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HomeMy WebLinkAbout273 20TH ST - Building Permits ADDRESS OF BALDING: 273 E 20TH ST LIMY: CITY OF COSTA MESA — BUILDING PERMIT .ONNErsNCEIFfGam: BOURGEOIS, BRADLEY L AODRESt BOURGEOIS, KELLY PERM NO: B 073010 r 273 E 20TH ST PERMIT NO: B 073010 PLAN CHECK NO: 02131-95 A GOVT: N SUPP : N :OSTA MESA,CA 92627714 ) 642-6007 • AFPL.MAILING ADORESS CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ADD J ARCNRECLORENtlNEER: BBC GEGNERAL CONTR. ue.laa: 00000 JOB DESCRIPTION : ADD 560SF 1ST FLR, 814SF 2ND & INTER. TI SQ FT: 5, 042 MCN.OR ENG'S ADDRESS: 273 E 20TH ST DMT: C.M. CA 92627 CLAIM VALUE: 100, 000 . 00 CALL—VALUE: 107, 662 . 40 GROUP OCC : R-3 /M-1 CONTRACTORS NAME: CONTRACTORS NAMING COMMENTS : KITCHEN, ADD 814SF 1ST FLR , 560SF 2ND FLR & 168SF PORCH S: UC NO.: d(-RFNh Rb RF1ERf Rb**RE1EaEaERfirde***RF***#REREN(-REdb#dE*IF1b**ihlEAhyEiEdbfEdbiEdhlE*#dflflEiEdE1EREif*Nf AE***aEiElhlEdEdkdbdbiERERERk Rbib Rf DMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby ellim under palely of perjury that I em licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)d Dannon 3 d the Business and Professions Code,end my license is in full force end effect. CRY LIC.NO.: LIC.CLASS; UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Dae: Contractor FRNT: 24 FT IN REAR: 8 FT IN FRNT: FT IN REAR: FT IN LEFT : 5 FT IN RGHT: 15 FT IN LEFT: FT IN RGHT : FT IN OWNER BUILDER DECLARATION:I hereby affirm under penny of perjury that I em exempt ham the Centred=License Law for the Ioliowiq reason(Radian 7034.5&nnesa and Professions Code:Any ay o county whidrneuires apmnatocenehud,elm,improve, PARKING REQ 2, PROV: 3 PARCEL: 42628405 ZNE: R1 REF NO: .lcensed or urssant t the epair any structure, to Contractors Liialso cecene Law(Chaplet 9j , CONSTRUCTION AND PLANNING ' POO SPA APPROVALS Permit# ( Date Inspector APPROVALS Permit # Date Inspector _r 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 his-q5- 1,4i, 56. Rough Plumbing & Pressure Test - • 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings %q5 6 et/6/ 58. Electrical Conduit-Undrgrnd. 8. Foundation y(6 6 pig L'7J 6W6- 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System . - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap , 63. Heater & Vent-Final 13. Roof Drains ' 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16, Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure' 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage-Tank 0 Gas 0 Oil 25. Roof Sheathing i/vb-fc 74. Overhead Hydro 26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing C22.: qe a( 76. Dry Standpipe 28. Lathing& Siding (12. AR6 acr C 77. FIXED SYSTEM FINAL 29. Insulation LQ Gas* 78. FIRE PREY. FINAL 30. Drywall Nailing 6.1-7-el& 644 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 3-5=16 6c-1 - 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric - • Notes: 7_,(gar y - Cc_ / C C L.v`+f�L 11- 34. Final Heating& Air Conditioning Me Vg .., -re 4t fC - <ac -6, 35. Final Gas Pipe-Test """ 36. Hood or Canopy / 1-1-25:- ®4? 4 37. Final Factory Fireplace • 4't6 /1.3_, .vg( es al 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backf low Preventer 43. Backf low Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation - 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING !r [- t6 6Li_ 48. FINAL PLANNING Lr� (� 49. Electric Release to Edison 50. Gas Release to Southern California Gases) 51. CERTIFICATE OF OCCUPANCY No. Date • City of Costa Mese. • California 92628-1200 P.O.Box 1200 - • Insulation Certificate /jJ7 Permit Number ✓ • 1 O /o 273 E. 2.,o - C-i . Number and Street City • O1r a-in, Co55 untty Subdivision Lot Number Description of Installation ROOF /� Material 04/1 Brand Name Corks [C, Thickness (inches) 6 Thermal Resistance (R-Value) R=IV EXTERIOR WALL Q Material aeill Brand Name Co ra. r 5. Thickness (inches) G/ �r Thermal Resistance (R-Value) �� -�� CEILING • ee22 Batt or Blanket Type v_af1 Brand Name CB rwfk 5 Thickness (inches) ` r' Thermal Resistance (R-Value) / -3_a Loose Fill Type Brand Name Contractor's minimum installed weight/ft2_ lb. Minimum thickness inches Manufacturer's installed weight per square foot to achieve Thermal Resistance (R-Value) • RAISED FLOOR Material Brand Name Thickness (inches) Thermal Resistance (R-Value) SLAB FLOOR 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 Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Admi trative Code. General Contra© auder) gLicen e Number `?/f Q ( Signal)= and Title t Date Sub-Contractor(Insulation Installer) License Number Signature and Title - Date 1907-46 I' NEWPORT-MESA UNIFIED SCHOOL DISTRICT 15.81. CER', .GATE OF COMPLIANCE OF DEVELOPi.._dT FEES , PURSUANT TO AB 1600 AND AB 181 �12 TO: ( X ) City of Costa Mesa District Receipt No. nr__. ( ) City of Newport Beach ( ) County of Orange Plan Check No. ,2/5/— ?Jt4 Applicant: ` I J r 4 LA 3 o u r(, o f ) Address: 1_73 �J - c,14- 9 Telephone Number: `/ /.L1 - (o tit; 6 Om 7 fraet/Par6hand bt-Nuniber(s): Location of Project: 2-7.3 e- 2,014- 5 ft• (�/i Number of Square Feet of // 9 Residential Space 43 ! y x $ 1.72 Total .- / 3 63 . 1 Residential/ Sr. Citizen Space x $ .28 Total Commercial and Industrial Space x $ .28 Total Warehouse Space x $ .2235 Total Commercial/ Industrial Project is: (Check One) Warehouses 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 This 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: slat/ i' yam// • / J ed Representative II\ 1 / The above representation as to square footage is true. Applicant agrees that if it is I er determined that such representations are not true then this certificate shall automatically terminate and the a r priate City/County shall be notified. 7 Date: C • L - q x _ Applicant x Br"/f-ti 73,0 r7 e ops BUILDING PERMIT LOG EMPLOYEE: ADDRESS: PERMIT NUMBER: TYPE OF PERMIT: VALUATION: SQUARE FOOTAGE: PERMIT FEES: • DATE: TIME IN TIME OUT ACTIVITY _7-/W- 95" 9:l5API /0:I5.s-at Cohf-I t cd-c — r't-u,,e *f4Q sc.sfe'sk m f h.,sr- - rcvc'/c rea.ir 11 -30- 15.- 10: TO 1/: ro 4- Cep-4 fedi" {am lek5 ho -l- 554-c-er- 9-N 93 B ! 0B 8l It; _ ve-f r,. Split 4 cG soec. - 4.4d- 9-T- dt9-T- qr 9; ya 16/3_0 Pit5 ,'- s-fl.: uk- f e-C- a'0,t�✓ - ONLY ONE ADDRESS PER SHEET—TIME IS TO BE CACULATED TO THE NEAREST 15 MINUTES PLEASE BE AS SPECIFIC AS POSSIBLE IN RECORDING ACTIVITIES • ADGFEss of BUtLDNO: 273 E 20TH ST UMTS " CITY OF COSTA MESA - BUILDING PERMIT v - OANEii SNAME IF MOWN: BOURGEOIS, BRADLEY L PERM NO: E 073011 ADDRESS BOURGEOIS, KELLY 273 E 20TH ST PERMIT NO: E 073011 PLAN CHECK NO: N GOVT: N SUPP : N s' =OSTA MESA,CA 92627714 ) 642-6007 .MAI APPLL.NR ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: ADD ARCRDECTORENtlNEER: BBC GEGNERAL CONTR. u"0, 00000 JOB DESCRIPTION : ADD 560SF 1ST FLR, 814SF 2ND & INTER. TI SQ FT: ARCaORENG.'SAOORESS: 273 E 20TH ST WIT: C .M. CA 92627 CLAIM VALUE: CALC-VALUE: GROUP OCC: R-3 /M-1 CONTRACTOR'S NAME CONTRACTORS MAILING COMMENTS: ADD 814SF 1ST FLR 560SF 2ND FLR & 168SF PORCH RE: #B73010 ADORES& UC.NO.: ititit♦fitititit**ititk*it**ititiEitittt**itititititititititiEititit*it*ititit*ititit#*itit*it31*it4it*♦fitiEitit*itit**it♦E*itit♦Eit#* MT: ZON ING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby anti,under penalty of perjury that I am licensed under provisions of Chapter 9 S E T B ACK S (commencing with Section 7000)d Divisum 3 of the Business and Professions Code.and my Scenes a in full force and effect Cm UC.NO.: UC.CLASS: UC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Dae: Contractor LEFT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby&firm under Penally d persay that I stn exempt Iron the Contractors License Lew for the following reason(Section 7031.5 Business and Professions Code:Any qty or county which requires a pennh to construct Ater,improve. PARKING REQ P RO V: PARCEL : 42628405 Z N E: REF NO: demolish.or repair any stmcture.prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she a licensed pursuant to the provisions a the Contractors License Law(Chapters(commencing with Section 7000)of Division 3 of the PLANNING NOTES> Susines,and Professions Code]or that he or she is exempt therehan end the basis for the alleged exemption.Any violation of Section > 7031.5 by any applicant for a;emit subjcs the applicant to a civil penalty of not mom than love hundred dollars 1150op. it it it it*it it*it iE it*iE it*it*it it it it it it it it****it irk****it it it it it it it it it it it**it*it it it*it it***it if****it****it it it**it it it* 3 IL as owner ofthe propeny ormyemptiness with wages as their sae compensation,wM do the wok,and 01e structure is not intended DEVEL OP MEN T SERVICES REQUIREMENTS or peered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an owner 01 properly who builds or improves thereon,end dm does such work himself or horse/or through his or her own employees.provided that such _ improvements are not intended adored f°'sat"d,salinnate'the beading or improvement is sad within one year of completion,the ZONING APPROVED BY DATE: owner.builder will have the burden a proving he or she did not build or improve for the purpose d... •). • ❑ I.as owner d the property.am exclusively contriving with licensed contractors • .. _. Sect on)Oso,Bw mesa end Profession Code:The Contractors License Lew does r apply to an owner. or improves thereon and who BUILDING APPROVED BY : DATE: contracts for such projects with a mntradads)licensed pursuant to the •1 : ). 1 ❑ Iamexempt under Sealant B.AP.C..for this reason. APPLICATION ISSUED BY: DATE: � 2Q ° r / ititifitiEifitititit****itiEitititiEitit7F'{Fit#it##****iF****iE***iE% **** F#***it*it**se*it it ifit **it # ititit Dam: b Z$ Y. / LEGALIZATION:N F ErE SUMMARY STRUCTURAL SEGMENT: N I do hereby sanity that I am aware d els understand the requbemeres d 1,mica ....wand Soley Code Sections 25505.25533.and 25534.pemi ao1hmlaany MurebuikvpoenteAtAtaklDm(genem• • eeid • combwkh ustion state ooai to amthe asnptl nhse BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING for 2 tor cansWclan f care building homthent l/vei m(chats l e' rid. to•• • l mmmdunepcFalvwnee remlelmnthesa provisions. PERMIT 33 . 45 Date: Applicant: . 5 0% SM I P/NON-RES PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of penury one ol the following dedaratbne: ISSUE FEE 15 . 00 0 Have end wil maintain a cendicate cA consent to sethirtsure kr workers'compensation,as provided for by Section 3)OOdthe Labor BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for perfamanc.dthe wakf«wlkctt this pennsis issued TOTALS----> 33 . 45 15 . 00 r ‘ 0 . 00 48 . 45 48 . 45 . 00 madam'I have end nil maintain mad 'compensation insurance.es required by Section 3700 d the Labor Coda.kr the performance d the work for which Na permit is issued.My waken'compensation insurance carder end policy number are: Cartier REVENUE DIVISION TOTALS--> COLLECTED : 48 . 45 OVER/SHORT: . 00 Perry Number. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK ,This section need not be completed y the perms is for one hundred dollars($7001 a ass.) 48 . 45 ❑ I certify that in the performance Slim work for with this penis is issued.I shall not employ any pavan in any manner so as to Leconte subpd to the wakes'mmWnemlm lana California and agree that s 1 should become sublad to the workers' it*itititit*it*itit*it*itit*dtklfitititititit#ititititit****i ****it********** tk********1E**********Se Mit M Met compensation provisions dw Section W a n 31the Labor Code.I shall forthwith campy with those provisions. INDIVIDUAL. F E E BR EAK D OW N Date: Applicant: .f, Warning:Failure to secure workers'compensation coverage Is',ninety!,and shall subject an employer to criminal penalties and TYPE QTY DESCRIPTION UNIT COST TOTAL COST civil Ines up N one hundred thousand dollars($704000).hi addition to the coal of compensation,damages as provided ler In Section 3706 of the Labor Code,Interest,and attorney's teat & ELE 8 FIXTURES, LIGHTING./ /1 ST 20 EA. . 75 6 . 00 CONSTRUCTION LENDING AGENCY:I hereby dams under penalty a peryay thin then is a construction lending.Nancy kr the ELE 20 RECEPT/OUTLET ..2 1 ST 20 EA. . 75 15 . 00 performance dthe work tor which the perm.aissued(Section 3Ow.Civ.C). ELE 6 RECEPT/OUTLET , ADDITIONAL EA. . 45 2 . 70 LENDER'S NAME: ELE 13 RECEPT/SWITCH 1 ST 20 EA. . 75 9 . 75 LENDER'SADDRESS:CHANGE LIVING ROOM TO LEND - OF FEES I ssubhave ns �� II • e�mhetw� Ponall aband�i ordinances • and laves relating to building application 43129, ,' au0,orcereprtata of ayupothheabovementtned properly for inspection purposes. 4 B LEY' : ',URGEOIS Yf� r Dere: grtawre d. a/AgenUAppinannCmtreda (515146 WP) White-Building A Safety:Green-Ale;Canary-Appicant;Pink-Revenue:Goldenrod-Assessor • . 1 .•CONSTRUCTION AND PLANNING POO 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 r Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 9/9 ,- .s7. 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 I 9 9 3 t;7 67. Fencing & Access Approval 17. Rough Wiring Sign 66, APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing • 76. Dry Standpipe • 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIG'CATE ISSUED /9afra. 33. Final Electric _91-1:55 a12171:a Notes: y 34. Final Heating & Air Conditioning • pqr/leti /00,7‘ 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final . 40. Gas Service-Final - ' 41. Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation , 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date �. : . , 5 a) oz. ©k.5 7-:--1 " ) , 7- C�/a- Mw i - lAaM/i-S ,�Ltc►Z«$m�vt ere' ` PANEL ? P i-2- jzc1 $ CIRC.CIRC.BRKR OUTLETS WATTS NO. POLE AMP LTS. REC_TM C REMARKS A B ,e A 1 I 2 0 I M I C,4Q�o \CfAy� A 2 ( ?pis W'uvAS ,'' ; t c .__ $ ' 3 ':1 (ter eller tcsbIS?85k1- _ 4 : 2- . _ €�1214� A _ 5 i 3 Kr�?,ri-ai 6mAU. APP A s -2 50 1 ET/-af•I 5 8‘ - I 20 - 3 _ I Itr'rtHlav SMA-tA., • • 9. 1 A 9 ' 20 i .G. o.r Dg L - - Cv- AK, s A 10 to _ KtCZPCS 'ENT'RY DINS/TV 9 11 P( 12 REcePTS 9AMILry 12M. A 13 10 Kee—e91-5 GAM RM ■ 14r 2. (p itktSPI-5 MA'SCER SDR - •. g 15 I 10 R>ccePr4 11EDCAM " 3 3 16 1 `✓ S RE-CfP'15 6CI)ROrx-i -et-2- A 17 { s5 t5 ' LI4,11'5 ,krrt3nzn►- 140o A 18 ( 17 as 15E12EKM 41- - t I'. 1 0 19 1 II-1- I.1 is Ar WIMAM_\LO0 6 2,0 17 u6.-4f '1‘meyNAL1 Ipagrm 'z I4z-5 - A 21 7 U U-WS N as-na2 cSEp t SpTN `4i 5 A 22 1 2 1.160x4 secv Rens loco 0 23 I V , 3 1-1 lofts X-HAS 5Zd 6 24, 1 SPAR `2A1 -A2 5 I 2-0 1 I ANTI C- Sv i u bt•Pri aE T 26 L I _ 'F A 1. .. 6 37 4, 'I// 1 , \A/AS HEA. 28, Z 30- 1 Z20 Daya2 A 29 ' — Z•ZO1312Y ' A 30 `I 2O 1 _ nl'zo tstyeQ e 31 2 _5o • 1 6ner2A-bg $ 32 a 20 CENT AI . VfK(� • A 33 Cemn2A'l-A/•ttr-C� A 34 C a io-A6t \ . . ; - 6 35 0 36 A 37 A 38 e, 39 0 40 -4.2- TOTAL WATTS: OA: 0B: PJC:. KW: LCI.: KW TOTAL KW @ VOLTS PHASE WIRE= AMPS FEEDER: MOUNT: MAIN: BUS: ADDRESS OFBUILDNG: 273 E 20TH ST UMT: CITY OF COSTA MESA — BUILDING PERMIT v OWNER'S NAME IF KNOWN: BOURGEOIS, BRADLEY L PERM NO: E 076251 ADDRESS: BOURGEOIS, KELLY 273 E 20TH ST PERMIT NO: E 076251 PLAN CHECK NO: N GOVT: N SUPP : Y COSTA MESA,CA 92627714 ) 642-6007 APPL.SWUNG ADDRESS CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ADD ARCHITECT ORENDNEER: BBC GEGNERAL CONTR. UC.NO.: 00000 JOB DESCRIPTION : ADD 560SF 1ST FLR, 814SF 2ND & INTER. TI SQ FT: ARCH.OR ENG.'S ADDRESS: 273 E 20TH ST DMT: C.M. CA 92627 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /U-1 CONTRACTORS NAME: CONTRACTORS MMUNG COMMENTS: ADD 814SF 1ST FL, 560SF 2ND FL, 168SF PORCH, #B73010 & #E73011 ADDRESS: UC NO.: 393E 3E 3E*3E 3E 39 39393E 3E*3939 3E*39 3E 393E 3E 3E 3H 3E 3H 4*3f 39 39*3f 39*393E 3H*3639 393E 3E 3E 3E 3E**3E*393E 3E 3f*3E 3E 3E 3f 39363E 3E 3(•3E*3e 3E 3f*iE 3E*39*3H 3H 3H UNIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. Cm LIC.NO.: LIC.CLASS: LIG.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dale: Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury Mal I am exempt from the Contractors License Law for the following reason(Section 7031.5 Business and Professions Code:Any city a county which requires a permit to construct,alter.improve, PARKING REQ: P ROV: PARCEL : 42628405 Z NE: REF NO: demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law)Chapter 9(commenting with Section 7000)of Division 3 of the PLANNING NOTES> Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 3. 7031.5 by any applicant for a permit subjects the applicant to a civilpenalry of not more than live hundred dollars POOH. 3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E#3f7E3E3E363E3f3t3f3F3E3E3E3E3fr3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3E3Eik#3E3k3E3E3E3E393E3E3E3E3f R1 I.as owner of the properly or my employees with wages as thele sole compensation,will do the work,end the structure is not intended DEVELOPMENT S• E.-R V ICES R E U I R E M E N T S or offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not appy to en Owner of property Q who builds or improves thereon,end who does such work himself or herself or through he or her own empoyees,provided that such , improvements era not intended or offered for sate.If.however.the building or inprovemenl is sold within one year of completion.the ZONING APPROVED BY DATE: owner-builder will have the burden of proving he or she did not build or improve for the purpose of sale). ❑ I.as owner of the properly,am exdusivey contracting with licensed contractors to construct the p .(Section 7044,Business eM BUILDING APPROVED B Y " I Professions Code:The Contractors License Law does not apply to an owner• property .5 or improves thereon and who DATE: contracts for such projects with a contractor(s)licensed pursuant to the Co.ta••wore License ,. / .2.4t1.1.1. ❑ Iamexempt tryiersyntion: B.AP.C.,for this resonn1 APPLICATION ISSUED BY: DATE: 2 r 'l �[ Owner: • /- ****3E3E3E3E3E* 3E3E3E3E3E3E#3E3E3E3E3E#3E3E3F3f3E3E3E3E****3E* ****3E 3Eif3F3f3E#3E3f3f3f****3E**3E3E*3F3F*##3443 **3 * Date: LEGALIZATION:N F E ESUMMARY STRUCTURAL SEGMENT:N Ido hereby certify that I am aware of and understand the requirements of domia Noah,, •Safely Code Sections 25505,25533,and 25534.andonllorenyrmodifcuture ationfomtheAwill/will M (gecle mentone)Didd.Re dent cwonstth ruction apodeinseerequirementsmfor ea BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING apermit ltd Mat I orcin fmodifiuliinhoc them Ouatiy Management District.Residential constrod sl to codesanare dthexemptfrom these provisions. PERMIT ' 18 50 Date: Applicant 5 0% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:l hereby affirm under penalty of penny one of the following declarations: PLAN o I have and will maim �a certificated consent to aef'insure for workers'compensation,as provided for by Section 3700 of the Labor ISSUE NGE 4 , 50 m BUILDING Code,for the performance of the work for which this permit isissued. —DIV—> PERMIT ISSUE PLAN CHECK TOTAL PAID DUE ❑ I have and willmeintan workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the TOTALS > 1$ . 5 0 4 . 5 0 0 . 0 0 2 3 ,0 0 2 3 , 0 0 • 0 0 work for which this permit is issued.My workers'compensation insurance carrier and policy number are: Carder REVENUE DIVISION TOTALS--> COLLECTED : 23 . 00 OVER/SHORT: . 00 Policy Numbed BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK his section need not be completed 9 the pennk is for one hundred dollars(3100)or less.) 23 . 00 ❑ 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 H I should become subject to the workers' .K.3(.3E31..K.3(.3f3f3E.M.3f.i43E3f.3hif3f3p3p.K..K.i43f3pN.3F3E3F#3!•3EiE.K..K..K..K.if..K.3Eif3E.N..M.if..N.ikih.K.3E#iE.K.3E.kit.1(.i(..K.3fi(.iE3EiE3(,3(,#,KlEif3E.M,3E3E3E3E.KK-.NN. compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with those provisions. Data: Applicant: INDIVIDUAL F E E BREAKDOWN Warning:Failure to secure workers'compensation coverage Is unlawful,and shahsublet,an employer to cdMnsl penalties and TYPE QTY DESCRIPTIO N UNIT' COST TOTAL COST civil fines up to one hundred thousand dollars($100,000),In sadlnon no the cost of compensation,darner*as provided for In ae, Section37of the Interest, ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 . 50 18 . 50 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that there is a construction lending agency for the . END OF FEES performance of the work for which this permit is issued(Section 3007,Cit C). LENDER'S NAME: LENDER'S ADDRESS: CHANGE LIVING ROOM TO I certify that I have read this application WWW$ppllptlfl ve!per isyonefA9tj(lo�with all city and county ordinances end stale laws relating to building condr to u Ne represen atwes of RIB oily to enter upon the above-mentioned property for inspection purposes. BRADL BOURGEOIS a: 001)9.1? 11:19'.7725 i Ca_ 2s. nG dm Nemo CC.Tt: Q''/U.i6 Tjrvc7 1! -al ppp J _ ) Date. �//�//I b J Signaler iOwnar/AgenVAppliranVConiredor 111 ((( p (515l'46 WP) White-Building&Safely;Green-File:Canary-Applicant;Pink-Revenue:Goldenrod-Assessor POOL ,PA CONSTRUCTION AND PLANNING • 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 UtilitytUndrgrnd. ' 54, Forms 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding • - -5. Steel Reinforcement 56. Rough Plumbing & Pressure Test _. - `6. Electrical UFER Grnd. 57, APPROVAL TO COVER-GUNITE • -7. Footings 58. Electrical Conduit-Undrgrnd. 8' Foundation 59. Gas Pipe, 0 Undrgrnd.,Test - _ , 9' Water Pipe --Undrgrnd. 60- Backwash Lines, P-Trap, 0 Undrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 1 13. Roof Drains A. 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 • - j 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 _r. - _ APPROVAL5_;0•f Permit #- 21. Ducts,in Structure - - •: ; 70. Underground Hydro 22. Ducts, Ventilating c 4'; 7 . - - --:•4 • 71, Product Piping'0 Gas 0 Oil 23. Gas Pipe-Rough & Test k • _ -' 72. Underground Flush , 24. Roof Framing ^ - - 73. Undergrnd.Storage Tank 0Gas 0 Oil 25. Roof Sheathing - ' - R , - 74. Overhead Hydro 26. T-Bar Ceiling {Structural) & tvlonocoat - r I • - 75o Dry Chemical - 27, Frame and Flashing _ ., - , •. :.- - '-I' 76. Dry Standpipe - 28. Lathing& Siding _.'t : - - 77: FIXED SYSTEM:FiNAE. 29. Insulation. ._ .. 78. FIRE PREY. FINAL , •• - i ' 30. Drywall Nailing ,. :HEALTH-DEPT. REOUIR•EIVIENTis - 31. Plaster Brown Coat. ' I t- e - - ' 79. FINAL INSPECTION -, 32. Electrical Power Met`er'Finai /fig 80:; FOOD CERTIFICAT•E ISSUED 33- Final-Electric. - , 8 4� r 1 tas: _ - -I 34. Final Heating& Air Conditioning - ,^ 35. Final Gas.Pipe-Test . .• - ' - ' - 36. Hood or Canopy . ' .. . ~-- . 37. Final Factory Fireplace :, I ----_� _ - 38. Final-Plumbing - 39- Water•Servide-Final ' 40. Gas Service-Final • - L L '4. • ..- , 41. Solar Dome5tic-Final- _ 42. Backflow Preventer • _ -- -- 43. Backf low irrigation. . , . - 44. Landscape irrigation System - - 45. Sound Attenuation -• r .__ ;, Il 46. Handicap Regulations - - - - i , 47. FINALSTRUCTURE & BUILDING - A 48. FINAL PLANNING 1 _ 49. Electric Release to Edison 50. Gas Releaseto-Southern CaliforniaGas Co - _ _ 51. CERTIFICATE OF OCCUPANCY t . - - No. Date • ADDRESS OF BUILDING: 273 E 20TH ST UMT: , CITY OF COSTA MESA - BUILDING PERMIT ✓ OWNERSME IF KNOWN: BOURGEOIS, BRADLEY L NAPERM NO: P 073013 ADDRESS: BOURGEOIS, KELLY 273 E 20TH :«T• . • a PERMIT NO: P 073013 PLAN CHECK NO: N GOVT: N SUPP : N COSTA MESA,CA 92627714 ) 642-6007 -' APPL.MAILSIG ADDRESS CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: ADD In • ARCHITECT OREflNEER: BBC GEGNERAL CONTR. UCNO.: 00000 JOB DESCRIPTION : ADD 56OSF 1ST FLR, 814SF 2ND & INTER. TI SQ FT: ARCH.ORENG'S ADDRESS: 273 E 20TH ST WIT: C.M. CA 92627 CLAIM VALUE: CALC-VALUE: GROUP OCC : R-3 /M-1 CONTRACTORS NAME CGTRACTORSDAMNS t_ COMMENTS : ADD 814SF 1ST FLR , 56OSF 2ND FLR & 168SF PORCH, RE: #B73010 ADDRESS UO ND.: ******************************AE************************************************ UHT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penalty of perjury that I ern licensed under provisions of Chapter S SETBACKS (commencing with Section 7000)of Division 3 of the Business end Professions Code,and my license is in full force and effect. CITY LIC.NO.: LIC.CLASS: UC.NO.: EXP: MAIN BUILDING ACCESSORY BUILDING Des: Contractor: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt tram the Contractors License Law for the following reason(Section 7031.5 Busies,and Professions code:Any cry or county which requires a permit to construct.alter.Improve. PARKING REQ: P RO V; PARCEL : 42628405 Z N E: REF NO: demolish,«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(commendng with Section 7000)of Division 3 of the PLANNING NOTES> , Business and Professions Codec or that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section .- > ^ 7031.5by any applicantfor a permit subjects theapplkamlo aavil penalyolsed mace than five hundred dolars(5500f. ififiEiEiFiflEiflEiEiEi(-#iFiEiEiEtE1FiF1EiEiEtEiEtk1E-0EdEiE1E1Ed(-tEt(-1(-1E3Fir-t(-1FiEfr-1ftf161fiE1f9F14***1EtEtEtklEaF1E1ElFiEffiEiElFiFiEiE1f1E1Etf-*** all L as owner of the property or my empbyeea with wages as their sole compensation,will do the work,and the structure is not intended DEVELOPMENT S E R V %I• C E Sf`t R E'- Q U I R E M E N T S or offered for sale(Section 7044«i ,Business end Professions Code:The Contractors License Law does not apply to en owner of property Y who builds nproroe thereon,and who does such work himself or horse,or through he or her own employees.provided that such oimprovements are not intended cc offered for eale.ff.however.the building or inprovermem o sold within one year d completion, ZONING APPROVED BY (,T r.- ' `�. DATE: wner-builder will have the burden of peeing he or she did not build or improve for the purpose ol sale). ❑ I,as owner of the property.em exclusively contracting with licensed contractors to constr project(Section 7044.Business and BUILDING APPROVED B Y : i - r'v DATE: Professions Code:To he Contractors License Law does not apply to an owner -.. builds or improves thereon and who contracts for such projects with a coromor(s)licensed pursuant tot/1 nada, . :w). i v r . ❑ Iamexempt undeSeclion: B.&P.O.,forthis rr APPLICATI,ON ISSUED BY: C / s v�.,, DATE: __ ... ************************************** *****#Y�+�****************** � ** Dalt -,- Z? ' �C ,� °wnernqufr / LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT:N I do hereby cents that I am aware d and understand the requinem- ne Caliomo Air end Safety Cob Sections 25505.25533.and -f�) 25534,and that I or any future building occupant will/wit no((circle one)need to•• . loch said state codes and the requirements ler iv) /„n a permit forconstmdion or modification horn the Ai Ou°My Management District.Resid•'pal construction applications we exempt from these BLDG PMT PLUMBING ELECTRIC ,' MECHANIC FIRE SMIP/RES GRADING proviaioes. PERMIT 96 . 00 •" • y ✓ SMIP/NON-RES 5% Date: Applicant: PLAN 2 O WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE ns: ISSUE FEE 20 . 00 7i r, ❑ Ihave and veil maintain acenJbteoconsent tose-insure for workers'rompenmtion,aspovidedfor bySerlion3700othe Labor BUILDING-DIV-> PERMIT ISSUE PLAN.-CHECK • TOTAL PAID DUE Code.f«the wd«manc.ag»wakf«when ince pent i.issued. TOTALS----> 96 . 00 20 . 00 n' 0: 00 116.00 116 . 00 . 00 ❑ I haveand win maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the �i work(or which this permit is issued.My worker,'compensation insurance carrier and policy number are: - Carder: REVENUE DIVISION TOTALS--> COLLECTED: 116 . 00 OVER/SHORT: . 00 Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC }-• FIREL' SMIP/TOT GRADING PLAN-CHECK This section need nor be completed the pesnsi is For one hundred dollars(S tool or less.) 116 . 00 .f / r )-? o I certify that in De performance o the work for which this permit is issued.I shall no employ any person in any manner to as to I -� become subject to the workers'compensation laws o California. end agree that n I should become sufajed to the workers' *************************************************lE,lE*,l*************************** compensation provisions d Section 3703 of the Labor Code.I shalt f«thweh comply with Daae provision,. INDIVIDUAL" F -E E B R uE 'P:' K D O W N Date: Applicant: _ • vl Warning:Fellursroaeeurs workers'compensation coverage la unfawlu(and& hi usyfecr en employer to criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines u p to one hundred thousand dollars(3100000),In addition to the coat of comperearlon,damages as provided for In . Section 3706 of the Labor Code,Interest,andarromey'a leen PLU 1 BATHTUB 7 . 00 7 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty Ofperury that there is a construction lending agency for the PLU 1 DISHWASHER - , 7 . 00 7 , 00 ped«manceoftheworkforwnidnthispenni (Section PLU 1 LAUNDRY TUB OR WASHER . - 7 . 00 7 . 00 LENDER'S NAME: PLU 2 SHOWER '' /'=I 7 . 00 14 . 00 LENDER'S ADDRESS: ,t CHANGE. LIVING rRp�OjOM TO PLU 1 SINK, KITCHEN ' 1 dl 7 . 00 7 . 00 Iceniythetlhewread Nisappldeti0n i1� l5p•Df m« n8rohoa-a(�hedryt�o m pnd«Ihlhee�bovB1dermmnio ed�io°Bp°ecacy° PLU 2 WASH BASIN ( , C, 7 . 00 14 . 00 and state move relating to bWld,ng cernd(Wtoot PLU i. WASH BASIN ( SET) 7 . 00 7 . 00 1«impaction Wrpaes. , . HRADL BOURGEOIS PLU 3 WATER CLOSET (TOILET) ' 7 . 00 21 . 00 PLU 1 WATER HEATER AND/OR VENT 7 . 00 7 . 00 PLU 1 GAS PIPING SYS OF ,2-1` jTO 4 OUTLETS ni 05?:0.0- Duca >cau to,- 5 . 00: Date: ^7-�`t- END'pF FEES . Xt... :; Signature owmnnganuAppfirenucomnador `vr (5151'46WP) White-euildig&Safey:Green-Ale:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor I 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. '6=uns - /�//A 53. Steel Reinforcement `fir i 3. Electrical Conduit Utility-Undrgrnd. _ 54. Forms 4. Electrical Conduit-Undrgrnd. ; 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. 82 Foundation 59. Gas Pipe, 0 Undrgrnd.,Test • £'. Water Pipe-Undrgrnd. lryl1: -60. Backwash Lines,P-Trap, C1 Undrgrnd. IP 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection :67. Backwash & Receptor-Final 12, Sewer Cap 63. Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final 14. Rotugh Plumbing *7 � �/, 65. Electrical-Final 15. Rough Electrical-Conduit !� Fi(�- 66. Solar System-Final 16'Rough Electric Wiring 67. Fencing & Access Approval -17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 118. 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 x 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 3a.-1>; �!J' ) 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding • 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric - Notes: '-`( ^�S CLVt m.•r.t i �/o 34. Final Heating& Air Conditioning f-1 � �� naR-rata 35. Final Gas Pipe-Test 36. Hood or Canopy Z /54, 13ycr� • 37. Final Factory Fireplace `' / \ •f ��� 38. Final Plumbing 1C1' The - r _ `►i,39. Water Service-Final ? ,. 40. Gas Service-Final g_ 41. Solar Domestic-Final 42. Backflow Preventer -43. Backflow Irrigation 44. Landscape irrigation System • 45. Sound Attenuation -. 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date .. , ADDRESS OFDawn 273 E 20TH ST WIT: -, CITY OF COSTA MESA — BUILDING PERMIT OWNERSNAMEIFIOI*H: BOURGEOIS, BRADLEY L PERM NO: M 073012 ADDREs' BOURGEOIS, KELLY : 273 E 20TH -ST • PERMIT NO: M 073012 PLAN CHECK NO: N GOVT: N SUPP: N :OSTA MESA,CA 92627714 ) 642-6007' APR..MMUNOADORES. CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: ADD ARcwnECTDRET,m/EERBBC GEGNERAL CONTR. MM., 00000 JOB DESCRIPTION : ADD 560SF 1ST FLR, 814SF 2ND & INTER. TI SQ FT: ARCRORFNO:SADmE55: 273 E 20TH ST WIT: C .M. CA 92627 CLAIM VALUE: CALC—VALUE: GROUP OCC: R-3 /M-1 CONTRACTORSRASE: CONTRACTOR'S MALDIO COMMENTS : ADD 814SF 1ST FLR , 560SF 2ND FLR & 168SF PORCH, RE: 4-87301O ADDRESS: UC.NO: *stat**************************************************************sot*******56***56* UNIT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Nim under penaly of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commenting with Section 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and ached. Cm UC.NO.: MC.CLASS: LJC.NO.: EXP : MAIN BUILDING ACCESSORY BUILDING Dale: Contradoc FRNT : FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury That I am exempt from the Contractors License Law for the latent('reason(Section 7031.5 Business and Professions Code:Any city or county which requires a permit to addend,after,improve. PARKING REQ: PROV: PARCEL: 42628405 ZNE: REF NO: demolish.or repar any structure.prior to Ss balance,also rewires the applicant for such pews to file a signed statement that he or she 7— is Deemed pursuant to the pro iwaw d W the Cradaa License Law(Chador m 9(commencing with Section 7000)of Division 3 a the PLANNING NU TES> ( Business and Professions Code)or thin he or she is exempt therefrom and the bale la lee alleged assns.Any violation Section > 7031.5 by any applicant(or a pens eApds the aPPfvhan toe Divi wally dnot more than Ma hundred stolen 13500D. *************************************.****************************************** k,] 1.es*wee(of the Orolparle or mY emPloyees wih wages as awls sola compensation,will do the work,and the structure is not intended U I R E M E N T S or offered for sale(Section 7044,Business end ProfessionsCode:The Codradnot ors License Law does apply to an owner of propeM DEVELOPMENT SERVICES R E Q who bolds or inpmvs thereon,end who does such work himself or henal or through his or her own employees,provided that such ownaa rbuisves q wwiilel it dttdeddeenaprovinppr frnMadt 'e did not bdbuilding r ipproveforhe wmesed n" -y do�P� '�e ZONING APPROVED BY ' DATE: o I,es owner d the property,ern exclusively contracting with licensed contractors to•.+1 .- .the• •".•( . . Business,Busins end Professions Code:The Contra License Law desetwplyb .pan owners: who•JJ.. ai•pmves'hereonandwho BUILDING APPROVED BY : y DATE: contracts for such prefects with a contractor(s)licensed pursuant to the Cont •- se La T. ❑ Iamexempt under Secem: r B.6 P.C.,br this reason: APPLICATION ISSUED BY • DATE• c' I ***********************************w***********s * at t********** Td ��** ldo (;--.2.- mac{ Owner: LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT: N m hereby candy that I em awes d vol understand the not(*c one)e)c.�-anis ltn ane Salary cove state es endw 2ss05.25533.and a2permit talaoryMurobalionng om thent Quaktyangemcomplyd.towcon s+knappicester requirements for BLDG PMT PLUMBING ELECTRICt MECHANIC FIRE SMIP/RES GRADING )534,lomat Mor any we modificationfromAr ill/wiMor(dreeo .-. 10W condndbn+ppodeismanexempt eme these provisions. PERMIT 1 3 . 50, . Das: Applicant: 25% ' SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm order penalty d perjury we d the blowup dedaneions: PLAN • • o !have ewiImeinUilacen4medconardtoselfansureexueka ,s ers'campenbndeededfobySedon3703dtheLabo IUILE FEE 15 . 00 rd Cods,forthenw walla which the permitit Sued. BILDING—DIV—> PERMIT ISSUE PLAN-CHECK ' TOTAL PAID DUE performanceof ❑ Ihadwiimabre:nworkers'ampenabStadion TOTALS----> 13 . 50 15 . 00 0 . 00 28 . 50 28 . 50 . 00 wm work for which this permit is Sued.My workers'compensation insurance carrier and poky number are: I Caner: REVENUE DIVISION TOTALS--> COLLECTED : 28'. 50 OVER/SHORT: . 00 Pdky Number: - _---- BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK :mit section need not be competed 4 the panne is for one hundred dollen($5001 or lass) 28 . 50 O I candy that in the performance o the work for which this perch Is issued,I shall not employ any person in any manner so as to beovne subject to the workers'compens tion laws d Ca4lomu,and ague S that I should cv beone soled to the mains ***********************************************a!*aE***************************** compenaimn provisions of Rediae 3700 of the Labor Code.I shall forthwith comply with those provisions. I N D I V I D U A I F E E H R 'E A K D O W N Date: Applicant: Warning:Failure to secure workers'compensation coverage b unlawful,and shall subject an employer to criminal penalties and TYPE QTY D E $ C R I P T I O N UNIT COST TOTAL COST civil fins up to one hundred thousand dollars($104000A M addition to Me coat of compensation,damages as provided for In Section 3706 of the Labor Cods,Interest and attorney's less. MEC 1 RELO FORC—AIR/GRAV FURN <= 100 K BTU 9 . 00 9 . 00 CONSTRUCTION LENDING AGENCY:I hereby affirm ands y d penalty perjury that there is construction lending agency tor m. MEC 1 VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 a 4 . 50 performance ci he work for wtidi this peini tn issued(Sedbn 3091,Civ.C). END OF FEES LENDER'S NAME: - • LENDER'S ADDRESS: Cion HANGE LIVING WROOM a TOOy _ lcertify that I have read this ead state laws naming to to bWdrngcocauauddion ! adhorg p Moven, pn�elrvea Muir*itoenter upon the aboe-mentioned propertyty ordinances ., • _ r for impeder,purposes. . RADLEh OURGEOIS4 } 6 zY—�c j /) • /Zura )AgenuAIor (5151-46.WP) White-Building 6 Safely:Green-Ate:Canary-AppiceM:Pink-Revenue:Goldenrod-Assessor ' , CONSTRUCTION AND PLANNING PQ�E APPROVALS Permit# Date Inspector APPROVALS Permits Date Inspector 1. Temporary Electrical Service or Pole 52, Pool & Equipment Location • 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 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 /�J 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 3- t1-76 �_ FIRE DEPT.REQUIREMENT .. 20. Rough Factory Fireplace ����_ll��dor ,419) FIRE APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush • 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. ,Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding ' 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD/CERTIFICATE ISSUED 33. Final Electric Notes: '�lS 4conaarina 34. Final Heating& Air Conditioning c2C -gC 35. Final Gas Pipe-Test C Z, 3 ! =bJ er/I 36. Hood or Canopy r -'q L/- /t Igen `.fa 37. Final Factory Fireplace �`Z-/' Oft-oat & r _ 38. Final Plumbing y'l• ?C ten �"i'i 39. Water Service-Final • ?- et. 40. _ 40. Gas Service-Final / 41. Solar Domestic-Final 42. Backflow Preventer 43. Backf low Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING .x.‘" 4 =48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No Date • Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. 1 CITY OF COSTA MESA • - PERMIT NO. • TRACT NO. LOT NO. BLDG.NO. - I • CONSTRUCTION PERMIT ' • ' - • '£ —/O7 O ' Project Address Z 7 3 C. 7_0 7-t TYPE OF CONSTRUCTION U NEW X ADD U ALTERATION U REPAIR - , Applicant's Mailing Address i T SAr‘e ❑ CONVERSION CI DEMOLISH OTHER - A.P.# - I Zone- ' 5 C74 L 6002 DESCRIPTION OF WORK S- • Q� Owner's Name e - Z _ $ Pack yoLtv'�PU S Phone - Ne su'r'e E„frr.'S+-, I{oj-t ' S Main Building: - Accessory Building:,' " O Address • • ' TYPEOF PERMIT LJ GRADING ElFOUNDATION LJ STRUCTURAL T Front ' ' . N• Arch/Eng. License No. - ❑ TENANT C.ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B ` t; 1 RearNI N Address• - CI OTHER A GM kl ER/B 4J Ioc- PROJECT DESCRIPTION S• Q. FT. OCCUPANCY C Right Contractor's Name Phone CONSTRUCTION TYPE • VALUATION $ S Left xK �• I ('t R Addiesslmailing) _ �P• '� - E ZONE GRADING CU.YDS. ACRES PSI Ref.# „ - EEA O D �_ Palk.Fees $ • Q City License No. p ii� 11 II 9 (� U LICENSED CONTRACTOR DECLARATION Remarks: J Etts'�8.. W y12w tT0 f / r / Parking Req./Pr v ded �' -h hCS`15 I hereby affirm that I am licensed under provisions of'Charter 9 (commencing �q 4!C v S (,rhGssa e, with section 7000) of Division 3 of the Business and Professions Code, and • t rl�) q Use of Building: �� t•{�j?a is E my license is in full force and effect. (M /d - - L, - �( Ucense Class License No. PLUMBING • I FEES Planning Notes: 0\11 ,`j 1 Us • E • Date Signature V . WORKERS' COMPENSATION DECLARATION • ; Bar Sink Showers N '•ereby affirm that.' have a certificate of consent to self-Insure or a Certificate - ' - - - - - -, -- • T Workers' Compensation insurance, or a certified•copy thereof (Section - BackflowPreventer Service Sink S JO, Lab. C.) _ Backflow Irrigation Sewer Cap • ELECTRICAL FEES Policy No. I Company 8 Certified copy is hereby furnished. Bathtubs , Sewer Connection - Automatic Washer • Transformer 0 15-50 KW Certified copy Is filed with the city Building Division. - 0 50+ KW Date Applicant • Clarifiers i Solar Collectors Construction Pole Sub. .... ._ EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Diihwasher . Solar Piping (This section need not be completed if the permit is for one hundred ($100)or P 9 i ' Cooking Unit Meter ❑up to 100 amps • less). - ' I certify-that in the performance of the work for which this permit is issued I Drinking Fountains Solar Tank , Dishwasher Meter Dover 100 amps shall not employ any person in any manner so•as to become subject to the Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers ❑Gas ❑Electric ' Sub Panel .J Date Signature NOTICE: if,iafter making this declaration,you should-become subject to the Floor Sinks ' - - 'Urinal Fan - - ' -- Workers' Compensation provisions of the Labor Code, you must forthwith Motors❑0-1 HP ❑1'/a-8 comply with such provisions or this'-permit shall be deemed revoked- Gas Service Outlets Water Closet - F.A.U. Inc Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance- Interceptors Water Heater - . Fixtures • of the work for which this, permit is issued (Section 3097 Civ. C.) - - J - Microwave In Lender's Name • Kitchen Sink _ Water Service Device Boxes ' Pole Light ' • Lender's Address Lavatories ` OWNER BUILDER DECLARATION • �7 Outlets r Range 1 �- I hereby affirm that I am exempt from the Contractor's.Llcense Law for the following reason (Section 7031.5 Business and Professional Code: Any city or P-Trap - . • 1 6,--Switches r,......- Sign V county which requires a permit to construct,alter,Improve,demolish or repair - _ any structure, prior to Its Issuance, also requires the applicant for such permit - Roof Drains ' Garbage Disposal Standing Sections to file a signed statement that he/she is licensed pursuant to the provisions of - the Contractor's License Law(Chapter 9(commencing with Section 7000)of • D!vlslon 3 of the Business and Professions Code)ror that he/she is exempt - Generator ❑0-5 KW ❑5-15 KW Trash Compactor :<s,;afrom and the basis for the alleged exemption. Any violation of Section Y.-1...t"y' S by.any applicant for a permit subjects the applicant to a civil t 3 LAA, 21Ity of not more than five hundred dollars($500). Reinspection Fee $25 , Issue Fee $ 3 - -� L y„) 1, as owner of the property or my employees with wages as their sole - Reinspection Fee $25 Issue Fee $ 3 • o pensation will do the work,and the structure is not intended or offered MECHANICAL FEES for sale (Section 7044, Business and.Professional Code: The Contractor's 'PUBLIC SERVICES REQUIREMENTS: License law does not apply to an owner of a property who builds or Improves Boiler • Hood or Type I 0 • thereon, and who does such work himself/herself or through his or her own - Zoning Approved By Date employees, provided that such Improvements are not intended or offered for Canopy Type I1 ❑ sale. If, however, the building or Improvement is sold within one year of com- Duct-Under Ground - Building Approved By Date pletlon, the owner will have the burden of proving he/she did not build or im- /'f,L y grove for the purpose of sale). Duct-Structural Refrigeration System Application Issued By aDate 7j' s�-�/ U I,as owner of the property,am exclusively contracting with licensed con • - tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 00-100,000 BTU 0100,000 BTU ' SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who - ' builds or Improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration • BUILDING PERMIT $ ' SMIP $ tractor(s) license pursuant to the Contractor's License Law). - PLAN CHECK • $ PERMIT 0 I am exempt under Section - ji & P.C.for this reason Firepl/Fart.Bit. ICBO# PLUMBING P$ ISSUANCE $ Date 7/7/Ky owner 'v`--1 ��( u.Ac5t.4 Heating System& Ducting PLAN CHECK 25% $ ENERGY P.C. $ I herebyacertify that I haverread thismapplication all arid state that the aboves • ❑0100,000 BTU 0100,000 BTL �C GRADING $ Information is correct. I agree to comply with all city and county ordinances - ELECTRICAL $ sl7/ and state laws relating to building construction, and hereby authorize rapre- PLAN CHECK 50% rd MICROFILM $ sentatives of this y to enc pen the above-mentioned pro ert for $ inspection purpo MECHANICAL $ 4 O 0 Signature _ /Z69te Z"Dz Drivers' License or SS# Reinspection Fee $25 Issue Fee . $ 3 PLAN CHECK 25% $ TOTAL FEE $ -02 a CMF 0865-46 rev.12/83 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor CONSTRUCTION.AND PLANNING - - POOL' 'A. - • APPROVALS Permit# .Date Inspector APPROVALS - Permit# -Date • Inspector 1. Temporary Electrical Service or Pole .52. Pool & Equipment'Location •- 1 r• . 2. Soil Pipe-Undrgrnd. 53., Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms , 4. Electrical Conduit-Undrgrnd. y - 55. Electrical Bonding - , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test •- 6. Electrical UFER Grnd. - 57.,APPROVAL-TO COVE R-GUNITE ' • • 7. Footings. 58. Electrical Conduit.Undrgrnd. - ' 8. Foundation - 59. Gas Pipe, O.Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash-Lines, P-Trap, 0 Undrgrnd. i 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property'Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap ' , - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final - • • 14. Rough Plumbing • • 65. Electrical=Final - • 15. Rough Electrical-Conduit 66. Solar System/Final • 16. Rough Electric Wiring 67. Fencing & Access Approval . . • 17. Rough Wiring Sign - ' I 68. APPROVED FOR PLASTERING' 18. Rough Electrical-T Bar•Ceilingl _ • ' 69. POOL/SPA SYSTEMS FINAL - 19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - •20. Rough Factory Fireplace • APPROVALS Permit# - •21. Ducts, in Structure 76. Underground Hydro 22. Ducts, Ventilating ' 71. Product Piping 0 Gas 0 Oil , 23. Gas Pipe-Rough & Test .' 72. Underground Flush ' 24. Roof Framing ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro • ' 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • • 27. Frame and Flashing . 76. Dry Standpipe • . • 28. Lathing& Siding ' 4 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE PREY. FINAL 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION • 32. Electrical Power Meter-Final -r . 80. FOOD CERTIFICATE ISSUED 33. Final Electric � � ��/ Notes: 34. Final Heating & Air Conditioning' ' ��� - ' 35. Final Gas Pipe-Test ''- - . 36. Hood or Canopy ' ' I - • 37. Final Factory'Fireplace I - 38. Final Plumbing 39. Water Service-Final ' 40. Gas Service-Final - , 41. Solar Domestic-Final - - - 42. Backflow Preventer . . - ' _ _' . 43. Backflow Irrigation : • - 44. Landscape Irrigation System : ' - , . 45. Sound Attenuation . • • 46. Handicap Regulations - - 47. FINAL STRUCTURE & BUILDING . 48. Special.Requirements Completed . 49. Electric Release to Edison - ' ' , - - - '. I - 1 • 50. Gas Release to Southern California Gas Co I • • • , 51. CERTIFICATE OF OCCUPANCY - • - -- - - - No. - bate. - -. i_ . _ - . 1 --adit.._ Applicant to fill 7n all spaces except those within heavy border lines and sign all appropriate declarations. • thy OF COSTA MESA' P MIT wye TRACT NO, ; LOT NO. BLDG,NO, 0785 {-1/314 - J.:+ T' OPieTRU1CTION PERMIT ' E .XCJ rZ0'': • • , ' !S�-E 7-9- -'- • TYPE OF CONSTRUCTION . 141, r I - y ' • p.cant's Mailing Address •— r� NEW U ADD U ALTERATION' U REPAIR .. • Prefect Address. -• Th Irg } � ❑ CONVER51_ON ❑ •DEM OLhSp1 ❑ OTH R - - Owner'sName - ]J Y`rlc •Y�KN ee i) Phone 62.431107 • DESCRIPTION OF WORK 1�t `Oe)* . e- t vH . _ _ - ' - - _ , ..� I • �G]L��/�r��QS-yI - - ZONING REGULATIONS Address Sr TYPE OF PERMIT ❑ GRADING .LJ FOUNDATION STRUCTURAL - A.P.# - , ZONE Arch/Eng, - License No.l _ ❑ TENANT g ELECTRICAL D PLUMBING ❑ MECHANICAL ' - " BUILDING - • .PLNG. REF.# + „ cPTaerx Qf1 CT Address - - - - ❑'OTHER - • TO BUILDING , �/-� PROJECT DESCRIPTION SO, FT. OCCUPANCY - PROPERTY LINE REAR YARD (TO P/L) ', Contrac[or's Name / < 1 'Phone' _ - _�f✓) CONSTRUCTION TYPE VALUATION �Q� LEFT SIDE YARD RIGHT SIDE YARD. Address(mailing) 7 � - + PKG.SPACE'REO. PROVIDED • 1 ZONE GRADING Cy.YDS: 'ACRES • ' • License No. 1r,�. . I�l{yq� II + .. • LICENSED CONTRACTO DECLARATION I I Remarks: I Le R6c34- 1 ,5yr7_ n [/0O 3.; -11�- , STREET WIDTH , ;PARK FEE$ - + I-hereby affirm that I am licensed under provisions of Charter'?(commencing ' ` 4- 7T - I with section 7000) of Division 3 of the Business and Professions Code,and J (' SPECIAL CONDITIONS: my license is in full force antlrefTect. • - NCt✓ CIt C.,'�', '' IK �CtNQSt Jvet,P SeU'l/'�cr>�rG'('� • License Class • r License No, LUMBING - 14 - I + Date Signature 1 . f I Bar Sink - Sewer Cap- ! i ELECTRICAL • WORKERS' COMPENSATION DECLARATION . - - ' • I hereby"affirm that-I have a,certificate of consent to,self.Insure,or a certificate _ . ._-_.� Automatic Washer ' eter El Over 100 amps - `:',Workers' Compensation Insurance, or a certified:copy thereof (Section Backflow Preventer• Sewer Connection -- -- - - � - - -. .. `�:.... • Construction Pole - Sub Panel I i y ea�^'10, Lab. C.) ) Backflow Irrigation Solar Collectors ' :? )icy No. 1 - ' • Company - -- - Cooking Unit Sub Pole ' 9'• - • 8Certified copy is hereby furnished, i • I i Bathtubs i I $Olaf Piping I _ Certified copy is filed with the city"Building Division, - I - Dishwasher .Motors ❑0-1 HP ALX-B I Date ' + Applicant 1 I Clarifiers Solar Tank j I + EXEM pTlO N;F ROM WORKERS'COMPENSATION DECLARATION - - - -Dryers"❑Gas''DElectrie' `-' " - Inc,Solar1D9-15 HP ❑16-15-e ' • , (This section need not be completed it the permit Is for,one hundred($100)or ' Dishwasher Swimming Pool w/Spa , ; + Microwave r Ilecert no that in the performance at the work for aswhichto- this permit is Issued,1 Drinking Fountains Urinal l Fan 1 • l i shall not employ any person in any manner so las to become subject to the - ' - F.A.U. PoleLigh4 Workers' Compensation Laws of California, , i Floor Drains Water Closet' - ' - `WatPY on oss Signature tf i th ambo shall ' NOTICE:If,after making this declaration, you-should-become subject-to the- --- Floor-Sinks __ - -i .- - -Water Heater - Fixtures - c Workers Compensation provisions,of the Labor Code, you,must.deemed revoked , Device Boxes • comply ,with such p + be ,deemed, revoked ' Gas Service ' 'Outlets' Watei.Service Sign ' CONSTRUCTION LENDING AGENCY - , f i - - - - - Outlets , I hereby affirm that there I- this. per tion lending agency for he'per Civ;- nce Interceptors ' 1 �� • Standing Sections , 0-0• of the•:work for which- this. permit is 'issued ..(Section ":3097 Civ- p.)' - - Lentler'S1 Name- - -- - - - , . - Switches _ _ Kitchen Sinkl •' i - 2 Trash Compactor ' Lender's. Address .. r - �) ; • - , - ' Garbage Disposal • O OWNER BUILDER DECLARATION' • - Lavatories, i7t , - t 9 P 1 hereby affirm-that I am exempt 'Irani the Contractor's License Law for the I I p-Tre . . Generator,❑0-5 KW ❑5-15 KW ' following reason-(Section:7031 5 Business and Professional(Code: Any city or _ P, ) - .. I ' • ' • I county whichi requires a permit.to construct,alter improve;demolish-or-repair q - pp p - -r ; RoofDrairis • - ( - Transformer 015-50 KW any lstructure,siprior tom nt that he/she requires thea ltcto te.such permit, I - S trd .to file a factor statement that h6/she is licensed pursuant to the-provisions of ❑5U+KW' the Contractor's License taw(Chapter 9 (commencingwhth Section 7000)of - ' 1 iRein4pection Fee $75 Division;3 of the ;Business.and,Professions-code) ori that he/she',is-exempt Showers ' , Reinspection Fee • $15 - • •d, -from-antl for,the alleged t subjects the applicant.ot.section • "� - ' - i •• Meter ❑u to 100 amps F# 5 by,;any applicant forun re cloths? Sithe'applicant to a civil 1 _-_. _ .. d _..P • - Issue Fee: •$ 3 �,-ty of not more than five hundred dollars($500). t• ;, I : i Service Sink - 1 r Issue Fee I' $' 3 Zoning Approved By • Date ' ' 1;'as;owner oft the;property or my employees with wages as their sole - - - - - I •, 1 I' mpensation wilIdo the work,and-the,structure is not intended or offered _ - - i' . • , MECHANICAL Application Approved BY Date I for sale)(Sec{ion 7044', Business and+Professional Code:•The'Contractor's - ��I71 ' J • ' License Law does not apply to:an owner of aproperty who builds or improves , ` • Refrigeration Systerrl 1 ' 1 J�(�{ / f thereon,i and who does,Such-work.himself/herself or through his or her own .t I Boder, t ` 1 I I .,I Application Issued By /// VVV "`---••' �' Date i employees, provided tht such improvements are;not Intended or offered for i ❑0-100,000 BTU ❑100,000 BTU , sale. If, however,the building or improvement is sold within one year of cdm- Duct-Unde(Ground SUMMARY OF FEES - pletion;the owner will have the purden of proving he/she did not build or im- , / • rove toy the purpose of.sale).- , -• I. - .� Duct-Structural i System Repair/Alteration ,BUILDING PERMIT' $ ��'h00 + i SMIP ,'$ •5�i ' U I,as owner of the property, am exclusively contracting with,licenied con- ' , I ; tractors to construct thelproject.(Section 7044,,Business antl Professlons.Code: i, •,. Duct-_Ventilating _ . - i -_ - - - -J-_ , _ - -'PLAN CHECKI $ - ( , PERMIT ' I'The Contractor's License Law does not apply to an owner of property who i 1 •' I• ISSUANCE ' $ 1 ;builds or Improves thereon,and who contracts for such projects with a con- PLUMBING , 1 ' tractor(s) license pursuant to the Contractor's License Law): I Exhaust System ❑ Multiple �' $I GRADING I $ D l,am exempt under Section '. i ;- B.& P.C.for this reason ; 5 Firepl/Fact.Blt. ICBG# ( • I - PLAN CHECK $'. w, Date ' I fo/�3' owner U 1 t3eoI> Heating System& Ducting •• • �' ELECTRICAL,• $$ ��•� 1 $ . 1.hereby. rtif that.I'have.reed-this application and state-that-the above- -❑0-100,000'BTU 0100,000BT1T- -- • -- -- -- 'PLAN CHECK • • $' 4 • MICROFILM. ' $ information is correct. I agree.to comply with all city,and county ordinances i I ' I • , TOTAL,FEE ' $ r ' , and"state laws relating to buildin •nstruction,and hereby authorize more- I - - , - , ;MECHANICAL $ - , 1 , sentatives of Hood or Reinspection Fee' $15 N I ' LESS y'to u••n the above-mentionetl pro arty for Typal ❑ ADVANCED.PC $ inspection purpoa�j 1 , _ �, '[O 'p Canopy, Type I ❑' - i ` PLAN CHECK •$'� Signature i ' ` � ' • ate / !7 , ' I Drivers' License or S5# > Registers 1. Issue Fee i ' $ 3 , i • .FINAL FEE , .$ ' 30.50 CMF 0865-46 rev,12/82 - White-Building;Canary-.Applicant;Pink-Accounting:Goldenrod-Assessor • - - - - . . - - - - • `'' - - - - - ' {v�TRUCTION AND PLANNING -' - _ ' - _ POOLS A' _ _ , • u Date Inspector Date Inspector ArePROVALS Permit# - APPROVALS • 'Permit.* - 1. Temporary Electrical Service or Pole 52: Pool &Equipment Location ' 2.` Soil Pipe-Undrgrnd. 1„ - 53. -Steel:Reinforcement _ , 3. Electrical Conduit Utility-Undrgrnd. z - 54: Forms - a' • , - - • - '4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding _ - . . 5. Steel Reinforcement . .. ' ' ,. - .56. Rough Plumbing &Pressure,Test - - 6. Ele'c#rical UFER Grnd:' 'dam iPG7-- :57. APPROVAL TO COVER-GUNITE l:/sti 7. Footings - ? 58. Electrical Conduit-Undrarn'd. . 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 . - ' .. -1' - - - - 16' Rough Electric Wiring • i 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 t 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 Friming - - ' ' - 73: Undergrnd.Storage Tank ❑Gas„El Oil 25. Roof Sheathing - .74: Overhead Hydro - 26. T-Bar.Ceiling (Structuragi& Monocoat . : -. -75. Dry Chemical _ , 27. Frame and Flashing .., - 76. Dry Standpipe i 28. Lathing& Siding 77. FIXED SYSTEM FINAL. • 29. Insulation r' 78. FIRE PREY. FINAL - ' 30. Drywall Nailing - , ' - Notes: 31. Plaster-Brown Coat " • 7 v-fy No - CN? ( / 11, -r 4-¢/7-- COit 32. Electrical Power Meter-Final { /MeL "tee a& ' J 33. Final Electric - - de v , -7/e-rai. t5n/liaP :es( /xtva4 7 J C /✓13t 34. Final Heating& Air Conditioning -. N-t.0 rig r c?J. E Oct.. ._, 35. Final Gas Pipe-Test 36. Hood or Canopy - 37. Final Factory Fireplace .. '. • ' 38. Final Plumbing , - 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final - ' 42. Backflow Preventer ,. ' -. I ' � 43. Backflow Irrigation . - _ • ' ' 44. Landscape Irrigation System - - - , - 45. Sound Attenuation - - 46. Handicap Regulations - " : ' 47. FINAL STRUCTURE & BUL{ IIN jD -5. 7.--y-eV ^yj : ' 48. Special Requirements Completed - / .�-r i , - 49. Electric Release to'Edison - - _- - ..- - - - • ' . 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY Nb. Date - - • . . • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 6992 8/31 /82 CITY OF COSTA MESA Pis IT NO. TRACT NO. LOTO. BLDG.NO. - I 19s B I ,TL CONSFEUCTION PERMIT (� Y41, 7 . 7I2 /J , Project AddressZ 7 ' 6. ZU *V 1 TYPE OF CONSTRUCTION- . ' • 'Owner .'C C , a - _ Phone i C' ,NEW ❑ ADD ❑ ALTERATION � - ❑ REPAIR ❑,CONVERSION ODEMOLISH 0 OTHER DESCRIPTION OF WORK • ' . a C Address ZONE I� PLNG. REF. - ' h a L ♦ • Phone TYPE OF PERMIT : • T-1 BU1(WpING 3147; Address- SETBACK C/L ST. PROPERTY LINE r • i - '• •` ❑GRADING ❑ FOUNDATION 0STRUCTURAL SIDE YARD 51/.•),, - . I j �•t LICENSED CONTRACTOR DECLARATION ,❑TENANT 0 ELECTRICAL OPLUMBING.-OMECHANICA I E YARD y �.2L I hereby affirm that I am licensed under provisions ofCharter9 (corn- - „RIGHT L�-�r f/ 11 mencing with. section 7000) of Division _3 of .the .Business and 0 OTHER'S ' - ' l • Professions Code, and my license is in full force and effect. TREAR'YARD(TO PP-) / / Orf • PROJECT DESCRIPTION ' License-Class - '- -- -- License No. - ,• -^-- • -- ._ PKG:SPACE REQ:- PROVIDED -� Date - - Signature--' - Sq_FT. -�7-� _ _ WORKERS'COMPENSATION DECLARATION OCCUPANCY CONSUCTION TYPE -K— TSTREET WIDTH PARK FEE'S I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION 7610• -- , 'ZONING APPROVED BY - /�l� f DATEI♦�) /e? certificate of Workers' Compensation Insurance, or a certified copy —ZONE - 1 JI7 `� `O thereof(Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: • ' Policy No. - Company - - - ' - .- _- - ❑ Certified copy is hereby furnished. REMARKS: Q C�/n��LA ''] Certified copy is filed-with the city Building Division. idG l7 FCJ - - - - - - - 'r • 4EXEMPTION 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 - subje_ct tope Wpppprkers'Co_mpensatio ws of C�1�t ornla,- . . .• - - __ UWt LLING GR RAGE s'/JJ�A•L n�a.� /mow- BATHTUBS - - - SHOWERS - • Date Signature !/ - / • , - - - • s. NOTICE: If after making this declaYation, you should become subject . TOILETS • URINALS - - - GENERATOR '0-1 KW_1-10 KW to the Workers' Compensation provisions of the Labor Code,you must - - ` TRANSFORMER ' forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS - • APPLIANCE 10-50 KW 50+KW - • revoked. •CONSTRUCTION LENDING AGENCY - - . ' " - -KIT.SINKS- ---- ----DISHWASHERS -MOTORS - - - -0-1 HP- 1.10 HP - - I hereby affirm that there Is a Construction lending agency for the per- SERVICE SINKSSUMP& - _�• _(INC.SOLAR)_ 10.50,HP 50 +.HP formance-of the work for which this permittis Issued (Section 3097 . • - -- -- - - - - FLOOR SINKS - ' -- 'FLOO RAINS- -- -FIXTURES y OUTLETS 7 SWITCHES Z - - 7 Lender's Name - - _ '" - - • - -DRINKING FOUNTAINS GAS�TUBE-SIGNS S Lenders Addiess - _ �•- '--- _ -- - - - - -OWNERBUILDER DECLAATION I hereby affirm that I am exempt from the Contractors License Law for INTERCEPTORS .•,•RIFIERS - POE'LIGHTS -- thefollowing.reason (Section-7031.5 Business and Professions-Code: SWIMMING POO. • TRAP Any city or county which requires a permit to construct, alter, POLES ' METERED - SUB improve,demolish or-repair any structure, prior to its-issuance,alsore- -WATER SERVIC ! • ALTERATION - PANELS - MAIN - SUBquires the ap,licant for such permit to file a signed statement that he islicensed pursuant,to the-provisions of the Contractors.License-law GAS SERVICE ' - `OUTLETS - - -- -SERVICE-- • • AMP - (Chapter 9 (commencing with Section 7000)--of Division 3 of, the - usiness antl Professions Cotle) or that he i5 exempt therefrom and the yyqT,ER HEATERS BTU OUTPUTbasis for-the alleged.exemption...Any`vioation of.Section 7031.5 by..any applicant for a`permit subjects the applicant'to'a_civil.penalty •SEWERCONNECTIONS =4`. - - .I . ._ - ' not more than five hundred dollars.($500):I,-as owner of-the -' -` ..Aproperty: or rny-emfiloyees wi[h`wagei gas lheirr' SOLAR TANK ` =�- COLLECTORS- -e compensation, will do the work,antl the structure is not intendetl oroffered forsale. (Section-7044, Business and-Professions Code:The' ' SOLAR PIPING SYS. -- ' -- -- - ISSUE FEE - - - whotuiLicense Law dreo not apply to as owher r a property or ' � /2 who builds or-improves-thereon,employees, provided and who does-such work himself or ISSUE FEE - - -- APPLICATION APPROVED B 1 .//J • �`�i/ through his own employees, provi ed that such improvements are not intended or offered forsale. If, however,-the"building or-improvement MECHANICAL -- PLAN CHECK . 'SUMMARY OF FEES is sold within one year of completion, the owner will have the burden of proving he did-not-build-or improve for-the-purpose-of sale). -HEATING SYSTEM 0-100,000 BTU • • ♦ 6 ❑ I, as owner of the property,.am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000,+ BTU and_Professions Code: The contractor's License Law.does not apply to - - an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU tracts from such-projects with a contractor(s) licesned pursuant to SYSTEM. - - the Contractor's License Law). rro�7� 100,000+BTU_ O I am exempt under Section ! _�`/ -B.-&-P.C.for this BOILERS BTU reason. y C.LJ N Y` clYk _ _ Date tl��1yr SYSTEM REPAIR,AL : - ION Owner ®. I hereby certify that I have read t s applicatio and state That the above EXHAUST$YS¢ i , MULTIPLE information is correct:-I agree•to comply-with all nd county ordinances and state laws relating to construction,and hereby authorize representatives of this city tO-enter upon-the above menthe ed• - . - -.. property for iR{pectio urposes. 11 7)87 Signature-- - or - - - . - — 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 Pipe-Undrgrn .. . - 44. Steel Reinforcement - • • , 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. -Electrical Conduit-Undrgrn 46. Electrical Bonding - - 5. Steel Reinforce_ . . _ . 47. Rough Plumbing & Pressure Test • . 6. _Electrical UFER Grn • . .. - 48. APPROVAL TO COVER-GUNITE " ' . • • ` . 7. Footings _. _ -. . 'o-5caa--- „$ 49. Electrical Conduit-Undrgrn ' 8. Foundation - - - - - ' . _. (o- T . 44 9t-7 50. Gas Pipe, D Undrgrn,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" . 13.13. Rough Plumbing .. _ .. - __ - 55. - Plumbing System-Final - 14. Rough Electric-Conduit - • - 56. Electrical-Final - _ - 15. Rough Electric-Wiring • - 57. Solar System-Final 16. Rough Heating & Aif-Conditioning - - - - 58. Fencing & Access-Approval „ • • . 17. Ducts, in Structure - . 59• APPROVED FOR PLASTERING . i . 18. Ducts; Ventilating - •- - - - - - - - - • -- . - _ - 19. Gas Pipe-Rough &Test- 60. POOL/SPA SYSTEMS FINAL . • - • 20. - Roof Framing - - - - - - • 21. Roof Sheathing . - . 1-Ao-33 •' 871.1 - 22: FlashingNOTES: Frame and c ,,Li • "1, az, . /o• 4'-.4:1 � •-+^ �/ s�-cl-rte,/ .q . 23. Insulation vo - - - - et_ • - L Gf/ `- ,�'- 24. Lathing & Siding 1 rwx&un Co�) - . ;-1 o-43 -.t 'Y'l - 14: yS rnn. --r�'Gr9-- 0).2 - ^G � rAQ a"' eeenir .r+• -8 `)+-1 25. Drywall Nailing - 1 __�' - ' • /-.2c)_8'9 -��•,,c,.„,u,,, Gyw.e,Zi„ /Lu .-t.C_ - .. 26. Plaster Brown Coat 3-IO-83 Z1 ?2'I _atrc -n reLna ,4 /(�ae� e��n ' d w.j 27. Electrical Power Meter-Final _A...a.4...2 t / � Q/ 28. Final Electric �3lJi��l/ AC o,� ,(�, 4-,....:-.1.--v--_ i/ • 29. Final Heating & Air Conditioning • - - - /?G /7-AO'5 -r-irrttf ou 6xs�lc-P, %i 64-TD tido,'t- 30. Final Gas Pipe-Test - - . -a9 uE[9l- (9151-y"70 bit v &Ate Fiin '�ilsa Y. _ 31. .Final Plumbing - ( / . 32. Water Service-Final • - - • - - - - -- - - - - • • ' 31 Gas Service-Final - - - • - 34. Solar Domestic-Final . I _ . - ' 35. Landscape Sprinkling System • - 36. Sound Attenuation - . -. - ' • 37. Handicap-Regulations - - 38. FINAL STRUCTURE & BUILDING - • - 39. Special Requirements Completed 40. 'Electric Release to Edison _ _ , 41. Gas Release to Southern California Gas Co. ' • • 42. CERTIFICATE OF OCCUPANCY - - - No ' Date - • - ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA Air_ CONSTRUCTIO�N rFRM,.T/s/,z) p I � - T PERMIT LTRACT NO. LOT NO. UNIT NO. 8886 9/26/84 8.00 IL �� LV Project Address 3 E/ L, jTi/ J [J REPAIR Applicant's Main. Address _ - ,�,,.� TYPE OF CONSTRUCTION ❑ NEW U ADD LI ALTERATION `� ^�D07 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name •_< �� _��� . Phone -4 DESCRIPTION OF WORK/USE OF BLDG. Address 2 ? E! O dr.,. - .y 7-rt O_,...z ' E Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING ❑ FOUNDATION ❑ STRUCTURALT Z Front 0 Address 0 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL BRear N P ❑ OTHER A I Contractor's Namp Cei/1NC`N\C-ZY- I bc^ Phone C Right N U PROJECT DESCRIPTION SQ.FT. OCCUPANCY K G Address(mailing/ City License No. /lPT•-7604-co ��,,ss���11 ��O CONSTRUCTION TYPE VALUATION $ S Left ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. R¢f.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: I�' r7Q� Planning Notes: M Q with section 7000) of Division 3 of the Business and Professions Code,and �7 -- ! rl-. my license is in full forceed eff,ct. T CC) License Class �— a 'eens• Noe,' J. , F.) Date i Signature �, s-� - ���. PLUMBING FEES 1 "ft' WORKERS'COMPENSATION DECLARATION i I hereby affirm that I have a certificate of consent' o self-Insure or a certificate Bar Sink Showers ELECTRICAL FEES 'of Workers' Compensation Insurance, or a certified cop ther f (Section Y Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW �.• 3800, Lab. C.) T 0 1550+ K Policy No. y�?c 9 Company T' Backflow Irrigation Sewer Cap Construction Pole Sub. W 8 Certified copy is hereby furnished. — - Certified copy is Wed with the city Bui/Qing Divlsio Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 9'L-7 z Applicant ll++as'M��_-G`- /27.---e‘} EXEMPTION FROM WORKERS'COMPENSATION DEj1 ARATION- Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit Is for one hundred ($100)or less). Dishwasher Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I - shall not employ any person in any manner so'as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP ❑16-15+ NOTICE:If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply .with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performancePole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors • Lender's Name - Water Heater 2�' Outlets Range s Kitchen Sink Water Se Switches OWNER y BUILDER DECLARATION - Sign I n affirm reaso t(Sl I am exempt1.5from the Contractor's License Law for the Lavatories following reason (Section 7031.5 Business and Professional Code: Any city or � Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair 1 P-Tra V any structure, prior to its Issuance, also requires the applicant for such permit p //v Z OC Generator ❑0.5 KW❑5.15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains - the Contractor's License Law (Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt Aherefrom and the basis for the alleged exemption. Any violation of Section 031 5 by any applicant for a permit subjects the applicant to a civil - >enalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee 1 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 l 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 ❑ sale. It, however, the building or improvement is sold within one year of corn- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground •Approved ey Date rove for the purpose of sale). �. /-1 2,-� I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By s rklgJ 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 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ID Multiple El System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o// 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.Bit. ICBG# PLUMBING $ -1. CO ISSUANCE $ Date Owner - Heating System& Ducting PLAN CHECK 25% $ I • 00 ' ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws rel. •g to building constr t'.•n and ereby authorize repre- sentatives of th'. ci y to eater upo • above entioned property for ('] inspection pure. es / MECHANICAL $ _ TOTAL FEE $ D Signature _sae �/ Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS Bt - CMF 0865-46,rev.4/84 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor CONSTRUCTION AND PLANNING POOL 6PA 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,-❑ Undrgrnd., Test ,9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O 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 115. Rough Electrical-Conduit - 66. Solar System-Final -16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - • • 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas El Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80.• FOOD CERTIFICATE ISSUED 33. Final Electric Notes:/0/,/ow liar p., ote LF.� 34. Final Heating & Air Conditioning 'S 35. Final Gas Pipe-Test - • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing #/20y c.o 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation _ 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date i — •`.'' •• / - - . Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. B405 9/19/B4 7.0- II A. �e PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY of dr sTA MESA CONS RUCTION PE MIT 7 Project Address / _25 i r U - I s ci 1 Applicant's Marlin• Address TYPE OF CONSTRUCTION U NEW Li ADD U ALTERATION U REPAIR S• 0 CONVERSION 0 DEMOLISH ❑ OTHER A.P.# - Zone • Owner's Name A a _...i_. 7 'h• t� u��Cb DESCRIPTION OF WORK/USE OF BLDG. "Address , 75 E • - - S Main Building: Accessory Building: *Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front ZO Address ✓_ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Nam' NG'/ L3•.,•ne ❑-OTHER A - j _ PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) 75 J /_s ' - 1/� - K G /f LL ! CONSTRUCTION TYPE OCCUPANCY VALUATION $ A Left R City License No. K�— • 7 k ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E r� I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - Planning Notes: - • Q with section 7000) of Division 3 of the Business and Professions Code, and M 1 my license is in full f• ce a••'e ect. .51 T ' - License ass a License o. ✓ r S. Date ---` �y�°�nature air - --�� — PLUMBING I FEES eneWORKERS'COMPE•SATION DECLARATION - t - I hereby affirm that I have a certificate of consent to self-Insure or a certificate Bar Sink Showers ELECTRICAL FEES ' of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink _- 3800, Lab. C 1 I p Automatic Washer Transformer 0 15-50 KW Policy No. 1-1.481 19 Company I kemoni- Backflow Irrigation Sewer Cap0 50+KW Construction Pole Sub. Certified copy is hereby furnished- n OW fieri ppylis filed with the city Bu0tlin9 vii . e (6 Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date-111'0{t]`1 Applicant :k'i Q}� 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 1 certify that In the performance of the work for which this permit is issued, I - - _ I shall not employ any person in any manner so as to become subject to the Drinking Fountains ' Solar Tank Fan Workers' Compensation Laws of California. Motors 00-1 HP ❑1'/z-8 Date _ Signature Floor Drains Swimming Pool w/Spa • F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE:if,atter making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks _ Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. - - - - - - Microwave _ _ CONSTRUCTION LENDING AGENCY I Gas Service _Outlets Water Closet 'j. `(� Device Boxes Pole Light ' I hereby affirm that there is a construction lending agency for the performance 9 of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Range Lender's Address - Kitchen Sink - 1 Water Service Switches' Sign OWNER BUILDER DECLARATION - + I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories following reason (Section 7031.5 Business and Professional Code: Any city or ��/ Z t Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Tra Generator ❑0-5 KW❑5-15 KW Trash Compactor any structure, prior to Its issuance, also requires the applicant for such permit p - - - 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 -•1 . Division 3 of the Business and Professions Code) or that he/she is exempt therefrom and the basis for the alleged exemption. Any violation of Section (- 1 7031.5 by any applicant for a permit subjects the'applicant to a civil enalty of not more than five hundred dollars($500). _ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 ,. compensation, will do the work, and the structure is not intended or offered • - - - - - - - Reinspection Fee I $16 Issue Fee $ 3 for sale (Section 7044, Business and Professional Cotler 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 sale. If, however, the building or improvement Is sold within one year of com- - Canopy Type II ❑ Zoning Approved By ' Date pletlon, the owner will have the burden of proving he/she did not build or Im- • Duct-Under Ground Building Approved By Date LJrove for the purpose of sale). (�� I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By y9C14-47Y Date G I ICI tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who • Duct-Ventilating 00-100,000 BTU 0100,000 BTU t, SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- ' tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple❑ System Repair/Alteration •i- ,'BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ • PERMIT 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.BIt. ICBG# - PLUMBING $ 1 •00 ISSUANCE $ Date Owner - - Heating System& DuctingENERGY P.C. $ _ r PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above - 00-100,000 BTU 0100,000 BTL— information TL information is correct. I agree to comply with all city and county ordinances r. rELECTR ICAL $ - GRADING $ and state laws rel.;fig to building c•- tpction,and hereby authorize repre- MICROFILM $ sentatives of th' ty to e ter u•on the abo •-mentioned property for PLAN CHECK 50% $ inspection pure• s. ',F1 �-_`[� r}/ MECHANICAL ' $ •� Signature _ ..u�a...� _ - Date / -07- TOTAL FEE $ Drivers' License or 55 CMF 0865-46,rev.4/84 white-Building;Canary-Applicant:Pink-Accounting;Goldenrod-Assessor 4111 • •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 • • 'I . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. ,Electrical Conduit-Undrgrnd. 55'. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • , 6. Electrical UFER Grnd. • 57. APPROVAL TO COVER-GUNITE • 7. Footings 58. Electrical-Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. • 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final ' 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof brains 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 r , 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 Flashing76. Dry Standpipe.. • 28. Lathing& Siding 77. FIXED SYSTEM FINAL ' 29. Insulation ' 78. FIRE PREV. FINAL 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' 79. FINAL INSPECTION , i . 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 9_,..1,0 .20 -s r' ll,.0 & 7 -C �- g_4(0 r AA y.r. 34. Final Heating & Air Conditioning o✓/ 4 i-Dentilt -/ ,4 u �g7a 35. Final Gas Pipe-Test . 1"/Y84' 4Y "e -- n- ha+.ti:4�F��D/a/Lr2r- 36. Hood or CanopyHa: Ko mote. taan �/�cY 37. Final Factory Fireplace • 38. Final Plumbing WS/1V 39. Water Service-Final . . - 40. Gas Service-Final 41. Solar Domestic-Final 4 42. Backflow Preventer • 43. Backflow Irrigation 44. .Landscape Irrigation System ' 45. Sound Attenuation 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING • , 48. Special Requirements Completed ' 49. Electric•Release to Edison . ' - , • • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date