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HomeMy WebLinkAbout187 22ND ST - Building Permits CITY OF COSTA MESA • t qe BUILDING DIVISION > •, , a DEVELOPMENT SERVICES DEPARTMENT PERMIT MBER °4t J1 /1i PERMIT �. 03-01233 %bolt'also(714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca..uUILDI NG PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 187 22ND ST Status: ISSUED Suite: Applied: 07/21/2003 Vicinity: ROOF/FRONT RESIDENCE Issued: 07/21/2003 Parcel Number: 42613312 Zoning: Applicant: LYONS, DANIEL F ISSUED BY: Address: 187 E 22ND ST Phone: 949-642-4541 COSTA MESA,CA Zip: 92627 Owner: LYONS, DANIEL F Address 187 E 22ND ST Phone: COSTA MESA,CA Zip: 92627 Contractor: OWNER-BUILDER Address: Phone: Zip: License: 000000 Arch : Eng: Address: Address: Phone: Phone: Zip: License: License: SCOPE OF PERMIT TEAR OFF EXISTING ROOF. INSTALL 30#FELT,NEW 7/16"OSB SHEATHING,30 YEAR,COMPOSITION SHINGLES. 1,050 S.F. FOR FRONT RESIDENCE ONLY. FEE SUMMARY Plan Check: $0.00 Calc Valuation: $2,100.00 Permit: $83.25 Claim Valuation: $2,100.00 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 PLANNING &ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0 Right 0-0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 Right 0-0 PARKING Existinq: 0 Required: 0 Proposed: 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ora.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 160 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS t ,.-'-; WORKERS'COMPENSATION DECLARATION: &rm I hereby afunder enalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (TMs ction need not be completed if the permit is valued at one hundred dollars($100)or less.) 1 I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' I compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these prove ns. Applicant Signature: p. PJ _.••••"------- Date: ' 7/7/ / WARNING:FAILURE TO SECURE WORKERS'COMPENS ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTI S AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lis.II Class N Contractors Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or 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 compensation,WILL DO THE WORK,and the structure Is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors Ucense Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or 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 within one year of completion,the owner-builder will have'the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) ' cense p ant to the Contractors License Laws.). Iffit I am a nd/tsec. / _/ Business and Professions Code for this reason: Signature: Date:% 77.7 Z pireo 3 Owner ID ye lied by drivers lice r:Pr 7 Yes 0 No Driver's License No. / E s:3—iv—O 9 Verification of Ownership by(type of doc :nt,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title e,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety, as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). __ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater then a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? j�Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If"yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correc ..pec •• rposes. :. -, .t to occupy or allow occupancy of any building authorized by ee to comp) wit• : ate s end city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the abov .ed prop: or i this p mit until line inspection. 7 7 i o 3 Signature Of Legal Owner(s) ate And/Or Authorized Applicant Date CODE I INSPECTIONTYPE QME INTRIAka ODE INSPECTION TYPE PAIL tNTmAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final z�T 208 Final Plumbing 200 Final Re-Roof /4-9-41 QT 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy 4`0-01 s9 CITY OF COSTA MESA 0 41• �^gF. CALIFORNIA 92626 P.O. BOX 1200 tones ...Cpp"6PP$" FROM THE OFFICE OF THE DEVELOPMENT SERVICES DEPARTMENT/ 4fre4ocmartiadi PLANNING DIVISION June 16, 1983 To: Building Safety Division Pacific Telephone Company (2) Business License Division Police Department - Ping. & Research Communications Santa Ana Heights Water Canpany County Administration Office Sanitary District Engineer County Clerk Southern California Edison Co. County Registrar of Voters Southern California Gas Co. • County Tax Assessor State Board of Equalization Engineering Division (2) Street Division Finance, Revenue Division United States Post office, Adams Avenue Fire Prevention United States Post Office, Santa Ana Manager, MID Zip 4 - Santa Ana Mesa Consolidated Water District File (2) Newport-Mesa Unified School District (2) The City of Ccsta Mesa wishes to advise you that in revising street addresses, the follaaing addresses have been changed: OLD ADDRESS NEW ADDRESS A.P. ND. 187 East 22nd Street 187 East 22nd Street, Unit A 426-133-12 187 East 22nd Street 187 East 22nd Street, Unit B 426-133-12 For your convenience we are listing the agencies above that we have notified of the change. In addition to those listed, you are advised to notify your correspondents of the change in order to avoid any possible interruption of mail service. Your cooperation in this matter is appreciated. Sincerely, Kristen Caspers Planning Intern KC:hwm (F-1-48) cc: Daniel and Deborah Lyons 187 East 22nd Street Costa Mesa, California 92627 77 FAIR DRIVE (714) 754-5245 • • W 115.os1 V)- ea't P h IN ft NI B t u-e' orNc A a\\ uri fa'.a • 4 ✓ rraN eco o r� C caNc. Priv?1� 0 cl6- \\. NM ...\ - \ \.,) . • 1p J, . V ` ... LW!'X�1fit:G I I\\ \ 'V /lol-O•'1TY•:h' \ MI-J G.O' I '�i.0gJll'-I .�...__ _t 171GwLVG BA.G AVL! {//y���� . O:CON� ''...S. - THo- ':2N 1/THo-CATH• =ma.jHtT = lose e.F. FOR UCAF GfR/'.GS. Sc E°._......Ni. E', - 9 4� a.=. Yo" o M et -4 .. . • 3 • - .•� Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - Cir—�F COSTA MESA., + PERMIT NO. TRACT NO. LOT NO. BLDG.NO. • -CONSTRUCTION PERMIT /Ui� S7 ? 1 Project Address t%t7 r ala iii d-. ` T2/1"-- OF COfySTRUCTION • • ' Owner '"-DGyt )---1b 'S Phone 642^ H KNEW101 ADD ❑ALTERATION. 1/4-72,6 - • Address £ ;,,j4_ ❑ - 0 REPAIR 0 CONVERSION DEMOLISH ZONING REGULATIONS l Arch/Eng. License No. 0 OTHER P 1 DESCRIPTION OF WORK .4 Address. ,ZONE PLNG. gRE1FLTp. * Contractor e,U7(WV" 4"4v^ / b4"4 f" Phone TYPEOF PERMIT • BUILDING SETBACK C/L STPRO PtEIRYNL NE . p Address 0 GRADING �7 FOUNDATION 0 STRUCTUR L SIDE YARD SEEE LICENSED CONTRACTOR DECLARATION 0 TENANT �LECTRICAL OPLUMBING E/MECHANICA SIDE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT - mencing with section 7000) of Division 3 of the Business and 0 OTHER . REAR YARD(TO P/L) Professions Code, and my license is in full force and effect. PROJECT DESCRIPTION License Class. License No. AO 26 PKG.SPACE REQ. PROVIDED Date Signature SO. FT. . WORKERS'COMPENSATION DECLARATION OCCUPANCY_CONSTRUCTION TYPE .STREET WIDTH PARK FEES ' 'I Fereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE !Z'2 ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance; or a certified copy thereof(Section 3800, Lab.C.). • GRADING CU. YDS. ACRES - ,SPECIAL CONDITIONS: • - :y No. Company - ' ertified copy Is hereby furnished. • . REMARKS: /3 6-37147 ../ .. . L�1"Certified copy is'filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - '(This section need not be completed if the permit is for one hundred . - ' - ($100) or less). - • 'I certify that in the performance of the work for which this permit Is - issued,-I shall not employ any perso In any manner 5o as to become PLUMBING-. PLAN CHECK •ELECTRICAL I PLAN CHECK _ subject to a orker5'Compenzati, ea% rn NWELLIN GARAbE P//]/�7/ - -ry `fftvvvn • BATHTUBS SHOWERS f 2t W D Signature y/ -5(a FT SO FT NOTICE: If after making this declaration, you should become subject TOILETS URINALS GENERATOR0-1 KW_1-10-KW to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER , • forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10'50 KW_50+KW revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS ' 0-1 HP / 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 + HP . '/ 00 • formance of the work for which this permit is issued (Section 3097 - - --�^ Civ. C.). FLOOR SINKS -FLOOR DRAINS FIXTURES/Z OUTLET$ .SWITCHESaa% .a )C7 Lender's Name ' Lentler's'Atltlrers DRINKING FOUNTAINS GAS TUBE SIGNS , , OWNER BUILDER DECLARATION INTERCEPTORS 'CLARIFIERS POLE LIGHTS ' I hereby affirm that I am exempt from the Contractor's License Law for -• -• . . - • the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP _LOINS 11-0../L IJUN , • Any city or county which requires a permit to construct, alter, .POLES METERED SUB - improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS / - MAIN .SUB - 7er) ...... • quires the ap,licant forsuch permit to file a signed statement that he , is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS 'SERVICE,'�'- pp AMP • (Chapter 9 (commencing with Section 7000) of Division 3 of the _ _ - - P BP iness and Professions Code) or that he is exempt therefrom and the WATER HEATERS - BTU OUTPUT - ( /— i 0 f9 M Sires��' - . - .a; for the alleged exemption. Any violation of Section 7031.5 by ' R -tj-applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - fl�,•}- ,•'� — �-e•itr \. ._ .- . - .i."dt more than five hundred dollars (8500). S � - ((DO CoLl I, as owner of the property, or my employees with wages as their SOLAR TANK ' COLLECTORS •- • • sole compensation, will do the work, and the structure is not intended - - -. or-offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE _ Contractor's License Law does not apply to an owner of a property - • APPLICATION APPROVED BY DATE who builds or Improves thereon, and who does such work himself or ISSUE FEE through his own employees, provided that such improvements are not 'intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK -- SUMMARY OF FEES is sold within one year of completion, the owner will have the burden / • BUILDING of proving he did not build or Improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU PERMIT $ ' • - SMTP $ O I, as owner of the property, am exclusively contracting with AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ PERMIT and Professions Code: The Contractor's License Law does not apply to - ISSUANCE S — an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING ' S the Contractor's License Law). 100,000+BTU PLAN CHECK $ • O I am exempt under Section B.& P.C.for this BTU ELECTRICAL $ • 8 reason - PLAN CHECK $ --� ' /c MICROFILM S Date -- Owner SYSTEM REPAIR,ALTERATION _ Iy TOTAL FEE E I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE ,MECHANICAL $ / �6 PLAN CHECK' $ •-3 n 5' LESS AD- information is correct. I agree to comply with all city and county VANCE PC S_ ordinances state laws relating to construction,and hereby authorize _ ' represents ve of t�js to nter upon the above en ionetl property {f50%ci .--#4' - 90r s. C FINAL FEE $-.f �! Signature / �( �#s �f'"�� ISSUE FEE — CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor.--------'.— = . '. . CONSTRUCTION AND PLANNING POOL&SPA `"-'. ,i APPROVALS Permit# a157)8' Date Inspector APPROVALS _ Permit# y Date Inspector _. 1. Temporary Electrical Service or Pole • • 43. Pool & Equipment Location - - - . 2. Soil Pipe-Undrgrn • 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn /-/-/if-'53 (C 45. Forms . 4. Electrical Conduit-Undrgrn ‘ *'y/E3 46. Electrical Bonding 5: Steel Reinforce 47. Rough Plumbing& Pressure Test - - 6. Electrical UFER Grn tj acv .g'3 LJ C 48. APPROVAL TO COVER-GUNITE - • 7. Footings . 49. Electrical Conduit-Undrgrn . 8. Foundation50.. Gas Pipe, ❑Undrgrn,Test • 9. Water Pipe-Undrgrn - 51. Backwash Lines.P-Trap. ❑Undrgrn ' - • 10. Structural Floor System 52.-- APPROVAL TO DECK 11. Property Sewer Line & House Connection •- 53. Backwash & Receptor-Final - • - • •12. Street Sewer Connection - - - -__ 54. Heater & Vent-Final 13. Rough Plumbing _ 2j a--- yr`1't• •• "55 Plumbing System-Final - - 14. Rough Electric-Conduit C• • -- - 56: Electrical-Final 15. Rough Electric-Wiring CXQ4/7?. -Se' aa,Crb •5-!l^TS?j Q - 57. Solar System-Final 16. Rough Heating & Air Conditioning .?/z17.Pt �jq'C b8. Fencing&Access Approval .. 17. Ducts, in Structure •. - 59. APPROVED FOR PLASTERING .. . 18. Ducts, Ventilating . -- . _ - i , • , . . 19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL ' * 20. Roof Framing - - _ - - _ 21. Roof Sheathing 22: Frame.and Flashing _ - NOTES: 23. Insulation ^• - .s /L -CS3 \3, .ct4...._t' ti Cleo SF/tJto .r= 0 C' 24. Lathing & Siding . - - - 25. Drywall Nailing _ • . . . 26. Plaster Brown Coat - ' ' - - 27. Electrical Power Meter-Final ‘ 1-16-61-3 e•C- - • 28. Final Electric " s - _ 7-5--14- C 3 ' 29. Final Heating &Air Conditioning .13 , 30. . Final Gas Pipe-Test _ - . / _ 31. . Final Plumbing • - 32. Water Service-Final - - /' - 33. Gas Service-Final / 34. Solar Domestic-Final • •- 35. Landscape Sprinkling System t • 36. Sound Attenuation . . • 37. Handicap Regulations - . 38. FINAL STRUCTURE & BUILDING • • - 39. Special Requirements Completed - -- - i 40. Electric Release to Edison - - - • - - -- - - _. - - • 41. Gas Release to Southern California Gas Co. - • - . . - 42. CERTIFICATE OF OCCUPANCY _ _ - . ' - - No Date - �• Applicant fill in all spaces within heavy border lines and sign all appropriate declarations. LPS! )CITY OF COSTA MESA '� PERMIT NO. TRACT NO. LOT NO. BLOG.NO.CONSTRUCTION'PERMIT IPS 49/0 rDEC 8 1982Project Address /97 E ?� A St. T�YPPEE OF CONSTRUCTION Owner Da„ 4 yon y Phone L(j44-4/541 IeTNEW ❑ ADD ❑ ALTERATION Lin CITY OF COSTA MESA - Address .54pe,{ F"� 0 REPAIR 0 CONVERSION ❑DEMOLISH ,/ ZONING REGULATIONS . Arch/Eng. License No. 0 OTHER - - Address DESCRIPTION OF WORK A.P. • • _ /Sn GIS A — ZONE PLNG. REF.If Contractor O W r1ro4 /b i. 4.tv'- Phone TYPE OF PERMIT BUILDING - 'I'p Bl. I 4)ING yft ,�/ SETBACK C/L ST. PROPERTY LINE Address s 0 GRADING 0 FOUNDATIONkka/ %STRUCTURAL DE YARD - LEFT LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL' PLUMBING ❑MECHANICA - SIDE YARD I hereby affirm that I am licensed under provisions of Charter 9 (corn- RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, .and my license is In full force and effect. . REAR YARD(TO P/L) PROJECT DESCRIPTION License Class License No. PKG.SPACE REQ. PROVIDED Date Signature SQ. FT. - ' WORKERS'COMPENSATION • DECLARATION OCCUPANCYCONSTRUCTION CONSTRUCTION TYPE STREET WIDTH PARK FEE $ Thereby affirm that I have a certificate of consent to self-Insure Or a VALUATION/PIOLC€-OZONE ZONING APPROVED BY - DATE . certificate of Workers' Compensation Insurance, or -a certified copy SPECIAL CONDITIONS: thereof(Section 3800,Lab.C.). �. GRADING CU.UDS. ACRES • ' 'by NO. Company •»""�I I &.y.swS . . ert ifietl copy is hereby furnished. , REMARKS: il 59 P/ - - .. -edified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - - (This section,need not be completed if the permit is for one hundretl - ' (5100).or less). • - " . ' I certify that in the performance of the work for which this permit is . - - • Issued,,I shall not employ any person in any manner so as to-become PLUMBING • PLAN CHECK - - ELECTRICAL ' . . PLAN CHECK . subject to the Workers'Compensation Laws of California. _ _ f. uW tLLING Date Signature (�AHAGt BATHTUBS SHOWERS — SO FT SO FT NOTICE: If after making this declaration, you should become subject TOILETS Z URINALS - GENERATOR 0-1 KW_1-10 KW - to the Workers' Compensation provisions of the Labor Code,you must � TRANSFORMER forthwith comply with such provisions or this permit shall be deemed . LAVATORIES Art Tt DOUBLE LAYS — 'APPLIANCE 10-50 KW_50+KW - , revoked. KIT.SINKS DISHWASHERS — 'MOTORS - 0-1 HP l'-10 HP CONSTRUCTION LENDING AGENCY I I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS •. SUMPS - (INC.SOLAR) 10-50 HP 50+ HP - formance of the work for which this permit is Issued (Section 3097 - ' Civ. C.). FLOOR SINKS - FLOOR DRAINS FIXTURES OUTLETS SWITCHES .Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS - • , OWNER BUILDER DECLARATION ' INTERCEPTORS CLARIFIERS POLE LIGHTS ' I hereby affirm that I am exempt from the Contractor's License Law for _ the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOLP TRAP EONSI Hut.I Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to its Issuance,also re- WATER SERVICE i ALTERATION t� — PANELS • MAIN - SUB quires the ap,licant for such permit to file a signed statement that-he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE 1 OUTLETSSERVICE ' ' AMP^ ' • (Chapter 9 (commencing with Section -7000) of Division-3 of the - Business and Professions Code) or that he is exempt therefrom and the - WATER HEATERS / BTU OUTPUT 4/0, � bads for the alleged exemption. Any violation of Section 7031.5 by — en r applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - } — - - -. t more than five hundred dollars ($500). I . f_ ., as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS - • • , sole compensation, will do the work, and the structure is not intended or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. W.*IA5�, 2 Af — ISSUE FEE Contractor's License Law does not apply to an owner of a property .J APPLICATION APPROVED BY - DATE who builds or improves thereon, and who does such work himself or ISSUE FEE . • through his own employees, provided that such improvements are not ' intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK • SUMMARY OF FEES Is sold within one year of completion, the owner will have the burden - of roving he did not build or Improve for the purpose of sale). • •• BUILDING • ,•v' - HEATING SYSTEM 0-100,000 BTU PERMIT $ �7:417) SMTP . $ ' as owner of the property, am exclusively contracting with AND DUCTING • icensed contractors to construct the project (Section 7044, Business 100,000 + BTU PLAN CHECK $ • PERMIT - and Professions Code: The Contractor's License Law does not apply toISSUANCE S an owner of property who builds or Improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING S g / •—•••• ' tracts from such projects with a contractor(s) licesned pursuant to SYSTEM . GRADING $ the Contractor's License Law). 100,00 /�n +BTU 'PLAN CHECK $ • - • . ❑ I am exempt under Section B.& P.C.for this BOILERS• BTU ELECTRICAL $ ' $ reason . PLAN S SYSTEM REPAIR,ALTERATION • PLAN CHECK $ • - Date Owner MECHANICAL E -• • TOTALFEE$- I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE • LESS AD- Information is correct. I agree to comply with all city and county :PLAN CHECK $ VANCE PC $_ ' ordinances an ate laws relating t onstruction and hereby authorize re resentativ s f this cit to ter upon the above mentioned ' property fo n pec(lo ,^,J1`L 4 Signature '-^ r-{�(f' Date�� 12.- FINAL FEE S_ Drivers' License or SS$ \tt ISSUE FEE - ��/ k . CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING • POOL&SPA _ - \ APPROVALS Permit# Date -Inspector - APPROVALS Permit# �`� - Date Inspector 1. Temporary Electrical Service or Pole - _ 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn - - /2_,qn- pj• 44. Steel Reinforcement • ' ' 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding - 5.. Steel Reinforce - 47. Rough Plumbing& Pressure Test - ' 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings - 49. Electrical Conduit-Undrgrn 8. Foundation .. 50. . Gas Pipe, 0 Undrgrn,Test 9. Water Pipe-Undrgrn /•z-./.9-n- /,1'£' 51. Backwash Lines,P-Trap. 0 Undrgrn ' 10. Structural Floor System 52. APPROVAL TO DECK 11. Property Sewer Line & House Connection ' -;f-yZ j%'(' . 53. Backwash & Receptor-Final . 12. Street Sewer Connection- - - 54. Heater &Vent-Final . • 13. Rough Plumbing 'J/;,tT/,y) , ; f*' 55._ •Plumbing System-Final 14. Rough Electric-Conduit - • -56. `'Electrical-Final . 15. Rough Electric-Wiring - 57. Solar System-Final 16. Rough Heating & Air Conditioning b8. Fencing&Access Approval . • 17. Ducts, in Structure 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating ' 19. Gas Pipe-Rough &Test • . - 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing - - - - ' • 21. Roof Sheathing - - ' 22. Frame and Flashing - -- NOTES: - - 23. Insulation - - - _ . 24. Lathing&-Siding - - - • - - • 25: Drywall Nailing _ ,. - ' - 26. Plaster Brown Coat - - . 27. Electrical Power Meter-Final , - .- - . 28. - Final Electric - - • - -- 29. Final Heating & Air Conditioning 'el`' ._ - 30. Final Gas Pipe-Test - - f28=f !'�' % 31. Final Plumbing -. _ _ .: • 32. Water Service-Final ` i,t-jf' .L _ f... • " -•' • • • 33. Gas Service-Final /_-7770 - • .. ' • ' 34. Solar Domestic-Final - - . . 35. Landscape Sprinkling System - - 36. Sound Attenuation ' 37. Handicap Regulations - 38. FINAL STRUCTURE& BUILDING - - 39. Special Requirements Completed - 40. Electric Release to Edison • • ' 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ' No Date .. - V i l Applicant to fill in all spaces within heavy border lines and sign e& pproptate declarations. 2. 031.13 I ILUU/!IP S;'U,(,3 Tt CITY OF COSTA MESA I P IT Nom. TRACT NO. Co NO. •BLDG-NO. CONSTRUCTION PERMIT J 0- J ��/ ' Affsr:/ / stit 2 - Project Address 1.$7 e aa^ .5 it. TYPE OF CONSTRUCTION /�, Owner �cnr+l A /yon 3 Phone L4•-•51...1-‘L4•-•51...1-‘4L4•-•51...1-‘45-id/ 0 NEW 0 ADD 0 ALTERATION - (,y/ _ - - -. Address _ 5q�'€ - ❑5EPAIR 0 CONVERSION ODEMOLISH �/r- Arch/Eng. c7C rll (T 4. � Cr - -License No.2(S'7 OTHER ZONING REGULATIONS Address QC( OW pori k..4{ . C-,PA. DESCRIPTION( IOF WORK 34F n+w 6arplp • A-P• • "7.77'65 ^ /'1 d , Oebend `e r&chap iho“St - ZONE PLNG. REF.45 ZG-ez.-//8 , Contractor Ow fol-/13,,,1rQYr Phone 54 ko Q TYPE OP PERMIT // BUILD/ G UI DIG • • SETBACK CAL ST. To, I' P IEOgPERTVNLINE u "C. .wo 'Address — Snm•e _ 0GRADING ❑ FOUNDATION STRUCTURAL SIDE YARD LI - - . LICENSED CONTRACTOR DECLARATION - 0 TENANT 0 ELECTRICAL ❑PLUMBING ❑MECHANICAL LEFT YARD -7/ I hereby affirm that I am licensed under Provisions of Charter 9(corn- . RIGHT mencing with section 7000) of Division 3 of the Business and 0 OTHER I I © Z // - Profesfions Code, and my license is in full force and effect. REAR YARD(TO P/L) /Z o PROJECT DESCRIPTION License-Class License No. / PKG. REQ. 4� PROVIDED• 4 SQ. FT. Date Signature _ STREET WIDTH PARK FEE$ WORKERS'COMPENSATION DECLARATION OCCUPANC -3 �l6�aSTTRUCTION TYPE V / I hereby affirm that I have a certificate of consent to self-insure or a VALUATION 5' /Tv ZONE ZONING APPROVED BY,Lgi✓ 64/.. DATE`t-6�'L certificate of Workers' Compensation Insurance, or_ a certified copy - ( .- ��-`�+AT thereof(Section 3800,Lab.C.). GRADING CU.YDS. ACRES SPECIAL CONDITIONS: • Policy No- Company HULD PUK SPtUAL Ktl(ULK$MEIVIS r' 'ertlfied copy is hereby furnished. ,REMARKS: - sriifled copy Is filed with the city Building Division. - .L...MPTION FROM WORKERS' COMPENSATION DECLARATION, • (This section need not be completed if the permit is for one hundred - - ($100 ) or less). - - - CBrtIfY thatthe pprfWmensa of the work which thisermit Is Issued, I shall (n no employ any person an m nn so as become PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK ' subject t h rs'COmpensatlor s of If n a. UW tLLING VARAOt BATHTUBS SHOWERS Date 2- Signature \ cs"s SO FT SQ FT ' NOTICE: f after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW ' to the Workers' Compensation provisions of the Labor Code,you must - , - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAYS APPLIANCE 10-50 KW 50 + KW , revoked. CONSTRUCTION LENDING AGENCY - - KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP • I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS . SUMPS ' - ' ' - (INC.SOLAR) 10-50 HP ' 50 +HP formance of the work for which this permit is Issued (Section 3097 Civ. C.). T 5e D��titIAJP- J ,1 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name , ✓ - - ' Lender's Address - - ` DRINKING FOUNTAINS GAS TUBE SIGNS .r OWNER BUILDER DECLARATION INTERCEPTORS - ,CLARIFIERS ' POIJE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for ,• the following reason (Section 7031.5 Business and.Professions Code: .SWIMMING POOL PTRAP - ' - LurvmI RUL IL AN IN - Any city or county which requires a permit to construct, alter, _ •. POLES METERED SUB Improve,demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION .. PANELS MAIN SUB , • quires the applicant for such permit to file a signed statement that he - is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP ' (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that,he is exempt therefrom and the- WATER HEATERS BTU OUTPUT . basis for the alleged exemption. Any violation of Section 7031.5 by _ ' ' , any5pplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - . o('`'� , ` more than five hundred dollars ($500). _ ., - t f<z0s owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS _ sotii 'ompensation, will do the work, and the structure is not Intended or offered for sale. (Sectlon-7044, Business and Professions Code: The SOLAR PIPING SVS. ISSUE FEE (J�7{,/ B Contractor's License Law does not apply to an owner of a property , who builds or improves thereon, and who does such work himself or APPLICATION APPROVED--ISSUE FEE -- • , DATE////8�ez_ through his own employees, provided that such improvements are not intended-or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES ' is sold within one year of completion,the owner will have the burden - of ovmg he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING 413•615 O� ,� /�?, • as owner of the property, am •C+tl�iwy' contracting withPERMIT - $ SMTP - $ AND DUCTING - Ilcensed contractors to construct the project (Section es7044,not Business 100,000 +BTU _ PLAN CHECK $ ��` PERMIT __ aM Professions Code: The Contractor's License thereon, es not apply to ISSUANCE $ an owner of property who builds or improves thereonand who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM - GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ I am exempt under Section B.& P.C.for this BTU . . ELECTRICAL $• '$ reason - PLAN CHECK g MICROFILM $ - Date Owner SYSTEM REPAIR,ALTERATION • TOTAL FEE$ I hereby certifythat I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ Information is correct. I agree to comply with all city and-county PLAN CHECK $ LESS AD- ordinance state laws relating to con truction,and hereby authorize VANCE PC $ represent Ives of thl cit ent upon the above mentioned S2o. • property for I speT' p Ose Z L Signature 1 1 Date FINAL FINAL FEE E • Drivers' License or 55 Yf ISSUE FEE CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor c - - _ . . , . • CONSTRUCTION AND PLANNING. - ' ' \ -, - ' POOL•& SPA - - APPROVALS Permit.# 4 6442/ Date Inspector . •s: Dater, ? Inspector APPROVALS Permit# - -- 1. Temporary Electrical Service or.Pole - 43. Pool& Equipment Location - - - 2. Soil Pipe-Undrgrn. . 44. Steel Reinforcement - - , 3. Electrical Conduit Utility-Undrgrn.. . 45. Forms ••- - - ; 4.- , Electrical Conduit-Undrgrn --- - . . _ 46.. .Electrical Bonding - • . . . • , 5. Steel Reinforce , • , 47. Rough Plumbing& Pressure Test - ' - - 6. Electrical UFER Grn - - 48. APPROVAL TO COVER-GUNITE 7. Footings - l • to-g?3 bS 49. Electrical Conduit-Undrgrn 8. Foundation - - • 50. Gas Pipe, ❑Undrgrn,Test 9. Water Pipe-Undrgrn - 51. Backwash Lines, P-Trap, ❑Undrgrn - 10. Structural Floor System . 52.- APPROVAL TO DECK .11. Property Sewer Line & House Connection 53. Backwash & Receptor-Final 12. Street Sewer Connection . 54. Heater&Vent-Final 13. Rough-Plumbing . • . - • 55. Plumbina System - Final 14. Rough Electric-Conduit -56. Electrical-Final . 15. Rough Electric-Wiring • 57. Solar System-Final 16. Rough Heating &Air Conditioning b6. Fencing &Access Approval 17. Ducts, in Structure - 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating - - - 19. Gas Pipe-Rough &Test _ 60. POOL/SPA.SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathing 9-3,7? > % f ,p;:r 22. Frame and Flashing©kr,-,.s,' pQn-4 cL'u,i _ NOTES: 1\3,8,� �(,� f) ; ,,,...a..- , 23. Insulation °X•f-o 1;,i 25 -z -•3l -�-2 i ota La 'D5 )-• -9'3 .- CP 24. Lathing & Siding `D• / _ -1-"? c` 1 DS 3-3_42 3 25. Drywall Nailing ll.$ . �,2. - pie-- -(-y t q -, 5 3-e/ Z Sfit.g.etred age/04 do 4' 26. Plaster Brown Coat .b5 I'2-v-d- ow& -) S ,. e r'-3 3 27. . Electrical Power Meter-Final 28. Final Electric _ 29. ' Final Heating & Air Conditioning - • 30. Final Gas Pipe-Test , 31. Final Plumbing 32. .- Water Service-Final .. • •- • >33. • Gas Service-Final - _ 34. Solar Domestic-Final - 35. Landscape Sprinkling System • 36. Sound Attenuation •- . . - 37. Handicap Regulations - 38. FINAL STRUCTURE & BUILDING 7)C, --).1%-----A-- - 39. Special Requirements Completed45t4 4 317/6_5 it •- 40. Electric Release to Edison - - _ - _ 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No. • Date - - / ; � % 4\olE OF TIMgFP QA�TCIn I CER IFICATE OF .. e=t) CONFORMANCE r HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES that the products identified below and on attached sheets Nos. are marked with the Collective Mark of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC) I and were manufactured in conformance with applicable provisions of U. S. Product Standard 1 PS 56-73, for Structural Glued Laminated Timber, and that such manufacture has been at our plant in Saginaw, Oregon , which plant has a quality control system approved by 1 the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION and inspected periodically by such Bureau. The undersigned manufacturer further certifies that the work has been done in accordance with the applicable job specifications. The manufacture of these members complies with the manufacturing and fabricating provisions of ( Chapter 25 of the Uniform Building Code. / / ei,4 ` /a eiz-L- JOB NAME: (Stock) Laminated Timber Services, Inc./Set /'O•' y9/ JOB LOCATION. Ontario, Ca/ / 'o1 /�S&€ (41.4... CUSTOMER'SOROBR NO. 3206 DATE 11/16/82 MFGR'S ORDER NO. BWS-11869-5 2 F-1/ D D' W.P. -G_ e Arch A• • , Ind Wra• Indus A.. ..d W \ r 1 sIGNATu7F A),_ ` E'- R. . Bohemia Inc. I TITLE Q. C. Director ADDR Saginaw, Oregon DATE 11/23/82 I AITC HEREBY CERTIFIES that the said company at its said plant is licensed by the 'j AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect of i products which comply with applicable provisions of said Standard, that the adequacy of the quality j control system in effect at said plant is periodically inspected and verified by the Inspection Bureau of j the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of the under- signed, said company is capable of complying with applicable manufacturing and testing provisions of I said Standard in respect of products manufactured at said plant. Conformance with the Standard in respect of any specific or particular product is the sole responsibility of the manufacturer; AITC's I guarantee hereunder being that the said company is qualified to produce a product meeting the said Standard and that its plant is periodically inspected and verified by the AITC Inspection Bureau. Gr.`.-, ".,,,,,,:,,t,",,, ;.r� t. A 58811 r;:,a,v , SBF AITC Cerlifi ate No. Signed for y ` ' •?':Vet`=""' AMERICAN INSTITUTE OF TIMBER CONSTRUCTION I ..�;,SE�AIL Y9 �_ w :e. —52.-02;.-; .--• -Zia(' /� l /'100. CyL9E-'Z�f; t^=s y �L.C/GG.'U`-r �"��- I j v I �F 4jWy PF,I 4.:1. _4 Russell Wail/ens Jack M,nnecs • t, . ra I . Executive Vico Prec dent Director. Inspection Bureau i-C}�' d'r+;h•-`(: • 1978 AMERICAN INSTITUTE OF TIMBER CONSTRUCTION C •:. AITC RnNAI IBCA 1 1 / • . . - • �• SHIPPER 2 ` 9 ;5 • �D��QG' v, '0' �,iD99B690eStQ`40 timber 5.36-41434:40. Services inc. • o ,,Yy STOCK xr .''. • p FAB It •.:4•,i , ( 1705 S. Bon View. Suile 303. Ontario, CA 91761 • 714/947-2121 Ship To: p SPECIAL STOCK :L;f:, ;;; •r I It?' Sold To: 6,5K6 f>e,vlrh 31,)d 1---- CUSTOMER'5 ORDER NO. OUR NUMBER SHIPPED VIA DATE SHIPP D 19/ 13- a- 3 G A ri IP�..:'OE1O“dW, .bT' St11ME0rnr.✓ .IZKJ4y.- iM.I Lhi. �iiCKSX4(.ty .}J4V1.:''‘.OESCRIPigPO.f V. :1 ix++:• �,�v\ .). ia - '•w �':.''- r-.krl. .`u 1/45/8' X /1 X 077 /gne/A,ea/(7,4/m,6e e / .1/1~ X //o/a- x 02v ' - ,/ / Sh x /4, /a- x 20 ' // e--e . /- - 83 Z6/,- ,c1,,e ,q /, Z7oaj //k , cp-/a&/ r, f2/T� • • dD %W Ift .t_;PCNSIBLE FOR DAMAta /9& il-Ar `10. _Duct o r ns _ .<: t • T , , 1 pl 4 _ . . ♦ • • , 1.. • 1 •' , I a ; 't ' t is • • , • • ♦ - -_ - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • - - ,- - CITY OF COSTA MESA, PE ITN TRACT NO. LOT NO.. BLDG.NO. . - CONSTRUCTION PERMIT /� jcf ' 0105 6/09/03 5e0 IL APPlicant's Mailing Address 142-4 L` S0- `,ice f4�A Q--'��"F� TYPE OF CONSTR CTION U NEW U ADD U ALTERATION U REPAIR • _ Project Address- Ir) E 1,A4 S} COS' h'` 5Y c1 - ❑ CONVERSION ❑ DEMOLISH ❑ OTHER ' Owner's Name IY'r•Sihrc h0.v' I—\4 O I%( Phone , DESCRIPTION OF WORK - ' ZONING REGULATIONS Address - - TYPE OF PERMIT 0 GRADING 1�FOUNDATION U STRUCTURAL A.P,qW - ZONE Arch/Eng. License No. ❑ TENANT ❑ ELECTRICAL Lf�PLUMBING ❑ MECHANICAL ' •PLNG. REF.REF.* - BUILDING - Address I ❑ OTHER . ' \ • TO BUILDING sr-renege nrsr rn 5T • h'\c,e \ 60.v1C(•9 C.P.ee Phone SS6-GC?D. PROJECT DESCRIPTION SQ. FT. OCCUPANCY• PROPERTY LINE REAR YARD (TO P/U Contractor's • Name Ica Address(mailing) !i \ kfi 3 rc.Yl5 e S C4•1 f Q hair a CONSTRUCTION TYPE VALUATION$ - LEFT SIDE YARD i RIGHT SIDE YARD - ZONE GRADING CU.YDS. ACRES PKG.SPACE REQ, PROVIDED License No. " LICENSED CONTRACTOR DECLARATION Remarks: - STREET WIDTH PARK FEE$ - - I hereby affirm that I-am licensed under provisions of Charter 9(commencing - , with section 7000) df Division 3 of the Business and Professions Code,and ' SPECIAL CONDITIONS: my licenseis in full ore d effect. - \ • License Class • Licgpse No. IC PLUMBING ' \`V'\, Date Co-C7-5.3 Signature 1 Bar Sink Sewer Cap • ELECTRICAL • WORKERS'COMPENSATION DECLARATIO ereby affirm that I nave a certificate of consent to self-insure ova certificate Backflow Preventer - - - ' Sewer Connection - - - Automatic Washer. .- Meter Clover 100 amps _. _ _ Workers' Compensation Insurance. or a cerWied co t er f (potion _ OD a00, Lib.tae. C.) '.g} \��rr,,..yy+�'��5 r /Backflow Irrigation Solar Collectors ^ Construction Pole Sub Panel �(, ' ucv No, (� k U —1S4FQ 11- Company s �rhlcSet t k 1)J t} r • j]`C¢rtified co - ' Bathtubs Solar Piping Cooking Unit • Sub Poi- /J py is with the etl. , P 9 INCertified opy's filed with the city Buil D vi ' n. p� Dishwasher Motors ❑0-1 HP ❑1%-8 Date'. `+� - � Applicant�' [ Clarifiers Solar Tank EXEMPTION•FROM WORKERS'COMPENSATIO ECLARATION - Dryers ❑Gas ❑Electric 'Inc Solar 09-15 HP 016-15+ (This section need not be completed if the permit is for,one hundred($100) or Dishwasher Swimming Pool w/Spa - less). Fan Microwave I certifylthat In the performance of the work for which this permit is Issued I Drinking Fountains Urinal . shall not employ any person In any manner so as to become subject.to the - F.A.U. Pole Light Workers' Compensation Laws of California. Floor DrainsWater Closet Date ; • Signature _ Fixtures NOTICE:If,after making this declaration, you should become subject to the ' Floor Sinks ; • _ •- - - - Water Heater - - - - Range, . . . . Workers' Compensation provisions of the Labor Code, you must forthwith Device Boxes i comply with such provisions or this permit 'shall be deemed revoked:. • , , Gas Service ,Outlets Water ServiceSign CONSTRUCTION LENDING AGENCY Outlets I hereby affirm that there Is a construction lending agency for the performance Interceptors - Standing Sections of the work for which this permit Is issued (Section 3097 Civ. C.). . - Lender's Name- - • ' Kitchen Sink . - - Switches Trash Compactor Lender's Address - ' - - ' OWNER BUILDER DECLARATION Lavatories Garbage Disposal I hereby'af firm that I am exempt from the Contractor's License Law for the P-Trap- Generator 00-5 KW 05-15 KW • ' following reason (Section 7031.5 Business and Professional Code:Any city or P - - . - county which.requires a permit to construct,alter,improve,demolish-or repair Transformer 15-50 KW ' any structure, prior to its Issuance, also requires the applicant for such permit Roof Drains .. • to file a signed statement that he/she is licensed pursuant to the provisions of - - ' 05U+KW the Contractor's License Law(Chapter 9(commencing with Section 7000) of - - Reinspection Fee 475' - .... i:',Ision.3 of the Business and Professions Code) or that he/she-Is exempt -• , Showers - , Reinspection Fee $15 - ' sefrom and the basis for the alleged exemption. Any violation of Section Meter ❑up to 100 amps Issue Fee • $ 3 71:5 by any applicant for a permit subjects the applicant to a-civil ; - I i_ _ - • nasty of not more than five hundred dollars($500). . - Service Sink Issue Fee $ 3 Zoning Approved By Date employees with wages'as their Sale - - - - I, as•owner of'the property or mY compensation' will do the work,and the structure Is not Intended or offered - MECHANICAL I - for sale Law Ion 7044; Business.and Professional Code:.The Contractor's - ---- - - - ---- ---- --- - - - -- ----- APP rCabon ApprOVed Date • . • 1 By r�' License Law does not apply to an owner of a property who builds or Improves Boiler i Refrigeration System Application Issued B • employees, who tloes;such work himself/herself or through his or her own • _ PP Y Date employees, provided that such Improvements are not Intended or offered for • Duct-Under Ground 00-100,000 BTU ❑100,000 BTU • sale. If, however, the building or improvement is sold within one''year of com- . SUMMARY OF FEES pletlon, the Ownerowl ll have the burden of proving he/she did not build or im- - , Uoveforthepurposeotsale). , I Duct-Structural 1 System Repair/Alteration BUILDING PERMIT $ SMIP $ ,• U I, as owner of the property,am exclusivelyctin !with licensed con- '.tractorsto construct the.project (Section 7044,Business and Professions-Code: .' . Duct-Ventilating- : . - - .. - 'PLAN CHECK, ' $ ' PERMIT The Contractor's License Law does not apply to an owner of property who - - - ' OU; ' ISSUANCE ' ' $ I ' builds or Improves thereon,and who contracts for such projects with a con- . Exhaust System 0 Multiple 0, , PLUMBING t $ •� tractor(s) license pursuant to the Contractor's License Law). - - GRADING i $ Can)exempt under Section B.& P.C.for this reason i Firepl/Fart.BIL ICBG 'PLAN CHECK $ ELECTRICAL $ $ Date Owner' ' Heating-System&Ducting i t MICROFILM • $ I hereby certify that I.have read-this applicationiand state-thaYthe above '.` ' '00-100,000 BTU 0100,000BTU - - - - - PLAN CHECK, $ information Is correct. I agree to comply with all city-and county ordinances i - . TOTAL FEE $ ' and state laws relating to building construction, and hereby authorize repre- - •Hood or Type I 0' 'MECHANICAL $ 1 sentatives of,thl 'city to nter,upon the above-mentioned property for yp , ReinspeQion Fee $15 LESS I inspection pure � p,P. ( p o Canopy' Type II 0 PLAN CHECK $ • ADVANCED PC $ • Signature /+ at/✓"^•' I: ' • Date b-7- Q3 I i •r i 1 1 , , _@Q Drivers' License or SS bl' Registers Issue Fee $ 3 - • i FIN_AL FEE I $ , • 5:• CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor "ma 'CONSTRUCTIONIAND PLA ING- : ` l - ;12. , "` _ • ;� ' r < < 3 - Date Inspector i" Date - Inspector: _- •,APPROVALS Permit# N- f •• •APPROVALS Pe'rmit.# z • _ - TT 1; Temporary Electrical ServiceorPole ' - - - ;;q - . !'52. Pool & Equipment-Location' _ - ' a 2i Soil Pipe-Undrgrnd.t .' ;.- ^2. 5 3. Steel Rift ' ' - enorcemen . , . 3t Electrical Conduit Utility-Undrgr -nd.i 54. Forms . = i =: i • - . ',i 4: Electrical Conduit-Undrgrnd: - " _ - 2. ." _ 55. Electrical Bonding, - - • 5r Steel Reinforcement , r i • - - • ;,- ,t: ...56.1 Rough Plu'mbing-& Pressure Test • - - 6: Electrical UFER Grnd.' • ' -- 4' ' _ 57.1 APPROVAL TO COVER-GUNITE- 7. ootings t • t - - 58. Electrical Conduit-Lin - . ` F . 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 Se'we'r Line & House Connection - - ,62. Backwash & Receptor-Finale, .. 12. Sewer Cap ' . ' - - 63. Heater& Vent-Final • - 13. Roof Drains ; , r .64. Plumbing-System- Final _ 14. Rough Plumbing ' I - •65. Electrical-Final . % - r15': Rough Electrical-Conduit - r --T' - r - -' ' .66.TSolar System-Final . .- - `, - - - - - - - pY „ 16. Rough;Electric Wiring.. � � t :: , ,-": 67.;Fencing & Access Approval - ,'- - - - - '17. •Rough-Wiring Sign ` , . : i = - 68.'APPROVED FOR:PLASTERING - - 18. Rough Electrical-T Bar Ceiling - • - - 69. POOL/SPA SYSTEMS FINAL - f 19. Rough Heating & Air Conditioning i . 1 _ FIRE DEPT. REQUIREMENT -_ . . ii 20. RoughFactory'Fireplace I ' i APPROVAILS! Permit'# . 7 1) 21_ Ducts, in Structure - , I ' I ' 1i 70., Underground Hydro , 1,,22. Ducts, Ventilating _ -: 1 , ` . . 1 ; 71. Product Piping O Gas 0 Oil ' . ' .7-. 'j,23. Gas Pipe-Rough&Test - , 1 ! , 72. Underground Flush • .1.: !;` 4. Roof.Framing- - _ - . o ,r; " , - 73., Undergrnd.Storage Tank ❑Gas _D Oil 25`Roof Sheathing ' _ - ' ; I. 74.;Overhead Hydro - • i ; " 26. T-Bar Ceiling (Structural).& Monocoat . . : l '• ' ' 75. Dry Chemical - " , w , 27. Frame and Flashing ' ' ' , I 76. Dry Standpipe ` L 28. 4Lathing&I Siding ! I �; I . I l• 77. FIXED SYSTEMtFINAL 1 _` 429.:Insulation; -- r: " 1 '' ` I I 78. FIRE PREV. FINAL ' 1 30. Drywall Nailing 1 „ l I i Notes: I I • ' 31. Plaster Brown Coat 1 - i -( -- r - - I- - - i - , - - -- - '32. Electrical Power MeterlFinal ' , ' I 1 f ' I l i . A l: .,33. Final Electric '. - - _ l -{_- _• ,- _ - _ - 34. Final Heating &'Air Conditioning I `'^ j -, 35. FinalGas,PipeiTe'st - H I ' • _ 4 - - 36. Hood or Canopy:: - 1 - .. - - - - 37. Final F.aetory Fireplace rt ! ; i - r , 38. Final P„lumbing i - 1 I 39. Water Service-Fihal' j r -, 40. Gas Service-Final - - • 41. Solar Domestic-Final 42. Backflow Preventer' . ' I ' l ' 43. Backflow Irrigation' l ��' - r - 44. Landscape Irrigation j �[� _ 45. Sound 'Attenuaiion I '- �+���-� � - 46. Handicap Regulations/I ' 1 r ` 1 , _ - . 47. FINAL STRUCTURE & BUILDING ., ' ' ' , 1- ' 48. Special Requirements Completed' e , ' ., , I j . 49. Electric Release to Edison, I 1 , _ - _I _: _ t- I _ ._ __'" 1 50. Gas Release to Southern California Gas Co I I I 51. CERTIFICATE OF OCCUPANCY j1 I ; - ; 1 -- No, ' ;I ' Date - - - . _ ._ 1 --{---�-- , Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ CITY OF COSTA MESA a P IT O. TRACT NO. LOT NO. BLDG.NO., 6128 :-.12;73:4 I ,a J.. TL CONSTRUCTION PERMIT �p� �� (/ Applicant's Mailing Address Sw-'-R- TYPE OF CONSTRUCTION LJ NEW U ADO U ALTERATION ❑ REPAIR - Project Address Ill I- ' '•).,*61' 51. El CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name ��^`'k kl S Phone 64'1--4541 DESCRIPTION OF WORK ZONING REGULATIONS Address 5H•I•"A_ - TYPE OF PERMIT Li GRADING U FOUNDATIO�NU STRUCTURAL A.P.4.6 ZONE Arch/Eng. PI- MECHANICAL No. ❑ TENANT 0 ELECTRICAL 0 PLUMBING MECHANICAL PLNG. REF.* - BUILDING cFTRAcie cji 5'T 0 CTHER REAR YARD(TO P/L) AddressTO BUILDING Contractor's Name O W Ww /b.."I A.r Phone PROJECT DESCRIPTION SQ.FT- /O L OCCUPANCY PROPERTY LINE ' CONSTRUCTION TVPF VALUATIONS LEFT SIDE YARD RIGHT SIDE YARD Address(mailing) /•� ZONE /7-2- GRADING CU.YDS. ACRFc PKG.SPACE REQ. PROVIDED License No. __ C�5—ver LICENSED CONTRACTOR DECLARATION Remarks: /3 d y / STREET WIDTH PARK FEE S I hereby affirm that I am licensed under provisions of Charter 9(commencing rI , with section 7000) of Division 3 of the Business and Professions Code,and • SPECIAL CONDITIONS: my license is in full force and effect. — , License Class License No. PLUMBING • Date Signature - ' WORKERS'COMPENSATION DECLARATION Bar Sink -Sewer Cap ELECTRICAL 'hereby affirm that I have a certificate of consent to self-insure or a certificate Backflow Preventer - Sewer Connection Automatic Washer 'Meter Cover 100 amps _ f Workers' Compensation Insurance, or a certified copy thereof (Section _ , • 4800, Lab. C.) Backflow Irrigation - Solar Collectors • Construction Pole Sub Panel • Policy No. Company - Cooking Unit. Sub Pole Q_Certifled copy is hereby furnished. Bathtubs . Solar Piping L� Certified copy is filed with the city Building Division. Dishwasher Motors D0-1 HP 0115-8 Date Applicant Clarifiers Solar Tank - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Dishw •asher Swimming Pool w/Spa Dryers ❑Gas ❑Electric Inc.Solar 09-15 HP 016-15+ (This section need not be completed If the permit is for one hundred($100)or less). %} Fan Microwave — I certify that In the performance of the work for which this permit is issueif,I Drinking Fountains Urinal Ci • Cs?shall'not employ any person in any manner so as to become subject to the ' F.A-U. , Pole Light • Workers' Compensation Laws of California. . Floor Drains Water Closet • Date Signature .. Fixtures Range NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Water Heater - - g - -• Workers' Compensation provisions of the Labor Code, you-must forthwith _ Device Boxes ' . comply ,with such provisions or•this- permit shall be deemed revoked.. Gas Service Outlets Water Service Sign . CONSTRUCTION LENDING AGENCY - Outlets I hereby affirm that there is a construction lending agency for the performance. Interceptors Standing Sections of the work for which this permit Is Issued (Section 3097 Civ. C.) Switches Trash Compactor - Lender's Name - Kitchen',Sink P • Lender's Address -' Garbage Disposal OWNER BUILDER DECLARATION Lavatories 9 W I hereby affirm that I am exempt from the Contractor's License Law for the P-TrapGenerator 00.5 KW 05-15 KW following reason (Section 7031.5 Business and Professional Code: Any city or • _ county which requires a permit to construct,alter improve,demolish-or repair — -- - - - - Transformer 015.50 KW - any structure;prior to its Issuance,also requires the applicant for such permit • - Roof Drains - 05U{KW ' to file a signed statement that he/she is licensed pursuant t0 the provisions of ` Reinspection Fee the Contractor's License Law(Chapter 9(commencing with Section 7000)of spa $15 :..Qtvision 3 of the Business and Professions Code) or,that he/she Is exempt - Showers - Reinspection Fee $15 „Ierefrom and the basis for the alleged exemption- Any violation of Section - - . -- --- - Meter pup to 100 amps Issue Fee $ 3 j `-031,5 by any applicant for a permit subjects the applicant to a civil _ _ e y of not more than five hundred dollars($500). Service Sink Issue Fee $ 3 Zoning Approved By Date as owner of the property or my employees with wages as their sole - -- - compensation will do the work,and the structure is not Intended or offered - . MECHANICAL Application Approved By Date for sale (Sec/Ion 7044, Business and Professional Code: The Contractor's License Law does not apply to an owner of a property who builds or improves Boiler , Refrigeration System Application Issued ByH.21 {� thereon, and who does such work himself/herself or through his or her own PP Date ��a a-O ' employees, provided that such improvements are not intended or offered for • Duct-Under Ground 00100,000 BTU ❑100,000 BTU sale- If, however, the building or improvement is sold within one year of com- SUMMARY OF FEES elation, the owner will have the burden of proving he/she did not build or Im- • - - - I shrove for the purpose of sale). - : Duct-Structural , . System Repair/Alteration BUILDING PERMIT $, SMIP $ ' LJ I,as owner of the property,am exclusively contracting with licensed con- ��� - $ . tractors to construct the project(Section 7044,Business and Professions.Code:. Duct-VentilatingTv�e 14/d 1 / PLAN CHECK PERMIT • The Contractor's License Law does not apply to an owner of property who , / l ' • ISSUANCE $ builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0, - PLUMBING $ • tractor(s) license pursuant to the Contractor's License Law), PLAN CHECK • $ • GRADING $ 0 ram exempt under Section B.& P.C.for this reason • / Firepl/Fact.Bit.ICBO'#//y/ 1 • �� r r $ • • ELECTRICAL $ .7 ” ' Date - Owner t - I ' Heating System&Ducting ' MICROFILM $ -I hereby certlfy-that I have read this-application and-state that the above"'- 00100,000 BTU 0100,000BTL - -- - 'PLAN CHECK' Information is correct. I agree to comply with all city and county ordinances • I TOTAL FEE $ and state laws relating to building construction,and hereby authorize repro- • Hdod or Type I ❑ MECHANICAL $ I9 , , sentatives of this y to ter on a above-mentioned property for I yP Reinspection Fee, $15LESS 1 - ,e:� PLAN CHECK )t// $ , ADVANCED PC ) $ Ins9 action purpose ) � - / '/ �s Canopy Type II ❑' , —i=— •i I Si nature lL/ Date S L L N • ) I I Drivers' License or'S5;¢ _ - Registers Issue Fee $ 3 . •FINAL FEE; i $ ' / CMF 0865-46 rev.12/82 White-Building;canary-Applicant;Pink-Accounting;Goldenrod-Assessor I et r1CONSTRUCTION`AND PLANNING' 3 - _-. • _ ---t _- ,r^: :POOL:, 'A - - - �r - APPROVALS Permit# Ptf-'1/NG, Date - Inspector ' - + Date Inspector 2p _ - _ . _ - APPROVALS 'Permit# • 1,.- Temporary Electrical Service or.Pole . . - - .52:- Pool &Equipment Location S - - • 2' Soil Pipe-Undrgrnd.: _ _ r - . 53. Steel Reinforcement , , 3' Electrical Conduit Utility-Undrgrnd. -- 54:'Forms ' _ 7. 4' Electrical Conduit-Undrgrnd. :55. Electrical Bonding. ) 5? Steel Reinforcement - - _• 56. Rough Plumbing & Pressure Test i .• - -� , 57. APPROVAL'TO COVER-GUNITE 6: Electrical UFER Grnd 7.'Footings ' , . - . . ; 58. ElectricaUConduit-Undrarnd.. 8. Foundation - ` - 59. Gas Pipe, O-Undrgrnd.,Test - 9. Water Pipe-Undrgrnd. 1 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:Systen, Final - 14. RoughPlumbing ' _ •-65. Electrical-Final- - - -• 15. -Electrical-Conduit' '- - - , ' -- - I ,66.-Solar System-Final -- - :. 46., Rough-Electric Wiring _ ; ',T. I : . "-67:. Fencing &Access Approval - - -- '•'17.;Rouyh.Wiring Sign 68. APPROVED FOR PLASTERING ' -, 18.cRough Electrical-T Bar Ceiling ,_ - ' - : 69. POOL/SPA SYSTEMS FINAL 5 !i 19. `Rough'Heating&Air Conditioning - ' ! , • FIRE DEPT. REQUIREMENT- ' 20.fRough:FactoryFireplace ' ' ! APPROVALS! Permit#° I ' 21. Ducts,in Structure: I 70.1 Uriderground Hydro - • 22. Ducts, Ventilating _ r ' 71.' Product Piping O Gas ❑Oil -'- 23.'Gas Pipe-Rough&Test - r - - -, - ' • - . 72. Underground Flush, ` i'24. Roof Framing'. , ! •-• - • ' ;' . . 73. Undergrnd.Storage Tank'O Gas O Oil • K 25_ Roof Sheathing • ? ' ; r _ 74. Overhead Hydro ' ' 26. '71-Bar Ceiling (Structural)-& Monocoat 'I 75.; Dry Chemical i - ' ,27. Frame and Flashing I - : 76.;Dry Standpipe - ' 28. la ;thing& Siding : : 1 77., FIXED SYSTEM FINAL i n ., 29. (Insulation ' i , I 78. FIRE PREV . FINAL - 30. Drywall Nailing ' , ' I Notes: 31. Plaster Brown Coat - , ( - - - -- - - _ ,� PowerMeter-Fit 32. Electrical eter- nal ; . 33. Final Electric • ' I . 77//3 /0 . , ' • 34. Final Heating&Air'Conditioriing , rj/-Y3 35. Final Gas'Pipe-Test - H n - - _ • ' - 36. Hood or Canopy-,, _ _ I - I - 37. Final Factory Fireplace ' ; ' ' 7_/_13 4:0::::;; 38. Final Plumbing ' r' ' • ' ' ,- 39. Water Service-Final' + ' I . - ' a , i - . i - . . 40. Gas Service-Final ' I , ' ' I ' 41. Solar Domestic-Final '�', 1..' � ' - Iry 42. Backflow Preventer. 43. Backflow!Irrigation i • 44. Landscape Irrigation.System • ' - 45. Sound� Attenuatiori a ;, ! ' ' I • 46. Handicap1Regulations'� _ - ' - 47. FINAL STRUCTURE & BUILDING ' - 1 , j , , ,- 48. Special ReI quirements Completed ' ! I ' ' I - , 49. Electric Release,to Edison' • 50. Gas Release to Southern California Gas Co ! ' i I i ' j • •• rj 51. CERTIFICATE OF OCCUPANCY • _;•- , --. ' .- 1 + I-- ' No ll II - . • Date i : • Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA PERMIT NO. - TRACT NO. LOT NO. BLDG.NO. CONSTRUCTION PERMIT 7Fj 7850 4/27/33 44.2a7 TL Project ASdress c4/17c4/17 t Q1 js TY"...OF CONSTRUCTION • . Owner 3.4 Y1 X yon S Phone 69.2-yss✓ NEW ❑'ADD 0 ALTERATION - Ti Addres A.......4-S ❑ REPAIR_❑CONVERSION ❑DEMOLISH ZONING REGULATIONS Arch/Eng. License No. 0 OTHER A.P.$ Z G - /3 3- i Z Address DESCRIPTION OF WORK • ZONE 'L PLN'rGp. REF.L1 •g Z E /- 9 Z•-// Contractor • - Phone TYPE OF PERMIT // SETBACK C/L ST.�T7se PROPERTY NE `,� �' Address - 0 GRADING 0 FOUNDATION 119 STRUCTURAL SIDE VA RD O� LICENSED CONTRACTOR DECLARATIONl F I hereby affirm thLt I am licensed under provisions of Charter 9 (corn- 0 T ANT 0ELECTRICAL OPLUMBING ❑MECHANICAL SIDE VARDD! mencing with section 7000) of Division 3 of the Business and ER 6' SILelS'/eaT 3/cele Freeti RICHT Professions Code,. and my license Is In full force and effect. ITLEA 0- ) PROJECT DESCRIPTION License Class License No. . . . PKG.SPACE REQ. PROVIDED • • Date WORKERS'COMPENSATIONrDECLARATION - • OCCUPA CSTRUCTION TYPE STREET WIDTH &��� • PARK FEE.$ •I hereby affirm that I have a certificate of consent to self-insure or a VALUATION ONE ZONING APPROVED BY XA.C. DATE///27/h3 certificate of Workers' Compensation Insurance, or a certified copy / SPECIAL CONDITIONS: 7 b thereof(Section 3800, Lab. C.). . -GRADING CU.YDS. ACRES ' • "cy No. Company edified copy ishereby furnished. REMARKS: 7e)/ — G r • .:ertified copy is filed with the city Building Division. - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This section need not be completed if the permit is for one hundred _ ' ($100) or less). I certify that in the performance of the work for which.thispermit is - Issued, I shall not employ any persop.jn any manner 5 as to become PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK - Dat subject he k z'Compensatio Lbws oa n - - (4.v w BATHTUBS SHOWERS DWELLING GARAGE Date Signature -SO FT SO FT NOTI : If a er making this decla ation, you shout become subject -TOILETS 'URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensation provisions Of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES • DOUBLE LAYS _ .APPLIANCE 10-50 KW 50+ KW revoked: • . . ._ _. - . _ _ - -_ . CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS _ MOTORS 0-1 HP 1.10 HP ' - - I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS - - (INC.SOLAR) 10-50 HP 50+ HP . formance of the work for which this permit is issued (Section 3097 - - Civ. C.). • _ FLOOR SINKS FLOOR DRAINS •FIXTURES OUTLETS SWITCHES ' Lender's Name Lender's Address DRINKING FOUNTAINS GAS TUBE SIGNS ' " -- - ' OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERSPOLE LIGHTS ' - ' I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions'Code: SWIMMING POOL ' P TRAP r LUNS I KUL I ION , Any cityor countywhich requires aPOLES METERED SUB s permit to issuance, , alter, improve,demolish or r any mit to fit a g to its cement hat re- WATER SERVICE ALTERATION PANELS MAIN SUB is quires the licant for such permit to file asignedatrstatement ce that h¢ - - - (s ppursuant to the provisionswithLicense(Chapter Section 7000) of Division 3 of the - Business a Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT' ' 1.--is f he alleged exemption. Any violation of Section 7031.5 by • - plicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ' I t more than live hundred dollars ($500). c. 1, as owner of the property,or my employees with wages as their SOLAR TANK COLLECTORS " - sole compensation, will do the work, and the structure is not intended • ' or offered for sale. (Section 7044, Business and Professions Code: The SOLAR PIPING SYS. ISSUE FEE - - Contractor's License Law does not apply to an owner of a property APPLICATION APPROVED BY • who builds or improves thereon, and who does such work himself or ISSUE FEE - DATE through his own employees, provided that such improvements are not - - intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK • SUMMARY OF FEES • is sold within one year of completion, the owner will have the.burden of proving he did not build or improve for the purpose of sale). BUILDING _ El I, as owner of the property, am exclusively contractingO with' HEATING SYSTEM 0-100,000 BTU- 21-,•PERMIT $ Z •S� • SMTP' $ - AND DUCTING licensed contractors to construct the project (Section 7044, Business 100,000 +BTU PLAN CHECK $ (7' 22-7,-- • PERMIT ' and Professions Code: The Contractor's License Law does not apply to - - ISSUANCE $ • an-owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) Iicesned pursuant-to 'SYSTEM - - - - GRADING- $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ • ' ❑ I am exempt under Section - ' B.& P.C.for this $ BOILERS BTU ELECTRICAL $ reason ' - - ' - PLAN CHECK $ MICROFILM $ - ' SYSTEM REPAIR,ALTERATION Date Owner - - TOTAL FEE$. I herebycertify that I have read this applicationEXHAUST SYSTEM MULTIPLE MECHANICAL $ ycomply and state that the abovety PLAN CHECK $ LESSANE p -✓ Information is correct. agree to comply with all city and county - . . VANCE PC $_ ordinances and state laws relating to construction,and hereby authorize _ ' representative f this cit to enter upon the above mentioned -- " v property for 'n o u 7 Signature (({(.JJA.-- 'll�� [�-�,I Date ii/27/d 3 FINAL FEE $_L.�r I Drivers'License or SS# ISSUE FEE - - - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor , CONSTRUCTION AND PLANNIN POOL&SPA APPROVALS Permit# 4 g» Date Inspector APPROVALS _ Permit# Dates Insgtctor 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location -- - - • • - 2. Soil Pipe-Undrgrn - 44. Steel Reinforcement • - 3. Electrical Conduit Utility-Undrgrn - 45. Forms . ' •4. Electrical Conduit-Undrgrn • - 46. Electrical Bonding ' 5. 'Steel Reinforce S,r[_R•2, IN-, 47. Rough Plumbing &Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings f �7••T,,Pe__ /-.2743 w4/ .4i 49. Electrical Conduit-Undrqrn 8. Foundation 50.. Gas Pipe, ❑Undrgrn,Test _9. Water Pipe-Undrgrn 51.- -- Backwash Lines.P-Trap. ❑Undrqrn ' 10. Structural-Floor System • - 52. APPROVAL TO DECK • 11. Property Sewer Line & House Connection ' . . 53. Backwash& Receptor-Final • .. 12. Street Sewer Connection - _ - - - - 54. Heater &Vent-Final 13. - Rough Plumbing _ • 55 Plumbing Svctem -Final - 14. Rough Electric-Conduit - -56. Electrical-Final - 15. Rough Electric-Wiring - - - - - - 57. Solar System-Final ' i ' ' ' 16. Rough Heating &Air Conditioning - _- 58. Fencing&Access Approval , 17. Ducts, in Structure _ 59. APPROVED FOR PLASTERING; 18: Ducts, Ventilating , . - - •i 19. Gas Pipe-Rough &Test . . - " 60. POOL/SPA SYSTEMS FINAL ' 20. Roof Framing - • - ' 21. Roof Sheathing - .: - 22. Frame and Flashing - . - - - NOTES: - ' 23. Insulation - 24. Lathing&Siding - - 25. Drywall Nailing . 26. Plaster Brown Coat • 27. Electrical Power Meter-Final ' ' 28. Final Electric - . 29.. Final Heating& Air Conditioning - . 30. Final Gas Pipe-Test 31. Final Plumbing 32.- -Water Service-Final - - 33. Gas Service-Final 34. Solar Domestic-Final - 35. Landscape Sprinkling System - _ - 36. Sound Attenuation - • _ •- - - ' 37. Handicap Regulations - - - - - . 38. FINAL STRUCTURE& BUI LDI NG 175 SQ-Rt - 39. Special Requirements Completed - - - - - ' - 40. Electric Release to Edison - - - - - - 41. Gas Release to Southern California Gas Co. •- • _ ' - . 42. CERTIFICATE OP OCCUPANCY _- . . ._ . No Date -- - - - . la�1Cs�o —__ APPROVED STRUCTURAL APPROVAL ONLY City of Costa esa Building Dept. 10vEII) SEPARATE PERMITS ARE REQUIRED // / ' CITY OF COSTA MESA FOR ELECTRIC-41 . PLUMBING, BY BATF 27 1913 PLANNING DEPT. HEATING, `,Ir 'T ' "-II'IG AND THESE PLANS' MUST BE ON JOB T ALL TIMES SUBJECT TO BLDG. DEPT. itEO. REFRIGERATION WORK MAKE NO CHANGES WITHOUT PRIOR APPROVAL /�'',��j'�- /� OF DEPT. BY I. ER DATES122±i --.. ..-- THE ISSUANCE OR GRANTING OF A PERMIT OR APPROVAL DIR OR OP PLANNING Permit .11_ t. 6 7'7 5 OF PLANS AND SPECIFICATIONS SH,AL NOT BE CONSTRUED THIS i�Ur"R.'7rt7 ( L I TO EE A PERMIT FOR, OR AN APPROVAL OF, ANY VIOLATION _ : d1,COMPANY CF ANY OF THE PROVISIONS OF THIS CODE. NO PERMIT PRE- ALL INSPECT IQIJ REQUESTS SUING TO CIVE AUTHORITY TO VIOLATE OR CANCEL THE _._ • PROVISIONS CF THIS CODE SHALL BE VALID, EXCEPT IN SO F^R AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL. R) Ll) 6S .1I-LL F :,SONS ARE TO THE ISSUANCE OF A PERMIT BASED UPON PLANS AND BE L PLO O, l�L S t.L.EST THAT THE j -::.ATID�\S SHALL NOF PREVENT THE BUILDING OFFICIAL e/ ST„IE OF C. =I F';.:NIA DIVISION DF -LESE.4FTER REQUIRING THE CORRECTION OFERRORS �\ \.. dyY/' IND Sf'AL SAFETY BE CONSULTED FOR I FLANS f:VD SPECIFICATION 03 FROM PREVENTING ! `,, N ADv JN.;L REQUIREMENTS. ' C RS OPERATIONS BEING CARRIED OH THEREUNDER WREN f ` NJ v _. _ . ' -”r L,T1CN OF THIS CODE OR OF ANY OTHER ORDINANCb { \` IV r 0\ l v = F.. ' �1 V 4� V l v4 .6I RESIDENCE RESIDENCE RESIDENCE RESIDENCE 1 I-- Lu Lu Cr e W k. I- in N 14111 I 11 / L + STREET e- • • TYPICAL 611 CONCRETE BLOCK FENCE Cement Coping Optional —_c I1 t i I MINT GENERAL— NOTES Channel Block With 1-3/8 0 Horizontal Top of all M. .. Fences I MORTAR: One Part Plastic Cement, and Three Parts Sand For Fences 5 or Less ' '� '� 1'.! GROUT : One Hart Cement, Three and s F One Half Parts and Vert. Bars 3/8"0at 4' -0" O.C., o = � COPING: One Part Cement, Three Parts Sand For Fences Higher Than 5' —' u` o _ _ CONCRETE. Well Mixed 1:2-I/2 . 3-I/2 Vert. Bars 3/8" Oat 32" O.C. > w r-- Fill Cells Solid With Grout > Max. of 7- 1/2 2 Gallons Cf � z _ I I" ,.�' Water Per Sack of Cement Where Steel Occurs >I �� Reinforcing Steel Shall -� ;I-co GROUT MAY BE POURED FROM THE TOP �6cwiacrw.fu-Sec A 1'5-3' w o _ OF THE FENCE IN CELLS WHERE STEEL OCCURS. Al T.M. ¶� aq If� C u H CELLS AND AREAS OF HORIZONTAL REIN- A11�rel to cflPirrPQsnLal re) ' �' _ REIN- FORCEMENT SHALL BE CLEAR,CLEAN& 24" k l Code FREE OF ALL MORTAR DEBRIS,ETC. N PROVIDE CLEAN-OUT AND INSPECTION HOLES AT THE BOTTOM OF CELLS CON' N U AL GRADE I I, TAINING VERTICAL REINFORCEMENT. _ BONDS SHALL BE PROVIDED BY LAVING z +Oe -Vag l 'R�' I ' •'•9 �� r .F. I , BLOCKS IN STRETCHER COURSES SO THAT '� , - o ' 0 D VERTICAL JOINTS ALTERNATE IN EACH 7 m �f k t Taff c o iv n .p ° •‘• • COURSE. • TWQ�Jj8"♦ABABA ♦ e CONTINUOUS TOP • -- t,A,r. _ _ & BO TUI . - WIDTH • - TO 16 O.C. MAX. _ L. - SEE CHART 'e -.I ALL STEEL MUST BE TIED IN BELOW - < - DEPTH OF EARTHTCOTH PLACE AT TIME OF TRENCH ' I p 1/3 THE HEIGTH OF FENCE INSPECTION. V - . INSPECTION. A. 1A BELOW BOTTOM. . ti LI OF FOOTING. ' lo" 1_, 41. SCALE: I/2" = I' FOOTING REQUIREMENTS CHART WALL HEIGHT - 6 ' i 5' 4' 3' WIDTH ' 14" t 14 12" 12" THICKNESS 10" r- 10" 8 " 8 " DEPTH OF EARTHTOOTH . . L.---24" . ' . . .20 16" 12" SPACING OF EARTHTOOTH. . 12' 14'. . . . . . 16' 16' OWNERS NAME_ \_ City of Costa Mesa, California JOB pE RMADDNUMBER _— Building Department SIGNATURE: a f=OHM PU2'_21A_?_a2 11111111111111.7 ,t11711111111 Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PF�§MIT NO. p TRACT NO. I LOT NO. BLDG.NO. . 0302 I I /i38/JP I lido •\ , CONSTRUCTION PERMIT,' — Q O IU 4. f(y j-9 24 Z Project Address-�s / '7 �, .'a I Q d: C.S-7 S YYj . TYPE OF CONSTRUCTION ' Owner JRhKtcI )h Dtts Phone 61 4/pll 0 NEW 0 ADD 0 ALTERATION Addres9_ C 7 E- e'f nai $+F 0 REPAIR 0 CONVERSION yI DEMOLISH V .5/ Arcft(1py 1-krr.( 7u krr License No.2/c6 7 0 OTHER ZONING REGULATIONS A.P.* u32C— 3" Address O/O} IL.�•n.J fb"d' lj� C.'iN\. DESCRIPTION OF WORK ' " mal° `2-,.:'9'r 7 "-/Z-- - qa '4fG 4:10/7. °tear 6-e4o+s( ft794- Aeu-C ZONE 7Z.—Z PLNG. REF.* .zs -T2-//.g Contractor ato NYr'/b L.V I�YY Phone %,,,-L TYPEOFPERMIT - BUILDING UISELDINGCK C/LST. PROgPEIRTpYNLINE Address 4A rss.w 0 GRADING 0 FOUNDATION 0 STRUCTURAL $IDE YARD LICENSED CONTRACTOR DECLARATION 0 TENANT 0 ELECTRICAL OPLUMBING ❑MECHANICAL RIGHT YARD (corn-hereby affirm that I am licensed under provisions of Charter 9(co - R G mencing with section 7000) of Division 3 of the Business and 0 OTHER Professions Code, and my license Is in full force and effect. • REAR YARD(TO P/L) PROJECT S�!DfTESCRIPTION License Class License No. 50. FT. SV "�`7Qr e PKG.SPACE REQ. PROVIDED - Date Signature STREET WIDTH PARK FEE$ • WORKERS'COMPENSATION DECLARATION OCCUPANCY .CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self-insure or a VALUATION � � ZZONE ZONING APPROVED BY I GATE certificate of Workers' Compensation insurance, or a certified copy thereof(Section 3800, Lab.C.). GRADING CU.YDS. -3-6 ACRES SPECIAL CONDITIONS: , • y No. Company i - ;rtified copy is hereby furnished. REMARKS: • ' L Certified copy Is flied with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - ' (This section need not be completed if the permit.is for one hundred • . - - . ($100) Or less). - - I certify that in the'performance of the work for which this hermit is . . issued, I shall{ not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK - .. Date subject/p Wpr s Signature Compensallgrf�awso li{m is BATHTUBS SHOWERS , Y/ /(` I 'I` . %1 UWtLLING (.A HH(aE I I\V SD FT 50 FT NOTICE. If after making this declaration, you should become subject TOILETS URINALS GENERATOR 0-1 KW .1-10 KW' ' to the Workers' Compensation provisions of the Labor Code,you must - - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW _ revoked. _ - _ - _ . CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS - MOTORS 0-1 HP 1-10 HP -• I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS (INC.SOLAR) 10-50 HP 50 + HP ' ' formance of the work for which this permit is issued (Section 3097 • Civ. C.). L z` A t FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name !� • Lender's Address - DRINKING FOUNTAINS GAS TUBE SIGNS . - - - OWNER BUILDER DECLARATION • INTERCEPTORS 'CLARIFIERS POLE LIGHTS I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNJS HUI-i Wig • Any city or county which requires a permit to construct, alter, POLES METERED SUB . Improve,demolish or repair any structure, prior to Its issuance,also re- -WATER SERVICE ALTERATION PANELS MAIN. - . SUB . -- - quires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License'Law - (Chapter 9 (commencing with Section 7000) of Division 3 of the SERVICE AMP GAS SERVICE OUTLETS Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS' BTU OUTPUT • - - r .- for the alleged exemption. Any violation of Section 7031:5 by - spplicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS - it more than'five hundred dollars ($500). ' Cl. •? as owner of the property,or my employees with.wages as their SOLAR TANK COLLECTORS - ' Sole compensation, will do the work,and the structure is not intended • -- I or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. . ISSUE FEE / Contractor's License Law does not apply to an owner of.a property - /+ who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATEP,ip 57, through his Own employees, provided that such Improvements are not intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK S MMARV OF FEES is sold within one year of completion, the owner will have the burden _ r' • of proving he did not build or improve for the purpose,of sale). HEATING SYSTEM 0-100,000 BTU - )BUILDING 7 SOD,1 D I. as owner of the property, am exclusively contracting with PERMIT E z SMIP $ Icensed contractors to construct the ro'ecl Section 7044. Business AND DUCTING PLAN CHECK S _PERMIT p I ( 100,000+ BTU and Prwn r of Code: The builds or I LicenseoveLawn,does not apply to ISSUANCE $ an ofrom of chproperty who builds Improves thereon, and whoa con- REFRIGERATION 0-100,000 BTU PLUMBING $ tractsC ntom such projects with a contractor(s) Ilcesnetl pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000 I-BTU _ • "PLAN CHECK $ • - ❑ I am exempt under Section B.& P.C.for this $ BOILERS BTU ELECTRICAL S ' reason - MICROFILM $ ' 1III SYSTEM REPAIR,ALTERATION PLAN CHECK $ Date / QO�a owner / V. TOTAL FEE E ' I hereby It ifyy that I have read this application and stat that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ PLAN CHECK LESSANEP AID- information is state I agree to comply with all city ane county $ VANCE PC $ representati ordinances and state laws relating to construction,and hereby authorize represthis �e�n}}ppr upon the above eptioned /(Q,00 property fo i ectlon r es1!/ Signature OOfP Date // FINAL FEE E Drivers'License or SS* ISSUE FEE - CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor - • - CONSTRUCTION AND !TPLANNINGpp POOL&SPA ' -• APPROVALS Permit�k 5 Date Inspector APPROVALS, Permit# Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location ' - - • • - ' .2. Soil Pipe-Undrgrn - 44. Steel Reinforcement - - . - - - 3. Electrical Conduit Utility-Undrgrn - - _ . 45. Forms . • • , 4. Electrical Conduit-Undrgrn - - - 46. . Electrical Bonding - • • 5._ Steel Reinforce - 47. Rough Plumbing& Pressure Test . 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. Footings Q� 49. Electrical Conduit-Undrgrn - 8. Foundation - .5\w-{-i - . , ' 6 50. Gas Pipe, 0Undrgrn,Test 9. Water Pipe-Undrgrn. ._ . 51. Backwash Lines.P-Trap. ❑Undrern ' 10.. Structural Floor System 52. APPROVAL TO DECK - - • 11. . Property Sewer Line.& House Connection - 53. Backwash & Receptor-Final • 12. Street Sewer Connection .. - 54.- Heater& Vent-Final 13. Rough Plumbing. 55. Plumbing Svitem -Final . 14. Rough Electric-Conduit - - - - .56.-- Electrical-Final 15. Rough Electric-Wring - -- - 57. - Solar System-Final ' - 16. Rough Heating & Air Conditioning • - - _ .. _ . _- bet . Fencing&Access Approval, 17: Ducts,in-Structure - • '. _. _ . 59. APPROVED FOR-PLASTERING , . - 18.. Ducts;Ventilating - - _ - _ _ _ -_ • _ , •. . 19. Gas Pike-Rough &Test . ' 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing - - _ -• _ . 21. Roof Sheathing -- - - - - .. . . 224- Frame and Flashing - - - - NOTES: •_ ,- 23. insulation - ' - - - _ _. ' '- - • ' 24. Lathing&Siding - • . - . _ _ . -_ - _ - 25.. DrywallNailing -. _. - . • 26. Plaster Brown Coat - . - • _ - . . 27. Electrical Power Meter-Final -- _ . . . - _ - - 28. Final Electric - - • . • -- " ' . • 29. Final Heating&Air Conditioning _ _ - _ _ - '-. . 30. Final Gas Pipe-Test - - _ - " - . 31. Final Plumbing . . . - - _ ' 32: Water Service-Final - . _ . . -- 33;4 33.: Gas Service-Final . - - . 34. Solar Domestic-Final : . . . 35. . Landscape Sprinkling System • i • - 36. Sound Attenuation - 37. Handicap Regulations - ' • 38. FINAL STRUCTURE& BUILDING • - - - 39. Special Requirements Completed - , 40. Electric.Release to Edison - - - •' ' ' • • - - - • 41. Gas Release to Southern California Gas Co. -. ' 42. .CERTIFICATE OF OCCUPANCY No - Date . . te • Tca Wells Insulation Ca - / 11362 Westminster Are.#G Garden Gros.CA 92643 714-530-9530 license # 384692 THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED.IN CONFORMANCE WITH CURRENT ENERGY REGULATIONS,CALIFORNIA ADMINISTRATIVE CODE,TITLE 25,STATE OF CALIFORNIA,IN THE BUILDING LOCATED AT: House LOTS TRACTS (-7EET_ 187 E . 22nd y Street CITY Costa Mesa EXTERIOR WALLS: 11 R- MANUFACTURER Manville THICKNESS/TYPE 3y VALUE 11 CEILINGS: . BATTs• _ Ma�iville- 6 R- 19 MANUFACTURER - THICKNESS/TYPE VALUE • BLOWN IN; MINIMUM R- MANUFACTURER THICKNESS - VALUE SQUARE FOOTAGE COVERED NUMBER OF BAGS USED FLOORS; R- MANUFACTURER THICKNESS/TYPE VALUE SLAB ON GRADE: r• R- MANUFACTURER THICKNESS/TYPE VALUE LJTH OF INSULATION INCHES "FOUNDATION WALLS: R- MANUFACTURER_ THICKNESS/TYPE VALUE GENERAL CONTRACTOR • • CALIFORNIA CONTRACTORS LICENSE # + • DATE SIGNATURE TITLE INSULATION CONTRACTOR . Wells Insulation Co. , Inc. CALIFORNIA CONTRACTORS LICENSE# DATE 3/29/83 • i/ / J . Pres. •• SIGNATURE 4" TITLE CITY OF STA MESA �l PARK FEES N2 112 /17 /�Feee Payment Receipt / Project Address Si /� 6, Li st Park Area A. P. No. // d ,3- 0-/��/6� /jJ5� Building Permit No. 1(n — r Owner's Name r. 4 i 'lrs • / , 5L11-LJ,-... £AQa _ °9/S c' • tine/VO 4 sore& el/ Mailing Address /�2 i FEE Single Family * No. of Units @ $455.20 = Multiple Family ** No. of Units _2 @ $321.32 = 0i-214i a4 V Total Feel ) /� r/— n Planning Department Approval Date ( V--- 7P-7573; tc_.?c✓P///"--� Applicant's Signature `�/I'�' +.c•Ihc--cY attar .1-1/49... �cr�,�,.L4fvr�-� ' City Ordinance 72-44 V \ o ++ City Ordinance 72-46 1 I '++ City Resolution 74-124 —car H. Cji0.0 $iii,White-Planning;Canary-Planning;Pink-Finance;Goldenrod-Applicant CMF 0174-26 c U 1 1 Ut 1 9a Costa Mesa Building Department 917, APPLICATION FOR PERMIT y111 EAST 20th STREET V BUILDING_ - - _1 COSTA MESA, CALIFORNIA - FOR APPLICANT TO FILL IN FOR OFFICE USE ONLY • e pt o. Permit.No. ' Building -' Address /g9— a SY; - ?el t Received,by Date •ec'd. Date Issued • Costa Mesa, California NearestI ? r,.c. i r Cross St. �� Building Address I Owner E-p Aj/y�Pch M -e-Pli, Costa Mesa, California MailYili ' Address /g 72 Nearest � �C T Cross St. City C ' n 5 7- 6- AieS Zone ' I No.of I Type I Group ' Architect or Lk. Plans I I Engineer No. Approved I ' by Date 'tdress CORRECTIONS . CJS-��1/7�d S; �P5�i Li%1.2, .,ontractor r /� N ,4 /�'/ Address /`7 t OIC/i /// S e /7�//1jY��e ' Legal Description II No.Lot 2 gezi Block I Tract/11,P - (Attach Metes and Bou,pa s Pf... O7.2' —�5C /� �` , J,1 • tN No.of Bldgs. lb_ ',' • Size of Lot 'S I Now on Lot / . - • 4;W _ - O Use of o.of No.of rr A Existing Bldg. fclafi gamili es I Rooms /-yt9' w Setback Line from Rear Yard i JerigeA c—_ - - '�, - --' " Z Center of Street A_ Side Yard 1! Jf' ' ,- 3 1 D r DESCR PPTIO — yT]'�r3/�✓V : "- New I Alteration Addition I '' • O /1ne;A' Repair I I Moving I Demolish '—v •, MES,l Buildin oo. 4/t Size .Ota- Y G7riv R r'{ S�'.tori es :tenor Wall Roof c _ avering TUGGo I Covering S 6 4k f 5 APPROVALS Use of New 04R �l (`7 (]L Foundation Location Inspector Date Building Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts • Lath. Int. I hereby acknowledge that I have read this Application and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building construction. Plaster,Int. Signature of Permittee �� 1 Plaster, Ext Authorized Agt. .../ - . _ Masonry Reinforced ' Valuation ermiFee $ b, DO Plan Check $ j, e D Bond Beam $ t D0 N Total �� 1•Pt , Fee $ 2 FINAL 0 c o n J n n • • Street PLOT PLAN Show location and distances from property line and between buildings. COUNTY OF ORANGE d BUILDING DEPT. 7 �/ 7 7 636 No.Broadway Perini[No Santa Ana,California - ' Application for Building Permit Phone:KI 2-6211 AND FOR A Certificate of Use and Occupancy y - Date h 4 j2-5 _ 1 / ie. -,-- rIJQi,rrfJ 1. OWNER'S NAME �Fi r Y I't -5 ; PHONE- m..f1�...7 MAILING ADDRESS 173 'ef,�..-�,7 '-_ `1 ,� 1/ CITY..-Gli `;7n ) '/1 c-4A Name .124-0"21-.415--- 'l.&J.l at/'�r/ &&l s i Name 13 f/', 01, -yeve i V (Architect or Engines 1 G� , C (C [ractor)� Address XI--/b -�'iT.e-'Q I `.1!.4 '1 of Address --T?-- ; 21 4 -,0....4 City • City t, C State (- State I Lic. No Phone. S.J 14 7% Lic. No...1.� 2 '� D ti Phone.../? j..15:1 PROPOSED USE- fie S / .0 0 ,i r,. ST (6' 2. JOB LOCATION---------------.. ..- 2 - --_ -T..-f1....._- .M...£1.Sf (House No.) (Na/me of Street) (Town or School District) 3. LEGAL DESCRIPTION: Lot..QRT E.0.M.P. a7�..^2Block Tract-Na111[''PERT #02e#71 (Metes and Bounds Description—Use reverse side of form) 4. CORNER LOT ( ) INTERIOR LOT ( ✓) THROUGH LOT ( ) SLOPE OF LOT ( ) pf 5. SIZE OF BLDG.:-,Yp X aG AREA• 7-P-S SIZE OF LOT:--SS.X-..RS_AREA• 7 y - S I p/ 6. HEIGHT OF BLDG • 1y CEILING HEIGHT. a NO. OF STORIES/ I 7. NO. FAMILIES 1 Size of Smallest Bedroom. w X 1. /.9- Size of Kitchen.. O....X.'..../-P 8. EXTERIOR WALL CONSTRUCTION:TPA�'A•e.. a`"S7.OuDINTERIOR WALL COVERING P... .A -57e a (Frame, Stucco, Etc.) / (Plaster•Drywall, Etc.) 9. SETBACKS: Front Yard From Center Line of Street ..57?"( 21.7.4„4,,..„ Nearest Side Yard ,5 Rear Yard V er Distance in Feet Between Bldgs. on Same Lot.....-...Nl4_e.. 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. H /1 i/ II. For (a) Footing: Width )Ll Depth in Ground /c.- Width of Wall Ey Accessory Siand (b) �.X, I/ Spacing 1'2 "CC Material of Floor Similardgs. Size of Studs:.....01..X, C.-:.0..MiK. 0 7:12... Structures: (c) Size of Floor Joists /IOW e- Spacing "CC (d) Size of Rafters- y X f Spacing ay "CC 12. VALUATION OF ROPOSED WO K: Includj all labor, plumbing, electrical wiring, heating, fire sprinklers, painting and sewage disposal $-->! . 00 b-0-- 4/ • • • sago 13. I HEREBY CERT FY HAT TO THE BEST OF MY KNOWLEDGE'AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Signed /c Owner) Plans Filed:...---- - l- -. -...�.l.,S..4 )'j /// By. .(,j t (Authorized Ageen$ ' FOR DEPARTMENTAL USE ONLY • FEES: rn CKING BY Bldg. Permit - $14.10-1) GROUP J,(...C/. APPLICATIO -- . - . HEALTH Plan Check - $.---.---3...0-'0, TYPE ZONING fl FIRE Total - • - $-.f 7.Q.Q.:.- ..- DIST. 0, PLANS AND � ARSHAL Receipt No. - _._,y„ MAP....--...... SPEC'S ��.U..1 TATE Paid to ( t /,f_ SHEET NO CORRECTIONS ENGINEER Date /��/Q ,[--4...---' VERIFIED CAL PER ' ! ows � EBOPIOHUE COUNTY BaUILTOR TDATE IQhlrLI estaurr SM-2.51 `1• Ytj METES AND BOUNDS DESCRIPTION: MA//y S5—(174 .Se/y 2 0O.0Ae7 44p. ,ere.-f err 10 20 309�0 SIO 6I0 illipmilt- -1 _s- ... .._ .m. _ _ MIAIMM.AMMOM II =MO IIIIIIII 1 - • MMENIIMMMOMMMEMEM MMEMEMEMEMMEM II I SIM _MMIUMMEMSMEM Ililimilme - 1 IIIIIIIII..1.1111111 milimill IIII imill _ . 1 . • p,„ ...flat,. Elimilmild iiiiiiiiiiiiiii _,. ........... ... .8.. ...,...,. dimillimpoligillippil1- fn 1 1111111111111 MILIIIIIIIIIIIMIN- Illi 1111:111111 11111111111111111 —I MICA. ii II 11 111 1 I 111111111111 g III 11 ■ A 1Y1Y1 OWNER PALMER, FRANK DATE 2-14-55JOB ADDRESS 187 - 22nd Street BUILDING PERMIT NO. 907 GENERAL CONTRACTOR Gentosi Brothers VALUE $ 800.00 LOT AP#118-072-14 BLOCK TRACT Garage _G 1P TYPE ZONE FIRE DISTRICT 917 r • PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR // �� DATE NUMBER Footing Trench E. -2-/I_/I Foundation Forms and Grade to Garage AW Rough Framing ?Cbl © i Plumbing, Rough to Slab //. -C- Plumbing, Rough Complete /fl 0 N,-e- Temporary Pole /(,t0 /-J-e- Wiring, Rough 1O /U-2 Heating,Rough ,(/n .(/-e Heating, Final to q/c Sewer km, /t/' Septic Tank or Cesspool 144 - Lathing lec-lr , Plastering >CC4t:-; 3 /g SIC P ing,Final,Fixtures Complete Nn /t/C- P!umbing,Final Gas Test .tfONe Wiring,Final 4/6 Ai' Occu•ancy zlGG 3-41.4 _, I F011,i 210 C-H ltd 12-53 • OWNER WATSON, GEORGE DATE 9-3-58 JOB ADDRESS 187-B East 21st Street BUILDING PERMIT NO. 7337 GENERAL CONTRACTOR Armitage Builders VALUE $ 9,1453.0Q 11RRC7ko-15 LOT TRACT FIRE ZONE DESCRIPTION OF WORK Sin. Fam. Res. & Att. var. GROUP I & J TYPE V ZONE R!a PLAN NO. INSPECTIONS DATE PERMITS ISSUED - SUBCONTRACTOR DATE NUMBER Trenches Forms Steel 6,---- V 50./6 $w Floor System Steel Reinforce Chimney Re-Rod n!. ,.,_A Bond Beam (9et /a-2-3 57 „a4....44.-e-c-cO Frame and Flashing £ /0 .5 d .a 7- Lathing, In Out /1-'/-4"34(•= Plaster, brown coat Underground soil /y}} W/G Pipe Teeth to 1t�8' Top Out�- Furnace 41-S /0-2,-- Gas Vents -�-y,-� � Rough Plumbing MIK m-a�-%?/-/et®,r/,. s'• 9-3- S'8 J9t / CJ -_ -� Cesspool Septic Tank ..- Prop. 'Prop. Swr. Liner House Cori:" St. att 11-1/4)--Y 6413-1-1-'-ir3.-4.. 1241 Y[ Sir (X 1/y Sprinkling System j Heating Final DV ht Plumbing Fixtures, Final 1 /2-sq-vs , Final Gas Test /t-104.111w k/ /,2,2q-1,V Construction Pole 74.Underground Power Rough Wiring r.1j /01-4/-5(' .*.g. ,e0 SS /,-ZS/-S8 7270----- Fixtures, Final 7"2! - /2e..1-1•L/ OCCUPANCY Rt. , 19 . Form 210-5M-1-57 7337