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Home My WebLink About2931 GRACE LN - Building Permits • ( 41TY OF COSTA MESA ` , pMFsq BUILDING DIVISION j• •,m.,.,, A� 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 PERMIT NUMBER: B11-00064 on PERMIT TYPE B_ROOF2 STATUS: ISSUED v. APN: 14122117 DATE ISSUED: 03/03/2011 • ISSUED BY: KJB JOB ADDRESS: U29314GRACEL`N?CM-"; Suite/Unit: • Vicinity: 's vr.,...J_....r .--.r, ..vaa Squares: 15400 Valuation: $28,470.00 SCOPE OF WORK: TEAR OFF EXISTING BUR SYSTEM. INSTALL NEW 4 PLY BUILT UP ROOFING. NON-CONDITIONED WAREHOUSE SPACE.APPROX. 15,400 SQ FT. NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling unit(s)is provided for verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card OWNER: TRICO-TCH LTD Address: 201 PAULARINO AVE Unit: PHONE: City/State/Zip: COSTA MESA,CA APPLICANT: HUMMEL,GARY P Address: 2173 N LOCUST AV Unit: : PHONE: 909.356.1091 City/State/Zip: RIALTO,CA CONTRACTOR: ROSSCRETE ROOFING INC License No. 738539 Address: 2173 N LOCUST AVUnit: PHONE: 909.356.1091 City/State/Zip: RIALTO,CA 92377 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: ti< FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $432.15 Reinspection Fee: $0.00 Bldg Std Admin Fund $2.00 TOTAL FEES $434.15 HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3/18/2010-PER CMMC Sec. 13-279 Monday thru Friday-7:00 am thru 7:00 pm. Saturdays-9:00 am thm 6:00 pm.Prohibitied all hours-Sundays and the following Federal holidays New Years Day, Memorial Day, Independence Day, Labor Day,Thanksgiving Day and Christmas Day • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) (EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. c00E r. INSPECTION TYPE DATE INTITIALS CODE II INSPECTION TYPE DATE !MATS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final , l 208 Final Plumbing 200 Final Re-Roof X �-010—1/ mPbyld 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: Owner 13 verified by driver's license. ❑Yes ❑ No • •I hereby affirm under penalty of perjury one of the following declarations: •Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code, for the - perfo once of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: / person is required to descend, will be made in connection with work authorized _ --S, by this permit,and that no building structure,scaffolding.falsework,or demolition •a (Pni�ssaon need not be mmryeted AmeJvemrtrs vowed al one hundred dollars($100)or fess) or dismantling thereof,will be more than thirty-six(36)feet high. (Chap.3.2,Grp r rte, sect Q�D ijp ?i�10 2,Ad 2,Sec.341,Title 8,California Administrative Code). Pilvr'"'�-ef ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's signature Date the L blot Code shall forthwit comply with these provisions. 71• � rrr+..� S' l7 Division of Industrial Safety Permit Number: n slSignawre fay—=o HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes ❑ No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000) of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full forceandeffect. _ a registration form for acutely hazardous materials? ❑Yes ❑No ss (Section 25533 of the California Health and Safety Code, with some f exceptions, requires registration with the Costa Mesa Fire Department by f v each business which at any one time has on hand a quantity of acutely c radar's'SignB re hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑ No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: Costa Mesa Fire Department may require the preparation, certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required. has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be fumished on applications for non-residential building permits). License Law(Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? ❑Yes ❑ No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK. and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec.7044, Business and Professions Code:The Contractors subject of this application, have all of the disclosures prescribed by California License Law does not apply to an owner of property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes ❑No thereon,and who does such work himself or herself or through his or her own 8. (If'yes", attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. property, ❑ I, as owner of the LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ am exempt under sec. the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction, and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature of Legal Ovine ) Date Signature Date 3057-46(3/07) ton br.Au odaed' p icanl Site Plan 2930 - 2941 Grace Lane, Costa Mesa 1 1 2940 Grace Lane 2941 Grace Lane A I CD E Fri--; H m co J L4 H G F E D C B A 0 o 111. I��',��- -' ; - k, -11 i_ U_ � V I II r -' LI- ' ► , '` I I I I I I ®%0I I l iI I N111 I I I IIIII ti__ . l U 1 t' h ° �°I1111111 11 i 1;i 1- 1 11111 11 1111 \ K „ , ,,,E,,,, J H G F E D C B A K J H G F E D C B A II -V -. - V'- V•-'U------U----U--U- 'V'-`V” V` j "V' 'V' 'V' 'V'-`V' "V' 'V-'V• V- "V' 1 2931 Grace Lane ___________-.0.11 2930 Grace Lane C 11111 . 4111 fr p CITY OF COSTA MESA f 4 BUILDING DIVISION o r. F , r._r' DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER PERMIT V07-00291 mr0 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.EL.zECTRICAL PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2931 GRACE LN Status: ISSUED Suite No B Applied: 04/06/2007 Vicinity: UNIT B Issued: 04/06/2007 Parcel Nunmber: 14122117 Applicant: FLANAGAN, TIMOTHY E ��►G'�� Address: 6751 MELBOURNE DR Phone: 949-322-4545 ISSUED BY: • HUNTINGTON BEACH,CA Zip 92647 Owner TRICO-TCH LTD Address 201 PAULARINO AVE Phone: COSTA MESA,CA Zip: 92626-3313 Contractor: Address: Phone: Zip: License: SCOPE OF PERMIT REF:B06-01400.INSTALL SPRAY BOOTH.ELECTRICAL TO INCLUDE:2 MOTORS AND LIGHT FIXTURES FEE SUMMARY Quantity . . Quantity ISSUE FEE $23.50 Temp Dist System/Lighting $0.00 0 Temp service test $0.00 Busway/100 ft $0.00 0 Res.a/c package $0.00 Standing Section $0.00 0 New Res(1-2 units) $0.00 0 Misc Electrical Equipment $0.00 0 New Res(34-units) $0.00 0 Transformers up to 1 kva/kw $0.00 0 Pool/Spa $0.00 0 - -. up to 10 kva/kw $0.00 0 Lighting Fixts , $2.20 2 up to 50 kva/kw $0.00 0 Recept Outlets $0.00 0 up to 100 kva/kw $0.00 0 Switches $0.00 0 over 100 kva/kw $0.00 0 Non Res Appl $0.00 0 Low Voltage Equipment $0.00 0 Res Appl $0.00 0 Low Volt Wiring System/Ckt $0.00 0 Service to 200a $0.00 0 Misc.Conduit $0.00 0 Service to 1000a $0.00 0 Misc.Conductor $0.00 0 Service over 1000a $0.00 0 Circus(gen or ride) $0.00 0 Motors to 1hp $0.00 0 Circus(mech ride or lights) $0.00 0 Motors to 10hp $24.60 ' 2 Christmas Tree Stand $0.00 0 Motors to 50hp $0.00 0 Fireworks Stand $0.00 0 Motors to 100hp $0.00 0 Other Electrical Fee $0.00 Motors over 100hp $0.00 0 Communication drops $0.00 0 , Investigation Fee $0.00 . Sub panel to 200a $0.00 0 Plan Check Fee $0.00 Pole Light Pkg $0.00 0 Reinspection Fee $0.00 Sign Circuits .$0.00 0 Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES $50.30 Intermed Pole $0.00 0 COMMENTS/ SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 • 244648(WOO) • • DECLARATIONS ( I r1 WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This(Tsection need not be completed if the permit Is valued at one hundred dollars($100)or less.) (�[ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' ///��compensation laws of alifomla,a d agree that If I should become subject to the workers'compensation provisions of Sectio 3700 of the Labor Code,I shall forthwith comply with these p v igns. n_ t�..//- rApp Icant Sif g ature: _�, )f/y�. Date: 1 (#j l�1 WARNINGI FAILURE TO SECURE WORKERS COMPENSA ION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL ENALTI AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES, LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lenders Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the properly,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure Is not intended or offered for sate(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or improvement is )��//sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' I,as owner of the property.am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,end who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). El I am ex p under,V�a�C�1 Business and Professions Code for this reason: �[ z r_-- 'Signature: V� Date: 7 (/U "Owner ID verified by driver's license. ❑Yes ❑No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 6,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: _ _ Dale: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes ❑No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application egermit for such construction or modification from the South Coast Air Duality Management District or from any other air pollution control district or agency? D Yes Ll No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any pan of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No Of yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. m 1 - R.J nature Of Legal Owner(s) C(L ,, !/6) 0�te litk C And/Or thodzed Applicant 1 r/! // ate coos 0 INSPECTION TYPE all 1107414 CODEI INSPECTION TYPE PAIS Ptd 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 6///7 Or 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy X13:. CITY OF COSTA MESA �L\ BUILDING DIVISION F• DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER PERMIT 07-00177 `4 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2931 GRACE LN Status: ISSUED Suite No B Applied: 04/06/2007 Issued: 04/06/2007 Vicinity: Parcel Number: 14122117 �y� Applicant: FLANAGAN, TIMOTHY ISSUED BY: I J Address: 6751 MELBOURNE DR Phone: 949-322-4545 HUNTINGTON BEACH,CA Zip: 92647 Owner: TRICO-TCH LTD Address: 201 PA_ULARINO AVE Phone: COSTA MESA,CA Zip: 92626-3313 Contractor: Address: Phone: Zip: License: SCOPE OF PERMIT REF:B06-01400. INSTALL SPRAY BOOTH.EXHAUST HOOD FOR SPRAY BOOTH. FEE SUMMARY Quantity Quantity ISSUE FEE $23.50 Repair/Alt Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $0.00 0 - Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 - Ventillation System $0.00 0 Repair/Alt Cooling/Heat $0.00 0 Evaporative Cooler $0.00 0 Inst/Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0_ 'Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $0.00 0 Factory Fireplace $0.00 0 3 To 15 hp/500 k BTU $0.00 0 Hood w/Mech Exhaust $10.65 1 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 • .Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15to 30 hp $0.00 0 Air Handlers< 10000cfm $0.00 0 - 30 to 50 hp . . $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $34.15 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21.92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(Nap) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number ere: Carrier: Policy Number: is ction need not be completed If the permit is valued at one hundred dollars($100)or less.) I certify that in the performance of the work for which this permit is issued,I shell not employ any person in any manner so as to become subject to the workers' compensation laws of California, nd agree that'f I should become subject to the workers'compensation provisions of Sec on 3700 of the Labor Code,I shall forthwith comply with these provisions V� 9 Applicant Signature:. .�/'K� CI/� Date: Cl WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVENciE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(51 mow).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.# Class# Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she Is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is old within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ket- I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044.Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). �'• am exempt ueT�sec. + Business and Professions Code for this reason: /� � Siwne>IDv r v�AM'�, Date: -Owner ID verified by driver's license. 0 Ye 0 No Driver's License No. E Aires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made In connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the Califomia Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). _ 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the Califomia Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? yes IJ No (Section 65850.2 of the California Govemment Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If"yes*,the facility must meet the requirement of Sections 25534 and 42303 of the Califomia Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes,attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. ature Of Legal Owner(s) _Date / ��07 0-4,4 cAnd/Ir Aut i.nzrd 'pplicant / ate CODE I I6SFECTIONTYPt QA1E =ELS LODES INSPECTION TYPE RKTID AIL IEL5 S 1616 Fixed System Final Fire Prevention 206 Final Mechanical s 7-3o-n7 Br! 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 •Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy ,411141- CITY OF COSTA MESA 4 BUILDING DIVISION a • •• ,.;. •. ,1 DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER Ft „I...air I J 4d� PERMIT B06-01400 mfriso (714)754-5273" 0 • Fax(714)754-4856 • www.ci.costa-mesa.BUILDING PERMIT • 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2931 GRACE LN Status: ISSUED Suite: B Applied: 08/17/2006 Vicinity: Issued: 04/06/2007 Primary 0cc: Type of Construction: Parcel Number: 14122117 Zoning: Applicant: FLANAGAN, TIM Address: 6751 MELBOURNE DR Phone: 949-322-4545 • HUNTINGTON BEACH,CA Zip: 92648 ISSUED BY: Owner TRICO-TCH LTD Address 201 PAULARINO AVE Phone: COSTA MESA,CA Zip: 92626-3313 Contractor: Address: Phone: • Zip: License: Arch : Eng: Address: Address: Phone: .Phone: Zip: License: License: SCOPE OF PERMIT INSTALL SPRAY BOOTH FOR"ACE SHUTTER FINISHING"IN UNIT B.REF:F06-00246 FEE SUMMARY Plan Check: $126.91 • Calc Valuation: sii,000.00 Permit: $195.25 Claim Valuation: Sil,000.00 SMIP Res: $0.00 SMIP Corn: $2.31 Other: $0.00 • Inspection: $0.00 Total: $324.47 PLANNING & ZONING SETBACKS MAIN STRUCTURE Front 0-0 Rear 0-0 Left 0-0' _ Right 0 0 ACCESSORY Front 0-0 Rear 0-0 Left 0-0 - Right 0-0 PARKING Existing: 0 • Required: 0 Proposed: 0 • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92.28,§1,12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result In the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjurne of the following declarations: ❑ I have and will maintain a certificgte of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. My workers'compensation Insurance carrier and policy number are: Carrier: Policy Number: (This stion need not be completed it the permit is valued at one hundred dollars($100)or less.) kr 1 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,a agree that' I should become subject to the workers'compensation provisions of Section 37Q0 of the j.abor Code,I shall forthwith comply with these provisions. _ T 0(//6-1 cAppGca'nt Signature: "I WA.- Date: WARNINGT FAILURE TO SECURE WORKERS'COMPENSATION COVERAG IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL ES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($10D,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect.Lic.A Class u Contractor's Signature: Date: CONSTRUCTION LENDING AGENCY: O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: • I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): O I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement Is ��,/y o(d within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). yp I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions "V Code:The contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). xe pt un c. *0.4.4,-s Business and Professions Code for this reason: O S fww Date: Owner ID verified by driver's license. 0 Y3s 0 No Driver's License No. __ _ xpires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Cale,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does�r will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No ._ futur'—.___ ___ ._._ _.._ ..difi ...._... 5 Does or will the Coast Airirt or present or emen building istct o from at any other require for the work which district the or of this a estion a eNnil for such construction or modification from the South Quality Management District or from other air pollution control or agency? �Yes �No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes 0 No (if yes',the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Cale). 7 If a permit from the South Coast Air Quality Management District or other;Jr pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct, I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. cd Sign Legal Owner(s) nd/t9r A'u 'clued iii., 1 ��60 / °Dat CODE I pISPECPONTYP[ PAL 1NTITIAI$ . ME I$SPECTIONTYPE ME. . =AU 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy C'-. 1,LIN\ • DECLARATION OF AUTHORITY Bldg. Permit 41306, • FOR AGENTS OF PROPERTY OWNER TO APPLY FOR PERMITS This Permit# Street Address: 2-931 —? 6gACE N. AP Number IµF22I 17 1. I (we), -11Z5(-0 TC H) t_TR , declare that I am the Owner of Title of the above referenced real property, and that I (we)hereby authorize: T\tQ L� Name: 1 ' \\ t W.�`(` \CNi ggVA Telephone Number: L\ 3)),-9 �� - lS1I S Street Address: G S \ 1 `1.,\,O CS w he, "Or w L City: C\u,h\\`nc\\O`t\ CQ e.A L\1 State: C 4 Zip: 416411 41 to obtain permits in my behalf,as owner/builder,for INSTAL-LA TION OF A S 1NA Y 13 OOT N at the above referenced property. 2. Should any person become an employee engaged in the improvement of the property, I (we)shall immediately provide Workers Compensation Insurance coverage and cause a certificate of that coverage to be filed with the Building Division of the City of Costa Mesa, as required by State of California laws. 3. As owner/builder in fact. I understand and accept that my responsibilities do not transfer to any other person, company or corporation. 4. I agree to indemnify and hold the City of Costa Mesa and its employees or officers harmless from any claim resulting in damage or personal injury to myself or any other parties as a result of work authorized by the permits from the City of Costa Mesa. 5. I declare under the' penalty of perjury that the foregoing is true and correct. �L Executed this / day of MA 4Q( H 20 01,at co 57m M EsA , California. • 'print Name: )LAPCN66 J. TVlcN&2 /'APIN E2 Signatu e: �O Da / /0-7 Note: This authorization does not grant authorization to perform the work as owner, it solely provides for limited power of attomey to secure this permit in any behalf. 07I946(rev.11N0) 2q.3 \ G*o&9 13 To , �U\\,c� \`l\or5cAn P\co C\Nec. h ..)Nuns\Oh r (� b0 (\ - O \`-l00 GfeD� GerArdo Y\av� &0h4- evet5t,h3 \ \ `M �owec . 4C)\ o OrnuJ \L15\Y\e55 \n Cos P1/4 1 '1 esc�, Cor a�mos�en cx \aear nou t\ tvuJ\ \\`no i F1w‘ ‘noJ Gi \oc ctV tAn r \o‘uv6\Y\a °A"\<"\31 SUVs\ c'''S SA \ \ L `Y\h j\\c. `3( u C Y�o 6455 �-AS Y.\ ;. `Cc\\Cc\-1/4 A X- U \'S to s\oxck mcc c*s` l3 \e-%' e- \\\"`A-\A5 \`\ laouC' C\\ , O e tc\c b�SVAG\eS I \'1Gv� \0, A_ co ove.rGorne O -V 4 Wc\s\ 1 ,1 o,L_korec `\ <V \N\1� \ILA \'(\e5� PAkA was mt� he- \\\� , �1 \\;\:.`s 1A3v �\v\o� �m \n v104 \asp\�o�\ a °J St�,co �rv3 Seo For \r , '\ 3O (;Y\\\ SAS\. fie- �.4t No\ \ o Oo v\\-c) Ikon `MUAL \ a 2lc\, 1 c k u x-c ` �AS aev e.\c ` t k cit �-he- \w t OF v bcA\h , ( rm COY\S\c3ec'c t lOolA Cove\& a\vo o ‘‘(ILA5S�Ak\ n°V\ Wou\& 'c qeLa� e- �yr � e.o. m ��r\ laoore, � k Cot- \\now. \(4lAc 5 �C' `� r p\AOG,cSs o\yC `)C,14 L1 ��.4 f ` 030107 e\oor,� �a3 Tr\eNs\ve. CartU1h1 A .06-A4di °1 PROJECT ADDRESS: 2931 GRACE LN UNIT: CITY OF COSTA MESA — SIGN PERMIT -- -— PERM NO: SB 051611. OWNER'S AMJOHNSON GERALD H — ADDRESS: 12365 FERNANDO DR PERMIT NO: SB 051613 PLAN CHECK NO; 01207-91 S GOVT: N SUPP; N SAN DIEGO, CA 92128 CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE: OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 10 WALL 6 I GROUND NON LUMINATED SIGNS SQ FT: ADDRESS: UNIT: CLAIM VALUE: 3, 600 . 00 CALC—VALUE: 3, 600 . 00 GROUP OCC; B-2 / PERMITTEE: ADDRESS: DICKERSON SIGNS 6 GRAPHIC ( 714 ) 546-8150 2930 GRACE LANE A COMMENTS: X • COSTA MESA CA 92626 ************ ***7.****x**-k***** xx********** r* **** *** ******N.-** ***ac******T< ** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section SIGN INFORMATIO N 7000)of Division 3 of the Business and Professions Code.and my license is in full force and ettect. DISTRICT; 3 TYPE: 1 GRND; 10 WALL ILLUMINATION; NON CATEGORY: NEW cIu-W-: 00 700 STATE LIC.: 31519 LASS: C— .5 DIMENSIONS: 1FT 00'IN X 3FT 10IN AREA: 56 , 00SQFT LETTER HT: 12 Date, 9/d// Signature: — _ STREET FRONTAGE 1 : 54 , 50 STREET 1 ; GRACE 'LANE. WORKERS'COMPE ATIO DECLARTION: Ihereby atti atIhave ceniticateGIconsent tosell-insure oracertilicateofWorkers' STREET FRONTAGE 2 : 0 . 00 STREET 2 : Compensation Insurance,or a certified copy thereof(Sect n 3800,Lab.C). PARCEL; 14122117 ZONE; MG LOCATION > FRONT: X REAR: troucvND.: 0638651-91 EAP.DATE: 04/01 /92 BUSINESS NAME: MISCELLANEOUS > LEFT: RIGHT: COMPANY: STATE FUND U T H E R T O T A L S GROUND S I G N ii Certified co is her by lurnished. 51 Certiliedcopy isfiled 'h the city BwltlmaDivision. THIS ACTIVITY 56 , OOSQFT OVERALL HEIGHT: SFT OIN 41 CT Il THIS SITE 56 , OOSQFT GROUND CLEARANCE: OFT 6IN Date: 4 Applicant: , � Air. ITEMS OF INFO 1 PLANTER AREA: 36 , OOSQFT EXEMPTION FROM WO KERS'COMPENSATION DECLARATION:ris section need not be completed if the permit is for one hundred($100)or less). ITEMS FOR ACTIVITY; 1 BLDG SET BACK: 1OFT I certify that in the performance of the work for which this p it is issued,I shall not employ any person in any manner so as to become COPY VERBIAGE : GRND; ADDRESS — 18 SF IN AREA subject to the Workers' Compensation Laws of California. WALL: MISC BUSINESS NAMES — 3 . 8 SF EACH Date: Signature: PLANNING NOTES: NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor ****x'*****if****3f'1f***********ii********************lf********1t**********a'.****x**** Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. DEVELOPMENT SERVICES R E Q U I R E M E N •T S CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097.Civ.C). • ZONING APPROVED BY Ll SIL DATE: _q_(i4toL_ LENDER: ADDRESS: BUILDING APPROVED 3Y : DATE; G G OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason APPLICATION ISSUED BY: r DATE I -1 (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or ***.*.****x************* • • • ' . . ... . . ********* . . *1 ** repair any structure,prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed L EGAL I 7.ATZON; N F E E S U M M A R Y STRUCTURAL SEGMENT; Y pursuant to the provisions of the Contractors'State 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 f$500f. BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the PERMIT 63 . 00 56 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Processional Code: The Contractors'State License Law SMIP/NON—BGS does not apply to an owner of a property who builds or improves thereon.and who does such work himself/herself or through PLAN 40 , 95 , 7 6 his or her own employees,provided that such improvements are not intended or offered for sate.If,however the building or S improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve mnISSUE FEE he purpose of sale). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I,as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business TOTALS—---> 119 , 76 0. 00 40 , 95 160 , 71 160 . 71 , 00 ❑ and Professions Code: The 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). I am aware REVENUE DIVISION TOTALS--> COLLECTED; 160 . 71 OVER/SHORT; , 00 that proof onnehWorker's Campensauoninsurance should beprovided tome. BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK ❑ I am exempt under Section: B.8 P.C. 63 . 00 56, 00 . 76 40 . 95 for this reason: *********x**if:x*if**********************if lie-****it**********Xi************.*;*********Of Date: Owner: INDIVIDUAL F E E BREAKDOWN I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 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 Irom the Air Ouality Management District.Residential construction applications are exempt from TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST these provisions. NO FEES WERE SELECTED FOR THIS PERMIT 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 relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection pur uses. Date: Signature: `�`'AL.� `��r�� C„f-m;• • I � ' r�_ "1-1: f'• _ ___________ Driver's Li ease or .wt Security.: .�-- � „ 1641-46 While—Building:Green—Code Entorcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor —'� CONSTRUCTION AND PLANNING lb P 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 4_17_11 [C C'y�Ji' 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 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 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 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 4.-211k 60, 48. FINAL PLANNING 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. GITY.OrGOSTA,MESA ONSTRUCTI04I�PERMI PERMIT NO. TRACT NO. LOT NO. UNIT NO. p702 111K /..!. ; eXq 5/ 5-rgcs , Mrvt -fl• 6 I `7t3Co`-f -:„ Project Address /- S� Applicant's Mailing Address i 6-Ych4--n. 7 TYPE OF CONSTRUCTION U NEW Li ADD U ALTERATION U REPAIR 0 CONVERSION ❑ DEMOLISH 0 OTHER A.P.aP Zone Owner's Name / C/7-�0�,1a `. 'hone b DESCRIPTION OF WORK/USE OF BLDG. Address / 5-ill C7-01t //'�) , q S Main Building: Accessory Building: E Z Arch/Eng. License No. TYPE OF PERMIT...." ❑ GRADING U FOUNDATION U STRUCTURAL T Front O Address 0 TENANT IC ELECTRICAL 0 PLUMBING 0 MECHANICAL B- Rear N Contractor's Namn Phone El -OTHER A - I PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address lmai ling) 0 65 CON STRUCTION TYPE VALUATION$ S Left G City License No: ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: 1 ,.�, ,� 3 Ja w I I o Planning Notes: M with section 7000) of Division 3 the6ness and Professions Code,and .100 M /a-./ my license is In full force and°floc(�r�� IIT License Class License No. S Date Signature _ _ PLUMBING I FEES . WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate ' workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer- Service Sink - ' - 10, Lab. C.) - Automatic Washer ' Transformer' ❑ 15.50 KW dcy No. Company Backflow Irrigation 0 50+ KW 9 Sewer Cap Construction Pole Sub. 8 Certified copy is hereby furnished. Certified copy is filed with the city Building Division. ' Bathtubs Sewer Connection Cooking Unit / Meter Cup to 100 amps S-00 Oate Applicant - • ,• 1 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 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 Motors 00-1 HP 0154-8 Workers' p tl ws of Calif /X\ Date 1�� Signaturev--- . • uld ✓ 1 Floor Drains Swimming Pool w/Spa F.A,U. IntSolar 09-15 HP❑16-15+ — 'NOTICE:If,after making this declaration, you sh 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 _ - 9 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 GarbageAuto-Wash Disposal following reason (Section 7031.5 Business and Professional Code: Any city or - - • P osal ;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 Compactor any structure, prior to its issuance, also requires the applicant'for such permit - . to filo 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 - - ' 11.5 by.any applicant for a .permit subjects the applicant to a civil - . - ' alty 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 Feo $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. I however, the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date motion, 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). ��,/� 1 ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By y- i - • Date tractors to construct the project (Section 7044,Business and Professions Code: ✓ , The Contractor's License Law oes not apply to an owner of property who Duct-Ventilating 0o-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con-- . .- . tractor(s) license pursuant to the Contractor's License Law). I am aware that ' Exhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT 'S 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.BIL ICBG# Fire Dampers PLUMBING $ • ISSUANCE $ - - Date• ,/D/E Owner � �--y t/�' Heating System 8( Ducting Registers PLAN CHECK 25% $ ENERGY P.C. S I hereby certify -that I have'read thistion a� that the above 00.100,000 BTU 0100,000BTL - GRADING $ , • information is correct. I agree to comply with all city and county ordinances ELECTRICAL $ 5•�T 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 - p �� Inspection purposls7 / / 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 POOL A y 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 ' , - i 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 & 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 0Gas ❑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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final / n"G/ (1-d_ 80. FOOD CERTIFICATE ISSUED 33. Final Electric / ` Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final • 40. Gas Service-Final 41. Solar Domestic-Final - 42. Backflow Preventer 43. 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 - illirr Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. — PERMIT NO. TRACT NO. LOT NO. UNIT NO. CITY OF COSTA MESA /CONSTRUCTION PERMIT/ ��/� G 2502 4/,04/05 ,Project Address za31 y2A�.�, l_}.1. UN/jT Y e./ I • , { ^ ' Applicant's Mailing Addressr G53/ G�LkJ Uti11TU TYPE OF CONSTRUCTION U NEW 1. l ADD U ALTERATION U REPAIR ,p A CG-a �z(/�A fl3 ' ❑ CONVERSION ❑ DEMOLISH hK7`ll OTHER (ti4— I tt 1--Mi.- A.P.# Zone Owner's Name t-. /� 1 c�7h'1 hone Yb'7g tT DESCRIPTION OF WORK/USE OF BLDG. - Address 24 3( yn ee Lk) E - f S Main Building: Accessory Building: Arch/Eng. License No. TYPE OF PERMIT LI GRADING U FOUNDATION E STRUCTURAL T Front O Address ❑ TENANT XELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear . N Contractor's Name D16GS tit-Car Phone %3510 I ❑ 'OTHER A C Right N Address(mailing) Ilvfo(o2 frit LukOeJ Ars T/L✓ M PROJECT DESCRIPTION SQ. FT. OCCUPANCY K G CONSTRUCTION TYPE VALUATION $ _. $ Left City License No. (O (0 R ZONE - GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION r -',/ _ Ping. Ref.# Parking Req./Provided . I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks:" /a/51 q// ("/�7G�2 Planning Notes: n/I • with section 7000) of Division 3 of the Business and Professions Code,and /-1 FVf T my license is in full for e and effect. 25 7: 'J'��J !!,, `` r+��s ,cam S License lass 7 /ens,: o., L� .— PLUMBING �J apiccuL. suer ca. f t.41 - Date - Signature :Cr it �N"'-'� ! WORKERS' 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' Compensation Insurance, or a certified copy thereof (Section Back flow Preventer Service Sink - 3800, Lab. "' �Q7�--- .. Automatic Washer Transformer D 15-50 KW Company ^+'+ 't Backflow Irrigation Sewer Cap0 50+ KW Policy No. _ _ - Construction Pole Sub. C rtified copy is hereby furnished. er}. led co y's filed with the city J/ g Dlyl o�F/ Bathtubs Sewer Connection Cooking Unit Meter pup to 100 amps 7' Date Y-41'7fo Applicant (l;o+k9.( aY�i�J' - fyq EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher \?; Meter iiiover 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 - Workers' Compensation Laws of California. �� Motors❑0-1 HP ❑1%-8 Date Signature _Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar 09.15 HP Eh 6-15+ \ '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 SwitchesSign % OWNER BUILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash 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 P-Trap LaundryTrays any structure, prior to its Issuance, also requires the applicant for such permit Generator ❑0-5 KW ❑5-15 KW Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000) of 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, 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 D sale, If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ Zoning Approved By _. _ Date pletion, the owner will have the burden of proving he/she did not build or im- Duct 1 Under Ground Building Approved By Date prove for the purpose of sale). [� G ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By `-'J C_ Date 1/7 0 k. 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 builds or Improves thereon; and who contracts for such projects with a con- SUMMARY OF FEES tractor(s) license pursuant to the Contractor's License Law). am aware that BUI LDING PERMIT $ SMIP $ of Exhaust System ❑ Multiple ❑ System Repair/Alteration proof 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# 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 ❑0.100,000 BTU 0100,000 BTL - ELECTRICAL $ �n' GRADING $ • Information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction, an hereby authorize repro- PLAN CHECK 50% $ MICROFILM $ senlatives of this • y to enter u n the abov mentioned oper y f r inspection purp•s'. //./ -��_ ( p9 MECHANICAL $ TOTAL FEE $ /O' Signature . Date of G Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ Drivers' Licen e or SS'$ - CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING NI. .t SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector -1. Temporary Eltrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Un grnd. ' 53: Steel Reinforcement I • 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, O Undrgrnd. 10. Structural Floor System ,f.`: 61. APPROVAL TO DECK - 11. Property Sewer Line & House Connection t 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 'ti, 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 PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION _ '51/17%, Electrical Power Meter-Final '51/17%, _80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing i 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 S. _> Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA . P MIT NO. TRACT NO. LCo.NBLDG.NO. 7896 6/ 16/82 31 .90 TL I CONSTRUCTION PERMIT gE - 3&89 , 3a7ar • F* Project Address z94/-p G-.cICE GN . TYPE OF CONSTRUCTION Owner&gAL Jo/JIVSo ri PhonegQ/.bRell( 0 NEW ADD 0 ALTERATION ��//J�� Address /SPf✓ / CAA/44M Ai. 8 {•J7°goi3L7y'HGHTa -❑ REPAIR 0 CONVERSION ❑DEMOLISH �.�I.�• Arch/Eng. License No. ❑OTHER ZONING� REGULATIONS TL`�HN% A.P. 5K WL Address zg3/- F 6-n4cE LN. DESCRIPTION OF WORK S I7 RAY PiiDlsTj-I �_ ZONE PLNG. REF.yfr Contractor re7t4A.IT 0 Phone5T7•-- v TYPE OF PERMIT BUILDIN 'RUIL$IG SETBACK C/L ST. OPERBV NLINE Address .LiQZVrE 0 GRADING 0 FOUNDATION 0 STRVCTURAL SIDE YARD LICENSED CONTRACTOR DECLARATIONLEFT �/ ,! I hereby affirm that I am licensed under provisions of Charter 9 (corn- TENANT 0ELECTRICAL ['PLUMBING ❑MECHANICAL, RIGHT.4 R6 px /p �� /-�/I mencing with section 7000) of Division 3 of the Business and 0 OTHER • R /rV� yY�! Professions Code, and my license is in full force and effect. REAR YARD 0 P/L) PROJECT DESCRIPTION License Class - License No 40PKG.SPACE REQ. PROVIDED SQ.FT. Date Signature �� STREET WIDTH PARK FEE$ WORKERS'COMPENSATION DECLARATIONateofc OCCUPANCY COiee:La- TYPE ZONING APPROVED BY (-a�/( DATE/•rv��/�, I hereby affirm that I have a certificate of consent to self-Insure or a VALUATION �-- LONE IIY//"'��77 uu• certificate of Workers' Compensation Insurance, or a certified copy SPECIAL CONDITIONS: thereof(Section 3800, Lab.C.). GRADING CU.YDS. ACRES ,��,lpicy No. Company_ I - l`'Gertlfled copy is hereby furnished. REMARKS: / �/e 3P9 Q U Certified copy Is filed with the city Building Division. �� L/ . - EXEMPTION FROM WORKERS' COMPENSATION DECLARATION \'Sere/Atzetekw (This section need not be completed If the permit is for one hundred -IL•<o-o}Zt ($100) or less). • I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK ELECTRICAL PLAN CHECK subject to th Workers'Copens• on Law of California. UwtLU NG GHri ALat Date G -I 1 m-PL_ Sig ure`- 4 A17 BATHTUBS SHOWERS 50 FT 50 FT NOTICE: If after making 0h1s d- lavation, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensat • •revisions of the Labor Code,you must - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW .revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS ' MOTORS 0-1 HP ! 1-10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS '- (INC.SOLAR) 30-50 HP 50+ HP formance of the work for which this permit Is issued (Section 3097 _ Civ. C.). FLOOR SINKS '\ \\ FLOOR DRAINS FIXTURES / OUTLETS SWITCHES ` 0 Sb Lenderis'-Name - - ' -1 • Lender's Adtlresf - .DRINKI NG FOUNTAINS_ GAS TUBE SIGNS - OWNER BUILDER DECLARATION . ` .. •' \ INTERCEPT, 7 ORS , CLARIFIERS POLE LIGHTS I hereby affirmtthat I am exempt fromsthe Contractor's Cicense Lawlor ` the following reason 'Section 7031.5 Business and Professions'Code: SWIMMING POOL P TRAP - wigs I KUL I - Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to Its issuance,also re- WATER SERVICE ALTERATION PANELS MAIN SUB quires the api.licant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Di,lsion 3 of the Business and Professions Code) or that he Is exempt therefrom and the WATER HEATERS BTU OUTPUT - ' 'is for the alleged exemption. Any violation of Section 7031.5 by - applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS ' lot more than five hundred dollars ($500). 4134. I, as owner of the property, SOLAR TANK COLLECTORS will do the work, and sthe structure is not The _ - or offered for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE " • V Contractor's License Law does not apply to an owner of a property _ / who builds or improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DAT E� / through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or ImprovementMECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have the burden of proving he did not build or improve for the purpose of Sale). - BUILDING �-• ❑ I, as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU • oo �r SQ PERMIT $ aG SMTP § licensed contractors to construct the projectAND DUCTING I !0 PERMIT (Section not Business 100,000 +BTU PLAN CHECK $ ( and Professions Code: The Contractor's License Law does not apply to - - ISSUANCE $ I an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING—$ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ J 0 I am exempt under Section' B.& P.C.for this BOILERS BTU ELECTRICAL $ -..S:OC $ ▪ reason zPLAN CHECK $ MICROFILM $ SYSTEM REPAIR,ALTERATION Date Owner TOTAL FEE$ MECHANICAL $ q I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE LESS AD- information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction,and hereby authorize • representatives of this city to enter Upon the above mentioned pro mspecti°�, p�p�o{e� n,' - 1• V Sig ature " Ws Date 7�� FINAL FEE $ Dri r ' lcense or SS5K - ISSUE FEE CMF 0865-46 White-Building;Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING 4. `i - POOL&SPA , APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole - 43. Pool & Equipment Location - , - 2. Soil Pipe-Undrgrn - - 44. Steel Reinforcement - • - - ..... . . • 3. Electrical.Conduit Utility.-Undrgrn , ; - - 45. Forms . 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - • • 5. Steel Reinforce _ 47. Rough Plumbing & Pressure Test - • - - 6....Electrical UFER Grn -_ • 48. APPROVAL TO COVER-GUNITE • 7. Footings ,- •_ -_ •- , 49. Electrical Conduit-,Undrgrn1 8. Foundation _ - - - 50. Gas Pipe, ❑Undrgrn,Test _ 9. Water Pipe-Undrgrn . . .• 51. Backwash Lines, P-Trap, ❑Undrgrn 10. Structural Floor System. 52. . APPROVAL TO DECK 11'.. 'Property Sewer Line & House Connection 53. '.Backwash& Receptor-Final J 12. Street Sewer Connection - • 54. Heater &Vent-Final , 13. Rough Plumbing _ • 55 Plumbing System- Final 14. Rough Electric-Conduit •56. Electrical-Final- 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning _ 58. Fencing& Access Approval _ 17. Ducts, in Structure -59. APPROVED FOR PLASTERING .18. Ducts, Ventilating ' - - ; 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing - - 21. • Roof Sheathing - . , - - 22. Frame and Flashing - • NOTES: , 23. Insulation - `/�7/8• Mer- wrT4_T9e+•s 6) //An./ dZT� Scecay/i.0 24. Lathing & Siding e4 es ,v MF4 /.ur ,tflc d%/5a Y�Dte.-'Zi'4e .�,� 25. Drywall Nailing - /NJy{SL$-/1./ Ctwt , So%,-y%,t ,L7'2./!r LUtire - 26. Plaster Brown Coat /t,a{(/S / y 27. Electrical Power Meter-Final ' - 28. Final Electric C 29. Final Heating & Air-Conditioning -1- o5 30. Final Gas Pipe-Test ] J 31. Final Plumbing `_• _, '--` ' '- `-' ' - - - _. , - 32. Water Service-Final . - ' 33. Gas Service-Final - 34. Solar Domestic-Final 35.. Landscape Sprinkling Systems 36. Sound Attenuation - • 37. Handicap Regulations • 38. FINAL STRUCTURE & BUILDING - 39. Special Requirements Completed 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY No. • Date ' 2613 1 F G-2AcE l_ rU , C. y.-t , S3 2 JnigtEP + SPRAvRoo?N PCOT rip cA &) \ FKO T — 2o ' -I ,-i_I °Frlct 1 \ _ APPROVED RY OF COSTA ESA / PLANNING DEPT. • ?.a..77 N ----a. C DG.SUBJECT TO BLDEPT. no. 1 BY..� 45/f DATE /�`�E 2 4Z• 1 I DI O2 OP PLANNING I" � -I A P P R U Ei :STRUCTURAL APPROVAL ONLY City of Costa Mesa B ilding Dept. SEPARATE PERMITS ARE REQUIRED BY DATE_ 6 / 9 FOR ELECTRINL, PLUMBING, THESE PLANS MUST BE ON JOB A ALL TIMES HEATING, VEI1TILATING AND MAKE NO CHANGES W+THOU PRIO' APPROVAL REFRIGER/TION WORK OF DEPT. THE ISSUANCE OR GRANTING OF • PERMI OR APPROVAL OF PLANS AND SPECIFICATIONS SHF I. NOT E CONSTRUED Permit ��11..# Be �� _ 9 TO BE A PERMIT FOR, OR AN AMC AL OF, ANY VIOLATION THIS NUMBER ' S: „CCOMPANY OF ANY OF THE PROVISIONS OF THIS CODE. f 0 PERMIT PRE. ALL INSPECT ION REQUESTS SUMING TO GIVE AUTHORITY TO V SLATE IR CANCEL THE PROVISIONS OF THIS CODE SHALL E VALI, EXCEPT IN SO I FAR AS THE WORK OR USE WHICH IT AUTHOR I ES IS LAWFUL p FOR BUILDINGS V;i t,,,: TZLSONS ARE TO THE ISSUANCE OF A PERMIT IASED U'ON PLANS AND 1, BE EMPLOYED, V:1 SUGCcST THAT THE • SPECIFICATIONS SHALL NOT PREVENT THE BU LDING OFFICIAL STATE OF CALK JR::,,a DIVISION OF . FROM THEREAFTER REQUIRING THE ;ORRECT'N OF ERRORS INDUSTRIAL SAFET( BE CONSULTED FOR IN SAID PLANS AND SPECIFICATION. OR FR. M PREVENTING ADDITIONAL REQUItEMENTS. BUILDING OPERATIONS BEING CARRIE I ON THi REUNDER WHEN , IN VIOLATION OF THIS CODE OR OF ANY OT ER ORDINANCE — ""- CF THE CITY. i f C 12EA 2n1 - r G (1-ACE L. :V - • I ',A. r -, J !'A,'AtI't OIL A Y. i':in OFL i •• • • �. KVPEL o 'A.-) 44iJ-i R:2 r..-, CLASS 3 v (Lou P Trf=. v 1 -. 1 v V{ . l -�� i.r7;1 pr) 41L1 C1T I-CI—I +r C/(gnr t.' in I{."W I. II i. :".::.,JAceo :IL,.ir. .0 FLi� NAzA2n01JS V.00A'11ohlS i 1j �' LIJl.IrJI h ,.i:tCl Jl��i 4-� ., (;Ar1IL i----\_ - - - --- i t'( Y.170T11 5 11 i 1 ° I i- I � ruler l <^ _ v — —A t f L ME IAL —j I I \ I I I Ci of Costa Mesa Building Dept. 1 o T I\ Bi'-- .-._•_DATE_ L :.19�• FIL 1; r THES PLANS MUST BE ON JOB AT ALL TIMES II II A.IAKE N CHANGES WITHOUT PRIOR APPROVAL OF DEPT. I— II I THE I:SUANCE OR GRANTING OF A PERMIT OR APPROVAL _ _ 7r q0PLANS A:;0 SPECIFICATIONS STOLL NOT BE CONSTRUED T BE A PER:MT FOR, OR NV fPF..OVAL OF, ANY VIOLATION -_-' OFI ANY Pi 110E PROVIS,°6S C! THIS CODE. NO PERMIT PRE. SG RING .0 GIVE AUTHORITY TO VIOLATE OB CANCEL THE PA 0 c''C Cis c - PR VISIONS Of THIS CODE SHALL BE VALID, EXCEPT IN SO FA AS THE WORK OR USE WHICH IT AUTHORIZES IS LAWFUL. 2_411 1 u• LAX! AL- FA 0 N. THE ISSUANCE CF A PEnVIT BASED UPON PLANS AND CJ1 SN CIFICATI INS SHALL NOT FR:TEhT `NE L:IILDING OFFICIAL / iPA}L 11000E A�ILA 1 IV U FE'...! THEE AFTER REQUIRING THE CORRECTION OF ERRORS b %L A b t IN ;AID FL NS A:ID S:ECIFICATION3 CR FROM PREVENTING EUI DING C ERATIOXS BEING CARRIED GU THEREUNDER WHEN -L (_Cr v(LAVE. IN UDLATIO I OF THIS CODE OR OF ANY OTHER ORDINANCE 3 -(1,100 C-F1"A f--',LGE ,:‘ 11-4._ OF'HE CITY LC) z 1 - F 6ILACt. LN r' I . ),I. , I A r l- "T‘-'it. -S \1•-l'i5C( L.%)E.11-4L t c sS7- S SU (' . NA . Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. 7895_ 6/16/82 17.00 TL CITY OF COSTA MESA PEr�"IT NO. TRACT NO. LOT NO. BLDO NO. - CONSTRUCTION PERMIT - 3.890 387g 7 _ • •Project Addressf - Zg31 - F (rR 4C� CAI TYPE OF CONSTRUCTION,� " Owner 6.e.„.„,.„.,, J 0 i4 tjso/J Phonecg7-53SC ❑ NEW LSTADD ❑ ALTERATION Address/Spy/ 6I?A14A14 M. 13. (pupetcry Mat-4T. ) ❑ REPAIR 0 CONVERSION ❑DEMOLISH ate+ ZONING REGULATIONS Arch/Eng. License No. ❑ OTHER • A P 7t�1T DESC RIPTION OF WORK d' /`�/' ZZ/—/ / k Address 2 d(3 1 _ F &/LACG c pp- I)V)LLe'-S ZONE a PLNG. REF.5P kal Contractor ?E7�IAiu7 0 12 Phone5S7s � TYPE OF PERMIT BUILDING.- x� BRi ;N �•i� SETBACK D SL OP YAdENS 0 GRADING 0 FOUNDATION 0 STRUCTURALMEA SIDE YARD LICENSED CONTRACTORIlicensed DECLARATIONunIR-TENANT 0 ELECTRICAL ❑PLUMBING ['MECHANICAL LSIEpGET YARD 11`a�ly I hereby affirm that I am Il 0) of provisions of Charter 9(tom- RIGHT J monting with section 7000) of Division 3 o1 the Business end 0 OTHER Professions Code, and my license is In full force and effect. REAR YARD(TO P/L) h PROJECT DESCRIPTION License Class • Licence No SD.FT. 1 4. ,1 PKG.SPACE REQ. PROVIDED Date Signature- -- WORKERS'COMPENSATION DECLARATION OCCUPANCYµ"1 CONSTRUCTION TYPE STREET WIDTH /��-�/P[A RI FEE E /¢/ p VALUATION 21420/11".42-ZONE ZONING APPROVED f3V/rA� I DATE/ // V 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 3800,Lab.C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: icy No. Company _ - Certified copy is hereby furnished. REMARKS: _ s.• .l Certified copy is filed with the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This ))section need not be completed if the permit Is for one hundred G IEcerttifyKS: Lor in the performance of the work for which this permit is . ct issued, I shall not employ any person in any manner so as to become PLUMBING PLAN CHECK - ELECTRICAL PLAN CHECK �I subject to the Workers Ce mpensa,Op laws`(If California uwtLLiNb (.AHAt.t Date L-/IL-PT" Signet /.✓__t4•4i.- BATHTUBS SHOWERS SQ FT SQ FT QNOTICE: If after making t • laratlan, you should become subject TOILETS URINALS GENERATOR 0-1 KW_1-10 KW to the Workers' Compensati, provisions of the Labor Code,you must TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+ KW _- revoked. CONSTRUCTION LENDING AGENCY KIT.SINKS DISHWASHERS MOTORS 0-1 HP 1-10 HP I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS SUMPS - (INC.SOLAR) 10-50 HP 50+HP formance of the work for which this permit is issued (Section 3097 Civ. C.). FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name Lender's Address • s DRINKING FOUNTAINS GAS TUBE SIGNS OWNER BUILDER DECLARATION INTERCEPTORS' CLARIFIERS POLE LIGHTS I hereby affirm that I am exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL P TRAP LUNS I Hut-I purr Any city or county which requires a permit to construct, alter, POLES METERED SUB Improve, demolish or repair any structure, prior to its issuance,also re- WATER SERVICE ALTERATION PANELS • MAIN SUB quires the aptllcant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS SERVICE AMP (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he is exempt therefrom and the WATER HEATERS BTU OUTPUT 'is for the alleged exemption. Any violation of Section 7031.5 by applicant for a permit subjects the applicant to a civil penalty SEWER CONNECTIONS .not more than five hundred dollars ($500). ce Act, as owner of the property, e ..., ... 1.,,..._ -'" .y_._ '...w SOLAR TANK COLLECTORS • re"-" r will do the work, and the structure is not intended - or offeretl for sale. (Section 7044, Business and Professions Code:The SOLAR PIPING SYS. ISSUE FEE Contractor's License Law does not apply to an owner of a property who builds or Improves thereon, and who does such work himself or ISSUE FEE APPLICATION APPROVED BY DATE6Z through his own employees. provided that such improvements are not ft intended or offered for sale. If, however, the building or improvement MECHANICAL PLAN CHECK SUMMARY OF FEES is sold within one year of completion, the owner will have the burden _ _ of proving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING /0.00 SMTP $0 1 O ❑ 1, as owner of the property, am exclusively contracting with L PERMIT S licensed contractors to construct the project (Section 7044, Business AND DUCTING 100,000+ BTU .& PERMIT PLAN CHECK $ and Professions Code: The Contractor's License Law does not apply to ISSUANCE S an owner of property who builds or improves thereon,and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant to SYSTEM GRADING $ the Contractor's License Law). 100,000+BTU PLAN CHECK $ ❑ I amexemptunder Section B.& P.C.for this BOILERS BTU ELECTRICAL $ -- - $ reason MICROFILM $ Date Owner SYSTEM REPAIR,ALTERATION PLAN CHECK S TOTAL FEE$ I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AD- information is correct. I agree to comply with all city and county ' PLAN CHECK ' $ 'VANCE PC $_ ordinances and state laws relating to construction,and hereby authorize representatives of this city to enter upon the above mentioned - - • prope r inspec5n 7pyypos-, gsf- - / _'4_p /7 OO , Sig ature • !/r/K.C�GtC�I..- Date VJ ! )-- FINAL FEE 5 Dri ors' dense or SS 1/ ISSUE FEE . . CMF 0865-46 White-Building; Canary-Applicant; Pink-Accounting;Goldenrod-Assessor CONSTRUCTION AND PLANNING - - POOL&SPA• . .. APPROVALS Permit# FM 0 Date Inspector APPROVALS Permit# `� Date Inspector ~ 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement- - - - . 3. Electrical Conduit Utility-Undrgrn ', _ --- - - _ 45. Forms . 4. Electrical Conduit-Undrgrn 46.- Electrical Bonding 5. Steel Reinforce J 47. Rough Plumbing & Pressure Test - 6. Electrical LIFER Grn _- _ _ 48. APPROVAL TO COVER-GUNITE- 7. .Footings - • __ - 49. Electrical Conduit-Undrgrn 8. Foundation . . 50. Gas Pipe, D Undrqrn,Test 9. Water Pipe-Undrgrn 51. Backwash Lines,P-Trap. 0 Undrgrn - 10. Structural Floor System 52. APPROVAL TO DECK . 11'.. Property Sewer•Line & House Connection - - 53: ': Backwash & Receptor-Final 12. Street Sewer Connection - 54. Heater& Vent-Final 13. Rough Plumbing 55. Plumbing System -Final 14. Rough Electric-Conduit • -56. Electrical-Final 15. Rough Electric-Wiring --- - ---.57. Solar System-Final 16. Rough Heating & Air Conditioning - bB. Fencing & Access Approval 17. Ducts, in Structure • 59. APPROVED FOR PLASTERING 18. Ducts, Ventilating • • - 19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing • ' 21. Roof Sheathing - 22. Frame and Flashing NOTES: 24. Insulation 24. Lathing& Siding - '14. � S- �'-�� 25. Drywall Nailing 26. Plaster Brown Coat ' . - 27. Electrical Power Meter-Final - 26. Final Electric 29. Final Heating & Air Conditioning • 30. Final Gas Pipe-Test - 31. Final Plumbing --" -- - - ,32. Water Service-Final . •'33. Gas Service-Final • 34. Solar Domestic-Final 35. 'Landscape Sprinkling System 36. Sound Attenuation . 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY • -No Date • I ; •• p c --- I -- ' ---- — I 2/E1 ./' a../tV .?i_A ' :� - -- 4 • So ,• Io, , 11 I If e • St Qs. c9 .� j1otaL , ` { s' --"C I i j �hH4H1-H 1 a --s .f _II --7.• - • eL't:> :Ye bn S£pt194 4'�•�/j �./ � .—_ - J 'I-• OF If-E-bEic `Q~C •US5'--Jw.yl�.,L��• '-�o i% _ . pR i fc fRP17JTs..- Off�' lilt ~1 tit .,f au • hi- Tr.. HR �� { 0 EHE fss,;-.... P4*.4 , nMEs ! iRT�!r r��D!, Rfa'JJR _ .f o I {. • o r' Hs = >soVu { £ifrJ�Ll• •'l n ,- �� 1� ��_ I J Of lA p`�.. , .-+, P • • /��?` r { 7f: - 1 IT-_ s 1 j ca U idJ h. y�'..., 1 ' �...F .? �_ • _ - r { 7 `�I. Ti�'l ! .I�' S MIN( 11 �l',9 .` �' I �F' VA! f 4_ r.71• I % Plat' TO 'i I lEIICA . 2 4E FAR AS CC { .,,,U;It l.Jl,_v R:1I14:to:4 1 1 jf..S1 I - I _� fptipnr_.tf.i, 4jr .. .i I �F '-1'�� . ��7 - _ _ T.If I1 bf ; 10; G-"!Ck ff it Ir --� -- .t flits, 1 2,7‘ fp TlIk I rJ H IT q I EXC L THT I.S;. n - �oFIOAF Sb U, ,,c AUTNUN Iq SO I - _ - t .,�, . ,ii' - - I f f I • I f rNOM 7NE SFS SHAL! N0l 'PtNIP yA'!k I Is !AN•F,UL. . I, f ( r- I T 4 _ - l I - { I j Bu ICU Fp P NST UUININUHr,10 :I La t1, _i. Va 4' - INO ��FFppAA NO SP r. 0, , Lc ,fy I __ I 0 PC�_41111 ' f arc .. _----- - I —i_.. PF.T n 4f� s'13HNC CANE f12S-'R/ fault �F iROES I� -^- j i Tj �)h: . NIS cU 9N WI Aqy QTERLU,IOFE IyNNO - i �, j' HFu dA�,.. FN r i . n J. ' 2i i ..J ; i I •n t\ < I " 17; .I,l i .. ;1;,/\ \ 4 fit j . t ! I . I" �%z I 1 _--- __--41---H-- ir ! ' 1 ,� l r BY . 1 • � .�, tc indica t4�j ✓q/lti ( ID/ COSTA MESA FIRE DEPT: 1 7 ` • BUREAU OF FIRE PREVENTION l COSITA LSA, CALIF. 1 ELIE 34 77 1 / BY > ' - A� . 1 I I; u I L: Cpprovol a;piie. to .la.a sub. I 1III� �„� 1 (^l ! _ cullod• and tot cous :ucticn indicatad t 1 TV - - _ _ thereon. Instailttion suLoct to £incl Snj. t • n arroctioa and acca;Y.ance. 1 �/ i \. J if, A tet •- c );' Vol:y::4, e9 04: 4c 4). .r4 G! ,, 6'p 4.1` 'V t 6- -N%'' �'.� .0 9A t9 o J' �-e` q d d �y< F P�0 yam\ AP cd2 IA i Ye r 9 d�OP II 3 OAA i ep 0,0',- nQ yqQ - 09el � /� PG9 yam- C* 1,,g'a . e* SEL �/ • 0 • -5 itik/1/4 LOALt. ArCC I .714 E -T1 a4t3 Eft- to €72-14.65 Zl��t,' I �\ ��NEulEcoNINaCTI®n1 ti STRUC1jJRAL APPROVFL ONL—YY � SPr nok I.e.,- /,I epa5 1l,, n SEPARAT-. PERM1 ARE tEQUIRED vie. oS+Y STEM vALvE Tv (i-e %z- GP-, Y.ce ��CUTiILbCr 6� ��„-, FOR ELECTp1., tya t f �e SSR INFO014w-7 HEAT i' VE':?'!^.Tf;11 AfIO 6, S -, ca,..�.a P FRIGERATION VI, ?,( {'hor¢ P r 7 re"--'- S K s-rem cb �.„.6. h.4,. , ---c-,—_ era's it # c) V ,_c-o/-aj ` HIS ill i IBER ,r, fi;:! 0?;,?ANY ALL NSPECIJU :;:21=STS • 3 S Pal Q IC Le.ft- - FOR BUIL BUGS ViIIiE,.0 PUS('JS ARE TO SPR1 N i4 St 5-Wit's, • DE EMPL NED, WE S ....1...5-1 THAT THE )4 Ams STATE C Lata 7,n .DI ISION OF + , INDUST�In ;:TED FOR d��9't1 ADDITIONAL REOUIDEMENTS. ----t _- 2- 31^ F tORAC E LAgLeg,1"� .. --....., • a P P k g V r-. t° KMJ� 0f Costa Mesa Building De t. �\� if ou Sl�E1 __ 6 /e6 .9 F'ILTEQS a TI-ESE PLANS MUST BE ON JOB AT AL : TIM I I gibe u l e LA7 • 9EI4IND MAKE NO CHANGES WITHOUT PRIOR Al Pt V, P ettili3F DE'Y. l ''4 I OF CP RI O Ic L_t1Z p 1 YA ISSUANCE OR GRANTING OF A PERMIT CR Ai [.OVALi. I-1 e.4 Ds ! IV 19 t t to\i ii- ovi ' OF PLA JS AND SPECIFICATIONS SI LL NCT l E C^YI "IED '�U O.T�{ 1 !S / = TO BE , PERMIT FOR. OR PN APPROVPL uF, I NY V ATI N BY OF ANY OF THE PROV:310L'S C: THIG COOL. 1.1 PERi`� PRE- COSTA MESA FIRE SEPT. SUMING TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE \ l ALT' '1.SPROVISIONS OF THIS CODE SHALL BE VALID, :XCEPT IN SO ` / BUREAU OF FIRE PREVENTILN FAR AS HE WORK OR USE WHICH IT AUTHORIZI S IS LAWFUL COSTA MESA, CAW. E ISSUANCE OF A PERMIT BASED UPC J PLANS AND PATE G - (L ,o Pd SPECIFICSTIONS SHALL NOT PREVENT THE BUILT INC OFFICIAL -+ �� (l.IA FROM TI EREAFTER REQUIRING THE CORRECTION OF ERRORS �DY IN SAW PLANS AND SPECIFICATIONS OR FROM PREVENTING �rII a sub- • !OPERATIONS BEING CARRIED ON THEREJNDER WHEN j.\OTE: :+,,P*Duel applie o DIN VIOLA"ION OF THIS CODE OR OF ANY OTHEF ORDINANCE "mined, and for conatnlctids iadicatod CF THE CITY. 7lhereon. installation euMett 'to 7ce1 10- �' _.._ Cnoc:':on end eccooteiko. I ,I 1 "AUTOMATIC" SPRINKLERS of the PACIFIC INC. -„r EXECUTIVE OFFICES 720 WEST 17th ST. manufacturers / engineers / installers COSTA MESA•CALIF. of approved fire protection devices LIBERTY 8-3445 SPRINKLER CONTRACTORS' INSPECTION OF - SPRINKLER EQUIPMENT AND UNDERGROUND PIPING SYSTEMS This inspection should be made by a representative of the owner of the property accompanied by a representative of the contractor. This blank should be filled out during the inspection. It should be signed by both In triplicate, one t copy to be kept by the owner, other copies to be sent to Superintendent of Installation for distribution to proper Inspec- tion Division. All defects noted should be corrected while the contractor's men are on the ground. It.is understood that the signing of this report by the representative of the owners In no way • prejudices any claim which they may have against the contractor for faulty material, poor workmanship, - or failure to comply with the requirements of the Insurance Companies or Local Ordinances. PROPERTY OF I f / /1 �� DATE STREET f `•"A(/AI'('/i-r/4S �j CITY 7.1_,--el �/A 7j y STATE OR PROVINCE l U -SV MITT , OR ACCEPTANCE'ACCEPTED BY (ORGANIZAT10N) DATE PLANSF NO `�� f :(J h UNDER— PIPE SIZE TO C PE AND CLASS OF PIPE USED CONNECTIONS Q� �� t� GROUND • I IN. FROM n YARD MAIN �'FRBLTCCMAIN ��//.,��1�JJJ /-G /v PIPE AND . TYPE OF JOINT ARE ALL FITTINGS �- HAVE PROPER CLEAR BEEN FITTINGS / PROPERLY STRAPPEDS ONO PROVIDED AT WALLS AND FOOTINGS, RISS-- ONO OR BACKED AND AT FLOORS IN EARTHQUAKE AREAS NUMBER INSTALLED TYPE AND MAKE ALL PROPERLY SET OYES f NO HYDRANTS PROVISION MADE FOR DRAINAGE ALL OPERATE SATISFACTORILY DYES f NO fn YES f NO Branches from existing or new underground mains to inside sprinklers shall be flushed out thoroughly before connecting the sprinkler riser. Where an outside underground piping system, Constitutes a part of an installation, such system shall be thoroughly flushed out under pressure at recommended flows through hydrants or blow-offs. It is the responsibility of the contractor installing the sprinklers to make certain that underground piping has been thoroughly flushed before connections are made to sprinkler risers. A flow of at least 150 Rpm. shall be established in 6-inch lines and smaller, a flow of at least 1000 gpm. in an 8-inch line; at least 1500 gpm. in a 10-inch line; and at least 2000 gpm. in a 12-Inch line. HAVE MAINS FOR SUPPLY TO NEW CONNECTIONS BEEN THOROUGHLY FLUSHED IN ACCORDANCE WITH THE SPRINKLER RULES n YES 0 NO UNDER HOW,WAS FLOW OBTAINED FOR FLUSHING MAINS THROUGH WHAT TYPE OPENING OTHER LFJ OR LIC WATER, TANK EFIRE PUMP nHYDT. BUTT PEN PIPE (SIZE Iv IN.) OR RESERVOIR GROUND HAVE LEAD-INS THEMSELVES BEEN THOROUGHLY E YES E NO PIPE FLUSHED IN ACCORDANCE WITH THE SPRINKLER RULES NOW WAS LOW OBTAINED FOR FLUSHING LEAD-INS - THROUGH WHAT Y-CO OSPIGOT FLANGE & OTHER FLUSHING P C WATER, TANK, FIRE PUMP TYPE OPENING R RESERVOIR-. I PEN PIPE (SIZE 114 IN.) AND Hydrostatic test should be made at not less than 200 lb. for two hours or 50 lb. above static pressure where static pressure is in excess of 150 lb. In systems with differential dry-pipe valves the clappers should be left open HYDROSTATIC during this test to prevent damage. LEAKAGE Underground mains should be tested before joints are covered. Water leakage through the joints should be measured by pumping at the specified test pressure from a calibrated container into the section of pipe being tested. TEST Care must be taken to expel all entrapped air and have the main completely full of water. Permissable leakage per 10 joints per hour is 2 1/2 quarts for 6-inch pipe, 3 1/4 quarts for 8-inch pipe, 4 quarts for 10-inch pipe, 5 quarts for 12-inch pipe, 8 1/2 quarts for 16-inch pipe, and 9 1/2 quarts for 20-inch pipe. ALL NEWUNDERGROUNDPIPINGIPHYDROSTATICALLY TESTED AT LB. FOR 7i HRS. PIPE SIZE 8 IN. 8 IN. 10 IN. 12 IN. 16 IN. 20 IN. NUMBER OF JOINTS /0 TOTAL AMOUNT OF LEAKAGE MEASURED IN HRS. GALS. QUARTS BUILDING EQUIPPED NO. OF SYSTEMS NO. OF SPRINKLERS MAKE .. JOEL (TOTAL) WET L IDRY h SPRINKLERS MARKING ON FRAME: DEFLECTOR: YEAR HIGH TEMPER .SPRINLJLE' - ' D INSTALLED HIGH TEMPERATURE AREA9NEAR UNIT HEAT RS A1N � OYES ONO OYES ONO BUILDINGS EQUIPPED V eiv ALARM C E a VES FLOW INDICATO'S(Vane type or others) NEW I( 7 y, ' NUMBER MAKE /:/ NUMBER / MAKE SPRINKLER ,.I ALL ALARMS LEFT IN SERVICE ALARMS MAXIMUM TIME TO OPERATE THROUGH SYSTEM TEST PIPE MIN. SEC Gams__ ONO BUILDINGS OR AREAS CONTROLLED MAKE AND MODEL IS INSTALLATION OFDRYDRY PIPE EQUIPMENT NUMBER COMPLETE .__ INSTALLED OYES ONO DRY BUILDINGS OR AREAS WHERE QUICK'-- `WERE_F.•M. APPROVED TRIMMINGS PROVIDED, PIPE OPENING DEVICES PROVIDED '- GAGES AUXILIARY DRAIN. ALARMS. ETC? OYES pi NO VALVES ON DRY PIPE VALVES — ---+________ TIME TO TRIP DRY PIPE WITH QUICK OPENING DEVICE WITHOUT QUICK OPENING DEVICE--WERE-SYSTEMS AND VALVE THROUGH I -IN. ALARMS LEFT IN O YES ONO SYSTEM TEST PIPE MIN. SEC. MIN. SEC. SERVICE . — BUILDINGS OR AREAS CONTROLLED NUMBER MAKE AND MODEL INSTALLED n DELUGELSYSTEM STEM SItQERVISED OPERATION DELUGE / HAS AN ACCESSIBLE HEAT RESPONSIVE DEVICE OYES ONO n es YES ONO O PNEUMATIC I�ELECTRIC BEEN PROVIDED IN EACH CIRCUIT FOR TESTING VALVES DOES DELUGE VALVE RELEASE MAXIMUM TIME IS INSTALCATION OF DELUGE EQUIPMENT COMPLETE. OPERATE FROM EACH CIRCUIT I IVES [1NO MIN. SEC.• YES ONO DOES DELUGE VALVE RELEASE WERE SYSTEMS AND ALARMS LEFT IN,SERVICE OPERATE FROM THE.MANUAL TRIP nYES []NO I I YES. I IMO AND/OR REMOTE CONTROL-STATIONS • Hydrostatic test should be made at no[ less than 200 1b. for 2 hours or 50 lb. above static pressure where static pressure is in excess of 150 lb. In systems with differential dry-pipe valves the clappers should be.left open during this test to prevent damage. SPRINKLER Dry pipe systems should also be tested at an initial air pressure of 90 lb. with loss not exceeding 1)1/2 lb. in 29 hours. SYSTEM Pressure tank tests should be made at normal water level and air pressure with loss not exceeding 1/21b.in 29 hours. • ALL NEW SPRINKLER OR WATER' SPRAY • TESTS PIPING HYDROSTATICALLY TESTED AT © /may LB. FOR �/ HRS. 6� (((�� AIR PRESSURE ATWHICH AIR PRESSURE LOSS PRESSURE TANK TESTED AT •- DRY SYSTEMTESSTED L9. IN 24 HRS. LB. LB. FOR HRS. IMPORTANT BLANK NUMBER USED LOCATION ALL REMOVED TESTING • I YES fNo GASKETS CONTROL WERE,ALL-14ITSCEFT WIDE OPEN DATE PROTECTION PERMANENTLY LEFT ON SYSTEM VALVES rYES 0 N HAS PERSON IN CHARGE OF FIRE EQUIPMENT B)E?( INSTHLITT£DQR TO / lai - INSTRUC— LOCATION OF CONTROL VALVES AND CARE OF THIS NEW EQUIPMENT: ES ONO TIONS .4.--- HAS A COPY OP INSTRUCTION AND MAINTENANCE CHART BEEN LEFT AT PLANT? EYES O NO V \l REMARKS . THE INFORMATION ON THOS FORM HAS BEEN EXAMINED AND THE INSPECTION AND TESTS HAVE BEEN WITNESSED BY: NAME OF SPRINKLER CONTRACTOR FOR PROPERTY OWNER (SIGNED) - /�.4-e- " �`y/ �r, :_ , . SIGNATURES / ,TITLE, FOR SPRINKLER CONT," TOR (SIGNED)' {� ✓ DATE'./ {q �/l' ''•cif I / 4 r . / / 1 F ? Ci' I 1V, ED ' • ``��TE OF TIMBe- F .:;4: 28 I W/6 • Aile DUKE TIMBER CONST. CO. CER IFICATE OFICENSIEE CONFORMANCE HE UNDERSIGNED MANUFACTURER HEREBY CERTIFIES that the products identified below and on attached sheets Nos. 1 and the principal mem- bers of which are marked with the Collective Mork of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC) were manufactured in conformance with applicable provisions of U. S. Commercial Standard, CS 253-63, for Structural Glued Laminated Timber, and that such manufac- ture has been at our plant in Saginaw, Oregon , which plant has a quality control system approved by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION and inspected periodically by such Bureau. The undersigned manufacturer further certifies that the work has been done in accordance with the applicable job specifications. JOB NAME: Hunsaker Buildings C & D (Duke Timber Construction Co. 93/ anOC R94// JOB LOCATION: Grace Laneosta Mesa California AlR 77 CUSTOMER'S ORDER NO. 2374 DATE 1127/72 MFGR'S ORDER NO. BWS-1337 LA..Loii!G SAFETY SAETf DEPT. iia1 1972 SIGNATURE ' Roy La 10coMPANY—L]HEI4_COGD_Sys TENS (]'s TITLEQuality Control DlrectorADDREss_Saginaw,, DrggQn DATE February 19,_1.912_ AITC HEREBY CERTIFIES that the said company at its said plant is licensed by the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect. of products which comply with applicable provisions of said Standard, that the adequacy of the quality control system in effect at said plant is periodically inspected and verified by the Inspection Bureau of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgment of the undersigned, said company is capable of complying with applicable manufactur- ing and testing provisions of said Standard in respect of products manufactured at said plant. Conformance with the Standard in respect of any specific or particular product is the sole responsi- bility of the manufacturer; AITC's guarantee hereunder being that the said company is qualified • to produce o product meeting the said Standard and that its plant is periodically inspected and verified by the AITC Inspection Bureau. .Oqp 1yAITC Certificate No. 9 316 2 Signed for ��►�!: ►`'� AMERICAN INSTITUTE OF TIMBER CONSTRUCTION �'[ ' �sa .1 , wits A. Executive Vice President Manager, Inspection Bureau 01970 AMERICAN INSTITUTE OF TIMBER CONSTRUCTION AITC FORM ID-I-TO The principal members of the job covere • this certificate are stamped with . one of the following type quality marks. L .i qualified plant has an individual - qualification designation. The designation"P-143" shown on the typical quality marks below is not assigned to any plant and is used only for the purpose of illustration. A TYPICAL CUSTOM PRODUCT QUALITY MARK . 4t %4 .r AITC designation of qualified licensed �' ' '�-�� ' Li"�� fi3 plant. is e•A _ r QUALITY 4 INSPECTED 9 CS 25343 Indicates that the designated licensed plant Indicates conformance to U.S. Corn- has met all requirements for qualification and " ' mercial'Standard for Structural Glued maintains an acceptable quality control sys- Laminated Timber. tern which is periodically inspected by AITC. A TYPICAL NON -CUSTOM PRODUCT QUALITY MARK AITC designation of qualified licensed • - " .Fr ( plant. • r• t a r r Designates type of adhesive, W for WET SPECIES USE or D for DRY USE. �UALITI' 000 RCH Name of wood species used. INSPECTED R CS 253-63 I Designates appearance grade. IND— Industrial. ARCH—Architectural. PREM —Premium. Indicates that the designated licensed plant Indicates conformance to U.S. Corn has met all requirements far qualification and mercial Standard for Structural Glued maintains an acceptable quality control sys- Laminated Timber. tern which is periodically inspected by AITC. Designates dry use stress. f—bending. t—tension. c—compression parallel to grain. P For a custom product the specifications covering the desired product are included in the plans and specifications. I> For non-custom products essential detail specifications are included on stamp. I' ECEIVED ' ET No. 1 FEB 28 1M ET NUMBER TOM TINUS R CUNST. CO. ITC Certificate of Conformance No. 93162 Dated 2/19/72 Job Name: Hunsaker Buildings C & D (Duke Timber Construction Co.) Job Location: Grace Lane, Costa Mesa, California Customer's Order No. 2374 Doted 1/27/72 Mfgr's Order No. BWS-1337 The following identifies the members and gives the basic specifications that were used on this job: Lumber Species: Douglas Fir Member Comhi- Adhesive APpear- Identi- Quantity Size nation Type ance Camber tication Grade B-1 4 5 1/8 x 18 x 29' 0" \2400F Casein Ind. 1 3/8" .CUTE OF TIM ♦� A s P" 171 co * o u' ' r of 1. Roy T,atoli Alit Licensed Plant No. zQ = Plant Quot�Yd' Co rol Supervisor U -T, Nib BOHEMIA WOOD SYSTEMS a February 19, 1972 • Company < i Date aUALI FIED,;r•w LICENSEE AITC Form 1B-235 0 1965 American Institute of Timber Construction SUPPLEMENTARY FIRESPRIN„KLERS INSPECTION REPORT OWNER: /2/7 I , I , ISSUANCE DATE: 4/070/ °JA ADDRESS: 77// A , PERMIT NO. : v4z63 f CNTRACTOR: /, VALUATION: $4 /� PERMIT FEE. $ 0� G h' �y�� /9 47i q-2- - C" p atiol .7z V 1 s2._„...f \_____'--___,_ s � ., `�� .. I ISM 2 f ' '`.9 l By 'Q Mr,Q v 1 — FAK NOP Ns /pt - DEpr Cy4H USr BF�.......DATEl v E /'/O /y 'Ild'nl�� OF PGAySISSOATJCE WIT UT JORIAr AEG T/ ... �� _V'lT.�`4 I_�`R.I',v'T. v OF Ally PSR../I sp... R�r TL.O OF R APPRO ALS -kfziwi.., � �- ; •� • -•./ / Sc /•G�o�� / rh (� N�MIT•crZE AST e / G; h0;., iAFRIS IJo0• c/Frfr/ R OSEL.h/1..,G BETE pR CARM�PT/ y F ICATI SOAN CN lr AGIp NCEG RE. l }' (J' 1 N SAID T0iNn!tiff?. �TAnc�yMIT BASEBBpRIZES 'SExcEP�F��pE HE IN l i.:�p , �-�70 1( OF THEC N OEA rfiN,C avo ciiR"uns OR q�ON00F FSOAGp E pk OF ANY ref UOR� HES +7E1441CS °"t;<"fpr C. City of Costa Mesa • 1. - o - -- 'Building safety Department - CERTIFICATE i O'F OCCUPANCY - ^ ,tty-. :2831: , P.O.Box 1200' t i Costa Mesa,California - y - • a The Building located at 3.v41 :n...m t.,.,,, .. - t -, has been inspected and found,to comply with the..prov.isions of all City of Costa Mesa Ordinances applicable,thereto for a Group -2 . - Occupancy. • - ° • -, Use of Building ''' 1t1 Unit Zndurcr-itat SStu1d145rr. . • -, _ _. ' Legal Description 141-221-15 0 17 (See reverse side for Metes and Bounds) ,, ,tBuilding Permit No ,s/t%e1, Electrical' Permit N t44ke • '+ ' 4 Plumbing Permit No. is. r-•'. 1 t'f` t ' - Number,of apartments Nand/or guest rooms - • • iu. " - • ISSU ED TO , ii Building Official : by s ,ar ;-1 9^rt;c CF. . , o kDate a .: . sc�7 This Certificate of Occupancy SHALL 66;posted in a conspicuousplace on the`premiaes and SHALL NOT BE removed except by the ' Building Official of the City of Costa Mesa under Sec. 306 (e1.U.B.C: , • - - '" • Form BU 34 Rev. 11/70' _. h .... - , „. OWNER ALAN SMITH' COMPANY DATE 3-6-79 JOB ADDRESS 2931 Grace Lane BUILDING PERMIT NO. GENERAL CONTRACTOR owner-uLAr, DESCRIPTION of WORK paint Spray Booth 0. 141-2_21-J7 LOT TRACT FIRE ZONE VALUE S 1,000.00 ID Signature Date TYPE Q GROUP F-2 ZONE M-1 s IL SUBCONTRACTOR PERMITS ISSUED GAS Date I Number I Signature / WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE i. HOUSE CON. D SPRINKLING SYSTEM I)'-$MISCELLANEOUS , ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND `�I� POWER tp ROUGH WIRING ❑ H)atQaq` � 1 TRENCHES I_J FORMS STEEL RE INF. n FLOOR SYSTEM BOND BEAM rl STEEL REINFORCE n SHEATHING FRAME AND FLASHING DATE, - SSG, Id__ LATHING — IN El OUT n PI '-TER. BROWN COAT S TURAL. FINAL EleCt[iC HEATING. VENT., REFRIG. AND A.C., FINAL PLUMBING. FINAL ANO GAS TEST n ELECTRIC. FINAL BIM DIue. FINAL 11 4.7 0.: e 04486 3/06/79 10.50 TL COSTA MESA BUILDING-SAFETY DEPARTMENT C P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only RECEIVED BY DATE RECEIVED D/•TE -i • %- BUILDING n p Cr 0« �G n C . .. _• �'/( ADDRESS /h ( /� //,.}- c -/. /` - r.1 OWN EC eT-IK.. / " /an .S.sr. /4) `a• A.P.NO./4/ 'O2/' /7 PER'ITN-.. . UILDING `�"G- !Gh c c _ ADDRESS 3/ / ' MAIL rI e/ 3 I ADDRESg�/"-�� (,j ,(� ADDRESS it TEL., 87 CITY Cor Q LOT BLOCK MYS4 NO. 74.r7/c/5 TRACT' CONSTRUCTIONNEW AD ALTER REPAIR MOVING DFMOLISH LENDER NO>` .. BRANCH t / +_/ da OWNER /LJ/rjJ�/ty/ ,rl ADDRESS w//�j, y [/ ,(,yet J • ARCHITECT TEL. USE ! �T/ / T /* ' /tom(/(/ OR ENGINEER NO. / FIRE �.� AD ZONE /PE , ROUP 22 ,,0 APPROVED e-6..--7. //_ �/) ONTR ACTOR pLUN'e V-- 17 V; ite-- BY DATE !6� /. / CCC I/ ADDRESS ZONE-/ INO.OF USE OF NEW TEL. (/// (PLANS Z BUILDING CITY TNO.E . STATE CITY YARDS APPROVED YARDS APPR ED I. LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING KI SIZE I NO.OF SLOGS. (FROM C/L STREET) 4.4 Gr OF LOT I NOW ON LOT FRONT T. //FT. Y USE OF ht'/ EXISTING BLDG. R SIDE /. FT. ', • _T Al 5 Separate permits are required for L161t'�2�1F welectric,plumbing and heating work. REAR FT.IP t . I V 4 FT. [..i USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& ., , }y / fit/ (X7 4 MAIN BLOCS. ACCESS.BLOCS. Q �/ \ QCI'NJ Cry D66 /ti. (Qx CUVARP.# Q /� APPROVED ./�•J� �> / - \ 7APPROVE DATE CJ—C-9 ! ..l _BYw� CL W 0 I hereby acknowledge that I have read this application and state n N 66 that the above information Is correct and agree to comply with a A, all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of m the State of California. m I hereby certify that I am properly licensed as a contractor under SO. FT. w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses ore In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE " am exempt from the provisions of the State of California Business l y and Professions Code, Division 3,Chapter VALUATION PERMIT FEE $/D I en Signature � PLAN CHECK $ C j,..�s U. a Permittee a P $ /nD TAX $ /) 62/'�/ / Aut •rued Agent •. TOTAL PAID $ ( ) OWNER HUNSAKER, S. V. DATE 4-20-72 JOB ADDRESS 2931 Grace Lane BUILDING PERMIT NO. 34597 GENERAL CONTRACTOR Automatic Sprinklers DESCRIPTION of WORK Fire Sprinklerc Jo. 141-221-16 &LOT TRACT FIRE ZONE VALUE $ 6.000.00 INSPECTIONS 77 Signature Dote GROUP TYPE ZONE SOIL SUBCONTRACTOR PERMITS ISSUED GAS Date Number I Signature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE ❑ HOUSE CON. D SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING Heating and Vent. TRENCHES 0 FORMS ❑ STEEL REINF. El FLOOR SYSTEM M BOND BEAM l l STEEL REINFORCE n SHEATHING FRAME AND FLASHING LATHING - IN n OUT n F ',TER, BROWN COAT CTURAL, FINAL Electric HEATING. VENT., REFRIG. AND A.C., FINAL^ PLUMBING, FINAL AND GAS TEST 1 1 ELECTRIC, FINAL ROII num FIueI CwsuSn ,J/lln.-.._ Al.',- ,n.. .. ..PSIDLa . . , S 34597• Pr, 21-72c�P O0 951* 32.x2 COSTA MESA BUILDING-SAFETY DEPARTMENT • P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely APPLICATION FOR BUILDING PERMIT RECEI gr D�[A�Gy E yECEIVED DATE ISSUED BUILDING — / —/-7J 1sJ 7 7- ADDRESS 2911 Grace Lane C M OO,� • /YjlG.�uV./0�// P�jMI 7 OWNER S.V. Hunsaker A.P.NO. "f MAIL BUILDING 9 Z ADDRESS P.O. Box 3820 ADDRESS I �I WU TEL. - TRACT LOT BLOCK I- Z CITY Fullerton, CalifND. CONSTRUCTIO NEW SOD ALTER REPAIR MOVING f1FMOl ISH Z - LENDER l;rocker Nat'l Bank /// J7 BRANCH Los AngelPC, Calif nr, • D J N p OWNER ,ele '�r /E��-.e[QP-/f) <,.. ADDRESS P.O. Box 60578, WInalAlVALUE J ` ARCHITECT AKen Helms & ASSn o. VSEL�2-f.L�l� �//1C�'.'��ivg $G/�4U U Q FIRE LCL ADDRESS 401 N. Brookhurst,Anaheim,Cki, ZONE - TYPE GROUP o.W W Z APPROV-,. / J Z CONTRACTOR I1 I a Ir_ II a • e i BY G _ DATE mZ the Pacific J cc ADDRESS 720 14_ 17th--St W W TEL. Z NO.OF USE OF NEW � _� CITY Costa Mesa. Calif. NO. PLANS BUILDING Z W o STATE CITY YARDS APP VED YARDS APPROVED LB O LIC. NO . 07rf 1855 LIC.NO.1 71 A MAIN BUILDI ACCESSORY BUILDING SIZE INO.OF BLOCS. (FROM CIL STREET) OF LOT NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG. R.SIDF FL FT, I- SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. • EXTERIOR WALL ROOF o COVERING [COVERING REAR FT. FL _ -- J USE OF BUILDING AND WORK TO BE PERFORMED r DISTANCE BET. BET. AIN& MAIN BLDGS. ACC .BLOCS. I VAR.# DATE O 3-'121;/H11 4/1 .. )rq�_4-1,i C.U.P.qy+ APPROV L. APPROVED C/) _gY DATE Z o TnTt VI hereby acknowledge that I have read this application and state / m 'that the above information is correct end agree to comply with 7f ix all laws regulating building construction, and I shall not employ t any person in violation of the workman's compensation laws of C/3 the State of California., TAX. m ? I hereby certify that I am properly licensed as a contractor under . FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR • Chapter 9, end that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: CC am exempt from the provisions of the State of California Business VALUATION 3�,oO� r-� +7 and Professions Code,Division 3,Chapter • fY 'C.r7$ g �� 6� D /) � PERMIT FEE $ r- D Signature of / / /// - of Permittee ' �� S 2 PLAN CHECK $ E r� .,-� 0 6,/ Authorized Agent / TOTAL � / '- sem Tl V ' 33768Pal , -i�.: ;n'.: CT7.771�,,. 4C ' 91 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 .� APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely 1. , RECE D B DATE RECEIVED • /' /0^t-7 7 ADDRESS „,i3/ _ /j: r /_A �-- 4 V . q // P.-MIT O. • ' ` A.P.NO. '--s"'i /-/OAF"'_ MAIL /� �7 nr i " _ ' Z ADDR�ESSS/�s�(7��,7E/�./_/,l �'/miffp /IIZ�'Ul .h . .s• r0_ U CI TY tj_412 4 J. 6?; l NOL Gf _• f �® zZ / C CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH O-N LENDER �O Ai a--- s am BRANCH J to ^ ' ' 1e' VCX--A G OWNER a ADDRESS O 3/ 1E b . al ARCHITECT TEL _ ._r.L .ti / $ r/ UOR ENGINEER . '�7/ i I Ne. A -6e0/ / W ADDRESS tib ® ii - 2 /.� / AdEr, a - GROUP d L J Z CONTRACTOR QCC/i(/b/L. i �� m Z 7.1,:c ADDRESS til w TEL ZONE NO.OF USE OF NEWrh-t 1 O= -721 PLANS BUILDING Z r CITY NO. / / /6 -O STATE CITY YARDS APPROVED YARDS APPROVE lil rn K LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING 0SIZE r (FROM C/L STREET)NO.OF BLDGS. +� �! &f b--far LOT /62k 2 Cp Ili 3 I NOW ON L07-0 �- FRONT 5/FT. �� 1O FT. • USE OF EXISTING BLDG. a C H.SIDE 46;T. FT. I- SIZE OF NO.OF Z NEW BLDG. /$7/ ) • ROOMS - STORIES — L.SIDE I FT. FT. U EXTERIOR WALL ROOF �� ' _ COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& MAIN BLDCS. ACCESS.BLOCS. O L/ /f Z" VAR.# DATE /GAI> Fln - 6.4.c 7cr- ait/ C.U.P.V#p (� APPROVED/ �J I- N / DAPPV Ds-1 •C�.S.77 DATE J/ .I-- / Z U I hereby acknowledge that I have read this application and state rte" .L A=.--"--- T�.. c-e� 4L, D that the above information is correct and agree to comply with t.�C CC all taws regulating building construction, and I shall not employ I- any person in violation of the workman's compensation laws of Rgr21tIREb E V.-- Ch the State of California. s�jr/ •FQ� FOR SYCCtAL m. d m�} , Z I hereby certify that I am properly licensed as a contractor under SD. O the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ' Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: AIL am exempt from the provisions of the State of California Business VALUATION and Professions Code, Division 3,Chapter 9. PERMIT FEE $ 7 Signature of / ) m Permittee �`� 1. $//6 i. PLAN CHECK $ / E �� o Authorized Agent U. TOTAL FEE $ — . — ►' • 33768 ''EC it!-7',T 00 65 I cv' - S Sn,,- COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill/n Completely RECEIVED BY DATE RECEIVED DATE ISSU D'J' ADDRESS 2931 Grace Ln., Bldg. C. Units rO�'� / PERMIT D. OWNER Sim Hunsaker ACJ AP NO•141=221-16 & 17 13760 MAIL BUILDING Z . ADDRESS ADDRESS W W TEL.U CITY NO. TRACT LOT BLOCK 1—Q CONSTRUCTION NEW ADD ALTER REPAIR MOVING DFMOI ISH O N LENDER J,j 0 BRANCH J n OWNER Q ADDRESS a VALUE J ARCHITECT TEL. USE $ OR ENGINEER NO. U n FIRE WQ ZONE TYPE GROUP 4 ADDRESS 0.W W Z APPROVED J U CONTRACTOR Owner—Bldr. By DATE CO J ¢ ADDRESS W W TEL. ZONE NO.OF USE OF NEW 0 r CITY NO. PLANS BUILDING Z H W 0 STATE CITY YARDS APPROVED YARDS APPROVED to CC LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 0 0 I (FROM C/L STREET) SIZENOF BLDGS, OF LOT IO,NOW ON LOT FRONT FT. FT. USE OF EXISTING BLDG, R SIDE FT. FT, h SIZE OF NO.OF Z NEW BLDG. ROOMS STORIES L.SIDE FT. FT. ✓ EXTERIOR WALL ROOF , _ COVERING COVERING REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& MAIN BLOCS. ACCESS.BLOCS. c.. VAR.# DATE O 10 Unit Light Mfg.Bldg. C.U.P.# APPROVED H APPROVED V) ' RY DATE Z 0 U I hereby acknowledge that I have read this application and state ✓ that the above information is correct and agree to comply with CC all laws regulating building construction, and I shall not employ I— any person in violation of the workman's compensation laws of (/) the State of California. co 111) ZI hereby certify that I am properly licensed as a contractor under SQ. FT. 0 the State of California Business and Professions Code, Divisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR 5 Chapter 9, and that such licenses Bre in full force and effect,or I _ THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: rt am exempt from the provisions of the State of California Business and Professions Code, Division 3,Chapter 9. VALUATIONco PERMIT FEE $ 336.50 ci Signature of m Permittee $ —0— PLAN CHECK $ E `o IL Authorized Agent TOTAL FEE $ 336.50 45423 COSTA MESA BUILDING-SAFETY DEPARTMENT 4982 1/30/78 1 5050 TL s P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP:LI•-'• •N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only REC +5. l DATE RECEIVED �yU�� BUILDING �9Z / A /+� J[n& l ( I /-/j� ADDRESS 1r J 17r1 rs li /✓ rvNUC-RaON • AP ND ZZ� '� PERMIT NO. OWNER &ARO/I-EIC. PRIu rw& s M 4i kw& cooSY" —/ MAIL BUILDING /)9 a/ A{7},6 c&- ADDRESS X93 / RG/Za-c C B ��/ ADDRELDINSS X11 -i CITY LG Sra_ �1E3,4 TNO. 'f/C7//,. d cj TRACT.1 ?g lLOT .7 BLOCK CONSTRUCTION NEW ADD1 ALTER REPAIR MOVING DFMCII ICH LENDER I/\X/l BRANCHaze- anomie 1- ,]�///, /IJ OWNE i��1��CE�-' _ _ /, ADDRESS ""-- ^ ..Tied '^�` �(�,LUE �]�fjf ARCHITECT TEL. ._- USE (•/[J vQpr�.$ S /fV(J OR ENGINEER NO � FIREel ADDRESS ZONE VP �G ROUPF i� re �`�`�ffJ/K/T/ /LLD�IU• l BPPROVED ��/ CONTRACTOR BV DATEf Q ADDRESS ZONE0/ NO.OF USE OF NEW s TEL. / PLANS BUILDING �� CITY NO. ► STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE (NO.OF BLDGS. (FROM C/L STREET/ 0. OF LOT NOW ON LOT FRONT FT. _ FT. Q USE OF CA EXISTING BLDG. R SIDE 1010 FT. CA 1 I^S• Separate permits are required for • L.SIDE FT. ( FT. electric,plumbing and heating work. W - REAR FT. FT. I.v USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN Si PieIwrLAt/G- i--Al A!Gifl/C- MAIN BLOCS. ACCESS.BLOGS. \ , I. ,/ p VAR.# DATE • 7 1" ti J DOO ftS (I.U _/ A) /HRCT!?l O� C.U.P.¢�s ..11 APPROVED/ R ).. /.i/4s.-,- 2 130/2'A-0 APPROVEy,.r� �ty DATE r �0'�V .-I 4fL�SV/ CL W O I hereby acknowledge that I have read this application and state n N Lthat the above Information Is correct and agree to comply with -- all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of 2 SSW the State of California. m 3 I hereby card,y that I am properly licensed as a contractor under SO. FT. tv the State of California Business end Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, end that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: to am exempt from the provisions of the ate of California Business VALUATION PERMIT FEE 5 and Professions oe,Division 3�, /. / rt.? C. n Signature .1 / PLAN CHECK S 'n SC -ore 0 Permittee 4.4.416,4_2.4. It ., ,J. I%_— TAX S U. D Authorized 'gent TOTAL PAID S - •_ //