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Home My WebLink About920 20TH ST - Building PermitsAGplicant to /III in all soaces except tnose wltn(n neavy eortler Ilnes ane sign all aoorooriate aeetaratlons. arY OF cOsrA MESA CONSTRUCTIO�ERMIT _ Pfpoect Address —G ��_ IA� • 2 /J � . -- � Applicant's Maiiing Address Ownu's Name - � hone/ �j�y.,l� Addreu � Ir�j��.l 7� % Arch/Eng. � uaieiiuido. Address Contractor's Na hone � Address (mailingl � City License No. LICENSED CONTRAC70H DECLARATION Lhereby a/firm fha[ I am licensetl untle� prOviSiOns ot Ch rter 9(COmmencing wltb section J000) ot DIvlSion 3 ot the Busineu antl Profes5im s Cotle, an0 my Iicense is in full torce antl effect. I.icense Class Licenze No. Ddte � Si9nature WORKERS'COMPENSATION DECLARATION I bereby affirm that I bave a certifiwte of consent to selNnsure or a certlfiwte ' ot Workers' Com e�ation I s rance, or a certitietl c py thereoi (Section 1800,-Lab. - —�l i r'olicy No. Com eCertifietl opY s hereby f m' hetl. ' CertifieU copy is filetl with tl' e city Builtling Division. Date Apo��nt EXEMGTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be comple[etl it tne permit is f0/ One huntlr¢tl (5100) or less). I certify lhat�ln Ihe pe�formance of the wo�k fo� which thiz perm�t i5 SueE, I snall not employ any Oerson in any pre nnet so as to be me o the WorlpR' ComCensyipn Laws ot Calimry�)C7 � , a CONSTRVCTION LENDING AGENCV I nereby atfl�m l�al t�e�e is a conSVuctlon lentling agency fo� Ihe pertormante of lhe work for whith this p¢rmll is ISSu¢tl (Section 309] Clv. C.) Lentler's Name Lentl¢Ys ACtl�ess - OWNER BUILDER OECLARATION I he�eby atfl�m thal I am exampt 1rOm [hn COnt�acto�'S Llcense Law tor th9 following reason (Sec[ion 7031.5 Business antl Professlonal Cotlo: Any city or county whiGh requi/es a pe�mi[ to con5t�uct, dlter, improve, tltmolisb o� �apai� any structure, prior lo its issuance, alzo.requires the apo��ant tor such parmit =to tiie a si9netl slalement that he/sne Is Ilcensetl pursuant to ihe OroWsions ot -tne Contracror's License Law (ChaD�er 9(commencing with Se<tlon 7000) of .,Division 3 oi t�e BuSinBzs antl Prole55ian5 Cotle) or thdt h¢/Sh< IS exempl thera/rom antl the Dasis for t�e allegetl axemptlon. Any vlolation of SecUon i�7031.5 ,by any applicant �or a p¢rmit subjects tno aOP��ant t0 a clvil frvenally ot not more Man fiv¢ hunErea tlollars (E500). :'L� I, as ownar ol thc propertyior my employcOs witn wages as their sole compensatlon, will tlo the work, an0 the structure Is nal Intendetl or oileretl tor sale (Seclion 7044, Business antl Protessional Cotle: Tho Con[ractor's License Law tloei nOt apply lo an ownet ot a Droparty wbo bulltls or imprOves thereon, antl wno aoes sucn work M1imselt/herselt or tnrough his or hor own employees, provlDeU that such improvements are not Intentlotl or offeretl lor sale. H, howeveq the tiuiltlin9 or Improvement Iz sold within one year of com- pletion, tne owner wlll' have tne burtlen of proving he/sne tliE not bulltl or Im- �rova tor the pur0ose of 5ale). I, as�owner of the pwp¢rty, am exclusivety contrac[ing with Iicensetl Wn- tractore to consV uct the project (Section 7044, Business antl Proleszionz Code: The Contractor's Licensa Law aoes not apply to an owner of property who builtls or improves [hereon, antl wha coniracls for Sucn projec[5 wlth a con- bactor(sl license pursuant to the ConVactor's License Law). I am aware tnat proo( of their WOrker's Compensatlon insutance shoultl De provltletl [o me. ❑ 1 am exemot untler Section � 8. L P. C..�or this reason have read this TVPE OF CONSTRUCTION I.J NEW L-J ADD L� ALTERATION I�F REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHE / � — DESCAIPTION OF WOAK/USE OF BLDG. � ��ST�LCi TVPE OF PERMIT LJ GRADING LJ FOUNDATION L'J STRUGTV i ❑ TENANT ❑ ELECTRICAL ❑ PWMBING ❑ MECHANICAL ❑ -OTH E (3 PROJECT DESCRIPTION S4.F7. OCCVPA v. �CONSTRVCTION TVPE VALUATION § � ZONE GRADINGCU.YDS. ACRES_ Remarks: � Bar Sink B�c�c(� Pr�venter __ a�c f�ow rr gatio�— Bathtubs Claritie�s ' Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors ' Kitchen Sink Lavamries � P-Trap Roo( Drains Reinspection Fea tlets $15 Boiler . Duct - Under Ground Duct - Structural Ouct � Ventilating � Exhaust System ❑ Mul[iple ❑ Firepl/Fact. Blt. IC80 # Heating System & Ducting � ❑a-i oo,000 aTu 0 i oo,oao eTi P Signature Y K " � � ro�� DaR� ' � OPIVe95^LiZ'€1f�aor�55 � — pe��sPa�:�on Fee $15 F 0865-46, rev. 30/B4 White - Builtlinq; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection $018f COIICCtOfS Solar Piping. Solar Tank � Swimming Pool w/Spa Urinal Waeer Closet Water Heater � Water Service Auto-Wash �aundry Trays , Isue Fea Hood Or Typel ❑ Canopy Type I I ❑ Refrigeration System � �6100,000 BTU 0100,000 System Repair/Alteration Fire Damperz Registers � , laue Fee A.P. qp� � S Main Buildin� � Front � A Rear C Right K g Left Ping. Re(. dk PlanninB Notes: - -Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F,A.U. . Fixcures � Device Boxes � Outlets Switches Garbage Dispoul Generator O65 KW O5-� S 3 5 3 � Reirispection Fee — DEVELOPMENTSER Zoning Approved By J Building Approved By Applintion luued By_ p77p 410�7�E5 Zone Acceuory Building: Parking Req./Pyovided . 17��i1 IL ELECTHICAL �FEES Transtormer ❑ 15�50 KW - ❑ 50+KW Meter ❑up to 100 amps ' Meter ❑over100amps Sub Panel MotorsO0.7 HP�ih-8 Ina Solar 09-15 HP � 16-75+ - Microweve - Pole Light Range S{n� _ : Standing Sections 5 KW Tresh Compactor ' . $15 Inue Fea ' $ 3 R � -. 2 O N 1 N G R E � M T 5 SUMMARV QF FEES ' �/' BUILDING PERMIT $ I D� O�� SMIP �$� P�AN CHECK $ (, � .SC� pERM1T PLUMBING . $ ISSUANCE $ PLAN CHECK 25% $ ENERG�' P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 5090 $ MICROFILM $ MECHANICAL $ TOTALFEE $ � PLAN CHECK �25% $ , I � � CONSTRUCTION AND PLANNING POOL .PA � Date Inspecior Date Inspector kPPROVALS Permit # APPROVALS Permit # 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement .3.. Electric� Conduit Utility-Undrgrnd. � 54. Forms 4. Electrical Conduit-Undrgrnd. � 55. Electriral Bonding � 5. Steel Reinforcement � � 56. Rough Plumbing & Pressure Test �6. Electrical UFE�R Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. � . -8. Fo4ndation 59. Gas Pipe, O 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 � � 15. Rough Electrical-Conduit 66. Solar SYstem-Final - i 6. 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.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Svucturaq & Monocoat 75. Dry Chemical 27.�Frameand Flashing 76. DryStandpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. F�NAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31: Plaster Brown Coat 79. FINAL INSPECT�ON 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' 36. Hood or Canopy 37. Final Factory�Fireplace ' 38. Final Plumbing�� ' - 39. Water Service-Final � - . 40. Gas Service-Final � 41. Solar pomestic-Finai • 42. Backflow Preventer � . 43. Backflow Irrigation 44. �Landscape Irripation System 45. Sound Attenuation . � . 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING � � Pn w 48. Special Requirements Completed o 3 (Qp ♦ VIQ C 49. Electric Release to Edison � 50. Gas'Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY . No. Date .� �O �'O-��r � G SSQ! t � 9a o � � d �� Ca s-�a It'�esc� fl��%ac�h9 0l � Wihc�Ot</ kJ, f� S��ql r) q�co rs _ 6�0 K �r'�" � r �l� � «my; �� . s�, � r� � � � �' n L �A �ti yn ;. � •J r�; of Cbsta Mesa Bui�ng,De, f. 'I fl'�..�. � � 1)� THES ilANS MUST BE C1J B Ai ALL iIMES ' MAKE NO CHANGES WtTHOUi PRIOR APPROVAC � OF Df�T. �, 7NE ISS�N OZ GRAN�IIV, OF A PERN,17 C.2 FFFRD`/AL' Of PLAlS ldrD £F CIflC0TI0DlS SHP�LL NCT e5 CONSTR!JEO 70 8f A FERV.IT fL•Ri OR 6N /FPR011SI C�, ANY V1�:AilOfV � I Of ANY (lf THE PR�Y 'C':� C� THG G�DE. N� {'CRt71F PRE• � &IMING 70 G�4E FUT RITY 7D VIOLATE OR CAVCE:.THE+ PRW:a1QNS Of 7Hi$ CO E SNALL BE VP.Lt6, EXCFPi LY SU I 61Rf67NFN'DRK�OR USE 'HICH 1TAU7HORIZCS 1S IAwFUL. (' � � 7:�L ISSUANCf OF A R.M.ti BASED 't FLANS A�vO �rions sNau nor ea�vc:r THE eu �iu� orricin� � Tt$47'1,FTCR REQUIRING TF+Yr^f ^'�^ �� ' i7rt�.<S ' �� IFIWNS HND $PECIFICATIO�i OR FROM PRL76V(In:; �dl?�6FiF.RAT70NS8£INC CARRIEDOY THEREUMDER N'N,E�t M �10WSI4N�OF THIS CODE OR Of .4MV OiHEH OP.uI. '� . � IN€ FLy.: �� ' ' � � -- ...� For Inspeetions Ca1l r ' F � -,i � �� t �� '� �� 5 � \` `�,G , i iCv� C� ) ,,. ' �� _�.i%' _ ` /� �� r % i j ---,___.�_ i'� I StRUCTI��p;� qpp�pVA� ��LY SEPARAiE PERMIiS qRE REQUfRED FQA ElFLTRfCA!, PI.U?✓,�fiiN,ri, N[ATIA'G, 'vEN7fLA7fNG AND n�Fa��,r,�n; �r�c;ir< �'��c�� #_ r��g3s�(.__._ -----__.. �.r: �iiISiU7JP✓,�8:�t^,�;t'SI ;i.CU•9;• �y Att IN5PEr; �U;y .,iGi�i,l�, y j �"-- � FOR 8(IiC01NGS Wy�RE Prr75�7 E'�'P«Yf�. U+E SUGGESf iKqJ CALIFOnivIA OIVISinn� �,� ........ HEUl�rREMENiS, '.--T ,_:_� ys dar � rif: st:.,: �1 t!Ri41 $.vFt`7y D017fONAl � �rr�% AVG��ant to fill in all spaces exceo� tnose within neavy eoraer lines ana sign a11 apvro0��ate tleclarations. 'ciTY GtiF COSTA MESr�A.. C,ON1STRUCLTIONc PERMIT PrOject Address q�LV �N '�"T ` Jt _ ilpplicanYsMailingAdd�ess q.�� w• �'N- ST Owner'sName P=�T2\G^C— �OLi�l�i/�� Phone Address � a 3 W OUT �l St �iJ.it�' ��%� Arch/Eng. License No. Address Contractor's Name Phone Address ( mai I i ng) Ciry License No. LICENSED CONTRACT00. DECLARATION 1 hereby a}firm Ihat 1 am licensetl under provisions of Charter 9(commencing wilh SecUon J000) oi Dlvlsion 3 0! tbe Buslness antl Profe55ions Cotle, antl my license is in full torce and etfect. License Class License No. Date Signature WORKERS' COMPENSATION DECLARATION ��ereby affirm that I have a certifiwte of consent to self-insure or a certificate �_�,',��Workers' Compensation Insurance, or a certitietl copy ihereof (Section �w'.' "°J0, Lab. C.) � Policy No. Company eCertifieC capy is here0y furnishetl. Certifietl mpy is tiletl with the city Builtling Division. Date Applicant E%EMPTION FROM WORKERS' GOMPENSATION DECIARATION (This section neetl not be completetl if the permit is tor one huntlretl (5100) or lesz). I certity that in lhe pe�fo�mance of thC work for which this pe�m�t is isSueQ I shall not employ any person in any manner so s to become subject to the Workers' C ti n l.aws o/ Calitor e I Date _ l%Si9nature NOTICE: If, af r m <ing this tleclara[i , you shoultl become subject to the Wo�kers' Comp¢nsafion prOvisions of t e Labo� Cotle, you mu5t forthwith comply wi[h such provisions or tnis permit snall be tleemea revoketl. CONSTFUCTION LENDING AGENCV I hereby a(tirm that there is a consVuction lentling agency for the pertormance of the work for which [his permit is issued (Section 3097 Civ. C.) Lentler's Name Lentler's Atltlress OWNER BUILDER DECLARATION I hereby aftirm that I am exempf irom the Contractor's License Law for the following reason (Section ]031.5 Business antl Protessional CoOe: Any city or counly which requi�es a permit to con5[ruct, alte�, improve, tlemoli5h o� repai� any structure, prior to its issuance, also requires the applicant for such vermit to (ile a siqnetl Statemenl tnat h¢/She is licensetl pU/suanl to the provision5 of the Contractor's License Law (Cnap[er 9(commencmg with Section 7000) of '�ivision 3 of the Business antl Professions Cotle) or that he/she is exempt �reGom antl the basis for the alle9etl exemption. Any violation of Section 31.5 by any applicant �or a permit subjects the applicant to a civil e Ity o( not more tnan tive huntlred dollars ($500). I, as owner oi the O�operty or my employees with wages a5 Meir sole mpensation, will tlo the work, antl Ihe structure is not Intentletl or otferetl for sale (Section 7044, Business antl Professional Cotle: The Contractor's License Law tloes not apply to an owner of a property wno builtls or improves lhereon. antl who tloes such wo�k himself/herself or Ihrough hi5 or het own employee5, provitletl that suGh improvement5 are not Intentletl o� oHeretl for sale. If, hOweveq the builtling or improvement is sold within one year ot com- pletion, the owner will nave the burden o! proving he/she tlitl not builtl or im- �rove to� Ihe purpose ot sale). 1, a5 owner ot the property, aT exclu5ively contractinq with licensetl con- Vactors to construct the project (Section ]044, Business antl Protessions Cotle: The ConVactor's License Law tloes not apply to an owner of property who bulltls or improves ihereon. antl who contracts for such oroiects with a con- trac[or�sl Lcense pursuant to rne ConVactor's License Law). I am aware thac proof of tM1eir Worker's Compens�atfion insurance shoultl be provldetl to me. ❑ I am e em t}�ntler Section /��' � B. & P. C, for this reason 4 o e / L I hereby cer[i y th t 1 have reatl this application antl state that the above information is correct. I agree to comply wrth a11 city antl county orainances antl s[ate laws relatin9 �o building construction, antl hereby authorize repre- senta[ives of tnis city [o enter upon the above-mentionetl Property for inspectlan pu�0 5. � SignaWre L Dat � Drivers' licen or 55 $ , r�� ....... .._ __ __ ..,.,, „ 1 TYPE OF CONSTRUCTION NEw aoo ALT ATION F ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A7 —TV DESCRIPTION OF WORK/USE OF BLDG.'QF�aCB '1b��LT '� �{O/7 A/A7� 1L7�✓1GC.(�NC NSfA' NTi —S OM7i TYPE OF PERMIT GRADING ❑ FOUNDATION ❑ STRUCTURAI. ❑ TENANT ❑ ELECTkICAL �PLVM8ING ❑ MEGHANICAL ❑ OTHER PROJECT DESCRIPTION 5Q.F7. oCCUVArvCV— CONSTRUCTION TVPE `AL fATION $ � a ZONE GRAOING CU. VDS. Rema�ks: Bar Sink Backflow Preventer Backflow Irrigation Bathtuhs Clarifiers Dishwasher Drinking Fountains Floor Orains Floor Sinks Gas Service Outlets Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee $15 Boiler � Duct-UnderGround Duc[ - Sttuctural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact Blt. ICBO # Heating System & Ducting ❑U700,000 BTU �100,0006T Reinspection Fee � S75 0865-66, rev. 5/88 White � Builtlinq; Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor P Showels Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Issue Fee Hood or Type I ❑ Canopy Type 11 ❑ letriqeration System 70. '��10,000 BTU ❑ 100,000 iy� Repair/Alteretion Fire Dampers - p Registers mP e e Issue Fee A.P. # S Main Buildi R E T Front �i A Rear C Right K Left S _ I Ping. Ref. # — Planning Notes: FEES P.utomatic Washer Construction PoleSub. p Cooking Unit Dishwasher pp Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes OuUets 2 Switches Garbage Dispoul /') b0 Generator �0-5 KW C Fee 2one Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps 5KW $15 Sub 7anel Motors 041 HP O1 %- 8 IncSolar �9-15 HP �16-15+ Microwave Pole Light Range Sign Standing Sec[ions Trash Compacmr luue Fee $ 3 DEVELOPMENTSERVICESREQUIREMENTS: 2oning Approved By FEES Building Approved By AppliwtiOn IssUed BV $ 3 N I N G R E Q M T S. FEES $ 3 SUMMARV OF FEES BUI�DING PERMIT $ SMIP $ PLAN CHECK $ PERMIT �j PLUMBING $ � • �SSUANCE $ Y PLAN CHECK 25% $ ENERGV P.C. $ � ELECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $ � ' PIAN CHECK 25% $ iJ � n� n.,�.c,.}f �.��'.:hj�i 'i� r�`r .. ��': "' _ ��5. �3!'s T?r': ;i i?; C(-iNSTRUCTION AND PLANNING POO �P,Q APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole -� 52. Pool & Equipment Location • 2. Soil.P.ipe-Undrgrnd. • 53. Steel Reinforcement .�� i 3. Elect[ical Conduit Utility-Undrgrnd. � � 54. Forms 4. Electr�ical Conduif-Undrgrnd. 55. Electrical Bonding 5. Steel'.Reinforcement 56. Rough Plumbing & Pressure Test • 6: Electric�l UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 7.,,Footings 58. Electrical Conduit-Und�grnd. ' ' 8:-Fountlation 59. Gas Pipe, O Undrgmd., Test � • � •� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. . . 70. Structural Floor System 61. APPROVAL TO DECK 11. Property.Sewer Line & HouseConnection � 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 !76. Rough E{ectric Wiring 67. Fencing & Access Approval r +17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18.- Rough �lectrical-T 8ar Ceiling 69. POOUSPA SYSTEMS FINAL .19. Rough Fleating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough FactorY Fireplace APPROVALS Permit # � 21. Ducts, in. Structure 70. Underground Hydro 22. Ducts, V.entilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 7$. Underground Flush 24. Roof Framing . 73. Undergmd. Storage Tank O Gas ❑ Oil T <' 25. Roof.Sheathing 74. Overhead Hydro 26. T-Bar(Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Fremeand Flashing 76. Dry Standpipe 28. Lathipg=& Siding � 77. FIXED SYSTEM FINAL _ . 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT -. 31. •Pla"ster Brown Coat 79. FINAL INSPECTION � ( .. 32. Elect�ical Power Meter-Final ' � i! 80: FOOD, ERTIFICATE ISSUED - . 33. Final �I�ctric .. I �_ � Notes. �; � ; � 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ��- 36. Hood or Canopy . 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final � 42. Backflow Preventer " • I rn.i-I� c ' 43. Backflow Irrigation � 44. Landscape Irrigation SYstem 3�0 _ __- ,.._. � - - , 45. Sound Attenuation ' r� 46. Handicap Regulations . �� 47. FINAL STRUCTURE & BUILDING � 48. Special Requirements Completed 49. Electric Release to Edison _'. ' � 50. Gas Release to Southem California Gas Co . �� i 51. CERTIFICATE OF OCCUPANCY . . No. Date � -1 - � ACO��ant to lIII In all spaces eKcept tnose wil�ln neavy borEer lines an0 sign all apOropriatv tleclarations. CITV OF COSTA MESA CONSTRUCTIOfi�PERiJIIT DF[iMIT N(1 TRACT N(1 1_OT NO. I IAIIT !.Ilt Project Address Q�O W • '3,ory S"�. ' Applicant'sMailingAddress qa3 W • �T�'� Sr Owner'sName PQTRIGK' �oLA�.7 Phone �45:'�1101�. Address qa3 �'�%• iUT�'� ST. Cvsra /�'1�.'SA Arch/Enq. License No. Address Contractor's Nam � Phone Address (mailing) City License No. LICENSEO CONTRACT00. DECLARATION 1 hereby a(firm [hal I am IicOnsetl untler prOvlSions of Charter 9(wmmoncing with section 7000) ol Oivision 3 oi the Buslness anU Protesslons Cotle, anG my Iicenze is In full torce ana effact. Li<ense Class Littnse No. Oale Si9nature WORKEfiS' COMPENSATION DECLARATION LhereDy affirm that I have a tertifiwte of consent to s¢If-insure or a certlfica[e `Workers' Compensation Insurance, or a certitietl coOY ��ereof (Section i0, Lab. C.) volicy No. Company eCertifietl copy is nereby turnisnetl. Certifietl Copy is tileG wi[h the Ciry Builtling DiviSion. �ate Applitant E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be Completetl il the permit IS fOr One huntlr¢tl (E100) Or less). I c¢r[ify tha� in the Oet�o�mance ol lhe work tor whiCh LhiS perm�t is i55uatl, I shall no[ employ any person in dny mdnn¢r 50 as f0 becOme subje<t [o the Worke�s' C�yn9atio w5 Of CdlilOr a. Date �� Slgnatur • NOTICE: II, aiter making thls tle� I tl. you shoul0 become sub7ect to the Wolkel5' Compensalion provi510d1. j G LdbOr COtle, you mu5[ fOrthwith comply with SUCh prOviSiOnS or t � pCrmit Shall DC Oe¢metl �evoke0. CONSTRUCTION LENDING AG C I nereby aifirm lhat there is a consVutHon lentlin9 a9ency for Ihe performance ot lne work far whith lhit permit is ISSueG (Section 3097 Civ. CJ Lentler'S Name Lentler's Atltlress OWNER BUILpER DECIA ATION ' I hereDv atfi�m lhat I dm ex mol from tha ConlractorY �icense Law t0/ the to n�e a sl9nod stai the Contractor's Li� Division 3 ot [he" xrefrom antl Ihe i J �b � I ■ TVPE OF CONSTRUCTION NE ❑ CONVERSION ❑ DEMOLISH DESCRIPT.ION OF Wf3.f2K/U$E QF J ADD L�J ALTERATION U REPAIR OTHER TVPE OF PERMIT LJ GRADING �IJ( FOVNDAT�ON LJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL LEI PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCFIPTION Sa.FT. OCCUPANCV— C O N STRUCTION TYPE V A LUATION S ZONE GRADINGCU.VDS. ACRES_ Remarks: INST�T�L D/SNwASyE� Backflow Preventer Backflow Irrigation Bath[ubs Clarifiers Dishwdsher Drinking Fountains Floor Drains Floor Sinks Gas Service OuUecs Sink Roof Droins j1.5=by any aq�lican[ forja plY�mit subjecis-Lhw'applicant to a UNi Ity o/ not morb l�an livo hu�tl/etl tlolla�5 (E5,00). I as owner ol lhe propertY O� my empl0yee5 with wa9ps-as Iheir SOIe RBinSpBttiOn FeB o ipensation, will tlo tho work, antl tne slructuro is not IntEnaetl or�oHeretl for sale (Seclion 7044, Business antl Professlonal Cotl�: The Contractor's l.iGense l2w Eoes nol apply to an Owncr 0! a propert1�wh0 builCs o� improves thereon, antl"wM10 Ooe5,5uch wOrk ItiTsel//hCrS¢tl or�brough hls o� her own amployaes, provitletl that such Improvements are t intendetl or ottere0 tor BOiler sale 11 however the builaing or improvement is oltl within orie year ot com- $15 pleilon, Ihe Ownor wlll hav0 the bu�tlen OI prov' g he/she Citl not bulltl or im- Duci - Under Ground prova tor [he purDOse ot sale). ❑ I, as owner of th0 proPerty, am oxclu5ively cont�acting with licensetl con- Dutt-S�/uC[U�dl IfacloR f0 <Ons[ruGhthe project (Seclion 7044, Busin¢55 dntl Profes5lon5 Cotla: The Contractor's Licanse Law dOes nOt apply to an owner ot property wh0 Duct - Ventilating builtls or Imoroves tnareon. anU who contracts for such oroiects with a con- tractor(s1 hcense purspant [o [ne.ConVactors License Law). I am aware that Exhaust System ❑ Mul[iple ❑ proot ot th¢ir Worke Ss COmpen�l og In uranca ShoJltl be provitletl to me, ❑ I am exemp� unaA� S�CtioP Y� B. 6 P. C. to� th15 reason Firepl/Fact. Blt. iC80 � �tl6Jn/ 6xL � �Sr/ /Y p G72. A� naia T� ,q � n.��>. � Heating System & Ducting I hereby cercity that I have reatl this aDP�ication ana state tnat tne abova �0.700,000 BTU 0100,00 BT information is correct. 1 agree to comply with all city antl county orEinances antl State laws r¢lating IO bulltling con5truttlon, antl hereby au[horixe rep�e- sentatives o/ tnis clty to enter upon lhe above-mentionetl properry for InSpection Ouyqases. n�� Signature �hwdLa.�- /�_ a"^ Oate � Drivers' �i �.ss o. cc � � _ Reinspactian Fee 0865-46, rev. 5/88 Wnite � Builtling; Canary - Applicanc; Pink - Accountlng; GolOenrotl - Assessor $15 $IIOWCfS Service Sink Sewer [:ap Sewer Connection Solar Collec[ors Solar Piping Solar Tank Swimming Paol wlSpa Urinal Water Closet Water Heater WarerService Auto-Wash Issue Foe IANICAL Hood or Typel ❑ Cenopy Type I I ❑ Refrige ion System 0 0o,000sTu ❑,ao,000 ystem Re ir�Al[eration Fire Dampers � Registers ��COf pate = _ ��ue Fee FEES $ 3 FEES A.P. qW S Main Buildi E T Front B Reer A C Right K g Left Ping. Ref. # Planning Notes: Automatic Washe Construction Poli Cooking Unit Dishwasher Dryers ❑Gas C Fan F.A.U. Fixtures Device Boxes DUtICtS Switches Garbage Disposal Generetor 065 Fee lectric Zone Parking Req.IProvided ELEC7RICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter Dup to 100 amps Meter poveri Oamps Sub Panel KW L15�75 KW $15 FEES MOtOr PiHP�1:5-8 In olar �9-15 HP �1E15+ icrowave Pole Light Range Sign Standing Sections Trash Compactor Iuue Fee $ 3 DEVELOPMENTSERVICESRE�UIREMENTS: � Zoning Approved By � Building Approved By � Application laued By � _ SU ARV OI BUILDING PERMIT $ PLAN CHECK $ PLU BING $ �-�O�D PLA�CHECK 25% $ • ELECTRICAL $ PLAN CHECK 50% $ MECHANICAL $ PLAN CHECK 25% $ N I N G R E O M T $. SMIP $ PERMIT ISSUANCE $ ENERGY P.C. $ GRADING $ MICROFILM 5 TOTALFEE S � �j �i,l'� '�"" i. J ' " ' w9y � - . .. . -T4 , � _ CONSTRUCTION AND PLANNING POO- iPA � i APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector i. Temporary Electrical Service or Pole , 52. Pool & Equipment Location '� 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement "� - 3. Electrical Conduit U[ility-Undrgrnd. 54. Forms .' � 4:'Elecirical Conduit-Undrgrnd. - 55. Electrical Bonding f i ' 5' Steel Re'inforcement � 56. Rough Plumbing & Pressure Test �� %! 6. Elecsrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . � 7, Footing3 ...� 58. Electrical Conduit-Undrgrnd. r ,� 8� Foundation 59. Gas Pipe, O Undrgrnd., Test � , ! 9 W�ter Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. . �: 10_ Structuial Floor System � 67. APPROVAL TO DECK �, 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final -' 72. Sewe'r Cap 63. Heater & Vent-Final � 13. Roof D�ains 64. Plumbing System - Final • 14. Rough Plumbing 65. Electrical-Final • 75. Rough Electrical-Conduit 66. Solar System-Final (76. Rough Electric Wiring 67. Fencing & Access Approval (17. Rough Wiring Sign 68. APPROVED FOR PLASTERING rT8. Rougfi:E�ectrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL �19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT �20. Roug ��ctory Fireplace ': APPROVALS Permit # 21. Ducte �n�Structure � � 70. Underground Hydro 22. Ducts,.Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pip`e Rough & Test ;; 72. Underground Flush • 24. Roof Framing � 73. Undergrnd. Storage Tank O Gas OOiI 25. Roof Sheathing �,� = 74. Overhead Hydro 26. T-Bar Cgiling (Structural) &.Monocoat 75. Dry Chemical 27 �Frame and Flashing � 76. Dry Standpipe i 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. �nsulation 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: ��' ��r �� 34. Final Heating & Air Condi[ioning � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing ' 39. Water Service-Final 40. Gas Service-Final � i 41. Solar pomestic-Final ' M� i` „ 42. Backflow Preventer � , � , � 43. Backflow Irrigation � II'ICOfllplf;tA Inspection� : 44. Landscape Irrigation System ZO 9� . 45. Sound Attenuation � � 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING �l 48. Special Requirements Completed 49. Electric Release to Edison ^� 50. Gas Release to Southern Califomia GasCo �� ` 51. CERTIFICATE OF OCCUPANCY No. Date r,i' ' OWNER DAVIDSON DATE ]OB ADDRESS 920 W, 20th St_ BUILDING PERMIT NO. (59% GENERAL CONfRACTOR j�f $ VAL[lE $ 1,�00.00 ll' � o. LOT 2j13 TRACT 1�12FIRE ZONE DESCRIPTION OF WORK Repair fire�lamaeed I?wel, Gl .P I TYPE V ZONE $1 PLAN NO. I I I DATE PERMITSNUM ER INSPECTIONS DATE SUBCONTRACTOR coat H �g Final P, .inq Ristu Final Gas Test 6K97 � . 6�9� COSTA MESA BUILDING DEPARTMENT P. O. BO% 31� COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN ADOREI55 � pL(,/ "'� �� OC.[,' J � COSTA MESA. CALIFORNIA MAIL ADORE55 CITV [.O� ARCHITECT OR E�' 'NE ADDRE55 LEGTL ILOT p oescwipriorv NO.Q A.P.NO. ��1� SIZE c/ OF LOT �J(�/ � USE OF exiSTwG BLDG. SETBiCN LINE FROM 3 /� �- TEL. NO. LIC. NO. CITY LIC. �; NO. .�/�. TEL. NO i- TRACT OF BLOGS. IOW ON LOT cENren oF srA[[r � i�/ REAR YARD� SIDE YARD RIGHT� j y�EFT �� NEW ' REPAIR Di i�� ..i.i.- I USE OF NEW � DESCRIPTION OF WORK ALTERATION ADDITION MOVING DEMOLISH � NO.OF Q ROOMS ^ STORIES ROOF �C COVERING � 0`»/[ �I ). � _ /1 // 1 �[�� s��9[�� -�� .�� IR1Af�CE DEPT. APPLIfCATI O�N �FOR�PER M IT BUILDING FOR OFFICE USE ONLY PECEIPT NO, /PE �IT O G ECE 'D BY p E RECEIVE TE 1 SU �� Q BUILDING�%'i D _ / _ .� �w � .�/ ADD�7 al. W OYl ��/ COSTA MESA. CALIFORNIA DATE ECTIONS GF CC1.`^'n •^� .�^��\2�: :� /iL'`r'� , I MEREBV ACKNOWIEDGE TH�T 1 HwVE FEwO THIS �PPLIC�TION �rv0 "- ' STwTE THAT TNE �BOVE IS CORRER �NO �GFEE TO COMPLY WITX �LL CITV OROIN�NCES �ND ST�TE L REGULITING BVILDING CONSTNUC� TION. VALUATION $IGNATURE O � % � PERMIT FEE S � PERMITTEE � PLAN CHECK $ � AUTHORIZ AGENT $/ TOTAL FEE $ � � ��