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Home My WebLink About789 PAULARINO AVE - Building PermitsAOP�icant to fill in all spaces eXcev� lhoze within neavy oortler lines ana sign a�� approDriate tleclarations. A MESA S RUCTION PERMIT 'E 'r "� Z� �^�"�° �°�T "� / UNIT NU. ' ��J�i,vo , -r �o -- � o�ect AddrRss Applicant's Mai�ing Address � " � Owner i Nam�B n � - ' Phone � � Address %`-n % , -L� ��n�O Arch/Eng. License No. , Address ��/�-� � Contracmr's Nart e " 7I-1�L� �7�h,}o/�e— �� Address (r^=' ^^� �� `r/�—� City License No. I 9n l Q1 � LICENSED CPNTRACTOR DECLHRATION ' ' j � I hereby af(irT [hat 1 am licensetl untle� prOvi5ion5 of Chdrte� 9(commencing with secliOn 7000) ot DlviSion 3 0( the Business antl Profe55ions Cotle, antl my Ilcense is in �ull 10 a�jtl Hect. p(� Licenie C^is _^�� LI<e o.ry �z / 7 Date Signalure A f��"� 6"�7-- � 'WOR E ' COMPENSATION D ARATION h¢r¢by affi�n� that I have a certi ' ate ot consent to self-insu�e o� a ce�tlfiWte �f Workors' Lompensation Insurance, or a cer[ifietl copy tnereof (Section 3800, Lab. C.) "' - - - ' - ' Policy No. Company �Certilletl cJpY is hereby furnisM1etl. Certifietl <OPY is filetl with the city Builtling Division. ' ' Date HPPllcanf EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (TM1is section neetl not ba completetl if the permii is for one huntlretl (g100) or less). I certify lhal in the perb�mance of Ihe wo�k fo� wltich this perm�t is issuetl, I sM1all nol employ any pe�son In any mann r So as to e Te 5 bj¢ct to the workers'�Cp �my �ation Laws oi Californi . ' • Date _��.Z,(�Si9natur � . 'NOTICEi"I�fatter making thi5 tleCl �atf n, you shoul ' cOrtte subject to �the Workers' CbmPensation provi5ion5 o the Labo� Cotle, you must torthwitlt comply with such provisions or I5 permit shall be tleemetl revoketl. - CONSTRUCTI�N LENDING,AGENCV, I hereby af(Irnt that i�ere i5 a const�uClion luntling agenq fo� the performant¢ � of the work 5or whicn this perm�i is issuea (Section 3091 Civ. CJ Lentler's Name ' LentleYs AEdress OWf�IER BUILDER bECLNRHTION I nereDy afflrl� that I am ¢x¢mpt frOm the Contractor'S License L.aw tor the following reason (Section 7031.5 Business antl Professional Cotle: Any city or ��r� wn�cn reouires a oermit to construct. alter. imorove. tlemolisn or repair ucture, Prior to�its issuance, a�so reqWres tne applican d 519IICd'SLdS2R1¢flI Shdl hf/ShE IS I�CCf15Ctl pUlSUdOI [O � /031-.5 by aPY applicant (or a permit subjects Ne apP�icant to a civil �enalty of not more than five huntlrea tlollars (E500). ' I, ai ownBr ot the pro0erty o� my employees with w2ges as tnei� sola compensation. �+��I tlo the wo�k, antl the Structure is not intantletl o� ofteretl ' �for sale (Sect�on ]046, Bu5ine5z a�tl Professional Cotle: The Cont�acto�'s License Ldw does not apply to an owner Of a property who bulltls or improves (� 4hereon; antl N'ho tloe5 Such work himself/he�selt oqtnrougM1 his or her own employecs, provitletl tha[ such Imp�ovement5 are not intenGetl or offeretl for ! sale. H, �hOwa+er, [be bulltling or improvemon[ I5 soltl wlthin one year of com- N pletloq tM1e o�+'ner will have the burden oi P�ovin9 he/she tliE not builtl or Im- �rave for lhe purpose of salc). I, a5 owne� of the prope�ty, am ¢xclusively Contra[ting with Ilcensetl con- tractors to construct the project (SecNon 7044, Business antl Professions Cotle: The ContractJr's License Law tloes �ot aPPly to an owner ot property who builas or Improves tnereon, antl who conVacts tor such pioiecis witn a con- Vacto� (; license puisuant to the Contractor's License Law), I dm aware that proof Ihelr Workei's Compensalion Insurance shOultl be provitletl to me. ❑' Pam exemVt untler Sectlon B. & P, C. for thi5 rea5on , Date Owner. I herebv rertiry that I hav¢ reatl this application antl stale lhat the abova Siqnature GMF 0865-46, � . TYPE OFCONSTRUCT�ON NEW ADD ALTERATION REPAIR fl CONVERSION ❑ DEMOLISH ❑ OTHER A p # �DESCRIPTION OF N10RK/USE OF BLDG. � �. � - E S Main Buildi TYPE OF PEflMI GRADING FOUNDATION STRUCTl1RAL . T FrOnt � ❑ TENANT '❑ E�ECTRICAI ❑ PLUMBING ❑ MECHANICAL B Rear ,� O OTHER ' A C Right PROJECT DESCRIP710N Sa.FT. � OCcuPAN5v�,� K CONSTRUCTIONT�'PE VALUATION$�.jl(1— S Left % ZONE - GRADING CU. VDS. ACRES p�ng. Ref. # Remarks: � � Planning Notes: 3ackflow Preventer 3ackflow Irrigation 3athtubs Claritiers ' Jishwasher Jrinking Fountains =1oor Drains =1oor Sinks � �asService • Outlets - Interceptors Kitchen Sink Lavatories � . P—Trap Roof Drains � Reinspection Fee $15 Duct- UnderGround Duct - Sttuctural Duct-Ventila[ing ' ' Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt ICBO # Heating System & Ducting � ❑ ai oo,000 aTu O i oo,000 en is� ci to ente�'� b the above-mentlonetl Jp�o ertj' �fyc ses L ��//�� L/i�� DateYL[�C peinsPectionFee 55 � � 0/84 Whlte - Builtlin9: Canary - qpplican[; Pink - Accounting; Goltlenrod - AsSessor $15 $IIOWCfS Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimmin9 Pool w/Spa Urinal � Water Closet � Water Heater _ Water Service � Auto-Wash Issue Fee Hood or Type I ❑ Canopy TypelP ❑ Refriqeration System ❑0.100,OOOBTU ❑100,0006T System Repair/Alteration � Fire Damperi Registers Issue Fee F 5 3 $ 3 Automatic Wesher Construction Pole S Cooking Unit Dishwasher Dryers �Gas, ❑E Fan F.A.U. Fix[ures Device Boxes OULIeLS ' $witChES Garbage Disposal Generator 045 KW � Reinspection Fee — DEVELOPMENTSER Zoning Approved By_ 8uiiding Approved By Applintion laued By_ lectric �.. �'., ' - ' _ _ _' t' 'y' 4/08/B6 �' 17,G �, 2one ELECTRICAL Transformer ❑ �15-50 KW - ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100 amps � , Sub Panel � Motors �0.1 HP O1'/, - 8 Inc.Solar �9-15 HP �76�15> . �Microwave - ' - Pole Light � ' Range 0 ; Standing•Sections 15 KW Trash Compacmr 1 r . �H i $15 � ; �.Issue Fee $ 2 O N I N G R E Q i� e � SUMMARV OF FEES • � BUILDINGPERMIT $ ��•Od SMIP ' $ PLAN CHECK i $ �•SO PERMIT PLUMBING 5 .��UANCE $ PLAN CHECK 25% $ ' � ENERGV P.C. $ , ELECTRICAL � $ � GRADING $ ' PLANCHECK 50%'$ � ' MICROFILM $ ' � MECHANICAL $ TOTAL PEE , $ � � ' � PLAN CHECK 25% $ � ' � ' CONSTRUCTION AND PLANNING APPROVALS Permit # 1. Temporary Electrical Service or Pole _ 2. Soil Pipe-Undrgrnd. 3. �Electrical Conduit Utility-Undrgrnd. _4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement "6. Electrical UFER Grnd. , 7. Footings - 8. Foundation - � 9. Water Pipe-Undrgrnd. 10. Structural Floor System � 11. Pr'operty Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing � 15. Rough Electrical-Conduit i6. RoughElectricWiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 79. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23: Gas Pipe-Rough & Test � � 24. Roof Framing � 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 9 30. Drywall Nailing 31 . Plaster Brown Coai � 32. Electrical Power Meter-Final 33, Final Electric 34. Final Heating & Air.Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final'Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation ' . 44. �Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations , 47. FINALSTR�UCTURE&BUILDING 48. Special Requirements Completed i 49. Electric Release to Edison. ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY. No. Date � Date Pl & SPA Inspector p�ppROVALS Permit # 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding ; 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, � Undrgrnd., Test 60. Backwash Lines, P-Trap, 0 Undrgrnd. . 67. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final 67. Fencing & Access Approval 6S. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydra 71. ProductPiping�Gas ❑Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINA� HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: Date � Inspector � C�� -_ ��1��{� �B�_____ ��'181 � N�' i_.J.—_._. _ . _.. . _ _ � . . i Si4UCTE;:`;;;l, �iFFR�?li�l 01�Y ( SEPn.�,'TC!�ER4�ifSAREAcit�JlP:�p � F^,; "i��R��,;i,'l�itr;.":�'r,. + NS_!;':I�,'6. `.`ir"�ii_all6L'. ;o\p . F'i:F;°r1[�ik'il;:i t'� ;siC ' � � rY: K�....�.�--_.....�) SZ�� _ ` " 2 p Pl i �.._ ...............m..� � � � { . '��.�?i� � � i:':Si�: J��ii1jQ�.13Y j (�!_.. !"..;t�:iv{�',1t: t-�C;�.!_`.SJ ; �____�__._.----__ __________.___._ t I'��: -,�:iAitiNii%�f;'" ":?' '. Ai? `:0 °E � i Str r: �.rF� ...��..c' ci; � 9 i 6 a�.ti�.,, 1 1- �.; 7r i U.�Si:'� t -�E'[ i„�� L;;�su! rta fne ae��t�e�ai 1 �'ala��` NEfIDEMCE I I I IIf610tMC[ IIE�IDCNCE '��/' ��U%i��ZfG1G STREET�_ — _ —^---- a ca �P� Osr�� w PL4NNING DEP7. ElillEGf TO BLDG• DE4T. 0.E6. dy,:�ewK:i� DATE...a/� p� ! OF rLANNIN6 r� �, 11[{fDtMCL � W W C ►. N � ,�--- ' � �� Cement Coping Optional Channel Bloek With'�� Horubrrtal,Top of all r Fenees '-- For Fences 5' or Leu � Vert. Bars 3/6'�. at 4' -0" O.C. For Fences Higher Than 5' — Vert. Ban 3/6'��at 32" O.C. Fill Cells Solid With Graut — Where Steel Occurs Reinforcing Steel.Shall Conform to Sec.A-1539 A.S.T.M. AllSteelto be Lapped !b " of to Code NATURALGRADE TWO 3/8" BARS ' CONTINUOUS 70P & BOTTOM TYPICAL s 0 a = �� • > w a = a >Z a i� W O U H o "�_� � �l b WID7 SEE CI ;, BE�OW 0 6�� CONCRE�E BLOCK FENCE FOOTING REQUIREMENTS GENERAL- NOTES MORTAR; p�g pa�t Plastic Cement, and Three Parts Sond GROUT: , One Part Cement Three and One Half Parfs S�and COPING: One Part Cemenl, Three Parts Sand CONCRETE: Well Mixed I: 2� : 3%2 Mox_ of 7%2 Gnllens of 9Vater Per Sack of Cement GROUT MAV BE POURED FROM THE 70P OF THE FENCE � CELLS AND AREAS OF HOR120NTAL REIN� FORCEMENT SHAIL BE CLEAR, CLEAN & FREE Of ALL MOHTAR DEBRIS, ETC. eONOS SHALL BE PROVIDED BV LAVING BLOCKS IN STRETCHER COURSES SO THAT VERTICAI JOINTS ALTERNATE IN EACH COURSE. 'H OF EARTHTCOTH I/3 THE HEIGTH OF FENCE �S�LOW BOTTOM OF FOGTING. SCALE: I/2��= I� WALL HEIGHT 6� 5�. 4� 3� WIDTH aF FOOT�NG 14�� 14�� 12�� 12�� THICKNESS 4F �071NG 10�� 10�� 8�� 8�� DEPTH OF EARTHTOOTH 24" 20° 16° 12� SPACING OF EARTHTOOTH 12� 14� 16� 16� OWNERS NAME; _ _ _ _ _ _ _ _ _ _ _ _ _ _ City of Costa Mesa, California ��B ADDRESS: _ _ _ _ _ _ _ _ _ _ _ _ _ _ Building Department Aoo��ant to /lll In ali spaces eKcept those within heavy boraer Ilnes anG sign a11 aoCroprlate tleUantlons. P RMIT NO. �ACT NO. �LOT NO. UNI7 NO. � CirY �3F Cosr,a MEsn OCQ,j/J� STRUCTION PERM/ITa � - ^ - P �ProjectAddress zQ/ �wup�Q/'fYln tiE� L /%% , Ap�licant'sMailin Addreu `-�4 Owner'sName r� �' r PhonaS�iL`�/S3 AUdress �A9 rQlL�Or/NO�i4e Arch/Eng. License No. Address Convactor's Nam ne � u�/da j- phone Address (mailing) � City License No. LICENSED CONTRACTOR OECLARATION 1 hereby altirm that t am licensetl untler provislons ot Cnartor 9(commencing WIIb SCCI�00 1Q�0) O� O�V�S�OO 3 Ot th¢ Buslne55 dntl Professlons Cotle, antl my Iicense is In iull force antl ettect. Llcense Class LICGnse No. Date Signature �+ORKERS'COMPENSATION DECIARATION �xeby aflirm that I �ave a certifica[e ol con5ent to SBIf-InSura or a Certiticate Worke�s' CompenSation InSurante, Or d certifletl cOPy thereot ($ectlon s800, Lab. C.) Policy No. Company 8 Certifiea copy i5 hertby tumishetl. Certifietl copy Is filetl with lhe city Builtling DiviSion. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This seclion neetl nol be completetl if lho p<rmit IS f0/ On¢ huntlr9tl (5100) Or iess). I certiry tnat in the performance al tne wo (for which this m�t is issuetl, I shall not employ any pe�son in dny mdn Y So a5 t0 b m0 bjet to the Worker5' L9ip��salleNLawS ot Califomi Date �f h 7 Signature NOTICE: I/, after making I�is tletlara , you Shou1G btCOmO Subject to lh0 Workers' Compensatian provisions o he Labor COUe, you must lor[hwith comply with such p�Ovi51on5 or lni5 permit Shall be tleemetl �evoketl. CONST0.UCTION LENDING AGENCV I nereby allirm that there is a conSVuttion IenGin9 agency for t�o Performance ot thG wOrk ior whith thi5 pCrmlt I5 isiuotl (Section 3097 Civ. C.) LPntle�'s Name Lentler's Atltlress OWNER BUILDER DECLARATION I hereby dl/irm Illat I dm exampt irOm t110 ContrattOr'S License LLw tOr the following reason (Section 7031.5 Businoss antl Professional Cotle: Any tlty or counly whlcll fequir85 a pefmit t0 COnslluC�, aller, ITprove, tlemOlislt Of lepair any slructufe, priOr �o It5 ISSudnce, also IeqWrCS the appllCanl fOr such pelfOlt to til¢ a signetl Sldtemenl Ihdt ho/slle IS IiCanSCd pulSuanl to Ih0 PfOVI5Iof15 ot _"�e Conlraclor'S License Law (Chapter 9(COmmencing with SaCtlon 7000) 01 '�'-`="'-/iiiOn 3 0� th¢ Businesi antl Ploiesiioni CO4¢) of lhal ho/ShC Is oxompt ''` 4refrom antl thC basis for the a�legeG exaTptlon. Any viOldtlon of SettlOn �' ri131.5 by any applicant tor a oermil subjecls tno applicant lo a Uvil (�e,nalty o/ no[ more than Iive huntlretl tlollars (5500). �91, as own¢r o1 tbe proparty or my ompl0y0o5 wi[Il wage5 d5 th0i! sole CompenSdtiOn, will tlo the wo�k, dntl tlte it�uG[u�e Is nol IntentlOtl O/ oHewtl for sale (Section ]044, Buslness an� Prolessional Cotle: The Contraclor's License Law does not apP�Y �o an owner ol a properry wno bulltli or improves lhoraon, antl who tloe5 SUGn wo�k hlmSMt/hOr5011 ot lhrOugh hit Or he� own Cmployee5, prOvldetl tM1at Sucl� improvements are not Inlentletl o� offe�etl fOr sale. If, however, the builtling or improvement Is soltl within one year ol com- pleSion, Ihe owner will have tha burtlen oi provin9 he/tho tlitl not builtl or Im- prove for the Ourposa ol Sale). ❑ I, a5 ownel of th0 propelty, am exUuslvely COnlraCtln9 wilh IICOn504 con- traclors to consVutt lhe project (Section 7044. Business antl Protassions Coda: The Conlrac�Or'S LicenSe Law does not appry lo an owner o1 property who builtls or im0/ove5 lhereon. antl who COnt�acl5 �Or su<h o�oi0cts wilh d mn- tractor(s1 Lcense pursuam to ine Conttactor's Liwnze Law). I am aware that proof o( tnei� Worker's Compensalion Insurance sltoul0 bo provitletl lo me. ❑ I am exempt untler Section—rt— B. & P r �^, lbis reason Signature Orivers' L 0865-46, — Owner I have reatl I ap ' a['� I agree [o c ry wilh a to building tlOn �. to en[er pon tn ab TVPE OF CONSTRUCTION �(TIEW L�iADD LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESC(iIPTION OF WORK/USE OF BLDG. C�L%2C'� TVPEOFPERMIT LIGRADING U FOVNDATION LJSTRUCTURAL ❑ TENANT ❑ EIECTRICAL ❑I �IUMBING ❑ MECHANICAL � OTHER _ S�g !f �S PROJECT DESCRIPTION S�.FT. CON STRUCTION TVPE b ZONE GRADINGGU.VOS. Remarks: /� IL°yi.l � % c ii.,ii�G µ�i Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Raof Drains Reinspection Fee PLUMBING Service Sink Sewer Cap Sewer Connec[ion Solar Collectors Solar Pipin9 Solar Tan Swi fiiing Pool wlSpa rinal Water Closet Water Heater Water Service Auto�Wesh Leundry Tra'ys $15 laue Fee Boiler Duct - Under GrOuntl Duct - Structural Duct - Ventilating ExhaustSys2em ❑ MWtiple Firepl/Fact. BIL iCBO dk Heating Syscem & Ductin ❑P700,000 BTU O7 ,000 Reinspection Fae � $15 White - Builtling: Canary - Appli<anl: Pink - Accounting; Goltlen�otl - Asse55or Hood or Ty ❑ Canopy pe II ❑ AC 9efri reti0n Syitem 100,000 BTU ❑ 100,000 BT System Repair/Alteration Fire Dampers Registers Issue Fee 3 A. . qW S Main B� E T Front B Rear A C Right K Left S Ping. Ref. dk � � /o / — o zone Accessory Building: Z O N 1 N G R Parking Req.lProvided E M T S. FEES Automatic Wesher Construc[ion Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas �Electric Fan F.A.U. Fixlures Device Boxes Out18t5 Switches Garbage Di osal ELECTRICAL Transformer ❑ 15�50 KW ❑50+KW KW �5-15 KW Meter tJup to 100 amps Meter �over 100 s Sub Panel Mo)pr� 0� 1 HP � 1"f, - 8 na Solar �945 HP �i6-75+ Microwave � Pole Light � . Sign Standing Settions Trash Compactor Reinspaction Fee $15 luue Fee $ 3 �EVELOPMENTSERVICESREQUIREMENTS;,, . �„_ Zoning APProved BY ��:��' FEES 8uilding APP�oved By �� $ 3 BUILDING PEI P�AN CHECK PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK MECHANICAL PLAN CHECK FEES $ 3 _Dnte �/� � V ' 4 $ �SU MARV OF FEES SMIP • � $ , �� $ PERMIT . $ ISSUANCE ; $ 25% $ ENERGV P.C. $ $ GRADING ? $ 50% $ MICROFILM $ � TOTALFEE� $ � 25% �� QQ�ti" : ' : �i. ��' ' " . OATC♦ QY,`�j/i'' I�tI�.C% ,A � '� PO � SPA ' ��CONSTRUCTION AND PLANNING . Date Inspector Date Inspector APPROVAIS Permit# APPROVALS Permit# � 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgmd. ' 54. Forms � 4. �Electrical ConduiPUndrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings ' 58. Electrical Conduit-Undrgrnd. . 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. .Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11, Property Sewer Line & HouseConnection ' 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 73. 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 7�8? Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19.� Rough Heating & Air Condifioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ^. APPROVALS Permit # 21! Ducts, in Structure ✓ 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test ;;' 72. Underground Flush .� 24.•Roof Framing . 73. Undergrnd.StorageTank �Gas ❑Oil �� 25. Roof Shea[hing ;.� . � 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 L 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 Faaory Fireplace , �. 38. Final Plumbing /�. 39. Water Service-Final ' ' / . 40. Gas Service-Final � / f � f 41 . Solar pomestic-Final ' ' 42. BackflowPreventer % ' �`� 43. Backflow Irrigation ' .h 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. CERTIFICATEOFOCCUPANCY '•! '�- No. Date �.. � \/ �� AGO�Icant to /ill in all spaces except those within �eavy borCer Iines an0 si9n all aOVropriate Ueela�ations. PERMIT NO. TRACT NO. LOT NO. . UNIT NO. CITV OF COSTA MESg.,BCQN UCTJON PE�`MIT Project Address � �y ��Q� � NV _ Applicant's Mailing Addre55 Owner's Name � Phone Address �a✓� �" Arch/Eng. _ License No. �� y Addre^ - � A Co� or'r�lame ^A'rp' �Phone 1-B1�f Addr, .ima'i'�nl� L e�p�Qi City License No. �� 7 6 r• LICENSEO CONTRACTOR DECLARATION 1 hereby affirm Ihat I am licensetl untler Orovisions of Charter 9(commenUng with section 7000) ot Division 3 of the Buzlness dntl Professions Cotle, antl my license is in full tor�ntl eltect. (� License Class 3Q ltcense No.�J27 v� oate Signature 'ORKERS' COMPE SATION DECIARATION aeby affirm [nal I have a cer[ifica[e of consenl to zelf-inwre or a certificate Worke�s' Compensation� yIn�surance, or a cerfifipd cooY thereof (SetOon PooOY No. 4.)�� ' •� ComPan ~ �� Certitietl copy is hereby fumishetl. Cert� � tl c i ile0 with [he city Bui i � S on. Date��-- %�PP��canl E%EMPTION FROM WORKERS• COM 5 ION DECLARATION (Thizsectian neetl no[ be completetl if t permit is tor one huntlretl (5100) or less). 1 cerlify that in lhe performance of the work for wq�ch this Oerm�t is is5uetl, I shall not employ any person in any manner so as to become subject to the Workero' Compensation Laws of CalitOrnia. Date Si9nature NOTICE: If, atter making tnis tletlaration, you ThOUItl become subjeGl to thB Workers' Comoensation orovisions ot the Labor Cotle, you must torthwith comply wiN such provisions or this permit sqall be tleemetl revokea. CONSTRUCTION LENDING AGENCV I hereby ai(Irm that tnere is a wnstruction lentling agency for the performance oi lM1e work for whith this permlt is issuetl (5e�tiOn 3097 Civ. C.) Lentler's Name Lentler's Atlaress OWNER BUILDER DECLARATION I h¢�eby affirm lhat I am exem0� from Ihe Con[rd[[o�'s Licens¢ Law fo� the following reason (Section 7031.5 Business antl Professional Cotle: Any city or <ounry which reQuires a permit to construct, alter, improve, tlemolish or repair any st�uclure, prior to its issuanG2, also requir¢5 [he appliCant to� such pe�mlt to lile a signetl sWiement that he/sne is licensetl pyrsuant to the provi5ions ot 'e Contractor's License Law (Chapter 9(commencing with Section 7000) of uision 3 of thc Business antl Pro/essions Cotle) or that he/sbe is exemp[ arelrom ana tne basis (or Ihe allegetl exemption, qny violaHon of SecHon '/031.5 by any dpplican[ fOr a perml[ subjecl5 the appllcant t0 a civll enalty of nol more [han five huntlretl tlollars (E500), �I � I, as owner of [he property o� my employ¢GS with wages a5 Ihei� sole � compensation, will Co the work, antl lhe s[ructuro is not Intentletl or o(teretl tor sale (SeGtion 7044, Business dntl Profe55iona� Cotle: The Contrac[Or'S I� Licanse Law tloe5 nol apply f0 an owner of a propeYty wM10 builtl5 O� improve5 Ithereon, anU who tloes such work nims¢H/nerself or [nrough his or her own employees, provitletl lhal such improvements are no[ intentletl m offeretl for sale. H, nowever, tne builtlin9 or improvement is soltl within one year of com- pletlon, lhe owner will have tne burtlen oi provin9 he/she tlitl not builtl or Im- prove for the Ourpoie Of sale). ❑ 1, as owner of the oroperty, am exclusivety coniracting with licensetl con- ttactors to consttuct Ihe project (Seciion ]044, Business antl Prote55ions Cotle: The ConVactor'S.License Law does mt apply to 8n owne� of prOPerty who builtls or improves SM1ermn. antl who contrac[5 for Suth oroi2Gts wlth a ron- traclor(s1 6cense pursuan[ ro ene Coneractor's Licanse Law). i am aware thac proof ol thelr Wo�ker'S Compenss[ion in5uranCe Snoultl be provitletl [o me. ❑ I am exempt untler Sectlon � B. & P. C. lor thls reason Date $ignatu�e Orivers' L 0865-46,i tlon an � ana nereDy du[nollze feple- the abovQ-mentioneG property �foQr �Date��pL � TYPE OF CONSTRUCTION LI NEW LJ ADD LJ ALTERATION IJ REPAIR ❑ CONVERS�ON ❑ �EMOLISH ❑ OTHER DESCRIpT�ON j�F WOFjJ�/USE OF ¢SDG. _� . �r00 TVPE OF PERMIT IJ GiSADING LJ FOUNDAT16N LJ STRUCTURAL • �� TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL I ❑ OTHER PROJECT DESCRIPTION CON STRUCTION TY ZONE Remarks: � .....�. Sink Preventer Irrigation Drinking Fountains Floor OrainS Floor Sinks GasService Outlets I nterceprors Kitchen Sink Lavatories P-7rap Roof Drains Reinspection Fae �� v VALUATIONS GRADING CU. VDS. A( $75 Duct- UnderGround Duct - Structural Duct-Ventilating � Exhaust System ❑ MWnple Firepl/Fact. BIL ICBO �k Heating System & Ducting ❑0-100,000 BTU �100,000 Reinspection Fea I $15 - White - Builtling: Canary - qpplltdnt; Pink - Accounting; Goltlenrotl - Asse55or Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank Swimmin9 Pool w/Spa Water Closet Water Heater Water Service Aum�Wash Laundry Tra'ys laue Fee Hood or ypel ❑ Cano Type I I ❑ Refrigeration System , ❑0-100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee f/ A.P. # S . Main Buildi E T Front B Rear A C Right K Left S Ping. Ref. # Planning Notes: ES Automacic Washer ConStruction Pole Sub. Cooking Unit Dishwasher Dryers �Gas ❑Elec Fan F.A.U. Fixtures Device Boxes �Ui�CtS Switches � Garbage Disposal Generator �0-5 KW C Bui Parking Req./Provided ELECTRICAL Transformer ❑ 15-50KW ❑ 50+KW Meter ❑up ro 100 amps Meter ❑over700amps Sub Panel Motors �O7 HP Oi'r4 - B Inc.So�ar �9-15 HP �16-75+ Microwave le Light Range Sign «r . I I Standing Sections 5-15 KW I I Trash Compacror Reinspection Fee $15 Issue Fee $ 3 DEVELOPMENTSERVICESREDUIREMENTS: ZoninB APProved By FEES Building Approved ey m r� �� $ 3 BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTRICAL $ PLAN CHECK 50Yo $ MECHANICAL $ PLAN CHECK 25% $ N 1 N G R E � M T S. FEES $ 3 , .J � SMIP $ PERMIT ISSUANCE $ ENERGV P.C. $ GRADING $ MICROFILM $ TOTALFEE $ "�7 C! FGr. ��_ ��n.,-�c9_ --- �- J: i_. C' � , ^g - �IiL� . l G`t\�.\ CONSTRUCTION AND PLANNING !� PO i SPA APPROVALS J�# Date Inspector AppROVALS Permit# �ate Inspector � 1. Temporery Electrical Service or Pole � 52. Pool & Equipment Location � i 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement i 3. Electrical Conduif�Utility-Undrgrnd. ' �� 54. Forms .��? 4:,Elect�ical Conduit-Ufidrgrnd. ' 55. Electrical Bonding �i� , 5. Steel Reinforcement�•� • � • 56. Rough Plumbing & Pressure Test ,� . � � e..• • • � � 6. Electiical UFER'.Grnd. � 57. APPROVAL TO COVER�GUNITE , � ,7��Footings i� �T' ,- j�� 58. Electrical Conduit-Undrgmd. 8. Foundation �� "' �',��.: 59. Gas Pipe, O Undrgrnd., Test � 9.,�Water Pipe-Undrgrnd. ,l'.� j' 60. Backwash Lines, P-Trap, O Undrgrnd. 70. •Structural Floor System - � 67. APPROVAL TO DECK 11'. Property Sewer Line & House Connection '� 62. Backwash & Receptor-Final 12. Sewer Cap"-� y . ��'! 63. Heater & Vent-Final 13. Roof�Drains- � � 64. Plumbing System - Final 14. Rou9h Plum�j , 65. Electrical-Final • �• 15. Rough Electrical-Conduit 66. Solar System-Final r_ _.t 16. Rough Electric Wiring �. 67. Fencing & Access Approval 17{ Rough Wiring Slgn � 68. APPROVED FOR PLASTERING 1'8.' Rough Electrical-T Bar Ceiling _-r 69. POOL/SPA SYSTEMS FINAL 19: RoughrHeating & Air Conditioning FIRE DEPT. REQUIREMENT 20. flough Factory Fireplace � APPROVALS Permit # �21. Ducts,:in Structure • _ 70. Underground Hydro 22. Ducts, Ventilating �� ' 71.•Product Piping OGas ❑Oil ' 23. Gas Pipe-Rough g� Test '" 72. Underground Flush � 24. Roof Framing �• .' �.r � 73. Undergrnd.StorageTank OGas �,Oil 25. Foof Sheathing . 74. Overhead Hydro , 26. T-Bar Ceiling (Structural) &:M000coat 75. Dry Chemical 27. Frameand'Flashing . ,. 76. DryStandpipe 28. Lathing�& Siding 'A,� � 77. FIXED SYSTEM FINAL 29. Insulation �� j� 78. FIRE PREV. FINA� 30. Drywall Nailing i" i � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat::'. r 79. FINAL INSPECTION 32. Electrical Power�Meter-Final � 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes �� // �� y�� C 34. Final Heating & Air Conditioning o NE o 35. Final Gas Pipe-7est 36. Hood or Canopy 37. Final Factory Fireplace . 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Flnal r i,- � 41. Solar pomestiaFinal �� 42. Backflow Preventer , '' � _ 43. Backflow Irrigation �� '� - ., 44. Landscape Irrigation System �;.,�. 45. Sound Attenuation ��i � � 46. Handirap Regulations � `j ' i 47. FINALSTRUCTURE & BUILDING lpo FN .O �. S�U iL.. -'� 48., Special Requiremen[s Completed � 49. Electric Release to Edison �J,J •� 50. Gas Release to Southern CaliforniaGasCo �� .� - �� 51. CERTIFICATE 0'F OCCUPANCY � ',r� ;, No. Date � �� J