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HomeMy WebLinkAbout3042 ENTERPRISE ST - Building PermitsOWNER Vu'Xwuzj Ur'urn;h DATE JOB ADDRESS 3 2 Enterprise Ave. BUILDING PERMIT N0.39 5 LOT Igo IPe I ACTIONS Signature Date TYPE N GROUP J ZONE ML SOIL SUBCONTRACTOR ERM 5 SS ED GAS Dote Number Si nature WATER Plumbing ROUGH PLUMBING PROP. SWR. LINE 0 HOUSE CON. E] SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND [] POWER F] ROUGH WIRING Heatina and Vent. TRENCHES FORMS Lj STEEL REINF. Lj FLOOR SYSTEM BOND BEAM STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN D OUT PLASTER, BROWN COAT F -URAL, FINAL HE. .IG, VENT., REFRIG. AND A.C., FINAL S soi0 PLUMBING. FINAL AND GAS TEST ELECTRIC, FINAL BUILDING, FINAL -i' OWNER HOEGK, Thomas L. DATE 1-21-77 pIOB ADDRESS 304Z Enterprise BUILDING PERMIT NO. R\4iAA-1 POWER BOND BEAM U ST SHEATHING FRAME AND FLASHING FIN CON. SUBCONTRACTOR OWNER COAST CARPETS -DRAPES SERVICE DATE -3-75 RJOB ADDRESS AO42-A ElzterDrise Street BUILDING PERMIT N0. 40509 0. Ih_. ECTIONS Signature Date TYPE GROUP ZONE SOIL SUBCONTRACTOR PERMITS ISS ED GAS Date Number Si nature WATER Plumbin ROUGH PLUMBING PROP. SWR. LINE Q HOUSE CON. SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING AND AIR CONDITIONING TEMPORARY SERVICE OR POLE UNDERGROUND ❑ POWER 0 ROUGH WIRING Heating and Vent. / TRENCHES ❑ FORMS Lj STEEL REINF. / FLOOR SYSTEM BOND BEAM F-1 STEEL REINFORCE SHEATHING FRAME AND FLASHING LATHING — IN OUT PL^'TER, BROWN COAT T 'URAL, FINAL Electric HEAD ING, VENT., REFRIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST ELECTRIC, FINAL / (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR UHIVE, GUb I A MtSA, UA yZbLb PLUMBING PERMIT Job Address: 3042 ENTERPRISE ST Suite No Vicinity: Parcel Nunmber: 41822301 Applicant: ALLEN, MARK Address: 3042 ENTERPRISE #F Phone: (714) 540-2253 COSTA MESA, CA Zip: 92626 Owner: MILLER, ROBERT L Address 1065 PRESIDIO DR Phone: COSTA MESA, CA Zip: 92626 Contractor: - PROSERV PLUMBING ISSUE FEE ' $23.50 Address: 3042 ENTERPRISE #F Backflow Preventer '$9.80 Bathtub " Phone: (714)540-2253 Connect (Ice,Soda,etc) COSTA MESA, CA Zip: 92626 Dishwasher $0.00 License: 467194 Arch / Eng $0.00 Drain, Roof $0.00 Address: $0.00 Expansion Tank $0.00 Gas Earthquake Valve $0.00 Phone: $0.00 Gas (Over 4 outlets) $0.00 Zip. $0.00 Gas Service $0.00 License: $0.00 SCOPE OF PERMIT INSTALL A BACK FLOW DEVISE (NOT FOR SPRINKLER SYSTEM). QTY Status: ISSUED Applied: 03/12/2001 Issued: 03/12/2001 -FEE SUMMARY -: AMT ISSUE FEE ' $23.50 Backfiow irrigation $0.00 Backflow Preventer '$9.80 Bathtub $0.00 Clarifier System $0.00" Connect (Ice,Soda,etc) $0.00. Dental Units $0.00 Dishwasher $0.00 Drain, Floor $0.00 Drain, Rainwater $0.00 Drain, Roof $0.00 Drinking Fountain $0.00 Expansion Tank $0.00 Gas Earthquake Valve $0.00 Gas (1-4 outlets) $0.00 Gas (Over 4 outlets) $0.00 Gas Repipe $0.00 Gas Service $0.00 Interceptors (Grease, Oil) $0.00 Interceptors (Sand Auto ) $0.00 QTY Status: ISSUED Applied: 03/12/2001 Issued: 03/12/2001 -FEE SUMMARY -: AMT QTY AMT QTY Laundry Tub / Washer $0.00 0 ;. ` Sump Pump $0.00 0 Landscape Irrigation $0.00 0 .. Swimming Pool - "$0.00 0 P -Trap $0.00 0 ,. Trap Primer_ $0.00 0 Pressure Regulator $0.00 0- Urinal,. $0.00 0 Process Piping (per 10 ft) $0.00 - 0 - Vacuum Brkr Bkf1ow(1-4) $0.00 0 Receptors $0.00 0, Vacuum Brkr Bkflow(5+) $0.00 0 Septic Tank $0.00 0 Wash Basin - $0.00 0 Sewer Cap for Demo $0.00. 0 Wash Basin Set $0.00 0 Sewer Connect $0.00 0 Waste and Vent System $0.00 0 Sewer Private Line $0.00 0 Water Closet (Toilet) $0.00 0 Shower $0.00 0 " Water Heater / vent $0.00 0 Sink, bar $0.00 0 " - Water Piping (Inst or Rep.) $0.00 0 Sink, commercial $0.00 0 Water Re -pipe $0.00 0 Sink, Floor $0.00 0 Water Service $0.00 0 Sink, kitchen $0.00 0 Water Softener $0.00 0 Sink, service/mop $0.00 0 OTHER $0.00 Spa (private) $0.00 0 VIOLATION $0.00 Spa (public) $0.00 0 PLAN CHECK $0.00 REINSPECTION $0.00 0 COMMENTS / SPECIAL CONDITIONS TOTAL CALCULATED FEES: $33.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 9248, § 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) 7545626 24x6.46 (6100) WORKERS' COMPENSATION DECLARATION: ' I hereby affirm under penalty of perjury one of the following declarations: ❑ I h and will maintain a certificate of consent to sell -Insure for workers' compensatlon, as provided for by section 37DO of the Labor Code, for the performance of the for which this permit Is issued. ve end will maintain workers'compensation Insurerlce, es required q'section 3700 of the Labor Cada, for Ne perfortnanco o1 Ne work for which Ws pertNt la Issuetl. coo s' mpen tion I�umrma career and policy number are:q rl /� p/ U 4Jt7nf� Policy Number: NCI% `(:(7V tion need not be com atetl it the permit is voluad of one hundred dollars ($104 $ f 00) or less.) ❑ 1 codify 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, and agree at ould become subject to the workers' compensation provisions of Sect,n 3700 of the Labor Code, I shall forthwith comply with these provisions. -Appllcbrit'SignaData: �1 12 WARNING: FAILURE TO SECURE WORKERS COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUSIECT AN EMPLOYER TO CRIMINAL PENAL71EA AND CML FINES UP TO ONE HUNDRED THOUSAND DOLLARE ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060F THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed un er r one of Chapter 9 (commencing with Section 7000) of Division 3 of the Business Md professions and my license Is in full /Code, force and effect. Llc. M Class M -Contrsttor s Signature: _ Date: CONSTRUCTION LENDING AGENCY: ❑ 1 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 Cade) 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 (5500).): ❑ 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 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. 7046, Business and Professions Code' 'Thii'conirectors 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 pAueet to the Contractors License Laws.). ❑ I am exempt under seC.)7 �'F '� Business and Professions Code for this reason: Signature: `-.'nom/ Date: 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 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 matedal7 ❑ Yes ❑ No (Section 25505 of the California Health and Safety Code requires, with some exceptions, that a Business Plan be filed with the Costa Mese 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 hazertlous materials? ❑ 7es ❑ No (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mese 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 theappplicant 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 en RMPP is presently required, has Section 25534 0l the California Health and Safety Cada been fully complied with? ❑Yes ❑ No 5 Does or will the applicant or present or future building occupant require for the work which is the subject ofthis a plication a ertnil for Such construction or modification � from the South Coast Air Quality Management District or from any other air pollution control district 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 an facility p ................. ... .. y pan of the facili to be constructed under this permit be within 1000 feet from the outer boundaries of a school? ❑Yes ❑ No (it '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 ❑ 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 compty 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. Date re L al_ 12101 And/Or Aulhodzed'ApplaI Date CODE I, INSPECTIONTYPE PAIS INITIALS CODE INSPECTION TYPE PATE Its 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing ��)) 200 Final Re -Root 210 Final Electrical 201 Final BlmkJRetaining 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/Ocoupancy ADDRERS M BUILDING: 3042 ENTERPRISE ST awNERS NAME IF," ": ROBERT MILLER ADDRESS: 1775 WHITTIER AV • C.M. 92626 7140 631-2931 APPL. MAIIIHG ADDRESS: ARCHITECT OR ENGINEER: ARCH, OR FAG'S ADORERS: UNIT: C UC. NO: UNIT: CONTRACTORS NAIO:: CONTRACTORS MMleq ADORES& UC NO.: UNIT: LICENSED CONTRACTORS DECLARATION: I herebr Safina trader parody of perp, Nat I ern Rate ad under prwieima of Cheater S (oornawouNI wish Section 7000) of Diwun S of Ne Duahisn and Pmlmelw Coce, and any Doerna b in Iu0 forte and effect. CITY LIC. NO.: LIC. CLASS: LIC. NO.: Data: Cwaauoc. tOWNER BUILDER DECLARATION: I h«tlpam y afunder penalty of perjury IM I am Scampm Nw from Contract. Liosbe lala Ne 'dbwnq reason (Rection 7001.5 Bmkem and Profession Code: Airy Gr or uurty which rapuhee a perms to construct. afaer, improv. Jemdah, a repair any structure. prior to ia'nwbrioe. afro rep lues 1M appbv la such Mona to Be a syrled alaterwerd gnat M a end I, llowaed Wrsuml Io IM prw6lom d Na Caaadon Li.. law lGhapter g (canmenuq with Section 1000) d Motion D of IM Buaurm and Rdaaaum Codal or that M or sine is sumpl d erelaw end tM bmu for Na alleged me axion. Any vidaan d Section 7MI.5 by any appfiowl for a puma Subjects the applicant to a dui Penalty of " more tMn We hundred dollen RS)ol) ❑ I.mownar dtha property a my anot,". min mllm as their will cvrapamall wT Or Oe work and one aNAcane b nd tolerated or dfernd for sale (Sedco 70sa, Butineuand Pldm oohs CoM: TMCaereeors license law dose not appy loan owner of property wM W Ws or inaaaa tMnm. and wtn does soda work lianme or MnaE or lh Lgh M or Mr own empbnen. awidW thud such impnove n. we nw ucanded or offend fa sod. S, however, line Wilding or Ynprownant b wtl a Din urea year of canpW i.-. de omer-0uitler all heat Ina bedaa d pmvin; M a we ofd M bold a mpmve la IM papas of me). ❑ I, m owner d Ina amp". am and v,* atndiNI ew fs>dbad mnoacbn to owed ud Na oo ed (swim TOu, Ba am and Pafaviau Code: TM Contractors Uceres law does nd appy to an owns of prapMr welt, bWb a'vapnwn Ottawa and who mnvecte fa allot, «elects wM a mnracta(al pcernod plc u W IM cotrauon Lcerbe land. memp _nder s.pdan: B P 7 0 4 4 B. a v.c., for IN* rmaan: y���,'� L�A We: — - Omer _ oar- S c ashy early Nat I em ewva dad uderabrd Uu -Sofro d Cellanu Naelth ends erY am 25505, 255DD, ane 2550x. W Nat I a arty Man butld'+p odameea. wi0 / W ripe Idcle one) need fo wmply wlth add pate adv and IM naukannb for epema la wmoudionanad'dretionham NSA' e�mepanwnd 0igde. ReridedW mMnueion eppiretioroen sump tmntMss Date: Applicants: WORKER'S COMPENSATION DECLARATION: I hereby affam oder prral d paperyoredUe WIMAng dadaalen: ❑ I heat end wilt meintan • eendivae d aarlaent Io sadawnrs fpr wankai wmmnWkn, m prwidod la by 9adion 0700 d the labor cods. to IM pNomurce d Ne work la wdicn Nie Penal u blued. ❑ I Mw end wilt meimekn waken' mnpamatMn InwrarAe, n npuued by Section S1W d Na Lenon Dnde, for 1M padormanca d IM work la whirh INS perms a mud. My verba' carnDaretlion truuarlce tarrbr and piC/ Sumner w: Car*. Policy Number: (Mia mot. need MIM oandefsa I "e penal u her we Madrsd d.Am ISI0(t) or AsmJ ❑ I corn Nat p tM padarnwrta d 1M work for Lam of aMob d Wued, I ahe0 mI empty cry paeans cry mercer n m to became auope to IM woM1re' n WOO f the Ism C Cefdamia, end epne Uly 2 I shorald bmlona subject to tM woMn' compensation pmdsiae d Section S1W tl IM lana cue..l.nae IOMWh Damply wiN Nor poddpns. Data: Applicant: Weming: F.Hun to se," wodeaa' corwansadon covor", Is u.UwM, and shall subject an errIoloya n cdMral panaltlm and dull Mm w he wa laudrea Iheuserd dollars (S10400)A an eaaldon to M oast of eerryanuWM1 brraall m povlaM har In Sacaon 07(16 of Ne Labor Cob, Interest and wRomoy's fam. CONSTRUCTION LENDING AGENCY: I hereby afhm under penalty of perjury Ina these b a aonatmction lending agency for IM Mdorm. of the work for v nid IM pamt b sewed (Section 0087. Cd. C). LENDER'S NAME: LENDER'S ADDRESS: I raniy IMt I neat nae No appfiowon end dale that Its above i formdion u correct. I agree to compy mh ell dyad owmy adinenros and state lam relating to MiMmg mnetrudon end Mrsby euNorbe lepreantMbp d INS day to enter upon IM abova-manticnuf rop" for impeaion tepoem. ROBERT MILLER (515149.WP) Whna-Buildkp A Safety; Gaen-FJe; Conry-Appfunt; Rnr-Revenue: OoMenrod-Aeemear CITY OF COSTA MESA - SIGN PERMIT PERM NO: SB 076294 PERMIT NO: SB 076294 PLAN CHECK NO: 00488-96 L GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: SIR SIG PURPOSE: OTH JOB DESCRIPTION : INSTALL FOAM LETTER WALL SIGN SQ FT: CLAIM VALUE: 800.00 CALL -VALUE: 800.00 GROUP OCC: B / COMMENTS: " BULLET PERFORMANCE ENGINNERING H.M.W. MASTERS" itdEdF***dE*iE****dEiEdEdE*iPdFfE**dFiF*dF**SEdFdFiEiEiEdEiEdFtEiE♦E*1E♦EdEiE1p♦EIp**iFiEifitiPdEiE♦E*dEdEiEiEdEiE*dEiEdEdFdtdEiE**dESE* S I G N I N F O R M A T I O N DISTRICT: 3 TYPE: FOAM LETTER WALL SIGN ILLUMINATION: NON CATEGORY: NEW DIMENSIONS: 1FT 09IN X 16FT 06IN AREA: 34.00SQFT LETTER HT: 11911 STREET FRONTAGE 1: 163.00 STREET 1: ENTERPRISE STREET FRONTAGE 2: 214.00 STREET 2: PAULARINO PARCEL: 41822301 ZONE: C1 LOCATION > FRONT: X REAR: BUSINESS NAME: BULLET PERFORMANCE ENGIN.> LEFT: RIGHT: O T H E R T O T A L S G R O U N D S I G N, THIS ACTIVITY 34.00SQFT OVERALL HEIGHT: OFT OIN THIS SITE 87.00S FT GROUND CLEARANCE: OFT.-OIN IttTEE�Mjjn OF.ggc,INFO p¢yy: 1 PLANTER AREA: O:OOSQFT CPY�VBIAGEIthTTBSET ULLET PERFORMANCE ENGINEERING;BBMW MASTERSK: 20FTr is PLANNING NOTES: l t k4 t L b j3 N T S E R V I C E S R E Q U I R E M E N T. t0NING APPROVED BY DATE: %S APPLICATION ISSUED BY: DATE: df if oft iE dE dE irk dE iE dE dE iE dEiE dE lE dE dE dE iE dE dE iF iFif3FiF7✓^iF3F7i:'3F'ALiF iF'iF'if'3FiF'iF'iF'fE7FiF7l:iFiF'iF'fF'Jf'1F7F+t*iE+Ei(+r iE iE** *iH LEGALIZATION:N F E E S U M M A R Y STRUCTUR L SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING PERMIT 21.00 PLAN 13.65 SMIP/NOON-RES ISSUE FEE BUILDING -DIV-> PERMIT ISSUE PLAN -CHECK TOTAL PAID DUE TOTALS ---- > 21.50 0.00 13.65 35.15 35.15 .00 REVENUE DIVISION TOTALS--> COLLECTED: 35.15 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN -CHECK 21.00 ,50 13.65 ♦E dE 1E * 1h * dE ♦E irk irk dk df dF dE * dE iE * dE lir dE dE dE dE dE dE * dE �F dE dE * * dE SE dE dE dE dE dE dE iE iE iE dE dF dE dE tE iE dh * k dE 1E it irk dE oft dE dE * dE 1E SE 1E ♦E iE d! * it dE dE dE ♦E dE dE * iE I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST NO FEES WERE SELECTED FOR THIS PERMIT n: Jct^':GE :15 3fi`. TOT - DATE: Oa, O' ii - - CONSTRUCTION AND PLANNINGPO_ APPROVALS Permit # Date Inspector, - & SPA APPROVALS Permit # Date Inspector !. Temporary Electrical Service or Pole •,j 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. _ 53. Steal Reinforcement �• 9t 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement - 56. Rough Plumbing & Pressure Test 6: Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE = -; 7. Footings 58. Electrical Condult-Undrgrnd. �! B. Foundation t59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, O Undrgrnd. 10. Structural Floor System �.j 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection ,r 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 - t 68. APPROVED FOR PLASTERING 18, Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Peirllit +-L.- 20. Rough Factory Fireplace - - 21. Ducts, in Structure 70. Underground Hydro 22• Ducts, Ventilating` 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rougb & Test 72, Underground Flush 24. Roof Framing - 73. Underg'rnd. Storage Tank O Gas Q Oil 25. Roof Sheathing 74% OOerhead Hydro 26. T -bar Ceiling (StructuraW & Monocoat - 75.'Dry Chemical•, - 27. Frame and Flashing . - 76. Dry Standpipe -- 28. Lathing & Siding 77. T)XED 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 .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 r Y�Y 45. Sound Attenuation 46. Handicap Regulations ' 47. FINAL STRUCTURE&BUILDING 48. FINAL PLANNING 49. Electric Release to Edison - -- 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESsaswLDON1: 3042 ENTERPRISE ST e ERSNAMEIPIWOWII: ROBERT MILLER ADDRESS: 1.775 WHITTIER AV CSOTA MESA CA 92626 714=631-29`31 11PPL. YAIUNG ADDRESS: A ITECT OR ENfdM: ARCK Gx wa•a ADDI�ss: Mire F FLOOD: X 47 I.C. NO, UNIT: coNIumorsNAME: PAUL'S ROOFING (714)995-2179 Ca MTORSMNIlNG 1011 E LACY AV ADDRESS: ANAHEIM CA LIGNO_ 489090 92805 DNR: LICENSED CONTRACTORS DECLARATION: 1 hereby, effem under penalty d perjury that I and limneed under a.visnnn d Chapter g (c ommandrp wish Emotion 7000) d Dbakn d Nnd D e Business aPmlesalorm Code, and my Beams u in full buttrk aeffect. Cm LIC. NO.:047761 Lic.CLASS: C 39 LIcc 4/899/090 EXP: 09/9�7�[ Dds: W j.ir Iq � Cantrwm L/./ N AV 11.51`Wf OWNER BUILDER DECLARATION: I hereby albs under pauly ;;'my com I nen stamp wvhvC.. littrme law 1« the Idkmiit wood (Section =15 Summers ak Protectionist Code: AM coy, or rourmy which mRlnee a permit to construct. am, do da e, demolish, or repair and senators. prur to is ere mmom. also mauihes the applicant for such permit to Be a momol twemad Nat he of shot it liearmad amused m the Worman e d the Contractors License law )ch. ser S (eommadrvdg wan section 7000) of Daakn 0 of mita Bumeera fok Prdeeeiore Corel or Into he or aha a "amp Na d um and me bass 1« the almped esemption. AM vklatkn of Section 7W t.5 by and a ,hoar 1« a permit abjure the aPpficant to a dml penalty of not more than two hundred laden PSOI)D. ❑ L as owes d Ilw atnertyor as, pb,. wan wa,esestheir acts oad,razian. wird da Ns wok, and the iucuia it dal (mended errdlemd1«eels(Sed6m7o .Bud for Prdeskom Cade: The Co IWMLI LawdeesltdappytomowneddPMPDM who buEea a rnpmves thereon. add who does such work nerd a hemel a IMagh h'm «her own en om year of comp Ihm . tho knpdarbu a fo.mwendedkeallow1«eels.D.he em thec1 orimprmfor the ntpicawdhioone resdromplelnn. NB owrsbuika h new me bdWen a Iwor'k9 nes ca she die hha Mede « imaos 1« IM Phapese of eek(. ❑ 1. a ohne d the papery. am esdmimy committed, wdn scorned contractors to construct dm Project (Session 7044. Bminsse ass Prdevbm Code: The Cm lnenss Law does nor apply m th owned aoLwho Malas err impraaes Iharatn for who comv leora prgetto sootmkeredpu.uent b the Commodore License Land. ❑ I am awnpt uw« Section: B. A P.C.. for Nie mem: Dote: Claws: I do hemby candy that I am awfoe of ane urkehstfok Na requirements of Cellocale Meech end Scary Code Sections 25505, 25555 end 25506, end that I or my Mum buileidq wowanl will /wall na (circle «n) need to comply with eek date codes mrd the nowimmenle ler awiemions. apanmimctionanweifioalbnhamthe A'r u y enepement Didrct. Rsekenlid cvndr«fion epgrali«mae exemglmmthaea ro. Dae: Applicant: WORKER'S COMPENSATION DECLARATION: 1 hereby amn wda penalty of perjury one of the facmig dedamiom: ❑ Coda. forthmainla oft hat ed ottesnt loaminrae is caused. omttmalbn.a aoykw l«Msemis a7W diM lab« Coda. for the pwormfoca d dale wok la which Nb panel w aaued. .L7 I haw for will mountain wwbm' mnpaadion i.., as repulsed by Section 37W of em labor Code, len the ped«mance of the .C' work 1« which thio permit u wsuw. MY mwrLere' mmPanad'an imurenca wrkr end pdiq number ere: Carred: STATE FUND EXPIRES Policy Number: 01/01/98 (TMs seism new nor be completed y the Perms is ler one hundred dram [Stoo] or ka.l ❑ cenlY that in Ne pedormentt d the wok ler whkh Ihie psml ie iesuw, I shell ml sneaky fory panne In end manna w as to bmoome subjad tothe wmurno compensation laws of California, and agree that R I sh ski becomers subject to the worke' compenawand ion. d Sect. 07M d IM Labor Code. I v mhweh co h Noe roviei«m. Dale: �T/049'1 Applkam: Warning: Follure do aesurs "A", rourywatlon comanager la unkwN1, and owl sub muployor to csfoo l pomm" and el H/ ff. w m me hundmd Ihuusfok cook. (SIOR"A Al motion" b Die nest of tamp naWrL Mentalism am ProYMed ler In Sactlm 07(16 of the Labor Cock, Interest, and etlp.ay's lea. CONSTRUCTION LENDING AGENCY: I hereby affirm ower pmaly of perjury that liters is a wnauuaion lending epedcy for Ne pad«mence of IM work ler which the Permit is awed (Section 0057. Co. C). LENDER'S NAME: LENDER'S ADDRESS: I teddy that, I hew read this application end alma Ihm IM above Woodwind is conact. I slime to campy, with all city ad county «dinadme and date laws do eq to buddimdp commutator and hereby authorize repreeentatbes of Ihk city m ems upon the above nharNbdded property 1. uspettkn Purposes. LISA R I Z Z O Purim Name dn(, v Oda: / Sqn r erlA,enVAppkenaCmuecta (515146.WP) W hoo-Ruddvq A Soley: Gdmdr ime; Celmid Applows: Pink-Rmml Gokomod-Nave« CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 081(101 PERMIT NO: B 081601 PLAN CHECK NO: N GOVT: N SUPP: H CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: OTH JOB DESCRIPTION T/OFF & REROOF W/BUILT—UP SQ FT: 16,000 CLAIM VALUE: 16,000.00 CALC—VALUE: 16,000.00 GROUP OCC: B / COMMENTS: REROOF 12500SF COMMERCIAL BUILDING W/BUILT—UP Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING--------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ).EFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 41822301 ZNE: REF NO: PLANNING NOTES> f D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N, -T S ZONING APPROVED BY BUILDING APPROVED BY APPLICATION ISSUED BY: iF#*F#lF* if3F7FiF IF**## 1F**iF#7FiF## LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE PERMIT 237.25 PLAN ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS ---- > 240.61 0.00 0.00 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 237.25 DATE: DATE: DATE: Z �Z ######## ## STRUCTURAL`SEGMENT:Y SMIP/RES GRADING SMIP/NON—RES 3.36 TOTAL PAID DUE 240,61 240.61 .00 240,61 OVER/SHORT: ,00 FIRE SMIP/TOT GRADING PLAN—CHECK 3.36 I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFC 16000 REROOF BY VALUE COMMERCIAL NOZONE 1.00 16,000.00 END OF FEES 82-12-1997/11:12 AM/$248.61 RCPT8:81-0881973 PERMIT:081601 ~ CONSTRUCTION RUCTION AND PLANNING APPROVALS Permit # Date Inspector POS S SPA 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. 4 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical LIFER Grod. 57. APPROVALTO COVER-GUNITE 7. Footings. 58. Electrical Conduit-Undrgrnd. 8. Foundation 59, Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd._ 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63, Heater & Vent -Final 13. Roof Drains - 64. Plumbing System - Final - 14. Rough Plumbing ' " 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final - 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas OOil 23. Gas Pipe. Rough & Test 72. Underground Flush. 24. Roof Framing 73. Undergrnd. Storage Tank OGas OOil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 76, Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29, Insulation 78. FIRE PREV. FINAL 30, Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final - 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34, Final Heating & Air Conditioning - 35. Final Gas Pipe -Test - 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumping 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 -- 4B. FINAL PLANNING 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date / r ' 384012 AY 14-74P—fbOO 5591, ul�. vrCOSTA MESA BUILDING -SAFETY DEPARTMENT r �1 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECEIVED BY I DATE RECEIVED nerP Issucn ADDRESS 2 RAo�'1�r '�V IN OWNER O`'AH I1tG, MAIL —II",n 1.1 -;f^44 CT BRANCH ADDRESS ARCHITECT ADDRESS CONTRACTOR O(MOK NO. OF USE OF NEW ADDRESSjU� ACCESS. SLOGS. PLANS BUILDING -,/01 DATE TEL. CITY f!f s/ , NO. STATE CITY LIC. NO. DATE LIC. NO. SIZE qNO.OF RE UIR� BLDGS. OF LOT ' �4 X 7I� 'moi 44 I NOW ON LOT USE OF EXISTING BLDG. AX m m SIZE OF I14_;�Ij NO. OF THE AMOUNT SHOWN UNDER VALUATION IS FOR NEW BLDG. ROOMS o �,t��^ �p f.STORIE' COVEERIING°'L-LC6nlG. COVERING nol;ry Uf4E OF BUILDING; AND WORK TO BE PERFORMED I hereby acknowledge that I have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not employ any person in violation of the workman's compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under .the State of California Business and Professions Code, Division 3, Chapter 9, and th t fbch licenses are in full force and effect, or 1 am exempt ons Cjotonstof t p te�o_} California Business antl Processions Crs onjlt a ter Signature of Permittee Authorized Agent A. P. NO. _ _011O _....... ..... L(Al BUILDING ADDRESS TRACT��In LOT BLOCK . OWNER VALUE FIRE ZONE APE V71GROUP G Z APPROVED /J 7 RY .I // DATE 7� 7-X� ZO NO. OF USE OF NEW MAIN SLOGS. ACCESS. SLOGS. PLANS BUILDING -,/01 DATE YARDS APPROVED YARDS APPROVED f!f s/ , MAIN BUILDING ACCESSORY BUILDING tFROM C/L SIREEW3 I_ r DATE 0 DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. SLOGS. VAR. 46 DATE t� C.U.P.# APPROVED ' APPROVE 4 DATE HOLD FOR SPECIAL RE UIR� 44 V> AX m m SO. FT. o THE AMOUNT SHOWN UNDER VALUATION IS FOR THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: o VALUATION m PERMIT FEE $ n' 7 $�•j /J Ls/ LAN CHECK $ Q • E ✓� ddd ((((((fff o / LL TOTAL FEE $ ir , Z . W W mu ZQ OW am _I 7 i ma J Q Uy Za W Cr cL Ill UJ Z JO M J K W W 02 Z_ I- 0 0 M 70 3 Eve, t, COSTA MESA BUILDING -SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 nn 17-71cF"'OO�s�9 AP LITN FOR BUILDING PERMIT For Applicant to Fill in Completely RECE E BV DATE RECEIVEDJE BUILDING ADDRESS��jjn}�'J U R S f A �NOU/}/v OWNER A.P. NO.MAIL �7 ADDRESS % D W [Ofe4ADDRESS BUILDING C OS T/9 TEL. MF S/3 NO. Ci GaCONSTRUCTION TRACT LOCITY WLENDER BRANCH OWNERADDRESSdid4rAORc"TEcT S ENGNEER (�ba� 2F76 +AS-�cnTiEL S4S8 [� /. ADDRESS"/^d0 C rnPUS /7Il �iGr PE ''nn CONTRACTOR VINJ/U DATE ADDRESS S^TEL. NO.OF USE OF NEW CITY NO.STATE PLANS BUILDING CITY PPROVED rREA..T. YARDS APPROVED LIC. NO. LIC. NO. UILDING ACCESSORY BUILDING SIZE NO.OF SLOGS. STREET) OF LOT F Z r [-t NOW ON LOT FT. FT. USE OF EXISTING BLDG. FT SIZE OF - NO.OF NEW BLDG. ROOMS STORIES FT. FT. EXTERIOR WALL ROOFCOVERING COVERING FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN SLOGS. ACCESS. BLOGS. I.PvnU S TR/RL tj 'J %% E. VAR. 4L C.U.P. + DATE APPROVED U tv t % APPROVED By DATE I hereby acknowledge that 1 have read this application and state that the above information is correct and agree to comply with all laws regulating building construction, and I shall not amploy any person In violation of Ma workmates compensation laws of the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. THE AMOUNT SHOWN UNDER VALUATION IS FOR the State of California Business and Professions Code, Division 3, Chapter 9, and that such licenses are in full force and affect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business antl Professions Code, Division 3, Chapter 9. VALUATION Signature of �-/tiTX PERMIT FEE $ Permittee i ' S PLAN CHECK $ s7% Authorized Agent TOTAL FEE $ , / Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. CITPOF COSTA MESA I PERMAT NO. TRACT NO. LOT NO. BLDG. NO. CdNSTRUCTION PERMIT I TYPE OF CONSTRUCTION7721 ❑ NEW ❑ ADD ALTERATION 1:1REPAIR ❑ CONVERSION, ❑DEM_ OLISH• ❑ OTHER 0•'�'\ - .!.\", -�• 1/02/91 6000 ZONING REGULATIONS [Adclressi��-,-M'l �Phon `�A I.J� F, - N V Arch/Eng. ( License No. DESC p AEON OF WORK A P TP Address -- - Z�C)_" ZONE PLNG; REF. $ `Contractor Phone TYPE OF PERMIT El ❑ FOUNDATION ❑ STR UCTV RAL 1:1 TENANT ❑ ELECTRICAL PLUMBING ❑MECHANICA SETBACK T. ID YARD SIEDE VA To Bt/I IrvG PROPERTY LINE - Address .. LICENSED CONTRACTOR DECLARATION 1 hereby affirm that I am licensed under provisions of Charter 9 (com- mencing with section 7000) of Division 3 of the Business and ❑ OTHER Professions Code, and my license is In full force and effect. REAR YARD (TO P/L) PROJECT DESCRIPTION License Class License No. SQ. FL _ PKG. SPACE REQ. STREET WIDTH PROVIDED PARK FEE $ Date Signature - WORKERS' COMPENSATION DECLARATION OCCUPANCY—CONSTRUCTION TYPE I hereby affirm that I have a certificate of consent to self -Insure or a VALUATION' ZONE ZONING APPROVED BY DATE certificate of Workers' Compensation Insurance, or a certified copy thereof (Section 3800, Lab. C.). GRADING CU. YDS. ACRES SPECIAL CONDITIONS: YNo. Company ertified copy is hereby REMARKS: Certiftetl copy is filed withth the the city Building Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This section need not be completed if the permit Is for one hundred - ($100) or less). - - I Certify that in the performance of the work.for which this permit is. Issued, I shall not employ any person In any manner so as to become PLUMBING .• PLAN CHECK - ELECTRICAL PLAN CHECK subject to the Workers' Compensation Laws of California. BATHTUBS SHOWERS Date Signature NOTICE: If after making this declaration,you should become subject TOILETS URINALS GENERATOR - 0-1 KW -1-10 KW to the Workers' Compensation provisions of the Labor Code, you must - TRANSFORMER forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW_50+KW revoked. -TR KIT. SINKS - DISHWASHERS 'MOTORS 0-1 HP - 1.10 HP C ONS ONSVCTION LENDING AGENCY 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 FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS - SWITCHES Civ. C.). Under's Name Lender's Address DRINKING FOUNTAINS - GAS TUBE SIGNS OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for INTERCEPTORS CLARIFIERS POLE LIGHTS - he following reason (Section 7031.5 Business and Professions Code: SWIMMING POOL PTRAP ' Any city or county which requires a permit to construct, alter, POLES METERED SUB - WATER SERVICE ALTERATION PANELS MAIN SUB improve, demolish or repair any structure, prior to its issuance, also re- quires the applicant for such permit to file a signed statement that he GAS SERVICE SERVICE AMP Is licensed Pursuant to the provisions of the Contractor's License Law EOUTLETS (Chapter 9 (commencing with Section 7000) of Division 3 of the WATER HEATERS BTU OUTPUT usiness and Professions Code) or that he is exempt therefrom and the -,sis forthealleged exemption. Any violation of Section 7031.5 by SEWER CONNECTIONS f applicant for a permit 'Subjects the applicant to a civil penalty not more than five hundred dollars ($500). SOLAR TANK COLLECTORS,, 1J 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. (Section 7044, Business and Professions Code: The SOLAR PIPING SVS. s ISSUE FEE " Contractor's License Law does not apply to an owner of a property ISSUE FEE .3 APPLICATION APPROVED BY DATE who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not MECHANICAL PLAN CHECK SUMMARY OF FEES Intended or offered for sale. If, however, the building or improvement 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 PERMIT $ SMTP $ icensetl contractors to construct the project (Section 7044, Business AND DUCTING 100,000+BTU_ PLAN CHECK $ PERMIT and'Professions Code: The Contractor's License Law does not apply to ISSUANCE $ an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU $ tracts from such -projects with a contractor(s) licesned pursuant to SYSTEM ,PLUMBING GRADING -$ the Contractor's License Law). 100,000 + BTU PLAN CHECK $ El am exempt under Section S. & P. C. foi this BOILERS BTU ELECTRICAL $ $ reason SYSTEM REPAIR. ALTERATION EXHAUST SYSTEM MULTIPLE PLAN CHECK $ MECHANICAL $ MICROFILM $ TOTAL FEE $ LESS AD - Date - r+wne _ _ _ I hereby certify have this application and state that the above isorel information is correct. agreect. I agree to comply with all city and county PLAN CHECK $ VANCE PC $_ tea and state laws relating to construction, uctlon, antl hereby authorize r - repesentantatives of this city to enter up proo the above menfionetl property. for imspectiq p oses Signature ��- Date\ �•- FINAL FEE $ Drivers' License or SS CMF 0865-46 White -Building; Canary-APplicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNIN t APPROVALS Permit # Date POOL & SPA Date. Inspector - .Inspector - APPROVALS Permit #_ 1. Temporary Electrical Service or Pole 43'. Pool & Equipment Location 2._ SoilPipe-Undrgrn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms ' 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding 5. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn S. Foundation 50. Gas Pipe, ❑ Undr rn, Test _ 9. Water Pipe-Undrgrn 51. Backwash Lines P -Trap, ❑ ndr rn - 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Receptor -Final 12. Street Sewer Connection 54. Heater & Vent -Final 13. Rough Plumbing _ Finni 14. Rough Electric -Conduit -56. Electrical -Final 15. Rough Electric -Wiring 57. Solar System -Final 16. Rough Heating & Air Conditioning - Fencing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. 19. 20. Ducts, Ventilating. Gas Pipe -Rough & Test Roof Framing 60. POOL/SPA SYSTEMS FINAL 21. 22. Roof Sheathing Frame and Flashing NOTES: 23. Insulation 24. Lathing & Siding - 25. Drywall Nailing - \ 26. Plaster Brown Coat - 27. Electrical Power Meter -Final _ 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe -Test 31. Final Plumbing 32. Water Service -Final - 33. Gas Service -Final . 34. Solar Domestic -Final 35. Landscape Sprinkling System 36. Sound Attenuation ' 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison _ - 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY - No Date Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. -CITY OF COSTA MESA -; PERMIT NO. - TRACT NO, LOT NO BLDG. NO: f CONSTRUCTION PERMIT pE 2! I PE OF CONSTR��JJ�C(�71,ION" _XY"OWne1' EWA ❑ADD ALTERATION - -- ❑ REPAIR ❑ CONVER ION ❑DEMOLISH- ❑7oTHER 11-� _.': ,7Z• 9769-I2I:2-I''I'B;I - ,'�-.39-25'I ZONING REGULATIONS- Project Address • (\'-'� .(� •� 's`•�"7y" Phon Address -' - - - - - - Arch/Eng. - License No. - - - DESCRIPTION OF WORK -(-- '- - - A.P. # - ZONE - - - PILING. REF. 501 Address- - ntractor Phone - TYPE OF PERMIT - ' - - ---- '0 GRADING- O FOUNDAT�syIII�O//////N O STRUCTURAL -El TENANT- 'ELECTRICAL -LpgLUMBING-�MECHAN ICA - �' DIN -- - ��k1 BUILDING SETBACK ST. _ _ OPE RTV LINE ' SIDE YARD -LSIDE VA - - - - -- - -- - Address -' - - - ' - - - LICENSED - CONTRACTOR DECLARATION - - _ - - 1 hereby that I licensed Charter 9 affirm am under provisions of (com- mancing with -section- 9000) of Divislon-3 of. the Business- and. ,f / -,� I ❑ OTHER RIGHT _ Professions Code, and my license is in full force and.effect., "' REAR YARD (TO P/L) + --..-- -- _- -- _ - _ _ _ _-- • PROJECT' DESCRIPTION - - License Class License No. , - ,' SQ. FT. ' - `--' --'--' - - PKC. SPACE REQ. -.. PROVIDED - -� _ .. _ �" Date- Signature' _ -'OCCUPANCY CONSTRUCTION TYPE --- - -- - - STREET WIDTH 'PARK FEE$. '( WORKERS' COMPENSATION DECLARATION- I hereby affirm that I have a certificate of consent to self-InSure. or -a r ;VALUATION' ZONE _ ZONING APPROVED BY certificate -of- Workers' Insurance, or a certified _._. .._ ._.. _ (-Compensation thereof Section 3800, Lab. CJ. �'G RADING CU. YDS. A ' � � ACRES SPECIAL CONDITIONS: 'cy No. - - - CompanY _ .:ertified copy is hereby furnished.. REMARKS:" LI Certified copy is filed with the city Building Division. - EXEMPTION FROM'WORKERS' COMPENSATION DECLARATION (This -section need notbe completed.1f.the permit Is for one hundred S$100) or less). I certify that..ln the-performanceiof-the work for which this permit is issued, I shall not employ any person Ih any manner so a1 to -become, y;PLUMBING�- . , i,. PLAN CHECK - - - "- - _ _ _ -ELECTRICAL - PLAN•CHECK - -- - .subject to.the Workers'_ Compensation La WS,Of. California. -BATHTUBS _ SHOWERS -) - - _ - - - Date Signature' NOTICE: If after making this declaration, you should become subject'. 1701 LETS; J- URINALS-- - (-'" - 'GENERATOR-- 0-1 kW 1-10 KW to the Workers' Compensation provisions of the Labor Code, you must ' - TRANSFORMER - forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE LAVS' - - " ' - APPLIANCE' 10-50 KW_50'+ KW- -- -- r -- revoked.._ �. -- _ _ _ _ CONSTRUCTION LENDING AGENCY _ _ KIT: SINKS' -` DISHWASHERS -' I - """ -MOTO RSA- -- -0;1 HP_I40 HP '- -yl Q' I hereby affirm that there is a construction lending agency for the per. SERVICE SINKS• " p SUMPS' ' ( - -- - (INC. SOLAR) - -30-50 HP_ -50-+ HP - - formance of the work for which this permit is Issued (Section 3097 --)' �''I f - r cam' FLOOR SWIGS FLrOORDRAINS— j --' - FIXTURES' -- OUTLETS SWITCHES -Civ: C:). -'-"-'-- --- ---"'-" -'----' -' --- -- - '� Lender's Name Lender's Address DRINKING FOUNTAINS -^"- -' - i - -GAS TU BE SIGNS - - --^- - - - - .. ,..c .,. .. OWNER BUILON"INTERCEPTOWS - 60ARIFIERS* �� "-' POLE El GHTS` 1 hereby affirm that 1 am exempt from the Contractor's License Law for that I a exemptI _ -SWIMMING POOL —-P,TR7iP' "-' - -' i -"- -LUNbl _ - the follow, reason- -7 Business -and Prof county(Section or permit to construct, alter, quire t construct, Any city or county which requires POLES METERED -SUB 'WATER -SERVICE ALTERATION -- - - - - -- "PANELS'-- MAIN - SUB -:1 "- +•�a' .I m r prior'to any -structure, oicant cement for SUCK permit to file a cstatement that he quires the ap for such to le ned statement that he quires the ap ---------- - '- ---- t- --^ - GAS SERVICE OUTLETS OG �. I -SERVICE"--'- --'-" "- --'AMP'- '-- - rsuant Contractor 's`License Caw' '( h pter 9pursuantencin with 70 Di Chapter 9 (commencing with Section 7000) of Division 3 of the ' Illness and PrWessions Code) or'that-he -irexempt therefrom -and the WATER -HEATERS "--'BTU OUTPUT ' - - _ - -' -'-"—' -'- — - _ -- - -• - -- - - for the alleged exemption. Any violation of Section 7031.5 by - SEWER CONNECTIONS ' ` I �• ,.-applicant for -a permit -subjects -the -applicant to -a -civil -penalty- _lot more than five hundred dollars ($500). I, as owner of the propertyT or my employees wlttiWWages as -their' -SOLAR TANK- _ COLLECTORS.•, ' "' - - .sole compensation, will -do the work, and the structure is not intended _ ••-` _ _ _ _ •_' or offered for sale. (Section 7044, Business and Professions Code: The _ SOLAR PIPING SVS. 11 ' ' S "-' _ ISSUE FEE - EE-Contractor's. Contractor 's,License .Law Coes not apply.to an owner of,a property-_ ISSUE FEE ' APPLICATION APPROVED'BV- '- - ---' DATE who builds or improves thereon, and who does such work himself or through.his awn employees, -provided that -such improvements are not_ MECHANICAL PLAN CHECK i __ ___ _ _ SUMMARY OF,FEES intended or offered for sale. If, however, the building or improvement have the burden -is sold within one"year of completion, the owner will Of roving he did not build or improve for the purpose of sale). HEATING SYSTEM 0-100,000 BTU BUILDING— -'-- - -- -- - - - `^'!.a-. as owner of theproperty, am exclusivelycontracting -with AND DUCTING PERMIT $ y': SMIR. sed contractors to construct the project Section 7044, Business p ( 100,000+BTU PLAN CHECK'$ ,.LPERMIT' ntl -Professions lode: The Contractor's License Law does not apply - ISSUANCE $ - - - ,and ocon-- an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,I— BTU PLUMBING $ f • 4. 1 -tracts-from such protects with -a -cont ractor(s) hcesned-pursuanF to- -SYSTEM - - - - �'-- ---- - -- - -- -- - -- -- -- GRADING S the Contractor's License Law). 100,000 + BTU PLAN CHECK.- HECKt' I r - L•� -B: '(]- 1 am exempt undePSection - -B: &-P: C. for this - - BOILERS BTU 7 -- $ ELECTRICAL $ -1 reason -- -- -- - -- - - SVSTEM REPAIR, ALTERATION I .MICROFILM -.$ PL -AN -CHECK $' - ` � TOTA L.FEE $,'--' � MECHANICAL'$ Date Owner I hereby certify that I have read this application and state that the above _ EXHAUST SYSTEM _ MULTIPLE - LESSAD- %' _ •! 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 'pi'thil city to enter -upon above mentlone ,. / r„ I -r - -,� •, r ^. propert r in fiction .{ n 11 S� Sl gnat ure - --ISSUE FEE -- - - ^- - - - - FINAL FEE $ - - -- _ - - Drivers' License or 55 CMF 0865-46 White -Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor CONSTRUCTION AND PLANNING APPROVALS Permit# -� Date Inspector POOL & SPA - =. _ ,Date_^ Inspector APPROVALS y I� �Oermii�#� 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 b. Steel ein orce 47. Rough Plumbing & Pressure Test 6. Electrical _UFERGrn_ -v 48. APPROVALTOCOVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn - . 8. -_Foundation '_ 50. Gas Pipe, .❑Undrrn,Test 9. - Water Pipe-Undrgrn- _ _' _ 51. Backwash Lines P -Trap.❑ Undrarn - - 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 -- 14. Rough Electric -Conduit -S - - 56. Electrical -Final 15. Rough Electric -Wiring • - - - - - - - 57. Solar System -Final 16. Rough Heating & Air Conditioning bS. Fencing & Access Approval 17. Ducts, in Structure _ APPROVED FOR PLASTERING 18. Ducts, Ventilating. 19. Gas Pipe -Rough & Test - - 20._ Roof Framing _ 60. POOL/SPA SYSTEMS FINAL. •• ' - 21. - 22.= Roof Sheathing Frame and Flashing- - NOTES:•'_' - 23.. Insulation- - - - - 24. Lathing & Siding - -- - - 25. Drywall Nailing 26. Plaster Brown Coat -27. Electrical Power Meter -Final 28. Final Electric - - - 29. Final.Heating & Air Conditioning . 30. Final Gas Pipe -Test 4 LL 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 -"- Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. Ale, COS ESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NU. Ae;tA�d`da' Z 6'Ls6 n /B 3¢26v A�plicant's*a'iliinq Address ^ TYPE OF CONSTRUCTION W ADD ALTERATION REPAIR rR Owner's Nam —x�` t`�� phrene � / ❑CONVERSION ❑DEMITS H � O�64 E r� (4, ,, G i / DESCRIPTION. OF WORK/l1SE OF 8 DGr [•�/ Address Cl✓s Gsa.�T Arch/Eng. License No. Address Contractor's Nam `lll'G SPZ—�4 L1 S Pho e Address (mailing) ZAA)D �y �ICea� City License No. LICENSED CONTRACTOR DECLARATION 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 my license is7fd_Jynyfp a /nd,eSfyct. Al, ­iI,-s WORKERS j' COMPENSAT}QN DEC LARA ON /) x hereby affl rrsethnt I h i5 a certificate �fto enc to self -ins re o a�,tlficate f Workers' Comperes ion Insurance, or a ertified cop eof (Section 3800, Lab. Policy No. � an rll l�.l Cer ted copy Is hereby furnished. tlf y ' etl with the DIVI51Pl . APPI(c EXEMP ON FROM WbRK ,' COI PEN TION DEC A A O (This sect Ion need not be'c pled if the per tis for on In m "dl 00) or less). I .-.+ I certify that In the p rmart a of the work f r which in permit is Issued I shall not employ any. on any man o as to become subject to the Workers' Compensation -kid Date�Sigrie[uie NOTICE: If, after making)t hiS'.lfecpration, you should become subject to the Workers' Compensation provipons:of the Labor Code, you must forthwith comply with such provisiods. o1. this permit shall be deemed revoked. 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.) Lender's Name `•� Lender's Address OWNER BUILDER DECLARATION I hereby affirm that 6m exempt from the Contractor's License Law for the following reason (Section 7031.5 Business and Professional Code: Any city or county which requirri permit to construct, alter, improve, demolish or repair any Sir uctu��r�e� pprior ts issuan Ce, also requires the applicant for Such permit to file a sig00'd`statemen t that he/shgJ55)icenseo pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of livision 3 Of the Business and Professions Code) or that he/she is exempt lerefrom and the basis for the alleged exemption. Any violation of Section 031.5 'by any applicant for a permit subjects the apPliCant to a civil Eof not more than five hundred dollars ($500). LlI, 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 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 thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for Sale. If, however, the building or improvement is sold within one year of com. iF�nthe owner will have the burden Of proving he/she did not build or im- r the purpose of sale). s owner of the property, am exclusively contracting with licensed Con. 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 builoS Or improves thereon, and who contracts for such projects with a con. tractors) license pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation Insurance should be provided to me. ❑ I am exempt under Section B. & P. C. for this reason Date Owner hereby certify that I have read this application and State that the above I nformatlon Is correct. I agree to Comply with all City and county ordinances and St wa lacing to builtlin construction, and hereby authorize repre- sentatl s o s city t ante upon the above-mentlonatl ropert' jo inspeG ses. �V Si to Dat rivers' License SS # TYIPEEI OF PERMIT U GRADING LI FOUNDATION LJ STRUCTURAL LyI ENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL W7 OTHER PROJECT DESCRIPTION SO. FT. OCCUPANC��Y�a�--ss'�'� 'CONSTRUCTION TYPE VALUATIONS ZONE GRADINGCU.YDS. ACRES_ Remarks: / L' Jj C> FEES Bar Sink Showers Backflow Preventer Service Sink Backflow Irrigation Sewer_Cap J Bathtubs Sewer Connection $15 Issue Fee Clarifiers Solar Collectors $ 3 Dishwasher Solar Piping Drinking Fountains Solar Tank DEVELOPMENT SERVICES Zoning Approved By Building Approved By Application Issued By Floor Drains Swimming Pool w/Spa Floor Sinks Urinal Gas Service Outlets Water Closet Interceptors Water Heater BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% Kitchen Sink Water Service SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE Lavatories Auto -Wash P—Trap Laundry Trays Roof Drains Reinspection Fee 1 $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑ O7 00,000 BTU E1100,000 Reinspection Fee 1 $15 CMF 0 v. 10/84 White - Building; Canary - Applicant; Pink - Accounting; Goldenrod - Assessor Issue Fee Hood or Type 1 ❑ Canopy Type If ❑ Refrigeration System ❑0.100,000BTU ❑100,000 System Repair/Alteration Fire Dampers Registers Issue Fee A.P. # S Main Building: E T Front ARear C Right S Left Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electri Fan F.A.U. Zone Accessory Building: Parking ELECTRICAL Transformer ❑ 15.50 KW ❑ 50+. KW. Meter Duo to 100 amps Meter ❑over 100 amps Device Boxes Outlets Switches Garbage Disposal Generator ❑65 KW 1:15-15 KW Sub Panel Motors 00-1 HP 01R-8 Inc. Solar 09.15 HP ❑ 16-15+ Microwave Pole Light Range Standing Sections Trash Compactor FEES Z O N I N G R E Q M T S $ 3 J Reinspection Fee $15 Issue Fee $ 3 FEES DEVELOPMENT SERVICES Zoning Approved By Building Approved By Application Issued By REQUIREMENTS: Date Date Date BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL PLAN CHECK 25% SUMMARY OF FEES $ :3.5.00 $ — $ $ $ $ . $ $ SMIP PERMIT ISSUANCE ENERGY P.C. GRADING MICROFILM TOTAL FEE $ •� $ $ $ $ $ S -b $ 3 .CONSTRUCTION AND PLANNING ,APPROVALS Permit# Date Inspector POOL & SPA 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test , 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' APPROVALS Permit # 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 0Oil •'� 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank ❑Gas 00il 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 It •' 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test' 36. Hood or Canopy 37. Final Factory Fireplace - �•� , 38. Final Plumbing - r 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 A- - ectionb _ • 46. Handicap Regulations 47. FINAL STRUCTURE &BUILDINGDate - , - -' -48. Special Requirements Completed , 49: Electric Release to Edison 50. Gas Release to Southern California Gas Co - 51. CERTIFICATE OF OCCUPANCY No. Date 4N 60 1 Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA WR UC I PERM Project Address UN O. Appticadl's Atilin/g�Address r Own'er's Name Ph 1 Address •'�L.LT' —A-- Zone . S Arch/Eng. License No. Address LJ FOUNDATION LJ STRUCTURAL ❑ PLUMBING ❑ MECHANICAL T Front Contractor's Na 6411!hdn Address (mailing) AkJG City License No Right LICENSED CONTRACTOR DECLARATION -' I hereby affirm that 1 am ncensord under provisions o1 Charter 9 (commencing With section 7000) of DiVision 3 of the Business and Professions Code, and my license isyr-(ulj�yrpe a�lft. Q — �71^7 WORKERS' COMPENSATIO NN LAR 'ON I hereby affirm that 1 have a cer fitate oft sent to 9 V Workers' Compensation In urance, or- certified 3800, Lab. _ / r POlicv No. _ any (This section need not be corn ted if the perml is for ndfed $100) or less). 1. I certify that In the-isBrfor "Ince of the work fo whit Is permit is issued, I shall not employ an Ys pere0in,.any manner s as to ecome subject to the NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation pmWsions of the Labor Code, you must forthwith comply with such'lprovisiobs%or this permit Shall be deemed revoked. CONSTRUCTION LIENDING AGENCY I hereby affirm that there is a cinstruction lending agency for the performance of the work for Which 3hls permit is issued (Section 3097 Civ. C.) Lender's Name _ Lender's Address OWNER BUILDER {DECLARATION I herebv affirm that Fam exempt from the Contractor's License Law for the I L lerefrom and the basis for the alleged exemption. Any violation of Section 331.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars ($500). ❑ 1, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the structure IS not intended or offered for Salo (Section 7044, Business and Professional Code: The Contractor's License Law doesnot apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own employees, provided that such Improvements are not intended or offered for Sale. If, however, the building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- prove efor the purpose of sale). ❑ 1,s owner of the property, am exclusively contracting with licensed con- tractors to construct the project(Section 7044. Business and Professions Code: The Contractor's License Law does not apply to an Owner of property who builds or Improves thereon, and who contracts for such projects with a con- tractor($ license pursuant to the Contractor's License Law). i am aware that proof V their Worker's Compensation insurance Should be provided to me. ❑ 1 am exempt under Section B. 6 P. C. for this reason Date Owner I hereby certify that I have rad info r is co t. I agree to antl s to I r atl g to b ildil septa v f is ny to nter nspa on S. Sig t e L_ Dri ers' License a SS 2)P CMF Z -48, rev, 1 84 White thisapplication and )in ply with all city a construction, and hl P RMIT NO. - ts 32 01 TRACT NO. LOT NO. UN O. 5233 2/17/81 TYPE OF CONSTRUCTION L^Ew Cl CONVERSION ❑ DEMOLIS OES IffTIQjJ QF yV01! t16G-i3F "" ( J �s ^7_ I U A//DD''D LJ ALTERATION REPAIR ❑ OTAi Fri r BLDG. (( �}� % _� I A.P. q{s Zone . S Main Building: Accessory Building: TYPE OF PERMIT El GRADING ❑ TENANT ❑ ELECTRICAL OTHER - El OTHER LJ FOUNDATION LJ STRUCTURAL ❑ PLUMBING ❑ MECHANICAL T Front B Rear C Right SMTP $ PERMIT ISSUANCE $ ENERGY P.C. $- GRADING $ MICROFILM $ TOTAL FEE $ —J ZLL PROJECT DESCRIPTION SQ. FT. OCCUPANC CON STRUCTION TYPE VALUATIONS ZONE GRADING CU. YDS. ACR S K S Left ' Ping. Ret. # Parking Req./Provided Remarks: f 4132 Planning Notes: Issue Fee $ 3 PLUMBING FEES -,s Bar Sink Showers ELECTRICAL Backflow Preventer Service Sink Automatic Washer Transformer ❑ 15-50 KW BackflowEl Irrigation Sewer Cap Construction Pole Sub. 50+KW � - Bathtubs Sewer Connection Cooking Unit Meter ❑up to 100 amps , Clarifiers Solar Collectors Dishwasher Meter ❑over 100 amps Dish Washer Solar Piping Dryers ❑Gas ❑Electric Sub Panel Drinking Fountains I Solar Tank Fan Motors 00-1 HP 0 y.- B Floor Drains Swimming Pool w/Spa F.A.U. Inc. Solar 09-15 HP ❑ 16-15+, Floor Sinks Urinal Fixtures Microwave Gas Service Outlets Water Closet Device Boxes Pole Light Interceptors Water Heater Outlets Range Kitchen Sink Water Service - Switches Sign Lavatories Auto -Wash Garbage Disposal Standing Sections P—Trap Laundry Trays Generator ❑45 KW ❑5-15 KW Trash Compactor Roof Drains Reinspection Fee 1 $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting 110.100,000 BTU ❑ 100,000 BT Reinspection Fee I $15 Canary - Applicant; Pink - Accounting; Goldenrod - Assessor 74.75 TI - Z O N 1 N G R E Q M T S FEES Issue Fee $ 3 Reinspection Fee $15 Issue Fee $.3 iANICAL FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By Application Issued By I Date Date Date Hood or Type ❑ Canopy Type I1 ❑ Refrigeration System 00-100,000BTU 0100,000BTU BUILDING PERMIT PLAN CHECK PLUMBING PLAN CHECK 25% ELECTRICAL PLAN CHECK 50% MECHANICAL - - PLAN CHECK 25% SUMMARY OF FEES $ '0t% $ 7.5 2 $ $ $ $ $ $ SMTP $ PERMIT ISSUANCE $ ENERGY P.C. $- GRADING $ MICROFILM $ TOTAL FEE $ —J ZLL System Repair/Alteration Fire Dampers Registers Issue Fee $ 3 CONSTRUCTION AND PLANNING APPROVALS Permit # Date Inspector _ POOL & SPA 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 LIFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P -Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor -Final 12. Sewer Cap 63. Heater & Vent -Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical -Final 15. Rough Electrical -Conduit 66. Solar System -Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical -T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit# r 20. Rough Factory Fireplace 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0Gas 00il 23. Gas Pipe -Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank OGas 00il 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe ' 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter -Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe -Test 36. Hood or Canopy 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 i 44. Landscape Irrigation System F :��'. �• - i 45. Sound Attenuation E X F 1 R E D 46. Handicap Regulations ' 47. FINAL STRUCTURE & BUILDING 1)t@ r •t .. 48. Special Requirements Completed t g 49: Electric Release to Edison 50. Gas Release to Southern California Gas Co r. 51. CERTIFICATE OF OCCUPANCY No. Date C �- a. Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA�MEESA CONSITRUCTION �PEERRMMIIT -Project Address._ -fit 2�y7��N q t��s--1-,t'� Applicant's Mailing Address�•�'I12 Owner's Name Phone AddressRte- k AN, Arch/Eng. ' icense No. C N , J / d Address r qt 2? ,TR Contractor's Name��L NA.�O G.QgsJfmsO Phone :EM -O e . Address (mailing) City License No. LICENSED CONTRACTOR DECLARATION I hereby affirm that I'am licensed under provisions of Charter (commencing with section 7000) of Division 3 of the Busines and Prof s ns Code; and my license is in full fort nd effect. License Class Lic ,Date — Signature WORKERS' COMPENSATION D LARATION hereby affirm that I have a certificate of consent to self -insure or a certificate IWorkers' Compensation Insurance,_ or a certified copy thereof (Section .800, Lab. O.)-// Policy No. C��t! Company �Certif ietl copy is Hereby furnished. , Certified copy iyii led with the city B Di n. Date �Z'ZJ-�� APPlicant � z — EXEMPTION FROM WORKERS' CO PENSAT ECLARATION (This section need not be completed if the permit is for one hundred ($100) or less). I certify that in the performance of the work for which this permit is issued, 1 Shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. Date Signature 'NOTICE: If, after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. 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.) under's Name Lender's Address_ OWNER BUILDER DECLARATION 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 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/she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of �lvision 3 of the Business and Professions Code) or that he/she Is exempt :refrom 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 ke nalty of not more than five hundred dollars ($500). U l;'as owner of the property or my employees with wages as their solo co�npenea tied, will do the work, and the structure is not Intended or offered 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 thereon, and who does Such work himself/herself or through his or her own employees, provided that such improvements are not Intended or offered for Sale If however the building or Improvement Is sold within one year of com- U 2 6478 12/27/85 51 n1:3 T1. TYPE OF CONSTRUCTION LJ NEW LJ ADD ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTH R DESCRIPTION OF WORK/USE OF BLDG. ll= ' )r _ZuPRo�� E Duct - Under Ground rfor the purpose of sale). , aS owner of the property, am exclusively -contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law tloes not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) Ilcense pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. A.P-# , .— O 1 Zone - - S Main Building: Accessory Building: Exhaust System ❑ Multiple TYPE OF PERMIT�r�tt---'���LJ /// GRADING LJ FOUNDATION EXSTRUCTURAL• ElTENANT yp ELECTRICAL 1:1PLUMBING WMM ECHANICAL ❑ OTHER T Front Q7(- O B A Rear Pjt(� I l N $ eSO ' Reinspection Fee. $15 N PROJECT DESCRIPTION SQ. FT. OCCUPArvpY - CONSTRUCTION TYPE :TVALUATION$ /O_� �© ZONE GRADINGCU.YDS. ACRES $ Left - - G R Ping. Ref. # Parking Req./Provided - $: $ $ $ QO ISSUANCE ENERGY P.C. GRADING MICROFILM ' TOTAL FEE - Remarks: Planning Notes: '� $ 3 PLAN CHECK 25% $ /1, O qE ' PLUMBING FEES !/ YB HC Bar Sink Showers ELECTRICAL i -FEES - Backflow Preventer Service Sink - Automatic Washer Construction -Pole Sub. Transformer 0-15-50 KW r �❑ 50+KW " Backflow Irrigation Sewer Cap- Bathtubs Sewer C nection Cooking Unit Meter ❑up to 100 amps' Clarifiers Solar Jklectors Dis1hwasher Meter ❑over 100amps ` - Dishwasher Sol Piping Dryers ❑Gas,❑Electric Sub Panel" Drinking Fountains lar Tank Fan Motors E10-11 HP'❑1X-8 401 Floor Drains Swimming Pool w/Spa F.A.U. 'Inc. Solar ❑9-15 HP 1116-15+ Floor Sinks rinal - Fixtures Microwave ' Gas Service Outlets W er Closet Device Boxes Pole Light Interceptors Wate Heater Outlets Range Kitchen Sink Water ervice Switches :y Sign Lavatories Auto -W sh Garbage Disposal) ;Standing Sections P—Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor Roof Drains Reinspection Fee $15 Issue Fee S 3 -' • t - Reinspection -Fee $15 Issue Fee $ 3 Boiler pletion, the: owner will have the burden of proving he/she did not build or lm- Duct - Under Ground rfor the purpose of sale). , aS owner of the property, am exclusively -contracting with licensed con- tractors to construct the project (Section 7044, Business and Professions Code: The Contractor's License Law tloes not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- tractor(s) Ilcense pursuant to the Contractor's License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. Duct -Structural ' Duct - Ventilating - Exhaust System ❑ Multiple ,. Firepl/Fact. BIL ICBO # ❑ 1 am exempt under section B. & P. C. for this reason Date Ow - I hereby certify that I hav r d this application and state that the above Heating System & Ducting [30-10o,000 BTU -0100,00061 information is correct. I ag e o com y with all city and county ordinances .and state I tin o u tling struction and hereby authorize repre- sentatives of t o ter the above.mentioned property for' inspection pu f Signature Date/7 'Z7 '✓ Diivers' License ' - BUILDING, PERMIT SUMMARY OF FEES $ %'J$O SMTP $ eSO ' Reinspection Fee. $15 CMF 0865-46, rev. 10/84 White - Building; Canary =Applicant; Pink - Accounting; Goldenrod - Assessor Hood or Type ❑ Canopy Type 11 ❑ Refrigeration System 00-100,000BTU 0100,000 System Repair/Alteration Fire Dampers Registers Issue Fee Zoning Approved By Jd---��K�g� Date Building ApproJed B�-s�'t�Lfi�t/ Application Issued By ,. Datel Data ,2 - n,7 -'R 5 4 ' - BUILDING, PERMIT SUMMARY OF FEES $ %'J$O SMTP $ eSO PLAN CHECK $ 'f�•3� PERMIT _. PLUMBING ' PLAN CHECK -25% ELECTRICAL'$ PLAN CHECK, 50% MECHANICAL' $: $ $ $ QO ISSUANCE ENERGY P.C. GRADING MICROFILM ' TOTAL FEE - $ $ $' $ $ ' 7/, $ 3 PLAN CHECK 25% $ /1, O CONSTRUCTION AND PLANNINGPOC APPROVALS Permit # Date Inspector SPA APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Polg 52. Pool & Equipment Location 2. Soil Pipe;Undrgrnd. t• ,'; 53. Steel Reinforcement 3. Electrical Conduif Utility-Undrgrnd: ,=, �" 54. Forms t ,r;��, . 4.Electrical Condu�-Undrgrnd. ;; ;i 55. Electrical Bonding f 5.' Steel- Reinforceni!nt',, 56. Rough Plumbing &Pressure Test 6. Electrical UFER Grnd;t '/ 57. APPROVAL TO COVER-GUNITE i n 7., Footingsi ", •� ;' �? 58. Electrical Conduit-Undrgrnd. i 8. Foundation; - �'.,j,• i 59. Gas Pipe, O Undrgrnd., Test _9. Water Pipe-Undrgrnd. 1 60. Backwash Lines, P -Trap, O Undrgrnd. 610. Structural Floor Sysiemo 't i5• 61. APPROVAL TO DECK ' 11. Property Sewer Lin€& House Connection i ' 62. Backwash & Receptor -Final 12. Sewer Cap - ' �� '• 63. Heater & Vent -Final 13.• Roof Drains n 64. Plumbing System - Final 14. Rough Plumbin� ,'� 9 9' 65. Electrical -Final 15. Rough_ Electrical -Conduit - 66. Solar System -Final ' 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 13, Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT APPROVALS Permit 20: Rough Factory Fireplace 23, Ducts, in Structure 70. Underground Hydro - -22. Ducts,Ventilating 71. Product Piping 0Gas LOil 23. Gas Pipe -Rough & Tpst 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T -Bar Ceiling (Structural) & Monocoat �. 75. Dry Chemical 27. Fiame'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 a} 33. 'Final Electric Notes: 34. Final'Heating & Air Conditioning �.. -3- •DVI U o '� ec,-c_ '>-a ' 35. Final Gas Pipe-Testt�0Yr18ie.7 e�-L-az7 36. Hood or Canopy (o dt6 M(CLbl. "OT tZ90Q 04 L-•rz.,J 37. Final Factory Fireplace p y� 8 38. Final Plumbing 39. Water Service -Final, 40. Gas Service -Final 41. Solar Domestic -Final 42. Backflow Preventer7 i . 43. Backflow Irrigation - •` "!` 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed , 49. Electric Release to Edison _ 4 50. Gas Release to Southern California Gas Co • ' .' 51. CERTIFICATE OF OCCUPANCY No. � Date ;. !