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HomeMy WebLinkAbout171 17TH ST - Building Permits CITY OF COSTA MESA r BUILDING DIVISION F rr�41 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us ;:s. PIC* FOR INSPECTIONS CALL:(714)754-5626 • it* PERMIT NUMBER: SB09-00057 PERMIT TYPE B_SIGN STATUS: ISSUED DATE ISSUED: 08/03/2009 ISSUED BY: BJK JOB ADDRESS: 171 E 17TH ST CM Suite/Unit: Vicinity: SQ. FT: 0 Valuation: $3,800.00 SCOPE OF WORK: 46 SF INDIVIDUAL ILLUMINATED CHANNEL LETTERS SIGN FOR"BAJA FISH TACOS." ELEC: 1 SIGN CIRCUIT OWNER: THE VONS COMPANIES INC Address: %COMPREHENSIVE PROP TAX Unit:PLEASANTON, CA PHONE: City/Stale/Zip: 5918 STONERIDGE MALL RD APPLICANT: GERMAN,TOM • Address: Unit: PHONE: 951-735-6727 • City/State/zZip: CONTRACTOR: TOM GERMAN ELECTRIC IN License No. 541267 Address: 224 W FRANCIS STUnit: PHONE: 951-735-6727 City/State: CORONA,CA ZipCode: 92882 CELL: ARCHITECT: License No. PHONE: ENGINEER: License No. - PHONE: SIGN PERMIT FEE SUMMARY • PLAN CHECK FEE: $63.21 - - - HOURLY PC FEE: $0.00 PERMIT FEE: $97.25 ELECTRICAL FEE: $48.10 SMIP FEE: $0.80 OTHER: $0.00 INSPECTION: $0.00 BLDG STD ADMIN FUND $1.00 TOTAL FEE: $210.36 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 II INSPECTION TYPE, MTh INTRIALs Coors INSPEC110N TYPE, PML IN1mAt4 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof 210 Final Electrical 0 MI WI. 201 Final Block/Retaining Wall 212 Final Fire Prevention 202 Final Factory Fire Place -♦Y-�� 220 Final Planning Approval 203 Final Sign -4 222 Final Site 204 Final Demolition 250 Final Building/Occupancy C. WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. 0 Yes 0 No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: 0 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. ❑ 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 m depth into which a number are: person is required to descend,will be made in connection with work authorized Carrfer:J by this permit,and that no building structure,scaffolding.falsework.or demolition or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sedan need not 0e completed the pent is valued al one hundred dollars(S100)Of less.) 2,Art 2,Sec.341,Title 8,California Administrative Code). Polidy.Number: 0 As owner-builder, I will not employ anyone to do work which would 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 becombecome su ct to the workers' mpensation provisions of Section 3700 of Applicant's Signature Date the Labo e.I shall fo ori reply with these provisions. 99 e --zoo? Division of Industrial Safety Permit Number: Applies s ature 122_319 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 (5100,000), 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.��JJa registration form for acutely hazardous materials? 0 Yes 0 No .Lic..# ( Class# C `� cetio 25533 rofe the CaliforniatinHealth and SafetysaCode, with somet b 2 �i exceptions, requires registration with the Costa Mesa Fire Department by ✓I 8 ,./ ZOO each business which at any one time has on hand a quantity of acutely Contractor ature ion 7 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 ❑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). ❑ 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 ❑ I. as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec. 7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a 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. Signature of,T�kral r I Date Signature Date /ja d 7�( Q n n g_ S' ZOO., 305746(3/07) "-1-4 ,,,///_---CC ��ll// And/or Authorized Applicant rblu'\ Baja Fish Tacos • cepgrocos7 ..........0._ „.„-. • .1 , —litr-i- 4C-7:::—.7.-•----..-c7,---. , '4-t-r a,.., . • z -e,•• ; eit ,/,‘„ •••,),/s, CVS Pharmacy ;.• -,,- . ^# Nyc„.-1--: , ,, _ .i .4. t.,*,a•-•,,es: - _ . t - - ' : - 1.,, c Y.::: •N's c; b,y; • . 0 ‘N•t 1: ; ‘0,..,,,,, ',4 . ".4.',4);S1/4 .,N,'"? • '" ,I, ,, .;-, ' ... .. '-1)-^ •-• . RcNts;ii... 4 *. '''' ' V. b r ‘-'S.,1-'' -, flet."'b.- ...c ; ..;';' ,. Top of Nails sP ..:: . . „„ 1:',.. •• . Beauty Supply ; • N.,r...., . 47...t,. ' '''‘‘,4.-4•11. . \., • N... -, ;-1 '.4-• C.11 • , zli,;>'" ...v Hair Spa --N . , 4,.. . c, - •••••.' - \ • :4C. ''.A., . / .,'• - ',..,,. .., 1 "--\ , — - ' 0. , .ts, S.-, •;•- ' 4,-, /\• ..,e ,••• „ J.:\ '' e. •1-1" ot •. •N. NO SIGN , - .c.,4k,- • -4, --I. •••,/ ,. cs. - ..• .• „?...„ ,, ,:. •;2••,,_ es:..> -' .•••• "Nt- ''' - s t:: 1/2: " •4•4, • ".': ..- 'a:, "'s"").4 :.• ,;',.. ,-eit .‘Ne. 1/2..", ,It•.,'•„...„ ..t '1 d e ‘dr-‘ % . . ' ...I •' - % 9:N1 •Pr - ' 1. ' % ,*;‘••`11S'i • -1 ' • _ e .\ 40\ 4,r - - - '. =*a - .(,.. .--P,NN ./. . , • .r., . ...;\) . . . '• , ...1( . . -i,' I '-t7'.- ' - - ---L; 4fr t fr• \ , •. •, • • ,v ,::"..•.‘ • _ <",•:." -' -.-7. _,,Y- Ji".t••-•ev . t •• ' • :- •,:-N.. ..! ••• • .r d). ‘ 4 do ''..,17.` -.,.... . LL - t.., N„..., WI .4,.,:, . , t'd...• '-.i i- .%.",)% -N-\' 4,41 4.'' '• ,4, '‘I:: „;\:47 14"A -- 1.c.an '7;;;I;r4-:(1711,1:?1,7th4St! CostaAllesa CA19262,1.2' ‘'.- • '-- - - '•. f".;,,N f..",: . -' ''' d." '-12:111 it itT-- -Ltil c---"•.‘-‘N, •int+ 7 -. - 4., . 170, .._,- ...: :4, t- , .;,--* ..., -- • . — • - . . • N N. 4 .. ..• . .• ,-..•N Z. '--" .. ..* 6 - f =14 . tr • • - N. I t 1 i, (7;4-4 A , • ? ISION OF BUILDING SAFETY • 405, ,N'e..., ! .-,z1.."--- -- --L• CITY OF COSTA MESA L.. VIE • 01101“:113DE COMPLIANCE , • -tr,) -ti.N1/4,. .., . r: • , ' ' ..i."-.Q. atriltt_ • Date S-0 5 4-1,11plars- and _s MUST_Oc_ ton " at all Imesand It is istastil to VONS NY"' - 11e88171thanges *Miffs WMforli • born the Disislce°faulting end Selety,City of Costa Most S aX— COS2' II.OV' , NO SIGN . 1-, ./ The stars:Mg of this Man and specificatan NOT te hid topenal bean isiproval ... _ al Its violation of any provisions of any City of Costa Mesa Ortfinince ancVor Style law. •• NO SIGN *%., These Mani ind pm*shall spire by Irritation and become rail and voil Its bultrm9 or work is not corirrerced ad mairsained achy°pyr CBC Set 1C6.5vothin I BO days of Issuance. .- . 4. I. 1 195" 4 • I DESCRIPTION: INDIVIDUALLY ILLUMINATED CHANNEL LETTERS WITH BLUE PLEXIGLASS FACES AND RED TRIM CAPS&RETURNS a 26‘e)QN Piste. THAT READ"BAJA;RED PLEXIGLASS FACES WITH BLUETRIM CAPS&RETURNS THAT READ"FISH TACOS". BLUE PLEXIGLASS WILL BE ACRYLITE GP 605 46 sq. ft sign RED PLEXIGLASS WILL BE ACRYLITE GP 278 "r, "': PLASTIC ANCHOR WITH#10 X 3"SCREW vr r �,6; 3 PER LETTER • r rtrt' ,,,I,t CC co :f t AI ,,,.•.;"J,s, 4 "t •/�/�9 �rL [ / ei.f.!.; �"1 STUCCO WALL //GV',ac riSL.%TQ.COS ., _I:s TRIMCAP ff.� ��// ��I mos � ". e-s—t- -Te �=.. j"le -LGci t'``6` -1-s-3,i :W"Es . .*-'s".a.: •4er;�n f•any n-cc 'b'C� 'c ` ? ,` tIr'` r.•^ =`b'1 .^a _ fAr �C .r �V'4'x er..> Transformer Bo. �ea�. //S rt.� ,rTO Pv CN-OII Sx+IN I J IN INPUT POWER CABLE I/BRINGS a.- POWER iOUY TO 111.04 Of PCBS ( NMPERCOHNECIOMI • ANVWHEAE ON PCB $ •ifx ` - RE%IGLASS PACER J I i C P REWR pRl il' �"1 f; I • - �, I 1 ilk 1 ?ix,I _� .1 e MOUNTING HARDWARE U H^,I i — AIO ALUMINUM RETURNS ]1a �!1 . „ Dnp +5 pRpC=1 _: a DC - x1657_xILL:a I1C'.:I:_re - - if.]L�I : :HoDailllgg11, 1 ill y" 1 1/4-TOGGLEPLETTBOLT Uv�%'L i c.. IPER LETTER ?�0G DJ Ted L tc • I. I e& A D !S ZS�`J V t%k r I -tti- � l ��r.:V�- Il 'P 1�:. ,� f r �fB' 1 • ' !' Coa,'CUSTA Sign. ure of Approval IL • f awv`�i. e s ire,, �£ "'J D9 SUBJE' ' • : it , ° . REo NOTE. A-BDITIONS, LETIONS ORCORREMIONS IfAtSaBISRAJ, FISH TACOS etAtt Electrical Is existing at sign location from previous tenants. APPR•V D B VE PL NNR4G D' 5 ALL k-AYLk TJ Co^. .y t-✓/ZUO7 GRC au- Cocr ion: Ilvll AST 17TH STREET 1 -_ efoc25yr G E O `T.!Gigs Tka Is an unpublished drawing,created by Stam Sign Dasipn h is submitted for your personal ,�• Drs n B E4.0 . -r • t • use in connection with the project being planned for you by Starr Sign Design h is not to be BY: . J _ , Tr ' o shown to anyone outside your organization,nor is h to be used,reproduced,copied or exhibited r — A a e: e S I l:� In any fashion whatsoever.All or any pan of this design(except registered trademarks)remain _ the property or sum si°n Design. Date: /30/09 1485 Pomona Rd A Corona Ca 92882 V L/"' `' 951.310.1877 ^PPLICATION FOR A BUILDING PERMIT ' BUILDING PERMIT NO. Electrical CO Tract Block Lot Permit No. e cL BuildingPlumbing Address CO 7 Z 7 Permit No. ob • D Cross Mechanical cL 0. Area (�^� ,' Street Permit No. Owner 7�T�_ _- Q Type of project: ❑ Now ❑ Altar ❑ Addition Address,(//�/7/ '^^`��"' ! 7 "� S7 ❑ Repair ❑ Convert ❑Demo ❑ Occupancy Pmt. City � ,v [( a�. Zip 924z7 Phonenip-frit, A.P. Sup.Dist./ Insp.Area Architect/ Zone SPI.Pmt.No, Designer License No. . Setbacks PP-Front C/L St. Street Width Address Yards Left Right Rear City Zip Phone Eave Yroi. Left Right I-.P. w Engineer License No. - - —- . - C Parking Spaces Required Provide Covered 0. Address m City Zlp Phone Strutt No.of No.of Height Stories Family U LICENSED CONTRACTOR'S DECLARATION Park Fees d Yes Fee to Required No C.T. Receipt E I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000 of Division 3 of the Business and Zoning Approved By: Date Professions Code,and my license is in full force and effect). License Class License Number • > Date Contractor Misc. E Address Proposed Use jy City and Zip Phone of Structure N CONSTRUCTION LENDING AGENCY ;uI hereby affirm that there is a construction lending agency for the S performance of the work for which this permit is issued (Sec. 3097, Occ. Type Code Civ.C.). Class Const. Year d Lender's Name USE/OCCUPANCY SIZE SQ. FT. C Lender's Address . ') • OWNER-BUILDER DECLARATION Ihereby affirm that I am exempt from the Contractor's License Law 1. co the following reason: as owner of the property, or my employees with wages as their 2. ' s le compensation, will do the work, and the structure Is not L intended or offered for sale. r 3. 3 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project, $ 0 I am exempt under Sec. B&PC for this reason 4' o y Date _Owner E WORKERS'COMPENSATION DECLARATION Total Valuation 3 I hereby affirm that I have a certificate of consent to self-insure, or a certificate of Workers' ompenatlon Insure qp �'{ a cert ifietl Encroachment Permit Required ❑ yds ❑ No C copy there cby( i t'tC'c `N ".L co_ Grading Pmt. Grading 8 ,Duey No " L p( T ompany J t Y V` Required ❑Yes ❑No Pmt.No. G Certifiad copy is hereby furnished. 0. 0 C ifigd o sled witr�Or nge ountEM Rough Grading re 'VQ � ) � y, Approved by: Date Date O` Applicant 3 CERTIFICATE OF EXEMPTION ' FROM WORKERS'COMPENSATION INSURANCE Z (This section need not be completed if permit is for $100 or less). C I certify that in the performance of the work for which this permit is 3 cr issued, I shall not employ any person in any manner so as to become ra, subject to the Workers'Compensation Laws of California. PERMIT FEES Data Applicant NOTICE TO APPLICANT: If, after making this Certificate of Structural $ Plan Check $ Exemption, you should become subject to the Workers'Compensation provisions of the Labor Code, you must forthwith comply with such Electrical $ Special $ provisions or this permit shall be deemed revoked. Invest. I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE INFORMATION IS CORRECT. I AGREE TO Plumbing $ COMPLY WITH ALL COUNTY ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION,AND HEREBY AUTH- Mechanical $ ORIZE REPRESENTATIVES OF THIS COUNTY TO ENTER UPON TH OVE MENTI NED PROPERTY FOR INSPECTION PUR- Inspection P SES. (��3 gJ� Inspection $ / (J((�J Pre-Grade Permit Of Appli t Agent Plan Issuance All spaces within this box must be completed to process Check By: Approved: CMF 0335-46(BU-28)rev.6/80 ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLI ATIONIP RUC13AeaPERMIT66e.0 1k ,. P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 //'' RECIDi-Y PERMIT 7�T0 50727 , For Applicant too`Fill in Completely —`/Use Ink OnlyBUILDING �J 1V C� ADDRESS X11 C. % 1.3.1--• 'Ei.�\tSCDt•i WVQSA' A.P.NO. // / —0A/— c �p�/�� OWNER OR ADDRESS!!BUILDING 1i 1 C.I 1 , y all TENANT ��^ N NI k ZQcz UNIT OR MAILING ', a, Ii UiSi SPACE NO. 3 ADDRESS /� TR.NO. LOT BLK. CITY-.51 �qS-� NOagt-et-SltJ NEW ADD ALTER EPAIR MOVING DEMOLISH CONSTRUCTION LENDER ¢.NTS BRANCH , OWNERS11WOO C Ooc e CkC� ADDRESS ARCHITECT TEL. USE je/ • all UU" X OR ENGINEER NO. I' ADDRESS ZONE /�t TYPE � GROUP /p CONTRACTOR bwl&Qe — 3u cLi>t2 APPROVED \\\/\\\`LLL////ry/---•• DATE 7/Z 3/6 Q ADDRESS- WO LXZ21--q. / F STATEry ou&t Qi K�CITVO v ' APPROVED SETBACKS LIC.NO. LIC.NO. SIZE �j NO.OF BLDGS (FROM C/LS EET)• W O. OF LOT \ ss, n, NOW ON LOT FROfJ� FT i yEXISTING BLDG. R I USE OF S�LIt //-t/ FT I CA (-1 Separate permits are required for L.SIDE T, electric,plumbing and heating work. REAR FT. (14„ USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION • ^ n DATE Q �'L1�'Q _(Q,R . APPROVED > —ELY R( el K DATE L --07-g—•3 V ..I W O I herebyacknowledge • - tlge that I have read this application and state • 04 that the above information is correct and agree to comply with CL all laws regulating building construction, and I shall not employ i. Z any person in violation of the workman's compensation taws of m 5lthe State of California. a 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 w Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business VALUATION and Professions Code, Division 3,Chapter 9. PERMIT FEE $ • O O n PLAN CHECK $ ^I Signature of _ , !, $ 7&CO Za.00 o Permittee It/•/'�t �•- LL or /�� TAX S P.•1rO U • Authorized Agent Date // ` TOTAL PAID S 66 ,J o '--"-" 914/ 12/27/79 53.30 :t1:1 'COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 Only RECEIVED BY 'PERMIT/ ^ LiO ze �� For Applicant to Fill in Completely — Use Ink Q /�!,/•rye '{ ,/ r-7 [� /� .BUILDING /70 /7- s1 A.P. NO. I11--031—.b°�+5 la�3I2 16 ZT5 ADDRESS ( (/ ( / TTENANC �T �-Y�1 '7 T R.K/ &EAJ J ADDRESS ` ( I ' 'ri'i ST UNIT OR MAILING SPACE NO. ADDRESS L02.7 /Ow lit fili.9/3 r� Ca-61 TR. O. LOT T7OY f y �+/rJ IBLK. TEL.CITY Loo (.l nl /r-t/J �00U/7 NO.47 9_2...3-ot ��79'��'f/y r M O L CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER x • BRANCH L OWNER rwr ADDRESS ^r s—_���o///���VALUE ARCHITECTL •Q TEL. '2 13 USE J Y § OR ENGINEER 11 Q Q1 �+NO. 55/2`-310:, �r/ n ADDRESS '2o Zl „ills- 1'G r��G � Lt Epi, APPROVED GROUP /g/` CONTRACTOR !WMat sr 's ,/r�a APPROVED DATE IZ/IT/ i ADDRESS IO7' 13rlarridl e.- 4T1'21 p0 !!!! tttt TEL CITY 1 rc r e (^fa NO� 1•" STATE " CITY APPROVED SETBACKS �y+ LIC. NO.13 303 t I LIC.NO. W SIZE NO.OF BLDGS. (FROM C/L STREET) 0. OF LOT NOW ON LOT FRONT y • USE OF ' ` t 1 EXISTING BLDG. R SIDE / 'cn /�Y�Qj'�14!^ti`r-- uun Separate permits are required for L.SIDE G7 electric,plumbing and heating work: REAR FT. — F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION a .s�Je -Grou -, Su DATE fo APPROVED } �ls \c0001 ul"NAA /�71'P q.o I ^' ROVED j DATE SLA 2-J7 ..4 '-7t1 �t a w 0 I hereby acknowledge that I have read this application and state $4 that the above information is correct and agree to comply with C. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of ,tw the State of California. I hereby certify that I am properly licensed as a contractor under SQ. FT. N D the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR cd Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e am exempt from the provisions of the State of California Business �J and Professions Code,Division 3,Chapter 9. PERMIT FEE $ 34 1:00 u+ YO.4102 Signature oh, PLAN CHECK $ ^ 0 PermitteeGC.,- 4.-1..y.-- $ /��//I/���/.('�/ TAX § aar `� "�.� O.SoAuthorized Agent Date 4 7- b5 / TOTAL PAID $ g3, 3 Q 91148 12/27/794/6e7U L e. ' - COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT I/ 11....,,` P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED BY 'PERMIT £749 �O ^� For Applicant to Fill in Completelyte — Use Ink Only t p 77 J ADDRESS nle /7-/���- / A.P.NO. ' 17— aO H 69 { �Q OWNER OR 17A A6 A) ,L.C✓ ADDRESS ,7' Er Ih-'-}- I7—jJ TENANT (N MAILING LLU� UNIT OR ADDRESS 202_ CCg7SPACE NO. K ` LOT SLK. LPON" letc2— CITY Ler, 1 it rQ( f S 'r n Nos? N ADD ALTER REPAIR MOVING DEMOLISH CONSTRUCTION 4 LENDER BRANCH OWNER ADDRESS LUEE c� )LfjUSEk� t/ARCHITECT L ''J4L TEL OR ENGINEER NO.St2- P' ADDRESS _0 Z / 94,roc if /_.q ZONE C 1 _ TYPE GROUP 8/ APPROVED CONTRACTOR C ex.--:---==r11-” : BY •' DATE /2- /T •.. tk&[r3)"not- ADDRESS t025. einAre o t c q7.j LI80 TEL..6:f pato CITY (pre, el54_ NO. ft STATE CITY APPROVED SETBACKS LIC.NO. 6 3 a15 Z 1 LIC.NO. 9.1 512E NO.OF BLOCS. (FROM C/L STREET) QOF LOT I NOW ON LOT FRONT !'" 7 VI USE OF �7 �, /l ry �� EXISTING BLDG. ((,E�t[lA.�' Arco R.SIDE T. / .!//V'�/w V FSeparate permits are required for L,SIDE ' L electric,plumbing and heating work. REAR �Y/ FT. (W-, USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION Q Q 112)4 HLintY14 � t&rzn J I APPROVED \ '� ROVE?we# DATE 12412479 >. TIefifoan cYM .c ICe y� _ Y .-I ( 0 ill Ct.0 • I herebyacknowledge that I have C g read this application and state co C6 that the above information is correct and agree to comply with L all laws regulating building construction, and I shall not employ S Z any person In violation of the workman's compensation laws of 12 IQ the State of California. m 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 full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY; e am exempt from the provisions of the State of California Business VALUATION PERMIT FEE $ and Professions Code,Division 3,Chapter 9. tm0 v+ en Signaturet ///��� PLAN CHECK $ / 'Zo o Permittee �.4LGtG— .i`--- l '�C'n� S tit OM TAX E u. rD- s S`� Authorized Agent Date /^? 7-//-`f TOTAL PAID E shy r'7 O V • • 5162 10/18/79 24.00 TL COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECEIVED BY (PERMIT For Applicant to Fill in Completely — Use Ink Only NB leilEEF- BUILDING /I/ 0 /7 I►/� A.P.NO. r ADDRESS ` — ADDR NG l•7/ C r /7 JC �Y, Clup OWNER OR _ II cr. ,- // ADDRESS /(( 7� TENANT �(.(� ✓V •w �-� UNIT OR MAILING /7[G] , / /t , SPACE NO. ADDRESS L T J �{�'�,C If //�� TR.NO. LOT BLK. 4L I V TEL. CITY Ka NO. - CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH PC LENDER [J��t}Q BRANCH %<� St . OWNER v ADDRESS VALUE ARCHITECT TEL. USE E OR ENGINEER NO. ADDRESS ZONE / TYPE GRO P �% APP . �// _ -& / I"CV CONTRACTOR �1� BY A�,C�(/rDQ+ iD9S�7,E ` �� ADDRESS TEL. CITY NO. F+ STATE CITY APPROVED SETBACKS LIC.NO. LIC.NO. w SIZE I NO.OF BLOCS. (FROM C/L STREET) 0. OF LOT J NOW ON LOT FRONT FT. Q USE OF y EXISTING BLDG. R SIDE FT. to E-. Separate permits are required for L.SIDE FT. G electric,plumbing and heating work: REAR FT. _ F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION - Q ATE l•ti! '.^r l .T APPR j I' I APPROVED i. i(0 .Ili /� c APPROVED } ���/`^'� �0� r I' �� RV DATE if a t?acknowled c •ge that I have read this application and state N. p$ that the above information is correct and agree to comply with 0. all laws regulating building construction, and I shall not employ Z any person to violation of the workman's compensation laws of u _ the State of California. it/ co I hereby certify that I am properly licen tl s a contractor under SQ. FT. co the State of California Business and Pr izssions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, and that such licenses are fall force and of )or I THE PURPOSE OF ESTABLISHING A PERMIT FEE O LV: u, am exempt from the provisions oft {ate of Californ. Buslness VALUATION e PERMIT FEE $ and Professions Division 3,Ch: er 9. • eh.... en v, Signature of ' 'ex Er PLAN CHECK $ LL Permittee TAX E or � $te / U Authorized Agent Date TOTAL PAID $ oD . 1 _ 3328 9/r?c e/7160lO TL • COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 RECFY PERMIT For Applicant to Fill in Co/mpplletely —./Use Ink Only VVVVVV /ry Nom { � BUILDING I (l C ` ±c5 �J'* ( A.P. NO.I/�/'0 / Z`y>47/7, B ADDRESS !7/ C E. 177-4.— ' t TENANT SQLt_ � �s}C BUILDING MAILING ( UNIT OR ADDRESS ry3J, -30(e41.0 /2" SPACE NO. /' /// TR.NO. LOT BLK. CITY'& �tg nee r-..., TNO. 777 ,q7j CONSTRUCTION NEW ADD ALTER REPAIR MOVING DEMOLISH LENDER !`X'� BRANCH1Js OWNER V V� ADDRESS /� 53-2-3100 y-� VALUE OR ENGINEER ARCHITECT In y!y�'�!/"/y� NOLJ-] 2- USE / '/�// $ s 7` ADDRESS / ZONE �l TYPE ,jam GROUP i'i APPROVED CONTRACTOR BY DATE ADDRESS TEL. CITY NO. i-4 STATE CITY APPROV ED SETBACKS LIC. NO. LIC.NO. W SIZE NO.OF BLDGS. (FROM C/L STREET) P. OF LOT I NOW ON LOT FRONT FT. n . briiyij Q USE OFVI n^�}�• cJ EXISTING BLDG. "-c`U 1I SHO R^(SIDE `1' ten Separate permits are required for L. FT. C' r G electric,plumbing and heating work: RE FT. IIJy F USE OF BUILDING AND WORK TO BE PERFORMED PLANNING ACTION G q 7 p�,/ , //n.; _ DATE Q Lean l r ,20-td /41.641::01— ,p APPROVEEDDJ� yn ' ./Y pi I/ Wsi AV APPROVFHy0K DATE / // �'Y a v n-4.6 ' 111 �J L4 aI hereby acknowledge that I have read this application and state n tK that the above Information is correct and agree to comply with Z. all laws regulating building construction, and I shall not employ i Z any person in violation of the workman's compensation laws of x the State of California. m 3 I hereby certify that I am properly licensed as a contractor under SQ. FT. N the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m CI 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• the State of California Business and Professions Code hapter 9. VALUATION PERMIT FEE $ m t� Signature of ��� '\/l��s PLAN CHECK $ /� co n N Permitteeo '�. L. S V J�©r. t COl/ LL y v �� TAX $ Authorized Date J/l7 - TOTAL PAID s/6 s 1 0 t_Ttna7Q�.. ` • ' • I 3 A - 7341 6/28/-7-8 —"... — !3. 16 .TU COSTA MESA BUILDING-SAFETY DEPARTMENT - P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 AP CATION FOR STRUCTURAL PERMIT For Applicant to Fill in Complete) Use Ink Only RE ED Y DATE RECEIVED I SUE�f' BUILDING /CC� � mo .YI ADDRESS `IV•G�/ �f�. _ /(/ .At 7 m Je/v�/ 7/r-(O. O /2 '�0 PERMIT NO. OWNER K (,i /OAj ,rysx �/ A.P.NO / MAIL 102-9 4 C . ' BUILDING P 4 /7 ADDRESS 3u[.i0 / �.1ZCL/2�i'f�/�y/(�j.Q-� '4DDRESS,?I G / - CITYajs CONSTRUCTION airy d,8Ix*: - _fin NE TRACTADDALTER REPAIR LOTBLOCK f1FMOCK t 51-1 LENDER f""' / "°'N BRANCH c -' ' n — OWNER�� ifemic ADDRESS �(/��) f �i ✓✓✓ a ARCHITECT Mflalt3Lc. hs4-EL.�O �"7 • USE �C�/�N rI�I IAa L`� LU$ �i]JJw.i1 • OR ENGINEER ?A �L M-G NO-7' FIRE �V/[�r�s/ . ADDRESS ell, , nQ S/2 ZONE Y E GROUP r ;a �r�.,/ 7 ?Fr APPROVED CONTRACTOR QQ7c/(,4,lar ml 4-&—r yrs/ BY DATE ���/ ADDRESS / ZONE NO.OF USE F NE TEL. G� IPLAh152._ BUILDING O • CITY NO. STATE CITY YARDS APPROVED YARDS APP VED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUIL I G L SI LO #Z Sd ♦ NNO.OF BLOCS.OW ON LOT �" (FROM ChiSTREET y 1"{�rv//USE OF /3 Y FRONT 1^?FT.( • EXISTING BLDG. /fl'4/L .J} R.SIDE `--SFT. co E Separate permits are required for L.SIDE �T. • ci electric,plumbing and heating work. REAR T. [W. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET BET MAIN SLOGS.. ^ ^ A(rFSS Z ,TD/1 7IK e2�L J/ net--- C.URPllidgg e/?,2 APPROV`ED6 97-77 ›, i�C- 57.1728=� /o /�$ RY RO c1 AO�a• DATE r+ 2:-2 CJ ..1 ig w QI hereby acknowledge that I have read this application and state in rt that the above Information is correct and agree to comply with o 0. ell laws regulating building construction, and I shall not employ i Z any person in violation of the workmen's compensation laws of SSW the State of California. 3 I herebycertifythat I amSO. FT. a properly licensed as a contractor under 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: _ em exempt from the provisions of the State of California Business io VALUATION and Professions Code, Division 3,Chapter 9. M PERMIT FEE $ ���/`' PLAN CHECK $ YV n �� Signature of = �(tY,/// q� • o gad Permittee S(0/ (. n TAX $ „a‘ f NRq U Authorized Agent TOTAL PAID $ /J, 16 ser,6B1 6/30/7a Y; 2.03e9d "-?l :•' . • . . 46'300 433 03 ,;.,... COSTA MESA BUILDING-SAFETY DEPARTMENT P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 APP ' • itFOR STRUCTURAL PERMIT For Applicant to Fill in Comple :y— Use Ink Only harej DATE RECEIVED s , tar /I- ' CI4- •^:L ' ' r '1C"- _ PERM! NO. OWNER /Y � LlfT01/lA.P.DIN el; � ./ ' '/7- , MAIL 20Z PACK. •ADD_ ADDRESS S 31460 �. (Paint R.I�/ /��' L/ �/,t ESS T L.pIIpS p TRACT CITY Qa rt q /eri/, ON �.entry -� LOT _ BLOCK CONSTRUCTION M �r�� /�, NC/W IS\�sR:l iLlIEN • "l( L. LENDER �r kat)) BRANCH A//� Si OWNER ./" . W r • - ADDRESS I i VALUE ARCHITECT 4/I • 7J7t 7 17Y'M••:" TE L.115 4 4 _ is / - s A� d OR ENGINEERR _ s• _ ♦ . agarut ADDRESS / ,Gy R�e}� 2/Z' •� � It -• a CONTRACTOR Vatr/�� Nor cal ye V-//�'/I OAT t/ eI Ad ADDRESS TEL. ZONE, / PLANS n USE OF NEW 1/ CITY NO. C/ V BUILDING F STATE CITY YARDS APPROVED YARDS APPROVED LIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING ia SIZE n� G0. NO.OF BLDGS. (FROM C!/1L�ST EET)a ye /n �, / L OF LOT rN 2 V`I S NOW ON LOT FRONT ;719 FT. C''V/ /7FCJjC/ a re. USE OF a �� / T BLDG.r•AI EXISTING —^ : t SIDE Q FT. FT. cO y� F Separate permits are required for L.s1DEJOT FT. FT. G electric,plumbing and heating work. REAR'4 %_ _ -_/ eF�AL. .Y cFT. Id USE OF BUILDING AND WORK TO BE PERFORMED s F DISTANCE BET. BET.MAIN& 0 MAAININ BLOCS. ACCESS BLDGS. tf YYII NTA - VAR. DATE Q I� %�� T�G�� C.U.P.#Cs '77. 27 APPROVEC 7�7—'7 7 •rl h, /A L J L/j 5 APPROVEyn,'� /Or DATE(O 1/-74 a rlC/rF� + r v HOLD FORVSPECIA REOIITP!MFNTS La O I hereby acknowledge that I have read this application and state tn n X that the above information Is correct and agree to comply with m cu all laws regulating building construction, and I shall not employ Z any person in violation of the workman's compensation laws of S the State of California. (//{./s/� a ' I hereby certify that I am properly licensed as a contractor under `� SQ. FT. H the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR o Chapter 9, end that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: — to am exempt from the provisions of the State of California Business VALUATION PERMIT FEE f e N1 end Professions Code,Division 3,Chapter 9. / m a/ ,•S� PLAN CHECK f ,�/_ 3 d u. Signature of L/ 111000 o O Permittee s / TA% f'�..�s�qr �7 6 s. V rD Authorized Agent TOTAL PAID sfti�/.g H. 463 6800 J0/1J/78 302.00 • COSTA MESA BUILDING-SAFETY DEPARTMENT 6800' 10/11/78 302.00LK P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626 6800 -00004A6303 IA LK- A LICATION FOR-STRUCTURAL'PERMIT u�- For Applicant to Fill in Co etely — Use Ink Only R ED Y DATE RECEIVED DATE ISSUE BUILDING /F/7 -/�'10 ADDRESS/ C''- T PERMIT NO. OWNER 1't.0 Cyr,. A.P.NO. BUILDINGMAIL 7 (7� '/�Sr ADDRESS ADDRESS TEL. TRAC LOT BLOCK CITY NO. CONSTRUCTION PJEW ADD I TER REPAIR MOVING nFOI ISH LENDERV'\X\ M BRANCH .� OWNER �if141060006- 6/772- s 72 ADDRESS D��s ^y�y—,VALUE ARCHITECT TEL. USE 1C c/!!AL �-.Y D/`� $ OR ENGINEER NOFIRE 7 ADDRESS ZONE TYPE /1/ GROUP claw APPROVED CONTRACTO 6Y? Ab,A r Lely BY DATE ADDRESS AM 671/ 6Lo 61e- ZONE NO.OF USE OF NEW TEL. PLANS BUILDING CITY NO. F STATE CITY YARDS APPROVED YARDS APPROVED gLIC.NO. LIC.NO. MAIN BUILDING ACCESSORY BUILDING W SIZE NO.OF BLOCS. (FROM C/L STREET) LL, OF LOT NOW ON LOT FRONT FT. FT. d USE OF col EXISTING BLDG. 9 SIDE FT. FT. to E Separate permits are required for L.SIDE FT. FT. electric,plumbing and heating work. G REAR FT. FT. 44 I- USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN& CMAIN BLOCS. ACCESS.BLD S. VAR.# DATE Q, C.U.P.# APPROVED APPROVED ...ELY DATE a w C.0 I hereby acknowledge that I have read this application and state .. g0 that the above information is correct and agree to comply with m S all laws regulating building construction, and I shall not employ i Z any person In violation of the workman's compensation laws of o the State of California. G. I hereby certify that I am properly licensed as a contractor under SQ. FT. D the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, and that such licenses are in full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: to am exempt from the provisions of the State of California Business VALUATION PERMIT FEE /7$1 e and Professions Code,Division 3,Chapter 9. $ ' ��� Signature of 12 PLAN CHECK $ u. 0 LL Permittee TAX E 4./ �� U Authorized Agent TOTAL PAID $ 40 "' CITY OF COSTA MESA 'o•�'- FFI,' BUILDING DIVISION F. �.- 77 FAIR DRIVE,COSTA MESA,CA 92626 • (714)754-5273 • Fax(714)754-4856 • 1wwi.ci.costa-mesa.ca.us LTimpirai ". icaFOR INSPECTIONS CALL:(714)754.5626 m .1 PERMIT NUMBER: BC09-00214 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: COM ALT DATE ISSUED: 07117/2009 ISSUED BY: BJK JOB ADDRESS: 171 E 17TH ST CM Suite/Unit: APN: 42542312 Zoning: , • Vicinity: BAJA FISH TACOS • Primary Occ: B Const Type: V-B SQ. FT: 2400 . Valuation: $30,000.00 SCOPE OF WORK: 2400 SF INTERIOR RESTAURANT TI FOR"BAJA FISH TACOS."WORK INCLUDES NEW HOOD, FREEZER, SALSA BAR,CHEF UNIT BEHIND COUNTER, DEMO PORTION OF COUNTER FOR ACCESS. ELEC: 10 OUTLETS, 10 SWITCHES, 4 NON RES APPL< 1 HP, 3 MOTORS TO 1 HP; MECH: 1 HODD W/DUCT AND MECH EXHAUST,2 VENT FANS, 1 AIR HANDLER, 1 REFRIGERATION UNIT, 1 EVAP COOLER,1 ABS UNIT UP TO 3 HP; PLUMBING: 1 CONNECT COFFEE/ICE, 1 GAS OUTLET (104), 1 BAR SINK, 1 COMMERCIAL SINK,4 FLOOR SINKS, 1 SVS MOP SINK 8/20/09: SUPPLEMENTAL PERMIT TO ADD 2 MOTORS TO 10 HP FOR ROOF-TOP NC UNIT CHANGE-OUT OWNER: THE VONS COMPANIES INC Address: %COMPREHENSIVE PROP TAX - Unit: PLEASANTON, CA Phone: City/State/Zip: 5918 STONERIDGE MALL RD APPLICANT: JOSEPH KHALAF Address: Unit: : Phone: 626-893-1514 - City/State/zZip: CONTRACTOR: J K REAL CONSTRUCTION INC License No. 484667 Phone: 626-893-1514 Address: 705 VIOLETTA DRIVEUnit: Cell: City/State: ALHAMBRA,CA ZipCode 91801 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $71.86 Building Fees: $442.25 Electrical Fees: $103.35 Mechanical Fees: $99.45 Plumbing Fees: $108.05 SMIP Residential: $0.00 SMIP Commercial: $6.30 Bldg Std Admin Fund $2.00 TOTAL FEES: $833.26 "Refer to fee receipts for all fees paid for project 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 permi CODE S. INSPECTION TYPE DATE INTITIALS gams INSPECTION TYPE DA �+ IJp'L 1616 Fixed System Final rite Prevention 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing • 7 200 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 /Q� lb if si WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes ❑No I hereby affirm under penalty of perjury one of the following declarations: Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-properly 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. • Cr[ac 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 ❑ I hereby certify that no excavation five(5)or more feet in depth into which a number are: N person is required to descend,will be made in connection with work authorized CS / A I . ' y this permit,and that no building structure,scaffdding,falsework,cc demolition Cartier. -!- f ! �- r dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2,Grp (This sedan need not be completed a the penin s wap.•at one hated db9ars(5100)• 'ss) 2.Art 2.Sec.341.The B,California Administrative Code). Policy,Number: 14({L ?Cl S — 6 l 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 Labgq��Code, I hall to h coo ly with these provisions. /� L/' 9 L O Division of Industrial Safety Permit Number: Applicant's Signature bate 1 �l •r HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: ARNING: 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? El Yes 0 No Licr#?- �9 Y(o6 7 Class#4,146- G. / 0 (Section 25533 of the California Health and Safety Code, with some p exceptions, requires registration with the Costa Mesa Fire Department by /� / ` Q "' 2� — J each business which at any one time has on hand a quantity of acutely oneed nature i,-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 IUCTION 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 ❑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 ❑No issuance,also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractors (Section 65850.2 of the Californian Government Code requires that the requested License Law(Chapter 9(commencing with Section 7000)of Division 3 of the information be furnished on applications for non-residential building permits). 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 sale. If, however, the building or improvement is sold within one year of control officer). completion, the owner-builder will have the burden of proving that he or she CERTIFICATE OF COMPLIANCE: I certify that under penalty of perjury the did not build or improve for purpose of sale.). information given above is correct. I agree to comply with all state laws and ❑ I, as owner of the property,am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a 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 slate 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. g V Si ur of erls, ,� - - Date �/p_ O v 1 Si nature Date ��.t f 3057-46(3/07) And/pr Aim-Ira-nen Applicant ,Date'1 • CITY OF COSTA MESA ;#1 BS BUILDING DIVISION F� A 77 FAIR DRIVE,COSTA MESA.CA 92626 • (714)754-5273 • Fax(714)754-4856 • www.ci.costa-mesa.ca.us FOR INSPECTIONS CALL: (714)754-5626 °"ot et PERMIT NUMBER: BC09-00214 PERMIT TYPE: B_COMBO STATUS: ISSUED Sub Type: COM ALT DATE ISSUED: 07/17/2009 ISSUED BY: BJK JOB ADDRESS: 171 E 17TH ST CM Suite/Unit: APN: 42542312 Zoning: , Vicinity: BAJA FISH TACOS Primary Occ: B Const Type: V-B SQ. FT: 2400 Valuation: $30,000.00 SCOPE OF WORK: 2400 sr INTERIOR RESTAURANT TI FOR"BAJA FISH TACOS."WORK INCLUDES NEW HOOD, FREEZER, SALSA BAR, CHEF UNIT BEHIND COUNTER, DEMO PORTION OF COUNTER FOR ACCESS. ELEC: 10 OUTLETS, 10 SWITCHES, 4 NON RES APPL< 1 HP, 3 MOTORS TO 1 HP; MECH: 1 HODD W/DUCT AND MECH EXHAUST, 2 VENT FANS, 1 AIR HANDLER, 1 REFRIGERATION UNIT, 1 EVAP COOLER, 1 ABS UNIT UP TO 3 HP;PLUMBING: 1 CONNECT COFFEE/10E, 1 GAS OUTLET (104), 1 BAR SINK, 1 COMMERCIAL SINK,4 FLOOR SINKS, 1 SVS MOP SINK OWNER: THE VONS COMPANIES INC Address: %COMPREHENSIVE PROP TAX Unit: PLEASANTON, CA Phone: City/State/Zip: 5918 STONERIDGE MALL RD APPLICANT: JOSEPH KHALAF Address: Unit: : Phone: 626-893-1514 City/State/zZip: CONTRACTOR: J K REAL CONSTRUCTION INC License No. 484667 Phone: 626-893-1514 Address: 705 VIOLETTA DRIVEUnit: Cell: City/State: ALHAMBRA,CA ZipCode 91801 ARCHITECT: License No. PHONE: ENGINEER: License No. PHONE: COMBINATION PERMIT FEE SUMMARY Building Plan Check: $71.86 Building Fees: $442.25 Electrical Fees: $78.75 Mechanical Fees: $99.45 Plumbing Fees: $108.05 SMIP Residential: $0.00 SMIP Commercial: $6.30 Bldg Std Admin Fund $2.00 TOTAL FEES: $808.66 "Refer to fee receipts for all fees paid for project NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations.(Ord.No.92-28,§1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. CODE s. INSPECTION TYPE DATE normu_S CODE; INSPECTION TYPE 2T INm1ALS 1616 Fixed System Final Fire Prevention _ 206 Final Mechanical 1266 Pool Spa Final 208 Final Plumbing 200 Final Re-Roof a 210 Final Electri .l• - 201 Final Block/Retaining Wall - 212 'inal Fire Pr ention A1 �- J 202 Final Factory Fire Place Sarai0 ,�.,n 203 Final Sign / /22/Final Site 204 Final Demolition 250 Final Building/Occupancy Iii / . • WORKERS'COMPENSATION DECLARATION: Owner ID verified by driver's license. ❑Yes 0 No I hereby affirm under penally of perjury one of the following declarations: - Driver's License No. Expires: ❑ I have and will maintain a certificate of consent to self-Insure for workers' Verification of Ownership by(type of document,i.e.-property tax bill or.deed): compensation, as provided for by section 3700 of the Labor Code, for the p rformance of the work for which this permit is issued. I have and will maintain workers'compensation insurance,as required by eclon 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:/ - /n\1 I person is required to descend,will be made in connection with work authorized -h 4ti4 G cj g2 -f l u S 0 E-A-,Lc E d 1 by this permit,and that no building structure,scaffolding.falsework,or demolition Carrier: ad 3 or dismantling thereof,will be more than thirty-six(36)feet high.(Chap.3.2.Grp (This seam need no be completed( perm(is valued al one kindred doears( rad)a leu) 2,Art 2,Sec.341,Title 8,California Administrative Code). Policy Number: ( Y Y y 7 o,� �- 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 Lab999r Code, shall forth 't comply withpthese provisions. _/, !1�/ A/ A/- 2_ / 7_ p p Division of Industrial Safety Permit Number: Y/(y//./••••• /J } pppltcanrs SlglgnaabjreL (�tll.1'r -�(e' l HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: ARNING: 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 ❑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. ,p a registration form for acutely hazardous materials? ❑Yes ❑No L` ya Y b,47, „ n Class`#, U - CZP "" (Section 25533 of the California Health and Safety Code, with some ",/- /, exceptions, requires registration with the Costa Mesa Fire Department by r� r�' ‘Kb t j 7'- 7- Q each business which at any one time has on hand a quantity of acutely ContractdorsSignature 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 CO STRUCTION 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 ❑ 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? ❑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? ❑Yes ❑No issuance,also requires the applicant for such permit to file a signed statement (Section 65850.2 of the Califomia Govemment 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 pan 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 ❑ 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 ❑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 ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH city ordinances regarding Hazardous Materials and Emissions. LICENSED CONTRACTORS to construct the project(Sec.7044, Business and Professions Code:The contractors License Law does not apply to an owner of Signature Date property who builds or improves thereon,and who contracts for such project with CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I a contractor(s)license pursuant to the Contractors License Laws.). certify under penalty of perjury that I have read this application and state that 1 the information given is correct. I agree to comply with all state laws and city ❑ I am exempt under sec. 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 4 inspection purposes. I agree not to occupy or allow occupancy of any building authorized by this permit until final inspection. �$/L"Caf dal, Date 77 d7 Signature Date IA- 305A46(310]7 And/or Authonred Applicants LData---1 ADDRESS(RSMLmPG: 171 E 17TH ST umit CITY OF COSTA MESA — BUILDING PERMIT a*NERSNMlEIFQCA7: BARROS, HERNAN R PERM NO: E 078311 AOCRESS: BARROS, ORFA T %JOHN BURNHAM 6 CO PERMIT NO: E 078311 PLAN CHECK NO: N GOVT: N SUPP: N P 0 BOX 2027 ESCONDIDO,CA 92033 APDL.MMWIG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE; ELE PURPOSE: OTH ARCHITECT ORENOINEER: UC.NO.: JOB DESCRIPTION : FIREWORKS STAND SQ FT: ARCH.OR ENG.'S ADDRESS: WIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / CCNRIACTORSIIMIE: AMBURGEY 'S ELECTRIC ( 714 ) 979-2311 caITRACTORSUMDC 945 CORONADO DR COMMENTS: FIREWORKS STAND FOR "COSTA MESA LITTLE LEAGUE" ADDRESS: COSTA MESA CA mot', 395199 +h+h*+E*#n-1E147EfEkiFif+ElEiFiF+r+r+4+cif+r+ElE+E+r#iE+EiF1F1E#ifififlFiEiE+t+t+t+E#itiE+E+F1EiE♦E♦tiE♦E1NifikfElE♦f!(•****1E1Er*****iFiEHEif 92626 WE: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby Nkm under penally a perjury that I un licensed under provisions of Chapter g SETBACKS (Commencing with Section 7000)a DMsbn 3 a the Bu lnae and Professions Code and my license is In h0 effect.ra end effect. CITY LIC.NO.: 023866 LIC.CLASS: C 10 LIC.NO.: 39 99 EXP: 02197 MAIN BUILDING ACCESSORY BUILDING \ FRNT: FT IN REAR: IN RGHT: FT IN FRNT: LEFT: FT IN REAR: IN RGHT: FT IN 6 2-5-' r0 °ontretl0firm �( LEFT: FT FT IN FT FT IN (BUILDER DECLARATION:I hereby afunder penally of perjury that I am exempt from the radonoLew for the MM11aa�� reason(Section 7031.5 Boehm and Professions Code:Any city or county whorl requires a Pe a to er improve, PARKING REQ• PROV: PARCEL: 42542312 Z NE: REF NO: 'demolish,or repai any amours,prior m as issuance.also requires the applicant for such permit to fie a signed statement ghat he or she PLANNING NbT E S> -licensed pursuant to the provisionsa tatContractors License Law(Chaptr B(commenting with Section 7000)a Division 3 a Ike sinew and Professions Code)or that he at or she a exempt therefrom ethe basis for the alleged exemption.My violation of Section > I,. 31.5 by any applicant for a permit subjects the applicant to a civil penalty of not mons than ft,hundred dole"j55cOD. ******************************************************************************* O I.asowneralhepropMyormyimplovseswithwagesastheisolecompensation,willdolhework.andtheatmctureisnotimended DEVELOPMENT S E,R V I C E S REQUIREMENTS or offered for sale(Section 7044.Business and Professions Cade:The Contractors License Law does not apply to an owner of properly who builds or improves thereon.and who does such work himself or Weal or through he or her own employees,provided that such C improvements are not intended or offered for sale.If.however.the building or improvement is sod within one year of completion, ZONING APPROVED BY - DATE; owner.buider will have the burden of proving he or she did not build or improve for the purpose a sale). - • I,as owner o the properly,am exclusively contracting with licensed contractors to construct the voted(Seamn 7044,Business and BUILDING APPROVED B Y : DATE: Professions Coda:The Contractors License Law does not apply to an owner of propend who builds or improves thereon and who - contracts for such projects with a tortracta(s)licensed pursuant to the Contractors Lianas law). /"• / ❑ Iamwemptunder Section: B.AP.C..for thireason: APPLICATION ISSUED BY: r' r • DATE: 5D **** ******************************** *************************** ** Due: Owner LEGALIZATION:N ,--ESE - SUMMARY STRUCTURAL GMENT:N I do hereby certify that 1 am aware of end understand the requirements a Cuaome Health end Solely Code Seaiana 25505.2s5.1.and 25534,end that l or any haunt building rampant will/will not(circle one)need to comply with said state codes and the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ea p.m*for construction or modification from the Ai u-Oslyl.�anagement District.Residential consructionappimtire are exempt from these PERMIT 11 .10 provisions. Date: Applicant 50% SMIP/NON—RES PLAN WORKER'S COMPENSATION DECLARATION:l hereby Yfum under penalty of perjury one of the following declarations: ISSUE FEE 22 . 00 O Ihave and will meintaoaceniicamof consent toself.insuefor workericompeneaton.asprovidedfobySection 370Dothe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,fathe penam.c.a hesoca fa with this permit is issued. TOTALS----> 11 .00 22 . 00 0 . 00 33 .00 33 . 00 . 00 _(� 1 have and soil maintain workers'compensation insurance.w required by Section 3700 a the Labor Code.for the performance of the 1_�\ work for which this perm is issued.My workers'compensation carrier ation insurance and policyat number e: Carrier: STATE FUND .EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 33 .00 OVER/SHORT; 00 Policy Number 13150 /3-95 07/01 /96 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK . faction need not be completediI the penult is for one hundred dollen 151 00)or less.) 33 . 00 'La I certify that in the performance of the work for with the permit is issued.I shall not employ any person in any manner so as to become subject to the wonders'compensation Mora a California. agree d I . . become abject to the %arka'. ******************************************************************************* compere on provisions of Section 3700 of the Labor Code,I sh with y with t +provisions. INDIVIDUAL F E E BREAKDOWN 6' -7Applies: : m ➢:Allure one hundred thousand compensation comp*is undwM,and shall sf!/ecr an /.loyar • . penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST roe up m ane hundred dollars(5100,000),In eddidon to the cost of co . fen • • provided for In Section 3705 el to Labor Coda Interest,and afemersl S. ELE 1 FIREWORKS STANDS EA. 11 . 00 11 . 00 CONSTRUCTION LENDING AGENCY: I hereby a lmm under penalty a perjury that there is a construction lending agency for the END OF FEES performance of the work for which the peril I.issued(Section 3097,Cit.C). LENDER'S NAME: LENDER'S ADDRESS: I candy thin I have read this application and Yue the the above information is correct.I agree to comply withal dry end county ordinances and stale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned propend for impaction purposes. 1 ).1'1c?w :.c_1224421 7- s T - ORV AMBURGEY Ti".-• i i ti • tatL` � ' Prim Nem / /) y J r�r—� _ AL �� Dale: !O -9 t/ C/ Signature of Own i 0enVApp-• r tractor (5151.46.WP) White-euidig S Safely;Green-Re:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor •m CONSTRUCTION AND PLANNING / POOL Y -nA Date InspectorDate Inspector APPROVALS Permit# APPROVALS Pern„r# 1. 7e1f4porary Electrical Service or Pote 52. Pool & Equipment Location '1' L. 2. Soil Pipe-Undrgrnd. `? I 53. Steel Reinforcement c i.Electrical Gondujt Uiility-Undrgrnd. 54• Forms _ 'T047),efectrical ConduK e ddrgrnd. 55. Electrical Bonding -. k1r :steel Reinforce r{ceMg 56. Rough Plumbing& Pressure Test - tn -•LC Vectrical UFEftJgr . 57. APPROVAL TO COVER-GUNITE yr?:. botingsc0,5 58. Electrical ConduiCUndrgrnd. -0.8 Foundation c.O a a 59. Gas Pipe, 0Uridrg"rnd.,Test r-•L ~ "9. yVdTfer Pipe.Undrnw-'rn 1. L • : - 60. Backwash Line{nlTTrap, CI Undrgrnd. 10. Stluctural Floor.System '61. APPROVAL Ti 9ECK 11. PrOerty Sewer Linet& House'r$onnection 62. Backwash & Receptor-Fi9aVI- 12. Sev_'er Cap 63. Heater & Vent-Final 13. Rdf Drains ., 64. Plumbing System - Final 14. Rough Plumbing. 65. Electrical-Final - y, . 15. Rough Electrical-Conduit 'T 66. Solar System-Final, 16. Rough Electric�Tjrinl 67. Fencing & Access-Approval 17. Rough Wiring Sign -� 68. APPROVED F iPLASTERING 18. Rough ElectricaL'Y Bar Ceiline 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating & Air ConditioningRE QEPT.�ECUIREMENT r • �•tr »: fr3 cc* FI _ r 20. ,fougti Faytor.Fil -ace ' a',d_ # S i --j.,.: nAPPR'AV S ` Per4nit # if 5' 21. Sucre;in'StruL+lurer a .. .. S x' c O r. H, 70, UndergP' fid Hydro 22. Duct's?V221tilq ngto* CJS k C J t-:,* e; 71. Produtn F' lin lJ C Oil •, M1 PJP gas 23. Gas Pipe-Rough & Tgst TS * rr 0• < G* -, 72. Undergrourid Flush a F 24. Roof=Frabin9" Q»'. ' F:-1 .. 4 x �* ".73 Undergrild.Stot.}cmTank;0Gas obit 25. Roof Sheghing 3 x E V* t„ .r ..... ,tit -' 747 OverheadrHydrg72 , 26. T-BaPteiling (Strt-et rall & NFo�,r^at K x C" t" 7 :DryChemical 7 'r 'r •• let"' * O 7 v"R i H� fi h' 27. Frame a Flashing j r "' r- -tt • 9 l -_r y C r mw 76. Dry Stan'dr . e` , . n. Cl .28. Lathing 5Siding (;'x .. 75F . £ " "I ' 7X� FIXED P4TEAIT'NAL ,in y * 0 H •• ” fv7 -J • 29. Insulation =* s •• r s K 7 . FIRE PREY. FLNZL ''30. Drywall tailing �t. �' ''" ;FfEALTtl, EPt.1RECUIREMENT tJ IY vl K t""• I * i .V.. ,uJ If j 31. Plaster BrgwntCoat E v , -rrrr 4 j .'79. FINAL IhSSPECTCON A 0 r. _I' 1 Irt rt:. _t • '4 - r-- 32. ElectricaUowe tY t rPircial * /` t 8C F000 GERTIF CATE 1 SQE0,., {" -33. FjnaI Elediric F* t d S ? N6test c.1'J ir: +- -: C : ;34. F,nakHeating'& Air Conditionin. S cE •r_ •S t"r= 4 - Ew rrl ti' • , : 1-+00 0 I E.C. 35. �inal-Gas PiPe:Tesbl,; ,-s .. * r+ �* , '^o i , . C -r .�• _ 7136. Hoo&or CanoPY * • rT_ 4. t C1 I ;t ' z n0 rr J -3 Y• i S 111 rl. i I OK t1, -... r:1 r srj -37. kna iat-tory Fireplace I F..c-. c t I k x * • -738. FinaPPlumbin "1* Co I - c j 'i: c --i o r "39. WaterService-Final* .l xm ! r ' ti` g r *140. Gas Service-Final C;* ci a'^c' S. < cr1 � Ort% ON :t L x _, tr c k4. - 0 x .c "Cr 2-41. Solar Domestic-FirS r,. y -- * G" T ;:1C _ 7' a L. ^42. Backflow Preventer c :.. f. M l >` , .._. ' 'r nt ^1-H c r. ;,rt Cr:C. S. -- - :r C•SS a; * •, a L' - 43. Backflow Irri'rtion t y * S * ; ' )i 44. Landscape Irrtgation4 System �n.10 x• * t-: C O a* N N 'n 't `L .. Attention r .Y. 2: c- r F-r. H r+ t Zl x 45. Sound. �aF.. r, . 71 1114. : C a C C . % 46. HandicaprRegulations H c , " 5 I:50 '- 4;. FIN4 STRLI TURF & BUILrDING * aj I 0 > - 1 48. PjNA.L PLANNING x al <+i., to 41 % • 1: _ C 49. ItlecMc Release to Edison t l: E* • •L' jc f 50. Gas Release to Southern CaliforniaGas Co r r;' -. t-1 C_ • 0 ir K C Ft. CERTIFICATEOFOCCUPANCY ` - C r'. H No Date mor 7y // PROJECT ADDRESS: 171 E 17TH ST UNIT A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: P 05533E OWNER,S,NAME: BARROS t`T' ADDRESS: 171 E1 7TH ST PERMIT NO: P 055339 PLAN CHECK NO; N GOVT: N SUPP: N COSTA MESA . CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: PLU PURPOSE; OTH ( 619 ) 743-1550 ARCH/ENGINEER: REG.NO.: JERLA & ASSOCIATES NOm JOB DESCRIPTION : COMMERCIAL T. I . (COFFEE HOUSE) SQ FT: ADDRESS: 424 E. VALLEY BL COLTON CA 92324 CLAIM VALUE: CALL VALUE: GROUP OCC: B-2 / PERMITTEE: ELITE PLUMBING ( 714 )722-03'74 ADDRESS: 1760 MONROVIA C-12 CTHE ALL NEW "CAFE CONCERTO! " COSTA MESA CA 92627 :OMMENTS- ***** ********* *gE+FSE* *i6*aE**�E***+E*x* F* FSE*** *******�tr�caE* **�rx*�r* *kr******** * LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with SectionZ ONIN G R EQUIREM E NTS7f0o)o1 Division 3 of the Business and Professions Code,and my li •nse is in full orce and effectSE TBACKS CITYuc.: 046562STATEuc.:539786 ss: 6 Dam: /2— a —�// signature:_ MAIN BUILDINGACCESSORY BUILDING WORKERS'COMPENSATION OECIARATIDN: thereby aNi thatI aveacenih to of consent to sell-insure ora certificate of workers' RNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Sect' 38'',Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: 1066304-91 E '.DATE: 01 /01/92 • 9OMPANY: STATE FUND PARKING REQ: PROV: PARCEL: 42542312 ZNE: REF NO: I Certified copy is hereby__byfurnished. Di Certified copy is filed • , city B ing Division. PLANNING NOTES> . � � — L Date: � – � , Applicant: 1 ."r, aF#1fif7Eah*lf****aE****afielfif****9E****lfifieifiEaElE****iF-lfifiF**1*if1EiF1F3e1EfE•#iflEiEfflEIt4E1FIfiEBf•ifiFlF3FiF1E****** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: lion need not pleted if the permit is for,one hundred(5110)or less). DEVELOPMENT SERVICES , REQUIREMENTS I certify that in the performance of the work for which this pe' sued.I shall not employ any person i0 any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: ' NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : r DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked.r'//�// CONSTRUCTIONtis LENDING AGENCY: 17.hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: �`•q r i ' _ �� DATE: fa....-- 2=-g? which this permit is issued(Section 3097.Civ.Cl. ,,,�: ************************ * A• � S "'! t ***3(.*{(�)p j(.** 7(�1t#�iF 3e *iF#.iE LENDER: p ************!a*************************Ih***- ***,r***********iF**********lEicy,.****** ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMI P/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT2 0, 0 0 repair any structure,prior to its issuance.also requires the applicant for such permit to tile a signed statement that he/she is licensed 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 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($500). ISSUE FEE 3,00 I, as owner of the properly or y employees with wages as their sole compensation. will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ m structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS---—> 20. 00 3 . 00 0, 00 23. 00 23 . 00 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 23. 00 OVER/SHORT: 00 forme purposeol sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 23 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors State License Law).t am aware ******.****.**.****.*******************.************.***.7E**.***************$***Y.*.**N-*.*. that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Droner PLU 3 SINK, BAR 2 . 00 6 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and PLU 2 WASH BASIN 2 . 00 4 . 00 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 PL U I WATER CLOSET (TOILET) 2 . 00 2 , 0 0 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. PLU 1 FLOOR DRAINS 2 . 00 2 . 00 Date: Applicant: PLU 2 SINKS, FLOOR 2 . 00 4 . 00 PLU 1 SINKS, SERVICE / MOP • 2 , 00 2 . 00 • I hereby certify that I have read this application and state that the.rove information is correct.I agree to comply with all city and county END OF FEES ordinances and state laws relating to building construction and hereb • s Ge rept- tatives of this city to enter upon the above-mentioned • property lar inspection purposes. pato._/ 02 2%/ Signature' � _ ._ _ • Driver's License or social Security a: . t641-46 White—Building:Green—Code Enlorcemen: anary—Applicant:Pink—Revenue:Goldenrod—Assessor Il \CONSTRUCTION AND PLANNING PC SPA 'APPROVALS Permit# - `Date Inspector APPROVALS Permit Date Inspector i.. Temporary Electrical Service o - r Pole 52. Pool & Equipment Location c r 2. Soil Pipe.Undrgrnd. - rl 1/4f 53. Steel Reinforcement 14 II 3. Electriral,Conduit Utility-On,tlrgrnd,- ' 54. Forms 4: Electrical ConduiYUndrgrnd 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- I 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61.-APPROVALTO'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 ///��-t 9 9 / '�/!'fti�Li7 - 65. Electrical-Final 15. Rough Electrical-Conduit L(� 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 - . 74.7,Overhead Hydro_ 26. T-Bar Ceiling (Structural) & Monocoat - _ 6 75' Dry Chemical .•t 27, Frame and Flashing76. Dry Standpipe T - _ 28. Lathin & Siding > L 9 . 77 FIXED SYSTEM:F-INAL• -29. Insulation } , 782 FIRE PREY. FINAL 30. Drywall Nailing , )/` ; - HEALTH-DEPT: REQUIREMENT _ 31. Plaster Brown Coat - 6, ' ,79l-FINAL INSPECTION • 32. Electrical Power Meter-Final I- ,80.•FOOD CERTIFICATE ISSUED - 33. Final Electric - , g, Notes: - - - 34. Final Heating& Air Conditioning• - •7 - _ • 35. Final Gas Pipe-Test• .- • • ,36. Hood or Canopy -'' % / 37. Final Factory Fireplace _ ✓j ' '38. Final Plumbing 4' _ t/giIQZ 4-c01 --- 39. Water Service-Final- ..��•!! {f ''' • ' -40. Gas Service-Final 2 : 41. Solar Domestic-Final . - _ • 42. Backflow Preventer' - 43. Backflow Irrigation • - •44. Landscape Irrigation System • • - - - 45. Sound Attenuation - 46-,Handicap Regulations - - • . 47. FINAL STRUCTURE & BUILDING l 48.'FINAL PLANNING � . 49. Electric Release to Edison - . ' i . 50. Gas Release to Southern California Gas Co I i ' - . - 51. CERTIFICATE OF OCCUPANCY • . , . . -. No. Date OJECT ADDRESS: 1171 E"17TH ST UNIT: A CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 05596% OWNER'S NAME: BARROS ADDREss: 171 E17TH ST PERMIT NO: B 055966 PLAN CHECK NO: N GOVT: N SUPP: N COSTA MESA CA 92627 CONSTRUCTION TYPE: 5-N PERMIT TYPE: STR PURPOSE: ALT ( 619 ) 743-1550 ARCH/ENGINEER: JERLA & ASSOCIATES REG.NO.: NONE JOB DESCRIPTION : COMMERCIAL T, I . (COFFEE HOUSE) SQ FT: 4, 309 ADDRESS: 424 E. VALLEY BL UNIT: COLTON CA 92324 CLAIM VALUE: 4 , 809 . 00 CALC-VALUE: 4, 309 . 00 GROUP OCC: B-2 / PERMITTEE: SANCO BUILDERS (714 ) 642-2104 ADDREss: 1668 BABCOCK A COMMENTS: 25% CHARGED FOR CHANGE OF CONTRACTORS tjte .f) 13SS2-S'S C.M. CA 92627 iEBF****EFEFyE*E6*x*sF*******EE******EF**FF***EE*+E**EF*****x- -* Tr*****fE***+6*********+6**+FEF** LICENSED CONTRACTOR DECLARATION: I hereby affirm that 1 am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is�in� full force and effect. SETBACKS CITY uc.: 050170 STATEUC.: S�517 • Date: /— Z—/-1? /signature:_ _ / MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby off )noir have acemhwte at consent to self-insure oracertificate of workers' FRNT: FT IN REAR: - "FT IN FRNT: FT IN REAR: FT IN Compensation 1psu�oCe.O,a,certifie§calpy thereof(Section 3800.Lab.5.3/01 /92 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: V .J L 9 b 7 1 EXP.DATE: COMPANY: STATE ,�Att PARKING REQ: PROV: PARCEL: 42542312 ZNE: REF NO; ❑ Cenified copy is hereby furnished. L? ' ed copy is filed 1►h 1 icy Building Division PLANNING N TES> t ate: !-2T,2 Applicant: _ ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This seam need not be completed if the permit is tor one hundred($100)or less). D E V E L O P M E N T SERVICES REQUIREMENTS I certify that in the penormance 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 DATE: Date: Signature: BUILDING APPROVED BY : DATE: NOTICE:If.alter making this declaration.you should become subject to the Workers'Compensation provisions of the Labor Code.you must tonhwith 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: DATE: \ t2,1 6 1 1 which this permit is issued(Section 3097,Civ. **************************************** * **************************h** '* #*** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY -"STRUCTURAL SEGMENT: Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES G G (Section 7031,5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 72 • 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 SMIP/NON-RES pursuant to the provisions 01 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.My violation of Section 7031.5 by 9 D any applicant for a permit subjects the applicant to a civil penalty Of not more than live hundred dollars(S500). ISSUE FEEBUILID �[ .� I, as owner of the property or my employees with wages as their sole compensation, wit do the work, and the TOTADSNG_D�V > PERMIT0 ISSUE PLAN-CHECK 702T90 144AL A90 -720., 00 ❑ structure is not intended or offered for safe(Section 7044,Business and Professional Code: The Contractors'State License Law does not apply to an Owner of a property who builds or improves thereon,and who does such work himselUhersell or through his or her own employees,provided that such improvements are not intended or altered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED: 72. 90 OVER/SHORT: 00 fortheemeposeolsolds lee)lnn one year Cl completion.the owner will have the burden of proving he/she did not build or improve BLDG2 PMTMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOOTT GRADING PLAN-CHECK Lor me purpose of Sale). . 90 h I,as owner of the property,am exclusively egmracting with licensed contractors to construct the project(Section 7044,Business U and Professions Code: The Contractors'&ate License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a cantractor(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 BREAKDOWN o I am exempt under Section: B.8 P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Dale: Owner: SFC 4309 aTER BY VALUE COMMERCIAL NOZONE 1 . 00 4 , 309 . 00 I do hereby[Wily 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(Cirde one)need to comply with said state codes and the requirements for a o 1 permit for construction Or nwdilication from the Air Ouahty Management District.Residential construction applications are exempt from these provisions. EXPIRED Date: Apd I: If•ECORrC!ot[C t.., [: (t5 I hereby certify that I have read this application d state that the above information is correct.I agree to comply vnth all city and c my x ordinances and slate laws relating to building Ovation and hereby a representatives of this city to enter upon the above- tuned properly lm inspection purposes. °Ste 01 00107:n.-a-11::::;11: :_'- 71.-- Clete: /-7>7Z Signature: - _ --�-- .. DATE: C1e27/92 `';" 1.•-•:(44 Driver's License or Social Security e: i 1641.46 White—Building:Green—Code Enlorcement:Canary—Apolicanl:Pink—Revenue:Goldenrod—Assesenr .11 .JtTION AND PLANNING POOL t J • APh, JVALS 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 i 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, ❑ Undrgrnd. 10. Structural Floor System • - 61. APPROVAL TO DECK i 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. 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 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 PREY. FINAL 30. Drywall Nailing I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED • I 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 I 42, Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING 49, Electric Release to Edison 50. Gas Release to Southern California Gas Co I • 51. CERTIFICATE OF OCCUPANCY No. Date 3... .ii '.. p , Costa 210esa Development Services, Division of Building and Safety • CERTIFICATE OF OCCUPANCY a" This certificate is issued pursuant to�the_requirements of,theF_Uniform Building Code, Section 308 adopted by the City of Costa Mesa certifiesSthat at the $me of,itis.issuance the building structure herein 77 ,. below described was inspected andiapproved=for;occupancrasfollows1 Cc 0>: ) N l Building Address 1.711/E\17TH ST #B/Co z\ Bldg. Permit No. 876791 /,fit % �� Use RESTAURANT) _ ,C,-µ:`i A, iv ti s '�5.:.r.. .. Th------;::___1‹.:' CV''\" .^'1 of. . _ C-1 Group A-3 Type of Copstruction V-N Fire-Zone: '' ' t\' Use Zone ' 7 k- 7”1:3 m.= r.:_,..RIao2 Finn\. !_/ I_' lJ Owner of Building_ E'er REAL' ESTATE Tenant BAJA=ERE.SH MEXICAN GRILL ,k „ - .x-b. n4, F1 .�v fi Address 1545 N. VERDUGD RD #115f GLENDALE CA 91208 /r .Y A ;- �\�i �� �„r B �� g BUILDING OFFICIAL-tong ct UC Baca v .-- $ ,',...A.,.._.,..9 ri f1f1/ ' ':/ \`a Date t c'tfir3' 94 REQUIRED TO BE POSTED-IN"A CONSPICOUS PLACE Cri--147 . A00RES4 OF SULONO: 171 E 17TH ST WIT: CITY OF COSTA MESA — BUILDING PERMIT rtInIER'S BARROS, HERNAN R PERM NO: E 078959 • ADOREMS: BARROS, ORFA T %BARCO REAL ESTATE MNGT PERMIT NO: E 078959 PLAN CHECK NO: N GOVT: N SUPP: N 1545 N VERDUGO RD #115 GLENDALE,CA 91208 APPL.MARINO ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCNRECTORENmtEFA: RICHARD STAGE UCN0. 1217 JOB DESCRIPTION : ILLUMINATED POLE SIGN SQ FT: Mai OR DalANmES% 3935 HARNEY ST um: 200 S .D . CA 92110 CLAIM VALUE: CALC—VALUE: GROUP OCC : U-2 / CDIRRACTORSWJF: CALIFORNIA SIGN COMPANY ( 619 ) 593-1113 cONIRACTORSMULN0 10035 RIVER ST COMMENTS: REF:SB-78958 ADORES& EL CAJON CA ucc. 662997 ********4**SEN-******** ************************+rte*****iFiF*********************** 92020 WIT: ZONING R EQU IR EMEN T S LICENSED CONTRACTORS DECLARATION:I hereby affirm a penalty d perjury that I an licensed under provision of Chapter P SETBACKS (commencing wish Section 7000)d Divider 3 d the Business ass and Profusions Code,and my(manse Si,full bon and effect. LIC.NO.: UC.CLASs: C 45 UC.NO.: 662997 EXP : 05/97 MAIN BUILDING ACCESSORY BUILDING 8/?/ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Contractor: l LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN •" ER BUILDER DECLARATION:I hereby dfinn under peaty of perjury that I am menet t the Ca-trades License Lew I«IM mowip sawn(Sedan 7031.5 Baseless and Profession Code:Any cIy or county which requires a panne to omstrw.after.Improve. PARKING REQ: PRO V: PARCEL: 4 2 5 4 2 312 Z NE: REF NO: molbh,or repel any structure.piaw a in bsuanoe.en°repdtea the eppimu for ret'perms to fide a signed smement that he Or she PLANNING NOTES> licensed pursuant to the provisions of the Contractors License Law(Chaprer S(commencing with Sedion 7000)of Division 3 of the Business and Professions Code)or that he or she a exempt therefrom and IM b®.for the alleged exemption.My vuldion at Swan > 7031.5 by any applied fore permerlapds theappfrard to a chi penalty d not mon then fee hundred dollen WOW. ******************************************************************************* ❑ I,as ovmer of the property or my empkwees veith wages as their sole compensation,will do the work.ard the elnicture is not intended DEVELOPMENT SERVICES REQUIREMENTS or agreed for esu(Section 7044,Business and Professions Code:The Contractors License Law does rod applyto anOnof property who bolds or improves thereon.end we does such work lima or herself or du«gh his«her own employees,Modeled thel such "Movements ere not"endedordlred for sale.S.however.the balding or ww inpnnS sell within met yesd=mpletbn.the ZONING APPROVED BY DATE: ownerauitdth er sun have e burden re proving he or she did w build or improve for the purpose of saki). ❑ Lasovner°the propeaty.an"dun/wnaadngclinn.dc«Wad°'sman.Nfthe°npd(sedion7044.Baia.and BUILDING APPROVED BY : DATE: Professions Code:The Contredor.License Law does rod apply to an owner of property who aceds or improves thereon and who contracts for such projects with a wddgmis rae)framed pursuant to the Contractors License Law). // ❑ lamexempt under Swion: B.SP.C..for tbleesonn: APPLICATION ISSUED BY: DATE: =� Dalt Owner. LEGALIZATION: N F E E SUMMARY STRUCTURAL .E Mr T:N I do hereby certify that I am aware d and understand the requirements of Cauda lash and Selly Code Swan 25503.25533.and 25.34,and that I or any future building occupant will/Wit not(circle one)need a comply with said rote codas end the requirements for theDistrictnsructfrom PERMIT BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. Date: APplkef: 50% SMIP/NON—RES PLAN WORKERS COMPENSATION DECLARATION:I hereby affirm under penally of perjury one of the following dedudbm: ISSUE FEE 22 . 00 ❑ the"end elmaintain aceddlceted"mem tos'bine" rsumsa'con rat awn.espw.iaedf«byswl«n3TOodthe Lel" BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Cale,f«the pedm oamcedthe work l«wNcn the permskiiasaed. TOTALS----> 23 . 00 22 . 00 0 . 00 45 . 00 45 . 00 . 00 11 I have end w1 maintain workers'mmperuu54.1110nd N ten Insurance.ea required by Sfon 3700 e Labor Code,for the performance the 1S' work for which this permit is hued.My workers'compensation insurance wrier and policy number are: Carder: GOLDEN EAGLE EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 45 . 00 OVER/SHORT: . 00 Policy Number. NW...34058000 08 /10/96' BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This sad{m need nor be competed s the menu S for one hundred dollen M00)okin) 45 . 00 ❑ I rally that In the performance of the work for which the permit is blued,I slid not employ any pram in any mantes en es to boson*subject to the workers'compensation laws el California.ave agree alt E I should become subject to the *Maws' ******************************************************************************* compsnw prods a Section3700 a In.LaborCode. was forthwith m was per. INDIVIDUAL F E E BREAKDOWN / 8�9/9c Ap rot: ning:Failuretoureworker:compensation shall to criminal a �ecfan oy« nalpsnsmeaand W aasecTYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines w to one hundred thousand dollars($104000),in addition to the coat of co tan deneg.a as provided coy In ro Section3softeLaborCodaIntre.Landafonnysf«e. ELE 1 RECEPT/SWITCH 1 ST 20 EA. 1 . 00 1 . 00 CONSTRUCTION LENDING AGENCY: 1 hereby affirm under peny of perjury that then Is a conrnwion lendn0 agency for the ELE 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 22 . 00 22 . 00 performance ci the work forwhichthispermlisissued(Swron3097.Ch.C). END OF FEES LENDER'S NAME: LENDERS ADDRESS: I certify that I have reed this application and date that the above information is caned.I e9ee to comply withal rely and county ordinances and stale eves relating to buiklig construction and hereby authorize representatives of this city to enter upon the above'memnrad property EXPIRED for inspection purposes.MARK CRUMPACKER \- p Print Nome Date:'8 /9 / mS� �" . •Signature d pvcertcanKtc�� t � lter 15151-N.WP) White-Statile&SellyGreen-FIE Canary-Appimnt:Pink-Rennes:Goldenrod-Masa lnsPeCt1015 fCONSTRUCTION AND PLANNING • PO` SPA' .-.t 'APPROVALS Permit # r _ j - Date Inspector APPROVALS Permit # ! Date Inspector le 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location r 2. Soil Pipe-Undrgrnd. - - 53. Steel Reinforcement . , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms -r ! 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER•GUNITE Imo/ 7. Footings 58. Electrical Conduit•Undrgrnd. ' 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test l 9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, 0 hlndrgrnd. •,- / 10. Structural Floor System 61. APPROVAL TO DECK ,� i 11. Property Sewer Line & HouseCormnection 62. Backwash & Receptor-Final 1 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 1 67. Fencing & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTER NG . - 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 O Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Ba'r 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 ' 4 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 48. FINAL PLANNING • . 49.t Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date ' `� ADDRESS OF WALC043: 171 E 17TH ST uNT: A CITY OF COSTA MESA — BUILDING PERMIT OWNERSNAMEIFIOOYIY BARCO REAL ESTATE PERM NO: E 077114 ADoREss:1545 N. VERDUGO #115 * GLENDALE, CA 90015 PERMIT NO: E 077114 PLAN CHECK NO: N GOVT: N SUPP: N ..J APPL.MMUNG ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCHITECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : 19 . 5SF ILLUMINATED WALL SIGN SQ FT: ARMOR ENG.'S ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / CONTRACTORS NAAI GREAT PACIFIC SIGN WORKS ( 805 ) 373-9822 caiTRAu'rolregaup 705 LAE EFIELD RD COMMENTS : "BAJA FRESH" WALL SIGN R.e t 5F5l-1 I13 ADOREasWESTLAKE CA ua ND_ 569588 +E*+Fif+t+t+t+t+FlEifiEttiE****tt+E+E+E*+rifik*it**** ******** if IFlElEiririfkifkiFlfifr*****1 ***Hr*1EiE****iE*SEiEHfif 91361 uNr F ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I Newby.Rem undpenaltyerpenaltylicensedof perjury that I am licensed under oron.Ione d Chapter R SETBACKS (commendng with 7000)al�O�ion 3 of the Business and Pmlession.Code end my license is In full force and effect. _ - CITYUC.NO.: C.CLASS:C 45 uc.No.:56 5 EXP• MAIN BUILDING ACCESSORY BUILDING Q/ �,," FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN iDate: t/-Z Y— )b Cal c..Uy/y Q et L/`-A,1.,J LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Othe WNER BUILDER yperyothat � iLaw wma � 703I$BBuMass and Professions Any Mich requires aperrme ommtidors Me mow. PARKING REQ: PROV: PARCEL: 42542312 ZNE: REF NO: demolish,or repair any sttcuve,pia to is inurnee.also requites the appcenrfor such permit to Mea signed statement that he or she PLANNING NOTES> Is licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)of DNSfon 3 of the > Business and Professore Code)or that he or de 4 exempt therefrom and the Iasis fa the alleged exemption.My violation of Section y�L�X.]C y�yv..y�c�Y Y.Y Y Y.Y >Y Y Y 7031.5 by any applicant lore prime subjects the applicant to ache penalty of notmore than fee hundred doMn(S500i)' R4llltitititilltltltlC�f�Fstse'�F�b4E4ETb Tb TE E E F*4************************************************** O I.as owner dthePrePorlY or mY mania/en web wages es thee sole compensation.eel do the work ard the structure is not intended DEVELOPMENT SERVICES REQUIREMENTS of dieted for sale(Section 7044.Business and Professions Code:The Contractors License law does not apply to an owner of property who holds or improves thereon, w and who does such rk tiea nor henor tSough he or her own employees,provided that such improvements are red intended or offered for sale d,however,the building or improvement is sold within one year d completion.the ZONING APPROVED BY DATE: er.b ownuider wtl have the burden d proving he or she did not bald or improve for the purpose of sale). O I.asownerdlhepropeM.anesdusivMycantredigwithkoereedCentrec,"leeeoaudthepojed(Sedion7044,Businessand BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and Me (� /G romexampt under Sect wnhawtnedMa)Itanaed pursuant to the Contractors License Law), APPLICATION ISSUED BY: I DATE: 'Ik (. lL lam exempt prier SMvh: B. P.C..lor site tome: *********************************************** ******************* ******** Dale: Omer: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N • I do hereby certify that I am aware d and understand the veg4re mew d Caliom4 Heath end Safety Code Sections 25505.25533.and ��// 25534.andlhel or any Mute buildig=WNW ma/veli nal one)need to comply lath said date Wdesandthe requirements far BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit foroorotruction or meditation boo the Ai Guakty Management District.Residential construction eppamliwe are exempt from these p ERM IT 15 .00 pmp ane. 50% SMIP/NON—RES Date: Appt''cant: PLAN WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of peryry are of the following dedwatkw: ISSUE FEE 15 . 00 )C Ihave and will maintainacotdicetedoreenttosMinurels workers'compensation.iasproddedforbySection3700dthe Labor BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE COde,(orre "p"' mnce d""work for MichmMarla issued. TOTALS----> 15 .00 15 .00 0 .00 30 .00 30 . 00 . 00 • ❑ I have and we ma tan workers'mmperaatian insurance,as repand by Section 3100 of the Labor Code.for the performance of the work for Mich dm4 permit is issued,My—kettyptitryttrpoky"anter are: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 30 .00 OVER/SHORT: . 00 Pony !Null 16951-'A 02/28/97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Poky Hunner: 30 . 00 (This sectio need nor be ampler•d i the perms 4 Mr one hundrod dopers 15100 i.40.1 ❑ I eerily Gal in the performance d the work for with this permit a/� � person in any manner 90 as to become aubied to the when'omron0tion laws et CaMoae 1� ` crbecane tamed to the wises. ******************************************************************************* penaell pro'.,. d 3100 d the Labor Code,I Ta,. y:oh;'.;+:rpyisigps, '� /lf ylan3 i t p I N D I V I D U A L F E E B R E A K D O W N Dale:. 1 L r ! Y Apo.: �'" , �� Worm/ng:FeRure me«ure wrten'rorrpereadon TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST , coverage la unlawful,and shall subject an employer ecdMnel pended end civil fines hp to one oro,hundredCo thousand dollars(S1000004 In ad kion to the cost of compensation,damages as provided for In gecrim3PDSofthsaborCode,Interest.and etrorrey'atea ELE 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15 . 00 15 . 00 CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjwy that there it a mutrwion lending agency for lie ND OF FEES • performance of the wok for which IS pemmi is anted(Section 3097.Cie C). LENDER'S NAME LENDER'S ADDRESS: ". M Ind that I have read theapplication and ode that the above information correct.I agree to comply all city and county cad eea and stale laws Sating to Wickg mmudipn and hereby mamba r.er..ertatnesd4a arytfoenter upon the ebovermmonedproPeM for mpair1'n lppm • 0 PALAC I OS `/ .I/. yL}�." . , , O _ - , -- - i :":. L--. . _ L.:.-..14 _ .-. ' PmNems r'.141.! : r. (,yc, 1_ ,! Dale: YJY / / Signature d owner/AgewAppEcarhVCatredo ,\ (5151 dB W P) White-Building&Sang:Green-tile:Canary-Appkrant:Pink-Revenue:Goldenrod-assessor CONSTRUCTION AND PLANNING v POOL & SPA ` APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location • . - 2. til Pipe-Undrgrnd. 53. Steel Reinforcement . . . 1:3. ,Electrical CondttJ Utility-Un'drgrnd. 54. Forms - • • 'v- ,< • 4. Electrical CondvitUndrgrnd.: 55. Electrical Bonding -. r 'r5. ;Steel Reinforcef €TQC 56. Rough Plumbing & Pressure Test , wq . -4§. Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE c 77: Footings - - $ 58. Electrical Cont{iij`Undrgrnd. 8.' Foundation 7 . 59. Gas Pipe, 0 Undrgrnd., Test 191 ;Water Pipe-Undcgi d.` ( l- 60. Backwash Line; .‘,Trap: O'Undrgrnd. 10. Structural Floor$ystem vi 61. APPROVAL T©6ECK • 11. Property Sewer�ine"& House.Connectionf ;r _ n-, 62. Backwash & Receptor-Finaf, 12. Sewer Cap 63. Heater & Vent-Final • 13. Roof Drains -- 64. Plumbing System • Final , 14. Rough Plumbing ' 65. Electrical-Final 15. Rough Electric4Co&uit .. , 66. Solar System-Pthal v. 16. Rough Electric Wiring:r. - 67. & Acce s Approval• ,. Fencing i. 17. Rough Wiring Sgn68. APPROVED FQR PLASTERING - 18. Rough Electrical-T Bar Ceiling 69. POO USPA SYSTEMS FINAL 19. Rough l{eating& Aif Conditioning, 7S r, .* ,-t -r FIREcSEPTJREQUIREMENT [r, 20. 'flouejh Fitton:, FiTh lace • Sr tCd S . APPEi'OV,ALS'` Permit# '- _ - .-.i7-. H 7''S -. 77 -:'f C . - N' T1 v it 21. Ducts,in-$trt ctur'a c :) 1- ^* r 70.r-Underground hydro of o S. .i • 22.:Duct,VentilstinguA 7:' r" Q a tia n 71. ProductrPiging_CLGas �.7 Oil - 23. Gas Plpe`Rou h&Test -•S -' ¢ C* - r g r•tr :AC T „ s+ r 72.Underground Flush tp > , 24. Roof Framing r; ' rrxHn,xr 7.. Undergrnd.Sto?a frJeTani/ 0Gas 0Oil 1 va 25, Ro ;Shathing e a1 v ^ m .:2s 741 Overhead HydrC- 26.j.Bar Ceiling (Strut turall & Mcl coat - ,- ,» '7 t 7T. Dry Cherhical '- ` •'.,s til 1 > m-- f.. p. _ 27. Prame and Flashir ; ,,� _ y mr. 76. Dry Stag-dpipe�� 28. Lathing&Siding Cxf ' 4' 7_T: FIXEDSY$TEUFINA:L- " _ T C R .. .- r 29. Insulation ... .. : ,L : r 7$. FIRE PREV. FINAL 1 ' r 30. Drywall Nailing . r ?F * MNEALTH.DEPfE. REQUIREMENT r of ;: 31. Plaster Biawil4Coat ; = _r c ' 79. FINAL p1'ECTtON * -_ .' 32.)Electrical.Power Meter-Final 80: FOOD CERTIFJCATE ISSUER ;r, , , 33. Final Elctric _ _ r - - r . .. tZ v f�9tes: r .+ ' -r A' F .. . 5p 34.-Final He-. r-Bt Air•Gpoditioning rs - .. , *.CC.... -. r Fc' -EC'' '- ,* = Z" 4 'r ` .r- r � -- xt . 36. Hood or Canopy ,,r n- v :* * r. - it h: 37. Final'Fact'ory Firep104J- r'- `(' - - • a.r ,. , c a S . . c_ -r v ._ .n 38. Final=Plumbing •_ . r tr f. ,4r 39. Water Service-Final * r %M' - "4 - �� 40. Gas Service-Final ` •'- ` i.,i_ `. * . I 1. r= • - • 41. Solar Domestic-Final _ * -* r•' . - ' .y i. .- ... ' 42. Backflow Preventer: . ' ._ ' - ; 'r7-. r43. Backflow Irrigation -"GC • " s 1 s 1 . i, r, '; '1t r -- n. • 44., Landscape Irripation,System�.; T . ' „ w df f - _ - 45. Sound Attenuations r- . .. T m Eta F _ ,7 ' r' '- ' '46. Handicap Regulations .. - - - 'r r r - 47.FINALSTRUCTURE & BUILDINGqr .- ' 48. FINAL PLANNING • . ,� r-• 49. Electric Release to Edison r r ♦ 1 50. Gas Release to Southern Califoinia Gas Co ' - 51. CERTIFICATE OF OCCUPANCY No Date • ADDRESS Of RMLGNO; 171 E 17TH ST tMT: A CITY OF COSTA MESA — BUILDING PERMIT CWNENSNASIEIFlfC.YN:BARCO REAL ESTATE PERM NO: E 077116 ,.y ADOREss:1545 N. VERDUGO #115 GLENDALE, CA 90015 1 — R PERMIT NO: E 077116 PLAN CHECK NO: N GOVT: N SUPP : N ADPL.IMIINO ADDRESS CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCHRECT OR ENGINEER: UC.NO.: JOB DESCRIPTION : 48 . 83SF ILLUMINATED WALL SIGN SQ FT: ARCH.OR ENO.'S ADDRESS: WIT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B / mmiunowspumEGREAT PACIFIC SIGN WORKS ( 805 ) 373-9822 CCNTRACTORSMMUNG 705 LAKEFIELD RD COMMENTS : "BAJA FRESH" WALL SIGN, RE: #SB77115 AWptss:WESTLAKE CA uc.NO: 569588 *************RERE************xRE*R6****RE****x*R6*** +Ex***xxRE*RERERE****R6*RH***Rt RE**R6**** 91361 UMT: F ZONING REQUIREMENTS UCENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7002.)q,Dnision 3 of the Business and Professions Code,and my license is in full force end effect. CITY UC.NO.: 0670S1' uc.CLASS:C 45 LIC. EXP: MAIN BUILDING ACCESSORY BUILDING, qq �] FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Dere: N' 1/Y 7�0 conan�« ��fj��T�(ty�1C /tyv(e LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: • FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason(Section 7031.5 Bushes and Professions Code:Any any or county whim requires a permit to cocaina-I,akar,improve. PARKING REQ: P ROV: PARCEL : 42542312 Z NE: REF NO: 'smdish,or repel any structure,prior to as issuance'ado requires the eppticant l«sof,permit to fib a signed statement that he or she PLANNING NOTES> licensed pursuant le the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)of Division 3 of the • .,usiness end Professions Code(or that he or she S exempt therefrom and the basis for the alleged exemption.My violation of Section > 7031.5 by any applicant for a permit subpds the applicant toe ad penalty of not more than free hundred dollars 1S500)). ******************************************************************************* O I.as owner d the properly«my employees with wages as their sole compensation,ail do the work end the stature is no intended DEVELOPMENT SERVICES R E Q U I R E M E N T S or offered for sale(upon 7044,Business and Professions Code:The Contractors License Law does not apptytoan Cisme of property who builds or improves thereon,and who does such work himself or Mensal or through he or her own employees,provided that such improvements are not intended or offered for sale.B,however,the building or lttproversent is sold within one yearo(completion,the ZONING APPROVED BY DATE: ownerbufder will have the burden of proving hs or she did not build or improve for the purpose Of sale). ❑ I,as owner of the properly,am exclusively contradi,g with licensed contractors to construct the project(Section 7044,Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does nor appy to an owner of properly who builds or improves thereon and who contracts Mn such prgecs with a Gaaretl«(s)kensed pursuant to the Contractors License Law). ❑ I am exempt under Section: B.AP.C..for this reason: APPLICATION ISSUED BY: DATE: 8 `16 ******************************************** ****************** ** Date Oewef: LEGALIZATION:N F E E SUMMARY STRUCTURAL _ EGMENT:N I do hereby certify that I am aware of end understand the requirements of Catiomia Health and Safety Code Sections 25505,25533,and --- 25534.and that l«any enure buildingoompeMwill/wDrel(circleone)needtocomplywthsaidgatecodesandtherequimmentsfor BLDG PMT PLUMBING ELECTRIC SMECHANIC FIRE SMIP/RES GRADING a Ferrel for construction omodification from the,AiQanagement Dieted.Residential construction appicati«w are exempt flout thio PERMIT 15 T;T provisions. 503 a-SMIP/NON—RES Date: Appcant: PLAN GJ 7r ill WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following declarations: ISSUE FEE t '. 00 C )Q] Ihave and will maintain acertificate dmnsenttoestinsure for workericompensaion,asprov compensation,as on bySed3700othelabor BUILDING—DIV—> PERMIT ISSUE PLAN=CHECK TOTAL PAID DUE Coda.lorthepedmanceotheworkfom wlichthispeeeesued. TOTALS----> 15 . 00 15 . 00 0 . 00 30 . 00 30 . 00 . 00 ❑ I have and wit maintain workers'compensation insurance,as required by Section 3700 of the Labor Code,for the performance of the I wank for which the permheesuM.Myw«leery,(.ppnppp�gjapiry�giprcadugy4yd poac/nambm are: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 30 .00 OVER/SHORT: . 00 Carrier: JVt'GK�LJII lVA1 Pricy Number: WUN 16957—A 02/28 /97 BLDG PMT PLUMBING ELECTRIC MEC ANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need ow be completed t mina na is for one hundred dollars 13100 . ) CO ❑ I catty that In the performance of the work for which this permit e'- I . 41 em•. y manner so as to become subjed to the workers'compensation laws d Califom/. . d M rd to the workers' ************************************-**oE**************************************** compensaf mvtsims doff Section30 0 d the Labor Code.I m/, ,, I N D I V I D U A L—C FEE BREAKDOWN Date: r- z / — s10 Applicant: i I OP L' Warning:Failure to secure workers'compensation coverage Is unbwlul,and shall subject an employer to cdminal penalties and TYPE QTY DESCRIPTIONO UNIT COST TOTAL COST civil fines up to one hundred Thousand dollars 010Q000).In addition to the coat of compensation,damages as podiv,for/n ' t T Section37O6 of the Labor Code,Interest,andartomaya fees. ELE 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15 . 00 15 . 00 . • CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of perjury that there is a construction lending agency for the END OF FEES performance of the work for which the parrot is issued(Section 3097.CO.C). J "J % ti LENDER'S NAME: 15< r. • 1t - LENDER'S ADDRESS: rs_1 d 1 o, k u C I certify that I have read Iiia application end date)het the above information S correct.I agree to comply with all city and county ordinances Qi f///////t�t�lt1/u� Q•T, /- (.` 76.1- for _ _ and stele leas relelig to building construction and hereby authorize napresantadveadtlis drywenter upon the ebove.meMioned propend VA,. L,4 IT'0 --01 '5'1 .53�-(t('' 'L :5220 7f_x4 1«inapedon PurpesesROMAN PALACIOS <4111"'��� y" _ ,1 _ DATE: '1/:?-'rr':7C Ti"r. ' 151::'_ /G%!%% / P A Data / _ t ' -1 1 Sig,—of Owner/Age WAppicam/Contract« (-7..J (5151-SOWNWhusBuildig A Safety:Green-Fl:Canary-Appacent:Pink-Revenue;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 ..;ffr3:,ElectricalCondt Utility-Undtgrnd. 54. Forms ..'7,14. Electrical Conduit-Undrgrnd." - . 55. Electrical Bonding _ �c,.5'Steel Reinforceme g 56. Rough Plumbing & Pressure'Test -,6. Electrical UFER-6fnd. 57. APPROVAL TO COVER-GUNITE • ."7;. - footings Ti i 58. Electrical Condo ,Undrgrnd. :_' 8. Foundation ., _1 .✓ '- 59. Gas Pipe, 0 U4yJrgrnd.,Test 9; Water Pipe-Undlyrnd.'= 60. Backwash Line",'P,Trap, 0 Undrgrnd. 10. Structural Floor,,System e r 61. APPROVAL TO DECK r 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 Electrics -Conduit '. , 9 66. Solar System-Final 16. Rough Electric Wirinxgt* 67. Fencing & Access'Approval 17. Rough Wiring On - 68. APPROVED FOR PLASTERING 18. Rough Electrics&-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19..Rough Heating &Ai(.Conditioning. f ;=t ,'.r • FtREcDEPT REOUIREMEMT -. ,. '- _ , k .. 20.?Rough Factory Fireplace - `t,. << * _ -- T r .. APPROVALS - Permit# * _ .� .. .. -.Y .� �X H rr r 21. Ducts, iritstriKtur@ a C... v ,- * - 70,FUnderground Hydro . 22.:Ducts, VTntilating ,s •rr > C cc, !J ,,, _ 71. Produ t Piping] Gas Lt,]' OII _ 23. Gas Pipe?F o kph 841st _, S `" K S t C 72. Underground Flush , 24. Roof Framing <t' + - '' �y • 73, Undergrnd.Storage Tank. O Gas ❑Oil . 25. Roof.Sheathin '� ; ` e e; - r'a . 9 _ - p, D* 74. Overhead Hydro - _ _ 26."f Bar.Ceiling (Struciturall & Am-at-moat ± -1 >•` * 75 Dry Chemical - - ,. 27.-Frame and Flashing: =, o - ; '" 76. Dry Standpipes �° --i 'ti: `. 28. Lathing& Siding i7R I, + 771 FIXED'SYSTEM FINAL- 29. Insulation( ;. _� t_ K g *. 7$. FIRE PREV. FII{TAL ,. '- ' - 30. Drywall Nailing ^+ t -.HEALTH DEPT. REQUIREMENT i . 31. Plaster B_rown•Coat ; ^ ' TLa x I .F 79. FINAL INSPECT,j�N a - -. , 32.Electrical-Power Meyer-Final 8@: FOOD CERTIFJCATE ISSUED - n 1c 33.-.Fina2Z;El tri V: :'* t^ y. ` '* Not`es:)0'10,9b?/,rr'/0 EkRAtS-__Q_a }vNYo a th. 34.:Finat,Heating-& Fjif:Conaitioning� r r - �_= ; - ' ' Lu17N: _lttow� /lbG n OF: SIC(( To 35.`Final Ga Pipe=Tell* 6 '* ' = '-"-- 4 . * INI5 EC,T ; xn- RIV 36.-Hood or-Canopy ,_* • , tr, - •r rr rc '- 37. Final-Factory Firepl ctc: • EL. ? AUUR�SSocewiwxo: 1711.E 17TH ST I 'WIT: B&C -`'_ '•i, CITY 'OF COSTA MESA — BUILDING PERMIT OWNERSNAMEIFIO4OWN:BARCO REAL ESTATE _ ' , . PERM NO: E 077602 AOpRess: 1545 N'VERDUGO RD •• • PERMIT NO: E' 077602 -UNIT 115 . . . PLAN CHECK NO: N GOVT: N SUPP : N , .LENDALE?. CA818-500-7257 'APPL.MAEINGADONESS: '� CONSTRUCTION: TYPE: V—N . .a PERMIT TYPE: : ELE - PURPOSE: ALT ARCKITECT ORENGNEER: UC.,No.: JOB ;DESCRIPTION : C/O "AIR CONDITIONING UNIT SQ FT: ARCH.OR END'S ADDRESS: . WIT: -c CLAIM VALUE: • CALC—VALUE: GROUP OCC: A-3 / CONTRACTORSNM*:RE S SAC ( 818 ) 241—771b CONTRACTORS MMIINCI 207 E. LOS FELLIZ COMMENTS,:: REF:: Mc 77601 . ' . AOOREss:GLENDALE CA tic.No.: 220253 ***iterstic**********it*at*ir*it**«+FitiEaf3tat3tifu�c*it******itatatr***iaAtitat**r*Ates*AE«xat***ia*atatitirit*if 91205 • we: . . .- ZONING REQUIREMENTS UCENS ED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions of Chapter 9S .E TB ACK S (commencing with Section 7000)ofDivision 3 althe Business and Professions Code.end my license is in full force and effect. . • - C' uc.NO.: uc.cuss:C 20 uc.No 22025 EXP: ' MAIN BUILDING ACCESSORY BUILDING _ ata: 9G O«,pd«; . fry SAM p FRNT: FT ' IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWN ' BUILDER DECLARATION:I hereby affirm under panty Of penury that I alt esempl from the Contractors License Lew for the .reason(Section 7031.5 Busies*and Professions Code:Any city or county which requires a permit to oonsauct.atter.Improve. PARKING REQ: PROV: PARCEL: 42542312 . Z N E: REF NO: demolish,or repo any structure.pear to es issuance.also requires the applicant for such permit to lila a signed statement that he or she PLANNING NOTES> is licensed pursuant to the provisions d the Contractors License Law(Chapter 9(commencing with Section 7000)of Denim of the - - _- uvea end Professions Code]or that he or she a exampr therefrom end the basis for the alleged exemption.Any violation of Section > . • 31.5byenyappficsnt for a panne subesds the applicant to a civil penalty of not more than fore hundred doll=(S5001). ******************************************************************************* L] I.es owner ol the properly or my employees with wages as their este compensation,*AI do the work,and the structure is not intended D E V E L O P M E N T SERVICES R V I C E S R E Qy�y U I R E M E N T S O offered for sale(Section 7044,Business and Professions Code:The Contractors License Law does not apply to an Owner of property - M who beads or inproves thereon.ended*does such work himself or herself or through his cc her own employees,provided that such improvements are not intended or offered for sate,5,however,the building or Inprovernent is sold within one yew of completion.the ZONING APPROVED-BY • DATE: ownw-0uider will have the burden d proving he or she did not build or improve for the purpose of sale). ❑ I,as owner of the property.tun exclusively contracting with licensed contractors to construct the project(Section 7044,Business end Professions Code:The Contractors license Law does not applyw to en corner of property who builds Im or proves thereon end who BUILDING APPROVED BY DAT E contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). ❑ I am exempt under Section: B.A P.C..for this reason: APPLICATION ISSUED BY: DATE: ************************************ * * dc************************ ** Date: Owner: LEGALIZATION:N F E E SUMMARY i STRUCTURAL SE MENT:N I do hereby certify that I am aware of and understand the requirements of Galloons Health and Safety Code Sections 25505,25533,and 25534,end mail or any future budding occupant will/ora not(circle one)need to comply with said state codes end the requirements for BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permittm forconaction or modification from the Ai Quality Management District.Residential construction applications are exempt from these provisions. ,PERMIT 7. 50 Date: Applicant: 5()% SMIP/NON—RES PLAN 31 WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty d perjury one d the following dedarations: _. ,ISSUE FEE - V5 .00I ❑ Ihays end will maintain a certificate d°msentm°elf'insure for workers'compensation.es provided for by Section 3703 of the Labor BUILDING—DIV—> 'PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code,I«IMpedommarlaedm.wc.kf«Mich mis permit is issued. TOTALS----> 7. 50 15 . 00 0 . 00 22 . 50 . 22 . 50 . 00 I have and veil maintain workers'compensation insurance.es required by Section 3700 of the Labor Code.for the performance of the . • work for which this permit is issued.My worknn'compensation insurance caner and polio/number are: . Carrier: CALIF IND . _EXPIRES ,_. REVENUE DIVISION TOTALS--> COLLECTED : _ 22 . 50 OVER/SHORT; . 00 Policy Number: N1039t04A 01 /01 /97 , _ BLDG. PMT PLUMBING ELECTRIC MECHANIC . FIRE SMIP/TOT GRADING PLAN—CHECK his sect/on need no(be completed I the perm]is For one hundred dollars(Al ON or less.) .. .. _ 22 . 50 "' J I caddy that in the performance of the work for which this permit is issued.I shall not employ in any manner°o as to become subied to the workers'compensation lard Of California, ant ea that if 1 subject tq the weaken,' ******************************************************************************* Mnaaysn arm/talons of Section 3700 ol the labor Code I shell latint ply with t L provisions. // ,. _ - - __ IP S B'afa /7� / Lf/✓ V —/cC I N -D I V I D. U A L F E E BREAKDOWN Applicant: 7 Warning:Failure to secure workers*comperuedon coverage Is unlawhd,and shall sublet an employer to criminal penalties and.•, ,TYP E _ ._ . ..QT,Y__ _ D..E .S ,C R. I P T I,.oiw UNIT COST TOTAL COST civil Ones up to one hundred thousand dollars($I0M000),M add/tion to dor coat of compensation,damages as provided for In Section 3706 of the Leber code,Interest and attorney's lees. __ ELE. ____, .1__ .-_. ,MOTOR/POWR APPARATUS... 1 . 1 — 10 .0 HP 7 . 50 7 . 50 CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there is a construction lending agency for the .END OF FEES L I performance d the work for which this permit is issued(Section 3097.Civ.C). . . - I I _ nit LENDER'S NAME • LENDER'S ADDRESS: 'b. f r I certify athet I have reed this application end state that above informationis caned. agree to comply with all city and county d property m v J art lawsemterelatingo .WildknpmWuctm and hereby adhorrzerepnesenla0taecttw arydenter upon the above-mentioned EXPYRE ' •, for inspection purposes.STEVEN PARMENTER .'1 ,from / (Q �j/ /� I\, . i. dear.i.4 '1..w Dale: ] /r /V DATE 't �Y � 5• 'r_.J` _ • slgretured• , ..l,.:w•.plimn - 1 ' �. _,. �' �' k� n... '. . ' .u.. rjy i. • 1 if, . (St5146 WP) While-Buildkq A Safely Green-Ft any-Applicant Pink-Revenue:Goldenrod-Assessor 4 COtISTRUCTION AND PLANNING POOL L A ' APPRQVALS Permit# Date Inspector APPROVALS Permit # • Date Inspector 1. TeTporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd., 53. Steel Reinforcement „ - -, C.- { e d E- -,r34. Elactrical Condu''urpity-Undrgrnd. 54. Forms tr •-C4. Electrical CondultoUtrdrgrnd. 55. Electrical Bonding r r al 1"T5.•$'teel ReinforcemdRt- 56. Rough Plumbing & Pressure Test ' ' Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE i- - ^" E •rrJ Footings v58.58. Electrical Conc6VUndrgrnd. 7' 8: Foundation bl - 59. Gas Pipe, 0 Ur,~dmrnd.,Test r.; S Water Pipe-Undrgud.� 60. Backwash LinestyP:Trap, 0 Undrgrnd. , r^ '- -1 10. Structural Floor System '4 61. APPROVAL Te•DECK 11. Property Sewer Lint& Housexonnection 62. Backwash & Receptor-Final 12. S er Cap -_ 63. Heater& Vent-Final 13. Roof Drains - 64. Plumbing System - Final 14. Rough Plumbing I T' 65. Electrical-Final 15. Rough Electrical;Coaduit '.. 66. Solar System-Fvaa+ 16. Rough Electric Wirifig • 67. Fencing & Accesspproval - A 17. Rough Wiring Sign 68. APPROVED FMR-PLASTERING. CO-,. 18. Rough Electrica'FT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. -Rough Heating &Air Conditioning _ * w• `•n 1 r F1REtDEPT:rREQUIR'EME6N -ri c 5:^' .r- _ ^ .. M -trJ:.G ^t * >• -a 20. Roui,�T Fr4tor4 Fiperlace ' Sr' r c ., S ' _ •A APPE(OVAL--tr• P?�,mit# .: v , H S, rr, XS r f, -1x '4 u < , t m 21. juuc(� in:$tructurc::, .sn - i - r, 70.EUndergrouNd l4 dro 4 -. - - S s .r tr.'S r Mtn le 22. Ducts; Ventilating'-* u r7 Q rl i"'* 'a 71. Prodg iping r ias t Oil r t- ••* M.. v cc:g F t• O 23. Gas Ripe ough SkT st M S. + r• t" •• O* 1 F r J >r r- t,r J:r� s tr: r 54 72. Undergreuud P,rush * r 24. Roof Framing r' M a > M r,* •4 7T Undergrn .St �g TanlJ{ ❑Gas ❑Oil r.. ..v >,- • N u M + � 7 Ri.. 25. ooSheathin '� v v v O > ns* r. �' g �. i-, x ^- m 7..*. 74. Overhead Hydnat- * 26.tT-Ba.-Ceiling (Struceural) & MeSi&oat >r C > C '7! Dry Ch ical -± x y n F 1 G c1 t -, 27. 'f{a nIeandFlashi : Ac -.;t,t.) _ *V '" vx 76. Dry Sta $ipee;r• - "a * r_, to G 28. -Lathing&Siding~'r _ Cr" 0 Q , ( i w 7V. FIXEDrsYSTE'�41'FINA ~ C I• :, * Su .. x * M z U, 3 . 29. Insulation' * r G a s * 71 FIRE PREY. FVNAL x _ I 30. Drywall Nailing +: i- rr F I I S R14EALT 'f,DEPT,�iEQUIFL$MENT f Yij * C, a: . x - 31.. Plaster BFnwr coat r s _ R I 1K ' 79. FINAL IOpECTIJj1 * p r - j+ -Electrical-Power Meter FiAaI • a ' .* ra, ' -o r 32. ..... 8� FOOD CP,TIFpTE IkSS1JE[7' ///�/J� 33. rin3VEleE`^•tri >x x^ • '? y M 14245, �,_ �..pm r -,q�,O, ;Dr-,y1 _O LX/i�- p. 34. ;EinaC letting t Air tonditionin`g 'ri :r 7 ) I * CV. ,-�rvo 0 1 E-C * �- r.. �• x +. .-, a , Er no.- or. ms ?. co C 35. eina Gas_Pipe-Test , O: r. :,. mo r •_tr, d' t k M • •••r; 4, 7' 36. Hooi-or,Canopy * r r Gti.-. r, ,- m * m zo #* M * '-r,- 37. Fina(Factory Firepl"ce.^ rH ,,• * ( 41 C vl '1 N I r; r; C. • . x .J L. m x 5 i b -- - 3- 8. Final-Plumbing .: - aT * M r-• lc - ` C tern s cc o 39. Water Service-Final ' E + -^ I t - v. 4 t. c *. C'-. r M r. M ..... .. .a. *-1•.. - vI t�� T 40. Gas Service-Final r F.:. p1 * I R` r • O Y 4: Q .. ix of n. ,--• x 41. Solar Domestic-Fina ti r ti l* •ttr -1e Oti 4 x V Backflow Preventer per,„ - 1" '* rrrl ..-÷,----4-4,---1- 42. t- .. -S r ,- * err -. r) L 43. Backflow lrriation :t >' 't M ` t t c- • 4Cii'<. Landscape- Irrigation System -. * .i; Q <1K E T t-4 OM re s F _ f .r .. c - -.r1-4, r- r ' r . , , -4 r:.n le G 4 45. ound emiction*' -, x M m m •• r* rtr 4 • Ft7 -t fi • i - V * r C: r ..z. CO '45. Handijcap iegulations c a s I i t v, tr. C U r T r ;W. FINAL STRUCTURE & BUILDING r 1- -t F• ! Sw . 4ti48. MMNQLPLANNING: IF - t - :e rr s * 4; 1 ' 1 49. Electric Release to Edison • 4 1 `1' t: cr• lc p 'r I u' S C rl I. 50. Gas *lease to Southern California Gas Co r -,- • S :o x a z' v -'- -, mo -7 x r_ C. - 51. CERTIFICATE OF OCCUPANCY No Date nootssortun.coa 171 E. 17TH ST WIT: 213 tic., CITY OF COSTA MESA — SIGN PERMIT _ an4ERswutEIIDaowta_BARCO REAL ESTATE PERM NO: SB 077115 ADDREs&1545 N. VERDUGO #115 GLENDALE, CA 90015 PERMIT NO: SB 077115 PLAN CHECK NO: 01330-96 S GOVT: N SUPP: N APPL.IMAM AOORES9: CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE: OTH ARCHITECT OR EN30lEER: (IC.NO: JOB DESCRIPTION : 48 . 83SF ILLUMINATED WALL SIGN SQ FT: ARCK OR END'S ADDRESS: um: CLAIM VALUE: 4 , 500 . 00 CALL—VALUE: 4 , 500 . 00 GROUP OCC: B / ggCTppg GREAT PACIFIC SIGN WORKS ( 805 ) 373-9822 CONTRACTOR,MMABn 705 LAKEFIELD RD COMMENTS : "BAJA FRESH" WALL SIGN WESTLAKE CA 569588 +t****�kit�rAe�tsk****�EAt�EAE�r�r+ESE� ****�E*�E�r�tAEAr�EN**********Ae Ar�E�E+E*********Anis******�E�E******* ADDRESS: 913 61 N0' gN: F SIGN INFORMATION LICENSED CONTRACTORS DECLARATION:I hereby Nim under penally d Perjury that l em Scented under praddoe d ChapterB DISTRICT: 1 TYPE: WALL ILLUMINATION: INT CATEGORY: NEW .._ (commencing with 1o30)daision3ithe asw,ess,,,d Professions sorer Immo and effect. DIMENSIONS: 16FT 00IN X 6FT 06IN AREA: 48 . 83SQFT LETTER HT: 19 INCH CRTvuc.No.: O7QS9uC.Cuss:C 45 LI Sby� STREET FRONTAGE 1 : 406 . 00 STREET 1 : 17TH ST ^ ^ a (� STREET FRONTAGE 2 : 445 , 00 STREET 2 : ORANGE Dere: y'ZY-4d co,treaa:G(( 14 .319m ik-hN4 PARCEL: 42542312 ZONE: Cl LOCATION > FRONT: REAR: OWNER BUILDER DECLARATION:I hereby affirm under penal,of perjury that I am errshe Codndoe license Law la the BUSINESS NAME: BAJA FRESH MEXICAN GRILL > LEFT: RIGHT: X folbwig reason(Section 70313&oiwn end Professions Code:Any ciy a county which requires a Permit to enflame'.der,Mprate. OTHER TOTAL S GROUND SIGN 'emdlsh.o repo any nu:tura vie*to is issuance,also requires the epptican Ice aNprmitoedea tllgW Melon,i IlmaMaehe THIS ACTIVITY 48 . 83SQFT OVERALL HEIGHT: OFT OIN ' Eornad pursuant to the provable d C the aurgon License Law[Chapter 9(commencing(commencingwith Section 7030)d DWeof ton 3 t Aransas end Prdas eesoCoda]athat hoashe a exempt therefrom end the basis to the alleged oemgbn.My vbWbn d SectionTHIS SITE 1383 . 00SQFT GROUND CLEARANCE: OFT OIN 1o3t.s bymay gams to a permit subjects the eppi nl to adds penury of not more than Dre hundred ddlere[S50O0. ITEMS OF INFO 4 PLANTER AREA: 0 . 00SQFT ❑ I.as owner of the properly or rny emPiorthe wih wages as thek sole compensation.mll do the work.and the structure is nal Intended ITEMS FOR ACTIVITY: 4 BLDG SET BACK: 20FT Oroffered kgsale(Sectinn7DU'Bunton end Proleeebmd neCode:TeCoaon Lk 'w' aeeldoes not appy loan_. properly COPY VERBIAGE : BAJA FRESH MEXICAN GRILL sh who buor Manes thereon. himself or and who does such work himsehoed o through his other own a rMinTeas,provided that such imov prerneds are no intended a offered to sale.d.however,the building or inpuwd i e rnesold within one yew d completion,the enter will have the burdens proving he or she did not build a improve to the papoa d sale). PLANNING NOTES : ❑ I.u owner d the progeny,am odusivay winding with licensed onuadae to coming the pgw(Sedbn 1044,Buns end ******************************************************************************* cnt� rca ) � agaoheowner of prcpwiy who w�a Improves thereon and who DEVELOPMENT SERVICES REQUIREMENTS contrbr projects with o tnctolslicensed not Cora,License Law). • j ❑ texnSection: B.AP,C • reason: CO DATE: Li .ZONING APPROVED BY Data: Owner: I do herebycedy that I mi,ew.ederd menus the requirements of cmiania Healhmd Sealy Code Sectfoo 25505.25533,end BUILDING APPROVED BY : DATE: 25534,and that I a any Mute building awpnt will/wit not(circle one)need to comply with said stale codes and the requirements for pp itnaonsirtdgnrmoddnWbnhonlMAiOuebIyMep enenentDimed.RadentsmnetndipnePPEGibrorexen eenpees ltemthe APPLICATION ISSUED BY; DATE: � Ff1�3F'3F **********************7f************************* **************** ** Date: Applicant: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT: Y WORKER'S COMPENSATION DECLARATION:I hereby earn under Penal,dpenloy ow d the blowingdederations: BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING )C3 I have andel maintain a certificate d cement to sea-insure for wad....compmatm. pr kas added for by Section 37004 the Labor PERMIT 99 . 75 Code.for the performance d the work tor which this permit is issued. SMIP/NON—RES _ ❑ I haveend who meitai,weeks&compensation insurance.es required by Sed'cn 3703 d the Later Code b the performance of the PLAN 64 . 84 . 95 wok for whist this permit is issued.My waken' poky numb.sue: i on. $YY� Y�YYp1"" EXPIRES ISSUE FEE Potty Number NDN 16957—A 02/28/97 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID _ DUE . (This section need nor be completed the permit b for one hundred dollars($13010 _-.j TOTALS----> 100 . 70 _ 0 00 64 . 84 165. 54 165 , 54 . . 00 .. ❑ f candy that in the pedamace of the work for with this permit is issued ' any manner o es to bearmeaq.atothewakas•wmpnemionlew,dcemana .issued/4X mth.woekas REVENUE DIVISION TOTALS--> COLLECTED : OVER/SHORT: 00 crmp's/Snobns Seeion3100d thelaborCork.l •• +'I - BLDG PMT PLUMBING ELECTRIC MECHANIC MIP/TOT GRADING PLAN—CHECK _Dere Y � 99 75 ¶54 S. 64 , 84leh.mousandccostcivil Ono res to sue hu Bred thousand dollars(510g000A In aition b tie coat of cerrkewmlpn•damages as Provided br InSeaton3706oftinLaborCadeIerestandatbrneyefees. I N D I V I D U A L E A K D O W N SdhL��NG bpersby affirm ww°a"rythd ha°e'wnm°°" k�°'°ewy lo,the ��Performance the work which tmitiissued(son l e) TYPE QTY DESCRIPTION 9 � UNIT COST TOTAL COST LENDER'S NAME: LENDER'S ADDRESS: NO FEES WERE SELECTED FOR THIS PERMIT I cooly that I have read this application and sate that the above information is coned.I agree to campy cath el Dy end county adnacr and state tews*dig to building connucto and hereby authorize representatives d this city to enter upon the above-mentioned property Isar nnsPectim MM."' M PALAC I OS Cl T'42117,.....,....-C1.2652! 6 T ; /////ny/r�"/Name /! r, DATE: U4/l1•V1 '.T;;}. 1.3:41-:/ Signature dOwrd/Apodm/C Appiuontreda (5151<6,WP) Whin-Butdig A Safety;Green-Rle:Canary-App4cenl:Pink-Revenue:Goldenrod-Assessor COr1STRUCTION AND PLANNING POOL _SPA APPROVALS Permit Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. pe- nrgrn . Soil PiUdd ' 53. Steel Reinforcement 3. 'Electrical Conduit Utility-Und'rgrhd. 54. Forms • . r 4. 'Electrical Conduit-Undrgrnd,:-.•,1 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing&Pressure Test 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE ,• -7: Footings 5B. Electrical Condiiit:Undrgrnd. 1 rt _ 8. Foundation 59. Gas Pipe, 0 Uodrgrnd.,Test , 9. Water Pipe-Undrgrnd._ - 60. Backwash Lines,P-Trap, 0 Uridrgrnd. 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-Conduit66. Solar System-Final • 16. Rough Electric Wiri84- _ 67. Fencing & Access Approval -17. Rough Wiring Sign r 68. APPROVED FOR PLASTERING ,18. Rough Electrical-T Bar Ceiling - 69. POOL/SPA SYSTEMS FINAL 19.Rough Heating &.Air Conditioninga, .. - C.' FIRE DEPT:REQUIREMENT 20.?Rough Factory Fireplace - .'r.D ', _ - APPROVALS' ,"Perplit#..,_ 21. Ducts,in Structure . � 70iUrndergto Underground Hydro 22. .,Ducts• Ventilating - - . .i...„._.1 • -'T : 115 - 71. P'ro'duct Piping-El-Gas ;0 Oil ' 23. GasVip&Rough& Test _ . rr _ .. -72.-Underground Flush _ • . 24. Roof Framing 1 , n„ 73.rllndefgrnd.Storage Tank 13 Gas 0 Oil 25. Roof Sheathing ' , .;.'. T - _ . `� 74.=overhead Hydro - . 26..T-Bar Ceiling (Structural) & Monocoat ' ,75.-Dry Chemicalp- :: 3. - 27. ,Frame and Flashio9' ,T. • ,_ '76.r-Dry Standpipe • • 28. Lathing& Siding . ., t - n - . 77. FIXED SYSTEM FINAL. • , 29. Insulation - • ,. :- 78. FIRE. PREV. FINAL ' ' 30. Drywall Nailing -7. - i. HEALTH-DEPT•. REQUIREMENT' 31. Plaster Brown'Coa%. - - _ 79. FINAL INSPECT;034 32. Electrical Power Meter-Final r 80. FOOD CERTIFICATE ISSUED . ' ' it 33. Final Electric y '_ Notes: ' 34.:Final Heating& Air Conditioning .- .- • - 35.,Final Gas Pipe-Test . -1 ' , ' ' .y 36.-Hood or Canopy ,- - • a. - . 1 M 4,� . 37. Final'Factory Fireplace - - 38. Final Plumbing - - . . •• . • - _ '1 i - .• 39. Water Service-Final I. I- -1• - - _ 40.-Gas Service-Final - - - - - < 41. Solar Domestic•Final ='- - m :' c - 42. Backflow Preventer , 43. Backflow Irrigation - - ^ .."" 44. -Landscape Irrigation System , • _ ' 45. Sound Attenuation - - - - 46. Handicap Regulations .. • -- . - - , 47. FINAL STRUCTURE &•BUILDING = - 48. FINAL PLANNING _ r - 49. Electric Release to Edison, . - - 50. Gas Release to Southern California Gas 0, - 51. CERTIFICATE OF OCCUPANCY No Date ADDRESSOFBMLI1Pd0: 171 E 17TH ST UNE S2 it / CITY OF COSTA MESA - SIGN PERMIT omumKAMEDKKOK7kBARCO REAL ESTATE Y PERM NO: SB 077113 anonss:1545 N. VERDUGO #115 GLENDALE, CA 90015 PERMIT NO: SB 077113 PLAN CHECK NO: 01328-96 S GOVT: N SUPP : N APPL. IAAOADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE: OTH ARCHITECT OR ENGINEER uc.NO.: JOB DESCRIPTION : 19 . 5SF ILLUMINATED WALL SIGN SQ FT: ARCH.OR ENG.'S ADDRESS: DHT: CLAIM VALUE: 2, 500 . 00 CALC-VALUE: 2, 500 . 00 GROUP OCC: B / axrm"cTarsKAMEGREAT PACIFIC SIGN WORKS ( 805 ) 373-9822 CQORACTORSMNLLID 705 LAKEFIELD RD COMMENTS : "BAJA FRESH" WALL SIGN AImREss:WESTLAl(E CA uc.NO, 569588 *******'N'*'K'*+t**AEAEAE*****kt**********it**sk****x*****Rt Ir*stir****sr*****+tlE**K-***+r*** **** 91361 imm F SIGN INFORMATION LICENSED CONTRACTORS DECLARATION:I hereby affirm under penallyd perjury the I anis licensed under provision,of Chewier DISTRICT; 1 TYPE: WALL ILLUMINATION; INT CATEGORY: NEW (commencing with Seak()7000)of Division 3 of the Business and Professions Code,end my licarteaSinfullforceaeeffect. DIMENSIONS : 9FT 00IN X 2FT 06IN AREA: 19 . SOSQFT LETTER HT: 19 INCH CITY LIC.NO.: 067OS5' LIC,CLASS:C 45 LIC.NO.: 5695 STREET FRONTAGE 1 : 406 . 00 STREET 1 : E 17TH ST 2N-4 (iYl�l�4—T f4�iCG �U (!(/O)�`STREET FRONTAGE 2 : 445 . 00 STREET 2 : ORANGE Dale: �- �, conned«: Q ( �'/ PARCEL: 42542312 ZONE: Cl LOCATION > FRONT: X REAR: OWNER BUILDER DECLARATION:Ihere"'affirm undxpenaly dper(uryOwl I an wane horn Connect=Lice's.Lae l«the BUSINESS NAME: BAJA FRESH MEXICAN GRILL > LEFT: RIGHT: followuq reason(Section 7031.5 Business and Professions Code:Any cryo county which requires a perms to construct.der,improve. OTHER T OTALS GROUND SIGN demdsh,c"lepra cry sma h"'prior a"issuance,aka rquios the applicant h«such pas to Re a sgned stain"'thea he et She / is licensed provisions THIS ACTIVITY 19 . 50SQFT OVERALL HEIGHT: OFT OIN ' Business'me Professions code]or that hil Of the is exams.therefrom and the basis tor the aped eaermahn.Any violeh o n o I Section THIS SITE 1383 . 00SQFT GROUND CLEARANCE: OFT OIN 7031.sbyenyap,Dmnt to a Porn*sutieaS'he aPpMam to adw penalty of not mors than lee hundred dollenIS500W ITEMS OF INFO : 4 PLANTER AREA: 0 . 00SQFT ❑ i ,orerdtMpppedy«myempWyaawlhwagesWI'S*Semmpeagon,wDdoNewM.udtheeWCMewndintended ITEMS FOR ACTIVITY: 4 BLDG SET BACK: 20FT or offered kr ale(Section 7044•BuaMa and Professions Code:The Conned=License Lawdoes not appy loan awed popery who bums or in prwa therert and who does sum work Mesa or harmed or trough his or her Oen empc/eaw provided that such COPY VERBIAGE : BAJA FRESH MEXICAN GRILL improvements are ret wended or Steed tor sale.P.however,the builiins or improvement is sold%Whn one yew of completion.the wn oer.buimtaad « ,pe have mw « idMhprovef«IMpws*of=de). PLANNING NOTES : o I.aowner a the popery.amestWv&Yaoruradiq with hoeredconneto to mamma Or pNrs(S5dMs7OM,Busies and ******************************************************************************* Pofae'asa Code:The Contractors License Law does no/appy to an on,of pony oho beads or improve thereon and w1e contracts he midi projects with a contractor(e)licensed pursuant to the Contractors Lose Lan). DEVELOPMENT SERVICES REQUIREMENTS ❑ I am exempt under Section: S.8 P.C..for It reason: ZONING APPROVED BY : Ga DATE: 4/$ f9� Date: Oran I do hereby caddy that l an aware of and understand the requirements d C.laomia Health end Sdey Code Salons 255°5.25533,and BUILDING APPROVED BY : DATE: 25534,end that 1 or any future buildup odsaer will/w not(circle one)need 10 comply wih said Yale codas and the requirements for permit r,iorh«mod6mtotr npnlMlv3aTreriment ylepeDirrict.Raddervielmutr«tioneppiretipmanaxemgh«nlheN �ono. p v. APPLICATION ISSUED BY: DATE: 41 *********************************************dF ******************* * **** Date: Applicant: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y WORKER'S COMPENSATION DECLARAd10N:!hereby affirm under prdyd perjury onsdth.following declensions: BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING }0 I have end all maintain a NNticete of consent to ad.insure for workers'compensation.a provided for by Section 3700 d the Labor PERMIT 74 . 75 Code.1«the performance d IM work for which this perrnb is Issued, ❑ Ihaveendwilmaims"wokers'comlN^�Mninsurance,asrquiredbySedln3700dmelaborCode,fortheperf«manoedlM SMIP/NON-RES work for which this permit is issued.My workers'ran .aton insurance caner end policy number are: PLAN 48 . 59 5 3 Carrion SUPERIOR NAT EXPIRES ISSUE FEE /` Poky Number NUN 1b95 /-A 02/28/97 BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TO PAID DUE ss needna wmpretlh.pm+leaone hundred eda.rslm«we.l TOTALS > 75 . 28 0 . 00 48 . 59 1 3 . 87 . 00 - ❑ I pertly that in the performance d the work b when the permit e' not -• in any manner so a to Moeaedwtheeokrs'mop.nsaMnaw.dc.ma:.. ker ' .7 wJblwethew«wrs' REVENUE DIVISION TOTALS--> COLLECTED : 3 /SHORT: 00 ranP,���powanadsrtMn 37°odtM lan«coa.l.Muf.�y�y�'�'! BLDG PMT PLUMBING ELECTRIC MECHANIC SII, ' ' SMI OT GRADING PLAN—CHECK Dere: y' V• fie. Applicant: ��% . 74 . 75 VI'. . 53 48 . 59 Warning:Failure to a&mindthou coaodorta($ ppm,in awir me cwnmNraaroroyrroosea ppaamaan ****************************************************************************** dvll Gnu la to ors eber Co Nouares eensa(SIOeycheered*s unlawful, addition re the cam of compensation.wwbo eemspa a povMrl roc In BICpM 3706 of IM Leber Code,Interest,and alto nays INA INDIVIDUAL F E E BR EAKDOWN CONSTRUCTION LENDING AGENCY:I hereby affirm under penally of perjury the thee is a mwtnudion lending agency for the performance of the work for Mach the parrot isissued(Swin3097.Civ.C). TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST LENDER'S NAME: LENDER'S ADDRESS: NO FEES WERE SELECTED FOR THIS PERMIT I cendy that I have read this eppficelah and rate that the above information is conal,l apse to cam*wih all thy and county Drdirwnres and sale laws Nang to buddies mm4Wian and hereby authorize representatives d this fry to enter upon the abovementioned property ermaeda ALACIOS PM Name _I e !4✓� Deb: 4. r41�.•l / 7 _ v_ 112- S /Ad O ra wner/AWrd/ApplcanlContt« _ r/ 1 151514 M 0.WP) Whim-Builiq 8 Peaty:Green-Fle;Canny-Appian:Pink-Keane;Oddauod-Assessor CONSTRUCTION AND PLANNING POOL di 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 OF ER_Grnd. 57. APPROVAL TO COVER-GUNITE 7..Footings 58. Electrical Conduit:Undrgrnd. `- 8: Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. ...._ 60. Backwash Lines;P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House:Connection 62. Backwash & Receptor=Firral 12. Sewer Cap 1' 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 • t-_. APPROVALS- Permit* 21. Ducts,in Structure ' • - _ • -.. _ -70. 'Underground Hydro' 22. Ducts, Ventilating' ! , • ^� 71. Product Piping ❑Gas 0 Oil P 9 h & Test 23. Gas Pipe-'Rou r 9 _ - . •72. :Underground Flush - , 24. Roof Framing ' ' - -, -73.'Undptg nd.Storage Tank i Gas 0 Oil 25. Roof Sheathing -74,rOverheacLHytlro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 7. 27. Frame and Flashing 76. •Dry Standpipe -t 28. Lathing & Siding 4 - t 77. FIXER SYSTEM FINAL -- 29. Insulation 78. FIREPREV. FINAL • 30. Drywall Nailing .- HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECT4ON •' . 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 - - . i - r ' 39. Water Service-Final - • - " - - ' 40. Gas Service-Final - , ._ • - 41. Solar Domestic-Final - .1 - •� - ` 42. Backflow Preventer " .. - ' - . 43. Backf low Irrigation - . ^ • " ' • 44. Landscape Irrigation System • - `- .;,, . • 45. Sound Attenuation ' 46. Handicap Regulations ` •, - 47. FINAL STRUCTURE & BUILDING = ` ` - - - # r• - 48. FINAL PLANNING ' • -^- - ' 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co - - 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF awLIMNO: 171 E 17TH ST DMT' CITY OF COSTA MESA - BUILDING PERMIT OWNEBSNAMEMMIO'MN: MESA VERDE DR PLAZA PERM NO: E 083470 I "DDRB: SUITE 209 i 1525 MESA VERDE DR EAST PERMIT NO: E 083470 PLANfCHECK NO: N GOVT: N SUPP : N I COSTA MESA, CA 92626 APPL.IDIOM"00RESs CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH I ARCHITECT OR ENGINEER: sae.NO.: JOB DESCRIPTION FIREWORKS STAND SQ FT: m. ARMOR ENG.'S ADDRESS: UMT: CLAIM VALUE: CALL-VALUE: GROUP OCC : / 1 COMr11ACTORSNAAE AMB URG EY' S ELECTRIC ( 714 ) 979-2311 CONTRACTORS MARINO 945 CORONADO DRIVE COMMENTS: FIREWORKS STAND FOR "AYSO" *MEM: COSTA MESA CA '' 395199 *x-+E*****Rr******+E*******RE* -?t*****Rr******Rr****RE*+r-x-*Rt***Rtit***x-Rr******************* 92626 ""T' Z ONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby di under penalty d perjure'that I am licensed under prodaions d Chapter 9 SETBACKS (commencing with Section 7000)d Division 3 d the Business and Professions Coda end my license is In full force and eDW. CITY uc."0.: 023866 uCLASS: C 10 uO ? 5199 EXP : 02/98 MAIN BUILDING . ACCESSORY BUILDING Dale: - a-S ^97 Contractor: �,L,E.. FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER WILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the on Lew for the following reason(Section 7031.5 Busies end Professions Code:Any coy a county which requires a perm to constrict. er,improve. demolish,or repair any structure:prior lo is issuance,also requires the applicant for such mperms to fib a signed statement that heaeh PARKING RE • PROV: PARCEL : 42542312 ZNE: REF NO: S licensed pursuant to the provisions d the Contractors License Law[Chapter 9(commencing with Section 7000)d Division 3 o the PLANNING N TES> dness and Professions Codec or that he a she S exempt therefrom and the basis for the alleged exemption.Any violation of Section 31.5 by any applicant for a permit subjects the applicant to a civil penalty d riot more then Me hundred dollars($500)). > �i•1•.� ▪ I.as owner of Irk(ayMn ce my employees with wages as their sole compensation,will do the work,and the structure le not Wended 1 p a offered for sale nm 7044,Business and Professions Code:The Contractors Lice e Law does not apply to an owner d propertyDEVELOPMENTP M E N T S .tr,.R' V I C E S R E Q U I R E M E N T S I who bolds or t improve!thereat'and who does such work himself or hens,or through his or her own mnare yes.provided that such 1:VI ownearbul wovements ilill have ilhe burden d proviingsale. or sit dd not buildmorrimproe faarihepupurpment pwseoi�mle)a"vOa`d`an°I"n'D" ZONING APPROVED BY �'i t1;r DATE: ❑ I.as owner of the properly,am exclusively contracting with licensed contractors to conmud the project(Section 7044.Business end lir. F' Professions Code:The Contractors License Lew does ea app to n owner of property who builds or Wproves thereon and who BUILDING APPROVED BY : i./;fh:, DATE: _ contracts for such projects with a contrador(s)licensed pursuant to the Contractors License Law). ',.std�. ❑ lam exempt WKS Section: B.AP.C..for this reason: APPLICATION ISSUED BY: ?�"'i'-. (/) DATE: liar l Dale: Owner ********************************.*ASA**********C se*************• ** LEGALIZATION: N F E%AE •TJ S U M M A R Y STRUCTURAL SEGMENT:N I do hereby unify that I am aware of and undersand the requirements o Camante Health and Safely Code Sections 2550s,25533.and ..y.' 25534,and that I or dry hewn building occupant will R I wnot(circleone)need to comply wth said Nate codes and the requirements for ,./- q apermb to construction o modification from the Aiyt mnpemaa District.Residential construction are fronds* BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ate. PERMIT (!/ /11 . 00 Dae: ADPbW: 50$ SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally d perjury one of the following declensions: PLAN ❑ I have and w mainlab a certificate d consent to setlinsure for waken'compensation,as provided for by by Section 3700 the Labor ISSUE FEE 22 . 00 Cee,lathepedamancedweworkfowuahtispermiti.issued. BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ I have end will maintab workers'compensatbn insurance.as required by swim nce of the Labor Code,br the performance a the TOTALS----> 11 . 00 22 . 00 0 . 00 33 . 00 33 . 00 . 00 work for which this panne S issued.My workers'compensation insurance corner and poky number are: Carer: C 'pmy 7,1*71, EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 33 . 00 OVER/SHORT: . 00 Policy Number. 4 ^1I cn•7fl 07 07/01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK t section need not be competed I the panda S for one hundred dollars(5,00)or lass./ 33 . 00 I certify that in the performance d the work for which this permit is issued.I shall mat employ any person b any manner so es to become subject to the workers'u700 of(ion ewe d Cal. 1 and agree thin R I *Mull become subieo m the waMn' ******************************************************************************* Dom ambo provisions of Section 3700 the labor Code I imp,,with tit povidone. Date: G— 7S 9 7 Applicant l '1 ,. �.w[r�/S INDIVIDUAL FEE B R E A K D O W N Warning:Failure to secure workers'compensation coverage a unlawful,and shall subject en employer loyer to admen,penalties ant TYPE QTY DESCRIPTION UNIT •ST TOTAL COST I civil fines up to one hundred thousand dollars($104000),In addition to the cost of compo setlo4 damages as prorWed ler in A Section 3705 of the Labor Code,Interest,and edomey's sea ELE 1 FIREWORKS STANDS EA. 1,lpg'� '�""" 00 CONSTRUCTION LENDING AGENCY:I hereby ellen under penally d perjury that there Ise onstnWbn lending agency for the """"'��� performance d the work for which this permit is issued(Section 3097,Cor.C). END OF FEES LENDER'S NAME LENDER'S ADDRESS: /� JUN 2 5 1997 I Miry that I have read the applicationt sad dun that the above information COMM'.I agree totcomply with rely end coalyed'pone [p''�p�.Irj• ��� O� and mate eewsreposes. building construction and hereby authorize representatives ottfne'aysemer upon the abows nhent3ahod properly COSTq ME for inspection purposes. ORV AMBURGEY L Sq Print Name '�L ¢�, � Dna:<g S•�j-7 1 Drel& ZSIG._-n Signature d Ormd ntfAppkcan Mrer3a / `. !J A. 7 E — ^- __ (5151-a6 WP) White-Building 5 Sddy;Green-Fb;Cmury-App5ran;Pink-Revenuer:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL 7 A 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. r 60. Backwash Lines,P-Trap,10 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. APPROVEDFOR 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 PREY. FINAL 30. Drywall Nailing HEALTH DEPT.REQUIREMENT 11%n 31. Plaster Brown Coat 79. FINAL INSPECTION - --� 32. Electrical Power Meter-FinaliA �" ;i 7D CERTIFICATE ISSUED 33. Final Elerr• �=� "'' r:r: 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 • 4.. 40. Gas Service-Final - - 41. Solar Domestic-Final 42. Backflow Preventer - 43. Backflow Irrigation �FJ' •- �'' 44. Landscape Irrigation System -7 45. Sound Attenuation -' 46. Handicap Regulations e - rt..) • 47, FINAL STRUCTURE & BUILDING • 48. FINAL PLANNING 49'. Electric Release to Edison • t 50. Gas Release to Southern California Gas Co " • - 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUILDING: 171 E 17TH S.. . uiT; BSC CITY OF COSTA MESA - BUILDING PERMIT OMIENSIUYEIFIIQW.BARCO REAL ESTATE PERM NO: M 077601 ADDRESs1545 N VERDUGO RD • UNIT 115 PERMIT NO: M 077601 PLAN CHECK NO: N GOVT: N SUPP : N ( LENDALE, CA 818-500-7257 APPL.MAUN0 ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: MEC PURPOSE: ALT ARCHITECT OREN3DIEER: UC.NO.: JOB DESCRIPTION : C/O AIR CONDITIONING UNIT SQ FT: ARCH.OR ENG.'S ADDRESS: UHT: CLAIM VALUE: CALC-VALUE: GROUP OCC: A-3 / cONIUACTCWSNAUERESSAC ( 818 ) 241-7710 CONTRACTORS WRUNG 207 E. LOS FELLIZ COMMENTS: X ADORESS:GLENDALE CA LIC.IIo_ 220253 *dESE+rlFitdEfEltlt♦E♦E♦Ex-St-Itx*+riFdtiF1E♦E♦EItlt9tlE-♦Ex-ifiEdE+E#dElt9tdE/EftltiF♦E♦EIE-9EiF+E♦EIt*****SEdEIt*#+Ei(-dE*+r«-*IEIt9E**dE3E*** 91205 DMT: .. ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby aIt m under penally of perjury that I am licensed under provisions of Chapter 9 SETBACK S (commencing with Section 7000)of Division 3 d the Business and Professions Code,and my license is in full force end effect. C. .No.: mcumC 20 m.No: 2 0253 EXP: MAIN BUILDING ACCESSORY BUILDING aii S_ 9ep� ContractorJ) FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN / aContractorid", LEFT: F.T IN RGHT: FT IN LEFT: FT IN RGHT: FT IN • ER BUILDER DECLARATION:I hereby affirm under penally of perjury that I am exempt from the Contractors License Law for the 'following reason(Section 7031.5 Business and Professions Code:Any city a county which requires a permit to construct,alter,improve, PARKING REQ: PROV: PARCEL : 42542312 Z N E: REF NO: )emol'oh,or repair any structure,prior to its issuance.also requires the applicant for such permit to fib dud signed statement t he or she PLANNING NOTES> Is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commenting with Section 7000)of Division 3 of the Business and Professions Cade)or that he or she is exempt therefrom end the basis for the alleged exemption.My violation of Section > 7031.5byanyapplicant for apermn subjects the applicant to a civil penally of net more than the hundred dollars[5500)). ******************************************************************************* ❑ I.as°veer of the propeny or mY emploYees with emges es their sole compensation,will do the wont and the structure is not intended D EVELOPMENT SERVICES REQUIREMENT S or offered for sale(Section 7044.Business and Pithy/Slain Code:The Contractors License Law does not apply lo an owner of propend i who Mind or improves thereon,and who does such work Mused or herself or through he or her own employees,provided that such improvements ere e rintended or nand is sale.5,howeer,the Mining or inprovan d is add within one year d completion,the ZONING APPROVED BY : "a DATE: owner-builder will have the burden of proving he or she did net build or improve for the purpose of sale). — ❑ I.m ower d the property,ern exciuthey contrediq wM"mad canvctacosspud as le the project(Sectio70 n u,Diems°end Professions Code:The Contractors License Law does napply to an owner of property who builds or improves thereon and who contracts APPROVED B Y DATE: et contracts for such projects with a axmactoHe)licensed pursuanl to the Contractors License Law). i ❑ I ern exempt under Section: B.&P.C..flhisreason: APPLICATION ISSUED BY: aDATE: ***************************************** * ******************** ** Date: OwnerLEGALIZATION:N F E E SUMMARY STRUCTURAL S GMENT:N 1 do hereby certiy that I an aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 25530.and that fpr any More building occupant will I wit nd(drob one)need 10 comply with said state codes andthe requirements ler BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING ' apenit for construction or modification from the Ai DualityManagement District.Residentielconstnnion applications these exempt eQ provisions. PERMIT IA/ 18 . 00 Date: Apprnt:aOr25% SMIP/NON-RES PLAN -WORKER'S COMPENSATION DECLARATION:I hereby affirm under penally of perjury y one the following dedermion: ISSUE FEE •ii /,t 15 . 00 ❑ Ihew and wiim°intenacereceledwwntleselfinsurebrwe'ericaopen°mien.nprovidedi« m by Seon370DdtheIS" BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Code,for rhes°d°nmeneddewe*f«which n" fame TOTALS----> 18 .00 15 .00 /^ 0;,00 33 .00 33 . 00 . 00 andhave sail maintain workers'cvpensation insurance,as required by Section 3700 d the Labor Code,for the performance of the work for which this permit is issued.My workers'compensation insurance caner and policy number we: - Cartier: CALIF IND . EXPIRES REVENUE DIVISION TOTALS--> COLLECTED :- 33 .00 OVER/SHORT: 00 Policy Number: A - - - 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK •i section need nor be completed I the pend is for one hundred dollars/51001 or less.) 1/31100' d I certify dial in the pedom°nce of the work for which this Permit is issued,I shall not empty an in any manner°o as to /.7 � 1 J become sublet to the workers'compensation laws d California, and ree that it 1 .... !.. : subject t• the where ***************************************,*******************************{�.******** •mpen°mbn d Section 3700 of the Labor Code,I Meg f h pig wiN .... . . - St" 4Y. 9 INDIVIDUAL` F E E BREAKDOWN • �Y/ Applicant g:Failure to"cuM workers'conpwueion Cweryge is unlawful,and shall subject an employer to criminal penalties end TYPE _ QTY D E S C. R I P T I Of�N ,,1 UNIT COST TOTAL COST c fines rpt to one hundred thousand dollars(4104000),M addition to the coat of compensation,damages as provided for In Section 3pdofmamprCode,Interest,end aro eyefeea MEC 1. _ _ INST FORC-AIR/GRAV FURN a<,_1 100 K BTU 9 . 00 9 . 00 CONSTRUCTION LENDING AGENCY:I hereby atfim ander penalty d perjury that there i e aonmrudien lending agency for the MEC 1 REFRIGERATION SYSTEM%) '<'=---100 K BTU/H 9 .00 - 9 . 00 Pedormenoe of the work for which this permit is issued(Section 3097.Civ.C). END OF FEES LENDER'S NAME: LENDER'S ADDRESS: / I I certify that I have read this application and state that the above information is correct.I agree 10 comply with all city and county ordinances I kei i and made laws relating to building construction and hereby authorize representatives of this city to enter upon the eboye.mentioned property _ Ia ins PAR ENTER _ '(�'' U' Ute: -? _; _ -sr A i-..ai ► Dale: I--T 76 Signature of• A.. .01T', tract (5151.46.WP) White-Buibin&Safety:Green-Rie:Canary-Appicant:Pink-Revenue:Goldenrod-Assessor POOL & SPA CONSTRUCTION AND PLANNING i ' APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector .r 1. Td.iporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. • 53. Steel Reinforcement ; . kiectrical Condol.i. lity-Undrgrnd. 54. Forms R. CEA'. Electrical ConduiitUtrdrgrnd. 55. Electrical Bonding n ntG„5,5lee1 Reinforcemet""itr, 56. Rough Plumbing & Pressure Test ,.. `T Electrical UFER Gond. 57. APPROVAL TO COVE R-GUNITE ^ C S zitriP Footings m , r 58. Electrical Cond4gUndrgrnd. tr ruer !am.'Foundation iy -C. c �-'nd.,Test r_ , 59. Gas Pipe, 0 Urldrgr - rt9 Wa,r Pipe-Undrg'd.v 60. Backwash Lines, aTrap, 0 Undrgrnd. `10. Structural Floor System 61. APPROVAL TebD=ECK , • 11. Property Sewer Line-& Housefonnection 62. Backwash & Receptor-Final I .p c4 12. Ser Cap v 63, Heater & Vent-Final 1 13. Roof Drains 64. Plumbing System - Final . M 14. Rough Plumbin& t, ni 65. Electrical-Final 15. Rough Electricaj;Co uit u.. 66. Solar System-Fi•iaY 16. Rough Electric Wiring 67. Fencing & Access tpproval -. 17. Rough Wiring Sign -' 68. APPROVED FOR PLASTERING m .. 18. Rough Etectrica T Bar Ceiling 69. POOL/SPA SYS-IttNIS FINAL 19. &Rough Heatklg&Ai{ .Conditioning, '7'U' i �. •;, .1:'x 7, Ft.R€'OFrPT.tREOUIREMENT Sz T :7:7 <4-2 tr. 1--.n D C al a >' C' M 20. gtou�ti Facto Filgrtlace r..Cr; IC< r S ,✓ o'r • 'APPEOVr:ESrr Permit# * Cr C :s: to r r�;.c i HE XS t :-4 -i -I* • D'1't .a 3 t1 t_ " 8-* r .. .. 1 _* ,4 -1tt}v 1 r 21. �]uc , i <Strubtur * Si-_ r CC ;J.* , 70. rUndergreend HIIdro * :a ti s .. r,i . nr 22.�D,�uc. Ventil4-7 Cr atin¢'Ja• C < ' F* 'I 71. ProdugPiping.O�(aas t)Oil `? ITIS * M. r 'Q O?: -' ti b 1,: H 23. Gas Ripe--r�Aoup11 &�T st 1-r. co * Sx: 1 72. Underground Fft.sh 4. .4.+ r 4. rr ••F. . i ''- S .I. , :a . 24. oo Franmin9 + g hi * n m r t •, 73.7 Undergrnd.Sto(t"TanICO Gas ❑Oil r -,, a-.S vv-< ca C.:* C; x 25. Joof�, hear thing .c , ,y r3 r-* 74: Overhead Hydrx tr r t- t•. . - a, t .• , r ., 26. C-Bar•Ceiting Structural & Mon-acoat * O >' Ct• 7 Dry Chemical -'=� ' t''` r. x * rn a. r1£ '•' C cr., fir' 27. cra �e and Flashing. T 7`^ * cr Y 1:1>+ r r 76. DryH m :< €.-• l r>j rM0.. 7 a: >' r $tars Pipe ��; x O ru r 1 28. Latig Sidingx •.1 •C.S.E O xZ . -I -4.:, , 77; FIXEDST '- INAa n Kr, 29. Insulati r1 * S ' rt x > o; C;d, qn * 5 O * S I Is 7 FIRE PREY. FINAL . ' H ~ 30, Drywall Nailing t: : ' r H R s cciEALTR'DEPT. REQUIREMENT le i fa r n3 • E :Y cr r - rr• 31. Plaster Bewr at .g, - �� r. 79. FINAL I.SQECT N * n . O ra� * i 32. .1. Polder Meter`mroal x O� j i 80:7 FOOD CERTIFICATE l5St7ED- <C cr. '7 T r- rr. - c rn m r '17 v �H ti:� 33. rina'lu-,'Eleitric% +. tr.tri .1:� F * c[ It N5ies: -ffitr . r/ .134. naI e•-i. Air drtioriin . 474-_-,c),/* I � $3 g: C^t>=1 g iTJ ,* n 1 :-.<... * -. ' 35. Fina Ga_Piper--Test y r. •' '"' ' !'� ,�. rm•'o C't,o n, _s' 'n - 70 2.36. .iooil.or4anopy r r, Cern c- y I I [n •ti o /X 471 ;.:m Sr * • • " ... "r 4 v * -.OM "37. P1nal'Factory Firepl1 ' `•H '' '. 4-44-4 T. O v - .. .. c- x tU - v. . Cr . J:C 538. Finarplumbing r tri i -1 * I c; ;. rU C x 4' :--to 11 l-g r. , --� r.'re. * m L. V 3g- Water Service-Final * E ' t * t>; f I tx : -a., * r'. - a: --a a: r -_ • a: (71 H i .[40. Gas Service-Final .•- tr yr• r• a r• . -• o s C. - CHH 41. Solar Domestic•Fine* 1-i .f i M Cr ^.o Cr r x G c• r: H N * I it im O i * S 42. Backflow Preventer * R.S r `c .-•i •,is Y- r � N i 43. Backflow Irrigation ' %•�� r x * t I ` n • • ry. * * 1.--• CU * 3 co .. x, * tn t-, ' ,r ., ru t.. ti 44. tEandscate,,IrigatiortSYstem.n< r; * •.� ¢ d;r ;.i E E pQ •t: S H `J . cC: r., �' F r .re .• ._ .1 C,. , Pr n" x 45. Sound AttenSation c " " M M r•.* F' C r- F'Q ' •o * Y n 4¢. fd; ancap'Regiilations s * S I Ix .r n w 47. FINAL STRUCTURE & BUILDING * F i ;. nt 2 r 48. §IN€L PLANNING; Hi- * tv I j n' 1: .. •4. lilecirrc Release to Eiiison i * .. a .1 4: •t: * r y cr +- 'S0. G'as 4lease to Southern Califormis;Gas Co ,r . . C , rt., VI. CERTIFICATE OF OCCUPANCY e C ^ No. Date . 1 PROJECT ADDRESS: 171 E 17TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO; F 06925C OWNER'S NAME: BARCO REAL STATE Amus: 1545 VENDUGO RD #115 PERMIT NO: F 069250 PLAN CHECK NO: 03604-94 L GOVT: N SUPP : N GLENDALE 91208 CONSTRUCTION TYPE: IV—NR PERMIT TYPE: FIR PURPOSE: ALT 818 ) 500-7257 ARCH/ENGINEER: K C ASSOCIATES REG.ND.: C-2461 JOB DESCRIPTION : INSTALL CHMICAL FIRE SYSTEM IN KIT HOOD SQ FT: ADDRESS: 14076 PO BOX UNIT: TORRANCE CA 92503 CLAIM VALUE: 1 , 000 . 00 CALC—VALUE: GROUP OCC : B-2 / PERMITTEE: EXECUTIVE FIRE PROTECTION ( 213 ) 433-3338 ADDRESS: 5133 CONANT ST COMMENTS: FOR " SCHLOTZSKY ' S DELI" RE; #867302 LONG BEACH CA 90808 +E+tfrirer�r*iE**e6***yF*�r**x-+r**ar****jc-****u-*#*x •4*********iFat+rar***#vraE****+tiF*aE* -*****#aria*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter •(commencing wi Section Z ON ING R EQU I R EMENTS 70001 of Division 3 of the Business and Professions Code,and -y license is in fun force a d effect. SETBACKS yu ,: 0.0.176 STATE LIC.: 547963/ Cuss: C1r E' :_(`,1 Date•_)d�� — l � Signature: I ! MAIN BUILDING ACCESSORY BUILDING !' FRNT; FT IN REAR : FT IN FRNT; FT IN REAR; FT IN RKERS'COMPENSATION DECLARATION: I hereby affirm t I have certificate n cense`to self-insu-or a certi cote of Workers' LEFT: FT IN RGHT : FT IN LEFT; FT IN RGHT; FT IN Compensation Insurance.or a certified copy thereof(Sectio 4:1-.La..C). POLICY NO.: ' P.DATE: COMPANY: PARKING RE • PROV: PARCEL : 42542312 ZNE: REF NO: '1 Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING N T ES> Dale: ApplicanL ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: section need not be comphbi if they ,I is le hundred(3100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certif that in the pubmance of the work for which this per .issued.I shall not ern, any n in.i. anner so as to become s • cl the V"ker Com•ensalionLaws ofCabfornia. , /� I,L• ZONING APPROVED BY DATE: :ate: /0 /� Signature: • .•!. . •hal ' BUILDING APPROVED BY OTICE:II.after making this declaration,you should y .me subj' t to the Work:! Compensation provisions of the Labor : DATE: Code.you must forthwith comply with such provision or this pe it shall be deemed revoked. I` Q CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED B Y: Q. l /)7� DATE: 'v l y which this permit is issued(Section 3097.Civ.C). W*********************' - - • " 7. . ^'k' '' . +e +— x—R'F'IT ********** r"'fF31s-Fi�": �le* LENDER: ******************************************** E********************************** ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT : N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish.or PERMIT 25 , 0 0 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 6 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 16 . 2J any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(S500). ISSUE FEE I. as owner 01 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----> 25 . 00 0 , 0 0 16 . 25 9 1 2 5 41 . 25 0 0 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED : 25 . 00 OVER/SHORT: 00 orimprovementprpise of le)hm 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). I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business '' 25 . 00 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who butts or Improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******'*****'K'***&'X-*****-le**************'M****'!r:'N'******************************:+f*** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: FIR 25 FIRE EQUIP FEE ( FROM BLDG VAL TABLE) 1 , 00 25 , 00 I do hereby certify that I am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant wilgwill 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. • I het• Applicant: • / I hereby certify(hal I have read this application and state That a above information is correc agree to p��y with all city-andme county - ordinancesandsllelaw relating to building construction and et by authorize repres laliv�r.his city lo•/ 'r upon the above-mentioned • pro .for ins /ction urposes. .000��, ��' Ppm . c o T Signature: ' ) `/ ` - 01 00169393-00169343 TrIT 25.00 / DATE: 10/12/74 TIME: 09:55 Driver's License or Social Security a: 1641-46 White—Building;Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POO. SPA APPROVALS Permit# Date Inspector APPROVALS Permit ?k 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, 0 Undrgrnd. 10. Structural Floor System / 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final +e 12. Sewer Cap L J 63. Heater & Vent-Final 13. Roof Drains �� " •. 64. Plumbing System - Final 14. Rough Plumbing ,r s 65. Electrical-Final ' ' 15. Rough Electrical-Conduit - - • 66. Solar System-Final 16. Rough Electric Wiring 0 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 limo 10-13-44 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 11 111 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED +L 33. Final Electric Notes: 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test '�- 36. Flood or Canopy 37. Final Factory Fireplace -� 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date AESWBmwtic: 171 E 17TH ST we: CITY OF COSTA MESA — BUILDING PERMIT ' DOR ONNERSNAMEglJf ?1: BARROS, HERNAN R PERM—NO: E 072999 1p° ' BARROS, ORFA T %JOHN BURNHAM & CO PERMIT NO: E 072999 PLAN CHECK NO: N GOVT: N SUPP : N P 0 BOX 2027 ESCONDIDO,CA 92033 ADPL.MAJLRIS ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ARCHITECT OR DINER: uc.NO.: JOB DESCRIPTION : FIREWORKS STAND SQ FT: ARCM OR ENG.'S ADDRESS: urT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / wNTRACTDR"ame: AMBURGEY ' S ELECTRIC ( 714 ) 979-2311 Ctl11RACTORSYAMIG 945 CORONADO DR COMMENTS : FIREWORKS STAND FOR "COSTA MESA LITTLE LEAGUE" ADORES& COSTA MESA CA LICNo: 395199 ***********************************+Err************ *rrAE+E***+E+E*+E*AE+ErEAE*********+E*AEx 92626 MT: Z ON ING REQUIR EMENTS LICENSED CONTRACTORS DECORATION:I hereby tem under peony of papal that I am rimmed under provisions of Chapter 9 SETH ACK S (commencing with Section 7000)d Division 3 d the Business and Prdeaabns Code and my'cense is in hit force end enact CRYuc.No.:023866 UC.CLASS: C 10 WC.N�O: 39 99 EXP: 02/ ' - MAIN BUILDING ACCESSORY BUILDING Dene: 6� -('S Contractor: d e11—r\ - _ _ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penalty of perjury that I em exempt from the • ors ! .Law for the fdowirg reason(Section 7031.5 Business and Professions Code:Any city or ooumy which requires a permit to•. .`r,alter,improve. PARKING REQ: P ROV: PARCEL : 42542312 Z N E: REF NO: _ demolish.or repair any*motors.prior to de issuance,also requires the applicant Ice such permit to file a signed stal• .nt that he or she Q is licensed pursuant to the provisions of the Contractors License Law IChapfer 9(commencing with Section 7000)d DMeion 3 ofthe PLANNING NOTES> 1. Business end Professions Code]or that he or she is exempt therefrom end the basis/or the alleged exempnn.My violation of Section > 7031.5by any ad:5cent nor a permit Nrbjeds the applicant to a civil penalty d not more than(we hundred dollars lS5001). ******************************************************************************* ❑ 1,m ower of the properly or my employees wth wagons the*sole compensation.will do the work.and the structure a not intended or offered or sale(Section 7044,Buanesaend Professions Code:The Cprdndora License Law does not appy to an owner of properly DEVELOPMENT S . E-• R V ICES REQUIR EMENTS who bolds or improves thereon.and who does such work Smell or through or ough hu or her own employees,Provided that such omww-0Wtla watiSehheaihen'"'or aaden of crewereding l'°Ie«an didrdt aaw«Mperrovetor use pe.laprovernent poeea me)�"y"`d°°m°I°I°n'dr° ZONING APPROVED BY DATE: ❑ I.es owner d the propeelm y.aexWdvey mMtrednern g wait licensed contractors to oavnw the project(Section 7044.Business and Professions Code:The Contractors License Law does not apply to en owner of woody who builds or improves thereon and Mo BUILDING APPROVED BY : - DATE: contracts for such projects with a co irador(e)licensed pursuant to the Contractors License Law). �+ ❑ I am exempt under Section: B.a P.C.,for this reason: APPLICATION ISSUED B Y: .- 4..._ DATE. � �( �7 S Date: Owner: ********************** s ********** ** I do herebycthat I am aware of and understand the requirements of California Healthend Safety Code Sections25505,25[ .and LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;N certify 25534.and that I or any future building occupant will/will cot(circle one)need to compy wih said state codes and the requirements for adrank'reconstruction ornodifcaoh from the As Gakty Management Dmdm.Resident*omatnrdion apsiruims are amend homtem BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 7 . 5 0 Date: Applicant: 50% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:d hereby affirm ulcer penalty of POW one d the following desratlens: PLAN ISSUE FEE 15 . 00 ❑ I have and wD maintain d feats el consent to sell-insure lor compensation.=prmded for by Section 3700 d the Labor / Code,for thepedonnaxedpermit the work issued. BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE/ ❑ I have and wil mama,workam'compensation ilISUM111*el IVKlUired by Section 3703 of dia Labor Code,for the performance ol the TOTALS----> 7 . 50 15 . 00 0 . 00 22 . 50 22 . 50 . 00 work for Mich this permit S issued.My workers'compensation insurance carrier and policy number are: Carrier: S'1'ATF Fran EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 22 . 50 OVER/SHORT. . 00I Polley Number. 1315073-94 07/01 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK (This section need not be completed r the permt is nor one hundred doflais/51001 or lees) 22 . 50 / ❑ d certify that in the performance el the work for which this genu*u issued,I shall not employ any person in any manner so as to bxnme subled to the*Dnare'camperwatian owe of Cdtloria. d ague that!I should acdne ernbject Ina wonken' **********************'****************'**********-****************************3*** n d 03 d the Labor Code.I with with cont ion provisions la,37 o wt p ilena. '� �'` INDIVIDUAL F E E BREAKDOWN Dater ?YJ Applicant w • . Warning:Failure to Secure worhen'conpanesdon coverage la unlawful,and shadsubject an employer to• penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST pall Nees rp to one hundred thousand datura($504030A In add/don to the coat or compensation, provided for In SectionLabor ro and attorney's -ELE 1 FIREWORKS STANDS EA. 7 . 50 7 . 50 CONSTRUCTION LENDING AGENCY: I hereby affirm under Penally of perjury That then is a construction lending fleecy for the END OF FEES performance of the work for which this permit u issued(Seaton 3097.Ch.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application end state that the above information is correct.I agree to comply with all city and county ordinances and slate laws relatig to building construction and hereby authorise representatives d this city to enter upon the above'mentoned properly for inspection purposes. ORV AMBURGEY 01 00185095-00185095 TOT 22.50 tBTe6,> Dene: dv . DATE: 06/28/95 TIME: 15:41 Signature d Owen/Agent/Arector (5151-45.WP) While-Bugling&Sdety:Green-Rle:Canary-Applicant Pink-Revenue:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector� 1. Temporary Electrical Service or'PO?Ie 52. Pool & Equipment Location' /- ' 2, Soil Pipe-Undrgrnd. 53. Steel Reinforcement ��' r 3_ Electrical Conduit Utility-UndrgPnd. 54. Forms 4".-Electrical Conduit-Undrgrnd. !I,. 55. Electrical Bonding rt.-, .l 5. Steel Reinforcement " ;'; 56. Rough Plumbing & Pressure Test . !'� , 61- Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' : 7. Footings 58. Electrical Conduit-Undrgrnd. 8, Foundation 59. Gas Pipe, 0 Undrgrnd., Test ./" 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, UUndrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK �; 11. Property Sewer Line & House Cofinection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final r' 13. Roof Drains e! /` 64. Plumbing System - Finalp: 14. Rough Plumbing ,c 65. Electrical-Final . 15. Rough Electrical-Conduit . 66. Solar System-Final - n 16. Rough Electric Wiring -4,,L..../ 67. Fencing & Access Approval �-i • 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING •/-r .J - 18. Rough Electrical-T Bar Ceiling I 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. Undergrhd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bir Ceiling (Structural) & Monocoat 75: Dry Chemical i.- " 27. Frame and Flashing _ •-• + 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL- 29. Insulation 78. FIRE PREY. 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- rt. ati 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. Backf low Preventer r 43. Backflow Irrigation - - - 44. Landscape Irrigation System--"' • - _ - 45. Sound Attenuation �, - ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING " • 48. *FINAL PLANNING. ` . -49, Electric Release to Edison :-./` 50. Gas Release to Southern California Gas Co " ' 5T. CERTIFICATE OF OCCUPANCY ' 4. - C /i I V\ Date `, J ' ADDRESS:• UNIT: sNAME: 171 E 17TH ST A CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 055253 • ADDRESS: BARROS Tillt 171E17TH STPERMIT NO: B055253PLAN CHECK NO: 04408-91 SGOVT; N SUPP; N COSTA MESA • CA 92627CONSTRUCTION TYPE: 5 NPERMIT TYPE; STR PURPOSE: ALT ( 619 )743-1550 RCH/ENGINEER: REG.NO.:ADDRESS: JERLA & ASSOCIATES NU1 TOB DESCRIPTION COMMERCIAL T, I , (COFFEE HOUSE) SQFT; 1 ,463 424 E. VALLEY BL PERMITTEE: COLTON CA 92324 CLAIM VALUE: CALL—VALUE; 17, 234 . 14 GROUP OCC; B-2 / ADDRESS: C. T.K. CONSTRUCTION (714 ) 631-8237 177 VIRGINIA LN A COMMENTS; 1463 SO FT/ THE "CAFE CONCERTO" C M CA 92627 **************** ******1F1F3FffiF#1EikifiElfiF3EiF�Eif3FaEifi6fElFafiEiflfiEiEiFlflfifiE#iEiE1FiF3fifdEiEilif3E+Eif#1E***)E*** LICENSED CONTRACTOR h aECURATanhereby affirmCa that am licensed under provisionsmofel Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 0l the Business and Prole stuns Code.and my license is m lull tome and effect. S E T B A C K S CITY LIC.: 049723 STATE LIG�468381 class: B • Date: /1— 22 —7/ (( Signature: ti� / MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that l have a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 38%.Lab.C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING REQ PROV; 266 PARCEL• 425 . 312 ZNE• Cl REF NO: PA-91-83 Certified copy is hereby furnished. Certified copy is Bled with the city Building Division. PLANNING NOTES> TI TO AN EX IS ING COMM S SR YET ANOTHER COFFEEHOUSE, > OFFSET HRS, APPROVED. ®®® Applicant ********************************. • ' ** ** ** *****************33*$********* * EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need riot be completed if the permit is for one hundred(3100)or less) D E V E L O P M E N,T•'—-' •' V C S REQUIREMENTS I certify that in the performance of the work lo Rich this permit is issued.I shall not employ any person in any manner so as to beco T. subject to the Workers'Compensation La of California. /�� �j ZONING APPROVED BY A�;' , ' I Z. / Date: // —ZZ-4/ g /�// ' G/ s.k t. DATE: I Z �•.� Signature: 4� \- NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILD ING APPROVED e ; %'—`� r` DATE; Code,you must todhwnh 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 '. TLC— {! .0E re A DATE; :1 C2. / , 1 which this permit is issued(Section 3097.Civ.C). *,{c.s{.{(-*.{c*****.k.K.{E{E.{F*** {L. . .:E'�.,�.�,�;s.�. {t.a4 if.{l.fit.�{.{(.*aE{E ;t##iF if 33LFFF 3r TF TP Tt iE 14 LENDER: ******************* ************* I 7TfY�`N+*******-lE*********IE***LE*******IF********** ADDRESS: LEGALIZATION;NS U M M A R Y STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT iiiip.UggiNG ELECTRIC MECHANIC FIRE SMTP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 189 . 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 of the Business SM I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 122 . 85 3 . 62 any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars(5500). ISSUE FEE I. as owner of the property or my employees with wages as their sole compensation, win 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----> 192 . 62 0 . 00 122 . 85 315 . 47 315 . 47 . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If,however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED ; 192 , 62 OVER/SHORT: • 00 1 for the purpose ol 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 189 . 00 3, 62 LJ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).l am aware ***.K.*.*******************.******.*.**..x,*,*,*, ,**,y,*,*,*,*.*.**,N.****,*,*,***,**,**,*,*,*************** that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BREAKDOWN ❑ I am exempt under Section: , B. &P.C. tor this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505.25533,and SFC 1 4 6 3 RES—INT. ALTER TYPE V—N —AVER 11 . 78 17, 234 . 14 25534 and that I or any future building occupant wit/will not(circle one)need to comply with said state codes and the requirements for a END OF FEES permit for construction or modification from the Au Ouahty Management District.Residential construction applications are exempt from these provisions. NCEv Date: Applicant: I hereby certify that 1 have read this application and state that the above information is correct.I agree to comply with all city and county Ordinances and stale laws relating to building con ction and hereby authorize representatives of this city to enter upon the above-mentioned properly for inspection purposes. �e� / A. C p (+ jj��,, /1—a a— f� Signature: `/" Df'1TG J�U. • "'�S L: ':J.�.1'� _�' ._ .` _ Date: �/— _, Driver's License or Social Security: • 164t-46 White—Building:Green—Cope Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING :a- POS, ...riteI APPROVALS Permit# ...rite Inspector APPROVALS Permit'# _ Date Inspector . '1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement • , 3.:Electrieal Conduit Utility-Undrgrnd. 54. Forms 4_, Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel'Reintorcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER-Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - - - 58. Electrical Conduit-Undrgrnd. W • 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 Fiteplace . . APPROVALS'.- _Permit # - • - :- - 21. bucts, in Structure, ' 70. Underground.Hytlro 22. Ducts, Ventilating •• , •• • - 71. Product Piping DGas ❑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 ` -- _ %, Ceiling26.:T-Bir (Structural) & Monocoat • _ 75. Dry Chemical _ �f. 27. Frame and Flashing' -• - ' 76. Dry Standpipe 1 t '28. Lathing & Siding ' . r-. 3- . - - 77,. FIXED SYSTEM FINAL _ - '29. Insulation •I 78. FIRE PREV. FINAL L/ca,, '30. DrywallNailing is HEALTH;DEPT,REQUIREMENT 1{ 31. Plaster Brown Cog• :•.1 \ 79. 'FINAL INSPECTION - _,..6 32. Electrical.Power Meter-Final ' • • - t ,80. .FOOD CERTIFICA-TE ISSUED Y re- •33. Final Electric. - -'' 1, 'Notus: - 34. Final H &eating' Air Conditioning . . . - F 'r •` 35. Final Gas Pipe-Test • . , , 36. Hood or Canopy- . ; • . ;, , i - 37. Final'Factory Fireplace _ ' 38. Final Plumbing . - . , , :� ,39. Water Service-Final - + .. IT a Ii' • >- - 40.'Gas Service-Final -'`, 4 4 ; :41. Solar Domestic-Final - t _ 4. 42. Backflow Preventer_ - 1 43. Backflow Irrigation , . ♦ Y1 - , a 44. Landscape Irrigation System, • ., 45._Sound Attenuation- ..- 46. Handicap Regulations - ; '� 47. FINAL STRUCTURE & BUILDING -- - . . , 48. FINAL PLANNING - - - • • r - • 49. Electric Release to Edison • 1. • - 50. Gas Release to Southern California GasCo , - r 51. CERTIFICATE OF OCCUPANCY •. - No. Date L • PROJECT ADDRESS: 171 E 17TH ST UNIT: A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 055442 OWNER'S NAME: BARROS • ADDRESS: 171 E17TH ST PERMIT NO; E 055442 PLAN CHECK NO: N GOVT: N SUPP: N • COSTA MESA CA 92627 CONSTRUCTION TYPE: 5—N PERMIT TYPE: ELE PURPOSE; OTH ARCNIENGINEER: (619)743-1550 REG.ND.: ADDRESS: JERLA S ASSOCIATES NOM. JOB DESCRIPTION : COMMERCIAL T. I . (COFFEE HOUSE) SQ FT: 424 E. VALLEY BL PERMITTEE: COLTON CA 92324 CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / ADDRESS: BUYER COMPANY ( 714 ) 642-2431 1760 MONROVIA AVE A-20 COMMENTS- RE; B55253 PRIMARY BLDG, PERMIT, r( Gip MF 7 ************************************>E****4*********+ETr****** *** ********•******* LICENSED CONTRACroP'd�CLAAAiION:'Th''eCreebby affirm that am licensed uncle,prroo'visions a rater 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and eltect. ' SETBACKS CITY LIC.: 4,49070 STATE LIC.: 56690,) CLASS: C10 Date:/.2.../.0 / Signature:. -e / ," ' MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that ave a certificate of consent to self-insure or a ccrtllicate of Workers' FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance,or a certified copy thereof(Section 38w.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: 1137424-91 EXP,DATE: 04 /01 /92 • IOMNY: STATE FUN PARKING REQ PROV: PARCEL: 42542312 ZNE: REF NO: certified ropy is hereby furnished. Certified copy is filed with the dry Building Division. PLANNING NOTES> qDate: a /0 7/ Applicant' - *******************************************1F********************************3L** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This sec need not be completed if the permit 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 shag not employ any person in any manner so.as to become subject to the Workers'Compensation Laws of California. f' ZONING APPROVED BY DATE: Date: Signature: ' NOTICE:IL after making this declaration.you should become subject to the Workers'Compensation provisions of dile Labor BUILDING APPROVED BY : DATE: Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. 4.-1/ f CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: ,�� it �4: DATE- L t6 Tl which this permit is issued(Section 3097.Civ.C). f *****.***************** . . . . . ***.*li*****a. -** LENDER: ADDRESS: /, :• ******************************** ***** ***y�.1L******************************* LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the Sowing 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,atter,improve.demolish,or repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed PERMIT 6245 . pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0% SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15.00 I. as owner of the properly or my employees with wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTALS----> 62 . 45 15. 00 0. 00 77 . 45 77 . 45 . 00 Itdoes not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED • 77, 45 OVER/SHORT: 0 0 for purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 77. 45 ❑ exclusively and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware *******.*********_****.*,05*******et-*************************35***************K.*if*_*X-*, that proof of their Worker's Compensation insurance should be provided to me. ❑ 1 am exempt under Section: B.8 P.C. INDIVIDUAL F E E BREAKDOWN for this reason: In. it TYPE , QTY- DESIRIPTION UNIT COST TOTAL COST Date: Owner: ,{' I do hereby certify that l am aware of and understand the requirements of CaliforniaHealth and Safety Code Sections 25505,25533,and ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. . 75 15 . 00 25534 and that l or any future building occupant wit/will not(circle one)need to comply with said state codes and the requirements for a ELE E X p 11'3� E D FIXTURESGTLIGS L HTING ADD I I TIOOAL EA. , 45 12 . 70 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from these provisions. ELEne"nPlete Tt6> ri:a(tt+A£CEPT/SWITCH 1 ST 20 EA, . 75 4 . 50 Date: applicant: 'fi:LE 1 SUB—PANEL 11 . 00 11 .00 fi MOTOR/POWR APPARATUS 0 , 0 — 1 , 0 HP 3 . 00 3. 00 I hereby cendy that have read this application and state that above information is correct. agree to comply with all dry and courtly a aa•-- i($.�„ . OUTLINE LIGHT SYS ON 1 BR CIRC 15. 00 15. 00 ordinances and slate laws relating to building construction and hereby authorize representatives of this oty to enter upon the above-mentionge END OF FEES property Tom insert tion.,ouurrp ses. /'/�� �}f .-./ Date://��v/� Signalure �f�2/ Fi _ . Driver's License or/Social Security e: �/ d • - _ 164146 White—Building:Green—Code Enforcement Canary—Applicant:Pink—Revenue:Goldenrod—Assessor I V • CONSTRUCTION AND PLANNING 0 PO4$?A Date Inspector Date Inspector • APPROVALS Permit # // i+ APPROVALS Permit # j I. Temporary Electrical Service oEquipment Pole 52. Pool & Location 47 2. Soil Pipe-Undrgrnd. =•J F' 53. Steel Reinforcement /l./ ,cJ 3. Electrical'Conduit Utility-Undrgrnd. I -r` 54. Forms .'�•4 4. Electrical Conduit-Undrgrnd. - 55. Electrical Bonding '5. Steel Reinforceme?it 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings - Aet • 58. Electrical Conduit-Undrgrnd. 8. Foundation • r/•.f 59. Gas Pipe, 0 Undrgrnd.,Test i/- „ i . 9. Water Pipe-Undrgrnd. LIP/ 14( 60. Backwash Lines,P-Trap, 0 Undrgrnd. f 10. Structural Floor System ) �l. 61. APPROVAL TO DECK 0v%1 11. Property Sewer Line & HousdConnection / 62 . Backwash & Receptor-Final !t 12. Sewer Cap / 63. Heater & Vent-Final t 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing" • 65. Electrical-Final • 15. Rough Electrical-Conduit F', Solar System-Final 16. Rough Electric Wiring / // , R' renting & Access Approval _ 17. Rough Wiring Sign Fr. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling �ZJ /l I f"3. POOL/SPA SYSTEMS FINAL '- . . 419. Rough Heating & Air Conditioning 777 <� FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace • • - - - - APPROVALS'. ' 'Permit# - 1�l 21. Ducts, in Structure - 70. Underground Hydro I- 22. Ducts, Ventilating • 71. Product Piping ❑Gas ❑Oil , • 23.'Gas Pipe;Rough& Test - - - . 72. Underground Flush- 24. Roof Framing r i • 73. Undergrnd:StorageTank 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 . ' 1 • 29. Insulation , - 78.-FIRE PREY. FINAL - }- 30. Drywall Nailing j 24. HEALTH DEPT. REQUIREMENT 31. Plaster Brown.Coat - „ - •I it 79. FINAL INSPECTION' 32. Electrical Power Meter-Final I 1,�jc; 80. FOOD CERTIFICATE ISSUED ,33. Fina) Electric. /!%'1 I ''Notes: - 34. Final Heating &-Air Conditioning • �; i -4. I ' - 35. Final Gas Pipe-Test / y . 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- 4. Landscape Irrigation System J - ,4 45. Sound Attenuation 46. Handicap Regulations .. - ' 47. FINAL STRUCTURE & BUILDING zp - 48. FINAL PLANNING - 5 , 49. Electric Release to Edison - 0 50. Gas Release to Southern California Gas Co ! ,0-01i . . . 51. CERT I F ICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 171 E 17TH ST UNIT: 0 CITY OF COSTA MESA — BUILDING PERMIT PERM NO: 4P 047974 • OWNER'S NAME: GRAF . ADDRESS: SAME AS ABOVE PERMIT NO: P 047974 PLAN CHECK NO: N . GOVT: N SUPP : N ; CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH 714 /548-9344 ARCH/ENGINEER: RHINO.: JOB DESCRIPTION : WATER HEATER REPLACEMENT SQ FT: ' ADDRESS: UNIT: CLAIM VALUE: CALC—VALUE: GROUP OCC : / PERMITTEE: NOCK PLUMBING ( 714 ) 895-1246 ADDRESS; 11610 SEABOARD CIRCLE COMMENTS: * STANTON CA 90680 ******************************************************************************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON ING REQU IR E M E N TS 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. SETBACKS • cm uc.: 0 5 0 3 8 6 STATE M.:511971 cSALS: C-36 ' A'' Date: S —' Signature: r--1/W� - MAIN BUILDING ACCESSORY BUILDING FRNT WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-Insure or a certificate of Workers' : FT IN REAR: FT IN FRNT: FT IN REAR: . FT IN Compensation lIns�ycg„q(�cprtifie Sppy thereof(Section 3800,Lab.C)3/01 /91 LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POUCYNO.: bb //77 LL VV EXP.DATE: "mat STATE FUND PARKING REQ: PROV: • PARCEL : 11910302 INE; REF NO: Certified copy is hereby furnished. 0] Certified copy is filed carr the city Building Division. PLANNING NOTES> _ _L] > Date: -7 - S [� Applicant: /--x--,7-i ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DEFAMATION: (Dns section need not be completed if the permit is is for one hundred(5100)or less). DEVELOPMENT SERVICES '. R EQUIREMEN TS ' 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 Calitomia. ZONING APPROVED BY DATE : Date: Signature: BUILDING APPROVED BY : NOTICE:y:IL after makingwthiso declaration,lwh hu should boor this subject the Workers'meempensation provisions of the LaborDATE Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE: which this permit is issued(Section 3097,Civ.C). ************************ iF3f*(/. *************,***********************.7e..7pIF . SW** , LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the foliovring reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: My city of county wfdch requires a permit to construct,alter,improve,demolish,or PERMIT 2 .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 25% SMIP/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business . . and Professions Cade)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by • any applicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars($500). ISSUE FEE 3,00 ' 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 ❑ tructure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS————> 2 . 00 3100 ' , •0 , 00 0 5 . 00 5 . 00 0 . 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. It,however the building or REVENUE DIVISION TOTALS——> COLLECTED • 5 . 0OVER/SHORT: 0,0 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 td construct the project(Section 7044,Business 5 • 0 0 j +' ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon • + projects l am aware ******************************************************************************* that proof of their Worker's Compensgtion insurance should be provided to me. INDIVIDUAL'j F E E BR EAKDOWN ❑ 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 HEATER AND/OR. VENT 2 . 00 2 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25506,25sal,and END OF FEES • • 25534 and that I or any future building occupant willhvill not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification from the Air 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 propDate: for inspection purposes. e M^A ,/� /1 Date: ✓C "�� Signature: v _,V ,11''„I�py�//e/// 01 00066570-0006657b TOT 5.00 Driver's License or Social Security it DATE: 07/31/90 TIt4E: 15:02 1041-40 White—Building;Green—Code Enforcement:Canary—Applicant;Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING PO#PA 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, 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 - I 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 O Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe • 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat. 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric N es:(Z-O-f-40 70L.esnr'r aPl2€40 .4S 34. Final Heating& Air Conditioning Pc_ zp,g a. ,:�] 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - - 39. Water Service-Final • 40. Gas Service-Final • 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date • haEC AODRESs: 171 E 17TH ST UNIT: CITY OF COSTA MESA/— SIGN PERMIT PERM NO: SB 078861 OWNER'S NAME: HERNAN BARROS • 5 ADDRESS: 431 N. BRAND BLVD . PERMIT NO: SB 058861 PLAN CHECK NO: 03371-92 S GOVT: N SUP!): N • GLENDALE CA 91203 CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE; OTH ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : INSTALL NON—ILLUMINATED FOAM LETTERS SQ FT: ADDRESS: UNIT: • CLAIM VALUE: 700 . 00 CALC—VALUE: 700 .00 GROUP OCC: B-2 / PERMITTEE: BEST SIGN PRODUCTS ( 714 ) 546-9750 ADDRESS: 2121 S. SUSAN I COMMENTS: THE "ZEE HAIR DESIGN" STORE SANTA ANA CA 92704 ****kE+E**k( k(***r******* ****k *** *** *****+Ex******** *its ********** *xk(*N****ea***at LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions a1 Chapter 9(commencing with Section SIGN INFORMAT ION 7000)of Division 3 of the Business and Professions Code,and linens "s m full torte and effect. DISTRICT: 1 TYPE: WALL ILLUMINATION: NON CATEGORY; NEW 6tTYLu.: 044834 sTATEuc.:5308000, ss: C4 DIMENSIONS: 1FT 021N X 18FT 00IN AREA: 21 . 00SQFT LETTER HT: 14" Date: �9Z Signature:// STREET FRONTAGE 1 : 500 . 00 STREET 1 : E 17TH ST 7STREET FRONTAGE 2 : 0 . 00 STREET 2 : WORKERS' MPENSATION DECLARATION: IherebyafIh eacertificate01consenttosell-insure or a certificate of Workers' PARCEL: 42542312 ZONE: Cl LOCATION > FRONT: X REAR: Compensation s ant e .Lab. ,c, -9�G `�fp��� EXP.DATE: 1101/93 BUSINESS NAME: ZEE PLACE > LEFT: RIGHT: COMPANY: STATE FUND OTHER TOTALS GROUND SIGN ❑ Cemfiedcopy ishereby fumished. IN5Cendiedcopy'. with I •tyBuilding Divisia . THIS ACTIVITY 21 . 00SQFT OVERALL HEIGHT: OFT OIN L /Qq �/ • THIS SITE • 21 . 00SLQFT GROUND CLEARANCE: OFT OIN dale: 5jt ', / / /Z _ Applican /3' • ITEMS OF INFO 1 PLANTER AREA: 0 . 00SQF1• EXEMPTION flOMWORKERS'COMPENSATION DECURA 0•. (This sectio ednot Decomplet¢dif. ITEMS FOR ACTIVITY- 1 BLDG SET BACK: 20FT pant is foronemmdred(sla)orless). COPY VERBIAGE : ZEE HAIR DESIGN I codify that in the performance al the work for whic s permit is iss.•d,I shall not employ any person in any manner so as to become Subject to the Workers'Compensation Laws of California. Oath: Signature: PLANNING NOTES NOTICE:If.atter making this tleclaralion.you should become subject to the Workers'Compensation provisions of the Labor ******************************************************************************* Code.you must fonlredth comply warn such provisions or this permit shall be deemed revoked. D E V E L O P M E N T S E R V I C E $ R E Q U I R E M E N T S CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued(Section 3097.Civ.C). ZONING APPROVED BY DATE: / ADDRESS: BUILDING APPROVED BY : S'% DATE: 7 �1�2 OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason APPLICATION ISSUED B Y• • DATE: aid 2 (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,Improve,demolish,or ************************ • **** '***Fif kiF' *.*�*.*., ******************** 9f +6****** repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed LEGAL I Z AT ION:N F E E SU MARY STRUCTURAL SEGMENT:Y pursuant to the provisions of the Contractors'Stale License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(S500). BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING I, as owner of the progeny or PERMIT 19 . 0 0 21 .0 0 my employees with wages as their sole compensation, will do the work, and the SMIP/NON—RES ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'Slate License Law does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through PLAN 12 . 35 . 50 his or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or ISSUE FEE improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE or the purpose ofsae). TOTALS----> 40 . 50 0 . 00 12 . 35 52. 85 52 . 85 . 00 I.as owner of the properly,am exclusively 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 properly who builds or improves thereon and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware REVENUE DIVISION TOTALS--> COLLECTED: 52 . 85 OVER/SHORT: . 00 that proof of their Worker's Compensation insurance should be provided to me. BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK ❑ I am exempt under Section: B. B P.C. 19 , 00 21 . 00 . 50 12 . 35 for this reason: **************************** ************************************************* Date: owner: I N D I V I ISY UAL F E E BREAKDOWN I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and 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 TY P QTY E� CR IP TION UNIT COST TOTAL COST Permit for construction or medidlation Nom the Air uality Management District.Residential construction applications are exempt from E X P R t 6 these provisions. Incomplete Iruµ'"c�OOYEES WERE SELECTED FOR THIS PERMIT Date: Applicant: u 1 hereby certify that I have read this application and slate that the above informs'. is correct.I agree to comply with all city and county " a+'+' ,/ o ordinances and stale laws relating to building construction and authorize r•• senlatives of t' icy to enter upon the above'mentioned 1�w, ac. Shp.—.'==---- Property tar inspection purposes. �� Dale: S7'/' 7y 2 Signature: —..a. Al, G� d .f '_'I 'n ' fi .. , : Driver's License or Social Security er • � - 164146 White—Building:Green—Code Enforce •r I;Canary—•.pticanC Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING - POOL A • 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, 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 X47. 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 Permii# ' 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating - •• _71. Product Piping 0 Gas 0 Oil , it 23..Gas Pipe-Rough$Test > - i_ `72. Underground Flush - - 1 24. Roof Framing • - - 73. Undergrnd.StorageTank DGaS ❑Oil d • 25. Roof Sheathing - 74.-Overhead Hydro • . 26..T-Bar Ceiling (Structural) & Monocoat ` _ 1 75. Dry Chemical - - _ 27.-Frame and Flashing. , - .76. •Dry Standpipe - • 28. Lathing& Siding . 77.•,FIXED SYSTEM FINAL • ' i 29. Insulation . • • In.'NFIRE PREY. FINAL 30. Drywall Nailing • _ I HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat. - I 79. FINAL INSPECTION- . t 32. Electrical Power Meter-Final . 130. 'FOOD CERTIFICATE ISSUED 33. Final Electric . NOt€s: , • 34. Final Heating & Air Conditioning I - 35. Final Gas Pipe-Test,: 36. Hood or Canopy - 37. Final Factory Fireplace - - I I . I . - '38.•Final Plumbing -• - - I t 39. Water Service-Final I 1 ' :40. Gas Service-Final - • I 1 I 41. Solar Domestic-Final - - Ii _ 42: Backflow Preventer 1 I Id - - 43. Backflow Irrigation - - 44. Landscape Irrigation System , . - • 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING " • ., .1 . - . 48. FINAL PLANNING - - - • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co I l I 51. CERTIFICATE OF OCCUPANCY - - No. Date w• PFibCTADDRESS: 171 E 17TH ST UNIT: A CITY-OF COSTA MESA - BUILDING PERMIT PERM NO: E 067303 j WS NAME: BARCO REAL STATE ADDRESS: 1545 VENDUGO RD #115 PERMIT NO: E 067303 PLAN CHECK NO: N GOVT: N SUPP : N GLENDALE 91208 CONSTRUCTION TYPE: IV-NR PERMIT TYPE : ELE PURPOSE; ALT 818 ) 500-7257 ARCH/ENGINEER: K C ASSOCIATES REG.RO.: C-0n,61 JOB DESCRIPTION : INTERIOR 1600SF TENTATIVE IMPROVEMENTS SQ FT: ADDRESS: 14076 PO BOX N TORRANCE CA 92503 CLAIM VALUE: CALC-VALUE: GROUP OCC : B-2 / PERMITTEE: V,N,J. CONSTRUCTION ( 213 ) 912-7542 ADDRESS: 122 S KILKEA DR COMMENTS : FOR " SCHLOTZSKY' S DELI" RE: #B67302 LOS ANGELES CA 90048 *******+E****ac****TEfE*****+E*****+E+a***** *******x******+Ear*+t•*******+Eras****iE***+eacx**it_ LICENSED CONTRACTOR DECLARATION: I hereby allirm that I am licensed under provisions of Chapter 9(commencing with Section Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. S E T BAC K S CITY LIC.: 061331 STATE LIC.:435772 ,�- CLASS: B f]-� Date: . { `L`'L_ Signature:_/&. rSR GAF ±` ( MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.Cl. LEFT: FT IN RGHT: FT IN LEFT : FT IN RGHT: FT IN POLICY ND.: EXP.DATE: COMPANY: PARKING REQ: PROV; PARCEL : 42542312 ZNE; REF NO: r ❑ Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> " Date: Applicant: ' **********************************-k**************************************************************** ' �' EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred(3)00)or ess). DEVELOPMENT ''S` E R V I C E S REQUIREMENTS I certify that in the performance o1 the work for which this permit is issued,I shall not employ any person in any manner so as to become r subject to the Workers'Compensation Laws of California. � r ZONING APPROVED BY - i' DATE: 7 Date: -Lt( � (CY LI Signature: / LThie NOTICE:If,alter making this declaration,you should become subject to the Workers'Compensation provisions oche Labor .n BUILDING APPROVED B Y • 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 pedprmance 01 the work IdAPPLICATION ISSUED B Y: 'a is-lie— DATE: - '^E L l�'( which this permit is issued(Section 3097.Civ.C). ' /A ! L., ***.N.*y.M.*******•9E****************j(.*************Tl.*.****.)(.yF********.y.*****.g {F.F ad-Wt. LENDER: / • " 4 .*******************************r************************************************ ADDRESS: /i LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for/the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement Chat he/she 6 licensed PERMIT g 1 0 0 pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business n 50 2 SMIP/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 live hundred dollars(5500). ISSUE FEE '175 . 00 I, as owner of the property or my employees with wages as their sole compensation. win do the work, and the BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ❑ structure is not intended or altered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 41 . 00 15 , 00 . 0 .00 56 ,00 56 . 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.If.however the building or • improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 56 , 00 OVER/SHORT; 00 for the purpose ol 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 56 . 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 contractor(s)license pursuant to the Contractors'State License Law(.l am aware **.**.y�*..***.*..y�*.**.k,*.*******,********,*.*.*i .1E,le***9E**,If**,1(,******************************** that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.&P.C. I N D I V I D U A L. F E E B R E A K D O W N for this reason: TYPE DESCRIPTION• O N UNIT COST TOTAL COST Date: owner: ELE 10 FIXTURES, LIGHTING S1 ST 20 EA. . 75 7 . 50 -1-- -I do hereby certify that t am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and ELE 15 RECEPT/OUTLET '" ' 1 ST 20 • EA, . 75 11 . 25 25534 and that I or any Insure building occupant will/win not(circle one)need to comply with said state codes and the requirements for a permit for construction or modification Iron theAlr Ouahiy Management District.Residential construction applications are exempt from ELE 5 RECEPT/SWITCH -' - 1 ST 20 EA, . 75 3 , 75 these provisions. ELE 1 SERVICES BELOW 600 'V & BELOW 201 AMP 18 . 50 18 . 50 - END OF FEES Date: Applicant: I hereby certily that t 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 for inspection purposes. "/ _ v� Date: P-}-4�4k Signature: }� DATE:105/25/9416 TIME: 16:10• 56.00 / Driver's License or Social Security x 164136 While—Building:Green-Code Enforcement:Canary-Applicant:Pink-Revenue:Goldenrod-Assessor •I`- CONSTRUCTION AND PLANNING j POOL .PA v (APPROVALS Permit;r Date I Inspector APPROVALS Perm t-1.5. Date Inspector 1. Temporary Electrical Service-or Pole r 52. Pool & Equipment Locate- - 2_Soil Pipe-Undrgrnd. __`- 1 53. Steel Reinforcement ` 3. klcctrina' Co^d_rt Ut• ity-Undrgrnd. F I 54. Forms 4. 5e-ctr-c_i Cnndu t•L''drar . I 155. Electrical Bordi'p 5. Stec! Reinforcement ( 56. Rough P1umh.ng 8 °,Lt-uri. 1..0, I 6. Electrical LIFER Gird 57. APPROVAL 10 COVER-GI, n'ItF 7. Footings - 58. Electrical Conduit Urur5^d. 8. Foundation 59. Gas Pipe, 0 Uruirr a ,Ts'. 1 . 9. ',hater Pipe-Urdrgrra. - 60. Backwash Lines,P T•zc, _it- - e 10. yructural Floor System 61. APPROVAL TO DECK ' 11. Property Sever Lire & House Connection 62. Backwash & Ric,: •F; :z' ; 12. Sever Cap 63. Heater & Vent-ci . • 13. Root Oro ns 1 Si. Plumbing Svsn'm-f-^al ---- - -- - -- - 14. Rougi.r Plumbing 65. Electricel4Final 15 Rough E.ectrical-Condu,t we p 166. Sr' . System•Finai I l • 16. Rough Electric Wiring ' 41 9 W r-encing & Acc:ss Aoo+c 17. Rough l'Lring SignAPPROVED FOR PLAS(E-.1043 i � 18. Rough Electrical-T Bar Ceiling B/�e i plc-e--- L. 69. POOL/SPA SYSTEMS FINA l y - -1 - - 1----- 12. Rauah Heating & Air Cordit•oning FIRE DEPT.REQUIREt..E&s'T ' 20. Roug`. Factory Fireplace APPROVALS Parniit ---_- 21. Ducts, In Structure 70. Underground Hyrlra - - ---- - -- - - - --- 22. Ducts, Vent"atm - q 71. Product Piping Gas O I- 23. Gai. P,pe•Rougn & Thst I O. Undernround Flu ^. -- - - - ` --- - 24 Rcot =gem;-.p -- - - - - f- 73. jndergrn.f.Sln::,g-T.. .. - - -- --------- - --- 25. Poof ShraU'i:nq i /4 Overread Hyuro 26. T'Bar Ceiling (Structural; & Monocoat I 75. Dry Chemical 27. Frame and Flashing ( 76. Dry Standp.c.- -- I --- - - -- _ 28. Lath.ng G Siang ( 77. FIXED SYSTE F'11AL I 21. Insulation 78. FIRE PRE V. F':eAL 3( f_Orywail i";a hng HEALTH DEPT. REQUIREMENT _ 3 . Plass- Brown Cat i 72. FINAL IN`Y CTIO s / 32 E'ectr cc iP, e ,.t-r-F.ra_-- - 0/471 50 FOOD CERT r iC..-c Shur ") -- __- _ I _ 33. Fina. Electric igotes.8.jry_,91 e ►-•"" S • 34. Final Heating & A.r Conditioning -R-\- � �o 35. "inai Gas P�paTe,t ---------- - ^ - - -- ---- -- - - --- - -- -- ---- - ------ - --' 36. Hood or G rJPY - --- - II - - -- `\ -- 37. Final FactoFireploce � Factory 38. Final Plumbing (..\_____. _ : 39. Eater Service-Final 40, Gas Service-I--:nc! i 41. Solar Domea:cF,rcl - 42. Backflow Preventer - -- ----_---_--- 43. Backflow Irrigation --- ---------_�- __ _ , 44. 'Landscape Irrigation Syst.rr - -- ----- _- -- --- -__ --- 45. Sound Attenuation - 46. Handicap Regulations -- -- ---- - -� - - -- - ------- - 47. FINAL STRUCTURE & BUILDING - 1 48. FINAL. PLANNI1,.- y 49. Electric f. - .,on - 1 50. C, - r. i . iuthern California Gas Co f . = OF OCCUPANCY No. _-_- __ Date ADDRESS a BUILDING:I 111 h 1 {'1H SI LINT: boo., CITY OF COSTA MESA — BUILDING PERMIT G?ILWSwMEly MOWN: .I. REAL ESTATE PERM NO: B 07 /466 ADOREsa:1545 N VERDUGO RD / 115 PERMIT NO: B 077466 PLAN CHECK NO: N GOVT: N SUPP : N LENDALE, CA UNIT 818-500-7257 APPL MumGADDxEss: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT A ieep roRE,+aINE!RDESIGN MATRIX ANO, C-4970 JOB DESCRIPTION : T/OFF REROOF W/HOT MOP SQ FT: 4 , 000 ARCM.OREIC,S ADDRESS: 730 NANDINA CT OXNARD CA 93030—M`10 CLAIM VALUE: 4 , 000 . 00 CALC—VALUE: 1 ' $0 . 00 GROUP OCC: A-3 / corlmACTaxaxAME:ROGERS ROOFING COMPANY ( 714 ) 995-2826 Ir.� CONTRACTOR'S MAI 4912 LINCOLN AV COMMENTS : "BAJA FRESH MEXICAN GRILL" REF:B 109 CYPRESS CA 468874 ************************************ *k**. ***************************** ADDRESS: 90630 ueNo' ZONING REQUIREMENTS INT: SETBACKS UCENSED CONTRACTORS DECLARATION:I hereby tint under penalty of perjury that I em licensed under provisions of Chapter o (commencing xL/lh'S3sor��p(nl]•�)d Division 3 d IMeus�dPd Pmisssi«u�oy s end pp CITY tic.Na)' -'�" ' UC.cuss:�- �y UC.No.: 4b � 7 /96 MAIN BUILDING ACCESSORY BUILDING FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN S-'f-e16 Contactor C i e lr #4 LEFT: FT o PARKING REQ: IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:I hereby affirm under penallyd perjury than em exempt from the C«eradon lemma law for a PROV: PARCEL: 42542312 INE: REF NO: lallowkp reason(Section]0315 Brensss end ProfessionsProfessionsCode:Any dY cc county which requires a enna to construct.elle.improve., dem demolish or repair any structure.Prior to u e,issuancalso requires the applicant for such permsme to file a signed statement that he or she PLANNING NOTES> is licensed pursuant to the provisions the e LicenseContracto (Chapletdractors law(Chapleta(commencing with Section d n]ODivision ion 3 the > . 7031,50 and Professions Codal«Inat heprshe e4emq therefrom and the basis ttM alleged exemption.,.My vblatnndSetbn *********************************************************************.**jE******* ]031.5 by any applicant lora permit subpas the applicant to a diol penalty d not more then five hundred dollars IS500D. ❑ I.as ea ner of the mo eny«my employee with wages as their sole compensation,will do the work.and the structure is m wended D E V E L 'O P M E N T SERVICES REQUIREMENTS or offered for sale(Section704,Business and Pmlesays Cods:The Coatradors License Law don nal apply to an owner d properly who bolds or an proves thee«,.end who doss such wrk liana or hent«dough he«her own employees.provided that such . improvements me not baendedor offend Ice sale.s.howewa,the building or impra rnenb sold within one mat dcompleton,the ZONING APPROV ED'BY : DATE: owner-builder xis have the bunion of proving he or she did not Said or Myers fon the purpose d sale) �j�� y- ❑ I.as owner d m the property.aeEchols y contracting with licensed sed contractors totheproje t(Section 7044.Business end BUILDING APPROVED BY : T/J /0'` DATE: ct./'V" Professions Code:The Contractors License Law does not apply to an owner of properly who builds or improves thereon and who ' contracts for such projects with a contractor(s)licensed pursuant to the Contractors License Law). • 'n'}`�_ _�`/j/' ❑ I am exempt under Section: B.A P.C..for this reason: iAfat********EO3NF*dZEiSEi***D*BiYEif************7E**AN**********************DiA41Tf*Ik**f�E*iE dF**** Date: Owner: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT: Y I do hereby certify Out I am aware 5 and understand the requirements d Cetdde Heath and Safely Code Sect ens 25505.25.533,end 25534,and thtl«any Mune building ompntwRl will not one)need to cam*wihssid Mae cedes and therquiranents lot BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a remit for mnsWd'on or modifretnn Iran to Al ly angement District.Residentilwatmdion appiWbm ere exempt from these PERMIT 87 . 25 provisbe. SMIP/NON—RES Date: Applicant: PLAN . 84 WORKER'S COMPENSATION DECLARATION:L hereby germ under penalty of perjury one of the following declarations: ISSUE FEE ❑ Ihave and MImantel,acertificate dcement tosaaLr .ebworkers'compesation,ssSection BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Coda for the pedormencednnwork ler Mich dMe,nl peisued. TOTALS----> 88 . 09 0 . 00 0 . 00 88 . 09 88 . 09 . 00 have end Ml meinten workers'compensation issuance.es required by Section 3700 of the Labor Code Sr the perfmnsnce d the work for whke this permit is issued.Myw«kemngaken irrard policy number are: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 88 .09 OVER/SHORT: . 00 Can"' 205 9G127G 01 /01 /97 BLDG87PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TO5 . 8TT 4 GRADING PLAN—CHECK Welt.PolicWelt. (This&Mian need rot S compbced I the puma is Mr one hundred dot=($t00(or less) O Ierllythet let theped«mmncedthew«klor whichthbCerra sed'I dug mat emplWanypenon in!Mmannersonto ******************************************************************************* become subject to the when'compensation laws d California.and agree that it I shah become subject to the wadies' compensation provisions of Swim 3700 of d the Labor Co ,I shallAh tonhcomplf.�,th those provisions. INDIVIDUAL F E E BR EAKDOWN •••-"-- Date: _lfApplicantha : jam" /(r Warning:Failure to secure workers'compensation coverage b unlawful,end shell eWlect an employerto criminal penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST e en civil fines w to one Modred Mouses dollars($104000),b addldon to the coal of compensation,damages as provided for In SFC 4000 REROOF BY VALUE COMMERCIAL NOZONE 1 . 00 4 , 000 . 00 Section 3703 of site labor Cod,Interleaf,and attorneys).feet As CONSTRUCTION LENDING AGENCY:I hereby affirm under penalty of peijry that there is dbthe oensmn lending agency for END OF FEES performance of the work ler which the ermi a issued(Section 3097.Cee.C) LENDER'S NAME: LENDER'S ADDRESS: I certify that have read this appliicationandowe that to oboes hd«nwicnecorrect.l agree toDamply with all dlynod wenryarddimtoes 01 'ii.� ' ':.i(I=!-r' r CT :_.:I and state len rel tip to building Contestation and hereby authorize representatives d this city b enter upon the ekes-mentioned propend - ''imeJdian purpmes'EF ROGERS L _ . /Y Prod Nene �/� r ] Dee: ..�/� % 1 'r / Seg re of Owner/Agent/Applicant/Contractor (5151 J5.WP) White-Badding&Safety;Green-fib:County-Appwg:Pink-Revema:Goldenrod-Assessor • CONSTRUCTION AND PLANNING POOL & ot'A ,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-Undrgrtd. 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. 1 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 glAy � 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 PREY. 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 1 47. FINAL STRUCTURE & BUILDING c/ti I 48. FINAL PLANNING 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date PROJECT ADDRESS: 171 E 17TH ST "IT' A CITY OF COSTA MESA - BUILDING PERMIT PERM NO: B 06730i OWNER'S NAME: BARCO REAL STATE ADDRESS: 1545 VENDUGO RD #115 PERMIT NO: B 067302 PLAN CHECK NO: 00265-94 A GOVT: N SUPP : N GLENDALE 91208 CONSTRUCTION TYPE: IV-NR PERMIT TYPE : STA PURPOSE: ALT ARCH/ENGINEER: 818 ) 500-7257 REG.NO.: ADDRESS: 14076 C ASSOCIATES C-aN961 JOB DESCRIPTION : INTERIOR 1600SF TENTATIVE IMPROVEMENTS SQ FT: 60, 182 14076 PO BOX PERMITTEE: CA 92503 CLAIM VALUE: 60, 000 . 00 CALC-VALUE: 60, 125 , 58 GROUP OCC: B-2 / PEflMI : ADDRESS:TTEEV, N,J, CONSTRUCTION ( 213 ) 912-7542 1 "22 S KILKEA DR COMMENTS : FORSCHLOTZSKY' S DELI LOS ANGELES CA 90048 +e+r* eE****±f*******+f************+r+e***+f************Tc+r**************+r+f*+e********ar** LICENSED CONTRACTOR DECLARATION: I hereby aflirm that I am licensed under provisions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T S 7000)01 Division 3 of the Business and Professions Code.and my license is in lull force and effect. CITY Llc./061331 pSTaiELIC.:435772 Y/; cuss B SETBACKS Date:_J .) L 4 signature:_tit-VP' _ _ l—s--.. MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: thereby affirm that have a certificate of consent to selhinsure ora certificate of Workers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN ' Compensation Insurance.or a certified copy Ih/reol(Section 3800,lab.Cl. LEFT: FT I N RGHT: FT IN LEFT: FT IN RGHT: FT IN I POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV: PARCEL: 42542312 INE: Cl REF NO: 0 Cenifiedcopy ishereby lurnished. 0 Cenifiedcopy isfiledwith the city Building Division. PLANNING NOTES> TENANT IMPROVEMENTS TO CONVERT A COFFEE SHOP INTO A > SCHLOTZKY' S. SANDWICH SHOP. Date: Applicant: ************************** ***************************************aE.iEAf**+'****** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed it me perm is for one Hundred(E700)or less). D E V E L O P M E N S E R V I C E S R E Q U I R E M E N 'T'S 1 certify that in the performance Cl the work for which this permit is issued,I shall not employ any person in any manner so as to become //77 subject to In Workers'Compensation Laws of California, � � ZONING APPROVED B Y �Q e �� Date: 1'-i--44 Signature: ! ,L,21r. ..,mel • DATE: ' �L�L�(,(4 NOTICE:II,alter making this declaration,you should become subject to the Workers Compensation provisions of the Labor BUILDING APPROVED BY : / Code.you must mnhwith comply with such Provisions or this permit shall be deemed revoked. DATE: p CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance al the work for APPLICATION ISSUED B Y; ,J • { which this permit issued(Section 3097.civ.Cl. ***************************************A' • • • • 'w .*• „ . ****D***** ��i� y,(** LENDER: ****************************************************************aE************** ADDRESS: LEGALIZATION: N F E E SUMMARY STRUCTURAL SEGMENT :Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTR I.0 •.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 I T 4 6 4 , 0 0 �,' repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed r. f pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business ,a r, SMIP/NON-RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 75 , 40 ” 12 . 63 any applicant for a permit subjects the applicant to a civil penalty 01 not more than five hundred dollars(S500). I S SUE FEE •`G, - I, as owner of the property or my employees with wages as their sole compensation, wit 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----> 476 . 63 0 . 0 0 75 . 40 552 . 03 552 . 03 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale. If.however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 476 , 63 OVER/SHORT: , 00 tor 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 464 . 00 j' / 12 . 63 ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon / and who contracts for such projects with a contractor(s)license pursuant la the Contractors'State License Law).l am aware *************************,***************'*************************************�* that prool of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.a P.C. IND IV I D U A,IY F E E BR EAKDOWN rot this reason: TYPE DESCRQTY /!.C R IP T ION UNIT COST TOTAL COST Date: Owner: '."-: I do hereby certify that I am aware of and understand the requirements of Calilornia Health and Safety Code Sections 25505.25533,and SFC 182 EQU-ALT COMM. AIR GOND -AVER . 69 125 , S8 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements lora SFC 60000 ALTER BY VALUE COMMERCIAL NOZONE 1 , 00 60, 000 , 00 permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from END OF FEES these provisions. • Elate: Applicant: I hereby certity that 1 have read this application and state that the above information is correct.I agree to comp),with all city and county ordinances and state laws relating to building construction and hereby autboriie representatives of this city to enter upon the above'mentioned property for inspection pWDoSes. �� Date: r LY — �7� Sgnature: rc. rO efht.pnte J• 01 00161070-00161071 TOT 476.63 Drivers License or Social Security K: DATE: 05/25/94 TIME: 16:11 1641.46 White—Building:Green—Code Enforcement:Canary—Appcant:Pink—Revenue;Goldenrod—Assessor AP - _ . CONSTRUCTION AND PLANNING POOL & SFA - - - --- -- - - - APPROVALS Permit Date Inspector APPROVALS Permit +� Date Inspector 1 . I crpere-y Electrical Service or Pole 52. Pool & Equipment Location 2. Sc • Poe hndrgrrd. 53. Steel Reinforcement 3. Elcclr:cal Conduit Ut.hty•Undrgrnd. I 54. Forms 4 5 eU tr cal Condu.!. ,rdry-" Bond i d 55. Electrical Bnng _i__--___I, 5. _'1. _c'u'r rnent I 56. Rough Plur,bing & Pressure Test I 3 Eluar.r.. OF ER Grad 57. APPROVAL.TO COVER•GUNITE I I 7. Footings 58. Electrical Corduit•Urdrgrnd. L__ c^u ! 6. clgt,om 1 58. Gas Pipe, v Undrun id., Test I I G. ;.pe-Undrgrnd. 60. Backe:ash l mous.P Tr,.p, 2 Unurnci 74-1 10. S' uct,ra! Floor System 61. APPROVAL TO DECK Frcpety Sc, , Line & Hz...c Connection 62. Q'cktvash & Pueeo'or-Fina' 1 2sa arCO2 G 63. Heater & Vent• incl ! 13. Poet Drains 64. Plumbing System • Final • . 21-,um, Plurmh;nn 55. Elcctrical;Fi".l -_-J__ ~'5 P-._.-2.i _;cctrical•Cona.r66. Solar Sysum-I'. .: -_____________4_ _________, -__- - - -----~y-- 1d, iRr tit Eier. t.tric C;irino i 67. Fencing & Acc : Approval , 47 RcLyh 71uing Sign 68. APPROVED FOR PLASTERING r8. 'n,ph Electriral.T Bzr Cen,ng Cg. POOL/SPA SYSTE:.,S FINAL -a 12 Re....h re,.t,ng & kr Condhroning FIRE DEPT. HEQUIREWiEN f 20. 79.42 i F.:story Fire;acL APPROVALS Permit ;r I 71 .JU^ U Structure 70. ,.dergrounu Flydro - - -- 71. Product Pining .-- Cr; "On 1 23.•Gzs Ppas Houah & Test 72. Underground Flush i i ?4. Reef Fram;nq ^i --- 73. Undergrnd.Starsnc Tank ' 1 Gas _O -r -- -- F--------- ---- - - -- -- --- --'- --- - - I 25. _.`r .th;cq I 74 O'.crh^ad Hyrax I 2'. L'2• .nq IStructurall E L:vweoat - 75. Dry Gremc. I I- 27 rr:.me and Flcirhing • ------ -----T 76. Dry Stand pip---- i 2E. Lath r.r at Sd,ng j 77. FIXED SYSTC • ?'^:AL 1 e?. --i' cm - - -II 78. ARE PREV_-H AL.-- - -- _- -- I ,7, Dr y: +,' :;Hing i y 4nY e HEALTH DEPT. REQUIRFW;ErtT F 31. P .imnr= Brown Co . 79. FINAL INS/ ICT!r'^v __- _____ - . _ _; 1 32. 'i'crr c:' Pot,...r '.'.ete .F .,e 1 r80. OOD CE!3'.1 ^ :'-. E ISSUED f 1 33. .= ,.s' Electric Notes: ,,tar, oft 41,01 1!- efieft 24. F nal Heating $ Air Conditioning 35 Rini: C,, Plpal.rst .L5/41-:-C °3 - __ - C36. Iiacd or Canopy _ I_ r V. Foal Factory Fireplace - T F_- 1 _35 F ^m Plumbing I- - --- --------- ------ - - I--- -"-- --- --- -- - -- -- - --+ � ?Si. :.etc- S?rvccu•Final • I 40. Gas Service-Final 41. Soar Domestic-Final 42. 9aekr:o Preventer 43, Ecc',flos' Irrigation 44. landsc.:pc Irrigation System --- -- 45. Sour.1 Attenuation 122. Handicap Regulations M� 47. FINAL STRUCTURE & BUILDING /P/01( /./Lff� I eia FINAL PLANNING ' c.zcTr is R-,lease to Edson --- -1 5C Gas Pete-Ise to Southern California Gas Co _-- 51. CERTIFICATE OF OCCUPANCY la Datr - f. PROJECT ADDRESS: 171 E 17:H. ,S UNIT: A CITY OF COSTA MESA - BUILDING PERMIT PERM NO; P 067305 OWNER'S NAME: BARCO REAL STATE ADDRESS: 1545 VENDUGO RD #115 PERMIT NO; P 067305 PLAN CHECK NO: N GOVT: N SUPP : N 4%; GLENDALE 91208 CONSTRUCTION TYPE: IV-'NR PERMIT TYPE: PLU PURPOSE: ALT 818 ) 500-7257 ARCHIENGINEER: K C ASSOCIATES REG.NO.: C-31761 JOB DESCRIPTION : INTERIOR 1600SF TENTATIVE IMPROVEMENTS SQ FT: ADDRESS: 14076 PO BOX TORRANCE CA 92503 CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 / PERMITTEE: V. N.J . CONSTRUCTION ( 213 ) 912-7542 ADDRESS: 122 S KILKEA DR COMMENTS : FOR " SCHLOTZSKY ' S DELI“ , RE: #867302 LOS ANGELES CA 90048 ****at****;'F************+E**+r******x*+E+t*aF*+6*+ ****+F?6******x-*******rt+6***********+E*** I LICENSED CONTRACTOR DECLARATION: I hereby attirm that I am licensed under prwtions of Chapter 9(commencing with Section Z O N I N G R E Q U I R E M E N T S 70X0)of Division 3 of the Business and Professions Code,and my license is in MI force and effect. SETBACKS CITY LIC.: 061331 STATE LIC.:435772 ce,- ` / Date:, J'J-4 % 1 signature:_ L '� MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or aceniticateofWorkers' FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT ' IN RGHT: FT IN POLICY NO,: EXP,DATE: COMPANY: PARKING REQ: PROV: PARCEL : 42542312 ZNE: h REF NO: - 0 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING -NOTES> irk 9v > Dale: Applicant: *********.************ie**********)f**************** **********ie****************** r, EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the rmit is Inn one hundred(s100)or less). D 1 E. V E L O P M E N T SERVICES LREQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ an/e,_so_n in any mann s as to become _ a subject to the Worker�sY"Compensatio/njLa`wJs of California. �t C.- KA (i/� ' - -`/C ZONING APPROVED BY --S DATE: 1 Date: 5:--al:- — ( —` Signature: /Lc�/he , NOTICE:If,allel'making this declaration.you should b come subject to the Workers'Compensation provisions of the Labor BUILDING r a PROVED BY . ,�I DATE: Code.you mu5zfoythWilh comply with such provisions or Ihis,permn shall be deemed revoked.' 4� I CONSTRUCTION I ENDING AGENCY: I hereby affirm that there is a o struction lending agency for the•peiformance of the work for APP L I CAT DN ISSUED BY: S N ;'J DATE- �I �� which this permiticii�dd(Section 3097,Civ.t). ��"� . �� ************************************* ******. ..y .*.****************** .�.********* LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E .-eS YU M 'M, .A R Y STRUCTURAL SEGMENT :N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 61 0 0 "', repair any structure,prior to its issuance,also requires the applicant for such permit to tile a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 25% ✓ ��_ 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(SSOO). ISSUE FEE 20,00 ' - 5 I, as owner of the property on my employees with wages as their sole compensation, wit 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----> 61 . 0 0 20 . 00 - 0 . 00 81 . 0 0 81 . 00 . 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees,provided that such improvements are not intended or ohered for sale.II,however the building or ,.•• (r f� .' I 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--> COITL-EC T ED : l, 81 . 00 OVER/SHORT: . 00 for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANI,C ' ' 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 8 1 , 0 0 � /y ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of property who builds or improves thereon -A ,,. ') and who contracts for such projects with a contractor(s)license pursuant tO the Contractors state License Law).I am aware ,*•,M*****************,******************IE.N,******,{f,****,*,**,Nlf*,lf*********************** that proof of their Worker's Compensation insurance should be provided to me. ❑ I am exempt under Section: B.A P.C. INDIVIDUAL `'F E 'E ” BREAKDOWN forEms reason: TYPETY DESCRIPTIO)S C R I P T I O Nv Q o .y UNIT COST TOTAL COST Date: Owner: i I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 2 SINK, KITCHEN' 7 . 00 0 14 0 0 25534 and that I or any fulwe building occupant will/will not(circle one)need to comply with said state codes and the requirements lora PLU 1 GAS PIPING $Y$ OF -I TO.-4 OUTLETS 5 , 00 5 , 00 permit for construction or modification from the Air uglily Management District.Residential construction applications are exempt from PLU 4 SINKS,LU 1 GAS RVICE VICER ) '4 F •-) 7 . 00 7 . 00 these provisions. PLU 1 SINKS, SERVICE / MOP • y' •'' 7 . 00 7 . 00 Dale: Applicant: I 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 END 1C FjE S.' ordinances and state laws relating to building construction and hereby authorize representatives of this city to enter upon the above'mentioned '_'/ ."‘ ! property for inspection purposes. / -' �'. Y v Date /a-tj—q ti Signature; r G S, C / ' I f. 01 00161067-00161067 TOT 81.00 Driver's License or Social Security 1 i. 164146 White-Building:Green—Code Enforceme ;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor • ' • ' •i• I DATE: 05/25/94 iIlE: 16:09 % • CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit-#- Date Inspector APPROVALS Permit Date Inspector 1. Temporary Electrical Service or Pole52. Pool & Equipment Locct on 2. Sod PiL Pipe-Undrgrnd. - �„�S ey,Jf. .� :.� 53. Steel Reinforcement I _ L 3. Electrical Conduit Utility-Undrgmd. 54. Forms 4. Electrical Conduct-Undrgrnrl. .55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Tas• • 6. Electrical L'FER Grad 57. APPROVAL TO COVER-GUS' Tr i :7. Footings 58. Electrical Conduit•Undcgrnd. 4 - ----- 1 - �--- , •8. Foundation 59. Gas Pipe. 0 Unuigrnd., Test I Hr • 9. Water Pipe•Uncirgrnd. t. ) 60. B ckv:osh Lines,P.Trap• ;' Undr rid I I 10. Structural Floor System - 61. APPROVAL TO DECK I` 1 T -I T . Property Sewer Line & Ho,<e Connection 62. Backwash & Reccptu Final I I - 12. Saner Cap 63. Heater & Vent-Final 13. Roof Drains II _ r G4. Plumbing System Fecal ( 14. ;'dough Plumbing Ci--t-471:46-1._ 65. Electrical-Final - t •-- 15. Rough Electrical-Conduit. 66. Solar System-Final 111 ' __ 16. Rough Electric Wiring i 67. Fencing &Access Ann.-oval T 17, Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I 19. Rough Heating & Air Condit.onirg FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Parrnit ;% 21. Ducts,in Structure 70. Underground Hydro i 22. Ducts, Ventilating 71. Product Piping Ll Gus r7 Oil 23. Gas Pipe-Rough & Test �' c s I 72. Underground Flus' I 24. Roof Framing 173. Urdkrnrnri.Stora,:'T_,k ;lGo+ . 25. Roof Sheathing I 74. Overhead Hydro il 26. T-Bar Ceiling (Structural & _n;coat i - - 75. Dry Chemical t__ - - - 27. Frame and Flashing ! 1 76. Dry St..tc!p ce I 28. Lathing & Siding - 177. FIXED SYSTEE, FINAL -I- t___ L29. Insulation ^_ 178. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREJ.1EI\ 31, Paster Brown Coot I 179. FINAL INSPECT Iffl I - -- -- ~---`- - - - 4 - 32. Electrical Pot-.er ?cent- i - I 30. FOOD CERTIFIC',i!_ ISSUED I 33, Final Electric I Notes: _ - - - t - --1--. - - ldDT-R ems. �, 34. Final Heating & /,.r Cm-, 1 on,cg _ ,{ -- Y-- - - --- - +---- 43.21,67-1¢-_ca-ru. e crcono_ A-tart4S 35. Final Gas Pipe-Test ..: 36. Hood or Canopy CO- 37. ._ 37. F.nai Factory F.-ap•ace . /Q _ Z e_t?L tZ6Z;/.vim - - - 38. Final Plumbing - 39. Water Service-Final 5-,3_d , 40. Gas Service-Final I _ 41. Solar Domestc-Fmzl 42. Backflow Prever ter -- ckf 43. Bacw trrgat'on --- - _--- -- -- - _--------- -- - -- -- 44. I Landscape Irrigation Svstair • 95. Sound Attenustmr 46. Handicap Regulations - --- -- - - , - ---- ------- - - -- - - - - - --- - - - - ! 47. FINAL ,TRUCTURE & BUILDING 48. FINAL_ PLANNING 49. Electric Release to Edison - • 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date PROJECT ADDRESS: 171 E 17TH ST UNIT' A CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 067304 OWNER'S NAME: BARCO REAL STATE ADDRESS: 1545 VENDUGO RD #115 PERMIT NO: M 067304 PLAN• CHECK NO: N GOVT: N SUPP: N GLENDALE 91208 CONSTRUCTION TYPE: IV—NR PERMIT TYPE; MEC PURPOSE: ALT 818 ) 500-7257 REc.NO.: ARCH/ENGINEER: K C ASSOCIATES C-4161 JOB DESCRIPTION : INTERIOR 1600SF TENTATIVE IMPROVEMENTS SQ FT: ADDRESS: 14076 PO BOX TORRANCE CA 92503 CLAIM VALUE: CALC—VALUE: GROUP OCC : B-2 / PERMITTEE: V.N.J. CONSTRUCTION ( 213 ) 912-7542 ADDRESS: 122 S KILKEA DR COMMENTS : FOR " SCHLOTZSKY ' S DELI" RE• #867302 LOS ANGELES CA 90048 *IE* **+E*4*****ip******Ir****kE*******4* *****x**+e************+EOE*********+r*******+r* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIR EMENTS 70001 of Division 3 of the Business and Professions Code.and my license is in full force and effect. : SETBACKS Ce uc 61331 STATE uc.: 4 3577 c" f B �,� Dale: a %( Signature: A � MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a ceniOcate of Workers' FRNT: FT IN REAR: FT IN FRNT : FT IN REAR: FT IN Compensation Insurance.or a cendied copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: EXP.DATE: COMPANY: PARKING RE • PROV: PARCEL : 42542312 ZNE: REF NO: 0 Certified copy is hereby furnished. 0 Certified copy is filed with the city Beading Oivision. PLANNING N TES> / > i Date: 44-4.1'1 Applicant: ************************************4**** ************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (IM section need not be completed if the permit is for one hundred(5100)or less). D EV ELOPMENT S E R•,V I C E S 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 (^' yl subject to the Workers'CompensationyLaws of California. �\ p vV ZONING APPROVED BY /T,. i Date: .l 3-4 — ! Li Signature: (C- rad lis. _..2 . — DATE: NOTICE:If,after making this declaration.you mould become subject to the Workers'COmpensatiOn provisions of the Labor BUILDING APPROVED BY 'L.. / DATE: Code.you must tonhwith comply with such provisions or this permit shat 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; 1-4• / j,;I DATE: �� (� which this permit is issued(Section 3097.Civ.CI ************************************.'1$r******* • ******************** *t****** * UNDER: ******************************************************************************* ADDRESS: LEGALIZATION: N F E E -S U. M. H ASR Y STRUCTURAL SEGMENT: N OWNER BUILDER DECLARATION: thereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMB ING ELECTRIC/1 MECHANIIC 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 t 49 :50 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed eL I pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business - ' I. l 2.5* SMIP/NON—RES and Professions Coder 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 penally of not more than five hundred dollars(3500). ISSUE FEE rt- ') 145 ..p 0 I. as owner of the properly or my employees with wages as their sole compensation. win 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——--> 49 . 50 15 . 0 0 0... 010 64 . 50 64 . 50 . 00 does not apply tO an owner Of a properly who builds or improves thereon,and who does such work himself/herself or through rte his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion,the owner win have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED •• ( 164 . 50 OVER 00 • for purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC "yil. '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 6'4 . 50 1 ]r ❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves thereon. and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware **.*.**.****.*.*.*.**.**.***.*.N.*.*.**.**{F*.*..x.*.*.**.*.{f" .�y 34*.*,*,*.• .4*******************************that proof of their Worker's Compensation insurance should be provided to me. KI ❑ I am exempt under Section: B.&P.C. IND IV IDUAL F—'E )E BREAKDOWN forthisreason: TYPE QTY DESCRIPTION Z UNIT COST TOTAL COST I do hereby certify that tam aware of and understand the requirements01 California Health and Safety Code Sections 25505.25533.and MEC 1 REFRIGERATION SYSTEM 1<a 100 rK ;BTU/H 9 . 00 9 . 00 25534 and that I or any future building occupant wilbwitl not(circle one)need to comply with said state codes and the requirements for a NEC 1 GAS PIPING SYS 1 4 �QUTL TS -''r; 3 . 00 3 . 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from MEC 3 INST HOOD W/DUCTS FED—'BI MEC 'EXHAUST 6 . 50 19 . 50 these provisions. MEC 2 VENTILATION FAN CONN ''O SINGLE DUCT 4 . 50 9 . 00 MEC 1 INST/REL FLOOR FURN W DUCT•ING 9 . 00 9 . 00 Date: Applicant: END_OFx FEES 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 mistucOon and hereby authorize representatives 01 this city to enter upon the above-mentioned properly for inspection purposes ill - / VT /'/�,, .0' 'Si Date: .T 1-4 - ci ti Signature: / L -14e t. eM47 .° 1 'a� DATE: 005/25//9016 TIME: 11069 61: 00T 64.50 Driver's License or Social Security x: 1 tB41d6 White—Budding:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor T CONSTRUCTION AND PLANNING - POOL & SPA I IIF ARPROVALS Permit dr Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location 2. Sal Pip_-Undrgrnd. 53. Steel Rcinforcemert I _ I 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ll ' -_~4. Elrctr cal Conduit-Undrgrnd. I 55. Electrical Bonding I 5. Steel P,,ntoreament I 56. Rough Plumbing & Pressure Ti:A i G. Electrnal LEER Gruel. 57. APPROVAL TO COVER-GUNITE 1. Footin}is 58. Electrical Conduit-Ururgrnd. i 8. Foundation _a 59. Gas Pipe, 0 Undrgrrd., Test t 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trcp, 0 Unclrnrnd i 10. Structural Floor System 1 161. APPROVAL TO DECK I I -- -~ 11. Pro ` pit ty Si aer Line& Hoes°Connection 62. Backwash & Receptor-Final I 12. Sewer Gilp 63. Hoatur & Vent-Final ---i +- ---I 13. co'pDrzin= - 64. Plumbing System � Friel � - -�, r-'4. Ro,:711 Plnmh,ng - 65. ElCctricaLFinal I- --- • -• - -J 15 rough Electrical-Conduit 66. Solar System-Final I I 16. Rcu.-h Electric Wiring + 5 67. Fencing & Access Approval ' 17. Rou;rh l':iimg Sign 68. APPROVED FOR PLASTERING 18. Sough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I 19 Rm.:ah Heating & Air cord:t.ioning FIRE DEPT. REQUIREMENT t 20. Ross Factory Fireplace I APPROVALS Permit =,' - ' 21. Ducts, in Structure Ii 70. Underground Hydro 22. Duets, Vent .atin -�- -----4-----45 71. Product Piping C.Gas Oil i I 23. Gas 'i t -,o.gh & Test - _ 72. Ur.ocrgrouno Flush -~ 24. loot Framing 73. Undergrnd.Storana Tank t'G.,< ".C, -7- - II11 ' 25 poen Sh:..,thing ---� - -f -- - --+ 7G 0'-rrt,cad Hvdro __ _r _� - 7E i-''Irr tcihnl IStructu-all & Monoceat ----_ --I 75. Dry Chemita! � -- I 27. F '.m^and Flashing I 76. Dry Standpipe- - `- --- -� - -- _ -- -'--- 28. ef,th rn to S ding 177. FIXED SYSTEM r-iNAL i - �- 29. Insu anon 78. FIRE PREV. FINAL -s- 30. D•vr-.alt ?:#1:1.ng HEALTH DEPT. REOUIigE:. E':7 31. PAstir dro:.n .^.a+.t -- --r-79. FINAL INSIECTIC': - - -- 32. 61ar,r_.1 P:C et ",:rte' F nal - - - ---- -t -- - r30 ?GOD CERT IS {f.Ai E: iSSUvr] - - I - --- 33. Fi"_I Electric - -- -- Notes: -'--- - i • I -;34. pinai Heating& Air Conditioning - -- _ - - - L 35. Final Gas Pipe-Test -_A = -_ ut Pry ti-e./7 - -_-:--,__ 36. Hood or Canopy Pr.S S - _ 170 r4l-'-vd-_ ' 37. F.oal FL story Fireplace 38. Final Plumbing i 39. Water Service-Final 40. Gas Sento-Final -' '- 41. Solar Gomcstic-tic-Final 42. Backflos^' Preventer ' 43. Ba chf'o:: Irr:gat:on 44. Lerdsca F-r- Irrigation System ------ -- --- -- - _ - , 45. Sound Attenuation ~-- -_-- --- - ----- - - -- - ' ------� -- ---- - --- - ------ --I 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING _ - -- _ 48. FINAL PLANNING 49. Electric Release to Edison - E50.. Gas Release to Southern Calitorn'a Gas Co 51. CERTIFICATE OF OCCUPANCY No.- Date IrPROJECT ADDRESS: UNIT: 171 E 17TH ST CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 068311 OWNERS NAME: BARROS, HERMAN R ADDRESS: BARROS ORFA T PERMIT NO: B 068311 PLAN CHECK NO: 02887-94 S GOVT: N SUPP ; N �� *JOHN �URNHAM & CO P O BOX 2027 CONSTRUCTION TYPE; PERMIT TYPE; STA PURPOSE; OTH ESCONDIDO,CA 92033 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : 2—INSIDE THE STORE WALL SIGNS SQ FT: 1, 000 ADDRESS: UNIT: CLAIM VALUE: 1 , 000 .00 CALL—VALUE: 1, 000.00 GROUP OCC; B-2 / PERMITTEE: SIGN TOPPERS INC ( 714 )458-1000 ADOgss: 22552 MUIRLANDS COMMENTS: "SCHOLTSKY' S " 2—NEON WALL SIGNS RE:#SB68309 LAKE FOREST CA 92630 *+6+N****+ex•*****+E******** r*******r*+E*******rfE***4*+e** *****r+t*5rk6****+r**r********* LICENSED Ci'TRACT'' IECLARATION: hereby affirm that I am li ensed under provisi• of Chap- t • ' ing with Section Z ONING REQUIREMENTS 7000)o u.• .on 3 of he Business and P•Iessions Code.and my I/nse is in lull •roe,nd elle . CITY ira 6r•'9 AT IC.: 63651 ' ` ` 3 XP: 07/94 S E T B A C K S rDae: I Signature:— W MAIN BUILDING ACCESSORY BUILDING WORK CO PEN•ATION DEC •RATION: I hereby atlirm that I have a cent icate of conse�•setbinsure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR: FT IN Compe ..ton nsura cc.on a ce died copy thereof(Section 3800.Lab.C). LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN POucYNO.: 115998• —94 EXP.D' E: 01 /0 /95 COMPANY: ,T• TE FUND I / PARKING REQ: PROV: PARCEL: 42542312 ZNE: REF NO: ❑ Certifies copy i• hereby turn'. ed. Q(Certified copy is file' 1 t he cit B (ding Divi . PLANNING NOTES> �\p �� ,r\ > / Date' Applicant: *******;:le*********************************************************************** EXEM' ROM ORKERS'COMPENSATION OECNflATIDN: (chis se • m:•no to completed if do per �• one hundred(5100)or less). E V E L O P M E N ;stint; E R V ICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person t manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY • • DATE: Date: Signature: NOTICE:U.alter 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 of the work for APPLICATION ISSUED B Y: DATE: (2 q t, which this permit is issued(Section 3097.Civ.C). ********************************************* *********************** ****** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Convenors'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 25 .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 of the Business SMIP/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN 16. 25 . 50 any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars($500). 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----> 25 . 50 0 . 00 16 . 25 41 .75 41 .75 .00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED: 41 .75 OVER/SHORT: .00 forthepurposeotsale). 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 25 .00 . 50 16 . 25 ❑ 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 projectswdlh acontractorls)license pursuant to the Contractors State License Law).I am aware *.**********.***************************,*.*******,*,******************************** that proof of their Worker's Compensation insurance should be provided to me. ❑ am exempt under Section: B.a P.C. I N D I V I D U A L F E E B R E A K D O W N for this reason: TYPE QTY DESCRIPTION UNIT COST TOTAL COST Date' Owner: SFC 1000 INTERIOR ILLUM SIGN BY VALUE NOZONE 1 .00 1, 000 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Salety Code Sections 25505,25533.and END OF FEES 25534 and that I or any future building occupant willwill not(circle one)need to comply with said state codes and the requirements for a permit lot construction or modification from the Air Duality Management District.Residential construction applications are exempt Irom these provisions. AI EXPIRED Date: Applicant: In.0 pleteInspections I hereby cer that have read this application and state that the" information•• ]�information is co ect. a• •mply ith all city and county ordinances •state axis relating to building construction and here •rize representati 'so y •!te u,•n the above'mentloned 1 I( Property to/sae tan Pile: 38th $Ig 01 00165161-00165163 T E�T 41.75 Date. _A._I A, Signature: h•_' I. .�4.���; DATE: 08/02/94 TIME: 11:56 Driver Lic nse or • ial Sec rity xi: 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL PA APPROVALS Permit Date Inspector APPROVALS Permit Date Inspector 1. ^mporary Electrical Service or Polen 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ro r_v', 53. Steel Reinforcement .•y a. z r _ ctri13,al Condi ij ility•Dndrgrnd trf 54. Forms ��`E G1lt`leei Conduit ndrgrnd. ri1 p 55. Electrical Bonding G7 = 6S t,5r SL2&5RRinforcea, TnD "CIx 56. Rough Plumbing & Pressure Test ti,..� :�. Hm m T �•.�1 gtrlwl UFE t -1;�. 57. APPROVAL TO COVER-GUNITE 1 - - c 'cSkEOtirlCs ',UG l.1 + 58. Electrical Conduit-Undrgrnd. •- _3� <' H 1 -1137..E, Fopndation SC 59. Gas Pipe, 0 Undrgrnd., Test c. 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. _4 n 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Ling-& Hope Connection 62. Backwash & Receptor-Final 'T C - 12. Sewerteap a. •,.. C1 63. Heater & Vent-Final 13. Roof Drains m It; 64. Plumbing System - Final a 14. Rough Plumbirig 0 T. 65. Electrical-Final 15. Rough Electric3 Conduit a 66. Solar System-Final • 16. Rough ElectricNdiring• G 67. Fencing & Access Approval 17. Rough Wiring Sign 4. 68. APPROVED FOR PLASTERING a 18. Rough ElectricajT Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT - l _• C. , ,-1 e' C E ': f• Cu 20.:Rough rrctory Fireplace • .c:u:1 f-- * O CI tr4 * APPRCn/AtSunCerctit 4 x ,r r. .f SX 1 z rr• .r..1' t S HCX * 0 Cc: CO/HE- '.' r C 0 21.;Quct3,inJSirtju'.turtej, 1 .. .. HS * S V -t - �0. tcergrp}tpery1ylo }: 22. _Ducts, V�rltiIutin¢' t CIS 4; S :a t kit. Product m.ir'dg 09.4; OOin ^ f nls 1 -1 r '1 a r71 g.-* r or 4 23. GasiRpeo 1 &'list l T r C x 1 1 I OG f O tt I [7S a m -.. K pr 2., Undergrsipdi Flusiy�r,r # F. O 24.rRooEFreming.. ,-'J* I E-i-1 ••i- Ct 0 t * S3..lndergrnc Storankr-T.ank 1 Gas 0 OP • ^.X nn, --• x .,l x •• I t1F0 X 25. Roo• ShQthing G I '' v X O r-• a y4•t y;lrhead Nydro, r 26. j'-Bary Ceiling (Strp:}urall & Moaocoat * a7 O m* * 75.:Dry Chemical - -S .. D 1. •-1s * '•n -1 r-,5 t 27.yrame and Fl hir T a, 4 Y r! x 76.�'y ScWnd rii^�r 0� ; s m Rf J _ ,� le V ...M O cr r. t+. . T_-'Cr~ - o n, .4, 8. 4-Lathing rtI Siding >. GI `11e;x G r- E •. "* * 77.CFIXED SYSTEM'* \IAL' t'" _ t �J- i'1 • .-. . t -1 ^t .;1^ X .+ n n ;29. Insulatid'rd �' ` e `D •• " x '' * t 78.#IRE PREY. FINIA1I : q cO • ra0. Drywall fdailiasl : z I' a w H N ALTHtfEPTA EOlifREt1ENT ; S i' ' • r I Ir . N__ 0 x "1 t t t *, 27,9.91NAL IN ' CTI( tC 71 O • 31. Plaster B Dw co3-'Y I i'IT 3 - I Y P PTtIrr r ._, tt32. •Electrica�'o �.r Meterrfrinal If nr r :u * t t80. tr"f00D CERTIFIOCIE 1990ED H; - S : •._ . 1 `7 r C }33. €ina7i7'EI A ric. Ce 1 C ' tr, x ' riilotf: -']S x t7 7 -44, 4 „.1 1 1 x `i x 4- y '1m A '? 0 Sm 4. p,,ina HeAing All ontiitionlr�S n * x * Q S ;1S x s m0 t i nt ..-• 1 }-.. V 5.3C5. rF�.inalt',as 'iperl'e �tv x t-. A * s ll Tro 0i-i t t• >t3 _ St •: x * 4 Cl . ..t1 f. Et. `36. 'fiood.or.anopy on z 1 ,•"7 4. * C1 r r F S Ct_. e •i;n M" -" ` T.}7 s )' 4. m 'nil r m ,.-rt •'37. 6SnaVFaoHtbry Firepi cti. : ;tea.. 4 m t 'I r t n 4, inm 4 1 X t•; r 0 c'x ez 1 •• •• :+i x t„ i . r• a 4 'C l•• ,38. FinaJPiugrbing ..r, cu i u * I. -* x S H X -s p .-, . T. ... -_, T . r.. 39. Watei:Service-FinaPP 1 :4 x i w t n arr: _. '- 0 AD. Gas Service-Fal 9* n * - H•+ • m I.1 '__ m t„mp' S # m I ' g* -, . %r'= 41. Solar DomesttW-Fi4et S C ,•• rF 0I * . 'C L- I-1 x .-1 0 01 t rri tc *' y to '"1N = X :C C 32. Backflow Preventer 1 * I * rtC :.'F • r 0 H 1 r i : , . nDNO r . 43. Backflow Irrigtion * a:S S * a trf-O x ') .� '" >r ti * * ; p; i * t'1 • Landscapg Irr,Watior System rpm; tr. r. •:) ci t7 , tQ cu ;u X0 x u ra fM . 3'E Z :•) : -C < ` '•`d r .` 1 ^.,C r r. 1L5. Sound Attenuation* 'CCE , it T. i- F F` 1 t', H ^-"H trgG t - n .3 t (TI to m* : F trr • HO lc . FndiwPSPIA 9ct'� '- m .. .. ..r . i a1 IationR`s ,,., _, {, lir r , M cC S . fl.) 47. EJNAL STRUCTURE & BUImING * ^ Ft ' y a: S^ 4 -n tr 4 t: H l- . r C * F 48. F�NAL PLAN<31NG: I ES-T, x n; i m m K r F `+ i .r 49. Electric Release to Edison i * : c Z C1 .nom * 0 X 0 ,0. Gas Releaa,,e to Southern Califoraja.Qas CD * * I- t- u 0 • :.m • x r? • a r1.4 X 11 [: 5.1. CEiRYIFICATE OF OCCUPANCVs ;. * . r F. t.o f r No. Date PROJECT ADDRESS: 171 E 17TH ST 0N1T' CITY OF COSTA MESA - BUILDING PERMIT PERM NO; E 068312 OWNER'S NAME: BARROS, HERNAN R ADDRESS: BARROS ORFA T PERMIT NO; E 068312 PLAN CHECK NO: N GOVT; N SUPP: N $JOHN BURNHAM & CO P '0 BOX 2027 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH ESCONDIDO,CA 92033 ARCH/ENGINEER: UNIT: JOB DESCRIPTION ; 2—INSIDE THE STORE WALL SIGNS SQ FT: ADDRESS: REG.ND.: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / PERMITTEE: SIGN TOPPERS INC ( 714 )458-1000 ADDRESS: 22552 MUIRLANDS COMMENTS: "SCHOLTSKY'S " 2—NEON WALL SIGNS, RE: #868311 LAKE FOREST CA 934--., + **+ +Er+r+r+rr:P:Px*r:r�P+r+P+ ********************:P*:P***:r:6+r*********:P:H********�P*,,ESP*:6:E�E�r*�k LICENSED CON CTOR I ECLARATION: I hereby affirm th. am licensee and r provision of Chapter 9(commencing with Section ZONING R EQUIREMENTS /000)of Divisi of I•' Business and Professions Code,army license s in II force a d ellen SETBACKS CITY C.• • 5f TE LIC.: 6365 I ' 4# 45 EXP: 07/94 Date: Signature. MAIN BUILDING ACCESSORY BUILDING WOBKE OMP' SATION DECLARATION: thereby affix ave a certificate of consent to self-insure or a certificate of Workers' FRNT; FT IN REAR; FT IN FRNT: FT IN REAR; FT IN compensatin In ii ance.or a certified copy thereof(Section 381 Lab.Cl. LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PDLICYND.: / 59985-94 EXP DA : 01 /0 /95 COMPANY: •.TATE FUND PARKING REQ; PROV; PARCEL; 42542312 ZNE; REF NO: ❑ Cenilier opy is he eby furnished. EX Certified rrr• ' ed with the I�, r :' i ion. PLANNING NOTES> Dale: eit/ Applicant: A ► A ******************************************************************************* EXE 'li FROM Wr•BE'S' DMPENSATION DECLARATION: (This section need no be cll.let:.if the r-rmit is for one hundred MOD)or less). DEVELOPMENT S ,E R V IC ES REQUIREMENTS I certify I at in the red ormance of the work for which this permit is issued,I sha not emplr .1 I: son in any manner so as to become subject to the W.kers'Compensation Laws of California. ZONING APPROVED BY , DATE: Date: Signature: 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 forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: DATE; i 2-i R N which this permit is issued(Section 3097,Civ.C). *.{ *{ *.***.******.******.*****.****.*************** ** * ***************** ***x�****** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION;N F E E SUMMARY STRUCTURAL SEGMENT;N OWNER BUILDER DECLARATION: I hereby affirm 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 30 • 00 repair any structure.prior to its issuance.also requires the applicant for such permit 10 file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 102 SMIP/NON—RES and Professions Code)or That he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by PLAN any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 1500 00 I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the BUILDING—D IV—> 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----> 30 . 00 15 . 00 0 . 00 45, 00 45 . 00 • 00 does not apply to an owner of a properly who builds or improves thereon,and who does such work himself/herself or through his or her own employees.provided that such improvements are not intended or offered for sale.If, however the building or improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS--> COLLECTED; 45.00 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 45 .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 contractor(s)Seense pursuant to the Contractors'State License Law).I am aware *************************************************************.**4444************ that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUAL F E E BR EAKDOWN ❑ I am exempt under Section: B.&P.C. • for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner ELE 2 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15.00 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 30 . 00 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. O Date: ,I Applicant: X \ `eet�0�5 I hereby certify th J'I hay:read this application and state clic above informa;pn is ci : .I our,'to comply 'Ili all City and county to\nSP 01 00165160-00165160 T�1 T 45.00 ordinances and Ile la .,elating tobuilding construction and yauthorize re 'sun.ive 0 this c to enter a the above-mentioned \ CQ p\e / DATE: O$/0.2/94 TIME: 11:55 properly Lr ••'ectio rurposes. sP A. • , Iflf ��(� Sig Date: W Signature: \ ilA `.' '� OF Driver's License or Social 'ecurity n: )at6 • 1641,46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL .?A APPROVALS Permit# 04te Inspector APPROVALS Permit # Date Inspector 1. temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. rt1 53. Steel Reinforcement H:1; ctrral Cond�Y'lltility-Uhdrgrncf t 54. Forms a CC :;,iifitiel Condu t,pndrgrntl. i 7 55. Electrical Bonding .;N DO r v-* M57 SfseX,RtinforceQ(ern 0 v 56. Rough Plumbing & Pressure Test .J n L.,_ cdpUF •Ir•�Nd, _. 57. APPROVAL TO COVER-GUNITE i"L.,_931:g. -r3l -f, !*2-I 4-i. -ts e- xT..4 *rr4s •"�S y 58. Electrical Conduit-Undrgrnd. `-. F ' opndation '' 59. Gas Pipe, 0 Undrgrnd.,Test 7 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. ✓• n 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Linn& Hoppe Conrction 62. Backwash & Receptor-Final n < 12. Sewer:Gap a / w ;, v y 63. Heater & Vent-Final 13. Roof Drains ( M 64. Plumbing System - Final 14. Rough Plumbing, O M. 65. Electrical-Final 15. Rough Electricrt-Conduit o 66. Solar System-Final _ 1 O. 16. Rough Electrio-Wiring -- 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18, Rough Electric=T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL I 19. Rough Heating &Air Conditioning FIRE DEPT. REQUIREMENT � . le , I•" " .. <. : C," f `7 C 7Ht:-• 'T, x . :rt 20.Rough Paton, F@:place I s .74 tn 4 j $ 0 0 o'* * caPPRONAt1S:DCPermit# * >f '1 S -t C Z* 1 >rn IiC * 5 1-1 7* * . C'0)ME, > t rq 21. ucr ,i rtStr�.Ztutjr. : f•-•E.-4 :[� * s �' '1'lc K `-D-]< t?7 s N �S`'� r * 1 • M..., r a M K * ^5 0. *dergr.co d<HYz 110 a M A S . , ., ^ :: r , r ,n: p ,. 22. Ducts, Vahtitating,* CJS x S 12* * M- 1. Product•*'+ iiig s &pit 1' ,1 ell* rn x r1 n Hy, 'k 6 4r,0 1 - z7 &p it to'7h &'T st ! 'x " �' I-.* x ,cc..,,,, t-1 i -''7 1`,., .� 4y C!1S f: :7 C < O*. w . 2, UndergrtN d, FIa•E �,✓J N r �' 1 y Ir. �'J - t;L' .' f 0 i- .-' e 24.L-13oo• F 4 ling• Nr I I-E. -•F c > 0 Cr * * Sri. Undergrnd?StoragltTank f Gas ❑Oil -4 na m _ x S $'' * '• -'t I (.;S * 25. Roc Sh9thing j# r v �:; 'd =1 7 Ira �q,-0verhead lYiydroBIF r -T c J i. r1 r. .1 r{. .. S L 26.�-Bati Ceiling (Struc{ural) &Penocoat * ^ a fit t 75.cry Chemical L.1 t I'"I C N .,� .- .. ptt S" 27.-Prameand Flashiti'r .a = 1;°-. I( * w * s rt7 CJ •-, :l •� . .G * c^ �+ +w* f 76.`DrY Stands:'ce t.'2, t 5 !-rl 5) c- x t 1. Z ` .0:-'1 r. ,. - 8. Lathing Siding n; c- 1C 4;4, g x K 77.0-FIXED SI`STEAMNAL* I J • _n ..I ..I 4. •-•. -,,Th qtr, * M n -n - %29. Insulatic r * r' " •• •` , At '1 I * * 78. y M * S * * EFIRE PREY. Flf�,q ; ;, '; ,� NMS t J is i o f w •r'7 ?0, Drywall (trailing 1 4 * * * M HHc EALTeEPT'R-EQt•1FREMENT rE , I rC-, I z r S I nes. * 1. Plaster B•f�"wn11 V f.Co t x v 11'•I tT' x I ** 49.rfINA L INkSCT1(3N' « J "' T • T. -32. cElectricafikw.. r Nieler5inal i t r" t. :u I it x tt0ti. It .;iFOOD CERTIFIC'A'SDISSUED HI 33.3n EIectri I + l C * ; I. * x <s r 3 c t`�lott:. :1,-, C7 ..t ct rf•13 I.I-+�.-i +' �. I�-- t'-., •�tL OIL I f . . .' 4.Ffltna`SHea#ing��r AiraConditiornlnyS ;� * Q •r<_. _•S Clx * S NC) ... I 0 7,: • n "''' i ' r 'K Ill 1--1nn t..... 1 .. 35. flinai-Gas''ipa�Teg* m ' * * f nos: s n ms * tr No �. ,* \ ` '•- x M .-* * 0 O r-I 4: try -r I * t 03 "•, . -*t•: -t6. s000r Garut* 7' ;. r 1 * * E -'fl y S it' I7. fRinaF-..facbry Fire dert . ' Sg -oz. ** to K 4 S it t - m I.. I F H * :t :c * .n m y Pi* x • If t C . = 8, Finaflfluntbing •.* cu I w f . Y * r.c S I.M m* a m, 39. Watel;Service-Fing+ i4 * i - * * f ctrl *' c; Ci 'C* x 1 * T. ; tr * >I til * M .ifD. Gas Service-Final;, rl it,-. S < n i 1 a x pv 0n k. l 3 .. - n: : n • ) % - . -,r ... ..' }Zl. Solar Domestic-Firto S C1 ••• t• is 1 -_* -.- <a "r * "y k ,r1 K I IT. f r .--+ C '."t*: n N ** J * d2. Backflow Preventer Y. F. N I I * M O/ Y.>F- * G I••: 3 3. f, : t . : x C1 -,Ey c. -, 43. Backflow Irriglition* M=S * * * irt- * 0 , * q•rR * * • F, w o- t� t....Y;f4. Landscape, Ir7''-Ipation;System x ny;� .r. .% m O a Of x x N N 'r,C.. r Y o.1 5. Sound Atter-Cation* : t:' -K Z F F* * t; 8M•tE-' er M CR) t;< t m I , k 7 .. •. * Cr1 r '71* 7 F Co `, • F..' * `',6. (FtandicapiRegtllatiorts M a ! * • 3 C y t c s x • y, I f Y < r O -" 417. EIINltt STRUCTUR* & BUICOING F I � , " 4 '1 CO S *.- -.. t I r trI K $ f I. ... -I 1 .3 48, £IN4 PLANNING t• I =.F-, it I ' * r ITI t*1 ' % F 49. Efectnc Release to Edison I t * , t M t '7 c I r I1.: > r1 vs, •C'I x J 1 K . K f J L. .. t Sb. Gas &lease to Southern California.Gas Co I ,a * F •-, 7, • --.m * 3 • 14 §1. CERTIFICATE OF OCCUPANCY' : * - S i7 -^o sc ~ >� No. Date fr-- PROJECT ADDRESS: 171 E 17TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 068310 GOVT; N SUPP: N • OWNER'S NAME: BARROS, HERNAN R ADDRESS: BARROS ORFA T BPERMIT NO: E 068310 PLAN CHECK NO: N *JOHN URNHAM 6 CO P 0 BOX 2027 CONSTRUCTION TYPE; PERMIT TYPE: ELE PURPOSE; OTH ESCONDIDO,CA 92033 REG.NO.: ARCHIENGINEER: UNIT. JOB DESCRIPTION ; 43 . 5SF LUMINATED 2—WALL SIGNS SQ FT: ADDRESS: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / PERMITTEE: SIGN TOPPERS INC (714 ) 458-1000 ADDRESS: 22552 MUIRLANDSCE?MMENTS: "SCHOLTSKY ' S DELI" LUMINATED 2-WALL SIGNS, RE:#5B68309 LAKE FOREST CA 92630 - - **+ ******** t*+tEE***r******** ESE********E *********************+t******************* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z ON I NG REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. SETBACK S c1TYLIC.: 056695 STATE LIC.: 6 36 5 1 2 cross: C 45 EXP: 07/94 } Dale: signature: MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARATION: I hereby affirm that I have a certificate of consent to self-insure or a certificate of Worker, FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation In..ranee a certified copy thereof(Section 3800.L..C). LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN POLICY NO.: '15: . 85-94 mum: 01 /01 /' COMPANY: 'T• • FUND PARKING REQ: PROV: PARCEL: 42542312 ZNE: REF NO: 0 Ce -`d co. is nrfur shed• IX is Iv. �thecity :uildingDivision. PLANNING NOTES> Date: �♦ ;.A Applicant: >/► ******************************************************************************* EXEMPT' WORKE'. COMPENSATION O RADON: (Thill need not it the permit is for one hundred ISIDO)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify I •eerier)/nce of th work f• which this permi d.I shall n�• y any person in any manner so as to become subject 4r orker�ompensat n L of C.'`r n . ZONING APPROVED BY : `� DATE: Date: A Signator, d� NOTI'}%t. : er aking this declaration.you should bee'ml Busied to the Wo• Compensation provisions of the Labor BUILDING APPROVED BY : DATE: Code. um f.. hwith comply with such provisions or is permit shall be 0 - revoked. \ `^ CONSTRUCTION LEN, NG AGENCY: I hereby affirm that there is a construction len. • •.ency for the performance of the work for APPLICATION ISSUED BY; 1 7 DATE: e 1.2- (f9.(4 which this permit is issued(Section 3097,Civ.C). **********************************************#tt��#FF************************lltt****** LENDER: ******************************************************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm 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 30 . 0 0 repair any structure.prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business 5 0* SMIP/NON—RES and Prolessions 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($500). ISSUE FEE 1500 1, as owner of the property or my employees with wa0es 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————> 30. 00 1 5. 00 0 . 00 45 . 00 45 . 00 . 00 does not apply to an owner of a property who builds or improves thereon•and who does such work himsell/nersell or through his or het own employees,provided that such improvements are not intended or offered for sate.If,however the building or improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve REVENUE DIVISION TOTALS——> COLLECTED: 45.00 OVER/SHORT: 0 0 for the purpose ol 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 45 . 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 contractor(s)license pursuant to the Contractors'State License Law).l am aware ******************************************************************************* that proof of their Worker's Compensation insurance should be provided to me. I N D I. V I D U A L F E E BREAKDOWN ❑ I am exempt under Section: B.&P.C. Mr this reason: TYPE QTY . DESCRIPTIO N UNIT COST TOTAL COST Date: Owner. ELE 2 SIGN/ OUTLINE_LIGHT SYS ON 1 BR CIRC 15.00 30 . 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 conicity 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: - Applicant: 1 hereby ertify .t I have ead this applicat n and state that the a.: e intrmation is x. ect.I agree to comply with all city and county EXPIRED ordinance a ••ate la IS 'aline too ildin onstruclian an.hereby tho'ereprese .i . of this city to enter upon the abov:•mentioned I��omplete Inspecti0 01 00165159-00165159 TELT 45.00 properly le etton p rpp�e�7 / DATE; 08/02/94 TIME: 11:55 (/( ►ia . 1 I Dale: Signature. 3at6 I1`_%ca.- Sig —fa a.-- Driver'• a—•— Dnver'• Lice, e or Sod,'Security•: 1641.46 Witte—Building:Green—Code Enforcement:Canary—Applicant Pink—• e:Goldenrod—Assessor 111111 COiJSTRUCTION AND PLANNING POOL ,PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. temporary Electrical Servrate or Pole v 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 2 < 53. Steel Reinforcement _ 4cSrcslal Con I�tJL ility-GndrgrntE't 54. Forms St sal COMITY]t ,E :Pndrg� rnnd I 55, Electrical Bonding ta5f 5t!dS !inforc i <7La r. 56. Rough Plumbing & Pressure Test a ..i, LArJrtt m . �.r'1 xS erica) OF E," th l.fthcod. ,.,1 57. APPROVAL TO COVER-GUNITE _'S��'in�s .^ate; v 58. Electrical Conduit•Undrgrnd. " St'-- F!gandation -5'5: `y 59. Gas Pipe, 0 Undrgrnd., Test •A 9. Nater Pipe•Undrgrnd. 60. Backwash Lines, P•Trap, 0 Undrgrnd. "-1 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line'& Hoche ConrneFtion 62. Backwash & Receptor-Final _n e H 12. Sewer-Bap "' .., .'a, ou c, 63. Heater & Vent-Final Ler t 13. Roof Drains '7 -r, 64. Plumbing System - Final ,e 14. Rough Ptumbin3 0 `T 65. Electrical-Final 15. Rough Electrict-Conduit 0 66. Solar System-Final s 16. Rough Electric-Wiring 67. Fencing & Access Approval 17, Rough Wiring Sign ` 68. APPROVED FOR PLASTERING 18, Rough Electric�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT l t , ; ,rt E 7 C �T tr rt.i- S a E• 73 20.;r.oiCh F' tory FLceplace I wn1 tE'-1 * 0 0 - * .a r.1APPRCCVAt9;02'ertmmit # x v , tr - 7a '� ..F2* t 'r x•-' * s M-1 7'I t :) x 5 .J 6.1 L. 2 c izit:, , 21.zn rJ i tr tutA* 1 E.E• MS ,-t '1 "1 * T .01< r * C•1 rsr Vit• �' I S * 5 � t-._ * 0. fader ga- diHv9'o ' 22.LDuct, V2ittic*tintt i :�St S-a S `4. * r,1. ProducttPa-Pa0't s D )il S I^. r. t„_Car t 1 v rt < Y Y ri I 23.`bas P1 pe o h &"1)st T ' �-t, -i r I t�S * Si C < or te r•:2. Undergrotmo Flgstr,aa , h -tr S.. * O ' � 24.;6'3oo$Framing• c4. t 5-IE•' ••f-,I 4. > O C' ` * * ,3.1YJndergrnc?.Stora •lank i° Gas DOia 25. Roti $he�thin9 � ' s * ?I nl •7 N.r * r 0 v ..E-1 r O r < . 6 * O 7 Ila, * -74.;'pverhead Hydro0 r a e -i C1. , t•I -J i + £ 26.t•Bsr1 Ceiling (Structurall &144 r co 0 * x 75.tDry Chem l J`a * 1-4 7 v 27.=frame an Flashi * 2 * m * ° 76.br Stan�,,��11"' •L2-,Z * S '1 7 q.-, ,,a t 0TH * C >• S* r Y �+Z ' N r S ,28. Lathing&Sidingmd .: '1'Q2 t>; r Z ••t• *. 77.u'FIXED S''GPEM"•cNAL$ V .4.: • r 4C c-. n * � I m r n r t•i ,7 i :29. Insulatig Or 0 ri •• •• > n + * NF}ly *r ,^.1* S ,. * r 78.iIRE PREY. FI7 .:, r., r.Itr z. :i 1. A. i ? s .l. v'7 i 1 r'30. Drywall flailing 1-t* I * 4 t~ HEALTHt 'EPT1REQUIREMENT 0 'l ., ( 1);. ** * r C c,: 1 1114 Q1. Plaster BTwn_Co 6 1' .r * r t-• �9. INAL IN�f'�F'CTI( ', * i7 r4 aa., Cc Cr r Q JK t-•r4 * 1 •6 ` 1.11•J r.7 , J L'^ -I 2. glectncai 'o:4r Ricec'Final d ru i ♦ D60.nIf000 CERT]FICATE)ISSUED y n 2<---ti.---Y---n-I-4-4,--a;- * ^, S4' 7 * Cr, * * m 7 •7Z * S Z33.'t`ina"'EIric• -Not : �, tri TJ . 'C:l55.,, .z1 4 r I r fi .:, 4-1'7 '7 T! ;. 'D F i7 '4.tF,inagHemingli .4if.t'djtiorpires n * "k • r 7.; qv -S ;'tx 4 S Nt7 5 .. -1- r --/ F Y i1 -inn n I '-4tf t_ >i 35. IRinif-Gas 1 Test * mN * I * r C.0•c 0n tas r r -dem I; V; fi * T t0 S • ••l 1 r. t•1 •�, ,16. too I or 4anopy Sr I rn *-7 n 1 I W r < E n0 * r o _ , a -.•* n • r C"1 rw - I t r rya ?; al l:m, 6r: 17. ' na7a#rY Firg1I)dt. r Sr ^, : :1 I 1J r Z n * "^ ,38. Fina{S�lumbing ?Ja co * I I ••fr i S it N ] _. .* .. -' •- T * 30. WatanService-Fine* .4" •! *x � I:. ,r >4 n ,�-' IC F-4 2 O. Gas Service-Final .,, m ,�.,,n. S :r ir1 I I* r 0;., Ord x :-1 r... . 4 v 4 • •-,T It a. TC1. Solar Domestic-FRal n •• * 0 I* r y0 I-' 1-i rn* C1 r * * cc rs.0 Cr 4t a: '42. Backflow Prevente:4 H ti):, * I i 1* t CC 7F.1 * d r ,'1. i �. r T 1 2j .10 * L .. 43. Backflow Irri 3tio'mp -g`SS * * ? a:t•-• x 0 -I r l r r•1 ' 3* tax r * r' ... r a .-.4. 4. Landscapg Irttpatigq;System 0 g; tv r m O G O V . S cu cJ i =:J . ri 0 45. sbund At enueti6oth .->~t, r -, ' x Y • : F,* * n "i,-i ^N SK a' „ J 5 1, n'I •• •• ••il f J / -iJ ••H i. . i3andicep`,tiei1latioras 3 * _ t c * tr, S S c.+0 s- 47. RINE STRUCTURE & BUICDING * I I I. * `i Cu:71 S en c r * 1- I !a z I e' a i-1 46. N J PLANNING.. I E.F," * pi r t m en r 4 4. 7 7 '': e 49. tonic Release to Edison 1 r I - " "' 1111 ' Z .. .. k 1 * 'rt •fa * t.i * r 5 v am v : ., Etas �elease to Southern Californjafras Co r. I �;. F •.-1 O o t'] v -OCCUPANCY-IFICATE OF OCCUPANCY- x . S' a .r,0 r Ho 0. No. Date FCTAODRESS: 1'71 E 17TH ST 0XIT: CITY OF COSTA MESA — SIGN PERMIT PERM NO; SB 068309 NER'S NAME: BARROS, HERNAN R ADDRESS: BARROS ORFA T PERMIT NO: SB 068309 PLAN CHECK NO; 02885-94 S GOVT: N SUPP; N %JOHN BURNHAM 6 CO P 0 BOX 2027 CONSTRUCTION _ TYPE; PERMIT TYPE: STR SIG PURPOSE: OTH ESCONDIDO,CA 92033 REG.NO.: ARCH/ENGINEER:DRSSJOB DESCRIPTION : 43 . 5SF LUMINATED 2—WALL SIGNS SQ FT; , ADDRESS: UNIT: CLAIM VALUE: 3, 000 .00 CALC—VALUE; 3, 000,00 GROUP OCC; B-2 / PERMITTEE: SIGN TOPPERS INC (714 ) 458-1000 A0°"E� 22552 FORESTMUIRLANDS COMMENTS : "SCHOLTSKY' S DELI" LUMINATED 2—WALL SIGNS L/ L r E C 92630 ***SE****;E;E;E;ESE;E+t*****�r;E+E;E****+6;E*+rx+t+e;6****+E**;r;E*;r***+6+r*****>ter*+r+r;E�E>E�r;E;Ea6**�r******* LICENSED CON ' CTOR 0 CLARATIDN: I hereby affirm that I : tensed under pr• ions of Chapter 9(commencing with Section SIGN I N F O R M A T I O N 7000)of Dlvisir• 3 01 the :usiness and Professions Code.and m li ense is in full I - and elect. DISTRICT.:_ 1 TYPE; WALL ILLUMINATION: INT CATEGORY: NEW CITY LI'.: 5 .S •TE C.: 636• li CLAS - C �45 DIMENSIONS : 1FT 02IN X 12FT 06IN AREA: 87. 00SQFT LETTER HT: 14 Date'. A Agi Signature: 111A.... ...earldk STREET FRONTAGE 1 : 390 .00 STREET 1 : E 17TH ST WORXE fir 0 PENS• ION DECLARATION: I hereby affirm that!have a certificate of ons•nt to self-insure or a certificate of Workers' STREET FRONTAGE 2 ; 445 ,00 STREET 2; ORANGE AV Compensation I surance.or a certified copy thereof(Section 380',Lab.Cl. PARCEL; 42542312 ZONE: Cl LOCAT ION > FRONT: X REAR; min.: 15,99 : 5-94 EXP. DATE: 01 /0 ' 5 BUSINESS NAME; SCHLOTZSKY'S DELI > LEFT; X RIGHT: COMPANY S : TE FUND OTHER TOTALS GROUND SIGN 0 Cenine• cop '. hereb furnished. '4' copy is filed with the city Building Division. THIS ACTIVITY 87 .00SQFT OVERALL HEIGHT: OFT OIN THIS SITE c 1 ,00SQFT GROUND CLEARANCE; OFT OIN ..7 Date: I / Applicant ITEMS OF INFO : 3 - PLANTER AREA: 0 , 00SQFT EXEMPTION 4 ORKER 'COMPENSATION DECLARATION: (This section need not be completed if me permit is for one hundred 151001 or less). COPYITEMS I ACTIVITSC: 3 HLOTZSKY'S DELI BLDG SET BACK: 20FT I certify tha :perform.nce of the work for which this permit is issued.I shall not employ anyperson in any manner so as to become FOR subject to the W•rkers'Compensation Laws of California. Date: Signature: PLANNING NOTES: NOTICE:If.alter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor ********************************'**'********************************************* Code.you must forthwith comply with such provisions or this permit shall be deemed revoked. DEVELOPMENT SERVICES REQUIREMENTS CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for t, which this permit is issued(Section 3097,Civ.C). ZONING APPROVED BY �)-{l7,YI DATE; el 2- / € "1 LENDER: ADDRESS: BUILDING APPROVED BY ; DATE; /n� OWNER BUILDER DECLARATION: I hereby affirm that I am exempt from the Contractors'State License Law for the following reason APPLICATION ISSUED BY: DATE: 8 ( 2 i 'l k (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct.alter,improve,demolish,or ********************************************** * * **************4****** *** ** repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars(S50). BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING I. as owner of the property or my employees with wages as their sole compensation, will do the work, and the PERMIT 54 .00 87. 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law SMIP/NON—RES does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through PLAN 3 5. 10 . 63 his or her own employees,provided that such improvements are not intended or offered for sale.If,however the building or peone year of completion.the owner will have the burden of proving he/she did not build or improve ISSUE FEE torthepurpose of sale). BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business TOTAL S----> 141 . 63 0 ,00 35 . 10 176 .73 176 . 73 .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 contractor(s)license pursuant to the Contractors'State License Law).I am aware REVENUE DIVISION TOTALS--> COLLECTED: 176 . 73 OVER/SHORT; , 00 that proof of their Worker's Compensation insurance should be provided to me. BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK ❑ I am exempt under Section: B.&P.C. 54 . 00 8 7.00 . 63 35 . 10 for this reason: Date: Owner: ******************************************************************************* I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and INDIVIDUAL F E E BREAKDOWN 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 Quality Management District.Residential construction applications are exempt from TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST these provisions. Date: Applicant: v n nn LNO FEES WERE SELECTED FOR THIS PERMIT I he •ry cer y t'+1 I axe read this app! aeon and state that we information is correct.I agree r comply with all city and county 11nCQm I r I R C D and nonce s d eta a I.ws re 1p bui ing construction and h ,uthorize r..resenl this ity r enter.m Ih' 'tinned #f A ere Inspec (ons — n purr rty mspecti.n rpose - ` n 01 00165155-00165158 TOT 176.73 j Date: fir/ signor e: ���A i &, )et !'1.1 f Ly Sig I DATE: 08/02/94 TIflE: 11:54 Driver�'nse or Social Security#: ` — I � 164146 (rule—Building;Green—Code Enforcement;Canary—Applicant;Pink—Revenue;Goldenrod—Assessor . ,\H-Th COftSTRUCTION AND PLANNING POOL ,PA APPROVALS Permit `r Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Servit a or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 'V r, • 53. Steel Reinforcement tactriczl CondPiF114lity-Ghdrgrnc7:'1 54. Forms ,C .rc�#ieel Condtt:Slndrgrnd, 1 m 55. Electrical Bonding ri 5r She-KR� vinforcen'1iwta •_•O 56. Rough Plumbing & Pressure Test ' Tom - - t6j W cal UFEP-, r1id. 57. APPROVAL TO COVER-GUNITE T :c R.: ort: ss C.' _ 58. Electrical Conduit-Undrgrnd. _Ilel 9 8 Foundation j O L.l 59. Gas Pipe, 0 Undrgrnd., Test 4. 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd. .• 10. Structural Floor System -. 61. APPROVAL TO DECK 11. Property Sewer Line-$, House Conne tion 62. Backwash & Receptor-Final 12. Sewer Bap 63. Heater & Vent-Final ,t co v j, 13. Roof Drains -L 64. Plumbing System - Final 14. Rough Plumbirig 0 65. Electrical-Final 15. Rough Electricyi Conduit 66. Solar System-Final c 16. Rough Electric1diring 67. Fencing & Access Approval co 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical''T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL o 19..Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT . •..v n.�. r 4s• ; c. ^' :;L=1 S 4 '- 20.[Rough Factory F (_eplace-,^.1-,F.q� ^E-s•p :7 t- 3 '9PPaG1(W,LS trt PEGSit`#'' '"' r )1 ... r T a- T n•-"t . n T1 rn yi K S -i :71'...< C3 yy SS^7.,t-, :-n 21. uGS, in tructur E- mitt Cis N TSr 4:: x 2 t� 7 * Ch .� te7.x = r.t*1[TISO CUN : S :a0.MAd7rground I-iyhhc' -i S k 22.DucG, VP✓ttilgting-.Y : ,t-+ r ••,vi•.3 Mt* 51.1'toill ct Piping ' s: 0t77 23. 'as,ipet�lo &'T st .,,qa " ^tzt t: c, 1: E�,., ug�i ••vOJ.ts ,„i ti r2.1JaigGrground Flusfb r,nv 24. ?ooyFr}aiing• UzE s s_tiE- c73. Utiargr741.Storage:Wank Cl -as' D'OiI p 25. RocirShe�rithing -Ex �,_.` c)CT] .. ut rl ,r 45` ,e?heaRkijvdrQ, V LF0 is 7^ 11 U.., t 1 0 l J+ r ..., S� 26. 4-Bac;Ceiling (StrpcLurall..$„MonS&n- t z W5.PIIfy Chemical ' 11 r 1-4 n 27.t rameaa Flawhin* r,et -2730 " " " -x * � 6.. YStadPe° T. FOO .4; S ;r, 28. 'lathing'Sibtng n;» --1';`:"4„:`.•� Mal •77. •PIXEDwYSTEM PrINTtL"1S 't: f _ 29. Insulati C'° �'�'u1T �1t n3 ••.,�,�V 8. FIRE F''' V. FINAL 1 m t Cr 30. Drywall Nailing .--1.5 -; '-.o 3 ^J OJOallINIMI I k .-HEALTHeEEPT.. RSQUIR+E'MENT n - r :"a M t7 cu;l1 N 'J l C �' ri1. Plaster BTgwncoat1* t, ",1 n ©t. FNAL IRISPECTIO�V� E; r ".> c• _ P' -tri:--=a--t-,.1 .., ., j2. lectrica ower I\gtr`�Flna:t -?n--, F $$ ap. FeCrD 08RTIF!CATE IS�ED t i i r. 1- x m r ,a ttt c' -7 n •-3. ' in Etta ,. 5. -, _ T { ote , E .1 -t:R * "' O N 24. Fina Heetingi ASF Conditioning, K I x 5,, ^Ix T 5 '7 i35. .�;inai'Gas 'ip&nTesttt t� 5 _ Il n xv .j;.:, T Cr -4 36. }1ookor J'1yanopy y .. NM E f [1�+ a; :� 37, f5naaetbrY Fire4acg. 'r:"T.r7.1 * rt hI L ;'i * to F 4 'na}:Plu'�nbin * 1 mn."T tJ * w I • 4. S '--, 39. Water:Service-FinaD?E -� • . 6-1 % 0 Ct * K ' SG 4` . M rt, ,; 0 ' t •-,..']i,N X 'C Ct .S rn'7 4 T. >. .. .L G V -, ..T tic '-',-..:61-..;i .. .. trV^.J * f L- • F ... Vo. Gas Slit-vice-Filial { 7,, < -- ,; -n 1 _ pro �v 4, .T ,o - •Cr: : v t� �.,r r rT m 41. Solar Domesti'pFinat r. Q-p1m m T Cfl l 4:L..- `� 42. Backflow Preventer .. F p t iC lc M* I , t t >E- ' s O �4. --1 .� 43. Backflow lrri9Htion 4 -rim - SSC T 4 �o xE--.t i ti ni�: IC t- n ..‘.• A W0. Landscape Irr,4ation7-SysieF.,• meq; , .. .. .- , ;tt O n Ge ; X. ,av t %u 45. Sound Attenuation " s rIc'11" r X H F+ t.- (r " -4 '"v K r. . H t>;i-• O * It1 .. .. ..r • ri._.. ••r, z. �. F(andicapt,flegy ations- .�r1 .. f'-r roc) CT. * S cc :: S • 0 , S t +. . P. • t r r' ' I I , r. ? r. * 47. EJN4L STRUCTURE & ateILDING 4 '-7 C.% S-.1 •' lV V, J 48. F�NALPLANNING.. ` `'<' • --.,TJ * N I Tin ^ tirt-, *--, F. �� 99. ieciric Release to E,,-7 "Nall _ t 01 ¢ le ' 5b. Gas Release to Southern California Gas Co i - i I - R, p, > •_• r., • t 1 ,, I1. CERTIFICATE OF OCCUPANCY T r. >• o• :ta -Co No. Date REs1 OFstwJn: 171 E 17TH ST — •uNT:-• B&C CITY OF COSTA MESA — BUILDING PERMIT ONNERSNTIIEIPKNOWN: BARO REAL ESTATE /t PERM NO; B 076791 A4pgES5: 1545 N VERDUGO RD UNIT 115 PERMIT NO: B 076791 PLAN CHECK NO: 00262-96 A GOVT : N SUPP: N 2LENDALE, CA 818-500-7257 • ).PPL.MAILING ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: STR PURPOSE: ALT ARcHrrclOREHaNEzm DESIGN MATRIX uc•Nc,; C-4970 JOB DESCRIPTION : 2400 SQ FT RESTAURANT T. I . SQ FT: 2, 400 ARCH.OR ENG.'S ADDRESS: 730 NANDINA CT O OXNARD CA 93030— 'T 910 CLAIM VALUE: 35, 000 . 00 CALC—VALUE: 36, 384 .00 GROUP OCC : A-3 / CpMgkamimmEJOBS BY BILL ( 818 ) 334-8011 caancroRSMMIaID 711 E HANKS ST COMMENTS : "BAJA FRESH MEXICAN GRILL" AZ USA CA 699670 **************�E�E�E�E *�E�E****** +E +E*�E�E****�E*�E�E�E�E*�E�E*+��EiE****�E�E�E�E********�E****sE�E�E�E�E�E AD°RE's' 91702 UCxo_ UMT: ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby tunder penalty d y perjury that I am licensed under prMdons of Chapter 0 SETBACKS train fi (commendrp with Section 7000 d DMsbn 3 of the BudneN and Professionsb m In full fpand CITY LIC.N 0667 uc.cuss: B � 4u NO.: e�1 EXP : /97 MAIN BUILDING ACCESSORY BUILDING '!/ FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN Date: �' Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER UILDER DECLARATION:I hereby NOnm under pendy of perhry that I am exempt from the Contractors License Law for the following reason(Section 7031.5 Busbies end Professions code:Any cty o county which nmdrse a permit to connect akar.Improve, PARKING REQ: PROV: PARCEL: 42542312 ZNE: Cl REF NO: antrenewWallathe PLANNING N TES> TENANT IMPROVEMENT TO COMBINE UNITS B & C IN VONS CENTER FOR licensed pursuant to the provisions of the Cwredos license Law(Chapter S(commencing with Radon 7000)d Division 3 of the > A MEXICAN RESTAURANT (BAJA FRESH MEXICAN GRILL) . sines and Professions Coder or that he orshepexempt lhoehamand the bests for then apehed exemption.Any violation d Section **********************************************************************_********* Ni.5 by any rofessio to a perms wrt*cts IM applicant to acre penalty d red more than the hundred dollen r15O3o. o I.as ovmer of the prepay ct my employees wth wages=thee sole compensation.will do the work,and the aucture is not inteneled DEVEL :O P M E N T SERVICES R E Q U I R E M E N =T,.S cc offered for sale(Section 7044.Business and Professions Code:The Contractors License Law does not apply to en?waned Propene , / who builds or inproves thereon, or end who does such work lamedhentor t through ough his her own empr ployees, ovided the'such I/ �/G improvementsintendedare not intended o offered fotab.If.however.the improvement is buddingimprovement sold within one year cf completion,the ZONING APPROVED BY �}' DATE: —3 /L� owner-builder will have the burden d proving he or the did rot bald or W improve for the purpose of e). /) Elra I.as owner of the pperty.amNh .elycarrsde iywithlrrd=dream mrmactocsawthe Peied(Sedbr7044.Business ad BUILDING APPROVED BY" : DATE: _ /-S— .,6 Professions Code:The Contractors License Law does not apply to an owner d property who builds Or improves thereon and who /2 . contracts for guar projects`wcontractor(s)with Scented 'u or('11`ead°cr' theia Contractorsm Lins Law). / 4; APPLICATION ISSUED .BY: ** . DATE: m ❑ I aexempt under er Son: B.A P.C.. this mann: *****************.******* * * *** ** *** **** ************* •** Dae: owner: LEGALIZATION:N F E E SUMM R YSTRUCTURAL SEGMENT:Y I do hereby certify Nat I am aware of and understand the requirements d Gnomes Health and Safety Code Sections 25505.25533.and 2553x,and that I o any Muss briding occupant wiAwa not w)rod m comply with said Nate codes and the requirements fix BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING a permit for wuaudion or mddcaMn from the Al Quaky Management Ditdd.Residential conWnctbn eppIWione are exempt frown these PERMIT 330 . 00 provisions. , _ y> Dale: App&cant: PLAN 53 . 63 SMIP7. 644 RES WORKER'S COMPENSATION DECLARATION:I hereby affirm wder penalty of perjury one of the following declarations: ISSUE FEE ❑ Ihave and wImeineinaWiWdconsent toseluwrefor worken'ooperatmesproidedfobySection 370044 the Lab« BUILD ING—DIV—> PERMIT ISSUE PLAN7CHECK TOTAL PAID DUE Cde.forthepdomancedteworklarMichwspermiiebsud. TOTALS----> 337 . 64 0 . 00 ..:53 . 63 391 . 27 391 . 27 . 00 jpI have and el meintab woken'compensation Imurvme.as required by Sedbn 3700 d the Labor Code.for the performance of the work l«whkhtia Pima"lstMY ni°"• nYite°s rot end pn°`y number at EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 337 . 64 OVER/SHORT: . 00 Carrier: 229 96U0014000 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Poky Number 7 . 64 maim dim need not be mmpdrad ri the permit is b one hundred dollars IStoo of feu.) L3 I certify that d wor at in the performance the k for which this pend b issued.I shall nottr nemploy y person b any roomer es armer to / become subject roe'wrosmmion levee d CeMornda and ogres Gra d I should become subject to the workers ******************************************************************************* ion ' section 3700 d the Labor Code,l forthwith anpfy those provisions. INDIVIDUAL F E E B R E A K D O W N ./..> Doe: - A� /J Warning: allure to secure workers' Son tonnage Is unbwnd,and shah to an employer criminal penalties and TYPE QTY DESCRIPTIO N• UNIT COST TOTAL COST civil fines t to ono Insulted thousand tiers(5104000).In addition to the cost ay compensation,damages as provided for In Seddon3706ofineLaborCode,Interestandattorney'shew SFC 2400 RES—INT. ALTER TYPE V—N ' —AVER 14 . 44 34 , 656 . 00 CONSTRUCTION LENDING AGENCY:I hereby arm abler penalty d perjury Oita Owe is a construction boding agency for the SFC 2400 EQU—ALT COMM. AIR COND —AVER . 72 1 , 728 . 00 performance ol he work for which this permit is issued(Section 3097.CN.C). END OF FEES LENDER'S NAME , LENDER'S ADDRESS: certify that I have read this application and date that the above information is caned.I agree to comply with at dry and county ordinances • ' and stale taws:elatiq to building construction and hereby authorize representative d the city to enter upon the above-mentioned property • for imp/WIfiov n©mxa. ryWoTSniJa ov y Name \ 1. X. Date: ?�/ wo Nan d /Are or / (5151-46.WP) While-&dmip 5 Safety.Green-Fle:Canary-Appicant:Pink-Revenue:Oddenrod-Assessor CONSTRUCTION AND PLANNING p1 POOL & A APPROVALS Permit# Date Inspector APPROVALS - Permit # Date Inspector 1. Temporary Electrical Service or-Pole 52. Pool & Equipment Location.f 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-U r�,lrrnd. 54. Forms 4; Electrical Conduit-Undrgrnd. '.., 55. Electrical Bonding - • _. . 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test " 6. Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings , 58. Electrical Conduit:Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd.,Test,,- 9. Water Pipe-Undrgrnd. r'7' 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 1 '-' 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Finale`,. 12. Sewer Cap 63. Heater &Vent-Final .sr' 13. Roof Drains 64. Plumbing System - Final . t 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 OGas boil 23. Gas Pipe-Rough & Test - 72. Underground Fluih • - 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil _ - 1 , 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 11-116-44. 75. Dry Chemical ' ` ` 27. Frame and Flashing 71-2.6-rip Qt 6- 76. Dry Standpipe - 28. Lathing & Siding `!' 'V 77. FIXED SYSTEM FINAL - . 29. Insulation - • 178. FIRE PREY. FINAL - 30. Drywall Nailing - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . 79. FINAL INSPECTION 32. Electrical Power Meter-Final .r 80. FOOD CERTIFICATE ISSUED 33. Final ElectricNotes: 34. Final Heating& Air Conditioning • - 3-ia.-L�/' a� J �i/ 35. Final Gas Pipe-Test , e [ ro t Y��_5,-(/,��- 36. Hood or Canopy • 37. Final Factory Fireplace - - 38. Final Plumbing • - ' ; - 39. Water Service-Final - - 40. Gas Service-Final •t 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations - 47. FINAL STRUCTURE & BUILDING S/(01../€6 i.,rS ' 48. FINAL PLANNING f • 49. Electric Release to Edison '-' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date MESS OF MONO 171 E 17TH ST — +IMT: .. B&C CITY OF COSTA MESA — BUILDING PERMIT wlNEwsicVni MC.Y+:BARCO REAL ESTATE ,ERM NO: F 077138 ADDRESs:1545 N VERDUGO RD • UNIT 115 PERMIT NO: F 077138 PLAN CHECK NO: 00691-96 L GOVT: N SUPP : N LLENDALE, CA 818-500-7257 APRL.MMura ADDRESS: CONSTRUCTION TYPE: V—N PERMIT TYPE: FIR PURPOSE: ALT . • ARCMTkTORENrsNEET:DESIGN MATRIX ucto.: C-4970 JOB DESCRIPTION : 2400 SQ FT RESTAURANT T. I . SQ FT: ARCH.OR ENG.'S ADDRESS: 730 NANDINA CT wit, OXNARD CA 93030-1910 CLAIM VALUE: 1, 800 . 00 CALC—VALUE: GROUP OCC: A-3 / mA co CT0WsNAM FLETCHER FIRE PROTECTION ( 818 ) 666-0184 CONTBACTORSMNUNG 1075 MORENO DR COMMENTS: "BAJA FRESH MEXICAN GRILL" ANSUL SYSTEM INSTALLATION, #B76 AOOREss:OJAI CA uclo.: 596907 *****+titit4*it************itiE*etxit*+e**iait*1t****It*****u*+ +F**It**SEiEit********it7FiFiFlt*at****st 93023 USW; ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby alum under penaly of perjury that I ern licensed under provisions of Chapter 9 SETBACKS (commencing with Section 7000)of Oiwion 3 of the Business and Professions Code.and my T nee is in full force end effect. uc.No.05647� uc.cuss:C 16 uC 59 9 EXP: 00/00 MAIN BUILDING ACCESSORY BUILDING / FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN D // f Conrado: e, S6t �� LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN NER BUIL ER DECLARATION:I hereby affirm under penaly d perjay that I em exempt from IM Contractors License Law for the lowing reason(Section 7031.5 Business and Professions Code:Any city or county which requiem a permit to construct.alter,improve, PARKING REQ: PROV: PARCEL: 42542312 Z NE: REF NO: demolish,or repair any structure,prior to m issuance.also requires the applicant for such permit to file a signed statement that he or she i licensed pollutant to the prwui ns of the Contractors License Law[Chapter 9(commencing with Section 7000)of Derision 3 of the PLANNING NOTES> tineas end Professions Coda)Of that he or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > 11.5 by and applicant fore permit subjects the applicant toe civil penalty of not more than five hundred dollen MOOD. ******************************************************************************* L] I,as owner o the properly or my employees with wages as their sole compensation,will do the work.and the etmdure is not intended D EVELOPMENT SERV ICES R EQUIREMENTS or altered ler sale(Section 7044.Business and Professions Code:The Contractors license Law does not apply loan bwnerof property who builds or improves thereon,end who does such work Nmset or herself or through his or her ovm employees prasded that such improvements ere rot intended«offered for salt d.however.the building of reesnt u inpmesob onal withineof wmpbtion,Ihe ZONING APPROVED BY DATE: owner,buAler will have the burden d proving he or she did not build or improve for the purpose of sate). ❑ I,as owner of the property,am exclusively contracting with licensed contractor'to cornered the project(Sectikn 7044,Business and BUILDING APPROVED BY DATE: Professions Code:The Contractors License Law does not apply to an owner of propertybuilds a Wbuilds improves thereon and who contractsfor such projects with a comrador(s)licensed pursuant to the Contractors License Law). exempt n ❑ IamwderSeo : B.3P.c..roNresew": APPLICATION ISSUED BY: DATE: *************************************** * ********************** *6 Date: arse LEGALIZATION:N F E E SUMMARY STRUCTURAL ME T: N Ido hereby candy that 1 am aware of and understand the requirements of California Heath end Safely Code Sections 25505,Pcsgl,and 25534,end Mal I or any tenure building occupant wig I we not(circle one)need to comply with said state codes and the requirements for e permit for mwmcticn o modification horn the Ar0yvanagemerr Olde .Residential constngkn applications are exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING provisions. PERMIT 41 . 00 Dae: Applicant: PLAN 2665%5% SMIP/NON—RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the blowing declarations: ISSUE FEE ❑ Iha"and wiimaintain cenirratedeonanitosedinsurebrwoke°'canp anon,mprwidedfubySeabn37o0dtneLabo BUILD ING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE Code.for the performance of Na work for with this permit is issued. TOTALS----> 41 . 00 0 . 00 26 . 65 67 . 65 67 . 65 . 00 ❑ 1 have end w maintain worker,'compensation insurance,as required by Section 3700 of the Labor Code.for the performance of the work for which this permit is issued.MY waken compensation insurance Caner and po&y number are: Caner: REVENUE DIVISION TOTALS--> COLLECTED : 41 .00 OVER/SHORT: . 00 Policy Number BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK Is section need nor be completed I the pemrx is for one hundred dollars 1$f0ol or less.) 41 . 00 HI candy that in the pedonnenee of the work ler which this permit a issued,I shall not em person in any mane°to become sniffed to the workers'compensation Owl of Ceidoma agree 1 baconw erhoject totIPhener waken' ******************************************************************************* e«nnen san n pawner oSwimSim 3700 of the Labor Code, hwnh ww, «a. INDIVIDUAL F E E BREAKDOWN r# '7/(79; Spoken Ole P_co *ming:Failure to secure workers'cor tnsaUon coverage Is unlawful,and shall*select an employer to admin.;penalties end TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines W to one hundred thousand dollars(slogan In addldon to the cost of compensation. ensation.damages as Provided for In saad7a on3goddLabor tb ereeandemeyad«aFIR 41 FIRE EQUIP FEE ( FROM BLDG VAL TABLE) 1 . 00 41 . 00 CONSTRUCTION LENDING AGENCY: I hereby affim under penally of Porten/that there ie a construction lending agency for the END OF FEES performance of the work for which this permit is Owed(Section 3097.Ch.C). LENDER'S NAME: LENDER'S ADDRESS: j✓ :0l I certify that I have read this application and stale that the above information is cored.I agree to comply with all city andcounty ordinances ,y and state laws relatig to building construction and pr hereby authorize reesentative°of this city to enter upon the above-mentioned properly ^ for inspection rposes.CESAA EU 0. 11 ' 2. —, pu • Wit'_ ',7 Sig .urs dOhwher/AgenuA.. Date f/��9y__. 1 (5t51-46.WP) Whiteg A Safely preerk+ve:C. . .. ww Pink-Ren:Goldenrod-AssesWhite—Mawn CONSTRUCTION AND PLANNING / J POOL L a a APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location, • 2. Soil Pipe-Undrgrnd. - rr 53. Steel Reinforcement -3. Electrical Conduit-UNlityUndrgrnd..- 54. Forms r y . • • 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding .5. Steel Reinforcement 56. Rough Plumbing & Pressure Test - - •-Q- Electrical LIFER Grnd. 57. APPROVAL TO COVER-GUNITE . - 7;-Footings ' _ 58. Electrical Conduit-Undrgrnd. fig, Foundation 59. Gas Pipe, 0 Undrgrnd.,Test . ' ' 9.-Water PipeUndrgrnd. ' Y 60. Backwash Lines, P-Trap, 0 Undrgrnd. 10. Structural Floor-System 61. APPROVAL TO DECK 11. Property Sewer Line& House'Conn"ection - 62. Backwash & Receptor-Final . 12. Sewer Cap - 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final r 14. Rough Plumbing 65. Electrical-Final I ' 15. Rough Electrical-Conduit 66. Solar System-Final 1 • 1 16. Rough Electric Wiring _ - 67. Fencing & Access Approval -.17. Rough Wiring Sign (: 68. APPROVED FOR PLASTERING s 18. Rough Electrical-T Bar Ceiling69. POOL/SPA SYSTEMS FINAL 19. Rough Heating,& Air Conditioning• 2. - .. r FIRE DEPT. REQUIREMENT ,-r 20. Rough Factory Fireplace • z, a a - 7.i` ^ APPROVALS Permit# - - 21. Ducts, in Structure 70. `Underground Hydro 22. Ducts', Ventilating ' ,t 11 ; 71. Product Piping E1,Gas 0Oil - I 23. Gas Pipe-Rough & Test - _ '_ 72. Underground Flush • • 24. Roof Framing '_ _ _ - `.� i 73. Undergrnd.Stor)ge�Tank.OGas CI Oil 25. RoofSheIthing • _ r - • 74. Overhead Hydra 26. T-bar.Ceiling 4Structura0 & Monocoat 755, Dry Chemical - 5-: 1- _ 27. Frame and Flashing - y•. 76. Dry Standpipe a•'-- 28. Lathing&Siding . _ ' • + _ r 77' FIXED SYSTEM'FINAL - ' - 7j-141 p 29. Insulation- _, 78? FIRE PREV. FINAL 5/'9� 30. Drywall Nailing .1 - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - ' 79. FINAL INSPECTION _ - - ' • . 32. Electrical Power Meter-Final - 80.- FOOD CERTIFICATE ISSUED 7 33. FinaLEleciric4 , ' .- • , Notes: - •_ - 34. FinaHeating& Air 'Conditioning - - - - -- - 35. Final Gas Pipe:Test ' ' ,• ' - - _ 36. good or Canopy - - r- ' - - - ' ';Y 37. Final•Factory Fireplace_ ,� zi, . ._ 38. Final Plumbing • r- - 39. Water Service-Final_ - .- 7/ , 40. Gas Service-Final - - - • - • • _• -'41. Solar Domestic-Final ll, 42. Backflow Preventer _ - 43. Backflow Irrigation �. 44. Landscape Irrigation System 7 1 - + - - -' ' c' - 45. Sound Attenuation - ' _ ': ..` 46. Handicap Regulations - r . 47. FINAL STRUCTURE & BUILDING t. _ J - 48. FINAL PLANNING - - 49. Electric Release to Edison - • 50. Gas Release to Southern California Gas Co ' 1 '• - 51. CERTIFICATE OF OCCUPANCY No. Date . ADOBES :ommu 171 E 17TH ST DMT: B&C CITY OF COSTA MESA - BUILDING PERMIT 04NEfNANElvlwwm, BARCO SEAL ESTATE "PERM NO: P 076795 ADORES& 1545 N VERDUGO RD UNIT 115 PERMIT NO: P 076795 PLAN CHECK NO: N GOVT: N SUPP : N LENDALE, CA 818-500-7257 ]PPL.IWUNO ADDRESS: CONSTRUCTION TYPE: V-N PERMIT TYPE: PLU PURPOSE: OTB ARCNRECT OREIaNEER: DESIGN MATRIX UGNC_ C-4970 JOB DESCRIPTION : 2400 SQ FT RESTAURANT T, I . SQ FT: ARCH.OR ENG.'S ADDRESS: 730 NANDINA CT INT: ' OXNARD CA 93030-1910 CLAIM VALUE: CALC-VALUE: GROUP OCC : A-3 / CONTRACTORS NAME: JOBS BY BILL ( 818 ) 334-8011 CONTRACTORS MARINO 711 E HANKS ST COMMENTS : "BAJA FRESH MEXICAN GRILL" / REF B-76791 ADDREss: AZUSA CA UC.NO.: 699670 *****+E**4******+(- -u-****+(-u-x-x-******'x**x-**+e****+r*u-*'>E****** -****+ESE**'N-***it-*iE**'SEN* -*** 91702 ma ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby elfim under penaly of perjury that I am licensed under provisions of Chapter 9 SETBACKS (commencing wiih Section 7000)01 Division 3 d the Business and Professions Code.and my license is in full force end effect ern'uc.No.: 066718 UC.CLASS: B U 69 70 EXP: 01 /97 MAIN BUILDING ACCESSORY BUILDING __ - ( ���4 Caamaa FRNT: FT IN REAR: FT IN FRNT: FT IN REAR : FT IN Dat / LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILDER DECLARATION:1 hereby mom under penaky of that I am exempt from IM tre"m License Lew la the following reason(section 7031.5&nixes and Pmleaafom Code:Any dry a county which requires a permit to construct.Seer.improve, PARKING REQ: P RO V: PARCEL : 42542312 Z N E: REF NO: is I�°ensedh.°rpurrsut any theprovisionsof the arm lalso yse Law[Chador°00ficart 9(momnemp to file Section de1Ae1 iDrv'wsionh3 of the PLANNING NOTES> �/ Business and Professions Code]or that he a and is exempt therefrom and the Was la the alleged exemption.My Volution d Section > • •• ICC) 7031.5 by anyappEcad for a permit subjects the applicant to Sold penalty drot more Nan feta hundred doners]SSOOB. ******************************************************************************* ❑ I,asowrwdthe pr°penyartryamplo/amwill wages as their sole mmpacmtgn,Wdothe wok and the salami snot intended D •E V E L O P M E N T S E R V I C E SV' R E Q U I R E M E N T S or offered la sale(Section 7044.Business and Professions Code:The Contractors License Law does not applyloan owner d property who bulds or improves thereon.and who does such work hsnsen or fermi or though his or her own erbployees.provided That such • A - n' ma umpnneree we ad Sanded a deredlaW.D ° .Mann'the bdtl'upa inaerwmid wnswAManeyerdcompMan.1M ZONING APPROVED BY -. DATE: owner-builder will have Ihe burden of proving he or she did net build or improve for the purpose of sale). ❑ I,tlowwerelthepmpa"y.amexd'mvaycantrad"gweh keesed ceneaM"te"tanhe Proiad(Sedion 7O44.B"sineee and BUILDING APPROVED BY : ' DATE: Professions Code:The Cont as License Law es not apply M d an owner property who builds a Middles thereon and who contracts for such projects with a contractor(s)licensed pursuers to the Contractor'License Law).this matron: /r(/.� t' 11, ' ❑ Section:Iemexempt under B.aP.C..er : /�/ APPLICATION ISSUED BY: r\ /V . DATE: •3 '_ ************************ ** * ** . ** ic****** ************* *' ** De1e1 Owner: LEGALIZATION:N F E E S U 'M ' R Y - STRUCTURAL SEGMENT: N I do hereby cenity that I am aware d and understand the requirements of Cellons Health and Salary Code Sedions 25505.25533.end E ..../ I ' , - 'LI. = f- 7 !Id (".. c"- 25534,end Nat I or any future building occupant win/will not(circle one)need to comply wth said eons codes end the requirements for a permi foroon°vudion or modifwatbnhem the Ai uegemw"Dianic.Residentialwmw nudion appiian n° asemp from diem BLDG PMT PLUMBING ELECTRIC, MECHANIC ; FIRE - SMIP/RES GRADING provisions. PERMIT Residential7', 00 - - • Date: Applicant: _ 25% • SMIP/NON RES WORKER'S COMPENSATION DECLARATION:I hereby dfvm aider peneby d d per)wy ams the following dedemi:ins: PLAN e . ISSUE FEE 20 , 00 ' ) ! , ' o Ihaveand wad omins,• neadeoasahLam loNOefaworkerimcpaen .nprovided labySeion370odthLeba BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK ' .-TOTAL PAID' DUE ccde.for the pedmd aenaNawakl«wi this permit issued. TOTALS----> 97 . 00 20 , 00 0 . 00 117' 00 ' 117 . 00 . 00 fl I have end dl maintain workers'comleneation insurance.asrequiredd the Labor Code.for the performance of Ihe •by Section 3700 ' . }C work for which this berme is sued.My workers'compensation insurance wrier and pascy number ere: /y Cerv«: STp,Tg FUND EXPIRES REVENUE DIVISION TOTALS--> COLL'ECT'ED, : 117; 00 OVER/S1{ORT.:, e- . 00 Policy Number: 774-960014808 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC • ;FIRE (%SMIP/TOT : GRADING PLAN-CHECK (This section M/cn needrn( completed d Me perm] face hundred dpaN)a MOOD pint) 117 . 00 • - t - � - r• 1 1- •. ❑ 1 certify Zsu Inje t t pthe workers' d theem work 110 which this permit is land ..I e not el • any comet a any mamas wo as 10 ': hempen subject m the workers'n 370oatie kw.dde Idad, and thco a I . lel Mneme urbjed to IM worked **********************************If**if****'*)IF*****1E�***************ik************* -, compensalice provisions dsedsn aMDd the LSM.Code ton 'moom. .1 ..... - F•' E 1E' "'BRE'B R E A RD- 0 14 N } qA- 1 """roe' I N D I V I D U A L; Oats: 3-/ 1 - r Applicant: • v- - �• ,',Warning:arning:Faiuretosecureworers'ccompewdoncoveragelaunts fendsMllal • an •oyer tocriminal penalties and TYPE QTY D E S C R I P T I O1 N v. �i h UNIT COST ' ,...,/, TOTAL COST tell fnes do one hundred thousand dollars(StO0,000A in addition • the cost of compensation,damages as prodded for in s` ") - l / '• Section3706of the Labor Code, attorney's and attom 's leen NPLU 1 SINK, BAR ! �, 7 , 00 ., s 7 . 00 CONSTRUCRON LENDING AGENCY:I hereby aft rider penally d perjury that(here is a construction lending agency'for the PLU 1 WATER CLOSET (TOILET)[ ' , ' ' 7 . 00 - 7 . 00 ped«m.n.atMwak«wed the � (Section w n3a .u.e). PLU 1 WATER HEATER AND/OR; VENT ` ' '' 7 . 00 7 . 00 LENDER'S NAME: PLU 1 GAS PIPING SYS OF ' 1, -T.0 4 ,OUTLETS , •5 . 00 5 . 00 LENDER'S ADDRESS: PLU 1 GAS PIPING SYS 5+ OU•TL P,ER ,OUTLET .1 . 00 1 . 00 1 ceNlythal have reed this ended/on and stele that deamkdadn u moconed.Iagree mcomply with all city end county ordinances PLU 2 SINKS, COMMERCIAL OR' PNDUSTRI-AL ' r 7 . 00 14 . 00 en state reeding Iobildgc inion and hereby authorizerepesenmlives of the city tower upon theeboe-madioned property PLU 5 SINKS, FLOOR .' t + 7 . 00 35 . 00 forIBM HOD SON PLU 1 SINKS, SERVICE / MOP ' fi /' ^; ' 7 . 00 7 . 00 A PLU 1 URINALS, WALL ^ ' ' - '•7 . 00 7 . 00 `_ ail PLU 1 INTERCEPTORS FOR GREASE„ rOIL, SOLIDS' - . 7 . 00 7 . 00 Ir.', '7'�•,�w• P'wY�r+a Date: , END OF% FEES 1r.'a. (5151-I6.WP) Were-Buildup&Safety;Green-Re:Canary-Appic°nl:Pink-Revenue:Goldenrod-Assessor • _I ' - , • CONSTRUCTION AND PLANNING POOL & SPA , .. • FPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or PoJe 52. Pool & Equipment Location i 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrnd. 54. Forms --2 4. Electrical Conduit=Undrgrnd. 55. Electrical Bonding . Steel Reinforcement ,/ 56. Rough Plumbing & Pressure Test ri- 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE --) .7. Footings 5B. 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 6, 61. APPROVAL TO DECK "-:-- --7 11. Property Sewer Line & House Conrfection 62. Backwash& Receptor-Final 12. Sewer Cape63. Heater & Vent-Final 1R. Roof Drains - 64. Plumbing System - Final "I 14. Rough Plumbing 4 Z s 4 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 - 7 - 71. Product Piping 0 Gas boil 23. Gas Pipe-Rough & Test 4-2+1 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 -t 78. FIRE PREY. FINAL ' 30. Drywall Nailing • 1 HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat -, 79. FINAL INSPECTION 32. Electrical Power Meter-Final .,/'. 80. FOOD CERTIFICATE ISSUED• /� 33: Final Electric ' Notes: 3 i1--t e_s-n 2.-erne)tt NA rek� ' L!r 34. Final Heating & Air Conditionin r p e n�uO o i,<. a g „Th_ 3 le -<� ��9� 35. Final Gas Pipe-Test 4-2.4--,6,i449 7-.2 r7 `�-/S , `�Y/ yq_twig et U Fr 40514 36. Hood or Canopy .` 37. Final Factory Fireplace - 4----a--C6 / ._ ofair T . . 38. Final Plumbing 4j- 2K 5i -J4-?-6 ?- _ 4- yf c Val) 39. Water Service-Final , ''��, T-24 // 40. Gas Service-Final `t_26-5,/ feczi-s kec owe Pra Ait..+76_ 41. Solar Domestic-Final ate 'et_ 0,6 A---,- /At -D»`9 �-7-r2-49I�i�"jLz� 42. Backflow Preventer „ 43. Backflow Irrigation 2P gen ..• t-,Int y,9; 44. Landscape Irrigation System • /ci--_9j 6 6.54..0_ 0, 45. Sound Attenuation ,J 1b-76 __ _ •'� 'A 46. Handicap Regulations6_3'_4_(✓ f/j� �r!c t' - 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison r 50. Gas Release to Southern California Gas Co r 51. CERTIFICATE OF OCCUPANCY N0. Date ADDRESS OF(WILDING: 1 /1 t 1 / 111 Si WIT: DDL. CITY OF COSTA MESA — BUILDING PERMIT MINERS NAPE IF BARCO REAL ESTATE ,/LSERM NO: M u /E /93 ADDu 1545 N VERDUGO RD UNIT 115 PERMIT NO: M 076793 PLAN CHECK NO: N GOVI : N burr: Pt GLENDALE, CA 818-500-7257 APPL MJ�aADDflEsx CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: ALT ARCHITECT OR ENGINEER: DESIGN MATRIX LIC.NO.: C-4970 JOB DESCRIPTION 2400 SQ FT RESTAURANT T, I , SQ FT: 730 NANDINA CT ARCH.ORENG:sADDRESS: OXNARD CA 93030—T910 CLAIM VALUE: CALC—VALUE : GROUP OCC: A-3 / JOBS BY BILL ( 818 ) 334-8011 CONTRACTORS NAME 711 E HANKS ST COMMENTS: "BAJA FRESH MEXICAN GRILL" / REF B-76791 CONfRACTORSYYUNc AZUSA CA 699670 ******+ *x-********** -+E*iE*+E+E+ * -+E************+ **+E+ +E****Y************************** ADDRESS: 91702 MHO.: Z ON ING R EQUIR EMENT S WIT: SETBACKS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penaly of perjury that I am licensed under provisions of Chapter 9 • (commencing wndDivision adthe Bigness and Professions 9 ointin"pma ./97 MAIN BUILDING ACCESSORY BUILDING Cry LUC.NO.: UC.CLASS: UC.NO: FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN ..------- Dale: 3- IC.--/'cn Contractor: LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN OWNER BUILOER DECLARATION:I herebyaffirm under penally of perjury that)am exempt from the Comrades License Lawlor the PARKING REQ1 PROV: PARCEL: 42542312 ZNE: REF NO: following reason(Section 7031.5 Buskins and Professions Code:Any ciy or county which requires a permit to construct alter,improve. demolish.or repair any structure,prior to its Intranet also requites the applicant for such Pernik to fib a Signed statement Owl he or she PLANNING NOTES> is licensed pursuant to the provisions of the Contractors License Law[Chapter 9(commencing with Section 7000)of Division 3 of the > fr Businessthe ******************************************irk lir******irk**************************** 7031.5 by any applicant fora permit sugeda We applicant to a ars penahy of not more than Ike hundred doges MOOD. D EVELOPMENT SERVICES REQUIREMENTS ❑ I.es owner el the properly or my employees we wages as Nei sole compensation,will do the work,end the structure is not intended or offered for sale(Section 7044.Business end Professions Code:The Contractors License Law does not apply to en owner of property ,rel who bolds or improves thereon,and who does such work himself or herself or through he or her own employees.provided the such ZONING APPROVED BY 'a DATE: improvements re not intended or offered for sale.If,however,the building or inprovement a sold within one year of completion,the ownerbuilder will have the burden of proving he or she did rid build or improve for the propose of sale). ' ❑ L as owner of the property,am erdusirdyeontradig with licensed contractors to construct the pitied(Section 7044,Business and BUILDING APPROVED BY : DATE: Professions Code:The Contractors License Law does not apply to an owner of property who builds or improves thereon and wt.o /p contractsexempt for suchdprojects: a mmreaor(e)Ikensed pure this a thes Contractors License Law). APPLICATION ISSUED B Y: aie '!/}�� DATE: ! �/U ❑ tem exempt under Section: B. P.C..for lite reawn: ******************101E*****iii[[[---** r' * 4 * ** **** ************** iy*****iF*** Date: Owner: LEGALIZATION: N F E E S U M M R Y STRUCTURAL SEGMENT:N 1 do hereby candy the I am aware d and understand the requirements of Caliente Health end Safely Cade Sections 25505,25533,end / FIRE S M I P/RES GRADING 25534,and that l or any future building occupant will/will not(* one) (circle need to comply wih said state codes and the requirements ler BLDG PMT PLUMBING ELECT[tIC"`' MECHANIC'' a permit forconstrucgon or modification from the A' u-8aity Management District.Residential conntrudion epplcatvsw exempt from these PERMIT _ - 29 00 previuob. '1 - ' 25% )-11/.ISMIP/NON—RES Date: Apprcem: PLAN • WORKER'S COMPENSATION DECLARATION:I hereby affirm under pendly of perjury eof de Sowing dederatero: • ISSUE FEE �' v 15 , 0 0 OM ❑ Ihave end elmainlenacerteofconsenttoseMinsurekrworkers'compenWSection of 37001Mleba BUILDING DIV > PERMIT ISSUE PLAN" CHECK TOTAL PAID DUE fin Code,for the performance al the work for which this puma is issued. TOTALS----> 29 . 00 15 . 00 0 . 00 ''44•, 00 44 . 00 . 00 • nI have and will mamas workers'compensation insurance,as required Section 3700 el the Labor Code,for the performance of the V work forwmdmispermneiswed.Myworkert Snap erand Pol)number we: EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: - " '44 .00 OVER/SHORT: . 00 Carrier: 229-96U0n14ROR 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 0: Policy Number: 44., 00 i (This section need not be completed i the panni is for one hundred dollars($7001 or lest.) (.• ,, . .r ❑ I certify that in the pedormence of the worker which this permit is Issued,I shall not emploYanY person in any manner so es to ***********************************,**1.,:'' **************'*************************** become subject to the workers'compensation laws of California.and agree that I should become subjed to the workers' • compensation provisions of Section 3700 of the Later Code.I shall fort con n those provisions. IND I V I D U A L' ' F E E BREXKDOWN Date: 3 - 1 C---p/(p Applmm: TYPE DESCRIPTIOI O N y • f •- c-- `/)1._ UNIT COST TOTAL COST e Warning:Failure to secure workers'compensation coverage Is un ,and shall subject an employer to criminal Penalties and f J 11'Sf" civil fines ,to one hundred thousand dollars($104000),In addition to the cost of compensation,damages Mt Provided for in MEC 1 REPAIR/ALT COOLING UN-T/SYS 'W/CNTL'S \ 9 .00 9 . 00 Section 3700 of the Labor Code,Interest,and attorney's less. V MEC 1 REPAIR/ALT HEATING UNIT/SYS W/GNTLS v 9 . 00 9 . 00 CDNSTRUCGON LENDING AGENCY:I hereby affirm under pen"'el -.perjury the there e a cord lending agenic!ler the MEC 1 INST HOOD W/DUCTS FED -BY MEC EXHAUST.+, 6 SO 6 . 50 pedamarcedlM work for which N;permitpermitis issued(sea�l3on'c"'c)" MEC 1 VENTILATION FAN CONN TO SINGLE DUGDUCTLENDER'S NAME: 74 . 50 4 5 0 LENDER'S ADDRESS: END OR,FEES I ceeiy the I have read this application and stale the the above nlormaen a coned.I agree to comply with all city and county odirsores 1 V ., ' �r andstate laws retatig to p4pgPy congquggP neinauthorize representatives el this sly to enter upon the abovememened propery >1 T r: I for inspection purposes. IUM liV!)C7S�N �i•vl w Print Name i Ct.4'. - .- i Data: l,.ign ur t/Contredor " ♦ 1 r rXJ (51514e.WP) Whits-Buildig A Safety:Green-Ale:Canary-Applcant:Pink-Revenue;Goldenrod-Assessor t I_ CONSTRUCTION AND PLANNING POOL & SPA . ' APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole- 52. Pool & Equipment Location , ' V • 2. Soil Pipe-Undrgrnd. r 53. Steel Reinforcement :. 3..Electrical Conduit•Utility-Uridrg nr d. 54. Forms N, - 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding - , 5.•Steel Reinforcement56. Rough Plumbing & Pressure Tast - ,l .6. •Electricaf LIFER Grnd. . 57. APPROVAL TO COVER-GUNITE _ ' ' . 7. Footings, - 58. Electrical Conduit-Undrgrnd. - , •• - 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test • 9. Water Pip€-Undrgrnd. 60. Backwash Lines,Q-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. Rdof Drains . 64. Plumbing System • Final I 14. Rough Plumbing Z 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 84 Test . ., - 72. Underground Flush r - • 24. Roof Framing • , 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Ro&f Sheathing ' 0 74. Overhead Hydro 26. T-Bar Ceiling (Structurall & Monocoat e -' _ ' 75. Dry Chemical - 27. Frame and Flashing - - 76. Dry Standpipe 28. Lathing& Siding, . 77. FIXED SYSTEM FINAL . 29. Insulation •• 78. FIRE PREY. FINAL ' 30. Drywall Nailing _ :',HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat - � - 79. FINAL INSPECTION - 32. Electrical Power Meter-Final ,' . 80. FOOD CERTIFICATE ISSUED : ,r33. Final, Electric. Notes: ` - 19‘ C'�2fbZ L _�L / nor/ /f�/��/ a 134.-Final Heating & AirConditioning 34e -\/ r 3_/7 �-6 gigs 35. Final Gas Pipe-Test /9 j - - a , / 36. Hood or Canopy / G 4 t `7.1 . .. ;' irlgIt4- PraW 1 rn`7 -a��y Raor-- 602 P 37. Fina(Factory Fireplace - - - . ..) 38. Final Plumbing ' ..- -2I 39. Water Service-Final IN 40. Gas Service-Final4e 1�10_ r= �'- - . 41, Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation • •44. Landscape Irrigation System' - . - - _. . •45. Sound Attenuation 46.'Handicap Regulations _ - 47.'FINAL STRUCTURE & BUI LDING , 48. FINAL PLANNING - 49. Electric Release to Edison • - 50. Gas Release to Southern California Gas Co i , 51. CERTIFICATE OF OCCUPANCY No. Date ADDRESS OF BUtl.WC UHT: ONNEfSNAME IF IOlUMN: 171 E 17TH ST B&C CITY OF COSTA MESA - BUILDING PERMIT 1-r ADDRESS: BARCO REAL ESTATE rum NO. C 076792 1545 N VERDUGO RD UNIT 115 PERMIT NO: E 076792 PLAN CHECK NO: N GOVT: N SUPP: N iFCtFEMPAUSES CA 818-500-7257 - -CONSTRUCTION TYPE: V-N PERMIT TYPE: E.ELE PURPOSE: ALT ARCHITECT OR ENGNEER: MHO.: (1 ARCKORENG1ADDRESS: DESIGN MATRIX Onr4970 JOB DESCRIPTION 2400 SQ FT RESTAURANT T. I . SQ FT: 730 NANDINA CT CONmACTORSNAI/E: OXNARD CA 93030-1910 CLAIM VALUE: CALC-VALUE: GROUP OCC: A-3 / Afe CCNmACTOnUuwa JOBS BY BILL ( 818 ) 334-8011 ADDRESS: 711 E HANKS ST UC NO.: COMMENTS : "BAJA FRESH MEXICAN GRILL" / REF B-76791 AZUSA oo'� 7 �� CA 6619670 **************************+EAkAF�E*�k****Ak**�k �E�EiE�E�kx*******+ASE**�E+E+E+F*�E�F+E�k�E+E�E*�E+E+f�E�k*+E* u LICENSED CONTRACTORS DECLARATION:I hereby affirm uddir petal'/al perjury Nati em licensed under provisions of Gheger B Z ON ING REQUIR EMENTS (commendr.g with Section 7000)of Division 3 of the Business end Professions Code,end my(bens is In full fate is effect. SETBACKS CITY LIC.NO.: UC.CLASS: LIC.NO.: 066718 .7 , � 9670 EXP": 01 /97 MAIN BUILDING ACCESSORY BUILDING -- Due: 3//'�/ Contrma: nLf FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN OWNER BUILDER DECLARATION:I hereby affirm under pen*ofperjuryt Iem exam he Caoacton license Law for the LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN following reason(Section 7031.5 Business and Professions Code:Any city of county whidl requires a permit to mmtmq,eller,Improve, demolish,or repair any structure,prior to itsissuance,also requires the applicant for such permit to Me a signed statement that he or she PARKING REQ. PROV: PARCEL: 42542312 ZNE: REF NO: ( is licensed pursuant to the provisions of the Contractors License Law(Chapter 9(cwmendng with Section 7000)of Dtrebn 3 of the yd Business and Professions Code)or that he or she is exempt therefrom and the basis for the alleged exemption.Any violation of seas. . PLANNING NOTES> ' 7031.5 by any applicant fore permit subjects the applicant to a civil penally of not more than Fire hundred dollen(55001). > ❑ I.as owner ofthe property or my employees with wages as their sole compensation,will do the work,and the siniatue is not iMended ***********************************W******************************************** or offered for sale(Section 7046 Business and Professions Code:The Contractors License Law does not apply to an owner ofpropiM DEVELOPMENT S E 'R V I C ES REQUIREMENTS who builds or improves thereon,and who does such work fmsef or herself or Ihrough he or her own employees.provided that such improvements are rot intended or offered for sale.If.however,the building or improvement is sold within one Vier or completion,the owter-builder will have the burden of proving he or she did not build or improve for the Ponca ofsale). ' ZONING APPROVED BY DATE: ❑ I,as owner of the properly,ant exclusively contracting with licensed contractors to construct the project(Seton 7044,Business and'- • Professions Coda:The Contractors License Law does not apply to an owner of property who builds or improves thereon and who.. ." euro contracts for projects with a contrador(S)licensed pursuant the Contractors License Law). BUILDING APPROVED BY : DATE: ❑ I am exempt under ion: B.&P.C..for No reason: ", v * . -�J/ // ig, _ APPLICATION ISSUED BY: DATE: JY ✓ /T Date: Owner:_ ************************* *' S 1**All***** ********* ******k****#* *** I do hereby citify that i am aware o and understand the requirements o California Health and Safety Code Sections 25505.23533,and LEGALIZATION:N F E _L S ULt M R Y STRUCTURAL SEGMENT: N 25534,end that I or any future building occupant will/wit rot(Code one)need to comply with said state codes and the requirements ler M epvnnofaconstructiona modirratimhantMAl�ueny anm gTeeni District.Residents dfMrudon appEreMrmnexempt aimmtMae provisions. BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING • IM( Date: Applicant: PERMIT 17 7 . 8 5 S0% SMIP/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby alfa under penalty of perjury one of the following declarations: PLAN ❑ I have end will maintain certificate of consent to settinsure for workers'sompensation,as provided for by Section 3703 of the Labor ISSUE FEE 15 .00 Cole,for the performanced iM work for which this panne®issued, BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE o I have and wil maintail workers'compensation insurance,as required by Section 3700 of the Labor Code.for the performance of the TOTALS----> 177 . 85 15 . 00 0 . 00 192 . 85 192 . 85 . 00 X work for which this permit a issued.My wan'kecompensators in urance carrier end poky number are: Carrier: Policy Number: SLAlh 1'UNV EXPIRES REVENUE DIVISION TOTALS--> COLLECTED: 192 . 85 OVER/SHORT: 00 f I (ma Sedlonnaedndeecompleted Ithe permit eror2d&leaAallijs4Dc*oc4 8 01 /01 /97 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN-CHECK • ❑ I certify diet in the performance o the work for which this permit is issued,I shag no.employ any person in snit manner so as to . 192 . 85 become subject to the workers'cceroensatbn laws of Cadwnia.end agree Nat if I shad] become subject to the workers' compensation provisions of Section 3700 of the Labs Code.I def h with those provisions. ******************************************************************************* -- Dela 3-+ 9(, Applicant IND IVIDUAL F E E BR EAKDOWN Warning:Failure tgMorehurdnedthousad Ms(ly00,00 n InaddllonWNecoatshall ofno comminution,damages proot anenat.7,12 21,1,Y to criminal videdforrea in TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Section 3706 0l Me Labor Code,Intern!,and attorney's Iwo. CONSTRUCTION LENDING AGENCY: I hereby affirm under penally of perjury that then is a condnd'an lending agency for the ELE 20 FIXTURES, LIGHTING 1 ST 20 EA. . 75 15 . 0 0 performance othe work forwnimtMpermlisissued(Sedun3037,Cit.C). ELE 36 FIXTURES, LIGHTING ADDITIONAL EA. . 45 16 . 20 LENDER'S NAME ELE 20 RECEPT/OUTLET 1 ST 20 EA. . 75 15 . 00 ti ' LENDER'S ADDRESS: ELE 2 RECEPT/OUTLET ADDITIONAL EA. . 45 . 90 Iceniy that)have read the application and date that the abvewmmation a caned.l agree tocwnplywsh all city and county ordinances ELE 10 RECEPT/SWITCH 1 ST 20 EA. .75 7 . 50 arra date laws relates tobufdng construction and hereby authorize representatives of the city to orae upon the abovemetbnedproperty ELE 3 COMMUNICATION DROPS 1 ST 20 . 75 2 . 25 ° 'nap°"e purposes. ELE 9 NON-RES APPLIANCE NOT OVER 1 . 0 HP 3 . 00 27 . 00 Tom u9p nELE 2 SERVICES BELOW 60 V & BELOW 201 AMP 18 . 50 37 . 00 • nl 3 � --p/ ELE 4 MOTOR/POWRAPPARATUS 0 . 0 1 . 0 HP 3 . 00 7 . 50 12 . 00 • Dor: ' )s ELE 2 MOTOR/POWR APPARATUS 1 . 1 10 . 0 HP 15 . 00 Sy ofOwnefAgenvAngcanbcamndw ELE 2 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15. 00 30 . 00 515146 WP) While-Bulkily b Safety:Green-Fl;Canary-Appkrnt:Pink-Revue;Goldenrod-Assessor le *.a ! f o CONSTRUCTION AND PLANNING POOL & SPA _ 1 ` APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspect ,, 1. Tempprary 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-Und+grnd. • , 55. Electrical.Bonding . I .,5. Steel Reinforcement56. Rough Plumbing& Pressure Test -6.- Electrical UF.ER Grnd. 57. APPROVAL TO COVER-GUNITE C7. 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 System61. APPROVAL TO DECK 11, Property Sewer Line & House ConnEction 62. Backwash& Receptor-Final- 12. Sewer Cap - r, 63. Heater & Vent-Final i 13. Roof:Drains , 64. Plumbing System - Final i 14. Rough Plumbing - 65. Electrical-Final .. 15. Rough Electrical-Conduit ` 13-18-76 /1 / 66. Solar System-Final 16. Rough Electric Wiring v� - 67. Fencing & Access-Approval 17. Rough Wiring Sign /�p��pA 68. APPROVED FOR-PLASTERING 18. Rough Electrical-T Bar Ceiling t�.. 7,5b Vy , 69. POOL/SPA SYSTEMS FINAL - 19. Rough Heating& Air Conditioning,- - V--� - FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplade -' APPROVALS Permit# _ 21. Dticts,pn 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 . ' • _ 7.3. 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 - •. 26. Lathing& Siding -- • - - 77. 'FIXED SYSTEM FINAL . ' 29. Insulation - 78. FIRE PREY. FINAL 30. Drywall Naming - . " • HEALTH DEPT. REQUIREMENT - 31. Plaster Brown Coat . - 79. FINAL INSPECTION Sill-______ 32. Electrical Pdwer Meter-Final . FOOD CERTIFICATE ISSUED 33. Final Electric r- I Notes: - - 34. Final Heating & Air Conditioning - - - - 35. Final Gas Pipe-Test 36. Hood or Canopy - - 1 - - . _ 37. Final Factory Fireplace , : -, > - 38. Final Plumbing - 3 - ,Y.. - - ' 39. Water Service-Final ; ,. • • 40. Gas Service-Final • r ' 41. Solar Domestic•Final - .. - 1 .- 42. Backflow Preventer - - i _ 43. Backflow Irrigation . 44.r Landscape Irrigation System - - r - 45.?-Sound Attenuation ' 46:Handicap Regulationsi - -- 47.' FINAL-STRUCTURE & BUILDING "'' 48. FINALPLANNING . ' ,v . 49. Electric Release to Edison - 50.:Gas Release to Southern California Gas Co - 51.•CERTIFICATE OF OCCUPANCY - No Date W • ADDRESS OF BUILDING: WIT: OWNERS NAME IF KNOWN: ADDRESS: PERMIT NO: E 076792 PLAN CHECK NO: 00987-96 N PAGE: 2 t AFPL.MMUNGCORE59: ildFililiPififillpipif3pildpdFNdEdPdEdliidiiEiliilfiEifilildl5idpiEiEdFN-Riif BldFiEipli#dEdEillEiEiliEilipipiEdEililiE#iidi5E5EiliidflEiElEfE#1l NiEiEdEiE . ARCHITECT ORENGINES: LC NO: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST ` ARCH.OR ENG.'S ADDRESS: WIT: END OF FEES CONTRACTORS NAME: c" CcfTRACTOR9 HARING ADDRESS: UC.NO_ UNT: • • LICENSED CONTRACTORS DECLARATION:I hereby atom under penaly of perjury that I sin(wind under provisions of Chapter 9 (commencing with Section 7000)d Division 3 d the Business end Profane Code,and my license is In WO taw end area. CITY UC.NO.: UC.CUSS: UC.NO.: Dale: Caaraaoc OWNER BUILDER DECLARATION:I hereby affirm under penally of perjury the I em exempt horn the Contractan License Law for the lolowii ream(Section 70315 Bailees and Professions Code:Any city a county which reaves a permit to comma,abet,imgore, demd'ah,or rspei any structure.prior to to aaiarre,deo restates the applicant for such permit to file a signed statement that he a she • u licensed pureuant to the provisions of the Contractors Howe Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business and Professions Code)a the he a she is exempt therefrom end the been for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a the penalty d not more than Me hundred clones($500D. ❑ I,as owner of the property a my employees with wages as thee sole compensation.coal do the work.and the structure a not Sanded a offered for sale(Section 7044.Business end Professions Code:The Contractors License Law does not apply to en owner of property who Meds a improves thereon,and who does such work IitnW!a herself a through his or her own employees,provided that such improvements are ml intended a offered for sale.I,however,the Wiring a improvement s sold within one year of completion,the owwrbuilder will have the burden of proving he a she did na build a improve for the maws of vele). O I.as owner of the property,ern exdusivey contracting with licensed contractors to construct the project(Section 7044.Business and Professions Code:The Contractors License Law does not apply to an owner of property who builds a Improves thereon end who contracts fa such projects with a contractor(*)licensed pursuant to the Geared=License Law). ❑ I am exempt under Section: B.6 P.C.,for this reason: Dale: Owner: I do hereby certify that 1 am aware a and understand the requirements of Cadent Health and Sally Cods Sections 25505,25533.end 25534,and that I a any Muni building occupant will I wit not(drab one)need to comply with sad rate codes and the requirements for a pewit for construction a modirmtionfro.the Ac ha anagamwt District.RsaidsrW construction applctios are exempt from thea provisions. Dab: Applicant: WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty of perjury one of the following dedaretcns: ❑ I have and oil maintain a certificate of consent to sstlinsure for workers'compensation.a provided for by Section 3700 of the Labor Code,la IM performance of the work for which this permit is Issued. O I have and ail maintain worker,'compensation insurance,as required by Section 3700 of the Labor Code.for the performance or the work for which the permit is issued.My woolen'compensation insurance ceder and pdcY number are: Cartier: ' Policy Number: y (This section need not be completed I the pant is for one hundred dollars RI00)or less) ❑ I certify that In the performance of the work ler which this permit is issued.I Wel tit employ any person n wry manner so a to become subject to the workers'compensation Lawn of California,and agree that I I should bscane subject to the workers' compensation provisions of Section 3700 of the Labor Code.I shall forthwith comply with those provisions. Date: Applicant: Warning:Fallon to secure wrkrs'ronprwpon cover ge Is unlawful,and shell sit/act an employer to aeMnsl penalties and clvIl Muss up to one husdrd thousand dollars(3IO400OA In sedition to the cost of compensation damages as provided ler In Section 3706 of the Labor Code,Interest,and attorney's lees. CONSTRUCTION LENDING AGENCY:I hereby edam under penalty of perjury that there is a construction feeding agency for the performance of the work for which the print u issued(Section 3097.Civ.C). LENDER'S NAME: LENDER'S ADDRESS: I certify that I have read this application and wale that the above Information Is coned.I pee to amply withal coy and cowry ordinances L rd site Laws relating to baddi g conavudion and hereby authorize representatives d the City tabove-menabove-mentionedr upon the above-mentioned pry opr for inspection purposes. • Rini None . Dos: Signature al DwnryAprNAppinr/Low�a (5151-46.WP) White-Buildcg 8 Safety;Green-Re:Crory-AppiwlY;Pink-Revenue;Oc dauod-Assessor CONSTRUCTION AND PLANNING POOL & SPA \V 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 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 O Gas O Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. 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 Factor,/Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44., Landscape Irrigation System �._. 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48:FINAL PLANNING 49. Electric Release to Edison 50. Ga Release to Southern California Gas Co • 51. CERTIFICATE OF OCCUPANCY No. Date C I ADoREssoc Pam> 171 E 17TH ST SMT: CITY OF COSTA MESA — SIGN PERMIT ONNERSNAei I'kDgwri BARROS, HERNAN R PERM NO: SB 078958 a mmol BARROS, ORFA T tBARCO REAL ESTATE MNGT PERMIT NO: SB 078958 PLAN CHECK NO: 03268-96 L GOVT: N SUPP : N 1545 N VERDUGO RD #115 GLENDALE,CA 91208 ApaL.MMLDNOAODRES& CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE: OTH 'ARCNRECT oft maim RICHARD STAGE uticz 1217 JOB DESCRIPTION : ILLUMINATED POLE SIGN SQ FT: ARCNOREia'aADOEEss: 3935 HARNEY ST um: 200 S .D. CA 92110 CLAIM VALUE: 16, 000 . 00 CALC—VALUE: 16, 000 . 00 GROUP OCC: U-2 / =mamma: CALIFORNIA SIGN COMPANY ( 619 ) 593-1113 commonM10035 RIVER ST * **rt ** * ** D*U** ******* D*** ** *L ** **** * ** AEt EL CAJON CA MAO.: 662997 ** * it*** 4* ** * E4x * 4** i ** * * ** * ******iEt**** 92020 WIT: SIGN INFORMATION LICENSED CONTRACTORS DECLARATION:I hereby affnmurdr penally of perjury that Iernlicensed under provisions of Chapter g DISTRICT: 1 TYPE: F.S . 25 ' HIGH SIGN ILLUMINATION: INT CATEGORY: NEW (commenapwthSection 70W)oDiisoand mil6mtaand DIMENSIONS : 6FT 07IN X 10FT 03IN AREA: 193 . 00SQFT LETTER HT: 2 ' 6" Clrfuc.NO.: 06 941 uc.CLASS: C 45 LIC.NO.: 6629 7 STREET FRONTAGE 1 : 406 . 00 STREET 1 : E 17TH ST �- D STREET FRONTAGE 2 : 445 . 00 STREET 2: ORANGE AVE /oa•: �/9 ) G Contractor: - PARCEL : 42542312 ZONE: Cl LOCATION > FRONT: X REAR: R BUILDER DECLARATION:I hereby strum under penaly d perjury the l am exempt from Contractors License Law Porde BUSINESS NAME: COSTA MESA CENTER (VONS) > LEFT: RIGHT: Wowing reason(Section 70315 B mese and Professions Code:Any ay or comfy which requires a panne to mead.attr,'anprove. OTHER TOTALS GROUND SIGN lemdah,er repel any structure.prom le Ea issuance.abo reyura the applicant for seri ant to Na a signed statement that he or she licensed pennant to the prmwion+alteDomsdOn License Law(Cheptra(mnmenap with Section 7000)d Divaon3dthe THIS ACTIVITY 193 . 00SQFT OVERALL HEIGHT: OFT OIN Amina and Professions Code)or that heor she 6 exempt therefrom and the basis for the alleged exemption.Anyvnlaon of Section THIS SITE1 . 00SQFT GROUND CLEARANCE: OFT OIN 7031.5 by any applicant for a masa subteen the applicant lo a cryi penalty of not more then fere hundred doles IS50oD. ITEMS OF INFO : 1 PLANTER AREA: O . DOSQFT ❑ 1.as owner Sties properly or my employeas win weppeestheir sole compensation.wil do the work'and the structure e'"'mended ITEMS FOR ACTIVITY: 1 BLDG SET BACK: 20FT or offered ler sale(Season 7044,Busies and Professions Code:The Contract=License law does rid apply to an owner d property who bolds or improves thereon.aMea d who such work lima or hereofa own through his or heremployees,prowled that such COPY VERBIAGE : VONS, LONGS DRUGS, MENU BOARD (VARIOUS TENANTS) , COSTA MESA improvements are rot intended ordfered for sale.N;however.the building or improvement i sold within one you dwfWetion,the CENTER, ADDRESS #S . ( 2 FS SIGNS [TOTAL 90 SF) TO BE REMOVED ) mwwweag whaethewmendp « m rwnvhesheddxadorbnpwel«theapo Porker.dsale). PLANNING NOTES : WILL REMOVE 2 FS SIGNS ON 17TH FRONTAGE. ❑ i.as 0.dthemaim.emexcinivelyc iractiq*Ith"zeroed oconctonloeamtnrdtheprged(Sedion7044.Bu:wad ******************************************************************************* Professions Code:The Comredm License rami does red apply to en owner of progeny who builds re improves thereon end who contracts for such projects with a comnadoe(4 licensed pursuant to the Contractors License Law). IDEVELOPMENT SERVICES REQUIREMENT • ❑ I am exempt under Section: B.6 P.C..for this reason: Dale: owerZONING APPROVED BY GG DATE: I dohereby 610vthellem ammo 08 and understand Ihe"'Own."dCaOmia Hellend S&dy Code Section 25.A5, 533,and BUILDING APPROVED BY : ��,�}} DATE: �! Mme' 96 25534.and Net I or any haus building omnpera,will/wit not(Sole one)need to comply nth mid gide codes end the regtk25ements for ` a permit for mawdionor moddmtion from the Nit aage em Durr.Resident's'mimxudion eppirAon are exempt from dub provisions. APPLICATION ISSUED BY; DATE: lin Dae: AppficW: ********************** *********************** ** LEGALIZATION:N FEE SUMMARY STRUCTURAL ; GMEN : Y WORKER'S COMPENSATION DECLARATION:I hereby affirm under prebyd perjury aped the followngdedaelioes: BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING ❑ I have and WM maintair a certdicate of camera to sell-insure tor workers'canpensidion.as provided for by Section 3roa o4 the Labor PERMIT 237 . 25 Code,for the performance of the work for Mich this permit is issued. I have e wmerenvoodoos's'componential insurance.a required by Sedan 3700 d rim the Labor Code,for the pnanoe of the SM I P/NON—RES 4' d0 mvoodoos'work for whirr the permit b m issued.My workers' nprasa insurance ance COMM end MEW number are: PLAN 154 . 21 3 . 36 Carr: GOLDEN EAGLE EXPIRES ISSUE FEE Poky Nurnberg: NWCJ2058000 08 /10/96 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE a (This section need nor a completed a the prole ie b one herded dolt WON orAm) TOTALS----> 240 . 61 0 . 00 154 . 21 394 . 82 394 . 82 . 00 -i 0 I certify dal in the performance of the work for which this permit' issued,I shah not employ fry pawn n fry manner n as to be au,Scltothewakrs'amprmaomMwedCaeddaadag'ee I roddbecoeat,iwtothewakes' REVENUE DIVISION TOTALS--> COLLECTED: 394 . 82 OVER/SHORT: . 00 giperespon awdSwon372odthe Labor Code,Ishallmhwlhe1t daapms�da. BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK ere: S/9pa Aowam: '�„ 237 . 25 3 . 36 154 . 21 Waning:Faaun m secure worth'conpansdon coverage Is wrwM,and shag artily an ernp2 cdMrstl penaMes and • e/v/i fines cep one hundred thousand adnate mound).I n ninon to dm cost of compensatbn,damages as provided forth ************************************************ ************************** Seclm 3706 of the Labor Coi*/meat and attorneys fees. INDIVIDUAL FEE we DOWN CONSTRUCTION LENDING AGENCY:I hereby arum under Pena?el perjury that ire is a construction isndvp Neat'for the prformrcedthe work this pica laissued(swop 30e7.c:..c). TYPE QTY DESCRIPTION c.TE ._ r` (0 NIT COST TOTAL COST LENDER'S NAME: LENDER'S ADDRESS: NO FEES WERE SELECD FO .rT 21 S PERMIT I certify that I have read this application and stele that the above idammson is correct.I agree to comply with all dry and coaly ordinances D PLS�' end state lava reWng to Wilding corabadon W hereby authorize representatives of this day to enter upon the above-mentioned property for inspection purposes. MARK CRUMPACKER / Pea Nan 9�p G J, _ _ - Dae: 8// /7v ,d Signatured e 4".90 / (5151 d1.WP) While—Building 5 Weir Green-Fla:Cary-Appian:Fink-Revenue;Goldenrod-Assessor • CONSTRUCTION AND PLANNING', _ POOt�;PA ' APPROVALS Peimit# Date Inspector APPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement e , 3. Electrical Conduit Utility,UndreJi'nd. 54. Forms 4. Electrical-Conduit-Undrgrnd. 55. Electrical Bonding • 5. Steel Reinforcement- 56. Rough Plumbing & Pressure Test r , 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings /9J�(/ 58. Electrical Conduit-Undrgrnd. '•f 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines;P-Trap, 0 1)ndrgrnd. 10. Structural Floor System 61. APPROVAL TO•DECK I ' 11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final 12. Sewer Cap / 63. Heater & Vent-Final 13. Roof Drains /1 64. Plumbing System - Final 1 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 11 67. Fencing & Access Approval • 17. Rough Wiring Sign 68. APPROVED FOR PLASTER}NG 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 Hydio 22. Ducts,Ventilating - 71. Product Piping OGas 0Ott 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof•Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe - 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. FinafElectric Notes: 34. Final Heating& Air Conditioning 35. Final Gas Pipe Test 1 •t 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 ,‘„y\, 48. FINAL PLANNING 49. Electric Release to Edison • 50. Gas Release to Southern California Gas Co _, 51. CERTIFICATE OF OCCUPANCY No Date • 7i