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HomeMy WebLinkAbout2603 ELDEN AVE - Building Permits (2) 1, S . - r _ 1 �(c CITY OF COSTA MESA - i1 BUILDING DIVISION j• r,,nnmanks ' DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER 4./. �PK : PERMIT 607-00092 • BUIEBINC PERMIT (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.Cc.us 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV Status: ISSUED Suite: G Applied: 01/26/2007 Vicinity: MAR ELDEN SQ CONDO UNITS G AND H Issued: 01/26/2007 Primary Occ: R-3 Dwellings/Cong Res<10 Type of Construction: V-N Parcel Number: TPN006088 Zoning: Applicant: WILLIAMS, LARRY Address: 101 THE MASTERS CIRCLE 0/ Phone: 714-444-1111 COSTA MESA,CA - ;� - Zip 92627_ ISSUED BY: /� Owner: MAR ELDEN-SQUARE HOA, Address 2603 ELDEN AVE- -- , - �,J,:--1' % -'1 , Phone 1 �,, COSTA MESA,CA\ i---, 1 - Zip 92627-4654 / - /,/'7 c A \ (1:-.--211---,---2-----17:: i / Contractor( ,/ALL.COAST ROOFING-AND:COATINGS _, Address:' X 101 THE MASTERS CIRCLE` - -N /7,17/ V \ �/7474.:r26Phone: 714-444-1111 " - i� COSTA MESA;CA- N ., / �/.' Zip: 92627//% License: 598440 \2 •:.` c , / 7 %!� //7:7 g, y !Arch :( <, //' : / Eng: �,'; - , Address: .,� -;' f - -- -r. Phone: • ;Phone: b Zip:_, ' '"V / •/ Lice,—nse' `(may License: \ _ 1I: F� , f7' - - SCOPE OF PERMIT -- " / - `-REROOF CONDO UNITS.-G AND H:INSTALL"30-YEAR GAF TIMBERLINE COMP SHINGLES"OVER ONE LAYER OF COMP. 1800 SQ FT PITCH 4:12, , i,,,; ,../; ./ V _,› - . i' ( (r ,;ra1-7 , � FEEESUMMARY - Plan Check: (1 $0.00 Lull if '): r r DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penally of perjury one of the following declarations: ❑ I have and will maintain a Certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. I have and will maintain orke 'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compo :ti.n In- ca `er and licy number are: � ' Carrier: ) — ♦t' Policy Number: 9-7 (This section need not be co plated it the pe rs valued at one . dre. •liars($100)or less.) • ❑ I certify that in the perfor' nce of the w. • whi• thi ,ermit is iss :d,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of C:l•mia,and agree t :t If shout become .eject to the workers'compensation provisions of Se ion 3700 the Labor Code,I shall forthwith comply with these pr.. • S. Applicant Signature: ' _ -� Date: I a—te, the? WARNING:FAILURE TO SECURE WORKER- COMPENSATION COVERAGE is UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMIN PENALTIE AND CIVIL FINES UP TO ONE HUNDRED THOUSAND COLLARE($106,000),IN ADDRION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby affirm that I am licensed ••e pr. •ons of Chapt: mmencing with Section 7000)of Division 3 of the Business P of ssions Code,and my license is in full force and effect.Lic.a 'MS zt_ S_ /� Class a Contractor's Signature: 1Y. "s•--..S Date: 7 t� _— CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however;the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. _ Business and Professions Code for this reason. Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2.Art 2,Sec. 341,Title 8,Califomia AdministratNe Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes ❑No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by pusinesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the Califomia Health and Safety Code been fully complied with? 0 Yes 0 No- 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application appermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? DI Yes LJ No (Section 65850.2 of the Califomia Govemment Code requires that the requested information be fumished on applications for non-residential building permits). __...1.000...._r.o_._..eouter — 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? Yes❑ 0 No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes ❑No B (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AN • ' ORI ON OF RY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree t• •+ ply with all state ws and •ty ordina• es relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-descri�arty for i specti. rpoj ogre: of to occupy or allow occupancy of any building authorized by this permit until final inspection. LAY/LI Y ignat fog f 0 Dat Nd/ r uthorizedApplicant CODE INSPECTION TYPE QA1I MAU CODE INSPECTION TYPE PAM INTIRAL$ 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof ® 2t0 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy - _ • CITY OF COSTA MESA BUILDING DIVISION nt) ,., DEVELOPMENT SERVICES DEPARTMENT PERMIT NUMBER F i � PERMIT �M05-00631 dP (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE,COSTA MESA,CA 92626 MECHANICAL PERMIT Job Address: 2603 ELDEN AV Status: ISSUED Suite No G Applied: 11/02/2005 Issued: 11/02/2005 Vicinity: Parcel Number: 93009748 - OAP /1,�� ISSUED BY: V j Applicant: LAURA YENULONIS Address: Phone: Zip: Owner: WATANABE, RENE M Address: 2603 ELDEN AVE#G • Phone: COSTA MESA,CA Zip: 92627-4654 • Contractor: ALLIED PLUMBING - HEATING -AIR CONDITIONING Address: 422 JENKS CI Phone: 714-998-4300 CORONA,CA Zip: 92880 License:610780 SCOPE OF PERMIT • CHANGE OUT EXISTING FURNACE AND NC UNIT,SAME LOCATION. , • FEE SUMMARY • Quantity Quantity ISSUE FEE $23.50 Repair/All Absorbtion Unit $0.00 0 Inst FAU<100 k BTU $14.80 1 Repair/Alt Refrigeration Unit $0.00 0 Inst FAU>100 k BTU $0.00 0 Ventillation System $0.00 0 Repair/Alt Cooling/Heat $13.70 1 Evaporative Cooler $0.00 0 Inst I Rep.Recess Wall Htr $0.00 0 Commercial Incinerator $0.00 0 Refrig Sys<100 k BTU $0.00 0 Domestic Incinerator $0.00 0 Refrig Sys>100 k BTU $0.00 0 Compressors/Absorption Systems Gas Piping $0.00 0 Up to 3 hp/100 k BTU $14.70 1 Factory Fireplace . $0.00 0 3 To 15 hp./500 k BTU $0.00 0 Hood w/Meth Exhaust $0.00 0 15 To 30 hp/1,000 k BTU $0.00 0 VAV Box $0.00 0 30 To 50 hp/1,750 k BTU $0.00 0 Vent Fan/Single Duct $0.00 0 Over 50 hp/Over 1,750 BTU $0.00 0 Appliance $0.00 0 Boilers Fire Dampers $0.00 0 Up to 3 hp $0.00 0 Smoke Dampers $0.00 0 3 To 15 hp $0.00 0 Inst or Relocate Appl Vent $0.00 0 15 to 30 hp $0.00 0 Air Handlers< 10000dm $0.00 0 30 to 50 hp $0.00 0 Air Handlers> 10000cfm $0.00 0 Over 50 hp $0.00 0 Floor Furnace $0.00 0 Other Mechanical Fee Floor or Suspend Heater $0.00 0 Investigation Fee $0.00 Plan Check Fee $0.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES $66.70 COMMENTS/SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 244646(900) DECLARATIONS WORKERS'COMPENSATION DECLARATION: t - –• I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the r.---wrnkfor this permit is issued. Hhaeve and will maintain viorkers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ,...__My-workps'compensgtion Insurance carrier end policy number are: I I Oanier"7 V `l1 r `MJr's L'QO-n'�� aPe ictnnber:—_�_—aQ 3' t,Y A -O (This section need not S completed if the permit is valued at one hundred dollars($100)or less.) I , ❑ I certify that In the performance of the work for which this permit Is issued,1 shall not employ any person in any manner so as to become subject to the workers' compensation laws of California,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro Z4•ns. I DLslgoawra:_._ a, - -JY•A-A-Q ... 3&Oate: `\- ARM •:FAILURE TO SECURE WORKE• 2,4. TION COVERAGE IS UNLAWFUL AND SMALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED TH(YJRAND aXURE(5100,000).IN ADDITION T• E COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE.INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section 7000)of Division 3 cf•the-Bus�iness and Professions Code,and my license is in full for -acini ',PC)l ln ' (� n basal--7 Ca0 C-3(0 caRllaarorrsgna ut re ins..1GPr-vt,-o g5 . \1 - 2— OS CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: • Lenders Address: Signature: ! Date: OWNER-BUILDER DEM-ARA ONS: I hereby affirm that under penal of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to Its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or 0{e or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty,• ore than five hundred dollars($500).): ❑ I,as owner of the property,or my p es with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Cor:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his'o,her, own empiRyees,provided that such improvements are not Intended or offered for sale.If.however,the building or improvement is sold within one year of completion,the own: ••. will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the properly,am EXCLUSI a TN, 6 -ACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does'no e an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License La.... ❑ . I am exempt under Sec. Business and Professions Code for this reason: Signature: i aw• 7 Owner ID verified by drivers license. ❑Yes 0 No Drivers License No. ires7-7 Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no pudding structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has e permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file end certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? ❑Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Flre Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an-RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the Califomla Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If en RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupantrequire for the work which Is the subject of this application agermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? IU Yes LJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). any _darle ._ —Er ." 6 Will any pert of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health end Safety Code). out..._...._ ._ . ._thea Be- - ._ _.... 7 application,If a permit from the South Coast Air Quality edManagement Healthal or other et goltion control district been or agency is required for the work which is the subject of this have all of the disclosures prescribed by Californiala and Safely Code Section 42303 made? ❑Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPIJANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for Inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. SI:an are Of Legal Owner(s) y� x Date OrAuthonzatl-A(fplRant ^„y,— Date ..� NU. INSPECTION TYPE PATE MALE PDF I INSPECTION TYPE �'� '�'••9/u.7%/E�i� lour .: 1616 Fixed System Final Fire Prevention 206 Final Mechanical s. 1268 Pool Spa Final 208 Final Plumbing •• 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval • 203 Final Sign 222 Final Site • 204 Final Demolition • - 250 Final Building/Occupancy r ' a - . t City of Costa Mesa ' Development Services Department 001472 109 7 2 Building Safety Division CERTIFICATE OF OCCUPANCY No. 6J 1`1 - P.0.Box 1200 `5 Costa Mesa,California ` The Building located at 2603 Elden Avenue#G has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto 1 4. fora Group 1-3 Occupancy. 4 Use of Building Condominium rl ? T Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) i `7 G18479 Building Permit No G18479 Electrical Permit No. G18479 Plumbing Permit No. x ? Mechanical Permit No. G18479. M19771 . M20178 Number of apartments and/or guest rooms 1 ,s. ISSUED TO: / Building Official /6-.4"/_1 ( /e ',�$ Mar—Elden Develorn(ent !A 18226 W. McDuruott by"--71 ( _ .477.E--4_,..., tr Irvine, CA 92714 ��� Date A,. 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. Lc 4 CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File ' S i1 • City of Costa Mesa • Development Services Department CERTIFICATE OF OCCUPANCY No. 001472 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2603 Elden Avenue4G has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto • for a Group W3 Occupancy. Use of Building Condominium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit No G18479 Electrical Permit No: G18479 Plumbing Permit No- G18479 Mechanical Permit No. (11847q• M1(4771 - M20178 Number of apartments - and/or guest rooms ISSUED TO: Building Official .l D- . (1.4,--24/1E- Mar-Elden CMar-Elden Eevelolxre_nt t b' (V 18226 W. Mcour ott y !'. • Irvine, CA 92714 Date r�y� Rif 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 (e) U.B.C. CMF 1015-46 rev.1/83 White-Owner:Canary-Numerical File;Pink-Bldg.Permit File CI I, Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. '.OF • COSTA,{'AES/)c.J • - - - - . - PERMIT NO.S "• TRACT NO. LOT NO. - • BLDG.NO. - - - . ' -" - • - 1258 G/� 6/{1.`j' - ? 'Oo e• 11_ CE,�ST.W}UCTION PERMIT ' . . G 19H 19 - 1?-2,Q'1 G _1 Project,Address - .03 E I dent Ave. #G - TYPE OF CONSTRUCTION U NEW. U ADD U ALTERATION U.REPAIR ' - --') .0 Applicant's Mailing Address:18226 W. MCDurmott, . Irvine ' ❑ CONVERSION ❑ DEMOLISH ❑/,,yOTHER - - A•p•#[,'34—O 7/ `D 7�S • I Zone /Q- o. Owner's Name' Mar-El den Development Phone:474-0601 DESCRIPTION OF WORK I t' J �`-' C : • • . S Main Building:' Accessory Building' Z Address 18226 W. McOurmott, Irvine 92714 TYPE OF PERMITiS�d ❑ GRADING S_EOVNDATION/l�'STRUCTURAL T Front y11 1 _ • Arch/Eng. Chris-R. 'Stephens --- License No. C12963' ❑ TENANT 10111f-ELECTRICAL ,r�.E`UMBING; MECHANICAL , ' B Rear • LSI, - _ 1 Address 18226`W.-- McDermott, Irvine 92714 • • :' ' ❑ 'OTHER - A N ((�� Contractor's NameThP Ri rherd 'F.P CrAWfnrrh-Goe. 474-0551' ,PROJECT DESCRIPTION SQ. FT.75 Q5`_' T �',OCCUPANCV L-5 K Right tTj` - - - _G �y " ' I ' .CONST RUCTION TYPE VALUATION$ � 000 _ $ Left ' 1211 . . i I R rry,�e Address(m-ailing) 18226 W. Mrflu rmritt rviy:nP 92714 iC%t ,l� ; E City License No. - •41A643�'i / ' ZONE GRADING CU.YDS. 'ACRES Ping. Ref. Park:Fees $ O SDR-s4-y7T-� i3, 3/�'vS' , °1, LICENSED CONTRACTOR DECLARATION-j, : _ Remarks: , <. 7y� gyL • Parking Req./Provided 3O / -50 • , • I. lhereby,affirm that I am licensed under provisions of Chart- 9 (commencing . , • R with section 7000) of Division 3 of the•Business and Pr• sions Code, and ' - t h • Use of Building: Conte _ .. my license•is in full force and effect. ' - _ - - E License Class 'teer: - - s: c X49 ' , PLUMBING - 'I FEES Planning Notes: ' --{'�"-� - E T.}t.�--;_ LVL .M Date ' / Signature ' ' Ck /•/�� pV4 nnn.ePF('S Al_I,.� - _ E [iV ' N u' i Bar Sink Showers - i . , WORKERS'COMPENSATION DECLARATIO • , • I T • 't:1,4hereby affirm that I hive a certificate of consent to self-insure or a certificate Back`low Preventer Service Sink _a • - i • -. S • f-Workers'-Compen@sation- Insurance,l or:a certified;copy tpereof-(Sectiopr'- - - - ' -• - - - . . - --- -- - 3800, tab. C.)-i ��� •i_' ",- / Backflow Irrigation Sewe,Cap '�„!-- ? a_ ,� , , ELECTRICAL ; 'FEES ." ' Policy No. lin zt)V_ Companysn't• er-elfA/011, ., - t . copy'Is heyby furnished. Imo' " . Z Bathtubs •, moi' , / Sewer Connection[ - uL Automatic Wesher y _ „certified1: • . ;Transformer 0 15;50 KW," JCCerti y t with the city Bow on. Li I t„ . , , - , . ~) • -nn1 V; - 50+KW". Date "r '�� •+ Applicant r�• J Clarifiers i Solar Collectors. ConstrucUomPole Sub 0 . EXEMPTION FROM WORKERS'COMPENSATIO LA TION- - t -1 - . . 1 Distiyvasher Solar Pi in (This section need not be completed if the permit Is for one no red($100)ors / - i P g _ Z - Cooking Unit, r- - ' 'Meter pup to 100 amps-' - , e or '%' .. •- I certify that In'the performance of the work for which this permit is issued L' Drinking Fountains - Solar Tank r(� . /,r if / Dishwasher .''i '.7 Meter (over 100 amps'.(',` 8 shall not employ.any person in,any manner so as to become subject to the — - , , - - ' Workers' Compensation Laws of:California. Floor Drains' t i Swimming Pool vv/Spa, / Dryers IQ;Gas ❑Electric •• 'Sub Panel ',` li ,f7TJ Date Signature ' - - • /, V NOTICE: If,after making this declaration,you should become subject to the , Floor Sinks • Urinal' / Fan Motors 00-1 HP 0134-8 i Workers' Compensation provisions of the Labor Code, you must forthwith' ' - - - - -- '- - - - - - - - , comply .with such provisions_or this,permit shall be'deemed revoked. i ./, Gas Service ' ZOutlets • 3 Water•Closet' ' - , _ 2 / -,'F.A.U.�' �, . Inc Sola;❑g-15�HP ❑16-15+ on i CONSTRUCTION.LENDING AGENCY - , _ __ _ • I hereby affirm that there Is a construction lending agency for the;performance • Interc¢ tors ^ ' Water Heater, % /', Fixtures . i _ P / _ `J- Microwave - (7; LU of the work .for which this permit'is issued. (Seth on 3092 Qv. C.) - I - - I 3 Lender's Name, - - Kitchen Slnk' - - ' Water Service 'Z -, ; Device Boxes /-- • .Pole Light Lender's Address. - i I - - • l - - - ' OWNER BUILDER DECLARATION : - I •} 3 Lavatories F"r.•• - I - I .1, '' 2.7 Outlets - '-k ,t'; a :'i R• ange '• 4 _•• 7 e•o I hereby affirm that I am-exempt from the'Contractor's-License Law for the' ' - , - i.` - - - following reason'(Section 7031:5 Business and Professional'Cede: Any city or P-Trap; '- - - - _ i lig,: Switches•• i ' I Sign f j 3 Op county which requires a permit to construct,alter,improve,demolish,or repair , - / any structure, prior to its issuance, also requires the applicant for such permit • Roof,Drains - I / [ Garbage Disposal,. Standing Sections':' ,/' • to file a'signed statement that he/she is licensed pursuant to the provisions of ' — - _ - ' .- 'the Contractor's License Law(Chapter 9 (commencing with'Section 7000) of - " E,erierator ❑05 KW ❑5-15:KW !, Trash Com a 'ivlsion 3'of the Business and Professions Code) or that he/she.is.exempt _. r - t'; p etor *� erefrom:and the basis for the alleged exemption. Any violation of Section - 'i - - _• " - , 331.5 by any applicant for a permit'subjects the.applicant-to a civil .Reinspection Fee; 3 lf � I' • LJenalty of not more than five hundred dollars($500). + Pe I $25 Issue Fee $ - I, as owner of the property or. my employees-With wages'as their sole MECHANICAL Reinspection Fee , '$25 -Issue Fee ' ' , , $ 3- compensation, will do the work, and the structure Is not intended or offered - _ . FEES .' • _ for sale'(Section 7044; Business and. Professional Code: The Contractor's - _ - PUBLIC SERVICES REQUIREMENT ' • License Law does not apply to an owner of a propertywho.builds or improves Boiler ' - I - Hood or Type I ❑ i _�/l fir,mss' •- thereon,'and who does such work himself/herself or through his or her own Zoning Approved-By - • l/s'"'`� 146.C_,11�- 1" Date -l�J-� employees, provided that such improvements are not Intended or offered for Canopy : Type II ❑ - �- Duct-Under Ground sale. If, however, the 11 building or improvement Is gsoldhe within one year of com- Application Approved By - I�n �-c - ' Date pradon, the owner:w111 have the burden of proving he/she did not build or im- - ' / , - prove for the purpose of sale). - , i Duct-Structural Refrigeration System Applibation Issued By Dat LJ I, as owner of the property, am exclusively contracting,with licensed con- ❑0-100,000 BTU ❑100,000 BTU . r+ ' tractors to construct the project (Section 7044, Business and Professions Code: Duct-Ventilating i • -•. SUM RY,OF FEES The-Contractor's License Law does-not apply to an owner-of property who ° eM 2,6 8 builds or Improves thereon, and who contracts for such projects with a con- - BUILDING PERMIT f $ 303.00 ' .SMTP .$'' 5 V V Exhaust System 0 Multiple 0 System Repair/Alteration r I tractor(s) license pursuant to the Contractor's License Law): APLA N-CHECK' $ .��•-7D • PERMIT ' ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBO'# f -.ZQ ISSUANCE I $ ' -' PLUMBING ! $ _ Date owner /' Heg�ng System& Ductin • g PLAN CHECK $..' - 4, f0. • ENERGY P.C. ' $ I hereby certify trio I ver .tl hand state that the above I MO-la0,000 BTU Q10.0,000 BTL • - '. '♦ / information t correct. A - o city and'county ordinances '•- -' ELECTRICAL r $ 3•�r (`O GRADING $ {. and-State laws relati �!% a • hereby authorize repre- MICROFILM f sentatives of this c' T Cte' •7•*"�-..�.'••e-mentioned roperty for • - , PLAN CHECK $ ''fit 7.1� $ , inspection purposes et/ f 7 /t - ( ' ,% MECHANICAL t $ + 7': Ol+ �7 Signature .is : -- - - "� �1 - • _ ,TOTAL FEE $ a}' Drivers' License or SS Reinspection Fee $25 • Issue Fee $ 3 PLAN CHECK $ 'r / + - CMF 0865-46 rev. 7/83 White-Building;Canary-App scant; Pink-Accounting;Goldenrod -Assessor - •- - 'r. ' " .. u i- , 4 0 +�CONSTRUCTION AND PLANNING > ''t,_ POOL WA - fiAPPRQVALS Permit# . Date Inspector APPROVALS Permit " Date Inspector ' • 'rip Temporary Electrical Service or Pole., , . 52. Pool & Equipment Location '2. SoilPipe-Undrgrnd. ' 40 .3/,�j�� 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. : . ' " 4 54. Forms -i.-_4. Electrical Conduit-Undrgrnd. /j/ ' CO 55. Electrical Bonding - 1•. ;; 5. Steel Reinforcement ' . j'/igt 714 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd.j - 57. APPROVAL TO COVER-GUNITE .• ` . 7: Footings ( (1' t'LU i-h/$s CM • ,.w7 58. Electrical Conduit-Undrgrnd.- • '.: • 8. Foundation 4711t. iP"l hr,i 3,10:54,-, psi •59. Gas Pipe, 0 Undrgrnd.,Test :, 9. Water Pipe-Undrgrnd. ..t ! ) ;, 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural"Floor System' . ' (,?; .;, .,,�� 61. APPROVAL TO DECK 11.E Property Sewer Line Si House Connection " 62. Backwash Receptor-Final 12: Sewer Cap - j, I 63. Heater & Vent-Final - . 13. Roof Drains ,. - 64. Plumbing System - Final 14. Rough Plumbing 74::Or C40 65. Electrical-Final - 15. Rough ElectricaRConduit - - 66. Solar System-Final - 16. Rough Electric Wiring 7''r I,✓ t, 67. Fencing & Access Approval 17. Rough Wiring Sign �Ii7,� 68. APPROVED FOR PLASTERING i' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning 7�(a CS I FIRE DEPT. REQUIREMENT 4 20. Rough Factory Fireplaces I - APPROVALS Permit# 21. Ducts, in Structure I 70. Underground Hydro 22. Ducts, Ventilating , - 71. Product Piping O Gas ❑Oil 23. Gas Pipe-Rough &Test - 72. Underground Flush 24. Roof-Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing `fie,,. 7/5455-- B7/11 74. Overhead Hydro - 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing .4:. 7/,) ft5-- en'? 76. Dry Standpipe - 28. Lathing& Siding (ll(g/'$r ffl 77. FIXED SYSTEM FINAL 29. Insulation :7/5r/�_ 7 78. FIRE PREY. FINAL 30: Drywall Nailing , , aj/lll7_/c//c ty HEALTH DEPT. REQUIREMENT X31. Plaster Brown Coat D'/ 79. FINAL INSPECTION 32. Electrical Power Meter-Final 0 //,�,// 27 8b. FOOD CERTIFICATE ISSUED ,.' 33. Final Electric IM.l i Notes:(it ( 7/1/$4--:;!1:,P-.21, 07,47/‘_.4 /07e�r � K ✓Ls�cce�tal� 34. Final-Heating & Air Conditioning ,n/z4/y.$-(l - : / . . % - 35. Final Gas Pipe-Test g4/z7.1s5" C9 ' - 36. Hood or Canopy ' / / - /• _/I4 37. Final Factory Fireplace. i,/ir/rC L 4 Raft n t A -/_ _ ,. Gc✓• _vac •2s-7I 38. Final Plumbing - ,110 'r_ri rv..a7. en\\aA ' ''""may/ � 3s (F / 39. Water Service-Final - 1. y r&S-- CS - - / f , 40. Gas'Service-Final c+t�.t n • � � • 41. Solar Domestic-FinalCe�a.o /`O _ _` � 7 42. Backflow Preventer ��yin �(-/"'C�� 4-1:-.1-°Z.:5- ( { Y�r zec�`Ln ti 43. Backflow Irrigation . . Oh J • .-y-VV T'Jam`_,- '`',:r.,:y/M1�ie:: 44. .Landscape Irrigation System 1; f0 •� . ' / / c�� 45. Sound Attenuation en eQ £Y-i4 7 9' r � �j.7 46. Handicap Regulations . 7/1"(4.5- • 1.1 .497 by 7-_0) v 'cam' 47. FINAL STRUCTURE &,BUILDING `s//5`Sr 48. Special Requirements Completed , //-;145-- /VJ2 osit cPSn t2 - 49. Electric Release to Edison . - r 50. Gas Release to Southern California Gas Co I - ' • - . ' 51. CERTIFICATE OF OCCUPAN G ,/j `� No. 17� Date . L�-S Y�G, / . - A'9(J"Kpplicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. " CITY OF COSTA MESA CONSTRUCTIONT� PERMIT,�/ PERMIT NO. TRACT NO. LOT NO. UNIT 0. Project Address g4 03 �7�� V A -/Y A/ — ` 9 7 7/ rr'' • • Applicant's Mailing Address F-''� IT1I1�5 TYPE OF CONSTRUCTION ❑ NEW u ADO U ALTERATION REPAIR - tcire9c ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.# 61 81 7/08/851 Zone 21012 L Owner's Name Phon `hl DESCRIPTION OF WORK/USE OF BLDG. Address _'C ,tiSeh ttt Ave �.A.01' S Main Building: Accessory Building: L LZ E Arch/Eng. Ole 74tas License No. TYPE OF PERMIT • El GRADING U FOUNDATION 0 STRUCTURAL E Front O Address �w El TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear N Contractor's Nam u hone /rs- El OTHER A I /� LI PROJECT DESCRIPTION 50. FT. OCCUPANCY C Right N - Cm, Address(mailing) �U(0 7 �S seilAs 04' Left _ G / CON ST RUCTION TYPE VALUATIONS s City License No. V 3 d R ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION _ Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: Planning Notes: QM with section 7000) of Division 3 of the Business and Professions Code, and my license is in full for a and effect. 7 O GT se C .Licenass Z 0 License No7-� y/ d S :Date //� 8' Signature ttJ 2.t_,11 ' '. PLUMBING FEES A WORKERS COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate ' ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - Service Sink 00, Lab. C.) - - Automatic Washer Transformer 0 15-50 KW Policy No. Company Backflow Irrigation _ Sewer Cap Construction Pole Sub. 0 50+ KW .B Certified copy Is hereby furnished. Certified copy is filed with the city Building Division. Bathtubs • - Sewer Connection ' Cooking Unit Meter Cup to 100 amps Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps ;(This section need not be completed if the permit is for one hundred ($100)or :less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel .1 certify that in The performance of the work for which this permit is issued, I • • 'shall not employ any person In any manner so as to become subject to the Drinking Fountains Solar Tank - Fan Motors 041 HP 01%-8 •Worker m ry�ati_oryLaws of Calito nla - iDate /l�T Y Signature G - Floor Drains Swimming Pool w/Spa F.A.U. - 09-15 HP 016-15+ 'NOTI Z: IP,inter making this declaraton, you shou,d become subject to the - Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks • Urinal Fixtures - Microwave comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY Gas Service Outlets - Wates Closet - Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater i Outlets Range Lender's Name • Lender's Address Kitchen Sink Water Service I Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal ;Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,Improve,demolish or repair P—Trap Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor any structure, prior to Its Issuance,also requires the applicant for such permit - -to file a signed statement that he/she is licensed pursuant to the provisions of 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 • 'refrom and the basis for the alleged exemption. Any violation of Section - • 31.5 by any applicant for a permit subjects the applicant to a civil .salty of of not more than five hundred dollars($500). 0 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 I 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: Boiler Hood or Type provided that such improvements are not intended or offered for I 0 sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By Date pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground,move - Building Approved By Date for the purpose of sale). .-- I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System • Application Issued By y 1 Date.y(/kW 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 9/ 0o-100,000 BTU 0100,000 BTU [/ CO SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- j tractor(s) 1lcense pursuant rto the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ❑ I am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers A PLUMBING $ ISSUANCE $ DateOwner Heating System& Ducting 3 Registers 6 ENERGY P.C. . $ PLAN CHECK 25% $ I hereby certify that I have read this application and state that the above / X0-100,000 BTU 0100,000BTL - GRADING $ information is correct. I agree to comply with all city and county ordinances ! ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- • PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned property for 9 inspection pu( srjQ es.� /�j/eA a MECHANICAL $ _ TOTAL FEE $ 01-4/11.--,- Drivers' Signature 7Y — CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor • CONSTRUCTION AND PLANNING POO IPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole. 52. Pool & Equipment Location t 2. Soil Pipe:Undrgrnd. 53. Steel Reinforcement • 3.4ElectVical Conduit Utility-Undrgrnd. 54. Forms • 4. Electrical conduit-Undrgrnd. .1 55. Electrical Bonding 5: Steer-Reinforcement . • 56. Rough Plumbing & Pressure Test 6:' Elerfrica& UFER_Grnd. 57. APPROVAL TO COVER-GUNITE • 7,'Foo in s I 9 58. Electrical Conduit-Undrgrnd. B.,,Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water'.Pipe-Undrgrnd. it, 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property.Sewer Line& House Connection 62. Backwash & Receptor-Final 12f'SAvierf,Cap ^' 63. Heater & Vent-Final 13. Roof Drains 1 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 �II13l�s (TOO 71. Product Piping 0 Gas 0 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 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: .4-7/7/1.95.-- V� �✓�j� �n`�y 34. Final Heating& Air Conditioning VIA/35- (427 St. /44. p /worse[ 35. Final Gas Pipe-Test //�T p 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. / PERMIT NO. TRACT NO. LOT NO. UNIT O. BOOS 8/02/85 HeOJ TL �1.710F COSTA MESA CONSTRUCTION PERMIT rn ; 7 • - _ - • 2'43 'ff�4�,/ _ Project AddressZZ7 .Applicants Mailing Address ft yr c cans.r S / I TYPE OF CONSTRUCTION 44NEW ADD ❑ ALTERATION REPAIR :/I' - ,/ ❑ CONVERSION. 0 DEMOLISH0 OTHER A,p-.,jt �9 y-'D7/ — /d .1 'Zone 2I..7 Owner's Name���12 L�Dfs./ !q's� Pho�je 04 ail' DESCRIPTION OF WORK/USE OF BLDG. •S Address ZVI" At Ad6 Z / a; ��-, s • Main Building: Accessory Building: Arch/Eng, � � SLicense No. /Z4 G5 TYPE OF PERMIT ❑ GRADING ❑'FOUNDATION ❑ STRUCTURAL T • C f F• ront •- 0 Address 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear . - N �1 A Contractor's Name,�z7L' _t•"' L`�Ahone�C 69 0 OTHER �� y C Right- . I N Address(mailing) Sae"6 - - PROJECT DESCRIPTION SQ. FT.[.. OCCUPANCY K Left G p " CON ST RUCTION TYPE VALUATION $ R • City License No, _2�G(o� . ZONE GRADING CU.YDS. ACRES' - LICENSED CONTRACTOR DECLARATION pre , - Ping. Ref.# Parking Req./Provided E I hereby affirm that 1'am licensed under provisions of Charter 9 (commencing Remarks: P� �(�� d y 'Planning Notes: ! •' M with section 7000) of Division 3 of the Business and Professions Code, and my license is in full fog and effect. We 4. (� ( (Zf[-7q T .:License Class cense No. 7 7 't• • 'DateL 1 –8-r Signature s PLUMBING FEES ^ 1 \.1 WORKERS'COMPENSATION DECLARATION Bar Sink ShowersELECTRICAL FEES 7 I hereby affirm that I have a certificate of consent to self-insure or a Certificate- Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - - Automatic Washer Transformer �❑ 15-50 KW - 10, Lab. C.) /G s/� S ��ND '❑ 50+ KW Aicy No. J J Company Backflow Irrigation 1 Sewer Cap • Construction Pole Sub. ' • ertified copy is hereby furnished. •• r - erti " py ' fs�rrd with the city But si n. Bathtubs • Sewer Connection Cooking Unit Meter Clop to 100 amps • Date • ' 4+ Applicant EXEMPTION FROM WORKERS'COMPENS ION DECLARATION Clarifiers Solar Collectors 1 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❑o-i HP 01,A-8 Workers' Compensation Laws of California. Date Signature Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP ❑16-15+ NOTICE:Compensation makingthis ideclaration,s hyourshould you subject to ite , Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - - Urinal - Fixtures - - - _. Microwave comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING.AGENCY ' Gas Service, Outlets Water Closet - Device Boxee ' I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater . Outlets Range Lender's Name - Lender's Address Kitchen Sink • Water Service Switches Sign • OWNER BUILDER DECLARATION - t • I hereby affirm that I am exempt from the Contractor's License Law•for the Lavatories Auto-Wash - - ' Garbage Disposal - - I Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap . • Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor • any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of 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 • '1.5 by any applicant for a permit subjects the applicant to a civil - ' • _ ilty 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 Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: • employees, provided that such Improvements are not Intended or offered for Boiler , sale. If, however, the building or improvement Is sold within one year of coca= Canopy Type II CI Zoning Approved By nate pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground Bpilding ApProvad By Date prove for the purpose of sale). y ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural • Refrigeration System • . Application Issued By i (—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 SUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con- - - , tractors) license'pursua • nt to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration • - BUILDING PERMIT $ _. ' SMIP $ • proof of their Worker's Compensation insurance should be provided to me. ,1� PLAN CHECK $ PERMIT •0 I am exempt under Section 0.8 P.C.for this reason Firepl/Fact.Bl t. ICBO# •I(T( Fire Dampers PLUMBING $ ISSUANCE $ ' Date Owner • Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $ I hereby c • ertify -that I have read this application and state that the above 0o-100,000 BTU-0100,000 BT • - - ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances t , and state laws rel to b Udine construction, and hereby authorize repro- PLAN CHECK 50% ' MICROFI LM $ ' sentatives of this ci er upon the above-mentioned property foorr, • $' inspection purpose ate tS���d/r ' ' MECHANICAL $ 1•00 � g'd0 Signature O .a ' TOTAL FEE $' Drivers' License or SS Reinspection Fee • $15 / I Issue Fee $ 3 PLAN CHECK ; 25% $ ' ('(DO CMF 0865-46,rev.10/84 White - Building; Canary - Applicant: Pink -Accounting; Goldenrod - Assessor /,CONSTRUCTION AND PLANNING %\ POOL r -DA - Oate Inspector Date Inspector ! APPROVALS Permit# APPROVALS Pen,...# 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location -2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3iElecttical Conduit:Utility-Undrgrnd. '� "ft- 54. Forms I iS •4.�'ElecfricakConduittl ndrgrnd. b 1'3 55. Electrical Bonding 5"jSteelfRefnfdreement ,:, '.t 56. Rough Plumbing & Pressure Test d G."Elgctgical 9,F 57. APPROVAL TO COVER-GUNITE 7 `Footings ;,..,t); ; n� : r 58. Electrical Conduit-Undrgrnd. ' 6' Foundationr Lc -'! 59. Gas Pipe, O Undrgrnd.,Test 4` 1 ).. 9. WetertPipe-Undrgrnd. / i`) 'f') 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Stioctural Floor System 61. APPROVAL TO DECK 11. Property'Segver Line & House Connection 62. Backwash & Receptor-Final 12. Sewer!Cap.; ;',) '+' (;a 63. Heater& Vent-Final ' r _ 13. Rod:brain; ,.ii; 64. Plumbing System - Final 14. Rough Plumbing'+ ...7 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 `,/....16/MC cep APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating a.-' 71. Product Piping 0 Gas 0 Oil 23, Gas Pipe-Rough& Test j) 72. Underground Flush 241 Roof Framing • ' - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25:"'Roof Sheathing %•r 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 3T 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 ,fy2 /ls' Ca 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 .A 50. Gas Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No Date . CITY OF COSTA MsiON • • PE. TT NUMBER , sV�Lp�N� �� I M05110604 DEVELOPMENT SERVICES DEPARTMENT • PERMIT '•'_"� DRIVE,COSTA MESA CA 92626 opti 77 FAIR • Fax{7141754-4656 w++�.ci.costa-mesa.ca.us .. 175q,5273 • NICAL PERMIT Status', ISSUED MECHA ` Applied' 101172005 Issued'. 40!172005 eir Zgp3 ELDEN A� / / Job Address: FI Suite No ✓:, REAR OF YARD ISSUED BV: Vicinity: -' _ Parcel Number'. '93009749' , ONIS, LAURAYENUL Phone 71a 998.4300 = 1 �� APPllcant• . q�JENKS CI 82680 CORONA(CA '"`' a x Owner: ARMSTRONG, NORMAN • • Address: 2603-0 Et-CalAVE -z , Phone: 92627 ',UNIT H COSTA MESA,CA AIR CONDITIONING ALLIED PLUMBING HEATING Phone'.714-998'7300 Contractor 422 JENKS CI Address Zip- 92680 _ - 610780 i` k CORONA CA License #, t ' 2 r c s 112 TO AiC$COPE O SIZPER D LOCATION (REAR YARD)FOR.•*; CE EXISTING 2 1 - Quantity REPLA MMARY ' - '0 UNIT H FEEFEE$ .� - --"� r $0.00" 0 hon Unit $0.00 0 r • '' Repair I AH Absorb Un' �,`50.00 r �� Quantity , It Refrigeration_ t, $0.00 0 ,, _Repai S stem - ,x$0.0 0 ▪ ;Erie; �523 50 f - Ventitlauon Y 0 ` ▪ 3 $000 0= — Cooler ,ir ;,$000 ;, gvaPoratNe- , ;I,inst FA EE k BTU "$0,00 0 .06111''moral ial Incinerator 'Inst FAU<100 pincinerator, io 0 _50..041.9 tion S stems : 80.00 Fnsi FAU l Re k SSBVji eat:. 0 r"'Com lessors I Absor $0.00 0 ' Cooling, - $0 OP >,� -!100 k BTU Rellig S'i 41°Css wallI - $000 0a� � . - Up to 3hp $0,00 1hsU ReP� .. $D 00 0 ; 3To 15 hPl500k8TU ., .5000 0 ` <M100kBTU, I1 p00k8T 0 RefrigSYS �10pkBTU': ' 15To30hPl1,750kB �,� ,'_50.00 TU Refrig SyS $0.90 0 30 To 50 hP1 Over 1,750 BTU ,$14.70 1 Gas dn $p 00 0 Over 50 hp Factory FlreplaE. £ ='$0.00 0 ;,,goi ers $0.00 0 fr Hood vv/MechFan/S Exhaust' $0,00 0 ,.Up to 3 hP $0.00 0 VAV.Box ." -15 hp $0.00 0 m Ie Duct $0.00 0 .,,,r , 5000 0 Vent Fan I S 9, $0.00 0 15 to 3011) Appliance;; $0 00 0 ° - '30 to 50 hP < Fire Dampers $p 004 Over 50 hP anwai F_ee $0.00 Smoke Dampers I Vent $0.00` '=0 Other Meeh $0.00 Inst or Relocate 0,00ctm $0 00 �0 ` '"Investi at!:on Fee '- ! $0.00 Air Handlers $600- =0 �; > P„tan Check Fee ,Iy ,, Air Handlers> nd Heater, er, edtee Fee - $38,20 $0 00 0 ReinsQ Floor Furnace �, _ LATED FEES'' Floor or Suspend Heater, : g = ., '@” ' �YOTAL'.CpLCU COMM ENTS'1 SPECIAL CONDITIONS ants under California statutes and tela handicap access requirements applicable is suspended or abandc per shall comply with all aPp� days,or it work this p not cemmenced Within 180 Y The work authorized by is applicable codes, al NOTtCEc No.92.28,§1.12'21.921 become void if workwith all appli, is erre' Ord. tically expire and must compo talion of m P regulations.( ll shall automa anal' wo rove!will result in the exp This Pen rmll to be considered nag final app for a period of 180 days. auttwrized under this Pe for ap ust be obtained.Failureto obiam inspect In order for the WO oval m INSPECTIONS'Inspections and anal ePPr rgqufredinaPec �q�754-5626 FOR INSPECTIONS CALL: P 1174Trrrinly Timm WORKERS'COMPENSATION DECLARATION: - ' ' ' ' - - I hereby affirm under penalty of perjury one of the following declarations: - ' ' ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for.the performance of the work, r which this permit is Issued. I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this Ilemlit is issued. My works 'compensa on Insura_nce carrier and policy number are: L� \r ra1St(`faC'1 C Qtr---' Policy Number..\L JC ' — 13 '652D = need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laof California,and agree that if I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these vis? n . ( � AppBcenf -` DiEa: - N F RE TO SECURE WO 'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN E DYER CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED HOUSAND CK)LLARE($00000).IN AD TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: +'r,:; I hereb al r.Brat?am licen ed,under provisions of Chapter 9(commencingawith Section 7000)of Division 3 o th' Busine and Professions Code,and my license Is in full �impor I .,T,s. _ coo ta COrllrauorslStgnature - '"''+ .n-s`, CI—05 CONSTRUCTION LENDING AGENCY: Z ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ 1,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not Intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ' ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. __ Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. ❑Yes 0 No Driver's License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,Califomia Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above, unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No x (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application apernit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? I1 Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? ❑Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signet Of Legal Owner(s) Date A A dd/Or AEth zedlAppiccant ., iii‘itni'..,"t:-7: CODE# INSPECTION TYPE RATE . JNTIAL$ CODE# INSPECTION q QAIE IIT�LS • 1616 Fixed System Final Fire Prevention 206 Final Mechanical , V- '.67 - SW 1268 Pool Spa Final 208 Final Plumbing - '200 Final Re-Roof 210 Final Electrical • 201 Final Block/Retaining Well,, , 212. , -Final Fire Prevention , • - 202 Final Factory Fire Place • • . - ' ' 220 •• Final Planning Approval - , . . '203 Final Sign 222 Final Site •. ' 204 ' Final Demolition ' ' . , - --250 ' Final Building/Occupancy - . ,--• • . -- PROaCr ADOflilk: 2603 ELDER AV UNIT: H CITY OF- COSTA MESA — BUILDING PERMIT PERM NO; B 05172E OWNERS NAME: son.;IDT ADDRESS: SAME PERMIT NO: B 051726 PLAN CHECK NO: 01334-91 S GOVT: H SUPP: W CONSTRUCTION TYPE; V—N PERMIT' TYPE;• STR PURPOSE: OTH 722-0416 ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : STD PATIO COVER SQ FT; 120 ADDRESS: UNIT: CLAIM VALUE; 550 . 00 CALC—VALUE; 1 , 656 , 00 GROUP OCC: R-3 / PERMITTEE: CAMPOS PATIOS ( 714 ) 776-9345 • ADDRESS: 709 N PAULINE ST COMMENTS: CITY STD PATIO COVER ANAHEIM CA 92805 *X•**X1E*X***********.kX*********X1E**X****XX****XM: XXX*****I!*is Xkf*XKXK****I4k*****MK>' LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING EQUIRR EMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACKS CITY te:_0 7p-3— STATE uc.:3 7 5 re:_ LASS: C_ _Date: toI SignaWrea_(-- t7WG � RAIN BUILDING ACCESSORY BUILDING ' WORKERS'COMPENSATION DECLARATION: Ihereby af rmthat Ihave acertificate ofconsent toself-insure or a certificate of Workers' FRNT; FT IN REAR: FT IN rERNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). LEFT: 5 FT IN RGHT: FT IN LEFT; FT IN RGH T; FT IN • .' r POLICY NO.: EXP.GATE: COMPANY: PARKING REQ: PROV: PARCEL ; 43907133 ZNE; R2 REF NO: ❑ Cerlifiedcopy ishereby furnished. ❑ Ceniredcopy atiled with the dtyBuilding Division. PLANNING NOTES> LATTICE PATIO COVER TO BE CONSTRUCTED TO THE REAR OF AN EX. > CONDOMINIUM• REAR OF UNIT IS ACTUALLY SIDE OF PROJECT. Date: Applicant: ********3r Tf X7E**ifa .;:}.7EIEN*ii•**Ifr.{n.k***it%*.#-if-3Eit3Ei*****+F}:3;.3E*Iii•***r.y.!fa**YE***ifintifiEa3i-drX*N3i EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Th¢section need not be compkl d if the pewit a forme hundred(5100)or less). DEVELOPMENT SER VICES REQUIR EMENTS I certify that in the performance of the work for which this per issu d.1 snag not empl any person in any manner so as to become r ,�,, subject to th workers' nmpensation Laws of California. � /y ZONING APPROVED BY "iLv/� DATE: pate: 44 te G 1 you shoo b`gpomseebo-11ou Compensation l c�> , , `—� Code,NOTICE: ,inter king this declaratgn,you Shm d becol me spermit to the a deems' revo provisions of the Labor BUILDING APPROVED BY DATE: Code.you must forthwith Comply with such provisions or this permit shall be deemed revoked. _ '— CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED d Y; ;as DATE• D //�/ which this permit is issued(Section 3097.Civ.C). If*16X*********1***14* -•' :ys- • . .. - . • .• • X-#(.r.***.{Eac.jp;y.**....,..4 i.�lfa'f LENDER: -N*****i(***M.T(1E**** iE*If1EX•*3l'-#**+X•**If****X"x*iE*X?IfiEX*if*M*******X*****-X***-X•u*r.***ii* ; ADDRESS: LEGALIZATION:N F E E o U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING EI' CTR IC MECHANIC FIRE SMIIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 39 . 00 . 50 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 25 . 35 any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(S503). ISSUE FEE I, as owner of the property or my employees with wages as their sole compensation, wig do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sate(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS——--> 39 . 50 0 . 00 25 . 35 64 . 85 64 . 85 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 64 . 85 OVER/SHORT: 00 for the purposeot sate). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SHIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 39 . 00 . 50 25 . 35 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who budds or improves thereon and who contracts tor such projects with acontractor(s)license pursuant to the Contractors.State License Law).I am aware *.**14)4.**0**Y-14******1***f !F*****ST*X***i(•****iso;-******#X***X•*X3t*:R******lc}iy.**?(.****1(.**V.)^ that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ 1 am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST • Date: Owner: SFR 120 RES—PATIO COVER—POST & TRELLIS 13 . 80 1 , 656, 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and END OF FEES . 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Ouahly Management District.Residential construction applications are exempt from these provisions, ,/ Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances and state laws relating to building construction and he authorize represent /of this city '• ter upon the above-mentioned properly for i pection urpOses Date: 4 7 . 5ignatur - 87UM A S . 4 I I/Ss _ 01 C0095113-0'3DE51122 ,O__ b. Driver's License or Social Security DATE: 04/17/91 FLEE: 12:36 164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING Pt,UL& SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location b 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, O 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 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-ear 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 IX(; pl 48. FINAL PLANNING V) (� 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date l - City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 001473 j Building Safety Division P.0.Box 1200 Costa Mesa,California $ The Building located at 2603 Elden Avenue #H has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto -++ fora Group R-3 Occupancy. IP ' Use of Building Condominium \j Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) O E "ti" Building Permit No 618480 Electrical Permit No. 618480 Plumbing Permit No. 618480 ,4 gi Mechanical Permit No. G18480, M19772, M20179�umber of apartments /� and/or guest rooms ISSUED TO: z BuildingOfficial_ �%i (� . ���� 18226826lden c1Duntottlextt 'Y e_ �0%1�i "__ 3 Sc. MODuanott by i i Irvine, CA 92714 ; 3 /ifs Date 2 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. /r'} CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File ,rT Y • City of Costa Mesa y Development Services Department CERTIFICATE OF OCCUPANCY No. • 0014 0 3 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2603 Elden Avenue fkH has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto- for a hereto- fora Group R-3 Occupancy. Use of Building Condominium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit No x18480 Electrical Permit No. 618480 Plumbing Permit No. x18480 Mechanical Permit No. G18480, M19772, M20179 Number of apartments - and/or guest rooms ISSUED TO: Building Official /6,P< Mar-Elden Davelonnent 18226 W. McDuamtt • by L-91(.. /1/4 . Irvine, CA 92714 1 Date 5' _ /1 This Certificate of Occupancy SHALL BE posted in aconspicuous 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 hose within heavy border lines and sign all appropriate declarations. • • -CITY�F COSTA MASA - PERMIT NO. T CT NO. LOT NO. BLD •. - 1259 G/16/BFr 53Y. T. ` COjISIRJJC-TION PERMI • T G ia9&o /2a94 • - t L . -_a--- r • " Project Address •1 Iden Ave. ill TYPE OF CONSTRUCTION U NEW U ADD LI ALTERATION U REPAIR - - Applicant'sMailingAddress 18226.W. McDurmott. Irvine ❑ CONVERSION ❑ DEMOLISH El OTHERp - - A.P.'µ+L./s9'-O7/ — 'Q--->/S - I Zooe•AR . , Mar-Flden Dpvalo men! Phone 474-0601 DESCRIPTION OF WORK keC A Owner's Name p S Main Building:. Accessory Building: z • 18226 W. McDurmott, Irvine 92714 y E o Address TYPE OF PERMIT ❑ GRADING rre�lf- OUNDAT ION,t/Lll STRUCTURAL T Front {%l 1 GL, N Arch/Eng 'Chr15 R. Stephens License No. C12963 - .❑ TENANT• ELECTRICAL IL .PLUMBING KSI MECHANICAL B - 1 18226 W. McDurmott, Irvine 92714 ❑ OTHER A ,Rear 1�r�D N Address: �,r ' The Richard F1. Crawford 474-0551, . PROJECT DESCRIPTION SQ. FT. a `{ y DCCUPA V C 'Right �� f G Contractor's Naim PleNV/C �1 18226 W. McDurmott, Irvine 92714 CONST RUCTION TYPE VALUATION$ o D $ Left SO 1f �� E Address(mailing) 4yp�,y�. e ! City License No. . Yf5'645 '2 GL/ ZONE ' GRADING CU.YDS. ACRES - Ping; Ref.# Q- -�/i7 T !; e4 Park.Fees $13/-26,/ a ogskiU LICENSED CONTRACTOR DECLARATION Remarks: 'pCs 7e/6 _ S-"'!'� Parking Req./Provided �O / �� . p I'herebyef firm that I am licensed under provisions of Charter 9 (commencing 25�! R with section 7000) of Division 3 of theyBusiness and Professions Code,and . • , Use of Building: L10ndo _" . - E my license is In full force and effect. war - • - 0 License Class • c {,x�p- __ • PLUMBING '� FEES Planning Notes: __- ......,r.nrn4EMTS M MryJ� Date y•iI Signature ;�/ Bar Sink Showers HOLD I•v`4 3t t%I•'1-t1' f'•0i,•'•..-' E U• WORKERS'COMPENSATION DECLARA IONS ^T— ' T N hereby affirm that I have a certificate of consent to self-Insure or a certificate Backflow Preventer Service Sink - .$ ' if Workers' Compensation Insurance, or• j a certified copy thereof (Section - - - - •• - - 3800, Lab. C,),. ,., /' - I• ; Backflow lrCgatidn l Sewer Cap ' • , - • ''% ELECTRICAL • FEES POIicy No. �s�Ov+ �w,% Company...:}/ Ny 31 - - ., - Certified copy is here y furnished. • // • �. 2 Bathtubs • / Sewer-Connection ' (p.007 • Automatic Washes ' • Transformer 0 15-50 KW'. Certifi c i 7ereby fwith the city =d"I. visio•/ • - _ -- , Date aI/•fr ' Applicant -e _� / '•/ ~Clarifiers Solar Collectors Construction Pole Suti'..: 0 50+KW• , -EXEMPTION FROM WORKERS'CO PENSATIO • •CLARATION- - / Dishwasher Solar Piping Cooking 'is- p - - ' - (This section need not be completed if the.permit Is for.one hundred ($100)Or' P 9 - Z y ' Unit- d Meter ❑U to 100 amps less). v Diinkin Fountains - -`' I certify that in-the performance of the work for,which this permit is issued;I 9 Solar Tank . . -. • /• Dishwasher„ .,t F / Meter Iffier 100 amps • g CO shall not employ any person in any manner so as to become subject to the' . . , Workers' Compensation Laws of California. Floor Drains Swimming Pool w/Spa / / Dryers Ates DEleciric / 'Sub Panel iI OQ Date • Signature — — • NOTICE:If,after making this declaration,you should become subject to the Floor Sinks Urinal - / Fan 'Motors 0O-1 HP 01$-8 Workers' Compensation provisions of the Labor Code, you must forthwith - ,_L_, - -- ,, I f.)()comply .with such provisions•or this permit shall be deemed revoked. / Gas Service Outlets 3 Water Closet • - ' 8+--a / F.A.U. .Inc.Solar 09-15 HP ❑16-15+ • v\ CONSTRUCTION LENDING.AGENCY - CO• ' 1 ei" I hereby affirm that there is a construction lending agency for the performance ' , Interceptors - • - ' / Water Heater .2 CO /1; Fixiures o- / .Microwave ' 3 of the work for which' this permit is Issued .(Section 3097 Civ. C.) Lender's Name- - / Kitchen Sink • ' Water Service - • 2-0 Device Boxes. ,Pale Light Lender's AddressLavatories - OWNER BUILDER DECLARATION ; - • - - . . ce (C 261 Outlets• ' • ./ •Range 1 CO I I hereby affirm that I am exempt from the Contractor's License Law for the P-Trap - ,l/ following reason (Section 7031.5.Business and Professional Code: Any city or • . /9 Switches' `• Sign • S ca county which requires a permit to construct,alter,improve,demolish or repair - - any structure, prior to Its Issuance, also reouires the applicant for such permit ' Roof.Drains Garbage Disposal " Standing Sections to file a'signed statement that he/she is licensed pursuant to the provisions of 1 . / - -• _ I �� the Contractor's License Law(Chapter 9(commencing with Section 7000)of - Generator ❑0.5 KW❑5.15 KW Trash Compactor Division 3 of the Business and Professions Code) or that he/she.Is exempt . . Pa 'therefrom and the basis for the alleged exemption. Any violation of Section - - - 4 7031.5 by.any applicant for a permit subjects.the applicant to a civil • 1 yy Reins ction Fee penalty of not more than five Hundred dollars(E500). Pa $25 Issue Fee S'3- ' LJ I, as,owner of the'property or my employees with wages as their sole , , Reinspection Fee $25 Issue Fee' S 3 compensation, will do the work,and the structure is not intended or offered • - MECHANICAL J FEES , for sale (Section 7044, Business and Professional Code: The Contractor's - - PUBLIC'SER VICES REQUIREMENT ' License Law does not apply to an owner of a property who builds or Improves Boiler ' '' Hood or Type I 0 s-.,'/�-� thereon, and'who does such work himself/herself or through his or her own - Zoning Approved By ✓. J C-- C-Ati !late .- 15-5 5 5 employees, provided that such improvements are not Intended or offered for - Canopy Type 11 0 I1C/ sale. If, however,the building or improvement is said within ono year of com- . Duct-Under Ground • Application Approved By �� Date a I- r pletion, the owner will have the burden of proving he/she did not build or Im •- • ,I_rove,for the purpose of sale). Duct-Structural I Refrigeration System Application Issued By - 4x1 flats '• Ll I, as owner of the property,am exclusively contracting with licensee con- ❑0-100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating ,- SUMMARY OF FEES Q The Contractor's License Law does not apply to-an owner of property who $ S.a� builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration I, BUILDING PERMIT $ 385•Ob SMIP tractor(s) license pursuant to the Contractor's License Law). •PLAN CHECK. 1 $ 1D•70 PERMIT ❑'jam exempt under Section • B.& P.C.for this reason Firepl/Fact.Bit. ICBG# PLUMBING $ 2-1.-0° ISSUANCE . $ Date Owner Heing System& Ducting , r PLAN CHECK $ • /c,.5(.3 ENERGY P.C. $ i hereby certif ha .aJ r •tic/on and state that the above LI'J0.100,000 BTU 0100,000 BTL I.'iT information i of . . ' e- cal/all city and county ordinances / - - - - - - . ELECTRICAL $ 34 • SO GRADING $ and state la, r. P• stru -on, and hereby authorize repro- • • LL a MICROFILM $ inspection fives • t�f ta' .dp. ...•. ..ova-mentioned property for l PLAN CHECK $ I S.Z b �y inspection •urp. ✓'mfr' MECHANICAL $ .-I MO' TOTAL FEE $ 35.3 Signature ` VAILn - oa43 " Drivers',License or SS /!� ' Reinspection Fee $25. Issue Fee $ 3 PLAN CHECK• .. $ .«� - 'CMF 0865-46 rev. 7/83 - White-Building;Canary-Applicant;Pink-Accounting;Goldenrod -Assessor - - ' ' - .. CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# ilv Date Inspector APPROVALS Permit# Date Inspector • 1. Temporary Electrical Service or Pole; 52. Pool & Equipment Location 12. Soil Pipe-Undrgrnd. Of/f 'are 53. Steel Reinforcement • r . r.� 3. Electrical Conduit Utility-Undrgrnd. { 54. Forms \ . - `, i4. Electrical Conduit-Undrgrnd. 5hi�( 0e 55. Electrical Bonding ' I: 5. Steel Reinforcement �// ss gni 56. Rough Plumbing & Pressure Test . .; 6. Electrical UFER Grnd.; . 57. APPROVAL TO COVER-GUNITE 7. Footings Aelaaak s... . 5/// 5r p2224 58. Electrical Conduit-Undrgrnd. 8. Foundation f'1l� rl//gs e '4 59. Gas Pipe, Undrgrnd.,Test , 9. Water Pipe-Undrgrnd. - !!, ! t I 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor S ystem �•, /•„ 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 6145.7- cm 62. Backwash &.Receptor-Final • 12. Sewer Cap -:-/#11 '!- - 63. Heater & Vent-Final 13. Roof Drains .i I 64. Plumbing System - Final • 14. Rough Plumbing 71/462.5 Geo 65. Electrical-Final - 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 7 f i toC d 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 *45 (LO FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating • 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing ,. ae_.r..crC 7/s/y5- €1 "1.1 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat I -I' ' n 75. Dry Chemical 27. Frame and Flashing 74).a/3 s ityi 76. Dry Standpipe 28. Lathing & Siding /rlrls3-- evil 77. FIXED SYSTEM FINAL 29. Insulation 7 31k t. 78. FIRE PREY. FINAL 30. Drywall Nailing Ph/sr evil HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final / 80. FOOD CERTIFICATE ISSUED ,(//r4'8 C-� �7ft 33. Final Electric f/ Notes: 4r .77$17. 2 c�Z/"fie ..erste A 34. Final Heating & Air Conditioning Mit Z/j� (,€� '''`^Q , '- a 1,`/ 8 T / / ( . �L 35. Final Gas Pipe-Test �/Z�g LED ,_•fes . �� A��� 36. Hood or Canopy - • C> �� LO-. - alet ev r �,� 37. Final Factory Fireplace u/�cr-f{ 74 tt/ir 0 - `^'J , ,� -� 7- a y 38. Final Plumbing !/ ,,,/r�� ,j1(t�C• °F""" /l� �/7 tee.-¢.._P. �- --i ¢�.-d +j 39. Water Service-Final Weir Cell _A..-0./.‘,../.4:24-40-1 /7_,_8 4'_,g_ 40. Gas Service-Final NT 41. Solar Domestic-Final 42. Backflow Preventer - • 43. Backflow Irrigation . 44. ,Landscape Irrigation System • 45. Sound Attenuation 46. Handicap Regulations' 47. FINAL STRUCTURE & BUILDING /(/g/r Kik - 48. Special Requirements Completed /(i_/_85 744<' I • 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OC ?s ` , G _ • No. /Y 7� Date ate 3 7✓" r y 4 ?(LFII/ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • _ City OF COSTA MESA CO ST UCTION PERMIT PERMIT NO.., TRACT NO. LOT NO. UNIT IyO. , . Project Address 2605 O'P_wI-j/ xa*-V't.-'' e t�1 J Ai — ( ? 77 JLyf�j' Applicant's Mailing Address /Z� (-•� a%sr'( frS (N / TYPE OF CONSTRUCTION U NEW El ADD Li ALTERATION REPAIR I w.. ' \f •' \ `/C ❑ CONVERSION 111 DEMOLISH CI OTHER Owner's Name /MP V Q N pkil• Phon CO A.P.# FI RP 7/f1R/Aq Zone nl I2 Z Sic ' SC4 `� ^✓s , M• DESCRIPTION OF WORK/USE OF BLDG. Address 7 /'� C S Main Building: Accessory Building: Arch/Eng. 7% w oA s S License No. TYPE OF PERMIT CI ❑ FOUNDATION U STRUCTURAL E S Front O Address El TENANT El ELECTRICAL ❑ PLUMBING El MECHANICAL B Rear N &r ❑OTHER A I Contractor's Name ',.L(/s'/(.� /„c1['14 Phone r• •ZS7� PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N Address(mailing) L/7�/ 3� /V PII1� - tali er� CONSTRUCTION TYPE VALUATION$ S Left R City License No. b 7 - ZONE- -. GRADING CU.YDS. ACRESE LICENSED CONTRACTOR DECLARATION Ping. R¢f.# Parking Req./Provided Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: -- - M with section 7000) of Division 3 of the Business and Professions Code,, and - my license is In f force and effect. � ) 7 p T W9 6/a • T Licen lass - License Nyc S Date Signature - • PLUMBING FEES_ - WOR ERS COMPENSATION DECLARATION -... ' Bar Sink Showers ' .1 hereby affirm that I have a certificate of consent to self-insure or a certificate : ELECTRICAL FEES •-`-f Workers' Compensation Insurance,- or a certified copy thereof (Section : Backflow Preventer Service Sink • . Automatic Washer Transformer 0 15-50 KW - - - 1e00, Lab. C.) Policy No. Company Backf low Irrigation Sewer Cap Construction Pole Sub. • 0 50+KW 8 Certified copy is hereby furnished. - - Certified copy is filed with the city Building Division. - Bathtubs Sewer Connection Cooking Unit Meter Duo to 100 amps/ Date Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers - Solar Collectors Dishwasher Meter Dover 100 amps' (This section need not be completed if the permit is for one hundred($100)or - less). DishwasherSolar 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 El 0-1 HP ❑1%-B • Worker omgensat4 n Laws of Calif rni - _ • Date V r Signature_� �..i.-✓ Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar❑g-15 HP ❑16-15+ 'NOT' If, fter 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 CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for which this permit is issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets Range • Lender's Name ' Lender's Address Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION • ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal , !Standing Sections ' following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,Improve,demolish or repair - P-Trap - / - - Laundry Trays • Generator ❑0-5 KW❑5-15 KW any structure, prior to its issuance, also requires 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 • - `herefrom 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 - - - - Lienalty 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 1 - Reinspection Fee - $15 Issue Fee . $ 3 • for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL 1 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- 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 the f oale). ' ❑ t as owner the property,roject am 7exclusively sinesscontracting witholicensedionscon- Duct-Structural • Refrigeration System Application Issued By }{y�Date The construct tctors the project (Section 7044, tos Business and Pf ot Cotle: • F builContractor's License Law does cooraapply to an owner 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- tractor(s) license pursuant to the Contractor's License Law). I am aware thatExhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation Insurance should be provided to me. - PLAN CHECK $ PERMIT ❑ I am exempt under Section e.& P.C.for this reason Firepl/Fact.Bit. ICBG# • Fire Dampers PLUMBING $ ISSUANCE $ Date Owner Heating System&Ducting Y Registers é SU PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above / YCO-100,000 BTU 0100,000 Bite ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances if Oa • and state laws relating to building construction,and hereby authorize repro- . PLAN CHECK 50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned/ropey�or l I inspection .0 .oses. MECHANICAL $ - n.' .-10TOTAL FEE $ C94/0 Signature i/ _ _ Dats%- _�ty Drivers' License 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 Pip(-Undrgrnd. 53. Steel Reinforcement 3:;Electrical Conduit'Utility-Undrgrrid. • 54. Forms 4. €lectiical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel .1Reinforcement, 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`.I'Structural Floor System 61. APPROVAL TO DECK 1.1.' Property Sewer Line.& House Cortri+ection 62. Backwash & Receptor-Final r 12.;Se'wer,Cap �, ', 63. Heater & Vent-Final 13c 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 a I k/ic L(/) 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 `((/ja5 C-.€9 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. ,CI'feV OF COSTA MESA CONSTRUCT!_ QN'PERMIT PERMIT NO. ' TRACT NO. LOT NO. UNIT N Project Address 24°35 / D�./ rj I m � t 7 q / 2.9 • 8004 8/02/85 oo�f1 TL Applicant's Mailing Address 4(t fll GA'�r_ if/t 2 TYPE OF'CON$TRUCTION NEW LJ ADO U ALTERATION PAIR �J p {''!�— CI CONVERSION 0 DEMOLISH 0 OTHER A.P.�/+ 739 O7/ — /0 I ZoneJZ L Owner's Name .41/4-at LQ�� -bed'. Phone\G S[> l DESCRIPTION OF WORK/USE OF BLDG. S Main Building: AccessoryBuilding:Address 2�y�t� /�ri C//f�Aeyc 4 Y 2 L •/✓� . g' Arch/Eng._J'1 ,s Z% �z4 rStLicense No. e /z91 3 TYPE OF PERMIT LI GRADING U FOUNDATION U STRUCTURAL T Front • 0 Address - El-TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear ' •- N ❑ OTHER • Contractor's Name��++/G.���/���� � �.. lon¢r�.�O9C C Right - • - - N Address(mailing) „970:4 4. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G ����� CON ST RUCTION TYPE VALUATION$ $ City License No. - - ZONE GRADING CU.YDS. ACRES - - - E ,, 'LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking fleq./Provided E t1C thereby affirm that I am licensed under provisions of Charter 9 (Commencing •Remarks: C, 7 VG Planning Notes: 0 w with section 7000) of Division 3 of the Business and Professions Code, and 7 M my license is In full foand effect. 1f7f lrl'�Q I S' License Class cen5e No. `/ �pv4� Tf�i'Tl i �_/•QS, J PLUMBING FEES • ' • Date Signature I WORKERS' COMPENSATION DECLARATION Bar Sink Showers ELECTRICAL FEES I hereby affirm that I nave a Certificate of consent to self-insure or a certificate - ' ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer- - Service Sink Automatic Washer Transformer 0 15-50 KW 1lic Lab. C.) / �X 4eNB 0 50+KW Policy No. GZSGS(� Company Backflow Irrigation Sewer Cap Construction Pole Sub. Certifiedcopy is hereby furnished. . ttl/cors filetl with the city Bul io Bathtubs Sewer Connection Cooking Unit Meter Dup to 100 amps Date l Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher? Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100)or ,- • •- . ' 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 00-1 HP 01%-8 Workers' Compensation Laws Of California. . . Date Signature Floor Drains Swimming Pool vv/Spa F.A.U. Inc.Solar 09-15 HP 016-15+ 'NOTICE:If,after making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - Urinal Fixtures' Microwave - comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service . Outlets Water Closet Device Boxes I hereby affirm that there IS a construction lending agency for the performance Pole Light of the work, for which this permit is issued (Section 3097 Clv. C.) Interceptors Water Heater Outlets Range Lender's Name Lender's Address . . Kitchen Sink - . Water Service Swit• ches Sign , OWNER BUILDER DECLARATION - ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories ,- Auto-Wash Garbage Disposal Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which-requires a permit to construct,alter,improve,demolish or repair P—Trap . Laundry Trays ' Generator00-5 KW 05.15 KW any structure, prior to Its issuance, also requires 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 Cohtractor's License Law(Chapter 9(commencing with Section 7000) of , Division 3 of the Business and.Professions Code) or that he/she is exempt - - 'herofrom and the basis for the alleged exemption. Any violation of Section . I ]31.5 by any applicant for a permit subjects the applicant to a civil • 3nalty of not more than five hundred dollars($500). - - • $ 3I 0 I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee - 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 noes such work himself/herself or through his or her own Boiler Hood Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: I employees, provided that such improvements are not Intended or offered for or yp • Zoning Approved By nate sale. If, however, the building or improvement is sold within one year of cora- Canopy Type II 0 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). Zi I, as owner of the property am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By 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 00100,000 BTU 0100,000 BTU builds or Improves thereon, and who contracts for such projects with a con- - SUMMARY OF FEES , tractor(s) license pursuar t to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration ' BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. `, PLAN CHECK $ PERMIT ❑ I am exempt under Section B.&P.C.for this reason / Firepl/Fact.Blt. ICBG# 1(.4 Fire Dampers PLUMBING $' ISSUANCE $ Date I Owner r Heating System& Ducting Registers PLAN CHECK 25% $ • ENERGY P.C. $ I- hereby certify that I have read this application and state that the above - 00-100,000 BTU-❑100,000BTL - - .- - ELECTRICAL $• GRADING $ information is correct: I agree to comply with all city and county ordinances and state laws relating to building construction, and hereby authorize repre- sentatives of tp tY enter upon the above-mentioned property for inspection purr, Date/.i. • MECHANICAL' $ �. I TOTAL FEE - $ $'00 Signature Drivers' License or SS 9f Reinspection Fee • $15 ( Issue Fee $ 3 PLAN CHECK 25% $ I .CD • _ CMF 0865-46,rev.10/84 White - Building; Canary -Applicant; Pink - Accounting; Goldenrod - Assessor CONSTRUCTION AND PLANNING i, POOL ?A ' • APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pohl 52. Pool & Equipment Location t...• 2. Soil Pilie•l`Jadrgrnd. di ,• • - w 53. Steel Reinforcement 3. Electrical Conduit'Utility-Undrgrnd. ' r 54. Forms 11 4:.Electrin.0T Condui(-undr0rnd. L'7 i 55. Electrical Bonding 5;'$teel,Reihfprcement_ o ' 56. Rough Plumbing & Pressure Test 6. Efeciijcaj U0ER•Grrid'"1 57. APPROVAL TO COVER-GUNITE j //Footings. : I q'a �,. 58. Electrical Conduit-Undrgrnd. `, 8., Foyndaiiorif i 't�(�.I. 59. Gas Pipe, Undrgrnd., Test 4. ' 9r WIie(iPipe-Undrgrrnd. - / t'l 41 60. Backwash Lines, P-Trap, 0 Undrgrnd. .n r. 10. Stru turial Floor System �: � 61. APPROVAL TO DECK 11. Pr'operty,Sewer tine& House Connection 62. Backwash & Receptor-Final 12. Sev4errCdp•` r ', 63. Heater & Vent-Final Y,, ,c 13. Roof'Draidf - ii ,�., 64. Plumbing System - Final 14. Rouge Plumbin6 "d! 65. Electrical-Final 15. Rough Electrical?Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - 20..Rough Factory Fireplace 1• Wear Ca APPROVALS Permit# _ 21. Ducts, in Structure ,.,• . W 70. Underground Hydro - 22.,Ducts, Ventilating . `. 71. Product Piping 0 Gas 0 0il 23.4Gas Pipe-Rough & Test 72. Underground Flush ' 4.'Roof Framing , 2 , 73. Undergrnd.Storage Tank D Gas D Oil • 25. Roof Sheathing I` 74. Overhead Hydro 26. T-Bar Ceiling (Structural) &-Monocoat 75. Dry Chemical 27. Frame and Flashing '( 't 76. Dry Standpipe 28. Lathing& Siding77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31%.PIaster Brown Coat 79. FINAL INSPECTION I 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test • 36. Hood or Canopy r 37. Final factory Fireplace /gLzq/dS GEO A. 38. FinaFPlumbing 7 • 39. WatSr Service-Final - 40. Gast$ervice-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 CITY OF COSTA MESA 0'"` r BUILDING DIVISION >;A A'9 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us • t' ' 4• Mika . FOR INSPECTIONS CALL:(714)754.5626 etbibmarn PERMIT NUMBER: M07-00538 PERMIT TYPE MECH STATUS: ISSUED DATE ISSUED: 11115/2007 ISSUED BY: KJB JOB ADDRESS: 2603 J ELDEN AV CM Suite/Unit: J Vicinity: - ,/� SO. FT: 0V��y- � SCOPE OF WORK: FAU CHANGE OUT: 70,000 BTU. LIKE FOR LIKE. NO RELOCAI A Dia OWNER: HOLLAND,MARCIE L Address: 2603 ELDEN AVE#J. Unit:J PHONE: . .. City/State/Zip: COSTA MESA,CA • APPLICANT: TEJEDA,GEORGE - Address: Unit:: PHONE: City/Stale/zZip: . CONTRACTOR: COAST AIRE . . . - -License No. 355425 Address: 202 E STEVENSUnit: UNIT G . . PHONE: 714-708-3664 City/State: SANTA ANA,CA ZipCode: 92705 . • CELL: MECHANICAL PERMIT FEE SUMMARY • - MECH ITEM FEE: $38 3 PLAN CHECK FEE: $0.0000 1 INVESTIGATION FEE: $0.00 REINSPECTION FEE: $0.00 TOTAL FEES: $38.30 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODE S. INSPECTION TYPE OMI INTn1ALS CODES INSPECTION TYPE DATE INTRIALE 1818 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final BIocWRetaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 , •Final Demolition 250 Final Building/Occupancy WORKERS'COMPENSATION DECLARATION: • Owner ID verified by drive ense. 0 Yes ❑ No I hereby affirm under penalty of perjury one of the following declarations: - Driver's License No. Expires: • ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document.i.e.-property tax bill or deed): compensation, as provided for by section 3700 of the Labor Code,.for the performance of the work for which this permit is issued. WI have and will maintain workers'compensation insurance,as required by V'section 3700 of the Labor Code,for the performance of the work for which this DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: permit is issued. My workers' compensation Insurance carrier and policy 0 I hereby certify that no excavation five(5)or more feet in depth into which a number are: person is required to descend,will be made in connection with work authorized L' / or by this permit,and that no building structure,scaffdding,falsework, demolition �arnd �/l�� IL/n d or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This secfbnn not be completed enthe perms/isvaatted at one hundred dog=(5100)n less.) 2,Art 2,Sec.341 Title 8,California Administrative Code). P-dicy,Number: 116 1117 r47 (opt ❑ As owner-builder, I will not employ anyone to do work which would ❑ I certify that in the performance of the work for which this permit is require a permit from the Division of Industrial Safety,as noted above,unless issued, I shall not employ any person in any manner so as to become subject such person has a permit to do such work from the division. to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of Applicant's Signature Date the Labor Code,I shall forthwith comply with these provisions. ��_ ///S-/D? Division of Industrial Safety Permit Number: b9 tore �+,�tXrce' HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: WARNING: FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE 1. Will the applicant or present or future building occupant need to file and IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL certify a Business Plan for emergency response to release or threatened PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? ❑Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS (Section 25505 of the California Health and Safety Code requires,with some PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE. INTEREST,AND exceptions, that a Business Plan be filed with the Costa Mesa Fire ATTORNEY'S FEES. Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of LICENSED CONTRACTORS DECLARATION: 500 pounds, or a volume of 55 gallons.or 200 cubic feet of compressed gas I hereby affirm that I am licensed under provisions of Chapter 9(commencing at standard temperature and pressure). with Section 7000)of Division 3 of the Business and Professions Code, and 2. Does or will the applicant or present or future building occupant need to file my license is in full force and effect. a registration form for acutely hazardous materials? ❑Yes 0 No �^ 15-570,5- EClass.#! (Section 25533 of the California Health and Safety Code, with some -' ///�� exceptions, requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely /. � fwe --+e7 hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard CONSTRUCTION LENDING AGENCY: temperature and pressure). ❑ I hereby affirm that there is a construction lending agency for the 3. Does or will the applicant or present or future building occupant need to performance of the work fa which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Lender's Address: ' --- Costa Mesa Fire Department may require the preparation, certification and -I ' • '' filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature . , i Date 4. If an RMPP is presently required, has Section 25534 of the California OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? ❑Yes ❑No I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE 5. Does or will the applicant or present or future building occupant require for CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, the work which is the subject of this application a permit for such construction Business and Professions Code:Any city or county which requires a permit to or modification from the South Coast Air Quality Management District or from construct, alter, improve, demolish, or repair any structure, prior to its any other air pollution control district or agency? 0 Yes 0 No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the California Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fa non-residential building permits). License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and 6. Will any part of the facility to be constructed under this permit be within the basis for the alleged exemption. Any violation of Section 7031.5 by any 1000 feet from the outer boundaries of a school? 0 Yes 0 No applicant for a permit subjects the applicant to a civil penalty of not more than (If"yes", the facility must meet the requirement of Sections 25534 and 42303 five hundred dollars($500).): of the California Health and Safety Code). ❑ I, as owner of the property, or my employees with wages as their sole 7. If a permit from the South Coast Air Quality Management District or other compensation, WILL DO THE WORK, and the structure is not intended or air pollution control district or agency is required for the work which is the offered for sale(Sec. 7044,Business and Professions Code:The Contractors subject of this application,have all of the disclosures prescribed by California License Law does not apply to an owner of properly who builds or improves Health and Safety Code Section 42303 been made? 0 Yes 0 No thereon,and who does such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for 8. (If'yes attach certificate of compliance from the appropriate air pollution sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE:'I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all'state laws and • ❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a camractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that ❑ I am exempt under sec. - the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of Business and Professions Code for this reason: the City of Costa Mesa to enter upon the above-described property for inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature or Legal Owner(s) Date //!`/� Signature Date 3057.46(3107) • City of Costa Mesa ' ` Development Services Department CERTIFICATE OF OCCUPANCY No. 00114714 Building Safety Division P.O.Box 1200 4 Costa Mesa,California C. ' The Building located at 2601 Elden Avenue 11,7 `t has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto �, fora Group R-3 Occupancy. • ' '1 Use of Building CofdQelnium . Legal Description 439-071-10-15 � a. (See reverse side for Metes and Bounds) Building Permit NoG18481 Electrical Permit No18481 Plumbing Permit No. G18481 / G18481, M19773, 1420180 Mechanical Permit No. Number of apartments ,�/ and//or guest rooms `5 ISSUED TO: Building Official At/ , �'\ • e Mar-Elden Development • 18226 W. McDurmott ',1 by !�� C� )1%//L101 4 ,4 Irvine, CA 92714 ±! /�� j p .4' Date ? /XCJI ., 27 iT 5 This Certificate of Occupancy SHALL BE posted in a This place on the premises and SHALL NOT BE removed except by the N; 1 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 Q . �. f 24. • • City of Costa Mesa y Development Services Department CERTIFICATE OF OCCUPANCY No. 0 0 1 1V 1 14 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at ,601 Pirit+n hunrnQ R,T • has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group R-3 Occupancy. Use of Building Condominium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit Nor18481 Electrical Permit NoG18481 Plumbing Permit No. 018481 Mechanical Permit No 018481, M19773, M20180\ Number of apartments and/or guest rooms ISSUED TO: Building Official he, X, Mar-Elden DevelcbuntoiBttent U C(1/ -11/2/7 �97A__ W. 18226 W. McDermott • by Irvine, CA 92714 Date 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*I spaces except those within heavy border lines and sign all appropriate declarations. 1260 41 6/87 `�� TI • rCJTY'UF COSTA MESA ' - - - PERMIT NO. - TRACT NO. LOT NO. BLD - .. " - -• J__� �' RUCTION PERMIT • I 'tBY�� / 029 / S • Project Address - •CI I d-n Ve. id • TYPE OF CONSTRUCTION .0 NEW U ADD H ALTERATION H REPAIR' 7 ' - 18226 W. McDurmott, Irvine '❑ CONVERSION 0 DEMOLISH ❑ OTHER - J/ -b7/--'JO-'IS . 7"Z -2 Applicant's MailingAddresspp _� A.P.# Zone Owner's Name Mar-Elden Development Phone474-0601 DESCRIPTION OF WORK fe.Li.� CInt\A(J - 1R776 W. McDurmott. Irvine 92714 •S Main Building: Accessory Building: - Z Address .TYPE OF PERMITT�yr LJ GRADING 11��I(�"-OUNDAT ION/��L`I STRUCTURAL T Front 7T •�t P N Arch/Eng. Chris R. Stephens - License No. C12963 ❑ TENANT KfLECTRICAL a PLUMBING faMECHANICAL B ,/,t 1 /•I 421 -.1 Address. 18276 W. Mrf)urmott. Irvine 92714 ❑ BOTHER r�2 Cir, /7A Rear "4 C/�ri JLC' - Contractor's NamPT hP Richard F•. G"rawfordP e 474-0601 PROJECT DESCRIPTION SQ. FT./7 / / 7 OCCUPArssl/�''Yll /y�,'3 - C Right 101 I • -- - G c9 Address(mailing) 18226 W Mrfurmntty Irvine 9 714 CON ST RUCTION TYPE VALUATION$ oJ, Q">O $ Left I E • M �. •� 'J ZONE GRADINGCU'VDS. ACRES _ 9 QQ—$E'J—y7 T/?29 13/ 36,•Osib>.Qu W City License No. 44 ^ sss...... Ping. Ref.# 7 Park.Fees $ LICENSED CONTRACTOR DECLARATION Remarks: �` ��/ .- g4L Parking Req./Provided �© / ,O 1 �-' I hereby.affirm that I am licensed under proyislons of Charter 9 (commencing w h at R with section 7000) of Division 3 of the;Business d Professions Code,and '' Use of Building: co/7 • I - -• E my license is in full force and'effect. ,/ ^ '/ • License 91;es ns .c /d�iT3 - PLUMBING 'I FEES Planning Notes: • - r -51 , -Date /- Signature - - - - • - — ' WORKERS'COMPENSATION DEL LA RAT - - Bar Sink • Showers ' i limn r0n QnECi At i1!:/titinr AJl� it :N ' I hereby affirm that I have a certificate of consent to self-insuie or a certificate Ile d-workers' Compensation' Insurance;or'a certified'copy thereof (Section .. Backflow Preventer Service Sink _ _ 3800, Lab. C.).- _ - - • _ - - r/ Backflow Irr.'gatiion Sewer Cap '..' ELECTRICAL t- 'FEES Policy No. •'� (•SZ - Company yC4/ /� _ _ Bathtubs ' Sewer Connecnbn - i • Automatic Washer"• '� Transformer 0 15-50 KW El Certified copy is eby_f urnish 2 / G D CAI-Tied copy,' Tied With the city Bu •"•isio' •. , - • - - - - ,� , Date ��•JC.+ Applicant y� - e ' _Clarifiers Iv ' Solar:CollectorsV •' Construction Pole Sub? ❑ SO+KW - EXEMPTION FROM WORKERS'COM'ENSATI• • •E• ARATION Dish Washer $alar Piping - (This section need not be completed if the permit is for one hundred ($100)on 1 L - Cooking Unit Meter ❑up to,100 amps ` less). . , . , _ • • - Drinkin Fountains / mer 100 ams -•, 8 £D . I certify that in the performance of the.work for which this permit Is issued, I 9 • $Ola'Tank • �. Dishwasher i gMeter p shall not employ any person In any manner so.as to become subject to the - Workers'.Compensation Laws of California. I Floor Drains, Swimming Pool•w/Spa'; / Dryers Rgas• ❑Eleitric .1 Sub Panel .. Date Signature _ ', • NOTICE: If,after making this tletlarf the you should become subject to the Floor Sinks Urinal / Fa• n i MO[Ofa❑0.1 HP ❑1 X-8 ' Workers' Compensation provisions of the Labor Code, you must-forthwith • - - - - - - - - - - - -- comply with such provisions .or this permit shall be deemed revoked. Gas Service Outlets I 3Water Closet' • • 9 .i CONSTRUCTION'LENDING'AGENCY - •. /' - / F.A.U. I '� x '.Inc.Solar ❑9-15 HP ❑i6-15+ I hereby affirm that there is a construction lending agency for the performance Interceptors - _„ . / Water Heater. I _ 7 ✓ / Fixtures_" / - Microwave 7 of the -work for which- this' permit .is issued ,(Section 3097 Civ. C.) - — /� J _ .ZO Lender's Name - = Kitchen Sink Water Service ' . I •• 2 Device Boxes ', Pole Light . Lendir's Address' r - • OWNER BUILDER DECLARATION `. 3 Lavatories .. _ . _ • de. --3o Outlets; J. Range 9 op I hereby affirm that 1 am exempt from the Contractor's License Law for the • /, fallowing reason (Section 7031.5•Business and ProfesslonaP Code: Any city or. - P-Trap, - . /4 Switches_ - ' I Sign ' 3' K O county which requires a permit-to construct,alter,Improve,demolish or repair - — • any structure, prior to its issuance, also requires the applicant for such permit ' • Roof Drains - - • / Garbage•Disposal 'Standing Sections • .to file a signed statement that he/she is licensed pursuant to the provisions of _ - the Contractor's License Law(Chapter 9(commencing with.Section 7000)of ' . - - -- ' Generator ❑0.5 KW❑5.15 KW Trash Compactor envision:3 of the Business and Professions Code)-or that he/She is exempt . . , - . . , P erefrom and the basis for the alleged exemption. Any violation,of Section 131.5 by any applicant for. a permit subjects the .applicant-to a civil • I "Reinspection Fee ^ $ 3 - l •� ^1 • analty of not more than five hundred dollars($500). Pe I $25 Issue Fee •LJ I,'as,owner of the property.or my employees with wages'as their sole Reinspection Fee �, I $25 Issue Fee $ 3 compensation, will do the work,and the structure is not intended or offered . ' ' MECHANICAL - .. FEES ` for sale (Section 7044, Business and' Professional Code: The' Contractor's - - PUBLIC-SERVICE$REQUIREMEN'S: • • License Law does not apply to an owner of a property who builds or improves Boiler • • I • Hood or Type I ❑ ' 1/ - thereon, and'who does such work himself/herself or through his or her Own • - Illr_ Zoning Approved By` FFG ' - sate SIS-85 employees, provided that such improvements are not intended or offered for Canopy Type 11 0 , Duct-Under Ground sale. If, however,the building or Improvement is sold within one year of corn- , ApplicationApproved ey- -�� •WISE �� Datapletion, the Owner will have the burden of proving he/she did not build or Im- - • ,prove for the purpose of sale). Duct-Structural Refrigeration System a' Application Issued By_' f !.I -)r •ate -I�i"�•TLI i,as owner of the property,am exclusively contracting with licensed con- ' ❑0.100,000 BTU ❑100,000 BTU • 'tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating 1 1SU nMMARY OF FEES • The Contractor's License taw does not apply to an owner of property who BUILDING PERMIT ' $ LS-DO $MIPbuilds or improves thereon, and who contracts for such projects with a con- Exhaust System ❑ Multiple❑ System Repair/Alteration $ �` �tractor(s) license pursuant tonne Contractor's License Law). • ,' •PLAN:CHECK $ •70 PERMIT ❑ 1 am exempt under Section i - B.& P.C.for this reason Firepl/Fact.Bit. ICBG# ISSUANCE $ • I PLUMBING • •I •$ - 29.EDate Ow Hea Ing System& Ducting .• "PLAN CHECK••. I • ' $ - 1i•se ENERGY P.C. $ I_hereby certify that ni• ea. n and state ltiat the above 11.16100,000 BTU ❑100,000BTL information Is nor hat Ci—- /•����/ ., I c .nd county ordinances / - - ELECTRICAL '; $. 3y•s.fa GRADING $ sentatives laws ; _ ..R•�L...an • - herebyiauthorize y to ' PLAN CHECK • i t -$ /-f.7� MICROFILM $ I.f�sf� ssTrTTf -rj( � he db Ove-mentioned property f inspection our•.. � rJ/O�� - • MECHANICAL' ' $ 7 TOTAL FEE $ Ci tr-g3 Signature 440/4/' Pink-Accounting;Goldenrod-Assessor - - - f _ - .- . _. - ll V. f CONSTRUCTION AND PLANNING POOL ,PA ;4PPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector ft Temporary Electrical Service or Pole; 52. Pool & Equipment Location _r . ,2! Soil Pipe-Undrgrnd. VA/r �(,qc 53. Steel Reinforcement I 3. Electrical Conduit Utility-Undrgrnd. • •.. • "� 54. Forms - . , ' 4.' Electrical Conduit-Undrgrnd. ./i)6S a _. 55. Electrical Bonding , f 5. Steel Reinforcementi//$s ek11 56. Rough Plumbing & Pressure Test f I 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - rlrnil 58. Electrical Conduit-Undrgrnd. ' ' I lss 8. Foundation g(I7(%- ,. 1 5,///$S 9^'l p��j 59. Gas Pipe, 0 Undrgrnd.,Test . 9. Water Pipe-Undrgrnd. 1' [l• r,J 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System- - "..--1 ' 61. APPROVAL TO DECK 11. Property Sewer Line &'douse Connection s/B& Is 62. Backwash & Receptor-Final 12. Sewer Cap _• 0% e." !t' 63. Heater & Vent-Final . • 13. Roof Drains •,1 •i • 64. Plumbing System - Final 14. Rough Plumbing 7/4105 (.10 65. Electrical-Final . 15. Rough Electrical-Conduit66. Solar System-Final . 16. Rough Electric Wiring .l f(ate- CC 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ;' ' 18. Rough Electrical-I Bar Ceiling 69. POOL/SPA SYSTEMS FINAL t, i r v19. Rough Heating & Air Conditioning 7/ Cert.0 FIRE DEPT. REQUIREMENT c20. Rough Factory Fireplace 0 APPROVALS Permit# y. >71 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 b*t Sao. 7/1437 8941 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 743, y' gni 76. Dry Standpipe 28. Lathing & Siding f7/' / $'J� 77. FIXED SYSTEM FINAL 29. Insulation 7 /� 78. FIRE PREV. FINAL 30. Drywall Nailing - `6/>c!/tu- jy1HEALTH DEPT. REQUIREMENT ;31. Plaster Brown Coat "' / 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOODICERTIFICATE ISSUED L. flirt C,� R 33. Final Electric • NJotes:;4,;,7 8 ss .ok 34. Final Heating & Air Conditioning f�Zv/or C*C. �`-� 4 4 �� ((�� 35. Final Gas Pipe-Test (,./L� (,�O _ ^7r- � � M` 36. Hood or Canopy `� ^��*YL L" 4) /_ , 37. Final Factory Fireplace `�//�/e'(, `fGi " / �jv-�-� /%'/"�� • 38. Final Plumbing //�!/Q�frJJ7'jt�z' 7(�x/gam �ita� �DQ_„�r,s��� o/ fj/IiSoT 39. Water Service-Final £/Z'4g- �7 t_ 4/'ai ' .,.. . �7it.' 40. Gas-Service-Final _ rwt 7/-gier"� (ic•-•-a-4..-44-: a--.-s, 7 %off y 41. Solar Domestic-Final 1 - q i2 42. Backf low Preventer '_ l/"�. ii-. -ter_! : - . 43. Backflow Irrigation . ., 44. Landscape Irrigation System • , 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING l,/f8 hi- elAl • 48. Special Requirements Completed • . Mk-SS M-C 49. Electric Release to Edison • ' ; 50. Gas Release to Southern California Gas Co '1 e. 51. CERTIFICATE OVAOCCUP t..i( >/ea./ _ C ;: l• No. Mill Pate '. /4 /9-P.ef...(./ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • CITY OF COSTA MESA CONSR UCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNI - Project Address 260'3 24' ti *1 — i 7? rr II • I Applicant's Mailing Address Zi 7 C.#4t 44 ESS TYPE OF CONSTRUCTION u NEW LI ADD U ALTERATION ❑ REPAIR -I n^ ^"_'•^^ ^' '^ '•L' Owner's Name C tN ' &Y, PhoneV_Z�_�Z_"'r ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A.P.#' I Zone • S' HH C/cl DESCRIPTION OF WORK/USE OF BLDG. Z(1 Address M�s / • S Main Building: Accessory Building: Arch/Eng. snap(e.vS License No. -- _ _ TYPE OF PERMIT U GRADING U FOUNDATION U STRUCTURAL E Front - ZO Address Y ❑ TENANT ❑ ELECTRICAL 0 PLUMBING 0 MECHANICAL B . Rear . N ' Contractor's Nam .. ..z Ad A: Sl2^ZS fl ❑ OTHER ... Phone T C Right - N Address _/� PROJECT DESCRIPTION SQ. FT. OCCUPANCY (mailing) t"• 4-/ _ �` CON STRUCTION TYPE VALUATION$ K Left City License No. ' &my 3 0 - S R 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: - Planning Notes: Q with section 7000) of Division 3 of the Business and Professions Code,and - M my license is in fu force nd effect, // T License lass ' LL fenso No� '84 O0 • S, Date Signature (V /F�.�— PLUMBING I FEES • WOR ER COMPENSATION DECLARATION -. ' Bar Sink • Showers ELECTRICAL FEES I hereby affirm that I have a certificate of consent to self-insure or a certificate I Workers' Compensation Insurance, or a certified' copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) - Automatic Washer Transformer 0 15-50 KW- - - -•- . Policy No. Company - Backflow Irrigation - Sewer Cip . " Construction Pole Sub. 0 50+ KW Certified copy is hereby furnished. Certified copy is filed with the city Building Division. BathtubsSewer Connection - Cooking Unit Meter Cup to 100 amps i Date Applicant ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors Dishwasher Meter Dover 100 amps . • (This section need not be completed If the permit is for one hundred ($100)or less). Dishwasher Solar Piping 1 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 HP ❑l h-8 WorkG�s' or�pe on Laws of Calllgrn'y�� _ Date-1 /jj Signature ,ZL, j._,&a�-�•+ Floor Drains' SwimmingPool w/Spa • 'NOT E:II after making this declaration,you should become subject to the p F.A.U. Inc.Solar ❑9.15 HP ❑16.15+ Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal • Fixtures Microwave ' - I comply with such provisions or this permit shall be 'deemed revoked. - - - ' - CONSTRUCTION LENDING AGENCY • • Gas Service Outlets Water Closet • B • I hereby affirm that there is a•construction lending agency for the performance - Deviceoxes Pole Light i of the work for which'this permit is,issued (Section 3097 Civ. CJ Interceptors' Water Heater - Outlets Range Lender's Name • • _ - - Lender's Address - - Kitchen Sink - Water Service - Switches Sign ' OWNER BUILDER DECLARATION • - I hereby affirm--that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal . iStanding Sections following reason (Section 7031.5,Business and.Professional Code: Any city or • _ - ' county which requires a permit to construct,alter,Improve,demolish or repair . P-Trap ' 'LaundryTra s , any structure, prior to its issuance, also requires the applicant for such permit y - Generator 00.5 KW 05-15 KW Trash Compactor to file a signed statement.that he/she Is licensed pursuant to the provisions of Roof Drains • ' the Contractor's License Law(Chapter 9 (commencing with Section 7000)of Division 3 of the Business and Professions Code) or that he/she is exempt • herefrom 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 - 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 $15Issue Fee $ 3 ' compensation, wilt do the work,and the Structure Is not intended or offered - for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL Reinspection Fee $15 Issue Fee $ 3 License Law does not apply to an owner of a property who builds or improves FEES 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 corn- 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, as owner of the property, am exclusively contracting with licensed con- ' Duct-Structural Refrigeration System • Application Issued By kr di ( Date 274 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 y Duct-Ventilating - 00-100,000 BTU 0100,000 BTU e/ CO SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- - T tractor(sj license pursuant to the Contractor's License Law). I am aware thatExhaust System ❑ Multiple❑ System Repair/Alteration BUILDING PERMIT $ SMTP $ proof oftheir Worker's Compensation insurance should be provided to me. PLAN CHECK $ 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# • Fire DamPERMIT Callipers PLUMBING $ -- ISSUANCE $ Date Owner Heating System&Ducting �fpj Registers - 6 $to PLAN CHECK 25% $ ENERGY P.C. :$ I hereby certify that I have read this application and state that the above } 0.100,000 BTU 0100,000 BTLr� - _ _ ELECTRICAL S GRADING $ Information is correct. I agree to comply with all city and county ordinances ( -- and-state laws relating to building construction, and hereby authorize repre- MICROFILM $ • ' sentatives of this city to enter upon the above-mentioned property for PLAN CHECK 50% $ `'') inspection purpo�F MECHANICAL $ _ TOTAL FEE $ p-�/�� Signature [t1 Pink -Accounting;Goldenrod - Assessor ' - - - - • '- . - CONSTRUCTION AND PLANNING POt_ 5 SPA APPROVALS • Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pote 52. Pool & Equipment Location 2. -Soil Pip-Oindrgrnd. ;; 53. Steel Reinforcement 2 .3, Electrical Conduit Utility-Undrgrnd. 54. Forms 4. ElectriEal'Conduit-Unc(rgrnd. ' , 55. Electrical Bonding 5. Steel'Reinforcement`• - 56. Rough Plumbing & Pressure Test 6t Electrical UF Ell Grnd. r • 57. APPROVAL TO COVER-GUNITE •-- '7: Footings 58. Electrical Conduif-Undrgrnd. 8: Foundation y1 • 1 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pape-Undigrnd. ( 60. Backwash Lines, P-Trap,0 Undrgrnd. , , .10. Structural Floor'System61. APPROVAL TO DECK 1.1'. Property Sewer Line & House Connection • 62. Backwash & Receptor-Final 12. Sewer Cap •`ti..� 63. Heater & Vent-Final 13. Roof grains 64. Plumbing System - Final �= 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final , .36. 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 ft bff C,e) 71. Product Piping 0 Gas 0 Oil . 23. Gas Pipe-Rough & Test - 72. Underground Flush f- ." 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: .i , ` 34. Final Heating& Air Conditioning (OW" C, 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 4 • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. ~ - PERMIT NO.Im TRACT NO. LOT NO. UNIT 8005- 9IO2IBS l - 6e0 i It CITY OF COSTA MESA CONSTRUCTION PERMIT ZO I.So 2 Project Address _.2683 .EG/�,6aw/ Awe. I ' Applicant's:Mailing Address Zg,] irl C/ IC e / C/yi TYPE OF CONSTRUCTION .[JEW ADD U ALTERATION U REPAIR i s A•.t JS(.LlE v. e.S1/t d9nf/ 0 CONVERSION 0 DEMOLISH 0 OTHER - A.P.# '�3 ' D�� ��Q .�� I Zone so` a_...- Owner's Name,/-Q'/ ` ' I^I _._Phon DESCRIPTION OF WORK/USE OF BLDG. Address iY'fA's CI,t4 - 3 —, I•e2-i ` - S Main Building: - Accessory Building: Arch/Eng..1.-.41/41644(---.5:74/244541.1.• License No. e /29L? TYPE OF PERMIT Li GRADING U FOUNDATION ❑ STRUCTURAL T Front - - O Address A - _ 0 TENANT 0 ELECTRICAL ❑ PLUMBING 0 MECHANICAL ' B Rear - N Contractor's Name ile� � • [t9Lr ecphonersgera7g51 O 'OTHER , C Right - - - N /� PROJECT DESCRIPTION SQ. FT. OCCUPANCY 9 'Address(mailing) .2411 /�71 G.ef'f.'C-- 3 I ?...-n • CON ST RUCTION TYPE VALUATION$ S Left G City License No. 3648 ZONE ' GRADI NG CU.YDS. ACRES - . - R -Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION Q I hereby affirm that I am licensed under provisions of Charter 9(commencing Remarks: • /4 G 7 4/4 -r/ V ti/ Planning Notes: M with section 7000) of Division 3 of the Business and Professions Code, and r� my license is in full force effect. /,i eq t,' S J License lass /P� cense No. r/2 ( Zl ' -- Date Signature ' PLUMBING FEES• - WORKERS'.COMPENSATION DECLARATION Bar Sink , Showers ELECTRICAL • FEES hereby affirm that I have a certificate of consent to self-insure or a certificate ' • ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer - -- - - Service Sink - - - ^ Automatic Washer 'Transformer ❑.15-50 KW - ,800, Lab. C. / �/' Policy No. 7k ` x e Company f)' re dir-i•A✓C? Backflow Irrigation,. Sewer Ca 0 50+KW ' t P Construction Pole Sub. Certified copy is hereby furnished.thcit Cerlifj etl�ops(iyfiletl with the city eui�r ion. Bathtubs • Sewer Connection Cooking Unit Meter ❑up to 100 amps J XS Applicant EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwash_er-' 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 00-1 HP ❑1'h-8 , Workers' Compensation Laws of California. - - _ 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 - Microwave - _ ' - - - comply with such provisions or this permit shall be deemed revoked. ' CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet - Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the work for .which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Range Lender's 'Name - Lender's Address - ' Kitchen Sink Water ServiceSwitches - Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories ' Auto-Wash Garbage Disposal !Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap . Laundry Trays Generator 00-5 KW 05-15 KW Trash Compactor • any structure, prior to Its Issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000)of 'llvision 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 ' - - ' ]31.5 by any applicant for a permit subjects the applicant to a civil - - ' LJenalty 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 Boiler Ho•od or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that Such Improvements are not intended or offered foryp Zoning Approved By Date sale. If, however, the building or Improvement Is sold within one year of com- Canopy, Type II ❑ elation, the owner will have the burden of proving he/she did not build or im- Duct-Under Groundl move for the purpose of sale). - _ Building Approved By /� Date O I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural • Refrigeration System Application Issued By S4 -' Date Z� 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 ' 0o-100,000 BTU 0100,000 BTU SUMMARY OF FEES builds or Improves thereon, and who contracts for such projects with a con- - tractor'(s) license-pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple ❑ System Repair/Alteration • BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should be provided to me. PLAN CHECK $ PERMIT ' 0.1am exempt under Section B.& P.C.for this reason / Firepl/Fact.BIL ICBO# �(a I Fire Dampers I �' PLUMBING $ ISSUANCE $ - Date Owner •` Heating System& Ducting Registers • PLAN CHECK 25% $' ENERGY P.C. $ I hereby certify that I have read this application and state that the above, 00.100,000 BTU 0100,000 BTL - ELECTRICAL $ GRADING $ - information is correct. I agree to comply with all city and county ordinances and state laws relating to Duiltli g construction, and hereby authorize repro- PLAN CHECK 50% $ • MICROFILM $ 1 sentatives of this cit en upon the above-mentioned property for inspectionurepurposes. /i / d. MECHANICAL $ -7 l 00, .TOTAL FEE $ -00 Signature Reinspection Fee $15 / Issue Fee 5 3 PLAN CHECK 25% $ I . CO CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor • - CONSTRUCTION AND PLANNING - POO SPA 11 APPROVALS Permit# Date`s Inspector APPROVALS Permit# Date Inspector ' 1. Temporajy Electrical Service or Potee ' : 52. Pool & Equipment Location 2. Soil PipraUndrgrnd. r- - 53. Steel Reinforcement 3;,Electl5caf Conduit Utility-Undrgrnd. .' ' ' 54. Forms 1 4!•Electiidal Conduit6Uiidrgrnd. 4 T' 55. Electrical Bonding C. r " S 4' 56. Rough Plumbing & Pressure Test /"' 5'Steel Reinfo4cemen , .Pr 6;j.E1;ctri4) d,JER;Grnd. r • 57. APPROVAL TO COVER-GUNITE • .4. t�, 7 ootiks • r , 58. Electrical Conduit-Undrgrnd. , 8.'�Fqundationl :1*. /71 ;. 59. Gas Pipe, 0 Undrgrnd.,Test 9. Watei:(Pipe-Und,gndt -/ ,��. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10! tiuctiiral Flooriystem i 61. APPROVAL TO DECK : ' 11;Prdperty.Sewer Line„& House Confection !t• 62. Backwash & Receptor-Final 12. Se0verlCap , j }' 63. Heater & Vent-Final r' f 13. RoofDrainy I. • ''•� 64. Plumbing System - Final -� 14. Roug}i Plumbing•i: • `r 65. Electrical-Final 15. Rough Electricaltonduit 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 ,, A/_ 'gr 44O APPROVALS Permit# _ 21. Ducts,in Structure �i,+` 70. Underground Hydro 22.,.Ducts, VentilatingL, 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 'i 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 1,: Plaster Brown Coat 79. FINAL INSPECTION . 82. 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. Fin3LFactory Fireplace /i/29/ic G,go 38. Final Plumbing `Y 39. Water Service-Final 40. Gas,Service-Final 41. Solarf•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 j elease to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date 1 y111 MF ,CITY CA'COSTA MESA a a BUILDING DIVISION >• ,k DEVELOPMENT SERVICES DEPARTMENT P MIT NUMBER 4, /s PERMIT B07-00111 * r„ , V (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesata.os bING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV Status: ISSUED Suite: K-J Applied: 01/31/2007 • Vicinity: Issued: 01/31/2007 Primary Occ: R Type of Construction: V-N Parcel Number: TPN007002 Zoning: Applicant: ANNIE PATTISON Address: 101 THE MASTERS CIRCLE i/ i _ Phone: 714-444-1111 /� COSTA MESA,CA _ ., '-Zip: - 92627 , ISSUED BY: - Owner MAR ELDEN-SQUARE-HOA Address 2603 ELDEN AV /,. �� -'� - , Phone: • ' . - , COSTA-MESA,CA�. Zip: 92627 Contractor:,'AL'L-COASLROOFING:AND:COATINGS - Address:.'/101-THE MASTERS CIRCLE - ', - ', ;,,,/,'/: "1„2" ' /'�':-i Phone: 714444-1111i \/ " ,, ' ,'j i COSTA MESA;-CA Zip: 92627/'4:- / " License: 598440 'Arch _ (- %i/ Eng: Address: „, �/ Address: • , t Phone: - Phone: (Zip:_ , 1,, ,, _. .License: - - - ' License: ' SCOPE OF PERMIT r`RE-ROOF OVER EXISTING LAYER. INSTALL 30 YEAR GAF TIMBERLINE SHINGLES,4:12 PITCH AND 2300 SQUARES FOR CONDOS.BLDG.K-J v i" j , i _ - _ _ _ -_ FEE-SUMMARY Plan Check:5, % $0.00 r (7-',"7'`'y /' �''' ,' C Calc Valuation: $2,300.00 1 Permit:' $83.25 `--' 1__-'_ '- _``' ' - •'--' G• -' Claim Valuation: $2,300.00 SMIP Res:' $0.50 ' i` SMIP Com: . $0.00' \ Other:\ $0.00 c: -4 . .v ----"/ -- '1'-1t, Inspection; ;,.,, $0.00 -- — t . \ c\\ `-Total: . $83.75 l , PLANNING &ZONING - SETBACKS ���'„ MAIN STRUCTURE Front ` t 0-0 Rear .'0-0-�. Left„ 0-0,.- Right 0-0:; , ACCESSORY j Front 0. �"' .Rear 0-0' " Left 0-0 -Right - 0-0 '\ /st V ' _ PARKING vA\ E Vin / 0���' F2k-_t 0 Proposed: 0 :„7-- \ - 'N:'"V A/ //�, ' AVV 9 ' '99/ / / \ NV N/((' i ;A <` �� \�. • • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92.28,§ 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within180 days,or if work is suspended or abandoned for a period of 180 days. _ . . . INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446.48(6'00) . '/ DECLARATIONS WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a Certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the _ ark for which this permit is Issued. I _have and will maintain a workers'compensation nceinsurance,olicyas required are:red by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My woricer5;eempeon 195npance carrierand policy number - ���� L- 'Gamer: .9e`d1 cc��(�`l+1 _/i/2r //Policy Number. '(This section n of be pleted A the pe /s valued at one hundred dollars($100)or less.) L� ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws alifomle, agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with thesero Worts. -ApplicantSigdatu�e: -,_ Date: ) �.✓ d 7 WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYERTO CRIMINAL P DES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I herebyaffirm that I am license under provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Business aD�rofessions Code,and my license is in full force cr a and effect.Lic.x. 1?7 �f 0 Class x -Q C l Contmctdr's Signature_ .....-- l Dete: _ • 3! �$ CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I.as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. _ Business and Professions Code for this reason: Signature: Date: Owner ID verified by driver's license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(typo of document.i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date:• Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: I Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this application aermit for such construction or modification from the South Coast Air(Duality Management District or from any other air pollution control district or agency? 0 Yes 0 No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes ❑No (If"yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject of this application,have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? 0 Yes El No 8 (If yet attach certificate of Compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct. I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection p n•ses.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Signature _a ner(s) ) ., P r ? w / 11,7 And/O Authorized Applicant r Date COBE S INSPECTION TYPE 26IE INTrnALS Lon INSPECTION TYPE OATS _- ' 1tIIID6ES 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final208 Final Plumbing 200 Final Re-Roof y® dgCr 210 Final Electrical • 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition _ 250 Final Building/Occupancy _ i r City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 001476 { Building Safety Division 1P.O.Box 1200 .1 Costa Mesa.California 1,. The Building located at 2603 Elden Avenue #K .r has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto 9 fora Group R-3 Occupancy. I G Use of Building ( rm YmAini Legal Description 439-071-10-15 ?I (See reverse side for Metes and Bounds) Building Permit No G18482 Electrical Permit No. G18482 Plumbing Permit No. G18482 . 11; Mechanical Permit No. 018482, M19774, M20181 Number of apartments and/or guest trrooms �i I/ ISSUED TO: Z> Building Official A0i /c r / ��/ 1`- Mar-Elden Develonientc��� / I{ 18226 W. McDuatntt by Oji j C iklairrdv�- Irvine, CA 92714 Date 7 .(l/1J-C, /915- i. 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. 'j CMF 1015.46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File 4 I I,t City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 001476 • Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2603 nem Atmnnq $R has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group AR-3 Occupancy. Use of Building Condominium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit No G18482 Electrical Permit No. G18482 Plumbing Permit NoG18482 MechanicaI Permit No. G18482. M19774. M20181 Number of apartments and/or guest rooms ISSUED TO: .t', Building Official f4a -Elden Development ! �r �/Oii � 18226 W. McDutmott by r��,1 pn- - 7rvine, CA 92714 Date 1/211,- This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 lel U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. I ,26 14/1.6/115 (I- C • . / 1T Y•;17f COSTA MESA • PER IT NO. TRA7 i 0 LOT NO. BLD ,C � - " 6 -U. - y''`.°'"' IL • CI0iST,RdCTIOiV PERMIT • �g� QJZ f.Za9L( K� 1 Project Address 7603 'E1 den Ave. , K - TYPE OF CONSTRUCTION ❑ NEW U ADD L'ALTERATION- IJ REPAIR - ' Applicant's Mailing.Address. 18226 W. MCDurmott, Irvine ❑ CONVERSION ❑ DEMOLISH ❑ OTHER' � ]] �' A.P. ,I/' `^ Zone LL DESCRIPTION OF WORK -- Atc,J Co,r4-v Main��O7/�/vim(� Owner's Name Mar-F1 den- Development Phone 474-0601 - S Building: Accessory Building: _ Z Address 18226 W. McDurmott, .Irvine 92714 OOCtt ^ �� • . Chris R. Stephens- 4 C12963 TYPE OF PERMIT U GRADING OUNDATION T� STRUCTURAL E Front /� I }{� t 0 Arch/Eng. License No. ❑ TENANT ,ELECTRICAL PLUMBING ILh MECHANICAL B Rear -� " ' '/ '_ ' - — -I Address•18226 W: McDermott, •Irvine 92714 ❑ :OTHER ' - •p2 /�jA N The RI chard F.a Crawforckier . 474-0551 ' PROJECT DESCRIPTION SQ. FT. /q/ 3 T7 / OCCUPANCY /2-1_ ,.S_____ C Right '5I - _ G' Contractor's Name '�s . Address(mailing)18226 W. MCDurmott. Irvine 92714 CONSTRUCTION TYPE VALUATION$ KY ttO S Left ,q 01 1 GC-SL_ R 7 ZONE GRADI NG CU.YDS. ACRES / o •y City License No. ' 3 J4/GG2 Ping. Ref.# Q-$c{-y7 T^,(.ZZ9y Park.Fees $I 310/,•Qg{Of4L U Co LICENSED CONTRACTOR DECLARATION' Remarks: 7 e,, .f ParkingReq./Provided /, , I hereby affirm that I am licensed under provisions of Charter 9 (commencing �� �"� —`� 30 3U - I I with section 7000) of Division 3 of the-Business and Prof cions Code, and Use of Building: Bio l�•/O . - - .. +R my license is In full f rce and effect. r • U E License C ass J PLUMBING FEES Planning Notes: --- —__. E Date Signature - ' I III I. K ;i_U C : '1111t • • Bar Sink Showers -N -1,�ORKERS'COMPENSATION DECLARA ION - RT hereby affirm that I have a certificate of consent to elf-insure ora certificate j`,x_ Backflow Preventer _ _ Service Sink. _ - _ __ .. T Workers' Compenn is: Insurance, or a certified copy thereof (Section; _ - 3800, Lab. C.)/s F(p4 . - �r�0- Backflow Irrigation Sewer,Cap -{-:f - - _-e ELECTRICAL • , FEES Policy No. Company d -'I ' . - y��.rerLtietl copy is here furnished. ,,�i� Z- Bathtubs '� „ Sewer.Connection. • .(n'_- Automatic Washes "; Transformer 0 15-50 KW i - .0 C rt ied copy�i'yf' with the city B rvi - - ' Date ././• r Applicant Clarifiers " • Solar,Collectors, ' i/�' Construction Pole Sub.- ❑ SO.+ KW1�, 'EXEMPTION FROM WORKERS'COMPEN D •ATIO(V .ri Dishwasher : .! - Solar Piping • CookingUnit it Meter ❑u to 100 amps I • (This section need-not be completed if the permit is for one hundred ($100) or- ! 2.-Q� PP ,,e less). - . _ _ c r, G _. .. I certifythatin-the performance-of the work for'which this permit is-issuetla Drinking Fountains Solar:Tank . ,T,'' 4 -- C I / Dishwasher .,-:, '.,' ,( Meter ver 100 amps, y R shall.not employ any person in any manner so as to become subject to the - ^ - - Workers' Compensation Laws of California. Floor Drains Swimming Pool•w/Spa. . - I / Dryers RGa's .❑Electric .l Sub Panel Date - Signature - ' — NOTICE:If,'after making this declaration,you should become subject to the ' Floor Sinks _ Urinal . . I Fan' 'Motors❑0-1-.HP.❑1%-8 Workers' Compensation provisions of the Labor Code, you must forthwith _ - - - - '"- '' comply with such provisions or' this permit shall be deemed revoked- / Gas Service 2,-Outlets' 3 Water Closet' . ii. /, F.A,U. / „' Inc.Solar ❑9-15 HP ❑16-15+ � CONSTRUCTION' LENDING AGENCY - - - - ( I hereby affirm that there is a construction lending agency for the performance i Interceptors . / -Water Heater , . 4' J /%, Fixtures / k Microwave of the work -for which this permit is issued (Section•"3097 Civ. C.) - - • - - ' Lender's Name Kitchen Sink _ - _ Water Service 2 (X - n Device Boxes' PoleiLight , j Lender's Address' - ' - - _ ' r OWNER BUILDER DECLARATION •3 .Lavatories , - ._ _ i • � _-ll30Range Outlets -, - / _ I • I hereby affirm that I am exempt from the Contra[tor'S License Law for the - • - - following reason (Section 7031.5 Business and Professional Code: Any city or P-Trap . . - ' ' iq' Switches Sign }7 0 county which requires a permit to construct,alter,improve,demolish or-repair , — - -. / any structure, prior to Itsissuance,-also requires the applicant for such permit • Roof Drains _ - Ga�bage Disposal, standing Sections • to file a signed statement that he/she Is licensed pursuant to the provisions of , _ - ( - - =„e Contractor's-License Law(Chapter 9(commencing with,Section 7000)of ' 'Generator ❑0.5 KW❑5-15 KW T • rash Compactor -z-Mision.3 of the Business and Professions Code) or that he/she'is exempt ' - - - ' i s P - ' refrom and the basis-for the alleged exemption. Any violation-of Section •- , 1031:5 by any applicant for a permit subjects the applicant to a civil - I �, 1% -�r ¢natty of not more than five hundred dollars($500). , - i Reinspection.Fee- I $25 _ Issue Fee i • $ 3 - - - LII, as'owner of the property or my employees with wages as their sole s - ' Reinspection-Fee $25 'Issue Fee $'3 compensation, will do the work,and the structure is not intended or offered , MECHANICAL ' FEES - ' - - - - - • for sale-(Section 7044, Business and Professional Code: The Contractor's PUBLIC SERVICES REQUIREMEN S' License Law does not apply to an owner of a property whmbuilds or improves Boiler • Hood or Type I - 0 ,r 4 -95 thereon, and who does such work himself/herself or through his or her own i yPZoning Approved By "lt. 1 c—V� Date "'/ � . - employees, provided that such Improvements are not intended or offered for ' Canopy Type II 0 - - n sale. If, however, the building or improvement Is sold within one year of com- Duct=Under Ground - Application Appioved By I ', Date pletion, the owner will have the burden of proving he/she did not build or im- - • - ' rove for the purpose of sale). - . Duct-Structural m Refrigeration System -- I Application Issued By Dat: -7 LI I, as owner of the property, am exclusively contracting with licensed con- ❑0-100,000 BTU ❑100,000 BTU v- tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating _ SUgMMARY OF FEES ' The Contractor's License Law does not apply to an owner of property who _ - 9 JSO� pp,, builds or improves thereon,;and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration - • BUILDING PERMIT $ SMIP $ S' e tractor(s) license pursuant to the Contractor's License Law). I PLAN-CHECK $ 547o PERMIT ❑'tam exempt under Section B • .& P.C.for this reason Firepl/Fact.Bit. ICBG# 4 PLUMBING $ Zq-00' ISSUANCE $ Date Own. , Heating System&Ducting • ) ' PLAN.CHECK . $ (.x;SO ENERGY�P.C. $ I hereby certify that I .,v• -ad Oat,��IL�+- �d state that the above . / 00.100,000 BTU ❑100,0008TU-' • _ - �'' GRADING $ information is co r -4.•_„-to cv and county ordinances ELECTRICAL $ ?14•SO and state laws - is ' -f/1-,,-�aaaa��� / nd hereby authorize repro- * r 'PLAN CHECK $ I 75 MICROFILM $ sentatives of i - .•ov--mention¢ proper ,y •f•r, inspection pu •ase f • Signature A r ,• •• Ca it ti% .MECHANICAL $ ''7��� TOTAL FEE ' $ 536.33 Drivers''LiII ce e or 55 - Reinspection Fee $25 �� Issue Fee $ 3 PLAN CHECK $ I 00 ' CMF 0865-46 rev. 7/83 White-Building;Canary-Applicant;Pink 1 Accounting;Goldenrod-Assessor - ' - - - - - CNSCAND PLANNING •7 - POC SPA Date Inspector Date Inspector ft0TRUTt0N APPROVALS Permit# APPROVALS Permit# '4 1•.Temporary Electrical Service or Pole'- 52. Pool & Equipment Location v 2. Soil Pipe-Undrgrnd. 4(//3/.!f f�trt" 53. Steel Reinforcement ,3. Electrical Conduit Utility-Undrgrnd. '/ 54. Forms . • - . 74. Electrical Conduit-Undrgrnd. 7/7/'< Op 55. Electrical Bonding - • 5. Steel Reinforcement I St/Ss . 1Jww 56. Rough Plumbing & Pressure Test t 6. Electrical UFE�R �Grrn-d.�1�. 9 v_` 57. •APPROVAL TO COVER-GUNITE •s ,_ 7. .Footings Lo{ 9.42 9,Qay'Q��`. 5/1s/gg gen 58. Electrical Conduit-Undrgrnd. . , . 8. Foundation 4171n--432* ,fl(/ fr /y,,, 59. Gas Pipe, 0 Undrgrnd., Test - ' .` 9. Water Pipe-Undrgrnd. '° . /i (' ' • • 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System` •',; , � • •61. APPROVAL TO DECK • • 11. Property Sewer Line & House Connection 6-/jy r,G� 62. Backwash & Receptor-Final • -I / "/ 12. Sewer Cap - . ; 63. Heater & Vent-Final 13. Roof DrainsI 64. Plumbing System - Final 14. Rough Plumbing Ve43 C.r° 65. Electrical-Final 15. Rough Electrical=Conduit 66. Solar System-Final ' 16. Rough Electric Wiring . 7/4<-CO 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 7//(b%'GEp FIRE DEPT, REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure • • 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil •' 23. Gas Pipe-Rough& Test - 72.. Underground Flush 24. Roof Framing - 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 706T7 1374,1 • 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Fleshing 743/ss- R-4'- 76. Dry Standpipe 28. Lathing &'Siding ' 1// �,j(',�{822.1 77. FIXED SYSTEM FINAL 29. Insulation -7 5s/ ' 29' 78. FIRE PREY. FINAL 30. Drywall Nailing ; S/q/$5-- 4-Y21 HEALTH DEPT. REQUIREMENT .31'. Plaster Brown Coat 79. FINAL INSPECTION . '32. Electrical Power Meter-Final II ,/ 80: FOOD CERTIFICATE ISSUED /1i(1 1(8 C.� 33. Final Electric ((( Notes: 7�=(S>- ��I �� /J et- 34. Final Heating & Air Conditioning /,'/t- Ca) , u ^r3 /. _ u'---2 �-s�2:7 4-% - /}7„„ 35. Final Gas Pipe-Test kya7,3'S- (F!/ 77-ZY tar p, I 7-0) c/ 36. Hood or Canopy ' ed^ il 37. Final Factory Fireplace ///y%r Mr _42.4244-0:24 e"'C. f /Y1� 38. Final Plumbing 4r/sr oer 39. Water Service-Final It E/ - ceo 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer - ` 43. Backflow Irrigation • ' 44. Landscape Irrigation System . . 45. Sound Attenuation • , 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING dr,/ 48. Special Requirements Completed //-/-8y 49. Electric Release to Edison - - - - 50. Gas Release to Southern California Gas Co • i , . , 51.i. , CERTIFICATE.OF OC ate ?NCy�' �_r c C•--) . No. 76 Date , (jfpc,�j 0}`�'�n'�' r ,O.' Pcow_/ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. • _ _ CITV OF COSTA ESA CO��uuS� zRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNITO. , - Project Address -2603 't�•L�r✓af/ ���1 /14 �/9 � �� • 6184` :7708/85 21 . 12 IL Applicant's Mailing Address /2/7 Gd4'a TYPE OF CONSTRUCTION LI NEW LI ADD LI ALTERATION U REPAIR ' L .2)4,,l/ T� ❑ CONVERSION DEMOLISH ❑ OTHER Owner's Name-MSG- G/ //$V Phone6'lZ"TS -DESCRIPTION OF WOR K/USE OF BLDG. A.P.# . I Zone , Address '�l tot, 4 sae Ats LAdy . 0. 4i ' ' - S Main Building: - Accessory Building: Z Arch/Eng..�,S_� f-e71License No. _ TYPE OF PERMIT LI GRADING ❑ FOUND/1TiON U STRUCTURAL T Front O Address /-/ '/ . ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 8 Rear . . •- N Contractor!s Name kV tits"— t4�w`uPhone 6 �-.)� ❑ OTHER A - PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right _ I Address(mailing) /7/7 • Lite At£'IQ1 este' - _S • - G 6 3 O , ' CONSTRUCTION TYPE VALUATION$ -Left R City License No. ZONE GRADING CU.vbs. i ACRES - LICENSED CONTRACTOR DECLARATION - . Ping. •R¢f,# Parking'Req./PlOvided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: • M with section 7000) of Division 3 of the Business and Professions Code,and _ my license is in full force and effect. �/� T License Class C�Zf) License No.Z7p 5/6 0 , • $ l Date j Signature LII .-e - • - PLUMBING FEES - WOR ER 'COMPENSATION DECLARATION , a- 1 hereby affirm that I have a certificate of consent to self-insure or a certificate . Bar Sink Showers I ELECTRICAL I FEES ' f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Pr¢v¢nt¢r Service$ink 1800, Lab.-C.) - - - Automatic Washer Transformer 0.1550 KW - Policy No. company - Backflow Irrigation , - Sewer Cap • - 0 50+KW - Conitruction Pole Sub. A Certified copy is hereby furnished. ; Certified copy is filed with the city Building Division. • Bathtubs Sewer Connection Cooking Unit Meter Out)to 100 amps • , Date Applicant ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION . Clarifiers Solar Collectors Dishwasher 'Meter Dover 100 amps • ' (This section need not be completed if the permit is for one hundred($100) or Dishwasher - . - - • ' less). - Solar Piping —• Dryers ❑Gas DElectric Sub Panel - ' I certify-that in the performance of the work for which this permit is issued I - _ ' shall not emplyyyyyyy any person in any manner so as to become subject to the Drinking Fountains Solar Tank I Fan' 'Motors❑61 HP ❑1'h-8 Date , ye�a2iw Laws of Calif rni s Date // 3 J Signature - - Floor Drains Swimming Pool w/Spa F.A.U. ' 'NOTIC I after making this declaration,you should become subject to the - .Inc.Solar❑9.15 HP ❑1615+ , Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply :with such provisions or this permit shall be deemed revoked. . - - - - - -^ -' t CONSTRUCTION LENDING AGENCY Gas Service .Outlets Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance - Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) • Interceptors Water Healer ' Outlets - Lender's Name - -- _ - - Range Lender's Address _ - Kitchen Sink Water Service •- Switches Sign OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractors License Law for,the Lavatories - following reason (Section 7031.5Business and Professional Cotle: Any city or r• Auto-Wash ,Garbage Disposal Standing Sections , county which requires a permit to construct,alter,Improve,demolish or repair P-Trap Laundry Trays Generator ❑O-5 KW❑5-15 KW any structure, prior to its issuance, also requires the applicant for such permit . . Trash Compactor to file assigned 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 - ierefrom and the basis for the alleged exemption. Any violation of Section . ' • )31.5 by any applicant for a permit subjectstheapplicant 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 UM,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- Canopy Type II 0 ' Zoning Approved By Date - t 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). /q` �i p ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System - Application Issued By p' f /ri! Date7/d�O < / 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 L Duct-Ventilating . 00-100,000 BTU ❑100,000 BTU 54 OD SUMMARY OF FEES ' builds or improves thereon,and who contracts for such projects with a con- _ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple❑. System Repair/Alteration BUILDING PERMIT $ SMIP $ proof of their Worker's Compensation insurance should 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 PERMIT ISSUANCE $ q PLUMBING $ Date Owner A Heating System& Ducting Registers & St PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that i-have read this application and state that the above t IVO-100,000 BTU❑100,000Bll. _ - - pd ELECTRICAL $ GRADING $ • information-is'correct. I agree to comply with all city and county ordinances - - - and state laws relating to building construction,and hereby authorize repre- _ $ MICROFILM $ • sentatives of this city to enter upon the above-mentioned proper y for PLAN CHECK 50% inspection duty. s- Signature `Q 1e Date& MECHANICAL $ TOTAL FEE $ ;�t/c7,-- Drivers' License or SS t �` 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 POC . 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 Condyit•Utility-Undrgrnd. • 54. Forms •4. Electrical Conduit:Undrgrnd. t 55. Electrical Bonding i 5. Steel,Reinforcement 56. Rough Plumbing & Pressure Test 6. .Electrical UFER•Grgd. - 57. APPROVAL TO COVER-GUNITE . :r' 4'7'-Footings - 58. Electrical Conduif-Undrgrnd. or 8: Foundation ` - ,y, 59. Gas Pipe, 0 Undrgrnd.,Test i, . 9. Vater 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 . • '111.•S(wer. Cap ' -Ta' 63. Heater & Vent-Final r._ 13. Roof Drains • 64. Plumbing System - Final 14. RPugh 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 Ifl( a5 d� C(O 71. Product Piping 0 Gas 1:10i123. Gas Pipe-Rough & Test lI - _ 72. Underground Flush 1 ".'. 6 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 j 33. Final Electric Notes: r•. . 34. Final Heating& Air Conditioning - I ifji/i< (,w - 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 OE OCCUPANCY . No, ' Date - ' • . Applicants • ttoo�fill �inn all spaccees except those within heavy border lines and sign a_ll appropriate declarations, • �T �� PERY P l LC7 I C� I • TR29T 0. LOT NO. UNit,nly.. ' eaa5 e�o2�es apoo' rl cri Y of COSTA MEA' CONSTRUCTION PERMIT ' • _ 1, K .- Project Address Zllo3 ELO E i Applicant's Mailing Address `2V( f� . a /N TYPE OF CONSTRUCTION ff�-NEW ADD U ALTERATION U REPAIR J /moi IGCP Phone�irx��� El CONVERSION El DEMOLISH El OTHER r A P # /!�f/�- •0 7/ - /b -AC Zone ',a”•2_,:.- ,.... Owner's Name r DESCRIPTION OF WORK/USE OF BLDG.. Y S7 l Address 2 q.. eh stay-ea- a / elm .MM.6s'f - S Main Building: Accessory Building: /Z� TYPE OF PERMIT ❑'GRADING ❑ FOUNDATION E I Z Arch/Eng.4M&IC S7%/A4 nSS License No. 43 USTRUCTU RAL T Front - 0 Address . El TENANT_ ❑ ELECTRICAL El PLUMBING El MECHANICAL B Rear - N El-OTHER A I Contractor's Name 2 /u'11 140 /14#44.041P1019 - - - --- g - - E PROJECT DESCRIPTION SQ. F7.- - _ OCCUPANCY ,E Ri ht N _Address(mailing/ - Left •. _ • '�a, CONSTRUCTION TYPE VALUATION $ $ • City License No. • ��. TS� . ZONE - GRADING CU.YDS. • • ACRES' R LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req./Provided E P hereby affirm [Wahl am licensed under provisions of Chdrt¢r 9 (commencing Remarks: �i �� ,� _ Planning Notes: M with section 7000) of Division 3 of.the Business and Professions Code, and v my license is in full fpr tl effect. /_ I Qr l/J '� ! I - S i License Class—� ce se No.��24 3 �-7 LJ`I U • _ Date p• I. b'S Signature • PLUMBING FEES .� WORKERS'COMPENSATION DECLARATION Bar Sink Showers r ELECTRICAL FEES 'hereby affirm that I have a certificate of consent to self-insdre,or a certificate ' Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service ink '" - '" -' .800, Lab. CJ ,' - I Automatic Washer" TransformeF 0 15-50 KW , /�`i Policy No. ��� Company Backflow Irrigation . I Sewer Cip Construction Pole Sub. 0 50+ KW ' Certified copy is hereby furnished. 4 Cerci d cop4y�5f{ ' d with the city Buil,l '"n Bathtubs ' _ , z Sewer Connection Cooking Unit Meter ❑up to 100 amps Date • i "iApplicant / ��� ' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers . Solar Collectors' Dishwasher`. Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100)or - - __ less). Dishwasher _ Solar Piping Dryers OGas ❑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 .-1 Motors 00-1 HP Di>s-8 Workers' Compensation Laws of California. . Date Signature _Floor Drains Swimming Pool w/Spa F.A.U. Inc.Solar ❑9-15 HP 016-15+ NOTICE: If,after making this declaration,you should become subject to the Workers' Compensation,provisions of the Labor Code, you must forthwith Floor Sinks - - Urinal' - Fixtures Microwave - r - - comply with such provisions or this permit shall be deemed revoked. - CONSTRUCTION LENDING AGENCY - Gas Service Outlets Water Closet ' • ' - ' I hereby affirm'that there is a construction lending agency fdr the performance Device BO%es Pole Light of the work for which this permit is issued (Section 3097 Civ. C.) • InterceptorsWater Heater •- • Outlets Range Lender's Name - _ - Lender's Address _ • ' Kitchen Sink Water Service Switches Sign - • ' OWNER BUILDER DECLARATION • I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories - Auto-Wash Garbage Disposal ;Standing Sections following reason (Section 7031.5 Business and Professional Code:'Any city or - t • county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays - Generator 00-5 KW 05-15 KW Trash Compactor any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of : Drains' r the Contractor's License Law(Chapter 9(commencing with Section 7000) of • "sivision 3 of the Business and Professions Code) or that he/she is exempt 'I - irofrom and the basis for the alleged exemption„Any vl olation of Section _ , 31.5 by 'any applicant for a'permit subjects the applicant to a civil _ . G-,malty of not more than five hundred dollars($500). - l I • r • : LI I, as owner of the property or my.employees with wages as-their sole • Reinspection'Fee I $15 Issue Fee $ 3 t • compensation, will do the work,and the structure is not intended or offered v' Reinspection Fee $15 Issue Fee $ 3 , for sale (Section 7044, Business•and Professional Code: The Contractor's' • , - , MECHANICAL License Law does not apply to an owner of a property who builds or Improves . • - FEES I 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 issoldwithin one year of com- Canopy Type II ❑ • 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 prove for the purpose of sale). ❑ I,as owner of the property, am exclusively contracting with licensed con- Duct-Structural ' ' Refrigeration System Application Issued By i Date' C y(Z • tractors to construct the project (Section 7044,Business and Professions Code: J The Contractor's License Law does not apply to an owner of property who Duct-Ventilating - _ 00.100,000 BTU 0100,000 BTU SUMMARY OF FEES ' builds or Improves thereon,and who contracts for such-projects with a con- tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP $ proof o11 their Worker's Compensation Insurance should be provided to me. PLAN CHECK $ - PERMIT 0 I am exempt under Section B.3'P.C.for this reason, Firepl/Fact.BR. ICBG#I/ I Fire Dampers PLUMBING $ PERMIT E $ Date ' Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. $1 I I hereby certify that I have read this application and state that the above - - 00.100,000 BTU 0100,000 Br ELECTRICAL $ • GRADING $ information is correct: I agree to comply with all city and county Ordinances' - and state laws relating to building construction,and hereby authorize repro- PLAN CHECK • 50% $ k MICRO F,I LM $ inspection fives of this city"tt3>e9ty�Pon the above-mentioned property for inspection purposes. /J` � & / g./ MECHANICAL $ 004a. 00 Signature Date ' I �' TOTAL FEE $ Drivers' License or SS# Reinspection Fee $15 1 Issue Fee ; $ 3 PLAN CHECK 25% $ ) . (DC) i I 1 CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod -Assessor T- - k CONSTRUCTION AND PLANNING POO" SPA APPROVALS Permit# Date Inspector APPROVALS Permit# • Date Inspector '1. Temporary Electrical Service or Pole -,'• 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. •a 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. %%; I 54. Forms 4.4Elect icai Cdnduit-Uhdrgrnd. { ) :;3 55. Electrical Bonding - '• 5. R •Steeltejnf2jrcemenr " 56. Rough Plumbing& Pressure Test ...-1 6:'"Electrical UFER,Grnd:/ 57. APPROVAL TO COVER-GUNITE . s • 7(�Foofingsi ? - 41 58. Electrical Conduit-Undrgrnd. i', _8r'7Foundation -j`': : 59. Gas Pipe, 0 Undrgrnd.,Test ? 9.}Water.Pipe-Undrgend. 'l.1 fil 60. Backwash Lines,P-Trap, 0 Undrgrnd. • _ 10.,SetucturalFloor/System ' • 61. APPROVAL TO DECK i, 11;,,Property.Sewer L'JPe & House Connection 62. Backwash & Receptor-Final 12. S•ewe�Cap r: - r; 63. Heater & Vent-Final 13. Roof Drains.; r' 64. Plumbing System - Final 14. Rough/iuin ingc• 65. Electrical-Final f ' 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 t/�/�S- 640 APPROVALS Permit# 21. Ducts, in Structure / 70. Underground Hydro 22. Ducts,.Ventilating r 71. Product Piping 0 Gas El Oil 23:Gas Pipe-Rough&Test 72. Underground Flush - • 2q Roof Framing 73. Undergrnd.Storage Tank O Gas 0 Oil 25-. Roof Sheathing r%' 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. 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: ' - - 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test • ' . 36. Hood or Canopy • 37. Final-Factory Fireplace /q/20.5- C-&) 38. Final Plumbing - . 39. Wate9Service-Final ' 40. GasService-Final 41. Solar:Domestic-Final 42. BacS4Iow Preventer - 43. Backflow Irrigation ' - 44. ,Land"scape 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 OI OCCUPANCY No Date, . ; a`, ' Mts. - CITY OF COSTA MESA - ppee BUILDING DIVISION >y'i;..�r DEVELOPMENT SERVICES DEPARTMENT PE IT NUMBER I. rill / PERMIT 07-00112 te dao o BHIHDINC PERNIK (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ce.us 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: 2603 ELDEN AV Status: ISSUED Suite: L-M Applied: 01/31/2007'= Vicinity: ROOF Issued: 01/31/2007 Primary Occ: R Type of Construction: V-N Parcel Number: TPN007002 Zoning: Applicant: ANNIE PATTISON sj , Address: 101 THE MASTERS CIRCLE Phone: 714-444-1111 c COSTA MESA,CA _ .Zip: 92627 ISSUED BY: Owner: MAR ELDEN-SQUARE HOA - Address 2603 ELDEN AV'12 - - Phone: - COSTA MESA,CA - Zip: 92627 Contractor:" n ALLCOASTROOFING AND COATINGS Address:;'101 THE MASTERS CIRCLE- - Phone: 714444-1111 COSTA MESA-CA' '-/Zip: 92627///7/ /" License: 598440 ,' ,/ / / , ///,.-y ,'Arch :% '' ( /.7,/,2/ Eng: Address: • Address: . / Phone: - Phone: Zip: ( ,, - , license: - - License: SCOPE OF PERMIT INSTALL 30 YEAR GAF TIMBERLINE SHINGLES OVER EXISTING LAYER,4:12 PITCH,2300 S.F.CONDOS.BLDG L-M , -- -- - _ FEE SUMMARY Plan Check:', • $0.00 7 - - - - / - -,Calc Valuation: $4,600.00 Permit: '$111.25 '' 1, 1/ %' ti • - • -` ' Claim Valuation: $4,600.00 ' SMIP Res: $0.50 c, - SMIP Corn: ' 50.00- ' '- , Other: - $0.00 Inspection: $0.00 ` •-Total: $111.75 .-/ ' PLANNING &ZONING SETBACKS- ' o. MAIN STRUCTURE Front� 10 Rear. 0 0 Left =0-0 Right 0-0 - . ACCESSORY . ' Fronts '0-'0 . . - •---,Rear 0-0 ' ' Left 0-0 " - - ' Right - 0-0 ::A PARKING,�\ Existin 'NJ 0��\ Required:�� 0 -)� - Proposed: -�0 \A ` f//'-N/,:.. > - - .� / -�� .iv1 % —j, „ — 1 _� - . o ` - ` NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12.21.92) EXPIRATION: This permit shall automatically expire and become void If work is not commenced within180 days,or if work is suspended or abandoned fora period of 180 days. • -A” INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2446-46(WOO) WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: O I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the rk for which this permit is issued. C —'have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers eens/a-tIon I ce carne and policy number are: flrner: . Jr wLLi calicy Nu—mbar:�ITS-7 Milli-action need not be completed if the permit is valued at one hundred dollars($100)or less.) ❑ I certify that in the performs of the work for wilt' this permit is issued.I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Ca and agree th )t I ouid become subject to the workers compensation provisions of Section 3700 of the Labor Code,I shalt forthwith comply with these provi /3/9 7 gppllcanL5lgnbture: - �-�-� Deter-^ WARNING:FAILURE TO SECURE WORKERS'COMPENSATION COVERAGE'S UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENAL 5 AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE($100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licen ugly er'ro 's'ons of Ch'.' 9(commencing with Section 7000)of Division 3 of the Business` Professions Code,and my license is in full Lterce and effect:tic.-d— - *date _I Clasa Contractors cttors.Signature:. — / � Date: CONSTRUCTION LENDING AGENCY: O I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec,3097,Civil Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter,improve,demolish,Or repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 dine Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon,and who does such work himself or herself or through his or her own employees,provided that such improvements are not intended or offered for sale.If,however,the building or improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). O I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet In depth into which a person is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title e,California Administrative Code). ❑ As owner-builder,I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number. HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Flre Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). future buil. file a 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Depanment by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑Yes ❑No (Section 23534 of the Califomia Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully compiled with? 0 Yes 0 No v..__......._.....___.._ ._ 5 Does or will the applicant or present ar future bustling r tram at other for the work which is the subject age of this application appeNnit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? �Yes LJ No (Section 65850.2 of the California Government Code requires that the requested Information be furnished on applications for non-residential building permits). 6 Will any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? 0 Yes 0 No (If yes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 It a permit Iron the South Coast Air Quality Management District or other air pollution control district or agency is required for the work which is the subject W this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and stale that the information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. „Prt f Legalfr Date A7r-e-Aa- 7757N tvAnd/OrAuthorized Applicant- to-- CODE I IucovmeN TYPE PIUE 1NRRAL$ goon INSPECTION TYPE • PATE 1.61a1.6L5 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final He-Roof 2 r 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site 204 Final Demolition 250 Final Building/Occupancy _ t, , . City of Costa Mesa Development Services Department 7¢ Building Safety Division CERTIFICATE OF OCCUPANCY No. 0 01 147 7 dt P.O.Box 1200 ( Costa Mesa,California •+ The Building located at 2603 FJs1en Avenue 4I. ihas been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto '-Y cy for a Group P—i Occupancy. t- - .1 Use of Building CO¢Y5aniniiat 4 ,' Legal Description 439-071-10-15 { (See reverse side for Metes and Bounds) '1. Building Permit No 18483 Electrical Permit NoG18483 Plumbing Permit No. G18483 .Q i Mechanical Permit No.G,PURI, M19775. M20182 Number of apartments and/or guest rooms -- /ISSUED TO: Building Official K , , / 9 Mar-Elden I1e'velrmrent YI,` 18226 W. McDunnott by(-----X n' /0/// k , , ,c,, Trvine. ca 92714 Date T7fxt- // 5 - , This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the ., Ct Building Official of the City of Costa Mesa under Sec. 307 CO U.B.C. „,, CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink -Bldg.Permit File y 1 ;( City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. 0 61147 7 Building Safety Division P.O.Box 1200 Costa Mesa,California The Building located at 2601 Elam.' Avnonito *T, has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group n-1 Occupancy. — Use of Building Condon nium Legal Description 439-071-10-15 (See reverse side for Metes and Bounds) Building Permit N 011848 Electrical Permit NoG18483 Plumbing Permit No. G18483 Mechanical Permit No.G1 R4R1, )41977c- M9fl1 R7 Number of apartments / and//or guest rooms ISSUED TO: Building Official /C, A ( lam Mar-Elden Develotanent 18226 W. McDunnott by Yt / ' fv.//1J-N-. Irvine. CA 92714 / - Date 7.J - /9f _D 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 (e) U.B.C. CMF 1015-46 rev. 1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File i /, Applicant to fill In all spaces except thus&within heavy border lines and sign all appropriate declarations. 1262 406/85 85 555 o C I TL -a - .W MESA PERMIT NO. TRACT NO. LOT NO. BLDG.NO. g „��.aCTION PERMIT 6 I °�t4' B3 /a29'-j . L • •e Praj c�tdress 2603 Elden Ave. #L TYPE OF CONSTRUCTION ,NEW rr: Li ADD U ALTERATION U REPAIR • , Applieanntt's Mailing Address 18226 W. McOurmott• Irvine ' • ❑ CONVERSION 1::] DEMOLISH ❑ OTHER A,p,#Z1 39.071—/0-÷t& Zone i2 Mar-Elden Development Phone474-0601 DESCRIPTION OF WORK Mil, ) 0 endlo S Main Building: Accessory Building: 2 Ow�r's Name V 9 Address 18226 W. McDurmott• Irvine 92714 TYPE OF PERMIT LI GRADING LOROUNDATIO STRUCTURAL T Front ./. -1- jtkeD N Arch/Eng. Chris R. Stephens License No. C12963 ❑ TENANT grELECTRICAL I PLUMBING MECHANICAL ' B '.� I GL Address 18226 W. McDurmott, Irvine 92714 ❑ OTHER ' A Rear '�[_ N Contractor's Name The -Richard Crawford C"-hone 474-0551 PROJECT DESCRIPTION SQ. FT. I 5`74 _OCCUPANCY ____ C Right ,�1/3/ I • G 18226 W. McDermott Irvine 92714 CONSTRUCTION TYPE '1/ -4.-3/4 VALUATION$ 65000 S Left vitpl �9'L E Address(mailing) ' ) / City License No. 418645^• -i ZONE GRADING CU.YDS. ACRES • Ping. Ref.#Dg-$9.-4 7'/ T / Park.Fees $i 3/ . 6, 1,o8 u LICENSED CONTRACTOR DECLARATION - /1/ 74 /_ _ (7(CLParking q, 'AO /s� f I Remarks: f'C Y CP IS r Re /Provided `� ' I-herebyaffirm that I am licensed under provisions of C " er 9 (commencing •.R with section 7000) of Division 3 of the Business and • •fessions Code, and . Use of Building: Co Q . E \Q my license,is In full force and effect. h: 00 License CI s� �����,, ce• =• G PLUMBING FEES Planning Notes: : _ M I Date ' �///-L Signature ..a _ 2SPECIAL r ' nail • E WORKERS'COMPENSATION OECLARA �' • ADLD FOR SFE,.._ L = N I I hereby affirm that I have a certificate of consent to self-insure or a certificateoev • -S if Workers' Compensation Insurance, or,a certified copy thereor(Section ., _ 800, Lab. C.) /(yr // - • • '^ ELECTRICAL FEES -- P01k No. ALO✓�[S S� Com Pan Yx C - _ IdD - `L• Yo6rtifietl copy is hereby furnished. s C(•. a� Automatic Washer f 'Transformer 0 15-50.KW Cert'fi tlo pyJ eed with the cityon By , - - ❑ 50+KW Date Li fi/ Applicant //sl Construction Pole Sub! EXEMPTION FROM WORKERS'COMPEN A ECLARATION • P[' ___ic Cooking Unit s , Meier ❑up t0 100 amps (This section need not be completed if the permit is for one hundred ($100) or 7i less). - "* - • I certify that in the performance of the work for which this permit is issued:1 • • I Dishwasher p .7 'Meter 111rcer 100 amps _ . C3 shall not employ any person in any manner•so as to become subject to the. , _ LJ Workers' Compensation Laws of California • ,• . • ■ _■ Dryers .Gas ❑Electric Sub Panel - • - Date Signature ' �-'- �� NOTICE: ,' per makingrov ions of h,you r you subject h iteIIIill1.1 Motors ❑0.1 HP ❑1'h-B Workers' Compensation provisions the Labor Code, you must forthwith •.81 comply with such provisions.or this t permit shall be deemed revoked. Outlets. III 'L• Inc,Solar 09-15 HP 016-15+ CONSTRUCTION LENDING AGENCY - - I hereby affirm that there is a construction lending agency for the performance /2 :Microwave of the work for which this permit is issued (Section 3097 Civ. C.) Lender's Name _ • Pole Light Lender's Address - OWNER BUILDER DECLARATION _ i 3, • Range I hereby affirm that I am`eiempt from the Contractor's License Law for the , ■ following reason (Section 7031No •,5,Buslness and Professional Code: Any city or Si n county which requires a permit to construct,alter,improve,demolish or repair g 'any structure, prior to Its issuance, also requires the applicant for such permit 1. Roof • III _1. • Standing Sections N to file a signed statement that he/she is licensed pursuant to the provisions of ;the Contractor's License Law(Chapter 9 (commencing with Section 7000)of , -5 KW 05-15 KW Trash Compactor Division 3 of the Business and Professions Code) or that he/she is exempt --:•yierefrom and the basis for the alleged exemption. Any violation of Section • 131.5 by any applicant for a permit' subjects the,applicant to a civil • e,a',natty of not more than five hundred dollars($500). "L7 I,.as.owner of the.property or my employees with wages as their sole 1 compensation, will do the work, and the structure is not intended or offered ' MECHANICAL ' FEES for sale:(Section 7044, Business and Professional Code:, The Contractor's PUBLIC SERVICES REQ • License Law does not apply to an owner of a property who.buiids or Improves ■ r thereon,'and who does such work himself/herself or through his or her own 1� nate employees, provided that such improvements are not intended or offered for • •• �. sale, if, however, the building or Improvement is-sold within one year of com- s. Date pletion, the owner will have the burden of proving he/she did not build or Im- rove for the purpose of sale). Duct-Structural Refrigeration System . .• Application IssThed By 9--te Date 4-1C-1 I, as owner of the property, am exclusively contracting with licensed con- 00-100,000 : 0100,000 : e tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a con- Exhaust System ■ Multiple ■ tractor(s) license pursuant to the Contractor's License Law): ❑ I am exempt under Section B.& P.C.for this reason :• - +o . Date - Owner / i HostingDucting 14'ell I hereby certify •. I have read ,sd� appl' ationand state .that the above. t O• I I I•• BTU ■ r I I1 I B _ information I, •. roc I ag�' to .• ply • t / I city and•county ordinances - - ADING $ and state la •I .i•• rltl onst ct'• 'and hereby authorize repro- sentatives • ,/ if th/above-mentione, prep t f r inspection y'�{�^:I�'/ , //.111 Di U • a• TOTAL FEE $ 5.30. 70 Signature .�'�8'• -'-.,._�� _ _ - _ Reinspection Fee '$25 Issue Fee $ 3 t • CMF 0865-46 rev. 7/83 White'-Building;Canary-Ap• cant;Pink-Accounting;Goldenrod-Assessor - - r ftCONSTRUCTION AND PLANNING . • POOL: A --`f�4PPROV$LS ' Permit# Date Inspector APPROVALS Permit# Date Inspector • •{ mporary Electrical Service or Pole":: 52. Pool & Equipment Location - - r2.•soil Pipe-Undrgrnd. - 53. Steel Reinforcement . • '3. Electrical Conduit Utility-Undrgrnd. r .- ' 54. Forms • 4. Electrical Conduit-Undrgrnd. JNA t 55. Electrical Bonding .-� 5. Steel Reinforcement r S1//9S niet 56. Rough Plumbing & Pressure Test • ''t� ' • 6. Electrical UFER Grnd. • .1 -57. •APPROVAL TOCOVER-GUNITE 7. Footings d( s/7/8.5-7 t 8-2402 58. Electrical Conduit-Undrgrnd. r.^ 8. Foundation 4761.5-A1 ehA6.7. opt 59. Gas Pipe, 0 Undrgrnd.,Test ' - 9. Water Pipe-Undrgrnd. ',' •••NT h .I ', I • 60. Backwash Lines,P-Trap, 0 Undrgrnd. i Id 10. Structural Floor System •�. �'•' 61. APPROVAL TO DECK . 11. Property Sewer Line & House Connection 5/45„.\ cm 62. Backwash & Receptor-Final ' 12. Sewer Cap 2., . 63. Heater & Vent-Final 13. Roof Drains, ! ' 64. Plumbing System - Final 14. Rough Plumbing • 7/ftsk „,47e 65. Electrical-Final 15. Rough Electrical-Conduit - 7� �' , 66. Solar,System-Final 16. Rough Electric Wiring . /lac dC- 67. Fencing & Access Approval 17. Rough Wiring Sign `' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT , 20. Rough Factory Fireplace , APPROVALS Permit# 21. Ducts, in Structure - 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 7/05-44.9 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical • 27. Frame and Flashing a 113 tier Q)1 76. Dry Standpipe 28. Lathing&Sidingn1/44 r i 77. FIXED SYSTEM FINAL 29. Insulation et//4//, '" fe 78. FIRE PREV. FINAL 30. Drywall Nailing /64r 4r , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • 79. FINAL INSPECTION 32. Electrical Power Meter-Final • , 80. FOOD CERTIFICATE ISSUED 33. Final Electric `0�3frc Notes zJ f 't,Ps'n-1, 34. Final Heating & Air Conditioning , /O2 '3- CIF° 35. Final Gas Pipe-Test • 40r09' • , 36. Hood or Canopy _ - ' • 37. Final Factory Fireplace. , 38. Final Plumbing 06/146M4:12 • 39. Wafer Service-Final - S'316gr L4o 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 /(/(g/3r (��'y��/j,/ , 48. Special Requirements Completed , f Mtp.�/ - • 49. Electric Release to Edison • I- (.� - • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY /ifs ...„,y, C Th . - . No. f77 Date 0-� � /i& ?Clive/ Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. PERMIT NO. - /^TRACT NO. LOT NO. UNIT NO. -CITY OF COSTA MESA/SA�CO[[N���S-T-�IR`U-C/TION PERMIT I _ /-�. �S L Project Address -2 aGG-V,Ga� Z"s 1 LJ ADD U ALTERATION U REPAIR CI O4 's InO.nG J i'7 d� /9�EAj�15 . TYPE OF CONSTRUCTION H NEWL Applicant's Mailing Address Cf.(r_(`J�/jr/ _V ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Owner's Name ��.- I/ f✓ Phone DESCRIPTION OF WORK/USE OF BLDG. A.P.# I Zone Address ZtjSc ,t tSC. bee,, EL S Main Building: Accessory Building: Arch/Eng. 5e tyo�ftws License No. -- TYPE OF PERMIT El GRADING ❑ FOUNDATION IE STRUCTURAL T Front _ O Address ` /'/ El TENANT ❑ ELECTRICAL ❑ PLUMBING El MECHANICAL B Rear N Contractor's Name�✓fb /✓ltibCS Phone[QY2-LS ❑ 'OTHER - A I �/ ova PROJECT DESCRIPTION SQ. FT. OCCUPANCY C Right N• Address(mailing) /2/7 �`✓� taii*S Cc) 4- Mj' 3 l ( CON ST RUCTION TYPE ' VALUATION$ S Left R City License No. 6 9 V _ ZONE GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION • - Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Q ( 9 Remarks: Planning Notes: with section 7000) of Division 3 of the Business and Professions Code, and MT my license is in full force and effect. / O •- Y �+ S Ucen ass Lice No. - PLUMBING FEES Date Signature #41,...Z • .If ERS COMPENSATION DECLARATION Bar Sink Showers - 'hereby affirm that I have a certificate of consent to self-insure or a certificate _ ELECTRICAL •• FEES f Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink 3800, Lab. C.) - Automatic Washer Transformer 0 15.50 KW Policy No. Company Backflow Irrigation - Sewer Cap - - 0 50+KW Construction Pole Sub. 8 Certified copy is hereby thehed. DateCer ified copy is filed with the city Building Division. Bathtubs • Sewer Connection Cooking Unit - Meter ❑up to 100 amps Applicant - • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred($100)or ' 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❑o-1 HP 01 s -8 Workea,Vpw+.peys�t7ly la i ws of Califor . �`"'f , � • - Date 4 . , Signature Floor Drains Swimming Pool w/SpaF.A.U. . Inc.Solar 09.15 HP 016-15+ 'NOTICE If, er making this declaratio , you should become subject to the ' - ' Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal Fixtures -- Microwave • comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY Gas Service Outlets - Water Closet Device Boxes I hereby affirm that there is a construction lending agency for the performance Pole Light of the 'work for which this permit is issued. (Section 3097 Civ. C.) Interceptors' Water Heater Outlets Lender's Name Range Lender's Address _ 1 Kitchen Sink Water Service Switches Sign OWNER BUILDER DECLARATION - I hereby affirm that 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 Generator ❑0-5 KW❑5-15 KW any structure, prior to Its Issuance, also requires 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 - .herefrom 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 penalty of not more than five hundred dollars($500). LJ 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 ❑ _ ____;j sale. If, however, the building or Improvement Is sold within one year of corn- 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, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued-By l a' Date 7 tracors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Z Duct-Ventilating '. 00-100,000 BTU 0100,000 BTU 41 es, • SUMMARY OF FEES builds or improves thereon,and who contracts for such projects with a con- tractors) 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 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.Bit. ICBG# Fire Dampers PLUMBING $ ISSUANCE $ Date Owner - ' Heatingr��s, System& Ducting et Registers 7 ca PLAN CHECK 25% $ ENERGY P.C. $ I hereby certify that I have-read this application and state that the above / Fµ100,000 BTU 0100,000 BT ir ELECTRICAL $ GRADING $ information is correct. I agree to comply with all city and county ordinances and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50°.G $ • MICROFILM $ sentatives of this city, to enter upon the above-mentioned pro erty�,for I - 9 /' inspection pure. es. �L -/ MECHANICAL ' $ TOTAL FEE , $ O'7i,� Signature �-�� - Date $ 3 PLAN CHECK 25% $ 7� CMF 0865.46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting;Goldenrod - Assessor CONSTRUCTION AND PLANNING POO.-_SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole- 52. Pool & Equipment Location • 2. Soil Pipe,Uridrgrnd. • 53. Steel Reinforcement 3,.�Electrical Conduit Utility-Undrgrnd. 54. Forms 4!Electrical Conduit-Undrgrnd. • 55. Electrical Bonding �) 5.' teel'Reinforcement 56. Rough Plumbing & Pressure Test 6:'::Electrical UFER;Grnd. 57. APPROVAL TO COVER-GUNITE 1:`.Footings• • 58. Electrical Conduit-Undrgrnd. •• . B.lFoundation •'; ' 59. Gas Pipe, 0 Undrgrnd.,Test 9. WatetPipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. , 10:y,Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line'& House Connection 62. Backwash & Receptor-Final 12.;Sewer--.Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing: . - 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# 21: Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating q/I;/35- (te/ 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 80. FOOD CERTIFICATE ISSUED '1 ' • ! 33. Final Electric Notes: • 34. Final Heating & Air Conditioning ORl`f i.-- r 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 qF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. • TRACT NO. LOT NO. I . _UNIT.NO. i . - 1 , , 8007, a/02/E5. - Oo0O TL LProlect Address 2C01T �!/ J/ / C . M IM ZD ( � Z 2_1..- Zi. i - - Applicant's Mailing Address Z V Fe5C/14�'- L • aiei. TYPE OF CONSTRUCTIONKNEW ADD U ALTERATION U REPAIR • - er S�Q�C� ❑ CONVERSION ID DEMOLISH C OTHER • A.P.# 1i3 S - 0 7 • /U ,.1� - _ Zone_C - Owner's Name !'t4 6LD�if�� �✓ Phon t) DESCRIPTION OF WORK/USE OF BLDG. _ .• S Z!/•f 0Ci1Cp�'Se 2 / C . at . S • Main Building: Accessory Building: Z Address �y , E g C set C mei'/ t'S License No. e/Zf43 TYPE OF PERMIT ❑ GRADING U FOUNDATION ❑STRUCTURAL T Front- - - • 0 ,Arch/En - Address ' ❑ TENANT ❑ ELECTRICAL ❑'PLUMBING ❑ MECHANICAL B Rear - Contractor's Name 2 G honeS!tC 3 EI -OTHER _ I. !�'� '7�'�`� !�/✓• �q{� C Right N Address(mailing/ E - PROJECT DESCRIPTION 50. FT. -- OCCUPANCY K- G g CONSTRUCTION TYPE VALUATION $ S Left , _ - - R City License No. 3y(�8. ZONE GRADING CU.YDS. ACRESE -LICENSED CONTRACTOR DECLARATION ���111 Ping. Ref.# Parking Req./Provided I `iCI _hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: G 7�/ t1/ Planning Notes: I M .with section 7000) of Division 3 of the Business and Professions Code, and v , my license is in full Torr/ and effect. .L/ �� �./a T �' Licen Class / 6 ♦License No. T �Y • - S Dated r/` s� Signature `a PLUMBING I 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 if Workers' Compensation Insurance, or a certified copy thereof (Section _.. .. - - , .800, Lab. C.) -- Service Company )4a4,0 Backflow Irrigation-•• Sewer Cap Construction Pole Sub. ❑ 50+KW ❑ Certified copy is hereby furnished. . ery,fJ�'ed courted with the city Bu���, '-n. Bathtubs Sewer Connection , Cooking Unit Meter Cup to 100 amps • Date 11C•/� Ir Applicant - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Clover 100 amps (This section need not be completed if the permit is for one hundred ($100)or - less). , Dishwasher Solar Piping I Dryers ❑Gas ❑Electric , Sub Panel • I certify that in the performance of the work for which this permit is issued I- - 1 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 Swimming Pool w/Spa F.A.U. - 09-15 HP 016-15+ NOTICE: If,after making this declaration, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks - - Urinal Fixtures - - Microwave - " comply with such provisions or this permit shall be deemed revoked. - - CONSTRUCTION LENDING AGENCY Gas Service Outlets • .WaterCloset -- I hereby affirm that there is a construction lending agency for the performance .- Device Boxes • Pole Light Of the work for which this permit is issued (Section 3097 Civ. C.)' Interceptors Water Heater - Outlets Range • Lender's Name - ' Lender's Address - - , Kitchen Sink Water Service - _ Switches Sign OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash , Garbage Disposal ;Standing Sections • following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays • . . Generator ❑0.5 KW ❑5-15 KW Trash Compactor - any structure,-prior to Its issuance,also requires the applicant for such permit to 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 - - -- -- - - -- L— herefrom and'the basis for the alleged exemption. Any violation of Section _ 931.5 by any applicant for a permit subjects the applicant to a civil - - natty of not more than five hundred dollars($500). • - - $ S l: as owner of the property or my employees with wages as their sole Reinspection Fee - $15 Issue Fee , • compensation, will do the work, and'the structure is not intended or offered - - Reinspection 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 Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such Improvements are not intended or offered for Boiler sale. If, however,the building or Improvement is sold within one year of com- Canopy Type II 0 Zoning Approved By nate ;Action, 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). 'C1� O I, as owner of the property,am exclusively contracting with licensed con- Duct:Structural Refrigeration System Application Issued By 9V/^w nate tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property,who' - Duct-Ventilating ' 00-100,000 BTU, 0100,000 BTU SUMMARY OF FEES builds or improves thereon, and'who contracts for such projects with a con- tractor(s) Ilcense•pursuarit to the Contractor's License Law). I am aware that Exhaust System 0 Multiple 0 System Repair/Alteration -• BUILDING PERMIT- $ SMIP $ • proof of their Worker's Compensation Insurance should be provided to me. `I� - PLAN CHECK $ PERMIT ❑ i am exempt under •Section B. , P.C.for this reason' '/ Firepl/Fact.Bit. ICBG#1 T k Fire Dampers (4- CL PLUMBING $ • ISSUANCE $ Date Owner Heating System& Ducting' Registers ' PLAN CHECK 25% $ • , ENERGY P.C. $ ' I hereby certify that I have read this application and state that the above, 00.100,000 BTU 0100,000 BTU- I ELECTRICAL $ GRADING $' information is correct. I agree to comply with all city and county ordinances, • and state laws relating to building construction, and hereby authorize repre- PLAN CHECK 50% $ MICROFILM $1 sentatives of b enter upon the above-mentioned property fo - - Q inspection purpose a " I , // pJ - MECHANICAL $ 1 1 Cr) TOTAL FEE $. tl. 00 • Signature -al�, Pink -Accounting; Goldenrod - Assessor 1 CONSTRUCTION AND PLANNING ;1 POOL PA • APPROVALS Permit# Date Inspector APPROVALS Permit Date Inspector .1. Temporary Electrical Service or Pol." 52. Pool & Equipment Location • 2. Soil Pipe-Undrgrnd. ;•j re, 53. Steel Reinforcement 3. Electrical Ci3nduitUtility-Undrgrnd. ✓ / 54. Forms • ; :'' 1 4.,•Electrical C9nduitrUnV•drgrnd. i1 . 55. Electrical Bonding . ,a " S ,pSteel;Remf rcem41,- - ' t 56. Rough Plumbing& Pressure Test % 6. ElectJeidalOFER?Grnd:f' 57. APPROVAL TO COVER-GUN ITE Y.-Footings I. `.° !i Conduit-Undrgrnd. 58. Electrical Cduit-Undd. - r: • 8„Foundation.l i. ��1 V ; < ' 59. Gas Pipe, 0 Undrgrnd.,Test ' 9;"Wyter.Pipe-Undrgrnd. i•i i',.. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10:4,S0uctural Floor System 61. APPROVAL TO DECK V 11,iPrbperty:Sewer Line & House Connection it 62. Backwash & Receptor-Final .12. Sewer Ci) ..• (263. Heater & Vent-Final ir '�' ,i 13i!floof Drains 64. Plumbing System - Final 14 Rout Plumbing! '' • 65. Electrical-Final • i.. 15. Rough ElectricaliConduit 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 Condit)roning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace .' 4%/ar Gra, APPROVALS Permit# - - 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough&Test :4 72. Underground Flush 24: Roof Framing 73. tindergrnd.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 31:1 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 . /0/E°i e Ltd 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 r 50.`Gas Release to Southern California Gas Co -51. CERTIFICATE OF OCCUPANCY No -- Date _ - • 4 so MF _ CITY OF COSTA MESA 4tBUILDING DIVISION / F .,iagairtra t ,. DEVELOPMENT SERVICES DEPARTMENT RMIT NUMBER t PERMIT . . off 800-01485 (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa. �SLDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 'BUJob Address: 2603 ELDEN AV Status: ISSUED Suite: M Applied: 09/21/2000 Vicinity: UNIT M Issued: 09/21/2000 Parcel Number: 93009753 - Zoning: Applicant: SCHAEFER, RICK ISSUED BY: Address: 3160 INCLINADO . . , / - -Phone: (949)361-9233 - SAN CLEMENTE,CA Zip: 92673 Owner HANAUER, SANDI . Address 2603 ELDEMAVE#M - , Phone: (949)5154100_ - - - -7 --N- , ,/ ., COSTA MESA,CA Zip: 92627 - Contractor: SKYLIGHT SPECIALTIES , : - Address: 3160 INCLINADO � . Phone:,., (949)361-9233 - • ' SAN CLEMENTE, CA - Zip: 92673 License: 395551 - ' - Arch : " - - . - Eng: Address: - Address: Phone: . Phone: • • Zip: , License: , / License: SCOPE OF PERMIT INSTALL NEW 22"x 37"SKYLIGHT-'(BRISTOLITE-ICBG#2469)•IN STAIRWELL OF EXISTING CONDOMINIUM-(UNIT M). .. ._ - __: .r . _ . . _ FEE SUMMARY. , Plan Check: . $15.28 _ _ , __. _ Calc Valuation: $500.00 ' 'Permit:' $23.50 - - - ..' Claim Valuation: .. ssoo.00 SMIP Res: ' $0.50 SMTP Com:. $0.00 Other: ' •$0.00 , : - . Inspection: . $0.00 - ' - % ; • Total: $39.28 - - - i---- /� , - PLANNING &ZONING � (,^ SETBACKS MAIN STRUCTURE Front 0-0 - Rear 020 _ Left 0-0.- Right :, 0-p ',/ ,„,/,/,• / i • ACCESSORY Front 0-0 - Rear 0-0 Left 0-_0 Right" '-'0-0-5,i' PARKING Existing: 0 -. Required; 0 Proposed: 0 NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714)754-5626 2448-46(6/00) DECLARATIONS WORKERS'COMPENSATION DECLARATION: - I hereby affirm under penalty of perjury one of the following declarations: • 0 I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit Is issued. /�- $' _I hav10and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. — My workers'compensation Inn rance carrier and policy number are: ^!7 Carrier: J- - 00."-(7) ber:O l {�� --I/) (Policy NumYtr— h(This section n a b completed If the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Cal ornla,and agree that If I should become subject to the workers'compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with these pro .' LAppllcant Signature: /V Oet /-24-6U WARNING:FNLURE TO SECURE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARE(S100,000),IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COOE,INTEREST,AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm t t-l.am.licepsed un er provisions of Chapter 9(commencing with Section 7000)of Division 3 of the Buslness.gnd Professions Code,and my license Is in full force and effect.Lidr q--7)9 / Clessl ' �5 Contractor's Signature: IDate — _7/ 00 CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,Civil Code). Lenders Name: Lenders Address: Signature: Date: • OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason(Sec.7031.5,Business and Professions Code:Any city or county which requires a permit to construct,alter;improve,demolish,or repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he or she Is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500).): ❑ I,as owner of the property,or my employees with wages as their sole compensation,WILL DO THE WORK,and the structure is not intended or offered for sale(Sec. 7044,Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds or Improves thereon,and who does such work himself or herset or through his or her own employees,provided that such improvements are not Intended or offered for sale.If,however,the building or Improvement is sold within one year of completion,the owner-builder will have the burden of proving that he or she did not build or improve for purpose of sale.). ❑ I,as owner of the property,am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to construct the project(Sec.7044,Business and Professions Code:The contractors License Law does not apply to an owner of property who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: Signature: Date: Owner ID verified by drivers license. 0 Yes 0 No Drivers License No. Expires: Verification of Ownership by(type of document,i.e.-property tax bill or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certify that no excavation five(5)or more feet in depth into which a person Is required to descend,will be made in connection with work authorized by this permit,and that no building structure,scaffolding,falsework,or demolition or dismantling thereof,will be more than thirty-six(38)feet high.(Chap.3.2,Grp 2,Art 2,Sec. 341,Title 8,California Administrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require a permit from the Division of Industrial Safety,as noted above,unless such person has a permit to do such work from the division. Signature: Date: Division of Industrial Safety Permit Number: HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the applicant or present or future building occupant need to file and certify a Business Plan for emergency response to release or threatened release of a hazardous material? 0 Yes 0 No (Section 25505 of the California Health and Safety Code requires,with some exceptions,that a Business Plan be filed with the Costa Mesa Fire Department by every business which has at any one time during a reported year a quantity of hazardous materials equal to or greater than a weight of 500 pounds,or a volume of 55 gallons, _or 200 cubic feet of compressed gas at standard temperature and pressure). 2 Does or will the applicant or present or future building occupant need to file a registration form for acutely hazardous materials? 0 Yes 0 No (Section 25533 of the California Health and Safety Code,with some exceptions,requires registration with the Costa Mesa Fire Department by each business which at any one time has on hand a quantity of acutely hazardous materials equal to or greater than a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas at standard temperature and pressure). 3 Does or will the applicant or present or future building occupant need to prepare an RMPP(Risk Management and Prevention Program for acutely hazardous materials)? ❑yes ❑No (Section 25534 of the California Health and Safety Code provides that the Costa Mesa Fire Department may require the preparation,certification and filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. 4 If an RMPP is presently required,has Section 25534 of the California Health and Safety Code been fully complied with? 0 Yes 0 No 5 Does or will the applicant or present or future building occupant require for the work which is the subject of this a plication •a emit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? D Yes U No (Section 65850.2 of the California Government Code requires that the requested information be furnished on applications for non-residential building permits). 8 W III any part of the facility to be constructed under this permit be within 1000 feet from the outer boundaries of a school? b Yes 0 No (If'ryes",the facility must meet the requirement of Sections 25534 and 42303 of the California Health and Safety Code). 7 If a permit from the South Coast Air Quality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (II'yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalty of perjury that I have read this application and state that the Information given is correct. I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. • Of Legal Owner(s) „7 / Date 7ndOrAuttwrrzedApplicant ..e.,....—... 7-t/ CODE I, INSPECTION TYPE PAH MALI COPES iLISPECIION TYPE MI IMAla 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site .a 204 Final Demolition 250 Final Building/Occupancy —�j 1JttJd7 &wit ,t I \ I • City of Costa Mesa q, - Development Services Department CERTIFICATE OF OCCUPANCY No. 061409 Building Safety Division P.O.Box 1200 } Costa Mesa.California r The Building located at 2603 Elden Atronun #M has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto 1 for a Group R-1 Occupancy. t 4 Use of Building RrClriontial rl- •1 Legal Description 439-011-1n-15 ;.,1 (See reverse side for Metes and Bounds) ' - . Building Permit No r21R4PA Electrical Permit No. (_1RARA Plumbing Permit No. r=1 n.IRA 1‘, Mechanical Permit No. M1Q7%,M)r1121 Number of apartments • /n and/or guest rooms �i . ISSUED TO: Building Official /� r /� ee _ 1 - 77 8226 w lden Ott by ntopnt ` --17, C' (i i t-1 Irvine, Ca. 92714 Date /—1 .) )Lei✓ /7 f) t This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the 1 Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. ',fr CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File t A • - .r City of Costa Mesa Development Services Department Wilkie yin A{ Building Safety Division CERTIFICATE OF OCCUPANCY No. 151 it lei cy P.0.Box 1200 Costa Mesa,California The Building located at 2603 Vidan Atrnnnc $M has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group R-1 Occupancy. Use of Building Racident Cal Legal Description 439-071-10-1R (See reverse side for Metes and Bounds) Building Perm it No (:1RAnd Electrical Permit No. aiRARA Plumbing Permit No. r_1 ail cm Mechanical Permit No. hf1977FiM7n1Az Number of apartments / and//or guest rooms . ISSUED TO: Building Official /J Mar-Elden Develoranent / 18226 W. McDurriott by Irvine, CA 92714 Date . . , 'r i 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 (e) U.B.C. CMF 1015-46 rev.1/83 White-Owner;Canary-Numerical File;Pink-Bldg.Permit File Alt c�.. ' Applicant to fill In all spaces except_those within heavy border lines and sign all appropriate declarations. • •LJF Ci*>TA MESA PERMIT NO. �` TRACT NO. LOT NO. BLDG.NO. 1263' " .;,NST1.LYCTION PERMIT. � fj��l �a�qy I-! 4���ie5. • _ 0.76955 Project•Address den Ave. ;M TYPE OF CONSTRUCTION )4NEW ❑ ADD U ALTERATION LI REPAIR Applicar•1's Mailing Address• 18226 W. McDurmott. Irvine ❑ CONVERSION ❑ DEMOLISH 1ep OTHER —] A-P•# Zone - SOwner's Name Mar-Fl den Development Phone474-D601 DESCRIPTION OF WORK le-L,LJ Q➢17_QJ u 39—fir/` ��-'+7:r .R•� S Main Building: Accessory Building: 11.1 Address 18226 W. McDurmatt, Irvine 92714 Iq� $L E I • Chris R. Stephens C12963 TYPE OF PERMIT UGRADINGjs L,V FOUNDATION STRUCTURAL T Front 'L© • Arch/Eng. License No. ❑ TENANT ELECTRICAL C�J.PLDM BINGMECHANICAL B Rear d�'s� �p -Address 18226 W. McDurmott,, Irvine 92714 ❑ BOTHER A ."t l l�'tr Contractor's Name The Richard F. Crawfor¢h�. 474-0551 PROJECTDESCRIPTION 50. F - r5���` x '�I TICUPANC K Right , (/Address(mailing) 18226' W. MCDurmott, Irvin 92714' CON ST RUCTION TYPE V 1Y VALVATION$� t S Left iS( GI •City License NO. ZONE GRADING CU.YDS. ACRES -. J !'' ((�� .q.} 3-. 3t��p Ping- Ref.# Q- -SI'� r7��lyf Park.Fees $ �� 7)�/ -Q.�\.y LICENSED CONTRACTOR DECLARATION Remarks: 13C07g10-sc.J Parking Req./Provided 3o ! 30 M I hereby affirmthatI amlicensed untlerprovisions of Charter + (commencing Wwithsection7000) ofDivision3ofttie^Business antl P.ot ons Cotle,antl � Use of Building: conat, l •I my license is in full force and effect. - �- - LicenseJC ass t� se :G PLUMBINGIFEES Planning Notes: �_—_s__ - -- -•• r•,.nsirTr'nin.Date "/•/1—Signature S _ ITOLD toot ai E•+�"�'��''- -WORKERS'COMPENSATION DECLARATION r9 Bar Sink ! Showers Z �.1 hereby affirm that I nave a certificate of consent to self-nsure ora certificate Backflow Preventer Service Sink - of Workers' Compensation Insurance, or a certified copy hereof (Section. - - 3800, Lab. C.),,;;.,....,/ '- ' >- ' ., Backflow Irrigation Sewer Cap =i'• - —• - - ELECTRICAL - FEES+ .! Policy No. J J CO - Co • • a i.r-• v i7 _ _. -' _ _ tifietl copy i5 hereby turn fished. r , Bathtubs • Sewer Connection Si,. ' .r„ • i_ 4, . Automatic Washer. -7. , Transformer 0 15-50 KW- ��/y`Ce�L�rtifjeq co y i}fi�9d with the city B ys• visi.! • Date N r ze•O S Applicant �a�!- Ai �� Clarifiers Solar Collectorss, j i • % Construction Pole Sub.• 0 50+KW EXEMPTION FROM WORKERS'COM PENS• • 'IIrE ARATION , Dishwasher Solar,Piping - ' • 2 •- Cooking Unit Meter ❑up to 100 amps (This section need not be completed if the permit Is for one hundred ($100)or,: _ less). - , 7• - Di-inking_ Fountains • ' ` �r C I certify that In the performance of the work for which this permit Is issued:I"' Solar Tank . -ems / Dishwasher '' / Meter (ver 100 amps r 5 shall not employ any person in any manner so as to become subject to the-. - a , Workers' Compensation Laws of California.. ' ., Floor Drains Swimming Pool w/Sipa L.!,, (i(f,,:. / Dryers as DElectric / Sub Panel - 6 Date Signature - — - - NOTICE:lf,'after making this declaration, you should become subject to the_ Floor Sinks 1 Urinal - / Fan, . ...- ._ Motors 00-1 HP.❑1'/z-8 —. workers' Compensation provisions of.the Labor Code, you must forthwith comply with' such provisions. or this permit shall be deemed revoked. Gas Service 2-Outlets Water Closet - / CONSTRUCTION LENDING -AGENCY - 2• / F,A,U. Inc,Solar ❑9-15 HP ❑16-15+ I hereby affirm that there is'a construction lending agency for the performance Interceptors • / Water Heater ,ZFixtures :Microwave • ..//C ' of the work. for which this permit •is issued (Section -3097 Clv. C.) - �' �� Fix:tures Y Lender's Name' - c/ Kitchen Sink 41/ Water Service _ Device Boxes .Pole Light Lender's Address - Lavatories y OWNER BUILDER DECLARATION • • I - 3 I - - y3 Outlets Range - • 7�O I hereby affirm that 1 am exempt from the Contractor's License Law for the OCn following reason (Section 7031.5 Business and Professional Code: Any city or •- P-Trap . /I/ Switches ' Sign 41 CO county which requires a permit to construcalter,Improve,demolish:or repair — - . ,: ; t,ily structure, prior to its Issuance, also requires the applicant for such permit . . Roof Drains •- I - / Garbage Disposal Standing Sections • ,.;;:.,:p file a signed statement that he/she is licensed pursuant to the provisions of ,'"the Contractor's License Law(Chapter 9(commencing with Section 7000)of - • •Generator ❑0.5 KW ❑5-15 KW Trash Compactor Division'3',of the Business and Professions Code) or that he/she is exempt , - pa 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 'Rains coon Fee3 - ' eenalty of not more than five Hundred dollars($500). , pe I $25 _ Issue Fee - $ , LJ I;.as owner of the property or my employees with wages as their sole ' MECHANICAL • Reinspection Fee $25 Issue Fee $'3 compensation, will do the work,and the structure is not Intended or offered , FEES - for sale (Section 7044, Business and Professional Code: The Contractor's - PUBLIC SERVICES REQUIREMENT': License Law does not apply to an owner of a property who builds or Improves Boiler Hood or Type I ❑ thereon,.and who does such work himself/herself or through his or her own - Zoning Approved By PP Date 4 t O/qtrJ' , employees, provided that such improvements are not Intended or offered for Canopy Type II 0 - sale. If, however, the buildingor Improvement Is sold within oneyear of com- Duct-Under Ground I�\, I S Application Approved By - tom- Date ' ;Melon, thetowner will have the burden of proving he/she did not build or im- prove m- I //!'� move for the purpose of sale). Duct-Structural Refrigeration System • Application Issued By . ;i'�.� Dat: ii���<77 LJ I, as owner of the property,am exclusively contracting with licensed con- ❑0.100,000 BTU ❑100,000 BTU tractors to construct the project (Section 7044,Business and Professions Code: Duct-Ventilating • SU OF • -The Contractor's License"Law does not apply to an owner of property who BUILDING PERMIT $ a� SMIP $ e�� builds or improves thereon,and who contracts for such projects with a con- Exhaust System 0 Multiple 0 System Repair/Alteration tractor(s) license pursuant to the Contractor's License Law). PLAN CHECK $ S •Z• PERMIT 0 I am exempt under Section B.& P.C.for this reason ' Firepl/Fact.Bit. ICBG# PLUMBING $ .1,5-.oat ISSUANCE $ Date owner m Heea g System& Ducting 471 PLAN CHECK $ - ' SO ENERGY P.C. $ • I.hereby certify that I have read th pplication and state that the above / 30.100,000 BTU 0 100,000 BTL. .. GRADING $ Information is reef. I agree c• with I city and county ordinances ELECTRICAL $ qtr-� , and state law •in• ••struct . , nd hereby authorize repre- MICROFILM $ sentatives o ; y ♦'C�v t- ...n t ' a•-ve-mentioned property for PLAN CHECK $ • �G•Z� / Inspection • `���/%fes / It e//# — • TOTAL FEE $ CZ SC Signature `e9ar67-- Pink-Accounting;Goldenrod -Assessor - - - - - - - CONSTRUCTION AND PLANNING - •• P��L &SPA 'tgDPROVALS Permit# Dater Inspector APPROVALS Permit# Date Inspector " • s, 1. Temporary Electrical Service or Pole. - - 52. Pool & Equipment Location • 2.j Soil Pipe-Undrgrnd. �( a fel: NC 53. Steel Reinforcement • 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4 4. Electrical Conduit-Undrgrnd, .570116-5-- �i w • 55. Electrical Bonding - -� { 5. Steel Reinforcement 4 Yl4/$s , 56. Rough Plumbing & Pressure Test "f .-n 4 i 6. Electrical UFER Grnd. , - 57. APPROVAL TO COVER-GUNITE 7. Footings "44;57;( / ' Put58. Electrical Conduit-Undrgrnd. ,. • 8. Foundation S' LZ}46 /i($Sr: kyr • 59. Gas Pipe, Undrgrnd.,Test �r I 9. Water Pipe-Undrgrnd. • r' i • � 1 _� 60. Backwash Lines,P-Trap, 0 Undrgrnd. . i 10. Structural Floor System �,-i , ,61. APPROVAL TO DECK • • 11. Property Sewer Line &'House.Conriection 5/d/ ' tie° 62. Backwash & Receptor-Final 12. Sewer Cap 7�`• f • i -j 63. Heater & Vent-Final i 13. Roof Drains J- • ,• 64. Plumbing System - Final t 14. Rough Plumbing r�'/5'94'(ar 65. Electrical-Final • it 15. Rough Electrical-Conduit ' 1 66. Solar System-Final • .16. Rough Electric Wiring $'1�/� et 67. Fencing & Access Approval ' • `17. Rough Wiring Sign 1 / l 68. APPROVED FOR PLASTERING 18.•Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT : 20. Rdugh Factory Fireplace APPROVALS Permit# 21. Ducts, in Structure 70. Underground Hydro 22: Ducts, Ventilating. . 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough &'Test 72. Underground Flush - 24: Roof Framing 73. Undergrnd.Storage Tank O Gas ❑Oil 25. Roof Sheathing -7/44/5- en/ 74. Overhead Hydro 26.. T-Bar-Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing ]fl/ ear76. Dry Standpipe I B 28. Lathing &•Siding r// s.?.... >'>NZ 77. FIXED SYSTEM FINAL 29. Insulation - ;At - / 78. FIRE PREY. FINAL 30. Drywall Nailing 8.451S- " HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final r.) 80• FOOD CERTIFICATE ISSUED el33. Final Electric {r ,�� '�� Notes: t-<<9/F,f 34. Final Heating & Air Conditioning /4/2yrdc(.jO � ,fir 4 _.L D-�' ter 35. Final Gas Pipe-Test f,/t�/6,r c. ) . "2-4.4664;10A ,44. 6-i. ✓0`KYttCGlv/75" - /i'i7 36. Hood or Canopy `C `1/ //, 37. Final Factory Fireplace•' - ' 38. Final Plumbing - ///f/a''Tfn 39. Water Service-Final 13401f.r C449 40. Gas Service-Final • : - 41. Solar Domestic-Final _ . • 42. Backflow Preventer - 11 43. Backflow Irrigation _ • " • 44. Landscape Irrigation System • - - ' 45. Sound Attenuation , • 46. Handicap Regulations :; 47. FINAL STRUCTURE &BUILDING /t1 45- e711 . 48. Special Requirements Completed 1 ll.../-8S n/T� 49. Electric Release to Edison V 50. Gas Release to Southern-California Gas Co ; . . . 5;1. CERTIFICATCPCCUPA/- Yo � "" , _ ' No:. / 97Date . Ifir • R '( ' ' Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. 6186 7/08/85 - 21 a 7E TL CITY OF COSTA MESA CONT UCTION PERMIT /PSEER//JMIT NO7 7co TRACT NO. LOT NO. UNI N - ProjectAddress !_60.5 �ea e6 - - -/� t t - I _ 'Applicants Mailing Address �7 /'P$ y /�'�! • TYPE OF CONSTRUCTION U NEW LI ADD U ALTERATION LJ REPAIR ` „ ❑ CONVERSION ❑ DEMOLISH ❑ OTHER A,P.# Zone Owner's Name M'fa..r, ALr7rm7 / T!due- it Phon 0P/- DESCRIPTION OF WORK/USE OF BLDG. ' Address ly f ,+ScLrsit Ak,4 &�' S Main Building: Accessory Building: ' Arch/Eng. Cede"' Jt fiCS License No. TYPE OF PERMIT ❑ GRADING U FOUNDATION U STRUCTURAL T Front • p Address �// ��[ L�(� ❑ TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL R Rear N Contractor's Name W eetA�b y�'.46Phone 692 ' ❑ OTHER • A I /� �/ aa4.4t PROJECT DESCRIPTION SQ. FT. - OCCUPANCY C Right N Address(mailing) / �� I tams ear Gam' CONST RUCTION TYPE _ VALUATION$ S Left G City License No. _ �/ Sl-'LG .-ZONE _ GRADING CU.YDS. ACRES _ R LICENSED CONTRACTOR DECLARATION - Ping. Ref.# Parking Req./Provided E I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: Planning Notes: • Q with section 7000) of Division 3 of the Business and Professions Code, and M my license is in ful force and effect. $ T License s License No Date Signature - PLUMBING FEES WOR ER '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 - - 3800, Lab. C.) — Automatic Washer Transformer 0 15-50 KW • Policy No. Company Backflow irrigation Sewer Cap Construction Pole Sub. 0 50+KW ' — Certified copy is hereby furnished- I _ Certified copy is filed with the city Building Division. Bathtubs • - Sewer Connection Cooking Unit Meter Dula to 100 amps Date Applicant - - - EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred ($100) or - less). Dishwasher Solar Piping ' Dryers ❑Gas, DElectric Sub Panel I certify that in the performance of the work for which this permit Is Issued, I - shall not emplo any person in any manner so as to become subject to the Drinking Fountains Solar Tank Fan Motors 00-1 HP 01%-B Workers;her of Calif Orn' . Date T Signature_ Floor Drains, Swimming Pool w/Spa F.A.U. Inc.Solar 09-15 HP ❑16-15+ 'NOTICE.If,a ter making this declaration,you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks ' Urinal - - comply with such provisions or this permit shall be deemed revoked. Fixtures- Microwave CONSTRUCTION LENDING AGENCY Gas Service Outlets Water Closet - Device Boxes -:1 hereby affirm that there Is a construction lending agency for the performance - Pole Light • of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Outlets Lender's Name - - Range L elider's Address Kitchen Sink Water Service Switches Sign • NER BUILDER DECLARATION I'hereby affirm that I am exempt from the Contractor's License Law for the Lavatories • following reason (Section 7031.5 Business and Professional Code: Any city or Auto-Wash Garbage Disposal ;Standing Sections county which requires a permit to construct,alter,Improve,demolish or repair P—Trap y y' Laundry Trays Generator ❑05 KW 051KW any structure, prior to its issuance, also requires the applicant for such permit - - 5 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 J penalty of not more than five hundred dollars($500). --- LI I, as owner of the property or my employees with wages as their sole Reinspection Fee , I $15I Issue Fee $ 3 compensation, will do the work, and the structure Is not intended or offered ' Reinspection Fee $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- - Canopy Type II ❑ 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 Data 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 , 2...Duct-Ventilating 00-100,000 BTU ❑100,000 BTU Gel SUMMARY OF FEES builds or improves thereon, and who contracts for such projects with a con- tractors) license pursuant to the Contractor's License Law). I am aware thatExhaust System 0 Multiple 0 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.A P.C.for this reason ' Firepl/Fact.Bit. ICBO# Fire Dampers PLUMBING $ PERMIT -ISSUANCE $ Date owner Heating System& Ducting Q Registers 7 90 PLAN CHECK :25% $ ENERGY P.C. $ I hereby certify that I have read this application and state that the above / X10.100,000 BTU 0100,000BT - - - GRADING $ information Is correct. I agree to comply with all city and county ordinances - CI ELECTRICAL $ and state laws relating to building construction, and hereby authorize repre- • PLAN CHECK '50% $ MICROFILM $ sentatives of this city to enter upon the above-mentioned properjy fo� inspectionureql /G/� - • MECHANICAL $ 1K, TOTAL FEE $ O-Y 73 Signature ����,/ Date .♦f.= • Drivers' License or SS# Pink -Accounting; Goldenrod - Assessor V CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pple. '. 52. Pool & Equipment Location -- 2. Soil Pipe';Undrgrnd. 53. Steel Reinforcement 3.'Electrical Cdnduit'Utility-Undrgrnd. 54. Forms °'I 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding 5. Steel4Reinforcement 56. Rough Plumbing & Pressure Test 6;'Electyic61 UFER'Grrfd. 57. APPROVAL TO COVER-GUNITE 7,`Footiiig5 58. Electrical Conduit-Undrgrnd. .8.1Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgr'nd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10..Structural Floor'System 61. APPROVAL TO DECK 11.'Property Sewer Lin&& House Co'rinection 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 /Il4I La 71. Product Piping 0 Gas 0Oil 23. Gas Pipe-Rough& Test 72. Underground Flush iil' 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas El 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 I / 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 MESA CONSTRUCTION PERMIT ,�P/ERMIT NO. • TRACT NO. / LOT NO. - UNIT NO. , ' A• 80DB B/OZ/B5 Q.OQ 'TL . Project Address a&a QLD 6,ej I:HI E )) 120 I 9) • r/ar2 z-r�{' c A-i � - ' ; c. , Applicants Mailing Addies5 aces-- /ft M. .'.. g / ' - TYPE OF'CONSTRUCTION to NEW /L. ADD LI ALTERATION Li REPAIR , - - ' r ❑ CONVERSION DEMOLISH.❑ .❑ OTHER r Zone Owner's Name ft't$121- E� gPhone c/ _o9/ly A.P.AP #• �3 9 d 71 �Q �3 I �'�� + Z�], rSu .c ` "kr DESCRIPTION OF WORK/USE OF BLDG. - Address - S Main Building: _ Accessory Building: • �s.�' E Z Arch/Eng.r4 S 's License No. C' /'ZFS ? TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL T Front • - O Address ��.a CITENANT 0-ELECTRICAL CI PLUMBING MECHANICAL '.,B Rear , ' - .. N Fie�a�C/li��'fsrtl! sffl-X09/1 • ❑-'OTHER A g Contractor's Name .0 Right - - N Address(mailing) -.gyri.•.= PROJECT DESCRIPTION SQ. FT. • OCCUPANCY K Left _ • �] CONSTRUCTION-TYPE VALUATION$ $. -City License No. 79t/�6 - ZONE GRADI NG CU.YDS. ACRES - . • R Ping. Ref.# Parking Req./Provided E LICENSED CONTRACTOR DECLARATION I hereby affirm that ''am licensed under provisions of Charter 9 (commencing Remarks: G 7(i`' i 'S"9 • L( 1 ' - Planning Notes: _ - M with section 7000).of Division 3 of'the Business and Professions Code;and 111, T my license is in full fort effect. i �i��,l�' � I,G2 ` `tS*1 • - • 1' $ Licens Class 'A,.,�.icense No. 7 CJ `.� Dat ` " Signature /f'y�(G/ - i PLUMBING - • FEES) _ WORKERS'ICOMPENSATION DECLARATION • , ' I hereby affirm that have a certificate of consent to self-insure or a certificate Bar Sink Showers , , ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section - Backflow Preventer • --I- -Service Sink - - Automatic Washer Transformer'❑ 15-50 KW" 3800, Lab. C.)` 2fL� 0 50+KW Policy No. C+ ) Company S � fei1✓� Backflow Irrigation. Sewer Cap j Construction'Pole Sub. ertified'copy is hereby furnished. , _ - , Certified copy is filed with the city Buildin Bathtubs Sewer Connection Cooking Unit Meter Sup to 100 amps Date Applicant • EXEMPTION_ FROM WORKERS'COMPENSATION DECLARATION Clarifiers , Solar Collectors Dishwasher Meter Dover 100 amps (This section need not be completed if the permit is for one hundred'($100) or - less). Dishwasher' Solar Piping t - 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 TankFan Motors 013,1 HP ❑1%-8 Workers' Compensation Laws of California. - Date Signature Floor brains 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- - ' - - Microwave - -- --- comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY - Gas Service Outlets • Water Closet , Device Boxes I hereby affirm that there is a construction lending agency for the performancePole Light of the work for which this permit is issued (Section 3097 Civ. CJ • • Interceptors - - Water Heater Outlets Range •Lender's .Name - " , Lender's Address - Kitchen Sink. - Water Service Switches ' ' Sign OWNER BUILDER DECLARATION - - • I hereby affirm that I am exempt from the Contractor's License Law for the ' Lavatories I • Auto-Wash - Garbage Disposal 'Standing Sections following reason (Section 7031.5 Business and Professional Code: Any city or — • - , county which requires a permit to construct,alter,improve,demolish or repair • P-Trap ' - Laundry.Trays , Generator ❑0-5 KW ❑5-15 KW ' any structure, prior to Its issuance, also requires the applicant for such permit - Trash Compactor • '.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 r . - , Division 3 of the Business and Professions Code) or that he/she is exempt - '.herefrom 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 . ''' - - , ' , - - , • penalty of not more than five.hundred dollars ($500). , - - r ' O 1, as.owner of the property or my employees'with•wages as their sole Reinspection.Fee I $15 , ' Issue Fee_ 1' •' $"3 , - compensation, will do the work,ands the structure is not intended or offered - Reinspection Fee , $15Issue Fee $ 3 for sale (Section 7044, Business and Professional Code: The Contractor's ' - ' t MECHANICAL FEES License Law does not apply to an owner of a property who builds or improves _• -� , Boiler 1 thereon, and who does such work himself/herself or through his or her own , ' Type - DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for - Hood or I 0 Zoning Approved By • nate - sale. If, however, the building or improvement is sold within one year of com- Canopy Type II ❑ - , pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground' ' • Building Approved By -7-- —CFS—Date----6-1r-- i DatO prove for the purpose of sale). Z ❑ I, as owner of the property, am exclusively contracting with licensed con- , Duct-Structural Refrigeration.System Appliation Issued By - Date — tractorsto 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 ❑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 0 Multiple 0 System Repair/Alteration BUILDING PERMIT $ SMIP • $ proof of their Worker's Compensation insurance should be provided to me. i _ PLAN CHECK $ PERMIT p ❑ I am exempt under Section B.& P.C.for this reason / Firepl/Fact.Bit. ICBG# Fire Dam 14-( pers PLUMBING $ ISSUANCE $ • Date Owner ' I Heating System&Ducting n Registers PLAN CHECK 25% $ ENERGY P.C. $ • I-hereby certify that I have read this application and state that the above ' • ❑0100,000 BTU 0100,000 BTU - • - ELECTRICAL $ ' GRADING $ information,is correct. I agree to comply with all city and county ordinances ' and state laws relating to building construction,and hereby authorize repre- PLAN CHECK 50% $ , ' MICROFILM' $ sentatives of this to nter upon the above-mentioned property for - ` • inspection purpose / /r i I MECHANICAL $. O �.� Signature Pink -Accounting; Goldenrod -Assessor . CONSTRUCTION AND PLANNING POOL .PA _ - DateInspector APPROVALS Permit# . APPROVALS Permit# Date Inspector -r 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•.Uridrgrnd. . 53. Steel Reinforcement 3. ,Electfical•G''onduiX,Utility-Undrgrnd. 54. Forms 4::flectrical Cdnduit-Undrgrnd. +i'; i 7. 55. Electrical Bonding - ' J 5':$teellRei,hfbrcementa i 56 . Rough Plumbing & Pressure Test 6:,;:E1ectrioal UFER'Grnd., ' 57. APPROVAL TO COVE R-GUNITE 7.-F,00tiigs ', .21 - ;; 58. Electrical Conduit-Undrgrnd. 8:`,Fd"unda{ion 'r - 'f •,' 59. Gas Pipe, 0 Undrgrnd.,Test. 9. Water%Pipe-Undrgind. . 11. 60. Backwash Lines, P-Trap, O Undrgrnd. ., 10MStr'tictural Floor System '' 61. APPROVAL TO DECK 11.P opertySewer It')he & House Connection 62. Backwash & Receptor-Final 12. Sewer.?Cip 'K,; 63. Heater & Vent-Final . :' 13. RdMf.Drain / , 64. Plumbing System - Final - 14. Rdugh PluMpingi. 65. Electrical-Final p 15. Rough Electrical;Conduit 66..Solar System-Final 161-.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 . - 8r/s/dr caw APPROVALS Permit# _ 21. Ducts, in Structure I 70. Underground Hydro 22, Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil . 23. Gas Pipe-Rough& Test f..,• 72. Underground Flush .f . 24,• Roof Framing - f; 73. Undergrnd.Storage Tank O Gas O Oil 25. Roof Sheathing • / 74. Overhead Hydro 26. T-Bar Ceiling (Structural) &'Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe '• - 28. Lathin & Sidin Vii' �' 9 9 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 I 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning - 35. Final Gas Pipe-Test - - - 36. Hood or Canopy 37. Finaf.Factory Fireplace • /0fr9/i5' (-- ) . 38. FinabPlumbing ' 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 -