HomeMy WebLinkAbout3047 LOYSBURG BAY - Building Permits AYApplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA PERMIT N �� TRA LOT nlo.. BL No. 069$ 6Y21 ("4:3,-- T 31 ce51_ ' it
• CONSTRUCTION PERMIT s, 11✓2)7 l •
, Applicant's Mailing A`dn• /� ,' ■ K v r1 I / TYPE OF CONSTRUCTION NEW LJ ADD LI ALTERATION ;REPAIR - • . 1 _ -�
Project Address L ❑ CONVERSION ❑ DEM•LI ; - _ '
Owner's Na /yam ,'/�•���jV�//�'� r- /� /� 1�/ DESCRIPTION OF WORK /r . 1 I ._ , 'ZONING REGULATIONS •.------ ,
Address _ • 1#k'_f47s/i� 'iI4' !. 4 ?i!l%.�/ i VK r `u ui •- ZONE • �- ^ i
,'�s^^�� err • . ' PE OF PERMIT LI GRADING v FOUNDATION I/STRUCTURAL A.P:9W 1-17 .
Arch/Eng. ' �'1\ as +✓��it n�'s'e,�N/�p �� 1-1
L-• ELECTRICAL; ID PLUMBING ❑ MECHANICALL Esq 1'x/7 BUILDING '
'ye /Y, 1 1 le ' of / - PLNG. REF.* 7N: / I�IYI} �� •
Address ` ' � •�'/ /�' ❑,OTHER ' ' - .BUILDING
rill er .- ��
TO BUILDING n •
Ir. .je r PR•PE: V .INE 0 r REAR YARD (TO P/L) I1 -
Contra*r's Nam:' i ge •Phone a a PROJECT DESCRIPTION .S OCCUPAN(Q...Vy'� -
CON STRUC O VPF VALUE TION$ ✓ ( LEFT SIDE YARD/If el ,.b1e •IGHT SIDE YARD OfaL• fd
Address(mailing) ' flu�- - � ,
License No. __ - - I ZONE GRADING CU.YDS. F�� 'ACRES PKG.SPACE REO. /') d I PROVIDED 0
// .�[/v .:/t
• s i d •J ( lJl/ UY LiJV
LICENSED CONTRACTOR DECLARATION IRemarks: • 1 STREET WIDTH -..531PARK FEE$ a8 I :5/
I hereby'affirm that I am licensed under provisions of Charter-9(commencing
with section 7000) of Division 3 of the Business and Professions Code,and . - SPECIAL CONDITIONS: r n Cl'4Vtl s ' -
my license is In full force and effect. I IwoFO St ECTAL P.,;`.� is
• ' lr
License Class' '" License No. ' PLUMBING 1
Date 1 • Signature -
WORKERS'COMPENSATION DECLARATION 1 Bar Sink i Sewer Cep'" , ELECTRICAL 1; •
-hereby affirm that I have a.cartlflcate of consent to self-insure or a certificate Automatic Washer_ 'Meter Dover 100 amps• - J
Workers' Compensation Insurance,'or a Certified'copy thereof (Section Backflow Preventer 'Sewer Connections - - - - ,�
I - - Construction Pole
.00, Lab. C.) Backflow Irrigation Solar Collectors' Sub. Panel' ! -
cy No, Company .. .. _.. f
c�kpi70wi Certifletl copy is hereby furnished •
, , Bathtubs - Solar Piping ' Cooking Unit Sub Pole -
LJ Certified copy is filed with the'city.Building Division. - - , •-
Clerifiers_ Solar Tank - Dishwasher Motors 00-1 HP/01X$ 4. •
?'-
Date Applicant _ __ _ ___ r -
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION - Dryers ❑Gas ❑Electric - Inc' Solar 09-15 HP 016-15+-
(This section need not.be completed if the permit Is for one hundred (f100)or Dishwasher Swimming Pool iv/Spa '?
less),. • - - '.f,:. Fan; , ' Microwave - •' +
I certify that In the performance of the work for which this permit is issued I ' Drinking Fountains Urinal - s - ! •.-
.
shall not employ any person In any manner so as to become subject.to the . - - F.Alt , Pole Light
Workers'.Compensation Laws of California.l Floor Drains j Water Closet _ 1 ' 9 -•
Date Signature - - - Fixtures
NOTICE:If;after making this declaration,you should become subject to the Floor Sinks i -- -- - Water-Heater - , — - - - i-- - - -- - - - _ Range _ . .
Workers', Compensation provisions of the Labor Code, you must forthwith - - - - •
. comply .with" such provisions-or this;permit shall be'deemed revoked-; • Ga•
s Service: • Outlets Water SerSice - l I Device Boxes r Sign • I I •! ,
CONSTRUCTION,LENDING AGENCY ' I ,
I hereby affirm that there is a construction,lending agency-for the,performance ' Interceptors -� . Outlets • , Standing Sections
• of the work for which this, permit'is issued ( :coon .3097 Civ. C.). _
Lender's Name. - J 1 '• i ' �' t • Kitchen Sink " - Switches Trash Compactor ••
Lender's Atldress• f1 s lit PI .44.•-.21 .tel -
OWNER BUILDER 0 CLARA ON j - Lavatories . .• Garbage Disposal ,
I hereby affirm that I am exempt from the Contractor's License Law for the - , Generator 00-5 KW 05-15 KW '
following reason (Section 7031.5 Business and Professional Code: Any city or P-Trap • , - _ , - '
county which requires a permit to construct',alter Improve;demolish or repair _ 1 ._ - , . - Transformer 075-50 KW -
any structure, prior to its issuance,'also requires the'applicant'for such permit Roof Drains, - - 4
to file a signed statementthat he/she is licensed pursuant to the provisions of ' ' - ' 050+KW, -
- the Contractor's License Law(Chapter 9(commencing with Section 7000)of - '- - ,Reinspection Fee $15
Oivision13-of the Business and.Professions Code) or that he/she,-is exempt , Showers . - • - •
r Reinspection,Fee $15 - -
r, efrom and the basis for the alleged exemption:Any violation of Section - - - Meter Dup to 100 amps 1 1 Issue Fee ' • ' •$ 3
1.5 by any applicant for a'permit subjects the'applicant to a.civil i __ _
°laity of not more than five hundred dollars($500): `• (Service Sink Issue Fee• ' $ 3 Zoning Approved By - ()hen l 'Date -
❑ I,:as owner of the property or'm'y employees with wages'as their sole '
compensation will do the work',and the structure is not Intended or offered ; • ' .. , MECHANICAL , Application Approved By 'Date M%
for sale (Section Business'an and Prf a oCode: The;Contractor's - -- --- • - --- --- - . i -
License Law does not apply to an owner of a property who builds or improves Boiler Refrigeration System Application Issued ByG
thereon, and who does such work himself/herself or through his or her own , _ ' PP •- Data / e
employees, provided that such Improvements issoit Intended or offered for i - 04100,000 BTU ❑700,000 BTU
sale. If, however,the building or Improvement sold within one' build f r Im- , , Duct;Under Ground , j 1 + SUMMARY OF FEES '
! ion, the purpose o have the Durtlan o/proving he/she did not Duild or Im- , I ! , 1
ve for the purpose of sale). Duct-Structural I System Repair/Alteration BUILDING PERMIT $ 3 O,— SMTP $
1,as owner of the property, am exclusively contracting with licensed con- ' - i
r tors to construct the project (Section 7044,.Business,antl Professlons,Cotle:_;. . Duct-Ventilating PLAN CHECK • $' 1 /. Sa PERMIT
The Contractor's License Law does not apply to an owner of property who - ISSUANCE ' $
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 PLUMBING - $ • .
tractor(s) license pursuant to the Contractor's License Law). - .PLAN CHECK* GRADING $
0.1amexempt under Section B.6 P.C.for this reason Firepi/Fact.Bit. ICBO 4 i i $ i )
• ELECTRICAL' - - ' $
Date - -- Owner - - Heating System&Ducting , $' MICROFILM $ '
I hereby-certify that I'have-read-this application and state that the above- --00.100,000 BTU 0100,000BTLT - - - --t f ,PLAN CHECK $ 1 j l
information Is correct, agree to comply with all city.and county ordinances , _ 11 ,• ' TOTAL-FEE I $
and-state laws rel ting o bulldIng construction,'and hereby auttori e repro- , MECHANICAL : Si. • ,
sentatives of this •ty to enter upon the above-mentions• Y•p for Hood or Type I ❑, Reinspection Fee $15 jDi Al. CHECK. LESS
inspection Durpos:E. - / U a. Canopy. Type II ❑• $: '
Signature /_vim Dat , , • t , ADVANCED'PC i $ 1 ,
Drivers' License.• � Registers Issue Fee $ 3 FINAL FEE $ j 3/r :51
CMF 0865-46 rev. White-Builtling:Canary-Applicant;Pink-Accounting;Goldenrod-Assessor
_ .. -- --- _ . - - - - -- --- - -
-
_2 •:;CONSTRUCTION AND PLANNING -•1 is :•?'x - nF -n _-. r - -; POOL A
• - ,-v_'
APPROVALS -7 Permit# n - - ' :. •Date - Inspector •?APPROVALS' - Permit# r_ if Date Inspector
1' Temporary,Electrical Service orrPole 1 :+< :i, r c ?° ' . - 52: Pool & Equipment'Location ': - ;
:�2: (Soil Pipe-Undrgrnd- y ; r_ �o_ ? E , `-y 1.:. _ , 53: Steel Reinforcement' '- -
•
3: Electrical Conduit Utility Undrgrnd! ; no ' - 5 - - 54- Forms ; ; - - - _ -ti ^ ' a
c. 4': Electrical Conduit-Undrgrnd > - ' c ::; �' :651-: Electrical Bondin - ' -
5: Steel,Reinforcement- `- t; ,j: . t: , I , 56., Rough Plumbing & Pressure-Test •`` ' -
6. jElectrical.UF.ERGrnd. , 4-2 • I ` 5 o p_ - 57': APP.ROVALT000VER-GUNITE-
7.-Footings ' - _ o ' I I1. • ,^ , • 58?_Electrical'Conduit-Undrarnri-
8. Foundation C.' ' I , I I s E 59. GasiPipe; O.Undrgrnd:;Test
9,-Water•.Pi'pe-Undrgrnd. j 1 ,' ° 1 ' iq '. Es: v60. Backwasli'Lines,P-Trap, 0 Undrgrnd. _ r. ,
10.-Structural Floo or by 3 I '' r'-1 7- , 61. APPROVAL TO DECK - ' - '
11. Property Sewer-line&iHouse Connection; - 4` I 62. Backwash &-Receptor-Final : .
12.5ewerCap ;' ,'63. Heater&_Vent-Final .
13. "Roof Drains ^i ' ' ' 'e- „ '_64. Plumbing System - Final . - - •'
14. Rough'Plumbing .7 oG ' ' x•65. Elecirical-Final - - - '
15`. Rough:Electrical-Conduit'; i ---I I i •66-'Solar •System-Final • •
ii6-Rough Eleciric.Wiring) -l ` 1 j"_-, .�-..a._ _,_•_ r, _ _
e „ iR ,., _ „ '" I r -,I _ •
_. f 67. Fencing&-Access Approval .I.
If17- •Rough•Wiririg'Sign, ' r•r ' I ,t 11 ` I•- !i ! 1 , i ,I I '' 681 APPROVED FOR PLASTERING _ i
I'18. RoughElectriral`T;Ba`r Ceiling' '( ( ; j i i I - 1 '69. POOL/SPA SYSTEMS FINAL • ' : I - I
I 19: Rough Heating& AirConditioning I ': j ! I I r I I I I FIRE DEPT. REQUIREMENT _
I I I I . I
70. ;Rough,Factory Fireplace I I i 11 ! I I 1 I i APPROVALS 1 Permit.# -
�+ 21. ;Ducts,in Structure , ' 1 D - II 1 i70.1 Underground Hydro
;22. Ducts, Ventilating I -. ! I d 1 1 ! i I I 71. Product Piping 0 Gas OOiI - '
t- 1:23. Gas Pipe-Rough& Test ° , 'iT y 1 t I 1 { 72J Underground Flush_ ,
i
• 1.24, 'Roof Framing* __l,.-• ' i 1s I,; I.. 1 rh I s I^, : ' - i s 73r Undergrnd.Storage Tank•❑Gas 0 Oil '
_ 25_Roof Sheathing ,' . ; ; '- I ^ ); ,_ - t : '74: Overhead Hydro
',-26- T-Ba"r•Ceiling (Structural),& Mono'coaf j CI '.' ' 'It I 'I ,,75. Dry Chemical I _ - -
27...tFramrand Flashings :,�; • , ' S I I'J-/�d 176., Dry Standpipe `
261Lathi99 & Sidmg' n , 'j i I I + 1 97. FIXED SYSTEM FINAL
e 29.,,:Insulauon =, q '. Sr; 1 1 I , I 478. FIRE PREV. FINAL ,
31. Plaster`Brown Coat I ;Notes) •
30. Drywall Nailing ' y _" ! I I /���� �� _- - - - -'_ - _ _- - -
, l I II III I 1 ! I ' I I I • ,
t. N . .f ; .. , I I I I I I t I !
%I 32.;Electrical Power Meter-Final i i� 1 , 1 I I I 1 - '
I ' I I 1 11 I 1 1_; j I I ! I 1 , j 1 , . I I `
33. Final Electric _ _ _ _ _ _
34, Final Heating&Air Conditioning „ I ; I H • ' l 1 ' Y I
35. Final Gas Pipe= ^Test ' l ti ; '`_ ; : .I I I l - -- : i j a - -
36. Hood or CanopY- ` ; I ^! Ji , , ' I - I - -
•
37. Final Factory Fireplaces t ! ril 1! : , I ' I i .� I , I I - - -. ' _ '
36. Final PlumbingF
1 sF' .. i
' I
39. Water Service-Final, ; I I I . - ,
1 I
40. Gas Service-Final , I 1 1 i I ! t I i I •. _ I
11 1 •
41. Solar Domestic-Final-.; I I •• " i- . - -. --'- ,_ _ __ - __I_- _- - •
ry, 1 • t- 1
•
42. BackfloW'Preventer, I , I_- .- - 4 _ _ - .,�_ ___! _- - - ! I- , -
r Vii . _l . -, - I p - ,
43. Backflpw,Irrigation' •i; i ;I: f 1-' i i-' Ii ^; :: r I . I "
-.ILL i -a i r -• - 1 I
44- Landscape Irrigation.SYstem I ;-k,. ;,aid I _ z. I,? ' `, I , '•i r" ..
I
45. Sound ILI I II I I I` '_'' I i ^1I I " • '
r - II "
.- • 1- r I
46. HandicaPlRegulatio s''I jl 1- is ;
47. FINAL STRUCTURE&& BUILDING It I - /t �q,�l , \ i I . 1 ,T '
a+l (A () 1 r
48. Special Requirements Completed Completed ���`/ ;�// �//L I i I 1
ill%
49. Electric Releaselto Edison) .1 I_ n_., T_, ___!.. ....1.2 I_ i_1 4__ _1 _I __ _- .`i • '
50. Gas Release to Southern California Gas Co I 1 I , I I : ! ! 1. !
7,.
51. CERTIFI,1�/ I CUPANCY -i -1.--
- j -Is - _J
CATQEOFOC /' / C' �. `1
No 6 /',. Date I 79e>1' - - ---- -- ---- - -
t - Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. Y
CITY OF COSTA MESA PERMIT NO • TRACT NO• . LOT NO. BLDG.NO.
CONSTRUCTION PERMIT p 7S9 9 J
I
.Applicants Mailing Address ' )X SeG '• TYPE OF CONSTRUCTION VI NEW U ADD U ALTERATION- U'REPAIR • Q7U6 E/`Ijy 3 -
ProjectAddress a [ '�� ,. a - r// - [17 CONVERSION ❑ DEMOLISH ❑ OTHER • 0C.; . TL
LO 97 g 33/0 DESCRIPTION OF WORK
Owner's,Name TIME? Ph• e ZONING REGULATIONS
�cl�il�
s� Addfe3s I��A1 rTy Klan TYPE OF PERMIT UGRADING' UFOUNDATION ❑ STRUCTURAL A.P.116 , • ZONE -
N�• Arch/Eng. _ License No. • _ 0 TENANT 0 ELECTRICAL pi-PLUMBING•• 0 MECHANICAL PLNG. REF.9W, -BUILDING _
'0 OTHER - _ erTanrx C/s el" -
Address ;/ TO BUILDING
Contractor's Name A/ � ✓� 1 �J�„,L 'Phone�3/7q%���/ PROJECT DESCRIPTION SQ.FT. OCCUPANCY PROPERTY LINE - REAR YARD(TO P/U
Address(mailing) ; -I'O/�187 v'„"'Un . '�C(/A'1V CONSTRUCTION TVPF .VALUATION$ , • LEFT SIDE YARD RIGHT SIDE YARD
&Sv (� ZONE • GRADING CU.VOS. ' ACRFS ' PKG.SPACE'REQ. • PROVIDED ' -
License No. . .
LICENSED CONTRACTOR DECLARATION .
Remarks: 75.4/, STREET WIDTH PARK FEE$
I hereby affirm that I am licensed under provisions of Charter 9(commenting
with section 7000) of Division 3 of the Business and Professions Code,and I SPECIAL CONDITIONS:
, my license-is In full force and effect. .� - - ' • I
License Class_ -'a(0 n. License N . L(.,./I. O . PLUMBING .1
Date /p'/�-n� Signature y"' /� -+`� -P/1VJr 0�!/.t� Bar Sink Sewer Cap ELECTRICAL
•
WORKERS'COMPENSATION DECLARATION , • - - -
A!jlereby.affirm.that I have a certificate of consent to self-insure.or a certificate" Backflow Preventer-- - / Sewer Connection -- - '.07 - Automatic Washer Meter ❑over 100 amps '- _-
�,'Workers' Compensation Insurance, or a certified'copy thereof (Section _ ,
:t100, Lab. CS ''/4 ,s� Backflow Irrigation Solar Collectors • Construction Pole ,Sub Panel
• Policy No. /��%1- /��`7r/ Company II J I SSIUn - '- Cooking Unit - Sub Pole
9ACertified copy Is hereby TurnIshetl. I I • ) , J , �„Bathtubs Solar Piping , — ' - I
F� certified cagy s.Iletl with the city Building Division. y �',���' Dishwasher ,Motors ❑01 HP ❑1:SA 1 i
_Data LO'/n� � AppllcBnt I AYn,i Y�AiCJ 7� (Y�IC 'fwl" Clerifier_s I Solar Tank I
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION J - •
- Dryers ❑Gas ❑Electfic Inc Solar'❑9-15 HP ❑16-15+
(This section need.not be completed IT the permit is for,one hundred ($10 ))or; ; J Dishwasher , Swimming Pool w/Spa . a
less), l ; i Fan I Microwave ' •• •
I certify that in the performance of the work for which this permit Is Issued•i , Drinking Fountains , Urinal , ,
, shah,not employ,any person In any manner so•as to become subject to the - • FAU. i P010 Light Workers' Compensation Laws of California, , , I I ' Floor Drains' ' // Water Closet "^. 9
Date Signature , f/ - .
NOTICE:11,-after this provisions_of
should become subject to the-, - a- Floor Sinks-. 1. - - - • Water-Heater -- •-- Fixtures
Workers'. Compensation provisions_of the Labor, Code, you must forthwith.
comply with! such provisions or this-permit ,shall be'deemed revoketl. Gas Service, 'Outle`ts' —Water S¢rvicl! Device Boxes :Sign, 4
CONSTRUCTION'LENDING AGENCY • - Outlets '
I hereby affirm that there Is a construction lending agency for the performance, Interceptors T -• . - i .-, " - . Standing Sections '
of the work for which this permit -is issued (Section 3097 Civ: CJ - - Switches ' '
Lender's Name.• - - ' - - -I Kitchen Sink' - - , , t ,Trash Compactor I ,
Lender's Address I - '-' i r 1 - I - - t / Garbage Disposal • '
OWNER BUILDER DECLARATION' ' Lavatories , - , f0
I hereby affirm that I am exempt from the Contractor's License Law for the P-Tra , . - Generator 00-5 KW ❑5-15 KW '
following reason.(Section 7031.5 Business and Professional•Oode: Any city or p .
county which requires a permit to construct,alter Improve,demolish.or repair ' - - - . . _ .. 1 ,� _ Transformer Ell KW I
any structure, prior to Its Issuance, also requires the applicant for such permit . - Roof Drains ' , -
•
to file a signed statement that he/she Is licensed pursuant to the'provisions of ' • - . ' ❑5U+KW' 1 •
the Contractor's License Law(Chapter 9(commencing with Section 7000)of - , Reinspection Fee - $15'
,Ivision 3 of the Business and Professions Code)-or that he/she is exempt Showers -• ' Reinspection Fee . $15 - '
-;f:fefrom and the basis for the alleged exemption. Any violation of Section ( - - Meter ❑up to 100 amps Issue Fee .$ 3.
,�"y..f1.5 by any applicant for' a•permit subjects 'the applicant to, a-civil . -__ -_ .
"'laity of not more than five hundred dollars($500). , Service Sink. - . _ Issue Fee $ 3 Zoning Approved By I Date ,
I, as owner of the;property or my employees with wages as their sole i MECHANICAL - .
compensation will do the work,and the —structure is not intended or offered _ , -• - t I , . Application Approved By nate •
for sale (Sec/ion 7044, Business and Professional Code:'The Contractor's - v
License Law does not apply to an owner of a property who builds or improves ' ' Boiler .- Refrigeration System , . '.`/ I • . / %7-c'3
•
thereon,.and who does;such work himself/herself or through his or her own - - I Application Issued By Date O
• employees, provided that such Improvements are not intended or offered for Duct=Under Ground ' ❑0,100,000 BTU 0100,000 BTU': -
sale- If, however,the building or Improvement is sold within one year of corn- . • I ; ' SUMMARY OF FEES •
pletlon, the owner'will have the burden of proving he/She did not build or im-
r.rove for the purpose of sale). ' - ' Duct-Structural System Repair/Alteration 'BUILDING PERMIT $' , SMTP ; $ '
LJ I, as owner of the property,am exclusively contracting,with.licensed con-
tractorsto.construct the project(Section 7044,Business and Professions Code: - Duct-Ventilating _•_ _ _ _ _ _ PLAN CHECK l $ ' PERMIT
The Contractor's License Law does not apply to an owner of property who ' ;PLUMBING u�$ ISSUANCE I $
builds or improves thereon,and who contracts for such projects with a con- • Exhaust System 0 Multiple 0 .�
tractor(s) license pursuant to the Contractor's License Law). ' - - • s�PLAN CHECK, $ . GRADING , ' $ '
❑ Lam exempt under Section a& P.C.for this reason Firepl/Fact.Blt. ICBG# •- i
' - 1 ELECTRICAL ' $ ( $
Date Owner• i - j ' Heating System& Ducting , , i $ ;
-I 'herebycertify that I.have read-thls application and state that'the above' - -(- ❑0100,000 BTU ❑100,000BTL - - - - - ---• PLAN CHECK- l $ MICROFILM
' Information is correct. I agree to comply with all city-and county ordinances , ' , - ; TOTAL-FEE
andstatelaws relating to building construction, and hereby authorize repre- , 'MECHANICAL I $ • - I ' $ .
sentative5 of this city'to enter•apo the ab ve-me tinned property ,for Hood or Type I ❑. j I .
? I q _ , Reinspection,Fee, $15 I LESS ,
InspectlOn purposel ,-//q/ / • Canopy Type II ❑ i ;PLAN CHECK I $, ADVANCED PC ; $
Signature , i )X.X. (i �j�Date --/11 '�� i - 1 I s s 1
Drivers' License or SS 9f . • i Registers ' • ; Issue Fee - - $ 3 I FINAL FEE' ' $ •3 3L
CMF 0865-46 rev,12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - '-
`- CONSTRUCTION AND%PLANNING . t: , -:i f; . - POOL
- C' K r o •r '- " P _ a :!Date - it',Inspector - - - - ;Date • Inspector
?;APPROVALS Permit# -APPROVALS: 'Permit#
1; Temporary Electrical Service or.Pole ',.-: : ° ' ^ ' _- ''';`•: I. 52 Pool & Equipment Location ' - -
0- 2t (Soil Pipe-Undrgrnd.= g I s.-2 c. ; t° emsti ' 533 Steel Reinforcement - - -
c- 3k Electrical Conduit Utility-Undrgrnd! ' , - . ' ' '_54:: Forms o - - - ' . •r
•u •4, Electrical Conduit-Undrgrnd._.. a ° r, r. _ F - 55 Electrical=Bonding - - •
5: Steel;Reinforcement 1 ' ` ' p v.' ' 56. Rough Plumbing.& Pressure Test
6:•IEiectrical UF ER Grnd.t ' ' - ' I * G ` . ° ' C� c - 57`. APPROVAL TO COVER-GUNITE '
.
7. Footings I Ili; 'r Ij = • , r11° ,' I 58> Electrical Conduit-Undrgrnd. '
8. Foundation I ' ' , ' ' ' .. : ' u i ° 1 59. Gas'Pip.e_;O Undrgrnd-,Test • • - ; • - _
9. Water Pipe-Undrgrnd. • I r. a• ' -, a ' r I `60. Backwash Lines,P-Trap, 0 Undrgrnd. _ .
10. Structurao-l Floor System i 1. . t - it .61. APPROVAL TO DECK • -
11. Property Sewer Line& House'Connectionl : 1 -- . `- 62. Backwash &-Receptor-Final _' -
12. Sewer Cap + ;2.; ' -iP. 63. Heater& Vent-Final - - = -
13, Roof Drains ' : r' ' .'64. Plumbing,System - Final
i 14. !Rough Plumbing -.j I ! � %?/ y_VaJ0e9tt ' :65. Electrical'-Final' '
` 1,-15ff-Rough-Electrical:Conduit•1- ---.7-r---r-4----1-7,--'-i-r-- -66. SolarSystem=Final... - -
.a Rai.6�IRough EleciriclWiring, I , IIT.c�7 I-: ; .:'!5 .j t I 67.1`Fthcing&•Access Approval - - -:-f; . .
17..,Rough_Wiring'Signt' n '- '1 '11-1. I••I . ', • I I _ ' '68.' APPROVED FOR PLASTERING ;' ! - 'c • -
18tiRougFi ElectricaicT`Bai Ceiling{ i', II i'- i:- I i 1 ro I ° , !69 POOUSPA SYSTEMS FINAL I I. •
✓ ' 19: Rough`Heating &'AiriConditioning R I i I ! I • ' + ' 1 . 'FIRE DEPT. REQUIREMENT
�. 11 1 1 . I ,
20. 'Rough Factory Fireplace i I ''. i+ i + I I - I t APPROVALS Permit# -
_ i 21.IOucts'in Structure, ' i+ : I I 1 I170.' Underground Hydro -
1'22.:Ducts, Ventilating t t ;i +' i ` 1 I • L-71-I Product Piping 0 Gas 0 Oil
4.23.!GasCPipe-Rough & Test 1` . " r^ 1 1 1,;l 172.1 Underground Flush' ' '
ca •'-24,rRoof Framing'; I I F. i' ,i 'ho`- as I'I I<! '� I ry 'v i TA 1 ;:j, n 1 Und1 se'rgrrid.Storage Tank•0 Gas 0 Oil, '
' Shhin ' t ° ' 1 1 '
;_25,,,116,4fI eat -9 I 1 : � -,( )rt l11 ` I., I-•-I. I t � I ,I 174.1 Overhead Hydro r '
•
11;• 26-7:Bar Ceiling'(Structural),&„Monocoat' I : I =; - I . >1 751 Drly Chemical
27. Frame end Flashing -, I i , • ' I - 1 i
„ - 1 9 I 11 1 , > , 1 I 176.; D�Y Standpipe ..
28-„Lathing& Siding' I i I 11 II I, I Ii I I I :77i FIXED SYSTEM FINAL .. . •
' 29. Insulation 3 �` 1 '' II ( I I 78' FIRE PREY. FINAL
7 g'30 !Drywall NaiIing ; n I I 1 ,: I I 1 I I I I (Notes:' ,
° - r - -I -I I - - - - . - -_ - ._
t;31.'rPlaster Brown Coat 1 I . I I :' II I I 1-.
I`32-!Elect•rical Power Meter-Final I I 't , ' ! .I I-• I , . i I ,
Ii 33 Final Electric_ •. I.-! l4,-1' + 2-....1,,,,-. _ 1 - - I, .-. - .
ry 34. Final Heating&'Air Cond-itioning !'-I I I I I i I ' ' `I
d 1• in:-' ,r, 1 - I ,', II I
35. Final Gas, Pipe-Testi '-1,: i ' ! 5I , ' i:! L-' I I° l l` ;": I 1 - -
roIL' I 1 , � tl 1 = Irl ). ;.1, , ,.
,- � I J
36. Hood or'Cano PYA I a I I r' 1 t , t I c 1,--:1 - i - - - •
_
, I ,Ti ._ of Iin 1 = 1.S^-- I- i I -I ° I : , s
37. Final Factory Fireplace I : 'I is/�- y l I I '{ II F _ •
38. Final Plumbing ' I I 1 ' i • }7(/tl/q: ;0,-5 : I ' , i -
39. Water3Service-Final ' i •yl '.(i I .1 I I. i - 1 I -
40. Gas Service-Final ' I I 11 I ' ' I I • i i
41. Solar Domestic-Final I i • I_ I I__ I I _ ' : l i ' 1 ' '
42. Backflow Preventer, r I ; I I .,i- I- . - -- 1--r -- , - --
c I � � -I I '' I •
w J
43- Backflow Irrigation; _1 , i ' I ;.;;;f4-T.4-4 ' "ri ` ' •.
•
44- Landscape Irrigation;System; �, 1 •I
I V i; Iv I i I" i I I I ; I ! ! -
46. Handicap Regulations I ; T I it ,Sn I, 1 1° "'' I I =1 i I - - - ,
47. FINAL STRUCTURE& BUILDING.' ; I I 1 I I I ; r
48. Special Requirements Completed , I 1 I i I - '
49. Electric ReleaseltoiIEdi'onI' I b 4 1- -' I
;-1.1_1 I-_- I
��--. - - - y . %,1 , .
II I !
50. Gas Release to Southern California Gas Co Ii l I I i • 1
51. CERTIFICATE,OF OCCUPANCY I' !- '_ ' 4 . ;...._,„_.../..... 1,.._..;._ .,_...i.-1 .- _ "
No I . I Date l I ' I I I ' t I I i , 1 •
Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. `
CITY OF COSTA MESA PERMIT NO. TRA T N9 LOT ff�� BLD .NO.
• CONS•TRUCTION PERMIT M 90 �G �� / �_ Y� 7241 I U/131'''u •
902 p_
'Applicant's Mailing Address ' / a - C/- /G / - �U- / •-' / TYPE OF CONSTRUCTION ANEW ❑ ADD U ALTERATION U REPAIR
Project Address ' °4 ` aCrGUXp ay ' ❑ CONVERSION ❑ DEMOLIS�-II 00Th: g,
Owner's Name J hOne (/ DESCRIPTION OF WORK tH1 Q //'
Address I X 50 /(YWtZA/ ' C, i, Svtl& �' f L^"'f' V ZONING REGULATIONS
TYPE OF PERMIT U GRADING U FOUNDATI N ❑ STRUCTURAL A.P.# ZONE
Arch/Eng, License No. 0 TENANT ❑ ELECTRICAL 0 PLUMBING MECHANICAL PLNG. REF.# BUILDING
Address - ❑OTHER TO BUILDING • eFTw nrx cm ST
- /cl', - - PROPERTY LINE REAR YARD(TO P/L) .
Contractor's Nam: _a.ii •P a _ 'hone IP ' PROJECT DESCRIPTION SQ. FT- OCCUPAN Y
rf, �- - LEFT SIDE YARD RIGHT SIDE YARD
Address(mailing) S�� Yt` ' /rte a [ g. • CONSTRUCTION TYPF VALVATION$ ��P�7
g D/5-2/40�t/O _ ZONE GRADING CU.YDS. AC RFS L PKG.SPACE REQ. PROVIDED
License No. _ 5.2
LICENSED CONTRACTOR 0 GLACIATION Remarks: ,�,J — 759/ STREET WIDTH PARK FEE$
I hereby affirm that I am licensed under provisions of Charter 9(commencing
with section 7000) of Division 3 of the Business and Professions Code,/ and SPECIAL CONDITIONS:
my license Is In ful or and effect. 7l /_
License Class tens o. lJO7eh PLUMBING I
Date Signature Bar Sink Sewer Cap • ELECTRICAL
WORKERS'COMPENSATION DECLARATI - -
ereby affirm that I have a certificate of consent to self-in lire or a certificate - Backflow Preventer • Sewer Connection - Automatic Washer Meter Clover 100 amps
Workers' Compensation Insurance, or a certifle copy thereof (Section - Construction Pole
_400, Lab. BT)./.A /��qp _Backflow Irrigation SolarCollectors Sub Panel
Policy No. r✓ (/Jb f0- Company � - . - Cooking Unit Sub Pole '
11Certified-copy is hereby furnished. • Bathtubs Solar Piping - , -_ _
ICert�j�p o feed with the city ntll Division. •
Dishwasher Motors 00-1 HP OM-8
Date i" Applicant a R &, Clarifiers Solar Tank
EKEMPTION,FROM WORKERS'COMPENSATI DECLARATION Dishwasher Swimming Pool w/$pe Dryers ❑Gas ❑Electric ' Inc,Solar 09-15 HP 016-15+ '
(This section need not be completed if the permit Is for one hundred ($100)or --
• less). • Fan Microwave
I certify that in the performance of the work for which this permit is issued, I Drinking Fountains Urinal
shall.not employ any person In any manner so as to become subject.to te - - F.A.U. Pole Light •
Workers' Compensation Laws of California.' Floor Drains' Water Closet'
Date Signature •
Fixtures Range
NOTICE:if,after making this declaration,you should become subject to the Floor Sinks . . . Water Heater - .
_ Workers' Compensation provisions of the Labor Code, you must forthwith, Device Boxes
comply with such provisions.or this,permit 'shall be -deemed revoked. • Gas Service' 'Outlets Water Service • Sign
CONSTRUCTION LENDING AGENCY - Outlets Standing Sections
I hereby affirm that there))s •a construction lending agency for the performance Interceptors ,
of the work for wMcba.taK permit is issued .(Section 3097 Civ. Ci- - Switches ,
Lender's Name �f"A� 1I11�� - Kitchen Sink Trash Compactor
Lender's. Address • Garbage Disposal
OWNER BUILDER DECLARATION - - Lavatories
I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap • f Generator 00-5 KW 05-15 KW
following reason (Section 7031.5 Business and Professional Code: Any city or - p
•
county which requires a permit to construct,alter,Improve,demolish or repair Transformer 015-50 KW
any structure, prior to its issuance, also requires te applicant for such permit Roof Drains' - - __
to file a signed statement that he/she Is licensed pursuant to the provisions of _ ❑so+KW Reinspection Fee • $15
• the Contractor's:License Law(Chapter 9(commencing with Section 7000)of Reinspection'Fee $15
• Islon 3 of the Business and Professions Code)- that he/she is.exempt Showers • P -
a s'a;efrom and the'basis for the alleged exemption. Any violation'of Section - - - « Meter Oup to 100 amps ' Issue Feet .$ 3
7.1.5 by-any applicant for a permit subjects the.applicant to a civil Service Sink' . Issue Fee -
-
c-,✓Salty of not more than five hundred dollars($500): . • 1 $ 3 Zoning Approved By Date
LJ I, as owner of the property or-my employees with wages as their sole MECHANICAL v
compensation will do the work,and the structure is not Intended or offered . Application Approved By nate
for sale (Section 7044, Business and Professional Code: The Contractor's ----- ----'' -- - - - -- ----- - - ---- ---- - `��
License Law does not apply to an owner of a property who builds or improves Boiler - Refrigeration System Application Issued By _/�5 - Date �O-�3-FS
' thereon,:and who does such work himself/herself or through his or her own ,
employees, provided that such improvements are not Intended or offered for Duct-Under Ground ❑0-100,000 BTU 0100,000 BTU
1 sale. If, however,the building or Improvement Is sold within ono year of corn- SUMMARY OF FEES '
elation, the owner
p ,will have the burden of proving he/she did not build or im•ove for the purpose of sale). , • , Duct-Structural ' . , System Repair/Alteration BUILDING PERMIT $ • ; SMIP $
U I,as owner of the property, am exclusively contracting with licensed con-
'_tractorsto construct the project (Section 7044,Business and Professions Code: - Duct-Ventilating, - -- PLAN CHECK $ • - PERMIT
The Contractor's license Law does not apply to an owner of property who $ ISSUANCE $
PLUMBING
builds or Improves thereon, and who contracts for such projects with a con- Exhaust System 0 Multiple 0 -
tractor(s) license pursuant to the Contractor's License Law). • GRADING ' $
0 Lam exempt under Section B.& P.C.for this reason ' Firepl/Fact.Bit.ICBG# • ' PLAN CHECK $
Date Owner sting System&Ducting I " ELECTRICAL $ $
-I hereby certify that I have read this-application and state mat the above • N0-100,000 BTU 0100,000BIU .. - - _ / PLAN CHECK $ MICROFILM $
information Is correct. I agree to comply with all city and county ordinances MECHANICAL • $ �— TOTAL FEE $
and1state laws relating to. building construction, and hereby authorize repre- ..--tt
sentatives of this-city t• art- u•'n the above-mentioned property for , Hood or Typal ❑ Reinspection Fee $15 PLAN CHECK $ iso-: LESS •
•
Inspection purposes, ' f Canopy Type II ❑:
Signature /%1 Date /o—N$3 , ADVANCED PC $
Drivers' License or SS ///� -_-� Registers Issue Fee $ 3 FINAL FEE- $ •
CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod'-Assessor - -
C CONSTRUCTION•AND:PLING
' -ANN � � •',, ^ ",POOL• 'A
= i il t .'Date: Ins ector #- Date In's ector
APPROVALS R Permit# = ,. p APPROVALS Permitp
, 1;: Temporary Electrical Service or Pole _ 'L., _ - _ 52- Pool & Equipment Location _
• _ I ,Y -T-ii .. i
�' 2: Soil Pipe-Undrgrnd.' g i i..r_ - _, _ 53- Steel Reinforcement '_ -
+:'3t Electrical Conduit Utility-Undrgrnd: :-..1, i ' 54: Forms - -
?• 4i Electrical Conduit-Undrgrnd. - - •- S' �- ' 55-'Electrical Bonding • -
5: Steel Reinforcement .r r ' ' a • a^ , -- -56. Rough Plumbing& Pressure Test '
6: (Electrical UFER Grnd- :4 ,,..' I (71• , - _ _ ' 57.. APP.ROVALTO,COVER-GUNITE2 _
• 7- Footings I . = - L .- 58- Electrical-Conduit-Undrarni• . . - -
8. Foundation -, . _ ', ^ • - - ;59. Gas Pipe,;0 Undrgrnd..Test'
9. Water Pipe-Undrgrnd. _ • ; a - 60. Backwash Lines;P-Trap, O'Undrgrnd., -
10. Structyral Floor System -, . ', ;- : - 61. APPROVAL TO DECK . •
11. Property Sewer Line&, e'HousConnection :- 62- Backwash & Receptor-Final - t -
12. Sewer Cap I ,. .I _ -63. Heater&.Vent-Final - - >
•
13. Roof DrainsI 0 64. Plumbing System,- Final •
-
14. ',RoughPlumbing •': : ' - ' I • : :65. Eletrical-Final - -
;1 -15:,RoughElecfrical=Conduit-1 r f _II- t,"7 1 T.----1-- 7 T66) Solar System-Final j - - . - - . - l •
.: .'16. Rough,Electric Wiring , U _ j - l-: i _ - 67: Fencing &;Access Approval - - - - - -
•. X17. Rough;Wiring`Signr i ' ' . " - 1 - - • ;68. APPROVED FOR PLASTERING '
- • 18. Rougti:ElectriraI:T+Bar Ceiling 1 " i' ; I 69. POOL/SPA SYSTEMS-FINAL T ! '
19.1 Rough'Heating &'AiriConditioning ' i tA9 f'j FIRE DEPT. REQUIREMENT -
'' 20. 'Rough:Factory Fir4place I 'I I' i I I 1 ' APPROVALS Permit# l
- 4 i r I I -
21.iD>ucts,lin Structure' 1 ' �. I 1 ( i � .70: Underground Hydro -
•
In .22.,Duds,,Ve"ntilating : � I ll i, I I i ' I ;71. Product Piping 0 Gas 0Oil I ,
- 5.23..Gas Pipe-Rough & Test c + 72. Underground Flush!
_ h . I _1_l _
j`24. 'Roof Framing: I -I ;i:;;IL' I r :;:. i73: Undergrnd.Storage frank'0 Gas; ❑Oil ! i '
Y, �_25.kRoof Sheathing I I• I ,.:�, i I a- `; 74. Overhead Hydro l
- 26.--T_Bar Ceiling(Structurral).& Mondcoat , : ' i , - - 75: Dry Chemical
Cr:27-:'Frame and Flashing, ; i ' II 1' i t ' ' r I. 76. Standpipe
Dry
f. 28. Lathing&Siding! 4 ; , it i1 I I j I ;77. FIXED SYSTEM FINAL •
� I ;
v ,; 29. 'T `
Insulation^ _ II 'i- I I , , 78. FIRE PREY. FINAL -
r -30.;`Drywall Nailing . I'lI I ! I I I I Notes: I
.31.'Plaster Brown Coat" ' I 1 i iI II I ; I I . .. ... .
i
' : 32,�Electrical;Power Meter-Firial :' ' j ' i i
' 33/Final Electric 1 : i ' ,i .j I J -- L 1 + I ' -,
r. 34- Final Heating.&tAir Conditioning n . 5 zeii, , Q/,/A- , - ,,
35. Final bee'P_ipe-Test •'' I ' ; ';:i 1, I - ,_ _
36- Hood A 1 or Canopy!"', � I ' -
n . . 1
37- Final Faetor'y Flireplacen I r I o, !, I . le - ' , - ' _ - - -
I. : , �i _
38. Final Plumbing) ; 1 I ;I I ; I' I . -
39. Watertervice-Final I , ' I d I ' • i i
40. Gas Service-Final I i I I •
• - , � - , . . I
41. Solar DomestiaFinal , - _ - .1 _ _ - _ _ _ _
42. Backflow Preventer - I ( • '
. �. g"ti. r ':
43. Backflow Irri ao`n i I Q I ! '�_ . u c _ 1 •
44. Landsca e Irr I lin I + - --I, , '' - - _ _
p igatiorrc;System• „
45. Sound tAttenuation,- i:- + i '1
46. Handicap Regulations) i .: I . ' '<•. ' I` I -'
f
47. FINAL STRUCTURE'&BUILDING- , ?• I I'- I -
•
48. Special Requirements Corimpleted 9 ' • : - I :i ' . . ,
49. Electric Release toy Edison i I i _ '4_•I .:.-; _;_..-_. ._ il. .1 i..Y . _ -__ -.
. ,
50. Gas Release,to Sorithein California Gas Co : ' I ; I I ,
51. CERTIFICATE OffOCCOPANCY a ' '_,I__'__ . - ' .4_ _ _ ' '
No. U :I 1 I I Datle 1 I I , i i 7
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations-
. --.r_ . - ... _ _ .. _ _ _ _
CITY OF COSTA MESA j T PERMIT NO. TRACT NO. . LOT NO. BLDG.NO. . _ ' -
CONSTRUCTION PERMIT , I , /(/j -: 7A g • '
'Applicant's Mailing Address •;0"L L CL_ - 1A.,Orange TYPE OF CONSTRUCTION ' ®•NEW ❑ ADD U ALTERATION LI REPAIR • , ' ' I , '
' Project Address 3047 T,nyMhllrg RA yT ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - I '
Owner's.Name ' M.D. Janes—Co. - Phone - • DESCRIPTION OF WORK metal flreplPOE • _ ZONING REGULATIONS - • '
Address -- TYPE OF PERMIT U GRADING U FOUNDATION- U STRUCTURAL _ A.P,fp 'ZONE - •
- _ .
' Arch/Eng: - License-No. ' ' ' ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ®„MECHANICAL PLNG..REP S' ' . BUILDING' --
Address - - ”' R26 I'❑ OTHER ' - .TO BUILDING ecTP ACK rn CT
Contractor's Name CnR ST F1 rep! RCP Phone 639-1 PROJECT DESCRIPTION SQ. FT. OCCUPANCY PROPERTY LINE REAR YARD (TO P/L)
Address(mailing) 1080—N N - B2tavia, 'Orange , 92667 CONSTRUCTION TYPE VALUATION$ (LE FT SIDE YARD RIGHT$IDE YARD _
'
License No. l E]/-106 ZONE • - GRADING CU.YDS. 'ACRES •
' P,,KG.SPACE REQ. - PROVIDED • ,
_ -
LICENSED'CONTRACTOR DECLARATION Remarks: ' • r -^75't/ STREET WIDTH _ PARK FEE$ -
I hereby affirm that I'am licensed under provisions of Charter 9 (commencing - / -
with section 7000) of Division 3 of the Business and Processions Code,and ' SPECIAL CONDITIONS: • -
' my license is In full farce and effect. , -
license Cl-ss asy I :its: N•, LI'3638 . PLUMBING . �.
Date . S: �
Signature [MIN= . . 2.L...... Bar Sink Sewer Cap ELECTRICAL
ORKERS'COMPENSATION DEC ' R,TION ' , /- '
°4 ereby affirm-that-i have a.cartificate.otconsent to salt-insure or a certificate- Backflow Preventer Sewer Connection' -- - - . Automatic Washer _ - _ Meter Dover 100 amps _
Workers' CompensatIon I surance or certified copy thereof (Section Construction Pole -
:•' 00, Lab. C'-) 517304830C6A/59JC •- • I Backflow Irrigation • Solar Collectors ' ' , t 'Sub Panel
Policy No. ' - - - Company - • t - I< I - . - Cooking Unit ' Sub Pole ' '
Certified copy I5 hereby furnished. / •
Bathtubs Solar Piping ;
Certified ppopy I filed with the city i �I 5-�s Dishwasher
Motors ❑0-1 HP 01 yr8
Date 11/1F+�83, APplicant `7 _ Clarifiers Solar Tank , {
. EXEMPT' NIF ROM WORKERS',COMP SA ION DECLAR �TION - I Dryers ❑Gas ❑Electric •) �ine- .15-.15 HP 016-15+ ,
This section need not be completed if th= permit Is for one hundred ($100)or Dishwasher Swimming Pool w/Spa '
i Fan Microwave
• I certify that in the performance of the work for which this permit is issued I : Drinking Fountains•p-' Urinal , '
shall not employ any person In any manner so as to become subject to the - , F.A.U. Pole Light
' Workers'Compensation Laws of California. - I Floor Drains' Water Closet I 9
Date • Signature - - - Fixtures •
•NOTICE:If,after making this declaration,you should become subject to the -- - Floor Sinks - - • - - Water Heater - - - . _ Range _, __ _ -
Workers'. Compensation provisions of the Labor Code, you.mustforthwith - r
Device Boxes Sign comply with', such provisions or this-permit shall be!deeme_d revoked:'. Gas Service : Outlets � ,Water Service - - , - 9 ,
CONSTRUCTION.LENDING AGENCY
I hereby'affirm that there is a construction lendingagency for theperformance • Outlets
9 Y Interceptors , I - Standing Sections
of the work for. which this permit Is!issued (Section 3097 Civ. C) _
Lender's, Name. ' - - . Kitchen Sink ' ' - . • - Switches .Trash Compactor
Lender's Address - ' ' - j Lavatories n _ •
- Garbage Disposal
OW NE R:BUILDER DECLARATION I - , ,
I herebyiaffirin that Iain exempt'from the'Contractor's.License Law for the - Generator 00-5 KW 05-15 KW ' '
following reason,,(SectiOn'7031.5 Business and Professional Code: Any city or P-Trap .. - - -
•county which requires a permit to construct,alter,improve,demolishorrepair - - , __ Transformer ❑15-50 KW ,
any structure, prior to its issuance, also requires the applicant for such permit Roof Drains' - ' . - - I •
to file a signed statement that he/she is licensed pursuant to the provisions of - ❑50+ KW - -
the Contractor's License Law(Chapter 9(commencing-with Section 7000)of Reinapeetipn Fee $15
' -vision 13-.of the Business and.Professions Code)'or;that he/she is exempt ' ShoWers - Reinspection Fee $15 • -
refrom•and the basis for the alleged exemption. Any.violation-of Section - - Meter ❑up to 100 amps Issue Fee. I -$ 3 •
31.5 by.anyapplicant for, a permit subjects the applicant to a- civil • - - _
enalty of not more than five hundred dollars($500). •• ; ' Service Sink I , Issue Fee $ 3 Zoning Approved By Date-
•'I I,-as owner of the'property br'my employees with wages•as their sole MECHANICAL• - — - - 1 •
compensation will-do the work,and the structure-is not Intended or offered _r - Application Approved By nate
for sale;(Secfion 7044, Business and'Professional Code:,The•Contractor's '
License Law does not apply to an owner of a property-who builds or Improves Boiler' ! r - • Refrigeration System ' £i •h' I // �.7-/8� r
thereon,'and who'does'such work himself/herself or through his or her own i Application Issued By 'Data
employees, provided that suchamprovements are not intended or offered for - ❑0-100,000 BTU ❑100,000BTU
sale. If, however, the building or improvement is sold within one year of com- Duct,-Under Ground t 1 t
pletion, the owner will have the burden of proving he/she did not build or Im- SUMMARY OF FEES
' glove for the purpose of sale). 1 . 1 Duct-Structural • System Repair/Alteration ' '
LJ I,as owner of the property,am exclusively contracting with licensed con- 'BUILDING PERMIT $ SMIP $ '
.tractorsto.coostruct the project(Section 7044,Business and Professions Code: . Duct--Ventilating - _, _ _ PLAN CHECK $ PERMIT i
does ,
• The Contractor's License Law not apply to an owner of property who ISSUANCE $ '
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple❑. PLUMBING $ ' I
tractor(s) license pursuant to the Contractor's License Law). I - ( GRADING $ I '
1:1I am exempt under Section-- B •
• .& P.C.for this reason 1 Firepl/Fact,Bit. ICBG#3195• - 4D0 PLAN CHECK: $ _ ;
'ELECTRICAL • $_ - . $ '
' Date Owner Heating System&Ducting - , - MICROFILM i $ • . •
I hereby-certify that I have-read this-application and-state that the above . ❑D-100,000'BTU 0100,000 BTLr- - - - ' - - PLAN' CHECK $
•
information is correct. I agree to mply with all city and county ordinances ,MECHANICAL $' 7•00 TOTAL FEE ' $ '
and'state laws relating to ulitlin construction,'and hereby authorize repro-
sentatives of chi enter upon the above-mentioned property for Hood or Type I ❑ Reinspection Fee $15 •00 LESS • , -
inspection p rp s Canopy Type II ❑ PLAN, CHECK' $, 2i ADVANCED PC i $ i •
Signature , , • Datel_1/1 6/83 I , - I
Drivers' License or Sc / Registers ! I Issue Fee 1 3 • ' , FINAL FEE ' $ 9. 00
'MF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod-Assessor - -" - - - - -
CONSTRUCTION AND PLANNING POOL 'A _.
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 Utilitv-Undrgrnd: 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding -1
5. Steel,Reinforcement - 56. Rough Plumbing& Pressure Test
6. Electrical UFER Grad: • 2 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrarnd.
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd.
10. Structural Floor System . ,. 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection •- ' 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
•
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final •
15. -Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing& Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING-
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
?0. Rough Factory Fireplace ab,e !A1��lq?C APPROVALS Permit#
21. Ducts,in Structure 70. Underground Hydro
• 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil
- 23. Gas Pipe-Rough & Test 1 72. Underground Flush
24. Roof Framing 73. Undergrnd.Storage Tank 0Gas 0OiI
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural)l& 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 Notes:
31. Plaster Brown Coat
32. Electrical Power Meter-Final
33. Final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace O�/,� 27dgs-
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
42. Backflow Preventer •
43. Backflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE& BUILDING
48. Special Requirements Completed •
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 922514 11 /17/fi b. 0:2.: 11
CITY OF COSTA MESA PERMIT NO. - TRACT NO. LOT NO. BLDG.NO. - -
CONSTRUCTION PERMIT/ �' - 76 .3 C, -
•Projett Address ykaki
s �7r!t TYPE OF CONSTRUCTION NEW ❑ ADD L� ALTERATION U REPAIR •
Applicant's Mallin: Addr• sATi
'KV �� art�- ❑ CONVERSION ❑ DEMOLISH ❑ OTHER . A.P.•/k _ I Zone
DESCRIPTION OF WORK J
Owner's Name 1=' - = - 'hone f S Main Building: Accessory Building: Z
Address TYPE OF PERMIT�j ❑ GRADING U FOUNDATION U STRUCTURAL E Front N
Arch/Eng. License No. ❑ TENANT/L-I ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B - . I
Address _ A Rear
Contractor's Nam- ,�,�_��
I . t 'h -*' PROJECT DESCRIPTION SQ. FT. OCCUPANCY _ C Right _ R
Address(mailing) \��,_ ' it .i.♦ CONSTRUCTION TYPE VALUATION$ $ Left
E
:�, I` ZONE GRADING CU.YDS. ACRES Ping. Ref.4 Park.Fees $ Q
City License No. f - U U
LICENSED CONTRACTOR DECLARATION Remarks: 6- 75' / / . Parking Req./Provided 1
I hereby affirm that I am licensed under provisions of Charter 9 (commencing R
with section 7000) of Division 3 of the Business and Professions Code,and Use of Building: , E
my license is in full effe• ,
License I \ �- LiSen L: 1' PLUMBING FEES Planning Notes: M -
Date l• KC.ignature • �� �.---���l�i�'
WORKER 'CO PENSATION DECLARATION _Bar Sink Showers T
N
'hereby affirm that I nave a certificate of consent to self-Insure or`c, 'Beate Backflow Preventer Service Sink S
f Workers' Cggqmpensat' n Insurance, or a certj4 e.O copy thereof (Sectldn
4800, Lab. QG�jyh Q' , y 1 ,-r�,\ Backflow Irrigation Sewer Cap ELECTRICAL FEES
Policy No. company
•--�]µ+� �
Cer ' ••copy is hereby furnished. Bathtubs Sewer Connection ' - I Automatic Washer Transformer.❑ 15.50 KW
er ilio, op • with the ulltling Division' - • ❑ 50+KW
Date 1 , Applicant ( _Clarifiers Solar Collectors Construction Pole Sub.
EXEMPT •N F-OM WORKERS'COMPENSATION DECLARATIO J Dishwasher Solar Piping •- CookingUnit Meter n'to 100 amps - s
(This section need not be completed if the permit is for one hundred 0) or 4lP p
less). DrinkingFountains
I certify that in the performance of the work for which this permit Is Issued, I Solar Tank Dishwasher Meter Dover 100 amps / —
shall not employ any person In any manner so as to become subject to the
Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa Dryers OGas .metric Sub Panel /p —
Date Signature
NOTICE:If,after making this declaration, you should become subject to the Floor Sinks Urinal Fan Motors 00-1 HP ❑1'/x-B /
Workers' Compensation provisions of the Labor Code, you must forthwith .
comply with such provisions or this permit shall be deemed revoked. Gas Service Outlets Water Closet / F.A.U. Inc.Solar 09-15 HP 016-15+ I
CONSTRUCTION LENDING AGENCY '
I hereby affirm that there is a construction lending agency for the performance interceptors Water Heater I/) Fixtures / Microwave .3
of the work for which this permit is Issued (Section 3097 Civ. C.) •
Lender's Name Kitchen Sink Water Service Device Boxes Pole Light
. Lender's Address
OWNER BUILDER DECLARATION . Lavatories Outlets Range a 50
I hereby affirm that I am exempt from the Contractor's License Law for the ^
following reason (Section 7031.5 Business and Professional Code: Any city or P-Trap • p Switches Sign t79-• ^-
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 Roof Drains 1 Garbage Disposal Standing Sections / •
to file a signed statement that he/she Is licensed pursuant to the provisions of
the Contractor's License Law(Chapter 9(commencing with Section 7000)of Generator ❑0.5 KW ❑5-15 KW Trash Compactor
nivision 3 of the Business and Professions Code) or that he/she is exempt P
erefrom and the basis for the alleged exemption; Any violation of Section —
)31.5 by any applicant for a permit subjects the applicant to a civil Reinspection Fee I $25 Issue Fee $ 3
enalty of not more than five hundred dollars($500). r
6 I, as owner of the property or my employees with wages as their sole MECHANICAL Reinspection Fee $25 Issue Fee $ 3
compensation, will do the work,and the structure Is not Intended or offered FEES -
for sale (Section 7044, Business and Professional Code: The Contractor's ------ ---- - - - - - -- -- PUBLIC SERVICES REQUIREMENTS:
License Law does not apply to an owner of a property who builds or improves Boiler Hood or Type I 0
thereon, and who does such work himself/herself or through his or her own Zoning Approved By Date -
employees, provided that such Improvements are not Intended or offered for Canopy Type 11 ❑
Duct-Under Ground
sale. If, however,wthe building dopro i sold within one yearofcom- Application Approved By - - _ Date
prove the owner sewill have the burden of proving he/she did not build or im-
rova for the purpose of sale). Duct-Structural Refrigeration System Application Issued By -s`�f/ �/ Date //.//44.3.
D I, as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU
tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating SUMMARY OF FEES
The Contractor's License Law does not apply to an owner of property who
builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $
tractors) license pursuant to the Contractor's License Law). PLAN CHECK $ PERMIT
0 i am exempt under Section B.& P. C.for this reason • Firepl/Fact.Blt. ICBG 4: PLUMBING $ ISSUANCE $
Date owner Heating System& Ducting PLAN CHECK $ ENERGY P.C. $
I hereby certify that I have read this application and state that the above 00-100,000 BTU 0100,000 BTUGRADING $
information Is correct. I agree to comply with all city and county ordinances _ ELECTRICAL $
and state laws relating to building construction,and hereby auth0//ize repre- - MICROFILM $ .
sentatives this city to enter up• -- aim,s- )ention••1gr�peerrt for/ PLAN CHECK $ _ c7
Inspection pu ec ``) ll ILLI d7 •_ MECHANICAL $ - TOTAL FEE $ S'S. O-�
Signature �ls�.�•,�ate
Drivers' License or SS 1`' I Reinspection Fee $25' ' Issue Fee $ 3 PLAN CHECK $
_
CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink=Accounting;Goldenrod-Assessor . _ - _
CONSTRUCTION AND PLANNING POO, 3PA •
;APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. • 54. Forms
•
4. Electrical Conduit-Undrgrnd. - _ 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. „ 57. APPROVAL TO COVER-GUNITE
7. Footings - 58. Electrical Conduit-Undrgrnd.
8..Foundation 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10-Structural Floor System 61. APPROVAL TO DECK ,
11:•Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains • 64. Plumbing System - Final
14:.Rough Plumbing, - 65. Electrical-Final
• 15. Rough Electrical-Conduit 66. Solar System-Final '
16. Rough Electric Wiring (f'43 •C C 67. Fencing & Access Approval
11. 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, Ventilating71. Product Piping 0 Gas El Oil
23. Gas Pipe-Rough &Test 72. Underground Flush •
•
24. Roof Framing . I 73. Undergrnd.Storage Tank 0 Gas 0 Oil '
25. Roof Sheathing74. 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 . . . j� 80. FOOD CERTIFICATE ISSUED
33. Final Electric //y.// 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 & BUI LDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co _
51..CERTIFICATE OF OCCUPANCY .
No. Date •
•
,
City of Costa Mesa
Development Services Department CERTIFICATE OF OCCUPANCY No. 000519
Building Safety Division
P.O.Box 1200
Costa Mesa,California
The Building located at 1(747 TCWCWTRC, Any
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group R-1 Occupancy.
Use of Building CCUDCHWIEM
Legal Description 418-131-•17
•lsy (See reverse side for Metes and Bounds)
• 4d
Building Permit No B-7541 Electrical Permit No. E-9636 Plumbing Permit No. 9-7599
Mechanical Permit No.M 9070. P1-9726 Number of apartments annd/or guest rooms
ISSUED TO: Building Official �.//`�i
M.D. JADES CO., DIC. by / ' e
2950 AIRWtY #D-9, COSTA MESA, CA. Date 2.6
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises(nd SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CMF 1015.46 rev. 1/83 White-Owner;Canary-Numerical File:Pink-Bldg.Permit File