of Lam` Owner(s) Date A uthonzed pplicanl' We; �' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. TY OF COSTA MESA LPEAMIT NO. TRACT NO, LOT NO. BLDG. NO. CONSTRUCTION PERMIT/�/ �% — .\41 Project Address 3151-V Airway Avenue, Csta Mesa TYPE OF CONSTRUCTION ' Owne,Western Pacifig Financial Phone75 - 11 NEW ❑ A00 ❑ ALTERATION Plan Address1601 Dove Street -Newport Beach ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Arch/Eng}{al es -Langston G License No.C-010$99 LJOTHER Address 777 S. Main #105 Orange, Ca, Office Condominiums' D�SCRIPTIONOFWORK Contractor The J. Donald Olson CO Ph6ne540-2506 TYPE OF PERMIT �{ Address 3151-E Ai rwa Avenue Costa Mesa El GRADING FOUNDATION [I STRUCTURAL LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANI I hereby affirm that I am licensed under provisions of Charter 9 om- , mencing with section 7000) 'of Division 3 of the- Business and ❑ OTHER Professions Code, and my license Is In full force andeffect. PROJECT DESCRIPTION License Class R License No. 3339 69 473 Date Signature SQ. FT. WORKERS' COMPENSATION DECLARATION OCCUPANCY - nf CONSTRUCTION TYPE5 11 s B- I hereby affirm that I have a certificate of consent to self -insure or a VALUATION $35Z - 235 ZONE certificate of Workers' Compensation Insurance, or a certified copy thereof (Se tlo 0, b C - GRADING CU. YOS. ACRES � �4 �� [� - Fairmont Insurance - y No. - - %+mpany ELECTRICAL ertlfied copy is hereby furnished. �rtifled copy Is filed with the city Building Division, REMARKS: , HEATING SYSTEM 0-100,000 BTU_ AND DUCTING 100,000 + BTU_ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION 1244 -0 (This section need not be completed if the permit is for one hundred _ ($100) or less). 1.10 KW _ + KW _ 1 cart(fy 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. _ PLUMBING BATHTUBS Date Signature NOTICE: if after making this declaration, you should become subject TOILETS to the Workers' Compensation provisions ofthe Labor Code, you must forthwith comply with such provisions or this permit $hall be deemed LAVATORIES revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS SERVICE SINKS 1 hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 FLOOR SINKS Civ. C.). Lender's Name WF � l�Jnpnrial DRINKING FOUNTAINS Lender's Address y OVe ree sL Newp r�� INTERCEPTORS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the ContractOr's License Law for the following reason (Section 7031.5 Business and Professlons Code: Any . city or county which requires a permit to construct, alter, Improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law' ((Chapter 9 {commencing with Section 7000} of Division 3 of the SWIMMING POOL WATER SERVICE GAS SERVICE WATER HEATERS P mess and Pro4essions Code} or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ippllcant for a permit subjects the applicant to a civil penalty .. .,ot more than five hundred dollars ($500). SOLAR TANK ❑ 1, as owner of the property, or my employees with wages as their sole compensation,•will�do the work, and the structure is not intended SOLAR PIPING SYS. or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE who builds or improves thereon, and who does such work himself or eck�451442' ZONING REGULATIONS A.P. — a ZONE GI _ PLNG. REF. :P %!. REAR YARD (TO P/L) PKG. SPACE REQ. a j PROVIDED ?� s STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE T�fSG_ 3' SPECIAL CONDITIONS: PLAN CHECK ELECTRICAL PLAN CHECK SHOWERS HEATING SYSTEM 0-100,000 BTU_ AND DUCTING 100,000 + BTU_ S[a_ FT_ and Professions Code: The Contractor's License Law does not apply to URINALS GENERATOR TRANSFORMER APPLIANCE 0.1 KW 10.50 KW -50 1.10 KW _ + KW _ DOUBLE LAVS DISHWASHERS MOTORS '(INC. SOLAR) 0.1'HP 10-50 HP .r 1.10 HP _ 50 + HP SUMPS ,' FLOOR DRAINS FIXTURES OUTLETS SWITCHES $ GAS TUBE SIGNS PLAN CHECK CLARIFIERS POLE LIGHTS P TRAP POLES METERED SUB ALTERATION PANELS MAIN SUB OUTLETS SERVICE AMP BTU OUTPUT COLLECTORS ISSUE FEE APPLICATION APPROVED BY rj, through his own employees, provided that such Improvements are not PERMIT G Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU_ AND DUCTING 100,000 + BTU_ of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to REFRIGERATION 0.100,000 BTU_ an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) ficesned pursuant to the Contractor's License Law), ❑ I am exempt under Section B. & P. C. for this SYSTEM j 100,000 + BTU---_ BOILERS BTU reason Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and a laws relating.40 construction, and hereby authorize representa this cit t enter u the above mentioned propert a tlo r -fes, ,„ p/ DriSIgvers' '��l ISSUE FEE Drivers' License or 55 � CMF 0$65.46 White "Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor PERMIT G SUMMARY OF 55�88p88.��.00n0n FEES 1 $ SMIP $ PLAN CHECK PLUMBING $ _�2f.l., $ PERMIT ISSUANCE $ GRADING 3 _ PLAN CHECK ELECTRICAL $ $ $ PLAN CHECK $ ' 'MICROFILM $ MECHANICAL $ TOTAL FEE $ PLAN CHECK $ LESS AD- VANCEPC $_ FINAL FEE $ 5-q9-M— CONSTRUCTION AND PLANNING APPROVALS Permit # fill Date Inspector POOL & SPAS APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil ipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility ndrgrn - 45. Forms 4. Electrical_Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn' 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash fines P-Trap, ❑ Uridrqrn 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55, Plumbing System, - Final 14. -' Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21. Roof Sheathing -t NOTES: �� - 22. Frame and Flashing ,' •!�- _ 7, 23. Insulation `i- 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation ` 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING , 39. Special Requirements Completed 40. • Electric Release to Edison 41, Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date -� Applicant fill In alf,spaaas within heavy border lines ald sign all appropriate declarations. tI Y OF' COSTA MESA P IT N r YRACT NO. LOT NO. BLDG. NO. , - CONSTRUCTION PERMIT 1151 Airway. Project Address CO to MBS CA TYPE O CONSTRUCTION - ' 3578 7/21/82 � 36•00 TI. Owner ,7DO Company Phone 540-260f _F ❑ NEIN ❑ ADD ❑ ALTERATION Address 3151 Airway; Costa Mesa, CA 92626 ❑ REPAIR- ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS ' Arch/Eng. License No:�' - DESCRIPTION OF WORK A P T= Address ZONE PLNG. RI1EfF.❑p� i Contractor Leaverton—Beck, Inc. Phone 979,-356)TYPE OF PERMIT PROPEIRTYNG LIN E Address 16721 Hale AVe. IrVi ie CA 92714 ❑ GRADING ❑ FOUNDATION Cl STRUCTURAL SETBACK I YARD LICENSED CONTRACTOR DECLARATION ❑TENANT ❑ELECTRICALLUMBING OMECHANICA I hereby affirm that I am licensed untler provisions of Charter 9 {com- !i E YA y �KU HT mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license is In full forte and effect. REAR YARD (TO P/L) C36 191969 PROJECT DESCRIPTION License Class Ice a No PKG. SPACE REQ. PROVIDED Datei' U • ft2 Signature SQ. FT. WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK FEE $ I hereby affirm that I have a certificate of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy reof (Se �St�i*°-�nB 07t1T�ab, C.). Great American GRADING CU. YOS. ACRES SPECIAL CONDITIONS: .y No. "'��"++ Company copy is hereby furnished. REMARKS: �Certified ertifietl copy Is filed with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION r' } (This section need not�be completed if the permit is for one-hundretl - - -- - - - _ ($100) or lessi. 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK ' subject to the Workers' Compensation Laws of California. Date Signature BATHTUBS SHOWERS SQFT. SQ -FT - NOTICE: If after making this declaration. you should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lendingagency for the per- SERVICE SINKS SUMPS (INC. SOLAR)- 10-50 HPL ---50 + HP - formance of the work for which this permit Is issued (Section 3097 Civ. C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES , Lender's Address DRINKING FOUNTAINS 1 GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's License Law for - the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP ' Any city or county which requires a. permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to its Issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (r'hapter 9 (commencing with Section. 7000). of Division 3 of the ness and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT for the alleged exemption. Any violation. of Section 7031.5.by applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTION b( not more than five hundred dollars -($500). _ - _ - ❑ I. as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. — ISSUE FEE Contractor's- License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE p •, _1 f� r/ APPLICATION APPROVED BY DATE through his own employees, provided that such improvements are not J Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECKf SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM. 0-100,000 BTU BUILDING PERMIT. $ SMlP $ ❑ I, as owner of the property, am exclusively contractingwith AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $�� PERMIT - and Professions Code: The Contractor's License Law does not apply to q �} ISSUANCE' $ an owner of property who builds or Improves thereon, and who con-- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM -- GRADING $ the Contractor's license Law). 100,000 + BTU PLAN CHECK S ❑ i am exempt under Section B. & P, C. for this BOILERS BTU ELECTRICAL $ t $ reason PLAN CHECK $ MICROFILM $ - - Date ---Owner SYSTEM REPAIR, ALTERATION - TOTAL FEE $ - $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLEMECHANICAL - LESS AD. information is correct. I agree to comply with all City and county PLAN CHECK $ VANCE PC $ ordinances and a Laws relatin construction, and hereby authorize - representatives f this city a er upon the above mentioned property or- pe tion pu s _ FINAL FEE $�"'✓ v Signatu a Drivers' License or 55 ISSUE FEET- -1 CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN APPROVALS Permit # 8a' Date POOL & SPA - Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pale 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbinq & Pressure Test ' 6. Electrical UFER Grn 48. ' APPROVAL TO COVER -G UNITE 7. Footings 49: Electrical Conduit-Undr rn , 8. -Foundation 50'. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash LLUgL±-Trao, El Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK - - 11 • Property Sewer Line & House Connection 53. Backwash & Receptor -Final, 12. Street Sewer Connection 54. Heater & Vent -Final 13, 14. Rough Plumbing Rough Electric -Conduit � - •56. - Electrical -Final 15.- Rough Electric -tarring 57. Solar System -Final 16- Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20: Ducts, Ventilating ' Gas Pipe -Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: r 23: Insulation 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat 27, Electrical Power Meter -Final 28- Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31: Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Serinkling System 36. Sound Attenuation " 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed - 40. Electric Release to Edison - - 41 • Gas Release to Southern California Gas Co. 42. 'CERTIFICATE OF OCCUPANCY No Date e, Is Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OP COSTA MESA PERMIT NO, �/ TRACT NO. LOT NO. BLDG. NO, 6ONSTRUCTION PERMITJ P — � 1j V ? Project Addressirway.CoEi:taCa.TYPE OF CONSTRUCTION 13:�LEW ❑ ADD ❑,ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER" DESCRIPTION OF WORK ry Ownernonaldbisim,Phone _ t -Address �( Arch/Eng. License No. Address Contractor- _ PhdnecJ79-356 TYPE OF PERMIT ' ❑ GRADING - ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT -DELECTRICAL �94UMBING ❑MECHANIC, Address LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- ❑ menCing with section 7000)- of Ojvision 3 -of the Business and Professions Coae, ana my 11cense Is In full force and effect. OTHER PROJECT DESCRIPTION License Clasg Llc6ose Civ. C.). - Lender's Name Date v• Signature SQ. FT. _�� _ WORKERS' COMPENSATION DECLARATION - — OCCUPANCY-.L—CONSTRUCTION TYPE I hereby affirm that I have a•certificate of consent to self -insure or a VALUATION ZONE certificate of Workers' Compensation Insurance, or a certified copy - thereof (S�rL-1 q ,3800, Lab, C.). Zenith National NoYCompany GRADING CU. YDS. ACRES rfty x;Certlfied Copy Is hereby furnished. REMARKS:.. ryCertafied copy Is filed with the city Building Division. ISSUE FEE Who builds or improves thereon, and who does such work himself or EXEMPTION FROM WORKERS COMPENSATION DECLARATIDN 0-1 KW 10-50'KW_50-+ (This section need not be completed if the permit -is for,one hundred ,MOTORS (INC. SOLAR) ($100) or less)- for IS 1-10 HP 50 + HP PLUMBING PLAN CHECK 1. certify that n the performance of the work which this permit issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California, BATHTUBS SHOWERS Date Signature TOILETS; �.URINALS NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS ' I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS Civ. C.). - Lender's Name DRINKING FOUNTAINS Lender's Address INTERCEPTORS CLARIFIERS OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the cis for the alleged exemption. Any violation of Section 7031.5 by SWIMMING POOL PTRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS_ • applicant for' a permit subjects the applicant -to, a"civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS LJ I, a$ '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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUANCE ISSUE FEE Who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not Intended or offered for Safe. If, however, the building or improvement is sold within one year of Completion, the owner will have the burden MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000+ BTU of proving he did not build or improve for the purpose of sale), ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to REFRIGERATION 0-100,000 BTU an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). SYSTEM -' 100,000 + BTU ❑ I am exempt under Section B. P. C. for this BOILERS BTU reason ' Date Owner SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I, hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives T this city t enter upon the above mentioned propertyf_for- pectlon pur S. Signaturd �C'�t''t /tLGZ 'ISSUE FEE ' Drivers' License or 55 :h� CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 6776_ 10/ 13/81 .-16.00 TL ZONING REGULATIONS A.P. ZONE SIuE YAHu RIGHT REAR YARD (TO P/L) P KG. SPACE R EQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS; 'ELECTRICAL PLNG.. REF. jr- •� PROPEIRTY L NE PROVIDED - PARK FEE $ DATE PLAN CHECK - GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50'KW_50-+ 1-10 KW KW ,MOTORS (INC. SOLAR) 0-1 HP v 10-50 HP 1-10 HP 50 + HP FIXTURES OUTLETS SWITCHES ' GAS TUBE SIGNS - - POLE LIGHTS --- - ' POLES METERED SUB PANELS MAIN SUB SERVICE `" _ AMP - - ISSUE FEE` ' APPLICATION APPROVED BY DATE - SUMMARY OF FEES BUIL-OING - - PERMIT $ SMIP $ PLAN CHECK Ste_ PERMIT ' �$ ISSUANCE $Ky ,PLUMBING GRADING $' PLAN CHECK $ , $ -ELECTRICAL $ MICROFILM $_ PLAN CHECK $ TOTAL FEE $ MECHANICAL $ LESS AD - PLAN CHECK $ VAN CE PC s FINAL FEE SK CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS �' Permit # Date Inspector 1A'isd Temporary ElecfricahService)o`r Pole 43. Pool & Equipment Location _ 2, Soil ipe-Undrgrn • 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn • 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test .9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra • El Undr rn 10. Structural Floor, System" 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection _ 54. Heater & Vent -Final 13, Rough Plumbing - 14. Rough Electric -Conduit •56. Electrical -Final - 15. Rough Electric -Wiring - 57-. Solar System -Final 16. Rough Heating & Air Conditioning 5B. Fencing & Access Approval 17. Ducts in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. _ POOLISPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing _. 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final _ 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32: Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date - Applicant to fill in all spaces within heavy border tines and sign all appropriate declarations, ,8JkOF COSTA MESA - PERMI:X. V TRACT NO. - - LOT - NO. BLD. G ANO. "CONSTRUCTION PERMIT 1/ ZONING REGULATIONS roject Address i4w T�Y(PE OF CONSTRUCTION 1�I.NEW ❑ ADD ❑ ALTERATION l,y, Owner e_ hone ' - Address- QArchlEng. ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK License No. - Address �_ 0-1 HP - Contractor L Phone/j S41 TYPE OF PERMIT Address '7 C.CJ/ 50+HP ❑ GRADING ❑ FOUNDATION - ❑ STRUCTURAL SWITCHES ❑•TENANT ELECTRICAL ❑PLUMBING ❑MECHANIC LICENSED CONTRACTOR DECLARATION. ZONING APPROVED BY DATE -- I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000)- of Division 3 of the Business and ❑OTHER _ Professions Code and y II In all f r PROJECT DESCRIPTION^ + , License Class. sten o, Date 'Signal WORKERS' COMPENSATION DECLARA O - Sq. FT `' .. _ -• `OCCUPANCY CONSTRUCTION TYPE - -CHECK .I hereby affirm that I have a certificate of consent to self -Insure or a Certificate^of Workers' Compensation In$urance, -or a. certified copy VALUATION ' ZONE PLAN T,nreof (Section 3800 La C-)_ ! n y Nah.)[ Wi I C]1s company--WtOki GRADING CU. YDS, ACRES .," a� ertified copy is hereby furnished. -_ - - copy is filed with the city Building Division.EXEMPTION FROM WORKERS' COMPENSATION DECLARATION FREMARKS:,Certified - (This section need not be completed if the permit is for one hundred($100or less).Icertify that Inthe performance ofthe work for which this permit ISIssued, I shall not employ any person in any manner so as to becomeMBING'- subject to the Workers' Co mpensation•Laws of California. '_ - �- - PLAN CHECK BATHTUBS SHOWERS - `Data r _ Signature NOTICE: If after making this declaration, you should become subject. to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked._ _ __ - �- - - - CONSTRUCTION LENDING AGENCY TOILETS_ p• URINALS LAVATORIES DOUBLE LAYS KIT. SINKS DISHWASHERS SERVICE SINKS ',,) •SUMPS '' I hereby affirm that there Is a construction lendingagency for the per• formance of the work for which this permit Is issued (Section 3097 FLOOR SINKS FLOOR'DRAINS — $ - Civ. C.). " - - - - -- Lender's Name DRINKING FOUNTAINS Lender's Address .� OWNER BUILDER -DECLARATION - hereby affirm that l am exempt from the Contractor's License Law for the following reason (Section- 7031.5 -Business and Professions Code: Any city or county which requires a permit to construct, alter, Impprove, demolish or repair any -structure, -prior to its•issuance-also re- quires the api-licant for Such permit to file a signed statement that he SWIMMING POOL- P TRAP - - - -' - WATER SERVICE ALTERATION is•licensed Pursuant to the provisions of -the Contractor's -License -Law {Chapter 9 (commencing with Section 7000) of Division 3 of the 'iness-and-Professions-Code) or that he is exempt therefrom and -the- Ithe alleged exemption. Any violation of Section 7031.5 by -GAS SERVICE OUTLETS - . - WATEWHEATERS - BTU OUTPUT - - SEWER CONNECTIONS" ' -- '- -- -• I applicant for a permit subjects the -applicant -to a-civil»Penalty- c . ,tot more than five hundred dollars ($500). -SOLAR TANK- - " - COLLECTORS - ❑ i, as owner of the property, or my employees with wages as their' - sole compensation, -will do the work, and the Structure is not intended SOLAR PIPING SYS. or offered for sale_ (Section 7044, Busiriess and Professions Code: The Contractor's License Law does not apply- to an owner of a properly who builds or improves thereon, and who does Such work himself or ISSUE -FEE r - - ' through his own employees, provided that such Improvements are not intended or offered for sale. It, however, the building or'improvement' is sold within one •year of completion, the owner will nave the burden of proving he did not build or improve for the purpose of sale),- '❑, I, as - owner -of. -the• property,. am exclusively contracting with licensed contractors to construct the project (Section 7044, Business _ MECHANICAL PLAN CHECK ' HEATING SYSTEM 0-100,000 BTU AND DUCTING - - - - - 100,000 + BTU and -Professions Code: The Contractor's License Law does not apply to REFRIGERATION 0-100,000 BTU , an owner of property who builds or Improve$ thereon, and who con- tracts.-fram. such projects -with a contractor(s) iicesned pursuant -to the Contractor`s License Law). SYSTEM - - -• - -- - 100,000 + BTU ❑ I am exempt antler Sectionliz ' B. & P. C. for this BOILERS BTU reason - Date Owner - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE rJ I hereby certifythat. I have read this application and state that the above inform orrect. I agree' to comply with all City and county ordi ces and s I s rel ng to construction, and hereby authorize' re pr entatives of ci td enter upon the -a trove mentioned "S prope n rposes. ISSUE FEE • Signature ate' Drivers' License or 55I CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 51235/20/82 ( .27. 75 Tl, ZONING REGULATIONS 1-10 KW ' A.P. :Plt ZONE - PLNTG.,REF,_9F APPLIANCE '- -10-50 SETBACK!: -JL ST. R ON RL YNLINE +•KW SS5IDpp YARD 0-1 HP - RIIGEA RU - HT - - ,(INC. SOLAR)- REAR YARD (TO P/L) , 50+HP PKG.'SPACE REQ. PROVIDi=D:, SWITCHES STREET WIDTH- -PARK FEE $ - -$ ZONING APPROVED BY DATE -- ,POLE LIGHTS SPECIAL CONDITIONS: _ ISSUANCE $ + , $ -CHECK .ELECTRICAL PLAN CHECK,,- { GRADING'_$ GENERATOR- 0 -1' -KW 1-10 KW (TRANSFORMER a - [��t APPLIANCE '- -10-50 KW_�50 +•KW -MOTORS - 0-1 HP - 1 -10 -HP ,(INC. SOLAR)- 10.50 HP 50+HP FIXTURES 'OUTLETS SWITCHES GAS TUBE -SIGNS - -$ rPLAN CHECK ,POLE LIGHTS -PERMIT , _ PANELS SERVICE &e(- if�l�lfl a - [��t ISSUE FEE- - - - '- - I . APPLICATION APPROVED BY --- - -. - - -- DATE - SUMMARY OF FEES BUILDING PERMIT 5 1 +.,.SMIP - -$ rPLAN CHECK -S -PERMIT , _ ISSUANCE $ pPLUMBING $ -CHECK GRADING'_$ PLAN $•• - -- ELECTRICAL MICROFILM E PLAN'CHECK $- - - - TOTAL'.FEE $' MECHANICAL _ E - - LESS AD - .PLAN CHECK $ - VANCE'PC $ _ FINAL FEE $-Z_ I CONSTRUCTION AND PLANNING / q Date APPROVALS Permit # -� G�[ 1 Vf Inspector POOL & SPA APPROVALS Permit 1 , Dates Inspector -. i 1 7 1. TemporarY Electrical Service or Pole 43. Poo! &Equipm-en't Locatiorn '- '»' ' ' " y - • " ' Soil Pipe-Uridrgrn 44. Steel Reinforcement 3. Electrical Conduit utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ 46.. Electrical Bondingr- 5. tee ein grce 47. Rough Plumbin &'Pressure Test- . .� ' ' '�� ` a ` 'F° ' 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITEt' - 7. Footings_ 49. Electrical Conduit-Undr rn B. Foundation _ _ _ 50:. Gas Pipe, [] Undr rn,-Test- 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra6 ' 0 Undr rn.' '•' 10. Structural Floor System _ _ 52. APPROVAL TO DECK .11. . Property Sewer Line.& House Connection' 53. Backwash & Receptor -Final. 12.. - Street Sewer -Connection _ ` ` -_ -• - - 54. Heater & Vent -Fina( 13. Rough. Plumbing 14. Rough Electric -Conduit - "` `,56.", Electrical -Final ?� 15. Rough Electric -Wiring -C�� Yl�r [� •57.` -Solar-System-Final 16. Rough Heating & Air Conditioning -Fencing & Access Approval ' 17. Ducts, in Structure + APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINIAL M 19. Gas Pipe -Rough & Test ; - 20:- roof Framing 21. Roof Sheathing- - - - - - NOTES_ �. ' 22. • Frame and Flashing _ -23:- -Insulation 24. Lathing & Siding - 25: Drywall Nailing -- - - 26- Plaster Brown Coat 27. --Electrical Power Meter -Final ' 28. Final Electric `' 29- Final Heating& Air-Condifioning 30. Final Gas Pipe -Test - - 31. -Final Plumbing 32. Water Service -Final - - - - -33. Gas Service -Final. ` 34. Solar Domestic -Final ' 35. Landscape Sprinkling System 36. Sound Attenuation " 37. Handicap Regulations ' 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40, Electric Release to Edison , 41. Gas Release to Southern California Gas Co. 42. ' CERTIFICATE OF OCCUPANCY No. _ Date `� • - s t ....... `C. N - ♦ V , -. - - V 3 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA 7PER�^�T NO. TRACT NO: L� 7/NO. -BLDG.NCONSTRIJCJEQ�I PERMIT�-3S1� v' _ 61 46 5/20/82 x_23.00 TL' r ZONING REGULATIONS. - 1 A.P. qj�- ZONE --' _ - PLNG.-REF. 9P-� BUILDING SETBACK - Project Addie oljl' A1rwayJP kCLg. Y 1, 0111y TYP CONSTRUCTION S YARD -' - NEW' ❑ ADD ❑ ALTERATION - Owner J.D. son Phone S'EP RIfGHTA ❑ REPAIR ❑ CONVERSION ❑DEMOLISH- Address 5131- O,1aiGA Airway Ave REAR'YARD (TO P/L) - ❑ OTHER ' Arch/Eng: License No. fff��V DESCRIPTION OF WORK T Address _ -_ 'STREET WIDTH ' - TYPE OF PERMIT, Contractor Safeway Heating - Phony 3 1 n yv[y ❑YGRADING,• - ❑-FOUNDATION ❑ STRUCTUR -- ❑ TENANT •❑'ELECT.RICAL ❑PLUMBING r CH AN ICA ❑.OT.HER _ + ' ROJECT DESCRIPTION- -� OCCUPANCY CONSTRUCTION TYPE - -+ VALUATION ZONE _ .- __ _ GRADING CU. YDS. ACRES ± Address] -3 Im eT a - an a' a LICENSED CONTRACTOR DECLARATION _ .__ -iI hereby affirm th:.t I am licensed 1uncter p ns of Char (com ,mencing with--section--7000) .of;•DIv n .3 f- the slnass Professions Code, land mX 1lcens s i ulI i d ct., 1. _. C LQ. _ Licentse Class Lice �ate,i��.,7 -Sig natu WORKERS' COMPENSATION ARAT[ I hereby affirm that I have a c ificate of Consent'to self-Insur a certlficate of Workers' Compensation Insurance, .or -a. certified copy'TM thereof (Sep��8 C.). Haines Ins. �}� l 'Icy No. Company - Cert if led copy is'hereby furnished..- _ _ 1 rCertified copy is filed with the city Building Division. r - -• - REMARKS: _ 61 46 5/20/82 x_23.00 TL' r ZONING REGULATIONS. - 1 A.P. qj�- ZONE --' _ - PLNG.-REF. 9P-� BUILDING SETBACK - PUPLYIL LGNE j S YARD -' - ' S nl ,,:-, t . i 14;t r., r. � lit. i 1 I Cert fy-that In the' performance of the work for which this pernilt is :Issued, I shallnbt employ any person In any manner so a5�to `become subject to the Workers' Compensation taws of California.`' ' << I • I + - - ^^^ Date Signature S'EP RIfGHTA - - `BATHTUBS -. _ SHOWERS ' �'^ - -~--- Y REAR'YARD (TO P/L) - �"- •- -- -i•- - - "-PKG'.SPACE 'REQ. PROVIDED *-- :revoked. - - CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- �formance of the work for which this permit is issued (Section 3097 Name------ - — --- - - - -- - - - - ICly. C.). s . ILentler' 'STREET WIDTH ' - -" PARK FEES _ -- _ MOTORS -- 0-1-h1P- -- 1-10 HP I _ (INC. SOLAR) 10-50 HP 50 + HP_ _ -r _ I '{ ZONING'APPR_OVED BY DATE - --- --- - SPECIAL CONDITIONS:-. ---' -�'• -' _Name Lender's Address INTERCEPTORS 'CLARIFIERS + T POLE LIGHTS — s I 'OWNER BUILDEWDECL'ARATION jl hereby affirm that t am exempt from the Contractor's License Law for ,thg following reason -(Section 7031.5 Business -and -Professions -Code : • city or county which requires a permit to Construct, alter, ove demo Iish-or•repair-any structure; prior to Its issuanCe, als0-re- Res the api.11cant for such permit to file a signed statement that he ' EXEMPTION FROM WORKERS' COMPENSATION DECLARATION :(This section need :not_be completed If the permit_ Is for one hundred ... . - -� " -- �, � — - ' S nl ,,:-, t . i 14;t r., r. � lit. i 1 I Cert fy-that In the' performance of the work for which this pernilt is :Issued, I shallnbt employ any person In any manner so a5�to `become subject to the Workers' Compensation taws of California.`' ' << I • I + - - ^^^ Date Signature "PLUMBING ' �.- '" ,';PL-AN'CHECK. •-I -- ' - ELECTRICALS--- -'-- P- PLAN•CWECK ► - - •- `BATHTUBS -. _ SHOWERS ' �'^ - -~--- Y (NOTICE; If after making this declaration, you should become subjects to the Workers' Compensation provisions of the Labor Code, you must ,forthwith comply with such provisions or this permit shall be deemed -TOILETS _ r, , �+ URINALS- -------- LAVATORIES DOUBLE L•AVS ---• •- -- -i•- - - ;GENERATOR- .-_ 0 -1 -KW - TRANSFORMER -- iAPPLIANCE- - -10-50 KW_50-+,KW. 171D;KW _ .. :revoked. - - CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- �formance of the work for which this permit is issued (Section 3097 Name------ - — --- - - - -- - - - - ICly. C.). s . ILentler' -- -KIT, SINKS'—DISHWASHERS- SERVICE SINKS -, t �.,� SUMPS• - •- - - -t- - - _ MOTORS -- 0-1-h1P- -- 1-10 HP I _ (INC. SOLAR) 10-50 HP 50 + HP_ _ -r _ I '{ -FLOOR SINKS" FLOOR DRAINS- - FIXTURES---- --OUTLETS - SWITCHES• - - '• - J ` DRINKING FOUNTAINS - - --- - - ;GAS TUBE -SIGNS. _Name Lender's Address INTERCEPTORS 'CLARIFIERS + T POLE LIGHTS — s I 'OWNER BUILDEWDECL'ARATION jl hereby affirm that t am exempt from the Contractor's License Law for ,thg following reason -(Section 7031.5 Business -and -Professions -Code : • city or county which requires a permit to Construct, alter, ove demo Iish-or•repair-any structure; prior to Its issuanCe, als0-re- Res the api.11cant for such permit to file a signed statement that he ' -SWIMMING POOL ' � -P TRAP -- - - `POLES-" "-- " "METERED SUH' WATER SERVICE- -' 'ALTERATION' - PANEL -S- - -MAIN -- -SUB _ -GAS SERVICE OUTLETS' :SERVICE. - AMP is licensed pursuant -to the provisions of the -Contractor's License Law ((Chapter 9 (commencing With Section 7000) of Division 3 of the Bustness-and Pro{essions-Code) or that he is exempt therefrom and the- „aria for the alleged exemption. Any violation of Section 7031.5 by pplicant fora permit subjects the applicant -to -a -civil -penalty more than five hundred dollars ($500), [ I as owner -of -the p--roperty,'or my employees with wages as'their - WATER HEATERS----- BTU OUTPUT - t ' -SEWER CONNECTIONS-- ' ' - ----- - ----- - - - ' - - - I SOLAR TANK ----COLLECTORS ' sole compensation, wilt do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The ;Contractor's license Law -does not apply to an owner of a property ,who builds or Improves thereon, and who does'such work himself or ` SOLAR PIPING SYS'--' ISSUE FEE - - - ------ ; ---' ISSUE FEE -""'-'• - "` ” ' - -'"- !APPLICATION APPROVED BY - 1 "1-E - -- -• = pA-- • - , through his own employees, provided that such improvements are not Improvement - Intended or offered for sale. If, however, the building or improvement- is sold within one year of completion, the owner will have the burden of proving he did not or ImproJe'for-the purpose oi-sale).' ❑ 1, as owner of -.the- ro ort am exclusive) contractin with•. P p Y, Y- 9-- 11Censetl contractors to construct the project {Section 7044, Business and Professions -Code: The Contractor's License Law -does not.apply.toM an owner of property who builds or Improves thereon, and who con- tracts from, such projects with a contractor.(s) licesned pursuant to- the Contractor's License Law). ❑ I -am exempt under Section= - B. &'P: C. for thisg01-LERS (reason -Date Owner 'I hereby certify that read this app' d state tnat the above information is" ect. agree to ply all city and county ordinances a stat I relati constr on, and hereby authorize represent es -of- is Cit 4 en pon the -above mentioned propert o_r i tion ur 5-13-82 MECHANICAL PLAN CHECK - - HEATING SYSTEM 0-100,OD0BTU •i�O -AND-DUCTING i - '----- a4 100,000,+ BTU REFRIGERATION 0-100,000 BTU _SYSTEM_::. _- _ rS _- _ _ __ 100,000 + BTU t BTU -' r - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE y -- - �' - - `SUMMARY OF FEES 1 0 ,, ,r, _.• ,;,ri A� - - BUILDING. PERMIT -- - _E _ I PLAN CHECK $ PERMIT I _'_ISSUANCE ;PLUMBING 5 - r "''GRADING'. S PLAN CHECK' $ � ELECTRICAL --$ '- - - - - ' -• -• - ---- t MICROFILM.$ r LPLAN CHECK $ - - TOTAL FEE $' - MECHANICAL�3 _- - PLAN CHECK g f VANCE PC ` $ •• ' ']-Q Slgnatr a Drivers ense or SS �j ISSUE FEE - r FINAL FEE $ o`er+' - CMF 0865-46 White -Building; Canary-Wplicant; Pink -Accounting; Goldenrod -Assessor , ,,,r,c1d ,t.,I,i CONSTRUCTION AND PLANNING �`��, • APPROVALS Permit # �Date Inspector �� POOL & SPA AppROVALS PerTrtit # 1 • -�� •t ; .t Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . 2. Sol ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding ,• _ tee em orce 47. Rough Plumbing & Pressure Test y - 6.- Electrical UFER Grn '` 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn. B. Foundation 50. • Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51._ Backwash Lines P Tra t❑ ' Heir rn•..: 10. Structural Floor -System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53.- Backwash & Receptor- Fibat 12. -Street Sewer Connection - .54. 'Heater & Vent -Final 13, Rough Plumbing 55, Plumbing Syste FTnaJI 14. Rough Electric -Conduit •56: ' Electrical -Final 15. Rough Electric -Wiring 57.- 'Solar System -Final 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts in Structure. APPROVED FOR PLASTERING 16. Ducts, Ventilating 60.- POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test - - 20. -Roof Framing 21'. Roof Sheathing NOTES: - 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric - 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final -33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. ?Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. ti CERTIFICATE OF OCCUPANCY L-1410 Date _ ` - PIPPIN Applicant to fill in all spaces except thole within heavy border fines and sign all appropriate declarations. �C�ITY_ORCOSTA MESA, - �- '�"� �- TNBLDG. PERMl7 TRACT NO. LO O. N��,y /i; 37�� h�7a?E i _ C014,TRumbN PERMIT '�.� MIs34 PSR= 141 I ; Applicant's Mailing Address .v:r�71 . �tt(.LJa✓ TYPE OF CONSTRU ION NEW ADD ALTERATION REPAIR � �Y y ❑ CONVERSION ❑DEMOLISH ❑ OTHER - ProjectAddress '�{� Q � T �F �� J� y1 Owner's Name '�S ��'gsrg Phoneme -�7� DESCRIPTION O I , WORK L+ � q[I[I • t+. 1 �Z I GRE ULATI - _ Address,faly r TYPE OF PERMIT GRADING FO UNDATIONt STRUCTURAL ' F1. P. # s 'ZONE ` L y Aich/Eng ' ►+ I License No, 6- ❑ TENANT ELECTRICAL PL'UMBfNG ��MECHANICAL PLNG. REF. - c,BUILDINGI - . A re ! ❑.o7HER I' - - #5 TO:BUILDING• 11 n rsct r s am v t:N hone�fI`7 �5��j l \PROPERTY PROJECT DESCRIPTION SR. — _ - OCCUPANCY LINE ! 'REAR YARD {TO P/L) 2 15 emim Ayf= F -7L0-•' Ck, %4Q(V I CONSTRUCTION TYPE ', ,.,.._ VALUATIDN $ L+9 cx� LE FT SIDE YARD j '" RIGHT SIDE YARD Address �mailingl 33'jc,4q ZONE GRADINGCU.YDS. • ACRES — P•KG.SPACE REQ. PROVIDED ;. I r License No: �- — - x (� t _ I LICENSED CONTRACTOR DECLARATION S I Remarks: STREET WIDTH d+�� = PARK FEE $ _ I"hereby,affirm that•I am licensed under provlslonsof Charter 9 (commencing , f with section 7000) of Division 3'of the Buslness and Professions Code, and _ `!f l0 I 1 I 5PI"CIAL CONDITIONS: { I ! my license,ls in full force and effect, I I 3�(1 j License��rCr,lass "r L' n No j + j PLUMBING ^ate Z- Signature I Bar Sink' Sewer Cap ; ! ELECTRICAL - t•++ 1 RKERS' COMPENSATION DECLAAATI N reby aiiirm.that Lhave a certificate•of consent.to self insure or.a certificate_ -_ + Backflow Preventer- - - - , - - , Automatic_ Washer-�_ _ Sewer ConnectionN - - - - - Meter Over 100 amps ; ,- -- - - r' OT Workers' Compensation ;lnsurante,• or„a certified copy thereof (Sectionr 1 3800, t+ , , 3800, Lab. C'�►_Q �$ - ��,� G+Nn !Backflow Irrigation r Solar_ Collectors `� 1 , Construction Pole,' Sub Panel o ' Policy No. .�QIOO+D+ Company.`G - - f �' r i �Certliledjcqpy.ls'hereby furnlshed. S.' I ! p i flied with the city , Bathtubs- I .,Dishwrdsher - Solar PipingCertif' Cooking Unit •' + Sub Pole ' j Motors ❑0-1 HP ❑ 1'/r8 Applicant ,J Clarifiers L, • Solar Tank 3 a te _ EXEMPTI N FROM WORKERS' COMPENSATION EC LARATI N 1 , Dryers ©Gas' ❑Electric ' Inc.Salar'❑9-15 HP,❑i6-15+ s 'I Dishwasher + ' Swlmmin POOL wIS a g p } �- (This section need not be Completed If the permit Is for one hundr ($100), or, less):. i �.f, that In the the for th15 it is issued l7; + Drinking Fountains , - �, , Urinal j •h , - '� Fan' F j1 r •; i ;Microwave i j I - , I certify performance of work which perp shall' no! employ. any person In any manner so as to become subject tot , - - - F.A.U, ^� { i ~';� -1 1 Pole Light C. Floor Drains' Workers Compensation'Laws of California;, �• ''{ ,,t`i Water Closet , / I Data Signature NOTICE: if, after making this declaration, you should become sabjert•to the • Fldor Sinks ; - - - �, _ < - r- --•Water_ Heater• -- 1 - -- - -- �• Fixtures 1 I _ _;., _ 'Range__ a.r - _ _Rol Workers'r Compensation provlslons.of the Labor Code, you must }forthwith. comply with'such,provl$lonS-.or-thisSpermlt ;Shall be 'deemed revoked:' r Gas Service :Ouilets' , �- ;n Water -Service'` j ' }v'' Device Bokes Sign CONSTRUCTION' LENDING AGENCY I hereby affirm that there is a'construction fending agency:for the performance. `a Interceptors - I - ', , •, ! - j s :' Outlets 1 Standing Sections of the .work for! which this permit Is ;issued '(Section 3097 Civ, C.) e _ Lender's Name` Kiichen�Sink} :, ; i - ; �, ti �. Switches Trash Com actor p Lender's, Address: OWNER.BUILDER DECLARATION' :' i� Lavatories • -r r/ y ,'- Garbage Disposal' ` I hereby affirm that I am-exemptlfmrn the'Contractor's Llcerise Law for the'” 7031.5 Business Professional Code: Any p—Tra p' - .I ri r; Generator; 00-5 KW 05-15 KW following reason (Section and city or county which requires a permit to Construct alter, improve, demolish'or repair �:;_. Transformer L1 15-50 KW "any structure; prior to its.issuance, also requires the applicantfor such permit ROof_'Drains' -• j to file a signed statement -that he/she is licensed pursuant to the provisions of _ ❑50'+ KW 1 Reinspection Fee $15 the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Isian 3 of the Business and' Professions Code)` or that he/she Is; exempt Showers C- t ReinspeetioniFee ' �r$4 i Meter ❑up '$ +efrom-and the' basis for the alleged exemption. Any violation"of,Section 1t5 by any applicant for 'subjects to i civil j t0100ampa Issue Feet , 3 ,a' permit ,.the -applicant . 6ialty'of not more than five hundred dollars ($500), r ! i a Service Sink i r i, Issue Fee $ 3� Zoning Approved By Date 1 h i I "as ,owner of� the property or my employees' with wages as their sole �_ , - MECHANICAL - � LC/ GG C, D �/�L i compensation- will do the work, and, the structure_is not intended or offered for Sale I(Sec{Ion 7044, Bus[ nese and Professional. Code:: The Contractor's '• Application Approved By a Date ; License Law does not apply to an owner of a property who builds or improves ` Bailer r l `- R&Ar eration System i Application Issued By �/DataZ i thereon, antl who Coes such work himself/herself or through his or her own amply ees, provided that such improvements areinot intended or offered for We. I waver, the building or improvement Is sold within one:year of com- Im- - Duct - Under, Ground 11 i' p 100,000 BTU ❑100,000 BTU f 1� �� QO SUMMARY & FEES j I pletion, the owner will have the burden of proving he/she did not build or rove for the purpose of sale). ;. , ' y Duct -Structural System Repair/Alteration I BUILDING PERMIT $; �. SMIP o -n $ I, as owner of the property, am exclusively, contracting with.licensed con- _tractors.to construct the. project. 7.044, Business.and Professions.Code: does'not en ' tin _ ; �r _ _ PLAN CHECK $ c�.3 1 I - PERMIT i ! The Contractor's License Law apply to an owner of property who builds or Improves thereon, and who contracts for such -projects with -a con- Exhaust System ❑ Multiple ❑ i r: I 'PLUMBING $ ISSUANCE , l $ ' tractor(s) license pursuant 10 the Contractor's License Law). ❑ lAm exempt under section B. & P. C. for this reason Firepi/Fact, Blt, ICBG # I s GRADING PLAN CHECK: $.. 'ELECTRICAL $ I ` Date f , Owner" 1 -that " eat Sys Ducti ! 1 QO= :. 1 --. 1 I PLAN CHECK $ r J� 0 MICROFILM $ 1 - I hereby- certify I' -have :read this-applicatlon and state that- the-ab6e Information Is correct..) agree to comply with all city and county ordinances' f ' 0 67 y' - —c - "' TOTAL,FEE. MECHANICAL $ $ j and state flaws relating to building construction, and hereby authorize repre- sentatives ` of I this -cjty me on the above-mentioned property for Inspection ourposeyJ�4 b%� f cod Or Type I ❑: f Cavo T e Il ❑' _ I Reinspection' Fee • 1 p j s , $�5 + , w PLAN CHECK $I 1 I i - AdVANCED PC f , $ z_e2• Signature �,/!�/�p r ti: t i to 81 �' I � ' R gist 1 issue Fee '� $ 3 � n S; ' �" I $ • Drivers' License or 55 1s i La , lam. FINAL FEE CMF 0865-46 rev. 12/82 . White - Building; Canary -'Applicant; Pink - Accounting; Goldenrod - Assessor V-- - r ' �,CONSTRUCTION•AND PLANNING-, POOL 'A + Date . Inspector � Permit #- . APPROVALS • - APPROVALS . Permit # Date Inspector ,• m 1- Tem orar Electrical Service or P le ' A Y o F' . -r ' 52: Pool & Equipment Location ,• 4K Soil Pipe-Undrgrnd. r �� J.. �3 53. Steel Reinforcement _ 3'. Electrical Conduit � tility=Undrgrnif: - F�, = :54 Forms `-� 4: Electrical Conduitbridrgfrid. - :E 55 Electrical Bonding ` ; 5. Steel,_Reinforeement , ,; ;' r:= 56.. Rough Plumbing & Pressure Test 6. Electrical 'LIFER Grnd, iL' ` �' ' '` ! 57 APPROVAL TO COVER-GUNITE * ' 7. Footings '. ', ';f - �„ -58. Electrical Conduit- Undrarnra. - i. 8. Foundation ; ' �� `='. 3 59. Gas Pipe, ❑ Undrgrnd., Test 9.'Water Pipe-Undrgrnd:,. `` :/ 60. Backwash LineS,-P-Trap, ❑'Undrgrnd. t" 10. Structural Floor System _ 61. APPROVAL TO DECK ' F 11. Property Sewer Line & House Confection ' ` 62. Backwash & Receptor -Final - 12. Sewer Cap =;; r� ' ' :r� .rte . 63. Heater. & Vent -Final - 13. Roof:Drains~r -` r :�• ,. ,� -64. Plumbing System 'Final 1 1. Rough Plumbing'- �' B5. Electrical -Final y 15..Rough" Electrical=Conduit , ` - ",' �, 66. Solai System -Final. 16. 'Rough -Electri c Wiring,fr,_ `t ' , !1'" !o - '67. Fencin &Access Approval 17.:11ou6h"Wiring Sidn ;68. APPROVED FOR PLASTERING 18: Rough ElectricalJMBo . Ceiling p�� g3 � ' 69.' POOL/SPA SYSTEMS FINAL 19.,Rough Heating & Air:Conditioning 1 a FIRE DEPT. REQUIREMENT APPROVALS' Permit # 20'. Rough Factory Fireplace ; ,..'; ' .' ; # 21. Ducts, -in -Structure; • K, 70. Underground Hydro 22. Ducts, Ventilating t r ! l 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Roiugh & Test i . r_ i� 72J Underground• Flush 24. Roof Framing { � ' - ; I : - �, + 73. Unde'rgrnd. Storage Tank 0 Gas'❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural)i & Monocoat 75. Dry Chemical .27. Frame.and Flashing 1 etd 2P/ 76.f Dry Standpipe --------------- 28., Lathing &"Siding,ll1lrr- •77., FIXED SYSTEM FINAL 29' Insulation 78. FIRE PREV. FINAL 30'Drywall Nailing v II 5 �� - -Notes., 31. Plaster Brown Coat ; 32: Electrical Power Meter -Final s AAa- 33. Final Electric 34. Final Heating &-Air Conditioning y�[ 35. Final Gas Pipe4est _ ' r 1 36. Hood or Canopy r� , 37. Final Factory Fireplace ; c 38. Final Plumbing l 39. Water Service -Final 1 r. 40. Gas Service-Fir4l 41. Solar Domestic -Final ' 42. Backflow Preventer , 43. Backflow Irrigation a 1' 44, Landscape Irrigation System .145, Sound .Aitenuation '46. Handicap Regulations: A 47. FINAL STRUCTURE'& -BUILDING;. ^ 3 48. Special Requirements Completed ' 49.jElectric Release to Edisori 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date g $�- 1 e - 3 &A OF COSTA MESA CONSTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border linCITes and sign fall appropriate declarations. RMIT NO. CT NO.rr-1 IS 3-Ilib'k Lc 1-1 MOVED) 4 y;� Project Address TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR Showers Applicant's MaiiinIAddress ; mu 5� ' , ❑ CONVERSION ❑ DEMOLI - o HER A.P. I �i �f Owner's Name Liv -a Phgne a��`7� DESCRIPTION OF WORK IMP. 5 Main Building: Dishwasher ! r�� L//.J`- F0 I Address TYPE OF PERM GRADING GRADING FOUNDATION STRUCTURAL T Front �t �1 ` Arch/Eng. �v/Y License No. f^i `Jl�cN e� ❑ TENANT & ELECTRI AL _ �� ❑ PL MBING ❑ MECHA ICAL �� W M� B Rear Address 212 pAl',�af,�.7 � ' � ❑ OTHER _ � _ p' Kitchen Sink UT7�Z /�jT- 5S7 11 Contractor's Nam Phortie` ) - PROJECT DESCRIPTION SG. FT [ . OCCUPANCY e� C )( Right I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, atter, Improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit Address (mailing) 1 ' -fLL � Cr CONSTRUCTION TYPE V VALUATION $ S I Left City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref. LICENSED CONTRACTOR DECLARATION Remarks: 1 Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing $ (goiter Use Building: with section 7000) of Division 3 of the Business and Professions Code, and $ Duct - Under Ground of my license Is In full for an effect, C{ License CI s L' s N �� + Refrigeration System ❑o-100,000 BTU 0100,000 BTU -- Planning Notes: Duct - Ventilating - PLUMBING FEES DateSignature WORKERS C MPENSATION DECLARATION Bar Sink Showers - Backflow Preventer Backflow Irrigation Service Sink - Sewer Cap I hereby affirm that I have a certificate of consent to self -Insure or a certificate Of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C,) / Q �S3 /•tA S -FVAJ Policy No. dd�lv�u - Company %% ��11+�� Iy�I Certified op Is hereby furnished. fj 7a! Certifl tl c ed with the city Bwltli Ivisia IJ /Date Applicant ! Bathtubs Sewer Connection Clarifiers Solar Collectors EXFMPTI N ROM ORI,ERS' COMPENSATION DECL RATION (Thiasectlon need not be completed if the permit is for one hundred 010 ) or Dishwasher Solar Piping , Drinking Fountains Solar Tank 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 tke Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Date Signature ' NOTICErIf,lafter making this declaration, -you should become subject to the Workers'. Compensation provisions of the Labor Code, you must forthwith comply ,with such provisions 'or 'this permit 'shall be deemed revoked. Floor Sinks Urinal -- - - - Gas Service Outlets Water Closet CONSTRUCTION LENDING AGENCY ' _ Interco tors �- p Water Heater - I hereby affirm that there is alconstruction lending agency for the performance of the work for which- this permit Is issued (Section 3097 Civ. C:) Kitchen Sink Water Service Lender's Name Lender's Address, OWNER BUILDER DECLARATION - Lavatories $ I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, atter, Improve, demolish or repair any structure, prior to Its issuance, also requires the applicant for such permit p -Trap p ' Roof Drains ._ to flie a signed statement that he/she is licensed pursuant to the provisions of - _ - he Contractor's License Law (Chapter 9 (Commencing with Section -7000) of Division 3 of the Business and Professions Code) or that he/she- is exempt therefrom and the' basis for the alleged exemption. Any violation of Section Reinspection Fee $25 _ Issue Fee S S 7031.5 by any applicant for a' permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). r 1, as owner of, the property or my employees with wages as their sole compensation, will CIO the work, and, the structure is not intended or offered forsale (Section 7044, Business and. Professional Code: The Contractor's 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 emploYeei, prOvidetl That such Improvements are not intended or offered for sale. If, however, the building Or improvement is sold within One year of com- platten, the owner will have the burtlen of proving he/she did not build or im. Ove for the purpose of sale), LJ I, as owner of the property, am exclusively contracting w(thilicensed con. tractors t6 construct the praiect (Section 7044, Business antl Professions Code: The Contractor's License Law does not apply to an owner of propertywho builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). MECHANICAL FEES t $ (goiter $ Hood Or Type I ❑ _ Canopy , Type II ❑ $ Duct - Under Ground _ Duct - Structural Refrigeration System ❑o-100,000 BTU 0100,000 BTU -- Duct - Ventilating - Exhaust System ❑ Multiple ❑ . , System Repair/Alteration - Firepl/Fact. Bit, (CBO f ❑ 'I am exempt under Section B. & P. C. for this reason Date Owner I hereby,certily that I. have read this application.and state that the above information Is correct. 1agree to comply with all city and County ordinances and'state laws relating to building construction, and hereby auth rIx repro- sentatives of this a ty t� ter/+up the above-mentioned P p ty for Heating System & Ducting 00.100,000,13TU ❑100,0006T� i - inspection purpos Signature bate 8 Drtvers' License or,SS � Reinspection Fee ffi5 1 Issue Fes $ 3 —717— CMF 0865-46 rev. 12/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Automatic Washer Construction Pole Sub, Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan - F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 00.5 KW ❑5.15 K 5372 3/05/ Zone Accessory Building: Park. Fees $ ELECTRICAL Transformer ❑ 15-50 KW ID 50 + KW Meter ❑up to 100 amps, Meter ❑over 100 amps Sub Panel' Motors El 0-1 HP EJ 114 - 8 Inc. Solar ❑9-15 HP E-116-15+Microwave Pole Light Range Sign ,Standing Sections W Trash Compactor R-nr. TL FEES ISS Z 0 N I N G R E O U I R E M E N T 1 Reinspection Fee 1 $25 Issue Fee 1 $ 3. PUBLIC SERVICES REOUIREMENTS: Zoning Approved By Date Building Approved By Date W f / Application Issued By b t• Dat ' SUMMARY OF FEES BUILDING PERMIT $ SMIP; i$ PLAN CHECK $ PERMIT - PLUMBING $ ISSUANCE $ PLAN CHECK 2596 $ � ENERGY P.C. $ i ELECTRICAL $r (J U GRADING $ PLAN CHECK 50%'$ MICROFILM '$ MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ _ I • CONSTRUCTION AND PLANNING APPROVALS Permit # �u�_ -_ Date " Inspector .r POU_di SPA _ APPROVALS Permit # - ,--Date �- F Inspector 1. Temporary Electrical Service or Pole ,• .52 Pool & Equipment Location 2' Soil Pi e•Undr rnd. 3.SteelRei'_nforcement , - 'r 3. Electrical Conduit Utility•Undrgrnd.. X54. Forms C, t 4. Electrical Conduit-Undrgrnd. 55: Electrical Bonding T 5. Steel Reinforcement :56. Rough Plumbing & Pressure Test. 6. Electrical UFER Grnd. 57:APPROVAL TO"COVER-GUNITE 7. Footings 58, Electrical Conduit-Undrgrnd. 8, Foundation 59. 'Gas Pipe, ❑ Undrgrnd.-, Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd: ' 10. Structural Floor System 61, APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash &Receptor -Final 12. SewertCap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System -Final - 14. Rough Plumbing 65. -Electrical-Final - 15. Rough Electrical -Conduit - .66: Solar•Systern-Final F' - 16: Rough Electric Wiring - 67 Fencing A&ess Approval 17: Rough Wiring Sign :68. APPROVED FOR PLASTERING I y 18. Rough Electrical -T Bar Ceiling '69' POOLJSPA SYSTEMS FINAL 19•. Rough Heating & Air Conditioning EQUIREMENT FIRE DEPT. REQUIREMENT- APPROVALS Permit , 20. Rough Factory Fireplace 20. i 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 71: Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush s 24. Roof Framing a ! 73. Unde'rgrnd. Storage Tank ❑ Gas' ❑ Oil 25. Roof Sheathing _ 74. Overhead Hydra 26. :r -Bar Ceiling (Structural) & Monocoat 175. Dry Chemical 27. Frame and Flashing I 176. Dry Standpipe 28. Lathing & Siding '77. FIXED SYSTEM FINAL 29. Insulation .78. FIRE PREY. FINAL + 30. Drywall Nailing i HEALTH DEPT. REQUIREMENTI 31. Plaster Brown Coat ' 79. FINAL INSPECTION , 32. Electrical Power Meter -Final 3 80; FOOD CERTIFICATE ISSUED I 33. Final Electric U Notes-. 34. Final Heating & Air Conditioning a 35. Final Gas Pipe -Test 36. Hood or Canopy r- 37. Final Factory Fireplace _ 38. Final Plumbing 39. Water Service -Final , 40. Gas Service -Final i 41. Solar Domestic -Final 3, 42. Backflow Preventer 43. Backflow Irrigation _ 44. Landscape Irrigation System 45, Sound Attenuation 4 46. Handicap Regulations , f 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 5 r- CITY OF COSTA MESA BUILDING DIVISION } 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 www...,costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5628 PERMIT NUMBER. B08-00188 PERMIT TYPE B_R00F2 STATUS: ISSUED I APN: 93894438 DATE ISSUED: 0612512008 j ISSUED BY: RIVID .JOB ADDRESS: 3151 G AIRWAY AV CM Suite/Unit: G Vicinity: JOHN WAYNE EXECUTIVE BUILDING ROOF Squares: 12000 Valuation: $26,971.00 SCOPE OF WORK: REROOF COMMERCIAL BUILDING "JOHN WAYNE EXECUTIVE BUILDING TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 15# FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR CLASS A FIBERGLASS SHINGLE$, APP 120 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: %VAKILI, MARK TR Unit: COSTA MESA, CA PHONE: City/State/Zip: 3151 AIRWAY AVE #E2 APPLICANT: HANSEN, DUKE_ Address. 260 E ALTON AVE Unit: PHONE: 714-557-7440 City/State/Zip: SANTA ANA, CA CONTRACTOR: ROSS AND BARROWS INC License No. 327802 Address: 260 E ALTON AVEUnit: PHONE: 714-557.7440 City/State/Zip: SANTA ANA, CA 92707 CELL: ARCHITECT: License No. PHONE: Al ENGINEER: License No. PHONE: FEE SUMMARY Reroof Plan Check: '$0.00 Reroof Permit Fee: $411.95 Reinspection Fee: $0.00 TOTAL FEES $411.95 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE t.1� pAIK INTMALS GONE I INSPE,cnoN 7rPE pAII Iffm $ 16113 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof/[L 210 Final Electrical 201 Final B1ockMetaining 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 BuitdinglOccupancy WORKERS; COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declaraSons: ❑ 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. ❑ 1 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: Carrier: c�%�T� y`CJU f (Thi sedfon need rbr be mmpdered r the perme a vae,ed at one hurxweu duears (s tool or ross.) P�y Number: d Z zap ❑ 1 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'1_ab r Code. I sh I forthwith comply with these provisions. Appnca tfgnature 0aft 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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. Lic. # 3 a Z C—Clais # r^ ttOr'SSignature IYdS_ c�_1 CONSTRUCTION LENDING AGENCY: ❑ I hereby affam 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 ($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.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature 3057-06 (3!071 Date I -Owner ID verified by driv nse. ❑ Yes ❑ No Drivers License No. 1 Expires: Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 -sir (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. Apphcanl's Signature Division of Industrial Safety Permit Number: bate 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? ❑ 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 rile a registration form for acutely hazardous materials? ❑ Yes ❑ 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 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? []Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7. If a permit from the South Coast Air Ouality 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? ❑ Yes ❑ No 8. (If "yes", attach certificate of"compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:'1'6ertify that under penalty of perjury the information given above is correct. I agree to comply with all state lam 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 stale 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. Srgnatur galOwner(s) Date Andlpr AuthOnz6d Applkant (.-nate, (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.'6.MLDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite: G003 Vicinity: G003 Primary Occ: B Eat<501 Office/ Bar<50 Type of Construction: V -N Parcel Number: 93894061 Zoning: Applicant: WILLARD FESLER Address: 4521 CAMPUS DR SUITE 578 Phone: 949-851-0888 IRVINE, CA Zip: 92612 ISSUED BY: Status: ISSUED Applied: 06/29/2005 Issued: 07/28/2005 owner: THOMAS AND HELENE MARKEL Address 3151 AIRWAY AV BLDG G3 Phone: COSTMESA ,A Zip: 92626 Contractor: OWNER -BUILDER . Address: Phone: Zip. License: 000000 Arch: WMF DESIGNSIWILLARD FESLER Eng: Address: 4521 CAMPUS DR Address: SUITE 578 Phone: 949-851-0888 Phone: IRVINE, CA Zip: 92612 License: C8627 License. - r SCOPE OF PERMIT . 310 SF INTERIOR TENANT IMPROVEMENT FOR 'CREDENTRUST•' IN SUITE G003. SCOPE OF WORK: CONVERT EXISTING BATHROOMS INTO BREAKROOM AND INSTALL NEW FURNITURE PANELS. ' FEE SUMMARY Plan Check: $81.71 - Calc Valuation: $36,000.00 Permit: $502.85 SMTP Res: $0.00 SMIP Com: $7.56 Other: $0'100 Inspection: $0.00 Total: $592.12 SETBACKS MAIN STRUCTURE Front' 0-0 Rear '0- 0 ACCESSORY Front 0-0 Rear 0-0 PARKING Existing: 0 Required: 0 Claim Valuation: $36,000.00 PLANNING & ZONING Leff 0-0 Right 0-0 Left 0- 0- Right o - .d • •-Proposed: Q _ > ,- NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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 f� 244e -as (SM) f ` fil I WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: Q 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. 0 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: Carrier. Policy Number. (This section need not be completed it the permit Is valued at one hundred dollars ($100) or less.) ❑ 1 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 o1 Califomia, 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: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CJVIL FINES UP TO ONE HUNDRED THOUSAND DOr1ARE ($10D,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: 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. Lic. 4 Class # Contractor's Signature: 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: Lender's Address: Signature: Data: 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 ($500).): Q 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 awn employees, provided that such improvements are not intended or offered for sale. It. 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.). ' ner 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.). ❑ 1 arrl a ec. Business and Professions Code for this reason: — ture: ` U J _OwnerfErverified by drivers licenser es [3No D em s License N EXpires: Verification of Ownership by (typA,/�of.document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Q 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 -3!X (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec, 341, Title 8, Califomla 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 relasse or threatened release of a hazardous material? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costs 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 [INo (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Deportment by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greeter 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 Costs 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. __"' ....................... _ .....— .................. fy .... ... . 4 Ilan RMPP is presently required, has Section 25534 of the Califomia Health and Safe Code been fully complied with? ❑ Yes ❑ No from the South Coast Air Quality Management„Distri t or from other air pollution control district or agencyi' 8 Yesµ —a Nox'_.. ''-..._.._....••••••.— 5 Does or will thea applicant or resent or future building occupant require for the work which is the subject of this a Ilcation a ermit for such construction or modification (Section 65850.2 of the Califomia Goverment Code requires that the requested information be fumished on applications for non-residential building permits). _..................._.._................................................................ —..................................... ,........................_......_.......... ............................................ _..... _.._r _ 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 0-4; (if 'yes'. the facility must meet the requirement of Sections 25534 and 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? ❑ Yes [I No _—....................................................._.-......................._....................................,,.................................................................................................... .................... ...... _.................. ............... ..............._................................ B (lyres W. attach certificate of compliance from the appropriate air pollution Control officer). CERTIFICATE OF COMPLIANCE: I cartiy 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 c9mply ell state laws a City ord ances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the e o inspection p es. 1 agr not to occupy or allow occupancy of any building authorized by this un it � al inspection. Signature s) 'Dale And/Or Authorized Applicant Date CODE 1. INSPECTION TYPE QAIZ INTCODES INSPECTION TYPE QAIE INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining 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 BuildinglOccupancy 2 (714) 754-5273 • Fax (714) 754-4856 • www.cl.costa-mesatLecTRICAL PERMIT 77 FAIR DRIVE, COSTA MESA, CA 9262$ Job Address: 3151 AIRWAY AV Suite No G003 Vicinity: UNIT G3 (CREDENTRUST) Parcel Nunmber. 93894061 Applicant: THOMAS MARKEL Address: BLDG OWNER Phone: 949-697-9753 Zip Owner. CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address %SOUTHERN CALIFORNIA %PROPERTY RESERVE I 10 E SO TEMPLE ST #400 Phone: BRUCE CHRISTENSEN, Zip: 84133-1101 Contractor: OWNER -BUILDER' Address: Phone: Zip: License: 000000 SCOPE OF PERMIT ISSUED BY: Status: ISSUED Applied: 07/282005 Issued: 07/282005 310 SF INTERIOR TENANT IMPROVEMENT FOR "CREDENTRUST' IN SUITE G003. SCOPE OF WORK: CONVERT EXISTING BATHROOMS INTO BREAKROOM AND INSTALL NEW FURNITURE PANELS. REF B05-01076. 46 LIGHT FIXTURES, 30 OUTLETS,.10 SWITCHES, 3 NON RES APPL FEE SUMMARY /+/Auu1=arC' I QnCrH AI 0-^k1r%1'r4^k10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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 2"548 0=11 Quantity ISSUE FEE $0.00 0 Temp service test $0.00 0 • Res. a1c packade $0.00 0 New Res (1-2 units) $0.00 -• 10 ' New Res (3+units) $0.00. 0 Pool 1 Spa $0.00 0 Lighting Fixts $40.98 46 Recept Outlets $29.30 30 Switches $11.00 10 Non Res Appl $14.25 3 Res Appl $0.00 0, Service to 200a $0.00 0 Service to 1000a $0.00 0 Service over i 000a $0.00 0 Motors to ihp $0.00 0 ' Motors to 10hp $0:00 6, Motors to 50hp $0.00 0 Motors to 1 00h $0.00.' 0 , Motors over i00hp $0.00 w 0 - Communication drops $0.00 0", - ,-Sub Sub panel to 200a $0.00' `' .. 0 a Pole Light Pkg $0.00 0" „a Sign Circuits $0.00 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 /+/Auu1=arC' I QnCrH AI 0-^k1r%1'r4^k10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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 2"548 0=11 Quantity Temp Dist System'/ Lighting $0.00 0 Busway.li00 ft ,>, $0.00 0 • Standing Section: '' ` $0.00 0 Misc Electrical Equipment $0.00 0 Transformers up to 1 kvarkw $0.00 0 ................up to 10 kvalkw $0.00 0 ..........:.:....up to 50 kvalkw $0.00 0 .................up to 100 kvalkw 50.00 0 :.............over 100 kvalkw $0.00 0 Low Voltage Equipment $0.00 - 0 Low Volt Wiring System 1 Ckt $0.00 0 Mise. Conduit _ ' $0.00 0 Misc. Conductor $0.00 0 Circus (gen or ride) $0.00 0 Circus (meth ride or lights) $0.00 0 Christmas Tree Stand $0.00 0 Fireworks Stand--_ $0.00 0 Other, Electrical Fee $0.00 Investigation Feer $0.00 - Plan Check Fee- _ ,: $0.00 Reinspection Fee _ $0.00 .TOTAL CALCULATED"FEES $119.03 /+/Auu1=arC' I QnCrH AI 0-^k1r%1'r4^k10 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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 2"548 0=11 DECLARAVONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ l have and will maintain a cartiflcate of consent to sell-Insure for workers' compensation, as provided for by section 3700 of the Labor Code, tar 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: Carrier: Policy Number. (rhls sect not be completed 1t the permit is valued of one hundred "ars ($100) or less.) �~ cor6fy that in the performan of the work for whin this permit Is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws o1 C ' oris, a ae that should become subject to the ricers' compensation provisions of Section 3700 of the Labor Code, (shell forthwith corn �Ap_pllcant Slgrlature:— G Date: - WARNING: FAILURE TO CURE WORKERS' COMPE ION COVERAGE I AND SWILL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE (3t00,13D0), IN ADDITION TO THE COST OF COMPENS AMAGES 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 4 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. Uc. s Class i< Contractor's Signature: 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). 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 requiras 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 8 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt thorefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit ub' cis 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. 044, 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 awn 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.). ' ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors Ucanse 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 exam der C. Business and Professions Code for this reason: Owner ID verified by driver's license. ❑ fes ❑ No Drlvers'Lla r" No. Explras'� 6 Verification of Ownership by (type of docume .a. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more loot 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: 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? ❑ 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? ❑ Yes ❑ No (Section 25533 of the California Health and Safety Code, with someexcaPbons, 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 fast of compressed gas at standard temperature and pressure). 3 � ❑ r will the applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? 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 Section of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. M..... ---•--.._.__.............................................................._._...............__....................................................,...,...........,...............---..................---.................._........................................... 4 It an RMPP is resent) required, has Section 25534 of the California Health and Safe Code been full complied with? P Y q Safety Y P ❑Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this application armit for such construction or modification gPa from the South Coast Air Quality Management District or from any other air pollution control district or agency? [3 Yes LJ 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 faclity to be Constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If 'yes , the facility must moot the requirement of Sections 25534 and 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 Coda Section 42303 been made? []Yes ❑ No --..._ ..........--- .......... •••....................................................................................,....................................._.._........................................................................................ 8 (If 7/es", 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 penally of perjury that I have read fhis 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. .11 Slgnatura 01 Legal ner(s) /y Dam Armd/Or•Autfio - d nt � �Ddts-� CODE t• INSPECTION TYPE DATE IKMALS CODE I INSPECTION TYPE U3 INTITIALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical Z 201 Final BfocklRetaining 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 (714) 754-5273 - Fax (714) 754-4856 - www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT Job Address: 3151 AIRWAY AV Status: ISSUED Suite No G003 Applied: 0728/2005 Issued: 07128/1005 Vicinity: UNIT G3 (CR EDE NTRUST) Parcel Number: 93894061 ISSUED BY: Applicant: THOMAS MARKEL Address: Phone: Zip: Owner: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: %SOUTHERN CALIFORNIA %PROPERTY RESERVE'i 10 E SO TEMPLE ST #400 Phone: BRUCE CHRISTENSEN ' Zip: 84133-1101 Contractor:; OWNER -BUILDER Address: Phone:, Zip: License: 000000 SCOPE OF PERMIT 310 5F INTERIOR TENANT IMPROVEMENT FOR "CREDENTRUST" IN SUITE G003. SCOPE OF WORK: CONVERT EXISTING BATHROOMS INTO BREAKR06M AND INSTALL NEW FURNITURE PANELS. ,REF B05-01076. 2 REPAIR/ALT COOLINGIHEAT. 2 VENT.FANSISINGLE DUCT FEE SUMMARY COMMENTS 1 SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit sholl 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 sit requl red 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 /V 244546 (SM) Quantity _ Quantity ISSUE FEE $23.50 Repair 1 All Absorbtion Unit $0.00 0 Inst FAU <100 k BTU $0.00 0 Repair l Alt Refrigeration Unit $0.00 0 Inst FAU'>100 k BTU $0.00 0 . Ventillation System $0.00 0 Repair/ Alt Cooling/Heat $27.40 2 Evaporative Cooler $0.00 0 Inst 1 Rep. Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Ref rig Sys X100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys >100 k BTU $0.00 0 Compressors 1 Absorption Systems Gas Piping $0.00 0 Up to 3 hp 1 100 k BTU $0.00 0 Factory Fireplace $0.00 0 3,To 15 hp / 500 k BTU S0.00 0 Hood w/Meeh Exhaust $0.00 0 15 To 30 hp 11,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp 11,750 k BTU $0.00 0 Vent Fan / Single Duct $14.50 2 ' Over 50 hp 1 Over -1,750 BTU $0.00 0 Appliance $0.00 0- Boilers Fire Dampers 50.00 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 to30 hp," >%,. $0.00 0 Air Handlers < 10000cfm . 50.00, 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 ' .E Floor or Suspend Heater $0.00, 0 - Investigation Fee • " $0.00 Plan Check Fee" $0.00 ' t Reinspection.Fee °, x $0.00 „„-,...TOTAL CALCULATED FEES $65.40 COMMENTS 1 SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit sholl 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 sit requl red 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 /V 244546 (SM) DECLARAVONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty Of perjury one of the following declarations: ❑ 1 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. ❑ 1 have and will maintain workers' compensation Insurance, as required by section 3700 of the Lab-of Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy Number: (Thies se on need not be completed It the permit is valued at one hundred dollars ($100) or less.) r I certify that In the performance of the work for which this permit is Issued, I shall not employ any person In any manner se as to became subject to the workers' scompensation taws of Callfomla, and agree that 111 should become bject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with t e AppHcard 6lgnature� Dew. 7 c7 wARNINe FAILURE TOS CURE WORKERS' =wFNsATION OOV IS UNLAWFUL AND SHALL SUBJECT AN EMPL0YFRh7CRIMINAL PENALTIES AND GVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (SI OD,0O0), IN ADDITION TO HE COST OF COMFIENSATiON, DAMAGES AS PROVIDED FOR IN SECTION O7oe 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 lorce and effect. Uc. p Class p Contractors Signature: - Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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 o1 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 110ensad pursuant to the provisions Of the Contractors license Law (Chapter 9 (commencing with Section 7000) of DMsfon 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 sub a 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 Cade: The Contractors License Law dogs 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.). ❑ 1 am exam r sec. Business and Professions Code for this reason: Signature: `�' o' Owner ID verified by driver's license. ❑ Y Driv9rs'iJcense'iV Ef xphe5:^' Verification of Ownership by (type of document, l.a. - pKDerty tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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 then thirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec, 341, Title 8, Calitomia 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mom Fire Department by every business which has at any one time during a reported year a quantity of hazardous materiels equal to or greater then 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 acuiety hazardous materials? ❑ Yes ❑ No (Section 25533 of the California Health find 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 test of compressed gas at standard temperature and pressure). _ ......... _......._.—........ ---... _........... ........................... _.... 3 Does or will the aappplicant 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? (] Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication 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? Yes U No (Section 65850.2 of the California Govetnment Code requires that the requested Information be furnished on applications for non-residential building permits). .........y................. _ ry — -- ---- _.__...._—......... _.—_........... —..................................... ._............. . _... 6 Will an art of the facill to be constructed under this rmit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 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 ail of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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 Emissi0ns. Signature: _ Date: CERTIFICATE OF COMPLIANCE AND AUTNORIZATI0N OF ENTRY: I certify under penalty of perjury that I have reed this application and state that the Information given is correct. I agree to comply with all state Iaw4 and city ordinances relating to building construction, and authorize representatives of the City of Costa Mesa to enter upon the abovo-described property for inspeclion purposes. I agree not to occupy or allow occupancy of arty building authorized by this permit until final inspection. ' nature Of Lagat Owner Date 7 And(Or A50rizsd. i Date y CODE ria. INSPECTION TYPE 9M lid CODE I INSPECTION TYPE �- 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block(Relalning Wall 212 Final Fire Prevention 202 Finaf Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Silo 204 Final Demolition 250 Final Buildingl0ccupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.cosla-mesaft�JMBING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite No G003 Vicinity: UNIT G3 (CREDENTRUST) Parcel Nunmber: 93894061 Applicant: THOMAS MARKEL ISSUED BY: Address: Phone a Owner: CORP OF THE PRESIDING BISHOP+,CHURCH"OF-LDS, Status: ISSUED Applied: 07/28/2005 Issued: 07/28/2005 Address %SOUTHERN CALIFORNIA`%PROPERTY RESERVE 1.. FEE SUMMARY i a 10 ESO TEMPLE ST #400:. .Phone AMTti'Y AMT r•- QTYf AMTCITY BRUCE CHRISTENSEN Zip: 84133-1101'+ --- Laundry Tub !,Washer $0:00 0 Sump Pump H+: 0 Backf owEEi ation' . ' g i E$$0.00 4 Landscape Irrigation $0.00 0 Swimming Pool $O.00r 0 Backflow Preventer $0.00 0 P -Trap $0.00; 0 Trap Primer • $0.06 0 Bathtub `', $0.00 Contractor: OWNERBUILDER Urinal' $0.00 0 Clarifier System $0.00 OR': Process Piping (per 10 ft) r $0.00 0 Vacuum'Brkr Bkflow(1-), $0,00 0 Address: $0A0 , --0 �_ ; Receptors $0.00 0 Vacuum Biki Bkflow(5+) $0.00 4 xi Dental Units Phone 0 € Wash'Basin:�' •y$1.9.60 2 Zip $9.80 a SewerCaplforOemo x$0.00, Q Wash63sinSet $0.00 License 000000 Drain, Floor �y`?%$0.00 0 Sewer *Connect $0.00 , 0Waste4nd Vent System $0.00 k Drain, Rainwater, $0.00 0 Sewer.Pnvate Line $0.00 0` x Water Closet (Toilet) 'S19.60 2 Drain, Roof $0.01) 0., Shower ;fier $0:00 0 ,Water Heater! vent $12.30 1 Drinking Fountain n $0:00 0" Sink, bar;t $Q.00 0 'h Water Piping (Instar Rep.) SCOPE OF PERMIT. 1 Expansion Tank :. - r;: ..3.10,SF INTERIOR: TENANT IMPROVEMENT FOR "CREDENTRUST' IN SUITE G003.-SCOPE,OF,WORK� CONVERT EXISTING BATHROOMS INTO BREAKROOM AND INSTALL NEW -FURNITURE PANELS. __ a REFB05-01076_ ,�.•f " `" tax ;1 DISHWASHER°*1 KITCHEN'S INK 2 WASH BASINS, 2 WATER CLOSETS ;1 WATER HEATERNENT,:1 :WATER PIPING, ; u3 FEE SUMMARY i a AMTti'Y AMT r•- QTYf AMTCITY Laundry Tub !,Washer $0:00 0 Sump Pump $0 00 0 Backf owEEi ation' . ' g i E$$0.00 4 Landscape Irrigation $0.00 0 Swimming Pool $O.00r 0 Backflow Preventer $0.00 0 P -Trap $0.00; 0 Trap Primer • $0.06 0 Bathtub `', $0.00 0... Pressure Regulator $17.00:` 0 Urinal' $0.00 0 Clarifier System $0.00 OR': Process Piping (per 10 ft) r $0.00 0 Vacuum'Brkr Bkflow(1-), $0,00 0 Connect (Ice;Soda,etc) ` $0A0 , --0 �_ ; Receptors $0.00 0 Vacuum Biki Bkflow(5+) $0.00 0 Dental Units so'bo ', 0 € Septic Tank ,,. . $0.00 0 Wash'Basin:�' •y$1.9.60 2 Dishwasher n $9.80 1 SewerCaplforOemo x$0.00, Q Wash63sinSet $0.00 Q Drain, Floor �y`?%$0.00 0 Sewer *Connect $0.00 , 0Waste4nd Vent System $0.00 0 Drain, Rainwater, $0.00 0 Sewer.Pnvate Line $0.00 0` x Water Closet (Toilet) 'S19.60 2 Drain, Roof $0.01) 0., Shower ;fier $0:00 0 ,Water Heater! vent $12.30 1 Drinking Fountain n $0:00 0" Sink, bar;t $Q.00 0 'h Water Piping (Instar Rep.) $9.80 1 Expansion Tank :. $0.00 0. F- SEnk commercial $0.00°:' o Water Re -pipe $0.00 0 Gas Earthquake Valve $0,00 6:: S�nk,`Floor " x $0:00 .0 Water Service $0.00 0 Gas (11 -4 outlets) $O.QO 0 � Sink, kitchen ;c $9.80 F .1° Water Softener,`. $OAO 0 Gas (Over 4 outlets) $0.00 _ `0 'Sink, servicelmop. .. n�$0.00 . 0 u OT1iER R.., : $0.00 Gas Repipe $0.00 • "Spa"{pnvate)n. $0.00 • • 0 -VIOLATION $0.00 Gas Service k0 Spa (public) ��a ; $0.00 0 PLAtJ'CHECK $0.00 Interceptors (Grease, Oil) $0.00REIiVSPECTION $0.00 0 Interceptors (Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $104.40 COMMENTS 1 SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permitshall 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 2446-46 (5100) 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 wilt 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: Carrier: Policy Number: (This sec ' n need not be completed if the permit is valued at one hundred dollars ($100) or less.) �1 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 Cali ia, and agree that if I should becomes ]act to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these n11 Appf€cant Signature: rD U i WARNING: FAILURE TO SECURE WORKERS' COMPENSAT{ON COVERAGE &LAWFUL 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 COMPE ATION, DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S 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. Lic. # Class N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction tending 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 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).): �.1, 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 safe. 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.). ❑ 1 am exam er s Business and Professions Code for this reason: Signe:_ Owner ID verified by drivers license.No DriJe'r cens6aVo. Cpires: .t L Verification of Ownership by (type of docume , 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: 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? ❑ 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). ........ ............................................... ............................................................................................................................... I--................................................................................................................................................................ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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 and filing with the Fire Impartment 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 Heath and Safety Code been fully complied with? [:]Yes ❑ No ..................................................................................................................................................................................................... 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication 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? I] Yes No (Section 65650.2 of the Caliiornia Government Code requires that the requested information be furnished on applications for non-residential building permits). ..............................................................................................................................................................................................1........................................................ 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 ❑ No (If "yes", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ..............................................................................................................................................................................................................................................-...................................................................... 7 Ii 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. ❑ Yes ❑ No ........................................................................................................................................................................................................................................... 8 (If yes", attach certii€cats of comp)€ante from the approprfate 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. Zl ria t Legal. ner(s) Z 7 kAhd1Or Author€zed App nl� - \,Da1e CODE QZ IRMIALS CODER INSPECTIONTYPE P IKTITIA4$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing B 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy th s ►3 Ti 3280 11/21/60 553.52 'COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ki RECEIVED Y rPE7RMI,-- For Applicant to in Completely — Use Ink Only .BUILDING A. P. NO. a� �- a 9i _ - - o ADDRESS so'. OWNER OR BUILDING, I ADDRESS TENANT Western Pacific Financ ia1 MAILING y r-. nal S ri C UNIT OR SPACE NO. ADDRESS •M. BILK. CITY Irvine Ca. 92714 rTE6`540=2606 NEW ADD ALTER IREPAIR IMOVING DEMOLISH LENDER Western Pacific Financial X BRANCH OWNER Western Pacific Financial (Same) ADDRESS VALUE USE p ARCHITECT ales -Lan $ton TE'�47-0$62 II g On EN 1NEER ADDRESS 777 S. Main, Orange, Ca. ZON767' TYPE GROUP J. Donald Olson Co. APPROVED DATE CONTRACTOR ADDRESS S ar Blvd..,Ste.B L. CITY Irvine Ca . 92714 NO.. 540-260 4 X6'23-2 7. APPROVED SETBACKS LIC. iE . ICYNO. 333969 L SIZE NO.OF BLDGS. (FROM C/LSTREET) OF LOT NOW ON LOT O FRONIT FT. USE OF Vacant Land EXISTING EXISTING BLDG. Separate permits are required for I L SIDE FT electric, plumbing and heating work. R F USE OF BUILDING AND WORK TO BE PERFORMED PWNINII ACTION Construct office building shell L -/ Q APPROVED 9184 S.F. APPROVED —a - a MOLD FOR SPECIAL REQUIREMENT: I hereby acknowledge that I have read this application and state e n that the above Information is correct and agree to comply with all laws regulating building construction, and I shall not employ i any person In violation of the workman's compensation laws of the State of California. ro I hereby certify that I amp parly I nsad as a contractor under SO. FT. a the State of California BLI ness an Professions Code, lvislon 3, THE AMOUNT SHOWN UNDER VALUATIDN IS FOR In Chapter 9, and that sue lican are in II f e a fact, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from the ovist of I tato f or a Business and Professlon3 Cod iv n 3, Ch Pt VALUATION PERMIT FEE $ • Ln Signature O " PLAN CHECK S M 0 TU .Ola Permittee 5 •/ yq9 TAX $ ' x Or Authorized A nt Date TOTAL PAI D 0 W H Q J Q } J cc W 10_ 0 a z UU _H W 13- 0 0 } CA) tl1 .. 2 H COSTA MESA BUILDING—SAFETY DEPARTMENT r.. P.O. BOX 1200 Costa Mesa, Caiitomia 8749 11/25/8i 24,16 CMF 0313-46, rev. 7/75 BLDG. PERMIT NO. For items not listed refer to Fee Schedule M� + I PERMIT O, TRACT NO. RECD BY F_—J LOT NO. DATE ISSUED BUILDING USE j [� / 1/ omue= al 7 BUILDING ADDRESS 3151 A11'AT�V Ayr'rn� SiTi_bp ELECTRICIAN 1 AppRESS 10885 Kahm River Rd. Unit E CITY TEL. NO.rj40^7%%3 STATE LICENSE NO. CLASS. CITY LICENSE NO. ��"� NO. ITEM RACN FEN COSTA MESA, CALIFORNIA Dwelling, Sq. Ft. $ NEAREST _ CROSS ST. Garage, Sq, Ft.F OWNER W P First 20 Outlets, eachIL p MA AdORE55�, 75 Outlets, Additional .12 • CrtC CITY costji� TEL. NO. 540-2606 20 First 20 Fixtures, each .2S I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLI- CATION ANp STATE THAT THE ABOVE IS CORRECT AND AGREE TOtCOMPLY_W1TH ALL CITY ORDINANCES AND STATE LAWS REG - ELECTRICAL WIRING. CERTIFY THAT I POSSESS THE ABOVE VALID STATE OF A CALIFORNIA CLASSIFICATION OR I AM THE LEGAL OWNER OF THE SINGLE FAMILY RESIDE IAL PROPERTY DESCRIBED ABOVE. SI9natun of PERMITTEE 18 18 Additional .12ULi1TING t6" DryerI Fan - Heater � Oven, Domestic ..j NO. ITEM EACH FEE! Pole, Construction Sign 6 t Trans. 2.00 Range, Domestic Transformers KW Misc.� Generators KW Motors [See Schedule] HP HP Sub -Total Fees HP APPROVALS Meters, aa.. INSPECTOR DATE TEMP. POLE Permit Fee 3 00 UNDERGROUND CONDUIT 1 i ROUGH FIXTURESPOWER Sub -Total Fees 2416 1 UTILITY CO. NOTIFIED 1 Total Fees CMF 0313-46, rev. 7/75 BLDG. PERMIT NO. For items not listed refer to Fee Schedule City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. j G P. O. Box 1200 Costa Mesa, California The Building located at 3151 Aird.V AVbirii.._ QG-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group --j3!-!2 Occupancy. Use of Building Interior Alteratiorm ^ Office Legal Description 427-291-14 (See reverse side for Metes and Hounds) Building Permit No, B-8033. Electrical Permit No. E^8125 Plumbing Permit No. Mechanical Permit No. M=8176 Number of apartments --0— and/o juest trrooms � —0- 1. ISSI.]ED TO: Building Official by 19000 YArth=, Newport Beach. CA This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015.46 rev. 1/83 White - Owner; Canary - Numerical File, Pink - Bldg, Permit File City of Costa Mesa Building Safety department CE RT IF I C A T'E O F •OCCUPANCY .i`J2 325 Q. ' P.O. Box 1200 Costa Mesa,,Cal0ornia The Building located at 11EiA 1%ir%rair.A-trtrril1p`-''rinif�- r..-1 has been.inspecied and found to comply with the provisions of all City of Costa Mesa.Ordinances applicable thereto for a Group Ize-7 Occupancy. Use of Building F%, -,---r,_,1 .. TA+-ra•r•;r,r_7A1-MnYrl*;.,„a ---- Legal' Description a a 4-11 104•— l Z (See reverse side for Metes and Bounds) Building Permit No B-1829 - Electrical Permit No. E-=1854 Plumbing Permit No.P-16.x8 Number of apartments and/or guest.rooms' "t7� ISSUED TO: Building Official by PAOTFTC rriw— -TAT, 4 Vicar C. N _wton Dilectol= BuilCJ= Div?. Date Jameiaxv 6 1982 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by the F -Building Official of the.City of Costa Mesa under Sec. 306 (4 U.B.C. I Form BU 34 Rev. 11/70- -i .S L-�,...� ; j ..� _ a -i : tl • L,�•N�V " City of Costa Mesa Building safely Department I{ C E RT I F I CAT E� '0 F O C C:U P.A N CrY s' .3548 ' P.O. Box 1200 ` .. { Costa Mesa, California ^� The Building located at 3181 A0T�umV, Aymilp. L 7 has been inspected and found to ' comply with the.provisions of all City of•Costa Mesa;Ordinances applicable thereto , ' fora Group Occupancy. Use of Building- —Tnt-Fnwirw Al Legal Descriptioh'el:P-i-,427-2t31z" Fico -^ ° i(See reuerse'side for Metes and Bounds)' !' Building Perm it`N o: B' 914 � �} E lectrical•Perm lit N o. �--425fE`-� _198 Plumbing Permit N o.D-47 Q 114i4t17.. Number'of'apartments"�,"�" "}.and/o-r9uest'rooms 155UED10 Building Official y J- ' v'61D G!i 3 'f + AbiY ' _ t7a] 1g7 • L � A.�s�;t » 3x � cal Ut .l[�ii1cF DiJ�.S Date' � 7. 13$1 t{ „ThW.Certificate,of.Occupancy SHA LL1BE posted in'a conspicuous place on the premises and SHALL NOT -BE removed except by the Building Official of the,City'of Costa Wsa under Sec -.,306 {e) U.B.C. } ;� '.For m.BU, 34 Rev. 11/70 _ - JI, i . , _ , } .• - • , + Applicant to fill in all spaces within heavy border lines and sign all,appropriate declarations. �Cl* Of COSTA MESA PERMIT O TRACT NO. LOT NO- BLDG. NO. ','AONSTRUCTION PERMIT �1 S�^Tc(�3�tj 911 ,1181 328.3 TL oject Address TYPE OF CONST'RUCTIOWH 'Owner N ' Phone ❑ NEW ❑ ADD ;a+ ALTERATION Address Q ❑'REPAIR ❑ CONVERSION ❑DEMOLISH "❑ ZONING REGULATIONS ArchlEng, License No. OTHER DESCRIPTION OF %S OAK f' P • Address 7 ZONE PLNG. REF. zr Contractor -s do Phone [ TYPE OF PERMIT �R�I j �iNG Address f �.p� ❑ GRADING CJ`FE)UNDATION ❑ STRUCTURAL SETBACK T. 51 YARD Y LINE LICENSED CONTRACTOR DECLAMATION 'r NANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA 1 hereby affirm that I am licensed under provisions of Charter 9 (com- p ARD MIGHT mencing with •sectlon 7000) of division -3 of the Business ,and _ ❑ OTHER Professions Code, and y license is in full force an f REAR YARD (TO P/L} PROJECT DESCRIPTIONe License Class - - L7 License No. PKC. SPACE REQ. PROVIDED' _ State Signature t.STREET Sq. FT.' - OCCUPANCY*2-'CONSTRUCTION TYPE WIDTH 'PARK FEE s -)RKERS' COMPENSATION DECLARATION ":'Iereby affirm that 1 have a certificate of consent to self -Insure or a VALUATION ONE ZONING APPA BY OAT t f • aTtificate of Workers' Compensation "Insurance. or a certified copy 1 ti-reof Section 3800, Lab. C.). ( GRADING CACRES SPECIAL CONDITIONS: y No. Company : f• i ertfied copy IS hereby furnished. 1.(ThiS REMARKS: '—` Cert fled copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION section need not be completed if the permit -is for one hundred $100i or less) I"certffy 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 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation taws of California. Dale Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW 1.10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith Comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50 + KW revoked. - - -- - CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS ;MOTORS 0-1 HP 1-10 HP 1 hereby affirm that there Is'a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 +AHP formance of the work' -for .which' this permit'is issued (Section 3097A Civ. C.). 7 Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES , Lender's Address �``'-`s ,ti>> �•� ORINKING'FOUNT/iINS,j GAS TUBE SIGNS OWNER BUILDER DECLARATION 1ti I. hereby affirm that I am exempt from -the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES MI=TERED SUB the following reason (Section 7031.5 Business and Professions Code: Anv city. or county .which .requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB I- ive, demolish or repair any structure, prior to its issuance, also re- : the applicantforsuch permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP 1, ansed pursuant to the provisions of the Contractor's License Law (Chaptor _9 (commencing with Section. 7000) of Division 3 of the WATER HEATERS BTU OUTPUT BL-Oness and Professions Code) or that he is exempt therefrom and the for the .alleged exemption. Any violation of .Section 7031.5 by SEWER CONNECTIONS 3ppllcant for a permit subjects the applicant to a civil Denalty L at more than five hundred dollars ($500). _ - SOLAR TANK COLLECTORS - - ❑ 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 SOLARPIPINGSYS. ISSUE FEE or offered for sale. (Section -7044, Business and Professions Code: The Contractor's License 1_aw'does' not apply to an owner of a property ISSUE FEE d'BUILDING APPLICATION APPROVEO BY DATE who builds or Improves thereon, and who does such work himself or through his Own employees, provided that such improvements are not MECHANICAL PLAN_CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT ❑ I, as Owner of the property, am exclusively contracting with AND DUCTING $7�v SMIP. - $ licensed contractors to construct the project. (Section 7044, Business 100,000+ BTU PLAN CHECK $ 'ill 7 PERMIT and Professions Code; The Contractor's License Law does not apply to / ISSUANCE $ an -owner Of property who builds or improves thereon, and who Con- REFRIGERATION 0-100,000 BTU PLUMBING § tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor 's.UCerise Law). _ 100,000+ BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ reason PLAN CHECK § _ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ I hereby certify that 1 have read this application and state that the above EXHAUST SYSTEM MULTIPLE ♦, -LESS �„ MECHANICAL $ AD - information is correct. I agree o comply with all city and county _ - - , v PLAN CHECK $ VANCE PC $ ordinances and st •laws r ati to co 151:1 :tion, and hereby authorize representat his y o enter on the above mentioned X0 , ,, y A t I • -�• propertys c pu e F FINAL EE $ Signature to Drivers' License or SS � ISSUE FEE -Assessor CMF 0665-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit-# Date Inspector • - POOL & SPA�r APPROVALS + Permit # Date Inspector 77 N 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms r 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee ein orce 47. Rough Plumbing & Pressure:Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE '"� ,�` •kvl� `• 7, Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, 0 Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -TW- 0 Undrqrn = 10. Structural Floor System 52. APPROVAL TO DECK 11.'' Property Sewer Line & House Connection 53.. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 56;_ Plumbing System - Final 14. Rough Electric -Conduit •56.% Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19, Gas Pipe -Rough &Test 20. hoof Framing 21. Roof Sheathing NOTES: - , 22. Frame and Flashing 23. Insulation 24. Lathing & Siding A-LAZ&4 LkaGJ D+ 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System` 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ?� 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY NoDate + - s �. �. ',' `• .`• - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. ,. CITY OF COSTA MESA PERMI NO. LOTNO. -BLDG.NO. EGNSYF3UCTION PERMIT `/9/,7c)JfNTRACTNO. !�I —1 R -Lr �--/ 8 98 11/23/81 500.54 TL NING REGULATIONS I , A.P. •L — 2C4 1 6 ZONE fA# 0-i— . PLNG. REF, 9?L REAR YARD (TO P/L) — ' PKG.SPACEREG. PROVIDED STREET WIDTH PARK FEE $ 'ZONING APPROVED BY5 F77 DATE SPECIAL CONDITIONS: , ELECTRICAL PLAN CHECK GENERATOR TRANSFORMER APPLIANCE rroiect muurm5 J 1'J 1 G-' 1 Al rwa Ave • L.M. OF CONSTRUCTION MOTORS (INC. SOLAR) . Owne Phone 752-767 hT�-YPE LJ NEW ❑ADD El. ALTERATION L4 FIXTURES Address a ew Ort Beach ❑ REPAIR [3 CONVERSION E] DEMOLISH GAS TUBE SIGNS Arch/Eng, Om Campos &' ASSOC License No. ❑ OTHER tenant improvement , Address Main St. Irvine DESCRIPTION OF WORK METERED ntractOr app Company Phone_ 640-260 TYPE OF PERMIT C1 Address _ St Mesa ❑ GRADING ❑ FOUNDATION - ❑ STRUCTURAL ' ISSUANCE 'S LICENSED CONTRACTOR DECLARATION 0 TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA OI hereby affirm that I am licensed under provisions of Charter 9 (com- _ GRADING $ mencing wlth section 7000) of Division 3 of the Business and 0 -OTHER Professions Code, and my license Is in full force and effect. Ucee Class R y Ucense No. �69 - ns PROJECT DESCRIPTION $ SG. FT. 3708 MICROFILM $ Date Signature MECHANICAL $ '_ TOTAL FEE $ _ _ `RKERS' COMPENSATION (DECLARATION OCCUPANCY—,.—ONSTRUCTION TYPE 0 +reby affirm that I have a certificate of consent to self -Insure or a VALUATION 55 67,12, LONE ^ ificate of Workers' Compensation insurance, or a certified copy ` ' �° J ereof (Section 3800, Lab. C.). ,.GRADING CU: Yds.,.— ACRES ' Icy No. Company _, Certified Copy is hereby furnished, - - REMARKS: - - _ certified copy is flied with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred ($1D0 or less). 1 II cartf(fy that in the performance of the work for which this.permit Is. - issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK subject to the Workers Compensation -Laws of California. �. - Date Signature BATHTUBS SHOWERS NOTICE. If after making this declaration, you should become.subject TOILETS URINALS to th0 WOrkeT$' Compensation provisions of the Labor Code, you must - for comply with such provisions or this permit shall be deemed -y LAVATORIES DOUBLE LAYS revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - formance of the,work for which this permit is issued.(Section 3097 Civ. C.)'WEstern Pacific Financial FLOOR SINKS FLOOR DRAINS Lender's Name - Lender's Address 11501 novo, NPwpnrt Beach - [DRINKING FOUNTAINS OWNER BUILDER DECLARATION I herebyy affirm that I am exempt from,the Contractor's License law for INTERCEPTORS CLARIFIERS the foilowing reason (Section 7031.5 Business and Professions Code: SWIMMING POOL - P TRAP _ Any city or county which requires a permit to construct, alter, 1-nrove, demolish or repair any structure, prior to its"Issuance,-also re- WATER SERVICE ALTERATION •s the applicant for such permit to file a signed statement that he ensed pursuant to the provisions of the Contractor's License Law' GAS SERVICE OUTLETS ,. .pter 9 (Commencing with Section 7000) of Division 3 of the °°ness and Professions Code) or that he Is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS BTU OUTPUT "3 `a li permit subjects the applicant to a civil penalty y SEWER CONNECTIONS di'notmt more than five hundred dollars ($500). ❑ I. as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS " sole co mpensation,Lwiil do the work, and the structure Is not Intended. or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply -to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE through -his own employees, provided that such Improvements are not rntended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU Cl I, as owner of the property, -am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU and Professions Code: The Contractor'sLicense law does not apply to an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from such projects with a contractor($) •licesned •pursuant to SYSTEM the Contractor's License law). 100,000 + BTU ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason Date Owner SYSTEM R EPAI R, ALTERATION I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE information is Correct. I agree to comply with all city and county ordinances and ditto -hers relatin to.constructlon, and hereby authorize represents of s [y o enter on the above mentioned - proper f ns ctlo pu oses. Signature Drivers' License or 55 qI -ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 8 98 11/23/81 500.54 TL NING REGULATIONS I , A.P. •L — 2C4 1 6 ZONE fA# 0-i— . PLNG. REF, 9?L REAR YARD (TO P/L) — ' PKG.SPACEREG. PROVIDED STREET WIDTH PARK FEE $ 'ZONING APPROVED BY5 F77 DATE SPECIAL CONDITIONS: , ELECTRICAL PLAN CHECK GENERATOR TRANSFORMER APPLIANCE 0.1 KW 10.50 KW -50 1-10 KW + KW MOTORS (INC. SOLAR) . 0-1 HP - 10-50 HP --;,-50 '1-10 HP ' + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS , POLES METERED SUB - .PANELS MAIN SUB SERVICE ISSUANCE 'S 'AMP PLUMBING $ _ GRADING $ PLAN CHECK $ ISSUE FEE' - _ APPLICATION APPROVED BY DATE 112 SUMMARY OF FEES BUILDING - PERMIT $_.,7-pJi= SMIP- $ !3 .9 PLAN CHECK $� PERMIT ISSUANCE 'S PLUMBING $ _ GRADING $ PLAN CHECK $ ELECTRICAL $ $ PLAN CHECK $ MICROFILM $ MECHANICAL $ '_ TOTAL FEE $ , PLAN CHECKn' $ VANCE PC $ _ ` ' �° FINAL FEE $ sbo CONSTRUCTION AND PLANNING APPROVALS V1 Permit # Date Inspector POOL & SPA • ' _ APPROVALS Permit # Date Inspector 1.' Temporary Electrical Service or Pale 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44.• Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. . Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. 'Electrical UFER Grn 48:1 APPROVAL TO COVER-GUNITE 7. T ootings 49. • Electrical Conduit-Undr rn 8. Foundation 50:- -Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51'." Backwash Lines P -Trap.❑ Undrgrn 10. Structural Floor System 52"- APPROVAL TO DECK 411. -Property Sevver'Line & House Connection 53. .Backwash & Receptor -Final - 12. Street Sewer Connection _ 54.~ -Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit 56.' Electrical -Final 15. Rough Electric -Wiring 57.» 'Solar System -Final 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts in Structure 59, APPROVED FOR PLASTERING 18. Ducts, Ventilating ? Y 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathin - ' NOTES: D 22. Frameand.Fleshiri , _Z•` _ 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 7 A r Ax 7 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test i 31. Final Plumbing .S. 32. Water Service -Final F 33. Gas Service -Final - 34. Solar Domestic -Final 35. stem - Landscape Sprinkling System- 36. 36. Sound Attenuation A. 37. Handicap Regulations 38. FINAL STRUCTURE & BUI LDING?9117 1P r 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No- •�� Date ' Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY QF COSTA MESA FERMI NO. TRACT NO. LOT NO.' BLDG. N l CONSTRUCTION PERMIT-/ 1, Project Address 3 ` TYPE OF CONSTRUCTION - - -8141 11 /12/61 9-00 TL! Owner%T,rn Phone 51YO-2Aa ❑ NEW )4 ADD ❑ ALTERATION Address C �� ❑REPAIR ❑CONVERSION ❑DEMOLISH Arch/Eng. cense No. ❑ OTHER ZONING REGULATIONS DESCRIPTION OF WORK Sr A.P. Address faAf ZONE PLNG. REF: � Contractor L. u Phone o TYPE OF PERMIT 1 1; TTpo gg�UJI ppI NG Address KS D .14 ❑'GRADING ❑ FOUNpATION ❑ STRUCTURAL SETBACK IDppF YARD PRDHRY' LINE LICENSED CONTRACTOR DECLARATIO �' ❑ TENANT [--],ELECTRICAL PLUMBING ❑MECHANICA A I hereby affirm that I am licensed under provisions of Charter 9 (com- RllGF- Ku / mencing with section 7000) of Division 3 of the Business and ❑ OTHER -Professions Code and my license Is in full for and 'affect'. REAR YARD (TO P/L) �� 3 (� .. (' �yc/' I PROJECT DESCRIPTION License Class Lican PKG. SPACE REQ. P DV lDEO Signature ? ` -SQ. FT. RKERS' COMPENSATION DECLAR ON " OCCUPANCY CONSTRUCTION TYPE STREET WIDTH PARK -FEE $ ' ereby affirm that I ,have a certificate of consent to self -Insure ora ZONEeof ZONING APPROVED BY DATE iflcate of Workers' Compensation Insurance or certified copyVALUATION (Section 3800, Lab. C.I.�T P GRADING CU. YDS. ACRES SPECIAL CONDITIONS: cy No. Company `G Gertltled copy Is hereby furnished. REMARKS:Certitied.copyIs filed -with the city Building Division.EMPTION FROM WORKERS' COMPENSATION DECLARATION is section need not be completed if thepermit is for one hundretl001orcess].rtify that'lr1 the performance of the work for which this permit is - issued I shall not employ any person in any manner so as'to'become subjea'to the Workers Compensation ws of 11f ni . PLUMBING ' PLAN CHECK ELECTRICAL PLAN CHECK Date L-%�'$t Signature _ c,R.. BATHTUBS SHOWERS NOTICE: If after making this declaratia au should become subject TOILETS ' URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVs APPLIANCE 10.50 KW 50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS 'MOTORS 0.1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS SUMPS (INC. SOLAR) ' 10.50 HP 50 + HP - formance of the work for which this permit -is issued (Section 3097 Civ, C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031,5 Business and Professions Code: SWIMMING POOL P TRAPUN city or county which requires a permit .to construct, alter, POLES METERED SUS, ova, demolish or repair any structure, prior to Its issuance, also re- WATER SERVICE ALTERATION ;PANELS MAIN SUB s the applicant for such permit to file a signed statement that he- ensed pursuant to the provisions of the Contractor's Ll cense Law GAS SERVICE OUTLETS 'SERVICE AMP ter 9 (commencing with Section 7000) of Division 3 of the ess and Pro4eSSions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by. any applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS of not •more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees with wages as (heir OLLECTORS- SOLAR TANK COLLECTORS* sole sole compensation,'will do the work, and the structure is not Intended or offered for sale, (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE — APPLICATION APPROVED BY DATE through his own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK SUMMARY OF FEES_ FEES is sold within one year of completion, the owner will have the burden Of .proving he did not build or Improve for the purpose of sale). ❑ - HEATING SYSTEM . 0-100,000 BTU BUILDING PERMIT $ -- . SMIP $ 1, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business • .100.000+ BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of properly who build$ or improves thereon, and who con- REFRIGERATION _ 0-100,000 BTU PLUMBING 3 tracts from such projects with a contractor(s) liceSned pursuant to SYSTEM GRADING S the Contractor's License Law), 100,000+ BTU. PLAN CHECK 5 ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL s $ reason '-' PLAN CHECK s MICROFILM s Date Owner SYSTEM Rl;Pg1R, ALTERATION TOTAL FEE $ MECHANICAL $ I herebycertify that 1 have read this application and state that the above Y pp EXHAUST SYSTEM MULTIPLE LESS AD- - iniormation I$ correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC s ordinances and stattjaws relating to construction, and hereby authorize representatives this cit t e er upon the above mentioned property nspactI n po �! !a, �Slgna - f FtNAL FEE $� re e Drivers' License or ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN APPROVALS Permit #� g Date Inspector POOL &SPA � - „ . APPROVALS Permit#- , Date Inspector` 1. Temporary Electrical Service or pole 43. Pool &' Equipment Location 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding b. Steel ein orce 47. Rough Plumbing & Presiure Ust 6. Electrical U ER Grn 48. APPROVALTO COVER-GUNITE• ' .' 7. Footings 49. Electrical Conduit-Undr rn- } 8. Foundation 50.- Gas Pipe, ❑ Undr gin, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra D' ndr rn' r ' 10. Structural Floor, System 52. APPROVAL TO DECK 11. Property,Sewer Line & House Connection 53. Backwash.& Rece tor-Final. { 12. Street Sewer Connection t. A- 10 .. 1 54. Heater & Vent-Final 13, Rough Plumbing - ' 14. Rough Electric-Conduit _ _ •56. Electrical-Final._' 15.-- Rough- Electric-Wiring- - - 57. _ Solar System-Final 16. •- Rough, Heating & Air Conditioning _ _ __W. FenciN & Access Approval 17. Ducts in Structure+t APPROVED FOR PLASTERING . 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - - ` - 19. Gas Pipe-Rough & Test 20. Hoof Framing - -� i 21. Roof Sheathing - - NOTES:- 22- Frame and Flashin "" 23.. Insulation 24'. Lathing & Siding 25._ Drywall Nailing i 26. Plaster Brown Coat ` 27. Electrical Power Meter-Final ' 28._ Final. Electric 29. Final-Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing /•�-/7$ f 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final- 35. Landscape Sprinkling System - - 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Compfeted ' 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. . CERTIFICATE OF OCCUPANCY 'No Date . . -�r t 613ayF - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF POSTA MESARMIT NO. PE TRACT NO. LOT NO. ,' NO. C61STRIj'CTION PERMIT S1;9�LDG. / `�, 4- Project Address S 2.�o TYPE OF CONSTRUCTION `"' t S_ 9538 12/15/01 ! ��(J Owner `Spi./ Phon EJ NEW E]AOD E] ALTERATION Address GJ —9L ElREPAIR 1:1 CONVERSION ❑DEMOLISH ❑ OTHER BONING REGULATIONS Arch/Eng. License No. OESCRIPT40N OF WORK .4 ✓% A. P, Address ZONE PLNG. REF. r#k Cbntractor_SA T7/4G© 41c, Ph6ne557 TYPE OF PERMIT TO BUILDING PROPERTY Addres s - �tZ_ �N�R ;4I ❑GRADING Q FOUNOATiON ❑STRUCTURAL St TSACK C L ST. SID YARD LINE LICENSED CONTRACTOR DECLARATI N 1-1 TENANT I- ELECTRiCAL ❑PLUMBING ❑MECHANICA SI E YARD I hereby affirm that I am licensed under provisions of Charter 9 (com- - RIGHT mencing with section 7000( of Division 3 of the Business and Q OTHER Professions Code and my license Is In full force and effect.. 4 G PROJECT DESCRIPTION - REAR YARD (TO P/L) License Class_ License NO.��o �/ PKG. SPACE REQ. PROVIDED Date Signature _ SQ. F�T' STREET WIDTH PARK FEE S -' RKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE iereby affirm -that t have a.certificate of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY - DATE rtifirate of Workers' Compensation Insurance, or a certified copy • thereof (Section 3800, Lab. C.). _ GRADING CU: YDS. ACRES SPECIAL CONDITIONS: ,fllcy No. Company Certified copy Is hereby furnished. - REMARKS:- L'I Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (ThiS' Sectlon need not be completed if the, permit is for one hundred - - - - - - - (5100) or less). -• - - I -certify that In they performance -of the work for wpich this permit is issued. I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws of California. Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, You should become subject TOILETS - URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER - - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_ 50 + KW, revoked. KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per. SERVICE SINKS SUMPS !(INC. SOLAR) 10-50 HP 50+ HP formance of the .work for -which this permit Is issued .(Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). Lender's Name Lender's Address DRINKING FOUNTAINS ,GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION 'PANELS MAIN SUB i—prove, demolish or repair any structure, prior to its issuance, also re- 'es the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP :erased pursuant to the provisions of the Contractor's License Law .,apter 9 (commencing with Section 7000) of Olvlsion. 3 of the WATER HEATERS BTU OUTPUT, +' i Business and Professions Code) or that he IS exempt therefrom and the s for the alleged exemption. Any violation of Section 7031.5.by for SEWER CONNECTIONS for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500).. SOLAR TANK COLLECTORS Li 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure Is not Intended - SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANiCAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose Of sale). HEATING SYSTEM 0.104,000 BTU BUILDING 'PERMIT E SMIP E ' ❑ I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business _ 100,000 + BTU PLAN CHECK. E PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). _ 100,000 + BTU PLAN CHECK $ ❑ 1 am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ § reasonPLAN Date Owner SYSTEM REPAIR, ALTERATION ` CHECK E Q't] MICROFILM $ ' TOTAL FEE E MECHANICAL I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD-- information is correct. I agree to comp) with all cit and county PLAN CHECK S VA CE PC E es and state laws lacing O Construction and hereby authorize tatives of th ity ter upon t1ie ,love mentioned f A r c Dur LDrivers' FINAL FEE $ _ _ License or SS ISSUE FEE - CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor t CONSTRUCTION AND PLANNING APPROVALS Permit# 221.(9 Date -- Inspector' POOL & SPA '_ "_ - '• .. APPROVALS Permit,# tiDate Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location .` 24 SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test ► . - �' 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE" `--�' 7. Footings 49. Electrical Conduit-Undr rn ' B. Foundation 50. Gas Pipe, p ❑Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap,❑ ndr rn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55, Plumbina System - Final 14. Rough Electric-Conduit .56. Electrical-Final- 15. - Rough Electric-Wiring 57. Solar System-Final 16. _ Rough Heating & Air Conditioning 5B. Fencing_& Access Approval 17.' Ducts, in Structure APPROVED FOR PLASTERING 16. Ducts, Ventilating 60. POOL/SpA SYSTEMS FINAL _ �•• 19. Gas Pipe-Rough & Test 20. Roof Framing 21. Roof'Sheathin NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning �(6 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape S rinklin System •36. `. Sound Attenuation , 37. Handicap Regulations 38. FINAL STRUCTURE & BUI LDING ' 39. Special Requirements Completed - 40. Electric Release to Edison - - 41. Gas Release to Southern Califo i Gas Co. v 42. CERTIFICATE OF OCCUPANCY N, _ Date 0 if Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. OF COSTA MESA r PERMIT O. TRACT NO. LOT NO. BLDG. NO. aTRUCTION PERMIT y p�),,3 1 1 a Address - �? / 4-/ ,.� Neer /E G Phone Address Arch/Eng. License No. I� Address i� Contra&c r �hhij - L IRC Ph6neSLi07123 II_ Address t G 5 4 , C -- LICENSED, LICENSED• CONTRACTOR DECLARATION - I .hereby affirm thr.t 1 am licensed under provisions of Charter 9'(com- mencing with section 7000)' of Division 3 of the Business and Professions Code, andmy license Is In full force and effect. License Class G icense o. Date S-% ^ $T Signature 'ORKERS' COMPENSATION DECLARATION iereby affirm that I have a certificate of consent to self -Insure or a s ,rtificate of Workers'- Compensation Insurance• or -a certified copy '•ereof (Section 3800, Lab. C.). licy No. Company .J-Certlfied copy is hereby furnished. - - - (] Certified copy Is filed with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if -the permit Is -far one hundred `1$100) or'lessl. certify that n 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.-- Oate Signature NOTICE: If after making this declaration, you should became subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with Such provislOns or this permit Shall be deemed revoked. - - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a Construction lending agency for the per- formance of. the work. for which this Permit_ is, issued (Section 3097 Civ. C.). - Lender's Name Lender's Address OWNER BUILDER.DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the following. reason' (Section 7031.5 Business and Professions Code: Any city or County which requires a permit to construct, alter, I-orove, demolish or repair any structure, prior to its issuance, also re- �s the ap; licant for such .permit to file a signed statement that he .erased pursuant to the provislons'of the Contractor's License Law .apter 9 (commencing with Section 7000) of Division 3 of the eko ',-.ness and Professions Code) or that he Is exempt therefrom and the r- for the alleged exemption. Any violation of Section 7031.5 by i'applicant for a permit Subjects the applicant to a -civil penalty not more than five hundred dollars ($500).- ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, -and the structure is not.lntended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License -Law does not apply to an Owner Of a_property who builds or improves thereon, and who does such work himself or through his own employees; provided that such improvements are.not Intended'or offered for sale. If, however, the building or improvement is sold within one year.of completion, the owner will have the.burden of proving he did not build or improve for the purpose of sale). 0=1, as owner of the property, am' exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Protessions Code. The Contractor's License Law does not apply'to an owner of properly who buildS or Improve$ thereon, and who con- tracts from such projects with a'contractor(s) 'licesned pursuant to the Contractor's License Law). El am exempt under Section B. & P. C. for this reason late Owner - I hereby certify that Ihave read this application and slate that the above Information is correct. I agree to comply with all city and county ordinantes.and State.laws relating to constructio and hereby authorize representatives of- this ity to e upo the above mentioned property tor._ pectin p S. Signature Date ,r - S gL Drivers' License or SS qF TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION 1:1 DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT, ❑ GRADING ❑ FOUNDATION- ❑-STRUCTURAL ❑ TENANT ELECTRICAL '❑PLUMBING-OMECHANIC. 0 OTHER - PROJECT DESCRIPTION.. - I SGS. FT. ' OCCUPANCY -CO . ISISTRUCTION TYPE VALUATION ' ZONE GRADING CU. YDS. ACRES REMARKS: _ - --- - -- ISSUE FEE' " CMF 0865-46 White-Buliding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 0240 1105/82 ZONING REGULATIONS A. P. 9� ZONE PLNG. REF. 9r RIGHT - I . `REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEES ZONING APPROVED BY DATE SPECIAL CONDITIONS: 8,00 TL SUB PLUMBING r PLAN CHECK BATHTUBS. SHOWERS TOILETS'. URINALS LAVATORIES OOUBLE LAVS KIT. SINKS OISHWASHERS 1 SERVICE SINKS I SUMPS FLOOR SINKS FLOOR DRAINS' DRINKING FOUNTAINS ' INTERCEPTORS CLATRIFIERS SWIMMING POOL PTRAP ' WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS " SOLAR TANK COLLECTORS SOLAR PIPING SYS. j ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0.100,000 BTU ; AND DUCTING 100,000 + BTU REFRIGERATION- SYSTEM • _ 0- 100,00.6 BTU 100,000'+ BTU - BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE' " CMF 0865-46 White-Buliding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 0240 1105/82 ZONING REGULATIONS A. P. 9� ZONE PLNG. REF. 9r RIGHT - I . `REAR YARD (TO P/L) PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEES ZONING APPROVED BY DATE SPECIAL CONDITIONS: 8,00 TL PANELS " MAIN' SUB SERVICE AMP' ELECTRICAL- PL.AN'CHECK "I SQ. FT M .,-.. . GENERATOR TRANSFORMERi. APPLIANCE 0-1 KW --1.10 KW 10-50 KW 50 + KW- ' .MOTORS - (INC. SOLAR) 0.1 HP 10-50'HP- 140 HP i 50 + HP - FIXTURES-- - OUTLETS SWITCHES GAS TUBE SIGNS PLAN CHECK $ 'PERMIT ; POLE LIGHTS ISSUANCE $' GRADING E 1 ,PLAN CHECK $ r PANELS " MAIN' SUB SERVICE AMP' ISSUE FEE-- - •APPLICATION APPROVED BY- '" DATE r SUMMARYOF,•FEES t 1 .1 4BUILOING-'.- 1 IPER.MtT $ SMIP $1:+. r PLAN CHECK $ 'PERMIT ; f PLUMBING $ ISSUANCE $' GRADING E 1 ,PLAN CHECK $ r {J ,.ELECTRICAL $_ ¢ �� S• PLAN CHECK $ � MICROFILM '$ 1 , MECHANICAL-$ TOTAL FEE $ i LESS AD• PLAN CHECK $ VANCE PC S _ • FINAL FEE s v CONSTRUCTION -AND PLANNING POOL & SPA = � Date Inspector" Date' Inspector APPROVALS Permit # a' APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool '& Equipment Location • - - -- - - 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. lectrical Conduit Utility-Undrgrn 45. Forms - 4, Electrical Conduit-Undrgrn 46. Electrical Bonding 5. -steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48: APPROVAL TO COVE R-GUN ITE - 7. Footings 49. Electrical Conduit-Undr rn 1 _ 8. , Foundation _ 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe•Undrgrn 51. Backwash Lines P-T ap. ❑ UhdWrn 10. Structural Floor System 52. APPROVALTO DECK- 11. Property Sewer Line -& House Connection 1 53. Backwash & Receptor-Final, 12. Street-Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing. _. - -- - 14. Rough Electric-Conduit - - - 56. - Electrical-Final 15. Rough Electric-Wiring 't - 57.`, Solar System-Final ' 16. Rough Heating•& Air Conditioning_ bB. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating _ 19. Gas Pipe-Rough &Test 60. POO L/SPA-SYST_EMSFINAL. 20. Roof Framing .. , 211 Roof•Shea thin 22• . Frame and Fiashin - NOTES: 23. Insulation ' 24. Lathing & Siding 25. Drywall Nailing 26.• Plaster Brown Coat _ 27. Electrical Power Meter-Final Ce�$;r< 28: -Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final = ' 35. Landsca e Sprinkling System " 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison ' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No' Date '. Applicant to fill in al, spaces within heavy border lines and sign all appropriate declarations, ISSUE FEE - TY Of COSTA MESA IPERMIT NO. TRACT NO. LOT NO. .BLOG. NO, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred CONSTRUCTION PERMIT Al Jq I G-3 BUILDING ►;'� - Project Address ?S iC4,j a a[_06 TYPE OF CONSTRUCTION Date Signature NOTICE: if after making tryis declaration, you Should become Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed Owner a yi Phone ❑ NEW ADD ❑ ALTERATION Q revoked. ` CONSTRUCTION LENOING AGENCY KIT. SINKS ? DISHWASHERS Address r%� Pf��L�C [�� `-El El -REPAIR ❑ CONVERStON ❑DEMOLISH [] FLOOR SINKS FLOOR DRAINS Civ. C.). - Lender's Name DRINKiNG'FOUNTAINS ❑ OTHER ZONING REGULATIONS Arch/Eng. License No. SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS Address DESCRIPTION OF WORK A. P. 9P ❑ 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. (Section 70440 Business and Professions Code: The • ZONE PLNG, REF. -P ContrectorSd C. lnl�, Phone - 4 TYPE OF PERMIT BUILDING TToo eBUt,jlL pINC Address Q I�^1 C7 GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBACK G ST. IDE YARD PtROPEf2TY LINE - LICENSED CONTRACTOFR DECLARATION I hereby that I licensed under of Charter 9 (corn- ❑ TENANT ❑ ELECTRICAL ❑PLUMBINGMECHANiCA SEF RD A c'2s affirm am provisions mencing with section 7000) of Division 3 of the Business and OTHER RIIGHTA Signature ate Drivers' License or SS Professions Code, and my license i5 In full force and ffREAR PROJECT DESCRIPTION' YARD (TO P/L) License CI ss License N07 -(O r PKG. SPACE REQ, PROVIDED Date O Signature SQ. FT. STREET WIDTH PARK FEE $ WORKS COMPENSATION DECLARATION OCCUPANCY +CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure or a' - VALUATION ZONE ZONING APPROVED BY DATE , certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS. Ilcy No. Company ISSUE FEE - Certified copy is hereby furnished, • -- -REMARKS: Certified copy is filed with the City Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($100 or less). ' I Cert fy that in the performance of the work for -which this permit is issued, I shall not employ any person In any manner so a5 to become BUILDING PLUMBING- PLAN CHECK subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS Date Signature NOTICE: if after making tryis declaration, you Should become Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed TOILETS- URINALS LAVATORIES DOUBLE LAVS revoked. ` CONSTRUCTION LENOING AGENCY KIT. SINKS ? DISHWASHERS SINKS - SUMPS I hereby affirm that there Is a construction lending,agenCy for,the per -SERVICE formance of the work for 'Which this -permit IS Issued (Section 3097 FLOOR SINKS FLOOR DRAINS Civ. C.). - Lender's Name DRINKiNG'FOUNTAINS Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city. or county wtilet) M14W eS a permit to construct, after, 7,pLove, demolish or repair any structure, prior to its Issuance, also re - res the applicant for such permit to.fiie a signed statement that he �rlcenSed pursuant to the provision$ of the Contractor's License Law i�.hapter 9 (commencing. With Section 7000) of. Division 3 of the Siness and Professions Co(ie) or that he is exempt therefrom and the S for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). - INTERCEPTORS CLARIFIERS SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT, SEWER CONNECTIONS SOLAR TANK COLLECTORS ❑ 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. (Section 70440 Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply to an owner of a property ISSUE FEE who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to Construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU AND DUCTfNG 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM _ 100,000 + BTU an owner of property who builds or improves thereon, and who con- tracts from such projects With a Contractor(S) licesned pursuant to the Contractor,'s License Law). ❑ I am exempt under Section B. 11 P. C. for this BOILERS BTU reason Date Own&r SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above information is Correct. I agree to comply with all city and county Ordinancestion, and hereby authorize and state l&E� A c'2s representatives of ton the above mentioned property' f r t ISSUE FEE Signature ate Drivers' License or SS CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor ISSUE FEE ELECTRICAL PLAN CHECK SUMMARY OF FEES - BUILDING GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW_50 '1-10 KW ' - - + KW PLAN CHECK S MOTORS (INC. SOLAR) 0-1 HP 10-50 HP 1-10 HP 50 + HP $ PLUMBING FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS PLAN CHECK $ ,POLE LIGHTS y $ . O PLAN CHECK POLES METERED SUB Za'b $� PANELS MAIN SUB LESS AD - VANCE PC S SERVICE AMP � 4 ISSUE FEE APPLICATION APPROVED BY DATE SUMMARY OF FEES - BUILDING PERMIT S SMIP S PLAN CHECK S IiMITISSUANCE $ PLUMBING $ GRADING S PLAN CHECK $ ELECTRICAL y $ . O PLAN CHECK S MICROFILM $ MECHANICAL Za'b $� TOTAL FEE S , PLAN CHECK $ LESS AD - VANCE PC S FINAL FEE $-� CY:Y CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA Date Inspector Permit # I e ` Inspector 4 DatAPPROVALS 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location = ' 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Ut lity-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46, Electrical Bonding 5. Steel ein orce 47. Rough Plumbing &•Pressure Test -6. Electrical UFER Grn 48. APPROVAL TO COVER -GUN ITE ' 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Tek 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra :'D Undrqrn -' 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12, Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55- -Plumbing System - Final 14. Rough Electric -Conduit ;56. Electrical -Final 15, Rough Electric-Wrin 57. Solar System -Final 16. Rough Heating & Air Conditioning- encing & Access Approval 17' Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough & Test Roof Framing' 60. POO L/SPA SYSTEMS FINAL 21. 22. RoofSheathin Frame and Flashing NOTES: { C 7 23. Insulation 24. Lathing & Siding 25. 26. Drywall Nailing Plaster Brown Coat 27. Electrical Power Meter -Final 28'. Final Electric 29. Final Heating & Air Conditioning p p' 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY .No. Date �\ •\� •� ` Applicant to fill in all spaces within heavy border—lines and sign all appropriate declarations. Y Of COSTA MESA - 7,01 : {IT NO _ / TRACT NO, LOT NO. BLDG. NO. NSTR'UCTION PERMIT [T! r..,7' ect Address 71 r - -1T _ Address Arch/Eng, License No, Address Contractor Ph6ne979-156 Address - LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section- 7000) of Division 3 of the Business and Professions Cod('e end my license 1s In full force and effect. - Llcense ass License 4,191969 Date— Signature J WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a Certificate of Workers' Compensation Insurance, or a cortifled Copy I thereof (Sectio 8 0 Lab, C.). ,Iicy No. Company Certified copy Is hereby furnished.. _I Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed.lf.the permit is for one hundred ($100) or less). f 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. Date Signature NOTICE: If after making this declaration, You should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 1 hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION 1 herebyy affirm that I am exempt from.the Contractor's License Law for the following reason (Section 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 re= ires the applicant for such permit to file a signed statement that he lcensed pursuant to the provislons'of the Contractor's License Law hapter 9 (Commencing with Section 7000) of Division 3 of the Business and Pro{essions Code) or that he Is exempt therefrom and the as for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty not more than five hundred dollars ($500). r��ole 1, as owner of the property, or my employees with wages as their compensation, will do the work, and the structure is not Intended or offered for sale.(Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are.not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑' I,- as owner of the prnperty, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- traCt$'from such projects with'a contractor($) licesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason ` Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all City and county ordinances and state laws relating to construction, and hereby authorize representatkves this City to enter upon the above mentioned property for o rp Signature Drivers' Licen r r SS Vft I :o_ TYPE OF CONSTRUCTION NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS DESCRIP ION OF WORK A.P. y 1/ ZONE PLNG, REF. TYPE OF PERMIT WBUILDING E]GRADING E]NE]FOUDATION STRUCTURAL SETBACK T, 51 YARD OPE{tTTY LINE ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA RIIGHTYARD ❑ OTHER REAR YARD (TO P/L) PROJECT DESCRIPTION- PKG. SPACE REQ. PROVIDED ' SQ. -FT.- OCCUPANCY CONSTRUCTION TYPE STREET WIDTH _ PARK FEE s ZONING APPROVED BY DATE VALUATION ZONE GRADING CU. YDS. ACRES SPECIAL CONDITIONS: REMARKS: ti 1 PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS- GENERATOR 0-1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10,.50 KW,50 + KW KIT. SINKS DISHWASHERS - GL. d MOTORS - 0-1 HP - 1-I0 HP SERVICE SINKS SUMPS (INC. SOLAR) 10-50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS 'SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL PTRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SU13 GAS SERVICE OUTLETS SERVICE - - "AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS, SOLAR PIPING SYS. ISSUE FEE ' ISSUE FEE APPLICATION APPROVED -BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP S AND DUCTING 100.000'+ BTU PLAN CHECK s PERMIT ISSUANCE $ REFRIGERATION 0-100,000 BTU PLUMBING $ SYSTEM GRADING $ 100,000 + BTU PLAN CHECK $ BOILERS BTU ELECTRICAL $ $ - PLAN CHECK S' MICROFILM $ /f �t SYSTEM REPAIR, ALTERATION TOTAL FEE $ �' MECHANICAL $ EXHAUST SYSTEM MULTIPLE LESSVANA - -PLAN'GHECK s - ISSUE FEE CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor FINAL FEE s t/ d "- CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA . Date Inspector APPROVALS Permit # Date Inspector 5 1. Temporary Electrical Service or Pole ' ' 43. Pool & Equipment Location SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn . _ 46. Electrical Bonding 5. Steel eiriorce -47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51, Backwash Lines P -Trap.❑ ndr rn 10. Structural Floor System 52. APPROVAL TO DECK 17. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing _47 .55, Plumbing System - Final' 14. Rough Electric -Conduit % •56. Electrical -Final 15. Rough Electric -Wiring 57, Solar System -Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. 19, 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24. lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing j 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landsca e Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date « Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. ':ICY Of COSTA MESA FERMIT NO. TRACT NO. LOT NO. SLOG. NO. CONSTRUCTION PERMIT&_ _i_ Owner Phone Address zwzze Arch/Eng. License No. Address Contractor Phone Address LICENSED CONT AC O 11E A R A TTb N I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, jnd my license Is in full force and effect. License ss 4rs��f��r License N rata Signature _ ORKERS' COMPENSATION DEC TION hereby affirm that I have a certifl. of consent to self -Insure or a Icertificate of Workers' Compensation Insurance, or a Certified copy *hereof (Sectl 3 0, b. C. - Icy No /ompany -- Certified copy is hereby furnished. r LJ Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be compieted if the permit - is for one hundred SEl00y or that n less). Ceorol fy the performance of the work for which this permit is issuedI Shall not employ any person in any manner So as to become subjacl to the Workers Compensation Laws of California. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY I hereby affirm that there is a Construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any City or county which requires a permit t0 -Construct, alter, 11 -Ove, demolish or repair any structure, prior to its Issuance,also re- ; the applicant for such permit to file a signed statement that ne ansed pursuant to the provisions of the Contractor's License Law ^Vnapter 9 (commencing with Section 7000) of Division 3 of .the RIness and Professions Code) or that he Is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty .,of more than five hundred dollars ($500). ❑ 1, as owner of the property, Or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or through his Own employees, provided that such improvements are not Intended or offered for sale, If, however, the building or Improvement Is sold within one year of completion, the Owner will have the burden of proving he did not build or Improve for the purpose of sale). ❑ 1, as owner Of the property, am exclusively contracting with licensed contractors to construct the project. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that t have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating t nstruction, and hereby authorize representativgs of this city to/p er upon the above mentioned /Drivers't4cen2 or SS qP ,CMF 0865-46 White -Building; TYPE OF CONSTRUCTION JiEVEW ❑ ADO, ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK 7. TYPE OF PERMIT ❑ GRAOING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT JR ELECTRICAL- ❑PLUMBING ❑MECHANi ❑ OTHER PROJECT DESCRIPTION SG- FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES 'REMARKS: bU1i 9/14/E1 ZONING REGULATIONS A.P. =P ZONE PLNG. REF. :P REAR YARD (TO P/L) PKG.SPACE REG. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE '$ DATE 1 � .6h T! PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBS SHOWERS 1,Q PT so_ F -T. TOILETS URINALS GENERATOR 0.1 KW 1110 KW TRANSFORMER LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW -50 + KW KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS ITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES_ BUILDINGPERMIT HEATING SYSTEM 0-100,000 BTU S SMIP $ AND DUCTING 100,000 + BTU PLAN CHECK E PERMIT ISSUANCE E REFRIGERATION 0-100,000 BTU PLUMBING y SYSTEM GRADING '$ 100,000 +BTV PLAN CHECK f BOILERS, BTU ELECTRICAL $ - - - (PLAN CHECK E MICROFlllvl S SYSTEM REPAIR, ALTERATION 'MECHANICAL TOTAL FEES E EXHAUST SYSTEM MULTIPLE LESS AD - PLAN CHECK 5 VANCE PC $ ISSUE FEE ; Pink -Accounting; Goldenrod -Assessor FINAL FEE $� I' CONSTRUCTION AND PLANNING APPROVALS Permit Date Inspector POOL & SPA Date Inspector' APPROVALS 6 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46.. ElectriGaj 136nding 5. Steel Reinforce 47. Rough Plumbing & Piressure'-Teit 6. Electrical LIFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Eleefrical Conduit-Undrgrn 8. 'Foundation 50, Gas Pipe', EJ Undrgra4 est 9. Water Pipe-Undrgrn 51. Backwash Lines, P -T -D"Undrqrn 10. Structural Floor System 52. APPROVALTODECK-- 11.' Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, i .;:�, % PluEnbinuSy5tem-Enal 14, Rough Electric -Conduit" -56. Electrical -Final 15-- -Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POO L/SPA SYSTEMS F INAL 19. Gas Pipe -Rough & Test 20, Roof Framing 21: Roof Sheathing NOTES: e 22. Frame and Flashiu 21 lnsulatiorx._.... 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29., Final Heating & Air Conditioning 30, Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkring System 36, Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE& BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA PERMIT NO. TRACT NO, LOT NO. BLDG. NO. CONSTRUCTION PERMIT TYPE OF CONSTRUCTION ❑ NEW ❑ AOD ❑ ALTERATION ❑ REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS s S Q �� — /''e-Phon FAdd--j Q� License No. DESCRIPTION OF WORK A.P. z0I ZONE PLNG. REP. =A' Address Contractor Phone TYPE OF PERMIT E) GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHANIC BUI L5TM=TTop SETBACK YARD S 6g I��DpINC PROPR7Y LINE Address LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under Provisions of Charter 9 (com- ❑ 51 E YARD RIGHT .onOng with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. OTHER REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. PKG. SPACE REQ. PROVIDED SQ. FT. — Date Signature STREET WIDTH PARK FEE $ YORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE ZONING APPROVED BY DATE I hereby affirm that I have a certificate of consent to self -insure ora VALUATION Certificate of Workers' Compensation Insurance, or a certified copy —ZONE 'hereof (Section 3800, Lab. C.), GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Icy No. Company . Certified copy is hereby furnished. REMARKS: ❑ Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred $100) or less). he work for ch this permit is Certify that in the performancK." issued, I shall not employ any in an er o as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subje to tri rkers' CompensLaws f nia. BATHTUBS SHOWERS _ Date Signature TOILETS URINALS GENERATOR 0_1 KW TRANSFORMER 1.10 KW NOTIC If after making thls decla tl yOu Shout ecome subject o! to the Workers' Compensation provislo the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for theper- SERVICE SINKS SVMPS (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS —CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: ^ny city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION MAIN SUB grove, demolish or repair any Structure, prior to Its Issuance, also re- res the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP licensed pursuant to the provisions of the Contractor's License Law Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ,SinesS and Professions Code) or that he Is exempt therefrom and the s for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS :^„ hot more than five hundred dollars ($504). SOLAR TANK COLLECTORS ❑ 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 SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Cnntractor's License Law does nut apply to an Owner Of a property who builds or improves thereon, and who does such work himself or - - ISSUE FEE APPLICATION APPROVED BY DATE through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, trio owner will have the burden of proving he did not build or improJe for the purpose of sale). HEATING SYSTEM 0.100,000 67U BUILDING PERM IT $ SMIP 15— Ell, as owner of the property, am exClUsively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S PERMIT and Professions Code: The Contractor's Licenso Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION D-100,000 BTU PLUMBING S tracts from such projects with a contractor(s) llcesned pursuant to SYSTEM - GRADING E the Contractor's License Law). 100,000 + BTU PLAN CHECK $ El 1 am exempt under Section B. 6 P. G. for this BOILERS BTU ELECTRICAL s s reason - - PLAN CHECK S MICROFILM E Date - Owner SYSTEM REPAIR, ALTERATION TOTAL_ FEE S MECHANICAL E I hereby certify that I have read this appliCatlOn and state that the above EXHAUST SYSTEM MULTIPLE LESS AO- informatio is correct. I agree to omply with all City and county PLAN CHECK E VANGE PC S _ ordinance d state laws rela t c nstruction, and hereby authorize represent s of this ty ter upon the above'oned property a lon ur S. q /;e FINAL FEE $�• Signature O Drivers' Licer or 5 ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA Date Inspector APPROVALS Permit # `Date Inspector. i 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51, Backwash Lines P-Tral2, ❑ Undrarn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. -Rough Heating & Air Conditioning 513. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING ; 18. 19. 20. Ducts, Ventilating Gas Pipe -Rough &Test Roof Framing 60. S d� - ,;'SS,) t POOL/SPA SYSTEMS FINAL ' 21. 22. Roof Sheathing Frame and Flashing f` NOTES: 23. Insulation 24. Lathing .& Siding 25. Drywall Nailing 26. Plaster Brown Coat ' 27.. Electrical Power Meter -Final - iQC-A ' 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final"Plumbing 32. -Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39\ Special Requirements Completed 40. Electric Release to Edison 41. 'Gas Release to Southern California Gas Co. 42. CNAOOUPANCYT Date 1 ' �1, *. , j• Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA - PERMIT N O. LOT NO. -' 2573' 1/21 /83 320.45. 7t. CONSTRUCTION PERMIT , - 13 3 3 I�f`i �t ` Applirant's Mailing Address 3lb I Ai rwaY' Ave.. - Costa --N *YPE OF CONSTRUCTION NEW El ADD, LJ ALTERATION-- RIn: 3151 Airway' Ave. G-2,. COSa !'lase C3 CONVERSION ❑ DEMOL,ISH Q OTH$R Project Address _ jhear5onl8me.H can EULe_ {,ane 9�0 DESCRIPTION OF WORK lnterl I}r improvement ' Owner's Name Address 19000 H agkthur -,7th Floor, Neviport' Beach I GREGULATIONS P �} �' 2 �' ZONE�� TYPE OF PERMIT' GRADING . FOUNDATION STRUCTURALA. Arch/Eng.- --e LicenseNo.. 4 rrvv Lit TENANT ❑ ELECTRICAL, ❑ PLUMBING• ❑ MECHANICAL PLNG.REF.� i BUILDING _ Address' 17779 "Fir Ela, "'St. Irvine a ❑,pTHER _ TO BUILDING + Y Contractor's Name.-.-� • U0010 WED .I��rSC�_lPhone�-.26 PROJECT DESCRIPTION SG. F -I.' OCCUPANCYCC R PE v INEPEAR YARD (TO P/L) "'Address(rhailing). 315.1 Airway An. E-1',CostaHesa CONSTRUCTIONT,YPF V -la• �11 VALUATION$28,500.LEFT SIDE: YARD RIGHT SIDE YARD: ZON)= GRADINfl CU.YDSr ACRES License No. �• ' PKG. REQ. PROVIDED L.ICEN5ED CON__TRACTOR DECL-ARATION { Remarks: +� .�� - S_ TREET WIDTH PARK FEE-$ I -hereby affirm that I am licensed under provisions of Charter 9 (commencing with iectlnn 7000) of Division 3 of the Business and Professions Code, and _ F SPECIAL CONDITIONS: ,. y license Is In Tull igrce end effect. { r I 33908 E 70 Llcen C ss [S ansa , PLUMBING 1 ; •, to S[gnature 1 t I Bar Sink i Sewer Cap r ELECTRICAL RKERS' COMPENSATION DECLARATION , ..areby affirm that I have a.certiflcate of cense to-self-[nsure,or a certificate-:. , _- Backflow Preventers - -- Sewer Connection' - -+- Automatic Washer,_ Meter ❑over 100 amps _ - of Workers' Compensation Insurince„ or a certlf,ed' copy thereof (Section i - . Construction Pole Sub Panel 3900, Lab. C.) F-2975 Fairlrlont. Backflow Irrigation i � Solar Collectors ! PoIiCY No. Company � EY-�Itr Certified copy is hereby furnished. t Bathtubs Solar Piping Cooking Unit , 1 I Sub Pole , , IlACertl c i filed with the clty B ing i n. Date �� rU ^Applicant r Clarifiers I , Solar Tank.y t Dishwasher 1 Motors ❑0 1 HP E11134-8 ; ! EXEMPTION'FROM WORKERS' COMPENSATI DECLARATIN Dishwasher Swimming Pool w1Spa ; l T D`ryeri- ❑Gas '❑Electric _5 "' jlnc.SoIar'❑9-15 HP 1:1 +� (This section need not be completed if the permit IsAor one huntlre ($100) or less}. I f I certlfy',that in the performance pT the work for which this permlt i5 ,$Sued I I in manner so las to become subject. to the Drinking Fountains , w Urinal ; a , t 1 Fan , i Microwave l l � l shall not employ any person any workers'. Compensation lLaws of California. i l t Floor Drains; Water Closet F.A.U. I Pole Light 1 Date ' Signature - - -- NOTICE: -If. -after making this declaration, you•should'become subject to theme Floor Sinks %• - ;- - Water Heater - 4 •- - Fixtures r - .-1 •- Range-- I- J • _ - r� i Workers' Compensation provislons,of the Labor Code, you.must-forthwith, comply with such ' provisions or • this, permit ,shall be deemed revoked. L; ', Gas Service Outlets , Water Service 1 a Device Boxes Sign r 9 + 1 CONSTRUCTION -LENDING AGENCY 1 # '" I 1 i I , ; Outlets r t I hereby affirm that there Is a construct Ion•lending agency. for the'performanCe l -3097,, Interceptors ; 4 ! ., i Standing Sections j I of the work for: yy i h this permit is ;Issued .(Seotlon Civ. C.) IY ' Switches Lender's Name Kitchen,Sink, r .a r t ( Trash Compactor p Lender's' Address! OWNER:BUILDER DECL'ARATION' { 1 _ LavatOries:� k �' -: I -r I Garbage Disposal t = r I hereby;affirm that I am exempt fr$m the'Contractor'S'Llcense 6v; for the following Ion'7031.5 Business Professional 'Code:' Any P, Trap! _ ! - r t _ r; Generator 00-5 KEN 135-15 KW reason, (Sect and city or ,county whichrequires a permit to construct, alter, lmprove, demolish,or repair , i,y structure, prior to its issuance, also requires the-appllcant•for such permit r Transformer ❑ 15-50 KW , Rpof Drains _ F« 4�ile a signed statement that he/She Is licensed pursuant to the provisions of Contractor's License Law (Chapter 9 (commencing with'Section,7000) of i - - ❑5U + KW Reinspection Fee - $15 Nr:. Islon 13 of the 'Business and Professions' Code) or that he she;is exempt r erefrom-and the basis for the exemption. Any vlolatlon of Section ' Showers Reinspection'Fee $15 Meter ❑up to 100 amps 1 alleged 7031.5 by . any applicant for • a . permit "Subjects the applicant to a. civil 1 malty of not more than five hundred dollars ($500). Service Sink Issue Fee $ 3 'issue Fee $ S. E Zoning Approved By , — Date I, is lowner of the property Ar my employees with wages aS their $ole compensation will do the work-, and,the'structureis not intended or offered - ; MECHANICAL_ App{(�tipn Approved sy `" " Date for sale'(Seei'ion 7044, Business' and, Professional, Code:iThe Contractor's License Law does not apply toran owner of a property,who builds or improves thereon, and does such worK himself/herself or through his or her own I _ Boiler Refrigeration System Application Isiued PP gY Date ;who emgloyaes, providetl that such improvements are'not Intended or offered for sale. If, however, the building or improvement is sold within one!year.of Com• ' butt =Under Ground ❑0-100,000 BTU ❑ 100,000 BTU platten, the owner:wlll have the burden of proving he/she did not bul[d or im- ,�QO for the of sale). : Duct - Structural , j System Repair/Alteration , SUMMARY OF FEES / grove purpose LJ I, I BUILDING PERMIT $ ' SMIP $ as owner of the property, arf� exclusively contracting'wlth,Ncensed con tractors to construct the project (SCctlon 7044,.Bu5iness,and.Professions-Code:. to Duct --Ventilating _: _ -, _ _ r_ _ . , _ I PLAN CHECK $ { [J� PERMIT The Contractor's License Law does not apply an owner of property who { builds or improves' thereon, and Who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ i ; I 'PLUMBING , $ ISSUANCE $ ' - tractor(s) license pursuant to the Contractor's License Law): ❑ I P y , PLAN CHECK $ GRADING r $ I am exempt under Section - 13. & C. for this reason Firepl/Fact. Bit. ICBG 51E l 4 I ' Heating System &Ducting i -ELECTRICAL' $ t $ r MICROFILM $ Date r { I r Owners i I -hereby certify that-I:have•read this!-appllcation-and state that -the above- Information is 1 with all city and county -� 09-100,000'BTU 13 100,000 BT --- l ?PLAN CHECK $ { i TOTAL.FEE, $ correct. agree to comply ordinances and state laws re ting to bulltlin construction,, and hereby authorize repro Hood or Type I ❑ MECHANICAL' $ r 3 I sentatives of It into pon the above-mentioned property for inspectlon purp es. + 7 n, I Cavo r T a II ❑I Reins action Fee a P $15 PLAN CHECK• $ LESS t ADVAN.CEO ) Signature 1 I Data I 1� c�� ) g , t r t PC $ I Drivers' License or 55 ; , Registers Issue Fee $ 3 ! r I FINAL 'FEE + $ .,}} CMF 0865-46 rev. 12/82 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - �CQNSTRUCTIOIV AND, PLA NII�I,Gry - � TO 'Inspector =a - ":.� i SPA '' _ :Dater• _ APPROVALS Permit # "APPROVALS Permit # Date Inspector' r. r 7emporary,Electrical Service or:Pol'e !4.'r •.52. Pool &•Equipment Location •• i 1` -2: ,SoWkpe-Undrgrnd` r r' .,' , ` `.' r ' ' 53: Steel Reinforcement r ' _3= Electrical Conduit Utility Undrgrnd. = _ 54. Forms '4- Electrical Conduit-Undrgrnd.= '- _ ''� 55. Electrical -Bonding ! 5: Steel'Reinforcement p : 1 r "' =56. Rough Plumbing & Pressure Test ` '6: Electrical UFER Grnd. ' ` R . 57:' APPROVAL TO-COVER-GUNITE _ 1 7. Footings 5i Electrical Conduit-Undrarnd. 8. Foundation 1 '' = 59. Gas.Pipe,'O-Undrgrnd., Test 9. Water Pipe-UArdrnd. i i �T ry,. 60. Backwash'Lines, P -Trap, ❑'Undrgrnd. - - =, ; 1 10. Structural Floor System ; '- _ 61. APPROVAL TO•DECK 11, Property Sewer Line & Ho,use,Conne'ction - 62. Backwash i& Receptor -Final 12. Sewer Cap; -63. Heater &;Vent -Final 13. Roof Drains "+' t r „ 64. Pkumbing System Final 14. iRough Plumbing.' ! ' ' - - 65. Electrical -Final 15: ;Rough Electrical'Conduit i _ -'r 1 - - , i 66.; Solir Sysfem-Final ,. •_ 16. 'Rough,Electric;Wirings-• - '` ' f1 �' r 67.' Fe»ci» &Access Approval g Ir1 1 s '_l 7.Rough Wiring Siggnr: ; fl I '. , . 68.' APPROVED FOR PLASTERING` f' ' 18.'Rough-Electri,al-T'$ar Ceiling ! . I ", 69.. POO L/SPASYSTEMS FINAL 19. RougFi'Heating & Air Conditioning f . ' FIRE DEPT.'REQUIREMENT - APPROVALS Permit # 20' Rough Factory Fireplace �, i 21..66cts,-•in Structure l� ii ;70.' Underground Hydro `x;22.. ,Ducts, VeMiilai ing ,. , ` ` , i71.R Product Piping ❑Gas ❑Oil I 1.23',1 as'kp-e-Rough & Test `,' . {' 72. Underground Flush, `24. Roof Framing ;'` ,, , 03. Undergrnd, Storage Tank ❑ Gas .❑ Oil 25.4R6of Sheathing j ! ; If i 74. Overhead Hydro i -26. T -Bar Ceiling {Structural}, $t Monocoat' I I 75. Dry Chemical 27. ,Frame and Flashing ry ; r _ #� ! `76. Dry Standpipe 28. Lathing & Siding 177., FIXED_SYSTEWFINAL , 29 ,Insulation i r L + _ i78: FIRE PREY. FINAL i ; "30, Drywall Nailing I ' ' I 1, } , c(_ ; 'Notes: , 31,'Plaseer•Brown Coat i =' S t ' - i 32jw6ectricallPower Meter -Final z 33,. Final Electric 34, Final Heating &'Air Conditioning 35. Final Gas Pipe-Testt rj 36, Hood or Canopy_"`' t-_ 37. Final Factory Fireplace- F 38. Final Plumbing i ; , V r _ 39. Water'.5ervice-Final 40, Gas Service -Final 41. Solar Domestic -Final , 42, Backf Ow" Pri venter 43, Irrigation Backflow 44, Landscape: Irrigation=System', 45. Sound,,Attenuation 46. Handicap Regulations ; + j '' - N' 47. FINAL STRUCTURE & BUILDING F 48. Special Requirements Completed' t I I I l 49. Electric Release'to Ed'++`son' I 50, Gas Release to Southern &Iifofn a Ga's Co , 51. CERTIFICATE OF OCCUPANCY No.� ! �Z6fr bate e77 J= j y.'. •• � _ -x :- -7=7- a,- Applicant to fill In 311 spaces except those within heavy border lines and sign all appropriate declarations. '=+CrTY (JF COSTA -MESA' - . -- .-,t, ' PERMIT N TRACT NO. LOT NO. BLD .� CONSTRUCTION PERMIT %�ry►1 �j 7 (p' , { E ' -13 Applicant's Mailing Address �' " TYPE OF CONSTRUCTION, i • ' NEW ADD ALTERATION- REPAIR , ProjectAddreSS L [.C�l� ❑ CONVERSION ❑DEMOLISH ❑ OTHER _ : ,� ] f r r q iti j : } DESCRIPTION OF WORK Owner's Nam` d hone S'�� ZONINGREGULATIONS" _ Address TYPE1OF PERMIT GRA IINGr FOUNDATION STRUCTURAL A. P-Sj� •- I ZONE ! Arch/En License No,' pp " _ Arch/Eng- i ❑TENANT ❑ELECTRICAL ❑PLUM BINGMECHANICAL- PLNG. REP. _ j MBUILDING. Address' + ? ! ! - '❑;OTHER 1 TO BUILDING -r ' .REAR YARD (TO P/L) Contractor's Nam w —� hone +PROJECT DESCRIPTION SQ. FT.' L 'PROPERTY P E T INE _l/ .•� �Q rG C0NSTRUCTIONT,YP I t VALUATION$ LEFT SIDE YARD RIGHT SIDE YARD; Address (mailing) a I License No. i ) i ZONj_ ? GRADING CU. YDS.--ACRER - PKG.SPACE'REQ. + e PROVIDED 7 LICENSED CONTRACTOR DECLARATION Remarks: r y r I i _ STREET WITH I PARK FEE $ •. + I hereby' affirm that I: ant'llcensed under provisions of Charter 9 (commencing f 1 with section 7000) of Division 3 of the Business and Professions Code, and -SPECIAL CONDITIONS: I license Is In fu11-;orc effect. License lass L n o.- I j PLUMBING 9 gate r Signature 1 ' r t IRKERS' COMPENSATION DECLA ATION Bar Sink ti i Sewer Cap= r i ELECTRICAL + ereby affirm that I have a certificate of consent to Self Insure OI a certificate 1 , , Backflow Preventer _.'. . _ 't _ ..Sewer_Connection` ConsAutotruction on Pole 'Mater ❑over 10b amps -, of Workers'-Compensatlon Insurance,! or a certified copy thereof' (Sect - - "' 3800, Lab. C. �I LVI-3 , _ar j Backflow Irrigation I Solar Collectors 1 Sub Panel J Policy No. T /3 ��Z Company �-A ly - A Solar Pi Cooking Unit f Scab PoleCertified copy Fs hereby frirnlstied. ' y ' Bathtubs � i , ping iith the CEt B a Appllcanty j - I Clarifiers Solar Tank ! Dishwasher ! Motors DO -1 HP O1'/,$ i EXEMPTION FROM WORKERS' CO ' ENSATION"DECLAR ION- - �� - Dryers -'❑Gas' ❑Electric._- ; (Th issect lon need not be completed .If. the permit Is for, one hundred ($100) or = Dishwasher j. Swimming Pool w/Spa I Inc.Solarl�9 15 HP 016-15+' " less}. r 4 I I Fan j ! Microwave ' I certify ythat in the for of the work for which this permit is Issued I Drinking Fountains j Urinal $heli? not employ any person in any manner so as to become subject. to It a _ Workers', Compensa_tlonr Laws of Callfornla.' Floor Drains a 1,. F p U ( t 1POIe Light Date. ° Signature i 1 ) ; Water Closet; } 1 NOTICE: If, after, making this declaration, you should; become subject to -the ' Floor Sinks i Water Heater Fixtures I ; ,Range f I Workers'. Compensation provisions of the Labor. Coda, you must forthwith comply 'with, such • provisions, •or,.this ..permlt,$shall be 'deemed revoked. , Gas Service' Outlets! Water'Service i Device Boxes F `Sign' CONSTRUCTION, LENDING AGENCY ' I hereby affirm that there is a.construction lending agency for the performance! Interceptors Outlets Standing sections j of the )work for;. which this permit: is tissued (Settion 3097- Clv. C.). I ^ s Lender's Name Kitchen'Sink' I' ; s ' - .- ! Switches t j Trash Compactor i Lender's' Ads rass r - , , ! f- Lavatories' !; I Garbage Disposal ; , OWNER BUILDER DECLARATION j ''i •- � - .. f :' � I. '. L•' � i ! � 4 I hereby �affirm,that I am exeriipt•from the;Contractor's-License law for the I _+ i ,7 I Generator.❑0-5 KW ❑5-15KW ' following reason-(Sectlon.,,7031.5 Business and• Professional,Code., Any city or' j i P=Trap _ = s t i ! county which requires a permit to construct', alter, Improve;-demolish'or,repair j. , _ Transformer ❑15-50 KW zany structure; prior to Its, issuance,.also requires the'applicant.for such permit r hoof Drains; ! ! 1 file a signed statement that he/she Is licensed pursuant to the provisions of. Contractor's License hw,(Chapter,9 (commencing ,with -Sectlon7000) of " + "'''. ' r' I . 050+ KW� 'Rein [tion Fee $15' '1 Islon,3 .of the Business and Professions- Code), or that; he//she is!exempi Showers �� r 1 Rainspection,Fae I $15 r sPe ; refrom-and the' basis for the alleged exemption. Any-violatiorrof Section Meter ❑up to 100 amps Issue'Fea $ $, ,7031.5 by,_,any applicant for! -a - permit subjects ,the applicant -to', a civil !.. enalty of not more than five hundred dollars ($500)'. { !. Service Sink i { Issue Fee = 3 r-- i + Zoning Approyed By Date !, as+owner of the :property or -my employees with wages'as their sole i compensation wili!do the work, and. the structure Is not Intended or offered i MECHANICAL' + f 1 f + Application Approved By ate ' 1 for sale (Seci'ion 7044, Business and Professional Code: .Tho; Contractor's ! r License Law does not apply to,an owner of a property.who builds or Improves Boiler �` Refrigeration System. '' j thereon, and who does 'such work.himsolf/herself or through his or her own 1 i Application Issued By !Date 'employees, provFtletl that such Improvements arejnot Intended or offered for , - ❑0-900,000 BTU El 100,000 BTU ' i• sate. 1f, however, the bulltling Or Improvement is sold within one year;of com- Duct- Under Ground ' r SUMMARY OF FEES '. pletlan, the owner will have the burden of proving he/she did not bulltl or im• i. rove for the purpose of sale): Duct - Structural I System Repair/Alteration i I i '' $ '- I' i ) .^ t. i BUILDING PERMIT $ SM1P ) ! -� F, as owner of the property, am exclusively contracting with licensed con- - , r tractors to construct the project f5ection 7044, Business and Professions Code: I Duct - Ventilating r ;PLAN CHECK' $. PERMIT „The`Contractor's License taw' Des not apply tq an owneroi property who ISSUANCE $ ! builds or improves thereon, and who.contracts,for suth,grojacts with a con- Exhaust System ❑ 'Multiple ❑: + I PLUMBING $ l j i tractor(s) license pursuant to the Contractor's License Law). : ) _ GRADING $ ' ❑ 1 am exempt under Sectio6 B. & P. C. for this reason , k Firepl/Fact, Bit, ICBG # 1 I + PLAN CHECK, ! $�' r. a I ELECTRICAL( ! $ . $ �. aDate Owner i Heating,System&Ducting a MICROFILM $ 1 :.I hereby certify that,l,have read _this application and state that -the above ,' ❑0-100,000-BTU,❑100,0006 9�O :PLAN CHECK' $.� information Is Correct. I.agree to comply with all city, and county ordinances i1 i TOTAL'FEE', $ and'a tate •laws relating.to.bu-ldln9 con$ ruction,',and hereby authorize repre- t- F i MECHANICAL $' , , sentatives' of ,this city' t er th above-mentloRed property for Hood or Type I ❑t s r r r I j einspection Fee $15 .PLAN CHECK' $ _�i,� r LESS Inspection p I Cano Type II ❑ r ADVANCED PC $ 1 Signature to �'� Registe�s� { Issue Fee �° $ 3 l FINAL FEE $ — Drivers' Llce se DHSS i CMF 0865-46-r'ev. 12/82 ' 'White' Building; Canary- Applicant; Pink'= Accounting- Goldenrod = Assessor `- ,' " I : '; " ' ' _; ' -�_. _ -•_t _ - r CONSTRUCTION AND PLANANG PQ i SPA ' , �_ - t .a >^ AP?R0VAL-SI� 'Permit Date}.7 = ;Inspectoir: _ - APPROVALS Permit, -Date Inspector _ -t�+4.i i`w } ! '' fJ r• w!.1 r'1 c. r Fr .l ++ ;7erriporary Electrical Service'or. Pol@ _ s ? ; i - a52. Pool &Equipment Location" _ C' {.2.jSoil Pipe`-Undrgr'nd. - .j t �' a _ -' "�, T yrr �53: Steel Reiriforcemenf - r , `(3.IElectrie'al ConduitzUtility�Undrgrnd; z� ' Vii= ?^ -54: Forms `. r4.Pectrical Conduit-Undrg�nd_i �" t' ; _ " , _ '' S5. ElectricaLBond'ing'. 5. lSteel Reinforcement '! *� . t ' a . '. 56. Rough Plumbing & Pressure Test r 1 „ r6. Electri6l OFER+Grnd. w , '~ i { a - _ 1,57. APPROVAL TO COVER-GUNITE J . 7. Footing's 58. Electrical:Conduit•UndrarnrV B. FoundationX59. Gas Pipe; D; Undrgrnd., Test' Y -, 9.1,Water Pipe-Uhdrgrnd�j .a ? '� _ f, ' ', _ 60, Backwash,Lines, P-Trap, D Undrgrnd 4, X10- Structural Floor 'Syste"rn ' 61. APPROVAL TO DECK + . I i - 11:' Property Sewer Line '& House Connec}ion F F - -' 62. Backwash & Receptor-Final _ i o , .r. 12. Sewer Capt I "- ..N S' :63.:Heater &Vent-Final 13.1 Roof Drains ; { L''' i o _ ::$4, sPlumbing System -Final ,�a 14.' Rough Plumbing' ;,+ 65•'.Electrical Final 15.1Rougli Electrical Conduits'-' I� -jam - i y ' 7 �"` I " 766. Solat`Sy`stem=Final'' i r- 16.x; Rough Ekecntric Wir}ng E r: ` , ; S7i-,Fencing'& Access ApP'rovalrif I ,� i ! _ I + 17.RougFi Wiring Signs 68: APPROVED FOR PLASTERING 1 , 4 , 1 1 - .1 18: R'ougFi Ekectrical'T_,Bar Ceiling �i i E - '', 169. fP00LISPA SYSTEMS FINAL 19,!!Rough Heating & Air Conditioning FIREIDEPT: REQUIREMENT APPROVALS Permit #' 20. Rough Factory Fireplace [ = +; I I i 21.'4Ducts, in+Structu, V_ ,; re" �,' i + 70. Undergro'und Hydro � , � + 22. LDucts, Veritilating` ; ' # iE { 71: Product Piping,C] Gas 0Oil i �23.�Gas Pipe Rough & Test7 j 72. Underground Flush t X24 ;Roof Framing + ^ '! ., - , j ; : - 73. Undergrnd. Storage Tank'0 Gas 0 Oil + s 25 jRoof Sheathing { I (� 3 i� ,;1 - E -,26.7 1 j : I _ ► E 74, Overhead Hydro ,•� Bar Ceiling' (Structural)+,& Moriocoat l i ; F r 75. Dry Chemical ,. Y'' y27.• Frame andaFlashing _ , ' #� I� ', I ` 1 i ' 76. l ry Standpipe ^28.�, IVathing &Siding n .; tr �t I f t f 77. FIXED'SYSTEM FINAL, ! 4, 29y1 Insulation r <+ I �� ; 78. FIRE PREV. FINAL r _ I� + + ".30.,'' Drywall Nailing y i �' ll 4 + Notes: _ 31 ?'Plaster, Brown Coat If ll ( - I- E - i T. I I 732.,Electrical Power Meter ; !i Final I 33.i Final Electric 34. Final Heating &-Air Conditioning s 35. Final Gas Pipe Test i `�J i IRI :^' ` ' _ nx 6, .' I.,- 36. Hoodor,ICanoP,Y .rj 37. FinalFactory-Fireplace 1 �,I -i 36. FinatlPlumbing �- 39. Water-Service-Final 40. Gas Service-Final 41, Solar!DomestickFinal 42. Backflow Pieventer,_ 'J' i < i I I + S ¢ 43. Backflow Irrigation v 44. Landscape Ir�igationt.SystemT I° f ! <- I. 4 - 45. Sound Attenuation'. j I 46. Handicap Regulations+ J � ' t: 47. FINALSTRUCTURE!& BUILDING'. c :I S I i I i 48. Special Requirements `Completed r 0 4, I ! I 1 i I I-�- 49. ElectAclhelease tol Edison -_I_�- "1 50. Gas Releaseato Southern &aliforniaC,asCo' 51. CERTIFICATE OF OCCUPANCY +--r - - - - I} f i I No DateiL iti__i i I i i Applicant LO fill In all spaces except those within heavy horde_ r lines and sign all appropriate declarations. *tet .iCITY.QF COSTA'AIESA - PERMIT NO I TRACT NO. LOT NO. +� -CONSTF(UCTION PERMIT ` J ' $'/ a� _ '' '2��i5r �7/�%', ' ' - . - I: , 4;eiS4. T+ • Appiicant'sMailIn Address / '� t v ''� �� TYPE OF CONSTRUCTION EW ADD' ALTERATION• REPAIR r y~ - r ❑ CONVERSION ❑ DEMOLISH ❑ OTHER, Project Address .l-_.Ll - Owner's N8 a hgnE1 r1 2�d ❑ESCRIPTION'OF WORK_-OKING REGULATIONS � - C1k1 Address' 'p�r r '�`�' I , TYPE OF PERMIT GRADING r FOUNDATION STRUCTURAL ' A. P.11 ZONE F T" Arch/Eng, -- —License No, ( ❑ TENAN j ELECTRICAL ❑%PLUMBING C1 MECHANICAL ' .PEND. REF„qW, [ - -BUILDING I Address' ' t Contractor's Nem ANK-�y-N' a�/[ y°' c honeG2�''/�2 ❑;'OTHER PROJECT DESCRIPTION. Sq. PT.' TO BUIL DING. f ' 'PROPE Y i E REAR YARD' TO P/L) f s , , ” + OCCUPANCY ' Address � 1- /`c%��"`'� `'4 Kiera CONSTRUCTION TYPE ! VALUATION $ LEFT SIDE YARD i RIGHT SI DE YARD ` +fineiling) License No, ZONJ= r GRADINGCU.YDS. ACRES PKG.SPACEiiEO. 1 ; i PROVIDED L LICENSED CONTRACTOR DECLARATION ; Remarks: , ; -^ Q t i STREET WIDTH i PARK FEE'$ I 1'he►eby;affirm that I am licensed under provislonsof'Charter 9 (commencing with section 7000) of•Divislon 3' of the Basineis and Professions Code, and t ? ; SPECIAL CONDITIONS: my license Is in full }�rce a d.effect. [ ( aV) r ( - Lliense LI n o. ; - t PLUMBING date'' Signature ; f-' - - t I -7 Bei Sink I I r Sewer Cap t ELECTRICAL IRK RS' C MPENSATION DECLARATION = , I ) • .ereby affirm that I have a Certificate of Con$.ent to selfansure or a certificate ' - - } ; _ ! _ Backflow.l�reyenter__� Setiver,Cannection� , Automatic Washer I ;Meter over 100 amps ` of` Workers' •Compensatton Insurance;, or- a_-certifledi'copy- thereof (Sectioni I 3800, Lab, t I L' r C 0�7 71 I,t�it ^rR's7 %rt��cC I I Backflow Irrigation j -__ ,_ .: _ - Solar Collectors 1 _ Construction Pole 'Sub Panel; [ Policy No. Company El stifled copy is hereby furnished. a i Bathtubs r; i I t i Solar Piping { { _ Cooking Unit Sub Pole I I� Ce Coy Iled with the city BuildF Ivislo Gam; • ' I I Clarifiers :� ! + ! Solar Tank s 1 Dishwasher t r Motgrs ❑0-1 HP %-8 5/ ; Date Applicant _ -EXEMPTION, ROMWORKERS'COMP SATION'DECLARATION -• i' ,. I l : t _, Dryers•0Gasr-❑Electric ^ '•Inc:Solar;❑9-15 HP ❑16=15+' wr- _ ; [' Dishwasher �~ Swimming Pool w/Spa ' r (This section need not be completed if the permit Is for one hundred ($100) or 1 less) I , I _.._. - + Fan' - l 1 I certIIyI'that in the performance of the work for whiCh this permit is Issued I Drinking Fountains t t Urinal [ E [ + 1 k :Microwave E : r shall; not employ any person In any manner sojas to become subject. to the s - - ) F.A.V. I 1 Pole Li hi g { Workers' Compensation' Laws of California.. s FI'Oor Drains' I + Water Closet 1 = I Date [ Signature NOTICE:•If, after making this declaration, you,shOUld become subject to .the 1 FI or ;_,_,{ 1.-_- _ Water Heater,. _ - _ _ _ Fixtures - f Ran e 9 Workers' Compensation provisions of the Labort Code• you must forthwlth comply 'with; such .provisionst or 'this .pertnit shall be ;deemed revoked, i r I Gas Service) Outlets • f 4 +Water Service Device Boxes I Sign, f CONSTRUCTION: LENDING AGENCY { thereby afflrrh that there is a'construction lending agency for the:performance. y Outlets _ t 1 Standing Sections ? Interce tors ; p I _ 1 of the work 'for, which'this permlt I_is il$sued•,(Section ' 3097 C_ Iv. C:) r Lender's- Name;: . _. _ _ _moi t --? [ °' s KiichemSin kl ' ` _ Switches Trash Compactor 3 c = I. = :' = 14+ t Lender's. Address OWNER BUILDER DECLARATION) ; a f - :: ff' I - i :ti Lavatories., i ., Garbage Di oral 9 Disposal [ I 1 i I herebyaffirmthat I am exempt.from the Contractor's License Law for the' r Professional'Code: , P-Trap I '. ! ', { Generator; ❑0,5 KW Q5-15 KW following reason=(SectIon•7031.5 Business and Any city or county which requires a permlt.to construct, Alter Improve' demotish'or. repair T .- 4 Transformer ❑15-50 KW i I 7 , , r- t,, any structure, prior to Its,issuance, also requires the applG'nt.for such permit- 4 Hoof Drains( file a signed statement that he she Is I1cenSed pursuant to the praVIslons of f ❑5U + KW I V, Contraitor's•Ucense L'aw;(Chapter 9 (commencing,with Section 7000) of or, ? on i3 of the ;Business, and Professions Code)cor• thaP he/she:is'exempt ' r•3 , _> + Showers :', 4 n- r s ! t -' r ! i ` Rai - $15 Reinspection Fee $15 { ' +fvrefrom and the basis for the'alleged exemption. Any violation of Section by 'any'applicant for; aIpermit-su0jects.the applicant to a.. civil * $ 3 MetBr p to 100,am1]s Issue Fee f I ! $ 3 1 ntyofnotmore than five hundretl dollars ($500);. r I , Service Sink Ensue Fee I Zoning Approved By ' Date �,O31.5 Ias ;owner of;thesproperty or*my employees-•with wages,as their solepensation•will+do the the structure Is not Intended or.offered ;" ; ) MECHANICAL j I I t f work, and r sale .(Sec{ion 7044; Business' and Profe4sional Code: • The' Contractor's ,i Application Approved By 'Date , License Law tloes not apply to,,an owner of a property who builds or improves r " )jailer"t _ �• Refrigeration System s I Application Issued By i + , r 1 Date t thereon, and who does' such work himself/herself or through his or her own 1 t employees, provided that such improvements are;not Intended ar offered for sale, If, however, the building or Improvement is said within one•year of com- - + Duct=Under Ground ! Li 10- BTU ❑100,000BTU' ( _ a ; + ; SUMMARY OF FEES ; Diction, the owner•wlll have the burden of proving he/she d[d not build or Im- rove for the purpose of sate). ' ; Duct - Structural ! System Repair/AlteratioA I 'BUILDING PERMIT S. SMIP ) i $ I, as owner of the property, am excluslvelY coMracNng with licensed con- i tractors to construct the, project (Section 7044, Business and Professions Code: to'an Duct - Ventilating I I I , PLAN CHECK! $ ?_ + PERMIT ' j `The Contractor's Lltense' Law does not apply owner of property who ' builds or. improves; thereon, and who contracts for such projecEs with a can- tractors} license pursuant to the Contractor's License Laws i Exhaust System ❑ Multiple ❑ ! 'PLUMBING i. $ I ISSUANCE s $ } ' ❑ 1 am exempt under Sectio4 E ' B. & P. C. for this reason t Firepl/Fact. Blt. ICBG # i i 1 ; j PLAN CHECK $I GRADING $ j i 'ELECTRICAL! $ 0 + I$ ' Date Owner • I s i ' [ t„ hereby certify that I_ have read this' application and .state• -that .the above ,�, _. , g, Y g' j Hsatin 5 stem & Ducting ❑0 100,000 BTU, ❑100,000 B I 6 .. „�� .' _ _ ,i i + PLAN CHECK' MICROFILM s ! $ i r J Information Is correct: I•agree to comply Witt, all city, and county ordinances ! t +' ,' , I 1 j MECHANICAL' $ ; T01 AL-FEEI I I $ andrstate laws relating to building construct hereby authorize re re- , sentatives of ;this !city to enter I upon the above-mentioned property for ' Hood or T Type I ❑ ! i ; ; Reinspection Fee , $15 c 'PLAN CHECK $; t t ` LESS ) ! Inspection pur ,/f + + Signature �`'` , ate 7 71 Cano . Type II ❑i = ! I ! ADVANCED PC I $ [ I i S 5 � Drivers' L cense or 5S =)p + Registers 1 = Issue Fee i } 1 $ 3 + : f I # I FINAL FEE [ 1 $ t l CMF 0865-46 rev. 12/82 � -White =Building—, Canary = APRIIcant;'Pink "- Accounting; Goldenrod -- Assessor' "' " "" _ - -'- " - c ' -- - - „- - __ _ �— _ _,__ . r _ _ ._..� . _ - • .. � rF . ,, . , ? �* CONSTRUCTION AND PLANNING : I - .... ` - a S.' Date 1 ' -APPROVALS; 'Permit . -.- -, , • _ - .,, p �� Iris actor -. - • . - : • PO I SPA - " r Permit Date - = ' Inspector' 4h u APPROVALS, . r 3• .� r Z. - ` - - - Tempoiary Electrical Service oc Pole ` _ r w ' i ' ? + 52. Pool &Equipment Location 2., Soif+Pipe Undrgrnd': .' ; _ _ �,' . 53. Steel Reinforcement - _t .jf;3.} Electrical Conduit` Utilitv•Undrg�rnrl. - _� 54. Forms - t �4.iElectrical Conduit-Undrgrn l-7 ,a `; - ` 55. Electrical Bonding _ 55ASteel Reinforcement ;5fi.-Rough.Plumbing & Pressure Test `'6•j Electrical UFER Grnd. i-GUNITE 57. APPROVAL TO•COVER 7. Foo tingsi �: u ; - R = 5$. ' Electrical Conduit•Undrar,�rl. I 8. Foundation - r' 59. Gas Pipe, ❑ Undrgrnd., Test - 9.1, Water Pipe-Undrgrnd. 1 10. Backwash -,Lines; P -Trap; D Undrgrnd. 10. Structural Floor'System a t i 61. APPROVAL TO DECK' 11.E Property Sewer Line & House Connection = 62.. Backwash _& Receptor -Final - 12.' Sewer Cap , I ` � � � - i� _ _- 63. Heater &Vent -Final. r 13., Roof Drains `. I 64. Plumbing System Final 14,` Rough Plumbing' 65• =Electrical -Final = ` 15.. Rough'Electrical-Conduitr"� -'�,�`�� c `I_ i --E" ' , "� - ' " 66�Solar System Final' -� -16 .4 Fiough Electric Wing i r 7•, r �,-`„ 67'. Fencing'& Access Approval �- : 17.�Rougti'Wir`ing;Sign' �; `� I t ;', , _ `� 4 68. -APPROVED!FOR PLASTERING = �18 it Ro6gh-Electric6i-7, Bar Ceiling yr I o ,/y b ,C 69. �PO6USPASYSTEMS FINAL 19,Rough Heating & Tkir,,Conditipnirig '; f ` _ ' I' + i : ; I ; I FIRE DEPT REQUIREMENT + 1 IAPPROVALS Permit + r 20.E Rough Factory Fireplace { , E, r- . 1 21_Pucts;,in Structured � i i '70. Underground Hydro i� i r` 22:-Ducts,;Vedilating'- 71. Prod uct'Piping; ❑ Gas ❑ Oil i ;.23. Gas"Pipe-'Rough & Testr ; 1 i.G� ., �T , 72. Underground Flush 24, Roof Framing, � ! i 4 s , I 73. Undergrnd.�Storage Tank:D Gas D Oil i { 25. Roof Sheathing i j ii-, t + i r ` f i - 74, Overhead Hydro y f t i 26. 'T -Bar Ceiling {Structural}li& Monocoat i + i 75. Dry Chemical 27.. Frame and Flashing 76. Dry Standpipe 28., Lathing & Siding i i I Y r 77. FIXED'SYSTEM FINAL _ 29.' Insulation"' � � T `, Y I i, � ; s � I i . 7$. FIRE PR EV, FINAL ' 30.'' I]rywall Nailing i; i i ' Notes: i 31. Plaster, Brown Coat If 132: Electrical -Power Meter -Final _ I { 33: Final Electric 34. Final'Heating•&.Air-Conditioning 35. Final Gas Pipe -test- - 36. Hood or Canopy', 1 . �, ' -Z, .,' ' = r 37. Final Factory Firepla"ce- ' ' 2- 38. Final Plumbing tk l 1 i C •' 39. Water'Service-Final i ' i ,�• ' 1 , i a 40. Gas Service -Final I -- 41. Solar,DOmestiC;Final 42. Backflow Prevente 43. Backflow Irrigation ; r,�, - 44. Landscape Irrigation` System' 45. Sound t4ttenuatipn r ' 46, Handicap Re gulations+ �v ' r. 47. FINAL STRUCTURE?&BUI,LdING`} 48. Special Requirements,Corrlpleteii 49. Electric�Release to Edison t I _ + 50. Gas Release -to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY li I I I Date ! 1 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. 000365 P. O. Box 1200 Costa Mesa, California The Building located at 3151 Airway Avenue #H-2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 5-2 Occupancy. Use of Building Office Legal Description 938-940-38 ISee reverse side for Metes and Bounds) J Building Permit No X11497 Electrical Permit No. BE:M-11497 -" Plumbing Permit No. 0 Mechanical Permit No. BI24-11497 Number of apartments 0 and/or guest rooms 0 ISSUED TO: Building Official G.iildhyuse Consultants by 3151 Airway Avenue, #E1, Costa Mesa, CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALLONOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File City of Costa Mesa Building Safety Department P.O. Box 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY ;° 3550 The Building located at 3151-Rireav Nvtme. Euilciina 1-1 _ has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group H-2 Occupancy. Use of Building C=Ttt-t.-ciao. office Building - Interior Alterations Legal Description -A•P•#427-291-05 (See reverse side for Metes and Bounds) Building Permit No B/E -457 - Electrical.Permit-No.-L—"�67 - P.lumbing Permit No. x'-447 Number of apartments _0— and/or guest rooms -0- ISSUED TO: Building Official t�"r,41 r RM- TRTTrF-C; Victor C.n Newt r-�Director Building Divisa�, Date October 20, 1731 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa -Mesa under Sec. 306 lel U.B.C. Form 8U 34 Rev. 11/70 CITY OF COSTA MESA - BUILDING DIVISION } 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 7544856 www.d.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER. B08-00134 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 93894027 _ DATE ISSUED: 04/23/2008 ISSUED BY: x J ' JOB ADDRESS:, 3151 AIRWAY ATCM 1 ', Suite/Unit:`��a'_� Vicinity: BLDG.C' Squares: 0 Valauation f $18,673.00 ,� .. a. SCOPE OF WORK: REROOF:'TIO WOOD SHAKE ROOF, REPLACE WITH 83 SQR'S OF CLASS A 40i R GAF FIBERGLASS SHINGLES 8 15# FELT. ROOF PITCH: 4:12 BLDG. C 7 _ GREEN ROOF INSTALLATION PER ESTEGACY REPORT #ER -5546 OWNER: CORP OFTHE PRESIDING BISHOP -CHURCH OF LDS Address --'z3_ - l %SOUTHERN CALIFORNIA %PROPERTY�RESERVEoI` _'>'' Unit: 10 E SO,TEMPLE'ST�#400 ""i, . PHONE: CitylStatelZip: BRUCE CHRISTENSEN', I; &-'S APPLICANT: HANSEN, DUKE Addressf N6646636 f Unit: PHONE: ,+• ,.' CitylStatelZip: a 41 2' ri � CONTRACTOR: ROSS AND BARROWS INC - License No 327802 Address: 260 E ALTON AVEUnit:'- PHONE: °7.14-55777440. �; City/State/Zip: SANTAANA'CA ;x;"92707, - - CELL # _ `-';4; ARCHITECT: - License No:' PHONE: :at - ENGINEER: Y License Nv..J' PHONE: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $307.25 Reinspection Fee: $0.00 Na NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. CODE /. INSPECTION TYPE DATE 1616 Fixed System Final Fire Prevention 1266 Pool Spa Final Q 200 Final Re -Roof 201 Final BlocklRetaining Wall 202 Final Factory Fire Place 203 Final Sign 204 Final Demolition INTFUL CODE11 INSPECTION TYPE 206 Final Mechanical 208 Final Plumbing 210 Final Electrical 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Occupancy DDT NI TMAL 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 i 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: J rCarrrier: S7 i A % 0L 6 (This section need not be completed dthe pennd is valued atone hundred dollars (S 100) or less.) Policy Number: D 9Z5—' Z ,DO v ❑> 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 tabor odeXshrthwith comply with these provisions. � ApplicanI's 5 nature r,. ,Date 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 DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 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. Class f! C Contractor'<Signature Dale 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'penally of riot,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.). ❑ 1, 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 3057-06 (3107) Date Owner ID verified by dri lice I] 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, wilt be mon: 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 Dale CERTIFICATE OF COMPLIANCE AND AUTHOR17ATION 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 taws 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. gnature of L I Owner(s) Dale 3/6 P/ And1Ur'Authoriz 'Applicant Date t� CITY OF COSTA MESA " 1 • ry - BUILDING DIVISION e } 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER B08-00133 PERMIT TYPE B ROOF2 STATUS: ISSUED APN: 93894027 r _ DATE ISSUED: 04123/2008 • ISSUED BY: JOB ADDRESS: 3151 AIRWAY,.ATCMt Suite/Unit _--, rVicifiiiNr BLDG. H Squa es:� 0 A r' f ti Valuation. t' $18,944.00 SCOPE OF WORK: REROOF:'TIO WOOD -SHAKE ROOF, REPLACE WITH 84 SQR'S OFCLASS-A 40,YR. GAF FIBERGLASS SHINGLES 8 15# FELT. ROOF PITCH: 4:12 BLDG. H /�'t •',1, ' r ;. GREEN ROOF INSTALLATION PER ES LEGACY REPORT #ER=5546 OWNER: CORP OF, THE PRESIDING BISHOP CHURCH OF LDS Address: ? =K``, %SOUTHERN CALIFORNIA %PROPERTY RESERVE?I+; Unit: 10 E SO TEMPLE ST #400. w ' J'S PHONE: !; } `! ,• City/State/Zip: BRUCE CHRISTENSEN' r' -- APPLICANT: HANSEN, DUKE Address: N6646636 _ Unit: PHONE: a City/State/Zip: . CONTRACTOR: ROSS AND BARROWS INC License;No.' 32.802 Address: 260 E ALTON AVEUnit:- ,,', ° PHONE: 714-557-7440 CitylState/Zip: SANTA ANA, CA ",k92707' - CELL`. ARCHITECT: License No. 3 , PHONE: ENGINEER: License No, PHONE: FEE SUMMARY- . r, Reroof Pian Check: $0.00 , Reroof Perrnit Fee: $307.25 Reinspection Fee: $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION, 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. CODE 0. InsPecn4tar= 4 ISA+, CODEN cL ON TYPE DATE INTMAt.s 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final BlocklRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site l 204 Final Demolition 250 Final Building/Occupancy WORKERSICOMRENSATION 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 workeis' 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: Carrier: (This sedfon need not be wnripleteddthepennd is valued of one hundred dollars (5100) orless.) Policy Number:/ 0 / 2— I 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 1 should become subject to the workers' compensation provisions of Section 3700 of the bo Code, I s all forthwith comply with these provisions. Applicant's Signature Date 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 DOLLARS ($100,000), IN ADDITION 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 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. Lic-# Z J Class.#•� Contractors ignature Dale 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 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 rile 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.). ❑ 1, 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 3057.46 (3107) Date Owner ID verified by drk, . lice Driver's License No. D Yes ❑ 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? ❑ 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 rile a registration form for acutely hazardous materials? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 partof the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (if "yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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: 1 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. Signalure of al Owner{s) Dale A�or Authorid Applicantt,f' Dale L� COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION F& hLfCf J_kAli, PERMIT600.28 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ' 6o0•a$ RECEIVE 13Y PERMIT 7 For Applicant to Fill in Completely — Use Ink Only J BUILDING • j�� ADDRESS A.P. NO. Z7- .z. �+ C33 0 f( OWNER OR f O +�12 f BUILDING Z / '/ ij (/`y IR! 1 /� IL-VL/7e'4MAILING TENANT rADDRESS SPACE NO. UNIT NADDRESSZan /OL'S'i � LOT BLK. ,f� ��.yy��/y/'TR.NO. CITY U// NOLj70p�C CONSTRUCTION NEW ADD LTER EPAIR MOVING DE LENDER BRANCH ^'::��, T D. 1 �"j�A' Ot a OWNER V ADDRESS USE `E / • VALUEX.37D C 11 j� JJ /� ��^- ) e4* S IC• TN OR ENR GINIT EER Vi 6.V ADDRESS ./'�- }�/ 20N TYP /" GROUP rZ CONTRACTOR —T.. Q� D APPROVED BY ae�k DATE T�� g 1 —}O 00-3 SI F.TE G Ca ADDRESS t llr�C� CITY t! N NOL"o w6 �[ T is /rt P f STATECITY APPROVED SETBACKS LIG. NO. �� LIC. NO. SIZE 0,OF BLDGS. (FROM C/LSTREETi OF LOT NOW ON LOT ONT FT. USE OF EXISTING BLDG. Separate permits are required for L SIDE electric, plumbing and heating work. REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE APPROVED APPROVED Z�✓' �I I hereby acknowledge that I have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and 1 shall not employ any person In violation of the workman's compensation laws of the State of California. 2 �" 1 hereby certify that I am properly licensed as a contractor under SO. FT. A' the State of California Business and Professions Code, Division 3, 01 THE AMOUNT SHOWN UNDER VALUATION 1S FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from the provisions of the State of California Business and Profession , C Ater 9. VALUATION PERMIT FEE S, Signature, Permittee S$ 7 �0 PLAN CHECK i TAX S ` 1.46 or / Authorized Agent Date — - TOTAL PAID 6o0•a$ COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 _ For Applicant to Fill in Completely -- Use Ink Only _BUILDING A.P. NO. qpr -. a9'i o ADDRESS OWNER OR Western Pacific Financial ADDRESS �IC✓!(% BI TENANT MAILING c/o J. na son Co. UNIT N SPACE NO. ADDRESS9003 kypiark BLK. CITY Irvine Ca. 92714 NO�40-260 3 Parcel 1 NEW ADD ALTER REPAIR MOVING DEMOLISH QQ! °ENDER�'Western Pacific Financial X _ BRANCH OWNER Western Pacific Financia ADDRESS (Same) VALUE ORENGINIFR Hales -Lan ston TE`547-0862 USE �%7 r ADDRESS 7 7 7 S . Main Orange, Cra . Iil ZONE �/ TYPE GROUP APPROVED CONTRACTOR J. Dong1d Olson—Co. BY DATE ADDRESS 18003 Skypark Blvd., Ste .B Irvine, Ca. 92714 M40-2606 CITY APPROVED SETBACKS LIC, NO 333969 LIC. NO. SIZE NO.OF BLDG& (FROM C/L STREET) OF LOT NOW ON LOT O FRONT FT. USE OF Vacant Land EXISTING BLDG. dy Separate permits are required for L. FT. electric, plumbing and heating work. R FT. USE OF BUILDING AND WORK TO BE PERFORMED P NNING ACTION Construct office building shell ZE 7q-)30 DATE APPROVED 6336 S.F. APPROVED ,� • DATE t7 Q MOLD FOR SPECIAL REQ[lIIRF;MENT-' I hereby acknowledge that 1 have read this application and state that the above information Is correct and agree to comply with all laws regulating building construction, and i shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I amp perly licensed 9s a contractor under SO. FT, the State of California B i ss and Professions ode, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that s Ii enses arein full f an f et, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from th pro sions oft a State al rnia usiness VALUATION PERMIT FEE S and Profesy1onic inion Ch ter 9.PLAN Signature o Permittee CHECK $ $� TAX $ or Authorized Agent Date --� II TOTAL PAID • 77 Ti;. 01 '' COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR(STRUC�'i'URAL PERMIT! 83,37 T - P.A- RAX 12M C_MTO MPRH CAI Ir-nRNIA ta9F9A RECEIVED PERMIT 7/, 5 For Applicant to Fill in Completely - Use Ink Only Bldg. .BUILDING Bld H3 per city A. P. NO. 4rY ADDRESS 3151-E3 ,H3Ave, Costa Mesa OWNER OR _ BUILDING 3 J� I ` fJ�I�� TENANT Western Pacific. ADDRESS i !�/t- i*� MAILING ADDRESS 1601 Dove St. UNIT OR SPACE NO. ,NO. LOT BLK. CITY Newport Beach NO. 752-7670 NEW ADD L ER REPAIR MOVING DEMOLISH CONSTRUCTION —LENDERWestern Parifir BRANCH Same OWNER i✓$ lrlf . ADDRESS VALUE ARCHITECT TEL, USE --- $ f j Opca OR ENGINES Hales -Lan stop 547-0862 7 f Y ,�/ tom- �Z C—L-- ADDRESS 777 S. Main Shite 105 -Orange ONE TYPE GROUP APPROVED Q, CONTRACTOR The J. Donald Olson CompanyBY DATE U ADORESS 18003 Sky Park Circ. Suite B TEL CITY Irvine NO.540-2606 STATE CITY APPROVE SET KS LIC. No. 333969 LIC. No. 22707 lwa SIZE NO. DF BLOGS. (FROM C/L STREET) DF LOT NOW ON LOT NT FT. USE of EXISTING BLDG. Separate permits are required for L. SIDE FT. electric, plumbing and heating work: REAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION DATE Commercial - Tenant Im rovements APPROVED APP ov D lite I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all Jaws regulating building construction, and I shell not employ any parson in violation of the workmen's compensation laws of the State of California. -.S O O C7 I hereby certify that I em properly licensed as a contractor under SQ. FT. the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professlons C visipn 3, Chapter V PLAN CHECK $ l Signature o / / I r Permittee S { ✓ �QI� TAX E or 00" Authorized Agent Date � ,_ TOTAL PAID E Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations, CITY'OF COSTA MESA PE NO. ` TRACT NO. LOT NO. .gG. NO. CONtTRUCTION PERMIT Protect Address C1 AlAh—0.17AYA.ly TYPE OF CONSTRUCTION Address T(yl/(/ /S d•; ssy,{E44,2=Z:: 3 Arch/Eng. License No. Or Address Contractor b0 Phpn Address 22 > �1 cnr4 C>7�d• eA4-.•- LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Llcerrse Class License No. Date ' Signature _ ,'- %RKERS' COMPENSATION DECLARATION reby affirm that I have a certificdte of consent to self -Insure or a ,ificate of Workers' "Compensation Insurance, or a certified copy tr,ereof (Section 3800, Lab. C.). Policy No. Company ❑ Cortlfied,copy is hereby furnished. - XCertified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed Ifthe permit is for one hundred. ($100) or lessi. I certify that n the performance of the work for which this permit is Issued. I shall riot employ any person in any manner So as to become subject to the Workers Compensation Laws of California. Date Signature NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provISIQns of the Labor Code, you must forthwith comply with such provision& or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Sect)on 3097 Civ. C.). Lender's,Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, irnprove, demolish or repair any structure, prior to its Issuance, also re- s the applicant for such permit to file a signed statement that he A;p- censetl pursuant to the provisions of the Contractor's License Law r ter_ 9 (commencing with SeetiOn 7000) of Division 3 of the t3usiness and Processions Code) or that he 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 dollar; ($500). ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, And the Structure I$ not intended or offered for sale. (Section 7044, Su&iness and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or Improve for the purpose of Sale). ❑ 1, as owner of the property- am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Cnntractor's "License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such pro)ects with a coritractor(s) Ilcesned pursuant to the Contractor's License taw). _ © I am exempt under Section S. & P. C. for tnis reason Date Owner ---- --- I hereby certify that I have read this application and State that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representativesyof s yyyrrr��y en[ r upon -the above meyrjWed Signature for�pns oLl�pur es.� �, �yl Signature �/' ,/ �� Warn �j -rarivets' L cense 'r S_ ❑ NEW ❑ ADD 16ZIERATION ❑ REPAIR ❑CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ELECTRICAL []PLUMBING ❑MECHANIC ❑ OTHER PROJECT DFSC I TION SQ. FT. , n/� OCCUPANCY�LCONSTRUCTION TYPE VALUATION ZONE GRADINGGCU. YDS. ACRES A.P. zb- ZONE 451 S/04/8� 21408 ING REGULATIONS PLNTG.. REF. � PROPtW--F LINE REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE REMARKS: L PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK, BATHTUBS SHOWERS TOILETS URINALS - GENERATOR 0-1 KW 1-20,KW TRANSFORMER LAVATORIES OOUBLE LAVS - -APPLIANCE 10.50 KW 50 + KW ' KIT. SINKS DISHWASHERS,MMCF �� 0.1 HP I-10 HP SERVICE SINKS - SUMPS (1 ( 10-50 HP -50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETSIC SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS , SWIMMING POOL P TRAP POLES METER D -SUB WATER SERVICE ALTERATION .,t PANELS 4 SUB GAS SERVICE OUTLETS SERVICE'- AMP d WATER HEATERS BTU OUTPUT SEWER CONNECTIONS ` SOLAR TANK COLLECTORS - - SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT S SMTP E AND DUCTING _ 100,000 + BTU PLAN CHECK $ PERMIT ISSUANCE S REFRIGERATION 0.100,000 BTU PLUMBING $ - SYSTEM GRADING $ 100,000 + BTU ti I , PLAN CHECK $ BOILERS ti��• BTU- _ ELECTRICAL $� $ �• PLAN CHECK $_ MICROFILM $ SYSTEM REPAIR, ALTERATION TOTAL FEE $ EXHAUST SYSTEM MULTIPLE - MECHANICAL $ LESS AD- PLAN CHECK $ VANCE PC $ _ ISSUE FEE ~�--- . 411e nt,e- Pin k7ACCOun-ting;-Goldenrod-Assessor. ' FINAL FEE $CA—I •ye> f / CONSTRUCTION AND. PLANNING APPROVALS Permit # Date 1. Temporary Electrical Service or Pole 2. SoilPipe-Undrgrn 3. Electrical Conduit Utility-Undrgrn 4. Electrical Conduit-Undrgrn 5. Steel ein once 6. _ Electrical UFER Grn 7. Footings 8. Foundation 9. Water. Pipe-Undrgrn 10. Structural Floor System 11. Property Sewer Line & House Connection 12. Street Sewer Connection • • 13. Inspector POOL & SPA. Date W Inspector - APPROVALS Perna ty# , E 55, Plumbing System - Final 43. Pool & Equipment Location - •'4= Rough Electric -Conduit 44. Steel Reinforcement -- ` - •56. Eleetrical-Final } 45. Forms Rough Electric -Wiring y96,1 46. Electrical Bonding 57. Solar System -Final 47. Rough Plumbing & Pressure Test - Rough Heating & Air Conditioning 48. APPROVAL TO COVER-GUNITE " �- _• encing & Access Approval 49. Electrical Conduit-Undr rn Ducts in Structure 50. Gas Pipe, ❑ Undr rn, Test 9. APPROVED FOR PLASTERING 51. Backwash Lines P -Trap.❑ Undrqrn Ducts, Ventilating 52. APPROVAL TO DECK _ 60. POOL/SPA SYSTEMS FINAL 53. Backwash & Receptor -Final 54- - Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit •56. Eleetrical-Final } 15. Rough Electric -Wiring y96,1 57. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17. Ducts in Structure 9. APPROVED FOR PLASTERING 18, Ducts, Ventilating _ 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing- 23. t Irisulation :'. •�= 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat J I a Applicant to fill In all spaces witnln heavy border lines and sign all appropriate daClarations. "CITY OF COSTA MESAM0.�� TRACT NO. LOT NO. BLDG. NO. .CONSTRUCTION PERMITPER1 L Owrier7/j '— S�GUtZ1 [ Phone Address ArcnlEng. License No, rl Address Contractor Addressfo.p (� CU 1 `(d 11 tJtlfL, LJfLyL4C;;i,r- LICENSED CONTRACTOR DECLARATION I he, by affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, my license is in full force and effect. License Qass License No.�u� Oats _ ~! — T Signature j 2*l%==.z2 - - WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a Certificate of consent to self -insure Or a rtificate of Workers' Compensation Insurance, Or a Certified copy jeof (Section 3800, Lab. C.), -icY No. Company w Certified copy Is hereby furnished. 6Certified copy is flied with the City Building Division. E EMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed If the permit Is for one hundred (51001 or less. 1 COrtify that n 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 taws of California. Data Signature NOTICE: If after making this declaration, you should become subject to thO Workers' Compensation provisions of the labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that tnere is a construction lending agency for the per- formance of the work _for which this permit is Issued (Section 3097 Civ. G-). Lender's Name Lender's Address OWNCR BUILDER DECLARATION I herePY affirm that I am exempt from,the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city Or County which requires a permit to construct, attar, Improve. demolish or repair any structure, prior to Its issuance, also re- quires the applicant IOr such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License taw rchapter 9 (commencing with Section 7000) of Division 3 of the islneS$ and Professions Code) or that he Is exempt therefrom and the lis for the alleged exemption. Any violation of Section 7031.5 by y applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). ❑ 1, as owner of the property, or my employees wlth wages as their sole compensation, wilt do the work, -and the structure is not Intended or offered for We. (Section 7044, Business and Professions Code: The Contrdctor's License Law does not apply to an owner Of a property who builds or Improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build or Improve for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed Contractors to Construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section S. & P. C. for this reason Date Owner 1 hereby certify that I have read this appttcatlon and state that the above Information Is correct. I agree t0 Comply with all city and county ordinances and state laws relating to construction and hereby authorize ropresCntatives Of this city to enter upon the above mentioned property for in Qtionpu oses. Signature. L to Drivers' License or SS TYPE OF CONSTRUCTION ❑ NEW ❑ ADO ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK IrYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL XPLUMBING ❑MECHAN -❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: ZONING REGULATIONS A.P. :0 ZONE PLNTTG.. ggR(lE�.F..9F SFTAACK CIL ST_ PRt3 kFlnGNE REAR YARD (TO P/L) PKG. SPACE R EQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ DATE f;, (ll r Tl_ PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK BATHTUBSSHOWERS S PLUMBING S PLAN CHECK TOILETS LAVATORIES URINALS DOUBLE LAVS GENERATOR TRANSFORMER APPLIANCE 0-1 KW 10-50 KW_50 1.10 KW + KW KIT. SINKS SERVICE SINKS DISHWASHERS SUMPS MOTORS (INC. SOLAR) 0-1 HP 10-50 HP 1-10 HP 50 + HP ' FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP q- 1"IbIKU'Lliul"I POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN 7 SUB GAS SERVICE OUTLETS SERVICE AMP WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE MECHANICAL PLAN CHECK SUMMARY OF FEES HEATING SYSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000 + BTU I BOILERS BTU I I I L SYSTEM REPAIR, ALTERATION I I J EXHAUST SYSTEM�EXHAuST SYSTEM MULTIPLES ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant; Pink-ACCOunting; Goldenrod -Assessor BUILDING PERMIT PLAN CHECK S PLUMBING S PLAN CHECK S ELECTRICAL S PLAN CHECK S MECHANICAL $ PLAN CHECK 3 SMtP PERMIT ISSUANCE GRADING S S MICROFILM 3 TOTAL FEE S LESS AD- VANCE PC S FINAL FEE S CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS ' i Permit # 1 Date; Inspector 1. Temporary Electrical Service or Pole 43:. Pool & Equipment Location SoilPipe-Undrgrn . 44. Steel Reinforcement _ 3. Electrical Conduit Utility-Undrgrn - 45, Forms 4. Electrical Conduit-Undrgrn5. 46. Electrical Bonding _ Steel 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn „ 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn " 8. Foundation - 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trao, 0 Undrac` 10, Structural Floor System '52. APPROVAL TO DECK -- • - --�- - 11, "Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12, Street Sewer Connection 54, Heater & Vent -Final ' 13, Rough Plumbing Plumbing System - Final, 14, Rough Electric -Conduit 56. Electrical -Final 15, Rough Electric -Wiring - - _ '57. Solar_System-Final. = + 16, hough Heating & Air Conditioning W3. Fencing & Access Approval 17, Ducts in Structure a APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - - 19• Gas Pipe -Rough &Test 20- Root -Framing 21. Roof-Sheathin T'- _ NOTES: 22. Frame and...ta ing 23- Insulation 24. Lathing & Siding 25. Drywall Nailing ' 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28, Final Electric 29. Final Heating & Air Conditioning ' 30. Final. Gas Pipe -Test 31. Final Plumbing 32• Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final ' 35. Landscape Sprinkling System 36. Sound Attenuation 37• Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. ' 42. CERTIFICATE OF OCCUPANCY No- _ Date - - - 1• � APPLICATION FOR A BUILDING PERMIT Parcel 79-391 Tract Block LOt BUILDING PERMIT NO. -519-76 Electrical Permit No. __7 Building Bldg. 11-3 per city Address 3151-E3 Airway Ave . , Costa Mesa Plumbing . Permit No. CrossMechanical Area John Wayne Air orF"" Redhill. Permit No. Owner Western Pacific Financial Type of Proiect: ❑ New Ile Altcr ❑ Addition Address 1601 Dove St. ❑ Repair ❑ Convert Demo ❑ Occupancy Pmt, city Newport Beach zip92660 Phone752-7670 A.P. Insp. Airea/ Architect Designer ales—Langston License No. SC 010899 Zone Sp1. Pmt. No. 77 S. Main Suite 105 Setbacks P/L Front C/L St. Street Width an a Zip 92668Phone547-086 Ards Le Rightear ve of. ,, �g Madole & Assoc. License No. RCE 14814r [Addr-s ng Daces equ re Ov a cr- over,,1820 E. 16th St.[Req nta Ana Zip 92701 Phome835-2548t t No. of Stories No. of Family LICENSED CQNTRACTQR'S DECLARATION ! hereby affirm that I em licensed under provisions of Chapter g Fees Yes ired Nn`commencing C.T. Fee Receipt g Approved By: Date with Section 7000 of Division 3 Of the Business and Professions Code and my license is in full force ana ptigF 69 License Class - _ License Number 111 Date ContraCtOr,J• Donald Olson Company MIs C. Aaaress 18003 Sky Park Circ. Suite B Proposed Use of Structure City and Zip 92714 Phono 540-2606 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction fending agercy for the performance of the work for which this permit is issued (Sec. 3097, Civ, C.). Lender's Name Western Pacific Financial Lender's Address 1_60_1 Dove St.,_ _ Newport Beach Occ. Type Class Const. Coae Year USE/OCCUPAN Y SIZE SO. FT. 1. OWNER -BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Lew 2. for the following reason: ❑ I, as Owner of the property, or my employees with wages as their sale compensation, will do the work, and the structure is not 3 Intended or offered for safe. ❑ f, at owner at the proparty, am exclusively contracting with licensed Contract Ors to Construct the project. E]i em exempt under Sec, , B&PC for this reason_4• Date Owner WORKERS' COMPENSATION DECLARATION Total Valuation Encroachment Permit Required ❑ Yes ❑ No I herebv affirm that I have a certificate of consent to self -insure, or acertificate of Workers'Compensation Insurance, or a certified copy thereof. Policy No Cornpanv .T ❑ erti}io0 copy is hereby furnished, ,�*tified CC//,�pp,.p.y��-s//}}iled'A ty, M Grading Pmt. Grading Required ❑ Yes ❑ No Pmt. No, Rough Grading Approved di Date Date�JApplican CERTIFICA E OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit is for 5100 or less). I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. PERMI FEES Data— Applicant NOTICETD APPLICANT: H after making this Certificate of Exemption, you should become subject to the Workers' Compensation Structural $ Ian Check y Electrical S pecial s I Vest. provisions of the Labor Code, you must forthwith comply with such provisions Or this permit shall be deemed revoked, I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION 1S CORRECT, I AGREE TO Plumbing s COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS Mechanical $ RELATING TO BUILDING CONSTRUCTION, AND HEREBY RUTH. ORtZE REPRE3 NTATIVES F THIS COU TY TO ENTER UPON THE4BC"VEWENTI E PROPERTY R INSPECTION PUR. POS , Pre -Grade Inspection s Sidp�pf�1^a/otf./�A li tar �A�g)a t Deta ��✓��7 Pre -Grade Rec. No. s Permit Issue S �]jL J/lls7CC.0 Print Applicant's/Agent's Name ' All spaces within this box must be completed t0 process Plan Check BY: lssuan[e Approved: CMF 0335.46 (BU -28) rev. 6180 Applicant to fill In all spaces withTh heaYy r _ )gn aN approprraa�..eclarations. CITWOF COSTA MESA P Eg;r I�rvO. TRACT NO. Lr5" _R0_ BLDG. NO. (CONSTRUCTION PERMIT C 1-167 1rv1 I\- 511h, I >Phr l0. ?soject Address 'q I pl, r NL,, - . Owner Phone -Address L4,500 C L' Arch/Eng. Q U I License No. Address ) IQ ' Contractor T, 10C Phone Address q4aQ S -r kvWpo0- EAc LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code CI my license is In full force and ffect. License Class LI N Date I Signature _ Wr7RKERS' COMPENSATION DECLARATION ;eby affirm that I have a Certificate of consent to self -insure or.a hfcate of Workers' Compensation Insurance, or a Certified copy eof (Section 38_00, Lab, C.). Policy No. Company ❑ Certified Copy is hereby furnished. - ❑ Certified Copy is filed with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is -for one hundred ($100) or less). (.certify that In the performance of the work for which this permit Is issued, I shall Wnot employ any person in any man er so as to Come subjec o t S ry ers Campensatio s Of�Ca a. Date 1 Signature r r NOTICE: If after making this declaration, you should be me'subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- formance of the work for which this permit is issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 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're- o•' -s the applicant for such permit to file a signed statement that he nsed Pursuant to the provisions of the Contractor's License Law 4er9 (Commencing with Section 7000) of Division 3 of the t .,ess and Professions Code) or that he 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), ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure isnot intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does Such work himself or through his own employees, provided that such improvements are not Ior offered for sale, If, however, the building or improvement is said within one year of compietion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an Owner of property who builds or Improves thereon, and who con- tracts from such projects with a contractor(s) Iicesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws relating to Construction, and hereby authorize representatives of this cit to enter the above mentioned property for ctio S. Signature O 1 Drivers' License or SS =f 1�13 11 TYPE OF CONSTRUCTION El NEW ❑ ADD USALTERATION S� ❑ REPAIR ❑ CONVERSION El DEMOLISH ` ❑ OTHER DESCRIPTION OF WORK -r-__d A I_.. TYPE OF PERMIT ❑,�ADING ❑ FOUNDATION ❑-STRUCTURAL I[] TENANT ❑ ELECTRICAL❑PLUMBING ❑MECHAN ❑ OTHER r PROJECT DESCRIPTION SQ. FT. il OCCUPANCY _ CONSTRUCT.ION TYPE VALUATION`ZONE t :t GRAOING CU. YDS. '-ACRES REMARKS: �P/ ) - •.i I A.P. :# ZONE • �IHtI tl�f►�inl ZONING REGULATIONS PLNTG. gREF..VL PROPP RTpY LINE REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: ,PROVIDED "— PARK FEE $ DATE 81 OK 49Z 4a C M6 0 1. C F,. r U. —.0 - PLUMBING PLAN CHECK �1 r ELECTRICAL PLAN CHECK BATHTUBS SHOWERS LJVV r TOILETS URINAL'S ti't GENERATOR 0.1 KW 1-10 KW TRANSFORMER �•j, LAVATORIES DOUBLE LAYS - ,APPLIANCE 10.50 KW, 50 + KW KIT. SINKS DISHWASHERS MOTORS �a 0.1 HP 1-10 HP SERVICE SINKS _ SUMPS (INC. SOLAR) 10-50 HP 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES, i OUTLETS SWITCHES '- DRINKING FOUNTAINS GAS TUSE,SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P TRAP POLES METERED SUB WATER SERVICE ALTERATION 'PANELS' - MAIN SUB - GAS SERVICE OUTLETS :.. - SERVICE AMP WATER HEATERS BTU OUTPUT r , SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE ' MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING -• HEATING SYSTEM 0-100,000 BTU PERMIT $ �> v SMTP $ AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT , ISSUANCE $ REFRIGERATION 0-100,000 BTU PLUMBING $ SYSTEM GRADING $ 100,000 + BTU PLAN CHECK E BOILERS BTU ELECTRICAL $.�_.0 $ SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ r�7} TOTAL FEE $ +�` MECHANICAL E EXHAUST SYSTEM MULTIPLE LESS AD-: PLAN CHECK $ VANCE PC $ _ ISSUE FEE N, FINAL FEE $ CONSTRUCTION AND PLANNING Date APPROVALS Permit # Inspector POOL & SPA � Date lnsjiector " APPROVALS Permit # 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 1 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Banding 5. tee em once 47. Rough Plumbing & Pressure Test- - 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7., Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas , Pi e p Undr rn, Test. 9. Water Pipe-Undrgrn V1151. Backwash Lines P-Tra ' ❑ Undr6rn 10. Structural Floor System XV 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection I Ah 54. Heater & Vent -Final 13. Rough Plumbing Al 55- Plumbing System - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring- 57. Solar -System -Final 16. Rough Heating & Air Conditioning - Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. t 1.r �. - POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough &"Test 20. Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric lec, 29. Final Heating & Air Conditioning" 30.- Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape S rinklin S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY NoDated �� t .f Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. p .-y 1:930 2/27/Bb �:CITV OF COSTA MESA, PERMIT NO. TRACT NO. LOT NO. BLO a CONSTRUCTION PERMIT 4« —//41P% � `I� PIt.fs3-oi ,44 . t , frdject Address 3151 Airway Ave. Sidq Applicant's Mailing Address' 3151 Airway Ave. E-1, Costa Me Owner's Name haul l dhouse Consultants Phone 540_____x_2605 Address 3151 Airway Ave. E-1, Costa Mle5a - ArchlEng. Torr) CanipOS & ASSOC- License No. Address 1777 -"F" Maul St.. Irvine - Contractor's Name J . ' Donail d Olson Co. -- _ Phone -540=-2 Address (mailing).-,Yi51 Airway Aye. F-1, Costa Mesa City License No.— LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with -section 7000) of Division 3 of the Business and Professions Code, and my license is in fu1 klOrCe and affect. License las License Date,—signature NORKERS' COMPENSATION OECLA'RATt I hereby affirm that I havo a certificate of consent to self Insure or a certlflcate of War kers' Compensation Insurance, or a certified- copy thereof (Section 3800, Lab. C.)L_ + Policy No. 1--2974 Company . Fairmont - - r�-Cert10 copy is hereby furnished. I a Certlf a Copy I flte with the city Bull ng fon• pace t Applicant EXEMPT ON FR M WORKERS' COMPENSATIA DECLARAqN (Thissectlon need not be completed It the permit is for one hund d (3200) 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. Date _ Signature NOTiCEt it, atter making this declaratlon, you should become subject to the Workers' Compensation provisions of the tabor Code,' you must -forthwith comply with such provisions or this permlt shall be I deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for whyq AthIs permit, is issued (Section 3097 Civ. C.) Lender's Name 1l tender's Address' OWNER BUILDER DECLARATION I hereby affirm'that I am exempt from the Contractor's License Law for the following reason' (Section,7031.5 Business and Professional 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 fits a signed statement that he/she is licensed pursuant to the provisions of e Contractor's License Law (Chapter 9 (commencing with Section 7000) of .41sion 3 of the Business and Professions Code) or that he/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 malty of not more than five hundred dollars (5500). 1, as owner of the property or my ,employees -with wages as their sots compensatlon, will do the work, and the structure is not intended or Offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such Improvements are not Intended or offered for sale, if, however, the building or Improvement is sold within one year of co m. pletion, the owner will have the burden of proving he/she did not build or Im- rove'forr the purpose of sale). I. as owner of the property, am exclusively contracting with licensed con- tractors to Construct the project (Section 7044, Business and Professions code: The Contractor's License Law dneS not apply to -an owner of property who builds or Improves thereon,+and wno contracts for such projects with a can- tractor(s) license pursuant to the Contractor's License law). 1 am exempt under Sectlon B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above Information Is correct. I agree to comply with all city and county ordinances and state taws relating to bultding Construction, and hereby authorize repre- sentatives of thf city to enter up the above-mentioned property for Inspection purpo ;8/23/ Signature Date aC 8Y TYPE OFCDNSTRUCTISDI IjKlNEW ADD ALTERATION t I REPAIR a ❑ CONVERSION ❑ DEMOLISH ❑ OTTpHER' _ A.P. yfb _ DESCRIPTION OF WORK Tenant lippro lygment S Main Building: E TYPE OF PERMIT El GRADING ED FOUNDATION 0 STRUCTURAL T Front ❑ TE.NANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ ,OTHER A PROJECT DESCRIPTION SQ. FT.-- _ .- 224-3 OCCUPANCYR-2-- C Right C0NSTRUCTIONTYPE VALUATION$33 Ci45-0 g , Left ZONE. GRADING CU.YDS. ACRES Ping. Ref. 911 Remarks. Parking Req./Provided ' Use of Building: PLUMBING FEES Planning Notes: Bar Sink Backftow Preventer Backflow' I rrigal,ion Bathtubs 'A- Clarifiers .y l Dishwasher Drinking Fourita'ins Floor Drains Floor Sinks I Gas Service Interceptors % Kitchen Sink Lavatories F -Trap Roof Drains .Reinspection Fee Outlets $2S Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ID Multiple ❑ Fimpl/Fact. Bit. iCBO # Heating System & Ducting ©0.100.000 BTU ❑100,000 BT ZOrte Accessory Building: Z .O N N iG R E a U 1 IIA NT S Service Sink Park.Fees $ -� ELECTRICAL FEES Sewer Connection Showers ` NT S Service Sink Sewer Cap -� ELECTRICAL FEES Sewer Connection Automatic Washer Transformer 0 15.50 -KW 0 50+KW Construction Pole Sub. Solar Collectors Solar Piping ti Cooking Unit 'Meter �p to 100arrlps r Solar Tank ' - Dishwasher Meter ❑over 100 amps Swimming Pool vv/Spa,r , Dryers10Gas ❑Electric Sub Panel s Urinat Motors 00.1 HP E'1% - 8!% , Water Closet F.A.U. Inc. Solar 119-15 HP 016-15+ Water Heater Fixtures Microwave Water Service Device Boxes Pole Light Outlets Range I 1299nSwitches . Sign Garbage Disposal Standing'Sections I Generator 00.5 KV4 ❑5-15 KW Trash Compactor Issue Fee S 3 Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES Npad or Type 1 (:1PUBLIC Canopy Type l! ❑ SERVICES R 1 EMT �� rE_^ Zoning Approved By � nate w Application Approved By Dale Application Issued By_ _ ,R r Date7 Refrigeration System ❑D-100,000 BTU 0100,000 8TU SU A Y OF FEES BUILDING PERMIT - $ D SMTP $ �•�s' r PLAN CHECK Z,5910 $ �g PERMIT,-' PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ 3. r GRADiNG $ PLAN CHECK $ 115,10 MiCRDFILM $ MECHANICALf7.�$ D TOTAL FEE $ System RepairlAtteration Drivers' License or SS 5 Reinspection Fee S25 Issue Fee $ 3 PLAN CHECK $ f & O i" zr- I ( ' CMF 0865-06 rev. 7183 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor _ r� W CONSTRUCTION AND PLANNING APPROVALS Permit # lel Date Inspector P &SPA 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7,i Footings 5B. Electrical Conduit-Undrgrnd. 8.' Foundation 59, Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 16. 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 f 66. Solar System -Final 16. Rough Electric Wiring yJ� - 67. Fencing & Access Approval 17, R'6ugh Wiring Sign 68. APPROVED FOR PLASTERING 18. 'Rough Electrical -T Bar Ceiling 3 Iq 8 e�0 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning JewFIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas E]Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ 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 Cast 79. FINAL -INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33, Final Electric Notes: p aIN C> 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 i 41. Solar Domestic -Final . 42. Backflow Preventer 43. Backflow Irrigation F 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations I r 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric' Release to Edison 50.' Gas Release to'Southern California Gas Co: . 51; CERTIFICATE OF OCCUPANCY' No. t✓�36� . Date Y T City of Costa Mesa Development Services Department CERTIFICATE O F OCCUPANCY No. 000877 Building Safety Division P. O. Box 1200 Costa Mesa, California The Building located at '11 til ATR1+Ti1Y a{lF_ RTT)n- :LIT --A has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building C%WTr't Legal Description A97-.)ql-1r (See reverse side for Metes and Bounds) Building Permit No, ij=i6nna _- Electrical Permit No. R -1A171 Plumbing Permit No.13-»19714 Mechanicai Permit No. M-1 C--71 5 Number of apartments and/or guest rooms ISSUED TO: Building Official by 'ii'il- ATRWAV AVr.. r'F-7 , rr)�na ht4!� f'A. %�!/G1Z I�D ` Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1183 White - Owner, Canary • Numerical File; Pink - Bldg. Permit File City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE O F OCCUPANCY No. 000333 P. O. Box 1200 Costa Mesa, California The Building located at '1151 .. BxnM,im _Ale rt T_') has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto Ay for a Group Occupancy. Use of Building __ T"&.=4—r ni+-,�,. +-; ,,. nf Legal Description 0'AG_0AA_A (See reverse side for Metes and Bounds) Building Permit No, Electrical Perm it.No. ic,_inc-4n i Plumbing Permit No. nn-1nt:nr Mechanical Permit No. - - Number of apartments and/or guest rooms n - ISSUED To: Building Official_. — - --------• �._, _�. ---,Y.- CA Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1U15-46 rev. 1/83 White -Owner; Canary - Numerical File; Pink - Bldg. Permit File L� �4 - 16 COSTA EAUILDIIBUILDING-SAFETY DEPARTMENT APPLICATION F8k9?ru1&bkT1PERMIT526•32 COSTACALIFORNIA T4 * 2IfZ 3G3• - 3�-- RECEIVYLD BY PERMIT For Applicant to Fill in Completely — Use Ink Only `�J] BUILDING A.P. NO. ADORESS OWNER R TENANT astern Pacific Financial BUILDING DDRESS c r ' I I ADDRESS_,._i / MAILING C o . na son Co. UNIT DR SPACE NO. ADDRESS 1 0,3 Sk ark Blvd, .Ste M. BLK. CITY Irvine Calif. NOL. 540-260 - NESN ADD ALTER REPAIR MOVING DEMOLISH LENDER r'o"Western Pacific Financial LENDER X BRANCH — OWNER Western Pacific Financia ADDRESS Same USE VALUES �7 A11117ECT TE /gyp ORENGNEER Hales -Langston 47"0062 ADDRESS 777 S. Main, Orange, Ca. ZONE TYPE GROUP CONTRACTOR,J. Donald Olson Co. BYPROVED DATE n ADDRESS 18003 Skypark Blvd. Ste .B CITY Irvine Ca NOL.540-2606 STATELIC. APPROVED SETBACKS O. 333969 LIC NO. SIZE 0. OF BLDCa� {FROM C/L STREET} OF LOT NOW ON LOT ONT FT, OF Vacant Land EXI EXISTING BLDG. Separate permits are required for L SIDE electric, plumbing and heating work. h REAQk rA. FT. AD USE OF BUILDING AND WORK TO BE PERFORMED PLA Pk5tX ACTIO Construct office buildingshell - DATE APPROVED 8589 S.F. APPROvisD _ _C210 -� ..�:tta1 e':.,.: a.'.�.... ]w eCS'.•d JAt 'L'!t'SZLt3 d� I hereby acknowledgo that I have read this application and state that the above Information is correct and agree to comply with all laws repulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that Iam pro ly licensed as a contractor under SO. FT. tho State of California Bus ss red Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that suc c es are in full fo a off t, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the p ons of the to C I rnia usiness VALUATION PERMIT FEE $ and Professions Cod ivision 3, Chep or 9. Signature o� PLAN CHECK E Permittee $ A TAX $1 or Ocy� �v Authorized Agent Date TOTAL PAID * 2IfZ 3G3• - 3�-- Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA rRMIT N . TRACT NO. LOTNO. BLDG.NO. CONSTRUCTION PERMITM �!o/ Project Address Owner j) QA1y- Phone5-/ Address J L Y Arch/Eng. cense No. - Address Contractor 6eZPhon Address//Z1, 62aA/7XXA1 LICENSED CONTRACTOR DECLARATION ,I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code and my license__JL In full force a d ffe_ct. Licen ass ' Q r+-te Z' Signature _ • '40(ER91 COMPENSATION LARATI :reby affirm that Ihave a certificate of consent to self -Insure or a certificate 'of workers' Compensation-1ri rance, or a certified copy reof {Section 3800, Lab U[Si:%%C Company, :€. Certified copy Is -hereby furnished. _ ;kz&rtlfled Copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred _ ($1001 or less). ! certify that in theperformance 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. - Date Signature NOTICE: If after making thisdeclaration, you should become subject to the Workers' Compensation provisions of the Labor Cade, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 civ. C.). - Lender's Name Lender's Address OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from.the Contractor's License Law for the following reason {Section 7031.5 Business and -professions Code: An,. city or countywhich requires a permit to construct, alter, eve, demolish or r-epair any structure, prior to its Issuance, also re- ; the applicant for such permit to file a signed statement that he ,ensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the P 'ness and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by Jpplicant for a permit subjects the applicant to a civil penalty' or ,iot more than five hundretl_tl_ollars ($500). ❑ 1, 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. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of .a property who builds or improves thereon,and who does such work himself or through- his-own-employeeS,L 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑' I, as ownerof the property, am exclusively contractingwith licensed contractors to Construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not'apply to an owner of property who builds or improves thereon, and who con- tracts -from such -projects with a contractor(s) licesned- pursuant to the Contractor's License Law). E]I am exempt under Section B. & P. C. for this reason - Date Dwner 1 hereby certify th t.l have read this application and state that.the above information i cor agree to comply with all city and county ordinances a g t nstruction, and hereby authorize representativ f this c y t ter upon the above mentioned property fo ec ion es. Signatur TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WDRK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL '❑PLUMBING ❑MECHANIC ❑ OTHER PROJECT DESCRIPTION S4: FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE _ GRADING CU. YDS. ACRES REMARKS: -A_//:r Drivers ens. or SS W ISSUE FEE- -MF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor XX- TL ZONING REGULATIONS A.P.:ht ZONE' PLNG. REF. RIGHT REAR YARD (TO P/L) PKG. SPACE RE4, PROVIDED STREET WIDTH PARK, FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: P _ - -1 F ;h ELECTRICAL PLAN -CHECK PLUMBING PLAN CHECK BATHTUBS SHOWERS TOILETS, RINALS- URINALS' LAVATORIES LAVATORIES DOUBLE LAVS KIT. SINKS- 'DISHWASHERS SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMING POOL- P TRAP WATER SERVICE ALTERATION GAS SERVICE OUT LETS,t . WATER HEATERS BTU OUTPUT -- SEWER CONNECTIONS SOLAR TANK COLLECTORS ; SOLAR PIPING SYS. ELECTRICAL $ ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0.100,000 BTU 100,000 + BTU REFRIGERATION SYSTEM 0-100,000 BTU 100,000 + BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE Drivers ens. or SS W ISSUE FEE- -MF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor XX- TL ZONING REGULATIONS A.P.:ht ZONE' PLNG. REF. RIGHT REAR YARD (TO P/L) PKG. SPACE RE4, PROVIDED STREET WIDTH PARK, FEE $ ZONING APPROVED BY DATE SPECIAL CONDITIONS: P _ - -1 F ;h ELECTRICAL PLAN -CHECK SO FT_ MAIN` - SUB GENERATOR" "" 0.1 KW TRANSFORMER - APPLIANCE - -10.50 KW 1-i0 KW ' -50 + KW MOTORS -" 0.1 HP (INC. SOLAR) 10-50 HP - 1-10 HP --50 + HP r FIXTURES' OUTLETS SWITCHES 'GAS TUBE SIGNS " - POLE LIGHTS ISSUE FEE POLES METERED SUB PANELS -- MAIN` - SUB "SERVICE --"- - AMP - ' ISSUE FEE 1 ' APPLICATION APPROVED^BY- DATE i SUMMARY OF FEES BUILDING ' - PERMIT $ SMIP $ - PLAN CHECK $ _ PERMIT ISSUANCE $ PLUMBING $ GRADING $ PLAN CHECK ,$ ELECTRICAL $ $ MICROFILM $ PLAN CHECK $ TOTAL FEE $ MECHANICAL" $ J �" LESS'AD- r r! PLAN CHECK $ VANCE PC $ _ FINAL FEE $.!. CONSTRUCTION AND PLANNING APPROVALS Permit # ZI Date ; ' Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool &Equipment Location 2. Soil ip�-Undrgrn 44. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrn 45. Forms A._`• � ti 4. Electrical Conduit-Undrgrn 46. Electrical Bonding tee ein orce 47. Rough Plumbing& Pressure Test5. 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water pipe-Undrgrn 51.• Backwash Lines P-Tra ❑ rstlr rn ' 10. Structural Floor System 52. ' APPROVAL TO DECK ' " ' 11. Property Sewer Line & House Connection 53. Backwash &'Rete for -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing Systerri Ftn'al 14. Rough Electric -Conduit - -56. .-Electrical-Final 15. Rough Electric -Wiring 57.'- Solar System -Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts, in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipp•Rough & Test 20. Roof Framing 21. Roof -Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric L �3- 29. Final Heating & Air Conditioning 0 30. Final Gas Pipe -Test 31. Final Plumbing is I 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. -`-Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40.' . Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY -Nd_ Date A Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY'C�F COSTA MESA j PERMIT O. TRACT NO. LOT NO. r'CONSTRUCTION PERMIT/ JBLDG.NO. 4Q - r Project Address /WA -V' _ TYPE OF CONSTRUCTION -. .6 Owner Phone ❑ NEW XADD ❑ ALTERATION Address �� [ay ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER ZONING REGULATIONS Arch/Eng. License No. -DESCRIPTION OF WORK A.P. Address ZONE PLNG. R Contractor L N (u Phone 6q-YIOL TYPE OF PERMIT 1 +BUILDINGTpp SET AC -EF. BgUuIL��pI G INE Address 3 I ,�i�. ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL IDpo YARD PRo$ LICENSED CONTRACTOR DECLARATION ❑ TENANT 0 ELECTRICAL {PLUMBING ❑MEGHgNICA " hereby affirm that I am licensed under provisions of Charter 9 (com- �" RIIGWTARD mencing with section 7000) of Division '3 of the 'Business and ❑ OTHER Professions Code, and my license Is in full force and effect. REAR YARD (TO P/L) G� ��y 3g 6 PROJECT DESCRIPTION w license Class Lice se No PKG. SPACE REQ. PROVIDED ,Date j� 1 Z�� i Signature SQ. FT. _ RK8R5' COMPENSATION OECLAR ION OCCUPANCY { CONSTRUCTION TYPE STREET WIDTH PARK FEE $ oeby affirm that I have a Certificate of consent to self -Insure or a ' VALUATION ZONE ZONING APPROVED BY DATE __tificate of Workers' Compensation Insurance, or a Certified Copy ereof (Section 3800, Lab. C-)•.�) ' GRADING CU. YDS.. ACRES SPECIAL CONDITIONS: Icy No. Company S4il•1"Z 1✓oywi� Certified copy is hereby furnished.- -REMARKS:'-- - Certifletl copy is filed with the city Sul Iding Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section -need- not be completed If the permit Is for one hundred - - - - ($1001 or less}. . ` a': r 1 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 PLUMBING '• PLAN CHECK subject to the Workers Compertaat�- .S of tifo to ELECTRICAL PLAN CHECK.. BATHTUBS SHOWERS u NU UIA H Date't/ /Z-1 Signature -�- _ _ NOTICE: If after making this deClaratlOyou should become subject to the Workers' Compensation provislOns Of the Labor Code, you must TOILETS URINALS GENERATOR 0-1 KW TRANSFORMER 1-10 KW forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW -50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS ;MOTORS 0-1 HP 1-10 HP , I hereby affirm that there Is a construction lending agency for the per -SERVICE SINKS SUMPS (INC. SOLAR]" 10-50 HP 50 + HP formance of_the.work for whlch this,.permit.is Issued (Section 3097 Civ. C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS . OWNER BUILDER DECLARATION I hereby affirm that l am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: INTERCEPTORS CLARIFIERS POLE LIGHTS Kut- i 1U114 Any city or County which requires a permit to Construct,_ alter, SWIMMING POOL P TRAP POLES METERED SUB PANELS MAIN SUB -ove, demolish or repair any structure, prior to Its Issuance, also re- WATER SERVICE ALTERATION s the applicant for such pgrmit_to file a signed statement that he SERVICE AMP - ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS ((.. apter 9 (commencing witt3 Section 7000) .of .Division 3 of the Or that he is exempt therefrom the - B'dness and Professions Code) and for the alleged exemption. Any violation,of Section 7031.5 by WATER HEATERS BTU OUTPUT applicant for a permit subjects the applicant -to a civil penalty SEWER CONNECTIONS of more than five hundred doilars_($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work,�and the structure Is not intended ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE _ through his own employees, provided that such Improvements are not _ SUMMARY OF FEES _ intended or offered for sale. If, however, the building or Improvement MECHANICALPLAN CHECK is sold within one year of completion, the owner will have the burden - - of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT - E SMIP E ❑ I. as owner of the propt:rty, am exclusively contracting with AND DUCTING - ,licensed. contractors to .construct the project, (Section 7044, Business 100,000.+ BTU PLAN CHECKE�- PERMIT' and Professions Code: The Contractor's License Law does not apply to � ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 07100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM . GRADING' $ .the Contractor's License Law), , 100,000 +BTU PLAN CHECK $ ❑ 1 am exempt under Section B. & P. C. for this 8011 -ERS IBTU ELECTRICAL S $ _ reason PLAN CHECK S - MICROFILM $ TOTAL FEE $ SYSTEM REPAIR,ALTERATION Date -Owner I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS f#O- -• Informati�correcagree to comply with all city and county to Construction, and hereby authorize e er upon the above mentioned PLAN CHECK $ VANCEPCordinancerelating representac t propert rp s 1- ,c a `/ $ Signature) • i FINAL FEE E ISSUE FEE - - Drivers' License o s 1 CMF 0865-46 White -Building; Canary -Applicant; Rnk-Accounting; Goldenrod -Assessor :•L 1•-.. , : r'.L 1:1C W. ., ,. - I _ L .. ., r,: _ f', . CONSTRUCTION. AND PLANNING y °I ' �• • L f APPROVALS Permit # + - l pate r-_,3nspector-�h POOL & SPA ;~Ins ector'y� - - -- t : n -� Date Y > p �, APPROVALS - Permit # 1. Temporary Electrical Service or Pole _ 43. Pool &`'Equipment Location' ---'4- -- - •=` - - - `•`-v --�"'- ,- . Soil ipe=Undrgrn 44: steel Reinforcement 3. `'Electrical'Conduit Utility-Undrgrn " " - -_" - - " 45.- Forms 1 4. Electrical Conduit.U.6d.rgrn- 46. Electrical Bonding r-5 -.-Steel Rem orce-•- _ -- - ,r ~Fir 47. Rout -Plumbing & Pressure Test_`_ --- - - !-6.-`""ElectricaIL' UFER,GFri -" --w" �r,+". f'� • '- a'r •'7 y'4B?' APPROVAL -TO COVER:GUNITE�-''--- '- - ! --7"�Footings----____--_ __-' -. - n r,a� .:v, •y, "49: ''Electrical'Concluit=Undr rn ,sr.71'l rGh1•' r. t�� 'e. -.l rn, ,-_'$"_Foundation"____ - ,-- JS0: -Gas Pipe,-D.Udr rnTestr,„,' �,' ,i x,17• `�.,, ',' •a' 1'' I- 9 Water Pipe-Undrgrn I-3 If 7-1 v 51Unes P-Tra_0. ndr rn r-10- -Structural FlboraSystem , -r,r -'527-APPR01/ALTO DECK - - '' ''"'e- L-11 Property_S w_ br Line & HousefConnection. +.tis '>,w'" - - 53. Backwash & Receptor -Final., t�. Iry ;-�9:c , t '� Seer Connection ".; - ---_ - ___ j12. `-S[reet w _4 54, Heater -&,Vent -Final J"` r" r1 .r LI wu,_�i'►a .;�n 1 F-1 Plumbi»g •- - - -- ��--= - r---- ___ �. _ •,r,_yr r s�____�_ cv1 v,7 j 14"""Rougfi'Electric Conduit " "` o56._iEIectr.ica I'Eihal_ _ n,t .F y' ., wlT F11ty. r47f ti vn A.1 tk flf 3r•: I-•-15--Rough-Electric-Wiring---- ---- -� 57..'Solar System-Einal "�?�Irn :, J33fJ FrpkTA2Yi39rAr7: `?na IHOW I OPS Y1girRF.T3Y._ L1.6.__ Rough-Heating_&.Air._Congitioning-_ l _ _58._ _ encing.& Access Approval tz>91 :o_(00il l 17! Ducts in Structure,lAJy 1A 1RT73.13 { j j �o'ti�V :Jr 9. APPROVEDrFOR PLASTERING n2 1onnam Y., ni nu Loa yrr.y(o1Gr'r, ]on flivz ! ,bouza 18! Ductsr, Ventilating �'-'.',i0;w :n�ti T a �`� 1 19! Gas P}pe%F3oggh•&Test__._4, N r"rl 201 RoofjEramingn'h - or' 0&01 :I:4A1-j"A 1 j d:7 _q iv 2JAV 1 I I 2VAJ 2-2 �I�L -,!,J T F+T �. All, .' . r+_ _ 316C Ru60. P60L/SPA1SYSTEMS7FdNA6o39ct bwortz 133b tint enblL r, ,x116 it :3:1ITOb !emm :joy abo:) YOd5J 301 10 znoial o".0 nolinen9q! !oo `zig7±wAi gm o 0:3 sd 1102 lirnt9q zidl to enc z ve,g rf:lux rf1 a gJotr= 11iiwr1110 1 211 RoofiSheathin 4 71 C-: _q" f.Q 2s1C3T0NA 22,l Frame•and-Flash'inW,'_ _af-: q - G, r+ara!�rr.._rviil I + I _ I ?q: Ha A'. ft I 1 f "N 3tO2.T Irl N7Y130A O1+1lO M13J NOrT�UH78N0: 1�7NOTES: r,ivT{c )rV F ]2 1 •ya otii tot yips i pri4bnsi DIOL?�u'1ar,n.r c 21 tt,g'+f tvi! iri,iitc �•d�tyn �. „ 231 Insulation 2f'f�YJtiv� 2,]J[l:J rs+'Irma 1 .. A Cr -- I 24! Lathing & Siding �or . t,-, r ,_ , . , -.�• a� - --- _ _ n ,ti•, 1 25: Drywall Nailing `FL.1 if7 1 dV- -i =r tt' �- :iL�1T!'.' '� 133-, Fl:;M. lt' 1131, v{( �Hf , ]rd ilr':1 i' _ I 26: Plaster Brown Coat f i ^V i I i' 7•- ! = C - [ _ ] ..1 i �1 - ..r eA 'G I 27! Electrical Power Meter -Final ' + ' j j I wnl r .. - ,-, +� . . T Ati l b , -_ i, ,:.� , , rt „ - ,.. , ., n•. I 281 Final!Electri&,', f 1 29. Finalii-leating & Air Conditioning ! f 1 �F, �,y �1 ! .C, -If J'T.'_ rn •NGbi '1Cr=iii L -'G _�1" rf i -r,: • -, 1 30; FinallGas Pipe -Test I I it -.,vi r• F , •-LP v4r_r, _ .' . of F Y j 31' Final;Plumbing ,' 6 j.3 cy..,ry.j I 321 Water, Service -Final "- , I I T _ v W K r�, .. ;i r . ' J, I 33. Gas Service -Final I 34, Solar l5ames-tic--h-na Ar9 - ' - -- -- ! . 1 fri hr."m. To r cr' 35. Landscape Srinklin System -� ` f ' .q,, o. bit' f,,n bi) •1....1 I 36. Sound Attenuation1'H. ^l✓'R'��r � r,� ttt77ai11r,[ sv.r_: r n• n, rc r9n;,o rc _ 1 =4 .'trt[ r.1,. •l ii `� 'rJT. I 37. Handicap Regulations ~� �� :[ t 1 �� fi„ n.. l r ' .an • ] .r... , 31f' ;r1n3 2nn 7 fO 9^n.r A An r� A c•i 1 Ls n .nrY ngb lrh 38.- I 36. --FINAL STRUCTURE & BUILDING _ rfJ�Hs.rlaJ7 � � •!T8 7`' • ,r, • [ t ` , Q :,. ,. „' QOi►001. r 1 39. Special Requirements Completed- . Jt.7f'., t 3.3J:; 1 -�w - I Y --W rya -- ~; - �' `� 3 __ _ .-� r.•,t • 2 �i r• n;• r I 40." -Electric Release to Edison I 1- I 41.- Gas Release to Southern California Gas Co • -')3` 42. CERTIFICATE O' F OCCUPANCYlli.r rlFJti Nps -^ Date - (-�- - - - - -- ly C1 O7 i^. Z, ; +f. r !'Ps ,IqR,: ; <, i f .-� ,7 r - .,a __i •, .. ,A- '.k• E^"nuc., ��- � � J Applicant to flit in all spaces within heavy border lines and sign all appropriate declarations. s CITY OF COSTA MESA0. TRACT NO. LOT NO. [BLOG.NO. CONSTRUCTION PERMIT PERM rro)eCT Address - l Owner 40.2— Address Arch/Eng, License No. Address- -- — Contract e Addr .LICENSED CONTRACTOR D CLARATION I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) o�ivlsion f the usiness and Professions C n rrtyrl se Is I for fact. LivenCIas n r Signature _ feby ERS' COMP SATION DE LARATI affirm that I have a Certl(icate of consent to self -in a or a ate of Workers' Compensation Insurance, or a certified copy "ereof (Section 3800, tab. C.). TYPE OF CONSTRUCT ION El NEW El ADD ALTERATION 1:1REPAIR El CON C3 DEMOLISH ❑ OTHER DESCRIPTION OF WORK PE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY- CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES A.P. �r ZONE 3t 69 E/ii ) ZONING REGULATIONS PLNG. REF. 7F REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ icy No. Company - -- - - Certified copy Is hereby furnished. REMARKS: ❑ Certified copy Is flled.with the city Building Division. T EXEMPTION FROM WORKERS' COMPENSATION DECLARATION t 15 for o hundred (This section need not be compAclaration. $2100rt? or less. ` I rtify that n the performancwni lhi permit is Issued, I shall not employ any o a o LUMBING PLAN CHECK ELECTRICAL PLAN CHECK. subje th o s Compensni BATHTUBS SHOWERS r Date Signatur NO CE: if after making this dc becomes bj ct TOILETS URINALS 3 — GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the LabOr Code, you st TRANSFORMER forthwith comply with such provisions Or this permit shall be deemed LAVATORIES DOUBLE LAYS � APPLIANCE 10.50 KW -50 + KW: revoked. INKS DISHWASHERS MOTORS 0.1 HP 1.10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per- cin=�r�INKS SUMPS (INC. SOLAR) 10.50 HP 50 + HP formance of the work for which this permit Is issued (Section. 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.I. Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION i hereby affirm that t am exempt from.the Contractor'$ License Law for SWIMMING POOL PTRAP the following reason (Section 7031.5 Business and Professions Code: .,ivy city. or county which requires a permit to construct, atter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN SUB AIN SUB ,;ov a, demolish or repair any structure, prior to its Issuance, also re- 'sthe applicant for to file a signed statement that he such permit `ensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP - (Chapter 9 (commencing.. with Section 7000) of Division 3 of the WATER 14EATERS - BTU OUTPUT Ines$ and Professions Code) or that he Is exempt therefrom and the for the alleged exemption. Any -violation of Section 7031.5 by. SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty u, not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ 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 SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE r APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his Own employees, provided that such Ir"pfovements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale, if. however, the building Or improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING PERMIT $ , SMTP $ ElI, as owner of the property, am exclusively contracting with AND DUCTING Licensed Contractors to construct the project. (Section 7044, Business 100,000 + BTU PLAN CHECK S PERMIT and Professions Code; The Contractor's License Law does not apply to ISSUANCE $ an owner of. property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING 5 r tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - GRADING $ t Contractor's License Law). 100,000 + BTU PLAN CHECK S I am exempt under Section . & . C. for this BOILERS BTU ELECTRICAL $ � $ reason - SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ TOTAL FEE s Date n MECHANICAL $ I hereby certify t I have r this ap ica ton and stat a above EXHAUST SYSTEM MULTIPLE LESS AD- Informa[ion is rrect. I gree to comp with all cit county PLAN CHECK $ VANCE PC $ ordinances an ate is latin cons u lon, and hereby authorize representati t' cl en n t ov o e property f ins n FINAL FEE E -12 Signature . Drivers' License or SS 5F ISSUE FEE n ` • GMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor C J t/ LOW uk'a4A_4 0 L CONSTRUCTION AND PLANNING APPROVALS Permit # r L r Date Inspector POOL & SPA - APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45, Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ern orce 47, Rough Plumbing & Pressure Test 6. Electrical UFO Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. W�anr Pipe-Undrgrn 51. Backwash Lines P-Trap.Ej Undrqrn Structurai Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit •56. Electrical-Final 15. Rough Electric-Wiring•• 57. Solar System-Final 16. Rough Heatin '& Air ConditioningFencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe- Rough'&-Test-._. 20. Roof Framing 21. Roofand NOTES: Fin 22. Frame and lashin 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service.Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co, 42. CERTIFICATE OF OCCUPANCY No Date +r Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. -CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. I. BLDG, NO. CONSTRUCTION PERMIT I Proiect Address Owner // v- J,} Q Phone Address Arch/Eng. License No, Address Contractor TJrt� G,461CMII` Phone hjfip3 Address 3 , /?±g: , LICENSED CONTRACTOR DECL-ARATION 1 hereby affirm that I am licensed under provlSions of harter 9 (com- mencing with section 7000) of Division 3 t Business and Professlons Code, and m license Is In f f ce and effect. License Class , ly ens o. D, —381 Signature RKER$' COMPENSATION DE LA TI I reby affirm that I have a certificate Of Consent t0 self -Insure or a ificate of Workers' Compensation Insurance, or a certified copy 1(y 'Tereof (Section 3800, Lab. C.). tl tNo. Company ifted Copy is hereby furnished. La Certified copy Is flied with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit Is for one hundred ($100) or less- I certify that n t Ihe 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. Date Signature NOTICE: If after making this decl9ration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work for which this permit Is issued (Section 3097 Cl v. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt frOM.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to Construct, alter, I --rove, demolish or repair any structure, prior to its issuance, also re- s.the applicant for such permit to file a signed statement that he. erased pursuant to the provisions Of the Contractor's License Law I,-.,apter 9 (commencing with Section. 7000) of Division 3 of the Lt�iness and Professions Code) Or that he Is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by ti otmoretthan five hunfor a ldredbdollars ($500)IiCant to a civil penalty 1, as owner of the property, or my employees with wages as their sole Compensation,, will do the work, and the structure Is not intended or offered for sale. (Section 7044, Business and.Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within One year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner.of property who builds or Improves thereon, and who Con- tracts fromsuch projects with a contractor(s) Ilcesned pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner Phereby certify that I h e r t ap kation and state that the above information is corre 1 re o mpty ith all City and county ordinances and st aw Ia ' g t on5t ctlon, and hereby authorize representatives hl t ter Pon the above mentioned property far i t r s A7' 1/J Signature .Date TYPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION '❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER - DESCRIPTION OF WORK TYPE OF PERMIT •❑,GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING EIMECHAN ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: PLUMBING PLAN CHECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLE LAV$ KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. $ - - ISSUE FEE $ TOTAL FEE $ MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTU 100,000 +BTU REFRIGERATION SYSTEM 0-100,000 BTU 100,000 +BTU BOILERS BTU SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE Drivers' Li n e or 5S CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor A.P. 0 ZONE 45913 9/04/81 8.01' TL INING REGULATIONS PLNTTG.. LLREF, PROBRO TDYNLINE REAR YARD {TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: ELECTRICAL PROVIDED PARK FEE $ . - DATE PLAN CHECK GENERATOR 0-1 KW 1-10 KW TRANSFORMER APPLIANCE 10-50 KW_50 + KW MOTORS 0-1 HP 1-10 HP (INC. SOLAR) 10-50 HP 50 + HP FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS PANELS MAIN SUB SERV ICE AMP - ISSUE FEE I Z APPLICATION APPROVED BY DATE FINAL FEE $ SUMMARY OF FEES BUILDING PERMIT E SMIP $ PLAN CHECK E PERMIT ' ISSUANCE $ PLUMBING $ GRADING E PLAN CHECK $ ELECTRICAL � E - g - PLAN CHECK $ -MICROFILM $ - - MECHANICAL $ TOTAL FEE $ PLAN CHECK $ LESS AD- - VANCE PC E - FINAL FEE $ CONSTRUCTION AND PLANNING APPROVALS Permit # r� Date Inspector POOL & SPA , APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pie ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51'. Backwash Lines P-Tray. ❑ Undrgrn -10. Structural Floor System - 52. APPROVAL TO DECK 11, Property Sewer Line & House Connection - 53. Backwash.& Receptor-Final , 12. Street Sewer Connection 54. Heater & Vent-Final I 13. Rough Plumbing 14. Rough Electric-Conduit _ _ .•56.. Electrical-Final 15. Rough Electric-Wring - 57. Solar System-Fina! 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts in Structure 59. APPROVED.FOR PLASTERING r . 1B. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL - 19. Gas Pipe-Rough & Test. 20. Roof Framing 21. Roof Sheathi n ; NOTES:. 22. Frame and Flashing 23, Insulation 24. Lathin & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric -$ G 29. Final Heating & Air Conditioning 30, Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34, Solar Domestic-Final 35. Landscape Sprinkling System ' 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill In all spaces within heavy border lines and sign all appropriate.peclarallonns.r GITYGi0ftOSTA MESA ' RMI O/ TRACT NO. LOT NO. BLDG. NO. _ CONSTRUCTION PERMIT Wj (�11rV1 `7 TYPE OF CONSTRUCTION 1:1 NEW NEW ADO ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER 2584 $/05/81 195e 10 TE. ZONING REGULATIONS Project Address ,(j , ;� j ('1 OwnerPhone Address Arch/Eng. / License No. _ DESCRIPTION OF WORK PLNG. REF. Address Contractor Phone 4 TYPE OF PERMIT. ❑ GRADING ❑ FOUNDATION STRUCTURAL ❑TENANT ❑ELECTRICAL ❑PLUMBING ❑MECHANICAI Mcn PROPERTYNLINE Address P/�/�/� j� �� LICENSED CONTRACTOR DECLARATION hereby affirm that I am licensed under provisions of Charter 9 (com- (� mencing with section 70 00) of Division 3 of the Business and ❑ OTHER Professions Code and my license Is in full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License PKG. SPACE REQ. PROVIDED — pl Signature , ,ff SQ. FT., Ay C2� _ '- STREET WIDTH PARK FEE $ tKERS' COMPENSATION DEC LARATiON OCCUPANCY CONSTRUCTION TYPE ZONING APPROVED BY DATE• F+' I nereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ~J - tificate of Workers' Compensation Insurance, or a certified copy . .of, (Se= 3800, LA!. C.. GRADING CU. YDS. ACRES SPECIAL CONDITIONS: o. Company -S7717;4 /ckl#" - ertified copy Is hereby furnished. _ REMARKS: Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This -section need not be completed if the permit is for one hundred {$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 PLUMBING t PLAN CHECK - CHECK - ELECTRICAL PLAN CHECK - subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS ' Date Signature .TOILETS URINALS GENERATOR 0.1 KW 1-10 KW NOTICE: It after making this declaration, you should become subject Iothe Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUSLE'LAVS APPLIANCE 10-50 KW_50 + KW revoked. _ KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS _ (INC. SOLAR) 10-50 HP 50 + HP formance of the work for which this permit Is issued (Section 3097 SINKS FLOOR DRAINS FIXTURES' OUTLETS' SWITCHES ' Civ. C.) -FLOOR Lender's Name /Y�/il/� - - - -- - - Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS - INTERCEPTORS CLARIFIERS POLE LIGHTS - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL 'P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: ' city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION + PANELS MAIN' SUB ive, demolish or repair any structure, prior to Its Issuance, also re- s the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law fr`ioter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ess and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS a.. applicant -for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ I, as owner of the property, ar my employees with wages as their sole compensation, will do.the work, and the Structure Is not intended SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's LJcense Law does not apply to an owner of a property - ISSUE FEE APPLICATION APPROVED BY DAT who builds or improves thereon, and who does such work himself or through -his Own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). BUILDING- © I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU _ _ AND DUCTING PERMIT $� SMIP S "�� - - licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK E r PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING S theontractor's License Law). 100,000 +BTU PLAN CHECK $ m exempt under Section '—' B. & P. G. for this BOILERS BTU ELECTRICAL 3 $ PLAN CHECK MICROFILM $ $ �'' Owner SYSTEM REPAIR, ALTERATIONTOTAL FEE $by MECHANICAL $ LDate certify that 1 have read this application and state that the above EXHAUST SVSTEM MULTIPLE LESS AD- ation Is correct. I agree to comply with all city and county PLAN CHECK $ VANCEPCances and state laws relating t construction, and hereby authorize sentatives f this city to nter upon the above mentionetl`�+rty f coon purpo�10 �fFINAL 'tur to FEE 5� `� SS' 1� License or SS ISSUE FEE(�rs' CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrad•Assessor - CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA �. APPROVALS Permit # Date inspector t• 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn ,. N 45, Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee em orce 47. Rough Plumbing & Pressure Test - 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50, Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53.` •:Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. - POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing � l� NOTES: M..�, �- r7; -V V N► �- 22. Frame and FlashingS , 23. Insulation- 24. Lathing & Siding - 25. Drywall Nailing 5 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing .32. Water Service -Final 33, Gas Service -Fina{ 34. Solar Domestic•Final 35. Landscape Sprinkling System 36. Sound Attenua;ion 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date 1- - Applicant to fill in all spaces except those within heavY border lines and sign all appropriate declarations. '� _.':Y OF COSTA MESA PERMIT NO._ V.h;16-3 RACT NO. LOT NO. BLD f CONSTRUCTION PERMIT ;(j,0-- /D� 5 O:S _01113,4A . F � 21:71 V10/64 Zone CL Accessory Builaing: Project Address i rwa - TYPE OF CONSTRUCTION l NEW ADD ALTERATION REPAIR "' ELECTRICAL -_ Bathtubs Sewer Connection - rr++ ' Applicant's Mailing Address' 3151 Al rwav Ave. E-1,, LO$ta I I Sa ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q -•p• �f, EXEMPTION FROM WORICERS'•COMP NSATIO DECLARAT N_- - (This section need not be completed if the permit € or one hundr d ($100) ori ldhouse Consultants Phone 540-2606 DESCRIPTION OF WORK Tenant Improvement Drinking Fountairis Solar Tank =. 9 --3 02 - PUBLIC SERVICES R�(� Owner's'Name -laui Address, X1_51_ rWay Ave . E-1, Costa Me s a S T Main Building:, Front TYPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL .A,,i . Floor Sinks t Urinal - Arch/Eng. Tom Cam IDS • - License No. . ❑X TENANT ❑ ELECTRICAL, ❑PLUMBING ❑.MECHANICAL B Rear F.A.U. Inc, Solar ❑9-15 HP E:116-15+ - n u Irvine Address ❑ OTHER - A Fixtures - ;Microwave r ' Zoning Approved ey Contractor's Nam? d . Donald Olson Phone 540-2606 p PROJECT DESCRIPTION SQ, FT. 2000 OCCUPANCY_ C KLeft Right ' Lender's Name €Y� n -_ Address {mailing) 3151 Airway Ave, E-1. Costa,Mesa i CONSTRUCTION TYPE - 'VALUATION $ S Outlets Range K City,LicPnse No. 022`707: ZONE GRADING CU -YDS, ACRES Ping. Ref. # , RoOf�OrainS, - LICENSED CONTRACTOR DECLARATION Remarks: Parking Req./Provided Reinspection Fee Thereby affirm that I am licensed under provisions of Charter 9 (commencing i Use of Building: 7031:5 by any applicant for, a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500).' I as owner of the roperty or my .employees -with wages as their sole ' with section 7000) of Division 3 of the Business and Professions Code, and my license is in full fgce and effect. - +. PLAN CHECK $ sentatives of city to er on the above-mentioned property for \\� 33969 License Cl s nse PLUMBING FEES Planning Notes: C Date- S€gnature Bar Sink Showers _ `• WORKERS' COMPENSATION DECLARATION H. I hereby affirm that I have a certif€tate of consen "If Insure or a certificate Backflow Preventer Service Sink • Reinspection Fee $25 -of Workers' Compensation Insurance„ or a certified- copy thereof (Section ' PIAN CHECK $ ��„S 21:71 V10/64 Zone CL Accessory Builaing: compensation, will do the work, And the structure is not intended or offered 3800, Lab,C#-2974 Fairmont�` Policy No. Company ®Certified copy ishereby furnished, •'I Certift o s filed with the city Buil g D" - Date Applicant Backflow irrigation Sewer Cap "' ELECTRICAL -_ Bathtubs Sewer Connection - +. Automatic Washer,• .Transformer E)15.50 KW El 50 + KW Construction Pole_ Sub. - Clarifiers Solar Collectors The Contractor's License Law does_not apply to an owner of property who builds or improves thereon,iand who contracts for such projects with a con- EXEMPTION FROM WORICERS'•COMP NSATIO DECLARAT N_- - (This section need not be completed if the permit € or one hundr d ($100) ori Dishwasher' _ 'Solar Piping "1 Cooking Unit Meter ❑up'to 100 amps Drinking Fountairis Solar Tank =. 9 --3 Dishwasher • Meter ©over.100 amps PUBLIC SERVICES R�(� less)- I certify that in the performance of the work for,which this permit is issued, I- shall not employ any person in any manner so as to become subject to -the' Workers' Compensation Laws of California- I - Floor Drains Swimming Pool wlSpa I Dryers ❑Gas -[]Electric Sub Panel Hood or Type I Ll/]/ Date Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks t Urinal - Fan •Motors 00-1 HP ❑1%-$ thereon, and,who'does such work himself/herself or through his or her own orthwith- Workers' Compensation provisions of the labor Code, you must forthwith, Gas Service OutletsWater Closet -- F.A.U. Inc, Solar ❑9-15 HP E:116-15+ - comply with such provisions or this permit shall be deemed revoked,. comply CONSTRUCTION', LENDING AGENCY i - I '• _ Interceptors Water Heater , - Fixtures - ;Microwave r ' Zoning Approved ey I hereby affirm that there is a construction lending agency for the performance of the work for whir.►yt this • permit, is issued- (Section •3097 Civ. C-) - Kitchen SinK � - Water,Service - device Boxes � � Pole Light Date Owner ' Lender's Name €Y� n -_ , Lender's Address OWNER BUILDER DECLARATION- Lavatories Outlets Range K t hereby affirm that I am exempt from the• Contractor's' License Law f6r.the following reason' (Section 7031.5;Business and Professional 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 file a signed statement that he/she is licensed pursuant to the provisions of ' Contractor's License Law {Chapter 9 (commencing with Section 7000) of :F""Vislon 3 of the Business and Professions Code) or that he/she -is exempt �` erefrom'and the basis for'the alleged exemption- Any violation'of Section P—Trap dSwitches » . Sign , RoOf�OrainS, - Garbage Disposal Standing Sections ' ' - _ r ^ , Generator ❑0-5 KW ❑5-15 KW Trash Compactor Reinspection Fee ' $25 ' issue Fee ` $ 3 i 7031:5 by any applicant for, a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500).' I as owner of the roperty or my .employees -with wages as their sole ' Reinspection Fee $25 'Issue Fee - compensation, will do the work, And the structure is not intended or offered MECHANICAL FEES ❑0-100,000BTU .❑100,000 BTU for sale (Section 7044, Business and Professional Code: The Contractor's S M ARY OF FEES ' The Contractor's License Law does_not apply to an owner of property who builds or improves thereon,iand who contracts for such projects with a con- BUILDING PERMIT $ Q �d SMIP $ Exhaust System ❑ Multiple ❑ -' system Repair/Alteration PUBLIC SERVICES R�(� License Law does not apply to aWowner of a property. who builds or improves Boiler Hood or Type I Ll/]/ s o 3� , $ PLAN CHECK $ PERMIT Firepl/Fact. Blt. ICBG # thereon, and,who'does such work himself/herself or through his or her own - - ❑ exempt under Section B. & P. C. for this reason _ Canopy Type II ❑ Zoning Approved ey employees, provided that such improvements are not intended or offered for sale. It, however, the building or improvement is sold within one year of tom- Duct - Under Ground Date Owner , roved B Application App y pletion, the owner will 'have the burden of proving he/she did not build or im- prove' -for the purpose of sale). ! Duct - Structural ELECTRICAL $ GRADING $ - Refrigeration System - Information is correct. I agree comply with all city and county ordinances and, state laws r ting•to building construction,'and hereby authorize repre- Application Issued By_ tE r 2112.50 -, % ` Z _ O N I N 4 R E Q U I rR E' M fE N ' .T mul ' Date " ��-!— `Date -"O I, as owner of the property, am exclusively contracting with licensed con- I tractors to construct the project {Section 7044, Business and Professlo'ns Code: Duct - Ventilating ❑0-100,000BTU .❑100,000 BTU S M ARY OF FEES ' The Contractor's License Law does_not apply to an owner of property who builds or improves thereon,iand who contracts for such projects with a con- BUILDING PERMIT $ Q �d SMIP $ Exhaust System ❑ Multiple ❑ -' system Repair/Alteration tractors) license pursuant to'the Contractor's License w). rta ~` s o 3� , $ PLAN CHECK $ PERMIT Firepl/Fact. Blt. ICBG # 'PLUMBING ❑ exempt under Section B. & P. C. for this reason ,I'am $ •ISSUANCE $ PLAN CHECK $� ENERGY P.C. $ Date Owner Heating System &Ducting t hereby certify that I have read this application and state that the above -to ❑0-100,000 BTU Ell oo,000BTL, - ELECTRICAL $ GRADING $ - - -' - - - - Information is correct. I agree comply with all city and county ordinances and, state laws r ting•to building construction,'and hereby authorize repre- I MICROFILM $ •en PLAN CHECK $ sentatives of city to er on the above-mentioned property for Inspection pu se i Signature Date .1,14184 Signats'•License MECHANICAL $ TOTAL FEE $ H. Dri�eror SS Reinspection Fee $25 Issue Fee $ 3 PIAN CHECK $ ��„S CMF-0865-46 rev, 7/63 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor r j ,CONSTRUCTION AND PLANNING '. - APPROVALS Permit 4 la5Q� Date Inspector •-Pt & SPA -gPPROVALS- Permit # Date Inspector 1. Temporary Electricai.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 � A , 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe,-❑ Undrgrnd., Test 9., Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10: Structurai 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 ��y �� 65. Electrical=Final = 15. Rough Electrical-Conduit - -i 66. Solar System-Firial 16. Rough Electric Wiring + �- 67, ,Fencing &Access Approval . 17. Rough Wiring Sign •68. APPROVED FOR PLASTERING 18` rRough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. 'Rough Heating &'Air Conditioning FIRE DEPT. REQUIREMENT, APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure j 70. Underground Hydra 22. Ducts, Ventilating ` T 71. Product Piping ❑ Gas '❑ Oil 23. Gas Pipe-Rough & Test , 72_ Underground Flush 24. Ooof Framing-' a ;a-' ' 73. Undergrnd'. Storage Tank ❑ Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydra 26. T-Bar.Ceiling (Structural)& Moriocoat, S 75.-Dry Chemical 27. Frame and Flashing 1 76. Dry Standpipe 28. Lathing,& Siding , 77. FIXED SYSTEM FINAL 29. Insulation y 78. FIRE R,REV. FINAL 30. Drywall Nailing 113, 1$+ = HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Finale'' 80. FOOD CERTIFICATE ISSUED 33. Final Electric i Notes: lo C' 34. Final Heating & Air Conditioning a 35. Finial Gas Pipe-Test . 36. Hood `or Canopy f= 37. Final Factoiy Fireplace _ 38. Final Plumbing � , s 39. Water Service-Final 40. Gas Service-Final , 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 1 , ;! 44. ,Landscape Irrigation System 45. Sound Attenuation i a 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING r + ,� 48. Special Requirements Completed ' r 49. Elecfric' Release to Edison ' l 50. Gas Release to,Southern,California Gas Co 51. CERTIFICATE OF,OCCIJPANCY- No. �QO �3� a Date 75!,TY OF COSTA -MESA CONSTRUCTION PERMIT Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Project Address /v" U --r J.- __4 "" ___N Applicant's Mailing Address : Owner's Name , dK d" �� "� Phone a� Address�- Arch/Eng.License No. Address Contractor's Nam � �"��f Phone Address'lMai Iing) la / . "'i �Ju'Cr City Liceriso No. 7 LIF LICENSED CONTRACTOR DECLARATION - Lhereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the BuSiness and Professions Code my license is in f fol a and effect. License Cl ss No Date 12WSignafi r /Z �- - WOR RS' 11PENSATIO I DE LARATION . I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compens/atiion/ insurance,, or a certified copy thereof (Section Po00y No.� 7-' l - Company ZI Ce led copy is hereby furnished. ' ertlfi cop i d_ with the city Buil g IviSlo� /' 1 Date/ s fApplicant �`�.• EXEM ION ROM WORKERS',COMP NSATION DECLARATION - (This section need not be completed if t e permit is for one hundred ($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.. Oate Signature ' NOTICE: If,'after making this declaration, you should become Subject to the Workers' Compensation provisions of 'the Labor Code, you must forthwith - comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY' I hereby affirm that there is a construction lending agency for the performance of the work -for Which- this permit isissued (Sectio n4'3097 Civ. C.) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031:5: Business and Professional Cade: Any city or county which requires a permit to construct, aiter, improve, demolish or repair any structure, prior to its - Issuance, also requires the applicant for such permit +o file a signed statement that he/she is licensed pursuant to the provisions of e Contractor's License Law (Chapter 9 (commencing with Section 7000) of ;vision 3 of the Business and Professions Code) or that he/she is exempt -.ierefrorn 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 enalty of not more than five hundred dollars ($500). 1, 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such'improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects with a con- _ tractor(s) license pursuant to the Contractor's License taw). ❑ I am exempt under Section B. & P. C, for this reason Date Owner I hereby certify that 1 have read this application and state that the above 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 th' city to e r n i above-mentioned pr party or ' inspection Purp a \f Signature Drivers' Liiderise or SS # e_ P72LI 1/19/AL I, I _7n 7L PERMIT NO. TRACT NO. LOT NO, BLD TYPE OF CONSTRUCTION_ElNEw ADD ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 'DESCRIPTION OF WORK ` REPAIR ,'• ^ i - r.� A,P-# Zone ' S Main Building: Accessory Building: Z TYPE OF PERMIT GRADING El FOUNDATION STRUCTURAL ❑ TENANT ELECTRICAL D,PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CON STRUCTION TYPE VALUATION $ - ZONE - ± GRADING CU.YDS. ACRES E.O T Front - N B' A Rear - N C Right G 5 Left ' E Ping, Ref. # A Park, Fees $ Q U Remarks: I r V D Parking Req./Provided I IF Use of Building: R E M E PLUMBING FEES Planning Notes: Bar Sink Showers N T S Backflow Preventer Service Sink Backflow Irrigation Sewer Cap ELECTRICAL , FEES Bathtubs Sewer Connection I Automatic Washer ' Construction Pole_ Sub. Transformer ❑ 15-50 KW ❑ 50 + KW { Clarifiers Solar Collectors ; Disliwashe{ Solar Piping Cooking Unit - Meter -u' lP 100 amps Drinking Fountains Solar Tank Dishwasher Meter ❑over 100 amps Floor Drains, Swimming Pool w/Spa Dryers ❑Gas ❑Electric Sub Panel --� Floor Sinks Urinal i _ Motors 1 HP Y. - 8 [, Gas Service Outlets Water Closet X21Fan' F.A.U. Inc.Solar 005 HP 1:116-15+ interceptors Water Heater Fixtures Microwave Kitchen Sink Water Service Device Boxes Pale Light Lavatories Outlets Range D P -Trap Switches' Sign Q .Roof Drains Garbage Disposal Standing, Sections V Generator ❑0-5 KW ❑5-15 KW Trash Compactor Reinspection Fee $25, Issue Fee s S 3 Reinspection Fee $25 Issue Fee $-3 MECHANICAL FEES PUBLIC SERVICES REQUIREMENTS: Approved By Date ' Application Approved By-� Date Application Issued By-- _ 7, y i �_ Data Boiler Hood or Type I El Canopy Type I I ElZoning Duct - Under Ground Duct - Structural Refrigeration System E10-1100,00OBTU 0100,000BTU Duct - Ventilating BUILDING'PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING $ q $ I ! d MICROFILM $ ' $ TOTAL FEE $� $ ' k Exhaust System ❑ Multiple ❑ System Repair/Alteration FirepllFact. Blt. ICBO # Heating System & Ducting ❑0100,000BTU ❑100,0006 Reinspection Fee $25 Issue Fee $ 3 'GMF 0865-46 rev. 7/83 ` -'White - Building; Canary - Applicant; -Pink -"Accounting; Goldenrod = Assessor - - CONSTRUCTION AND PLANNINGPO. •APPROVALS Permit # �- 3 �.�p � Date Inspector _;t SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Poles .52. Pool & Equipment Location f 2. Soil PiperUndrgrnd.f !? 53. Steel Reinforcement 3. Electrical Condu t_,UtilAy Undrgrnd. 54. Forms 4. ElectricaPConduit=Undrgrnd. 55. Electrical Bonding , Z. Steel Reinforceme4 t 56. Rough Plumbing & Pressure Test 6. �Electrica!`UFER Gr-id. 57. APPROVAL TO COVER•GUNITE/' 7. Footings,f ,�' 58. Electrics! Conduit Undrgrnd. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9.,Water Pipe-Undrgrnd.; J , • Y � V l < 60. Backwash Lines, P-Trap, ElUndrgrnd. � 10. Structural Floor System r vt r i 61. APPROVAL TO DECK 11. Property Sewer Line-& House Clinn'ection r T 62. Backwash & Receptor-Final _ 12. SewO�Cap 63. Heater & Vent-Final f 13. Roof Drains 64.,,Plumbing System - Final a� 14. Rough.Piumbing i �� 65. Electricai-Final .� 4 15. Rough Electrical-Conduit 66. Solar System-Final 16: Rough Electric Wiring , ��. 67. Fencing & Access Approval 117. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling -7/ny N rPU 69. POOL/SPA SYSTEMS FINAL 19. Rough Heat yg & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank D Gas ❑ 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 FOOD CERTIFICATE ISSUED 33. Final Electric �y� Notes:ve Z 7 34. Final Heating & Air Conditioning s �U-4 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 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces except those wlthin heavy border lines and sign all appropriate declarajions.Ile .. r CITY.OF COSTA -MESA' PE M T NO, TRACT NO. : " LOT NO. BLD J CONSTRUCTION PERMIT / - /Q (p q-7 `r. ` Project Address 1 ' TYPE OF CONSTRUCTION LJ NEW ADO IM ALTERATION LJ REPAIR L h3 %'/�Lf h fo �,� i''? ❑ CONVERSION ❑ DEMOLISH ElOTHER T �� A.P. Zone' y ~ Applicant's Mailing Address3c%/% Owner's NameG - Phone �7G-.u,D DESCRIPTION OF WORK S Main Building: Accessory Building: Z �- Address' J �� TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front a N A_rch/Eng. License No. - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANiCAL } BRear ❑ OTHER A N Address a t1 - C Right •' 1 G Contractor's Name �nA�r✓r✓�'' "' 14 �2 Phone -3Q 4 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K R �/% / ✓f �t �1 Address {mailing} __�• _ _.0 � p /`i IVA�grr_ CONSTRUCTION TYPE VALUATION $ S Left E ZONE GRADING CU. YOS. ACRES Ping, Ref. # Park. Fees $ City License No. - U LICENSEE CONTRACTOR DECLARATION Remarks: - - (� �(� Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter9 (commencing R with section 7000) of Division 3 of the Business and Professions Code, and Use of Building: f` my license is in full Lorce and effect, M License Cta ice No � S PLUMBING FEES Planning Notes: E Date _2 4 Signature ' a� Bair Showers 1 ' N WORKERS' COMPENSATION DECLARATION, T ) hereby affirm that I have a certificate of consent to self -insure or a certificate Backflow Preventer Service Sink k S of- Workers' Compensation' Insurance, or- a certified- copy -thereof (Section . 3800, Lab. `. ��S• Com• �� '`� ��' Backflow Irrigation Sewer Cap ELECTRICAL FEES f Policy No,Company Certified copy Is hereby furnished. /JFJL'4• -�. : Bathtubs i Sealer Connection Automatic Washer I Transformer El15-50KW Cert)fle copy s filed with the city B o �4f , t ❑ 50'+ KW Date,_L�- Applicant Clarifiers Solar Collectors ConstruciionP_oIeSub. EXEMPTION FROM WORKERS'•COMPENSATION DECL ATION - - - - Dishwasher Solar Piping -- Cooking Unit - Meter' ❑up t0 100 amps (This section need not be completed if the permit Is for one hundred ($100) or Ile certify that in the performance of the work for which this permit is issued, 1 ' Drinking Fountains ' Solar Tank Dishwasher Meter ❑over 100 amps ' shall not employ any person in any manner so as to become subject to the Workers' Compensation, Laws of California.' Floor Drains' Swimming Pool w%Spa ` ' Dryers ❑Gas .❑Electric Sub Panel Date Signature i NOTICE: If,'after making this declaration, you should become subject to the Floor Sinks , Urinal r Fen Motors ❑0.1 HP ❑1 A - e 'Workers' 'Compensation provisions of the Labor -Code, you must forthwith _ _ _ _ - - - comply with such .provisions or this -permit shall be deemed revoked. Gas Service Outlets, - Water Closet r '' F.A,U. _ 'Inc.Soiar 09.15 HP C1 11,615+' CONSTRUCTION LENDING AGENCY - 1 hereby affirm that there is a construction lending agency for the performance Interceptors Water Heater Fixtures Microwave of the work for which" this permit 'is issued .(Section .3047 Civ, C.) Lender's Name ' Kitchen Sink I Water Service Device Boxes Pole Light Lender's Address - _ ! OWNER BUILDER DECLARATION i �- ,. , - Lavatories r Outlets Range I hereby affirm that I am exempt from the Contractor's License Caw for the P—Trap • _ I following reason (Section 7031.5,Business and Professional Code: Any city or - _ _ Switches Sign ' 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 RoofDrains_ Garbage Disposal Standing Sections Jo file a signed statement that he/she Is licensed pursuant to the provisions of pe. Contractor's License Law (Chapter 9 (commencing with Section 7000) of - Generator ❑Q5 KW ❑5-15 KW Trash Compactor P r. jvision 3,of the,Business and Professions Code) or that he/she' Is exempt '��ierefrom 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 Reins ,tion pe $25 Issue Fee $ 3 r malty of not more than five hundred dollars {g500). -Fee 1, as owner of the- property or my employees with wages as their sole F Reinspection Fee . $25 Issue Fee $ 3 compensation, will do the work, and the structure is not Intended or offered MECHANICAL FEES for sale (Section ,7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMENTS: License Law does not apply to an owner of a property who builds or Improves Boiler Hood or Type I ❑ - k thereon, and who does such work himself/herself or through his or her own Canopy Type 11. ❑ _., Zoning Approved By - Date , employees, provided that such Improvements are not intended or offered for Duct -Under Ground I sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale}- j Application Approved By Application Issued By Date Dat Duct - Structural _ Refrigeration System 1, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: Duct - Ventilating ❑0-100,000 BTU ❑100,000 BTU � SUMMARY OF FEES .-The -Contractor's License Law does not apply to an,owner of -properly who- builds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ tractor(s) license pursuant to,the Contractor's License Law)_ ❑ Section P. this PLAN CHECK $ PERMIT 1 am exempt under B. & C. for reason Firepl/Fact. Blt. ICBG # ,�i .5/^4 f y UTL,E%S ISSUANCE $ PLUMBING $ Date Owner Heating System & Ducting 1 PLAN CHECK $ ENERGY'P.C. ' $ I hereby certify that I have read -this application and state that the above 00.100,00013TU ❑100,000 BT GRADING $ Information is correct. I agree to comply with all city and county ordinances' _ ELECTRICAL $ and -state laws relating to building construction, and hereby authorize repre-I PLAN CHECK $ -S' MICROFILM $ sentatives of this, city ent upo the above-mentioned property for p Inspection ur s �G MECHANICAL $ 2 t ,4 �Z �� TOTAL FEE $ n� Signature - Oate��, Reinspection Fee $25 Issue Fee $ 3 PLAN CHECK $ S Z� Drivers' Lic nse or SS: 'CMF 0865-46 rev. 7/83 White -'Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - •µ - - - - - - -• r� - - • -- - EW CONSTRUCTION AND PLANNING -r4PPROVALS Permit # ANI D",1._ Date Inspector P0, A SPA APPROVALS Permit # Date Inspector 1.' Temporary Electrical Service or Pole - S 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. ►, 53. Steel Reinforcement f 3.'Electrical Conduit-Utility-Undrgrnd s 54. Forms 4., Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6• ElectricaPUFER Grnd. .57. APPROVAL TO COVER-GUNITE 7., Footings 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe,.❑ Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. J 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10.1 SAructural 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 6B. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning f �l r�� FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72, Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 2T. Flame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. 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 o7 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 a 42. Backflow Preventer 43, Backflow Irrigation 44. ,Landscape Irrigation System 45. Sound ,Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 4B. Special Requirements Completed 49, Electric Release to Edison ti - 50. Gas Release to Southern California Gas Go a 51. CERTIFICATE OF OCCUPANCY' No. Date 1 Applicant to fill In ail spaces except those within heavy border lines and sign all appropriate declarations CITY OF COSTA MESA CONST�iUCTION PERMIT PERMIT O. —. �4 ), 6 72 TRACT NO. 1�vft-L, MAio LOT NO. IAf22 BL Z�3 { --- 1680 I f /05/64 r;(,71o30 T Project AddressAve. - Applicant's Mailing Address 31U Airway Bldg • E-1. C.M. TYPE OF CONSTRUCTION W NEW LJ ADD LJ ALTERATION U REPAIR ❑ CONVERSIDN ❑ DEMOLISH ❑ OTHER A.P. 906 J I "7Z �— �S u Zone GL Owner's Name •Guildhouse C•Qfl-SLIT-t-antS .-Phone 540-2606 Address 3151 AIrway Ave: B-1, Costa Mesa DESCRIPTION.OFWORK igtprinr t S Main Building: ' Accessory Building: - Z TYPE OF PERMIT GRADING" FOUNDATION STRUCTURAL O(TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ ,OTHER PROJECT DESCRIPTION Sq. F -I OCCUPA��N��jCjY - CON STRUCTION TYPE VALUATION $ _I_Z 840.00 E T Front a N Matteo Nardini C6291 Arch/Eng, License No. Address 926 Town- Country, Orange B A Rear l N Contractor's Name d - Donald Olson _ Phone 540-2606 `Address (rriailingl 3151- Ai rway Ave. B-1 , Costa Mesa K Right - R S Lef i �E Ping, Ref, # Park. Fees $ 1 Up / City L1CPnse Na- ..2 �-.2 7 Q +% LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full forCp and -effect. 333969 Ll cense las D cense Date U Signature ORKERS' COMPENSATION DECLARATION ereby affirm that i have a certificate of consen to self -insure or a certificateT f Workers' Compensation Insurance, or a certified'.copy thereof (Section 3800, Lab, C.) Policy No. F 1 7 Company "'cm Certified copy is hereby furnished. , t 11.d Certijiy�U(Lrog5y 8Rled with the city Bu i ng v' ion. Date. ( Applicant ZONE GRADING CU.YDS. ACRES Remarks: Parking Req./Provided Use of Building: JIQT �OR AL7r ``I C7fV.S j LQJ i R E PLUMBING FEES Planning Notes: . M E Bar Sink Showers N Backflow Preventer Service Sink Backflow Irrigation Sewer Cap ' - S ELECTRICAL FEES.-. Bathtubs Sewer Connection Automatic Washer Construction Pole Sub, (Transformer ❑ 15.50 KW 13 50 + KW r, Clarifiers Solar Collectors EXEMPTION FROM WORKERS -COMP NSATIOECLARATI N (This section need not be completed if the permit is r one hundre ($100) or less).Drinking 1 certify that in the performance of the work for which this permit issued, I shall not employ any person in any manner so as to become subject to the Dishwasher - Solar -Piping - Cooking Unit Meter ❑up to 100 amps Fountains - 9 Solar Tank Dishwasher r Meter El over 100 amps � FIOor Drains' Swimmin Pool wlSpa g Dryers ❑Gas -)Electric - Sub Panel Workers' Compensation Laws of California,. } Data Signature Floor Sinks Urinal Fan _ Motors 00-1 HP El %- B +� NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation- provisions of the Labor Code, you must -forthwith Gas Service OutletsWater Closet F,A,U, Inc. Solar 09-115 HP ❑i6-15} comply with, such provisions.or this permit shall be deemed revoked. CONSTRUCTION LENDING -AGENCY," _ , I hereby affirm that there IS a construction lending agency for the performance of the work for vR this permit Is issued (Sect -ion 3097 Civ_, C.). . interceptors' Water Heater Fixtures Microwave Kitchen Sink Water Service r Device Boxes l Pale'Li ht g - Loder's Name ! ^_ Lender's Address � - � �- � b - OWNER -BUILDER DECLARATION .- = I hereby affirm that I am exempt_ from the Contractor's License Law for the following reason, (Section 7031,5 Business and Professional Code: Any city or nty which requires a permit to construct, alter, improve, demolish or repair prior to Its issuance, also requires the applicant for such permit a signed statement that he/she is licensed pursuant to the provisions of Lavatories 1 Outlets Range P—Trap Switches Sign gstructure, Roof Drainsile r Garbage Disposal Standing Sections Contractor's' License Law (Chapter 9 (commencing with Section 7000) of ision. 3:of the Business and Professions Code) or that he she is exempt refrom and the basis for the alleged exemption. Any viola tonof Section_1,5 I - .. - Generator ❑0-5Kw ❑5-15 KW Trash Compactor Reinspection Fee $25 Issue Fee $ 3 ' -Reinspection by any' applicant for a permit subjects the _applicant to a civil alty of not more than five hundred dollars ($500), Fee $25 Issue Fee $ 3 1, 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- nrova for the purpose of sale), MECHANICAL FEES - Boiler - Hood or Type I ❑ Canopy Type II ❑ PUBLIC SERVICES REQUIREMENTS: Zoning Approved By - Application Approved By Application Issued By Date S•PH Date - - Dat - Duct - Under Ground Duct - Structural Refrigeration System I, as owner of the property, am exclusively contracting with licensed con- . 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 :.,, builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). ❑ I am exempt under Section - B. & P. C. for this reason E1&100,000BTU ❑ 100,000 BTU Duct - Ventilating SUMMARY OF FEES BUILDING PERMIT $ s SMIP r'• .( PLAN CHECK 7 $ �..-.c......� PERMIT PLUMBING $ ISSUANCE $ `� PLAN CHECK $ ENERGY P.C. ' $ ` ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ 44A.0 - PLAN CHECK $ _ Exhaust System ❑ Multiple ❑. - System Repair/Alteration _ , Firepll�act, Bit. ICBG # Heating System &Ducting ❑0100,000 BTU 0100,000BT -?• � } Date Owner', I I _hereby certify that I have read this application and state that the above Information -is correct, t agree -to comply with all City, and county -ordinances and state laws rela g to building Construction, and #iereby authorize repre- Sentatives of this sty to anter up Cha above-mentioned property for inspection putpq . Signature - Date 0/25/84 Drivers' License or SS I - ; I Reinspection Fee $25 Issue Fee $ 3 CMF 0865-46 rev..7/83 White - Building; Canary- Applicant; Pink - Accounting; Goldenrod •?Assessor `CONSTRUCTION AND PLANNING _ APPROVALS -Permit # Date Inspector am SPA 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 y' 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59.- Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd.• 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & Hou%e Connection 62. Backwash & Receptor -Final 12. Sewer Cap t 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 APPROVALS Permit # 20. Rough Factory Fireplace .s „ 21. Ducts, in Structure ' 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof ,Framing 73. Undergrnd, Storage Tank ❑ Gas ❑ Oil 25. Roof "Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat �L%raf �S 75. Dry Chemical 27. Frame and Flashing �5 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing �+ HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final. 60. 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 1 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING r �� 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas, Release to Southern California Gas Co `51. CERTIFICATE OFCCUPANCY No. Date � �� r G � • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C(TQF CQSTA MESA C NSTRUCTIQN PERMIT PEkMIT NO. TRACT NO. LOT NO. UNIT NO. Project Address 3 151/ Applicant's Mailing Adores Owner's Namu ' Ph -..5W -21W Address Arch/Eng, License No. Address Contractor's Namwl�e -163 i Address (mailingl Ak1 (,\ [ A tr i nrn,�� CtL�Q C/+ R City License NNo_ Vr LICESED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. - -7� License Class Date l (—I S —� Signature WORKERS' COMPENSATION C RATION I hereby affirm that I have a cert to of consent to self -insure or a certificate �f Workers' Compensation Insurance, or a certified, Copy thereof (Section J800, Lab.�'-C�lr / 1 �}_' l _ Policy No.+v�SOGL41�� Company {�`rtG1G' B Certified copy Is hereby furnished. - Certi(ied ropy is i ed with the city Br ing Divis' Date — Applicant, - EXEMPTION FROM WORKERS' CO NSATION DECLARATION (This section need not be completed if ! e permit.is for one hundred {$100) cr. less). " I certify that in the performance of the work for which this permit is Issued, I shall not employ any person in any m ner SQ as t me subject to the Workers' orr7 ensat�(� Maws of Callfornl Date i �=i- t -Signature •NOTICE: If, after making this deciara io you should become subject to the Workers' Compensation provisions o e labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ, C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason {Section 7031.5 Business and Professional 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 Adklofile a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9(commencing with Section 7000) of ,qED"'Ision 3 of the Business and Professions Code) or that he/she is exempt ".,.from 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 .natty 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 worn, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 tier 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 com- pletion, the owner will have the burden of proving he/she did not build or Im- rpve for the purpose of sale), 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and _who contracts for such projects with a con- tractors) license pursuarit•to the Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C, for this reason Date Owner 119 I hereby certify that I have rea Is application and state that the above information is correct. I agree to mply with all city and county ordinances and, state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection p oses, Signature Date �� { Drivers' nae TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. �k DESCRIPTION OF WORK/USE OF BLDG. 5 Main Building: E TYPE OF PERMIT 17 GRADING 17 FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY K CONSTRUCTION TYPE - VALUATION $ S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: Planning Notes: (05- 4- 2166 11/14/84 Zone Accessory Building: Parking Req,/Provided 5980 TL Z O N I N G R E Q M T S CMF 0865-46, rev. 10184 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING FEES ELECTRICAL FEES f Bar Sink Showers Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW t ❑ 50 + KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit + Meter ❑up to 100 amps i Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps' Dishwasher Solar Piping Dryers ©Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors 00-1 HP Ell 'A - B Floor Drains Swimming Pool wlSpa F.A.U. Inc. Solar 1:19-15 HP 016.15+ Floor Sinks Urinal Fixtures Microwave Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Neater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal ; Standing Sections P—Trap Laundry Trays Generator 00.5 KW 05-15 KW Trash Compactor Roof Drains Reinspection Fee $15 issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Dat Boiler Hood or Type I ❑ Canopy Type II El Duct -Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU 0100,000BTU Duct - Ventilating BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELEGTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY $ $ $ �� $ $ $ $ $ OF FEES SMIP S PERMIT et7 ISSUANCE $ ��- ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICSO # Fire Dampers Heating System & Ducting ❑0.100,000 BTU El 100,000 BT Registers Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 10184 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor iM 'CONSTRUCTION AND PLANNING APPROVALS . Permit # Date Inspector SPA 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 S. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.. Electrical OFER'Grnd. 57, APPROVAL TO COVE R -G UNITE 7. Footings 58. Electrical Conduif-Undrgrnd. 8: Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 ��Y L 65. Eiectrical-Final 15. Rough Electrical -Conduit 66. Solar System -Final 16.. Rough Electric Wiring 67. Fencing & Access Approval 17.1 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 APPROVALS- Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil " 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73, Undergrnd. Storage Tank ❑ Gas ❑ 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 f2•l/�yf [red 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 47. FINAL STRUCTURE & BUIL-DING 48. Special Requirements Completed 49. Electric Release.to Edison 50. Gas Release to Southern California Gas Co 1 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in ail spaces except those within heavy border lines and sign all appropriate declarations. .' CITY OF COSTA MESA CONSTRUCTION PERMITPERMIT Project Address 3 � 4r0 't K C• ►Yt, 9A) •?-`3 s� NO- TRACT NO. LOT NO. UNIT NO. 2099 11/13/84 28e06 PL TYPE OF CONSTRUCTION LtffNEw LJ ADD H ALTERATION LJ 11 CONVERSION El DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. REPAIR 1 _ `}flJ ` \`JV i 'Applicant's Mailing Address 31N L -t Ro -t-4- Owner's Name _ —. -Phone �� Address _ _ A.P. jjE Zone S Main Building: Accessory Building: Arch/Eng. �'�l""- �!%L License No. 3Sl 29 Address TYPE OF PERMIT GRADING 0 FOUNDATION ��TRUCTURAL 11 TENANT ❑ ELECTRICAL 1:1 PLUMBING L� MEC:HANICAL ❑ •OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES T Front p B A Rear N 1 Contractor's Nam 6/t'[s� 6 30- �z %� Clicr� a �t✓!/t hone Address (mailing) 319 �iofL�'i`!'~ A�'! - City License No. - R LIC64SED COiVTRACTODECLARATION I hereby affirm that I am"licen$od under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, Intl my license is in full farce and effect. ��129, License Class 4 Z� Lice se o. Date -,/' r�'� Signature C Right G K g Left + R ne Pig, Rf. Parking Aeq.�Provided E Remarks: L L.L1O Planning Notes: - Q M r T S PLUMBING FEES I WORKERS' COMPENSATION DECLARATION ereby affirm that 1 have a certificate of consent to self -insure or a certificate I here", Bar Sink Showers ELECTRICAL FEES 11Ff Workers' Compensation Insurance, or a certified copy thereof (Section 800, Lab. N� Policy No. Company ��'��r"' - i �, �tifietl copy is hereby furnished. BaGkflow.Preventer Service Sink Automatic Washer Construction Pole Sub- Transformer ❑ 15.50 KW ❑ 50 + KW ' I I Backflow Irrigation Sewer Ca g P Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps L!'Certi� ed �o�y icil�d with the city uil D Si f Date„ / 9 1 Applicant _ a-� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION _ (This Section rued not be completed -it the permit is for one hundred ($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. Clarifiers Solar Collectors Dishwasher Meter Clover ,100 amps - Dishwasher ' Solar Piping Dryers ❑Gas QElectric •Sub Panel ' Drinking Fountains Solar Tank t Fan Motors El o- 1 HP Elim.- 8 Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP ❑16-15+ : -_Date Signature NOTICE: If, after making this declaration, you should become subject to the Floor Sinks- Urinal Fixtures Microwave - , Workers' Compensation provisions of the Labor Code, you must forthwith comply ,with' Such provisions or this permit shall be, deemed revoked. Gas Service Outlets Water Closet Device Boxes Pole. Light CONSTRUCTION LENDING AGENCY 1 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,) Lender's Name Interceptors - Water Heater Outlets Range g i Kitchen Sink Water Service Switches Sign i Lender's Address OWNER BUILDER DECLARATIOfV I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of 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 herefrom 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). 1, 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who,butldS Or imProves thereon, and who does such work himself/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 com- pletion, the owner will have the burden of proving he/she did not build or lm- Prove tot the purpose of sale). Lavatories Auto -Wash Garbage Disposal Standing Sections P -Trap Laundry Trays Generator CIO -5. KW ❑5 15 KW Trash Compactor Roof Drains , ' : Ri inspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee' $ 3 MECHANICAL FEES Boiler Hood or Type I ' ❑ Canopy Type I I ❑ DEVE LOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date- ' Building Approved By Date , -- Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU ❑100,000 BTU ❑ I, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and contracts for such projects with a con- Application Issued By — — — - Data Duct - Ventilating ,--- SUMMARY OF FEES Exhaust System ❑ Multiple ❑ System Repair/Alteration _who tractors) license Pursuant'to'ihe Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ i am exempt under Section B. & P. C. for this reason BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ SMIP $ PERMIT ISSUANCE $ E Firepl/Fact. Bit. ICBO;+k Fire Dampers Date Owner I hereby certify that I have read this application and state that the above information is Correct. I agree to comply with all city and county ordinances Heating System & Ducting ❑0.100,000 BTU ❑100,000 BT Z2 Registers PLAN CHECK 2596 $ ELECTRICAL $ ENERGY P.C. $ GRADING $ %3 �� and state laws relating to building construction, and hereby authorize repre- , Sentatives of this y. t ant r on the Bove -mentioned property for inspection purpas Signature - Date �� 13 -�7 Drivers' License or SS PLAN CHECK 5Q% $ MECHANICAL $ PLAN CHECK 2596 $ MICROFILM $ ' TOTAL FEE $ _ 5 C) 0 v Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 10/84 White - Building: Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING •- Nor i. APPROVALS - Permit# Date Inspector P SPA 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. ,y 54. Forms 4. Electrical Conduii-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough'Plumbing & Pressure Test 6. Electrical'UFER Grnd. 57. APPROVAL TO COVER-GUNITE , 7. Footings 58. Electrical Conduif-Undrgrnd, 8: Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap r 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 Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19.` Rough Heating & Air Conditioning /��' G,Ef) FIRE DEPT. REQUIREMENT APPROVALS" Permit # 20.• Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas 0 Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. 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 Pluinbing 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 i 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison _ 50. Gas Release to Southern California Gas Co t 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF -COSTA ESA CONSTRUCTION PER MIT 2 ,. Froject Address15 air, wa L �—J PERMIT NO. � I (a19141 I HAUT NU. LO NU. UNIT NO. 1I0Blnc1 52PG5 TL TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. !� 11 Applicant's Mailing Address 2 { t e t C 440 Owner's Name _ �• Phone Address f S aCOS%g 0 Arch/Eng. License No. Address Contractor's Nam _ k = 1 hone .� Address {mailing] a Z ttQf+e C 6 City License No.�Xy LICENSED CONTRACTOR OECLARATION t hereby affirm that I am licensed under provisions of Charter 9 (commencing with $ett]on 7000) Of Division 3 of the Business and Professions Code, and my license Is In full force and effect. License Cl G ice�ce N9 3A.0-2-3 A.P, q16 Zona S Main Building: Accessory Building: TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT ELECTRICAL 1:1 PLUMBING 1:1 MECHANICAL EJ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU. YDS. ACRES E T Front Z 0 B A Rear N I C Right N K S Left G Ping. Ref. # Parking Req./Provided E Remarks: Planning Notes: Q M T S PLUMBING FEES Date tel --I - Signature ftiL_ WORKERS' COMPENSATION O LARATION hereby affirm that I have a certificate of consent to self -Insure or a certificate Bar Sink Showers ELECTRICAL FEES Worker$' Compensation Insurance, or a certified copy thereof (Section 800, Lab, C.) pp _ Policy No.Company R�rtifiod copy Is hereby furnished. gackfiow Preventer Service Sink Automatic Washer Transformer El15-50KW C350 + KW Construction Pole Sub. Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter El up to 100 amps CertifledIs filed with the city 9ullging Div s14Qn�. F_1 py Applicant r �LLTe-t: t— Date 1c EXEMPTIO FROM WORKERS' COMPENSATION DECLARATION T (Thi$ section need not be completed if the permit is for one hundred {5100) or lass). I certify that In the performance of the work for which this permit is Issued I $hall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps Dishwasher. Solar Piping Dryers ❑Gas ❑Electric , Sub Panel Drinking Fountains Solar Tank Fan �, Motors 01111 HP 21 % - 8 y CO Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar ❑9-15 HP ❑16-15+ 0C Date SIgnature 'NOTICE: If, atter making this declaration, you should become subject to theI Floor Sinks - Urinal Fixtures Microwave Workers' Compensation provisions of the Labor Code, you must forthwith comply with Such provisions or this permit shall', be deemed revoked. • CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance Gas Service Outlets Water Closet Device Boxes Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Name Interceptors Water Heater Outlets g Range Kitchen Sink Water Service Switches Sign Lender's Address OWNER BUILDER DCLARATION EE I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 file a signed Statement that he/she is licensed pursuant to the provisions of e Contractor's License Law (Chapter 9 (commencing with Section 7000) of &0e Sion3 of the Business and Professions Code) or that he/she Is exempt Lavatories' Auto -Wash Garbage Disposal ;Standing Sections P--TrapLaundry Trays Generator ❑0-5 KW El 5-15 KW Trash Com Compactor Roof Drains ' ¢refrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a Civil enalty of not more than five hundred dollars ($500). I, a$ owner of the property or my employees with wage$ as their sole Compensation, will do the work, and the structure is not Intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's 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 employyees, provided that such Improvements are not {ntentlad or offered for sale. If, however, the building or Improvement Is sold within one year of com- pletion, the owner will have the burtlen of proving heJshe did not build or im- rove for the purpose of Sale). i, as owner of the property, am exclusively contracting with Ilcensed con- 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 builds or improve$ [hereon, and who contracts for such projects with a con- Reinspection Fee $i5 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES Boiler_ i Hood or Type I ❑ Canopy Type 11 ElZoning DEVELOPMENT SERVICES REQUIREMENTS: Approved By -- nate Building Approved By Date Application Issued By Data Duct - Under Ground Duct - Structural Refrigeration System ❑0 100,000 BTU ©100,000 8TU Duct - Ventilating SUMMARY OF FEES Exhaust System ❑ Multiple El System Repair/Alteration tractors} license pursuant to the Corctractoi's License Law). I am aware that proof o their Worker's Compensation Insurance should be provided to me. L7 lame xempt untler Section 9. a: P. C. for this reason BUILDING PERMIT $ SMIP I$ PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ Firep1lFact. Bit. ICBG # Fire Dampers Date Owner I hereby certify that I have read this application and state that the above- information Is correct. I agree to comply with all city and county ordinances Heating System & Ducting 00-100,000 BTU ❑100,000 BT Registers PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ Z, GRADING $ and state laws relating to building construction, and hereby authorize repro- .sentativos of this city t ant upon the above-mentioned property for Inspection pur uses. /MECH Signature l _g IV Drivers' ense or SS -01 r d PLAN CHECK 50% $ 1--f ,. 5 MICROFILM $ ANICAL $ �AZ • �- PLAN CHECK 25% $ TOTAL FEE $ Reinspection Fee $15 Issue Foe $ 3 CMF 0865-46, rev. 10/84 White - Building: Canary - Applicant, Pink - Accounting; Goldenrod - Assessor ' -!CONSTRUCTION AND PLANNING ' ,APPROVALS Permit # Date Inspector P SPA 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 p 7. Footings. _ 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe-Undrgrnd. . 60. Backwash Pries, P -Trap, ❑ Undrgrnd, 10. Structural Floor System 61. APPROVAL -TO DECK 11. Property Sewer Linei& House Connection. 62. Backwash 8i Receptor Final �. 12. -Sewer Cap 63. Heater &Vent -Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing S 65. Electrical -Final 15. Rough Electrical -Conduit - 66. Solar System -Final 16. Rough Electric Wiring -zn).O* 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling%'I 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air -Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace t 21. Ducts, in Structure 1 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing = 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Mono coat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29, Insulation 78. FIRE PREY- FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final jy/� 80.; FOOD CERTIFICATE ISSUED 33. Final Electric 1i�f? 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 -Finale - - 42. Backflow Preventer' 43. Backflow Irrigation' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING, i 48. Special Requirements Completed r t49. Electric Release to Edison -- 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY t • No. Date - - I ' 0 ADD,—ESS OF BOILOam: 3151 AIRWAY AV UMT: 1-3 0WNEFT7 NM4E IF slaw*: S ARAF , R E Z A Acca-% P . O .BOX 5 719 IRVINE CA 92616 a7_ T 470--11`22 APPL, MAILM ADDRESS: ARCRRECT OR omIER: LONNIE LANGU I S mm, C 4 6 3 0 1 ARCM OR EM'S ADDRESS: 4 CYPRESS TREE LN UNIT: IRVINE CA 92612 CONTRACTOR'S RAVE: C(MRACTOR9 MAILM ADDRESS LIC. NO.: UNIT: LICENSED CONTRACTORS OECLARATiON: I hereby affirm under Penalty of p *q that I em leensed under prwisiorn of Chapter 9 (oummencing with Section 7000) of Dirision 3 of the Business and Proleseians Code, and my 6mnse is in full torte end effect. CITY LLC. NO.: LLC. CLASS: UC. NO.: EXP: Date: Contractor: OWNER BUILDER DECLARATION: I hereby affirm under penalty of perjury that I am exempt from the Cotredos License Law for the fdlowng reason (Section 7031.5 Bushone and Prdeseioi Cade: Any cky or county which requires a permit to construct, after. improve, olish. or repair ary structure, prior to its issuance, also requires the applicant few such permil to fib W a signed statement Vhe or she `acolicensed pursuant to the provision of the Contractors License Law [chapter 9 (oorrumen eft with Section 7000) of Division 3 of the Bueiness and Professions Codel orthat beer she is exempt therefrom and the basis for the alleged eaernpton. Any violation of Section 7031.5 by any applmrs for a permu subjects the applicant to a civil penalty of cop mors than fire hundred do0ers [5500D. I, as owner of the property or my ernpbyeas with wages as their sob mmpsnatioh, will do the wok, and the structure is not Warded or offered for sale (Section 7044, Br®ness and Prdessio s Cade: The Contractors License Law does nor apply to an owner of property who builds or improves thereon. and who does such work himself or herself or tfrouo his or her own employees. provided that such improvernenrs are not irtended or offered for sale. 6, however, the bedding or inprovemem is sold within one year of oompletion. the V owner -builder wig have the burden of proving he or she did not build or improv for the purpose of sale). f jL�J I, as ower of the property. an eir4®vely mnreang with 6oersed contractors to construct the p"W (Sedco 7044, Business and Professions Code: The Correctors License Law does not apply m an owner d property who builds or impose thereon and who cent for such praieae . a axiractor(s) licensed pcesuard to the Contractors License Law). I am exempt B. a P.C., kit that n: Date: Ow1er: I do here .4 that flge, and understand the requlremems d omia Fleakh end S Code Sections 25505, 25533, and 25534, and that I or any ure bu"M occupant wig/ will not (mole to comply with state oodes end the requirements kn a permit fol construction or rnodifiral'hon from the Ai eul emagemerd Otstdcl. Residentiai aonstrudion applications are exempt from these provisions. Dale: Applicare: WORKER'S COMPENSATION DECLARATION: I hereby afftm under penehy of perjury one d the k0owing dederman: l have end wil rlmntan a cedificate of consent to s@04=rre for workers' mmparhmtion, as provided for by Section 3700of the Labor Code, for the perfornmen of the work to which this pemdl is issued. L.1 I neve and will maintain wwrtrere' corn atlon rt>suraos• an requcad by $adon 370D of the Labor Code. td the pedonmence of the work for which this permll is ipued. My wrier[ twmpe sdion insurance canis end policy number ae: carder: Policy Number: (This section reed nil be eompolad T the perrnk is for oma hu Bred do0ars [MO/ or less.) I caddy that in the performance of the +rode for which this permit is issued, I shall not employ any person in tory manner so as to become subject to the wdkwe' oonpersation laws of California. and agree that R I should became subject to the workers' *ompensatjon provisions of Section 3700 of the Labor Code, i shell forthwith *amply with those provisions. Data: Applicant: Waming: Fallure to sacra• warkere' carpermllon corwaya Is Lmim 'Itr( and shall aubjacr an ernployw to cdmfnal pandllee and civil ffnes up to one hmdred thousand dollen (5104000X In addidon to the cert of compwhandarT6 damages as provided for In Sacdon 3706 of aro Labor Cods, Interest, and sftwnsy i fees. CONSTRUCTION LENDING AGENCY: I hereby alfidn under penalty of perpsy thin there is a conssrtrdion lending agency for the performarm of the work for which the Permit is issued (Section 3097, Civ. C). LENDER'S NAME LENDER'S ADDRE$9: I *edify that I have read this application and state that the above information is omen. I agree to comply with all city and county ordinances and state laws rokdrg to building construction and hereby ar@naue represenlawas d this Baty to ems upon the above-mentioned property 'efnsp-d IWp*--REZA SARAF t C Date: Sigraure of pp6rantlCortrado 15151 da.WP) White-Baltdna Safety; Green -.Flo: Canary-APplicam: Pink -Revenue; Goldmrod"Assessm CITY OF COSTA MESA - BUILDING PERMIT 9 a - ©op3,7 PERM NO: M 086737 PERMIT NO: M 086737 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V -N PERMIT TYPE: MEC PURPOSE: ALT JOB DESCRIPTION : REMODEL OFFICE SPACE SQ FT: CLAIM VALUE: CALC--VALUE: GROUP OCC: B / COMMENTS: "TOUCHTONE SOFTWARE INC", RE:#B86735 �F j6 �F �F i6 if -16 -16 -16 d6 d6 d6 d6 i6 i6 �6 �6 �6 �6 �6 �6 i6 d6 d6 i6 k• d6'lE'lE'lE'lE'lE'lE'lE'lE 1(•'lE 16'lE �6'lE 1(• 1(• 16 �F X616 1(• i6 i6'lE 1(• d6 i6 i6 d6 i6 1(• iE 3k � � irk � �E'lE �6 d6 k• d6 d6.16.16'lE �F �6 �F k• �6 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE • PROV: PARCEL: 93894041 ZNE: REF NO: PLANNING NOTES> > �E'lE'lE �E •16.16 iE �E'lE 1(• �E �E iE �F �6 �6 1(• iE 3E iE � � * * * * * � � i6 if * * dE j6 d6 �F �6,�t � i6 �6 �6 � � � iE � � d6 alE � �6 iE j6 �! i6 �F iE � � � � � �6 3E d6 �6 � ?f �6 # 3E jE alE �F �6 aE ��. D E V E L O P M E N T S E R V`•' I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: 1 2(p •16 �6 # # k• •16 �6 # # � k• k• •16 1(• i6 i6 i6 1616 1(• 1(• 1(• i6 1(• 1(• �6 k• k• j6 �6 �6 i6 iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 31.00 25% SMIP/NON-RES PLAN ISSUE FEE r 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 31.00 22.00 11, 0.00 53.00 53.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 53.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 53.00 alE a1E a1E a1E i6'lE iE alE a1E i6 alE iE -i6 jE �6 j6 �6 �6 j6 # # �6 lE •16.16 # •16 a6 � � � � 16 � aEiE aE � * � 16 k• j6 �6 fE d6 a1E X616 aE * � 16 1(• aE 16 �6 16 alE a1E �E �6 k• j6 �6 �6'lE iE � � i6 iE •16 ilk •16 �F �6'lE � I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O_.N UNIT COST TOTAL COST r• MEC 1 REPAIR/ALT COOLING --UNIT/SYS W/CNTLS 12.25 12.25 MEC 1 REPAIR/ALT HEATING UNIT/SYS W/CNTLS 12,25 12.25 MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 6,50 6.50 END OF FEES V 91-26-1998/89:29 AN/$53.99 R0TWI-0818687 PERMIT:@$6737 CONSTRUCTION AND PLANNING ' APPROVALS Permit # Date inspector r.j0_ A SPA APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 52, Pool & Equipment Location 2. Soil Pipe-Undrgrnd- 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54• Forms 4• Electrical Conduit,Undrgrnd. 55• Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57, APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10, Structural Floor System r 61, APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63• Heater & Vent -Final 13, Roof Drains 64, Plumbing System - Final 14, Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67• Fencing & Access Approval 17, Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Eiectricai-T Bar Ceiling 69, POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning rOpp 44 FIRE DEPT. REQUIREMENT APPROVALS Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑ Oil 23. Gas Pipe -Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas © Oil 25• Roof Sheathing 74. Overhead Hydro 26: T -Sar Ceiling (Structural) & Monocoat 75, Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29, Insulation 78, FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 34, Final Heating & Air Conditioning qp_�&• PP �f rx Notes: _t$J.v [zE_t _11l 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 - 5. 45. Sound Attenuation ' Fr 46, Handicap Regulations c 47. FINAL STRUCTURE & BUILDING `.. 48. FINAL PLANNING J 49, Electric Release to Edison .. 50. Gas Release to Southern California Gas Co ' r 51. CERTIFICATE 0f OCCUPANCY No Date e ADDA1:SSOFOUXIMta 3151 AIRWAY AV UNIT: O0MFr9NAMEIFKNO1l : SARAF, REZA ADDRES& P . O .BOX 5 719 IRVINE CA 92616 .PPL. KAILING ADDRESS: ARcRrmcTonumlEEn LONNIE LANGUIS UC.ND_ C46301 ARM OR ENG'S ►D011ESS: 4 CYPRESS TREE LN LINT: IRVINE CA 92512 CONTRACTORS NAM COITiRACTOFM NAMM ADORES& LIC. NO.: UNIT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjhey Net I am I urhder peov®ru of Choose 9 (oommar>mhg with Section 7000) of Demon 3 of the Business end Pr I ids Code, and my 5cerw is in full force and Mex. CITY LIC. NO.: UC, CLASS; UC. NO.: EXP: e . Date: Comnaor. 'OWNER BUILDER DECLARATION: I hereby affirm under penally d perky that 1 am exempt from Ilse Caaraaore License Law for the kaDmV reason (Swon 7W l S Buaihm end Prof ' , s Cade: Arry eery or murvy which re I iss a permit to oon stru i, cher. improve. W"KfiLh. or repel arty strurbos, pnor b as "swamps. afso requires the applcem for wch perm to Me a signed emm Per that he or she s licensed poi uert to ft provisions at the Contractors License Law ]Chaam 9 (commenmq with Sarson 7000) of Division 3 of the Busts and Prdassiorm Cade] at that he or dere is exempt therekorn and the b® for the alleged e.empion. Array violation d Section 7001.5 by arty for a perm[ erd*m the apprcam to a chs penahy, of sewer man than fare hWdfbd dMera iS,ADD. I. as owner of the property or rnny employees with wegm as their ode compensation. will do the work and the stnastaa is not 'wended or offered for *am (Serbon Tone. Suemess and Profesaiwrs Cade: The Corareaors License Law down not appy to an Amer of poparty who builds or inpavee Thereon, and who does such work limeel or hersell of turoughh to or her or yaplayeea, provtled that such improvanwrm are not Wended a offered for sale. r, howwver. the buildup va or inpronam ld er is soone year of completion, the X owmer4xddw will have Lha btadwn d provM he or she did not build or Improve for Lha purpose of edit). I I. m owner of ft property. am excsrovely unntraong with licensed c rtrecson to oondua ft project (Section 7044. Business and PrdmMn Cade: The Cmtreaors Lcaee Law does not apply to an owner d property who builds or insproves thereon and who te Ax oor"cw projects with a contrineme) licwnned pursuant to the Contractor, I I., Law). ❑ 1 am evernpt Ader $494n; S. d P.C.. for Kia ` Date: Ownw: 1 do hereby eanry Nd am aware of and unxiersWM the requiremenm Of 94is Health and Sally Swdiom 25505. 25533. send 25534, and that I or Ary future building occupant will ! will mol (circle one) need to comply wlh said stele codes and the requirements for ■ pernM Fa uarotrurcliorh ase modi5ca<on horn the Air u iy 1�anagemem Distrix. Residemid construction app5eatlans w exempt from [hate Date: Apolin:ert: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the M6owft dedweibnsa ❑ I have and *0 maintain a c rsofipte at mhserw to sedwinwre for workers' mnpernetion, as podded for by Stolon 37M at the Labor Code. for the performance of the work for which this permit is Issued. I Nva and nil mausah wodaers' cornperneaion insurance. m usque by Section 3700 at the Labor (:oris, for the performance at the work for which dhis permit is mud. My workers wmperndion irmurence ranker and policy member are: ` Carrier: Parrs larmler (7hia section need nor be aompeeted i efts prmi a for am hundred dollars fSI00f or Teva I certify the in the performance of IIs work for which thin permit is issued. I shop not employ my person it any manner w as to beconr subject to the workers' mrpervena n laws d California_ and agns that if I shored beconr tA+jerr to the workers' cor peranim p uimis of Section 3700 of the Labor Cade. I fiat forlb-th campy with [Mss province Dow Appticam: WarrrLp: Fa@roe to aww woArsn' eonprruadon cc, v pa N unlawM. and shdi atejea an ermployer to erlmind peraloq and dv6 On" hp to area hm~ thousand ddhers (iff)QDW, lot addldon to 0e coat or eorrpernatbti dates m prodded for In Sectfan 3706 of Ow Labor Codi kdaras; and &Mw7 ey i fess CONSTRUCTION LENDING AGENCY: I bm baby affi under penally of psejury that there in Mthe ■ oonduai n lah7 agency lor Performance d Iha work for which this permi is issued (Sea on 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I candy that I have read this appl"icafon and mate that Ne above information a oonea. f agree to me* with a9 airy end county ordanancee and suds laws ntlating to building mm"ction and hereby authorize representatives of this city to emer upon the abwa-medioned property ` Irnepeetnan p po"a. R E Z A SARAF Date: fa 412�11 (5151r6.WP) Whte4kWdim9 d $afaty: Green -Fla; Canary-Applicam: Pink4Wnrus; (ioWsnrod-Aaseswr CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: P 086738 PLAN CHECK NO: N CONSTRUCTION TYPE: V -N PERMIT TYPE: PLU JOB DESCRIPTION : REMODEL OFFICE SPACE CLAIM VALUE: CALC-VALUE: NY -o 07 PERM NO: P 086738 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B / COMMENTS: "TOUCHTONE SOFTWARE INC", RE:#B86735 iE iE iE i4 iE if iE i4 iE iE iE i4 iE iE iE ii ii ii ii )F iE iE ii ii i(• )F )i )i )i )i iE )i if if if if if iE )i if � if lF )F )F )F iE i(• )F )F i(• i(• i(• ii ii ii ii i(• i(• it it it dfr )i )i )i if lF iE if iE dtr if Mfr iE iE � if iE Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- ---------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93894041 ZNE: REF NO: PLANNING NOTES> > i(• dE iE i4 i4 )F i4 i4 �E �E �E �E i(• �E'lE dE i°JlE'lE it it it it �E'lE if )i )i iF �i iE it 1F 1F �E 1F 1F �F �E iE iE ii 1F 1F 1F 1F 1F �EiF �E 1F iE iE dE iE �E 1F 1F � * iE 1F iE dE dE iE dE dE �E �F 1F 1F iE iF iE iE ii �E iF D E V E L O P M E N T S E R V I C E S L,,R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: 2 LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N PERMIT BLDG PMT PLUMB8ING ELECTRIC MECHANIC FIRE SMIP/RES GRADING .75 25% SMIP/NON-RES PLAN ISSUE FEE 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 8.75 22.00 0.00 30.75 30.75 .00 REVENUE DIVISION TOTALS--> COLLECTED; 30.75 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC F.TRE SMIP/TOT GRADING PLAN -CHECK 30.75 I N D I V I D U A L F E E '"B R E A K D O W N (TYPE QTY D E S C R I P T I O N - UNIT COST TOTAL COST PLU 1 SINK, BAR � 8.75 8.75 END OF FEES 61-26-1998/89:29 AM/i30.75 RCPTN•61-0016688 PERMIT:086738 CONSTRUCTION AND PLANNING ' APPROVALS Permit # Date Inspector �(. +SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole <, 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Stebl Reinforcement 3. Electrical Conduit Utility-Undrgrnd, �� 54. Forms 4. Electrical Conduit-Undrgrnd. r 55. Electrical Bonding 5. Steel Reinforcement 56, Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final I 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 14. Rough Plumbing X11(7 �( 111 a .64. Plumbing System - Final o . 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 Etectrical-T Bar Ceiling 69. POO USPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 .7 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 x 45. Sound Attenuation �~ 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING i r, 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUR 1141- 3 15 1 AIRWAY AV UW; WHER'SNAMEIFDOW SARAF, REZA IF IRVINE 19 ECA92616 470-1122 APDL. BAILING A0 KS& ARCIfrr�croRr�+meffR: LONNIE LANGUIS acro: C46301 ARCH. OR EMD_'S ADDRESS; 4 CYPRESS TREE LN UM: IRVINE CA 92612 CONTRACTORS NAME_ CONTRACTOR'S MAILING ADORES& LIC. NO.: UWT: LICENSED CONTRACTORS DECLARATION; 1 hereby affirm unMx parlay d perjury dw 1 am loonsed under provisions of Chaper 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my Soertse is in hA fame and effect. CrrY LIC. NO.: LIC. CLASS: LIC. NO.: EXP: I Date: Comredor- ]WNER BUILDER DECLARATION: I hereby affirm under penally of perjury that I am exempt from the Cmnscfors License Lew for the followig reason (Sedion 70315 Business and Prdeasione Code: Any city or county which requires a pamil to oonsow. after, improve, wnd6h, or repair any structure, prior to its issuance, she requires the applicant for such perms to file a signed statement stmt he of she licensed pursuers to the prrn®ons of the Contractors License Lew [Chapter 9 (cortuneneng with Section 7000) of Division 3 of the ,umreae and Professions Code) or that he or she is exempt therdrm and the basis for the eleged exemption. Any violation of Section 7051.5 by any applicant for a permit subjects the applicard 10 a civil peraiy d not more than Gus kindred dollars [SSoo]). ❑ I, as owner of the papery or my ennployem with wages as their ode compensation. will do the work, and the structure is not intended or oflared for We (Section 7014, Business and Professions Code: The Contractors License Law does nit apply W an owner of property who bulda or inprwas thereon. and who does such work himself w heroel or through his or her own employees, provided that such improvements we not inlanded or offered for sale. R, however. the building or improvement is sold within one year of Completion. the x ownerMuikler well have the burden d Proving he or she did nod build or improve for the purpose of eels). ❑ I, as owner of the property. am exclusively contracting with karsed contractors to consaw thle project (Section 7014, Business and Professions Code: The Coruradors License Law does rot appy to an owner of Property who builds or improves lheraw and who contracts for such �rojada with a owdrador(s) licensed Pursuant to the ContractFzli I am exempt un a Section: B. A P.C., kr this Mea Dale: Owner: I do he /I Certify em a d and understand the requirements of ie Heekh and Safety Sections 25505, 25533, and 2553x, and that I or any future baldly occupant will win not (Cirols on a) sed to comply with said slate Codes and the requiremems for a permit forconstructionor modification from the Ai upMy anagement District. ResideMialGmslnnion appicidionsaro exempt from these provrsore. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affum under pansy of perjury orad Oa k6owh g de I ions: ❑ I have and will maintain a oertdrate of oonaerd to selfminsure for worker' compen salion, as provided for by Section 3700 of the Labor Code, for the performance of Or work for which this permit is issued. r] I have and will maintain workers' companatbn insurance, w required by Section 3700 of da Labor Code, for the pmformmroe of the work for wfnidn this Permit is issued, My workers' compensation insurance carrier and perky number we: Carrier: Policy Number: }, chis secrlon need not be comphrted u7 the permit is for one hundred dollars jSf 00/ orles,.) I certify that in the performance of the work for which this pemd is iastuad, I shall rKA employ any person in any marvher so as to become suhjed to the workers' compensaim laws of Cardomis, and agree that it I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I @hell forthwith comply wish doss Provisions. Deas: Applicant: Warning: Failure to swum wortars' conponsadon coverage Is unlawful, and shaf; subpO an rnpfoyr to cdmrnsl penaltfu and cfvll Rnsa tv to one hundred thousand dellen (41=0004 In addition to ffta cost of cornpansstion , dantopa u provided for M Sacdon 7706 of the mbar Coda. Interest, and aftomeyi is". CONSTRUCTION LENDING AGENCY: I hereby affirm under pennhy of perjury that there is a conbrudim landing agency for the parformencn of the work for wtfxh this pw ml is issued (Section 3087, Civ. C). LENDER'S NAME; LENDER'S ADDRESS: I ceruty that I hers reed this application and elate that the above Information in cored. I agree to oanpiy with all ooy and ootunty ondi a aces and state laws relatkhg to builldng construction and hereby authorize represematives of this ooy to aver upon the above-mentioned Property for inspedi0rt paposes. R E Z A SARAF ----"`--Pnnl--•' -- Date: (51511e.WP) Whae-Budding b Salary, Green -Flo; Canary-AppFanv; Pink-fbvenue; Goldenrod-Asseaaor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 0867351 PERMIT NO: B 086735 PLAN CHECK NO: 05339-97 A GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION REMODEL OFFICE SPACE SQ FT: 4,500 CLAIM VALUE: 4,500.00 CALC—VALUE: 4,500,00 GROUP OCC: B / COMMENTS: "TOUCHTONE SOFTWARE INC" dF aE �E �E if if if if if if if f�E if �E �E if if 3E if if if if �E if �E �E �E �E if �E �E �E if if if �E if �E �E �E i4 iE iE iE iE i4 i4 iE iE iE iE iE •lE -IF iF iE iE dE * * -1E aE �E dE f�E �E �E �E aE aE aE aE aE �E aE aE iE aE -1F Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT; FT IN RCHT: FT IN PARKING REQ: PROV: PARCEL: 93894041 ZNE: CL REF NO: PLANNING NOTES> MNIOR INTERIOR ALTERATIONS FOR OFFICE. > r� 9t,lt D E V E L O P M E N T- S E R V I C E S R E Q U I R E M E N•YT S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; / DATE: APPLICATION ISSUED BY: t VC. DATE: R i 9t 9t �k 9(- iI- iI• �E �E �E �E 9t 9t �E �E �E iI• �E• dE 3E ik iE iE �E # # -IF # 9t # # -1E 9E 3F 3E (LEGALIZATION:N �%F E E S U M M A R Y STRUCTURAL'SEGMENT:Y BLDG PMT PLUMBING ELECTRIC�.�MECHANIC FIRE SMIP/RES.t' GRADING PERMIT 99.75 y , PLAN 16.21 f SMIP/NON-RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN -:CHECK= TOTAL PAID DUE TOTALS ---- > 100.70 0.00 116.91 116.91 .00 REVENUE DIVISION TOTALS--> COLLECTED,: a 100.70 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC !, FIRE SMIP/TOT GRADING PLAN --CHECK 99.75 i .95 �I 9t 9t dE dE dE �E 1E �E �E �E �E �E �E iE �E �E �E dE �E dE dE dE aE aE dE �E �I 9t 9t *4 I N D I V I D U A L' 'F rE. E'G' B R E A K D O W N ,4, r TYPE QTY D E S C R I P T I O,N / UNIT COST TOTAL COST SFC 4500 ALTER BY VALUE COMMERCIAL NOZONE 1.00 4,500.00 END OF FEES 81-26-1998/89:38 AM/f188.78 PERMIT. -086735 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector rvC SPA 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd, 8, Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 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 APPROVALS Permit # 20. Rough Factory Fireplace 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 30. Drywall Nailing ��l //f 78, FIRE PREY. FINAL HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 33. Fina! Electric 34. Final Heating &Air Conditioningf$�71 35. Final Gas Pipe Test 80. FOOD CERTIFICATE ISSUED o----- c Notes: / G / -r �K� oOee ewt/ 0,e I� C 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 ' r, 44. Landscape Irrigation System r' ; 45. Sound Attenuation ' 46. Handicap Regulations71( 47. FINAL STRUCTURE & BUILDING Zoj' ' _4- v 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas CD rhr5•-1, CERTIFICATE OF OCCUPANCY No: Date ADI)KM OF SULtnsO: 31 1 AIRWAY AV UNT: ONNENSkMEIFIOWRyh SARAF r REZA AOm_n P . O. BOX 5719 4IRVINE CA 92616 APDL. "LNG ADDRESR IwcxrrEcroREf+m+EER LONNIE LANGUISRo, C46301 ARCH.oR UW9 ADDRESS: 4 CYPRESS TREE LN gra; IRVINE CA 92612 oDNr Wags ru m COMACTORs MAJUM ADoaEss Lic, NOa UKT, LICENSEO CONTRACTORS DECLARATION: 1 hereby affim t1 -, panty d perjury OW I am Ilrased under provisions of Chapter g imm-enciry with section 7000] or Division 3 of me chess and Prolesims Code. and my loose is n hA force end effect. CITY LIC. NO.: LIC. CLASS: LIC. No.: EXP: Dare: Contredor. OWNER BUILDER DECLARATION: I hereby alfm pander penalty of perjury that I am e:ampl from the Cotmaon License LAW for the following reason (Section 7031.5 Dusimu and Profesaiorre Code: Any city or noway whidl requires a permit to mrsftW. efts. 'improve, 'enwfsh, or repair any Structure, Pdor to its esushos, also requmes the applimrt for su ch psmi ID fie a signed haatanert tM hs a she , licensed pm umi to the provisions of the Conrractm Lcw*e law [Chapter g (oommmct with Section 7000) of Division 3 d the Business and Professions Code] or that he or she is exempt therefrom and the basis lot the ageged memption. Arry violation of Section . 7031.5 by arty applicant Im a panni $ubjscta the applicant to acid Peraly of M more Than two ho Bred doses [3500.'` ' ❑ I, as owner of the property or my employees with wages as their rola atmpmattiim will do the sank. and the strumae is not mended" " or offered for sale (Sedan 7044, Business and Profsasiors Cade: The Cmirador Lowe Law don rear apply to an irwner of property, who meds or improves thereon. and who does such work hinseC cc hersa or dvungh he cc her own errQwyeas, provided that such r imprwements are net inaerded or .6 for ash, 11. however. the bta►dk sir improvement a sold whhln one yam of mmplelon. the ' X owner4s1dw with have the burden of proving to sir she did not build or improve for the purpose of sole). ❑ I, as owner of the property, am mdemvaly contrdkV wilh flossed carmeetor to eonsbw the poject (Section 7044. Bmwms and Prof sssiar>: Code: The Co tredans Lim Law does M apply to an owner of property who buriids as [harem and who ' coranacb for such p with a oontrdor(s) lensed pursuant to the Contractors License Law). ❑ I em exam under B. h P.c.. for uses Dade: owner: ` ,I I do hereby certiry that I am aware of and understand the requmerrherts d Cal Health mrd Sentry Sections 25WS, 25533. 25534. and that I or any future building oomq rd wg I will rid (droie one) to comply w4h said state codes and the requirements for a perms for mstnFebon or moddicMion from the AirTGN mapemerrt District, Residential mmmrdon ar F ima aro exempt lrom Ihase provisions. Date: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm cards penalty of perpa ,ora of the boowiq dederatio s: ❑ I hew mrd wit mpiman a certilirata d mrsst to se!14 a For woken' ocmparsafion, as provided lot by Seoion 37W of the Labor Code, for the parfnrmahoa of the work for which this parryA is issued. ❑ I have and VAN maintain worker' compssatin Insurance, as required by Section 3700 of the Lebo Code. fa the performance d the wok for which this permit In issued. My waken' compensation insurance canis and policy number are: Carrier: Polly Number: (This sedfon need not be comdafed T flea prmt is For ane hrudred dWtars 131001 or ism) ❑ t candy that in the performance of the work for which this permit is Issued, I shat✓ not employ any person in any manner so as to beoome subject to the worker' conpasafion laws of Callonhia, and epee that A I tId beoome subjed to the walmn' mmpemetim provisions of Section 3700 of the Labor Cads. I shall fonhwuh oom* with dose provision. Dale: Applicant' Warning: FlAuaa to securer WOdura' Compensagon eorrage Is unb rtlrl, and afudf subfipa an employer to a*draf powdif" and edrg ffnrs up to ane hurxkvd fhouasd dolLr ISIOQOQOA ki &"don to ft cmc of coal w=Vori durVes as porddsd for In Semon 3796 of Qhs Labor code, frnmssL and afromeye fen. CONSTRUCTION LENDINO AGENCY: I hereby affirm under paraly of peroury that there Is e misrmlion Ierdrhg agency For the Performance at the work for wlhidh 016 pemhl is haired (.Section 3097, CM, C). LENDER'S NAME LENDER'S ADDRESS: 1 comity that I have reed this application end state that the above information a cared. l epee to Oanply, with as my and county ordihmhcse and sate laws relaxing b &Alin conatrhrrom and hereby authorize reprraraYrvea of the dry to atm upon the above-merai med property, 'o`a"pc`ionprp—'REZA SARAF Data: 11A41. 91 f ApKIAppkcardr or (51514&WP) White-GuUM a SaW, Green -File: Canary-AppAnrd; Plnl -4vwn,e; ail lenrod-Assessor - CITY OF COSTA MESA — BUILDING PERMIT x'98 o o4ty PERM NO: E 086736 PERMIT NO: E 086736 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT JOB DESCRIPTION REMODEL OFFICE SPACE SQ FT: CLAIM VALUE: CALL—VALUE: GROUP OCC: B / COMMENTS: "TOUCHTONE SOFTWARE INC", RE:#B86735 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 93894041 ZNE: REF NO: PLANNING NOTES> > iE iE 1F iE 1F iE dF dF dF dF 1F 3F lk 1F iE iE 1F iE iE �E fF �E �E ulE �E �E �E iE iE �E �E iE ulE �1-'iE �E �E iE �E lk iE iE iE iE iE ulE iE * � * iE iE ulE iE * * lk lk �E �E iE lk � iE iE iE iE iE lk * lk iE �E ulE �E * iE �E iE D E V E L O P M E N T S E;R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY % DATE: BUILDING APPROVED BY : ✓ DATE: APPLICATION ISSUED BY: DATE: Zia ****dkiEiEiE�***iEiE�E�iE�ifiEdf� ifiEiE-iEaE�EiE3E��F if* LEGALIZATION:N F E E-�j S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 24.00 50% SMIP/NON--RES PLAN ISSUE FEE 22.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 24.00 22.00 0.00 46.00 46.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 46.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 46.00 IE ulE �E IE IE IE iE �E �E ulE ulE ulE ulE ulE ulE ulE * 11- iE ie iE 1F 1F 1F � dF dF if * dk � dk 1F dF 1F dF �E >ti- � 1F 1F 1F 1F iE 1F � 1F � * � 1F >ti- � �E iE 1F if •lE � � �E 1F 1F 1F iE iE �E if ulE �E iE � iE � lk � dF * lk I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 4 FIXTURES LIGHTING 1 ST 20 EA. 1,00 4.00 ELE 10 RECEPT/OOTLET 1 ST 20 EA. 1.00 10.00 ELE 10 RECEPT/SWITCH 1 ST 20 EA. 1.00 10.00 END OF FEES 61-26-1998/89:28 IRS/S46.88 RCPT0:61-818686 PERWIT:086736 CONSTRUCTION AND PLANNING APPROVALS Permit �¢ Date Inspector - POS a SPA 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 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final I 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 3 67. Fencing & Access Approval 17. Rough Wiring Sign V.)il q� y,� q� f1 a, APPROVED FOR PLASTERING l 69. POO L/SPA SYSTEMS F I NAL 18. Rough Elearical•T Bar Ceilingi /� 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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. Drywalf Nailing HEALTH DEPT. REQUIREMENT 31, Plaster 8rown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 'U FOOD CERTIFICATE ISSUED 33. Final Electric2�T Jotes: 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 u 47. FINAL STRUCTURE & 8UILDING 48. FINAL PLANNING 49. Electric Release to Edison = 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date City of Costa Mesa Development Services Department Building Safety Division. CERTIFICATE OF OCCUPANCY No. 00 3 &, 5 3 P, O, Box 1200 Costa Mesa, California The Building located at 'A1 q1 a r,;,�tt. nip I_n has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group n_,9 Occupancy. Use of Building Offit7p CnAr•A _ Legal Description d77 -2A1_1 d (See reverse side for Metes and Bounds) Building Permit No.AN4>:117g17 Electrical Permit No.nMr,?rZ?'Plumbing Permit No. f Mechanical Permit No. Number of apartments and/or guest rooms ISSUED TO: Jav Three Partnership 151 Kalmus Dr. K--3 Costa Mesa, CA 92626 Building 01ficial/_ronrr*d:% VATnj Qrr,n_, "y -Z" , - ` �rf�Sr DateAnri 1 1 ft - 1 QAQ This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the _ Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015.46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File V CIT', OF 41"Ir Development S&Vices, COSTA MES Division of Building and Safety CERTIFICATE "OF This certificate is issued pilrsuant to the requirements of:,Ithe UnAiim Building Code, Section 308 adopted by the City of Costa Mesa certifies that at the time of its issuance the building'structure herein -below described was inspected and approved for occupancy as follows: 7_ Building Address 3151,£' J00�1! "Airway Ave" ::,.:"Bldg. Permit Number B05-01971 ky Use Commercial B Group Type of Construction- Corp,,9f;,",t.he Presidi'ng,-Bi ' sho,'j. Owner of Buildingf tb S Churc o Storsta d Kibq eey,,E. e aznp e j__., e S t Address o e .#x;400.. Salt LjLk e UTS,84 13 k12 2 B znir T -%i r-(-%T7T7Ti-1AT 1=1 is 09/06 REQUIRED TO BE POSTED IN A CONSPICOUS PLACE Use Zone MP City of Costa Mega Building Safety DepartmentCERTIFICATE OF OCCUPANCY '-' 3 ? � P.O. Box 1200 Costa Masa, California The Building located at 11r',1. A;rc.rn.S Axrmnnr. - .7-') has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group ccupancy. II Use of Building Wmaerc-Lal - Interior AJLtp--atioii Legal Description A.P.T,`•477-291--13 Mae reverse side for Mates and Bounds} Building Permit No` ='�IAC! Electrical Permit No. s -1117 T-- 1114`Plumbing Permit NoTi.:. Number of apartments -0- and/or guest rooms -�- ISSUED TO: ;i Building Official by10 ,T-TTTJZ;' PACIFTC FnVrJ •'.TAT. Victor C. ��fton-Dira-Cfior RaUc -rv—,• 7it7i3i ), J. D. 0LS01 M-1PANly Date T+ar+can}ti-zr in 1aR1 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT.BE removed except by the Building Official of the City of Costa Mesa under Seo, 306 (9) U.B.C. Form BU 34 Ray. 11 City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY P.O. Box 1200 Costa Mesa, California I,w The Building located at '11zl 7�im7av Fa-c-_rkw%. T-3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group ii --2 Occupancy. U se o f B u i I d i ng Co b=iz — Zntexim Uterations Legal Description tl••'r_s27-2r1—&3?-09 (See reverse side for Metes and Boundsl Building -Permit No - _1 +� l•Electrical•Permit No.L--37W-r+$1 Plumbing Permit No. '•3412 V.. Number of apartments ' `"4— and/or guest rooms "13` ISSUED TO: Building Official by I lr;� FM PA= IC PrNARM VicWr C. New-Lori—Director iaii.i ldin(-T Diva .moi„ Date September 22, 1981 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form BU 34 Rev, 11/70 - CITY OF COSTA MESA . BUILDING DIVISION > 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 - Fax (714) 754-4856 www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBS B08-00226 PERMIT TYPE B_ROOF2 APN: 42719334 STATUS: ISSUED DATE ISSUED: 07/3112008 ISSUED BY: RMD JOB ADDRESS: 3151 J AIRWAY AV CM Suite/Unit: J Vicinity: BLDG J ROOF Squares: 10200 Valuation: $22,407.00 SCOPE OF WORK: TEAR OFF.(E) ROOF MATERIALS, INSTALL 1 LAYER OF 15# FELT ON A 4:12 PITCHED ROOF AND REROOF WITH CLASS "A" FIBERGLASS SHINGLES, APPROX 102 SOUARES FOR BUILDING J. OWNER: KOLL IRVINE COMMUNITY ASSN Address: %KOLL MANAGEMENT Unit: NEWPORT BEACH, CA PHONE: City/State/Zip- 4343 VON KARMAN AVE APPLICANT: HANSEN, DUKE 1, Address: N6646636 - Unit: PHONE: City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC Address: 260 E ALTON AVEUnit: City/State/Zip: SANTA ANA, CA . 92707 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $363.25 Reinspection Fee: $0.00 TOTAL FEES $363.25 License No. 327802 PHONE: 714-557-7440 CELL: License No. PHONE: License No. PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 wilt result in the expiration of this permit. CODE 1• INSPEcnoyiN06Ll CODE INSPLOI)ON JYPE QBIE iNTMAL 1616 Fixed Systom Final Fire Prevention 208 Final Mechanical 1268 Pcd Spa Final 208 Final Plumbing 200 Final Re -Roof �y �� 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Placa 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Dernoition 250 Final Building/Occupancy 1. WORKERS' COMPENSATION DECLARATIOW' I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to setf-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: —Carrier: �/ Te_ ! `J 1J (This section need not De c_NTOeted i The perng is vahw.d at one hun,*W dollars (S f 00) orfess.) P IO icylNumber: 62_5S-3-9- Zia e ❑ 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 beco a subject to the workers' compensation provisions of Section 3700 of ab r Code, I shall forthwith comply with these provisions. A , pOmidhfs Signature Date 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 DOLLARS ($100,000), IN ADDITION 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 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. Li rpz — Class # �— 3 �- Contractors Signature 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 pedury 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) nr 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).): ❑ 1, 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.). ❑ 1, 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 3057-46 (3107) Date } Owner ID verified by drfvr,. tense. ❑ Yes ❑ 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, 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. Applicant's Signature Division of Industrial Safety Permit Number: Date 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? []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 ❑ Yes ❑ 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 and riling 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be fumished 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 ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No 8. (if yes", aitach certificate of compliance_ from the appropriate air pbllutibn 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 stale 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 L er(s) Date '7 Andl Authorized Arpplicant (._ Da (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite No .1001 Vicinity: UNIT J001 Parcel Nunmber: 93894027 Applicant: SUNNY JONES Address: 14252 CULVER DIR A528 IRVINE, CA PLUMBING PERMIT Phone: 949-651-9739 Zip: 92604 Owner:, CORP OF THB PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY E %PROPERTY RESERVE 10 E SO TEMPLE ST #400 " Phone: BRUCE CHRISTENSEN Zip: 84133-1122 Contractor: JONES AND SON PLUMBINGHEATING AND AIR CONDITION Address: 14252 CULVER DR A528 Phone: 949-651-9739 IRVINE, CA Zip: 92604 -License: 859767 SCOPE OF PERMIT 02/13/06 REVISEE): ADD 2 WASH BASINS AND RELOCATE WATER HEATER., Status: ISSUED Applied: 01/3112006 Issued: 01/3112006 PLUMBING PERMIT FOR 2,OOOSF INTERIOR T.I. FOR "NUVIS", UNIT J001. REF#: B05-01971 WORK TO INCLUDE: REPLACE AND RELOCATE 1 WASTE AND VENT SYST, 1 WATER PIPING AND 1 WATER SERVICE. COMMENTS ! SPECIAL CONDITIONS NOTICE: The work authorized by this p$rmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 18D 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 perm FOR INSPECTIONS CALL: (714) 754-5626 2446-46 (6M) AMT ISSUE FEE $23.50 Backflow irrigation $0.00 Backflow Preventer $0.00 Bathtub $0.00 Clarifier System $0.00 Connect (Ice,Soda,etc) $0.00 Dental Units $0.00 Dishwasher $0.00. • Drain, Floor 0 Drain, Rainwater $0.00 Drain, Roof $0.00. Drinking Fountain $0.00 Expansion Tank $0.00 Gas Earthquake Valve $0.00 Gas (1-4 outlets) $0.00 Gas (Over 4 outlets) 0 Gas Repipe $0.00 Gas Service $0.00 Interceptors (Grease, Oil) $0.00 Interceptors (Sand Auto ) $0.00 COMMENTS ! SPECIAL CONDITIONS NOTICE: The work authorized by this p$rmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 18D 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 perm FOR INSPECTIONS CALL: (714) 754-5626 2446-46 (6M) FEE SUMMARY QTY AMT QTY AMT (QTY, Laundry Tub ! Washer $0.00 0 Sump Pump $0.00 0 0 Landscape Irrigation 50.00 0 Swimming Pool $0.00 Q 0 P -Trap $0.00 0 Trap Primer $0.00 0 0 Pressure Regulator $0.00 0 Urinal $0.00 Q 0 Process Piping (per. 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 0 SepticTank $0.00 0 Wash Basin $19.60 2 Q Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 0 Sewer Connect $0.00 0 Waste and Vent System $9.80 1 0 Sewer Private Line $0.00 0 Water Closet (Toilet) 50.00 0 Q' Shower • $0.00 0 Water Heater 1 vent $12.30 1 0 Sink, bar $0.00 0 Water Piping (Inst or Rep.) $9.80 1 0 Sink, commercial $0.00 0 Water Re -pipe $0.00 0 Q Sink, Floor $O.00 0 Water Service $9.80 1 0Sink, kitchen 50.00 0 Water Softener $0.00 0 Q .' Sink, service/mop $0.00 0 OTHER $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 0" Spa (public) $0.00 Q PLAN CHECK $0.00 0 REINSPECTION $0.00 0 0 TOTAL CALCULATED FEES: $84.80 COMMENTS ! SPECIAL CONDITIONS NOTICE: The work authorized by this p$rmit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 18D 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 perm FOR INSPECTIONS CALL: (714) 754-5626 2446-46 (6M) L DECLARATIONS WORKERS' COMPENSATION DECLARATIO . I Hereby affirm under penalty of perjury one of the following declarations: ` ❑ 1 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 for which this permit is issued. i h e 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 workar ' co pensetlon Insurance can and p licy number are: r 1 Wsos' `-IHead not be competed if the permit is valued atone 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 Califomia, an/ ree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these pr ' ' Qate: �- .WARNING'. FA�ILI R ,yT j5 L WORK R PENSATION COVERAGE IS UNLAWFUL AND SHALL Su&JECT AN E P TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED RE (S1 OD=) IN ADD O THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I are censed a provisions of Chapter 9 (commencing with Section 7000) of Division and Professions Code, and my license is in full orce and affact, Lic. �. -- ' Class # U G Contracto sSignalure 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: 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 end 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 properly, 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 driver's license. ❑ Yes ❑ 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: ❑ 1 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, Wsework, 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Pian 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 tha applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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 and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ............................................................................................... 4 It an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ...................... ................ ...................... .................................................................................................................................................. ...................................................._........................................................................................................ 5 Qoes or will the applicant or present or future building occupant require for the work which is the subject of this a plication 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? UYes 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 ❑ No (If 'yes*, the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). ....................... I.......................... ......................... .............................. ................................. .... ........................ ---.......... ................................................................................................................................................................................ 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? ❑ Yes ❑ 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. nature 1 O (s) ate Applicant � ate CODE /• INSPECTION TYPE DATE CODE INSPECTION TYPE j�)� f�4� 1616 Fixed System Final Fire Prevention 206 Final Mechanical 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/occupancy f (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 3151 AIRWAY AV Status: ISSUED Suite No J001 Applied: 01/19/2006 Vicinity: FRONTAGE, J001 Issued: 01/192006 Parcel Nunmber: 93894027 Applicant: THOMAS ROSE Address: 12 FRONTIER STREET Res. a/c package Phone: (949) 85B 3515 . Standing Section , TRABUCO CANYON, CA Zip 92679 $0.00 0 Owner: CORP, OF -THE PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD, KIMBERLEY.E %PROPERTY RESERVE $0.00 10 E SO TEMPLE ST #400" Phone: Lighting Fixts BRUCE CHRISTENSEN Zip: 84133-1122 Contractor: THOMAS ROSE ELECTRIC INC Address: 12 FRONTIER STREET Switches, ` Phone: (949) B58-3515 16 TRABUCO CANYON, CA Zip: _ 92679 , r License: 80243B _ Res Appl ' SCOPE OF PERMIT 0 ELECTRICAL PERMIT FOR 2,000SF INTERIOR T.I. FOR "NUVIS", UNIT J001. ISSUED BY: REF#: B05-01971 WORK TO INCLUDE: 61 LIGHTING FIXTS, 37, RECEPT OUTLETS AND 16 SWITCHES. t FEE SUMMARY Quantity Y ISSUE FEE $23.50 Temp Dist System 1 Lighting Temp service test $0.00 _ Busway 1100 ft Res. a/c package $0.00 Standing Section , New Res (1-2 units) $0.00 0 New Res (3+units) $0.00 0 Pool l Spa $0.00 0 Lighting Fixts $51.93' 61 Recept Outlets $34.41 37 Switches, ` $17.60 16 Non Res Appl $0.00 0 Res Appl ' WOO 0 Service to 200a $0.00 0 Service to 1000a w `$0.00 � .10 Service over 1000a , . , $0-00'."\ ; 0 Motors to 1 hp : Sam 0 .. Motors to 10hp 30.00, -0� , Motors to 50hp $0.00' 0 Motors to 100h p .� 50;00':' 0 Motors over 1 00h 50.00 0 f Communication drops < 50.00 0 Sub panel to 200a 50.00 0 Pole Light Pkg $0.00 0 Sign Circuits 50.00 0 Temp Pwr Pole $0.00 0 Intermed Pole $0.00 0 rnrauruT@ rent_l 4 A I rnr1r%11^1nu@ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-26, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if wo k .. suspended or abandoned for a period of 160 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must corp y with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval wilts It in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446.46 (6100) Quantity Temp Dist System 1 Lighting $0.00 0 _ Busway 1100 ft $0.00 0 Standing Section , $0.00 0 Misc Electrical Equipment $0.00 0 Transformers up to 1 kvalkw $0.00 0 .,..:....up to 10 kvalkw $0.00 0 , ................up to 50 kvalkw $0.00 0 ' .............up to 100 kva,'kw $0.00 0 . ..................over 100 kvalkw $0.00 0 Low Voltage Equipment $0.00 0 Low Volt Wiring System 1 Ckt $0.00, 0 Misc. Conduit $0.00 0 Misc-Conductor $0.00 0 Circus ( gen or ride) $0.00, 0 Circus (mech ride or lights) $0.00 0 Christmas Tree Stand $0.00 01' Fireworks Stand $0.00 0 Other Electrical Fee $0.00 , Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $127.44 rnrauruT@ rent_l 4 A I rnr1r%11^1nu@ NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-26, § 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if wo k .. suspended or abandoned for a period of 160 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must corp y with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval wilts It in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 2446.46 (6100) k DECLARATIONS WORKERS' COMPENSATION DECLARATIO 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.w�this permit is issuod. _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. TT My workers' co ensatic sur8nce iiarrier and policy number are: ,Garner. �r C.A_ Polic ,Numb_. _f,_4��T��_ (This section need not be complelvdit the parmlr is valued at one hundred dollars {$100} or less, j - ❑ 1 carfity that in the per4Comia, nce 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 and a ree that if I should become subject to the workers' compensation provisions of action 00 of the Labor Code, I shall forthwith comply with these pro0Applicant.Signature:g3� T Date:, y WARNING: FNJ_LIRErTO SECURE 6RKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TOC IMINAL PE TIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: 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. Llc. # Cfass�kLZ ..civ^r ✓ r„•:.-- Contrap oes Signature: i7ate: 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: l 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 g (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).): ❑ 1, 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 contraclor(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: 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? ❑ Yes ❑ No (Section 25505 of the California Hsallh 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). ......................................................,...................................................................................................................................................................................................................111-1..................................................I.................... 2 Does or wily the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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). I ........... I.......... ---1111-11111 ............................................................................................-----..............................................................................................................................,,,....................................--------.--....................... 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 apartment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. .........................11 .....p-r-...en"'..'y r' -q-' i*r**..**,***.:....S. e' c. t'i'......................-f t'...........----••--•-------- ---------- -----....... ef,'"t-y",*C***........b,'e"'......iii-I i...............iie' ......iih,...................................................................................-----.....----................. 4 If an RMPP is presently required, h#s Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this 2pplication a permit for such construction or modification from the South Coast Air quality Mpnagement District or from any other air pollution control district or agency? LJ Yes ❑ No (Section 65850.2 Of the Califomia Government Code requires that the requested information be furnished on applications for non-residential building permits). ................111, .............1.111....................1.111,..' --................11- ----------------------............................................................................................................................................................................................................................................ 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 ❑ No (If 'fres", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No .:.............................................................................................................................................................................................. 6 {If yes", attach certificate of compli#nce from the appropriate air pollution control officer), CERTIFICATE= OF COMPLIANCE: I carlify 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 propfor inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection, s Signa Le al Owner(s) C Date �_- nd/Or A17tKorized Applicant QaTO CODE 0 INSPECTION E QAH INTITIA CODES INSIDECTIONTOE MALS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 5r-" 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy I�r (714) 754-5273 • Fax(714)7r>4-4856 • www.ci.costa-mesa.cBUILDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 3151 AIRWAY AV Suite: J001 Vicinity: UNIT J001 Primary OCC: B Eat<501 Office/ Bar<50 Type of Construction: V -N Parcel Number: 93894027 Zoning: Applicant: ROBERT CARDOZA/BUILDING OWNER Address: 3151 AIRWAY AV #J3 Phone: 714-754-7311 COSTA MESA, CA Zip: 92625 Owner: CORP OF THE'PRESIDING BISHOP CHURCH OF LDS Address %STORSTAD;'KIMBERLEY E %PROPERTY RESERVE 10 E S0 7EMPLL. ST #400 Phone: " BRUCE CHRISTENSEN Zip: 84133-1122'' Contractor: Address: Status: ISSUED Applied: 11/01/2005 Issued: 12/15/2005 ISSUED BY: 2�� Phone: r Zip: License: , Arch : `` RON YEO, FAIA ARCHITECT INC Eng: Address: 500 JASMINE AVNEUE Address: Phone: ,949-644-8111 Phone: CORONA DEL MAR, CA: Zip: 92625 License: C3567 License: SCOPE OF PERMIT 2,000SF INTERIOR T.L,FOR "NUVIS", UNIT J001. WORK TO INLCUDE: REMOVAL OF EXISTING NON -LOAD BEARING PARTITION WALLS, INSTALLATION"OF NON -LOAD BEARING PARTITION WALLS AND MINOR EL AND PL WORK (NO RELOCATION OF PLFIXTURES, CHANGE OUT ONLY): FEE.SUMMARY ' Plan..Check: $385.94 Calc Valuation: $45,000.00 Permit: $593.75 Claim Valuation: $45,000.00 SMIP Res: - $0.00 SMIP Com: $9.45 Oth $0 00 - er. Inspection: $0.00 Total: $989.14 SETBACKS MAIN STRUCTURE Front 0-0:'-"' . Rear ACCESSORY Front 0' 0 Rear PARKING Existing:0 Required: PLANNING & ZONING 0-.0- Left 0- 0 ` `. `:' :.:.Right 0-0 _ 0-0 Left 0-0 Right0- 0 0 Pr000sed: _ 0: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or 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)/54-W26 244848 (9100) a DiEcLAkATIONS WORKERS' COMPENSATION DECLARATION: r r I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a cerilliceta of consent to self -Insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the pedormance of the work for which this permit Is issued. ❑ 1 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: Carrier: Policy Number: (This section need not be completed if the permit is valued ar one hundred dollars ($100) or fess.) ❑ 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: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUaIECT AN EMPLOYER TO CRIMINAL PENALPES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE (S10D,D00), IN ADDrrION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE, INTEREST, AND ATTOFINEVS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I em 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. Lic. q Class ff Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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 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 safe (Sec. 7044, Business and Professions Code: The Contractors Ucense 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 acid 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, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors Ucense 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 axe der ifec. Z Business and Professions Code for this reason: Signature: Owns verified by driver ❑ nse. Yes No Drivera��,s License No Expires: ' / Verification of Ownership by (type of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 hereby certify that no excavation five (5) or more toot 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, Tltle 8, Califomla Administrative Code). ❑ As owner -builder, 1 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? ❑ Yes ❑ No (Section 25505 of the Celitomia 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), _ __....... .... _.—_.......................__.................................................. _ ................_.......................................11..11.................._ ._ _1_111 - ............. — ........ —1_111 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? []Yes ❑ No (Section 25533 of the Califomia Health and Safety Code, with some exceptions, requires registration with time 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). ............................................. ................................................ ........... ...................... ......................................... ................................. ........... .................. ........................... .. ....... ............................................. _11.11.....111.1........................ 3 Does or will time applicant or present or future building occupant need to prepare an RMPP (Risk Management and Prevention Program for acutely hazardous materials)? ❑ Yes ❑ No LSecilon 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 apartment of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. _.— ..................... �...................... _................................................... _ ........................_................. ..._............................... ._ ........ .._ .............. _................. ..._111_1....11..1..1............. ......... _ 4 If an RMPP is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which Is the subject of this a plication a Kermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? U Yes 17 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 pert of the facility to be constructed under this permit be within 1000 feet from the cuter boundaries of a school? ❑ Yes ❑ No (If -res", the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). _....... ..................................... _ _..... _............................ .....................................__.............................-------------••--•--•---.-..-........................---_..........................................._................1111......_.................... _111.11.111......._.................. 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 subioct of this application, have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑ Yes ❑ No _ ................._....... ..................... .......... ................... .._................................. _............................_ ...................1111.................. --............................ _.................. _.................... -1_1_11. 8 (It j+es", attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: 1 certify that under penalty of perjury the information given above is correct. I agree to comply with all state taws 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 agreetp com ly with all state laws end city ordinances relating to building constructio ,.and authorize representatives of the City of Costa Mesa to enter upon the above -des ' pro 1 inspec i urposes. agree no to occupy or allow 000upan any building authorized by this rmit un ' final inspection. ignatu Of agar Owners Date And/Or Authorized Applicant Date CODE It INSPECTION TYPE 2&U Ill, CODE P , INSPECTION TYPE • • 2&U fNT17MLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 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 I "" 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 MECHANICAL PERMIT ,lob Address: 3151 AIRWAY AV Status: ISSUED Suite No J001 Applied: 02/06/2006 Issued: 02/06/2006 Vicinity: Parcel Number: 93894027 ISSUED BY: Applicant: JARED STEINLEITNER Address: Phone: 714-970-3839 „ t - Zip: Owner:% , CORP OF THE PRESIDING -BISHOP CHURCH OF LDS Address:, - %ST CiRSTAD,.KIMBERLEY E %PROPERTY RESERVE . . 10 E S4 TEMPCE,ST #400- Phone: BRUCE CHRISTENSEN Zip: 84133-1122 i Contractor: ADVANTAGE H V A C Address: 1210,N ANDREA LN ' Phone: 714-970-3839 ANAHEIM, CA Zip: 92807 - License: 734759 ' SCOPE OF PERMIT 2,000SF INTERIOR TI. FOR "NUVIS", UNIT J001. WORK TO INLCUDE: REMOVAL OF; EXISTING NON -LOAD BEARING PARTITION WALLS, INSTALLATION OF NOWLOAD BEARING PARTITION WALLS AND MINOR EL AND PL WORK (NO RELOCATION OF PL FIXTURES, CHANGE OUT ONLY). REF,:.B05-01971 MECHANICALTO INCLUDE: -1 REPAIR/ALT COOLING/HEATING AND 1 AIR HANDLER < 10000 CFM. ... ✓ ,:' FEE SUMMARY Quantity' Quantity ISSUE FEE $23.50 ---_ _ :. - -, . - Repair/ Alt Absorbtion Unit $0.00 0 _ Inst FAU X100 k BTU $0.00,- 0 Repair/ Alt Refrigeration Unit $0.00 0 Inst FAU >100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $13.70 1 Evaporative Cooler $0.00 0 Inst 1 Rep. Recess WalI Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys X100 k BTU i $0.00 0 Domestic Incinerator $0.00 0 Refrig.Sys >100 k BTU $0.00 0 Compressors 1 Absorption Systems Gas Piping $0.00 0 .; , ,;�; Up to 3 hp 1100 k BTU $0:00 0 Factory Fireplace $0.00 0 3 To 15 hp 1500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 s:. 15 To 30 hp 11,000 k BTU $0.00 0 VAV Box $0.00 ,z ,C� ' , '' 30 To 50 hp 1.1,750 k BTU $0.00 0 Vent Fan I Single Duct 00- 0 Over 50 hp 1 Over 1,750 BTU-' $0.00 0 Appliance `.��, �� ` 10.00; 0;� Boilers Fire Dampers\,`�\ "/ ,� `° $0.00,, °0, ' Up to 3 hp r $0.00 0 Smoke Dampers -$0.00 ` �70� "1 _ 3 To 15 hp $0.00 0 Inst or Relocate App! Vent $0.00 '0'.' ' ". 15 to 30 hp $0.00 0 Air Handlers < 10000cfm $10.65 -1 30 to 50 hp $0.00 0 Air Handlers > 10000cfm,` ; ` $0.00. .0, 'f a Over 50 hp $0.00 0 Floor Furnace $0.00; 0, Other Mechanical Fee Floor or Suspend Heater $0.00 0-1 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee . $0.00 TOTAL CALCULATED FEES 547.85 COMMENTS if SPECIAL CONDITIONS NOTICE: The work authorizes! by this permit shall comply with all applicable handicap access requirements under Cafifomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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`alI required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiratiowpe rnft. FOR INSPECTIONS CALL: (714) 754-5625 2446-s (spoo) 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. ❑ 1 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: Carrier: Policy Number: (This section need not be completed it the permit is valued at one hundred dollars ($100) orless.) 1 1 B ify that in the performance of the for w ich this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' %compensation laws of calif ee th 1 should become subject to the workers' compensation provisions of Section 3700 fin Labor Code, I shall forthwith comply with these provis' 4ppN1 Ca�nt�Srignatuie:� e�:, WARNING: FAILURE TO E S' COMPEN ATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMP �OY WIC CAI 1NAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DO4LARE ( AD ITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3705 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am,lice ns�d.undet pro ' io s of Chapter 9 (commencing with Section 7000) of Division 3,of.the,Business �and Professions Code, and my license is in full ,flat ,e an�ic. # - �lj aClas_s # " 40 Contractors g atnre:=r ""r ` {?etaJr — r Da f 6 4(16 CONSTRUCTION LEN ING 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: Data: 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 o1 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 o1 not more than five hundred dollars ($500).): ❑ I, as owner o1 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.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Cade: 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 (typo of document, i.e. - property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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, fatsework, 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 Wilt 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 ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be tiled 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). ...........................................................................................................................................•-•-----....................................................................................................................................._............. .................................. 11..11...................... 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑ Yes ❑ 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). ................................ ................................... ................ ...................................................................................................................................................... ....................................................................... ....-..................................... 1111.. 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? ❑ Yes ❑ No ........ .... .................. ... ......................... .................................................................................................... I........................... ................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes L] No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). ........... ............................. ............................. ....................................................................................................................................... ....................................................... -----............. -.................................................. ................................... 6 Wil! any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (If'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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. i natur Le Owner(s) Date "IOLAridlogAdthorizeSARplicant CODE /• INSPECTION TYPE R9IE CODE 1 INSPECTION TYPE 1616 Fixed System Final Fire Prevention 206 Final Mechanical - 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 Final Sign - 222 Final Site 204 Final Demolition 250 Final Budding/Occupancy 0 W H a _0 J a } J Er W CL O Q a Z W 2 H r3= UJI CL ti O } C!] 2 H 1 COSTA MESA BUILOING—SAFETY A NT 3 5 3 a`G EKE P. 0. BOX I200 0751 7./22/81 i !.aG TL Costa Mesa, California ` �y� TRACT NO. ContIactot_/7�" 11 /�/ /�� LOT No. rl,_ AddressjZ 0 O %Z BUILRiHG USE %GATE ISSUE tp Code State License No.ZGtri Class. C—Z0' BUILDING 7 3� AooRESS 3 / .5 / �411va A L . 601 3 - 3 City License No.4 � _S-7-6Tel. No.� \; NO. ITEM EACH FEES COSTA MESA, CALIFORNIa� FAU, wall, or Gray. Furn. Incl, Ducts and Vents over 100,080 BTU I Vent lit not incl, abovell Sus ended Heater Alter or Replace Appliance Over 10 teet o gas piping BOILERS OR COMPRESSORS 3 H.P. or less Over 3 H.P. to 15 H.P. Bathroom Verit Fan—Sin le Duct' Kitchen ,('"� �'� 1y' Ventilating,}Hood ! "Po MMaim�F ira•Pblaces ICBO # Mi Plan Check Reinspection Fee Sub -Total Processing Fee I TOTAL FEES CMF 044946 s' OWNERzToD , C)us0 11MAIL ADDRESS /p0 0 CiTY! �2�1,N?'. TEL. NO._15_eZ0 v I hereby acknowledge that 1 have read this application and state 'that the above is correct and agree to comply 40 rw th+61P'City Ordinances and State Laws regulating Heat- ing, Ventilating, Refrigeration and Air -Conditioning. v I certify that i possess the above valid State of Calif- ornia classification or i am the legal owner of the single family residential property described above. Signature of Permittee RFMARKS: APPROVALS INSPECTOR DATE Ducts Underground Ducts in Structure Ducts Ventilating Heating — Rough Hoods Refrigeration Lines Pressure Test Air-Cond. Final Q Ventilating Final Heating Final / C� p Refrigeration Final Final Gas Test O G Utility Co. Notified BLDG. PERMIT NO. F1 3290 11/21/80 47s.ae :% COSTA MESA BUILDING -SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT ti P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 r'J 17_' a, i a N D M_ �o a _0 M M 0 LL )U RECEIVED$Y_ PERMIT D cant to Fill in Completely —Use Ink Only L FDDR A.P. NO. BUILDING ADDRESS Western Pacific Financial C/0-3. Ona MAILINGt sOn 0'a UNIT R SPACEN ADDRESS O 03 S CITY Irvine Ca. 92714 No540-2606 79-391ParcelBLK NEW ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION LENDER Western Pacific Financial BRANCH OWNER Western Pacific Financial ADDRESS Same VALUE USE ARCHITECTTE OR ENGINEER Hales -Lan S 1;on 47-0862 /1 � ADDRESS 777 S . Mains Oranges Ca. ZONE G TYPE GROUP APPROVED CONTRACTORJ DonaldOlson-Co__BY DATE ADDRESS 18003 Sky2ark Blvd., Ste .B CITY Irvine Ca. 92714 NEo 540-2606 �• STATE CITY APPROVED SETBACKS LIC. NO. 333269 LIC. NO. SIZE NO. OF BLDCS, /� 0 (FROM C/L STREET) OF LOT NOW ON LOT FRONT FT, USE OF EXISTING BLDG. Vacant Land Separate permits are required for L. SIDE 911 electric, plumbing and heating work. REA USE OF BUILDING AND WORK TO BE PERFORMED PLAN ING ACTION Construct office building shell Z� - _ DATE APPROVE 7479 S.F. APPROVED _ L� MOLD FOR SPECIAL RE UXREMENT: I hereby acknowledge that I have read this application and state that the above Information Is correct and agree to comply with all laws regulating building construction, and I shall not employ any person In violation Of the workman's compensation laws of the State of California. I hereby certify that I am roperI licensed as a contractor under SO. FT. the State of California sl ss and Professlons Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that ch lic nses are in full force and ct, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. am exempt from t provi ons oft a State Gal rnie usiness and Professtona C de, slon 3, C apter 9 VALUATION PERMIT FEE s Signature PLAN CHECK S Permittee $ 21 S 3qs TAX S or Authorize Agent DateTOTAL PAID so 17_' a, i a N D M_ �o a _0 M M 0 LL )U Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PENN . TRACT NO, LOT NO. NO. CONSTRUCTION PERMIT �BLDG. f �Jl 5/�B/al BOOC Project Address �t/i4 TY E OF CONSTRUCTION Owner A1! AC ( ' Phone EW ❑ ADD ❑ ALTERATION �- B AddresszaI A El REPAIR El CONVERSION ❑DEMOLISH - , OTHER ZONING REGULATIONS Arch/Eng. es Tcv�o License No,❑ Address '� C4A, A DESCRIPTIDN OF WORK A p 11��//s� ' ZONE PLNG. REF. # Contractor NJSQA1 Phone . a_ YPE OF PERMITTTpp B�t�tILp ING Address (//Ke 'CONTRACTOR ❑GRADING ❑ FDUNDATION ❑STRUCTURALSID SCTAC C LST. YARD LW, PROPERTY LINE LICENSED DECLARATION - ❑,TENANT 1-1ELECTRICAL❑PLUMBING ❑MECHANiCA E YA I hereby affirm that I am licensed under provisions of Charter 9 (tom- RIGHT - mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license is In full fort er REAR YARD (TO P/L) (� PROJECT DESCRIPTION License Class _ License No. PKG. SPACE REO. PROVIDED Date Signature SO. FT. - STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION,TYPE - I hereby affirm that I have a certificate of consent to self -Insure ora VALUATION ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.). _ _ GRADING CU. YDS., ACRES SPECIAL CONDITIONS: Policy No. Company ❑ Certified copyis hereby furnished. REMARKS: - ❑ Certified copy Is filed with the city Building Division. q 'MPTION FROM WORKERS' COMPENSATION DECLARATION Q. i Section need not be completed -if the permit is -for one hundred •• - - . J0) 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 becomePLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. - Date Signature BATHTUBS SHOWERSSo FT NOTICE: If after making this declaration, you should become subject[KIT, TOILETS URINALS GENERATOR 0.1 KW W 1- 1-10 KW ' to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith Comply with such provisions or this permit shall be deemedLAVATORIES DOUBLE LAYS 10.50 APPLIANCE _ + KW - revoked.- - - CONSTRUCTION LENDING AGENCY SINKS DISHWASHERS ! 'MOTORS 0.1 HP 1.10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - SUMPS (INC. SOLAR) 10.50 HP 50 + HP formance of the work for whichthis permit -i issued (Section 3097 Civ, 's Name 1 Lender's {� � e �CC/v FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES e �tlPs✓��%.Ci �aC Lender's Address �U., DRINKING FOUNTAINS GAS TUBE SIGNS I = OWNER BUILDER _ DECLARATION I hereby affir.m.that I am exempt from.the Contractor's License Law for INTERCEPTORS RS CLARIFIERS POLE LIGHTS POOL P TRAP the following reason (Section 7031.5 Business and Professions Code:SWIMMING Any city or county which_ requires -a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION PANELS MAIN =a SUB improve, demolish or repair any structure, prior to its issuance, also re- quires.the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP is licensed pursuant to the provisions of the Contractor's License Law (Chapter .9 (commencing with Section 7000) -of Division. 3 of the WATER HEATERS BTU OUTPUT - - Business and Protesslons Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS - ,, ❑ I, as owner of the property, or my employees with wages as their -,ompensation, will -do the work, and the Strutture is not Intended SOLAR PIPING SYS. ISSUE FEE )ered for sale. (Section 7044, Business and Professions Code: The .ractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE who builds or improves thereon, and who doe$ Such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). - BUILDING - '' ❑ !, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU _ AND DUCTING PERMIT S SMIP $ licensed contractors to Construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK S PERRAiT - andProfessions Code: The Contractor's License Law does not apply to - ISSUANCE. $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $� the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ~ ❑ I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ 00 $ reason _ PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR,ALTERATION TOTAL FEE $ MECHANICAL $ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - 'LESS AO - information is correct. I agree to comply with all City and County PLAN CHECK E VANCE PC $ ordinances and state laws relating to nstruction nd hereby authorize representatives City t e er upon above mentioned property f n p e _moi Signature // _ - FINAL FEE E_S-J� Drivers' Lcen ise or SS ISSUE FEE CMF 0965-46 White -Building; Canary-Appllcant; Plnk-Accounting; Goldenrod -Assessor � CONSTRUCTION AND PLANNING APPROVALS Permit # w Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee ein once 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grin 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn S. Foundation 50.' Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ Undrgrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbong System - Final 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES. 22. Frame and Flashing 23. insulation ` 24. Lathing & Siding ' 25. Drywail Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final - } 28. Final Electric - I 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39, Special Requirements Completed 40. Electric Release to Edison 41, Gas Release to Southern California Gas Co. - - 42. CERTIFICATE OF OCCUPANCY No Date 4 Applicant to fill in all spaces within heavy border lines and, sign all appropriate declarations. CITY OF COSTA MESA NO. TRACT NO. LOT NO. BLDG. NO. FPERMIT CONSTRUCTION PERMIT 375' Project Address j1"P1111J. TYPE OF CONSTRUCTION _ 0873 7/23/81 C4ee4 Owner J. Phone ,NEW E1 -ADD ❑ ALTERATION - .Address - ❑ REPAIR ❑ CONVERSION 0DEMOLISH ZONING REGULATIONS Arch/Eng. License No. ❑ OTHER DESCRIPTION OF WORK A.P. Address ZONE PLNG. REF,+ Contractor ��t Phone TYPE OF PERMIT 7�•pp Ut�1L pINC PRO$ERTY LINE + Address ❑GRADING ❑ FOUNDATION El STRUCTURAL SETBACKL T. StD YARD LICENSED CONTRACTOR DECLARATION I hereby that I am licensed Charter 9 ❑ TENANT ELECTRICAL ❑PLUMBiNG ❑MECHANICA WIl E YARD affirm under provisions of (com- ,',lancing with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code, and my license Is in full forte and effect, REAR YARD [TO P/L) T PROJECT DESCRIPTION Lice 1 s U.canse N.. PKG. SPACE REQ. PROVIDED; Date 3 Signature w i_ Sq. FT. STREET WIDTH PARK FEES WORK RS' OMPENSATION DE RATlO OCCUPANCY CONSTRUCTION TYPE DATE ' I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION ZONE ZONING APPROVED 8Y certificate of Workers' Compensation insurance, or a Certified copy thereof (Se ti 3800, Lab. C.). GRADING CU. YDS- ACRES SPECIAL CONDITIONS: rr y No.�O �%J �fOCompany FA4�''•'rZXSertlfied copy is hereby furnished. w REMARKS: ertified Copy is filed with the city Building Division.MPTION FROM WORKERS' COMPENSATION DECLARATION . 2 O section need not be completed If the permit is for one hundred _ 0) or less). certify that in the performance of,the work for which this permit Is Issued, I shall not employ any person in any man er so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subjectto the Work 5 Compensatl Laws of rnia. Date Slg . BATHTUBS SHOWERS NOTICE: If after making this d la ation, you hould become subject TOILETS URINALS GENERATOR 0-1 KW 1-10.KW to the Workers' Compensation pr ions of the Labor Code, you must TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE -10-50 KW -50 + KW revoked. CONSTRUCTION LENDING AGENCY , KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS - SUMPS - (INC. SOLAR) 10-50 HP 50 + HP - formance of the work for which this permit is Issued (Section 3097 Civ. G.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURE OUTLET WITCH Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for SWIMMING POOL P TRAP POLES METE=RED SUB the following reason (Section 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 re- WATER SERVICE ALTERATION PANELS MAIN SUB - quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE AMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS' BTU OUTPUT Business and Pro4essions Code) or that he is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ❑ I, as owner of the property, or my employees with wages as their F -ompensation, will, do the work, and the structure Is not Intended SOLAR PIPING SYS. ISSUE FEE OQ 'ered for sale. (Section 7044, Business and Professions Code: The 'k� ;actor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY DATE 23 ST who builds or improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden HEATING SYSTEM 0-100,000 BTU of proving he did not build or improve for the purpose of sale). BUILDING PERMIT $ SMIP $ ❑ 'I, as owner of the property, am exclusively contracting with AND DUCTING ' licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK 5 PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE S REFRIGERATION 0-100,000 BTU an owner ofproperty who builds or improves thereon, and who con- PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law), - - 100,000 + BTU PLAN CHECK $ I am exempt tinder Section B. & P. C. for this E]u ELECTRICAL $ $ BOILERS BTU reason PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ MECHANICAL $ I hereby Certify that i have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD - information IS correct. I agree to comply with all city and county PLAN CHECK $ VANCEPC $_ ordinances and state laws relating to construction, and hereby authorize representatives of this City to a ter upon the abovem� enc ed Property for Ins ge tion purpose �3„ FINAL FEE S Signature ate Drivers' License o 5 ISSUE FEE - -Assessor CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # POOL & SPA" Date Inspector APPROVALS Permit a# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. tee ein once 47. Rough Plumbing & Pressure Test fi. Electrical LIFER Gin 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Un i rn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12.. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - E'nal 14. Rough Electric -Conduit 56.. Electrical -.Final / 15. Rough Electric -Wiring - ?rerl(� °L • 57.- Solar System -Final 16. Rough Heating & Air ConditioningFencing & Access Approval 17. Ducts, in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe -Rough & Test= 20. Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. 'Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric f C� 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final ' 33. Gas Service -Final - 34. Solar Domestic -Final 35. Landscape Sprinkling. system 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE~ & BUILDING -- 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY Nb Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLDG. NO. ' CONSTRUCTION PERMIT /�—ti3 .3 ' "Project Addressli`51 AirwayTYPE OF CONSTRUCTION OwnerDonald ffl,,on Phone 61 NEW ❑ ADD ❑•ALTERATION - 1372 Address48003 -Sky Park, I;tp- rIne. ❑ REPAIR ❑ CONVERSION .❑DEMOLISH ❑ OTHER ZONING REGULATIONS 'J.Wf. Arch/Eng. License NO. DESCRIPTION OF WORK A.P. Address - ZONE PLNG. REF. �r Contractor Phon _ W TYPE OF PERMIT- p�pPlll�'TY LINE Address a -Be r' ❑ GRADING ❑ FOUNDATION ❑STRUCTURAL SIDBACK C/L YARD T LICENSED CONTRACTOR DECLARq IpN ❑ TENANT ❑ ELECTRICAL ❑PLUMBING- ❑MECHANICA IIFHT - I hereby affirm that I am licensed under provisions of Charter 9 (com- } mencing with section 7000) of Division 3 of the Business and ❑ OTHER professions Code, and my license is In full force and effect. REAR YARD (TO P/L) License lass a se NO.�_ PROJECT DESCRIPTION PKG. SPACE REQ. PROVIDED �U Date �"�o?1^r! LSignature c i SQ.FT. STREET WIDTH PARK FEE S WORKERS' COMPENSATION DECI. 1 AT{pry OCCUPANCY CONSTRUCTION,TYPE I hereby affirm that I have a certificate of consent to self -Insure or a ' VALUATIONZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 38 Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: Policy No. Company - - - ❑ Certified copy Is hereby furnished. REMARKS: 1� Certified copy Is filed with the city Building Division. r -MPTION FROM WORKERS' COMPENSATION DECLARATION 7P amg� section need not be completed if the permit Is for one hundred 4 0)) or lessi. - I carttfy that n the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation -Laws of California.. _ Date Signature BATHTUBS SHOWERS 'GENERATOR NOTICE: If after making this declaration, you should become subject TOILETS URINALS 0.1 KW__ 1-10.KW tothe Workers' Compensation provisions of the Labor Code, you must TRANSFORMER t + forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_^50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there Is a construction lending agency forthe per- SERVICE SINKS SUMPS Y�I (INC. SOLAR) 10-50 HP 50 + HP - formance of the work for which this permit is Issued (Section -3097 Cl V. C.). y Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES - OUTLETS SWITCHES _ Lender's Address ORINKiNG FOUNTAINS GAS TUBE SIGNS ' OWNER BUILDER DECLARATION - I hereby affirm that 1 am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS SWIMMING POOL P'TRAP the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, POLES METERED SUB WATER SERVICE ALTERATION" PANELS MAIN SUB Improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS SERVICE - AMP Is licensed pursuant to the provisions'of'the Contractor's License Law BChapter_ 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT - - usiness and Professions Code) or that he•is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS - any applicant for a permit subjects the applicant to a'civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS — L ❑ 1, as owner of the property, or my employees with wages as their -,ompensation, will do the work, and the structure is not intended - SOLAR PIPING SYS. ISSUE= FEE - iered for sale, (Section 7044, Business and Professions Code: The L _ractor's License Law does not apply to an owner of a property t - - ISSUE FEE c APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that Such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the.owner will have the burden of proving he did not build or Improve for the purposeof sale). HEATING SYSTEM 0-100,400 BTU BUILDING PERMIT 5 _ SMIP 5 El 1, as owner of the property, am exclusively contracting -with AND DUCTING _ licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK S PERMIT and Professions Code: The Contractor's License Law does not apply to p ISSUANCE $ an ownor ofproperty who builds or improves thereon, and who con- REFRIGERATION 0.100,000 BTU -PLUMBING $ tracts from such'projects with a contractor(s) 11cesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ ❑ I am exempt under Sectlon B. & P. C. for this BOILERS BTU ELECTRICAL S $ reason PLAN CHECK $ MICROFILM'S Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEES. MECHANICAL $ I hereby certify that I have.read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD - Information is Correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC 3 _ ordinances and state lawsrelating to construction, and hereby authorize representatives of this city to enter upon the above mentioned property for i n poses Q /f FINAL FEE $ Signature Drivers' License dWSS f# ISSUE FEE -Assessor CMF 0865-46 white -Building; Canary-AppllCant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # -] Date Inspector I. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement - - 3. Electrical Conduit Utility-Undrgrn 45, Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce _ 47. Rough Plumbing & Pressure Test - 6. Electrical LIFER Grn 48. APPROVALTO COVER-GUNITE" • 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Tray.❑ Undr n 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection _ 54. Heater & Vent -Final 13. Rough Plumbing -' 14. Rough Electric -Conduit •56.. Electrical -Final 15. Rough Electric -Wiring `, 57. ' Solar System -Final 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts, in Structure--99-APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25: Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY , No Date APPLICATION FOR A BUILDING PERMIT Parcel 79-391 Tract Block Lot BUILDING PERMIT NO. Elect Permit No, Building g. - per city Plumbing . Address 3151—BI Airway Ave. Costa Mesa �.—� �/ ` 7 Permit No. Cross W. chanical Area John Wayne Air orT"' Redhill rmit No. Owner Western Pacific Financial Type of Project: ❑ New ter ❑ Addition Address 1601 Dove St. Ne art Beach ❑ Repair ❑ Convert ❑ Der io ❑ Occupancy Pmt. Zip 92660 Phone752-7670 A.P. up.City %so Dista nsp. Area Architect/ SC 010894 Designer Hales -Langston License No. Zane Pi, Pmt, No. Andress 777 S Main Suite 10 Setbacks P/L Front C L St. Street Width Clly Orange Zip 92668 Phone .547-096 Paras Hear Ave Ptoj. Ri ht Engineer License No. Madole &Assoc .- _„_ RCE 48�.—,_ _ ParTg�paGas-� �egtfir'eE ` �I over Address 1820 E. 16th S t . City Santa Ana Zip 92701 Phone 835-254E Struct Height No. of Stories No. of Family LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provisions of Chapter 9 Park Fees res Rev.11rep No C.T. Fee Receipt zoning Approved By: Date commencing with Section 7000 of Division 3 of the Business and Professions Code,$nd my license is in full force and e c 1 License Class +� License Number 5TJ969 Data Contractor J. Donald Olson Company — Misc. Proposed Use of Structure Address .18003 Sky ;;irk Cirr__ _SiliteR- _ --- Tryino_____ (071.4} -Phone 54C)-9606 City and Zip — — 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, Civ.C.). Lender's Name Western Pacific Financial Occ Class Type Const. Code Year USE/OCCUPANCY SIZE SO. FT. Lender's Address 1601 Dave St , Newpart Beach ). OWNER -BUILDER DECLARATION I hereby affirm that i am exempt from the Contractor's License Law for the following reason: ❑ i, as owner of the property, or my employees with wages as their 2. sole compensation, will do the work, and the structure is not Intended or offered for sole. ❑ I, as owner of the property, am exclusively contracting with 3 licensed contractors to construct the project. ❑ I am exempt under Sec. , B&PC for this reason 4• Total valuation Dat- Owner WORKERS' COMPENSATION DECLARATION Encroachment Permit Required Yes ❑ No I hereby affirm that I have a certificate of consent to self •inwra, or acertificate of Workers' Comaenszition Insurance, or it certified Grading Pmt. Grading Required ❑Yes ONO Pmt. No. copy thereof, Policy No Company tilieci copy is hereby furnishe Gratified cop isfited with Date! Applicant Rough Grading Approved 4y: Date CERTIFICA E OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if permit is for 5100 or lessi. I certify that in the performance of the work for which this permit is PERMI r FEES Issued. I shell not employ any person in any manner so as to become subject to the workers' Compensation Laws of California, Dates Aonlicant NOTICE TO APPLICANT: If after making this Certificate of Structural s Pian Check s Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such Provisions or this permit shall be deemed revoked, Electrical $ Special $ Invest, Plumbing s I CERTIFY THAT 1 HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBY RUTH- ORIZE REPRESENTATIVES OF THIS 99UNTY TO ENTER UPON Mechanical s pre -Grade InsoeCtiOn s THE MENTI PROPER FOR INSPECTION PUS- PO $i tore f Applicant or Agent ate Rec. o. s Rec. No. ssruelt s Print Applicant's/Agents Name All spates within this box must be completed to process Plan Issuance Check BY: Approved: CMF 0335-46 (BU -28) rev. 6/80 co c a 7 w n CL CL I I" • - Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESAFrIT �q .; CONSTRUCTION PERMIT G%T' TRACT NO. LOT N . [9LDG. NO. ICY} cj 4 9866 E 2/2+x/61 _ 258.20 _ 1t , Project Address TYPE OF CONSTRUCTION Owner11 Westera Pacific inane al Phone 52_767 UNEW ❑ ADD ❑ ALTERATION ' Address 1601 Dove Newport Beach ❑ REPAIR ❑ CONVERSION EI DEMOLISH 1 Arch/Eng. Tom Campos & ASSOc.License No. ❑ OTHER ZONING REGULATIONS Address 17779-F Main St. Irvine DESCRIPTION OF WORK A. P. -- ZONE PLNTGp. REF. =,f tTenant Contractor '0jJ Phone 540-260 TYPE OF PERMIT PROBP£IF3TY IG{NE Address 3151 Airway-Ave. E:-1 Costa Mesa ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SETBAC' ST. Elp YAR❑ LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed of Charter 9 KI TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANICA YARD under provisions (com• mencing with section 7000) of Division 3 of the Business and, 1:1 OTHER R11GE R GHT Professions Code, 'and my license Is In 11 forte a jAe-(�ct. REAR YARD (TO P/L) PROJECT DESCRIPTION Llcens , ass cense jj77bb / PKG. SPACE REQ. ROVIDEO Date � � Signature ' _�' /7 SQ. FT. ! 7 �� /Jj I/ STREET WIDTH PARK FE£ $ WORKERS' COMPENSATION DECLARATION �I hereby affirm that I have a certificate of consent to sell-insure ora OCCUPANCY,LL-ZCONSTRUCTION TYPE rZ ,_ _ VALUATION ZONE ZONING APPROVED 8Y DATE:: certificate of Workers' Compensation insurance, or a certified copy thereof (Section 3800, Lab. C.). , GRADING CU. YOS. ACRES SPECIAL CONDITIONS: Policy No. Company ' Certified copy is hereby furnished. . REMARKS: ' Certified copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION G 3, This section need not be completed If the permit IS for one hundred {$100) orlass)• 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 'PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation taws of California. DateSignature BATHTUBS SHOWERS UVYLLPONU NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0.1 KW 1.10 KW ^ to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be doomed LAVATORIES DOUBLE LAYS APPLIANCE 10.50 KW—.:-,50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS 0.1 HP 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS .10-50 HP 50 + HP formance of the work for which this permit Is issued (Section 3097 Civ. C.). o Western Padflc Financial. 'Lender's,Name FL'DOR SINKS,., r' i FLOOR DRAINS OUTLETS -SWITCHES' UAB - ' sender's Address DRINKING FOUNTAINS GNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License taw for INTERCEPTORS CLARIFIERS j SWIMMING POOL P TRAP UN METERED SUB the following reason (Section-7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB Improve, demolish or repair any structure, prior to Its Issuance, also re- quires the applicant for such permit to file a signed statement that ne GAS SERVICE OUTLETS SERVICE - AMP Is licensed pursuant to the provisions of'the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ' Business and Professions Code) or that ne is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS ;Y any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS ' ❑ 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 SOLAR PIPING SYS. ISSUE FEE' or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE Z 8 through his own employees, provided that such Improvements are not MECHANICAL PLAN CHECK p.+,A SUMMARY OF FEES Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner will have the burden of proving he did not build or Improve for the purpose of sale). , BUILDING �,,,,�� ❑'I, as owner of the property, am exclusively Contracting witn .1 HEATING SYSTEM 000,000 BTU PERMIT \a E _I � SMTP $ ' AND DUCTING licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to 100,000 + BTU PLAN CHECK $.GL_ PERMIT ISSUANCE $ an owner of property who builds or improves thereon, and who can- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a Contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License, Law). 100,000 + BTU PLAN CHECK s ❑ I am exempt under Section B. b P. C. for this BOILERS BTU ELECTRICAL $ S reason .PLAN CHECK $ MICROFILM $ Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ MECHANICAL S l hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTI PLE LESS AD- information is correct. I agree to Comply with all city and county PLAN CHECK E VANCE PC s _ ordinances and st ws relating [ construct , and hereby authorize representati IS cit to enter up the above mentioned property sp tlOn p o h - ZO Slgnature / wv/�� r�� i (...! ! FINAL FEE,$ Orlvors' License or SS � ISSUE FEE , f �f CMF 0865.46 White-9ulldlng; Canary-Applicant, Pink-Accounting; Goldenrod-Assessor CONSTRUCTION AND PLANNIN APPROVALS Permit # aC� Date Inspector POOL & SPA . APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3, Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER -GUN ITE 7. Footings 49. Electrical Conduit•Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap. ❑ Undrgrn 10. Structural Floor System 52. .APPROVAL TO DECK Property Sewer Line & House Connection 53. Backwash & Receptor -Final Street.Sewer Connection 54, Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit _ �56. Electrical -Final . 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 68, Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POO L/SPA SYST EMS F I NA L 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation 1.2 -36-Y1 b ey aA,, e 5 24. Lathing & Siding Gcl 25. Drywall Nailing 26. Plaster Brown Coat ''7 Electrical Power Meter -Final Final Electric Z9. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33.• Gas Service -Final 34. Solar Domestic -Final 35. ' LandsmpASprinkling 5 stem 36. Sound Attenuation 37. Handicap Regulations 36. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE F OCCUPANCY No Date /Z `3a - N _ Applicant to fill in all I c:4 OF COSTA MESA FPERMIT NO. �,-WNSTRUCTION PERMIT � - - ces within heavy border lines and sign all appropriate declarations. TRACT NO. LOT NO., L G. NO. q/— - _ z -a- uwner , y,P n LS Lj ,�,1 Fhon Address 51V / iILZ-' L:- r�/L �4� 6. �• Arch/Eng. License No. ^. Address COntrectors4^h-� A (a.a Argy., Phori!� (,x), Address Z(E p trx _ '� --A,1714 A nfAr• LICENSED CONTRACTOR DkcLARAFrioisi i hereby affirm that I am iiCen$td under provisions of Charter 9 (Com- mencing with section 7000) of Division 3 of the Business and Professions Code, and 3 license is In full force and If t. License Class C— cp _ License NZ�� Date Signature _ WORKERS' COMPENSATION 4ECLARATtON I hereby affirm.that, I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a Certified copy thereof (Section 3800, Lab. C.). Policy No. C6mpany ❑ Certified copy Is hereby furnished. ❑ Certified copy is filed with the city Building Division, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed If the permit Is for one hundred [$1001 or less}. I certify that in the performance of the work for which this permit is Issued. i shall not employ any person in any manner so as to become Subject to the Workers Compensation Laws of California. Date Signatur® NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such prOvi$iOn$ or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the per- formance of the work.for which this permit Is Issued (Section 3097 Civ. C.). Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Cede: Any city or county which requires a permit toconstruct, alter, improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit t0 file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the Business and Professions Code) 4r that he 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 ($500). ❑ I. as owner of the property, or my employees with wage$ as their sole compensation,'will do the Work, and the structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does hot apply to an owner of a property who builds or improves thereon, and who does such work himself or through his 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 will have the burden of proving he did not build W improve for the purpose of sale). ❑ 1, a$ owner of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who con- tracts from such projects with a contractor(s) lite$ned pursuant to the Contractor's License Law). ❑ I am exempt under Section— B. & P. C. for this reason Date Owner I hereby certifythat I have road this application and state that the above information is correct. I agiy to comply with all city and county ordinances and state I s ! 9 0 c nstructlon and hereby authorize representatives o i to perr~tie above entionetl property for r S S / Signature TYPE OF CONSTRUCTION ❑ NEW ❑ AOO ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑OEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHAN ❑ OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY1 CONSTRUCTION TYPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: PLUMBING PLAN CHECK BATHTUBS SHOWERS TOILETS ' URINALS LAVATORIES DOUBLE LAVS KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMING POOL PTRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS SOLAR TANK COLLECTORS SOLAR PIPING SYS. FIXTURES ISSUE FEE SWITCHES MECHANICAL PLAN CHECK HEATING SYSTEM AND DUCTING 0-100,000 BTUs,,_, 100,000 + BTU REFRIGERATION SYSTEM 0-100,000 BTU— 100,000 + BTU_ BOILERS BTU SYSTEM REPAIR, ALTERATION / EXHAUST SYSTEM MULTIPLE Drivers' Licen o SS ISSUE FEE CMF OB65.46 White -Building; Canary -Applicant; Rnk-Accounting; Goldenrod -Assessor i V 3 9966 12/2B/BI ZONING REGULATIONS A. P. =pF ` ZONE PLNG. REF. REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: ELECTRICAL PAGPERTY LINE PROVIDED PARK FEE $ GATE PLAN CHECK GENERATOR 0-1 KW 1-10 KW _ TRANSFORMER APPLIANCE 10-50 KW -50 + KW _ MOTORS 0-1 HP 1-30 HP — (INC. SOLAR) 30.50 HP 50 + HP , FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS POLE LIGHTS PANELS MAIN - SUB SERVICE AMP F 7.00. TU ISSUE FEE APPLICATION APPROVED BY DATE t SUMMARY OF FEES BUILDING PERMIT $ SMIP f PLAN CHECK $ PERMIT f PLUMBING $ ISSUANCE $ GRADING $ PLAN CHECK 5 ELECTRICAL $ PLAN CHECK $— ` MECHANICAL a_ FLAN CHECK $ S MICROFILM S TOTAL FEE 3 LESS AD- VANCE PC $ FINAL FEE $ CONSTRUCTION AND PLAN NG Date APPROVALS "� ; .Permit # Inspector* POOL & SPA Date Inspector APPROVALS Permit # 1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location-•-=' Soil Pipe-Undr-grn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47, Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pie ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap.❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK ' 1 . Property Sewer Line & House Connection 53. Backwash & Receptor -Final 2. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, Plumbing System - Final 14. Rough Electric -Conduit 156. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17: Ducts in Structure APPROVED FOR PLASTERING 18, Ducts, Ventilating 60: -POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flash in 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final Final Electric �9. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing , 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. c -Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed y 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. - CERTIFICATE OF OCCUPANCY No Date - CRY, Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - - TRACT NO. LOT NO. BLDG. NO. Y OF COSTA MESA PERMIT NO fi r, p ;�CQNSrR JCTION.PERMIT s Project A'ddress315-1 I,QGJ �'� Z` TVPE OF CONSTRUCTION ;_L '_ I Owner ftp � .�� Phone [I 'NEW 0,ApD' ❑ALTERATION r M1 Address `�+ '� - - - ❑'REPAIR ❑CONVERSION ❑DEMOLISH • ❑.OTHE' R.. ZONING REGULATIONS ArChlEng. - License No.-- A. P. ' Address - __ - _- DESCRIPTION OF WORK - ZONE ,PLNG. REF. � Contractor Phone TYPE OF PERMIT - - p - Tp %Lp NLG PROPERTY INE ' Address °r ❑ ❑ ❑ SETBACK C ST. g , GRADING FOUNDATION- STRUCTURAL SI YARD LICENSED CONTRACTOR -DECLARATION ❑ TENANT ❑,ELECTRICAL'PLUMBING ❑MECHANICA SIDE YAR - ^ I hereby affirm that I am licensed under provisions of Charter 9 (com- RIGHT ' mencing with section- 7000)" of, Division' 3 of the Business and ❑ OTHER ! Professions Code; and my license is in full force and, effect. a r REAR YARD (TO P/L) PROJECT DESCRIPTION _ J _ T -- j License Class _ License No.. ,� PKG, SPACE REQ. PROVIDED Dal@ Z- Signature �'>�A y �� l`1'r7•J±`.�<- SQ. FT.'• _ r�1 _- WORKERS''COMPENSATION DECLARA ION OCCUPANCY—CONSTRUCTION-TYPE. STREET WIDTH PRR4( FEE S. I h@reby affirm that I have a certificate of consent to self -insure or 'certificate VALUATION ZONING APPROVED BY r , DATE of Workers' Compensation Insurance, or a certified copy \ thereof (Sectign 3800, Lab. C.). t' ..GRADING C177:YDS. ' ACRES SPECIAL CONDITIONS: 1 - ., ��,�,, Policy No. -Company s&l r�,.:�..f.?L!1 ❑ Certified copy i5 hereby furnished. -- •- T — REMARKS: !" a' '-� • / - - . -_ 1..,. _ _ .,. _ _ '+' - _ r , Certified copy is filed with the city Building Division, EX(WPTION FROM WORKERS' COMPENSATION DECLARATION -- '- - - - - (This section.need not be Completed if the permit is for one hundred - ($1110) or less). I certify -that n tho.performanca of the -work for. which this permlt,W Issued. I shall not employ any person In any manner so as, to become PLUMBING -, 7 �' - PLAN CHECK ELECTRICAL PLAN CHECK, = subject to the Workers' Compensation. Laws of, California. - ,_ _ - -- -_ ,_ Datil Signature BATHTUBS SHOWERS _ _ - .. NOTICE: if after making this declaration, you should become subject'[KIT. TOILETS + ,1., URINALS - GENERATOR 0-1 KW 1-10rKW' to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER f forthwith comply w7th such provisions or this permit shall be deemedLAVATORIES DDUBLE LAYS APPLIANCE' 10.50'KW_- 50'+ KW ' revoked,- - - - ! CONSTRUCTION LENDING AGENCY _ _ _ _ _ _ _ _ SINKS _ DISHWASHERS - _MOTORS 0.1 Hp' _ I -]D HP I herebyaffirm that there is a construction lending Agency for the per- g g y - - r •-� SERVICE SINKS', 1 SUMPS' (INC.,SOLAR } 10-50 HP-- 50 + HP - -- -• - forrhance of the work for which this permit is issued (Section 3097 Civ.'C Lender's _Name FLOOR SfNKS .� FL:OOR DRAINS -FIXTURES"- 'OUTLETS SWITCHES " Lender's Address ORINKING FOUNTAINS GAS TUBE SIGNS - - - ` ` OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031,5'BusineSS'ancl-Professlom Code:- INTERCEPTORS CLARIFIERS � `- - POLE -LIGHTS - - Any city Or county which requires a permit to construct, alter, SWIMMING POOL PTRAP POLES METERED - SUB• improve, demolish-or'repair'any structure, prior to'its Issuance, also re= WATER SERVICE ALTERATfON '"PANELS - MAIN "SUB- quires the apl.liCant for such permit to file a signed statement that he Is licensed -pursuant to the provislons"of the Contractor's License Uw' GAS SERVICE OUTLETS SERVICE y - AMP (Ch$pter 9 (commencing with Section 7000) of Division 3 of the -� ; Bbusiness and Professions Code) -or that -he'IS exempt'therefrOnt and the basis for thealleged exemption. Any violation of Section 7031.5 by WATER -HEATERS- P- BTU'OUTPUT4 ;2 — r -any applicant -for a permlt'-subjects the applicant to a civil -penalty SEWER CONNECTIONSf- Of not more than five hundred dollars ($500). t� _ ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK "COLLECTORS Sole Compensation, will. do the work, and the Str,utture isnot Intended_ or Offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE - - - -Contractor's License Law -does not apply -to an Owner -of a.property-. - who builds or improves thereon, and who does Such work himself or - - - ISSUE FEE t '-APPt:ICAT10N APPROVED*BY -PATE - through his own employees, provided that such-im provementS.are_not- intended or offered for sale, if, however, the buffding or improvement Is Sqld within one.year,of Comptetion, the owner will have .the burden MECHANICAL PLAN CHECK SUMMARY OF, FEES -.+ �• r of proving he did not build or improve for the purpose of sale). ❑ 1, the -am HEATING SYSTEM 0.100,000 BTU_ BUILDING"' PERMIT $ * r -' - - - "- - 5MIP• 3• as owner of property, exclusively contracting• with- __ _ __ AND pIJCTING _ _P _ - -- _ ' licensed contractors to construct the project (Section 7044, Business and Professions Code: -The Contractor's License Law does not apply to 100,000 + BTU PLAN CHECK S - -� p• PERMIT -- ISSUANCE '$ - an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,f1DO BTU PLUMBING $ o 'r I I r; V) -traCts^from such' projects with a contractor(s) licesned -pursuant-to the Contractor's License Law), SYSTEM _ -- - - 100,000 + BTU - - --•^- -- - PLAN CHECK '•S GRADING $ h a` _ _ ❑ I am exempt underect Sion � - � �-- � B. eP. C. for -this redSOn ELECTRICAL S E� .• MICROFILM-$ BOILERS 13 -PLAN C- CHECK - CidSYSTEM Date -._ Owner REPAIR, ALTERATION MECHANICAL-$ k TOTAL FEE $ i Q ,I hereby certifythat I have.read this application and state that the above EXHAUST __ SYSTEM MULTIPLE ' -• LESS AD - Information is correct. I agree to comply with all city and county -PLAN CHECK -$ VANCE PC ordinanCes.and state laws relating to Construction, and hereby authorize + representatives his cit t enter upon the above mentioned ' ,proberty -inspect) n rp 5 -„_ _ - _ , �i•_.+ Slgnat8re at, *7- FINAL FEE $ priVeri' License o - -"" - - ISSUE FEE - - � - - - • �- - -- - - - - - - - - - - CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Golden COd-ASSe SSor e CONSTRUCTION AND PLANNIN / Date APPROVALS Permit # Inspector POOL & SPA,- Date Inspector •, APPROVALS Permit# 1. Temporary Electrical Service or Pole 43. Pool& Equipment Location 41 - 2. SoilPipe-Un rgrn 44. Steel Reinforcement - .S 3. Electrical Conduit Utility-Undrgrn �,. 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test -- -- 6. Electrical UFER Grn 48. APPROVAL TO COVER GUNITE - - - -- 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test. 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.'E] Odr rn 10. Structural Floor System 52. APPROVAL TO DECK 1. Property Sewer. Line & House Connection 53. Backwash & Receptor -Final 2. Street Sewer.Connection 54. Heater & Vent -Final 13. Rough Plumbing;. - 14. hough Electric -Conduit -564 Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 58. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18, Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20.. Roof .Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 3. Final Electric .e9. Final Heating & Air Conditioning - 1 30, Final Gas Pipe -Test 31. Final Plumbing( 32. Water Service -Final 33.- Gas Service -Final 34, Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & 81JILDING 39, Special Requirements Completed 40, Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date OF COSTA M Applicant to fill in alt spares with{n heavy barge IineS and sign all appropriate declarations. 99h2 �. ter- - =`— _ _ _-. _ .- ..,. �. 11.24 �� F NO. / T{��0: LOT NO. SLOG. NO. _ _ - _ .. ct Address - `- TYPE OF CONSTRUC710N, `-a w� s, • 'i er 1 '' - one ❑ NEW ❑ AGri , ❑ ALTERATION -ess r � -* - - •❑•REPAIR ❑-C ONVER51t�A1 ❑DEMOLISH,• '' �_�..-License ''•r•; •' OTHER ZONING REGULATIONS 4/Eng: No. - - OF WORK A.P. ess '- " `- - - __PESCRIP-nON ZONErPLNG.REF.*+ractor G C 4C Phone � phn TYPE OF PERMIT — -- B Tpg t�pING '-- PROP�RTY LIN£`�ess1� n -. ❑GRADING .❑ FOUNDATION ❑STRUCTURAL SETBAc LS LID YARDNSED . CONTRACTOR-DECLARATION•- - --•Q TENANT �EL'ECTRiCAL--❑PLUMBING ❑MECHANICA by affirm that i am liceriseq under provisions of Charter 9 (com- +. r + 51DEYA RIGHTng with' Secifon 7800) of Division 3 of the Business and• OTHER sions Code, antl my license {s In fu(1 force and eff ct. REAR YRRO (TO P/L)P_ROJECT DESCRIPTIONse Class PKG,SPACEREQ. PROVIDED.cG2 - L 5i9natur� " SQ.Ff:' - r+ 1' r r STREET WIDTH PARK FEE $. f WORKERS' COMPENSATION OECLARATIO - -I OCCUPANCY CONSTRUC.T,ION TYPE. affirm that I have a certificate of consent to self-Insure;or.a VALUATION - ZONE ZONING.APPROV,Ep BY DATE - �! .hereby certificate of Compensation Insurance; or -a certified copy _ thereof (Section 3800, Lab. C.). r GRADING CU.',YDS. ACRES SPECIAL CONDITIONS: J Policy No. Compariy - ' -❑-Certified-copy is hereby furnished. .- - REMARKS:- ' ❑ Certified copy Is filed with the City Building Division. Jr. j EXEMPTION FROM WORKERS' COMPENSATION DECLARATION- _ .(This section need•not,be completed if the permit is for one hundred ($100f or less). r - - - - I certify that-in.,the performance of.the.work-for which.thls permit is -PLAN Issued, I shall not employ any person In any manner so as toibecome PLUMBING CHECK ELECTRICAL PLAN CHECK { l subject.t0 the Workers' Compensatlon Laws.Of California.• 'r - -. „ Date Signature; _ BATHTUBS SHOWERSUAHAUL FT. _ , NOTICE: If after making this declaration, you should become 'Subject TOILETS URINALS- '- - - GENERATOR 0-1 KW - - 1-10 KW to the Workers' Compensation provision$ of the Labor Code, you must TRANSFORMER forthwith comply( with Such provisions or this permit shall be deemed LAVATORIES OOUBi_E-LAVS - - APPLIANCE 10.50 KW_50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT, SINKS DISHWASHERS -MOTORS 0.1 HP 1-10 HP I I hereby affirm that there is a Construction {ending agency for the per- SERVICE SINKS SUMPS -(INC. SOLAR{ 10:50 HP_50,+ HP - - - - formance of the work for which this permit is Issued_ (Section 3097 Giv'C.). - - - - Lender.'S Name FLOOR SINKS- FLOOR DRAINS FIXTURES OUTLETS-"SWITCHES as Lender's Address ` DRINKING FOUNTAINS GAS TUBE SIGNS ' - -- - - - r j _ -OWNER BUILDER DECLARATION- - I hereby affirm that I'am exempt from the Contractor's License Law for, INTERCEPTORS CLARIFIERS w -POLE'LIGHTS r- the fol lowing' reason (Section '7031,;S-Buslness'and Professions Code:- SWIMMING POOL PTRAP Any city or county which requires a permit to construct, alter, POLES METERED SUB,, r fi +. improve, demolish-or repair any-structure, prior'to'its issuance;'also re= WATER SERVICE ALTERATION w PANELS MAIN SUB ' quires the apl.licant for such permit to file a signed statement that he < i• + •- is licensed pursuant to the provisions of the Contractor's License-Law-SERVICE- GAS SERVICE SERVICE- - - -AMP -' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and ProTessions Code) or that he is exempt therefrom and the' WATER HEATERS BTU OUTPUT basis for the alleged exemption. Any violation of Section 7031.5 by 'any _applicant fora permit Subjects the applicant to a civil penalty' _ ' SEWER CONNECTIONS of not more than five hundred dollars ($500). + ❑ 1,-as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS -sole.compensation, will do the work,.and.the Structure is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS.ISSUE FEE Contractor's. License Law does not apply to an owner of a Property - - - who builds or improves thereon, and who does such work himself or . - ISSUE FEE - APPLICATION APPROVED BY DATE through. his ownemployees., provided that such Improvements are,not intended Or offered for sale. If, however, the building or Improvement MECHANICAL PIAN CHECK '1 SUMMARY OF, FEES is sold WI thin. one year of. completion,. the owner will have the burden. of proving he did not build or improve for the purpose of sale). the -am HEATING SYSTEM 0-1D0,000 BTU l BUILDING' PERMIT ., - - - - - _ - - - -�_ $ SMIP $ ' as- owner of property, exclusively contracting with licensed AND DUCTING � - - _ - contractors to construct the project (Section 7044, Business and_Professlons- Code: The Contractor's License Law does not apply to 100,800 + BTU PLAN CHECK$ - PERMIT ISSUANCE an owner of property who builds or improves thereon, and who con- tracts from such projects-with -a contractor(s) licesned- pursuant to the Contractor's License Law). REFRIGERATION 0-100,000 BTU- SYSTEM 100,000 + BTU PLUMBING PLAN CHECK $ $ _ - - GRADING $ S - -❑ I am exempt under Section • B.'& P. C. for this BOILERS BTU ELECTRICAL reasonPLAN CHECK $ - MICROFILM $ f Date Owner SYSTEM REPAIR, ALTERATION MECHANICAL _ TOTAL FEE S' S EXHAUST SYSTEM ,I hereby certify- [hat i nave read_ thi$,application and state that the.above MULTIPLE LESS RD-' information is correct.. I ogre to comply with all City and county ordinan s rel g to construction, and hereby authorize_ PLAN CHECK $ - VANGE PC $ _ 4+ repres tatives Of is ci to enter upon the above mentioned grope y_ for - i ction oses +� _ ;i �fr .�/ S19natu Date_ FINAL FEE ... _ Drivers' License or S 'ISSUE"FEE -- - ' - _4• -" CMF 0865-46 White-Building; Canary-Applicant. Pink-Accounting; Goldenrod-Assessor f CONSTRUCTION AND PLANNING APPROVALS Permit :# Date Inspector ��POOL & SPA,,, •, APPROVALS Permit # Date, Inspector 1. 2. Temporary Electrical Service or Pole SolPipe-Undrgrn 43.,f5ol &Equipment Location Steel Reinforcement 3. Electrical Conduit Utility•Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. Steel em orce 47. Rough Plumbing *essure Test 6. Electrical UFER Grn 48. APPROVAL TO COVE R -GUN ITE 7. Footings 49. Electrical Conduit-Undr rn S. Foundation 50.. Gas Pipe, ❑ Undr rn, Test 9. Water pipe-Undrgrn 51. Backwash Lines P -Tr -E] Ondrim 10. Structural Floor System 52. APPROVAL.TO DECK *1. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 2, Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing -55- Plumbing System - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning 5B. Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. . Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing .23.E Insulation 24. Lathing & Siding 25. Drywall Nailing G _Z 26. Plaster Brown Coat 27. Electrical Power Meter -Final 3. Final Electric [9, Final Heating & Air Conditioning 30. Final Gas.Pipe-Test 31.. Final Plumbing -- 32:, -Water Service -Final 33, Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System. 36,• Sound Attenuation 37. Handicap Regulations 38, FINAL STRUCTURE & I)UILDING 39. Special Requirements•Corimpleted 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. -42. CERTIFICATE OF OCCUPANCY `.No. Date - ' S Applicant to fill In all spaces within heavy border line%and sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. BLD N .� -,,C ON PER oZ/ 7oZ' ' =" TYPE OF CONSTRUCTION gs� 2/9r<�� 8•Q(] TSI ❑-NEW ❑ ADD ❑ ALTERATION /� t ct Address Z hon 1_ ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ZONING REGULATIONS ❑OTHER A.P. - ' DESCRIPTION OF WORK ZONE PLNG. REF. � ess Eng, License No. ess r'nmencing acto , C 4 Phon TYPE OF PERMIT - Tp pple ING BACK CIL ST. PROPERTY LINE L7 GRADING ❑ FOUNDATION ❑ STRUCTURAL SIFT YARD ❑'TENANT LECTRICAL ❑PLUMBING ❑MECHANIGA 5 p YARD ' RIIGHT ❑OTHERions REAR YARD (TO P/L) P140JECT DESCRIPTION ' PKC. SPACE REQ. PROVIDED SQ. FT. OCCUPANCY CONSTRUGTlON TYPE STREET WIDTH PARK FEE $ ZONING APPROVED BY DATE '- VALUATION -ZONE - - }- GRADING CU. YpS. - ACRES SPECIAL CONDITIONS: - Ness iy }-- '� SED CONTRACTOR DECLARATION affirm that I am licensed under provisions of Charter 9 (corn- g with section 7040) of Division 3 Of the Business and Code, and y Ilce Is In full force nd effect. R License Class ` (`-' cense o�� DateC Z( Signator -WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to Self-InSure'or a certiflOate Of Workers' Compensation Insurance, or-a certified copy thereof (Section 3844, Lab. C.). Fblicy No. Company 13 Certified copy is hereby furnished. .._ Q Certified copy Is filed with the city Building Division. - REMARKS: ^� CXEMPTION'FROM-WORKERS' COMPENSATION DECLARATION _ - - - (This section need not be completed if the permit is for one hundred - 5100) or less). - 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 PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK - subject.to the WOrkerS'�COmperiSatiOn Laws of California. -. - , BATHTUBS SHOWERS ft Oate Signature TOILETS URINALS -GENERATOR 0.1 KW 1-10 KW TRANSFORMER LAVATORIES DOUBLE LAVS - APPLIANCE 10.50 KW_50 + KW - NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the tabor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked. _ CONSTRUCTION LENDING AGENCY KIT, SINKS "DISHWASHER$ - MOTORS "-0-1 HP' 1-10 HP I hereby affirm that there IS a construction lending agency for the per- formance of the work for which this permit is Issued (Section 3097 Civ. C.). Lender's Name --- (INC. SOLAR) - -10-50 HP 50 + HP ' SERVICE SUMPS 11 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES DRINKING FOUNTAINS GAS TUBE SIGNS _ Lender's Address INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION- I hereby affirm that i am exempt from the Contractor's License Law for the foilowing reaSOn (Section 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 re- quires the api•licant for Such permit to elle a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) Of Division 3 of the QuslneSS and Professions Code) or that he Is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by SWIMMING POOL- PJRAP -LONSI Hut- I MAI POLES METERED SUB WATER SERVICE ALTERATION—, f-� - - PANELS' - 'MAIN _ SUB _ GAS SERVICE OUTLETS SERVICE - ' AMP' WATER HEATERS- - BTU OUTPUT - N SEWER CONNECTIONS Any applicant for a permit 'subjects the applicant to a civil penalty 6l�f not more than five hundred dollars ($500). u 1, aS owner of the property, or my ernployee5 with'vvage5 as their- SOLAR TANK COLLECTORS Bole compensation,, w111 do the work, and the structure is not Intended SOLAR PIPING SYS. ISSUE FEE- or offered for sale. (Section 7044, Business and Professions Coda: The ` Contractor's License Law does not apply to an owner of a_property Who builds or Improves thereon, and who does such work himself or through his own.omployees, provided that such Improvements are not Intended Or offoreq (Or sale. If, however, the building Or improvement is sold, within one year of Completion, the Owner will have the burden of proving he tlitl not build or Improve for the purpose of sale). ❑ I, as owner-of the properly, am exclusively contracting with licensed contractors to construct the project (Section 7644, Business and Profossion$-COde: The Contractor's L)Cense Law does not apply to do owner of property who builds or improves thereon, and who con- tracts from Such projects with a contractor(s) licesned pursuant to the Contractor's License Law). ISSUE FEE APPLICATION APPROVED BY• - - BATE MECHANICAL PLAN CHECK SUMMARY OF FEES BUILDING HEATING SYSTEM 0-100,000 BTU PERMIT $ - SMIP $ AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT - r� ISSUANCE S REFRIGERATION 0-104,000 DTU PLUMBING $ SYSTEM- - _ GRADING S 100,060 + BTU PLAN CHECK $ `] _ Q ❑'I am exempt under-Section B. & P. C. for this reason - - — ` Oat©� Owner ,l hereby certify that I have read this application and. state that the above Informal rr ct, k gree to Comply with all city and county ordin e5 and Ste laws atfng to construction, and hereby authorize - BOILERS BTU ELECTRICAL $.. 5 P LAN CHECK MICROFILM $ SYSTEM REPAIR, ALTERATION $ .1 TOTAL FEE 5' - _ EXHAUST SYSTEM MULTIPLE MECHANICAL 5 LESS AD- --PLAN,CHECK• S VANCE PC ' S _ repr entatives this rty.-to enter upon the above mentioned prop ecti purposes. Slgndtur Date�Z a Drivers' License or S FINAL FEE E ISSUE FEE - - -- - CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting; Goldenrod-Assessor CONSTRUCTION AND PLANNING APPROVALS Permit LJ Date Inspector POOL & SPA APPROVALS Permit Date Inspecto► 1. Temporary Electrical Service or Pole 43, Pool & Equipment Location - 2. Soil ipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms. 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48, APPROVAL TO COVER-GUNITE 7, Footings 49. Electrical Conduit-Undr rn 8. _ Foundation 50. Gas Pipe, ❑ Undr rn, Test ' 9. Water Pipe-Undrgrn 1 51. Backwash Lines P -Trap,- On r 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 2. Street Sewer Connection -3 -Rough 54. Heater & Vent -Final T Plumbing 55.' Plumbing Skste - Final 14. Rough Electric -Conduit - -•56. -Electrical-Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning W. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Praming 21. Roof Sheathing_ - - NOTES: 22. Frame and Flashing 23. Insulation 24. Lathing & Siding ' 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final' RG ?8. Final E=lectric ' 29. Final Heating &.Air Conditioning 30. Final Gas Pipe -Test 31. Final plumbing 32. -Water Service -Final 33. Gas Service -Final 34. Solar bomestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY _ No_ - Date Project Address A¢plicant'ssMailing Address 151 Kalmus Drive K- , CM 9 62 Owner's Name Jay Three PartnershipPhone714-75 -73 1 Address 151 Kalmus Drive K-3 Costa Mesa 92626 Arch/Eng, Ron Yeo, FAIA _ License No. C-3567 Address- 500 Jasmine, Corona Del Mar, 92625 Contractor , sName owner/builder Phone Address (mailing) City License No. 004746 LICENSED CONTRACTOR DECLARATION I herebyaffirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION I Hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 0900, Lab. C.) Policy No. Company eCertified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMOTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($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 s t bac asub" ct tot a Workers' Co pen ti n Laws of Callfo11 r Date Signature NOTICE. -A.' Afer WiVing this dec Ion, y04 sh ecome subject to he Workers' Compensation provisi s of the Labor ode, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ, C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section -31.5 by any applicant for a permit subjects the applicant to a civil aity of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the struCture Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for Sale. If, however, the building or Improvement is sold within one year of Com- pletion, the owner will have the burden of proving he/she did not build or im- r re for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- ractors to construct the project (Section 7044, Business antl Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contract$ for such oroiects with a-ron- tractor(s) license pursuant to ine Contractor's License Law). I am aware the proof 1)f their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date – Owner Ihereby certify that i have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws r i to building construction, and hereby authorize repre- sentatives of th s cit to ante the ab o e-mentionetl property for Inspection purpo s. Signature Date_�� drivers' License or � REAIR TYPE OF CONSTRUCTION NEW ADD ALTERATION P 1:1 CONVERSION ❑ DEMOLISH El OTHER DESCRIPTION OF WORK/USE OF BLDG, tenant improvements 3 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY di CQSTA MESA 1, ' - 3151 CONSTRUCTION PERMIT Ai rwa J-3 FEES PERMIT NO 373 TRACT NO,. P:-rGel 4 LOT NO. 155-1 UNIT NO. A.P. a Project Address A¢plicant'ssMailing Address 151 Kalmus Drive K- , CM 9 62 Owner's Name Jay Three PartnershipPhone714-75 -73 1 Address 151 Kalmus Drive K-3 Costa Mesa 92626 Arch/Eng, Ron Yeo, FAIA _ License No. C-3567 Address- 500 Jasmine, Corona Del Mar, 92625 Contractor , sName owner/builder Phone Address (mailing) City License No. 004746 LICENSED CONTRACTOR DECLARATION I herebyaffirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION I Hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 0900, Lab. C.) Policy No. Company eCertified copy is hereby furnished. Certified copy is filed with the city Building Division. Date Applicant EXEMOTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred ($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 s t bac asub" ct tot a Workers' Co pen ti n Laws of Callfo11 r Date Signature NOTICE. -A.' Afer WiVing this dec Ion, y04 sh ecome subject to he Workers' Compensation provisi s of the Labor ode, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ, C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section -31.5 by any applicant for a permit subjects the applicant to a civil aity of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the struCture Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for Sale. If, however, the building or Improvement is sold within one year of Com- pletion, the owner will have the burden of proving he/she did not build or im- r re for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- ractors to construct the project (Section 7044, Business antl Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contract$ for such oroiects with a-ron- tractor(s) license pursuant to ine Contractor's License Law). I am aware the proof 1)f their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date – Owner Ihereby certify that i have read this application and state that the above Information is correct. I agree to comply with all city and county ordinances and state laws r i to building construction, and hereby authorize repre- sentatives of th s cit to ante the ab o e-mentionetl property for Inspection purpo s. Signature Date_�� drivers' License or � REAIR TYPE OF CONSTRUCTION NEW ADD ALTERATION P 1:1 CONVERSION ❑ DEMOLISH El OTHER DESCRIPTION OF WORK/USE OF BLDG, tenant improvements S E T 13 A Main Building: Front Rear I FEES TYPE OF PERMITS GRADING FOUNDATION STRUCTURAL ® TENANT E4/ELECTRICAL ❑ PLUMBING MECHANICAL ❑ ,OTHER C s Right Left Ping. Ref. PROJECT DESCRIPTION SQ.FT. OCCUPAN v�-- 7 7 CON STRUCTION TYPE VALUATION $ ,O( ZONE GRADINGCU.YDS. -- ACRES -- Meter ❑up to 100 amps Planning Notes: L, SUMMARY OF FEE—SA/I Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee 1 $15 Boiler Duct - Under Ground Duct - Structural 'Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO Heating System & Ducting 00.100,000 BTU ❑ 100.000 BT Reinspection Fee 1 $15 rev. 5/88 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor - 188 Zone Accessory Building: Z O N N G R Parking Req./Provided E Q M S. Reinspection Fee ELECTRICAL FEES DEVELOPMENT SERVICES REQUIREMENTS- Q —��—U'7 MBING FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15.50 KW ❑ 50 + KW r Showers Service Sink Cooking Unit Meter ❑up to 100 amps Sewer Cap SUMMARY OF FEE—SA/I Dishwasher Meter Dover 100 amps 'Sewer Connection BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ .�•: Dryers ❑Gas ❑Electric _ Sub Panel Solar Collectors Fan Motors 00-1 HP ❑ 8 Solar Piping F.A.U. Inc. Solar 09.15 HP C1 16-15+ Solar Tank Fire Dampers ireDa pens Fixtures—Microwave PLAN'CHECK 50% $ MICROFILM $ OC7 MECHANICAL $ �.!„� TOTALFEE Swimming Pool vv/Spa Registers Device Boxes Pole Light Urin Outlets Range ater Closet PLAN CHECK 25% $ (p r 3s Switches—Sign Water Heater 01 0'_02662 I--Ut03 _14 YIDT �T105' Garbage,Disposal Standing Sections Water Service Generator ❑0-5 KW ❑5-15 KW Trash Compactor Auto -Wash Laundry Tra(,s Reinspection Fee $15 Issue BeF$ 9� DEVELOPMENT SERVICES REQUIREMENTS- Q —��—U'7 Issue Fee $ 3 Zoning Approved By '" +`�r—(�1�� Date "Building Approved By Date Application Issued BY Data MECHANICAL FEES Hood or Type I ❑ Canopy Type II ❑ SUMMARY OF FEE—SA/I BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT $ ISSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ Refrigeration System 100,000 BTU ❑100,000 BTUPLUMBING System Alteration Fire Dampers ireDa pens PLAN'CHECK 50% $ MICROFILM $ OC7 MECHANICAL $ �.!„� TOTALFEE Registers PLAN CHECK 25% $ (p r 3s 01 0'_02662 I--Ut03 _14 YIDT �T105' Issue Fee g C2/17!S4 16:29 CONSTRUCTION AND PLANNING APPROVALS Permit # � Date Inspector POOL' A , 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 f �J 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE .7, Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test r .9. Water Pipe-Undrgrnd. r 60. Backwash Lines, P -Trap, ❑.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 fib. Solar System -Final It) Rough Electric Wiring 20 � 67. Fencing & Access Approval � 1,7; Rough Rough Wiring Sign 68. APPROVED FOR PLASTERING �1f8r Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL E1,9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 120. Rough Factory Fireplace 2�1. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil F 23. Gas Pipe -Rough & Test "T 72. Underground Flush 24. Roof Framing 7,3. Undergrnd. Storage Tank ❑ Gas ❑ Oil - J 25. Roof Sheathing) jj X74. Overhead Hydro 26. T -Bar Ceiling (Structural) &'Moriocoat 75. Dry Chemical _ 27. Frame and Flashing" `. 76. Dry Standpipe 28. Lathing &)Siding ' 77. FIXED SYSTEM FINAL 29. Insulation 1' ^ i 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT.. R EQUIR EMENT! 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric yi �1��"-$q Notes: /L 34. Final !-!eating & Air Conditioning � � ( C 35. Final Gas Pipe -Test + 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service -Final 1" 40. Gas Service -Final i r 41. Solar Domestic -Final 42. Backflow Preventer • F i,'i.l� �{ ',� t a n 43. Backflow Irrigation F ''• 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ; 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date Y f heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO, LOT ND. UNIT NO, CITY OJ� COSTA MESA CONSTRUCT PERMIT � 3-11 33 � A.P. # Project Address ��1/q��%�� J�� Applicant's Mailin Address Jif- LATA;S DLA4`� QM Owner's Na`1ne {�w, (� ne ITflo Address i��# DQ_ 9`S CA rn C Arch/Eng, �:f License No, e'— Address Contractor's Nam Phone Address (mailing) City License No. 4 LICENSED CONTRACTOR DECLARATION I herebyaffirm that I am licensed under provisions of Charter 9 (commencing with section 70001 of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class License No, Date Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate '} Workers' Compensation Insurance, or a certified copy thereof (Section A0, Lab. C.) eolicy No. Company eCertified copy Is hereby furnished. Certified copy Is filed with the City Building Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit is for one hundred ($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 �vs of California. Date Signature , NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provision4 of the Labor Code, you must forthwith comply with such provisions or this permit Shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she Is exempt •efrom and the basis for the alleged exemption. Any violation of Section 1.5 by any applicant for a permit subjects the applicant to a civil ally of not more than five hundred dollars ($500). LJ 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 (Section 7044, Business and Professional Code: The Contractor's License taw 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- r e for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- ' ra tors to construct the project (Section 7044, Business and Professions Code: ` The ContiiAor's License Law does not apply to an owner of property who builds c. mproves thereon. and who Contracts for such Droiects with a can- tractr,.(s) license pursuant to the Contractor's License Law). I am aware that ; prrjf of their Worker's Compensation insurance should be provided to me, I am exempt under Section B. & P. C. for this reason Date+ ' Owner I hereby Certify that I have read this application and state that the above information is Correct. I agree to Comply with all city and county ordinances antl state laws r Fdtrl�g to building Construction, and hereby authorize repre- sentatives of t is It to on the a ova -mentioned property for inspectionurp Date Signature Drivers' License or SS 4k TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR 7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TYPE OF PERMIT 0 GRADING El FOUNDATION 11 STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ, T. OCCUPANCY CONSTRUCTION TYPE v VALUATION $ l♦�� _ ZONE GRAOINGCU.YDS. ACRES Remarks: S Main Building: Accessory Building: E T Front A Rear C Right K S Left Ping. Ref. Parking Req./Provided Planning Notes: Zone O N 1 N G R E Q M T S. Reinspection Fee 1 $15 0865-46, rev. 5188 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee f $ 3. 01 CGC125431—G302543 T011' aarE. �v� ��2� Yi111;: 1J:v1 ELECTRICAL FEES PLUMBING FEES Automatic Washer Construction Pole Sub. Transformer ❑ 15.50 KW ❑ 50 + KW Bar Sink Showers Backflow Preventer Service Sink Cooking Unit Meter Cup to 100 amps Backflow irrigation Sewer Cap Dishwasher Meter ❑over 100 amps Bathtubs Sewer Connection Dryers ❑Gas ❑Electric Sub Panel " Clarifiers Solar Collectors Fan Motors ❑0.1 HP 01 i6 - B Dishwasher Solar Piping F.A.U. Inc, Soler 09-15 HP Ell 6-15+ Drinking Fountains Solar Tank Fixtures Microwave Floor Drains Swimming Pool w/Spa Device Boxes Pole Light Floor Sinks Urinal Outlets Range Gas Service Outlets Water Closet Switches Sign Interceptors Water Heater Garbage Disposal Standing Sections Kitchen Sink Water Service Generator 1:10.5 KW ❑5-15 KW Trash Compactor Lavatories Auto -Wash P -Trap Laundry Trays Roof Drains Reinspection Fee $15 Issue Fee S 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date .- Application Issued By _ _ rtat Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES Boiler Hood or Type I ❑ Canopy Type II ❑ SUMM BUILDING PERMIT S PLAN CHECK S PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ F FEES SMIP $ �r— PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ r7 TOTAL FEE $ , Duct -Under Ground Duct -Structural Refrigeration 5y stem ❑0.100,000 BTU 0100,000 BTU Duct - Ventilating Exhaust System ❑ Multiple ❑ System Repair/Alteration FirepllFact.Bit. ICBO# Fire Dampers Heating System & Ducting ❑0.100,000 BTU 0100,0006 Registers Reinspection Fee 1 $15 0865-46, rev. 5188 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee f $ 3. 01 CGC125431—G302543 T011' aarE. �v� ��2� Yi111;: 1J:v1 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POO[ PA APPROVALS Permit # J r_ Date_ Inspector 1: Temporary Electrical Service or Pole 52. Pool & Equipment Location = 2. 50il Pipe-Undrgrnd. 53. Steel Reinforcement ; 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ! 4...Electrical Con jui t-Undrgrnd. 55. Electrical Bonding 5. 'Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6.'.Elect ical,UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. ,Footings t 58. Electrical Conduit-Undrgrnd. 8.1 Foundation 1 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnri. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. I 10, Structural Floor System 61. APPROVAL TO DECK 11. Property: Sewer Line & House Connection 62. Backwash & Receptor-Finaf 12. Sewer Cap,) _ 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing r 65. Electrical -Final 15. Rough Hectrical-Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 1-7., 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 APPROVALS Permit # 120. Rough Factory Fireplace - 21. Ducts, in Structure r 70.. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & T- 7 2. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. FINAL 30. Drywall Nailing -� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat �. 79. FINAL INSPECTION 32. Electrical Power Meter Fina! 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: Z_-1 Ck 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 r 1 43. Backflow Irrigation 44• Landscape Irrigation System j 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING Z! 48, Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co r I 51.' CERTIFICATE'OF OCCUPANCY No. Date ��_ 6City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE O F OCCUPANCY No. O C S1 647 P. O. Box 1200 Costa Mesa, California The Building located at 3151 ATRL4AV AVM31F� C"Tw aic—grin has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B=2 -__ Occupancy. Use of Building OF'F'7t�i: Legal Description 422-291—jr, (See reverse side for Metes and Bounds) Building Permit No-1;:nln Electrical Permit No. Plumbing Permit No.ap—L7000 Mechanical Permit No. 14-13682 Number of apartments and/or guest rooms ISSUED TO.: Building Official -Z, (1]T .DRC%T].gF- rn>Mtrmammg by 3151 AliMAY AVE., OE -1, COSTA MESA, CA. Date 6/-�l��`7` This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 {e} U.B.C. CMF 1015-46 rev. 1/83 White • Owner; Canary - Numerical File; Pink - Bldg. Permit File M City of Co.sta,Mesa Development Services Department Building Safety Division C E R T I F I C A T E OF OCCUPANCY No. U V U O P. 4. Box 1200 Costa Mesa, California The Building located at 3151 AIRWAY AVENUE UNIT K-111 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Fi-2 Occupancy. Use of Building CtFFICE Legal Description 427-291-15 (See reverse side for Metes and Bounds) Building Permit No, EP -1597 5 „ „Electrical Permit No. F,1 1-3988 Plumbing Permit No. IRP -1 1;471; Mechanical Permit No. M-1 Number of apartments , and/or guest roo�mjs ISSUED TO: Building Official 3151 AIRWAY AVE. OE -1. COSTA MESA, CA. Date This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/63 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File 1 City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. O U (J u P, 0, Box 1200 Costa Mesa, California The Building located at 3111 AIl&W 61,. '. #IK -105 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group r3-2 Occupancy. Use of Building 427=2_91-15' GFF'I(T_ Legal Description 421-291-1i__ (See reverse side for Metes and Bounds) Building Permit No A Electrical Permit No.lr-1 487 Plumbing Permit No. P--irnnA Mechanical Permit No. M-1621-2Number of apartments and/or guest rooms ISSUED TO: GUI%DH*OUSE CONSLILTANTS. LTD. BuildingOfficial -`! �L r CL by e 3151 Ann y ogE i.. l osA rA. Date 29 DCZ, This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White -owner; Canary - Numerical File; Pink - Bldg. Permit File r -I CITY OF COSTA MESA BUILDING DIVISION k i 77 FAIR DRIVE, COSTA MESA, CA 92626 • (714) 754-5273 - Fax (714) 754-4856 - www.ci.costa-mesa.ca.us ` FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00281 PERMIT TYPE B_R00F2 APN: JOB ADDRESS: 3151 K AIRWAY AV CM Vicinity: BUILDING K ROOF Squares: 0 STATUS: ISSUED DATE ISSUED: 11113/2009 ISSUED BY: RMD Suite/Unit: K Valuation: . $16,832.00 SCOPE OF WORK: REROOF $UILDING "K". TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 15 FELT ON A 812 2 PITCHED ROOF AND REROOF WITH 40 YEAR RIBERGLASS SHINGLES ON COMMERCIAL BUILDING, APPROX 40 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: CORP OF THE PRESIDING BISHOP CHURCH OF LDS Address: PHONE: C4/State/Zip: APPLICANT: HANSEN, DUKE Address: N6646636 PHONE: 714-412-7223 City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC Address: 260 E ALTON AVEUnit: CitylStatelZip: SANTA ANA, CA 92707 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plant Check: $0.00 Reroof Permit Fee: $279.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $280.25 License No. License No. PHONE: Unit: Unit: License No. 327802 714-557-7440 CELL: PHONE: PHONE: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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 renal approval will result in the expiration of this permit, COOP =, INSPECTION TTP(; DATE 1"TIAL f&DE A INSP CTION TTPAQATE NiMAL 1816 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Root 210 Final Electrical 201 Final BlocklRetainirlg 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 WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a c@rlifcate 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��e�` ( Dia socr on need not be completed a the penrw is valued at &* hurr*ed dotars (5100) dr less,) Poljcy, Number: I certify that in the performance of the work for which this permit is sued, 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 th a r Code, I hall forthwith comply with these provisions. Appic mature Date 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 DOLLARS ($100,000), IN ADDITION TO THS, 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 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. Classr4_C,3!G '--Contractor'sSignature C;:_--0ate#, CONSTRUCTION LENDING AGI=NCY: ❑ 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 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 ($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 4n 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.). ❑ 1, 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 3057-46 (3107) Owner ID verified by drivers 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. Applicant's Signature Division of Industrial Safety Permit Number: _ Date 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? ❑ 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? ❑ Yes ❑ 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 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? ❑ Yes ❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ Yes ❑ No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for iron -residential building permits). 6. Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries ofa, school? ❑ Yes ❑ No (if 'yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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. Signal I Legal Owner(s) Date �� A MFZW Applicant C::�te� (714) 754-5273 • Fax (714) 754-4856 CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT .lob Address: 3151 AIRWAY AV Suite No Vicinity: SUITE 'K' Parcel Nunmber: 42729114 Applicant: NOCK, RON Address: Owner: ,HOULIHAN, MICHAEL" Address j %� �� "�.- r } Phone_ Contractor. ".NOCK•,PLUMBING Address: ' 11612 KNOTT 5T r. Zip: .. GARDEN GROVE, CA,' , PLUMBING PERMIT Phone: Zip: Phone: Zip: PERMIT NUMBER P98-00724 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 0924/1998 Issued: 0924/1998 i Phone: 714 895-1246 tel. Zip:,, 92841 License: 707775 - Arch l Eng: Address: f r } Phone_ �. Zip: .. . ' License: w - -SCOPE OF'PERMIT ' INST WATER HEATER. Y FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE ' $22.00 Laundry Tub/ Washer , . $0.00 0 Sump Pump $0.00 0 Backflow irrigation $0.001, 0 Landscape irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00; 0 P -Trap $0.00 0 Trap Primer $0.00 0 Bathtub $0.00 '0 Pressure Regulator $0.00-' 0 Urinal " $0.00 0 Clarifier System $0.00 \` Q:' Process Piping (per 10 ft) '10,00'. 0 Vacuum Brkr Bkflow(i-4) $0.00 0 Connect (ice,Soda;etc) $0.00 '0, -Receptors $0.00 0 Vacuum Brkr BkfTow(5+) $0.00 0 Dental Units .$0.00 0 �`; - .,Septic Tank: $0.00 0 Wash Basin i $0.00 0 Dishwasher $0.00 0- Sewer Cap for Demo - $0.00 .0 - - Wash Basin Set $0.00 0 Drain, Floor _$0.00 0 Sewer Connect _ $0.00 0 Waste and Vent System $0.00 0 Drain, Rainwater $0.00 ` 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Drain, Root $0.00 0 Shower $0.00 0 Water Heater / vent $11.00 1 Drinking Fountain $0.00 01 Sink, bar' .$0.00 0 Water Piping (Inst or Rep.) $0.00 0 Expansion Tank $0.00 0 Sink, commercial $0.00 0 Water Re -pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas (1-4 outlets) 50.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Gas (Over 4 outlets) $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa (public) $0.00 0 PLAN CHECK $0.00 Interceptors (Grease, Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors (Sand Auto ) $0.00 0 TOTAL CALCULATED FEES: $33.00 COMMENTS l 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 fins] approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 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. 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' componsatIon II < ranye_carri"rd-pplicy number are: L� / Carrier. _ _ — Us/-�0 ? jj�J Policy Number. 61 T ! � 7 (This section need not be completed it the permit is valued at one hundred dollars ($100) or lass.) ❑ 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 Califomia, and agree that if I should become subject to the workers' componsatlon provisions of Section 3700 o1 the Labor Code, I shall forthwith comply with these provisio , Applicant Signature: `l `� ____ __ Data: WARNING: FAILURE TO SECURE WO (ERS' CAMP TION COVERAGE 15 UNLAWFUL AND SHALL SU13IEC r AN EMPLOYER TO CRIMINAL PENALTIES AND CAVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDMON TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed un provis' of ter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In full force and effect. Lic. p Class p,� Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency lot the performance of the work for which this permit is Issued. (Sec. 3097, Civil Code). Lenders Name: Lender's Address: Signature: Data: 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 ($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 contractors) 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 ❑ No Drivers License No. Expires: Verification of Ownership by (type of document,-i.e. - property tax bill or dead): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ 1 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, scaflolding lelsework, 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). I ❑ As owner -builder, I will not employ anyone to do work which would require a permit from the Division o1 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? ❑ Yes ❑ No (Section 25505 of the Califomia 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 ❑ No (Section 25533 of the Califomia Health and Safety Code, with some excaptlons, 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). ..... ........................................... I,.................................................................................................................................................................................................-..................... 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. ..................................................................................................................................I...I...I...........-............................................................. 4 If an RMPP Is presently required, has Section 25534 of the California Health and Safety Code been fully complied with? ❑ Yes ❑ No ...................... ... ......................................... .................................................................................. ........... ................. ................................... ......... ........................................................ 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication 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? L] Yes I No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be furnished on applications for non-residential building permits). ...............r---•l----------- .......-.....--r-m..-6---------.............-.............................;u-n....--•--..-................................................................... ....................... 6 Will any pall of the facility 10 be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑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 Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ 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 ell state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Data: 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. 1 net a Of Legal Own ) Date And/Or Authorized Applicant Date COOS L INSPECTION TYPE 2AM CODE I 1N9PECTIONTYPE IIAIE 1l�ALS 1616 ' Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing y'�3,_gj �TY 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 2446-4a J Job Address: 3151 AIRWAY AV Status: ISSUED Suite: Applied: 02/09/2007 Vicinity: EAST STAIRWAY OF BLDG K Issued: 02/098007 Primary Occ: Type of Construction: V -N Parcel Number: TPNO07003 Zoning: Applicant: JON HASTINGS Address: 34145 PACIFIC COAST HIGHWAY UNIT 520 Phone: 949-292-3567 DANA POINT Zip: 92629 ISSUED BY. Owner. CORP OF THE,PRES IDING BISHOP CHURCH OF LDS _ Address CIO JOHN WAYNE'EXECUTIVE GUILD OWNERS AS COSTA MESA, CA - Phone: 714-540-5568 3151 AIRWAY AV SUITE K101 Zip: 92626 Contractor:" ' JOWHASTINGS CONSTRUCTION INC - Address:/',34.145 PACIFIC COAST HIGHWAY -,� Phone: 949-292-3567 UNIT 520' 'ter, � ` r DANA POINT;� j' .' Zip: 92629 License: 392715 Eng: Address: ,' , , '�,' Address: _ Phone: Phone: Zip:_ ,'r %�- - License-, License: SCOPE OF PERMIT/ 'BUILDING K I �r ` REPAIR EXISTING EXTERIOR STAIRS'ON.THE EAST SIDE OF BUILDING K. WORK TO INCLUDE REMOVING ROTTED STAIR STRINGERS AND REPLACE.WITH EXACT SAME MATERIAL AND DESIGN, ' L ) FEE SUMMARY Plan Check: $0.00 = - Calc Valuation: $3,750.00 -Permit: $97.25 ` :, Claim Valuation: $3,750.00 SMIP Res: $0.00 ` SMTP Com: $0.79 --- — -- �� -Other:',,$0.00- N Inspection: $0.00 % Total:. 598.04 ,=4 -%PLANNING & ZONING SETBACKS _ ; MAIN STRUCTURE Front, 0 '0�� t: 'r ' 'Rear 0- 0 Left 0-0 Right 0= 0 ACCESSORY :\ Front 0-0 Rear 0-0 Left 0-0 Right • 0-0-, PARKING �\�-Existing //0',, Re uire •�'�-.0� Proposed: 0 21 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or 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) 7545626 2446-46 (6=) DECLARATIONS WORKERS' COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the fallowing declarations: ❑ 1 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 Iwork for which this permit is Issued. 01 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 pensation Ins rence carrier and policy number are: iCARm -. 1(Thls section need not be completed it the permit is valued at one hundred dollars (5 f 00) 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 It I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with these ons. T Applicant Signature: Det q l D� WARNING: FAILURE TO SECUR KERS' OOMPENSA ON COVERAGE IS UNLAWFUL AND SHALL SUEUECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), 1N ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3700 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licenseA under pr visions of Chapter 9 (commencing with Section 7000) of Division 3 of the Businest5nd Professions Code, and my license is In full force and effect. Lic..11. 3 "[ a7 /rrl n Contractor's Slgnature: toa 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 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 ($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 Professlons 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.). ❑ 1, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Business and Professions Code: The contractors Ucense 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 10 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: ❑ 1 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-bullder, 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? ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Pian 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). _.......w ----.....------ ................................... _ _ _ ............... __......_. — _-.........— .................. . _ .-.-•--...................--.-----.............................................._._ 2 Does or will the applicant or present or (utura building occupant need to file a registration farm for acutely hazardous materials? ❑ Yes ❑ 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 and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. ..........................................._._...._.._—._.w......................................._-e---........ r'n-.....H,"a.....-- -.."-d"............. C—ode" ....e"o-.............................................................e,...............................................................................,...... 4 it an RMPP is presently required, has Section 25534 of the California Health and 5afery Code been fulky, complied with? ❑Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication aPPermil for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes LJ 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 constructed of the facility to be constrted under this permit be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No (it 'yes', the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ No ............... —_.._.......................... ....................................._........... ......—....................................................................... .............................................................................................. 8 (I1 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. Slgnature: Data: 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. $iQnature Of Legal Owner(s) n Data Andlp� orized�Appllcant -� "t Pate.- CODE ateCODE I. 1NSPEQ112N TYPE p6I1: INS CODE 4 INSPEOWLTYPT 1 1�6IE 1NTITIA45 1616 Fixed System Final Fire Prevention 206 Final Mechanical J 1266 Pool Spa Final 208 Final Plumbing 200 Final Re -Roof 210 Final Electrical 201 Final Block/Retaining Well 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 _ ,?99,,3 Applicant to fill ;mall spaces within heavy bordelr lines and sign all appropriate declarations. - CITY OF -COSTA MESANO. TRACT NO. O. BLDG. NO. L T - :CONSTRUCTION PERMITDcyr,_;,s-ge Project Addre&s- rr / .S/ ,D P F corusrRucrloN 1 Own �(�� Phone NEW ❑ ADD ❑ ALTERATION 6i 43 5/2tI/B� 137.00 TL AddresL3/,j C - ❑ REPAIR CONVERSION ❑DEMOLISH `❑ ❑ ZONING REGULATIONS Arch/Eng. - _� -. License No. OTHER Address DESCRIPTION OF WORK A.P. � - - `ZONE-PLNTFG.. REF. #_ . r '� ContractoPhon TYPE OF PERMIT. YLDYNG ' SET Address �'- r❑ GRADING ❑ FOUNDATION ©-STRU�C,TTUU AL AC T. PRO IID WARD LICENSED CONTRACT6R DECL AT a Qom.' 'D TENANT ❑.ELECTRICAL ❑PLUMBING. +iSMECHANICA 1 hereby affirm thLt I am licensed under provisjons of Chprtbu9 (c RIGgIEpE YARD HT mencing with section 7000) of Division 3' of thq,' usine ntl ❑ OTHER1 Professions Code, nd IEcen Is i full a ct " REAR YARD (TO P/L) " �fr"C _ ROJEC7 DESCRIPTION-` License Cla Lice s �PKG. SPACE REQ. PROVIDED Date - Slgnat WORKERS' COMPENSATIO ARATI N FT' OCCUPANCY - CONSTRUCTION TYPE -STREET WIDTH --.,.PARK FEE $ 1 hereby affirm that 1 have a ificate of consent to self-insur ora UATION ' ZONE ZONIN;G'APPROVED BY DATE i certificate of Workers' Compensation .Ensu ance,,,or a_ceerrtiified copy,kGA •eof (SerL3$ - Loh-,� Company 'f{�l�lr -y'No _ - - DING CU. YDS. ACRES _ -SPEC IA'L CONDITIONS: ,.�o � Ce titled copy. ls-hereby furnished.ARKS: 'L? Certified copy Is filed with the city Building Division- EXEMPTION FROM WORKERS' COMPENSATION DECLARATION av (This section need not be completed if the permit is for one hundred ($100) or less).ICertify that n thelperformance of the work for which this permit IsIssued, -1 shall" not -employ any person In 'any manner so -as to'becomeBING,_,, .`, PLAN CHECK .-ELECTRICAL PLAN'CMiECKsubject to the Workers' Compensation Laws ofCalifornia.'- "- Date._ Signature TUBS -SHOWERS-' _GAR T - -NOTICE: If after making this declaration, you should become subjectETS .,URINALS- - ;` -- - aGENERATOR 0.1 KW-'1J0,KW to the Workers' Compensation provisions Of the Labor Code, you must rTRAN5FORMER .forthwith -comply with such provisions or this permit shall be deemedATORIES DOUBLE -L -AVS -- - - - -- -,APPLIANCE ---10-50-KW;50 + KW- -- reyoked. CONSTRUCTION"LEf4 ING AGENCY - -" ` KIT. SINKS -- ---DISHWASHERS--- + - - -.MOTORS-- 0-1 HP- I hereby affirm that there is a construction lending agent for the per- SERVICE SINKS -, SUMPS - ,,..• � _ !(INC..SOLAR). 10 -50 -HP 50 + HP�r''' - - formance of the work for which this (y permit Is issued Section 3097 _ 1 Civ. C.). -- -- - - -- Lender.'s Name FLOOR SINKS- FLOOR DRAINS--- -"' FtXTURES - OUTLETS SWITCHES - - Lender's Address+ -- DRINKING FOUNTAINS - - - - -'GAS TUBE SIGNS -- OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS" ' - CLARIFfERS '"- .. POLE LIGHTS _• - the -following reason (Section 7031.5 Business and Prof essions.Code: Any city or county which requires a permit to construct, alter, SWIMMING POOL - •P -TRAP -` - - . POLES � METERED __SUB-_ - - improve, demolish or repair any structure, prior to its issuance, also re - WATER SERVICE -- ALTERATION 'PANELS- - - -MAIN --^-- SUB --- - - - quires the aptlicant for such permit to file a signed statement that he •� i is licensed• pursuant to.the.provisions Of the. Contractor's License Law GAS SERVICE OUTLETS - -�- SERVICE - - - AMP �C;papter 9 (commencing with Section 7000) of Division -3 of the WATER HEATERS BTU OUTPUT -� -- --- - -- --- _ fess and Professions Code) or.that_he is exempt -therefrom and the - 1 -,for the alleged exemption. Any violation of Section 7031.5 by - permit applicant. -to a civil . �i'sappliwnt_fn a -penalty of 'hat more than five hundred dollars ($500). SEWER CONNECTIONS-- -- - - - -i El -I; as -owner of the property; or -my employees witn-wages-as their-, SOL -AR -TANK,- - -COLLECTORS------ - ��~ - sole compensation, will do the work, and the structure is not intended •' -� "SOLAR PIPING SYS. ISSUE -FEE - - or offered -for sate. (Section -70447 Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE -" -"-' '-` ' -- APPLICATION -APPROVED BY - -- - DATE -- who-blUlld$ or Improves thereon, -and who does such work himself or through his own employee$, provided that such improvements are not - MECHANICAL - PLAN CHECK - - ' ` SUMMARY OF FEES• . Intended or offered for-sale.-If,'however; the'bullding or improvement is sold within one year of completion, the owner will have the burden of -'proving he did -not build or Improve for the-purpose� ot•sale). © -- HEATING SYSTEM 0-]00,000 BTU - #BUILDING - - - - - --- - - - -• - - - �. PERMIT $ '• SMIP . - $ I,-as.owner-of the -property, am exclusively,_ contracting with licensed contractors to construct the project (Section 7044, Business AND DUCTING 100.000.+ BTU - f r, and -Professions Code: The.Contractor's.License, Law,does not apply to- IPLAN CHECK $ PERMIT. >, , - ISSUANCE $ an owner of property who builds or improves thereon, and who con- tracts -.from such projects with a_contractor(s) licesned .pursuant to, REFRIGERATION 0-100,000 BTU SYSTEM i "- - PLUMBING $ - r . GRADING S the Contractor's License Law). r. 100,000 +BTU _ 0 PLAN CHECK S -' ❑ I am exempt untler•Section B. & P. C. for -this - - r $ BAILERS BTV r ELECTRICAL '$ reason Date Owner _ SYSTEM REPAIR, ALTERATION $ MICROFILM S PLAN CHECK J TOTAL FE_ E S ' I hereby certify that I h Cad this applicati state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL E O. LESS AD r lihformation is c I gree to, c with alt City and --county ordinances an to I w elating nstructi and hereby authorize PLAN CHECK S 'VANCE PC, S representati Of • -city enter the above mentioned property r ins ion p o s -g ��j�� I FINAL FEE ISZa> Signatur ISSUE FEE } 3 _ $ Drivers'" se or SS ren -Assessor � � �A, w • - CMF 0865-46 White -Building; Canary -A nt; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS r• Permit# r �� 't i, Date Inspector POOL & SPA 1�0APPROVALS ��Pe�mit;#�r�_ t� Date . $nspectoc 1. Temporary Electrical Service or Pole 43. Pool & Equipment cat r: 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn 46. Electrical Bonding b. Steel em orce 47. Rough Plumbing & Pres'sur'e.Tesil 6. . Electrical UFER Grn _ 48. APPROVAL TO COVER GUN ITE-,'f- TE",''-`7. 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50: Gas Pipe, ❑ Undr rn,-Test',-. 9. Water Pipe-Undrgrn '51. Backwash Lines P --Trap, ❑ ndr 'r'n �•.• ~ - 10. Structural Floor System , 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection_ 53. Backwash & Rece tor,Final 12. Street Sewer Connection 54, Heater & Vent -Final I;- cam.- rxl� .�. 13. Rough Plumbing ' 14. Rough Electric -Conduit - •56. 'Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning Fencing & Access Approval 17. Ducts, in Structure O -U. -APPROVED FOR PLASTERING 18. Ducts, -Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathin NOTES: , 22.- Frame and Flashing 23, Insulation 24. Lathing & Siding 25. Drywall Nailing 26, Plaster 8rown Coat 27. Electrical Power Meter -Final 28. Final Electric - - 29. Final Heating & Air Conditioning - 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final - 33. Gas Service -Final 34. Solar Domestic -Final ' 35. Landscape Sprinkling System 36.-5 Sdund Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING ' 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co.. ', `� �• 42. CERTIFICATE OF OCCUPANCY 11 No " Date- .. ^ t' T Li II Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA*[MESA1 P IT N TRACT NO, LOT NO. t BLDG. NO. - CONSTRUCTION PERMIT Yom'Me7 R 3569 7/21/82 9p•00 Project Address 3151 Airwa , Costa Mesa, CA TYPE OF CONSTRUCTION } Owner J Donald Olson Phone 54Q-26Q ❑NEW ❑ ADD ❑ ALTERATION Address 3151 Airway,Costa Mesa CA 92626 ❑ REPAIR ❑ CONVERSION ❑pEMOLISH LJOTHER ZONING REGULATIONS 1� Arch/Eng. License No. DESCRIPTION OF WORK A. P. Address .ZONE PLNG. REF. =P V fAntractor Leaverton-Beck, Inc. Phone 979-356 TYPE OF P1 RMIT SBUILDING ETBACK T;- Tp Bt�ILF NG PROPERTY LINE - Address 16721 Hale Irvine CA 92714 ❑ GRADING ❑ FOUNDATIO ❑ STRUCTURAL SIFT YARD l LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL�JLUMBING ❑MECHANICA that I licensed of Charter 9 (com- 5IpE YARD` I hereby affirm am under provisions men Ong with section 7000) of Division 3 of the Business and ❑ OTHER RIGHT Professions Code,C],n9 my license is in full force 1ird9e ?r" PROJECT DESCRIPTION REAR YARD (TO P/L) Licens Cl a s i License No, 1111 6611 PKG.SPACE REQ. PROVIDED "" Date Signature SQ. FT. STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION OCCUPANCY - CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self-insure ora VALUATION ZONE ZONING APPROVED BY. + DATE certificate of Workers' Compensation Insurance, or a certified copy reof.(`}� �%A b. C.). V18If Great American GRADING CU. YDS. ACRES SPECIAL CONDITIONS: :y No.` ` Company Certified copy Is hereby furnished''. - REMARKS: .Certified copy is filed with the city. Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This Section need not be-completed if the permit Is for one hundred•- -- -- - - - - - - - ($100) or less. I. certiify that n-the performance of the work for which this permit is Issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK + ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California, Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS' URINALS GENERATOR 0.1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must -TRANSFORMER - - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10.50 KW-50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS MOTORS 0.1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP 50 + HP formance of the work.for which thispermitis.Issued-(Section 3097 r Civ. C.). Lender's Name FLOOR SINKS FLOOR ORAINS FIXTURES OUTLETS SWITCHES Lender's Address DRINKING FOUNTAINSQ GAS TUBE SIGNS INTERCEPTORS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION 1 hereby affirm that l am exempt from.the Contractor's License Law for, SWIMMING POOL P TRAP POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to_construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERV ICE OUTLETS SERVICE AMP is licensed pursuant to the provisions of the Contractor's License Law frhapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT ,ess and Professions Code) or that he is exempt therefrom and the for.the alleged, exemption. Any violation ofSection7031.5 by SEWER CONNECTIONSG 00 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). SOLAR TANK COLLECTORS - - ❑ I, as owner of the property, or my employees with wages as their Sole Compensation, wilt do the work, and the structure is not intended SOLAR PIPING SYS. it/ ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property who builds or improves thereon, and who does Such work himself or ISSUE FEE APPLICATION APPROVED BY - - DATE through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner will have the burden BUILDING -- - o1 proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ SMIP_-- $ ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. (Section 7044, Business AND DUCTING 100,000 + BTU PLAN CHECK $ PERMIT' and Professions Code: The Contractor's License Law does not apply to � ISSUANCE S an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 + BTU PLAN CHECK S ❑ lam exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ $ r - reason PLAN CHECK S - MICROFILM S - - Date Owner SYSTEM REPAIR, ALTERATIDN TOTAL FEE $ I hereby certifythat I have read this application and state that the above EXHAUST SYSTEM -MULTIPLE MECHANICAL s - LESS AD- information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction, and hereby authorize G " �v representatives of this city to en er u on the above mentioned property fo i purposes FINAL FEE $ �Jo Signature Drivers' License or ISSUE FEE CMF 0865-46 White-Building; Canary-Applicant; pink-Accounting; Goldenrod-Assessor T Li CONSTRUCTION AND PLANNING APPROVALS Permit # a' Date Inspector POOL & SPA t, , Date Inspector .. APPROVALS Permit # ; 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location . SoilPipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. - Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn-_ 48. APPROVAL TO COVER-GUNITE 7. Footings '49. Electrical Conduit-Undr rn ' 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test ` 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ Undrqrn " 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 53. Backwash & Receptor -Final Y „` 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing ti (,W ystem 14. Rough Electric -Conduit •56. Electrical -Final - 15. Rough Electric -Wiring - 57.'. Solar System -Final 16. Rough Heating & Air Conditioning encing & Access Approval 17: Ducts, in Structure '59. APPROVED FOR PLASTERING 19. Ducts, Ventilating 60. POOL/SPA_ SYSTEMS FINAL 19� Gas Pipe_Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: i 22. Frame -and Flashing ; 23. Insulation 24. Lathing & Siding 25, Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28'. Final.Electric 29: Final Heating & Air Conditioning ' 30. Final Gas Pipe -Test 31: Final Plumbing 32: Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation ' 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release' to Edison 41. Gas Release to Southern California Gas Co. 42. ' i CERTIFICATE OF OCCUPANCY -N Date _ Applicant to fill in all spaces within heavy border fines and sign all appropriate declarations. CIYY OF COSTA MESA[ -PE IT NO. TRACT NO.LOT NO. -SLOG. NO. CONSTRUCTION PERMIT /t3 &!5-- t K 6%66 (0/13/81 '.SHOO Project Address 3151. Airwa Costa TYPE OF CONSTRUCTION Owner J. Donald Mon Phone — NEW ❑ ADD ❑ ALTERATION Address 18003 Skypark,Irvine,7j ❑ REPAIR ❑ CDNVERSIDN ❑DEMOLISH 7K/v ❑ 20NING REGULATIONS Arch/Eng. License No. - OTHER A P Address _ DESCRIPTION OF WORK ZONE PLNG.. RUlEF..ppc Contractor Leavertoh-Beck Ing Ph0^ _ TYPE OF PERMIT YN PROPEIR•TLINE Address- 16721 Hale ❑ GRADING ❑ FOUNOATION ❑ STRUCTURAL' SETBACK T. I YARD LICENSED CONTRACTOR DECLARATION I hereby aftlrm that I am licensed under of Charter 9 (com- ❑ TENANT ❑ ELECTRICAl "?'fPLUMBING ❑MECHANICA SI E YA provisions mencing with section -7000) of -Division 3- of the Business -and ❑ OTHER- RIGHT Professions Code, land my license Is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION -PKG, License Clas License Na SPACE REQ. PROVIDED- SQ. FT. Date�Q Signature _�� - STREET WIDTH PARK FEE S WORKERS' COMPENSATION OECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure ora -VALUATION ZONE ZONING APPROVED -BY DATE certiflcate of Workers' Compensation - Insurance, or a. certified copy *`��eof (Section 3800, Lab, C.).SPECIAL GRADING CU, YDS. ACRES CONDITIONS: y No. P771 Fid- ' - Company Zei:•i3:th P;i t}e13d+ ertlfied copy is hereby furnished. - REMARKS- zertified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed if -the permit Is for.one hundred ($10o) or lass, i cert(fy that n the performance of.the work for which this permit Is issued,_ I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAWCHECK - subject to the Workers' Compensation Laws.of California. - - .. _ _ UAHAUL Date Signature BATHTUBS SHOWERS NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0.; KW 1-i0 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS'� APPLIANCE 10-50'KW_50 + KW revoked. - _. _ _ CONSTRUCTION LENDING AGENCY KIT. SINKS OISHWASHERS - MOTORS 0-1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) 10.50 HP 50 +•HP formance of the work for which this permit is Issued (Section 3097 Civ C.). Lender's Name FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Address _ DRINKING FOUNTAINS GAS TUBE SIGNS ` OWNER BUILDEWDECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS - the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a Permit to construct, alter, SWIMMING POOL PTRAP POLES METERED -SUB Improve, demolish or repair any -structure, prior to Its Issuance, also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE - AMP (Chapter9 (commencing with Section 7000) of Division 3 of the PP e$s and Pro4essions Code) or that he is exempt therefrom and the WATER HEATERS STU OUTPUT for the alleged exemption. Any violation of Section 7031.5 by .pplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS of not more than five hundred dollars ($500). ❑ I, as owner of the property, or my employees with wages as their SOLAR TANK COLLECTORS sole compensation, will do the work, and the structure is not intended Or offered for sale. (Section 7044, Business and Professions Code: The � n S S 1,%r� , Lam! ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE through his Own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have.the burden of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT BUILDING $ SMIP $ [:11, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK s PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner of property who builds or improves thereon, and who ton- REFRIGERATION 0-100,000 BTU �a PLUMBING S K tracts from -such projects with 'a contractor(s) Iicesned pursuant to SYSTEM GRADING $ the Contractor's_ License Law). 100,000 + BTU PLAN CHECK $ El I am exempt under Section B. & P. C. for this BOILERS BTU ELECTRICAL $ s ` reason PLAN CHECK S MICROFILM s Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE S I hereby Certify that I helve read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD - information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and stat laws relating to construction, and hereby, authorize representatives of his city to enter upon the above mentioned property f ction purpos Signature' 1-4-1 /Va FINAL FEE $ • �"�✓ Drivers' License or SS 3¢ ISSUE FEE CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor TL( CONSTRUCTION ANDYLANNING d%r3 APPROVALS Permit # Date Inspector POOL & SPA DateI Inspector APPROVALS Permit # - - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Sol ipe-Un rgrn 11 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding tee ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn '48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-TraI2, ❑ Undrqrn 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 0 53. _ Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater &Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit - •56. Electrical-Final 15. Rough Electric-Wiring - 57•. Solar System-Final 16. Rough Heating& Air Conditioning encing & Access Approval 17.. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough & Test 20. Root Framing 21. Roof Sheathin NOTES: 22. Frame and Flashing 23. Insulation - 24. Lathing & Siding 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter-Final 26. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test . 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar Domestic-Final 35. Landscape Sprinkling System 36. Sound Attenuation 37, Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all space$ within heavy border lines and sign all appropriate declarations. CIT` OF CQSTA MESA PERMIT NO. TRACT NO. LOT NO. ` BL G. NO. COPISTRUCTION PERMIT TYPE OF CONSTRUCTION 6.113 5/20/82 96.84 ProjeftAddrea%3t � .1/1/x. (� )� ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑CONVERSION. ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK �" A'P' -,f ZONE ZONING REGULATIONS PLNTGO• . Owner of:l CC4„C' IIOftA�Z��F7% Address Arch/Eng. License No. Address Contractor ` I_C Phfine(7 TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ELECTRICAL ❑PLUMBING ❑MECHANIC ❑ OTHER PROJECT DESCF(IPTION - BUILDING gRUEF..�h SETBAC PROPEIRTY LINE ' EIFFFr YARD SIDE YARD 77 I HT REAR YARD (TO P/L) • + PKG. SPACE R EQ. 'PROVIDED. Q V Address J1 c e LICENSED CONTRACTOR DECLARATION- - I hereby affirm that I am Ilcensed under provisions of Charter 9 (com- mancing with section '7000) of Division --3- of the- Business - and Professions Code, f�,/r my license Is in full force and ffect. License -Class _ • cense o u21V53 Date 5" p �8-� Signature ,WORKERS' COMPENSATION DECLARATION _ .I hereby affirm that I have a certificate of consent to self -insure ora•VALUATION' certificate of Workers' Compensation insurance, or a•certified copy -eof (Secti n 3$ 0, Lab. C.). r II 'w y No. Company SQ. FT. OCCVPANCY • CONSTRUCTION TYPE - ZONE GRADING CU. YDS. ACRES STREET WIDTH PARK FEE'E ZONING APPROVED BY DATE SPECIAL CONDITIONS: - ertified copy is hereby furnished. .-. Lcertified copy is filed with the city Building Division. REMARKS:' G _ EXEMPTION FROM WORKERS" COMPENSATION DECLARATION '(This section need not be completed if the permit is for one hundred ($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. ' _. - Date Signature • PLUMBING ••, PL -AN CHECK ELECTRICAL POAN-CHECK _ TUBS SHOWERS iA Al, - NOTICE: If after making this declaration, you should become'subjectETS. to the Workers' Compensation of the Labor Code, must URINALS - GENERATOR TRANSFORMER 0=1 KW 1.10 KW - provisions you forthwith comply with Such provisions or this permit Shall be deemedATORIES DOUBLE LAVS ' rKIT.' $APPLIANCE 10-5D KW -50 + KW revoked.- •- _ _ CONSTRUCTION LENDING AGENCY SINKS DISHWASHERS MOTORS 0-1 HP1-10 HPI hereby affirm that there Is a construction lending agency for the per -ICE 'formance of the work for which thts perm_ it is issued (Section 3097 SINKS , f SUMPS (INC. SOLAR) - 10-50 HP- 50 + HP FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS' SWITCHESZ' Lender's Name _.a y lti 1� DRINKING FOUNTAINS GAS TUBE 'SIGNS - --- , _ _ Lender's Address - CLARIFIERS POLE LIGHTS - OWNER BUILDER DECLARATIONINTERCEPTORS I herebyY affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business -and Professions Code: Any cityi or. county' which, requires ,a- permit`to construct,' alter, imprq,vI , demolish or'repair any structure, prior to Its issuarice, also re• qu res'the apkilcant for such permit to file a signed statement that he SWIMMING POOL P'TRAP' ' r,• + POLES METERED SUB WATER SERVICE " ALTERATION" PANELS MAIN SUB ^ j GAS SERVICE OUTLETS SERVICE AMP -90 is licensed pursuant to the provisions of the Contractor's License Law 9 (commencing with Section 700D) of Division 3 of the r ess and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section 7031.5 by WATER HEATERS BTU OUTPUT - - SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty- of not more than five hundred dollars ($500). SOLAR TANK - -COLLECTORS ❑ 1, as owner of the' property, or my employees with wages as their sole •compensation,.will do the work, and the Structure Is not Intended or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law-doeS_not apply to an owner of a property: who builds or improves thereon, and who does such work himself or _ SOLAR PIPING SYS. ISSUE FEE ISSUE FEE APPLICATION APPROVED BY DATE - ' *� r! through hl$ 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 will have the burden of proving he did not build or improve for the purpose of sale). ❑-I, as owner of the property, am exclusively contracting with ,licensed conlraCturs to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improve$ thereon, and who con- ,tracts from such projects with a contractor(s) licesned pursuant to athe Contractor'$ License Law). MECHANICAL PLAN CHECK HEATING SYSTEM 0-100,000 BTU -AND DUCTING 100,000.+ BTU REFRIGERATION 0.100,000 BTU SYSTEM - t 100,000.+ BTU BUILDING PERMIT $ PLAN CHECK $ PLUMBING S PLAN CHECK $ SUMMARY OF FEES - - '. + SMIP' PERMIT �• ISSUANCE $ - GRADING 's ' , t ❑ I am exempt under Sectiori B. & P. C, tor'this reason - Date Owner 1 hereby certifytha[ I have read this application and slate that the above informs correct. I agree to comply with all city and county or ces an la s relating to construction, and hereby authorize d, rep r entatives of city o enter upon the above mentioned props y for i n p es. Slgnatu Date a Drivers' License or SS BOILERS BTU - SYSTEM REPAIR, ALTERATION EXHAUST SYSTEM MULTIPLE ISSUE FEE ELECTRICAL $ f PLAN CHECK $ MECHANICAL E PLAN CHECK $ • $ - MICROFILM '$ ' TOTAL FEE $_' , .+' LESS AD- � . VANCE PC 3-- FINAL FEE S -Assessor GMF 0865-46 White-Buiiding; Canary -AP PIitarnt; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING 1; APPROVALS Permit # 3 Date Inspector POOL & SPA.1 . APPROVALS Permit.#` Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment' l.oca[ian ` 1 "' `" "'7 ' ' 1 �"" ' T''•�' '� ' 2. Soil Pipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utitity-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - 5. Steel Reinforce 47. Rough Plumbing & Pressure Test • 6. Electrical LIFER Grn 48. APPROVAL TO COVt;R`-GUNITE` 7. Footings 49. Electrical Conduit-Undr rn 8. .Foundation . _ 50. - Gas Pipe, ❑ Undr rn, Test y -.9. Water Pipe-Uridrgrn" 51. Backwash Lines P-Tra' C1 ride rn1 `+ 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection _ 54. Heater & Vent -Final 13. Rough Plumbing 55, = = 14. Rough Electric -Conduit i •56. •Electrical -Final- 3[ 15. Rough Electric -Wiring r _g2 57. Solar System -Final 16. Rough Heating & Air Conditioning • -Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating .60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test 20. Roof Framing 21. Roof Sheathing NOTES: 22.. Frame and. Flashing 23. Insulation . 24. Lathing•& Siding ju.LRrAQg. L XC �� -ro 25. Drywall Nailing r U S $ 26.. Plaster Brown Coat a 27. - Electrical Power Meter -Final .3!etc 28. Final Electric " / 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test ' 31. Final.Plumbing 32.- Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date % . \ [. '� - .. -i/ T Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. .0TYlZ)F COSTA MESA I PERMIT NO. _ I TRACT NO. I LOT NO. BLDG. NO. CONSTRUCTION PERMIT Proiect Address 1191-11 b; va.. TYPE OF CONSTRUCTION ()Plan Check #51442 Owner h WCa LCI One ❑ NEW ADD ❑ ALTERATION Address 1501 Dove Street ❑ REPAIR ❑ CONVERSION ❑DEMOLISH Arch/EngHa i es -Lan Ston License No.C-010899 ❑ OTHER Address ]]] S. Main St 5 DESCRIPTION OF WORK Comercial — Contractor D Phone j' 12 _ TYPE OF PERMIT Addrew 3151 Airway Avenue, ❑ GRADING i3 FOUNDATION [I STRUCTURAL LICENSED CONTRACTOR DECLARATION ❑ TENANT ❑ ELECTRICAL ❑PLUMBING ❑MECHANIC I hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license Is In full force and effect. B 333964--- PROJECTESC7Rf1IPTION {i]5nV! License Class License No. 1 7 Date Signature _ WORKERS' COMPENSATION DECLARATION SQ'' OCCUPANCY ONSTRUCTION TYPES I br. I hereby affirm that I have a Certificate of consent to self -Insure ora1�%VALUATiDN NE flcate of Workers' Compensation Insurance, or a certified copy yOf (Se�tiyr 3gQ0,jpljr CJ. GRADING CU. YDS- ACRES A. P. 9F ZONE ZONING REGULATIONS PLNG. REF. �% REAR YARD (TO P/L) PKG. SPACE REG. '�1r STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: PROVIDED PARK FEE $ G, DATE No. - 4 - — ,ompany_t( 1�[AL�Clt TnSllrelnf^P HOLD FOR SPECIAL REQUIREMENTS ertifled copy Is hereby furnished. REMARKS: ertifled copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed If the permit is for one hundred ($l00) ar less}. f Certify that in the performance of the work for which this permit is Issued , t shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK, subject to the Workers Compensation Laws of California. Date S[gnature BATHTUBS SHOWERS UARAULFT 5Q -Fl NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS 1, , 3• APPLIANCE 10-50 KW 50 + KW revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS - MOTORS 0-1 HP 1-10 HP I hereby affirm that'there is a Construction lending agency for the per- SERVICE SINKS SUMPS (INC. SOLAR) s I 10-50 HP 50 + HP formance of the ark for wh h this Qerm'(� is issued,'( ection 3097 Civ. C.). Western fl Corp r .�aci c Fi nand a� .w Lender's Nama` FLOOR SINKS FLOOR DRAINS FIXTURES, OUTLETS �SwITCHES Lender's Addres$10U1 Ove lee ,.. ewpor. eac , DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION thereby affirm that I am exempt from.the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS the following reason (Section 7031.5 Business and Professions Code: ..SWIMMING POOL ;P TRAP i ,Any city or county which - requires a permit` to construct, alter, � - �� POLES METERED SUB Improve, demolish or repair any structure, prior to Its issuance, also re- WATER SERVICE 'ALTERATION PANELS MAIN SUB quires the applicant for such permit t0 file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE t OUTLETS SERVICE AMP ( ater 9 (commencing with Section 7000) of Division 3 of the P,Ss and m and he I$ exempt 'violat on WATER HEATERS, •liBTU OUTPUT for the alleged exemptiessions ,Anyton of. Section) 7031.5 031.5 by; ,y a,._ applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ' of not more than five hundred dollars ($500). ',.1. E3 I, a5 owner of the property, or my•employees wlth'wages as their ,SOLAR TANK COLLECTORS Sole compen'satlon, will do'the work, and the structure Is not Intended , ,or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING_ SYS. '.. ISSUE FEE Contractor's License Law does not apply to an owner of a property - who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE '1 through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden -MECHANICAL,i .. PLAN CHECK SUMMARY OF FEES of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDIPERMITNG$ 1 , 513.00 SMip7A)e $ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING —. licensed Contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property. who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contraCtor(s) licesned pursuant to SYSTEM GRADING -S - the Contractor's License Law). 100,000 + BTU t ! PLAN CHECK $ ❑ I am exempt under Section B. & P• C. for this $ BOILERS BTU ELECTRICAL $ reason Date Owrter SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ - TOTAL FEE $ ��^ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ AD LESS LESS AD - Information is correct. I agree to comply with all city and county PLAN CHECK $ E PC $ ordinances ordinances and state laws relating to construction, and hereby authorize representatives of this City to enter upon the above mentioned property to sp Ion p rpgaes�� `�/ -FINAL FEE Signat ure�i�� $� Drivers' License or SS ISSUE FEE i CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit #�Date Inspector - _POOL & SPA, �' APPROVALS h Permit # Date .Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement . 3. Electrical Conduit Utility,Undrgrn- _ 45. Forms 4. Electrical Conduit-Undrgrn _ 46. Electrical Bonding 5. Steel ein orce 47.- Rough Plumbing & Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8, Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Trap.❑ Undrqrn 10. Structural Floor System 52. 'APPROVAL TO DECK 1.1. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection 54. Heater & Vent-Final 13. Rough Plumbing 55, Plurnb6ag System - Final 14. Rough Electric-Conduit •56. Electricai-Final 15. Rough Electric-Wiring 57. . Solar System-Final 16. Rough. Heating & Air Conditioning b8. Fencing & Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22, Frame and Flashing 23. Insulation a` ' 24. Lathing & Siding fo c� 25. Drywall Nailing 26. Plaster Brown Coat aye- a 3 W 27. Electrical Power Meter-Final 28. Final Electric 29. Final Heating & Air Conditioning S a $- - 30. Final Gas Pipe-Test 31. Final Plumbing s b P 32. Water Service,-Final 5- .L '33. Gas Service-Final 34. Solar Domestic-Final �JCia 35. . Landscape-Sprinkling System 36. Sound Attenuation - - 37. Handicap Regulations 36. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40:.. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - "No Date ADMiS OF un mm, 3151 AIRWAY AV UNT: K-20 WNER'SNUE IFWOV t SO CAL SUNBELT DEVEOLPERS MDREss: 3151 AIRWAY AV #150 COSTA MESA,CA 92626 540-5568 ADPL, F XUM AOOIMS& ARCHITECT Oft emEm- LANCE POLSTER & ASSOC Lrcm_- C10085 ARCH. OR EWS A00RES5: 2094 S COAST H WY uw-. 5 LAGUNA BEACH CA 92651 cmucTOR'sxw- SOUTHERN CALIF SUNBELT DV (714)777-4411 CONTRACTOR'SMAlum 4 501 EAST LA PALMA ADDRESS: ANAHEIM CA m No.: 670560 92869 uwT: 200 LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty d pe" sat I em iioensed provisions of Chapter 1) PaMith Somion 7000) d Division 3 d the Business and Professions Code, end my limtse 13 tnforce end: 69 77 uc.cuss: B uC.NO.: 670560 P: 05/98 Contractor: ER D LARATION: I hereby affirm under penalty d perjury tlmat I am Orem the Coruradary Ltnearea Lewn (Section 7047.5 Business and Prolonjorrs Code: Arry city or county whirl a permit to oorsbuct, after, inprova, pair any sbtnctu s, prior to 'as astumos, also requires the applicant for such ' to fits a signed swarnenl tat he or she rsue t to the provaiam d the Cmaradare License Lew [Chaper 9 (tame with Section 7440) d Division 3 d the PrdeniDem Code] or that he or she is exempt Ihsefrom and the basis for the alleged exemption. Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hsdmd dollars )5500]). f, as owns of the property of my emplryees with wages as their soh compensation. will do die work, and the structurals not intended or offered for sale (Section 70", Business and Professions Code: The Contractors 1 Law does not apply to an avmer d property whit builds or improves thereon. and who does such work himself or hersel or through he or hs own employees, provided that such improvements we rot im&I or offered for sale, 4, however, the building or improvement is void wtthin one yea of completion, the ownerhodder will have the burden of proving he or she did not build or improve for the purpose of male). ❑ 1, as owner d the property, am exclusively contracting tractig with lirainaed cor&wbors to construct the project (Sertun 7044, Btsinss and Professions Code: The Comramore License Lar does not apply to an owner of property who builds or impress thereon and who contracts far mil+ prajerts with a oortmctor(s) licemed pursuant to the Contractors Lioense Law). ❑ I am exempt under Section: B. A P.C., for this reason: Date: Owner. I do hereby candy that I am arae of and undsaland the requiremens of California Health and Safety Code Sections 25505, 25593, and 25594. and that I or any future building orxxnpam will I will not (circle one) need to conrpiy with said slate cods end the requirements for a permit for msuuctm or n xtdiieazion horn the A'f= y a-negement District. Fteme.ti f oarstruuion appicwton we exempt from there prevfefons. Date: Applin": WORKER'S COMPENSATION DECLARATION: I hereby arfirm under penalty of perjury one of the Fallowing dederations: ❑ I haw mrd wit maiaaki a omlifrae d orient to sell-irmmrefor worked mnpdm i m, as provided for by Semon 3700 of the Labor Code, for the pedorinance of die work for "ch this permit is issued, r have and will maintain workers' compansmon insurance. As required by Section 9700 of the Labor Code, for the perknronce of the went for which mm permit is issued. My workers' G45L DEN EAG�,�poky num are: EXPIRES carrier: Policy Numb - 06/27/98 17his wKiion need not be oormphaad t rhe permit a fw Ona hundred do@as (hoof or is®.} candy that in the performance of the work kr which this permit is issued, I shat not employ any pyam in any manner so as to s bjed to the wonkas' compensation hews of California, and agree that 4 1 slwuld betl subject to the witless' ors ion ' ions of Section 3700 of the Labor Code. I shall f ' h Comply with A te: Applicant Wa Ing: !u re secure workers' cornponsatfon coverage Is umrawfUl, and &hall rnb an Mrtployer to crhwnal pens I Mau tp to ane hundred thousand dole" (SlattOW), ki addidon m Me cost at fiorb damages u provided for fit Sactlan 3706 01 as@ Labor Cods Interesk mrd attorney's fast CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that Then Is a mnidniction lending ogarw r kr the performance of the work for which Ihw permit is immed (Section 3097, Civ. Q. LENDER'9 NAME LENDER'S ADDRESS: V I certify that I have read this application and state That the above information is torted. I agree to cw#v wvh at ray and county ordinances and state laws relating to buMng constmnoion and hereby authorize representatives of this ray m suer upon the abovarmetioned popery for inspection purpose. DONNA SEAL ilr47 ' rim Dere: SW%WU d (51514AMP) Whho4knidig d Safety: Groan-FIe: Canary-Applcam; Pink -Panne: C3oWeuod-A9sessor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: H 08405 PERMIT NO: B 084053 PLAN CHECK NO: 02836-97 A GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; OFFICE TI SQ FT: 2,300 CLAIM VALUE: 2,300.00 CALC—VALUE: 2,300.00 GROUP OCC; B / COMMENTS: "--" OFFICE TI Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------------------- ACCESSORY BUILDING----------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN I;EFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PLANNING NOTES> TENANT IMPROVEMENTS TO RECONFIGURE EXISTING OFFICE AREA FOR > AN ENGINEERING FIRM. iF*�E***4E 4E 4E 4E 4E 4E 4E 4E 4E 4E*****j}****�*4EiF*�E4E4E4E4E*****4E 4E*4EiFiFiFiFfk4E4E4E*ft*4E 4E*****4E*****'j}iFiF***iFiEiEiF D E V E L O P M E 'N- S E R V I C E S R E Q U I R E M E N"T S ZONING APPROVED BY C -C DATE: BUILDING APPROVED BY DATE' APPLICATION ISSUED BY: , DATE: * * * * * * � � * * * * iE iE iF 1F 1F * �F 1F 1F �F 1F * �F ir• ir• ir• ir•.ir• ir• -� �F LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/•RES GRADING PERMIT 74.75 SMIP /NON --RES PLAN 12.15�' .50 ISSUE FEE BUILDING—AIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS-----> 75.25 0.00 12,15 87,40 87.40 ,00 rte, REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN --CHECK 74.75 r` .50 I N D I V I D U A L _ • F E E B R E A K D O W N r TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Y.1 SFC 2300 T.I. OFFICE ;d BY VALUE/$1 1.00 2,300.00 FEND OF.FEES The work auth00zed b .'; cnrnply Ill ell Y lets perm, shall ti -� aPPlkable harp G �r axes" ri"Wr9mente under California 08-05-1997/09:46 AMA 75.25 AL, etata,rfs gra WSW ffi10118. RCPT#:01-0610222 IN LORI. NO. 82.28, PERMIT:084053 CONSTRUCTION AND PLANNING I- POOL & APP OVALS Permit # Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole., 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. _ 53. Steel Reinforcement 3. Electrical.Conduit_Utility-Undrgrnd. 54. Forms 4, Electrical Conduit•Undrgrnd. 55. Electrical Bonding -5..Steel Reinforcement 56. Rough Plumbing & Pressure Test - 6: 'Electrical_UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7; Footings-' r 58, Electrical Conduit-Undrgrnd. 8'- -Foundation _ 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe_Undrgrrid. % 60. Backwash Lines-, Pr -Trap, ❑ Undrgrnd. 10. Structural' Floor -System 61, APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap • - 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14• Rough Plumbing 65. Electrical -Final n 15. Rough Electrical -Conduit s 66. Solar System -Final 16. Rough Electric WiriNA 67•- Fencing & Acces;'�Approval _1 ' 17, Rough Wr1's q Sign - li$: APPROVED FOR -PLASTERING 18. Rough Electrical T Bar Ceiling =69, POOL/SPA SYMMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS'- Pei mit # ' 20. Rough Factory Fireplace 17 21. Duct;, in Structure 7Q. Unciergrp•ugd Hydro 22. Ducts. Ventilating- t a F 71. Prod L, t;Piping'Q7Gas Oil 23. Gas PipeTRough &'Test ;. a 72, Underground Flush _ 24. -Roaf Framing - •-- f 73. Undergrnd. Stori-b Tann ❑ Gas ❑ Oil + r r 25. RocWSh "thin r' •- 'a 9 "' _i �= `�" - f .. 74,E Overhead Hydro 26: .Bar• Ceiling (Structurai) & Monocaat -• 'j ~" ' 75. Dry Chemical - 27. Frame and F!a+shigg i '? _# 76'.' Dry Standpipe.-, 28. Lathing & Sidings , _ '1 j �.._ x 77: FIXED SYSTEWFINAL 29. insulation 78. FIRE PREV. FINAL �• 30. Drywall -Nailing r/gyp!♦'? DERT:•REQUIREMENT ' _HEALTH 31, Plaster Brown Coat . - : ;- � E� 79`. FINAL f NSPECT7ON , .. � ;. 32. Electrical Power Meter:Final , �_ r 80: FOOD Ct=RTI171CATE ISSUED _ 33. Final, Electric y ;� �f ^� ;f .t Notes: Jl,tq7-��{,C;, r + =-=r t r' r 34, F'snal'Heatin & Air Conditioning-' r's, ^ ''' 35. Finat'Gas Pipe•Test ' : Y - -' z '7 36. Hood or Canopy 37. Final Factory Fireplace 38. •Final Plumbing r 39 -Water Service -Final - a a _ .. :z W r ti t t 5 40. Gas Service -Final + _ :�: ' R• r- = C 1 _ i 41. Solar Domestic -Final _ �' - iz 42. Backflow Preventers -43. Backflow Irrigation t - * _•;~ ` z- C? ' -44, Landscape lrrigatio' System-� ,rl , =45. Sound Attenuation+ ' A r - ca 46. Handicap ReMilatiobs ,Y • IP 47. FINAL STRUCTURE & BUIt-DING r r 48. FINAL PLANNING 49.-Eledtric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. Date ADDRESS OF BUILDING:1'A 11 A II xx WWAyy V UIaT; K- 2 4 0 OWNER'S WMEIF1I101111b SO COAL SUNHEL� DEVEOLPERS ADORm. 3151 AIRWAY AV #150 COSTA MESA,CA 92626 540-5568 ADPL, MAILING ADDRESS: AmmrTECTORFmmlt; LANCE POLSTER & ASSOC LIC ND.: C10085 ARCH. OR M'S ADDRESS: 2094 S COAST HWY UNIT: 5 LAGUNA BEACH CA 92651 CONTRACTOR'S NAW_ SOUTHERN CALIF SUNBELT DV (714)777-4411 CONTRACTORS1111AILIN0 4501 EAST LA PALMA ADDRESS. ANAHEIM CA uG Ng,: 670560 92869 uyr; 200 LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty d perjury that 1 am licensed d Cheger 9 (commendn9 with Section 7000) d Division 3 d the Business and Prdmaors Code. end my Irrxnse b nrdand effect. C WPtjC. NO.; 0697177 uc. crass: B ue. No,:,, 6 7 0 5 6 0 137.44=. : no 5/ 9 8 Data: : Canunctor. OW p1 R BUILIR D LARATION: I hereby affirm under penalty d perjry Ihaz I am eranpt from s Contmctas License Law for the wtng rensorn (Sed'ron 7031.5 Business end Profession Code: Any cry a county which requi a permt to a Mjd, after, improve, demoWh, or repair arty structure, prior to its issuance. sell reghans the applicant fa sudr o file a signed statement that Ind or ahs is licensed pursuant to the provisions of the Contractors License Lew [Chapter B (common wth Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt lo— ofnCo. and the basis for the alleged exemption. Any violation of Section 7031.5 by a" applicant For a permit s1mjeG7 the aWcant to a d+d penalty of not more than Five htadred dollen ($500D, I, as owner of the property or my employees with wages as their sole compensation, wf do the work, and the sesrbae is not intended or offered for sale ($action 7044, Business and Prdas6m Code: The Contractors Ucerse Law done net applyio an bwnerd property who buids or inprwes thereon, end who does such work himself or Iversel or through his or her own employees. provided that such improvements are nd inlanded oroffer For sale. C. however. the building or improvement is sold within as year of complatbn. the owner-buiWor will have the burden of pwrg he or she did sol build or improve for the purpose of sole). 0 I, m ower of the property, am exclusively contracting wan lcensed contractors to owratnrct the project (Section 7044, BMinps and Professions Code: The Contractors Bente Law doss rnal apply to an owner of property who builds or improves thereon and who eontracb For suds projecta with a oortrada(ej t cen Puxsuert to the C intradors Lioerhaa Law). 1 am exempt under Section: B. A P.C., for this remon: Dere: Duper. I do hereby candy that I am aware of end understand the requirements of California Health end Safety Code Sections 25.505, 25533, and 25534, and that I or any hares building oonnpeN will i will not (circle ane) need w comply with said stele codes and the regtdrements For e permit far corstnnction a nwdifr�ion from the Ai�imTly I�arspemert District. Redderusi mnstructun applications are mrempt from these provisions, Data: Apptcsxt: WORKER'S COMPENSATION DECLARATION: I hereby aff'am under perxehy of perjrry one of the Following declarations: 1 have and will maintain n oertiFrain d carom to "Ulmer for workers' aornPensazlon, m presided for by Bection 3700 d Ins Labor Cods. for the perlomsnee of the work for which tar pemW in issued. I hears and will maintain workers' campef>aarion ins mows, as regxured by Section 370D of the Labor Code, far the patllm+ence of the work for which this permit is lotted. LNy waken'laUL 1�, ! � r pdhey man' ars. EXPIRES Cartier: la Polly Number - 06/27/98 ;This sedan need not be complaGed I Ins permit is Aw ass hundred doNsrs IS10of or Amj oertdy that in ape d the wok for which this permit b issued, I shell owl employ any s arty manner m m to ■ suYjs to O worker' conPeneetion laws d California. and q s that d I ahortd b ams su ' to the workers' in need n curial a S ion 3700 d the Labor Code, I shag for f comply wth too" p ,ions. Daze: Applicant: We ng: Fall woAwo' esmpaasatlon coverage is umhwhA and shell sub)nc! anployer to nyfrdnaf pandCes and cl Anes up ro h rad thousand dofhrs (fftg000), !n neddltbn m the cost of co ` fbn, atarrspss as provMsd for In tlon 3706 of me Labor Cads, lnfersst; and ah'.pmeYa fess. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjhsy that therm is a oon4rudion Ienctng agency For the performance of the wok for which this pemnf is Issued (Section 3097, Civ. C). LENDER'S NAVE LENDER'S ADDRESS: I'cenity that I have read this apps cition and state that the above information in carted. I agree to comply with all city and county ordinances and state laws ratstig to budding construction and hereby autror¢e represertsWas of this city to enter upon the above-mentioned property for inspection purposes. DONNP SEAL tat e Data: Sign re of owed U v (5151-46.001`) Whte-xnld'ng l ; Canary-Appieant; Pi nk-flevene; Goldenrod-Aeeeaaar CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 08405' PERMIT NO: B 084052 PLAN CHECK NO: 02837-97 A GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : OFFICE TI SQ FT: 2,300 CLAIM VALUE: 2,300,00 CALC-VALUE: 2,300.00 GROUP OCC: B / COMMENTS: "--" OFFICE TI ��*��****1Fiti�Fi[•iC•iC•i[•i[•i[•ic•***************irtirtirtirtirtirtififif*it+ic•*��*��**�� Z O N I N G R E Q U I R E M E N T S S E T B A C K S -- MAIN BUILDING ---------- ---'-------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN RARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PNING NOTES> ADD WALL TO DIVIDE SUITE INTO 2 SUITES. NO TENANT IN THIS > SUITE; ENGINEER IN SUITE 250. �FiI"*iI"i4"1F**********iI"iI"iI"iI"iI"**iI"iI"iI"iI"iI"iI"*IFIFiI"IFififil"ifififi[•ififiliFilif*�*i[•ililil***ifilil*i�******:*'il******ilifil D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N`'T S ZONING APPROVED BY { DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: " LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y r BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 74.75 PLAN 12.15 '*f SMIP/NONN—RES ISSUE FEE .50 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS ---- > 75.25 0.00.1 12.15 87.40 87.40'- .00 REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 74.75 .50 1F if iF iF iF i(il:• )F �F )F �F �F * * )F * iF i� ililililili� i� iF iliF iF i� iF iF * * * iF * * * iF iF iF iF iF iF iF iF 1I iF iF iF iF iF iF if iF ili� * iF iF iF if iF * iF * iF iF iF iF iF iF iF iF iF it at I N D I V I D U A L F E E B R E A K D.0 W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST r SFC 2300 T.I, OFFICE BY VALUE/$1 1,00 2,300.00 END OF FEES ebvork n 1 D ply Wfth all by this _ 1'v sgce88 r u a11��F�b► Pern'+It Sy 8�-85-1997/©9:47 fad/S15.25 and, alI R014:a1'-fiJ18223 {Ord No 82 gl t i QU �� Acap FUER M I T : 084 U52 2 21`8�j CONSTRUCTION AND PLANNING POOL & S 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�ondun utility•Undrgrnd. '54. Forms .4.-Electricat-Conb�it=Undrgrnd. 55, Electrical Bonding J5. Steel Reinforcement- 56, Rough Plumbing & Pressure Test 5. Eiectricaf.UFER Grnd. 57. APPROVAL TO COVER-GUNITE {~71 Footings*' 'I y 58, Electrical Conduit-Undrgrnd. g• Foundation+ 59. Gas Pipe, D Untfigrnd., Test 9-. Water Pip-Undrgritid.-' 60. Backwash Linen, P -Stag, ❑ Undrgrnd. ;'10': StructuraTi Flooi,System 61. APPROVAL TO DECK 11. Property Sewer' -Line & House Connection 62. Backwash & Roceptor-Final 'J2. Sewer Cap 63. Heater & Vent -Final 13, Roof Drains .. 64. Plumbing System • Final 14, Rough PlumGilhg t 65. Electrical -Final 15. Rough Eiectrical-Wduit r 66. Solar System -Final 16. Rough Electric-Wirinq 67. Fencing & Access Approval 17. Rough Wiring Sign _ , 68. APPROVED F -OR PLASTERING 18, Rough Electrical,T Bar Ceiling 69, POOLISPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE'DEPT. REQUIREMENT APPROVAL -S, Permit # 20,?Stough Factor Fireplace Q - 21, Ducts, in -Structure- r - _, - 70: -Underground Hydro I< 22. Ventilating • + 4 `_ �. 71. Prod uct:Piping Q7Gas P Oil _Ducts, 23,'Gas ugh &' ast x `. 1 72. Underground Flush_ 24, . Roof; Framing. � 4 , -r - - , 1, 7 Undcrgrrid. Star§e Sang ❑ Gas C 0i1 'i P 25. RooTSheathing '" I ' . - - ,._ ; 7? Overhead Hydro' i, t 1 . . 26.'T -Bar Ceiling (Structural) &. donocoat= - 75; Dry Chemical • `� `' - - rt - 27. zFrame anO Flashing" 76 tDry Standpipe-`, * " 28,'Lothing-,& Siding! -, 7.7. FIXED S,YSTEMtFiN L� _ 29. tnsulatioq T9. FIRE PREV. FINAL 30. Drywall•Nailing jHEALT#-i DEPT. REQUIREMENT--- _ 31. Plaster Brown Coat . _ 79. FINAL 1NSPECTION ` y 32.r.Electrical Power Meter:Final _ �� - 80. FOOD CERTIFICATE ISSUED 33 'find Electricy 4: - r Notes: f�j�% ico,rs«�l 34. Final: Heating:& AirtConditioning � = t r� e 'r, r L 35, -.Final Gas Pips -Test 36. Hood or Canopy -7z ;• : r f -�� F• 37. Finil'Factory Fireplace c: ra 38. Final Plumbing �. 39..Water Service -Final`_'` 40. Gas Service-F?nal 1 41..Solar Domestic -Final _ ^� r •• r r--. -:ni ' 42. Backflow Preventer- .43, Backflow Irrigation - s - r44. Landscape Irrigatio6 System :45. 'Sound Atten6ation' - - f -• = # �• '46x'Handicap,Reguiatio�s a � 47 -FINAL STRICTURE &BUCEDING • • 48; 0, IIVAL PLANNING: 49. -Electric Release to Edison f r ' -50-..Gas Release to Southern California Gas Co ,'51: CERTIFICATE OF OCCUPANCY - No. Date u gs OF BUILDING: 3151 AIRWAY AV UNM K-2 OWER'sN MEIF10M: SO CAL SUNBELT DEVEOLPERS ADDRESS: 3151 AIRWAY AV #150 COSTA MESA,CA 92626 540--5568 APPL.IWUNG ADDRESS: ARCHITECT ORElmmit: LANCE POLSTER & ASSOC LIC.NO.: C10085 ARCK OR END'S ADDRESS: 2094 S COAST HWY UNIT: 5 LAGUNA BEACH CA 92651 MMUTOR'SMIAL SOUTHERN CALIF SUNBELT DV (714)777-4411 CONTRACTOWS NAILING 4501 EAST LA PALMA arm. ANAHEIM CA mNg,; 670560 92869 UNIT: 200 LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty d perjury timet I ern licensed under provisions of Chapter 6 (comma-. ' h Section 7000) d Division 3 d the Business and Prdessions Code, and my Goanse a in full fad a force an@fle. crrY No.: 69777 uc.cuss: B LIC.NO.: 670560 XP: 05/98 Contractor: VErL R D CLARATION: I hereby affirm under penally d perjury that I am exemp0.. the ComrectersLiot—Law fa tBusiness and Professions Code: Any city or county which a permit to construct, after, improve, ape's any structure, prior to its issuance, also requires the applicant for such file a signed swernent that he or she is licensed pursuant to the provisions d m the Contractors License Law (Chapter 9 (commencing with Section 7000) d Division 3 d the Business and Professions Code] or Ibal 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 rat more than live hundred dollars 125001). ] I, as owner of the property or my employees with wages as that sole compensation, will do the work. and the structure is not intended or offered for sale (Section 7044, Business and Professions Coda: The Contraotans License Law does not apply to an owner d property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, provided that such h improvements are not intended or offered for sale, 0, however, the building or improvement is sold within one year of complelion, the owner -builder will have the burden of proving he or she did not build or imprrva for the propose of sale). 1, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sector 7044, &mince and PrtAesscrs Code: The Contredors License Low does nol apply to an owner of property who builds or improves thereon and who contracts for such projects with a oonaractor(s) lensed ptusumd to the Contractors License Law). l am exempt under Section: 8. A P.C., fa this reason: Dale: I do hereby certify got I am aware d and understand the requirements of Csliomut Heabh and Safely Coda Sections 25505, 25573, and 255.74. and that I or any future building occupant win I wit not (circia ane) need to comply with amid elate codes and the requirements for a permit far construction or modification has the Ai of wry F�%apen+ent Diserid. Residemiel eonstnrtan eWIDstiora are e+templ Iran these provisions. Date: Applicant: WORKER'S COMPENSAT10N DECLARATION: I hereby affirm under penalty of perjury one of the fallowing deft mions: I neve and will maintain a certificate of consent to seMinsure for wxxkero'ownparsation, as provided for by Sector 3700 of the Labor Code, for the pedwmanrte of the work lar which this permit is issued. [ I have and will maintain workers' mnpansatbn insurance, as required by Section 370D of the Labor Code, for the pedarmenos of the work for which this permit is issued. My workers' 55 iT`rffAhL T Policy number are: EXPIRES Policy Number: '- 06/27/98 (This section need not be completed i the permit !s for ane hundred dollars IS1001 arks.) I cattily that in the performance at the wank la which this permit is issued, I dreg riot employ any parson in any manner so m to boom Su fact the workers' compensation lawn d California, and agree Thal 'rf I should subject to the workers' n p ions of Section 3700 of the Labor Code. I shall f h comply with chose ' 'ons. D e: Applicant: a Q: FaflWe f .. worXsrs' canrtpsrmasGon covereps r. urfawlul, end serf solo an employer tocrfnabral penerdss and ftnles uta to one hundred fhouoand dollars ff10Q000), In addition no fits cast of n.Wertestlor4 damages as prow for In ecdon 3706 0! de Labor Code, Mfrast, and aftomer s fess. CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of parovy that thane in e construction larding agency for the performance of the work for which this permit is issued (Section 3067, Civ. C). LENDER'S NAME LENDER'S ADDRESS: Icerldy that I have reed this application and Bete that the above information is cored. I agree to comply whh as day ant oDunty odihences and slate laws relating to building construction and hereby authorize representatives d this city to onto upon the above menti property as inspection purposes. DONNA SEAL (5151-46.WPI Done: Irk -7 Safety: Qroer-Rle: Canarv-ADDioant: Pink -Revenue: Goldenrod -Assessor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 08405 PERMIT NO: B 084051 PLAN CHECK NO: 02838-97 A GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION OFFICE TI SQ FT: 2,300 CLAIM VALUE: 2,300.00 CALC-VALUE:. 2,300.00 GROUP OCC: B / COMMENTS: " " OFFICE TI Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RIGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PLANNING NOTES> TENANT IMPROVEMENTS FOR ENGINEERING FIRM IN SUITE AT JOHN > WAYNE EXEC. GUILD CENTER, * * if'1f 9t iE iE iE'1f'1f'1f'1f'1f 4E iE 4E 4E iE'1f'1f it #f 4E �E 4E'4E * aF il• il• 4E 4E 4E iE il• iE aF aF * iE iE 9E 9E �t �t �t �t �t � 9E �t it;# ;# iE iE � �t �t * iE iE iE iE iE iE iE iE * �t * �t 4E iE � �t �t 4E �t D E V E L O P M ESN T SERVICES R E Q U I R E M E N_ -T S ZONING APPROVED BY -'��' �l�Y�' DATE:l BUILDING APPROVED BYf. DATE:," APPLICATION ISSUED HY: DATE: r iE iE iE * il4E 4E 4E iE iE * il• �t it �t #E * iF >1E dE it,>f * iE a( -")E 4F 3E iE aE iE -?(• * �t LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTR'IC'' MECHANIC FIRE SMIP'/RES GRADING PERMIT 74.75 SMIP/NON-RES PLAN 12.15 .50 ISSUE FEE t i_ BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 75.25 0.00 12.15 87.40 87.40 .00 REVENUE DIVISION TOTALS--> COLLECTED: 75,25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 74,75 �'a .50 'k'IE'IE 1F')f')f 1! iE iE iE'1F 1F 1F')f il')f i� iE iE'1t''1F ")f')f'14 iE iE iE iE 14 * il�4 iE iE iE,iE * * * �4 iE')t' 14 14 * * 14 * 44 44 * * �4 Il• iE 14 it �4 iE iE iE'1l• * i4 i4 "1F iE 14 iE iE iE 14 *'It• 'It• iE '14 'It• 'It• I N D I V I D U A L° 1' ', F`P"E E B R E A K D O W N TYPE QTY D E S C R I P T I,,Q N �;r UNIT COST TOTAL COST SFC 2300 T.I. OFFICEr' ;'BY VALUE/$1 1.00 (, 2,300.00 END OF FEES The workauthorized by camPly ryyj"!1 aPP1►cthis Permit shall (4} f access r aWe handicap statutes am reiat under CWKomia (Ord. No, ;�8ated egulatlons. § 21-92) kCPT�:51-Gal'r22 ��PERMIT:084051 CONSTRUCTION AND PLANNING ": POOL & S r R APPROVALS Permit #' Date Inspector APPROVALS Permit # • Date Inspector 1. Temporary Electrical Service or Pole 52• Pool & Equipment Location 2. Soil Pipe-Undrgrnd'• ' 53. Stedl Reinforcement - '�3,`� ctricail;'C uit,Utility Undrgrnd. 54. Forms 4:;ElectricaI Conduit-Undrgrnd, 55. Electrical Bonding y -16'.Steel ReinfotGefrent I 56, Rough Plumbing & Pressure Test '�+�; ElectricafiGF.ER Grad. 57, APPROVAL TO COVER-GUNITE' ' t. + --j'7' Foot ings-J 5$. Electrical Con duit•Undrgr•nd. l Foundation 59. Gas Pipe, D Undrgrnd,, Test r9. Water Pipe:Urid?br-6d. 60, Backwash Line's'; P-Trap, a Undrgrnd.' ' ; 10'Structural, Floor:System A ? 61, APPROVAL T-0 DECK '-11. Property Sewer'Line & Houi -Connection. _ _ 62: Backwash & Receptor-Final ,,12. Sewer Cap 63. Heater & Vent•Finai 1 , 13. Roof Drains _ 64. Pturr►bing System •Fina€ 14. Rough Ptumbin§ : z 85: > icctrical F'snal i 16. Rough Elec€rical-Conduit _ 66 Solar System Final r 16. Rough Electric Wiring 1 r ; 67, Fencing & Acees�Approval I u 17. Rough Wiring Sign "' ; r ; 68• APPROVEDFORPLASTERING' ' 18. Rough Electrical-T Bar Ceiling 69, POOL/SPA SYSTEMS IS FINAL 19, Rough Heating & Air Conditioning T FIRE DEPT. REQUIREMENT APPROVALS' Permit 20.^Rough Factory Fireplace �� • w I. :' i ~ 21.`Ducti, in-Siructu e - ^ s , v _ - ' 70:-Undergr3�und I hydro 22. Duets, Ventilaiing µ: -� S '' ;_r 71. Product- Pi ping'' ;teras G Oii 23. Gas`Pipe Rough & gest ; 72. Underground Flush. r., - 24.~Roof; Framing n. cl - R J 7-3. UndergFnd. Stn e Tan! ❑ Gas ❑ Oil -N i y. 25. Roof Sheathing _ * - u Ts _, .: _ rU 74...Over.he8a Hyd),O i 26.sT-Sar• Ceiling (Str6cturai) &,Monocoat -, 'y CV " � e 7�5. Dry Chemical c x 27.4rame and F14shing` _ �; �; Y _ x :r z o- n rr1 76. Dry'Stai�i�pipe�-+ J 28.' Lathing & Siding " .+ ti �" 77. FIXED-SYSTF3V`rFINAIL 29, Insulatipn �. 0"Ir 78. FIRE PREV. FINAL 30. Drywall>Naikrig - -HEALTH DEPTt--REQUIREMENT,_ 31. Plaster Brown_ J r i x _ 70, FINAL E INSPECTION ,Coat 32.-Electricai Power Metef:Final �^ ,. f§ ;r 60. FOOD CERTIFICATE PSSUFG 33.'`Fsnai.Electric i�fotes:�-- r 34.rFirtal; Heating & Air &C ditioning� ; '' '� =, w 35, inal'Gas Pipe-Test y r,.; / o' Ca,K 36.'Hood, or CanoPY ; c F c i 3r - {- •_ I ' -- -- Y - - - , . ; �-• t . Y `+ --11 ' 37.CFinai'Factory FirepiaCE` !1 ,r _. Sr _ r p, = rr: A {3 38. Fina45Plumbing ,- L w. w• f i n r u4 39. Water Service-Final-+ r. 4 ,. '. H-'7r v: 40.rGas Service-F.inaI ! 41-Solar Domestic Final 42.`BacVfiow Preventers - = w r 43, Backflow Irrigation'' '_;._ 7 f =44'• Landscape irrigation System' 1 { �• C :45'. •Sound ALtenwationl Handicap,Regulavops 1 77 471-FINAL STRUCTURE & BUi'LDING rZ6�-- +� .- 4 l 1 � 48::FINAL PLANNING,' _'_ t , t; + J w49',�=Electric Release to Edison r ; } s V• t _ i t - '50'..Gas Release to Southern California Gas Co CERTIFICATE OF,OCCUPANCY No. Date 'ADDRESS OF BUILDING: 3151 AIRWAY AV OWNER'sNAMEIFKNOINN: SO CAL SUNBELT DEVEOLPERS ADDRESS 3151 AIRWAY AV #150 ' COSTA MESA,CA 92626 • 540-5568 APDL. MAILM ADDRESS: VNIT: K-25 ARONRecTone mEER: LANCE POLSTER & ASSOC LIC.NO.1 C10085 AaaL OR Ella'S ADDRESS: 2094 S COAST HW Y UNIT: 5 LAGUNA BEACH CA 92651 CONTRAMOR'S NAME= SOUTHERN CALIF SUNBELT DV (714)777-4411 CO►IMACTORsNAILING 4501 EAST LA PALMA ApgR�q ANAHEIM CA „�� 670560 92869 gam: 200 LICENSED CONTRACTORS DECLARATION: I hereby affirm under perky of perjurythal I am I' PEXP005/98 der Prorialons d ChePler B (mmnnenrsq with Section 7000) d d th Division 3 e Business end Professions Cade, end my boensef force rstd sflect. 9nymNo, 069777 Lic.cuss: B LIC.NO.: 670560 'Doe: - Coranwor: _ OW!} BUILD D LARATSON: I hereby effum under perky d PerFnY tfhel I em exons m the Comranon lhrxree Ler+ fa to ,�pXdvrthg reeeon (Sxtion 7091.5 Busies end Pidessiore Code: Awry d7r err oourNy which uiros a perm$ to aorstnnct, after, irWrowh, demolish, or repair any strtrcturo, prior m *a esushre, abo requires IM epplicanl Far such pertrdt m his a signed etetrhmeris that ha or she is licensed pursuant to the provisions of the Contractors Lioene Law [Chapter 9 (oanmenaing with Section 7000) of Division 3 of the Business and Prdesaior Code[ or that he or she is exempt thmehom and the basis for to efeged exemption. Arty violation of Section 7091.5 by any applicant for a panful subjects the appfrant to a dd penally of not mom then two hundred dooms M500D, I. as owner of the property or ny employees with .rapes as their ids aompergalion, will do to work. and the ohudure in nor i Larded or offered for sale (Section 7044, Busirmg and Proleesio sCode: The Contractors License Law does not epplyto an ornerd properly who builds or inproves 1hereon, and who does such work Inmset ar herself or throuo hes or her awn employees. provided trial such improvemew are not intended or offered for sale. f, however, the building or mproverna i is add within one year of completion, the owner -builder well have the burden of proving he or she did riot brad or improve for the purpose of sale). I, ere owner of the prepay, am erdrsively contracting with Been sed contractors to constrb the project ($anion 7044, Bteinass and Prdea ms Coda: The Contractors License law does rot apply to an owner of p,4- y who builds or inproves thereon and who oonteds for such prajette with s ommolor(s) Imensed pursuant to the Contractor Lionise Law). I am exempt rude Section: S. 8 P.C.. for the meson: Date: Owner. I do hereby catdy thal I am aware of and understand the requimmorm of Celiornis Health and $ahoy Coda Sections 25505, 25313, and 2559a. and that t or any loose building oaogsm will 1 will not (aircle one) need to mhhNy with said state codes and the requir mats for a Persil for construction or modkzlion hen the Ai uMM aepahe9DiWrid. Rasidaa®I oonrudbn appfrffiitrs ere aernp lrorn time provision. tote: Applicant: WORKER'S COMPENSATION DECLARATION: f hereby afamt under perdAy d penury one d Vis folbwing dedaatiota: I here and will maintain s earl ire of coned to sellans re for worker' eomponantion, as Provided far by Section 370D of the Labor Code, for the performers of the hark for which the Perm* is Issued. I have and will maimoin workem' coert; alm marmnae, as requirireed by $adion 37�0Q0 d 0e Labor Cade, for the performaros d the work Tar which this parmit a Trued. My ,sorters' 55Lr_h h1V rarA 9poky number �: EXPIRES Pay Nurnbo 06/27/98 (This seeders need rid be completed r dw permit is foc one hundred dDHars (s100] or ism.) 7 I oatly tet m the pe fmwice d the work for which this Pam* is Teamed, I def not era loy non in any manrwr so m to IQ the worlon , oornpo satin laws of CalAonhi4 and Tisa the ff I sfhould oma s jot to the worker' p itis d Section 7'100 d the Labor Cade, I dhe0 f comply with Appfcaol: 41'W..1.,A-, to secure evrkero' contpalutlon coverapr la urrlasU and airs$ aA an errpl W ro erbnlmd ptndtlaa and mtndnd thousa d dollars (SIGaO100A ka addl0on to Ws coal of R damages as prorldad for fn 0! Ola Labor Coder Internal, and cftn7ey i lou CONSTRUCTION LENDING AGENCY: I hereby affirm under pasfly of perjury that there is a comtnrdion lending agahcy lar the performance of the hark for which 1hq permit a asusd (Sedan 9097, civ. C). LENDER'S NAME LENDER'S ADDRESS: Pcertily Ihhat I hew reed this application and stale thet the above irdom+eim is correct. I spree to comply with of City and county ordinances and sude lawn relating to buadii0 coraor rcfim and hereby adhorbs representatives dlh4 city to ata upon the abwrmaaioned property =f« irspemah purpoaev. DONNA SEAL r Doe: (515146.WP) "a,43uildiv A Safety. Oman -Rio; Canary-Appioam: Pink-fieweru e; Goldenrod-Assawor CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 08404 PERMIT NO: B 084049 PLAN CHECK NO: 02839-97 A GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION ; OFFICE TI SQ FT: 2,300 CLAIM VALUE: 2,300,00 CALL -VALUE: 2,300.00 GROUP OCC: B / COMMENTS: "--" OFFICE TI Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PLANNING NOTES> TENANT IMPROVEMENTS FOR OFFICE USE (NO GENERAL/SPECIALIZED > CONTRACTORS) IN SUITE OF JOHN WAYNE EXEC. GUILD CENTER, ***�4*�4*�EiE�EiEiEiE�E�E�E�E�EIE'lflE********'If�E�E�E�E�E�E�E�EdE�E**ill•**dE�E�E�k�E*dE**�E�E�E***�E�E��E�t*�E****dE�E�E�E**dE* D E V E L O P M E N'+.T SERVICES R E Q U I R E M E -N.-;5 S ZONING APPROVED BY� DATE: BUILDING APPROVED BY DATE: RISN1 APPLICATION ISSUED BY: DATE: �4 * * ilililit ill' illi aE * * iE 1titE� aE * trF it illi illi' ifi�i��E �t *�E �E �E � � � � lE LEGALIZATION:N F E E 5.0 M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC_i'.MECHANIC FIRE SMIP-%RES GRADING PERMIT 74.75 r ,` V { SMIP/NON-RES FEE 12+1- ,C - lHl t �} BUILDING -DIV-> PERMIT ISSUE -"FLAW CHECK TOTAL PAID DUE TOTALS ---- > 75.25 0.00 _12,.15 87.40 87.40 .00 REVENUE DIVISION TOTALS--> COLLECTED: 75.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN -CHECK 74.75 .50 j I N D I V I D U A L, F'E E B R E A K D O W N TYPE QTY D E S C R I P T I'O N UNIT COST TOTAL COST SFC 2300 T.I. OFFICE �` �BY'VALUE/$1 1.00 2,300.00 END OF #&P" authorized b �, y this Permit shall / 0orriply with all applicable handicap j`26/�l p �• a0c0ft requirements un L 0 ^ ' Statutes and related re �r Calffamia ( Na. 92-28, § 1, 12292) 08-05-1997/09:45 AM375,23 �i4��'"� �" i�G.�• kF:PT�:81-eG1ac21 P= :f-CMIT:084049 i S CONSTRUCTION AND PLANNING POOL & S APPROVALS Permit #` Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrndi. = 53. Steel Reinforcement 3..Electrical,Cgnduit.Utility-Undrgrnd- w 54. Forms 4, Eleetrieal-CoriduiL.Uridrgrnd 55. Electrical Bonding 51 St Reinforcer'`ient 56, Rough Plumbing & Pressure Test r 6; E1ectri"T4jFEFi Grnd. 57. APPROVAL TO COVER-GUNITE �7. Footings* '- 1 �`.y 58. Electrical Conduit-Undrgrnd. ^B. •Foundati6'n' - 59. Gas Pipe, C3U6drgrnd.; Test 9: Water Pipe;Undrgrnd. ; - r- 60. Backwash Lines. PI -Trap, ❑ Undrgrnd. .. s , '10: Structural Floor-sistem 61, APPROVAL TpbECK f11. Property; Sewer Line & House Connection 62. Backwash & Receptor-F.inai -12. Sewer Cap , 63. Heater & Vert -Final 13. Roof Drains _1 64. Plumbing System - Fin�C- _ 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical-Coriduit - 66. Solar System -Final 16. Rough Eleetrie•Wiri,g 67. Fencing &Access Approval ' 17. Rough WiriAg Sign _ 68. APPROVED FOR PLASTERING l 18. Rough Electrical T Bar Ceiling 69. POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVAL=S- Permit 20. --Rough Factory Fireplace + " 21.F.Ducts, in.Structufe, - �: 70.=Unc% ground Hydro } 22. Ducts, V.eritilaling, # +.j `' ' - _ - 71. Prodtt� Pi ing-`E las POil 23. ;Gas P•speTFiough &' ,est 72. Underground fJ.us.h. 24. ;Roo#. Framing- x x : 73. Undergrnd. Storage Tan?ft ❑ Gas C3 Oil 25. Roof; Sheathing > 4 74:,Overhead Hydro , . t 26. -T-Bar, Ceiling (Strktural) & Nlonocoat r 74. Dry Chemical 27. =Frame and Flashing ^' 1 �• x 7. 'Dry Star &ipe•_; 28. Lathing & Siding y•rx r 77'. FIXEDrSYSTE�A=F1N'�]_ 29. Insulatiop J - 4. 78. FIRE PREY. f:INAL x ._ 30. Drywall Nailing a =' ,lt fj ,:-+HEALT;! DEPTt REQUIREMENT .� 31. Plaster Brown Coatw 79. FINAL.tNSPECTION ; r' - 32.. Electrical Power Metel-,Final µ r 80: FOOD CERTfFICATI; ISSUED 33.E in21' EEectric R Notes: L= 7,1 34.'Find! Heating & AiryCohditioning ;1 _.."r .-, .^ • . 35.rfinahGas Ne -Test" -' -I��Qa 36.' Hood or Canopy , �GesISG[/ -,., 37. FinallFactory Fireplace . 1 3 41 a .c 38. -FinaL,Plumbing t; 39. Water Service•Final' i ' ► r� �= ;n - r 40. Gas Service-Ftnal = -- - �^ 41. Solar Domestic -Final ti r. •• ► '� 4 } rtZZ�. 42.`Backflow Preventers U -43. Backflow Irrigations -�17 i �• _ K _44. Landscape Irrigation System - - _rr _ - ' ,1 _45.'Sound Attenuation • < 46. Hand icap'FRegulations ;Z a , _ 471. FINAL STRUCTURE&BUILDING r- �•� 4$.IN 'FAL PLANNING` - ` »491..1le&Tic Release to Edison 50. Gas _Release to Southern California Gas Co , • .' . i 51! CER-TIFICATEOF,OCCUPA'NCYNo. Date I _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. C17Y ( CQSTA ESA C�NSTR UCT ON PE`R'MIT PERMIT NO. TRACT NO. LOT NO. UNIT NO, Project Address. CP /S /—" "4 w rl" i0 14a I'� /O >' Applicant's Mailin Add r/ s . A� /2 2 7—,ciAAL�d�_ �! ION,: Owner's Na , tl - Phone Address �Jss,(-!'P, (:f�+_f-may - �— �oS_T•¢ %l.tr' Arch/Eng, License No. Address Contractor's Nam IW AM Phone l� Add ressimai lingl 2- City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (Commencing with section 7000) of Division 3 of the Business and Professions Code. and my license is in f II for a and affect. �� License Class / Li o. Date Signature ')RK6S. C MPENSATION OE RATION areby affirm that I have a certificate of consent to self -insure or a certificate vf. Workers'. Compensation Insurance, or a certified copy thereof (Section 3800, Lab, C.) • Policy No. Way XS q� 16a' G� Company Cr0��W C� Z7 4'" -f K7 corfifled copy Is hereby furnished. rt fje py I ' I with the city B II ing D / Date O r Applicant �•(� EXEMP ION FIROM WORKERS' C PENSATION DECLARATION .(This section need not be completecV1 the permit Is for one hundred (5100) 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. Date Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Componsation provisions of the Labor Code, you must forthwith Comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY _ I hereby affirm that there Is a Construction'lending agency for the pperformance o1 the work for which this permit is issued (Section 3097 Civ. C.) Lender's Namo - Lender's Address DWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the, following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct, altar, Improve, demolish or repair any structure, prior to its Issuance, also requires the applicant for such permit •o file a signed statement that he/she Is licensed pursuant to the provisions of s Contractor's License Law (Chapter 9 (commencing with Section 7000) of vision 3 of the Business and Professions Code) or that he/she Is exempt erefrom 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 t enalty of not more than five hundred dollars ($500). . I, as owner of the 'property Or my employees -with wages as their sole compensation' will do the work, and the structure is not intended or offered for sale (Section 7044, Business and 'Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are -not Intended or offered for sale. If, however, the building or improvement Is sold within one year of com- pletlon, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale), • 1, as owner of the property, am exclusively contracting with 'licensed Con- tractors td construct the project {Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thoreon,'and who cdntracts'for such projects with a con- tractor(s) Ilcense pursuant'to'ihe•Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner �I-hereby certify that -1 have read this application and state that the above information is correct. I agree to comply with all. city 'and county Ordinance$ and state laws relating to build Ing construction, and hereby authorize repre- sentative$ of thi It y .to e e on m above-mentioned property r` inspection purp Signature to Drivers- Li nse or SS :r, �r 159 ey TYPE OF CONSTRUCTION LJ NEW LI ADD LJ ALTERATION Li REPAIR FEES ❑ ❑ ❑ CONVERSION DEMOLISH OTHER Bar Sink A.P. DESCRIPTION OF WORK/USE OF BLDG. ELECTRICAL FEES Backflow Preventer Service Sink- S Main Building: Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KIN ` ❑ 50 + KW E Bathtubs TYPE OF PERMIT GRADING 0 FOUNDATION 0 STRUCTURAL. T Front ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ❑OTHER Dishwasher ` A Rear Solar Piping C Right PROJECT DESCRIPTION SO. FT, OCCUPANCY Solar Tank CONSTRUCTION TYPE VALUATION$ Fan 5 Left . ZONE GRADING CU.YDS. ACRES Ping. Ref.,916 Remarks: Lp 1-3-g 7-5—Planning Inc. Solar 119-15 HP E] 16-15+ Notes: 1235 10/31/84 67.60 !TL Zone Accessory Building: Z O N N G 'R Perking Req./Provided E Q M T S CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING FEES Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink- Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KIN ` ❑ 50 + KW Backfiow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers i Solar Collectors Dishwasher ` Meter Dover 100 amps _ - Dishwasher Solar Piping Dryers ❑Gas ❑Electric 3 Sub Panel Drinking Fountains Solar Tank Fan Motors 00-11 HP ❑1 f, - 13 9 (� Floor Drains Swimming Pool vv/Spa F.A.U. Inc. Solar 119-15 HP E] 16-15+ Floor Sinks Urinal Fixtures I Microwave Gas Service Outlets Water Closet F Device Boxes Pole Light , Interceptors _ Water Heater Outlets ' + Range Kitchen Sink Water Service Switches Sign' Lavatories Auto -Wash Garbage Disposal ; Standing Sections P—Trap Laundry Trays Generator 00.5 KW 05-15 KW Trash Compactor Roof Drains ,Reinspection Fee $15 - Issue Fee $ 3 Reinspection Fee $15 Issue .Fee $ 3 MECHANICAL FEES' DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Date_ Boiler Hood or Type 1 ❑ ' Canopy Type )I ❑ -- Duct'- Under Ground' Duct - Structural I Refrigeration System Pa100,000 BTU _0100,000 BTU t _ Duct - Ventilating _ BUILDING PERMIT PLAN CHECK PLUMBING I PLAN CHECK 25% ELECTRICAL PLAN CHECK 50°.G MECHANICAL I PLAN CHECK 25% SUMMARY OF'FEES $ SMIP , S � � , , $ PERMIT ' ISSUANCE ;S '$ ENERGY P.C. I S (p-Q�% f GRADING 'S l $ S_ MICROFILM $ I is TOTAL FEE $ $ i Exhaust System ❑ Multiple ❑ ,System RepairlAlteratiori I FirepllFact. Sit. ICBO Fire.Dampers i Heating System &Ducting i 00-100,000BTU ❑100,ouueI Registers 1 i Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # 1. Temporary Electrical Service or Pole,' _E i Date j Inspector PL & SPA APPROVALS Permit # 52. Pool & Equipment Location Date Inspector f 2. Soil Pipe-Undrgrnd. . ' 53. Steel Reinforcement ry 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 Grnd. '' % ` 57: APPROVAL TO COVER-GUNITEi 7. Footings'` } l 58. Electrical Conduit-Undrgrnd. B. .Foundation -59.. Gas Pipe, ❑ Undrgrnd., Test ,! 9. Water Pipe-Undrgrnd. .- 60. Backwash Lir;es, P -Trap, ❑ 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 G 67.' Fencing & Access Approval 17. Rough Wiring Sign 68, APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling <277 !/ 69. POO USPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 2B. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 3D. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 8D. 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 47. FINAL STRUCTURE & BUILDING ' 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date I CT c — V6J11v$4._ A� ci7Y 6F*caSTA*MESA CONSTRUCTION PERMI-K-100/ Project Address -3 S I Ar � (,� 7><r C, it,— Applicant's Mailing Address Owner's Name n Phone Address 10 1240' Arch/Eng, i��h watt! _ I �— License No. _�S 12-2 Address J4 0..r [.t, r .. / ¢Z Contractor's Nam - �>�/� Phone 3 �y Address (mailing)- 3 l/.- LC 4.04 �,1 City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my License is in full for and effect. License Class �- 2 - Lice se a. Date / I` l3-� Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a certificate ' of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C. pp,� - - - ,./ ' Policy No. -7 - - -7 _ - � ' Company MP*6P Lu 7�'G ified copy is hereby furnished. 120 Certlf•etl co y is fit d with the city Bui g isi Date �!^ /� �+Applicant EXEMPTION FROM WORKERS',COMPENSATION DECLARATION (This sect ion. need not be completed if the permit is for one hundred (5100) 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 taws of California. Date Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/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 enalty 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for saleIf, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License taw does not apply to an owner of property who builds or improves thereon, antl who contracts for such projects=with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that l have read this application and state that the above ' 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 thi city to ter upon the bove-mentioned property for inspection r s. / C Signature TT 3-•-z- Date Drivers' License or SS :� :ant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO c-tO TYPE OF CONSTRUCTION NEW LJ ADD ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p -0 DESCRIPTION OF WORK/USE OF BLDG. ' S Main Building: TYPE OF PERMIT GRADING FDUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION Std. FT- ��o OCCUPANCY - C Right CONSTRUCTION TYPE VALUATION $ S Left ZONE GRADING CU.YDS. ACRES Ping. Ref. Remarks: Planning Notesi' 2047 11/13/84 Zone Accessory Building: Parking Req.IProvided Is as 2 !1w Z O N I N G R E O M T . S Reinspection Fee $15 I 1 Issue Fee MECHANICAL Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ F irepl)Fact. Bit. ICBO Heating System & Ducting ❑0.100,000 BTU ❑100,000BT, Reinspection Fee I $15 1F 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type I ❑ Canopy Type 11 ❑ Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTU System Repair/Alteration Fire Dampers Registers I5/d Issue Fee $ 3 PLUMBING FEES - ELECTRICAL FEES Washer Transformer ❑ 15-50 KW- - ❑ 50 + KW � Construction Pole Sub. - Ba"r Sink Showers • Back#love Praventer Service SinkAutomatic Backflow Irri ation Sewer Ca g P Bathtubs Sewer Connection + Cooking Unit Meter ❑up to 100 amps Clarifiers r Solar Collectors Date Date Dat Dishwasher Meter' ©over ,700 amps Dishwasher z Solar Piping Dryers ❑Gas ClElectric Sub Pane( Drinking Fountains Solar Tank Fan Motors ❑0-1 HP 01 A - 8 Floor Drains , Swimming Pool vv/Spa F,A:U. Inc. Solar ❑9-15 HP ❑ 16-15+ Floor Sinks Urinal $ 3 Fixtures Microwave. Gas Service Outlets Water Closet Device Boxes Pale Light Interceptors Water Heater Outlets Range i Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal ;Standing Sections P—Trap Laundry Trays Generator ❑0.5 KW ❑5-15 KW Trash Compactor Roof Drains Reinspection Fee $15 I 1 Issue Fee MECHANICAL Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ F irepl)Fact. Bit. ICBO Heating System & Ducting ❑0.100,000 BTU ❑100,000BT, Reinspection Fee I $15 1F 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type I ❑ Canopy Type 11 ❑ Refrigeration System ❑0-100,000 BTU ❑ 100,000 BTU System Repair/Alteration Fire Dampers Registers I5/d Issue Fee $ 3 Reinspection Fee $15 1 1 Issue Fee $ 3 FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By Date Date Dat S Z BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ $ $ $ S S S `� ' SD S I SMIP $ PERMIT ISSUANCE $ ENERGY P.C. S GRADING $ MICROFILM S TOTAL FEE $ ' -+ $ 3 ' CONSTRUCTION AND PLANNING APPROVALS . Permit # Date Inspector POU L & SPA APPROVALS Permit # Date Inspector E� 1 .. Temporary Electrical Service or Pole 52. Pool & Equipment Location .2. -Soil Pipe-Undrgrnd. 53. Steel Reinforcement r 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6, Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 87 Foundation 59. Gas Pipe, ❑ Undrgrnd., Test , 9"Water Pipe-Undrgrnd, 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10, Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connectign 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 1.7. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18:' Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ��.7 FIRE DEPT. REQUIREMENT APPROVALS. Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23.'Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas I] 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 PREY. FINAL 30, Drywall Nailing HEALTH DEPT. REQUIREMENT l 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50, Gas Release to Southern California Gas Co ; 51. CERTIFICATE OF OCCUPANCY No. Date' Applicant to fill in all spaces except those within heavy ya border lines and sign all appropriate declarations. "'�CITJ:'OF COSTA MESA, 6PNSTRUCTION PERMIT 'FE R NO. TRgCT NO. LOT NO. P (S� '53--- B D - - Sewer Connection Project Address• 1 rwaAve. - 05 a_ ,less - TYPE OF CONSTRUCTION X NEW ADD ALTERATION REPAI R ,. Clarifiers Solar Collectors •:• Applicant's Mailing Address 3151 Ai rway, E-1 s Costa Mesa ❑ CONVERSION ❑ DEMOLISH ❑ OTHE)3- y A.P. # ` a + h • = -• • - -- �� Dishwasher Solar Piping Ovvn&'s Name` Gui 1 dhouse -.Consul tants ' Phone 540-2605 pEscRiPrION.0F WORK . interior improvement + Drinking Fountains ; Solar Tank Dishwasher 'Meter Dover 100 amps - Floor Drains Swimming 1 001 w/Spa Address, '3151 Airwak'Ave. E-1. Costa Mesa ' r Floor Sinks Urinal + S E Main Build F. ,Inc. Solar ❑9-15 HP ❑16-15+ i AU•CONSTRUCTION Interceptors 1` Water Heater `� 2 Fixtures t ' 'Microwave } i , Dann Stant�/ ' C1O559 Arcl-/Eng. � }<' License No, TYPE OF PERMIT GRADING: FOUNDATION STRUCTURAL ® ❑ ELECTRICAL ❑ PLUMBING ❑ T Front P -Trap' , 1 ' .r TENANT MECHANICAL B Rear Generator 00-5 KW 05-115 KW ' Trash Compactor 1 Address 926 Town $t ''Country; Ora nge❑ oTI1sR A Reinspection Fee $25 Issue Fee $ 3 _ w MECHANICAL FEES Contractor's Name O • Donal d 01 Son. - Phone 540-2606 • PROJECT DESCRIPTION SQ. FT. OCCUPANCY - C Right Address [mailing} - CONSTRUCTION TYPE V -N _� VALUATION $-;.1.OQ_•00 S Left f= City,License No, �o�.��, 7 YDS ZONE ,. .� - - GRADINGCU.. ACR ES Ping. Ref, # Refrigeration System '� LICENSED CONTRACTOR DECLARATION ' I .hereby affirm that l am'licensed under provisions of Cnarter;9 (commencing Remarks: , Parking Req./Pr 1 with section 7000) of Division 3 of the Business and Professions Code, and _ Use of Building Duct - Ventilating my license is in full forC� a`n�,d effect. License,bla - LS^1 cense 33959 mate 11 i r BUILDING PERMIT $ PLAN CHECK $ PLUMBING h $ 1 PLAN CHECK $ ELECTRICAL $ PLAN CHECK MECHANICAL $ , j PLAN CHECK r $ Planning Notes: PLUMBING signature Bar Sink { Showers ORKERS' COMPENSA710N DEC LA RATIO v i 1 151 10/3D/B4 '013 L ;,� �• Zone L ,� I r Accessory Building: •- Z N L G E Park Fee Q U i N r}�I Certified copi'ls hereby furnished, 'b97 XJ( Cer i+u1a-�1i�i filed with the:city B din �loIn. Date yv Applicant Bathtubs t Sewer Connection Automatic Washer Oonstruction P_ole'Sub. Transformer ❑ 15-50 K EN ❑ 50 + KW _ Clarifiers Solar Collectors •:• EXEMPTION FROM.WORKERS' COMPENSATI DECLARATI N (Thissection need not be completed if the permit " for one hundr ($100) or less). Icertify that in ,tile performance of the work forjwhich this perrikit Is issued, I shall, not employ; any person in any manner so as to become subject to the Workers' Compensation, Laws of California. i Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' -Compensation provisions of ,the Labor Code, you must forthwith 'with Such previsions. or this permit , shall be , deemed revoked., LENDING. AGENCY; I hereby affirm that there is a:construction'lending agency for the performance of the work for. whiff this permit -is issued Section -3097 Civ: C,) Lender's Name • I�/ - .. (- _ Lender's Address OWNER BUILDER 5ECLARATIONLavatories` 1 hereby, affirm that I am.exempt from the Contractor's, License t:aw for the following reason (Section, 7031.5Business and Professional Code:.Any city or county which requires a permit -to construct, alter, improve, de_moiish or repair any structure, prior to its issuance, also requires the applicant for such permit file a,signed statement,that, he/she is licensed pursuant to the provisions of e 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 therefrom and the basis for the alteged exemption. Any violation of Section 7031.5 by. any applicant fora permit.• subjects the appllcantt to a civil penalty of not more than five hundred dollars ($500), :- LJ I, as�owner of the prop erty;or my'employees'. with wages as their sole t compensation, will do the work, and the structure is not intended or offered for salet (Section 7044, Business and Professiohal Code:. The' Contractor's License taw 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 employees, provided that such,improvements are not intended or offeredlfor sale. If, however, the building or improvement is sold within one year of com- I pletion, the owner' will have the burden of proving he/she did not build or lm- • groverfor the purpose of sale). h • = -• • - -- �� Dishwasher Solar Piping . - - Cooking Unit- r- ;!Neter- 06p to 100 amps �- - Drinking Fountains ; Solar Tank Dishwasher 'Meter Dover 100 amps - Floor Drains Swimming 1 001 w/Spa Dryers ❑Gas []Electric :Sub Panel i r Floor Sinks Urinal + Fan Fan j Motors ❑0-1 HP ❑1%z-'8 ' r Gas Service r Outlets ' Wter Closet' F. ,Inc. Solar ❑9-15 HP ❑16-15+ i AU•CONSTRUCTION Interceptors 1` Water Heater `� 2 Fixtures t ' 'Microwave } i • 1 Kitchen Sink Water Service � i Device Boxes Pnle Light + "` _ 2 Outlets Range ; P -Trap' , 1 ' Switches Sign I t + Roof Drains, v Garbo a Disposal ns $taridin Sectioi ! g i - 9. , l - C Generator 00-5 KW 05-115 KW ' Trash Compactor 1 � '+ 1 4•' Reinspection�Fee ,. + ' - $25, v Issue Fee.• $'3 Reinspection Fee $25 Issue Fee $ 3 _ w MECHANICAL FEES �, + Boiler, :_ I -� Hood or Type ! ❑ , - Canopy Type II ❑ - PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Application Approved By , I Appliption IssuedBy i Date ll u� t(i Hate , i - ' Qat 0 '` b 1 Duct - Under Ground Duct - Structural r Refrigeration System '� L❑J I, a5 owner of the property, am exclusively contracting with licensed con- , tractors to construct the project ((Section 7044, Business and Professions Code: The COntractor's License_law_does not.appiy -to an owner of property who builds or improve$ thereon, and who contracts for such ,projects with a con- tractors) license pursuant to'the Contractor's License La ❑ lam exempt under Section -- B. & P. C. for this reason ❑4100,000 BTU ❑100,000 BTU Duct - Ventilating r BUILDING PERMIT $ PLAN CHECK $ PLUMBING h $ 1 PLAN CHECK $ ELECTRICAL $ PLAN CHECK MECHANICAL $ , j PLAN CHECK r $ SUMM RY OF FEES f �1 $MIP $ = �• PERMIT ' ISSUANCE $ e ENERGY P.C. $ 1 GRADING $ i MICROFILM $ _ TOTAL FEE $ r + ` , t r Exhaust System ❑ Multiple ❑' _ System System Repair/Alteration v Firepl/Fact,Blt. ICBG # ' r ma=y Date Owner. I i - r I hereby certify that I have read this application and state that the above information is correct. I agree to 'comply with all city -and county ordinances and state laws relatingtto building construction,' and hereby authorize repre- sentatives of thl city to ent u the above-mentioned ,property for Inspection pure s lO�lO�84 Srgriature I } Date Drivers' Licerise or,SS 1 1 t Heating System &Ducting ❑0-100,000 BTU ❑ f 00,000 BTS -i - i 1 ' I Reinspection Fee $25 Issue Fee $ 3 GMF Oa65-46 rev. 7/83 White - Building; Canary-- Applicant; Pink - Accountlrig; Goldenrod-- iAssessor - - r- _.• - _ _ __� { I �•=� CONSTRUCTION AND PLANNING •1 APPROVALS Permit # Date Inspector F _ & SPA APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole- 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 64W 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 Grind . , 57. APPROVAL TO COVER-GUNITE 7. Footings f I 58. Electrical Conduit-Undrgrnd. B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 Iild7i7 up 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72 LUnderground Flush 24. Roof Framing 73. Undergrnd, Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat s �• j� 75. Dry Chemical 27. Frame and Flashing 11 7 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing �- r�8 HEALTH DEPT: REQUIREMENT 31. Plaster Brown Coal 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 iZ��1�cC (hD i 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final _ 42. Backflow Preventer 43. Backflow Irrigation 44. ,Landscape'lrrigation System 45. Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDINGS, 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 5 r Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. �TY O.F COSTA M5A,C0TRUCTION PERMIT -11 PERMIT NO. I TRACT NO. I LOT NO. I UNIT NO. PPoject Address lo Applicant's Mail, ess —2—UP X Owner's Na �Phone Address Z5 7 r Arch/Eng. License No, Address Contractor's Name yi4�t% 10 loll Phone .,.- ,s��`s� Address (mailing) ��/—� L � �y��'�% f C! C,ty License No, cw?47 zce LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, my license is in ful forcaand effect. License Clas v L Date Signature PORK S' C MPENSAT ION p RATION hereby'affirm that I have a cert tate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab.S� �� Policy No:G�LLLk,d' Company�l��s Certified copy is hereby furnished. Cor -fie is iled with the city B ' 'ng Divisj4. 7 Date Applicant EXEMP Ia FROM WORKERS' COOVENSATION DECLARATION (This section need not be completeo the permit Is for one hundred ($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. Date' Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with' such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY 4 I hereby affirm that there is a construction lending agency for the performanC0 of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the foliowing'reason (Section 7031.5.Business and Professional Code: Any city of 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 'o file a signed statement that he/she is licensed pursuant to the provisions of he Contractor's License Law (Chapter 9 (commencing with Section 7000) of Avision 3 of the Business and Professions Code) or that he/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 Jenalty of not more than five hundred dollars ($500). 1, 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 (Section 7044, Business and Professional Code: The Contractor's License Law does not apply loan owner of a property' who bullds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for We. If, however, the building or improvement Is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- prove fol the purpose of sale). ' ❑ 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who Contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section . B. & P. C. for this reason Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact, Bit. ICBO'# Date Owner Heatmg System & Ductmg I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BT information is correct. I agree to comply with all city and county ordinances and state laws relating to buil ing construction, and hereby authorize repre- sentativeZpurs city to o the above-mentioned grope inspectio SignaturDrivers' SS Reinspection Fee CMF 0865-4f, rev, 10/84 White - Building; Canary - Applicant; pink - Accounting; Goldenrod - Assessor $15 4ANICAL FEES LIALTERATION. LJ Reinspection Fee $15 issue Fee 3667 12/07/84 62aN0 TYPE OF CONSTRUCTION W 0 ADD REPAIR Date Dete pat Z Hood or Type 1 ❑ Canopy Type 11 ❑ Refrigeration System E1&100,000BTU ❑100,000 BTU ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. Zone' DESCRIPTION OF WORKlUSE OF BLDG. • 5 Main Building: Accessory Building: - — E - z TYPE OF PERMIT/ GRADING FOUNDATION STRUCTURAL T Front . 0 �� ❑ TENANT I ELECTRICAL ❑ PLUMBING ❑,MECHANICAL B N ❑ OTHER ' A Rear I C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G CONSTRUCTION TYPE VALUATION $ g I Left r R ZONE GRADING CU. YDS. ACRES ping. Ref. is Par king, Req./Provided E Remarks: i _ {� Planning Notes: M T S PLUMBING FEES Bay Sink Showers ELECTRICAL FEES Backflow Preventer - Service Sink ; Automatic Washer Transformer ❑ 15-50 KW Backflow Irrigation Sewer Cep Construction Pole Sud. ' 0 50+ KW Bathtubs w). Sewer Connectionf Cooking Unit Meter up to 100 amps S Dc Clarifiers Solar Collectors Dishwasher Meter []over 100 amps _s Dishvvasher_ Solar Piping Dryers OGas OElectric Sub Panel ed 4— Drinking Fountains Solar Tank Fan Motors ❑0.1 HP /r - B Floor Drains Swimming Pool w/Spa F•A.U. Inc. Solar ❑9.15 HP ❑ 16-15+ Floor Sinks Urinal Fixtures Microwave" S �( Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water ServiceSwitches Sign Lavatories Auto -Wash Garbage Disposal ; Standing Sections P—Trap_ _ Laundry Trays Generator 00.5 KW 05.15 KW Trash Compactor , Roof Drains Reinspection Fee $15 Issue Fee _ $ 3 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact, Bit. ICBO'# Date Owner Heatmg System & Ductmg I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BT information is correct. I agree to comply with all city and county ordinances and state laws relating to buil ing construction, and hereby authorize repre- sentativeZpurs city to o the above-mentioned grope inspectio SignaturDrivers' SS Reinspection Fee CMF 0865-4f, rev, 10/84 White - Building; Canary - Applicant; pink - Accounting; Goldenrod - Assessor $15 4ANICAL FEES Reinspection Fee $15 issue Fee $ 3 DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By ._ _ Building Approved By Application Issued By Date Dete pat Z Hood or Type 1 ❑ Canopy Type 11 ❑ Refrigeration System E1&100,000BTU ❑100,000 BTU SUMMARY OF FEES BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ 3� �b PLAN CHECK 50% $ J{a9O MECHANICAL $ PLAN CHECK 25% $ SMIP, $ PERMIT ISSUANCE $ ENERGY P.C. S GRADING S MICROFILM S �—�j TOTAL FEE $ `� c ' 24 System Repair/Alteration Fire Dampers' Registers — Issue Fee $ 3 �1CONSTRUCTION AND PLANNING :APPROVALS Permit # Date a Inspector F. L & SPA APPROVALS Permit # Date Inspector �. Temporary Electrical Service or PoW ` 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. `� i °'~ 53. Steel-Reinforcement i 3.jbectri'cal Conduit Utility-Undrgrnd" 54. Forms ,4,Electrical Conduit-Undrgrnd. 55. Electrical Bonding .5. Steel Reinforcer»ent 56. Rough Plumbing & Pressure Test 6' Electrical UFER�Grnd. 57. APPROVAL TO COVER•GUNITE 4 r, ,7�-Footings 58. Electrical Conduit Undrgrnd. + 8.' Foundation 59. Gas Pipe, ❑ Undrgrnd., Test ' 9. Water'Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. ,r f 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 i 137 Roof Drains 64. Plumbing System - Final 14. Rough Plumbing' 65. Electricai-Final l ,15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring - t 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. , Rough Electricat-T Bar Ceiling ��} 69. POOL/SPA SYSTEMS FINAL 19. ,Rough Heating & Air-Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71, Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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. Back flow'Preventer ` 43. Backflow Irrigation 44. Landscape Irrigation System r 45. Sound Attenuation 46, Handicap i Regulations 47, FINAL STRUCTURE & BUILDING r 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co i 51. CERTIFICATE OF OCCUPANCY No. Date • ' , C S C- Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO, TRACT NO. LOT NO, UNIT N ✓CITY OF COSTA MESA CONSTRUCTION PERMIT Project Address _-31S-1 /4 Applicant's Mailing Address 3tj// ' � /✓Glop- 0-a Owner's Name �Q .� d • Phone Address Arch/Eng. -��" �f A.OL- "- - /4 r � License No. 5/ Address Contractor's Name_- 7'wgNac rw, _ ` ' Phone Address imailing) 3�7 LIQ► ��+�'� �i1/`' Zr City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full fore and effect. License Class �- Za Li ns No. 3 sy2 c% Date "- /3- E Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that l have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C tt -7 �1 1/ n t �l Policy No. �1 1Z� ! COrppany /44/i'�Nc.c,a� Certified copy is hereby furnished. Certlf�/d curly is? tywith the city ul ng vi Date _ 77 7b. i Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thi$section need not be completed it the permit is for one hundred (5100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation' Laws of California. Date Signature NOTICE: If, after making this declaration, you should become Subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section -7031.5 Business and Professional Code: Any city or county which requires a permit to construct, after, improve, demolish or repair any structure, prior to its' Issuance, also requires the applicant for such permit to file a signed statement that •he/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section -7031.5 by any applicant for a permit subject$ the applicant to a civil enalty of not more than five hundred dollars ($500). 1, as owner of the property or my employees with wages as their sole compensation, will do the work, and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who.builds or Improves thereon, and who does such work hlmself/herself or through his or her own employees, provided that Such Improvement$ are not intended or offered for sale. If, however, the building or Improvement is sold within one year of com- pletlon• the owner will have the burden of proving he/she did not build or Im- prove for the purpose of Sale), ❑ I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon, and who contracts for such projects with a con- tra ctor(s) license oursuant'to the Contractor's License Law). I am aware that proof o their Worker's Compensation Insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner i hereby certify that I have read this application and State that the above 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 th)e city to ter, upon thyabove-mentioned property for Inspection p rp s Signature Oate Drivers' License or SS 9P - z FEES -�o TYPE OF CONSTRUCTION NEW ADO ALTERATION El REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. 916 DESCRIPTION OF WORK/USE OF BLDG. ELECTRICAL FEES Service Sink 5 Main Building: Automatic Washer Construction Pole Sub. E 'Transformer ❑ 15.50 KW C] 50+KW TYPE OF PERMIT GRADING 11 FOUNDATION STRUCTURAL T Front El TENANT ❑ ELECTRICAL ❑ PLUMBING MECHANICAL B Rear ❑ -OTHER A C Right PROJECT DESCRIPTION SQ. FT. OCCUPANCY KLeft CONSTRUCTION TYPE VALUATION $ $ Sub Panel ZONE GRADING CU.YDS. ACRES Ping, Ref. Remarks: R ► _ (\ Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P -Trap Roof Drains Reinspection Fee I $15 Boiler Duct: Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBG # Heating System & Ducting ❑0.100,000 BTU El 100,000 BT Reinspection Fee 1 $15 Applicant; Pink - Accounting; Goldenrod - Assessor 2096 11/13/84 zone Accessory Building: Parking Req./Provided' 21.75 TL Z O N I N G R E Q M T S PLUMBING FEES Showers ELECTRICAL FEES Service Sink Automatic Washer Construction Pole Sub. 'Transformer ❑ 15.50 KW C] 50+KW Sewer Cap Sewer Connection Cooking Unit Meter ❑up to 100 amps Solar Collectors Dishwasher Meter Clover 100 amps, Solar Piping Dryers ❑Gas ❑Electric Sub Panel Solar Tank Fan Motors C] 0-1 HP ❑1 fr B Swimming Pool w/Spa F.A.U. Inc. Solar ❑9.15 HP ❑ 16-15+ Urinal Fixtures Microwave Water Closet Device Boxes Pole Light Water Heater Outlets Range Water Service Switches Sign Auto -Wash Garbage Disposal ; Standing Sections Laundry Trays I Generator 00.5 KW 05.15 KW Trash Compactor issue Fee $ 3 Reinspection Fes $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: - Zoning Approved By Date . Building Approved By Date Application Issued By -- A' Dat Hood or Type I ❑ Canopy Type I I ❑ Refrigeration System ❑0.100,0006TU 0100,00013TU Z BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY $ $ $ $ $ $ $ i�- $ OF FEES SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ 7 System Repair/Alteration Fire Dampers %3 Registers SI¢ Issue Fee $ 3 • CONSTRUCTION AND PLANNING APPROVALS . Permit # Date Inspector VUOL & SPA APPROVALS Permit # Date Inspector I . 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 58. Electrical Conduif-Undrgrnd. i 8:• Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 grains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Fina! 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%3f (,gyp FIRE DEPT. REQUIREMENT APPROVALS. Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71, Product Piping ❑ Gas ❑ Oil 23.1 Gas Pipe -Rough & Test l 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 l ; 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 Preve6ter 43, Backflow Irrigation , 44, Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINALS TRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co l I 51•. CERTIFICATE OF OCCUPANCY No.,,,._ --- Date 71 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. I UNIT NO. CITY OF COSTA MESA 11170 In 11CTIUlm R rrI^I - Project Address ._ I S�! f ►AiDLy V Applicant's Mailing �ddres Owner's Name of `Jk Phones�.n'_c0 Address 2 I t (V�f 12W Arch/Eng, License No. Address Contractor's Nam D Phone I Address (mailing) ` V e City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Buslness and Professions Code, and my license is in fuil forcend effect. Licens¢ lass Date If — Signature NOR KERS' COMPENSATION D RATION I hereby affirm that I have a certifl to of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Policy No. WCS�G�C} I Comp.r., fact3 eCertified copy is hereby furnished. Certified copy •s f�i�led with the city B_ uil i g Divisi Date l i�r—a `•r Applicant EXEMPTION FROM WORKERS' COMP ATION DECLARATION (This section need not be completed if th ermit is for one hundred ($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 m ner sq as:V4 e subier't to the Workers: ompensation Laws of Calitori Date Signature NOTICE: If, atter makik this declarat n, you show ecome subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be, deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section ._7031.5 Business and Professional Code: Any city or county which requires a permit to construct; after, improve, demolish orirepair any structure, prior to its issuance, also requires the applicant for such permit 'o file a signed statement that he/she is licensed pursuant to the provisions of 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 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 ' enalty 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such,!mprovements are riot intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or,im- Irove for the purpose of sale).. , as owner of the property, am exclusively contracting with licensed con- { tractors to construct the projectiSection 7044, Business and Professions Code, The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and _who contracts for such projects with a con- tractor(s) license pursuant to"the Contractor's- License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that 1 have reas application and state that the above informatidon is correct. 1 agree to o ply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection potes. Signature Date rSs GMF 0865-46, rev. 10/84 Z SUMMARY OF FEES BUILDING PERMIT $ SMIP PLAN CHECK $�PERMIT PLUMBING $ �� .: J�_ ISSUANCE PLAN CHECK 25% $ 3 iD(ENERGY P.0 ELECTRICAL $ GRADING PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ 2167 1 1 / 1 4/64 IBM TL TYPE OF CONSTRUCTION NEW 0 ADD Ll ALTERATION El REPAIR ❑ CONVER51ON ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. A.P. Zone $ Main Building: Accessory Building; TYPE OF PERMIT GRADING 0 FOUNDATION 11 STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ 'OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION 5 ZONE GRADING CU.YD5. ACRES E T Front Z O B A Rear N I Right N K K S Left ,_ G R- Ping. Ref, yll= Parking Req./Provided E Remarks: + 1 Q S Planning Notes: O M T S PLUMBING FEES Bar Sink Showers ELECTRICAL I FEES Backflow Preventer Service.Sink Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW ❑ 50+ KW - Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter El over 100 amps. Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors El 0-1 HP ❑1 /r - B , Floor Drains Swimming Pool w/Spa . F.A.U. Inc. Solar E] 9-15 HP Eli 6-15+ Floor Sinks Urinal Fixtures Microwave Gas Service Outlets Water Closet Device Boxes Pole. Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto-WashGarbage Disposal ; Standing Sections _- P—Trap-- - -Laundry Trays Generator ❑0-5 KW 05-15 KW Trash Compactor Roof Drains Reinspection Fee $15 I I Issue Fee MECHANICAL Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # — Heating System & Ducting ❑o-1 oo,o00 BTU ❑ 100, 000BT1 Reinspection Fee I $15 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type I ❑ Canopy Type 11 ❑ Refrigeration System ❑0-100,000 BTU ❑100,000 BTU System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 Reinspection Fee $15 Issue Fee FE ES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By $ 3 $ SUMMARY OF FEES BUILDING PERMIT $ SMIP PLAN CHECK $�PERMIT PLUMBING $ �� .: J�_ ISSUANCE PLAN CHECK 25% $ 3 iD(ENERGY P.0 ELECTRICAL $ GRADING PLAN CHECK 50% $ MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ $ 3 $ 3 $ - CONSTRUCTION AND PLANNING !APPROVALS - Permit # Date Inspector L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment'Location j 2. -Soil Pipe-Undrgrnd. 1 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. - 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. SteeliReinforcement 56. Rough Plumbing & Pressure Test -6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 58. Electrical. Conduit-Undrgrnd. 8' Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 111Z 71-JL( Lam% 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. POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS. Permit # 20.i Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71, Product Piping ❑ Gas © Oil 23, Gas Pipe-Rough & Test 72.-Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 i Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing CICO 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation I 44, Landscape Ir rigation System 45, Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric. Release to Edison 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY No. Date TA MESA TION PERMIT Project Address J1J1 tilIwo y myt:. N–IU/ , LUJLCL ITIC,d Applicant's Mailing Address. 3151-A1 ruay Ave. E-1, C.M. v Owner's Name dui l dhouse Consul tants phone 540-2606 Address 3151 Airway Ave. E-1, Costa Mesa Arch/Eng.. Cary astien &'Assoc.LicenseNo. C011164 Address 2902 Redhill Ste 210, Gta Mesa Contractor's Name Phone45 0-2606 Address(maiting) 315LA•irway Ave- E-1, Costa Mesa— rCity Licr.nse No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provlslons of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fuN force and effect. _ 3 969 License Class CS L N Date - 10125. 8-4 Signature ORKERS' COMPENSATION DEC RATION , iereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation' Insurance, or a certified copy thereof(Section' 3800, Lab. C.) _ Policy No, _ —=d-_/ Company � %/Yi d4 Certified copy is hereby furnished. Gertijled okled with the city BU ng, ion Date L} Applicant EXEMPTION FROM WORKERS' COM NSATID DECLARATI N (This section need not be completed if the permit is for one hundred (5100) 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. Date I Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor'Code, you must forthwith comply with such provisions • or -this • permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for sfvjy(ch, this permit Is issued -.(Section 3097 Civ. C.) Lender's Name I1// ltil Lender's Address OWNER BUILDER DECLARATION - -_ .l -hereby -affirm that_ -am exempt, from.the Contractor's License Law for the following reason (Section 7031•.5 Business and Professional Cotler 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 ro file a -signed statement that'he/she is licensed pursuant to the provisions of e C.ntractor's-License Caw (Chapter 9 (commencing' with Section 7000) of lvision 3 -of the�Business and Professions Code) or that he/she Is exempt .nerefrom 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 , enalty of not more than five hundred dollars ($500). 1, as owner of the property -or my employees with wages as their sole Compensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such 11mprovements are not intended or offered for sale, 1f, however, the building or improvement is sold within one year of com- pletion, the owner wlll.have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the pro perty,am exclusively contracting with licensed con- tractors 10 Construct the project (Section 7044, Business and Professions Code: The Contractor's License Law• oes not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under section B. & P. C. for this reason Date Owner I hereby certify that I have read this appliCatlon and state that the above information is Correct. I agree to comply with all city and county ordinance$ and state laws rel ng to building Construction, and hereby authorize repre- sentatives of th city O e er inspection purpon the above-mentioned property for s. 10/25184 plicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. PERMIT NO -/�D S(5: TRACT O. LOT NO. BLDG. NO. 'SLI"' Z I $25I Issue Fee $ 3 I pA�2 r_._0-7 1 _ CONSTRUCTION NEW ADD ATERATION REPAIR TYPE OF CONAl Zoning Approved By ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. # 7 �– z7,DESCRIPTION OF WORK Interior Improvement S Main Building: Date TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL T Front ®A TENANT '❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - B [:],OTHER A Rear 2125 PROJECT DESCRIPTION SQ. FT. OCCUPANCY - C Right CONSTRUCTION TYPE VALUATION $ 31 875.00 g Left ZONE GRADING CU.YDS, 'ACRES Ping. Ref, 916 Remarks: G ` 4 A Parking Req./Provided Use of Building: PLUMBING FEES Planning Notes: It Bar Sink Backflow Preventer Backflow Irrigation r Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Flpor Sinks Gas Service . Outlets, Interceptors Kitchen Sink Lavatories P -Trap , Roof Drains, _ Showers Service Sink Sewer Cap ; Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service M■ Reinspaction,Fee $25 l Issue Fee MECHANICAL Boiler Hood or Type • El Duct - Under Ground Canopy Type 11 ElDuct-Structural Refrigeration System Duct - Ventilating ❑0-100,000 BTU E1100,000BTU Exhaust System 1:1 Multiple 1:1 System Repair/Alteration Firepl/Fact. Bit. iCBO # Heating System & Ducting 0 0-100,000 BTU 0100,000 BT Signature Date Drivers' License or SS Reinspection Fee I $25 I I Issue Fee CMF 0865.46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor ' $ 3 FEES $ 3 Automatic Washer . Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan _ F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator E10-5 KW E15-15 K ' 1 done/05 Accessory Building: Park.Fees $ • i - GQ 2 'A-UT4S Ar�'' T(f" ELECTRICAL Transformer 1115-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps Sub Panel =Motors ❑0.1 ' HP 111%-8 Inc. Solar ❑9-15 HP C]16-15+ Microwave 'Pole Light Range Sign Standing Sections W Trash Compactor 33705 •!ti Z O N _N G R E - Q U I R •E' M E N ' T -5 FEES, - P MM no ■E ®o ■■ ME ,■ I Reinspection Fee I $25I Issue Fee $ 3 I PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Application Approved By Date Application Issued By Dat su�MMARY Q� FEES BUILDING PERMIT $ 11 p SMIP � g $ _ K3 PLAN CHECK $ w - r Se! PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL $ TOTAL FEE $ �0 PLAN CHECK $ - UCTION AND PLANNING Permit # Date V Irispector PO 4 SPA :APPROVALS Permit # Date Inspector ary Electrical Service or Pole 52'.".Pool,& Equipment Location F' 2. Soil Pipe Undrgrnd.53. Steel Reinforcement 3.' Electrical Conduit Utility-Undrgrnd. 54. Forms ;4.' Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6•. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings / ; 58. Electrical Conduit-Undrgrnd. 8. Foundation �t f + S 59. Gas Pipe; 0 Undrgrnd., Test 9. Water Pipe-Undrgrrid. • 60. Backwash Lines; P -Trap, ❑ Undrgrnd. 10. Structural Floor System Y 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 ; ; ' 1 ' 68. APPROVED FOR PLASTERING 18. Rough Electrical -T -Bar Ceiling 4. 69. POOL/SPA SYSTEMS FINAL 19. Bough Heating &'Air Conditioning FIRE DEPT, REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace { 21. Ducts,' in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23.• Gas Pipe -.Rough & Test - 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat(/a � 75. Dry Chemical 27.. Frame and Flashing %2/�c� _I �f ' 76. Dry Standpipe 28.1' Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30' Drywall Nailing �3 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION i 32. Electrical Power Meter -Final ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ` V�� y S, 34. Finat Heating & Air Conditioning . i 35, Final Gas Pipe -Test 36. Hood or Canopy 37. Final'Factory Fireplace i t 38. Final Plumbing I 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 47. FINAL STRUCTURE'&BUILDING ( oe, 48. Special Requirements Completed 49. Electric Releese to' Edison 50, Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANC No. US Date' Sy _ rss op BUILDING: 3151 AIR WAY AV .. ERSfM011' oloam: SUNBELT CONSTRUCTION ADDRFss: 4 501 E LA PALMA AV SUITE 200 ANAHEIM, CA 92807 APPL. MAILING ADDRESS: UNIT: K ARCHITECT CAumm: LANCE POLSTER & ASSOC ur-NO4 C10085 ARM OR Sn'S ADDRESS: 2099 S O COAST HWY UNIT: 5 LAGUNA BEACH CA 92651 COHTRACTORSNAIW- SO CAL SUNBELT DEVELOPERS (714)777-4411 CONTRACTORSmam 20082 ROGERS DR ADORE ORANGE CA Amo.; 670560 92869 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury IMI 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 11 and l LIC. CLASS: B LIC. NO.: 0 ,- P OUILIER Contractor: DECLARATION: I hereby affirm under penalty perryry that I am exa pl the Cortreotors a Law for de following reason (Secion 7031.5 Business and Professions Code: Arty oily o county which requires a pertnit to sons ,eller, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to fib a signed statement that he or she is licensed pursuant to the provisions of de Contractors License Law (Chapter 9 (oommencinrg with Sedion 7000) of Division 3 of the Business and Professions Code( or that he o she is exempt thrershom and the basis for the alleged exemption. Any violalion of Section 7031.5 by any applicant for a permit subjects the applk M to a cissa penalty of rel more than five hundred dollars IMD, I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the stmeture is net iMertded or offered for sale (Section 7044, Business and Professions Code: The Contractors License Law doss not applyioan owns of popery who buids or inprevss thereon, and who does such work himself or hersed or through he a her own employees, prvrided that such impvvernems are nal intended or offered for sale. H, however, the building or irnprvvernem is sold within one yew d completion, the owner -builder wRI have the burden of proving he or she did net build or improve for the expose of sale). I. as ower of the propeay, am exrh lively eontraclN with licensed contrectors to conamict the project (Section 7044, Business and Professions code: The Contradors License Law does nal apply to an owner d poparty who builds or improves Iherear and who contracts for such projects with a rasredar(s) licensed pursuers to the Cadredore License Law). 0 I am exempt under Section: B. A P.G., for dia' reason: Date: Owner: I do hereby candy that I am aware of and understand the requirements of Caliomia Health and Safety Code Sections 25605,255,'13, end 25534, and that I or arty future building oom pem will I win ncl (circle one) need to comply with said state codes and the requirements for a permit fa conetrnwtion or modi5ention Irom the Airanagomem Disl6a. Residential omhsnuction appFaions aha mmmp from these provisions. Date: - Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty d paory one d the following deciarmins: I have and wig maintain a certificate of consent to sell -insure for workers' compeneatidn, as provlded for by Section 3700 of the Labor Code, far the performance of the work for which this permit is issued. 1 have and wig maintain workers' mmpansdon insurance, as required by Sedion 3700 of the Labor Cade, for the performance of the work for which this purmi is issued. My warkars' rnmpsnaation insurance eanrier and policy number are: Carrier: Policy Number. {This section need not be compfefed P the permit is IAD one hundred dDAars IPM) or low.) �] I certify that in the performance of the work for which this permit is issued, I shall not employ any �t�MA�nbecome su6jed to IM workers' carrrpeneetion laws d California. and agree tenet i1 I compensation /��^a.me of Section 3700 of the Labor Cada, I shall hwit with r.111__...1,_,F,,1',CT,0N ta: Y- Appk., d. ami Failure to secure rontere' roarpenaaCon coverage b n f, and aftaff aubfect an toyer I. urhrtfnd purnutftlea and up to one hundred thousand dollars (SIGQ000A In addidon to dna cost of comperradtfor% damsp e v provided for In 06 of dna Labor Code, Interest, and sfWrrrq'a lea. LENDING AGENCY: I hereby affirm under penalty of perjury that there is a oonstnrdion landing agency for the performance of the wok fa which this perms is issuad (Section 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I cert** that l Mee reed this application and state that the above information is correct, I agree to comply with all city and county ordinances (5151-460P) White -Building A Safety; Gratin -File; Canary -Applicant; Pink -Revenue; Goldenrod-A9eessor CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 084938 PLAN CHECK NO: N CONSTRUCTION TYPE: IV PERMIT TYPE: MEC JOB DESCRIPTION : ADDITION OF 1HR CORRIDOR/ RESTROOM CLAIM VALUE: CALL—VALUE: q -aoo3e_) PERM NO: M 084938 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B / COMMENTS: "SPEC SUITES" REF:B-83448 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RIGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING NOTES> > r, iE�E�E�E�E�EiEiE�E�E�E�E�E*****iE��*�**�iF��EiE11-��iE11-11-iE141f11-*i4 i4�E11-11-****dE*11-�EdE�E�E�E*fir*�iriEiEiE�E D E V E L O P M E N T S E R!V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: /Z - 11E �E ;tE iE iE dE d4 iE it fit• iE iE � -lk iE * * i4 i♦ * * iE 3F iF ilr 9E iE �r iF iE �F iF iE iF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 13.00 254 SMIP/NON—RES PLAN ISSUE FEE 22.00 BUILDING -DIV—> PERMIT ' ISSUE PLAN—CHECK TOTAL- PAID -DUE TOTALS --7—> 13,00 22.00 0.00 35.00 35.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 35.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 35.00 >f iE dE iE � iE 1E iE iE iE � iE iE �E iE i4 iE iE iE it• it• i4 iE it iF iF iE iF iE iE iE iF �- iE �4 iE �4 i4 ore �4 �4 �4 if iE iE �E * �G i4 �E of iE iE * if +4 +4 -Yt iE �sl- iE +E ,>f � ;F iE iE �E iE iE � ;G � � * y{- ,k ie I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST MEC 2 FIRE DAMPERS 6.50 13,00 END OF FEES 09-29-1997/94:02 PrvI 35.Z. - kLPT�l:31-aOlcriSs P Lk,i11 i : 64 CONSTRUCTION AND PLANNING POOL SkH APPROVALS Permit # Date inspector APPROVALS Permit # Date Inspector 1. Temporary glectrical Service or Pale 52. Pool &Equipment Location 1 1 2. Soil Pipe-Undrgrnd. ' 53. Steel 'Reinforcenient -3, Electricai=Conduit'.6fility-Undrgrnd, 54: Forms ?4: Electrical Cohdujt•tJ6rgrnd, 55. Electrical Bonding ' r 3. Steel Reinforcement 56. Rough Plumbing & Pressure Test .6- Electrical UFE'R:Cnd. 57, APPROVAL TO COVER-GUNIT£ 7. Footings , �•� �, 5B. Electrical Conduit-Undrgrnd. -8w Foundation ' -' 59. Gas Pipe, C Undrgrnd., Test _9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. StructuraE'Floor!aYstem 61, APPROVAL TO DECK E 11, Property'Sewer Cine•& House.Connection 62. Backwash &Receptor -Final 12. Sewer Cap 63. Neater & Vent•Fina4 r 13. hoof Drains _ 64. Plumbing System Fin al 14. Rough Plumbing, 65. Electrical- Final 15. Rough E€e tricai=Conduit 66. Solar System -Fina! ` 16. Rough Electric Wiring / 67, Fencing'& Access Approval ' 17. Rough Wiring Sign . _ 68, APPROVED FOR PLASTERING- , 18. Rough ElectricaLT Bar Ceiling 69. POOUSPA SYSTEMS Fl NAL T9: Rough treating &-Air Conditioning- FARE C�_PT.-REQUITEMENT APPROVAL'S ;, w Permit # 20. 'Nough Factot:l� Fi l lace ' t '; E f. t _ , 21. Ducts, in.Structure" 5 j' 70. Undergrougcf Hydro " 22. Qucts Venti€afing ; •' 71. Produet Piping ❑jGas Q Oil 21 Cas Pipe -Rough & Test r rt L 72. Undergrot,rid F,lu�h - - - T1 24, Noof'Frarnin ?i--' 5 - -. • 73- Undergrrid. Storage Tank [3 Gas ❑Oil �. , , .; y 25. Roof:Sheathing 74: Overhead Hyde r 26,18ar"-Ceilin uctural) & Monocoat g {Str 75.: Dry Chemical _ �rt 27. Frame and Flashing : - , N �' r 76. Dry Standpipe 28. Lathing & Siding '' `, ' 77„ FIXED S,�TEjI=PINAL r 29, Insulation- ,7z: t 5 ti r. :� - 78: FIRE PREV. FINAL r 30. Drywall Nailing .K i 7 -HEALTq DEPT. REQUIREMENT _ F 31. Plaster $ o'wn Coat . .- , �� 79. FINAL [1 SPECTION F 32, 'F lectr'sca�Povv4r f>lleter'Final I ! :} 60. FOOD CERTIFICATE I$SIJED. 33. FinallrElectriC _ r :. ;� N6Yes: =' w ► -, IX r ' 34. Final'-He6ting & Air GnnG'stianir�g' /.�7�I 35. Final Gas Pip�.Test 36. Hood�or Canopy 37. Rinal.Factory Fireplace -- 3 i !► 36. Final=Plufribin 39. Water•Ser.vice-Final i K ' 40, Gas Servi e-Flnal F: z; .� ,-+�{ is +•', i !t ., ',� 41. Solar Domestic-Finaf 42. Backflow Preventer f - s ! - , , 43. Backflow Irrigation { 44, Landscape irrigation, System 45. Sound Attenuation 46. Handicap -Regulations o ' 471. FINAL STRUCTURE & BUILDING r ! 'r ' ' 0 _ 48. FINAL PLANNING 49. EEe65c: Release to Edison 1 56. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY " No. Date ADOF4SSOFBUILDWO: 3151 AIRWAY AV UNIT: K v'_^TER'yNNE IF10O"T SUNBELT CONSTRUCTION K - ADDRESS 4501 E LA PALMA AV IF SUITE 200 ANAHEIM, CA 92807 APPL.IIAUNG ADDRESS: ARCHITECT ORENGNEER: LANCE POLSTER & ASSOC ur-NO.: 010085 ARM OR EWS ADDRESS: 2099 SO COAST HWY LIM, 5 LAGUNA BEACH CA 92651 CONTRACTOR'SrrAff_- SO CAL SUNBELT DEVELOPERS (714)777-4411 CONTRACTDWS MAl1Di6 20082 R OG E R S DR ADDRESS. ORANGE CA uc-No.: 670560 92869 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby affirm ander penalty of penury that I am Licensed under proMeim d Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full lace and effect. C�C. No.: LIC. Cuss: B UC. NO.: 670560 Axa : Dote: - - catrador; R BUILD DEC ATION: I hereby s6mn under penehy d perjury That I errh examplj Ihe Conlrectore License Law followig reason Section 7031.5 Busness and Professions Code: Any city or county which requires a permit to mnehud, alter, improve, demolish, or repair any structure, prior to 49 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 exemplion. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penally of not more than live hundred dollars 1S,,0oj). 1, as owner d the property or my employees wih wages es their We compensation, will do the work, and the structure is not intended or offered foe sale (Section 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or innn pee Ihereon, end who does such work himseh is a or herself or through hher own employees, pid oved that such m improveents we not intended or offered for sale. h, however, the building or improvement is add within one year of completion, the owner -builder will have the burden of proving he or she did not build or improve foe the purpose of sale). I, as owner of the property. am exclusively contracting with licensed contractors to construct the project (Semon 7044, Busineas and Professions Cone: The Contractors License Law does not apply to an owner of property who builds or impovas Iherea and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors License Law). Q I am exempt under Section: B. A P.C., for this reason: Date: Owner: J 1 do hereby certify that I am aware of and understand the requirements of California Health and So" Code Sections 25505.25533. and 25534, and that l or any future buildig Docupant will! will not (circle ane) need to comply, with *ad state codes end the rsquiisi mIs for a permh for wwrt ction or modificst= from the Amity Ww-tagame t District. Residential amnanmion eppirimions ane exempt from chase pro.mahe. oma: Applicant: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the ldbwi g declarations: 1 hews and will maintain a cenificete of casm to selfA sure for workers' compenemion, es provided for bySenrion 3700 of the labor Cade, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as required by Sector 37oD d the Labor Code, for the perlormanca d the work for which this permit is issued. My worksm' rompenemion insurance carrier and policy number are: Comer. Policy Number: {oris section need not be completed i the paned is Aw one hundred dollars JSf001 or fess.) 1 cattily Ihm in the Performance d the work for which this permit is issued, I shah not employ any person in any manner no as to a subject to the workers' compassion laws of CafiWmia, and agree that 'd l should beco subj to the waYare' co pensa'o proviaion 'd Semen 3700 d the labor Cade, I sh" ell forth comply with Ilhose provjei me: rti Applicant: Q r1p ro one hundred thousand dollars f11f7Q 000), M adifdon ro floe cwt o! cs tlon, dameyea u prerld4d rot In 706 of the Labor Code, Interest, and artomey's fees. CONSTRUCTION LENDING AGENCY: 1 hereby affirm under penally of perjury that there is a construction lending agency for the performance of the work for which this permit is issued {Semon 3097, Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I certify That I have read this application and sate that do above information is mrred. top to comply with all my and county ordinww" end slate laws relating to buildig canssudion and hereby authorize representatives of this city to enter upon IM above-mentioned property for inspection purpose9. DONNA SEAL Date: (515145.WP] Whits -Building d Seery; Green -Flo; Canary-App9mrt; Pink- levans; Goldenrod-Peeeesor CITY OF COSTA MESA - BUILDING PERMIT — co© 1.61 PERM NO: M 084371 PERMIT NO: M 084374 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: IV PERMIT TYPE: MEC JOB DESCRIPTION : ADDITION OF 1HR CORRIDOR/ RESTROOM CLAIM VALUE: CALC-VALUE: PURPOSE: ALT SQ FT: GROUP OCC: B COMMENTS: "SPEC SUITES" REF:B-83448 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING-----•---- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN SZRKING RE8: PROV: PARCEL: 427291.15 ZNE: REF NO: PLANNING N TES> > t jE )E jE jE �E iE �E iE jE jE irr irr jE jE �E aE iE �E �E i4 if iE it i� jE Mfr Mfr � jE -!f � � aE � �E )E Mfr 1rr �E �E �E i'E'1E �E �E � i'E � if iE if iE irr irr iE iE iE iE jE k IE 7rr irr irr irr jE � jE iE � iE )E �E �E ie iE �E � �E D E V E L O P M E N T S E RSV I C E S R E Q U I R E M E N T S n ZONING APPROVED BY f� DATE: BUILDING APPROVED BY DATE: APPLICATION ISSUED BY: DATE: Mfr iE �E �E �E jE jE )E if �E'1E 7E dE iE iE j4 iE'lf- �4 jE * iF iF air jF iE iE dE �E UZZ..— * LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTR%ICr__ MECHANIC FIRE SMIP/RES GRADING PERMIT 98.00 25% SMIP/NON-RES PLAN ISSUE FEE l ,l 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 98.00 22.00 f 10.00. 120.00 120.00 .00 REVENUE DIVISION TOTALS--> COLLECTED.: li 120.'00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC Y FIRE SMIP/TOT GRADING PLAN' -CHECK • 120.00 ;! irr �E 1fr Mfr iE if i'E i'E i'E irr * Mfr Ifr Ifr iE iE �E �E �E �E �E i4 * * �E Mfr Ifr �E Mfr �E jE jE jE i'E �E jE it �E iE �E �F �F jf 1F 1F 1F irr k )f 1F * � iE jE * jE � jE iF jE * if jE i'E iE iE jE iE iE iE )E )E )E � ii: )E is iF I N D I V I D U A L F E E' B R E A K D O W N ,�`+ TYPE QTY D E S C R I P T I O N r;�..)� UNIT COST TOTAL COST MEC 4 REPAIR/ALT COOLING 'UNTrT,%SYS W/CNTLS 12.25 49.00 MEC 9 REPAIR/ALT HEATING UNIiT%SYS W/CNTLS 12.25 49.00 ,.END OF FEES r 9d-22-1997/11:©5 {j�1Y�12r;.�8 REPT4:01-2011203 PERMIT:0134374 ' • �CONSTRIJCTION AND PLANNING 1- % f c -'- ,APPROVALS Permit # Date �' Inspector POOL & brA 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 COVE R-GUNITE 7. Footings - 58. Electrical Conduit-Undrgrnd, 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., "fest 9, Water Pipe Undrgrnd. 60, Backwash Lines, P -Trap, ❑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 a 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 Hering & Air Conditionirig' i. FIRE DEPT. REQUIREMENT APPROVALS Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72, Underground Flush 24. Roof Framing 73, Undergrnd. Storage Tank ElGas D Oit 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT, REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 60. FOOD CERTIFICATE ISSUED 33. Final'Eiectric 34, Final Heating &Air Conditioning �7/4�/�p� Notes; 35. Final Gas Pipe -Test g 22112.11517 (f 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - 39. Water Service -Final ' 40. Gas Service -Final ° 41, Sotar Domestic-Finat 42. Backflow Preventer -43. Backflow Irrigation ' 44,. Landscape Irrination System _ 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING i -- 46. FINAL PLANNING - 49-. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51! CERTIFICATE OF OCCUPANCY No. Date EA I 7• rk ADDRFSSOFBUILDff10: 3151 AIRWAY AV UNIT: K OWNER'S' NAME IFI MN: SUNBELT CONSTRUCTION ADDREmS: 4 501 E LA PALMA AV ` SUITE 200 ANAHEIM, CA 92807 APPL. WJLITW ADDRESS: ARCHITECT ORMMEER: LANCE POLSTER & ASSOC uc.No-. C10085 ARCR.Oil Ella'S ADDRESS: 2099 S O COAST HW Y UNIT: 5 LAGUNA BEACH CA 92651 CORMACTOn NAME- SOUTHERN CALIF SUNBELT DV (714)777-4411 CONTRACTOR'sMAtJNo 4501 EAST LA PALMA Apg g; ANAHEIM CA moo, 670560 92869 U,R; 200 LICENSED CONTRACTORS DECLARATION: I hereby affim under penalty of perjury that I am licensed under provielone of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prtisss:ons Code. and my ficerse fs in fad lona and dfea. CITY LIC. NO.:069777 uc.Cu+ss: B LIC. NO.: 670560 EX : 05/98 Date: Cmmaaor j LE&& �L- OWNER BUILDIR D LARATION: 1 hereby affirm under penalty d perjury that I am a rem the Contractors L w for the fdbwing reason ISoction 7031.5 Bush end Prdessions Code: Any coy or county . requires a permit to construct, alter. demofeh, or repair arty structure, prior to is issuance, also requires the applicant for such permA to fib a signed stat~ drat he or s is licensed pur& M to the provisions d the Contractors License I"(Chapter 9 (commencing with Section 7000) d Division 3 of the Business and Professions Cods) or the he or she is exanpt theeharn and the basis for the aDeged exemption. Arty violation d Section 70711.5 by any applicant for a permit art oas the appfram to a civil penalty of ria more than five hundred dollars )s5001). ❑ 1. as owner of the property or my employees with wages as their sale compensation, will do the work and the structure is not intended or offered for sale (Seam 7044, Business and PrdessiN Code: The Contractors Liomme Law does not apply to an Amer of property 1' who 6tdds or inpwm thereon, and who does such work him9sa or hersei or Cvanph his other arm empbyees, prwAded that such imprerernads nue nor intended or offered for sale. 9, however, the balding or inprovernerd is said wehin one year d completion, the owner -builder will have the burden d proving he or she did not build or improve for the purpose d male). ❑ I, as ower of the property, am exclusively comramig with 5aersed contractors to corstroct the project (Section 7044, Business and - Prdessions Code: The Contractors Lease Lew does nor apply to an owner of property who b ilde or irn{noves thereon and who contracts for such pr*cts with a comracor(s) licensed pnusuem to the Contractors Lbems Law). • ' ❑ I am exempt under Section: S. A P.C.. for this reeaon: i Dope: Owner I do hereby certify this I am aware d and understand the requiromermp d California Health and Safety Code Sections 25505.25533, and 25534. and that I or any haure b tiding occupant will! wilt not (circle one) need W comply with said own codes and the requkernamis for e permit for constriction ormod6cauon freetheAi anepentem District. Residersialconstruction eppfumiamore exempt tr m these provisions. Data: APp6caa: WORKER'S COMPENSATION DECLARATION: I hereby dire sitar penalty of perjury one d the k8owi g declarations: ❑ I here and will maintain a c srtieere of consem to selarnlre for warkass' plmpersatim, a provided lot by Section 3700 of the Lobar Code, for the pedormahce d the work for which this permit is issued. ❑ I have and will moirsan workers' carnj erIon insurance. as required by Section 3700 d the Labor Code. br the performance of the work for which this permit is issued. My workers' compensation insurance cornier and policy number ere: Canisr: Policy Number: `ho section need not be c rnpWod I Me partat is for one trsscsd dollars fS100) or lead •, I oertty that in the perlomu uvo d the work torwhich ihle l>ennd is Wwmd. I " nor employ arty person N any manner m m io become subject to the workers' cornposation laws of California, end agree that it Ibanes¢ to IM wafers' compen lion tors d Section 3700 d the labor Code, I shall f h ' h comply with Data: -7111 Apotont: Werrting: F Nnue to secure wortsn' corrQeraatlon coverage is unkwhd, and shall subject an arnployer n crfmfns! rid civil firma up to one htndrsd thousand dollars (7i0QOWA In addition to Me met of corrgaruetfon, dernegm a provided 107 7.1 Section JAM of ms Labor Coda, Infsrml and aHorrmy m fsas. CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the performance d the work for which this permit is' ISection 3097, Civ. Q. LENDER'S NAME. LENDER'S ADDRESS: I comity that 1 have read this application and state that the above ittonrWon is correct. I agree tmmnpiy with e4 city and county ordinances and stale laws reletig to buidiq const ucbon end hereby authorize representatives of the dry to order upon the above-mentioned property for inspection purposes. DONNA SEAL Date: (5151-46.WP) White43uildiq S Sdery; Green -File: Canary-Appicant; Pink-F7evenue; Goldenrod -Assessor CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: E 083679 PLAN CHECK NO: N CONSTRUCTION TYPE: IV PERMIT TYPE: ELE JOB DESCRIPTION : ADDITION OF 1HR CORRIDOR/ RESTROOM CLAIM VALUE: CALC-VALUE: PERM NO: E 083679 GOVT: N SUPP: N PURPOSE: ALT SQ FT: GROUP OCC: B / COMMENTS: "SPEC SUITES" RE : #B 8 34 4 8 •$ $' 053 Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ------------ --------- ACCESSORY BUILDING----------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING NOTES> � � �E � � �E �E �E 1F 9E 9E �E � � �f- � it al• aE jf aE ?E aE it it 3f iE it iE it iE it aF iF fE iF iE ?E it � �E iE �E * * is >� 3F �k aE � �E * iE aE * � iE iF * it � fE fE jE 1E it * ?E df it iE iE aE ii * * � D E V E L.O P M E N T S E -"R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY; DATE: APPLICATION ISSUED BY: DATE: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC �FIRE SMIP/RES GRADING PERMIT 429.90 •50% PLAN � ISSUE FEE 22.00 BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTALS-----> 429.90 22.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 451.90 SMIP/NON-RES TOTAL PAID DUE 451.90 451.90 .00 451.90 OVER/SHORT: .00 FIRE SMTP/TOT GRADING PLAN -CHECK +t df aE iE 1E iE df * df * aE jE jE lf- df iE * � * * * * iE if * 3F * * * * * fE jE ale• �E�E �E #E �E IF -IE #E �E #E � �E IF � �f 'lE #E �E 3E � #E IF �E �E jl-19E ?E fE �E if ?E * * * * yE �E 9E �E �E �E ?E �E dl• jE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I 0,N UNIT COST TOTAL COST ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. 1.00 20.00 ELE 82 FIXTURES, LIGHTING ADDITIONAL EA, .65 53.30 ELE 20 RECEPT/OUTLET 1 ST 20 EA. 1.00 20.00 ELE 55 RECEPT/OUTLET ADDITIONAL EA. .65 35,75 ELE 20 RECEPT/SWITCH 1 ST 20 EA. 1.00 20.00 ELE 29 _ RECEPT/SWITCH ^'-ADDITIONAL £A. .65 18.85 ELE 2 NON -RES APPLIANCE NbT OVER 1.0 HP 4.25 8.50 ELE 34 RESAPPLIANCE N HP 4.25 B7-B9-1447/89'SB1AM/f45 ELE 4 SER'VIC_ESBELOW6000VES BELOW 201 AMP27.25 . END OF FEESPERMIRMOM-M87 CONSTRUCTION AND PLANNINGPOOL APPROVALS Permit # Date Inspector L 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-Undrgrno. 54. Forms 4. Electrical Conduit-Undrgrnd. 55, Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd, B. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ 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 S-21-17 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 APPROVALS Permit # 20, Rough Factory Fireplace 21, Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas © ail 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Gar Ceiling (Structural] & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 26. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30, Drywall Nailing HEALTH DEPT. REQUIREMENT 31, Plaster grown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 33, Final ElectricV; 34. Final Heating & Air Conditioning 7b 0. FOOD CERTIFICATE ISSUED Notes: Or%n�5%n�: 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38' Final Plumbing 39. Water S6rvice-Final 40, Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43, Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation �' o 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING r, C, L 48. FINAL PLANNING 49. Electric Release to Edison"' m ,t 50, Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date C ADDRESS OF BUILDING: 3151 AIRWAY AV OY1NEiTSNAME IFMM: SUNBELT CONSTRUCTION mora. 4501 E LA PALMA AV • . SUITE 200 ANAHEIM, CA 921307 APPL, MLING ADDRESS: UKT: K ARCRrrECTORM"NEER: LANCE POLSTER & ASSOC ur-NO.: C10085 ARCROREWSADDRES,: 2099 SO COAST HWY UNIT, 5 LAGUNA BEACH CA 92651 OONTRACO"NA -' SO CAL SUNBELT DEVELOPERS (714)777-4411 coNTRAcmnmmuNG 20082 ROGERS DR ADDRESS ORANGE CA Mww 670560 92869 UKT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under penalty of perjury that I am licensed under prarmcts of Chapter 9 (ctrnmancing with Section 700DI of Dirmion 3 of the Business end Professions C.)de. and my dxnse is in pati bite and effect. CITY LIC. NO.: uC, CLASS: B LIC. No.: 7 0 5 6 0 E y P Contractor. OWNER BUILDER DECLARATION: I hereby affirm under penalty of per) my that I an horn the Cartractors Lirenae the Wowing reason (Section 7031.5 Business and Professions Code: Any ray or oounty which roquuea a permit to ommuet alle, imprme, demoleh, or repair any mnuc%um, prior to its issuance. also requires the applicant for such psrmnt to file a signed statement dna he or the is kensed pursuant to the provisions at the Contractors License Law [Chapter 9 (oommmdng with Section 7000) of Division 3 d the auwwa aid Professions Code) or that he or she is exsnpt therefrom and the beat for the alleged examptinn. Arry violation of Section 7031.5 by any appliare for a perms subjects the appT— to a civil penalty of not more than TNe rammed dollars ill. ❑ 1, as owner of the propa„y or my arnpbreas wlh wages as their sole compensation. will do the work and the amx:tura is nit wended or offered for male (Section 7044, Business and Prdessions Code: The Ceerectore Lioarrse Law does not applyto an owner of propenry who had is or improves thereon, erre who does such work himself or herself or through his or her own amployeae. provided that Bud, inprvvernmxs me nal Wended croft for este. 0, however, the building or inpn NWee is sold within one yam of ovnpkXbn, the owns -b i will have the burden of proving he or she did not bold or improve for the Isapose Or Bele). ❑ I, as owner of the property, am esduaivaty oontradig with licensed contractors M construct the project (ueaion 7044, Business ed Professions Code: The Contractors License Law does not apply to an owner of properly who builds or impnwas thereon and who conuams for such projects with a owaraaor{si licensed pursuant to the Contractors License Lew). ❑ I ern exempt under Section: S. A P.C„ for this reason: Date: Ownen I do hereby candy that I am aware of and undsmiene the requirements of California Fleelh ant Safety Code Sections 25505.25533. ant 25534, and that I or my future building oompant will l will not (circle one) need to comply wih said male miss and the naquiremmto for a permit for construction or modificet;on from the Ai CQ 1y IXmragement Dimrid. Residential commrrdion eppicalio s me exempl from those provisions. Date: Appi am: WORKER'S COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and wil maintain a certificate of consent 10 904noure for +corkers' compensation. es provided for by Section 3700 of the Labor Code. fed the perfomsnce of the work for wlid this Permit is lasued. ❑ i have and wil maintain workare' cwmpeselion insurance. as required by Section 3700 of the Labor Code. for the perform ce of the work for which this permit Is Issued. My workam' compensation insurance came and policy number are: Carrier: Policy Number. ,71,s "amn need na be completed d the perm r is for one hundred loners (3 rev) or tsar) I tartly that in the performance of the work for which this permit is issued, I shall not employ in any manner so an to berms abject to the workers' con+pensalion Laws of Calilomla, sr+d agree that I I to Lha woriars' cornof Section 9700 or the Labor Code, I shall f ply with arose Date: ID Z7 '7 Appfram: warning: laffurm L seuoe nonrma' compensrrdon c&v+rww la urrlsA and Shelf ora arrwlayar to erfnnlrot and cfvu lyra w to one hundred thousand dollars (SIOfi 0001 In addltlon to are cost of don d++npse es Section 3709 of The Labor Coda, Interest end affpmry'a Asse. CONSTRUCTION LENDING AGENCY: I hereby affirm under penally, of perjury that thea la a aonstrunim kwxW g agency for the perkwmanae of the weak for which this perm4 is issued (section 3097. Civ. C). LENDER'S NAME: LENDER'S ADDRESS: I can" that I have read the application and mate that the above Wormalkn is coned. I agree to comply with all city and aunty oridtwhom and suds taws relatig to taddig tonetrvuctiory and hereby arehorae .q.—weaves or the city to ems upon the above -marooned property fmins Purposes - DONNA F I• P Data. c�.....h.,.s rw.....r�...,.hre..w..,w reser... r (51514e.WP) 5 Safety; f3reerrFh, �ievenua; C3olderhrod-/�vaeasar NO S A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 083448 PERMIT NO: B 083448 PLAN CHECK NO: 02065-97 A GOVT: N SUPP: N CONSTRUCTION TYPE: IV PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION : ADDITION OF 1HR CORRIDOR/ RESTROOM SQ FT: 18,000 CLAIM VALUE: 18,000.00 CALC—VALUE: 18,500.00 GROUP OCC: B f COMMENTS: "SPEC SUITES" Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- ---------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: CL REF NO: PLANNING NOTES> INTERIOR ALTERATION TO CORRIDOR AND RESTROOMS. _ �E'JE iE irk � if � if if if if if if of if if if � #� � if ?fiE it #4 tf t(• if if # tE if tE if # �c tE # tf tf tf �(• tf tE tf tE tE tE •1ItE tE tf if if tf tf tE tf tE �E if if if �E if `IE�IE iE tf tf tf �4 �4 if •11• �4 tE D E V E L O P; rM E ;� -T S E R V I C E S R E Q U I R E M E N' T: S ZONING APPROVED BY r l^r DATE: k - - ---- .. t �� BUILDING APPROVED BYE; Z DATE: q_ APPLICATION ISSUED BY: �f.:4 DATE: I if it• iE �4 iE i(- iE ->E iE ->E fit• � iE � � fit• iF il• irk iE �(• 14 i(• �F iE iE aE• # aF iF if• •Nr aE 9E iE LEGALIZATION : N F E E S U- ,M M A R Y STRUCTUFMIr SEGMENT : Y �` e i BLDG PMT PLUMBING ELECTRIC, MECHANIC FIRE SMIPfRES GRADING PERMIT 274.75 r r;' SMIP /NON—RES PLAN 44.65 ;;' r 3.89 ISSUE FEE ,{ BUILDING—DTV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE TOTALS-----> 278.64 0,00 44;65 323.29 323.29 .00 REVENUE DIVISION TOTALS--> COLLECTED.: 278,64 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 274.75 %, 3.89 .. ter. _ •' if if if if if if if if if iE iE iE iE iE iE iE iE iE iE iE iE iE if if if iE if iE iE * iE iE iE iE �E iE �E � it• it• i4• iE i4 i4 iE i4 i4 i4 � irk � * iE � � iE ?E iI• iE i4�F � * irk iE iE i4 irk �F i4 iI• * iI• iI• iI• iE i'E i'E iE I N D I V I D U A -,L' 'F 'E E Fir R E A K D O W* N TYPE QTY D E S C R I P T I O'• N• (� UNIT COST TOTAL COST SFC 18500 ALTER BY VALUE COMMERCIAL NOZONE 1.00 18,500.00 END -'OF FEES PERM I T a @83448 CONSTRUCTION AND PLANNING .APPROVALS Permit # Date Inspector POOL PA APPROVALS Perm it Da te Inspector 1. Temporary Electrical Service or Poie 52. Pool & Equipment Location 2` Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms r 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER•GUNITE 7, Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ^' 11. Property Sewer Line & !-louse Connection 62. Backwash & Receptor -Final 12, Sewer Cap -63. Heater & Vent -Final 13. Roof Drains t 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 Sar Ceiling 69, POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71, Product Piping El Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73, Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 27, Frame and Flashing 28. Lathing & Siding / _g7- - � 75. Dry Chemical 76. Dry Standpipe 77. -FIXED SYSTEM FINAL 29. Insulation 30. Drywall Nailing 78. FIRE PREY. FINAL HEALTH DEPT. REQUIREMENT " 31. Plaster Brown Coat 79. FINAL INSPECTION 32, Electrical Power Meter -Final 33. Final Electric 34. Final Heating & Air Conditioning 80, FOOD CERTIFICATr' ISSUED Notes: J dr/rte L� 141 l_ C`�/ ` 35, Final Gas Pipe -Test 36. Hood or Canopy 37. Final Factory Fireplace r 38. Final Plumbing , 41 39. Water Service -Final 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation r 46. Handicap Regulations e - j M 47� FINAL STRUCTURE & BUILDING yl�_�` 48. FINAL PLANNING 49. Electric Release to Edison _Q 50. Gas Release to Southern California Gas Go �� ry .. ca 51. CERTIFICATE OF OCCUPANCY No. Date 011 imDlli ss of atnLllfNc 31 51 AIR WAY AV ulrT: K OWNETSIIAMEIF001101k SUNBELT CONSTRUCTION 4501 E LA PALMA AV SUITE 200 ANAHEIM, CA 92807 ADPL, LtA UP60 ADDRES& AKVffECTOREmagi ; LANCE POLSTER & ASSOC u- C10085 ARCIL OR EM'S ADORES4: 2099 S O COAST H W Y aNT: 5 LAGUNA BEACH CA 92651 OWMACTOII'SNAL_ SO CAL SUNBELT DEVELOPERS (714)777-4411 CONTRACTOFTSMAILIM 20082 ROGERS DR ADOREss; ORANGE CA ucNo.: 670560 92869 UNIT: LICENSED CONTRACTORS DECLARATION: I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 d the Business and Pmleselma Code, and my Ik:erne Is In full force and affect. MY LIC. No.:�[uc. cLAss: B uc. No.: 670560 EX P C OWNER BUILDER DECLARATION: I hereby Om under perjury llnp I Nrh erernp from the Caarectors Lowe law for the following reason (Section 7031,5 Busnsss and Profasesons : Any city or county which requires a permit to construct, after, improve, demd'ah. or repair any structure, prior to Th issuance, also requires the applicant for such permit to file a signed statemere that he or she s Iiraneerl pursuant to the provisions or the Contractors License law [Chapter 9 (commencing with Section 7000) of Division a of the Business and Proleasionv Code) or that he or she is exempt thwekan and the basis for the alleged exemption. Army violation of Section 7031.5 by any applicant for a permit subjects the applicand to a civil perhahy of not more than five hundred dollars [55001). ❑ 1, as owner of the property or my employees with wages as their We compensation. will do the work, and the structure in not intended or offered for sale (Section 7044. Business and Professions Code: The Contractors Lioeme Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or hersell or through his or her own ampkrysns, provided that such improvements are not intended or offered for sale. lt, however, the building or i ix ova erd is sold within one year of completion, the owner -builder will have The burden of proving he or she did rat build or improve for the purpose of sale). ❑ 1, as owner of the property, am exclusively contracting with ioensed contractors to construct the polect (Section 7044, Buskrtrss and Professions Code: The Contractors License law does not apply ben owner of prope who low or impoves thereon and who contracts for such projeda with a cortmrtor(s) Deemed pursuant to the Cortroclove Loewe law). ❑ I am exempt under Section: B. d P.C., for Nis re®on: Date: owner. I do hereby certify Net I am aware of and understand the requirements of Caliorrhta Health and Sally Code Sodom 35505, 25533, and 25334. and that I or any future building occupart will / will not (circle ons) need to comply with said state codes and the requiremartts for apmtfor oonetnolon or modification from the AK rely asanhepemeM District.flarrldraglal construction applications era exemptfrom these provisions. Date: Applicant: WORKER'S COMPENSATION DECLARATION: t herhby affirm under penalty of perpry one d the fo0owirg declarations: ❑ I have and nil makdasn a certdime of oormsd to selfbsme for works' compensation, as provided for by Section 3700 of the Labor Code, for the p«fammnce of the work la whidt this perm is issuled. ❑ I have and will maintain warta,rs' corn ion Vmur oe. as required by Section 37W of the Labor Code. for the performance of the work for Which a" penult is issued. My walaors' compensation insurance carrier and policy number aro: Cartier: Poky Number. (Buis section need not be completed i the permit is for ane hundred dollars 151001 or bas} �] I certify Ilam in the performance of the work for which this perm is ' , i shall not employ ary parson n any manner so as to become subject to the workers' compensation laws d agree that d I should beacons K4W 1 woe"", Co/mrpensation provisions �Jaction 3700 d the Lebo Cole IaMwi h comply Date: /� • •[ Wamarg: FaOure m secure erortare' eorrpeewdon s unlatvRnf, and uNhB! anh811Ct an anpIcyor to erhrirai pariallfu and clavff fins rpt to one hundred thousand dollars ($1040001 it ddlgon to tbs cost of compensatlorL "ma as u provided for In Sse#on 1706 of data Labor Cods, Interest, and sttoMWA hes. CONSTRUCTION LENDING AGENCY: I hereby atfrm miler penally d per}ay that there is a oxidrudion herding agsw7 for the performance d the work for which the permit is issued (Section 3097, Cir. C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have reed this application and state that the above information is ronsct, l agree to comply with ail coy and county ordinances and state laws relating to building construcion and hereby authorize representatives d this city to enter upon the above- m s ioned property for inspection purposes. BENNY WILLIAMS (5151-460P) Whto-Building A Safety; Greork File; Canary -Applicant: Pink -Revenue; Goldenrod-Asseesor CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 083138 PERMIT NO: B 083138 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: IV PERMIT TYPE: STR PURPOSE: ALT JOB DESCRIPTION DEMOLITION TO PREP FOR T.I. SQ FT: 1,400 CLAIM VALUE; 1,400.00 CALC—VALUE: 1,400.00 GROUP OCC: 8 / COMMENTS: "SPEC SUITES" / REF PLAN CK # 2065-97A Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING------'------ FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42729115 ZNE: REF NO: PLANNING NOTES> df iIiIK• i(• ii ii n1E n1E ii # ii t# it �(• i(• fE iE �f• iE �(• iE �(• iE irk it �(• �(• ill- ll• iE �(• i# iE iE iE iE �(• ii � iF •K• df ii df ii iIiE irk df ii n1E iE df irk •K• d{• iE iE �(• df df iId(• � � lk lE iE iF .� •1E '1k !f n1E n1E n1E n1E niE D E V E L O P M E N S E R V I C E S R E Q U I R E M E,N",f S ZONING APPROVED BY DATE; BUILDING APPROVED BY t DATE; l APPLICATION ISSUED BY; DATE ; ,, C-2— 9 iE it � it �(• df �(• d{• iE iE iE iE iE •lE iE �f• iE )k * � if iE iE fE �E iE �(• �(• irk iF iF 7F -!(• it• LEGALIZATION:N F E E S U M M A R Y STRUCTURALSEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC ETRE SMIP/RES GRADING PERMIT 45.75 ' SMIP/NON-RES PLAN .50 ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 46.25 0.00' 0.00 46.25 46.25 .00 REVENUE DIVISION TOTALS--> COLLECTED: 46.25 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TOT GRADING PLAN -CHECK 45.75 .50 d} lE -1E iE iE �(• if it � * * * d(• 3E •?E �(• iE if if if if if d(• 3E iE n1E n1E 4E !f )<• irk irk irk *irk irk * d(• iE 1f )<• irk irk )E � d(• 4E irk n1E �k d(• t1E n1E n1E.)E )E d(• iE n1E �(• if �k d(• � irk irk lE 1f iE �(• 1E if )!• )F ME 4E niE 4E n1E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 1400 DEMOLISH BY VALUE COMMERCIAL NOZONE 1.00 1,400.00 END OF FEES 1lib v"r'•rr,; r,ry�lj;;4a dby it .. iia F1�ilrlii Silrir coon E � RY With all aPPlicable handicap ��``�� access requirements under California G Statutes and related regulations. ! 1.1�� ©b -8-1997/12;x3 Pr3/846. PS (Ord. No. 82-28, § 1, 12-21-92) I PEkI.aZ T - 083'1 3& ZONSTRUCTION AND PLANNING . APPROVALS Permit # Date Inspector POC SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location. is Soil Pipe-Undrgrnd, 53. Steel Reinforcement ' 3. Electrical Conduit [ltility•Undrgcnd. 54. Forins 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding �. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ` 6. Electrical UFER Gfnd, 57. APPROVAL TO COVER•GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe,'C) Undrgrnd., Test j 9. Water Pipe-Undrgrnd. 60. Backwash Lines,'P-Trap, D Undrgrnd, 10. Structural Floor System 61, APPROVAL TO DECK 11. Property Sewer Line & House Confrection 62. Backwash & Receptor -Final ; 12. Sewer Cap F 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 r 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL r 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas ❑Oil c 23. Gas Pipe -Rough & Test 72. Underground Flush 'r 24. Roof Framing 73. Undergrnd. Storage Tank ©Gas ❑ Oil '``CA 25. Roof Sheathing 74. Overhead Hydro ' s cN 26. T -Bar Ceiling (Structural) & Monocoat 75. Ory Chemical 27. Frame and Flashing 76. Dry Standpipe -2 CSE 28. Lathing & Siding 77, FIXED SYSTEM FINAL � n r� `J 29. Insulation 78. FIRE PREY. FINALS 30. Drywall Nailing HEALTH DEPT. REQUIREMENT a G 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 Irriqation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTUPE & BUILDING 48. FINAL PLANNING ! ` 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date I T Adss—r "'fs�Ir"inN �)ppllcant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY & COSTA MESA CONSTRUCTION PERMIT Project Address —3It S 1 _-ADoK Applicant's Mailing Address Owner's Name q Phon Address JD O CSO• Q- Arch/Eng.'�y ��'�" —�IiG License No. 3SLz—/ Address Contractor's Name M44ro'V P -`A lc- Phone 'ydsZ Address (mailing) - 3q / ior L'n R,r_sL,s- 44 City License No. LICENSEO CONTRACTOR DECLARATION I, hereby affirm that I am licensed under pravisiuns of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in full f ce and effect. License Class ' L' ryyv 35/� 9 Date J!— 13'5 signature'�— WORKERS' COMPENSATION DECLARATION IFT I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, -Lab. C7c) I N �� . ct .s , �( /,0Policy No, `- �7 -� Company tified copy is hereby furnished. ert;i�ie `rp!y ? jiled with the city Bu' n lv' ' Date ]] 1!77 Applicant EXEMPTION FROM WORKERS' COMPENSATION OECLARATION (Thissection need not be completed if the permit Is for one hundred (5100) 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 o 5 t become subje ! he r rV mp fop s of Cali rn _ 1 "/ natu NOTI . It"ZIller making chi Iaratl0 u sh eco subject to the Workers' Compensation provlslons of the Labor Code, you must forthwith comply with Such provisions or this permit shalt be deemed revoked. CONSTRUCTION LENDING AGENCY I noreby affirm that there Is a construction lending agency for the performance of the work for which this permit is Issued (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 asigned statement that he/she Is licensed pursuant to the provisions of the 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 .herefrom 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 enalty 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 (Section 7044, Business and Professional Code; The Contractor's 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 employees, provided that Such improvements are not Intended or offered for sale. If, however, the building or improvement Is sold within one year Of com- pletion, the owner will have the burden of prOving he/She did not build or Im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves !hereon, and who contracts for such projects with a con- tractar(s) license pursuant'to the Contractoi'i License Law). I am aware that proof Qf their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above 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 it to enter+ uoon the, above-mentloned property for inspection p rpo Signature Drivers' License or SS :(k Date—/ / / PERMIT NO, ZIZ TRACT NO. a LOT NO, LIN IT NO. K -10b 2096 11/13/84 5ya6� TYPE OF CONSTRUCTION NEW ADD El ALTERATION ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. REPAIR A.P. 906 Zone S Main Building: Accessory Building: TYPE OF PERMIT GRADING El FOUNDATION STRUCTURAL ❑ TENANT ElELECTRICAL ❑ PLUMBING MECHANkCAL ❑ ,OTHER . PROJECT DESCRIPTION SQ. FT. �e OCCUPANCY a "" CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU. YDS. ACRES E T Front Z O 8 A Rear N I K Right N S Left - G R Ping. Ref, Parking Req./Provided E Q Remarks: Planning Notes: (y . T S PLUMBING FEES Bar Sink Showers ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer ❑ 15-50 KW -- ❑ 50 + KW Backflow Irrigation Sewer Cap Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains Solar Tank Fan Motors 00-1 HP ❑ 11A - B• Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 139-15 HP ❑16-15+ Floor Sinks Urinal Fixtures Microwave Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service Switches Sign Lavatories Auto -Wash Garbage Disposal ; Standing Sections P—Trap Laundry Trays Generator 00.5 KW 05-15 KW Trash Compactor Roof Drains Reinspection Fee $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 Boiler Duct - Under Ground MECHANICAL Hood or Type I ❑ Canopy Type I1 ❑ FEES DEVELOPMENT SERVICES Zoning Approved By Building Approved By Application Issued By, REQUIREMENTS: Date Date chlDat Duct - Structural Refrigeration System ❑0100,000 STU ❑ 100,000 BTU 2 L Duct - Ventilati ; i�,v -'S BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN -CHECK 25% SUMMARY OF FEES $ SMIP $ $ PERMIT $ ISSUANCE $ $ ENERGY P.C. $ $ GRADING S $ ��'�I� OFILM $ $ TOTAL FEE $ $ Exhaust System ❑ Multiple ❑ System Repair/Alteration Firep1lFact.Bit. IC60# / 1 Fire Dampers `'1 Heating System & Ducting ❑0-100,000 BTU ❑100,000 BTLZ/ Registers Reinspection Fee $15 Issue Fee $ 3 CMF 0865-46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING APPROVALS . Permit # Date Inspector PG- _ & SPA 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 ;, 58. Electrical Conduif-Undrgrnd. 8: Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. `' 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK' 11. Property Sewer Line & }louse 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 APPROVALS. Permit # 20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23.'Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 r 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 Flegulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY_ No. Date _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. SIT OF COST CUNSTR UCT OIN PERMIT Project Address 45 PERMIT NO. TRACT NO. LOT NO. UNIT Nf} /��wy A Applicant's Mailing Add ss T /'f✓t QVNst!• Owner's Name r Phone Address C?A57 i IN /4'W*/ ��_ - C'u"O—qc ft7�.J9` Arch/Eng. License No. Address / Contractor's Name '�fq� /tiJ f-�i7 f G Phone Address Imai Iing) /�2ry,62 Z �� ✓n �� o City License No. LICENSED CONTRACTOR DECLARATION ' I hereby affirm that I am licensed under provisions of Charter 9 (commencing 'with section 7000) of Division 3 of the Business and Professions Code, my license js in lifo ce and effect. License la s Lice o Date / Signature `'ORKERS' C MPENSATION DE RATION iereby affirm that I have a certifiate of consent to self -insure or a certificate r_Workers' Compensation Insurance or a certified copy thereof -(Section_ 3800, Lab, C.) Polley Noa W Q�Compan ��p'r CCN tJW �' Cer Ified copy is hereby furnished. rtl6 d py fit d with the city Buil g ivisio Date _ / Applicant EXEMP ON F OM WORKERS' CO MYENSATION DECLARATION (This•section need not be completed if the permit is for one hundred ($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. Date Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Comoensation-provlsions of the Labor Code, you must forthwith comply with ,such, provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY • -w I hereby affirm that°there is a construction tending agency for the performance of the work for which , this permit Is issued .(Section 3097 Civ. C.) Lender.'s Name Lender's Address ` OWNER BUILDER DECLARATION, - -• I hereby ,affirm that I am exempt from the Contractor's License Law for the - following reason (Section 7031,5 Business and Professional Code: Any city, or county which requires a permit to Construct, alter, Improve, demolish or'repair any structura, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of?, tie Contractor's License Law (Chapter 9 (commencing with Sectl6n'7000) of vision '3 of the Business and Professions Code) or that he/she.i5'exempt erefrom and the basis far 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 ($50D). . I, as 'owner of the property or my employees= 1 CONSTRUCTION AND'PLANNING . = APPROVALS Permit # 1 POS Date Inspector Sc SPA ' APPROVALS Permit # Date Inspector • 1. Temporary Electrical Service or Pole, 52. Pool & Equipment Location 2. Soil Pipe= Undrgrnd. r}. �' 53. Steel Reinforcement `rf, .3;Electdcal-Conduit Utility-Undrgrnd ,1l �" 54. Forms 4 'Electrical.Condui, -Undrgrnd. 55. Electrical Bonding 5.1 Steel Reinforcerrient 56. Rough Plumbing & Pressure Test r 6. {Electrical UFER Grnd. �`� 57. APPROVAL TO COVER-GUNITE ( t r,� .-7.'Footings ', r 58. Electrical Conduit-Undrgrnd. �r } 8. F'o`undation I .� ! , i 59. Gas Pipe, ❑ Undrgrnd., Test 9..Water Pipe-Undrg end. ti - 60. Backwash Lines, P -Trap, ❑ Undrgrnd. I'r 10.tStructuraI Floor System 7 f 61. APPROVAL TO DECK ' 11. Pr8perty5ewer Line.& House Connection �•� 62. Backwash & Receptor -Final �! 12.%Sewer Cap '• : t� .�' 63. Heater & Vent -Final 13"Roof Drains y �� 64. Plumbing System - Final i 14. Rough Plumbing.: 65. Electrical -Final 15. Rough Electrical=Conduit 66. Solar System -Final r' 16. Rough Electric Wiring !/� 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling otq 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23, Gas Pipe -Rough & Test 72.' Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. 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 :,!N1 47. FINAL STRUCTURE & BUILDING , ompleted 48. Special Requirements Completed- 49. Electric Release to Edison 49. ` 50. Gas Release to Southern California Gas Co I P 51.' CERTIFICATE OF OCCUPANCY No. Date - ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTIONgERMIT PERMIT NO TRACT NO LOT NO - Peje!:t Address i -r rvm. 1 o �;, Applicant's Mailing Addre 11m •r v'e Owner's Name l -u Ir 111-C Phone Address Arch/Eng, License No. Address Contractor 'sName E464 !O Phone 636-1113 Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect. -7 License Class C —13 a I is a o. Date 10-31-8Signature YORKERS'COMPENSATION qfjLARATION , hereby affirm that I have a cert tate of consent to Self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec n.- 3800, Lab. C. GS 6 ?-•Y1� Sri Policy No. Company Certified copy,is hereby furnished. l Certified copy" s filed with the cityw tling Division Date �; Applicant _ EXEMPTION FROM WORKERS' CO P NSATION DECLARATION ' (This section need -not be'completed i e permit is for one hundred ($100) or, less). I certify that in the performance of the work for which his permit is Issued,1," ' shall not employ any personinany m er so as to a subjeFt to the i Workers' Com ens�ti�Laws'of Califor I Date �h ��/- �`? Signature :NOTICE: If, after making this declar 'o you should become subject to the Workers' Compensation provisions o e Labor Code, you must forthwith comply with such provisions or this "permit shall be deemed revoked. 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 (Section .3097 Civ.. C•) Lender's Name , Lender's Address: OWNER BUILDER DECLARATION. - 1 hereby affirm that I am exempt from the Contractor's License Law' for the following reason (Section 7031:5 Business and Professional 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 'o file a signed statement that he/she is licensed pursuant.to the provisions, of ; e Contractor's License' Law (Chapter 9 (commencing with Section 7000) of vision 3 of the Business and -Professions. Code) or that he/she'is exempt _nerefrom and the'bas)s for the alleged exemption^Any violation of Section 7031.5 by -any- applicant for, a 'permit subjects: the applicant to, a civil penajty of not more than five hundred dollars ($500). ; ❑ 1, as 'owner of the property or my employees with wages as their sole compensation, will.do the work, aod:the structure is not intended or.offered for sale (Section 7044; Business and 'Professional Code. The Contractor's License Law does not apply to an owner of a property who builds or improves ' I thereon, and who does such work himself/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 com- pletion, the owner will have the burden of proving he/she did not build or im- prove for the purpose of,sale). , ❑ I. as owner of the property, am exclusively contracting with•licensed con- tractors to Construct the project (Section 7044, Business and Professions Code: The Contractor's tiicense Law does not apply to an owner of property who builds or improvestthereon,'and _who'contracts'for such projects with a con - :tractor( pursuant'to:the Contractor's License Law). I am aware that proof otf. their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner ' 't hereby certify that I 'have read" this application and state that the above 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 enter upon the above-mentioned property for •inspectlo,I rpoSeS. Signature Date/6-11- I ate/ -11- Drivers' ' ell or SS Vt CMF 0865-46, rev. 10/84 Whi e - UNIT TYPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION D REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. # DESCRIPTION OF WORK/USE OF BLDG. S Main Building: TYPE OF PERMIT 0 GRADING El FOUNDATION EISTRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear COTHER A PROJECT DESCRIPTION SQ. FT. OCCUPANCY—C Right K Left CONSTRUCTION TYPE VALUATION $ $ ZONE GRADING CU.YDS. ACRES Ping. Ref, Remarks: . �5cj'(Planning Notes: Bar -Sink Backflow Preventer a Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks GasService. Outlets Interceptors Kitchen Sink I - ?� Lavatories P—Trap Roof,Drains . { Reinspection Fee I SIE Boiler_ Duct - Under Ground, Duct - Structural Duct - Ventilating - Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBG # Heating System & Ducting — E3&1 00,000 -BTU ❑ 100,000 BT J I , I Reinspection Fee nt; Pink - Accounting; Goldenrod - Assessor $15 PLUMBING Showers Service Sink Sewer Cap" Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa , -� Urinal - 3 Water Closet Water -Heater Water Service Auto -Wash Laundry Trays Issue Fee FEES 'i+Cl MM -IANICAL 'Hood or Type ❑ Canopy Type II ❑ Refrigeration System [--10-100,000 BTU _❑ 100,000 BTU ,System Repair/Alteration FirO Dampers Registers 1 , J S' FEES' Issue Fee S 3 1 ! Automatic•Wazher Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas 'CElectric Fan F.A,U, Fixtures Device Boxes Outlets Switches Garbege Disposal I Generator'❑0-5 KW 05-15 K I 1.267 10/31/81L Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15.50'KW 1-150 +KW Meter Cup to 100 amps Meter Cover 100 amps Sub Panel Motors C10.1 HP EJ 11% - 8 Inc.Solar 1:19-15 HP ❑16 i5+; Microwave" - - t Pole Light Range ! Sign s Standing Sections W Trash Compactor i t 23.01 �+- FEES a a I Reinspection Fee i $15 I Issue Fee ' $ 3 DEVELOPMENT SERVICES REQUIREMENTS: 1 t Zoning Approved By Date Building'Approved By I Date t Application Issued By— Date /b 1 Z O N I N G R E 0 M T S SUMMARY OF'FEES 1 BUILDING PERMIT '$ SMIP $ PLAN CHECK ' $ PERMIT PLUMBING $Y„ g'ISSUANCE $ I PLAN CHECK 25% S y 4 ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ f MECHANICAL S TOTAL FEE $ 5j . Od PLAN CHECK 25% $ ` C*NSTRUCTION AND PLANNING APPROVALS Permit # _ Date - Inspector PL - & SPA APPROVALS Permit # Date Inspector 1..otemporary Electrical Service or Poli 52. Pool &Equipment Location -; 2. ,Soil'Pipe-Undrgrnd. 53. Steel Reinforcement 3 3:,-Electrical Conduit U#ility-Undrgrnd. - „ _ 54, Forms 4.LElectrical Conduit-Undrgrnd. 55. Electrical Bonding �. 5-Steel Reinforcement" - .j 56. Rough Plumbing & Pressure Test ;! 6•f Electrical LIFER Grnd. - 57. APPROVAL'TO COVER-GUNITE 4= 7. Footibgs - '_ `=� : s'. 58. Electrical Conduit-Undrgrnd. 8#o6ndation �_•_.' `"I 59. Gas Pipe, ❑ Undrgrnd;, Test 9. Water, Pipe-Undrgmd'. 1 60. Backwash Lirties, P-Trap, ❑Undrgrnd. d' 10: Structural Floor System ,'• i `- �! 61. APPROVAL TO DECK 11:-`Property Sewer Line & House Connection 62. Backwash &Receptor-Final 12. sewer Cap ;; 63. Heater & Vent-Final r 13. Roof Drains , 64. Plumbing System - Final r 14, Rough Plumbing 10"64 Lgo 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. POO VSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72: Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing r 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ;1j -Plaster Brown Coat 79, FINAL INSPECTION 1 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 1212 II 39. Water Service-Final 40. Gas Service-Final ! ' 41. Solar Domestic-Final 42. Backflow Prevenkter 43. Backflow lrrigation ' 44. Landscape Irrigation System 45, Sound Attenuation 46. Handicap Regulations 47, FINAL STRUCTURE & BUILDING' 48. Special Requirements Completed a 49. Electric Release to Edison ` 50. Gas Release to Southern California Gas Co J 51. CERTIFICATE OF OCCUPANCY No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations - TY OF COSTA MESA - - -• DINSTROCTION PERMIT •'rcwtc?-Address 31D1 n I r-WGI.y D I U4.4. R-tUJ LUJLct rIC]ct 4p-icant'sMailing Address 3151 Airway -Ave. E-1 C.M. Owner's NameGUl l dhouse Consultants-, L 4Ione 540-2606 Address` 3151 Airway Ave. -E-1, Costa Mesa Arcri/E�g, Mateo• Nardi ni L;eenSe No- C6291 Address 926 Town & Country_, Orange ti Contractor's Name i � -Donald 01 Spn ' Phone 540-2606 Address}[mailing)3 1 A'rga Av : E--1 Costa Mesa City License No. 22707 LICENSED CONTRACTOR DECLARATION i,herebyaffirm that Fam licensed under provisions of Charter 9 (commencing With section 7000) of Division 3 of the Business and Professions Code, and my license is in fullf� rc and effect. I ucens las ' , ti-� lc s 333969 Date r - Signature VORKERS' COMPENSATION DECLARATIO10 hereby affirm that I have a certificate of cohsent to Self -Insure or a Certificate -of - workers' - Compensation Insurance,'•or a certified` -copy -thereof (Section Policy Lib. c')F-2974 . •_ , Fai rnont Policy No. - Compahy ' Certified copy is hereby furnished. ` K Certifiq[tF gyFiilgd with the city Bui Ings Date 1V 13 84 Applicant -EXEMPTION;FROM WORKERS' COMP $ATIO�ECLARATI(This section neednot be completed if the permit i100) or less). ' i certify that in the performance of the work for,%,Nch 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. Date Signature NOTICE: If, after making this declaration, you should become subject to the , Workers', Compensation provisions -of the labor Code, you must forthwith comply -with such provisions ,or this permit � shall be deemed revoked• CONSTRUCTION LENDING?- AGENCY- I hereby affirm that there is a,construct{on lehdin6 agency for the performance of the ,work ;tor VA: this permit ,is issued (Section 3097 Civ. ,C.), Lend is Name,-' ' Lender'sAddress OWNERSUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's LicenseL,Law for the , following reason.(Section 703I.5.Business and Professional Code: Any city or county which requires a parmit.to construct alter, Improve, demolish or'repair ,any structure- prior =to,its-issuance, also,regWires the applicant for such permit 'a file a signed statement,that he/she is licehsed pursuant to'the provisions of - Contractor's License Law (Chapter 9 (corn mencing;witt§'Section 7000) of vision 3 of the Business and Professions Code) or that he//she is exempt, erefrom and the basis for the alleged exemption, Any violatlon-of Section 7031'5 by any applicant for -a permit sUbjects-the applicant -to a civil .malty of not more than five hundred dollars ($500). t LJ 1, as. owner of the property-on'my employees -with wages as their sole compensation, will do the work, and the structure Is not, intended or offered , for sale (Section 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of d property who.builds or improves thereon, and'who does such work-himself/herself or through his or her own employees, provided that such'improvements are not intended or offeredrfor sale. If, however, the building or Improvement Is•sold within one year of com- pletion, the owner will have the burden of proving Fie/she did not build or im- ' rvve,for the purpose of sale)- ; I, as owner of the property, am exclusively contracting' with licensed con- tractorsto construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apbly to an owner. of, property who builds or Improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to•the Contractor's License Law): , ❑ I am exempt under Section ,� B. & P. C. for this reason Date, Owner i I hereby certify that I have read this application and state that the above information is correct. i agree -to comply with all -city and county ordinances �o-antl state laws r lating-to building construction,' andihereby authorize repre- inses. , sentatives of t s• city o ent u n th@ above-mentioned property for spection our j 10/15/4 , Signature i Date Drivers' License or SS ' CMF 0865-46 rev. 7/83 White - Building; t;anary. PERMIT NO. CT LO�j NO.- -BLD0-, �s� - ci_41uY1+- LOP NO, - L -11111 S TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMO{-iSH E O"fHER DESCRIPTION OF WORK nt rl r -lm rovement .• - - - - - I938 10/26/8li 'l(oa6 -1 WP,# _t 1 S ZOnO rn ' ' S 'Main Building' _ ' Accessory Building: Z TYIPEEIOFPERMIT GRADIN FOUNDATION STRUCTURAL US,I TENANT D ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ BOTHER PROJECT DESCRIPTION SQ, FT.1737 OCCUPANCY - CON STRUCTIONTYPE V -N VALUATION$ 26.055.00 ZONE4 GRADING CU.YDS- ACRES T Front N, $ A Rear - - •" N C Right G S Left R E Ping. Ref. # Park. Fees $ , Q Remarks: (eq"'i r 9 A Parking Req./Provided C. - - I Use of Building: -• • R PLUMBINGFEES Planning Notes: M E Bar Sink Showers Backflow Preventer Service Sink' r T S Backflow Irrigation Sewer Cap t ELECTRICAL FEES Bathtubs Sewer Connection y Automatic Washer Construction Pole Sub, , Transformer ❑ 15-50 KW ❑ 50+ KW Clarifiers Solar Collectors. � - Dishwasher Solar Piping - Cooking -Unit - - Meter Llup to 100 amps Drinking Fountains Solar Tank Dishwasher . Meter ❑over 100 amps Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric 'Sub Panel { Floor Sinks Urinal Fan' 'Motors 00-1 HP ❑l Y� - 8 Gas Service Outlets Water Closet F.A•U.Inc. Solar El 9-15 HP ❑16.15+ Interceptors Water Heater Fixtures Microwave t + �• Kitchen Sink Water Service Device Boxes Pole' Light Lavatories Outlets Range I P=Trap' f Switches 1 Sign 'Roof Drains Garbage Disposal 1 Stand ing,Sections .' Generator=00.5 KW 05-15,KW ;Trash Compactor I Reinspection Fee -. i $Z5 Issue Fee § Reinspection Fee $y5 Issue Fee' , $ 3 + 'MECHANICAL _ - FEES PUBLIC SERVICES EQUIREMENTS: L Date Zoning #pproved By�,Z?yAi-� Application Approved Date &2 :X Application Issued'By Dat O Boiler Hood or Type I . ❑ ' ' _ Canopy Type I I ❑ Duct - Under, Ground Duct Structural Refrigeration System ❑0 100,000 BTU ❑ 100,000 BTU Duct - Ventilating i BUILDING PERMIT $ PLAN CHECK�S�/p $ PLUMBING $ PLAN CHECK $ ELECTRICAL $ PLAN CHECK 1 $ MECHANICAL $ PLAN CHECK $ gU(11jM Y O_F FEES 7 SMIR $ 9 PERM(T ISSUANCE $ ENERGY'P.C. ' $ GRAIJING § $ MICROFILM $ TOTAL FEE $ CA 0 ALA -- , ' { k ' ItxhaustSystem ❑ Multiple ❑' System Repair/Alteration Fjrepl/Fact.Blt.IC60# ' Heating System &Ducting ' E] 0-100,000 BTU E] 100,000 BT _ I ' { r Reinspection Fee $251 Isiue Fee $ 3 icant; Pink - Accounting; Goldenrod. -!Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector K & SPA APPROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole 4 52. Pool & Equipment Location 2, Soil Pipe-Undrgrnd. 53. Steel Reinforcement 1 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 5$. Electrical Conduit-Undrgrnd. $. Foundation r x� 4 u,�� / L 59. Gas Pipe, El Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. 8ackwash Lines, P -Trap, ❑ Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12, Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64, Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17, Rough Wiring Sign 68, APPROVED FOR PLASTERING i$. Rough Electrical -T Bar Ceiling 69, POOLISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70, Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24, Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing S 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78, FIRE PREV. FINAL '30. Drywall Nailing 'b 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY No, 99 7--- Date r• Cltlh OF COSTA MESA CONSTRUCTION PERMIT' e .� 1 to L O n 6 islo Bus D rt sent cert y 9 AT1 mit for so us Lebo mit ding SSue Con d P alta Tres se d (corn Cod ptl bjec ($5 Ploy uctu ssio pro arse are rat Is ovin ly c 4, B ly t cis LIC call h a Ion ab ane Applicant to fill in all.spaces except those within heavy border lines and sign all appropriate declarations. Project Addies3 31 D 1 M I i-Wdy AV D I l9. it-LUU , L--I''L_- AprAicant's Mailing Address 3 - C. Owners Name',- iiui l dhOUSe Cons 11tS Phone 540-2606 Address - 1 Costa Mesa - Arch/Eng. Mateo Nardini icenseNo. C6291 Address 926 Town & Country, range Contractor's Name J - .Donald Olson _-Phone 540-2606 Address rnailingl 3151 Airway Ave -1, Costa Mesa City License Na. 22707 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under Prov ns of Charter 9 (commencing with section 7000) of Division 3 of the Bu ss and Professions Code, and my license is in full f ce and effect. I License I s - cense o 33969 r -)ate Signature I 4 OR KERS' COMPENSATION DECLARATI ti hereby affirm that I have a certificate of con to self -insure or a certificate of Workers' Compensation Insurance,' -or a (fled' copy thereof (Section 3800, Lab. C. Policy No. =2974 Compan Fairmont ® CertifCertified copy is/hereby furnishth the ed. Buil n jon. DatetT Applicant EXEMPTION FROM WORKERS' COMPENS DECLARA ION (This section need not be completed if the per for one hundred ($100) or less): i certify that'in the performance of the work 'which this permit is ,issued I shall not employ any person in any manner as to become subject to'tke Workers'. Compensation Laws of California. Date Signature NOTICE: lf,'after making this declaration, yo hould become Subject to the 'Workers' Compensation provisionS-Of the r Code, you must forthwith -comply with, such provisions or -this per Snail be' deemed revoked. CONSTRUCTION LENDING- AGENCY I hereby affirm that there IS a construction• len agency for the performance of the work for wlljdh this permit •Is i d r (Section 3097 Civ. C.) Lender's Name Lender's Address ' OWNER BUILDER DECLARATION -0 i hereby affirm that I am exempt from the tractor's License Law for.the following reason (Section 7031'.5 -Business an rofessional Code: Any city or county which requires a permit to construct, r, improve,'demolish or repair any structure;priorto its Issuance, also reGu the applicant -for such permit file a signed statement that he/she is Iiceh pursuant to the provisions of ' e Contractor's License taw (Chapter 9 (co racing with Section 7000) of i ivision, 3- of the Business and Professions e) or that he/she is exempt therefrom and the basis fortthe alleged examon. Any violation of Section 7031:5 by any applicant for -a permit Su is the applicant to a civil ; ,� enalty of not more than five hundred dollars 00). I, as owner of the property Or my em ees with wages as their sale compensation, will do the work, and the str re Is not Intended or offered for sale (Section 7044, Business and Prate nal Code: The Contractor's License Law does not apply to an owner of a party who builds or improves , thereon, and who does Such work himself/h If or through his or her own employees, provided that such improvements not intended Or offered for sale. If, however, the building or lmproveme sold within one year of com- pletion, the owner will have the burden of pr g he/she did not build or im- rove for the purpose of Sale). 1, as owner of the property, am exclusive ontracting with licensed con- tractors to construct the project (Section 704 usiness and Professions Code: The -Contractor's License Law does not app o an owner of property who builds or Improves thereon, and who contra for such projects with a con- tractors) license pursuant to the Contractor's ense Law). ❑ I am exempt under Section B. & P. C. for this reason l Oate Owner' I hereby certify that I have read this appli on and state that the above information is correct. I agree to comply wit II city and county ordinances and state laws relating :to building construct and hereby authorize repre- sentatives of in }� city to'en er don the pve-mentloned property for SignatureInspectiopurWSSes �% p 17 84 Signature � r 1:. Date C7 f✓ / /___ Drivers' License or SS 9 PERMIT NO. TRACT NO LOT NO. BLDG. P �0©O irv,rre tS3-1 of� �d TYPE OF CONSTRUCTION 'NEW AD L , ERATION REPAIR ❑ OTHE ❑ CONVERSION ❑ DEMOLISHS DESCRIPTION OF WORK interior improvement 010T V TYPE OF PERMIT GRADING FOUNDATION RUCTURAL ® TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ -OTHER' PROJECT DESCRIPTION SQ. FT. OCCUPANCY - CONSTRUCTION TYPE VALUATION $ 124,155.00 ZONE GRADING CU.YDS. .ACRES 7.382 . 9/29/84 r �,,-tsg50 i - Zone A.P.AP# � C— L S Main Building: Accessory Building: Z T Front N B A Rear �1 N C Right 'G g Left R E Ping, Ref, # Park, Fees V Q U Remarks: Parking Req./Provided I r Use of Building: R jE 'M E p N .l' s PLUMBING FEES Planning Notes: Bar Sink Showers _ Backflow Preventer Service Sink i a Backflow Irrigation Sewer Cap,,-, 1'� 1 ELECTRICAL FEES. Bathtubs Sewer Connection ` Automatic Washer Construction P_ojeSub, Transformer ❑ 15.50 KW ❑ 50+ KW Clarifiers Solar Collector4x- Dishwasher Solar Piping - Cooking Unit -� Meter ❑up to 100amps- Drinking Fountains SOlar Tank? � i r Dishwasher Meter ❑over 100 amps Z Floor Drains' Swimming Poo1•w/Spa' Dryers ❑Gas ❑Electric Sub Panel f '- Floor Sinks J Urinal Z Fan Motors ❑0.1 HP 0114 - 8 I Gas Service Outlets Water Closet - F.A.U. 'Inc.Solar ❑9-15 HP ❑16-15+ Interceptors Water Heater Z .- Fixtures i Microwave Kitchen Sink Water Service Z Device Boxes Pole Light LavatoriesDfj Dutlets Range P—Trap t Svti itches Sign Roof Drains .7" Garbage Disposal Standing Sections Generator ❑0 5 KW ❑5 15 KW Trash Compactor -Reinspection Fee-, $25 Issue Fee $ S3 ' Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES PUBLIC SERVICES REQUIREMENTS: / +� /' `� Zoning Approved By -ni ate Application Approved By Date Apoi ation Issued By at 8 Z 2 Boiler Hood or Type I ❑ Canopy Type 11 ❑ tG Duct_ Under Ground Duct - Structural Refrigeration System ❑D-100,000 BTU ❑ 100,000 BTU Duct - Ventilating BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK ' MECHANICAL PLAN CHECK $ $ $ $ $ $ $ $ SUMMARY OF FEES C� 47H3•00 SMTP $ ' ) 1 i PERMIT % CD ISSUANCE $ ! F7 QQ ENERGY'P.C. $ GRADING $ MICROFILM $ TOTAL FEE $ l.L Exhaust System ❑ Multiple ❑ Firep1/Fact. Bit. ICBG # System Repair/Alteration ' Heating System & Ducting 00-100,0.00 BTU ❑100,0006T ` Reinspection Fee S25 Issue Fee $ 3 CMF 0865-46 rev. 7/83 White - Building; C ry - Applicant; Pink - Accounting; Goldenrod -Assessor - CONSTRUCTION AND PLANNING" _ � APPROVALS Permit # Date � Inspector P. - , & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole '52.. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. CA71SLf6410 53. -Steel Reinforcement- einforcement''3. r3.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 E:7. Footings - 58. Electrical Conduit-Undrgrnd. 'r8., Foundation 59. Gas Pipe;,❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, D 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. "POO L/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro -22. Ducts; Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test r 72. -Underground Flush -24: Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil -25. Roof Sheathing 74. Overhead Hydro 26. C Bar Ceiling (Structural) & Monocoat Yp 75. Dry Chemical 27rame and Flashing 4�4 � 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 Nates 34. Final, Heating &Air Conditioning i a71 35. Final Gas Pipe -Test G 36. Hood or Canopy 37. Final Factory Fireplace ' 38. Final Plumbing 39. Water Service -Final 40, Gas Service -Final 41. Solar Domestic -Fina! _ 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System , 45. Sound Attenuation + + 46. Handicap Regulations r 47. FINAL STRUCTURE & BUILDING tD l�� 4B. Special Requirements Completed 49. Electric Release to Edison -- _ 50, Gas Release tolSouthern CaliforniaGas Co ; 51. CERTIFICATE QF OCCUPA��NCY • No. Date (40 CITY OF COSTA MESA CONSTRUCTION P#RMIT Project Address _-X 5/ 70 cu Al 1C,r Applicant's Mailing Address -+a Owner's Name o Phone Address -- 3/5 C /oAXE ... Arch/Eng, License No. Address Contractor's Name,Phone ��q Address (mailing) l� L.''Jfi�Lxt City License No. a LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fu fo_c and effect. U License ss "c e Date / of Signature 7 �- YVOR KERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of consent to self -insure or a certificate of -Workers' Compensation Insurance,. or .a .certified copy thereof (Section. 3800, Lab. b-7 .) ' L ' 1 Policy No. C I �� r � � Company �-' Certified copy is hereby furnished. Certifietl cop is filed with the city,uildin pivision. $ DaIei�G Applicant _EXEMPTION FROM WORKERS' -COMPENSATION DECLARATION _ (This section need not be completed if the permit is for one hundred ($100) or less). t I certify that in the performance of the work for.whlch 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. Date Signature NOTICE: If, after making this declaration, you should become subject to the ' Workers' Compensation provisions of the Labor Code, you must forthwith comply with such ,-provisions or, this permit shall be i deemed revoked. 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 (Section 3097 Civ. 'C.) Lender's Name Lender's Address `• - OWNER BUILDER DE_CN_ LARATIO- I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she Is licensed=pursuant to the provisions of ; 'ie Contractor's License taw (Chapter,9 (commencing with Section 7000).of ivision 3 of the Business and Professions Code) or that he/she is exempt nerefrom-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 ` enalty of.not more than five hundred dollars ($500), I, -as owner of the property or my "employees with wages as theirsole compensation, will do the work, and the -structure isnot intended or offered for sale (Section •7044, Business and Professional Cude: The Contractor's 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or -improvement is sold within one year Of COm- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and -who contracts for such projects with a con- tractor(s) license pursuant'to'the'Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section B. & P. C. for this reason Date Owner 1 hereby certify that I have read this application and state that -the above Information is correct. I agree to,comply with all city and county ordinances and state laws relating to buil ing construction, and hereby authorize repre- sentatives of this city to En r up h above-mentioned property for inspection purpo s, 1 rr Signatur Date�`�d�/ d plicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERR�/IT�NO. 2- TRACT NO. LOT NO, UNIT NO. TYPE IOF COONSTR(UUCTION LJ NEW Apt? ALTERATION LJ1 REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. # DESCRIPTIONOF WORK/USE OF BLDG. S Main Building: E TYPE OF PERMIT GRADING ❑ FOUNDATION ❑.STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUM BINGN:3AECHANICAL - B Rear ❑ OTHER PROJECT DESCRIPTION 5Q. FT. OCCUPANCY C Right K CON STRUCTION TYPE VALUATION $ S Left ZONE GRADING CU.YDS- I ACRES Ping. Ref. # Remarks:L Jp j,� (r](�( Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers t Dishwasher ' Drinking Fountains Floor Drains Floor Sinks ' i - -•• Gas Service ''Outlets Interceptors a Kitchen Sink - Lavatories P—Trap Roof Drains ' Reinspection Fee "l $15 Boiler ' Duct - Under Ground Duct - Structural Duct - Ventilating - Exhaust System ❑ Multiple ❑ Firepl/Fact. B1t.'ICBO # i Heating System & Ducting ❑0-100,000 BTU ❑ 100,000 BT Drivers' Licen a I Reinspection Fee $15 CMF 0665.46, rev. 4/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 9799 10/10/84 Zone Accessory Building: Parking Req./Provided 3t+ec5 A . Z O N I N G R E' O M T S. FEES 1 11 Issue Fee' i ! $'3'I 1 11 PLUMBING, FEES Reinspection Fee $15 Issue Fee Showers $ 3 ELECTRICAL Service Sink DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By _ _,_ Building Approved By Application Issued 8y _ Automatic Washer Construction Pole Sub. Transformer El 15-50 KW ❑ 50 + KW Sewer Ca P Sewer Connection } Refrigeration System 00-100,000 BTU ❑100,000 BTUSUMMARY Cooking Unit Meter ❑up to 100 amps Solar Collectors SMIP $ , PERMIT ISSUANCE $ ENERGY P.C.. $ GRADING $ MICROFILM $ TOTAL FEE $ _-.� �- Dishwasher Meter Clover 100 amps Solar Piping t Dryers ❑Gas ❑Electric Sub Panel Solar Tank Fan Motors ❑0-1 HP 01'/z - B Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP ❑16-15+ Urinal Fixtures Microwaye — Water Closet Device Boxes Pale Light Water Heater 1 Outlets Range i Water Service F Switches Sign Garbage Disposal Standing Sections , Geherator 00-5 KW ❑5-15 KW Trash Compactor 3t+ec5 A . Z O N I N G R E' O M T S. FEES 1 11 Issue Fee' i ! $'3'I 1 11 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By _ _,_ Building Approved By Application Issued 8y _ Date Date Dat Hood or Type I ❑ Canopy Type ❑ Refrigeration System 00-100,000 BTU ❑100,000 BTUSUMMARY BUILDING PERMIT , PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% OF FEES $ $ $ $ $ $ $Z , ZS - $ SMIP $ , PERMIT ISSUANCE $ ENERGY P.C.. $ GRADING $ MICROFILM $ TOTAL FEE $ _-.� System Repair/Alteration Issue Fee $ 3 'CONSTRUCTION AND PLANNING s APPROVALS Permit # Date Inspector PG & SPA APPROVALS Permit # Date Jnspector 1.* Temporary Electrical Service or Pale 52. Pool & Equipment Location kv 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms J 4. Electrical Conduit UAdrgrnd. 55. Electrical. Bonding 5, Steel Reinforcement 56. Rough Plumbing & Pressure Test : •r 6• .Electrical LIFER Grrid. 57. APPROVAL TO COVER-GUNITE 7. Footings. - -e 58. Electrical Conduit-Undrgrnd. {J, 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10, Structural Floor System' ' 61. APPROVAL TO DECK 11. Property Sewer Line -,& House Co; lection 62. Backwash & Receptor -Final A 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 '� y d („�rQ FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas f] Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing '73. Undergrnd. Storage Tank ❑ Gas ❑ 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 �oj/f/ ao 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPAhJCY No _ Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. r PER T NO. TRACT NO. LOT NO. UNIT NO, CITY OF COSTA ESA CO�]STRUCTiOIM PERMIT -Prc*_,t Address ISI fF i AQW A,, r � .00 Applicant's Mailing Ad �� v e c /I ku G Owner's N mey ` DA, — - — phones:2.69' Address Arch/Eng. License No. Address _ Contractor's Name ktgvieLZ TX-_nra Phgne 41>e-- Address (mailing) ( i City License No. dls 7 LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of,Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, my license is in full1orce ond effect. ) Lfcens�l ss Liffe o. Date Signature �[J WORK RS' 06MPiNSATION DE RATION ; hereby affirm that i have a certificate of consent to self -insure or a certificate of Workers' Compensation insurance, or a certified copy thereof (Section 3800, Lab.�� ! Policy No. I Company CvAifiecal copy Is hereby furnished. ert' ' copy 's filed with the city B 'I g Divlvin, Date Applicant /�[{ EXEMPT ON F1hOM WORKERS' C ENSATION DECLARATION (Thissection need not be complete f the permit is for. one hundred ($100) or less). ' I certify that In the performance of the work for'ywhlch 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. Data Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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 (Section 3097 Civ. C.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 state ment'that. he/she is licensed pursuant to the provisions of ie 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 .herefrom 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 enalty 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 (Section 7044, Business and Professional Code: The Contractor's 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 employees, provided that such improvements are not Intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- rove for the purpose of sale). , I, as owner of the property, am exclusively contracting with licensed con- 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 builds or Improves thereon_, and _who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. n 1 am exempt under Section S. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that trio above 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 enter upon the above-mentioned pro erty or Inspection pur ses. �� Signature Drivers' ense or SS :p TYPE OF CONSTRUCTION I"�NEW LJ ADD LJ ALTERATION L I REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. # DESCRIPTION OF WORKIUSE OF BLDG. S Main Building: E TYPE OF PERMITGRADING FOUNDA-riON STRUCTURAL T Front EDS TENANT L ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ -OTHER A PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right CONSTRUCTION TYPE VALUATION $ S I Left ZONE GRADING CU.YDS. ACRES Ping. Ref, # Remarks: Planning Notes: Bar Sink Backflow Preventer Backflow irrigation Bathtubs Clarifiers ' Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepi/Fact. Blt. ICBO qb Heating System & Ducting ❑ 0.100,000 BTU ❑ 100,000 BT' Reinspection Fee 1 $15 CMF 0865-46, rev. 4/84 White - Building: Canary - Applicant; Pink - Accounting; Goldenrod - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater 'Water Service I FEES 9110 9/13/$11y3.,;; Zone Accessory Building: Z O N I N G R Parking Req,/Provided E O M T S. ELECTRICAL FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches , Garbage Oisposal Generator ❑0-5 KW 05-15 KW Transformer ❑ 15-50 KW ❑ 50 + KW Meter Kup to 100 amps Meter ❑over 100 amps Sub Panel Motors ❑ 0.1 HP @ei'h - 8 t j Inc. Solar 09-75 HP 016-15+ Microwave Pole Light t Range Standing Sections Trash Compactor Issue Fee $ 3 Reinspection Fee $15 Issue Fee iANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By �w �} Application Issued By [ [ [ Hood or Type I ❑ Canopy Type 11 ❑ Refrigeration System 00.100,OOOBTU ❑100,000 BTU BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL x PLAN CHECK 50% 1 MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ $ $ $ $ I $ $ $ SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE System Repair/Alteration Issue Fee $ 3 21 $ 3 CONSTRUCTION AND PLANNING 'Date " .+�PROVALS Permit # ! Inspector PG I 9 SPA APPROVALS Permit # Date inspector 1. Temporary Electrical Service or Pole. 52. Pool & Equipment Location 2. Soil Pipe:Undrgrnd. I �^ 53. Steel Reinforcement 3.' Electrical Condtfp_t.Utility Undrgr�ndr �_ 54. Forms- 4,�Elec�cal.-Conduit-Undrgrnd. t 55. Electrical Bonding 5.-Steel Reinforcement '.% '� 56. Rough Plumbing & Pressure Test S IElectrica! LIFER Grndren i 57. APPROVAL TO COVER-GUNITE 7..Fo6tings+ rl� ? 58. Electrical Conduit-Undrgrnd. �r 8. F undatior) +" n 7 59, Gas Pipe, ❑ Undrgrnd., Test '9. Water Pipe-Undrgrnd, Iw lam' 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10:-�,Structural F=loor System ��; i �X 61. APPROVAL TO DECK 11'iProperty Sewer Line'& House Connection 1 a } 62, Backwash & Receptor-Final i 2..Sewer'Cap 7�' r � /1 � 63. Heater &Vent -Final �. 1S. •Roof Drains ` �- �. r r ' 64. Plumbing System - Final 14.-Rough Plumbing,, 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring qn 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. hough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # - 20. Rough Factory Fireplace. 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. hoof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural), & Monocoat 75, Ory 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: 91y mol 34. Final Heating & Air ConditioningJ.0 OlJdrbWft -4 WAVE fto 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison -• 150. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY ! j. Date tr e City of Costa Mesa Development Services Department Building Safety Division CERTIFICATE OF OCCUPANCY No. Vlit,��% P. O. Box 1200 Costa Mesa, California The Building located at 3151 Airway Avenue OL -1 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building Legal Descriptio Office 938-940-63 (See reverse side for Metes and Bou nclO $ ' Building Permit -No BP -11070 Electrical Permit No. E-11081 Plumbing Permit No J BP -110707 Mechanical Permit No. — 1+-11464 Number of apartments 0 and/or guest rooms 0 ISSUED TO: Building Official - Cuildhouse C arisultantS t by ! 1 /' L- 3151 Ll wa Avenue, #f:l, Costa Mesa, CA ' Date, This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-4G rev. 1/83 White - owner; Canary . Numerical File; Pink - Bldg. Permit File _f City of Costa Mesa Devebpment Services Department CERTIFICATE OF OCCUPANCY No. 001755 Building Safety Division P. O. Boz 1200 Costa Mesa, California The Building located at 3151 Airwav Avenue Suite L2 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R2 Occupancy. Use of Building r.SA ipevelonment Legal Description 427-291-14, 15 — (See reverse side for Metes and Bounds) E25643 Building Permit No BP25270 Electrical Permit No. E25305 Plumbing Permit No. BP25270 Mechanical Permit No. M25547 Number of apartments j and/or guest rooms ISSUED TO: Building Official 1-7-1. Consultants. Ltd. 3151 Airway Avenue E-1 by Costa Mesar CA' Date L -� This Certificate of Occupancy SHALL BE posted in a conspicuous place on the_ "premises aitd SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015.46 rev. 1/83 White • Owner; Canary - Numerical File; Pink - Bldg. Permit File ,1. r City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. n Building Safety Division O U�' P. O. Box 1200 Costa Mesa, California The Building located at -41r.1 81EC y wp _T,3 has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building rtt.rrr Legal Description___ 930—UA–n4cr (See reverse side for Metes and Bounds) G13893 G13893 G13893 Building Permit No Electrical Permit No. Plumbing Permit No. G13893 Mechanical Permit No ISSUED T O : (=MUSE OXE TLiANTS Number of apartments Building Official 3151 AIMAY AVE. E--1, C.M. CALIF. by and/or guest rooms This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises SHALL NOF BE removed except by the {O Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File CITY OF COSTA MESA BUILDING DIVISION s 77 FAIR DRIVE, COSTA MESA, CA 92626 - (714) 754-5273 • Fax (714) 754-4856 - www.ci.costa-mesa.ca.us t^ s FOR INSPECTIONS CALL: (714) 754-5626 PERMIT NUMBER: B09-00172 PERMIT TYPE B_ROOF2 APN: 93894063 JOB ADDRESS: 3151 L AIRWAY AV CM Vicinity: BUILDING L ROOF Squares: 8400 STATUS: ISSUED DATE ISSUED: 08/26/2009 ISSUED BY: BJK Suite/Unit: L Valuation: $21,522.00 SCOPE OF WORK: REROOF BUILDING 'L'. TEAR OFF (E) ROOF MATERIALS, INSTALL 1 LAYER OF 15 FELT ON A 4:12 PITCHED ROOF AND REROOF WITH 40 YEAR ASPHALT SHINGLES ON COMMERCIAL BUILDING, APPROX 70 SQUARES. REPAIR AND REPLACE SHEATHING AS NEEDED. OWNER: CORP OF PRESIDING BISHOP CHURCH OF LDS Address: %SOUTHERN CALIFORNIA SUITE 200 PHONE: City/State/Zip: 3230 E IMPERIAL HWY APPLICANT: HANSEN, DUKE Address: N6646636 PHONE: City/State/Zip: CONTRACTOR: ROSS AND BARROWS INC Address: 260 E ALTON AVEUnit: City]StatelZip: SANTA ANA, CA 92707 ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $349.25 Reinspection Fee: $0.00 Bldg Std Admin Fund $1.00 TOTAL FEES $350.25 License No. 327802 PHONE: 714-557-7440 CELL: License No. PHONE: License No. PHONE: Unit: BREA. CA Unit: . NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. 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. ODE I. INSPECTION TYPE DATE INS CODE / INSPEnoN TYPE DTE INTRIALS 1615 Fixed System Final Fire Prevention 208 Final Mechanical 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 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 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. <�71K 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 In rance carrier and policy number are: t Carrie �%/-� %P_ T 1,1A J (Trus section need not be oompleled d the perm# is valued atone hundred dollars (S 100) or less) Policy'NSmber: n Q $��" /" 2_2 x 0' ❑ 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 beco subject to th workers' compensation provisions of Section 3700 of th abo Code, I forthwith comply wish these provision . rf�z Applicant's Sigriaiure 'Date 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 DOLLARS ($100,000), IN ADDITION 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 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. �Z- -2,S-02- Grassier 1.5,� Contractor' Signature . -.Date CONSTRUCTION LENDING AGENCY: ❑ 1 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 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).): ❑ 1, 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 Lam.). ❑ 1 am exempt under sec. Business and Professions Code for this reason: Signature Date 3057-46(3107) 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 t0 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. Applicant's Signature trate 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? ❑ Yes 0 No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with Ile 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 ❑ No (Section 25533 of the Califomia 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 acutety 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? ❑ Yes 1❑ 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 permit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? ❑ 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 ❑ No (If yes", the facility must meet the requirement of Sections 25534 and 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? ❑ Yes ❑ 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 tate 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 this permit until final inspection. Si nature of Le nem� s} to G z Andlor Aulhonted Aper nL_ Applicant to fill in all spaces within heavy border Iines and, sign all appropriate declarations. CITY OF COSTA MESA PERMIT NO. TRACT NO, I LOT NO. BLDG, NO. CONSTRUCTION PERMIT 61/ /0 - 3q i I Pca I— Plan Check W ,51442 Project Address 31bl—L Airway Ave., LOsta mesa TYPE OF CONSTRUCTION Owner Western Pacific Financial Phone 52-767 91 NEW ❑ RDD ❑ ALTERATION i ;.,o 57UL Address 1601 Dove Street Newport 'Bch. Ca. ❑ REPAIR ❑ CONVERSION C1 DEMOLISH ❑ OTHER ZONING REGULATIONS Arch/Eng, Hal es-L_an stun License No. C-010899 DESCRIPTION OF WORK Commercial Office Condomimi ums A P : ZONE PLNG.'REF. Address777 S. Main Ste 105 Oran Ca. Contractor The J. Donald Olson CO.Phane 540-260 'TYPE OF PERMIT,.,,., Z?"FOUNDATION ❑GRAOING Yd'FOUNDATION STRUCTURAL ❑TTENANT ❑ ELECTRiCAL ❑PLUMBING ❑MECHANICA SETBAPROPEI�TYNIJNE EIPE YARD eer SIL L Y Address 3151 Airwa Avenue E Costa Mesa Ca. LICENSED CONTRACTOR DECLARATION I that I licensed Charter 9 hereby affirm am under provisions of (Com- with section 7000) of 1 Division 3 of the Business and r ❑ OTHER RIGHT mencing Professions Code, and license is In full force a effect. REAR YARD (TO P/L) e) my License Class License No, 33 69 PROJECT DESCRIPTION 6997 � PKG. SPACE REQ. -' PROVIDEDOS Data Signature 5Q. FT. 'CONSTRUCTION STREET WIDTH PARK FEE $ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -insure or a OCCUPANCY TYPE — VALUATION. 9A QRn ZONE ZONING APPROVED BY DATE ,Certificate of Workers' Compensation Insurance, of a certified copy - " .yeof ( ti9�/l 0 �Latb. C.). ADING GU. YDS. ACRES SPECIAL CONDITIONS: y Ne�-1%y4_01?()-1un-0Company Fdi-1^I11ont- Insurance[KIT. + REMENT' r rtifled copy Is hereby furnished. Aertified MARKS: '. copy Is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION This section need not be completed If the permit is for one hundred - -- $100) or less). + . 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 becomeUMBING • PLAN CHECK ELECTRICAL PLAN'CHECK subject to the Workers Compensation Laws of California. THTUBS SHOWERS Date Signature NOTICE: If after making this declaration, you should become subjectILETS URINALS GENERATOR 0-1 KW 1-10 KW r to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemedVATORIES DOUBLE LAVS APPLIANCE 10.50 KW_50 + KW , revoked. CONSTRUCTION LENDING AGENCY SINKS DISHWASHERS s , MOTORS 0.1 HP 1.10 HP I hereby affirm that there is a construction lend ing,agency,for the per- SERVICE SINKS SUMPS.'� F • (INC. SOLAR) NP 10.50 50 + HPformance. of .the work for. which this permit is Issued, (Section 3097 - �' \ -P -� �• FLOOR SINKS FLOOR DRAINS FIXTURES rOUTLETS ,%'SWITCHES Lender), Name Western Pacific Financial Corp. Lender's Address Ove WIER. Newoort DRINKING FOUNTAINS GAS TUBE SIGNS T ` INTERCEPTORS CLARIFIERS POLE LIGHTS 1 n • + OWNER BUILDER DECLARATION I hereby affirm that I am exempt fromtheContractor's License Law for SWIMMING POOLP TRAP - POLES METERED SUB the following reason (Section 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant ,for. such permit to file a signed statement that.he. GAS SERVICE OUTLETS SERVICE AMI? Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT " -nese and Professions Code) or that he is exempt therefrom and the for the alleged exemption. Any violation of Section. 7031.5 by SEWER CONNECTIONS applicant for a permit subjects the applicant to a civil penalty .. iot more than five hundred dollars ($500). SOLAR TANK COLLECTORS .. ❑ 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 SOLAR PIPING SYS. ISSUE FEE or offered for sale. (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of a property ISSUE FEE APPLICATION APPROVED BY OAT - who builds or improves thereon, and who does such work himself or through his own employees, providedthatsuch improvements are not MECHANICAL PLAN CHECK ' OF FEES /0 Intended or offered for sale. If, however, the building or improvement Is sold within one year of completion, the owner will have the burden _SUMMARY of proving he did not build or improve for the purpose of sale). ❑ I, the contracting with HEATING SYSTEM -0-100,000 BTU PERMIT.BUILDING $ 7E1=50 5MIP' $G�� ,��LL as owner of property, am exclusively licensed Contractors to Construct the project (Section 7044, Business AND DUCTING _ 100,000 + BTU PLAN CHECK- $,— PERMIT and Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or Improves, thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licensed pursuant to •SYSTEM "•- - "" - - GRADING $ -- the Contractors License Law), - _ 100,000+ BTU 4; r + PLAN CHECK$ C1 I am exempt under Section B. & P. C. for this BOILERS BTU - - - ELECTRICAL $ $ reason SYSTEM REPAIR, ALTERATION PLAN CHECK $ MICROFILM $ _ TOTAL FEE $ 11/l�L,G Date - Owner I hereby certify that I have -lead this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS, Information is correct. 1 agree to comply with all cit and county g Y Y PLAN CHECK $ VAN E P VANCE PC $ ordinances and state laws relating to onStruction, and hereby authorize t , representatives o t s city to, ter upo the above mentioned fp-a: y 7131.53 property �p o �l/J�C Signature FINAL FEE $ Drivers' License or SS ISSUE FEE CMF 0865.46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor I CONSTRUCTION AND PLANNING APPROVALS Permit # i d Date Inspector POOL & SPA ' APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn - 45. Forms 4. Electrical Conduit•Undrgrn 46. Electrical Bonding5. Steel em orce 47. _ Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48, APPROVALTO COVER-GUNITE 7. Footings 5 _ 49. Electrical Conduit-Undr rn -8.- Foundation 50: Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap,❑ Undrqrn 10. Structural Floor System 52. -'APPROVALTO DECK 11.• Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection a 54. Heater & Vent -Final 13. Rough Plumbing - -- 14. Rough Electric -Conduit 56. Electrical -Final 15. Rough Electric_Wiring - _ 57. Solar System -Final 16._. Rough Heating & Air Conditioning b8. Fencing & Access Approval 17 Ducts in Structure 9. APPROVED FOR PLASTERING 18. Ducts, Ventilating J60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough & Test ! 20. Roof Framing 21, Roof. Sheathing S-3 - NOTES: �� 22. Frame and Flashin 23. Insulation j 24. Lathing & Siding r 25. Drywall Nailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30.. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. ` Gas Service -Final 34. • Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37: Handicap Regulations 38, FINAL STRUCTURE & BUILDING 39. Special Requirements Completed - 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - • f 42. CERTIFICATE OF OCCUPANCY No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CI.TY OF COSTA MESA P tp�IT N =. TRACT NO, LOT NO• BLD CONSTRUCTION PERMIT /J'/1f i L/r dress/� f� 81 fir• �L,l! Q f CONSTRUCTION 6142 • F{ 5/20/82 27.00 J =� Phone ❑ D--- ❑ AL•TERATIONl3/•� 4YEF -4 —-CONVERSION ❑DEMOLISH rArch/Eng. ER ZONING REGULATIONS License No.- - DESCRIPTION OF WORK R.P. ZONE ' PLNG:REF,I' - Phon TYPE OF PERMIT_— - - - • •_ _ _.__ lSETBACK C ST. TO BUIL�ING PROPER Y LINE' r� Address {i/RADING ❑ FOUNDATION-- ❑ STA C URAL - _ .51pE YARD `} LICENSED CONTRACTOR D CLARATION hereby licensed isions 9 m- �wiENA NT"❑ ELECTRICAL ❑PLUMBING HANICA L�fipFEYAR -f I affirm that I am untl of rter mencing a Ith section 7000) -•of slo antl ✓✓✓��\ ❑'OTHER IGHT --o - _Bus! ,Professions Code, sand My li se fu orce a feet, ti REAR YARD {TO P/L} �- - -• -Y PROJECT DESCRIPTION License Class' — - r ' PKG. SPACE REQ. - -PROVIDED - Date K .Sign ur :' ._ ��. - - - • STREET W10TH - -PARK FEE $ - WORKERS'•COMPENSATI CLARK .ION OCCUPANCY% - CONSTRUCTION TYPE ,I hereby affirm that I have certlticate of consent to self -in a or a •t VALUATIDN ZONE - ZONING APPROVED BY --- Certificate of- Workers' Co mpensation.Insurance,.or-a certified copy _ i, - thereof (Se l0 3 DOL �i.�-1(L ��{ ,GRADING CU. YDS. ACRES -+? - SPECIAL- CONDITIONS: -- fir, „ - �- - -;-•- +• cy NO , < Company flit -S 7 ` �y '' e lifted t0 furnished. _ copy is hereby - - _•,_ REMARKS:p•.- r -•� ...� Certified Copy is filed with the city Building Division. EXEMPTtON"FROM WOftKERS' COMPENSATION DECLARATION I{This section need not -be comple!Qd if the permit Is for one hundred - $100) or less),' 1 I 1 certify that in the performance of the work for which this permit Is 'Issued, I shall not employ any person in any manner so a5'to-become PLUMBING;,, PLAN CHECK- r- - -• ELECTRICAL •-- - PLAN -CHECK- subject to the Workers' Compensation Laws of California.•"' - Date I Signature - — - - -'BATHTUBS - '- SHOWERS - �' ` - --. - ,NOTICE: It after making this declbrallon, you should becomeisubject• must To_ ;r, 'f", 'I -- - - - - - A •LAVATORIES GENERATOR D-1 KW—- 'TRANSFORMER 1,iD KW ' - •-- a --- to the Workers' Compensation provisions of the Labor Code, you to .,forthwith comply with such provisions or this permit shall be deemed DOI'J8LE LAVS --- _A - — APPLIANCE - •10-50,KW---;50 + KW''' ' •- __ _� I revoked. _ _ _ .CONSTRUCTION LENDING AGENCY _ --KIT.-SINKS -� ^� - - DISHWASHERS - -- MOTORS __ -D-1 HP 1-10• P' _ H I hereby affirm that there is a construction lending agency for the per -(IN SINKS -SUMPS - -- - - - - _-_ ., ' (INCL. SOLAR) 10-50 H? 50_+ HP "•t•� ' 1 Jormance of the work for which this permit is Issued (Section 3097 f - ' FLOOR SINKS FL•OOR-DRAtNS- Name -' FIXTURES - DUTLETS-- -SWI-TCHES---� (Lender's Lender's Address -- - --- " -----_ DRINKING FOUNTAINS -'GASTUBE.-SIGNS.. INTERCEPTORS' CLARIFIERS - POLE -LIGHTS OWNER BUILDER -DECLARATION - -- - - _ _ I hereby affirm that I am exempt from the Contractor's License Law for SWIMMtNG-POOL--- PT,RAP�•-- - ` - - POLES "-" -' METERED'--- 'SUB - - - � -- - the following•reason {Section 7031.5• Business and Professions .Code : 'Any city or county which requires a permit to construct, alter, -WATER SERVICE - - ALTERATION• -- - (� i PANELS - • MAIN _ _ _ - Improve, demolish or repair any structure, prior to itsdssuance, also re-. ' quires the ap�lirant for such permit to file a signed statement that he - - - - ' GAS -SERV ICE --'OUTLETS' •• - - - - 'SERVICE ��-. - _ - .. ., AMP Is licensed -pursuant to -the provisions of -the Contractor's License Law_ 1Chapter 9 (commencing with Section 7000) of Division 3 of the that he is the_ _.WATER HEATERS --BTU•OUTPUT - -- - •• - } Business and Prolessions•Code) or -exempt therefrom and 'is for the alleged exemption. Any violation of Section 7031.5 by -SEWER CONNECTIONS - - --- -- ' - applicant -fora-permit subjects -the applicant to a civic .penalty- not more than five hundred dollars ($500).- - SOLAR -TANK - - -- -- -COLLECTORS- COLLECTORS L1'1,'as -owner of the 'property, Or my employee5-wlth wages as their- Ole Compensation, wilt do the work, and the structure is not intended Ole + SOL'RR'PIPING SYS'. ISSUE•FEE ------••-- .. "-` -_. __ .., or offered for sale. (Section 7044, Business'and"Professions-Code:-The- .Contractor's License Law doesnot apply to an Owner of a property who build$ or improve$'thereon,.'and who does such work himself or r, r �. _ __ -- ISSUE'FEE ' - -' - _ APPLICATION APPROVED BY _ DATE.. through his own employees, provided that such Improvements are not - MECHANICAL - -'PLAN CHECK '- - ; - ..� -'- - -' `•- SUMMA'RY,OF.'FE_ES ---. . .,- intended or offered for Talc. If, however, the-bullding'or Improvement is sold within one year of completion, the owner will have the burden { of proving he did -not' build or Improve for the purpose -of,-sale):• - - - - •- •- -BUILDING__,. HEATING SYSTEM D-100,000 BTU } PERMIT $ 'r�` l:': = ».'• �. SMIP $ Y :❑ I,.as owner of__the..property, am .exclusively _contracting with •1 - -AND DUCTING d_ licensed contractors to construct the ro'ect Section 7044, Business p 1 ( 100,000 *,+ BTU PLAN CHECK4 $ PERMIT and. Professions Code: The Contractor's License Law does not apply to_ _ _ _ -'ISSUANCE $ an owner of property who builds or Improves thereon, and who Con- tracts from projects with-a..Corttractor(s)-Ilcesned-pursuant-to REFRIGERATION 0-100,000 BTU SYSTEM— '��_ PLUMBING $ 'GRADING $ the Contractor's License Law). 100,0001+BTV PLAN CHECK' $, - - - +' j ❑ I am exempt'under•SectlOn _ � - - - B. & P'C. for this- •- • - ._ _ BOILERS •BTU I • l't l ,,' ELECTRICAL $ •--- ' - -• - reason�- _ _ .. -' `j PLAN CHECK .-$ _ MICROFILM $ - Date Owner SYSTEM REPAIR,-ALTERATEON ,-MECHANICAL b -. TOAL FEE $• '_ I hereby certify ve read this 10 and state that the above _ EXHAUST SYSTEM MULTIPLE r` $ ..l' LESS AD- , Informatio I agre compt ith all city -and county corre PLAN CHECK, $ , VRNCE PC -$ ordinanc d s aws re ng to co ction and hereby authorize F ' 4 repres a;nS' this y to upon• tie above-mentioned prop y f nspec es, - �...._-- _ . " -„ 7.4 - Sign t - - ISSUE FEE _ 3 - ` FSNAL FEE SCR brave License or SS �i - - --- - - -Assessor CMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod .L'; CONSTRUCTION_ AND PLANNING APPROVALS Permit r �5"tea- Date Inspector �.L POOL & SPA � Date Inspector APPROVALS j�'5\\)Permit# ��' �` -�•'�. •1i�t� \ = +� - 1. Temporary Electrical Service or Pole 43. Pool & Equiprrierit,Location 2. Soil Pipe-Undrgrn . 44. Steel Reinforcement 3: Electrical Conduit tility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Reinforce 47. Rough Plumbing& Pressufe Test + "" ' ' ' ' 6. Electrical UFER Grrr ; 48. APPROVAL T,O C01/lrR GUNITE� 7. Footings _ _ r 49. Electrical Conduit-Undr rn B. Foundation 50. Gas Pipe, ❑ Undr rn-.Test ..: .. 9. Water Pi a-Undr rn• p 9 51. . rQ" Backwash Lines P-Tra � '[} ndr rn..-'�-•:� � ..- ' 10. Structural Floor System 52. APPROVAL TO DE K'- 11. Property Sewer Line & House Connection - 53. Backwash & Receptor -Final 12. Street Sewer Connection - 54. Heat&r & Vent -Final 13. Rough Plumbing - - - ' 14. Rough Electric -Conduit - �- -56. 'Electrical -Final 15. Rough Electric -Wiring "' '57. Solar System -Final 16. Rough Heating& Air Conditioning Fencing & Access Approval 17. Ducts in Structure - APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL 19. Gas Pipe -Rough Wrest - 20:- Roof Framing 21. Roof Sheathin NOTES: 22. Frame and Flashin - 23. Insulation - - 24•: Lathing & Siding 25. Drywall Mailing 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32, Water Service -Final 33. Gas Service -Final ' 34. Solar Domestic -Final 35. Landscape Sprinkling System 36 : ' Sound Attenuation , 37. . Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison,, a�Y 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date No _� _ ,• . ' Applicant to fill in all spaces wltnln neavy Dorcer Imes ano sign all appropriate declarations. CIAFY OF COSTA MESA TRACT NO. LOT NO. BLDG. NO. v PER T NO. CONSTRUCTION PERMIT TYPE OF CONSTRUCTION ' ❑ ADD ❑ ALTERATION El REPAIR EI CONVERSION ❑DEMOLISH I OTHER - - " �7�7 10/ 1 �' ZONING REGULATIONS Project Address Owner Phone _IEW AddressTrwngm _ Arch/Eng. License No. DESCRIPTION OF WORK A.P. ' -- - - Address ZONE PLNG. REF. =41 Contractor Phone _ TYPE OF PERMIT ❑ GRADING © FOUNDATION ©STRUCTURAL E TENANT ❑.ELECTRICRLr LUMBING ❑MECHANICA BUILDING SETBACK C L ST. SIp E YARD LEFT RD Tp BUILDING OP R Y LINE PR E T Address 'LICENSED _C0NTRACTOR DECLARATION I hereby. affirm that I am licensed'under provisions of Charter 9 (come RI�HTP mencing with section 7000) of Division 3 of the Business and _ w El OTHER Professions Code, and my ilcense-,Is in full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Clas3 License N PK_ G. SPACE RECD. PROVIDED 5Q. F7. Da_te�/ Signature %ze_1 STREET WIDTH + PARK FEE $ ' WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -insure ora VALUATION ZONE ZONING APPROVED BY DATE, certificate of Workers' Compensation Insurance, or a certified copy thereof (Sect�pq,3ggp Lab. C.). _ YLLlb4 Zenith Nationa� GRADING CU. YDS. ACRES SPECIAL CONDITIONS: .y No. Company certified copy Is hereby furnished. ARKS: Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section need not be completed if the permit Is for one hundred - - - - ($100) or less). k t - I certify that In the performanceofthe work for which this permit is Issued, I shall not employ any person in any manner so as to becomeMBING-' •' PLAN CHECK ELECTRICAL PLAN -CHECK .subject to the -Workers' Compensation Laws of California. HTUBS SHOWERS [KIT. Date Signature -' URINALS GENERATOR 0.1 KW '1.10 KW ' NOTICE: If after making this declaration, you should become subjectLETS to the Workers' Compensation provisions of the Labor Code, you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemedATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50 + KW revoked. - - SINKS DISHWASHERS MOTORS 0-1 HP 1.10 HP ,CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per-VIGE SINKS SUMPS (INC. SOLAR) 10-50 HP 50,+, HP formance•of the work for which this permit is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Civ. C.). Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS INTERCEPTDRS CLARIFIERS POLE LIGHTS OWNER BUILDER DECLARATION .1 hereby affirm that I am exempt from -the Contractor's License Law for SWIMMING POOL P TRAP COMM I "OU 1 10114 POLES METERED SUB the following reason (Section 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 re- WATER SERVICE ALTERATION PANELS MAIN SUB + quires the applicant for such permit to file a signed statement that he GAS SERVICE OUTLETS ' 1 SERVICE RMP Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (Commencing with -Section -7000) of Division 3 of -the WATER HEATERS BTU OUTPUT .. !siness and Professions Code) or that he Is exempt therefrom and the ;s for the alleged, exemption. Any violation of Section 7031.5 by , SEWER CONNECTIONS - - applicant for a permit subjects the applicant to a civil penalty more than five hundred dollars ($500). SOLAR TANK COLLECTORS (� I, as owner of the property, or my employees with wages as their sole compensation, will do the work; antl the structure•is'not Intended - , 5f�� ' ISSUE FEE ' or offered for sale. (Section 7044, Business and Professions Code: The [not- Contractor's License Law does not apply to an owner of'a-property ISSUE FEE - - - APPLICATION APPROVED BY DATE who builds or improves- thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARYOF FEES ' intended or offered for sale. If, however, the building or Improvement -have is sold within one year of completion-, the owner will the burden - - of proving he tlitl not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU - PERMIT BUILDING $ r SMIP - ❑ 1, as owner of the property, am exclusively contracting with AND DUCTING .$ licensed contractors -to construct the project (Section 7044, Business .100,000 + BTU - PLAN CHECK $ _PERMIT _ and Professions Code: The Contractor's License Law does not apply to _ J ISSUANCE S an owner of property who builds or improve$ thereon, and who con- REFRIGERATION - 0-100,000 8TU PLUMBING $ ' tracts from such projects with a contractor(s) Ilcesned pursuant to SYSTEM _ GRADING $ the Contractor's License Law). lOD,000 +BTU PLAN CHECK $ ❑ I am exempt under Section B. & P. C. for this$ BOILERS BTU ELECTRICAL 5 - ,$ reason PLAN CHECK $ MICROFILM Date Owner SYSTEM REPAIR, ALTERATION TOTAL FEE $ I hereby certify that I have read this application and state that above EXHAUST SYSTEM MULTIPLE MECHANICAL"'$ LESS AD - information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC , S 'ordinances andstat laws relating to construction, and hereby authorize - representatives o this City to enter upon the above mentioned , -propertyFfo ! pur s. 6. action, Signature r - � - - - - -... FINAL FEE $ - - - Drivers' License or SS ISSUE FEE GMF 0865.46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA APPROVALS Permit # Date Inspector 1.. Temporary Electrical Service,or Pole [ • V [ s L 43. Pool & Equipment Location Soil ipe-Un rgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4, Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49, Electrical Conduit-Undr rn ' 8. Foundation 50. Gas'Pi e, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines -P -Trap, ❑ Undr rn 10. Structural loor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection R1, 10 -VA-vj 53. Backwash & Receptor -Final 12. Street Sewer Connection 54• Heater & Vent -Final 13. Rough Plumbing 55, PlumbingSystem - Final 14. Rough Electric -Conduit •56. Electrical -Final 15. Rough Electric -Wiring - 57. Solar System -Final 16. Rough Heating & Air Conditioning encing &Access Approval 17. Ducts in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL r ' 19. Gas Pipe -Rough &Test 20, Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing 23. Insulation . 24. Lathing & Siding 25. Drywall Nailing 26, Plaster Brown Coat 27. Electrical Power Meter -Final' 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final 33. Gas Service -Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37, Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No - Date Appiicant to fill in all spaces within heavy border lines and sign all appropriate declarations, _ CITY OF COSTA MESA PERMIT N TRACT NO. 40T NO. 6LN0. • !CONSTRUCTION PERMIT �� Project Address Ir �� %a?r� ;r✓f/j. TYPE OF CONSTRUCTION Owner ` n,,_a C-Zt,' hone -25-Z-7) ❑ NEW ❑ ADD ❑ ALTERATION Address ❑ REP13 AIR ❑CONVERSION ❑DEMOLISH - i - ' •C 'N ❑ OTHER ,6114 5/20/82 3 3. 418 TL.l 1NG REGULATIONS Q Arc4,1 ng, icense o. DESCRIPTION OF'WORK • A.P. 1P1 • Address I- ZONE PL•NG. REF. :P Contracior , +� L�� Phoney-jp TYpE OF PERMIT ❑ GRADING ❑ FOUNDATION - C1 STRUCTURAL - ❑ TENANTELECTRICAL'❑PLUMBING ❑MECHANICA -❑ OTHER'- 1' �" ' ' PROJECT•DESCRIPTION' — - -- -- +.: SQ: FT. - _ - OCCUPANCY CONSTRUCTION TYPE p ' V 4LUATION - ZONE 1 - - GRADING•CU. YDS. ACRES BUILDING To BUILOINO SETBACK C L ST. PROPERTY LINE- Address ( CC � -- DE YARD i LICENSED CONTRACTOR' DECLARATION' - ^^ 1, hereby affirm that _i_am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of -the -Business and Professions Code, 1 d my 1 In f l f e f ct: - License Class - cens or Date 5 ^'7 0 �5Z Signature ,WORKERS''COMPENSATION-DECLARATION - - - - i hereby affirm that i have a certificate of consent to self-inSure:or a certificate of Workers' Compensation -insurance,-or- a'cettifled copy thereof (Section 300, Lab._C.). .� f� t.licyNo CC]J 11 Drs Co.; anyt Certified copy Is hereby furnished. - - 7�fCertified copy is filed with the city Building Division. SIDE YARD RIGHT REAR YARD (TO P/L) - PKG. SPACE REQ. PROVIDED STREET WIDTH PARK FEE.$ - ZONING APPROVED BY , 5 DATE �" , SPECIAL CONDITIONS: REMARKS: t - - '-' " •� L �" EXEMPTION FROM WORKERS' COMPENSATION OECLARATION This section need -not be completed if -the permit -is -for one hundred. ($100) or less)- I-certifythat 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, - - - Date Signature 4 fit-�„ - -•- - �, _ - �•• f .,yt .�H'a. ',w �• f PLUMBING f� PLAN CHECK - 1ELECTRICAL PLAN CHECK , _ - BATHTUBS SHOWERS _ o NOTICE: If after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must - forthwith comply with such provisions or this permit shall be deemed �'f'OI L'�TS, '•• •r URINALS ,GENERATOR 0-1 KW TRANSFORMER .APPLIANCE- 10-50 KW -50 1-10 KW - •- - : _ + KW _ - _--_ -_ LAVATORIES DOUBLE LAVS , revoked: CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the per-. forCiv.mance,of, the: ork _far which this_ -permit is iss_ue_d (Section 3097 L nd .). Name �''� • �' �~ '} T- •� - -- KIT. SINKS DISHWASHERS^ - -' ^ ' MOTORS 0-1 HP (INC. -SOLAR)- ) 10-50 HP ' 1-10 Hli ;. �- 50'+,HP i i SERVICE SINKS'., SUNFPS l FLOOR SINKS 4.FLOOR DRAINS~ FIXTURES 3 -OUTLETS SWITCHES ! Lender's Address DRINKING FOUNTAINS j; - GAS TUBE SIGNS INTERCEPTORS CLARIFIERS • IPOLE LIGHTSr.-- OWNER BUILDER DECLARATION ^. I herebyaffirm that I am exempt from the Contractar'S License Law for the following reason• (Section 7031.5 Business and-ProfeSSions Code: Any _city ,or cuuntywhich •requires a -permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, aisc re- quires•the apl-licant far such permit to file a. signed statement that he is licensed pursuant to the provisions of the Contractor's License Caw (commencing, with Section 7000) of Division 3 of the (Chapter 9_ C Business and Professions ode) or that he 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 -($500).• SWIMMING POOL P TRAP- POLES METERED ` SUB n WATER SERVICE ALTERATION •`4, • • f:: ry ,, / PANELS f^ - MAIN SUB - GASSERVICE OUTLETS _ ' 4SERVICE -.AMP` - - -, WATER HEATERS BTU OUTPUT - - - ` _ -SEWER CONNECTIONS - - - - SOLAR TANK COLLECTORS^� - E]I, as owner of the property, or my employees .with wages as their sole compensation, will do -the work,-and-the-structure•is not intended or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. + - _ - -_ - •�, ISSUE -FEE _ _ - - Contractor's License Law does -not apply- to•an•owner -of a property,_ who builds or improves thereon, and who does such work himself of through- his own employees, -provided that such -improvements are not. Intended or offered for sale. If, however, the building or improvement s sold within one .year of-completion,,the owner will have -the burden . of proving he did not build or improve for the purpose of sale). ElI,J a$owner' of the- property, am exclusively''contracting' with .licensed contractors to construct the project (Section 7044, Business and Professions Code: The-Cohtractor'S License law does'not apply to' property who builds or Improves thereon, and who con- an owner of.u tracts 'from'sch projects with a"contractor(s)' licesned -pursuant- to the Contractor's License Law).__ _ _ _ ❑ I am exempt under Section B. &-+'. C. for tnis1 reason - - `- - "'- -- --- - -' - - Date ' --Owner •- -- - - I hereby certify that-Lhave read this appiication.and State that the above Inform rrect, I agree to comply with all city and county 0 dm ces and sta I s reia ' g Lo.construction, and hereby.authorize ISSUE FEE '� APPLICATION•APPROVED BY "DATE MECHANICAL PLAN CHECK _ SUMMARY OF -FEES -- _ r, '4' •• _ ' i -BUILDING" ' -- - PERMIT $ _ SMIP'y - $ r' ,` rt LAN CHECK $ PERMIT' • ;P- - ^--- - - -ISSUANCE'-'$ --_ - 'PLUMBING $ - - -GRADING J$ PLAN CHECK `$- r ' � , %}• ' ELECTRICAL $ 3. •+ PLAN CHECK $ - ---•-' 'MICROFILM $ • -_' TOTAL F,EE $ l ,MECHANICAL S _ 'LESS AD- •' _ PLAN CHECK $ VANCE PC $ HEATING SYSTEM 0-100,0006TU , AND DUCTING - _ - - __ 100,000'+ BTU t REFRIGERATION 0-100,000 BTU j 'SYSTEM - 100.000.+ BTU BOILERS BTU - SYSTEM REP_AI R, ALTERATION EXHAUST SYSTEM MULTIPLE repre en[atives of i5 ci to enter upon the above mentioned. prope y- for i ion- poses, __ _(� FINAL FEE $ I -ISSUE FEE Signatu pate- Drivers' License or SS -Assessor CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod CONSTRUCTION AND PLANNING APPROVALS Permit # f- 3� 0 % Date Inspector POOL & SPA APPROVALS Permit # Date _ Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment'L'ocation 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45, Forms 4, Electrical Conduit-Undrgrn 46. Electrical Banding S. Steel em orce 47. Rough Plumbin &Pressure Test ' - ' - --!~ • s 6, Electrical'UFE_R Grn 48, APPROVALTO COVER-GUNITE- 7. Footings 49. Electrical Conduit-Undr rn 8. ._ Foundation 50. Gas.Pipe, ❑ Undr rn, Test V 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ~ ❑ UnjrcjrH - -' 10. Structural Floor System 52. APPROVAL TO DECK -�= Y -= -{-• - - ` 11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 1.2, . Street Sewer Connection _ 54. Heater & Vent-Final ' .•'" 13. Rough Plumbing J' r' "�� - 14. Rough Electric-Conduit 56. - Electrical-Final 15. Rough Electric-Wiring - e - -57. Solar System-Final 16. --Rough Heating & Air Conditioning- r - _- _ Fencing &.Access Approval 17, Ducts in Structure' 9. APPROVED,FOR PLASTERING 18.. Ducts, Ventilating P-000SPA SYSTEMS FINAL 19. Gas Pipe-Rough &Test60. 20, Roof Framing 21. Roof Sheathin _ NOTES: -22.. Frame and Flashing _ -23. Insulationr�-L. _ t-E ' e, 24. Lathing & Siding 25. Drywall Nailing c 26., Plaster Brown Coat 27. Electrical Power Meter-Final 1 eel- 28. Final Electric G 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33, Gas Service-Final 34. Solar Domestic-Final 35. Landscape S2rinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. I 42.• CERTIFICATE OF OCCUPANCY ' No Date I ` ) !' % 1 4---� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESALEM CONSTRUCTION PERMIT IT N LL 01 ,27 TRACT NO. LOT NO.. BLDG. NO. L $ SMIP $ " Project Address 3151 Airway, Costa Mesa, CA TYPE OF CONSTRUCTION m Owner JDO Company Phone540-2606 El NEW ❑ ADD ❑ ALTERATION Address 3151 Airway, Costa Mesa 92626 (INC. -SOLAR) ❑ REPAIR ❑ CONVERSION El DEMOLISH 50 + HP ' ❑ OTHER Arch/Eng. License No. SWITCHES DESCRIPTION OF WORK Address N'� Contractor Leaverton-Beck Inc Phone 979-356 TYPE OF PERMIT Address 16721 Hale Ave. Irvine CA 92714 MECHANICAL ❑ GRADING . ElFOUNDATIO ❑ STRUCTURAL LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and Professions Code, and my_ license is In full force and effect. License Class LJcense N 191969 y LESS'AD- VANCE PC S ❑ TENANT ElELECTRICAL PLUMBING ❑MECHANI( ❑ OTHER PROJECT DESCRIPTION i Date _ -- Signature SQ. FT. _ WORKERS' COMPENSATION DECLARATION OCCUPANCY CONSTRUCTION TYPE 1 hereby affirm that I have a certificate of consent to selfdn$ure ora certificate of Workers' Compensation Insurance, or a certified copy VALUATION ZONE thereof RC3091OOitb C Company Great American GRADING CU: YDS. ACRES srtified copy Is hereby furnished. r'. Y certified copy Is tiled with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION~ FREMARIJKS, + This section need not be completed if the permit Is for one hundredE100y or less1j.certifythatjnheperformance of the work for which this permit isissued !shad not employ any person in any manner so as to becomeNG subject to the Workers Compensation Laws of California.- alifornia.Date PLAN CHECK BATHTUBS SHOWERS DateSignature NOTICE: If after making this declaration, you should become subject TOILETS URINALS to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS revoked. CONSTRUCTION LENDING AGENCY KIT. SINKS DISHWASHERS SERVICE SINKS SUMPS I hereby affirm that there Is a construction lending agency for the per- formance.of the work for which this permit Is Issued (Section 3097 FLOOR SINKS FLOOR DRAINS A Civ. C.). Lender's Name DRINKING FOUNTAINS d Lender's Address INTERCEPTORS CLARIFIERS OWNER BUILDER DECLARATION I herebyy affirm that I am exempt from.the Contractor's License Law for the following reason (Section 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 re- quires the applicant for such permit to file a signed statement.that he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commenting with Section 7080) of Division 3 of the 4usiness and Professions Code) or that he is exempt therefrom and the vis for the alleged exemption. Any violation of Section 7031.5 by f applicant for a permit subjects the applicant to a civil penalty .snot more than five hundred dollars ($500). SWIMMING POOL P TRAP WATER SERVICE ALTERATION GAS SERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS au' 8 Q SOLAR TANK COLLECTORS -- r © 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 ��-+•---.+.f„r. ale. (Suction 7044, 0uciness and Professions Code: The Contractor's L�cenac-law aues not apply to an owner of a property who builds or improves thereon, and who does such work himself or througgh his 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 will have the burden of proving he did not build or improve for the purpose of sate). 1:1I, as owner Of the property, am exclusively contracting with licensed contractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to SOLAR PIPING SYS. d ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0.100,400 BTU AND DUCTING ° 100,000 + BTU REFRIGERATION 0-100,000 BTU SYSTEM 100,000+ BTU an owner of. property who builds or Improves thereon, and who Con- tracts from such projects with a contractor(s) ticesned pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this BOILERS BTU reason SYSTEM REPAIR, ALTERATION . Date Owner EXHAUST SYSTEM MULTIPLE I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all city and county ordinances and state laws relating to construction, and hereby authorize representatives of,his city to ter pon the above mentioned property for a tionpurpo —� Signature Drivers' License or SS -t I ISSUE FEE CMF 0865-46 White -Building; Canary -Applicant: Pink -Accounting; Goldenrod -Assessor A. P. =* ZONE 3569 7/21/82 dING REGULATION,' PLNG, REF. 9F REAR YARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONING APPROVED BY SPECIAL CONDITIONS: ELECTRICAL 51.00 TL NE PROVIDED PARK FEE $ •' DATE PLAN CHECK GT GENERATOR 0-1 KW 1-10 KW TRANSFORMER PERMIT $ SMIP $ " 'APPLIANCE 10-50 KW— 50 + KW - MOTORS 0-1 HP 1-10 HP (INC. -SOLAR) 10-50 HP 50 + HP ' FIXTURES OUTLETS SWITCHES GAS TUBE SIGNS MICROFILM $ , POLE LIGHTS TOTAL FEE $ ,PANELS MAIN SUB SERVICE AMP ISSUE FEE APPLICATION APPROVED BY DATE SUMMARY OF FEES BUILDING PERMIT $ SMIP $ " PLAN CHECK $� PERMIT ' ISSUANCE $ PLUMBING $ GRADING E PLAN CHECK $ ELECTRICAL $ $ MICROFILM $ PLAN CHECK $ TOTAL FEE $ MECHANICAL $ PLAN CHECK y LESS'AD- VANCE PC S - FINAL FEE $Aiii!i_ CONSTRUCTION AND PLANNI G APPROVALS Permit # - Date Inspector POOL & SPA - APPROVALS Permit # Date Inspector i. Temporary Electrical Service or Pole 43, Pool'& Equipment Location 2. SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding 5. Steel Fein orce 47. Rough Plumbin& Pressure Test 6. Electrical LIFER Grn 48. APPROVAL TO COVER-GUNITE 7, ootings 49. -Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ n r rn 10. Structural Floor System 52. "APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing 55, PluMbing System - Final 14, Rough Electric -Conduit •56._ Electrical.Final 15. Rough -Electric-Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning b8, Fencing & Access Approval 17: Ducts in Structure 59. APPROVED FOR PLASTERING 18' Ducts, Ventilating 60. POOL/SPA SYSTEMS FINAL ` 19! Gas Pipe -Rough &Test 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing - 23. Insulation 24: Lathing & Siding 25. Drywall Nailing - 26. Plaster Brown Coat 27. Electrical Power Meter -Final 28.•_ Final Electric 29. Final Heating & Air Conditioning t 30. Final Gas Pipe -Test 31. Final Plumbing h 32. Water Service -Final 33. Gas rvice-Final 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No _ Date Contractor's Nam hone _?a0- 6nfi PROJECT DESCRIPTION SQ. FT. 1 _•. OCCUPANCY— - K Address(mailing) 3151 Airway Ave. E-1, •Costa Mesa CON STRUCTI ON TYPE VALUATIONS 29,6nn.a0 s Left City License No. AO 7 ZONE GRADING CU.YDS. ACRES Ping. Ref, # LICENSED CONTRACTOR DECLARATION Remarks: — Parking Req./Provided I heAtry affirm that i am licensed under provisions of Charter 9 (commencing wittirsection 7000) of Division 3 of the Business and Professions Cade, and + + 1 Use of Building: my.11cense Is In ful ,fp ce and effect, License Class -`1 teens -333969 PLUMBING Z=EES Planning Notes: -)ate '1 130IR4 Signature ' "_7 J Bar Sink Showers a0 ,YORKERS' COMPENSATION DECL4RAT10 I hereb affirm that I have a certificate of consent to self -insure or a certificate i� T' 4122 2%09/64: t 2ii6.'43 Ti Zone L ' Accessory Building: Z - N N G R E Park.Fees $, Q U E E N 1 T Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Backflow Preventer CITY OF COSTA MESA .PERMIT NO: TRACT NO. LOT NO. BLDG. Nu. 4 CONSTRUCTION PERMIT I 1 454p--' /-1070 . - 3 Sewer Connection , Automatic WaShd , -Transformer ❑ 15.50 KW I Project Address _3151_1.)"wa Ve. ` OS a —L me TYPE OF CONSTRUCTiC1N NEW ADD ALTERATION REPAIR . Clarifiers Solar Collectors EXEMPTION FROM WORKERS' C0f4PZN_`S4TICkd.I5IZCL:A_RA ION (This section need not be completed if the permit is for One nun red ($100) or Applicant's Mailing Address r AVe,. E- I ❑ CONVERSION _❑ DE=MOLISH � OTHIrR A.P. # ^� -- Meter ❑up to 100 amps - - - - - - Guildhou_se Consultants 540-2606 less): I certify that in the performance of the work for which this permit Is issued I shalt not employ -.any person in any manner so as to become subject t0 tke Workers', Compensation Laws of California.' DESCRIPTION'OFWORK —interior lmprove111enL Soiar Tank ,t Dishwasher _-_p Owner's Name - -hone Floor Drains � - � S Main Building: .Sub Panel Address 3151 Airway -Ay -el �7 s ' OOS a i�Esd __ . -- TYPE PERMIT GRADING FOUNDATION STRUCTURAL - T Front Fan• Arch/Erig. -- - :1O91-CC1MP0 License No. 11 Qs TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL R Closet Address 17779 "F" Main _ _ Irvine Inc. Soiar ❑3-i5 HP ❑16-i 5+ ❑ ,OTHER - A Rear ' Fixtures ' •Microwave ' 976 g 2 C Right Contractor's Nam hone _?a0- 6nfi PROJECT DESCRIPTION SQ. FT. 1 _•. OCCUPANCY— - K Address(mailing) 3151 Airway Ave. E-1, •Costa Mesa CON STRUCTI ON TYPE VALUATIONS 29,6nn.a0 s Left City License No. AO 7 ZONE GRADING CU.YDS. ACRES Ping. Ref, # LICENSED CONTRACTOR DECLARATION Remarks: — Parking Req./Provided I heAtry affirm that i am licensed under provisions of Charter 9 (commencing wittirsection 7000) of Division 3 of the Business and Professions Cade, and + + 1 Use of Building: my.11cense Is In ful ,fp ce and effect, License Class -`1 teens -333969 PLUMBING Z=EES Planning Notes: -)ate '1 130IR4 Signature ' "_7 J Bar Sink Showers a0 ,YORKERS' COMPENSATION DECL4RAT10 I hereb affirm that I have a certificate of consent to self -insure or a certificate i� T' 4122 2%09/64: t 2ii6.'43 Ti Zone L ' Accessory Building: Z - N N G R E Park.Fees $, Q U E E N 1 T of«Workers' Compensation • Insurante, or- a certified' -copy- thereof (Section 3800, Lab. C.)L] 7n _ Backflow Preventer Service Sink ' S Backflow Irrigation Seiner Cap ELECTRICAL FEES ' I 1 Policy No. �F�2974 Company_ Certified copy is hereby f6mislieq- _ , -' ' bathtubs Sewer Connection , Automatic WaShd , -Transformer ❑ 15.50 KW I Corti ep,�gp ifgs filed with the city Buil n. Date, V=4 Applicant Construction Pole Sub. 0 50 + KW Clarifiers Solar Collectors EXEMPTION FROM WORKERS' C0f4PZN_`S4TICkd.I5IZCL:A_RA ION (This section need not be completed if the permit is for One nun red ($100) or Dishwasher - -'• I Solar PipingCooking -Unit -- Meter ❑up to 100 amps - - - - - - [1 less): I certify that in the performance of the work for which this permit Is issued I shalt not employ -.any person in any manner so as to become subject t0 tke Workers', Compensation Laws of California.' Drinking Fountains Soiar Tank ,t Dishwasher Clover Meter over 100 amps I Floor Drains - Swimming Pool w/Spa Dryers ❑Gas ❑Electric .Sub Panel t Date Signature NOTICE: if, after making this declaration, you should become subject to the Floor Sinks _ Urinal Fan• MotorsE10-1 HP ❑1'f, - B 11 Workers' Compensation, provisions of -the Labor Code,•you-must forthwith comply 'with• such provisions or this.permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY. I -- - Gas Service 'OutletsWater Closet F.A,U. Inc. Soiar ❑3-i5 HP ❑16-i 5+ Interceptors ' �- - Water Heater - cam Fixtures ' •Microwave ' I hereby affirm that there is a construction lending agency for the performance of the work for whNp Nhls, permit is issued- (Section 3097 Civ_ C.) Kitchen Sink Water Service Device Boxes Pale Light Lender's Name - IY/ _ r ' Lender's Address OWNER BUILDER DECLARATION i ;• Lavatories Outlets ;Range t I hereby affirm that I am exempt from the Cdntractor's'License Law for the following reason (Section 7031.5 BUsiness and Professional Code: Any city or county which requires a permit to construct, alter, improve• demolish or repair -ny structure, prior to lts,issuance, also requires the applicant for such permit file a'signed statement that he/she is licensed pursuant to the provisions of .. P -Trap Switches Sign t r -' ' _ - _ - _ _ Y . - ._ - Roof Drains { , •- Garbage Disposal Standing Sections i _- + ' Generator ❑0-5 KW ©5-15 KW Trash Compactor a Contractor's License Law (Chapter 9 (commencing with Sectlon-7000) ofi Division 3 of the Business and Professions Code) or that he/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 - malty of not more than five hundr4d dollars ($500). .� 1, as owner of the' property or my employees -with wages as ttielr sole compensation, will do the work, and the structure is not intended or offered - _Reinspection Fee ,. '$25 Issue Fee $ 3 Reinspection Fee $25 • Issue Fee $ 3 - - MECHANICAL - FEES PUBLIC SERVICES RE IRE ENT ; � —n_ d[J Zoning Approved By Date�L '-•,9-a¢ Application Approved By Date Application Issued By Date �_�•� for sale(Section •7044, Business and, Professional Code: The Contractor's 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 employees, provided that such improvements ara not intended or offered'for , sale. If, however, the building or Improvement is sold within one year of com- pletion, the owner will have,the burden of proving he/she did not build Or im- rove",for the purpose Of sale). ' I, as owner of the property, am exclusively contracting` with licensed con- tractorsto construct the project (Section 7044, Business and professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon,,and who contracts for such projects with a con- traCtor(s) license pursuant to the Contractor's License Law), El 'i am exempt under Section-- - - B. & P. C. for this reason Boiler ( T' , Hood or Type I ❑ , r Canopy Type 11 ❑ . - Duct -Under Ground , Duct - Structural __ Refrigeration System ❑Q100,000 BTU ❑100,000 BTU Duct - Ventilating �o BUILDING,PERMIT PLAN CHECK PLUMBING CHECK , ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK SUMMARY OF FEES 40 ; O% 0 $ $ _9�' SMIP ' $ �-�+-'+�— .1L'ERMIT ' $ ��'� ISSUANCE $ $ moi: Cd ENERGY'P.C. $ i GRADING $ ; $ , $ MICROFILM $ $ TOTAL FEE $ f $ Exhaust System ❑ El. . system Repair/Alteration Fireptlfact. Sit. lCBO # Date Owner - T' I hereby certify that I have read this application and state that the above 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 chi city o en r on the above-mentioned property for inspection pure s, 1 1,3CI$� Signature Date Drivers' License or $S Heati n4 System & DuctingPLAN ❑0.100,000 BTU ❑100,000 BT - -�`- - - - - _ ' , t , Reinspection Fee $25• Issue Fee $ 3 CMF 0865-46 rev. 7/83 ' White - Building; Canary -Applicant: Pink -.Accounting; Goldenrod -!Assessor `CONSTRUCTION AND PLANNING ' APPROVALS Permit,# G Date Inspector L & SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location I 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4, Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. ' 8, Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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. POO USPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21'. -Ducts, in Structure 70. Underground Hydro '`221 Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test •` 72 -Underground Flush 24. Roof Framing f 73. Undergrnd. Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling {Structural} & Monocoat 75. Dry Chemical 27. Frame and Flashing �% S 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 47, FINAL STRUCTURE & BUILDING 3 a / 48. Special Requirements Completed . 49. Electric Release to Edison 50. Gas Release to Southern California Ga's Co , 51. CERTIFICATE OF OCCUPANCY No,._ BW3loG Date ' G ' r \V CITY OF COSTA MESA CONSTRUC110N PERMIT Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PER MIT NO TRACT NO LOT NO. BLD Project Arwess 'c-,'" 4 - r I_%� . Zq lica�A�i6a D Appnt's MailiQaa--Andress . r Owner's Na y hone yG Z eOA Address�� Arch/Eng. License No. Address Contractor's Name d r7 —42P, �— phone Address (mailing) C� L14 441'74 City License No. ln.;?, L LICENSED CONTRACTOR DECLARATION l hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and -w license Is in f far a and effect. ense CIdS7s ^ co 2 ._ate 2; `S—Xj Signatur WORKERS' COMPENSATION DE LARATION 1 hereby'afflrm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C Policy No. 2 Company --N►" �..�!_! Certified copy Is hereby furnished. Certified CO y is f led with the city B Date^�_ Applicant EXEMPTION FROM WORKERS' COMP NSATI N DECLAR ION (This sectlon need not be Completed If the permit is for one hVdctred ($100) or less). I certiTy that in the performance of the work for,whlch this permit IS issued I shall not employ any person In any manner so as to become subject to tke Workers' Compensation Laws of California, Date Signature NOTICE: tf,tafter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be -deemed revoked. 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 (Section 3097 Civ, C.) Lender's Name Lender's Address' OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the 'ollowing reason (Section 7031.5 Business and Professional -Code: Any city or writy which requires a permit to construct, alter Improve, demolish -or repair ,y structure, prior to Its:lssuance, also requires tie applicant for such permit co file a signed statement that he/she Is Ilcensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing. with Section:7000) of Division 3 of the Business and Professions Code) or that he//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 ��enalty 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 (Secilon 7044, Business and Professional Code: The Contractor's License taw does not apply to an owner of a property who builds or improves thereon, and who does such work hlmself/herself _or through his or her own employees, provided that such improvements are not intendetl or offered for Sale. If, however, the bullding Or Improvement Is sold within one year of com- pletion, the owner wliI have the burden of proving , /she did not build or Im- rove far the purpose of sale), I, as owner of the property, am ex%luslvely contracting with licensed con- tractors to construct theproject(Section 7044, Business and Professlons Code: ' The Contractor's License Craw does not apply to an owner of property who builds or improves thereon, and who Contracts for such projects with a con- tractors) )!cense pursuant to the Contractor's License Law): ❑ I am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that I have read this application and state that the above - information Is correct. I agree to comply with all city and county ordinances and state laws relating t bulldl g construction, and hereby authorize repro- 0' of this en po the above-mentioned property for inspection u at a 3 - Signature Drivers' License or SS 59� J/ TYPE OF/CONSTRUCTION NEW ADD ALTERATION 0 REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P. qjE DESCRIPTION OF WORK S Main Building: TYPE OF PERMIT LJ GRADING M FOUNDATIQN _ STRUCTURAL T Front ❑ TENANT El ❑ PLUMBING ECHANICAL B Rear ❑ pTHER A PROJECT DESCRIPTION SQ. FT, OCCUPANCY C Right K [Lf t CONSTRUCTION TYPE_ VALUATION $ $ ZONE GRADING CU.YDS. ACRES Ping. Ref. # Remarks: Parking Req./Provided 51 Use of Building: PLUMBING FEES Planning Notes: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher - Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee 1$25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating. ' c Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating,System & Ducting 00-100,000 BTU ED 00,000 BT Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service ' r Issue Fee $ 3 4ANICAL Hood or Type I ❑ Canopy Type II ❑ FEES Refrigeration System !]0.100,000 BTU 0100,000 BTU I� System Repair/ Alteration Building Approved By Reinspection Fee T $25 Issue Fee $ 3 CMF 0865.46 rev. 12/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 4764' 2/24/84 ' 30-50 TL Zone Accessory Building: Z O N I N G R E Park. Fees $ Q U R E M E N T ELECTRICAL I FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas DElectric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator ❑0.5 KW 05.15 KW Transformer ❑ 15.50 KW ❑ 50+KW Meter LJ up to 100 amps Meter ❑over 100 amps Sub Panel Motors [30-1 HP❑ VA 8 Inc. Solar 09-15 HP El 16-15+ Microwave Pole Light - Range Sign Standing Sections Trash Compactor Reinspection Fee 1 $25 i Issue Fee . '$ 3 PUBLIC SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By- //� Data SUMMARY OF FEES BUILDING PERMIT $ SMIP' I $ 1 PLAN CHECK- $ ' PERMIT PLUMBING $ ISSUANCE $ ; PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ 5 MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $r? . _ _ • P CONSTRUCTION AND PLANNIf4 r (o APPROVALS Permit # 1 Date Inspector JL & SPA =' _ '` APPROVALS Permit # •. Date y ' 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. Etectrical Conduit-Undrgrnd. 55: Etectrical, Bonding 5.• Steel Reinforcement 56, Rough Plumbing ,& Pressure -Test 6• Electrical UFER Grnd. 57. APPROVAL TO COVE R -G UNITE' 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0•Undrgrnd., Test - 9. Water Pipe-Undrgrnd. , ' 60. Backwash Lines, P -Trap, 0 Undrgrnd. _ 10. Structural Floor System 61. APPROVAL -TO DECK 11.Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. $ewer Cap 63, Heater &Vent -Final , 13.'Roof Drains 64. Plumbin System- Final. ! - 14. Rough Plumbing 65. Electrical -Final' 15. Rough Electrical -Conduit + ti ! 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing&_-Access•Applroval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling '69. POOLISPA SYSTEMS FINAL ;. 19. Rough Heating & Air Conditioning �� FIRE DEPT. REQUIREMENT- APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro ! ? 22. Ducts, Ventilating 71. Product Piping ❑ Gas, 0 Oil 23. Gas Pipe -Rough & Test 72. Underground Flush i t 24. Roof Framing 73. Undergrnd, Storage Tank 0 Gas.' I] Oil ! = t 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar•Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe _ _ r 28. Lathing & Siding 77. FIXED SYSTEM FINAL •, { f I $ 29. Insulation 78, FIRE PREV. FINAL , 30. Drywall Nailing HEALTH DEPT. REQUIREMENT + 31. Plaster Brown Coat 79. FINAL INSPECTION + 3�2. 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 .Y 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 I s 46. Handicap Regulations { 47. FINAL STRUCTURE & BUILDING I F 48. Special Requirements Completed 49. Electric Release to Edison -� 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date TI _ . - Applicant to fill in all,spaces except those within, heavy border lines and sign all appropriate declarations. , fly 'OrY OF COSTR'MESA I PPPM1T_Nn I TnAf T NO I nT NO I RI MR CONSTRuRION PERMIT UPI Project Address � Applicant's Mailing //--Address : Z , lldwe' �/UCj Owner's Name` �R�� ' JFXd>Phone Address Arch/Eng.' License No. Address Contractor's Nam�r1n A/VWA)aJ l 'Ieu7•4rC' Pine�o Addressiimailing) 7",1 /�C € City, License No. L"ICENSEO CONTRACTOR DECLARATION i- 1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions C 4nd -0icense is in full force and effect. tense Class v LI o, .rate �_1 V Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab.) Al Policy No. -'� �/ company AIRQHlIFAJ FJ � �• W,grtif€ed copy is hereby Nrnished. Mm ie flq 1 d with the city Bu tll Di sl tri Date fJ Applicant f`^ EXEMP ION FROM WORKERS' C ENSATION DECLARATION erm (This section need not be Completed the pit is for, one hundred ($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. Date Signature NOTICE: If;iafter making -this declaration. you should become subject to the - Workers, Compensation provisions of the Labor Code, you must forthwith comply with such provisions or 'this 'permit shall be deemed revoked: CONSTRUCTION, LENDING AGENCY 1 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.) Lender's Name Lender's Address OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's. License Law for the ',3Ilowing reason (Section 7031.5 Business and Professional Code: Any city or )unty which requires a permit to construct, alter improve, demollsh.or repair .ny structure, prior to Its issuance, also requires the applicant for such permit to Site a signed statement that he/she Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of .Division 3 of the Business and Professions Code) Or that he/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 enalty of not more than five hundred dollars (5500). 1, 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 (Secllon 7044, Business and Professional Code: The Contractor's 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 employees, provltled that such improvements are not intendod or offered far sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractor construct the project{Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason TYPE OF CONSTRUCTION L41NEw LJ ADD L ALTERATION. Ll REPAIR ❑ CONVERSION 1:1 DEMOLISH 1:3 OTHER DESCRIPTION OF WORK A,P. # S, T B- A Main Building: TYPE,OF PERMIT GRAr)lNG_QF6UNOATION 0 STRUCTURAL ❑ TENANT ELECTRICAL WLUMBING ❑MECHANICAL ._ ❑ OTHER Front Rear. . PROJECT DESCRIPTION SQ. FT, OCCUPANCY CONSTRUCTION TYPEVALUAT€ON $ t ZONE GRADING CU.YDS. ACRES C. S Right Left p R f -JJ- Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepi/Fact. Bit. ICBO Date Owner Heating System & Ducting 1 hereby.certlfy that € have read this application and state that the above ❑(M 00,000STU ❑100,000BTI, Information Is correct. 1 agree to comply with all city and county ordinances ' and'state laws relating to b Idf construction, and hereby authOrIX' '" pra- sentatives of t city t nye upo the above-mentioned pr irm ,toy Inspectlon pur Signature Drivers' Lic nse Or SS q)t Reinspection Fee Wpa—White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $25 LIBI -2/10/841 1 Zone' Accessary Building: - Park. Fees $ 416;0 ' TL ELECTRICAL Ing. e . Remarks:? Q Meter up to 100 amps Parking Req./Provided Meter ❑over 100 amps ric Sub Panel Use of Building: " _Motors ❑0.1 HP W1,4 - 64 up PLUMBING FEES Planning Notes: Bar Sink Showers Pole Light Refrigeration System Backflow Preventer- Service Sink Sign BUILDING PERMIT PLAN CHECK Backflow Irrigation Sewer Cap 5.15 KW Trash Compactor $ Bathtubs Sewer Connection' Automatic Washer Clarifiers Solar Collectors PLUMBING Construction Pole Sub. Dishwasher Solar Piping $ Cooking Unit Drinking Fountains Solar Tank ! Dishwasher Floor Drains Swimming Pool w/Spa ENERGY P.C. GRADING Dryers El Gas ❑Elec' Floor Sinks Urinal Fen Gas Service Outlets Water Closet MECHANICAL, F.A.U. Interceptors Water Heater ' ' Fixtures Kitchen Sink Water Service Device Boxes Lavatories, Outlets P—Trap Switches Roof Drains Garbage Disposal - Generator 00-5 KW E: Reinspection Fee $25 Issue Fee $ 3 Fee MECHANICALReinspection FEES Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepi/Fact. Bit. ICBO Date Owner Heating System & Ducting 1 hereby.certlfy that € have read this application and state that the above ❑(M 00,000STU ❑100,000BTI, Information Is correct. 1 agree to comply with all city and county ordinances ' and'state laws relating to b Idf construction, and hereby authOrIX' '" pra- sentatives of t city t nye upo the above-mentioned pr irm ,toy Inspectlon pur Signature Drivers' Lic nse Or SS q)t Reinspection Fee Wpa—White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor $25 LIBI -2/10/841 1 Zone' Accessary Building: - Park. Fees $ 416;0 ' TL $251 Issue Fee 1 $ 3 Z O N I N G R E Q U I R E q Hood or Type I El ELECTRICAL FEES Transformer ❑ 15.50 KW ❑ 50 KW. Canopy Type II ElZoning Meter up to 100 amps r)— Meter ❑over 100 amps ric Sub Panel s " _Motors ❑0.1 HP W1,4 - 64 up Inc. Solar ❑9-15 HP ❑16-15+ Microwave r _Date Pole Light Refrigeration System Range ❑0.100,600 BTU 01100,000BTU Sign BUILDING PERMIT PLAN CHECK Standing Sections ' SUMMARY OF FEES 5.15 KW Trash Compactor $ $251 Issue Fee 1 $ 3 Z O N I N G R E Q U I R E q Hood or Type I El PUBLIC SERVICES REQUIREMENTS: Canopy Type II ElZoning Approved By Date _ Building Approved By Application Issued By r _Date Date Refrigeration System ❑0.100,600 BTU 01100,000BTU BUILDING PERMIT PLAN CHECK $ $ SUMMARY OF FEES SMIP PERMIT $ System Repair/Alteration PLUMBING $ ISSUANCE $ PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% $ $ $MICROFILM 3.�'' 4 4d ENERGY P.C. GRADING $ $ $ �r MECHANICAL, $ TOTALFEE / S Issue Fee $ 3 PLAN CHECK 25% $ 1 CpNSTRUCTION AND PLA DL &SPA v" C �8 APPROVALS Permit #i�l Date/ inspector - APPROVALS Permit # Date Inspector rf 1• -Temporary Electrical Service or Pole 52. Pool & Equipment Location = 2/Soil Pipe-Undrgrnd.; .: (j - 53- Steel Reinforcement . 1 3: Electrical Conduitrc!4iylUndrgrnd � :. _ 54. Forms 4. Electrical Conduit-Und`rgrnd. - 55. Electrical Bonding ' 5. $teel;Reinforcemen r 56. Rough Plumbing &Pressure Test 6. Electrical UFER Gr d'.- 57. APPROVAL TO COVER-GUNITE 7. Footings ; 58. Electrics! Conduit Undrgrnd, 1 S. Foundation 59. Gas Pipe, ❑ Undr rnd., Test , 9. Water'Pipe-Undrgrnd.'% ; r 60. Backwash, Lines, P -Trap, ❑ Undrgrnd, 10. �ucturai Floor System l A 61. APPROVAL TO DECK 11. Property Sewer Line &House Conn ion 62. Backwash & Receptor -Final r 12. Sewer Cap �. ' i 63. Beater &.Vent -Final 4 , 13. Roof Drains"' r f�, f _ _.� 64. Plumbing System -Final 14. Rough,Plumbing i 65. Etectrical-Final 15.'Rough' Electrical -Conduit 66. Solar System Final ` r 16.' Rough Electric Wiring- - � �, � 67. Fencing &Access Approval ,' 1 ._ 17`. Rough Wiring Sign 68, APPROVED FOR PLASTERING 18; `Rough Electrical -T Bar Ceiling 69., POOL/SPA SYSTEMS FINAL i ' 19. Rough Heating'& Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # " 1- 20. Rough Factory; Fireplace ' 21. Ducts, in Structure 70. Underground Hydro 22. Dyets, Ventilating71. Product Piping El Ga ❑ Qil ' 23.,Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing- 73. Undergrnd. Storage Tank 13 Gas ❑ Oil' 25. Roof Sheathing 74., Overhead Hydro 26. T•Bar Ceiling (Structural)' & Monocoat 75. Dry Chemical ! .27. Frame and Flashing 76. Dry Standpipe '28, 'tithing & Siding 77. FIXED SYSTEM FINAL _ 29. Insulation 1 78. FIRE PREY. 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 t" 35, Final Gas Pipe -Test 36. Hood or Canopy t 37. Final Factory Fireplace r 38. Final Plumbing 39. Water Service -Fina! • r 40. Gas Service -Final I 41. Solar Domestic -Finale 42. Backflow Preventer 43. Backflow Irrigation I 44..Landscape Irrigation System i 45. Sound •Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING, 48. Special Requirements Completed' , 49. Electric Release to Edison - k 50. Gas Release to Southern California Gas Co 51. CERTIFICATE -OF OCCUPANCY No. ' � - Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 16.11TY OF COSTA MESA CONSTRUCTION PERMIT P@R N TRACT NO. LOT NO. UNIT NO. Project Address Applicant's Mailing Address 3 - I fasizull Owner's Name ' 6LDH-QULAE�: e�l11�;11�rNnOPhone Address 061 it -1 Arch/Eng. License No. C I /»R Address i Contractor's Name J�t Phoneryl�{+��' D Address (mailing) 3151 AlA1.3a!j ZE—% CO--,JorII,1�S� City License No, ;2.;I:z LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with'section 7000) of Division 3 of the Business and !Professions Code, and my license is in full for and effect. License Cla s i ense o. Date Signature WORKERS' COMPENSATION DECLARATION . 1 hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation insurance, or a certified copy thereof (Sectl6n 3800, Lab. C.) ,r,,t Policy No. -31 nt317!i/-Aompany /r1I351er, Ak4L1J9JJCAtJ ❑ Certified copy is hereby furnished. ert(fie co y 5 filed with the city Buil 9 'v' ion, Applicant EXEMPTION 9ROM WORKERS' COMPENSATIO DECLARAON (This section need not be completed if the permit is for one huntl ed ($100) or less). 1 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 tke Workers' Compensation Laws'of California. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm.that there is a construction lending agency for the performance of the work • for w igtyt this permit is issued (Section 3097 Civ. C.) Lender's NameLender's Address - - OWNER BUILDER DECLARATION I hereby affirm that I am exempt from. the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and' Professions Code) or that -he/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). 1, as owner of the property or my employees with wages as their Sole -ompensation, will do the work, and the structure is not intended or offered 3r sale (Section 7044, Business and Professional Code: The Contractor's -icense 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 employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is Sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- Erove fof the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- tractorSt4 construct the protect (Section 7044, Business and Professions Code: The Contractor's' License Law does not apply to an owner of property who builds or improves thereon, and who contracts -for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. ❑ •1 am exempt under Section B. & P. C. for this reason Date Owner I hereby certify that 1 have read this application and state that the above 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 th city to enter pon the above-mentioned propert for' inspectlon,pur es: Signature Date Drivers' License or SS 7071 11/12/86 1,1j.25 TL CMF 0865.46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor xYPE OF CONSTRUCTION NEW LJ ADD LJ ALTERATION D f ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. REPAIR A. P. # _ Zone _ S Main Building: Accessory Building: TYP7E�7OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL jL] TENANT C�'ELECTRICAL ❑ PLUMBING 1:1 MECHANICAL DDD OTHER T Front O A Rear N PROJECT DESCRIPTION SQ. FT- .2 3'f OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU. YDS. ACREPing. Z C Right - N S Left , R Ref. # Par king'Req./Provided E Remarks: Planning Notes: M T S -PLUMBING FEES r Bar Sink Showers, ELECTRICAL FEES Backflow Preventer Service Sink Automatic Washer Construction Pole Sub. Transformer ❑ 15.50 KW ❑ 50 + KW F Backflow Irrigation Sewer Cap ' Bathtubs Sewer. Connection Cooking Unit Meter. Cup to 100 amps Clarifiers Solar Collectors Dishwasher Meter P6ver 100 amps Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel W ' Drinking Fountains Solar Tank Fan Motors 00-1.HP ❑ VA - Floor'Drains Swimming Pool vv/Spa F.A.U. Inc. Solar ❑9-15 HP 01Cr15+ Floor Sinks Urinal Fixtures Microwave Gas Service' Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink- Water Service Switches -' Sign Lavatories Auto -Wash Garbage Disposal 4 Standing Sections P -Trap,,, Laundry Trays Generator ❑0-5 KW 05-15 KW Trash Compactor i Roof DiFains Reinspection Fee, $15 Issue Fee $ 3 Reinspection Fee $15 Issue Fee $ 3 MECHANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Boiler Hood or Type I ❑ Canopy Type I I ❑ Duct - Under Ground Duct - Structural Refrigeration System 00.100,000 BTU ❑10D,000 BTU - Duct - Ventilating BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL - PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ SMIP $ $ PERMIT' I ' $ ISSUANCE $ . S. ' ENERGY P.C. $ $ GRADING $ $ MICROFILM $ $ TOTAL FEE $- $ _ - Exhaust System ❑ Multiple 0 System Repair/Alteration Firepl/Fact, Bit, ICBG # Fire Dampers Heating System•& Ducting 110- 100,000 BTU ❑100,000 BT • Registers i - J Reinspection Fee $15 Issue Fee $ 3 CMF 0865.46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNINGPOOL APPROVALS Permit # Date Inspector & SPA _ APPROVALS Permit # [5:2. Date Inspector 1. Temporary Electrical Service or Pole 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. s 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 171Rough 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 APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 PREY. FINAL i 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 r 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 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed R 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _ • - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. MY%5F'COSTA_LMESA •CONSTRUCTION PERMIT PER NO'r ! TRACT NO. LOT NO., NIT N 41:2j �7 Project Address' Applicant's Ma ILj Address -. Owner's Name • Q o tQa _,_,.Phone Address Arch/Eng. License No. Address Contractor's NameI E9 , t Phone _ 2 -LS -9 Address (maitingl 1'S1bC� l �{j2oc1Z4i�31PI=r IZ�� City -License No,- - "141 - LICENSED CONTRACTOR DECLARATION I hereby affirm that 1 am licensed under provisions of Charter 9 (co Tenting with section 7000) of Dlvislon 3 of the Business and Professions Code, and my license is in full force and effect. LlGense.,Cl�ss �� se IN Dacus— Signature WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self- ure ora certificate of Workers' Compensation Insurance, or a,certified copy thereof (Section 3800, Lap. Ce, ^� _e policy No.-742'�`�y ` _YL Company Certified copy is herePy furnished, Certifletl copy ' filed with the city BjyiiU ng) Ivss�n�., uate Applicant CC ExEMPTION FROM WORKERS' COMPENSATION DECLARATION - (Tnis section need not be completed if the permit is for one hundred ($100) or icer 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 t(le Workers' Compensation Laws of Ca IfOrnia. Date Signature NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked, CONSTRUCTION LENDING AGENCY 1 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.) Lender's Name Lender's Address - OyYNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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 fite a signed statement that he/She is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of -Division 3 of the Business and Professions Code) or that he/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 enalty of not more than five hundred dollars ($500). t, 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 or sale (Section 7044, Business and Professional Code: The Contractor's _ie.ense Law does not apply to an owner of a property who builds or improves thereon, and who does Suchwork himself/herself or through his or her own erriployees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- pletion, the Owner will have the burden of proving he/she did not build or im- for the purpose of sale), rove 1, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts -for Such projects with a con- tractof(s) license pursuant to the Contractor's License Law), i am aware that proof of their Worker's'Compensatlon insurance should be provided, to me. ❑ I am exempt under Section—.B. & p. C. for this reason Date Owner ' ' ' I hereby certify that t have read this application and state that the above 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 th' ci to enter, Pon t above-mentloned property for inspection Pur o5 s: Signature nate /d -7 - Drivers' Llcense or SS :P CMF 0865.46, rev. 10/84 White^Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 4679 f OID7166 TYPE OF CONSTRUCTION NEW ADD ALTERATION LJ REPAIR ❑ CONVERSION ❑'DEMOLISH ❑ OTHER + A. P. # Zone ' DESCRIPTION OF, WORK/USE OF BLDG. S Main Buitding: Accessory Building: E TYPE OF PERMIT LJ GRADING FOUNDATION STRUCTURAL T Front ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 13 Rear ❑ OTHER A _ PROJECT DESCRIPTION SQ. FT. —OCCUPANCY—C Right KLeft CONSTRUCTION TYPE VALUATION $ $ ZONE GRADING CU. YDS. ACRES Ping. Ref. # Parking Req./Provided Remarks: 5'a v Planning Notes: ' Bar Sink Backflow Preventer Backflow irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptorse' Kitchen Sir k Lavatories P—Trap Roof Drains Reinspection Fee Outlets $15 PLUMBING FEES Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service _ Auto -Wash Laundry Trays Issue Fee $ 3 MECHANICAL FEES Boner Hood or Type I ❑ Canopy Type 11 El ti Meter ❑over 100 amps Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU ❑ 1100,000 BTU Motors g0-1 HP ❑ 1114 - 6 Duct Ventilating Exhaust System ❑ Multiple ❑ system RepairlAlteration Microwave Firepl/Fact. Blt_ ICBO # Fire Dampers Date Heating System•& Ducting 0 0.100,000 8TU 13 100,000 BT Registers Sign Dat Standing Sections Reinspection Fee - l $15 Issue Fee ELECTRICAL Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator 1:10.5 KW 115-15 KW Transformer ❑ 15-50 KW ❑ 50+KW, 31 .2a TL FEES Z a N I N G R E Q M T S 1 Reinspection Fee Meter LJup to 100 amps Meter ❑over 100 amps DEVELOPMENT SERVICES REQUIREMENTS: Sub Panel Z Motors g0-1 HP ❑ 1114 - 6 inc.SOlar ❑9.15 HP 016-15+ Date Microwave Pale Light Date Range �- Sign Dat Standing Sections SUMMARY OF.FEES Trash Compactor BUILOING PERMIT $ 31 .2a TL FEES Z a N I N G R E Q M T S 1 Reinspection Fee I $15• Issue Fee $ 3 ' DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Application Issued By Dat SUMMARY OF.FEES BUILOING PERMIT $ SMIP $- PLAN CHECK S PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK - 254(0 $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50°% $ MICROFILM $ MECHANICAL ' $ TOTAL FEE $ PLAN CHECK 25% $ CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector POOL & SPA 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 COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, ❑ 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 APPROVALS Permit # - 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 �Q - V B0. 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 ' 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50, Gas Release to Southern California Gas Co r s 51. CERTIFICATE OF OCCUPANCY No. Date i Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. -JF COSTA'MESA ' CONSTRUCTION PERMIT RMI NO. TRACT NO. L07 NO. tWIT oiect Address'.?ll 4ije& 4=1. ' Contractor s (Chapter ApG,1cPr,i's Poiailing Address TYPE OF CONSTRUCTION I I NEW LJADD LJ A T ATIoN LJ REPAIR Backflow Irrigation Sewer Cap•' Construction PoleSub.. ��A'� �� Phone EJCONVERSION ElDEMOLISH 1:1OTHER ', A . # Dishwasher - - Owner's Name .. F DESCRIPTION OF WORK/USE OBLDG. Dishvrdsher _ Solar Piping Dryers ❑Gas ❑Electric ' Drinking Fountains Solar Tank ' Fan Address � ��e'-� F.A.U. S Main Building: Device Boxes interceptors. Water Heater Oeitlets s Kitchen Sink -r - Water Service i Switches ❑•t am exempt under Section B: & P. C. for this reason_ Lender's Address_ _ Arch/Eng. License No. TYPE OF PERMIT GRADING FOUNDATION STRUCTURAL •T Front : Generator 00-5 KW 135-15 K ' ❑PLUMBING ID MECHANICAL Address . ❑ OTHER A Rear Contractor's Nam Lirt-0-81.4r Phone C Right I T1,3D �ae.k!jij�ST /73 Address (nse PROJECT DESCRIPTION Sq. 1 T. OCCUPANCY K .CONSTRUCTION TYPE ' VALUATION $ S Left N , City License No. _ZONE GRADING CU. YDS. ACRES Ping. Ref. # LICENSED CONTRACTOR DECLARATION _ I hereby affirm tnat I am licensed under provisions of Charter 9 (commencing Remarks:O y Planning Notes: /j with section 7000) of Division 3 of the Business and Professions Code, and 11 my license is in fu)1.forc and effect. �%1� �icyense A License Class Date 7-12-- re- Signature ' PLUMBING FEES WORKERS' COMPENSATION DECLAFtATION ger Sink Showers I hereby affirm that I have a certificate of -consent to self -insure or a certificate of Workers' Compensation Insurance or a;certified copy thereof (Section Contractor s (Chapter 3600, Lab. C. ' { � �,.� Policy No.? 6-7 ' � Company ; Fr��s�• Certified copy is hereby furnished. Cel�oer7i opy is filed with the city Biding Oivision Applicant �� r C-•- .EXEMPTION FROM WORKERS' COMPENSATION DECLARATION . Backflow Preventer Service Sink ' Automatic Washer Backflow Irrigation Sewer Cap•' Construction PoleSub.. Bathtubs Sewer Connection Cooking Unit _ - Clarifiers ' Solar Collectors Dishwasher - - la •gWorkers' . ' - (This section need not be completed if the permit Is for one hundred ($100) or less). I certify that in the performance of the work for which this permit Is issued, I employ any person In any manner so to 1) subje o the Shall not ion Laws of Califo omp nsa r la Date Signature NOTICE: If, after making this declaration, you should beCOMe-Wbject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall . be deemed revoked. 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 (Section 3097 CIv. C.) Lender's Name Dishvrdsher _ Solar Piping Dryers ❑Gas ❑Electric ' Drinking Fountains Solar Tank ' Fan Floor•Drai6:s Swimming Pool w/Spa F.A.U. , FIOOr Sinks Urinali 4 Fixtures Gas Service Out ' Water Closet Device Boxes interceptors. Water Heater Oeitlets s Kitchen Sink -r - Water Service i Switches ❑•t am exempt under Section B: & P. C. for this reason_ Lender's Address_ _ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional 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/she is licensed pursuant to the provisions of the License Law 9 'commencing with Section 7000 f LavatofieS Auto -Wash f ' _ Garbage Disposal P--Tra ' p Laundry Trays : Generator 00-5 KW 135-15 K Roo} Drains wi ) o Division 3 of the Business and Professions Code) or that he/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 malty of not more than five hundred dollars ($500), ' I, as owner of the property or my employees with wages as their sole 'ompensation, will do the work, and the structure is not intended or'offered Dr sale (Section 7044, Business and ,Professional Code: The Contractor's _icense 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 employees, Provided that such improvernents are not intended or offered for sale. If, however, the builtling or improvement is sold within one year of com- pletion, the owner will, have the burdon of proving he/she did not build or im. •rove for the purpose of sale). . Lf l', as owner of the property, am exclusively contracting with licensed con- tractors to construct the protect (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Proof of their Worker's Compensation insurance should be provided to me. -- , E Reinspection Fee $15 Issue Fee i t MECHANICAL Boiler i Hood or Type t ❑ Canopy Type 11 ❑ ' Duct - Under Ground Duct - Structural Refrigeration System ❑0-100,000 BTU ❑ 100,000 BT Duct - Ventilating Exhaust System ❑ Multiple ❑ System Repair/Alteration Firepl/Fact. Bit. ICBO # Fire Dampers ❑•t am exempt under Section B: & P. C. for this reason_ Date Owner I hereby certify that I have read this application and state that the above Information. is correct. I agree to comply with all city and county ordinances and state laws relatin t building construction and hereby authorize repre- Heating System & Ducting ❑0-100,000 BTU ❑t00,000BT Registers sentatives of th ci o enter the ve-mentioned proper y or - Inspection pu pos s. ( i 6i,Signature' /� Reinspection Fes $15 'rivers' License Or SS 5.46, rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod • Assessor ' 3035 '9/18/86 Zone , Accessory Building: 1 Perking Req./Provided y 24.00 TL I ELECTRICAL FEES Transformer ❑ 15.50 KW ❑ 50 + KW Meter ❑up to 100 amps Meter Rover 100 amps i Sub Panel J Motors ❑ 0.1 HP ❑ N - 8 Inc. Solar 09-15 HPl❑ 16-15+ Microwave Pole Light Range Sign Standing Sections W Trash Compactor $ 3 t Reinspection Fee S15 Issue Fee $ 3 'FEES ' DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved By Date Anolication Issued By 51.+� hate T Z' Issue Fee I I -S 3 Z O N I N G R E Q M T S BUILDING PERMIT +PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% S g. S S $ $ $ $ SUMMARY OF FEES SMIP PERMIT_ ISSUANCE ENERGY P.C. GRADING 7. MICROFILM TOTAL FEE . S S $ $ 1 $ ^_R $ CONSTRUCTION AND PLANNING APPROVALS - Permit # Date Inspector POOL & SPA 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. 1-)7-19& /Q[-4 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57, APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60: Backwash .Lines, P-Trap, ❑ 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 n it 66. Solar System-Final 16. Rough Electric Wiring �L 67. Fencing & Access Approval 17. Rough Wiring-Sign 68. APPROVED FOR PLASTERING 18, Rough Electrical-T Bar Ceiling O/ 69. POOOSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑,Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 c 146. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48.-Special Requirements Completed 49. Electric Release to Edison u ' 50. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY o. Date _ 1 ; . C Appticaht to fill in all spaces except those within heavy border lines and sign all appropriate declarations, CITY OF COSTA MESA. PERMIT Project Address W • A Applicant's Mailing Address Owner's Name >�l^J Irl] ��Nt V 1 Phone,,, �1L��✓� Address' 1119--" E '- �_! �• _ I� Arch/Eng. _ �� -License No., Address Contractor's Nam N hone{ 3� , Address (mailing) -36 \ E L6 PIN'-h�A -AhJ P0461 -LM City License No, ! LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Oivision 3 of the Business and Professions Code, and my license is in full orce and effect. Ucensa,lass - se 5 Date Signature WORKERS' COMPENSATION DliCLARATION I hereby affirm that I have a certificate of consent to self -Insure or a certificate of Workers' Compensation Insurance, or a ce i ed co y tpereof ($@ctfo�l 3800, Lab. C.)a�o/vort.N. sctiorC/i Policy No. $ CompanyeAc , Certified copy is hereby furnished. S. G 29 C rtified ca y Is filed with the city Dat Applicant On ef E MPTION FROM WORKERS' C MPENSATION OEC LA IATI N (This Section need not bq completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued 1 shall not employ any person in any manner so as to become subject to tlke Workers' Compensation Laws of California. Date _ —Signature NOTICE: If, after making this declaration, you should.become subject to the Workers. Compensation provisions of the Labor Code, you must forthwith comply wlth. such • previsions or this permit shall be. deemed revoked. CONSTRUCTION LENDING AGENCY - - I hereby affirm that there I$ a construction lending agency for the performance of the work for which this permit -is Issued (Section 3097 Cly, 'C.) Lender's Name- Lender's ame••Lender's Address - - -- - -- - OWNER BUILDER OEC LA RATION I hereby affirm that I am exempt from the Contractor's' License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which require$ a permit to construct, after, improve, demolish or repair any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of 'the Contractor's License law (Chapter 9 (commencing with. Section 7000) of Division 3 of the'Busihess and Professions Code) or that he/she Is exempt therefrom and the basis for the alleged exemption. Any -violation of Section 7031.5 by any applic4nt for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). I, as owner of the property or my employees with wages as their sole :ompensation, will do the work, and the structure is not intended or offered or sale(Section x7044, Business and Professional Code: The Contractor's License Law does not abply to an owner of a property who'builds or Improves thereon, and who does such work himself/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 com- pletion, the owner. will -have the burden of proving he/she did not build or im- LJrove for the purpose of Sale). I, as owner of the property, am exclusively contracting with licensed con: ' tractors to construct the project (Section 7044, Business and Professions Code: , The Contractor's License taw does not apply to an owner of property who' builds or Improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). ❑ 1 am exempt under Section B.'& P. C. for this reason Date Owner I herebycertify that I have read this application and state that the above 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 t nter Don he above-mentioned property for inspection ose 120 _Z y - Signature Dat Drlvers' icerise or SS CMF 0865.46 rev. 7/83 inK -Accounting; Goldenrod - Assessor PERMIT NO. TRACT NO. LOT NO. BLDG. NO. TYPE OF CONSTRUCTION NEW AOD ALTERATION F REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK TYPE OF PERMIT 1:1GRADING D FOUNDATION M STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING. ❑ MECHANICAL ❑ 1OTHER PROJECT DESCRIPTION SQ. FT. OCCUPANCY CONSTRUCTION TYPE VALUATION $ ZONE GRADING CU.YDS. ACRES 43.00 TL Remarks: t Zone S Main Building: Accessory Building: PLUMBING FEES Bar Sink Showers - Backflow Preventer Service Sink Front Backflow Irrigation e' Sewer Cap Bathtuhsr+, �' ;.: Sewer Connection Clarifiers Solar Collectors C Dishwasher Solar Piping Drinking Fountains Solar Tank Floor Drains ,eSwimming Pool w1Spa IS Floor Sinks Urinal Gas Service Outlets Water Closet ` Interceptors Water Heater Use of Building: Kitchen Sink Water Service Lavatories P -Trap Roof Drains Reinspection Fee $25 Issue Fee $ 3 MECHANICAL FEES Boiler Hood or Type I ❑ Canopy Type l l ❑ _ 0 Duct - Under Ground Duct - Structural Refrigeration System DO- 100,000 BTU 0100,0001 TU Transformer ❑ 15-50 KW o °L Duct - Ventilating Exhaust System ❑ Multiple ❑ System Repair/Alteration ` Cooking Unit Meter ❑up to 100'amps Firepl/Fact, Bit. ICBO # 2 �Y tL Meter Clover 100 amps.. C30 Heating System & Ducting 110- 100,000 BTU ❑ 100,000 BT Sub Panel + Fan . .. _ Motors ❑0.1 HP Ell 112 - 8 - r F.A:U. Inc. Solar 09.15 HP 016-1 5+ Fixtures , Microwave Reinspection Fee $25 Issue Fee $ 3 !l� 4049 9/29/85 43.00 TL A.P. Sib t Zone S Main Building: Accessory Building: E - T Front B A Rear C Right SLeft IS Ping. Ref, 0 Park.Fees $ ' Parking Req./Provided Use of Building: Planning Notes: 0 ELECTRICAL FEES .^ Automatic Washer Transformer ❑ 15-50 KW '•r•,� Construction Pole Sub. ❑ 50+ KW ` Cooking Unit Meter ❑up to 100'amps s. ? Dishwasher Meter Clover 100 amps.. Dryers [:.]Gas ❑Electric Sub Panel + Fan . .. _ Motors ❑0.1 HP Ell 112 - 8 - F.A:U. Inc. Solar 09.15 HP 016-1 5+ Fixtures , Microwave Device Boxes Pole Light Outlets Range Switches Sign Garbage Disposal Standing Sections Generator El 0-5 KW 115.15 KW Trash Compactor Reinspection Fee $25 Issue Fee S 3 PUBLIC SERVICES REOUtREMENTS: Zoning Approved By mate Application Approved By Date Application Issued By _ _._, Dat F SUMMARY OF FEES BUILDING PERMIT $ SMTP $ , PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK $ MICROFILM $ MECHANICAL co $ TOTALFEE $ �• , PLAN CHECK u $ -_ !l� 'CONSTRUCTION AND PLANNING APPROVALS Permit # Date "Inspector POOL & SPA APPROVALS Permit # Date Inspector 1, Temporary# Electrical Service or Pole., ^. 52, Pool &Equipment Location 2. Soil Pipe Ondrgrnd. 53. Steel "Reinforcement 3. Electr.�cal:Conduit' Utility-Undrgrnd. 7 54. Forms , 4. Electrical.Conduit=Uri r end. `_;, 55. Electrical Bonding f` . 5. Steel Reinforcement , , �, , 56. Rough Plumbing & Pressure Test 6•Jalectrical UFER'Gr.ndl: 57. APPROVAL TO COVER-GUNITE 7. F'ootin�s ;. !' J 58. Electrical Conduit-Undrgrnd. 8. F61rndation ; ; t. } ! I 59. Gas Pipe-, ❑ Undrgrnd., Test" 9. Water Pipe-Undrgrnd: ,:? 1!. 60. Backwash Lines, P -Trap, ❑ Undrgrnd. 10. Structural Floor System :�:,' .* = ,. ;` 61. APPROVAL TO DECK 11. Property ewer Line ,& House Corin ti '� '; ..: 62, Backwash & Receptor -Final 12. Sewer Cad. } - `F 63. Heater & Vent -Final 13. Roof Drains '. ,7, 64. Plumbing System - Final 14. R'bugh'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. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning to -e-8-6 L.4p FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21 .'Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 44-04 1.49 71. Product Piping ❑ Gas [--)Oil 23. Gas Pipe -Rough &Test 72. Underground Flush a 24. Roof Framing 73. Undergrnd. Storage Tank ❑ Gas ❑ 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 1017- LJ5j 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 X43. Backflow Irrigation s44, Landscape Irrigation System _45. Sound Attenuation :_46. Handicap Regulations '147. FINAL STRUCTURE & BUILDING 48, Special Requirements Completed i 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co .51. CERTIFICATE OF OCCUPANCY," No. Date _ ` may. Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations, to CITY -OF CO TA MESA PERM T NO. TRACT NO. kOT NO. BLDG. CON RU TION PERMIT �5'%0Plt1.'l53--' fAR ! 2 i- 5. 2 Project Address —.3151-AirwayVe. - Costa es TYPE OF CONSTRUCTION NEW ADD _;ALTERfkTLON REPAIR 2840' 9%10/86 323.68r, Applicant's Mailing Address �.�{ 3151. Airway Ave. Rl dg.. E-1. C M. ❑ CONVERSION ❑ DEMOLISH ❑ OTHE=R enan l mproyement , A P # 2 �� c) J —. I IE �$ zone Guil dhouse Consultants, �iiOfie 540-2606 DESCRIPTION OF WORK Owner's Name 5 'Main Building:. - - Accessory Building: ~ • Address 3151 Airway,Ave. E-1, Costa Mesa, 'Ca.E YPE OF PERMIT GRADING FOUNDATION STRUCTURAL Fro t' \ Robert Alcumbrac, AIjy 010381 Arch/Eng... 'Cicense No. 2033 -.Calle Li 1 eta pal ni Sp ri n s Ca. T L?3' ® TENANT ❑ELECTRICAL _ PLUMBING• ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. ' 2934 occuPANcv I�-i - . CONSTRUCTION TYPE VALUATION $ 44, 000.00 GRADING CU.YDS.- ACRES 13 n B A Rear L Address Contractor's (vamp JDO Company Phone 540-2606 Address (mailing) 3151• Airway Ave. E-1 Costa iMesa Ca City Licrnse No.22']0ZONEZON LICENSED CONTRACTOR DECLARATION I herebyaffirm that I am licensed under provislons of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Code, and my license is in fulFL;force and effect, License Cl Licen 33969 C Right S Left Ping. Ref. # Park. Fees $ ; Remarks: - ,,._ Parking Req./Provided PLAN CHECK ELECTRICAL : •;, PLAN CHECK MECHANICAL PLAN CHECK Use of Building: PLUMBING FEES Planning Notes: (%>S/t}tjE�-OPM1^N'r. Bathtubs ENS' • SER ELECTRICAL Transformer D 15-50 KW ❑ 50+,kW Meter ❑up t6'100 amp Meter ❑over 100 ps- ic ' Sub Panel ? , Motor_5_P0 1 HP Ell % - B 1 Solar'❑9-15 HP Ell 6-15+ i Microwave Pale Light Range Sigri Standing'Sections i�15 KW Trash Compactor $25 Issue Fee- z O N 1 N G R E O -U R E r�C M E N T FEES $.3 E TS:9 Date r -�O' 'SUMMARY OF FEES $7-57K, 00 SN11P $ $ '411 PERMIT $ 00 ISSUANCE $ $ pp ENERGY P.C. $ $ GRADING $ $ F MICROFILM $ $ TOTAL FEE. $ $ WORKERS' COMPENSATION DECLARATI Bar Sink Reinspection ee Showers - ,.ti Backflow Preventer 1, as owner of the property, am exclusively contracting with licensed con- 't L-30-1 00 TU ❑100,000 BTU tractors to construct the project {Section 7044, Business and Professions Code: Duct - Ventilating ' TheContra ctor's.License. Law does not apply to an owner of property who ❑ builds or improves thereon, and who contracts for such projects with a don -Exhaust System Multiple ❑ stem Repair/Alteration tractor{s} license pursuant tv,the Contractor's License Law}. ❑' I am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO * Service Sink 4q J I hereby affirm that I have a certificate of consent to self -insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof, (Section 3800, Lab, )' ` �* ' :11i•s'si on American Policy No. 1 Wi i ill 3 AF4 mpany Backflow Irrigation PLAN CHECK ELECTRICAL : •;, PLAN CHECK MECHANICAL PLAN CHECK Sewer Cap,,,-; _ ' - Bathtubs CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor _ Sewer Connection. Automatic Washer;', Certified copy is hereby furnished. ; - f. Li Certjfi cop is filed with the city Bui .g D- ion. Date Applicant Clarifiers - Solar Collectors-' Construction Pole'Sub. EXEMPTION FIROM WORKERS' COMPEN5ATI0 ECLARAT N - (This section need not be completed if the permit i r one hundred ($100) orJ Ilecertify that •inahe performance of the work -for which this permit isjissueit; It shall not employ any person in any manner sofas to become subject to the workers' Compensation Laws of California., Dishwasher Solar Piping`- Cooking Unit } _ - n Drinking Fountains r Solar Tank i • 'f Dishwasher f, s Floor Drains Swimming Pool w/Spa Dryers ❑Gas DElec Date Signature NOTICE: If,'after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with' such -provisions � or this - permit j shall be, deemed revoked.. CONSTRUCTION LENDING- AGENCY• I hereby affirm that there is a construction lending agency for the performance of the work for ,whi h this permit Is -issued_ (Section 3097 Civ. C.) Floor Sinks 1 Urinal Q Fan Gas Service Outlets y .2 Water Closet - I Q i f F,A,U. - Interceptors Water Heater l 02 (% - Fixtures • Kitchen Sink ! Water Service Device Boxes ' Lender's. Name lY !i Lender's Address - _ D OWNER BUILER DECLARATION - I hereby affirm -that I am exempt from the Contractor's License Law for,the following reason (Section 7031.5 Business and Professional Code: Any city or; county which requires a permit to construct, alter,'improve; demolish or, repair 2 Lavatories - - „• Ouilets P -Trap' - - {• Switches '• Roof Drains- _ - Garbage Dis 1 ,any structure,prior to its Issuance, also requires the applicant for such permit •to file a signed statement that he/she is licensed pursuant to the provisions of 'the Contractor's -License Law (Chapter 9 (commencing with Section 7000) of • , 'Division 3 of the Business and Professions Code) or that he/she is exempt -_ f i Genera r ❑0 5 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 enalty of not more than five hundred dollars ($500).. ' Reinspection. Fee $25 - Issue Fee $ 3 ENS' • SER ELECTRICAL Transformer D 15-50 KW ❑ 50+,kW Meter ❑up t6'100 amp Meter ❑over 100 ps- ic ' Sub Panel ? , Motor_5_P0 1 HP Ell % - B 1 Solar'❑9-15 HP Ell 6-15+ i Microwave Pale Light Range Sigri Standing'Sections i�15 KW Trash Compactor $25 Issue Fee- z O N 1 N G R E O -U R E r�C M E N T FEES $.3 E TS:9 Date r -�O' 'SUMMARY OF FEES $7-57K, 00 SN11P $ $ '411 PERMIT $ 00 ISSUANCE $ $ pp ENERGY P.C. $ $ GRADING $ $ F MICROFILM $ $ TOTAL FEE. $ $ 0 I, as, owner of the property or'my employees with wages as their sole ECHANICAL compensation, will do the work, and the structure is not intended or offered FEES for sale {Section 7044, Business and Professional Code: The Contractor's ) - License Law does not apply to an owner of d property who builds or improves BoilBr- �� Hood or Type 1 1 Lll - thereon, and who: does such work himself/herself or through his or .her own �' employees, provided that such Improvements are not Intended or offered -for Canopy Type 11• ❑ sale. If, however, the building or improvement is sold within one year of com- Duct -Under Ground pletion, the owner will have'the burden of proving he/she did not build or im- rOve for the purpose of sale), , , Duct -Structural ' Refrigeration Syst - Reinspection ee PUBLIC SERVICES REQjJ l,; 11 Zoning Approved By , -Application Approved By Application 15suediBy..., ,.ti 1, as owner of the property, am exclusively contracting with licensed con- 't L-30-1 00 TU ❑100,000 BTU tractors to construct the project {Section 7044, Business and Professions Code: Duct - Ventilating ' TheContra ctor's.License. Law does not apply to an owner of property who ❑ builds or improves thereon, and who contracts for such projects with a don -Exhaust System Multiple ❑ stem Repair/Alteration tractor{s} license pursuant tv,the Contractor's License Law}. ❑' I am exempt under Section B. & P. C. for this reason Firepl/Fact. Bit. ICBO * -� .F' BUILDING PERMIT r, -'PLAIN CHECK PLUMBING Oate_ Owner, Heating System & ting 1 hereby certify that 1 have read this application and state that the above 00-100,00 U f]100,000BTL 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 pty to enter po the above-mentioned ,property for inspection purpo/1986 Signature Date Drivers', License or•SS # Reins ion Fee $25 lssue Fee $ 3 PLAN CHECK ELECTRICAL : •;, PLAN CHECK MECHANICAL PLAN CHECK CMF 0865-46 rev. 7/83 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor ENS' • SER ELECTRICAL Transformer D 15-50 KW ❑ 50+,kW Meter ❑up t6'100 amp Meter ❑over 100 ps- ic ' Sub Panel ? , Motor_5_P0 1 HP Ell % - B 1 Solar'❑9-15 HP Ell 6-15+ i Microwave Pale Light Range Sigri Standing'Sections i�15 KW Trash Compactor $25 Issue Fee- z O N 1 N G R E O -U R E r�C M E N T FEES $.3 E TS:9 Date r -�O' 'SUMMARY OF FEES $7-57K, 00 SN11P $ $ '411 PERMIT $ 00 ISSUANCE $ $ pp ENERGY P.C. $ $ GRADING $ $ F MICROFILM $ $ TOTAL FEE. $ $ CONSTRUCTION AND PLANNING APPROVALS, ,Permit # Date Inspector _" r POOL & SPA APPROVALS Permit4# Date,, inspector. ,1, Temporary Electrical Service or Pole 52. Pool & Equipment Location. �2. Soil Pipe Undrgrnd. LCO 53. Steel Reinforcement 3: Electrical'Conduit Utility,-Undrgrnd. 54. Forms- '4. Electrical Conduit-Undrgrnd.. r. 55, Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57.'APPROVAL TO COVE R-GUNITE 7., Footings 58. Electrical Conduit-Undrgrnd, 8. Foundation �L �%� G 59. Gas Pipe, ❑ Undrgrnd., Test 9, Water Pipe-Undrgrnd. a -/S -y6 L,Zj 60. Backwash Lines, P -Trap, ❑ 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 ?-zq '(0 (.{/) 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 APPROVALS Permit # '20, Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 7i. Product Piping ❑ Gas ❑ Oil 23. Gas Pipe -Rough & Test 72. Underground Flush t 24+ Roof Framing 73. Undergrnd, Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75, Dry Chemical 27. Frame and Flashing ! ie 76. Dry Standpipe 28. Lathing & Siding 77, FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL'INSPECTION 32, Electrical Power Meter -Final 80. FOOD,CERTIFICATE ISSUED 33. Final ElectricC. Notes:q;1,-;_4_ p 4 F d $ink. L 34, Final Heating &.Air Conditioning / [• pr 35. Final Gas Pipe -Test' - _ EQ.;1�1'% �,(�, 36. Hood or Canopy 4 37. Final Factory.Fireplace 38. Final Plumbing _ 1043`4 L.G 1 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 -47. FINAL STRUCTURE & BUILDING D 48. Special Requirements Completed 49, Electric Reiease to Edison - ' 54. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY No. Date , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITE( Au COSTA MESA -- - �� - �- • �� -'� &*STRICICTION PERMIT r - ProjectAddress lay Ve.Idg. . ,.AppIiear'7t's Mailing Address 3151 Ai rway Ave. E-1, C.M. Owner's Name Gui 1 dhouse Consultants Phone 540-2606 Address, 3151 Airway Ave. E-1 Costa Mesa Arch/Eng: Mateo aardini License No. C-6291 Address �26'•iown &. Country. Orange Contractors Name 0. 'Donal d 01 son Phone' 540-2606 Address (mailing) 31,E E-1> CO•sta Mesa City License No. LICENSED CONTRACTOR DECLARATION , I hereby: affirm that I am licensed under provisions of Charter 9 (commencing with section 7000) of Division 3 of the Business and Professions Cordae, and my license is in full Ice and effect. 333969 License Cla icens Date Signature WORKERS' COMPENSATION DECL RAT,10 ;hereby affirm that I have a certificate of cons to self -insure or a certificate Workers' Compensation insurance,, or a certlfie .copy theieof-(Section• ' 00, Lab. C.) f Policy No. Company A?4n 6L�Y ❑ Certified copy is hereby furnished. ' h(J Certjjig�op,� ,js filed with the city Bui g Div ion. "r ' Date f]�ti4 Applicant EXEMPTION FROM WORKERS' COMPE SATIO ECLARATI N .i • (This section need not be completed if the permit's or, one hundred ($100) ors less). , %E11 1 l•': I certify'that,In the performance of the work for.whlch this m perlt I$ issued 1 ' shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ' Date Signature - - NOTICE: If, after making this declaration, you should become iubjeCt to the ' Workers'- Compensation provisions ofAhe Labor'Code,-you -must forthwith' comply with such provisions or. this permit: shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY t -- I hereby affirm that there is a construction lending agency for the performance of c the work for w this permit is, issued .(Section 3097 Civ. C.)' Lender's Name Lender's Address _ OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section,7031.5 Business and Professional Code: Any city or county which requires a permit to construct, atter, improve, demolish or,repair ,any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractor's License law (Chapter 9 (commencing with Section 7000) of Division 3- of the Business and Professions Code) or that he/she' is exempt therefrom antl the basis for the alleged exemption. Any violation of Section 1031.5 by, any applicant for a, permit' subjects the applicant to a civil enalty of not more than five hundred dollars (8500). I, as owner of the, property or my employees with wages as their sale compensation, will do the work, and the structure is not Intended or offered for sale-' (Section 7044, Business and, Professional Code:' The Contractor's License Law does not apply to an owner of a property= who. builds or improves ` thereon, and twho does Such work himself/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 com- ' pletion, the owner will have the burden of proving he/she did not build Or im- ' rove for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed con- 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 builds or improves thereon, and who contracts for such projects with a con- , tractor(s) license pursuant to the Contractor's License Law). ❑ I am exempt under Section B. & P. C. for this reason ' Date Owner I hereby certify_that I have read this application and state that the above ' information Is correct. I agree to comply with all city and county ordinances and state laws relating to building onstruction,'and hereby authorize repre- sentatives of th' cit"o ' e r on the above-mentioned property for Inspection pure s J 6/20/84 Signature Date Bar Sink Showers Backflow Pre`venter i Backflow -irrigation Service Sink Sewer Cap ' Bathtuhsr^ S TYPE OF CONSTRUCTION L9 NEW ADD LJ ALTERATION El REPAIR - ❑ CONVERSION ❑ DEMOLISH ❑ pTHEFt Solar Pipirig - A.P. #' .DESCRIPTION OF WORK interior -improvement Floor Drains ! Swimming'Pool vv/Spa Floor Sinks Urinal S Main Building: Interceptors Water Heater Kitchen Sink Device Boxes a ' TYPE OF PERMIT GRADING 0 FOUNDATION EJ STRUCTURAL_ T Front ® TENANT El ELECTRICAL L1 PLUMBING, Ll MECHANICAL B l ❑ BOTHER - - A Rear PROJECT DESCRIPTION Sq.1993 TMJ _ ' OCCUPA �Y •- C K Right $ $ 'CONSTRUCTION TYPE '• VALUATION$ � g I Left. ZONE GRADING CU.YDS. .ACRES Ping. Ref. # Remarks: $ Parking Req./Provided TOTAL FEE $ Use of Building: PLUMBING FEES Planning, Notes: L 1J -y Bar Sink Showers Backflow Pre`venter i Backflow -irrigation Service Sink Sewer Cap ' Bathtuhsr^ S Sewer Connection Clarifiers fes, I Solar Collectors" Dishwasher ) Solar Pipirig - Drinking Fountains Solar Tank'-/ Floor Drains ! Swimming'Pool vv/Spa Floor Sinks Urinal Gas Service OutletsAJ Water Closet Interceptors Water Heater Kitchen Sink Device Boxes a ' Lavatories r P -Trap - , Range Roof Drains) 1 Switches Reinspection Fee R $25i Duct` Under Ground Duct - Structural Duct - Ventilating ' Exhaust System El Multiple E3Firepl/Fact.'Bft. ICBO # Heating System & Ducting E]0.100,000 B TP El 100,000 BTL Drivers' License or SS Reinspection Fee $25 ,CMF 0865-46 rev. -7/83 White = Building; Canary - Applicant; Pink •'Accounting; Goldenrod -Assessor water Service ' L Issue fee ••� 5'3 -IANICAL FEES Hood or' Type I , El Canopy Type I! ❑ r, Refrigeration System ❑0-,100,000 BTU ❑100,000 BTU ' System Repair/Alteration issue fee 1 $ 3 r 3155 6/28/04 � _ :�:.`:� {.� • �, .-� Zone -, Accessory'Building: ' Park. Fees $ ME 3 w . &o -o s � ELECTRICAL FEES �.- Automatic Wastiei•' Transformer ❑ 15-50 KW � Constr 1-1 50 + KW ucti an P I o e Suh. �.. Cooking Unit J Meter- up to 100 amps' - Dishwasher ,❑Electric 'Meter ❑over 100 amps 1 Dryers ©Gas r Sub Panel ,• '� Fan Motors ❑0-1 HP 1 % �8,j SUM/MARY OF FEES %-3`-0'� F.A?U. ! Inc. Solar'❑ 9-15 HP ❑ i 6-15+ I Fixtures ''.Microwave $ Device Boxes a ' .Pole Light l Outlets + , Range $ Switches Sign l Garbage Disposal •Standing Sections , Generator 00.5 KIN El 5-15 KW Trash Compactor , � 4 Reinspection Fee $25 'Issue Fee , t$3 r�PUBLIC SERVICES REQUIREMENTS: � yZoging Approved By Date Application Approved By �.. Date Application Issued'By ' t D_at `0 ,T 'BUILDING PERMIT SUM/MARY OF FEES %-3`-0'� 69' $ �PLFAN)CHIE CK%%-S� � / 36 � SMIP PERMIT $ J. PLtJMB1rN_G-� $ ISSUANCE $ . 1 -41''r' _P.L-41V'CH�CK $ ENERGY P.C. $ ELECTRICAL rPLAN $ � 4 GRADING MICROFILM $ $ CatHECK $ r`}•3e- MECHANICAL' $ .l3 n TOTAL FEE $ �•,r;' PLAN CHECK $ 40 i CONSTRUCTION AND PLANNING ' Date APPROVALS :Permit # ` Inspector Ins POOL . ,,PA 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. _ CJ 55. Electrical Bonding 5?'Sfeel Reinforcement - 56. :Rough Plumbing & Pressure Test 6., Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7., Footings _ 5$. ElectricaLConduit Undrgrnd, 8. Foundation _ i - 59. Gas Pipe, ❑ Undrgrnd., Test 9. Water Pipe-Undrgrnd. 1 60.• Backwash Lines; P-Trap, ❑ Undrgrnd, 10.; Structural Floor System r 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap M1 ; 63. Heater & Vent-Final 13. Roof Drains _ : = 64. Plumbing System - Final 14. Rough Plumbing C;90 65. Electrical-Final 15. Rough Electrical-Conduit j -66. Solar System-Final 16. Rough Electric Wiring , 7 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 Condi#ionirg =. ` �l.� FIRE DEPT. REQUIREMENT , APPROVALS - Permit # 20. Rough Factory Fireplace ' �' 21, Ducts, in Structure70. • iy.. '1 Underground Hydro ,. 22: Ducts, Ventilating j 71;• -Product Piping ❑ Gas ❑ Oil . 23, Gas Pipe Rough & Test .', ', 72. -Underground Flush 24. Roof Framing ! - ,. 73. Undergrnd, Storage Tank ❑ Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75..Dry Chemical 27. Frame and Flashing 7/10/v 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL .30. Drywall Nailing ir/31 �' �5• +HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION , 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Note 34. Final Heating &'Air Conditioning- F 7�"1 ( G r 35. Final'Gas Pipe-Test 36. Hobd or Canopy 37. Final Factory Fireplace 38. Final Plumbing, t !t 7` (.�off 39. Water Service-Final , 40. Ga"s Service-Final 4 ; 41. Solar Domestic-Final 42. Backflow Preventer . r` _ 43. Backflow Irrigation 44. .Landscape Irrigation Systema 45. SoGnd'Attenuation 46, Handicap Regulations' i 47. FINAL STRUCTURE & BUILDING 48. Special Requirements�Completed 49. Electric'Release to Edison - 50. Gas Release to Southern California Gas Co ..`' , c .` , 51, CERTIFICATE OF OCCUPANCY' No. �� L Date y n [Cl d OWNER F j PACIFIC DATE 5/18/81 JOBADDRESS 3151—R1 Ait'umir nimniw 1,1 .. _ —_l 01111 NIL— r,rn.. r — GENERAL CONTRACTOR DE RIPTION of WORI( 'y°i- AP No, 427-291.-08 LOT I INSPECTIONS 30PL TRACT 51 nelure FIRE Dot. ZONE VALUE; TYPE GROUP SUBCONTRACTOR PERMITS Date Plumbfn ra ZDNE Number Si GAS ;:ATE AOUGX PL UNrg ING PROP, SWR" LIN( - HOUSE CON. �] SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND ASR CON01710MING TEMPORARY SERVICE OR POLE UHDERGBOUHB 7 POWER ROUGH WIRING " N.erf Rnd Vont. TRENCHES FORMS STEEL REINF" FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING = IH OUT PLASTER, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFRIG. AND R.C., FINAL Y C_ - 'a PLUMBING" FINAL Alm GAS TE5T ELECTRIC, FINAL BUILDING. FINAL [� rS 7.`a �• SPECIAL REQUIREMENT UTILITY NOTIFIED" GAS ELECT. OCCUPANCY CMF pq 86-g6 (BL14] 51875 OWNER DATE AP No. 427-291-08 COT_ Pct 7 TRACT FIRE ZONE VA! OF I , r`nnn nn� INSPECTIONS SOIL GAs ROUTER Si nature D-ra TYPE GROUP ZONE SUoCONTRACTOR Oe}e Number SI .tura Pl. bin R011GR PL JMBlNG PROP, SWR. LINEMOUSE CON. 1 SPRlNKL IMG SYSTEM — MISCELLANCOUS POUGN HEATINt ANO AIR CONB17to"I HG TEMPORARY SERVICE PR POLE UMOERGROUHO3 POWER 0 ROUGH WIRING '7r N.nfln cmd V. T. !TRENCHES Lj FORMS STEEL REIHF. IFLOOR SYSTEM BOH❑ 9EAM STEL RCOHFORCE --� j SHEATHING FRAME ANO FLASHIN ILAT HING —IN=OOT PLASTER, BROWN COAT STRUCTURAL, F.NAL _ -- �--I HEATIHG. VENT., REFRIG. ANO A.C., FINAL PLUMBING. FI.YAL AND GAS TEST --- ELECTRIC, FINAL BUILDING. FINAL S_P$CIAL REQUIREMENTS! UTILITY MOTIF IED, GAS` ELECT. OCCUPANCY — CMF/ , CA 9&46 (6U4) 51876 _ r OWNER J.D. OLSON DATE 5-25-81 !Oa ADDRESS 3151 Airway Avenues go -J, BUILDING PERMIT HO. 52077 GENERAL CONTRACTOR OwnerlBUiIderDESCRIPTION of WORK tenant linerovements AP N.A77-7a1-m/naLOT Par_ 7 TRACT 79-391 FIRE ZONE - VALUE: . SUBCONTRACTOR WATER ROUGH PLUMBING PROP. SWR. LINE [_-] HOUSL CCN. Li'. SPRINKLING SYSTEM MISCELLANEOUS ROACH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND E]WE POR ❑ ROUGH WIRING TRENCHES ID FORMS STEEL REINF FLOOR SYSTEM _ BOND BEAM ❑ STEEL REINFORCE [l SHEATHING FRAME AND FLASHING LATHING - IN [] OUT I—f PLASTER, BROWN COAT STRUCTURAL_ FINAL _ HEATING, VEKT., REFRIG. AND A.C., FINAL PLUMBING, FINAL ANO.' AS TEST [� ELECTRIC. FINAL BUILDING, FINAL SPECIAL REQUIREMENTS UT[LITY NOTIFIED. GAS `'I ELECT, n CMF G446-46 (6V 4)__....__... 5Ztz77 _.... _.__.._ __ .�[.VIV �� '�