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210 15TH ST - Building Permits
i -a-- ' _ r ` S Applicant to fill in all spaces except those within heavy bordtr lines and sign all app`ropriate'declaratlons. -- CITY OF COSTA SA C NST CT 0 PERMIT PE IT NO T 69 OT NO. UNI N0. I�,1O �• I _Fj�J_ " Z� 67� • I - �p� • ��jl 9171 12/23/86 396 50 T� •aGQlect Address �G �jl r' • _� eLL-I A -App ' ht's Mailing Address TYPE OF CONSTRUCTION NEW ADD U ALTERATION ❑ REPAIR, 134 �e� y'� 111 P�. ❑ CONVERSION ❑ DEMOLISH ❑ OT Eq� ' DC Owner's .�'WIZ*" INV v-i 1 H phone / �/ a 0 4-e.# ` - A.P.4 4�j ✓ - ��I �� Zone . r/ M,rSTfr/i I(/ 'DESCRIPTION OF WORK/USE OF BLDG. Address • S Main Building: Accessory Building: Arch/Eng. + - License o. TYPE OF PERMIT ■ GRADING U FOUNDATION STRUCTURAL E Front 36, 0 0-� O 7T/ s I (L/_, /� El PLU BI G ❑ ECH NI AL g v N Address i 4 UI// %egad1 V ❑ TENANT //LUr/�f W {p� er Rear Contractor's Name OGt.1l�-.)�.s Phone ❑ OTHER • TT"a' VECAC s 7 a��•�� A 7' I PROJECT DESCRIPTION SQ. - . Q [7 OCCUPA Y �:///%�Q O Right S N Address(mailing) : K �� ,f G •CON STR CT�I/pN TYPE 1 VALUATION$ MITI// S Lefts City License No. ZONE ^(� GRADING CU.YDS. 0 AC- e5-� /� R LICENSED CONTRACTOR DECLARATION Ping. Ref.4 PR SA— IOD Parking Req./Provided /../ y E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ./f — c//+s, - g o Planning Notes: M with section 7000) of Division 3.of the Business and Professions Code,and t� ow 4 FUR s.I' j 1' pp �•�� my license is In full force and effect. . (ULD ✓<VA SYIICIAL REQUIREMENTS T • License Class License No. 1 t to 'Signature • ,-: - PLUMBING - FEES T��(C/C-I ©1/'�f� d eaL/sf•I � )R KERS'COMPENSATION DECLARATION Bar Sink Showers _■ ELECTRICAL FEES • 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 Service Sink 3800, Lab. C.) _ �,, Automatic •Washer Transformer ❑ 15.50 KW ., Policy No. - Company Backflow Irrigation Sewer Ca 0 50+KW P Construction Pole Sub. Certified copy is hereby furnished. Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Clop to 100 amps Date Applicant _ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (Thissection need not be completed if the permit is for one hundred($100 or less). L Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel I certify that In the pe ormance of tt7 . kdor_which this perm' ' ssue• I shall not emp •y any,••rson in any „ er so as to becom: ' bj- t to the• Drinking Fountains Solar Tank Fan Motors❑0-1 HP 01%-8 u Workers' --P• ws of Califo a !' Date 4r Ab Signatute L _ - a Floor Drains Swimming Pool w/Spa F.A.U. NOTICE:I ,after a ing this ded .bon,you should become Jtbject to the Inc.Solar 09-15 HP ❑16-15+ Workers' ompe satlon provisions.of the Labor Code, you 'Test forthwith Floor Sinks Urinal • Fixtures comply ith Such provisions or this permit shall be •. ed revoked. Microwave CONSTRUCTION BENDING AGENCY Gas Service Outlets Water Closet Device Boxes !hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name - Range • Lender's Address /UOIJL— - - Kitchen Sink Water Service OWNER BUILDER DECLARATION Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories r . Auto-Wash following reason-(Section 7031.5 Business and Professional Code: Any city or - - Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap ' Laundry Trays Generator ❑0-5 KW ❑5-15 KW - - any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor • to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 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 0 penalty of not more than five hundred dollars($500). _ - I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 - Issue Fee $ 3 ' compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 ' for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES 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 DEVELOPMENT SERVICES R Q I EMENTS: employees, provided that such improvements are not intended or offered for Boiler - Hood or Type I 0 ^^^777'''��� 1 ZoningApproved ByDI-- ��/C( . sale. If, however, the building improvement is sold within one year of corn- Canopy Type II 0 pp Date / pletlon, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Building Approved By ` Date 2. 17 pp ve for the purpose of sale). Nd I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Data 1z/2 / tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU S MARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Cont ctor's License Law). I am awarBUILDING PERMIT $ 3 00 SMIP $ 4.7 P roof of the W er's Compensa surance should be prod•• 0 •• Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $ 7PERMIT 6 0 17 eqtct.. J ve& SZF 6 B. P C.f• t reasoq alElFirepl/Fact.BILICBO# Fire Dampers PLUMBING $ ISSUANCE $.Date O errd _.. - ,Heating System& Ducting Registers . PLAN CHECK 25% $ ENERGY P.C. $ a -\I here yfy that I haves •. this application and state t the above ❑0-100,000 BTU ❑100,000 BT ELECTRICAL $ GRADING $ infor atio correct. I agree to comply wit. .11 city and c• ty ordinances and state,ave. relating to building constr • .n,and en '. -uthori e repre- ■ . PLAN CHECK 50% $ MICROFILM $ sent -07 this-city' o ente upo• he above- here ed pr••erty f•. inspectio poses. ` / MECHANICAL $ 1;39 Sr, }� Signatur -- - _ t� Date L/I_ TOTAL FEE $ n• Drive icense or SS%' • $15 . Issue Fee $ 3 III PLAN CHECK 25% a$ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION 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-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 UFERGrnd. gain 10 57. APPROVAL TO COVER-GUNITE 7. Footings • 5c1t44. 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. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final . 14. Rough Plumbing 65. Electrical-Final , 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL .- 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT .: ' 20. Rough Factory Fireplace APPROVALS Permit# ''• . .5; 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 3'1,p7 y 77. FIXED SYSTEM FINAL , 29. Insulation / e 78. FIRE PREY. FINAL • 30. Drywall Nailing '� 01 - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i g� 79. FINAL INSPECTION f , . 32. Electrical Power Meter-Final f Z�� 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 34187 ,..�� • / ‘ Oirfi 35. Final Gas Pipe-Test '6 ( `-^C p,( ,�4 _ PI 36. Hood or Canopy . ;•,,, 37. Final Factory Fireplace - . , 38. Final Plumbing %% . -. 39. Water Service-Final _ 40. Gas Service-Final :j , 41. Solar Domestic-Final - 42. Backflow Preventer - - - 43. Backflow Irrigation r , .r: 44. Landscape Irrigation System '-;. .:i' 45. Sound Attenuation '. 46. Handicap Regulations qqq _ -- : - 47. FINAL STRUCTURE & BUILDING � 6'/t/J �' 48. Special Requirements Completed ` o . - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date • 1. • - I l CITY OF COSTA MESA DEVELOPMENT SERVICES DEPARTMENT P. O. Box 1200 Costa Mesa, California 92628-1200 scam-a) i1ac4 C2Z13-5ZV :onodc UJ.LSC,Ca :notlsu1-nj Date: December 23, 1986 To: WoodCo Investments 3400 Irvine - Ste 117 Newport Beach, CA 92660 Re: Subcontractors List We note that you have recently been issued a City of Costa Mesa Building Permit to do construction or home improvements at 210 E 15th St. ❑ The Building Permit indicates that you are the General Contractor. Our Municipal Code re- quires that all subcontractors working on your job purchase a City business license. We are requesting that you complete the enclosed Subcontractors List and return it to the Planning Division. It is your responsibility to see that all subcontractors purchase a City business license prior to your request for final inspection. Final inspections will not be given until all subcontractors are licensed. O The Building Permit indicates you are the Owner/Builder. If you are acting as the General Contractor, our Municipal Code requires that all subcontractors working on your job purchase a City business license. Please complete the enclosed Subcontractors List and return it to the Planning Division. It is your responsibility to see that all subcontractors purchase a City business license prior to your request for final inspection. Final inspections will not be given until all subcontractors are licensed. ❑ The Building Permit indicates that you are the Owner/Builder. If you are acting as Owner/ Builder, please complete the Certificate of Exemption which is on the reverse side of the Subcontractors List and return it to the Planning Division. It is your responsibility to see that all subcontractors purchase a City business license prior to your request for final inspection. Final inspections will not be given until all subcontractors are licensed. ❑ Not all Subcontractors at the job site have obtained City business licenses, therefore, as of , the Building Division will no longer respond to your requests for inspections. This is the only reminder you will receive from this office. Should you have any questions in this matter, please do not hesitate to call the undersigned at 754-5623. Thank you for your early response. Sincerely, (fin B - 2(000 -1 • Nancy unge, C e Enforcement - 156 - `65551 di (pi J72r, CMF 1115-30 White-Addressee;Canary-Intl Notice Addressee;Pink-File OObGa1IQ,1 CITY OF COSI A MESA PARK FEES /� E . Payment Receipt ,� �' " 001055 9170 12/23/86 1229.38 TL Project Address o2_JO C� . /5'S56LtO' L1i.., A.P. Number 4 5' 331 - D 3 • Building Permit Number Owner's Name W55DCl') huvrArtirAnS MailingAddress3100 WINA )E; Ave, STE 1/7 ,0-/oRa r13 If'f'y al • eblv(0 FEE; Single Family * Number of Units 2-Bedrooms or Less @ $ 861.76 = 3-Bedrooms @ 1,205.67 = 4-Bedrooms @ 1,545.62 = 5-Bedrooms+ @ 1,810.50 = Multiple Family ** •Bachelor or Studio @ 474.37 = 1-Bedroom @ 573.18 = 2-Bedroom @ 881.51 = 3-Bedrooms+ I @ 1,229.38 = /Z.2=7. 59 Total Fee «». /2.2.12Planning Department Approval Date /Z - 7)-Sh By �. �" 7 _ iZ Applicant's Signature City Ordinance 72-44 •+ City Ordinance 72-45 ••• City Resolution 78-116 't.��tt CMF 0174-30,rev.7/05 White—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant U'Jll IM City of Costa Mesa INSULATION CERTIFICATION Building Safety Division 210 6. is" DA LAN i F 14 Gos{a- Meso orum a" Number and Street City County • Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material WaiL4Geh MSG* Brand Name ©1A9�'h->-5 v p Thickness (inches) Q-c4 — C. L Thermal Resistance (R Value) 4'1 1 EXTERIOR WArLLL� ( ,,..!' Material Pt* C S {'u ' Brand Name 014-)Sic 4 Thickness (inches) i( 3 � Thermal Resistance (R Value) g, H 1 CEI LING Batt or Blanket Type Brand Name Thickness (inches) Thermal Resistance (R Value) Loose Fill Type Brand Name Minimum Thickness (inches) Number of bags _ Weight per bag lb. Area Covered (ft2) Thermal Resistance (R Value) FLOOR, ELEVATED Material Brand Name Thickness (inchesL Thermal Resistance (R Value) FLOOR,SLAB Material Brand Name Thickness (inches) _ - Thermal Resistance (R Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current regulations setting Energy Conservation Standards for new residential buildings (located in Title 24 of the California Administrative Code). SrzwiN dr./ft—OS-8 1c1 9gS7._ neral Contractor(Builder/ License Number fit S /-i2 -88 Signature and Title Date zcwti Staaid 46194sZ Su ntractor(Insulation Applicator/ License Number Signature and Title Date CMF 1106-46 i ' -" Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 71111111111 CITY OF COSTA.MESA CONSTRUC ON PERMIT ( v I�N� TRACT NO. LOT NO; UNIT. 10E64 I /22/8] 2-10 —F is��S� f�oL / 35,50 TL Project Address y/ - Applicant's Mailing Addr ss Ilam Merril/ //t TYPE OF CONSTRUCTION [NEW ❑ ADO U ALTERATION ❑ REPAIR /B ,rp.h LI CONVERSION III DEMOLISH El OTHER A•P•4/6 I Zone Owners Name 'WilOr. LO ..-Stv#//1-+-tech . Phone -r�`I i DESCRIPTION OF WORK/USE OF BLDG. '�v/7'� Address. j 3Curt -�N'rl.e 7µt. , SdY, //) . ff �� / S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING LJ f9(1NDATION 0 STRUCTURAL E Front 0 Address / asp ❑ TENANT ❑ ELECTRICAL ❑L/PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam- ! ' 'yam I -� - ' one b �s ✓. ❑ OTHER A I alit PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) le T� AitGn-'f ['' /,Wt CONSTRUCTION TYPE VALUATION$ K Left •• R City License No. .2 se 97 Z. • ZONE GRADING CU.YDS. ACRES K LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E F�� I herebyaffirm that I am licensed under provisions of Charter 9(commencing _ ).....66 7& - M Remarks: /J (/ Planning Notes: M withata ysectionIs 7000)II of e and 3 of the Business and Professions Code, and V T my license Is In f II or and effect. _ - S License Class i i ns// 1 Date Signature I tOt7 .i4 r- PLUMBING FEES Ok. •ar / ORK:RS' C•MPENSATION DECLARATION BSink • Showers ^' 4ereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES `/VC of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink /y1 .� s(.. Automatic Washer Transformer 0 15-50 KW I Polliiiccy No.P� 9F/369 Company Ar 4 /r $ _'. / Backflow Irri anon 0 50+KW 9 Sewer Cap _ Construction Pole Sub. • `� ^ titled copy is hereby furnished. 51°- 'c!/ Certif'ed opy is f with'the city B4 g``w'. •,r' `� 2„Bathtubs / Sewer Connection 'Cy, Cooking Unit Meter Cup to 100 amps Date Applicant ��` _ - EXEMPT N F OM WORKERS'COMP NSATION DECLARATION Clarifiers' Solar Collectors Dishwasher . Meter Dover 100 amps (This sect on need not be completed if the permit is for one hundred($100) or , • less). / Dishwasher : Solar Piping i . . .' W ' Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner. so as to become subject to the Drinking•Fountains Solar Tank Fan Motors❑0.1 HP ❑1 X-8 Workers' Compensation Laws of California. _ Date Signature Floor Drains 'Swimming Pool w/Spa - F.A.U. Ina Solar ❑9-15 HP ❑76-75+ . NOTICE:If,after making this declaration, you-should become subject to the - • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks . . Urinal Fixtures • ' comply with such provisions or this permit Shall be deemed revoked. - Microwave CONSTRUCTION LENDING AGENCY / Gas Service Outlets '2 Water Closet -6 . '� Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance �--t g of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors :� Water Heater . r,C - CSO • Outlets ' Range Lender's Name Lender's Address 1. Kitchen Sink _/ Water Service L, Switches - OWNER BUILDER DECLARATION _7J �_ Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories / Auto-Wash C9' OZD Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW any structure, prior to Its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of - ROOF Drains - ' 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). ., LJ I, as owner of the.property or my employees with wages as their sole Reinspection.Fee I $15 Issue Fee $-3 • compensation, will do.the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section •7044, Business and Professional Code: The Contractor's - MECHANICAL FEES 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 Hood or Type I ❑ 'DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler ' Approved By sale. If, however, the building or improvement is sold within one year of com- Canopy Type 11 ❑ Zoning pP oved (late pletion, the owner will have the burden of proving he/she did not build or Im- Duct- Under GroundBuilding Approved By 'Date 1 rove for the purpose of sale). _ CO. / /n� �1 I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System . Application Issued By Date i E tractors to construct the project(Section 7044,Business and Professions Code: The Contractor's License Law does not apply to,an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES 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 • Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $, SMTP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason ' Firepl/Fact.Blt. ICBG# Fire Dampers ( i J ISSUANCE $ • PLUMBING - $ a/9/ ' Date - owner Heating System&Ducting Registers Illir PLAN CHECK 25% $ l9-�S n ENERGY P.C. $ .. I hereby certify that I have read this application and to that the above ❑0:100,000 BTU 0100,000 BTL GRADING $ • information is co • t. I .,ree to comply with all city county ordinances ELECTRICAL $ and state laws -lac g •b d'ng constructor reby authorize repre- MICROFILM $ • sentatives of- •t/1•o en upon t entioned property for - , PLAN-CHECK 50% $ - -- inspection pu set - �2J 4`) MECHANICAL $ _- TOTAL FEE $ y3C< 't�� Signature • ' � Date f Reinspection Fee $15 • Issue Fee $ 3 PLAN CHECK 25% $ ' Drivers' License or SS# . -�� CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION 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-Undrgrnd. //n/7 •/Q 2f' 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. I/j y/ Or 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 yA9,t 65. Electrical-Final 15. Rough Electrical-Conduit �� 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing - 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE 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:,/��/¢? 1f ,9 d C 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test %'yr/q/il A LL 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing s!/le 4 75 39. Water Service-Final f 40. Gas Service-Final %,��y/t7 Ar/ 41. Solar Domestic-Final L 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 P AIT NO. . 2 TRACT NO. LOT NO. UNIT N Project Address )-ID e- - 1St `�} . „ �A�AI L • 1606 2/05/67 8.00 IL `, ' 3400 iV V\nC Au-e- TYPE OF CONSTRUCTION ❑ NEW Li ADD Li ALTERATION REPAIR f Applicant's Mailing Address El CONVERSION L7 DEMOLISH C7 OTHER A,P-# Zone Owner's Name y�r(WI co Ir�J���rT'Cn� CO . Phone��"$ 1 DESCRIPTION OF WOR K/USE OF BLDG. - . • Address -1,1400 ICVina, AJe S Main Building: Accessory Building: ,J,.,.,�,> �/ w 1 �j --se^' E Z Arch/Eng. +c-�rai .4147.443 OV License No. VCO l TYPE OF PERMIT El GRADING ❑ FOUNDATIOen STRUCTURAL T Front O Address w77��-yy ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING LJ MECHANICAL B Rear N OtLZ0 e. Phone fat en 7 ❑ OTHER A I Contractor's Name C Right N o ,,wc. ..... We PROJECT DESCRIPTION 5Q. FT. OCCUPANCY Address(mailing) 30 ��t'Z^'�- �Tf'� S Left G CONSTRUCTION TYPE VALUATION$ R City License No. ' ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking • Req./Provided E LICENSED CONTRACTOR DECLARATION -• Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: • 'Planning Notes: - M , with section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. te6/_ e64 S T License Class License No. / Date Signature • PLUMBING FEES . 'ORKERS' COMPENSATION DECLARATION ' IBar Sink Showers ' iereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES df Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink 3800, Lab. C.) • Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation . , Sewer CapConstruction Polesub., 0 50+ KW Certified copy is hereby furnished. _ - Certified copy is filed withthe city Building Division. Bathtubs - Sewer Connection _• Cooking Unit • Meter ❑up to 100 amps • Date Applicant_ _ - EXEMPTION FROM e WORKERS'COMPENSATION DECLARATION, Clarifiers Solar COII¢ctor5- - - Dishwasher Meter Dover 100 amps , • - (This section need not be completed if the permit is for one hundred ($10017or less). /�I / Dishwasher Solar Piping ; • Dryers ❑Gas ❑Electric Sub Pane) I certify that in the pert ,mance,o trifle k for,which thisrpermit'is issued, I • - orl ' employ any L Him er so ;s to tiec.me•subiect to the Drinking Fountains Solar Tank Fan • Motors ❑0-1 HP ❑1%-8 Workers' •.mpensa 1..n f Hf. lila. — Date ./ Signa re -��'-� - ' - �-� Floor Drains Swimming Pool w/Spa F.A.U. - Inc.Solar 09-15 HP 016-15+ • NOTICE: f,of-r .0ng this d c . ation, you should becom; subject to the • Workers' o •, sation ,provisio s of the Labor Code, you ust forthwith Floor Sinks Urinal Fixtures ' comply with •uch. provisions or this permit shall be . emed revoked. Microwave CONSTRUCTION LENDING AGENCY t...'s Gas Service Outlets - Water Closet Device Boxes Pale Li ht• • I hereby affirm that there is a construction lending agency for the performance 9 • of the work for-which this permit is issued (Section 3097 Civ!CJ Interceptors Water Heater Outlets Range Lender's Name 9 Lender's Address. - Kitchen Sink. - Water Service Switches - Sign - OWNER BUILDER DECLARATION . I hereby affirm that I am exempt from the Contractor's License Law.forthe Lavatories • Auto-Wash - - following reason (Section 7031.5 Business and Professional Code: Any city or - Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or✓epair P-Trap ' LaundryTrays ' any structure, prior to its issuance, also requires the applicant for such permit - y Generator 00-5 KW 05-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of ROOF Drains 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 fivehundred dollars ($500). ❑ I, as owner of'the property or my employees with wages as their sole Reinspection Fee' I $15 ' Issue Fee ' $ 3 • • compensation, will do the work, and the structure is not intended or offered 1 , for sale (Section 7044, Business and professional Code:'The Contractor's MECHANICAL FEES Reinspection Fee $15 Issue Fee • $ 3 License Law does not apply to an owner of a property who builds or improves - f thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or ' Type I 0 • ZoningA' roved - sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 • pp By Date letion, the owner will have the burden Of proving he/she did not build or im- ' Duct- Under Ground d ' pro or the purpose of sale). Building Approved By //�/ Date I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Vi____, Date Z/`r/e7 tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU' 0100,000 BTUSUMMARY OF FEES builds or improves thereon, and who contracts for such projects with aeon- tractoc(s) license pursuant to the contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration - BUILDING PERMIT $ SMIP $- proof Of their Worker's Co nsation-insurance should be pvovitled to me. , • rP PLAN CHECK $ PERMIT - I am exempt under Section ' -- _ . & P.C. r this rr 7- Firepl/Fact.Bit. ICBG#/$E Fire Dampers ISSUANCE $ .7�.I /{^_ /rr 1 PLUMBING $. D e "�/ G "t Own r ' �' Heating System&Ducting Registers - ENERGY P.C. $ PLAN CHECK . 25% $ reby certify that I have re this application and state that the above El 0100,000 BTU 0100,000 BT -- _ GRADING $ i ormation is correct. I agree to comply with all'city and county ordinances - • ELECTRICAL $ and state laws relating to building const( ctionrand hereby authorize reprq- $ MICROFILM' $ sentativet=oftttyhs-ciyyyyyy-to-enter upon t eieabove-mentioned, pr erty f r- PLAN CHECK 50% inspection /1- es./ If •dLe i f MECHANICAL $ 7 00 TOTAL FEE. $ �p Signature �� Reinspection Fee $15 Issue Fee -$ 3 PLAN CHECK 25% $$ /, 00 Drivers' License or 55# „./ - - CMF 0865-46,rev.10/84 White - Building; ary Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND-PLANNING - • POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1.-Temporary Electrical Service or Pole 52. Roth & 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 i 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. . '8.,t oundation • - - 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 • 20. Rough Factory Fireplace ' 007 elf APPROVALS Permit# 21. Ducts, in Structure rr// ��!! // �/r . 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 DEPTJREQUIREMENT r 31. Plaster Brown Coat . 79. FINAL INSPECTION i 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 r A, . if/ ?37. Final Factory Fireplace 38. Final Plumbing /, ••' 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final " • r 42. Backflow Preventer I - -43. Backflow Irrigation . •i I' 44. Landscape Irrigation System - - 45. Sound Attenuation 46. Handicap Regulations • '1. 47. FINAL STRUCTURE & BUILDING i.. 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 CONSTRICTION PE Mn�1T PERMIT .$ TRACT NO, LOT NO, UNIT NO, Project Address 7 (to Iq ' IS SI-.Gick, yece, a. 2498 2/ 18/87 24°25 TL Applicant's Mailing Address ' TYPE OF CONSTRUCTION 'NEW ED ADO LJ ALTERATION LI REPAIR r - Aoo0LlnCI CONVERSION CI DEMOLISH CI OTHER A.P.# Zone Owner's Name IMn�/1 V 5'+1tlhone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: Arch/Eng. Se.-vr„Q License No. TYPE OF PERMIT ' ❑ GRADING ❑ FOUNDATIONf�7 ❑ STRUCTURAL E Front ZO Address ❑ TENANT ❑ ELECTRICAL LI PLUMBING 1'r.MECHANICAL B Rear N Reseal",Cif/Is �tc.G .760y ❑ OTHER A I Contractor's Name t� ly hon1p p c PROJECT DESCRIPTION SQ, FT, OCCUPANCY C Right -- N Address(mailing) 'S3 ` Mon-M-'CN/4 (-i A-7• O• 9266�J G CONSTRUCTION TYPE VALUATION$ s Left City License No. Z JsoZ ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking Req./Provided E LICENSED CONTRACTOR DECLARATION ^ Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: tag.( ( ,, R - Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and vv r! • T my license is in full for e and effect, r / - S License ss 'Z �LAi Lice -, C\ Date � an Signature .._�_ • PLUMBING • FEES ' Iso ORKERS' COMPENSATION DECLARATIO • Bar Sink Showers ELECTRICAL FEES Lb ereby affirm that I have a certificate of consent to self-insure or a certificate \ „f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW 3800, Lab, C.) Q� ! ('' /' '� Policy No. �Q•'1 ) Company t(f iv,IIIDYt.l-.CA-5-(� . Backflow Irrigation Sewer Cap0 50+ KW 9 Certified copy is hereby furnished. _ - Construction Pole Sub. ,.....0 L Certified,copis ilegl,_with the city Buildip �j tj isio / 4 Bathtubs Clop Connection Cooking Unit Meter up to 100 amps Date .4 DateApplicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or • less). Dishwasher - Solar Piping • Dryers ❑Gas ❑Electric Sub Panel • I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors ❑0-1 HP ❑1'/:-8 Workers' Compensation Laws of California. ,��—_1L— _ Date Signature Floor Drains Swimming Pool w/Spa , F.A.U. /d'♦:(114a ' • Inc.Solar 09-15 HP 016.15+ NOTICE: If,after making this declaration, you should become subject to the — - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which thi$ permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Ran e Lender's Name MA— 9 Lender's Address Kitchen Sink Water Service • OWNER BUILDER DECLARATION - Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the 'L-avatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or _ , Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P=Trap LaundryTrays any structure, prior to its issuance, also requires the applicant for such permit _ ' • y Generator ❑0.5 KW 05-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • goof Drains ' 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). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 ' for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES 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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler . Hood or Type I 0 sale, If, however, the building or improvement is sold within one year of com- Canopy Type II 0 ' Zoning Approved By Date pletion, the owner will have the burden of proving he/She did not build or im- Duct- Under Ground . Building Approved By Date prove for the purpose of sale). e 7f v p 0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By 5 L./1 Date Z,/f\ p r/ 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 ,J1udt-Ventilating — ❑o-100,000 BTU ❑100,000 BTU SUMMARY OF FEES 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 Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P. C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers • PLUMBING $ ISSUANCE $ Date OwnerHeating System&Ducting Cf Registers 9- 0.) 1 CO ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above 1 0-100,000 BTU 0100,000W GRADING $ information is correct. I agree to comply with all city and county ordinances y. _ ELECTRICAL $ and state laws relating to building co (ruction, and hereby authorize repre- MICROFILM $ sentatives of thi ' y to Aent- u the above-mentioned property for PLAN CHECK 50% $ inspection pure..: /�, •L-. 9� 2 rel- _ MECHANICAL $ TOTAL FEE $ �/•�� Signature, /, y.Lc'r ! Date rJ o Drivers' License or SS# Reinspection Fee $15 Issue Fee . $ 3 PLAN CHECK 25% $ • a CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION 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-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 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 "/zrSp ,fl' FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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 p 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final/Heating & Air Conditioning /Vr7 //fic 35. Final-Gas Pipe-Test 7 / 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 - - II • 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 -ea__ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ti 'r' 'z P.CPQLT.-DLJ^ / TRACT NO. LOT NO. UNI U. CITY of COSTA MESA CONSTRUCTION PERMIT �O^I /c J( Project Address 09./0 E /S')( 1—'i C.-7 /a+.1---� 2206 2/11/8751 . 15 1 Applicant's Mailing,AddreTYPE OF CONSTRUCTION ® NEW LI ADD ❑ ALTERATION 0 REPAIR r T I0400407` / Lv-�' CI CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone Owner's Names On GCD �/--2-72.1LAS ^^C 444.-K Phone J ( aJ 34‘06) �rru A I "�Y �U q � DESCRIPTION OF WORK/USE OF BLDG. Address v t- 41/41 epon" l fecrc4 ` • S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front 0 Address 60)///fan- 1 J / 7"' -�t' ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Namp (Jd/�,' ..5 F /4IYrjit Phone&/frw'SC// 1 ❑ OTHER A 1 Address(mailing) /099/3 So /% •f`f S c PROJECT DESCRIPTION SQ. FT. / FY' OCCUPANCY K Right G �n 73 6� 4 ~�� CONSTRUCTION TYPE VALUATION S S Left R City License No. ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking Req./Provided E LICENSED CONTRACTOR DECLARATION �1 J Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: p.[ p ( 7 5t Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and - J.J td my license is in full/{arcepad effect. // ///'/ •. S License lass `-� ( Licen e No. `d`70 4 '9 • - Date —//-f7 Signature --- PLUMBING FEES ' d YORKERS'COMPENSATION D LA-v' ON Bar Sink $hOWerS hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES • of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink3800, Lab. C„),,... �-/,/ / _ Automatic Washer Transformer 0 15-50 KW Policy No. W r '7`,2S Company •i /c/P u•-i. a Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+ KW Certified copy is hereby furnished. Certifiedcopyis filed with the city u ing Divin. r ' Bathtubs Sewer Connection • Cooking Unit Meter ❑up to 100 amps Date ,2 7 Applicant {S/p (..i`-5 /` I T7 nor EXEMPTION FROM WORKERS'C PENS :ION DECLARATION Clarifiers Solar Collectors //-D ishwa5her / V Meter Id Over 100 amps �t� (This section need not be completed if the it is for one hundred ($100)or - !!! V less). Dishwasher Solar Piping Dryers Zeas ❑ElectricSub Panel= Z - C. f1() I certify that in the performance of the work for which this permit is issued, I — - / Sd shall not employ any person in any manner so as to become subject to te • / Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. • _ Date Signature - - - Floor Drains . Swimming Pool w/Spa F.A.U. ❑ NOTICE: If,after making this declaration, you should become subject to the Inc.SOIar 9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal ''// Fixtures 1D'A comply with such provisions or this permit shall be deemed revoked. �7,- Microwave O! tO • CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet -'' Device Boxes I hereby affirm that there is a construction lending agency for the performance ,( Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater 32- Outlets Range =�D Lender's Name - Lender's Address Kitchen Sink Water Service ,L OWNER BUILDER DECLARATION /y 'Switches Sign nD I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash 1 following reason (Section 7031.5 Business and Professional Code: Any city or / Garbage Disposal Standing Sections 00�sty county which requires a permit to construct,alter,Improve,demolish or repair P—Trap - Laundry Trays A. Generator 00.5 KW 05-15 KW any structure, prior to its issuance, also requires the applicant for such permit Ys Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 'r '+ the Contractor's License Law (Chapter 9(commencing with Section 7000) of fj. 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 r l' 7031.5 by any applicant for a permit subjects the applicant to a civil _. x'- , penalty of not more than five hundred dollars($500). LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's i MECHANICAL FEES 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 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I -sale. If, however, the building or improvement Is sold within one year of comr Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By • Date prove for the purpose of sale). ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 'CLde� Dat it tractors to construct the project (Section 7044,Business and Professions Code: �{ ,",II The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES • 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 Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP . $ proof of their Worker's Compensation insurance should be provided to me. - PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers SS UANCE $ 1.11LPLUMBING $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above ❑0-100,000 BTU 0100,000BC / - GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ l] and state laws relating to building construction,and hereby authorize repre- sentatives of tit city to -nter on the above-mentioned property for inspection .rpes. A—//—� r- MECHANICAL $ TOTAL FEE �� r / _ Signature /�/ Date Driversnse ••i , Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ t CMF 086 -46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION 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-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd `mac. S - J -J/a// - 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& 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 IT-ze 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED 33. Final Electric O & ler Notes: >_)41,4,-77'o w3 " ed., hc- � e •34. Final Heating & Air Conditioning VV / ,' Si17Vr GF') C� It De-k ow 7Gr„a 35. Final Gas Pipe-Test 7/ /4. 4a/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 • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING _ { 48. Special Requirements Completed 5y\ 49. Electric Release to Edison •�-� 1� 50. Gas Release to Southern California Gas Co '• 51. CERTIFICATE OF OCCUPANCY No. Date 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY GF•'COSTA MESA CONSR UCTI ON PERMIT — P MIT NO. (� TRACT NO. AOT NO. UNIT�jO. ProiecVAddress 2-10 e• 15 GT. C/Q l 9gye 1 � ( 1/J�1�7 For 13 Tf' 2aEE 7/'- . Apr}licant's Mailing Address 9A M e TYPE OFCONSTRUCTION NEW ADD UALTEOATION U REPAIR O.vnErSName 1.t]t5 ❑ CONVERSION El DEMOLISH OTHER A.P.#1445-- Zone p WOOD CA-0 E Phone7ser SS57 1_ 3 3/ -Da go2J A DESCRIPTION OF WORK/USE OF BLDG./{dd1/-lnrl nose �s Address �ME S Main l.i 1�.6 Accessory Building: Z Arch/Eng. ( �G�EU�1' C��`-EL icennse No. • TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL T Front 9q 1 a� O Address 231 Es '/"' St. L•/-4 ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BA Rear 22/ci hi 2/_IG1 N Contractor's Name 0 Phone ❑ OTHER ; C Ri ht `l-Y • N -•�/�.� ,/ -A� PROJECT DESCRIPTION 5[3. F,T,_, T/ON PA CV—� K g 51 I Cyt G Address(mailing) a C� L.!'�(��/V E �l �^ r CJ /1 CONSTRUCTION TYPE VALUATION S /D $ Left • R City License No. _ ZONE GRADING CU.YDS. ACRE t �y � iSe LICENSED CONTRACTOR DECLARATION ' • , Ping. Ya 0 RI I •alt rig Req./Provided LI/4 (�V•• 'Ii I herebyaffirm that I am licensed under provisions of Charter 9 (commencing 1 bath' a ( g Remarks: Planning NOt¢s:.��1'Y�/p I I 0 0 -0 • LSMA a M with section 7000) of Division 3 of the Business and Professions Code, and • -mss s `s�Ai my license is in full/Tree and of lett. p p p fL �.,/� License Class License No. % 4 FGL 1 F . A SZ • .3_ / • C 1 Q— a / 4. 5 . .a �• f • �J/.��1L�i , Al • .� - u •/. $ ate Signature _ t PLUMBING FEES 4 o / • a. -h c T 1. room '. • • f `x OR KERS' COMPENSATION DECLARATION • ' I hereby affirm that I nave a certificate of consent to self-insure or a certificate _ ,Bar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW • Policy No. Company _ Backflow Irrigation Sewer Cap0 50+KW •Certified copy Is hereby furnished. Construction Pole Sub. B Certified copy is flied with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps ' Date Applicant - - lb, EXEMPTION FROM WORKERS'COMPENSATION DECLARATION • Clarifiers Solar Collectors I Dishwasher Meter Dover 100 a (This section need not be Completed If the permit is for one hundred ($100)or • les / - Dishwasher Solar Piping Dryers DGas DElectric Sub Panel icer fy that in the performanc t e w•rk for which th's perp- ytiCed, I _ s a I not q ploy any sonde ah r-so :. to be< • subject to the' Drinking Fountains Solar Tank Fan Motors❑ HP ❑1 X-8 W. •r a mpe• .tie s o C ifor. . - _ qac l j' ' y� ig u `�� �,I _ s _ Floor Drains Swim g Pool w/Spa F.A.U. Inc. r 09.15 HP ❑1615+~— &ICE: ,after making thi d larat on,you should becom,,-ubject to the drkers' ompensation prov ons of the Labor Code, y0ust forthwith Floor Sinks nal Fixtures omply Rh such provisions or this permit shall be A.f•med revoked. ash e CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance V. Pole Light - of the work ,for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name - Range Lender's Address Kitchen Sink - Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that-I am exempt from the Contractor's License Law for the Levaloriea Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires.a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays s Generator ❑ KW ❑515 KW any structure, prior Co Its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of •ROOf Drai - 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). I • LJ I, as owner of the property or my employees with wages as their solo Reinspection Fee V $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered -- Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES 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 DEVELOPMENT SERVICES REOUIR NJ employees, provided that such Improvements aro not intended or offered for Boiler Hood or Type I 0 ZoningApproved By / /� sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 pP Date 7�// r/fez pietion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Dateate r ve for the purpose of sale), I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural • ' Refrigeral' n System Application Issued By at 2 tr tors to construct the project (Section 7044, Business and Professions Code: Th Contractor's License Law does not apply to an owner of property who ! Duct-Ven Ventilating 00 ,000 BTU ❑100,000 BTU builds or improves thereon,and who contracts far such projects with a con- SUMMARY OF FE S '7 tractor(s) (/ license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ 0•Tc7 SMTP $ i/D proof of their Worker's Componsat • nsurance should be provided • e. t--�T PLAN CHECK $ J •3.3 PERMIT ❑ I am exe pt nd• Sectio a-a P. .for s on Firepl/Fact.Blt. ICBG# Fire Dampers SSUANCE $ r PLUMBING $ Date 'a- Ower / I iii >�. Heating System& Ducts Registers PLAN CHECK 25% $ ENERGY P.C. $ �����- I hereby ce 1y that 1 haver-.d i a•pl . n and tate a••e ❑0-100,000 BTU ,000BTL GRADING S - information Is co • t. I ogre. o amply with all city and c• 'ty ordinances ELECTRICAL $ and state „mg g to building construction, .na hereb thorize repr MICROFILM S Z Inspection f7X•Aly_to anter u•on t•, -••- e-menti• d p arty f)^,r PLAN CHECK 50% $ TOTAL FEE $ � �/'� Inspection p r•. - ,— �� -/ � Signature/ j. - / Date // 7 ' $ 3 PLAN CHECK 25% $ ' I - `� CMF 0865.46,rev.10/84 white - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION 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-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement, lko ape- 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings s�a(IRr� 58. Electrical Conduit-Undrgrnd. 8. Foundation r� 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, ❑ Und`grnd. 10. Structural Floor System ' //22/`61 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 ►e�f/Q? 7,c, 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing CJ�/174.t/ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat ` 75. Dry Chemical 27. Frame and Flashing 5'tore- 76. Dry Standpipe ' ,•---N 28. Lathing& Siding Id/n/� G 77. FIXED SYSTEM FINAL - 29. Insulation { ` 78. FIRE PREV. FINAL 30. Drywall Nailing db�/tr 6N HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 5`/ ems " 79. FINAL INSPECTION • • 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: ! ?/.1 .76tSY.0 4,417_77, l//T (y ' 34. Final Heating & Air Conditioning 9 'S P. /��___ff,¢ _��/ 35. Final Gas Pipe-Test ?EC ' •'t•) PL ,1,i.f ""O"^�'�� CAI 36. Hood or Canopy /0/28 / rr- M,t7% 37. Final Factory Fireplace !&/V;1 / I ;11 /r - N . 38. Final Plumbing //2 /MS/ A-AA CD 2/-e to P WD� 39. Water Service-Final o CO /t/, • �s T�f ca�PLa.I - 40. Gas Service-Final a 41. Solar Domestic-Final 471115042. Backflow Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 2./7/ . 48. Special Requirements Completed rx// /tel,/�.7/ s. MAA M 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • - 51. CERTIFICATE OF OCCUPANCY • No. Date - 17 CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES. ' NEWPORT-MESA UNIFIED SCHOOL DISTRICT Developer/Applicant : , *on/Qool / If..0 Address : .34100 :77(7///A,/ b- // 7 itka/k•c% gjenee -72-66c Telephone Number : De, ^ orJ el / Tract/Parcel and Lot Number( s ) : �`� / Location of Project : Z/o 4 / Number of Square Feet of d 3,��..�S Residential Space x $1 . 50 Total Number of Square Feet of Commercial and Industrial Space O x $0 . 25 ,Total The provisions of Government Code Section 53080 are not applicable . This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995 . Checks are to be -made payable to Newpo t-Mesa Unified School District . • Business Manager Newport-Mesa Unified School District The above representation as to- squame footage is true . Developer/Applicant agrees that if ;,iit is later determined that such representations are not true then - this certificate, shall) automatically terminate and the -appropriate City/County shall be notified . 4 r Date : _� u/ 11,12/177 DeSeloper Applicant • • - +-_ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate P P 9 tlecla\ations. CITY OF COSTA ESA CONSTRUCT ONrE iMIT 3L�QS� TRACT NO. LOT NO. UNDO. • ✓,E.E °/ : ' . ; /V. 7 �/. lett , Project Address _ r�/ Applicant's Mai��l-jq/p ddress TYPE OF CONSTRUCTION_ - -.H NEW. L'J ADCr u ALTERATION LJ REPAIR I (N ❑ CONVERSION ❑ DEMOLISH ❑ OTH,ER �' I ' Owner's Na a" e0 «� Phone rd R�•.�,..,, A.P.# Zone o wry S DESCRIPTION OF WORK/USE,OF BLDG.- Address 7 S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT H.GRADING-- E Z OUNDATION-.❑ STRUCTURAL T Front O Address I • ❑ TENANT ❑ ELECTRICAL, PLUMBING 01 MECHANICAL BRear N Contractor's Name 624441elf odte"C"We I'hone5 1 113 ❑ OTHER• .. A �'}/ ,G PROJECT DESCRIPTION 50.-FT. - . OCCUPANCY C Right G Address(mailing// 5-7 Y�� ��� - K Left R a' i,-,c ` ,CONSTRUCTION TYPE VALUATION $ $ • City License No. T 7 ZONE ''GRADING CU.YDS. • ACRES Ping. Ref. # Parking Req./Provided E LICENSED CONTRACTOR DECLARATION . ' . - - Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: . . . ' ' Planning Notes: M with section 7000) of Division 3 of the Business and Professions♦ Code, and antl �� � �' T my license is in full tort- and ff-ct. oAti 4,e7 S License p .� e 7 ` Date rte/ Signature �9 � • ._PLUMBING .FEES r ORKE^S'COMPENSATION DELL• RATION Bar Sink .. Showers -I ELECTRICAL FEES 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 Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW • Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. 050+KW • U Certified copy is hereby furnished. - Certified copy is filed with the city Building Division. / Bathtubs Sewer Connection .2 OD Cooking Unit Meter ❑up to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher, . Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or - less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of •e work for which this ••rmit is issued, I shall n e plo any person in any yyynner -• a�vete. e subject to the Drinking Fountains Solar Tank Fan Motors❑o-1 HP 01%-8 Worke o/np{ynon Laws of Calif. U - _ Date / / non Signature _ o Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: If, fter making this declaration, you should become subject to the - — _ Workers' Compensation provisions of the Labor Code, you must forthwith —Floor Sinks Urinal Fixture'sMicrowave comply with such provisions or this permit shall be deemed--revoked. • CONSTRUCTION LENDING AGENCYGas Service Outlets 7 Water Closet a 04 Device Boxes " Pole Li v • I hereby affirm that there is a construction lending agency for the performance i9ht of the work for which this permit is issued (Section 3097'Civ. C.) Interceptors Water Heater Lender's Name p _ -_ / 2 0J Outlets ,i Range Lender's Address Kitchen Sink Water Service OWNER BUILDER DECLARATION Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the / Lavatories Auto-Wash anOD Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish.or repair P-Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW, ••• Trash Compactor • any structure, prior to its issuance, also requires the applicant for such permit - P / to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 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). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 - ' Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered - ^ Reinspection Fee ! $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES - - 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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered fur Boiler Hood or Type I ❑ • sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved ByDate prove for the purpose of sale). lJ ��'�/�1 ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU SUMMARY OF FEES ' 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 Exhaust System 0 Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided.to me. _ - PLAN CHECK $ PERMIT E I am exempt under Section B. & P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ i '. a0 ISSUANCE $ Date Owner Heating System & Ducting Registers PLAN CHECK 25% $ 2ENERGY P.C. $ .V J I hereby certify that I have r-ad this application and state that the above 00-100,000 BTU 0100,000 BT . ELECTRICAL $ GRADING $ infor • • is correct. agree o comply with all city and county ordinances . and s ate . s relatin r to •ui .ing construction, and hereby authorize re re- PLAN CHECK 50% $MECHANICAL $ TOTAL FEE $MICROFILM $ sentatives • th chi t•-. -r upon the t• -. Ser inspection f rpo 's. Y Signature I r AN. Date Oil License or SS ,. Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 4 CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND.PLANNING POOL& SPA J APPROVALS Permit* APPROVALS Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 9/t7' //.qj " 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. /J" • �%�J /� 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. ,54/F, Off 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 9/2 % j 65. Electrical-Final 15. Rough Electrical-Conduit •- 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approvali • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling : . . 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑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& Siding77. FIXED SYSTEM FINAL. : 1 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. aminal Plumbing ,x/777 �lyi� 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 - • r 47. INAL STRUCTURE & BUILDING 1 48,,Special Requirements Completed - A9: 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. CITY OF COSTA MESA CONSTRUCTION PERMIT� PERMIT NO. TRACT NO. LOT NO. UNIT 6131 9/26/67 20050 T. Project Address 210 6./.574 . .. f4[t M 3D4491 11�� Applicant's•Mailing Address TYPE OF CONSTRUCTION U NEW U ADD XALTERATION i REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name woos e Ln Pesti✓ Phone DESCRIPTION OF WORK/USE OF BLDG. Address S Main Building: Accessory Building: E Z Arch/Eng. , License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front O Address /i-� " ��6. Lim - // El TENANT ❑ ELECTRICAL ❑ ysYPLUMBING MECHANICAL B Rear N Contractor's NameJ SikF71{.ty[y f/3 s5 Phone Gs72.-76 7 El OTHER C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY G Address(mailing) - CONSTRUCTION TYPE VALUATION$ $ . 9 K Left City License No. ��,i��-7 c.L •Z-. R ZONE GRADING CU.YDS. ACRES Ping. Ref. # Parking Req./Provided E LICENSED CONTRACTOR DECLARATION ..nss��'nnn /` ,a, 0 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: &.r.eiT�2OYdy Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and �� sr'�r VVV��_ s my license is in full fo ce and effect. T License Gips - ZI Lir•s .o. o9y/7 S Date v-29t? Signature Sha PLUMBING FEES '/O RKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy th-reof (Section 3800, Lab.t CL Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No.I�J 7Y1-3r.2,of Company =t�' / --.r • ' Backflow Irrigation Sewer Cap - 0 50+ KW []-Certified copy Construction Pole Sub. is hereby furnished. cert slid co Is led with the city • - iii• r Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date �- rY Applicant . -r a EXEMPTION FROM WORKERS'COMPENSATIO DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This Section need not be completed if the permit is for one hundred($100)or less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is Issued, I ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0.1 HP ❑1'A-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. .NOTICE: If,after making this declaration, you should become subject to the - Inc.Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks comply with such provisions or this permit shall be deemed revoked. Urinal Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry,Trays Generator❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit - Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 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). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered — Reinspection Fee I $15 Issue Fee $ 3 for sale (Secion 7044, Business and Professional Code: The Contractor's MECHANICAL FEES ' 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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will'have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date V tractors to construct the project (Section 7044,Business and Professions Code: - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating • 00-100,000 BTU 0100,000 BTU a-OD SUMMARY OF FEES 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 Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ PERMIT ❑ l am exempt under Section - B.& P.C.for this reason Firepl/Fact.BIL ICBG# ■ Fire Dampers SS UANCE $ r PLUMBING $ Date _ Owner • & f PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above I.1 as Udlt1thhhhhh1hhhhlhh1afl V GRADING $ information is co ct. I agree to comp) with all city and county ordinances O. ELECTRICAL $ and state laws la 'ng to •uildyng,go . ructlok and hereby authorize repre- sentatives of h' city �• eryt'e yip the a�•ve-mentioned "Finnerty for MECHANICAL $ TOTAL FEE $ Oto 'go inspection p p• s: ` /�/ p fir/ MTW Signature /L- ` Date 7J Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS — '` CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant: Pink -Accounting; Goldenrod - Assessor CONSTRUCTION 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-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, 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 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oi' 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 k;) 26. T-Bar Ceilingi(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 /.24.,�7 J/�L 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 M 41. Solar Domestic-Final 42. Backflow Preventer 43. Backf low 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 1 K Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 1 •CITY OF COSTA ME 9 CONSTRUcC.T N RMIT — PERMIT NO. TRACT NO. LOT NO. UNIT NUJ. Project Address ` O EE/ / 77 $S " t `� r„/' L6 _/J`J•�' 0614 12/02/87 .900' Applicant's(Nailing Address ( TYPE OF CONSTRUCTION ❑ NEW ADD L'J ALTERATION REPAIR f ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ A.P.# Zone Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. • Address S Main Building: Accessory Building: , E z Arch/Eng. - - -. License No. TYPE OF PERMIT GRADING 0 FOUNDATION U STRUCTURAL T Front G Address �'rr //����1yy //♦♦ ❑ TENANT /ELECTRICAL 0 PLUMBING ❑ MECHANICAL B Rear N Il�lll/3 NIMML''/.e. (4,on / o ❑ OTHER A Contractor's Nam C C Right - N 4 4 I /� 1. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K - G Address(mailing) Ito SCS / S �. a $ R A /� ••'� s CONSTRUCTION TYPE VALUATIONS Left City License No. Q o7 - ---- ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION (/�� 1^l [)/ Ping. Ref.# Parking Req./Provided 1 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /l a 7 T Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code and •!� T my license is in full for e effect. Y7�I'(// Licens Class_ ! y] S • Date a Signature /•��[( PLUMBING FEES • 'ORKERS'COMPENSATION DEC LA RATIt1N Bar Sink Showers .ELECTRICAL FEES \ hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified Co.y thereof (Se ion `I� 3800, Lab. C.) 1 Backflow Preventer Service Sink V Automatic Washer Transformer 0 15-50 KW Policy No.E7 company /•';a frit Backflow Irrigation Sewer Cap0 50+ KW fi Construction Pole Sub. Plcerlitied copy is ereby furnished. A /{��/� Er 11,I Certi 11��ggd cp}1y is II with the city Bu r'ng Often. `�I// Bathtubs Sewer Connection - Cooking Unit Meter Lrgp to 100 amps Date "`/rte— ! Applicant jef/ i .4 rAK i EXEMPTION FROM WORKERS'COM' SATI'N OECL•RATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0-1 HP ❑1%-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa ` F.A.U. Inc.Solar ❑9-15 HP 016-15+ / NOTICE:If,after making this declaration,you should become subject to the - (. Pti Workers' Compensation provisions of the Labor Code, you must forthwith —Floor-Sinks Urinal 3 Fixtures •Microwave • W comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes 1 hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Lender's Name - _ `j Outlets Range Lender's Address Kitchen Sink Water Service /- Switchesr idtOWNER BUILDER DECLARATION — `p Sign I I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 P Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 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). U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work,and the structure Is not Intended or offered ,---- — _ - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES 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 — DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for foiler Hood or Type i 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date elation, the owner will have the burden of proving he/she did not build or im- uct-Under Ground Building Approved By Date prove for the purpose of sale). Building ❑ I, as owner of the property,am exclusively contracting with licensed con- uct-Structural Refrigeration System Application Issued By Doti f tractors to construct the project(Section 7044,Business and Professions Code: — - The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES 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 Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT S SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT • ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0100,000 BTU GRADING $ information is correct. I agree to comply th all city and county ordinances _ ELECTRICAL $ Wel state laws relate• to bu/.in• s /tion, and hereby authorize repre- -- PLAN CHECK 50% $ -�L� MICROFILM $ sentatives of this it/ to er..rr e above-mentioned property for /L CO inspection purposes. / �_2 ' 7 MECHANICAL $ TOTAL FEE $ i Signature ,:.u•a� / CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor /_ Ii•' tCL. • - POOL& SPA CONSTRUCTION AIyD:PLANNING • • - .0 Date . Inspector Date Inspector APPROVALS Permit.# _- ._ APPROVALS Permit# 1: Temporary Electrical.Seivice 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. Fpun lation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. WaterPipe-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 ''i' 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro r• r 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL c,-' . 29. Insulation 78. FIRE PREV. FINAL ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT ; 31. Plaster Brown Coat 79. FINAL INSPECTION Pin 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED `e 33. Final Electric },-iO--82. Notes: ('i 34. Final Heating & Air Conditioning - 1Ij - 35. Final Gas Pipe-Test • 36. Hood or Canopy - 37. Final Factory Fireplace • - dl 38. Final Plumbing • i , 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final •c , 42. Backflow Preventer - 43. Backflow Irrigation 44. Landscape Irrigation System - - • 4 •45. Sound Attenuation '! '46. Handicap Regulations • - - ' 47. FINAL STRUCTURE & BUILDING i' •-; L ' I 48. Special Requirements Completed • • . ^ - .r 49. Electric Release to Edison -.- 50. Gas Release to Southern California Gas Co - , 51. CERTIFICATE OF OCCUPANCY ' i, - 1 No. Date I � Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCT/ION PERMIT PERMIT 3 TRACT NO. LOT NO. UN12(1J0. 6409 9/30/87 8 Project Address aw F /CII `rT G l / ` App',`cant's Mailinay)Add,1ress /VUs/ .� • /'<i77�1�e1/��j/— (y TVPE OF CONSTRUCTION U NEW U ADO ALTERATION U REPAIR Owner's Name/�O&)C-( --1 xi OPJ�MP Ph ne- f S4 —SS? ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone 3 rVU =/s+/A.IQ 4rJP. s4,762 ,,/ . 9�, DESCRIPTION OF WORK/USE OF BLDG. AddressA p S Main Building: Accessory Building: Z Arch/Eng. License No. / TYPE OF PERM U GRADING ❑ FOUNDATION H STRUCTURAL T Front 0 Address ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N /I / 7'' ❑ OTHER Contractor's Name 4_,4//lrfa.t A- in/`4d••• Tic-Phone Pg, V// PROJECT DESCRIPTION 5(]. FT. OCCUPANCY C Right N Address(mailing//Si4)%a So. /C ys.l,a .-Cr rl{•re.. CG. Left R �f0737 7 C ON STRUCTION TYPE VALUATION$ $ City License No. `"`7777"`` / ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: KE s t a 947/6 l� Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code, and i[ass..JJJ J M my license is in full fo e an• effect. /, T Cense Clas Licen • No. 4'704/f1 $ dir .gate - — MP Signature -- '..— — !- PLUMBING FEES WORKERS'COMPENSATION DEC • -ATION Bar Sink Showers tap hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES tap of Workers' Compensation Insurance, or a certified copy thereof (Sec Ion Backflow Preventer Service Sink 3800, Lab. Cy �+�7 C r . Automatic Washer Transformer 0 15-50 KW \ Policy No. (� �/ f Company�J �C /-"`V�/CCii(! Backflow Irrigation Sewer • 0 50+ KW \5 Cap Construction Pole Sub. ertified copy is hereby furnished. `, eerPy4i—Sif copy-is filed with the city Bu din - .ivBathtubs Sewer Connecti• Cooking Unit Meter ❑up to 100 amps Date (- >•+r7 Applicant -�^� / ;4°22:4 _ , EXEMPTION FROM WORKERS'dCCi TION DECLARATION Clarifiers Solar Dolle ors Dishwasher Meter Dover 100 amps (This section need not be completed if t petmlt is for one hundred ($100) or less). Dishwasher Solar P'•ing - Dryers ❑Gas ❑Electric Sub Panel 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 Drinking Fountains Sol Tank Fan Motors 00-1 HP DIA-8 Workers' Compensation Laws of California. _^ Date Signature Floor Drains S imming Pool w/Spa a. F.A.U. Inc.Solar ❑9-15 HP 01615+NOTICE:If,after making this declaration,you should become subject to the - - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal S FixturesMicrowave / comply with such provisions or this permit shall be deemed revoked. CO CONSTRUCTION LENDING AGENCY . Gas Service Outlets Water Closet ''/ Device Boxes Pole Light I hereby affirm that there is a construction lending agency for the performance - / g of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 3 Outlets Lender's Name _ Range +� Lender's Address Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash / following reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays • Generator ❑0.5 KW ❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit P to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains' the Contractor's License Law(Chapter 9(commencing with Section 7000) of (•j 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 LIe nalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES 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 - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0 • sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date • pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Data • 1prove for the purpose of sale). U I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeratio ystem Application Issued By �yDat� tractors to construct the project (Section 7044, Business and Professions Code: t f The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-1 :APO BTU 0100,000 BTU SUMMARY OF FEES 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 System ❑ Multiple❑ ystem Repair/Alteration - BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ _ PERMIT ❑ 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE $ _ PLUMBING $ Date owner Heating System& Ducti f Registers .PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 0o-100,000 BTU 0,000 BT nn GRADING $ • information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ ,40 0n('� and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 5f1% $ ` • �l% MICROFILM $ • sentatives of tis c to nter Pon the above-mentioned property for A Inspection Pur oses. p ^]�� MECHANICAL $ TOTAL FEE $ U . iyO Signaturen Pur os,, Datq/—�1/"�)Drivers' iceC ns€or SS t Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION 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-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, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Lind& 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/.bf/� C/, 67. Fencing & Access Approval 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT , - 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-.Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank ❑Gas 0 Oil ' 25. Roof Sheathing r74. 'Overhead Hydro I. • 26. T-Bar Ceiling (Structural) & Monocoat :/75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe , 28. Lathing & Siding 77. FIXED SYSTEM FINAL 7 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing • HEALTH DEPT. REQUIREMENT i 31. Plaster Brown Coat 79. FINAL INSPECTION .- -- . . 32. Electrical Power Meter-Final FOOD CERTIFICATE ISSUED 33. Final Electric 04947 C Notes: . 34. Final Heating & Air Conditioning I . 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 143. 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 I : • 50. Gas Release to Southern California Gas Co ,' , 51. CERTIFICATE OF OCCUPANCY No. Date