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Home My WebLink About353 LA PERLE LN - Building PermitsICITY OF CF, Project Pytlre ON PERMIT � nn� Applicant to fill In all spaees exceD� tnose within heavy OorGer Ilnes anA sign all appropriate Eeclarations. P IT NO. TRACT NO. LOT NO. UNIT NO. A P�y Applicant's Mailing Address I� Owner's Name A N!J -��A'i�.l SO /J ohone �¢.31-�� Address �.3L�—P��-�-� �'nSTA MES ya C.A ArchlEng. Licenu No. Address Contractor's Nam Phone t Address (mailing) City License No. LICENSED CONTRACTOR OECLARATION - 1 he�eby afti�m lhdt 1 am Iice�setl untler p�ovi510n5 (comm¢nCing with 5ection 7000) of Dlvislo� 3 of the B s antl Professlons Cotle, antl my licenze is in full force antl 6tfect. Li<ense Clazs License No. Oale Si9nature 1 , WORKERS' COMPENSATION DECLA ATION 'ereDy affirm tnat 1 �ave a ce�tificate o/ consent to self-insure or e certiticate Workers' Compensation Insurance, or a certlfletl copy thereof (Section _e00, Lab. C.) Policy No. Company Certifietl copy iz hereby furnishetl. C itietl c ❑letl with <�� iltling Diyislan� Date A^nO" -�' AAM EXEMP ION FROM WORK COMPENSATI N ECLARATION (This section neetl not be comp�etetl if the perml[ r one huntlre0 �5700) or less�. I certify that in the performance of the work for wnich this perm�t is issuetl I snall not employ any Oerson in any manner so as to become sublecl to t�e Workers' Compensation Laws of Cali(ornia. Date Signature NOTICE: It, after making lhis tletlaration, you shoultl become sublect to the Workers' Compensation provisionz ot the Labor Cotle, you must forthwith comply wi[h suc� proWzions or tnis permit 5hall be tleemetl revoketl. CONSTRUCTION LENOING AGENCV I hereby afBrm that [here is a Gonstructlon lentling agency for the pertormance of the work ior which th�s permlt Is issuetl (SectlOn 309� Civ. CJ l.entler's Name Lentler•s Atltlress OWNER BUILDER DECLARATION 1 hereby atfirm lhat I am exempt from the Conlractor'S Li<ense Law for tha followin9 r¢asOn (Section 7031.5 BUSiness antl Profe55iondl Cotlei Any city or counly which requires a p¢rT�< <o cOnstruct, d1ler, imptove, tlemolish or r¢pair any structure, prlor to its issuance, also requires the apDlicant tor such permit to tile a signeC 5tatement t�a� he/she is IlcenseU pursuanl to Ihe provislons o( 4he Contractor's License Law (Chapter 9(commenting with Sectlon 7000) of f;yj'�,jSion 3 of the Bu5lness a�tl Prote55ion5 Cotle) or that he/She is exempt �� aefrom antl the basis for phe allegeC exemption. Any violatlon of Section -.y1.5'by any applicant for a permil subjects the aOP��cant to a civil �e�y Ity of not more than five nuntlretl tlollars (E500�. �' "w�z A� I, as owner of the prop6rty ' le .aempertsahew, wlll do [ne work, antl tna sVucture is not intentletl or offeretl for sale (Seclion 7044, 8usi�e55 antl Pro(essional Cotle: The Contractor's License l.aw does not apply to an owner ot a property who builOs or improves lhereon, antl who tloe5 such N'ork him5¢If/he�self o� through hls ot he� own employee5, provitlCtl that Such imprOv2ment5 ar8 not Intentletl ol offeretl fOf sa�e. If, however, Ihe builtlinq or improvement I5 soltl wllhin one year o/ com- pletion, the owner will nave the burtlen of proving he/she tlitl not builtl or im- �rove for the purpose ot 5ale), I, as ownG/ oi Ihe propertY, am exclu5ively contraCting with IicenS¢tl <On- tractors to construct lhe project (Sectian 7044, Business antl Professions Cotle: The ConVactoYs license l.aH' does nOt apply to an owner of proPerty who builds or Imoroves thereon. intl who contracts lor sucn oroietts with a ron- tractor(5) Lcense pursuam [o me Con[rattor•5 License Law). � am aware that proof oi their WorkeYs Corr�Pensation Insurance shoultl be provitletl to me. ❑ I am'eaempt untler Section 8. & P. C. for thls reason �r—L�,.�—�� . Date ��_61�..d.�_ O� I nereby dertity a/at I nave intormation is wrrect. I agrei antl state laws relatin9 [o bu Sentatives O/ thls city IO e inspection p oses. Signatur Oriv • License or 55 1 state that the abova ana countv or0lnances �� 79 /S- TYPE OF CONSTRUCTION NEW AOD ALTERATION REPAIR ❑ CONVERS�ON ❑ DEMOLISH ❑ OTHER DESCFiIPTION OF WORK/USE OF BLDG. TYPE OF PERM17 LJ GRAOING ❑ TENANT ❑ ELECTRICAL ❑ OTHER PROJECT DESCR�PTION SQ.FT.— CONSTRUCTION TYPE VALUATION $ GRADING CU. VDS. AC 1FOUNOATION LJSTRUCTURAL PLUMBING ❑ MECHANICAL Remarks: � ' PL Bar Sink =� Backflow Preventer Backflow Irrigation %'.' Dishwdsher Orinking Fauntains Floor Drains . Floor Sinks Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof DrainS mave aas-�'eed Irne Reinspaction Fee � $15 Boiler Duct - Under Ground Duct - Structural Duct � Ventilating Exhaust System ❑ Multiple Firepl/Fact. Blt. iCBO # Heating System & Ducting ❑P700,000 BTU �100,000 Reinspection Fea � $15 0865-46, �ev. 5/88 Wnite � Builtling; Canary - Appll<ant; Pink - Ac<ounting; Goltlenrotl - ASsessor ShOWerS Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater �p�l,n � W ater Service Auto-Wash laue Fee Hood or Typel ❑ Canopy Typell ❑ Refrigeration Sysiem ❑0.100,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers laue Fee S MaiT Builtling: E T Front B Rear A C Right K g Lett Ping. Ref. �p Planninp Notes: FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher i� Dryers ❑Gas '�Elec� Fan ��' F,A.U. Pixtures � Device Boxes ✓/' Outlets Switches � Garbage Dispoul Generator 065 KW C $ 3 FEES $ 3 2one ELECTRICAL __ Transformer ❑ 15-50 KW ❑ SO+KW Meter ❑up ro 100 amps � Meter �over 100amps Sub Panel Motors OPt HP O1 h- 8 Inc.Solar �9-15 HP �16�15+ Microwave Pole Light Range Standing Sections 5-15 KW Trash Compactor � Reinspection Fee �$15 � � Issue Fee DEVELOPMENT SERVICES RE�UIREMENTS: Zoning Approved 8y Building Apvroved By � Application Issued BY ^� FEES $ 3 O N I N G R E Q M T S. SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING - § � ��UANCE $ PLAN CHECK 25% $ ENERGV P.C. $ EIECTRICAL $ GRADING $ PLAN CHECK 50% $ MICROFILM $ ��J MECHANICAL $ TOTAL FEE $ _l..� PLAN CHECK 25% $ #��..�f �... JL�eS�IG Y1��-LS1�� 1i -'.i ' oi caozssE;-o�oz�ab� rc+z ;.ao D47E: 0's/2I/89 TIME: 16:1i CONSTRUCTION AND PLANNING . POf •SPA APPROVALS Permit # Date Inspector �jppROVALS Permit # Date Inspector 1. '�'emporary Electrical Service or Pole _' 52. Pool & Equipment Location .� 6oil Pipe-Undrgrnd. 53. Steel Reinforcement 1 � 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ��' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding , 5. Steel Reinforcement ' 56. Rough Plumbing & Pressure Test . . • �6. Electrical UFER�Grnd. � � 57. APPROVALTO�COVER-GUNITE � - � � 7. Footings , � 58. Electrical Conduit-Undrgrnd. '�8. Foundation ' 59. Gas Pipe, O Undrgrnd.� Test 9. Water Pipe-Undrgrnd. �, 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System � 61. APPROVAL TO DECK � 17. Property Sewer Line & House Connection 62. Backwash & Receptor-Final . 12. Sewer Cap � � ' 63. Heater & Vent-Final"'+� ��f`='��: "" � ' • ' 13. Roof Drains 64. Plumbing System - Finsl ' 14. Rough Plumbing 65. Electrical-Final �� 15. Rough Electrical-Conduit 66. Solar System-Final r �iS' 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 i20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72.FUnderground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas OOiI 25. Roof Sheathing _ 74. Overhead Hydro 26. T-Bar Ceiling (Structura�) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe � 28. Lathing & Siding 77. ,FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. •,FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 1 �. 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test 36. Hood or Canopy . 37. Final Factory Fireplace 38. Final Plumbing 9 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final ' , 42. Backflow Preventer "�l ' 43. Backflow Irrigation 44. landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed 49. Electric Release to Edison :�::, � 50. �Gas Release to Southern California Gas Co �. ,-� 51. C�ERTIFICATE OF OCCUPANCY � :� � ' No. � Date �-� J% v Aop��ant to till in ali soaees except tnose wltnin neavy border Iines ana slgn all approp�iate tleclarations. ��—� �� PERMIT NO. TR CT LO N UNIT NO. � CITV�OFCOSTAMESA CON THUCTIONPERMIT � �3 �,-�"�' �� q•p•9y aS- //' O zO1e K, ProjE�t Adciess a��`� � �� - S Main Building: Attessory Building: Applicant's Mai�ddress n ! TYPE OF CONSTRUCTION NEW ADD A�TERATION REPAIR E � Z Ownef'S Neme 0/ T I.l ho� ��'zZlp � CONVERSION ❑ DEMOLISH ❑ OTHER T FrOnt �5 �� , � 3S� L 7 DESCRIPTION OF WORK/USE OF BLDG. B Rea� 'a�'�{�� N Address O�f �a — �� 2/ ' . F' I Arch/Eng. License No. TVPE OF PERMIT GRADiNG FOUrvOATION STRVCTURAI. ��K Ri9ht a�j�� G Addre55 �/!� _ ❑ TENANT ❑ ELECTRICA ❑ PLV ING.E ❑ MECHANICAL L , g� LEft a� � ❑�OTHER 23yfz"d �tQEy �M�N �l�� 2S�W � Pin Ref.# Parkin Re R Coniraaor's Name� Phone —� � 9• g q./Provided E /� PROJECT DESCRIPTION Sa. FT. OCCUa rvCV �� n Address (mailingl--lo� Planning Notes: ��] - M �, CONSTRUCTIONTVPE �«� VALUATION$ZO�„_I T Ciiy License No. ZONE GRADING CU. VDS. ACRES LICENSEO CONTRACTOR DECLARAT�ON 'L S' I hereby a//irm tnat I am licensetl untler provisions ot Charter 9(commencing Remarks: �T�o� with 5ection 7000) of Division 3 ot the Bu5ine55 dntl Profe55ions Cotle, antl � my ilcenso Is in tull force ana ef�ect. - ' _ ELECTRICAL FEES ' License Clazs License No. Date Signature PLUMBING FEES Automatic Washer Transformer ❑ 75-50 KW �RKERS' COMPENSATION DECLARATION gar Sink Show2fs ConStructi0n PoleSub. � 50+KW re0y aHilm tFlat I have a cer[i/iCd[e of ConSGnt t0 5¢H-Insure ol a c¢ftI(Icate Workers' Compenzation Insurance, or a cerlifietl cooY thereof (Section Backflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps 3800, Lab. C.) Policy No. Gomaany Backflow Irrigation � Sewer Cap . - Dishwasher Meter pover 100 amps 8 Certiti¢tl copy ii hereby tumisnetl. , Certifietl copy is (iletl with the city Bui�tling Dlvision. Bathtubs Sewer Connection � Dryers ❑Gas ❑Electric Sub Panel Date Applicant ' Fan EXEMPTION FROM WORKERS' [OMPENSATION DECIARATION Clarifiers �Solar Collectors � Motors �0-1 HP O1'h-B (This section neetl not be completetl if the Oermit is tor one huntlreU (y300 or iess). � Dishwasher Solar Piping �-* F�p`�V� Inc.Solar �9-15 HP q16-15+ I certNy tnat in the performance of the Work tor which this ermk iz Izsuetl, I � - Fixtures ' shall not employ any person in any ma so as om bject to the Dfinkin9 Fountain5 'Solar Tank !. � Miaowave Workrs�, C p ion La 5 of Cal' � _ � Date 6�-��ignature �� Floor Drains ' Swimming Pool w/Spa � Device Boxes Pole Light � NOTICE: If, after making this tletlaration, You shoultl become subjett lo the Workers' Compensation proviiions ot the Labor Cotle, you must forthwith Floot Sinks Urinal Out12t5 Range • comply wlth suth prOVISiOns o� this perTlt shall be U<¢TeG revok¢d. � CONSTRVCTION LENDING AGENCV . SWiLChES . Si n Gas Service Outlets Water Closet - 9 I nereby afiirm thal Ihere is a construction lentling agency tor the performan<e Gs�ba�2'Di Osal or the work tor wnicn tnis permit is issuetl �(Sectlon 3097 Civ. C.) � Interceptors Water Heater 9, � � Standing Sections Lentler's Name -. �enaer's Atlaress � Kitchen Sink Water Service ,> / Geae�ator �Q5 KW �5-15 KW Trash Compactor OWNER BUILDER DECIARATION . I hereCy atflrm lha[ I dm exempt from the Gont�actor'S License Law tor thB L2`/dtO�i¢5 AUtO-WBSh � �✓' following reason (Section 7031.5 Busine4s antl Professional Cotle: Any <ity or � munty which requires a p¢rmit t0 conSt��Ct, altC/, Imp�ove, tlemoll5h o� �epab p-T�3p LBUndIy T�eyS ' any Struclure, prlor to its issuance, also rGquires the applicant for zuch permit � � � lile a si9netl slatement thal he/she is Ilcensetl pursuant to Ne provisions oi Roof Dreins '�� Contractor'S License Law (Chap[er 9(commencing wlth Section 7000) ot . " '� ision 3 of the Businass antl Pro(essions Cotle) or tnat ne/she is exempt , �'Reins eetion Fee refr m antl Ihe Dasis for the allege0 Pxemption. Any violation of Section , �- P _ . ' $75 Issue Fee $ 3 703 by any applicant for a permiC 5ubjects the applicant to a civil e ty ot noe more than five huntlretl tlo��ars (E500). ' Reins ition Fee , $15 laue Fee $ 3A - DEVELOPMENT SERVICES REQUIREMENT.Sy ,�, . I, as owner of the property or my employees with wages as their sole � � Zoning Approved By �'�1��'�� compe,nSatiOn, will tlo the wo�k, antl the st�ucturB IS OOt IntenAetl o� o/feretl - DetB for sale (Section 704a, Business antl Professlonal Cotle: Tha Contractor's MECHANICAL FEES � Building Approved By - - Date 2� LicenSe Law tlo¢s not applY to an Own¢r Of a p�op¢rty wlto builtls o� improve5 ' . ihereon, anU who tloes such work himSC�f/her501f or tnrougM1 hls o� her ow� BOil2f HOOd O� T C I ❑ � APPliption'15suetl By ' Date employee5, provitl¢tl that Such Improvement5 are nOt Intentletl or offeretl t0� YP sale. It, however, tne builtling or improvCment Is soltl within one ear of com- ! ` pletion� the owner will have tne burtlen Of Proving he/she tlltl not builtl or im- Duct - Under Ground �nopy Type I I ❑ `= 2�6 ��SUMMARV OF FEES � prove tor the purpose ot sale). ,.,BUILDING PERMIT� $ �r�0 SMIP ❑ I, as own¢r ot me property, am excws��oly convacting with Iicens<tl con- Duct - Structural Retrigeratfon System p�,4N CHECK $ pEflM1T $ Iraclors to construct tM1e project (52ctiOn 7044, BuSiness antl %ofa55iOns COtlB: - The Contractor's C-Pnse Law does not appry to an owner of property who Duct- Ventilating '❑a100,000 BTU ❑100,000 BTU ' ' ISSUANCE builtls or improvesl�.reon. antl who contracts �or such oroiects wlth a con- PLUMBING $ $ tractor(s1 hcerie ourivanc to �ne Contraaeort �icense Law). I am aware thac � PLP,N'CHECK 25% $ ENERGV P.C. $ prooi of their worker•s Compensation insurance shoultl be provltlea to me. Exhaust System ❑ MWtiple ❑ System Repair/AI[eration -ELECTRICAL $ GRADING $ �] I am exempt un�er Section � � . .. tor thls reason Firepl/Fact. Blt. ICBO �k Fire Dampers � MICROFILM $ PLANCHECK 50%:i$ Date - - owner - Heating System & Ducting fiegisten " MECHANICAL �� I hereby certify that I have reatl this aPP�ication antl state tnat the aoove ❑4100,000 BTU �100,OOOBT _ i � TOTAL FEE $ J�.LL=_ Information is correct. I agree to comply with all tity antl county ortlinances �PLAN CHECK 25% $ antl state laws relating-to il4iw nsHuction, antl hereby aulhoilze repre- Sentative5 O( [h' �t o entef upo �h¢ dbove-mentlon8tl prop¢Ity tOl n I r 11� 00 inspection p 5. - 7,. � - L�X�V��'� �78`[� � 9 Dat� � � , �34 51 nature � - `lSQsX.l2t`3 �- 1U4ea9 narr. mimioa z.Tnr� ii.:e ' = �� 0865-46, rev. 5/88 Whi[e - Builtling; Canary - Applicanq Pink - Accounting; Goltlenrotl - Assezsor i ' _� : CONSTRUCTION AND PLANNING APPROVALS Permit # 1. Temporary Electrical Service or Pole . 2. �Soil Pipe-Undrgrnd. �,Electrical Conduit Utility-Undrgrnd. 4. Electricai Conduit-Undrgrnd. 5. �S[eel Reinforcement � 6. Electrical UFER Grnd. 7. Footings ' � 8: Foundaiion 9. Water Pipe-Undrgrnd. , i 10. Structural Floor System 11 . Property Sewer Line & House Connection 12. Sewer Cap 13. Roof�Drains 14. Rough Plumbing 15. Rough Electrical-Conduit 16' Rough Electric Wiring 17. Rough Wiring Sign 18.. Rough Elearical-T Bar Ceiling 19� Rough Heating & Air Conditioning 20. Rough Factory,Fireplace � 27. Ducts, in Structuie 22. Ducts, Ventilating � � � � 23. Gas Pipe-Rough & Test _ .24. Roof Framing • - � � ,. •- r 25.iRoof Sheathing-, � ' . 26. T-Bar Ceiling (Structural) &�Monocoat 27. Frame and Flashing ' . 28. Lathing & Siding 29. Insulation ' '� 30. Drywall Nailing, � � 37. Plaster Brown Coat � � __ , 32. Electrical Power Meter-Final 33. Final Electric •�'� 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - 36. Hood or Canopy 37. Final Factory Fireplace." 38. Final Plumbing .39. Water Service-Final - � 40. Gas Service-Final � � 41. Solar pomestic-Final ' 42. Backflow Preventer , 43. Backflowlrrigation-_ ��- ' _ 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations . • " 47. FINALSTRUCTURE & BUILDING 48. Special Requirements Completed 49. Electr�ic.Release to Edison � � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY Date Date � PC g SPA Inspector �� APPROVALS Permit #, � 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding , 56. Rough Plumbing & Pressure Test 57. APPROVAL�TO COVER-GUNITE ' � 58. Electrical Conduit-Undrgrnd. �' 59. Gas Pipe, O Undrgrnd., Test �, 60. Backwash Lines, P-Trep, O Undrgrnd. 61. APPROVAL TO DECK ' 62. Backwash & Receptor-Final ;� 63. Heater & Vent-Final � 64. Plumbing System - Final 65. Electrical-Final � 66. Solar SYstem-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro . 71. ProductPipingOGas ❑Oil . � 72. Underground Flush 73. Undergrnd. Storage Tank � Gas ❑ Oil . 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION � 80. FOOD CERTIFICATE ISSUED A Notes: ��G � Yv�1 i Date Inspector .i I _ t • � 4PE ��EA-,-n o G' D�-- ',. � et� S 2 f � Kd/i � = C . ) � (!� ,..' - . � . r, .:• �' � i. � _. I Applicanl to fill in all spaces except those within heavy borGer Iines antl sign all appropriate Eeclarations. Ci71�'OF COSTA MESA CONSTRUCTION PERMIT 1 ProjectAddre�s �Sa .�n �Rcc ��'- C'-/Yi. _ ApplRant's jvlailing Address �" - /� Owo�r's Name �Y'r � �q �.t Phon2'3��2Z�8 Address �p�T� Arch/Eng. License No. Address Contrector'sNam Q��s�e �++Z�ic7:c PhoneSa � Address (mailing) t City License No. LICENSED CONTRACTOR DECLARATION I M1ereby aftirm that I am litensetl untler provisions of Charter 9(commmcing with section 7000) of Divlsion 3 of the Business antl Professions Cotle, antl my license is in full force antl efte<t. License Class License No. �ate Si9nature WORKERS'COMPENSHTION DECLARATION I hereby affilm that I have a C¢rtiticate o/ COnS¢nt to Selt-InSUYe of a Celtlficate o( Workers' Compensation Insurance, or a certifietl copy thereot (SecUon 3800, Lab. C.) , Policy No. Company BCerfifietl copy is hereby (umishetl. Certi(ietl copy is filetl with the city Builtlin9 Division. Da[e APPlicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (7hissection neetl not be completetl it the permit�is tor one hunarea ($100) or less�. � I certify that in the performance ot the wo�k (or wh' isp m�t i5 i55uetl I ' Sndll not employ any person In any man O become ubject to t�e Work��CorIlpe ' n Laws ot Ca1it �� Date EY� Si9nature NOTICE: If, aRer making�this tleclarati you shoultl become subject to the Workers' Compensation provisions ot the Labor Cotle, you must torthwith. cOmply wi[h such pwvi5ion5 0� this pe�mit shall be tleemetl /evoketl. CONSTRUCTION IENDING AGENCV I hereby affirm that tnere is a construction lentling agency for the pertormance of lne work for which this permit Is issuetl (Se<tion 309� Civ. C.) lRntler'S Name �entler's Atltlress � , OWNER BUIIOER DECLARATION I hereby aftirm that I am exempt from the Contractor's License �aw Tor the follawing rea5on (Section 7031.5 Business antl Professional Cotle: Any tlty or county which �equires a pe�mit to conSGUCt, alteq improve, tlemoli5h O/ �e0air any struG[ure, O�lor to its i55Uance, al5o �equires Ihe applicant tor such permit to file a signetl Statement that he/she is IicenSetl pu�suant [o the O�ovi5iOn5 of tne Contractor's License Law (Chapter 9(commencing wlth Section �000) ot Division' 3 of the Business antl Professions Cotle) or that ne/she is exempt herefrom antl the basis tor the allegetl exemption. Any vlolation ot Section !031.5:by any applicant for a permit subjects the applicant to a civil y�y��a'lty ot not more than five huntlretl tlollars (E500). �e��, as owne� ot the p�op¢/ty or my employee5 with wages as thel� Sole yi cotnpenSdtiOn, will tlo the wo�k, antl the structu�e is not intentletl o� otf¢�etl for sale (Section 7044, Business antl Professional Cotle: The Contractor'S License Law tloes not apply [o an owner of a property who builtls or improves [hereon, antl who tloes sucn work himsel(/herseli or throu9h nis or her own employees, provitletl that such improvements are not In[entleG or offeretl tor sale. If, nowever, the bulltling or Improvement is soltl within one year of com- pletion,:the owner will have the burtlen of proving he/she tlitl not builtl o� Im- prove for the purpose of sale). ❑ I, as owner oi the property, am exclusively contractin9 with licensetl con- tractors to construct the oroject (Section 7044, Business antl Protessions Cotle: The Contractor's License Law tloes not apply to an owner o('property who builtls o� imProves thereon. antl who cont�dGts to� Such oroiects witn a mn-� tractor�s) license pursuan[ m cne Contractor•5 License Law�. I am aware that' proof of thei� WorkeYS COTPensation Insu�ance Shoultl be provitled to me. ❑ 1 am exempt untler Section B. & P. C. tor this reason Date ' Owner I hereby certify that I have reaa this application antl state that the above Information is correct. 1 agree to comply with all city antl county ortlinances antl State laws relatin i+tling- ruttlon, and h¢reby authoriie r¢pre- sentatives of��t##hM1M1�� y to enter upon he above-mentionetl property for Insoection� �_ . �l1 Slgnafure � „ DateZ'y� �1 Drivers' License or 55 � . ._" ___..__. __. __. ..... . A.P.# — 37 30 S Main Buildl TYPE OF CONSTRUCTION NEW ADD '' ALTERATION REPAIR E ❑ CONVERSION ❑ DEMOLISH ❑ OTHER - T FfOnt DESCRIPTION OF WORK/USE OF BLDG. A Rear TYPE OF PERMIT GRADING FOUNDATION ❑ STRUCTURAL I C Right K. Left ❑ TENANT ELECTRICAL ❑ PLVMBING ❑ MECHANICAL � S ❑ �O7HER Ping. Ref. # PR0.IECT DESCRIPTION 5(i. F7. OCCUPANCV Planning Notes: CONSTRUCTION TVPE VALUATION $ ZONE GRADINGCU.VDS. ACRES Remarks: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor SinkS ' GasService �OuUets Interceptars Kitchen Sink - Lavatories _� P-Trap Roof Drains Reinspection'Fee� � $15 Boiler Duct�- Under Ground Duct - Structurel Duct - Ventilating ExhaustSystem ❑ MWtiple❑ Firepl/Fact. Blt. iC60 # Heating System & Ducting ❑0-100,000 BTU 0100,OOOBT Reinspec[ion Fee I $15 0865-46, rev. 5/88 White - Builtling; Canary - Applicant; Pink - Accounting; Goldenrotl - Assessor $FIOWQIS Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal . Water Closet Water Heater Water Service Lau Issue Fee Hood or Typel ❑ Canopy Typell ❑ Retrigeration System ❑0-t00,0008TU ❑100,000 System Repair/Alteration Fire Dampers Registers � Issue Fee � � $ 3 fEES $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Oishwasher Dryers ❑Gas ❑Elec Fan F.A.U. Fixtures Device Boxes Outlets $WitCh¢5 Garbage Dispoul Generator �0-5 KW C Building: Parking Req./Provided ELECTRICAL Transformer ❑ 15-50 KW 50+KW Meter o 100 amps Meter over 100 amps Sub Panel Motors �41 HP �1 X- 6 Inc.Solar �9-75 HP �16-15+ Microwave Pole Light Range I I Standing Sections 5-15 KW' Trash Compactor � Reinspeaion Fee !$15 I � luue Fee DEVELOPMENT SERVICES REQUIHEMENTS: Zoning Approved By Building Approved By Application Issued By ' � SUMMARV OF FEES BUII.DING PERMIT $ SMIP PLAN CHECK $ PERMIT PLUMBING $ ISSUANCE PLAN CHECK 25% $ —�5'5� —� ENERGY P.C. ELECTRICAL $ �7.7•J� GRADING PLANCHECK 50% $ MICROFILM MECHANICAL $ TOTAL FEE PLAN CHECK 25% $ FEES $�� N I N G R E � M T S. oz eoQ2�zas-nna2z2s� �r�� :;.s� pATE: �2/?E/39 TItiE: 14:i6 , � � CONSTRUCTION AND PLANNING POO� _ $PA �� APPROVALS Permit # Date Inspe` ior qppROVALS Permit # Date Inspector 7. Temporary Electrical Service or Pole -� 52. Pool & Equipment Location �2. iSc�il Pipe-Undrgrnd. � 53. Steel Reinforcement �' 3. Elec[rical 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. � �� ' e. 8.' Foundation �� ' : 59. Gas Pipe, O Undrgrnd., Test �,,1 9. Wate�• Plpe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. .� 10%Structural Floor System '�1 . 61. APPROVALTO DECK 11. Property Sewer Line & House Conneaion 62. Backwash & Receptor-Final 12�Sewer Cap j 63. Heater & VenbFinal � 13.'Roof�Drains 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final r 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 19. 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 # _ `1. Ducts, in Structure � 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. RoofFraming 73. Undergrnd.StorageTankOGas ❑Oil 25. Roof Sheathing 74: Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL • 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �31�. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing - 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer • �i 43. Backflow Irrigation � 44. -Landscape Irrigation System 45. Sound Attenuation � • � . , 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING ' , 48. Special Requirements Completed � 49. Electric Release to Edison 50. Gas Release to Southem California Gas Co � �, j 51. CERTIFICATE OF OCCUPANCY f'- I _' i' No. Date !� � . _ ApO��eanl lo fill In all spaces except those within neavy EOrtler tines anC sign all approp/iata Ceela�atians onrT nin i nr nin � GTY OF COSTA M SA CQNS'�,1`LCTION PEFjMIT Project Addre s 'S�._!d f`�T�L6 `ti - - � � AppliLant's Ma� � ddress . Owner's Name � Phone '��' Z Z � Q Address � � , Arch/Eng. � License No.. Address Convactor's Nam �� Phone _ '.� Addiess (mailing) City License No. LICENSED CONTRACTOR DECLARATION 1 hereby atiirm lhal I am licensetl untler prOviSiOns ot Charte� 9(commencing witn seclion �000) ot Division 3 of tne Business antl �rotesslons Cotle, antl my Ilcense is in lull force antl efiect. License Class License No. oate Si9nature , W00.KER5' COMPENSATION DECIARATION 1 hereDy ai/irm that I have a certificata oi conient to selt-insure or a certiflcate ot Workers' Compensation Insurance, or a certifletl copy thereof (Section 3800, Lab. C.) Policy No. Company Certitietl copy 6 �ereby fumishetl. Certitietl copy is filetl with the city Builtling Division. Date Applicant EXEMPTION FROM WORKERS' GOMPENSATION DECLARATION (This section neetl no[ be comO�etGd if the permit i5 fo� One huntlretl ($100j o� less). 1 c¢rtify that In lM1e performance ot th¢ wo�k fo� whlCh UIIi�ECO��t is i55uetl I shall not emD�oy any person in any mann o ecoma suo ct to t�e Warkers' C �sa f�n �Laws o� Calif �ate .i7%I(' Si9nature � 6�ss+a ��. NOTICE. If, afte ma mg this tleclaration, you sh ultl become subject to the . Workers' Compensatlon provisions oi the Labor Cotlo, you must forthwitn comply with such orovisions or thiz pe�mlt shall be tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby afilrm tha[ tnera is a construction lentlin9 agency for the performance ot the wark ior whith this permit i5 i55uetl (Sec[ion 3097 Civ. C.) LPntle�'s Name Lentler'S Atldress OWNER 9UILDER DECLARATION ' I hereby affirm lhat I am exempt irom the Contractor's License Law for the following reason (Section 7031.5 Business antl Protessional Cotle: Any tity or county wnich requires a permit [o construct, alter, improve, tlemolish or repair any'slruc�ure, prlo� lo Its is5uance, alw requi�es lhe applitan[ t0/ such pe�mit to til¢ a sign¢tl slat¢Tent thdt'he/sh¢ is IicenS¢tl pu�suanl to the prOvisions of [ne Contractor's License Law (Chapter 9(commentln9 witb Section 7000) of Divisi n 3 of the Busines5 antl Protessions Cotle) or that ne/she is exempt `ner rom and tne basis tor [he alle9etl exemption. Any violatlon of Section �0 5 by any applican[ tor a permit sub7ect5 the applicant to a civil e Ity o( not more ihan five buntlretl tlollars ($500). i, as owner o/ tne property or my emPloyees with wages as their sole compen5ation, will tlo the wo�k, antl the Structure i5 not inlentletl or ofteretl fo� sal¢ ($edion 7044, Busine55 antl Pr0(e55ional Cotl¢: The Cont�acto�'S License Law Coes'nol appty to an owner of a property wbo builtls or improves thereon; antl who tloes such work himselt/herseli or Ihrough his or her own emD�oy¢es, p�ovitletl that SUGh imprOvements a�e nOt Inte�tletl O/ of(eretl fo� sale. 11, however, the builtlin9 or improvement is soltl wlthin one year of com- o�eli the owner will have Ihe burtlen of oroving he/she tlftl not bulltl or im- p the purpose oi sale). as owner oi the property, am ezclusivety contractin9 with IlGensetl mn- traCtorSto constructtne project (Section ]046, Business ana Profezsions Cotle: Tne ConVatlor's Li<ense Law dOes no[ appty f0 an owner ot property who builtls or imoroves thereon. antl who mnVacts for such oroiects with a r.on- tractor(s1 hcense pursuam to me Contrattor's Ucente L.aw). i am aware tnac proo/ o( tM1eir Wo�ker'S COmpensation insu�anca Shoultl be provltletl to me. ❑ I am ¢zempt untler Section B. & P. C, for Ihis reason Date Owner 1 hereby certi(y that I nave reatl this application antl state that the above information is corretL I agree to comply with all tlty antl county ortlinances antl state laws relat [o Ntlirrt�eensicucUon, antl hereby au[horize repre- sentatives o/ th c o ent pon 71ie above-mentlonetl pro rty� or Insoecllon p — $i9nature o 4 Da[¢ � � 39403 I ,I� i I - TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVPEOFPERMIT GRA�ING FOUNDATION STRUCTURAL , ❑ TENANT ELECTRICAL ❑ PLUMBING ❑ MECHANICAL , ' ❑ OTHER PROJECT DESCRIPTION C O N ST RUCTI ON T V ZONE Remarks: Bar Sink Backflow Preventer Backflow Irrigation Fountains Floor Sinks Gas Servic.e In[erceptors Kitchen Sink Lavatories . P—Trap Roof Drains Outlets 'T. �T"' '� � OCCUPANCY � `F�R.p/�E VALUATION$_ GRADING CU.YDS. ACRES_ Reinspaction,Fee ` $15 Boiler Duct-UnderGround Duct � $tructural Duct � Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. iCBO dk Heating System & Ducting ❑0.700,000 BTU 0100,OOOBTI heinspectiOn Fee � $15 OB65-46, rev. 5/88 White - Builtling; Canary � APP��tant; Pink - Accountin9: Goltlenrotl - Assassor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank � Swimming Pool w/Spa Urinal Water Closet Water Heater � Water Service Auto-Wash � Laundry Trays Issue Fee Hood or Type I ❑ Canopy Typell ❑ Refrigeration System ❑4700,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers luue Fee A.P. qW S Main Buildi E T Front B Rear A C fiight gLeft Ping. Ret. # Planning Notes: FEES P.u[oma[ic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas ❑Electric $ 3 fEES $ 3 Fan F,A,U. Fixtures Device Boxes Outlets Switches Garbage Disposal Generator �0.5 KW C Zone AcceSsory Building: ELECTRICAL . Trens(ormer ❑ 15�50 KW ❑ 50+KW Meter �up to 100 amps Meter ❑over100amps Sub Panel Motors 00.1 HP Oi'/, - 8 InaSolar �475 HP �i6-75+ Microwave Pole light ' Range Standing Sec[ions 5-15 KW Trash Compacror � Reinspaction Fee '� $15 I I Issue Fee DEVELOPMENT SERVICES REQUIREMENTS: 2oning Approved By Building Approved 8y Auolication laued Bv FEES N I N G R E Q M T S. SUMMARV OF FEES BUILDINGPERMIT $ SMIP $ PLAN CHECK $ PERMIT PLUMBING � $ ��UANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL $ � GRADING $ ' PLANCHECK 50% $ MICROFILM $ MECHANICAL $ TOTqLFEE $ � PLAN CHECK 25% $ 01 00035302-00033302 1'ri "f 311. ". DATE: 07/19/II9 TI(9E� 16:17 F OI 0 � CONSTRUCTION ANDPLANNING P00. .SPA APoROVALS Permit # Date Inspector AppROVALS Per"mit # Date Inspector 1. "iemporary Electrical Service or Pole � 52. Pool & Equipment LoFation ' � , i �2. Soil P.ipe-Undrgrnd. G�, 53. Steel Reinforcement . 3, �Electrical Conduit Utility-Undrgrnd. _�. 54. Forms r' 4: iElectrica`I Conduit-Undrgrnd. � 55. Electrical Bonding � 0 5:tSteel�Reinforcement 56. Rough Plumbing & Pressure Test � �• 6` Electrical UFER �Grnd. 57. APPROVAL TO COVER-GUNITE � �7,c'Footings � '_ 58. Electrical ConduirUndrgmd. � 8. � Fou�dation �`� '" 59. Gas Pipe, O Undrgrnd., Test 7 9� Watei Pipe-Undrg�nd. ��r1 60. Backwash Lines, P-Trap, O Undrgrnd. �� „ � lO.tStructural Floor System ,i 61. APPROVAL TO DECK 7�15Property Sewer Line & House Connection 62. Backwash & ReceptorFinal 12. Sewer Cap �+ 63. Heater & Ven[�Final ��' 13. Roof Drains 7' 64. Plumbing System - Final �, 14. Rough Plumbing 65. Electrical-Final � / 15. Rough Electrical-Co�duit 66. Solar System-Final (1;6. Rough Electric Wiring 7� 89 � 67. Fencing & Access Approval •17. Rough Wiring $ign � � 68. APPROVED FOR PLASTERING -18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 1�9. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough FacEory Fireplace ,- APPROVALS � Permit # 21. Ducts, in Structure , � 70. Underground Hydro 22. Ducts, Ventilating ! ��; 71, Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Te'st � 72. Underground Flush 24. Roof Framing ,� t 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structurel) & 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 �o� / � Notes: 34. Final Heating & Air Conditioning ` - 35. Final Gas Pipe-Test 36. Hood or CanopY 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. BackflowPreventer �j�� ,-�� i� 43. Backflow Irrigation ' 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations - � �47. FINALSTRUCTURE&BUILDING -�1-- ' 48. Special Requirements Completed 491 Electric Release to Edison '-' ,, 50. Gas Release to Southem Califomia Gas Co 't- . -- i -- ' 51. CEF�TIFICATE OF OCCUPANCY `,� t �� ?'�„ ` No. Date j � ' � �1� . .- : ' c. �., - X � AOV��ant to fill In all spaees except thosa wit�in �eavy Eortler Iines anE si9n all apO�eP��ata Eeelaratlons. PERMIT NO. TRACT NO. LOT NO. UNIT O. CITYOF COSTA ES CO TRUCTION/PERMIT E_ �-� 62 � AP qW ProjectAddress �� T- LM. �'�, S MainBuildi AppliCant'S Maili�dd�CSS TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR E Owner'S Name ��- V�3 pho� (�].il� � CONVERSION ❑ DEMOLISH ❑ OTHER ' 7 FfOnt DESCRIPTION OF WORK/USE OF BLDG. B Rear Address A Arth/Eng. �s 'p`� License No. TVPE OF PERMIT GRADiNG FOUNDA7iON STRUC7URAL K Right Addr¢ss � r �� ❑ TENANT ELECTRICAL ❑ P�UMBING ❑ MECHANICAL g� Left Contracroi's Name �'�"`�T�'k ��F�= Phone ��aTHER Ping. Ref. # SR^1 PRQIECT DESCRIPTION 5�. F7. OCCUaArvCv Plannin Notes: Addresslmailing) � CONSTRUCTIONTVPE VALUATION$ 9 Ciiy LiC¢nSC NO. ZONE GRADINO CU. VOS. ACRE$ LICENSED CONTRACTOR DECLARATION I hereby afiirm that I am li<ansatl untlar provisions ol Charter 9(commenting with zection 7000) ot Divislon 3 0( the Buslness antl Protesslons Cotle, antl my license is in i W I force ana nitect. License Glass Licanse No. Date Si9nature WORKERS'COMPENSATION DECLARATION }ereby aftirm that 1 hava a cerUfiwte o/ consent to solNniuro or a certifiwte .Workers' Compensation Insurance, or a cerUfietl copy theraof (Settion .d00, Lab. C.) Policy No. Company CertifiGtl copy 6 �ereby fwniShGE. Certitiatl copy is filea with the city Builtling Dlvision. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Tnis seclion n0etl nOt G¢ COmpletetl H lhe DGrmlt IS fOr One huntlretl (E100) or less). I C¢ltify tlldt IO Ih¢ p8lfOlmdI1CG O� [hB WOfk f01 ClT�t i5155U8tl I shall not employ any person In any m as lo be<o subject to t�e Work ' pe 'on Laws ot Ca' . � Date — Si9natura NOTICE: Ii, atter kin9 this tleclara on, you shoul ecome subject to tne Workeri' Compensation provlsions of lhe Lnbor COUe, you muit forthwitn comply with such p�ovlslon5 or this p<rmit Shall b0 tle0metl �evok¢tl. CONSTRUCTION LENDING AGENCV 1 nereby af(irm that thare is a connruction lentling a9ency for tM1e pertormance oi Ihe work for w�ich lhls Dermil Is Issuetl (Sectlon 3097 Civ. C.) Lentler's Name �entler's Atltlress OWNER BUILDER DECLARATION I he�eDy affirm Ihat 1 am Cxampl frOT Ibe Conlydtt0�'S Llcensa Ldw fo� tha (ollowing reason (Sectlon 7031.5 Business antl Pro/nssional Cotlo: Any dly or county whlch lequirai a palmll l0 cOnslfu<t, dltOf, ImO�OVB, tlGTollsh or ropalf any slruc[ure, prim to its issuanca, also requlres the applicant for such pormit to file a signatl statemant that he/sho Ii Iicensetl Oursuant [o lhe provlslons of (r, e Contractor's License Law (Ghapler 9(commencing witb Settion 7000) ot -��,fsion 3 of tho Business antl Prolosslons CoUe) or that he/she is exampt '�;;'�°;'?;efrom antl tne ba515 for the allegetl oxemplion. Any violation of SecHon `-',�.;G1.5 by any apPlicant tor a pormit subje<ts tne appllcant to a civil ¢ ally oi not mor¢ than tive huntl/Ctl tlolldr5 (5500). I, a5 owne� o! th0 P/oporty o� my Omployees with wages a5 lhelr zola c mpensatlon, will tlo tno work, antl tho slructure Is not Intentletl or ofteretl tor sale (Seclion 7044, Business antl Profestlonal Cotle: TM1e Contraetor'S License Law tloes not applY to an owner ol a property who Eulltls or Improves Ihereon, antl wno tloCs su<h work nIm5811/hersell or IhrOugh h15 Or �er own em0loy¢es, provitletl ttlat SUGh ImprovCmenli ar8 nOt Intefltle0 Of oHeletl fOr , sale. II, nowever, tne bulltling or ImOrovomont Is Soltl wlthin ona year of coT- plelion, the ownor wlll have the burdan ol proving he/sho eltl nol buIIG or Im- prove ior the puroosa otsale). � � I, as owner of Ihe property, am exclusively contracting wilh Ilcensetl con- hatt0/sto <OnslruGt Ihe OrOjeC[ (5¢cUOn 7044. Butincis antl Prote551on5 COtlO: The Contractor's LicenSe Law doos nol appty to an owner al property wbo � builtls or imoroves thereon. anC who <ontracts for sucn oroiec[5 witn a r.on- tractor(s1 Lcense pursuan[ [o me Conuactor'S LI<ense Law). I am aware thai prool of lneir WOrker'S Compensatlon IniuranGa shoultl �e provitlatl t0 me. '. ❑ I am exempt untler Sectlon B. & P. C. for this reason Date Owner I hereby certity that I have reatl this application antl state tnat the above informdtion is corrett. 1 a omO�Y �'�� all cily antl COunly OrtllnanCeS antl state laws relat' u Itl�n9 c uction, antl hereby authorize repre- 5¢ntative5 Ot thl ent<r upon IG dDov¢-TenUOnOtl prOp¢rty fof inzpec[ lon 0 DateZ �Z & � �Q Signature Drivers' �tcense or SS � Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Ciarifiers Dishwasher Drinking Fountains Floor Drains Floor Sinks Gas Service Outiets Interceptors Kitchen Sink Roof Drains Reinspection Fea I $15 Dutt - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/FacL BIL ICBO # Heating System & Ducting 06100,000 BTU � 100,000 BTi Reinspec[ion Fea � $15 0865-66, rev. 5/88 W�ite - Builtling; Canary - APPlicant; Pink - Accountin9: Goitlenrotl -�Assessor Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool wlSpa Urinal Water Closet Watei Hearer Water Service Auto-Wash laue Fee Hood or Typel ❑ Canopy Typell ❑ Retrigeration System ❑o-ioo,000eru ❑�oo,000sTu System Repair/Alteration Fire Dempers Registers Iswe Fee FEES Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Oryers �Gas ❑Electric Fan F.A.U. S 3 FEES $ 3 Device Boxes �uIlELS $witCh¢5 Garbage Disposal Generetor O0.5 KW Zone ELECTRICAL Transformer � 15-50 KW SO+KW Meter to 100amps Meter over 100 amps Sub Panel Motors � 0.1 HP � 1 X- 8 �nc.Solar 09-15 HP �16-15+ Microwave Pole Light Standing Settions 15 KW Trash Compactor ' Reinspection Fee �$15 ' I luue Fae DEVELOPMENT SERVICES REUUIREMENTS: Zoning APProved By Building Approved By Application lauad By FEES $� SUMMARV OF FEES BUILDING PERMIT $ SMIP $ � PLAN CHECK $ PERMIT PLUM6ING $ �SSUANCE $ , PLAN CHECK 25% $ �= �y ENERGV P.Q 5 ELECTRICAL $ _J� GRADING $ �' PLANCHECK 50% $ MICROFILM $ . MECHANICAL $ TOTALFEE $ �3"� , PLAN CHECK 25% $ . I N G R E � M T $. O1'dOfi27270-GU027270 TDY �3.5G DATE: 02/28/89 TI�iE• 14:i? CONSTRUCTION AND PLANNING . POf SPA ' APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector i. .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 Condu�it-Undrgrnd. 55. Electrical Bonding 5:, Steel-Reinforcement 56. Rough Plumbing & Pressure Test � 6' Electrical UFER Grnd. 1 57. APPROVAL TO COVER�GUNITE � 7,.� Footings � , 58. Electrical Conduit•Undrgrnd. '1 8.' Foundation - �� 59. Gas Pipe, O Undrgmd., Test 1 ' 9.� Water Pipe-Undrgrnd. , 60. Backwash Lines, P-Trap, O Undrgrnd. 10: Structural Floor System ' 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final � 12. Sewer Cap ', 63. Heater & Vent•Final ,� 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final -' 15. Rough Electrical-Conduit 66. Solar System-Final � 6. 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 �i . 20. iiough Factory Fireplace APPROVAIS Permit # 21. Dutts, in Struaure 70. Underground Hydro 1 22. Ducts, Ventilating 71. Product Piping �Gas ❑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-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical - 27. Frame and Flashing 76. Ory 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: O Cr / L� /a� e�Q 34. Final Heating & Air Conditioning _ [LiP /1 i/� '� � 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Final _ 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer • 43. Backflow Irrigation � 44. Landscape Irrigation System . _ � 45. Sound Attenuation �� ' �i 46. Handicap Regulations ! 47. FINALSTRUCTURE & BUILDING 48. Special Requirements Completed � 49. Electric Release to Edison '. 50. Gas Release to Southern California Gas Co �, . 51. CERTIFICATE OF OCCUPANCY � t� i . . N0. Date � •� OWNER �SIN & ROBIPISON DATE • JOB ADDRESS 353 � Perle GENERAL CONTRACTOR Owner e �a.1i7-2 -50 �oT I� ECTIONS soi� c�s WATER �ROULH PLUMBING PROP. $WR. LINE � HOUSE CON. �SPRINKLING SVSTEM MISCELLANEOUS �ROUGH HEpTING AN� AIH CONOITIONINF iEMPOAApY SERVICE OF POLE 11NDERGRqUND � POWER � ROUGM WIqING TPENCHE$ FORMS STEEL REINF FLOOR SVSTEM BON� BEnM ❑ STEEL REINFORCE ❑ SXEATHING FRAME �ND FLASNING ^ LATHING — IN OUT `�' PLaSTER. BROWN COAT TUqAL, FIN�L Hc.._. �NG, VENT., REFRIG. ANO �.C., FINAL PLUMBING, FINAL AN� GAS TEST n ELECTRIC, FINRL BWLOING, FINAL -� SUBCONTRACTOR NG PE OWNER NOU4„ r�omo�n�r PROV. $WR. LINE `— SPRINMLING SYSTEM MISLELlANE0U5 ROIIGN HERTING AND ��..ene�wv SfRVICf WIRING FRAME AND FL i erwiuc — IN POWER ANO A.G. i TEST IY RE OATE SUBCONTRACTOA OWNER j{F',rjDl�,I,�-�,ij�j•�[Q j. � MAY 1 3 1957 DATE ?_]1-C�7 � JOBADDRES3 '�j La Perle Lane BUILDINGPERMITNO. (�(1Zf}7 GENERAL CONTRACTOR OW11CI' BZdZ'. VALUE a 9(�0.00 AP117-261-20 �L�' LOT 22 e�ocK TRACT 1175 Pvt. Gara�e TVPE INSPECTION$ Footing Trench Foundation Forms and Grade to Rough Framing Plumbing, Rough to Slab Plumbina. Rounh Complete Heating, Final Sewer, House Sewe Septic Tank or Cesspool Lathing, In Out P 'ering F .�bing, Final, Fixtures Coi Plumbing, Final Gas Test Wiring. Final Oecupancy FORM 2�0 3M lO�vS DATE F4L`I� SUBCONTRACTOR FIREDISTRICT �y3(�'j PERMITSISSUED DATE � NUMBER i i 1�287 OWNER AP. No. 116- INSPECTIONS OCCUPANCY . �[,NIO J. LOT 22 THACT l. I DATE SEP 1 4 1960 SUBCONTRACTOR BUILDING PERMIT ZONE Form 210—SM-11-59 SB P � R0I70W31 of permit �4287 � 12448 COSTA MESA BUILDINGSAFETY DEPARTMEN' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADIDRE55, JJ �%I/—E� {. / , OWNER kMI�'.� /7AN„ . L�ii.t/• ADDRESS . 3 �%I � /�� ,E .G TEL. CITV CoS% ME4R "o.LYS-i� CqN5TRUCTION LENDER BRANCH ADDRESS ARCHITECT TEL. Pai� r ;r;,,�- a', �li -8-77r�=•Ot) R��• ., , FORSTRUCTURALPERMIT DATE RECEIVED nnrc wcum A.P. NO.,� � ��C� � ^� �! U BUILDING 3S3 L �L� �F ADOFESS TFACT � I �J LOT �( W ADD A T F P OWNE �a,y.2�.J 3 R. wtZ4� VALUE FIflE ADDRESS �ONE APPROVED CONTRACTOfl gV � � ADDRESS ' TEL. ZaNE NO.O CITY � NO. �� P�� o-F. STATE CITV �'ARDSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING {Lj SIZE NO.OF BLDGS. (FROM C/L STREET) �+ OF LOT ' � NOW ON LOT FRONT % a USEOF �� ^ EXISTING BLDG. � E FT. V1 r— I FSeparate permits are required for L. SIDE FT. Q electric, plumbing and heating work. REAR b �FT. W USE Of BUILDING AND WORK TO BE PERFORMED F OISTANCE BET. QMAIN BLDGS. � VAR. � J C.U.P. # Q � � �_/ APPROVED / �, t/ 'l W SPE� � I hereby acknowledee ihat I have �ead this application and state p: that the abova info�metion 15 correct antl agree to comply with Sf � ell lews re8uleting builtling construction, antl I shall not employ .L �Z any pe�son in vlolatian of the workman's compansation laws of ,� <he Stace of Califomle. � 3 I heraby certlfy ffiat I am properly licensatl as a contractor untler SQ. FT. the Staie of California Businass antl Profewions Cotle, Diviston 3, THE AMOUNT SHO� Chapter 9, anE that such licences are in full force and affect, or I THE PURPOSE OF ES am exampt from the provisions of theState of California Businecs VALUATION and Professions Code, �ivision 3, Chapter 9. Signature of a� . $ � �} � Permittae ��Dil�/.P�w Y Authotizetl ABent MIT NO. " ) /] { 1/�. C% BLOCK USE OF NEW" a$ TnOr BUILDING *�T��a<,o� VARDSAPPROVED ACCESSORV BUILDING DATE APPROVED ` , / _ n m > . I m� N JN UNDER VALUATION IS FOR m Q P.BLISHING A PEflMR FEE ONLV: �� PERMIT FEE $ d n \ro PLAN CHECK $ "� 0 LL � TAX $ � � V TOTALPAIO $ JUL ?_0-77�M5�002240 0*** 130.OG COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 7200 COSTA MESA, CALIFORNIA 92626 P CA ION FOR STRUCTURAL PERMIT For Applicant to Fil1 in Com [ely — Use Ink Only R Eo Y DATE RECEIVED DATE ISSUED BUILDING ADDRESS � /� PEFMIT NO. OWNER � ��NS O/JjNS A�P� NO. MAIL BUILDING � . / AODRESS ADDRES —(„�J TEL. TRACT LOT BLOCK CITV NO. CONSTRUCTION W A AL P LENDER BRANCH ' OWNER ADDRESS ��'� VALU$ ARCHITECT TEL. SE OR ENGINEER N FIRE ADDFESS ZONE TVPE GROUP APPROVED CONTRACTOR ' BY DATE ADDRESS TEL. Z�NE NO.OF USE OF NEW CITV NO. PLANS BUILDING STATE CITV YARDSAPPROVED VAROSAPPqOVED LIC. NO. �IC. NO. MAIN BUILDING ACCESSORV BUILDING SIZE NO.OF BlOGS. (FROM C/L STREET) OF LOT NOW ON LOT RONT FT. FT. USE OF E%I5TING BLDG. F7 Separa[e permits are required for L. SIDE FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAR.#` DATE C.U.P. $ APPROVEO APPROVED 1 haraby acknowladpa that I hava reatl this application antl state thet the ebova info�mation Is corract and agree to comply with ell lews repulatlnB buildln8 �onrtruction, antl I shall not empioy any person In vlolatlon of the workmen's compensation laws of the State ot Celtfornla. I hereby cartify that I am proparly licansetl as a contractor under SQ. FT. Ma Stata af Californie Business antl Profeuions Cotle, Division 3, THE AMOUNT SHOWN 11NDER VALUATION IS FOR Chapter 9, antl thet cuCh Iicansas are In full force entl effect, or I THE PVRPOSE OF FSTABLISHING A PERMIT FEE ONL � nm ezempt from the p�ovisions of the Stete of Calitornia Business VALUATION PERMIT FEE S entl Professlons Cotle, q�yision 3, Chapter 9. P�AN CHECK E Signetura of Permlttee $ TAX 5 Authorizad ABent TOTAL PAID E �4 F � [i] a G y y F A I � � 44��3 f ��! -6-77�"„-1°on 8F„ .. �.. �,:1 � 5; 'COSTA MESA BUILDING-SAFETY DEPARTMENT ' P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only APPLICATION FOR STRUCTURAL PERMIT FECEIVEDBV DATERECEIVED TE UED BUILDING , AODFESS / J� � OWNER A.P. NO. /I/ '�(�J � S(/ ERMIT NO. BUILDING �� N_ MAIL �7 ADORESS — ADDRESS.J �� ' �N. r TEL. ys � TRACT% �J LOT BLOCK CITV NO. CANSTRUCTION � W A A' P LENDEF BflANCH OWNER � ADDRESS ��1� VALUE ARCHITECT TEL. S U $ OR ENGINEER FIRE ADDRESS ZONE T PE � GROUP //JJ APPROVED � i/D � CONTRACTOR BV DATE L ADDRESS TEI. ZO ^ NO.OF �J USE OF NEW �� CITV NO. �pG P�� J BUILDING r STATE CITY �'ARDSAPPROVED VAROSAPPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLDGS. (FROM C �EET) OF LOT � U U NOW ON l0T qONT FT. FT. USE OF ( EXISTING BLOG. � — S T. FT. r % Separate permits are required for L. SIDE �j FT. FT. electric, plumbing and heating work. AEAR / FT. FT. USE OF BUIL�ING AND WORK TO BE PERFORMED DI5TANCE BET. BEf. MAIN & MAIN BLDGS. ACC65. BLOGi. VAR. # DATE � C.U.P.qW APPROVED APPROV Q , � / / I hereby acknowletl8e Shai I ha�e �eatl ihis application and stete tha� the ebove intormation Ia correct and agree to comply with ail �ews repulatln0 buildinp connrucNon, and I shall not employ any person In vlolatlon of <he workman'z compensation laws of tha Siate of Cellfornie. `� 1 he�eby certify thet I em p�opB�ly Ilcaetsetl as a tOrtt/eciof untle� ��U SQ. FT. tha Steta ot Calitornia Businass antl Profealons COtle, Dlvision 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chepter 9, and thet such Iicensas are In full force entl attact, or I THE PUFPOSE OF ESTABLISHING A PERMIT FEE ONLV; am exampt from tha provisionsof theStete of Ce�Ifornie eusiness VALUATION PEFtM1T FEE S antl Protasslons Cotla, Dlviaion 3, Chapter 9. SlBneture of/� /'�� /c��// A B� PLAN CHECK S Permlttae � /Y/�/ / //.�—�/-d�..J $ �// � TAX S d Authorizetl Agent TOTA� PAID E �� n s i �1 � n � J ,• . �. � i/ � P0.I6OOZ24� vd's5tk20.C� JUL 20-77c�isa �COSTA MESA BUILDING-SAFETV DEPARTMENT . P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR STRUCTURAL PERMIT For Applicant to Fill ' C etely — Use Ink Oiily RECEIVED BV ' DATE FECEIVED DATE ISSUEO BUILDING /� ry/r -/ ADDRESS �r �rc.cc� .v ' PERMIT NO. OWNER � N�' A.P.NO. BUILDING � !� � �C� MAIL ADDRESS �� ADDRESS TEL. TRACT LOT BLOCK CITV NO. CONSTRUCTION W P LENDER BRANCH � A � OWNER v ADDRESS VALUE � AFCHITECT TEL. S S OR ENGINEER FIqE ADDFESS ZONE ' TVPE GROUP APPROVED CONTRACTOR BV DATE ADDRESS TEL. ZaNE NO.OF USE OF NEw CITV NO. PLANS BUILDING STATE CITV �'ARDSAPPROVED VARDSAPPROVED LIC. NO. LIC. NO. MAIN BUIIDING ACCESSOFV BVILDING SI2E NO.OFBIDGS. (FROMC/lSTREET) OF �OT NOW ON LOT RONT FT. FT. USE OF EXI5iING BLOG. fT. FT Separate permits are required for L SIDE FT: FT. electric, plumbing and heating work. PEAfl FT. FT. USE OF BUI IDING AND WOFK TO BE PEFFORMED DI5TANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BLDGS. VAfi. #` DATE C.U.P.qW AP7ROVED APPROVEO I hareby acknowletlge thet I hava reatl this applicetion anE stete thai the above Information ia eortect antl agrea to comply wlth ell laws reguleSlnB builtlinp construcNon, and 1 shall noi employ eny Oarmn In violation of Ma workman's compenution laws of the State ot Californla. I hereby cartify thet I em proper�y Iicensed es e contractor �nder SQ. FT. the Stete of Callfornie Business entl Profassions Code, D(vislon 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, entl that cuch Iicensas ere In tull forca and effaei, or 1 THE PUFPOSE OF ESTABLISHING A PERMR FEE ON V: am exempt from the provlslons of tho State of Cellfornia Businass VALUATION PERMIT FEE y entl Profassiona Cotle, Division 3, Chaptar 9. 1 ` / PLAN CHECK S SlgneIDre of �� Permlttea $ yX TAX S Authorized AB0^t �/ TOTAL PAID 5 ` ,: , ' � � ' 436'7 ,:� COSTA MESA BUILDING DEPARTMENT P.O. BOX 31] COSTA MESA. CALIFORNIA FOR APPLICANT TO FILL IN BUILDING �� /v„ _ /J. � ADDRE55 /l.'✓l1GC�� IOWNER CITY l_.�(.�- ARCHITECT OR ENGINE ADDRE55 COSTA MESA. CALIFORNIA NO. LIC. NO. oescaiPnoN INO. O�q'� IBLOCK ITRACT �/ ' A.P. NO. 1�� j I —� O SIZE Q� /� (�� No. ov o�ocs. ' OF LOT / / Now on �or USE OF ' � / � E%ISTING BLDG. (,� SETBPCK LINE GPOM � 7 � CENTER OF STREET REAR VARD ✓ SIDE YARO _ RIGHT �/_ IEFT 7Q � DESCRIPTION OF WORK NEW A�TERATION ADDITION REPAIR I �MOVING I DEMOLISN BUIlO1NG�o. X .y//� NO.OF SIZE s[.�' ROOMS STORIES E%TERIOR WALL ROOF COVERING COVERING USE OF NEN' //�� /� BUIL�ING Q_A��/� f�.IY)/wMi"OiI vi�� 2/i/ � f �-�� '�� ,�g� % APPLICATION FOR PERMIT BUILDING FOR OFFICE USE ONLY !/�V"� ��'� �� ' BUILDING AOORE55 COSTA MESA. CALIFORNIA FIRE ZONE APPROVED SUB.IECT TO �G. DEPT. REG. STATE TNAT TNE �BOVE IS CONRECT 6Np 1GFEE TO COMPIY WITH 4LL CITY OFOIN�NCES AND $TATE LAWS REGUL�TING BUILOING CONSTRVC� iioH. VALUATION SIGNATURE OF PERMIT FEE 5 �-� PERMITTEE �/O � PLAN CHECK 5 � $ V / AUTHORIZED AGENT TOTAL FEE S / �. �� .,� � 12448 COSTA MESA BUILDING-SAFETY DEPARTMENT P. O. BO% 917 G06TA MEBA. CALIFORNIA For Applieanf io Fill In Complefely � MAIL COSTA MESA CALIFORNIA TEL. 61ZE �� X �� O / I No. oP Bt.noe. OF LOT NOW ON LOT USE OF _ J EXIBTING BLDG LC B[TBACK LIH[ PROM / �NT¢N OP 9iR8ET — REAR YA � 81D8 YARD ILEFT RIGFiT � DESCRIPTION OF WORK NEW I II ALTERATION I II ADDITION REPAIR I IIMOVING I IIOEMOLISH BUILDING n ( ''�10. OF ( 81ZE �/ n/� ROOMS J STORIE6 EXTHRIOR WALL ROOF COVHRINO COVERING U88 Qj'y BUILDIN6 AND WORK TO BE PERFORMHD FEE REC�IV�1� 6 -a �� 60 - ��. �' . fINANCE DEPT. r�ry nc r�,cT� enrnp APPLICATION' FOR PERMIT BUILDING For Offiee Use Only nece�rt rvo. I rawnrt No. COSTA MESA. � J� ZONING ZONE I NO. OP I U9E OP NHW PLANB BUILDING �a„� 1- v= '�— � �i ocaew�wr�ou / � ICSM[P LINE BT.) APPROVED � ! , 1 HEPBBY ACI(NOWLCDOE TXAT 1 HAVE R¢A� TXIB APPLIWTION TXE AMOUNT BXOWN UNCeR VALUATION 19 FOR THE AND BTATE TMAT TH6 A�OVC IB COfiRER AND AORHB TO COM- pURPOBE OR ¢BTABLIBHINO A PERMIT FEE ONLY. PLV WITM ALL C11Y OPDINAN�B �D HTATB LAWB 1l80ULATNO HUILDINO CONBTRU ON. VALUATION �a/ ,� SIGNATURE OP � PERMIT FEE g OG PERMI7TE /J�^}' ///� �^ $ V V � PLAN CHECK $ � AUTHORI2ED AGENT �"� � TOTAL REE /�