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Home My WebLink About3585 HARBOR BLVD - Building Permits_ � � �� ' - ;�3I51 ' COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O.-BOX1200 COSTAMESA,CALIFORNIA92626 For Applicant to Fill in Completely BUILDING�S pS T}y�"C��/.�i�i ADDRESS OWNER `!�QNDo�cN �'�Q�3clt' �'�: MA�� ? �� . �RV��!-� l✓�Y Z ADDFESS dU CITY / �/ /��/ � NO�. �/.0 �i ZZ Q CONSTRUCTION � �^ ON LENOER 2 6] J � BRANCH ._�' J N ' m J ADDRESS ' 2 ` m ARCHITECT D I� I. ^C NELJ 'G� J N OR ENGINEER U Q W 2 A�ORESS aw J O CONTRACTOR m Z J � ADORESS w w TEL. � CITV NO. 2H w � STATE CITY y� LIC. NO. LIC. NO. 7 � S12E NO.OF BLDGS. OF LOT �� O X�Q � NOW ON LOT USE OF ,/ E%ISTING BLDG. 3 /" L H SIZE OF �� .�'2 ROOMS STORIES S Z NEW BIDG. a E%TERIOR WALL� ROOF � �% COVERING J/�LGO COVERING J USE OF BUILD�NG AND WOflK TO BE PERFpqMED a a o � ��B�P�' . H N z � VI hereby acknov,�ledge that I have reatl this applicacion antl swce � that ffie above information is correct and agree to comply with � all laws regulating builtling construciion, antl I shall not employ F nny person in violation of the workman's compensation laws at y the State of Calitornia. zI hereby certify that I am prope�ly licensetl eS a conhacfor untler the Stare ot Caq}ornia Business antl Profassions Cotle, Divisicn 3, Chepter 9, and that such licenses are in full force antl etfect, or I am exempt from [he provisions of the Stat¢ of California Busin¢ss antl Professions Cotla, Division 3, Chapter 9. Sie�et�re of Permlttee '1 Authorizetl Apeqt �� PAIO/1n -,� - . . . . _ r.. i�l': � �"7 ! � ' APPLICATION FOR BUILDING PERMIT RECEIVED BV DATE RECEIVED D^ATE ISSU '/ �� A.P. NO. 3 /'� BUILDING ADDRE55 � OWNER FIFE ZONE APPROVED ZONE NO.OF C3�� PLANS VARDS APPROVED MAIN BVILDING DISTANCE BET. MAIN BLDGS. V AR. $ /LOY � BLOCK �/l1 (C�-�-""�! �1 VA�UE ��, H 5 GROUP l� ATE � �� JSE OF NE � 3UILOING � 1'P.%10S APPROVE� ACCESSORV BUILDING BET. MAIN & ACCF�. BLDGS. DATE APPROVED �� n `7`— . / � SQ. FT. o THE AMOVNTSHOWN UNDER VALUATION IS FOR � THE PURPOSE OF ESTABLISHING A PERMIT FEE ONIV: m ¢ VA�UATtON � � m v PERMIT FEE $ � 7 , � m 5 O� • P�P.N CHECK $ ✓ S E `o LL TOTAL FEE $ � COSTA MESA BUILDING-SAFETY DEPARTMENT + P.O.BOX1200 COSTAMESA,CALIFORNIA92626 For Applicant to Fill in Completely — Use Ink Only MAILING ADDRE55 CITY li ARCHITECT OF ENGINEER I/ ADDRESS �� CONTRACTOR TEL. NO. N�3. APPLICATIOI�itF RECEIVEDBV PI N.P. NO. ADD RE55� S�C UNIT O�T SPACE NO. TR.NO. LOT NEW AOD LTI USE ��s�� I�j4'�1��.�. PERmtiT 53. 30 TL N° -� BLK. REPAIR MOVING DEMOLI51 VALUES�[I)� � `/L TEL. CITV - �Ff/Q-� NO. (� F STATE CITV APPFOVEOSETBACKS � LIC. NO. — LIQ N9. {y SIZE NO.OF BLDGS. (FROM C/L STREET) L pF LOT � NOW ON LOT ONT FT. � a USE OF / .�. EXISTING BLDG. C6- �/Q-L h FSeparate permits are required for �. sio � � electric, plumbing and heating work: REAR T. U, rp I� VSE OF BVILDING AND WOFiK TO BE PEFFORMED PLANNIN ACTIO �' ¢ � � J DATE Q � /� APPROVED � � APPFOV } � � ..1 C u� � I heraby acknowletlpe that I have reatl this epplication antl stete � � that tho ebove information is correct antl agree to comply wlih � 0. all laws regulaLng buildinB �onstruction, antl 1 shall not employ � Z any perwn in violaiion of the workman's compansation laws of Q Tt�e Staie of Celifomta, m 3 I haroby certify [hat I am properly licensatl as a conttactor und¢r SQ. FT. �+ t�e Stata of Calitornie Buzinass antl Professions Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl that such lieenses ere In full torce antl aftect, or I THE PURP06E OF ESTABL5HING A PERMIT FEE ONLv: " u am exempt trom the provisJpnz of tha State.6f Californla Business VALUATION PERMIT FEE � O a and Profassione Cotlo, DI �on 3, Cha ter (/ a Q m n S(pnatura of � � OQ PLAN CHEGK f �%O O o Permlttea S � 7� f or / / TAX S , SO u AuthoNzed ABent Date _� TOTA� PAID S �� _ Z A � Applicant to fill in all soaces except tnose witnin neavy boreer linas ana sign a11 aov�ovriata aeclarations. �'� �C!?'Y OF COSTA ME�SVA� �CQP�T�CTION PERMIT Pro'ej c[Address � KSvP, BL1%r% Applicant'sMailingqddress 2aQ) �fiYiil �LAA i7� T•Mr � -` Owner's Name �`1(�' _ VR�� opR,s p� Phone Addreu _La_Q� }��i�Ei:. P�:LA=�� 2 Arch/Eng. ✓ �ice�se rvo. 5 2�{-3^2 Address 2 �� •"�' I r�l{rY er� / COntractor'sNam�l�lf�� J-� � Phone��l Address(mailing�.�Q$�k `�2�Lq 5/iN11� QAyy�1 Q2']C�1 City License No. _ '2{�(�1_4 LICENSED CONTRqCTOR DECIARATION I bereby attirm that � am Ilce�?setl.untler provisions o1 Charter 9(commen<ing witn section J000) bf Dlvislon 3 0l [he Business antl Profe55ions Cotle, antl my Iicenze 6 in full /orca ana M/ect. Licanic Iass Lic so N. y Dalc_�=�� Signature WORKERS' COMPENSATION DECLARATION I b0�eby ai/i�m that I have a certiflcate of Consent to Sel/-Insure ot a cerUficate of Workers' Compeqsatlon Insurance, or a certiflatl coOY therco� (Sectlon eo ub .� - )Ilc No Compai �C r[ifi coPY s q¢ CbY It oisney. C r f e cop is fil w tne c[y ' din9 D vision Date Applican EXEMPTION FROM WORKERS' COMPENSNTION DECLARATION (This saclion neetl no� bo completotl it tha permlt is lor one hunaretl (5100) or Icss). I certiy that in tne ber/ormance oi the wor hlch lhis perm4 is i uetl, I ihall nol employ any porson in any ma er so 5 to etome bj to the Workerz' pen lon Laws ot Califo a. Date �� 5 _�r-�,�gnature � � `NOTICE: I(, after makin9 this tleclaration, ou shoul be o e su �ect to the Workers' Comoensat�on provisions of the Labor Cotle, you must forthwith comply with such provislons or this permit shall be tloamutl revoketl. CONSTRUCTION LENDING AGENCV I hereby attirm that there is a construction IenOing agency tor tbe performance of lho work tor, Which [hi5 permit is issuetl (Section 309] Civ. C.) Lentler's Name Lentler'S Atltlreu � OWNER BUILDER bECLARATIOti . I hereby atfirm t�a[ i am exempt trom the Contrac[or's LI<ense Law far the /ollowing reason (Section 7031.5 Businesz and Professional Cotle: Any ci[y or county which requires a permlt to construct, alter, Imvrova, tlemolish or reoair any structure, pri6r �a i�s Issuance, al5o reqWrez the applican[ tor such permi[ f0 file a 5ignetl statemenl thdt heJShe Is Ilcense0 pursuant to Ihe prOvisions of the Contractor's License Law (Cnapter 9(commentinq with Sectlon 7000) of Division 3� of the Bu5ine5s and P�otessions Cotle) or that he/she is exempt tlterefrom antl the qasis tor tbe allegetl exemption, Any vlolation of Section ]031.5 by any applicanl (or a permit subjects the aOPlicanl to a clvil �enatty of not more �han tive huntlretl tlollars (g500). ` � I, as owner o( Ihe PrOp¢rty o� my employe¢5 wlth wages as thei� Sol¢ comoensation, will tlo the work, antl the ztructure Is not Intendetl or otferetl for zale (Section 7044, Business an0 Professional Cotle: The Contractor'S LicenSe Law tloes no( apply to an owner Of a properry who builtl5 or Improves lhereon, antl who tloes such work himselt/nerselt or throu9h hiz or her own employ¢es, p�ovitletl [hat Suth Imp�ovemenls ara n0[ intentletl o� offeretl tor sale. If, hawever, [ne Dulltling or improvement is soltl wlthin one year of com- plGtlOq t�e owner Will havo Iho buttlen of provin9 hC/She tlltl not builtl or im- ptOve to�the purpose ot salo�. ❑ I, a5 own¢r ol thp O�oporty, am exclusively cohtracling wilh Iic¢nsetl con- trattors to conSVuct [ha PrOjett (SecUon 7044, Buiinezs antl Pr0lessions CotlO: The ContractorY Litense Law dOcs not appry lo an owncr o1 propCrry who builtls o� Improv¢s �heroon, antl who contract5 for suGh prolacts with a con- trattor(5} ftense pursuant�to the Con[rac[or'S Llcan50 Law�. I am awaro [na[ proof ot thelr Worker's Comoonsation insuranco snoultl be provltletl to me. ❑ I am exempt untlOr $ecllon B. & P. C. �or this rea5on Dato _�T Owner I nnreby certify tha( � navo rcatl ihiz appliw0on antl state that the aDovo inlormation is mrrecp i a rce lo compty with atl city antl county oralnances antl state laws rela[i o uiltling conSVuctlon, an hereby authorize repre- snntativas oi t city entc upon th abov enlionatl property (or Inspettion o s. � Signature �� Dat Orivers' Licenu o 5� � �� ,��,z� l I� i o 8 3 � r�;:•r�r � TYPEOFCONSTRUCTION NEW aoo ALrEaA ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. —J �T ��OK TION LJ REPAIR TVPE OF PERMIT ❑ GRADING � FOUNDATION PQ STRUCTURAL t:✓IOP ❑ TENANT �ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTNER PROJEC7 DESCRIPTION 5�. FT. OCCUaarvCv — CONSTRUCTIONTVPE V+� VALUATIONS2�� ZONE GRADING CU.YDS.� ACRES '�� Remarks: Bar Sink Backflow Preventer Backflow Irrigation Jrinking Fountains Floor Drains Floor Sinks � �as Service Outlets Interceptors Kitchen Sink Lavatories - ?—Trap Roof Drains' �. Reinspection'Fee $75 Dut� � Under Ground Duct - SVuctural Duct - Ventilating Exheust System � Mul(iple ❑ Firepl/Facc Blt. ICBO dh Heating System & Oucting , �0.100,000 BTU D 7 00,000 BT Reinspaction Fee I $15 CMF 0865-46, rev. 30/84 Whi[e - Bulltling: Canary - qppllcant; Plnk - Accountln9; Goltlanrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Piping Solar Tank Swimming Pool w�Spa Water Closel Water Heater Water Service Auto-Wash Laundry Trays laue Fee Hood or Type I 0 Canopy Type II ❑ Refrigeration System �4700,OOOBTU ❑100,000 System Repair/Alteration Fire Dempers Registers Issuo Fee 9 FEES A.P. � S Main Buildii E T Front e Rear A C Right K Left S Ping. Ref. # Planning Notes: � Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher , Dryers �Gas ❑Elec[ric Fan F.A.U. Fixtures Deviceeoxes Outlets Switches Garbage Dispoul Geuerator �a5 KW C 4218 6/O6/85 Zone Accessary Building: Parking Req.�Provided � ELECTRICAL •• Trans(ormer ❑ 15�50 KW ❑ 50+KW Meter Uup to 100 amps Meter ❑over t00amps Sub Panel ; Motors 00.1 HP �7 h- 8 Inc.Solar �9�15 HP �16-15+ Microwave _ ., . . Pole Light Range ' ! Standing Sections 75 KW Trash Compattor $ 3 Reinspeetion Fee • $75 - Issue Fee fEES DEVELOPMENTSERVI� RE� IRE TS: � ' Zoning Approved By � Building Approvad By Aooliration Issued Bv` r $ 3 . �G54;�:, i_ Z O N I N G R E Q M T S FEES $ 3 � SUe A V OF FEES � I q BUILDING PERMIT $ --�ii;� SMIP $ PLAN CHECK $ O PERMIT PLUMBING ,r § � ��UANCE $ . P�AN CHECK 25% $ � �ENERGY P.C. $ ELECTRICAL �$ ' GAADING $ PLANCHECK �50% $ MICROFI�M $ MECHANICAL $ _ TOTALFEE :$365 Slp PLAN CHECK 25% $ �_� a CONSTRUCTION AND PLAN I�d POOL �..PA ') ApPROVALS � Permit � Date Inspector APPROVALS Permit # Date Inspector 1. 7emporary Electrical Service or Pole : 52. Pool & Equipment Location 2. .�joil Pipe-Undrgrnd. 53. Steel Reinforcement . 3. Electrical Conduit'Utility-Undrgrnd. 54. Forms 4. �lectrical Conduit-Undrgrnd. ' 55. Electrical. Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 1 6. Electrical UFER Gmd. •• 57. APPROVAL TO COVER-GUNITE . � 7.- Footings �._ . 58. Electrical Conduif-Undrgrnd. 6: Foundation � � 59. Gas Pipe, � Undrgrnd., Teit � 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. ' 10'. Structural Floor System S�/�iQ � �+ fT % G�i/% 61. APPROVAL TO DECK } 1, property Sewer Line & House Connection � 62. Backwash & Receptor-Final 72. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains � � ' � 64. Plumbing System - Final 74. Rough Plumbing- 65. Electrical-Final 15. flough Electrical-Conduit 66. Solar System-Final . � 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 6S. APPROVED FOR PLASTEflING 7$. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIFiE DEPT. REQUIREMENT . 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Duc[s, Ventilating , 71 . Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test � � � 72. Underground Flush 24. Roof Framing � . � 73. Undergrnd. Storege Tank O Gas ❑ Oil 25. Roof Sheathing ' - . 74. Overhead Hydro � 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and F.lashing s '• tu , /� Ly 76. Dry Standpipe . ! (7s 28. Lathing & Siding '. . 77. FIXED SYSTEM FINAL 29. Insulation . �� . 78. FIRE PREV. FINAL 30. Drywall Nailing � 6/}� 8 �E� ' HEAL7H DEPT•. REQUIREMENT � 31. Plaster Brown Coat . '� 79. FINAL INSPECTION 32: Electrical Power Meter=Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: j�6s- mn ' o�c.Y 34. Final Heating & Air Conditioning . / �� !a2 O 35. Final Gas Pipe-Test U�; � 36. Hpod or CanopY 37. Final Faaory Fireplace _ 3 �� 38. Final Plumbing - s- a 39. Wster Service-Fina1 eN 6 - 40. Gas Service-Final S - 41. Solar pomestic-Final • 42. Backflow Preventer /S . �1 43. Backflow Irrigation � ,� + � � f 44. Landscape Irrigation System �- o< � /-' � /J 45. Sound Attenuation �SI 46. Handicap Regulations w�l 7/g� � 1 � / 1 47. FINAL STRUCTURE & BUILDING� 8� ' / 48. Special Requirements Completed � , . 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - b1. CERTIFICATE OF OCCUPANCY � , , No. Date Aoo�leant to fill in all soaces axcepl those within neavy eoraer Ilnas ana sign all approorlate aeclaratlons. CITY OF COSTA MESA CON./�ST. R UCTION PE/lRMIT PERMIT Nq„ ,� ,� ,� TRACT NO. LOT N0. UNIT NO. Project Address�S��//1��2 .UGUO� �„j Applicant'sMailingAddreu L��L��j ��'�— Owner's Name Phone Address Arch/Eng. License No. Address ' Contractor's Nam � — Phone ' ' � /1ddrC5s (mailing) � p � LL..� Ciry License No. ��L /ti�T�/ d- � LICENSED CONTRACTOR DECLARATION --Tq,��j� I h¢�eby affirm t�al � am Iicensetl untler prOviSions ot Chdrto� 9(commencin9 wlth sectlon ]000) a} Divlsion 3 0l tne eusiness ana Profeizions Coae, antl my li<ense is in tull orce an e/te<t. ��(///J�f r��,�/G� Licanse lass - � Licente N',f��N�-�--- Dat � Signature WOR ER ' O PENSATION DECLARA ION I hereby aHirm that I pave a certiticace ot consent to sell-insure or a certificate �f Workers' Compen�t�pn Insurance, o� a cer[itied copy thereof (Section 360, Lab.. . ir ��j�� oli No � � ComDany �./Y�r��'!�'%� ' Certltie mpy is hereby furNshetl. Certl ietl Y is tiletl witn the cily,BBlltling Divisio /%/l Oale Applicdnt�� ' k'�T Li E%EM 10 M WpRKERS' COMPENSATION UECLARFTION (Tnis section neetl no[ pe campletetl it tne permit is for one huntlred (E100) or less). 1 certity that in the perto�mant! 01 the wo�k for whlcb thl5 p¢rT�t Is izsuetl I shall not employ any parson in any manner so as to bGtOme subjett [o �t�e Work¢rs' Comp¢nsati0n Lnws of CalitOmia. . Data 519nature 'NOTICE: If, after making this tletlaratlon, You shoultl become subjeGt to the Worke�s' COmpensation provlsions ot Ihe Labor CoUu, You mu5[ fo�thwitM1 comply wilh such provlsion5 or thi5 permit shall be tlC¢med revOketl. CONSTRUCTION LENDING AGENCV I nereby altirm that tqere is a comtrucUon lentling agenty for the perrormance ot [ho work 1ot Which Ihis permi[ is issuetl (Sectlon 3097 Civ. CJ �entler's Name Lenaer's Atlaress OWf�IER BUILDER DECLAftAT10N I horeby aflirm that i am oxem0� lram tha Contractor's License Law tor the /ollowin9 rea5on (Sattion 7031.5 Business antl Proicsslonal Cotlo: Any ci[Y or county wlilGh requirpz a pe�mil lo con5truct, aliCr, Improve, 0¢moli5h o� �epair any structure, prlor to Its issuance, also requires the appliwnt for sucn permit to lile a Si9ned StateMenl thal he/she Is lit¢nwU OU6uan[ to Ih0 P/ovi5iOn5 0( No Con[ractorY l.icenso Law (Chapter 9(commeneln9 w��h Sectlon 7000) ol Division 3 ot Ihe Busin¢ss antl ProfesSiOns Gotle) or thal he/she is oxempt lhCrafrom antl Ihe 4a5i5 for th0 alle9etl exemptlOn. Any violatlOn of SectiOn 7031.5 by any applicant lor a pc/mlt Subjects tha ap0�icanl lo a clvil �enalty ot not more than livo huntlrod tlollars (5500). I, as owner ot tne property or my employees with wa9et as tneir sole I Compen5atlon, will tlo [h¢ work, antl t11e SVUGtufe IS nOl InlenOeC of Otf¢rCtl lor salu (SeG[ion 7004. Buzinoss antl Professional Cotlu: Tha Contmctor's liGense Law tloe5 nOt appty to an Own¢r ot a pmpe�ry wh0 bWltls O/ improv¢s t�creon, antl who ap¢z such work nimseli/herself or tnrou9h his or her own employnes, provitlea tnal such Improvements are not Intentlea or oHeretl for Sale. It, however, tn8 builtling or improvement is soltl wlthln one year of com- Dlotlon, tM1a owner Will nava tna bur�en o/ provin9 pe/she ditl nol builtl o� im- prove for the purposg ol salo). ❑ I, as owner of tn¢ property, am excluzively contracttng with 11<ensotl con- tractor5 to const�uct Iha project (Settion ]044, BvSiness and PrO�es51on5 Cotle: Tha Contractor'z Llcense Law does not apPIY to an owner oi property wbo bullds or improves tnereon, antl who conVacls (or such projects with a con- trac[or(s1 Ilcense puYSudn[�to tno�COntractOr's License Law). I am aware [hat Droof of lheir Worker'S Compensatlon insurance shOultl be provitled to me. ❑ I am exempt untl¢r Sectlon B. & P. C. lor this reason �ate Owner _ 1 h¢r¢by certi/y tbd[ I hdve reatl Inis iMormaHon is correCL I agree to compl antl state laws relatin9 to builtling cons zentatives of tNs' cily to enter upon Inspectlon pu es. Signature Driver5' License or S � �� TVPE OF CONSTRUCTION LI NEW U ADD/CJ ALTERATION Ll REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL ❑ TENANT. ELECTRICAL ❑ PLUMBING ❑ MECHANIGAL ❑ OTHER PROJECT DESCRIPTION Sq. FT. OCCUPANCV CONSTRUCTION TVPE VALUATION 5 ZONE GRADINGCU.YDS. ACRES Remarks: Sink kflow Preventer sflow Irrigation Clarifiers Dishv.2sher � Drinking Fountains Floor Drains FIOOf $i�k5 Gas Service Outlets Interceptors Kitthen Sink � Roof Drains Reinspec[ion Fae � $15 Boiler Duct - Under Ground Duct � $LruC�urdl Duct - Ventilating Exheust System ❑ Multiple ❑ Firepl/Fact Blt. ICBO # Heating System & Ducting ❑ 0.7 00.000 B TU O t 00.000 BT Date� �� Reinspection Fee $15 CMF 0865�46, rev. 30/04 White - Bulltling: Canary - qppiicant: Pink - Accounting; Goltlenrotl - Assessor PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash Laundry Trays laue Fee Hood or Type I LJ Canopy Typell ❑ Refrigeration System ❑o-ioo,000eru ❑ioo,000 System Repair/Alteration Fire Dampers Registers Ittue Fee FEES $ 3 $ 3 A.P. qW S Main Building: E T Front A Rear C Right g Left Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outlets 6776 6/12/85 I;oli TL Zone , �Accessory Building: Parking Req,�Provided ELECTRICAL 7ransformer � 75-50KW ❑ 50+ KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel Motors �0-1 HP 01 Yh - 8 Inc.Solar �9�15 HP �16�15+ Microwave Pole LigAt Garbage Disposal I I; Standing Sections Generator 00.5 KW �5�15 KW Trash Compacror � Reinspection Fee �$15 � � luue Fee DEVELOPMENT SERVICES RE�UIREMENTS: ZoninB Approved By Building Approved By Application luued By �� FEES 5 3 Z O N I N G R E Q M T S SUMMARY OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK 5 PERMIT PLUMBING $ ISSUANCE $ PLAN CHECK 25% 5 ENERGV P.C. $ ELECTRICAL § � GRADING 5 � PLANCHECK 50% $ MICROFILM $ MECHANICAL S TOTAL FEE $ � PLAN CHECK 25% $ CONSTRUCTION AND PLANNING POOL i...r'A APPROVALS Permit# Date Inspector p�ppROVALS Permit# Date Inspector �1. Temporary Electrical Service or Pole� j. 52. Pool & Equipment Location r 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement 3. Electrical Conduit�Utility-Undrgrnd. - 54. Forms 4..Electrical Conduit-Undrgrnd. � �j �� C�D 55. Electrical Bonding . 5. Steel Reinforcemeht � 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnil. • 57. APPROVAL TO COVER-GUNITE ' 7. Footings ' � '� 58. Electrical Conduit-Undrgrnd. � .8. '�oundation �' I �' 59. Gas Pipe, O Undrgrnd., Test 9. Water Pi e-Undr rnd. � , P 9 , i 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 Orains �•� 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final 15. ;Rough Electrical-Conduit-- 66. $olar SYstem-Finab 16.' Rough Electric Wiring �3 �tl 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 CAnditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structure '' 70. Underground Hydro 22'. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23� Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing i 74. Overhead Hydro �26. T•Bar Ceiling (Structura�) & 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. Eiectrical 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 pomestic-Final � 42. Backflow Preventer . � 43. Backflow irrigation ' ' 44. .Landscape Irrigation System 45. Sound A[tenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Ediso� 50. Gas Release to Southern California Gas Co � � 51. CERTIFICATE OF OCCUPANCY . . No Date Applicant to flll in all spatts ezceot those within h! y GarOer Iinas and sign all avVrooriate aeclarations. CITY G�,JSTA MESA CONSTR,U�CT/�ION PE�I'T/ � P�MIT NO. . TRACT NO. LOT NO. - � un�1T n�/� Piirct Address � -3 ��5 ��`��%%�' � �%U - Applicant's Mailing Address � � � �� .Nj ��t'��Z'�✓�/ � Owner's Name �O�N V�/� �V�'� Phone Address Arch/Eng. License No. � Address �-y� Contractor's Name S Z� �L P� ��' phone , T do Atldreulmailing) ��/y �Q" �-e'"��• n�' ��• Cify License No_ ' 0� S� e q' LICENSED CONTRACTOii DECLARATION ' I hereby attirm tnat I am Iicensetl unaer provisions of Charter.9 (commencin9 � with section 7000) of Divizion 3 of the 6usiness an0 Professlons Cotle, antl my license is in f WI force ntl e(fect. - q�O� License Qass � c� � Lipense o � Date �-" �Z -� Signature �W ?5� - WORKERS' COMPENSATION DECLARATION � I hereby atfirm that I have a certificato of consent to selt-insure or a certiticate ot Workers' Compensation Insurance, or a certitietl cooY thereoi (Sect n .3800, Lab. C. - cr�''�i � olicY No. T� �� ComPa^Y ' " "-' � �Certitietl copy is hereby fumished. CerC ied �gpy i[y�tl wiM the city Bu� in ivi i ( oa�e "L J APPlicant • EXEMPTION FROM WORKERS' COMPENSATION DECLAR TION ' (This section neetl not be com0�etee if the permit is for one hu tlretl (5300) or less). I certi(y that in the perto�mance o1 [he work fOr whioh this perm�t is i55uetl, I� � shall not employ �any pe�son in any manner so as to become subject to [hC.' Wo�kers' Compen5a[ion LawS of California� , Date $i9nature �NOTICE: If, after making this tleclaration, You shoultl become subject to the Workers' Compensalion proWsions ot the Ldbor Cotle, y0u must forthwith compty wi[M1 such provisions o� this pe�mil shall be tleemetl �evoketl: CONSTRUCTION LENDING AGENCV.. - � I hereby affirm that there is a construction lentling agency for the performance of the work tor w�ich this permit i5 �SSu¢tl (Section 309] Civ. C.) �enaer's Name Lentle�'s Atltlress � , , OWNER BURUEN dECLARATION - I hereby affirm lhat I am exempt trom the Contractor's License Law tor the following reason (Section 7031-.5 Buslness antl Professional Coae: Any city or county which requires a petmit to ConslruF�: alte�, imp�ove, tlemolish or repair any structure, prlor to its issuance, also requires [he appticant 5or such permit to (ile a signetl Statement �hat ne/she is IiGenSetl pursudnt to the provisions of Ne Contractor's License Law (ChaO�er 9(commencin9 �+�tn Section ]000) ot , Division 3 of the Business antl Professions Cotle) ontnat he/she is exempt theref�om antl [he basis for the allegetl eXemptlon. Hny violaiion' ot SecHon 7031.5 by any'applicant for a permit subjects [he applicant to a civll penalty of not more than /ive M1untlretl tlollars (y500). � � � I,'as owner oi the property or my employees with wages as tneir solo compensation, will tlo tne work, antl tne 4Vucture is not intentletl or otteretl for sale -(Section ]044, Business antl �Professional Cotle: The Contractor's ' license l2w tloes n0[ appry to an owner ot a property who builtls or imp�oves thereon, antl who tloes such work himseif/herselt or through his or her own employees, provitletl that such�improvements are'not intentletl or otteretl for sdle. If, however, Ihe bulltling or improvart�ent is soltl wi[hin one yea� of com- pletion, tbe owner will have the bu�tlen of Proving he/she tlltl not builtl or im- '� rove tor the Ourpose Ot sale). I, as owne� ot the property, am ezclu5��ely contracting with Iicensetl con- Vactors to construct the project (Section 7044, Business antl Professions Cotle: , The Contractor's License Law tlocs noi aPP�Y to an owner ot property who builtls or. improves tnereon, antl wno con<racts for such projects with a con- Iracior(5) liceni¢ pursuant to�the Gontractor's liten5e Law). I am aware [hal � proot o( thei� Wo�ker's Compensation insurance shoultl be provitled to me. ❑ I am exempt untler Section 8. 3 P. C. fo� lhis reason Date �Signature Y�• � Drivers' License or 55 CMF 0865-46, �ev.� 30/84 Owner tnis Z- TVPE OF CONSTRUCTION ' LJ NEW � ADD LI ALTERATION LJ'REPAI R ❑ CONVERSION ❑ DEMOLISH ❑ OTHER OESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT� IJ GRADING �yLJ FOUNDATION LJ STRUCTURAL ❑ TENANT ❑�ELECTRICAL ILTPLUMBING ❑ MECHANICAL ❑��OTHER . � _ PROJECT OESCRIPTION Sp.FT. OCCUPANCV= CONSTRUCTION TVPE VALUATION $ ZONE GRADWG CU. VDS. ACRES- Remarks: Bar $ink � Backflow Preventer Backflow Irrigation Bathtubs Clarifier5 Dishwasher � Drinking Fountains Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories • P-Trap RoOf Drains � 'ReinspeMion Fee $15 Duct - Under Groundl ' Duct - Structural Duct � Ventilating ExhaustSystem ❑ MWtiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑6100,000 BTU �100,000 Reinspection Fee � $15 White - Builtling; Canary - Applicant; Plnk - Actountin9: Goltlenrotl - Assessor - PLUMBING Showers Service Sink Sewer Cap Sewer Connection Solar Collectors � Solar Piping - Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service. ' . Auto-Wash Issue Fee Hood or Typel ❑ ' Canopy Typell ❑ u Refrigeration Sys[em Oo-ioo,000eru Oioo,000i System Repair/Alteration � Fire Dampers � Registers - _ $ 3 FEE i luue Fee I $ 3 I � A.P. s� S Main Bi E T Front B Rear A C Right K Left S Ping. Ref. # Planning No 4801 6/12/85 . Zane Accessory Building: � Parking Req./Provided , Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures _ Device Boxes Outlets Switches Garbage Disposal Generator �65KW �S'� Fea ELECTRICAL' , , - Transformer- �-15�50 KW ❑ SO+KW Meter ❑up to 100 amps Meter ❑over100amps Sub Panel • Motois 00.1 HP 01'h - 8 Inc.Solar 09-15 HP �16�15+ .Microwave . - Pole Light Range I I; Standing Sections 5 KW' Trash Compactor $15 � � Issue DEVELOPMENT SERVICES RE�UIREMENTS: Zoning Approved By Building Approved By �_, ' 16.a� T1, �.J $ 3. 2 O N 1 N G R E Q M T S SUMMARV OF FEES � BUILDINGPERMIT '$ SMIP, ,$ � PLAN CHECK $ � PERMIT ' PLUMBING $ .._ �� ISSUANCE $ PLAN CHECK 25% $� - n � ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTALFEE $r� PLAN CHECK 25% �$ ' , '��CONS7RUCTION AND PLANNING � , � POOL & SPA � APPROVALS Permit# Date Inspector ppPROVALS Permit# Date Inspectoi 1. Temporary Electrical Service or Pofe 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. , ('ol %� G�� 53. Steel Reinforcement . 3.. Electrical Conduit Utility-Undrgrnd. ' 54. Forms � � 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding 5.� SteeY R�inforcement ' � - 56. Rough Plumbing & Pressure Test � 6• Electrical UFER Grnd. -57. APPROVAL TO.COVER-GUNITE • 7. Footings , _ . 58. Electrical Conduit�Undrgr�nd. • 8. FoundJtion 59. Gas Pipe, O Undrgrnd., Test 9; Water Pipe-Undrgrnd. 60. Backwash Llnes, P-Trap, 0 Undrgrnd. 10. Structural Floor System - � 61. APPROVAL TO DECK � - -� 11: ProperxY Sewer Line & House Connection _ 62. Backwash & Receptor-Final _ 12. Sewer Gap _. 63. Heater & Vent-Final _ 13. Roof Drains � � 64. Plumbing System - Final 14. Rough Plumbing (e �S (�/� 65. Electrical-Final ' 15! Rough Electriral-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. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVAIS Permit # 21. Ducts, in Structure 70. Undergrou�d Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof F�aming 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing � . � 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame 2nd 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 7/j �,� L$D � 39.�Water Service-Final � 40. Gas Service-Final 41. Solar pomestic-Final ' 42. Backflow Preventer .. . 43. Backflow Irrigation � , " 44. Landscape Irrigation System � 45. Sound Attenuation ' 46. Handicap Regulations' � , � � � ' � � � 47. FINAL STRUCTURE & BUILDING � . 48. Special Requirements Completed � , ' 49. Electric Fielease to Edison � " �, • 50. Gas Release to Southern California Gas Co � � .. . � 57. CERTIFICATE OF OCCUPANCY . � � No. Date , � . . _ �_ , � � � � � n� S � , , � � � - � ` .Y� 7 0�� . � , � �'1L, �I ��A.'?.�_�"'t._ 1° �� r�.�� . . . . 1 ^ . n�� `'' �� a ' � µ • '� `��'. ,. -. . _ .� .. .. .. . .,�� . ... : ....... . : . . . ..._N'. „ ._••�. .. • � ,� � ,�,� .. t�- .. , _ . . .. ,.�1 j'�' City of Costa Mesa . - ' „ , ' _. � � . . I � ' Building Safety Depertment _ C E R T I F I C A T E O�F O C C U P A N C Y- -�� !�� ' P.O.iBox 1200 ` . . � , - � �.. ' . , • . . . . . . " . , ,. . Coste Mese, Celifornie _ . . . , � 'Y ,. y�, � 1 '� � - ._ . � , , ' :' : . . . . � : . p . '� . % " ' The Builiiing located at ti�h'�iS.7tnr'1;iN.�Tk1ui7 "'` 1�� '.'�-.' �i� . - ='�.a ' ' - � - ii� � � � .'has�beem;�inspected and found,-to comply,with the,pr'ovision�s of�all Cify;.,of Costa•Mesa�Ordinances applicable�theretoYl� �� ,f i ,l . � ; e �. for a Grou ;,_� ` . � � � ' `� �p Occupancy. � . � . - . � -� . . . � .�i�' .. _ , � . . . . , . .,. , �j' - • :. .� - ' . � :. , Use of Building ..�`�s,,.A ar,,,.�. . - - ^ � � '- ' ' � �� , , . ,; ;.. a „ . .,�. . .i39-0?_1.i�i ' � d� ^� � .. � Legal Description- � � - � �- � �� - � � w � � (See reverse eide tor'Metas and Bounda) � ' -� . �' . � . . . . '.i' _' .. � l�Y. r' qi; �F� �'�S' " r;.d,:�� . - � , 'It-. . . . � ... . . �:�.� ,F. ,� , ,. . '`-k"^ �•"'Building`Pe"rmiiNo-=�'*��^�+-"::`."ElectricaLPermitNo'•.-^,"��=-"��x+Plumbing=Permithc�:=-x='�•'.-":'—'.- -. 4 ,.. � . � � ;j" r_ ' . _ . � ,;..,'.r, ; _� � � ' �Numberof apartments � � - 2nd/orguest rooins�- - - � . , � -. , � . . . . .... � , �" - ' " . .t�' . . • '. � - � . [ ISSUEDTO:,-. • � BuildingOfficial�_` '. S� " S:' M1.; � �'�I. � �� ' i` � � '. � _ � !°b � j ?;' ��. :K . � � �� iY � 7 " 6in4t � "��Airi � Th�ihTi,xa P'�ritiAlrii� ii ' � � '.� • y � a � { M�. , � , � , , ' . . � 1 . . � . . . „ . ° .. -- � :� �Date � ta.;t„s��..,,,��ti�.: ir'rv.a � - . .. - �.� . This.Certificate of Occupancy SHALL BE ported in a conspicuous �place on the premises end SHALL NOT�.BE removed except by the , � Building Official of the City of Costa�Mesa under Sec: 306 (e)-U.B.C! �" '� � � , � "� ,t � - - „ . - , . � � • . , ' � • Form BU 34 Rev. 11/70 -�'� ' ' � ` t. . . . . .. , . . . . � y. q. , p . - . , � .. � , � , �, � ;Y .. � t � � . � . _'. . , ° � � �. „ � �' � . ; c y �,+ r ' '!' , i,. � ., ; o �,/. t ' . . `�� h . � ' 1 %� n .. . . ..�n ' , - � • . .. . ... 2Y ...V Lc.l�.�� i.. .i� �a.�.rs�.xix> .. ..��,r.n� .. . a�:�� i na� a�V(,