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HomeMy WebLinkAbout201 17TH ST - Building Permits • PROJECT ADDRESS: 201 E 17TH ST UNIT: KIOSK CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 064858 OWNER'S NAME: PERLMUTTER, DAN M ADDRESS: PERLMUTTER, SANDRA G PERMIT NO: B 064858 PLAN CHECK NO: 02631-93 L GOVT; N SUPP : N P 0 BOX 8414 NEWPORT BEACH,CA 92658 CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: NEW ,.( ARCH/NGINEuw SS FR1ANK N1 MIRJAHANGIRST REG.NO.: C20N435 JOB DESCRIPTION ; PEPLACE 98SF KIOSK SQ FT: 10, 000 • Hal . CA 92692 CLAIM VALUE: 10, 000 . 00 CALC—VALUE: 10, 000. 00 GROUP OCC: B-2 / 41 PERMITTEE: OSO KOENIGSHOFER ( 714 ) 642-5101 ADDRESS: 201 E 17TH ST COMMENTS : "PHOTO STOP" KIOSK REPLACEMENT C .M. CA 92626 **************#*+s*#*+ *yE##*******###*#####EE#####x*#*yc#BY#+r#+t#aE##*######********#* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section ZONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: Signature: MAIN BUILDING ACCESSORY BUILDING Date: WORKERS'COMPENSATION DECLARATION: Signaby affirm that have acertilicale of consent to self-insure oraceM1ificate 0l Workers' FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN Compensation Insurance.or a certified copy thereof(Section 3800.Lab.C). POLICY NO.: EXP.DATE: COMPANY: PARKING REQ: PROV; PARCEL; 42520318 ZNE: C1S REF NO: 0 Certified copy is hereby Wrnished. 0 Certified copy isfiled wnhthe city Building Division. PLANNING NOTES> REMODEL EXTERIOR AND INTERIOR OF EXISITNG PHOTO KIOSK, > Dale: Applicant: #**************************'3F3644**************************#******#************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). D E V E L O P M- E N T SERVICES R E Q U I R E M E N T S I certify that i he pe !mance of the work for which this per issue..I shall not employ an person in any manner so as to become /� subject to l Worker 'Compensation Laws of California. ZONING APPROVED BY. ' : . ' Gee) DATE: \` to RN Date: w q 3 Signature: ►- i i - I Lk._- 4-` BUILDING APPROVEDBY '' . NO CE:II, ter making this declaration,you should recome subject to the Workers'Compensation provisions of the Labor : I. DATE: E0 e.you must forthwith comply with such provisions or this permit shall be deemed revoked. - �^ _(,y 1 / CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY; :. LIQ• . �-O� DATE: lirl(o( ci 3 which this permit is issued(Section 3097, +} #******#* LENDER: *********************#******'*************************************************** ADDRESS: LEGALIZATION: N F E E S U M`M A R Y STRUCTURAL SEGMENT;Y OWNER BUILDER DECLARATION: I hereby affirm that am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter.improve,demolish,or PERMIT 117 . 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 of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business p LAN 76 . 05 • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by ISSUE FEE + - 2 . 10 any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($5110). I, as owner of me properly or my emVloyees wish wages as their sole compensation, will do the work, and the BUILDING—DIV—> PERMIT ISSUE PIAN=CHECK TOTAL PAID DUE ❑ structure is not intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law TOTAL S————> 1 1 9 . 1 0 0 . 00 76 :0 5 19 5 . 15 195 , 15 , 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 :7\ /`t 119 . 10 OVER/SHORT: 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve BLDG PMT PLUMBING ELECTRIC MECHANIC-, forthepurposeofsale). 117 . 00 FIRE SMIP/TOOT GRADING PLAN—CHECK • ,,LL,, I.as owner of the property.am exclusively contracting with licensed contractors to construct the project(Section 7044,Business - L•.: and Prolessions Code: The Contractors'Stateicense Law does apply tao owner orctorsrtyah builds improves thereon and who contracts tor such projects wth a contractor(s)license oLaidoese pursuant to the Contractors'State License Law).Iest aware *********************-ft ************ac* ******************************************* that proof of their Worker's Compensation insurance should be provided to me. IND I V I D U A L. , F E E — BREAKDOWN o I am exempt under Section: B.B P.C. for lhi reason: n YPEQTY D E S C R I P T I, O .N ( 1 p /`` , 1 UNIT COST TOTAL COST et Date: < <0 �'3 o«ner: f'' / L4�C 10000 STRUCTURAL BY VALUE PER $$1 00 1 , 00 10, 000 . 00 I do here A certify at I am aware of and understand the requirements of California,Health an tett'Cade Sections 25505.25533,and END OF -FEES 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a _ permit for construction or modification from the Air Duality Management District.Residential construction applications are exempt from • -- ,-, these provisions. Date: Applicant: 1 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 - ,i'] - ordinances and s to law relating to building construction and refry out r e representatives of this city to enter upon the above-mentioned property for in ection urposes. - • p� 4, v / 01 00150478-00150479 TOT 119.10 _r Dale: `r y��i Signature��/�•' R�1��'ry �, ' � -; , DATE: 11/12/93 TIME: 15:32 Driver's cense Social Security to: • .. y 164146 White—Building;Green—Code Enforcement;Canary—Applicant:Pink—Revenue;Goldenrod—Assessor CONSTRUCTION AND PLANNING POOL et SPA APPROVALS Permit Date Inspector APPROVALS Permit ,' Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location - 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing& Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 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 Pioe-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. Flame and Flashing j' �• 76. Dry Standpipe 28. Lathing & Siding -072 l' 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing 1t 'r/p '� - HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat /g j: r 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33, Final Electric Notes: dog-teterY, lar/4/t Cr 34. Final Heating & Air Conditioning I [ O0-41-7-Z-L-YJ doe !`/j Jr fe.3 ICL �i 35. Final Gas Pipe-Test .� 36. Hood or Canopy >'I ^ 01:1 1 L1 4 37. Final Factory Fireplace +v�'1 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final A 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations / ✓ 47. FINAL STRUCTURE & BUILDING /.079i.11: I 48. FINAL PLANNING -49. Electric Release to Edison _ n_ 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date �P','ECTADORESS: 201 E 17TH ST UNIT: KIOSK CITY OF COSTA MESA — SIGN PERMIT PERM NO: SBE 06493: rERS NAME: PERLMUTTER, DAN M ADDRESS: PERLMUTTER SANDRA G PERMIT NO: SBE 064933 PLAN CHECK NO: 04521-93 S GOVT; N SUPP: N P 0 BOX 84147 t NEWPORT BEACH,CA 92658 CONSTRUCTION TYPE: PERMIT TYPE: ELE STR SIG PURPOSE: OTH ARCH/ENGINEER: REG.ND.: JOB DESCRIPTION : 26SF LUMINATED WALL SIGNS SQ FT: ADDRESS: UNIT: CLAIM VALUE: 1 , 500 . 00 CALC—VALUE: 1 , 500 . 00 GROUP OCC: B-2 / PERMITTEE: RASNI KHARBANDA ( 714 ) 642-5101 ADDRESS: 201 E 17TH ST COMMENTS: 3—"FOTO STOP" LUMINATED WALL SIGNS C.M. CA 92627 **************7r**ar*+t+t+t*dty¢**************** ¢*+e****+e+e+EFr******+r***********dE****d¢**+r LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section S IGN I NE OR MAT TO N 7000)of Division 3 of the Business and Professions Code.and my license is in lull force and effect. DISTRICT: 1 TYPE: WALL ILLUMINATION: INT CATEGORY: NEW AelrYLlC.: STATELIC,: CLASS: DIMENSIONS : 2FT OOIN X 7FT 00IN AREA: 26 , 005 FT LETTER HT: 18 Date: Signature: STREET FRONTAGE 1 : 410 . 00 STREET 1 : E 17TH ST WORKERS'COMPENSATION DECLARATION: I hereby al firm that I have a certificate of consent to self-insure or a certificate of Workers' STREET FRONTAGE 2 ; 340 , 00 STREET 2 : ORANGE AV Compensation Insurance.ora certified copy thereof(Section 3E00.Lab.C). PARCEL: 42520318 ZONE: Cl—S LOCAT ION > FRONT; X REAR: X POLICY NO.: EXP.DATE: BUSINESS NAME: FOTO STOP > LEFT: X RIGHT: COMPANY: OTHER TOTALS GROUND SIGN . ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. THIS ACTIVITY • 26 . 0 0 SQFT OVERALL HEIGHT: OFT O I N THIS SITE 26 . 005 FT GROUND CLEARANCE: OFT . OIN Date: Applicant: ITEMS OF INFO : 5 • PLANTER AREA: 0", OOSQFT EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be complNMil the pernmis fa one hundred(S100)or less). ITEMS FOR ACTIVITY: 5 BLDG SET BACK: 30FT"- I certify that in the performance of the work for which this permit is issued,I shall not employ a person in a manner so as to become COPY VERBIAGE : FOTO STOP — 1 — 2 ! X 7 ' ( EAST ELEV) AND 2 — 2 ' X 3 ' ( 1 — subtect to the Work s'Como1Rnsation Laws of California. �y//7 y� ,�.�, NORTH ELEV & 1— SOUTH ELEV) ,4 Date: 1 ) J 6 I q3 Signature: IJc� F I cI4 6k • PLANNING NOTES: NOTICE:II.atte making this declaration,you should become s}sect to the Workers'Compensation provisions of the Labor ***************************************************************!f'*'*'!F*•**'**'*'!'x'**'N'* Code.you must forthwith comply with such provisions or this p rmit shall be deemed revoked. DEVELOPMENT SI' E 'R V I C E S REQUIREMENT 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 Lc.) (31_ DATE: VII I G I co LENDER: ADDRESS: BUILDING APPROVED BY : DATE; i OWNER BUILDER DECLARATION: I hereby al firm that I am exempt from the Contractors'State License Law for the following reason APPLICATION ISSUED B Y: DATE: k( ( (o r 9j (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or ********************************************************************.y(. .�*.yE * ;** repair any structure.prior to its issuance.also requires the applicant for such permit to lite a signed statement that he/she is licensed LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:Y 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.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 8500). BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING I. as owner of the properly or my employees with wages as their sole compensation, will do the work, and the PERMIT 35 . 00 45 ,00 26 . 00 ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law 5 0; 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 22 . 75 • . 50 his or her own employees. provided that such improvements are not intended or offered for sale.If,however the building or ISSUE FEE ' 1.5 . 00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve fpr Ih¢purpose of Sal). BUILDING—DIV—> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE ,,++..tt I,as owner of the property,am exclusivelycontracting with licensed contractors to construct the project(Section 7044.Business TOTALS----> 106 . 50 1S . 00 -.22 . 75 144 . 25 149 , 25 . 00 IH and Prhcontracts ontratsdIDhprojectsowihState contractor(s) ontraseLawdoes buildspursuatoon theCrproperty wAoLaw).oIamarere REVENUE DIVISION TOTALS--> COLLECTED ; 144 . 25 OVER/SHORT: 00 and who ssions Co for The Contractors' with a e License Lawlicense notapply t to the erContractors'State wh uildse improves st aware7 that proof of their Worker's Compensation insurance should be provided to me. BLDG PMT PLUMB ING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK 0 I am exempt under Section: B.&P.C. 35 . 00 60 . 00 26 . 00 . 50 22 . 75 for this rea n: , Date: 1 i i // \ �[) Owner: /14/4illefillj" • ***********************************if,******************************************ie I do hereby certify that I a aware of and understand the requirements of California.aIth and Safety Code Sections 25505,25533,and I N D I V I D U A L F E E B R E A K D O W N 25534 and that I or any future building occupant will/will not(circle one)need to comp y with said state codes and the requirements for a TYPE QTY DESCRIPTIO S C R I P T I O N permit for construction or modification from the Air uality Management District.Residential construction applications are exempt fromtUNIT COST TOTAL COST hese provisions. ELE 3 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15 . 00 45 . 00 Date: Applicant: END OF 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 construction and her authori:`representatives of this city to enter upon the abs mentioned property for ins ection p poses. 1 // I " 1 Date: I 1 6 signature: 01 00150792-00150796 TOT 144.25 Driver's License or Social entity a: DATE: 11/16/93 TIME: 11:56 1641-46 White—Building,Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor f CO NSTRUCTION''AND PLANNING POOL SPA PROVALS PermitiiihN I 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 Unclrgrnd, 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final I 12. Sewer Cap 63. Heater &Vent-Final 13. Roof Drains 64. Plumbing System - Final 14, Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough& Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing& Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREY. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION +� 32. Electrical Power Meter-Final // I . FOOD CERTIFICATE ISSUED 33. Final Electric / 'h/QCe j ( Notes: G .," _teryc- 34. Final Heating & Air Conditioning ff r-/ 35. Final Gas Pipe-Test I /1,1y(y� 36. Hood or Canopy L . 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 a jjj / 47. FINAL STRUCTURE& BUILDING //f /48. FINAL PLANNING ,J """ `Z40.4 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date _ ,1 2 /863 ` NOV 29-67cHSp001305 0*****6.00 `. COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 9262E . For Applicant to Fill In Completely APPLICATION FOR PERMIT' ::0. TYPE OR PRINT BUILDING CUILDiNO'S�1 "'3 on .4 4./..-5 .. at.5:, DVO1 � , :,. . J.,:c.,For_Office.Use_Only MI ADDRESS '2 W.�.I:Z� S7 i •. C � .� _. - .. " RECEIPT.NO E IT yr; " TA COS _MESAS CALIFORNIA t0,:: 1.. I. ... . -1-'. .. ..4 1.11..X..±.1 . ' 0_1: ..Uou alio. to L .,"'.RL' ,.,.1 aJ. Lai misarvaD[Y' IiwT[R[C[IV[D 1 DAT[1[6u[ OWNER_/=o7C?444 7n COQ'%•i o .• -., !',:U,' „. . ... ".. ../�97LZY .//,_z�67 BUILDING^ MAIL /7zv KL j Aft ,S7 ADDRESS �'=. :f ' „F17.-G n a:i(.�1 ADDRESS %% - _ a:,0-..i.„. ,61i y D9.. U L. 'VL/,".'�1 ._,1-19_6tL. t,..t-1,:. PINE 0 •..O J1 V6GL CITY• LX v 0L.L..4j ^U 'RI ZONE .__..J'•'/TSP ��-a• GROUP./ APPROVED /{� % //^, t:,6 IECHITE�CT}'•.�D•/-���•+�y'o:0 ;Nu ELtE.¢EL:.J0l. iN my., - ,,.-♦ DATE/ 2 NGINEIR'y�" '/"/OI=r=S i T NO. / ADDRESS ����--------���, 3955 /?/2C/4 St NEwtAEfeai o ZONING ru?n M T 7[ NO.OF BUEOFNEW �� Puw BUILDING , CONTRACTOR � A7C2 /� I ADDRESS uEcnIPTON 0DT. –hiU�j..., .( CrTY A.P.NO. I ,-7—/S�— Q/ O NOTE: NO EAVE OVERHANG SHALL BE LESS THAN STATE TEL SO'TO SIDE&REAR r.L. LIC.NO. NO. EAVES SIZE NO.of°LOOS. ALLOWED (U.B.C.REQUIREMENT) OF LOT NOW ON LOT YARDS APPROVED YARDS APPROVED USE OF MAIN BUILDING (ACCESSORY BUILDING 5, EXISTING BLDG. (PROM C/L STRHC��(r,,,111)))���'''��-JJJ �// — SETBACK LINE FROM ,RGM-c(/u'Ipr. �L . '/ rr CENTER OF STREET REAR YARD Q _PPP, wog YARD LEPT RIGHT R.SIDE /U PT. pa, JA A�NT�l�'!/ DESCRIPTION OF WORK LSIDR;` 9PT.G! %I ((y��/U(/��VVVT o-L-� f I _ ALTERATION _ ADDITION REAR f. r "" V DISTANCE BET. BET.MAIN e REPAIR MOVING DEMOLISH MAIN BUMS. ACCESS.BLOCS. / DATE BUILDING NO.MOFVAR.* / ! (; /// APPROVED!/ V7 SIZE ROOMS STORIES C.U•Py#�p4 yl��,n 7(//1b,/ n Q �7 EXTERIOR WALL I ROOF COVERING /a ly AT �/p• {J" �/ COVERING (0. U'� USE OF BUILDING ANDWO KTO BEPERPO MED I/� ('2u cTurL� /04. . e, &t-.ta t.1-1-17-e_.... m Oeiue -174 2u P 076 Peocc -cc/Al 4 HOLD FOR SPECIAL REQUIREMENT: I 44 fACTO SupPL y S4 ce,5 . SQ.Ft i 1 HEREBY ACKNOWLEDGE ThAT.I HAVE READ THIS APPLJGTON THE AMOUNT SHOWN UNDER VALUATION IS FOR THE .Fai AND STATE THAT THE E CORRECT AND AGREE TO COM. PURPOSE OF ESTABLISHING A PERMIT FEE ONLY. PLY WITH ALL CITY ORDINANCES AND RAT[LAWS REGULATING VALUATION BUILDING CONSTRUCTION. PERMIT FEE E 6 , OO W SIGNATUREOr -r,„444T Coen E PERMITTEP �1'' �n, _ ��l ��/ RIZED AGENT(/1 cut,' - C�iK^�'^ s O� PLAN CHECK S 00 w TOTAL FEE $ G, 638CS - cnal Conditions: • 1. That-the -gpplicant 'relocate or-remove-the-building at no expense to.the City-in-the event that' 17.th .Street .is to be widened;• 2. Time limit of one year at no additional';cost' to-the applicant for • reapplication,: and if' applicati-on is riot-approved--by -the-Council, — then'-Fotoinat-Corporation must removethe _building_at_.their expense- within a 30-day period:-.f: , -3: : siibject tito-.the location of.the building_being-under-the"direction - kthe:Planning Department'.- _-- ; '------ - ---- -__--= • 4: ‘..,That •agcopy of sal iagreemen-E be submitted.-.to the Building Dept: for Sanitary-..facilities. ' ------ -- - - - -- - --•-- -- (i _ • .1 -4-71.1, . •.0:: _ i..a ---- - - -. _ r-! �_ C....-y`?'. ❑ 1._ City of Costa Mesa Building Safety DepartmentCERTIFICATE OF OCCUPANCY NO P. 0. Box 317 Costa Mesa, California The Building located at 2Ai Fust WI RtrPnt has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group PC Occupancy. Use of Building eityni*T'CQL ^`- 't •' '=• structure Legal Description 117.154' Es at ��,r� pp� (See reverse side for Metes and Bounds) Building Permit No. :27&S3 Electrical Permit No. 279' Plumbing Permit No. 4 Floor Load Signs have been installed as Room Capacity Signs have been instaled as required under Sec. 2308 U. B. C. . required under Sec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied . until the owner or operator has been issued a valid certificate of occupancy by the enforcement agency. (b) A new certificate of occupancy shall be obtained whenever there is a change in: 1) Occupancy classification of a building or portion thereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of apartments_ and/or guest rooms ISSUED TO: • Building Official • PM*? COPPORMION by 444t Nc-- oy Date anuary 23, 190 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. Form 3u34-1M-11-e3--S-B P r ADDRESS OF GUIDING 201 E 17TH ST uM: CITY OF COSTA MESA - BUILDING PERMIT - ONNERSNAMEIFIOgKTiDMP PROPERTIES PERM NO: E 073003 Acmes: PO 8414 NB CA 92658 PERMIT NO: E 073003 PLAN CHECK NO: N GOVT: N SUPP : N 720-8166 APPL.MMLDa ADDRESS: CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH • ARCNRECT ORENGNEER: UC NO.: JOB DESCRIPTION : FOREWORKS STAND SQ FT: ARCH.OR ENG'S ADDRESS: UM: CLAIM VALUE: CALL-VALUE: GROUP OCC: B-2 / CONfBATOWSNAe AMBURGEY' S ELECTRIC ( 714 ) 979-2311 CONTRACTORSUMM 945 CORONADO DR COMMENTS : FIREWORKS STAND FOR "TEN MOST WANTED" ADDRESS: COSTA MESA CA uc.xo.: 395199 ** ***Wxet*rtat********-RE*iE*it******+t**** at**Tt-*****+ *** -atiE*it*+F**+t*****x*****at******+t 92626 war ZONING REQUIREMENTS LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perjury that I am licensed under provisions al Chapter 9 SETBACKS (commencing with Section 7000)of Division a of the Business'and Professions Code,and my license bin fug force and effect. CITY Llc.No.:023866 LIC.CLASS: C 10 LIC.NO: g P : 02 /96 MAIN BUILDING --- ACCESSORY BUILDING Dale: b.._ a-6-7 .. Cons.. FRNT: FT IN REAR: FT IN FRNT: LEFT: FT IN REAR: IN RGHT; FT IN LEFT: FT IN RGHT: FT IN FT FT IN OWNER BUILDER DECLARATION:I hereby affirm under Mud),of Perjury that I am exempt Iran the Contractors ' w a the logroving reason(Sectico 7031.5 Business end Professions Code:Any city or c,C4J•IY eiliCh Intiree•Per,*tO•••••UM pARKlNG REQ: PROV: PARCEL : 42520321 ZNE: REF NO: demolish,or repel any structure.prior to its issuance.lino requires the applicant for such permit to fib a Signed etnemea that he or she is licensed pursuant to the awniars of the Contractors License Law[Chapter 9(commenting with Section 7000)of Dixeton 3 a the PLANNING NOTES> lustiness and Professions Code]or that ha or she is exempt therefrom and the basis for the alleged exemption.My violation of Section > . 031.5 by any applicant fore permit subjects the applicant toe chit penalty of not more than fire hundred dollars[$500]). ******************************************************************************* ❑ I.as(inner of the Gfocely or my employees will wages es their mg compensation,still do the wait,and the structure'a not intended b F F L O p M I N T S F.'R V I C E S R E Q U I R E M E N T S or offered for sale(Section 7044.Business end Professions Code:The Contradora License Law does not apply to an Owner of propend who bolds or inaaves thereon,wit who does Such work himself Cl herself or through his or her own employees,provided that such improvements are not intended or offered for sale.I,however,the building or improvement is sold within one year of completion,the ZONING APPROVED BY DATE: owner-builder wig have the burden of proving he a she did not build or improve for the purpose of sale). ❑ properly. 0ilicensed an� mion hiness and hof sowner Code:TheCos ,as Law does apply INho construct the wa. estenoend who BUILDING APPROVED BY : DATE: contracts for Saar projects with a w radoels)lensed WSW"to the Contractors License law). ❑ Iamexempt under sedion: B.SP.C..for this reason: APPLICATION ISSUED BY: _-,. � DATE: -4441� Owner:Dal OwasEDEE**T******************************* Sat•fe+.******************DATE ** LEGALIZATION: N F E .E'r'' SUMMARY STRUCTURAL SEGMEN : N I do hereby certify that I em aware of ant understand the requirements of California Health end Safety Code Sections 25505,25533.and a that534,permit for ructionorfutmodification atinDom theAwill/wManagemertrcle r)reedtawith Mid nappirborawe exmpffmaasse BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING 2penmlt for aI or any fmoelbWiinhoccpant r'aiTiitnotspemeolDistrict e to comply construction saidisnepcotate des an and the e remptfamthese provisions. PERMIT 7 . 50 Dae: Applicant: 5 0% S M I P/NON-RES WORKER'S COMPENSATION DECLARATION:I hereby affirm under penalty ci Felon one d the taming dedarabns, ISPLSUE FEE 15 . 00 ❑ I hen and ml maintail•mete of consent lo sell-insure fer woken"compensation,es prodded for bY Section 3700 a the Laha BUILDING-DIV > PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE Calf.for the padormarce of the work for which this pant n blued. ❑ Ihave and MImainni,workers'compensation insumice,as required by Section 3700 al the Labor Code.kr the performance of the TOTALS----> 7 . 50 15 . 00 0 . 00 22 . 50 22 . 50 . 00 work for which this permit is issued.My workers'compenw ion insurance eaMer and polity number are: Carrier: STATF PINT) EXPIRES REVENUE DIVISION TOTALS--> COLLECTED : 22 . 50 OVER/SHORT: . 00 Polky Number: 1115071-94 07/01 /95 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK (Thi,salon need not be awp/eted y the pen.S for as hundred do/are/5100)Or lees.) 22 . 50 ❑ I certify that in the performance of the work for which this permit n issued.I shag not employ any person in any manner so ae 10 became subMd to the wakes tIXapesaticn lawn a cexamia, end agrae Nat E 1 ehwdd becanr eaAject to the wvkon' ********************************************E********************************** 00 an provisions of SecIM 37ca w the Labor code.I hwthy wM pro bks. INDIVIDUAL F E E B R E A K D O W N Date: 1 r Apt Eei 'C ` Wanting:Failure to secureworkers compensation coverage is unlawful,and stall sr!/sc,an employer to rSry penalties and TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST civil fines up to one hundred thousand dollars(5104000),in addition to the coat of compensation,damage.AAAprovided for In Section 3705 o1 the Labor Cod.,IntevsL and attorrrsys/ws. ELE 1 FIREWORKS STANDS EA. 7 . 50 7 . 50 • CONSTRUCTION LENDING AGENCY: I hereby affirm under penalty of perjury that there b a construction rending agency for the END OF FEES performance of the work for which this peons is issued(Section 3097.Cit.C). • LENDER'S NAME: LENDERS ADDRESS: I certify that I have read this application and gate that the above information n correct.I agree to comply with all city and county ordinances and stele taws relating to building construction and hereby authorize representatives of this city to enter upon the above.mentioned property for inspection purposes. ORV AMB RGEY O1 001851S 1-00185111 TOT 2.1,50 Dater -all-5. c DATE: 06128/95 TIME: 15:50 Signature of of Oer/Omer/Agent/AD read 5151-40.WP) White-Building&Safety:Green-Rle:Cewy-Applcat:Pink-Rename;Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL & SPA Date Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# 1. Temporary Electrical Service or ladle 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. %Ai 53. Steel Reinforcement •y /C 3. Electrical Conduit Utility-Undrgrnd. 54. Forms j, 4. Electrical Conduit-Undrgrnd. r>. 55. Electrical Bonding „ ! 5.. Steel Reinforcement 56. Rough Plumbing & Pressure Test - � 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE t . 7. Footings 58. Electrical Conduit-Undrgrnd. -8. Foundation 59. Gas Pipe, 0 Undrgrnd., T�e/� , 9. Water Pipe-Undrgrnd. fit, L1 60. Backwash Lines, P-Trap, C(ndrgrnd. 10. Structural Floor System - r 61. APPROVAL TO.DECK �- 11. Property Sewer Line &1-louseCtfn�ection , 62. Backwash & Receptor-Final') 12. Sewer Cap ' 63. Heater & Vent-Final 13. Roof Drains �n 64. Plumbing System - Final ` 14. Rough Plumbing 65. Electrical-Final I ./2 • 15. Rough Electrical-Conduit l 66. Solar System-Final -_1 •j 16. Rough Electric Wiring - 67. Fencing & Access Approval .`'' ,---c• 17. Rough Wiring Sign • •-,..,i 68. APPROVED FOR PLASTERING ' 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ^ 20. 'Rough Factory Fireplace _.', r APPROVALSPermit# 21. Ducts, in-Structure - - - : 70. Underground Hydro , 22. Ducts, Ventilating . 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test _ ` l- 72. Underground Flush 24. Roof Framing ' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bai Ceiling (Structlual) & 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-Finali :" 80. FOOD CERTIFICATE ISSUED . 33. Final Electric IA576---, ,/,' Notes: 34. Final Heating & Air Conditioning _ 35. Final Gas Pipe-Test ., ij - 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 .7. 49. Electric Release to Edison .Lt - 50. Gas Release to Southern California Gas Co �/' 51. CERTIFICATE OF OCCUPANCY ,r No Date m,a,'In .,u, I 'r T v PROJECT AMA E 17TH ST UNIT: KIOSK �I:YsOF COSTA MESA — BUILDING PERMIT PERM NO: E 064859 OWNER'SNML; PERLMUTTER, DAN M ADDRESS: PERLMUTTER SANDRA G PERMIT NO: E 064859 PLAN CHECK NO: N GOVT: N SUPP: N P 0 BOX 8414 NEWPORT BEACH,CA 92658 CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: NEW ARCHIENGINEER: FRANK MIRJAHANGIRREG,NO.: C20435 JOB DESCRIPTION : REPLACE 98SF KIOSK SQ FT: ADDRESS: 18281 GOTHARD ST UNIT: H . B . CA 92692 CLAIM VALUE: CALL—VALUE: GROUP OCC: B-2 / PERMITTEE: OSO KOENIGSHOFER ( 714 ) 642-5101 ADDRESS: 201 E 17TH ST COMMENTS: "PHOTO STOP" KIOSK REPLACEMENT, RE: #864858 C.M. CA 92626 *************+t*y6******+6ya******aF*a6a6*******y6*********SFa6r***a6*******a6xy6*** -***x*** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G R EQU IR EMEN TS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: STATE LIC.: CLASS: Date: 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 Workers' FRNT: FT IN REAR: FT IN FRN T: 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: 42520318 ZNE: REF NO: 0 Certified copy is hereby furnished. ❑ Certified copy is filed with the city Building Division. PLANNING NOTES> > Date: Applicant: ******************************************************************************* EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (This section need not be completed if the permit is for one hundred($100)or less). DEVELOPMENT SERVICES REQUIREMENTS I certify that in the pe ormance f the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Work s'Comp sation Laws of California. '- ,/�/Ik- ZONING APPROVED BY DATE: Date: 1 i /° 3 Signature: R. 412 w✓ba NOTICE:I after maki this declaration.you should me su ect to a Workers'Compensation provisions of the Labor BUILDING APPROVED BY DATE: Code.yo must forth 'th comply with such provisions or this permit shall be deemed revoked. ,. G 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: ` ,(O 1 ` which this permit is issued(Section 3097.Civ.C). ******************************iY************************************** ***** *** LENDER: ******************************************************************************* . ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 2300 , repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed 5 0% SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)al 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 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 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————> 23 . 00 15 . 0 0 0 . 00 38 . 00 38 . 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 REVENUE DIVISION TOTALS--> COLLECTED : 38 . 00 OVER/SHORT: . 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose 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 38 , 00 L and Professions Cade: 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 acontractor(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 ❑ I am exempt under Section: B.8.P.C. for this re on / r TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: �'/ /0 90 owner. ELE 2 FIXTURES, LIGHTING 1 ST 20 EA. . 75 1 . 50 I do hereby c bfy that am aware of and understand the requirements of California Health and fety Code Sections 25505,25533,and ELE 4 R EC EP T/OUTLET 1 ST 20 EA. . 75 3 . 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 ELE 1 SERVICES BELOW 600 V & BELOW 201 AMP 18 , 50 18 , 50 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. END OF FEES Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county ordinances antl ale laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for in ectiony�rpnses. ` o ate:- 1 /0 /f7 signature&7e tr X' ((At:WAYAt 01 00150480-00150480 TOT 38.00 Drivers L ease o�soctal Security a: DATE: 11/12/93 TIME: 15:32 1641-46 White—Building:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING P00.. _ SPA APPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector •1. Temporary Electrical Service or Pole - 52. Pool & Equipment Location �I2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 1111h3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 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 170. 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 f328. 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 6/ 6 /PI ////���� 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 48. FINAL PLANNING • 49. Electric Release to Edison 1, 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date