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Home My WebLink About723 VICTORIA ST - Building Permitsow Nee. KOLL, RENNETH W. DATE 3-9-56 � JOBADDRESS .�'jQ3 V1CtOP�B—St. BUILDING PERMIT NO. (�l GENERALCONTRACTOR OI.n7er VALUE$ ZO�3ZO.00 i�� Q1 BLOCK raacr 23�t6 Residence & Gar. GROUP I&�T TVPE V ZONE �1 FIREDISTRICT 2�l87 PERMITS ISSUED INSPECTIONS DATE SUBCONTRACTOR DATE NUMBER Footing Trench ' 1.3 —. � Foundation Forms and Grade to GaraCe . Plumbi �ewer, House d1, (; y�/ Sewer, St. � —7 .s" �7 S(,� o _ ,f� i. p, . �a _ L ' 14 � Septie Tank or Cesspaol � l �ng, In Out �.� �-,�i— ZZ� F .erina C �O'�NF^ '� • .. �.. /O — Plumbing, Final Gas Test /y`� „(y �� R�, Wirina.Final �/A/ o. FOFM 210 3M 10-•v9 � �- AOp�icant to fill in all ipaces axce0< <hose within �eavy UorCar Ilnas anE sign all appropriate aaciarations. CITV OF COSTA M T$lp-� CO1NJ STRy�UCTION PERMIT Project Address ��,] V� C FO 21 /} Applica.t's Mailing Addreu Owner'sName P�L/r1m�L�:J phonea3aki�C9 Address _ Arch/Eng. Licenu No. Address Contrnctor'sName ' ' '� � Phone �;7–]oDi% Addresslmailing�� 3�u� n+�+�C (LC.A�..$��`�n �i4t_/J{_ City License No. V�a �%� a� � � LICENSED CONTRACTOR DECLARATIOIV I he�aby afiirm [�at I am IicenSltl untle� p�ovislons ot Cha�ter 9(comTencinq with zectlon ]000) oi Dlvislan 3 0l lhe Business ana Protessions Cotle, antl my Iicense is In full force antl effect. �S� �/� Ucensa Class LI nze No. Date �—��'�� $i9nature WORKERS' COMPENSATION DECIARATION 1 heroby a1(irm that I have a certiflcate of tonsent to selbinzure or a certlflcata `, WOrke�s' CompensatiOn Inmrance, or a certitietl cnpy thereot (Sectlon 00, Lab. C.) G �7 � I� J� olicy No. G� f0�1 Y� Company �GI�M—� BCertifiatl copy is hereby (urnishetl. ' Certifietl copy is filea with the city Buil� .'n-y��o—��ision. Date Z'�J�'1. AOP�icant /✓��/�^ EXEMPTION GROM WORKERS' COMVE SATION DECLARATION (Thi55e<tion neee not be campletetl ii thG pe�mit I5 fo� one ItunA�etl (E100) or less). I cGrHty that In the perto�manCO 01 thG wo�k 10� whlch tnls petm�t is iSSuatl, I shall not employ any per5on in any manne� so d5 lo bGcome Subje<t [o [he Workers' Compensation Laws of California. Date' SignaWre NOTICE: If, al[er making [his tleclaratlon, y0u sbOWd beGome subject to lne Workers' Compensation provl5ions of the laDor Gotle, you must forthwith <omply witn sucn provi5iOn5 Or thls Oe�mil shall be tleemetl �OvokeU. CONSTRUCTION LENDING AGENCV 1 neraby alflrm that there is a constructlon lentlin9 agency for the performanca ol tno work for which thls Dermit IS ISSuetl (SectiOn 3097 Civ. G.) LAntlar'S Name - Lontlar's Atltlreis OWNER BUILOEH pECLARATION I nereby uflirm that I am exompt irom the Contractor'S Licansn Law for tho iollowing reason (Section 7031.5 BuSiness and Professional CoOe: Any cily or COunty whith rEqW/es a pe�mil lo const�uct, alt¢q improve, tlemoll5h or mpair any strucluro, prior to its issuance, also requires the apolicant tor sucn pormit to lilo a 519ncA statement that ho/sha is Ilcensetl pursuant to the provlsions of the Conlractor'S License Law (Chapter 9(commencing with Section 7000) o/ Dlvislon 3 of Ihe Businezs antl Prolossions Cotla) or [hat ne�sne is exompt 'hC�Ol�am antl Ihe basis ior th0 allegetl exemptlOn. Any vlolatiOn O7 $acllon �31.5 by any applicanl tor a permlt zubjects [he aDPlicant lo a tivil nally of not more than tive nuntlretl Uollars (y500). J i, as ownar ot tne orooarry or my omo�oyees witn wage5 d5 IhOir soie componsation, w111 tlo tha work, antl tne sVucture is not Inton0t0 or olleretl for sale (Soction ]044, Business antl Protassional Cotle: The Contractor's Llcense Law tloes not apply to an owner of a property who builtls or improves lhareon, antl who tlo¢5 Such work hlm5alf/he�salf or thrOu9h hls o� �ar own empinyoos, provitletl that such Improvemants aro not Intentletl or ollorod for I ule. It, howover, the bulltling or Improvoment is Soltl wilhin ono yea� ol com- , plelion, lho owno� will nav¢ lho �uttlen of prOving he/Sh¢ tli0 nOt builtl o� IM- �rove tor tna purpose of sale). I, as owner ot [he property, am exclusively tontracting with Iitensed con- lractors t0 cOnStruct the project ISeCUOn 7044, Bu5ine55 antl Pro/eszlons Cotle: The Cont�acto�'S Li<ense Law does not apPry ta an owner of proparty w�o builtls or improves thereon, antl who conVacts lor such proje<ts wlth a con- tractor(s) IKense pursuant to the ConVactor'z License Law). I am awara that prool o( tbei� WOrker's Compensatlon Insurant¢ Thoultl be provltlo0 lo m0. ❑ I am exemp[ untler 5¢Ction B. 3 P. C. IOr Ihii rBd50n Date I herGby c¢rtity t iniormation is con antl state laws re1: 58n[atives ol th'S inspection purp e Signature Drivers' LicenSe TYPE OF C��RUCTION NEW ADD ALTERATION REPAIR ,O CONVERSION ❑ DEMOLISH ❑ OTHE Ap � - DESC PTION OF WORK/USE OF BLDG. ��/ -�� • �!4 U— � ��'G (1— /.. � �oo S Main Buildi TVPE OF PERMIT IJ GRADING FOUNDATIOrv STRVCTURAL T Front O TENANT ❑ ELECTRICAL. ❑ P�UMBING ❑ MECHANICAL B Rear ❑ OTHER %� PROJECTDESCRIPTION SO.FT. oCCVaarvCv C Right CONSTRUCTIONTVPE VALUATION$ S left ZONE GRAOING CU. VOS. ACRES ping. Ref. # Remarks: Planning Notez: _ Own¢r � I have reatl this application antl state tnat lhe abov¢ I agree to complY �+'�� all clty antl munty OrtllnanC85 to bulldin9 �onsVuction, antl hereby autho�ize repre- �[o C�ter upon 24e above-mentionetl properly for � � – � Date,�/p Y) 3ackflow Preventer 3ackflow Irrigation 3athtubs �larifiers ]ishwasher �rinking Fountains ;loor Drains Floor Sinks 3as Service Outlets Interceprors Kitchen Sink lavatories � P—Trap (ioof Drains ' Reinspection Fea 515 Boiler Duct - Untler Ground Duct - Suuctural Duct � Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating Sysrem & Ducting a�ai oo,000 aru O i oo,000 aT Reinspectian Fae � $15 CMF 0865-46, rev. 10/84 White - BUIltling; Canary - AOOlican[; Pink - Accounting; Goltlenrotl - ASsessor 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 Leundry Trays Issue Fea Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑0.700,000 BTU 0100,OW System RepaidAlteration Fire Dampers Registers . Issue Fee G' S 3 FEES $ 3 Automatic Washer Construc[ion Pole Cookin9 Uni[ Dishwasher Dryers �Gas ❑ Fan F.A.U. FixWres Device Boxes OuUets 3969 3/13/87 za�e ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter ❑up to t00amps Meter ❑over 100 amps Garbage Disposal Generator �45 KW �5�15�KW $ub Panel Motors 00.1 HP � 1 Y, - 8 Inc.Solar �9-15 HP �16�15+ Microwave Pole Light Range Sign Standing Sections Trash Compattor Fee �$15 I I luue Fee 7.00 TL FEES 5 3 DEVELOPMENTSERVICESREQUIREMENTS: Zoning Approved By �ate 8uilding APP�oved By Data Appliption Inued By Date . SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PEFMIT PLUMBING $ ISSUANCE S PLAN CHECK 25% $ ENERG� P.C. $ ELECTRICAL . § GRADING 5 PLANCHECK 50°6 $ ��j� MICROFILM 5 MECHANICAL $ / � TOTALFEE $ •�D PLAN CHECK 25% $ 2 O N I N G R E Q M T $ CONSTRUCTION ANDPLANNING FOOL&SPA APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test ' :=' -� 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . 7. Footings 58. Electrical Conduit-Undrgrnd. � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test � ��~ 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, RTrap, O Undrgmd. •� 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final ' � 12. Sewer Cap i � 63. Heater & Vent-Final :�� 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit . 66. Solar System-Final 16. Rough Electric Wiring � 67. Fencing & Access Approval � 17. RougFi Wiring Sign 68. APPflOVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating �� 71. Product Piping �Gas ❑Oil 23. Gas Pipe-Rough & Test � 72.'Underground Flush 24. Roof Framin � ' 9 ��73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � � : '�s • 74. Overhead Hydro .. 26. T-Bar Ceiling (Structural) & Monocoat • �' 75. Dry �hemicai 27. Frame and Flashing ,� � 76. Dr.y Standpipe 28. Lathing & Siding '.:.� ` ' ` Z7. ' FIXED SYSTEM FINAL 29. Insulation '•.� � 78.,fIRE PREV. FINAL 30. Drywall Nailing . HEALTH DEPT. REQUIREMENT , 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electric�al Power Meter-Final +. 80. FOOD CERTIFICATE ISSUED- � ' 33. Final Electric Notes: �+/� � �p ��K - . � 34. Final�Heating & Air Conditioning .�� ? e�.�7 �� p(�,�� p V�„�G LE,l% 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace ' � i• 38. Final Plumbing 1 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. FINALSTRUCTURE&BUILDING . ,; 48. Special Requirements Completed 49. Electric Release to Edison � � 50. Gas Release to Southem Califomia Gas Co " � 51. CERTIFICATE OF OCCUPANCY , No. Date � AVP��ant to 1111'in a11 spaees axcept thosa within neavy Cortler �Inas anE stgn all apo�oo��ate Geclaratlons. CITv oF COSTn naESA CONSTRUCTION PERMIT PER yq.� _�_ __ _ �Q�¢ LOT NO. UNIT N0. ProjectAddress 723 Vietoria Applicant's Mailing Address 10G22 Treak Ave_ Owner's Name —DO^ H�� ^n Phone 720-3042 Address %] [9r� �*�A ArchlEng. License No. Address ConVactor'SNama s-omaa D1nmMno�Waniiln�e—j3D�26%Q Addreulmailing) �n422 '(raak Ave� Ciry License No. (1b�+4 LICENSED CONTRACTON DECLARATION I hereby affirm lhal I am IlcenSeG �ns of �CghAar}t¢ery (9(commencing wltn sectlon 7000) ol Div(slo of tna Busin s anifAW o s Cotla� anC my Ilcense is in full�prc�ba� f«. 50307 License Class _Licenb � WORKERS' COMPENSATI qECLARA�f�N < LL,.�;nereby affirm tnat I have a certlikate of6pfisent to setl-Insure or a certificate Workers' Componsatio Insurance, or a certi(ietl copy thereof (Section ;'�3`soo, �Bc�c�00713 0004 Nationvide Policy No. Compa�y Certified copy is nereby furnlshetly. Dateertltl�9G�pXjF(Iietlwl�th�P.tanttAB8II1C8 PYum�la�Heating_ 3 il aa EXEMPTION PROM WORKERS' COMPENSATION DECLARATION (This section noetl not be <ompleted I1 the pe�mil is for one huntlretl (E300) or less). I certity [hat in tne pe�/ormancn Of the work fOr which thii pe�m�t i5I55uetl, I snall not empioy any parson in any manner so as to become subjet[ to tne Workers' Comp¢nzation LawS of Cali/omia. Data Si9nature NOTICE: H, aiter making this aoclaratlon, you shoultl become subject to the Wo�ker5' CompenwllOn provi5ion5 ot lM1a �bor Cotle, you must forthwi[h Comply with Suth provislon5 or tbis permit shall be tleemetl revoketl. CONSTRUCTION�� LENDING AGENCV �' V I nereby atiirm that tnere is a tonztructlon Ientling agency for tne peitormance oi lne work lor w�ith [his permil ii ISSu<tl (SectiOn' 309� Civ. CJ LonOer's Name - -- Lentle�'s Atltlress - OWNER BUILDER UECLARATION I he�eby aHl�m that I dm exempl frOm lh¢ COntracto�'s LJCEnse�l:aw tor the following reason (Sacllon ]031.5 Buslnass ana Profe551onal Cotle: Any ciry or county wnun reqWrei a parmtt to conitruct, alter, imO�ove, tlemolisn or rapaFr any strutlure, pNar lo its issuanco, also raq�ires the applicant for,buch permlt to lile a si9netl statament lhat he/sna IS IlcPnsetl pur5uant to�the'piOvi5ion5 of tha Contractor'i Ucense Law (Chaptar 9 �commencin9 wilh Sectibn 7000) of -: DIvi5lon 3 of lhe Businasi antl Proles5ion5 GpG¢) or lhat he/ihe is exempt ¢"'�nerCt/om antl the ba5i5 IOr ttte allogetl oxOmplion. Any v101ation ot SectlOn �_°il%031.5 by any apPlicant tor a permit sub�ects the a0011cant to a Uvil �enalty of not more t�an �IVB huntl�atl Oolla�s (5500�. I, as ownor of [ho proDerty or my eTployees with wagGS az tnei� sole <ompen5ation, will ao the work, antl tne struGture is not IntnnOetl or otterotl lor ulc (SOUion 7044, Busine5s antl Proiessional CoOe: The Contra<tor's License Law tloes not apply to an ownar of a property who builtls or improves tbereon, antl who tloes such work himselt/he�self or thrOugh his o� her own emo�oyeas, provitlotl tnat su<h improvrtmen�s are not intenaetl or otleretl for ule. II, however, tha builtlin9 or Improvompnt Is soltl within one year ot com- plction, Ihu owncr wlll have th0 burtlen Oi p�oving h¢/She tli0 not builtl or lm- prove forthe purpose olsale). ❑ I, as owner ol Iha property, am exclusiv¢ly contracUng with Iicensetl con- tractors to construct the projuct (Sectlon 7064, Buslness antl Professions Cotle: The ConVactoYs Liconse Law tloes nol app�y to an owner o1 proper[y who builas or improvat thermn, antl who conVac[s for such projects with a<on- tractor�sl bcenso pursuant to the ConVaceor's Licensa Law). I am aware that p�oof of [heir Workar'S Compnnsatlon inSUrance shoultl be provided So me. ❑ I am exempt untler Sectlon B. & P. C. tor Ihis redSon Date � Drivers' �itense or 55 CMF 0865-46, rev. 10/84 owner state that the above �d couniv ortlinances TVPE OF CONSTRUCTION LI NEW LJ ADD LI ALTERATION LJ REPAIR ❑ CONVERSION �Q DEMOLISH. ❑ OTHER q,p,.�6 DESCRIPTION OF WORK/USE OF�BLDG. S Main Bu E TVPE OF PERMIT GRADING FOUNDATIOIV STRVCTURAL T Ffont ❑ TENANT ❑ ELECTRICAL ❑ 7LUMBING ❑ MECHANICAL A Rear ❑ OTHER � C Right PRQIECT DESCRIPTION Sci. FT. '^ OCCUPANCV K CONSTRUCTION TYPE VALVATION 5 S Left ZONE GRADING CLL VDS. ACRES p�ng. Ref. �/r` Remarks: PlanninA No� Sink Preventer Irrigation Floor Dreins Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatorie5 P-Trap Roof Drains Reinspection Fae $15 eoiier Duct - Under Ground Duct � Structural Duct - Ventilating - � Exheust System ❑ Multiple ❑ Firepl/Fact Blt. ICBO � Heating System & Ducting ❑ ai oo,000 eru O i oo,000 sn Reinspettion Fee � $15 Building; Cdnary - ApplicanF, Plnk - AccOunting; GoltlenrOtl - AsSessor $howers Service Sink Sewer Cap Sewer Connettion Solar Collectors Solar Pipin9 Solar Tank Swimmin9 Pool w/Spa Urinal Water Closet Water Heacer Water Service Auto�Wash laue Fee Hood or Typel ❑ Canopy Type I I ❑ Retrigeration System ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registe�s Issue Fee FEES Automatic Washer Construction Pole S� Cooking Unit Dishwasher Dryers ❑Gas ❑EI Fan F.A.U. � Fix�ures Device Boxes OuUets Switches Garbage Disposal Generaror �0.5 KW 7373 3/23/B� Zone Parking Req./Providetl ELECTRICAL . Transformer � 75-50 KW ❑ SO + KW Meter ❑up to 100 amps Meter ❑over 100amps Sub Panel Motors �61 HP �1'rS � 8 Inc. Solar �9-15 HP �16-15* Microwave Pole Light I I Standing Sections 5-15 KW Trash Compactor " S3 Reinspection Fae $15 luue Fee FEES �DEVELOPMENTSERVICESREQUIREMENTS: Zoning APOroved By Building Approvad By ^ Appliration Issuad By �� $ 3 5,0[1 TL FEES $ 3 SUMMARV OF FEES BUILDING PERMIT � $ SMIP $ PLAN CHECK $ ��)� PERMIT PLUMBING $ ��C/� ISSUANCE 5 P�AN CHECK 25% $ ENERGV P.C. $ ELECTFi1CAL § GRADING $ P�AN CHECK 50% S MICROFILM S. MECHANICAL S TOTALFEE 5 S.00 PLAN CHECK 25% $ 2 O N I N G R E U M T S � � ' POOL & SPA CONSTRUCTION ANDPLANNING �- � � APPROVALS Permit # � Date Inspector Date Inspeetor ' APPROVALS Permit # 1. Temporary ElectricBPService or Pole 52. Pool & Equipment Cocation ' i� 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 Grod. 57. APPROVAL TO COVER-GUN�TE i 7. Footings � �_, 58. Electrical Conduit-Undrgrnd:_ 8. Foundation 59. Gas Pipe, O Undrgrnd., Te� j 9. Water Pipe�Undrgrnd. ' 60. Backwash Lines, P-Trap, O�Undrgmd. 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 Approvai � 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 APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro . 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil '. 23. Gas Pipe-Rough & Test � 72. Underground Flush .. � ,p � 24. Roof Framing 73. Undergrnd.StorageTank OGas ��Oil ' .'` v 25. Roof Sheathing . 74. Overhead Hydro � � 26. T-Bar Ceiling (StructuraQ & Monocoat 75. Dry Chemical f; 27. Frame and Flashing 76. Dry Standpipe '� �' 28. Lathing & Siding 77. FIXED SYSTEM FINAL � �Z 29. Insulation 78. FIRE PREV. FINAL :, 30. Drywali Nailing HEALTH DEPT. REQUIREMENT �'.,� , 31. Plaster Brown Coat 79. FINAL INSPECTION �j. 32. Electrical Power Meter-Final 80. FOOD CERT�FICATE ISSUED �_7 33. Final Electric Notes: � �� r 34. Final Heating & Air Conditioning ✓,i%'� 35. Final Gas Pipe-Test � 36. Hood or Canopy � 37. Final Factory Fireplace �^ �. �� , . - 'i 38. Final Plumbing �7 � �� L�D � . - ' i � � 39. Water Service-Final a� � �� ;� . '� J ' .40. Gas Service�Final -_ i • � � � t � i'. ' ' i", � �41: Solar pomestic-Final r. � ' ` , ' i 42�.+Backflow Preventer � ro � " �43.rBackflow Irrigation ' � . �. � 44. Landscape Irripation System , ' � � � � .: r . � 45. Sound Attenuation .� . '�' �> n:. 46. Handicap Regulations - - . .. 47..FINAL STRUCTURE & BUILDING � ` � � `' � ,. ^ r � 48. Special Requirements Completed �� , � i � 49. .Electric Release to Edison . ' " � �� 50. Gas Release to Southern California Gas Co - '" 51. CERTIFICATE OF OCCUPANCY No. - Date . . .,� , �� Gosta Mesa Bnilding Department qQ �/APPLICATION FOR PERMIT ^ •�� 111 EA8T 20th STREET �`tv • g U I L D 1 N G � • COSTA MESA� CALIFORNIA �OR OFFICE USE ONLY FOR APPLICANT TO FILL IN Reeefpt No. Permit o. Building � �/ Address 723 oictoria Street 6 ��i=!f1 Costa Mesa, California Received by Date Rec'a. ke i� d rvearest —7 3 — CY •-j � MA�'y ��y6 Cross St. 8uildina W. Koll port Blvd. Seach No�'Hr. ° �d ress City Lla _ ,ntractor No. Address Legal Lok I Descrfptlon No. Zl I Biock � T�acfL3 (Attach MeLes and Bounda) . No. of Bldgs. Size of Lot (0 x 100 Now on Lot Use of No. ot No. ot Existing Bldg. I Familles I Rooml Sethack Line from Rear Vard 27� Center oT Street 50 � Side Yard .�r� nEscx,�ox oF woRg New I)( I Aiteration I I Addition I Repalr I I-Moving I I Demolish I Building No. of S�ze 1�200 Rooms 6 Stories 1 :rior Wall Roof iering StUCCO Coverfng COtnpO Use of New Buflding Residence � � Costa Mesa, California APPROVALS ion � Inspecto� Forms. Materials Under-Pinning Frame: Fire Stops, Bracing, Bolts I hereby acknowledge that I have read this Application � and state that the above is mrrect and agree to comply Lath. Int with all CYty Ordinances and State Laws regulating building construction. Lath. Ext Signature of Permittee d n Plaster,lnt F � 1 LI ,--� _ _ .. / � Valuation 1� Permit Fee $ 26.�0 Masonry Reinforced Plan Check $ 13 •�� Bond Beam g 10.32o rota� 39.0 Date u J ti PLOT PLAN Show location and distinces from property line and between buildings f!� nCOSTS � ` i��(�-�J"S$PUueSA� 34a x..t�:.39A0 0 a ADP�icant to flll In al1 spaees exceot those within heavy Gortler lines ane sign all aoo�o0��ate tleclarations. CiTY oF COSTa MESA CONSTRUCTION PERMIT ProjectAddress �� i rhpr{A � Appliwnt's Mailing Address 10472 TYaSk AVe� Owner'sName DOTi—Hem1Lt0*+ Phone]20-9042 Address ZJ 68LL�IIg ArchlEng. nse No. --�.1��n] Address 1p422 'Fraek hve Contractor'sNamP ne...e., nl.....i.fno�unnN..mhone��1-944Q Address (mai7ingl—YQL�$7 _i L e • City License No. §§�[y LICENSED CONTRACTOR DEC ARATION . 1 hereby aftirm that I am I'Censetl untle� provi5lon5 of Charter 9(mmmendng with S¢Ction ]000) oi �iv ( th slne55 antl Protes51on5 Gotle, antl my Ilcenze is in iull torce ap�y ife t. License class �+ Ite o- 03� � Dd[¢��_ Si9ne[u - WORKERS' COMPENSATIpN RATION I hereby aHirm Uat I have a cer if� e of consent to selHnsure or a certi(icate 11 WorkerY Comp¢nsatlon �� uran e, o� a certHied cOOY tM1ereof ($ectlon J800, lab. C.) Policy No. � any C�OAW BCertifietl copy is hereby tUmis e Certifietl copy is filetl with the Bulltlii g Div Nn. Date 3 08-88 APPlica ' ' EXEMPTION FHOM WORKEHS' O ATION OECLARATION (Thissection neetl not be tornplet it he permlt Is for one hundretl (5300) or less). I cer[Ity thal in the pertorTance ot th¢ work fo� which this petrnit ISISSUGtl I shall not em0�oy any De�son in any manne� So a5 to become Subj¢ct to t�e Workers' Compensatlon LaWs of Califomia. Date Si9nature NOTICE: It, after making tnis tleclaration, you shoultl become subject to tM1e Workers' Compensation prOvizions of the Iabor Cotle, you must forthwi[h comply witn suth p�ovl5ion5 or tnis Oe�mit Shall be Oeetlietl revoked. CONSTRUCTION LENDING HGENCV ,� 1 nereby affirm that there is a cons[ruction lentling agency for tha�perrormance ot [hn work for which thls permit i5 ISSueO (Section 3097' Civ. C.) �.enticr's Name Lentler's Atlaresz 'i OWNER BUIL�ER DECLARATION ' I hereby aHirm that I am @xem0� trom the Contracto�'s LicenSe L'aw fOr tne following reazon (Section 7031.5 Business antl Professional Cotle: Any city or cOunty which require5 a pe�mit t0 construcl, alte�, improve, EentOlish o� rCpair any structure. P��or to Its �ssuance, also requires the applicant for;such permit to (ile a signetl statement thal he/she is IicenSetl pu�5uant to the p�ovl5lon5 ot the Contracror's License Law (Chapter 9(commencing with Section 7000) of Divislon 3 of the Bu5ine5S antl Profe55ion5 Cotle) or (hat he/she IT exempt tiere/rom antl the basis for the allegetl ezemOtion. Any violation of Settlon A31.5 by any applicant for a permit subjects [ne applicant lo a clvil �enalty ot not more than fiye nuntlretl tlollars (E500). I, as owner of the prOperty O� my employee5 with wage5 as thel� Sole compenSdtiOn, will tl0 the �yprk, antl the sVucture I5 not infentletl or Otferetl for sale (Section 7044, Business antl Professional Cotle: The Contractor's LiC¢nse Law tloe5 not apply t0 an ownar of a prOperty who builtls or Improves the�eon. antl who tloes SucM1 work himself/harself or throu9M1 his or her own employees, proviaetl that such imorovements are not intentletl or otferetl for wle. Ii, however, the builtl�ng or improvement is soltl within one year of com- pl¢tlon, tM1e owner will nave the burtlen of Oroving tte/she tli0 not bulltl or Im- �/ove forthe purpose oisale�. U I, as owner of the p�ope�ty, am exclu5ively contractlng with IlcenS¢tl com tractors to construct th¢ prpj¢ct (Section 7044, Business and Professlons Cotle: Tbe Contractor's Li<en5e �w does not applY lo an owner of pro0erty wno builas or imDroves lhereon, antl who <ontracts tor such projects wlth a con- t�actor�s) I¢ense pursuant �o fhe Cont�actoYS LlcenSe Lawj. I am aware that p/Ooi of [heir Worker's Compen5ation insu�anC¢ iboultl be provitl¢tl to me. ❑ I am exempt untler Secqon B. & P. C. tor this reason ws � CMF 01 Owner N tha above ortlinances ,",.,�.., �IO ...._...- -- - .....,,..,. TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, �6 DESCRIPTION OF WORK/USE OF BLDG. 5 Main Building: TVPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL T Front '❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAI A Reaf ❑ OTHER PRWECTDESCRIPTION Sp.FT. OCCUPANCV ' C Right K COIVSTRVCTIONTY�E VALUATION$ S L2ft ZONE GRADING CU.YDS. ACRES . Ping. Ref. # Remarks: ' , Planning Notes: Sink Preventer Irriqation Drinking Fountains Floor Drains Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Drains FeinspeMion Fee � $15 Duct- UnderGround Duct � Sttuctural Duct - Ventilating Exhaust5y5tem ❑ MWtiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑6100,000 BTU � 100,000 o ar 55 � �/' �- I I Reinspection Fee 10/84 Wh��e - Builtlin9; Canary - Applicant; P��k - Accounting: Goltlenrotl - Asseszor $15 Showers Service Sink SewerCap 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 Type I I ❑ Refrigeration System ❑aioo,000eTu ❑ioo,000 System Repair/AI[erafion Fire Dampers Registers ' . . . r•`. . ; ' Issue Fee FEES $ 3 $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers �Gas ❑Elec1 Fan F.A.U. Fixtures Device eoxes Outlets Switches Garbage Dispoul ' Generator �65 KW C Fee 6462 3/�9/88 � Zone Accessory Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Meter LJup to 100amps Meter �over 700amps Sub Panel Motors �61 HP �1 %- 8 InaSolar 09�15 HP �16-15+ Microwave Pole Light Range Slandin9 Sections 5�15 KW Trash Compactor $15 luue Fee� DEVELOPMENTSERVICESREQUIREMENTS: , 2oning APProved By Building Approved By �� 5v0I1 TL 2 O N i N G R E Q M T S FEES � $ 3 SUMMARV OF FEES - BUILDING PERMIT $ SMIP $ VLAN CHECK $ PERMIT ' P�UMBING ' $ � ��UANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAI $ GRADING ' $ PLAN CHECK 50% $ ' MICROFI�M $ MECHANICAL $ TOTALFEE g S,OO PLAN CHECK 25% $ _ CONSTRUCTION AND;PLANNING � POOL & SPA � - � - APPROVALS Permi4 # Date Inspector qppROVALS Permit # Date Inspector : � 1. Temporary Electrica!'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 N� 58. Electrical Conduit-Undrgrnd. � 8. Foundation t'� �' 59. Gas Pipe, O Undrgrnd., Test � �� 9. Water Pipa,-'Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgmd. . •ir 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 Plumhing 65. Electrical-Final � 15. Aough 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. 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 C7Gas ❑Oil 23. Gas Pipe-pough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil . 25. Roof Sheathing _ � f .. 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - " . - 27. Frame antl Flashing h 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. Electriral power MeterFinal � 80. FOOD CERTIFICATE ISSUED i�i; 33. Final Electric Notes: �� 34. Final HeaYing & Air Conditioning . � ' � � � 35. Final Gas Pipe-Test � • � 36. Hood or Canopy � ; � . � 3J. Final Factory Fireplace . . �! . � �.� � � �. 38. Final Plumbing �Q � �' �' � r � ' i� � � � 39. Water Service-Final '� � r'40: Gas Service-Final , ' �.- i - < ' 41'. Solar pomestic-Final � `� ' � t. � i , � 42t Backflow preventer - - i . 'i �. � 43. Backflow Irrigation �. ��• � `� i> 44. �Landscape Irrigation SYstem - ~� --= ��- � � � � � i� � „ ., i� ' i r � . 45. Sound Attenuation ' �� „_ "� r � �`� ` ' � � ' Y. . .� f �: 46. Handicap Regulations �i! �n '`- '�, w ,'" � � 47. FINALS7RUCTURE&BUILDING �� `' ` ' ' ' `'" �' � c t i.. .. � t;, 48. Special Requirements Completed � i. c �,:; ;. � /' � i �. �,. . 49. Electric Release to Edison ��; �� , .'' '' � 50: "Gas Release to Southern California Gas Cq � ' �� r�, � 51. CERTIFICATE OF OCCUPANCY � � I No. Date "' .^�r _ n. 't I