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HomeMy WebLinkAbout233 21ST ST - Building Permits PROJECT ADDRESS:.. -233 21ST ST UNIT: I CITY OF COSTA MESA - BUILDING PERMIT PERM NO: G 044850 ' OWNER'S HOME: 'BRADFORD J. SARVAK i . T ^°QNEss: Am I PERMIT NO: G 044850 PLAN CHECK NO: 01359-89 S ' GOVT: N SUPP: N . 4 CONSTRUCTION TYPE: PERMIT TYPE: ELE MEC PLU STR PURPOSE: ALT ARCH/ENGINEER: REG.NO.: I JOB DESCRIPTION : REMODEL • SQ FT: 15, 700 ADDRESS: UNIT: CLAIM VALUE: 15, 700 . 00 CALC-VALUE: 15, 700. 00 GROUP OCC: R-3 / PERMITTEE: .RADFORD J. SARVAK ( 714 ) 955-1961 iwN* , • ADDRESS: 233 21ST ST • COMMENTS: TURN 3RD 6 4TH BDRM. INTO ONE LARGE BDR. CM CA 92627 *****ar+ ***+raE*yr****arae**�E�E****�E*�E****iE******�E******** ar >E+E at** r*'+ear�E#+E ****** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS - 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: . Date: Signature: MAIN BUILDING ACCESSORY BUILDING • WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: _FT IN RGHT: FT . IN POLICY NO.: EXP.DATE: • COMPANY: PARKING REQUIRED: PARKING PROVIDED: PARCEL: 42620226 ZONE: R1 f, Certified copy is hereby furnished. ❑ CeNlled copy is filedwdh the chi Building Division. PLANNING NOTES> APPROVAL FOR INTERIOR ALTERATIONS TO EXISTING DWELLING > .4: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed K the permit a fa one hundred($700)or less). DEVELOPMENT S E .R V I C E S R E Q U I R E M E N T S I certify that in the pertormance of the work for which this perm issued,I shall not employ anyy rson in any manner so as to become r , subject to t Wokers'Compensation Laws of California,,, / ZONING APPROVED BY : on ($7•E 6'I L� DATE: ,`0 6• __ Date: ' G r/y 5 Signature: 0.i ` `_/ ` • ROTI If,after mating this declaration,you should become subject to the orkers' mpensation provisions tithe Labor BUILDING APPROVED BY y'' DATE: , {Q p'2:11. Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. �-7 �� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: .1-�- • r DATE: 1 1-0 6 -C which this permit is issued(Section 3097,Dv.C). r ********************** -.V•- - (E 7f ff lE iF ik 9F iE if iF*1F 3F iE lE if it lF 3F iiPP**ik LENDER: ************************************ ,****************************************** ADDRESS: • LEGALIZATION:N F E .E , SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELvTRIC MECHANIC . ' FIRE SMIP/RES GRADING • (Section 7031.5 Business and Professional Code: My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 171 . 00 8 • 0 0 . 28 . 50 4 ,50 1 10 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed25% 5 0% 2 5% SMIP/NON-R E S pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ' and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN 111 . 15 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3 . 00 15 . 00 15 . 00 I, as owner of the property or my employees with wages as their sole compensation, win do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE D) structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 213 . 10 33 .00 111 . 15 357. 25 357 . 25 • .00 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 employees,provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold vnthin one year of completion,the owner win have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED : 357. 25 OVER/SHORT: 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK • + I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 171 . 0 0 11. . 0 D 4 3 . 5 0 19;. 5 0 1 . 10 1 1 1 . 15 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon - • and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State license Law).l am aware • *********************************.*******.*****..*****.*******.**.**.**.********.*{4.*.**.*..**. that proof of their Worker's Compensation Insurance should be provided to me. • INDIVIDUAL F E. E B R E A K D O W N ' ❑ I am exempt under Section: 8.&P.C. for this ason: HTYPE QTY DESCRIP T I O N • ' UNIT COST TOTAL COST -, Date: / L/0 truer�Y� D �A9-1MA\ SFR 15700ALTER BY VALUE RESIDENTIAL NOZONE 1 . 00 15, 700 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and ELE 16 FIXTURES, LIGHTING 1• ST 2 0 + EA. . 75 12 . 0 0 ' 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a ELE 7 R E C E P T/OUTLET 1 S T 2 0 EA. . 75 5 . 2 5 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. ' ELE 11 RECEPT/SWITCH 1 ST 20 EA. . 75 8 . 25 ELE 1 MOTOR/POWR APPARATUS ' 0 .0 - 1-.0 HP 3 . 00 3 . 00 Date: Applicant' MEC 1 • VENTILATION FAN CONN TO SINGLE DUCT 4 . 50 • 4 . 50 I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county P LU 1 BATHTUB _ 2 . 00 . 2 . 00 ordinances and state laws relating to building construction and hereby authorize representatives of 's city to enter upon the above-mentioned PLU 1 SHOWER t, 2. 00 2 , 00 property for hecionpurposes. PLU 1 WASH BASIN (SET) i 2 . 00 2 . 00 1 ` ��/�t�j �p-k . PLU 1 WATER CLOSET (TOILET) . • 2 . 00 2 . 00 Date: ` Signature: 1 Driver's License or Socul Security X: END OF FEES 164146 white-Building;Green-Code Enforcement;Canary-Applicant;Pink-Revenue;Goldenrod-Assessor - i • • -C.ChNSTRUCTION AND PLANNING 1. • POOL A APPROVALS Permit# Date _Jnspector APPROVALS Permit+ Date Inspector' f l if Temporary Electrical Service or Pole �,'�- 52. Pool & Equipment Location --- N ,-..J'I 2.+_Soil Pipe-Undrgrnd^ n_ 53. Steel Reinforcement IA.,3 -1 Conduit"Utility-Undrgrnd. - 54. Forms ' J .....1r 5. Electrical Conduit-Undrgrnd. 55. Electrical Bonding •,l5'. Steel Reinforcement 56. Rough Plumbing & Pressure Test n: vr 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE r•+7.1. Footings 458. Electrical Conduit-Undrgrnd. ,T,- - l..-_- 8r6. . Foundation I-•• 59. Gas Pipe, Undrgrnd., Test --• (v_ 9'. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. •' 10. Structural Floor System l • 61. APPROVAL TO DECK - 11. Propeity Sewer LirieI& House Connection / 62. Backwash & Receptor-Final "2 • 41 12. Sewer Cap %) 63. Heater & Vent-Final V ..--,b i 13. Roof Drains �. csi c.:di.' •� 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final I 15. Rough Electrical-Conduit '� �i 6. Solar System-Final ,4.‘� Electric 16. RoughT.Wirin9 / JJam- I �„LK.t>y� 67. Fencing & Access Approval \ 1 • 17. Rough Wiring Sign ```" 68. APPROVED FOR PLASTERING 1,8. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL 19)Rough Heating &_Air Conditi Hing ,yr, * 23 to d* * 7 c.•FIRE_REPT. REQUIREMENT rir, yr.-z,_;--r" r.. J '-'‘t-;.2, ., .a, -r v b• •J r ., st err rJ_%cr `1. * T 1,, _,-1..r fir,..:1r ' 20.7Rough Factory Fireplace SI-+ G¢ * s f, '24; ,: -APPROVALS,::-_Permit # -a-r.C'.r r:=e nr . 1-;-• tut- k H L.,* ♦• S '•^.H M ti r rn 21c-Ducts,irj�Structur.e': n* -,70. Under round Hydro , 22_Ducts, Ventilating:* r' *0 O: 1: * 471. ProductttP.iping •0 Gas OiOil - 23.'Gas:Pipa-Rough & Test [n5 * n C 'C O* * -D72. Underground Flush�� * `� H -. -.t••' :J H ': 7 V c' r, x > Lu rr C• ___•�- .� 24:'Roo`f Framing x,-,a1-40 :K _ 7 S r-,!: * ••73-:Undergrnd.Storage_frank OGas 000 y • 25. Rooi Sheathing _ „ r Y •' r ,_ a •-a:... `-J* t741'0'verf cad Hydro' ' " D-oo * rl rMeH ••:,, r: > V nM * J' y l `: V '. G' 'i fl QnutJC+.S 26.yT-Bar Ceiling (Structural) &`Menocoat_ * 0 �. O; M 75 Dry Chemical :-.:44•1 -.S S: _ '7 r•! artCnat C7 tea; 272-Frame and Flashirig- DMM ^ u � > d* * 76. Dry Standpipe F'm" * -- :741 -1 c -inc It-"L"--:":Zr: -I n r < .-i r. n >:* v: <!-4 . * 0 rj «,^^ G r-'.-,17 IX X28. Lathing& Siding_ :r OCT+ .4; * .n: L• _ F'. * 77:7 FIXED SYSTEM'FINAL* �n ran C cc' c c 29. Insulation * v -S ` - - I' %'r, • {y4-- k 78.:,ElRE P�REV. FINAL * ` ^ _ _, �.~ :,--. --,�_ n 1 c n7r •C n ...14_,., ss F'1 n r Y. E U P° r: •r7 m is u n'^r-- CQ ~30. Drywall Nailing :r, r, * p: xc Son: o H EA LT H-D.E PT,r RE Q U I R EMENT1 et~ C31. Plaster Brown Coat`? S ' �^ �" * rte, r^I J i;2 * ^79 FINAL INSPECTION` x - ns mr4 'A_ ,32 Electrical PoZr Me`ter-Final. Cam * �'' : I! f t%a• r FOOD CERTIF IcCATE ISSU.ED!., ,4; Qr. v1- ,,,,_ r a+ 5 .-..- - _ 335Finr. Electric• O' n • nn /k , r" s • i "tet n ��J" 1" id. - r•:1 m r -r e r, .-..-, n n + .1 .-r m�� :.'S 0:,-,•-: Z l Yo Y(f P,-'r C�YLVW l+" _73- E`34 Final Heatin & Airc.Con`ditionih' >'� a' L_ •14V* S 'n"� * ,� _ /l`7:G -" G.C�r' -. 3'J'Z_L- Q'1, . .�1�11�O 1! ]'-Jeui14� �ii_saw"' 35f-Final Gas Pipe-Test. C--- tn' r-•I ; fi * 7 K.� C7t-tru r; E,rJN:.... p��L�iy ••..• H r v� rtL. * 1 1.1 ft T' M '7 F.•1 w-4, �/�'/J�36._Hood or Canopy w : c y; �] ' -v /1"37 -Final Factor Fire lace%. i-• .. F * ! r tl Iet rt r_x'p"'.�r,_�( /J Q �/�y//ry�- n Y P r. .. .. ,.-. : n! I rr, r. a� (/U (� 1 W1" F¢4(�-^ 'r' 'a� :J• _ ..-, Tal Plumbi�9 C : ;-!r, G t(y/y; � x > r, r-�ru,� o u-s :(._ __ • `39 Water Service-Final z , * s 6 • I 1, .r N u L. V. S!-nG? ft ;.40. Gas.Service-Final! b7 art^ t<C x n i PE * ^:L-• - 'a `41.Solar Domestic-Fnal- -, X nr :c 42. Backflow Prevent r, r; ' j- ' w '' i� ' s O U ,> 43. Baokflow Irr,Igation JS * a x '_ - 1 77 _44. Iriigation System-r'!; `1 x r' C a* ` • H -',a 'j'' - � c a- _ is; - - C -45?-:Sound -Attenuation - •• ca- :r± ^:1. : ▪ q • FC =46.•HarjdirapRegulanghs 'c, c• `I .. : e x. ,47:FINA' L.STRUCTURE & BUILDING ��22'A�' I/P_ 1i -- - 48.7FINAL,PLANNIN4rn viiii rr ;:S c Ll %49.`.Elecfric`-Release to,-Edison ^,i r n11-'us•it: ,: ., y ci . • y -, - _ - 1 `ej50TGastRelease to Southern California Gas Co t: 'l1 . 'L.* . -. o \51. CERTIFICATE OF OCCUPANCY -- . •0. Date I� I • • • 11Applicant to fill in all spaces except those within heavy border lip wand sign all appropriate declarations. . ' TY OF COSTA MmeFs,a+ CONSTRUCTION ER PERMIT NO. a TRACT NO. �COnNO. UNIT NO. 7EF� 5/1 ' /C7 IL. . 03 rasr 2/& ger 841 I I I Proj "•Press •Apl .nt's Mailing Address e132* C/•'/N. (punk L,N pJ/7] TYPE OF CONSTRUCTION Q NEW U ADD Li ALTERATION ❑ REPAIR ' ,s p,�,� y ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name ` leAO 7 i+s� Phone s-070/ A.P.dp L�a� �'� - Zone �,� DESC TION OF WORK/USE OF BLDG. _ •�iJdress,22.3✓pE>�zr/��T f%_ w3T? MESA}_ 9Z�7 aUt rr rf jJ��/b S S . Main Building: Accessory Building: /S 'Ar.;h♦�n .. �• ^nw-lye Jy.� License No. uZ�7(onp7 TYPE OF PERMIT ❑ GRADING FOUNDATION III STRUCTURAL T Front - I .01'101 `- O 4. •Addrei3 •q5/ & ( JMlflb j&E&c- y T�nA2 e(A (C4PQ ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL - s BA Rear ,���•••��1 I N • Contractor's Name / '�Sf/� 7 S PhoneJOl--.11‘3 OTHER �Y ' Ad icess(mailin 127,}2!! Cfri-/ Gove,l.�) L N (4. 9�G7PROJECT DESCRIPTION SQ. FT. .3 C.5- OCCUPANCY C Ri I N g 7 1*' c, 1 bl Z(P03�P ,CONSTRUCTIONTYPE OCCUPANCY /(4 S Left City License No. R . . ZONE GING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION //s1/ Ping. Ref.# Parking1Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: ' \ I ca k 7S Pla nolo Notes: o p l}, ^ �'�/ �.1 0 with section 7000) of Division 3 of the Business and Professions Code,and s �•/ g ^"'fIJt Apo L b^"""-'—' M my license is in full for a effect. )'t"S .0.0'�' 0 T a License Class nse No.13/2674,1 s',v` S ` Date f51'7 Signature •-/d j .t' • PLUMBING FEES r iWORKERS'COMPENSATION DECLARATON Bar Sink Showers Illll I hereby affirm that I have a certificate o consent to self-insure or a certificate • ELECTRICAL FEES -( Workers' Compensation Ins nce, or Lsertifled copy th r of (Sectio Backflow Preventer Service Sink 00, Lab. ) ca./-24-W. �f„ ��" �j� 11 a!� Automatic Washer Transformer 0 15-50 KW olicy No. t QD-02g O Company ///LPays n Backflow Irrigation Sewer Cap ❑ 50+ KW Construction Pole Sub. / 8 Certified copy is herebyfurnished. l Cer left copy is filed with with thhe city,flBathtubs Sewer Connection Cooking Unit Meter pup to 100 amps Date `!" IT Applicant aS Y EXEMPTION FROM WORKERS'COMPENS DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (Thissection need not be completed if the pe it Is for one hundred ($100)or less). Dishwasher Solar Piping Dryers OGas ❑Electric Sub Panel I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to te Drinking Fountains Solar Tank Fan Motors 00-1 HP W-1i5-8 Workers' Compensation Laws of California. _ Date Signature Floor Drains Swimmin Pool w/S a NOTICE:If,after making this declaration,you should become subject to the 9 p p0 F.A.U. Inc.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heaterts Outlets Lender's Name Range Lender's Address Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or y 9 P Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair ,KP-Trap LaundryTrays any structure, prior to Its issuance, also requires the applicant for such permit 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 - Q D-P 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 131.5 by any applicant for a permit subjects the applicant to a civil — natty of not more than five hundred dollars($500). J 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 $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES - License Law does not apply to an owner of a property who builds or improves ___ __ _ __ - ___ thereon, and who does such work himself/herself or through his or her own - _ - a DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 f 4. 5•S•8 / sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By ..Aa ........L Pate sa�f'a pletion, the owner will have the burden of proving he/she did not build or Un- - Duct-Under Ground Building Approved By oar Date 7 prove for the purpose of sale). ❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Saki ral Refrigeration System Application Issued By - Date (//r7 tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU SU M RV F 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 Multip ■ System Repair/Alteration BUI LDING PERMIT $ Pnik r 0 SMTP $ Z /Z proof oftheir Worker's Compensation insurance should be provided to me. _ - '' PLAN CHECK $ "/S /q 3 PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# ire Dampers PLUMBING S :al? ISSUANCE $ Date Owner Heating System& D4ng Regis PLAN CHECK 25% $ n ENERGY P.C. $ _ I hereby certify that I have read this application and state that the above ❑o-100,000 BTU 0,000 BTL ELECTRICAL $ (�«O J GRADING $ information is correct. I agree to comply with all city and county ordinances 'I' and state laws rela ing to building construction, and hereby authorize repre- 1 PLAN CHECK 50% $ 4. MICROFILM $ sentatives of t i. city to en er upon tr- above-mentioned property for I inspection p .$1'4.. • y /. / - MECHANICAL $ TOTAL FEE $ Drivers'Signer �_ /�vData Jam'!/" 7 Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ (1.60 License or SS • - CMF 0865-46,rev.10/84 White - B.ilding; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor I CONSTRUCTION AND PLANNING POOL & SPA Date Inspector APPROVALS Permit # Date Inspector APPROVALS Permit#,• 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location jl/67 0 e. 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement AM 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. 7i 57. APPROVAL TO COVER-GUNITE SIV it 7. Footings 58. Electrical Conduit-Undrgrnd. 410 os4 8. Foundation 59. Gas Pipe, E�fds(ndrgrnd.,Test i; et Q? 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- I /rvlf g•7 V �1 13. Roof Drains 64. Plumbing System - Final t t/g"j A-i4- • 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval /pI Q? bit 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ""-/O f r7 Do- i 4IICI - -_ 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 174. Overhead Hydro ac, - P 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .. le 27. Frame and Flashing 76. Dry Standpipe .. 1 , 28. Lathing& Siding 77. FIXED SYSTEM FINAL 1' 29. Insulation 78. FIRE PREV. FINAL 4 <t 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: 34. Final Heating & Air Conditioning 9i2 7ts4.920....o en ® AA- 35. Final Gas Pipe-Test R 6 c it/31 D,� ` • i `^' &e ,6(_ _�'+36. Hood or Canopyr `J /v ( *r` 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. Special Requirements Completed . 49. Electric Release to Edison - ,t 50. Gas Release to Southern California Gas Co - • :AL:- 51. CERTIFICATE OF OCCUPANCY - No. Date _ _ r7 e Ill Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6195 3/04/98 CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 3000(] TE. Project Address233 East '21st .t. 1 1BEP28419 4524 2 Applicant's Mailing Address 213'24 Camino Capistrano, Ste 181 TYPE OF CONSTRUCTION n NEW U ADD LI ALTERATION U REPAIR Brad Sarvak 645-0701 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ A.P.# I Zone Owners Name Phone DESCRIPTION OF WORK/USE OF BLDG. Address' . 223 E. 21st St. Costa Mesa, Ca. 92627 Gunite Pool/Spa S Main Building: Accessory Building: Arcle D. Kramer License No. 326760 TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front Zo Adtliess 451 El Camino Real, Tustin, Ca. 92670 ❑ TENANT ❑ ELECTRICAL. ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name Mission Pools Phone ❑ OTHER A IN Address(mailing)27324 Camino Capitrano,L.N. Ca. 92677 PROJECT DESCRIPTION SQ. FT. 305 OCCUPANCY K ' g t G 26036 CONSTRUCTION TYPE VALUATION$ 16,000 s Left —, R City License No. ZONE GRADING CU.YDS. ACRES . LICENSED CONTRACTOR DECLARATION ping. Ref.4 Parking Req./Provided E Jt Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: P.C. #269-875 Planning Notes: with section 7000) of Division 3 of the Business and Professions Code, and M my license is in full force gi effect. �- ,ter— T 9! C +e S License Class is e N 760 r"'� S l d Date Signature a`aC+ Y v-c"'i�-1 ,Ate..----- PLUMBINN FEES R WOR775� S��1C,O a': NSATION DECLARATION 3,1ifereb1'affim, Mr* have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES Workers' Compensation'Insurance, or a certified copy thereof (Section — X200, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No. PWC 40-028880&mpany CNA—BRED Co Backflow Irrigation Sewer Cap ❑ 50+KW Construction Pole Sub. 8 Certified copy is hereby furnished. Certified copy iii'lellwjlh the city [7y II0in9 iv'sio�l ,- •p Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date 7 t0// pplicant b C _ EXEMPTION Clarifiers Solar Collectors RS'COMPENSATION Done •N Dishwasher Meter Dover 100 amps (This section need not be c plated if the permit is for one hundred (Siff •r less). Dishwasher Solar Piping I certify that in the performance of the work for which this permit is issued, I p g Dryers Gas ❑Electric Sub Panel shah not employ any person in any manner so as to become subject to the Drinking Fountains Solar TankFan _ Motors 00-1 HP 011/2-6 Workers' Compensation Laws of California. _ Date Signature Floor Drains SwimmingPool w/Spa ' NOTICE: If,after making this declaration,you Shouldbecomesubject to the 1 P 3 ]Q F.A.U. Inc.Solar.❑8-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. Fixtures . Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light 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 Water Service Switches "Sign OWNER BUILDER DECLARATION I hereby affirm that-i-am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbo a Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9Standing Sections county which requires a permit to construct,alter,improve,demolish or repair X P—Trap Laundry Trays Generator ❑05 KW❑5.15 KW any structure, prior-to its issuance, also requires the applicant for such permit Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt ierefrom and the basis for the alleged exemption. Any violation of Section 331.5 by any applicant for a permit subjects the applicant to a civil analty of not more than five hundred dollars($500). LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee I $ 3 — compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Secion 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a Property who builds or improves thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended Or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date prove for the purpose of sale). - 0 as owner of the property,am exclusively contracting with licensed CodeDuct-Structural Refrigeration System Application Issued By Date 3—W� tractors to construct the project (Section 7044,Businessand The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU ❑100,000 BTU L builds or improves thereon,and who contracts for such projects with a con- Re` t3'' I/.� J ler SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration G ERM! SO.OD SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBO 4 Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System&��ycting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00-100,000 BTU1i 100,000BT GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the, - • e-mentioned property for PLAN CHECK 50% $ inspection purposes. Gary cCounting; Goldenrod - Assessor ,1 CONSTRUCTION AND PLANNING POOL& SPA 1 APPROVALS Permit# Date Inspector, APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • '3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60: Backwash'Lines, P-Trap,.❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property SewerLine & 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'D 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. 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: 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test r) 1 36. Hood or Canopy r 1 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 sin els 12)9._ • 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. CITY OF COSTA MA CQNSTR U,CON PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. 6500 10/01 /8] •Project Address __2r -7) i• JI " 5irctt Pa 3� 55 4 145z^lr/� ' Z - 1240 TL rtt's Mailing Address ?t�24 C jetO f1p fEW 9� TYPE OF CONSTRUCTION LI NEW 1--1 ADD U ALTERATION LI REPAIR Appli<a �• f 1 LI CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# II Z&"Zc-z. --44, Zone ,Owner's Name RfYjd SaeVa1's Phone_.10_45_.—_6.10 DESCRIPTION OF WORK/USE OF BLDG. �(CL✓ Poi"'els •.•Address' —.1,— • e a a...1 •t. I t S Main Building: Accessory Building: E Z ArchLLTg: 4110--.—` rArsler License No. 3zlf1`i6d TYPE OF PERMIT GRADING H FOUNDATION [-.1 STRUCTURAL T Front . 0. Address�4s51ft y/AC,,Court:AA Beer /-j-ps- ;Apte 926gb ❑ TENANT RI ELECTRICAL ® PLUMBING ❑ MECHANICAL AB Rear N Contractor's Name!t%S4 h Pmts Phones 33 ❑ OTHER Address(mailing) Z•)3 z� !'tks ma Ca •f tea L. PROJECT DESCRIPTION SQ. FT. OCCUPANCY C RightfN • G �rs� CONSTRUCTION TYPE VALUATION$ S R City License No. Z 603 s2617 ZONE GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION p �/ �]. ,f Ping. Ref.4 Parking Req./Provided I hereby affirm that I em licensed under provisions of Charter 9 (commencing Remarks: REF. a s P (, a 4./ 7 Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, andT my license Is in full fort and effect. 3 1Z 6760 T - Licensgg Class 53 _ Lic se No. Q7` Date "td.fa Signature kj_a. $2 PLUMBING FEES I WORKERS'COMPENSATION DECLARATION ' Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure a certificate ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink ini�• 500, Lab. ) ._1sA�a'�gyp�pp�!� / I, `` _ Automatic Washer Transformer 0 15-50 KW Policy No. Ic- tsJ y-}�pxJ6lompany GN4 Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW ACertified copy Is hereby furnished. CertJi,ffiegL �}''copy i iill4d with the city wilding Divisio . Bathtubs Sewer Connection Cooking Unit Meter Our.to 100 amps Date `�� 1I Applicant ! - • EXEMPTION FROM WORKERS'COMPENSATION DEC LAR Clarifiers 1 Solar Collectors - 3 co Dishwasher Meter Dover 100 amps (T is section need not be completed if the permit is for one hun•.• $100) or les,. Dishwasher / Solar Piping 2 DO Dryers ❑Gas DElectric Sub Panel I ce ify that in the performance of the work for which this permit is Issued I shall -t employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Worke ' Compensation Laws of California. Motors❑0-1 HP ❑1'h-8 Date Signature Floor Drains Swimming Pool wlSpa - `— F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: after making this declaration,you should become subject to the Workers' C• pensatioh provisions of the Labor Code, you must forthwith , Floor Sinks Urinal Fixtures comply with such Provisions or this permit shall be deemed revoked. Microwave CONSTRUCT •N LENDING AGENCY Gas Service Outlets Water Closet Device Boxes Pole Light ' I hereby affirm t'at there is a construction lending agency for the performance of the work f• which this permit Is Issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets Range Lender's Name Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER D.CLARATION I hereby affirm that I aw exempt from the Contractor's License Lfor the Lavatories Auto-Wash Garbage Disposal Standing Sections following reason (Sectio 7031.5 Business and Professional Code: Any city Or county which requires a p. mit to construct,alter,improve,demolish or repair P=Trap Laundry Trays Generator 00.5 KW 05-15 KW Trash Compactor any structure, prior to its i -uance, also requires the applicant for such permit to file a signed statement th- he/she is licensed pursuant to the provisions of Roof DralnS the Contractor's License Law hapter 9 (commencing with Section 7000) of solar coml. to Mob:Ir 1 00 Division 3 of the Business an. Professions Code) or that he/she is exempt • '•erefrom and the basis for the . leged exemption. Any violation of Section 131.5 by any applicant for a •ermit subjects the applicant to a civil malty of not more than five hundr• dollars ($500). 1.1 $ 3 I, as owner of the property or employees with wages as their sole Reinspection Fee I $15 Issue Fee • compensation, will do the work,and t structure is not intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and • ofessional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner o a property who builds or Improves thereon, and who dots such work himself •erself or through his or her ownDEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvement •re not intended or offered for Boiler Hood or Type I 0 Zoning Approved By sale. If, however, the building or Improvemen s sold within one year of com- Canopy Type II ❑ Date pletion, the owner will have the burden Of prov .g he/she did not build or im- Duct-Under Ground Building Approved By Date 7 prove for the purpose of sale). GO•-/-8 IDI, as owner of the property,am exclusively co acting with licensed con- Duct-Structural Refrigeration System Application Issued By Date tractors to construct the project (Section 7044,Busin_ s and Professions Code: The Contractor's License Law does not apply to an .wner of property who Duct-Ventilating Do-loo,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon, and who contracts for su • projects with a con- tractor(s) license pursuant to the Contractor's License L. ). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should •e provided to me. _ PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P. .for this reason Firepl/Fact.Blt. ICBG 4 Fire Dampers PLUMBING $ B a ISSUANCE $ Date Owner Heating System& Ducting Registers - PLAN CHECK 25% $ ENERGY P.C. S I hereby certify that I have read this application and state tha' he above ❑o-100,000 BTU 0100,000 BT ELECTRICAL $ ¢. •�O GRADING $ information Is correct. I agree to comply with all city and county o •finances and state laws relating to building construction,and hereby authori repre- _ PLAN CHECK 50% § MICROFILM $ sentatives of this city to enter upon the above-mentioned prope for inspection our ses. MECHANICAL $ TOTAL FEE $ 12 ` o0 Signature _ ,e.Mlt-j� Date jam. 'IS License or SS Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ `MF 0865.46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND,PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# - Date Inspector 1..Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test • 6. Electrical UFER Grnd., 57. APPROVAL TO COVER-GUNITE 7. Footings ' - 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line.& House Connection 62. Backwash & Receptor-Final . 12. Sewer Cap 63. Heater & Vent-Final - 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final _ 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 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# r 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 O 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 r. i 28. Lathing & Siding 77. FIXED SYSTEM FINAL ' , '1, 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT t. . 31. Plaster Brown Coat 79. FINAL INSPECTION - , ! 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric ,3/./,/ge Dit Notes: 34. Final Heating & Air Conditioning - t - 35. Final Gas Pipe-Test 36. Hood or Canopy r' 37. Final Factory Fireplace .,. 38. Final Plumbing 3///A7 Ar/ • ''• : •i. ,.' • 39. Water Service-Final 1., - 40. Gas Service-Final i ' I - ;7.1 1- ; 41. Solar Domestic-Final- I r. I ., - 't42. Backflow Preventer i 1_ ' a ; ;,• f 5 43. Backflow Irrigation . ). ` i � i . 44. Landscape Irrigation System �' I,�� �.• •`" I /15. Sound Attenuation , '%,n'C( 1, I •i` r- - - v ,n.1 .. 1 46. Handicap Regulations �� I' r. "'. 47. FINAL STRUCTURE & BUILDING ! ' I ' • I 48. Special Requirements Completed t.• '.. I, . . - 49i Electric Release to Edison - t-'. • 'el Gas Release to Southern California Gas Cov • Q. CERTIFICATE OF OCCUPANCY .. . • „.K No.' Date - - ' . ' ` Component identification . L • 1 `r1 • • ` ....... VACV OM RELIEF ry/ d�,,_ --_OP TIE DOV:NJIK SHORT COUPLER $2 TOP HEADER LONG COUPLER(Q PANEL BODY S I RAPS /���I • • PANEL BODY "����y ,y ,Q,'{ --- / �� Y V� j�..';;/,�+ �� Miy��� f j ys> ,r '3• ` / /At-.' lV / / T'Y .+r+, / r. .yy,v' ,art -Laj / 1 ift xe 'rti'-',• . ,4-t;" END CAP _ r .F yA Hyl r(1j�yE', SUN SENSOR / !rf SHORT COUPLER / SUBS1 HAIE -. BOTTOM HEADER .: .lAt / 0 C•LONG COUPLER • r ,• • 1---- i � � ®��® .1----- -----City e# -os a .a Building Dept. . . a � BY D41 a (o r( 1 921 AUTOMATIC O CONTROL P NEL B9.0 Y THESE,PLANS MUST BE N 6�,}f r�wi.MES MAKE \ �y BALL VALVE '—"— fOCIRANPES'WIT-HOt1D•RIOR ABBRGVP,L OF DEPT. • ./r] I } /� pE3OSl' c �' 4 Ttiq!S5U->NCE OF. GRANTING A PFRN�IT OR APPROVAL OFTO lip or 220V- ,1 BALL VALVE I',..N3 AND S'rECIF:CATION55 .i L PUO[SE CON'STP.U'.D TO BE A .; - -�'� TEE _"q_j:41T FOR. OR AN"AF%RO'vA O', ANT/Tn'TLhia�ThPF ANY OFT-- A a WAY THL PIOVISiONS OFTKS CO. ,^l� I:r?ICIM &TIE'OO$NS GIVE �`\CHECK . FROSs ��yp�t HEATER -- -�{ AULl,ORITY TO Mi•OLAT:[ OR jR T1EeRhtKtTONS OE THIS \VALVE I I Y' "' Y COTE SHALL BE VALID, EXCEs {''.i t. FAR AS THE. WORK OR USF \ \ � 9 d r `rrt"CH IT AU1HO51iia IS LAW,el. FILTER VALVE in A-. ! WATER ?%+E ISSUANCE Of A PER,HT BASED UPON PLANS AND �� sENson Fr.".! TSHALL NOT P WENT THE BUILDING OFF CIAL I ' a FICA.!ONS �,�. . E9 - Lal5 .PLANS AND SPLCIFICA *kw ORT . ' EVEN INC I(III - pF' .,....„ •,•.:RUING OPERATIONS BEND ARRIEry1h'Ob �E1NDER V,HEN I r2r- çlsNE y 'ntr.•ll n!:OH OF Lm CvC=Q OF AI!'Y OTNco rTODINe Nf� (Oraon118 DI IT eawy3Wlatl // �' �- EXHAUST �' Panel Body Dimensions 1 �jti?�4� _SINE i j:' PUMP • `�_ ;., , (714)364-1305 (( In . / .... r1T cwic o0 /ollarr T0POOL ` S; �" ErnnglirraccUung. Unc. - 1'- ' FROM POOL ' Conuactors 27972 Forbes Road, Unit A ----'i Loc. r 387219 Laguna Niguel,California 92677 • • • FAFCO SOLAR HEAT EXCHANGER DESCRIPTION: The FAFCO Solar Collector is manufactured in Menlo Park, California. The collector is a specially developed, highly stabilized polyolefin and is of parallel,circular channel design. It is unglazed, uninsulated,and designed for low temperature applications such as swimming pool heating, heat pumps, aquaculture and hydroponics. DIMENSIONS: Header length: 51.5 in. (1.31 m) Width: (Panel body)=47.5 in. (1.21 m) Overall. 4 ft. X 8 ft. (1.22 x 2.44 m) Effective area: 30.8 ft2 (2.86 m2) 4 ft. X 10 ft. (1.22 X 3.05 m) Effective area: =38.8 ft2 (3.60 m2) ROOF MOUNTING SPACE: Width= (Number of panels X 51.5 in.(131 cm)] +24 in.(61 cm) Length=Panel length+24 in. (61 cm) RACK SPACE Width = (Number of panels ):51.5 in. (131 cm)] +2 in. (5 cm) Length=Panel length+6 in. (15 cm) FLOW: Maximum recommended flow=8 gpm per panel 3.53 psi head loss (1817 1/hr, 0.248 kg/cm2) Minimum recommended flow=3 gpm per panel 0.50 psi head loss (681 l/hr, 0.035 kg/cm2) Recommended flow=4 gpm per panel 0.88 psi head loss (908 I/hr, 0.062 kg/cm2) PANELS PER BANK: 12 panels single end feed (maximum) 17 panels diagonal feed PRESSURE: NORMAL OPERATING MAXIMUM INTERMITTENT PRESSURE PRESSURE 80°F (27°C) 0 to 30 psi 45 psi (0- 2.2 kg/cm2) (3.21 kg/cm2) 212°F (100°C) 0 to 5 psi 5 psi (0-0.35 kg/cm2) (0.35 kg/cm2) 70°F (21°C) Measured burst pressure of panel body=700 psi(49 kg/cm2) TEMPERATURE: Normal operating temperature =60°F to 90°F (16°C-32°C) Maximum continuous operating temperature=212°F(100°C) Maximum intermittent temperature (unpressurized)= 250°F (121°C) Melt temperature =338°F (170°C) • . • CHEMICAL RESISTANCE: Compatible with common collector fluids • CORROSION: Non-corrosive FREEZING: The system should be drained before freezing. WEATHERABILITY: Weatherometer, accelerated outdoor exposure, and other extensive laboratory testing demonstrates long-term weather- ability of FAFCO collectors. (See warranty.) WEIGHT: Without water= 19 lbs (8.6 kg) or 0.47 lbs/ft2 (2.3 kg/m') (4' X 10') Full of water=53 lbs (24 kg) or 1.33 lbs/ft2 (6.5 kg/m2) ABSORPTIVITY: 0.96 EMISSIVITY: 0.90 TIME CONSTANT: 64 seconds PERFORMANCE CURVES: • EFFICIENCY 1.00 - MEASURED EFFICIENCY INCIDENT 1.0 90 - Average flow rate 3.7 gpm (840 /hr) ANGLE Average wind velocity 3.7 mph (6 km/hr) MODIFIER INCIDENT ANGLE 80 - CHARACTERISTICS .70 \� 9 - .60 - .50 .40 - .30 - .20 - • .10 - 0 .7 0 .04 .08 .12 .16 0 .2 .4 .6 .8 .10 EFFICIENCY 080 EFFICIENCY VS. FLOW PRESSURE VS. FLOW (for typical conditions) HEAD LOSS (feet) 8 0.70 - 6 0.60 - 4 2 0.50 0 1 2 3 4 0 0 1 2 3 4 5 6 7 . FLOW RATE(GPM) FLOW RATE (gallons per minute per panel) Additional test data available on request P/N 02756 Rev.31a1 _--) THE FAFCO SOLAR SYSTEM. • . ENGINEERED FOR HIGH PERFORMANCE AND DURABILITY. THE FAFCO SOLAR Full-wetting and a high, COLLECTOR SPECIFICATIONS • COLLECTOR even flowof water through the Sire: 4 ft.by 8 ft.or 4 ft.by 10 ft. collector means that PAIinfective Area. 30.8 sq.ft.or 38.8 sq.ft. At the heart of the FAFCOcollectors (under normall co condi- header Length: 51-1/2 in. Solar System is the unglazed, tions)can transfer between 75 Header Diameter. 2-3/8 in. polyolefin solar collector.It and 90 percent of available heat Designed Flow Rate 4 gpm per collector for optimum is black in color too absorb the energy to circulating pool water sun's energy most efficiently. for maximum heating efficiency. efficiency The color isn't just painted Head Loss: (3 gpm = .50 psi)(4 gpm = .88 psi)(8 gpm = 3.52 or layered on"—it's the actual ,,,„..,,c..s mwP,•ro.. psi). Collectors plumbed in parallel for low back pigment of the collector—so raaea -- pressure/high flow-rate system it can't fade,crack,or peel off. suoo • Collector Temperature. 60°F to 90°F (normal operating Hundreds of tiny channels aoro temperature).212°F(maximum or tubes make up each collector, operating temperature) allow•inpool water to touch r'0°° Ce.-7Collector Normal Operating Pressure: 0-15 psi at 80°F. virtually every square inch of O.oco [ 0-5 psi at 212°F the collector's energy-absorb- novo Absorptivity. 0.97(from 0.3 to 1.8 microns) ing surface.This is why the Emissivity: 0.90 FAFCO collector is called a"full)'- ..eco ha— Time Constant: 64 seconds wetted"collector.Full wetting ;000 of the collector surface ensures ' .r. .11.' SYSTEM CERTIFICATION AND TESTING that the sun's energy is trans- ,nod........,....-/----. The FAFCO Solar System has undergone extensive certification ferrel from the collector to o and testing—perhaps more than any other pool heating system: water most efficiently This is a s so ,d =o ad 30 35 40 .s Certified Date why the FAFCO collector stays n..tor-Tool 24 Hour 4+°0• UL(automatic control unit) 3-79 cool to the touch when the Swimming Pool Daily Thermal tosses 1APNIO 3-76 FAFCO System is operating. Versus Average Temperature If it felt warm,it would mean Differences and Wind speeds DADS COUNTY 8-83 that energy was beingwasted. (Average Humidities) Test Location 'dye Date „„00,,,_r,,, DSET, ASHRAE 93-77 12-78 o Phoenix,Arizona Obit"'. __ ■ ■ OM s sans A IN Lockheed, ASHRAE 93-77 8-78 EM F.111111111111111\14%4 MNUII \ ■■■ .■ ■ Sunnyvale,California �� �` �_ Comair Wind-tunnel testing 12-78 .y 3IMn AMS �� ��� o nr a San Diego,California at 120 MPH. •� ' Eel...: w '■■■ :,•■■�■ In addition,the FAFCO system ma .nun►. it. r spflssi�. y PATENTED DESIGN MRSIMMOMMNI\ Q �r^7 has successfully passed tests for •��. �••••/••�► ■ o ��� static burst,hail,fire,and other As of 1985. 19 loreign o . 2 a . s 0 2 s a .o environmental hazards. and domestic patents had .a .a a w a .42 .14 A _. Ho.Awe Can Pot Minute. been issued to FAFCO on the d,.\ m 'faro n•-Ha roan Pon*,has toy a.hood an n 04.3.a flow at. - PA PCO SolarSystem and on P. a r.m,Cna,ong tor.waw 0.1. 02•14hmo.e PO. Computed FAFCO 1ND/cnel Head Loss vs Flow Rate ` the company's state-of-the-art EH-kink:4n With wind Speed FAFC,rI Sole Ilea raehanger a manufacturing equipment. as a Parameter u '6 M Water Flow Rate= 16 GPM r—.,tl'--..r•'‘..a.�. .._,......—• LY\. • FAFCO.Inc. 235 Constitution Drive Menlo Park,CA 94025 'Telephone•i 15/3213650 - .' . Represented by ��� • • G'D Participating Member National Swimming Pool Institute CI* Energy Awareness Program I i R. WiIIMMUMIel. MIU t 7 i A . i iit i 1 i lc _s Dccc. _5' ■ I. taSI D*CE OWNER: ---r-:(.,--c-r.: 't}`i- POOL AREA TO POR CITY . Loi- ' Z-' CLOSING AND SE 'c=*, 1 .-4 WET DOWN CONI TWICE DAILY FOR 1 .d 3L--- DO NOT TURN C POOL IS EMPTY. 611251: p=�r DECK DRAINS TO ' (UNLESS NOTED.) MISSION NOT FRONT SPRINKLER SYST WISE SPECIFIED. ELECTRICAL MISSION NOT Rh I I ROUTING OR DPW G ® ® H — NEATER PLEASE DO NOT © P — PUMP POOL IS FILLING F — FILTER CENTER OF TILE LI HH G — GAS STUB MISSION IS NOT VERBAL AGREEMEI ® — PLUMBING ALL ITEMS ARE LIS'. SIGNED NDARD EQUIPMENT ICS/ACCUPA ESS A35316 Ltui4bier Tb?c. t4�s 404 Pitch T5?.e. aF 6,07 r 333 l st _ 1000/5 Cos / J "'wy (Jet 1y (110017 p • ' N mp ,, Hirt& • ojoss -- - TI /J ~r 6NG/..r CuG6/4 r 1 1 - - -d i Cl -7 tel Sinc� VY' / fMS I YG — / e-1 "0 Q C a LIP oh c �h yr ,+ pit4 / U IoHs 1or � GAS rari0 is "./7 • �r • r /1j,1 ISI ISI 12,4 n Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6163 9/26/67 5050 TL . CITY OF COSTA MESA CONSTFICcTION PERMIT - PERMyr�°� 5 TRACT NO. LOT NO. UNIT NO. ddress 2-3-6 21 JT - (' cJ cant's Mailing Address 233 Zt Sr. TYPE OF CONSTRUCTION ❑ NEW H ADD H ALTERATION LJ REPAIR G�j�,{� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone , ner's Name S�2VRI�. Phone �33 If3� DESCRIPTION OF WORK/USE OF BLDG. — Addtess 233 2-I sr ✓I I-CGI S Main Building: Accessory Building: Arch/Eng. License No. — TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION T O LLU STRUCTURAL Front �� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Address A I ❑ OTHER Contractor's Name Phone C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCYK G Address(mailing) CONSTRUCTION TYPE VALUATION$ S Left City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION _ / q Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: wnAw C� lit' ���[[[ K (�/ Planning Notes: M with sectionis 7000) of a and 3 of the Business and Professions Code,and f+V�"Y (//).r`r !kE! P aq/i9 ` T my license is in full force and effect. C61 J License Class License No. $ Date Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES hereby affirm that I have a certificate of Consent to self-insure or a certificate '--' Workers' Compensation Insurance, or a certified copy thereof (Section ..—.--_______ Backflow Preventer Service Sink • .',2$00, Lab. C.) Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW ❑ Certified copy is hereby furnished. • ❑ Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter 0u to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps • (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel - I certify that in the performance of the work for which t - mit is issued, I shall not employ.any person in any manner as o becof-ubject to the Drinking Fountains Solar Tank Fan Motors ❑0-1 HP 01%2-B Workers' om a sa on Laws of California. �— Date __ Signature - Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: f,after making this declaration, you sho Id become subject to the Workers' Compensation provisions of the Labor ode, you must forthwith Floor Sinks Urinal Fixtures I I Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY ' Gas Service 1 Outlets Water Closet 20 Device Boxes Pole I hereby affirm that there is a construction lending agency for the performance Light of the work for which this permit is issued (Section 3097 Civ. CJ _ Interceptors Water Heater . Outlets Range Lender's Name Lender's Address Kitchen Sink Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage DisposalStandin g Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair_• - P—Trap LaundryTrays Generator0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit y Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of'- Roof Drains the Contractor's License Law (Chapter 9 (commencing with Section 7000) of '" Division 3 of the'Business and Professions Code) or that he/she is exempt -- — •erefrom and the basis for the alleged exemption. Any violation of Section • 131.5 by any applicant for a permit subjects the applicant to a civil epalty of not more than five hundred dollars($500). /-I, as owner •f the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 cam.• atio // ill do • work, ... the structure is not int-•tletl or offeI Reinspection Fee I $15 Issue Fee $ 3 for ale (5••f''on 7:•4, Busi - a d Pro .. 'onal Co.,. •e Cont • s MECHANICAL FEES Li ense f•doe of a•ply • an o ner : a • opert • o b.dds • po•ves _ t ereo . d a doe• s wor h'- elf/h-rself • thro .h or he own DEVELOPMENT SERVICES REQUIREMENTS: -mill.•e• , • •vided th• such i• • •vemen . a - not intent-• or offered-for Boiler Hood or Type I 0 sai• If, .' ever, the building o mprovem is sold within one year of com- Canopy Type II 0 Zoning Approved By Date • -tion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground 0Building Approved By Date •ve for the purpose of sale). t dI, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat '/t ors t0 construct the project (Section 7044,Business and Professions Code: ' Th• 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 ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. _ - PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO# Fire Dampers • PLUMBING $ ISSUANCE $ Dater Owner Heating System& Ducting Registers I ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have read this a 1 anon and state that the above ❑0-100,000 BTU 0100,000 BTL GRADING $ information is correct. I agree to comply ith all city and county ordinances ELECTRICAL $ and state laws relating to buil• nstruction, and hereby authorize repre- MICROFILM $ sentatives of this city o en'• •on the above-mentioned property for PLAN CHECK 50% $ �.�D inspection pur•-. �� �; MECHANICAL $ Signature �;r ' ., - Date 7 TOTAL FEE $ _ CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION ANd PLANNING POOL &SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit#. -- • 1!temporary ElectricaLS�rvice 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, 0 Undrgrnd., Test 9. Water Pipe-Undrgrn¢.L;. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final • 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing _ 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 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 :�I 22. Ducts, Ventilating 71. Product Piping 0 Gas O,Oil 23. Gas Pipe-Rough & Test 72. Underground Flush ' i(17 24. Roof Framing 73. Undergrnd.Storage Tank'0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,��• 27. Frame and Flashing 76. Dry Standpipe ' r 28. Lathing& Siding 77. FIXED SYSTEM FINAL t 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 t', 33. Final Electric Notes: (-1 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test SH88 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 & BUILDING 481 Special Requirements Completed. 49. Electric Release to Edison:' 501 Gas Release to Southern California Gas Co 51. CERTIFICATE O .•0000PANCY,- •• No. Date -- _ ' Gun, - , REPORT OF INSPECTION ON Masonry • Concrete p �\ \\� To: V¢ Yom/ L �F. 2} �r cfc�f��F ` Address : 77 (.9 , e 7r, e0.3 74 lesn \ A OWNER: tSAeJA K ! PROJECT: .S40249,y1i ,JG DL i.L/S'�R Report No. _ i- - Address : 4213 Li .ai sr S'' �i Al • Permit No. $,2?F c.,I2//1 . Architects • Contractors ///t 55ic).J -Teo LS i Address: Address: /IA&'de/A ,V16-+4r L Engineer: Te`./K9A)ck Subcontractors I-4) /!lace•eco., ' (Gunite, Address : Masonry or S.,J ire • Concrete) Address: 141-9/Ate1ticf%Pf- Mix Used: A4%.5-- / Rebar: Slump, Inches: - Admixture: Brick: ' Designed Strength, PSI : c9e o� Inspector: lm � •:1-0+5- 61-4j Block: o`l.$) cF63 -6ovcj' The following Inspection was performed in accordance with the approved drawings. Cu.Yds . No. of • DATES Placed Cyl . • Remarks . -.c/.,-,f- c 7 _ 4 e4eeaX✓e73 - 0,-..S. 7-- ?. .4NL5. �eG, _______ A31Z_ s .._.___ • se :c: ,,,p,A.i fir, A A. G7 r �z[.cl i rt., 4 4e- 4.) e- � t fir then Leie,y7 /..d ,4 cS---mac FicrvFy /114A/tie r , , 0oL F -R Irece.il7 2eq ,- ie) C &swis %, . 1 Copies of Reports to: (INDICATE WHICH BLDG. DEPT. i FURNISH ADDRESS OF ANY NOT LISTED) / day :at- G c -sTVE, - Om 7-4 /Iecr Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. WA MESA CONSTRUCT ION PERMIT PERMIT NO. • TRACT'1N LOT NO. UNIT NO, 9326 6/09/E7 �� pr�r ' Z 33 Z 1 S '4TReer B 2 g7l� Z ^�CyrJ2� r1'(1 2 TYPE OF CONSTRUCTION . NEW U ADD LJ ALTERATION ❑ REPAIR ing Address Z33 zlYIZ� T .�!! •�f �'yz� /— pIZgD SARdgIL Phone rOTDI CONVERSION ❑ DEMOLISH ❑ OTHERA.p. A � �� J�2 2 S �(� Zone I``,�,,..'� DESCRIPTION OF WORK/USE OF BLDG. S� f'1<- r� Address 7r 33 atm 5-' 'r 1 • .4 pLaCJ_' e- _ E Main Building: Accessory Building: Z Arch/Eng. License No. ,TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION STRUCTURAL T Front. D Address - ;a-OTHER ❑ TENANT DI ELECTRICAL ❑/_ &PLUMBING ❑ MECHANICAL A Rear N Contractor's Nam Phonef_cy RI f r Y� OTHER rQ��/Up / 24)(J PROJECT DESCRIPTION SQ. FT. OCCUPAry Y C Right N Address(mailing) q�/�/..���. .. K G CON ST RUCTION TYPE VALUATIONS 0•'IQ $ Left City License No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref. # ` Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: St.-0 y STo St Lf , Planning Notes: / �l 54,1 `OCs. �ck 'au M with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. J T License Class License No. S Date Signature PLUMBING FEES , 'yORKERS'COMPENSATION DECLARATION Bar Sink Showers hereby affirm'that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap ❑ 50+KW I Construction Pole Sub. I ACertified copy is hereby furnished. A' Certilfes1 cowl!filed with the city Buyt9 D%vlslo Bathtubs f Sewer Connection - Cooking Unit Meter ❑up to 100 amps t Date/�V- —7_FROM Applicant /V/I`IATI Clarifiers EXEMPTION FROM WORKERS'COMPENSATION DECLARATION 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 OGas ❑Electric Sub Panel I Certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan ❑f HP ❑1%:-8 1 Workers' Compensation Laws of California. Motors Date Signature r Floor Drains Swimmi : 'ool w/Spa F.A.U. NOTICE: If,after making this declaration, you should become subject to the Inc :der 09-15 HP 016-15+ workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Ur'' comply with such provisions or this permit shall be deemed revoked. Fi%tur¢s icrowave CONSTRUCTION LENDING AGENCY Gas Service Outlets ater Closet 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 Water Service Switches OWNER BUILDER DECLARATION Sign I hereby affirm that'Ram exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Dispo • following reason (Section 7031.5 Business and Professional Code: Any city or Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap LaundryTrays r any structure,prior to its issuance,also requires the applicant for such permit y Generator r10-5 KW 05-15 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 - . Therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will do the work,and the structure is not Intended or offered - Reinspection Fee I, $15 Issue Fee $ 3 FEES for sale (Section 7044, Business and Professional Code: 'The Contractor's MECHANICAL • thereon Law doesapply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her ownDEVELOPMENT SERVICES EQUIREMENTS: —S-1/ employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I ❑ v(. I7 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date ` prove , the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By • Date -.- Date p p prove for the purpose of sale). (y-!—O I ❑ I. as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 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 BTU ❑100,000 BTU SUMMARY OF FEES .� builds or improves thereon, and who contracts for such projects with aeon- tractor(s) license pursuant to the Contractor's License Law). I am aware that • Exhaust System 0 Multiple 0 ) L� stem Repair/Alteration BUILDING PERMIT $ 1 .00 SMIP $ proof of their worker's Compensation insurance should be provided to me. PLAN CHECK $ /2 PERMIT CI I am exempt under Section ^��I1 B. & P.C.fo this reason Firepl/Fact.Blt. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System& Ducting Registers• PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00100,000 BTU 010 OBTL GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- sentatives MICROFILM $ of tl�iy city to enter/upon the s}bove-mens Date propertygfor PLAN CHECK 50% $ • p Inspection pur,,,_,fSrt C'Zf/ Date C's • MECHANICAL $ TOTAL FEE $ 31 .SC signature Date ---_ Drivers' License or SS# ..‘ Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • - iiiime '1 CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. / 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test i 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 (y 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 i 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush i 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 t 31. Plaster Brown Coat 79. FINAL INSPECTION f. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED /'� 33. Final Electric Notes: 4(R�B7 401 E� @ (r/r �, ,1_, 34. Final Heating & Air Conditioning n -. .4.` C `c' Do- 35. � /Q� 1!s'� 35. Final Gas Pipe-Test OA- �a Gia 6'/47 . 36. Hood or Canopy 33 J 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 b/fl//O G-- • 48. Special Requirements Completed 49. Electric Release to Edison 4 50. Gas Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date ! ____ -----,_ 1112A4) Pe ll;L OJ7 I U 4 E )J1EGRA: iz 7 l (014:- rc�2SEL r) Sl(s) P4(147 (414-et A6in kT / tit, lb ,'Ju1 r..64)0 lite Srllad Floe_ CAME O dT -tt, bee A IOE W piege /0 i s, 9 017*"g- I > 19eem if I- tJZJ 1.4).4cL5 , e 2 15 pear fes - Cole- C-a-i (e 464 ., / 'u- ire-nig-0o ?P ciry el ,IQ.)/2e P'e'72ly i 7 rwitiMD-i2 1MND LA, 1 • • g4. 87 � 2 APPROVED City of Costa Mesa Building Dept. BY f�� D • ATE G"/7 19 ! • I • I THESE PLANS MUST BE ON JOB AT ALL TIMES MAKE k Fp NO CHANIGE` W! H SWT PRIOR APPROVAL OF DEPT. THE' SSUA`.CE CP G"4K ;R.;0. OF A PERMIT OR APPROVAL OF PLANS AND SP?C;C4)tat 5 SHAD.NO1 K.E.CONSTRUED TO BE A PERM!! .OR, OR AN APPROVAI.OF, AN" V;GL ATION ON ANY OF ` , THE PROVISIONS Co FIS CODE.NO PERMIT PRESUMING TO GIVE �t1!i II AUTHORITI TO VIOLATE OR CANCEL THE PROVISIONS OF THIS �� 1 CODE SHALL.BE VALID. EXCEPT IN SO FAR AS THE WORK OR USE • WHICH IT AUTHORIZES IS LAWFUL. �/ ` s _ THE ISSUANCE OF A PERMIT BASED UPON PLANS AND Qf.'W�(f �'7 SPV IFICATIONS SHALL NOE PREVENT {E ill .,,DING OFFICIAL Q i ® + FRO,T', THP EAFTER REQUIRING „1S COS.'eC.•(2q OP ERRORS IN \ V • fin]\jL(,'T�) S!•;L` PLNNS AND SPECiFiCATIGNS Or FROM PREVENTING f pp �,TSTA MESA BU J VC, OrJ. MONS CODE CA,OF ANY ON THERE!J INA WHEN U\` L_ ,.•'FIOr l 1.=THIS OR ANOTHER ORDINANCE OF W • y�pNLUDG•pFP[•U."3.O . ! z . A y DA ny 01C: CF ° f a • I 4 - p �1 rrsw[rec rnlsrrsi . auwrru wean _q b` b. G i, V ha W it IC /ll. h. w M N . • 233 • T • STREET A _ 21 57 • .. BLOCK if WALL — ' BB—‘EBITA-IPo—PNRS—O,VED-'DE LBEiTI-°rN4114,ECO;,p01u3EincioltRi,R!GECDTEI—Op,`Ai—,lrisn... —vmE— amit . i ,—,S<LUCB—PJliEPcCLT-APOT-O—BLDG. DEPT. REG .— U Dincroe OP PLANNG•40 -..- -1---1-1*-1-1.-1— . •a. irTh 10461"3 71 a es& 2. z CS t tbtkiNtvilot . APPRO VE0 . --1 Ciir of C nsta Meso Build. BY ing Dept. 4 116 I --------------- RC, 4 .. ---- e DATE' S-- f fr O Ch,A,. ,.-... '''';'•5' ^?(C.;.• •44.Pr4.4.1•A I. OF Dri .. ' AUJ 11 1'1-1qA114 - •" .JCL" 4.. '576 A r 7. -,4,/41?/irim.D.,/,. ".:1:.'^e'l'tr.:-C.:.,.- .... ' ••• 't t- • /Flic::::::EiNisit7,114;41,''FNALAIsNallifpli.:F:14::::::::‘:::11:1::::::::::::::::!cPt.:::::::: ' / Ni NA . 1 / SAits pi 111i : 7N1/1"ibilliNAGTO'ERA M34P8tCrilffJC"1C)COR:RETCHF: ;IivoS:I THE City N°F TM 5.C.Q%.ftell-gett'WilitThvEJ 'NG" i• /4 .6. L., ‘ferrisitl NN 10 4 tbets.s.,NeN%.: 0>" ' \ ktvevatk Ata -,.. _ , , ,,..r cvf R.,E E . _.. . T z 1-_-,.. i.........1 Or • STREET & • •a A 1 41 i -1 e a b w • A ti a 1 G w • 141 e O, w 1 , ,' 1 r S a w b • a a w STREET ,... TYPICAL 6" CONCRETE BLOCK FENCE . 1 Cement Coping Optional NOTES Channel Block With 1.3/80 11 snrr I r - Horizontal Top of all � _ Fences I I MORTAR: One Part Plastic Cement, and Three Ports Sand GROUT: One Port Cement Three and For Tenon 5'or Les. s One Half Ports tendvan.caro 3/e••¢.t 4•-0••o,C. d� tc _ I I I II II COPING: One Port Cement, Three For FeHigher Than 5' I` u. u Parts Sand nn vert.Ban 3/8"¢at 32"O.C. c W - CONCRETE: Well Mind 1:2-1/2:3-1/2 Max.= of 7-I/2 Gallons of Fill Cells Solid With Grout i CI > Z I 1 I I Water Per Sock of Cement Where Steel Occurs .�i > - Reinforcing Steel Shull PTI 1 u I ' GROUT MAY BE POURED FROM THE TOP I 1 OF THE FENCE IN CELLS WHERE STEEL Conform to Sec.A-15.39 u 0 OCCURS. A.S.T.M. 2 CELLS AND AREAS OF HORIZONTAL REIN- IIpIe w n I I ' I I FORCEMENT SHALL BE CLEAR,CLEAN& All Steel to be Lapped FREE OF ALL MORTAR DEBRIS,ETC. 24"or to Code i� NATURAL GRADE 9 wy_ v. • • •A - TWO LC'm BARS ���� s , . .. .• . . ' . CONTINUOUS TOP I 1-0 -- _. ,.. Si BOTTOM -may 1-�-WIDTH • .�, TO 16' O.C. MAX. . SEE CHART ." a I M01217..STEEL MUST BE TIED IN BELOW . . • DEPTH OF EARTHTCOTH PLACE AT TIME OF TRENCH a' 1. - I/3 THE HEIGTH OF PENCE INSPECTION. ,' j„ • ; • .trtOW BOTTOM OF FOOTING. kis �o'� 1 Z. — SCALE: 1/2" • 11 . • • • FOOTING REQUIREMENTS CHART 1 • WALL HEIGHT 6' 5. 1 41 : 31 1 _ WIDTH 140 14* I _12"..L. _ 12'..a THICKNESS 10" . .l0" 8" 8 " ' DEPTH OF EARTHTOOTH . . . 24" 20" I6" . . : 12" ' SPACING OF EARTHTOOTH. . 12' 14' 16' • 16' OB NEADDRESS: _ a..-5-3 I (Cot, City of Costa Mesa, California PERMIT NUMBER: On Building Department SIGNATURE: trill• _ . 1__ _ _ _ _ , o.... ....24-4•4-0-t: feesnibest, INV.az . t • te. 122.09- • 3L PATTY WALL AGREEMENT �' if .. ►y� THIS AGREEMENT, made and entered into this / day of A-`( , 19 by and between ��� 4A (� 5,j (� hereinafter referred to as "LAND OYd4ER", and J ANef A o f MS hereinafter referred to as "ADJACENT PROPERTY OWNER". It is hereby agreed that a party wall will be constructed on ()JAY Sr c)O a Wx C • �. property line between a33 tit C slut � � �/��lh Y , (Address of Adjoining Properties) in the City of Costa Mesa, County of Orange, State of California, as per map recorded in Bock , Page of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach IN WITNESS WHEREOF, the parties have entered into this Agreement the day arca year first above written. LAND G'NER ADJACENT PROPERLY OWNER (!Signature5-"L":4/11— Grt gnature) A-La A1155 Rw D SA(OliaL Jane, PA a-m S Name (Typed or Printed) • Name (Typed or Printed) a53 C0 st- C $+1 mess 20citi- A).an a ) I,bai (Address) (Address _Jkji 1 z b z (NOTE: Please see reverse side for notary's statement) STATE CF CALIFORNIA ) , . •- ss. CUNT' OF ORANGE ) • On before me, the undersigned, a Notary Public in and :•r the County of Orange, State of California; personally appeared known to - to be the person(s) whose name(s) is subscribed to the within instrument a • acknowledged to me that (he/she/they) executed the same. WITNESS my hand and • ficial seal. (SEAL) • Signature Name (typed or print-•) STATE OF CALIFORNIA ) ss. COUNTY OF ORANGE ) On , be are me, the undersigned, a Notary Public in and for the County of Orange, Stat: of California, personally appeared known to me to be the person(s) whose name(s) is ubscribed to the within instrument and acknowledged to me that (he/she/they \executed the same. WITNESS my hand and official seal. (SEAL) (Signature) Name (typed or printed) Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 7126 5/0 1 /87 CITY OF COSTA MESA CONS��UCTION PERMIT - PERMIT LN 3 2 2 ACT2O LOT UNIT NO. 39e27 Ti. • Project Address ,,) 53 a--1 L AS O Vies& y Applicant's Mailing Address C) htiL TYPE OF CONSTRUCTION H NEW ❑ ADO U ALTERATION ❑ REPAIR () ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � Owner's Name �j P.l�9 a'F-' Phone�7 'I�l�o� A.P.AP # Q2,6 --2 p2,— '22(p Zone K/ 11 1—� DESCRIPTION OF WORK/USE OF BLDG. Address a-13 �\ �S`F+ noes& / $ Main Building: / Accessory Building: Arch/Eng. License No. TYPE OF PERMIT Ell GRADING FOUNDATION ST RUCTV RAL E Front to CIT •req 1sv(R Z ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B N Address / p- d— Rear /�/ /5—St AO,/ ❑ OTHER A / � •Contractor's Name �.//{ A Phone PROJECT DESCRIPTION SQ. FT. OCCUPANCY E— C K Right 'fV N Address(mailing) CONSTRUCTION TYPE V W VALUATION$ /1 ZU s Left 4Z.J G City Licei. nse No. ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# I Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: a " `4- �M-�_- (414- M with section 7000) of Division 3 of the Business and Professions Code,and my license is in full force and effect. � � T License class License NOS Dte Signature PLUMBING //& . `(]y} - V"^�r(— G1./` " WORKERS' COMPENSATION DECLARATION Bar Sink Showers hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL • FEES of Workers' Compensation Insurance, or a certified copy thereof (Section ' 800, Lab. C.) Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation Sewer Cap0 50+KW eCertified copy is herepy furnished. Construction Pole Sub. Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit ' Meter Ours to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar CollectorsDishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Piping 7 Dryers ❑Gas ❑Electric Sub Paper' I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any rcui er so as to be ome subject to the Drinking Fountains Solar Tank / - Fan workg+s' ompeppsyjIon Laws of Calif po Mors 00-1 HP 01%-8 Data' —(^dy- Signature �'C/` -ep-P11/74"-- Floor Drains Swimming '.o`'w/Sp a NOTICE: If,after making this declaration,you should become subject to the F.A.U. • �nc.Solar 09-15 HP 016-15+ Workers' Compensation Provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. - Fixtures Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets . er Closet Device Boxes ....- I hereby affirm that there is a construction lending agency for the performance Pole Light 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 Water Service Switches Sign OWNER BUILDER DECLARATION I hereby affirm that'I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or Garbage D oral Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundr Trays any structure, prior to its issuance, also requires the applicant for such permit _ y y Generator 00-5 KW 05-15 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 . therefrom and the basis for the alleged exemption. Any violation of Section 131.5 by any applicant for a permit subjects the applicant to a civil - • realty of not more than five hundred dollars($500). colc as owner of the property or my employees with wages as their sole Rein •=ction Fee I $15 Issue Fee $ 3 mpensation, will do the work, and the structure is not intended or offered for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee I $15 Issue Fee $ 3 License Law does not apply to an owner of a property who builds or improves FEES thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REIQ} IREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ ( ��( p�� sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By Date / pletion, the owner will nave the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). y'- ❑n, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 1'I/XI tractors to construct the project (Section 7044,Business and Professions Code: i The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-110;000 BTU ❑100,000 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 thatExhaust System 0 Multiple❑ stem Repair/Alteration BUILDING PERMIT $ .2 %-5 SMTP $ r� proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ c'.Z1 PERMIT 13I am exempt under Section B & P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers ER MITAN $ (..s.._ PLUMBING $ Date �—�3 Owner y"]r-r( A�dk Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I here certify that I have read this application and state that the above 06100,000 BTU 0100, BTL $ GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL and state laws relating to bus ing construction, and hereby authorize repre- sentatives of-- Is city to er upon the above-mentioned property for ? inSispection oses. A w r f_es} MECHANICAL $ TOTAL FEE $ 7%'?'7 Drivers'gnerDate Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ License or SS# � CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service,or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. J/' //� 57. APPROVAL TO COVER-GUNITE 7. Footings / o` gal 58. Electrical Conduit-Undrgrnd. 8. Foundation /// ` 59. Gas Pipe, O 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 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush • '24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas O 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: 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 Domestic-Final 42. Backflow Preventer 43. Backf low Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING gpfee •Aff 48. Special Requirements Completed • • 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. ITY OF COSTA MESAPERMIT NO. TRACT NO. LOT NO. BLDG. NO. . • =v3-TR UCTION PERMIT 4 - 1;-1 , ? v - -' - •Pro�jjectAddress 'ra a I e sk-c \l z.as_ TYPE OF CONSTRUCTION NEW ADD ALTERATION ❑ REPAIR 92204/24!84 �9e3/ TL Applicant's Mailing Address Iyy,S'Pr's'.• l��, .0 CONVERSION LI DEMOLISH ❑ OTHER - A'P' #�/(p1{ `7 /�`, .s /o, Zone Ors � V�l�t �� Pho QI._TSE(4ia DESCRIPTION OF WORK 'Pt I-•Asa-1E0- �� -O -¢7�sM� - - - Lr/ C�L7� ���✓ - �/ �Q S- Main Building: • Accessory Building: 2 Address � y �-/1.r e-m�`� dd- TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front iii _ ( N s/Arch/Eng. Ch4N1ER./btask4eR_ - License NO.. ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B (/"' i): ` O Rear l N Address ❑ OTHER A I\ y Contractor's Name Phone- PROJECT DESCRIPTION SQ. FT. OCCUPANCY - C Right (� '�J" I Ind. G Address(mailing) "/ CONSTRUCTION TYPE VALUATION$ !F O V C7 $ Left Q v r. )` 7 ' E �/ • ZONE GRADING CU.YDS. ACRES Ping. Ref.# Park 1 �s /Y 0 City License No. fL"/1(V" \U LICENSED CONTRACTOR D CLARATION Remarks: Parking Req./Provided I hereby affirm that I am licensed under provisions of Charter 9 (commencing - R with section 7000) of Division 3 of theBusiness and Professions Code,and Use of Building: E my license is in full force and effect. _ (j - License Class icense No. PLUMBING FEES Planning Notes: p I - (elf-9� M Date : Signature - V I E WORKERS'COMPENSATION DECL RATION Bar Sink Showers /n N ,reby affirm that I have a certificate of consent to self-insure or a certificate - - .k (ft ^ T Yorkers' Compensation Insurance, or' a certified,copy thereof (Section Backflow Preventer Service Sink ✓ ✓'J $ JO, Lab. C.) Backflow Irrigation Sewer Cap ELECTRICAL FEES Policy No. Company 8 certified copy is hereby furnished. Bathtubs Sewer Connection Automatic Washer Transformer ❑ 15-50 KW Certified copy is filed with the city Building Division. ❑ 50+ KW Date Applicant Clarifiers Solar Collectors Construction Pole Sub. EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishwasher Solar Piping • CookingUnit Meter ❑u to 100 amps (This section need not be completed if the permit is for one hundred ($100)or P P 7� less). DrinkingFountains I certify that in the performance of the w rk for which this perms is issued, Solar Tank Dishwasher Meter Dover 100 amps shall not mployrrany person in any m ner so as tyyo becomes jest to tl Dorker5faplge�paSiyn-Laws of Calico i - // /_ // Floor Drains • Swimming Pool w/Spa • Dryers ❑Gas DElectric Sub Panel • Date cG��:�{{A• 5-rii tr!! `Y/ Laws of C i `off - - ' NOTI If,a t r milking this declare o ,you sh Id become subject to the ' Floor Sinks - Urinal - Fan - Motors❑o-1 HP O1%-8 Workers' Compensation provisions of the Labor ode, you must forthwith comply withi such provisions or this permit shall be'deemed revoked. Gas Sdrvice ' Outlets Water Closet - F.A.U. Inc.Solar ❑9-15-I P 01'6-15+CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agencyfor the performance Interceptors Water Heater. - ' _ Fixtures Microwave '-'� '-I' of the work for which this permit is issued (Section 3097 Civ. C.) , Lender's Name .- -- - Kitchen Sink Water Service - Device Boxes .. 1 ' Lender's Address - - - - Pole Light, OWNER BUILDER DECLARATION . Lavatories' . • • Outlets Range , ," I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section.7031.5 Business and Professional Code: Any city or ' p-Tra p ' _ • •. Switches ,Sign ,ter county which requires a permit to construct,alter,improve,demolish orrepair - - 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 Generator ❑05 KW ❑5-15 KW " r"••ision 3 of the Business and Professions Code) or that he/she.is exempt - Trash Compactor 'from-and the basis for the alleged exemption.-Any violation of Section • - ' .5 by any applicant for a. permit subjects the applicant to a civil Reinspection Fee I • • )(ay of not more than five hundred dollars($500). . Pe •1 $25 Issue Fee $ 3 - • 7�yr I, as owner of the'property or my employees with wages as their sole lJ Reinspection Fee $25 Issue'Fee A, F':1 $'3, coin 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 D • i/ thereon, and who does such work himself/herself or through his or her own - yp • I - Zoning Approved By ►e/(s'��"`-' 1-Date' /a//-{��2d�/[y(I`�/ employees,oever,provided thatsuch o'improvements are not intendedhiooroffered ofcfor Canopy Type II ❑ �Y/'l(Y ,µj'� J"¢ sale. If, however, the buildingor improvement Is sold within oneyear cam- Duct-Under Ground " ' / Building Approved By Date pletIon,the owner:will have the burden of proving he/she did not build or in-- > (n1 - LJrove for the purpose of sale). Duct-Structural Refrigeration System , Application Issued By : N//' Date 3t/ r� I,as owner of the property, am exclusively contracting with licensed con- 00-100 000 BTU ❑100,000 BTU • l - tractorsto construct the project.(Section 7044,Business and Professions Code: ' Duct-Ventilating •- . - _. _ SUMMARY OF FEES The Contractor's License Law does not apply to an owner of property who , PERMIT ',LTV ` SObuilds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration $ SMIP - -j $ ' • tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK .$ 1// 3:7 : PERMIT -' ' ❑ ham exempt under Section B.& P.C.for this reason ' Firepl/Fact.Bit. ICBG# - ISSUANCE • ' .. PLUMBING I$ $ Date 4- 1 Yd Owner Ia . '' • .� '. < • Heating'System&Ducting - PLAN CHECK 25% '$ - ENERGY P.C.. $ I hereby cerci have read this application-and state that the above-- ❑0-100,000 BTU 0100,000 BTL " - - ELECTRICAL i GRADING $ information is correct. I agree to comply with all city and county ordinances $ , and state la relating to building co -truction,and hereby authorize repre- $ ' MICROFILM! $ sentatives o�his ci •-to enter up• the abs e-mentioned pro arty for PLAN CHECK 50% - inspectlon • p - Signature mm " � /_ ' / d o MECHANICAL $ - TOTAL FEES $ �9 �al .TO 4 - Date Drivers' L • se or 5 E Reinspection Fee --$25 Issue Fee • $ 3 PLAN CHECK 25% $ .., - CMF 0865-46 rev.12/83 White-Building; Canary-Applicant;Pink-Accounting;Goldenrod-Assessor , - - - - CONSTRUCTION AND PLANNING . - • . POOL ' 'Ai - - , Date Inspector • + Date Inspector '�.ACOPPROV LS Permit# APPROVALS Permit# It _ . 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. Footing _�,• g,.8 Com_ . 58. Electrical Conduit-Undrgrnd: , 8. Foundation 59. Gas- Pipe, O Undrgrnd.,Test , - > 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trdp, ❑ Undrgrnd.- 10. Structural Floor System 61. APPROVAL TO DECK . , ' 11. Property Sewer Line & House Connection I 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 , :A Ducts,'Ventilating 71. Product Piping 0 Gas. 0 Oil , ' 2-j. Gas Pipe-Rough.& Test72. Underground Flush '-24. IRoofFraming ' 73.. Undergrnd.StorageTank'OGas-0Oil. ' • i 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 I ' 31. Plaster Brown Coat 79. FINAL INSPECTION ! 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED I 33. Final Electric Notes: ' 34. Final Heating & Air Conditioning 35. Fina{,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 • . - 4 ( alitz.G NO L0'M '' si1't 48. Special Requirements Completed ' - , A/OL • Y ' 49. Electric Release to Edison - . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - • - No. Date' _ _ - _ . _. , . :ale . Or' C1Y OF Clan • PLANNING DEPT il/UFn TO &DO. DST. er+Dlitectoa0 .Ea °P► iso RESIDENCE RESIDENCE .y RESIDENCE RESIDENCE ti tU• Q14) aTh N STREET i TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional - �ni ■,i, . ' . - GENERALipt NOTES Channel Block With 1-3/8 0 Horizontal Top of all Fences [ MORTAR: One paastic Cement, and Three Sand GROUT: , One Part Cement Three and For Fences 5'or Less ..._ I' ail _ One Half Parts StandVert. Bars 3/8" Oat 4' -0"O.C. o - - COPING: One Part Cement, Three o Parts Sand For Fences Higher Than 5' i, CONCRETE: Well Mixed 1:2-1/2 . 3-1/2 Vert. Bars 3/8" oat 32" O.C. y w_ - > _ II Max. of 7- 1/2 Gallons cf Fill Cells Solid With Grout > Z Water Per Sack of Cement Where Steel Occurs y'.- — Reinforcing Steel.Shall —� II f to '� GROUT MAY BE POURED FROM THE 70P Conform to Sec.A-15-39 w p - • OF THE FENCE IN CELLS WHERE STEEL ' z OCCURS. A.S.T.M. CELLS AND AREAS OF HORIZONTAL REIN- All Steel to be Lapped in I=-II 1 _ FORCEMENT SHALL BE CLEAR,CLEAN& la NH FREE OF ALL MORTAR DEBRIS,ETC. 15"or to Code � ' NATURAL GRADE if BONDS SHALL REPROVIDED BY LAYING ,h\w' ,, IIn*, V _ II II BLOCKS IN STRETCHER COURSES SO THAT `l iY - as ' • - o . . S : VERTICAL JOINTS ALTERNATE IN EACH ""'-'z, - \ L\.(\. \� D O -p N_ A . b Sn . n e COURSE. TWO3/8"0BARS Dom , D s ♦ }I ♦_. e . CONTINUOUS TOP . -. &BOTTOM -40—I IWIDTH TO 16 0 C. MAX. o- SEE CHART �< -. • P BELOW• q —c - DEPTH OF EARTTCOTH pLi 1/3 THE HEIGTH OF FENCE � ' . BELOW BOTTOM OF FOGTINGH G'. 10" T 2„� SCALE: 1/2" - I' • FOOTING REQUIREMENTS CHART - WALL HEIGHT _ _ 6 ' 5. 4' - 3' WIDTH 14" 14” 12" 12" THICKNESS 10" 10" 8 " 8 " DEPTH OF EARTHTOOTH . . 24" 2d' 16" 12" 4. SPACING OF EARTHTOOTH. 12' 14' . 16' 16' ,r OWNERS NAME: City of Costa Mesa, California JOB ATDDRESS: ' .-Ting Department SIGNATURE: �1ouE �`t1�+eteP,s I' Sacu usE - Lsfi a.�'YTAstc¢s aye Pt -10M - IP, (o N Askces Loft -tAR L. _ APPROVE -- Footio 5 ?L1 j 30" nap AMM F\ulsl� SARAT]E - Wooee D °set) - $ woot) CRY OF :114" `T•A• SA l oortx, l a„ Pd. . • �ro t .. oar. EEG. n , 41 q '�e.bne �,eo BYDATE w MOOR OP PLANNING LP ax.4.-"rel M MEQ i -/2 X10 Ams V1 li W c^OOAPPROVE ® Lz'sa, �4City of Costa M sa Building Dept. \_9 ci -4- et OATS 19$ N THESE PLANS MUST BE CU JOB A ALL TIMESji r r Ott e OFcri MAKE DEPT.NO CHANGES WITHOUT PRIOR APPROVAL' I ©n9 ser rr // i THE ISSUANCE OR GRAAUNG OF A PERMIT OR APPROVAL OF PLANS AND SPECIFICATIONS SH:LL NOT BE CONSTRUED `� TO BE A PERMIT FOR, OR IN IPPROYFL Ci, ANY VIOLATION OF ANY OF THE FfiCV:_i0'.; Cl MI: CODE. NO PERMIT PRE. &I/l `, SLIMING TO GIVE AUTHORITY 13 VIOLATE CZ CANCEL THE O PROVISIONS OF THIS CODE SHALL BE VALID, IXCEPT IN SO U FAR AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL l THE ISSUANCE OF A I'ERMIT BASED UPON PLANS AND SPECIFICATIONS SHALL NOT PREVENT THE EUILDING OFFICIAL -0 FROM FROM THEREAFTER REQUIRING THE CORRECTION OF ERRORS IN SAID PLANS AND SPECIFICATION OR FROM PREVENTING �-'Q_I�yd� BUILDING OPERATIONS BEING CARRIED ON THEREUNDER WHEN ro LA IN VIOLATION OF THIS CODE OR OF ANY OTHER ORDINANCE 7 OFT, 9ii , CITY OF COSTA MESA SERVICE REQUEST & PUBLIC ASSISTANCE FORM i Date gV^ / / J//��', }� Time �+ Caller's Name AI .�J `� / 9 Address .2---A3 e '�Y' a. Phone o y4 ^ `� ` 119. Nature of Request: (location, type, severity) r F- wf° °— r ' Referre t��oe.frile-----' ��jj � (�GL.Y. d ,fou. A, ,"1! d `a,4, 42.46;144:711 back farl pa . k/T �a / "'d o ! U�Ol C��� erviced Ira- VI _ y/D y,e. $ -/:.?_ 7 ythformation Only Person Receiving Call _ O9 /v' 1 ' 443 FEE RECEIVED COSTA MESA BUILDING-SAFETY DEPARTMENT JULP. O. BOX SIT COSTA MESA. CALIFORNIA - JU3 1952 For Applicant to Fill In Completely FINANCE DEPT. O� PP P Y APg�p¢�IC�}g�1RtiT TYPE OR PRINT BUILDING BUILDING ADDRESS 233 R. 21st Street cosi-A MESA. CALIFORNIq For Office Use Only drtiir,� RECEIPT NO. PERMIT HQ OWNER Robert- orbes--- 7 I ) '7y57 MAIL RECEI7aD BY OA RECEIVED DATE ISSUED ADDRESS 2052 Newport Blvd., w I r-,-7- `_- 7- i -6 --- TEL. 6-1 L /� CITY Costa Mesa NO. 6-1252 ADDREIN ✓-..fl 3 3 p.- .4-14 ,S:,/, ARCHITECT TEL. ORit 'OR ENGINEER Vern Threlkeld NO. 33330 COSTA MESA. CALIFORNIA ADDRESS FIRE ✓• \ ZONE ,( TYPE GROUP/1iY__ j CONTRACTOR Robert Forbes AP` BYPROVE /IX DATE / %^ `--- ADDRESS 21152 Newport Alva.. //✓/ ZONING C �q ZONE NO.OF USE OF NEW Slugl 'ChM CITY costa Mesa, California R-1 IPLANS 2 I BUILDING w/ att gar SIC IJD. .1 $ q 3 , TEL. M[ 6-1252 LEGAL } Lot 243( t µ( O DESCRIPTION corp Loth 21I.3 p`i�l• 241. 52 ) SIZE t♦♦ ' / '/ NO. OF BLOTS. ��A.P.NO. 116-102.12 & 15 OF LOT D Li y1- NOW ON LOT USE OF ._ -- YARDS EVES EXISTING BLDG. _ APPROVED ALLOWED SETBACK LINE PROM L (CENTER UNE ST.1 �J 7 al- ,CENTER OF STREET REAR YARD FRONT '/ FT. g Z/ IN. SIDE YARD I LEFT I RIGHT R.SIDE 7 FT. I"/� IN. DESCRIPTION OF WORK L.SIDE 7 FT. / N. NEW I I" ALTERATION I V ADDITION I REAR /0 FT. W. ' REPAIR I MOVING I VDEMOLISH BYPROVE W. T. D. DATE 7/z/c/-- BUILDING /5 p' OOS 7 SIZE STORIES / RLB EXTERIOR WALL �..:7ROOF COVERING 0/ CcTTCOVERING USE OF BULaj. G AND WO-K OBE F RFORMED `'/-. . /War _ e 4 -r a' 515// l I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION THE AMOUNT SHOWN UNDER VALUATION IS FOR THE AND STATE THAT THE E IS CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY CEO AND STATE LAWS REGULATING BUILDING CONS :•CTIOON. VALUATION SIGNATURE O 40 PERMIT FEE $ -- PERMITTEE / . , N $ /� �`�J ,PLAN CHECK $ 02 7 .:i AUTHORIZED AGENT TOTAL FEE f/ D $ IL