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HomeMy WebLinkAbout211 20TH ST - Building Permits •4W MF CITY OF COSTA MESA ` 4 BUILDING DIVISION > 4-Sr: DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER f I r„a�w ,ri: I j • PERMIT ' ,,,,mom er E05-00301 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 211 E 20TH ST Status: ISSUED Suite No Applied: 04/11/2005 Vicinity: Issued: 04/11/2005 Parcel Nunmber: 42627306 Applicant: DANIELS, JOHN ISSUED BY: Address: 25331 CAMPINA DRIVE Phone: 949 235-8959 MISSION VIEJO,CA Zip 92691 Owner: TUNTLAND, ALAN J Address 211 E 20TH ST Phone: (949)722-1853 COSTA MESA,CA Zip: 92627-2217 Contractor: C B I ELECTRICAL SEVICES , Address: 25331 CAMPINA DRIVE Phone: 949 235-8959 MISSION VIEJO,CA Zip: 92691 License:845254 SCOPE OF PERMIT INSTALL NEW 200 AMP SERVICE) nq, r 0 V/hs/•,1 n 4N FEE SUMMARYC ^ /• c1r. Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $0.00 0 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $30.50 1 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 Investigation Fee $0.00 Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $54.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS - WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and wit maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation Insurance,es required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (pp sect/on need not be completed i/the permit is valued at one hundred dollars($106)or less.) if I certi that in theperformance of the work for which thispermit is Issued,I shall not employ any p oc person In any manner a as to becomeof subject abo to the,I shall forthwith laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith rit�compty with thegeprevisi s. ^ �_ nt Signature: , \� Da: :: I/ —1/— 0 ,S µYARNING:FAILURE TO S WORKERS'•• ATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(Sr 000 IN ADDITION TO .....z OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full 11x11,and effect.Lie.N r /Oafs a I Eon/tractor's Signature: �6-k ` b 'tL\ , (J- \ C Data: 0 —70 — -y/" 0 CONSTRUCTION LENDING AGENCY: u �/ ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,Improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. • 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such Improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractors) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding.faisework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2.Sec. 341,Title 8,California Administrative Code). o As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to dO such work from the division, Signature: Date: Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? Q Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds.or a volume of 55 gallons. or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare en RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department el an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 II an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? LJ Yes LJ No (Section 65850.2 01 the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Witt any part of the fadlity to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If'yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If`yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: _ Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws end dty ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. \ ^ �r� Signature Of Legal Owner 1_77 to\\/ j f- `� A�nNQr?Aulliodied APP11Cerlt Pede1 Mc–) TYPE gAIE INTOIAIfi CODE! INSPECTION TYPE MIL RLTNSIS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ` z 200 Final Re•Rool 210 Final Electrical tr.' 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy , I CITY OF COSTA MESA �. ► BUILDING DIVISION • ' I DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER �` PERMIT J y� r 4(4 4. jP 00-00690 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 PLUMBING PERMIT Job Address: 211 E 20TH ST Status: ISSUED Suite No Applied: 12/14/2000 Issued: 12/14/2000 Vicinity: C , 4Y Nunmber: 42627306 ISSUED BY: �'T Applicant: DEIRDRE TUNTLAND Address: Phone: 949-722-1853 Zip: Owner: TUNTLAND, ALAN& DEIRDRE Address 211 E 20TH ST Phone: (949)722-1853 COSTA MESA,CA Zip: 92627 Contractor: Address: Phone: Zip: License: Arch / Eng: Address: Phone: Zip: License: SCOPE OF PERMIT INSTALL 1BATHTUB, 1GAS PIPING,GAS REPIPE, 1LAUNDRY TUB, 1SEWER HOOKUP,2SHOWERS, 1SERVICE SINK,2WASH BASINS, 1WASTE VENT, 1WATER CLOSET,2WATER HEATERS, 1WATER PIPING FOR RESIDENTIAL ADD,RE:B00-011618 FEE SUMMARY AMT QTY AMT QTY AMT QTY ISSUE FEE $23.50 Laundry Tub/Washer $9.80 1 Sump Pump $0.00 0 Backflow irrigation $0.00 0 Landscape Irrigation $0.00 0 Swimming Pool $0.00 0 Backflow Preventer $0.00 0 P-Trap $0.00 0 Trap Primer $0.00 0 Bathtub $9.80 1 Pressure Regulator $0.00 0 Urinal $0.00 0 Clarifier System $0.00 0 Process Piping(per 10 ft) $0.00 0 Vacuum Brkr Bkflow(1-4) $0.00 0 Connect(Ice,Soda,etc) $0.00 0 Receptors $0.00 0 Vacuum Brkr Bkflow(5+) $0.00 0 Dental Units $0.00 0 Septic Tank $0.00 0 Wash Basin $19.60 2 Dishwasher $0.00 0 Sewer Cap for Demo $0.00 0 Wash Basin Set $0.00 0 Drain, Floor $0.00 0 Sewer Connect $24.65 1 Waste and Vent System $9.80 1 Drain, Rainwater $0.00 0 Sewer Private Line 30.00 0 Water Closet(Toilet) $9.80 1 Drain,Roof $0.00 0 Shower $19.60 2 Water Heater/vent $24.60 2 Drinking Fountain $0.00 0 Sink,bar $0.00 0 Water Piping(Inst or Rep.) $9.80 1 Expansion Tank $0.00 0 Sink,commercial $0.00 0 Water Re-pipe $0.00 0 Gas Earthquake Valve $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Gas(1-4 outlets) $6.15 1 Sink,kitchen $0.00 0 Water Softener $0.00 0 Gas(Over 4 outlets) $0.00 0 Sink,service/mop $9.80 1 OTHER $0.00 Gas Repipe $9.80 1 Spa(private) $0.00 0 VIOLATION $0.00 Gas Service $0.00 0 Spa(public) $0.00 0 PLAN CHECK $0.00 Interceptors(Grease,Oil) $0.00 0 REINSPECTION $0.00 0 Interceptors(Sand Auto) $0.00 0 TOTAL CALCULATED FEES: $186.70 CUICt11AC1ki 1 S r arck.lv.L,(.UNUI I tUrva NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or If work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 • / / 2446-48(6400) (J�/ DECLALATIaNS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: o I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed i/the permit is valued at one hundred dollars($700)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shell not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE CAST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Lic.# Class II Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit acts the applicant to a civil penalty of not more than five hundred dollars($500).): I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or Improve for purpose of sale.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) licen ursuent to the Contractors License Laws.). ❑ I am a ptt and s,^�efifi. o --+_ M _Busii ss and Professions Code for this reason: ,c7� Signature: .1,� Jiff A t )\-1 t �V'l Y Date: _ ) 6 V Owner ID ve'fled by drivers license. , Yes ❑No Drivers License No. � Expires: -- ins Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: o I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application akPermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? 0 Yes L-I No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet frem the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: (-CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that 1 have read this application and state that the information given is orrect. I agretto comply with a state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the a M�escribe roperty for ins ctio pu oses .I ay not__to occua,or allow occupancy of any building authorized by this permit unti tial ipspecgon. XX(QI /nLXO• Signature Of egal Owner(s)jl/r�/�r�V(�1XI (I r/�) D6rttl1/(nJ )\ And/Or Authorized Applicant Date CODE, INSPECRON TYPE Qat IffRRAL6 CODFE INSPECTION TYPE DATE Iti 1616 Fixed System Final Fire Prevention 206 Final Mechanical �Y 1266 Pool Spa Final 208 Final Plumbing ,5-,Q 3-ori (./ 200 Final Ra-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy r 1 CITY OF COSTA MESA - 4. 9 BUILDING DIVISION ). • ,,,,,, ..s,li DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F 1 P/A t PERMIT /M00-00537 4Ikb J • + I (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 211 E 20TH ST Status: ISSUED Suite No • Applied: 12/14/2000 Issued: 12/14/2000 Vicinity: Parcel Number: 42627306 ISSUED BY: S Applicant: DEIRDRE TUNTLAND Address: Phone: 949-722-1853 Zip: Owner: TUNTLAND, ALANf'& DEIRDRE Address: 211 E 20TH ST Phone: (949)722-1853 COSTA MESA,CA Zip: 92627 Contractor: Address: Phone: Zip: License: Arch/Eng: Address: Phone: Zip: License: SCOPE OF PERMIT INSTALL 1A/C, 1FAU, 1GAS PIPING,2FANS FOR RESIDENTIAL ADD, RE:B00-011618 FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Vehtillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $14.80 1 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $6.15 1 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $14.50 2 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $73.75 • COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work Is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244ede WOO) (ZA. DECLARATIQNS , f WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is Issued,1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that it I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000).IN ADDmON TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3708 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is In full force and effect.Uc.A Class It Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Cafe). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(5500).): x/y,(y I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I.as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,end who contracts for such project with a contractor(s) licen ursuant to the Contractors License Laws.). .....7.. ❑ I am eiiit under'1 c. r a Busi a•ss and Professions Code for this re Signature: I _.lI �rf�II a a ```` • Expires: a— inp Verification of Ownership by(type of doc ant,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth Into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be flied with the Costa Mesa Flre Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). __ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous matadors)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP Is presently required.has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coact Air(Duality Management District or from any other air pollution control district or agency? Yes D No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential budding permits). 6 -Will any part of the facility 4;1;constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air polturi&T-conliqr district or agency is required for the work which is the subject of this application,have all of the disclosures prescnbed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No _.e_ . .__ .__..___ _.._ __ ___.............._...._...__.____....__.... 8 (If yes",attach certificate of compliance from _the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: TIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given Is c rrect. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter uponth a olescribe pror pure s I agree no 0 occupy or allow occupancy o y building authorized by this permit until nal in pection. la lit no Signal re 01 Legal Owner(s) Date And/Or Authorized Applicant Date SODS I tNSPECTiONTYPE PETE IIDQIELS CODEC IfISPECRON TYPE WAILS . 1616 Fixed System Final Fire Prevention 208 Final Mechanical 5.43•o . AnTn( 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy , 1 CITY OF COSTA MESA - 4 ► BUILDING DIVISION }. a(r DEVELOPMENT SERVICES DEPARTMENT PER NUMBER o In • PERMIT 00-01183 Siz, R00 ano (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 211 E 20TH ST Status: ISSUED Suite No Applied: 12/14/2000 Vicinity: Issued: 12/14/2000 Parcel Nunmber: 42627306 Applicant: DEIRDRE TUNTLAND ISSUED BY: S PS Address: Phone: 949-722-1853 Zip: Owner: TUNTLAND, ALAN$& DEIRDRE Address 211 E 20TH ST Phone: (949)722-1853 COSTA MESA,CA Zip: 92627 • Contractor: Address: Phone: • Zip: License: SCOPE OF PERMIT INSTALL 1A/C PACKAGE,42FIXTURES,28OUTLETS, 18SWITCHES, 16COMM DROPS, 1SUBPANEL,CONDUIT FOR RESIDENTIAL ADD, RE:B00-011618 FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $54.50 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(3+units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 up to 10 kva/kw $0.00 0 Lighting Fixts $38.06 42 ' up to 50 kva/kw $0.00 0 Recept Outlets $27.84. 28 up to 100 kva/kw $0.00 0 Switches $19.80 18 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $18.20 1 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $0.00 0 Christmas Tree'Starid ' $0.00 0 Motors to 50hp $0.00 0 Fireworks Stdnd $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $17.60 16 Investigation Fee $0.00 Sub panel to 200a $30.50 1 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits $0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $230.00 Intermed Pole $0.00 0 COMMENTS/SPECIAL CONDITIONS • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 i 2446-48(8/00) v A DECLAR% TIONS 1 WORKERS'COMPENSATION DECLARATION: f • • I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califomia,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.k Class# Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit �]subjects the applicant to a civil penalty of not more than five hundred dollars($500).): / I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) lic pursuant to the Contractors License Laws.). O I a exempt der sec Business and Professions Code for this reason: Signature: I� Ai —" ' . Expires: el— 11.--(15...„..Verification ^nrJ/Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, ' or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feel of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? ❑Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is rr t. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the — ab e=describe properly fQr inspectionl cg purpo5.I agree nil;to occupy or allow occupancy of gmy building authorized by this permit u til fine)nsppeection. Al Signature Of Legal Owner(s) Dat And/Or Authorized Applicant Date ;ODE L INSPECTION TYPE DATE INTRIALS CODE I INSPECTION TYPE PATE INTRULS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 9'21-DA RiS 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _ 204 Final Demolition 250 Final Building/Occupancy ,.1 - r.r'. , ' M CITY OF COSTA MESA 4 ° BUILDING DIVISION >:j' � DEVELOPMENT SERVICES DEPARTMENT /MIT NUMBER `1. his t PERMIT !' "# B00-01618 IttlePoRoTto (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. ,yiLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 211 E 20TH ST tSVI Status: ISSUED Suite: Applied: 10/09/2000 Vicinity: 1ST&2ND STORY ADDITION Issued: 11/29/2000 Parcel Number: 42627306 Zoning: Applicant: TUNTLAND, DEIRDRE ISSUED BY: ` Address: 211 E 20TH ST Phone: (949)722-1853 COSTA MESA,CA Zip: 92627 Owner TUNTLAND, ALAN & DEIRDRE Address 211 E 20TH ST Phone: (949)722-1853 COSTA MESA,CA Zip: 92627 Contractor: Address: Phone: Zip: License: Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT CONSTRUCT NEW 1246 SQ FT ADDITION TO EXISTING SINGLE FAMILY RESIDENCE. DEMO 361 SQ FT OF EXISTING 1ST FLOOR&CONSTRUCT NEW 656 SQ FT FAMILY ROOM,LAUNDRY ROOM,&FRONT ENTRY.ALSO,CONSTRUCT NEW 590 SQ FT 2ND FLOOR FOR MASTER BEDROOM&BATHROOM ADDITION.ALSO, DEMO 154 SQ FT EXISTING PATIO AND CONSTRUCT,220 SQFT NEW REAR PATIO. CONSTRUCT NEW 42 SQ FT COVERED PORCH. FEE SUMMARY Plan Check: $685.98 Calc Valuation: $110,756.44 Permit: $1,055.35 Claim Valuation: $0.00 SMIP Res: $11.08 SMIP Corn: $0.00 Other: $0.00 Inspection: $0.00 Total: $1,752.41 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existing: 0 Required: 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord. No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)7545626 2446.46(6/00) t" I WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This section need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these provisions. Applicant Signature: Date: WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lie.# Class a Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Cade). Lenders Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.It,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) lic e pursuant to the Contractors License Laws.). ❑ I a e mpt u40, �er^spec. ( �— siness and Professions Code for this reason: rr Signature: ' l`C J. . j*k�A AA� Date: III��rQn Owner ID v rified by drivers license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec.. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions, that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health end Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application a ermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? U Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Duality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is co e I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the ab e- scribed property fo 'nspagltppyl urpoAs`e�,I agree not occupy or allow occupancy of any building authorized by this permit u I galinspection.pe )1J,Jx1�/UN/1`,1n(J •E}(�Si •gnature`f Of 1Legal�Ol`wner(s) II Date lel J And/Or Authorized Applicant Date CODE If INSPECTION TYPE PEE INTRIAL$ ODE It INSPECTION TYPE 2AIE RIIMAka 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site / /� 204 Final Demolition 250 Final Building/Occupancy ! -let 6'T (i .. . , ) 3613 . NEWPORT-MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: (X) City of Costa Mesa District Receipt No. ( ) City of Newport Beach ( ) County of Orange Plan Check No ,410b Applicant: Ili /7 a 7-71g#,& it r° C Address: ,tail £ 2-0 ft S / Q Telephone Number: 5 y9 — / 2-zAPS- 3 Tract/Parcel and Lot Number(s):�� • — —� � Location of Project: O`// 4-4-- -2v " 5t1 C-05+4 /k/ encu Number of Square Feet of: c / Residential Space /S a c��+S J F$1.84 Total �//02a, / O Commercial and Industrial Space x $ .30 Total Commercial/Industrial Project is: (Check One) _ Warehouse _ Motel _ Preschool R & D _ Bank _ Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage Racquet/Health _ Large Office Heavy Industrial _ Hotel _ Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because i his certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. SZ- By.A !E Representative J& �L/ The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true,then this certificate shall automatically terminate and th propriate City/County shall be notified NOJ 29 2888/3:26 PH/1 1628.40 /1/47 C44 RCpT8:81-88689 Date: Igfrp kg) Applicant 370th NEWPORT-MESA UNIFIED SCHOOL DISTRICT CERTIFICATE OF COMPLIANCE OF DEVELOPMENT FEES PURSUANT TO AB 1600 AND AB 181 To: ( JU City of Costa Mesa District Receipt No. ( ) City of Newport Beach 9� � // ( ) County of Orange //, D Plan Check No/5 /cj J8 Applicant: (-J' 024P ,c e Tail 7LL51-- Telephone �f_ Address: LJ - /� —7TH 5 1 Q Telephone Number: Q�-% — < 0-2-- 1 Q J 3 Tract/Parcel and Lot Number(s): '97-6 -- 2-73 -A(O Location of Project: �/l X at 11---c—SF Number of Square Feet of: a� / Residential Space �� x $1.84 Total 7 C•-, �j, '2 (116eitre-6;,,i:L-2 g,r0 a Commercial and f !' / . '• Industrial Space Lam— $ .30 Total Commercial/Industrial Project is: (Check One) _ Warehouse _ Motel _ Preschool - R & D _ Bank Auto Repair Movie Theater _ Neighborhood Shops _ Hospital Mini-storage _ Racquet/Health _ Large Office _ Heavy Industrial Hotel Office Bldg. Regional Shops _ Medical Office _ Restaurant Light Industrial _ Office Park _ Fast Food This project is exempt because ibis certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code sections 53080 and 65995. The Building Permits for this square footage in this proposed development may now be issued by your jurisdiction. Checks are to be made payable to Newport-Mesa Unified School District. By: ?7701 i att/192, Autho' ed Representative The above representation as to square footage is true. Applicant agrees that if it is later determined that such representations are not true,then this certificate shall automatically terminate and ppropriate City/County shall be notified. 15 2888/12: PH/$ 64.48 I ONUN1 ARA/K)70A4RC 818814285 a�lSl/m 114885 Date: // U lJ nt Alan J. Tuntland 211 E. 20`h Street Costa Mesa, CA 92627 949/722-1853 (HM) 949/643-7414 (WK) March 5, 2003 Ed Petros Senior Inspector Building Department City of Costa Mesa P.O. Box 1200 Costa Mesa, CA 92628-1200 Subject: Request for Building Permit Extension Permit No. B00-01618 211 E. 20`h Street Dear Mr. Petros, As suggested by Gary Hook, this letter is to request an extension for Final Building Permit Inspection. Plumbing, Mechanical and Electrical have received final inspections and only Building Final remains (attached is a copy of the inspection card). Remaining work is to install the fireplace hearth, patio cover and stair handrail. While I am performing the work myself, fabricating the finish architectural woodwork and working only on weekends, I do not expect to be complete by March 24, 2003 (the 6-month point from my last inspection). I therefore request an extension for three (3) additional months to June 24, 2003 to attain building final inspection. Please feel to contact me if you have any questions. Thank you for your consideration of this request. Best Regards, --WA1111111.4111111141 Alan J. Tuntland Attachment . \ I ' • CITY OF _JSTA MESA, BUILDING SAFETY DIVISION POST IN CONSPICUOUS PLACE ON THE JOB NOTICE schedule inspection one workday in advance. To schedule inspections, call (714) 754-5626. Provide the following information? Permit number, 2) Job address, 3) Inspection item number, 4) Day and date you need the inspection. Building Address: 2 €// C. ?O' --41/2.,&Z._44 Owner: rani 71 min c 1, Building Permit II:b00- 0/6'/5 Electrical Permit e: Contractor: i Mechanical Permit a: Plumbing Permit II: Job DescriptionAs ti r ..� r�, /fa YnwU Type: Group: e - vr- .3 FiC. Plan Check No. Issue Date: NEW ADALTE REPAIR 1I MOVING DEMOLISH PERM TS EXPIRE 180DAYS (6 MONTHS) FROM ISSUE OR LAST INSPECTION .. -- . .. - - s 1:_. _ , .,,._.,'-h_; .. :LCON4STRUOTIi aPPROVALS,t.:. .I. --'....4t +-.l i:Er.' w ':-,.s.,. __.:_ar.;.. Item M STRUCTURAL Date _ Inspector Item a POOL&SPA Date Inspector 4 Footings IL-22-00bac" 94 Pool& Equipment Location 6 Slab 12 -� `Tam 96 Steel Reinforcement 8 Structural ;:rtivziti100 Electrical Bonding 12 Roof Sheathing 7,-i f 9 1 6 102 Rough Plumb& Pressure Test 14_ T-Bar Ceiling-Structural , _ 104 Approval to Cover-Gunite 16 Exterior Shear Panel 7- f'-Q l 6 66 , 106 Elec Conduit•Underground Q18 Frame& Flashing it-&-C( GOAT/ 108 Gas Pipe/Underground Test • 20 Lathing&Siding 110 Backwash Lines, P-Trap, 22 Insulation //-/(9--0I _11:c-4.j/L Underground 24 Drywall Nailing /,(2(.--o ( ,G/ 112 Approval to Deck 26 Plaster Brown Coat _ 116 Pool Plumbing System-Final 30 Pre-Grout 118 Pool Electrical-Final 33_ Disabled Access 122 Fencing&Access Approval 124 Approval for Plastering _ ELECTRICAL 126 PooVSpa Systems-Final ���38 Elec Conduit-Underground, r Rough Etec-Wiring pCndr ck 11 t/( C v ham. 8 Elec T-Bar Ceiling wk,�r;All FIRE DEPARTMENT:APPROVAL.--t -- , . _ _ ezidt,rr.ctr 1 L •.. 1 • _ 5u Elec Power Final v 1610 Overhd Hydro/Overhd Rough - _ QK I1-lb' . 1612 Dry Chemical PLUMBING &MECHANICAL 1614 Dry Standpipe 52 Soil Pipe-Underground I a-pcb Ew 1616 Final-Fixed System Water Pipe-Underground e Rou.h Plumbin. ' .. Ja b co A ..' FINAL INSI?ECTIONS ' i H. , , .4 Rough Mechanical it—0-V l rl% Call(714)754-5626 for the following: Date Inspector ' Q.a Rough-Factory Fireplace �y�1 //rte- _ 200 Final Re-Roof 72 Gas Pipe-Rough Test '1"' 201 Final Block/Retaining Wall 90 Gas Pipe Test-Final 203 Final Sign . 92 Water Service-Final _ 204 Final Demolition 20$ Final Mechanical _ K 23-10a Ncv . . 1 t 'NOTES..1 'j' ar ;' .'t', ; • i''."v,-4 sins Final Plumbing S-a3-o, iJ tf • GP Final Electrical ye nate 7-29--Z X', c- /-'o/ -- S[ -e p/ 0 ./ . Call(714)327-7400 for the following: Date Inspector rt--g- 1 e`er —aezie212 Final Fire Prevention i fei .. l?Jcr of rc y 0.0 _!�/AC -Call(714)754-5335 for the following: Date Inspector ' '//.L'I 3 v=r re . trioleeT. a Pt yet e l a .°, -. _ 214 Final Transportation Sys. ry r4',, 1, (Frit; r i h,Y, -(Ce tall (71r.)754.3 1 for fuliowiric:- Date Ins lar ul 1 •�+,r, . j'r..}.>l' 1'.' J, 1 ru1 /1 1. j l I _ Pec e70,.1(, .0 / 216 Final Engineering Approval _ r I , /a3/•z 2-4/e/ pr-ge�l ,/`' /' G`�'oifec/'U,41%-s Call(714)754-5307 for the followini: Date Inspector DC' wjre S-i?r ActA J/c'7 -/Z- 5>oc .,Cc 218 Final CMSD Approval _ - Call(714)754-5245 for the following: Date Inspector 2 '/ / -e L 3 jlf 220 Final Planning Approval —_—y� CO L 71reoz too. Clf. .... ' fzccd_ ._ Call(7141754-5626 for thefollowir:_ f Date — Inspector //F(? / _xi 222 Finai Site -4" 250 Final BuilllinytOccupancy -46 (rota/CO ./lit Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CI Y COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 'st}) ject Address 2// Ga /� •_ E a17 9.i6 4938 3/30/87 5070-- TL Pro Applicant's Mailing Address '�rQ M• / s ,4 El's L' TYPE OF CONSTRUCTION U NEW U ADD ❑ ALTERATION U REPAIR f /7 4'{.y PhonenL-31 CI CONVERSION ❑ DEMOLISH ❑ OTHER A,p,# Zone Owner's Name • 7s DESCRIPTION OF WORK/USE OF BLDG. Address - 0 y - — -Ase e4 $ Main Building: Accessory Building: Arch/Eng. - License No. TYPE OF PERMIT ❑ GRADING LI FOUNDATION LJ STRUCTURAL E Front. O Address 1�/, ✓✓✓���� n p ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Nameniltri ys —..[� JL � Phone ❑ OTHER A I `' 1 // PROJECT DESCRIPTION Sq. FT. OCCUPANCY C Right N Address(mailing) K CONSTRUCTION TYPE VALUATION$ S Left G City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR D CLARATION Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed untler provisions of Charter 9 (commencing Remarks: 5ac_8 38 Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code,and M my license is in full force and effect. T License Class License No. S Date _. Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES ' hereby affirm that I have a certificate of consent to self-insure or a certificate Workers' Compensation Insurance, or a certified copy thereof (Section .0, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Ca 0 50+KW 8 Certified copy is hereby furnished. p Construction Pole Sub. Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter Dup 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 ❑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 01%-8 Workers' p mPen ation Laws of Califo(/iis Date..7/ 61 7 Signature _(/ a. fla7n.PJZi Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09.15 HP 016-15+ NOTIC If,a(ter making this declar ion, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal i Fixtures Microwave Comply with such provisions or this permit shall be deemed revoked. , CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there Is a construction lending agency for the performance Pale Light of the work for which this permit is issued (Section 3097 Civ. C.) ' Interceptors Water Heater Outlets Ran e I, a Lender's Name 9 Lender's Address Kitchen Sink Water Service . witches 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 DisposalStanding 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 Division 3 of the Business and Professions Code) or that he/she is exempt . -,t,''.refrom and the basis for the alleged exemption. Any violation of Section 44:1.5 by any applicant for a permit subjects the applicant to a civil . Y salty of not more than five hundred dollars($500). I, as owner of the propertyReinspection Fee I $15 Issue Fee $ 3 cion, will do the work,and the structure is not intende 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 ❑ Zoning Approved By ///���� Date prove , the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground Building Approved By Dated prove for the purpose of sale). '�/ 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By f. Dat 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 ❑0.100000 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 $ SMIP $ 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 4 Fire Dampers PLUMBING $ ISSUANCE $ Dateb owner tf fle7Zs��+/ Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify th t I have rea is application and state that the above DO-100,000 BTU 0100,000 BT ELECTRICAL. $ GRADING $ information,is correct. I agree to mply with all city and county ordinances and state laws relating to building construction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for - inspection pu osig�ii. MECHANICAL $ TOTAL FEE $ Signature !!; /, P.0-2.7Oata Drivers' Li}eennse or SS 9F Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ t5.7t CMF 0865-46,rev.10/84 white - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor — _ _ I. 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. i5 7 442,6) 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 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 ei 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 I28. 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 7.2/,g? '3-.c. Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' 36, Hood or Canopy . 37. Final Factory Fireplace 38. Final Plumbing , n 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final - • 42. Backflow Preventer 43. Backf low Irrigation ' 44. Landscape Irrigation System i - (- � 45. Sound Attenuation -46. Handicap Regulations • . 47. FINAL STRUCTURE & BUILDING f 48: SpecialRequirements Completed t ' 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 within heavy border lineLaed sigh all appropriate declarations. / ,ITY OF COSTA%MESA pi_RMIT N0��^� �Js�CT NO. • T NO. BLDG.NO- CONSTP,�JCTION PERMIT C.— S / 2, 4909 4/21 /82 269.28 TL Project Address �'j/// S. 20? . • TYPE OF CONSTRUCTION •Owner JOy�,E //D e•A./ X1 TPhonec,3 f-311 0 NEW X.ADO ALTERATION �)_ Address 7/ Z0 Th Sr, Cps/,4 /19�SA ' 0 REPAIR 0 CONVERSION ❑DEMOLISH V �� fF' ZONING REGULATIONS • Arch/Eng. f License No. '0 OTHER A P # 7 ,.rr _ Address - DESCRIPTION OF WORK rilaPi t- r'i0 7 t-u0— Z/ 3— / 139 • '7' stir. ALTtL -77Oev�• ZONE /�/ PLNG. REF.'$ Contractor 61.4.4.,/S- - PhoneG,3(-317(• TYPE OF PERMIT !� .BUILDING II RoOgPLElR Y LI SETBACK CIL ST./I aIEOPERTY LINE Address 2i/ n ST (-arm_ .t/esic 0 GRADING -El FOUNDATION STRUCTURAL 9lpg VARD ' LICENSED CONTRACTOR DECLARATION' /-! LEFT j� h/ • 0 TENANT ELECTRICAL PLUMBING MECHANICAL S5IDE VARD ,r•p /�/r I hereby affirm that I am licensed under provisions of Charter 9 (com- -• RIGHT }M1 mencing with section 7000) of Division 3 of the Business and 0 OTHER / /Q� /a(/ Professions Code, and my license is in full force and effect. - <. REAR YARD(TO•P/L) C PROJECT TCr RIPTION - • License Class License No. ' co Z C. PKG.SPACE REQ. PROVIDED • Date Signature SQ. FT. r WORKERS'COMPENSATION DECLARATION - 'OCCUPANCY /4 CONSTRUCTION TYPE STREET WIDTH ',I''/ PARK FEE$ /// I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION 0 ZONE - ZONING APPROVED BV (j I DATE.94/49z, certificate of Workers' Compensation Insurance, or a certified copy - - - - /V-f` thereof (Section 3800, Lab. C.). _ -GRADING CU.YDS. ACRES SPECIAL CONDITIONS: , ••y No- - Company - • - _ - -. artified copy is hereby furnished. - - - REMAR KS:-' " - - • L_ .,ertified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - • - _ (This section need not be completed if the permit is for one hundred($100) or less). - ` - - -- - • I certify thatin the performance of the workfor which this permit is -.- Issued, I shall not employ any perso in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL - PLAN CHECK - subject tot a Wo kers'Compensati[p{/ypLAaw�s,-of Calif orrnl/a, • UW FEEING GARAGE • Date -7--- ��'✓��/z+" 4«L�•' 18ATHTV BS, / SHOWERS • -� 00 50 FT /SOL SO FT - IS 0`J NOTICE: If a ter making this matron, you should become subject-pjUOILETS • URINALS 00 GENERATOR - 0-1 KW' 1-10 KW ' to the Workers' Compensatlo revisions of the Labor Code,you must ..-4TRANSFORMER forthwith comply with such ovisions or this permit shall be deemed AVATORIES DOUBLE LAVS - -$ OO APPLIANCE -10-50-KW_50+ KW - revoked. - s, __ —.. - .- __ - ' CONSTRUCTION LENDING AGENCY `KIT.SINKS - '" DISHWASHERS - —3 a° MOTORS - 0-1 HP 1-10 HP I herebyaffirm that there Is a construction lendingagency for theper- - - - - (INC.SOLAR - -y SERVICE SINKS SUMPS , ) 10-50 HP 50+HP formance�of the work, or which-t this-;permit is issued (Section 3097 - Civ. C.). • - FLOOR SINKS FLOOR DRAINS -s • • 'FIX. - OUTLETS' SWITCHES - • Lender's Name - • - - Lender's Address - _ DRINKING FOUNTAINS GAS TUBE SIGNS z . OWNER BUILDER DECLARATION ' S INTERCEPTORCLARIFIERS POLE LIGHTS - -- ' - - - - ' I hereby affirm that I am exempt from the Contractor's License Law for - the following'reason '(Sectlon`7031.5-Business and-Profdsslons Code:- SWIMMING POOL P TRAP - - - - UNHUNLSI.HUL UN — - Any city or •county-.whichr requires a,permit.-to construct, alter, - POLES METERED SUB ' improve,demolish or repair any structure, prior-to Its issuance,also re- WATER,SERVICE - ,7 ALTERATION - ' , 2 so PANELS MAIN SUB - . quires the apt.licant for,.such permit to file a signed statement that he - . - • '• Is licensed pursuant to the provisions of the Contractor's License Law 'GAS SERVICE OUTLETS Z - - - - • (Chapter 9 (commencing with Section 7000) Of Division 3_of the. = -s 'SERVICE ' - AMP - Business and Professions Code)-or that he Is exempt therefrom and the' /WATER HEATERS N.— - BTU OUTPUT .I Q� bt..;,-_-tar the alleged exemption. Any'violation of Section 7031.5 by • - - -_:pplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - -'- - - / '- .. - • ''t more than five hundred dollars ($500). r �. 't , • EJ-I, as owner of the property, or my employees with wages as their SOLAR TANK ' COLLECTORS . ' - " sole compensation,_will do the work,and the structure.Is not intended _ _ _ ' '- an ' or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ' r ISSUE FEE '- Contractor's License Law er does o not apply to an Owner of a• or _ - - - - -p at APPLICATION APPROVED BY DATEy�j'/�i2 who builds or improves thereon, and who does such work himself or ISSUE FEE J "`CCC r! f through his-own employees, Provided that such improvements are not - intended-or offered for sale. If, however, the building or,Improvement MECHANICAL - ' PLAN CHECK ' SUMMARY OF FEES is sold within one year of completion, the owner will have the burden - - of proving he did not build or-improve for the purpose of tale). 'BUILDING-- ' n - - q / t /• HEATING SYSTEM•,0-100,000 BTU 39 oo.- 00 PERMIT $ �ZQ •.�O n• SMIP $,�4__l2 I- as, owner of the'property,'am excluslLely contracting with AND DUCTING- , / t lensed 'contractors)to construct.the.prolect (Section 70.44, Business t. •h).1•Ij , 100,009,t BTU PLAN CHECK $ 83't'Z PERMIT and Professions Code: The Contractor's License Law tloe3'not dpplsi'ro'• $ 7 If 0O ISSUANCE $ an owner of property who builds or improves thereon, and who con-/ REFRIGERATION 0-100,000 BTU PLUMBING 3 tracts from such projects with-a contractor(s) licesned pursuant to SYSTEM - 1 - - - ' GRADING $,. the Contractor's License Law). 100,000+BTU I ;PLAN CHECK $ •- • ❑ 1 am exempt under Section - B.& P.C.for this - Q . BOILERS BTU ELECTRICAL $ /Q r to $ - reason - - MICROFILM $ - _ Date Owner SYSTEM REPAIR,ALTERATION PLAN CHECK 'S TOTAL FEE$ ' I hereby certify that I nave read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ 7 00 Information is correct. I agree to comply with all city and county ,PLAN CHECK- $ V - VANCE PC $_ representatives es state laws relating to t construction,t end hereby authorize of this city to enter upon the above mentioned �/7� gy property foy/ins cllOn pU Ose� ./ FINAL FEE $�•C . LV • Signature Se .U-7-7-iQ�— Date •271/47/-77 , Drivers' 'cense Or SS yr ' ISSUE FEE ,3 o _ �MF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL&SPA c APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector . 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - - 2. Soil Irpe-Undrgrn' 'Q_j3 e 3 44. Steel Reinforcement . _ . . 3. Electrical Conduit Utility-Undrgrn _ _ 45. Forms 4. Electrical Conduit-Undrgrn _ ' 46r Electrical Bonding - 5. Steel Reinforce l _ 47. Rough Plumbing & Pressure Test - - - . . . 6. Electrical UFER Grn _ . 48. APPROVAL COVER-GUNITE - -• . . . 7. Footings _ _ ` - 49. Electrical Conduit-Undrgrn 8. Foundation '3,Q JAL; - ))-3 .6":1^8_ 50. Gas Pipe, 0 Undrqrn,Test 9. Water Pipe-Undrgrn - 51. Backwash Lines.P-Trap. ❑Undrgrn - 10. - Structural Floor System - 52. APPROVAL TO DECK 11._ Property-Sewer Line &House Connection - _ _ 53. Backwash & Receptor-Final • • - 12. .Street Sewer Connection - ... • 54. Heater & Vent-Final _ 13. Rough Plumbing - _ - 7/fl/,.py .f, C'- •• "55 Plumping System- Final` 14. Rough Electric-Conduit •- - •56. Electrical-Final 15. Rough Electric-Wiring . • • • 3 ,CyEtj - (r 57. Solar System-Final • 16. Rough Heating &Air Conditioning 1 /1- 'PJ' _/.� 58. Fencing&Access Approval 17. Deet ' ��-,,,,, _',..,A 2,//9/F5' SVC 59. APPROVED FOR PLASTERING 18 Ducts, Ventilating - -. , - 19. Gas Pipe-Rough &Test ', 60. POOL/SPA SYSTEMS FINAL ' 20. Roof Framing • . 21. Roof Sheathing b. S H k lR - ' 7 . • 22. Frame and Flashing <,,.:,• „;,16.; _ -t/ - NOTES_ g- LGVGL/dEts,N17 ON kieeNT acr 2/4 at 23. Insulation - AC _ 7.//RAcr Tb rec Lures Arxirr7N6. rnear/L �'B�!'. ,L4-. 24. Lathing & Siding - - "ladNOT ea lPn. R-12 t) .� 25. Drywall.Nailing . - - - c-13-g'3. /J,n "p,Anye F � „Ars,.., ii r (..i.�rF•ee/rr 01 :no -t...e4.r� 26. Plaster Brown Coat • /,`''�`n1 G.A.,ata;G.4%47 Cal. u.,V.s.,<.Yi q,.,�� 27. Electrical Power Meter-Final �, (t . qea ., e w �r r L. - 28. Final Electric • - 1,/1//BS f Cr x.9.4 a„R, 4,,-�-J `t^�o� W/� i 29. Final Heating & Air Conditioning .. - yr 7Qw a✓ T.6.r�/f e, �,i��i2-I�7-sen.Ar.eJcrr%o /?./l 30. Final Gas Pipe-Test a/l�y4C , ./".... _ /j7 -F -;2Z tlin , ' 31: Final Plumbing /f//�f�f g�� C7_.>i 1S M Q. e c i c . - n -,1--P1 • 37. Water Service-Final 4-Q-fj // ,�,4 I,,���t 7.T,,qt,t��,' teen :Sri D.y.-_. • 33.• Gas Service-Final - - • _ - G,.,J �yr .Q, - "7""v 34. Solar Domestic-Final '• -ZS-B3- Oat Iwo( t2-e-e re sky ,p-. a� Cmc/< �;,..-stat sTsMt, 35: Landscape Sprinkling System - . .. _ /3-tk3 r�A)5• -Pi 24-... re; 1/le A C e - 36. Sound Attenuation - P.Q/{/otct, 7,,k pe, - ac4 ,PCS ac2C7 4 ,,-5 ,-G Dr7b,P c! 37. Handicap Regulations • ' / CCC!!l U 38. FINALSTRUCTURE & BUILDING - a///i (Dy cpn/sa - //n/PS n. ' 39. Special Requirements Completed 40. Electric Release to Edison - - - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date • --../.4_A2 /1-.1- — ✓.4_.v /_J-- <78_3 b/-a , • .4420.4424..722_1.571 e2Ctlear• O_iir/.vEe - T'c!<LUC2 -Cosi /%fs4- 1 C4 . - . . - /12G42,1/7- - 3336' ver�e% �-z=6o-x GB- /u .,_�Y� /sS ao o/•.t r�e/efe60 Lr-7�fLri too - hd©g/_s j`_/2io✓.de_ex:4 e-sT_- '.�s =� 1bS/q_!/_-_f�e7`41J---✓�cf./7�-�rJ_ fe p/G�Ge_!o?_ f4lwr.<(_l _/�oQ.Le-z - - - - - 4" ' _ /5efk% , ..�-s��//_.� _6���1�ss_Tnse.�fo�/5e/it/cc:ft_ - _____62.1. 4114.4_(/j�- ow/-/r! �e�/-a q���<q. /n5.a/fa 7'y oAA.ef74 cl'%fe_Cadet,—,54 -O-J-*2`!_/ooT—asci 5-a-b _4de - - - _yr/ass--S�«r /es --- -- -- - — -- — / end_//1.577 /4.::1_/.7 6cl- - /nef2r e7nd ..9a.4 7e.A /h 1c4// orf /t/A-cokneI o7�.es�it_T2Hq lou-s�.- —-- - •- ----- - - ---- -- / - - ltJ47/c-.6e/o.a ado_lize , -ilJ<tido uJ .//ne • - - ---- - ---- --- -- - - -- - - - ---- - - • - - - - n • - - r Applicant to fill In all spaces except those within heavy bottler lines and sign all appropriate declarations. ^- '\ CATV OF COSTA MESA' PER IT NO/. TRACT NO. LOT NO. t BLDG.NO. • I 'tz CONSTRUCTION PERMIT- / 44 — (07 2� p• , • • - • - Aprlicant's Mailing Address / Ca ' 'd fir TYPE OF CONSTRUCTION: IJ NEW YJ ADD U ALTERATION H REPAIR _ • Project Address �✓ ' =-j - / - + ui23 4/GI/„i3 ' -1;;; i ❑ CONVERSION ❑ DEMOLISH AL Owner's Name - Os - 'hone�3/- /•f� - DESCRIPTION OF WORK KL : eEP/ >4�� r . , ---s_ / ZONING REGULATIONS • Address ? 1/f' -70 Thi_ CI- c7 ,Af r4- i - a .. ' / - TYPE OF PERMIT U GRADING.U FOUNDATIor1Ns U STRUCTURAL A.PI*: . ZONE' Arch/Eng: - License No., ❑'TENANT ❑:ELECTRICAL El PLUMBING 0 MECHANICAL ' ' ' - PLNG.REF,516, I BUILDING - • • • crTnArie r/, CT ❑ OTHER -REAR YARD (TO P/L Address - - , •• . - • TO BUILDING i Contractor's Name • J - . PROPERTY LINE , Q -Phone_ PROJECT DESCRIPTION 50:FT. ' OCCUPANCY f/ CONSTRUCTION TYPE VALUATION$ .LEFT SIDE YARD,' RIGHT SIDE YARD Address(mailing) - � ' • ' ' ' ' 1 ' 20N)= GRADING CU.YDS: ACRES PKG.SPACE'REQs PROVIDED f LiceSse No, - __ ' i - ' - - - - • LICENSED CONTRACTOR DECLARATION - 1 Remarks: - ' 3j' 3X STREET WIDTH ' I - PARK FEE$ I . I hereby affirm that I-am licensed under provisions of Charter9(commencing VVV - _ •I with section 7000) of Division 3'of the Business and Professions Code, and ' - ' _ , SPECIAL CONDITIONS: I , my license Is in full force and:effect. - - - • - - 1 Ucense Class _. ! - • License No - I I PLUMBINGII • (• I i I� Date " ! Signature • ' I • 1 i - i Bar Sink ; I Sewer Cap , { !'. i I ELECTRICAL , 1 ' ORKERS'COMPENSATION DECLARATION % 1 , • I _ - 1 , �, .;;ereby:affirm that I nava a,Certificate of consent to self-Insure or a.certifirate I • ; Backflow'Preventer-- •, - •Sewer Connection' - - -i-- -. -- L .-- Automatic Washer ' _, _ :Meter Clover 100 amps 1 i , 1 Workers' Compensation Insurance,.or a certified(copy thereof (Section i - - "' ' '3800, Lab. C.) I I ' g . 1 — • Solar Collectors_ ., Construction Pole I I 'Sub Panel! , I I ' ! Backflow irrigation . - • Policy No. ' ' Company • - Cooking Unit , Sub Pole I 8 Certified copy Is hereby furnished. , ' • • i Bathtubs I Solar Piping I I ; - Certified copy Is filed with the city Building Division. ' I ' i • 1 j ( Dishwash"er j :Motors ❑01 HP 11%$ ' Date I ' Applicant ! Clarifiers , Solar Tank I EXEMPTION'FROM WORKERS COMPENSATION DECLARATION : Dish Washer • I I Swimming Pool w/Spa , , Dryers'OGi3sI ❑Eleotric ' ' Inc' Solar ❑9-15 HP ❑1615+ i (This section need not be completed if the permit Is for:one hundred($100)or , - less): i I , I I • 1 , I ' Fan i ' Microwave ' 1 I I certify•that In the performance of the work for which this permit is Issued I I I Drinking Fountains , Urinal - _ 1 , I shall;not employ any person in any manner sofas to become subject to the •- - I i , I , workers" omp n}at n'Laws of California ' ! i Floor Drains " I F.A.U. , Pole Light I 1 , Date' // /s) Signature _ -' i • i 1 Water Closet;f ft L. Fixtures 1 Range _ _ NOTICE;i ,a er making this declot. on-you s Quid-become-subject to the- r --4.. Fldor Sinks I - - , - i - -7 Water Heater - - - t-- -- _ - t 9 - - _ -1_ _. Workers': Compensation provisions G. the Labor, Code, you emed) revoked., th, I - - - , comply ;with( such provisions o this, permit Ishall be'deemed� revoked 'z I Gas Service. i ,pullets! Water,Serir¢e ' ' ! I Device-Boxes , Sign! i j ' ' CONSTRUCTION;LENDING'AGENCY ' ' r , t ' - Outlets I ' ' I hereby affirm that their'is this-&construction lending agency for the,performance I i. Interceptors' ` ( _ - - - �Standing Sections , of the :work for, whlchr this- permit -is ;issued .(Section-3097- Civ- CJ.- ' - `'" I ' " • - ' Lenders Narita/ ' 4 -• - r ' - I - - i - Switches . , ,Trash Com actor _ Kitchen Sirik• { I I I /. .. P4 : Lender's' Address• - /t/ /4 • I . I - OWNER BUILDER DECLARATION' f r LavaLOflei .. i q - _ i -„ Garbage Disposal ( [ 1 ` f l , c' i • I hereby reason hat I am exempt,from ss and ntraession License Las'for the P Tra - ! , Generator,❑O-5 KW ❑5-15 KW I i t ' following reason;(Section perm t-to cosiness and Profession de e: Any city or . n, '. i - ' ' county. which.requires a permit ce al st ruct,alter,improve;demrl;shot.eepee I 'an structure, prior to itr.issuance,also re uires thea licanb permit , _ Transformer :]15-50 KW , Y q PP for such _ Roof Drains, - ! � - - •j . I 'to file a signed statement that he/she Is licensed pursuant to the provisions or ' - - .r, - ' ,- ' il - the Contractor•t Ucense Law,(Chaptfe 9(commencing'or withSectionis7000)ext of _ , • • • I 050+KW; 7 •,Reinspection Fee $15' 11':ision'3'of the Business and.Professions Code) or: y viole/she-:is:exempt I ' ' Showers ` , - , Reinspection Fee ' '$15 - - - ,iVeirom and the.bath plica for the alleged permit-subjects•the Y'violicant f Section , i r - - - , - ; - - I Meter Duo to 100'amps I Issue Fee! ! ' $ 3. }:331.5 by:anyapplicant nt for ta -applicant to a civil , „ 1 - _- _ 1 _ te I ¢chaffy of not more than five hundred dollars($500). Service Sink I 1 Issue Fee I $ 3 , /.: Zoning Approved By Date • 1 I,-:as'owner off the!property or my employees with Intendwages,as their sole , _ , e 1 r : compensation' willido the work,and the•structure•is not The ed or offered : i - s I i MECHANICAL 1 Application Approved By l •Hate ; for sale (Section 7044; Business'aridr Professional Code::Thel Contractor's • - C/L(�)'� y , Ucense Law does not apply to.an owner of a property;who builds or improves j Boiler ' Refrigeration System Application Issued Ely 'r / 1 ��/•/" ' I thereon,land who does,such'such work himself/herself or through his or her own i '' , , ' • , - I I , PP Date employees, provided that such improvements Is s Intentletl or offered for : - ❑0-100,000 BTU EJ100,000 BTU. ' : sale. If, however, the building or Improvement is sold within one year:of corn- , i Duct''-.Under Ground l - I I 1 1 rspletion, the owner!will have the burden of proving he/she did not build or im- ' - _ ( SUMMARY OF FEES , ) 1 lye for the purpose of sale). , - Duct-Structural t S stem Re err/Alteration I I 1 t . . i 1 I Y. P - BUILDING PERMIT $, , SMTP j 1 $ ' i �c, �.,Iq I,as owner of the property, am exclusively Businesscting.withei<enied<on- _ - 1 I , I i I I •'tutors to construct ctchese La ct(Section 7044, and Professions Code: ., Duct-Ventilating _ - I -PLAN CHECK' $� I PERMIT 1 r The Contractor's License Law does not contracts to an owner of property who , ! ' builds or improves,thereon, and who for such projects with a con- I ' ISSUANCE • $ ' - ' pExhausts st9m ❑ Multi le�� ;PLUMBING $' tractor(s) license pursuant to the Contractor's License Law). I • I y P - - I GRADING $ ' 'Om exem t under Section B.& P.C.for this reason i tit_ • i 1 - 'PLAN CHECK $ I p - Firepl/Fact.Blt.•iCBD . ! 1 ,ELECTRICAL' $ i .. r i s I I r : i Mydyi/ i l 1 1 ! I , $ I • I ` I Date l : Owner' ' I ! ' i I Heating':System& Ducting i I I I I I ' ' - _ ;PLAN CHECK, S. MICROFILM $ , • I-hereby certify that is have read this applic all and state that the above- �0-100;000;BTU 0100,000 BTb•r. - - i ' $ i ' ' information is correct. I agree to comply with all cityiane county ordinances ' ; i I • i , TOTALFEEI ' j and-state laws relating to building construction:and hereby authorize repre- 1 - 'MECHANICAL eI .Ori: 1 I 1 sentatives of(this:city l to enter l upon the above-mentioned property for 1 , Hood or Type l ❑I 1 i 1 , Reinspection,Fee ' I , LESS i I Inspection pu ,oses_ i ' Canopy, Type II ❑' I : r :PLAN CHECK; i $; �'�n qD VANCED;PC 1 $ ( ; Signature / e or ;/�P': �`�_ f Date /' -' I FINAL FEE. $ ' d - Drivers Li '. 'se or 55 ' - - • 1 ./ ' i Registers 1 I Issue Fee I <-'I $ 3 I I O • CMF 0665-46 rev.12/62- White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor ' -: ' CONSTRUCTION AND;PLANNINC. .'APPROVALS Permit,;# ' ' ' -; c: Date Inspector ,`APPROVALS' ?'-Permit,# - : Date - Inspector o. t1, Temporary/Electrical Service or.../Pole ,a I f_//, ' l ''52: Pool &'Equipment Location ,- • - 2: Soil PipUndrgrnd•' ",.. ...,.e.-- ; ; - 53Steel Reinforcement ment . - -- 33. Electrical Conduit Utility-Undrgrnd. rtt. '^r • -54. Forms, _ -, -. . ` .. 4. Electrical Conduit-Undrgrnd'.; ; ; _ _ 1. 7 _ 55,E Eledtrical.Bonding - - ' - ' 5[ Steel'Reinforcement /1 ' T , ' ' '''',v • •- 56. Rough Plumbing:& Pressure Test.,: ' . ' •6. -Electrical UFER,Grnd.' ° ; - , ,, - - - : 57? APPROVAL TO COVER-GUNITE, 7. Footings • ' ' - *, I I i.l . ge •• -7. - ..58. Electrical-ConduitUndrornd. • '- ' . 8. Foundation t ! I ' - ; 1 Y - • I 59. Gas Pipe,=O Undrgrnd7,Test ' - • ' 9.,Water Pipe-,Undrgrnd. ' r, I ; -• } 60. Backwash Lines,,P-Trap, O Undrgrnd. ' - ' 10. Structural Floor System ; '•rf t , " ' - - - , 61. APPROVAL TO,DECK ' _ 11. Property Sewer Line &House Connection' i ^' .,,;;, 62. Backwash &.Receptor-Final ' - - . . • 12. Sewer'Cap i ' , '' , ' 63. Heater&.Vent-Final • : 13. Roof Drains ; ' , i `• . .- . ,'64. Plumbing System - Finale 14. Rough Plumbing; ::•-1/ ' ' : - I ' • -65. Eledtrical-Final- - : - - - - - 1 ' 151 Rough Electrical-ConduiYi'- --ii--I. - -I - - r ,66. SolariSYstem-Final' _ ' -- - -_ - --- - - • , "16: 'Rou'Rough:Electric • I ; ' - 1; ' ' r---7- ' - _ - - . - ._ •. 9 g, � �1 � � 67: Fencing&'Access Approval . 17. Rough Wiring Sign : ,.r ' `' ; • ___—codeoR.4✓A/ de.4/A494-C__ SZO.R 1 cr Z.�/_�. - - - r-.074-4���`}}`T r Co 5747 Ain-4 - - - —//icre-/S q 2./4A._s/ope go n e _ - 71;f- o-�_r-e_e*r/sz-np �yo.use-_T_lmo.f-_s/o 6- on d /_de -S/v.Ac_,S__1._77A Trope76.y, v-f - - -------.7yie_Ao-ce e__sl¢6 7;17%e_/So77oT- - .cyw7Ter City of Costa Mesa INSULATION CERTIFICATION Building Safety Division _Z/1 ZD7�lr Coc/A A'6 A CW,gs /er-r( Number and Street City County Subdivision Lot Number DESCRIPTION OF INSTALLATION ROOF Material Brand Name Thickness (inches) Thermal Resistance (R Value) EXTERIOR WALL Material f/ 4P peikr c$ Brand Name Cee 7e71///7 r' !/ c-L Thickness (inches) / .7 Thermal Resistance (R Value) /1 CEILING � Batt or Blanket Type ,Ti6Gj-'7, 4s S Brand Name CCF7j472a" , /// Thickness (inches) 4y, Thermal Resistance (R Value) /9 • 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 (inches) 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). Ov✓A/gte ?Cif l air �d General Contractor Mundell.) cense Number r 6/5A#r Signature and Title Date Sub Contractor(Insulation Applicator) License Number 0 Signature and Title Date CMF 1106-30 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -CITY OF COSTA MESA PIT NO_ TRACT NO. LOT NO. BLDG.NO. 7I 22 6/09/82 26.90 TL, g- S CONSTRUCTION PERMIT &sq ' pi i-Hf- . porZO Project Address_Tij ft 7 r TYPE OF CO.N�S'TRUCTIOf� Owner44, 4 . Phonerer _ 0 NEW ADD ALTERATION :� C, Addrs` .1E .Cf 'o 6 f 0 REPAIR 0 CONVERSION ['DEMOLISH ZONINGREGULATIONS Arch/Eng. a License No. 0 OTHER - DE RI PT 10 N OF WORKA • Address 0tcw A-tY(TEOAi ZONE I PLNG. REF.* -cc -- Z ^_] Contractor TYPE OF PERMIT - - - BUILUIN - TQ g�1I DING / -I- a ,,// SETBACK ST. PROPERTY LINE I 1 'r• Phone 0 GRADING 0 FOUNDATION (� STRUCTURAL SIDE VA RD 24-1lo" LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OPLUMBING ❑MECHANICsiDE Ys ARD WassAlLa(1,( Q I�II I hereby affirm th (:.t I am licensed under provisions of Charter 9 com- A RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, and my license is In full force and effect. • REAR YARD(TO P/L) PROJECT CRIPTION - . - .- _ 44---'"License Class License No. PKG.SPACE REQ. PROVIDED Date Signature SQ. FT. �• WORKERS'COMPENSATION DECLARATION OCCUPANCY ONSTRUCTION TYPE STREET WIDTHV PARK FEE$ / I hereby affirm that I have a certificate of consent to self-Insure or a - CI) � ZONE ZONING APPROVED BY P�C-�W14LDATE co{{{IG - certificate of Workers' Compensation Insurance, or a certified copy -VALUATION 4� 44--�� thereof(Section 3800, Lab. C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: "dict' No. Company - Certified copy Is hereby furnished. - REMARKS: - Certified copy Is flied with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - ' (This section need not be completed If the permit Is for one hundred • ($100) or less). • I certify that In the performance of the work-for which this permit is Issued, I shall not employ any person In any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to the WorkersCompensat on ws of f.aIlfpla. DWELLING •GARAGE Date A_O- g2 Signature �� �+���. BATHTUBS SHOWERS • NOTICE:lIf after making this declaration, ou should become subject TOILETS URINALS -GENERATOR -p-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must _ TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW_50+KW revoked. 1 . . .. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS • MOTORS -' 0-1 HP 1-10 HP - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS- (INC.SOLAR) 10-50 HP 50 + HP formance of the work for which this permit is issued (Section 3097 - Clv. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address - DRINKING FOUNTAINS GAS TUBE SIGNS - . OWNER BUILDER DECLARATION INTERCEPTORS , CLARIFIERS POLE LIGHTS I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: I SWIMMING POOL P TRAP LUNS I Hut.I we/ -- — Any city or county which requires a permit to construct, alter, POLES METERED SUB I Improve,demolish or repair any structure, prior to Its Issuance,also re- WATER SERVICE ALTERATION PANELS 'MAIN SUB quires the apl.lisant for such permit to file a signed statement that he - is licensed pursuant to the provisions of the'Contractor's License Law GAS SERVICE OUTLETS SERVICE - AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT - basis for the alleged exemption. Any violation of Section 7031.5 by • - applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS I - 1 tot more than five hundred dollars ($500). - I, as owner of the property, ca ' " ^^^ SOLAR TANK COLLECTORS - • - (} fplG.wsnperteaiiefr, will do the work, and the structure is not Intended - ' `4[- or offered for sale. (Section 7044, Business antl Processions Code: The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law tloes not apply to an owner of.a property • c • who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BV' ♦/ DATES - through his own employees, provided that such Improvements are not intended or offered for sale. if, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY e is sold.within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of sale). BUILDING HEATING SYSTEM 0-100,000 BTU •+ ❑ I, as owner of the property, am exclusively contracting with AND DUCTING - licensed contractors to construct the project (Section 7044, Business 100,000+BTU 0 and-Professions Code: The'Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from •such-projects with-a- contractor(s) Iicesned pursuant to SYSTEM ' the Contractor's License Law). 100,000 +BTU_ ❑ 1 am exempt under Section - - - - B.& P.C.for this BOILERS BTU reason '- -- - Date- - - Owner- - - SYSTEM REPAIR,ALTERATION TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE - AD- information is correct. I agree to comply with all city and county ordinances.end state laws relating to construction,and hereby authorize representatives sofp this city to enter upon the above mentioned ■, .property-tL.p��r%i%nspectlis p r@to • Signature T �-4 .e• .. ISSUE FEE CMF 0865-46 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 - _ 43. Pool & Equipment Location''- - - • • 2. Soil PrinIndrgrn 44. Steel Reinforcement - . 3. Electrical Conduit Utility-Undrgrn • 45. Forms . - . ' 4: Electrical Conduit-Undrgrn , . - _ ' . , . 46. Electrical Bonding 5. Steel Reinforce 2.4.,_.,„..041 �) Y . _y3 /3 47. Rough Plumbing & Pressure Test . . _ - . 6. Electrical UFER Grn / 48. APPROVAL TO COVER-GUNITE 7. Footings 23•5-'%3 _7'' 49. Electrical Conduit-Undrqrn 8. Foundation - X •S-6? '7?-2-"/ 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines, P-Trap, ❑Undrqrn 10. Structural Floor System ( ce d.5---lig B')ti 52. . APPROVAL TO DECK 11. Property Sewer Line & House Connection 53. .Backwash & Receptor-Final 12. Street Sewer Connection - _ 54. Heater & Vent-Final 13. Rough Plumbing _55. Plumbing System -Final 14. Rough Electric-Conduit 56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning _ 58. Fencing & Access Approval 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating . 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing 21. Roof Sheathing NOTES: 22. Frame and Flashing e..o/�C�' •� �4 '-rn • � 2) 5 -i23-P3 23. Insulatione„a.jS" .)S Vifi _ 24. Lathing &Siding o --r- \--NrAv sw_ Q-+2lLi_r- .i 6-33...-2 i rag, QR.i e-,,, 25. Drywall Nailing '0::3‘5r as (/l/5 - 26. Plaster Brown Coat 27. Electrical Power Meter-Final •• 28. Final Electric • 29. Final Heating & Air Conditioning _ 30. Final.Gas pipe-Test _ 31. Final Plumbing "�" -• - • •- - N 32. Water Service:Final -- .33.` Gas Service-Final _ 34. Solar Domestic-Final • t35.- 'Landscape Sprinkling System. - 36. Sound Attenuation • ' • . . 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 7/f7/K� A_ . , 39. Special Requirements Completed 40. Electric Release to Edison . • 41. Gas Release to Southern California Gas Co- 42. CERTIFICATE OF OCCUPANCY '-No • Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. cQ/a 39 PE IT NO. T• • T Na LOT NO. UNIT NO. 1 CIT,..aOF COSTA MESA CONSTRUCTION PERMIT -�• k„ hof �5 A.P.# 4� — 2-7' — Co l Zone R. I _ - 37 7!S Project Address - w�+ ��7 E. S Main Building: Accessory Building: 1 Applicant's Mailing Address S,4.N T s 5/U G TYPE OF CONSTRUCTION U NEW IN ADD ALTERATION U REPAIR E (1 _ Z Owner's Name e./OSA/. "- - �m/s/G� Phone 4E 1 - 3f7 0 CONVERSION yV❑ DEMOLISH 0 OTHER T Front +a -G -1 l f'O DESC<RI O ;#4153 ICE E 0 77 _ v i A Rear (cO 1 N Address k (�jy; L LL (— Arch/Eng. License No. TYPE OF PERMIT GRADING U FOUNDATION ❑ STRUCTURAL I K Right t 2/ GN Address //�//� 0 TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL s Left ecus& R Contractor's Name a/A/F - 3'ndo..e Phone 0 OTHER I Ping. Ref.'s Parking Req./Provided E Address(mailing) PROJECT DESCRIPTION SQ. FT /6•S/(cS TION$ N �CL-/ x ��6 4 M CONSTRUCTION TYPE Y VALUATIONS2.3T Planning��a�..��ooNnnOles 11, _ 1 .�• 11L�'7 41 meq �n.e City License No. ZONE GRADING Cu.YDS. ACRES Ww1- A eil�1k` 1lA.l-(0 ✓isJ S. LICENSED CONTRACTOR DECLARATION 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 full force and effect. ELECTRICAL FEES License Class License No. Date Signature PLUMBING FEES Automatic Washer Transformer 0 15.50 KW • WORKERS'COMPENSATION DECLARATIONConstruction Pole Sub. • ❑ 50+ KW i 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 Dulato 100 amps 0, Lab. C.) / s-olicy No. Company Backf low Irrigation Sewer Cap Dishwasher Meter Dover 100 amps 8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electr IC Sub Panel Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Date Applicant Fan Motors 00-1 HP OVA-6 EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors �_ (This section need not be completed if the permit Is for one hundred($100) or Dishwasher F.A.U. Inc.Solar 09.15 HP 016-15+ less). Solar Piping I certify that in the performance of the work for which this permit is issued I Fixtures Microwave shall not employ any person in any ma ner,.lo as to becommmeaa subject to the Drinking Fountains Solar Tank — worker C Al p ion Laws of Canto a•_// E' - / Device Boxes Pole Light ' Date Y D" Signature B Lws• v�}'C1is� Floor Drains Swimming Pool w/Spa 9 NOTICE: If,after making this declar I n,you should become subject to the - — Outlets Range Workers' Compensation provisions the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or his 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.) Interceptors Water Heater �.., . Garbage Disposal Standing Sections Lenders Name - "A",...,_ Generator ❑0-5 KW 05-15 KW Trash Compactor Lenders Address Kitchen Sink Water Service 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 t 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 r Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee I $15 Issue Fee $ 3 w sefrom and the basis for the alleged exemption. Any violation of Section � 5 by any applicant for a permit subjects the applicant to a civil / -'fd�Yalty of not more than five hundred dollars($500). DEVELOPMENT SERVICES REQUIREMENTS: Zoning Q wagesReinspection Fee I $ 3 Zoning Approved By v I Date<�'7-� J 1�7-y�I, as owner of the property or myemployees with as their sole Pe $15 Issue Fee1 for sale ion, 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 License Law does not apply to an owner of a property who builds or improves Date / thereon, and who tloes such work himself/herself or through his or her own Application Issued By Dat, ©-` ir Hood or Type provided that such Improvements are not intended or offered for Boiler I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 SI,MAer 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 safe). Oak.BUILDING PERMIT $ 00 SMTP $ 0'.22 ❑ i, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System PLAN CHECK $ Y.C. /0 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 BTUPLUMBING $ ISSUANCE $ builds or improves thereon-and who contracts for such orolects with a con- tractorslicense pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof oftheir Worker's Compensation insurance should be provided to me. ELECTRICAL $ GRADING $ IDI am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers MICROFILM $ /�/ PLAN CHECK 50% $ _ Date ?/a IR9 Owner e�� Heating System& Ducting I Registers MECHANICAL $ - TOTAL FEE $ /93.6o I hereby erti that I have re this application and state that the above ❑0100,000 BTU ❑100,000BTL Information is correct. I agree t comply with all city and County ordinances PLAN CHECK 25% $ and state laws relating to build g construction,and hereby authorize repre- 1 sentatives of his city to enter upon the above-mentioned proper for Inspection p cos-Signature Q Signature i./Cyf,Date Drivers' (nse or SS# Reinspection Fee $15 Issue Fee $ 3 01 00027741-00027743 TOT 1'. ,r,� 0865-46,rev.5/88 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor DATE= 03/07/x9 TINE: 11:12 'CONSTRUCTION AND PLANNING POOL 'PA 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 Reinforcertient 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE • 7:,Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Ges.Pipe, 0 Undrgrnd.,Test 9. Water Pipe•Undr9rnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10: Structural Floor System 61. APPROVAL TO DECK • 11.•Property Sewer Line & House Connection • , 62. Backwash & Receptor-Final 12. Sewer'Cap 63. Heater & Vent-Final 13:Roof•Drains • • 64. Plumbing System - Final 14...Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 1,8. Rough Electric Wiring 67. Fencing & Access Approval • W. 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. Underg?ou,id Flush 24.:Roof Framing 73. Undergrnd.Storage Tank ❑Gas ❑Oil • 25.' Roof Sheathing ''r 74. Overhead Hydro 26. T-Bar Ceiling (Stluctural) & Monocoat 75. Dry Chemical 27. Frame'arid 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' .1°INAL 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 - , l 41. Solar Domestic-Final 42. Backflow Preventer ' 43. Backflow Irrigation 44. Landscape'lrrigation System 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUI LDI NG 3-/V.s� 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - t. 51. CERTIFICATE OF OCCUPANCY c Na. ` Date • ' , ' NOTE: SHOW AND DIMENSION PROPOSED PATIO COVER AND YARD AREAS t SEE DETAILS ON REVERSE SIDE —1.7_ -- f - `0 ••"4., "'ROOF SHEATHING ;� tl FOR INSFECI • ► I,S I I OVERHANG /�Ai./ = zc' CA Co ✓e-,e 754-5626 _.....x_RAFTERS AT_0.C. . ,• L' ___ O ible./41 to 754-f 627 0 _x___BEAM r---I .4--e I- T-STRAP EA. SIDE Li FOR POST-BEAM CONNECTION. o g T8 -877/5° a U _ a I 1 APPR DV � a o.0 rc g Cl)ri D ¢ a u . co o _ Ci of C esa BuiWdi NI De.t. o .1 to F _ ppp ��pI M y a. o it -p_ �Y/1 BY OA !3 n!' PATIO' a�`, Z x _I z o ADDITIONS, DELETti OPTS, OR CORRECTIONS SHALL THESE PLANS MUST BE ON JOB AT AL�IMES ARIA R 2" la 5 ape o a NO CH 1NGES WITHOUT PIJOR APPR ti,L DEPT. a O v BE APPROVED BY HE PLANNING DEPARTMENT 'DI I 1 ► SLOPE TD DRAIN I PLATE 1" �� I 1 THEIISSIIANCE OR GRANTING C- A PERMIT 17 anon,/ n / ABOVE SLAB'1. PLANS Al'D SPECIFICATIONS SHAT NOT BE CONS.'8ED'TOiBF A : ^ PERMIT FOR, OR AN APPROVAL OK, ANY VIOLAT a' THE PROV SIONS OF THIS CODE.N J PERMIT PRESU/ G TO GIVE _ 1 'LSI AUTHORI Y TO VIOLATE OR CAN El THE PROVISIO 2� GASG I. FLASHING N 1 1 VIPs Qbid WHIICSH M 1I AUTHORIZES ES IAWFU PT IN 3y FAR AS THE WORK O (jD FLOOR yl__ J I TO 5 F• ONSTRLSTION PIERS 12 SO�' o C OF COSTA MESA THE I,SUANCE OF A FERMI BASED UPON PLANS AND Q PLANNING DEP1� t �- NS SHALL NOT PRE ENT THE BUILDING OFFICIAL sr !MEC!TO oE�• DEPT IB'A. FROM TH REAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATIC NS OR FROM PREVENTING a Z ��� �� BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN la: �r o� IT -1---�� STREET IN IOLLATIONOFTHISCODEOR(FANYOTHERS110ECEELEVAT10N PLOT PLAN • CONSTRUCTION DETAILS 20ths.ROOF• CONNECTION DEVELOPMENT PATIO COVER DETAILS SERVICES DEPARTMENT ' BUILDING SAFETY DIviSICN T Y P. PLANS CONT. SOLID BLOCK LEDGER — OWNER: ✓r/21n1 t- • 22./47? DATE : '21 frill .1*1111111 ADDRESS: 7/f C 20 "A. S 7-• PHONE: �3/l—.?J7- • 1/2" DIA. X 5" LAG 5CR. CONTRACTOR: vix/A/.� - $e.' 7i7Eif' LIC. NO. AT 32" O.C. ADDRESS: PHONE: • DETAIL I RAFTERS RAFTERS APPROVED FOR CARPORT, PORCH OR PATIO LIGHT WEIGHT ROOF COVER OF BUILDING PERMIT NOT SUPPORTING CEILING LATH, FIBERGLASS, ALUM. • By Date SIZE. SPACING SPAN SIZE SPACING SPAN 2"x4" 12"O.C. 9'-6" 2"x4" 16"O.C. 9'-6" CR a CL "TECO" rENERAL NOTES: GRIPS OR JOIST 16" 8'-0" 24" 8'-0" HANGER 24" • 6'-6" 32" 6'-6" 1. These plans must be CLEDGER '' ---- -----32" - -- 6'-0" - • -. 48" 5'-6" . kept •on the job at a 18" ; . . r :5' -6" 2"x6" 16" 16'-6" all time during 2"x6" 12" : •16'-6" 24" 14'-6" construction. 16" 14'-6" 32"• 12'-0" 2. All framing to be 845" DIA. x 5" LAG SCR. 24" • 12'=0" ' 48" 10'-0" Douglas Fir N92 AT 16110.C. 32" , 10'-6" 2"x8" 24" 19'-0" grade minimum. 48" 8'-0" - ._._ "_ 7' ' 32" 15'-6" 3.. Rafters may not DETAIL 2 : 2"xB" 24" 15'-6" ' • 48" 13'-6" attach to facia ex- 32" 13'-6" cept for 1011sroofs 48" 111-6". . as shown on details; IOIbs.OR . LIGHT WEIGHT ROOFS 4"x6" 24" . 17'-0" . - HEADERS 201psroofs must use ONLY CONNECTION DETAILS 32" . 15'-0" a continuous ledger 36" 14'-0" • LIGHT WEIGHT ROOF ONLY attached as shown • X FACIA-MIN.REO. 4"x8" 24" 21'-O" SIZE POSTSPACINGon details #14.42. 2":11frl[ . .. ' • 32" 19'-0" ' 4x4 6'-0" 4. Light weight roofs 36" 18'-O" 4x6 • 9'-0" may attach to facia CM' 48" 16'-0" 4x8 12'-0" for 14' span max., srlii /dna 4"x10" 32" 22'-0" 4x10 15'-0" spans over 14' must 36" 21'-0" use a continuous CARPORT. PORCH OR PATIO ledger as shown in 48" 2O'-O" SIZE POST SPACING APPROVED METAL detail #3. HANGER 72"- 17'-0" " ' ""' 4x4 5'-0" 4x6 8'-O" DETAIL 3 4x8 10'-0" 4x10 12'-6" On ORO i arm ........m r City of Costa Mesa MEASURE "G" EXEMPTION Plan Check # Exemption # 89-239 Permit # Case # Address: 211 East 20th Street Unit: ApplicantJohn E. Joner FACTS: 0 Residential ❑ Commercial/Industrial ❑ Other ❑ Existing Lot ❑ Not Part of Larger Project Project Description: Legalize 165 sq.ft. patio cover attached to existing single family residence , No. of Dwelling Units one Gross Floor Area NA Square Feet F.A.R. NA Estimated Traffic Generation: NA Avg. Trips/day FINDINGS: The above described project is exempt from compliance with Measure "G" for the following reasons: ❑ 1. Project is a commercial/industrial development which meets all of the following criteria: gross floor area is equal to or less than 10,000 square feet or has an average daily trip generation • of less than 130 daily trips, has buildable floor area ratio of less than 0.5, on an existing lot, and is not part of a larger project. ❑ 2. Project is a residential project of four dwellings or less on an existing lot. ❑ 3. Project is residential construction that does not increase the number of permanent housing units on the parcel where the construction takes place, such as remodeling or rebuilding of an existing house. ❑ 4. Project is commercial/industrial construction that does not increase the footprint or square footage or change the use on the parcel where the construction takes place, such as remodel- ing or rebuilding an existing structure. ❑ 5. Project is a public benefit facility, which is defined as public libraries, public administration facilities, public parks, public utilities, and religious facilities. ❑ 6. Project is a facility serving the health and safety of the people, which is defined as hospitals, police, fire and safety facilities, and schools. Exemption ratified by: x❑ Planning Commission Date February 27, 1989 ❑ City Council Date afN 164&30 - t .11 : Applicant to fill in all spaces exceptthose within heavy border lines and sign all appropriate declarations. ` PERMIT NO. TRq CT LOT NO. UNIT NO. CITY OF COSTA MESA CONSqT UCTION PERMIT 2hue“..) RT 6740 10/05/87 34¢33 TL Project Address '2-I I 'a. ZO "' 1z7� 05-as- HF is�JTS P012/ 203 - NOiicaift•s Mailing d :2s.. )i LA-Sal la lana r t I�/'�}�M MPlscIa PE OF CONSTRUCTION LI NEW tri, RUJfALTERATION LI REPAIR C>=•NJ N �4t 3lir '❑ CONVERSION ❑ DEMOLISH ❑ OTHER �J' r A.P.# y 2(o — 2 7 3 -O Co Zone . A I. Owner's Name ..� PhoneF�"1� 1 DE RI TIO PF ORK/USE OF QLDG. Z1"--E s'�/ CLfrC� Address Z 11 a. 7-c I��LCi S Main Building:4/"t aex wan' Accessory Building: Arch/Eng. License No. TYPE OF PERMIT GRADING U FOUNDATION LI STRUCTURAL T Front 60 " O Address 0-TENANT ❑ ELECTRICAL ❑/'PLU/M�BING 0 MECHANICAL BA Rear Q -' N Contractor's Namejlit'\-LZ'j� t 3L --Lissm- ❑ OTHER G(^,' /, o,,/ T'�Q-( p'� /N/[$p t g O ��11''�II tib• �Pfhone / C Right i N Address(mailing) 7136 - o�-TY• , C� PROJECT DESCRIPTION SQ. FT. OCCUPANCY, ,t7u K Left G all S�� CONSTRUCTION TYPE VALUATION$ /P On $ City License No. is-1 ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E CI I hereby affirm that I am licensed urn: provis• of Charter 9 (commencing Remarks: Planning Notes: �( k kW lJ� wan.. cob M with section 7000) of Division 3 • Bu ' es• and Professions Code,and T my license is In full tome e • p&. License �+ ic:'$e�y1 7/7•_� & I---f • S Date i0� Signature WE r— rnI - PLUMBING FEES WORKS S'COMPENSATION DECLARA ION Bar Sink Showers ELECTRICAL FEES I— ,- -hereby affirm that I have a certificate of conse • self-insure or a certificate Workers' Compensation lnsur-- , ••r a rtifl=• copy thereof (Section Backflow Preventer Service Sink \ ,800, Lab.Zf.)ti If ,S� _ Automatic Washer Transformer 0 15-50 KW Policy No.eco. 1 Coma y S 1 �� Backflow Irrigation Sewer Cap0 50+ KW 9 Construction Pole Sub. �, C�Jtified copy is hereby t rthe cit. ' Certified copy is flletl wi the city eu' in• j Bathtubs Sewer Connection Cooking Unit - Meter ❑up to 100 amps fian�s" Date /0-5-37 A•. 'cant .•� � �- - I'd EXEMPTION FROM WORKERS' • -ENSATION DECLARATION Clarifiers Solar Collecto Dishwasher Meter ❑Over 100 amps (This section need not be completed if the permit is for one hundred ($100) or • less). Dishwasher Solar Pip' 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 Sol ank Fan Motors 00-1 11/2-6 Workers' Compensation Laws of California. Date Signature Floor Drains imming Pool w/Spa F.A.U. Inc.Solar 9-15 HP 016-154- 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 Mi ave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Ole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water H¢at¢r Outlets Range Lender's Name • Lender's Address Kitchen Sink Water Service Switches i Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage DisposalStanding 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 -- -- - erefrom and the basis for the alleged exemption. Any violation of Section )31.5 by any applicant for a permit subjects the applicant to a civil kenalty of not more than five hundred dollars($500). 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 - 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 ❑ f(] -5' —) sale.sale. If, however, the building or improvement is sold within one year of com- Canopy T pe II 0 Zoning Approved By �1 eV\ Date ;station, 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). - C _�/ae� 0 I,as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refri ation System Application Issued By ��- � [ r \ 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 100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- • (yam tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ .2.-C2• SO SMIP $ s '-� v proof of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration PLAN CHECK $ i 4 . 33 PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ' ISSUANCE$ $ Date _ 0 ner Heating System& Duct Registers PLAN CHECK 25% $ ENERGY P.C. $ I here certify that I h. e read if is ap kation and state that the above El 0-100,000 BTU 0100,000 BTL_ ELECTRICAL $ GRADING $ infor tion is correct( I .•ree to wi all city and county ordinances and st to laws relatirCk t• buil.' '• ruct on, a•d hereby authorize repre- PLAN CHECK 50% $ MICROFILM S sentatl es of this ci as,�a". • th- a•- j ntioned property for �I inspect on purposes. IQ.5 Q^7 _ Signatu Date 77 6 / i MECHANICAL $ TOTAL FEE $ 33 Drivers' License or S# ! 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 ry1 Gple.( ,56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 1I LL`` . 57. APPROVAL TO COVER-GUNITE 7. Footings r'O'sIf' .. 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 ' f. 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil - t 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 - i 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED . 33. Final Electric Notes: /Q/s'/g-7 01c, TO (3-iZ461/tG'_•,4J 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace _ ' --- 38. Final Plumbing 1� •• - ' 39. Water Service-Finalr • 40. Gas Service-Final •''', L.. -, 41. Solar Domestic-Final • r • 42: •Backflow Preventer :7 - • • 43. Backflow Irrigation . r.- . - • • - .. • y • 44. Landscape Irrigation System • I - ,' :,45. ,Sound Attenuation , . - • . - • . 46r Handicap Regulations - - r ,,47"FINAL STRUCTURE & BUILDING n �g Ind -b ( A - ! '- ;- ; - 48. Special Requirements Completed -•/`� gel ,D"r r t • 49. Electric Release to Edison r `- .tr - '4 50: Gas Release to Southern California Gas Co 0, 51. CERTIFICATE OF OCCUPANCY t• -i No. Date . • • I P ` TYPICAL e CONCRETE BLOCK FENCE a - . . Cement Coping Optional :-1' -- •— `' GENERAL— NOTES Channel Block With 13/80 'II Horizontal Top of all Fences MORTAR; One part Plastic Cement, and Three Ports Sand For Fences 5'or Less Q GROUT: One Part Cement Three and X One Half Parts $and Vert.Ban 3/8"0 at 4' -0"O.C. 1d1 0 I I I COPING: a = One Part Cement, Three; For Fences Higher Than 5' li Li.a ~ I _-.P--arts'Sand- Vert.Ban 3/8"m at 32" O.C. > w CONCRETE: Wei 1 Mixed 1:2-1/2: 3-1/2 cc = Max. of 7- 1/2 Gallons of -\ Fill Cells Solid With Grout I I > Z I " Water Per Sack of Cement Where Steel Occurs : > - - - - - --- -- - - - - ----- Reinforcing Steel Shall - E 'a GROUT MAY BE POURED FROM THE TOP Conform to Sec.A-15.39 1 W O OF THE FENCE IN CELLS WHERE STEEL A.S.T.M. . 0 u i- x I OCCURS. CELLS AND AREAS OF HORIZONTAL REIN- 1 n I _ _ _ �- FORCEMENT SHALL BE CLEAR,CLEAN Ea All Steel to be Lapped �� e< - -� - — - FREE OF ALL MORTAR DEBRIS,ETC. 24"or to Code NATURAL GRADE p�U ; iIIPL �/ 01 ' %r � � iIy un — TWO 3/e"¢BARS � _ D r • � • • �- . . CONTINUOUS TOP I I . &BOTTOM -� I•- --W'IOTH TO 16' 0 C. MAX. SEE CHART �s �. 0 HOazSTEEL MUST BE TIED IN BELOW , DEPTH OF EARTHTCOTH PLACE AT TIME OF TRENCHel t' e. i/3 THE HEIGTH OF FENCE INSPECTION. L -�13EC.OW BOTTOM OF FOOTING v �„ 0" z..� SCALE: 1/2" 7. I' • • • TING REQUIREMENTS CHART ' WALL HEIGHT 6 ' 5' ! 4' 3' I WIDTH . 14" 14" i .12",.- . . . . . 12" z THICKNESS . . . . .10" 10" g ". g " DEPTH OF EARTHTOOTH . . 24" 1 20" 16". . . . 12" SPACING OF EARTHT00 12' 14' I6'. .. 16' OWNERS NAME: _ rz 4.Ca._--4-61\._(A--- City of Costa Mesa, California PERMIITUDRE NUSBER:_ _ {_I _ ± _ _ _ _ _ _ _ Building Department SIGNATURE. _ _ , - 1. 410 W / - a IP APPROVED • � : uJ: L f COSTA. v�o FwT L o-e 'F THESE PLANS MUST BE ONI JOB AT ALL T+MiS MAKE 4Kt pN1` Dubin y�B TU la t�� NO CHANGES WIThCU1 PKION. =.P=ROVAt OF DEPT. io_ 5 - s 1 THE{I5SU:.> r.„- O.".GRAVING. n( n=am', ..n. .F...T:v.u.OF DATE.---" ELAN", AN:i:.;':14CiQrCi!�i S'-:AtIl NC.'F- :Gy�TRuED I^lf A k r( iNIMp PF.R:n1T Kin, CT:AN AP}50V hI :r, t=:Y`.',; PARTY MALL AG'REEt4Eih . - - b 1 THIS AGREEMENT, made and entered into this day of ��/Di Euq f3Tfe., atg7by and between (,0,1-2,y1/2,/,/=r ,..720,44--2 hereinafter referred to as "LAND OIdIER", and ,4-4,/,Ale/e-7-r' OAF/G 1 '7 ' hereinafter referred to as "ADJACENT PROPERTY CANER". It is hereby agreed that a party wall will be constructed on the property line between 7..// Pp -/--4 2S-77 ph,-1 (Address of Adjoining Properties) /992 CfegA/GE C5atoof • in-the City 'of Costa Mesa;rCounty of Orange, State of California, as per map recorded in-Bock / :;_PP'age 33 of Miscellaneous Maps, in the office of the ,r,County.Recorder of said .Cointy. The party wall shall be permitted to encroach 4;/7hov/ma /Y J/-SP inlhPS v,J each S/dco nfp. ✓ef- IN WITNESS WHEREOF, the parties have entered into this Agreement the day and year first above written. LAND OWNER ADJAC PROPERTY OWNER " (Signature) ( gnature ' Uo,f/.t/ F-144 ni // OE'3/4/E027` Name (Typed or Printed) Name (Typed or Printed) /99 Z Ce4-71) -E_ /14/ff (Address) (Address) C05771 E s 19- 1 i' C4 7 26 77 . . • /.,. x/ ;ray , GC I i yE /.v ft a/jt// SEP 19g987 E= cs a 0 x Z2 DONNA J. LIGHT AAA- 4 4 NUTtAy PUBLIC, MAINE /l7- V MY COMMISSION EXPIRES AUGUST 10. 1994 !j6'7'a 3 (NOTE: . -Please see reverse side for notary's statement) Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA a PE IT NO. �� TRACT NO. LOT NO. BLDG.NO. , CONSTRUCTION PERMIT - ' •�' r F J� ST, •. Applicant's Mailing Add�rressa?/-�-,/ ,`f TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION' U REPAIR - '7 / Project Address - 4.Qyf�4>f / 1°/�F El CONVERSION ❑ DEMOLISH 0 OTHER • Owner's Name + - •hone�/ 31�� DESCRIPTION OF WORK $ ZONING REGULATIONS • Address S�o'I'v At 4 -anwF TYPE OF PERMIT U-GRADING U FOUNDATION U STRUCTURAL A.P.* ZONE Arch/Eng. • License No. 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL PLNG.REF..* BUILDING _ Address, 0 OTHER , _ TO BUILDING gprRerr co $T • Contractors Name ogIil/�.e, Phone PROJECT DESCRIPTION SO. FT. OCCUPANCY PROPERTY LINE .REAR YARD (TO P/L) Address(mailing/ CONSTRUCTION TYPE VALUATION$ - LEFT SIDE YARD RIGHT SIDE YARD l I I - ZONE GRADING CU.VpS. ACRES • PKG.SPACE,REQ. PROVIDED License No. _ LICENSED CONTRACTOR DECLARATION . Remarks: STREET WIDTH PARK FEES , •I hereby affirm that I am licensed under provisions of Charter 9(commencing • with section 7000) of Division 3 of the Business and Professions Code,and • 1 SPECIAL CONDITIONS: • • my license is in full force and effect. • _ License Class License No. ' • ' PLUMBING Date i ' • Signature • WORKERS'COMPENSATION DECLARATION ' Bar Sink I' Sewer Cap ELECTRICAL • ( * ,:,,hereby affirm that I have a certificate of.conzent.to self-insure or n.tertificata - - ..� - Automatic Washer - !Meter Dover 100 amps • . ' Workers' Compensation Insurance, or a certified copy thereof (Section BeCkflow'Preventer $aver Connection .� 74800, Lab. C.) ' Backflow Irrigation , Solar Collectors Construction Pole - Sub Panel , Policy No. Company ' - l • - .. - _ - Cooking Unit Sub Pole I • ' 8 Certified copy is hereby furnished.) , . Bathtubs ' i Solar Piping 1 Certified copy is filed with the city Building Division. Dishwasher Motors ❑0-1 HP ❑1 c s Date Applicant Clarifiers _ Solar Tank , ! EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dryer? ❑Gas' OElectric Inc.Solar'❑9-15 HP 016-15+ (This section need not be completed if the permit is for•one hundred($100)or Dishwasher I i Swimming Pool w/Spa less). I - - • i I cetify that In the performance of the work for'which this permit is Issued 1 Drinking Fountains I ' Urinal Fan , • Microwave ' snail not employ any person in any manner so as to become suDjecl to the - i - F.A.U. Pole Light I • Workers' Cympeny on'Laws of Cali i z/ Floor Drains' , Water Closet - ' Date E (2.. /� Signature /,/ // Fixtures NOTICE lf,aftY/making this clad Ion, you u d De a sublecl to-the - Floor Sinks -. ) - Water Heater -- - - ' fleng0 - •_ , Workers• Compensation Drovl Yio f the Labor Code, you,must-forthwith - - - , comply .with such provisions this permit'shall be deemed revoked. Ga'sService tOutlets Water Service ' ' Device Boxes ' Sign ' CONSTRUCTION LENDING AGENCY ' ' • - - - • • Outlets I hereby affirm that there is a construction lending agency for the•performance Interceptors, ' Standing Sections • of the work for which this, permit is issued (Section 3097 Civ: C:). . - , Lender's- Name ' . , - Kitchen Sink .• ' - • Switches• ' 'Trash Compactor ,• • Lender's Address • ' Lavatories - Garbage Disposal ° • OWNER BUILDER DECLARATION' - I hereby'affirm that 1 am exempt from the Contractor's License Law for the P-Trap - - • - • Generator ❑0.5 KW ❑5-15 KW • • following reason (Section.7o31.5 Business and Professional'Code: Any city or I -., - - I county which requires a permit to construct,alter improve,demolish or repair — - - Transformer ❑15-50 KW any structure, prior to Its issuance,also requires the applicant for such permit . Roof Drains, ' , �OU �� to file a signed statement that he/she Is licensed pursuant to the'provisions of - • ❑50+KW Reinspection Foe the Contractor's License Law(Chapter 9(commencing with Section 7000)of - �' Safi- -'vision 3 of the Business and Professions Code).or that.he/she Is'exempt ' Shower's • - Reinspection Fee 515 �j - / ' refrom and the basis for the alleged exemption. Any violation of Section Meter Coup to 100 amps ' Issue Fee 1 • $ 3 • .31.5 by any applicant for a permit subjects the applicant to a civil Service Sink lane Fee $ 3 - - - B,epalty of not more than five hundred dollars($500). Zoning Approved By Date lel, as owner of the property - MECHANICAL J - I m@@y¢Siiim will-do the work,and,the structuro.is not intended or offered • Application Approved By Date 20 for sale'(Section 7044, Business and Professional Code:.The Contractor's - ' License Law does not apply to an-owner of a property who builds or improves - Boiler - Refrigeration System 1 ) Application Issued By / z0' s thereon„and who'does.such work himself/herself or through his or her own - DP Date _ employees, provided that such improvements are not intended or offered for Duct-Under Ground ❑0.100,000 BTU ❑100,000 BTU sale, If, however, the building or improvement is sold within ono year of com- _ SUMMARY OF FEES Motion, the owner,will have.the burden of proving he/she did not build or im- - ' tor c the purpose of sale)-. Duct-Structural . , , System Repair/Alteration .BUI LDING PERMIT $ • SMIP - $ U I,as owner of the property, am exclusively contracting wit h'llcanzod con- - tractors to construct the project(Section 7044,Business and Professions Code: ... Duct-Ventilating _ - - ', . PLAN CHECK $ ' PERMIT The Contractor's License Law does not apply to an owner of property who • ISSUANCE $ ) builds or improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple❑, PLUMBING $ , tractor(s) license pursuant to the Contractor's License Law). - ' GRADING i $ 0 I am exempt under section B.&P.C.for this reason Firepl/Fact.Bit.ICBG# I PLAN CHECK $ • • - !ELECTRICAL $ 8. . $ Date ' owner ' • , Heating System&Ducting • , I MICROFILM I $ I hereby certify that I'have read this application and state that 'the above ❑oloo,000 BTU 0100,0001M. - - '- • PLAN CHECK $ - . - ' information is correct. I agree to comply with all city and county ordinances _ ' '' TOTAL FEE $ ' and state laws relating to building construction,and hereby authorize repro- Hood Or - _MECHANICAL $' { � sentatives of.,this city,to enter upon'the above-mentioned property for , - Typel ❑: Reinspection Fee' $15 ' LESS ' inspection - rp• eY. / / t Canopy Type 11 ❑ PLAN CHECK $ ADVANCEDPC • $ -- - Signaturei _ Date / 7a/y/, ' , Driver'license or 55 , Registers I .. - : Issue Fee $• 3 - ' FINAL FEE ¶ $ • O� • CMF 0:65-46 rev.12/82 White-Building:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor I? [7 CONSTRUCTION AND.PLAN ING - :_ . --- . ,;- POOL ?A s ' , - t'/ - :`Date - Inspector Date Inspector ° APPROVACS Peri-nit-#: ..L.�"' : f ' v -APPROVALS . Permit#Sa .1 ' 1_ TFmporary;Electrical Service or Pole • - • , . 52, Pool &'Equipment Location ,- ,t, ,, 2: 'Soil Pipe-Undrgrnd. _ t--o= " I 53. Steel Reinforcement - . 1. .3iliEleetfica'I Conduit Utility-Undrgrnd. _ 54. Forms : • - • ; 41 Electrical Conduit-Undrgrnd'. =>.. , - __ - 55. Electrical Bonding - • 5; St61'Reinforcement - - 56. Rough Plumbing&Pressure'Test I. I 6: Electrical 1./F ER Grnd. .: • Aci• +( qr _ 57T APPROVAL TO COVER-GUNITE - 7. Footings i - I : - =?= - , 58. Electrical COnduit•Undrornd. 8. Founpatlion . 1. - ( 59. Gas Pipe/0 Undrgrnd.,test - 9. Wale, Pipe-Undrgrnd. ' , 60. Backwash Lines,P-Trap,fl Undrgrnd. 10. Sttuctural Floor System - - _ - a .61. APPROVAL TO DECK 11. Property Sewer Line& House Connection - _ - 62. Backwash& Receptor-Final ' 12. Sewer Cap - ' E.,- 63. Heater & Vent•Final •` 13. Roof Drains _ 64. Plumbing System • Final - 14. Rough Plumbing I .2. - ' • 65. Electrical-Final- ' 15. Rough-Electrical-Conduit - "--- - -; -" 66. Solar System-Final - 16. Rough Electric Wiring, = -- F -! 7.- ' - _ 9 9, . o I - - 67. Fencing&Access Approval - , 17. Rough Wiring Sign;- . , ; ; I i- : • :, I. 68. APPROVED FOR PLASTERING - 18. Rough Electrical-T.Bar,Ceiling, ,, _ -- ' , '69., POOL/SPA SYSTEMS FINAL . 19. Rough Heating& Air Conditioning ,. i o, I , , FIRE DEPT.'REQUIREMENT , 20. 'Rough Factory Fireplace ; y ; APPROVALS i Permit# - , 21. Ducts;in Structure 1 1 l ' 'i i , 70. Underground Hydro 22. Ducts, Ventilating 1 •i ., t l . i 71.1 Product Piping 0 Gas ❑Oil ' 23. GasrPipe-Rough & Test ._ ;)'- I ' 72. Underground Flush 1-24. ,Roof Framing 1 •m , , .•i I ,-s' '- 73.E 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 •' I ' ' ! j 76. Dry Standpipe 28. Lathing& Siding , i; '77. FIXED SYSTEM FINAL 29. Insulation 'I 1 1 ' 178: FIRE PR,EV. FINAL l, • 30. Drywall Nailing ' , ,• I � , ' , Notes:, ';31. Plaster Brown Coat j h l I i i I ,• I 32. Electrical Power Meter-Final .i ,I_ ' 33. Final Electric I •- I i-- - , 34. Final Heating& Air Conditioning I ' 35. Final Gas Pipe-Test • H '.2 • , ' - - _ 36. Hood or Canopy . - 37. Final Factory Fireplace =;' Il ' . - - , ' - - 38. Final Plumbing , ; ; , i if: ' I .. - ' - 39. Water Service-Final' • i1 ' ' ( 40. Gas Service-Fin& ' ' ' l • t ' ' 3 41. Solar Damestic-Final i I t - -- 44 42. Backflow Preventer , ! I - l I 43. Backflow Irrigation - • � r;- _ I , 44. Landscape Irrigation System i _ ! ' 45. Sound Attenuation ,, ,,.. 1 . l I , 46. Handicap,Regulations , , 1 I i I - 47. FINAL STRUCTURE & BUILDING ' : I l ' 1 ; I , I ' I 48. Special Requirements Completed- - ; , I . 49. Electric Release to Ediion -- - -- - - _'- - • 50. Gas Release to Southern California Gas Co - 1 ,, , ' I , 51. CERTIFICATE OF OCCUPANCY 'i '_ .;- _L._i 1 - _ I _ _ r. 1 ' • t No Date ' I I nn _ _ .4777k-A0.4/1_- _ke tNSE_v7/44S_to<t/l.Ci.rrY-o.7��-_ - �os749 ; - - - - - - S7 A4e-v7 or e'1V/t;c- l�t��L pE �'EGARO,n C 6A r7 ul Z '4) coot t, e l7 °Nonnn 79ed 8i UCK. PE-4' T I _ -.- 333, Er - :3338 47 -ler" - 4714 - - - - - - - E - 4097 Z el/1 a'/7 the /Voll /7Pces-say7`e> 4n,sh - -- The ��fi/i,oy/ee��r-- co/e -ei_Z/y_fhe��o6o1ve/erirn/s _ . d� COn/i-Odoes A sc/6-Eon/r•nd4f% G /n44v-c/g,o/f Ger_e- /ry�o/✓e� - dam, zo_ 4. 57 � - CosTq -grs4i _ - 4/5--/8r 403 9 3 34088/21 /78 5/,15011._ COSTA MESA BUILDING-SAFETY DEPARTMENT �// , P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 `/i//�/ APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completelyy� Use Ink Only ]y� REC/E/VED( �p/�E 5fyee.t RECEI�r/!N O�i7//J O ' JC ` ....,e- ADDRESS Z1) E. Z.O U /�, //�-09.3—/S PERMIT NO. 1'B OWNER JM Pcwl MCA/00 A.P. NO. MAIL �j /� BUILDING cP// ao.t_ �^� ADDRESS Z85 Ma9vlot( moi ADDRESS Of CITY CAS Ille NOI.P-12.5zib� N� RACTTEn Ors LOT BLOCK CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOI ISH LENDER • BRANCH O OWNER 1/4 Cl t— gte,4,)oa ;- ADDRESS /P� 1 A.C? h. ARCHITECT TEL. USE $ L/ 'r— OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR OWh er BY DATE ADDRESS Le a //z • Zl / NO.OF ^ USEOF d1t /a TEL. PIANS O"/, BUILDING da� CITY NO. E^• STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING / ACCESSORY BUILDING y SIZE INO.OF BLDGS (FROM C/L S EET) / 0.. OF LOT INOW ON LOT FROM (,/ fc/( /, FT. Q USE OF enEXISTING BLDG. R.SIDE l�7 2FT �/1 o fCIOTT.\. F^T» Separate permits are required for L.SIDE X77 F ( a /" �X Fy delectric,plumbing and heating work. REAR / �/////A W Qt�� +^ FT. F., USE OF BUI DING ND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& o LlZ�- MAIN BLDGS. _ ACCESS SLOGS. - pail is Cover- Covme�hvl3 CURPq DATE APPROVED house +6Joarcx@elbTee-5e tAia5) "PPR 472.-/b DATE W p. O I hereby acknowledge that I have read this application and state n n Oe that the above information Is correct and agree to comply with m L all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of E ,may. the State of California. ,� 3 I herebycertifythat I amSQ. FT. H properly licensed as a contractor under the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business vt VALUATION PERMIT FEE $ e and Professions Code,Division 3,Chapter 9. i 0 C In P� /� t7a PLAN CHECK o Signature p.,SJ`/�rNW/VCor /�/nf ' cu. Parmitto� J $ rrr vvv D TAX $ s JQ U Authorized Agent TOTAL PAID $ S 50 lb- OWNER McADOO, PAUL DATE 8-21-78 JOB ADDRESS 211 East 20th Street BUILDING PERMIT NO. 46593 GENERAL CONTRACTOR Owner-Rolldrr DESCRIPTION of WORK Legalize Patio Cover (Breezewa3 .,`,"""c" . 118-093-15 LOT TRACT Nwp.Hts.FIRE ZONE VALUE f 400.00 IIF",eCT10N5 Stratum Data -TYPE V GROUP ,T ZONE R-1 OIL PE$MITS ISSLED As SUBCONTRACTOR Data Number Signatory �) TER Plumbing ROUGH PLUMBING PROP. SWR. LINE _1 HOUSE CON. U SPRINKLING SYSTEM ISCELLANEOUS- OUCH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND E POWER `ROUGH WIRING1 'Hyating and Vont. fJ TRENCHES FORMS ❑ STEEL REINF. U FLOOR SYSTEM BOND BEAM [1 STEEL REINFORCE 7 . SHEATHING FRAME AND FLASHING� LATHING — IN 1 1 OUT n PLAtTER, BROWN COAT ISM e� 5' 'URAL. FINAL ZHV ,..J-fir E Ile owl HE..'NG. VENT., REFRIG. AND A.C.. FINAL �i1�+ --gale-b-/NJ O'�"l PLUMBING. FINAL AND GAS TE$T:644 ELECTRIC. FINAL / 0 C I 41 ' r(f\\ BUILDING. FINAL l / C.L.. V tJ,.j i < re' 7e