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Home My WebLink About425 20TH ST - Building Permits% aMESA CONSTRU TIONPERMIT �f-25' �. �O� S�'`. . AOPlicant to fill in all spaces except those witM1in heavy Eorder lines antl sign all appropriate tleclarations. I ApplicanYs �vlailin ddr ss � - Own�•'s N/am�e.� � Phon� 2, Address T��_ - � 11�a � ,/%%PCG Arch/Eng, nse N� -s � Address �� Address (mailing) � �� City License No. LICENSED CONTRHCTOR DECLARATION I hereby affirm that I am licensetl untl<r p�ovi51on5 01 Cnarte� 9(comm¢ntlng with seciion ]000) of Division 3 of the Business antl Professions Cotle, and Ty IiC¢n5¢ i5 10 fUll (OIC¢ dOtl ¢ft¢Ct. License Class License No. Oate Signature WORKERS'COMPENSATION DECLARATION '`9reby ai(irm that 1 have a certifltate of consent to self-insure or a certifi<ate Norkers' Compensation InSuran<e, or a certlfietl copy thereOf (Settion i0, Lab. CJ Policy No. Company BCertifietl copy is nereby /urnishetl. Certifietl copy is filetl with the city Builtling Division. Date Applicant EXEMPTION FHOM WORKERS' COMPENSATION DECLARATION (TM1is section neetl not be complete0 if the Oe�mii is fo� one huntlretl ($300) Or Ie55). 1 certify that in the pertormance of the work for whlch Ihis perm�t i5 is5uetl, I sball nol ploy ny person in any mann r So as to bPc E�ect to th¢ Worker ' ' Laws of CalifO�p'�/^ Dale Siynature / ( �' NOTI : If, aiter m king t�is decla�on, you shoul(y.Oq4ome ject to the Wo�ke�s' Compensalion provisions ot the Labor Cotle, yo enu5[ fOrthwith comply with suc� provisions or this pe�mii s�all be tleeme0 �evoke0. CONSTRUCTION LENDING AGENCV I herety affi�m Ihal [here i5 a wnstruclion lentling agency fo� tne pe�fo�mance ot [he work for which this petmit is i55uetl (Se<tion 309] Civ. CJ Lentler's Name ' Lenaer's Atltlress OWNEH BUILDER DECLARATION 1 hereby aftirm that I am exempt trom tho Gontractor's License Law for the following reason (Section 7031.5 Business antl ProteSsional Cotle: Any city or munty which requir¢5 a pe�mit lo construcl, alter, improve, tlemolish o� repair any structure, prio� to its isSuanCe, al5o require5 the applicant fo� Such permit l0 111¢ d SIJf1Ed SIdICR12f1� lhd� hC/ShC IS IICCOSCd pOISUdIII IO IhC pIOVI510f15 Oi roe Contractor's License Law (CbaOter 9(commentinq wi[h Sec[ion 7000) ot nivision 3 ot [he Business antl Profe55ions Cotle) or that he/She Is exemOt �.�efwm antl the basis fo� the allegetl exemptlon. Any violatlon oi Section 31.5 by any ap0licant for a p¢rmit subjects Ne applicanl t0 a civil .nalty of not more Nan five huntlretl tlollars (E500�. ❑ I, as owner of the property or my employees with wages as thelr sole compensation, will tlo the work, antl ttte slructure is not iniendetl Or oifGr¢tl for sale ($ection ]044, BuSiness antl' Profe55ional Cotle: The Conlractor'S LicenSeyLaw tloes not apply to an owner of a property who builtls or Improves [hereon, dntl who does such work bimself/hers¢It or through his o� her own em0loyee5, provitled that Such improvements are no[ intentletl or offeretl for Sale. If, howevet, the building or improvement i55oltl within one year of Com� pletion, the owner will have the burtlen ot proving h¢/she tlitl not builtl or Im- Q��,� ve tor the purpoze of sale). Jddl, as owner of the property, am excWsively contracting witn licensed con- tractor5to construct the project (Section ]044, Bu5ine55 antl Plo/¢SSionS Cotle: The Contractor's License Law tloes mt apply to an owner oi property who builtls or improves [M1ereon, antl who cont�act5 for such projects with a con- tractor(s) Iicense pursvant to the Contractor's License Law�. I am aware that �pyroof ot tbeit Worker's Compensation insu�ance Shoultl be provitlatl to me. y� I am ex� pt untler Seciion B. & P. C. for this rea5on Oate ion r la have reatl tnis Signature /' �'G Drivers' License or— 5� n antl state [ at the aGove cily antl counly ortlinances antl herebv authoriEe reOre- � as1 d. rJN rt+Ns -� z�� TYPE OFCONSTRUCTION EW DD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH OTHER D_,€SCRIPTION QF WpRK/USE OF BLDG. � :S,/ �Q= �� TVPEOFPERMIT�'y .LSJGRADING� pV3,"FOVNDATION 1�'STRUCTVRAL ❑ TENANT y¢,ELECTRICAL �t`J'PLUMBING�MECHANICAL ❑ OTHER PROJECT DESCRIPTION Sq. FT. ' ^y oC aAN V CONSTRUC ON TVPE Z�T -Y' ZONE�� GRADINGCV.YDS. � ACRES_ Remarks:��s � v Bar, Sink � Backtlow Preventer Backflow Irrigation � Balhtubs Clarifiers Drinkin9 Fountain5 Floor Drains Floor Sinks Gas Service � Interceplors Kitchen Sink Lavatories P-Trap Roof Drains Reinspection Fee �Outlets $75 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL BIt. ICBO # Heating System & Ducting ❑ o-i oo,000 aru O i oo,00a sr Reinspection Fee � $15 � �'S-�6, rev. 30/84 White - Builtling; Canary - Appllcant; Pink � Atcouniing; Goltlenrotl � Assessor Showers Service Sink $ewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Watcr Closet Water Heater Water Service Auto-Wash Laundry Trays Issue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0-100,000 BTU ❑100,000 BTU System Repair/Alteration Fire Dampers � Registers Issue Fea A.P. # S Main Bu E T Front B Rear A C Ri9ht K Left S Ping. Ref. # Planning No' tEF'r �Ccr � L' i Aummatic Washer Construction Pole Sub. Cookin9 Uni[ Dishwasher Dryers Gas ❑Electric Fan F.A.U. Device Garhage Dispoul Generator �0�5 KW �'_'l E/� / � zo�a K 1 2 O = 367. s � ��7 sa.pr. " G ' Parking Req./Provided � +� �-a.�.� n� o� �'+ti -rp � = � qEw ,.+rKNc �2.GA2 ADD. = 19 • S' 1. cAF 6k¢�k ELECTRICAL FEES Transtormer � 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter �over 100 amps Suh Panel Morors 00�1 HP 01 h- 8 IncSolar �9-15 HP �16-15* Microwave Pole Light . Range Standing $ections KN1 Trash Compactor �; $ 3 Reinspection Fee $15 FEES �DEVELOPMENTSERVICESREQUI 2oning Approved By Building Approved 6� $ 3 BUILDING PERMIT �5 �LPLAN CHECK $ � PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 5096 $ MECHANICAL $ PIAN CHECK 25% $ Issue Fee SUMMARVOF $ 3 E Q M SMIP $ �� PERMIT ISSUANCE $ � ENERGY P.C. $ GRADING $ MICROFILM $ -7 TOls.�cFE $ �i CONSTRUCTION AND PLANNING POOL & SPA \ APPROVALS �Permit # � Date Inspector p�ppROVALS Permit # Date Inspec - � 7. Temporary Electiical Service or Pole 52. Pool & Equipment Location � i" 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrnd. � 54. Forms � 4. Electrical Conduit-Undrgmd. 55. Electrical Bonding 5. Steel Reinforcement !' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.. �j� 57. APPROVAL TO COVER-GUNITE 7. Footings � , 58. Electrical Conduit-Undrgrnd. � � 8. Foundation . 59. Gas Pipe, O Undrgrnd., Test " 9. Water Pipe-Undrgmd. 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Floor System s` 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 9/� a' 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring �� .8"'j 67. F�ncing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPASYSTEMS fINAL '� 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # _ i 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping �Gas OOiI � 23. Gas Pipe-Rough & Test 72. Underground Flush � 24. Ro�t Framing 73. Untlergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro I 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical -. 27. Frame and Flashing b� � 76. Dry Standpipe � 28. Lathing & Siding Q G F/ , 77. FIXED SYSTEM FINAL '' 29. Insulation �� G, 78. FIRE PREV. FINAL ' 30. Drywall Nailing a yp � r/. HEALTH DEPT. REQUIREMENT •� 31. Plaster Brown Coat d�Z GI'�/ 79. FINAL INSPECTION 32. Electrical Power Meter-Final `Z 3 80. FOOD CERTIFICATE ISSUED - 33. Final Electric '�c� Notes:r"�� -� G��qG� 34. Final Heating & Air Conditioning �, �y_y `6 7 . . � � 35. Final Gas Pipe-Tesi . S L 5� � V`1/ �' _ 36. Hood or Canopy � 3 � � 1 �/�L� CLCES,S 37. Final Factory Fireplace - ..-i ��0:� ( 38. Final Plumbing ��y �� l' / /q � q��,. �crrecl�i'G�5 '� c-� /� 39. Water Service-Final 40. Gas Service-Final . - 41. Solar pomestic-Final 42. Backflow Preventer . � 43. Backflow Irrigation 44. Landscape Irrigation System �' 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING / /gY �,q_�/ 48. Special Requirements Compipted � " 49. Electric Release to Edison � ^ �� 50. Gas Release to Southern California Gas Co • / 51. CERTIFICATEOFOCCUPqNCY ,' No. Date � r' �i ` //(o o, , i -, .. • . . �� . j „' . CERTIFICATE OF COMPLIANCE PAYMENT OF SCHOOL FACILITY FEES NEWPORT-MESA UNIFIED SCHOOL DISTRIC7' s� Developer/Applicane: ��J,G�� /%/,I�Y � Address: �ZS �• 70'� S7� C-4� //�/C'_��i %�2� 7'elephone Number: F� �6 — /�'�2- T�-ac-t/Parcel and Lot Number(s): 20� Location of Project: Y�-zs�' z�C�%/ S� �S'�' //��eS'�C-- Number of Square Feet of ��D 04 Residential Space �ZO x $1.50 Total Number of Square Feet of Commercial and Industrial Space _ x $0.25 Total The provisions of Government Code Section 53080 are not applicable. This certifies that the above-named Developer/Applicant has paid school facility fees in compliance with Government Code Sections 53080 and 65995. Checks are to be made payable to Newport-Mesa Unified School District. �`Sk� -z � � Busi ess Manager Newport-Mesa Unified School District The above representation as to square footage is true. Developer/Applicant agrees that if it is later determined that such representations are not true then this certificaCe shall automatically terminate and the appropriate City/County shall be notified. . Date: Z ,�� Deve !� r/Applicant CityofCostaMesa INSULATION CERTIFICATION BuildingSafetyDivision �-la.� �a-s-r �"`' �+reD � �',��}� n��sr�- Y � . Number and Street City Counry DESCRIPTION OF INSTALLATION HOOF Material _FIB°n . A4Sf. � Thickness (inches) �� EXTERIOR WALL Material FIBERGLASS Thickness (inchesl 3� CEI LING Batt or Blanket Type Thickness (inches) Loose Fill Type Minimum Thickness (inches) Area Covered (ftzl FIOOR,ELEVATED Material Thickness (inchesl FLOOR,SLAQ Material Thickness (inches) Width (inches) FOUNDATION WALL Material Thickness (inches) �Q� Lo[ Number Brand Name MANVTT.T.E Thermal Resistance (R Value) }S� Brand Name MANVTT.T.F. Therma! Resistance 1R Vatue) 11 Brand Name Thermal Resistance (R Value) Brand Name Number of bags Weight per bag Ib. Thermal Resistance (R Value) Brand Name Thermal Resistance (R Brand Name Thermal Resistance (R Value) Brand Name 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 Ilocated in Title 24 of the California Administrative Code1. General Contrector (Builder) Signature and Title I+�ELLS INSULATION COMPANY, INC Sub Contrector (lnsulation Applicator) ��/� � � PRES. Signeture and Title CMF 1306-46 License Number Date 3A4f,97 License Number DECEMBER 9. 1987 Date 1 � CITY�OF COSTA Project Address � ApplicanYs Mailinc (7Wner's Nam� Address � � . PERMIT Applicant to fill in all spaces except those within heavy EorGer Ilnes anG si9n all appro0riate Eeclarations. PERMIT NO. TRACT NO. LOT NO UN1T NO. Contractor's Name - O� Phone Address (mailing) Ciry License No. LICENSED CONTRACTOR DECLARATION I hereby afiirm that I am Ilcensotl untler provizlons ot Charter 9(<ommencing with section ]000) of Dlvision 3 of the Business antl Professions COEe, antl my Ilcense Is in full force antl eHect. IJC2�T¢ CIa55 LiC2n5C NO. Da[e Si9nature WORKERS' COMPENSATION DECLARATION I hereby affirm tM1at I bave a certifitate of consent to zelt-insure or a certifiwte f Worke�s' Compensalion Insurance, o� a ce�[ified copy the�eof (Section d00, Lab. C.) PoliCy No. Company eCertifietl copy i5 hereby /urnishea. Certifictl copy is tiletl with tho ciry Builtlin9 Divislon. Date APpllcant E%EMPTION F0.0M WORKERS' COMPENSATION OECLARATION (Thissection neetl not be compleletl It the pe�mit is fo� one hund�etl ($100) o� less�. I certity that in the perlormance ot tha work for wnicn this permit is issuetl I snall not e oy a person in any manner 5o aS�to b ubject to the WO�k¢ � w5 OI CdIIfO� ./! Dat S�9�atur � ' NOTI : I(, a er m kln9 this tl ela on, you snoultl bec subject to the Wor ers' Compensatlon provlsl of the Labor Cb'ae ou must forthwith comply with such provl5ion5 or thi5 pe�mit sh be tleemetl revoketl. CONSTRUCTION LENDING AGENGV I hereby affirm that there is a cons[ruction lentlinq agency for the per�ormance of tho work for which this permit is is5uetl (Sectlon 309] Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUIL�ER �ECLARATION I he�eby aftirm that I�am oxempt irom the Cont�acio�'S License Law for Ihe tollowin9 reason (Section 7031.5 Business antl Protessional Cotle: Any city or munty whlcn requires a permlt to construct, alter, improve, tlemolish or repair any sVutture, prior to�its Issuance, also requires the applicant for such permit to tiie a signetl stateinent tnat hC/Sh¢ is licensetl pursuant to the provisions of the ConVaclor's LlcenSe Law (ChaD�er 9(commenCinq with Sec[ion 7000) ot Divlsion 3 ot the Bu5ine55 antl Protessions Cotle) or that he/She is exempt 'herefrom antl the ba5is tor tne allegetl exemption. Any violation o� Section 031.5 by any applicant tor a permit subjects tM1a aDPlicant to a civil ie,ndlty of no[ more than five huntlretl tlollars (§500�. U I, as owner of the property or my employeez with wages as their sole compensation, will tlo Ibe work, antl th¢ structure Is not Intentletl or ofteretl for sale (Section ]044, Business antl �rotessional Cotle: Tho Contractor's License l.dw tloes not apply t0 an own¢r Ot a property who builtls o� imp�oves tbereon, antl who tloes su<h work himselt/herselt or throu9h nis or her own Cmploy¢es, prOvitleO lhat such ImprOvement5 ar¢ not intentletl or offeretl for sale. If, however, the builtlin9 or improvement is soltl within one year ot com- ple[lon, Ihe Owner will have the burtlen of proving he/she tlitl not builtl or im- p�ovB �or the pu�pose ot sale). s owne� of the p�operty, am exClusively contracling with litensetl con- ra ors to construct the project (Sectlon 7044, Buziness antl Protessions Cotle: The Cont�actor's License Law dOes not apply to an owne� of property who builtls or improvei Ihereon, antl who cont�acts for suth projects wltM1 a con- t�aclor(s) license pursuanl to the ConlractoYS Licenze L.aw�. I am aware tha[ proof o( their Warker's CompenShclOn insuranc¢ shoultl be provitletl to me. � I am exempt untler Section B. & P. C. for this reason ihat I have r¢Stl�thi5 applicStlon antl state�[hai-C�e above �rrecL I agree to comply with al1 tlty antl <ounty ortlinances elaling to builtl�ng cons uciion, antl her¢by duthorize reprP- iyyitv to ent� u he dbove-menUonetl orou4rtv Sbr Signahre� � �� DriverY icense or 55 � CMF OB65-46, rev. 10/84 WM1ite - Builtling; Canary g 2 8- � z3 PN (o -'��hg �Po�r �-µ TYPE OF CONSTRUCTION NEW AIJ D� LJ ALTERATION REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OT R - DESCRIPTION OF WORK/""� no oi nr_�Q,�� =• nL y`�� C TVPEOFPERMIT GRADING FOUNDATION STRUCTVRAI_ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PR0.IECT DESCRIPTION 50. FT. OCCucarvCv CONSTRUCTION TVPE VALUATION 5/OOO . O 20NE GRADINGCU.VDS. ACRES Remarks: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavamries P-Trep Roof Drain Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimmin ool w/Spa OVater Closet Water Heater Water Service Auto�Wash FEES Fee � $75 � � Issue Fee � $ 3 Boiler Duct - Under Ground Duct - SVuctural Duct - Ventilating Exhaust System � Multiple Firepl/Fact. BIL ICBO # Heating System & Duct ❑6100,000 BTU 00,000 peinspection Fee � $15 ; Pink - Accountin9; Goltlenrotl - Assessor A.P. � ( S Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planninq Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers-OGas ❑Electric Fan F.A.U. Pixtures Device Boxes Outlets Switches Garbage Disposal Generator �0. W �5�15 8619 5/?C/ 7 Accessary Building: ELECTRICAL ° Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100amps Me[er ❑over100amp Sub Panel MororsOO- P�iX-8 Inc. Sol 9�15 HP 016�15+ Pole Light Range Sign Standing Sections Tresh Compacror Reinspection Fee I$15 Issue Fee IANICAL FEES Hootlor T DEVELOPMENTSERVICESRE�UIREMENTS: � ypel ❑ Zo�ing Approved By Canopy Typell BUilding Approved By /-�/ Refrigeration tem ❑aio� aru ❑ioo,000 stem Repair/Alteration Fire Dampers Registers luue Fee � $ 3 FEES $ 3 SUMMA V OF FEES eUILDING PERMI7 $ I%• O SMIP $ d� SO PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ GRADING $ PLAN CHECK 50% S MICROFILM S MECHANICAL 5 TOTAL FEE $ �S � �O PLAN CHECK 25% $ ' CONSTRUCTION AND PLANNING . POOL.& SPA APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector 1, Temporary Electrical Service or Pole . 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd". 55. Electrical Bonding � 5. Steel Reinforcement �. ' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.' � 57. APPROVAL TO COVER-GUNITE � 7. Footings � 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 70. 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 Plumbin9 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sic�n 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 �Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil - 25. Roof Sheathing � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical 27. Frame and Flashing 76. Drv Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing � 39. Water Service-Final 40. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING �j �� 48. Special Requirements Completed '49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date � l ' � CITY OF COSTA MESA ENGINEERI� 11VISION APPLICATION AND PERMIT FOR WORK DESCRIBED BELOW �.� - J J��' ❑Class A Permit (Owner/Builder) 3 COPIES OF SKETCHES OR PLANS WI �Class 8 Permit (Licensed Contractor) REQUIRED PRIOR TO PERMIT ISSUA� % = % � �.. _. l � Address or Location of Work � � ✓ t �` , l Type of Work to be Done � } -' � � • ��'/ '" ' � � �� 'r S[art Date '�� Permit No[ Valid Contractor's Name -•-/��r�vi%n.,.- / "� Telephone No. (Day1L > > ��-� %� State License No./Class s/ / Applicant's Name� Telephone No. �� /r7 i Nam2 of Insurance Co. � 24�Hour Emergency Contact_ FEES Bond S Cash Deposit S �"�'� ��> . /T 1) lssuance S % 5 • V-U � Inspection S � �� • � �D TOTAL 5 ---�'}� •��V (Night)� �� N / (Expiration Date) Plar r Address ;,��=�� ✓�� ,1 � ? City & State �y' — City Business License No. THIS A L N�E � MES A PERMIT- J_yyH�I�P�ED VALIDA7ED y` TAM SA841.3 ii��iE7.%�l�L.; Date �/ �/�� _Telephone No. �nsurance Cert. No.(s) Telephane No. ING PERMIT PERMIT APPROV D FOR CITV ENGINEER Accoun[ # ; BY "� ' "�. .•;'-` r'�^�^ I I 7 u v n Date 7�� 7- 8 7 Account # Underground Service AlertlD No. Permin¢e shall contac[ the Ciry Inspector's office (75A3323) at least 2G hours prior to commencin9 any work. Failure [o obiafn proper inspections prior to commencement of work may be cause for its rejeccion. THIS PEPMIT WITH APPROVED PLANS MUST BE ON THE JOB AND AVAILABLE TO CITV REPRESENTATIVESAT ALL TIMES. Vou are guided by Municipal Code $ections 1-33, 15�25, 15�39, and 15-48. THE UNDERSIGNED PERMITTEE HEREBV CERTIFIES: 1. Thac all work shall be performed in accordance with che Standard Spacifiwtionsfor Public Works Construction (latest editionl; Standard Drawings of the City of Costa Nksa; special agency provisi0n5: end all appliwble laws and ordinances. 2. Control of traffic shall conform to the Work Area Traffic Control Handbook (W.A.T.C.H.) (Latest editionl. The permittee shall furnish antl/or install all si9ns, ligh[s, barricades, treffic concrol or waming devices, tla9men antl flashing arrow board. The permittee shall obtain appmval of che Traniportation Services En9ineer for all svee[ closures, derours, tum res[rictions, parking prohibitions and methods of accommodating [raffia The permiitee s�all nocify Emergency, Fire and Police services antl residents or businesses twenty�four 124) hours in advance of any access limicaiion or vatfic resvictions. 3. Tha[ a maximum of _/_ lanels) may be closetl if necessary w perbrm work within the public right ol way during the hours of 8:30 e,m. • 3:30 p.m. Monday through Friday es long as treffic can be maintained in each direction with flagmen unless otherwise approvetl by the Transportation Services En9ineer. 4. That throughout all phases of construction ihe work site shall 6e kept clean and free of rubbish, debris and dust and draina9e shall 6e mainiainetl. SUBJECT TO THE NOTES OELOW: (lnspector will initial in boxas) 1. Ciry will provide inspection during normat working hours only (B:00 a.m. � 4:00 p.m., Monday - Friday�. 2. Prior to placing Portlantl �mene Concreee or Psphalt Concreie (A.C.1, the following will haue been inspected antl appmvetl; native �and imponed � subgrades and torms O. Flyash is not allowed as a cament substitute. 3, Curh and g�tter shall not be removed on tha tley prior to a weokerd or a city ohmrved holidey. 4. Fill in areas left by curb nnd guaer rertawl (lush with ehe edjacent pavoment on ehe same day that removal occurs. 5. Bore under all sveets, cur6s and gu[rers, sitlewalks, cross�uners end drive>vdy approaches. Tunneling is not allowed. 6. Open excavations muse 6a backfilletl or plateU wiih spikes nnd A. C. �acketl eround ed9es during non�working hours. 7. Sitlewalk shall be cons[ructed per City of ('qsta Masa Standartl DrawinB No. . 8. Driveway approach sh�ll be constructetl per Ciry of �osta Mesa Standard Draw�ng No. . 9. No vaffic allowetl on concrete for minimum of five tlays for curing. See veffic conv0l B6ove. 10. Trench compa<tion and resurlacing shall tonform to GtV of Costa Mesn Smndartl Drewing No. 813. 17. Trenches exceedin8 ��a (51 �ae� in tlepih require a permie fmm tha Division o( Industnal $afety, State of Califomia. 12. Permil[ee shall puy for all S.E., compaction end materials tests deelnetl necesiary by the Ciry. 13. All [renches shall be purmanontly patched within ten (101 days of complation of �,iork below subB�nde. � 14. Pormitiee shall provide the Ciry with recortl drawings of parmined work betore final inspection by [he City. 15. Other. NOTICE: Contractor must natify the tollowing Ueiliry Companies two working tlays before s�arting work: Costa Masa Sanitary Diztric� Meza Conwlidated Water District UNOERGROUND SERVICE ALERT: (�74) 637�1731 (7101 631-1200 Toll Free - 1-800�422�4133; After Houn 6 Molidays -17141 7393031; (213) 621�3111 CMF 0103-62, rev. 3I86 White - Iqsp¢ctors; Gnary � Enginaerin9: Pink - Fiqance; Go�denrotl - AOC�icant ot Record: CERTIFICATE OF INSPECTION 1 herebvi certity Nat ihe s[reei work allowetl by this permi[ has been constructed according ro the plans and specifications and I herc by accept [he work in this manne� By: Insoector I certify I have read and understand all of the above and that all statements made are correct and complete. Applicant's Signature Date Kurt Donat Associates Architecture Interior Design September 26, 1983 Mr. Victor C. Newton Assistant Development City of Costa Mesa 77 Fair Drive Costa Mesa, Ca. 92626 �� l� i i ,7�h , �--� S- �. �� Services Director/Building Safety Re: Plan Check No. 303 Dear Mr. Newton: The above mentioned plan check number is for a residential remodel and was submitted March 30, 1983 for plan check. The drawings have been checked and are ready for issuance of permit. Due to excessive projected costs for construction of the above mentioned remodel and the difficulty of obtaining favorable financing, I am unable to commence construction prior to the original 180 day expiration time. I therefore am requesting a 180 day extension to facilitate rebidding and financing. Respectf ly, �L onat, A.I.A. �X �G�, S /�a/t /g��/—'� ✓P 1/ /G_�'l S /�/}y// L'G `!"C !'c�a SrG� �p / C O ! C/ i � L� / /' / 446 N. Newport Blvd. Suite 101 �r ��d �1'Q� S . TO �� h � � h Q � ��C� d� ��,� � �� `�-�� Gw� �r . 1!G. /%��h . Newport Beach, Ca. 92663 714 645 • 4170 ---- �-—'- " Appliont to flll In all s0aem e:cept I�ow wlt�in �eary OorEar Ilnes CITY OF COSTA MESA CONSTRUCTION PERMIT APPlitent's Meiling Addre ' S ,,, i Project Address � Owner's Name ho Addrea � � A�ch/Eng. ice No. Addrett Contmctor's Nam � hone Addrezs (meilin9) License No. LICENSED CONTRACTOR DECLARATION I �BreEy af/irm that I am Ilcansetl untler provlilons o/ C�arter 9(CommenNng wlth sectlon 7000) o} Olvlsion 3 oi lhe Businass A�tl Profettlons Cotle, anO my Ilcanie Is in lull lorce antl affect. Lltense Class Llcansa No. ❑ate Signaturo '0.KER5'COMVENSATION DECLARATION .re0y aftlrm that 1 hava a tertNlcata ot tonsent ta seiT-Inaura or a carti9rate � Workari' Gompansatlon Insurance, or a certi(letl copY /thereof (Se<fion 3800. Lab. C)��n ��S/1 ComPany �r V,� "`� PoIICY No. a j� IJ !/ ertliletl copy is nereby furnishatl. �� r ii iletl wit� tha city B � Data " APPllcant EXE PTION�X�RKERS' COM E TION DECIARATION (Thls section neatl not ba comDlateO I/ the D mit Is tor ona huntlretl (5100) or lessj. � � - ' I certiry.that In the perlormanca ot the work lor wn�ch this perm�t Is Issuetl I shall not employ any person in any mannar so as �o become subject to ti�a � Workers' Compansatlon Laws o7 Call/ornla.' ' Data Si9nature ' NOTICE: If, after making thli tleclaration, you sho4�tl bacoma subject to the �, Workers' ComponSaUon provlsions of t�e Labor COEo, you'musl fortMwilh comply with. such provislons or 'lhis permlt sMall be Oeamea rovokeC. , �CONSTRUCTION LENDING AGENCV ' I hereby afilrm tM1at t�ere I5 a<onstruction Ientling aqen<y tor tha partormanca of tha work tor �cl� t ihs_Dermit is'Issuetl (Sec�lon 3097 Clv. CJ LenAer'r NamO GAI� Lentler's AOtlrass - OWNER BUILDER UECLARATION I herebv a/flrm that I am eYemot Irom the ContraC�or's..Licenie Law lor the antl as owner ol tho -Oroperty or my employees w��h wages as thoir sole mpen5ation will do t�o work, antl the ilructure �5 not IntanOetl or ot/ereC -for wle (Secflon 7044, BuSiness antl Professlonal Catle: The Contractor'S License Law tloes not aOPly to an ownor o/ a propeRY �o builAs or Improwa [heraOn, antl w�0 CO¢5 Such work himself/hees011 0/ thrOugh hi5 O� �e� own employ ees, provlaetl that such Improvamants are not Intentletl or ofterea br sale. I/, however, t�e builtling or Improvomont is sold wit�in ono year o! com- pletion, tha owner will have lha burtlen ot praving pe/zhe Cltl not builC or Im- �OVB IOt th¢ pulpoz0 O( Sd10). � I, as owner af the Oroperty, am ezclusivaly contracting with IlcenSetl con- [raclors to construct the pra�ect tSectlon 704a. Buzineu antl Rotesslons Cotla: ' The Contraclor's License Law doei not appry to a� ownar of properly who , bullGi or Improvat t�ereon, antl w�o contracls for such projectt wlth a con- trdclof(s) IICBn59 pufsUan[ tOlhB COntrdtlOr'S LICBn50 Ldw'). ❑ I am axamD� unaer Sactlon B. & P. C. for this reason Date Ownar I hareby certify t�at 1 have reaa tnli apWliwtion antl stata Informatlon Is mrrwct I ae.nw tn mmnlv Ith rll dlv antl ca �l � PE OF CONSTRUCTIOfI ❑ CONVERSION � DI DESCRIPTION OF WORK TVPE OF PERMIT LJ GRADING ❑ TENANT ❑ ELECTRICAL ❑ UTNER Ceclaratlons. /O � � . � • ADD LJ ALTERATION LJ REPAIR fHER 1 FOUNDATION JLS�STRUCTURAL PLUMBING ❑ MECHANICAL PR0.IECT DESCRIPTION S�.FT. oCCUVAr�cv CONSTRVCTION TYPF VALUATION S_� ZON� GFADINGGU.VDS. ACRE$_ Remarks: 3ackflow Preventer 3atkflow Irrigetion 3athcuhs �larifiers � 7ishwa5her , Jrinking Fountains FIOD! D�81�5 Floor Sinks � � uasService �Outlets Interceptors Kitchen Sink� ' Cevatories � P—Trap " Root"Drains' Showers ' Service Sink , Duct- Under Ground Duct-Structurel • Duct - Ventilating Exheus;System ❑ MWtiple Firepl�Fact. Blt. ICBO � Heating System & Ducting ❑P700,000 BTU �100,000 Hood or Type I ❑ orivers' Llcen or 55 � I I Registers CMF 0865-46 rav. 12/82 Whlte - Bulitling; Canary - AP�Iiwnt; Plnk - Accounting; Goltlenrotl - Assessor SewerConn Solar Collec Soiar PiPing Sotar Tank Urinal �(Jetef G058t Weter Heater Watar Sarvice Reinspection Fee laue Fee ❑o-ioo,000sru ❑ioo,000aru System Repeir/Alteration S15 S 3 Rei�pection Fee $15 laue Fee $ 3 PLNG.REF.9p ylU9 u� �. /, � > PROPERTV LINE REAR VARD (TO P/U LEFTSIDE VARD RIGHTSIDE VARD PKG.SPACE REQ. PROVIDED STREET WIDTH �r, � PARK FEE S ic W asher Metei Llover 100 emps tion Pole Sub Panel Unit . ' Sub Pole �er r•� Motors �0-7 HP ❑1,'6$ � 7Gas ❑Electric Inc.Solar �9-15 HP �i6-15+ ixtures evice Boxes � I I.MicrowavE . . Pole�L�ght $eCtiOnS Switches Tresh Compacror Garbage Disposal � ' � . Generator�0•5KW 05�i5KW � Transformer 015-50KW ❑5U+KW ReinspectionFee 515� Meter Dup to 100 empe ' Issue Fee - � S 3 2oninB APProved By Date Applintion Approved By Date Applimtion Issued BY � Date � �� . ' SUMMARV OF FEES `'� BUILDING PERMIT $ � SMIP $ � PLAN CHECK $ PERMIT PLUMBING $ _�� ISSUANCE $ ' PLAN CHECK $ GRADING $ EIECTRICAL � $ � $ PLAN CHECK' $ � MICROFILM $ MECHANICAL $' TOTAL FEE $ PLAN CHECK $ � LESS , � ADVANCEDPC $ � � ' , FINAL FEE $ � �� E'CONSTRUGTION�AND"PCANNWG = " ' - -- � � ' � ' n PO�,-�SPA - - Date ° "'Inspector ' ' '- �" ` - Date �'� Inspector APPROVALS � Permit #' __ - ° APPROVALS � Permit # . � ^ �1: Temporary Electriral Service or. Pole - � �52. Pool &�.Equipment Location - - �•. 2: ;Soi� Pipe-Undigrnd:' � �� :` _. � " _ - . � 53. Steel Reinforcement � . - ` 3. Elecirical�Conduit Utilitv-Undrgrnd. ' . - 54. Forms � � - ' � � . �� •" 4� Electricai CbnduibUndrgmd.. ,'� t �, �' 55: Electrical Bonding " 5: Steet'Reinforcement . ' - �_ . . ' - � 56: Rough PI'umbing & Pressure Test 6. ,Elestriwl UFER �Grnd. ` . . 57. APPROVAL TO COVER-GUNITE -� � 7. Footings � • „ � ;' . - 58. �Electrical �pnduit•Undrar�ri.. 6. Foundation • � ' ' , �� -_ . 59. Gas Pipe, O Undrgrnd., Test : � 9. ,Water Pipe-Undrgrnd. ' � , 60. Backwash Lines, P-Trap, O Undrgrnd. � - - 10. Stiuctu�al Floor System „ � '' 61. APPROVAL TO DECK 11. Property SBwer Line & House Connection �_ � '�_ � 62. Backwash & Receptor-Final . �, 12. Sewer Qp • � . ' � 63. Heater,&"Vent-Final � � 13. Roof Drains.r � -, , , 64. Plumbing SYstem - Final . � � 14. Rough PlUmbing � � - 65. Electrical-Finaf . � '95. Roug'h Electrical-Conduit , - - - - --, - � 66.. Solar,System-Final ' ' �16.^Rough_ElectiicWiring, , , � - ' _ _ 67. Fencing`& Access Approval - 17. 'Rough Wiring.Sign'� ' ' i �.� 68.. APPROVED FOR PLASTERING - 18. .RougFi Elec[rical;T Bar Ceiling� ' • �' � 69. POOL/SPA SYSTEMS FINAL 19. :Rough�Heating & Air Conditioning ' �. � FIRE DEPT. REQUIREMENT � 20. 4Rough Facto "ry, Fireplace � ;, ' � APPROVALS Permit # ' � � 2L �Ducts,��in Stcucture . � ,� � � ' 70.� Underground Hydro • '22.•'Duc[s, Ventilating ' ' 71.' Product Piping O Gas ❑ Oil ' ' 23: Ges�Pipe-Rough & Test ; � � , � � ' 72.. Underground Flush -, �'24. FRoof Framing - � - � 73.� Undergrnd.SiorageTank �Gas ❑Oii • 25. Roof Sheathing � . � 74. Overhead Hydro . �� t 26.� T-8ar Ceiling (Structurat). & Monocoat- � '. 75.' Dry Chemical � � � ��27. Frame and Flashing -. � �' � 76. Dry Standpipe � 28. ,Lathing & Siding � � ' 77. FIXED SYSTEM FINAL � 29. Insulation -- . �� j J8. FIRE PREV. FINAL . � ;-30. Drywall Nailing ' ' .� �� ! 'Notes: � � � :, i+Y . " r . . . � _ _ . _ . . _ . • _ : 31. Plaster Brown Coat . . , , � - � � „'32. "Electrical Power Meter-Final � �+i '. ' � i ' • 33. ;Final Electric � �. � � . ' 34. Final Heating & Air Conditioning � ' � -' ;:v. Final Gas.Pipe-Test �. � � � � ' � - . . � .- � � - ' ' "36. Hood or Canopy -, �' = ; , - - - � ' _ - � � ' 3�/. Final Facto'ry Fireplace : � "� �� _ � 38. Final Plumbing , ' . ' �� . - � , , �, I 39. Water Service-Final� • .� � , � , . • � 40. Gas Service-Final � ' � . � • � '� ,/ 41. Solar pom�tio-Final ' � - i � - - -- 42. Backflow Preventer . � ' . " ' ._ . . _ _ , 43. Backfloavlrrigation• "� � � , ' � ' • r . � � 44. Landscape' Irrigation System � � � '" � ' . _ ' � _ 45. Sound Attenuation ' �' � � � �" ' ' . i " � " - 46. Handicap Regulations , ' � ' ! , ' ' � 47. FINAL STRUCTURE & BUI�DI�NG � r/ . . � , . 48. Special R,equirements Compieted � ' . � . ' � , 49. Electric Release io Edison �� _ , . _.. . � � - - • '� . 50. Gas Release to Southern Califomia Gas Co , , �' � � � 51. CERTIFICATE OF OCCUPANCY ' ' ' ' ' ' _. , . No � � - Date ' � � �, �