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Home My WebLink About789 20TH ST - Building PermitsApplica�t to,fil� all spaces except tnose within heavy boraer lines antl siqn all aDP�aGriate aeclarations. F Applicant's Mailin Address '�'r L+ � �/l //`If �� . Owner's Name �%a�� ' �L� �� i%f�Ph neJC�—�rG Address k�/l` AVOGAi>a [J(!�l'' C.OROwJ19• (%,+'/(e� Arch/Eng. — S/ ��%�� License No. �� 3 O Address - ��'=� � Contractor's Name—� %`I��'�'/�'� Phone Address, ( mai ling) p � City License No. �7 ( ' ' LICENSED CONTRACTOR DECLARATION � I M1eYeby afFlrm that �I am licensetl untler provisions of Charter 9(commencing witli section ]000) of oivision 3 of the eusiness antl Professions Cotle, antl my license is in tull t ce antl efiect. License Class� ""' Lic se f�o. � 3 Date� � � Signature � WORKERS'COMPENSATION DECLARAT N ' � I hereby atfirm that I have a certiticate ot conseni to self-insure or a certificate of Wo�ke�s' Compensation.ln5u�ance; or a certifietl Copy.thereot (Section � 380Q Lab. CJ - ' . , . - Policy No. � ' ' Company - �Ce�tiiietl copy is hereby furnishetl. , //�) � �Certifietl copy is filetl with the city Builtling�pi.dision ' �ate Applicant . EXEMPTION FROM WORKERS',COMPENSATION DECLARATION (This section neetl not be completetl it the permit is for one huntlretl ($300) or less). I certify that�in the performance of the work for which this perm�t is issued, I shall not employ any person in any manner so'as to become subject to the Workers' Compensation LawS of California. . Date ' Signature ' �NOTICE: It, atte� making this tlecla�ation, you sM1oultl become subject to the Workers: Compensation provisions ot the Labor Cotle, you must forthwith comply with such _provisions or this permit shall be tleemetl revoked. CONSTRUCT,ION'LENDING.AGENCV ' " I hereby affirm that there is a construction lentling agency for the pertormance oi ihe work for which this permit is issuetl ($ection 309] Civ. C.) Lentler's Name � � Lentler's Aatlress - � OWNER BUIL�ER OECLARATION � I hereby aifirm that I am exempt from the Contractor's License Law for the followinq reason (Section� �031.5 Business antl Professional Cotle: Any city or county which �equires a permit [o construct, altev,.improve, tlemolish or repai� any struc[ure, prior to its issuance, also require5 the applicant for such permit to file a signetl statement that he/she is licensetl pursuant to the p�ovi5ions of the Contractor's License Law (Chapter 9(commencing with Section 7000) oi Division 3 0/ the� Bu5ine55 antl Pro(essions Cotle) o� that he/she is exempt theref�om antl the ba5i5 for the allegetl exemption. Any violation of Section ]031.5 ,by any applicant for a permit subjects the applicant to a civil '� enalty of not more than Lve huntlred tlollars (g500). ' I, as awner oi the property or my employees with wa9es as their sole compensation, will tlo the work, and the structure-is noi intendetl or offeretl for sale (Section �]044, Business antl Professional Cotle: The Contractor's License law tloes not appty to an owner ot a property who builtls or improves the�eon, antl�who tloes such wo�k himself/herself o� through his or her own employees, provitletl that such improvements are not intentletl or otteretl for sale. It, however, the builaing or improvement is soltl within one year of com- pletion, the owner will have�[he burtlen of proving he/5M1e tlitl not builtl or im- prove for the purpose of sale). ❑ I, as owner of the property, am exclusivety conlracting with licensetl mn- tractors to construct tM1e project ($ection ]044, Business antl Professions COCe: � The Contractor's license law tloes not apply to an owner ot property who buiitls or imp�oves thereon, antl who cont�acts for such projects with a don- tractor(s} license pursuant-to the Contractor's License Law). I am aware that � pvoof of their Worker's Compensation insurance shoultl be provitletl to me. ❑ 1 am exempt untler Section B. & P. C. for thi5 reason Date Owner "I hereby certify tnat I have �eatl intormation is co��ect. I agree to < antl state laws relating to builtlina sentatives of this city to er�te� inspettion p r ses. p Signature � �C�'1"' i1 Drivers' License or 5 $ �� fhe ❑on"antl state that the above all citv antl rounN ortlinances !�� O � Z .— � OFCONSTRUCTION NEw Aoo CONVERSION ❑ DEMOLISH ❑ OTHER SCRIPTIOPLOF�WQRK/USE OF BLDG. _LZ� TVPE OF PERMIT � LJ GRADING ❑ TENANT ❑ ELECTRICAL O OTHER PROJECT DESCRIPTION 5c�. FT, CONSTRUCTIONTVPE � ZONE GR Remarks: Bar Sink Backflow Preventer Backflow Irriqation Clarifiers Dishwasher Drinking Fountains � Floor Drains . Floor Sinks Gas Service ' Outlets Interceptors KitcFien Sink Lavarories P—Trap Root Drains � ALTERATION lJ REPAIR JFOUNDATION LJ STRUCTURAL PLUMBING ❑ MECHANICAL � —>-J � OCCUPANCV • VALUATION$_ ADING CU. VDS. ACRES— � a ��7 �'— o i� Reinspectian Fee $15 Boiler Duct- UntlerGround Duct - Structural Duct- Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ a� oo,000 aTu � i oo,000 sT Reinspection Fee � $15 CMF 0865-46, rev. 30/84 White - Builtling; Canary - qpplicant; Pink - Accounting; Goltlenrotl - Asse55or EES SIIOWEfS Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Water Closet ' ' Water Heater � Water Service A uto-W ash Issue Fee I $ 3 Hoodor Typel ❑ CanopY � Type I I ❑ Refrigeration System ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 A.P. # S Main Building: E T Front A Rear C Right S Left Ping. Ref. # Planning Notes: 2001 4/29/85 Accessory ELECTRICAL � Automatic Washer Transformer Construction Pole Su6. Cooking Unit . Dishwasher . . Dryers ❑Gas'� ❑Electric Fan F.A.U. Fixtures V Device Boxes Outlets Switches Garbage Disposal Generator DO-5 KW �5-15 KW 5oE0 TL Zane FEES 15-50 KW 50+KW Meter LJup Lo 100 amp5 . Meter ❑over100amps - Sub Panel Motors DO-1 HP �1'/:-8 ' Inc.Solar 09-75 HP �16-15+ Microwave - � ' Pole Light � Range Sign � ', Standing Sections Trash Compactor I Rainspection Fee !$15 � I Issue Fee DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Approved By Application Issued 6y �� $ s Z O N 1 N G R E Q M T S SUMMARV OF FEES � BUILDING PERMIT $ SMIP � . $ PLAN CHECK $ PERMIT PLUMBING $ S•C�Ci �SSUANCE $ PLAN CHECK 25% $ � SO ENERGV P.C. $ ELECTRICAL $ GRADING $ P�ANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTAL FEE $ S' �� PLAN CHECK 25% $ NSTRUCTION AND PLANNING • . POOL & SPA ' p/x(�S� Date �� Inspector Date Inspecmr PROVALS Permit �# APPROVALS Permit # ._7:�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 Reinfor�ement �` - 56. Rough Plumbing & Pre'ssure Test ' � ' ' 6.�;Electrical UFER'Gmd:� . ' _ 57. APPROVALTOCOVER-GUNITE . ' .,r . 7. Footings. " � 58. Electrical Conduit-Undrgmd. � 8. Foundation ' � 59. Gas Pipe, � Undrgmd., Test � • 9..Water�Pipe-Undrgmd. ' � 60. Backwash Lines, P-Trap, 0 Undrgrnd. tOL Str.uctural Floor System ' 61. APPROVAL TO DECK � �- 11. Property Sewer Line & House Connection �62. Backwash & Receptor-Final 12.�Sewe,rCap � 63. Heater & Vent-Final .� , . 13�. Roof'Dcains � 64. Plumbing SYstem - Final - - � �14. Rough Plumbing ' 65. Electrical-Final . 15. Rbugh Electrical-Conduit 66. Solar System-Final I, 16. Rough Electric Wiring 67. Fencing & Access Approval r 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Eaectrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts,in Structure 70. Underground HYdro _ 22 �Ducts, Ventilating . � . , 71. Product Piping O Gas ❑ Oil 23:'Gas Pipe-Rough & Test . 72- Underground Flush . 24! Roof Freming •� 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing , 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical , � 27.,Frame and Flashing . 76. Dry Standpipe 28.1 Lathing & Sidiny 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 , S0. FOOD CERTIFICATE ISSUED 33. Final�Electric Notes: 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test � 36. Hood or Canopy � 37. Final Faaory Fireplace � . 38. final Plumbing �/�� 2 . - - 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. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed ' _ ' 49. Electric Release to Edison ' �- - �--� �50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY � , , - ' � � No. ' Date ' � ' - ADDRESS OF BNLaNQ %$ 9 (� Z Q T x � T ankxsNu��ca+oo«: WARLAUMONT, LARRY TR aooxess: 219 E BAYFRONT BP.LBOA 15LAND,CA 92662 • �nv�. �uiu+c �noxess: u�cxrtEcr ox �+�aw�+: YKX.OH ENG.'S ADDRE55: uc. xo.: UNT: uxT: caim�cTarsxurt NEWPORT COAST ROOFIPIG (714)598-6337 CpRN1CTWISMAlIlNO 817 W 17TH ST �noxess COSTA ME5A CA uc.no: 653201 92627 uxr: 18 110ENSED COHfRACTONS OECLAP�TION: I horeM +R� uMx penely d pa�ury IMt I un Icar roE under pa�iume d Cheqer 9 (mmmend�p xilh Sec�ion ]000) d Orviaion 3 at �he Businesa eM Pmtmtima Coda, vM my lioenee b in lull bres eM e11ea. cmuc.No.:059165 uc.cuss: C39 �N 6532Q1 £}{P: 05;95 �Dete: L � S ConVeaa: �/L.., '� 0 IEH BUILOER DECIAPATION: I Mnby elfirm wde� Vene�Y d perN�Y �� e��q ��m IM Coniratlae� olbwip reewn (Setlion 1031.5 Bueinee� eM Pro�esaione Code: Rny eiy w eaunly xfiieh raQuiree e peem� b edreVud, ellm, improve, • demd'uh. a repei any aVucturo, pin l01s bwerFe. ebo rcVui�ev iM epplirent Iw euch paimtl lo fik e ayied Neiemeru thei he a eM ia lieemed W��1 to IM pra+uiom d tM Conifedare Lieenu lew ICheqar 9(mmmeexriq wnh Seaon )000) d Oimion � d tlr Business aM Profesaionn Coda� or Ihel M w eha u�emq �herelrom enJ �M bavn la IM elbpeE exemqian. My violetion ot Setlion ]031.5 by eny epWirenl for e permn eubpea the epDliceni lo e tivil penelry of rw more then Ine hurdred ddlen �SSWn. ❑ �.moxn..ainewwenvmmr�dw�•.tinwepe?av�ne:edemmvenae�io�.w�eoinev.ork.eMtl»evucNmum�inimaed w Mered br mle (Secwn )066. Businea er�A P�aseane Cotle: The ConlreUors liceroe lewdoes �at eppy�o en ownerM propam� who W iEa a inpmrm tharean. end xfio does auch work NmaeM a hene� ar Mrouph he a her awn emply�eae. pwiEeE �het euch imprtwemeNa ve rw imxded a oHerad lor ae�e. tl, lawo-rer, the Wiki�q a inpmanem u vatl xnhin ar ym d mnpl&ion, the ow�rerbuiMer will have �he WNen d pro+in0 he or ahe d'd nd WiIJ w �mprove Iw iM WT�e ot aeb). ❑ I. ss awror d �M papaity. em extlusively ctlM�tiq w�lh IiomseE <ontrecion to mrauW iM proptl (�a^ )�. �iron eM Prdeaime Coda: The Cantradon Licenae Lew tloes rw� eppry to en owmr d papMy who Wike a impoves �Ir�ean aM who conlrecle f« euch proi�a wnh e mnued«(f) �kensaA W�uent m tha Comrmwe Li'eme law�. � I am examq uMer Sed'wn: B. 8 P.C., la thu �enwn: Dale: Owner: i ao nerenv �nM mm i em e.,,a d.�e ��aan�e ine rea��e�n d cen�u w.nn,m smnr c� s«a�m. nsos, zss.v..�e zssx, ena me� � or eny nnura nu�nama ow�oN� w�� wa� na Ici�cle rn,el need �o comvy wnn effia mme coam ena �rre �eaW�mnen�s ia ��. eoermtl�o.m,ewno�wmodifirallontraminano-'d ��amosmeniD'a�na.aeudeiuielmimiueunappiratianereeumqtmmaese a��a. Ioma: Aod�� WOHKEN'S COMPENS�TON OECIAPATION: 1 �erobY effi�m u�der pareXy d perjury aw d tlro Idloxirp Eedudiona: � I heve uM MI meinlan e cMifWe d mmm�� a vatlimun b xaken' compeiuetbn, ss pwkeE lor by Sedion 3]00 d ihe labor �g c�. i« ina rodo��e d ub ..o� r« w�n mh v�u n�we. I \ na�e �a �;e �m� won�� o�re�me� ma�„��,, m�,a��,<e br see�a, aiao m me �e« coe., i« ma oano,�,� d m. work lor xfiieh tM1ie pennn ie isaued. My worken' mmpanmtion imureera fimer ud pdi.y numbw are: c�.: STATE FUND EXPIRES Polry Number: � __�) _— Y 10 / 01 / 9 5 .(11ris seeion rroed nd de romFbteJ I lheV�] a hr are huMred ddbra /S�WI w Iesa.1 ❑ I eenity Ihel in Ihe peAoimviea d ihe woM �a� wM1�h t�ie paimil ie iwued, 1 slWl ewt empby eny panon in vry menner eo m to becuna wMa to tM wxkers' comW��ion lewa d CeIA«nie. Wree Ihel il I eM1ouN be�ortie wM� to iM xorknn' pansmiom m� vn of Seaion 3)00 d Ihe lebw Catle. 1 shell hwnh oomp�y� Ihwe poye n w / !l�/_ Appcenc /.;._ /7'�.41 Y� mlrp: Fsllun ro��curo woilrx�'rompwwAe� roverap l� unHwN( �nd �MO iub/sct m�mp/oy�r fo crinYml p�n�ltlls �nd civll H�p� y� ro ans hunarstl fhouurM oo/Mn (S10({000), In W�11tlon ro tl�� cwt ol co�vxueHan, tlunp� u povltletl ror In Sxtlan 9106 0l fM Lebor Cod, inrons4 arM e�msy i/su. CONSTqUCiION LENDINO AGENCY: I heraby elf�m unEer panely d perNN �� here ia e mnstruaion bMinB epenry la tM oename� d�ne wnc ror .nim �ne wma �. am� Isaa� aae�. c:.. c1. . LENDEfl'S NRME: LENDER'S AODRE55: I cerliry �hm 1 heve reaE Ihis eppicelbn eM a�da the� �he ebore inimre�ian e wned. I epree lo oompy xilh ell ury enE o�umy ardinenroa end etele lexs relmin0 �a �ildinp conmruaan eiM �ereby eNhor¢e repevenletivea d ihia fny lo enier upon ihe ebwe�manibnatl D�VeM Iwinspaeion purposes. � � oa,a z C S (5151<6.WP) Whna-Buildiq 8 Selary: Greert-Fle; Cenery-ADV�� Fnk-Fbvenue: GolEanro�Aaxnn CITY OF COSTA MESA - BUILDIA]G PERMI'P �rnrir, iv : n iv i 1 i�� PERMIT NO: H 071157 PLAN CHECH; NO: N I v-�-. :---�r ;�� CONSTROCTION TYPE; V-N PEP,MIT TYPE: STR PURFOSE: OTH JOB DESCRIPTION : T/O SHEATH & REROOF W/BUR SQ FT: S,OQO CLAIM VALUE: 5,000.00 CALC-�'ALUE: 5,000.00 GROUP OCC: .�''�a•3�— /::ar COMMENTS: . KE DET 'c.T ., , , D �� *-«�u�t**�r�t+t+F��t*��r**�r-��r*+��r+r**�tir+r��*****�u�***r**�r�t�r+�**+rr�c�u?��-**acu*-u*�c�at�c,«�R«�*+��**�-+�x Z O N I N G R E Q U I R E M E N T S S E T H A C K S' ------ ---- MAID7 BUILDING ---------- --------- ACCESSORY bUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN F.EAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ:• PROV: PARCEL; 92227201 ZNE: REF PJO: FLANP]ING AJOTES> i jf �E iE af )f-1E !E if�If if if if i(� )fif if �fit�)f df 1E jf jf if iE lE�F it i(-�1f iFif af af if?f if if i(�jf ff # iE i' if-if it if 1f iF if-N�if IF 1�'M�1E if K�lf if if !f if�1FM iF if�k�1f�14 if if iF If�)F iE iEiF V E L O P P1 E N T S E R V I C E S R E Q U I R E M E N T S � •' ' . 'R'F ' `-'� DATE; HUIL c BY ; � DATE: APF'LICATION ISSUED bY; �� DATE; __�%7[��[�-/ 1� *�csiEitififiEiaifiaifie#iaiEiaiFif+f�ltif+tiF7FTF3i�r+�Fi7'�rT�i'citbZ atiti�-i�Ti�iaii�r� Fi �ir��r�«'�ic-w�+EiFrar-itruxif� c +e�Jac iFafiFjk�fjEifif�FiFiE?fiEiEiFifitjfifKiE�f�fafifififjfjfjfif�flfaf�Fjf�FaEifif*�4if{4MiEifjfififififKiFif�RaFifififaFiFaE*�N-iFififif .ifiFif afi(�?f%if LEGALIZATIO*7;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y bLDG �D1T PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GP.ADING PERMIT 72,Q0 ,50 SMIP/NON-P,ES P LAP] ' ISSUE FEE HUZLDING-DIV-> PERMIT ISSUE PLAN-CI-IECK TOTALS----> 72,50 0,00 0.00 REC7ENUE DIC'ISION TOTALS--> COLLECTED; BLDG PMT PLUMBING ELECTRIC MECHANIC 72.00 TOTAL PAID DUE 72.50 72.50 .00 72.50 OVERISHORT; ,00 FIRE SMIP/TOT GRADING PLAP7-CHECY: .50 ih 1E #iF if # iE 1E# 1f # if iE # if if if M 1f'lE if K# if�lE iE if if iE M if Y iE�f�IF if-iE ff if iF if iE ±E'k fE YFif if iE 1f4M �Fif 1E +f i! iE if # Y if��f a�M # 1Fi4 iEiE af fE if YiEif+E +f iE I DJ D I CT I D U A L F E E B R E A K D O id P7 TYPE SFR QTY SODO D E S C R I P T I O N REROOF BY VALUE RESIDErdTIAL NOZONE END OF FEES � � �� Ir,l� � �I � r UT]IT COST TOTAL COST 1.00 5,000.00 oi cai��4-003��77s ra�T �?.su Dp7c': F1�/16f9:� 7Th1E: f19;5Q CONSTRUCTIQN ANO PLANNING J' P¢Ol � SPA , � APP��20VALS Permit # � Date Inspector APPROVALS Permit # Date Inspector i �"i. Temporary Electriral Service or Pole 52. Poot & Equipment Location i � � 2. Soii Pipe-Undrgrnd. . 53. Steel Reinforcement � � 3. Electricai Conduit Utility�Und�grnd. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Piumbing & Pressure Test 6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. ' .r 8. Foundation 59. Gas Pipe, O Undrgmd., Test • i �� 9. Water Pipe-Undrgrnd. , 60. Backwath Lines, P-Trap, O Undrgmd. , 10. Scructural Floor System 61. APPROVAL TO DECK i i. Property Sewer Line & House Connection 62. Backwazh & Receptor•Final 12. Sewer Cap 63. Heater & Vent-Fina! ' 13. Root Drains 64. PlumUing SYstem - Fina! � � 14. Rough Plumbing 65. Electrical-Finai - 15. Rough Electrtcal�Conduit _ 66. Solar SYstem-Finai • i 6. Rough Electric 4Viring 67. Fencing & Access Approval � 77. Rough Wiring Sign 68. APPftOVED FOR P�ASTERING i 18. Rough Electricai�T 8ar Cailing ' 69. POOUSPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace „ APPROVALS Permit # � 21. Dutts, in Structure � 70. Underground Hydro 22. Ducts, Ventilatin9 , 7/. Product Piping O Gas ❑ Oii 23. Gas Pipe-Rough & Test � 72, Underground Flush � j 24. Roof Framing 73. Undergmd.SmrageTankOGas ❑Oil , 25. Roof Sheathing �� 1'� 74. Overhead Hydro � 26. T�Bar Ceiling {Strucwraif & Monocoat 75. Dry Chemicaf � D. Frame and Flashing 76. Dry Standpipe ' 28. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation 7B. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Elec.ricai Power Meter-Finai 80. FOOD CERTIFICATE ISSUED � 33. Final Electric � Notes: 2JZ2 qS ,v� ��i�}� � 34. Final Neating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Finai Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service�Final 47. Solar pomestic-Finai 42. BackFlow Preventer 43. Backfiow irrigation 44. Landscape Irrigation System 45. Sound Attenuation . 46. Handicap Regulation5 47. FINAL STAUCTURE & BUILDING 48. FINALPLANNING 49. Electric Release to Edison 50. Gas Release to Southem California Gas Co 5L CERTIPICATE OF OCCUPANCY N0. Date �- " App � . spaces except those within neavy borEer linei antl sign all appro0riate Oeclarations. CITY OF COSTA MESA Project Address � Appliwnt s Mailin/9 A,,,dd��re,.ss, Owner's Name ! .lYlS.LS_ UCTION PERMIT a.�nie�y. -' 0 w NC-'/? ��cense rvo. �i/ a 3 � Address Contractor'sName��/1�1c'y (�L�04A��./7UMOJU�Phone�7 -3S Address (mailing) . �7 Ciry License No. � �� / LICENSED CONTRACTOR DECLARATION I hereby affirm tha[ I am licensed untle� proviSiOns Of Charter 9(commencing � witn section ]000) of Division 3 of the Business antl Professions Cotle, and my Iicense Is iri tull t$%ce a tl eifect. License Class _L�_� llcense;N � 0 O oate 2 � / %.PT ' Siynature , WORKERS' COMPENSATION DECLARATION � I hereby alfirm that I nave a certificate of consent lo seli-insure or a certificate � of Workers' Compensa[ion Insurance, or a certifietl copY thereo( (5¢ttion 3800, Lab. C.) - ' ' Policy No. ' Company � CCrtifietl copy is hereby fumishetl. Certlfie C py I5 1❑'th the city Bui '� g DIvi5lon. /, r„ , p_ _� Date ' Applicant �i��CU�CR�-<�K. EXEMPTIO FR MWORKERS'COMPENSFTIO ECLARATION i (Thissectlon need nat be completetl if the Oermit Is r one huntlretl�($]00) or less). I cerlify ihal In [he pertormance of tM1e wo�k to� which this perm�t iz issuetl, I shall not �employ any pe�son in any manner so ds to become subject to the workers' Compensation Laws oi Califomia. , Date Si9nature 'NOTICE: If, alte� making [hi5 tleUaration, you snoul0 become Subj¢ct to Ih¢ Wo�ke�s' Comp¢nsation provisions of the l.abo� Cotle, you must forthwith ,comply wi[h s�cli O�ovisions o� this permlt shall De Ueemetl �evoketl. CONSTRUCTION IENDING AGENCV I h¢reby aifitm Ihal there is a construction Ien�ing agency fo� the Oertormance oi the work tor whiCh this permlt is I55ueC (SeCUon 309] Civ. C.) lPntl¢r'S Ndme LCpdBf'S {\dd!!55 OWNER BUIIDER UECLARATION I hereby d/flrm l�at I am ¢xempt f�om the Contractoi's licen5e Law for ttte tollowin9 reason (Section 7031.5 Business and Vrotessional Cotle: Any ciry or county wnicn reqWres a permit to wnstruct, alter, improve, tlemolish or repair any structura, pdor to Its issuance, also requires the applicant tor zuch oermit to file a si9netl slatement that he/she i5 licenzetl pursuant to the provisions of the Contractor's License Law (Chapter 9(commentin9 with Section ]000) of - Division ,3 of the Business antl Professionv Cotle) or that he/she iz exempt theretrom anE the basis for the alle9etl exemption. Any violation of Section ]031.5 by dny applicant tOr a pe�mit subjects the applicant to a civil �enalty of no[ more than �ive huntlretl tlollars (y500). I, -as owner of the property or my employees with wage5 as thei� sole comp¢nsation, will tlo the work, antl the slruc[u�e Is not intentletl o�'of(eretl (Or sale �Soction 7044, Business and Protessional Cotle: The ContraG[or's licen5e Law tloes not apDly to an owner ot a property who builtls or imoroves . ihereon, antl who aoes such work nimseli/herself or through his or her own employees, p�ovitletl that such imOrovements ara nOt IntentleG or offeretl fo� I sale. Ii, bowev¢r, the builtling or imptovement I5 soltl wlthin one yea� ot com- I Olatlon, Ne own<r wlll have the bu�tlen of proving he/shc tlitl not builtl or im- ' prove tor Ihe OurOose of zale). • ❑ I, as owner oi the property, am exclusively tontracting wilh Ilcensetl con- IractoR t0 construct [he ptoject ISec[ion ]044, Buslne55 antl Professions Cotle: The ConVatlo�'S License Law [lces not apply lo an owne� of pro0erty who builtls or Imoroves tnereon, antl.who contracts for such orojects with a con- iracto�(zl licehse pur5ua�nt�to�the Cont�actoi'S LicenS¢ Law). I am aware that proof o� their Worker's Compensation insurance shoultl be provitle0 to me. ❑ I am exemp[ untler Section B. 3 P. C. for this reason Date 1 � �)�.�� Owner I hereby certity that I have rea in/ormation is mrrec[. I a9ree to antl state laws relating [o Duiltlir sentatives o( this city to eMer inspecUon puroo s. , / Signa[ure ��a' Driveri' Lic¢nze or 55 � �n antl state that tne above tlly and county ordinances antl nereby authorize repre- ve�mentionetl p�operty for �_ Date 2 ^%F.ds / 7S�S' (o L � Z TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' A,p.# DES RIPTION OF WORK/USE OF BLDG. � r�''�/G -F S�!> �ti � �� 5 Main Buildi TVPEOFPERMIT GRnoiNGc� FOVNoaTiOnrv STRUCTURAL � T Front ' ❑ TENANT ❑ ELECTRICAL el PLVMBING usy MECHANICAL A Rear ❑ OTHER PROJECT DESCRIPTION SQ.FT. � 3� C Right OCCUPANCY K. � CONSTRUCTIONTVPE VALUATION$ S Left . ZONE GRADING CU. VDS. ACRES Ping. Ref. # Remarks: - , Planning Notes: Bar Sink Batkflow Preventer . Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinkin9 Fountains ' Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink . '—Trap ' Roof Orains Reinspection Fee � $15 Duct - Under Ground Duct � SVuctural Duct � Ventilating Exhaust System � Multiple ❑ Firepl/Fact Blt. ICBO # Heeting SVscem & Ducting ❑ ai oo,000 aTu O i oo,000 sr Rainspection Fee � $15 CMF 0865-46, rev. 10/84 White - Builtlinq; Canary - Applicant: Pink -/>ccounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Cloiet Water Heater Water Service Auto-Wash Issue Fee FEES Construction Pole Sub. Cooking Unit '. Dishwasher ' Dryers ❑Gas ❑Elec Fan F.A.U. Fix[ures - Device Boxes Outlets Switches Garbage Dispoul Generator �0-5 KW C /(�d� 2/ I b/f9b 1 L„ i'� - Zone Acceuory Building: Z - o N I N G R Parking Req./Provided � E Q M T S � ELECTRICAL Transformer � 15-50 KW ❑ 50+ KW Merer LJup to t00amps Meter ❑over100amps Sub Panel Momis�O1 HP �1'h-6 Ina Solar 09-75 HP �16 Microwave —� - Pole Light� Range ; Standing Sections 5 KW Trash Compactor Reinspection Fea $75 Issue Fee IANICAL FEES Hoodor T DEVELOPMENTSERVICESREQUIREMENTS: ypel ❑ ZoninB Approved By Date Canopy Typell ❑ . _ Building Approved By _ Data Refrigeration Sys[em Oa�oo,aoaeTu ❑ioo.000 System Repair/Alteration Fire Dampers Registers Issue Fee � $ 3 i FEES $ 3 SUMMARV OF FEES . BUI�DING PERMIT $ SMIP $ PLAN CHECK .$ PERMIT � PLUMBING $ %.DO �SSUANCE $ PLAN CHECK 25% $ �� ENERGV P.C. $ � ELECTRICAL $ � GRADING $ PLAN CHECK 50% $ � MICFOFILM $ /c�� . MECHANICAL $ 60O � TOTALFEE $ � ' PLAN CHECK 25% $ .%S V CONSTRUCTION AND PLANNING . POOL iL SPA ". � . Date Inspector � Date Inspector APPROVALS Permit� APPROVALS Permit# • i. Tempora`('y 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-Undrgmd. 55. Electrical Bonding '_ 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test � - 6..Electrical UFER Gmd. " 57. APPROVAL TO COVER-GUNITE 7. Footings , - 58. Electrical Conduit-Undrgmd. S. Fo'undation ' . . � 59. Gas Pipe, � Undrgrnd., Test _ 9. Water Pipe-Undrgrnd. 60. 8ackwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System � . � 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap � . 63. Heater & Vent-Final 13. Roof D�ains 64. Plumbing System - Final 14. Rough Plumbing 3 ff �r L 65. Electrical-Final 15. Rough Electriral-Conduit - 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign � , 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro ' 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23.� Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. floof 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: 3�,S" '� '�,�„ �,�. � �� W 34. Final Heating & Air Conditioning ` ' C 7 G� ,+� O �u 35. Final Gas Pipe-Test , �� , ^�/ r ^ �� ' 36. Hood or Canopy - . 37. Final Factory Fireplace � 38. Final Plumbing f� �S� � � 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. FINALSTRUCTURE&BUILDING . ' 48. Special Requirements Completed 49. Electric Release to Edison i - � i 50. Gas Release to Southern California Gas Co ' . , 51. CERTIFICATE OF OCCUPANCY ' . � No. Date _ _ .. � , . . . ADVlicant to fill in all spaces exceDt tnose w(inin neavy Goraer Iines ane sign a11 avProvriate aeclarations. iITY O� COSTA MESA C!�ONST/�RUCTION PERMIT-�L �L (� � PE/R�MI� NO.,�j� 2 TRACT NO. LOT NO. UNI NO. � Prolec�Address 7�/ N�. � b fh . S �• " `-� rJ J ' � Applicant's Mailing Address TYPE OF CONSTRUCTION NEW /aDD ALTERATION REPAIR /,.i9RRY ARL�I MONT phone � CONVERSION ❑ DEMOL�SH OTHER Owner's Name DESCRIPTION OF WORK/USE OF BLDG. Address Arch/Eng. License No. TYPE OF PEFMIT� ' GRADIrvG FOUNDATION STRUCTURnL AddreSS '•, �/p��7�� ❑ TENANT �4 ELECTRICAI ❑ PLUMBING ❑ MECHANICAL' Con�raCtor'SName OC �r✓ Phon�� 'OTHER / Address (m�'�'�nl �� PROJECT DESCRIPTION Sq. FT. oCcuvnNCv "��O iJ CON STRUCTION TVPE VALUATION b Ciry license No. /��' ZONE � GRADING CU. VDS. ACRE$ LICENSED CONTRACTOR DECIARATION � 1 nereby attirm mat I am licensetl untler provisions of Cnarter 9(commencing Remarks: ' Yj.� (� S'� � with sectlon 7000) ot Division 3 of Ihe Business antl Professions Cotle, antl my license is In full jy�c�a �f�e«. �,33 / a Licen2CJa}/ �- licen f No. Date�/ �� 5'9 [ ' � WORICER ' COMPENSATION �ECLARATION 1 nereby aftirm Ihat I have a<ertificate ot ronsent to Seli-insure or a certiticate � of Workers' Compensation Insurance, o� a certitietl coOY t�e�eof (Sectlon 3800, lab. C ' � /t_ I�,y Policy No. ��Z�� Company '\hS LtJ' V�✓ Certifietl copy is hereby furnisnetl. /�. Cer[i,' 0 5�letl with the city Buptl�ly D1jjbion. Date___e?�� APPlicant Ld� �i , EXEMPTIO FROM WORKERS' COMPENSATION DECLARATION • (This zection neetl�nat be completetl if the permit is for one huntlretl (E100) or less). I certity that in the Derto�mance of the work for which thi5 pe�m�t i5 i55uetl, I snall not employ any person in any manner so as to became subject to the Workers' Compensation Laws of California. � • Date Si9nature 'NOTICE: If, after making this Ueclara[lon, you shoultl become subject to the Workers' Compensation provisions of lhe Labor Cotle, you must forthwith comply with Such prOvi5ion5 or this perml[ shall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV I hereby a�(Irm that ttiere is a construction lentling agency for ine�performance , Df the wo�k far which thi5 permit i5 is5uetl (Se<tion 309� Civ. C.) Lentler's Name � Lentler'z Aatlresi � , OWNER BUILOEN DECLARATION - I hereby afflrm that 1 am ezempt from the Contractor's License Law for the tollowing reason (Section 7031.5 Business and Protessional Cotle: Any city or county whicb �equires a permit [o cOnst�uct, dlter, improvo, tlemoliSM1 o� repair � any structure, prior lo its issuance, also requires the aoPlicant for such permit [O tile a signetl Stat¢ment that he/shC i5 licensetl pu�suant to Ih¢ prOvisions o1 the ConVaztoYs License Law (Chap[er 9(commencing with Section 7000) ot Division 3 of the Business antl Prolessions Cotle) or tha[ he/she is exempt therehom antl the basis for lhe allegetl exemp[ion. Any violation of SecNon 7031.5 by any applicant for a p¢rmil subjects lhe applicant [o a tivll �¢ndlty of not more than five huntlretl tlollars (E500). 1, as owner o1 the property or my employees wRh wages as their sala compCnsation, will tlo Ih¢ wo�k, antl Ihe st�uclure 75 not inlentletl Or offetetl tor sale (Section 7044, Business an❑ PrOfe55ional Cotle: The. Gont�acto�'S License I.dw tloes not appty to an owner of a property wno builtls or impmves thereon, antl who tloes sucn work hlmseli/herselt or through his or hor own employees, proviCetl thal zuth Improvemen[5 are not intentletl or ofteretl for zal0. 11, howeveq Ih¢ bulltling or Improvemen[ is sola wlthin ona yaar of com- D�etlon, tne owner wlll have lhe burtlen of proving he/she tlitl nOt bui10 0� Im- p�ove tor[he pu�pose o/sale). ❑ I, as owner ot tbe property, am excluslvely contractinq wi[h IicenSetl ton- tractors to consVuct the project (Section 7044, Business antl Protessions Coae: The Contractor'S License Lnw tloes not apply to an owner of D/operty who bulltls or improves thereon, antl who conVacts tor such projects with a con- tractor(s license pursuant�to tne�Contractor's License L.aw). I am aware tM1at proot o� [heir Worker'S Compensation insu�ance shoultl be provitletl t0 me. ❑ I am exempl untler Set[ion , B. & P. C, for this reason Date Owner _ I hereby certify that 1 have reatl Ihis a informati�n is correct. I aoree [o comolv Signature / �� Orivers' License or 55 � repre- y fo� Sink king Fountains r Drains �r Sinks ' Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspaction Fee � $15 Boiler Duct - Untler Ground Duct - S[ructural Duct - Ventilating Exhaust System ❑ Multiple ❑ FirepVFact BIL ICBO # Hea[ing System & Ducting ❑4100,000 BTU O 100,000 BT Reinspection Fee � $75 CMF 0865-46, �e�. 30/B4 �White - BuilOing: Canary - Applicant; Pink - ACCOunting; Goltlenrotl - Aszesso� $hOW2f5 Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Clout Water Heater Water Service Auto-Wash laue Fee $ 3 A.P. 51� S Main Building: E T Front ARear C Right g left Ping. Ref. # Planning Notes: Automatic WasHer Construction PoleSu6. Cooking Unit D ishwasher Oryers ❑Gas ❑Elec Fan � F.A.U. Fixtures E 878�1 3/06/;ld >-a;'. zone Accessory Building: Z O N 1 N G R Parking Req./Provided E � ' M T S ELECTRICAL Transformer � 15-50 KW �50+KW Device Boxes E--- Outlets �—� Switches �G Garbage Disposal Genereror �0-5 KW �5-15 KW Meter LJup ro 100 amps Meter ❑over100amps Sub Panel Motors �0.1 HP 01'f. - B Inc.Solar 09-15 HP �16-15+ Microwave - Pole Li9ht Range ; Standing Section� Trash Compactor � Reinspection Fee $15 luue Fee IANICAL FEES Hoodor T DEVELOPMENTSERVICESREQUIREMENTS:. YPe� � Zoning Approved By Canopy Typell ❑ - . ' Building Approved By Refrigeration System . ❑ai00000eru ❑ioo,000aTu System Fiepair/Alteration Fire Dampers Registers laue Fee $ 3 FEES $ 3 SUMMARV OF FEES � � BUILDING PERMIT $ SMIP $ PLAN CHECK � $ PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ 1' ENERGV P.C. $ ELECTRICAL $ ��L�Q GRADING $ � PLAN CHECK 50% $ (y�(�C7 MICROFILM $ MECHANICAL $ ' TOTAI FEE � $ 22'E�� PLAN CHECK 25% $ ' � � � POOL n SPA ' CONSTRUCTION AND PLANNING ' �APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Insp?ctor . 7. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgmd. 53. Steel RelnPorcement 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. Electrlcal Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, � 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 3'�3 . �F 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 OEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Vent��ating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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 & 5iding 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 � V f N�tNs: 34. Final Heating & Air Conditioning 35. Final Gas PiPe-Test 36. Hood or Canopy 37. Finai Factory Firepface - 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 47. Solar pomestic-Final 42. Backflow Preventer " � 43. Backflow Irrigation 44. Landscape Irrigation System ' 45. Sound Attenuation � � 46. Handicap Regulations ' ' 47. FINALSTRUCTURE&BUILDIfVG 48. Special Requirements Completed � �49. Electric Release to Edison � 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY _ , � � Nn. Date TYPICAL CONCRETE BLOCK Cement Coping Optional� Channel Block With I-3/8� 0 Horizontal Top Of All Fences 6�� Concrete Block Fence � For Fences 5� Or Less Vert. Bars 3/8" 0 At 4�-0°0, For Fences Higher Than 5� Vert. Bars 3/8° 0 At 32°0. Provide Inspection And Cleanout Hole At Locafion � Of Vert. Reinforcement Fill Cells Solid With � ► � Grout Where Steel Occurs NATURA GRADE FOR WIDTH SEE CHART r a f w U 2 w LL �� N � y O ¢ � a " � m� w O U � a� Qo °mz �� F a� rn= wo 0 J m p V U 3 - F �n DEPTH OF EARTHTOOTH 1/3 THE HEIGHT OF fENCE. BELOW BOTTOM OF FOOTING. FENCE '�G ENER AL-NOTES" MORTAR: One Part Plosfic Cemenf, And Three Paris Sand GROUT; One Port Cement, Three And One—Half Parts Sond COPING: One Part Cement, Three Parts Sond CONCRETE:WeII Mized. 1�2-I/2�3-I/2 Max. Of 7-I/2 Gallons Of Water Per Sack Of Cement REINFORCIN6 STEEL SHALL CONFORM TO � SEC. A-IS-39 A.S.T.M. ALL STEEL TO � LAP WHERE SPUCED, 2�-0�� MINIMUM. GROUT MAY BE POURED FROM TOP OF FENCE IN CELLS WNERE VERTICAL STEEL� OCCURS. HOI.ES SHALL BE CLEAR, CLEAN, AND fREE OF ALL MORTAR, DEBRIS, ECT. .W�TH INSPECTION HOLES AT BOTTOM. � BOND SHALL BE PROVIDED BY LAYING BLOCKS IN STRETCHER COURSES SO THAT VERT. JOINTS ALTERNATE IN EACH COURSE. SCALE� I/2��= I� CHART HEIGHT ....................6�................ 5�...................4�................. 3� W I DT H . . . . . . . . . . . . . . . . . . . . .14��. . . . . . . . . . . . . . . . I 4 �� . . . . . . . . . . . . . . . . . . I 2 �� . . . . . . . . . . . . . . . . I 2�� THICKNESS . . .. .. . ..........10��. . . ....... ...... 10��... ............ ...8° .. . ............. 8�� DEPTH OF EARTHTOOTH . . . . ..24° . . . .. . . .. .. . ... 20°. .. .. ..... .. . . . . ..16°. . . . . ........... 12�� SPACING OF EARTHTOOTH....12� . . . ... ...... ... 14�. .. .. ............ .16�. . . . . ........... 16� City Of Costa Mesa , California Building Department �� . ��tY of Costa Giesa Bui�din, � � . 8Y TNESE PLANS _ ��' � MAKE NO CHANGES Sy,�,3E �lY d�� f� ..� ��-.; . OFDEPT. 7f��NF PF�I@� A,�V;�VA:. �HE ISSUANCE OB f ^ �'�= �+; „� �F PIANS ARO SPF'!' �' �':,rl 0� pPP20'!p6 TO BE A PERL7�T � � . �,. � � ��t �•O7 BE CON OF ANY dF iHE , � '��YdC Of, SiRpE� SUt,tIMB TO t'�•p: `.... :'...: ;6DE: NO pERL�7AFldG PROYI lON4 G� .�) ll;.Y O:' J'.ATE BR PRl� k^, :;�€ 'Y 1 CJJf S$.l.l G3 VAND CAt/CEl '� r((} F' OR� }(S: VLI1,.H (t nU.N • ENCEPT IN T�E �3?� N,?�E AF j�1=f6 f�J LAtYFI SF£CIf�P �/ tj� . � A Pi8'�:li 83SFJ U10:1 ?i.l.'Jj A; HR L q3( P„EVEfI� iHE BWLOGl� OFFC1, #�8i`� ib€R�}ffiER ��}Jlnl:�3 iHE C08RECiiO�� Of EkRQ� ��E �! � 6�EhRf dY�§ g�iV91OAqp�EO Q 1 iHERF1�H0E7EnNL•` I� ��9EAfiIQN 8� {(IIS ��E ({R Of AdY OTHFR C�E:;V,y�:C. flE ib€ �If�: APPROVAL OF Tf-IcS� STRUCTURAL PLAiJS DOt$ NOT CONSTITUTE �i'PROVAL OF FLUMBING, ELECTRICAL OR CONT1iVGENT INSTALLATIONS. , �'�: ,�t�� r'�� THIS NUMBER MUST ACCOMPANY ALL INSPECTiON REQUESTS TO ;{EEP BUILDING PERMITS VALID N/ORK MUST �E CO;.;'.ifNJED WITHiN 60 DAYS WITH R4U ��.�t 1N3PECTfONS AT LEAST ONGt tVE.:7 50 DAYS. F�LL STRUCTU ,, .. � . � '•: FLOqR HEICHT ELEVAI i0 t L' ::; I�CliES (6") ABOVE L'E�: i. F_��:: JF AD3ACE�7T STREEI. �� C11'Y Q'r �--��T.A A'''[5A P1..1 Ni,1G ULPT. sur�,tc, To�� .�-� �� .z°•r�; ■� L� � � AVGlicant to fill in all spaces except t�ose witnin heavy DarEer Iines anE sign all appro0riata Eeclantlons. CiT+OF COS7A MESA CONSTRUCTION PE MIT Project Address 7%�9 W � c �� .S % ApplicanYs Mailing Address �//L /�1 YG Gr9 Da AVt^ c�� r Owuer's Name ��'/P� wp/��A ✓�+ oN'7 Phone (c7S"-3SG� Address �� 7 i4 ✓U G/Q/Jo /'�V/.t C/' %Y/ � Arch/En . O ��/= ? 9 ,L License No. I Adtlress ' �� Contractor's NameiR/�Q��/�Lq r/u. e�J7 ahone � 7�=3��1' �� Address (mailing) Z � � City License No. ^ x- � Z 7� LICENSED CONTRACTOR DECLARATION t �ereDy affirm [hat I am'Iicenzetl untlli p�oW5loni of Chdrter 9(commencing wlth 58ction ]000) of DIviSIOn 3 Of ttie Business antl Profe55ion5 CoOe, anG my license is in full rca an eT(ect. •. ., Llcense Id55O �� LIC2958 NO. O Date �^ ` +R 519 t . �.�/"�_�il�� WORKERS'COMPENSATION DECLARAYiON � I hereey aHirm that I have a tertifiwte of consent to self-insure or a certlficata of Workers' Compensation Insuranca, or a certifletl copy "thereot (Saction 9800, Lab. C.) _ • .._ ?olicy No: Company �Certlfiea copy is nerrby�-fumisnetl. ' ""` ' I CerHtie -co �is fletl with the city B tling Divisio� � /�-� Date APPlicant��d /�.�!/ E%EMGTION FROM WORKERS' COMPENSAT ON DECLA0.ATION (Thls saction,naetl not ba completetl If th¢ permit IS for one huntlre0 (E300) ar 1855I. . . ` ."' . I cartity that in the pertormance of th¢ work for which this permk is issuetl I s�all nol ¢mploy any person in any manner so as to become subject to t�e Workers' Compensa[ion Laws of Califomia. . Date 519nature ' ''� �NOTICE: If, aiter making this tleclaration, you shoultl become subject fo t�e WOrkeR' COmp¢n5dtion prOvisions of the labo� Cotle, you must forthwlth complY `�'��n such p�ovisions or thlz p¢rmit Shall be tleemetl �evoketl. CONSTRUCTION LENDING_AGENCV 1 hereby affirm that there is a'construction IenCin9 agenty tor the performance o� the'wark for which�thfi per:nit Is Issuetl (Section 309� Civ. C.) Lentler'S Name L¢ntle�'s AEtlre55 � OWNER BUILOER OECLA0.ATION� ' "'�'� 1 hereby aHirm that 1 am exempt (rom the3COntrdctor's License Law for the tollowing reason (Settion 7031.5 Business'antl Professional Cotle: Any tity or tounty which reqWres a permit to construct, alter, improve, tlemolish or repair any structure, prior to its issuance, also requires the applicant for sucn permit to file a signetl Statement that h¢/sh! is Iicensetl pu�suant to tne p�ovi5ion5 of the Contracfor'S License Law (Chapter 9(commencing with Section ]000) of �ivision 3 of [he Business antl Professions Cotle) or that he/she is exemD� Ih¢r¢frOm dntl the �asls tOr the allegetl exemption. Any vloldtion of Sectlon '�31.5 by any applicanl for a permit Subj¢tts the applicant to a civll nalty of not more than five huntlretl tlollars (5500). J I, as owner ot the property O� my employees wilh wages a5 thelr Sole compensation will tlo the work, antl the structura is not intentletl or offereC for sale (SecFion 7044, Business antl Professional Cotle: The Contractor'S - �icense Law tloes not apply to an owner of a property who builtls or improves tM1eteOn, antl who tloes such wo�k himself/herself o� thmuqh bis ot he� own emDloYeeS. provltletl that Such Improvements afe not Intentletl or ofterltl fOf t, boweveq Ihe oWitl�n9 or n, the ownet will �ave Ihe fm ine pu�pose of Sale). as owne� oi t�e prop¢rty, � bWItlS O� ImprovES tnereon,'ana wtto cOOV� tractor(sl�license pursuant to the Contractoi proof o( their Worker'S Compensation insu ❑ I am exempt untler Section Date ^ - Owner I hereby certify tnat 1 have reatl this appl inlormation Is correcL I a9ree to comply wi' antl State IawS relating to builtlmg construcl sentatives of this city to e er u n the InspeGtlOn pu�p se5. Signature - IS SOIQ WI[OIO 002 y8d( Oi COT- 'in9 h¢/she tlitl not build or im- contracting with Iicensetl con- Business antl Professions Cotle: to an owner of property who �, for such projects with a con- Licens¢ Law). 1 am awar¢ that ca shoul0 be provi7etl to me. — B. & P. C. fdr this reason a state � �3s ��- , z TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p y�y Z DESCRPTIO O O/USEOFBLDG. a/rF/G�7',' S�TGh� /•� (rh( ��(� � S Main Buildi TVPE OF PERMIT GRAD�NG FOUNDATION STRUCTURAL T Ftont ,� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear ❑ OTHER A PROJECT DESCRIPTION 5�. FT. 3 OCCuvANCv. Right � CONSTRUCTION TVPE VALUATION $ �%� g Left � ZONE GRADING CU. VDS. � ACRE Ping. R¢f. �k � Remarks: �� ' —� PlanninyNOlet: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories P—Trap Roof Drains aReinspaction Fee Showers Service Sink Sewer Cap . � Solar Collectors Solar Piping Solar Tank � r Swimming Pool w/Spa _ Urinal Outlets Warer Closet Water Heater Water Service Auto�Wash $75 Boiler Duct- Under Ground Du[t- Structural . Duct - Ventilating Ezhaust System ❑ Multiple ❑ Firepl/Fact BIL ICBO # Heating System & Ducting ❑4100,000 BTU 0100,000 BTi . I Drivers' License or SS � � ��— I pein5pection Fee $75 � CMF 0865-46, rev. ]0/84 White - Builtling; Canary - qppi�cant; Pink - Accounting; Goltlenrotl - Aiseisor laue Fee Hood or Type I O Canopy Typell ❑ Fefrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Regis[e�s . Issue Fee FEES iifll�� Auromatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec'� Fan F.A.U. Fixtures Device Boxes . Outlets Switches� - . Gartiage Dispoul Generainr �a5 KW C $ 3 '' .. ' _ Reinspectian Fee FEES �DEVELOPMENTSERV ZaninB APProved By— BUllding ApprOVed By � Appliration Issued�BY— $ 3 7544 2/ I t: /b:i Zone Parking Req./Provided ELECTRICAL Transtormer � 15�50 KW ❑ SO+KW ' Mecer �up to 100 amps Meter �overi00amps �� Sub Panel Motors �0-i HP � t Yh - 8 � Inc. Solar �9-15 HP 01G75+ Microwave PoJe Light ' � � � � Range � Sign � ; S[anding $ections_ 5-15 KW ' ; Trash Compacror � .l • \\ ;> _��. _ -� Z O N 1 N G R E Q M T S FEES �� 515 I . .I, Issue Fae ' . � 'EQUI9 EME TS: ^ ' �`. �G / ` � A _ �ate � � ' � ' 'SUMMARYn�yF FEES� � �(� v BUILDING PEFMIT -$ ��2�-3 Q`� SMIP� :$ Y'��v'� "' PLAN CHECK . $,�_12�_.•Iv PEfiM1T PLUMBING $ �ISSUANCEp%$ PLAN'CHECK 25% $ % ' 'ENERGYP.C'.jl'$ '� ELECTRICAL $ ' GRADING�✓"'$ ' � PLAN CHECK 50% $ MICROFILM - $ �/7 MECHANICAL' $ � � TOTALFEE $ �T,�•, � �PLAN CHECK 25% $ � , ,� , � � CONSTRUCTION ANDPLANNING � APPROVALS Permit# �n 1. Temporary ElectricBl Service or Pole 2. Soil Pipe,-Undrgrnd. , � 3. �ElectricaV Conduit Utility-Undrgrnd� 4. Electrical Cond�uit�Undrgrnd. . 5. Steel Reinforcement' 6. Electrica�l U�FER Grnd. � 7. Footin9s ' � 8. Foundation • �� ,� 9. Wa}er'Pipe-Undrgrnd. � � 10. Structural Floor System. . SQ,�„�_ .. 11. Property Sewer Line & House Connection 12. Sewer.Cap . . � i 13. Roof Drains � i 14. RougH Plumbing ' � 15. -Rough Electrical-Conduit - 76. Rough ElectricWiring � 17. Rough Wiring Sign 18. Rough Elec[rical-T Bar Ceiling 79. Rough'Heating & Air Condit`ioning 20. Rough Factory Fireplace � 21. Ducts, in Structure 22. Ducts, Ventilating � ;� - 23. Gas Pipe-Rough &.Test � . 24. Roof Framing �.� �• �� , � Z 25. Roof Sheathing , , 26. T-Bar Ceiling (Structural) & Monocoat 27. -Frame and Flashing � a+�c...�.� 28.� Lathing &�Siding ��'' n� 29. Insuiation � 30. Drywall Nailing -�,c, 5+�. rrw�+y 31. Plaster Brown Coai�� 32. Electrical Power Meter-Final ' , . 33. Final Electric � 34. Final Heating & AirConditi'oning 35. Firal Gas Pipe�Test 36. Hood or Canopy 37. Final Factory Fireplace r- 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomes[ic-Finai . 42. Backflow Preventer� ' 43. Backflow Irrigation 44. Landscape Irrigatiun System 45. Sound Attenuation 46. Handicap Reyulations � 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison ' � 50. Gas Release to Southern California Gas'Co Date Date 0 '� POOL. A Inspector AppROVALS Permit# 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms ' 55. Electrical Bonding 56. Rough Plumbing & Pressure Test � 57. APPROVAL TO COVER-GUNITE ' � 58. Electrical Conduit-Undrgrnd. . � 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. � 67. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit# 70. Underground Hydro 71. Product Piping � Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro . 75. DrY Chemicai 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 30. FOOD CERTIFICATE ISSUED Notes: ,�@ yl� c,�Qc ��J� �,! y'- - , . l�..�.��7�_ ��.� ��..�-af� .� Date � Inspcctcr e n flCi�ri�� ///1\C v il/"� "" �' L�_G/ E'O ' . . � _, . . . �. .- I � K/�.7iv.: . �� C6a'�v us.� -+�/a-/ 0¢e�• ,r �/e�T^ a Y �flrr,r��id.�. �Df��cL(i � %t0 v' �Cuo%.t/ oF'F�r� �- �'9ea��-e- � 4 eN FoeM iie eu, �own iaea INSULATION CERTIFICATION This is to certify Miol, in conformcnce with the curmnt energy regulations ICalifomia Admiriis- hative Code, Title 15, State of Califomia•) and approved plons, insulation has been installed in the building located at: ..... .i /!. i_i �� . / .i �oon T� 0/ Wt�L [XTEl10t WAI� Trpe o/ Wtairi� qILIMOf uns: i� ol WtuiLL1 $p. it �IOWN: Type ot Wt�ruL c..e 1� ��Yr Twtl IY, DESCRIPTION OF INSTALLATION WnuLcturer T�ickneu N Wlue•'_ i .i � �.,..... /� V�lue••� �o, nw. e..� Wnulaturu TAictneu No. B�as_ 10� �nr 1Y��1 Wt./&t 5a. :t. CovnM R YNw••— rlOOlf Typt of Wt�rid MmulMurer Thickness R Ydue••_ m, r�w. w.� . fLAt ON O�AO! . Tyq ol Wt�rul 14nuhctunr TAi�Rn�ss R Y�lue••— m, u.w r..� �AM 01 6auWion Irchfi fOUND1T10N WALLf (N rMu1rM) irpe of Wterul _ M�nuixlurer. m, i�.w r..i �IAII�RKt (M NsIrN) fAioknesti � YiluP• Gn�nl ContrMm (Buik�Q Linme NumMr &tY tnctor �uuuution App�ir�tm)�.ZIL'KY INSTALLATION.� Ut�nu Nnb�r 269456 a.� � — Mte �• .:. ��.i.i.nw�n 4w. b.n. �...i«�.. /yW��. �rlww. QDM M Y�. I�A! N Y 11y1A w� VMr f�M .r w. Mn. �I:ru. Y1r u�Nwly d I� I�.w�46r M I•Mwlr, �� M 41MI.i ...iwy ..� �. �...i.«.. w r i...ir� i. �.�.w.. .i. r �.��.r.n d r n�.i.��r� w�i r w.rw .w ..�nr N "w. w��.r. .r rnw.n « d.�ia .w�1lsx.i r� • wh r r �«.�.��.. �rr��.. W A w. A�M.. t�� ...��i�� rN�w www, w�. .rN. w�r� 4.r. �.r r Mti w.4��.i �V WII r^1� �1 • �IIY� N[�liw �11�1� r��MI�N."I ��IIIIY I� �MIIMN �\�II V I�Iw1 H�w� �►IIIiY V��1 �Nu Iti ��n�M� �� 1�� l.�R�� Y�NI�N �Yq� bNl�ll� �� Y�Iw I� IV Y w� M IY MIIIM M��Y�W �►IU�� pM�n�� wN\11�1�� M�M11� OI� yy/yl.•• Y�I�w�� M��A� d��. !V TI�N�� Nw 1�1 �I �p��ry� Mrl�l�� YII YI IWW � wl� 1� �11w�n I�tly.l � r� us —e CUIIDING NFMS, INt., JO55 OwM�t �.t.. lm ��.�K. e.nr. son�--mnnasen form 11l�� WIDINL INOIISTNY LAOCIII�DN Of GIIfORNIA INC., 157] Berttl� BtM., lof M�ehs, GIM. 10025�21]16255171 A � 'n � OWNER �AY CON5TftUCTiOM CO., TiQC. JOB ADDRESS 7 9 W, 20th St. GENERAL CONTRACTOH Bay Const. o.� : AP. No. ll � - 2 LOT T1tACT INSPECTIONS I DATE SUBCONTRACTOR OCCUPANCY Form TI�SM�11.59 Se P 7-11i-60 PERMIT NO. .. • .. f 12�51 ,COSTA MESA BUILDING-SAFETY DEPARTMENT p, O. 60X 917 COBTA MEBA, GLIPORNIA For Applicanf fo Fill In Complefely TYPE OR PRINT ■ ARGH � BIZE COSTA MESA. CALIFORNIA ce bl LINB PROM TEL. SiLi. ZONE� !I �, R LEGAL �Q6CR I NO. OI BLDGB. DESCRIPTION OF WORK r.r x H., _�e.,.,,.., I II ....,,_,,. BUILDING NO. OF 81ZE ROOMS 6TORIES EXTERIOR VdALL I ROOF COVHRIN COVERING � USE OP BUILDING AND WORK TO BE PERFORMED 1 H6R8BY ACNNOWLED00 THAT HAVB RBAD TX19 AIPLIGTION AND BTAT! TMAT TM6 ABOV�GORRYR ANO�RH�� 4- PLY WITN ALL CITY ORDINA AND BTATH LA NO OUILDINO CONBTI1UGilOJ1. AGENT FE RECEIl��D JUL 1 41960 INANCE DEPT. APPLICATION��R{yjEl�lQJ�p MESA BUILDING For Offiee Use Only xeceivr No. p� �L�� / � eY o�re nece�veo o�re ieaueo fi ��/✓—__/n y_iii_L,.i COSTA MESA. ZONING /I NO. Oi I I19E OF NEW PLANB BUILOINO _ ' �_ � �< , //. '��J � C/ � YARDS EVES APPROVED (C6NTHp LIHB 8T.1 TH8 AMOUNT BHOWN 11NDER VALUAiION IB VOq TXe PUIiP08H OP HBTABLIBNING A PEPMIT P¢H ONLY. / VALUATION e�j_ / PERMIT FEE S i f � - S� � PLAN GHECK $ /� _ � 0 TOTAL FEE � OWNER Tt4RT.AlTMONT, LARRY - DATE 12-20- JOB ADDRE55 �A9 West 20th Street BUILDING PERMIT P No. >> S_zLli_F�R LOT TRACT FIR c�s W1TER I'/�- '� �Z 'Z I %L t Lr i � RaUGH cCti'nB�NG PROP. SWR. LINE �1 NOUSE CON. � SPRINKIING SYSTEM MISCELLnNE0l15 ROUGH NEATING � iEMPORnRY SEHVICE OA POLE UNOEAGROUN� POWER � FOUGH WIRING TRENCHES I✓FORMS STEEL REINF. FLOOR SYSTEM BONO BEAM [—I STEEL REINFORCE n SHEPTNING FRAME PN� FLASH�NG PLASTER.BROWN COA $TP"CTURAL.FIN4L H G, vENi., FE�f PImnBING. FIN4L 4N0 � SUBCONTRACTOR . ��7�� r COSTA MESA BUILDING-SAFETY DEPARTMEN P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVI6DING � ' � �D S ADORESS OWNER �� Ll� �� VI°?C/V MAIL ADDFlE55 Z �b L U r TEL. CITV CD/ O/✓ L` /� � NO. =S CpNSTRUCTION �1 /� •' IIFF C� /TC/T BRANCH ADDRESS ARCHITECT �„ . , _ � . � .n TEL. FE� A.P. NO. � BUILOING ADDRESS'�� TFACT W AD l OWNER L/11LI G FIRE ZONE APPROVEO A OB63 izieai�e FOR STRUCTURALPERMIT DATE RM AODRESS / Z ✓Q � Q �/�: —� TEL. ZO NO.OF iiSE OF NEW-/- VlANS BUILDING CITVCO'� I✓�i C' No. -3S'Cd' F STA7E CITV �'AR�SAPPROVED VAROSAPP LIC. NO. �� Q ��D LIC. NO. ' MAIR7 BUILDING AC ESSORV � SIZE NO.OF BLDGS. (FROM dL ST T) � W pF LOT � Z? �( ,3 � NOW ON LOT � RONT � VSE OF ^ i �f� � �� / / E%I5fING BLOG. � � / C %` J � .y. � F Separate permits are required for L. SIDE O FT. electric, plumbing and heating work. � ` =� REAR FT. � W USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS.BLd /� VAR. aY+ DA7'E a:J ^ / �/� �j. � G/` � C.U.P. APPROVED � � iu�kOV �. ,�v ' 9-iir,G u.tU..✓G C 2�� w � 1 herBby acknowletlga s�at I have reatl Nis appll<ation antl stete � that the above Informatlan is correct and agrae to comply wlth all laws re0ulatinp bulldin0 conr[ruction, antl I shall not employ Wany person in violation of Ma workman's compenution lews of �, the State of Celifornie. 3 I hereby cartify that 1 am properly Ilcansetl as a contracior untlar � SQ. FT. tha Stata of Caltfornle Bustnas� and Professions Cotle, Dlvision 3, THE AMOUNT SHOWN UNDER VALU Chapxer 9, antl t�at such licenses are in full force end effect, or i THE PUFPOSE OF E5TABLISHING A PEFP am exempi irom the prov(sions of the STace of Callfornla Business VALUATION and PYotesslons Cotle, Divislon 3, Cha/piar 9. PERMfT FEE _ I SlpneT��e of J D -� PLAN CHECK S PermRtee ��%v'�� !s /•'r _ , _ $ /Z • � �j 6 rnx s Authorized Apant TOTAL PAI D S 106.48 TL N n m m N TION IS FOR � m T E O e �� a ui m � � 0 a � � .,: a �� rE� R�.CktVED ' s�r7-6o v� iCOSTA MESA BUILDING-SAFETY DEPARTMENT FINANCE DEPT. P. O. BOX 917 CABTA MESA. CALIFORNIA Fo� A lieant io Fill In Com le+el CITY QF CUSTA MESA PP P Y APPLICATION FOR PERMIT '%�C �_TYpE OR PRINT gU16DING fo. AD RE'88/ 20th�� CASTA MESA. CALIFORNIA For Office Use Only oWNER Ba Construction (.'O ITIC aecfi�vr NO, PCHMIT rao. r � MAIL �+! ev o�rs rtecerv o�re ies eo' ADDRESS 1 Placentia Ave ,'/ I S-i� _�a I- -Fo an NewpOrt BeaCh. No: a � BUILDING ADDRE88 �- � � ARCHITECT OID`dS TEL. I• � o.r GINEER S t'1& No. COSTA MESA. CALIFORNIA i a�se 1 12 Ponderosa Santa An "'RE �',I/ ZONE TYPE GROUP CONTRAGTOR BS O St. ti PPROVED ��I' G DATE � � 1- ADDRE55 1 Placentia Ave. ZONING ZON I NO. OP I UBE OP N¢W " G�T' NewDort Beach _ Pu�a Bl1�LDINO zz L1G.TN0. NO. MI.C�— 22. "o"` � �� :� T.IoI D88CNIPfION OF LOi i55 i[ 122 I��' OP oLoee. O NOW ON LAT � � � � A. P. NO. USE OF YAROS EVES EXISTINC BLDG TIO 6 pppROVED ALLOWED 6ET8ACK LINB PROM ICcniHP 4N6 eT.l NL� � C¢Niert oP eineeT �f t REAR YARD 61f Y. FRONT FT. � � �! 61DE YARD I LEFT 4O1 fi I RIGHT O1 ti R. SIDE FT. IN. DESCRIPTION OF WORK �. SIDE � FT. N. NEN" I �ALTERAiION I IIADOITION I pEAR •S� FT. l CK REPn... I IIMOV�NG I nDEMOLISH I BYPROVED / v-- ♦ l DATE L —f 4 � $BUZEDING 33 X 7� ROOMS 7 $TORIES 1 EXTERIOR WALL ROOF COVERING ZS�iP�OVERING COID O� U8E OF BUILDIN6 AND V✓�RK TO BE PERFORMED x =2.�'f/ G rao z c,(` New business office for Bay Construotion Co. � � - * `� � HBPHBY AGRNOWLPDO6 TM�T 1 HAVB pBAD THIB �PPLIWTION TXC AMOUNT BX N ONpER VALUATION IB IOR THE `'-� AND BTATi THAT THH ABO IB GORfiCGT AND A6R66 TO COY- pYRP098 OP e ABLIBHINO A PHRMIT FEE ONLY. PLV WITH ALL CIN OqplNµ�e AND BTATe L.�WB qEOUTATINO BUILDINO cON6TRUCTIOp, VALUATION �J "31GNATURE OF PERMIT FEE $ J0. �� 'vMITfE �� ,�G / a ti ONSTAUC�PION CO. $/� O! �r PLAN CHECK $ �V �—� `� F � GHNT / -� p TOTAL FEE � r � � " 19349 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. 90X 90 CQg�p M68A. CALIFORNIA For Applieant fo Fill In Completely TYPE OR PRINT • REISS 7VJ Yl• ZOttl• St• COSTA MESq, CALIFORNIA � AO RE58 !�7 W• Z�t=1• St• n__i' nn_"_ TEL. �YiZlei' unL' II LIC?NO. i Z B—1 NO. MI 6�G`YV. F LOT L $ 122 I N�� OP oLD08. NOW ON lAT USE OF EXISTINGBLDO. BI.LBSx]e$S offlce 8¢TBACK LIN¢ PHOM [O � 0 � CENTER OF BTREET l �2EAR YARO SIDE YAROI LEPf O� RIGHT O � DESCRIPTIQN OF WORK S ZE�1N6 G Y+LL PtOOMS Z 6TORIEH 1 EXTERIOR WALL qOOP }�� COVERING S�uC'C' COVERINO C�"'Y• USE OF BUILDING AND WORK TO BH PERFORMED Partiffition to se arate the two areas. Cabinet with sink and I HEREBY �CKNOWLEOOE THAT �{�AVe RBAD THIB �PPLICAT�ON AND BTATe TH/�T THE �BOVe 19 COqqBCT ANO AOpHB TO COM- PLY WITH ALL CITY ORDINANCpg AND 9T T8 LAW9 R80lILATINO BUILOINO CONBTNURION. SIGNATURE OF PERMITTE AUiHORIZE0A6ENT SBCYet�'y/�BaB• j('�� p(Q� ` r/lr T � '� i t 1 j"_' � k,.^ ' 7 APR 2 � �� 6 1963 FlNNr,�ct otP�. CITY OF Cncrn APPLICATION FOR PERMRMESA BUILDING Por Offiee Use Only RICtIR NO. P6HM�T N0. BUILDIN6 , � O� � �6'Ci� �i//�� ADOR658 O d�` FIRE >nvw � TYPP r.wnuv • � ZONINC; � NO.OP UBeOPN W �/ PLAN9 � pUILO�NO ��U /� �.0 i � cE- � � E � / S '3 L/c�� iri� NOEAVEOVERHAN08MA LBELEHBTHAN EAVES ALLOWED YARDBAPPROVED MAIN BUILDINO VAR. $R YARDSAPPROVED ACCE650RV BUILOING BET. MAIN B ACCE&8. BLDOH. OATE � APPROVHO oaTe �.-�ln �� T1H AMOUNT BXOWN UNOER VALUATION 19 POfl TH8 PURP09E OP 88TABLIBXINO A PBpMIT PHH ONLY. VALUATION � � �✓ PERMITFEB $ $�`�'� r�rs. «e � � -- e s O H 0 , � Y 1" •\ � :�7795 COS7A MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 ForApplicant to Fil/in Comp/ete/y BUILDING ADDRE,^.S OWNER MAIL Z ADDRESS W W a U CITV ~ Z CANSTRUCTION ZQ O � LENDER R C1 J � BRANCH J N Q W qDORE$S r i ARCHITECT �� OR ENGINEER U Q w � ADDFESS a u,+ w Z CONTRACTOR J Q m Z J � ADDRESS W W � CITV ZH w � STATE y � LI0. NO. _� SIZE OF LOT TEL. NO. TEL. NO. CITV LIC. NO. NO. OF BLDGS. NOW ON LOT BUILDING � ADDRESS�� TRACT FIRE (/ ZONE APPROVED ( ;/,'� _�.�i,rnu0� 70T7 ��t,: ��, 39.91 TION FOR BUILDING PERMIT DATE ECEI E DATE ISSVE .. /- -� /_�� NE NO.OF VSE OF NEWCQUYP• t PLANS Z BUILDING S�ELTL� �'AR�S APPROVED VAROS APPROVED MAIN BUILDING ACCESSORV BUILDING H SIZE OF NO. OF Z NEWBLqC. ROOMS STORIES I.SIDE FT. FT. U EXTEfll4R WALL ROOF COVERING COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFOPMED OISTANCE BET. BET. MAIN b n MAIN BLDGS. AOCFSS. BLDGS. / VAR. � DATE O C.U.P.9� APPROVED F � P.PPROVEDI .�` �� N w Z O ZE VI horoby acknowlodBe �hot I have rooC this application antl state � that tho obove intormntlon is correct nntl aB�ee ro comply with � oll laws regulacinB builtling construction, ond I shall not employ F„ uny per5on in violation of tha workman's compensation laws of /� m y the tatp of Calitornle. � • O � Z1 hereby certify thet I am properly licensetl es a contractor untl¢r P SQ. FT. o Me Statg of California Busineas antl Professions Code, Divisicn 3, THE AMOUNT SHOWN VNDER VALUATION IS FOR � Chapter g� antl cha� such licenses are in full force and ettac2, or I THE PUFPO6E OF ESTABLISHING A PERMIT FEE ONLV: ° am exompc from tt e provisions of the Stntn of CalHornia Bvstnass ¢ VALVATION m entl Professions Cnoe, Division J, Chapter 9. D,y �pERMff FEE 5 � SiBnatura of � ��]]] �qq f m Permittee f /'i S� /� VLAN CHECK $ � E `o Auihoriietl Bant 1 TOTAI FEE $ LL Z . ww a U Z ZQ ON n. ¢� J � J N Q'U UN Z a W ¢ aW W Z J Q m Z J � W W O= Z �- w� N � � � � z Q U J � H N z � F U � � F N Z ., � � � / �� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 Jd`i28-7�:{;�=0C�1034 ox**��77.00 Af�L�C TION FOR BUILDING PERMIT ForApplicant to Fill in Com le }! REC rv o v OATE RECEIVED DATE ISSUED BUILDING I . 7 � % ' � ADDRESS �l/ �fl IT O. OWNER 6 A.P. NO. MA I L BUI LDING r7 � ADDRESS �+DDRESS p.�V TEL. TFACT LOT BLOCK CITV NO. CONSTRUCTION W P LENDER BRANCH OWNER � ADDRESS (��•� VALUE ARCHITECT TEL. 5 �^��+ S OR ENGINEER FIRE � ADDRESS 20NE T PE GROUP APPROVED O' CONTRACTOR BV DATE ' Q ADORESS TEL. Z�NE NO.OF USE OF NEW CITV NO. PLAN$ BUILDING STATE CITY �'AROSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BVILDING ACCESSORV BUILDING SI2E NO.OF BIDCaS. (FPOM C/L STREET) OF LOT NOW ON LOT RONT FT. FT. USE OF E%ISTING BLDG. S FT. $12E OF NO. OF NEWBLDG. ROOMS STORIES L.SIDE FT. FT. EXTERIOR WALI ROOF I� COVEFING COVERING REAR FT. FT. \ USE OF BUILDING AND WORK TO BE PERFORMED OISTANCE BET. BET. MAIN & ' MAIN BLDGS. ACCFSS. BLDGS. VAR.# DATE C.V.P.# APPROVED APPROVED I hereby ocknOwletlpa that i have reatl [his application antl itate /� that the above into�mation Is cor�ect entl apr¢e [o comply with �� all laws reBulatin9 b�iltlinB consttuction, anC I shall not employ any person in violetion of the workmen's compenaation lawa of t�o Stato of California. � I heraby certify thot I am proparly Iiconsetl os n controctor untler SQ. FT. o Me Steta of Californlo Business antl Professions Cotla, Divisicn 3, THE AMOUNT SHOWN UNDER VALVATION IS FOR Chopter 9, entl thet such liconws oru in full force entl ef(ect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: ¢ um axampt irom U'e Orovislons oi the Smm of CalifOrnia Businass and Protassione Cnue, Division 3, Chaptar 9. VA W ATION � m PERMIT FEE S � ] SiBna[ure of m Permlttoe 5�� PLAN CHECK 5 E Authorizatl ABant LL TOTAL FEE $