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HomeMy WebLinkAbout192 22ND ST - Building Permits PROJECT ADDRESS: 192 22ND ST UNIT: - CITY OF COSTA MESA — BUILDING PERMIT ' PERM NO:- B 044864 WN( S ONAME: JOHN POLECINO uss: 538 W. LINCOLN , ANAHEIM PERMIT NO: B 044864 1PLAN CHECK NO: 01379-89 S GOVT: N SUPP: N • A ' ' CONSTRUCTION TYPE: PERMIT TYPE: SIR_ • PURPOSE: NEW ARCH/ENGINEER: RICHARD SHUIRMAN • REO.NO.:S1373 JOB DESCRIPTION : 106 LF 30" .RETAINING WALL . SQ FT: 106 . ADDRESS: 1705 LAISE ST UNIT: • 4 H.B . CA 92648 CLAIM VALUE: 3, 000 . 00 CALL—VALUE: 3, 180 . 00 GROUP OCC: M-1 / . PERMITTEE: JOHN PELOCHINO ( 714 ) 960-3447 • ADDRESS: 1705 LAISE ST COMMENTS: H.H . CA 92648 *******+rip*****sE********+r*****it***+Esr*Ee**sr ** *****N•********sE****+r+Esr********sr**** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions at Chapter 9(commencing with Section ZONING REQUIREMENTS • ' • 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and ef*. SETBACKS • CITY LIC.: /// y s TE LIC.: c s. • , t• Date: `0/ 7/Q Signature: `�a� MAIN BUILDING ACCESSORY BUILDING '! YORKERS' MPE TIONO CLARATIDN: I here. rmt 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 ompensation Insurance,or a certified copy thereo •c'• :00,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT, IN RGHT: . FT IN. POLICY ND.: EXP.DATE: COMPANY: PARKING REQ• PROV: PARCEL: 42606120 ZNE: R2 REF NO: EP8902 ❑ Cemredcopy.ishereby fumished.. 0 Certified copy isfiled with the city Building Division. • PLANNING NOTES> 30" HIGH CONCRETE RETAINING WALL WITH A STONE VENEER > ENCROACHES INTO THE PUBLIC RIGHT—OF—WAY Date: Applicant. ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Th's section need not be completed if the permit is for one hundred 15100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N, T 'S I certify that in the pe•ormanc•of the work for which this permit is i •• 1 shall n. • •d., a999yyy•••fififiani as to become subject to the o • 'Co••ysati•• Laws affalifomia. ' � � /ZONING APPROVED BY L DATE: ‘��^Ol� ) Date: i ((Signature: -../ NOTICE: .after .king this•eclaration.you shou• •' subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code,you must forthwith comply with such p• •fon .r this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby Ott'•• ..t there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: DATE: which this permit is issued(Section 3097.Civ.C). ************************************************ ****************** •RiF 1E lE* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY ' STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC 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 63. 00 - . 50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN 40. 95 •SMIP/NON—RES and Professions Code)or that he/she'6 exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by -v applicant for a permit subjects the applicant to a civil penalty al not more than five hundred dollars($500). ISSUE FEE 1, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE el structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 63 . 50 0 . 00 40. 95 104 . 45 • 104 . 45 • .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 far sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 10 4 . 4 5 OVER/SHORT: 00 Improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve . 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 6 3'. 0 0 5 0 40 . 95 ❑ and Professions Code: Tie Contractors State License Law does not apply to an owner of property 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 ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E .BREAKDOWN 0 1 am exempt under Section: B.&P.C. for this reason: SI _i -TYPEQTY D E S C R I P T I O N UNIT COST TOTAL COST Date: //i/Ver 4e' O /Oriderre SFR 106 RES—RETAIN WALLS UP TO 3 FT W/SURCH 30 . 00 3, 180 . 00 I do hereby certify that I am re of and understand the requiremen.. . •rnia Health and Safety Code Sections 25505.25533.and ENDOF FEES 25534 and that I or any luture builtling occupant witUwill not(circle o to comply with said state codes and the requirements for a ' permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. . • • Date: • • Applicant: • 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 ordinances and state laws -.ting to building construction and hereby a .• -prase .fives of this • • u., the above-mentioned . property for inspection •.p•ses, Date: (Signature' _ , — 'T� • '- ; _ _ _ Driver's License • Social Security it — •_ �. t i ._ . 1641.48 White—Buildino:Green—Code Enforcement:Canary—Aopticant:Pink—Revenue:Goldenrod—Assessor . i - .. - • COI';SITRUCTION AND PLANNING OOL & SPA . APPROVALS . Permit# Date Inspector APPROVALS Permit # Date Inspector 1 - . • • 1.:Temporary Electrical Service or"Pole 52. Pool & Equipment Location 2.`Soil Pipe:Undrgrnd- • . 53. Steel Reinforcement 30Electrical`Cond-uit-Utility-Undrgrnd. 54. Forms '1 r4FElectric4Conduii=Undrgrnd. 55. Electrical Bonding :.•i'5`Steel Reinforcement 56. Rough Plumbing & Pressure Test ; - • C'F6.FElectrical;I:FEH rnd. 57. APPROVAL TO COVER-GUNITE --7.-�Footings"rt _r: 58. Electrical Conduit-Undrgrnd. .�� 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9.4Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10:2-Structural Floor System ` ' 61. APPROVAL TO DECK 11:property Sewer Lin&& House'Connection 62. Backwash & Receptor-Final , 12. Sewer Cap r_ c_ 63. Heater & Vent-Final 13. Roof DDrains,,,_ 4' , 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 &r. -•Conditioning r_ - _ -: _FIRE DEPT. REQUIREMENT 20 =Rough Factory F.i place - r a _" ;APPROVALS`:Permit# T - 21:---D ucts, in-StructuE,es '• ' ^S r• = - r^' - :70. Underg-ound Hydro ^ _ is .J IX, k _ a `1 r' Y. tlJ S CSS i 22:�Ducts, Ventilating,, r rr, .-G rl -v; 'r 71. Product-Piping 0 Gas 0Oil 23.•Gas-Pipe-Rough & Test _ nn � r = �Z C r r. 72. Underground Flush. t• _ 24TRotif Framing `� -• ';y ;,` S F- ;. y ;73=Undergrnil.StoragtTank,OGas OOiI 25. Roof Sheathing ., H ea ' ,t - ;'_' r 74; Overfiead Hydro!,_ 26`T-E5r Celin (Structural) &`-Monocoat`-1•'� r� C-.- 4 9 J_ x ,l y r 75_-D_ry Chemical -7, . ," 27:-..-Frame and Flashing �- . r Z : ?: 76 . Dry Stan7pipe -'28. Lathing& Siding •;" 't .--..1*-:-:. Cone; :` r 77- FIXED SYSTEM FINAL - , - 29. Insulation • r - .F ( ,. x a 78- FIRE PREY. FINAL --- ---- _ « ,_, x. :- # 14EALTHJ•DEPT. REQUIREMENT 30. DrywalrNail g • _D31. Plaster Browh Coat' S l_.- �='-' I ! 1K ': '79.h.FINAL INSPECTION _ _ _ 32:�Electrical Power MeteT.Final _,• y r' r ; '80 (FOOD CERTIFICATE ISSUED ' ti =33:zFinal Electric, * r- r, - r'.y _ !: Notes: .- 'a1 -t'-: r, x ' ` ~„34YFin21 Heating& Aik Cpnditioninj ..' -J "rS ^ .. - 35,---Final Gas Pipe-Test: ;: __ G: s; - _ . r ::36.Hood or(Canopy x p ``=f,* C. 'r e _ _ -_37.•Final Factory Fireplace; - --,, �' .. • r. _4._ _ • r38:::::F incl Plumbing -'' :'t ---.1•-.7*-. I '$' ,: S "� 4` - ''39.TWaier Service-Final- -- ;1 c t; c ' w ; -- •- a. ` .c !; 40..Gas Service-Final• e 17; 'C.1- l__ SI- * r, It * '54:- i c.: r X41.-Solar Domestic-Finel" _ ,';, "' q'-, t tr < - _ 42. Backflow Preventers , I sr * - x: `J .l_,-- I-- : i-. * * t^. x ._ . r .. - 43. Backflow Irrigation - _ _ :, 4. ' * r r44. Landscape litigation System^• a a ' �T <f# Y .C.,2 '^: n t• _ • - �_= _fr `'45`."'Sound ;Attenuation .. ` '-t y ` - - 46. •Handicap Regulations -' Ct^. '. ': '!• - - ••,_, - n .-,47rFINAL STRUCTURE & BUILDING . - _ n .. i Vy C � . . . , 4874INAL PLANNING -r' -- 7 4 I 1: �, ." r'• - a -- 49:„Ele`ctric:Release toaEdison ` I I t'" . - '^ 50�GarReleasetoSouthernCalifornia Gas Cn a rt ' r '^ - .y �=' - - - 51. CERTIFICATE OF-OCCUPANCY • ' - 4 r - No.. Date - _ ' City of Costa Mesa < • Development services Department —:C R T IF I C A T E OF OCCUPANCY ' „ No. 003.53 Building Safety Division Costa Mesa,California The Building located at ' 192 East 22nd. Street, Units A through •E has been inspected and found to comply with the provisions of,all City offcosta Mesa Ordinances applicable thereto for a Group R1 .. Occupancy. s' Use of Building Condominiums - • • • Legal Description 426-061-12 .• "(See reverse side for Metes and Bounds, - Building Permit No B 21997 Electrical Permit No.B2222O,P.22661 Plumbing Permit No: P 44705 ' MechaMechanicalPermrt No. •M26446, M26160- Number of apartments - � a"ndjor guest rooms ' I ISSUED T0. Building Official Tony C'De Baca I John E: Palnrhinn , ,1 - - f 1705 Lake Street by :>i_�.�.r.74` \t'. - Hunt i ngpron Rear+, C A • UO64a ` Date March 1'3; 1991 , This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official•of the City of Costa Mesa under:Sec.-307 (e) U.B.C. . . . CMF 1015'-46.rev1/83";.White-Owner;-Canary,-Numerical'File;Pink Bldg.Permit.File • City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 192 East 22nd. Street, Units A hhrorunh t, has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto •tt1 for a Group R1 Occupancy. 00 qq-� J� AA Use of Building Condominiums if 4a .�LLr_ �OnLl03 1t_E fl Legal Description 426-061-12 (See reverse side for Metes and Bounds) Building Permit No B 21997 Electrical Permit No.P.22270.P276F1 Plumbing Permit No. P 44705 Mechanical Permit No. M26446, M26160 Number of apartments - and/or guest rooms ISSUED TO: Building Official Tony C'De Baca ,7nhn R. Paine—hi nn 1705 Lake Street by )- • , r.. ,t 'A Hitn hincjjrnn Ragrh, ("A a)FalA Date March 13, 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the ( • Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File • • •� l Applicant to fill in all spaces except th4e jI/nAtvy rder lines and sign all app,_priate declarations. - , �J !niling L� PE IT IqQ,/n� TRACT NO. — LOT NO. UNIT NO. • t cosTa A CONSTgUCTIt_ PERMIT p( r 7 A•- E \.' ' 41. � 1, , ,V 4�+ OOTRTIONADD U ALTERATION U REPAIR ' Address Jee Sr CA Kos ISAO 0 r a ❑ CONVERSION r ❑ DEMOLISH ❑ OTHER A.P.#, //�� • Oawner:Name JOAN F PELnneimio Phone 9La0-$S�17 R�•.S CC L\f4\T"S 4a V/"'���0 — �� I Zone �a DESCRIPTION OF WORK/USE OF BLDG. 5 I �Ad.iress ' F T u - ,. v . S Main Building: Accessory Building: •Arch/Eng,PNR(S R. StSFIS N1 License No. _ '' I TYPE OF PERMIT U GRADING X FOUNDATION STRUCTURAL T Front 2/-G• rr.1-c' O/&i,eC 0 IlQV1 Ili CA' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 0 MECHANICAL A9 / vt N Address y7�—�� +?/ Rear r Contractor's WIMP wove Aitein /ER Phone 94 2••9 31C ❑ 'OTHER ,��� 1 C Right / y! N Address(mailing) ••7 -L f • NMI 6gtl - PROJECT DESCRIPTION SQA./pT._—_,--OCCUPA CV-•�•-s K �o _ G • p' CON ST RUCTION TYPE 1/ VALUATIONS 4'o / I s Left `O/ 14 2Q/t4577 •City License No. 6 / wa• •.J '`1, a / R ZONE GRADING CU.YDS.�'`-i'''SACRES ' Ping. Ref.#�� -.240\ Parking Req,/Provided E LICENSED CONTRACTOR DECLARATION ;}^\•y��•y`•�•��j�•��`+� 0 I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: 5msi„ \ 3 M • • with section 7000) of Division 3 of the Business and Professions Code, and T my license is in(tillforceand effect. P '7 License Class__y /�hI,jj<�e ito Np.3 32 8 4 9 C-� 04 / " g s HOLD ! Sp—a• S Date 1 t— of •SS Signature .�w.wrw� PLUMBING FEES �l rt"I `1r-f<•`s�ld, ,ZP!{JJ•AR`slr� - �L WORKERS'COMPENSATION DECLARATION B �,�ink Showers ELECTRICA FEES I hereby affirm that I have a certificate of consent to self-Insure or a certificate • ' Workers' Com•ensatio suran or . certifiep�copy �pe�pof {5� i ' 100, Lab. C. sip -" = �•q{�'1(�rM Ory ! �iYs � � a• flow Preventer Service Sink__ . Automatic Washer Transformer 0 15-50 KW Policy No. a It. 1.•plpany AONenanit111, saany(L� Backflo • rri ation �� 11 g Sewer Cap Construction Pole Sub. 0 50+KW" Certified copy is hereby f •.s - - Certified cop is file• wi the city Bui i Dlvis�a... ^ Bathtubs Sewer.Connection /Cooki Unit • Meter pup to 100 amps •• ate_P� - S •PPlicani - ATI .D - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors �� Dishwasher Meter Clover 100 amps �• (This section need not be completed if the permit is for one hundred ($100) or Solar Piping St Gas Dishwasher p 9 - �• Dryers �AGdt ctric 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 Ta -.! 'r Fan Motors❑0-1 011,4-8 Workers' Compensation Laws of California. �� Date Signature Floor Drains Swi log Pool w/Spa �. F.A,U. Inc.Sol 9-15 HP 016-15+ 'NOTICE: If,after making this declaration, you should become subject to the �� , Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks mal �• Fixtures M'• owave _ f� comply with such provisions or this permit shall be deemed revoked. - _ CONSTRUCTION LENDING AGENCY Gas Service Outlets Wa Closet Device Boxes . ��• I hereby affirm that there Is a construction lending agency for the performance _ i •_ Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water - ler Outlets Lender's Name ^ - • - Range - �. Lender's Address Kitchen Sink Water Servic_ Switches - - �. OWNER BUILDER DECLARATION '• Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Disposal Garbage following reason (Section 7031.5 Business and Professional Code: Any city or 9 ;Standing Sections .-...• county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Traysell Generator❑0.5 9 ❑5-15 KW — Trash Compactor any structure, prior to its issuance, also requires the applicant for such permitPa tO file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drai •' 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 r .'erefrom and the basis for the alleged exemption. Any violation of Section - , 31.5 by any applicant for a permit subjects the applicant to a civil - • .laity of not more than five hundred dollars($500). 3 _ - LI I, as owner of the property or my employees with wages as their sole -einspoction Fee $15 Issue Fee $ compensation, wiJI do the work,and the structure is not intended or offered _ - .- ' Reinspection-Fee I-$15 s ' 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/horself or through his or her own - - i DEVELOPMENT SERVICES EO IR M NTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ 1YJ� �P1_1• sale. If, however, the building or Improvement is sold within one year of tom- Canopy Type II ❑ Zoning Approved ey- !Y /` Date pletion, the owner will have the burden of proving he/she did not build or Im- Duct-Under Ground 'Building Approved By V/•A( /71\ 134 •,IL•GJ-` Date "-� Prove for the purpose of sale). -.------ � 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ( JlDat •,1116tractors to construct the project (Section 7044,Business and Professions Code: , �%j The Contractor's License Law does not apply to an owner of property who Duct- tilating ❑6100,000 BTU 00 BTU • ._ SUM OF EES builds or Improves thereon,and who contracts for such projects with a con- f���Illppp ys^� tractor(s) license pursuantto the Contractor's Ll cense Law). I am aware thatBUILDING PERMIT $ SMTP $ W f( Exhaust System ultiple 0 System air/Alteration (�, lil��� Proof o their Worker's Compensation Insurance should be provided to me. 91/ PLAN CHECK • $ �.� PERMIT ❑ I am exempt under Section B.8 P,C.for this reason Firepl/Fact.BIt. ICBG# ire Dampers PLUMBING , $ ISSUANCE $ Date Owner Heating System& Ducting s ' . PLAN CHECK 25% ;$ ENERGY P.C. $ •1 hereby certify that I have read this application and state that the above 06100,000 BTU ,000 BTU ELECTRICAL .s $ GRADING $ information is correct. I agree to comply with all city and c unty ordinances ;Ii tate laws relating to building construction and herebye authorize repre- t _ ',.PLAN CHECK -50% $ MICROFILM $ n abves of this Ciry t0 enter upon the above-mentl0 d property for m ection purr. .-s. MECHANICAL.... $ 7a1,29..29 S nature _.eL -- ..,.1 ate 11-41,5;e5 TOTAL FEE $ rivers' License or SS# Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ •� -I ----^-MF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor 1 CON•,JiTR"UCTION AND PLAN,.,NG POOL .'PA �• Date Inspector Date Inspector 'ROVALS Permit# APPROVALS Permit# .'7ervporary Electrical Service or Pole 52. Pool & Equipment Location 2.'VI Pipe-Undigrnd. - 53. Steel Reinforcement jlectn_ l Conduit Utility-Undrgirid. 54. Forms ;Electrical • Conduit-Unn"drgrnd. 55. Electrical Bonding . y r, 5. Steel Reinforcement' 56. Rough Plumbing & Pressure Test 6. Electrical UFER.Grnd. 57. APPROVAL TO COVER-GUNITE 7. •Footing$ -1240 i ft, VC... 58. Electrical Conduit-Undrgrnd. 8. Fppndat;on „ • ' / ,e 59. Gas Pipe, 0 Undrgrnd.,Test 9. .WaterPipe-Und4,nd. ! 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Prdperty"Sewer,Lino& House Connection . 62. Backwash & Receptor-Final ' 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains • - - 64. Plumbing System - Final 14. Rough Plumbing• 1 65. Electrical-Final 15. Rdugh'Electricalbonduit - 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 ❑Oil 23.:ths Pipe-Rough & Test 72. Underground Flush r 24. Roof Frarriing - 73. Undergrnd.Storage Tank 0 Gas ID Oil I 1 25. Roof Sheathing 0/1142 74. Overhead Hydro 26. T-Bar'Ceiling (Structural) &'Moriocoat 75. Dry Chemical 27. Frame and Flashing 11/240 dp 434.. 76. Dry Standpipe I. 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation $3' Q978. FIRE PREY. FINAL 3Q.••Drywall Nailing Sjt � / HEALTH DEPT. REQUIREMENT 31• Plaster Brown Coat 79. FINAL INSPECTION . 32: Electrical Power Meter-Final . I , 80. FOOD CERTIFICATE ISSUED IF l 133. Final Electric q Notes: 34. Final Heating & Air Conditioning 1' ,( $� •y S 414 IL 35. Final Gas Pipe-Test Dies /tot 1/d eQ,:Yaf a i.41 't -n- 36. Hood or Canopy ;•i S6 l L- • 37. Final FactoryFireplace ,' s' A p Y// B �K /o W P^�k-g d), [n n/,/ 38. Final Plumbing kg in C (14zo v OK •!�v' II 39. Water Service-Final 1 u e? to �,t,,_a- 40. Gas Service-Final 7_N-fl a.wL 0 d47-0444.5 kr 41. Solar Domestic-Final at11YpVs/ (9 at 42. Backflow Preventer '1/-�s(j_I�7 1, Q, ` Q OF. D{�"- 43. Backflow Irrigation J-�(��/� /� , / I' . U�O .� O� - • 44. Landscape Irrigation System *t.:•.; 6/Z(lto" $1 A 0 1�.1% p4. - 45. Sound Attenuation (7J(f7op £ A ,to Vita `- 46. Handicap Regulations \ 7 �" 47. FINAL STRUCTURE& BUILDING •ji1,$ 1 ypyy�gi��l! 48. Special Requirements Completed a// ` "''iiii���'"'����rr�-;, v 49. Electric Release to Edison �J �0 ` /�f1 ] Q ' ' 50. Gas Release to Southern California Gas Co C�1/� !/ti/ 51. CERTIFICATE OF OCCUPANCY No. Date . 1 j FINAL GRAQING CERTIFICATION Project Address: - 192 E. 22nd St. , Costa Mesa • Tract 12183 • ' • Lot Number: Permit Number: By Civil Engineer: . I certify to the satisfactory completion of grading in accordance with the approved plans, ' specifications, local and state codes. All drainage devices required by the grading permit, grading plan and grading ordinance have been installed. Adequate provisions have been made for drainage of surface water from each building site. The minimums are: 2% Fall from structures within 5 feet from exterior walls. ' 1% Fall for asphalt surfaces and landscaped areas. 0.5_%_Fall for concrete surfaces to approved disposal areas. • The final monuments as shown on the recorded tract map were set. All final grading eleva- tions are within ± 1/10 of the designed elevations. • Supervising Civil Engineer K• &ASM J, Reg. No: 3 y tc7 (Signature) r Date ,J4 4. 18 , 1191 EXCEPTIONS: _ • THE CONCRETE AREA ALONG THE W'LY. PROPERTY LINE HAS 0.5% FALL TO THE • CONCRETE SWALES,HOWEVER, SOME 'SECTIONS, OF THE CONCRETE SWALESEzea----040FESS/04,4e• ARE LESS THAN 0.5%. FtT JFK yc F`J.. • • a m' 3685.7 jO• ill 130191.. CIW�\f \PE CAl • • • • STAMP and SIGN • I 1891-,6 F-TY OF COSTA MES:' ) CALIFORNIA 926281200 P.O.BOX 1200 Insulation Certificate /Pz. • 2 2.1t/D, — /9 do frig- ne54— Number and Street City (9/4,/tJy County Subdivision Lot Number Description of Installation ROOF Material 30y/-coMp9tn7 .il 417.9,4‘7.,- Brand Name M' fNS‘4n-974/.J Azq-T�/T/cc Thickness(inches) fo 4/'Feer.1.:JLyluiOn Thermal Resistance(R-Value) EXTERIOR WALL 4,,/ (546,?‘ /C24bug— eo2ivar///y Material 17efc - 'ooL 7j �///Y Brand Name Thickness(inches) 3 172 :• Thermal Resistance(R-Value) R // CEILING O4/EN5—Carro/.v! Batt or Blanket Type 6, 77 Brand Name r i 7 - - , I Thickness(inches) // " . Thermal Resistance(R-Value) ff_- 36 • Loose Fill Type ----- Brand Name Contractor's minimum installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR /yip__ Material /"//' Brand Name Thickness(inches) Thermal Resistance(R-Value) /SLAB FLOOR Material et04' NO 0/1— Brand Name . Thickness(inches) ? 4'/Su d3 fGrq/f Thermal Resistance(R-Value) Width(inches) 3 /, pit f/F 1.4-7. 742' �SuR I I0CC SLAB, FOUNDATION WALL . Material /'/J to' G71l Eire' Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. Contractor(Builder) ' cider Z/ �Case Number ' fie.-. G Signature and Tide /Date Sub-Contractor(Insulation Installer) License Number Signature and Tide Date r-TY OF COSTA MES ') • CALIFORNIA 92628-1200 P.O.BOX 1200 Insulation Certificate • /92. 6 22-ND, — /3 L r7-, - A7&5cz- Number and Street City Cie/9446- County Subdivision - Lot Number • Description of Installation ROOF '/ Material 30 ye Coat, os/r/o,tr 199/447-- /v Brand Name o Zvi?.e/27/oft," Thickness(inches) 3o I far—3/igitpd.iota, Thermal Resistance(R-Value) EXTERIOR WALL �y Material F//�'e4'( fc -�Gff- llooL Brand Name :04/6--/v5— CoA'N/iv y Thickness(inches) 3//Z" Thermal Resistance(R-Value) // CEILING fin-or Blanket Type A-7r Brand Name OCdevs-- Co feiLinvif Thickness(inches) //„ Thermal Resistance(R-Value) 4- 30 Loose rill Type Brand Name Contractor's minimum installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material 4'/f Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR h Material ///4'Ph 0R Brand Name . Thickness(inches) 34-2„/, ,52/d3 SGs1/3 - Thermal Resistance(R-Value) Width(inches) 33,v/' / W,P/6h vm- 762,a S6/2 crier sing, FOUNDATION WALL Material a// (ONGRErb— Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. jetac_r for(Builder) License Number Signature and Tide Date Sub-Contractor(Insulation lnstaljer) License Number Signature and Title Date TY OF COSTA MES -) • CALIFORNIA 92628-1200 P.O.BOX 1200 Insulation Certificate /9z F 22ti0 — G Gos7:49- /76:s,¢ Number and Street City a/3/9/rr9E County Subdivision Lot Number Description of Installation ROOF // r Material ?o/4'G-O/y/JDS/7/o.t/:Nee. Brand Name fiv iv fr./ -71.0.d Thickness(inches) iv FC-Z-7-3,r uxi.0 Thermal Resistance(R-Value) EXTERIOR WALL Material icserg//033-,p vc/f6000e- Brand Name Chews-- eoe/vi/vc Thickness(inches) 3/iy Thermal Resistance(R-Value) /$—// CEILING /� Batt or Blanket Type /' /r Brand Name O/.V/EA/S— rele/wZ! Thickness(inches) // Thermal Resistance(R-Value) if— 30 those Fill Type -- Brand Name Contractors minimum installed weight/ft' lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material /U/f4– Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material 1-49",D S' — Brand Name Thickness(inches) 344J'rug f/ne Thermal Resistance(R-Value) Width (inches) ,33/,s,,,dj/aP//E7ved/n — 3"ii Svgp gc r 5Lfl. FOUNDATION WALL Material /4-// 44ic err Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. • doir ,,. 'on• «a(Builder) License Number u d Signature and Tide � //!/ Date Sub-Contractor(Insulation Installer) License Number Signature and Tide Date ( TY OF COSTA MES! ;, . CALIFORNIA 926281200 P.O.BOX 1200 . Insulation Certificate /9t 5: 22_/un •— d (2<7,4L NEST¢ Number and Street City County Subdivision Lot Number • Description of Installation • ROOF r� Material .lar—c�/aj�of/7/oAA49A1/Gj Brand Name A'U -�I�.SG1i47/w A7.,9179/ , Thickness(the3o A fe-Gr—3/tr//,t7 Thermal Resistance(R-Value) EXTERIOR WALL Material ,655 .4//>c5—4 9aaletot Brand Name OoJENC— Co R/biy4. 'Thickness(inches) 3 //y' Thermal Resistance(R-Value) /p—// CEILING Bau or Blanket Type /S29T1 Brand Name 0/4/644/5— C'4s/W6— Thickness(inches) // Thermal Resistance(R-Value) 4- 30 Loose Fill Type /- Brand Name Contractor's minimum installed weight/ft2 lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material 41/4— Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material ,1//fr%o,47 — Brand Name • Thickness(inches) ,3 " SG,lSGg/i - Thermal Resistance(R-Value) Width(inches) 7 3r 1/R /?/&An',n—f"tJi Sv,PAGE .Ctgg. FOUNDATION WALL Material A3// e‘bile-4E7-&-- Brand Name Thickness(inches) Thermal Resistance(R-Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code., al on acts(Builder) - License Number • Signature and Tide �� / Date Sub-Contractor(Insulation Installer) License Number Signature and Tide Date C TY OF COSTA MES. CALIFORNIA 92628.1200 P.O.BOX 1200 • Insulation Certificate /9Z.- p e, 22tiD, — L v'722- /17 C - -- Number and Street City County Subdivision Lot Number Description of Installation ROOF Material 3.01/x—�:ovi/s/Tie d-g7%'8Gr Brand Name Aid -Ziu fo4nci y 471167c.40L-- Thickness(in s) 7o 'ter_wro000 Thermal Resistance(R-Value) EXTERIOR WALL Material f erif aii,.CS — eaCA /0"C"- Brand Name 04/E.VS.— Co/?,v,AJq Thickness(inches) 3 Thermal Resistance(R-Value) CEILING Batt or Blanket Type �q7t' Brand Name W&us—Go/t/uJ/fJ 4- Thickness Thickness(inches) //" Thermal Resistance(R-Value) 0E— So Loose Fill Type Brand Name Contractor's minimum installed weight/f lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance(R-Value) RAISED FLOOR Material /f///� Brand Name Thickness(inches) Thermal Resistance(R-Value) SLAB FLOOR Material/9/8/5-404 — Brand Name . Thickness(inches) 3/z/e ju/jf44'3 — Thermal Resistance(R-Value) Width(inches) 33i/"J,fl/'/sic ni— 3/,29 s2'6Ga — £495. FOUNDATION WALL Material /32Z G'otiCRETC Brand Name Thickness(inches) Thermal Resistance(R-Value) • Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the California Administrative Code. rel Contractor(Builder) t� License Number �iy �� iiGi�cE•�c� 2:47r ///j Signature and Title Date Sub-Contractor(Insulation Installer) License Number Signature and Title Date -r I, � CITY OF Cu6TA MESA ) 4524 1 1 /20/85 61(•8050 IL I , iPARK FEES ' • Fee Payment Receipt N! 1015 • Project Address 1011 P. aa-222 Sf-. A.P. Number t-12(n — 06 I — I a Park Area Building Permit Number Owner's Name j1,41J P(,r..4 LI N.10 Mailing Address 170.2 L oRe ST Tt i, rnr Gw.J ?L P 4 FEE: Single Family * Number of Units 2-Bedrooms or Less @ $ 861.76 = 3-Bedrooms @ 1,205.67 = ----------- 4-Bedrooms 4-Bedrooms @ 1,545.62 = 5-Bedrooms+ @ 1,810.50 = Multiple Family '" ✓ Bachelor or Studio @ 474.37 = 1-Bedroom @ 573.18 = 2-Bedroom @ 881.51 = • 3-Bedrooms+ 5 @ 1,229.38 = b1146.90 Total Fee "` (47,lifio.ga Planning Departme '.*pray+ a .te /—fir ���,� .4,,r.) .G-, CG2 • 4/ • Applicant's Signatur ����i►`%� - 4 •CM. ,4-3CI' dinance2Rev. :72-44 erdlnance 72-45 '•'City Resolution 76-116 CUSG������ Ite—Planning;Canary—Planning;Pink—Finance;Goldenrod—Applicant U FIELD MEMORANDUM Job No. : -'/2Ss_ r . — At, r° Client: '-la//N Pee- e-//:4/0 Site: 19a er• .mar' cr /70 S G A/ec= ST CG S 779 bets-4 k/u/i7 .J( 7c/✓ 1?r'/•2c/1 Engineer Geologist/Technician: Date:, //c/ Time: Ina!q,s Out /o:30 ' T Scope of Work: /—On , It stnr Geotechnical Reports or Plans: %/74'O ___ „✓, Findings/Conclusions/Recommendations: ,�,✓-/�,rF., ,y,c- c / „�, ��, ,.� AS /OT/2 Ar" 0,•/ floor 0.e/ "t•-, /// /w/�'v,CST�f/ , UAB /f n,00S$i c —#- cTcp4- n✓JAOE ,R r cm"; ,c,. -1 r f..i, .✓r=.c.a r.,/ rc tee -0 171/ —flier r-7e, T. i✓/. P" 7 re-7,1-/ "Mae:- Fn a/✓n , n //✓ TO Prot,=.e/t- T7FJc'rc=✓I c ,n,tT.=NT SC/� ( �� CGsa$T To j r•r )/Axs-a.esv Dern-,f.." 7- 1 . <7T /- ✓,•,./,�n/n/ hr'Prf./ of /N'/ti/r"f/S RrL OW / Ow et Cr A// tti C,S../7 C/ispn(C ✓.✓ Aft. .,,r�ngw,!/= r..,. 77� T//C .4G'OVL:- /FewEn'ct, -r 4Am a., i:l/- Ani_ s c):!"/v e,sss.✓n_r 'rr,r SU A. ter.- cre,,r>.r ten— /' . • ' ' / /T • f se- • 1l L."'" es . /7 `�. '/c NOTES: Si . . gne'd': � i' Li . Any loose material, debris, mud, or ponded water should be removed from � excavations prior to casting concrete. - This approval applies only to conditions existing on this date. Subsequent Verification By: changes in condition (e.g,effects of rainfall,etc)may invalidate the approval. This Field,Memorandum does not waive inspection by governmental agencies AAI\O GEOTECHNICAL ENGINEERING AGE-114 CONSULTANTS:INC . SHEET No. 4TTAHMENT NUMBER 2TO /TC Certificate of Conformance No. 23230A Dated 3/31/86 Job Name: JOHN PELOCHINO Job Location: CALIFORNIA Customer's Order No. Dated 3/11/86 Mfgr's Order No. 86059 The following gives the additional specifications that were used in the manufacture of the members on this job: 1. LUMBER Species: DOUGLAS FIR Grading Rules: WCLIB 16 Paragraph: 154 Grades: L1 , L2 , L3 Slope of Grain: 1 : 16 1 : 14 1 : 12 1 : 8 2. MOISTURE Range: 9 - 14% CONTENT Variation per member: 3. END JOINT 9127 AVERAGE PSI 92% AVERAGE WF 4. ADHESIVE Conforms to ASTM D 2559-72s ecifications. LT881\-SSL-477 Type: WATERPROOF Botch NoFM264-S68-062 5. GLUING Pressure 100 PSI MINIMUM Pressure Period 12 HOURS Glue Spread 63 - 6811 MSGL P. 175 �<tplE OF TIMpe_ W AITC Licensed Plant No. Al l C PI uaContr upervisor TIMFAB INC a 10/22 8/86 Company a , z Dote QUALIFIED LICENSEE AITC Form 1B3•65 © 1965 American Institute of Timber Construction , NUMBER TO ATTACHMENT SHEET No. : . /TC Certificate of Conformance Na 23230A Dated 3/31/86 Job Name: JOHN PELOCHINO ' Job Location: CALIFORNIA Customer's Order No. Dated 3/11/86 Mfgr's Order No. 86059 The following identifies the members and gives the basic specifications that were used on this job: Lumber Species: DOUGLAS FIR de fief Quantity Size Cambi- Adhesive �ae�er- nation Type Camber fication Grade B 1 3 6 3/4 X 162 X 21 ' 0" 24F-V4 WP IND 1600 175 A`.c 3TE OF TIM@._ P- 5 co / . a AITC Licensed Plant No. AIi C 53 z PI Quality Con ro upervisor TIMFAB INC 3 10/28/86 Company Date QUALIFIED LICENSEE AITC Form 1B-2.65 0 1965 American Institute of Timber Construction F M FORBES • MANSHADI ENGINEERING 1 • ESTRUCTURAL DESIGN & CONSULTING November 10 , 1986 John Pelochino 1705 Lake Street Huntington Beach , California 92648 . • Re : 5 Unit Condo "Creekside" in Costa Mesa , CA . ( FME 684-232-4 ) Dear John : This letter is to discuss repairs to account for over-notching or drilling of floor joists . 1 . Where holes exceed 14" in diameter and are within 2" of bottom or top of floor joist : add a 2" x 6" 12" past each side: (min . 36" long ) last hole or notch . Nail with 16d @ 6" o . c . staggered . 2 . Where drain pipe occurs : see same correction as above but also add 2x4 x 24" along bottom of drain . 3 . The roof rafters called for on plans were to be 2x8 ' s ; 2x10 ' s were used . The larger size will carry the added load of the solar water units ( 960 lbs , plus or minus . ) If you have any questions , please feel free to ask or call . Sincerely yours , FORBES/MANSHADI ENGINEERING "Sof oREN Da b e s , C . E . C-30407 DLF/dvf LIC. EXr• 3131188 17332 IRVINE BLVD . , SUITE 115 , TUSTIN , CA 92680 ( 714 ) 838-3997 -411 PROJECT ADDRESS: 19.2 22ND -ST • uxm ATOE CITY OF COSTA MESA — BUILDING PERMIT PERM NO:: P 044705 OWNER'S NAME: JOHN F. PELOCHINO - ADDRESS: 1705 LAKE ST. PERMIT. NO: P 044705, PLAN CHECK NO: N GOVT: N SUPP : N HUNTINGTON BEACH • ; CA92648 • CONSTRUCTION TYPE: V D1 PERMIT TYPE: PLU PURPOSE: NEW ARCH/ENGINEER: REc.NO,: JO.DDESCRIPTION INST. OF SOLAR COLLECTORS SQ FT: ADDRESS: • UNIT: t - • ' CLAIM VALUE: CALC—VALUE: GROUP OCC: R-1 '/ PERMITTEE: JOHN F. PELOCHINO ( 714 ) 960-344 • 7 ADDRESS: 1705 LAKE ST. 0 COMMENTS : R S-.v l _ HUNTINGTON BEACH CA 92648 ******************* N-** ** * * *************************************#**#****** • ( LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section • ZONING R -E Q U I R E M E N T S - • .I 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T• B A C K S• CITY.LIC.: STATE LIC.: CLASS: E. • Signature: - --- ---- —" MAIN BUILDING -- -------- ACCESSORY BUILDING ACCESSORY RKERS'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 . ompensation 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 : 42606120 ZONE: 3 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> • .. . > . - - . . Date: Applicant: #*######*###*#*#******#**######***###***#*#****.**#**************##**** ******** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($119)or less). DEVELOPPMENTSERVICES ,, REQUIREMENTi 'S I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY - DATE: Date: Signature: - - - - . NOTICE:IL after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. - c CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work far APPLICATION, ISSUED B Y: • DATE: !C7 7 which this permit is issued(Section 3097,Civ.C). ************************** * #### *** W • *# *******************/t#iE/** LENDER: . *************#********************************** ***************************** ADDRESS: LEGALIZATION:N FEE SUMMARY ' STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason - BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,'alter,improve,demolish,or PERMIT 13;• 00 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed • '2 5% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7190)of Division 3 of the Business -d Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN , applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). . I S SUE FEE , 3 . 00 ' 4I, as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE , E J structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--—>. 13 . 00 3 . 00 0 . 00 16 .0 0 1 6 . 0.0 . 0 0 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 REVENUE DIVISION TOTALS--> COLLECTED• 16 . 0 0 OVER/SHORT: . 00 forthe improvement rpose of sold one year of completion,the owner wig have the burden of proving he/she did not build or improve 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 16 . 00 1E 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 *****************************************************************************#* that proof of their Worker's Compensation insurance should be provided to me. IND IV IDUILL F E E BR EAKDOW N • • ❑ I am exempt under Section: B.8.P.C. ••, for this reason: TYPE QTY , • D E S C R 'I. P T .I O N UNIT COST TOTAL COST Date: owner: PLU 1 SOL. COLLECTOR COMPL UP TO 1000 SF 3 . 00 • 3 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PL LI 5 SOL STOR . TANK COM PL UP TO 750 GA 2 . 00 . 10 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a - permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from - END OF FEES - • these provisions. ' • Date: Applicant: ' . , , I hereby certify that I have read this application and state that the above information' I agree t•comply with all city and county ' • ordinances and state laws relating to building construction and here, 'er: •sentatives or his ent n the above-mentioned , • Date:property for inspectionfpurposes. le. Date: 7[//7/a / Signature: — / . - __ Driver's License or Social Security A.' • D:.-fa - , �,�--- .4146 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLA!....i 40,..,,_ & SPA I APPROVALS Permit# Date Inspector APPROVALS Permit.# Date Inspector r"• 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd: 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' 5.-Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER'Gr"nd. ' ' 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, ❑ 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 • Q(7110 LEt7 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 _ 1 ' _-70. Underground Hydro -- 22.-Ducts, Ventilating : Y - ' • •71. Product-Piping 0 Gas OOiI 23. Gas Pipe;Rough & Test - - - • ' 72. Underground Flush - 24. Roof Framing 1 " :" 73. Undergrnd.Storage-Tank 0 Gas ❑Oil 25. Roof Sheathing;?l ' 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 V . _ 78.;FIRE PREY. FINAL 30. Drywall Nailing . /'., - • .. Ir HEALTH DEPT. REQUIREMENT _ � I •. 31. Plaster Brown Coax• - •'- ._ 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. Hodd or.Canopy ' . -37, Final Factory Fireplace - - --/ - • - 38. Final Plumbing . , tilt) t_ 39. Water Service-Final: - 'f- 240. Gas Service-Final -, ' ' ',- - • . 41. Solar Domestic-Final I ' 42. Backflow Preventeri_ - - 43. Backflow Irrigation ' - • - - .44. Landscape Irrigation System - - _ 45.-Sound Attenuation - - -- :46.-Handicap Regulations , - ' 47. FINAL STRUCTURE & BUILDINGt. - 48TFINAL PLANNING •' . - } 49. Electric Release to Edison ' " ' - - 50. Gas-Release to Southern California Gas Co ;� . • .. - 51. CERTIFICATE OF OCCUPANCY ' No. - Date , rili �� • • r licant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. (I P ITN LOT NO. ///��' 60 /14y1 i'TV pr COSTA MESA CONSTRUCTION��rr PERMIT j �'c� UNIT NU. ' 7f/,__ I'Proje Address I q 1 7.2 fY 0 s l Y '� ' p-"� r rs atyTtrebi9 ! L � �� 11TYPE OF ONSTRUCTIONLl ADD ALS TERATION LI REPAIR • - UCTION AddressA.P.f 72 C -ft /9i✓r+-Gt..-K ��.�• I S Main Building: Accessory Building: Z Arch/Eng. Licen No. TYPE OF PERMIT GRADIN ��.I OUNDATION ❑ STRUCTURAL E Front 0 Address �� Q� / BO TENANT ELECTRICALIt /1 GING ❑ MECHANICAL BA Rear N Contractor's Name .Q. &'-c_ N Phone 9(02-g3/p ❑ 'OTHER I �6. W- _i .r71P CT DESCRIPTION SQ. FT. OCCUPANCY . K Right N ^^/ G Address(mailing/ S 4 OrM�s^ V TRUCTION TYPE VALUATION$ S Left R City License No. /lisp a� /9y Z E _ GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E ICENSED CONTRACTOR ECLARATION 0 hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and I my license is inJ,ull force and effect. �n�j 2 g S T License Class p — 0$a 8 99 License No. `� / 9 ! 'ate/1-i9-*/S Signature at., yw./..A PLUMBING • FEES .JORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compyosation�.1 s rance, or a certified copy thereof (Section — 3800, Lab. C.) el -34; i ' Backflow PreventerService Sink Automatic Washer Transformer 0 15.50 KW Policy No. Q^"' d/'"�" Company t� e / Backflow Irrigation p0 50+ KW 9 Sewer Ca 400 Construction Pole Sub. rlified copy is here y furnished. 1 Certified copy is filed with the city Bugling Division S Bathtubs i Sewer Connection �2 00 . Cooking Unit Meter Dup to 100 amps Date —/4-Sf Applicant .NSA -1-- ,ECLARA ION l \n EXEMPTION FROM WORKERS'COMPENSATION DECLARATION — Clarifiers — Solar Collectors Dishwasher Meter Dover 100 amps V (This section need not be completed if the permit Is for one hundred ($100)or Dishasherless). Solar Piping /Q 00 Dryers ❑Gas ❑Electric Sub Panel 1 certify that in the performance of the work for which this permit is Issued, 1 I ( shall not employ any person in any manner so as to become subject to te Drinking Fountains .— Solar Tank Fan • Motors DO-1 HP ❑1'h-8 Workers' Compensation Laws of California. s,r) Date Signature -- Floor Drains -- Swimming Pool w/Spa F.A.U. Inc:Solar 09.15 HP 016-15+ J 'NOTICE:11,after making this declaration,you should become subject to the - -- • - 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 • 0 Gas Service Outlets Water Closet I hereby affirm that there is a construction lending agency for the performance / SO 00 Device Boxes . Pole Light of the work for which his permst(us�sis issued tion 3097 Civ. C.) — Interceptors r Water Heater AO 00 Outlets Range Lender's Name eJ/ ,.J - - Lender's Address y 's LL+ne.L�'..�.�t Kitchen Sink ( Water Service - i I. OWNER BUILDER DECLARATI N aelfi -.( 0yyyee9t/l+L• r� ��N' 'T Switches Sign I hereby affirm that I am exempt from the Contractor's License Law for the j5 Lavatories - Auto-Wash 317 00 Garbage Disposal Standing 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 any structure, prior to its issuance, also requires the applicant for such permit -"' P—Trap Laundry Trays Generator 00.5:KW ❑5-15 KW S 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 enalty of not more than five hundred dollars($500). I ' 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 1 Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 Zoning ApprovedBy" n Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By i fa•7 Date • / Prove for the purpose of sale). v•!{--• itteeter ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System ,Application Issued By nate ( z 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 _ /' SUMMARY OF FEES builds or Improves thereon,and who contracts for such projects with a con- , tractors license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 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. IC80# —IF ire Dampers • PLUMBING I $ /39.00 ISSUANCE $ Date Owner Heating System&Ducting Registers _ . 'f 'PLAN CHECK 25% $ 3 ,00 ENERGY P.C. $ I hereby certify that I have read this application and state that the above 00.100,000 BTU 0100,000 FIT - - • 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- "PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for Inspection Pur es. MECHANICAL ' $ TOTAL FEE $ /73,00 , Signature Date /1-fr1-gs Drivers' License or 55 Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building: Canary - gpplltant; Pink -Accounting; Goldenrod - Assessor v RAND i MIN. -JL &SPA ' rCdNSTUCTI0N Date Inspector APPROVALS Permit# Date Inspector • ArtibVALS Permit# j 1Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 7/76-1, r 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 OF ER 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# 21. Ducts, in Structure 70. Underground Hydro - 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test L(.l'v..,,,y' ,/7/t6. Aker 72. Underground Flush ' • . 24. Roof Framing' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical .. ' 27. Frame and Flashing 76. Dry Standpipe . 28. Lathing & Siding 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION . 32. Electrical Power Meter-Final • 80. FOOD CERTIFICATE ISSUED i 33. Final Electric Notes: /,'/6►G .7z AjaS- t • ___ eagief___ 34. Final Heating & Air Conditioning kalt i nit- eAqripialwil 74 O SaPateaL 35. Final Gas Pipe-Test q4i-/oto Cr age / / 4Z _ J / a., 36. Hood or Canopy ////�'P‘ nom! •' " !V4r Or • rt 37. Final Factory Fireplace q//y/.n i4 JIt A Jeerr nie CO 38. Final Plumbing eft G•O / ` r 39. Water Service-Final Le /A//�' Ox'ar 40. Gas Service-Final '7' �td" 41. Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed 49. Electric Release to Edison . 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • rr Applicant to till in all spaces except those within heavy border lines and sign all appropriate declarations. • fCITY OF COSTA MESA C N T N PERMIT t PERMIT NO. TRACT NO. LOT NO. UNIT NO. ////// /1 ac c./LL 7883 I ( /26/86 j,3p00 .TL JI Project Address / Applicant's Mallin ddress / a 0 ��l 14 /I ..� TYPE OF CONSTRUCTION qL NEW U ADD U ALTERATION Li REPAIR , Lada Phone El CONVERSION ❑ DEMOLISH ❑ OTHER 1� A.P.# Zone *Owner's Name 7� D CRIPTION OF WORK/USE OF B •G. t 0 '-P1 r'`r7rlos.!( 11- Address ' �• `. EW_ •� `I' '�. 11- e. IP _ ,-- C ► �'7 S Main Building: Accessory Building: E • Z Arch/Eng. I License No. TYPE OF PE-MIT MI GRADING al FOUNDATION A STRUCTURAL T Front 0 Address BA t -ICP 6/ c r [11TENANT CI ELECTRICAL ❑ PLUMBING I' ECHANICAL B Rear N Contractor's Nam-•9 an! ' / • a A' s ❑ OTHER AD PROJECT DESCRIPTION SQ. FTS.) OCCUPANCY C Right N Address(mailing)/ 3i, L/�OfjC. kb CONSTRUCTION TYPE VW VALUATION $ - S Left G City License No. 3 2/ ZONE GRADING CU.YDS. ACRES R LICENSED CONTRA OR DECLARATION `1��� 7 Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: 'I P ../ Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and (•' / \y license is in ful •.r�e . r�ifect. , •pQ / r� _ S T cense Cl ss icons- o --J• /!•C _ 7 J Date •��y Signature r_ _ _ PLUMBING FEES - • WORK-RS' OMPENSATION /FA ION ' Bar Sink Showers • • ,ereby affirm that I have a c- -u- of consent to self-i •re or a certificate ELECTRICAL FEES Workers' Corn•.nsati•n Ins rance, or a certified copy thereof (Sec n Backflow Preventer Service Sink 3800, Lab. C �,p. Automatic Washer Transformer 0 15-50 KW . Policy No. / �� / 0 Compans��la L(f,/ z#"c7' a Backflow Irrigation Sewer Cap Construction Pole Sub. • 0 50+ KW yCertifi co•y •reby urn' hed. . Cer Q.co Is with the city d g Ivisio P r Bathtubs . Sewer Connection Cooking Unit Meter pup to 100 amps Date G � Applicant � .t0e'en js�sn��/ - EXEM ION ROM WORKERS'COMPENSATION DECLA A{ION Clarifiers Solar Collectors Dishwasher Meter Cover 100 amps (This s tion eed not be completed if the permit Is for one h ndred ($100) or ' less). Dishwasher Solar Piping Dryers ❑Gas ❑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 Motors❑0.1 HP ❑1%-8 Workers' Compensation Laws of California. _ Date Signature Floor Drains ' Swimming Pool w/Spa F.A.U. ~- NOTICE:If,after making this declaration,you should become subject to the - Inc.Solar ❑9-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that ther is a construction lendip.�agency or the p rformance - Pole Light L the work for Alfas p¢rr�i_t Jl:+is/Ce Civ. C.) Lender's Name /[/J`ry1/, V/" r/ Interceptors Water Heater Outlets Range Lender's Addres er .A}'70 Kitchen Sink Water Service Switches OWNER BUILD D CLA RAT ON/ Sign ' hereby affirm that I am exempt fr m the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ' •flowing reason (Section 7031.5 Business and Professional Code: Any,city or 9 P Standing Sections mnty which requires a permit to construct,alter,Improve,demolish or repair P-Trap LaundryTrays Y Generator❑0.5 KW ❑5-15 KW Trash Com actor • oy era gre• prior to its issuance, also requiresicestheapplicanttfor provisiopermitns p to fileCa signedtr statement that pte i9 lpursuant to the pro vi00) of Roof Drains the Contractor's LicenseiLaw(Chapter 9 co(commencing with Section 7Is ex)of - tl retro 3 of the sis and Professionsd code) or that aSection pt ' r 31.5om and the basiscfor the alleged smey violationpat ofa /031.5 any applicant for a permit subjects the applicant to a civil _ _ - _� - LJI, a of not more than five hundred d r dollars($500). o I,compensation,owner ill toe a work, n my structures with intens d r of sold Reinspection Fee V $15 Issue Fea $ 3 le ( will do the work,and the of scion Is not intended Contractor's oHerra - Reinspection Fee I $15 Issue Fee $ 3 for nse aw d7044, ly to ane and Prf a oper Cotle: The mroveMECHANICAL FEES thereon, Law does not apply to owner f a propertyro builds or Improves thereon, sntl who does such work himself/herself or through his or her own Boiler Hood-or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: . employees,If, ho provided that such improvements men are not intended or offered of c for yP sale. If, thwown, the buildingve dopro isgsold within one year d rim- Canopy Type I 0 Zoning Approved By - Date station, 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). �g� /�////// � � 0 I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Aa Ta s )A2:% ,5_t-'- Date /(- 16 S tractors to construct the project (Section 7044,Business and Professions Code: - - - r 00 The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 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 that Exhaust System 0 Multiple 0 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 e Firepl/Fact.Blt. ICBG Fire Dampers d 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 00-100,000 BTU ❑100,000137 GRADING $ •information is cor •ct. I agree to comply with city and county ordinances ELECTRICAL $ and state law : ata g to build]• •onstr.rti• and hereby autho ize repre- MICROFILM $ sentatives o this t to en .4 pon e �1•••ve-mentioned pr•pe t o PLAN CHECK 50% $ Inspection p •• - / ' '' u 0U Signature _I. • (� Date// / MECHANICAL $ /-3 TOTAL FEE $ y ' ac ���tt♦� 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 UF ER 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# _ 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 ❑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 36. Hood or Canopy / 37. Final Factory Fireplace /tido l tO 38. Final Plumbing • 7 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 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY _ No. Date - • -z • '/ "..'Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.• ., CITY OF COSTA M �a -C TR7Uf/II9NgRMIT , PERMIT NO/CO /R(1 CTT N LOT NO.. i UNIT NO. . Project Address .tea• °` d /✓1 (� /�--O1� • 6607 - /.' 9i s TYPE OF CONSTRUCTION .NXNEW ADD ❑ ALTERATION ❑ REPAIR gF I /nf, DC 63.00 TL Applicant's Mailing Addressdr/ ..i WAV le-A4110 Phone ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone .Owner's Name DESCRIPTION OF WORK USE OF BLDG. Address 1705 Lakeside Street,Huntington Beach, Ca. - , r.e _ S Main Building: Accessory Building: ' Arch/Eng. License No.- TYPE OF PERMIT N GRADING EM FOUNDATIONMVv'I N STRUCTURAL E Front - o Address - f� ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING XLXI MECHANICAL B Rear N Contractor's Name Radiant Air Cond i t i on i n1 07p 9219493(213)❑ OTHER A - - I N Address(mailing) 13310 Map ledale Street, Norwalk PROJECT DESCRIPTION SQ. FT. OCCUPANCY R—1 K Right • G - CONSTRUCTION TYPE "/ ,.J/A1 VALUATION$ s Left • - R MCI City License No. 3 ` f 5 ZONE _ GRADING CU.YDS. ACRES 'Kt LICENSED CONTRACTOR DECLARATION _`' y/�1 /�///��� Ping. Ref.# Parking Req./Provided • E \� I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remark* . ,c 799 Planning Notes: - M 1 with section 7000) of Division 3 of the Business and Professions Code, and /n ivy license is in II Q{ce and effect. ' PC. t 2/ 7 T License —�`� / Aense��o256 6 S �� s - S I Date 81 •• Signature ,. :. . ._ ... PLUMBING FEES • `NOR KERS' COMPENSATION D A' ON Bar Sink Showers L / Toe iereby affirm that have a cert a consent to self-ins. r a certificate ELECTRICAL FEES . Workers' Compensatio Ins. ce, or a certified co- here• (Section ' 3800, Lab. Backflow Preventer Service Sink Automatic Washer Transformer D 15-50 KW - Policy No. • 4 O Company CC'+ r ✓ -7+ - _ p A: Backflow Irrigation Sewer_Cap Construction-Pole Sub. ❑ 50+ KW Certifi-• cop is er-by f rnished. 021'W •'-�y dr[ry �1, ' ' — Cart co•%/r led with the city a 'Iding •' Ision Bathtubs Sewer Connection Cooking Unit • _ Meter,Dula to 100 amps Date, / Applicant /.e r _ EXEM- 10 FROM WORKERS'COMPENSATION DECLARATION Clatifiers Solar Collectors - • Dishwasher Meter Clover 100 amp, • (Thiss'ction eed 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 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 • Workers' Compensation Laws of California. Motors ❑0- 'P ❑i%-81 Date ' - Signature Floor Drains ' Swimming '•01 w/Spa F.A.U. Ina So ■9-15 HP 016-15+ :NOTICE: If,-after making this declaration, you should become subject to the - - . • workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urin. ' • comply with such provisions or this permit shall be deemed revoked. - FixtUreS kif owave , , CONSTRUCTION LENDING AGENCY Gas Service Outlets 'ate;Closet . DeviceDevice Boxes I hereby affirm that there is a construction lending agency for the performance - • Pole Light ' of the work -fo which his permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name Rank or Newport . - Range • ' Lender's Address Goa. • • . . • • • ,Ca Kitchen Sink • - • - Water Service - Switches Sign - -" -- OWNER BUILDER DECLARA ION - I hereby affirm that 1 am exempt from the Contractor's License Law for the Lavatories Auto-Wash . ' GarbageDisposal 'allowing reason (Section 7031.5 Business and Professional Code: Any city or P Standing Sections :ounty which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0.5 ❑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 Drai- the Contractor's License Law(Chapter 9 (commencing with Section 7000) of ivision 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 ,031.5 by any applicant for a permit subjects the applicant to a civil — - n enalty of not more than five hundred dollars($500). ' ' I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee' l $ 3 ' compensation, will do the work,and the structure is not intended or offered - Reinspection Fee f $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 Boiler Hood or Type ❑ DEVELOPMENT SERVICES REQUIREMENTS: ,.employees, provided that such improvements are not intended or offered for yp ZoningApproved • sale. If, however, the building or improvement is sold within one year of com- - - - Canopy Type II ❑ pp oved By Date pletion, the owner will have the burden of proving he/she did not build or Im- Duct- Under Ground 'Building Approved By l Date 4 rove for the purpose the of oe). a �/y LI t as owner construct thetproperty,roject exclusively contracting ing wrof licensedioncon- Duct-Structural • Refrigeration System • Application Issued By d^•n.svti Dat eN hetors asu L the project (Section 7044, to Business and Professions property Cotle: (l The s Contractor'smproLicense Law does not apply to an owner je pro ithta wno Duct-Ventilating ❑0-100,000 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 ❑ Multiple ❑ System Repair/Alteration • BUILDING PERMIT $ -SMIP - $ proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT - • . ❑ I am exempt under SectionB.& P.C.for this reason Firepl/Fact.Blt. ICBG# _ Fire Dampen PLUMBING $ ISSUANCE $ Date _:. Owner C Heating System& Ducting n Registers a0 PLAN CHECK 25% $ ENERGY P.C. $ • I hereby certify that I have read this application and state that the above KO-100,000 •1111 B GRADING $ information is correct. I agree to comply with all city and county ordinances ex ELECTRICAL $ 'and state laws relating to •gqiltling • struction,and hereby authori re•re- • PLAN CHECK 50°� $ MICROFILM $ sentatives o his city o/enter 10 above-mentioned o irty f•r ' inspection . ....i.. 's' / J OL7 / 00 _ •,/ r - - I MECHANICAL $ 6• TOTAL FEE $ 14 • Signature Date 1 �/ Drivers - 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 u_urV` LED FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE 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 /N�/� L�) 35. Final Gas Pipe-Test 111 r • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System • 45. Sound Attenuation • 46. Handicap Regulations • 47. FINAL STRUCTURE & BUILDING 48. 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 CITY.°F COSTA NTESA - CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO: Project Address /9a F a a h_/3 sr cc-- E. a� D • e (Applicant's Mailing Address / 8 ' 3 MARLS/3,"O TYPE OF CONSTRUCTION ErNEW 1J ADD LI ALTERATION U REPAIR frouNT/gIN l.',4LI«f' El CONVERSION III DEMOLISH El OTHER A.P.# bU/b I C/r v/U: Zone _J'hlti t' FL _Owner'^ ne• J6�N p=FOCµ//V/1 Phone �Lo-341y� DESCRIPTION OF WORK/USE OF BLDG. Address 'G�1CC ST NUIYr /3C/-1 S Main Building: Accessory Building: Z v Arch/Eng. Qi S7S.°4cNS License No. C--/ ZW C3 TYPE OF PERMIT�r.❑ GRADING El FOUNDATION ❑ STRUCTURAL T Front 0 Address /RU/Nr - El TENANT TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name .TTEI/F lien Ov Fie Phone 96z-83i-5' ❑ 'OTHER __. -_ A I PROJ€ECT DESCRIPTION SQ- FT. 5. f-4- OCCUPANCY -C Right • N Address cens(mailing) ie"'Cr Call n L`//S--1aJa'//4 d @�blybq/N s_act^7N$T RUCTION TYPE VALUATION $ g Left R City License No. 3W !79 CCZCOOYNE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION - `/ A Ping. Ref.# Parking Req./Provided - E Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks] l v/I p iM6 00 i/ T /3 - 2 / 9 9 7 Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and (` - T my license is in full force and effect. T License Class_63 Lieg a No. __ 28 c'Y 4 �' Date /2 - 2-.-7-83-.Signature . d .(Gt-�-s+n-..� PLUMBING FEES • 'YORKERS'COMPENSATION DECLARATION . Bar Sink Showers ELECTRICAL • FEES hereby affirm that I have a certificate of consent to self-insure or a certificate i Workers'/Compensa,i4 I.yra�cp,pr a certified copy thereof (Section Backflow Preventer Service Sink , y teoo,.Lab1 C.) K 1p SI ij Automatic Washer Transformer 0 15-50 KVV 5 00 N. Policy NIO!..- lika—zaelals6. ompany,a .tL2 '✓t ON T Backflow Irrigation Sewer Cap / Construction Pole Sub. 050+ KW S. i 1 iC tified copy is hereby furnishe G€girtifii:tl copy is tiled with to ty B y1�Anq Di,V�s on. Bathtubs Sewer Connection /'t Cooking Unit S Meter /up to 100 amps 'a JC Ot' D t� /a1-=21-R APPII nt '•p-.cpe,Hr -✓L • T E MPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors 5 Dishwasher Meter Dover 100 amps 5, Oa (This section need not be completed if the permit is for one hundred ($100) or less). l Dishwasher Solar Piping - ,5 Dryers IFfGas ❑Electric 7 t Sub Panel SO DC I certify that in the performance of the work for which this permit is issued I f shall notrempioy any person in any manner so as to become subject to the .y Drinking Fountains Solar Tank - Fan -- Motors 00.1 HP Di'/x-8 Workers'-.Compensation Laws of California. _ __ Date - Signature Floor Drains Swimming Pool w/Spa ' F.A.U. • — Inc.Solar 09-15 HP 016-15+ .5;00 'NOTICE:If,after making this declaration, you should become subject to the • Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal ® Fixtures - -_ Microwave oo comply with such provisions or this permit shall be deemed revoked. a CONSTRUCTION LENDING AGENCY 'Gas Service Outlets Water Closet r Device Boxes -- Pole Light I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater ,g4•Outlets J c g Range 3i, OC Lender's Name Lender's Address Kitchen Sink - Water Service 75- Switches ' . . Sign 15, OO OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the, Lavatories . Auto-Wash - ,� 5, OD following reason (Section 7031.5 Business and Professional Code: Any city o .� Garbage Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays — Generator 00.5 KW 05-15 KW any structure, prior to Its issuance; also requires the applicant for such permit Trash Compactor 5f OD to the a signed statement that he/she is licensed pursuant to the provisions of Roof Drains ' 'he Contractor's License Law (Chapter 9(commencing with Section 7000)of ' vision 3 of the Business and Professions Code) or that he/she is exempt - arefrom and the basis for the alleged exemption. Any violation of Section J31.5 by any applicant for a permit subjects the applicant to a civil - ' • enalty of not more than five hundred dollars($500). $15 Issue Fee $ 3 U I, as owner of the property or my employees with wages as'their sole Reinspection Fee 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 Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: , employees, provided that such improvements are not intended or offered foryp Zoning Approved By Date sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II ❑ pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Alk .Date prove for the purpose of sale). /1 (V�� ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Ail sate Ia-7 US tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon;and who contracts for such projects with a con- - tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT- $ SMIP $' proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ PERMIT ISSUANCE $ Date Owner Heating System&Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ ' I hereby certify that I have read this application and state th t the above 00-100,000 BTU ❑100,000 BT -- ELECTRICAL $ IlP'7• V GRADING $ - information is correct. I agree to comply with all city and cou y ordinances - • and std a laws relating to building construction,and hereby thorize repre- PLAN CHECK 50% $ 7y�,�� MICROFILM $ Son n t' es of this city to enter upon the above-menti d property for int/ pur s7/ � Date / z--a7-85' MECHANICAL • $ TOTAL FEE $ "�7�• Sig at a rC! Reinspection Fee $15 • Issue Fee $ 3 PLAN CHECK 25% $. ' Dri s' License or 55# P CMF 0865-46,rev. 10/84 White - Building: Canary -Applicant; Pink -Accounting; Goldenrod -Assessor r CONSTRUCTION AND PLANNING PC SPA 'APPROVALS Permit# Dat Inspector APPROVALS Permit# Date Inspector II i/•S i• 1. Temr ary Electrical Service or Pole 12pa(£1 &a 52. Pool & Equipment Location -2. Soil-P-ipe-Undrgrnd. / 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. -.0 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 7 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 r Rough Electric 16. Wiring j/ g-S �� /.1�+, �� �� 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating \ 71. Product Piping O Gas O Oil 23. Gas Pipe-Rough & T.es` i+ 72. Underground Flush 24. Roof Framing �� 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 111'9. Insulation 78. FIRE PREV. FINAL . Drywall Nailing HEALTH DEPT. REQUIREMENT . Plaster Brown Coat 79. FINAL INSPECTION . Electrical Power Meter-Final f 80. ///F)))OOD CERTIFICATE ISSUED . Final Electric q/a( o Notp / ntel 34. Final Heating &Air Conditioning / t •� r(fI/ 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer i 43. Backflow Irrigation. 44. Landscape Irrigation System 45. Sound Attenuation ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 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. rYOF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. / TRACT NO. LOT NO. UNIT NO. TE !o ae:i�C.-7, "_ Project Address /4 2 E 7 a iv', s/ � �/ _ `1{G{j,SC �7 2� • Applicant's MailingAddress /g 2.t5 /a-i9/4LS C4...40 TYPE OF CONSTRUCTION - J NEW. U ADD LI ALTERATION REPAIR 5937 A/Il4/RC 'r ,'r• te 11. Owner's Name ilei P}N A3CI-O c////f"Ophone I—L./ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone '' LL,, 1�tr �/ qq /�_ DESCRIPTION OF WORK/USE OF BLDG. Address ,4,41-/cAr h�i�r, NelyS Main Building: Accessory Building: Arch/Eng. • - License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ E STRUCTURAL T Front_ ZO Address /i�P ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name t5-7215-4-d C„ aOvA •Phone itz--g"f r ❑'OTHER A - 1 C Right N �tS GAF}g'(S ig LA //, PROJECT DESCRIPTION SQ. FT. OCCUPANCY K c Address(mailing) nsN !3 CONSTRUCTION TYPE VALUATION$ S Left City License No. C/ 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: 3 hi V .2I ..c7 Planning Notes: - M with section 7000) of Division 3 of the Business and Professions Code,end Uy .ins-.--t V� 7 /� s n I. 2 2 T .` my license is in full force and effect. � L _�— � C.Cif _ �'% .% O� S C� License Class—/3_"L p�Licens ,,�-� Cr `I Date i (—14( Signature •Y'' �— ca.L+-A1 PLUMBING • I FEES ORKERS'COMPENSATION DECLARATION / Bar Sink Showers \ ,lereby affirm that 1 have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or-a certified copy thereof (Section • Backflow Preventer Service Sink 1_ 3800, Lab. `` moi, • i Automatic Washer Transformer D 15-50 KW �) Policy No. r 3/ � 1_ Company /r.4/RN 4J./T Backflow Irrigation Sewer Cap0 50+KW Construction Pole Sub. Certified copy Is hereby fur 'shed. Certified opy is filen wit the city Bull ivision. Bathtubs Sewer Connection Cooking Unit Meterup to 100 amps Ittate I '_E C• pplicant DL.Y-� �jy1t�Lil , EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - • - Solar Collectors - Dishwasher- - Meter Cover 100 amps (This section need not be completed if the permit is for one hundred ($100) or Dishwasher less). Solar Piping - • Dryers ❑Gas ❑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 • Workers' Compensation Laws of California. Motors ❑0-1 HP ❑1%-8 Date Signature • Floor Drains Swimming Pool w/Spa • , 1 F.A.U. - 'NOTICE: If,after making this declaration, you should become subject to the _ Inc.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 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. CO Lender's Name Interceptors Water Heater • Outlets Range Lender's Address _ Kitchen Sink Water Service OWNER BUILDER DECLARATION Switches Sign 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 Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for Such permit Trash Compactor •o file a signed statement that he/she Is licensed pursuant to the provisions of Roof,Drains - le Contractor's License Law (Chapter 9(commencing with Section 7000) of - ivision 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 - enalty of not more than five hundred dollars ($500). ' $ 3 U I, as owner of the Property or my employees with wages as their sole Reinspection Fee $15 Issue Fee compensation, 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 $15 Issue Fee $ 3 ereon Law does not ply to owner f a property who builds or improves FEES thereon, andwho does such work himself/herself entsror intended his or her own DEVELOPMENT SERVICES REQUIREMENTS: le. If,employees, provided that such improvements are not withintor year c for Boiler Hood yf Type ❑ sale. If, the owner building improvement of pro issold one yeur of rem- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or On- • Duct-Under Ground proveBuilding Approved By Date n S for the purpose Of sale). L1 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - ❑0-100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- SUMMARY OF FEES tractor(slicense pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT . $ SMTP $ proof of their Worker's Compensation insurance should be provided to me. - $ PERMIT — PLAPLAN CHECK ' MBING ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBO# Fire Dampers $ ISSUANCE $ Date — Owner Heating System& Ducting Registers ENERGY P.C. $ PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTL 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 above-mentioned properly for PLAN CHECK 50% $ �' O •MICROFILM $ inspection pur _ ' _air - • MECHANICAL $ TOTAL FEE $ /0.50 Signature _�/ham ...C.-0,161-..,- Date 7/— Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' License or SS# —�� - — — CMF 0865-46,rev. 10/84 White - Building: Canary - Applicant; Pink -Accounting; Goldenrod - Assessor Fr , . CONSTRUCTION AND PLANNING PC &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-Undrgrrid.' 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. Footings58. Electrical Conduit-Undrgrnd. .8. Foundation 59. Gas Pipe, ❑ Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. • 10. Structural'Floor System i ! 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 - i. 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 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 NailingHEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' ' B / 9. FINAL INSPECTION 32. Electrical Power Meter-Final :'d. FOOD CERTIFICATE ISSUED • 33. Final Electric TM / - 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. Backflow Irrigation • , 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - - 50. Gas Release to Southern-California Gas Co 51. CERTIFICATE OF OCCUPANCY r - No. Date Ill- Applicant to fill in all spaces except those within heavy border tines and sign all appropriate declarations. 6933 2/416/6S - Ir,971E TL CITY OF COSTA MESA CONSTRUCTION PERMIT PERMI/T�/�/jO �a 1/J// TRACT NO. LOT NO. UNIT Nt Project Address t9 2_ CJ2 2- Ai ID �r C!�✓// C • ' �"'"• "' XNEW Mailing Address ZgZsrr a4d4LS-en p <1,T TYPE OF CONSTRUCTION U ADD H ALTERATION U REPAIR - Owner's Name - '1 x/OII/Y /�=�bCHf/}��pep6v-3�'r/7 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ - -- - A.P.# Zone DESCRIPTION OF WORK/USE OF BLDG. Address LA k F cr fry/vT IBc/J. S Main Building: Accessory Building: Z Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION Li STRUCTURAL T Front O Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING l29 MECHANICAL BA Rear N ^^ Contractor's Name .57/r i = C�nQ Vie Phone 912 - / . ❑ 'OTHER C Right N �/`f PROJECT DESCRIPTION SQ. FT. /r�a OCCUPANCY 9 Address(mailing) ie.2CS CA Pl.c_/7Ah F. ✓f K G ' p CONSTRUCTION TYPE VALUATION$ S Left R City License No. 3( `,791/ ZONE GRADING CU.YDS. ACRES E \ e(� LICENSED CONTRACTOR DECLARATION (34_,„,...„,„, (''1 Ping. Ref.# Parking Req./Provided \7 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: //';, „ 7� 9j2 fp 9 -7 Planning Notes: DA with section 7000) of Division 3 of the Business and Professions Code, and Ir-� Vy"'� 404._ 7 ` my license is in full force an. effect. T g 9-€1 ! S License Class L r Licens• . 3 Dated '^ Signature ..mi" C ..a-_/ . PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL l`/ - ' hereby affirm that I have a certificate of consent to self-insure or a certificate . f Workers' Compensation Insurance, or a Certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. Cl., • Automatic Washer Transformer 0 15-50 KW Policy No. _/[- S / Company CAI le A" D N' Backflow Irrigation Sewer Cap0 50+KW Construction Pole Sub. B Certified copy is hereby the furnished. - Certified 5opy 1 d with the city Bui}� g DDl vlsio Bathtubs Sewer Connection Cooking tit Meter ❑up to 100 amps Date f^L -ROMW Applicant sEr�i�L 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 this permit is issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains . Solar Tank .' Fan Motors❑0-1 HP ❑1%-8 Workers(Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ 'NOTICE: If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Outlets Water Closet Device Boxes POIe Li ht I hereby affirm that there is a construction lending agency for the performance 9of the work for which this permit is issued (Section 3097 Civ. C.) InterceptorsWater Heater OutletsRan e Lender's Name 9Lender's Andress _ - Kitchen Sink Water Service SwitchesSign OWNER BUILDER DECLARATIONI hereby affirm that I am exempt from the Contractor's License Law for the1GasService Lavatories Auto-Wash Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or 9 W ;Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW❑5-15 KW Trash Com actor anye ontr cto 'sprior its Issuance,walsorrequires thei ag with nt for such permit P to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law (Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt herefrom and the basis for the alleged exemption. Any violation of Section '031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). U 1, 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 I FEES - License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own _.. DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for ■Boiler HoOd or Type I ❑ sale. It, however, the building or improvement is sold within ono year of com- Canopy Type II ❑ � Zoning Approved By Date ,� pterion, 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). ill ' /wl ❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural IIRefrigerationSystem Application Issued By ��- Dab (/�, /F, 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 00100,000 BTU ❑100,000 BTU SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware that Exhaust System pSystemp / BUILDING PERMIT $ SMIP $, of ❑ Multi le ❑ Re air Alteration proof their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT Efl MIT 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBG# 3 q - Fire Dampers PLUMBING $ ISSUANCE $ PLAN CHECK 25% $ Date Owner gating System& Ducting Registers ii„.: ENERGY P.C. $ 11'b� I hereby certify that I have read this application and state that the above 0100,000 BTU 0100,000BT ELECTRICAL $ GRADING $' information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- MICROFILM $ sentatives of this city to enter upon the above-mentioned property for PLAN CHECK 50% $ inspection purpo i¢si - - _�� etG MECHANICAL $ / 10[/ r� • Signature i+2 4!�/`Ol4-N Date / L� r TOTAL FEE $ Drivers' License or SS# � 5 ■ Reinspection Fee $15 . Issue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POC 3PA . APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole ° 52. Pool & Equipment Location • • 2. Soil Pipe-Undrgrnd. ;C 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.'Electrica1 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7.•Footings ,1 • 58. Electrical Conduit-Undrgrnd. • 8. Foundation ' 59. Gas Pipe, 0 Undrgrnd.,Test 9: Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. 10r.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 ��_24--8 L O FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace (1_76' 16 L " APPROVALS Permit# 21..•Ducts, in Structure _ 70. Underground Hydro 22. Ducts, Ventilating 160/tb (AK 71. Product Piping 0 Gas 0 Oil • 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing • 73. Undergrnd.Storage Tank ❑Gas DOR • 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 10e/fa "4° 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace /93405 Lj9 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 • 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. 8994 2/Li6/Qu Ice%L IL •CITY OF COSTA MESA CONSTRUCTION PERMIT I PERMIT N TRACT NO. LOT NO. UNIT • Project Address 2— a �/,h .sr U/1/T .E.- i do e Applicant's Mailing Address Z�/s2 t3S el -el -O TYPE OF CONSTRUCTION 131 NEW ❑ ADD U ALTERATION U REPAIR /ONA/ / ahOI^/1/W1.1/Phone?G�3• '4 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# Zone Owner's Name DESCRIPTION OF WORK/USE OF BLDG. Address I.4k' (Cr ,' -1/lir /3 C N - S Main Building: Accessory Building: Arch/Eng. - License No. TYPE OF PERMIT LI GRADING CIU STRUCTURAL T FrFOUNDATION E Zont Er O () Address DI TENANT DI ELECTRICAL Li PLUMBING CJ MECHANICAL B Rear N \v Contractor's Name ,7 V g fC19OOV r/@Phone 9/2-e l-" r ❑ 'OTHER C Right N Ct Address(mailing) X82 LS3 erd/PLf i(3�4 p L/1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Lett G // p CONSTRUCTION TYPE VALUATION$ S 1 City License No. 367 / y ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION ,` Ping. Ref.# Parking Req./Provided E \V\\1 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �4,,��/. �iw -n �� I c19 Planning Notes: M CI \ vith section 7000) of Division 3 of the Business and Professions Code, and •"e sss..��"'•.s--, /TTT ly license is In full for and effect. /V/ T 1 License Class _ License •. a a `� $ nate — - Signature _% . __ Ai--a i PLUMBING FEES OR KERS'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL 'FEES ✓ nereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW 3800, Lab. Ca).,, - Polic No. _it- 3Ct / Company /'i*-lR.N 021'T Backflow Irrigation • 0 50+ KW PolicyP y9 Sewer Cap Construction Pole Sub. C Certified copy is hereby furnished. Certified copy is filed with the city Bu"UAifta Division p.�M'•' Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date ,-- i +SL Applicant ••ET .l�iL 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 DElectric Sub Panel I certify that in the performance of the work for which this permit is issued, I - - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank • Fan Motors 00.1 HP 01%-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ NOTICE: If,after making this declaration,you should become subject to the — — Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Fixtures 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 Heater Outlets Range Lender's Name Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for the Lavatories . Auto-Wash Garbage Disposal ;Standing Sections allowing 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 Laundry Trays Generator ❑0-5 KW❑5-15 KW Trash Compactor I any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of • Roof Drains he 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 LIenalty of not more than five hundred dollars($500). 3 I. as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ - compensation, will do the work,and the structure is not intended or offered - Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler Hood or Type I 0 Zoning Approved By Date sale. If, however, the building or improvement Is sold within ono year of com- Canopy Type II 0 /� pe the owner will have the burden of proving he/she did not build or im- / Duct-Under Ground 3 W Building Approved By Date provrovt Prove for the purpose of sale). ' ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: • The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑4100,000 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 that Exhaust System 0 Multiple 0 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.Blt. ICBG# 3IQC/s Fire Dampers Lf oo/� PLUMBING $ ISSUANCE $ 14 VV 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. I 100,000 BTU 0100,000 BTL ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for S inspection purp _/SBC MECHANICAL $ ✓� Drivers'ure or SS yr - Applicant: Pink -Accounting;Goldenrod -Assessor CONSTRUCTION AND PLAN. .iC F . &SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipd-Undrgrnd. 53. Steel Reinforcement 3. Electrical.Conduit Utility-Undrgrnd. , , 54. Forms • , 4''Electric5l Conduit-Undrgrnd. - 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test • 6. Electrical UF ER 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. Secver 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 //-26-d6 (-Co FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace (1_24-it C.,e2 APPROVALS Permit# 21. Ducts, in:Structure �� (4-1;et[yl(/ :),l7/3%G //,ff' 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • _ 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding y' 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 e(j/34/ga (ciao 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 16/3Q40 LED 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 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. •.r CITY OF COSTA MESA��/1CONSTRUCTION PERMIT N // PERMIT NO � TRACT NO. LOT NO. UNIT NO. 9234 2/11/86 uo�'C) T: Project Address 9y- E >2 a2 N b � OW/r F!F!.3 MY'A 2 �O Applicant's Mailing Address I e 2`5S" `Ase &5 soap . . V TYPE OF CONSTRUCTION KNEW ADD Li ALTERATION Ii REPAIR 1 Owner's Name ✓nN/V /0aJ nCN//VO PEnfqqr ❑ CONVERSION ❑ DEMOLISH 1111 OTHER A•P•# I Zone / DESCRIPTION OF WORK/USE OF BLDG. s Address /A/1-r- S 7 /-/-W Tv 0.4 G/-/ , S Main Building: Accessory Building: • Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front O ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - N Address ❑ Air P406 sY9?LM A Rear I L�T�L/t �(PC1L'!YE/ OTHER C Right • N Contractor's Name CA �o (mhon,9. -83(S- PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address(mailing) ✓♦�Z.fv� ` �� 5 N.4� f,-id. CONSTRUCTION TYPE VALUATION se0 — g Left R City License No, 86 7 9� ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./ProvidedE \ 1 hereby affirm that I am licensed underprovisions of Charter 9 (commencing0 P Remarks: Planning Notes: • M 'd[h section 7000) of Division of 3 of the Business and Professions Code, and y license is In full fo ce and effect. �f es T _icensenClass , Lice .,��sKO 9� _ S l Date_a�/ /!p�t„Signature PLUMBING FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers t I 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- Backflow Preventer Service Sink 3800, Lab. C' 3GG8 Preventer Washer Transformer 0 15-50 KW l Policy No. N.• Company as The All 0A/r Backflow Irrigation Sewer Cap0 50-1--.KW �Certifietl copyConstruction •Pole Sub. is hereby furnished. Certified copy�isffiil/l-, with the city Bulltlin Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps Date W Applicant .. �A ierjhATIO/t EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Clarifiers Solar Collectors Dishwasher Meter Dover 1008.•.5 (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher a , Solar Piping _ ' Dryers OGas OElectric Sub Panel • - I certify that in the performance of the work for which this permit is issued, I - - ' shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Ta • Fan Motors �0-1 HP ❑1%-8 Workers' Compensation Laws of California. _ Date - Signature ' Floor Drains Swi ming Pool w/Spa `— F.A.U. If,after making this declaration, you should become subject to the _ !�_ In . olar 09.15 HP 016.15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks rine) Fixtures • comply with such provisions or this permit shall be deemed revoked. Microwave • CONSTRUCTION LENDING AGENCY 'Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) • InterceptorsZWater Heatef OutletsLender's Name Range Lender's Address Kitchen SinkWater ServiceOWNER BUILDER DECLARATION - - -- SwitchesSign hereby affirm that I am exempt from the Contractor's License Law for the LavatoriesAuto-Wash Garbe a Dis osalsnowing reason (Section 7031.5 Business and Professional Code: Any city or9 P Standing$¢coons _ounty which requires a permit to construct,alter,improve,demolish or repair P-TrapLaundry Trays Generator •>-5 KW ❑5-15 KW ch any structure, prior to its issuance, also requires the applicant for supermit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of ,Roof Dr 5 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 • enalty of not more than five hundred dollars'($500). I LJ I. as owner of the property or my employees with wages as their sole Reinspection Fee 4 $15 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered 11 - - 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 - - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ sale- If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved ByDate pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground �� prove for the'purpose of sale). Building Approved By Date / ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By ‘--77Bye-.. 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 - - ❑0-100,000 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 that Exhaust System 0 Multiple 0 System Repair/Alteration • BUILDING PERMIT $ ¢ �fL/ a.5SMIP $ O proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBO# Fire Dampers $ PERMIT - PLUMBING $ ISSUANCE $ HeatingSystem Date Owner y em& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and-state that the above ❑0-100,000 BTU 0100,000 BT , $ information is correct. I agree to comply with an city and county ordinances ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- MICROFILM $ • _ sentatives of this city to enter upon the above-mentioned property for ,( Q PLAN CHECK 50% $ inspection put I A/FQ rL Co ie J MECHANICAL , $ 6.'00 TOTAL FEE $ 2:51 40 ' Drivers' License or SS# ! - Signature i0 i a' ....KS..i Date 1-...//---29 C - Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ •• 7.5 . CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLAN.._ .v .POOH 81 SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. I 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. r 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. Sewe:Cap•! 1, • ' 63. Heater & Vent-Final • 1'3. 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 11_24-t(, LEO FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# '. 2-1.-Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing •' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning /q/300 L.e 35. Final Gas Pipe-Test • 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final . 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation • 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations / 47. FINAL STRUCTURE & BUILDING (00C1 48. Special Requirements Completed 4444! 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. / CITY OF COSTA MESA CONSTRUCTION PERMIT i PERMIT,sNQ. _ / /a"7 TRACT NO. LOT NO. U NO. Project Address /t2 a /2I /2�.a.' Nn y7 /!N/7 R N{1 '�`J IWn Jh • I f�\I[��/ 0931 2/06/06 IEg7F TL Applicant's Mailing Address /Q7.SS `A a Q 7- TYPE OF CONSTRUCTION 0NEW U ADD U ALTERATION LI REPAIR • se'ou nTissrN �.'w`��7 ❑ CONVERSION, El DEMOLISH III OTHER -# - . I Zone Owner's Name Jr FIA! (.1L-r/0G.! /gyp Phone-94.3....34/4/7 DESCRIPTION OF WORK/USE OF BLDG. Address r S Main Building: Accessory Building: • Z Arch/Eng. License No. TYPE O PERMIT ❑ GRADING U FOUNDATION STRUCTURAL T Front O Address ❑ T NAM' ❑ ELECTRICAL ElGl/PLUMBING IMECHANICAL B Rear N Contractor's Name 5-FV tcROOYPaephone qb z-le /s ❑ O ER •- A 1 I / PROJECT CRIPTION SQ. FT. /.S.Sa9 OCCUPANCY C Right N `t`�, Address(mailing) ,3 ,rS (7.��iLS/RAD cr- CON STRUCTION.TVPE VALUATION$ K Left G _�z( City License No. .��'�9 ZONE GRADING CU.YDS. ACRES $ E \`I(}3 LICENSED CONTRACTOR DECLARATION .k Ping. Ref.# Parking Req./Provided I hereby affirm 7 that) I am licensedion under provisions charter 9 code, nd Remarks: ,// kv, /eRa = Q�.� ,s�c, ^7 Planning Notes: M Q with section 7000) of Division 3 of the Business and Professions Code, and "ae V T 1 \y Ilcense is in NI force pnd effect. ,cense Class y A} s/ l _jam—License No. 3-? -2 e 7 9 S N.nl Date_ L �� �Signature .y/ �s ) ew.�n.i.� PLUMBING FEES •• WORKERS'COMPENSATION DECLARATION Bar Sink Showers I 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 Backflow Preventer Service Sink ., 3800, Lab. C.) _ Automatic Washer Transformer 0 15-50 KW tJ Policy No. R3dG Ia/ Company_TA/A lin ON 7 Backf low Irrigation Sewer Cap Construction Pole Sub. • 050+KW Certified copy is hereby furnished. — Certified copy is filed with the city Buina Dlvisio / Bathtubs Sewer Connection Cooking Unit Meter Dug to 100 amps Date '` (e•-0./ Applicant .qz'.. A ..4/4/1X']+•tA 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 this permit Is Issued, I . shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑O-1 HP ❑1/a-8 Workers' Compensation Laws of California. . Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP❑16-15+ 'NOTICE: If,after making this declaration,you should become subject to the - - - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes • I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION • hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ;Standing Sections allowing reason (Section 7031.5 Business and Professional Code: Any city or aunty which requires a permit to construct,alter,improve,demolish or repair P—Trap • Laundry Trays Generator ❑0-5 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 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). ' $ 3 ❑ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee 4 compensation, will do the work,and the structure is not intended or offered - Reinspection Fee , $15 ' Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or Improves - thereon, and who does such work himself/herself or through his or her own Boiler Hood or Type 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered forZoning Approved By Date sale. If, however, the have ng or Improvement Is sold within one year of com- Canopy Type II 0 �s�,'� _ prove , the owner will have the burden Of proving he/she did not build or Im- ` Duct-Under Ground 3 CX, a** Building Approvatl By Dat prove for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ - • SMIP $ proof of their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ PERMIT 0 I am exempt under Section B.&,P.C.for this reason ) Firepl/Fact.Bit. ICBG# Y,�) qS 14 Fire Dampers DvLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting✓3 Registers CoW 4 PLAN CHECK 25% $ ' ENERGY P.C. $ I hereby certify that I have read this application and state that the above / 't-100,000 BTU 0100,000 BT ELECTRICAL $ GRADING $ - information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- MICROFILM $ sentatives of this city to enter upon the above-mentioned property for • PLAN CHECK 50% $ inspection purposes � q� /n/' 5 Signature i6C/...•a . ld-ero+•Ci1 Date /—C^E � MECHANICAL. $ 1 ..��Dr1� TOTAL FEE $I `"' Drivers' License or S5# - • Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ _ —r1S r CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod • Assessor CONSTRUCTION AND PLANT . L'L &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 Conddit-Undrgrnd. .- - 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd.: 57. APPROVAL TO COVER-GUNITE 7: Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, ❑ Undrgrnd.,Test 9. Water;Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 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 .1,7.-Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T.Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning '1_2&_W1. 440 FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace I/-16 teg (,$O APPROVALS Permit# 21._Ducts,i.rStructure of rec.;4 •-/7/te 'f" 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 ❑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 143444 L40 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 'piano vQ 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 7 44. Landscape Irrigation System 45. Sound Attenuation • 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison • _ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - No. - Date - -• - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 3933 2/U6/Jr. 1 _071 IL CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. tj/ow]we TRACT NO. LOT NO, UNIT N / - Project Address 141. FLJA1/O7" G ��`� t v I Applicant's Mailing Address J�.2,CC el-ern1 'CAA TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION LJ REPAIR Owners Name //a LLA/ ,p FOU/ TR//✓ V.4L,y/IZ(. CI CONVERSION CI DEMOLISH ❑ OTHER A.P-qy, Zone Phone !! DESCRIPTION OF WORK/USE OF BLDG. Address 1C,/4RE S T N[JP T Pa. e)..4 S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING U FOUNDATIO_NN//U STRUCTURAL T Front O Address ❑ TENANT El ELECTRICAL CIt PLUMBING t„lidMECHANICAL B Rear N Contractor's Name 5'? VPS //Q/10VE!¢ Phone ' 2-&,Z /S CI OTHER A I PROJECT DESCRIPTION SG. FT. / -S3U OCCUPANCY C Right N ^,� Address(mailing) /et C-C �A-R/SAA/Z }7w/1-T. �.A4t K - G COO S• . ..V�i/ /--�/C`ONST RUCTION TYPE VALUATION$ S Left R CityLicense No. —J{r-i '! ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION .�z "per/���'. /_{,/Q y- Ping. Ref.# Parking Req./Provided I hereby affirm that I am licensed under provisions of charter 9 (commencing Remarks: {€L, .4.. V G--LM -2- . )3 g/c-? 7 Planning Notes: - M `C with section 7000) of Olvision 3 of the Business and Professions Code, and Iv T y license Is in full force and effeet. cense Class rt �Licerye�Vo. 33 a s `i'C/ S Date / -I — Signature ../4.__•- .ar),_ 1 PLUMBING FEES • WORKERS'COMPENSATION DECLARATION I hereby affirm that I have a certificate of consent to self-insure or a certificate gar Sink Showers ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer • Service Sink ii4 J 3800, Lab. C.) Automatic Washer Transformer 0 15.50 KW Policy No. ___R---313 _ Company /�F'I RM tO" ' Backflow irrigation Sewer Cap0 50+KW la9 Construction Pole Sub. Certified copy is hereby furnished. Certified cJ py 15 f'enywith the city Buil ^ Division. 7 Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date /- V '- MaM 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 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 01'h-8 Workers' Compensation Laws of California. _- Date Signature Floor Drains Swimming Pool w/Spa F,A.U. Inc.Solar 09-15 HP❑7615+ 'NOTICE: II,after making this declaration,you should become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's Name 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 Garbage Disposal I Standing Sections mowing reason (Section 7031.5 Business and Professional Code: Any city or , Iunty which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays Generator 00-5 KW ❑5.15 KW Trash Compactor .ny structure, prior to its issuance, also requires the applicant for such permit 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‘civll penalty of not more than five hundred dollars($500). LI 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 $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I 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 Boiler Hood or Type I ❑ DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for yp ZoningApproved sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 !� pproveBy Date pletion, the owner will have the burden of proving he/she did not build or im- (• Duct-Under Ground J Building Approved By Data prove for the purpose of sale). ❑ 1, as owner of the property, dm exclusively,contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 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 that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance should be provided to me. �l �1� PLAN CHECK $, PERMIT IDI am exempt under Section B.8 P.C.for this reason Firepl/Fact.Bit. ICBG# '3 j S Fire Dampers 'f up PLUMBING $ ISSUANCE $ Date • Owner Heating System& Ducting Registers vT PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above I 004 00,000 BTU 0100,000BTL information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ GRADING $ - and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for PLAN CHECK 50% $ inspection purpo !. a. MECHANICAL $ i //f Signature ' d - a . -�J ti . i Date I -c a Reinspection Fee $15 Issue Fee $ OTAL FEE $ ! 7`� Drivers' License or SS# � Pe $ 3 PLAN CHECK 25% . a CMF 0865-46,rev.10/84 White - Euilding; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANK,,, , OL_& 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. :v 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6.. Electrical UF ER 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, ❑ 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 lb.'Rough Heating & Air Conditioning ((-j - 4 L ED FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace ((-z_1jb LED APPROVALS Permit# 2C-Ducts, in.Strueture -i� -' � f 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil . 23. Gas Pipe-Rough &Test 72. Underground Flush .. 24. Roof Framing '. • 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) &.Monocoat 75. Dry Chemical ' 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32.;Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric ��-�//// Notes: 34. Final Heating& Air Conditioning /pr4O t 35. Final Gas Pipe-Test I 36. Hood or Canopy 37. Final Factory Fireplace (913070 LEs? 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 & BUI LDI NG 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. TL PERMI]'RO s,.� TRACT NO. LOT NO. UNIT NO. 830 2l06/3f 1 z1O7 CITY OF COSTA M/$/g/, CO S'{C{��'UCTION{`P�RMIT, I//VV 11 \Lh Project Address /z(�Z' 99- L.2)--et !' • ON/r A- 1 �yT i REP Applicants Mailing ddres4 ,L/�( TYPE OF CONSTRUCTION C.9 NEW Li ADD Li ALTERATION LI REPAI R �y%CLP ❑ CONVERSION ❑.DEMOLISH ❑ OTHER A.P.# Zona Owner's Nam cCp�m P/hroneEs_,L DESCRIPTION OF WORK/USE OF BLDG. Address a j/_ ✓,p- v, "O'er S Main Building: Accessory Building: TV PE OF PERMIT ❑ GRADING ❑ FOUN DATI N El E Front Z Arch/Eng. License No. _ 2.. T - O Address ❑ TENANT El ELECTRICAL III PLUMBING MECHANICAL BA Rear N Contractor's Name STCLIE . 6R00 V1=P� Phone y�l'd.2-t3"5 CI OTHER - q _ _ - Address(mailing) /F�t SS CCIQLs'84 D �G'T Fa✓N1A/N- PROJECT DESCRIPTION SQ. FT. �-S L OCCUPAN -1 C Right • N ,/� CONSTRUCTION TYPE VALUATION$ 0J � s Left G City License No. ���QT V'4Z4`r r R (y ZONE GRADING CU.YDS. ACRES Ping. Ref.# _ Parking Req./Provided E LICENSED CONTRACTOR DECLARATION - 0 I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: �[b /� ( '� Planning Notes: with Section 7000) of Division 3 of the Business and Professions Code,and 'J/'z �i���� 'nut, //,../ 9 M 'y license is in ful olce and effect. C; �t �� T ,cense Class �LiGensee.Nyy ...4-a �-R l9 `/ S. Date I— In-S� Signature 4ile .G- GA-4.-el i PLUMBIN FEES WORKERS'COMPENSATION DECLARATION • Bar Sink Showers r • • ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate' if Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - - 3800, Lab. C. Automatic Washer Transformer'❑ 15-50 KW Policy No. 3r6 C. S/ company /�A!/ M 6" 'T Backflow Irrigation Sewer Cap0 50+KW Q. Construction Pole Sub. Certified copy is hereby furnished. - _ Certified copy isffiledCwith the city By•l�fy-n-9 D�ivisio��/ Bathtubs Sewer Connection Cooking Unit Meter Dula to 100 amps Date PT L Applicant_ PENS -- �(/ �) EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need nbt be completed if the permit is for one hundred ($100) or less). I Dishwasher - Solar Piping Dryers ❑Gas DElectric Sub Panel I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar TankFan Motors❑0-1 HP 01%-8 Workers' Compensation Laws of California. • Date Signature Floor Drains Swimming Pool w/Spa F.A.D. 'NOTICE:If,after making this declaration,you should become subject to the - _ Inc.Solar 1119-15 HP ❑16-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks -Urinal - Fixtures - comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY 4 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 • DUile25 Range Lender's Name Lender's Address • Kitchen Sink - Water Service Switches OWNER BUILDER DECLARATION Sign ' hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Wowing reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal ;Standing Sections Iviounty which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundr Tra s 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 • - 7031.5 by any applicant for a 'permit subjects the applicant to a civil -. • Limalty 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 $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 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I ❑ sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By - nate pletion, the owner will have the burden of proving he/she did not build or im- li I Duct-Under Ground 3 Building Approved By • Date� prove for the purpose of sale). ! ❑ I,as owner of the property,•am exclusively contracting with licensed con- Duct-Structural . Refrigeration System Application Issued By Date_!t/.UCyt tractors to construct the project (Section 7044,Business and Professions Code: bb The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 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 that Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. r ,/ M PLAN CHECK $ I PERMIT ❑ am exempt under Section B.& P.C.for this reason / Firepl/Fact.Blt. ICBG# .z1 9 7 Fire Dampers ' 7 CO PLUMBING $ ISSUANCE $, Date ' owner mg System& Ducting Registers tT) W PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify'that I have read this application and state that the above ✓ Q0-100,000 BTU 0100,000 BTL 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- MICROFILM $ sentatives of this city to enter upon the above-mentioned property for PLAN CHECK 50% $ ++r- (�I� • . inspection Pur. =. /�4 6 -• - MECHANICAL $ TOTAL FEE $ `�. IJ Signature / _. I A Date Drivers' License • or 55.* Ai; Reinspection Fee $15 Issue Fee $ 3 I PLAN CHECK 25% $ Zed CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor rf CONSTRUCTION AND PLAN 9 '06 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 Utilit Undr r`hd. , . Y- g . 1 54. Forms 4, Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' 5: Steel Reinforcement.pw 56. Rough Plumbing & Pressure Test 6: Elect•rical UFER Grnd. . 57. APPROVAL TO COVER-GUNITE • 7. Footing's 58. Electrical Conduit-Undrgrnd. 8..,Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9..Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. • ' 10'StructuralFloor System . 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection - 62. Backwash & Receptor-Final '12. Sewer Cap _ 63. Heater & Vent-Final 134 Roof Drains ,,J 64. Plumbing System - Final 14.1-Rough Plumbing . i 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval i17: Rough Wiring Sign ' 68- APPROVED FOR PLASTERING •r 18:- Rough Electrical-T Bar Ceiling i 69. POOL/SPA SYSTEMS FINAL . 19'. Rough Heating & Air Conditioning f!• Z4-86 CE,D FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace it-1446 140 APPROVALS Permit# - . . 21; Ducts, in-Structure'a__ .p` .,„W„, ' ,i/y75i , ' 70. Underground Hydro 22. Ducts, Ventilating71. 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 '1 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monrocoat 75. Dry Chemical 27. Frame and Flashing - '1 i• 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL t • 29. Insulation k - 78. FIRE PREV. FINAL 30. Drywall Nailing ' - HEALTH DEPT. REQUIREMENT 31/Plaster Brown Coat , i... FINAL INSPECTION . 32.'Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 1. 33. Final Electric Notes: - 34. Final Heating & Air Conditioning - ' X18440 35. Final Gas Pipe-Test ' 36. Hood or Canopy ' , 37. Final Factory Fireplace to 8. QO C,ay7 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 ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 7-- 3, Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6832 3/I b/H;: _ 89,G0 TL ` CITY OF COSTA M SA /CON�STR,UCTIO7N PERMIT PERMIT NO. Q TRACT NO. LOT NO. UNIT NO. k Project Address �92. E• 22 �). _`/ 64,7,0-/r/l-S,j' J 4� f 13183 . 1 �, 7 2.:Ay e. ,•J/Oh'%p.''TQ•L' f TYPE OF CONSTRUCTION )(NEW LJ ADD H ALTERATION L I REPAIR ' O• wner's Name ilin Address // ❑ CONVERSION ❑ DEMOLISH ❑ OTHER R� Owner's Name Phone 7Q� DE$CRIPTIQQf�1 OF WORK/USE OF BLDG. � 1C'— i/#Sentry A.P.AP # At2(.1a Q�' Zone Address /7 r j ff Sr",I/e 4/74 -few lea,(/ / S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING FOUNDATION 12(STRUCTURAL B Front hp/ .r g', („JyL, p ' /• ' N VJ Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL Rear 0/ / Contractor's Name Phone El OTHER Ai Address(mailing) PROJECT DESCRIPTION SQ. FT. OCCUPANCY F i == C Right--% ,S/ i N CONSTRUCTION TYPE VALUATIONS 2i S_bd $ Left o 7 R City License No. ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ret.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: (� .W J' �u ca,• PlanningNotes: /I � �� ��,,// ,,..��j� Q , with section 7000) of Division 3 of the Business and Professions Code, and L 2.p �, F. woo p ',vice- I ��1..• LOL' Lc s isaL•��('i LN r/ - 4 (,.A�l M ✓✓ T iv license is in full force and effect. Pt 'C A fJe7s / �s /A.�}: /�, ___ s n _OPV S Date Class License No. — s_V 7't 66 PLUMBING FEES 1 awvi)j /j) I: r�sans,a,e-Prrcys4' 10 "�A Date Siqnat ure 1 T WORKERS' COMPENSATION DECLARATION Bar Sink Showers I 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 Backflow Preventer Service Sink 3800, Lab. C.) Automatic Washer Transformer 0 15.50 KW Policy No. Company Backflow Irrigation Sewer Ca 0 50+ KW BCertified copy Is hereby furnished. p ConSVuctiOn Pole Sub. Certified copy is filed with the city Building Division. Bathtubs Sewer Connection Cooking Unit Meter ❑up 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 er ify that in the performance of the work for which this permit is Issued, I shall not employ any person in any manner so .• to be - s .lee o the Drinking Fountains Solar Tank Fan Motors ❑0.1 HP ❑1'/.-R Workers' Compensation Laws of Calif() _ Date 5ignatur — ��d.. Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP 016.15+ NOTICE:If,after making this decla /! ou should •ecome subject to the — — Workers' Compensation provisio he Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave- comply with such provisions • 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 ry, jjhh}}ss�pe It is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Ran ¢ Lender's Name ✓zf//fs/ ,/r/ /J g • Lender's Address n ba -Si ., . i' / - ' - Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash a;;iollowing reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal Standing Sections ciounty which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays Generator ❑0.5 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 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). o 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 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 — DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 _ �s/1 a y^t7�� sale. It, however, the building or improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By M" ` Date �I♦.+ `•S , pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date Ve for the purpose of sale). �'(/ Wv as owner of the property, am exclusively contracting with licensed con- Duct-Structural - Refrigeration System Application Issued By Date 3— I 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 SUM V OF FEES builds or improves thereon,and who contracts for such projects with a con- a Co tractor(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ i OD SMIP $ proof of their Worker's Compensation in ranee should be provided to me. Exhaust System ❑ Multiple 0 System Repair/Alteration PLAN CHECK $ • PERMIT ❑ I a exempt and r ctiy G ;/B�& P.C fort is reqs n Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE $ 2 /OW/0�y /1' O • A6, g/i Baia., SystemDucting 9 _ PLUPLUMBINGN 25% $ ENERGY P.C. $ Dae Owner t.. Heating & Registers I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BT GRADING $ information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ - _ and state laws relating to buildin• ucti n, and hereby authorizepot repre- sentatives - MICROFILM $ of this - -440,..„. t above-mentioned y PLAN CHECK 50% $ inspection pur • -5. LL ♦ pp p QQ / Signature /` yW- Date7 - MECHANICAL $' TOTAL FEE $ ♦+ I<F9� Drivers' LiageSS# Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ 1 CMF 0865-4.,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor 2 - CONSTRUCTION AND PLANNING , POOL &SPA APPROVALS Permit# Date InspectorAPPROVALS Permit# Date Inspector APPROVALS 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 34549--�� 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - 3/2..44 6,° 58. Electrical Conduit-Undrgrnd. -. 8. Foundation • / 59. Gas Pipe, 0 Undrgrnd.,Test ;as 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 Q Gas ❑Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat • 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL • 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • 33. Final Electric Notes: 34. Final Heating & Air Conditioning • 35. Final Gas Pipe-Test ' 36. Hood or Canopy I 37, Final Factory Fireplacet- 38:.FinalPlumbing - •'i� 39. Water Service-Final - 40. Gas Service-Final ,41.Solar Domestic-Final •42. Backflow Preventer 43.• Backflow Irrigation 1. - - ` ' 44. Landscape Irrigation System - , , X45. Sound Attenuation - - - �, .: 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 77J so 7.6. tie n1d ( • 48. Special Requirements Completed 3/ 49. Electric Release to Edison ! .% 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF9CCUPANCY r i No. "Date - f' PARTY WALL AGREEMENT THIS AGREEMENT, made and entered into/ this frbte ,Sited day of , 1983, by and between J°17/4/ Ute_ J,TlO hereinafter referred to as "LAND CANER", andJ..t 3JL.a � �Lu- -- 4 /iJeJ hereinafter referred to as "ADJACENT PROPERTY OWNER". 1 It is hereby agreed that a party wall will be constructed on the property line between /9� e 22 / /`j� 3 7)A-r�q � (Address of Adjoini Properties) d in the City of Ccsta Mesa, County of Orange, State of California, as per map C, , o/tax--Z,i S' ua c� ✓r Pc a/& 3-G s-- 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 /8" ON/a /93 7//%.-4.-/e- ,Q/n IN WITNESS '4{EREOF, the parties have entered into this Agreement the day and year first above written. LAND OWNER ADJACENT PROPERLY OWNER ature) Al ;/nat e) {� / ��MJ Ar Ale.--lcjs-p .LOSGpA =1I � / l, cht}LC!` Name (Typed or Printed) Name (Typed or Printed) (Address) (Address) • (NOTE: Please see reverse side for notary's statement) STATE OF CALIFORNIA ) ss. 03UNTY OF ORANGE ) On before me, the undersigned, a Notary • ..lic in and for the County of Orange, State of California, personally appea -. known to me to be the person(s)' whose name(s) is subscribed . the within instrument arca acknowledged to me that (he/she/they) exe ed the same. WITNESS my hare] and official seal. (SEAL) Signature • Name (typed or printed) \. STATE CF CALIFORNIA ) ss. COUNT! OF ORANGE ) • On , before me, the undersigned, a Notary Public in and for the County of Orange, State of California, personally appeared known to m> to the person(s) whose name(s) is subscribed to the within instrument - % acknowledged to me that (he/she/they) executed the same. WITNESS hard arca official seal. ` (SEAL) (Signature) • Name (typed or printed) PARTY WALL AGREEMENT rc THIS AGREEMENT, made and entered into this ;LS 3 • day of 87 1Wwrfir , 19q, by and between TOW t ,, / t� o L Phh/J� ahereinafter referred to as "LAND OWNER", and t---CRT/5i/ CV90 Crg--Ld hereinafter referred to as "ADJACENT PROPERTY OWNER". It is hereby agreed that a party wall,�Jwill be constructedQon the Property line between FP-- EL. 22. ' sr: 0-1/ is:, 2� "'A S7"' coS� (pre! pre cof Adjo. i opert -6ie_s)r. 2:7� y J in the City of Costa Mesa, County of Orange, State of lifornia, as per map go, Ea open- xicui-in extr.it 145--nfrn. recorded of Miscellaneous Maps, in the office of the County Recorder of said County. The party wall shall be permitted to encroach 6•172X, r rt ok /Y 1 /watts a al- j2 tip S r ero ¢rt l8' (r)c /\ co^tort7c )00 $TS sre-dIQ1Q- pr-/er7�r �( ,. z IN WITNESS %HEREOF, the parties have entered into this Agreement the day and year first above written. LANDOWNER NZAC PROPERTY OWNER 'gnature) ( i nature) t%,v,v 6-70C/ 0 L o ti /9-/Z�o✓6-5—w Name (Typed o Printed) Name (Typed or Printed) /los G, e sr . 32-`f ter( 56-7-77 (Address) p.VT/ Tt*i se—wept (Address) �,J A- ➢ CL- cyMA—Ai /_ C id 72696 c4-14 F 12-C (NOTE: Please see reverse side for notary's statement) STATE OF CALIFORNIA ) • ss. COUNT! CF ORANGE ) On before me, the undersigned, a Notary • is in and for the County of Orange, State of California, personally appears. known to me to be the person(s) whose name(s) is subscribed to e within instrument and acknowledged to me that (he/she/they) execut-. the same. WITNESS my hard and official seal. (SEAL) Signature • • Name (typed or printed) STATE CF CALIFORNIA ) ss. COUNT! CF ORANGE ) On , before me, the undersigned, a Notary Public in and for the ounty of Orange, State of California, personally appeared known to me to •- the person(s) whose name(s) is subscribed to the within instrument . ,: acknowledged to me that (he/she/they) executed the same. • WITNESS . 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. r IT NO. n TRACT NO. LOT NO. UNIT NO. 9233 2/I1/36 P:503.5 TL CITY OF COSTA MESA CONSTRUCTION PERMITt ' P U1 Project Address /q 2- F 22 ALq_r UNI r 132 2 72 I(�� pppppp lS2si-C city?Ls !.�,4D C'r TYPE OF CONSTRUCTION 12FNEWEICLADD U ALTERATION H REPAIR Applicant's Mailing Address ❑ CONVERSION ❑ DEMOLISH LJ OTHER wner's Name `.�0H-A/ eg/Q C./- /(t/QPhone17/p -.3'W A.P.A # Zone DESCRIPTION OF WORK/USE OF BLDG. __ Address /AR_ U/✓ - e/-1 S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT U GRADING U FOUNDATION El STRUCTURAL T Front 0 Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's Name t5"7- V/= �ROO1/b`7Phone G 2' 3/ �pp❑,,�II OTHER fQ//Q noto a s/c]-OM A - I Address(mailing) /16.Z1�ftnA R(S IS AB ,O:J/707ta �• ��O ECT DESCRIPTION SQ. FT. OCCUPANCY C Right G �e 7� � YS'ONSTRUCTION TYPE VALUATION$ e 6 0 $ Left B City License NO. •, ZONE GRADING CU.YDS. ACRES Ping. Ref.# Parking Req./Provided E �� LICENSED CONTRACTOR DECLARATION - 0 I.hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and T C1, w license is in full bred and effect. VV Jcense Class + ^ Licens N. .R'.3 2999 S i\a Date - — —; Signature .i _ - .e-. •.i.._i PLUMBING FEES WORKERS' COMPENSATION DECLARATION Bar Sink Showers '..\\(\ I hereby affirm that 1 have a certificate of consent to self-insure or a certificate ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer- Service Sink \ 3800, Lab. C. ? Automatic Washer Transformer 0 15-50 KW I Policy No. ♦ 3(e Qj Company /'4/1214(11Y 7— Backflow Irrigation Sewer Cap IN Construction Pole Sub. ❑ 50+,KW l B Certified copy is hereby furnished. r� Certified copy Is filed with the city Bui}�rgg�i gny�J _ Bathtubs 1 Sewer Connection CookingUnit Meter ❑u to 100 am s E, \/ Date ef ^//+ C. Applicant .. T� IVAll „ P P EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter-Clover 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 this permit is Issued, I shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Ta Fan Motors 00-1 HP ll• Workers' Compensation Laws of California. Date Signature - Floor Drains Swi • ing Pool w/Spa • F.A.U. Inc.Solar •'-15 HP 016.15+ NOTICE: If,after making this declaration,you should become subject to the - _ _ Workers'-Compensation provisions of the Labor Code, you must forthwith Floor Sinks •rinal Fixtures comply with such provisions or -this permit shall be deemed revoked. Micr•• ave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance 'ole 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 OWNER BUILDER DECLARATION Sign • ' hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • Auto-Wash • Garbage Disposal Mowing reason (Section 7031.5 Business and Professional Code: Any city or 9 P 'Standing Sections aunty which requires a permit to construct,alter,improve,demolish or repair • Generator Laundry Trays . ❑0.5 " ❑5-15 KW Trash any structure, prior to its issuance, also requires the applicant for such permitCompactor • 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 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 ' �e natty 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 $ 3 compensation, will do the work,and the structure is not Intended or offered _.. Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's - • MECHANICAL S. FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own --- DEVELOPMENT SERVICES REOUIREMENTSi employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ . sale. If, however, the building or improvement Is sold within one year of com- Canopy Type II 0 Zoning Approved By A Date ['lotion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground -v, Building Approved By � Date 2.! ^e,a prove for the purpose of sale). _ 2--f I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System ' Application Issued By Date tractors to construct the protect (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 $U M}RV QF FEES • builds or improves thereon, and who contracts for such projects with a con- tF (J tractor(s) license pursuant to the Contractor's License Law). I am aware that IIIExhaustSystemSystem teratiBUIL ❑ Multiple❑ Rir/Alon DING PERMIT $ SMIP ' $ f O proof of their Worker's Compensation insurance should be provided to me. PLANBUIL CHECK $ PERMIT ❑ (am exempt under Section B.& P. C.for this reason . Firepl/Fact.BIt. 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 00.100,000 BTU Di00,000 BTGRADING $ information is correct. I agree to comply with all city and county ordinances • ELECTRICAL - $arid state state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ sentatives of this' city to enter upon the above-mentioned property for ' •�1//j ��DO/� O n�-f Signainspecture purp�- • /T l I` MECHANICAL $ 2GC3 Signature .4` - .I . -.....c•-.....• - Date ,r`[�V/'�gZ TOTAL FEE $ Drivers' License or 55 5 - - . - Reinspection Fee I $15 Issue Fee $ 3 PLAN CHECK 25% $ •7 CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod • Assessor CONSTRUCTION AND PLANN...4 OOL& 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 Utilixy-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. i 55. Electrical Bonding 5. Steel,Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. • 57. APPROVAL TO COVE R-G UNITE 7.-Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, O Undrgrnd. 10. Structural Floor SYsiem 61. APPROVAL TO DECK 11. Property Sewer Liner& 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 t,ZGfL LCO FIRE DEPT. REQUIREMENT 20. hough 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 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 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 4341•0 (,gyp 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing -39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation . ; 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations �Y47. FINAL STRUCTURE & BUILDING gerlei B,- 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY • No. Date 'IIIII - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONSTRUCTION CONSTRUCTION PERMITY- II ,, P RMIT NO. TRACT NO. LOT NO. UNIT NO. 9231 2/11 /86 2E025 IL Project Address /9a .e- a a NNS s UiY/7- LD IM11 122n -//�`_s ,/ Applicant's Mailing Address /8!Z,..57.5- RLS ASA nTYPE OF CONSTRUCTION L .NEW U ADD U ALTERATION LI REPAIR e ^ye _;tie,/ ❑ CONVERSION CI DEMOLISH ❑ OTHER A,P,# Zone Owner's Name i- . d Phone DESCRIPTION OF WORK/USE OF BLDG. Address —/- 4 tit J= .5"7-- tr4Lill/T. /Sr/4 r S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT LI GRADING U FOUNDATION Li STRUCTURAL T Front 0 Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING 0 MECHANICAL B Rear N Contractor's Name C76" ��Oe)/in PhoneatZ2 0-Pfc CI OTHER M 7 R 1—L, DOS 5 YS /Cti1 C Rear N AddPROJECT DESCRIPTION SQ. FT. _ OCCUPANCY g City Licensmailing) t e•++� d/RFZ LS 13 A-0 f7 U7 G 3i 7`3 '/ CONSTRUCTION TYPE VALUATIONS �CJ� § Left City License No. `1 ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: 0 •ith section 7000) of Division 3 of the Business and Professions Code, and y license is in full for • nd of pct. T _icense Class s Lice•S• No.1S'ln Q a 99 S Date.cj1=Fa- Signature -.F.- ....ke. o- PLUMBING I FEES WORKERS'COMPENSATION DECLARATION Bar Sink Showers f ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate . of Workers' Compensation Insurance, or-a certified copy thereof (Section Backflow Pre,enter Service Sink / 3800, Lab. C. T Automatic Washer Transformer 0 15-50 KW Policy No. �("'` Company �i�1'I��O��/ Backflow Irrigation Sewer Cap Construction Pole Sub. 0 50+KW BCertified copy is hereby furnished. Certified so,0y I II with the cityull Ilio ,Bn. Bathtubs Sewer Connection CookingUnit Meter Dupto 100 amp's Date R r-!(� Applicant4_,....4..._- EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers I . Solar Collectors . Dishwasher MeterDover 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 this permit Is Issued,I shall not employ any person in any manner so as to become subject to the Drinking Fountains _ Solar T. Fan -Motors 00 P 01,A-B Workers' Compensation Laws of California. Date Signature Floor Drains S . ming Pool w/Spa F.A.U. Inc.S• .r 09-15 HP 016-15+ V( 'NOTICE:If,after making this declaration,you should become subject to the - v Workers' Compensation provisions of the Labor Code, you must forthwithFloor Sinks Urinal Fixtures • comply with such provisions or this permit shall be deemed revoked. I' crowave 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 Lender's Name p Outlets Range Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION hereby of firm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash allowing reason (Section 7031.5 Business and Professional Code: Any city or Garbage Disposal ;Standing Sections ' ,:ounty which requires a permit to construct,alter,improve,demolish or repair P-Trap • Laundry Trays Generator ❑ KW ❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit Trash Compactor to file a signedstatement that he/she is licensed pursuant to the provisions of Roof ins the Contractor's License Law(Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Cade) 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), • U 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 ' .1 Reinspection Fee $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's ' - MECHANICAL I FEES License Law does not apply.to an owner of a property who builds or improves - .. thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: / ' l ❑ f employees,f, that such improvements are not ptl or oftl for Boiler Hood or TypeZoningApproved Byt sale- if, however, the building or improvement is sold within one year corn- if Canopy Type II 0 PP r Date p , the owner will have the burden of proving he/she did not build or im- prove Duct-Under Ground Building Approved By � e' Date 2� //�(�� for the purpose of sale). Application Issued By /� �" •-i,- ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System _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 ❑0-100,000 BTU ❑100,000 BTU SU RV OF FEES f • builds or Improves thereon,and who contracts for such projects with a con- tractor(s) license pursuant to the Contractor's License Law). 1 am aware that Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP I $ ( �O proof o their Worker's Compensation insurance should be provided to me. PLAN CHECK $ ' PERMII O 1 am exempt under Section 0.& P.C.for this reason Firepl/Fact.BIt. ICBG# Fire Dampers PLUMBING $ ISSUAIJCE $ Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERG:V P.C. $ I hereby certify that I have read this application and State that the above 00-100,000 BTU 0100,000 BTU ELECTRICAL § GRAING S information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- sentatives of this city to enter upon the abve-mentioned property for �.s r ! p� £ inspection pure _L_ �/ iZ [ Al/T I t CO B DO MECHANICAL $ 61 GPV �7 29 Signature i...--L� Date - /�-�IC �x TO) FEE $ Drivers' License or SS# • _�__ Reinspection Fee 515 Issue Fee $ 3 PLAN CHECK 25% $ 177 CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • • CONSTRUCTION AND PLANT.- .G 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 UF ER 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, ❑ Undrgrnd. 10. Structural Floor System • 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final - 12. Sewer Cap . k 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 11_26_771 (4n FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, i rico /-,21/-ft. ��� 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas 0 Oil 23. Gas Pipe-Rough,& Test 72. Underground Flush 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 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 gliatCfq (4,0 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final • 42. Backflow Preventer • 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING /0 '' pit 48. Special Requirements Completed 49. Electric Release to Edison I ' 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 MESA CONSTRUCTION PERMIT If A_ PERMIT NO. TRACT NO. -LOT NO. UNIT NO. 9232 2/II/B6 E:•o::S IL Project Address /9 Z•.a R.2 Nb CT //4/1 T c_ EM 2 211 22 �y Applicant's Mailing Address /F9'2-Cc c✓'T2 R2-5 eA-v s TYPE OF CONSTRUCTION CNIEW ADD LI ALTERATION LI REPAIR 1 Y ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# I Zone Owner's Name de HA/ /a�L UCNldl�Phone9Z4-.3y 7 DESCRIPTION OF WORK/USE OF BLDG. Address AAK/- 5T fliwr7 /Sc /••7t- f S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT L I GRADING LI FOUNDATION U STRUCTURAL E Front Z ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B N Address TG ❑ OTHER AIR FLOG 19 A Rear Contractor's Name sTEV� �•�RGb pVL I�'hone`9L2-�3 JS �YS T��~ C Right N Address(mailing) /Rar•-.S CIA R.L1�A3 A/J / 1, / PROJECT DESCRIPTION SQ. FT. OCCUPANCY K g CONSTRUCTION TYPE VALUATION$ :.Y} �- s Left G o R , City License No. �y 7 / ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION ping. Ref.# Parking Req./Provided E - Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: M vith section 7000) of Division 3 of the Business and Professions Code,and .1 • )-license is in full for a and tett. .icense Class ....- Licensalp. 3 3 z s, 9 c/ s Date V •-11-a4 Signature .t.a.•-J-- X�•�rj.c-yam PLUMBING FEES \s9 WORKERS'COMPENSATION DECLARATION Bar Sink Showers I hereby affirm that I have a certificate of consent to solf-insure or a certificate ELECTRICAL FEES f Lie of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Pre nter • Service Sink •'(v1 3800, Lab. CA / Automatic Washer Transformer ❑ 15-50.KW Policy No. PT �3(L P� Company F/4/�M ON T Backflow Irrigation Sewer Ca 0 50 KW P Construction Pole Sub. Certified copy is hereby futhe Na cit - Certified Jay is I d with the city Bulaa Division Bathtubs Sewer Connection Cooking Unit Meter [pup to 100 amps Date 'ate/// --ell Applicant +moi � a•- 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 Lc) 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 T. Workers' Compensation Laws of California. • Motors ■t- HP ❑1%-B Date Signature Floor Drains • SwFan ' ming Pool w/Spa F.A.U. In ole' ❑9-15 HP 016-15+'NOTICE: If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Coda, you must forthwith Floor Sinks • Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave CONSTRUCTION LENDING AGENCY Gas Service -•Outlets • Water Closet I hereby affirm that there is a construction lending agency for the performance Device Boxes 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 ' hereby affirm that I am exempt from the Contractor's Licenso Law for the Lavatories Auto-Wash allowing reason (Section 7031.5 Business and Professional Code: Any city or Garbage Dispos 'Standing Sections ' county which requires a permit to construct,alter,improve,demolish or repair P-Trap LaundryTrays any structure, prior to its.issuance, also requires the applicant for such permit y 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 D ins 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 LIenalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 ' compensation, will do the work,and the structure is not Intended or offered - Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL I FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 ' 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 ey 6 Oate 2 / prove for the purpose of sale). - /' - ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 2 ' tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who - Duct-Ventilating 00.100,000 BTU 0100,000 BTU SUMINIjRV 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 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ a Sb proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ r PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. 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 00-100,000 BTU 0100,000 BTU— information is correct. I agree to comply with ell city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of this city to enter upon the above-mentioned property for /� ��L?/! r� OC PLAN CHECK 50% $ Signature pure s7����� ',s ? V MECHANICAL $ e,00 TOTAL FEE $ 2•S/�� S- Signature iY-•4- !/4..nro--r Date P �//8� Drivers' License or SS# - Applicant; Pink - Accounting; Goldenrod - Assessor . . . CONSTRUCTION AND PLANT G POOL& SPA Date Inspector APPROVALS Permit# 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 UF ER Grnd.4 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 r 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 14-46 t.64) FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation - 78. FIRE•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 EltiCro C5-9 35. Final Gas Pipe-Test ��tt 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 te0 o' 48. Special Requirements Completed 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date 111111r . • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONSTRUCTION PERMIT II of P MIT NO. TRACT NOJo LOT NO. UNIT NO.ProjectAddress / 92 C La_Nn 1-, LainL- �'► 22'724- 9235 2/ 11 /86 vuo.:% T� Applicants Mailing Address E82urSC9QALC lV(] � I/ TYPE OF CONSTRUCTION L- 'NEW U ALTERATION U REPAIR Johvii f LO C/-//ALQ-Phone946-31/4/ CI CONVERSION ❑ DEMOLISH Cl OTHER A.P.# Zone Owner's Name DESCRIPTION OF WORK/USE OF BLDG. Address /lA-/CP-- 5'T •t-ii7- 12<14 S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT El GRADING ❑ FOUNDATION Cl STRUCTURAL E Front tcs_ ,Z Address ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL'/ BB Rear Contractor's Name 5"7-. 1...2_, G/2m't/ ❑ OTHER �/IQ f Loa '�y S j`�(^�F�Phone ��- 3/ gAddress(mailing) #S2.SS c—�4/P 1.$ GAP $ 1/, SPROJECT DESCRIPTION SO. FT. OCCUPANCYK Refht` �, ,I CONSTRUCTION TYPE • VALUATION$ S2Ja1 ��City License No. t C_ 4 ZONE GRADING CU.YDS. ACRES $LICENSED CONTRACTOR DECLARATIONPing. Ref. # Parking Req./ProvidedI hereby affirm that 1 am licensed under pBusiness of Charter 9 (commencing Remarks: Planning Notes:C rwith section 7000) of Division 3 of the Business and Professions Code, and -ty license is in full far antl�ffect. � - , =cense Class - L ansa o /Date a..r-//—Q/ Signature �le.�a/.f.,r PLUMBING FEES1 WORKERS'COMPENSATION DECLARATIONI hereby affirm that I have a certificate of consent to self-insure or a certificateBar Sink , Showers ELECTRICAL of Workers' Compensation Insurance, or a certified copy thereof (Section - - - 3800, Lab. Co.)... �� ,.s �� _ Backflow Preventer Service Sink - Automatic Washer Transformer 0 15-50 KW Policy No. i t Company./_.4//t-/J AO/V / Backflow Irrigation Sewer Cap Construction Pole Sub. • 0 50+KW Certified copy is hereby furnished. Certified copy fi uil visio d with the city Bn. Bathtubs Sewer Connection m Cooking Unit Meter ❑Up t0 100 aps Date { ^'//nL Applicant .9-0-14-411- EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers _ _ Solar Collectors Dishwasher Meter Dover 100 a s • (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher - Solar Piping ' Dryers ❑Gas ❑Electric SubPanel I certify that in the performance of the work for Which this permit is issued,I - shan not employ any person in any manner so as to become subject to the ' Drinking Fountains Solar Tan - Fan • Motor 0-1 HP 01%'-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swim.- ng Pool w/Spa F.A.U. 'NOTICE: H,after making this declaration, you should become subject to.the - _ i I. .Solar 0915 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks na - - Fixtures, Microwave comply with such provisions or this permit Shall be deemed revoked. - _ . CONSTRUCTION. LENDING AGENCY ' Gas Service Outlets' Water.Closet - Device Boxes 1 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 Range Lender's Name - - • Lender's Address Kitchen Sink Water Service . Switches Sign OWNER BUILDER DECLARATION " - - ' hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Dispos ' ;Standing Sections Mowing reason (Section 7031.5 Business and Professional Code: Any city or • • aunty which requires a permit to construct,alter improve,demolish or repair P-Trap ' Laundry Trays . Generator �O-5 KW❑5-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit , to file a signed statement that he/she is licensed pursuant to the provisions of RoOf Dr3- 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 Feb 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 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, arid 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 Zoning Approved By Date ' sale, if, however, the building or improvement is Sold within one year of com- Canopy Type II 0 plebe n, the owner will have the burden Of proving he/she did not build or Im- Duct-Under Ground -. Building Approved BY era------C 2 _l prove for the purpose of sale). o I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By Date 2 i} tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - 00-100,000 BTU ❑100,000 BTU SUMMA V F FEES -� builds or improves thereon,and who contracts for such projects with a con- 0 $ ,�D tractor(s) license pursuant to the contractor's License Law). I am aware that Exhaust System 0 Multiple 0 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. ICBG# III Fire Dampers 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 00-100,000 BTU 0100,000 BT • ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances • and state laws relating to building construction, and hereby authorize repre- sentatives of this c'ty to enter upon the above-mentioned property for yy..,, �p Q n .�j inspection purpos-p n �w-c fig '.r1-U61 " "� v MECHANICAL $ �I�t� 2S,---/ ,/\ Signature .e _ rI/, rJ. - a Date ry --N—ve I 0 TOTAL FEE $ I" \ Drivers' License or SS# / - _ _ Reinspection Fee $15 Issue Fee , $ 3 PLAN CHECK 25% $ !7 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANN•...i 'OOL &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.;Electeical Conduit Ufility-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.-ttructural.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 /1-24-SG e_6-0 FIRE DEPT. REQUIREMENT • 20. Rough Factory Fireplace APPROVALS Permit# 21.;Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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 ,D/37//TO LiA0 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 I . 42. Backflow Preventer 43. Backflow Irrigation . , 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations / 47. FINAL STRUCTURE & BUILDING /07 �j^ sit 48. Special Requirements Completed f� 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co • 51.. CERTIFICATE OF OCCUPANCY No. Date OWNER MAITREJ"L'AN, C-.__I., •`DATE 8-20-54 . JOB ADDRESS 192 - 22nd Street BUILDING PERMIT NO. 481 • GENERAL CONTRACTOR South Coast Construction VALUE $ 2,000 00 L 5 BLOCK TRACT 269 Dining Rm.& Garage GROUP J TYPE V ZONE Rh FIRE DISTRICT #492_ PERMITS ISSUED • INSPECTIONS DATE SUBCONTRACTOR G DATE NUMBER Footing Trench cs-g c 2 la-4 A /�, 6 ,.. �,� / - /,7- re- Foundation e Foundation Forms and Grade to Garage ,,P y(i' d.. - Rough Framing v , t ur �� ,_/ . ,/ ,•' Plumbing,Rough to Slab 6t' 7- c fti �� •,_,7.-��q- Plumbing, Rough Complete ,!/ ‘51) 6 Temporary Pole ������j1 1c1'V"• Wiring, RoughiM2q"�ic-r/// Heating, Rough �v�K•g�-�• •"d7 C �¢t/rn2�1./- .!/dr/ �.,]S_'sq �,-1, 07-.0 . • Heating,Final ', • o e.' Sewer LOatallir Septic Tank or Cesspool C I .3 LIArt r ---3, 19 W 1 L; -19 Mang. P, -ring Wan nF F IMF Plumbing,Final,Fixtures complete tiral i ti I a y Plumbing,Final Gas Test I/ Wiring,Final ril r r Occupancy Form 210 C-H 161 12-63 Costa Mesa Building Department APPLICATION FOR PERMIT 111 EAST 20th STREET 492 BUILDING 'I COSTA MESA, CALIFORNIA sir FOR OFFICE USE ONLY FOR g Addresss APPLICANT TO FILL IN - Receipt No. PerreIt No. Building / ! 2 ' .2 12.1r'4 M.+/A/(! ed 02 n,P‘ 00 Costa Mesa, California Received by Date Rec'd. Date Issued Nearest �y g-a'�-S Cross St. (4q,4-c_e•-/ (/�f l Building )44/27A Address Owner ` 4/u .c ♦-4-(--/L.4.-.._ Costa Mesa, California Mall //� Address//7 g yZ `L. L + 06,/L�l Nearestr Tel.' ss St City `' K+iA A/010-4 No. Zoor I Plans I Type V I Group/ Architect or /J''1 Lie. /� I J Engineer [- J.Ccr14142-4-/3s No. Approved by Date Address CORRECTIONS / ? �/ Ory Ltc. Contractor,//WiI�y/�M,o/J.'IiMidi/4h � Jilt (;`50('9 . r"1 'res.!!°T 3 0 -S-0 I/4 M1' A /I di/4h..79 /OaredAl: /-� v; P�r n Description I No. .p I Block / I Tract l q (Attach Metes and Bounds) ---- �s No. g Size of Lot/ /X / Nowof onBldLots. / 0 Use of No.of No.of n o 1_ 11 0 Existing Bldg. ,I,�.l tQxe4 I Families I Rooms 7 _ ,■ ZS Setback Line from �� / Rear Yard ■ Center of Street ._�I Side Yard / L y DESCRIPTION OF'WORK AUG 2 0 1954 r New I I Alteration 17i I Addition k Repair I I Moving I I Demolish I CITY OF COSTA MESA Building No.of Size Rooms Stories Exterior Wall Covering � 0 X� Z IR I Covering APPROVALS •.—of New ding ovL {2.4ai Add-d-,/Lt"j. it../.414 CO Foundation Location Inspector Date / Forms,Materials, Under-Pinning Frame: Fire Stops, Bracing,Bolts I hereby acknowledge that I have read this Application Lath. Int. and state that the above is correct and agree to comply Lath. Ext. with all City Ordinances and State Laws regulating building contra tion. / /� ` , /y ��J,r7 Signature of �-71( / /// y /® _ J// , Plaster,Int Permittee ,v /(( I"A-s4.�/( l_.ONCIi( �-�Cl / g yvaLe�` Plaster, Ext. Authorized Agt. Y/�'" Masonry Reinforced Valuation 21 0 0 bet Permit Fee $ , O - Plan Check $ Bo .Beam $ Tota U Fee $ . FINAL FORM 204 G-N EM 5-54 all - d J C _ C J o n • a 1. - a • • • • • . .Streetfi':.. • i ` _ . . _. .,s1; �' - •nr , . • •c PLOT PLAN -- - + • Show location and distances from `r•. ' p peifyy',,7ine+and betweer {�u t lldinos. . _ - _ . _- . . _ . -- . - - . . 11..•. - I - ' ' - , - ____ . _ —__ , • _ c - - _ _ _. __ __I . ___ _ . _ _ - . , . ..