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HomeMy WebLinkAbout2200 HARBOR BLVD - Building Permits (6) ac"li.t�� CITY OF COSTA MESA y! �`4. BUILDING DIVISION t' ' DEVELOPMENT SERVICES DEPARTMENT �• PERMIT PERMIT NUMBER 4441boierret 1 (714)754-5273 • Fax(714)754-4858 77 FAIR DRIVE,COSTA MESA,CA 92626 ELECTRICAL PERMIT Job Address: 2200 HARBOR BL Status: ISSUED Suite No 11 Applied: 07/08/1998 Vicinity: Issued: 07/08/1998 Parcel Nunmber. 41903106 Applicant: JOHN NIRSCHIL Address: Phone: • • • ill --7��\ A i I i \ / ��L Owner: GRAY ENTERPRISES i 11 //C.,---,:-.,-. • Address 1421 EDING/ER•AV#� ��- I I �� �, zir, TUSTIN,CA --Zip:- 92680'--�_ J Contractor: FLUORESCOSIGNS No �L� ( \CI\ (fry N / J/A,.i Address:7 870 W CIENEGA #7 A� //(� A/7 /(��i Phone'4909-592-0870 \,-�`\ 7!1 \ SAN,OIMAS,CA Zip: 91773 _ \•ISA A�r }}��� \� ;/ .- -c:: ;License) 738628 I " f �/ ��\ c "1 1.11( l C l�/%r / Il �l 1i. i •\� �� L. _/ 2.7/.A ` 7 �:F?1 'L`SCOPE OF PERMIT_- - c_ A' \\\„,, r '\''''\' 1 �,/ electrical for illuminated wall sign,re:sb98-00087 '�� - - I SAI �A i i �, ��y> ` \ A 7/- :;Ii _ / 9',Hr � FEESUMMARYV fr • � -r--� A �� ,<� I ! A1,,,'antI O� 5,�� Ind i �., ?�!, °"1 KIsl;, A '.,, • , Quantity _ _ r Quantity - • J \ ISSUE FEE 1/,'-I I $22.00 Temp Dist System/:Lighting / $0.00 0 Terrrp Service-test,'V,1‘,"', l'• $0.00 \ , Busway/100 ft N. $0.00 0 - . Rea' a/c package s $0.00 A . t "Standing Section (.�_,_ , $0.00 0 , - - NewrRes(1t2 units) VV 1�. $0.00 - • �_' - ,Mist Eledrical,Equiprnent " '' ,: $0.00 0 , Iii;' New Res.(3+units) \;\\'',;, $0.00 Transformers up-to Ykva/kw" $0.00 0)` , Pool/Spa ( I $0.00 up to/10 kva/kw l $0.00 0'• - , Li htin` Fixts----- " �' 9 01'� $0.00 up.to 5.0 kva/kw �$0.00 0/1; �, �� Recept Outlets v\", $0.00 $0.00 F -up to.100 kva/kw $0.00 -0,' 4 1 / / Switches \&\ V\ \\ \.i6$0.00 over 100 kva/kw !$0.00 %0' I / t Non Res ApplV��/ k $0.00 �I Low,Voltage Equipment I$0.00 A�0 "-- �/,; i Res Appl \ - \$0.00 , Cti ,LLovi-Volt Wiring System/Ckt $0.00 0 l I Service to 200a, �L $0.00 '-11 'Misc/Conduit, $0:00// 0 ; Service to 1000aA $0.00 l } y- ,4•Q°Misc.Conductor x$0:00" 0S_' /1�� Service over 1000a -$0 00\� V Crrcus(gen or,ride) •,-2-5.,$6.00/ 0 Motors to 1hp A ///$0.00�V !, V�o ��Cucus(mech ride-or lights) -$0.00.0 ,0 „C\ Motors to 10hp A' '/,$0.00 N ,C. 7)Y-S1 '1 Christmas Tree Stand'��- $0,00 �/o 1 Motors to 50hp '� $0.00,- A��� v Fireworks Stand A/ $0.00,,�0( / Motors to 100hp $0.00 7.-\ _�� -,Other Eiec Stand- \( -10.00 �),/ Motors over 100hp $0.00,;(7 //."- - --` _ _ -- 1,, ," /i AV Communication drops - $0.00 /, /, Investigation.Fee i i •,`c"$0.00' Sub panel to 200a $0.00 ,, C ,��/ t1J�� ;_ Plan Check Fee a\1\ -$0.00: Pole Light Pkg $0.00. -r i / _I , - 'Reinspection Feed . ;;,$0:00 Sign Circuits $22.00 -V1; _ --� �,N�.;' _,-...,Ji Temp Pwr Pole . $0.00 0 ---- r .TOTAL CALCULATED•FEES $44.00 Intermed Pole - $0.00 COMMENTS/SPECIAL CONDITIONS • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned fora 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)75456226 • DECLARATIONS ' 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 parfomlance of the work for which this permit is Issued. O I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit Ls issued. My workers'compensation Insurance ( cu] er d icy number are: Cartier: Policy Number6—C.4.-/.4.-)6C0-5 LV A)6& —S - / d< /// (This section need not be completed If the permit Is valued at one hundred dollars($100)or less.) • ❑ I certify that In the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of Califo and agree that If I should become subject to the workers' pensatlon provisions of Section 3700 of the Labor Code,I shall forthwith comply with the sio n (1 _s Applicant Signature: Date: /7 E 9 &' WARNING:FAILURE RE WORKERS'COMPENSATION COVERAGE IS UNLAWFUL MD SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES MD CIVIL FINES UP TO ONE HUNDRED THOUSAND .000).IN ADDITION TO THE COST OF COMPENSATION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE,INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Secl1e6 7000)of Division 3 of the Business and Prof Ions code,and my license Is In f force and effect.Uc.# 2 3 t G 2 Fl / Class a C rt. 7C 7 gt` p Contractor's Signature: , Date: " — S — CONSTRUCTION LENDING AGENCY: ❑ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued.(Sec.3097,CMI Code). Lender's Name: Lender's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby affirm that under penalty of perjury.that tem 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'}o 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 i5,Ilbealsdd pursuant to the provisions of the Contractors Ucense Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professices'Codk dr,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 jo eaiCii i penalty of not moors than five hundred dollars($500).): ❑ I,as owner of.thee..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 Ucense Law does not appy 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 Ls 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 Ucense 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 Ucense 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(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, a 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&ppermit for such construction or modification from the South Coast Air Quality Management District or from any other air pollution control district or agency? PI 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 Califomia Health and Safety Code). 7 If a permit from the South Coast Alr Quality Management District or other air pollution control district or agency Is required for the work which Is the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes 0 No 8 (If'yes',attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE:I certify that under penalty of perjury the information given above Is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to comply with all state laws and city ordinances relating to building construction,and authorize representatives of the City of Costa Mesa to enter upon the above-described property for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final Inspection. Ign lure Of al Oytnner(s / go__ 7^ _ }a --796 And/Or Auth died Applicant f Date • =LS IaseErnoa TYPE gait' ItIMIALs CQ9EJ IKSPECToa TYPE gdlE WUUMS 1818 Fixed System Final Fire Prevention 206 Final Mechanical 1268 '~Pool ape 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 Anal Bu_ilding/Occupancy 2446-46 40 . ,'i !4r- CITY OF COSTA MESA y , b. i BUILDING DIVISION ti 1 DEVELOPMENT SERVICES DEPARTMENT S898-00087 PERMIT PERMIT NUMBER (714)754-5273 • Fax(714)754-4856 BUILDING PERMIT 77 FAIR DRIVE,COSTA MESA,CA 92626 Job Address: r21200 HARBOR BL Status: ISSUED l Suite: ` Applied: 07/08/1998 • Vicinity: Issued: 07/08/1998 Parcel Nunmber: 41903106 Zoning: Applicant: JOHN NIRSCHL Address: 870 WEST CIENEGA#7 Phone: (909)592-0870 SAN DIMAS,CAZipL ,91773_` - _wit) /o Owner: GRAY ENTERPRISES � ' I i ._ , Address 1421 EDING/EF2"AV uA% 1- �� �� �� & Q Z4 \ Phone:i 1 LA!? /. , Dps TUSTIN,,CA�� ='Zip:-92680 � 407 C \ \ /2/cam '.:,--_—'-:±T"1--'---`•-__ _------7,,<:----.._-..„,::\ ContractorUORESCO IONSI j�� ;� �- CN,/ ��A�Addre 70 W CIENEGA,#7� ��������\� gi, N / � Phone: 909-592-0870 '\ \/\/\x/ ��-.\ SAN DIMAS;CA' Zip: 91773 \V� //� iw License:/�738628 , \ �\ \Address li.,�`;� I ; j�'_" ,\‘)-\\\\, , -�' ` \ \. v ill/'?+' (i�� SCOPE OF PERMIT ----- 71 V \, 14 ^\ , l l \ ,i y w 58.2 sq.ft.illumin�d wall sign,29.36sf monument change of face - �' ' ', • I '\! t / i 'i., i 0/:9.'Irn fLP ni'nlnic;1:n� (I >f^"G.l , - Plan Check: ',R.? Calc Valuation: $9.9 0 ��PeFmit: '' 7? Claimed Valuation: ??; 'I ,SMIPRes: 1'l,?? ' _,\-'��' ._- ct,- i�' .r' \SMTP Com: �`1\$1.05 " r (---- —� L1\ Other:) ??fi ! / i v i , ii i inspection. , -:\ \I I /�' . ` Total:• / $165:64 i / _vnL /,/ / , �;1-/ N' PLANNING&ZONING ,"/' ' I;/ \S\, Uri �,�oo-(7,4q v,,7 .o n'�/ SETBACKS\. /2 �� /)y.)66 �;n ,tri '!i .� j��w j//; �- / / �i// MAIN STRUCTURE Front 77-??/ \Rear 77?7/°�1 9g ,Left't7-??� Q` !%jRtght ??-??- w /t, / ACCESSORY Front-77 / Rear-??j_--7 _ 'cLeft-7???- ,::% Right';]?-\4?�j/� PARKING Existing:? 'Regu ed r?? _m . Br000sed'X77 \�`\\ \\' %•j/ �� �� / r;1 I I -1 ii E: f 11 Iti i \ \ ��\'� � ..<7� NOTES: l \i . �. �j%,i • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days,or if work Is suspended or abandoned fora 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 DECLARATIONS r • WORKERS'COMPENSATION DECLARATION: I hereby affirm under penalty of perjury one of the following declarations: • ❑ I have and will maintain a certificate of consent to self-Insure for workers'compensation,as provided for by section 3700 of the Labor Code,for the performance of the work for which this permit is Issued. ❑ I have and will maintain workers'compensation insurance,as required by section 3700 of the Labor Code,for the performance of the work for which this permit is issued. My workers'compensation Insureace card r and policy number am:? / ' / 4 �y/ Cartier. (�'-Y-., � C Policy Number. G-�/it/(a�✓�7-/� (This section need not be completed If the permit Is valued at one hundred dollars($100)or less.) ❑ I certify that In the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the workers' compensation laws of California, agree that if I should become subject to the workers'-compensation provisions of Section 3700 of the Labor Code,I shall forthwith comply with(hese Drovi (� r/ Applicant Signature: �� ! Date: �` -�(1 ---01 WARNING:FMLURE TO SE 0f (ERS COMPENSATION E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS($1•••••,IN ADDITION TO THE COST OF COMP TION,DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR COOS INTEREST.AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Seco 7000)of Division 3 of the Busine��sgg and Prof ions code,and my license Is in full / force and effect.tic.e `7 3 a 7 Sl Class N C.'/4J Contractor's Signature: _ L-�•-, 42 Date: 7� 1 � CONSTRUCTION LENDING AGENCY: ❑ I hereby,a�rm 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 Jt emesL,•fr�, .. Lender's Address: Signature: 'akin kv t �f:v's Date: OWNER-BUILDER DECLARATIONS: n.,• I hereby affirm that under penalty o1 perjury that I em 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 ls licensed pursuant to the provisions of the Contractors License Law(Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toe 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 properly who builds or Improves thereon,and who contracts for such project with a contractor(s) license pursuant to the Contractors License Laws.). ❑ 1 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,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 application apermit 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 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 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 Ls the subject of this application,have all of the disclosures prescribed by California Health and Safety Code Section 42303 been made? 0 Yes ❑No 8 (If yes",attach certificate of compliance from the appropriate air pollution control officer). CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the information given above is correct.I agree to comply with all state laws and city ordinances regarding Hazardous Materials and Emissions. Signature: Date: CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY:I certify under penalty of perjury that I have read this application and state that the information given is correct.I agree to 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 properly for inspection purposes.I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. Slgneture OI LeMgal Owners) D§t�(/ And/Or A oizedApplicant Date DAM M- H4CI gOgE-I. QM If11IDALI CDDEl D1APFr.TON TYPF DATE . =ALB 1816 Fixed System Final Fire Prevention 206 Final Mechanical - '1286 Pool Spa Final 208 Final Plumbing' • - 200 Final Re-Roof 210 Final Electrical 201 Final Block/Retaining Wall 212 Anal Fire Prevention • 202 Final Factory Fire Place 220 Anal Planning Approval • 203 Final Sign 222 Final Site • • 204 Final Demolition 250 Final Building/Occupancy 2446.46 City of Costa Mesa Development Services Department CERTIFICATE OF OCCUPANCY No. Building Safety Division P.0.Box 1200 Costa Mesa,California The Building located at 2200 HARBOR BOULEVARD UNIT H • has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group 8-2 Occupancy. . Use of Building RETAIL SALES/FABRIC "HOUSE OF FABRICS" Legal Description 419-031-06 (See reverse side for Metes and Bounds) Building Permit No B61539 Electrical Permit No.E62862.E63076 Plumbing Permit No. Mechanical Permit No. Number of apartments and/or guest rooms • ISSUED TO: Building Official TONY ,C'DE BACA GRAY ENTERPRISES 11791 MONARCH STREET by GARDEN GROVE, CA 92641er'4r / / /� Date 23/i-S / 4/ This Certificate of Occupancy SHALL BE posted mica 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 • - PROJECT ADDRESS: 2200 HARBOR BL UNIT: H CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 061539 I OWNER'S RAMP GRAY ENTERPRISES • ADDREss: 11791 MONARCH ST PERMIT NO: B 06.539 ' PLAN CHECK NO: 00428-93 L GOVT; N SUPP: N GARDEN GROVE / CA 92641 CONSTRUCTION TYPE: 5—N :SP PERMIT TYPE: STR PURPOSE: OTH - - ARCH/ENGINEER: ( 714 ) 893-8373 flEC.NO.: ADOREss:DANIEL E. MACDONALD C—]ur�ilr571 JOB DESCRIPTION : COMMERCIAL T. I . (RETAIL SALES/FABRICS) SQ FT: • 14, 490 13400 RIVERSIDE DR PERMITTEE:SHERMAN OAKS CA 91423 CLAIM VALUE: CALC—VALUE: 122, 295 . 60 GROUP OCC: B-2 / ADOTEss:JOHN R . HUNDLEYA INC , (714 ) 893-8373 11791 MONARCH Si COMMENTS: THE "HOUSE OF FABRICS TENANT IMPROVEMENT, • GARDEN GROVE CA 92641 ###aE#### x############sE##iE#### #*###�6##############�E# *###*####xx#####*>F ##x>i>t# LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section z 0 N I N' G REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS clrYuc.:056925 STATELIC.:306331 `B " Date:302_,/g_ Signature: �— _ MAIN HHILDING ACCESSORY BUILDING WORKERS'CDMPENSATIddrN+DECLARATION: I hereby aflirm that I have acertificat•of consent to self-insure or a certilica• if Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3803.Lab.CI. LEFT; FT IN"RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.:USL&H 1D9200627 EXP.DATE: 1 0/16 /93 COMPANY:EAGLE PACIFIC PARKING REO' PROV; PARCEL : 41903106 ZNE: C1S REF NO' El Certified Copy is hereby furnished, Certified copy isfil.. .'• the city B 'dr.°Division. PLANNING NOTES>- INTERIOR ALTERATION FOR THE NEW HOUSE OF FABRICS SUITE. 3 /z /93A > �_ ate: Applicant: #############,##TE iF##-lE##iF####3f-%##1E######)E##fE#####!(#IE##!F#16IE####lf ll Jf#%#1(#.k#3f iF 3F#3i#### EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($10)or less). D E V E' L O P M E N T SERVICES R EQUIR EMENXS P� I certify that in the performance of the work for which this permit is issued.I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED' BY R - _ ,j��'>l, • DATE; Date: Signature: NOTICE:If,atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY ; . it • DATE; .)._--49. Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. / t. �� /�� CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY:— ("Ir'. ` �A DATE•:: ...4rj% which this permit is issued(Section 3097,Civ.C). ######################3en-rt-e #k..n --##1e Jena # ic• rera,letup##ik#.#.I(.lE.#..li..I6le# de' A -* %?f LENDER: ##le################k#####N###!ei(•###"le########3e#©t#!F##ie N fele#It 1e1F##!e##M•1e 1e#3e##IE#Ie***le* ADDRESS: LEGALIZATION; N F E E `w, U, M M A R- X- , ., STRUCTURAJ0 SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that Ram exempt from the Contractors'State License Law for the following reason • t, �, ~' s (Section 7031.5 Business and Professional Code: Any city of countywhich requires a permit to construct.alter,improve,demolish,or BLDG PMT PLUMBING NG ELECTRIC i MEC�-lA�}$C FIRE SMZ P/RES' GRADING repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 72 $$ ( . pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 70W)of Division 3 of the Business f ' . _ 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 468 . 00 .' •�� qi^ ' J 25 . 68 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE :4 — / ` • I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL—T- PAID DUE ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 745. 68 0 . 00 , - 4,6 8 , 9,0 - 1243 , 68 1213 . 68 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through f�,; "- ` his or het own employees.provided that such improvements are not intended or offered for sale.If,however the building or I J. 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£ .'; 145, 68 OVER/SHORT: , 0 0 for purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHAN.YC/ " FIRE := SMIP/TOT GRADING PLAN—CHECK .I� I.as owner of the property,am exclusively ate License with licensed contractors to construct the project(Section 7044.Business 720. 00 " .9 25 . 68 Lr and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware N..N.#1I..II.#.lE.lf###.1F#.N..#.N.k.k.le.x.#.I(.#.#1(.#.* ******.343e.N.#iFiE*x-*#i,Ckf1f N.#y.if.#.***# i'3e1(.*#*ie##*3e**x*###le##le* that proof of their Worker's Compensation insurance should be provided to me. IND IV I D U A Tr 'F E E /, B R'-E A K O N 0 I am exempt under Section: B.8 P.C. /, 7• / _� W for this reason: TYPE QTY D E S C R I P T I O` N' '•,, UNhI' COST TOTAL COST i IDtlo hereby certify that am aware of and understand the repuirementOs of California Health and Safety Code Sections 25505.25533,and SFC 1 4 4 9 0 STO—INT, ALTER TYPE VIN `2—AVER ---I 7 . 42 107, 515 . 80 25534 and that I of any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a SFC 14490 E [(—ALT COMM, SPRINKLER SYS / � 7aVER . 33 4 , 7 81 , 70 permit lot construction or modification from the Air Ouarity Management District.Residential construction applications are exempt from SFC 14490 EQU—ALT COMM, AIR GOND / —AVER . 69 9, 998 , 10 these provisions. ,END 'OF FEES / - 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 '41 _ ' ordinances and state laws relating to building construction and hereby authorize representatives of •is city to enter upon the above•mentioned +y property for in pettion purposes (; , Date: 7 ay //ql-'P Signature: —___ �� j• 1�• '!' j Driver's License or Social Security a: ''1 -i ✓ / • ' f 164146 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor • f • CONSTRUCTION AND PLANNING PC & SPA • APPROVALS Permit `r - Date Inspector APPROVALS Permit -1I- Date Inspector 1. Temporary Electrical Service or Pole 52. Pool,& Equipment Location ' '2. Soil Pipe•Undrgrnd. • 53. Steel Reinforcement 3. Electrica', Conduit Utility-Undrgrnd. - 54. Forms ! 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steal Reinforcement 56. Rough Plumbing & Pressure Test 8. E:ectrica' LIFER Grnd. 57. APPROVAL TO COVE R-GUNITE 7. Footings 58. Electrical Conduit•Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test • r . 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System , 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection •' 62. Backwash & Receptor-Final I I 12. Sewer Cap ' • 63. Heater & Vent-Final I P 13. Rouf Drams 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final I 15. Rough Electrical-Conduit 1 66. Solar System•Fine! i 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough C:iring Sign 68. APPROVED FOR PLASTERING 1 . 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 4 21. Ducts, ?n Structure 70. Underground Hydro 22. Ducts, Ventilatinj 71. Product Piping O Gas OO l 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank C Gas 0 Oil p�// J 25. Roof Sheathing r 3 04 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Moryercoat (((( 75. Dry Chemical 27. Frame end Flashing 5ttriad- 76. Dry Standpipe 28.. Lat�&Siding \ 410 77. FIXED SYSTEM FINAL 29. Insular on78. FIRE PREV. FINAL .._; . � 30. Dryt:all Nailing -1 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION i 32. Electrical Power Meter-Final ; 80. FOOD CERTIFICATE ISSUED , 33. Final Electric I rF• Notes: //�17v �o/ „A� 34. Final Heating& Air Conditioning I ' ` 0./. /r /- Cit.'P*17e on W x(4.1,`! Xs( I 35. Final Gas Pipe-Test v ���/ r ^ 36. Hood or Canopy ,�� 37. Final Factory Fireplace • //. ^/� /A y/ 38. Final Plumbing 7A� t MAI/0/ s aI( 4'c Cly en 39. Water Service-Final I War 4/0 fC/-, Q I-4004e5 ,O/jA( r 40. Gas Service-Final 04 r /`%% 41. Solar Domestic-Final 42. Backflow Preventer ✓"t L�"-'1 IMI Ti VU. nVh-191{._ 43. Backflow Irrigation 1 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations ,Q�- 47. FINAL STRUCTURE & BUILDING 0(0_,�//// 48. FINAL PLANNING 49. Electric Release to Edison , . 50. Gas Release to Southern California Gas Co . 51. CERTIFICATE OF OCCUPANCY - '- Date 74111 PROJECT ADDRESS: 2200 HARBOR BL UNIT:H CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 062863 , Y OWNER'S NAME: ENTERPRISES ADOREss: 11791 MONARCH ST PERMIT NO: E 062863 PLAN CHECK NO: 02385-93 S GOVT: N SUPP : N GARDEN GROVE CA 92641 CONSTRUCTION TYPE: 5—N SP PERMIT TYPE: ELE PURPOSE: OTH ARCH/ENGINEER: (714 ) 893-8373 flEC.NO.: DANIEL E, MACDONALD C-1 X71 JOB DESCRIPTION : ELECTRICAL CIRCUITRY FOR COMPUTER SYSTEM SQ FT: ADDRESS: 13400 RIVERSIDE DR I ' PERMITTEE:SHERMAN OAKS CA 91423 CLAIM VALUE: CALL—VALUE: GROUP OCC: B-2 / aooNlss:PACIFIC COMMERCIAL CONST. ( 818 ) 347-1179 23728 SANDALWOOD ST COMMENTS: THE "HOUSE OF FABRICS TENANT IMPROVEMENT / RE: 861539 WEST HILLS CA 91307 ********4*******Tr***a ********************+FTFxx***********************x *****er*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G REQUIREMENTS 7000)of Division 3 0l the Business and Professions Code,and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.57657 S;C-10 cater —z' - 93 Signature:_AL_ _ --_ MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby ale a ertiticate 0f consent to sel6lnsure or a certificate Of Workers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof ISecto M.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN 'OLICYNO.:N1809 14 07 EXP.DATE: 09/01 /93 COMPANY:TRUCK INSCH PARKING REQp• PROV: PARCEL: 41903106 ZNE: REF NO: Cil Certified copy is hereby furnished. 1 Certified co is filed with the city Bu ding Division. PLANNING NOTES> > Date: 1 '"' 2 — q3 Applicant: *************************************'****************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: ( - sectio nem n I be completed if me permit is la one hundred(s100)or less(. DEVELOPMENT S ESR V I C E S REQUIREMENTS I certify that in the performance of the work for which this permit ' dI shall not employ any person in any manner so as to become !t subject to the Workers'Compensation Laws of California. ZONING APPROVED BY. • :Ai- DATE: Date: Signature: NOTICE:II.after making this declaration,you should become subject to the Workers'Compensation 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 allirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: —' • C¢F i DATE: fes/�� which this permit is issued(Section 3097.Civ.Cli ************************ ' ** ' * . ' ***** * *** -***************IE* it****�F***** LENDER: *********************************** ******* ********************************* ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Slate License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 1031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve,demolish,or PERMIT 78 . 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 01 the Business ' 5 13% SMIP/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 P LAN '39 :25 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dofars(5500). ISSUE FEE 15 :0,0 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7644.Business and Professional Code: The Contractors'State License Law TOTALS----> 78 , 50 15. 00 , ) 39 , 25 132 , 75 132 , 75 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ,/ his or her own employees,provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 132 . 75 OVER/SHORT: , 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I,as owner of the property,am ewdusively contracting with licensee contractors m construct the project(Section 7044,Business • 9 3 . 5 0 39 . 25 ❑ and Professions Code: The Contractors'Stale License Law does not apply to an owner of propertywho builds or improves thereon , ', and who contractsfor such protects with acontractor(s)license pursuant to the Contractors'Slate License Law).l am aware *****,**.*.,N..****************************)****************************************** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.&P.C. I N D I V I D U A 'I. F E E B R E A K D O 14 N for this reason: TYPE QTY D E S C R I P T I O, N - UNIT COST TOTAL COST Date: Owner: ELE 2 RECEPT/OUTLET "11- ST 20 EA. . 75 1 . 50 I do hereby certify that I am aware of and understand the requirements 01 California Health and Safety Code Sections 25505,25533.andELE 7 MISC APPARATUS NOT 'LISTED REQ PERMIT 11 . 00 77. 00 25534 and that I or any future building occupant wilt/will nal(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END:. OF FEES 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 taws relating to building construction and hereby authorize representatives of this city to enter upon the aboveimentioned • property for inspection purposes, e' Date: 1— Z— C_3 Signature: a1 TT Driver's License or Social Security x: $ 1 DATE:107/02/93142199 9 TIME: :13 / 137.75 4146 white—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING F _ & SPA APPROVALS Permit# Date Inspector APPROVALS Permit # '- , 1. Temporary Electrical Service-or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. . . 54. Forms • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit•Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. :' _.� 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer DP 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final i 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • APPROVALS Permit# 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas ❑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 I I i 77• FIXED SYSTEM FINAL 29. Insulation I 78. FIRE PREY. FINAL 30. Drywall Nailing I I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION 32. Electrical Power Meter-Final' • i - 80. FOOD CERTIFICATE ISSUED / ,, �f�J 33. Final Electric ' rtes: Z4 y2C--- /�� �����%� _ �-1 f��1�� Com 34. Final Heating& Air•Conditioning I ".per . � 6.5Con/�eG�Q7 "Id 35. Final Gas Pipe-Test I i 36. Hood or Canopy , 37. Final Factory Fireplace 1 38. Final Plumbing - I 39. Water Service-Final I I 40. Gas Service-Final I 41. Solar Domestic-Final I I 42. Backflow Preventer I ' { - 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations I � 47. FINAL STRUCTURE & BUILDING � • 48. FINAL PLANNING ' , 49. Electric Release to Edison I 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 2200 HARBOR BL UNIT:a CITY OF COSTA MESA - BUILDING PERMIT PERM NO: E 063076 OWNEg's NAME:GRAY ENTERPRISES ADDREss: 11791 MONARCH ST PERMIT NO: E 063076 PLAN CHECK NO: N GOVT: N SUPP : N GARDEN GROVE CA 92641 CONSTRUCTION TYPE: 5-N SP PERMIT TYPE: ELE PURPOSE: OTH ancxfENGINEER: ( 714 ) 89E. MACDONALD JOB DESCRIPTION COMMERCIAL T. I . (RETAIL SALES/FABRICS) SQFT; DANIEL E. MACDONALD onus: 13400 RIVERSIDE DR UNIT: SHERMAN OAKS CA 91423 CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 / PERMITTEE: FLINT ELECTRIC COINC, ( 310 ) 430-3055 AVENUE BLOOMFIELD 9 COMMENTS: THE "HOUSE OF FABRICS" TENANT IMPROVEMENT RE•41361539 ' LOS ALAMITOS CA 91 t ****************sr*iExvr*************************TE****4***it**xs6* ****x SE*x******** LICENSED CONTRACT° DECLARATION: I hereby affirm that I am lice ed under.r. ...ns of Chapt•r•(commencing with Section ZONING REQUIREMENTS 70001 of Dorsi 3 oft Business and Professions Code.and m • /�in lull e and eft 7 SETBACKS CITY _ /q,0 4 srATE LIC.279361 Y '.C1 t' 7 Date: / 3 signature: MAIN BUILDING ACCESSORY BUILDING WORKERS COMP SATION DECLARATION: I hereby affirm that I ha -a cenilicate of manse •Linsure or a certificate of Workers' FRNT; FT IN REAR : FT IN FRNT: FT IN REAR; FT IN Compensationlnnsuura'n�gyramatlip�ocopy thereof(Section 3800,L.b.Cj, LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.:B W 4 L O / /1 EXP.DATE: 11-)/4 . � COMPANY:H GHIAND . PARKING REQo• PROV: PARCEL : 41903106 ZNE: REF NO: ._7 Certified c'.y is h:eby furnished. ❑ Certified copy's file • ey:. . r:.'m. PLANNING NOTES> _ ` Date: Applicant: •� EXEMPTION '.MW!FINERS'COMPENSATION OECURATION: I section need not be toms• the permit is for one hundred(S100)or Mss). DEVELOPMENT .SERVICES REQUIREMENTS. I certify that in the p'rformance of the work for which this permit is issued.I shall not• .ny person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY ' DATE; Date: Signatuyoushou: BUILDING APPROVED BY : = DATE: NOTICE:y:II.afterstmaking this dpith s, hu o become orthis subjectemis the deeed Compensation provisions of the Labor Code.you must forthwith comply with such provisions or tics permit shag 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 B Y: - "' . ' _.a.� ta DATE: 7 (co l which this permit is issued(Section 3097,Civ.C). ********************************'************iE4F iE************************ ** * .14)* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 22750 • repair any structure.prior to its issuance.also requires the applicant for such permit to rile a signed statement that he/she is licensed 5 0 S SMIP/NON-RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or Mal he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty 01 not more than live hundred dollars($500). ISSUE FEE 15 ,00 I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 227. 50 15 . 00 0 , 00 242. 50 242 . 50 . 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.It.however the building or REVENUE DIVISION TOTALS--> COLLECTED • 242 . 50 OVER/SHORT• . 00 improvement is sold within one year of completion,the owner will have the burden of proving he/She did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 242 5 O ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law),l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. ' INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: owner: ELE 20 FIXTURES, LIGHTING 1 ST 20 EA, . 75 15 , 00 I do hereby certify that I am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505,25533,and ELE 152 FIX TURES LIGHTING ADDITIONAL EA• . 45 6D 40 25534 and that I or any future building occupant will/will not(circle one)need to comply with said slate codes and the requirements for a ELE 20 RECEPT/O{ITL ET 1 ST 20 EA, . 75 15 . 00 permit for construction or modification from the Air Ouahty Management District.Residential construction applications are exempt from ELE 8 RECEPT/OUTLET ADDITIONAL EA. . 45 3 • 60 mese provisions. ELE 16 RECEPT/SWITCH 1 ST 20 EA, . 75 12 . 00 Date:_ Applicant: ' ELE 1 SERVICES BELOW 600 V 6 201- 1000 AMP 3750 37 . 50 I hereby term,that I ha-•read this application and state that the.... e infor ti.•is correct.I ogre' .comply with all city and county ELE 2 SUB-PANEL 11 , 00 22 . 00 ordinances am statela• s relating tobuidmg construction. , ere..• p, ere esen.. . tr. •y toenter upon the above-mentioned ELE 4 MOTOR/POWR APPARATUS 1 • 1 - 10. 0 HP 7. 50 30 . 00 propertylor gni. purposes. ELE 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15 . 00 15 , 00 Date: Signature' ELE 3 SIGN/ADDTN'L BR CIRC WITHIN SAME EA. 3 . 00 9 . 00 END OF FEES Driver's L cense. Social Security.: 01 00143028-00143028 T E]T 242.50 • DATE: 07/16/93 TIME: 14:06 164146 White-Building:Green-Code Enforcement:Canary-Applicant: ink-Revenue:Goldenrod-Assessor szis - I CONSTRUCTION AND PLANNING PL _ & SPA i APPROVALS Permitter Date Inspector APPROVALS Permit '„= Date inspector ; ?. Temporary Electrical Service or Pole - 52. Poo! & Equipment Location I - �. So:' Pipe-Undrgrnd. 53. Steel Reinforcement - _1 IT 2 'J,ctricti Conduit Lthty-Undrgrnd. .. i r I 54. Forms 4. kl+rctncel Condwt-Undrgrnd. 55. Electrical Bonding I 1 5 St'-r' R•:nfu-ceme"r.- 56. Rough Plumbing& Pressure Test G. E.,v-r 7' L' E!1 C rd 51. APPROVAL TO COVER•GUNITE I I 7. Footing, 58. Electrical Condo t-Undrgrnd. ---- I r-- i8. Foundation 59. Gas Pipe, U Undrgrnd., Test , re `.rte- Pip; U^d"^rid. CO. Eackv:ash Lines, P-Trap, 2_ Un rorr'd. 10. S'ri,Lturl F ccr Si:ter.' - _ - H 61. APPROVAL TO DECK � 62. b c:ash & Recapmr•Final I - 7-7 12. Sip - -_ _ _ _i __ -_ \ ) { 163. Heater & Vent-Final 13. Roo+ Drain. ✓� I G . Plumbing System • F•nal r ., 14. Flou I Pie r^h'ng I i 65. Electrical-Final -15 Roush Electriou-Condla I 66. Solar System-Final J, 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring S'gn 68. APPROVED FOR PLASTERING 1 18. Roegh Electrica':T Bar Ceiling 69. POOL/SPA SYSTEMS F INAL 19 Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT Y- - 2G i;ucid i actnry r rn'ace APPROVALS Permit V' 21 Ducts, 'r Str,rtu^ I, 170. Underground Hydro -- ---'-- 1- -- -- 1 + 1 7. Dt.r:, i; -it-':t.r9 I 71. Product Piping C Gas LiOd - - -- - --- -- �- 1 - - - - -- . 3`.'.p r-Ro_.gh & "e;t I 72. Underground Flu;n 24. CIL A Framlrg ---- - I _--_-_ J 73. Undergrnd.Storax„ Tank _Go; C 25. Huai ii..ti J - - --i- - -- -i- - 74.-O.r•h.ad Hycun 2F. E+ .r C ''.-rt lS:ric:u r- .. ?. I :IF -11- - -- - --' :y. Ur; Chcm'co' Y--- -- -- - - -- - - - - - 2r. r-:arie end Flarh r, -` 76. Dry Standpipe -- -- - - ----- - --- - - - - _ 7_ _ 28. Llhno °vSlir g _- -F i ` j 77. FIXED SYSTESYSTEMFINALA; r i 20. in:u'.irrn r I j 78. FIRE PREV. FINAL 1 30. Dryt•.a'i !tiailmo I I I HEALTH DEPT. REQUIREMEP'T 11 31. Britt' Broitn Coat ,I I 79. FINAL. INSPECTION I i ^ 3? r 'i.r r• c Pa,,.p y ter-Fr,r' ��qj /1/J-///f, 80. FOOD CERTIFICATE ISSUED I- cif, 33. Pial Fist_: _ V_ { "�+ Notes: -�- 1 't- r i a^ ' r nJ•. 3, ri ,. L� .tiro �': .+ Coro t o y I 35 Fina: Gat P,e.Tes: . 35. Hurd or Carapy I I 37. ,re' Fctto•y FraClac, 1 • - - - - - ---- - 30. Crater Service-Final 40. Gas S:mice-Final I I- 1 41 Solar Domestic•Final v2. 2nc`.flrn^. Preven:er t - ----------- -~ 43. 9aclitlovr Irrigation ----- ----1 44 ! ,,',Rrl:e Irri;etlw. System - --�-- 1. n - I ______.___-_- ri= F':rdicap Regulations - - -- -- -- ---- -- - -- -- - '----'4-- I --- -- ------- -' 1.7. FINAL STRUCTURE Si BUILDING i ! r--- - i ' i -- -i i 1.9 1. :115.L 'CANNING '-r -- ----I--^ ----- - ------- 4, i r,;;.te Ri::.asc to Eo.so^ l I 5C. Co; Reic,se to Southern California Gas Co • _- 51. CERTIFICATE OF OCCUPANCY 1 No. _-_ Date - _