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HomeMy WebLinkAbout2650 HARLA AVE - Building Permits I' CITY OF COSTA MESA _ • , �:o BUILDING DIVISION • • i t moINTInn w. J. ` 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca. 4%4 wa � FOR INSPECTIONS CALL:(714)754-5626 • PERMIT NUMBER B07-00881 • PERMIT TYPE B_ROOF2 _ STATUS: ISSUED DATE ISSUED: 07/30/2007 ''•:ISSUED BY: RMD • • • JOB ADDRESS: 2650 HARLA AV CM --_. _j Suite/Unit:'''=`'>' Vicinity: DETACHED CARPORT ROOF 3: Const Type: ??< : • SQ. FT: 1000 '•-i:,2- 'Valuation ,$0.00. r ' �z SCOPE OF WORK: TEAR OFR(E)ROOF.MATERIALS INSTALL BUR SYSTEM ON DETACHEDIICARPORT ONLY,APPROX 10 SQUARES . r FOR APARTMENT COMPLEX. - OWNER: T-PAC INVESTMENTS INC ' ' , •;,;. ,,,- . -Address %GROWER&ASSOCIATES Unit:ORANGE,CA PHONE: j(If City/State/Zip `„ _` .1940 N TUSTIN AVE#114 ,' ' ,:. " ,p � . • APPLICANT: SOUTH COAST ROOF INC Ml Kms'" yno 1 Address: 1132 W BARKLEY AVE ;'Unit• ' PHONE: 714-744-5996 - City/State/zZip: ORANGE,CA CONTRACTOR: SOUTH COAST ROOF INC 7 - _- License No. 365271 ' Address: 1132 W BARKLEY:AVEUnit: ; - • - - PHONE: 714-744-5996 3. City/State: ORANGE CA "nZipCode 92868 213 'i CELL:; ARCHITECT: : • `I . . License No. tL PHONE:, ENGINEER: - _ License No. _ - PHONE: -% y,L . ,32. ni,, ;if j.rill / ,i.. FEE SUMMARY . • Reroof Plan Check: $0.00 - - • Reroof Permit Fee: Reinspection Fee: $0:00 '` ' -,.:,; •r . • • TOTAL FEES • $66.20 . ` • 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 il INSPECTION TYPE MTh IN1TALS mu INSPECTION TYPE . pm MIMES 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 204 Final Demolition 250 Final Building/Occupancy I •.-. WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive ;e. ❑Yes 0 No I hereby affirm under penalty of perjury one of the to..-...ng declarations: Driver's License No. Expires: ! s O I have and will maintain a certificate of consent to self-Insure for workers'; -Verification of Ovmership 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. . - . •- • ' 0 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 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: ///iii person is required to descend,will be made in connection with work authorized c.,'1- ?T2— F'&/n by this permit,and that no building structure,scaffdding,falsewark,or demolition Cartier: J l q f C= ��' UUU 1 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (Ths section need not be completed if the permit is valued at one hundred dollars($100)or less.) 2,Art 2Sec.341 Title B,California Administrative Code). Policy Number: btu"2-3DC0 " 2 ' 1a 0 As owner-builder, I will not employ anyone to do work which would O 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 sub'ect to he workers' compensation provisions of Section 3700 of the b de. alll for7glwicomply with these provision . /YVJ1C/ 7(33/07 Applicants Signature Division of Industrial Safety Permit Number: Date • 1111 !manes Signet e Date 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? 0 Yes 0 No ($100,000), IN ADDITION TO THE COST OF COMPENSATION. DAMAGES AS (Section 25505 of the Califomia 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 ATTORNEYS 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? 0 Yes 0 No .i Lic.# 36Class# (Section 25533 of the California Health and Safety Code, with some C.,n /S -7C//,{� �/ exceptions, requires registration with the Costa Mesa Fire Department by 1 - ,l' C7�1 a each business which at any one time has on hand a quantity of acutely "` omractor's nature 0.'e 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 for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 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 filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature Date 4. If an RMPP is presently required, has Section 25534 of the Califomia OWNER-BUILDER DECLARATIONS: Health and Safety Code been fully complied with? 0 Yes 0 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 ❑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 property who builds or improves Health and Safety Code Section 42303 been made? ❑Yes 0 No, thereon,and who does such work himself or herself or through his or her own 8. (If yes",2tWchcertificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of control officer). . completion, the owner-builder will have the burden of pfoving 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 city ordinances regarding Hazardous Materials and Emissions. ' ❑ 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 signature Date. property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: a contractor(s)license pursuant to the Contractors License Laws.), certify under penalty of perjury that I have read this application and state that 0 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. Sig . re or Lt l Owner(s) D e - Signature Dale.- -.I 7/96 o 7 305746(3/07) // J / And/or AuthM/•Applicant Date • : , . CITY OF COSTA MESA ` : BUILDING DIVISION 441* t ' "A\\ 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us 4. • FOR INSPECTIONS CALL: (714)754-5626 • PERMIT NUMBER 607-00882 PERMIT TYPE B_ROOF2 STATUS: ISSUED . DATE ISSUED: 07/30/2007 a;•-._ . ISSUED BY: RMD JOB ADDRESS: 2650 HARLA AVpCM Sulte/Unrt Vicinity: DETACHED CARPORT ROOF -.;:1-•-• 'Const Type^ ?7 SQ. FT: 1000 • ;` ti • • Valuation $0:00, SCOPE OF WORK: TEAR OFF-(E)ROOF MATERIALS INSTALL BUR SYSTEM ON DETACHED CARPORT ONLY,APPROX 10 SQUARES FOR APARTMENT COMPLEX. ::r r '"'? "4,1 ' . OWNER: T-PAC INVESTMENTS INC r ''-� 'Address: 4 %GROWER&t'ASSOCIATES: Unit:ORANGE, CA ' -• PHONE: - City/Slate/Zlp: --•, ,. �• - . �.1940 N TUSTIN AVE#114 .. •. ��I r APPLICANT: SOUTH COAST ROOF INC 5..tvU`// Address: 1132 W BARKLEY AVE Unit:,, PHONE: 114-744-5996 City/State/zZip: ORANGE;CA • CONTRACTOR: SOUTH COAST ROOF INC r • .License No. 365271 • Address: . 1132 W BARKLEYAVEUnit: . - - - PHONE: 714-744-5996 City/State: ORANGE,CA •-ZipCode:--92868-1213, . --. . CELL:: ARCHITECT: •\ ', ' "4• - License No. ENGINEER: _ - License No. . _ PHONE: • V FEE SUMMARY Reroof Plan Check: $0 00 F - Reroof Permit Fee: $66.205;nr �,-t . l,�' • • Reinspection Fee: $O OQ:_ ' r rimy; • TOTAL FEES $66.20 - - ;y;. _. - t.. • • • • 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 r INSPEc110N31'PE gAm INTI11At5 cOPER INSPEC110N TYPE pALG IN1nIFL@ 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 204 Final Demolition 250 Final Building/Occupancy I. I. r ) WORKERS'COMPENSATION DECLARATION: ..k., . Owner ID verified by drive, ;e. ❑Yes ❑No I hereby affirm under penalty of perjury one of the fdir,i.ing declarations: i ` _ Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure'or 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: - ❑ 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 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 _w/r-r iMt tr`�� tl„Vr 0 by this permit,and that no building structure,scaffolding,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sedan need not be completed if the perm!is valued at one hundred dollars($100)or less) 2,Art 2,Sec.341,Title B,California Administrative Code). Policy Number 066 130 8 2-00 r7 0 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 1 the workers'compensation provisions of Section 3700 of Applicant's Signature Date the ab e, hall it 'th comply with these provisions. �/�a/6 ' Division of Industrial Safety Permit Number: pphoanfs Si nature Date 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 ❑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? 0 Yes ❑No ofLic. r _ Class# exceptions, 25533 the CaliforniatinHealth and SafetysaCode, with sometb AT eachpbusin requiress registration with the Costa Mesa Fire Department y each business which at any one time has on hand a quantity of acutely actors I lure • e 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 for 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 I:1No (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 filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature 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? 0 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? ❑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 for 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 property who builds or improves Health and Safety Code Section 42303 been made? 0 Yes ❑No, thereon,and who does such work himself or herself or through his or her own 8 (If"yes", attach certificate of compliance from the appropriate air pollution employees;provided that such'improvements are not intended or offered for 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 property, am EXCLUSIVELY,CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. • ❑ I;as owner-of the • , 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 contractor(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. -gn A re or g.l Owners) `Date Signature - Date ' / /, _ ",/- /a1 305]-461310]) l' `/ 'J A/ And/or Author'ed Applicant D to 4. • / CITY OF COSTA MESA BUILDING DIVISION • F y; I. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754.5273 • Fax(714)754-4856 • www.ci.costa-mesa. .us a. FOR INSPECTIONS CALL:(714)754.5626 " • PERMIT NUMBER B07-00883 r PERMIT TYPE B_ROOF2 STATUS: ISSUED DATE ISSUED: 07/30/2007 ISSUED BY: RMD JOB ADDRESS: 2650 HARLA AV CM • •Suite/Unit:''. Vicinity: DETACHED CARPORT ROOF' Const,Type:' ,7? •' SQ. FT: • 1000 ' Valuation: ,-$0.00 ` • SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS INSTALL BUR SYSTEM ON DETACHED CARPORT ONLY,APPROX 10 SQUARESFOR APARTMENT COMPLEX. • ' ", ''i•- r OWNER: T-PAC INVESTMENTS INC - : Address: , %GROWER&ASSOCIATES Unit:ORANGE,CA PHONE: City/Statefzip: .. �. • - .1940 N TUSTIN AVE#114 • • . APPLICANT: SOUTH COAST ROOF INd Air Ise: Ac.en (O{E Address: 1132 W BARKLEY AVE Unit: PHONE: 714.744.5996 _ City/State/zZip: ORANGE,CA . CONTRACTOR: SOUTH COAST ROOF INC - .. • . . _ _ License No. • 365271 Address: 1132 W BARKLEY,AVEUnit: • • i PHONE: 714-744-5996 . City/State: ORANGE,CA ZipCode: 92868-1213, _. - CELL: _ ' ARCHITECT: ' ' License No. , , ,- PHONE:i.. ENGINEER: License No. - . ' - •,• -PHONE: r FEE SUMMARY Reroof Plan Check: $0.00 • . • Reroof Permit Fee: - - Reinspection Fee: $0.00 ., - •t _ • - TOTAL FEES $66.20 ,. - .. ' NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12.21.92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. Con/ INSPECION TYPE WE IN1t1AU con INSPEcTON TYPE pMg IN711UL$ 1616 Fixed System Final Fire Prevention 208 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Root 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 Am • S. •••••:: WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive ;e. 0 Yes El No I hereby affirm under penalty of perjury one of the ft...__.ng declarations: Driver's License No. Expires: O 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. - . 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 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 r6edb by this permit,and that no building structure,scaffoMing,falsework,or demolition Carrier: or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sect n need not be completed Ethel pane isvalued a d atonehundred cblars($100)or less.) 2.Art 2.8cc 341,Title8,California Administrative Code). Policy Number: ON 23 0 $ - D / 0 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 o the workers'compensation provisions of Section 3700 of Applicants Signature Dam Lab r ode shat) orttt)vnth comply with these provision • �C.�"� / 3 oh? Division of Industrial Safety Permit Number: prcants srglkrure ale 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 CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 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 ATTORNEYS 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? 0 Yes 0 No Lic.# bS O' I Class# (Section 25533 of the California Health and Safety Code, with some /-. ' j ,/j� /� exceptions,in requiress registrationat nywiththe Costa Mhand Fire Departmentof y �•l9yl/ b4 A` each business which at any one time has on hand a quantity of acutely con eel-Signs Date 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 for which this permit is issued.(Sec.3097,Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: hazardous materials)? 0 Yes 0 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 filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature 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? 0 Yes 0 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 for 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?. ❑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). O 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 property 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 8. (If'yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for 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 • am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. properly,❑ I. as owner of the 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 contractor(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. gree p•1 L/ • er(s) to Signature Date, r ���_ 305]x6(3b]) `-tor Author) ,•Applicant to ' • CITY OF COSTA MESA • • : BUILDING DIVISION f yr�,II 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754'5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us t, FOR INSPECTIONS CALL:(714)754-5626 ScWinsarris* PERMIT NUMBER. BO7-00884 PERMIT TYPE B_ROOF2 STATUS: ISSUED DATE ISSUED: 07/30/2007 . - ISSUED BY: RMD JOB ADDRESS: 2650 HARLA:AV CM '. Suite/Unit:` ` Vicinity: DETACHED CARPORT:ROOF - Const Type: ?? SO. FT: 1000 ' Valuation:.- $0.00 SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS INSTALL BUR SYSTEM ON DETACHED CARPORT ONLY,APPROX 10 SQUARES FOR APARTMENT COMPLEX. i • ' - • OWNER: T-PAC INVESTMENTSINC s i ,.i i Address: : %GROWER&ASSOCIATES Unit:ORANGE,CA PHONE: ' City/State/Zip: . " . . 1940 N TUSTIN AVE#114 APPLICANT: SOUTH COAST ROOF INC M X-c,A5cnMN4- Address: 1132 W BARKLEY AVE Unit: PHONE: 714-744-5996 . City/State/zZip: ORANGE,CA , CONTRACTOR: SOUTH COAST ROOF INC - License No. 365271 Address: 1132 W BARKLEY AVEUnit: i PHONE: 714-744-5996 • City/State: ORANGE,CA •ZipCode: 92868-1213 . ii - . CELL: ARCHITECT: ' - License No. . PHONE:: . - ENGINEER: License No. PHONE: • FEE SUMMARY Reroof Plan Check: , •'$0.00 ' • _ - : • Reroof Permit Fee: $66.20 Reinspection Fee: TOTAL FEES $66.20 • • 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. BODE/ INSPECTION TYPE PAA IN1mALs cOOEI INSPECTION TYPE all INTTALS 1618 Fixed System Final Fire Prevention 206 Final Mechanical 1288 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof u/!2/i , t 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 WORKERS'COMPENSATION DECLARATION: Owner ID verified by drive ;e. 0 Yes 0 No e I hereby affirm under penalty of perjury one of the fm...mng declarations: • Drivers 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 workfar which this permit is issued. - , ❑ I have and will maintain workers'compensation insurance, as required by - DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: section 3700 of the Labor Code,for the performance of the work for which this 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 � q- r —= gi D by this permit,and that no building structure,scaffolding.falsework,a-demolition Came%1 v r or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This section need not be completed)the permd is valued at one hundred dollars($100)or less) 2.Art 2,Sec.341,The B,California Administrative Code). P licy.Number: 0 b()-2-30e) 20001 0 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 --the Labor Code I s I foUhwie. comply with these provisions Applicant's Signature Date l'�Q9 Division of Industrial Safety Permit Number: ,01a7 Ap if2nt's Si re___- Fa1e 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? 0 Yes ❑ No c-Llcf#—T �1 Class#-- 03/ (Section 25533 of the California Health and Safety Code, with some exceptions, requires registration with the Costa Mesa Fire Department by/,(�// "7/40/11 each business which at any one time has on hand a quantity of acutely "!,_convacm[s Si re hazardous materials equal to or greater than a weight of 500 pounds, or a l 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)? 0 Yes 0 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 filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature 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? 0 Yes 0 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 property 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 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that such improvements are not intended or offered for control officer). 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. 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 p rty, am EXCLUSIVELY CONTRACTING WITH. city ordinanbes'regarding Hazardous Materials and Emissions: proe ❑ I, as owner•of the 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 contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 0 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. gnat [of Leg. er(s) Dat9//r gn / �r 3D/a1/ Signature Date / dl 3057-46(3/07) An 7 et it • CITY OF COSTA MESA / . r'c-iilei* BUILDING DIVISION i`4- 1. 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • wvnv.ci.costa-m a.ca s J. � FOR INSPECTIONS CALL:(714)754-5626 . . PERMIT NUMBER. B07-00885 • PERMIT TYPE B_ROOF2 STATUS: ISSUED DATE ISSUED: 07/30/2007 --. ._. ISSUED BY: RMD JOB ADDRESS: 2650 HARLA AV CM .:—T. t., : ' S uite/Unit:` Vicinity: DETACHED CARPORT ROOF' ' , - • Const Type: ?? SQ. FT: 1500 :r r' 'Valuation: $0.00 `. `'i. - f `. SCOPE OF WORK: TEAR OFF(E)ROOF MATERIALS INSTALL BUR SYSTEM ON DETACHEDCARPORTONLY,APPROX 15 SQUARES • FOR APARTMENT COMPLEX. '. OWNER: T-PAC INVESTMENTS INC(` , _ Address: %GROWER 8 ASSOCIATES Unit:ORANGE,CA PHONE: •-`City/State/Zip:. . ? - .1940 N TUSTIN AVE#114 APPLICANT: SOUTH COAST ROOF INV,i /KI k..�A 3-041114— Address: 1132 W BARKLEY AVE Unit: . PHONE: 714-744-5996 ' ,. . City/State/zZip: ORANGE,CA CONTRACTOR: SOUTH COAST ROOF-INC - _ License No. 365271 Address: 1132 W BARKLEYAVEUnit:. PHONE: 714-744-5996 City/State: ORANGE,CA- '.:ZipCode:_92868-1213 . CELL: - ARCHITECT: - License No. PHONE:- ' ENGINEER: License No. - - PHONE:' FEE SUMMARY • • Reroof Plan Check: ' $0.00 Reroof Permit Fee: -$69.25-.-, ' . ' Reinspection Fee: • ' TOTAL FEES $69.25 ' . - - - ' • • -, . • NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under,.California statutes and related regulations.(Ord.No.92-28,§ 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained.Failure to obtain inspections and final approval will result in the expiration of this permit. CODEA INSPECTION TYPE DA_1L iirm1AL$ CODE! INSPECTION UPg pyg INTTAL$ 1818 Fixed System Final Fire Prevention 208 Final Mechanical • 1288 Pool Spa Final - 208 Final Plumbing 200 Final Re-Roof •© i 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 k ., Ni WORKERS'COMPENSATION DECLARATION: ,, Owner ID verified by drive :e. 0 Yes 0 No 1 hereby affirm under penalty of perjury one of the b .. ing declarations: • Driver's License No. " Expires: 0 I have and will maintain a certificate of consent to self-Insure for workers' • Verificati •on 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. - ❑ 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 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 hr MID by this permit,and that no building structure,scaffolding.falsework,or demolition Carrier: f v or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp nu sect=need not be pmp(efea'Itne perm�d1a�reN�edof one hundred°bears(Srp21 orIn./ 2,M 2.Sec.341,Title 8,California Administrative Code). Policy Number: 460 Z'3 r7 8 ^(2697 0 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 or o e,I all fortth,,,ccc000=ply with these provisions. g� `�/j 6/D7 Division of Industrial Safety Permit Number: A, Signaw ( Dat 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 CML FINES UP TO ONE HUNDRED THOUSAND DOLLARS release of a hazardous material? 0 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? 0 Yes 0 No Lic.# 36 Class# 3 (Section 25533 of the California Health and Safety Code, with some efrll i exceptions, requires registration with the Costa Mesa Fire Department by I���. each business which at any one time has on hand a quantity of acutely Contractor's Signet re r.le hazardous materials equal to or greater than a weight of 500 pounds. or a I 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 for which this permit is issued.(Sec.3097.Civil Code). prepare an RMPP (Risk Management and Prevention Program for acutely Lender's Name: • hazardous materials)? 0 Yes 0 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 filing with the Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire Department. Signature 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? 0 Yes 0 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 Califomia Government Code requires that the requested that he or she is licensed pursuant to the provisions of the Contractors information be furnished on applications fcc 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? ❑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 property 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 8. (If yes",attach certificate of compliance from the appropriate air pollution employees, provided that'such improvements are not intended or offered for 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 ' ' city ordinances regarding Hazardous Materials and Emissions. ' ❑ 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 . Signature r Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(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. Slaw/�r))///y,J11 Legal i7(s) to Signature Date nal rrrze77pnl D 7 3057-46(YO]) PROJECT ADDRESS: 2650 HARLA AV UNIT: CITY .OF COSTA MESA - BUILDING PERMIT PERM NO: P 060041 OWNER•SNAME: JANES MICHAEL DAVID ADDRESS: M D JANES CO PERMIT NO: P 060042 PLAN CHECK NO: N GOVT: N SUPP: N 26 CORPORATE PARK IRVINE,CA 92714 CONSTRUCTION TYPE: 5-N PERMIT TYPE: PLU PURPOSE: OTH ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : PARTIAL WATER RE-PIPE SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALC-VALUE: GROUP OCC: R-1 / PERMITTEE: MICHAEL R. CLEAVINGER ( 714 ) 565-4525 ADDRESS: 2085 PLACENTIA AV 4 COMMENTS: APPROX. 140FT OF TYPE L COPPER COSTA MESA CA 92627 *�E*x�r� **4*******4*x*****x**4E4E*****Bt****BEBEBEBE*****xBrBr*BE***+E*SE*BEaE*****KBE******** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 70001 of Division 3 of the Business and Professions Code,and my license is In tall force and effect. SETBACK S CITYLIC.: s33ATEuc.:5949 4 fjAss: C36 '2¢o�o�v r '^ \ MAIN BUILDING ACCESSORY BUILDING Dale: / /���p�/q2$gnatpre: erv_ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATIObtEc S/6ef•TherebyaNYnithat l have a certificate of consent to Sell-insure or a certificate of Workers LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensationks r ce. r7a}��ynm- �qgy Ne3¢ (Section 3800,Lab. ) POLICY NO.: c/�b—�G N 1JL 1� EXP.DATE: V1 /01 /93 IOMPANY:STATE FUND _ PARKING REQ: PROV: PARCEL: 13936209 ZNE: REF NO: ' J Certified copy is hereby furnished. X1 Certified copy ID with-�e ciittyy Building Division. PLANNING NOTES> Date: Wk2.- � Z Applicant: \ �t✓'�Y `.' ***********************************************.******************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Otis section need not be completed it the punt is for one hundred($100)or less). DEVELOPMENT SERVICES- REQUIREMENTS 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 ,• . C• DATE: Date: Signature: y NOTICE:If,after making this declaration.you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code.you must Nhwith 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 BY: tt DATE: .2d which this permit is issued(Section 3097.Civ.C). ************************ **** iF* * **** ***************** * * LENDER: ****************************************** *********************************** ADDRESS: LEGALIZATION:N F E E S U M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I herebyattirm that I 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 7, 0 0 repair any structure.prior to its issuance,also requires the applicant for such permit to life a signed statement Thal 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 2 S Y 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 any applicant for a permit subjects the applicant to a Civil penalty of not more than live hundred dollars(6500). ISSUE FEE 20,00 I. as owner of the property or my employees with wages as their sole compensation, will do me 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----> 7. 00 20 . 00 0. 00 27. 00 27. 00 , 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. II,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 27. 00 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 27.00 ❑ 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 concretions)license pursuant to the Contractors'State License Law).I 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.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: PLU 1 WATER RE-PIPE 7. 00 7. 00 I do hereby cerbly 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 Duality Management District.Residential construction applications are exempt from these provisions. Date: Appfican0 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 corsuuction and hereby autho' representatives of this city to enter upon the above-mentioned property for inspection purposes. (1� Date: ‘Ay ,1 � �e — Signature: l yti v Driver's License or Social Security a: 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor • CONSTRUCTION AND PLANNING PC 1 SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector • 1. Temporary Electrical Serv'.eubr Pole. ,. 52. Pool & Equipment Location 2.5,Soil Pipe-Undrgrnd., .c.-I 53. Steel Reinforcement , . _9 ?t n 3!:Eleptrical Conc(akkltilityligd ;nrt 54. Forms •.:4.0 lectticalCondnft-lfndrgrndfi'li s 55. Electrical Bonding s5 Stern Reinforce-in-Liz a' - `C N -< 56. Rough Plumbing & Pressure Test - L .R L:: r-. , L 'r6. Electrical UFER.Grad. o. - 57. APPROVAL TO COVER•GUNITE cl4f..• r 4: •. .- ni Footings �� 58. Eiectrical Conduit•Undrgrnd. °_' 8. F6undation 2•: 59. Gas Pipe, 0 Undrgrnd., Test > y. Water Pipe-UniVrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System - 61. APPROVAL TO DECK 11. Property Sewer Liner& House ConrSPction 62. Backwash & Receptor-Final 12. Sewer Cap c', G. 63. Heater & Vent-Final r 13. Roof Drains "c 64. Plumbing System • Final -- t 14.Rough Plumbing -- 65. Electrical-Final P 15. Rough Electrieal-Conduit 66. Solar System-Final 16. Rough Electri&Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrifdl•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &'Air Conditioning FIRE DEPT. REQUIREMENT - .. _ _ 20FRotghctoty F+lbplace t `tea ' O = C"; * ClekPPPID VAl $ CPe it # : Y - 21.-Ducts,i0 Stcyur cte,: , •• •• r_ ?a S .s - R 7 * 70. Undergrtfuhd HvHro e T 22,,Du'Es, yentiptirig'4 t�Sr. * c S F* x w 71. Produc{1P7ping 0 Paas clod 234'Ga6 iP,e Ro h •_'Jest "` y .-" x r- T- i I c•c is '_, 1 ^s t. r rs < •- x < i-72, Underground Rusty . 24a'Ro5f Flaming 7x I-11" ••i x > g s ra . -73EUndergrral.Stora©g..Tank$JGas 0Oil 25. Roof SC' , x :£ ti., a .r ri Q A)* * ' " / g ,v .= v • . '7 > •.7 r6 x 74.3Overhead Hydro; a ' _ _. 26:0T-Bar Ceiling (Structural) &.Mrro ocoat r .n 75-' Dryca Che l - a ` -3 1 27:'Frarfe and Flasliiii _ * 'O ` " ° a., .a ' X -- >. x x J6r Dry StantlPlPe -.nom r '-28. Lathing/3i Siding-sit. r•: ' Cid x x >' •• ••�*r x 777 FIXED S�'.C�-E i'r AL 29. Insulation :x S ., x ' I,4? < 7tiF FIRE PREV. FINAL x ? c i •a ,... . .7 c.r 0 - 730. Drywall Nailing _ c * t s t- ••w' • HEALTH DEPT. REQUIREMENT K :-. ltix •:-,-, O 4� C- a: C :-31. Plaster€rovep C 5 i r 5, x 79 "�It�AL� RECTI N * ' 7 r. Cu v .t - .. - x-tc- rr.�.-. . t.- -32.„-Electrical Power Meter-Final, x :9 / ' 17 r80:nFOOD CERTIFICATE ISSUED r - -, >'333Final Eilctric _ I s .t r 1 x 'x s'Nbies: •z :> u. V. . '34,^+Finar.Co l Heating&Aindltiarrjjuj C � x - R :c t :ixK S -• r xti * x 1 .-.S x 35.;FInal Gail Pipa•T`es r sx : x i",/.4 /? .'< r• til i Ir e ( _J c- t 36. Hood or Canopy - x .!L• ,c .' r E ^o 4 .- - r r ^^ . �rrr ,�c _' x r- ,CG x si :Ti 1 S;r Tu ? R1 •alb,,_ t- X r.=37;Final Factory Fire lace x %x x ;r. -38. Final Plumbing 4 cr Witt,twee ' s x m X39. Water Service-Finar J I 'i. x ? X x Cl rntr * x ,40. Gas Service-Final ;: tr., ca,rtr S r < x o;n _ s: / -• C • ly ." + ! r -41. Solar Domestic-Finer.; f +. Os t x SC r-t x -1 x it A * . Cr -.. r t F ..3 : x . - a 42.'Backf low Preventec ' :u * '� AO. u; _ "7510 .. _ rL ro x .43. Backflow Irrigation .:SS x r. * X:- IC0 • M ? r. :.: -.J i r, x 1.T. 7$ 1 '. .,. •, ' V n44. Landscape krigation Systerrx ,f;, x * ,r, :).w x °C :9 :1: :I-10 f9 = -Cr - .- -t ; t 2 S ' 45%Sound Attenuatiox --i 5': Z _r -r .r y n - 4 • :x 4 C .46::Handicap R'Ggulations - S 47'FINAL STRUCTURE & BUILDING J * x.q I Jr ^ 1 ?= •� x 48'. FINAL PLANNING r' - • I , .L' 1/4 ;c1.4 :* S - T r.49.r Electric Release to-iEdison I I x < E .0 - * rt < p50,;Gas Release to Southern California Gas Co * VC. x 'x:51. CERTIFICATE OF..000UPANCY * c r i ti = r No. Date I e PROJECT ADDRESS: 2650 HARLA AV 0NIT` CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05085E OWNERS NAME: JANES MICHAEL DAVID ADDRESS: p 0 BOX 7127 PERMIT NO: B 050858 PLAN CHECK NO:. N GOVT: N SUPP: N NEWPORT BEACH, CA 92658 CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; ALT 411 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REROOF GAF 20 .YR, BASE, TWO PLY, ROCK SQ FT: 5, 250 ADDRESS: UNIT: –10- CLAIM VALUE: 5, 250 . 00 CALC—VALUE: 5, 250 . 00 GROUP OCC: B-2 / PERMITTEE: REES ROOFING, INC. ( 714 ) 953-0134 ADDRESS: 517 N. FAIRVIEW 200 COMMENTS: * • SANTA ANA CA 92703 *******sr****SF*x*«***************+e*sr****HESE*x-iF***iE*sexiE****SF***+E*SE**Sr>F****,t******* LICENSED CONTRACTOR DECLARATION: I hereby alfirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 0l the Business and Professions Code.and myt cnse is in lull force and effect. SETH ACK S CITYLIC.: 013190 STATELIC.:291971 d'ASS C-39 Date. 1 -30- 42?/____ Signature: /r � ifri )... MAIN BUILDING ACCESSORY BUILDING certificateconsent o" to self-insure or certificate Workers FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN WORKERS'COMPENSATION DECLARATION: thereby affirm tha I ye a Compensation Insurance.or a certified copy thereof(Section Lab.Cl. LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN POLICY ND.: 384115-90� E%P.GATE: 05/15/91 COMPANY: STATE FUND PARKING REQ• PROV: PARCEL; 13936209 ZNE: REF NO; Certified Copy is hereby taW rnished. combd ed copy i with tyre`,y Building Division. PLANNING N TES> • ' /L > Date: ! -,30-._ /q/ ApDliWnl: *******************************************************************k3_E*if******** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (7i–-.coon need not be ca.,plted it the permit is for one hundred(5100)or less). DEVELOPMENT SERVICES R E Q U I R E M E N -T S I certify that in the performance of the work for which this permit is issued.I that not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: ..7--..t Date: Signature: NOTICE:If.atter 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 affirm that there is a construction lending agency for the performance 01 the work for APPLICATION ISSUED BY: 2itli , — / DATE• / � / which this permit is issued(Section 3097.Civ.C). ************************ **** % ** T **** ****************/�, +lit** LENDER: ******************************************** . *********************iF*********** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL' SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SM I P/RES GRADING (Section 7031.5 Business and Professional Code: My city 01 county which requires a permit to construct,alter,improve,demolish,or PERMIT 81 . 00 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 0l the Business SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(3500). ISSUE FEE •% 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 7044.Business and Professional Code: The Contractors'State License Law TOTALS————> 81 . 79 0 . 00 0 . 00 81 . 79 81 . 79 . 00 does not apply to an owner of a property who builds or improves thereon.and who does such work himself/hersell or through his or her own employees,provided that such improvements are not intended or altered for sale.II,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: 81 . 79 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 exclusively contracting with licensed contractors to construct the project(Section 7044,Business 81 . 00 . . 79 • , ❑ and Professions Code: The Contractors'Slate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a conlractor(s)license pursuant to the Contractors'State License Law), I am aware ******************************************************************************* that Drool of their Worker's Compensation insurance should be provided to me INDIVIDUAL F E E BREAKDOWN o I am exempt under Section: B.8 P.C. for this reason: 'TYPE QTY DESCRIPTIO N • UNIT COST ;TOTAL COST Date: Owner: SFC 5250 REROOF BY VALUE COMMERCIAL NOZONE 1 . 00 / . 5, 250 . 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 Ouality 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 ve information is correct.I agree to comply with all city and county • / '', ordinances and stale laws relating to building construction and here y: 'horde rept sentativesol this city to enter upon the above-mentioned 01 00079595-00079E47 '1 DC7 v. property for inspection purposes.osDATE: 01/31/91 TIrE: 16:17 Date: l—.30 `_/' Signature: _ / Driver's License or Social Security N: `V// t64r'46 Wmre—Building:Green—Code Enforcement:Canary—Apolicnnf Pink—Revenue:Goldenrod—Assessor { CONSTRUCTION AND PLANNING i SPA APPROVALS Permit # Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility•Undrgrnd.. 54. Forms - ..-/ 4..Electrical Conduit-Undrgrnd.'. - 55. Electrical Bonding 5.'Steel Reinforcement' 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7: Footings 58. Electrical Conduit-Undrgrnd. t • 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 I 67. Fencing & Access Approval I 17. Rough Wiring Sign; I 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.,Duets, in Structure •• ,. . . • i _ * .70. Underground Hydro 22. Ducts, Ventilating ' ' x , _ ` , 71. Product Piping O Gas O;OiI 23. .Gas,Pipe-Rough & Test , - t,, • • ,• t. . 72. Underground Flush; 24. Roof Framing ' • ; •-l• t ' X73. Undergrnd.Storage-Tank O 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 ' •z ••' ' 77' FIXED SYSTEM'FINALb I. 29. Insulation - •• 1 I I I . - 78. FIRE PREV. FINAL . 30. Drywall Nailing I `�' HEALTH DEPT: REQUIREMENT 31. Plaster Brown Coat ; , • I ' 1 • 79. FINAL INSPECTION 1 t 32. Electrical Power Meter-Final: I I . .�. 1 80. FOOD CE• RTIFICATE ISSUED 33..Final Electric • r- ; Notes: . I ' I , 34., Final Heating& Air Conditioning ' I' : ' , 35. Final Gas-Pipe,Test • ,1 , ' I , - 36. Hood or CanoPY . - ' 4..: < _ - - • 37. Final Factory Fireplace • ( `� ._ 38. Final Plumbing 39. Water Service-Final I •t-ti, - . 40. Gas Service-Final - :) - , 41. Solar Domestic-Final . . • I I l' ' .1 ' 42. Backflow Preventer ' -- i I, . . 1 43. Backflow Irrigation . 44. Landscape lirigation System _ ' _ . . . 45. Sound Attenuation • ' ' - '46. Handicap Regulations J C, .� • // � //�J 47. FINAL STRUCTURE& BUILDING Z�t � 41x ' 5-�G,� a L9, 48. FINAL PLANNING / I I/ ,- 5-,seed---- 49. Electric Release to Edison i 50. Gas Release to Southern California Gas Co I I /.4 . , 51. CERTIFICATE OF'OCCUPANCY • ,. , No. Date Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. •CIT SOF COSTA M''" ` CONS,7TpR�]j(�,TIPF]RMIT PERMIT O. I 2 TRACT NO• . . LOT NO. UNIT NO. 1633 1/30/87 • 3:,, . Proles ltidress• •✓� J7'9GiVe�Lv/4" /• / ._. �- l t Applicant's Mailing Address r,5 T/G- S/ • /sfi !� TYPE OF CONSTRUCTION ❑ NEW L I ADD U ALTERATION U REPAIR I �^••-•�T������� s7/ ❑ CONVERSION ❑ DEMOLISH 0 OTHER A.P.# Zone Owner's Name -1`CP) Ales. Phone DESCRIPTION OF WOR KlUSE OF BLDG. • Address r ,. - I • a,Lj8 S Main Building: Accessory Building: ,Arch/Eng. License No. 3 -I 70 TYPE OF PERMIT 0 GRADING U FOUNDATION ❑ STRUCTURAL E Front ZO Address - . LI TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL 'B • N /' gd —r/! ❑ OTHER A Rear 1 Contractor's Name C.rerGP�'�')� rI j Phone rP vi ' C Right - N Address(mailing) 3�i N, tS PROJECT DESCRIPTION SQ. FT.35- OCCUPANCY K G g / �(„rJ CONSTRUCTION TYPE VALUATION§ Z^•" 5 �L¢ft CityLicense No. T D _ -- - R ZONE GRADING CU.Y S. ACRES Ping..Ref.4 Parking Req./Provided E LICENSED CONTRACTOR DECLARATION Q I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: l p •`�(�,(f • Planning Notes: Iyl with section 7000) of Division 3 of the Bu 'n;-s .nd Professions Code, and sem' tent l I' - T my license is in full force an. • ect. -/� ]t//1 /�, 111 /f (/ • - S License CIa�s_1• ., ense No. Y 7'V ! /•� • Date /�3 Signature ,G&ci PLUMBING FEES 'ORKERS'COMPENSATION DECL, •ATION Bar Sink Showers iereby affirm that I have a certifica . of consent to self-insure or a certificate • _• ELECTRICAL FEES of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink3800, Lab. C.) Automatic Washer Transformer 0 15-50 KW ' Policy No. • Company Backflow Irrigation , Sewer Cap Construction Pole Sub. 050+ KW 8 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 DECL• -ATION' Clarifiers Solar Collectors - - Dishwasher Meter Cover 100 amps (This section need not be completed if the permit is or •n •undyed ($100)or less). / DishwasherSolar Piping - .. Dryers ❑Gas ❑Electric • Sub Panel I certify that in the performance of the won fo ' 1 is permit Is issued, I .� _ shall not employ any person in any man -r become subject to the Drinking Fountains Solar Tank _ Fan - • Worker ' om ynsalba��aws of Californ Motors❑O7 HP ❑1%;8 Date ! rV17 Signature . / Floor Drains • Swimming Pool w/Spa F.A.U. Inc.Solar 915 HP ❑16-15+ NOTICE: If,after making this declare o you should become subject to.the_ — : Workers' Compensation provisions of e Labor Code, you must forthwith Floor Sinks Urinal Fixtures Microwave comply with such provisions or th' permit shall be deemed revoked. . CONSTRUCTION LENDING AGENCY • Gas Service • Outlets I Water Closet ' • 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 • Lender's Name r Outlets Range Lender's Address . Kitchen Sink • Water Service Switches - Sign OWNER BUILDER DECLARATION I hereby affirm that-t1-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 P county which requires a permit to construct,alter,improve,demolish or repair P—Trap ' , Laundry Trays Generator 00-5 KW 05-15 KW any structure, prior twits 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 he Contractor's License Law(Chapter 9(commencing with Section 7000) of )ivision 3 of the Business and Professions Code) or that he/she is exempt ' therefrom and the basis for the alleged exemption. Any violation of Section I • 7031.5 by any applicant for a permit subjects the applicant to a civil enalty of not more than five hundred dollars($500). 3 I, 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 L 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 Hood or Type I 0 DEVELOPMENT SERVICES REQUIREMENTS: employees, provided that such improvements are not intended or offered for Canopy Type I I 0 Zoning Approved By Oate sale. If, however,•the,building or improvement is sold within one year of com- pletion, the owner will have the burden of proving he/she did not build or im- Duct-Under Ground • Building Approved By Date /. �e 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 • CD 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 00-100,000 BTU 0100,000 BTU _ SUMMjA Rey" OF7�FEES /\) builds or Improves thereon, and who contracts for such projects with a con- $ sJJ'O`•••�SMIP $ '�s� tractor(s) license pursuant to the Contractor's License Law). I am aware that I BUILDING PERMIT • Exhaust System ❑ Multiple❑ System Repair/Alteration proof oftheir 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.Bit. ICBG 4 Fire Dampers PLUMBING $ PERMIT ISSUANCE $ • Date Ow• Heating System& Ducting Registers ENERGY P.C. $ /�. PLAN CHECK 25% $ I hereby certify that ha ad this application and state that the above . 00-100,000 BTU 0100,000 BTL - GRADING $ information is corre to comply with all city and county ordinances ELECTRICAL $ and state laws r . .uilding construction,and hereby authorize repre- MICROFILM $ sentatives of c r to enter upon the above-mentioned property for PLAN CHECK 50% $ inspection p • Ai - _ 7� MECHANICAL $ - TOTAL FEE $ `) Signature ' Dow,/ 7 Reinspection Fee • $15 • Issue Fee $ 3 PLAN CHECK - 25% $ • Drivers' Lice. • •r S5 4 ���� CMF 0865-46,rev. 10/84 White - Building; Canary -Applicant; Pink -Accounting; Goldenrod - Assessor ' 'CONSTRUCTION AND PLANNING _ POOL&SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary ElectricalfService 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 COVE R-GUNITE 7. Footings - • • 58. Electrical Conduit-Undrgrnd. 8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap • 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final ' 15. Rough Electrical-Conduit - 66. Solar System-Final 16. Rough Electric Wiring • 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit# , _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23, Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe . 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT i 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 /4/1 - ,' i , 48.-Special Requirements Completed T��oo r• • 149. Electric Release to Edison • , 50. Gas Release to Southern California Gas Co . 14 - 51. CERTIFICATE OF OCCUPANCY - • , - + No. Date , • _ _ - -- - - _ Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. . _ _ PER NO. TRACT NO. LOT NO. U r�o. 5535 • ; 1 I CITY (it'COSTA ESA COf1JSTR,UCTIQ[yE T " as� C 3'° ,• 1 Project Address 6,50 mar/i4 .5/7 (f tf' , 1 - TYPE OF CONSTRUCTION U NEW U ADD U ALTERATION U REPAIR • Applicant's Marlin Address I Jam— �� ❑ CONVERSION ❑ DEMOLISH ❑ OTHER _ • oar's Name Iii at."GS 2` i'b�a 040-r Phone • A.F.d/' I Zone �O' LOX 7 .) U 6. DESCRIPTION • OF WORK/USE OF BLDG. Address ' S Main Building: Accessory Building:. r Arch/Eng. ' License No. TYPE OF PERMIT LI GRADING U FOUNDATION ❑ STRUCTURAL• • T Front I O Address • El TENANT ❑ ELECTRICAL 0 PLUMBING ❑ MECHANICAL 0 Rear ; I , ' ' N Contractor's Name /ppr _ 6,1?18)33 ❑ OTHER • A - --- I G/.fez ti 7477 Phone 3+J C Right N Address(mailing) 37! �3Mc/ • //1/'6. PROJECT DESCRIPTION SQ. FT. OCCUPANCY K Left G ,/ )97 CONSTRUCTION TYPE VALUATIONS $ _ ; R City License No. K9 7 ZONE • GRADING CU.YDS. ACRES LICENSED CONTRACTOR DECLARATION Ping. Ref.# Parking Req,/Provided I E I hereby affirm that I am licensed under provision of Charter 9(commencing Remarks:r�—•.drJcii l (e)rt)• ' Planning Notes:. i O • with section 7000) of Division 3 of the Bus e - and Professions Code and ��sJ4 M my license Is in full fo,j -nd effect. / •'i LI1)?(/O G/ S /Y A. - - S License Clas sew 3 ��'� • Licen Se No.✓ _ - ! Date - < .4 Signature PLUMBING• FEES • - !� WORKERS'COMPENSATION DE R iBar Sink , Showers ereby affirm that I have a certific. : of consent to self-insure or a certificate s ELECTRICAL - FEES Worker's' 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 • RCertified copy is hereby furnished. ' Certified copy is filed with the city Building Division. Bathtubs Sewer Connection ' Cooking Unit Meter ❑up to 100 amps Date • Applicant - •. - EXEMPTION FROM WORKERS'COMPENSATION DECLAR• ION Clarifiers _ Solar Collectors - Dishwasher - - .Meter;Dove's 100 amps • ‘ (This section need not be completed if the permit is for •rn u "'red($100)or less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric Sub Panel - I certify that in the performance of the work f• c h •ermit Is issued, I - 1 shall not employ any person In any manner f. t•'•ve•me subject to the Drinking Fountains Solar Tank Fan • • Workers'ygmp tlOn�,aws of California. / , Motors❑Of HP ❑1'h-8 Date /� ��` Signature 4 .d Floor Drains Swimming Pool w/Spa F.A.U. _ Inc.Solar ❑9-15 HP ❑16-15+ • NOTICE:' If;after making this declaration, y• '5 ouli become subject to the — - - - - - t • Workers' Compensation provisions of the .bor Code, you must forthwith Floor Sinks • UrinalFixtures comply with such provisions or this •-emit shall be deemed revoked. Microwave , CONSTRUCTION LENDING AGENCY • Gas Service 'Outlets - Water Closet ' 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 Lender's Name • - Range - Lentler's Andress - - Kitchen Sink - Water Service - Switches '- Sign - OWNER BUILDER DECLARATION I hereby affirm that I am 7031.51 from the Contractor's License Law for the Lavatories Auto-Wash Garbage Disposal following reason (Section Business and Professional Code: Any city or Standing Sections • • county which requires a permit to construct,alter,improve,demolish or repair P-Trap Laundry Trays I 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 _ - _ I _ ;�:')tdvision 3 of the Business and Professions Code) or that he/she is exempt • • ,aolrom and the basis for the alleged exemption. Any violation of Section ' . •t• 031.5 by any applicant for a permit subjects the applicant to a civil - - ' 35eenalty of not more than five hundred dollars($500). I$ 3 _ • LL1l 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: Tho 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 ❑ DEVELOPMENT SERVICES REQUIREMENTS: , employees, provided that such Improvements are not intended or offered for Boiler Canopy Type II 0 Zoning Approved By - nate sale. If, however, the building or improvement is sold within one year of com- - ' prove , 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). all3�_y,{!�_� I, as owner•oi-the property, se exclusively contracting with con- Duct-Structural Refrigeration System _' ..Application Issued By - Date JO—/✓ s+% . 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 ❑0100,000 BTU 0100,000 BTU $UMf�1�V FEE$ - • „may , builds or improves thereon,and who contracts for such projects with a con- — •- '(�J Sts 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. 1PLAN CHECK $ .PERMIT 0 I am exempt under Section B.& P.C.for this reason Firepl/Fact.BIt..ICBO# Fife Dampers • PLUMBING • $- ISSUANCE' J $ ' Date • - Ow r - • - Heating System& Ducting Registers • :ENERGY P.C. $ - PLAN CHECK 25% $ __ - I hereby certify tha- I fav/ead this application and state that the above ❑0100,000 BTU 0100,000 BTU—7 ELECTRICAL - GRADING S ' information Is co e .fag . to comply with all city and county ordinances - - $ .and state taws . . t• •ullding construction,and-hereby authorize retire- _ PLAN •CHECK 50% _ MICROFILM S sentatives of i I- ;� • enter upon the above-mentioned property for -..1 i $ inspection p .l(. e ���j-b-,C. - MECHANICAL $ - - -TOTAL FEE $ scrso Signature tor i/ Date Drivers' Lice- e •r If Reinspection Fee $15 Issue Fee $ 3 • PLAN CHECK 25% $ - CMF 0865-46, ev.10/84 White - Building; Canary -Applicant; Pink -Accounting;Goldenrod - Assessor CONSTRUCTION AND PLANNING POOL &SPA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical 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, O 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 ❑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: 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 ,/9 47. FINAL STRUCTURE& BUILDING /0/M : • 48. Special Requirements Completed i !'u' 't i 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ` 51. CERTIFICATE OF OCCUPANCY No. Date • ,...4“.44,L41 r • • City of Costa Mesa Building Safety Department CERTIFICATE OF OCCUPANCY 2908 P.O. Box 1200 • • • Costa Mesa,California • The Building located at 2650 Harla Avenue, Costa Mesa,Californii has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto fora Group N / Occupancy. Use of Building 42 Unit Apartment Building • Legal Description 139-362-09 • 4354/G7.6Q� z 4��1)�`�(12� (See reverse side for Metes and Bounds) 43306/43886 L O 4 b6 Building Permit No see above Electrical Permit No. Plumbing Permit No. _ . Number of apartmenti—C42 andlor guest rooms_ ISSUED TO: Building Official lichaet Janes by _ Tha Tnnns rnntnnnv Date 11/18/77 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:306 CO U.B.C. Form BU 34 Rev. 11/70 PROJECT ADDRESS: 2650 HARLA AV UNIT: CITY OF COSTA MESA - BUILDING PERMIT PERM NO; r 051:.4: OWNER'S NAME: 7—PAC INVESTMENTS INC _•,�,� ADDRESS: %COUNTYWIDE PROPERTY MGNT PERMIT NO: P 061249 PLAN CHECK NO: N GOVT: N SU. . , N 2045 S RASTER ST #10 ANAHEIM CA. 92802 CONSTRUCTION TYPE; PERMIT TYPE: PLU • PURPOSE: OTH 549-244`1 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : REPIPE PARTIAL HOT WATER RETURN LINE SQ FT: ADDRESS: UNIT: CLAIM VALUE: CALL-VALUE: • GROUP OCC: R-3 / • PERMITTEE:MICHAEL LACENTIAGAR ( 714 ) 565-4525 *OMMENT E*>F*-x*x*+c+ex*WORK�EgEgE*x�E x-x-x -x-x-x *x�Ex*x-x �E>E�Ex-x-ax�cx#x>F ADDRESS: 2085 PLACENTIA AV 4 COMMENTS: NO OTHER APPROVED C,M, CA 92627 t*x x--E� x x � +E�E Exp*xx- LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E: Q IT I R E M E N T S 7000)of Oirsim yf th_Business and Prof ns o nd my license is in fyII,or a and effect. S E T $ A C K. S . CITY LIC.:'" STATE LW: CLASS:at of - MAIN BUILDING • ACCESSORY BUILDING • Date, Signature:_ FRNT; FT IN REAR: FT IN FRNT; FT IN REAR: FT IN- WORKERS' OMPENSATIONDECLARATION: thereby affirm tallhave acertificate ofconsent toself-insure pracertificate ofWorkers'- LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN compensation(Is'Irece.9r3HOiPJd•eo tpere$(Section 3 00.Lab(F)1 /.01/94 ' PDucrNo.:STATE EXP.DATE: PARKING REQ: PROV; PARCEL: 13936209 ZNE; REF NO: CDMPAxv: PLANNING N(3'i'ES> ❑ Certified co y is he eby furnished. n Certified co.y is filed with the city Building Division. > Date: 3 4 r'I,j Applicant:` DEVELOPMENT SERV I C E S`/�j • R E Q ,U I R EMENTS EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: is section need not be completed if the permit is for one hundred(5700)or less). t` _ 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 ZONING APPROVED BY DATE: - - - - - - - subject to the Workers'Compensation Laws of California. _ - Date: Signature: • BUILDING APPROVED BY ; -- - _- -- - DATE: NOTICE:If.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor - - - 4 7 Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. . - - _ - APPLICATION ISSUED B Y• DATE• -511/44 ( 91 CONSTRUCTION LENDING AGENCY: I hereby affirm that there R a construction lending agency for the performance of the work for *.*.**.********BE********x*.it,**********x*********%.* ****** e*k*****************-R kx* which this permit is issued(Section-3097,Civ. C). LENDER; ***********************************************4******************************* - ADDRESS: • • LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that 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 7• 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5% SM I P/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 that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE ' 20 . 00 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK • TOTAL PAID DUE I. as owner of the property or my employees with wages as (heir sole compensation. will do the work. and the TOTALS----> 7 . 00 20 , 00 0 , 00 27, 00 27 , 00 , 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Stale License Law htobuildsonhtoneappwespptadedpertywhomrveentsetndetlwhodoessorale.k ,howeverthebrldor REVENUE DIVISION TOTALS--> COLLECTED : 27, 00 OVER/SHORT: 00 his or herfown an�ene. provided that such improvements are not n,intended pro does for sale.wIf, however the buildingroor • improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT- PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK for the purpose of sale). 27 . 00 I,as owner of the property.am exclusive) contracting with licensed contractors to construct the project(Section 7044,Business ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon 7C**************************:*******-x**x•************************x**x*******x***** and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law). I am aware that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E B R E A K D O W N ❑ l am exempt under section B.a P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: owner: PLU 1 WATER RE PIPE 7. 00 7. 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 Am Quality 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 hereby authorize representatives of this city to enter upon the above-mentioned property yffor/nspection Gurp`ossees. ' ---7 Date:3/ K j1 J Signature: Driver's License or Social Security v' 01 0C134!:/:::—0:11.348 i2 rear :?7.[(Q Mtn 03/C4/Y3 t[i4F: '9:37 1641,46 White—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor t IN c---39 _ '- _ - _._ . _ _ _ - _ _. . ._. _ .... . .._ , I - POOL & SPA, - 9 1 CONSTRUCTION AND'PL-ANNING_ : ' _ i ° . - ' Date- - Date' Inspector "- Date ,Inpector APPROVALS Permit# - _ APPROVALS Permit # ._ 7. Temporary.Electrical Sereice.oF Pole ly >- .. - _- - - 52._.Pool &-Equipment'Location - - 2. Soil•Pipe-Undrgrnd. a 53._Steel Reinforcement ..- 6 3. Electrical Conduit Utility•Undrgrnd- - 54.1Forms . - • INt - 4, Electrical Conduit-Undrgrnd. - •- - 55. Electrical Bonding _ 5: Steel Reinforcement _ , :• 56. Rough.Plumbing'& Pressure Test •- - • 6.- Electrical UFER Grnd. :11. 57. APPROVAL TO:COVER'GUNITE 7. Footings 58. 'Electrical Conduit-Undigrnd. 8.'Foundation , - .' I , - 59- Gas Pipe, J Undrgrnd.,Test - �=., 1) - 9. Water Pipe-Undrgrnd. - 60.-Backwash L • ines„P-Trap;D Undrgrnd. ' + , ` I10: Structural Floor System ' O ' 61. APPROVAL:T :DECK. - - 11. Property Sewer Line & House Connection I. - - 62."Backwash & Receptor.Final - l\ • I 12. Sewer Cap 11, . ' 63.-Heater& Vent-Final ` 13. Roof Drains - 64- _Plumbing Systern - 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%SPASYSTEMS FINAL i - - 19..Rough Heating &•Air Conditioning • " -' FIRE'DEPT:REQUIREMENT • 20. Rough Factory.Fir..eplace I _ - APPROVALS- Permit# 21, Ducts,in Structure 70. Underground Hydro 22. Ducts,.Ventilating. 71. Product Piping Li 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 ( I t 77. FIXED,SYSTEM FINAL , 29. Insulation - • I I i 78. FIRE PREV. FINAL 30. Drywall Nailing'r, I ' I 1 -- HEALTH DEPT, REQUIREMENT 31. Plaster Brown Coat II j: 79. FINAL INSPECTION ..• 32. Electrical Power Meter-Final I I 1 80. FOOD CERTIFICATE ISSUED- 33: Final Electric I 1 � Notes: -. • " 1 34' Final Heating& Air Conditioning r I I I ; ,- 35. Final Gas Pipe-Test •, • I ! I- , -, 36. Hood of Canopy . I I i, 37:. Final Factory Fireplace, : 1 I I -}T - ________ 38. Final Plumbing " . -S ?J Lam/ : 39. Water Service-Final I I ' r • • 40. Gas Service-Final I II - -- 41 Solar Domestic-Final I I 1, • - 42. Backflow Preventer I 7 I 43. Backflow Irrigation - - ' 44. Landscape Irrigation System - - . .- 45. Sound Attenuation - - • rI 1 , 46, Handicap Regulations - I t . 47. FINAL STRUCTURE &BUILDING I I -LI 48: FINAL PLANNING I '1 - , . 49. Electric Release to Edison ' ' :-( I ,� 50. Gas Release to Southern California Gas Co I 1 - 51. CERTIFICATE OF OCCUPANCY - . . No. Date • -`7- Applicant to fill in all:spaces except those within heavy borderlines and,sign�all appropriate declarations. _ _ - _ _ ' __- _• •T,-_�.__ T ... _�♦ r- ice_. •_.__ ��.w.:. .�.1..;.� - -Y ..-.- ' _` PERMS O. TRACT NO f 'LOT NO. U T } i : I } } ' I t CIT!)10F COSTA MESA��i�'1CON TRUCT�ION PPEpMIT j 1 1 } , ; f j r i - It I s , �. - p- -�/.S/y • ' • ' I .5534 •.ItO/2D/86 I 35. 0 ITL. i* j Applicant's Mailing Address 375 0-!.e�.3 /tr .% ��/D. L3• 'r / : TYPE OF CONSTRUCTION �U NEW U ADD; L MALTERATION R PAIR• r 1 ' 1 1 1 t I - I + 1 -' ' • 1 i ❑• CONVERSION' ❑ DEMOLISH- OTHER 1 I 1 I„ A'p_#.-- -_._t_,:_� _}4,t- • -), - ; ,._�'--,�I 1 1 Owner's Name Phone 'DESCRIPTION OF WORK/USE OF BLDG. ' • I 1 ' •' I AddresCPO `�'T� 4-I�� ' kX � :' '91.)&.3� ' + t r ) I .i t i- , S Main Building: I 1 1 • I ;Accessory,Building:I I I I , Arch/Eng } - ; f ; I License No.• S]4T� ' TYPE OF PERMIT �❑ GRACING ❑IFOU• .NDP.TION ❑ STRUCTURAL ..• T Front 1 t •. •i 4 I I 1 1 } •i I L .O Address I ) I I j❑ TENANT �❑ ELECTRICAL .❑ PLUMBING ❑ MECHANICAL p } B Rear ) 1 , • I 1 I I- 1 i I I . I N I t I 1 • L. ! tro�la-aa33 !❑ OTHER._,. _ .. .. _ ' J-.__✓S.- _ .._F_. _A _ -!.. ' tt Contractor's Name - -L' + �' '1l Phone } s - $ - 7 1 1 , N I -! I G, 1 ' I PROJECT DESCRIPTION $4. ET. OCCUPAN i K Right i } (- ' G Address(mailing) �7 S �� 1�, 45• 1 + f • - I + CONSTRUCTION TVPE - VALUATION $ L¢ft } " } ' 1' City •License •Na ' ' ' ! ZONE ' 1 1G RADING CU'.YDS.- ACRES ' • $ t 1 •f C 1 .� 1 1 t • I t ' R I r „ - 'Pin Ref.# , Parkin Re /Provided. I L LICENSED CONTRACTOR DECLARATION; • 4 •1 I 1 I g' i ! 9 q 1 Q 1 • t hereby affirm thatil am'licensed underlprovrsions of Charter 9 (commencing Remarks: ��'�j•yL� �. /��_' J} _ �n� y t •: I Planning Notes.' , } 1 • 1 1 I. } M, �. 1 with section 7000) of Division 3 of the Business'and Professions Code, and • VV • j,/� 1 my licensers In OJAI fort rid effect. " 1 I ei - ; : ; +- I .:e' 1 - 1 - s ; ' ' T ' , m •, i ! -? i 1 5 I I I 1 I T . Ucense Class 'cense No. 91 i - I I ` PLUMBING I a ; 1 J r. _FEES } 4 I , • I I" r 1 g I i t '1 + 1 u , 7 ; I 1 I + ,- ;: Date 1/d -e0-11.%' Signature , /--✓ 1 • 1 - i _. , • 'ORKERS'COMPENSATION OECL RATION , 1 t Bar Sink ' i + 1$h Owers ' .. $ ' i-' 1 ' -i >r I _ . I ;reby affirm that I nave a certificate-of consent to self-insure or a certificate 1 ;!-•.1 .. 1 .- I tu I + , ELECTRICAL '. 1 _ I u. FEES i Workers' Compensation Insurance, or a certified copy thereof (Section ! ^ " 1 _. j r 1 •+ - i 9 ( - . : - J - ,,, - Backflow Pieventer• 1 j 'Service Sink^ •l s , ^i ; _ i S• 3800; Lab. C.)' S r 1 1 1 • 1 - -+; 1.- C 1 , ' Automatic Washer tis I,_ _Tiansformei ❑,15•50 KW 1 4 Policy No. ' 1 1 r Company - ' I ' ' Backflow Irrigation , !Se-wet-Dap` a " I '" , '` 1 tt i + - i ❑ 50 H. `•4:21. '� ;' Certified copy is hereby furnished I i - _ - -1 I ' - COnstruction'POIe Sub ., • t - a 1 I �a I - Certified copy is filed with the city Building Divisions 1- , • 1 Bathtubs LL -y ` Sewer Con Oectjoh 1 • t) ; . !'-' ! p •} ;, Cooking Umty 1 i i r ,Meter!Opp;[0,100 amps 1 - • 1 1 - Date , 'Applicant - - - . .' EXEMPTION FROM WORKERS'COMPENSATION OEC LAR TION } Clarifiers} I I .' I" i }Solar Collectors• 1 - 1 • I' v :al 1 �: I ;" Dishwater; - I I 'P I :Meter f❑over"100 amps].; tr - I a • (This section need not be completer/1f the permit Is for one h :dred ($100) or ' less) i - t ; ! 1 I 1 Dishwasher - - ' I ',} .I y, i , ;Solar Piping F. I I r - Dryers ❑Gas, ❑Electric , I .F -SubPaneI ' . - I a; $ ‘111 3 ! ' .1 . ' I certify that id the performance of'the wor • ' Jh t ' permit is issued, I , - t ( ' shall not employ any person in any mann •' come subject ito the Drinking Fountains, )Solar Tank i I " , -} i L. 1 ' Fan,, , a, i J" - _ rv, _. - :Motors❑0?1 iHP ❑1h-,8' I I Date s'�o nsatlon Laws of Californl �� ! , .+ _ti_l - - + I_- *`_ VI I Date ' ,Signature • I _ Floor Drains • Swrmmmg Pool w/Spa ' _ ° F':A.U' t t• -NOTICErlf;after makinglthis declaratio ,- •' sh:•1$ come subject twthe'-'=--' - "� --— '- — '-- - "- - ' - .I fIC Solar_❑9-15 HP ❑16.,15+ - , f Workers' Compensation provisions''of tit- Labor Code,• you must forthwith • Floor Sinks . - ' I 1Urinal j i 'I I } Fixtures 11 ' '' ' s , comply with such 'provisions or this permit shall be deemed revoked. i . y , i A I I Microwave •. I I I .1 C I CONSTRUCTION LENDING•AGENCY ' ( I Gas Service I ' .Outlets I 1 Water Closet 1 .i 1 ' ., I 1 ' Device Boxes I, 1 ' r I L I hereby affirm that there is a construction lending agency for the performance - . r { 1 POIe Light , i, i _ - - 4 of the work for 'which this permit .is issued (Section' 3097 Civ. -C.) 1 i ,--- ;, , Interceptors ( I ( Water Heater 1 } Outle[ss_ - - "f' • j ' Lender's A ams. r • -'r- i 'Range' '1 I .. Lender's actress - "`_�-.-;_-.-'.. _.. ..___, _ti,,._: _ __ t. _ Kitchen Sink -. '^I_-'..� -Water-Service•'!' - _ _ - _• - _. _, _ _ _ ' 1 I OWNER BUILDER DECLARATION I- s i , - - i -_. "- F 7 i Switches ' i i } Sign 1 i C. } -} -''t . ' } I hereby affirm that P'am exempt from the Contractor's License,Law-for the- - ' Lavatories f , 1 AU10-Wash l I Garbage Disposal I ' 1 • 1 _ following reason,(Section!7031.5-Businesrand Professional Code::Any city or i ' ' I 9 P , r i Standing Sections • - county'which•requires,a permit to construct,alter,•improve,demolish or repair P-Trap 1 I LaundryTrays , any structure, prior toils issuance„+also requires the applicant for•such permit - ' y '1 1 Generator❑0-5'KW❑5-15 KW ! Trash Compactor I • ( to file a signed;statement that he/she is licensed pursuant tol the provisions of - I - I I ,I + • the Contractor's License-Law(Cha ter 9�commencip with Section 7000 of Roof Drains • , , , I , t f -, l _ , • livision 3 of the Business and Professions Code) or that he/she is exempt • • , - • nerefromand the basis for the alleged"exemption. Any violation of Section 1 ' ' } ! { i y+ 1 ij i ; 1 • 7enalty by any applicant for a permit subjects the applicant to 'a civil 1 L I r t , 1 i 1 - _ ' ' 1, - ' : • ens .a lnoi more than five rty ortl dollars ($500). 1 4 1, I - I i s r i ' $ '3 1 ; ; 1 _ i i t I - '( { t } ;- • I LJ 1p as owner of the 'property my'employees with wages as their sole Re fllspectlon .Fee ' $15 I I _ 'Issue Feel • ., -' Ifomensation, will do the Businessand the structure is not intended or offered 1 i I f p 4 '- Reinspection Fee ; _I'- .. ! Issue Fee $ 3 .w 'forr-sale: apply lynand Prof'of a opCode: The -Contractors - t ; 1 , 4MECHANICAL I FEES 1 - _ I thereoe-Law tl hoTho apply to o 'himself a propertyor whothrough ghs h s•or improves - - - _ -_ _ ' � � - - , i pon; provided- ch impr ve elf/h!arelnot i h roc her own .: - DEVELOPMENT SER VICES REQUIREMENTS: ' i I i • S. • employees; ever th t building il sing r a e not intended or offered for Boiler Hood or 'Type I ❑ i I } . , - ' j , , , ay • • ,sale:If,_howowner ell hav ng,or improvement is sold within one year of tom- ' _ ' Canopy (Type II- ❑ •: } :. Zoning Approved By I ' - I Date ' ' } cpletibn„the owner.will have the burden of proving,he/she did not build or im- - Duct-Under,Gr000: , s 1 I , ., •, I Building'Approved By - ' } - i Date_ 1 :Provo fat the purpose of sale)., , 'x• I I r . I ❑iq'asrcowner'of;the property, am exclusively contracting with scions Code- Duct.Structural , ' j Refrigeration System, ' 1 I t Application Issued By' ' ' . I t I I - 1 Date 7 0124/fib tractors tract struct the a Lawt(Section•1044, Businessland Processions Code: _ $ ' ' I Theds ontractor'stLice re Law does not apply to r such snot property who 7 ❑0-100,000 BTU`❑100,000 BTU : _ ; F POOL &SPA ,,CONSTRUCTION AND PLANNING : I 0 ( - APPROVALS 'Permit#' "Date Inspector, "VALS - ' , ^Date-; Inspector APPROVALS Permit# _r I 1 1..Temporary Electiical Service or Pole • ' l , i ' ' 52.;Pool & Equipment Location i , t : -i . ' 2.-Soil Pipe-Undrgrnd. I , i I ' ' . " 53.;Steel Reinforcement, i ' i i I t .• 3. Electrical Conduit Utility-Undrgrnd. , i . 54'.'-Forms ;: I ; R 4! Electrical Conduit-Undrgrnd. , _ ' 55. Electrical'Bonding i • , , , 5', Steel Reinforcement • , , i. 56. Rough Plumbing& Pressure Test . 6. ElectricalLIFER Gmd. - 57 'APPROVAL TO COVER GUNITE ' !v ' • t. 7. Footings •r:{. ' 58. Electrical Conduit-Undrgrnd. 8. Foundation -S' `: 59. Gas Pipe, ❑.Undrgrnd.,,Test • . . '• -i t• ' 9. Water'Pipe-Undrgrnd. _' ' 60.. Backwash Lines;P:Trap, O,Undrgind! .. '' 10. Structural Floor System ' 61. APPROV A LITO�DECK I i - i ;. 11. Property Sewer Line& House Connection : , 62. Backwash& Receptor-Final. f e 12. Sewer Cap - ( 63. Heater & Vent-Final I P '_13' Roof Drains . - 64. Plumbing System - Final , C- I I, , 14'. Rough Plumbing •_ '• ` • 65. -Electrical-Ficial , I _ I r • '4 15:' Rough Electrical-Conduit . - -' , ' I - I ,66. ,Solar System-Final ; ) _ I •. ; • - r ' ' 16. Rough Electric Wiring - - - .. • - - - ; 67.-"Fencing &Access Approval tal , ; }-17= -: .. . 17--Rough Wiring Sign - • -- - . - '. 68. 'APPROVEDIFOR'PLASTERING- -- - - ' t - - -• ' - • - - 18r Rough Electrical-T Bar Ceiling: -" -- _ 69-POOL/SPA SYSTEMS FINALI _ 19. Rough Heating & Air Conditioning . . , i FIRE DEPT. REQUIREMENT ; - _ ' 20. Rough Factory Fireplace ' - ; "t .. -' APPROVALS-- -Peirnit.#-' ` • 4' -• r 21. Ducts, in Structure 70. Underground;Hydro !' • ' 22. Ducts, Ventilating- „ • 71. Product Piping Gas �O 0,1 1 _23. Gas Pipe,Rough& Test : r � , ,72. Underground'Flush I r -• - ' 24. Roof Framing 1 , • , - i73. Undergrnd.Storage Tank O Gas ❑Oil 25. Roof Sheathing • - 74. Overhead Hydro:" _' • I I - . .•I - '^-- 26. T-Bar Ceiling (Structural) &,Monocoat • • - • 75: pry Chemical . i + 27".-Frame and Flashing '! - - - - , , --' '.' 76. -DryStandpipe •-, - , ,-• - 1 ^ `28. Lathing& Siding • . " 77. ,FIXED SYSTEM FINAL ' - - . r 4429. Insulation ' . 78. FIRE PREV.'FINAL • •-'- 30. 'Drywall Nailing, ' HEALTH DEPT. REQUIREMENT ' ,31. Plaster Brown Coat t • 79. FINAL INSPECTION i , '32. Electrical Power Meter-Ficial , . , , . 80. FOODiCERTIFICATE ISSUED , , „ - ti ' .•33. Final Electric Notes; t, ` 34. Final Heating & Air Conditioning t y. ; 1-;-,.•, _ , _ . ' 35. Final Gas Pipe-Test • • , 2 - ' • , 36. Hood or Canopy . r- - -. - - . - �` f'S 37,. Final Factory Fireplace- •' - • ` "j ' ,�•i- ra•. 38' Final Plumbing 1.•�+ ' 39. Water Service-Final' - _ I '-"' 40. Gas Service-Final. - - ` ' v. .' ' { 1 • ct 41. Solar Domestic-Final ;F .• .x { t ;, , 42. Backflow Preventer . - - - - • , . - : - - is 43. Backflow Irrigation=' - •• - •44. .Landscape Irrigation System •• . ' _ - , : . . _ r.'... - r' ,, ,• L45. Sound Attenuation . - ' r - 6- ` -r,' •r'!' on ' 46.• Handicap Regulations r • ` - ' 47..FINAL STRUCTURE & BUILDING "j irld,-Completed _ :. - - lc," '_49°Electric Release to Edison _ - - s' • 50:Gas Release to:Southern California Gas Co �' - .;� t• � .`r ' . •'51."CERTIFICATE OF OCCUPANCY, • - - '- - _ ,�.?' No. - - Date . '� ' /o/ 4/0=2et? ileovy _ 42559 420 I —�qy 1� ;5"�t,P`thwA z3 ,�:;7.'i9 7 COSTA MESA BUILDING-SAFETY DEPARTMENT / , P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 / APP IIT FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only //__yy(('//��_TGJJJJ ,/J �( /�1� REC DATE RECEIVED D T I/$SVE ADIDR ESS m�/G �'(lG r I'I' //��j/%'� �/f 7 A OWN ' Ike • �/ 1 I�/ BUILDING • �� � ER IT NO. OWNER �/C //�,� �'/ C A.P.NO. �j� 1-- 1 ' ADDRESS t'l{ ( �/ �l�/�h/`I� ( ADDRESSCiD .�J {� � , •Q CITY l/eU/Ne TN0 9 ,E iSw poLOT-"� BLOCCKC � LENDERCT � G K� "J��IO � - NEADD ALTER REPAIR MOVING DFMOI ISH BRANCH l X ,�f// , OWNER �I7s�/O� ADDRESS •��ypz� �j ./�t 1J� // f�,���/yam 06-1: ,,,,,, t J OR EHARCHGINEER ITECTnmeme /�/L��f(��/4 NEo 7f I/�- S- Jr M//N E -. (/G . r///.`LU$ ' /,'/// ADDRESS //� t i 3` Ld0aPS�n &4, ZONE TY•E 17 GROUP ' J CONTRACTOR ,��t/.Gel / 0BY % DATE ` / (9 / ADDRESS �M + TEL. •44i - ,r INO.OF USEIDI NEW44471. CITY NO. KCt/ [f! PLANS BUILDING WO(`/ • I#.. STATE • CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDIN.G/ _ ACCESSORY BUILDING SIZE (FROM sac) /1 Y 3?// 'NO.OF NOW ON LOT G T '� FRONT STET) g 0. O LOT FT. ." FT. . W USE OF J_--r / i EXISTING BLDG. R.SIDEfil_D FT. FT, N I-•' Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. � / �� cu— REAR 6'7 FTeC _ FT. LIZE,. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET.�/ 7 z BET. MAIN& // • y //�1 �j MAIN BLOCS. �S ACCESS. BLyOCSS.(//j /n//. Q 8 owl '✓r71 I7tLO1 (r . "� / 0 , CU.P.96ZE r/JJ AP ROVEDV /4 7.6/ >' 466,7 t APPROV I. � _ G• lP D. ' 1 moi_ or a611.616 • �-: • A too " .tl 0 I hereby acknowledge that I have read this application and state j IOLD .FOR SPECIAL .REQUIREMENTS n y that the above information is correct and agree to comply with m G all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of u W the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. a the State of Callfor 'a Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and 7uch licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:am exempt froprovi sot the State of California Business eand ProfessionsDI ion VALUATION PERMIT FEE $ 6 co //� /, S PLAN CHECK $ r2/0 Cy� 0, PeSignature rmlttee of��� SW 1//�J� TAX $ !K �/'/`J/ u. V Authorized nt lj//„ J �(�V TOTAL PAID $ / /7 ZONA�� Pa All r —IV 17-7.PaA 001003 •t :''112 l COSTA MESA BUILDING-SA ETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Com•letely — Use Ink 0 ly �//}/� RECEIVED BY DATE RECEIVED % E' AT ICCU D # BUILDING�ZVs/ , /J//s -l / DAT 17 • ADDRESS R /� I G sq�/ MIT NO. JlJ �E7 OWNER LCC A.P.NO. MAIL BUILDIEG ADDRESS ADORE TEL. CITY NO. TRACT I LOT BLO K • CONSTRUCTION NEWT As! • _R I REPAIR (MOVING f)EMOLISH LENDER /` BRANCH I ‘ • OWNER ` ADDRESS C 9 ARCHITECT TEL. USE /Or OR ENGINEER NO. FIRE /� ADDRESS ZONE TYPE GROUP J - APPROVED CONTRACTOR • BY DATE ADDRESS TEL. ZONE INO.OF USE OF NEW CITY NO. PLANS BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING t1.1 SIZE I NO.OF BLOCS. (FROM C/L STREET) L OF LOT NOW ON LOT FRONT FT. FT. a USE OF Ca EXISTING BLDG. R.SIoF FT._ FT• to 2Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work.Ci REAR FT. FT. • al USE OF BUILDING AND WORK TO BE PERFORMED F MAIN NCEBLO BET. BET.MAIN& QQ MAIN BLDGS. ACCESS.SLOGS. VAR.# DATE aC.U.P.S' APPROVED l APPROVED } _ .BY DATE LC 9.1 • a o I hereby acknowledge that I have read this application and state 'n r. a that the above information Is correct and agree to comply with — m 0• all laws regulating building construction, and I shall not employ •Z any person In violation of the workman's compensation laws of I the State of California. m I hereby certify that I am properly licensed as a contractor under SQ. FT. w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERM EE ONtLY em exempt from the provisions of the State of California Business VALUATION 2 /��n and Professions Code,Division 3,Chapter 9. PERMIT FEE S ! r at PLAN CHECK E ", Signature of c LL Permittee S TAX $ (,,L/ 2 Authorized Agent TOTAL PAID E ol��L/�/ U I . g /05-lv8l ',.. 425SU E 20S — ZOc5;;, 75'76v-7:001924I - * z23.% . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 /I _1 APPII(k1 gtON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely— Use Ink Only //►►/'"I 'Jy�'- '�/r /�/f.,�j�_,� A, n' RECE DATE RECEIVED77. „,naDADBUILDING DRESS / � / //!//�/p� /SVG. /�1 �j (IOWNER r&CV �/���/��•A A.P.NO/3962 O� rt7RQN]RLV�J(Jt.J BUILDING ADDIRESS/(�� 16 0570`( /t7� 6j.'J�"r /� ADDREESS�IQ/�� fr'n/s �TG(,�.L7 CI Ty 112 /A/c r'w ' - N / //.3 /12/'TR'AC7-" 1..ALOT Yy BlcCE CONSTR(UCTIOf/ t.%' g / �r�.� NEW ADD ALTER REPAIR MOVING DFMOI ISH LENDER /s/f..r ----- �7 \ / BRANCH -_ /J�--- /�}•l La_ �.Q ADDRESS �y-t'l 7/,_ /� /�/� XALUE (11, OR ENGINES - T•• '. USE !1 W�L�/L�J Il/ l-l. sT l[_ E AOR HITT T ��jj�� r� /rays TE ,A� `aFIRE dy ADDRESS 23019 '�,s 14/00/ 131-0 �. C-'A ZONE a47PE f i GR P �. CONTRACTOR Lis`rp/`- /GV APPROVED DATE �//,��ADDRESS C.�'��,EO /// TEL. ZO l NO.NS USEIOF NEW {�u'L PLANS BUILDING CITY NO. F� F STATE CITY YARDS APPROVED YARDS APP OVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY B I DIN Ice, SIZE soot NO.OF BLDCS. (FROM C/ TR�ET) hLM / G S OF LOT Lam_ x��� NOW ON LOT FRONT 147 FTX (,4 L F / Q USE OFfn / EXISTING BLDG. R.SIDE W FT. FT. CA) / F Separate permits are required for L.SIDE 97 FT. FT. electric,plumbing and heating work. /� / // O REAR /.7 FT./ FT. [IQ. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. // BET. MAIN& /1 At _MAIN BLOCS. �� ACCESS. BLOCS. t A/n, CP I I VAR.* DATE '7 Q f i ul.flr 4,7l RI/I, Ie + /L CO2 C.U.P,gp /y_?p(., APPROVED/Fie-7 7 n lll j/� `'�, APPROVE / rl Arr lh/7/ M T 06141 ee W Rv r E ii-/(D-7 a �(dkGz 11 GLI / a �` 0 ID FUR o I hereby acknowledge that I have read this application and state C /�l REQUIREMENTS uz ed that the above information is correct and agree to comply with m O. all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of o {s7 the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that uch licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from t provisi of the State of California Business VALUATION e and Professions Co &Divi on 3,Chapter 9. PERMIT FEE E n V PLAN CHECK $ "I Signature of / / /�/ n Permittee /J s/�Y1 /�� TAX $ 5z 71 U Authorized Ag l / a TOTAL PAID 24 .5/ 7 5 .4v► PAIL IV �hOa1oot! —I ,`l; O.0 FP .. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in CI pletely — Use Ink Only RECEIVED BY DATE RECEIVED D E IbS .E BUILDING LSO I . Q� /`/7., ADDRESS J /C r �p PERMIT NO. OWNER /�L� A.P. NO. MAIL BUILDINGS5 yn/,, ADOR ESS ADDREhe.TEL. CITY NO. TRACT I LOT BL C K CONSTRUCTION EW ADD ALTER REPAIR MOVING DFMOLISH LENDER • BRANCH �/l OWNER%%MA3 y • ADDRESS / �/ s VALUE • ARCHITECT TEL. USE 0�ysr frati! D� ,ter— $ OR ENGINEER NO, FIRE _yyyyy �5" ADDRESS ZONE TYPE r GROUP/ APPROVED CONTRACTOR - BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. E+• STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING 'ACCESSORY BUILDING 47.1 SIZE NO.OF BLDGS. (FROM C/L STREET) O. OF LOT - • NOW ON LOT FRONT FT. FT. Q USE OF EXISTING BLDG. R SIDE FL FT. rn , F Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work.Cc REAR FT. FT. tW. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& Q MAIN BLDGS. ACCESS.BLDGS. O .. VAR.+ DATE aC.U.P.+ APPROVED 7 APPROVED } - ..—gY ,DATE C W .. Q I hereby acknowledge that I have read this application and state N g., that the above Information Is correct and agree to comply with - co n. C• all laws regulating building construction, and I shall not employ i i Z any person in violation Of the workman's compensation laws of Sthe State of California. w I hereby certify that I am properly licensed as a contractor under SQ. FT. ci the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F ONLY:: am exempt from the provisions of the State of California Business VALUATION w e and Professions Code,Division 3,Chapter 9. PERMIT FEE $ !!!///111 PLAN CHECK $ en Signature of G Permittee U ///�/ TAX $ u_ U Authorized Agent TOTAL PAID $ ;.11 1/ • _. 42551; C ao9 - 07/ PAtu -- COSTA MESA BUILDING-SAFETY DEPARTMENT G JS-76�,;St06192��r *`+*171.51 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APP CAT N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only sec a DATE RECEIVED BUILDING it 6 HSR Ove: [� , ./�i O• E ISSUE ADDRESS �f_' ,s� /�,s V •`Y¢/'// OWNER G /��VV. A.P.NO/3/J9�-X37 -p EReq.. _ �.,a•_ ADDRESS MAIL // a % h— /' ADDRESS'-4flp�'tt./' („A/�A(JJ, �'ttj,C CITY heave TNO fl.337d / liwcTC ✓" oLIOT !/ BLOCK CONSTRUCTIONMyr 6� { r`I EL'y ADD ALTER REPAIR MOVING DFMOI ISH LENDER \X/ 11//��77__ � -- /�y,� BRANCH ' La OWNER9G{�Y �+(J ADDRESS //., _ y� I VALUE OR ENGINEE T�7/_/]// (A// TE USE I a(,I +� •�' a/ / AOR ENGINE —Jf—( 7!' w 7FIRE /j j,,J ADDRESS ?/�0 7.-44/0°L946. ZONE YPE Jf� GROUP • s __ APPROVED CONTRACTOR .��,�� a / "OZ'L.. BY , Aires,' DATE — 0" ADDRESS ' title/ TEL. nZONE NF USE ON NEW CITY lr I/�P PLANSa_ BUILDING F- STATE CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING W SIZE �p/ y / NO.OF BLDGS. (FROM C//L$,�T�R'��[T) /f t s OF LOT /` 3 3� NOW ON LOT FRONT GV TA FT. et USE OFCII ,�'`/ // EXISTING BLDG. R Sine l./ FT.I/ FT. cti SF Separate permits are required for L.SIDE 7/ r FT. + FT. electric,plumbing and heating work. a // C REAR /n FT./ FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. /y/ /• BET. MAIN& / O1 I MAIN BLDGS. �l;+y--����().5 ACCESS.BLDGS. pQ/p L 12 U NJ 497. PJL 6 C URP 9WZ�_HY ` �I^ APPROVED �=/(n 7TI • > L I LYJI • . 5, •• C/ - APPROVED r1ATF //// �� jars- ...) a —jai- • il FOR SPECT:L REQUIRE a v O I hereby acknowledge that I have road this application and state w C4 that the above Information is correct and agree to comply with CixZ alln laws regulating buildingworkman's construction, and I shall not employ 7C' m / i Z any person in violation of the work moo's compensation laws of m Sthe State of California. I hereby certify that I am properly licensed as a contractor under O. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and the such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; e am exempt from a provis a of the State of California Business VALUATIONvt PERMIT FEE S and Professions C e, DM on 3,Chapter 9. �-(f u, /PLAN CHECK S /�_ L� LL re Signature of Q3 75-2) Permittee - \ $ D . /J U TAX S � , U Authorized A� TOTAL PAID $ / • • • /� o/ PAH' L.f .,.x„ 17-;r,Pl-0o,0o3 d*..x :33?.30 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill i Completteeelly'—Use I k Only/// RECEIVED BY DATE RECEIVED � goe s -. DATE ISSUED BUILDING . ADDRES PERMIT NO. OWNER C A.P. NO. '.�`,�jf� //�� MAIL BUILDING �f,3�ll6��- —w Vflr`i�� V ADDRESS ADDRES TEL. TRACT LOT BLO CITY NO. CONSTRUCTION EW ADD ALTER REPAIR (MOVING DFMOLISH LENDER r BRANCH w -\, OWN u ADDRESS -,/s VALUE ARCHITECT TEL. USE i u $ OR ENGINEER NO. JJ FIRE , ADDRESS ZONE TYPE GRO VPV sr , - APPROVED CONTRACTOR BY GATE ADDRESS ZONE INO.OF USE OF NEW TEL.CITY NO. PLANS BUILDING F STATE CITY - YARDS APPROVED YARDS APPROVED gLIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING {r] SIZE INO.OF BLDGS. (FROM C/L STREET) B. OF LOT NOW ON LOT FRONT FT. FT. 4 USE OF .4. EXISTING BLDG. R.SIDF FL FT. (n • Separate permits are required for L,SIDE FT. FT. Gi electric,plumbing and heating work. REAR - FT. FT. [W. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 0 MAIN BLDGS. ACCESS.BLDGS. a • VAR.+ DATE — C.U.P. APPROVED _ APPROVED } _BY DATE _ C2 W a I hereby acknowledge that I have read this application and state O r rg that the above Information is correct and agree to comply with m a all laws regulating building construction, and I shall not employ z any person in violation of the workman's compensation laws of 'T the State of California. co I hereby certify that I am properly licensed as a contractor under SQ. FT. rp the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: u am exempt from the provisions of the State of California Business VALUATIONs_3 ,/,30 p p PERMIT FEE V and Professions Code, Division 3,Chapter 9. n t PLAN CHECK E o Signature of �' C TAX $ li Permittee $ 2 U Authorized Agent TOTAL PAID $ 33 . 'CI -• p i/C /2/ Gvy °2/� agig a`2/G ?5.76�xr-OO1926 ` ** Z91S.4S COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A CA ION FOR STRUCTURAL PERMIT For Applicant� to Fill in Completely — Use Ink Only R ED v DATE RECEIVED D (ISS E G ADO RESS 4C[J ( IN 1 ERM / �//� c 'A,1 �� i OWNER 1/i6 A/J en t A.P.NO. 31 gico2 —.0 fl:‘ q/ — �,�y fl:j 2 BUILDING MAIL 1-79b� /t� /^^,J/�21� •F" ADDRESSG6a, 4-AVM • ;SCSI) ADDRESS t CITY kvild� NO.%73-7j37`� "`A� / LOT / BLOCK CONSTRUCTION UCTION / 111 / tic ' � NEW ADD ALTER REPAIR MOVING DEMO'ISH , LEBRANCH !Z. /'AJC/ OWNS ADDRESS VALUE it -- ARCHITECT ARCHITECT TEL ;f( S Apr $ OR ENGINEER��14�/ AI 711 NO..7S-ADD / •n / FIRE ADDRESS 2300 WEST&VVe JL / •do. LA 1 • ZONE T PE % GROU APPROVE' CONTRACTOR It , or 012— BY /. DATE 0- - ADDRESS 4n hq6•12- TEL. Z NE q NO.OF USE OF NEW J CITY NO. ;Es, C/_ PLANS BUILDING ,("/j%//sQ J • F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING tu SIZE �^ I I NO.OF BLOGS. n_..... (FROM C/L T EET) 11 fL OF LOT OO K 33 II (NOW ON LOT .•-•CFRONT UFT. FT. Q USE OF '�� ten EXISTING BLDG. 4 B,SIf7F OFT. ,,// FT. rn ^a 5 Separate permits are required for L.SIDE QT T. t FT. E l 3 electric,plumbing and heating work. REAR FT FT. /It- [.. FUSE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. / t, BET.MAIN& QQ 1 // y� MAIN BLOCS. J , �7`'7 ACCESS. BLOGS. ,271 DATE ..1 / s/- (11117 Gil' 7VL-o1'c- ` CU.P.#ZE7 /PCC APPROVEDP/6�4 'et ��77 2 _ n / / C3•V(nl 4) Cil l `? BY ROVEq��__ DATE /A=/e ,� - n rnL t SPE(�l t�l REQUiREMENfl a. I I / O I hereby acknowledge that I have read this application and state � fY that the above information Is correct and agree to comply with d m all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of e 14 the State of California. I hereby certify that I am properly licensed as a contractor under g 3/ O. FT. - a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and th.Jj such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from : pro ions of the State of California Business VALUATIONcl PERMIT FEE E and Professions•••e, s vision 3,Chapter 9. n PLAN CHECK $ n Signature of ///� //AI /^�� D,�U uo Permittee 1 it S//5l (•. /I/1 TAX $ / 3 b u Authorized'•'..ent ` / J "`' TOTAL PAID $,499 7 ''y/r .hrM COSTA MESABUILDINGSAFETYDEPARTMENT 6 Z— "I'�+ 17 -- 1�O10nu G= 5E1.50 P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP LI AT N FOR STRUCTURAL PERMIT For Applicant to Fill in ompletely—Use Ink Only RE I D Y DATE RECEIVED D E I S ED BUILDING '� l x _ / ADORES ,.� / �/ 4/077 170 PE RMI NO. OWNER A.P. NO. MAIL GUILDING nt ADDRESS ADORES rJ TEL. CITY NO. TRACT LOT BLO K CONSTRUCTION NEW IADD ALTER.I REPAIR MOVING DFMOI LSH LENDER X BRANCH ' OWNS ADDRESS / ALUE ARCHITECT TEL. USE. $ OR ENGINEER NO, FIRE ADDRESS ZONE TYPE GROUP APPROVED ' CONTRACTOR BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. CITY NO. PLANS BUILDING _ r-., STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE INO.OF BLOCS. (FROM C/L STREET) C. OF LOT NOW ON LOT FRONT FT. FT. Q USE OF .�.. EXISTING BLDG. R SIDE FT. FT. cn 2Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. REAR FT. FT. IQ f—. USE OF BUILDING AND WORK TO BE PERFORMED [� DISTANCE BET. BET. MAIN& O MAIN BLDGS. ACCESS. BLDGS. VAR.#+ DATE aC. U.P.qy APPROVED > APPROVED > _ELY , DATE K 0. I hereby acknowledge that I have reed this application and state x. x. (Y. that the above Information Is correct and agree to comply with - . CI• all laws regulating building construction, and I shall not employ Zany person in violation of the workman's compensation laws of E k7 the State of California. 3 I hereby certify that I am properly licensed as a contractor under SQ.FT. N the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in fun force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — am exempt from the provisions of the State of California Business VALUATION ��/, Al m and Professions Code,Division 3,Chapter 9. PERMIT FEE $ {{(////// r u, PLAN CHECK § m Signature of / TAX $ U. o Permittee $ 5 2 7 U Authorized Agent TOTAL PAID $ -7/A 6c, • • 4256) PFIB ♦ t7i•tt*115. min ?5-76cf,r(}01927'. 18 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.90X 1200 COSTA MESA,CALIFORNIA 92626 AP LI 'r 'ION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only REC 1 �lDATE RECEIVED DAT 2 IASG u�id/� Ade. ri OWNER 77y60otti Qea, A.P.NO. ?q-36.-36.2--o% P Mee Sl: 7 BUILDING MAIL ADDRESS /7R AJSmpO/N/ 0it,A ADDRESSMARLAAv. �J�� �$ y//��/� CL CITY //C.,V/ NOW/ /-3 7 aalferiecJ �LO�_/e/ BLOCK CONSTRUCTION Aar C"wel ✓/tri.✓f ) I ADD ALTER REPAIR MOVING DFMOI ISH LENDER �`rvt �i�L'C+cel c••v BRANCH r OWNER . ill* . -_ _ :- Ter_ ,Til • ADDRESS ��-/y/� GJ /,� 29 /(�/t� /'� ( s /�{,�I _ OARCHITECT R ENGINEER �"'/e/ri / knot" TEL. �/r�� USE /I LQA/ �l • (r/V///L`/$ / an � /� q / q FIRE �,s�./yam I� ADDRESS `Jao Weak" a'o. m ZONE TYPE I/r'ROUPJ///ttt APPROVED I I / )( 'J / 76 CONTRACTOR cc.QQ��ss��,,//e� •. • -�� BY I DATE ` /'/XXX/// ADDRESS (J�!/M E NO,OF USE OF NEW CITY NOL ZrGP IPLANS 2 r BUILDING/nt rpt 14 F• STATE CITY /'YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING LIZ 'Lear 33/' (FROM C/L STREET) r/ A• O SIZE NO.OF BLOCS. / �. OF LOT NOW ON LOT FRONT FT, �i FT.c2 G USE OF / t CA EXISTING 11LDG. R.SIDF ET. n/ FT. H .y I i� F^s- Separate permits are required for L.SIDE FT. L7COLI 3 FT. electric,plumbing and heating work. /'/ if Lal REAR FT. 4j FT.00 I.. USE OF BUIL rOI NG AND WORK S TO BE PERFORMED DISTANCE BET. BET.MAIIN:& ^_w f s f O _ 7 .1dl� Cba Zr7'1)C� ewz, _MAIN BLOCS. L/�'7 ACCESS. BLOGS. ;[//1 DATE ..1 + i-Ath etzCg Vh/C� I4, COVARP.g ZEE K APPROVED7.-07/ >0 Q / y 1n JG /. Qrl 4/ ROVEp1w � _ IIATF /�/ /'C./ WJ V C/��L'//,/ �: o I hereby acknowledge that I have read this application and state 1OLD FOR P fl S ECIlLL P,EnI Inflame e IY; that the above information is correct and agree to comply with m G• all laws regulating building construction, and I shall not employ Z any person In violation of the workman's compensation laws of o ythe State Of California. J/�� m I hereby certify that I am properly licensed as a contractor under /7 SQ.FT. w the State Of California =usiness and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, end that s il licen.. . e In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from th. +ovist• sof the State of California Business '0 VALUATION PERMIT FEE E and Professions Co.. •a Tutsi.n 3,Chapter 9. m j PLAN CHECK E c Signature 01 / /� 0 sem` _ �r 1 (Jv—v LL Permittee $ > TAX $ f Authorized Ag. t TOTAL PAID E 4S/ts U w. . . ht.- . zia563 , Par: *. ,*''Tile vn ���„:O8ioor C COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Com tletely — Use nk Only RECEIVED BY DATE RECEIVED DA ISSUE BUILDING `` / ADDRESS .f/v -17— Y (� 1 NO. OWNER \ if /�.�� , A.P.A.P,NO. ERMIT MAIL BUILDING4/5^^ tehiv ADDRESS ADORES ((// TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION NEWHADD ALTER REPAIR MOVING fFMOI ISSH LENDER If,/�x`/ BRANCH O W N E Rta2a. do ADDRESS rr /\ a �Ag a i=�LUE ALT ARCHITECT TEL. I USE /S7�-I�� E OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL. ZONE INO.OF USE OF NEW CITY NO. PLANS BUILDING F. STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 10 S. NO.OF BLDGS (FROM C/L STREET) LL OF LOT NOW ON LOT FRONT FT. FT. Q USE OF EXISTING BLDG. _R SIDE FL FT. VS FSeparate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. C REAR FT. FT. # USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& 'C MAIN BLDGS. ACCESS. BLDGS. VAR.sK DATE MC.U.P..)Ib APPROVED 'C > APPROVED } may' DATE ...1 CL W L I hereby acknowledge that I have reed this application and state O n a, that the above information is correct and agree to comply with m as all laws regulating building construction, and I than not employ Z any person in violation of the workman's compensation laws of _ o ,ii. the State of California. -I I hereby certify that I am properly licensed as a contractor under SQ. FT. w the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR as Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT E ONLY am exempt from the provisions of the State of California Business T #VALUATION PERMIT FEE V $ T and Professions Code,Division 3,Chapter 9. �s 't% n PLAN CHECK $ Signature of o [ l�.�l/ o Permittee $ TAX $ & if; Authorized Agent TOTAL PAID $ . . A '1 ri E- 11 PAID t s}fr.'f: O 4256 } 1G ?5-76cM�;001928' 23..0 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 I AP IC TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only R ( 2 BY DATE RECEIVED/ I' T IS UED BUILDING ^ djpa�/w Ater Y/// _� ADDRESS /����I//d//��(��Tr,(�/,�J/�j',yV' /J / •� / /j OWNER f sem O C4 A.P.NO. /3 y-3bd—O + P.4 MAIL y��/ (��//�/�J f Trr ADIDRIESn�/ ���QQ ADDRESS / • Qxifrog C I ! Ss••lf�� 4 car A"• TE{{ / `-c/T RAL< � LOT'_/y CC— BLOCK CITY / / NE '^l� CONSTRUCTION //p���;�s-��q��� FF NEW ADD ALTER REPAIR MOVING DEMOI ISH LENDER �r/t./ ✓ K '70W Xe BRANCH / /1/3 OWNER 4 / VALVE / ADDRESS (/! �• �r rA/f�t� AR ENGINE T A AAiIi,�/��/ �� NEOL�2(�WO- S L�LI/s- (�F $ Y(�(/f/ OR ENGINEER //�9 fV s 7L e"i/ FIRE ADDRESS Z31d'tf / ✓R7 ZONE TYPE /GRO P t CONTRACTOR On'C�/ pufte(YYC. BVPROV D I( DATE ADDRESS / ,lNF NO.OF USE OF NEW TEL. Kj/rr/..11/�_G/h—n PLAfQS BUILDING CITY NO. 4/1. F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W � SIZE orX 33/' NO.OF BLDGS. (FROM C/L STREET) ' /� �/ 0• 4 OF LOT NOW ON LOT FRONT FT. FT. / L USE OF 4 EXISTING BLDG. R.SIDE FT. / FT.t CI) / iSeparate permits are required for L.SIDE FT. 3 FT. electric,plumbing and heating work. • /// W REAR FT. //0 FT. I--, USE OF BUILDING ANO WORK TO BE PERFORMED DISTANCE BET. BET. MAIN& //11 �Q MAIN BLDGS. �J ACCESS. BLDGS. (1/ DATE a 4 CAC_ Ofjac/Ji O 6024662 C U.P.#ZE3 2 APPROVED ./�j 7 >" "' ILnI6> . w.ci'Y✓1J C70 ) PAPP,ROV EDS �fff�iii'''/�'!A DATE //✓/( 74 a 6�` w O I hereby acknowledge that I have read this application and state u D4 that the above information is correct and agree to comply with 00 all laws regulating building construction, and I shall not emplcmr . t�ry��rsw� ii dd �y m Z any person in violation of the workman's compensation laws on /I h F77p SDFC M 13F(11.IintAA A p Sthe State of California. /f rr. •• "'�'��" .: I hereby certify that I am properly licensed as a contractor under 4$ SQ. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPC6E OF ESTABLISHING A PERMIT FEE ONLY: am exempt from t . provi ons of the State of California Business a VALUATION PERMIT FEE $ and Professions Co:e, Div Ion 3,Chapter 9. m Signature of /i� PLAN CHECK $ . �l ) ° Permittee I•� $ //1(f l/ /1 TAX $ LLLL IIIYYY (/ u Authorized A•- TOTAL PAID $ 2 /moo .a yasI 9.1 PA:. }t I f COSTA MESA BUILDING-SAFETY DEPARTMENT .�,f 1 7'7�rT•c OO .00 , c�' o.• O P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A LI AT ON FOR STRUCTURAL PERMIT For Applicant to Fill in ompletely — Use Ink Only /�J�,/A/ REG I D l DATE RECEIVED eTE ISSV Ep • ADDRESS 'BUILDING ,4f a 11-17:%5 (� PERMIT NO. OWNER \ a_sr��1��- A.P. MAIL BUILDING G ADDRESS ADDRESS / /✓31 sss/✓��� TEL. CITY NO. TRACT ✓� LOT BLOCK CONSTRUCTION NEW ADD ALTER I REPAIR I MOVING DEMOLISH . LENDER Ill �I BRANCH OWNER ADDRESS � VALUE -6- ORN OR ENGINEERL. USE § NE NOTE FIRE ADDRESS ZONE TYPE GROUPS. APPROVED CONTRACTOR _ BY DATE ADDRESS ZONE INO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED gLIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING ly I SIZE NO.OF BLDGS. (FROM C/L STREET) L OF LOT NOW ON LOT FRONT FT. FT. Q USE OF EXISTING BLDG. R.SIOF _FL FT. en 5 Separate permits are required for L,SIDE FT. FT. electric,plumbing and heating work. G REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCEBET. BET.MAIN& G MAIN BLDBLD GS. ACCESS. BLOCS. VAR.# DATE Q C. U.P.# APPROVED — 7 APPROVED D.e .EL DATE ..1 a • w Q I hereby acknowledge that I have read this application and state n N EY, that the above Information is correct and agree to comply with m Ge all laws regulating building construction, end I shall not employ Z any person in violation of the workman's compensation laws of i. the State of California. I hereby certify that I am properly licensed as a contractor under SO. FT. n the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR D Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F ONLY: to— am am exempt from the provisions of the State of California Business VALUATION / X and Professions Code, Division 3,Chapter 9. PERMIT FEE $ �I tJ n PLAN CHECK § � in Signature of G a Permittee $ TAX $ 2 // .a.1 D Authorized Agent TOTAL PAID $ • YAA< :� .4.2565 iilf PAID } {:5:4•.`. C 75-75c,Fr001929' 73.90 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 For Applicant to Fill in Completely- Use Ink Only A PLIkDATERECEIVED FOR STRUCTURAL PERMIT A RE E Dfy�'I$Sy E � BUILDING .y PADDRESS rj/1 /IARLO , aci . ++(t II77 11 _ OWNER / F.46 t)A0ocs nln-x /� . A.P. NO.�.76,7157MA IL PERMItT<Po�i ws.l ADDRESS /7966 Gfe`/ (/mss •/' A ADDRESS BUILDING Z�jj�� ) /�itigLA Au!.�C n ' 7 / V TEL. 1-44/Ag IQW PLOT/-,t/ BLOCK CITY /L`UBJ C7' NO.: 3 A'Zu?7 CONSTRUCTION _.a..._ .r ��,� �� { NEVjt ADD ALTER REPAIR MOVING DFMOLISH LENDER �-VV .t� BRANCH y�RI_v\] OSE 1 (`t $ / — ADDRESS �/3 rib VALUE ARCHITECT -7 f TEL. _ ,,ter USE OR ENGINEER /k L. L • ! �/ pp ift 00 FIRE r� ADDRESS 2-Soo (,U AIt100 j3 $'t ZONE I{ I'T1 TYPE I/— GRO1UP 1�s `/W41t1I/6UILoe� BPPROV CJI / II^l CONTRACTOR// BY ` DATE ADDRESS �J]M� ZONE NO.OF USE OF NEW [[ TEL. kit-02 PLANS 2_ BUILDING /L c.o, e CITY NO. K L f /%f-C F STATE CITY YARDS APPROVED YARD APPROV 'D LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L TR TIy 1 NO.OF BLDCS.�1� 5/p FT.� C. OF LOT X 331 NOW ON LOT V FRONT ! FT. Q / USE OF 'y EXISTING BLDG. -S- R.SIDE a7 FT. FT, rA / F Separate permits are required for L.SIDE Si FT. FT. electric,plumbing and heating work. / t. IO REAR 9 FT. FT. I.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& /F' QMAIN BLDGS. ACCESS. BLOGS.(� Jf/ Q, G/,t / VAR.# rrrr DATE f j fl g t•'� CnA2/3Gf9 C.U.P.#2.626-•p 42� APPROVED/4e-76 ✓ �]h'Lh tG , ) 05a v �1 I ROVED�S1'P 4� — 7/1/-4> /- /O'--7.r l l -DATE �/ w E• i �a� T r- C I hereby acknowledge that I have read this application and state 401.D FOR SPECIe.L REQUIRE y' that the above information Is correct and agree to comply with ftlKl�l`N m G all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of u .Wj, the State of California. � 3 I hereby certify that I am properly licensed as a contractor under (/ SQ. FT. o the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR in Chapter 9, and that such licenses are in full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from t - provisions of the State of California Business VALUATION PERMIT FEE S e and Professions C••e siv - b' 3,Chapter 9. Jr m a PLAN CHECK S Q 3 A m Signature of r o Al Permittee ,' ill $ /on•— TAX E • JC'"Zj 2 / / (� u Authorized ' •_nt TOTAL PAID E . 3. To • 4"asd " l "l17-7ri11 ��1009 vfi::<<::ii6. G COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA,CALIFORNIA 92626 ARPLIC TION FOR STRUCTURAL PERMIT For Applicant to Fill in fompletely — Use Ink Only Ay1I� q/q/q/ SUED 1 BUILDING r//s//////,� I K// BV DATE RECEIVED �RME1 NO. ADDRESS 21/s�, IFC /% • OWNER J At k t A.P. NO. MAIL \ _'7 BUILDING Z�� L. is A _ ^_ ADDRESS ADDRESS nA (s�'V�$ TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION ' .CIFW{ADO ALTER REPAIR MOVING DEMOLISH LENDER • BRANCH ADDRESS I \ OWNER \VLN���•K�/i {.y1 VALUES ers - ARCHITECT \ TEL. USE "/ $ OR ENGINEER NO. , \ FIRE ADDRESS ZONE TYPE It GROUP CONTRACTOR \ APPROVED BY DATE ADDRESS \ TEL. ZONE NO.OF USE OF NEW CITY \' NO. PLAN BUILDING (--i STATE CITY YARDS APPROVED YARDS APPROVED ve LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING (FROM C/L STREET) 14 SIZE INO.OF SLOGS L OF LOT NOW ON LOT FRONT FT. FT. et USE OF EXISTING BLDG. R.SIDF FL FT, N] 5 Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. C REAR FT. FT. tel USE OF BUILDING AND WORK TO BE PERFORMED E.. USE BET. BET. MAIN& GMAIN BLOCS. ACCESS, BUMS. Q VAR.# DATE C.U.P.# APPROVED APPROVED yr RY ,DATE tt ILI s 0 I hereby acknowledge that I have read this application and state N cg that the above information is correct and agree to comply with n m M all laws regulating building construction, and I shall not employ i Z any perfon in violation of the workman's compensation laws of d the State of California. 9�t I hereby certify that I am properly licensed as a contractor under Y '-U SO. FT. a 9 the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR ro Chapter 9, and that such licenses are In full force and effect, or I THE PURPOSE OF ESTABLISHING A PERMIT FE • 'p LV am exempt from the provisions of the State of California Business 'and Professions Code,Division 3,Chapter 9. VALUATION PERMIT FEE S c� n PLAN CHECK $ ^, Signature of O Permittee $ �` TAX $ u. 1�/ 2 U / Authorized Agent TOTAL PAID $114 s PAIfl 42566 WG ?5.76 tr00193D'? ****31.70 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 PPLIC TION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only /� Ave.. E VE BY DATE RECEIVED D TE{IS UFS/ ADORES,G jHK� EVES / I. 17 // A.P. NO J/� "dr,_ / a P RMIT NO. OWNER eV 656 NG 26s-.0 A MAIL (79bi 5k 'iP� I - BUADDRESS 44A, MAIL ESS�f �/JQ CITY //C.d/ NII1 / /•3371Izl{I A wed ot• /-/& BCO CCK_ CONSTRUCTION NEVjI^ ADD ALTER REPAIR MOVING OFMOLSH LENDER 3-near-a° X BRANCH ~— ��JJ �r OWNER ADDRESS L, Z1 VALUE / .,, al , ARCHITECT Zfleme�l dGZy TEL. 71 'y�C USE l� `ry2 `x[ '71 C. S�L(J (J OR ENGINEER n '- FIRE ADDRESS /1/300 �/ b . ZONE TYPE •GROU I-/�� CONTRACTOR CoUtfei'y/6 ia-e,�YC- BYPRO � DATE ('"I �' / ADDRESS C ZOJt EE NO OF USE OF NEW /— TEL. K /O PLANS /•f BUILDING CITY i/ -42 4STATE CITY YARDS APPROVED YARDS APPRD O Sy 5 LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING Lid SIZE NO.OF BLDGS. 1 • 4:,"-C. (FROM C/L STREET) / S OF LOT "W O Ir 3 3/ NOW ON LOT FRONT FT. //O FT. hUSE OF ^ / / •f EXISTING BLDG. R.SIDE FL ri[�j FT CD I II Separate permits are required for L,SIDE FT. Q FT. electric,plumbing and heating work. r lO - REAR FT. //tom FT. F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CG MAIN BLDGS. ACCESS.BLDGS. PZ VAR.# �+ ^�/ DATE .. ��/Z IJ(///.1 ..J�E/J� C/: L�/J,Ij[� C.U.P.9W�r 7�I// APPROVED,/37,6 a _(gQ7-00��(//., APPROVED /�//�J '/ _ !7L `r'og r 4 0 4 _aY �I4Y+ //� DATE ///� ! GP C4 I hereby acknowledge that I have read this application and state ' that the above Information is correct and agree to comply with ! `O�D 'EOR. SPEC'.'.�I 'P.Er?t. J!P_EM PITS" O. construction, and I shall not employ m all laws regulating building P V 2 Z any person in violation of the workman's compensation laws of the /Peso State of Californie. aI hereby certify that I am Properly licensed as a contractor under SO. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and the such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: - am exempt from provisio of the State of California Business VALUATION PERMIT FEE $ '0 and Professions C , [Avis n 3,Chapter 9. CYOm ,r PLAN CHECK 5 2/ ; Signature of ....../ o Permittee $ / O 0 TAX $ U. Authorized 4 t TOTAL PAID $ / 'l,7- .' L/ -366 ' V ,7-7ti"All 001010 62.1;c COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 A L AT N FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only /s RE E DATE RECEIVED D E S UED BAUD ILDINsGA1-rye . I-�ARLA Lia ._` ` ON b ^ • ID NO. OWNE^'w\ G7 /`•O A.P.NO. MAIL BUILDING 2` E0 1 1 _ szL pL rI C ADDRESS ADDR E55 hp `Fe7F'^ fl{V TEL. CITY NO. TRACT LOT BLOCK CONSTRUCTION `NEW/ ADD ALTER REPAIR MOVINf, DWOOLISH LENDER / BRANCH �ANES Co OWNER ADDRESS 6a�s VALU$ ARCHITECT TEL. USE OR ENGINEER NO. FIRE ADDRESS ZONE TYPE GROUP APPROVED CONTRACTOR BY DATE ADDRESS TEL.— . ZONE NO.OF USE OF NEW PLANS BUILDING CITY ' NO. w. STATE . CITY YARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING 18 SIZE I NO.OF BLOCS (FROM C/L STREET) 0. OF LOT NOW ON LOT FRONT FT. FT. USE OF • ti EXISTING BLDG. R SIRE EL FT. cit - FSeparate permits are required for L.SIDE FT. FT. C. electric,plumbing and heating work. REAR FT. FT. W — USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCE BET. BET.MAIN& Qn MAIN AIN SLOGS. ACCESS. BLDGS. VAR.# DATE ..1 C.U.P.# APPROVED a 7 APPROVED ).. --ELY _DATE CC W 0 I hereby acknowledge that I have read this application and state N N ix that the above Information is correct and agree to comply with m 6L all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of u W the State of California. - 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. a the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: am exempt from the provisions of the State of California Business VALUATION n v PERMIT FEE $ % / 0 v, and Professions Code, DWiiion 3,Chapter 9. e m PLAN CHECK $ `n Signature ofe Permittee $ TAX $ LL � U Authorized Agent TOTAL PAI❑ $ 62, la 4350& -rn 14-77P°F ' OO 719": *r** 73.i6 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 , A P CA ON FOR STRUCTURAL PERMIT For Applicant to Fill in Completely — Use Ink Only RE E DATE RECEIVED DATE I UE BUILDING t�—� _ ADDRESS 1 +i Harla Avenue I Pr/ 1st?-3� i- PERMIT NO. OWNER Janes Company A.P. NO. `� MAIL BUILDING �- ADDRESS 17932 Skypark Suite D ADDRESS , 5— „,..4 �/c CITY Irvine NTo`979-337F / <) /LOY Y BLOCCC_ CONSTRUCTION NEW I ADD ALTER REPAIR (MOVING DEMOLISH LENDER X BRANCH ADDRESS OWNER Janes(]/1Company �• p Q/��0111 ARCHITECT TE 1'I 1 vicrE Jwieffro 15 � n OR ENGINEER H. M.Hansen NO`2a6-913'" . - . - . FIRE •//� T ADDRESS 9126 Las Tunas,Temple City ZONE TYPE.. GROUP APPROVED 2/4-7P CONTRACTOR California Pools, Inc. BY DATE ADDRESS 11836 Downey Avenue TEL. ZONEQ,l O.OF 9 USE OF NEW W CITY Downey, Ca. No. 865-627F f/l.��LANS BUILDING F" STATE CITY YARDS/ APPROVED YARDS APPROVED A 5� LIC.NO. 185102 C 53 LIC. NO.1011 , MAIN BUILDING ACCESSORY BUILD( Y SIZE • • ^ "• -y/�.l' �j �y / 4 OF LOT • • • FRONT // FT.� " .. r / FT. � �r Q EXISTING BLDG. R.SIGF } /FTQ /, ��T. Cl el to Es Separate permits are required for L.SIDE FT. FT. _ electric,plumbing and heating work. REAR —'T _Lag' FT. W USE OF BUILDING AND WORK TO BE PERFORMED F DISTANCEABET. BET.MAIN& Q� MAIN BLOCS. ACCESS. BLDGS. C�'_y I A and spa VAR.# �I DATE ./s•s'•I• `I swim p001p C.U.P.qW I'/ APPROVE7 7 APPROEyIdLr ^"i'Fs39':///'7/ )., Ry S JJ� J Wr . ... . . _ . . .. ,.. .. . 0 I hereby acknowledge that I have reed this application and state N C4 that the above information is correct and agree to comply with n m O• all laws regulating building construction, and I shall not employ X any person in violation of the workman's compensation lows of o W the State of California. ogi- v 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. SPAI`• rmv the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT F E ONLY: to am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ f!•L/{e'8 `t and Professions Coda,Division3,Chapter 9. ; iI'� rNn /' pair. PLAN CHECK $ '!70"��y M Signature of J �at /,_i �' tY O � o u. Permittee / uQ/�" $ !ice"� 6. U TAX $ �7 t0 u. Authorized Agent g TOTAL PAID $7 1 J / _ PA1 l 43886 pa ar 77,.`.00 597'I ,: *33.56 a COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill in Completely —Use Ink Only REC : DATE RECEIVED BUILDING ✓✓ff���� . s `=� I ADDRESS LL(J�✓� ban�.� � OWNER -727/6 J�� W f A9. NO. I#SCI 1( �ll4ERMIT NO. �J ,/j�,� rte) BUILDING' ` ',- At - ADDRESSJ 93Z 'Vg fie20 Y(/ " ADDRESS 0 •t}IRl�l^�,1]r` • CITY/Iru S a , /G 7/4 NOL9f� TRACT LOT BLOCK CENT UCTION /kw° s '// NEW ADO ALTER REPAIR MOVINS 11FMOLISH c4J1L4/ff/Ss p x BRANCH t s , r _ _0. ADDRESS L , Q 1ARCHITECT OWNE j ^j�V� 7` -. ///� VALUE �I �,0 OR ENGINEER Gy-r A //L!� NOl.4�-4030 / §ai/ ADDRESS 2-300 £4Jt��f ���. FIREYP �j, OLi — i --- ZONEPR Li / GR / �� ip APPROVED CONTRACTOR Om ua+�— BY DATE ADDRESS TEL. ZONEF46#L0A.ONSF� U9USIELDOFNNh ' CITY NO. 6t F STATE CITY ARDS APPROVED YARDS APPROVED LIC. NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING _ L � (FROM C/L STREET W SOIFZELOT )�o NNOWNBLOG . ONi FT. Q USE OF /�vYJ con EXISTING BLDG. �"T a � . • . F Separate permits are required for L.SI , ip � � �J� electric,plumbing and heating work. {'+.1 - REAR FT. T. F• USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& G MAIN BLOCS. ACCESS BLOCS. VAR.# DATE a S f�(14���eites- �iQ(�S 9 C.U.P.9ie ,r/j////� APPROVED ✓ .-11eAe2 C'§`ti��c/�� APPROV A/A SATE91-2:2/F77 ..1 1 'U W 0 I hereby acknowledge that I have read this application and state m N a that the above information is correct end agree to comply with m ''• all laws regulating building construction, and I shall not employ Z any person In violation of the workmen's compensation laws of o the State of California. ,: I hereby certify that I •m properly licensed as a contractor under SQ. FT. cv the State of Callforni: Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, end that ch licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: to am exempt from th. provi on o the State of California Business o and Professions Co--,Div 3,Chapter 9. VALUATION ©O PERMIT FEE § e m Sipnetura •f % //fA�/t PLAN CHECK $ / O o Permittee _ /'' $ ✓sem ©D TAX $ ! �a U. U Authorized Ag. TOTAL PAID $