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Home My WebLink About562 19TH ST - Building PermitsCity of Costa Mesa Building Safety DepaMment P. O. Box 317 Costa Mem, Califarnia 1 ii-"^� 1 �• CERTIFICATE OF pCCUPANCY ]v� 2343 C �+i? i The Building located at 562 Weci 19th Street has been inspected and found fo comply with the provisions of all City of Costa Mesa Ordinances applicable therefo for a Group 1� Occupancy. Use of Building restauz'8271: Legal Description A• p• �1�'S�321�6� (Soe ravono �ida for Matei ond Bound�) Building Permit No. 21`� �9 Elecirical Permit No. �5�� Plumbing Permif No. ��3�2 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. 8. C. _ 17050. CERTIFICATE OF OCCUPANCY. (a) No opartment house, hotel, or lodging house shall be used or occupied until the owner or operator has been iss�ed a valid certificate of occupancy by the enforcement agency. (b) A new certificafe of occupancy shall be obfained whenever fhere is a chpnge in: 1) Octupancy clossification of a building or portion ihereof 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required �nder Sec. 17050.1 (d), California Adminisirative Code, Title 8, Chapter 9, Article 8. Number of apartments and/or guest rooms ISSUED TO: Building Off'cial Don B. Ayres bY y�l ,,,,,e tdarcn 11, 1 6 This Cerfificate of Occupa�cy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building OfFicial of ihe City of Costa Mesa under Sec. 306 (e) U.B.C. Fo� avae-_iax—ii_ea—s�s r # �� ;, � � CITY OF COSTA MESA ... _, ��`""'F, B!/ILDING DIVISION ' - � ,.,,,.-: � , � 77 FAIR DRIVE, COSTA MESA, CA 92626 • p14) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us � -- --• �. � FOR INSPECTIONS CALL: (714) 754-5626 �"` PERMIT NUMBER: B11-OQ256 PERMIT TYPE B_ROOF2 STATUS: ISSUED APN: 42214146 DATE ISSUED: 08/2212011 ISSUED BY: CAC JOB ADDRESS vicinity: Squares: 0 r562� 19TH ST CM Suite/Unit: Valuation: $27,000.00 SCOPE OF WORK: TEAR OFF BUR TO WOOD DECK INSTALL MALARKEY COOL ROOF CRRC 850-0002- APPLY BUR CAP SHEET 8400SF. ADRESS 562-590 W 19TH ST NOTE:RESIDENTIAL RE-ROOF: Final approval of permit shall not be granted until access to dwelling uni[(s) is provided tor � verification of the installation of smoke and carbon monoxide alarms by the City Inspector. See Attachment w/Inspection Card � OWNER: OELKE, HERBERT G TR %MC NAUGHTON, KENT AAddress: %KENSKI PROPERTIES TR FOR KENT MC NAUGHT Unit: HUN7INGTON BEACH, CA PHONE: City/State/Zip: PO BOX 1129 APPLICANT: CARLOS ZAMORA Address: PHONE: 866�444-5325 City/State/Zip: CONTRACTOR: MONTROSS WEATHERPROOFING SYSTEMS INC License No. Address: 22512 ASPAN STUnit: PHONE: 866-444-5325 Ciry/State/Zip: LAKE FOREST, CA 92630 CELL: ARCHITECT: ENGINEER: FEE SUMMARY Reroof Plan Check: $0.00 Reroof Permit Fee: $411.95 Reinspection Fee: $0.00 Bldg Std Admin Fund $2.00 License No. License No. t. r. 1� . ; i'j..��'. J..rf7 Unit : 499050 PHONE: PHONE: ;.�r:o�S:,r � r.lpf �`� . . .. AL FEES $413.95 � '� ' " �l- HOURS FOR CONSTRUCTION ACTIVITY; EFFECTIVE 3N8I2010 - PER CMMC Sec. 13-279 t:,, ;; Monday thru Friday - 7:00 am ihru 7:00 pm. Saturdays - 9:00 am thru 6:00 pm. Prohibitied all hours - Sundays and the following Federal holii New Years Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day and Chnstmas Day i NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No, g2-28, § 1, 12-21-92) EXPIRATION: PERMIT EXPIRES 180 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required inspections and final approval musl be obtained. Failure to obtain inspeclions and final approval will result in the expiration of this permit. CODE�. INSPECPONTYPE O�T INlI11RL5 COOE� INSVECl10NTYPE ORTE INTITIRLS 1616 Fixed System Final Fire Prevention 206 Final Mechanical 1266 Pool Spa Final ,, �� 208 Final Plum�ing 200 Final Re-Roof � �/�� h1r "-' � 210 Final Electrical 201 Final Block/Re�aining Wall 212 Pinal Fire Prevention � '� �' 202 Final Factory Fire Place 220 Final Planning Approval 203 Final Sign 222 Final Site _. � 7 204 Final Demolition 250 Final BuiltlinglOccupancy - ` � V.� i .. � � �R. WORKERS' COMPENSATION DECLARATION: I hereby aKrm under penalry of perjury one of the following declaretions: ' ❑ I have and will maintain a certificate of consent to selGlnsure for workers' compensation, as provided for by section 3700 0( the Labor Code, (or the Der(ormance of the work (or which ihis permit is issued. I have and will maintain v.nrkers' compensatbn insurance, as required by �n 3700 of Ihe Wbor Code, for lhe peAormance of the work for vmich this t is issuetl. My workers' compensation Insurance carrier antl policy are: �� v�Tko/ r nneetlnotb completedd(he rtisvalve ��a� Z�C� ❑ I certify that in the pert ance ot the vrork for which this permit is issuetl. I shall not emplo y pers n in any manner so as to become subject to Ihe workers' com sation laws of California. and agree that if I shoultl become subject to e vrorkers' compensation provisions of Section 3700 of the Labor Code, hall forthwith ply with these provisions. .72• A lir s 51g �e WARNING: FAIL E TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSANU DOLLARS ($700,000�. IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, IMEREST, AND ATTORNEI^S FEES. LICENSED CON7RACTORS DECLARATION: I hereby aKrm lhat I am licensed under provisions of Chaprer 9(commencing with Seclion 7000) of Division 3 of the Business and Professions Code, and �ense is in ull force and eftect. ��fc. a � �n ,� G3 i or's - aWre �tv � CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirtn that �here is a conslruc�bn lending agency (or lhe peAortnance of the xork fa vfiich this pertnit is issued. (Sec. 3097, Civil Code). Lender's Name: Lentler's Address: SignaWre Oate OWNER-BUILDER DECLARATIONS: I hereby a(frm Ihat under penalty o( perjury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Pmfessions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to fle a signed statement that he or she is licensed pursuant to the provisions of the Contractors License Law (Chapler 9(commencing with Section 7000) of Division 3 of the Business and Pro(essions Code) or �hat he or she is exempt Ihere(rom and the basis for the allegetl exemption. Any violation ot Section 7031.5 by any applicaM for a permit subjects the appliwN to a civil penalty of not more than five hundretl tlollars (5500).): ❑ I, as owner of the property, or my employees with vrages as Iheir sole compensation, WILL DO THE WORN, and the strucWre is not intended or offered (or sale (Sec. 7044, Business and Professions Code: T�e Conlractors License Law does not apply to an owner of property who builds or impmves thereon, and who does such work himself or herself or through his or her ovm employees. provitled Ihat such improvements are not intended or ofteretl for sale. If, however, the building or improvemenl is sola within one year of completioq the ovmeo-builder will have the 6urden of proving that he or she ditl not build or improve for purpose of sale.). ❑ I, as ovmer o( the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to constmct the prqecl (Sec. 7044, Business and Professions Code: The coniractors License Law tices not appy to an ovmer ot property who builtls or improves thereon, antl who contracts for sur.h project with a cont2ctor�s) license pursuant to the CoNractors License Laws.). ❑ I am exempt under sec. Business and Professions Code for this reason: ignaWre Date 305Z46 (3/0 � � Ovmer ID verifed by driv�se. ❑ Yes ❑ No Driver's License No. Ezpires: � Venfication of Ownership by (type of document, i.e. - pmperty tax bill or�deed): DIVISION OF INOUSTRIAL SAFEN PERMIT CERTIFICATION: ' ❑ I hereby certdy that no excavation five (5) or more feet in depth into which a person is required to descentl, will be made in connection vnth v.ork authonzetl by Ihis pertnit, and that no building sWcture, scaf(dding, falsewurk, a demolition or tlismantling thereot, vnll be more than thirty-six (36) feel high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Ttle 8, Cali(omia Atlminist2tive Code). � , ❑ As ovmer-builder, I will not employ anyone to do vrork which would require a permitfrom the Division oflndustrial Safety, as noted above, unless such person has a permil lo tlo such vrork from the division. . Appliwnt s SignaWre Division of Intlustrial Safety Permit Number: Date HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1. Will the applicant or present or fu�ure building occupant neetl to file and certify a Business Plan for emergency response to release or threatenetl release of a hazardous material? ❑ Yes ❑ No , (Section 25505 of ihe California Heal�h and Safety Code requires, with some exceptions, t�al a Business Plan be fletl with the Costa Mesa Fire Department by every business which has at any one time tlunng a reported year a quantity of hazartlous materials equal to or greater Ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic leel of compressed gas al s�antlard lempereNre and pressure). ' 2. Does or will the applicant or preseM or fuWre building occupant need to file a regislration form tor acutely hazardous materials? ❑ Yes ❑ No (Section 25533 ot the Califomia Health antl Safety Cotle, with some ezceptions, requires registration with lhe Costa Mesa Fire Departmenl by each business which at any one time has on hand a quaNiry of acutely hazardous materials equal lo or greater ihan a weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compressed gas al slantlard temperaWre antl pressure). , 3. Does or will Ihe applicant or present or tuture building occupant need Io prepare an RMPP (Risk Management and Prevemion Program for acutely hazardous materials�? ❑ Yes � No (Section 25534 ot Ihe Califomia Health and Sale[y Code provides Iha� Ihe Cosla Mesa Pire DepartmeN may require Ihe preparelion, certification and filing wit� t�e Fire Department of an RMPP by businesses which are required to register acutely hazardous materials with the Fire DeparimenL �, 4. If an RMPP is presently requiretl, has Section 25534 of ihe California Heallh and Safety Code been fully complied with? ❑ Ves .❑ No 5. Does or will !he applicant or presenl or (uture building occupaN require lor the work which is the subject of this appliwtion a permit for such consWction or modification from the Swth Coast Air Qualiry Management Distric[ orlrom any other air pollution control district or agency? ❑ Yes ❑ No� (Sectbn 658502 of the Califomia Govemment Code requires that the requesletl information be fumished on applications for rron-residential building pertnits). 6. Will any paA o( the faciliry lo be consVucted untler Ihis permil be within 1000 feet from the outer boundaries of a school? ❑ Yes ❑ No pf yes". the (aciliry must meee the requirement of Sections 25534 antl 42303 of the Califomia Heallh and Safely Code). 7. If a permit from lhe Soulh Coast Air �uality Management Dislrict or other air pollu�ion coniml district or agency is required for the work which is Ihe subject ol this application, have all of the disclosures prescribed by Califomia Health and Safety Code Section 42303 been made? ❑ Yes ❑ No 8. Qf yes", attach certificate of compliance from the appropdate air pollution control oKcer�. CERTIFICATE OF COMPLIANCE: I certify that untler penalty of perjury Ihe intormation given above is wrrecL I agree to comply with all stale lav5 and city ortlinances regarding Hazardous Materials and Emissions. Signalure Date i CERTIFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRY: I certify under penalry of perjury that I have read this application and etate that the in(ormation given is wrrect. I agree to comply with all state laws and city ordinances relating to building construction, antl authonze representatives of Ihe City of Costa Mesa to enter upon the above-0escribed property for inspec�ion purposes. I agree not to occupy or allow occupancy of any building aWhorized by this permit until fnal inspection. ignaWreol gal0 eqs) Dale �,� -ZZ-'// AnElorAut�o Aooi��n .pa�e . , �' •� / �%' � Job Address: 562 W 19TH ST Suite: Vicinity: Parcel Nunmber: 42214146 Applicant: SCOTT BP,RKAS Address: SIGN PERMIT Zoning: Phone: 909-885-4476 2ip: Owner: OELKE, H�RBERT G TR %MC NAUGHTON, KENT A Address %KENSKI PROPERTIES TR FOR KENT MC NAUGHT HUN7INGTON BEACH, CA Phone: PO BOX 1129 Zip: 92647-1129 Contractor: QUIEL BROTHERS SIGNS Address: 272 SOUTH'I" ST Phone: 90&835-4476 SAN BERNARDINO,CA . Zip: 92410 License: 217345 Status: ISSUED � Applietl: 12/01/2004 Issued: 12/ 1/ 004 ISSUED BY: EXpIRED DA'�'� 3 � Arch / Eng : - � , Address: Phone: Zip: License: . SCOPE OF PERMIT REFACE FR�ESTANDING SIGN AND ADD THREE WALL SIGNS FOR "DOMENICOS" - 92 SQ.FT: TOTAL FOR THE PROPERTY. � - FEE SUMMARY Plan Check: $54.11 - Calc Vatuation: Sz,50o.00 $0.00 Permit: $83.25 Claimed Valuation: s2,soo.00 SMIP Com: $0.53 Other: $0.00 $0.00 Inspection: $0,00 � �$0.00 � . _ � $0.00 Total: $137.89 PLANNING & ZONING NOTES: NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and reiated regulations. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: Thls permlt shall automaticalty expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legal, such work must comply wlth ell epplicable codes, and all requlred Inspeetlona and tinal approvel must be obtained. Failure lo oblain inspections and final approvat will result in the expiration of this permlt. FOR INSPECTIONS CALL: (714) 75q-5826 .. zaae-as lsroo) WORKERS'COMPENSAnON DECLARAnON: . � . I hereby aHirm under penalry ot perjury one o� Ihe Iallowing Oeclaratlons: � ❑ I have end wlll maintein e ceNflcate of consent ta self-Insure lor workers' compensatlon, es proNded tor by section 3700 of Iha Lebor Cade, tor the peAormence ol the work tor whkh Ihis permit is Issuetl. ' ,'�^TherO erW wlll mainlain workers' compense��on Insurance, es requlratl by sectlon 3700 ot Ne Lebor Code, tw Ne peAomiance of the wwk fw whkh NIs pBrtnll is iswed. end pollcy number ere: Q�r�a � Pblr ..Num6er.� � velued el one hundred dollar5 ($100) ar less.) �'��-----`� ❑ I ceNfy thet In Ne paAormence oi the work for which Ihis permii is issuetl, I shell not emplay eny person in any mannor so es to become subject to tha workere' compensatlon laws ol Celifor enC e8rea thet If I shoultl become sub' t to tho w A ers' compensetion provisions of Section 3700 of the Lebor Cotle. I s�elllonhwlth .�„��°��o. � �3 ,� ,�� 0��. �°/ Y iit SlpneWre: l dv r, '� �f /LL/ `� Date:� .<" O`" /—�/ ',WARMNCi�FACORETO� RE WORKERS' COMPF1dSAT�OM COVE GE IS UN WFUP L PND SHALL SUBIECT PN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO ONE HUNDRED TTIOUSAND DOLLAflE (5100.000), IN ADDRION TO'�HE CQST OF COMPENSATIIXJ, DAMAGES AS PROVIDED FOR IN SECiION 3708 OF TNE IABOR �UE, INTEREST, AND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: I em licensgd underpmNSlgpyS ol C�epter 9(commencing with SeMlon 7000) ot Divisior�tt„aBusl i[�ess and Proless�s Cade, end my Ilcense Is In full CONSTAUCTON LENDING AGENCV: ❑ I hereby aHirtn that chere is a canswction lending egency tor the pedormance of t�e work tor which Ihis pertnit is issued. (Sec. 3097, Civil Cade). Lentlers Name: Lendefs AdAress: Signature: Date: OWNER-BUILDER DECLARATONS: 1 heraby aHlrtn that under penelry oi perjury t�et I em E%EMPT FROM THE CON717ACTORS LICENSE LAW for ihe lollowinp teason (Sec. 7031.5, Business entl ProfeSsiong Code: Any ciry or counry which requires e pe�mit Io construct, alter, Improve, demolish, or repeir eny structure, prior to its issuance, elso requires �ha epplicant tor such permit b file a signetl stetement that he or she is Ilcensetl pureuanl to Ihe provisions ot ihe Contractars License Lew (Chapter 9(commencing wit� Sectlan 7000) of Dlvision 3 0l the Business and Proleuions Cotle) or t�et he 0� she is exempt therefrom end the bosis for Iha elleged ezemption. Any violation of Sectlon 7031.5 by eny epplicent for e permit su6�ects the aDP�icant to e clvll penalry of not more ihan fiva hundred dallers ($500).): ❑ 1, es ownar of Iha property, or my empl0yees w0h weges es their sole compensatlon, W1LL DO TNE WOAK, end the structure is nof Intended or ottarad irn sele (Sec. 7044, Business and Professions Cotle: The ContractoB LicenSe Law does not apply to an owner of property who builds or improves thereon, and who does such work himsall or herselt or through his or �er own employees, pmvided thet such Improvements ere not Intendetl or oNered br sflle. It, however, tha building or Improvement Is sdd within one year ol wmpletion, the owneo-builder will heve the burden of proving ihat �e or s�e did not build or imprwe lar purpose of sale.). • ❑ I, es owner of the properry. em EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to conswct the pmject (Sec. 7044, Business antl Pmfeulons Catle: The wNreaors LJcense Lew does not epDly to en owner ol proparty �vho bulltls or Improves thereon, end who conirects tor such proJect with e conlreclor(s) license pursuant to the Contractors Uc6nse LewsJ. ❑ I am exempt under sec. Business and Proleuions Cada tor this reason: Signeture: Oate: Owner ID veniied Dy tlrivers Iicense. ❑ Ves 0 No Dnvefs License No. Vedflcetlon of Ownership by (rype oi tlaumenl, i.e. - propeny tex bill ar tleetl): Expires: DIVISION OF INDUSTRIAL SAFETY VERMIT CERTFICATION: ' ❑ 1 hereby certly that no excavetlon five (5) or more feet In tlepth into which n pereon Is requlred to descentl, will be matle in cannectlon wit� work euthodzed by Ihis permit, end thet no DUIICing structure, sceHoltling, talsework, or demolition or dismantlinp t�ereol, will be more ihan t�lrty-slx (38) taet high. (Chap. 3.2, Gry 2, Art 2, Sec. 341, Tltle B, Calilomia AtlministraUve Code). ❑ As owner-builtler, I will nol employ enyone to do work which would raquire e partnit trom t�e Oivision ol Indusiriel Selery, as noted ebove, unless buch person hes e pertnit to do such work from the tlivisior�. SigneWre: Date: Division af Industrial Safery Permit Numbar: CERTIFlCATE OF COMPLIANCE AND AIfTMORVA710N OF EMRY: I ceniy untler penalry ol per�ury that I heve read this epplicatlon and state thet the inlormation glven is carrect. I epree to comply with ell stete laws end city ortlinances releting to bull0ing wnstructlon, end euthodze representatives of t�e Ciry ol Coste Mese to enter upon the eDove-descnbed property for inspection puryoses. I agree not to occupy or ellow occupency of eny building au�horized bylhis pertnll until finel inspecNon. ' i�, .i % !� _ �� • / ��/.ii :i• ��i.. — _ CODE �. INSVECTIONTYPE 1818 FixeA System Final Fire Prevention 1266 Pool Spe Final 200 Final Re-Roo1 201 Final Block/Retaining Well 202 Final Factory Fire Place 203 Finel Sign 204 Final Demolition . Q� UQ�� CO�E1 PISVECiIONTYPE 206 Final Mechanical 20B Final Plumbinp 210 Final Electricel 212 Flnal Fire Prevenilon 220 � Final Planning Approval 222 Final Site 250 Final BuAding/Occupflncy PAIE 1t�Li v� (714) 754-5273 • Fax (714) 754d856 • www,ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 562 W 19TH $T Suite: vicinity: Parcel Nunmber: 42214146 npp�icanc NGUYEN, LOC H Address: 14865 DILLOW STREET WESTMINSTER, CA � SIGN PERMIT Zoning: Phone: 714-206-9739 Zip: 92683 Owner: OELKE, HERBERT G TR °/aMC NAUGHTON, KENT A Address %KENSKI PROPERTIES TR FOR KENY MC NAUGHT HUNTINGTON BEACH, CA Phone: �- , PO BOX 1129 ' 2ip: 92647-1129 Co,ntracror. LOC H NGUYEN P,ddress: 14865 DILLOW STREET WESTMINSTER,CA Arch I Eng : Addr@ss: Plan Check: Permit: SMIP Com: Other: Inspection: : � Phone: 714-206-97-39 Zip: 92663 License: 817606 Phone: Zip: License: ISSUED BY: Status: ISSUED Applied: 04242006 Issued: 0424I2006 EXp R�D oa'� 5 SCOPE OF PERMIT 37.5 SQ.FT. CABINET SIGN FOR'THAI TAS1Y CORNER". THIS IS THE ONLY SIGN ON THE BUILDING. ' $35.10 $0.00 $54.00 $0.50 $0.00 $0.00 $0.00 $0.00 $0.00 FEE SUMMARY � Calc Valuation: $t,soo.00 Claimed Valuation: s�,soo.00 ,Total: � 589.60, -- . , � � , --.',-,- �, , � - , . - - ,, i, � , ' � � � PLANNING 8 ZONING '. �- , NOTICE: The work authorized by lhis permit shall comply with all applicable handlcsp access requiraments under Calitomia statutes and related regulatlons. (Ord. No. 92-28, § 1, 12-21•92) EXPIRATION: 7his permlt shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or ebandoned for a period of 180 days. INSPECTIONS: In order for �he work eulhorized under this permit to be considered legal, �such work must comply wlth all applicable codes, and all required Inspectlone end Iinal approvel must be oblained. Failure to obtain inspections and•final approval will result in the expiration of this permlt. FOR INSPECTIbNS CALL: (714) 754-5626 2aa848 (8�0�) WORKERS'COMPENSATON DECLARAnON: � ' . � t hereby 9ffirtn under penalry of perjury one of the followinp tleclaretions: . � ❑ I have an0 wlll maintain a ceNflcate ot consent to sett-Insure for workers' canpenseUon, es provltleA tor by sectlon 3700 0l Ne Labor Code, lar the peAortnente ol ihe work }w w�lch Ihis permll Is issuetl. ❑ I �eve arW wi�l malntain workers' compensatbn inwrence, es requiretl by satlon 3700 ot Ne Lehor Cade, iw Ne pBAortnance of Ne work fw which 1hLq pertnit is is5uetl. My workers' compensation Insuranca cerder enA pollry number ere: Certier. � Policy Number: (71r1s aecNon neetl no( be completed i! rhe perMfls veNed er ane nundred dollars (S �00) or less.) ��'I�certify that in the perfarmance ot Ihe work lor which t�is permit is iuued, I shall not employ eny person in eny menner so as to becoma sublect lo tha workers' —coinpensation lews af Celilomia, e egree thet tl I should become suE�oct to Ihe workers' compensetlon O�oNslons ot SecNon 3700 of the Lebor Code, i ahan fonhwlth comply with these provisions. � � / �Q� Ap`pllcent SignaNre:_ �� Date:'�� 2-/ ARNING: FNLURE TO SECURE WORI(ERS' ENSATION COVERAGE IS UNUWFUL AN� SNALL SUBJECT AN f.IPLOYER TO CRIMINAL PENALTIES M1D CIVIL FlNES UP TO ONE MUNDHED T}IWSPIJO WLLARE ($100,000). IN ADINiION TO THE COST OF COMPENSATION, DNMGES 0.S PRONDED FOH IN SECf10N 3]OB OF iHE Ll�BOR CODE, IMEREST, AND ATfORNE'I'S FEES. LICENSED CONTRACTORS DECLARATION: ol C�epter 9(commencing with Sectlon 7000) at CIe59 M end Protesslons Cade, entl my Iicense is in tull CONS7RUCTION LENDING AGENCY: ❑ I hereby attirtn thet ihere is e conswction IenCing agency tor Ihe pedormance ol the work lar which Ihls permit is issuetl. (Sec. 3097, Civil Code). LenCefs Name: SignaWre: _ OWNER•BUILDEFi DECLARATONS: LentleYs Address: Date: I hereby aHirm Ihat under penelty ot perjury thet I em EXEMPT FROM TME CON7RACTORS LICENSE LAW lor ihe tollowing reeson (Sec. 7031.5, Business antl Professlons Cotle: My ciry or counry which reQuires e permit to consiruc�, alter, improve, demolish, or repair eny structuro, prlor �o Its issuance, also requires Ihe eppllcant lor such permil to tile e slpned stetement t�et he or she Is Ilcensed pureuent to the provisions ol Ihe Comrectore License Lew (Chepter 9(wmmencing wlth Sactlon 7000) of DlWslon 3 of the Business entl Protesslons Code) or tha� he or she Is exompt therefmm end the besls tor the allepetl esemptlon. My violation oi Section 7031.5 Dy eny eppllcent tor e pertnl� sub�ecta the epplicant to e civil panelry ol not more l�en five hundred dollers ($500).): ❑ I, as ovrner of the property, or my employees with weges es thelr sde comperuatlon, WILL DO TME WORK, ena Ihe swcwre is not IntendeG ar ofleretl tor sale (Sec. 7044, Business and Profeuions CoOe: 7Te Coniractors IJcense Lew tloes not apDh to en owner oi pro0orty who builds or imprwes Ihereon, antl who does such work himself or herself or thiouph his or her own employees, provided Ihat such Improvements ere not intended or oHered lor sale. II, however, the bulltlinp or Imprwement Is sold within one year of completion, the owner-builder will hava tho burden ol Drovinp that he or sho tlitl not build or imprwe for purpose ol sele.). • ❑ 1, es owner of the propeM. em E%CLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to construct the project (Sec. 7044, Buslneu enA Protesslons Gode: The contractors Llcense Lew does not eDP�' �o en owner ci property who bullQs or Improves ihereon, en0 w�o contrac6 for such project wlih e comrector(s) license pureuant to ihe Comranors License Laws.J. ❑ I am exempt untler sec. Businou antl Professions Cade lor Ihis reeson: SignaNre: Oate: Owner ID verifietl by tlrivers license. ❑ Yes ❑ No DriveYs License No. Explres: Verilicatlon ot Ownership by (type oi tlocumeni, i.e. � property lex blll ar deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I �erehy cenify thal no excavetion live (5) or more feet In depth Into which e person lv requlred to tlescentl, will be metle in wnnection wllh work euthorizetl by t�ls pertnit, end that no buildinp sWCWre, scaHolding, talsework, or demolition or dismantling thereol, witl be more Ihan thirty-six (36) teet high. (Chap. 3.2, Grp 2; An 2, Sec. 341, Title 8, Cellfomia AtlmInlS�retive Cotle). ' � As awner-builder, I will not employ enyone to do work which would require e permit Irom the DlNsion ol Intlus�nal Sefety, as notetl e6ove, unless suc� pereon hea a permit to Oo such work irom Ihe division. Signature: Date: � DFnsion ot Intlusirial Safery Permit Number. CERTIFlCATE OF COMP�IANCE AND AUfHORVA710N OF EMRV: I certity under penelry of perjury Ihel I heve reetl Uis eppllcation end slale Ihet Ihe intormatlon given lv correcL I egree to comply with ell stete laws entl tlty ordlnances releting ro builtling conslrucUon, end euthodze represenlatives of Ihe Ciry o� Coste Mese lo enter upon Ihe above-doscdbed property lar inspectlan purposes. I egroe nol to acupy or ellow occupancy ot eny builtling emhodzed by Ihis pertnit until tinel insDection. COUE I. MSPECTONTYVE 1616 Fi:ed Sysiem Final Fire Preventlon 1268 Pool Spa Finel 200 Finel Re-Roof 201 FIneI BIacWRetaining Well 202 Flnal Fectory Fire Pleco 203 Final Sign 204 Final Demoliilon GODE 1 INSiECTION TYPE 206 Finel Mechenical 20B Flnal Plumbing 210 Finel ElectAcel 212 Final Fire Preventlon 220 Final Planninq Approval 222 Final Slte 250 Finel Building/Occupency P�IF It�64 0 � (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.CH.1Ls_TRICAL PERMIT n FAIR DRIVE, COSTA MESA, CA 92626 tltl: Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Adtlress: 562 W 19TH ST �r�;�s�iy LOC H NGUYEN 14865 DILLOW STREET Phone: 774-206-9739 WESTMINSTER, CA Zip 92683 Owner: OELKE, HERBERT G TR %MC NAUGHTON, KENT A Address °hKENSKI PROPERTIES TR FOR KENT MC NAUGHT HUNTINGTON BEACH, CA Phone: PO BOX 1129 2ip: 92647•1129 Contrador. LOC H NGUYEN Address: 14865 DILLOW STREET � WESTMINSTER,CA Phone: 714-206-97-39 Zip: 92683 Licanse: 817606 status: ISSUED Applied: 04/24R006 Issued: 04I242006 ISSUED 8Y: � EXpIRnE�(D DATE��I ^� , SCOPE OF PERMIT ' ' "37:5 S�.Ff. CABINET SIGN FOR'THAI TASTY CORNER". THIS IS THE ONLY SIGN ON THE . , . BUILDING. REF.: 5806-00036 ISSUE FEE � � Temp service test Res. alc package , New-Res (1-2 units) New Res (3+units) Pool / Spa Li9htin9 FiMs Recept OuUets . Switches Non Res Appl . Res Appl Service to 200a Service to 7000a Service over t000a Motors to 1 hp ' Motors to 10hp �� '� Motors l0 50hp , Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuiis Temp Pwr Pole Inlermed Pole ELECTRICALTOINCLUDE: t SIGNCIRCUIT. 323.50 S0.00 so.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 50.00 so.00 $0.00. ' . $0.00 : � � $0.00 � 50.00, . $0.00 $0.00 50.00 $0.00 $0.00 50.00 $24.60 50.00 $0.00 Quan�iy 0 0 0 0 0 0 0 0 0 0 0 �, 0 �� 0� 0 0 0 0 0 0 1 0 0 FEE SUMMARY � Temp Dist System / Lighting _ � " , Busway 1t00 fl - � Standing Seclion - - Misc Eledrical Equipment Transformers up to 1 kvalkw ..............:.up to 10 kvalkw ..........:....:.up to 50 kvalkw .................uP to 100 kvalkw ..................over 100 kvalkw � � Low Voltage Equipment �, low Volt Wiring System / Ckt � Misa Conduit � Misa Conductor - , � - Cirws ( gen or nde) � . Circus (mech ride or lights) . - Christmas Tree Stand . Fireworks Stand � - � Other Electrical Fee - Quantiry $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0' 50.00 0 $0.00 0 so.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 ! 0 $0.00 0 $0.00 � 0 $0.00 Investigation Fee ' S0.00 " Plan Check Fee 30.00 Reinspedion Fee $0.00 TOTAL CALCULATED FEES 548.10 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply wlth all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21•92) . • EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned tor a period of 180 days. � INSPECTIONS: In order lor ihe work authorized under lhis permit to be considered legal, such vrork must comply with all epplicabla codes, and all requlred Inspectlone and flnel epproval must be obtained. Failure to obtain Inspectio�s end final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 � 26a&48 (fl�00) WORKERS'COMPENSAnON DECLARATON: . I hereby eflirm under penalry of perJury one of Ihe Idlowlnp declaretlons: . � I �eve entl wlll mainteln e teRlticale ot consent Io 9e11-Insure tor workors' compenseUon, es provided tor by sedlon 3700 0l t�e Lehor Code, for Ihe peAormence af the work tor which Ihis pBrmli Is issuetl. ❑ I heve enO wlll melntaln workers' compensation InsurerKe, es requiretl by section 3700 af Na Lebor Cade, fw Ihe peRormence ol Ne vrork ta whicl� Ihis pertnit is Lssuetl. My workera' compensation Insurance cartler arM pdiry numDer ero: � � Carner: � Policy Number: (7)tls secNon need nof be cwnp�etetl i/ the permit is valuea ef one huntlretl tldlars (5700) or less.) ;I;certity that In the peAartnance of the work lor whic� this permit Is issuetl, I shall not employ eny parson in any menner so as to hecome subjeM lo Ihe workere' compansallon laws of Calitomia, end egree that if I should becoma sub�ect ta the workers' compensaUon proNsions ol Sectlon 3700 01 Ihe Labor Cotle, I ahall forthwllh comply wlth these provisions. 1,��.� (p � /� ;eniBipneture: `—' � Vy v Deta: /� l`�[� d(iJ IIM3rFAILURETOSEWREWORKERS'COMPENSATI COVEM�EISUNUWFULANDSHALLSUBIECTANEMPLD7ERTO�CFIMI -PENALTIE ANDCMLFlNESUPTOONEHUNINiED SrW D DOLLARE (5100.0001. IN ADDITION TO THE COST OF COAIPENSATION. DAAMGES AS PiiOVIDED FOR IN SECf10N 3)OB OF THE UBOR CODE. INfEREST, AND ATTORNEYS FEES. LICENSED COHTfiACTORS OECLARATON: I hereby etti�_thet I em licensetl under pmvisions of Chapter 8(wmmendng with Section 7000) of Divislon 3 af the Business end Pro�055ions Code, end my Ilcense is in full tace'enC affect..Liatl.- '- � l% ��CJ CIeSs'R�-:-Cl.r —S T _ Contrec�Signatura: �—�T� �.�.( ��a�Ee; �� u�0�1 ,..� �-- "v r �- .---- iT�TT CONS7RUC710N LENDING AGENCV: � ❑ I hereDy ettirm Ihet t�ere Is a wnstructian lending agency tor ihe peAormance ol the work for which t�is pertnit is Issued. (Sec. 3097, Civii Cotle). Lendefa Name: Lentlefs Address: Signature: OWNER•BUILDER DECLARATONS: Date: 1 hereby eMirm thel under penelry oi perjury Ihat I em EXEMPT FHOM THE CONTRACTORS LICENSE LAW tor Ihe lallowing reason (Sec. 7031.5, Business and Prolessions Cotle: Any ciry ar counry whlch requlres e permlt lo canstruct, eltor, Improve, tlemdish, or repair eny strucwra. pdor to its Issuence, elso reQuires the epplicam tor such permlt lo tile e sipned sletement Ulat he or she Is IlcBnsBd pursuent lo Uie provisions oi Ihe Contreclors LJcense Lew (C�epter 9(tqmmendng with SecNon 70W) at Divislon 3 ot Ne Business and Professions Cotle) or thet he or she is exempt thorelrom entl t�e besis tor the ellopetl exemptlon. Any Nolatlon ol Sedion 7037.5 by eny appllcant tor e pertnit su6jects Ihe epplicant to e civil penelry ol no1 mora than tNe �undred dollers (5500).): ❑ I, es owner af tha property, or my employees with weges es thelr sole compensation, WILL DO TNE WORK, anC Ihe structure Is not intenCetl or otlereC lor sale (Sec. 7044, BuSiness enO Professlons Cotle: The Contractors License Lew does nol appN �o en owner of properry who Duiltls or improves ihareon, and who tloes such work �imsell or herself or through his or her own employees, provided that such improvements are not intended or oflereO �or sale. II, �owever, the building or Imprwement Is soltl wilhin one year of completion, the owner-builder will have ihe Durden ol proving Itiat he or she did not bulld or improve for purpose oi ule.). � ❑ I, as owner oi the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consuuct t�e prqect (Sec. 7044, Busineu and Professions Cotle: The mntractors License Lew tloes not apply to an owner ot DmDehy wfw builds or Improves t�ereon, entl who wmrecls tor such project wit� a contractor(s) license pureuam to the CONradors License Lews.). ❑ I om oxompl untler sec. Signeture: Owner ID venfied by drivers license. ❑ Ves ❑ No Business end Pmtessions Code for I�Is reason: Vedficetlon oi Ownership by (type oi document, I.e. � property tax blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CER7IFICA710N: Dnvefg Litenso No. Dete: Explres: ❑ 1 hereby ceNly that no excavetion tive (5) or more feet In depih Into which a person is requirad ta descend, will be mede In connectlon wi�h work authonzed by this pertnit, end thet no builtling structure, scaHoltlinp, falsework, or demolition or dismantling ihereol, will Ee more Ihen thirty-six (36) teet high. (Chap. 32, Grp 2, Art 2, SeC. 341, Tltle 8, Califamia Atlministrative Code). � ❑ As owner-bullder, I wlll not employ enyone lo tlo wot< whic� woulG repuire e permit iram Ihe DMsion of Intlustriel Selery, as notetl ebove, unless �such person has e pertnit to do such work from ihe Oivision. , SignaWre: Date: Divisian ol Industnal Safery Permit Number: CEHTIFlCATE OF COMPLIANCE AND AUfXORPA710N OF EMAY: I certity under penaly ot perjury Ihet I heve read Ihis epplication and state that the InformaGon given is cortecc I egree to compy wIU� all state laws entl dry ortlinances relating to building constmction, end authodze representatives of t�e Ciry of Costa Mesa to enter upon Ne above-tlescribed property tor inspection purposes. I agree nol to acupy or elbw occupancy at eny building euthorized by Ihis permit until final inspecUon. COOE 1. INSVECTIONTYPE 1816 FixeC System Final Fire Prevention 1266 Pool Spe Final 200 Finel Re-Roof 201 FIneI8lock/Fleteinin9 Well 202 Finel Fectory Fire Plece , 203 Final Sign 204 Finel Domolltlon COOE� INSPECTIONTYPE 206 Finel Mechanicel 208 Flnal Plumbing 210 Finel Electrlcal 272 Flna� Fira Prevention 220 Final Planninp Approval 222 Finel Site 250 Final Building/Occupancy � � auoxruaem�w+c: 562 W 19TH ST avruxswueiva�a�x OELKE HERHERT G TR �ss $BERTbLINO, PIERRE J 1014 ARHOR ST --� COSTA MESA,CA 92627 �cv�: wuurw �ooxess: �ucxirccr ox exm��n: umx on �o.�s,won�ss: uc xo.: ��+T: CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: E 081704 PLAN CHECK NO: , N CONSTRUCTION TYPE; V—N_. _ PERMIT TYPE: ELE JOB DESCRIPTION : 33 SQ FT ILLUMINATED WALL SIGN UNT: CLAIM VALUE: CALC—VALUE: coam�crarswu� CORPORATE DESIGN/BR ENTER (719)253-4612 cwm�cTorcs�uiu'c 2102 BUSINESS CENTER DR �oo�ss IRVINE CA uexo, 635917 92715 uM: LICENSED COHfpACTOfl4 DECLAFAnON: I hereby elfim uMx penely d peejury Uut I em liwnasd uMm prwieb�u (f GMqy 9 I�menarq xi�h Seetion >Ooa) d Dnio� � d Me Bueims uM Pmimeipw CoEe. antl my Ikenee e in NII lorea eM aMatl. cmuc.No.:060990 uc.cuss: C qs uc.No.: 635917 EXP: 12/97 Dma: � �l i`7 "'1 � Contrapm: OWNEN BIIILDEN DECLIRRTION; I hereby dlum under pruly d prjuy Ihet I em uemp 1 e Camrsuon Liomsa 'bv.iq �mmin (Seuion )W t.5 &niWs eM Rdvdona CoJe: Am' ciY a mmiy Mitl� n" e pwmd to amamct. ep>. imww*. Nnd'oh, w repei mry sirueluro, peior i0 m waeMa, ebo �puim tM epp4ren11or wM ppmn �o fib e mpr�ed ewemenl Me� M a eM e IicemeE qmueM lo �M provmpro d��M�atla* l+ema Law �Chaqer e(mminwiip wGh Satlion )000) d D'v'nian 3 d ib Bue'vru erd Prdra4a Cotlel a thei Ir a tln w ummq iherWun uM the bam la Ne eOeqeA mamqion. My vitlmcn d SW un ]W 1.5 by airy epp4cem la e permil �ubjetl� Ihe eppl'rem io a dW peneAy W np mda then fxe hunErtE do0an �S,r00�. ❑ I.avowMrdiMpW�YamYaTM�'bswYhwq�e+mlheieobwm0��.witlEOlheMwk.e�dNsoWCYun�nd"vueMeE a dlmad br veb (Sxlian ]OU. B��ea eM Pmlma'vnCods: The Cammtlmlioeroe lewdoss nal epp!/loen an�ard pope�ly who WiEs a inpa+e tM�em. erd w1a Aoes audi xoA h'vnrX n MnM a thraph he rt her own anWeY�. V�� Aet euch imqovemenle era rot imeMeE aOMereE lor sele. M, however, tM buiking or'rnpwemeM ie eoN wnhin pro yeer ol compinbn, the owrorbuiNer xi11 heve t�e burden d pavin0 he a eha dN � buiW or impmro far IM puryovs d veb). ❑ I. m owror d ihe D�W�Y. am e�d�'M' oonlrm�9 wilh licaneed oonlrecYas m conW W ihe MN� (SeCion ]Os1. &u'vims eM vrotmams coee�. rne comreaac Licenee law eoee �w. eroN w en ownx a wwMv who wiwe a Imw�+m lhmeo� m�a wru eoMreda far mxi� prqetla xilh e��Ma) IieemeE punueru lo IM Caueaqors lim'ue lewl. ❑ i.m �a � s.no�: e. a v.c.. m. w. �: Dtle: Ox+w: i eo nreM �r �nm i em ,ware a da �..�,�d me ��«w a c.00m. �benn ene smw coa. s.aion. uws. rsn. �a 25534. vd thel I a enY �uro buiWinp Oewpent xill / wil �(areb ane) � to eompy wih uid eble mAu end tM epui�emaMe br .w�a�«cwwwc�ion«nwaifi�onrta��n.�:�t v�nwuDiaiitl.Paue.vilcvnnivaionwpic.�ion..i.mm+a�mmmm. P�eiona. od.: nooir.m: W ORKEN'S COYPENS�TON DKL�qATiON: 1 heraEy eHvm under pruXy d prpvy wa d iha Idbwinp dedvtl'vu: ❑ I hew e�d xi1 maimen a ceMNicme d ooroam b ea11-ineuro for weken' compemtlbn, m povidad fp by Setlbn 3]OO d tha lnbor coe.. ra �ne v��e a u,. wn� �« w:w �hi. vu�n u u.u.d. ❑ inm.m�d.u�a.:�wmw.•oo.�v��,rerc....�wm.eMs.abnarooam.ieno,coa..�«mew�«mem.am. work la xhidi Mie pamin u ivued. MY �an' �P�� uunrtence mrier end pd'v.y numbr aro: c.m«: Pd'ry Number: I� y(1Absxtionne.drrorbecomuhfM/�Mw�rinbra+ehurMrsdadleraRfao/wbo.1 ��. •r] I onM � in ihe pertmwica d tM wak tar which �his p'me u iseueE. I eha! �xf emplvy ury pacn n amy mannr �o o to n«o� .�qea m m, .on�s• c�aa+W� �.w. a cdn«oy. �e m,.. �m a i enwb e�om. wp.a �o me wona.� canoeoser � wa�eb�� m seemn a�oo a me �.ehor coae, �.w� �onnwim comvN wnn �noNA w�e � om.: ^3 a c�� I_, �oa�: � /1 W�minp: hNun b seeun woilrw�' e0mpe�wtlon ew�np� l� unNwlu( �ntl �hsll iub/1cM an loyw b nfiNml pm�ltlu entl aM� M.. w m en. nu�avd mou...d awm.ls�o4aooA a.miwn ro m. eo.t or rn�ryru�rbn ��w� u a+evxwa ror N S�ctlon J106 0l tln Labor Cob, Inf.rNt �d aRam�y� hq. consrnucnoN �aarm �oeNcr. � n�nr ma� �d.� w�r d w�iwv �n.� m.. e.�m�w� r�.ey .�..y i« m. �OT19110 O� 1�10 MVk �OI W�Ilf�l ��1Y V�� 9 C811l� (5lf11011'.I�Qi. (�rM. rii. IENDEP'S NMI E: LENUEX'9 �ODPESS: I canM tlim I hrve reM Nin epplicmion mk pete ihet Me eEove iNwmelion ia cartsy, l epres lo canply rrit� e0 dy enE ewnry adiiwree eM etete lewa Melirp to buiMinO conelrud'an end he�abY aNhorixe re�xesenlelivee oi lhis tlly ro emm upon Ihe ebove�memioned pmpMy �a ��°'d� "„°°°°'. MAR I E � � n e W�ile-Buildip d MY: GreeMFb: Cvwy-Appicen�: Rnk-Rewnue: CiddenmFMwea PERM NO: E 081704 GOVT: N SUPP: N PURPOSE: ADD SQ FT: GROUP OCC: B / COMMENTS; "DOMENICOS" WALL SIGN / REF SB 81703 x��r**x*�***x*��*�e�r*�*�e*�x�*�**�e�r**rx��+rx�+r**+�***�*x��r�r**�r�r*�r�t�r�r**x�r�r**�r*�r�r*�**�r�r* Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- ------ -- ACCESSORY BUILDING --------- FRNT: FT IN_REAR: FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV: PARCEL: 42214146 2NE: REF NO: PLANNING NtST'ES> 1 1k ik i4 iF ik iE 1E 1E 1E iF 1F 1f 1f if if 1f 1E k 1k iE k 1E fF ff iF if 1! iF iE 1(' iF iE k 1E 4 iF iElf if 4 k 1f iF 1f 1E ii 1f if 1f iklF 1k 1k ik 1k k 1E iF if 1E 1E iE iF iE 1k 1k d! ik iE ik k iE 1E 1f iE iF iF if iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPAOVED BY c APPLICATION ISSUED HY ik 1F 1F 1F 1k iE fE 1E 1E 1E 1E iF 1f if 1k if 1E 1F iF 1E ik LEGALIZATION:N F E E S U M M A R Y DATE; DATE: �V� itikkiflkikiEif kiE STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 22,00 SOE SMIP/NON—RES PLAN ISSUE FEE 22,00 HUILDING—DIV—> PERMIT� .ISSUE, PLAN—CHECK TOTAL PAID DUE TOTALS----> 22.00 22.00 0.00 44.00 44.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 44.00 OVER/SHORT; .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 44.a� k iE 1E k iE 1E iE 1k k fE iE iE 1E iE if if 1E iE 1f iE k iE fE if k ik ik 1k 1E 1F iE iE k k 1E iE 1k iE k k dE 1E k'1f iE ik if if 1f Ik iF iE 1k if iE 1E iE iE 1E iF 1k iE 1f k if iE 1E 1E iF if IE iF 1E i! 1E i! ik')f �F ._ I N D I V I D U A L F E E B R E A K D O W N ELE QTY _, D E S C R I P T I O N UNIT COST 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 22.00 END OF FEES �%�r'�RED � Incompiet . (rs�ecUons � Yt�� E�� --_..� TOTAL COST ?Z.�� 82-28-1997/12;q4 DM/fq4.BB PERMITeTB81704 c CONSTRUCTION AND PLANNING � P� � SPA � App1;OVALS Permit # � Date I�spec[or AppROVALS Permit # Date Inspector �, "�nporary Electrical Service or Pole 52. Pool & Equipment Location �� I 2, Soii Pipe•Undrgrnd. � �53. Stael Reinforcement � I . . . 3. Electrical Conduit Utilitv-Undrgrnd. 54. Forms • ' - 4: Electrical Conduit=Undrgrnd. , 55. Electr.ical 8onding 5. Steel Reinforcement 56. Rough Plumbing & Pressure iest � 6. Electrical UFER Grnd. . 57. APPROVAL TO COVEF•GUNITE � 7. Foot�ngs -` - � 58. Electricai Conduit-Undrgrnd. � 8. Foundation ., _ � 59. Gas Pipe, � Undrgrnd„ Test I 9. Water Pipe-Undrgrnd. ,� 60. Backwash Lines, P�Trap, O Undrgmd. 10. Structural Floor System �� 61. APPROVA� TO DECK . ' 11. Properry SewerLirie & House Connection 62. Backwash &'Receptor•Final � � 12. Seyaer Cap �_ 63. Heater & Vent•Final 13. Roof Orains �' � 64. Plumbing SYstem - Final _ 74. Rough Plumbing, - 65. Electrical-Final � 15. Rough Electrical�Conduit � 66. Solar System�Final ' 16. Rough Electric Wiring �i 67. Fencing & Access Approval � 17. Rough k'Jiring Sign - , 68: APPROVED FOR PLASTERJNG � - 16. Rough Electrical=T Bar Ceiling 69. POOL/SPA SYSTEMS FINAIi � 19. Ro�gh Heating & Ai� Conditioning - � � PIRE DEPT. REQUIREME T - - " - n 20. Rough Factory Fireplace " ' � . - ' APPROVqLS, _ Permit # 2/. Ducts, in�Structure � - � - . 70.�Underground HVdro � 22. Ducts,Ventilating� " _ `, ' 77, product�PipingO�Gas ❑Oil 23. Gas-Pipe-Rough & Test � -- - 72, Underground F4ush 24. Roof� Framing = � � . 73. Undergrnd. Storaye Tank OGas ��Oil 25. Roof Sheathing '_ . � - 74. Overhead Hyd.o 26. T-Bar Ceiling �Structural) & Monocoat � 75. Dry Chemical �� 27. Frame and Ffashing _ �• �- � 76. Dry Staodpipe-� �� • 28. Lathing & Siding -" � 77. FIXED SYSTEM FINAL_ 29. Insulation � . � . 78. FIRE PREV. FINAL ' - 30. Drywali Nailing • �-HEALT,H DEPT'REQUIREMENT , 31. Plaster Brown Coat . - � �, 79, fINAI INSPECT-ION 32. -Electricai Power Meter�Finai �' , 80'. FOOD CERTIFICATE ISSUED • � 33. Final Electric _ , . Notes: - • � � 34. Final Heatinq-& Air Conditioniqg'. - -' � ' ' '_ - � . � 35. Final Gas Pipe-Test; . � , . - - . ` - 36. Hood or Canopy - - 37. Final Pactory Fireplace .. .. , . .. - � t. 38. Final Plumbing � - ' � ' _ . - � 39. Water Service-Finai �� 40. Gas Service•Final • . � � 41. Solar pomesticFinal '= . , � _ ; , � 42. Backflow Preventer � , ,.-� M » ;"`�- . ' - �� - ' S 43. Backf�ow Irrigation � � _ 44. Landscape Irripation System - � - � - - - � 45. Sound Attenuation -� ' ��„ ' _, ; � _ , 46. Handicap Regulations . � � : _- _ _ , 47. FINAL STRUCTUiiE & BUILDING - - � 48. fINAL PLANNING - : �49. EfecYrie Aefease to Edison j- ' - ' . - � 50. Gas Neiease ro Southern California Gas Cn 51. CER7IFICATE OF OCCUPANCY , , __ , No Date (714)754-5273 • Fax(714)754-4856 Job Address: 562 W 19TH ST ' Suite: Vicinity: COMPLETE ROOF Parcel Number: 42214146 Applicant: ODILLE P. RASOA Address: 939 SERRA WAY CITY OF COSTA MESA BUILDING D/VIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT BUILDING PERMIT COSTA MESA, CA ' owner: OELKE, HERBERT G TR Addre55 °hBERTOLINO, PIERRE J � ' , COSTA MESA, CA � , " _ � " 1074 ARBOR ST � � Contractor: #1 BEST ROOFING COMPANY Address: 939 SERRA WAY COSTA MESA, CA Zip: 92626 Arch : Address: Phone: Zoning: .Phone: 774-034-2525 Zip: 92626 Phone: Zip: 92627 Phone:� 714-434-2525 License: 722805 , /� Eng: Address: PERMIT NUMBER B99-01971 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: 12/16/1999 Issued: 72/16/1999 ISSUED BY: � � " / Phone: i -,Zip: ' � � License: � License: SCOPE OF PERMIT REROOF - TIO, USING EXISTING SHTG, INSTALL NEW 2 PLY BUILT UP ROOF. SUBJECT TO FIELD INSPECTION. Plan Check: $0.00 Permit: $251.25 SMIP Res: $0.00 SMIP Com: $3.09 Other: $0.00 Inspection: $0.00 Total: 5254.34 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY �Front 0-0 PARKING Existina: o NOTES: FEE SUMMARY PLANNING & ZONING Rear 0- 0 Left 0- 0 Rear 0- 0 Lefl 0- 0 Required: 0 Pr000sed: 0 Calc Valuation: Ciaim Valuation: Right 0-0 Right 0- 0 $14,702.DD s�a,�oz.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not iommenced within 180 days, or if work is suspended or abandoned for a penod of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspectlone end final epproval must be obtained. Failure to obtain inspections and final approval wifl result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSAnON DECLARAnON: I hereby aHirm under penalry oi perjury one oi ihe tollowing declarations: � ❑ I have antl will meintain a certlticate ot consent to self-Insure for workers' compensation, as provided for by sectlon 3700 of the Lebor Cotle, for Ihe pertortnance ot the work for w�ich ihis permit is issuetl. � � ❑ I have and will mainlain workers' compensatlon insurance, as required by section 3700 ot the Labor Cotle, for Ihe peAortnanca of lha work for which this pertnit Is issued. My workars' compensation Insurance�errier end�olicy number ere: Carriec �{,(_(� mlaf> 1..IM t�'f� N Policy Number. /This secfion rfeed nar be comaletetl / the oertnlf /s ve/ued et one hundred dollars ($100) ar /BSsJ ❑ I certity t�at in Ihe pertormance ot ihe work for which this permlt is issued, I shall not employ eny person in eny manner so as to become subject to the workers' compensation laws of Calitomia, and egree that if I should become sublect lo the workere' compensetlon provisions of Section 3700 of ihe Lebor Code, I shall foM1hwith comply with these p c�l ' s`.� 9 Applicant Signeture: � �+ Date: �L _l� �q WARNIN6: FAILUFE TO SECURE WOPo(ERS' CAMPENSATION CAVERAGE IS UNLAW FUL AND SHALL SUBIECT AN EMPIOYER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO ONE HUNDRED THOUSMID DOLLARE ($100,000�, IN AODITION TO THE COST OF CAMPENSATION, D�MAGES AS PROVIOEO FOR IN SECTIIXJ 37060F THE LABOR CODE, INTEREST, AN� ATfORNEV'S FEES. LICENSED CONTRACTORS OECLARATION: I hereby attirtn that I em licensed under rovisl ns oi Chapter 9(commencing with Section 7000) of Division 3 ot Ihe Business and Profession5 Code, and my license is in full torce ana ettect. Lic. a 722 ��.� Class s �—� , Contractors�Sgnaiurei _ Date: 1'L _ 1� 9� CONSTRUCTION LENDING AGENCV: . ❑ I hereby aHirtn Ihet ihere is a consiruction lending agency for the peAormance ol the work for which ihis permit is issuetl. (Sec. 3097, Civil Code). , Lentler's Neme: Lentler's Atltlress: Signatura: Date: OWNER-BUILDER DECLARATIONS: I �ereby aflirm ihat untler penalry of perjury thet 1 em E%EMPT FROM THE CONTRACTORS LICENSE LAW for �he following raason (Sec. 7031.5, Business and Professions Code: Any ciry or counry which requires a pertnit to consiruct, alter, imprrne, demolish, or repair any struciure, D�a� �o its issuance, elso requires the applicant tor such permi� to file a signed stetement that he or she is licensetl pursuant to the provisions ot the Contradors License Lew (Chapter 9(commencing with Sectlon 7000) of Division 3 ot Ihe Business entl Protessions Code) or that he or s�e is enempt Iherefrom and Ihe basis for Ihe elleged exemptlon. Any dolation oi Section 7031.5 by any epplicant for e pertnit subJects the applicant to a civil penalry ot not more than tive hundred dollars ($500)J: ❑ I, es owner oF ihe property, or my employees with wages as their so!e compensetion, WILL DO 7HE WORK, entl the stmcture is not imentletl or ottered for sele (Sec. 7044, Business antl Pmfessions Code: The Conirectors License Law tloes not apply to an owner of properry who builds or improves thereon, and who does such work himself or herself or ihrough his or her own employees, pmvided thet such impmvements are not intended or oHered for sale. If, however, Ihe building or improvement is sold within one year ot completion, the ownerbuilder will have the Durtlen of proving that he or she tlitl not builtl or improve tor purpose of sale.). ❑ 1, as owner ot ihe properry, am E%CLUSIVELV CONTRACTING WITH UCENSED CONTRACTORS to constmd lhe pro�ect (Sec. 7044, Business and Professions Cotle: The contractors License Lew does not epDly to en owner oi property who builtls or improves thereon, anC who contracts tor such prqect with a contrector(s) license pursuant to the Contrectors License Lews.). ❑ I am evempt untler sec. SignaNre: Owner ID venfietl by dnvers licensa. ❑ Ves ❑ No Business t�ntl Professions Cotle tor ihis reason: Venfication of Ownership 6y (rypa of document, i.e. - pmperry tax bill or Geetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivefs License No. Date: Expires: ❑ I hereby cenify that no excava�ion five (5) or more teei in depth into which e person is required to descend, will Ge made in connection with work authorized by this permiL en0lhat no builtling siructure, scettolding, falsework, or demolition or dismantling ihereof, wlll he mOre than thirty-six (36) tee� high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8, California Adminisirative Coda). ' ❑ As owner-Duiltler, I will not employ anyona to tlo work which would roquire e pertnit from the Division ol Industnal Safety, as noted above, unless such person has a pertnii Io do such work irom ihe divi5i0n. Signature: Date: � Division ol InduStnal Selety Permit Number: CER7IFICATE OF COMPLIANCE AND AUTHORIZATION OF ENTRV: I cortify under penalry of perjury ihat I have raad this application and state Ihat tha intortnation given is correct. I agree to comply with all state laws end city ordinances relating m buildinq construction, end authorize representatives ol ihe City of Costa Mesa to enter upon the ebove-tlescnbad property lor inspection purposes. I egree not to occupy or allow occupancy ot any builtling authorized by this permit until final Inspection. �SignaWre Ot Legel Owner(s) Da�e /�._ ,�_qq Antl/Or Authonzed Applicant Date COpE �, INSVECTIONTYPE 1616 Fi:ed System Final Fire Prevention 1266 Pool Spa Final 200 Flnal Re-Roof 201 Final BIocWReteining Wall 202 Finel Feclory Fire Place 203 Finel Sign 204 Final Demolition [aati ac oa� INTIfIALS K-=�cA--�( .�z+� COOE I INSPECTION TVVE 206 Final Mechanical 200 Finel Plumbing 210 Finel Electrical 212 Finel Fire Preventlon 220 Final Plenning Approval 222 Final Sile 250 Final Builtling/Occupancy oarE INfIfIpLS ,monFss or amiwnc: _,5 6 2, W 19 TH S T ,. � uNT: _ a^+ERs"WE�F�+o"": OELKE, HERHERT G TR A�DflESS YHERTOLINO, PIERRE J ' 1014 ARHOR ST " COSTA MESA,CA 92627 ��-� ..wwm �noness: urcxrtecton�ax�n: JERRY TUCKER ��NO= 2187 urcx.on�•s�oonEss� � �508 NEWPORT BLVD �M� _,N.B. CA 92663 cor+m�crortswuie: � CONfRACTORS NYIING /iWNESS: IlG NO.: uxr: IICENSED CONTPACTOflS OECIAN�TION: I Iweby Mnn uMy penNy W paijury Ihm 1 un IicanseE uMx pro`mia d Cheqs e (commercirp wilh Seclion ]000) d Oiriaun 3 d Na &�tinen end PNn�a Cade. end mY lioenae is in lull fau and e1�eG. cm uc. No.: uc. cuss: uc. No.: , E X P;_. Dme: Cauntla: OWNEfl BUILDER DECU�RATION: I heeeby alfirm unEar qreiy d p�Nrv �� I em eumq Iran iM CaMretlaa lieenee law Ia Ihe ibwn9 ��son (Setlion )031.5 Bus'vims and Vrdmsuns CoEe: piry c1Y a muNy whiCi �uirea a qrmA �o muhuct. eYer.'unqova. mole�, or repev any s�r�etura, qia io Ga eauenee. ebo eeQu'ves �M eppl'reN la ach permil lo fib a siprcd etmemeN tlet he a ehe 1'mnseC pureuem lo �ha prwivona ot Ne Contreaas lirome lew �Cliepler 9 jmmmendep wil� Seaion A00) d Dvoion 3 d ib Buaine� uM Pralmsons Code� or thei he « ehe a eaemq thereham enA tM betis /or IM dbped memqion. My violmun d Seqion )031.5 by anY eDVlirant lor e permil eubjade IM eppl'rau to e dW pa�dH ot na mare Ihen IHe hundretl ddlen �5500�. I. m ox�r d �M papanY a my emplv�aes wY� xepee n Ihei eda mmpemetion. wdl Eo IM xnrk. end �M eWCNn e na inteMed -a Mwed br eab (Seclion )oN. BueineneM Pmlmwon�Code: Ths Caureaore lioenee law doea �at MVM �o en amard popeny who W iM a inpovas tMreon, and who Eom �uM wmk h'vnaetl a MisM n throuph he a �er own empbyee�, pwideE �Mt euch impwemeMa ere rat inieMM a Weretl la eab. tl. howws. �Iw hriki'p a inpv.amenl is edtl wnhin ms yser d canpbion. tln o.,�,.w��. �;u na�a ins w� d ao.+m n. «.n. ea �n nma « �mwo.. i« �n� wmo.e a.w�. � I, m ovmer d Ihe propeM. � axd�nivay conlrad'np xith 4ceweE conUactan lo cmarud Iha qajeU (Safion 101�, &p'uma aM Pmleviane CoEe: The Commnm L'rame Lew Eom rwi eyqy b en owner d propeny x1w WiICa a impovr thsrson uM who conlrecla la eurl� prqecYe wilh e mnlretlor(e) IcenssC punueN lo tM CUYreCas LicenSe lew). aumq urMer Senion: B. 8 P.C.. br n �eeyso�n: /-- . Dme: . � � 6mw: �e 1 \ l � cen�ry w� i� e.m, a d,a uneem.m m. na��«w a cviom�. H„an d,e smnr coa. seaion. uws. usa�..�a Y553t. erd ihet I a enY tuture Wikiiq om�pem xiu / wil na (tircb orol r+�d to oompy wYh vaid ¢We aoEee erd tM ipu'vem�nb Ior epemNipcputru[�bnamodilce�bnhomlMAi�y empenwCDW�id.Rmidwniloonp�ucloneppivtiqqyay�emqrypnthpe oa�e: nnp�: WOHKER'S COMGFNSpTION DECUNATION: I Mreby eflum unCer paneliy d perjury an tl tl�e Idbrrirp Aetlarmim: ❑ I heve uq wil maman e cerlifrale M mment �o eeMi�mna lor Ndkere' wmpenemion. m provided fw by $ection 310U d tM Lebor coaa. r« m, n,nom,�� d me ..aw io, w:on mo �u 4 m�e. ❑ in��aw��m.:��•oo�o�mo�,��a,�..m�rv�.aws«�ma�oodu,.�m.cas.(«meo.n«�en. work la whi 1� thie pe1mX u inued. MY �+'�+�' �p�� ^a�� erd pN'v.Y number va: Caner: PWioy Number. (iM1u settim nee0 mf 6s comPbredY tM1s P�t u/a ms hwdreC d� litOVl a ba.) ❑ I cen/y thm in the peAwmu�m d tM wark br xTich Rns prme is iewed. I shM rrot em0loy enY Po� in enY men�ror eo u �o becwne wEjed lo ihe woM1ere' compenWion kw� W CelMqnie. uM ep�ee thm il I ehould become wbjw �o the xpksn' mnpenea�ion qovieune d Sspbn 3]00 0l tM lebor CoEe. I ehd� IMhwnh aompM �h iMes provieione. Dete: Appfcem: W�m/np: F�ll�n b ucun waMm�'romp�ru�tlon ro✓�rp� l� ur��+'ful, �iW �M/I wD/�cf�n Imployx to crlMnl pw+�ftlq �M nM� M.. �y ro on. nure.w rrou,.w ed4n lsfa4000A b.�d��n ro m. co.t or mmp.r,wrrory wm�pw n povro.e ror �n 9�etlon 9�06 el tli� L�6o� COM, lnM1nst. entl attomry'� M1u. CON4TflUCT10N LENDIN� GOENCY: I AaeCy eHvm uMx peiuM1y d per'�vy thtl Ihae is e oonq�upion bMirp epency br ths nename�we a ine ..w� iv .n�m inw v�� u ew,.d (sscia, aoe�, cH. cl. LENDEfl'4 NI1ME: LENDEH'S ADDFESS: ' I canily ihet I heva reM tM1ia epdKeiion enE neie ihm �he above inlamalnn b conetl. I epree lo comply wilh ell rny vd county pdinenne vM eime lewe raldnp io builEinp mnaVuction erq Mreby einhorrza �apesm4e�ivn d Iluv tltY lo an�m upon iM eEo.•e.memioried papMy Iw impeqian purpoxa. v PETER SAAHI , (5151' Je.WP) o�e: y`�—°t �' Whiie-BuiWl^0 8 SetelY: O'een-FJe: Cerern'�PO��: Pink-Rs.enue: OONmroG-Aveaaar __ . CITY OF COSTA MESA - HUILDING PERMIT ` PERM NO: E 07703 PERMIT NO: E 077037 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE; OTH JOB DESCRIPTION : RAISE SIGN FROM 2' TO 6'4" _ SQ FT: _ CLAIM VALUE: CALC-VALUE: .. GROUP OCC: B / *�******��+Rt�***�t*�********D**�******�t�***(��*�x�*H***�****x��tx��t*x ��c**x�*�r��r+r+r��t* Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILDING ---------- FRNT: . FT IN REAR: FT IN LEPT: FT IN RGHT: FT IN --------- ACCESSORY HUILDING --------- FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42214146 ZNE: REF NO: PLANNING NOTES> i if 1E 1(� iF 1E IE IE 1E IE iE 1E 1! iE 1E 1E 1f' iE 1P fElE 1f 1E 1E if 1f if if if 1f 1f 1f 1E �II� if 1E 1f iE i(� 1E 1k 1f if if 1f if if 1f ii 1f if if if 1E 1E 1E iE 1E 1! 1E 1E IE fE 1E IE iE iE IF iF ik iF 1E if 1E if iE 1! i! IF iE D E V E L O P M E N T S E R V I C E S R E Q U I Ft E M E N T S ZONING APPROVED HY . _ DATE: BUILDING APPROVED HY : DATE: / �� APPLICATION ISSUED BY: DATE: o 1FIFIEIEIE7EIE1E1E1E1E1E1f'1Eif141fif1FKlfif 161E1E1E1EiE1E1ElElE �E1E LEGALIZATION:N F E E S M M A A Y STRUCTURAL S GM NT:N HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMZT 15.00 SOt SMIP/NON-RES PLAN ISSUE FEE 15.00 HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE TOTALS----> 15.00 15.00 0.00 30.00 30.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN-CHECK 30,00 if 1E 1E iE 7E 1f 1E 1E 1f 1E iE if 1E IE iE 1E 1E 1E if 1f iE 1f 1E if iE ik 1f 1k 1f 1E 1E 1F'M'141F 1E 1E 1E 1f 1E if 1k 1E 1f if 1E if 1f' iE 1E 1E iE iE 1E 1E 1E IE 1E 1F 1E iF iE 1E if 1E IE 1E 41! 1E 1E IE 1E 1E 1E iE iF iE 1f I N D I V I D U A L F E E H R E A K D O W N TYPE QTY. . D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC _ END OF FEES r �� _ n / �11LC�'�r� �" . , �v.� I'�•• +'— —�\ V \ ....i �� '. �. 15,00 15.00 �� i71r:'I-��-J . "...j_ __ �_: __ �i��: Jr�"_�'. .i. _ _'� k. � jRUCTIONANDPLANNING �� P�� SPA ' Ar .JVALS Permit# Date Inspector qPPROVALS Permit# Date Inspector 1. yemporary Electriwl Service or Pole � 52. Pool & Equipment Location ' I� 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3; Electrical�Eonduit Utility-Undrgrnd. 54. Forms '! .�' - - - I 4: Electrical'Conduit-Undrgrnd. 55. Electrical Bonding �. ��) � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test n �' �.' _6._ Electriwl UFER Grnd. 57. APPROVAL TO COVER�GUNITE , - _7. Eootings �'� �. 58. Electrical Conduit�Undrgmd. �8: •Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. � j 60. Backwash Lines, P�Trap, O Undrgmd. 10. Structural Floor System . '1 61. APPROVAL TO DECK 1 t. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final 12. Sewer Cap � �,n 63. Heater & VenbFinal 13. Roof Dreins - -_J� 64. Plumbing System � Final 74. Rough Plumbing ,: 65. Efectrical-Final 1. 15. Rough Electrical-Conduit " � 66. Solar SYstem-Final • ;� i6. Rough Eiectric Wiring 67. Fencing & Access ApProva� '„ 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING �� 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEA9S FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Hough' FaetoryfFirFAlace ; ��'. „^, r� APPtiTOVAL,S,_. - Permit #�-- 21. Dutts: in Structur �. s •� �� << � ;�; 70. L7ndergr�uod F{�rdro Y 22. Dutts, Veatila�ng"` '" �' `; .r � -- 71. Product�Piping O�6as �Oil 23. Gas Pipe-Rouqti & Test = *-r .� a. C� y 7p. Underground F)ush ', ' 24. Roof-fraining - ; _ � � ` � . r.'. 7�: Undergrh"d. Stora�e Tank � Gas ❑ OiI 25. Roof.She��hing �.� � c - - ��n � 7q; Overhead Hydr� _ f_ (., ` _ 26. T�Bar Ceiling (S[ructuraq & Mopomat .;. �y c 75� Dry Chemical �• r� � 27. F�ameand-Flashing . �, ��s; . � r�� 76. DryStari�'�ipe�G ,,, " 28. Lathing & Siding ,' � `- �� "• . , - " ",s 77: FIXED SLs�TEM{INA4 �.. - � 29. Insulationr .- ti� � � 78:; FIRE PREV. FIt�AL ;�. = � 30. Drywall Nailing a� u S HEALT�I''DEPfi. REdUIR�EMENT ,31. Plasrer Brownif.oah. - � �--- � �- 7g� FINAL IN3PECT(ON � - r - 32. Electrical Po4ver fvi�tei�Fipal ,• '� B0.'� FOOD CERTIFtCATE I�SUED . , 33. Fnal EIeEEric � : . t, � � � Notes - '- - � � _ = � - 34. �nal`Heating & Air Conditioning � � I � a; •�� .<' � , � o;� �- �a, -+oc - -`.•t r %� 35. Final� Gas Plpe•Test � . �� l;R�' � ` � " - - , , ' 36. Hood or CanoPY � - ,' _ ' � . .� � � �_ � , . - n 37. Final Factory Fireptace • - _ , ' � ��.� � , 38. Final Piumbing .. . �' ' , _ a 'i' .' 39. Water Service-Final.: � '. �.. ' - , ' r 40. Gas Service•Final •. .�* ? + c-, a nc ' r��' - 'w �- • ra � � � �. • �, � . ` ._41. Solar pomes[ic•Final.. , ,. � , - .y� �� y �. . 42. Backf�owPreventer - + t - �F . - r _ _, 43. Backflow irrigation _ � ' ' :� � . � �'. 44. Landscape. irriGation System = T' �- � - � ' �� - �a - . - 45. Sound Attenuation ' ; '^�' � '- ' � ,,. ' .- .^C, , .. . K t . � . - '� ' _ 46. Handicap Regulations � C� � - • x . a 47. FINAL STRUCTURE & BUILDING ' y'r 1 : - �, 48. FINAL PLANNING � � • " ! - . C • � � � • � Y r 49. Eiectiic Release to Edison • '- " y 'I' � . 50. Qas Release to Southem Calitornia Gas Co �-" � ' . r: � � � 51. CERTIFICATEOFOCCUPANCY � ' .. . .. - . No. Date •oonessaew�ar� 562 W 19TH ST oxr,�"sru�EiFa�'": AFSANEH CACIO � � ,. �u 562 W 19TH STR�ET COSTA MESA �' �� 696-5831 nwo woxess MCHRECT Ofl ENfiNFFA: 1PCN.Ofl BIG'S 100NE55: °NF CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: E 072800 PLAN CHECK NO: N CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE �"�- IJOB DESCRIPTION : ADDING 15 CAN LIGHTS UNf: CLAIM VALUE: CALC—VALUE: �� TRACY ELECTRIC (714)548-2317 cwrn�cmxs�miwa 1887 MONROVIA AVENUE �o� COSTA MESA CA ��= 527459 92627 urar: LICENSEU CONfflACTOHS OECL�RRTION: I Mreby � m uMa per�ely d perjury tlw I am licenxd uMer poNeons d Cheqer 9 (mmme�raq rrith Section )000) d Oimion 9 d Ns Busroo xtl Vrduaav Code. and mY Wmw'v m fuG bw vtl Matl. cm uc. No.: 0 4 5 3 uc. cuss: C 10 ue. No.: zF✓�%4.�r/' : 0 3/ 9 5 %are: cani.aor � 0 IER 9UIL0 OE LAR�110N: I hmaby dfi�m untler peeWy Ihm 1 mn avmq hom IM Caqietlan liurue lew lu tlr Jbxip reeaan (�� ]�1.5 &niese enE Rdreime Code: A cry o ooumy r,1�'rA rpuiim e pwmil lo mmuucl. Mr. imqan. pnd'sh. a rapei enY e��e. PKK b Ga eauence. abo nQimp �he yplirau la wch pxmY to fib e vpned mU�nru tlut M a�he < i�<e w�w m me aw�. a m. comrem. u,y,,, �,w Icnwx a(�«.�,a wun sw:M �aaol a a.eo� 3 a iro Bwinms eM Protmsiwu Cadel ar ihm he v ehe n eRemp theralmn end iM bmu lor Ns dbY� mamqion. MY vWatun d Sedion �mis by .�y.��u t« a rom�e wnpas we e�rcam io e dv+ pwwry d m mae �nen r�va n�d�sd eooen �ssoop. � I.mowrerdiheVWeMamYemNW�rAhwepeamlM1eiedemmW�seibn.wiAAotlnwork.udNe�WctwserwliMenEsd «onaee r«.d. (sam, roa.. am�... ene a�ae.m,.wa.: Tn. cammea, uwn,.le.. me. m war�o ��+,d n,,.u� xfio buida u inMw'ee I�eiem. end Mp dou euM xork hinaep a hxeM a IhuN� M a Mr ovm emplv�ses. iwideE ihM aM imprvnmm4 are nd iMendad a aflereA ta eeb. tl, howe�er, iM Witlifp a inqovemeN u eotl wqlun qp yw d compMun. IM owo«�waa. �.m n� m. ned.� a nw�m ne «.ne eu m waa «�a�. �a �n. a+mo.• a w.). ❑ �. a. oxm, a n» nwam. �.•tl�aw�r �u.mnu .�m u�ee �ow.oia. ro cmeo-w m. wqw (sea:n �a.. ai.ine.. ene aMeavw wa: rne cw�aeoi. ucaw �e. me. na ewN m e� o.mer a ww�r .no daa. w vn�w« maaa, .na wno wnvaw �« .utl� aaaa• .m, . mu�.n«I.� �s«,»e wn�m w �na comracv. uwroe �..�. � I em a�emp wder SxYbn: B. d P.C.. br ihu �on: Oeb: Ox�wr: i eo � r � r mm i�.... o a.� a � d� a m. � m+�� ro a c ar e o�. � m w s m� r c o e. s. a�. u w s. u s�..� a 25534. arM tlut I a e^Y Mura buJEvq mvpem wll / wa ml (mde ana) rred b canVN wTh emd nma aode� aM IM iaO��Mb br ao�a�«m�um�eron«moeirv�a�hanm.�:�l ae�raaa'w.a.ma.+dw�nrvniMeroeretion..i.a..mao-omNe.. Woviflona. Daa: Apqicmp; WORKEN'S CAYVENS�iION DECWi�TION: I Asretry Nhm uMs priepy d peepry wr d Ihs k0ovrinp Aetlmeons: ❑ IhewenEwilmeinteneeenAcatedmvenitoaetlirounhwaken'canpenWion,nprwkedlabySerbn�SlODdtMlebw wa. i« me oen�. d m..m� i,. wKn me o«+�a n m�.a. ❑ � new ene wi� meimen xorken� wmommton irduraw. ro revu'u.e M s.aian mo a m. Labo, coa. r« �ne w�«merc. a �n. wak In which Mie Carmn u mued. M' wakas' wmpe'unnion vmvanca urtir erd D� Y wmbx an: c�,,: Pd'cyNumbec merc„ mee mr bs ammdered r rne mmt i. �a. ons hu,wne edbrs Rtaol w be..) b I anh tM m tM Dertamenea d �M roek tar whieh ihu pemw u eawE. I tlW mi ampM �V 0�'v� enV menner n n io wM� :o iM wlm�s' m�penamion kxa d CeNwnle. erd BmeyE E I ahouM Esemr w4� �o iM woebis' pavveiion wi s d Setlbn 3100 d tM Lebor Cods, I eMp tp h m 6li4iiy� e: �vavm: ( ( i . Wemlip: F�B b w nor.tas' mmperrutlon covwp� l� �ntl alvfl ub/st an �mplqw ro wlnYiul pwNp mL ehll flnu �c ro an h,nLrW lhouurM rlaJYn fttaq000A h Itbn ro tln cwl oI ronpeivaWn ae�rpn u provltlM br In sectlon 91a6 0l M l�or COEe. INwsL ��y'+ Isu. CONSTflUCT10N LENDINO AOENCY: I Iweby alfirm uMa prully d pe'ryry Ihet Ihen c e mwrwfion 4ndi�p apanry br �hs peAamenu d Ne xak br whidi thu O�Y u oaued (SeGion �051. Cw. C). LENDEfl'S NAME: LENpEP'S ADDXESS: Icanihthmlhevera 1UnnppfirsiionendmmaihettheeboueiNammion'vcortetl.lep�wlocanplyxilheAtlryenAmumyadinanres entl sW a lews mlmiq lo Euddiq � W Mreby eWwrrse �apeeauetirea d ihe dry mxux upon tM ebv.e-memiwwd propMy IOfIMpB:lpn Wf009et. � l om.: wnno-a,m�v a smw c�r,i,: cd+w-�oar�u: wox-w..�»: oou��oa-�..� PERM NO: E 072800 GOVT; N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: B-2 / COMMENTS: NO OTHER WORK *�+t+t+t**�r�r*�r�*�r*�+t*x �*�r*�r�r+e****��*��r****�*��x�*�t*��**�x�x�*�+t�� *�**�� **��* Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING RE(j: PROV: PARCEL: 42214146 2NE: REF NO; PLANNING NOTES> i ik iE rt iF 1f if iE iE k it itr it 1t iE iF iF 1t if it iE iE iF iE itr It if it if 1F iF it 1t it it if 1E iF iE 1F if iE k if k if iE k iE iE iE 1E i! 4 iE iE iE 1f�±E itr 1f iE rt iE iE 1E iE iE iF 1E 1E iE iP it if� �t iE it if iE D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY . BUILDING APPROVED HY : APPLICATION ISSUED HY: �/�R/�� M'k if iE iE 1E 1F k 1E 1E 1E if iE if 1! 1E'k 1F ik 1E iE 1E Q LEGALIZATION:N F E E S U M M A R Y BLDG PMT PLUMHING ELECTRIC MECHANIC PERMIT 27,00 SOt FIRE DATE; DATE: DATE: ��tl�� if1E1EfE�E1EiE1ffE STRUCTURAL �EGM NT:N SMIP/RES GRADING SMIP/NON—RES PLAN ISSUE FEE 15,00 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 27.00 15.00 0.00 42.00 42.00 .00 REVENUE DIVISION TOTALS--> COLLECTED: 42.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 42,�� fk iE IE 1F ik i! ik ik 1f iE 1ElE k iE 1k 1E iF 1F 1F 1ElE 1E 1F 1f'lE 1E iE 1k'k 1E 1E 1E 1! 1E iE M'k 1E 1E 1E'IE �f' k i! i! 1E iE fE i(' ik 1E 1E �E fE iE 1h �F iF ik iF 1k 1E 1E'k if 1l' 1E 1E iE iE 7E iE 1f'If' 1E 1E if iE iF I N D I V I D U A L F E E B R E A K D O W N M14'i;7�1 ELE ELE ELE QTY 15 6 3 3 D E S C R I P T I O N FIXTURES LIGHTING RECEPT/OGTLET RECEPT/SWITCH SIGN/ADDTN'L BR CIRC UNIT COST 1 ST 20 EA' y .75 1 S T 2 0 EA`.�ti�o� 7 5 1 ST 20 -�\¢EA? � % 75 ITHI �SAME \EP:. �+''3. 00 �` mP�P�l S�¢, "� �.�I°�b.- / TOTAL COST 11.25 4.50 2,25 9.00 �%/.�" C�1 '�!J?3,��i—�OIP40g9 Ta�tS :,�.u� r UATE: Qb�13;�'S ?TFE: i?"-ro UCTION AN� PLANNING;� s, ;VALS Permit# Date 1. Temporary Electrica� Service or Pole �' 2. Soil Pipe-U�drgmd. � ' . 3. Electrical CAnduit Utility-Undrgrrtd. 4. Electricai COnduit�Undrgrnd. 5. Steel Reinfarcement 6. Electrical UFER Grnd_ 7. Footings _ B. Foundation - 9. Water Pipe�Undrgrnd. . . ' ��. Strucmrai P�oor System 11. Property Sewer Line & House Connection 12. Sewer Cap 73. Roof DrainS 14. Rough Plumbing - 15. Rough EleMrical-Conduit i6. Rough ElectricWiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar CeiHng 19. Rough Heat�ng & Air Conditioning 20. Rough Factory Fireplace 21.�Duccs, in Scructure � 22. Ducts, Ventilating . . 23. Gas.Pipe•Rough & Test - � 24. Roof�Frar�ing . 25. Roof Sheathing - 26. T-Bar Ce�ling (Structural) & Monocoat ' . 27. Frame and Flashing - 28. Lathing & 5iding _ , � , _ - 29. Insulation - ' 30. Drywall Nailing 31. Piaster Brown Coat - , , . 32. Electrical POWer Meter-Finat � 33. Fi�al Electric 34.�"Final Heating & Air Conditioning- 35. Final Gas PiPe-Test , . 36. Hood or Canopy - ' � 37. Final factorY Pireplace : ' " � 38. Final Plumbi�g 38. 4Vater ServiCe�Pinat � 40. Gas Service-Final - .. 41. Solar pomesticFinal ' - 42.`Backfiow Preve�ter 43. Backflow Irrigation � � 44. landscape I�rigation SYstem " 45. Sound Attenuation � ' 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING . -� . 49.'Electric Release to Edison ' 50. Gas Release to Southern California Gas Co . 51. CERTIPICATE OF OCCUPANCY Date PO i SPA i Inspector qppROVALS Permit # 52. Pool & EGuipment Locat�on � 53. Steel Reinforcement - 54. Forms � �'�� 55. Electrical Bonding � 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER�GUNITE 58. Elecirical Conduit�Undrgrnd. 59. Gas Pipe, � Undrgrnd., Test �� 60. Backwash Lines, P-Trap, � Undrgrnd. 67. APPROVAL TO DECK : 62. Backwash & Receptor�Fiaal . 63. Heater & Vent-Final . 64. Plumbing System � Final 65. Electricai-Final 66. Solar SYstem�Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. FOOL/SPASYSTEMSFINAI FIRE pEPT. REQUIREMEN7 , - � APPROVALS Permft # � 70. Underground Hydro _' 77. ProducYPipin90Gas L�OiI ' � 72. Underground Flush ' � . 73. Undergrnd. Storage Tank � Gas O Oii 74. Overhead Hydro 75. Dry Chemical � �, "� 76. Dry Standpipe = .- �" 77. FIXED 5YSTEM'FINAL -- � � 78. PIRE PREV. FINAL � , � HEALTFiDEPT.REQUIREME 79. FINAL INSPECTION - „ - 80. FOOD CERTIFICATE ISSUED � �x Notes: - � Date _ _� . . � - � , � ir . . - i . _ A i Inspector ; i � � � ,moxEssaceimm�c: 562 W_19TH. ST_ __ __ ___urir:,_.,_,_,____ .� CI1'Y, OP COSTA_MESA_-._SIGN_,PERMIT __ .�__. - - _ _._��_..�_...��-. , � , - , . wvr�xsru��iv'wxx OELKE HERBERT G TR�' ' _ . _ _ ._ _ __ ____ _ . _ . . � woaEss 3BERT6LIN0, PIERRE J � �� . __ �` �` `4 ._ 1014_ARBOR ST ,_ .,.._ _ PEAMIT NO: SB ,0,817,03.. __... PLAN CHECK NO: 00707-97 L q COSTA MESA,CA , � 92627 �vx.�uuw�+�ss . CONSTRUCTION TYPE: V-N __ .... _PERMZT TYPE: STR SIG_ _ ummECT on e,mi�e WCII OH FNa9 �WXFSS: uc w: UNT: I �� CORPORATE DESIGN/HR ENTER (714)253-4612 ��T�� 2102 BUSINESS CENTER DR �� IRVINE CA ��, 635917 9 2 715 ,,,�„ LICENSEU COMflACTOP4 OEC WUTION: I Mrepy pl�m uMr perWy d pp'ryry Nq I em i�,.d � Row�, a cneq« u �ewnmend�q xilh Seclian ]OM d Divnon 9 d I�e 9�einev enE Pmleeebne Gode, end m Ikenm ia in lull loece erd ellae, emuc.xo.:06 99� uccuss:,C 45 uc..No.: 6359�7 __. . � . � Ome: Comrsua: / OW NEN BUILOE DECLAHATION: I hereby elfirm �� paWy d per'µry tAtl I em examq liayi t Contrepon Licams lnw la tlr m.:w �(seeian ]ro,s au:....na r.awbn. coe.: Mr ��Y p aiwv wniM i.a��a n io mmwn. enr. "vnpan. wmofeh, v rpv vy tvuciure, p"v u as a�uentt, ayo npWro tM epplimnl ta ac� pemX lo fib e egneA YtlemaM tlW M a�M e u�.o.e w� �o m. no�� a N. cw,m,,, uo.�,. V. �cn.a« e �oo�m�wre .nn see�, �oao� a o:.wo� a a n,. B�ea mE VeMa�ioro COEsI a �M M a Ms u vomq 1lvMmm uk iM bnm la tM MWad mamqin. MY vidmion d Senun ]IX11.5 Gy etry eppireN la e pmmC MjW� IM applsvq �o a cvi pamlly d nol man iNn IMa lwM2d tloCu� �SS00�. � I.do�.nerMlheVWe��Yam/emOM�xthw�mthaiedswmVsnWion.WlEONev.oM.enAlM�truclurewnal'vqaMd a dlasd b ub (Smion)ou. BuvwveM 7mtaaiom Cods: TM Caunqm liow� lew dw na wvN �oen awwd papaity MAp blllbi Of TO�� 11MBCII. Y1d Mq d0l� �y� WOfk hY11Mtl IX �1lI�G� Of ��IQ10� b IX �M! OWII MI�JjM�. plWldpd I�IN tUCA imqowmaes en na'vuadetl a dbnd la uls. tl. howwv. tM duNinp a inpo.amw e wIE Whn ans Y� d oomplNion. tlr oxrw-0Wder wiY heva tM Mvden d pwinp M a qn GC nd WEJ a Mpova la ths puryoea d eebl. � �. m o..mr d Ihe paw�Y. am ad�MY m.�ea�a x'uh 6wmod mmedon b oamw Ne P�9a (Seann lW.. Bu.ns,.d vmeesm. coa: n» cum�.na. licrn. �ev m. m wdr ro.� o.,w a ww�v wno wuan « unrw� ma.o� .nd .nw mevim Ar vM piajwa wiN e mm�etla(�) li�y�ya p�y b iM Casma� l"vne lew�. ❑ I am xem7 udr Sxiim: B. 8 F.C.. br Ne �amn: Dms: oww y 1 do MetlY ��Y tlut I em ewe d eM wWnNM Ne �ePo�mb d Cellomis Ilsetlh eM SeMV Coda Saaiom P5505.255�. W PSSN. W Ne I w em' Miva Wtivio � We mY i v0 na (mcle awI roW ro camoN wih uiC mte codm od tM nawwns�b b eW��/nmmtruclbnartoEifrtlion6vmiMAi w�y anepenw�l0iqritl.MdEemiNmMiutlione00�iomueuemqtmmNws poritia�u. Ume: I�ppliura: won�n•s couvou�non occuruTroN: i �w.q. e�„„ �.�e., �,uy a o.a.y o�. a m. imo.'vq eeanabne: � IheveeMWmeintenecaWiralsdwwntlosWinw�sforxaken'canpenWbn.npwiEeEfabySmion3]OpdiMlebor Code. fa iM partvmace W IM wk la wlirh �hu pyme y{ywd. � i neve.�w w mewe:, wak.n• mn,w�mu� 4uw.M.. o na�ub W swion aroo a w. iee« cme. w ine o�a�w. a m. work fw xfiidi thia parmu u issueA. My waken• �p��p� in�urercs urtisr eM poliry n�mber ers: c�« Pdiy Nwnber. {�/�ua mdion rieM rtof b mnplefM l W prm] o ty pp hunpnd ddbrs �SIP01 w Hm.) ��J I cMy Nm'v� tlr perlmneica d tM wdk br �W Ny pM�q e uvrE, I Ne0 M ampb/qm psmn n e�y memw n m �o beeana wDjea io ine v.wkees• mmpr�s?�bn lews d Ce4tomie. uM Wraa Oa il I ehoup Yewma abi� �o tM worlan' w.mMa: F+aus m..cun wn.n• ro�tlon ornr.p. b un6rM, uw M.�Net �n «ro�qw ro a�m�m� prumn.ne c�va nir. �q ro m. n�ne..e moua.na ad�.n l�lo400aA b��n ro m. co. o compau.rnn mm.Y.. u p.oNd.e ro. ln S�etlon J)f16 0l fM la6or Cob, INwmL N✓ ��m�y'� Ms. CONSTXUCTION LENpNO �OENCY: I heeeby elf� a�y pyuyy d qiryry �M iMn h s m�ut'ufbn Isd"vp e�pney br iM pslmmxo d tM wk tor wtiitli Nu prmi u umy ($bui �pp]. CM. CI. LENDFJI'S NAYE lENOER'S ADDNE59: I��niN �Mt I Me ntl Nu eGMiraum eM vW Ilut tla abv.a Wammon is canad. 1 e0�b to comV�Y xil� N�y aM aouNY oN'vwav md nme Iew. nMM m buld:q mmwion W haraby �uUw¢� nawNaivu H �hu ti�r rowr uD� �he ebaw�mrauned popa�ty �« w,o� o�wb. MAR I E (5151J6.WP) Dma: � �O l� �mY: ��w�-FJs: Geneiy-nw�uM: Pink-Rawnus: Ookavod-Aswnor SOB DESCRIPTION CLAIM VALUE: ;,33 SQ FT ILLUMINATED WALL SIGN 1,500.00 CALC-VALUE: 1,500,00 PERM NO: SB 081703 GOV.T: N SUPP; N_ _ . PURPOSE: ADD • SQ FT: i GROUP OCC: B / COMMENTS: "DOMENICOS" WALL SIGN *�rx***�r**��e�***�***�r�r*****�r*�e*�r�r*�eit**�t�r�***�r*x*at�r***�*�e�x�r�r��r�r�r*+��ex��x�r�r**��r�*** S�I G N I N F O R M A T I O N DISTRICT: 1 TYPE: WALL ILLUMINATION: INT CATEGORY: NEW DIMENSIONS: 3FT OOIN.X 11FT OOIN AREA: 33.00SQFT LETTER HT: 36 IN S'TREET FRON'1'AGE 1: 60.00 STREET 1: f9TH ST STREE'P FRONTAGE_2: 12,7.00 , STREET 2: MAPLE PARCEL: 42219146 ZONfi: C].. _._. I�OCATION > FRONT: X REAR: .. BUSINESS NAME: DOMENICOS > LEFT: RIGHT: O T H E R T O T A L S G R O U N D S I G N THIS ACTIVITY . 33.00SQFT OVERALL HEIGHT: OF'f OIN THIS SITE . 68.00SS?FT GROUND CLEARANCE: OFT OIN ITEMS OF INFO 1 PLANTER AREA: O.00SQFT ITEMS FOR ACTIVITYc. 2 � , BLDG SET HACK: 20FT COPY VERHIAGE : DOMENICOS PLANNING NOTES: 1EifikiElElEif1llFkiklfiEkkiFiEif1E1E1EiEifiFlFlEiF1ElEkiklEiElF1EiliflEkiFif1f1E1k1Eif1E1fik1ElEikkiFiEifififlEiElkkiEiEkiFlkftiEkklEiflfkiflfkif , D E V E L O P M E N T S E R V I C E 5 R E(J U I R E M E N T S ZONING APPROVED HY I`f�l� DATE: 2'Zt� �, BUILDING APPROVED BY ; W�� DATE: Z'"ZD� (/ APPLICATION ISSUED BY; DATE: Z JZD— � iFlfi4iEifiEikiEki4iEkklflFifkifiF1E1E1E 1EiffEklElFiF1F1k1E ff LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC SICN SMIP/RES GRADING PERMIT 48.50 PLAN 31,53 . _.. . ISSUE FEfi BUILDING-DIV-> PERMIT ...ISSUE PLAN-CHECK TOTALS---->. 49.00 0,00 31,53 REVENUE DIVISION_TOTALS-->_ COLLECTED; BLDG PMT PLUMBING.EL6CTRIC MECHANIC 48,50 SMIP/NON-RES .5� TOTAL PAID DUE 80.53 80.53 .00 80.53 OVER/SHORT: 00 SIGN SMIP/TOT GRADING PLAN-CHECK ,50 31.53 ifiE1E1f1t1EiEfElEiEiFiElflf�fltiflEklEiE1E1E1F�flEkff1E1f1k1Eif1E1f1E1E1E1F1F16fEfF1f1E1t4iE1f1t1E1ElEiE1Ek 1EiE1E1E7f1l7FiF1F1FlE1E1l1E1k1f1E1l1EiE I N D I V I D U A L F E E B R E � W N Y TYPE QTY D E S C R I P T I O N 1';� , OST TOTAL COST NO FEES WERE SELECTED FO IS UA,� � _ 82-28-1997/l2:45 PM/f8B.53 PERMITe981703 GONSTRUCTION AND PLANNING � P� & SPA ' APPROVALS Permit # Dete In,pector APPROVALS Permit ,$ Date Inspector 1. Tempora�Y Electricat Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe�Undrgrnd. • 53. S[eel Reiniorcement ' 3. Electrical Conduit Uiility•Undrgrnd. 54. Forms ' - � 4. Electrical Condalt-Undrgr�d. 55. E�ectrical Bonding 5. Sceel Reinforcement 56. Rough Plumbing & Pressure Test 6. .Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 58. Electrical Conduit-Undr rnd. ' � 7. Footings - 9 � 8. Foundation � • 59. Gas Pipe, O Undrgmd., Test , 9. Water Pipe-Undrgrnd. ' - 60. Backwash Lines, P-Trap, � Undrgrnd. � 10. Structural Floor $ystem ' 61. APPROVAL TO DECK � 1}, p�ope�ty Sewer Line & House Corinection 62. Backevash & Receptor-Final � i 12. Sewer Cap �' � 63. Heater & Vent-fina� -- 73. Roof DrB�ns • 64. Plumbing System - Finai_ � . .. , 14. Rough Plumbing - ; 65. ElettricabFinai ,. 15. Rough Eleccricai�Conduic 66. Solar SYstem�Final ; 76. Rough Electric Wiring 67. Fencing & AcceSs Approval . 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING � 18. Rough Eleccripl-T Bar Ceiling ' 69. POO VSPA SYSTEMS FINAL ' 79. Rough Neating & Air Conditionin9 FIRE DEPT. REQUIREMENT . 20. Rough Factory Fj[eplace ' APPROVAIS Permic #' � 21..Ducts, in Structure - � -- , � 70. Underground Hydro . 22. Ducts, Ventilating _ - . , ��71. Product Piping.C3Gas �f70i1 23. Gas Pipe-Rough & Test - � 72.. Underground Flush -. 24. RoofFraming " - - 73. Undergrnd.StorageTan&OGas ❑Oil 25. Roof Sheathing � 74. Overhead Hyd.o 26. T-Bar Ceiling (Structuraq &�Monocoat . 75.� Dry Chemical . 27. Freme and Flashing � 76.. Dry Standpipe - - 28. Lathing & Siding_ - " 77. FIXED SYSTEM PINAL = 29. Insulation - 78. FIRE PREV. FINAL 30. Drywall Nailing - � ' � HEALTH DEPT. REQUIREMENT 31. Piaster Bcown Coat � . 79. FINAL INSPECTION 32. Etectricai Power Meter�Final - � B0. FOOD CERTIFICATE ISSUED 33. Final Electric . Notes: � 34. Finai Heating & Air Cpnditionin9 - . 35. Final Gai Pipe-Test , _ � 36. Hood or Canopy � � . � -. 37. Final Facaory Firepiace, - � , 38. Fina� Plumbing �• - � - , ' 39. Water Servica-Final � ' • . , v, 40. Gas Service-Final - � � � _ i 41. Solar pomesticFinal � " � 42. BackflowPreventer " � •,��,' _ 43. Backttow krigation - � � " 44. Landscape Irrigation System � ' . �45..Sound Attenuation ' _ '� - 46. Handicap Regulations . � , -_ 47. FINAL STRUCTURE & BUILDING 48. FINAL PIANNiNG 49. Electric Release to Edison � 50. Gas Rele2se to Southern Califomia Gas Co � - � - � 51. CERTIFICATE OF OCCUPANCY -- _ No. Oate NECT AOORES� . .: _ _ , ki � i OWNEB'SNAME: .a�.iH �../1�.+0 moness: �u� l� iS';H C�REE� �G:.;Tei N�::,A �►� 64u 5�31 AflCHIENGINEEfl: FDUNESS: NEG.NO.: uxir: �-:.T�t GF 1.G5:11 1:E::,� bu.L.D1:iG i':"�.I�:.1 ._i:. :: ._: .. PERhi1T NO; i. 0681°3 FLAi� CHECi: NG; ,`: ,�_Vf; ., ,.';i •, , CONSTRUCTIOA7 TYPE; V-N F�RNIT TYF�E: E'�E ,'L'?,' •... : � UNIT: PEflMITTEE: 'Fll;'..i �.I,ECTti?l: (�1'f)�J�a—Z31i ADDNESS: =3i17 h10NROVSA 11VBNUE cUs;f� :��ESA CA 925.:7 UCENSEO CONTBACTOH DECLABATION: I �ere0y affirm t�at I am IicenSeE un0er pmvisions ol CAaD�e� 9(cammencing with Seciion 7000) ol Divisian 3 of the Business antl Pmlessions Cotle. and my license is in lutllorte and efiect. ciTruc.: �.'+��3c sraTeuc.:527459 cuss: �'7 EXP: 03/�S / _ Si nature: —Bat¢"— 9 WOBKENS' C PENSA ON DECIANAiION: I hereDy attirm 11 nave a cenificate af consent ta sell-insua or a cenilicate ot workers' Compensation Insurance. or a certifie0 capy t�ereol I�cnon 3800. LaG. C). POLILY NO.: EXP. ORTE: COMPANV: ❑ Cenilied couy ¢ �ereby Nmisnetl. ❑ Certified copy is file0 wit� I�e ciry Builtling Division. Oata ApDlicant'. E%EMPTION FNOM WONRENS' COMPENSPTION OECIANATION: (This section nee0 nat he camDletetl ii the permit is lor one hundre0 (SiW) ar less). i certily that in ihe petlormance ol the work lor w�ich this permit is issued I s�all not emDloy any person in any manner so as to become subiec� to �ne Wotl rs' Com Gnsaiion Laws oi Calilomia. Z / Signature: NOTICE: I. after ma ing ihis Ueclaration. you shoultl come su0ject m t�e Workers' ComDenution Dmvisions of the Labor Coae. you musl lonhvntn camply witn sucn o�ovisions or inis permit snall Oe aeeme0 revokea. CUNSTflUCTION LENUING RCENCY: I �er¢by aHirm t�at IDere is a canslruciion IenUing apene/ lof I�e p¢Aormance o� t�e wod for which inis permii is issuea 15ec�ion 3097. Civ. C1. �exoex: aooAcss: OWNEB BWLDEfl OECLAflATION: I here0y aHirm Ihat I am exempt iwm t�e Contractors' State LicenSe Law lar ihe followinA �eason �Section 7031.5 Business anU ProleSsional CaOe: Any city ot counry whic� reQuireS a permi� to ton5tmc�, al�er, imD�ove, tlemolish, or repair any simcmre. D�ior to its issuance, also repuires the applicant lor sucA permii to lile a siOneG statement ihal nelshe is Iicense0 pursUant lo I�e provi5ion5 0� Ne Caniratlors' State License Law (ChaO�er 9(cammeMing with Section 7000) ol 0ivision 3 oi the Business antl Pmlessions CoOe� o� i�ai �e/sne is eaempt thereirom ana the basis for ihe allepetl exemption. My violatian al Section 7031.5 Oy any aODlicant lor a permit suUletls t�e apD��nt to a civil penatty ol nol more than hve hunJreE tlollars (f500�. I. as owner of ine Dmpeny or my employees witn wapes as tneir sole compenution, vAll Uo Iha work, antl the ❑ stmcmre is not imende0 ar olterea lor sale (Section 7044, 0usiness an0 Pmfessional Cotle: The Contractors' State License Law tlo¢5 noi appty �0 an owner oi a D�ope�y who butlAs Of improveSlAerean, and wAa Ooes SUC� work him5¢If/h¢rsefl or [hmuAh nis or ner own empl0yee5. provideA Ihat Such impmvemems are n0� inlentleG or Otlefetl br SaIB. I�, howev¢r the 6uilding ar impmvemen� is salU wil�in one year ol completion, Ihe owner will have ��e �uraen ol provinp he/she ditl no[ builtl ur impmve for ine purpose al sale�. I, as owner of t�e property. am exclusively coniracting with licensee coniractore ro constmct tAe pmlect (Sectlon 7044, Business ❑ and PrOfe55ion5 CoUe: TM1e Conifatlors' Siate LiCense Law do¢5 nol apply l0 an owner of prODe�y wh0 UUiltlS Or impmVes lherean an0 who comracis br suth pmlects wii� a comrac�oqs)license Dursuantto IOe Contractors' State Licensa Law),I am aware I�al prool o� IAeir WorkEr's Compensation insurance shoultl �e O�ovitleE Io me. � I am e�empt unAer Sedinn: B. 8 P. C. lor Ihis teason: ` Date: I tlo hereby CeNfy Ihal I am a 255]a an01na1 I or any �mure permit tor consimcuon or ma ihese O�ovisions. Owner. ina un0erstantl the requirements oi Calilornia Health anE Salety Cotle Sections 25505, 25533, and oCtupani wiil/vnil not (Circle one) n¢¢tl �o Comply wi�h 5ai0 SI212 toAeS an0 ihe reQuirements Por a i Imm �he Air Ouality Management OisUict. FesiGential wnsimction apDlications are exempt imm Uale: ApO�icani: I �ereUy t¢rldy Iha1 I �ave reatl I�is appliCaiion and S�ate ��ai IAe a0ave inlormalion is COrretl. I agrtOlo mmply vnlA all tiry antl Counry or0inances and staie laws re�ating to OuilOing wnstmctwn an0 hereby aut�orae reDresentatives ol tha city to enter upon the aGme-mentionetl pm0eny �or inspenion purposes. A �� a e', � Signa�ure: _ odwrs ucense or Sociai Securiiy M: JOB DESCRIPTIOiV . AUDiidG 20 CAid LIGHTS Jk � i I CiAlit VAi,UE; 2,�00.00 CALC—VA:,UE: 3:•.uJ? �_�. E—� . CO:�:�1ENT5: NO O'lHER L•IORK �x:�#kit�:�;f!::f�f:tt•if:. X#%��#jE##%?fdF###-lF�%�i(lE%if'k#iE�%�Yf#3F7fJP��F#-]t:•?•`E�Air#�M�Yx'tYl .�:.�:'� . _ :a �.,: ♦ :i�. Z O N I N G R E Q U I R E,�1 E N;� S E T B A C I: S ------------ MAIN BUILDING ---------- ----.---- I,CCE5SGhr b�ZLGI:'� --- - FRNT: FT ZN REAR: FT IN FRNT• FT_ I2! REAc.: �'T =.1 LEFT; FT IN RGHT: FT IN LEFT; FT it� :,,;.i:: :_ _.. PARY.ING REQ: PROV; PARCEL: 42214146 ZNE: Rc.F :.i,; PLANNING NOTES> > YiitiF##iE#1(-###if##iF1E#itil��lEi£1EiFlP###itiFiF1E###'####iF�lffFi;##9E?t##i'�{::: �iFi'.. i�iEi"iFt'%i:Ye9'�:-iF. :'.y�..r. k • D E V E L O P�. E N T � E R V I C E S R� Q U� x' M E;d i� ZONING APPROVED BY � BUILDING APPROVED BY : APPLICATION ISSUED HY: ` if#iEiE#IEiEiF3fi!#iF##iE;e�f3FiFi'iEiE#iM1i!#it #if�Ril # #it�Y.�'�TifiF�ilFiF�##. iEi6#iEkifiFiFiE#iE�14it#iE##?41EiFiE3EiE#iEiE###it#iFi�'rift'�ikYa#k�.£K #iE 3'itiFiE#•K�it LEGALZZATION;N F E E 5 U M M A R Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 18.OU SOk PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 18,00 15.00 0.00 REI,TENUE DIVISZON TOTALS--> COLLECTED: HLDG PMT PLOMBING ELECTRIC MECHANIC 33,00 # y. FIRE Li.:E: LF�TE: ��^ �`� .. D}1TE: � i ! �% k- L 3 i : �: ,: ': - " � . � if i k-'r 'i :: :' t t[ +'� ' , + . •. , STRU�:TURe1:. NE _::� ;: S„IP/HES ....... _; (. �J.:lt /iV�:�—i�.c�. TOTAL FAIL - � 33,00 ji,,00 �.JL 33.00 OVER/SHORT: ,�,� FIRE SMIPJTOT CRADTNG PLAIJ-�:,�", #%�X #iE�1EiEiEiFif#X�###3ciEiE##iE##iEiE#itiFiF##�N#�lE1FiF#�K�i6N�###ib#iF##'c�t.i; ifk-iFi:±i�r•%3Fi4! f,�r. �.: f:#3,i-•., �k t' Y • •. + ' I N D 2 V I D U A L F E E B R E A K D O[d W TYPE QTY D E s c F�.x,F�r`.R,EjDo N UP7I7 CObY TG�A' _..�_ Incotrij�4" ► (nspect�ons " ELE 20 FIXTUR^S L.r�kTING ' ST 20 EA, ,75 ' ELE 4 REC�P.%�''q�lI!' H ]: f 20 EA. ,75 �,; !d E „�;y7. ,� ,._. SI� . _•: .�...,.FEES . V 02 00164539-0016y`g4 7'riT ?3.u; — DRTE: Q7/22194 1IM�: i4::; 1641�a6 WM1ne—Buildmg', Grean—Cotlo EnbrcemenL Canary—Apphcan0 Plnk—Revenue: Goltlanrod—Assossor . .. _ . -CO�PUCTION AND PLANNlNG APPF�JVALS Permit # Li�Temporary Electrical Service or Pole � ' 2, Soii Pipe�Undrgrnd. � � 3, Eiectrica� Conduit Utility•Undrgmd. 4. Elecirical Conduit-Undrgrnd.' 5. Stee! Reinforcement 6. Electr�cal UFER Grnd. 7, Footings 8. Poundation .`; 9. Water Pipe-Undrgmd. � .� }p, Siruct�ral F400r SYstem 71. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 14. Rough Plumbing 15. Rough Electriral�Conduit � 76. RoughElectricWiring 17, Rough Wiring Sign 78. Fough EIec,Yricai-T Bar Cei�ing 19, Rougfi Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducu, in Structure 22. Ducts, Ventilating 23. Gas Pipe�Rough & Tes. 24. Roof Framing 25. Roof Sheathing 26. T�Bar Ceiling (Structural) & Monocoat Q7, Frame and !Flashing 28. Lathing & $iding 29. Insulation � 30. Drywall Na�ling 37. Plaster Brown Coat 32. Electricaf Power AAeter��inat 33. Fina1 Electric 34. Final Heatiiig & Air Conditioning 35. Finai Gas Pipe�Test 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service�Final 40. Gas Service�Final q1, SoYar pomestic-Finai 42, Backflow Preventer 43 Backtlow trrigation 44. Landscape Irrigation SYstem 45. Sound Attenuation 46. Handicap Regulations 47, FINALSTfiUCTURE&BUILDING 46. FINAL PIANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc Dlo. Date ' �_ Daie r POQL �s SPA . Inspector APpROVALS Permit # 52. Pooi & Equ pment Location � 53. Steei Reinforcement 54. Forms ' 55. Electricai 8onding 56. Rough Plurt�hing & Pressure Test 57. APPROVAI. TO COVER�GUNiTE 58. Electrical C�nduit�Undrgmd. .' 59. Gas Pipe, O Undrymd., 7est 60. Backwash Lines, P�Trap, Q Undrgmd. 67. APPROVALTO DECK 62. Backwash 8 Receptor�Final 63. Hea2er & Vent-Final 64, Plumbing System - Final 65. Electrical�Fina� 66. Solar SVstem-Final 67. Fencing & <tccess Approval 68. APPROVED FOR PLAS7ERING 69. POOL/SPASYSTEP,7SFINAL FIREDEPT.REQUIREMENT APPROVALS Permit # 76. Underground Nyc!ro 71. Product Piping OGas OOiI 72. Underground Flush 73. Undergrnd. Stora9e Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry CBemical 78. Dry Standpipe 77. FIXEO SYSTERA PINAL �-. 78. FIRE PREb'. FINAL - HEALIH DEPT. REQUIRERytENT ., 79. FINAL INSPECTION 80. FOOD CERTV�tCATE ISSUED Notes: ` . . Date Inspector i � � �nonEssocemimc 562 W 19TH ST ss °""Eas""�EiF�u�o''"': OELKE, HERBERT G TR / "��"� EBERTOLINO, PIERRE J � 1014 ARBOR ST � COSTA MESA,CA 92627 IFPI. MAlI1NC'AUDXES& •. . ""�"�CTOX"�+�: JERRY TUCKER WCX.OPF�.'S�OOPESS: SOB NEWPORT HLVD N.B. caxm�crars N��• ca+m�croas �uimo �noxEss uxr: uc�: 2187 UNT: CA 92663 uc xo.: UNT: LICENSED COIRflACTOflS DECLPN�TION: I Mraby eli�m uMn pereYy W pw�ury it�n I em Ikensed uMer qovieiona d Cheqer 9 (mmmerwrp wilh Section ]000) d Oihson 3 0l the B�yi��y yb pro/¢yyp�s Code, erd my limnve ia in full brca ud eHep, cm uc. no.: uc. cuss: uc. No.: Dme: Canreaar: OWNER BNLDEN DECL�RATON: I hemby dfi�m wqsr pa�uly W perjuy thea I em e`emp tmn the Comrmon lioeme lew la ihe Jbwrq raeson (Swion )W 1.5 Busiress erd Prolespp�a Code: RM ciy w muntY �✓� n0uim e pertnil to aonsbuct. qller. impove. imd'oh, a npei eny eVunuro, prior b 4v ba�anm, yp �u'vea iM applirom la euch pwmn lolJs e aqred sW ameru tlw M a sM .e liceneed puraueni io ihe prweione W IM CoMreGqe ��iue law �Chepter B(commena�p xil� Sed'pn 1000) d D'vuion J d Ihe Buainao eM Prdeeabna Code� «thei he or aha ia axemq ihaehom arM IM be�ie lor iM dbped exampion. My vblelbn M Setlion ]W t.5 by ary epplirant la e permn wbpW IM eppli�¢�I lo e dvil penehy W ml mas Ihen I've huMrad tldbn �5500��. n I.avoxmrd�MpuGenYamYemdW�wYhW¢Oma�iMieobmnCemelian.willEONawak.eMNeel�u.YunondWmMed tr aoRereClaeelelSeclion]Ou.B�rovvdP�0lmvonaCoCe:ThaContreaanlxxuaLewdmsmteVGNtoencn�erdqoqry wlw Wida a inprovea iMreon, end Ma Eoea sy�h wah NmaeX or henal a Nraph M a her own empbyeee, pwidod thet vu li imD��md ve rot irveMed a di«eE la sela. tl. howewr. �he Wiltinp a inqwemeM o sd1 w41i'v� ons Y� d wmWa�nn. tlr av�wrbuilder xill heve �M huNen d pwinp M a eM did ml Wik a imqova la iM purywe af aeb). ❑ i... a..b, a m. nwenr..m �am«an �armro �.en u�eee ��. ro w�m,�a in. c�rea �sea� ro«. a,.�. �e aMe�o�. coe.: rne comraeon uca,�e �ow eoe. na eoWr ro en owne. a ww«�r ..no wiu. « imwo+.. �n..w� e�e wno mntrecb M aM pqetls wnh e mrurma�e) Iqs�� wnueru to IM CaNraGm L'mna Lew). � I em eaemq uMer Seclbn: B. 8 P.C., br t j 1 eie: - . ow�,�: c.�. � r..o «- i nmenr o«iM u�m i em e.ere a ene u�d.B�d �n. nn�v�m,mm a ce��o�rce ween end smnr cme smion. zsws. zssa3. ene 25534, end thm I«em ��re WilAirp axupent wi11 / wil nd (tlrtb one) md ro camply wih eeid atme codea aM tM rsquinmaw lar aP�AlnmmWCYmamodificelionhanlMA'r eu�y ��yD'etntl.ReddxliNcmLtutlunWV�ome2exemP�ImmNeas a��. om.: �our a„c W O(iKER'S COYPFNSATON DECIARATON: I hsreEy elfvm urdx penMy d pejury aw d Ne Idbrrinp JSWatiom: ❑ I heve eM wil mdnlain e cenAcme d wnaeni io vaM�irourc Iw worken' compenW ion, u povideE ta by Safion �)W d IM Labar coae. �« me o.�o�. d in. � i�..i:�n in�. o�n m e.�d. .. � � I heva eM wiA meinlein woMere mmpenaetnn inaurence, ea reQuireE by Seabn J)00 d Ihe lebar Cade, br the perbrmenm af iM wwk fw whidi thia pemiM e isvueE. MY waken' �p�eqp� imuraice wiim and pdiry number ue: c�a.: Pdiry Numbar. (rnb a«e� �.e �a ba romdnee r� w�t e ro. m. n�ae adr�rs /.siaol a �m./ ❑ I mnly Ne� in the perimnuca d �he wak b y�Kh t�ie pamu ie �iaC. I MN np amplq vy pmvi in vry men�ror n m to e«o�b wei� �o �na �.� �w�m� m.,. d e.m�a .�a w� uw a i.ro�b n«o� � io m. �.� �wnoe�ae�ia, ww�.oio a seam a�ao a m. lmo. was, i wa �onn.mn owncN wan moee yovm�v. oda: ncd'cw: Wam/n0� Fe/lun ro�xun Wartwi co�e«wtlon �ywrap� i� un/awNl, entl sN/l wbpcl en xnp/oysr ro crlMml p�naMu eM elvll 9ro� ip ro on� huntlrotl thouu�d tlWYn (Slpqpppl� In Md/tlon ro M� cost al rompens�HOM1 danxpsi u provlCSC br In SxNon 3]fA6 0/ M� Labor COW, Inhns4 antl afrory�syY lsu. � CONSTflUCT10N LENDINO AGENCV: 1 hveby etfirm undar pendy d pmjury ihat iMn u e wruirudion bMieq epeney lur ihe p,n�� d ma �x ro� wn� �w o�+� a�a �s<ao� eos�. cH. cl. LENDEN'S NMIE: �� LQlDEN'S AODPE54: � cnnlN �ne� � neve reee �nia mdcmion end aeie �nv ihe emra in�ame�bn b c�nea. � eoiee �ocanoN wan m� ar ene munn o.d'vivwes eM et�e levn �elmiq �o buiN�p consvumon erd Mrepy aN�¢e iepmentmivae d tAo �8y w entw upan ihe ebova�membneE qopery lorinspedion purpoeee. , PETER SHAHI ,� � (5151�6.WP) e o�,: 4— 3—`� l� a smay: a�Fb: c�-�p�d,c aox-a�: c.�oe-�.�« PERMIT NO: SH 077036 CITY OF COSTA MESA — SZGN PERMIT PLAN CHECK NO: 01255-96 L CONSTRUCTION TYPE: PERMIT TYPE; STA SIG JOB DESCRIPTION : RAISE SIGN FROM 2' TO 6'4" PERM NO: SH 07703 GOVT: N SUPP: N SQ FT; PURPOSE: OTH CLAIM VALUE: 200.00 CALC—VALOE: 200.00 GROUP OCC: H / COMMENTS: RAISE ILLUMINATED MONUMENT SIGN *it�et*�titetit*iEx��rit+t+titititit�t*it+tititititit**it**�rieie+t�tieiEit**itx�+t+tit�tirititt�+tatitx�*x ie+r�*�tit�r�ritit*+t*�t*�*+�+� S I G N I N F O R M A T I O N DISTRICT.: 1 TYPE; FREESTANDING ILLUMINATION: INT CATEGORY: NEW DIMENSIONS: 7FT OOIN X SFT OOIN AREA: 35.00SQFT LETTER HT: 24 INCH STREET FRONTAGE 1: 60.00 STREET 1: f9TH ST STREET FRONTAGE 2: 127.00 STREET 2: MAPLE PARCEL: 42214146 ZONE: C1 LOCATION > FAONT: X R6AR: HUSINESS NAME: DOMENICO'S PI2ZA > LEFT: RIGHT: O T H E R T O T A L S G R O U N D S I G N THIS ACTIVITY . 35.00S FT OVERALL HEIGHT: 11FT 4IN THIS SITE . 245.00S�FT GROUND CLEARANCE: 6FT 4IN ITEMS OF INFO : 1 PLANTER AREA: 70.00SQFT ZTEMS FOR ACTIVITY: 1 HLDG SET BACK: 20FT COPY VERBIAGE : DOMENICO'S PLANNING NOTES: *ie�r+t�r+t+t*�it*�*�ia*ieir�r+�**�it*�*�*iciE+ria+t+t**+�it*x iE*�+t******�r�it*it�*it*+ait+tit��***+t*atit*ieiert*it D E V E L O P M E N T S E A V I C E S R E Q U I R E M E N T S ZONING APPROVED HY �� DATE: / BUILDING APPROVED BY : ��Q DATE: V APPLICATION ISSUED BY: DATE: *��**�***��*��*��*� ��r**��*�r +r* LEGALIZATION:N F E E S U M M A R Y STRUCTURA SEGMENT:Y HLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING PF.RMiT 15_00 PLAN_ 9.75 ISSUE FEE BUILDING—DZV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 15.50 0.00 9,75 REVENUE DIVISION TOTALS--> COLLECTED: HLDG PMT PLOMBING ELECTRIC MECHANIC 15.00 _ SMIP/NON�—RES TOTAL PAID DUE 25.25 25.25 .00 25.25 OVER/SHORT: .00 SIGN SMIP/TST� GRADING PLAN—C9E75 iE IE iF iF 1f 1E 1E 1f' iE 1E 1E 1E 1f I(� 1F If iE K 1E 1E iE iE IE iF 1E iE 1f if iF 1E 1E 1E 1f� fE if IF if M 1f ik fE 1E 1E 1E iF 1F iE 141(� iE iE iF if i(� if If If i(' IF 1E IE 1F if 1E iE 1E 1f IE iE ik 141k iF iE iE iF iE if if �� I N D I V I D U A L B R E A K D O W N TYPE.,.QTY D_E,S C R I P�'Q�1 _ _.,,_ _ UNIT COST TOTAL COST �/ K,NO_aFEES S _ R,„THI$_yPERMIT DA� D 05:,i', C' ,�,-, ,. . _. _ , . . . ... u;i:s _. .:,-„- �._ l.. CONSTRUCTION ANO PLANNING PO-� � SPA Bate Inspector - qppROVALS Pe�mit �h Date Inspecmr AwPROVALS Permit # ' 1/ TemDorary Electrical Service or Pole � 52. Pool & Equipment Location `�,� l 2, Soit Pipe-Undrgrnd. y) 53. Steet Reinforceme�t ^ • �.�ElectricabGonduitUtility�Undrgrnd. � 54. Forms 'i n„ _ � . T=4..Electrical;Gonduii-Undrgrnd. - � 55. ElectricaiBonding .; _ : �. _ •. .-:c � 5: S4'eel flei�.forcement 56. Rough Plumbing & Pressure Test ,; �- - 6. •Electrical�"UF-ER Grnd. 57. APPROVAL TO COVEFi�GUNITE �' ��-7.'fooiings ��' 58. E4ectrical Conduit�Undrgmd. � �'8� Foundation 59. Gas Pipe, O Undrgrnd., Test �9 : Water Pipe�Undrgrnd. '� 60. Backwash Lines, P�Trap, 0 Undrgrnd. 10. �Svuctural Ploor Svstem �, 67: APPROVAL TO OECK 17. Property Sewer Line & House Connection ' 62. Backwash & Receptor-Final 12. Sewec Cap ' �t; 63. Heater & Veni-Fina{ 13. Roof Drains -; 64. Plumbing System � Final 74. Rough Plumbing 65. Electrical�Finai 15. flough Electrical-Conduit � � 66. Solar SYstem-Final cil i6. Rough Ele'ctric Wiring � 67. Fencing & Access Approval � 17, Fough Wiring Sign 68. APPR�VEQ FQR PLASTERING i 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA 5YSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREME11tT ' - - - s � � -.�r s, 20. RyughFadtor�Fir"epface^' "`'�� _ -: .�_� 'r ❑ APPROVALS : P,ermit�;�"� 21. Qucts,in$true'2ure;� x��=-r;., '" �� °;r S 70. Untl�tgroundHytlio` ' ' - > ,-. - 22. Duc[ss Ventilating.- �` �'r . [. ' . �' � � ' ��' � r 7'i. dtoditct Piping � Gai ❑ (�il k i r. rr f. s.7 C 23. .�`ias f�lAe�Roug#i & 1'ebT =? j,: �- r- ;r r 72. l7nderground Flusfi " � 24. Roof=Framing • '- - _'� ;�= `� 53. Uqder�md. StoragE Tank'D'Gas n Oil 25. floof�SheaFhin9 �- - =;,�n ..c � 74. Ovcrhead�HYdro C ^ �' 26. T-BarCeiling (Structurall & MonocoaC ,�. * �_ }5. 6ry ChCmicatV . ^� ' ` 27. Frame andPiashin4 y � --- = r 76. Dry StandPlPe -� - f 28. Lathing&.Siding ., ['� •_ - - ' - ' 7Z. FI?(E�ySYSTEM:FINAL�` ; _ ' p � -29. Insulation -. •r� - �• `.":-�---, '� � � � 78. FIREPJiEV.FINAL ' - 30. Prywall N.ailing '-`' � - "�� - �L ' ' � r '- HEAITH'DEPT. REQUI'R'EMENT � `37. P�asterBrown.CoaT'�;' ,� � 79. FINItL'jNSPECTI9N� - ' :32. ElectricalPowz^t Metet•FinaC 80. F�pD�ERTI�ICATE I$SUED ' � � s33. Finai Electric � . �- ; �� I Notes:. -.,� � = * _. - „ , _ , r _34. Final.�Neaiing & Air Cotlditioning i_ � ! � tr' _ l" ' .. � � - a - r' _' =�35. FSnal Gas Pipe Test � � ` �- t .' ' ; .' �; � :^.'� ` ' ' � . 36. Hoo��or 6anoPY � � � �l � = . � - � % ' i T i � c-�. 37. F: F ctory FirePlace , ��' - ¢ �{ ; � ~ . �na{ a �.. . .. � ` z . ,. ... �' . ' - - -38. Final Plumbing !. G .�..-.r.r � r � - = � � __ t � �t A '39. lNater Service•Final � �< � , � � � ^ _ �� _ . - , :a .. . - ='40. Gas Service�Final . 'cai � �� - � � - � � v -- - • � - -4/. Solar pomesiic•Final� "�''= � -!-' i - " ; • ,,, `� � Yr_ . . ' 42. Backftow Prevanter r . '-' '. " �: � � . � - r "-. � - x 43. Backflowirrigation -' c:_�`" ;.` r,:'�'�- r�. V -�. `_ 44. Landscape IrriqationSysteqr; '�.` • • �• -! ' - Q;; - �; , ,r 45. $,ound Attenuation ' " r�:., `'- '" : ';" _ -', `r�f ' f � rL T �;• �i.. - . F r� " 46. Nandicap Regulations `- . .. ..' � �= � w� . • � �. �. rr u - �, '" _ . . 47. P+NAt STRlS6TURE & BUYLOING � ' J.-� 'K ' ='� � _ _ . ; ,.�-r- , - 48. FFNAt PLANNING ;� .. w � ' ,? ,: m _ r c. • - , . 49. Etectrie Release to Edison � • 1 - �.' r - � z . � yj/��* . 50. Gas Release to Southern Califomia Gas Co • %' ' a,• . F. �. . .' 51. CERT#FICATE OF OCCUPANCY � , , ?� � , _ No - Date � �� k cn �'i _ _ _ "�-- : , Applicant lo fill in all spaces excepl those wit�in �eavY CorEe� lines antl sign all appropriate Oeclaralions. Ci7v oF COST,4 MESA CONSTRUCTION PERMIT 7 ProjecrAddress �:OZ w �gf �'�T Applicant's Mailing,Address a�s /��LAD9y � OwneriName � ��=��✓ Phone�-�) Address �� w- � 37�r Aich/Eng. License No. Address � Contracmr's Name—��r�c AW�J/�/b5 Phone ��S-1el'3 Addresslmailing) 2�l N.QGL/�aQ1� � City License No. 39(c�.� LICENSED CONTRACTOR DECLARATION � flefeby affilT tM1dt I am IICOnsOtl untler provi5ions o( ChdlLel 9([ommpnting with section ]000) of Division 3 of tne Business antl Professions Cotle, antl my license is in full force antl eifect. �Q/�O Llcense GI ss � Licen No. � Oale al/�e� Si9nature �✓' WORKERS' COMPENSATION OECLARATION lereby affirm that I have a certlflcate of consent to 5¢Ihinsure or a<ertificate Worker5' Compensation Insurance, or a certifietl coOY �hP.�Gof (Settion .B00, La .) �. � Policy N , Comp�~ �M��` �Certi " py is heteby furni5hetl. Certifie4cppY,lLfiletl with the clty_guyyi�ig DiviSiop�/�—� � i ms secoon neea no� oe compie�ea i* ine pe�mrt is io� One nunOrBO (ElUO) or less). 1 certi}y that in the pertormdnCa ot the wo�k fo� wblch this p¢rml� is ISSuetl, I shall not employ any person .In any manner so as to become subje<t to tne Worker ' nsation Laws of Callfomia�f' A . Date Si9nature 771/V� w`N""O,}� NOTIC : If, atter making this tleclaratlon, you shoultl becoma subject to the. Wo�ke�s' Compensation provi5ion5 0( the l2bo� Cotle, y0u mu5t forthwith comply with sucn provisions or� this permit shall be tleemetl revoketl. CONSTRUCTION IENDING AGENCV I her¢by atfi�m that there is a conitruction lentling agency fo� [he Oe�formance 01 the work tor 'which tnls permit is issuetl (Section 309] Clv. C.) l.enaer's Name Lentler's Atltlress OWNER BUILDER DECLARATION I hereby attirm that I am exnmp[ trom t�e Gonlracto�'s License Law for the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county which requires a permit to construct, alter, improve, tlemolish or repair any sVucture, prionto,its iszuance, also requires the apP�icant for su<h permit t0 tile a signetl statement that he/she Is licensetl pur5udnt lo lh¢ provlsions'of the Contractor's License Law (Chapter 9(commencin9 with Sectlon 7000) ot �vlsion 3 of tM1e'Business antl Protession5 Cotl¢) or that M1E/She Is exempt •retrom antl the ba5is for [he allegetl exemption. Any vlolation o( Section .131.5 by any applicant for a permit subjects the apPlicanl [o a civil �enalty ot mt more than five huntlretl tlollars ($500�. I, as owner o( the� property or my employees with wages as their sole compensation, will tlo.the work, antl the strucWre is not Intentletl or oHeretl for sale (Section 7044, Business antl Professional Cotle: The Contractor's �icense Law tloes not apply to an owner oT a property who bulltls or Improves tpereon, antl wno tloes such work himself/herself or through his or her own employees, provitletl [ha[ su<h Improvements a�e no[ intentletl o� oftere� fo� Sale. If, howeve�, the builtling or imp�ovemenf is soltl wit�in one yea� of com- pletion, the owner will hav¢ the burtlen ot 0/oving he/she tlitl no[ builtl o� im- �rova fOr the OurpoSe 01 sale�. I, as owner of the property, am ezclusivey contractinq wi[h licensetl con- l�attOrs to con5truct [he project ($ectlon ]044, Husin¢55 antl Protlzslon5 Cotle: Tbe Contractor's'LicenSe Law doM-not appty to an owner ot property who builtls o� improves [hereon, antl who contracts for such D�ol¢Cts wlth a cOn- lracto�(5) I¢enSe pursuant to the Conlractor's License Law). I am aware that prOof of their Wo�ke�'S CompenSaliOn insuranre shoultl be provitletl [o ma. ❑ 1 am exempt untler Sectlon B. & P. C. tor this reason Date Owner I hereby certify that I have �natl tnis application anC state thal the abOv¢ information is mrrect. I agree to comply wlth al1 city ana county ortlinancez antl state laws relating to builtling tonstruction, antl hereby autnorize repre- sentatives of t 'city to enter upon the above-meniionetl properry for insoettion p oses. Signature Date_� Drivers' license or 55 � IF 0865-46, rev. 30/84 _.... .._. � Z y � ►� �FARA75 PoR Ze - TVPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTIONOFWORK/USEOFBLDG.rR� ! n,��1L��„�-�— TVPE F PERMIT LJ GRADING LJ FOUNDATION II�II STRUCTURAL �TENANT ❑ ELECTRICAL ❑ PLUMBING O MECHANICAL � OTHER PROJECT DESCRIPTION S�.FT. oCCUPANCv— CONSTRUCTIONTVPE VALUATION$ u�"- ZONE G0.ADINGCU.YDS. ACRES— R<marks: Bar Sink Backflow Preventer Backflow IrrigatiOn Bathtubs Clarifiers Dishovasher . . Drinking Fountains Floor Drains Floor Sinks ' Gas Service Outlets Interceptors ' Kitchen Sink � Lavatories P-Trap Roof Drains , C Fee $15 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Bit. ICBO # Heating System & Ducting ❑a�oo,000sTu�iog oer� Reinspection Fee � $15 Whi[e - Bulltling; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor J Showers Service Sink Sewer Cap'. � Sewer Connection Solar Collectors Solar Pipmg Solar Tank . Swimming ol w/Spa� V�dfer Closet Water Heater Wa[er Service Auto-Wash Laundry Trays Issue Fee iANICAL Hood or Typel � Canopy Typell ❑ Refrigeration em ❑o-ioo osTu ❑ioo,000eT� em Repair/Alteration Fire Dampers . � Registers Issue Fee A.P. # ` S Main Building: E T Front A Rear , C Right g Left Ping. Ref. # Plannina Notes: � Automatic Washer Construction Pole Cooking Unit Dishwashe( Dryers .�Gas C Fan F.A.U. Fixtures Device Boxes OuUets 372E �/! / 7 i. . _ � / — / zo�e G/ Accessory Building: 2 � O . N I ' N G R Park_in'g .Re`q/./Provided E (.�-�"� a M T S ELECTRICAL Transformer ❑ 75-50 KW ❑ 50+KW Garbage Dispoul Generetor 065 ❑5-15 KW $ 3 Reinspection Fee $15 FEES DEVELOPMENT SERVICES REQ Zoning Approved By � Building ApproVed By Aoalimtion laued BY $ 3 Meter ❑� Meter �c Su6 Panel MO[Of5 ❑ IncSol ' M owave Pole Light Range to 100 amps �.r 100 ampy ❑1f.-8 HP �16-75+ "- Standing Sections Trash Compactor luue Fee FEES $ 3 �-/8-g7 SUMMARV OF FEES BUILDINGPERMIT s�L4• 5a SMIP $ Q' S� PLAN CHECK $? R• 4� PERMIT PLUMBING 5 ISSUANCE $ PLAN CHECK 25% $ ENERGV P.C. $ ELECTRICAL � $ GRADING S P,LAN CHECK 50% $ MICROFILM $ MECHANICAL � $ TOTAL FEE $��- 5 3 PLAN CHECK - 25% $ � I 1 �\CONSTRUCTION ANDPLANNING POOL&SPA APPROVALS Permit# � Date Inspector p�ppROVALS Permit# � Date Inspector 1!�Temporery Electiical�Service or Pole 52. Pool & Equipment Location . . \ c I2. Soil Pipe-Undrgrnd. � 53. SteEol Reinforcement 3. Electrical Conduit Utility-Undrgrnd. ' 54. Forms 1 4. Electrical Conduit-Undrgrnd. 55. Elec:trical Bonding � 5. Steel Reintorcement 56. Rough Plumbing & Pressure Test , i 6. Electrical UFER Grnd. 57. APF'ROVAL TO COVER-GUNITE 7. Footings :, ' , 58. Eler.trical Conduit-Undrgrnd. 8. Foundation � , 59. Gas Pipe, � Undrgrnd., Test. ' .i, K: 9. Wafer Pipe-UndFgrnd: . . 60. Bacl<wash 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. Plurnbing 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 FINA�L 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace , � APPROVALS Permit # � _ 21. Ducts, in Structure 70. Underground Hydro ��' .. 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush " � 24. Roof Framing 73. Undergrnd. Storage Tank•O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hyciro . t 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemiral . -� �� 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 - c .. ~ �. 32. Electrical Power Metei-Final 80. FOOD CERTIFICATE ISSUED � 33. Final Electric . Notes: - • 34. Final Heaiing & Air Conditioning ' �� _ � � 35. Final Gas Pipe-Test ��' 36. Hood or Canopy � 37. Finsl Factory Fireplace . ' L ' "' 1 38. Final Plumbing ' U � . � 39. Water Service-Final � �a� �. 40. Gas�Service-Final � • ti' � t 41. Solar pomesticFinal " Y�' � -S 42. Backflow Preventer � � � . ' i' • � ,- 43. Backflow Irrigation - � � y � ,� ' �' J� 44. Landscape Irrigation System - � ' � Y '4 a;; '• 45. Sound Aitenuation '� �. _ ' 46. Handicap Regulations ,L. •• �' 47. FINALSTRUCTURE&BUILDING g ,� G�.J. - `( . �; j . •`• i 48. Special Requirements Completed � ' �� e � 1� 49.' Electric Release to Edison �� ' � 50. Gas�Release to Southern California Gas Co P 51. CERTIFICATE OF OCCUPANCY - . .` . r i , No. ' Date AOP�icant to fill in all soaces except those within neavy Dortler Iines antl sign all approo��ata aeclaratlons. CI OF COSTA M a CON TR I N PE MIT PERMIT NO. / TFjACJ,�Op LO�O. UNIT�� A p# 1 L � /L�� CL i�1-'I %,L. I 1 ( �oject Address ( n,...r__:..... nn_.�..._ n.�""" SL) tiL — I iarcn/tng7Ve�� L��•_ i+�i Licenu No. Addry{s Con:ractor's Name Phone Addresslmailing) � City Licenu No. LICENSED CONTRACTOR DECLARAT�ION � 1 her@ fi�m lhat I am Ilcensetl untler.provisions of commencing with section ''' antl P�ote55ions Cotl¢, anA �" 'ic s ' t q ( � �t s cl � � Si9nature —"�� ._. '�ORKERS' COMPENSATION DECLARATION 'eraby aHirm that I have a cer(iticate of consent to zeH-insure or a certificate Worker5' Compen5ation Insu�ance, o� a certlfi¢tl CoOY ��ereof (Sectlon d800� Lab. C.) . Policy No. Company 8 ce.tified cnpy is hereby tu.nishea. ,_ Cerlifietl copY is tiletl with tne city Builtling DlviSion. Date Applicant '� EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completetl if the permit is tor one huntlretl ($300) or lezz�. I cart{�y that in the performance oi the for which thl�rmR is issuetl, I shall not e O�o a y p son in any ne So a5 to 6 a SubjeCt to Ihe Worker s t' ws of Calif ' � �i �� , Date Si9natur NOTI � t, at e ma ng tbis tlecla�atlon, you Shoultl becOme Subject to the Workprs' Comp sation provisions ot the Labor Cotle, you mus[ fortM1wlth wmply with such provisions or Ihis parmit shall be tleemed revoketl. CON$TRVCTION LENDING�AGENCV 1 hereby aHirm that tM1ere is a construct7on lentlin9 a9en<y tor t�e performance ot the work for which IhiS permit IS ISSuetl (SectlOn 3097 Clv. C.) LRntla,r's Name Lentl¢r's Atldresz OWNER BUILDEq DECLARATION I^^reby a(firm ihat I am ¢xempt trom the Contractor'S LICenSe Law tor the vinq reason (Section .7031.5 Business antl Professlonal Cotle: Any tlry or �-'*.`5ere/rom antl tne basis for [�e allegetl axemption. Any violaElon of Section '�'%031,5 by any ap0��wnt for a permit sub�ects the applicant to a civll ppe��a'l�y of not more than five huntlretl tlollars (E500). y+� i. as owner ot the property or my amployees with wagas as thelr sole 'EOMpensation, will tlo the work, antl the struGtu/e Iz nOt Intantletl O� offerftl for sale (Section 7044, Business antl Protessional Cotle: The ConVactor's License Law tloes not apply lo an owner ol a properry who builtls or improvez thereon, antl who tloes such wO�k himself/h¢rSeH o� Inrough his o� her own employees, providetl lbat Sut� Improvem¢Ots a�e not int¢ntl¢0 0� ott¢retl to� sale. It, howeveq Ihe builtling or improvement is soltl witbin one year of com- o�etipn, tne owner will have the burtlen of proving he/stle tlltl not builtl or im- provq tor the purpose of sale). ❑ I, as owner oi the property, am exclusl�ely contractin9 wlth Iicensetl con- tractors to construct the project (Section 7044, Business anE Pro(esslons Cotle: The Con[raclor's �License Lnw does not apply to an owner o/ property who builtls o! improvEs thereon. antl who COntlact5 �o! such orOi8Ct5 wltll a �on- tractor(s hcense pursuanc ro tne Contractor•i Litense 1„aw). I am aware tM1ac pro t Iheir Work Compensation insurance snoultl be provlCetl to me. ❑ m pt un r 'on B. & P. C. tor [Ais reason � r e, ! Owner I have r¢a I agree to lo builtlu' to eryEr mre �wi /�-/�� rs' License or 55 $ _ 0865.y6,rev.5/88 'tate lhat the above �tl county ortlinances eby author�¢¢ repre- lonetl ro `rty o Date �✓ TYPE OF COiVSTRUCTION LJ NEW L1 ADiJ LJ ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER L�ESCRIPTION OF WORK/USE OF BLDG. TVPE OF PERMIT GRADING FOUNDATION STRUCTVRAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBINIG ME/p HANICAL � OTHER �L OG IL W Pc�l�. �/✓G��GL7 PROJECT DESCRIPTION 5c2. FT. —OCCUaP,aOC� GONSTftUCTION�TVPE VALUATION `0�0 20NE GRA�tNGGU.YDS. ACRES Remarks: Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Drinking Fountains Floor �rains Floor Sinks . Gas Service Outlets Interceptors Kitchen Sink Lavatories P—Trap Roof Oreins - . Reinspaction Fee Boiler Duct-Under Ground Duct - Sttuctural $15 ExhaustSystem LJ Muliiple Firepl/Fact. Blt. IC80 # Heating System & Ducting ❑0.100,000 BTU 0100,000 Reinspection Fee � $75 White - guiltling; Canary - Appll<ant; Pink - A<counting; GolGenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash laue Fee � $ 3 Hood or Typel ❑ Canopy Type tl ❑ RefrigeretiOn System ❑0�100,000 BTU ❑ 100,000 BTU System Repair/Altere[ion� Fire Dampers Registers Issue Fee $ 3 S Main Buildi E , T Front B Rear A C Right � g Left Ping. Ref. # � Planning Notes: �lutomatic Washer Construction Pole Sub. Cooking Unit Dishwasher zona Accessory Parking N N G R E Q M T ELECTRICAL Transformer ❑ 15-50 KW ❑ 50+KW Fan F.A.U. . . . � . Fixtures Device Boxes �UtIEtS Switches Garbage Disposal Generamr �0.5 KW �5-15 KW Meter LJup to 100 amps Meter �over100amps Sub Panel Motors OO-1 HP O1 h- 8 Inc.Soiar �9�15 HP �16^75+ Microwave Pole Light Range Sign Standing Sections,. Trash Compactor Fee � $15 � I �ssue Fee � -DEVELOPMENTSERVICES REQUIREMENTS: Zoning Approved 8y "Buildin9 APProved BY h� b`9 .T1 BUILDING PERMIT $ PLAN CHECK $ PLUMBING $ PLAN CHECK 25% $ ELECTFICAL $ P�AN CHECK 50% $ MECHANICAL $ XPLAN CHECK� 25% $ OP FEES r _ SMIP . _ PERMIT _ ISSUANCE ENERGY P.C. GRADING _ MICROFILM — TOTAL�FEE FEES $ 3 $ ' .1� $ $ S $ 38� �x�c„^ �s„"`""t�i, _/ r �±.TcOG9�Y-`��!]g0Y7��E i o�c Y � `�7 � ,� �CONSTRUCTION AND PLANP 'O� x SPA � APPROVALS .� Fermit # Date Inspector Date' Inspect� APPROVti_ . Permit # ' � 1. Temporar.y�Electrical Service or Pole .!� 52. Poof & Equipment Location '�.; :� .. ) v.. . .: � 2. Soil,Pipe,Undrgrnd. �� I :� 53. Steel Reinforcement ��--' t/�,`� ri ., 3.)Electiical�Eonduit UtilitV-Undrgrnd. !j � 54. Forms �'[ � ' �%� � , iv �.-i-i�� r: � ..� . � .4�..�Elect_r.ical,Con�irUndrgmd. 55. Electrical Bonding :.. �' 'r 5. Steel'Relnforcement ;; 56. Rough Plumbing & Pressure Test r �!,..� ,� . � ' `-- ;<'i' '" 6.��lecti,ical UFER Grnd. �� 57. APPROVAL TO COVER�GUNITE �� L'� ��r'� �: .. .��. . �.• Eooiings .j � 1�%L• �' � 58. Electrical Conduit-Undrgrnd. � r�' ..r :' � -ri �� B;�Fou:ndd� n +� r� 59. Gas Pipe, O Undrgrnd., Test �1 U' ' r . �: V '9!'WateiLPipe-Undrgrnd. � • 60. Backwash Lines, P-Trap, O Undrgrnd. � 10!jStru�turalFloorSystem � ! �' ' 61. APPROVALTODECK 1'1�� Property Sewer Line & House Connection .'�' � 62. Backwash & Receptor-Final � i� t 12. Sewer, CaP � %� 63. Heater & Vent-Final �V� .•� � i. iC 13. Roof-D�ins '�� 64. Plumbing System - Final (y� 14. Rough•�lumbing 65. Electrical�Final �� 15. Rougk;Electrical-Conduit 66. Solar System-Final T6! Rough�Electric Wiring 67. Fencing & Access Approval � ii7. Rough Wiring Sign 68. APPROVED FOR PLASTERING 98. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 1.9. Rough Heating & Air Conditioning FIRE DEPT. REaUIREMENT in 20. Rough FactoryFireplace APPROVALS Permit # � 21. Duc[s, in Structure 70. Underground Hydro � 22. Duas, Ventilating 71. Product Piping OGas ❑Oil 23'Gas Pipe-Rough & Test 72. Underground Flush - IN '24'. Roof Framing'�� 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing � 74. Overhead Hydro 26. T-Sar Ceiling �Str�ctural� & Monocoat 75. Dry Chemical �27� FrameandFlashing J6. DryStandpipe �;8. Lathing & Siding^ 77. FIXED SYSTEM FINAL 29. Insulation � �� 78. FIRE PREV. FINAL ��qJ � 30. Drywall Nailingi �. HEALTH DEPT. REQUIREMENT r 31. Plaster Brown;Coat� 79. FINA� INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED � 33. Final Electric ' Notes: 34. Final Heating & A�r Conditioning �Q],D ��]� .��Cj�j. ]�Qjj�i�Ts 35. Final�Gas Pipe-7est _, q� g �`� i �36. Hood or Canopy y � o� L37. Final.Facfory Fireplace - �� Vr._ r �38. F. n� al,Plumbing _. � � -39. Wsier Service-Final-; - !i � _ - 1 40.GasService-Finali'.'" - � =��: . _ �..41. Solar pomestic-Fina,l� _ . +I 1 _. r � ' 42. Backflow Preventer?, _ � / �+7`r- "� � �,' . c 43. BackFlow Irrigation` � � ��. ° �{`�� 44. Landscape I�rigation System j�f n � 45. Sound Atienuatio�� r 46. Handicap Regulations � ` �/ � 3D3 47. FINAL�STRUC7URE & BUILDING �- �� ` � C � 0 48. Special Requirements Completed � �� 49. Elecv-ic Release to Edison �f� ;'' �,, �� i '� 50. GaslRelease to Southem California GasCo ��;�'^ • ,�9 ''� G •J 51. CEfiT�FICATE OF OCCUPANCY r,� � � !_I No. Date