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HomeMy WebLinkAbout2633 ELDEN AVE - Building Permits f Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 4 �/s l� - T. CITY OF COST .MESA. 589-- 31 tO/G3> A PERMIT NO. TRACT NO. .LOT NO. BLDG.NO. i CONSTRUCTION PERMIT • ; to tp 'StQ..9 ; •' •• ' Applicant's Mailing Address /7 -.Sr-. ,c-bw. ' t/L$ L'S'- ' TYPE OFCONSTRUCTO U NEW U ADD U ALTERATION- U-REPAIR , r , 4 I I ' •. t '� ProjectAddreS! 2G 3 ,E2s CN'' , C' - ktrstl ' ' 0 CONVERSION DEMOLISH 0 OTHE I • ! - . ' ' • _ �Ce , • VA0.G4 .0 OSy. 7W-ivy - DESCRIMION OF WORK RMOVE Mfr-rte CorcF,t _ - Owner's Name P Joh/• } -Phone ` •p f})p"f' rip N S • - • ZONING REGULATIONS Address •3!7 P 57•. . •O LOw( ' , ' - m , 4- LJ - - _ TYPE OF PERMIT GRADING U FOUNDATION U STRUCTURAL A.P.qW ZONE Arch/Eng. • _ License NO. ❑• TENANT ❑ ELECTRICAL PLUM GING ❑ MECHANICAL PLNG.REF.qW BUILDING 1 ` ❑'OTHER ecrw nry rIr ST- Address i - - -PROPERTYNLINE REAR YARD (TO P/L) Connector's Name d ' Phone PROJECT DESCRIPTION 50.FT. - OCCUPANCY - - , - • CONSTRUCTION TYPE VALUATION$ SD�� 'LEFT SIDE YARD I RIGHT SIDE YARD ' Address(mailing) - . . - ' ZONE m • GRADING CU.YDS: ACRES PKG.SPACE REQ. l PROVIDED l License No; •__ - • M W" - - LICENSED CONTRACTOR DECLARATION RemarW: • ' I 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 • 1 • 1 I i SPECIAL CONDITIONS: _ • _ • . . I - rimy Ilcenieris In full force and,effect. • ' license Class License No. . I PLUMBING . . - I • j Date' Signature ' - - WORKERS'COMPENSATION DECLARATION Bar Sink , Sewer Cep • ELECTRICA • L 'I hereby affirm.that.l have a.certlflcate.of 6onsent.toself-insure or a certificate-'_ - - Backflow Prevents` -- -' ,- - -- Sewer Connection -- ---- -- : - Automatic Washer - _ ._.' (Meter_❑Over 100 amps ____ _ • of Workers' Compensation Insurance, or a certified copy thereof (Section - 3800, Lib. C.) Backflow Irrigation • ! Soler Collectors • - Construction Pole 'Sub Panel' - Policy No. , Company " " . - - 8 Certified copy ii hereby furnished. Bathtubs . Solar Piping Cooking Unit Sub Pole ; Certified copy is filed with the city Building Division. Dishwasher Date - Applirnl _• Clarifiers Solar Tank I c ,l .Motors ❑0-1 HP ❑1'h-8 EXEMPTION FROM WORKERS'COMPENSATION ISECLARATION - Dryers ❑Gari❑Electric - 'Ina So lar,00-I'S-TIP ❑16-15+ (This section need not be completed if the permit Is for.one hundred($100)or Dishwasher , : Swimming Pool w/Spa , less).. , Fan • I .Microwave I certify that in the performance of the work for which this permit is Issued I Drinking Fountains I Urinal I �' , i , shall,not employ any person In any manner so as to become subject.to the • I • F.AU. _FPole'Light j ' Workers' Compensation Laws of Callfornle.l Floor Drains; Water Closet, • �'- Dale Signature I - • - i ' Fixtures 1 NOTICE:If,after making thissions anon;You should become subject to the- : Floor Sinks --, Water Heater :- - :- ,' • - �- . - Range - •- - -_- _ _ - .. Workers' Compensation provisions of the Labor, be st forthwith - - Device Boxes comply with such provisions or this'-'pormlt shall be deemed revoked Gas Service. • •Outlets Water ServiceSign i I CONSTRUCTION I LENDING AGENCY • - - ' - - • I hereby affirm that there IS a'construction lending agentyfor the performance, y m Interceptors • '� ; _ I ' • _ Outlets IStanding Sections of the :work for.which this permit-is,issued (Section -3097 Civ. C:) • •., •a Switches I • Lenders: Name • _ - ' _ -' Kitchen Sihk' - • , .! 'Trash Compactor I • Lenders' Address - I ' '' , ' - - /, - - ' - - OWNER,BUILDER DECLARATION , _ , 1 , Lava?orjes'C R EPA( Re' - I - • _ _Garbage disposal I I hereby,affirm'that I am'exempt'from the Contractor's License Law for the . Generator ❑0-5 KW ❑5-15 KW ' ' • following reason' 7031.5 Business and Professional Code: Any city or T ' P-Trap• . , - i _ - ' county which requires a permit to construct,alter Improve,demolish or repair . - , - I _ Transformer ❑15.50 KW any structure:prior to its'issuance,'also requires the applicant for such permit • • Roof Drains '- .. m ' to file a signed statement that he/she is licensed pursuant to the provisions of . - . - - ❑5U+ KW ' ' the Contractor's License Law(Chapter 9(commencing with,Section 7000)of m - - - - . Reinspection Fee $15 ;9ivision(3'of the Business and Professions Code)-or,that.he/she isexempt ' Showers -. , d i -. Reinspection Fee 4 -$15• , T:: refrom and the,basis for the alleged exemption.-Any violation of Section - ' - -- - Meter pup to 100 amps • •Issue •Fee 1 -$ 3 -431,5 by any applicant for; a,permit"subjects'the:applicant to a civil • 1 I • arty of not more than five hundred dollars($500). I .. Service Sirik I I m lane Fee 7, $ 3 Zoning Approved By • Date I: as:owner of the property - - - - " • - _ • - - ' oat ctionlh do the work;and.the Structure'is not Intended or offered - . MECHANICAL • •p . • Application Approved By `late • for salmi a (Settlon 7044, Business and Professional Code: The,Contractor's - , License Law does not apply to an owner of a property who builds or improves m Boder. I I y , Refrigeration System • Application(sued B Date �I� thereon, and who d that such work himself/herself or through his or her own I i1 PP Y , employees, provided that such or ements are not Intended or offered for - - - - m 00-100,000 BTU ❑100,000 BTU' , sale, If, however, the building or improvement Is sold within one year of com- • , Duct-Under.Groundr pletlon, the owner will have the burden of proving he/she did not build or im- SUMMARY OF FEES • LJrove for the purpose of sale). I , Duct-Structural System Repair/Alteration •'•`, BUILDING PERMIT $• ' SMIP $ . i I,as owner of the property,am exclusively contracting with licensed con- I - . m , I • tractors to construct the,Oroject.(Sectlon.7044,Business and Professions Code: . Duct-Ventilating_ - - _ _ _ _ . _ -• - I. ' _ - .' PLAN CHECK $ - PERMIT The Contractor's License Law does not apply to an owner of property who ' • I ISSUANCE ;• I S m builds or Improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 I 1 ' PLUMBING ' $ r tractor(s)license pursuant to the Contractor's License Law). ' , GRADING $ • ❑ 1 am exempt under Section B.& P.C.for this reason m Firepl/Fact.Bit.ICBG 4' I I e - •PLAN CHECK $ • •1 m I , He•ating System lir ' ' 'ELECTRICAL j $ - • • $ Date - Owner • g Ducting l _ _ PLAN CHECK! $ 1 MICROFILM $ • -I hereby-certifythat Phare read-this-application and-and ate that the above- - • —: ❑0.100,000 BTU-0100,000 b 1L • information is correct. I agree to comply uc with all city county ordinancesrepre- - ' TOTAL.FEE. $ • ' antl`'state laws relating to building construction,and hereby authorize r , i - •MECHANICAL • $ • sentatives of ltnis aty,t enter ,on the •ova-mentioned Dr•pe ts' for Hood of Typal ❑, • Reinspection Fee. $15' I I LESS Inspection orse �'�ss r ' t d-, i Canopy Type 11 ❑ nsPa •PLAN CHECK $• , • I SI nature LG" �+ i Date _ • ! t ; I ADVANCED PC $ Drivers' License 6x55 m Registers Issue Fee • $ 3I - l 1 , FINAL FEE f $ S-_ ' CMF 0865-46 rev.12/82 White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor . 7 ,2C , _ _ .. - ; � - POOL•_ .A 'i ca ` _. . CONSTRUC ' .":.' ND,PLA ING - - /. - - � � lq `Date - Inspector Date Inspector - a SAPPROVALS Perinif# .APPROVALS- Permrt# - - - ro ;1- Temporary.Electrical Service oryPole y t • c. ' 527 Pool &:Equipment Location, - - ' • {i `! ,Soil Pipe-Undrgrnde ; ; I "; ' 53'. Steel Reinforcement - ' n• 3! Elect/lea' Conduit Utility-Undrgrnd, i �-• •,54 Forms ° ,J' .. '. . - r 4' Electrical Conduit-Undrgrnd: P . - r : •; : 55 'Electrical Bondingt. `., - - _ c 5: Steel,Reinforcement ; c i I ' ' - - -56 Rough Plumbing&Pressure Test _ . o 6: 'Electrical UF ER Grnd., • - . 57:; APPROVAL TO COVER-GUNITE' _ 7. Fodiings `- - ' - 58 Electrical Conduit-Undrarna.. . . i 8. Foundation , , • ;' ,,, _ 59. Gas,Pipe, O Undrgrnd.-,Test 9. Water Pipe•Uridrgrnd. a- rz - - ' '60. Backwash:Lines,P-Trap,'0 Undrgrnd. _ ' - 10. StiucturalFloor System V•' ' . 61. APP.ROVALTO DECK ' . 11. Property Sewer Line'& House Connection - 62. Backwash & Receptor-Final,i, - - .. 12. Sewer Cap - 63. Heater& Vent-Final - 13. Rpof,Dreins - - - ' 64. Plumbing System.- Final . 1- - 14. Rough.P.lumbing v. ' ' 65. Electrical-Fihat - .. • • E 15-.:Rough-Electrical:Conduit' - - -- ,' , - - r - -" 6675o1ar System=Final - - - --- '-- - H'16...Rough-Electric Wiring, - _ - '-+ i._' 67:'Fencirig&'Access.Approval - - :- - • • -17. 'Rough.Wiririg'Sign - • : ' - , 68 APPROVED FOR PLASTERING , • ' 18. ;Rough Electrical-T Bar Ceiling, ' 69.' POOL/SPA SYSTEMS'FINAL ' ' •• I 19. 'Aough`Heating& Air Conditioning i ' ` it$ - l � .FIRE DEPT. REQUIREMENT . . - • , 20:'Rough•FactoryFireplace '. ' APPROVALS• Permit# 21 yDuc[s,'in Structure 1 I , 70.' Underground Hydro '. t22. Duct ts;Ventilating • • ' '' ' • ! ,71. Product Piping 0Gas 0Oil , _ _ ''.23..Gas.Pipe-Rough&Test 1 ' ! , : • ' 72. Underground Flush . ";24. Roof Framing! I -• ' „ . I. 73.' Undergrnd.Storage Tank 0 Gas 0 Oil, n 25.`Roof Sheathing , ' • -, I _ ' • 174.1 Overhead Hydro • 26. T,Bar'Ceiling (Structural.& Mon • ocoat' 95: Dry Chemical ' . - +. ,;27. 'Frame-and'Flashing, , : ' 76.. Dry - - ' 0 28. +,Lathing&Siding ; ', � I .77.' FIXED SYSTEM..FINAL ' ' •, • 29Jllnsulation • ' Iu ,78.1 FIRE, PREV. FINAL • 30.1Dryviwall Nailing i I. I I Notes:, . , 31. •Plaster Brown Coat �'`� I� � � i 4-1^ -' q 32.,Electrical Power Meter;Final I, 1 ! I i ��", Q tl_ ' -33. :Final Electric ' , i L • '_ _ __ _ 34. Final Heating&'Air Conditioning ` 1 , I I y - 35. Final Gas Pipe:Test t- , ' l.- , , • I - -• • '' 36. Hood or Canopy-. ' , 1 ' - ' - I - - 37. Final Factory Fireplace - • - 38. Final Plumbing 1 I ' •i1 . , 4;/-13 , .- 39. Water Service-Final' , I I i! 1 1 , , , ' ' , 40. Gas Service-Final '� I _ _ , 41. Solar Domestic:Final ' I ' 42. BackflowPreventer. I .' • i - _ _• .-_ _ _ - _ • 43. Backflow Irrigation , 1:. l l �' • t 44. Landscape Irrigation Systemw , ! -- 45. Sound "Attenuation ' • i • , ! _ ' I , , _ _- •- 46. Handicap.Regulations l I _ I -I I • , - , 47:FINAL STRUCTURE & BUILDING, ' 48. Special Requirements Completed , -; I 49. Electric Releaseto Edison I I ' ' - 50. Gas Release to Southern California Gas Co ' , ! ' ,• 51. CERTIFICATEOFIOCCUPANCY ! ' 1 - ' •' No '• , , Date , ,: ; , i' 1 i - t i • r • EE RECEIVED 7741 10 .Jl0 s 8 J COSTA MESA BUILDING DEPARTMENT P.O.BOX 317 NM K. COSTA MESA. CALIFORNIA ' aft Of COM U FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ADBUDRESSILDING,:,? (35 4%.4 SC BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY /// / RECEIPT NO. PERMIT./' NNjj. OWNER `%i%i0,4S „Xii /.�/S pyre,/ n■ • Z1 AMAILDDRESS /�J� i- Wil t� RECEIVED / BOE 6RE�S� OnEIVED �iFQlssirt9t,� ``/J( V / TEL. BUILDING V lJ � 1 CITY eel/Via/ A4/:f NO. ADDRESS ARCHITECT r LIC- OR ENGINEER NO. COSTA MESA. CALIFORNIA ADDRESS ►� ' e FIRE ZONE • ., TYPE GROUP ./ llia OONTRACTO t.r� �� 41_ ._.I .. , slkd a F 'I ADDRES+ C r .y FSI iti NCI. J / i D BY ../ D ' DATE tQArt , LEGAL CORRECTIONS DESCRIPTION ir BLOCK TRACT a A.P.NO. - _,e, Q _ OSIZE F LOT i06 0 3m ._. ilitlInla- USE OF EXISTING BLDG. CITY OFIIISTA MESA CESETBACKNTEROF LINESTREET FROM PLAN Q G DEPT. �' .� i• . • : SIDE YARD RIGHT . . LEFT 4...S.-- i laI DESCRIPTION OF WORK Ir.-SP1 • 1 4 ` NEW Y ■�i ALTERATION • .I ADDITION A REPAIR ■l1 MOVING ■I DEMOLISH SIZIE DING cn v`.3 .3 NO.OF se ROOMS STORIES EXTERIOR WALL'` ROOF COVERING COVERING j+// // USE OF NEW /i -&g/✓.L�R/J'r ^l Gy// Ny BUILDING OE / �ear'C I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND 70'2 ///111 STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL //O. — CITY ORDIN STATE LAWS REGULATING BUILDING CONSTRUC- TION. T" VALUATION SIGNATURE t��'./� ,p�� � 2 PERMIT FEE S ��-- PERMITTEE /Ste • *'•�'�"`�"� P. �-\\ //A S /7/ (-3 PLAN CHECK S 7a -' AUTHORIZED AGEN L� - 4* // / TOTAL FEE S ,16 - '°"F 1 1 City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 002167 Building Safety Division P.O.Box 1200 Costa Mesa.California The Building located at 9A-3q r1Apn D,T.Cnnp, Tinitq Da E. and P has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-3 Occupancy. Use of Building A,narttnpnts Legal Description 439-071-19 (See reverse side for Metes and Bounds) B25001 E25279 P25237 ," Building Permit No n7COO 9 Electrical Permit No. E25278 Plumbing Permit No. P25237 Mechanical Permit No. 1‘474977 • M24921 Number of apartments 2 and/or guest rooms F25557 ISSUED TO: Building Official t^i 11 i nr T. ^' Jackson Voorhies • , 2633 C Elden Street by -• •.r a. , . 1.11. Costa Mesa, CA 92627 Date May 1 i . 19117 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File _ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. _ CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO r, TRACT NO. LOT NO. • UNIT NO. It 1 1507 8/1 5/86 360. 1 :r *Project Address .2633 �LbtI►.s 2 '� 0 0 / �, 6t • �"�' F 1 • • Applicant's Mailin Address 2 3 3 G E L b 1E>J ,p- TYPE OF CONSTRUCTION NEW U ADD ❑ ALTERATION ❑ REPAIR , • Owner's Name 9 s�4DA 1I 1 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ � _ Z )d(.Ir.SOU VOOe1.l lifc.l Phone y 4 VFJ IT' A.P.AP # 4'3-I�b'�' I _ Zone >� 2633 �LD� Ii LT C-h � 6 � , DESCRIPTION OF WORK/USE OF BLDG. STOI1�( X07+ Address /' • ; _ S Main Building: N.F a Accessory B wilding: Arch/Eng. Lt/S KIE.P{4AJY Licenssee,NNo.l •.--a71 *TYPE OF PERMIT ' ❑ GRADING LI FOUNDATION STRUCTURAL T Front let 4z)'2433 / . o Address &24 `S T '•��L"a 0� �"•' V'241!'I • ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Contractor's NameOW N 1t2 B. LI)A '•1 Phone'S4$-41'4 ❑OTHER t4O `- �.� . C Right +ZB � N 3 (, - PROJECT DESCRIPTION Sq. FT. l DaCUPAUF4 • -�3 S q Address(mailing) 26 3 �.L.D {� K Left •• CONSTRUCTION TYPE -"Cr�t VALUATION $ City License No. .- - ZONE _ GRDING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION �1/[p �• PIng. Ref.# Parking Req./Provided E • I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: PO c � 7p 23o.7x7 . 3/T/p rp Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. /�c. •2Y'-fir. /28-�'� ' T License Class _License No.. - !r _ _- , -_ _ S tate Signature ' "• PLUMBING FEES HOLD FOR SPECIAL REQUIRt4Y LIM IS • WORKERS'COMPENSATION DECLARATION - ereby affirm that I have a certificate of consent to self-insure or a certificate Bar Sink Showers ELECTRICAL FEES Workers' Compensation Insurance, or a certified copy thereof (Section BAckflow Preventers Service Sink - „CA Automatic Washer Transformer 0 15-50 KW policy No."4q 041 - 8ti. CompanyTAT_t f Corn? kkAS T Backflow Irrigation - - $ewer Ca - I - . 0 50+KW • P • Construction Pole Sub. • BCertified copy is hereby furnished. rUIJD "' - — , Certified copy is filed with trinity Building Division,/ , Bathtubs' : / Sewer Connection Cooking Unit I Meter ❑up to 10 e amps Date Applicant - - , EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . , Solar Collecto 1 Dishwasher' Meter ❑Over +ID amps (This section need not be completed if the permit is for one hundred ($100) or less). Dishwasher Solar Pi. g I Dryers Gas ❑Electric Sub Pane - - I certify that in the performance of the work for which this peimlt is issued,I . shall not employ any person in any manner so as to become subject to the Drinking Fountains . Sol. ank - Fan Mot. s 00-1 HP ❑1'h-8 Workers' Compensation Laws of California- 1 _ - - Date Signature _ `. - - • Floor Drains wimming Pool w/Spa - F.A.U. - 'NOTICE:If,after making this declaration-, you should'become subject to the • - _ re.Solar09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal L3 Fixtures comply with such provisions or this permit shall be deemed revoked. I - ' Microwave CONSTRUCTION, LENDING AGENCY f Gas Service 4. Outlets 3 Water Closet 23 Device Boxes Pole Light • . I hereby affirm that there is a construction lending agency for the performance of the work for 'which this permit is Issued (Section 3097 Civ. C.) • ' Lender's Name Interceptors -y _ 1. Water Heater Ls-- OutletsRange - '-Lender's Address-' - - • - - - 1 Kitchen Sink ' f 1 Water Service - - IS Switches . • Sign OWNER BUILDER DECLARATION - - I hereby affirm that I am exempt from the Contractor's License Law for the ? Lavatories .y . 1 AutO-Wash 1 Garbage Dispo - • following reason (Section 7031.5 Business and Professional Code: Any city or " -1 9 P ;Standing Sections , county which requires a permit to construct,alter,Improve,demolish or repair P—Trap - r •- LaundryTrays • ' any structure, pi o'r to-its issuance, also requires the applicant for such permit - � y Generate �D-5 KW ❑5"15 KW Trash Compactor to file a signed statement that he/she Is licensed pursuant to the provisions of ROOF Dr. s' - the Contractor's License Law (Chapter 9 (commencing with Section 7000) of • .v - ' rvision 3 of the Business and Professions Code) or that he/she. is exempt-" ' - . • terefrom 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 - _�- ,pe0a7ty of not more than five hundred dollars($500).r -,1S("1, as owner of the property.or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3• ' compensation, will do the work,and the structure is not intended or offered Reinspection Fee I $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves thereon, and who does such work himself/herself or through his or her own - - - - DEVELOPMENT SERVICES UIREMENTS: employees, provided that such improvements are not intended or offered for Boiler Hood or Type I ❑ ZoningApproved By ( Date 1/4� Fi sale. if, however, the building or improvement is sold within one year of corn- - - Canopy Type II ❑ • pP pletion, the owner will have the burden of proving he/she did not build of im- Duct"Under Ground Building Approved By Date V/ �� Fe for the purpose of sale). _ jYt/ I,as owner of the property,am exclusively contracting With licensed con- Duct-Structural '. Refrigeratio Lein Application Issued By ' - Datn / /8� factors to construct the project (Section 7044,Business and Professions Code: ' ' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100 0 BTU 0100,000 BTUSUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con- j tractor s/` license pursuant to the Contractor's License Law). I am aware thExhaust BUILDING PERMIT ' $ 35'_7.00 SMIP - r0 ' proof of their Worker 's Compensation insurance should be provided to me. ' System Multi(JIe❑ S tem Repair/Alteration $ . PLAN CHECK $ ' PER MIT 0 am exempt under Section B.& P.C.for this reason I Firepl/Fact.Blt. ICBG# Fire Dampers ISSUANCE' ' $ PLUMBING $ Date - • Owner 1 Heating System&Ducting - Registers - PLAN CHECK 25% $ ENERGYy.C. $ - I hereby certify that I have read this application and state that the above 1 YO-100,000 BTU 0100 0 BTL ELECTRICAL $ GRADING $ Information is correct. I agree to comply with all city and county ordinances and state law relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $ L sentatives of his c'ty to en er upo the above-mentioned property-for -' inspection put.oses.p MECHANICAL $ • TOTAL FEE $ ��O• Signature v'�+p • • Reinspe on Fee $15 Issue Fee $ 3 - PLAN CHECK 25% $ VS CMF 0865-46,rev.10/84 White - Building: Canary - Applicant; Pink - Accounting: Goltlenrotl - Assessor POOL & SPS, - CONSTRUCTION AND PLANNING Date Inspector' Date Inspector APPROVALS Permit# APPROVALS Permit# 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 COVE R-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pips., 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System art.. I0 Vs L Def- 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection J _ 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring ' . 67.. Fencing & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit# _ - 21. Ducts, in Structure 70. Underground Hydro - - 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 OW 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing _!r ////��-� 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing _.�7y 74. Overhead Hydro . 26. T-Bar Ceiling (Structural) & Monocoat ` JJ�•_ 75. Dry Chemical 27. Frame and Flashing _,(� ,V�.. 76. Dry Standpipe / •- 28. Lathing & Siding 5+6a �p � 70 G' 77. FIXED SYSTEM FINAL • 29. Insulation ' 97 Q* 78. FIRE PREV. FINAL 30. Drywall Nailing. �05187 04e- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 3/r f87 0-* 79. FINAL_INSPECTION 1 , ._ 32. Electrical Power Meter-Final / 80. FOO6CERTIFICATE ISSUED I 0 /m�$il86 ¢a� ©K ATO I 33. Final Electric' Notes: �((A.p._� 'wog A__, 34. Final Heating & Air Conditioning ,i2.. ,, - ,1 6- 35. Final Gas Pipe-Test �%�/rj` V `P} D 36. Hood or Canopy ` �• 1 37. Final Factory Fireplace ., 38. Final Plumbing • • 39. Water Service-Final C c ` e /� - 40. Gas Service-Final v x..C�SA/ Q /nerls - c'C - 41. Solar Domestic-Final lkYl.vt - - - 42. Backflow Preventer - 43. Backflow Irrigation A 44. Landscape Irrigation System 45. Sound Attenuation -' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 47 7 se •- . - 48. Special Requirements Completed S., /i117 49. Electric Release to Edison t _ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY'- . No. Date l .r ApO�icanfill inlexcept those within heavyborder lines.a ntl sign all appropriate tleclaration s. _ -. - OB Ii`35T� - ' - -- 2spaces c 00 2 • I506 015/86' CIT OF COSTA MESA CONSTRUCTION PERMIT • P T N TRACT NO., LOT NO. 1 uNiT N Project Address 2 (.+.33 Ft-gD PSN OVd.1tTS ` ,. ' ` ` _• 1 - j ^ Ap�licantl5 Mailing Address, Cs 3 '� Krf--fl fc.l., TYPE OF CONSTRUCTION NEW U ADD U ALTERATION U REPAIR F C p ID CONVERSION El DEMOLISH ❑ OT.HER ( - A.P.#-� /, - _ - • -• �ZOre, Owner's Name �A[.LG.SDIJ VOQ(LNtBLS PhoneU�B` 1J'� —r UA yrs. -t. ��� -��-� �vl �?" • DESCRIPTION OF WORK/USE OF BLDG....- Address - Address 1-6330 ILL.DP•,.►i C-f-+ 'q 24,2'"L�• i z, 6A EAGEs1 i S Main Building: %kg ” . Accessory Building: tt f� Arch/6e9. J _f-r `- tP&Ul "- License No.C' -•a-7 74 • TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL • T Front +�� �/f ,� ��(�r/���`� T G •@q'_Ba .�' �' 2(�3( 0 Address z7•.t- i- - E gpl ots Cp CiI4A ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING '❑ MECHANICAL B Rear Q�S�u•+yQ POt,3J c, 10/ 1•0 , 433 e N t. ' ❑,OTHER - - 1 !U _ _.,4, LD'�- Ad- / A ]. Contractor's Name pLf. 1-3R-T1 _ �iZ}U"k1/411L.ti Am- Phone\ �1'"II'7'{•I C Right tet' - rj ' N 2 3 G ` i Dt..IJ CA: a , x- PROJECT DESCRIPTION SQ. FT OCCUPANCY kr- 3, K 1 G Address(mailing) E. � • _ -• CQNSTRUCTION TYPE ' i VALUATION$•IST/ 9654 S Left '� -o. • Cv` • , R City License No: ZONE GRAD NG CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION ` - I . ' 1 ' / J ,/ �J/- - Ping. Ref. # 1,-85-_, y, Parking Req./Provid¢d Q I hereby,affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /�C•, O- 1T6 370. 83 , ft / r 3/4t/V b Planning Notes: •- , : ' M with section 7000) of Division 3 of the Business and Professions Code,-and / - // �1 / - -- - my license is in full force and effect. _ • /"` •-fes �2 y.��� L - _ ! . _$ License Class' License No.' 7 (._ T'--' PLUMBING - 'w - FEES - �U r�R:SPECiAL REOUjgg,�LFNTR rte Signature' f • - - , - - - - • • - •' .JORKERS•COMPENSATION DECLARATION' -� - - I I hereby affirm that I have a certificate'of consent to self-insure or a certificate Bar Sink Showers -- - - ELECTRICAL-5 • FEES, of Workers' Compensation,Insurance, or a certified copy thereof (Section ,V 7 Backflow Preventer Service Sink , u 3800, Lab.F.L. I tc I/ -_ • Automatic Washer' - Transformer D'15-50 KW' Policy No-(-0-44 fl43 pal Company STPTIC �+ 0 I-%? 8 S. Backflow Irrigation. - Sewer Ca - - - ,) 1 ❑_50+ KW P y 9 P Construction Pole Sub. ® Certified copy is hereby furnished. A.V N D i ' • Certified copy is filed with the city Building Division- I ' Bathtubs Sewer Conner '•n „ Cooking Unit - M¢Ler'D up to 100 amps ' Date - Applicant I `• ' ;' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clafif refs(-, • - ' ' Solar Col ctors ' - - Dishwasher ' ' . Meter -Dover 100 ps , . (This section need not be completed if the permit is for one hundred1($100) or , , less). . Dishwasher Solar `icing. . Dyers ❑Gas Electric Sub Panel , , • • 1 certify.that,in the performance of the work for which this permit is issued, I - - i • - shall not employ any person in any manner so,as to become subject to the Dtinking Fountains - •lar Tank ' - ' - Fan - i r. Motors -1 HP-DIV'8 ' - Workers' Compensation Laws of California. - - - - - _ - :Date • Signature Floor Drains Swimming Pool w/Spa FA'.U. .. - Inc olar.D9-15 HP D16-1St - -NOTICE: If;after making this declaration,you should become-subject to the - - - -. - . • Workers' Compensation provisions of.the Labor Code, you must forthwith -- Floor Sinks Urinal Fixtures. icrowave comply with such provisions or this permit shall be, deemed revoked. 1 . CONSTRUCTION, LENDING AGENCY - R Gas Service Outlet Water Closet Device Boxes • I ' I hereby affirm that there is a construction lending agency for the performance . . - -. ,1 Pole Light of •the work for,:which this permit is, issued (Section 3097 Civ. 'C.) , i / - Interceptors- , r; Water Heater Outlets . t Range Lender's Name' - Lenders Address "- - - - - • - - Kitchen Sink ,., ; Water Service - - - - -" Switches• - Sign OWNER BUILDERAECLARATION _ I hereby affirm that tam exempt from the Contractor's License Law for the I - • Lavatories ty ..i.: Auto;Wash' 1 Garbo ¢Dis osal • , following reason (Section 7031.5 Business and Professional Code: Any city or 9 P - $Landing Sections • county which requires a-permit to construct,alter,improve,demolish or repair: P-Trapr-. l'' " > y y - - - -Generator DO"5 ❑5=15 KW - E r �-,- Laundr Tra s •Trash Com actor i any structure, prior twits issuance, also requires the applicant for such permit ' ,, p to file a signed statement that he/she is licensed pursuant to the provisions of - - 1 , ' {f i the Contractor's License Law(Chapter 9 (commencing with Section ]000) of ROOF Gini e , Division' 3 of the Business and Professions Code) or that he/she is exempt • • • therefrom and the basis for the alleged exemption. Any violation of Section • - I 7031.5 by any applicant for a permit subjects the applicant to a civil -• - ' I 1 . seIty of not more than five hundred dollars ($500). - ,Tas owner of the property or my employees with wages as their sole ' Reinspection Fee $15 Issue Fee $ 3 compensation, will do the work, and the structure is not intended or 's • _ - Reinspection Fee 1,$15 ' Issue Fee " ' $ 3 1 : for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL ; FEES _ . -- -thereon, and. Law does not zpplyho an owner of a property who builds or improves - - . • , thereon, and,who does such work himself/herself or through his or her own DEVELOPMENT SERVICES RE UIREMENTS. employees, provided that such improvements are not'intended or offered for Boiler CaHonodpy or Type I ❑ ' t. Zoning Approved B C+' / /ry - saeti n,however,wnthe building urden of pro issold within one year of rim- 1 Canopy Type II 0 i PP y /��, Date Q t pletio n,the owner will have the burden of proving he/she did not build or im- Duct- Under Ground 1 ' i. • Building Approved By. - _ (vim/ .Date �' / r a for the purpose of sale). /� z I, as owner of the property, ani exclusively contracting with licensed con- 1 Duct-Structural ' Refrigeration Sy- m Appliiation Issued By I --Date PC tractors to construct the project (Section 7044,Business and Professions Code: - -1 - - ' The Contractor's License Law does not apply to an owner of property who Duct-Ventilating • ' ' 00-100,00 TU 0100,000 BTU - - ' SUMMARY OF FEES, builds or improves thereon,and who contracts for such projects with a con- —. - - )A or tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System D' Multiple ❑ Syst Repair/Alteration _ I BUILDING PERMIT $ S70' Sel SMIP -� i ,+ $ `[v/071 proof. off their Worker's Compensation insurance should be provided-_to me. - • PLAN CHECK $ PERMIT • `! 0 I am exempt under Section B. & P.C.for this reason Firepl/Fact.Blt. ICBO# ire Dampers PLUMBING -. $ 1 ISSUANCE $ Date Owner - Heating System& Ducting Registers PL ting 25% $ _ ENERGY P.C. $ I hereby certify that I have read this application and-state that the-above Do-100,000 BTU 0100,000 .. r - -'"GRADING $ R' ' - information is correct. agree to comply with all city and county ordinances I FELE CTRICAL - $ - and state laws relating to building construction, and hereby authorize repro- _ I PLAN CHECK '50% $ -MICROFILM $ sentatives -of this' city egt¢rI upon.the 'above-mentioned propert for. "- t- - p inspection pu ose V • Reinspection Fee I ' $15 - Issue Fee $ 3 'PLAN CHECK'125%' $ , .... o#. -CMF_ 08`65-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor +-CONSTRUCTION AND PLANNING - - ,- POOL&SPA ?, -APPROVALS . Permit# Date Inspector APPROVALS Permit# • Date Inspector' 1: Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. ElectricalNConduit Utility-Undrgrnd. 54. Forms r 4. Electrical Conduit-Undrgrnd. 55. Electrical,Bonding • _ • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. • 8. Foundation 59. Gas Pipe, ❑ Undrgrnd.;Test 9- Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System (t .. . f90/*6 Sof 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection / _ 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater &,Vent-Final 13. Roof Drains • 64. Plumbing System - Final - 14. Rough Plumbing 65. Electrical-Final • -- 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL -- 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit# • -_ 21. Ducts, in Structure 70. Underground Hydro . 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil / i 25. Roof Sheathing 2,04 44 74. Overhead Hydro - , • 26. T-Bar Ceiling (Structural) & Monocoat / ,p. 75. Dry Chemical 27. Frame and Flashing 9.b0 Q p7 0 $9 76. Dry Standpipe , • ,- - 28. Lathing & Siding aAa. 'r ,Dit 77. FIXED SYSTEM FINAL - 29. Insulation it 9704 . 78. FIRE PREV. FINAL - • 30. Drywall Nailing /8.7 p0 HEALTH DEPT. REQUIREMENT j ', 31. Plaster Brown Coat 6187 04 ' 79. FINAL INSPECTION _ •. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED ; S 33. Final Electric Notes: szky jko &C 'VD Q"�-L_ 34. Final Heating & Air Conditioning • a)10-- � 35. Final Gas Pipe-Test . eI O& 0 e 36. Hood or Canopy V 37. Final Factory Fireplace `-' 38. Final Plumbing KT t p`.=, 0 e / - , 39. Water Service-Final s/////G•7 Q A gp_ ..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 ..chy.r, • 48. Special Requirements Completed L /f/87 flit - - / .49. Electric Release to Edison ' \ _ 50. Gas Release to Southern California Gas Co1. `-&.,1"--,` 51. CERTIFICATE OF OCCUPANCY'•. • - f No. Date - • I . - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. - ` • CITY OF COSTA MESA CONSTRUCTION PERMIT - PERMIT1s10;� C_ _ _I TRACT NO. LOT NO. UNIT pp. ' [� acc) r-+ 2888 9/10/86 48.90 IL `Project Address 2.4. C3 - F LC:PIE••� Usk- Applicant's Mailing Address 2 �s- y 3 C. r!1.-0 E,{-3 I>g TYPE OF CONSTRUCTION LI NEW' LI ADD ❑ ALTERATION U REPAIR • ' \]IL `qp q l41 ❑ CONVERSION ❑ DEMOLISH ❑ OTHER • A p # Zone Owner's Name//J C its(.. 1.\ Op 21.1{/Arct Phoned r1- DESCRIPTION OF WORK/USE OF BLDG. Address �p.2 a L - �-L a E w1 N u 1P- S Main Building: Accessory Building: • Arch/Eng. L ics 1Q,E 71.1 &tart License No. I�- 37 71-. TYPE OF PERMI U GRADING LI FOUNDATION ❑ STRUCTURAL T Front - 0 Address r� CI TENANT /1irn�ELECTRICAL El PLUMBING El MECHANICAL B Rear - N Contractor's Name ALL A-1D-L._ £ -{�R Phone-- ❑ OTHER_ A - - - - - I PROJECT DESCRIPTION SQ. FT. 4 9 _Z OCCUPANCY w .. C Right , N Address(mailing) G .CONSTRUCTION TYPE VALUATION$ - $ Left City License No. ZONE - GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under Provisions of Charter 9 (commencing Remarksl�C • O with section 7000) of Division 3 of the Business and Profession's Code, and Remark*: •7 •�O 1 Planning Notes: M my license Is in full force and effect. T S License Class License No. - - - - Date Signature • PLUMBING FEES ' WORKERS'COMPENSATION DECLARATION Bar Sink Showers - , I hereby affirm that I have a certificate of consent to self-Insure or a certificate - ,. ELECTRICAL FEES of Workers' Compensation Insurance, Or a certified copy thereof (Section • Backflow Preventer Service Sink Automatic Washer Transformer 0 15-50 KW '3600, 4b.j -� _ _ ` i- al• -.t•=c:` �'�'S�'_ - ._ .� Backflow Irrigation Sewer Cap • - Construction Pole Sub. �— 0 50+KW. Ni • Certified copy is hereby furnished. ---=._ - - - • Cer ":• co• :�^; • _1- _Bathtubs' _ Sewer Connection Cooking Unit . 1 Meter Dub to104amps 5- DO .a--�ssraci`"-----App can �___0 Vs«-._-� - EXEMP ON ROM WORKERS'COMPENSATION DECLARATION - ' Clarifiers • - Solar Collectors - + Dishwasher Meter Dover.100 amps 1 7) (This Section need not be completed if the permit Is for one hundred ($100) or ,• •W less). Dishwasher - • _- ,Solar Piping • - i Dryers ❑Gas 'Electric. '^s—earel - • . b, exi I certify that in the performance of the work for which this permit is issued,I - shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank. Fan D Workers' Compensation Laws of California. . - - - Motors❑41 HP ❑1'h-8 ��n Date Signature • Floor Drains ' Swimming Pool-e/Spa ' . - '' F.A.U. S� --•NOTICE: If,after making-this declaration, you should become subject to the- — - + inc.- InSOIar,❑9-15 HP 016-15+ I.- OD Workers' Compensation provisions of the Labor Code, you must forthwith , Floor Sinks ' Urinal .3 ati - 1� Fixtures comply with such provisions or this permit shall be deemed revoked. 1`',, Microwave • CONSTRUCTION LENDING AGENCY - Gas Service ,' Outlets Water Closet 1t ft%evice Boxes ' Pole Light I hereby affirm that there is a construction lending agency for the p. ormance y -- ^ g - . of the work for hich this permit I' is .e• Section 3i9 P iv.Lender's Name Name ,, - A ` •) _Interceptors'; Water Heater Outlets , t i$ Range 5' 0 Lender's Address • Orl i' 1Lwwt*YL7' &r.f V&11. A - Kitchen Sink. W• ater Service 21 Switches Sin - - OWNER BUILDER DECLARATION g d✓ I hereby affirm that am exempt from the Contractor's ¢ensLaw for the Lavatories • . Auto-Wash ^^ following reason (Section 7031.5 Business and Professional Code: Any,city'or i • Garbage Disposal Standing Sectiohsl i• IN county which requires a permit to construct,alter,improve,demolish or repair P-Trap . - Laundry Trays Generator ❑0.5 KW ❑5-15 KW Trash Com actor' any structure, prior to its issuance, also requires the applicant for such permit - p to file a signed statement that he/She Is licensed pursuant to the provisions of Roof Drains • • • the Contractor's License Law(Chapter 9(commencing with Section 7000)of 6' chip YC.Ir p(6r1C1-r'($a. , , Division 3 of the Business and Professions Code) or that he/she-'is exempt' ' " -- - i.- - - therefrom and the basis for the alleged exemption. Any violation of Section • •- • . - • 7031.5 by any applicant for a permit subjects the applicant to a civil _ • - - • e ty of not more than five hundred dollars($500). . - -'A` [p�Q��Q'I,,.as owner of the property --tm>-mplOyees ' th w es a` the"-,e1e Reinspection Fee $15 Issue Fee. $ 3 • •kA 'gcdmp).nsaNerss will do the work, and the structure is not intended or offered _ --- . Reinspection Fee ' 41'$15 , Issue Fee _ $ 3 • ds for 'sale (Section 7044, Business-and Professional Code: -The Contractor's • MECHANICAL FEES - • License Law does not apply to an owner of a property who builds or improves thereon, and who does such work hlinself/herself or through his or her own - - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not Intended or offered for Boiler - Hood or Type I 0 - sale. If, however, the building or improvement is sold within one year of com- Canopy 'Type 11 0 Zoning Approved By Date - pi S(po,_the utiles-vim have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date II•::. ve for the purpose of sale). //�\�� q _/O-x/ tj:'i I, as owner of the property, am exclusively contracting with licensed con- Duct Structural Refrigeration System • Application Issued By 1/ sz� • Date 10 �-,// T. tors• ntrac nstruct the project (Section 7044,Business and Professions Code: L/ he Contractor's-License Law does not apply to:an owner of property who Duct-Ventilating ' ❑0-100,000 BTU ❑100,000 BTU . • SUMMARY OF FEES • / builds or improves thereon, and who contracts for such projects with a con- - tractdr(s) license pursuant to the Contractor's License Law). I am aware thatBUILDING PERMIT $ SMIP' - . -- $ proof Of their Worker's Compensation insurance should be provided to me. Exhaust System 0 Multiple 0 System Repair/Alteration - • PLAN CHECK $-' PERMIT- - • ❑lam exempt under Section a & P.C.f•r this reason Firepl/Fact.Bit. ICBG# Fire Dampers • 1 • ' PLUMBING $ ISSUANCE $ e •�1�Lvat Own:-` •.- . - � e Heating System& Ducting Registers pLAN•CHECK 25% $_ .ENERGY P.C. $ ' I hereb ce ify that I have read this application and state that the above ❑4100,000 BTU 0100,000 BTU GRADING $ _ • Information is correct. agree to comply with all city and county ordinances ELECTRICAL • $ 'and state laws relating to building construction,and hereby authorize repro-- PLAN CHECK 50% MICROFILM $ I ' sentatives of t •5 city o enter u•on the a•Ove-mentioned Pr perty for - $ i Signature ` _ Date R/Gii ' Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $ /' CMF 0865-46,rev.10/84 White - Building: Canary - Applicant: Pink -Accounting; Goldenrod -Assessor u----------- J CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permits Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 54. Forms 3. Electrical Col• ilki.11itkUr - atre 4. Electrical Conduit-Undrgrnd. c r.3o_5f_/ 55. Electrical Bonding , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15: Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring P•3 rr4) Il_�-� ' 67. Fencing & Access Approval - 17. Rough Wiring Sign • 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning • FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test • 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing . 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical _ 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION ' 32. Electrical Power Meter-Final 1QJ/i .4e../ 80. FOOD CERTIFICATE ISSUED 33. Final Electric f////7 7 gZ Notes: 34. Final Heating & Air Conditioning I - 35. Final Gas Pipe-Test ' 36. Hood or Canopy - 37. Final Factory Fireplace - . _ ' '38. Final Plumbing . 39. Water Service-Final l 40. Gas Service-Final - . •41. Solar Domestic-Final 1 - 42. Backflow Preventer , 43. BackflovQ 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 - - f 51. CERTIFICATE OF OCCUPANCY. No. ' Date - 288.7 9/l4/B6 'R I .- v • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 1319E PERMIT Ng,, TRACT NO. LOT NO. UNIT N ,� • CITY OF COSTA MESA CO1h�N TRUCTION PERMIT I •r• dS, /7G p E Project Address IC&3 3 •11 IL• E.�.D E va T`I C a • Applicant's Mailing Address - 6 4% C. t-VDe,� TYPE OF CONSTRUCTION L i NEW U ADD LI ALTERATION PAIR ' Owner's Name \\�G-K So$....1 +V/ E CONVERSION ID DEMOLISH ❑ OTHER A P # Zone Co •�i�1IIE.SPhone S��"���� , DESCRIPTION OF WORK/USE OF BLDG. ' Address _2 6 2 'tC W L.i7 rc-....1 q S Main Building: Accessory Building: Arch/Eng. i-C..S K. PICT 2 D 1.1 License No. C - 17&, TYPE OF PERM! GRADING GRADING ElFOUNDATION El STRUCTURAL E Front Z Address • ❑ TENANT -nom ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N OW L.1 tE4• Q 1. P K. Phone ❑ OTHER . A _ I Contractor's Name - rT� C Right " N PROJECT DESCRIPTION SQ. FT._. .oG OCCUPANCY L' WC". Address(mailing) CONSTRUCTION TYPE VALUATION$ S G Left City License No. RZONE GRADING CU.YDS. ACRES Ping. Ref. 4 Parking-Req./Provided E LICENSED CONTRACTOR DECLARATION - I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: g '1 ,,Q O '_ Planning Notes: _ _ M with section 7000) of Division 3 of the Business and Professions Code,and pt- my license is in full force and effect. _ - _ i • - T License Class License No. - - s Date _ - Signature PLUMBING • I .- FEES _. _ WORKERS'COMPENSATIONDECLARATION Bar Sink • Showers I hereby affirm that I have a certificate of consent to self-insure or a certificatele ,. ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink • 3800, Lab. a ;Z Automatic Washer' Transformer 0 15-50 KW ��waca•r - - •+� Backflow Irrigation . 'Sewer Cap Construction'Pole Sub. ❑ 50+KW - - ertified copy is hereby furnished. _ jgtlfrnny is.filed - ci y ildi•g Div s+� Bathtubs Sewer Connection ' _ Cooking Unit Meter Cup to 100 amps 3 /S On EXEM N FROM WORKERS'COMPENSATION DECLARATION Clarifiers • Solar Collectors el Dishwasher Meter flneer inn-.nips a. 00 (This section need not be completed if the permit is for one hundred ($100)or - less). Dishwasher - -• Solar Piping _ . a. Dryers CGas .Electric Sub Panel �j - DO I certify that in the performance of the work for which this permit is issued I — - — �-• shall not employ any person in any manner so as to become subject to the ' Drinking Fountains Solar Tank 7 Fan -Motors❑0-1 HP ❑1'/-8 - n� np Workers' Compensation Laws of California. Id Date Signature Floor Drains I Swimming Pool w/Spa - > F.A.U. NOTICE:If,after making this declaration, you should become subject to the -. Inc.Solar ❑g-15 HP ❑16.15+ ..•.Q Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks permit shall be deemed revoked. _Urinal 'Fixtures 'T complywith such provisions or. 43Microwave rI Io - CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes g I hereby affirm t .t there is a construe on lending agency for the performance Pole Light • y, of the work f. hi h this perm t 's__issued Section t!.:7 Civ. C.) Lender's Name fl d " - $ i- ' a i n • Interceptors Water Heeter ��Outlets Range Lender's Address. CIO fla.. 0 our r. stJ'1'c/L,- • ID Kitchen Sink - - - Water Service - - N r3% Switches 7T� OWNER BUILDER DECLARATION -L)pl.) ►C t-r (51EQC 121 th, • Sign ^ - 1• 0 I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • Auto-Wash r T following reason (Section 7031.5 Business and Professional Code: Any city or • Garbage Disposal �' Standing Sections'. r�•'V county which requires a permit to construct,alter,Improve,demolish or repair P-Trap„'•' Laundry Trays Generator ❑0.5 KW ❑5-15 KW Trash Com 2 any structure, prior-to Its issuance, also requires the applicant for such permit Compactor Y: file a signed statement that he/she Is licensed pursuant to the provisions of ROdf-Drains • • the Contractor's License Law(Chapter 9(commencingwith Section 7000) of ski t� S '1 OC . Division 3 of the Business and Professins Code) r that he/she Is exmpt 2 5. 1�I1 V£t�C•T04. iJ therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil e ty of not more than five hundred dollars($500). I, as owner of the property;• •• •••• • .. • . . Reinspection Fee $15 Issue Fee $ 3 ��\77 • •will do the work,and the structure is not Intended or offered I >- - Reinspection Fee I $15 Issue Fee $ a - �a for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _- thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: ' employees, provided that such Improvements are not intended Or offered for Boiler Hood or Type I ❑ ”' sale, If, however, the building or improvement is sold within one year of coni- Canopy Type II ❑ Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground• Building Approved By - Date prove for the purpose of sale). - I El I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By Date fi'''b-R40 tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0.100,000 BTU ❑100,000 BTU projects with a con- SUMMARY OF FEES builds or improves thereon,and who rantrr's for such ) I BUI LDING PERMIT $ - SMTP $ ' tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration • proof of their Worker's compensation insure nce'sho ultl be provided to me. PLAN CHECK $ PERMIT 0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# , Fire Dampers _ISSUANCE" $ 4 • I PLUMBING $ • Date Owner (fyr�s�v-\,�•-� Heating System&Ducting Registers ENERGY P.C.. $ _ —r= PLAN CHECK 25% $ I hereby erti y that I have read this application and state that the above ❑0.100,000 BTU ❑100,00087 & GRADING $ - Information Is correct, I agree to comply with all city and county ordinances ELECTRICAL $ b -1• +� and state laws relating to building construction,and hereby authorize repre- MICROFILM $ inspection of his city to enterl yyypppo., the above-mentioned pr P ty for _ _ • PLAN CHECK -50% $ �3• inspection pure sus. 1 1 / MECHANICAL - $ , Signature Reinspection Fee $15 Issue Fee $ 3 ' PLAN CHECK 25% $ CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical on 'xlJtiljg,Avant 54. Forms 4. Electrical Conduit-Undrgrnd. 4}31:.4L /e,�y V- 55. Electrical Bonding 5. Steel Reinforcement ! G! 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation • 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Liries, P-Trap, 0 Uridrgrnd. 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 �fr7 /tee', 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING - 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT' 20. Rough Factory Fireplace - APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping ❑Gas ❑Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final ,J/ 80. FOOD CERTIFICATE ISSUED 33. Final Electric y//'J elk Notes: 34. Final Heating & Air Conditioning //' 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final - 40. Gas Service-Final 41. Solar Domestic-Final • 42. Backflow Preventer - 43. Backflow Irrigation • 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • • • - - Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA ME.S�A/� CON UCTI N PERMIT •'FERMI NO. TRACT NO. LOT NO. UNIT •NO. • R.`J� - - r - . Project Address 2 eft p� �'as .3� 4 27851 ! 9/00/B6 . 179.25 TL Applicant's Mailing Address M+rr;i/ ( r �j� sow • TYPE OF CONSTRUCTION NEW Li ADD H ALTERATION U REPAIR rduo". )'/O>4i4✓ - Phone aI /e-/o// ' w❑ CONVERSI•ON ❑ DEMOLISH ❑ OTHERA.P.# _ . _ LZpne Owner's Name1 DESCRIPTION OF WORK/USE OF BLDG. Address C- £/ 7.-s G S Main Building: Accessory Building: • • Arch/Eng. License No. TYPE OF PERMIT U GRADING FOUNDATION ElSTRUCTURAL E Front - Z Address ' /s . ,t, ❑ TENANT ❑ ELECTRICAL PLUMBING ❑ MECHANICAL B Rear N Contractor's Name D.ee. rice/444 /7V Phan,' f':J.3' ❑ OTHER • A • _ - I Address lmailingl—iR./ /leerl// Pl .lI 9 , 't-PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N �-.'• CONSTRUCTION TYPE VALUATION$ S Left • City License No. _ 2v97Z ., 40"-ZONE GRADING CU.YDS. ACRES R LICENSED CONTRACTOR DECLARATION - `�s,t ) Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing ) Remarks: A- e1 [ 7/// Planning Notes: - Q with section 7000) Of Division 3 of the Business and Professions Code, and Lv �•+ N7 my license is in full fprrcy•d effect. e T Licenslass CL.• 33 Li•-nse N. Ver Q� 1 .I� es Li Date , • _ Signature Wee • i - - ' PLUMBING FEES S !Y WOR ER 'COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES '1 I hereby affirm that I have a certificate of consent to self-Insure or a certificate • of Workers' Compensation Insurance, or a certified 5opy thereof Section `:r • 3800, Lab. p • •�' Jj Q Backflow Preventer. Service Sink Automatic Washer •• Transformer 0 15-50 KW Policy No P� 9(1367 Company t *1 'C -FZ4t•••-•7 • Backflow Irrigation ,✓ 9 Sewer Cap- Construction Pole Sub. 0 50+KW �itif letl copy is hereby furnished. � c//j /i/// ,� - - Certi d d with the city B. •g l o ,//Sl.�� Bathtubs Z Sewer Connection 1_- Or Cooking Unit Meter Our)to 100 amps . Date Applicant �(/I EXEMP O FROM WORKERS'COMPENSATION DECLARATION - Clarifiers Solar CollectorsDishwasher Meter Dover 100 amps- ' (This sec ion need not be completed if the permit is for one hundred ($100) or' h - less). -2_Dishwasher Solar Piping 4., 0 V Dryers ❑Gas ❑Electric Sub Panel • I certify that in theperformance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the _ ' Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-8 Workers' Compensation Laws of California. Date Signature Floor Drains I Swimming Pool w/SpaF,A.U. - NOTICE:-If,after making this declaration,you should become subject to the- - Inc.Solar 09-15 HP 016-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. 7y Fixtures Microwave' ' CONSTRUCTION LENDING AGENCY ' � 2 Gas$ervoe /b Outlets 6q Water Closet ' OO Device Boxes I hereby affirm that there is a construction lending agency for the performance �^pf� • Pole Light -.d of the work for which this permit is issued (Section 3097. Civ. C.) Interceptors 2 Water Heater . W Outlets Lender's Name ' - - T ; - Range ' Lender's Address - Z Kitchen Sink - - Z Water Service • - - - OWNER BUILDER DECLARATION �(�- �u' Switches - Sign I hereby affirm that I am exempt from the Contractor's License Law for the L Lavatories . Auto-Wash iW, CO -• - following reason (Section 7031.5 Business and Professional Cotle: Any city or 1� Garbage"Disposal Standing Sections county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW❑5.15 KW - any structure, prior to its issuance, also requires the applicantfor such permit o Trash Compactor .- to file a signed statement that he/she is licensed pursuant to.the provisions of ' Roof Drains the Contractor's License Law(Chapter 9(commencing with Section-7000)of . ii, ' Division' 3 orthe and Professions Code) or that he/she Is exempt . • . - _ therefrom and the basis for the alleged exemption. Any violation of Section . 7031.5 by any applicant for a permit subjects the applicant to a civil - - - penalty • of not more than five hundred dollars($500). - I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee $ 3 compensation, will CO the work, and the structure is not Intended or offered - Reinspection Fee f $15 Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 'FEES License Law does not,apply to an owner of a property who builds or Improves thereon, and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: - employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I ❑ . , ' sale. If, however;the building or improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By - Date 'pletlon, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date rove for the purpose of sale). I, as owner of tna property,am exclusively contracting with licensed con- Duct-Structural Refrigeration SystemApplication Issued By 1 Dat tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ❑0-100,000 BTU ❑100,000 BTU ' builds or improves thereon,and who contracts for such projects with a con- SUMMARY OF FEES _ - tractor(s) license pursuant to the Contractor's License Law). I am aware that , Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ - . SMIP • $ Proof a p their Worker's Compensation insurance should. & P.C.provided e me. PLAN CHECK $ rpg - PERMIT - •❑ I am exempt under Section • B. & . .for this reason Firepl/Fact.Bit. ICBO# Fire Dampers • ISSUANCE $ PLUMBING $ - Date Owner Heating System& Ducting Registers ENERGY P.C. $ ❑6100,000 BTU ❑100,000BTV— PLAN CHECK 25% $ _ • i hereby certify . I have read this yppli a ' d state that the above GRADING $ information Is •rate I to comply • • y and county ordinances ELECTRICAL $ and state law ri a 9 -'d r cons >�o• d herebyiauthorize repre- sentatives e pre- _ MICROFILM $ sentativez o l•is c er up• ��e� mentioned r r for •- _ PLAN CHECK 50% $ - [� inspection p r•oses /� /� �j��/ • MECHANICAL $ TOTAL FEE $ (7 1 •as ' Signature .A18..../' 'Date ly '•'v Drivers' License or 55# ' Pink -Accounting: Goldenrod - Assessor r1) CONSTRUCTION AND PLANNING POOL &SPA - APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole ,��/� 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. D/��� �yy� 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. / MC 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. Cl Jp_1(o c,go 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line& House Connection 4..50.44 (.O 62. Backwash& Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing //9/P7 c 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing &Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS.FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping ❑Gas ❑Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL - t 29. Insulation 78. FIRE PREV. 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 Notes: 9 /p( _term .�.....; - 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy p / / i/i ,o / //i/.per/ 11 ,fri it r la)?t r4 did 1'/ lC 37. Final Factory Fireplace r ✓ 38. Final Plumbing Ot/i7 /42, r 39. Water Service-Final )kik3/ 4 Ve , • 40. Gas Service-Final W'v4' 4. - . 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation •.44. Landscape Irrigation System • 45. Sound Attenuation - - . 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING , j 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. _ 2740 9/08/86 CITY OF COSTA p(IE�,A33 ONS.T JCTIQN PERMIk PERMpNO. 37• TRACT NO. LOT NO. UNIT NO. •- •( 43.63 '�L Project Address l•�o dm.,1/4 /�fyo Applicant's Mallin Addrpss it , ����II TYPE OF CONSTRUCTION 1TJ NEW U ADD U ALTERATION U REPAIR•4-40- ❑ CONVERSION ❑ DEM LISH ❑ OTHER fq-p- Zone Owner's Name e/CJO•t n'B'r hi/ Phone r 49V7 DESCRIPTION OF WORK/USE OF BLDG. Address 2G-33 47 to A-lyP. C_ S Main Building: Accessory Building: Arch/Eng. License No. . TYPE OF PERMIT U GRADING W FOUNDATION U STRUCTURAL T Front o Address /. J I��'""""""Phone � El TENANT ❑ ELECTRICAL lU PLUMBING ❑ MECHANICAL B Rear N me. are.A.}-� fwm4ly GEl OTHER A I Contractor's Namp C Right N PROJECT DESCRIPTION SQ. FT. OCCUPANCY Address(mailing) /eV A4rrr•ill llerK G n p, _ CONSTRUCTION TYPE • VALUATION$ S Left R City License No. ! ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION _ Ping. R¢f. Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' -. a ',Z Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code,and [J my license is in full Jpr=oppd effect. O J- T License QQI�ss�s c•---- •-?fi se �� Date_____ Signature - ,- . . PLUMBING FEES - r■>Ur WORK R COMPENSATION DECLARATION •Bar Sink Showers I hereby affirm that I have a certificate of consent to self-Insure or a certificate ELECTRICAL FEES - I of Workers' Compensation Insurance, or a certified copythereof (Section Backflow Preventer - Service Sink 3800, Lab, C RAutomatic Washer Transformer 0 15-50 KW Policy No. '1[/31 ? Company fPaOfi 'l Backflow Irrigation Sewer Cap0 50+ KW rtified co Construction Pole Sub. copy is hereby furnished. G. 00 • Cert le 'ed with the city a� g Ipp7 a..Bathtubs- Sewer Connection CookingUnit Meter ❑up to 100 amps Dale Applicant EXEMP 1O FROM WORKERS'COMPENSATION DEC LA ATION Clarifiers - Solar Collectors - Dishwasher Meter ❑over 100 amps - . (This sec ion need not be completed if the permit is for one hundred ($100) or less).' 2.—Dishwasher Solar Piping 4._ DU- Dryers ❑Gas ❑Electric Sub Panel - I certify that in the performance of the work for which'thls permit is issued, I - • shall not employ any person In any manner so as to become subject to the Drinking Fountains. 'Solar Tank . Fan Workers' Compensation Laws of California. Motors❑0-1 HP ❑iX-8 Date Signature : Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ NOTICE:If,after making this declaration, you should become subject to the - - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures comply with such provisions or this permit shall be deemed revoked. Microwave i • CONSTRUCTION LENDING AGENCY f(; / Gas Service Outlets i3 Water Closet _ %,J (, Pole Light I hereby affirm that there is a construction lending agency-for the performance Device Boxes g of the work for which this permit Is issued (Section. 3097.Civ. C.) •• Lender's Name ,� Interceptors •! Water Heatert. Outlets- Range Lender's Address -- - - 1 Kitchen Sink - - - - Water Service - '- DU . Switches Sign ' - -" OWNER BUILDER DECLARATIONP - I hereby affirm that I am exempt from the Contractor's License Law for the 3 Lavatories . - ( Auto-Wash , e- 00 , Garbage Disposal Q Standing Sections .v , following reason (Section 7031.5 Business and Professional Code:-Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays Generator ❑0-5 KW 05-15 KW - Trash Com any structure, prior to its issuance, also requires the applicant for such permit pactor to file a signed statement that he/she is licensed pursuant to'the provisions of Roof Drains I the Contractor's License Law (Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt - - therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil . — enalty of not more than five hundred dollars($500). I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee, $ 3 - • compensation, will do the work,and the structure is not intended or offered - • Reinspection Fee I $15 Issue Fee $ 3 for sale (Section.7044, Business and Professional Code: The Contractor's MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _ _ _ _ _ ' ' thereon, and who does such work himself/herself or through his or her own -� DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 ' sale. If, however, the building or improvement is sold within one year of com- 1 Canopy Type II 0 Zoning Approved By Date pietion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Building Approved By Date LIrove for the purpose of sale). _ ( I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By \N Y Date 9 e1Pe tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating 00-100,000 BTU 0100,000 BTUSUMMARY OF FEES builds or improves thereon, and who contractsforsuch projects with a con •- tractors) license pursuant to the Contractor's License Law). I am aware that- Exhaust System 0 Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP ' $ ' proof of their Worker's Compensation insurance should be provided to me. _ - PLAN CHECK $• PERMIT 0 i am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt. ICBO# Fire DampersPLUMBING $ 3 s'St ISSUANCE $ • Date owner Heating System& Ducting Registers PLANCHECK ` 25% $ g•V 'ENERGY P.C. $ _ - I hereby certify I h • ead this applicati-. .nd state that the above 00.100,000 BTU 0100.000 BT - information is •rrec . I to comply f. ity and county ordinances ELECTRICAL $ GRADING $ and state la •lati til ing cons v and hereby authorize repre- MICROFILM $ sentatives • his c je r up���rl.ove-mentioned pro.erty fpr PLAN CHECK 50% $• [[ /_ inspection . .-' % /. Date •HY - MECHANICAL $ - .TOTAL FEE , $ 3,Y73 - DSriverure, Reinspection Fee $15' •'Issue Fee $ 3 - PLAN CHECK 25% $lImmiSsellIalnilninalla Drivers' License or ! CMF 0865.46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor /' 1 CONSTRUCTION AND PLANNING POOL &SPA - APPROVALS Permit Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location // 2. Soil Pipe-Undrgrnd. !,/f�' �j�C 53. Steel Reinforcement . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. 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. q•30-riCi 440 60. Backwash Lines,.P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection Q ebb tie 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains • 64. Plumbing System - Final 14. Rough Plumbing '/9/27 iiif#17i 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - ' 68. APPROVED FOR PLASTERING - • 18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT 20: Rough Factory Fireplace APPROVALS Permit# .- 21. 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 0il 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 0il 25. Roof Sheathing 74. Overhead Hydra 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27. Frame and Flashing _ 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation78. 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: /v/�e �` rne.// Atm 44-111141t- 34. Mu - 34. Final Heating & Air Conditioning / t rs / S 35. Final Gas Pipe-Test ,l�Uitt '' .Ltt ` ///s12-9 R,/,e6 A4r dsaT. ' H,rt% -YRP 36. Hood or Canopy 37: Final Factory Fireplace • 38.'Final Plumbing [���/ W 39. Water Service-Final /d%Zlyfy4 ,4 P4' - 40. Gas Service-Final A /I(//g.7 ��j? ... • 41. Solar Domestic-Final ( JO,L"-' - • 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 ' 4 No: Date ' . - a - . • _ Applicant to fill In all spaces except those within heavy border__ lines and sign all appropriate declarations. + TRACT NO. • LOT NO. UNIT 1 23,00 TL- • CITY OF COSTA MES NST UCTION'PERMIT PEIT yO� p � 7 2 L rel. 024 'I /21 /07 Project Address 26 g :..171�fJ ;( 7 t 1`— ` I 'Applicant's Maililtr�Address z� •Q. L.elk./...-1 TYPE OF CONSTRUCTION NEW H ADD IJ ALTERATION H REPAIR - �/I\ LSJ�Doa c Phan- S- 4t ❑ CONVERSION ❑ DEMOLISH E OTHER I - A.P.# - Zone Owner's Name 7 DESCRIPTION OF WORK/USE OF BLDG.2 1St(12 y DEPT U-U Iy- Address `.�6 3 3iCL. 1E,a,, ST G�-t' G�6/2.7 S Main Building: I _ Accessory Building: Z Arch/Eng. 1_'f£S ft.17'Iy`tart Licen a No. Cj— ?...77C-, '7?4. TYPE OF PERMIT U GRADING ❑ FOUNDATION ❑ STRUCTURAL E Front 0 Address �•4s 4 'SP V14 Q'4 al �Q "'I�Lk6( / ❑ TENANT ❑ ELECTRICAL '❑ PLUMBING KMECHANICAL B Rear N Contractor's Name Qt 4 Jif i1---pt DQ- Phones 4Zsf'I ❑ OTHER �t / A - - ( q PROJECT DESCRIPTION 'SQ. FT. I'"1 o 1 OCCUPA Y C •Right I • N Address(mailing) 6 Z �. .L 1)�t�a $ K G CON ST RUCTION TYPE • _ VALUATION$ S Left City License No. • ZONE GRADING CU.YDS. ACRES E LICENSED CONTRACTOR DECLARATION ••v • _ Ping. Ref.# 1 Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: I� S s�' Ls'�' '� Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and .•.a my license is In full force and effect. • . , . - - T License Class - License No. - - - - S. Date Signature PLUMBING -FEES - • - - I WORKERS'COMPENSATION DECLARATION Bar Sink - Showers • • , ELECTRICAL' FEES • I hereby affirm-that I have a certificate of consent to self-insure or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink _w /r ..r Automatic Washer Transformer 0 15-50 KW 3800, Lab. '1.S�t7/ 51 /, C l.rd�P Ian - - • Policy No.�k9n 1 '6b C mpany Backf low Irrigation Sewer Ca I - .0 50+ KW P' Construction Pole Sub. _ • 8 Certified copy Is hereby thehed. Fu up — ' Cert i�fietl c.o�py is,filed with ty �ull.�lyng Di son. 1 ' Bathtubs Sewer Connection Cooking Unit' Meter Cup to 100 amps • Date '12112.• Applican • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION ' Clarifiers Solar Collectors _ - Dishwasher ' Meters Dover 100 amps I (This section need not be completed If the permit Is for one hundred($100) or ' less) Dishwasher Solar Piping - D• ryers 0Gas ❑Electric _ - •Sub Panel I certify that in the performance of the work:for wh leh)this permit is issued I . shall not employ any person in any manner,so as to become subject to the Drinking Fountains I Solar Tank Fan Motors❑41 HP ❑1'h.-8 Workers' Compensation Laws of California. , 1 0 - ` Date Signature - Floor Drains I • Swimming Pool w/Spa •• • • F.A.U. • • NOTICE: If,after making.this•doclaration,you should.become_subject-tO the -- - _ - Inc.Solar ❑9.15 HP ❑15-1$+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' -Urinal ' Fixt Ures ` ' comply With such, provisions or this permit shall be deemed revokqed. -. Microwave .-. , CONSTRUCTION LENDING AGENCY 4.T ' pts Service Outlets , •Water Closet • Boxes Device I hereby affirm that there is a construction lending agency for the perform - Pole Light' f of the work for 'which this permit is issued (Section 3097 Civ-C.) Interceptors Water Heater '�' a Outlets Ran e • Lender's Name - - I . -Lender's Address. l r_ 9- Kitchen Sink • , Water Service—• . - Switches — Sigh - - '_ - : - ' OWNER BUILD ER'DECLARATION t m - I hereby affirthat I am exempt from,the Contractor's License Law for the Lavatories Auto-Wash ' - following reason (Section 7031.5 Business and Professional Code: Any city or "' Garbage Disposal • Standing Sections county which requires a permit to construct,alter,improve,demolish or:repair P'-Trap • ' Laundry Trays I f Generator ❑0.5 KW ❑5-15 KW any structure, prior to Its issuance, also,req litres the applicant for such'permit Trash Compactor to file a signed statement that he/she is licensed pursuant to the provisions of ,Roof Drains the Contractor's License Law(Chapter 9(commencing with Section 7000) of - Division '3 of the Business and Professions'Code) or that he/she-is exempt . therefrom and the basis for the alleged exemption. Any violation of Section • 7031.5- by any applicant for a permit subjects the applicant to,a civil o ' e alty'of not more than five hundred dollars($500). • I • �L].(yi; as Owner of the'property or my employees with wages as their sole Reinspection'Fee I $15 Issue Fee $ 3 !ompensation,-will do the work,and the structure is not intended or offered • 1 - Reinspection Fee 1-'1 $15 Issue Fee $ 3 • for saleSe (Section a lyBusinessnand f Professional Code: The Contractor's es _ — _- ' _ —_ MECHANICAL Type —e t th • Liereon Law does not apply to owner if h ea-propertyowho builds or improves • thereon; and who does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS: . t , employees, ever,provided that such Improvements are not intended or offered for Boiler ' I Hood or T e I 0 - ,.however, the building or improvement is sold within one year of com- Canopy Type II 0 3 • 3 Zoning Approved By Date • pletion,'the owner will have the burden of proving he/she did not build or im- • Duct-Under Ground „ Building Approved By Date •rove for the purpose of sale). - 1 CO as owner of the property, am exclusively contracting with licensed'con- • Duct-Structural Refrigeration System Application Issued By Dat tr-c o . ••struct the prof t (section 7044,Business and Professions Code: The Contracto . • se dVe4 not apply to an • • •• • -• operty who Duct-Ventilating ' ❑4100,000 BTU ❑100,000 BTU - ,- SUMMARY OF FEES builds or Improves the •.- •nd who cos • • such projects with a con- - • tractor(s) license pursuant • a,' -'.• rector's License'Law). I,am aware that BUILDING PERMIT '$ SMIP - $ I Exhaust System ❑ Multiple ❑ ' System Repair/Alteration _ proof oftheir - ion'om - atio e should be provided this reasonto me.• PLAN CHECK $ - _PERMIT - ❑ •xempt under Section' for this I Firepl/Fact.Bit. ICBG ��- -5iee-Dampc9T. y oP ; 4. , e>o ISSUANCE $ • PLUMBING $ • I ' Date ' - ' Owne' ' -. ' - - - Heating System& Ducting ' Registers 10P - J 1'r” ENERGY P.C. $ • P LAM CHECK 25% $_ 4 I hereby certify that I have read this application and state that the above I 140.100,000 BTU 0100,000BT11,._._ _ _ GRADING $ i information is correct. agree to comply with all city and county ordinances - - J+ - �' 00 ELECTRICAL $- antl state laws elating to building constr Uctlon,and hereby authorize repre- - MICROFILM $ inspection purism t is cit to en or upon t above-mentioned property for PLAN CHECK 50% $ .•-� ^� : Inspection purp'ses, I' t ,_ ZI . "1 MECHANICAL $ . TOTAL FEE $ •' 3-06 Signature ,t/ _ - Reinspection Fee $15 Issue Fee - • $ 3 PLAN CHECK 25% $ s CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod -Assessor . • CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater& Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical-Final • 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning i/j ( 7 /9pt FIRE DEPT. REQUIREMENT - 20. Rough Factory Fireplace //; /y2 fir APPROVALS Permit# 21. Ducts, in Structure ,j' Z 70. Underground Hydro 22. Ducts', Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &Test 72. Underground Flush 24. Roof Framing. 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing - 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL . • 29. Insulation 78. FIRE PREV. FINAL ' 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final.Heating & Air Conditioning c/�✓ Pee 35. Final Gas Pipe-Test ,• ' ll/S 36. Hood or Canopy - 37. Final Factory Fireplace f/,f/fs 4/4£ • - 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 0 • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. t PE T /- • 'TRACT NO. : LOT NO: UNIT NO. CITY OF.COSTAMjS�3.c IvsTRUCTfQI� PERMIT cvC�al 2716:, t �2• DS i • �p625 j1721787 45950 'TL Project Address e�99 If.,1J (y{-I'�'�'S ' ._- : - - Applicant's Mailig1g Address E's 3 ({'�( fl(�, s TYPE'OF CONSTRUCTION �� NEW U • 'ADD U ALTERATION U REPAIR 1 - ' • ' Owner's Name'••••••) � L.C.'S QIf-J DO ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ A.P.# _ . _ _ -. ' Zone _ H- 2b33 C. is LDtt fJ •QR c(� ( 2 i DESCRIPTJON� �O�R K�US OF BLDG. PT UNI {'S Address { eC r�o�t� o / L`99 , S Main Building: Accessory Building: Arch/Eng.I-t»S e.E f l4( .R.T License rJp. C -'217 b TYPE OF PERMIT ❑ GRADING ❑ FOUNDATLOI�t• ❑ STRUCTURAL T Front. • i p 22'•( L ST ' t ILao A Cah `I 4. 1 0 TENANT 0 ELECTRICAL' 0 PL MBING a: MECHANICAL B Rear ' N Address p . 0 OTHER S 6 ' G-bfLPC--E S A •- _ _ _ _ _ • _ _ I Contractor's Name dwN IL n.- BLbR.- Phone 5b11 da, f� ,�� C Right `• G Address(mailing) lc fl R. PROJECT DESCRIPTION SO. FL -7(S � �-•I U OCCUPAii NC`V, r(9•- •K I - I ; , • CONSTRUCTION TYPE VALUATION $1r`Ii 144 : $ Left , • R City License No. • ZONE ' - - GRADING CU.YDS. ACRES Ping. Ref.# ' , Parking Req./Provided E LICENSED CONTRACTOR DECLARATION - - I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: ' JCC Q ' • _ Planning Notes: (N with section 7000) of Division 3 of the Business'and Professions Code, and - -- ' T _ ' my license is in full force and effect. ;P ' ^� C a 7 O ' I - _ , .• _ $ License Class License No. FL d' �] 1 O PLUMBING FEES Date Signature - i - ' .. WORKERS'COMPENSATION DECLARATION Bar Sink - Showers - ilI hereby affirm that•I have a certificate of consent to self-Insure or a certificate - -' ELECTRICAL FEES y of Workers' Compensation Insurance, or a certified copy,thereof (Section Backflow Prevehter , Service Sink t 3800, Lab. ],, Automatic Washer , Transformer 0 15-50 KW ' •�Duty No. `M1qo43 �� Company s i AC1c �1+U t-1 , Backflow Irngation Sewer Cap ' • ❑ 50+ KW - .. FU p - Construction Pdle S ub. - t, I J� • Certified copy is hereby the cit i _ 1 • ,w Ce[[LiiPP��d copx is filed with the city B�ildin Division 1 Bathtubs Sewer Connection I Cooking.Unit' - Meter alp to 100 amps 1 Date)l"' Ai _ `1 Applicant v , - - " EXEMPTION FROM WORKERS'COMPENSATION DECLARATION : Clarifiers ' Solar Collectors• _ Dishwasher I ' Meter Hover 100 amps - ' (This section need not be completed if the permit is for one hundred ($100) br - , _- less). Dishwasher, Solar Piping -_ - Dryers-❑Gas ❑Electric Sub Panel - I certify that in the'performance of the work for which'this permit is issued I • _ - ' _ ' ' - r shall not employ any person in any manner-so as to become subject to the Drinking Fountains. ;Solar Tank I - ' - Fan _ Motors❑0-1.HP ❑1%-8 - • Workers' Compensation Laws of California. , • _ Date Signature ' t 1 • t Floor Drains. — ! - Swimming Pool w/Spa' - - - NOTICE:If„after_meking this declaration, you should.beCome.subjectlo the. - I _ t FA.U.� _ - _. IInc.Solar ❑g-15 HP ❑i6-15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks , Urinal I Fixtuies - comply with such' provisions or this' permit shall be deemed revoked. • ' ' Microwave, • : i CONSTRUCTION LENDING AGENCY 'a:• ; Gas Service Outlets Water Closet I I i - G •v . ';qr I Device Boxes •, Pole Li ht I 1 hereby affirm that there is a Construction lending agency for,the performance 9 i of the work for which this permit is issued (Section 3097. Chir1C.) Interceptors tors , •Water Heater ' Ran e Lender's Name • Fa - p •'/ , Outlets g - i Lender's Address - - • .” . Kitchen Sink WaterService - - - ( - - -• 1• -- --. OWNER BUILDER DECLARATION ---- -- • i - Switches Sign , /. I hereby affirm that I am exempt from-the Contractor's License Law far the lavatories Auto-Wash • i Garbage Disposal following reason (Section 7031.5 Business and Professional Code: Any city or _ •4,._ - Standing Sections county which requires a permit to construct,'alter,improve,demolish ora'epair . P.,(-Trap : I Laundr Tra s •' Y. Y - Generator ❑0-5 KW ❑5-15 KW Trash-Com actor ' any structure, prior to its issuance, a is licensedequirethe applicant tor,such permit i P • to file a signed statement that he/she is pursuant to the provisions-of r -- - - ' the Contractor's License Law(Chapter 9(commencing with Section 7000)of Roof Drains - - •Division 3 of the Business and Professions Code) or that he/she is exempt ft - - — - - - - - --, - - - - - - - - - -- - -- 1 therefrom and the basis)for the alleged exemption. Any violation icnt of Section , len y- any applicant for a permit subjects the applicant to'a civil ' t • ' I - l - l i en not more than five hundred dollars($500 . • I • I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 , - . • Issue Fee, I $,3 ( ' ' o pensation, will do the work, and the structure is not intended ed or offered - Reinspection •Fee I; $15' Issue Fee ' '• $ 3 • for -sale (Section 7,044„Business and Professional Code: The Contractor's MECHANICAL II FEES , - ' i License;Law does not apply to an owner of a property who builds or improves _ _ __--S_ - thereon, and who does such work himself/herself or tnrough his or her own i DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not Intended or offered for Boiler .. •7 Hood or - Type I ❑ -sale. If, however,rt ne building or improvement is sold within one year of con- ,` Canopy ' Type II ❑ 3.00a. - 6 pp ?Doing Approved By nate - pletion, the owner will-have the burden of proving he/she did not build or Im- Duct-Under Ground - r i Building Approved By Date •-o . for the purpose of sale). •wner of the property, am exclusively contracting with licensed con- Duct-StructuralRefrigeration System , Apphn2tlOb Issued By Y,r Date actors to -• uct the project tt%�eyytii�on 7044,Business and Pr. • ions Code: i �� r !L 4• The,Contractor's. '• - Law 4Oelylot apply to an . of property'who I • I. ❑0- i i iii : - ■ •s, `v - -• . ' ' " i builds or improves thereo -• .ho contr. " such projects with a con- _ i r SUMMARY OF FEES tractor(sl license pursuant tot •. 's License Law). 1 am aware that - ■ System,Repair/Alteration•, - - BUILDING PERMIT $ - SMIP - ,$ proof off their Work -• pensation insure ••uld be provided to me, ' - • - ' t ' • ' PLAN CHECK , $ PERMIT l tL ❑ ham ex-••- under section) B.& ••. -. this reason - =• ' - 40-',1 , - (7 o PLUMBING d $ ISSUANCE •$ Date' - - ' Owner - - a n Registers I_, , i Oo` - - - ENERGY P.C. $ 1� PLAN CHECK :125% $ ' - l• I hereby certify:that`' have read this application and state that the above it0-100Q00 ■ 00,000 pe - - , information is correct. I agree to comply with all city and county ordinances �' 'y-- 2c r '� OG_ ELECTRICAL $ GRADING $ - - • - • and state la s relating to building:construction, and-hereby authorize repre-' - - MICROFILM - $ sentatives O this ity to Lent r upon the above-mentioned Property for - + PLAN CHECK 50°.G. $ T inspection pu poses[[ @@ t �_ - _ MECHANICAL $ 1•09 TOTAL FEE $ '1�•co Drivers' ✓J'or•SS* . -Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning ,4 /r, !Q �'9 FIRE DEPT. REQUIREMENT i/ ,�/ 20. Rough Factory Fireplace /`p-y A�!/�G/�e� APPROVALS Permit# _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling(Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT • 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final.Heating &Air Conditioning chile #hie 35. Final Gas Pipe-Test // 36. Hood or Canopy 37. Final Factory Fireplace ehWO /L1a� - 38. Final Plumbing /�� • 39. Water Service-Final . 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backf low Irrigation • 44. Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co i-- 51. CERTIFICATE OF OCCUPANCY •. No. Date i Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. COY OF COSTA MES�a CONT/RUCTION UCTION PERMIT PENT NO. TRACT NO. LOT NO. r UNIT NO. i • Project Address 2633 �Z'/d u, Are.—. /4-45.Z52.57-5;i7'. - :' 4114 9/30/86 • Applicant's Mailin Address 1W Mer/a/( /1 TYPE OF CONSTRUCTION [XbNEW ❑ ADD U ALTERATION U REPAIR 33e00 TL ❑ CONVERSION ❑ DEMOLISH ❑ OTHER 'Zone_ - Owner's Name IRC 4/0"- Vat�e1�lfi-�CJ Phone -976( A.P.#DESCRIPTION OF WORK/USE OF BLDG. ..- ' Address 2633 IThe.. -Zysvr. - S Main Building: Accessory Building: Arch/Eng. License No. • TYPE OF PERMIT El GRADING ❑ FOUNDATION ❑}STRUCTURAL E Front ZO Address w pp(� //s+) ❑ TENANT ❑ ELECTRICAL. ❑ PIkUMBI�NG ❑ MECHANICAL BA Rear • N Contractor's Namn AA. JrrL-/4.'Yd $t.esA 7Whone GAJ J+w ❑ OTHER p ., U/1�LTe't-r•.{Y r'/IOP C Right • N Address(mailing) �� Merrill 7 /r / PROJECT DESCRIPTION/5G. FT. / OCCUPA�}FY K - G CONSTRUCTION TYPE VALUATION$ S Left • City License No. 2 g 7Z•- R ZONE GRADING CU.YDS. ACRE Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION ^� I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: /� y Planning Notes: - 1 Q with section 7000) of Division 3 of the Business and Professions Code,and /e9, e'� i•/ 1 50.0 my license is in fnlljorcg4nd effect. �0 ttt/// TS `•� License Cla s ZS}Lr ken5e NO 1 ate Signature�7��7-ew//-// /� - PLUMBING FEES WORK RK R�SATION DELLA RATI Alio Bar Sink . Showers ereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL - 1 FEES Workers' Compensation Insurance, or a certified copy thereof ( ection Backflow Preventer Service Sink • Automatic Washer - Transformer ❑ 15.50 KW f� 00, Lab. 90/J 6q -- ' Policy No. Company /' "�� '�- Backflow Irrigation Sewer Cap Construction Pole Sub. ❑ 50+KW C fled cop is hereby furnished. ert 'e o filed with the city B 9 'e// Bathtubs - Sewer Connection • Cooking Unit Meter ❑up to 100 amps Date Applicant _ _ ��I • EXEMPT FROM WORKERS'CO * �•TlfN DECLARATIe N Clarifiers ' - Solar Collectors Dishwasher - Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100)or less). Dishwasher ' - Solar Piping Dryers ❑Gas ❑Electric ' Sub Panel ' I certify that in the performance of the work for which this permit is Issued, I - shall not employ any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors❑0.1 H • P ❑1'/x--8 Workers' Compensation Laws of California. •- _ Date • Signature Floor Drains - Swimming Pool w/Spa F.A.U. NOTICE: If,after making this declaration,you should become subject to the - Inc.Solar ❑9-15 HP 016.15+ ,_ - Workers' Compensation provisions of the Labor Code, you must forthwith , Floor Sinks FixturesUrinal comply with such provisions or this permit shall be deemed revoked. • . Microwave, • CONSTRUCTION LENDING AGENCY Gas Service Outlets • Water Closet • Device 80xesI I hereby affirm that there is a construction lending agency for the performance • - POI¢ Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors ' • Water Heater Outlets Ran Lender's Name -- --. - - ge, - Lender's Address -- , .. _ - _ - - Kitchen Sink - ,- • Water Service ' Switches - -- -- - - - " OWNER BUILDER DECLARATION Sign I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - . Auto-Wash Garbage Disposal • following reason (Section 7031.5 Business and Professional Code: Any city or I 9 P Standing Sections •county which requires a permit to construct,alter,improve,demolish or repair P-Trap ; • ' Laundry Trays Generator ❑0-5 KW ❑5-15 KW Trash Compactor any structure, prior to Its issuance, also requires the applicant for such permit P to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000) of -ivision 3 of the Business and Professions Code) or that he/she is exempt - - - • ' - -- - - ' erefrom and the basis for the alleged exemption. Any'violation of Section I 031.5 by any applicant for a permit subjects the applicant to a civil pendlty of not more than five hundred dollars($500). Ir a , LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee $ 3 ' compensation, will do the work,and the structure is not intended or offered - Reinspection Fee I $15 Issue Fee • $ 3 for sale (Section 7044,'Business and Professional Code: The Contractor's MECHANICAL FEES - License Law does not apply to an owner of a property who builds or improves a thereon, and who does such work himself/herself or through his or, her own - DEVELOPMENT SERVICES REQUIREMENTS: •• employees, provided that such Improvements are not Intended or offered for Boiler Hood or Type I 0 sale, If, however, the building or improvement is sold within one year of com- Canopy Type II 0 • Zoning Approved By Date elation, the owner will have the burden of proving he/She did not build or im- Duct-Under Ground Building Approved By Date prove for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By - - Date tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - 00100,000 BTU 0100,000 BTU $ RV OF ES builds or improves thereon,and who contracts for such projects with a con- �r tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUI LDING PERMIT $ '. SMIP $ / iJ a proof off their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT. 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# . - • Fire Dampers PLUMBING $ ISSUANCE • $ Date ' Owner Heating System&Ducting Registers - ENERGY P.C. $ - PLAN CHECK 25% $. - I hereby certify Hi- I have read this application •state that the above 00-100,000 BTU 0100,000 BT - GRADING- $ _ information is cora. I awe: t• comply wit Aand county ordinances ELECTRICAL $ - and state laws r in• to ing construe 'y • hereby authorize repre- PLAN CHECK 50% $ MICROFILM. $ . sentatives of t cit : to eon h•�.i.* mentioned pro r for - inspectionpur•+ /e // MECHANICAL $ �j�J ,p—) Signature' /�.a�` / `� - Date _ - TOTAL FEE A 9 'S ' � /! Drivers' License or Pink -Accounting;Goldenrod - Assessor CONSTRUCTION AND PLANNING ' POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# - Date 'Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final • 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# - 21. Ducts, in Structure • 70. Underground Hydro 17-22-i7 �/7�-� 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil , `/!' 23. Gas Pipe-Rough & Test 72. Underground Flush - 24. Roof Framing 73. Undergrnd-Storage Tank ❑Gas ❑Oil 25. Roof Sheathing 74. -eagelasd 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 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