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Home My WebLink About168 23RD ST - Building Permits Applicant to(ill in all spaces except those within heavy border Imes and sign all appropriate declarations. 39—/i . t- 'I:IT-V F COSTA MESA CONSTRUCTION PERMIT Lg MIT NO. _ TRACT NO. LOT NO. UNIT NO. Proteel,;ddress /68 E. 23_A Jr �'��t D3-189 S D A.P.# fP 26I — 63 , o� zone /L2 -5-7$ N. AYMH CT 42 20 IS`.4, TYPE OF CONSTRUCTION X NEW U ADD U ALTERATION ❑ REPAIR $ Main Building: Accessory Building: /�pplicanl's Mailing Addresl ¢ E i z dwner's Name Al _Wb7G/✓G CP�r, 0e s¢8- 02?� ❑ CONVERSION IE ID T Front 2Q 0 Address//3 7re c��4-O4 X�.�s�Ot. /!/�t #J,ay Q co/,a4. 5- DESCRIPTION OF WORD/SE OF BLDG- a B Rear �/ G f l N Arch/ang. geill4&� /en OT/-1‘74111/1-_/ icense No. TYPE OF PERMIT IN GRADING II FOUNDATION � STRUCTURAL C Right �j G Address PC '• /774/N S%• F/ ZOd/.1241V 2.4. 4-14/4 44. ❑ TENANT ❑1 ELECTRICAL ❑ PLUMBING G��❑ MF_CH ANICAL $ Left G"�� R 0 OTHER 11 j3 515 Cc/ — Ping.Ref.+ y. Parking Contractor's Name Phone , G y- / -( D e�•� Req./ProvidedHD E U PROJECT DESCRIPTION SQ. FT. /�'Q'' OCCUPANCY , -1 4 Q Address(mailing) 0/ IO tanning Notes: ("I pro• PL,C,I Mai 9 - M / CONSTRUCTION TYPE 'T. VALU TION[$ C FIb N `L City License No. ZONE /Q_2 GRADING CU.YDS. A E d --- LICENSED CONTRACTOR DECLARATION I • /� �1_ n( 1 S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: N^ ('''_ p^} �1 I, n �p,p LL.,a +a LI2- 1r'•�eIDfe IO.CdeVe. (e\O a/Se with section 7000) of'Division 3 of the Business and Professions Code,and V c -i-ets. C 1 051 pa...9 ct— 16 --Ub my license is in full force and effect. �s ^ ` �� .—pR I— ELECTRICAL FEES License Class License No. +'"1' O I FEES Automatic Washer Transformer 0 15.50 KW Date Signature PLUMBING WORKERS'COMPENSATION DECLARATION 0 50+KW Bar Sink Showers Construction Pole Sub. hereby affirm that I have a certificate of consent t0 self-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter r❑up to 100 amps .800, Lab. C.) • • Dishwasher Meter Dover 100 amps Policy No. Company Backflow Irrigation Sewer Cap �- , 8 Certified copy is hereby furnished. • ' ' Dryers OGas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant - - Fan Motors 00-1 HP ❑1%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers $olar Collectors , (This section need not be completed if the permit is for one hundred ($100)or F.A.U. Inc.Solar 09-15 HP 01615+ ' less). Dishwasher Solar Piping I certify that in the performance of the work f r n�}lch this permit Is issued, I - Fixtures Microwave 5 shall not employ any person In any manner f c e subject to the - Drinking Fountains Solar Tank , workers' '-LI nsati La sof California. Device Boxes Pole Li ht Date 3-LI - R4 i9nature / • / Floor Drains Swimming Pool-w//Spa. -" r 9 ' • NOTICE:if,after mak ng this declaration, you s uld b c e subject to the Outlets Range Compensation provisions of the Labor Code, u must forthwith Floor Sinks Urinal - comply with such provisions or this permit shall be deemed revoked. $i n CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches '. g I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal- - Standing Sections Lender's Name Lender's Address ' Kitchen Sink Water Service - Generator 0o-5 KW 05-15 KW Trash Compactor• ' ' OWNER BUILDER DECLARATION - f n affirm that I amOn exempt1.5from the Contractor'sofioLicense Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays - any structure, prior to its issuance, also requires the applicant for such permit • . -to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)of - s Division 3 of the Business and Professions Code) or that he/She is exempt Reinspection Fee' $15 Issue Fee $ 3 C {f O31.5om and the basis for the alleged exemption. Any violation of Section - 'I'yi'I031.5 by any applicant for a permit subjects the applicant to a civil . chatty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: / U I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By (nr nate�`'2' compensation, will d0 the work,and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL l FEES .Building Approved By (3S1 Date I --):1• License Law does not apply to an owner of a property who builds or improves (_.� 2 q ,�7 1 thereon, and who does such work himself/herself or through his or her own Application Issued By 7J ase Date3-22-1"2'I lL..�l 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 com- Canopy Type II ❑ ' ' • SUMMARY OF FEES Motion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground •1Q,s �� ave for the purpose of sale). - ` _BUILDING PERMIT $ /7 21-4e-2 SMIP $ LO I LZ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System p�" PLAN CHECK at* '1 TOe-c-•� PERMIT ((doctors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not applto an owner of property who Duct-Ventilating ❑0-100,000 BTU 0100,000 BTU PLUMBING $ _ Cob 03 ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. - - ELECTRICAL - $ GRADING $ is am exempt under Section B. & P.C.for this reason/ Firepl/Fact.Blt. ICBO 4k Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date -2-.1- Ry( /Owner 44_ al Heating System&Ducting Registers MECHANICAL $ TOTAL FEE $ ''h7 1 hereby certify that I have read this applica •n and e that the above 00-100,000 BTU❑100,00087 �J '�n 11information is correct. I agree to comply with -II city a d ounty ordinances PLAN CHECK 25% $ L and state laws relating to building co struction,and her y authorize repre- sentatives of this cit o ant u above-mentioned property for Inspection purposes. / �/ I, _ Signature ate OJ-21-01! - I1S3� XG�(O� . v:� •" ._ ..__ .•,37iq 7,- -"-- .. ,..- ___- Drivers' License or 55 9t r _� Reinspection Fee I $15 Issue Fee $ 3 SVC-S S` xs,..13p �..- .; ^f OO / / G.. _i t19- TINEf GSt/i 0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor ( r i. EON&SRUCTION AND PLANNING POC s SPA 1 I Date Inspector Date Inspector *APPROVALS, Permit # .- APPROVALS Permit# - 0'remporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pirie-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. 74y 57. APPROVAL TO COVER-GUNITE ..7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation amp 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 Can 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 ;' 1 70. Underground Hydro 22,„Ducts, Ventilating - ' 71. Product Piping 0 Gas ❑Oil 23: Gas Pipe-Rougtp& Test -- 72. Underground Flush ,24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing• • • II e6Gp1pn� �� 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat '" 75. Dry Chemical I 27. Frame and Flashing . 01Z05q 76. Dry Standpipe 28. Lathing &Siding , ; 77. FIXED SYSTEM FINAL 29. Insulation 0-7 z4e) 78. FIRE PREV. FINAL 30. Drywall Nailing f`r• 2.5"2: HEALTH DEPT. REQUIREMENT e1 31. Plaster Brown•Coat;rr '1 79. FINAL INSPECTION 32. Electrical Power Meier-Final 7/ 80:• FOOD CERTIFICATE ISSUED 33. Final Electric 'J' Notes: I 3 ' 1-IV ► . -& 2-cern 34. Final Heating & Air Conditioning Raeeoa\ Fcq7nh-9 Og- Pc%. Dat. _ `-.., 35. Final Gas Pipe-Test Pc.Vr,3, -s 4-4--5°c 36. Hood or Canopy I 37. Final Factory Fireplace - o67-4,91 F/2e✓Au UNI: CI Or= c iTC/llG 38. Final Plumbing . .' f OlJL11/Sr'�iAt9 ill All.[ /L..--‘ ovnlp' 39. Water-Service-Final • - • 40. Gas Service-Final 0707 c-1 Olt- TO o1'-'-i(�!�L '2, f-iii nL/> . - 41. Solar Domestic-Final - - - - ._/ 0-11S'%b DL`-.L.kl.L A(QO� p/S� 42. Backflow Preventer ; r ' \� >` az- A9 . ' 43. Backflow Irrigation - 44. Landscape Irrigation-System •- 45. Sound Attenuation 46. Handicap Regulations / 47. FINAL STRUCTURE & BUILDING slu/ 0 fr - 48. Snecial Requirements Completed Lb it) v _. 49. Electric Release to Edison ' • j 50.-Gas Release to Southern California Gas Co - 'i l' 51. CERTIFICATE OF OCCUPANCY . • . i No. Date __ .-. U ' ` +o f �nfIE I:4 t i enr��-Na-t J:P e rx ";c 5 -,^-•3 `,x'x "i4-4V-! `'i`r ^a.. t i � er ' - irSURVEYIN,G A V , „ t -� i4 , F A iS 1 .. 'RON MIEDEMA - _ -7. i' p d47 E 17TH.Stree[ • • ,`r.1 ° - \ Cota'Mesa CA 92627 . „ ;j r ` r ,�e., y ”` � 3 7Y'4/5483881 x 4-'17; �L54653- \ ' \• f fi r 'January '11 , 1990 :: , City of Costa Mesa ...7, „,,,,,,.,,,,,,, < Inspection ..Dept , ;'D+ r Ej -' • - 'r t ,• Reference Project: • Condominiums located at 168 E 23rd Street,'{f , • - - Costa Mesa -;:;__;;•'•-••••:',..,,,,;?:?;;;:. f4i -c M v.� GwF y ' Wt ...• -iI j __:,-,, ,- ,..,;subject:, Fin al Grade Certification ;�a .>s , ��\ i \ To Whom it may concern; ' - i I have checked the final -.grade -for this-,project- ,and have-.found I 1 that -the 'gradeng and concrete:_flat work is substantially_ in : I conformance',wi'th 'the approved :grading plan ,c '� 4 J '.O F t,a Lr .•U _n .1.,...",t1,1/4;.., RF t ..d rwr eF .°. ,t 3 'G� e Et d' . T9 e .,M er: 4. �{ .1\«r3 !.:-:- ! f- i i 1 ut .i'-'' Sincerly , sr JC _ •• Ron Miedema L S 4653 -, i1,-"16;;C::... > .4 s... r n � , c frY 8 0 9r *' w:r v ,,:-.‘,e;. N _RON MIEDEMA ! :,, ,<, r; - t jl QrYI I EXP'DATE? 9/30191 .,- ! ) CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRICT ' Developer/Applicant : 64/6 COi+-Po24-j-/o4/ • Address : /37r 44'G11X7 Ple/vim � /y/:W/'o4-T aeC/-/ C4 • f2C(o Telephone Number : 7/5/ - 551 - 023c Tract/Parcel and Lot Number(s) : %,j,' 9A- Z;7 — o•J/oaf Location of Project : ("8 C 2-..? "'d 5T• - GD574 A9554 3;75-2- Number of Square Feet of Residential Space 0e�0 2• V6r x $1 . 50 Total r ' y.9Z . dl .J, 25& Number of Square Feet of Commercial and Industrial Space / x $0. 25 Total Commercial/Industrial Project is : (Check One) • Mini-storage Motel Preschool Movie Theater Bank Auto Repair Racquet/Health Neighborhood Shops Hospital Warehouses R & D Large Office Heavy Industrial Hotel Office Bldg. Regional Shops Medical Office Restaurant Light Industrial Office Park Fast Food 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 to2wport-Mesa Unified School District . si, jar:WI) HRisiness Manager Newport-Mesa Unified School District The above representation as to square footage is true . Developer/ Applicant agrees that if it is later determined that such representa- tions are not true then this certificate shall automatically terminate and the appropriate/ City/County shall be notifi • . . Date : IM, Devel. per/Applic. nt .19 y ft/ oA, ✓2. 'FIELL SOILS TECHNIICIAN DAILY REPORT roo' Soils Technician: Job No: Submitted to: Client: / . Total Field Time (hrs.): � Date: ' Approved By: /Go Z 3' f re/ �s/a ,c COMPACTION TEST RESULTS ELEV.OR MOISTURE DRY DENSITY RELATIVE SOIL TEST NO. LOCATION OF TEST DEPTH OF TEST 1%) LBS./CU.FT. COMPACTION TYPE Remarks: (Re) /177 sc. -a6aC_ /-%4#, ars---ate; - 71 4 2/2/ar=-/e �f�e p „A e- g. �l ec //i Com/.✓ //'lJ.`�.71; / v p Petra Geotechnical, Inc. Job No.: • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ' PERMIT NO. TRACT NO. LOT NO. UNIT NO. � rj of COSTA MESAaaCONSTRUCTION TION PERMIT �o roc lob A.P.# U3q �1 _ 031 0¢ Zone Rz. P,ry�ject Address «V fr/• i3 'f7 ,1 p��',1 1-- f S Main Building Accessory Building: Applicant's Mailing Addie i 378 GAther pg. N "1 gal Jit,TYPE OF CONSTRUCTION U NEW LI ADD U ALTERATION L I REPAIR n� •/ �� /1� �\ yup „' ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front W \G•VI"s &fit. 4. Lf.7Qst `s— O Owner's Name �•��/u�I r`� ��y�� y� ,P�honge �� pTION OF WORK/USE OF BLDG. A Rear QU I rte, �o N I. I Address IJ�•-�!'pi•...��^ t`ILl^' V�fL . w^1 { P v..-.'--- N Arch/Eng. License No. TYPE OF PERMIT LI GRADING ❑ FOUNDATION LI STRUCTURAL C Right O� 7 I - N G Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $ Left a 0 '/' 1 R • ❑ OTHER Ping. Ref.# -^. ki ing Req./Provided E Contractor's Name Phone / 11•'d_� ��rk O an\ PROJECT DESCRIPTION SQ. FT. OCCUPANC - PlanningNotes �1�` �7 42 Address(mailing) f `J CON STRUCTION TYPE VALUATIONS ��n YV `��•�'��'�y^��//,!` 1J /�I�^ �,-� I jjj�� M City License No. ZONE GRADING CU.YDS. ACRES _ ��C/Yl<'1• (- L04YL WZC-01S, LICENSED CONTRACTOR DECLARATION JJ ,�, � p I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: 2.4 3 lir rt-^�- 0.J- � vcot..l with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. • If �. 1 11-r�v.1l ts��., nG� q .'�G ELECTRICAL FEES License Class License No. � It•/S ^'°"^ ' �"" r ` D 1 Date Signature - - l PLUMBING I FEES Automatic Washer Transformer ❑ 15.50 KW WORKERS'COMPENSATION DECLARATION Construction POleSub. 0 50+ KW l hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers Workers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter Duo to 100 amps 0, Lab. C.) Dishwasher Meter Dover 100 amps olicy No. Company - Backflow Irrigation Sewer Cap 8 Certified copy Is hereby furnished. Dryers ❑Gas ❑Electric —J Sub Panel Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan Motors D0.1 HP 01%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. less). Ina Solar 09-15 HP 016-15+ I certify that in the performance of the work for wh h thi permit is issued, I Fixtures shall not employ any person in any manners o b• o : • CONSTRUCTION AND PLANNING POOI TA APPROVALS Permit Date Inspector APPROVALS Permit# f Date Inspector 1. Temporary Electrical Service or Pole I+ 52. Pool & Equipment Location • 2. .Soil Pipe-Undrgrnd. 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. , 54. Forms r 4. Electrical-Conduit-Undrgrnd. 55. Electrical Bonding r. 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE T. Footing`s - Z_2.,- _ 58. Electrical Conduit-Undrgrnd. 8. Foundation 09.� ' �� t 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 Cep 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rotigh 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 Condifionirig 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 y 79. FINAL INSPECTION 32. Electrical Power Meter-Final - - 80. FOOD CERTIFICATE ISSUED -33. Final Electric • , Notes: y/ � /e�f- e�J 34. Final Heating & Air Conditioning _ �CS� /Gy y /J 35. Final Gas Pipe-Test �/�D��f..XA� / ':'Ll/// 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 S/zt/90 p7� 48. Special Requirements Completed I/ ai w 49. Electric Release to Edison / 50. Gas Release to Southern California Gas Co • .51. CERTIFICATE OF OCCUPANCY • r• No. Date 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . - s. CITY OF COSTA/At ' RUCTION ERMIT PERaT NO. TRACT NO. LOT NO. UNIT NO. "Project Address RAO -• :i JVI' S� v 3 /p1 DO A.P.aW Zona• S Main Building: Accessory Building: TYPE OF CONSTRUCTION 'moi NEW U ADD L I ALTERATION LI REPAIR E " Z Applicant's Mailing Address je ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front 0 Owner's Name �� Phone�•�%n"f�h/ DESCRIPTION OF WORK/USE OF BLDG. —Pie x A Rear N AddressfI 0 Arch/Eng. - --- License No. TYPE OF PERMIT L GRADING FOUNDATION LI STRUCTURAL ' K Right G Address CD TENANT ❑ ELECTRICAL .�jl PLUMBING ❑ MECHANICAL S Left R Contractor's Name/Fl9ec/t/�Y P. . /.di:. Phone.77//I4.S ❑ OTHER' I Ping. Ref.# Parking Req./Provided R Address(mailing)/t*Ct/ CZ$/f2ZAV GT T. PROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes: M 74/2/71 CONSTRUCTION TYPE VALUATION$ City License No. T/Gr'/71 ZONE GRADING CU.YDS. ACRES T LICENSED CONTRACTOR DECLARATION /� �jI S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing P eiarks: r) 37295— with section 7000) of Division of the Business and Professions Code,and r my license is in full force and eft ct.. -9,02:„. ELECTRICAL FEES License Class --sG &' License No ,3/��-n� Date�^•' Signature /3✓7...9.1./-/ /CZ /'---/ PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS'COMPENSATION DECLARATION POIe Sub. 0 50+ KW I hereby affirifT,that i have'a certificate of consent to self4nsure or a certificate Bar Sink Showers C4j " Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter Due to 100 amps 'au---.00, Lab. C.) Backflow Preventer Service Sink f' Dishwasher Meter Dover 100 amps • 'v'il Ce No.d cop A-"¢%s/.7 -Clsd Company F,�F i 71/� Backflow Irrigation Sewer Cap 1 p "g Certified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel LI Ce1r ified copy'sled with the city B ,ildin DiviSlon. V 9 Bathtubs _ / Sewer Connection a3.t o Date EXEMPTION FROM 7 Applicant M 'IInt? _(�, /�C - Fan Motors 00-1 HP Di 4-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers • Solar Collectors (This section need not be.completed if the permit is"tor one hundred ($100) or F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ less). - Dishwasher Solar Piping R. D 0__ I certify that in.the performance of the work for which this permit Is issued-i Fixtures shall not .any person In any manner so as to become subject to the Drinking Fountains Solar Tank - Microwave Compensation Laws of California. 1 • • Date' _ Signature -r Floor Drains Swimming Pool w/Spa Device Boxes , .-9 '"/. .. . Pole Light NOTICE: If,after making this declaration,you should become subject to'the - - Outlets Workers' Compensation provisions of the Labor-Code, you must forthwith Floor Sinks Urinal • Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Sign Gas Service Outlets /3 Water Closet 3 OD 9 I hereby affirm that there is a is permit. lending agency for the performanceCly. C of the work for which this permit. is issued (Section 3097 Clv. C.) Interceptors 4 Water Heater e DC Garbage Disposal Standing Sections Lender's Name r1 Lender's Address g Kitchen Sink is. Water Service Iy'(^v DD Generator ❑0-5 KW ❑5-15 KW pa OWNER BUILDER DECLARATION 1, Trash Compactor I hereby affirm that I am exempt from the Contractor's License Law for the /7 Lavatories � Auto-Wash Nk o0 following reason (Section 7031,5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair ' P-Trap Laundry Trays any structure, prior to Its issuance, also requires the applicant for such permit to file a signed statement that he/she Is 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 'herefrom and the basis for the alleged exemption. Any violation of Section Reinspection Fee $15 Issue Fee $ 3 )31.5 by any applicant for a permit subjects the applicant to a civil puffy of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: 0 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 - Zoning Approved By Date for sale (SectionBusiness and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date License Law does notof 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 Application Issued By employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I ❑ Dat sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 elation, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground SUMMARY OF FEES prove for the purpose of sale). BUILDING PERMIT $ SMIP $ ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: ��// ^T The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTU PLUMBING $ jY- (- ISSUANCE $ builds or Improves thereon. and who contracts for such oroiects with a con- tractors) license pursue ns to the Contractor's License Law). I am aware that —Exhaust System 0 Multiple 0 System Repair/Alteration I . PLAN CHECK 25% $ ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO ' Fire Dampers / PLAN CHECK 50% $ MICROFILM $ TT Date Owner Heating System&Ducting Registers TOTAL FEE MECHANICAL $ $ 13,y,DL/ I hereby certify that I'have read this application and state that the above 00-100,000 BTU 0100,00087E information is correct. I agree to comply with all city and county ordinances - PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for . inspection puyes. Signature /` xn�a.'Pc714Date7j Ls n _ e� Reinspection Fee $15 Issue Fee $ 3 Js usO.l_•F_OC-00025501) TOT 124• e Drivers' Li nse or SS - r•E, ee 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor ME: �}s�3>1�p9 TIpE: �*A3i 'CONSTRUCTION AND PLANNING . POOL ?A APPROVALS Permit# Date 1 Inspector APPROVALS Permit# Date Inspector ,i • . 1. Temporary Electrical Service or Pole ////,, 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. fin r 53. Steel Reinforcement ( L Y �/�I 3. ,Electrical Cond t Utility-Undrgr,ntl. y 54. Forms ' 4. Electrical Conddit-Undrgrnd. l' • 55. Electrical Bonding 9 • . Steel Reinforcement. :, 56. Rough Plumbing & Pressure Test ; Electrical UFER Grnd.^ •57. APPROVAL TO COVER-GUNITE %�/ . Footings .. 58. Electrical Conduit-Undrgrnd. - , 8. Foundation - '. 59. Gas Pipe, 0 Undrgrnd.,Test j '1 9. Water Pipe-Undrgrnd. , •,RI/j y/d1 fffe60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK ' 1;1. Property Sewer Line & House Connection+07 D ;62. Backwash & Receptor-Final 12. Sewer Cap _ ` ,' / 63. Heater-& Vent-Final ' 13. Roof Drains o- ' 64, Plumbing System - Final •14. •Rough Plumbing.N . !0(/ y4 .1-07 65. Electrical-Final 15. Rough Electrical-Conduit -\ r 66.. Solar System-Final 1 . Rough Electric Wiring. 'r r� .� 9 7 67. Fencing & Access Approval L 17. Rough Wiring Sign ` 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL pi Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - J.2-6. Rough Factory Fireplace " . • APPROVALS Permit# 21. Ducts,in-Structure 70. Underground Hydro 22. Ducts, Ventilating 1- 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test AA ,- 72. Jlnierg(ound 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 ,,`. .r • 80'. FOOD:CERTIFICATE ISSUED 33. Final Electric t� ' Notes•. 'ri rZaK 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test 36. Hood or Canopy - 37. Final Factory Fireplace - 38. Final Plumbing //f/AS 39. Water Service-Final t/a//' a 40.Gas Service-Final - 41.-Solar Domestic-Final _ 42. Backflow Preventer "�' 43. Backflow Irrigation 44. Landscape Irrigation System '1 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 tho e within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION PERMIT PE79T NQ,s „ ^ TRACT NO. LOT NO. A UNIT N0. A P +Y, I Zone Project Address�lpa'^^� -� CJ� �� - �Y� _1'Lo�''G/►Y S Main Building: - Accessory Building: Applicant's Mailing Address TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIRZ IIICONVERSION ❑ DEMOLISH ❑ OTHER . T Front O Owner's Name 04/4 SUR ea- Phone - DESCRIPTION OF WORK/USE OF BLDG. A Rear N Address .-5:c7 ?-- TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL I C Right N Arch/Eng. License No. - I-IK G U Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING •MI ECHANICAL $ Left i/� _ /.(/G. / ❑ OTHER Ping. Ref.# Parking Req./Provided R Contractor's Nam: ..,--_[.....a.- < one / E Address(mailingl.F/�G OP// kis /.2-9C.?7. Cir PROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes: M �a CONSTRUCTION TYPE VALUATION$ T City License No. '��-59 ' (62.,...2-?/:: Z ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION i $ I hereby affirm that I am licensed under Provisions of Charter 9 (commencing Remarks: /Dee 42/T /YO• /�• .-37aJ/C - with section 7000) of Division 3 of the Business and Professions Code, and (/ my license is in full force and effect. IIII ELECTRICAL FEES License Class /C-•••2 0 ' ansa 51<e:77.'7/7/ Date/I./ate/27 e/27 Signature 4�� PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW WORK€€RS' OMPENSATION DECLARATION Bar Sink Showers Construction Pole Sub. 050+KW i.7. 'hereby affirm that I have a certificate of consent to self-insure or a certificate Workers' Compensation Insurance, o((( a certified copy thereof (Section Cooking Unit Meter ❑up to 100 amps 00, Lao. C.) _4c2- 6 Backflow I Preventer r Service Sink Policy NrQ/4 Ca_ C �l,,,o.T� �Om ./.� Dishwasher Meter Dover 100 amps {!/ panv,(.ry/, Backfl wlrrigation Sewer(:ap eCertified copy is hereby furnished. {p Dryers OGas ❑Electric Sub Panel1. Cert ifi opy is filed with the city B titling ion. Bathtdbi Sewer Connection Date ��9 Applicant ,'}`�,1� (�Ds/vl's's ?w (.�✓� Fan Motors 00-1 HP 011/2-8 EXEMPT FROM WORKERS'CO the per VON D CLARATION Clarifiers .-• Solar Collectors (This section need not be completed if the permit is for one hundred ($100)or Dishwasher Solar Piping F.A.U. less). Inc.Solar 09-15 HP ❑16-15+ I certify that in the performance of the WOrk for which this permit is issued, I ll Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California, Date Signature Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If,after making this declaration,you should become subject to the Outlets Range Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Switches Sign II I hereby affirm that there is a construction lending agency for the performance of the work for which this permit i5 issued (Section 3097 Civ. C.) Garbage Disposal Standing Sections Interceptors j• Water Heater Lender's Name -" Generator ❑0-5 KW ❑5-15 KW Lender's Address Kitchen Sink Water Service Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Businest and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for Such permit to file a signed statement that he/she is 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 Reinspection Fee $15 Issue Fee $ 3 herefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: flI, as owner of the property or my employees with wages as their sole Reinspection Fee • $15 Issue Fee Zoning Approved By Date compensation, will do the work,and the structure Is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL / FEES Building Approved ByDate License Law does not apply to an owner of a property who builds or Improves A ))) thereon, and who does such work himself/herself or through his or her own Hood or Type I 0 Application Issued By Dat •P0 Boilers;employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES pletion, the owner will have the burden Of proving he/she did not build or Im- Duct-Under Ground • prove for the purpose of sale). BUILDING PERMIT $ SMIP $ ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Re igeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: 2 The Contractor's License Law does not apply to an owner of property who '� 0.100,000 BT. ❑100,000 BTU 1�-0I PLUMBING $ ISSUANCE $ builds or imoroves thereon.and who contracts for such oroiects with a con- S - 1 tractor(s) license pursuant to Inc Contractor's License Law). I am aware thatIl Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ _ ENERGY P.C. $ _ proof of their Worker's Compensation insurance should be provided to me. ELECTfl ICAL $ GRADING $ ❑ I am exempt under Section B.& P.C.for this reason . Firepl/Fact.Bit. ICBG# ■ Fire Dampersen OF PLAN CHECK 50% $ _,r(`'�� $ HeatingSystem& Ductingg=•�:•'••�• g LTV Date Owner ® Y �� iii MECHANICAL $ 1 -� OTAL FEE $ I hereby certify that I have read this application and state that the above u{i 4100,000 BTU 0100,000 BIS (�.�� T information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ `.p U and state laws relating to building co• traction,and hereby authorize repre- lves of this city to enter -on the above-mentioned property for inspection p es. / Signature 'Or/ /V -��'--✓�� Date 5C 9 Drivers' License or SS Reinspection Fee I tI $15 Issue Fee (c $ �l]„=j.Ty—CP w.r'839 TOT 0865-46,rev. 5/88 White - Building; Canary -Applicant: Pink -Accounting; Goldenrod - Assessor . ;TE: f;), 'art: 1.7::-5 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 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush , . �I 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. 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 29. Insulation 78. FIRE PREY. FINAL r . 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 't f 33. Final Electric /'r Notes: %) 34. Final Heating & Air Conditioning /�/��yj ,�/ ar - - 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. Backf low Preventer .1' . 43. Backflow Irrigation i-.1• 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 1,•' 51. CERTIFICATE OF OCCUPANCY No. Date 1� Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. r1 PERM O. TRACT NO. LOT NO. UNIT NO. CITY OAdrs //ILSA ere C^ONSTF}�UC�QNPERMIT 1 39�Sq A.P.# Zone Project Address �A ere ..0 �� e�_- �J yV��--ee—�' - O NEWH ADO ❑ ALTERATION U REPAIR S Main Building: Accessory Building: Z Applicant's Mailing Address TYPE OF CONSTRUCTION • ,.✓/_ e �t�t ❑ CONVERSION ❑ DEMOLISH ❑ OTHER T Front O Owner's Name -17/1\1€2 Mt Phone �1 DESCRIPTION OF WORK/USE OF BLDG. . A Rear • N Address lr- I 1-1 Arch/Eng. License No. TYPE OF PERMIT LI u GRADING ❑ FOUNDATION LJ STRUCTURAL C Right G Address `�-��j `I _/ �••p / ❑ TENANT LM ELECTRICAL ❑ PLUMBING ❑ MECHANICAL a Left R Contractor's NameH1-.+4. *CO itS Eteeahoner !'�fl7(0 ❑ OTHER I Ping. Ref.# Parking Req./Provided E +•2/742-63:, �'� `S+ r PROJECT DESCRIPTION SQ. FT.S7SZ OCCUPANCY i Q Address(mailing) Ii0 'L•f YYtI S,Si Bs� (fl rtf-0 Planning Notes: M l (� C ON STRUCTI ON TYPE - VALUATIONS 'i T City License No. 30 �%[/ ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION A S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks -s/ d 1 /�-3 7 f"7 I. • with section 7000) of Division 3 of the Business and Professions Code, and �O�l-zvM' P' ,t/O - V a , my license is in full force and effect. (/ ELECTRICAL FEES License Class - License No. Date Signature PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS' COMPENSATION DECLARATION Sink Showers Construction Pole Sub. ❑ 50+ KW I hereby affirm that I have a certificate of consent to self-insure or a certificate - Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit 5 Meter Duo to 100 amps 1c 101 --r 00, Lab. C.) Backflow Preventer Service Sink (Y It Dishwasher L� /�Aeter Dover 100 amps roti ce No. Company Backflow Irrigation Sewer Cap pt p _ - Certified copy is hereby furnished. - Dryers ❑Gas ❑Ele lc )t' ub Panel - Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date ApplicantFan Motors❑0-1HP ❑1%-8 • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors / (This section need not be completed if the permit is for one hundred ($100) or F.A.U. Inc.Solar 09-15 HP ❑16-15+ less). Dishwasher Solar Piping b, I certify that in the performance of the work for which this permit is Issued, I — ' / Fixtures shall not employ any person in any ne so as toj ec• e sub ec to the Drinking Fountains - Solar Tank 1 Microwave 3 Workers',�OCo a sat' ws of Ca ../ Date (o- i"FaSignatur. .r. arm 0101nt- Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If,after making this declaration, you should become subject to the - • Workers' Compensation provisions of the Labor Code, you must forthwith Outlets Range Floor Sinks Urinal g b comply with such provisions or this permit shall be deemed revoked. 14. �� s CONSTRUCTION LENDING AGENCY T Switches Sign 3,00 Gas Service Outlets Water Closet g I hereby affirm that there is a construction lending agency for the performance Garbage D s osal of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9 P Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service , Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or q county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Rte //,,1�[sy�t ' //� any structure, prior to its issuance, also requires the applicant for such permit 4�-:' -I ' — FA to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains l/ the Contractor's License Law(Chapter 9 (commencing with Section 7000) of - y Division. 3 of the Business and Professions Code) or that he/she is exempt - Reinspection FeeI W tC $ '-•erefrom and the basis for the alleged exemption. Any violation of Section P $15 Issue Fee 131.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). I 3 DEVELOPMENT SERVICES REQUIREMENTS: 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee ! $15 Issue Fee $ compensation, will do the work, and the structure is not intended or offered Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL - FEES Building Approved By Date License taw does not apply to an owner of a property who builds or improves / thereon, and who does such work himself/herself or through his or her own Application Issued By Date 403247 employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 Ci) sale. If, however, the building or improvement-Is sold within one year of com- Canopy Type II 0 SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • prove for the purpose of sale). BUILDING PERMIT $ SMIP $' ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: _ __ The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- ENERGY P.C. $ tractors) license pursuant to the Contractors License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration F PLAN CHECK 25% $ proof of their Worker's Compensation insurance should be provided to me. ELECTRICAL $ I�� .S GRADING $ 0 I am exempt under Section B.& P.C.for this reason — Firepl/Fact.BIt. ICBG# Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date owner Heating System& Ducting Registers I hereby certify that I have read this application and state that the above 00-100,000MECHANICAL $100,000 BTU 0100,000 BTL TOTAL FEE $ / / Y/ .�1 information is correct. I agree to comply with all city and county ordinances - PLAN CHECK 25% $ and state laws relating to building construction, and hereby authorize repre- sentatives o s ty to e r th Ove-mentioned property for • ' inspection ur se / �.5 /� _ SI nater • Date(G/ er / I Ja3:2'�. g / / Reinspection Fee $15 Issue Fee $ 3 tl 1 - 112036$79 Tray y 1�i.,v,j . J Drivers' License or SS/7 , 1 CTE: f1,/ZC/gg TINE: 1.; _ 0865-46,rev. 5/88 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL _ .PA .L�PPROVALS 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. Electfical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding : S 5..Steef Reinforcement • 56. Rough Plumbing & Pressure Test j _ 6• Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE .. . • 7f1Footings / _ , 58. Electrical Conduit-Undrgrnd. - - • 8. Foundation / • , 59. Gas Pipe, 0 Undrgrnd.,Test • • 9. Water Pipe-Undi-grnd. • ). 60. Backwash Lines, P-Trap, 0 Undrgrnd. e • 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 Solar System-Final 16. Rough Electric Wiring 7-2.--5216*** f-`^� . Fencing & Access Approval flu} Rough Wiring Sign 68. APPROVED FOR PLASTERING 18! Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19C Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT Ttii 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 :t' 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 f0,_iern ,C80. FOOD CERTIFICATE ISSU / 33. Final Electric 4A'194f cC otes: 7.749rc' tt $ A _mei,y 34. Final Heating & Air Conditioning ///lll 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 -L_. l J 42. Backflow Preventer • 9 43. Backflow Irrigation C.-re- ) ';1 44. Landscape Irrigation System ,� ".,T 45.,Sound Attenuation ) K 46. Handicap Regulations -� 47. FINAL STRUCTURE & BUILDING 1 • 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co -'� 51. CERTIFICATE OF OCCUPANCY _ '"i V t y, /; • No. Date 3 O < ; f- 1 4 1 r !: '--t Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. — 1111114111111 CITY O TSTA MESA `CONSTRUCTION PERMIT PERMIT-1� NO. TRACT NO. LOT NO. UNIT NO. A.P.Yak Zone 'Proyect Address Al/6 D ti 27 o S` 7'- .1ss' 7o'77 - -f r f S Main Building: Accessory Building: Applicant's Mailing Address 777 6 LLf/r TYPE OF CONSTRUCT O U NEW ❑ ADO U ALTERATION U REPAIR E Z /�a'''41.03' // ❑ CONVERSION DEMOLISH ❑ OTHE• T Front O Owner's Name //N' GO'�• - �// 4 Phone Y 70 / 0 SCRIPTION OF O-K/USE OF BLDG. • - �o - A Rear N Address /37s CNA* g�vfi % • . ' .kL- _ �J0A/ 02 ,t,. 2 g et- TYPE OF PERMIT NI GRADING li FOUNDATION IN STRUCTURAL C Right Arch/Eng. nse No. K G Address S7{/� -? /� IstriN -arT- - / TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL S Left Contractor'sQ{de•' one h a 7Y ,'OTHER /JjrG �O ,/70,1/ Ping. Ref.# Parking Req./Provided E Address(mailing) r O�///L` '/4 . t PROJECT DESCRIPTION SQ. FT. OCCUPANCY ?..`a u Planning Notes: M CONSTRUCTION TYPE VALUATION$ 11f10N ......c.._ T _City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION S. 1 here• affirm that I am licensed under provis •• - harter 9 (commencing Remarks: with sec -- 7000) of Division 3 • :usiness and Professions Code, and .8..4.•...10 1.s. _at . n•el__ my license is in • • ce .-- ect. ELECTRICAL FEES y License Class •✓� Licenr Not'' PLUMBING FEES Automatic Washer Transformer ❑ 15-50 KW D ' Signature WORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. 0 50+KW i hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers o' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter Oup to 100 amps , Lab. C.) , Dishwasher Meter Dover 100 amps -e No. Company _ __ Backflow Irrigation / Sewer Cap p BCertified copy is hereby thr he Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date ApplicantFan Motors 00-1 HP 01%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100) or F.A.U. less). Dishwasher Solar Piping inc.Solar 09-15 HP 016-15+ I certify that in the performance of the work for which this permit is issued I Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' LLom pensation Laws of California. ,(�/�/L hje Device Boxes Pole Li Date /--t.)- -9% Signature /% 4 t/ Floor Drains Swimming Pool w/Spa NOTICE: If,after making this declaration, you should become subject to the — Outlets Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal ange comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY GaS S¢rvic¢ Outlets Switches• Sign I hereby affirm that there is a construction lending agency for the performance Water Dldut 9 i of the work for which this permit is Issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name �i Generator 00-5 KW❑5-15 KW Lender's Address Kitchen Sink Water Service Trash Compactor I OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to its Issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains 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 Reinspection Fee I $15 Issue Fee , th=refrom and the basis for the alleged exemption. Any violation of Section $ 3 ' .5 by any applicant for a permit subjects the applicant to a civil ty of not more than five hundred dollars($500). I DEVELOPMENT SERVICES REQUIREMENTS: L- 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 Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By . Date License Law does not apply to an owner of a property who builds or improves QQ thereon, and who does such work himself/herself or through his or her own Application Issued By ate j__-r rl — 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 ono year of com- Canopy Type II ❑ 11a"+� SUMMARY OF FEE pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground . ar— „n)roye for the purpose of sale). BUILDING PERMIT $ ” f.00 SMIP $ UtI, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System tractors to construct the project (Section 7044,Business and Professions Code: PLAN CHECK $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100;000 BTU ❑100,000 BTU PLUMBING $ r , 00 Ofd ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con-tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 ystem Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof • �✓ oftheir Worker's Compensation Insurance should be provided to me. I ELECTRICAL $ GRADING $ (a l am exempt under Section ]CB.& P.C.for this reason Firep/Fart.Bit. ICBG# Fire Dampers MICROFILM $ PLAN CHECK 50% $ Date !✓�-y that Owner // ✓ / / Heating System& Ductin Registers MECHANICAL $ '•� •.$'R� I hereby certify I have read this application and ate that the above 004 00,000 BTU 0100,000 BTL TOTAL FEE $ Y Information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ • and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for Inspection purposes. ///,,� Signature L(tG �� Date /'- Reinspection Fee $15 Issue Fee $ 3 Drivers' License or SS / ; ') 01 00023696-00023698 TOT 33.50 0865-46,rev. 5/88 White - Building; Canary - Applicant; Plnk -Accounting; Goldenrod - Assessor DATE: 01/05/89 TIME: 11:33 I POOL P "DA CONSTRUCTION AND PLANNING, , APPROVALS Permits ` Jate Inspector APPROVALS Pen....# Date Inspector fTemporary.Electrical Service`or Pole 52. Pool & Equipment Location I 2. Soil Pi a-Undr rd. P 8 P 53. Steel Reinforcement 3:'Electrical Conduit Utility-Undrgrnd' 54. Forms • 4: Electrical Conduit-Undrgrnd. , 55. Electrical Bonding , i ,, 5.-Steel Reinforcement ; 1 56. Rough Plumbing & Pressure Test . 6. Electrical•UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings, ' - - , Conduit-Undrgrnd.58. Electrical Cduit-Und • • 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test . 9. Water Pipe-Undrgrrid. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor•sSystem : 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!ireplacei, I APPROVALS Permit# 21.r Ducts,'in Structurer 70. Underground Hydro _ 22. Ducts, Ventilating ,l h. 71. Product Piping 0 Gas 0 Oil r-- 23. Gas Pipe-Rough & Test72. Underground Flush r _ 24. Roof Framing - /I,- 73. Undergrnd.Storage Tank 0 Gas 0 Oil • 25. Roof Sheathing i : ) 74. Overhead Hydro 26. T,Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing l 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation ' 1/ 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat._ , 79. FINAL INSPECTION 32. Electrical Power Mefe1-Final ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: , 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final i 40. Gas Service-Final , 41. Solar Domestic-Final 1. I,r -J 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation - 46. Handicap Regulations • • •. , , 47. FINAL STRUCTURE & BUI LD I NG aang -f �,127C .y 48. Special Requirements Completed ,(mrd ��J \ L49. Electric Release to Edison 1 I 50.'Gas Release to Southern California Gas Co \51.'CERTI FICATE OF OCCUPANCY Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ammo PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY CFLOSTA ME/S nA CONSTRUCTION PERMIT - {�j�_c� A.P.# I Zone Project Address 16 U v, �s23 A� j/'zorir ,B— 3 7 0 7� ( S Main Building: Accessory Building: Applicant's Mailing Address �7 3- G Xy a- TYPE OF CONSTRUCT 0 U NEW U ADD U ALTERATION U REPAIR '/ CI CONVERSION DEMOLISH ❑ OTHE• ' T Front 0 Owner's Name ��/L�. Ux� °ani• Phone Arv-ro '7 �� -, 7 S B Rear N D CRIPTIONDF ORK/USE OF BLDG. Address _:a .•r ' ' v ,fl40//Iib *v 'fie- ('` /6 ems• s-mo, A 1 �11 :4-/ _ i �r C-P-7/( TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑ STRUCTURAL I C Right N Arch/Eng. _ 'erne No. K G Address /f N' ,ngm, .ff.►� T CI TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' s • Left R Contractee hone 7GO'tr2f I$1 OTHER D/MOG7TJO4/ Ping. Ref.# Parking Req./Provided E [a �2 �,��/��v/a- PROJECT/ DESCRIPTION SQ. FT. _ J OCCUPANCY ACC=3 Planning Notes: 0 Address(mailing) a' T --"" CONSTRUCTION TYPE ✓N VALUATION$ //000 9 M City License No. T ZONE GRADING CU.YDS. ACRES S. LICENSED CONTRACTOR DECLARATION I here:• ' m that I am licensed under •r• 'sions of Charter 9 (commencing Remarks: /� with section 71.. . •' islon • e Business and Professions Code, and V 4- 4 s•/ S �—�+—� �-� ~� my license is in full for • ELECTRICAL FEES License Cl. 4 License Ny- Date -S-if Signature Mt 24/ I, PLUMBING FEES Automatic Washer Transformer 0 15-50 KW WORKERS'COMPENSATION DECLARA IONCOnstructiOn Pole Sub. 0 50+KW I hereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers Yorkers' Compensation Insurance, or a certified copy thereof (sectionBackflow Preventer Service Sink Cooking Unit Meter Cup to 100 amps 1, Lab. C.) A or Policy No. Company Backflow Irrigation / Sewer Cap 50,00 Dishwasher Meter Dover 100 amps BCertified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection r. • Date /te " Applicant Fan Motors 00.1 HP ❑1x-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred ($100) or Dishwasher Solar Piping F.A.U. Inc.Solar 09-15 HP ❑16-15+ I certify that in the performance of the work for which this permit is Issued, I Fixtures shall not employ any person in any manner so s to become subject to te Drinking Fountains Solar Tank Microwave Workers' Co ypen a Ion Laws of California//JJ • ��• Device Boxes Pole Light Date Signature /-/(•- p Floor Drains Swimming Pool w/Spa 9 NOTICE: If,after making this declaration, y should become subject to the Outlets Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range comply with such provisions or this permit shall be deemed revoked. • Switches CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Sign I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (section 3097 Civ- C-) Garbage Disposal Standing Sections Lender's Name Interceptors Water Heater Lender's Address Kitchen Sink Water Service Generator 00.5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P–Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000)of nivision 3 of the Business and Professions Code) or that he/she Is exempt Reinspection Fee ! $15 Issue Fee $ 3 -efrom and the basis for the alleged exemption. Any violation of Section 1.5 by any applicant for a permit subjects the applicant to a civil .alty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: .– 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 Zoning Approved By Date compensation, will do the work,and the structure is not intended or offered -- for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL ,FEES Building Approved By Date License Law does not apply to an owner of a property who builds or improves _ thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type I ❑ Application Issued By A. t II - - Dat – .– am.;,.; / employees, provided that such improvements are not intended or offered foryp - - sale. If, however, the building or Improvement is sold within one year of cpm- Canopy Type II 0 O SUMMARY 0 F 1S pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground .�–.r� pr for the purpose of sale). BUILDING PERMIT $ 1•S. Ot7 SMIP $ - 7 V 0i I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU PLUMBING $ it .OJ ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- — tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ pro of their Worker's Compen3�tio nsurence should be provided to me. ELECTRICAL $ GRADING $ OJ-1 am exempt under Section //4 B.& P.C.for this reason Firepl/Fact,Blt. ICBG# re Dampers PLANERICALK 50% $ MICROFILM LM $ ADate Q.�S Owner Heating System&Ducting Registers MECHANICAL 33 t So I hereby certify that I have read th s application and state that the above 00-100,000 BTU 0100,000 BTL $ TOTAL FEE $ information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building construction,and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for inspection purposes. /J�itar I i Signature /_/ 7C�/fN f7 Date ••/� Reinspection Fee $15 Issue Fee $ 3 Drivers' License or SS# �� 01 00023693-00023695 TOT 33.50 -- 0865-46, 0865-46,rev. 5/88 white - Building; Canery - Applicant; Pink -Accounting; Goldenrod -Assessor DATE: 01/05/89 TIME: 11:32 ir•CONSTRUCTION AND PLANNING POOI .PA ,` /APPROVALS Permit#LDate Inspector APPROVALS Permit# Date Inspector .r ..,At. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd, 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd: - 54. Forms ' ' , 4.'Elect'rical Conduit-Undrgrnd. ,/ 55. Electrical Bonding • S. Steel Reinforcement ) . g . 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'Undrgrn.1. 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' i;)40 .P 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 _ .I 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING i8'. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 1• 9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough FactoryFireplace / APPROVALS Permit# _ 21. Ducts, in,Structure ) 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 1 23. Gas Pipe-Rough. t TJ -• 72. Underground Flush 24. Roof Framing 'I 73. Undergrnd.Storage Tank 0 Gas 0 Oil ` 25. Roof Sheathing I 74. Overhead Hydro 26. T-Bar*Ceiling (Structural) & Monocoat 75. Dry Chemical '- 27. Frame and Flashing .1 76. Dry Standpipe 28. Lathing & Siding i 77. FIXED SYSTEM FINAL 29. Insulation I 78. FIRE PREY. FINAL - ` 30. Drywall Nailing f. HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat I 79. FINAL INSPECTION 32. Electrical Power Meter-Finalc 80. FOOD CERTIFICATE ISSUED I 33. Final.Electric ., Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy ' 37. Final Factory.,F ireplace '' 38. Final Plumbing 39. Water Service-Final - 40. Gas Service-Final '• 41. Solar Domestic-Fin& --n• ., 42. Backflow Preventer I _ ) ' 43. Backflow Irrigation I •I 44. Landscape Irrigation System . - 45. Sound Attenuation - '-I. 46. Handicap Regulations 47. FI NAL STRUCTURE & BUILDING//1 7 m0 r-11--9",1 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 5`1. CERTIFICATE OF OCCUPANCY - No. _ Date i' t Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ CITY OF COSTA MESA CONSTRUCTION. � PERMIT - PEWIT NO. TRACT NO. LOT NO. ' UNIT NO. 95I B 9/O4/85 590r1 IL Project Address b g a3.►-d moi- a o_ 7�n ff � Applicant's Mailing A rens - TYPE OF CONSTRUCTION LJ NEW ❑ ADD_ LI ALTERATION LI REPAIR /11SP� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • A.P.# - • . I Zone Owner's Name. 1( Phone DESCRIPTION OF WORK/USE OF BLDG: ' Address S Main Building:, Accessory Building: Arch/Eng. License NO. - ' TYPE OF PERMIT ❑ GRADING FOUNDATION ❑ STRUCTURAL T Front ' 0 Address . El TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear • N {{ry�1.77 [p•�� e�/��` �'y� ❑ OTHER A Contractor's Namppit �yjrA" /'�+z(t(/ Phone•,/`jt>7"/!7(1� ,� C Right N • Address(mailing) 1�l- it Q Y l l • PROJECT DESCRIPTION SQ. FT. - OCCUPANCY `, .�(} 1 J CONSTRUCTION TYPE VALUATION$ S Left R City License No. ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided , I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: 0M with section 7000) of Division 3 of the Business and Professions Code,and my license is in f •r e and effect. T CSV License - .s - s -1 • L'ce se No. S I Date 4 ®• ' Signature print. i - I -l �I A PLUMBING FEES • WORKE'S'COMPENSATION DECLARATION 'Bar Sink Showers hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink . - - ' " i1300,--Lab.- )I'�_ (1�� 7� n IA_ Automatic Washer Transformer 0 15-50 KW I Policy No. FF/ Company odete f lho,• Backflow Irrigation Sewer Ca ❑ 50+KW _ U P j Construction Pole Sub. 0 Certified copy is hereby furnished, Cerci y i etwith the city Bp�ai i�ysi�jn Bathtubs Sewer Connection Cooking Unit I Meter Duo to 100 amps' Date (�/Iy,./d/(f Applicant (� ON 7V(DECLARATION L` EXEMPTION ROM WORKERS'COMPENSATION DERATIOClarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred($100)or less). Dishwasher Solar PipingDryers ❑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'/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+ r Workers' Compensation' provisions of the Labor Code, you must forthwith Floor Sinks . Urinal - Fixtures • comply with such provisions or this permit shall be deemed (evoked. 'Microwave CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet • I hereby of firm that there Is a construction lending agency for the performance .< Device Boxes Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors . 1 Water Heater a tr. Outlets Range Lender's Name 1 • Lender's Address . Kitchen Sink Water Ser• vice Switches Sign OWNER'BUILDER DECLARATION • 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 ❑45 KW❑5-15 KW any structure, prior to Its issuance,also requires the applicant for such permit Generator Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of • ROOf Drains 1 the Contractor's License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she Is exempt - 'herefrom and the basis for the alleged exemption. Any violation of.Section - _ /031L5 by any applicant for a permit subjects the applicant to a civil - enalty of not more than five hundred dollars($500). O 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 — ' 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). ❑ 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: I The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTU / • .' 'fSUMMARY 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 0 System Repair/Alteration -BUILDING PERMIT $ - SMIP $ proof of their Worker's Compensation insurance should be provided to me. s , PLAN CHECK $ '�^r-ter, PERMIT ❑ I'am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# • Fire Dampers PLUMBING $ '7-u V ISSUANCE $ ' Date Owner Heating System& Ducting Registers ' ENERGY P.C. $ I hereby certify that (.have•read this application and state that the above 00-100,000 BTU 0100,000 BTI. - n PLAN CHECK 25% $ - information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ GRADING $ and state laws relating to building construction,and hereby authorize repre- • f PLAN CHECK 50% $ MICROFILM $ r sentatives of this city to a ter upon the above-mentioned pr.perty f�ofr r ` inspection oufooSt vn f' i/ . . _ Date I -b7 _ MECHANICAL • $ TOTAL FEE $ L7c V r- { ,' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ .- APpllcanto Pink -Accounting: Goldenrod -Assessor .. - ‘-‘"A CONSTRUCTION AND PLANNING POOL a SPA / APPROVALS Permit# Date Inspector APPROVALS Permit# Date Insper �� .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 OF 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 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: /.- 29 -f 44•LY" /' - 34. Final Heating& Air Conditioning o 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final r • 40: Gas Service-Final ' 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation y= ' r 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 , I51. CERTIFICATE OF OCCUPANCY. I No. Date _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. P RMIT NO. - TRACT NO. LOT NO. UNIT NO. CITY of COSTA MESA CONSTRUCTION PERMIT A.P.# Zone :V. / ` z7.,-� .trine� 1 . 7 O ZS Project Address v� / '��/'/ - /O S Main Building: Accessory Building: Applicant's Mailing Address 43 / On- TYPE OF CONSTRUCT O LI NEW U ADD ❑ ALTERATION U REPAIR E Z Un6 "- �7•f�s / L �.1— Vali ❑ CONVERSION DEMOLISH ❑ OTHER , T Front O Owner's Name Phone J �' / `7 D CRI TION OF RK/ E OF BL G. /A�/YO 4/r/QN ac I 0 Rear N Address /37:5_ 646.4%7 n' 'CO/Y,�vyy`.`�,�, _ �l /e� C. 194- / Jr-, A I Arch/Eng. A9L,0 fr Ja6 4 License No. C(93/r TYPE OF PERMIT U GRADING FOUNDATION ❑ STRUCTURAL I C RightR N Address -r7 1� ,7 ❑ TENANT ❑ EL CTRICAL ❑ PLUMBING ❑ MECHANICAL S R �, >�, . - 7G0�f�!! OTHER •p i�tl no,/ Ping. Ref.# ParkingRe /Provided E Contracto ' „hail: ' '•ne / Req. /Provided DESCRIPTION SQ. FT. OCCUPANCY �"�-i O Address(mailing) y `1 �.•A'��I4t.0✓�- te. Planning Notes: M CONSTRUCTION TYPE 4y VALUATION$ // 00L�• ar T City License No. ZONE GRADING CU.YDS. ACRES LICENS a ONTRACTOR DECLARATION $' I hereby affirm -.1 I am licensed under provisions of charter 9 (commencing Remarks: T With section 7000) • •ivislon 3 of p: :. ••-ss and Professions Code, and Q ea my license is in full force .••• . ELECTRICAL FEES License Class - erNo. Date -- — Signature a , PLUMBING I FEES Automatic Washer Transformer ❑ 15-50 KW WORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. - 050+KW . :hereby affirm that I have a certificate of consent to self-insure or a certificate Be!Sink Showers 7 Workers' Compensation Insurance, or a certified copy thereof (Section Cooking Unit Meter ❑up to 100 amps t v t:10, Lab. C.) Backflow Preventer Service Sink , policy No. Company Backf low Irrigation Sewer Cap Dishwasher Meter Dover 100 amps BCertified copy is hereby furnished. Dryers ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date ApplicantFan Motors 00-1 HP 01%-8 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit Is for one hundred($100) or F.A.U.less). Dishwasher Solar Piping Inc.Solar 09.15 HP 016-15+ I certify that in the performance of the work for which this permit is Issued, I Fixtures shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Microwave Workers' Compensation Laws of California./ ,f 1/,._�'/ , Date / 4(6 Signature /N/IF(� N'V Floor Drains Swimming Pool w/Spa Device Boxes Pole Light NOTICE: If,after making this declaration,you should become subject to the Outlets RR Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Switches CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet /Sign I hereby affirm that there is a construction lending agency for the performance Garbage Disposal of the work for which this permit is issued (Section 3097 Civ. CJ Interceptors /water Heater 9 P Standing Sections Lender's NameC// Lender's Address Kitchen Sink ' — Water Service Generator 00-5 KW 05-15 KW • Trash Compactor OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of ')ivision 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 ferefrom and the basis for the alleged exemption. Any violation of Section 031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: 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 Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By - Date License Law does not apply to an owner of a property who builds or Improves - thereon, and who does such work himself/herself or through his or her own ❑ Application Issued By Boiler Hood or Type I employees, provided that such improvements are not intended or offered forDat sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ (� � SUMMARY OF FEE pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground Y'•ew'.-'�e pryve for the purpose of sale). BUILDING PERMIT $ 2o-% op', SMIP $ r O 0 L'7 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refri tion System K PLAN CHECK tractors to construct the prosect (Section 7044,Business and Professions Code: - $ PERMIT The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 0.100,000 BTU 0100,000 BTU 'PLUMBING $ ISSUANCE $ 1 builds or imoroves thereon.and who contracts for such oroiects with a con- tractor(s) license pursuant to [ne Contractor's License Law). I am aware that Exhaust System ❑ Multiple System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ egoist of their Worker's Compensa[�Ytion, jq;ura nce should be provided to me. MLECTRICAL $ GRADING $ I am exempt under Section '�/ B.& P.P.C.C.for this reason Firep I/Fact.BIt. ICBG�k Fire Dampers _ MICROFILM $ f — PLAN CHECK 50% $ _ Date Owner Heating System& Ducting Registers MECHANICAL � �• I hereby certify th t I have read this y with application and state that the above ❑0.100,000 BTU ❑100,000 BTU $ TOTAL FEE $ 62r.. •6-0 information is correct. I agree to comply with a,l city and hereby authorizeutirepres PLAN CHECK 25% $ and state laws relating to building construction,and repre- sentatives of this city t• enter upon the above-mentioned property for Inspection purposes. e / 6 / Signature D Date —(---19 Reinspection Fee $15 Issue Fee $ 3 01 00023699-00023700 TOT 25 Drivers' License or$5 9f - .:'11 0865-46,rev. 5/88 White - Building: Canary -Applicant; Pink - Accounting; Goldenrod - Assessor DATE: 01/05/89 TIDE: 11:34 • . CCONSTRUCTION AND PLANNING POO .SPA "APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electijcal Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrria. i 53. Steel Reinforcement 3.;Electrical Conduit Utility-Undrgrnd: 54. Forms • • • 4: Electrical Conduit-Undrgrnd. ,• 55. Electrical Bonding . 5.•Steel Reinforcement i' 56. Rough Plumbing & Pressure Test i 6' ElectricaltiFERGrnd. - 57. APPROVAL TO COVER-GUNITE • 7; Footing's ' 58. Electrical Conduit-Undrgrnd. • 81' Foundation ,• i 59. Gas Pipe, E Undrgrnd.,Test 9'.'Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, D Undrgrnd. 10/Steuctural 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 Electricdl;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 �w,. APPROVALS Permit# Q • 21. Ducts, in Structure • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping D Gas D Oil ,• 23. Gas Pipe=RougFi& Test 72. Underground Flush 24. Roof Framing -' 73. Undergrnd.Storage Tank D Gas ❑Oil " 25. Roof Shdathing - _ 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 r Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy • 37. Final Factory Fireplace . 38. Final Plumbing 39. Water Service-Final CI 40. Gas Service-Final -i 41. Solar Domestic-Final I 4 • . i. 42. Backflow Preventer 1 43. Backflow Irrigation I •' 44. Landscape Irrigation System ' r 45. Sound Attenuation •i ; 46. Handicap Regulations -1 47. FINAL STRUCTURE & BUILDINGare•1I f ifC ti, 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co , r 51. CERTIFICATE OF OCCUPANCY I ' , ' ' No. Date ,1: Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA CONSTRUCTION PERMIT E 3.--1 ( loo A.P.# Zone Project Address (! nicia.C1 ,,��,�7'�T'��//�],� /�.� fS Main Building: Accessory Building: Applicant's Mailing Address ( 2 �K'�'e cw I TYPE OF CONSTRUCTION IJ NEW IJ ADD U ALTERATION U REPAIR E - Z ��rr1t�� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 1 TFront 0 Owner's Nagle C.ri+�J el . • ' POh�one- DESCRIPTION OF WORK/USE OF BLDG. B Rear N Address 1175 GL4lAXy AIwa.e-r ?fY9c4 f A . 1 TYPE OF PERMIT GRADING U FOUNDATION U STRUCTURAL C Right N ❑ Arch/Eng. License No. K ' G Address //J1��,,�� ,�,"� ,� ./ ❑ TENANT ❑ ELECTRICALe0 PLUMBING ❑ MECHANICAL S Left R Contractor's Name4tftltllt-cs�4 Phone ��7! ❑ OTHER 'IMA c ujEve__ Ping. Ref.# Parking Req./Provided E Address(mailing) E11041 41e4tr-en,Pdt CAF• PROJECT DESCRIPTION SQ. FT. OCCUPANCY Planning Notes:LL M ''I CONSTRUCTION TYPE VALUATION$ City License No. �l_ ZONE GRADING CU.YDS. ACRES T LICENSED CONTRACTOR DECLARATION S. I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: with section 7000) of Division 3 of the Business and Professions Code, and my license is in f force and effect. z/�.-�...,�� ELECTRICAL FEES License las y� cense No.��z z Date /(/7 Signature �Y PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW WORK RS'COMPENSATION DECLARATIONBar Sink Showers ' Construction Pole Sub. • ❑ 50+ KW �'1 St I hereby affirm that I have a certificate of consent to self-insure or a certificate - 1 = workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 0, Lab. C.) licy No. Company Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps U Certified copy is hereby furnished. Dry¢rs ❑Gas ❑Electric Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan Motors 00-1 HP ❑1 h-B EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors (This section need not be completed if the permit is for one hundred($100)or F.A.U. Inc.Solar 09-15 HP ❑16-15+ less). Dishwasher Solar Piping I certify that in the performance of the work for w I this permit is issued, I Fixtures shall not employ any person in any manners a become subject to the Drinking Fountains Solar Tank Microwave Worker o Ion Laws of Califor �" Device Boxes Pole Light DateOFI Signaturedeclaration, Floor Drains Swimming Pool w/Spa 9 NOTICE: ,atter making thisoyou hould becomesubject to te Outlets Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Range comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCYGas Service Outlets Water Closet Switches Sign I hereby affirm that there is a construction lending agency for the performance Garbage Disposal of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater 9Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05.15 KW Trash Compactor OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains t7�•-p the Contractor's License Law (Chapter 9(commencing with Section 7000)of -'1- Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee a $ 3 1 'refrom and the basis for the alleged exemption. Any violation of Section 1.5 by any applicant for a permit subjects the applicant to a civil .alty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: U $ 3 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee Zoning Approved By Date compensation, will do the work,and the structure is not Intended or offered - - - - for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date License Law does not apply to an owner of a property who builds or improves -- thereon, and who does such work himself/herself or through his or her own Application Issued By - Date 1 "'- 11 - elk 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 corn- Canopy Type II 0 SUMMARY OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground prove for the purpose of sale). BUILDING PERMIT $ SMIP $ O I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU PLUMBING $ ISSUANCE $ builds or improves thereon. and who contracts for such oroiects with a con- tractor(s)dreense pursuant to tne Contractor's License Law). 1 am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ^� ENERGY P.C. $ proof of their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ �Z� $ ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBO# Fire Dampers GGRADING LM $ PLAN CHECK 50% $ Date - Owner Heating System& Ducting Registers MECHANICAL VO I hereby certify that I ha a read this application and state that the above 00-100,000BTU ❑100,000BTL—' $ TOTAL FEE $ 2.� information is correct. I a• ee to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relatin• to •uilding construction,and hereby authorize repre- sentatives of t is cis t• -r upon the above-mentioned rop rty for Inspection Signature pu tW ��„� (Dater( [� Signature IL 11 '' Reinspection Fee $15 Issue Fee $ 3 Drivers' License or SS 9f � 01 00024404'00024404 TOT 22.50 0865-46,rev. 5/88 white - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor DATE: 01/17/89 TINE: 10:16 CONSTRUCTION AND PLANNING POOI PA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector _ 1. Temporary Electrical Service or Pole_ Z_! H9 "• 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. B 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ,4iElec[rical Conduit-Undrgrnd. 55. Electrical Bonding _- 5. Steel'Reinforcement'^-- 56. Rough Plumbing & Pressure Test .� 6� Electrical UFER'G(nd. 57. APPROVAL TO COVER-GUNITE 7.;Footings % 58. Electrical Conduit-Undrgrnd. 8. Foundation - ry 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pipe-Undrgrnd. I:, 60. Backwash Lines, P-Trap, 0 Undrgrnd. 4- 10. S$uctur.al Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap t` 63. Heater & Vent-Final 13. Roof Drains ,'r 64. Plumbing System - Final 14. Rough Plumbing-. 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing &Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20.- Rough FactoryTFireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas 0 Oil 23. Gas Pipe-Rough,& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 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