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Home My WebLink About601 19TH ST - Building Permitsp�4) 754•5273 • Fax (714) 75a•4856 • www.ci.costa-mesa.ca.us P FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 601 W 19TH ST Suite No Vicinity: Parcel Nunmber: 42421118 Applicant: TIM FYKE Address: 1250 E GENE AUTRY WY ANAHEIM, CA Phone: 714-712-0744 Zip 92805-6716 Owner: NINETEENTH ST PARTNERSHIP . Address %LEE:B ASSOCIA7ES �� - - ORANGE, CA � � - phone: � � , � 701 S PARKER ST STE 7000 2ip: 92868-4748 � . Contracror: NAZZARENO ELECTRIC CO INC Address: 1250 E GENE AUTRY VJY � � Phone: 714-772-4744 � ANAHEIM, CA Zip: 92805-6716 ' • License:681792 ISSUE FEE � � Temp service test Res. alc package NeW Res (1-2 units) New Res (3+units) Pool / Spa Ligbting Fixts , Recept Outlets Svritches Non Res Appl Res Appl SeNice to 200a SeNice to 1000a Service over too0a MotOrs to 1 hp � ' � Molors l0 10hp � Motors to 50hp . Mofors to 700hp MotOrs over t00hp Communication drops Sul panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Inlermed Pole Status: ISSUED Applied: 02/03/2006 Issuetl: 02/03/2006 ISSUEp Bv: SCOPE OF PERMIT 800SF IN7ERIOR TENANT IMPROVEMENT FOR "PLANNED PARENTH000". WORK TO INCLUDE: CHANGE OUT OF 4 TRANSACTION WINDOWS AND INSTALL "SHAITERGARD" SECURIIY AND SAFETY GLAZING, 1 PARTITION WALL, CHANGE OUT OF 3 INTERIOR DOORS AND NEW GYPSUM BOARD. REF.: BOS-02329 � � ELECTRICAL TO INCLUDE: 3 OUTLETS AND 2 SWITCHES. .' ,. � � i, $23.50 $0.00 $0.00 50.00 $0.00 $0.00 $3.3D sz.zo 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 % $0.00 $0.00 50.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 Quantiry 0 0 0 3 z 0 0 0 c--�0 0 � 0 0 0 � 0 0, 0 0 0 0 0 0 0 FEE SUMMARY �, Temp Dist System / Lighting� . �Busway/t00fl �"- �Standing Seqion - Misc Electrical Equipment Transtormers uplo 1 kva/kw ................up to 10 kva/kw .................up to 50 kvalkw ..:..............up to 100 kva/kw ..................over 100 kva/kw Low Voltage Equipment Low Volt Wiring�System / Ckt Misc Conduit � - ' Misc.Condudor Circus ( gen or ride) Circus (mech ride or lights) Cfirislmas Trea Stand Fireworks Stand Otber EleUrical Fee . Quantity 50.00 0 50.00 0 $0.00 0 ' 50.00 0 $0.00 0 50.00 0 50.00 0 sa.00 0 50.00 0 $0.00 0 $0.00' 0 $0.00 0 $0.00 0 50.00' 0 $0.00 0 $0.00 0 $0.00 0 50.00 - - -Investigation Fee �50.00 Plan Check Fee , $0.00 Reinspection Fee � " 50.00 . TOTAL CALCULATED FEES 529.00 COMMENTS I SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92•2B, § 1, 12-21-92) EXpIRATION: Thls permit shall automatically ezpire and become void if work is not commenced wilhin 780 days, or ii work is suspended or abandoned tor a period of 180 days. IN$PECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requ(red (�epeet(o�e and final epproval must ba obtainetl. Fallure to obtatn inspections and final approval wiN resutt in the expiralion of this permi FOR INSPECTIONS CALL: (714) 7545626 za+e-ae lerool WOpKERS' COMPENSATION DECLARATION: ' �.1� I hefeDy aXirtn under panelty of perjury one ol Ihe tollow�ng declarations: ❑ I heve and wlll malntain a certiticate of consent to self-Insure �or workers' campensation, es pmvitled for hy seIXion 3700 of Ue Labar Cotle, for Ne pertortnence ot the work 1or whiCn ihis permit i5 issued. -D�I:fSBve arW will maiMein workefs' Comp8n5Btion insurence, es required by Sectlon 3700 of Ne L3bor Catle, tor Iha pedortnance o� �he work for wNch Ni5 permit Is �ssued. My workers' compensatlon Insurance carrler end policy number ere: Cerrier S � C"� v.�<,'— PoIIcyNumber.--WS O I� �� 3��"� ,(This�secNon'need nol be completed it the pemrit is veWed af one huntlretl da)ars (Sf 00) o� iess.) ❑ I certity Nat in the poAormance ol tha work to� which t�is Derm�� Is IssueQ I shell not employ any pereon In eny manner so as to becnmo sub�ect fo fhe workers' wmpensation laws ot ' mi en0 epree IM1et II I s�oulC become subject to t�e workers' wmpensallon pravisions of Sectlon 3700 oi Ihe LeDor Cotle, I shell fonhwlth comptywiththese ovisions. qP0licanLSignaWre: . D�� /� � � � �WyNiNOSFARVRE TO RE WO ERS' P OGVERAGE �5 UNLAWFUL AND SHALL SUBIEC7 AN ER TO CPoMINAL PENALTIES AN� CNIL FlNES UP TOONE MUNDRED TIqUSAND DOLURE (E100,000). IN ADDRION C06T OF COMPENSATION, OMMGE$ PS PFOVIpED WR IN SECTION 31060F TME LABOfi CWE, IMERE5T, MIDATTORNEY'$ FEES. LICENSED CONTRACTORS DECLARATION: I heleby attirm Ihat I em Ilcensed �unQe.�r �rovislons ol Chapter 9(commencing wlth Sectlon 7000) o� Divlsion 3 0� �he Business and Prolesslons Cade, and my licensa is in tull forte enA edetL.LIC..R"�� y'^"'� � z-- Ciess �� 4" ConS[eaoFe�Slp� net�re_ �� __ 6aie: ��O�S/L�' CONSTRUCTION LENDING AGENCY: ❑ 1 heroby eflirm ihat ihere is e wnsiruction lentlinp agancy tor t�e peAortnance oi tTe work tor which this permit is issued. (Sea 9097, Civ�l Cotle). Lendefs Neme: Lentlers ACdress: Signature: Date: OWNEfi-BUILDER OECLARATONS: I hereby ettirtn that under penalry ot Derjury lhat I em E7(EMPT FROM THE CONTFiACTOR3 LICENSE LAW tor Ihe lallowing rea5on (Sec. 7031.5, Business antl PmfesSions Code: My ciry or counry which requires e Dertnit to construct, elter, imD�ove, demolish, or repair any sirucWre, pdor to its issuanca. elso roqulres Ne applicam for such pertnit ro lile a signetl statemen� that he or she is licensed Dursuent to the proNsions at the Cantrectors Ucense Lew (CheO�er 9(commencing with Sectlon 7000) ot Oivision 3 of Ihe Business end Professions Code) or Ihat he ar sha ia ezempt there�rom anA the besLa for the elleped exemption. Any vidation of Section 7031.5 by flny apP��en� �or e pertnit subl��s Ihe applicam to e civil penalry ot not more then tive huntlretl dollars (5500).): ❑ I, as ownet ot the properry, or my empbyees with wages as their sole compensation, Wtll DO THE WORK, enC the structure Is aot intended ar aHeretl tor sale (Sec. 7044, Business end ProFessions Code: The Comractors License Law tloes not apply to an owner of properry who builds or improves thereon, and who tloes such work himself or harsell or t�rouqh his or her own amployees, provided Ihet such improvaments are not intendetl or offered lor sele. If, however, tha building or improvement is soltl within one year oi wmplelion, Ihe owneo-builder will have iha burden of pmving Ihat he ar she did not build ar improve for Durposo ol sele.). � � I, as owner ot the property, em E%CLUSIVELV CONTRACTNG WITH LICENSED CONTRACTORS �o construct the project (Sec. 7044, Business end Professions Catle: The contrectars License Lew Goes not epply to en owner o/ pwpeny who hulltls or Improves Ihereon, ena who conirects tor such project wlih e contrector(s) license pursuent ta [he Cantraclors Ucanse Lews.�. ❑ 1 em exemp� under sec. Business antl Prolessions Code for �his reason: Signature: Date: Owner ID verilied by tlrivefs license. ❑ Ves ❑ No Drivels License No. Expires: VenO��io� ol Owne�ship by (rype of daument, i.e. - D�aPerty tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CEF7IFICATION: ❑ I hereby certify that no excaveuon five (5) or more feet in depth into which e pewon is required to descend, will be made in connection with work euthonzed by ihis permil, and ihat no builtling sirudure, sCeflolding, talsework, or tlemWition ar tlismantling thereof, will be more then thirry-six (36) leet hlph. (Chap. 32, Gry 2, Atl 2, Sec. 341, Titla 8, Cdllfomla Admini5��ative Cotle). ❑ As owner-builder, I will no� employ anyone to tlo work which would require e permi� trom the Division of Indusirial Safery, as noted ebove, unless such person hes a pertnit to tlo such work Irom the tlivision. SignaNre: Date: Divis�on ai Intlustrlel Selery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORVA710N OF EMAV: I certity untler penelry of perjury Ihal I heve reatl Ihis epplicalion entl state Ihat the infortnation given is correci. I egree to comply with ell stete laws and ciry ortlinances relsiing to bullding consiruction, antl authodze representatives of Ihe Clty ol Costa Mese m ente! upon the ebove-descnbed proporty br inspection purposes. I eB�ee not to acupy or allow occupency of any building authonzod by this permit unUl finel inspection. LOpE t, INSPECTIONTY4E � QdjE �$ 7676 Flxed System Flnal Fire Preventlon 7266 Pool Spe Final 200 201 202 203 204 Finel RB-Roof Final BIxWReteining Wall Finel Fectory Fire Place Final Sign Final Demolition COpE� MSPECiIONT'PE 206 Flnel MachaniCal 208 Final Plumbing 210 Finel Elecirical 212 Final Flre Prevention 220 Finel Planning Apprwal � 222 Final Site 250 Final Building/Occupanty Date �� (714) 754-5273 • Fan (714) 754-4856 • www.ci.costa-mesa.�y}LDING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite: Vicinity: Primary Oa: Parcel Number: 601 W 19TH ST FLOOR 2, UNITS A AND B R3 4242111$ nppiicant: STEPHAN COMERFORD Address: Owner: Address Contreclor. Address: Type of Construdion: V-N Zoning: NINETEENTH ST PARTNERSHIP °kLEE & ASSOCIATES . ORqNGE,CA � ' 701 S PARKER ST STE 1000 . SR COMERF,ORD CONSTRUCTORS 500 E FRANKUN AVE� - Phone: 310-640-1000 Zip: Phone: Zip: 928684748 Phone: 310-640-1000 ELSEGUNDO,CA Zip: 90245 License: 453518 Arch : KENNETH KORMAN, AIA Eng: Address: 10500 N/YiON DRIVE Address: Status: ISSUED Applied: 12/19/2005 Issued: 01I30l2006 I � • : ��✓ Phone: 310-475-1777 Phone: LOS ANG�LES, CA - - ' Zip: 90024 � License:, C017316 license: SCOPE OF PERMIT 800SF INTERIOR TENANT IMPROVEMENT FOR "PLANNED PARENTHOOD". WORK TO INCLUDE: CHANGE OUT OF 4 TRANSACTION WINDOWS AND INSTALL "SHATTERGARD" SECURITY AND SAFETY GI.AZING. 1 PARTITION WALL, CHANGE OUT OF 3 INTERIOR DOORS AND NEW GYPSUM BOARD. ' FEE SUMMARY Plan Check: $208.81 . Permit: $32125 SMIP Res: $0.00 SMIP Com: $4.20 Other: $0.00 Inspection: $0.00 Total: $534.26 Calc Valuation: Szo,000.00 Claim Valuation: E2o,000.00 PCANNING & ZONING SETBACKS � �e ; � � � � � -r J.- � MAIN STRUCTURE Front �0; 0; ;, .� ` Rear 0- 0 ' Lefl 0. 0 � Right �� 0- 0 � .,.. /,j �,�,�C; . , � , , i/.� , ACCESSORX�� F�ont .'0-0 � � ;�Rear 0-0 � ,- ' Lek 0-0 - .Right� -0=0" ; , , � �- , , . ��. � . , . PARKING `� Ezi_stinq: 0 Reauired: � 0� � Pr000sed: 0 � NOTICE: Tha work aulhorized by this permit shall comply with all applicabla handicap access requiramenis under Califomia statutes and related regulations. (Ord. No. 92•28, § 1, 12-21•92) EXPIRATION: Thls permit shall automatically expira and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under ihis permit to be conslderad legal, such work must comply with all applicable codes, and all requlred Inspeetlons and }Inal approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zsaws (doo) WORKERS'COMPENSAnON DECLARAnON: . � I hereby ettirtn untler penelry of perjury ona ot Ne following tleGeretlons: - ❑ I have end will main�ein a ceniticate oi consent ro sell-Insure for workers' campensetlon, es proNdeO lar by sectian 3700 of Ihe Lebor Cade, tor Ihe peAormance of Ihe ��vo�r Which this pertnli I515sue0. [� I hav and �� me�ntain workers' compensation insurance, es requiretl Oy sectlon 3700 0l the Lebor Code, for Ne pertortnance of Ne work for whlch Nis pertnit is issued. �My orkefs' compensatlon Insurence carrier end pollcy numbe� ere: �� 7�j ZS �. Z�� arrier: ( � V Policy Number: (This neetl not be p/e(ed i/ the permit is va/ued et one hundretl tlWlars ($100) or IeuJ _ ❑ I cenify Iha� in the pertormence of the work for which Ihis pertnit is issued, I shall not employ eny pereon in any manner so as to bocome sublect lo the workers' compensation laws oi Celifomla, entl agree ihat II I should become subject ta ihe workers' compensetlon provislons oi Secllon 3700 of the Lebor Cade, I shall forthwith compty wilh Ihese pr 6 q � ;�awre� ' oa�e�—� � 70 � O WARNING: FN��PENSATIOM COVERAOE IS UNLAWFUL AND $HALL SUBIECi Ml EL2LOYERiOGPoMINAL PENALTIES PND GVIL FlNES UP TO ONE HUNDRED ff1005/WD OOLLARE (E100,000), IN ADDRION TO THE COST OF NMPENSATION, OMMGES AS PiiOVIDED FOR IN SECiION 31060F TME UBOR CO�E, INTEREST, AND FT�OIWEVS FEES. LICENSED COMAACTORS DECLARATION: ol Chapter 9(commencing with Sectian 7000) of torce entl eNect. Lic. N CONractor's SignaWre: Class p Professions CaOa, and my license is in full CONSTRUCTION LENDING AGENCY: '� ❑ I hereby aR�� that there is a construcGwi lentling agency for iha pertormance at tha work br which this pertnit is issuetl. (Sec. 3097, CiWI CoOe). Lendefs Name: Signe�ure: _ LentleVs AOtlress: Date: OWNER-BUILDER DECLARATIONS: I hereby affiRn inat unUer penalry ot perjury ihat I em EXEMP7 FflOM TME CONTRAC70R5 LICENSE lAW for the tollowing reeson (Sec. 7031.5, Business entl Profe551ons Cotle: Any ciry o� �unty whic� reQuires e permit to consiruct, alter, Improve, demolish, or repair eny swcture, prior m its Issuance, elso requires me epplicant lar such permit to flle a signed s�atement thet �e or s�e is Ilcensed pursuent to ihe provisions of ihe Con�rectors License Lew (Chepter e(commencing wil� Sectlon 7000) at Divislon 3 0l tha Business entl Ptofessions CaAe) or Ihet he or she is exemp� therofrom entl the Easis for ihe alleged esemption. Any violatlon af Sectlon 7031.5 by eny applicant lor e permit subjects the applicant to e civil penalry of no� more Ihan five hundred dollars ($500)J: � f, es ov+ne! af the property, or my ampla�ees with wages as lheh sofe compensetfon, WILL DO TT1E W ORK, and the stndure is not intendeC oi oitere6 tor wla (Sec. 7044, Business end Professlons Code: The Contrac�ors Llcense Law tloes not eppty l0 en owner ol property who bulltls o� improves Ihereon, entl who does such work himseli ar herselt or through his or her own employees, provideC tnat such impmvements ere rwt Intended or oflere0lor sale. If, however, the building or improvement is sold within one year oi completion, t�e ownerDuilder will �ave t�e burden of proving t�at �e or she did not 6uiltl or Improvo lor puryose of sale.). � ❑ I, as ownef ol the proparty, em E%CWSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct ihe Oroject (Soc. 7044, Business antl Professions Catle: The contractors License Lew does not apply to en owner oi property who builds or Imprwes Ihereon, antl who contracts br such project with e conirector(s) license pufsuant to the Contractors License Lews.). ❑ I em exemp� untler sec. Business enA Professions Catla tor lhLq raason: SignaWro: Dete: Owner ID venlied by tlnver's license. ❑ Ves ❑ No Dnvers License No. Vedfication of OWners�ip by (rype ot document, i.e. - properry tax bill or tleed�: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Expire5: ❑ I hereby certity that no excavetion (rve (5) or more feet in depih inro which a person is requiretl to tlescend, will be made in wnnactian with work authorized by this permit, end �he1 no building siructure, 5cattolding, falsework, or tlemolition or dismantli� ihereol, will be more Ihan Ihirty-six (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec. 341, Title 8. Cfllifomia Administrative Gode). � As owner-builder, I will not employ enyone to do work which would require a permii trom the Division of Intlus�riel Sefety, es notad above, unless such person �as e pertnit to tlo such work trom tha division. Signeture: Date: Division of Indusl�al Salery Pormit Number: CERTIFlCATE OF COMPLIANCE AND Al7i}IORQAiION OF ENTRY: I certiy untler penalry ol perjury Iha1 I have reatl this epplication and state that the information given is wrrect I agree itl �mply with ell sta[e lews antl ciry ordinances relating to building construction, antl authorize represema�ives of Ihe Ciry ot Costa Mesa to enter upon the e6ove-described p�o0erty for inspection purposes. 1 eqree not ta occupy or ellow occupancy ot eny builtling authonzed by this permit until tinel inspection. cooe �. �NsreenoNTYPE 1618 Fixed System FInelFire Preventian 1266 Pool Spe Final 200 Finel Re-Rooi 201 FInaI BIOCWRetainlnp Wall 202 Final Faciory Fire Place 203 204 Finel Sign Final Demolition Q�jF �NTff1ALS COUE 1 INSPECTION TYPE ZO6 Final Mechanical 20B Finel Plumbing 210 Final Electncel 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Builtling/Occupancy , I[f�AL$ V ia� �aa-ozis • rax (na) �sa-aa56 • www.cLwsta-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 PLUMBING PERMIT Job Atldress: 601 W 19TH ST Suite No Vicinity: Parcel Nunmber: 42421118 Applicant: ROBERT YANKE Atldress: Owner:, Address Contractor: Address: Phone: 818-785-4628 Zip: � _, �. . NINETEENTH ST PARTNERSHIP ,%LEE�&ASSOCIATES ";- " i � ORANGE,.CA Phone: 701 S PAI2KER ST STE 1000 Zip: 92868-4748 GLOBAL PLUMBING CO INC 7404 VALJEAN AV Phone: Zip: ,license: VAN.NUYS, CA 818-785-0628 91406 ' 350223 Slalus: ISSUED Applied: 02/09/2006 Issued: 02/09/2006 /i/, � • '� ` SCOPE OF PERMIT 800SF INTERIOR TENANT IMPROVEMENT FOR "PLANNED PARENTHOOD". WORK TO INCLUDE: CHANGE - OUT OF 4 TRANSACTION WINDOWS AND INSTALL "SHA7TERGARD" SECURITY AND SAFETY GLAZING, 1 PARTITION WALL, CHANGE OUT OF 3 INTERIOR DOORS AND�NEW GYPSUM BOARD. � � , � REF.: BOS-02329 , . . .� .. ' . � ' . . .. � PLUMBING TO INCLUDE: 3 SINKS LOCATED IN THE NURSE'S STATION AND EXAMINATION ROOMS. " AMT � ISSUE FEE $23.50 � Backflow irrigalion $0.00 0 BackflowPreventer � $0.00 0.� 6athtub , � `� '� , $0.00 0 Clarifier.System � �� $0.00 0 Connecl(Ice,Soda,etc) � ,50.00 0 Dental Units ' �$0.00 0 Dishwasher $0.00 0 Drein, Floor , $0.00 0 Drain,Rainwater $0.00'��. 0'��:�� Drain, Root � ' $0.00 � ` 0 Drinking Fountain,� ._�.� 50.00_ `�-0 ��ti� - flxpansion Tank,� , ;,, , $0.00� ,, 0 ��" �' Gas Eadhquake Valve�-, $0.00 ' � 0 � Gas (1-4 outlets) � _� $0.00 �0 � - Gas (Over 4 outlets) ' � $0.00 - ' 0 � Gas Repipe �. SD.00, � 0- � � Gas Service 50.00 �. 0 � Interceptors (Grease, Oil) $0.00 0 �. Interceptors (Sand Auto ) $0.00 '� 0 � � �� . FEE SUMMARY � . , - - � �' gMr . .grY. Laundry Tub I Washer � $0.00 '0 Landscape Irrigation $0.00 � 0 P-Trap � � 50.00 0 Pressure Regulator ' . �$0�.00 0 Process Piping (per 10 fl) $0.00 �� 0 Receptors --. ' � �- $0.00 0 Septic Tank 50.00 0 Sewer Csp for Demo �$0.00 0 .SewerConnect $0.00 0 � Sewer Private Cine $0.00 � 0. �'� . Shower � ' ' $0.00 0 �� Sink, bar � � - 50.00 0 . Sink, commercial $0.00 0 'Sink, Floor � $0.00 � 0 Sink, kitchen � � � '$0.00 . 0 � Sink, service/mop $0.00 0 Spa(private) $0.00 � 0� Spa (public). . $0.00 0 COMMENTS 1 SPECIAL CONDITIONS SumpPump ,' Swimming Pool Trap Primer � � � Urinal Vacuum Brkr Bkflow(1-4) � Vacuum B�kr BkQow(5+) Wash Basin � Wasb Basin Set - Waste and VeM System � Water Closet (Toilet) � Water Heater I vent . � �� . Water`Piping (Inst or RepJ Water Re-pipe . , Water Service ' -- WaterSoftener OTHER � VIOL4TION PLAN CHECK , REINSPECTION TOTAL CALCULATED FEES: AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $29.40 $0.00 50.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 E52.90 QTY 0 0 0 0 0 0 3 0 0 0 0 0 0 0 0 G NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes antl related regulations. (Ord. No. 92•28, § 1, 12-21•92) EXPIAA710N: This permit shall automatirally expire and become void it work is not commenced within 780 days, or it work is suspended or abandoned far a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all requlred inspectlona and final approvel must be obtained. Failure to obtain inspections and final approval will result in the e� FOR INSPECTIONS CALL: (714) 7545626 zaasas larool WORKERS' COMPENSATION DECLARATION: I �ereby effirtn under penalry of perjury one oF the followinq tleclaretions: , ❑ I have a�tl will mainlain e certificete ot consent to self-Insure for workers' compensatlon, as provitletl tor by section 3700 0l Iha Lebor Code, br the pertormance of the � work tor which thi5 pertnit is issued. p I certity �hat in Ihe pedo nce the w i compensation laws ot G Ifomi , antl a E comply with ihese prov' ons. App�caniSigna� -�- �'� MMRIJIPG: FAILURE TO SECUFE WORKERS' COMPE 7FqUSAND DOLLA0.E (SIOO,OW), IN PDOfT1IX�l TO hj LICENSED CONTRACTORS DECLARATION: �.rance, as required by sectlon 3700 ot ihe LEhor Cotle, for Ihe peAortnance ot Ihe work br which Nis permit Is issued. olicy number are: ,, 1 L„ �/�, l/. I� 47n��' PolicyNumber:'�WH�� 4� etl�y onB hundied do��ars ($100) orless.) �- ch this permlt is issueQ � shall not employ any person in any manner so as to become subject to tha workers' t should bacome sub�act to the wodcers compansalion provisions ot Seciion 3700 ot the Labor Cotle, I shall torthwitr — �Date:• `.'�'�.�—O �o COVERAGE IS UNLAWFUL ANO SHALL S1191ECT AN EMP OL VER TO CRIMINAL PENFLTIES M1D GVIL FlNES UP TO ONE HUNDRED F COMPENSATION, �AM4GE5 /S PROVI�ED FOR W SECTION 3IW OF THE LABOR CODE, IMEREST, AND ATiORNEY'S FEES. of Chapter 9(commencing with Section 7000) of Division Code, antl my license is in full GONSTRUCTI�N LENDING AGENCY: [] I hereby attirtn ihat ihere is a wnstruction lending epency tor t�e peAottnance of the work lor whiG� ihis permit is issued. (Sec. 3097, Civil CoCe). Lentlef5 Name: Lentlers Address: 5�gnature: Date: tlN�NER-BUIIDER DECLARATIONS: I hereby aHirtn thet untler penelry of Oerjury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe following reason (Sec. 7031.5. Business and Protessions Coda: Any ciry or county which requires e pertnit to constmct, elter, improve, demolish, or repair eny stmcture, prior to its issuence, elso requires the epplicant for such permit Ip tila a signad stetemant t�et ha or sha is 6censed pursusnt to tha provfsfons ot the CoMreciors LfcenSe Law (Cheptar 9(commendnq wMh Secifon 7000) oi DWfsion 3 ot the Business and Professions Code) or that ha or she is exempt iherefrom end the basis tor Ihe alleged ezemption. Any violation oi Sectlon 7031.5 by any applicant for e permil subjecis the eppliwnt to a civil penalry of not more Ihen tive hundred dollers ($500).): ❑ I, as owner of the property, or my employees with weges as their sole compensation, WILL 00 THE WOF;K, antl the structure Is not intendetl or oftered for ule (Sec. 7044, Business and Protessions Code: The Coniractors License Lew dces not apply to en owner ot properry who builds or Improves Ihereon, and who does such work �imseli or herseli or ihrough his o� �er own employees, pmvitletl Ihat such improvements ere not Intended or otteretl for sele. If, �owever, the builtling or improvement Is sold within one year of completion, ihe owner-builtler will have ihe burden of proving thal he or she did not 6uild or improve tor purpose of sale.). ' ❑ I, as owner of the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTHACTORS ro construct the projecl (Sac. 7044. Business antl Professions Cotle: The conirecmrs License Law tloes not appry to an owner ol property who builds or improves Ihereon, and who coniracts br such project with a contrector(s) license pursuant to the Contrectors License WwsJ. ❑ I am exempt under sec. Signatura: Owner ID verified by tlrivers license. ❑ Yes ❑ No 6usiness end Professions Cotle tor lhis reason: Varitication ot Ownerehip by (type ot tlocumant, i.e. - D�aPerty taa blll or deetl): Driver's License No. Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ I hereby certify that no excavation five (5) or more teet in tlepth into which a person is required to descend, will be matle in Connection with work euthorized Dy this permit, and that no building siruMura, scaHolding, talsework, or tlemolition or disman0ing thereol, will be more ihan thirty-sia (38) feet high. (Chap. 32, Gry 2, Atl 2, Sec. 341, Title 8, Calitomia Administrative Code). ❑ As owner-builder, I will not employ enyone ro tlo work which would require a permit irom ihe Division of Industdal Safery, es noted ebove, unless such person hes e permit to do such work Irom Ihe division. SignaNre: Date: Di�ision of Indusinal Satety Permit Number: CEfl7�FlCATE OF COMPLIANCE AND AUTHOROJITON OF ENTAV: I cehify under penelry ot perjury that I have read this epplication and state t�at ihe infortnation given is correct I agree ro wmply with ell state laws end ciry ortlinances relating to Du�lding conslruction, antl authonze representatives ol the Ciry oi Costa Mesa to enter upon Ihe ebo�e-descri pr rt lar inspeGian purposes. I agree not to occupy or ellow occupancy of eny building authorized by Ihis permit until finel inspection. �i 1�. INSPECTION TYPE 1616 Fi:ed Sysiem Final Flre Prevention 1266 200 207 202 203 204 Pool Spa Final Final Re-Roof Final BIocWRetaininp Wall Final Factory Fire Place Finel Sign Final Demolition QdjF �§ 4,Qyf,j INSVECTIONiYPE � 206 Final Mechaniwl 208 Final Plumbing 210 Final Electncal 212 Final Fire Prevention 220 Final Planning Approval 222 Final Site 250 Final Building/Otcupenc (714) 754-5273 • Fa�c (714) 754-4856 • www.cl.costa•mesa.ca.us 77 FAIR DRIVE, COS7A MESA, Gn 92626 Job Address: Suite No Vicinity: 601 W 19TH ST 2 ENTIRE 2ND FLOOR Parcel Number: 42421118 Applicant: COMERFORD, STEPHAN Address: 500 E FRANKLIN AVE EL SEGUNDO, CA MECHANICAL PERMIT Phone: 310-640-1000 2ip: 90245 Owner: NINETEENTH ST PARTNERSHIP Address: Contrector. °/ LEE & ASSOCIATES ORANGE, CA " Phone: 701 S PARKER ST STE 1000 Zip: SR COMERFORD CONSTRUCTORS Address: 500 E FRANKLIN AVE El SEGUNDO, CA 92868-4748 Phone: 310.640-1000 2ip: 90245 License: 453518 Status: Applied: Issued: ISSUED 08/19/2002 08/79/2002 ISSUED BY: � SCOPE OF PERMIT MECHANICAL TO INCLUDE: 1 AIR HANDLER < 10000 CFM AND 1 COMPRESSOR/ABSORPTION SYTEM UP TO 3 HP REF.: 802-00947'PLANNED PARENTHOOD' ENTIRE 2ND FLOOR ISSUE FEE Inst FAU <100 k BTU Inst FAU >100 k BTU Repair/Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Re(rig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < t0000cfm AirHandlers> t0000cfm Floor Fumace Floor or Suspend Heater 323.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.65 $0.00 $0.00 $0.00 Quantity 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 t 0 0 0 FEE SUMMARY a, ,., Repair / Alt Absorbtion Unit - - - - Repair / Alt Refrigeration Unit Ventillation System Evaporative Cooler Commercial I nci nerator Domestic Incinerator Compressors / Absomtion Svstems Upto3hp/100kBTU 3To15hp/SOOkBTU - 15 To 30 hp I 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp I Over 1,750 BTU Boilers ' Upto3hp 3To15hp 151o30hp ,,, 30 to 50 hp Over 50 hp Olher Mechanical Fee InvesUgation Fee � � Plan Check Fee � Reinspection Fee ' TOTAL CALCULATED FEES COMMENTS / SPECIAL CONDITIONS Quantiry $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $14.70 1 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $48.85 NOTICE: The work authoiized by this pertnit shall comply with all applicable handicap access requirements under California slatutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) E%PIRATION: This pertnit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work euthorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all requlred Inspections end flnal epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiratlon ot this p� FOR INSPECTIONS CALL: (774) 7545828 zawe laroo) � i / WORKEAS'COMPENSAnON DECLARAnON: � I hereby aXirm under penelry of Derjury one of Ihe following declaretlons: ' ❑ I have en0 wlll mflintain e certificate of consent ta selt-Insure for workers' compensatlon. es providad for by section 3700 of tha LeDor Code, lor the peAormanca ot the work tor which Ihis permil ls issuetl. [� I heve and wlll meintain vrorkers' campensation insurence, es required by section 3700 of Ihe Lebor Cotle, for ihe peAortnance of t�e work for which Ihis pertnit Is iuued. My wor s' compel7setlon Insurance carner and policy num6er ere: —7 Carrier: '��5�� % Policy Number. ` � z"S ' ZCD � (Thls section nee0 nof be cqmpleted il fhe permif is valued et ane huntlretl dollers ($f 00) or less.) ❑ I certlly t�at In t�e pertortnence of ihe work For which Ihis permit is Issued, I shall not employ any person In flny manner so as to 6ecome sub�ect to the workers' compensatlon laws of Celtlomla, and e that'f I sho ecome sublect to Ihe workere' compensetion provlsions oi Sectlon 3700 oi Ihe Lebor Code, I shell forthwith wmpty with these provislon �J Applicent Signature: Dete: �J � �� "� WARNING: FNLURE TO SECURE WORKER$' CC ENSA OI OVEMGE IS UNLAWFUL M!D SHML SOBJECT Ml EMPLOVER TO CRIMINFL PENALTIES AND CML FlNES UP TOONE HUNDRED TKKISAND DOI.URE (5100.000), IN ADDITION TO THE COST OF COMPENSATIpN, �AANGES AS PROVIDED Fdi IN SECiION 3]W OF THE IABOR CO�E, INTEREST, M!D ATTORNEI"S FEES. LICENSED CONTAACTORS DECLMATION: I hereby aXirtn that I em torce ana exect. uc. s_ Contrectars SigneWre: of Chapfer 9(wmmencinq with Section 7000) ot Division 3 oi �he Busines ntl Professions Cade, anA my license is in full Class M _ __� oate: � 19 . 2��- CONSTRUCTION LENDING AGENCY: ❑ I hereby aflirm ihat t�eie Is a consiruction lending egency for ihe peAormance ol lhe work for w�ich ihis permil is issued. (Sec. 3097, Civll Code). Lendefs Neme: Lendar's Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eHlrtn the� under penelry ot perjury Ihat I am EXEMPT FROM TME CONTRACTORS LICENSE LAW tor ihe following reason (Sec, 7031.5, Business antl Professions Cotle: Any ciry or counry which requlres e permit to construct, elter, Improve, tlemolish, or repair eny structure, prior to its luuance, elso requires the epplicant tor such pertnit to Ille e signed atatement that he or she Is licensed pursuent to ihe provisions ot the Cantractars License I.ew (ChaD�er 9(commencing with Sectlon 7000) of Dlvision 3 of the Business anA Proteulons Code) ar thet ha or she is exempt therefrom entl Ihe besis tor the alleged exemptlon. Any violetlon of Sectlan 7031.5 6y eny epplicant for e permit sub�ecis ihe eppllcen� to a cMl penalry of nat mare Ihan live �untlred tlollars ($500).): ❑ I, as owner oi the properry, or my employees with wages as Ihelr sole compensatlan, WILL DO TNE WORK, antl the structura is not Intended or oHeretl for ule (Sec. 7044, Business and Protessions Cotle: The Conirectors License Lew does no� apply to en owner at property who builtls or improves Ihereon, and who tloes such work himself or hersetl ar ihrough hls or her own employees, proNtled thflt such Improvements ere not iniended or otteretl lor sale. If, however, the building or improvement is sold within one year o1 completion, ihe owner-builder will heve Ihe burden of proving Ihat he ar she did not Duiltl or improve for purpose af sale.). ❑ I, as owner of the property, am EXCLUSIVELY CONTRACTING WITH LICENSED CONTFiACTORS to construct ihe pro�ect (Sec. 7044, Business anA Professions Coda: The comrectars License Lew does not epply 10 an owner ol properry w�o builCs or Improves Iherean, end who camracts for suc� Droject with a conirector(s) license pursuant to ihe Contractors License Lews.). ❑ I am exempt under sec. Business and Prolessions Code for this reason: Slgnature: Date: Owner ID veritietl �y tlAve/s Iicense. ❑ Yes ❑ No Drivefs License No. Expires: Veriticatlon ot Ownership 6y (type o1 document, i.e. - property taa blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICA710N: ❑ I hereby certify t�et no excevetlon tive (5) or more teet in depth into which a person Is required ro descend, will be mede In connectlon with work eut�onzed by this permit, antl t�et no builtling structure, scaHolding, talsework, or domolitlon or dismentling ihereof, will be more ��en thirty�six (38) ieet hlgh. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttla B, Calilamle Administretive Cade). ❑ As owner-huilder, I will not emplay anyane to da wark which wauld require e pertnit trom the Division ot Indusiriel Satery, es noted ebove, unless such person hes e pertni� �o do such work from Ihe division. SipnaNre: Date: Division of IndusMal Sefery Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUTHORVATION OF ENiRY: I cenity untler penalry of perjury that I have read this epplication end state Ihat ihe Iniortnation given is correct. I egree to comply with ell stete laws end city ordinences relating to building construction, anG authotlze representatives of the Clly af Caste Mese to enter upon Ihe ebove-descnbed properry lor inspection purposes. I egree not �o occupy or allow occupency oi eny building authorized by this permll until final inspection. LegelOwner(s) � Dete ''� •a �nowd Annlirant De�B 4�� . . ' nl�� ' 1676 ' Flxetl System Final Fire Prevention 1268 Paol Spe Flnal 200 Finel Re-Root ' 201 Finel BIocWReteining Wall Pdg II�LH COUE I INSPECTION TYPE !1 PATF. 206 FinalMechanlcal bf��t i-oa 20B Final PlumDing 210 Finel Eledncal 272 Finel Fire Preventlon 202 Final Fedory Fire Place � 2z� 203 Finel Sign. �y . . � ,.. . . . . . .. . . . � , .2� ... 20C Finel Demoll�ion 2`� Final Planning Approval Final Site Final Building/Occupenq � MECHANICAL PERMIT Job Address: 601 W 19TH ST Suite No 2 Vicinity: 2 Parcel Number: 42421118 Applicant Address: Owner: Address: ROYE,MIKE 650 COCHRAN ST UNIT 2 � Phone: 805-582-9188 SIMi VALLEY, CA . Zip: 93065 NINETEENTH ST PARTNERSHIP °/ LEE & ASSOCIATES ORANGE, CA � Phone: 701 S PARKER ST STE 1000 Zip: 92868-4748 Contractor: DAHME HEATING 8 AIR CONDITIONING INC Address: 650 COCHRAN ST UNIT 2 SIMI VALLEY. CA Phone: BOS582-9188 Zip: 93065 License: 590084 ISSUED BY: SCOPE OF PERMIT SUITE2, REF B02-00947 AND M02-00369. REMOVE 7.5 TON AC ROOF UNIT AND REPLACE WITH SAME SIZE AND THE SAME PLACE. ISSUE FEE Inst FAU <700 k BTU Inst FAU >100 k BTU Repair / Alt Cooling/Heat Inst / Rep. Recess Wall Htr Refrig Sys <100 k BTU Refrig Sys >100 k BTU Gas Piping Factory Fireplace Hood w/Mech Exhaust VAV Box Vent Fan / Single Duct Appliance - Fire Dampers Smoke Dampers Inst or Relocate Appl Vent Air Handlers < 10000cfm Air Handlers > 10000cfm Floor Fumace Floor or Suspend Heater $23.50 $14.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 Quantity 1 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Repair / Alt Absorbtion Unit Repair I Alt Refrigeration Unit Ventillalion System Evaporative Cooler Commercial I ncinerator Domestic Incinerator Compressors / Absorption Svstems Upto3hp/t00kBTU 3To15hp/SOOkBTU 15 To 30 hp / 1,000 k BTU 30 To 50 hp / 1,750 k BTU Over 50 hp / Over 1,750 BTU Boilers Upto3hp 3To15hp 15to30hp 30 to 50 hp Over 50 hp Other Mechanical Fee Investigation Fee Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES Slatus: Applied: Issued: ISSUED 09/18/2002 09/18/2002 Quantity $0.00 0 so.ao 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 $38.30 NOTICE: The work authorized by Ihis permit shall comply with all applirable handicap access requiremanis under Calitomia statutes and related regulations. (Ord. No. 92-28, § 7, 72-21-92) EXPIRATION: This permit shall automatically expire and become void it work Is not commenced within 180 days, or it work is suspended or abandoned for e period of 180 days. INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepectiona and tinal epproval must be obtained. Fallure to obtain inspections and final approval will result in the expiration of lhis pertnit. FOR INSPECTIONS CALL: (714) 7545626 �...,..,, �,.M„ WORKERS'COMPENSAnON DECLARAnON: I hareby eftirtn under penelty ot perjury one oi Ihe following tledarations: ❑ have antl wlll maintein a cenl0cate of consem to salf-Insure tor workers' compenseilon, es provided for by section 3700 of Ihe Lebar Cotle, tor the pertortnance of Ihe work tor which ihis pertnit is issued, ve and wlll mai tain workers' compensaC n insu2nce, as required by section 3700 of the Lebor Cotle, for Ne nce ol Ihe work for whlcli Ihis pertnit is issuetl. y o r�/co�n�nsatlor �surence car i r antl pollcy number ere: � ��/ errier: �'f'yl , � ei1 � Z9 �i'G 0 � icy Number. section neeO not be c`�p/efetl /l e pe it is valued at one hundred dollars ($100) or /ess.J ❑ 1 certi hat in the periortnance of ihe work for which this pertnil is issuaq I s�all not amploy any pereon in eny manner so es to become subjed �o ihe workers' pensa ,h I SBs of 10 omle nC apr f ould become sub�ect to Ihe workars' compensetfo ' s o1 Sectlon 3700 of t�e Lflbor CaAe, I shell farthwit� PP 9 D ( � 7 l �,a: —��/� - C� 2 Iiwm Si natur W . E TO SECURE WORKEHS' COMPENS ON COV RAGE IS UNIAW FUL PND SMALL SUBJECT AN EMPLOYER iQL7iAFINAL PENALTIES AND CIVIL FlNES UP TO ONE NUNDRED THOUSAND DOLLARE (5100,000), IN AODITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 37060P THE LABOR CODE, INTEREST, AND ATTORNEV'S FEES. LICENSEDCONTRACTORS of Chapter 9(commencing wit� Sectlon 7000) oi CONSTRUCTION LENDING AGENCV: Cotle, and my license Is In tull ❑ I �ereby aNirm ihat Ihere is a construction lentling agency for Ihe pertormence ot the work for whic� ihis pertnit is issuetl. (Sec. 3097, Civil Cotla). Lendefs Name: Lende�s Address: Signeture: _ OWNER-BUILDER DECLARATIONS: Date: I hereby aHirm thet under penalry of perjury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business antl Prolessions Code: Any city or counry which requlres e permit to construct, elter, Improve, demolish, or repair eny structure, prior to its Issuance, also requires Ihe epplicant for such pertnit to flle a signed statemem that he or she Is Ilcensed pureuent lo �he provisions of the Coniracmrs LJcense Lew (Chapter 9(commendng wit� Sectlon 7000) of Divlsion 3 01 Ihe Business end Prafessbns Cafe) or ihet he or sha is exempt therefrom flnd the besis tor Ihe allegetl eaemptlon. Any violetlon ot Section 7031.5 by flny aDPlicant lor e pertnil sub�ecGs the epplicant lo a cFril penalry of no� more ihan five huntlreA tlollars ($500).): ❑ I, as owner oi Ihe property, or my employees with wages es their sole compensailon, WILL DO THE WORK, antl ihe structure Is not inlentle0 or otleratl tor sale (Sec. 7044, Business and Protessions Code: The Conirectors License Law does not epply to an owner of property who Gulltls or Improves thereon, end who does such work himsalf or hersetl or Ihrough hls or her own employees, provideU that such Improvements ere not Intentletl or oHered tor sele. If, however, ihe building or improvemenl is sold within one year oi completioq �he owner-builder witl heve the burtlen of O�oving that he or she ditl not build a imprave tor purpose oi sele.). ❑ I, as owner at Ihe property, am E%CLUSIVELV CONTRACTING WI7H LICENSED CONTAACTORS to construct Ihe projact (Sec. 7044, Business anC Professions Code: The rnmrectars License Lew tloes not aDPN to en owner of property who Oullds or improves Ihereon, entl who wmrects tor such pro�ect wi�h a coniracroqs) license pu�suenl to ihe Contractors License Laws.). ❑ I am exempt untler sec. Business an0 Professions Code lor this reason: Slgnelure: Date: Owner ID verifietl by tlriver's license. ❑ Ves ❑ No Driver's Licanse No. Vedtication ot Ownership by (rype oi tlacument i.e. - pmperry tex bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION: Expires: ❑ I here6y certity that no excavelion five (5) or more teel In depth into which e person is requiretl to descend, will be mede in connection with work authonzetl by thls permit, and �het no builUing sirucNre, scaflolding, talsework, or demolition or dismantling Ihereot, wlll be mora then Ihirty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltla B, Calllamia Atlminisiretive Cotle). ❑ As ownervbulltler, I wlll no� amploy enyane to do work which woultl require e permit from the Divlslon of Industriel Setety, es noted ebove, unless such person hea e pertnit to do such work trom the tlivision. Signature: Date: Division of Indusinal Sefery Pertnit Number: CERTIFlCATE OF COMP4ANCE AND AUTMORVJ1710N OF ENTRV: I certify under penalry of perjury Ihet I have reatl ihis epplication and state that Ihe iniortnelion given is correct. I agree to comply wlth all stele lews end ciry ordinances relaling to bulltlinp construction, end euthodze representatives of Ihe Ciiy of Coste Mesa to enter upon the above-descnbed pmperty lor inspection purposes. I egree not to occupy or allow occupency ot eny building euthorized by lhis permi� until finel in5pection. CQOE 1, ixsvecnoxrrve �� QAIE II�ELS 1616 Fixetl System Finel Fira Preventlon 1266 200 201 202 203 204 Pool SDe Finel Finel Re-Root Final BIocWRetaining Well Final Factory Fire Plece Finel Slgn Finfll Demolition COpEI INSPECTIONTYPE QejE � 206 Final MBthenical �� 0 a�% 208 210 212 220 Final Plumbing Final Electncal Final Flre Preventlon Final Planning Approval 222 Flnal Site 250 Final Building/Occupency (71a) �54-5273 • Fax (7i4) 75a<BSG • www.cl.Coste-m6Se.Ca.US 77 hAIF1 UMIVt, u!5 i n mcan, i.n azozo Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: 601 W 19TH ST ENTIRE 2ND FLOOR 42421718 COMERFORD,STEPHAN 500 E FRANKLIN AVE ELSEGUNDO,CA PLUMBING PERMIT Phone: 310-640-1000 Zip: 90245 Owner: NINETEENTH ST PARTNERSHIP Address %LEE & ASSOCIATES ORANGE,CA 701 S PARKER ST STE 1000 Phone: Zip: 92868-0748 Contractor. SR COMERFORD CONSTRUCTORS Address: 500 E FRANKIIN AVE � Arch / Eng : Address: ELSEGUNDO,CA Phone: 310.640-�000 Zip: 90245 License: 453518 Phone: Zip: License: ISSUED BY: Status: ISSUED Applied: 08/19/2002 Issued: 08/19/2002 SCOPE OF PERMIT PLUMBING TO INCLUDE: 1 P-TRAP, 1 KITCHEN SINK, 1 WATER RE-PIPE, AND 1 WATER HEATER. REF.: B02-00947'PLANNED PARENTHOOD" ENTIRE 2ND FLOOR � ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clanfier System Connect(Ice,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Dnnking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 ou0ets) Gas (Over 4 wtlets) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) AMT $23.50 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 on 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $9.80 Pressure Regulator $0.00 Process Piping (per 10 k) $0.00- Receptors .$0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 snoWer $o.00 Sink, bar $0.00 Sink, commercial � $0.00 Sink, Floor $0.00 Sink, kilchen $9.80 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 QTY 0 0 1 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 Sump Pump Swimming Pool Trap Primer Unnal -Vacuum Brkr Bkflow(1-4) Vacuum Brkr,BkFlow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water SoRener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $12.30 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL CALCULATED FEES: E65.20 QTY 0 0 0 0 0 0 0 0 0 0 1 0 1 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requlrements under Califomia statutes and related regulations. (Ord. No. 92-28, § 1, 1241-92) EXPIRATION: This pertnit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspendad or abandoned for a pedod of 180 days. INSPEC710NS: In order for the vrork authorized under this permit to be considered legal, such wark must comply with all applicable codes!an�l requlred Inapeetiona and flnel epprovel must be obtained. Failure to obtain inspections and tinal approval wlll result in ihe expiratlon of ihts�pertnit. FOR INSPECTIONS CALL: (714) 7545826 �� zus�e (erool WORKERS'COMPENSAnON DECLARAnON: I hareby aNirm under penalty of perjury ona of the lollowing declaretlons: ❑ I heve entl wlll meintein a cenificate ot consent to self-Insure lor workere' compensation, es provltled for by section 3700 of ihe Le6or CoCe, for Ihe peAormence of t�e work for which this permit Is issuetl. [[� I have and will mainWln workere' compensatlon Insurance, as reQuiretl Dy section 3700 oi ihe LeWr Cotle, for the pertortnance of Ihe work far w�lch Ihis pertnit Is issued. My warke ' ��i ^In��su-r-ance cartier enA policy number ere: �7Cr Certier. ��"� � C �'1.J f� �i Policy Number. G I Z'-� ' ZOC7 I (Ihis sectlon need not be romp�eretl i� tne permitls velued ar one hundred da�ars (5100) or �ess.) ❑ I cenity thet in the peAormance of the work tor whlch ihis pertnit is issued, I shall not employ eny person In flny manner so as to become sub�ect to ihe workers' compensation laws ai Calif � a ee � et If I IC become sub�ect to ihe workers' compenselion provlsions of Sedian 3700 of the Lebor Cotle, I ahell torthwith compry wit� these provi d p Applicant Signeture: Dete: _ �.? � � I•� Z WARNINO: FNLIIRE TO SECURE WOPKERS COMPENSq dJ CpVEqppE IS UNLAWFUL AND SHALL SUBJEGf M! EMPIAYER TO CRIMINAL PENALTIES AND CM� FlNES UP TOONE HUNDHED TFIOUSAND DOLURE (5100,000), IN ADDITION TO TNE OF COMPENSATION, DAAMGES AS PROVIDED FOR IN SEGTION 3lOe OF THE LABOR CODE, INTEHEST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I hereby aflirtn t�at I am force end eflecL Llc. a_ Comractor's Signature: CONS7RUCTON LENDING AGENCY: at Chepter 9(commencing with Sectlon 7000) ol Divisian 3 of the Business e,Q.�rofessions Cade, anA my license is in full Cless q � /> oaca:� �1cj.o—� � I hereDy ettirtn ihat there is a consW ctlon lending agency for Ihe Dertormance of the work tor which t�is pertnit is issued. (Sec. 3097, Civil Code). Lendels Neme: LendeYs Atltlress: Signature: Date: OWNER-BUILDER DECLARATIONS: I here6y aHirm t�at untler penalry ot perjury Ihet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor ihe following reason (Sec. 7031.5, Business and Professions Code: Any ciy ar county which reqWres a permit to construct, elter, improve, tlemolish, or repair eny sWctura, prior to its issuence, also requlres t�e epDllcant for such permit to file a signetl stetement ihat he or she is Ilcensed purauent to the provisions ol the Contrectors License Lew (C�apter 9(commencinp with Sectlon 7000) of Dlvision 3 ot ihe Business end Pratesslons Code) or that he or she Is exempt theretrom and t�e besis for Ihe ellegetl exemptlon. Any violetion of Sedion 7037.5 by eny applicant for a pertnit subjecis Ihe appllcent lo a civil penalry of not more Ihan five hundred dollers ($500).): ❑ I, es owner of Ihe properry, or my employees wlih weges as their sola compensatlon, WILL DO THE WORK, and ihe strucWre is not intentleA or oMeretl for sale (Sec. 7044, Business and Professions Code: The Contradors License Lew does no� apply to en owner of property who builds or improves Ihereon, end who does such work hlmsell or hersetl or through his or her own employees, provitled ihat such improvements ere not Intentled or ottere0 for sele. II, however, tha bullding or Improvement is sold within one year oi completion, the owner-builtler will have �he burtlen ot proving that he or she ditl not Ouiltl or improve for purpose of sale.). ❑ I, es owner of ihe propeM. am E%CLUSIVE�V CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe project (Sec. 7044, Business entl Prolessions Code: The contrectars License Lew tloes not eppry to en owner of properry who builds or Improves thereon, end who coNracts for such proJect with a contractor(s) license pursuant to ihe ConiraMors License Lews.). ❑ I em exempt under sec. Busineu and Prolesslons Gode for (hLa reeson: Signature: Date: Owner ID venTietl by tlAver's Iicensa. ❑ Ves ❑ No Drivefs License No. Expires: Verificalion of Ownership by (rype of documem, i.e. - properry tav blll or tlaetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CER7IFICATION: ❑ I hereDy certify thet no ezcavation five (5) or more feet In depth Into which a person is required ro descend, will be made in connection with work euthodzed by this permit, end thet no building sirucwre, sceMolding, falsework, or tlemolitlon or tlismaNling ihereol, wlll be more than thirty-six (36) leet high. (C�aD� 32, Gry 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ As owner-builtler, I will not employ enyune to do work which would require e pertnit Irom the DiNsion al Indusiriel Selery, es noted ebove, unless such pereon hes e pertnit to do such wark irom Ihe division. Signalure: Date: Division ot Intlustdel Safety Parmit Numbar. ICERTIFlCATE OF COMPLIANCE AND AUTHORQATION OF ENTRY: I certity under penalry ot perjury thet I have read fhis epplication end state that the informalion given is I coneCL I egree to wmpty with flll slate laws and ciry ordinances relating ro building construclion, end authodze representatives oi the Ciry oi Costa Mesa to enter upon Ihe above-descnbetl pmperty tor inspection purposes. I egree not to occupy or allaw occupenq ot eny building euthorized by Ihis pertnit until finel inspection. COOEI' INSPECTIONTYPE � 1616 FIxeO System Final Flre Preventlon 1268 200 Pool Spe Final Flnel Re-Rooi � 201 Finel BIocWReteining Well 202 Flnel Factory Fire Place 203, Final Sign 204 Finel � Date � ' F/• �3Z Date CQOE� INSPELTIONTYPE 208 Finel Mechanical 208 Finel Plumbing 210 Finel Electricel 212 Finel Fire Prevention 220 222 Final Plenning Approval Final Site 250 Final Building�Occupancy PAiE 1t�E64 • •. �i \ (714) 754•5273 • Fe�c (714) 754-4856 • www.ci.COsta-mesa.ca.US 77 FAIR DRIVE, GC75IA MtSA, GA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: 601 W 19TH ST 2 ENT�RE 2ND FLOOR 42421118 Applicant: COMERFORD, STEPHAN Address; 500 E FRANKLIN AVE ELSEGUNDO,CA ELECTRICAL PERMIT Phone: 310-640-1000 Zip: 90245 Owner; NINETEENTH ST PARTNERSHIP Address Y,LEE 8 ASSOCIATES ORANGE, CA Phone: 701 S PARKER ST STE 1000 Zip: 92868-4748 Contractor, SR COMERFORD CONSTRUCTORS Address: 500 E FRANKLIN AVE ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool I Spa Lighting Fizis Recept Outlets Switches Non Res Appl Res Appl Service to 200a Service to 1000a Service over t000a Molors to thp Motors to 10hp Motors [o SOhp Motors to 100hp Motors over 100hp CommunicaGon drops Sub panel to 200a Pole Light Pkg Sign CircuiLs Temp Pwr Pole Intermetl Pole EL SEGUNDO, CA Phone: 310-640-1000 Zip: 90245 License: 453518 Stams: ISSUED Applied: 08/19/2002 Issued: OSI19/2002 SCOPE OF PERMIT ELECTRICAL TO INCLUDE: 25 LIGHTING FIXTURES, 13 OUTLETS, 7 SWITCHES, AND 1 MOTOR TO 1 HP. REF.: 802-00947'PLANNED PARENTHOOD' ENTIRE 2ND FLOOR $23.50 $0.00 $0.00 so.00 $0.00 $0.00 $25.65 $14.30 $7.70 $0.00 $0.00 $0.00 $0.00 $0.00 $4.75 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 Quantity 0 0 0 25 13 7 0 0 0 0 0 t 0 0 0 0 0 0 0 0 0 0 FEE SUMMARY Temp Dist System / Lighting Busway I100 ft ' Standing Section Misc Electrical Equipment Transformers up to 1 kvalkw ................up to 10 kva/kw .................up to 50 kva/kw .................up to 100 kva/kw ..................over 100 kvalkw Low Voltage Equipment Low Volt Wiring System / Ckl Misa Conduit MisC. ConduCtor Circus ( gen or ride) Circus (mech ride or lights) ChrisVnas Tree Stand Fireworks Stand Other Electrical Fee InvesUgaUon Fee Plan Check Fee Reinspection Fee �uantity $0.00 0 $0.00 0 $0.00 0 ao.00 0 30.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 $0.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 . 0 $0.00 0 $0.00 $0.00 50.00 50.00 TOTAL CALCULATED FEES $75.90 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall compy with all applicable handicap access requirements under Calitomia statutes and related regulations. (Ord. No, g248, § 1, 12-21-92) EXPIRATION: This permit shatl allomaticalty e�ire arM become void if work is not commenced wlthin 180 days, or if work is suspended or abandoned tor a period of 180 days. INSPECTIONS: In order for the work eWhorized urMei this permit to be considered legal, such work must compty with ell appiicabie codes,.end ell requlred Inspeetlons end final epprovel must be abteined. Fallure to obtain inspections and final epproval will result in the eupiratlon o�s�permfl. FOR INSPECTIONS CALL: (714) 751-5626 j �.,P.o �aw� WORKERS' COMPENSATON DECLARATION: I hereDy eXirtn under penalty ol per�ury one ol Ihe lollowing declaretions: ❑ I have end wlll maintain e Cenllicete of consent Io selt-Insure tw workers' compenseUon, es proWtletl tor by section 3700 of the Lebor Catle, tw the pertormence af the work tor which this permit b IssueO. @�I heve arW wlll malntain workers' mmpensetlon Insurance. es required by sectlon 3700 0l Ne Labor Code. lor the peAwmence of Ne work far whkh Ws pertNt is Lswetl. My work c mpensation Insurence carrier end poliry number are: � Z �, ZQO I Cerrier. ��U IJr% Poliry Number. (ihis section need not be aomplete0 i! t�e permit Is va1�eC ef one huiMred dollers ($100) ar Ieu.) ❑ I ceniy Ihat in the peAortnence ot t�e work lor which this pertnil is Issue4 I s�all not employ eny person In eny manner so as to become su��ect to Ihe workers' compensation laws of Califomla, enC egree Ihet if t sh become sub�acl to the workers' compensetlon provlslons of Section 3700 of Ihe Labor Catle, I ahall tort�with comply with these pravisian . � q Applicanl Sipnature: � Dete: � � l' � WARNINO: FNLURE TO SECUfiE WORKEfiS' PENSATI COVERADE IS UNLAWFUT AND SMALL SUBJECf AN EMPIOVEfi TO CRIMINAL PENALTIES AND CIVIL FlNES UP TO pNE HUNDREO T/10USAND DOLLARE (5100,000), IN ADqTION TO THE C06T OF COMPENSATION, DMM�ES A$ PRON�ED PoR IN SECfION 3708 OF THE LABOR COOE, INiEREST, FND ATTORNEV'S FEES. LICENSED CONTRACTORS DECLARATION: 1 hereby ettirtn Ihat I em forCe entl etfeCi. IJC. N_ Coniraci0r's Signalure: oi Chapter 9(commencing wit� Seclion 7000) o} Divislan 3 ot the Business and Professions Code, end my Ilcense is in full Glass p � Date: �' I °1 •O 2 CONSTRUCTION LENDING AGENCY: ❑ I hereby ettirm ihet Ihere is e constructlon lending egency lor the peAormence of I�e work tor which this permit is Issued. (Sec. 3097, Civll Cotle). Lenders Neme: Lender's AGtlress: SipnaNre: Date: OWNER•BUILDEH DECLARATONS: I hereby elfirm tha� under penelry of per�ury ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ne fdlowing reason (SeC. 7031.5, Buslness flntl Professions Cade: My dry or counry which requlres e pertnit to construa, alter, improve, tlemMish, or repair eny structure, pdor to its Issuance, elso requlres Ihe epplicaN fa such permit to lile e sipned stetemem Ihet he or she Is Ikensed pursuam to the proNslans af the Contrectors LJcense Lew (C�apter 9(commendng wlth Sectlon 7000) of DMsion 3 oi the Buslness enG Professions Code) or t�at �e or s�e Is exem0� ��eretrom erW the besls for the elleged asemptlon. Any Wdatbn of Sectlon 7031.5 by eny applicant for e pertnit sub�ects the epplltent to e clvll penalry of not more Ihan flve huntlretl tlollars ($500).): ❑ I, es owner of Ihe property, or my employees with weges es thelr sole compensatlon, WILL DO THE WORK, end the siructure Is not intentled or otferad tor sele (Sec. 7044, Business and Professions Code: The Coniractors License Lew tloes not eppty to an owner ot properry who builds or improves thereon, entl who does such work �Imselt or hersetl or ihrough his or her own employees, provlde0 that such Improvemenis are not Intended or oHered for sela. If, however, t�e Duilding or improvement is sold within one year oi completlon, the owner-builder will have Ihe burden of proving ihat �e or she did not build ar improve for purpose of sale.). ❑ I, es owner of Iha properry, flm E%CLUSIVELV CONTRACTNG WITH LICENSED COMRACTORS lo construn che praject (Sec. 7044, Business end Professions Gotle: The wmrectors License Law tloes not eppty ta en owner ot propeny w�o builtls or Imprwes t�ereon, en0 who contrects for such pm�ecl with a coniractoqs) Ilcense pureuant to ihe Contractars License Lews.). ❑ I em exempt untler sec. Business entl Professiau Cotle for this reason: Signeture: Date: Owner ID veAileO by tlrivefs Ilcense. ❑ Ves ❑ No DrlveYs lkense No. Expires: Vedlication af Ownership by (type of daument, i.e. - O�aPerry tax bill or deed): DIVISION OF INDUSTRIAL SAFETY VERMIT CER7IFICATON: ❑ I hereby certity Ihet no excavation INe (5) or more feet In tlept� into which a person Is requireA to tlescenQ will be metle In connectlon with work euthonzed by this pertnit, and t�a� no huilding strudure, scettoltling, falsework, or demolltlan or dismentling theraof, wlll be more than thirly-six (36) leat �Ig�. (Chap. 32, Gry 2, Atl 2, Sec. 341, lltle B, Celifomis Adminlsirative Cotle). ❑ As owneo-builder, I will not employ enyone to do work whlch woultl require e pertnil trwn the DlWsion of Industdal Safety, es noted ebove, unless such pereon hes e permil to tlo such work Irom Ne tlivision. Signature: Date: Division of Intlusirial Satery Partnit Number: ICERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF ENfAY: I cenity untler penalry of perjury that I �ave reatl this epplication and state that the information given Is I conecL I agrea to compty wlih ell stete laws and ciry ordinances relating to building construction, end authodze representatives ol the Clry ol Costa Mesa to enter upon the above-described properly lor inspection puryoses. I egree not to oaupy or ellow occupancy of eny building authonzed by Nis permit until final inspection. 4QOE �. INSiELTION TYPE � 1816 Fixetl System Finel Fire Preventlon 1268 Pool Spe Final 200 Final Re-Root 201 FIna181ock/Retaining Well 202 Finsl Fectary Flre Place 203 Final Sign 2M Final Demolitian PAg �� g'I`1 •o2„a,n Date COOE I INSPECTION TYPE 206 Final Mechanical 208 Finel Plumbing 210 Flnal Electdcal 212 Flnel Fire PrevenUon 220 Final Planning Approval Y22 Finel Site 250 Final Building/Ocaipflnq �.1 IJIII. f / I � �/� (714) 754-5273 • FeX (714) 754-4856 • www.Ci.coste-mesa.Ga.us 77 FAIR DHIVE, GOSIA MESA, (:A 92626 FIRE SUPRESSION PERMIT'�, . _ _ ,,. ', � Job Address: 601 W 19TH ST Suite: 2 Viciniry: 2ND FLOOR � Parcel Number: 42421118 Applicant: SNYDER, BRIAN Address: 14620 NOVICE ST 1• ,.i Zoning: � Phone: B7&8935656 PANORAMA CITY, CA Zip: 91402 Owner: NINETEENTH ST PARTNERSHIP Address %LEE 8 ASSOCIATES ORANGE, CA Phone: 701 S PARKER ST STE 1000 Zip: 92868-4748 Convactor: A ACTION FIRE PROTECTION Address: 14620 NOVICE ST Status: ISSUED Applied: 09l04/2002 � . a •Issued: 09/04/2002 ISSUED BY: Phone: 818-893-5656 PANORAMA qTY Zip: 91402 License: 489982 SCOPE OF PERMIT- RELOCATE 7 EXISTING AND ADD 2 NEW FIRE SPRINKLERS IN 2ND FLOOR ONLY. REF.: 802-00947 "PLANNED PARENTHOOD' FEE SUMMARY Plan Check: $25.19 Permit: $38.75 Other: $0.00 Total: $63.94 Calc Valuation: $sso.00 Claimed Valuation: Ss5o.o0 m NOTICE: The work autho�ized by this permit shall compty with all applicabte handicap access requirements under Califomia statutes anC related regulations. (Ord. No. 92-28, § 1, 12•21-92) . EXPIRATION: This pertnit shall automatically expire and become void if work Is not commenced within 180 days, or if work is suspended or abandoned ��, for a period of 180 days. INSPECTIONS: In order tor the work authorized under this permit to be considered lega�, such work must comply with all applicable codes, and all required inspeetlona end flnel approval must be obtained. Failure to abtain inspections and final approval will resu�t in the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 754-5828 � WORKERS' COMPENSATION DECLARATION: _ I hereby efflrm under penalry of perjury one o1 Ihe following dedarations: ❑ I heve entl will maintein e certificete of consent to selbinsure tor workers' compenseUon, es proWEed 1or by sectlon 3700 of the Lebor Code, for the peAortnence ol Ihe /�ork lor which Ihis pertnit Is Issuetl. �� t heve erM will maintaln workers' compenSallon insurence, es requlrotl by sectbn 3700 ot Ne LEbor Code, for No pertortnence ot Ne work ta wh�h Nls pertNl is issued. My worke penSaUon Insurence carder end polcy numbar era: � oaMe� -= S�'T� �u n� v � C,p�y N;,,,,oe,: 5l0 5' / (rlib secrron neea nor ae oomp�ered ir u,e permu �s vewed ef ine nwMrea adlers �aloo) w�ess./ ❑ 1 ceniy that in the peAormance ot the w N r w ic� ihis pertnit La issuetl, I shell not employ any person in any menner so as to become sub�ect to the workers' compensetian laws oi CaliPomie, end ree Ihet� I shoultl come sub�ed to Ihe warkers' compensetlon provisions ol Seciion 3700 of the Lebor COCe, I ahell tonhwith complywith I fo s. � ��O � ApPIICB�ipneture:' - �Dete:, s � WARNINO: FAILURE TO SE E WORKERS' COMP ERAGE IS UNUWFUL AND SHAl1 SU&IECT AN EMPLOVER TO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED THIXISAND DIX1ME (5100,000), IN ADDITION TO TME COST OF COMPEN$ATipN, pAMpGES AS PRWIDED FOR IN SECiION 31080F TME UBOR COOE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRACTORS DECLARATION: I hBreby affirm that I am licen undef oWSio far� end et1eU. L1c..Y $ L CONSTRUCTION LENDING AGENCY: of Chapter 9(commendng with SecUon 7000) ot Division 3 M � entl my Ilcense is in tull ❑ I hereby eRirm �ha� lhere i9 e ConsWciion lending egency for the pedarmence of Ihe work tor which t�ls permit Is issuetl. (Sec. 3097, Civil Cotle). Lendefs Neme: Lentlefs Adtlress: Signeturo: Date: OWNER•BUILDER DECLARATIONS: I hereby eHirm that untler penelry of per�ury Ihel l am E%EMPT FROM TME CONTHACTORS LICENSE LAW lor the tollowing reason (Sec. 7031.5, Business enC Professions Cotle: Any city w counry which requires e pertnit co consiruct, alier, improve, demolish, or repeir eny strucWre, pdor lo Its Issuance, eLso reqNres lhe applicant lor such pertnit to flle a aipnetl stetement that �e w she Is Ilcensetl pureuant to the proNsbns of Ihe Contreciors Licensa Lew (Cliepter B(commendm� with SecUon 7000) of DhAslon 3 oi Ue Business end Pratessions Code) or that he or ahe Is exempt I�ereirom end Ihe basis lor the alleged exemption. Any Wolation of Section 7031.5 by any epplicent for a pertnit subjects the applicent lo e civil penalry of not more Ihen tive hunAretl tlollars ($500).): ❑ I, es owner o1 the property, or my employees with weges es their sole compenseilon, WILL DO TT1E WORK, entl t�e siructure is not intended or oHered tor sale (Sec. 7044, Business entl Professlons Cade: Tha Conirectors License Lew Ooes not eppty lo an owner of propeny who builds or improves therean, end who tloes such work himsell or herself or through his or her own employees, provitletl t�at such Improvements are not intended or otteretl tor sale. I(, however, tha bullding or Improvement Is sold within one year of crompletion, the owner-builtler will �ave the burden of Droving that he or she did not builA or Improve for puryose ot sale.). ❑ I, es owner of the properry, em E%CLUSIVELY CONTRACTING WITH LICENSED CONTAACTORS to construct the prqect (Sec. 7044, Business and Pmfessions Cale: Ttie contmctors License Lew tloes not eppty to en owner ot property who builCs or ImDroves thereon, anG who contracts for such pro�aq wl�h e contractor(s) Ilcense pursuem ro the Contrectors License Laws.). ❑ I am e:empt under sec. Business entl Pmfessions Code for this reason: Signature: Date: Owner ID ventied Dy tlrlvers Iicense. ❑ Ves ❑ No Drlvefs License No. Expires: Vedlication of Ownership by (type of document, i.e. - properry tex bill or tleetl): DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby cerlity that no excavetlon Ilve (5) or more feet In depih Into which e person is required to descend, will De matle In connection wlth work euthorized by this permit, entl ihet no building sWcture, SCeHolding, lalsework, or demolllion or dismentling Ihereot, will be more t�an thirry-sin (36) leet high. (Chap. 32, Gry 2, Art 2, Sec. 341, Tltle 8, Caltlomla Adminlstretive Code). ❑ As owner-Ouilder, I will not employ enyone to tlo work w�ich woultl reQuire e permil from the DiNsion at Intlustriel Sefery, as notetl ebove, unless such persan hes e permit ta do such work irom t�e division. Signeture: Date: Division of Intlusirial Safery Pertnil Number: CER7IFICATE OF COMPLIANCE AND AUfHORIZATON OF EMRY: I cenily under penalry of perjury �hal I have read lhls application end stete Ihet Iha informatlon given Is correct. I egree to comply wlth ell state laws end ciry ordinances relating to bullding constructlon, entl euthodze representatives o1 the Ciry oi Cwta Mesa to enter upon the ebove•descrlbetl D��NY �ar insDection purposes. I egree no� to occupy or ellow occupenq of any building euthorizetl by t�is pertnit until tinel Inspectlon. COOE �. INSPECipN TYPE V 1618 Fi:ed System Final Fire Preventlan 1268 Pool Spe Final 200 Finel Re-Roof 201 Final BbcWReteining Well 202 Final Faaory Fire Plece 203 FinalSipn 26o Final Demditbn 1�L1E 1i�64 CODE� INSPEC710NTYPE 206 Finel Mechaniwl 208 Finel Plumbing 210 Final Electrical 212 Finel Flre Prevenllon 22o Flnel Plenning Approval 222 Flnel Site 250 Finfll Bulldinp/Occupanry � ' � � (714) 7543273 • Pa�c (714) 754-4856 • www.ci.costa-mesa.ca.us n rAm unrve, wa i N m�on, �n aeom Job nddress: 601 W 19TH ST Suite: Viciniry: Parcel Nunmber: 42421118 SIGN PERMIT Zoning: Applicanr. POLSTER, CHRIS Address: 151971IGHTHOUSE LN� ' - Phone: 903541-9676 LAKE ELSINORE, CA Zip: Owner. " NINETEENTH ST PARTNERSHIP Address �oLEE & ASSOCIATES . '- ORANGE, CA � � . Phone: � - �]01 S PARKER ST STE 1000 Zip: 92868-4748 Convactor: NATIONAL VISUAL SYSTEMS INC Address: 5482 OCEANUS DR UNIT G Phone:. 714-891•2670 - �HUNTINGTON BEACH, CA , Lp: 926431043 , License:' S81553 Arch / Eng : Address: Phone: Zip: License: Stalus: ISSUED Applied: Ot/27/2003 Issued: 01/27/2003 ISSUED BY: SCOPE OF PERMIT 13.4 SQ FT NONILLUMINATED WALL SIGN OFF ANAHEIM AVENUE AND 37.5 SQ FT NONILLUMINATED WALL SIGN OFF WEST 19TH ST FOR "PLANNED PARENTHOOD." Plan Cfieck: Permit: SMIP Com: Other: Inspection: Total: NOTES: $21.22 $0.00 $32.65 $0.50 $0.00 $0.00 , $0.00 $0.00 $0.00 $54.37 FEE SUMMARY, Calc Vaivation: s�a2.00 Claimed Vatuation: s�az.00 PLANNING 8 ZONING NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under CaliFomia statutes and related regulations. (Ord. No. 92-28, § 1, 12-27-92) EXPIRATION: This permlt shall automatically expire and become void if work is not commenced wi�hin 180 days, or if vrork is suspended or abandoned for a period of 780 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 requlred Inapeetiona and finel epprovel must be oblained. Fallure to obtain Inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5828 2a0&a8 (8'00) WORKERS' COMPENSATION DECLARATION: � • I hereby eMirm unaer penalry ol per�ury one o1 Ihe tollowing declaretions: • ❑ I heva end will maintain e ceriificete ot consent ta selbinsure tor workers' compensetlon, es provitled tor by section 3700 0l t�e Lebor Cotle, for Ihe pertortnance of Ihe work lor which �his permll is Issued. � I heve flnd wiil maintain workers compensatlon Insurance, as required hy sectlon 3700 of the Lebor CaEe, tor the peAortnance ol Ihe work tor whbh Viis permit is iuuotl. My workers' compensetlon nsurence carrler end policy number ere: cama�: �UQn� _�st ATTi�niA� _ POIIqNumber. Z� 000O.�S25'-03 (This section neetl not be comp/efetll! fM1e perml! Is ve/ued e! one huntlred dWlers (E100J or Iess.J _ ❑ I certlly tha� in the peAormence of Ihe work br whic� this pertnit Is Issuad, I shell nat employ any peison In any menner so es ta become subJect to the workere' compensetlon laws o1 Celitomie, entl epree Ihet II should become sub�ect lo the workers' compensetlon provisions ol Section 3700 01 the Lebor Cotle, I shall fonhwit� compy with tnese proyisions. ApPlicant Sipneture: � - oe�e: / J27 �n� WARMNG: FAILURE TO SECUPE WORKERS' COMPENSATION COVEPAGE IS UMAW Fl1L M�D SHALL SVBIECT AN EMROYER TO CRIMIN�L PE TES AND CML FlNES UP RJ IXJE HUNDRED THOUSAND DOILARE (5100,000), IN ADDfiION TO THE COST OF COMPENSATION, DMUGES IS PROVIOED FOR IN SECfION 3108OF TME L4BOR COOE.IMEREST, AND ATTORNEI"5 FEES. LICENSED CONTHACTORS DECLARA710N: 1 herahy ettirtn that I am lice�e�uqd$ �o �i�sions ot Chapter 9(commencing with SecUon 7000) of Division 3 oi the Buslness antl Professions CoAe, end my license Is in full lorce entl elfect. LJc. M �� _ Class x C 4 S Contrector'S Signeture: �� Date: �%7 � D � CONSTRUCTION LENDING AGENCV: ❑ 1 hereby eNirtn Ihat there is e constructian IenEing agency for the pertormance ol Ihe work tor wNch t�is permit is iuued. (Sec. 3097, Civil Cotle�. Lendefs Neme: LenOers Address: Signaturo: Dete: OWNER•BUILDER DECLARATIONS: I hereby eMirtn Ihet under penelry ot perjury that I em EICEMPT FROM THE CONTRACTORS LICENSE LAW far the following raason (Sec. 7031.5, Buslness end Professions Code: Any Gry or counry which requires a permil to consiruct, elter, Improve, demolish, or repair eny strucWre, pnor to its issuance, elso requires the epplicant tor such pertnit to file e sipned stetement Ihet he or she is Iicensetl pursuant to t�e D��sions of the Contrectoro License Lew (Chepter 8(mmmendnp wlih SecNon 7000) at Dlvision 3 0l t�e Busineu and Professions Cotle) or thet he or sha Is exempt thereirom end ihe besis for the allegod exemption. Any violatlon o1 Section 7031.5 by eny epplicant for e permfl subjecis ihe eD0licant to a civil penelty of not more than fiva hundred Aollars ($500).�: ❑ I, as owner of the properry, or my employees with wages es Iheir sole compensation, WILL DO THE WORK, and the structure Is rrot Intanded or otteretl tor sale (Sec. 7044, Business and Prote55ions Code: ThB CAntractors License Law tloes not apply to an owner of propeM who builds or improves ihereon, and who does such work himself or herself or through his or her own emplqrees, provided that such imprwements ara not intended or oflered br sale. It, howeveq the building or improvemem is soltl wit�in one year of complation, the owner-builder will heve the burden of proving ihat he or she did not build or improve for purpose of sale.). ' ❑ I, as owner ol the properry, em EXCLUSIVELY CON7RAC71NG WIT1 LICENSED CONTRACTORS to construct the prolect (Sac. 7044, Business end Professlons Cotle: Tha cantractars License Lew does not eppty ro an owner oi properry who builds or improves �hereon, end who conirecis lor such pro�ect with e contractor(s) license pursuant Io Ne ConVettors Litense Lews.j. ❑ I am exempt under sec. Business anA Pmlessions Code for this reason: Signature: Date: Owner ID verified by drivefs Ilcense. es ❑ No Drivefs License No. Explres: Vedlicatlon ot Ownership by (type ol tlocument, I,e. - pmDerry tax bill or deed): DIVISION OF INDUSTAIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby certity that no excavetlon five (5) or more faet In depth Into w�ich e person is raquired to Oescend, wlll be matle in connectlon with work euthorizetl by this permit, entl thei no building struCWre, sCefl0lding, fal9ework, Or demolition or dismantling thereoi, wlll he more �hen thirty-si: (38) feat high. (C�aO� 32, Grp 2, Ar12, Sec. 341, Tltle B, Califomle Adminisirative Code). , ❑ As owner�builder, I wlll not employ enyone to do work which would require e permi� trom the Dlvlsion ot Industriel Sefery, es noted ebove, unless such pereon has e pertnit to tlo such work trom �he Civision. Signature: Date: Division ot Indusirial Safery Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AVTHORVA710N OF EMAV: I cenity untler penalry of perjury thet I heve reed Ihis epplicetlon end slete thet the Infortnetlon given Is correct. I egree to comply wlth ell state laws en0 ciry ortlinences relatlng to bulltling construction, end authodze represeniatives oi the Ciry ot Coste Mesa to enter upon t�e ebove-descnbed pmperty br inspection purposes. I egree not to occupy or allow occupancy oi eny building authodzed by Ihls pemut unGl linal inspection. S' re OI Legel Owner(s) Date � - ��2% UJ Md/Or Authonzed ApDlicant Date GOOE �. INSPECTONTYPE 1676 Fixetl System Finel Fire Preventlon 1266 Pool SOa Final . 200 Final RaRoof 201 Final Blotk/Relaining Well 202 Final Fectory Fire Place � 203 204 Finel Sign Finel Demditian ' COpE� INSPECTIONTYPE � 206 Final Mechanical 208 Final Plum6ing . 210 Final Electdcal 212 Finel Fire PrevenGon 220 Final Planning Apprwal 222 Final Site 250 Final Building/Occupency QL7F. �� (714) 754-5273 • F9x (714) 7543856 • vnvw.ci.costa-mesa.ca.us 77 FAIR DFiIVE, GOS I A MtSA, (:A 92ti1ti BUILDING PERMIT Job nddress: 601 W 19TH ST Suite: 2 Vicinity: SUITES A AND B(2ND FLOOR) Parcel Number: 42421118 Applicant: COMERFORD, STEPHAN Address: 500 E FRANKLIN AV ELSEGUNDO.CA Zoning: ISSUED BY: Phone: 310-640-1000 Zip: 90245 owner: NINETEENTH ST PARTNERSHIP Address %LEE 8 ASSOCIATES ORANGE, CA Phone: 701 S PARKER ST STE 1000 Zip: 92868 Convactor: SR COMERFORD CONSTRUCTORS Address: 500 E FRANKLIN AVE ELSEGUNDO,CA Zip: 90245 Phone: 310-640-1000 License: 453518 Status: ISSUED Applied: 06/26/2002 Issued: 08/19/2002 Arch : KERRY WILSON H HENDY ASSOCIATES Eng: Address: 2415 CAMPUS DRIVE " � Address: 101 Phone: 949-851-3080 � � � Phone: IRVINE,CA Zip: 92612 License: C19204 License: SCOPE OF PERMIT 1,213 S.F. INTERIOR TENANT IMPROVEtviENT TO SUITES A AND B(ENTIRE 2ND FLOOR). DEMOLISH WALLS AND CONSTRUCT WALLS, INSTAIL NEW PARTITIONS, RELOCATE LIGHTS, NEW ELECTRICAL WORK, ADD A KITCHEN SINK IN BREAK ROOM, NEW FINISHES AND NEW DOOR. Plan Check: $733.30 Permit: $1,128.15 SMIP Res: $0.00 SMIP Com: $25.95 Other: $0.00 Inspection: $0.00 Total: $1,887.40 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0-0 PARKING Ezistinq: o NOTES: Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING Lek 0. 0 Left 0- 0 Proposed: 0 Calc Valuation: Claim Valuation R�9n� a o Right 0- 0 $123,555.00 $123,555.00 NOTICE: The work aulhorized by this pertnit shall comply with all applicable handicap access requirements under Califomia statules and related regulations. (Ord. No. 92-28, § 1, 12-21-92) E%PIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspentled or abandoned for a period of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, arM� requlred Inspectiona and flnal epproval must be obtained. Failure to oblain inspections and final approval will result in the expiration of this pertnit./ FOR INSPECTIONS CALL: (714) 7545828 �/ zae-/e �eroo� WORKERS'COMPENSATION DECLAqATON: _ I hereby aHirm under penalry of perJury one oi Ihe following tleclaretions: ❑ I have end wlll malntain e certificate of consent ta self-Insure tor workers' compenseilon, as provided tor by section 3700 of ihe Lebor Cotle, for the performance of Ihe ,/ work for which Ihi�permil i5 issuetl. I�J�I have aM wW meintain workers' campen5ation insurance, a5 requiretl by sectlon 3700 oi Ne LeEor Cotle, for Ne pertwmance ot Ne work fw whiGi Nis pertnll is issued. My w rs' compensatlon Insurence cerrier end pollcy number ere: �q 25' Z �GerAer: �'�. i�'VN✓% CPo�icyN mu�'be.r � � (Tliis section need not be complefed i! the permit is velued er one hunared dollers (5100) oNess.) ❑ I certify ihat in the pertortnanca of Ihe work for which Ihis pertnit is issuetl, I shall not employ eny person in any manner so es to become suDject to ihe workers' compensatlon lews of Celifomia, end agrea th uld become sublect ta the woAcers' compensatlon provislons of Sectlon 3700 ot t�e Lebor Code, I ahell fonhwlth comply with thesep naai` ��s�e�acu�e: `u,�;=. 8 ` 1 �l • �L WARNINO: FAILURE TO SECURE WO KERS' iM ISATION COVEMGE IS UNLNWFUL ANO SMALL SUBIECT AN EMPLOVER TO CRIMINAL PENALTIES AND CNIL FlNES UP TO ONE HUNDRED TMOUSNND DOLIARE (5100,000), IN ADDITION TO TH DST OF CqMPENSpTIdJ, DAMAGES 0.S PROVIOED FOR IN SECiION 3]OB OF THE IABOR CODE, INfEREST, AND FTfORNEYS FEES. LICENSED CONTRACTORS DECLAflATION: I hareby aHirm that I em Ilcensed under orovisia contreciors of Chepter 9(commencing with Section 7000) ot DlWsion 3 oi Ihe Buslness�tl Protessians Code, end my license Is in tull CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm Ihet Ihere is e conslruction lentling egency lor iha performence ot the work for which ihls parmit is issued. (Sec. 3097, Civil Cotle). Lentlers Name: Lendefs Adtlreu: Slgnature: Dete: OWNER•BUILDER DECLARATIONS: I hereby afFlrtn thet under penalty ot petjury thet I em E7(EMP7 FROM THE CONTRACTORS LICENSE LAW tor the tollowing reeson (Sec. 7031.5, Business entl Protesslons Code: Any city or county whic� requlies e permit to consiruct, alter, Improve, tlemolish, or repair any structure, pnor Io its Issuence, elso requires the epplicant for such pertnit to flle e signed stetement Ihat he or she Is Iicensed pursuent to ihe proWsions of tha Conirectors Llcense Lew (Chapter 9(commencing with Sectlon 7000) of Dlvlslon 3 af ihe Business and Pmtesskns Cotle) or that he or sha is ezempt therefrom end the besis tor the flllegetl exemption. My vidatlon of SecGon 7031.5 Dy any epplicant br a pertnit subjecls the epplicant to e civil penalry ot no� more than Ilve huntlretl dollars ($500)J: ❑ 1, as owner ot �he properry, or my employees with wages as Iheir sole campensaiion, WILL DO THE WORK, antl the siructura Is not intentled or olfered for sale (Sec. 7044, Business and Professions Cotle: The Conirectors License Lew does not apply to an owner ol property who bullds or improves thereon, and who does such work himselt or herself or through his a her own employees, providetl ihat such Improvements are no� intendetl or oflered for sale. tl, however, the building or improvament Is sold within one year ot comDletion, ihe owner-builder will heve the burden of proving Ihat he or ahe did nol build or improve lor purpose ol sele.). � I, as owner of the D�operry, am EXCLUSIVELY CONTRACTNG WITH LICENSED CONTiiACTORS to construct the pro�ect (Sec. 7044, Business end Pratesslons Cotle: The contrectors License Lew does not apply ro en owner oi property who bullds or Improves �hereon, and who contracts for such pra�ect with e contrector(s) license pureuent lo [�e Contrector9 Ucense Lews.). ❑ I am exempt untler sec. Business end Professions Code 1or this reason: Signature: Date: Owner ID veritietl Dy tlrivefs license. ❑ Ves ❑ No Dnvels License No. Verlfication ol Ownership by (type ol tlocument, i.e. - propetly tex blll or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CEHTFICA710N: Eapires: ❑ I hereby certtly that no excavatlon tive (5) or more feet In depth Into which e person is requiretl to descend, will be mede in connection wit� work authorizetl Dy this pertnit, and ihat no building struqure, scaHoltling, felsework, or demolition or dismanUing Ihereot, wlll be more than ihirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title B, Calilornla Atlminlstrative Code). ❑ As owner-builder, I will not employ anyone to do work which would require e permit irom the Divislon oi Intlusirial Setety, as noted e6ove, unless such persan has e pertnit to tlo suc� work irom Ihe tlivision. Signature: Date: Division of IndusMel Satety Pertnit Number. CERTIFlCATE OF COMPLIANCE AND AUfHORVATION OF EMRY: I certify un0er penalry of perjury thet I have read this epplication end state Ihet the information given is correct. I egree to comply with ell stata laws end ciry ordinences relating to building conslructlon, anC euthonze represematives of the Giry of Coste Mesa ro enter upon t�e ebovatlescnbed property Por inspection purposes. I agree not �o occupy or ellow occupancy oi eny bullCing authorized by this permi� until finel insDecNon. CODE t• INSPECTIONTVPE 1816 Fi:ed System Final Fire PrevenNon 1266 200 201 202 2Q3 204 Paol Spe Final Final Re-Root Fine181wWRetaining Well Final Fectory Flre Plece Finel Sign Final Dem veg uume�a � � I� • �'��a ��a � �fj INSPECTONTYPE 206 Flnal Methanicel 20B 210 212 220 Final Plumbinp Final ElecMcel Finel Fire Preventlon Finel Planning Approval 222 Finel Site 250 Final Building/Oaupenry aag u�e�a PpaE . �• 601 W 19TH ST � mvNEp. , . A . �O . LAMll CO . • noof. ;;;16'1CAM:CN6 CAPISTRANO � � - SAN`.TUAN CAP., . tA 9?.675 • 1714)�240-13A2 AqCHIENGINFEN: aooxess: flE0.N0.: uxrt: uxR; PEflMITTEE: 'j'F.MP POWER SYSTEMS ( 714 ) 632-1999 � ' aooeess: 1111 �l. 'PU5TIN AV ANAHEIM CA 92806 11tENSEO CONTMCTON OECUMTION: I hereUy allirm [hat 1 am Ilcense0 untler O�oNsions ol Chapter 9(commencin0 �� c6an 7�) of Division 3 at t�e BuSiness anA Pmieuions Code, an0 my Ilcense is in tull farce an0 ettecl. i cmuc.:03912 s J¢uc.:4�3433 c C-10 �y� � Oate: � ( Signature: �� — WOBKEBS'C MPENSpT10N0EIXAMTION: IhereDyaffirmtAatl�aveacertificateo5consentmsel4insureoracerti/lcateatWorkers' Campensation Insuranca, w p, cerUfjed Gpp1t ��ul ISection 3eo0, 1a6. L�� O.'l / 9 O PoucY xo.: � V b U 7 1/1V 1 1 L l! �p, ppTE; 1 � cotnraNr: �TA7'E: EUND � � Certi(ie0 coG� ��y ul+eW �umiSDe� �^ Ceni�ie0 coGr �s tYee witA IM aN �p �� / ' / //1/I.rA// .,aie; ' i '6 APDlicani: �—_�y�t�— E%EMPfION FROM WOBKEHS' COMPEN&1TION OECIAIWTION: (TAis section neetl not �e comDletetl if Ue permlt is lor one AunUreA (5100) or tess�. I ceqiry I�at in Iha pertormance of Ihe vrork for wMCA this permit is issueE, I shall not employ any permn In any manner so as to Eecome su�ject m the wo�kers' Compenvtion lam nl CaUtoma. Daro: SiOnature: NOTICE: 11. atler makinp tnis Eeclaratlon, yau snoNE 6ecome suUiect m[Ae Warkers' Compensation pmNsons ol tAe La6or CoOe, you musl tort�wit� comD�Y �� suc� Drovisians or t�is Dermit s�all 6e OeemeA revoketl. � CON$ipULTION IEN�INC IIGENCV: I �ereDy affirm that Mere is a construction Ientlin0 apency lor Ihe peRormance ol tAe wark �or whicn t�is permfl is issueA (Sectlon 3097, Civ. Ci. � IFNDEfl: �ooxess: , � , � ' - , OWNEP BUIIDEfl �ECUMTION: I her¢Ey aflirm that I am exem0� ��m I�e Conlraclors' State Lirense Law for tAe fallounnp reasan (Section 7D31.5 BuLness antl Professronal CaEe: My ciry oi counry whic� requires a permit ro construct, alter, imOrove, Eemolish, ar repdir any rrucWra, pnor to its iauana, also reQuirgs the apDGcant �or sucA permit ro iJe a si0ne0 sutement ttut �UsM is IicenseE Dursuant ro t�e pmvisions ol the Contacrors -5tate License Law (C�aD�er 9(commencin0 �� ion 7000) ot 0ivision 3 al t�e Business and p�ofessions Cotle), or that �e/s�a is exemD� ��aretmm and tAe Uasis br the a11e0eE exemD��on. Any violation ot Section 7031.5 hy any apD�icant tor a permit suGlects ihe apDlicant to a civil penalry ol nat mora t�an_live hunAred tlallars (5500�. '� I, as owner of IAe D�Geity or my amployeu with wapes xs Neir sole compensation. will tlo tM work, and ttce ❑ seructurz Is mt inteMeE or atlereC lar ula (Secuon 7044, Busiiress and Professional Code: Th¢ fqntactors SWro �icense Law Eces not appty to an ormer of a property w�o Mrilds or imprpves tAereon, and who Oces such work �imsell/�erselt or t�rough his or �er trwn employ,res, proviEM that mcA imprwement� are not intendeE or ollereO for sale. Ii, hawever IAe WilEing or ' imDmvemeni is m10 mtAin one year of completion, the awner vrill have t�e GurOen ol Orovinp hds�e diC not huild or impmve for the Durpose of sale). . , , -' . � I, as ownar oi Ihe properry..am exclusively contracting with Ilcense0 wntrectors to construct Ihe pmlect (SecUon 7044, Business ❑ and Protessqrrs CWe: The Coniractors' Stata License Law Aoes not appty to an owner of Draperry wtio builtls or ImD�oves Nereon aM wtw controcts lor such pmjttR wlt� a emiractoqs) license pursuant to t�e Contractors' State �cense law). I am aware IAaI praof of tAeir Workei s CompenSalinn insurance shoul0 E8 prwlEeE ro me. � I am evempt un0er Seciion: B. 6 P. C.' ' ; . for tnis reason: : � � ' , � Dal¢: - - Owner. I dp pereby certiry ��at I am awaia of antl unAersWnO the reQuiremenis of Calilomia Heali� anG Satety CoUe Secuons 25505, 25533, an0 25$3G an0 ttut I or arry tuWre WilEinp acupam wilUwill not (cirUe one) nee0 io wmpry vntA ui0 sWte caEes anE me apuimments for a permit for wnstmction or modi/icafion from Ihe Nr ualiry Manapemem psMCL ResiEen�ul conswclion apD�iwl'wns are exempt trom lhese pmvisions. . � Da(e: Appiicanl: I here�y cenity that I �ave reaA ihis aDDlication antl state that the aEove information is correct. I aAree to compty vn'�p all ciry anA caunry orGinances antl state laws rclatmp ro OuilAiiry canstruction an0 trerebY �thoAze represmGtives of t`�r(the a0we�mentioriea DrqpeM �orinSDeMian purposes. � Oale: Sipnature: �/ Dr'ver's License o� Soriai Securiry x: 18q48 W�ite-9uiMina; Green—COEe EnlomemenL CanerV—ApplicenC Pink—qevenue; GOIEenroE—Asseasor ,' � CITY OF COSTA t4ESA - BUILDIDIG PERMIT PERMIT NOc E 045325 . PLAN CHECIC NO: ' N CONS'TRUCTZON TY.PE: ', PERMIT TYPti: F,L£ JOD.DESCRIPTION : TEMP. POWER POLE W/1 SOB POLE CLAIM UALUE: � CALC-VALUE: . "'F'ERM NO:: E 045325 'GOVT: N SUPP: DI ' 1 PURPOSE: NEW SQ FT: GROUP OCC:. / , COMMF.fd'1'5 : *+�***�+��c*��*��**x�***�*�r*�**�*�**+�****�**��**�*�*�r��*�*�r�**�r�*****�r�*+�**+��ar�r** • Z O N 1: N G, R E Q U I R E M E N T S . S E T D A C i<'S -- --------- MAIM DUI.LDING ---------- -------- ACCFSSORY BUILDING FRNT; FT IN i2EAR: FT ' IN �'RNT: FT IN REAR: FT IN I,EFT: FT TN RGHT: FT � IN L�i?T.: FT 1:N RGHT: FT � IN : PARKING REQ• PROV: PARCE�.: 42.421111 ZNF.: REF NU: PLANNING N(STES> > �*at�atitit*�*�i��t**�**ie***�it*x�*ie�ie**it�itat***��***x*��*at��**ie��***�*ati�*�**�ifxit�rt+t�rit D E'V F. I, O F M E N T S L R V I C E S R E� U I R�£ M E N T S �. � � 7.ONING APPROVF.D BY ,__ � DATF.r BUILDING APPRGVEL BY : � ' •DATE; � " APPT,ICATION IS'SUEU BY.;�j -.��g� DATE: / 2 iklFifiEiE3fiE3EitiE#aE#'i'�k-�IEaf�liEiEif3fit�'itiF�iF�4 �F�F 1E1Elf-lEiElfifffifif�7�� j� ifff iEiEiEjFi°iE3EifiEif%�EiF3fiF3fifiEiflE3EiEiEi:�iEiEiEiE3EiEiEifiEiEiEiE, iEiEikiPiF�E3FiEiE iPiE�liEi'�EitiEititlEfEiEiEiEiEiFiEiEifiEiEl6iEiEiEiEiElE LEGALIZA'PION:N F E E� S U M M A R Y �STRUCTURAL SEGMENT:N� 19LDG PMT PLUMBING ELECTRIC MECHANIC FIRE 'SMIP/RES GRADING PERMIT 15.00 508 SMIP/NON-RES ��Lar� • • • . , . ISSUE FEE ' 15.00 HDILDING-llIV-> P$RMIT� ISSUE PLAN-CHECH' TOTAL PAID �• DUE TOTALS----> 15.00 1�5.00 0.00 30.00 J0.00 .00 REV�NUE UIVISION TOTALS--> COLLECTED• J0.00 OVER/SHORT: ' 00 fJLUG PMT PLUMDING r�.GCTRIC MECHANIC_ FIRE SMIP/TOT GRADING PLAN�CHE(�K 30..00 iF iE iE 3;-iE iE 3E if �k k 1E lf if N 3f if jE if k iE �E if dE dE i4 aE i(-jE iF iE iE if iE iE if if if ff if iE iE if ik iE )E iE iE iE 3E iF iF iE IE �%iF iE �E 3E iE iE IE'k iE if iE iE iE iE iE it if iE iE iF 9E it if If4t � I N D I V I D U A L k' � E B R E A K D O W N ' TYPE QTY L E S C�R I P T I.O N. UNIT COST� �TOTAL CUST ELE ' 1 TEMP SER�� 1�WR POLF. W/OUTLETS EA. 15.00 ; 15.00 END OF FEES � 01 0004931i-00049314 TOT • 30.00 DATE: 12/0$/E9 TIME: 13:41 , 0 0 CONSTRUCTION AND PLANNING - APPROVAIS Permit # Temporary Electrical Service or Pole ,� il Pipe•Undrgmd. ' _ .� 3: E�ectrical Conduit Utility-Undrgrnd. .4.'Electrical Conduit=Undrgrnd:--. � 5.-$teel Reintorcement - 6. Electrical UFER Grnd. � - 7. Footings . . $. Foundation 9. Water Pipe-Undrgrnd. �> � 10. ytructural Floor System !�' 71, property Sewer Line & House Connection 12.�ewer Cap " 13. Fioof Drains �^r 14. Fough Plumbing � ��' � 15. Rough Electrical-Conduit � � , 16. Rough Elettric Wiring � � 17. pough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Condi[ioning 20. Fough Factory Fireplace 21. Ducts, in Stiucture - 22. Ducts, Ventilating • 23. Gas Pipe-Rough & Test ��, f{oof Framing 25. Roof Sheathing � � 26. 7�Bar Ceiling (Structural) & Monocoat 27, Frame and Flashing 28. l.athing & Siding ' � ' � 29. Insulation • 30. Drywall Nailing 31. Plaster Brown Coat " � 32, Electrical Power Meter�Final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test .. 36. Hood or Canopy, � , - 37. Final Factory Fireplace 38. Final Plumbing - , 39. Water Service-Finai 40. Gas Service-Final � -q1. Solarpomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation SYstem , � 45. Sound Attenuation ' � 46. Nandicap Regulations . 47. FINA� STRUCTUAE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 59. Gas Release to Southern falifornia Gas G 51. GERTIFICATEOFOCCUPANCY No_ _ Date Date Inspector POOL ?A � APPROVAIS Permit # . 52. Pool & Equipment Location 53. Steel Reinforcement I 54. Forms I 55. Electrical Bonding � 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER�GUNITE 58. Electrical Cqnduit-Undrgrnd. � 59. Gas Pipe, � Undrgrnd., Test 60. Backwash Lines, P-Trap, � Undrqrnd. 61. APPROVALTO'DECK 62. Backwash & Receptor�Final 63. Heater & Vent-Final 64. Plumbing SYstem � Final 65. Electrical-Final � 66. Solar SYstem-Final 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING � 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # � 70. Underground Hydro 71. Product Piping � Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas O Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77.• FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT � 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED. Notes: - ' � � � Date I Inspector � � ,,; y " �ooness ov ewianc: 6 0 1 W 19 T H S T uxT: OYMEN5IUYEIFIWIXM: TRIANGLE SQ ST VENTURE woness:33161-A CAMINO CAPISTRANO SAN JUAN CAPISTRAN0,92675 APPL. M/JIJNG �OOHE55: urcxrtecrox�ax�x: HI HENDY ASSOC. �.�.: 19204 nncx.onu+c.�s,�oox�ss: 2415 CAMPUS DR uxT: 110 IR CA 92715 cartxncrarsxu� J. RAY CdNSTRUCTION ( 714 ) 660-8888 CONfPACTOR5YNIAlC 2 6 9 9 WH I T E RD �oox�ss IRVIN� 92714 �A uc.r�o.. uNr64250 LICENSEO CONfRACTONS DECLAN�TION: I hereby eflirm undm peneXy of pe�jury ihm 1 em Icenaed undx prwieions M Cheqer 8 (mmmandng wilh Section ]000) ot Oivisim 3 W �he Busi�wm end Proleaeiona Gode, erM my licanae u in full fwca eM eHecl. cmuc.N.:006 97 uc.cuss: g o 1 6^6 EXP: 06/96 Dme: � • CaNreaa: OWNEfl ILUEP 0 CIAN�TION: 1 Mrqyy �� uMm penely N perN�Y �� I em exi m �M Contreeaa Lioeiva lew la Iha Idbwiq �aa+on (SaUion'!W 1.5 Buaieu �d Pmlessuna COAe: Airy cIy a counN �' �iae e pertnil to wnsNwt. Ma. imqovs. Eemdc�, a repei eny siructure, prior b ne osuenro, abo reQuins iM applirent ta axh permil to fila e aipned metement IMt he a eM �ie lioarued W�� o ihe pwieiom d �ly Comrepws lirome lew �Chep�er 9(oomme�iq wilh Seeon ]000) W DNeion 3 d �he Businev uM Rolemione COEa� or ihd M w sM ie exemq therNmm enE IM bnws fa �ha elbpeA exempion. My viole�bn ol SarJion ]0�1.5 by eny epWie�anl tw e parmn eubpqa ihe epplieenl lo e tivil panely W na mwa then live hundred dolWa �S5W��. � 1, av owner d Ihe propeny ar my empbyeea wah wepea av Ihe'v eole mmpenaetien, will Eo IM xnrk, end �he ewnure e nM inle1Med or MereE (or sale (Seclbn ]Oad, ButiMyy ¢�tl Proleaebna Coda: The Conlreclan Licenx Lewdoea nM epply lo an owner o/ propeM ..no n�+a. o� �o�s me,aoo. �e „+w d� a�<n woM Mm�n o. n�ee o, m,o�an ne «ne� o� �aiw�, a,oaeae mm w�n impmvementa ere iat imeMeE ar oHe�ed Iw aab. II, Mwever, tM buiMirp a'vnprovemaM ie voN wnhin wre yeer of mmpblion, Ne owner-0uilder xdl heve IM Wrden q p�inp ha ar ehe d"d nd WiM or improve /or �M puryme d eele). � I. av ox�r d IM MWaM. em e�duanely oonireG'vq vril� licamad convecwe w cmW W IM PM� (5aevn ]016. Bwir�ms ud r�or,�o�. caa: rn. com.aea, �„�„ �w eo� �a acdr w�� a�rr wno wm. «;,�,o.�e, ina�.o., e,�e � mmreeis /a wrh prqMa wi�h e mrh�qoe(e) IieemeE W�� to iha Convmve Lioeroe Ler�. � 1 em exemp uMer Seciion: B. 8 P.C., br Nia meaon: Dete: Ovmx: I Eo hereby cetliry ihet I em ewma d eM uMantend the requimmenM of Celiomie HeeXh end Sefery Catla Sed'wna 25505, 25593, enE 25SM, end Mel I a any INuro EuilEirp aoap¢m �vill / wYl nm (circY one) need to compty wIM1 eeid pme oodo enA iM rpuiremann far epermitlamnawctianmmodA�aionhwn�haAi a�y enepememDiatna.Resdentieloonslrudioneppkatioreereexemptimmlhwe wcrisio�e. Date: Md� W ONKER'S COMGENSRTION DECLANATION: I hmaby alfiim under penely d pe�ury aw d ihe tdbxirp Eetleietioru: � I heve aM xil meinten e ceMificele M mnaent lo aell-inw�e for warkan' mmpenambn, ea prwided f« by Saeion 3100 d Ihe lebor Code, fa tM pe�larmance W Ina woA Im wMch Ihis permn ie inuaA. � I heve and wil meinlain wwken' mmpanee�ion insurerce, m myuirad by Seeim 3)OD d the Lebm Code, for �he pertormenw o/ iM woik /or which thia permN ia inueE. My wakerm mmpeneetbn ineurance cerrier arM poliry number ere: c�.�. UNICARE INS EXPIRES Pdky Numbec — — Q 1� Q 1� 9 6 (Tnra sxtiar neee mm �e comWerod r �ne penne;s ro. m. nvneive edws (S�ro/ w bsa.1 � ❑ I mnh Uw in Ne Famm�vice a �he wwk i« whcn inn Va^nn ie muad. I a1Wl m� emWW �Y ro� in em menMr eo m to become wqeq ia �M w�ke�s' cOmpensation lexa d Cel' ie, nd epre Ih ' I ehouM bawma wbjetl lo ihs xvAaa' mm � as�m� a�ao a me �m, caes. � in � n in inom po,s;o,,,. Oma: ApplicaN: Wern/np. Fallun ro cun wotltn�'rompMupon roverp� b unbw/ul, en ah !Yb/ICt qp Mlp/OyN f0 CtlIMNI pINIH41IlO clv/l flro� W ro on� huntlreC tMuanq dolMn (Sfo0,000), In etltl/tbn ro fhe t ol rompmw0on, demepr� u provlJW Mr In 9xtlon 91P6 0/ fhe Labor CoM, Inf�t, and etromeyL Ins. CONSTRUCTION LENUINO ��ENCY: � Mreby eifiim under panelry d perNrY �� hero ia e can�t�udion bMi�p epancy br Ne perlormenm d the xwk lor which iha pa�Y ia oaued (Sedon JOB]. CN. CI. LENDEN'S NAME: �ENDEP'S AOONE39: I cenM �� I heve reed this epd�� eM atme Ihat Me abave iMamelbn u wirea. l p�ea to comply with ell ary eM muMy adinanoes eM alele lexs releling lo buik'vp canftruryqn ud Mreby aNhwae roproeentelives d �hio cily lo entar upon Ihe ebwe-menlonaE pope�ty �or mavsaio� w�w�a. C.�1 �UNN I NGHAM � (St51�B.WP) Whna-Buikiq d Selery: GreaMFb: CenW-Appf�eni: Rnk-Rwanue: (3oldaneo�Mmamr CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: B 073981 PLAN CHECK NO: 02938-95 L CONSTRUCTION TYPE: C'-N SP PERMIT TYPE; STR JOH DESCRIPTION : 2NDS STORY 5294SF T.I. PERM NO: B 073981 GOVT: N SOPP: P1 PURPOSE: ALT SQ FT: 247,000 CLAIM C'ALUE: ,247,000.00 CALC-VALUE: 247,000.00 GROUP OCC: B-2 / COMMENTS: " PLANNED PARENTHOOD" 3E df 1E iF if iE IE 3E 1E 3E iE iE df if 1f !E iE IE 9E 3E 3f iE fE iE 1f Ib if 1E iE IE iElE 9E 3E dE 3E iE iE iE IE iF iE if If if iF i6 iE 16 if iF iE iE iE 1E IE �E iE 1E iE iE iE iE iE iE 9E dE dE iE 3E iE iE iE 1f IE iE iE 3E iE 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 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 PARRING RE • PROV: PARCEL: 42921118 ZNE: C1 REF NO: PLANNING N�TES> INTERIOR ALTERATIONS ON FIRST FLOOR OF COMMERCIAL BLDG. % fE iE'K� 3Elk iE 1E iE dE iE iE df if 3E iE iE 1E 9E iE 3E iE jE fE 3f 1E iflf !E �E 1E'K-!E!f �E fE 3E �E 3E �E iElE if if ik if 1E df jE 1f 1E!(� iF iF 1f 9f IE if ik 1E iE ik if 7f fE iE 1E iE iE 9f'1F iE iE'� 9f �E iE 9FlE 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 ' �J'.10- DATE: � 2�� HUILDING APPROVED.BY Y APPLICATION ISSUED BY ik jE If IE iElElE �E if iElE iE 1F 1E �E iE iE df 9E if 1F LEGALIZATIC�N;N BLDG PMT PERMIT 1,154.00 F E E S U PLUMBING ELECTRIC DATE: �, DATE: �Z� � �f'3F �F{FiFiFiF7F�F3F9EiE'IE-0kiflEiE3f3EiE ffif M A R Y STRUCTURAL SEGMENT:Y MECAANIC FIRE SMIP/RES GRADING SMIP/NON-RES PLAN 750.10 '� 51.87 ISSUE FEE i%i' BUILDING-DIV-> PERMIT ISSUE P,L'AN-CHECK TOTAL PAID DUE TOTALS----> 1205.87 0.00 ,:� 750.10 1955.97 1955.97 ,.00 J • - d REC�ENUE DIVISION TOTALS —> COLL^EG,TED: 1205.87 OVER/SHORT: .00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 1154.00 , i 51.87 IE �E iElE 1E 1E if jE 1f 1E �E �ElE 3ElE iE 3E iF iF 1E 1E iF aF �)E!E iE 4 iE 9k iElf if 3F 1E iE jE 1E 1E 1E k IE fE jE 3E fElE iE iE iE iE IE IE fE 1ElE 9E iE 1E fE �FlE if ik if fE 9E 3E 3E 9E 1t iE i(� 3f iE 3f iE jE �E iE 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 SFC ' 247000 ALTER BY VALUE COMMERCIAL NOZONE 1,00 247,000.00 END OF FEES EX�i�ED�J�, DATE �'�� IvV , Ul 411i�S_o0-C"vi8925! �T!:'� -tl:: JAT`� �v/-:?:-'� 7Tr'c. ].;�;` ,L �J ' 1 CONS7RUCTlON AND PLANNING POOL d SPA APPROVALS Permit # Date Inspector APPROVALS Permit # Date MspeCtor 1. Temporery Electrical Service o��Poie 52. Pooi & Equipment Location .-" r 2. Soi! Pipe�Undrgrnd. "- , 53, Steel Reinforcemzni -- " 3. Electrical Conduit UtilitY•Undrgmd. ' � 54, Forms +�- ,- A. E�ectrical Conduit�Undrgrnd. 55. Electrical Bonding . 5. Steel Reinforcement 56. Fough Plumbing & Pressure Test - �' 6. Efectrical UFER�Grnd. 57. APPROVAL TO COVER�GUNITE � 7. Fooiings � ' 58. Electncal Conduit-Undrgrnd. a. Foundation ' --' S9. Gas Pipe, � Undtgrnd., Test 9. Water Pipe�UndFgrnd. �_ . . 60. Backwash Lines, P�Trap, �'Undrgrnd. ip. Structural Floor SYstem _ 67. APPROVAL TO DECK ' . 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Fi�ai - 12. Sev{er Cap •'' 63. Heater & Vent�Final ' 13� fioof Orains , �� ! 64. Plumbing System -,Final ib. Rough Plumbin9 * 65. Electrical�Final . ' 15. Rough Electrica6Conduit 66. Solar System�Final � 16. Rough Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring Sign � � fi$, APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEh4S FINAL 19. Rough Heating & Air Conditioning _ FIRE DEPT. REQUIREMENT 2tl. Rough Factory Firepiace . APpROVALS Permit # 21. Oucts, in Svuciure � • - _ 70. Underground Hydro ' 22. Ducts, Ventitating , 77, Produc[ Piping � Gas ❑ Oil � 23. Gas Pipe-Rough & Test � 72. Underground Fiush 24. Foof� Freming � 73. Undergmd. Storage Tank d Gas ❑ Oil 25. floaf Sheathing � 74, Overhead Hydro 26. T-Sar Ceitin� ,acruccura•� & Monocoat �.3.5� �� 75. Dry Chemical Z7. Frame and Flashfng � 76. Dry Standpipe 28. Lathing & Siding. ' � '� 77, FIXED SYSTEM FINAL , 29. Insulation - -. 7$, FIRE PREV. FINAL 30. Drrivall Nailing �� HEAL7H DEPT. REQU4REMENT--� 37. Piaster Brown Coat . ', � 7g, FINAL INSPECTION 32. Electrical Powzr Meter-Fi�al � � 8�. FOOD CERTtFICATE 1$Si'�p 33. Finai.Electric ' Notes: /�' _�u� �� _ _� � �, 34. F�nal Heating & Air Conditioning� = ' �_ , � l �� 35. Finai Gas Pipe-Test � � � - � 36. Hood or Canopy � - � . ' _ '� ` ' 37. Final Factory Fireplace - i;' � ' 38. Final Plumbing � •" "'?:. . _ �- - 39. Nlater Service-Final � � 40. Gas Service-Final � � � , 41. Solar pomesticFinal . ' 42, Backf�ow Preventer � � 43. Backfiow irrigation � 44, LandscaPe trrigation System � - . . ' � � 45, Sound Attenuation ' . - • 46, Mandicap Regulations� _ � ' 47, F{NAL STRUCTURE & BUILDING - = �;' - r n . ••, 48. FINAL PLANNING � �' i 49, Electric Release to Edison �T --_. �, . 50. Gas Release to Southern California Gas Co �> _ .. 51. CERTIFICATE OF OCCUPANGY No Date - fr �oonFss a ew�owa: 6 0 1 W 1 9 TH S T ovmeRaru�eicioiwvraTRIANGLE SQ JT VENTURE "0°1E5133161-A CAMINO CAPISTRANO SAN JUAN CAPISTRAN0,92675 �vx. �uuxo �ooxcsx un,wrtEn on Et+rn+�x: E� uc. rio_ uxr: UNf: c«`m�cTarsxuu RESCUE ROOTER—ORANGE COUN ( 714 ) 558-0284 CQlIN�ttORf YYI➢p 10 8 S N MA I N S T �o�%%ORANGE CA ��= 353170 92667 u�: C UCENSED COMNACTOPS DECWIAT�ON: I M�aby � �vder qrely W pryry Nel I am licqutl wder prorieivn d Chaqsr 9 ImmmendnY xnh Section 1000) d Divbnn � d rtn Buamm ad Pmfvdan Code. eM mY fioenm o in hA Ivcs eM afletl. r uc.r+o.:034408 �°0�"C 36 uc.No.:35�70 /� 12/97 om. �- s � � ��,_ OWN BUILUEP DECLANRTION: I MApy dfi�m uMr pmNy d perj.ny ihel l mn aaamq hom 1M ComreCas Licenes lew la tAe Idbxi u�mson (Seuian 1rot S&»nma nd PrGa�dom Coda: �m' UY a odeuy Mi'rli �equim a v�i to mruwn. Mr.'anprow. h. a rpei mry sWnun, prior b Ya ev�enee, abo ep�im tM epplirsN la wch pormu �o fJe e opnad etetxmnt UW M a�M � purnw,� �o ine wobcm a m. commean lioen.e lew fchaqr e(oomm«�dro .un seaon �aao) a olveo� a a �M euv�e.. �e a.ae..ov caae� «mm n. «.n, m.�p m��, �a m. mri. �o. m. d�,a a.�,w:M. n�r •w.��, a see:� )0�1.6 by enY eOW�� In e{qrmG wdjqpp IM epplceN lo e aW psWly d nol moro �hen frva huM�ed doAe�e �55oop. � I.mmmerMiMpapenyamysnpb�enwihwabean�Miedeaompnumion.yiYEOIMwaM.mdNeewmuaenoliNeMeJ a MaeE tar aeb (Satim 10u. Bwinaw and Vmlmuau CaAe: TM Cavrenan L'mes law Eme not eopYto en owrw d pWeM o.,,s�wnaa...a neve ms wdw� d o�*ro ns a.ns eid na daa «imww. a. ue wwd• a msl. ❑ i...�«am.nw.m.�<.a,:wr�vm:ro.anc,.me�w.m.mo�mwa»aa.dts«i�roN.a,.:.,..m PMem�s Coes: Tne Caandm L'vw ler dws m adr n en anw a Rw�Y who huld� n u+Po+'m ihreon eid vAn cmaece b rrf� pN�+ �n s mu�ecM�) Gc«uee o��+b Ns C«ureoon liow� leW. � I em aumq uidr Seaion: 8. 8 P.c.. b tiv iaewn: De�e; Oww: I tlo heroby ceniy MN 1 em ewua d enE �nivW iM �epiunmWs d Cdian4 HeMh uM Setely Cods Seqiom?5505, ?55�. eM 255�, uM Mn 1 a erry Mwa WJ0'vq am�peril wiG / wil m� (tlrtb one) naeA b canpfy wih yiA mis aoG� uN IM �p�i�emnro lor e pxmil la wrovucYian a modifrdionham�M Iv�enepensv Oiarc�. Raedroel canqrvp'v� uGVFmioroen ewamN Imm �Ms a�. DNa: Mp��: WOPI(EN'4 COYPplS�TION DEC WIATION: I IrW/ �m �vdr prrtly a1 pr%.y ar d tlw lopow4q AstleM'vp: � IM1m+enEvn7meintenecanfratsdouuNlowtl�h�webwMr+'ounp�iuuion.mpwidedtaby8e�oi�]OOdIMIeEw GoM.la iM pMoemenes d Or vak la MiN Ow psmY h ivW. � n.r..ne wi� me'vn.:i .on�..• mmo.�:„ �.n.. o r.am.a M s.a�m amo w m. �eeor cod.. a m. w�� a m. il work la xliid� Nu G�m u miwd. yY wwlw�' mnprsmion "vmvenc� ariw rN D�Y rumEr rs: c�«: ARC:Af7NAfiT TNS EXPIRES ParryNumEx wr�c.sn�n�an�a 01/�1/98 (iA(s asctian nwJ iwt Ee canP'kb l�M w�t u fa aa Mmded AaPere Itiwl a Mu.) ttn�Y Nol in IM W�mne�ce d ilr work br xhlU� ilvw 0�� e uswd. I tluG ro� rndW �Y Vd� N enY merunr w m io b come wbiea io �M w4nre' ¢anpenwbn lewe d CelAan4, vM pras tl�n tl 1 Moub bocome wbjea ta iM xoMen' ca peneety� po+iauns d Sepbn �10p d �M lebor Cods. I tluA taNw�ilh °� MN ihms p�vmoro. �'� q % �cc�.�: � . _/1� �_ DNs: amin F•uun ro ucun roMNi comqrwtlon n��r�T l.'nYrM. uW iIWI u!/�ct.n MnPlqw ro MM�rIVwMu •iW e I II �q ro wr� mntlrW Mouuro pdqn lit040o0A h�dd7tlun ro tln ewt o/ mnpwu�Wn �Yu �s provMM lor In �1G6 0l IM laDw Cob, IMNyI, aq �tlom�y� /Na � codsrnucnoH �aarw anerxw i n.�M .� �. wuW a o«ior �nr u.e o. onm�ww� wmro ro•+w ro. n. PoAamerce d tM xM M wNN Iliu Mni u ewed (Swion 3041. Cv. C). LENOFA'S NIWE LFNOEH'4 MDPE54: I cenity ihN I Aevs ntl thia epd'catlm ad uN� iAet tl�a �Eova edametion n cartw. I epir to oomply r.'rh N ay enA caumy ordinenom end oWa Iex� eeWiq p Wild'n0 ��9a� W Iwsb/ aWwr¢s npaaeNefrvw d IM ary �o arar upon IM ebv.e-meniwwd popay la iropodion Wrpmee. Tor�Y eeN�r (5151�6.WP) Wbe-'��Ob Date: f �— 3 RnkJWsiva: CidEai�otl-Nnsv CITY OF COSTA MESA - BUILDING PERMIT PERMIT NO: P U82356 PLAN CHECK NO; CUNSTRUC'TION TYPE: V-N SP PERMIT TYPE: PLU JOB UESCRZPTION : 25FT OF SEWEl2 LATERAL, CLAIM VALUE: CALC-�'ALUE : N PERM NO: P Ori23S5 GOVT: N SUPP: N PURPOSE: REP SQ FT: GROUP OCC: B / COMMGN'CS : X IE 1E iF iElElE 1E N iF iE N N iE �f !f !f 3E M k iE fE 1f ff if 1E 1f 1E IF iE 1E 1klF iF iE 3ElE fE fF iE 1E iE IE 1E IE �E 3E IE IE jf 1k 3E 1f if i' 1f Ik iE IE 1k fF �F?E iE 9E if 1f 3k 1f if if iE fE IF fE 41E iE if iE Z O IJ 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 --------- --------- 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: PARCEI,: 42421118 ZNE: REF NO: PLANNING NOTES> �r i - *�+�**rt*ie�*�****�it�**�****�t***xie+��**x*x*�+�*�*at**�t*****x+��***��*�*�**�**�+E**��** 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 APPROVEG BY . BUILDING APPAOVED HY : r •; APPLICATION ISSUEU BY: � -' �' �f�EIFiFiElFiflfiElEikiElEifiEiE##ifiE3(-iEiFiF��if3f�f��f�i��3fiF��F� �fiF��lF LEGALIZATION:N F E E S U M M A R Y BLDG PMT' PLUMBING ELECTRIC MECHANIC PERMIT 22.00 25$ , OT TA1 . , FEE 22.00 ING—DIV—> PERMIT ISSUE PLAN—CHECK S____i 22.�� 22.�� , �,�� DATE: DATE: DATE : 1 �1 iFiFiE�flEifiEiF �� 121E STRUCTURAL SEGMENT:N FIRE SMIP/RES GRADING SMIP/NON-RES TOTAL PAID DUE 44.00 44.00 .00 REVENUE DIVISION TOTALS--> COLliECTED; 44,00 OVER/SHORT: ,00 BI�DG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CFiECK 44,00 k' 14 k k �E fE 7E ff� i! if !E 1E �E 1f if ft iE 1E 1E fE i[ 1ElE i(' fE 1E �! if fE 1f M fE iE iE iP�iE fE 1f !f iE 1E i( ff k!E 1( 1f 1f �!' N' If 1Flf 1E if ff IE fE 1E 1F iE 1E 1f fElE 1f fE fE 1E fE iE 1k 1E it 1t if iF 1Elf I N D I V I D U A L- F E E B R E A K D O W N' TYPE QTY D E S C R I P T I Or N UNIT COST TOTAL COST y PLU 9 SEWER, CONNECTION TO BUILDING EACH 22,00 22.00 END OF FEES ea-es-i��ie�:3� anisaa.ae RCPiN:81-80045ft0 PERMIT:082356 CONSTRUC710N AND PLANNING - POOI .. SPA APPROVALS Permit# Date f�spector APPROVALS Permit# Date Inspector 7. Temporery Electriwl Service or Pole - 52. Pool & Equipment Location 2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms . 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding - 5. Steel fleinforcement 56. Rough Plumbi�g & Pressure Tett � � 6. Electrical UFER Grnd. � 57_ APPROVALTO COVER_GUNITE • 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd„ Test 8. Water Pipe•Undrgrnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK i t. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap � 63. Heater & Vent•Final -'� 13. Roof Drains � 64. Plumbing System - F��al 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical�Conduit � 66. Solar System-Final 16. Rough Electric Wiring 6J. Fencing & Access Approval � . 17. Rough Wiring Sign � fi8. APPROVED FOR PIASTERING 18. Fough Electrical�T Bar Ce�ling 69. POOUSPA SYSTEMS f�NAI 19. Rough Heating & Air Conditioning ' FIRE DEPT. REnUIREMENT 20. Rough Factory Fireplace � APPROVAIS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product P'�ping O Gas OOiI 23. Gas Pipe•Rough & Test 72. Undergro�nd Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T•Bar Cei�ing (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing � 76. Dry Standpipe 28. Lathing & Sidin9 77. FIXED SYSTEM FINAL 29. �nsulation 78, FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plazter Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Finai 80. FOOD CERTIFICATE ISSUED 33. Finat Electric Notes: ._.G�� j C_ 34. Final Heating & Air Conditioning 35. Final Gas Pipe-7est 36. Hootl or Canopy 37. Final Fattory Fireplace 38. Final Plumbing . S�/� 39. Water Service�Final � 40. Gas Service-Final 41. Solar pomesticfinal 42. Backflow Preventer 43. Backflow 4rrigation 44. Landscape Irripation SYstem 45. Sound Attenuation 46. Handicap Fegulations 47. FINAL STRUCTURE & BUILDING 48. FINAIPLANNING 49. Electric Release to Edison . 50. Gas Re�ease to Southern California Gas Cn 51. CERTIFICATE OF OCCUPANCY No. Date �I �ooness a ew�uwa 6 0 1 W 1 9 TH S T °""E""''"'E"�vr� TRIANGLE SQ JT VENTURE "°°"�' 33161—A CAMINO CAPISTRANO SAN JOAN CAPISTRAN0,92675 �vv�. �u�o �onx�ss: u�cxrtEcr ox u+m+aa: /JiClL OP ENO.'8 ADDflESS: uc. no.: UNT: UNT: coNm�crarswua MADRID FIRE PROTECTION IN ( 719 ) 642-7201 c��%�� 3001 RED HILL AV ESP VI �� COSTA MESA CA uo.no.: 577067 92626 urar: 106 IICEN$ED CONiPACTONS DECLANATION: I herob/ tlfvm uMer penelly ol pmjury ihat I em Ikenead uMx povieiam d Chaptar p (mmm��p wi�h Sxtion ]000) d Oiviaion 3 M Na BunMas eM PMqeiom Coda. and my Ilosnss b in lutl laca en0 Mad. cmuc.No.:057123 uc.cuss: C 16 uc.No.: 577� �C 09/96 De1a: 1 jZr6 �9 � OamfBa_�gb �i� OW NEp BUILDEN UECUR�TON: I M�etr/ elfimi uMa pxWy d parjiry �hm I un uemq hdn Ihe Caqrepon Liroroe taw 1a Ne Idbwip raemn (Sedqn )W1.5 Bwiias� end PioleaioN Cods: Aery cty or munry whitli Ryu'ves e parmil lo Mahucl. BEer. imqv.a. demdqh, p repei enY el�ucture, prior b ib iewence. ebo mQuirae tM eppl'vxM tor euch psrmu �o fib a�ipnod slaie�renl Net he a�M ', 4c�y� wrnunt m �ne pwisiun w ihe caurmas Licame te�. lchapr 9(om,menu,q .'an seeia, ]000> a Di.sia, � a ur uvi�en vM PrMeasiom Codal or IIW he n Me n aaemq tMrehan eM iM beme la Ne elbOb uemqion. My videtion W Seqbn /W 1.5 py yry eppliceni lor o parmn euEjxta Ihe epplicen� to a dvil pendy W roi mae then Me huMrsA Edlen �f.500�. ❑ I. ¢y ox�e d Ina qapaM a my empbieee xih wepm a� ihei sds wmpevation. will do �M wwk. vM �he evueNn e rol imeMed w oRereE (w+da (Seclion 90M, Butinen end Proleasiona Cade: Tha ConlreGon Licenee lew doae iwl epply io en oxmerd praparry wM Euida or inpwx tAereon. vM Mw Eom auW wk NmaeM a hena� «thraq� �e a Mr own emplayeen. qwidetl ihm auc� iinqwemenia ere M intanEeC a ollend la eeb. II, however, llw buiWiip a'enprovamenl e aoN xiihin are yeer ol completion, ihs awmrWikm xill heve iM1e buNen d povinp he or ehe dk iwl builE or improva Iw iM WNo+e ol eeb�. ❑ I, m oxnar W tM popeny. em e�MitivNY oontreeM xM limsed eonnecmn w emmua ihe VoM (Seaon ]W,. &v'vws vd Prolsaeians Gade: The Con�redan Licenae law Aoea M epph/ lo en o�mer d qopeity who Wilie a impoves IMreon eM who CdIVBCG iIX 61M�1 p1Vl�s WI1�191IX11f8tlO!(9) GCOM1%d p111811811� 10 ��1l:�M1�18dIXe �IfppB �IMi. ❑ I yn exemq uedx Seelbn: B. a P.C..1« tM �mwn: Deb: Oxnar: I do �Oreby ceNy Net I em eware d enE uMenieM �he repuiramenb d Cellortue NeaM aM $elety COEs Saqiwa 25505, 255�3. arM R5536, eM Mm I a enY Mure buiMiiq ooa�pent xill / wY �(dreb one) ��o cwnpy wY� eeN pata mdm enE the reW'vammd Ior epermnlaconavuctionormodAre�ionhaniha�i u i�iy a�epemenld¢Irip.RenkeMidcmwivabnappiWimeereeaemqimm�h»e wOVI610M. Deio: ApplicaM: W�AKER'S COMPFHSATION DEttARAT10N: I henby efNm unEs pe�uhy d pspvy one d iM Idbwiiq Aederetiom: ❑ I�yvMwilmeintenacmWicWdoonaenlbealFiruurobMdkencomPo��.%+p�eElwbySeeion3)OOdihelebor Cotle, lor �he pMmnvKs d iM waM1 la xtich Nu pemiu b mueE. ❑ I h¢w vd xil meinleii rmMn' mmpenwion inwrerca. o rpuiM by Seabn 3)00 d tlro laEa Cotle. lor �In pe�lamence W iM wak lor xfiii� th'v pertnA u iuueE. My waFse' oomperwtion inwrerce mmm end pdiry numbar ere: c�,,: STATR F[iNi� EXPIRES aa�N�m�,: ��4—osnnnnnaa� 01/01/96 Thi9 6Mion need nd be comO�Ole! I f�v Pe�d b b are hVrMredOWlen /f100/ or bss.f ❑ I cenly thet in �ne perlormenca of Ihe wwk kr whch ihia pa�mii ie i»ueC. I ehell iwt emplvy erry penan in eny menner eo aa Io h«ome wd� �o �no woM�.� canpenution mw. a cmi�«ni.. .�,d w� �M1m tl �.nwa es«�+ w� �o �n. xwken' companaeti prwieian d Seaian 3]00 o11M LeEor COAe. I eMll lorlh � h comp�y t P/rmyf Dma: Eod� L�A/I Wem4p; F� un ro s�cun wohwi romperwtlon cwenp� Is �n4Mvl, antl �1WI wpJ�ct an wrWloyw h MMiW psneltls� eM tlM If� ap ro ais hurCrW �Iwuaud Odl�n (S10qG00A M Ms/tlon ro M� cw! ol �pRp.nutbM1 Lan�pu es povltlW br In Sactlpy> »O6 0/ fhs LeDor Cotl�, l�nnst end etromsy i l�u. e CON$Tq11a11pN LENDING AOENCY: I hsaGy eifirm uMx parolry d per'�vy ihe� thya u e canYrupian Imd'vq epency br tM1s ro�amence okthe work Iw which Ihb pe'mY ie baueA (Seuon �09). Civ. C). ��LENDEq'S NAME: LENOEN'S ADONES9: I cenily ihm I law read Nu epplketion uW 9eb iAm Ne ebove iMortnPoion c conen. I epne to mmply r.nh NI qry end mumy wdinenro� eM s'ye kws rNmM a wr�!'mp conah�Mwn W herebYe'nhoiue nM�e1'rvm d �h6 vry�omtm uw�+tM aba+�mentionad pvperry la'uypad'an Wrpma+. KENNFTH HELTON miNeme n // Dete: Sipn d Ovmer/qpenVApph ntetla (St51�6.WP) WhHe-Buikvp d Sde�y; GraeirFb; Cenery-�ppYcent: Fnk-Revenue: Oddenro�Maeveor CITY OF COSTA MESA — BUILDING PERMTT PEkM NO: F 074377 PERMIT NO: F 074377 PLAN CHECK NO: 03465-95 L GOL�'f: N SUPP: N CONSTRUCTION TYPE: V—N SPAINK PERMIT TYPE: FIR PURPOSG: OTH SOB UESCRIPTION : INSTALLATION OF AUTOMATIC FIRE SPRINKLER SQ FT: CLAIM VALUG: 4,800.00 CALC—VALUE: GROUP OCC: B-2 / COMMENTS: X *****�*��*�r��****��***�**rt****+t*�***�**�**+�*+��***tt�*��**+�*�**x***x�*x�**�***+��+� 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 LEFT: FT IN RGHT: FT IN — ACCESSORY BUILDING — — FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42421118 ZNE: REF NO: PLANNING NOTES> % aE fE if iE if iE iE iE fE iElf if ih �E iE iE iE if if iF iF �E 3E 1E jE 1E 9E fflE * if iF if-1E-)E iE iE 9E 3f jE iElf 9Elf 1f if if iEaE !F aE iE dE iE iE iE 3E 1E iE 9't iE 3E jE 3E if iE �E iE IE �E iE fE iE iE'lE iF 1E 3E �E 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 APPROVEU BY DATE: BUILDING APPROVED BY : DATE; APPLICATION ISSUED BY: �L DATE: �, Zg�� 1h�FiE1E3FiElfififfF1f3E1EiflE�fifiEiEiE�E1E t , iE1f1E�('�E{E�IF1E1EiEi�iF iF iEiE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 72.00 658 SMIP/NON—RES PLAN Q6.80 ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE TOTALS----> 72.00 0.00 46.80 118.80 118.80 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 72,00 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK %2.�� 3F iE iE 343f ih dk i4 �F iE iF iF iE 3E 9F if aE iE+E iE 9E if i4 if it 1E if iE �lE 1E aF 3E'k iE if� aE jE ik iE iF if iE iE if iE aE if �R dEdE 3f -lE �K �E jE-lE iE M 1E iF iE 9k 1F 1E 1F if iE i!-1E if if 3f 3f df iE iE'1F-1F 1E , I N D I V I D U A L F E E B 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 FIR 72 " FIRE EQUIP FEE (FROM HLDG�VAL TABI,ES 1.00 72,00 • END OF FEES ?i am9:+�1-9�i4?.161 -ro�-r �z.ao DATE: 69l24;45 TItiE: ]d:06 CONSTRUCTION ANOPLANNING POOL� !A � APPROVALS Permit # Date Inspector AppROVALS Permit # Date lnspeStor 1, Temporary Electrical Service or Pole 52. Pool & Equipment Location� . " � 2. Soil Pipe-Undrgmd. '' 53. Steel Reinforcement • 3. Electrical Conduit Utility•Undrgrnd. - 54. Forms •; �.� ^� 4. Electrical Conduit�Undrgrnd. 55. Elecirical 8onding I .. 5. Steel qeinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE ' 7. Pootinqs 58. Electrical Conduit-Undrgrnd. � '� 8. Poundation - 59. Gas Pipe, O Undrgrnd., Test . � i 9. Water Pipe-Undrgmd. �• 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structural Fioor Svstem 61. APPROVAL TO DECK . � 11, Property Sewer �ine & House Conr�ction � 62. Backwash & Receptor-Final > �Q, $ewer Cap ' 63. Heater & Vent-Final . . 13. fioof Drains ' 64. Plumbing System � Finai • 14, Rough Plumbing .� � 65. Electricai�Finat � 15, fiou9h Electrical-Conduit r 66. Solar System-Finai , 16. Rough Electric 4Viring 67. Fencing & Access Approval i 77. Rough Wiring Sign � 68. APPROVED FOR PIASTERING i$, Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning F1RE DEPT. REQIlIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. pucts, in Structure 70. Underground Hydro 22, putts, Ventifatin4 71. Product Piping �Gas ❑Oil 23. Gas Pipe-Rough & Test 72. Unde�ground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas rJ0i1 25. Roof Sheathing 74. Overhead ti�-=v � - - �. � 26. 7•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Fiashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM1I FINAL %Q'(j.p)S �, 29. Insulation 78. FIREPREV.FINAL J�.! ,9t�.� 30. DrY�vall Nailing HEALTH DEPT. REQUIREMENT 31. plaster 8rown Coat 79. FINAL INSPECTION 32. Electrical Power Meter�Final - 80. FOOD CERTIFICATE ISSUED 33. F�nal Electric Notes: . 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test � 36. Hnod or Canopy - 37. Final Factory Fireplace 38. �inai Plumbing ' 39. Water Service-Final 40. Gas Service-Final 41. Soiar �omesik-Finat 1 42, Backflow Preventer � 43. Backfloev Irrigation 44. Landscape Irrigation System � 45. 5ound Attenuation 46. Handicap Regulations . q7, FINAL STRUCTUFiE & BUILDING = 48. FINAL PLANNING • 49. Electric Release to Edison �. 50. Gas Release to Southem Califomia Gas Co 51. CERTIFICATE OF OCCUPANCY N0. Date AOOPE540FBUILqNO: FjOl W 19TH ST� oxr�acruueivaaxx: TRIANGLE SQ ST VENTURE �u 33161-A CAMZNO CAPISTRANO SAN JUAN CAPISTRAN0,92675 �vv�. wuuna �oowess: UNT: 1PCMAECTOFFIl�NEEN: HI HENDY ASSOC. uc.r+o: 19204 urcx.an�as�a: 2415 CAMPUS DR vur: 110 IR CA 92715 coNrn�narswua J B FORD PLUMBING (714)631-294') CCMPACTOR9YNltlq 1835 WHITTIER ST �,00�ss: COSTA MESA CA �G�, 589070 92626 �NT, F-11 UCENSEU CONTNACTONS DECLAN�TION: I IwaEy Nim uMx prWy W psyvy Ntl I em IicwneE uMx prwi�bn� d Cheqx Y ��.�w.mns«ua,�000�aon��aam.��...wv�a.,.�,cm...�an70 omiwmR..�e 04/96 c.No.: 05054A� uc.cuss: C-36 uc.No.: 8 ov !• 7- 4s �� NEH BUILOEX OECLANITION: I hweby dfim+ u�der iry IAtl I am anmq han IM COMredon llosiue Lew la tM Idbwiq iaamn (Saaion )Wts Bwirou W Rdudom a aduaY whiN nqw�a . G�tl �o mmwd. etlx. Mpow. eemdeA, or ropei eny owciun, pbr m Ya'v�uuvs, ebo tM eppGum la ach pamW to fib a�ipned Natomonl ihm M w eM 'm�+se wnuem m uw a�• d ma cam�seas uwnae le. �Cha�x e(��+G •'vh swun lwo) a oi+eion s a �ns nen uW Rdsa'vm Cadal a t�m M a eM u awemq therahom erd iM bem ta tlr eYeWd eiampbti.'MY vitluion d SW on .a1.5 W ury eppiran la e permd wApaa Ihs eppfwv to a dW ps�etly d nal man �Mn fn� huM�ad ddW� �f500p. � I. m oMnar d iM propMy a my anplo/w �+ih wapsa n Uri ds mmpemtlnn. W Eo Ns Mak utl Ihs �Mxlive's nol'vileMsA «dlasdtor eeb (Sanion'lo1�. Bimmw� md Prolrtion� Cade: Tha CaareCm Lica�ve lawdaas nd epp!/to enowrrd papury Mn d�lAe a inpo.et Ihmson. md wM Eoea tutl� r.vtk IvneeR a MteN a IMdph Iv a Iw own anplq�n. piwidsE IIW wch �Pw«�em. a. oa :a«dee a and.e i«.w. e. ro.«.. u,. e�'ew « mw�w e.de wee:, m. rw a oomq.��,. u» own«-0u�f.. �;o ne�. me w�a.n a ww+m ns «.ne ad �a nwd «�naow iv ine wmas w wel' •� ❑^ i. u omw a me aw.m..m.•a�M mm�eero .en 6m�,a.d omo-aaa. a mm�w ua wda Is<aon rou. ew�n.. aik Prtlw'vn Code: TAe Cmtmfm liuma lwY dow M wWv b en oww d o�W�Y Mn W�b w�inpww �Ivaan �nd who eonVeeb br urA PMa� wCh e amomMe) IieameE P�uw b �M Can�rm� Lia�eu� lew). � / � I em uemq ueda Seefion: B. 8 P.G.. br Nu rmm: .� '� Dete: �: i eo n..w �wr mu i.m ..... a.oa �.d..ww u» �a�«m a cwo�,a. w.en .�e s.i«r coe. s.e�. uws. zxs.v. eoe 255J�. eM tl�et I a em� Mun EuikmO � xi0/ rA mi (eaeY ar) nss! ro oomeN win wid peis ood�� ad �M naulewnam for •pemdllormeuvueiionamoEd�ulianhamilw�i3ue�Y ��D'wtritl.RuiE�Nilmuirudion�COk�lamNa*wnqfmnlhp� pwiaone. om.: �o,r�wu: WOAKEF'9 COYVEN9�TION OKWI�TION: I hrW� elfum uMr pruEy N paNey w oi IM bbx4p dwWYbm: � I heva enE W meinten s centliuu W mwnt lo wtluw�s br whan' mnpouelbn. n pwid�d la by 8qion �)00 d IM leba coes.l« tM o�miwri d uw .ak Ia w1:cn cb vxmC b bW. ❑ i n....oe w m.on.:,.�k«.• o�o«,m�:,a�.�w...,'.am.a sr s.ie, mm a m. �.no� we.. w in. o.�m�m.�,o. w m. �t«.,nKnw.w�:m�.a.n�rwa�'R�PU�BLI��NWme«•,•: E}CPIRES p„� ,m,,, O 1/ O 1/ 9 6 :, .se.M n.�w mr e. comwb � rn. c«me u m. cn. N,�m.a� anw rs�ml o..W.J �I on,Y Nel In iM W�amerrw d IM rM tor �fikh Nu i� b b�wE. I tlW m� NnOM M' Ow� M' mximr w n lo Decome wbjw to iM xakas' �mpa�r�ion bxs d CefiMNe. uk pr L I NouW bs • bjw to tM xoM1en' oom/w�ro.�� wwuu�. cn �mo a w len« coe.. �.n n� wn Nn. a� .b . Oms: 7 • � • 9� MMbw: W�mlrp: F�Yun ro�cun Mvrtw.'rompwwtlon . nW i/Wi rL/cl �n unolqw ro eAn/rol p�ltlu uM eiM� nnu w ro on• nu�ene rnou.w aaw (t�oo,aooA n ro m. co.r or mmoru.wn d.m.o.. .. povro.e ror �n 9�ctlon J106 0l M� l�6or Codr, Int�nst �nJ �rtomry'� I. CON9TIIUCiION�IENDIN4'�QENCY: I Mnby efNm uMr penaAy N perMuy tAm iMro u e mut�uabn MnEinp epsncy br �M pMormarce d �M r.ak laf.`xfiid� th"v p�mil u'swM (�� . G'v. Cl. LENDER'S NAME: LENUEX'S AODFE93: � Cl111�1' 1�1Y � �1GV! IlM� I�1U �WO1414 Yll! I�1l1 tl10 CbP� 111�P11W1011 O CORly. ��N IO CTO�'/ Mil� LD �' Mld WIIMY Old�fWlp� and etme levn reW �q ro briMip con%rudion W heraby eu�hor¢a rap�awnietivas d tM tiry w wnu upon tM ebo.e�memionaE pioperry �°`�'°`�'""°�"� S�FF FORU � Oete: � � � ��J (StSt�s WP) Wnde-Buddiq 8 Sefwy: �reen-Fla: Cevry-Appfran: RnkJiw�nw:OddenmE-Nww CZTY OF COSTA MESA - BUILDING PERMIT PERMIT NO: P 074110 PLAN CAECK NO: N CONSTRUCTION TYPE: ��-N SP PERMIT TYPE: PLU PERM NO: P 07411.0 GOVT: N SOPP: PI PURPOSE: ALT JOB DESCRIPTION : 2NDS STORY 5294SF T.I. SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 / COMMENTS: " PLANNED PARENTHOOD" REF: B-73981 IE �f If 1E �E iE if 1E iF K iF ik 1E if iE iE IE iE iE iE if 1f iE 1E iE 1E 3E iF IF iE aE 1ElElE jE iF iF iE iF jE iE iE if if iE iE iE �ElE iElF 9E 9E�Elf iE if iF iE iElE 9E iF iElE if 1f iE iE 3E iE k if if 3f 3E fE if iE 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 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 REQ: PROV: PARCEL: 42421118 ZNE: REF NO: PLANNING NOTES> i - iF ik iE if fF iFlElf fF iE fE iE iE iE 3E 3f iE 3E ak iE 1E 3f If 1E iE 1E if 1E 1f if !f if iE 1F iE iE 1E 3ElE jE fE iE iElE aE iE �E iE fE 1E 3E iElf 3f 3E 1E 3E 3ElF {E iE 1E iE 1f if iE �E-)f if jE if !E jE iE 9E aE dE iE iE D E C� 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 8Y . f:li� i71 �7 � �e7_\:] �:i�]y al �f:iU APPLICATION ISSUED BY: A�^ � ��i if iE if iF iE if iE 1f-�f iF iE iE iE If iE iE iE 3E 1E IE fE iE��iF�iF�FiF�'k'fFif��FiFiFiFiF iF 7F�7F LEGALIZATION:D! F E E S U M M A R Y BLDG PMT PLUMBING ELECTR�IC �,MECHANIC PERMIT 173.00 25� ISSUE FEE 20.00 �� r- � BUILDING-DICT-> PERMIT ISSUE PLAN'-CHECK TOTALS----> 173.00 20.00 � 0.00 REVENUE DIVISION TOTALS--> COLLECTED:•�: BLDG PMT PLUMBING ELECTRIC MECHANIC 193.00 � DATE: DATE: i- �iF3E3E3EiED�FiE#�iE�E iFiE STRUCTURAL S GMENT:N FIRE SMIP/RES GRADING SMIP/NON-RES TOTAL PAID DUE 193.00 193.00 .00 193.00 OVER/SHORT: 00 FIRE SMIP/TOT GRADING PLAN-CHECK 7F iF iF iE 1F iE iE iE fE fE iE 7E 1E iF if IE IE iE 1f iE 1E IE 1E iE IE iE if if 1F �E if if k k IE 3E iE 1E 1E iE If 1E 1E 3f !E iE jE ff if if �F if fE iE iF iE iE iE IE 1E 1f 3E if 3E IE iE iFlf-if iE iE if if 1E jE 1E jE iF iE I N D I V I D U A li�'F E E- B 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 PLU 1 SINK, KITCHEN �-� � 7,00 7,00 PLU 4 WASH BASIN ! , 7,00 28,00 PLU 4 WATER CLOSET (TOILET) , 7.00 28,00 PLU 2 WATER HEATER AND/OR VENT 7.00 ' 14.00 PLU 1 GAS PIPING SYS OF. � 1'•T,C�� 4�OUTLETS 5.00 5.00 PLU 1 SEWER CAP / DEMOLITION -, �..' EACH 7.00 7,00 PLU 10 SINKS, COMMERCIAL OR/%INDUSTRIAL 7.00 70.00 PLU 1 INSTALL/REPAIR WATER P.IP..ING EQUIP. 7.00 7,00 PLU i REPAZR/ALTER DRAINAGE/VENT PIPING 7 Qp 7.00, END,.OF FEES �7 ��+`%'�Y-fl"v1E9779 Te'e'r :•��DO . oflTe: osio��4s ftrt: ;y::u CdNSTRUCTION AND PLANNING ' POOL 2A Date Inspector Date Inspector� APPROVALS Permit # APPqOVALS Permit # --, � , 1. Temporary Electrical Service or Pole 52. Pooi & Equipment Locadon' �-•' .. 2. $pil Fipe-Undrgrnd. � 53. Steel Reinforcement • 3. Eiectrica! Conduit Utility�Undrgra.d. 54. Fosms � 4. E�ectrical ConduibUndrgrnd. � 55. Electrical Bonding ! ' 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electriwl UFER Grnd. 57. APPRQVAL TO COVER�GUNITE �� 7. Footings 58. Elearical Conduit�Undrgmd. i 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test �� 9. Wacer Pipe�Undrgrnd. '� � 60. 8ackwash Lines, P•Trap, �, nu!grnd. 70. Structural Floor System , 67. APPROVAL TO DECK :' L 11. ProPerty Sewer Line & House Connection 62. Backwash & Receptor-FiPal / 12. Sewer Cap : 63. Heate� & Ve�t-Fina� 13. Roof Drains . 64. Plumbing SYstem - Final "� i �. 14. Rough Plumbing �� 65. Electrical-Final ."� 1 15. Rough Electrical-Conduit 66. Solar SYstem�Final � , 16. Rough Eiectric Wiring 6J. Fencing & Access Approval �i 77. Rough Wiring Sign 6$. APPROVEp FOR PLASTERING +V 18. Rou9h Electrical-T Bar Ceilin9 69. POOIISPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � APPROVALS Permit # 21. Ducts, in Structure � 70. Undergraund Hydro 22. DUccs, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74, Overhead HVdro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Fr2me and Flashing 76. Dry Standpipe - 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78: FIRE PREV. FINAL 30. DrY�vall Nailing � HEALTH DEP7. REQUIREMENT 31. Plaster Brown Coat 79. F�NAL INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTtFICATE ISSUED 33. Final Electric Notes:� �� -�,�? ^ � � t_v-°-`-d-'"-� � - - 34. Final Heating & Air Conditioning '� `D �� 5 35. Final Gas Pipe-Test . __ / QT�c7 . q C- �?� [-Lj� 36. Hood or Canopy ` �� _ Z--��.�� ,�/��, _ r • � 37. Final Factory Fireplace 38. Final Plumbing � 39. Water Service-Final � , 40. Gas Service-Final 41. Solar pomestic•Final � , 42. BaGkflow Preventer 43. 8atkflow irrigation 44. Landscape Irriaation SYstem , 45. Sound Attenuation . 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING - �-- 49. Electric Reiease to Edison � 50. Gas Release to $outhern California Gas Cv �- 51. CERTIFICATE OF OCCUPANCY . No Date �� '7 ADOlieant to fill In all s0aces eacept those wit�in Iteavy Oortler Ilnes anC sign all a0V�o0rlate tllclaralions. CITY OF COSTA MESA C�O�1NST('b� U-sC'T)ION PERMIT /�7 ?ERMIT NO._ TRACT NO. LOT NO. UNIT NO. Project Address � O� w. �(//Y ST `� � Applicant'sMailingAddress ��7��l�yT`�'p��CIRiN��N. Owner'sName G7yU��tfi7IFHt5�Q Phone�jn`4-S3Z3 Address % 7 F�� • �''� ' ArchlEng. License No. Address Contractor'sNam �� Nt% �L�i .��NL��o Phone L� Addresy�meiling) 177$� /SKy�!%�Q� �Li�.r ��1)NT. f �i2�� City License No. �� S y LICEN$ED CONTRACTOR DECLARATION I bereDy a(firm thdl 1 am li[ensetl untler prOvi51on5 of Charte� 9(COmmen<in9 with section ]000) ot Division 3 O/ the Bu57nGis antl Protessions Cotle, antl my license is in (ull force antl eHect. �License Class �--' Lice se No.�3 � 7,L � Date6-(i- `��i Si9nature WORKERS' COMPENSATION DEClA0.AT10N — I heteby aHirm Ibal 1 Itave a c¢r[ilica[e O� consent [o self-insure o� d certifiGate " Workers' Compensation Insurance, or a cerilfietl copy tnareof (Section � )0, �ab. C.) � ..,licv rvo. n?7C []7"� ComPanv S"7%tii., F�/„1y17 ❑ Cer�i{ietl copY is hereby furnizhetl. �jd..Certjli¢tl capy isetil¢tl wi[h tbe city B�I�tling� I ion. �• Date �` - 1 Z' 8 i APPlicant � 1 .C.IM.t . EXEMpTION FROM WORKERS' COMPENSATION ECLAR TION (Thissg��ion neetl not be completed i� the permit is for one hunGretl (5300) or less�. I certify [hat in lhe p¢rfo�mance of Ihe wo�k for which Ihis perrti�t is i55u¢tl, 1 shall nol emploY any pe�5on in any Tanne� So as to become subj¢ct to the Workers' Compensatlon Lawz oi Califomia. Da[e Si9nature NOTICE: If, after making this tleclaration, you shoultl become suDje<t [o the Wo�kers' CO�nPensdtiOn provislon5 Of [he LabOr Cotle, y0u must torthwith mmply with such provisions or tnis permlt snall be tleemetl revoketl. CONS7RUCTION LENOfNG AGEMCY 1 hereby affirm that [here is a construction lentlin9 agency for tne performance oi thg work tor wbich [nis permit is iszuetl (Sec[ion 3097 Clv. CJ Lentler's Name l.entler•s Atlaress OWNER BUILDER DECLARATION I hereby aftirm lhat I am exampl trOm the Contrdctor's License Law for the following reason (Section 7031.5 Business anC Professional Cotle: Any city or counly whicn r¢quire5 a permlt lo ConStruC[, alter, ImprOve, tlemOlish Or repdir .any struclure, prior [o its issuance; also requires tne applicant for sucn permit to tile a Siqnetl Sta[eOlent that he/sbe i5 IicenSCtl pUrSuant to the plOvlsions Ot che COnlractor's License Law (Chapter 9(commencing with Sectlon 7000) of pivisi0n 3 0/ [ne Business antl Professions Cotle) or that he/sne is exempt -}ereirom an0 the basis for the alle9eU exemption. Any violatlon of Section �31.5 by any applicant for a permit subjects the applicant to a civil nalty ot not more than tive huntlred tlollars (5500). � �, as owne� of the p/o0e/fY ot my employeas with waget ds thBii Sol¢ comp@nzation, will Oo the work, antl the structure is not intentleC or otferea for sale (Section 7044, Business ana Protessionai Cotle: Tha Contractor•s Licenbe Law aoes not apply to an owner of a properly who builtls or improves there0n, antl who tloes such work himselt/hersell or through his or her own emplOy¢es, provitletl tnat suGh iTP�oveTents dre not intended or oftCretl for sale. Ii, nowever, the builtling or improvement iz soltl within one year of com- pletion, ttt¢ owne� will have the burtlen o( prOving ne/she tlitl not builtl O� im- prove tor the purpose o( sale). ❑ i, as owner oi the oroperty, am extlusively contractin9 wflh licensetl <on- tractors to construct tne o�oject (Section 7044, Business antl Protezzlons Cotle: The ConVactor's License Law tloes not apply ro an owner of pwperty who builtl5 or ImP/oves tM1ereon. dntl who contracts �or SUch o�oiects with d con- tractor(s� hcense pursuant to me ConVactor's Licensa Law). I am aware thai prooi o tneir Worker's Compensation insurance shoultl be provitleC to me. ❑ I am exempt untler Seclion B. & P. C. for this reason TVPE OF CONSTRUCTION LI NEW LI ADD IJ ALTERATION LJ, REPAI R ❑ CONVERSION � DEMOLISH � OTHER DESCRIPTIONOFWORK/USEOFBLDG. �T�L1SI�SII�IGLE TVPE OF PERMIT IJ GRADING LJ FOUNDATION •LJ STRUCTV RAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SQ. FT. � �-» OCCUPAN V_ CONSTRVCTIONTVPES'�-�.G�ta VALUATION$� ZONE GRA�ING CU. VDS. ACRES_ Remarks: Sink Preventer Irrigation iking Fountains >r Drains x Sinks Service Outlets Kitchen Sink Lavatorie5 P-Trap Roof Drains Reinspection Fee ! $15 Boiler � Duct-UnderGround Ouct - Structural Duct - Ventilating Exhaust System ❑ Multiple FirepVFact. Blt. iC80 dk � Date Owner Heating System & Ducting I ne�Qby certifY that I havG reatl this applicatlOn antl StatG Nat t�e abOve ❑a1�Q0008TU �1�0,��0 information is correct 1 agree to comply with all tlty anG county ortlinances antl s�ate lawz relating to builtling cons(ruction, and hereby autporize repre- sentatives of tbls tlty to eP lBB9��M1 4po the abOv¢-mentioned property (o� inspection OurpoSes. �y �� ^ fg �o� Signa�ure �" Date 7 ! •J Orivers' license or 5$ � �� "/� �� Reinspeetion Fee -''F, r¢v. 5/88 W�ite - Builtling; Canary - qpplicant: Pink - Accounting; GOItl0nro0 - A55e55or $15 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auro-Wash LaundryTra'ys � laue Fee Hood or Typel ❑ Canopy Type I I� J0. 1,OOOBTU ❑100,000 iystem Repair/Alteration Fire Dampers Re9isters laue Fee g 3 FEES $ 3 A.P. # S Main Buildi E T Front 6 Rear A C Right K - Left S Ping. ftef. # Planning NoteS: Automatic Washer ' Construction Pole Sub. - Cooking Unit Dishwasher Dry¢rs ❑Ga5 ❑Elettric Fan F.A.U. . Fixtures . . Device Boxes � OutIQtS Switches Garbag¢ Disposal Generator �0.5 KW 05-75 KW Zone Building: Feq./Provided ELECTRICAL , Transformer ❑ 15-50 KW ❑ 50+KW Meter Uup to 700 amps Meter ❑pver100am Sub Panel Motors -1 HP �1`/,-$ In olar �9-15 HP �7645+ Pole Sign Standing Sections Trash Compactor 0 FEES N I N G R E Q M T S. � Reinspection Fee �$15 � I luue Fee ' $ 3 I DEVELOPMENT SERVICES REQUIREMENTS: Zaning APProved By , Date Building Approved By Date _ Application Issued By �_�_Datfl ��I� �8�,.(.� _ $�l1Mry[�p�Fgy� _�� FEES ��T $ —�_ SMIP ' $ . PLAN CHECK $ PERMIT i PLUMBING . $ �� SSUANCE $ PLAN CHECK 25% $ ENERGY P.C. $ ELECTRICAL $ GRADING $ PLqNCHECK 50%� $ MICROFILM $ '� MECHANICAL $ TOTAL FEE $ ��• PLqN CHECK 25% $ 01 4000';,�33-�G03`v239 Ti ��' -'. J t DaTE: n�li3: :S T1.�IF: thijU • • �i :, CONSTRUCTION AND PLANNING ' P�� PA I � APPROVALS Permit # Date Inspector qPPROVALS Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location . 2. Soil Pipe-Undrgmd. • � 53. Steel Reinforcement � Y � 3. Electrical Cond'uit Utility-Undrgrnd. � 54. Forms � - 4. Electrical Conduit-Undfgrnd. _ 55. Electrical Bonding - � ' 5. Steel Reinforcement � . 56. Rough Plumbing & Pressure Test .• 6: Electrical UFER Gmd. .- 57. APPROVAL TO COVER-GUNITE . - 7. Footings .' • ' 58. Electrical Conduit-Undrgrnd. S. Foundation � . 59. Gas Pipe, O Undrgrnd., Test - 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap ' 63. Heater & Vent-Final • 13. �Roof Drains 64. Plumbing System - Final 1,4. Rough Plumbing . � 65. Electrical-Final 15. Rough Electriral-Condu�t - 66. Solar System-Final � F°7 16. Rough Electric Wiring ' . 67. Fencing & Access Approval �'17. Rough Wiring Sign _ 68. APPROVED FOR PLASTER�NG . 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19: Rough Heating & Air CAnditioning 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.StorageTank OGas ❑Oil . 25. Roof Sheathing � 74. Overhead Hydro � 26. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical . � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � , 78. FIRE PREV. FINAL � 30. Drywall Nailing � HEALTH pEPT. REQUIREMENT 31. Plaster Brown Coat � 79. FINAL INSPECTION 32. Electrical Power Meter-Final ' 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test � . 36. Hood or Canopy " � 37. Final Factory Fireplace .� . 38. Final Plumbing ' 39. Water Service-Final ' � • '', � 40. Gas Service-Final , � � i 41. Solar pomesticFinal � ' , �� 42. Backflow Preventer � � � 43. 8ackflow Irrigation � - � 44. Landscape Irriqation System ' � 45. Sound Attenuation � � 46. Handicap Regulations � 47. FINALSTRUCTURE&�BUILDING , 6ZS Sc�1.� ' p/�. 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southem California Gas�Co � . 51. CERTIFICATE OF OCCUPANCY �1.. - No Date . � -- ' aem�oun: 60]. W 19TH ST ��"sruueivaawr+: TRIANGLE SQ JT VF.NTURE � �o� 33161-A CAMINO CAPISTRANO � SAN JUAN CAPISTRAN0,92675 / .na�. uuww.00nEss UNT/ • CITY O� COSTA MESA - BUILDING PERMIT PERMIT NO: E 074069 PLAN CHECK NO: N CONSTRUCTION TYPE: V-N SP PERMIT TYPE: ELE ANCHRECTOHENmNFFP: H, HENDY ASSOC. uc.r+o.: 19204 urcx.on�ors�oo�a: 2415 CAMPUS DR uHT: 110 IRVINE CA 92715 coNrn�cTarsxu�: B& B ELECTRIC ( 909 ) 780-4146 CONfPACi0fi4YNlM0 15181 VAN BUREN BL �ooxess RIVERSIDE CA ��, 514966 92504 uNT: 267 LICENSED COMNACTOPS �ECIAF�TION: I Mmby dlim uder peraly d prjury Net I em licenaed uMa prowbn d Cheqer 9 (cammandM wilh Seclion )000) d Oimion 9 W Me Budron xq P�deswn oA ud mY lioen�s u m IWI bres end aHetl. cmuc.No.:O 3 44 uc.cuss: C-10 ue.N .�%1q966 EXP: 09/95 om,: co�mm«: '� omm OWNEN BUI�DEP UECIAH�TION: I haeby tlfum uiEx pmely per"Wy thet I am aaanq Imm iM Caq�etlm liroiva lrw la Ne IOIbwM �aefm (Sedian )OJ1.5 &uiiafe uM Adeaana Gode: ��ry cty a mun�Y xfiidi nGui�p e W�Y �o wnsWd. aAar. impwe. damdsh, a rapai eny auucture. pnor b Ia aauarxn, e6o reyuiree ths appfiunt ta wch pamil to fJe e spneE �tmemeni thei M«eM . u IicemeE Wm�e�u to Ne pmv'au d tln Catlrmae liwiue law IGMps 9(�'munanmq wtlh Satlion'l000) d Oivcion 3 01 �M .' ��uainea erd Rdmenna Codal a iMt he w ehs b memq ihaehan eM the bmw la Ihe elbped memqbn. My videtion W SeUion/� ai s M an �� e o«ma uepas me.cN�m �o. ca w�v a m mn. wn r.. nune�.e ma.n IssooD. : �] I.moxmd�MAWa�Y«nn�OM�=xvhwepwnNw�aleaom0�.rri0dolhe'�vk.aMtM�wm�neMimmded� n uneree �« seb csxYcn )a.. e�ren,ena vmteaa"vn cuee: m. com�.aon Liwv.l.raoe. �a woN �o.n own« a wWeny W�10 b11be IX�IIP�y Ih8lBql. G!d Yl�q dCOo f W�I W Vll �i11Y1� R 11MG� Of �IIUY0�1 �1G IX�IM ONT MI�. Qf0I14ld I�Itl PIC�I� �wo.e�«n �.a oa �n�eed «one�a �«.de. n. ro..e�.. ine a�wro «mwa+m� e.da wunn �. r.a d o�d+o�. m. a��w�ae, �;u nw, m, w.a«� d v�'ro n. a.ne ab �,a dae «��.+i�, m. wme.. a.d.�. � �, u owner d tM pweM. em uCuervW mnirae�q weh fiuneed wntractm ro oonatrw tlro wNb (5aaion ra1. Busiroee uM. aw.mao coee: n» caureeon �.�n. ie., ro.. m wcN m.� o.,�er a aw�r •ro aaa. «:mo+o me.on .nd wro mnireeb lor vM peopa� wuh e mNretlar�a) 4anaW quswN to iM Caurwas l'xeme lewl. � I un uemq uMa Seclion: 6. 8 P.C.. tar N6 �aawn: Deta: �: I do MrabY ��h tlw 1 em ewere W rtl WrsiaM tln reV�ven+aas d CeOarie IbNh W SeMY CaEs Saqlun 25505. RSS�J. aM 255J0. eM iMt I a ury Mun buildirp ompeni will / wil nal (�r a+) �d to oomply wN �eid nma wdm eM IM �epWmm�nb br s0�llawmiuctionamoE�frelionhamNSlv�ue�i enepenwv0iqritl.WritlWelmMiutlionePW'dionuaaaemqinmthaa a�. Ums: /�Gd�: WOFKEN'S COMPENS�TIqI DECL�RATON: I MrWy Nfinn uMr prWy d payey a� d IM fa0owinp ErWetnm: � �n..�.wwmeun.�.oww�weaw.rvio..nJn...w.�vek«.�ov�wweion...a�r«Ma.aanarooam.�an« COG. la �M pMmnence M IM wark la wNrh Ne prmn b e�usd. ❑ in.�..mw�,i.:�wen.��o.��w�.�...o�.aw�ews.e�a�aodm.�.eaeoe..i«m.w�«m.�c.am. woni �« wniN w. v�a u u.�.e. Mr.�an• wm ia, :,w�erc. aril« .nd wetr �e« u.: c�« S'�ATE FUND EXPIRES v,r� rm�n. - 0 L/ 01 / 9 6 'Ww aaa�n new nar w mnplw.EYw o�i u ra w hwnnd eman Is�ool n.ImJ � I cMly Net in Ns O�omuMw d IAe wak la xliic� INt Du�d b htueA. I dieY nol amV�W �Y D>� In enY mennv p n lo Wcmw wDjep lo tM wM1r�' oompriWian Iex� d C�fdmie, tlu� ! I NaM becpns a�wf b �M waFon' 'Sn p i' n� M Sstlbn 3)00 d iM lebar Cab. l tluY 1 pfy W� Ycw pwuim�. Dms: �YP��: �/�—'1 �r W�minp: F�Yw ro ucun wort�ri mmpwwtlon covw�p� b,mWM, uH �IWI rb/�cf �n wrplqw ro crlMlrl pwoaltlp nrL �M� n�.. w ro o�. m.w�.e mo��,w awa.. lrioaaooi h.mwo m m. oo.� o� ce�.�wuon e+�+w u wo�e ro. i� 9�ctlan ]]O6 0l M� Ltlor COW. /nfwC Ne ��mry i Iw. CONSTtiUC110N LENDINO AOENCY: I hanEy elfirm ueq�e panetly d per'Fey �M IMn o e wnqfutlbn WMinp p�r�ey tar iM perlareme d iM xork br whiN ihe pmmi u ewed (Saaion ]081. Civ. CI. LENOER'S NAYE LENOEH'S ADOflESS: i n... � m�.�: n tMe�ip b dutlnp tautr ^wrw.n. ... _..., Ma tMt ihe ebaa iNon�Wion b cmw.l eWw �o oomON witA e0 �N' md odvaY wdmvpn n end Meetr/ vNvcs �WA�a�+d Ub �dy b mtls Wm IM aEo.a�mW iarE popmry FURMAN ^� !� � ._�,.�_.._.___ om.� (5151<6 WP) WMsBuldiq 8 Selap; 6reenAe: Cwry�ppFaa: Pink-Rewnu�: (iollwo�Iu�r PERM �10: E 074069 GOVT: N SUPP; N PURPOSE: AI,T JOB DESCRIPTION : 2NDS STORY 5294SF T,I. SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 / COMMENTS; " PLANNED PARENTHOOD", RE:#B73981 �r�*x��**�r**�*�r*******��**�x��*******�r*�**�****x�*�***��+��*x��**�**�**�x�****�** Z O N I N GS ERTEB�AUCIKRSE M E N T S ------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING --------- 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: 42921118 ZNE: REF NO: PLANNING NOTES> i ��**�*�**��*�*�*��*�***+�*+�*�*x**+�*��**��***+�*�*��*��r+��*�*��*�*��****�**�** D E �� 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 ZONZNG APPROVED BY ;� DATE: BUILDING APPROVED BY : i DATE: APPLICATION ISSUED BY: DATE:�� iEiElElEklEiE3EiFk1F�EfE1ElEiElEiElfiEfElE iEiEiEiEiElEaEiEiEiE lE1E LEGALIZATION:N F E E'; S U M.M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC` FIRE SMIP/RES GRADING PERMIT ' S9.85 - • ` • SOt � �" ' SMIP/NON-RES PLAN �:' � , � •� , . ISSUE FEE 15.'00 - ' BUILDING-DIV-> PERMIT ISSUE PLAN=CHECK., '� TO,TAL PAID DUE TOTALS----> 59.85 L5.00 , 0;00. �, 74.85 74.65 ,00 REVENUE DIVISION TOTALS--> COLLECTED: '' 74i.85 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC ' FIRE 'SMIP/TOT GRADING PLAN-CHECK 74.85 ' . � if 1E 1k 1E ff !E f(� 1E 1ElE fE If i! iE K iE k iE iE iE 1E iE ik fE iE iE if iE iE fE fE 1E �E iE 1E 1E 1F iE iE fE iE iE iE iE 1f 1E 1f IF iE IE if IE i! IE 1E f! %1E k jE iE IF 1F 1E iE IE 9E 1E 1E if iE iE iE iE 1E iE jF iE 1E I N D I V I D U A L�. F E E�' .B,rR E A K D O W N TYPE QTY D E S C R I P T I O-N'i �� •+ UNIT COST TOTAL COST ELE 20 FIXTURES, LIGHTING " 1' ST '20 �'', EA. . 75 15.00 ELE 12 FIXTURES, LIGHTING �ADDITIONA•L' EA. .45 5.40 ELE 20 RECEPT/OUTLET , 1„ST 20- y,• EA. .75 15.00 ELE 20 RECEPT/OUTLET ADDITIONAL EA. ,45 9.00 ELE 20 RECEPT/SWITCH liST 2,0 '�; , EA. .75 15.00 ELE 1 RECEPT/SWITCH ADDITIONAT� �• EA. .45 .45 END 'OF FEES , ; ,y, Of �0339ti74-G0179674 T �eT � uA7c G�/Od/9� rI�EE= 14:42 74.85 f cONSTRUCTION AND PLANNWG ` APPROVALS Permit # 1. Temporary Electrical $ervice or p6le 2. Soi� Pipe-Undrgrnd. '' • -' 3. Electrical Conduit Utility�Undrg�nil. 4. Electrical ConduiPUndrgmd. 5. Steel Reinforcement 6. Electrical UFER Grnd. 7. Footinqs S. Foundation 9. Water Pipe�Undrgrnd. 10. Structural Floor SYstem ' - • 11. Property Sewer Line & House Connection 12. Sewer Cap 13. Roof Drains 74. Rough Plumbing 15. Rough Electrical-Conduit 16. ftough Electric 1Miring . 77. Rough Wiring Sign 78. Rough Eiectrical-T Bar Ceiling 19. Rough Hea[ing & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe�Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T�Bar CeiJing (Structurai) & Monocoat 27. Frame and Ffashing 28. Iathing & Siding 29. Insulation 30. Drywall Nailing 31. Plaster Brown Coat 32. Electrical Power Meter-Final 33. Finat Electric � 34. �Fina1 Heating & Air Conditioning 35. Fi�al Gas Pipe•Test � 36. Hood or Canopy 37. Finai Factory Fireplace 38. Final Plumbing 39. Water Service�Fina� 40. Gas Service-Final 41. Solar pomescic•Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cc Date Date � rv�� o� � I Inspector qppROVALS Permit # � 52. Pool & Equipment Location � 53. Steal Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNtTE 58. Electrical Conduit�Undrgrnd. 59. Gas Pipe, O Undrgrnd., 7est 60. Backwash Lines, P•Trap, � U�drgrnd. 67. APPROVAL TO DECK �l ' 62. Backwash & Receptor•Final 63. Heater & Vent�Final 64. Plumbing System � Final 65. Electrical�Final 66. Solar System�Final 67. Fencing & Access Approval � 68. APPROVED FOR PLASTERING �(k� 69. POOL/SPA SYSTEMS F�NAL .� FIRE DEPT. REQUIREMENT . APPROVALS Permit # . 70. Underground Hydro 77. Product Piping O Gas O Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEP7. RE�UIREMENT � 79. FINAL INSPECTION Rf.�j.'OOD CERTIFICATE ISSUED , �E_-� Inspector City of Costa Meu ' Development Services Depariment Building Safety Division P. O. Box 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY No.��`�� The Building located at 6p1 r.ig�.. i q�r��q�,-.,0t� E`nit jti has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of Building I�ntal (1ffi�a Legal Description 42A-211-17. _ __ __ (See reveru side tor Metes and Bounds) Building Permit No.ndFK�� Electrical Permit No. Mechanical Permit No. J Number of apartments ISSUED TO: Trian�lc Cn�iara T�in* V�n 33161 Camino Capistrano (#A) can .Tnan f'an+a+rann� ra �j2675 lumbing Permit No and/or guest rooms _ BuildingOfficial T.+n.. r�n.. n.,�� / �/.�-/ i �• • f L�f�i by . Date AurJuRt 1 7. 1 q9(1 This CertifiGate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed excep[ by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 3015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File / Pfl0.1kC�f 1100RESS: Fj O 1 W 1� TI{ ST ' '�, � .�uNi7: � aWxEPsxaMi: TRIANGI�E SQUARE JOINT VEN ' ��-,RDOBESS: '331(1 �AMINU CAPISTRANO , � � ` �#A,' �SAN JUAN CAPISTRANO � _ , ' - .� ' 240-1382 � - � ' ' ��RCN/ENGINEER: NODIA ASSOC ' � � ,.. eea.xo.:C1.1588 . nooxess: ��901 CAMIDtU DE EiTREI,LA uxrc: CAPIS'tRAD10 BEACH` CA � 92624 PEflMITfEE:L.A. COUTITY LAND CCl' (�14)240-1:582 aooeess: 331f,1 CAMINO CAP]:STRADIG A SAN JUAI� CAPISTRANO CA 32G75 IICENSED CONiMCTOB DECUMTION: I hereEy atlirm tAat I am licensetl un0er provisions oi Chapter 9(commencinp with Section 7000) bi Division 3 of the Business antl� Prolessions CaOe, an0 my license is'in lull lorce and effett. cirr uc.: 0 4 R A 7 7 sTnre uc.: 2 5 3 2 0 0 uss: H- Date: —�— Sipnai .o'� �• � . WONNENS' COMPENSpTION OECUIUTIO : I �ereDy aflirm tAat I have a certificate ol consent �o seli-insure or a certificate ai Workers' Compensatiun Insuranc or a certifie coD Ihereoi (Secfion 3800. Lab. C). roucrHo.:�Yfl�-?z7�196�-1� EXP.DRTE: ISJOi /9O. . coMrnxv: i'REMONT ❑ CertifieO coDY is hereby fumisheU. � CenifieE copY Is filetl wilA tAe ciry BuilEi p Division. � . 7 p % � � Date:3 ��— ` � .. I ApPliwnt ' . . �r— IXEMPf10N FlIOM WOflI(EIIS' COMPEXSITIOX OECW W OTI N: (IhiS Sectian nee0 no� 6e mmDleteO il Ihe permit is br orre hunEroE �f700) or less�. I certity that in the De�armance oi t�e woM lar w�icA Ihis permit is iuue0, I s�all nol employ any person in any manner so az m Decome suEject ro t�e Workers Compensation Laws ai Calitomia.' . . Oate: � - �Siqnature: - NOTICE: tl, atter maldnp tAis aeclaation, yau sAoulO Eicame su61e� �o Ihe Workers' Compensation D�ahsions of the Labar Code, you must tonhwitA comply wit� such provisions or ihis permit,shall be tleemed ravoked. ' � CONSTBUCTION IENUINO �GENCY: I here�y amrm t�at t�ere is a construclion Ien0in0 a0ency lor t�e peRormance of Ne wark tar whicn this permitis issued (Section 3097, Civ. C). . . � LENOEfl: , . ' . . ' �OOBE38: ' ' , . . _. . . . _ i OWNEB BOIIDEP OECLARATION: I here�y atlirm Rwt I am exempt fmm the Contactors State License Law for t�e lollovnnq reason (Section 7031.5 Business anU:Pratessional CoEe: My dry oi wunry which repuires a permit to canslruct, alter, impmve, Oemolish, or repair any structure, O�or io its issuance, also requires ��e apP�� or such De�mit to file a sipne0 statement t�at he/she is licensetl pursuant ro ��e pmHsions a1 t�e Con[ractors',State Licenu Law (C�apter 9(commencinp wit� Section 7000) al Division 3 oi [he Business' anE Pmfessians CaUe) or ihat Ae/she is exempt therefrom anU the basis /ar IAa alle0ed exemption. My Nolation at Sedion 7031.5 by any applicant for a permit suGlects tAe aDPlicant to a ciNl penalry of not mara tAan Me hunOred Eollars (5500�. �' ,, I, az. owner of t�e pmDeM ,or my employees vnih wages as �t�eir wle camDensation, vrill Uo the work. and tha ❑ structure is nat intendetl or ottere0 for sale (Secllon 70Cd, Business an0 Pmfessional Coae: The Cantacrors' SW[e licensa Law dces not appry ro an owner of a D�opeM w�o huiltls or Improves I�ereon, an0 wAo Eoes such work �imsel�/herself or Ihmup� " his or her own emDloyees, OmviEeE IAat such improvemenis are not int¢nOed or otter¢0 for sale. 11, hawever Ne builEinO or impmvement is sold vnthin one year af completion, the owner vrill have Ihe burden of provinp Ae/5Ae Oi0 not �ui10 or imprave for t�e purpase oi sale�. . ' - . � � . . 1, as owner of t�e pro0erty, am exclusively contrectinp with Iicense0 con[racrors �o constiuct the prolect (Section 7047, Business ❑. and Professions CaOe: The Coniraclors' State License Law does not aDUy ro an owner ot Droperry who buAtls ar imOmves ihereon I an0 who conirac[s for such projects wit� a con[ractor�s) license Dursuant ta [ha Coniractors' State License Law). I am awara that proof at their Workar's ComDensation insurance shoulE Ee providetl to me. ' � I am exempt un0er Sec[ion: B. E P. C. for this reasan: � Date: Owner: � ' � I tlo hereDy certiy ihat I am aware oi anU unders�anA IAa requiremenis of Califomia Health anU Safety CoUe Sections 25505, 25533, and' 25534 anA that I or,any tuture buildinp occupant will/will not (circle ane) neetl to comDly wit� saitl state wGas anE the requiaments for a permit for cons[ruciion or modification imm Ihe Air �ualiry ManaAement Olstrict. Re5i0¢ntial consimction aODlications are exempt trom these provisions. . ' Date: � � tipPlicant: • � i 1 hereby certity [hat I have reaA tAis apDlication and state that tha above information is correct I apree ro compty witA all ciry anA caunry ordinances anA state laws 2latinA �o huilding constmction and �ere0y autAonze re0resenGtives of this ciry lo ente on t�e above�menipnad pmpetly for in50ection purpa5es. ' � � oate: _�-2�L'"�'0 '� $'ipnaWr./'� - ��."� ' ' Driver's License or Sociai Secunry x: � � W�i1e—Builtlingj Gmen—Cotle Enlorcement; Cenary—Applicenf Pink—Ravenue; Goltlanrotl—Assessor CITY OF COSTI�' ME5A -+DUII,DING P�RMIT PERM NO: A 046�622 - t , • PEFtMIT, NG: B 046622 N�,; ,' PLAN CHECK_,NO: 07259-90 A GOVT;' DI SUPV: D! ; CONSTRUCTION TYPfi: V=�f� '� , PERMTT TYFE: ESTR� • � • ,YURPOS�; AI,T JOH DESCRIFTION : 19175E DF.NTAL 0I'FSCE "P.2'. ` SQ 1'T:' 1;917 CLAIM VALUE: �0,000.00 CALC-,VALUE:': '14,652.62 GROUP OCC: B-2= /, , `�. •' . COMMEDITS: � ' • � . ****�r**��*�*****��**�i�****��c*+t**�-a�******�-�tat�*�r�x-*r*�t�r�e**� �*�*x�**�-ir***+��tx�*it�r*��**�x�.��t ' Z O N�I N:G, R E Q U I,R E` M E N T S �� , S, F. T B A C.. K S ' .. , .. I-------'------ MAIDI� BUZLDING ---------- � --------:-- ACCESSORY,BUII�DING --------:- FRNT: FT IN P.EAR; F'P IN FRNT: b'T IN RF.AR: FT IN LEPT: F,T � IN RGHT: PT IN , LEFT: • FT IN RGiIT:, 'FT IN PARKING REQ: HROV: ' PARCF.L: 42421111 ZNE: C.1 RF'P NO: �.' , PLANNIDJG NOTES> INTERIOR ALTERATION FOR A DENTIS'P. , . . > ' �- . . . . _ . � . . . . . . iE �t iE iE iE �E �IE 3E jf iE �)F iF �1f �lE �1f �lE it # jF iE-0E 3E iE 3E iE IE 1F it iE iE iE jF i( iE iF iE iE i(� iE 3f i! iE jE K-.1F�lE it ik if iE if fE 1f �1(-iE%iE%if if iE i! it iE i! iE 7t !( �it iE.iE iElE iF iF iF IE.if iE ; D ti V E L O'F�:M E N-•T S E R V I C E S R F. Q U I R E M E N�T�S Z.ONING. APPROVF.D BY `�r. :_ ___ �Y,��-_ ' DATLe � .=-L� �y $[JILDING APPROVED BY i : -s•` -- DP.TE: . - . z. �j APPLICATSON ISSUEU BY: �: � U'yS�� DATE; '=�Z.:� �i�F� �c-�c-*ar�ie�t�x�it****at*�tx�*x�*�*3F�'iFiF7b7F'�FTFiF�iFiFiF' i6'�FiFfFi��"iF3�F�r•��r***�[x��x � )F '�* iE��1F�Eif3E�1hIf3E3EiE#IF3Eif3FifiEiE�1(-3E3(�iF�lEiFitiEiElEiEiEihif##if1E iE�lE3E�lEiFif3FiFiEj(-iE1FiEiEakifiE�iliF�lEiEi@iEkiEiFlfiEifMiEiflf3EihifiFik9EiEit LEGALIZATTON:N • F E G S U M M A'R Y. " �STRUCTURAI, SEGMENT:Y ` BLDG PMT �PLUMBING 'ELECTRIC �MECHANIC FZRE SMIPLRF•.S" � GRADING PERMIT� �. 252,00... ' .. . - . . �, , • SMIP/NOTI-RES'; . PLAN 40.95 ' .. , . 3.70 ' "ISSUE FEE . -' � '�.; ' BIJILDING-DI.V--> PERMIT ISSUF. PLAN-CH�CK � TOTAL PAID ' ..DUF. TOTI�LS----> 255.70 � 0.00 �. 40.95 296.65 296.65 , '.00 , . -� . , : RI:VED]UE DIVISION TOTAI.S--> ' COL'L'ECTED: 296,65' OVBR/SbIOR'T: .00 ' BLDG PMT PLUMBING &LECTRSC-MECHANIC F'IRfi SMIP/TOT GRAD.ING P.LAN-CIiECK . 252.00 , ' 3.70 � 40.95 �1f �lE iE 3E iF i(� 3E �1f� iE if k'9E 9f iF iF i(� if if Y�1E 3t�iF 3E i(-iE 9E iE # iF if 3f iE �)E iF iE'ik i4 If iE iF iE iE iF iE iF 1E 1E i6 if �k �1E iF �)t if if �lE �k� if iE iF #�1f 3E i(� �h if i(�-0F if it iE iE �1f-1E'if 7F i6 if �1E i • I N D S. V I' D U A I�`r F E� B R E A K D O W N. ' � `Z : ; _ .fi � . . . 'PYPE QTY , T1 E S; C,R I P T I.O�N ' UNIT CnST � TQ'PAI, COST , � � SFC, 197"7 MED-7NT: AI:TER TYP��a'V-N -AVER • 1?.86 •'� 24,652.62 . ' . , .. END 'OF' FEliS ' .� . i . . . �.'� , , � � t • � . � � ' , ' . �J SEc. 33os, c'xc: s '' :a''. � : ; . . ' _ . . � ... , `�' � , i � ' . . . • . i , C�i . , � � ; � �� . � i , � . � Di OOQ56b93-00056695 'rrj� 29&.ti5 DA7f: D3/22/9D TI►IE: it�:34 - - a e Q 0 C CONSTRUGTION AND PLANNING . � � ' . POOI & yNA � . � r�, APPROVALS Permit # - Date Inspector qppROVALS Permit # Date Inspector. � 1�- Temporary Electrical Service or Pole , �� 52. Pool & Equipment Location " 2. ,Soil Pipe-Undrgmd. �- � � �� 53. Steel Reinforcement , � � ,3r Electrical Conduit Utility-Undrgmd: -- � � 1 � ` 54. �Forms � A Electrical Conduit-Undrgrnd. �. � - . 55. Electrical Bonding , n � �5: _Steel Reinforcement . "- � ' 56. Rough P.lumbing & Pressure Test �6.;ElectricalUFERGrnd. � . 57. APPROVALTOCOVER-GUNITE '�7,.-Footings - - � � � �� 58. Electrical Conduit-Undrgrnd. � "'$:.Foundation ,- _�, ' ,, ' �� 59. Gas Pipe, a Undrgrnd., Test � �9^.Water Pipe-Undrgmd. '�, „�, , 60. Backwash Lines, P-Trap, O Undrgmd. �� 1.O�Structural�FloorSvstem '� � - , � � 61. APPROVAL�TQDECK � 11 `Property Sewer Cine & House�Connection � i 62.' Backwash & Receptor-Final ,`j � / 12. Sewer Cap - . - ' � 63.. Heater & Vent-Final � � � „ 13. Roof Drains. . •� . � 64., Plumbing System - Final ' 14. Rough Plumbing - , i� � , 65. Electrical�Final . 75. Rough Electrical-Conduit� . � 66. Solar System-Final � � 16. Rough Electric Wiring - ' 67. Fencing & Access ApProval � 17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling ' . � 69. POOL/SPA SYSTEMS FINAL - 1g_ Rough Heati�g & Air Conditio�ing- , � �_ , , FIRE DEPT. REQUfREMENT 20-�Rough Factory Fireplace ��- �� - i: . � . APPROVALS:.;�Permit# � 21: Ducts, in Structure - - � -- �70. Underground Hydro 22._Ducts, Ventilating , - -. t71. Product Piping O Gas ❑ Oil i � 23. Gas Pipe_Rough & Test _ _ ,� 72. Underground Flush � � - - ry, 24. Roof Framing " ' .- ' � , :73.- Undergrnd.StorageTank OGas OOiI 25. Roof SReathing �� ; � - 74� Overhead Hydro �. ,- �'? 26�,T�Bar Ceilin9 (Structural� &�Monocoat - , ,x ' 75. Dry Chemical • � . - �"' 27.: Frameand Flashing �• 76. Dry�Standpipe �' si: ''28. La�ing & Siding : - � ' " �• �.; ,� 77�� FIXED SYSTEM PINAL - -�� 29. In�lation - 78%-FIRE PREV. FINAL , �; �� 30. Drywall.Nailing � �� _ - HEALTH DEPT. REQUfREMENT ' 31. Plaster Brown Coat c �'- �'79. FINAL INSPECTION �.�32.�Electrical Power Meter'-Final ' �' �80 _`FO00 CERTIFICATE ISSUED _ ,33.'.Final Electric [: _ _� . � _�- ' NoteS: 53 �: - 1 34._Final Heating & Air Conditioning _ � . � � - 35. FinalGasPipe-Test: - • � �� :� ��• � _ " - � * 7 _36._Hood or Canopy � _ , � , - � _. -37.JFinal FaMory Fireplace �- �� - . , _38= ;Final Plumbing ' '� , -� � _ ' x. - " ' 39.'Wa(er Service-Finah -- - . +� . � . � ' ":40. Gas Service-Final ': ' � '� � � � ' - . . ;41,`Solar pomesticFinal - � .. - . � . . . 42, Backflow Preventer; ', � '. „ ..,, ' � ` ,- _ 43. Backflow Irrigation - - . � _ � � "'44, Landscape Irrigatio,n System�r . � ' ' ' . ,` `_ . . .. . r- 45,--Sound Attenuation •• .• . �; � � � , • -•�.' , � �46, Handicap Regulations -_ � ; _, � '«•j � '_ �- � � � �47,��FINALSTRUCTURE&BUILDING �' � �� - 48,_ FINAL PLANNING � ' ' � � - _ . ��49,.�Electric Release to Edison . � ;r,; �- � � .+, .. 50, Gas;Release to Southem California Gas Co ` '� ] " ' _ ' - ' 51, CERTIFICATEOFOCCUPANCY � � ' No Oate PflNECT AODRESS: E � 1 W 19 TH 5 T , awxex•sxeMe: TI2ZAMGLE SQUARE JOIN7 .VEDI . aonness: 33161 CAM'.INO CI�PISTRANO , ItA, SAN JUADL CAPISTRANp UNR: A 240-1307 ' ' xec.xo.:Cl'1588 �flLH/ENGINEEP: [�]ONA Fi$$�C noonEss: 2690] CI�MIDlO DE ESTRELI,A �N�T� ' C1:FISTRANO BEACH CA 926?.4 e�pMrrt�E: FROGRESSTVE DESIGNED PLMG (213)437-8366 anoeess: 1542 SEAARIGHT AV • LONG II6ACH CA 90813 IIJCENSEO CON�MCTON OECIAMTION: I Aire6y aKirm that I am Iicense0 unUer pmvisions af ChaD�e� 9(commencinp wl�h Section 7pp0) ol DNision 3 of tAe Business anU Professions Cotle, an0 rtry licertu is�in tull torce arq ellect. I cm' uc.: p 4 9 5 4 5 sptere uc.: 3 3 4 7 9 9 D n cu�3_ 6� oate: �-� 3 ^6 O Sipnature: �G� t. WpAKfPS' COMPENyS�AT,I9N OECUP0.TI6X: I Ire�eOy aflirm tnat V have a iehitiwte of consent to 5Hi-insu�e or a certificate ot Wwkers ComPenuuon �¢SW W l. q� �cRrt�led Copy tGe�ol (Secuan 3800, Lab. L�� / O 1/ 9 0 pppCY NO.: -� •� V b V/ 1 U U ll 1 E7(p, p�7E: 1 carnraxr: NATIONWIDE ❑ CertiileA capy is �ereby lumishetl. � Cetlified copy is eO h the ciry Buil0in0 0'slon. � bare:3 - .Z 3 „"O U ppPlican�: i �..--r�^�'- • .' � 6 � IXEMVf10N FBOM VIOflIIEi13' COMPENSI�TION OECIAMTION: (iA¢ sectlon neeE not Oo compkte0 il tAe pemut is la ane AurNreO (E10� m less�. I cehiy tAai In tAe pedormance ol Ne work for which this De�it is issue ,� shall not employ any person in any manner so as ro become sublect to the Workers Compensation Laws oi Calitomia. 0 � � -� t�� NO710E: If, after malang tAis Oeclaration, you s�oultl beeome suEl� �o tAa Wo�kers CamDensaeion pmvisians af t�e Lahor COEe, you must btlhvnN comDM �th such D�oMsrons or Ihis permit sAall he deeme0 revokea' CON3iNUtTION 1EN01NU �GENCY: I Aer¢Oy allirm ihat I�era is a constructian lentlinq a0ency for the peAormance of the work for w�ic� t�is permii is issuetl �Seciion 3097. Gv. C). � � , . � j • � IENOER: � ' ' • ( I aooxess: - . pWNEN BUIIDEP OECUMTION: I Aerehy aMirm ihat I am exempt trom tAe Contracrors Stata Liurae law far t�e follawinp reason (SeL!ion 7IXi1.5 Business xnE Professional CaOe: Fny ciry ol counry which aQuias a permit to consiruc6 alter, imDmve, Eemolish, or rep9�r any structure, Onor ro its Issuance, also repuires the applicant tar such permii ro file a sipne0 statement Ihat he/she Is IicenSeO pur5uant to t�e provitions al iha Con[racrors' State License Law (Chapler 9(commencing witA Section 7000) at Division 3 oi tha Business an0 Pmfessio� Catle) or Ihat twls�a is eaempt t�erelmm anC Ihe Uazis Por the a0e9� exemptian. My dolatbn ol Section 7031.5 Ey any aPN�t far a permit subjects t�e applicant to a civil penalry at imt more tAan five nunOred dollars (`�. � I, as owner of ihe pra0erry ar my empIOYees �wit� waAas az IAelr sole compensatian, will Eo tha work,.an0 tAa ❑ stmcture is not intentletl or oflereU for sale (Sectlon 704C, Business antl Prolessional CoOe: .The Contractors' SW[e License Law tlas not apDN to an mmei oi a p�openy wlro Uuittls o� lmDro'+� �Rereon. antl who does such wwk �imsetllhersell a throuyh ks or �er own em0�'�s, Drovided tAat sucA improvemenis are no� inten0etl or otlere0 lor sale. il Irowever t�e Duildinp or imprmemem is SOIC wit�in one year ol wmpletion, the owner will hava Ne �uNen ol proving �e/stie tli0 nat huild ar improve for t�e purpose al ule�. • . i 1, as owner ai ihe D�ope�1y, am exclusively contractin9 wltA IlcenseE conhactors ro constmcl tAe Droject (Section 76W, Business ❑ an0 Professians Cade: The Contractors' State Licensa Law Aoes not apply Io an m�+�er ot DmpeM w�o bmltls or improves Nereon dIIE WIIO fAll[fdCtS i0f SUGI pf0�2L15 W1ih i COfRfdtlO!(5) IILEf15¢ p1115W�110 111C �A�113L1015 Stata �rcenu Law). 1 am awara tlut Drool oi Neir Worker'S Compensatlon insu2nce sMuIE 6e proviEeE to me. , � I am exem0� unGer Seciion: B. 8 P. C. ' , ' �or t�is reason: . bate�. Qwner. ' I Oa �eaEy cerciry tnat I am awaa oi anC unaerstana tlre repuiremenis of Calilornu Healtn anA Safery CoCe Sections 25505, 25533, an0 25534 an0 that I or any luture GuilGinp xcupant wilVwill not (circle one) neatl to wmDly wit� ui0 state co0es anG the repuirements for a p¢rmit lor ConstNcibn or motlification imm I�e Air uatiry Manapement Disidq. ReSiEential consiNttian appliCations are exempi Irom IheSe provi5ion5. . ' . Da�E: ' Appliwnt I hereEy certiy Ihal l have rea0 t�a apPliwtlon and state lhat I�e a�ove inlormatlon is co�act I apree ro camDly wit� all ciry anE counry or0inances aiN state laws alatlnq to huilCinO ��N�n and here0y auttwrize repreunWtNes ol Ih¢ dry to ¢nier upon tM a6wrmentloneU pmpeM �or inspection purposes. • /�� '� Date'. { � �..3 " r%(i Sionaw�e�, r � ��+�'��C:fic._.J • , . omrer's License ar Sociai Secutlry x: W�Ite--BuilOinc; Grean-Cotle Enlorcame�C Cenary-Applicent; Plnk-Ravenue; GolOenroE-Assaswr � � CITY OF COSTA'tdESA -'BUILDING PERMIT . , PERMI9' NO: P 046655 . FLAN CHECK D10: � N CONSTRUCTION TYPE: V-N ' PERMIT TYPE: PLO JOB DGSCRIPTION : 7917SF DENTAL OFFICE'T.T. CLAIM•VALUE: CALC-VALUL: ' PERM NOe P 0'46656' GOVT: N SUPP: N PURPOSE : O'Cii S,Q FT: GRUUP OCC: D-2 / COMMENTS: RE: II46622 PRIMARY DLDG. PERMIT'. � +t*�***�r*�rx�*�**+t***�*��a��r*�**�r�*�r*�**+�*****�r*��x+��*+�**�*��+��i**�x�*+t*��i�*�**** Z O N I N G. R E Q U'I`R E M E N T 5 S E T B A C K S � ------'----- MATAI BUILPIDIG ------.---�- ---------- ACCESSORY BUII,I�IDIG -�-------- FRNT: FT SN REAR: FT IN FRNT: FT , I,N It�AR: ' FT � IDl iEFT: F7' IN RGHT: FT IN LF_FT: FT IN RGFIT; FT' 'IN- PARKING RE(�: PROt�: PARCEI,: 42421111 ZNE: REF MO: PLANNING NOTES> ' ' , � . � ��*at***��t��**x�*��*��at�c�*itit�***��+�itx-*.****it�e�*xx*�*x**�**�eit��+�atat�*�**x�*�-�xk �x�* U E V E 1, O F M E N T S E R V-I� C E S•'� R E Q U I R E M E N T 5 ; .^;r 7.ODIING APPROVL•:D HY ! _ _ ___^ DATE: __ _ BUILDING APPROVLD I3Y :_ � _ -��f'� _ " DATG: APPLICATTON ISSUED HY: �� F�ti7. DATE: �� 3 ��j iE iE it if iE iE'iE 3E iF 3f if if if IE �1(� it it if %if iE ielF'�iE��it f FiF�iF# �iFiF'i�Fib k if iE it iP it iE it �fE li iE'i� � iEiEiFlflfiEMlflEiFifiEiE�ElfiEiffEiE3FiEiffEft%ifiEiEiEiEif7EiFiEififiFikifl(�iEi6 . fEiEikklfiFiEifkfFiEiElEiEi6i4iE9Eif#1EitiEiEki(�lEiEiEiFaE#7EKiE LEGALIZATIODI:N � F'E E, S'U M M A R Y STRUCTURAL SFGMENT:DI� • � BLUG PMT PLUMBING EL6CT,RIC MECI�ANIC FiRE SM•IP/REi Git�1DING PERMIT � � 50.00 :-� • ' . , - �258. � SM:IP/D10N-RES, � ' pLAn� . �; • , ISSUE FEE 3.00 •'' � ' BUILDING-DIV-> PERMIT ISSUE PliAN-CHECK TOTAL FAID llUF. 'fOTALS----? 50.00 . �ri.UO ;�,; 0.00 SJ.00 + 5'3.00 .00 ' - . ' . . 'i . . , .. -RE.VGDIUE DIVISION 1'OTALS--> COLLEC•TEDe 53.00 OVER/SHORT: � .00 • BLLG L�MT FLUMBING EL�CTRIC MECHADIIC FIRE SMIP/TOT GRADING PLADI-CHECK , ' �Jc).:�Q . ' - ' . ' _ , , ' iEiffEkitit�ltiEififiEiE�1E�1k1EiE�lfiEiEkiE#1E%iEifkitiEiEiEiFikiFikiF�lEiE1EiFlkitiEifiElEiEiEitiklfiEjfi4ikikiEiEiF%ifiEiEjElfiFiEiflklEiEiElFiEikik3fiEiF . I �l D I V I D U A I� � F G E B R E A K D O W N • TYPF' (�'J'Y D E S C R T P T I O N UNIT COST TUTAL COS1' ' � ' •� PLU ' • 13 �WASH BASIN ' �=. ,.., 2,00 26.00 ' PLO � 1 WATER HEATER ANU/OR'VENT 2.00 ,� 2.00 PLU. . 1. WA1'ER SERViCE 2.00 , � 2,OU , PI.0 , l. GAS L?IPING SYS OPc 1 1'O 4 OUTLETS 2.00 c.00 PLO • i3 FLOOR DRAINS ' 2.00 �76.00 PLU 1 SINHS, COMMERCIAL OR INDUSTRIAI, 2.00 2.00 , , END OF 'FEfiS O1000S68S�-OOOS68S4 TOT 53.0� DATE: 03/23/90 TIME: 13:01 - � ' • CONSTRUCTION AND PLANNING � ' POOL � ,rA qpVROVALS Permit#� �� .Date � Inspector Date Inspector _ �; � , APPROVALS � Permit # : ') • i. 7emporary Electrical Service or Pole _ �� -, � � 52. Pool & Equipment Location �� 2; �'aoil Pipe-Undrgrnd. � y, , _ k 53.=Steel Reinforcement ��' �3: Electrical Conduit Utility-Undrgind. � : . 54. Forms . �4. Electrical Conduit-Undrgrnd� ' � 55. Electrical Bonding � r5:, 5teel Reinforcement� -' - � • . 56. Rough Plumbing & Pressure Tett , �6" �lectricat UFER Grnd. '- ' 57. APPROVAL TO COVER�GUNITE _ � 7.� Footings , r � ,. 58. Electrical Conduit-Undrgrnd.. �'8:� Foundation �`' �,/ f ^. ��7 ,,,� : 59. Gas Pipe, O Undrgrnd., Test �-9�� Water Pipe;Undigrnd. ' � � /� 60. Backwash Lines, P-Trap, O Undrgrnd.. ' 10. Structural_Floor System .* � . � 67. APPROVAL TO DECK � 11,'property Sewer Line & House Connection -�� 62. Backwash & Receptor-Final � �2' SeWe� CaP ' � �.` " �� 63. Heater & Vent�Final � � r 13. Foof Oreins " � �� ' � � '� � �0� 64. Plumbing System - Final 74, qough Plumbing ' �'� 65. Electrical-Final 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wirinq 67. Fencing & Access-Approval 17, pough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19, pough Heating &�Air Conditioning � _ FIRE DEPT.�REQUIREMENT , 20.-.Rough:FactoryFireplace '' , � . . APPROVALS Permit# � - 21: �Ducts, iri Structure ' ' ' � ' � 70. Underground HYdro " 22. Ducts,Ventilatirig'. - .- � _ � •77, ProductPipingOGas ❑Oil 23. GasPipe�Rough & Test � �- 72. Underground Flush � 24. Roof Framing `, � " .. ' 73. Undergrnd. Storege.Tank O Gas ❑ Oil 25. Roof Sheathing .' ' 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat - 75. Dry Chemical -� � 27�. Frame and Flashing •. • . 76. Dry Standpipe � - '- '28. Lathing & Siding.. - . '-' ' � ' " , 77. FIXED SYSTEM�FINAL . - - 29. Insulation • 78.'FIRE PREV. FINAL � 30. �rywall�_Nailing ', _ "�'; ` HEALTH DEPT. REQUIREMENT` � 31. Plaster Brown Coat �� ' 79. FINAL INSPECTION � ' 32. E�ectrical Power Meter�Final �P';� � 80� F000 CERTIFICATE ISSUED � .,33rFinal Electric � � � � : Note • t�.$Q�(Q-� �('yqs 1y��'t'jQ, (,� 34. Final Heatirig &�Aii Conditioning� ' ' . ' �� T�� L�� _ 35: Final Gas Pipe�T.e'st �- Q,Q l.�,0. �� • ' �_ 36. Hood orCanopY ' - "_ � ' Fi�i� . ' - -�37:.Final Factory Fireplace � � �. ��- � - - .38. Finaf Pfumbinq ' - . � ' QD (� � - _ . 3g. Water Service-Final' . `� > � -. 40. Gas Service•Final = � ' � , � 41. So�ar pomestic-Firial- � - � - � 42. Backflow Preventer • � � ' ' - 43. Backflow Iriigation ' . � � � • � � • ' 44. Landscape Irriqation System � ' • - ` ' � � ' _ ' _ 45. Sound.Attenuation ." - � � _ �-� � � �46:•HandicapRegulations � . ��' -� � � ' 47. ftNAL STRUCTURE & BUILDING , : �� . 48.-�FINALPLANNING - -� � ` . �`J: 49. Electric Release to Edison '�,� - :' 50. Ga; Release to Southem California Gas Co ' ',%' ' 51. CERTIFICATEOFOCCUPANCY ' ' No. Date PflpJECTR00BESS: �OL W 19TH ST ' � uxir:A . owHen�sxnrne: TRIANGLE SQUARE SOINT VEN � �aoness: 33161 CAMINO CAPISTRANO . ' kA, SAN JUAN CAPIS'PRI�AlO 740-�1;382 ABCNIFNCINEEp: NODiA ASSOC � � � eca.rro.�: C 1 1 5 R 8 , aooxess: 26901 CAMINO DE ESTRELLA uxrt: � � CAPISTRANO HEACH CA 97.624 PENMITTEE: ATiVI�NCED AIR CONCEPTS ( 71'4 ) 380-8223 nuni�sa: 25108 MARGUERZTE PHWY B1II3 MISS.T.ON VZEJO CA 92692 UCENSED CON7MCfOR OEttAMT10N: I �eahy amrm that I am IicanseA un0er provisions ot C�aD�er 9(commencinp with Section . 70ryp) of Division 3 al tAe Business ana Protessions CoOe, an0 my Ikense is in lull lorn an0 ellect. citruc.: 050329 su�uc.:52.1204 cusa: C-20 • Daro: �_�� G 9pnamre: WONKEIIS' COMPENSRTION OEClAM710N: I �eaby aMrm that I luve a ceNfrcate oi consem ro setl-ursure or a certificate at WOMers' Compenution �swa�c� gr a�c¢r�ye� copy thereo� lSectron 3eo0. �zo. �17 / O 1/ 9 0 wuicrxn.: GOLDEN1EAGLE ��"°'��` ' COMP�NY: Q ceNree copy is nereoy mmisnea. C'}S fzniflee mpy is �dea wrcn tne riry euiieino Division. 41e: ••.. ••� � pPplicant: �� /"ii_�l�Y� IXEMPf10 FPOM WOqlFA3' COMPEXSITION O[SLAMTION: (Ilis sttvon me0 noi Ee romp�ete0 tl Ne pem�i ¢ ia ane hunOretl (f700) a less). I certity t�at in the Deharmance of t�e wark �or w�ic� t�is permit a iuueQ I stull not empby any Derson in any manner so ss to become supject la I�e Workers' CompensaGon Laws ol California. Dale: Siqrcaturt: ' NOTICE: If, afler maldnA �his Eedaratlon, you shoWE Eecoma SWjecl to t�e Workers' ComOenution prwisions ol I�e La�or COAe, you must lonhwit� compty wit� such prwisions or tlia perrtit 5ta0 Ue Eeemetl rewkeE. CONSTNULf10N 1EN01NG �CENCY: I �ereGy attirtn [�at tAere is a constmction IenAing aAe��Y �or tAe peAormance ol Ihe work for whic� this permit is iuuetl (Section 3097, Civ. C�. • IFNUFP: � . . �ooeesa: � • OWNEN BUILDEfl DECUMTION: I �ereCy aflirm that I am exempt from IM Cant2ctois' State License Law lor ttia lWlovnnp reamn (Section 7031.5 Business anG Profeuional CaUe: My ciry of counry w01c� reQWres e Dermit to consWq,�alter, imOmve, demolish, or mpalr any stmctum, prbr la Ifs L55uance. aLSo reQwes tAe apWkant fo} wC0 permil Io file a sipnetl sWtement that helshe is Ilcensed Dbrsuant m t�e provislons ol �he Convactors' State License Law (Ctupter 9(commenciip wit� Sectlon 7000) ol qvision 3 of Iha Business an0 Pmtessions CoGe) or Itwt ANshe is exempt Nealmm anG �he basis lar t�e allepeG enemptlon. My vioWtian ol Sectlon 7031.5 Dy any aODlicant lar a permit su0jects tM aDOrGnt to a uvil penalry of �rot moro t�an (ne AunEred Eollars (5500). a 1, u mmer ol tlu prvperry w Ry emy oyees x1N wapes u IheU sola comyensi0on,' wW Oo Ihe work, an0 Ihe sWCWm is not IntendeE ar oHareC lor sale (Section 70Ad, Buuness an0 Professional COCe: T�a Coniractors' State License Law Gces not aODW �a an owner of a D�operry wM huiWs or impmves t�emon, an0 who Uoes suc� work �imSelVAarsell or iMouO� his or her own emDloyees, proviEeE Itwt suU imDrovements ara no� IntenOed or oflere0 tor sate. If, �owever Iha Euil0in0 ar imprmement Is so1E vni�in one year ol mmpletion. IM owner will Aave I�e Ourden ol Drovin0 twJs�e Oid nat OuiIG or improve lor Ine Ourpasa ol sale). , �- . I, as awner ol ihe D�aOerry. �m axclusiveIy contractinp wit� Gcensed contnctors ro wnstmct t�a Dmlect (Section 70CC, Business I d an0 Prolessions Catle: The Contractors' State License Law does not aODN �a an owner o1 properry xTo Em1As or Imprwas t�ereon anA wno contracis lar sucn D�ojects wttA a caniroctor(s) liceiue pursuant m tM Contncmri State Ucanse Law). I am aware tAat proof ol tneir workar'a CampertaUon insurance SIroNE �e 0«� ro me. � I am exempt unEer SeCtbn: B, 8 P. C. lor InLS red5on: Data: Owner. � tlo hereby unity that I am aware of antl unUerstanE IM mQuirements ol Califamia Mwlth anE Sal¢ry Catle Sections 25505, 25533. antl 25537 and that I or any fuWre huJLinp occupant wiNvntl rrot (tirde aie) need �o comDN w+�� sule cotles an0 tne raQu(rements (or a permit lar construction or motlilication hom the Air Uualiry Manapemem OislncL flesi0ential construction appliuGons are exempt Irom �AeSe prOvi5iaR5. . • ' �d10: ApDIIGdOi: I here0y ceniry Itwt I iwve rea� tNs aOPtication aM state tAat t�e above informaGon is cortect. I aprea ro wmply wiih all city antl counry OrOinances antl state laws relatinq to huBEinp crostructian a�M Icerehy auVar'vn reDreseniatives al ihis cM a enter upon Ihe aGov�mentionee CrapeM Iorinspe�ciio/n purpases. p � �� Oate: �� —/ �� O Si9namre: �.� ,�_ ig 4.,, briver's License or Saiai Security x: . 1W1�G6 Wlllta-9u�IGRIp: (iroBn—G009 tntwceT8n1: G8n6ry—Mp�Canl: Ylnx—ngvenue; uaa6nrO0—wvesiq CITY OF COSTA MESA.- BOII,DING htiRMI1' PERM NO; M 04fi807 PERMIT NO: M' 046807 PLAN CHGCIC NU: N' GOV1': N SUFP: N CONSTRUCTIUN TYPE: V—N PERMI:'P TYPE: MEC 'PURPOSE: OTH JOB DFSCR.iFTION •: i.9]'7SE' ]>ENTAL• OfiFICE T.I. SQ FT: CLA7M VALUE: CAI�C—VALUL': � ' GROUP OCC: H-1. / COMMENTS: RE: D46622 PRIMARY BI,DG. FERMZT. � IE il� iE �k # ik if �e if 3f ih if ik # iE iF it iE k iE iE 3E iE if iE 3f !f iE IE 1E i! �t i! iE �1(• if iE if it 1F if if iE iE iF jf if fE if 1P 1E it ik 3E 1E k if iF 1E �E iE 3f lE iE it iE #!E �E iE !f iE iE �k iE iF k ik # 2 O N I N G R E(d U I R E M E N T S ' S fi T B A C K S . - ------------- MAItd BUILDIDIG ---------- -------- ACCESSORY BUILDIDIG --------- FRNT: FT IN RF.AR: FT IN FRNT: FT IN I2EAR: FT � � Ihl LEFT: FT IN.RGHT: FT SN LEFT: FT IN RGHT: FT I�1 PARKZNG RLp • PHOV: PATiCEL: 4Z421t11 7.NE: ftEP DIO: ' PLANNIDIG NbTES> ' , ' , � . . iE iE it 1f iE IE �I(� if if �1F iF If ik �f IE iF?f iElf iE K iE iE iE iE K if dE ii iE �lf ff iF 1ElE if iE iE 1E fE?k if iE if iE jf iL if fE iE if 1f i(� �Ik 1E �lE iE fE !E !E!k 1E iE iE iE iE jE iP 1f �k iF it iE iE?F�7k?E )f If D E V E L O P M S N T S E R<V I' C E S R F_ Q U.L R E M E N T S , ZONING'APPROVED BY _ DATE: � BUILDING'APPROVF.D AY ; __ �y� - DATE: ' APFLICATION ISSUEU i3Y: �% . ��/�/'/ DAT�: .C/ /� �c*�t*�t��c�*x�*x��**r*rxir***a"FTF'i�'�-�x�i��trtR'iF�'9 37'1Fii��'�3�"Or riF�F7Fi� F'3SiFi��t��r**x��r*7F'i�i�'1F1F7+F�"iF��* if�r*��c*�ti�it�e,��;��e+er*��;�***�+e*�it�ie�*x*�r*�eit��u *�titit��*+�+�-�r*�r+�*��****��rx�c�v*x� LEGALIZATIOM:N +F E E. S U M M A R Y - STRUCTURAL SrGMENT:DI BLDG PMT PLUMBIDIG ELECTRIC MECHANIC FIRE SMIF/RES GRADING P£12MIT� � � - 1$.00 � A ^ 254 SM2P/NODI—AES � PI�AN ' � • ISSUE FE� 15.00 ' BUILDING—DIV—� FERMIT ISSU� PLAN—CHECK TOTAL FAID DpG TOTAI.S--,--> 18.00. �5.00 0.00 ]3.00 73.00 .00 REVENUF. DI�'ISIUN TOTALS--> COLLECTED: 33,00 OVER/SHORT: .00 IILDG FMT L'LUMI?ING ELECTRIC MECHADITC FIRE SMIP/TOT GRADI�IG PLADI—CHEC]< ]].�� ii �E i6 it iE ik iF iE if 3E N� iE if iE iF a(- IE N if 3E jE aE iE M iE 3[; k iE il- if i!� IE M k ie iE 3f N� IElf iE �(� IE # K� 3E ik N df N• iE M iE 9E 9f af if IE it i! if i! M� if iE � iE if iE iE if M-�M- iE it if M% M I N D I V I- D U A L F E� B R E A K D U W N � TYPH tdEC MEC (QTY D L• S C R I P T I O 1J " ONIT COST 1, RGPAIR/ALT COOLIt,IG VAIIT/SYS HI/r�,�Ti,S 9.00 1 RHPAIR/ALT AEI�TING UTdIT/SYS W/CMTLS J.00 • Et�id OP FGES e TOl'I�L COST i.0� 9.OU a c u A 0100057$06-04057806 T�]T 33.OQ DqTE: 04/04/90 TIt1E: 11:22 � - . .. . _ .� CONSTRUC710N AND PLANNING "� , POOI A APPROVALS Permit # Date Inspector AppROVALS . Permit # Date Inspector _ ` t. Temporary Electrical Service'or Pole � ' 52. Pool & Equipment Location ' 2. $oil Pipe-Undrgrnd. '� � � � . 53. Steel Reinforcement : 3. Electrical Conduit Utility�Undrgrnd. ,t- 54. Forms ,4. Electrical Conduit�Undrgrnd: � ;% 55. Electrical Bonding r' -5� Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE � �7. Footings .. 58. Electrical Conduit-Undrgrnd. � 8. Foundation . %- ',> 59. Gas Pipe, O Undrqrnd., Test ': 9. Water Pipe-Undrgrnd. � '� 60. Backwash Lines, P�Trap, O Undrgrnd. - 10. Structural Floor System � ' 61. APPROVAL 70 DECK 11: Property Sewer Line & House'Connection /' . 62. Backwash & Receptor-Final +� ; 12. Sewer Cap " , l � 63. Heater & Vent-Final j 13. Roof Drains - '`�" � � .;� 64. Plumbing System � Final :, 14. Rou h Plumbin �� . 9 9 - . 65. Electrical-Final' . .' 15. Rough Electrical-Conduit � i . • 66. Solar System-Final � ' 16. Rough Electric Wiring . 7 � 67. Fencing & Access ApProval • � 17. Rough�Wiring Sign . , 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPl1 SYSTEMS FINAL 19. Rough Heating & Air Condition:ing , � � . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � , APPROVALS- . Permit # 21. Ducts, in Structure ' �, �� 7p, �Underground Hydro 22. Ducts, Ventilating ' - � • 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rou9h & Test ' , 72. Underground Flush � � 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing " ' 74. Overhead Hydro 26. T-Bar Ceiling IStructural) & Monocoat . 75. Dry Chemical . . 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding ' .� , ��' 7�. FIXED SYSTEM FINAL 29. Insulation ' 78. FIRE PREV. FINAL � 30. Drywall Nailing, . �j.: , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat • �, 79. FINAL INSPECTION 32. Electrical Power MeterFinal , f• `' S0. FOOD CERTIFICATE ISSUED 33. Final Electric ' �� Nates: ' ' 34. Final Heating &;Air Conditioning � C�'� ' 35. Final Gas Pipe-Test ' - 36. Hood or CanOpY .. � � � � _ 37. Final Factory Fireplace -i �"- � - . in _ �;• , 38. Final Plumbing . ' y,�' � � 39. Water Service-Final - `� . . ' 40. Gas Service�Final ' ' ' - �y - � � _ ` 41. Solar pomesticFinal -. '� - . 42. Backflow Preventer � � 43. Backflow Irrigation . , � 44. Landscape�IrrigationSystem, • ,- - 45. Sound Attenuation '. ' 46. Handicap Regulations - � � 47. FINAL STRUCTURE & BUILDING '''� � i 48. FINAL PLANNING ,+. • 49. Electric Release to Edison 50. Gas Release to Southern California Gas Co ';^ . 51. CERTIFICA7E OF OCCUPANCY No. Date � � PP0.1Egi �pJIqESS: " , . UXIT: � OWXEB'S NAME: � � 1 W 19 TIi ST � ' � .�'. , r- AEDHESS� TRIANGLL SQUARE JOINT � EN 331,61 CAMINO CAPTSTRA�)U , - . #A, SAt�. JI]A+�l CAPISTRANO , �RCHIENGINEEB: ` 9 O— I. � H 2 � • qEG.NO.: � ' eooeess: NONA ASSOC ' C]:,��88 26901 CAMIDIO�.Dfi ESTRELLA -CAPISTRANO HEACA CA 92624 YEBMITTEE: J'BE ELECT CONTAACTUR � ( 714 ) 6�32-9818 �ooxess: 18i0. TYMPANI CL . � ANP.HEIM- , CA 92807 LICENgEO CONTMCTOP OECUMTION: I here6y aflirm that I am licensad wder provisions oi CAaD�er 9(commencing with Sectlon 7000) o� Division 3 0� iha Business an0 Vrotessions Cvde, aM my license u In �WI fwce and ettect. � ciTr uc.: 0 3 7 5 slnre uc.: 3 6 4. cuas: 'C� _ Oata: . � � � Sipn re' 7/� �� ` / � WONKEBS' COMPENSATION UECUIMTI : I here a f t a[ I have a— £ertiticate 6i consent to seti-insure or a cei[ifcate oi WOBe ' Compensatinn Insurance, or a certif�e0 copy [Aere lion 3800, La�. C�. � • POLICY NO.: F S O I i�% ' EXP. DATE: O G/ O 1 I 9 O � coMvenr. pIiIRMONT ' . ❑ Certified copy.is hare0y furnishea. [}� Certi/le0 copy is tile0 with Ihe ciry Bu110' Uivisian. � �-2Z-5o `�' ',.. �Ie: A . . � .— f� ^ � � IXEMpT(OMFROMWOHKER3'COMPEN&TIQNO . rree0irotbetanpletetlAthepermitis�wareMWrtN(5100)mIeSS�% I certity ��at in t�e DeAormance ot t�e work for IS De�mit is issu¢A, I Shall nat employ any persan in any rtla0ncf 5a a5 to betetl(e,+ sublett to tAe Workers' CamOensation Laws of California. � , �/' ,,. ,� .Date: ' SipnaWm:- - J ' NOTICE: If, atler makin0 t�is Aeclaration, yau s�ou10 Uecome suEject to Ihe Workers' Compenutlan provisions oi the Labor i� CoEe, you must totthwit� comDly with.suc� O�ovisions or [his permit shall be Aeemetl revoked. � �+�� - CONSTBOCTION IFNDINO �CENCY: I hereby aflirm t�at there is a construction lentlinq aqency for IAe peRarmance of [he wark im� whicp tAis permitis i5s�e0 (Section 3097, Civ. C). � � - t LENDEB: . . . � � � �\ 110UPE35: ' ' . ' . . - -. - . . . , f . . . OWNEB BUIL➢ER OEClAq11TI0N: I �ereby attVm that I am exempt imm tha Contractors' State License Law for the tollowin0 reason (Section 7031.5 Business and Protesslonal CoOe: . Any ciry oi coumy which r¢Quires a Oermi[ to constmct, alter, imprave, Oemolish, or repair any stmcWre, prior ro Its issuance. also requires ihe applican[ tor such parm0 ro file a sipnetl statement ifiat he/she id licen5¢4 purspam ro Ne Omvisions of tlie Contractors' State Licensa Law (Chapter 9(commencing with Section 7000) of Divisian 3 oi tAe Busineu anE Professions'CoOe) ar Ihat he/s�a is exempt theratrom antl the 6u¢ for ihe alle0e4 ezem0uon. My Hola�ion oi Section 7031.5 by any aDPliwnt for a permit subjecls ��e applican� ta a civil p¢nalry oi nat more t�an tive hunareE tlollars (S500I. ' . I, az owner ol the Omperty or my employees �wi[h wages as their sale,compensation,.will, Oa ihe.work, an0 ihe ❑ stmcmre is not intenAeE or ottereA for sala (Secbun 7094, Business anA Pmfessional CoOe: The Contractors' Sta[e License Law Ooes not appry to an owner of a pmperry who huiltls or;improves t�areon, antl who does such work himselV�ersell or �hrouph �is or her own emDloyees, pmvidea ihat such improvemen[s are naLintentled or dttered tor sale. Ii, however Ne �uildinp or impmvement is 5010 wit�in one year af campletlon, I�e owner vrill'Aava t�e burtlen af pmvinp �e/s�e did not 6uilA or imDrove for the�puryose of sale�. ;� . , � ,- . ' I, as awner of fhe OrapeM. am exclusively contradinp xfih Iicense0 contraciars ro con9mcf fhe prolecf (Sec6on 7044. Business � an0 Pmiessions CoOe: iha Comractars' slaro Licenu Law Coes not appty ro an owner of pmperry who emlJs or impraves the2on and'who caniracls lorsuch prol�s wlt� a contractoqs) licensa pursuan� to the Coniracrors' State License Law�.'I am aware t�at prooi at [h¢ir Worker's Compensation insurance s�oultl be pmvitletl to�me. , � I am exempi under Section: . B. 8 P. C. ' , , , � for this reason: • � � � Oata; � Owner: I Oo Aerehy certity t�at I am aware ai an0 untlerstand the requirements at Calilomia Healih an0 Safery COUe Sections 25505. 25533. and 2553C an0 [hat I or any future OuilEinA occupant will/will nat (circle one) nee0 to comply with said state codes an0 t�e requirements fona permit for construction ormoditication frpm Ne Nr Uualiry Management Oisince Pesitlential wnstmction aDPliw[ions are exempt trom �Aese Orovisions. � �� ' Date; Applicant � I hereby certity t�at I �ave reatl this aDP�ication�anU state t�at Ne above iniormation is correct. I agree ro comply wi[h all ciry an0 counry ordinances znE siate laws relannq to building canst ction an0 hereby aN�onze representatives uf Nis ciry to enter upon the a0ove-mentione0 OropeM for ins�pejition purp/ose's. ' /�� Dat�:_T GZ�7 " • S n u��.��//L —' � �er's Licenu or Sociai Secunry x: 186L48 Wnita—BuiltlinB� Graen—Cotla EniarcemeSt; Canary—Applicen�; Gink—Revenue: Galtlenrotl—Assessor ' . � � - �_r,i� �_ C]:TY OF �OS'TA MF;SA - HOII.DIDIG PERMIT PERM NO: E 0966J7 . � �.�� . . . , . . . , . .PERMZT MO: '�'�; 046637 PLAN CHECR NO: � N GOVT: N. SUP,I?: A1 ' •CGNSTRUCTION'TY.PE�: ~V-Dl • PERMIT TYPE: ET.�E , PURPUSr: .AL'I' JOB DESCRIPTIODt :' 191,7SF DF.rITAli OFFICE T, I. I� � SO FT: , �CLAIM VALUE: CALC-VALU�: GROUP OCCS B-2 �I COMMENTS: REFER TQ NH4f;62'l { . ��***�*****�r�**�***��***x�*�r*�*****ar�*�x*�+r��*��r*x***�ra�*�****�c�+r�;**��*�x x'��: ' � 2 O N I N G' R�E� Q 0:L R� M E N T S . ' '' � S F T 8 A C K S ---'-------- MAIPI BDILDIDIG --------- -------- ACCESSORY BOILDING -----•--�-- PRNT: ' FT IN RL•AR: FT TN FRNT: FT� IN R£AR: FT IId�` LEFT: FT IN RGIIT: , FT , IN LEET: F'T ' IN RGHT: PT I•Id: PARFCING RE�; . FRC�V; , PARCEL: 4?421111 ZNE: REF NO: PLANNING NOTLS> � ' , -. � ' . . . . _ . _ � . . .. . � '�E iE if iE if iE �M lf iE i(� �( aE 3f k N jf iF if iE # iE k jE if iE 3E 1E iE 9E 3E df 3f 4 3F'if'iE�iE iE iE iE �E if ik iE iE iF � k iE iE jf iE 3F iE iE 3F if if iE iE fE K� fE �� iE if 3E 3E if �f iE 3F 3f iF if iF M 3E 3F D E �� E.L G P M P N T, S. E�R �� I,C � S R E Q U I R E M F. N T S ZONING APPROVED BY DATE: � e t R BUILDIDIG APPROVEU BY ;_t ^'-- �.` _ - � �-- DATE: �---- Lr .". `, .. t APFLICATIt.IN ISSUED BY: r DATE: — �•lb • ifaElE�EiEifiEiEaE?fif#EifiEifN'N3E3EiEikit�F�iF3F' - t. ��iEiEiElEiEiE3EjEiEiE�i�#��aF?�'iEiE �EiFiEiFiFififif�lE�EiEiEiEiflEiEif�Ejf3EitiEiE�E%�K�1(�fF3fiEiEiE1(�jf3E�EiEaF3ffEiFiEiFififififitifiFlEiE�EiEfEiEiElElfikifiE%�3E�EfEiEif�EiEiEjEiE�E�CiE3(�iEaf � �LEGAL�IZATION:N , • F£'^E " S U M M A R' Y� � 51'ROCTURAL SEGM�NT:19 ' FtLDG'PMT YLOMBING ELF.CTRIC MECHANIC FIRE SMIP/RES GRAD'ING PERMIT 124_65 � � � 503 � , SMIP/NODI-REa i PLAN ' , � � ' ISSUE FEE : - 15,00 BUILD'ING-UZV-> PERMIT, ISSUE PLAN-CHECK � TOTAi, � PAID DQ1' TOTAI�S; -,—> _ 124.65. 15'.00. i 0.00 1J9.6S 139.�5 .0� REVEDIUE DIC�IS'IO1J TOTALS--> � COLLECTED: 139.65� OVER/SHORT: .00 � DLDG PMT PLUMDING ELECTRLC; M�CHANIC FIEtE: SMIP/TOT GRADIPdG PLAf1-CHECFC � zs9.bs � : iE if iF i! �� iE K�F if �E 3f 1f if �E jf IE 3E ih if ik if� iE iE iE iE iF if� iE itiE iF iE�iE iE 3E iE if iP K-jP if iE iE ±f iE aE �� iE iE if if 3E if 1E jE if 7f 1E iE- iE iE iE iE iP iE if if 1E if 3f �E i4 j(� 3f iE i4 3f it iE � I N D I V I.P U A I� F E E Q R E A Y'D O W N TYFE QTY D E 5 C R l: P T]. U N UNIT CO;T TOTAL COST ELE 20 FIXTURF.S, LSGIiTING ' 1 ST 20 EA. .75 ' 15;00 ELE 55 FIXTURES, :LIGHTIDIG ADDITIONAL EA. ,.45 , 24.75' HI.E 20 : RECEPT/OUTL�T 1 ST 20 EA. .75 15.00 �I,L•: 63 RECEPT/OUTliF.T ' I�DDITIONAL EA. .45 . 1^,f},35 ELF , 20 RLC�PT/SWTTCIi 1 S'� 20 EA. ' ,. 75 ' 15. UO ELE 39 RECEFT/SWITCH ADDITIONAL EA. � .45 17.55 GLE 3 't40TOR/FOT4R AFPARATUS 0.0 - 1.0 IiF 3.00 9.00 - - � EAID OF FEES ' � t Q 1 Ua056750-000567`0 T C� T 139. b5. I. DATE� 03/2219C1 TIME: 14:17 � ' ��CQNSTRUCTION AND PLANNING " � POOL � a . APPROVA�S Permit # Date Inspector qppROVALS Permit # Date Inspector F � - • !Ai 1. Temporary Electrical Servic�o'r Pole�r : . 52. �Pool &�Equipment L'ocation � � �� Soil Pipe,-Undrgrnd., .: U` _ - � , - 53. Steel Reinforcement � �� 3; ;ElectricaCCo�duit�Utility-Undrgrnd. 54.. Forms � %.' i4�-Electrical.Conduit�Undrgrnd'✓ ' �,? � . 55. Electrical Bonding . � �� 5t-Steel Reinforcement ' ' 56. Rough Plumbing & Pressure Test - -_�6��._Electrical�UFERGrnd. ,�` �. �� ,/? 57. APPROVAL70�COVER�GUNITE �•� �i/, �7t�Footings _ - _� �;' '!/ 58. Electrical Conduit�Undrgrnd. � �'� �. i 8'.,_Foundation • ��; . � ;.�'� � � 59. Gai Pipe, O Undrgmd., Test �1 �, 7.�= 9._-Water Pipe�Undrgrnd., �'� �:=� " � 60. Backwash Lines, P-Trap, O Undrgrnd. % i' � r 10..Structural FloorSystem � a,�� r 61. APPROVAL TO DECK - � l�tf 11.-Property Sewer Line & Ho�elt�•onnection .�r 62. Backwash & Receptor-Final '�i 12. Sewer CaP �.- . � " � ` . . . j�� 63. Heater & Vent-Final� . j 13. Roof Drains '� . _ � f - � � . 64. Plumbing System - Finab ! 14. Rough Plumbing � � 65.'Electrical-Final ' � 15. Rough Electrical-Conduit t 66. Solar System-Final � � 16. Rough Electric Wiring 67. Fencing & Access ApProval � 17. Rough Wiring $ign ' ; 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling- � 69. POOL/SPA SYSTEMS FINAL ' 19. Fough Heatin9 &_Air Conditio,ning _, _FIRE DEPT. REQIIIREMENT . _ ., ,20 - Rough Factory Fireplace � . .- . - � . APpROVALS�. Permit # - � , 21.�DuC(s, in StrUcture� � � � ' �70. Underground'Hydro 22.-Ducts, Ventil5ting ., ' ' � - i �.77. Product�Piping OGas ❑Oil :,�. �Gas Pipe-Rough & Test � " ' 7z, Underground Flush � 24� Roof Framing � � . -� � - : . - -J3: Undergrnd. Storage'Tank O Gas ❑ Oil. � 25. Roof Sheathing ''' � ^ • '' 74, Overhead HYdro._ _, 26.�T-Bar Ceilin9 (Structuraq & Monocoat - 75,_Dry Chemical -• . �_ - - 27.. Frame and Flashing �- � 76. Dry Standpipe '' � - - `28. Lathin9'& Siding' , - , _ , ' �„ 77. FIXED S.Y.STEM FINAL - � • � 29. Insulation �_ � 78r�FIRE PREV. FINAL - - -- � 30. DrywalLNailing _ , ` HEALTH DEPT�. REQUIREMENT � 31. Plaster Brown Coat ' 'r' _ -�79. FINAL INSPECTION � ' -..32.,.Electrical Power Meter-F,inal _ SO.��POOD CERTIFICATE ISSUED_ � ', �33._Final Electric � � � � � Notes: -- - � ' `�34.. Final Heating & Ail-Conditioning- ' �� . , - `� - _ _ : �� 35`-.Final Gas Pipe�Tesh - � . � �� ' . - � � _ 36. Hood or CanoPY ; ��. _ � " - ' - ` � _ � - 37.-Fina�l Factory Fireplace V � '.38. Final Plumbing . � - �; y - � � � 39. Water Service-Final. � - � - ; - . • �40. Gas Service-Final - ' ' ' � f ' ' - � , ,, _,41. Solar pomesticFirial ' �� , - � ,- 42. Backflow Preventer : �. _' . i 43. Backflow Irrigation _ " - . - � � . "�44. Landscape Ir�ipation System ` . • � . � � � . ' _ � 45. Sound Attenuation �.. . .�,- . � . ' 46. Handicap Regulations ` . �_ . - _ _ 47. FINAL STRUCTURE & BUILDING _ � _ � � _ " 48: FINAL PLANNING -� � • � • 49. Electric Release to Edison . " ' � - - - � 50: Gas Release to Southem California Gas Co � ' : . 51. CERTIFICA7E OF OCCUPANCY � � , No. Date - . � �\ PP0.IECT ROONESS: ( U 1 W 19 TIi ST � �� uxrt: ,• oWx' $,y�r:,q•RIANGLE SQUARC JOINT VEN laD°AE�: 3 7 7 61 CAM INO CIiP I; TRANO • 8A S'AN JUAN CAP.T.STRANO ,. ►Rt1+IEXaIXEEfl: �ALI�W S AJSOC eE0.N0.:COOOO ' AJDRE�: 2485] DEL PftADO UNR: - DAP1A POINT • CA 92629 � •PFflMIREE:TRIANGLE SQUARE JUINT VEN (714)2�F0-1302 , nooeess: gJ161 CAMPO �APISTRANO A � SAN �7IIAN CAPISTRANO LA 92675 IICEN5E0 CONTMCTON OEClAM7tON: I IrereOy amrm t�at I am Ikense0 uMer praNsbns ol CAapter 9(commencinp wit� Section 7000) oi DNaion 3 a1t1IAe Buuness anE Professions COEe, uM nry ae�tte b in tull fora anE ettect. , Cltt 11C.: �{8 7 7%SiRTE 11C.: ZS�3O0 UA&S: [3 —/ . Da�e: SipnaNre: V/ONKENS' COMPENSATIOX OECtAMfION: I AereE attirm tlut 1 fava a ceNfkafe af consenf la utt-insure or a cetlifiw�e of Workers' Compensation Insurance, or a certilieU mD Uereot �Sectlw 3800. LaO. C). roucrxo.: /��22�2 rxv.an: /��i`90 , LOMPIINY: ��CenifieE coDY �s hereEy Nmis�etl. ❑ CertifieE cppy ¢ fileG wp� tM dry Buil4inA �sion. ,,,.m: !2 2! ppaiirant: �. .. �- IXFMPfION Fl10M WO COMPEN3111IOM DEAAM110N: �(� 5ection nx0 nd Ee compet[E il the DP+m� n fu ak AuMred (5100) m kss�. I CErtlty t�at in Ihe pertormance oi IM WOfk lof wlriC� N¢ pemril a i551mE, I Shall mt empl0y alry persan' nlannet 50 aSlo �etome , SublCct to the Workers Compensatlon Laws ot CaGfomu. . . in . � Oate: � ' SipmWre:, - ,_` � -- NOTICE: II, alter maltinp tltis Eeclaratlon. you shoul0 Decome subjttt to ihe Warkers' Compensation provLsions oi the LaOar COCe, you must lartlrvnt� cumPH �U � D�o�s or this pemut slWl Ee EeemeO revoke0. fANgfAUCTIOX LENOIN6 IIGENCY: I IrereEy atfirm WI Ihea 6 a conSinKtion IeMinp apmcy lor Ihe perlormance ol tM woM �or wNch thic Dermit 5 issueE (Section 3097. Civ. C1. • . LENUEfl: AOORESS: ' - - OWNEB BUILOEB DFCUMTION: I IrettW affum Itul I am exem0� �m tla Cant2ctors' StMe Lketrse law lor I�e Io0wrin0 mason (�Cion 7071.5 Business an0 Proie55bnY CaEe: My dry ol caumy wtd�li reqWres a permit lo cu�utNct, alter, ImO�o'�a, deowllsA, or repair any.sWctum, p�br m hs iuuance, aLw repuiru Ne appliwnt fa sucA permit to lile a 510�eC statemeni lhat Iw/s�e b Iicensatl Dursuam m tne pmylslons ol �ne Cont2qors' State License Law (Chapter 9(cammendnp wlt� Sactbn 7000) ol OlWsbn 3 of Ine Business ' anJ pmlesslons CoEe) or Ihat IwJSAe h exempl 1�e2trom anC the Uasiz br the alleqetl exemptlon. My vblatlan of SecGon 763115 by any appliunt Iw e DerMt suCjects Itie applkant ro a WII penalry ol rwt more than tive AunOreC Adlazs (f5W). . i, u awner o� tne properry or my e�pioyers wiN wa0es u metr soie compensatiwi, wiii do tne wark, ane the ❑ sVucmre is rrot7ntenUeC w ottereC lw sale (Secfbn 701d. BusNess arM Proleasiorta! CoCa: iM CoMractm3' State Licensa Law Oces not aDPh' �o an awner at a pro0erty who CuilOs or imOrwos ��ereon, anC who Eoes suc� xroA himsell/�ersell ar t�raup� �is or �er own employees, D��4e0 t�at sucA imprwemems are not intenEetl or oflere0 tor sale. II, �owaver t�e builUlnO or improvamem Is sold witAin one year ol com0�etian, t�e mmer will h�ve I�e DurOen ol DroWnp �ySAe AIU nol builE or ImD�ove lor tna purposa ol ule). - � I, as owner al tne O�W�M• am eadusFreN wnuacWp witn Ike�eE rnnvactors lo mnsvuct Na vraject (Sactlon 7W1, Buslneu � anO Prohssiqts Cade: ihe ConVxlws' SYate Lkense Law Eceg fpt apply W an ormer al propeRy wlp 6uiMs or ImproveS Merean- d110 W110 COfIIl2LL{ IO! SOCII pf01ECI5 Wltll i C011(pCIDf�S) GC211SB p06W0� IO IhB COIllfdtl015� $IdIB LIL2058 L2W). I 8111 dW2f0 �Aat D�� a� ��eir Worker'S Campensauon i�urance sIroNO Ge pronOeO lo me. . � I am exempt un0er Section: B. 8 P. C. _ � lar ttds reason: � � ' ' ' Date: ' Umer. I Oa nereCy ceniry ttu� I am aware ol an0 un0erstanE t�e repuirements ol Calilomu Healtn anE Salery COEa Sections 25505; 25533, anE 25531 antl t�at I or any luture buil0inp acupanl v�nlVwill n¢1(cirde one) nee0 ro comDh wtl� sziE state coGes anE t�e requimmems Por a parmit for canslmpWn or moEilicatian Irom t�e a'r Oualiry Manapement District. Resitlemlal conslrucUon applications are exampt Iram ��eSa provisions. ' � Oater MD�C I hereEq urtiry tlwt I Aave aaE th¢ apv�on antl sWte Itut tlu a0ove inlwmation is cprrect. I aprea to compty ' � all pry anE counry orelnanca anE state Wws relatinp to Ouildnp rnaSrucfion a'M �ereEy autAor've rtpreSenUtives ol tluc dry to ente n the aEove-mentionM properry forinspectlon Durpo Fs. Date: �Z 2'( SB�tu � orrver's �ianu or Soda� securitv �': , 1Bat.bg W�ite—BuiWina: Grean—COEe Enbrcamem: Canarv—ADo��ce�t: Pink—Revenua: GOltlenro0—Asaessor �—. . CIT1: OF CO�A �4ESA F3UI1,D]:NC PEf2MIT PERMIT NO: II 045993 YLAN CHF.CIC NU: 02049-(39 A CONSTflUCT.ION TYPE: p--�-$-P. N J PERMIT 'PYP6: STR: JOB�DESCRIPTION CLASM VALUE: COMMENTS: �'. �"�' j{"x' * Y * �'�' PI:RM tJO: B Q459J] GOVT: Y $UPP: tl PURAU5E: LIEW : SHELL ONLY PERMIT R�FER TO #b457�4 a4 FT: 9U7,187 �027, �F78, o0 627.A'1D.00 CALC-VALUE: '—'$,�.5,�:-5£ GROUP UCC: D-"l /B-7 ' ��/ � OUND PL ' �3 ?'9 ExC6p% �L.�(�L./,t.1� �:� *. x•�� *x .��rx**x�� -�rt**x��*+��«�� N� N CS .��E `„„� N T S �f . FRNT---20 T Lp�� p , �F ��(�i -�--�FTC_ESSON�REARLDING �,�,---`ZN LEFT: 15 E• �.i ' �':� `'T L•. ' FT IN RGHT: FT IN �FiARKING RTs'Q: 26 PROV: 26 PARCEL: 42421111 2NE: C1 REF PLANNING NdTES> MEDICAL,BLDG OVER PKSNG CAltAGE_ VAItIANCE GRANTFb > TURNAROOND ANp TRANSFORMF.R IN 51'11KS PER VARIANCE �t.atx��at;�3t*k*�r;s�,�*�t�-�rk�;�****-�c��*��-�****��*itit*�-��**�-x�*+e*�rp�} �(! D E V E L O P M E� N T -S E R V I C E S R E Q�"D%�N� E� id 1 Nl./� NO: PA8989. FOit pKING, . ZONING APPROVED'BY UATE: /a DUILDING APPROVED DY : /VcS% " .__ _____ DATE: �'t- * P.PPLICATION ISSUF.D DY: • �� DAT£•.: /-2/2//�� t�t*+r**�rx�+ex+e�t*�c�*�-�r+�+��** . . . 3FiF3FTF3F�F'�F�F�F,F'�i'iFi�***��t�r**�t*�F,r"iF'iF'i�iF'iF�F'iF�� . �7tifiEikitif3EifkiFiE*ikiEifititiFiEifif9litlfiEiEif�lEik�iEiEiEffif�ltit�lElti(�lEitK-7E�1Eifi!-J(-iEiEif�lfitiEiEiEif#itiEifiEiFitiEiFN-itat�%ifiEif�kKi!�iEik1E � LF•,GALI"ZATION:N � F E E 5 U'M M A R Y STRUCTURAL .riEGMENI':Y '� DLDr, PMT PLUMFJING ELECCR�,C MECHANIC FIRF_ SMTP/RE5 GRADING PG:RMIT 43,4]J.50= '• ,+r;,; � SMIP/NON-RES PL'AN 7,057.94 � ; . =' r,;: • 141.97 issos r•sF • ,., • FIUILDING-DI:V-> PF3RMIT ISSUF: PLAN�CHECK TOTAL PAIll DUE TOTALS-- --> 0.00 0.00 ,; .;.;=. 0.00 0.00 .00 .00 REVEAIUE DIVISION TOTALS--> COLLE�T.LD: .00 OVER/SI�ORT: .00 � . DLDG PM'1' PLUMBTNG ELF.CTRIC MGCHANIC FIRE SMIP/TOT GRADZNG PLAN-CHECK •r' �fE iEiF k k?F it iE ik iE if k 3F 3t # M� iE it iE iE iE % 3E ii� iF iP if il� 3f iE K; 3E iE k DEiE J�,iE'A iF iE IF i4?E i!� 3t if # iE 1f iE iE 3f-iE ik k iE iE iE it�ie ir iF it if iE 1E if �1E iP # 1E i! iE 3E k it i^ if I Al U T V S D U P.L= �'=;,F E� F] R G A K D O W N TYPE QTY L L' S C R I P T I O� N F��; UNZT COST TOTAL COST ,, ��3 63/.So sr•c 3�osis OFF-TYPE v-i iIOUR -AVGR sz.io ^^ �� ,• �� ' SFC a672 b`UC-TYPE V-,i HOUR '- �' -AVER �1.20 �Z.83�f396.40 ' ,•END oF . r• r•_� s ��; �-e4�k.�L � '�,J SEC, 33oS•^, �'xc. 5" V / �f� o-ti �'�+� $ - �5.�3 9 . � � ��9�9� , '� 01 Q0050308-00050308 Tl7T .00 OATE: 12/21/89 TIt1E: 10�16 � CQNSTRU�T�ON ANpPLANNING � . - POOL PA �!.'PRO�f'ALS�: Permit#�_ Date Inspector qppROVALS Permit# Date Inspector . T: TempDr1ry Electrical Service or Pole � .. 52. Pool & Equipment Location . 2. Soil�r'ipe•Undrgrnd. . - 53. Steel Reinforcement 3. Elec[rical Conduit Utility�Undrgrnd. � . 54. Forms 4. Electrical Conduit�Undrgrnd. , I 55. Electrical Bonding ' 5. Steel Reintorcement � 56. Rough Plumbing & Pressure Test 6. Electrica� UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation � �� 59. Gas Pipe, O Undrgrnd., Test ,� 9. Water Pipe-Undrgrnd.� i� 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structurel Floor System 2(o Q,d , 61. APPROVAL Tp DECK • 11. Property Sewer Line & House Connection � . 62. Backwash & Receptor�Final •� 72. Sewer Cap 63. Heater & Vent-Final 13. Roof Dreins � 64. Plumbin9 System - Final 14. Rough Plumbing , 65. ElecVical-Final � 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring; � 67. Fencing & Access Approval ' 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEN7 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro � 22. Ducts, Ventilating 71. Produc[ Piping OGas ❑Oil - 23. Gas Pipe-Rough & Test 72. Undeiground Flush 24. Roof Freming � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Struct�ral) & Monocoat 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding � � 77. FIXED SYSTEM FINAL 29. Insulation ' 27 �j � 78. FIRE PREV. FINAL 30. Drywall Nailing �� HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat -� ( �(D � 79. FINAL INSPECTION 32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: �, s � �1�� ' �aT•✓ S�lU 34. Final HeSting & Air Conditioning 'W � 35. Final Gas Pipe-Test 36. Hood or Canopy " 37. Final Factory Fireplace 38. Final Plumbinq ' 39. Water Service-Final 40. Gas Service-Final �i ' 41. Solar Oomestic�Final � 42. Backflow Preventer � 43. Backflow Irrigation " 44. Landscape irripation System 45. Sound Attenuation 46. Handicap Regulations ,� 47. FINAL STRUCTURE & BUI�DING 1 46. FINAL PLANNING 49. Electric Release to Edison .��'S 50. Gas Release to Southern California Gas Cn v 51. CERTIFICATE OF OCCUPANCY No. Date �' 6U1 W ].9TH ST e•sn�Me: ,TRIANGLE SQUARE �70INT VEN •nooxess: 33161 CAMINO CAPISTRANO ' 1kA SAN JOAN CAPI:STRANO UXIT: -* �pC!!iFNGINEEB:��Aj�j,�jpj 5 ASSUC ' � nea.xo.:C0U00 �ooness: 2 q g 5 3 DEL PRAllO uxi1: DANA POINT CA 9"1619 ' PEpMiTTEE: TRIANGLE SQUAiiE JOINT. VEN ( 714 ) 240-1382 nooaess: 33151 CAMPCS CAPISTRANO A SAN JUAFJ CA}?ISTRANO CA 92675 IICENSE� fANTNNt10B OECIAMTION: I �ereDy aifirm that I am licensed unEer prodsions oi C�apter commenrAnp wit� Section ''� 70W) al Oiv/is�ion 3 at IAe Buslness antl Pmlessions Cotle, an0 my fcense is in full lorce anU effect. , � , LITY LIC.: '/ � 7 8111TE LIC.: ZS^3 2��'_7/� C/y�q� �' Date: SipnaNra: �l -�'./� � � �' WOBKEBS' COMP SATION �ECUMTION: I �ereEy aflirm tAat I have a certificate af consent lo setl-insure or a certiliwte oi Workers' Compenution Insurznc , or certifie0 coDY thereof (Seplon 3800, Lae. C�. roucr xo.: s��- 2 2TZ exr. onre: /j�� /�"jp . LOMP►NY: ' � CertifreA topY is//��7+efeby IumiSheJ. Certi�ied topY u Iiletl wnn the i Buikinp DI�' ion. �e�e: �=! � � Appliwnt: , G " • F%EMVfION FPOM V/OPIIEBS' COMP NSGIION OECIAMTON: (iAis se�yion need nm Ee wmDleteU if ine ce�mit is lor ane hunUmO (f100) ar less�. , I certiry ihat In the DeAormance of t�e work lor whic� this permit is issue4 I sAall not emDloy any Oerson in any mannar so as ro Eecame sublect ta tAe Workers' Compenutlon Laws of Califomia. , �ate: Sipnature: 1 NOTItE: tl, afler makinq t�is declaratlon, you 5hau10 Uecortre SuEI� �a Ihe Woders' Campensation provisions al t�e Labor CoOe, you must tontmitA comDN ��h suc� prodsions or ��is permit stwll Ge UeemeU revaketl. � CONSTRULTION LENOINO �GENCY: I Aereby affirm that Ihem is a construction ImElnp apency for [�e peAormance al ltce work for wAkh t�is permR is issueE (Section 3097, CN. C�. � IENOEB: . ' . . noowess: . � - - 'I ' . � . -� . . . �. i . i OWNEH OWLOER OECIAMTION: I OeraGy aflirm tAat I am axemp� tmm [he Contracrors' State License Law far I�e IOIIovAnp reason ' (Section 7031.5 Busineu a� Pmhssional Cotle: My ciry oi wunH �icA repuires a Dermit m wnstmct, alter, impmve, Uertwlish, or ' apair any strudua, pAor ro i6 issuance. also repuues t�e apWica�� for sucA permit m file a si0ned statement ihat he/s�e I5 licensed pursuant ta [�e D�ahsions of Ihe Contradors' State License Law (Cliapter 9(commendnp xit� SecLon 7000) ol Division 3 of Ihe Busineu an0 Prolessians CaEe) or that he/sAe a exempt t�eretrom anU tM basis tar Ne allepe0 eKemption. My Wolatbn ol Soction 7031.5 �y any ap0licant for a permd suEjects the applicant to a civil Denatry at not more Itwn five �unCreE dollars (5500). ', I, as ovmer of t�e properry or my employaes vAt� wa0es as their sole compenution, will Oo t�e wod, an0 the ❑ stmcture is not intenEeA ur offered lor sale (Section 7674, Business ana Vmfessional CoOe: Tha Contractors' Sid[0 LiG8n50 L2W Uces not aOPly to an owner al a pmpeM w�o �uiltls or Imp�oves thereon, anG wAo Ooes sucA work himself/herself or I�mupA �is ar her own employaes, 0�%'iCeE that such imDravemenis are nat intenEeO or ofle20 for sale. II, �owever t�e 6uil0inq or , ImDravement is sa10 vntAm ane year ot comDletion, Iha owner will twve I�e Ourden'of pmNnO he/she Eitl not Eui10 or improve .for t�e�purpasa al ule). � • I, az owner ol Ihe D�Perty � exGuSNep wniractinp x1i� Iicense0 contractors to cons[ruct I�e Drol� (Section 704C, Business � an0 Professians Cade: TM Cantractors' State license Law ry� �t appy to an owner ol properry xlio DuilQs or improves t�ereon an0 w�o contrac6 for such OmjecR vnU a coniractoqs) li�ense Dursuant lo Ne Cantractors' State �icenm Law).-I am aware tha� proof of their Workar's Compensation insuranro should be 0�'iEetl ta me. , � I am exempt un0er Sectlon: . B. 8 P. C. , � ' for ihis reason: ' , - ' i Oate: � Qwner: � I tla hereGy cenity ttwt I am awam ol an0 unUerstanE tAe reQuiramants oi Califomia Healih anA Safery COUe Sections 25505. 25533, an0 25534 an0 that 1 or azry �Nure Cuikinp acupalll wilVwiA not (cirde Ona) need �o comph with SaiU stata cOEes antl IM repuiremen6/or a permfl for cortsWction or moEifiatlon Irom t�e N'Ur uatiry Mana08ment Ustrict. Resitlenqal canstructian applications are eKemD� ��om t�eu Dmvisions. , . Uate: � Fpp�icant: I �erthy certiTy t�at I Aave aa0 this apD�icalion anA state I�ai ihe aqove information is correct. I apree ro compl with all ciry an0 counry artlinances and state Wvrs relatlnp to EuilAinA �nstruction an0 hera�y aulhorhe 2presentatives ol tAis ciry to en pon tha ahove�mentlonetl proOertY �or/inspection purpaus. Da[e: `o� — � '� /� � 9gnaWrn'.i� — r Oriver's Liunse or Saia� securiry x: . 189Ft8 W�ite—BuilEiiq; Groen—COCa EnlorcemenL Cenerv—Apo�iwn[ Pink—Revenue: GoWenrotl—/wwsor --,_. � � �CITY OF CUSTA MF_SA - BOILDING PEftt4IT PE.RM PO: B"0453s9 P�ERMIT NO: B 0453J9 PLAN CHECK NO: 01856-8;9 A GOVT: N SUPT?: N CONSTRUCTION 7'1PE: :i. C�J pERMIT TYPE: STR pURPlJSE: D1EW V 70B DESC..RIPTION, : FOONL "L'ON qNLY PERMIT FOR MEn BUILDING Sp FT: 17,1F17� - - . , CLAIM VALUE: 627,47f3.U0 CALC-VALOE: 627,477.90 GROUP OCC: B-2 /B-1 COMMENTS: *.��**�t�t*��*�;r*�******�r***+t*x-�c-+rff�r*�x-+t�-+t�x��t**-x-***��***f�*�-*��+�**�r**+�*x�*****��*x�***x�**** ' . Z O N I N G R.E Q U I R E M E N T S , ` s�. T n A c x s --------=--- MAIN f?UILDTNG ----------- — -------,ACCESSORY DOILDING ---------- FRNT: "LO F'T IN REAR: PT IN FRNT: FT IN REAIi: ,FT IN LEFT: 15 FT TN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: 26 PROV:. � 26 PARCEL: 42421111 ZNE: C1 R£.F NO: PA8910f, PLANNING N07.'ES> TURNAROUND & TRANSFORMER OK TO ENCROACH INTO FT AND LFT iIDE � > STBK RESF'F. PKING REDUCT.ION.OK THRU VARIANCE (PAt39E19) k iF iE ik �f if iF iE if iE iE if it if IE iE �f M iE jE 3' �K- i(� iF # itr if if 1t iF iE �Yc iE iE iF i6 iE iE dE if if iF #�E iE iE # 3EiE 3E iF iE M� if if k if �k iE if iE iF af'k if 1E �E �E iE ifciE iE iE iF iE k if iE iE ll, 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_ _�.-� QUILDING APPROVEU BY : B.S� _� DATE: �2�5-�4 APPLICATION ISSOED BY: ��• DATE: t— f �8. 8 (�aj ii�Eitfl�**�t*iEiei�itiEiE#iE�t��Eiti�iEit'iFiFSFA�' ��_ . �k��t*�t�t**�Ei!� . !�F�* it ik ie 1k K� �1E 1E if iE iF df dF iE iF i( if� �Y, 3E i' iE iE iE it it iE iE iE if !E iE iE iE !F it iE if X� it i! iE iE iE 3E fE i! 1f i! if iE iF k iF iE jF iE�X� iE fE if jt 9f if iE iE # if iE iE iE iE iE if iE iE fE iE 1E �)f iE LEGALIZATION:N ,F E E S-U•M M A R�Y � STRUCTURAL SEGMENT:�Y 0 0 �LDG PMT PLUMBING ELECTRIC MECHANIC FTRE SMIP/RES GRADING PEAMIT 2,42J.50 ' SMIP/NON-RES PLAN 393.42 .�. � 94.P2 ISSUE EEE ' • , � • �BUILDING-DS�V-> PE2'tMI.T'; ISSU� P1,AN-CHGCK TOTAL PAIU DUE TOTAI,S----> ,' ;'1517.62' O.UO ' 393.82• 2911.44 2911.44 ' .00 REVENUE DIVISION TOTALS-->• COLLECTED: ��2911.44 OVEF2/SFIORT: .UO ' BLDG PMT PLUMBING ELECTRIC MFCHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 2423.50 , ,, , 94.12 ��j3.02 iE dE iE iF it iF il� if ik �1E� #-1f if ik 3E if �f if ii-ie jF if if !t iE �%� i! iE iE i! i;-iPie� 3E ik 1f iF iE �1(-jE iF iE iE iE iE 3(- iE if iF 3f iE 3E iE �1f iE ik iE iE i! 4 iE if iE iF iE iE iE 1k iE iE iE fEiE iE dE �E i6 if ih i N U I C� I D U A, L, F E E fl R E A K D O W' N ' 1 TYP� �'TY li E S C. R I P T�T O N ' UNIT, COS'T TOTAT, COST SFC E3515• OFF-T.YPE V-i. HOUR -A��ER /52,10 447,G31.50 SFC 0672 PUG-TYPE V-1 IiOUR -AVER , 7.1,20 .�18�gII¢�0 • END OF FEES P�� \ dd ! H A�. '�.J SK, 33oS, �"Xc, S R '...L:....�. . DEC O8 19� �11Y pF COSTA MESA � CQNSTflUCTION AND PLANNING . �> APPROVf�LS Permit # 1. Temporary Electrical Service or Pole S � �. Soil Pipe-Undrgrnd. � 3. Electrical Conduit Utility-Undrgrnd: -4: Electrical Conduit-Undrgrnd. - 5. Steel Reinforcement , : 6.. Electrical UFER Grnd. ' ..f 7. Footings .. - 8. Foundation � 9.- Water Pipe�Undrgmd. . 10. Structural Floor;System . � - 11: Property Sewer Lirie & House Connection �. i 12. Sewer CaP . . � 13. Roof Drains ' 14. Rough Plumbing 15. Rough Electrical-Conduit 16. RoughElectricWiring� 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning . 20.�Rough Factory Fireplace 21. Ducts, in Structure . 22. Ducts, Ventilating , 23. Gas Pipe-Rough & Test _. 24. Roof Framing � - � 25. Roof Sheathing 26: T-Bar Ceiling (Structurel� & Monocoat . 27. Frame and Flashing - - �- 28. Lathi"ng & Siding , . � . 29. Insulation - 30. Drywall'Nailing '' 31. Plast`er Brown Coat � � • 32. Electriwl Power Meter-Final - 33. Final Eleciric ' -• �� 34... Final Heating & Aii Conditioning .. 35. Final Gas Pipe-Test . 36. Hood or Canopy � . ,. ' � 37. Final Factory Fireplace � � �- 38. Final Plumbing . ' 39. Water Service�Final - 40. Gas Service�Final ' - � ' 41. Solar pomesticFinal ,- � , 42. Backflow Preventer ' � 43. Backflow Irrigation � - � 44. La�ndscape Irripation System 45. Sound Attenuation 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNING 49�. Electric Release to`Edison ' 50. Gas Release•to Southern California Gas Ca 51. CERTIFICATE OF OCCUPANCY No. Date Date POOL ;PA Inspector qppROVALS Permit # - 52. Pool & Equipment Location 53: Steel Reinforcement 54. Forms . � 55. Electrical Bonding 56. 'Rough Plumbing & Pressure Test 57. APPROVAL TO COVER�GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test ' 60. 8ackwash Lines, P-Trap, O Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor�Final ' 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final . 66. Solar System-Final � 67. Fencing & Access ApProval 68. APPROVED FOR PLASTERING � 69:'POOUSPA SYSTEMS�FINAL FIRE DEPT. REQUIREMENT . . . APPROVALS Permit # ' 70. Underground Hydro � 71. Product Piping O Gas ❑ Oil ' 72. Underground Flush 73: Undergrnd. Storage�Tank,O Gas ❑ Oil . 74. Overhead Hydro � � 75�. Dry Chemical , - 76. Dry Standpipe �� , 77. FIXED SYSTEM FINAL � • 78. fIRE PREV. FINAL � � - .HEALTH DEPT. REQUIREMENT � 79. FINAL INSPECTION � � 80. FOOD CERTIFICATE ISSUED 0 � S Date Ilnspector ,.: � S PI1I�ECT RUORE38: ( O 1 W 19 TH 'ST �WNER'SN�ME: L, A. COUNTY LAND CO. - ROORESB: �� I G i CAMINO CAP ISTRANO SUITE A SAN JUAN CAPISTRANO, CA ' 714/240-13f32• , ' ABCNIENGINEER: '� � - ' , _ nooeess: HEO.NO.: UNIT: uxir: PEpMrtr�E: PROGRESSIVE DESIGNED PLUM ( 213 ) 437-83G6 .nooeess:� 1542 SEAHHIGIiT ' LONG PEACH CA 908'13 � LICENSEO CONTMCTOB OECUMTION: I �ere�y allirm ��at I am IicenseA unUer provisions oi CliaDter 9(wmmencinp with Secfion 70W) ai Division 3 al IAe Business an0 Professians Catle. anU m�y,fj" "se is in tull for anU ellect. . cinuc: A9 45 �a�uc.:334799// �cu .�� Da[e: �� Siqnatum: �!" y%�� WOX1(EBS' COMPENSRTION OECUMiION: I herebp attir tAat I �ave a certilicate oi wnsent ro selbinsum or a certificate oi Woders' ComDensation Insurance, or a certilie0 cop ihereof (Section 3800, Lab. C�. i � roucrxo.:73WC008071�01 , exv.oeh: 10/U1/90 wMrnxr: NATIONWIDE � Certitied copy rs n�e�re�hy tumis�eA. � Cetlifie0 coDY �/f th ihe ciry BuilOin i'on. }Uate: / J`- �"' Applicant: _a�� ` E%EMPfION FBOM WORNEBS' COMPEN&1TION OECIAMTIDN: (iAis saqion nee0 nat �e comDletetl if Ne permit is for one huMreO (E100) or less�. I certiry IOa(in tAe De�ormance of tAe work for which t�is Dermit is i5sue0, I sAall not.emDlay any person In any manner sa as to Cecome subl�� o the Wo�CerS'Compensatian Laws oi Califorma. - ;,<. Date: � Si9natum: NOTICE: II, arter'riuldnp tAis Eeclaation, you 5hould Decome suGjecl to tAe.Woileers' Compenutlonlpravisions ol I�e LaGor CoAe, you must IonMvrth comOW �� suc� DroNsinns ar I�is permit s�all Ce GeemeO rewkeC.. � CONSiNUCT10N lFNU1NG AGENCY: I hereby aflirm t�at t�ere is a conslruction len`din0 aAency lar'IAe Dehormance ol t�e work for which Ihis Oermit 15 issueA (Seclian 3W7, Civ. C). ' < 9 lENOEH: • . � . . RDOflES3: — . . - . . ' OWNEP BUILDFB �ECIAMTIOM: I hereby atfirm ttut I am eMemp[ irom t�e Cont2crors' Sta[e Licenu Law for Ue lollowinp reason (Section 7631.5 Busineu anE Professional CoOe: My ciry ol counry whicA repuires a permit m construct, alter, imprave, Eemolish, or repair any slrucNre, prior ro its issuance, also repuires t�e aDDlicant for wcA permit to file a sipneU sta�ement Mat he/she I5 Iicense0 pursuanttothe proNsions of��e Contractors'State limnse Law(Chapter9�commencing with Section 7000)oiDiWsian 3 oit�e Businass anE Professians CoEe) or that he/she a exempt the2trom antl t�e Dasis tor Na alle0etl exemption. My violation oi Section 7031.5 hy arry appGcant lor a permit su6jects the aDUliwnt lo a cNil penalry of irot mora tAan I'rve �unOreE 7ollars (5500�., ' ' I, as mmer al the D�DeM�or my emplayees vnt� wapes as Neir sole compensatbn, will do the work, an0 IM ❑� Siructum is noi in[¢nEeE or aflereU br sale (Sectian 70<d, Business anA Professional Cotle: � IDe Contractas � State License Law Ooes not appty to an owner oi a proDenY wt�o huilas ar improves Ihereon, and who tloes suc� work �imself/�arsell or IMaupA • � �is or Aar awn emDloyeas. pravitle0 Ihat such imDiovemenls are not iniende0 or oflere0 lor sale. If, Iwwever the EuilainA or ' 'improvement is solC wrthin one year ol wmpletion, t�e owner�vnll �ave Ihe burEen o� pmvinA he/she tliE not builG or imOmve lor t�e DufpOse at Sale�. ' I, az owner of Ihe D�rty am exclusiveI� contacting wi[� IicenSeE contactars ro canstruM I�e project (Sectlan 7041, Business ❑ arq Pmfessions CaOe: The Contrac[ors' State licenu Law Eoes not apDN to an owner al O�Per1y � �� or impraves ttureon an0 wlro comracts for such pmjects vrit� a contractor(s) licenu purwant to the CanV�ctors',State �icense Law�. I am awara that Droof oi t�eir WOMer's Compensatlon insuronce stroul0 be pmdOed to me. . . � I am exempt unAer Section: � . B. 8 P. C. , � for t�is reasan: ' � � Uare: � Umer. ' . I Oo nea6y ceniry tnat I am awam al anU un0erstana t�e repuiremenis of Calilomia Heatt� an0 Safery CoOe Sectiora 25505: 25533, an0 25534 anE rtwt I or any fuWre buil0inp occupam wilUwill not (circle ane) nee0 to campN ��h saiA sW[e co0es antl Ne reQwremenis lor a permit lar wnstmcqon or matlitiwtian from Ihe Fir ualiry Manapement Oislrici. HesiOential canswction applicatians aa exempt trom th¢5¢ prOvi51on5. � � - Uate: ApDlicam: I h¢ROy ttrtity Itut I Aave reaE tAiS aDO��tion and sute tAdt Ihe aDove information is con¢cL I aqree to wmpry wiin all ciry anE rAunry - orainarces anE sfate laws relatmp ta hWQnp carttruclioo aM �e a rize represen oi tiry to emer upan the aEove-meniionetl properry lor inspeceian Duryoses. 'I�,'/� // Oa�e:�/ ✓ �— Sipna�ura: T t��'/�/// , . . oriver's �icense ai Socia� secunry x: 16a1-a6 W�ito-BuiWinn: Gree .Cotla Enlorcemani; CenarV-ApO�Kant: ink-Revenue: olEenroE-Avessor CI'CY OF COFiTA MESA — BUILDING PEF2MIT PERMIT NO: P 045582 PLAN CHECK NO: N CONSTRUCTION TYPE: JOB.DESCRIP'TION . CLAIM VALUE: PERMIT TYPE,; PLU PLU SHELL ONLY MEDICAL BLDG CALC—VALUE: _ PERM NOc F 0455�'l \ GOVT: N SUPP: N , ' - PURPOSE: � NEW : Sl,� ET : GROUF OCC: . / COMMENTS: B-45493 . � x��r��*x *�****�**�***x **�� r��«�*��*��r*�r*��r*x � ****��r*x�*�r�c* x�**�**��r��r*�r**��+r�*+�*+r • 7. O N I• N G R E Q U I R E M E N T 5 ' 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 RE(j: . PROV: PARCEL: 42421111 ZNE: ' REF NO: , PLANNING NOTES> . � ' .. .. . . . _ it iF iF if iF 1F if 3F 1E 1FlF fF iE if if if if if iF fF IF it it iF iF iE iF iF jf iF M 1k iF 1k if 1F i! iE ik M 1E if k IE If If ik iE k if 1E if if �lf 1E ik fE 1k f! i! 1!!k ik iE 4 �E iF 1E iE k 1E iE 3E if jE iP iE if iF 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 HY .',� DATE: � BUILDItJG APPROVED BY : -. DATE: � APPLICATION ISSUED DY: �� `' DATEe �J � ififif3fMiffFMiEikMikiElfiEiEif1f1E16fE�E3F�iFiF�{Fi�� F�iF3f3Fif3F;F��fif'ifik#iEiF�klklE# M1F iF if ik K iF if if k iE if k iE if iF it 1F M if if if 1F iE k M iE if ik iE ik M iE iE IF iF iE ik iE iF iF if if M IE if if M if iF M iF 1FiE iE iE 1f i! k 1f�'iE if iE if k if K if i6 if iF �IF 1F df iE 1E iE if i6 iE iE LEGALIZATION:N F E E S U M M A R Y -',STRUCTURAL SEGMENT;N. BLDG PMT PLUMBING� ELECTRIC MECHANIC FIRF SMIP/RES . GRADING PERMIT 61.00 . 258. , � SMIP/NON—RES PLAN � , ISSUE. FF.E - 3.00 -- • BUILDING—D.IV—> PERMIT ISSUE PLAN—CHECK TOTAL PAIll DUE TOTALS--- > 61.00 3.00 ' 0.00• 64.00 64.00 .00 RE�7GNUE DIVISION T'OTALS--> COLLECTED: 64.00 OVER/SHORT: .00 HLDG'PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK ' 64.00 ;i . if iE iE ik iE iF ik iE if iklf if if it iE if if iE 7E IE iE Ik ik if k 1! iE if ik if if ik iE iE iP iF iE 1E iF k iE 1k ik 3E k ik if if k iF IF iF it iF IE K if iE if ik if �t ik iE 1t iF iF if iF 1k k 1E iF 3E iE iE iE it iE I N D I V I D U'A L� F E E B 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 PLU 4 FLOOR DRAINS " 2.00 fi.00 PLO 4 WASH HASIN 2.00 8.00 PLU '4' WATER CLOSET (TOILE�T) 2.00 A.00 PLU • 2 WATER HEATER AND/OR VENT 2,00 4.00 PLU 1 �CONNECTION TO DUILDING SEWER, EA 5.00 ' S.00 PLU - i4 RAINWATER SYSTEM =.cPER DRAIN 2.00 28.00 • END OF FEES . 0 c� a 6 A 01 00051016—OOOS1016 T U T , 64.00 DA7E: 01/D3/90 TI%E: l5:00 : • . � CONSTRUCTION AND PLANNING . � POOL �,. „PA ° � Date Inspector Date Inspector � APPROVALS Permit � � APPROVALS Permit # 1�. Temporary Electrical Service or Pole:� . � 52. Pool & Equipment Location � 2._,So:IPipe-Undryrnd� _' "''��. � ylqo (�p 53. Steel Reinforcement ' '. 3:-Eteciri2al Condilit'l�tility-Undrgrnd? '. 54. Forms .�:.rn-_. � - ,z y 4.-Eleoir�al Conduit�Undrqrnd. -�`j , 55. Electrical Bonding �:5.<SteQ. Reinforcameni`. ' �� 56. Rough Plumbing & Pressure�Test ;,'i _. � s � .,..� ' �,.6r�Eleoi?.icaIUFFA:Gmd. � - . � � 57. APPROVALTOCOVER�GUNITE ,� ��7.`Footings - u 58. Electrical Conduit-Undrgrnd. ` , r';��FoiMldation �- � � 59. Gas�Pipe, O Undrgrnd., Test . 9.jWater Pipe�Uniligmd. ' � 60. Backwash Lines, P�Trap, � Undrqrnd. ' tO.�Structurel Floor System , � . 67. APPROVAL TO DECK � 11 vPropertySewe�Lin��& House.Connection ��ri qd (�,�p 62. Backwash & Receptor-Final 12. Sewer Cap i c: � r'n , v , '' 63. Heater & Vent�Final � n 13. Roof Drains S.�y�KO'l� 3%' � 64. Plumbing System � Final 14. Rough Plumbieg ci0 65. Electrical-Final 15. Rough Electrical�Conduit 66. Solar System�Final 16. Rou9h Electrie,Wiring' 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING ' � 18. Rough Electrical-T Bar Ceiling , 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning _ fIBEn EPT, ftEQUIREMENT T � i7 n.: T� ...�, x f ._i Y.. M - c _ �T�r. ... ♦ _ -_ . ^C� 20rRo�hFactayF,iiE`place Sr �� i; S;' �xT :APPROVAL$-"-`'Permit# y_= ��j_-' .., � 27 �Ducts, in�Str�ucture� ' .. " ^� � `� � -+'�: ^' ^ - -. _ . . . � - 70. CJndergioand Hudro r w ��-. X ; � H tl 1" �K �. 'A '� � l::i E 5 C.r: K r, �t,� _'. . 22:=DuCfs, Ventilating x . ;� ;� � � q FX r 71. Product.Frping QGas O:OiI _ 23.�GarPipe=Ro�gh & Test �'"T'=' � ?� = �^. :�x * 72, Undergrodnd Flqsli� " v � !� T-•• l'v!'1 'k I^ r,' r:A i r-:.. K � 24?Roof Fra'min '4 `-` ..F" "�'' '- " �*'. - � '• `�' '" < ..�=+a �I _ 9 =,� J ;.> >, . � �_ �-� � :73_Undergrnii.Storag�Tank,QGas ❑Oil � 25. Roof ShEathing c x �`a; v•�: ^ C^.^� {; 74=0verhead Hyd%� � -� y l: p :'J s M �- x H m s ' 3 rl �:. 26-�T-Bar Ceiling (Suuctural) &'M.onocoat .� � y �,. r 75gDry Chemlcal c,� �;� ��,pG ` 27xFrame and Flashing: •. 4, ^ [- C� -� +a, Y�r 76�, Dry Stand�ipe �,`� �_ O= _iTSS I -28. Lathing-& Siding # " jG�;,; ` M ' "� "� ' ix ; 77;; FIXED SYSTEM�4NACw ..� -y �C -,;;,�f,.� �29. Insulatian ;<� S �• .k � � . �t' * 7gy.p�IRE PREV. FINA�L * � -� Q`' .�;c^ :r ^ i: 4 1 � �F K r i r.! v r^ J ~ '1 (:: � 30. DrywalLNailing y; � . * r, � ; ��; x s•�;� ^7iEALTFI_DEPr. R�EQ�OIRENIENT r,�. �^31. Plaster 8rown Coatx S !�^!' �Y � i �K ;^79�JFINAL I�TSEECTION x. v �� a'`• �...-. -Y ^, � _ � :-, = �.32.=Electriql Po:wer Metei-Final' ' x�� j i *�' SO�FOOD CERTIFIC%'1TE IS�'�S�JED,y ;� V , l.� � . {�1 'G ^ f33?Fine�l Elpctrio � � c; a' � i Ix. ^ Notes: � N�4;0 U�;;;�LA6G (SfLAt�hb OIGW,ru� N-34,_`?Fin`al Heating�& AiP�Co�ditioning- �' � ^ � � * ^ � �^.`� x = ` �= S ^`7 ;� 't �•: '1 :R � !# t J �-t I FQ fi Ct... t_ r : . . - < r I . I^ .. � � i_� .. . _ 135,-Final Gai Pipe-Teste �; W •• a. �-. i .i � Co �� E�NCG' �%36. �Hood or�Canopy ` � :T'-; �. r. C, � � � �x� - t ?tc K � :i�_ � S C rJ G.i�. t:t I I i�'% C' %�O 'i!�J ��it-�: --37��Fina1 FactorV Fireplace;, � F•;- c.�. �x � � � ,.� x x ��r� ' .. i i i. r"38. Final Plumbing K �� ' `" �� ,�lY��. T' H K ii.� ��. X `-` �. ��sn X M .'F CI, '�39. Water Service�Finalt � , � * � � i p: r; , �' c"` �: � .`-40. Gas Service-Final '.' m C^? = x!-i ; � `x � G4 �^� '` V �"� :. M �r. t � c s. x r; �S :� •• a.. � � •r � � � .-, i �41. Solar pomesticFinal r .,c { '.�� # �r �yo v: ^ > , _ 42. Backflow Preventer-. ' ": r.. - ! y,� r: � >:� * c+ :-{ _-•:,i .-� 1-; �.. z r. 'k M t^ [' �, k c� x. , ^S:5 x .: R .... .F �J _. ....vi..,v: 43. Backflow Ir?igatioq; �� x,� 'r. �'d i x f� •�•• � .� =44. LandscaPe Irrigatioh SYsterrN-;;' � x:. �� v C•7 x.. ,J ^' ..."' *^' f� p��=�� (. -i � vc C. e! %: x i i �".. V•� M S ti r .A u � � (_ in Y' �. �."" �"' -. :� 'X, : !-� H �.T � '�l "45;Sound iAtte:nuatior} -,�.: .. � t n �_- �-;,� * � �. :� �G • r-,-� x - r46 •Nandicap Regulations +--� O * x '� ^ G `-' �= � S �, � •• <- xr i �. �. r �� [a r47=fIfV,AL STRUCTURE & BUhLDING �` � � �" " " " � � ; , � � F � j Fe �: � C' �� 48.=FINA� PLANNING :^F� + c� ' ! +>. F ^ .=i < � � . r: I � .r. �. � r� r;; 5 x c ='49.=,Electric Release to'Editon ' ,�, j ". '� * ,� �`',� � � �,. _ �50 _Gas�Release to $outhem Califomie Gas Co �� k �c * � G � c:"• +� O ✓•� � l�^ � ~ . • � -- x x . ^�o n �: ;� aoa�o_, -�51. CERTIFICATEOF'OCCUPANCY � >� x s +� .,,- ,. � r v�.:......,.. , No. Date OIECTRODPESS: 6O1 W '19T'H S'� ' " owxex•sxrMe: TRIANGLE SQ .TOINT VENTURE � �ooeess: �3161 CAMINOCAPISTRANO SAN JUAN CAPISTRANO CALIF. ' �NGI/FNOINEEfl: IIDORESS: uxrt: ' NEO.MO.: UNR: PENMIITEE: AIA UNLIMITED '� ( 77.4 ) 632-5310 �oowess: 1230 LAS HRISAS ANAHEIM CA 92806 ULENSED LON7MGTOB DECUMTION: I here0y aKrm Uat I am �cen , E unEer prov5ion , ol Gwpler 9(wmmericinp with Section 7000) ol Oivision 3 al t�e Busineu an0'Prolessions CaCa, and my Iken I� in lullforce � ette . arruc.:0 1060 gr�Teuc.:322935 ��C-? —o�ce: ' — O sio�wm: ' WOBkEp3' COMPEN&ATION OEClAMT10N: 1 trere atfum Wt I lim a i te N t to utl-iRsum or a aNfiwte ol WOBers' Compinsatwn InSutance. Or a terti/l!G Wpy Nereol�5tctbn 3800, LaL. C), POLICY NO.: �% �. O% 1 3 IXP. ORTE: O 9 1� 9 � � comanNr: STATE FUND ❑ Certifie0 copy I5 herehy fumiSAeE. � CerlifieE capy is fileE ' iM city uil 01 sbn. . . Jate: - U ��d � —lU ppplicam: IXEMp�ON FlIOM WONIlEIIS' LOMPFNSlITION OECIAM710N: (fh¢ n Ee if Ne pem0'¢ ta are AudreO (f100� or kss�. � CeNty tha� In �he pCAOtmante ol �M vrotk 10f wNC� IMS pefmil'6 i eU, Stu no� l0'� Iny Oe�n in any mannef W a5 to AeCome suoiec� �o me war�ers Com ensation Laws ol Calilomia. ; Date: Sip�uture: I NOTICE: Ii, aher maldnp tlus Eetlaation, you 50oNU 6ecome e t to he Wark rs' ComDe�lion prmision5 oi the LaUor � CAEe, you mus� larthxit� tampy wi�t1 suU v�o'��s or Ittis pEr StW Oe CeemeE revake0. r, fANSTpUCTION LENOING �GFNLY: I heaby �Mrm Nat Ihere 5 a mi¢ ti n lentlinp ape�y lor the peAormaixe of tAe woM lor wAicq thls permit is issued (Section 3W7, Civ. C). LENOEP: �ooeess: OWNFR BURDER DECUMTION: I �erehy attirm Itut I am exemD� ��m Iha Cantactors' Stata Licensa Law lor I�a tollovnn0 reason (Secpon 7031.5 Business anA Profe55ional Cotle: My tiry ol caunry wtnch requires a permit Io construct, alter, imprave, UemoliSR or reDair any slmcNm, D�a� ro Its Luumce, aLSo reQWres I�e apD�� or suCA Dermit to lila a slpne0 statement that he/she I5'llcense0 purs�ant m tne pravislons of tAe Camnctors' SGro Licensa Law (Cliapror 9(wmmendnp wiN SecGon 7000) al Divislon 3 of the Business an0 Proleulons Catle) or tMt M/stre is ezemD� �M�elram an0 tM Guis for the ylepe0 exemptlon. My vioWtion ol Sec�ion 7031,5 Oy airy ipqkant lar a'pemrit wDjau Ne appGunt to a dvil penalry oi w� more ttian iNa nuMreO OWars (SSW). I, as owner al t�a D��Y or my emW�yees xit� wapes as t�eir sole compensaiim, will Oo t�e work, end the � simctum Is nat intenEeE ar olfered Iar uk (Sectbn 704A, Buvness anE Pmlessianal CaOe: 7Ae Contractore' St�te License Law Ooes not aDDly lo an avmer al a pmpe!�Y �o Uullas or ImD�a�s t�emon, an0 wlio Aaes suc� work Mmsell/Aersell or I�muph his or �ar own emD�N'�, Drovl0e0 tlut suc� improvements ara not IntenOetl or oNereO for ule. II, �owever the Euiltlinp or Improvement is sold wiWn ona year oi comdetlon, tAe owner vnll luve Ne UUNen ol DmNnq �U50a UIU noI 6wld or Improve � far Ina purpoSB at 5ale�. I, as owner ol t�e pmpe�ry. am evGusivery wnVactlnO with IkenseC contactors ro canstruct I�e Dmject (Sectlon 701d. Business ❑ ana Pro�essions Caee: TAe Contractors' Sute iJceme Uw aoes not awry to an wmer ot o�oerry who �uilQs or imD� ��ereon antl wtw conlracR lor suc� Drojects wlt� a cont2clor(s) licensa Oursuant �o the Controctars' State Licensa law�. I am awara that Drool of lheir Worker's Campenutlon insurance s�oNO Ge O�aviOeE to me. � I am exem0� unEer Section: B. 8 P. C. , lor this reason: � oate: Pmer. I Eo hereUy cerilty that I am awam ot antl untlerstanG tM repui2ments ol Glifomu Healt� anO Safery Code Sectlons 255U5, 25533, and 25534 and ttut I or any tutum OUIICInO awpant will/will rrot (drde one) neeU m comDN �th 5ai0 siate coUes ana Ue repuirements for a permit lar canSWc(ion ar moN/iwfion from lhe a'r�ualiry ManaOement U'stnc[ ReSiGentlal rqnstruction appficatians am exemD� «om these PrmriSians. Oata: ApD�c _ I �er¢6y certity ihat I Aave aa0 t�is applicatlon an0 state that or�inances an0 state laws relatin0 �a �uilEinB canstruction aM � '�. ProPerty for inspectlon Ourposes. qG Date: ��' LG � �� Si9�Nre: _ oriver's �icenu or Saiai Secudry x: �° i861�fi WFtle—BuilLing; Graen—COEa Enforcemanl; G inlormaii0n with all cily anA counry on1Ae above�mentioneA GalCenrad—Assasaor CITY OF COSTA MESA — BUILDTNG PERMIT PERM NO: M 046303 - FERMIT'.�N�n�7 ' •046303 PLAN CHECK NO: N GOtJT: N SUPP: N �:f . CONSTRUCTION�'TYFE: • PF.RMIT TYPE: MEC PURPOSE: OTH JOB DESCRIPTION : MECH FOR NEW CONSTRUCTION SQ FT: CLAIM VALUE: p.�� CALC--VALUE: GROUP OCC: / COMMENTS : � `� 7v � /J ' ififMitMiEiE�EiFlFk ±f iEMkkiE3FiEihlfikikiFiEiFitkMMifkMififlfiFififitMMifMiEitlfliMiFkkkkifkififiEMkiFifikiEiFiElkfflkififMkifiF . Z O N I N G R E Q U I R E M E N T S S, E T D A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUZLDING --------- FRNT: FT IN REAR: FT IN �FRNT: FT IN REAR: FT IN. � LEFT: FT IN RGHT: FT ZN LEF'T: FT IN RGHT; FT IN� PARKZNG REQ: PROV:' PARCEL: 42421111 ZNE: REF NO: PLANN.ING.NOTES> > -. it iE K if if iE if iF iP iE iE ik 3F iF 3t iE if 3f if if iE 3k if iF�F 1E iF iE if if 1E iF N iE M if 1F'iE'iP if iE iE iE iF it iF iE it ik iF if IE ik iE iE iF9f iE 1E if iF iF iF if if if iF ik iF �F it k if 1t iF ik it 3f 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 �HY __ DATE: __ _ BUILDING APFROVED BY : � DATE: APPLICATION ISSUED BY; a" DATE: 2— Z� 9� if�klE�N�iEiEiEiFkiFkiFitlfikififitikiFifiE ��iF��F1hMMitiF3kiEiFMif iE1E ifiFifiFMifiEikklEifiEififitiFMltiEiFilifkikiFfFifikiliFlEMiEitifififiFliiEiElFlfMikiEMifMMMIPMikifMkifMMiFiFiEiEiFMitifMiEiEMiklEiFiFiFiflk LEGALIZATION:N F E E S U M M A R Y " STRUCTURAL SEGMENT;N �BI,DG PMT PLUMBZNG F.LECTRZC MECHANIC FIRE SMIP/RES GRADING PFRMIT 37.50 . zsi SMIP/NON—RES PLAN � ISSUE FEE iS.00 BUILDING—DIV--> PERMIT ISSUE pLAN—CHECK TOTAL PAID DUE TUTALS----> 37.50 15.00 �.- 0,00 52.50 52.50 '.00 . � REVENUE DIVISION TOTALS--> COLLECTED: 52.50 OVER/SHORT; 00 BLIIG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIF/TOT GRADING PLAN—CHECK � SZ�S� ifMlEitNMif�kitifiElEKiEkitMkNiE1EMiFiFkiFiFMMiFlEifiEkklfifMltiEifiEkkifiElElkatiklFiFiEiFMIFMiEIEataEiFifNlfMiEiliEiFiEffMiE3fiFkMk I N D I V I D U A L F E E ,B R E A K D O W N TYPE QTY . D E S C R I P T I O N UNIT COST MEC 1 REFRIGERATION SYSTEM <= 100 K BTU/H 9.00 MEC 2 fl6FRTGERATION SYSTEM > 100 K ATU/H 11.00 MEC 1 VENTILATION SYS NOT UNDER PERMIT,EA. E.50 END OF FEES TOTAL COST 9.OU 2?.00 6.50 01 OOD55205—OOOS5105 T C�T 52.SG DATE: D2/23/90 .TI%i: 15:55 .. - - � ; �CONSTRUCTION AND PLANNING � - ""' " POOL � .,PA� • � � APPROVALS Permit # Date Inspector qppROVALS Permit # � Date Inspector 1. Temporary Electrical Service or Pole� :. 52. Pool & Equipment Location �2. Soil�Pipe-Undrgmd.;, � `'= 53. Steel Reinforcement ��3. Elecfrical Conduit�Uiility�Undrgrndrti, , 54. Forms � � -4.�EletVical CondUit�U{�drgmd. = 55. Electricaf Bonding �. .5.T Yeel Reinforce�ment � �s 56. Rough Plumbing & Pressure Test � ��6'-E�ectrical UFER.Grnd. '' 57. APPROVAL TO COVER�GUNITE - � �.7..( Footings 'r_'..., 58. Electrical Conduit�Undrgmd. °' �B.�F�oundation 59. Gas Pipe, � Undrgrnd., Test i i-„ _ - • 9_Water Pipe�Undrgrnd. •' - 60. Backwash Lines. P�Trap, O Undrgmd. _ ' 10_`Structural Floor System � � � 61. APPROVAL TO DECK 1�1.•Property Sewer Lin;e�& House Conriection '. 62. Backwash & Receptor-Final T2. Sewer Cap - �- • � � 63. Heater & Vent-Final � ` c 13. Roof Drains .. -, � 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final r 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric,Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19._Rough�Heating & Air Conditioning i. .' � �* F_, ,_,FIRE QEPT. REQUIREMENT __ ; `� -- ' � T� G.=., 1 L. .: w - r��., �:�� In �k ', `iT - 20TRoagh F,actory Fireplace _r x.< < c _ ;•u f �APPROVALS;�..�Permit# � - _- - - _ .� 21�Dus, :n'Struauie' •• •' �S F S - -,A � - ~��-�-i . y? _ t � , * ;70. Underground Hydro 22;Ducts,Ventileting' ,�:- � r�:; 17�, ProductrP,ipingO6as O�OiI 23�GarPipe-Rouqh & Test _ �;" F� �_ 4: �� ' �7z, Underground FIu3h' y " � ^ r � F =. �. - � - +� ,. ; � �� - y .-�c . 24.`'Ro6f Fiemirig �� i-, ,"� „� r� � x; J.73r,Undergrnd. Storag�Tank:O Gas ❑ Oil� 25. Robf Sheathing�"" � � �_ `ti'� rt 7q 'Overhead HydroJ_�., ` 26'_T�Bar Ceilin IStructural� & Monocoat ` � ' nr * 75�Dr Chemical ��, � ' r 9 x'_ _ C'. « Y ' i- •- 27^Frameand Flashing' : ' ' ''� �Y { 76. Dry Standpipe �.� � � - �, '� '': -.2- c x.- .. . ..r�: '� - - ,.C•- , 28. Lathing.& Sidin� ; - � r � , ,� ;; 77 ; FIXED SYSTEN}' F!INAL, ,- i rr : � 29. Insulation =� •' � ' '= ' ,�,� � J y � � � , k �' 78,=FIRE PREV. FINFj,L � � �� `�30. Drywall'Nailing ;;i a; F � �: : s HE�ALTH�DEPT: REQUIREMENT � �' • -- G31. Plaster Brown CoatY � r• L � � -79.�FINAL INSPECTION " . ,y32'.Electrical Power Meter�F,jnal � {' ; � � �'80'rF00D CERTIFIGATE ISSUED_ ;•;�. _ �33'�Firial Electric r•. � -� i � ;� . Notes:� ��';QA'/�Ol"tQjfe.4�P-(�e' L��(J y' ' L L� �34:Fin`a,i H¢atin8 & Ai(:Contlitioning � � vt Q� (�'�� 'K " S ;'�4` - _ ' ,,, ti �. �- :� r � - - 35^Firial Gas Pipe-Testa C4 •• '� �� A` * - r�' � - 1 ._ � .�- `36.,Hood orCanoPY '� _ -^ -= !c ,-. ' �L� v - .y ',c .c _ - -: . -� xJi� �:� :.n � ;s�. r. �o . _ _ r-t-. �1 �J ♦' , - � V � - ..w � � � . .. . --37.:Final Factory Fireplace: i �-� _. � '' ;t �� :. � x - l !" tY } �38. Final Plumbing � ^ ,- ' ^ � ' °"' - --' "� , � `� '� -V � r�-' l � TR �- . o S x` '�39. Water Service-Final', g � _, , # -. > � �v�J �� >- � [:��-t" ti. . T40. Gas Service-Pinal �. �' - .y� � � -- �r :. C:.: ;,�c� : �.y � x �i � � t, M •t , t. . �, : _< y as ';;41. Solar pomestic-Final �;; �� '� ` '- � r� . ; w :- ' (� x . �,� � - � F „ - - 42 �Backflow Preventer� '- n r �i fl -.ry I�. : tr ;r;' • r � _ - 4 ' "_ • w .�• - _ - 43. Backflow Iriigation: --' �n � +� � �� * � _ _ (. ` . t''44. landscape IrciAation SYsterp. -�';? .. '. `� " � d^ " - r• ; : �^�� -� ` ` � �, . � _ � a ,: �:; :� _� � ,�. ,a- _ � c;- ;c' �- r_ r^ -- r ,, t _ .- �-. . ..,`w-. -45.`�Sound ,Att nwcion : .. # r• r: -;�. r. -. ., - • 46.•�HandicaP Regulations �7 K K ^ : ^ `� •�c - ' � � � n �., ,�47''FINAL STRUCTURE & BUILDING * F � i s � � � 'i � �-. 48.-FINAL PLANNING � F- •� .� * � � �� `' . � � � �49 Electric Release to.'Edison ` ' �'' ` - '" : > � .i r . r, � ^50 :Gas:Release ro Sou%hem Californ� Gas Co * � j'�. n" "- -'�� 4 C� " -51. CERTIFICATE OF`OCCUPANCY ' i/' ' - � ""' - " ` No. - Date '� ' m � 0 PflO1ECi�00flESS: � 6O1 W 19TH ST ' owNex�sr+une: TRIANGLE SQ JOINT VENTURE . ADOqE3S: J3S61 CAMINO CAPIST12AtJU-A - SAN JUAN CAPISTRANO �, CALIFORNIA 92675 �HCNIENGINEEk. � l 4� 2 4 0-1' 3 f3 2 � _ ADDflE38: � � � � ' . UNR: ._ flE0.N0.: ONIT: �, PEflM1TTEE: fBE ELECTR�ICAL CONTAACTOR ( 719 ) 632�-9818 RDOIiE3E: 1 8 Z ii TYMPANI CR p � LICENSEO CONTRACTOR OFC�LA{RATION ! RereGy atlkm that I am IkenseC ullCer pArovis'q9rtszo�Cl�+ap7rer 9(commencMO �7th Section 700D) al Division 3 al t�e Business and Profeuions Catle, an0 my license is in h1l lorce ane ellep. cin uc.: 0 9 0 3 7 5' srnre uc.: 3 6 4 2 1 cuss: �-10 •. Date: � �-/ L ^9 -� SionatGS�6�/'%- • . WONNEIIS' COMPEN3pTI0N OECIAMiION: I hereb ifir t�at 1 have a ceNfica[e oi consam m selt-irrsum or a ceniliwm at Workers � Campensa�ion Insurance, ar a cenifie0 wDY ��ereof an 3800, LaG. C�. voucr xo.: F50177 exr. onre: OG /01 /90 "` coMa�Nr: FAIRMONT ❑ Certilied coDY is hereby fumis�eE. �+ CertifieU capy,is (ile0 w1tA Ne cityBuildinp Divislan. oate: �/�LG � - 5'0 a�vrwm. � -_ ,±" IXEMPTION Fl10M WOq1IEAS' WMVEN311TION OFCLAWITI : k secM1on nKE �rot Ce mmp@t[d il Uk pemtil is �or one IiwMreE �f100) a less). I cenity that in the Oarfarmance ol ihe work tor wtiich t" ermit is issue0, I shall not emD�oy any person in any manner so as t0 hecame . '�IsuEiect ro tAe Waders' ComDensation Laws ol Calitomia. , �! DatO: � $iOnaNR: - ' ' NOTICE: tl, after maldng this Ueclantion, yrou should hecome su6jeq to the WaBers' ComDensaGon proviskns of [he Labor � CoUe, you must torlMvit� comDN �� such provisions or tMs permi� stull be tleemetl revakeU. � CON$TRIIC710N 1FN01NC RGENCY: I AereEy amrtn that there is a constnution IenEing apency tor the peAormance of Ne work lor wtiich this permii is issuetl (Secuon 3097, Gv. C�. � tENOER: � ' � , . � '. "` ' ROOPE88: . . ' , , , . . . . y � � . OWNEB BUILUEP OECUMTION: I �emby amrtn tlul I am exempt tram,lhe Contractors' Stata Liiensa Law tor Iha tWlovnnp reason (�Rion 7031.5 Business �n4.Pmfesslanal CoGe: My pry of caunry wliic� requires a permit to crorrstruct, atler, im0�ove, Uemolisti. or repair any sWcture, Dnor ro its issuan�e, also requires IAe apWiant for such permit to file a 5iqne0 statement that �e/slie iS Iicense0 pursUant to t�a pmvisions of the ConVacrors' State License Law (C�apter 9(commencinq whh Section 7000��of Division 3 at t�e Business an0 p�ofesslons Code)�or tAat �e/she'IS exempt t�ealrom anG the hasis br �he allege0 exemptian. My Nolation of Section )031.5 by any apD�icanifor a permi� SUEjects tha aOPlicant to a cMl Denalry oi nut mare than live �unEreO tlolWrs (5500�. � I, as owner oi the prapeM or my einplayees wit� wapes az l�eir sole wmpensatlon, will �Co Ine work, and t�e ❑ stmcwm a natintenEetl w olfereElarsale (Section 704A, Business anE ProtessionalCatle: T�a Contadars' State Lkensa Law Ooes not apDN ro an owner at a pruperry xTo CuilCs or ImDmves t�ereon, an0 wAo Does suc� work �imsell/�erzelf ar t�mup� - 'his or Aer awn employees, proviAeO [hat suc� imprwamena ara not imenUeO ar ottereA br sale. II, however Ne buildinq or imOrovement is w10 within one year of completion, Iha owner wiil Aave the Curden o1,Drovinp he/she 4i0 not Guiltl ar imprme ior the Duryose oi salel. � � . I, as owner ot the pmperry, am exelu5ively.contractin0 ��h license� coniractors to conslmct t�e Droled {Sectlan 7044. Busine4s ❑ and Profcuions Cotle: ihe camrzttors' state Licenu Law Oces not apON �o an owmr of D�PeM � �wlds or im0�s Ihereon anU wha can�racts for wc� projecls witA a conirattor(s) Gcenu Dursuant ro I�e Contractars' SWte �icense Law). I am aware tAal proof of Iheir Worker's ComDensation insuance 5�ou10 �e prwiGetl to me. , � I am exemD� unCer Section: B. 8 P. C. , ' tor Inis reasOn: .. ' ' Date: Ownec � tlo liereby certity tUat 1 am aware ol an0 uneerstan0 tAe mquuements al galilomia Healib and Safey CoOe Sec6ons 255Q5,� 25533, a�E ' 2�3C an0 i�at I or any �Nure OUIlOinp occupani w��IVwill n�(circle one) n�etl ro comply wit� saitl state codes an0 Na requiremenis for a permR Por constmition or'moditicmion imm t�e Nr Oualiry Mana9ement Distdct. ResiOenUal wnstmction applicatians am exempt Irom thes¢ provisions. ' ' ; ' � Oa�e� ApD�icant: � � I nereby cenity tlul I have reatl t�is appliwuon inA stah tlut the abore inPormafian is arrec[ 1 apree M wmpty wiM all dry antl counry orUinances antl state laws reWGrp ro huildinq consWcuon an0 �eaby authorize represenlathres of this d to enter upon Ne a0ovementione0 prop¢�y tor insDecuon purposes. ' ' � � , Date: - � Si9nature� •� . �+��er's license a SocialSecunty M: Whiro-BUIIEin9l Grean-CqEe Enlorcement: Cena7-MPlicent: Pink-Nevanue: GalOanrpd-Asyassor , ' CITY OF COSTA MESA - BUILDING PERMIT PEI7MIT NO:, E 045747 PLAN .CHECK NQ: N CONSTRUCTION TYPE: PERMIT�TYP6c ELE JOB DESCRIPI'ION : ELEC FOR SHELL.MEDICAL BUILDING PBAM NO: E '045747 GOVT: N SUPP: N � PURPOSE; NEW 5Q FT: n � . . CLAIM VALUE: CALC-VALUE: - GROIIP OCCe. /= � COMMENTS: B-4549J (B-45JJ9-FOUNDATION ONLY) �C 2ou9-84 lSs,6- 89�' . iE If 3f iElF �E # iF iE iE iE 3f 3E 1E ff iE iElf iE if it i! If ak ik 3f if 3!-iE 1E iflE 9E it if !f iFlF iE K-i! �k ik 1F iE iE IE �f iE 3E fE 1Elf iE it it M k iFiF iE Ik ik K� 1t k iE ik if �k k iE 1E iF k if ib iE iE Z O N I N G R E Q U I R E M E N T; •' • S E T H A C R S ------------ MAIN BUILDING ---------- � --------- ACCESSORY HUILDING --=!--=--- FRNT: FT IN.REAR: FT IN FRNT: FT IN REAR: ET IN LEFT: FT � Iid RGHT: FT IN LEfiT: FT IN RGHT: • FT IN PARKING REQ: � PROV;' pARCEL: 42921111 ZNE: REF NO: � PLANNTNG NOTES> - > . • . .. iF iE iE K iE iE if 1f iElf 3E 1E 1f iE iE iE #�E iE 1f iE # iE 3E if if iE iE �E if iE if iE �E �E iE iE iE 1E �E it 1F if iE iE 1f 1E fE 1E ff 7E iE fE 1E 1E 1f iE iE jE If !E iE ik fE iE iE if iE it it it i! iE �IE iE iE it 1f iE D E V E L O P,M E N T 5-E „R V� I C E S R E Q U I R E M E N T S . ZONING APPROVED HY �•� DATE: � � BUILDING APPROVGD BY : � DATE: f� APPLICATION ISSUEG BY; DATE: I�O 9 v �E#�EiflfiEiElEkiEiE�fiEiE3flt3Eii3EiflEk ifiElEifiFiEif3EiE3E ikM IE �E k if 1E k iE �E k IE !f fk M iE 3E iE iE iE iF iE fE iE 3! fF It jE iE if if 1E.iE iE iE iF if� 3E iF iF 1f ff iElk iE fF ik ik iE iE M ik iE it �f 1E 4 iE 3f iE !E iE if iF iE �)E iE iE �f iE iE �Ik it 3E iF * iE 1F 1k 3F i6 LEGALIZATION:N : F E'E S U M M�A R Y � STROCTURAL SEGMENT:N BLDG PMT PLUMBING . ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 209.65 , . , ' SOE ' SMIPLNON-RES ' PLAN •i. . , ISSUE FEE . 15.00 • BUILDING-DIV=> PERMIT ISSUE...PLAN-CHECK TOTAL PAID DUE TOTALS----> 209.65 15:00 0,00 224.65 224.65 ' .00 REVENUE DIVISION TOTALS--> " COLLECTED: 224.65 OVER/SIiORT; �.00 HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK � . 224:65 . � ik iE iF jk �)E IE k iE if iE iF �Elf 1f ih if !E iE df iE if iE 1E k iF iF iE if iF 1E iE 3E ik ik iElF k 1E if iF iE IE iE �E 3E ff IE iE iF ff iE iE iE iE IE iE iE w if iE iE iF IF iE ik iE k iElE 1E fE iF �f iF iF �f it * iE • I N D I.V I,D U A L F E E B R E A K,D O W �L • TYPE QTY• D E S C R I P T I O N UNIT' C05T � TOTAL COS'T ELE 20 FIXTURES, LIGHTING 1 ST 20 @A. � .75 15.00 ELE 67 ' FZXTURES, LIGHTING ADDITIONAL EP. .45 30.15 ELE 9 RF.CEPT/OUTLET' 1�ST ?0 EA. .75 6.75 ELE 11 RECEPT/SWITCII 1 ST 20 EA. .75 ' fS,25 ELE ' f3 ' MOTOR/POWR APPARATOS 0..0 - 1.0 HP 3.00 ' 24.00 ' `ELE , 1 hfOTOR/POWR APPARATUS 1.1 - 10.0 HP 7.50 7.50 IELE 4 SERVICES BELOW 500 V&�BELOW 200 AMP 18.50 74.00 ELE�- ' ' 4 SUB-PAMEL 11.00 44.00 �END OF FEES 0 01 0�051447-ODOs1947 TO T DATf� 01/16/90 TIME: 14:5? ,CONSTRUCTIONANDPLANNING � - POOL„SPA � � . APPROVALS Permit # Date tnspector qppROVALS Permit # Date Inspector ,1. Temporary Electrical Service or Pole-�- ' - . 52. Pool & Equipment Location , .�� „ 2. Soil, Pipe�Undrgrnd.�,� "; ti� , ' 53. Steel Reinforcement . �.� '��;�Elect"rical CondGit'Utility-Untlrgrodr C � 54. Forms � � • 4: Electiiial Cond�it�Undrgrnd. � � 55. Electrical Bonding � - �57 Stee��Reinforcem�eTnt ?: � 56. Rough Plumbing & Pressure Test J6�� Electrical UFER.Grnd. ,� � . 57. APPROVAL TO COVER-GUNITE �'_ 7.: Footings �' - . .. 58. Electrical Cqndui[�Undrgrnd. - '"B:�F,ounilation t,,� 'd - . j � � 59. Gas Pipe, O Undrgrnd., Test 9�tWdter Pipe�Undrgrnd. � ' � 60. Backwash Lines, P-Trap, O Undrgrnd. 10: Siruaural Floor;System � ' . 61. APPROVAL TO DECK • 11-. �property Sewer_Line�& Hou'se�Co�nection .? 62. Backwash & Receptor�Final • 12: �Sewer Cap u c, _ ,r 't . 63. Heater & Vent-Final .. 13. Roof Drains ._ e � � 64. Plumbing System � Final � � 14. Rough Plumbing� 65. Electrical-Final � 15. Fiough Electrical-Conduit -� �� 66. Solar System-Final � 16. Rough Electric�Wiring . Fencing & Access Approval 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrica�.T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. _Rough Heating &�Air Conditioning _ r„ FIRE OEPT. REQUIREMENT� � - �n : �. � i � - r - "!-: -� r - -� � � :. ..- . r . r � �-•_J:'. n, _''"^'_F-" 20.';Rough Factor•y Fireplace . � �.is �: M:x .:: ,APPROVAL•S: �.�Permit # - --- -r�r=;: - 21..Ducis, in�Structure " " �^ � "'� " �70. lJnderground'Hydro ;, U �� F � 22.�Ducts, Ventiljting.,, , ' ._ ,y ; r''.,; .� c77, ProductPiping OGas OOiI 23. GarPi e•Rou h & Test - " �� ''' �� '� -� ` � . P_ �9 _ ___ ;�';, .,-72. Undergro�ndFlush _ .,24.rRoof Framing .�.; � ' � j x ' `' ^ `� '� -:73.=Undergrnd. Storag�Tank �O Gas O Oi� � ' 25. ftoof Sheathing --r � •� �� y _ _ •� l7q�Overhead Hydror._ � 26.=T-Bar Ceilin (Structural) &'Monocoat ` �" � " � ` �� - ' � " 9 . >. .-' i , 75;_Dry Chemical , _..,--� - - �-'.: 27.-Frameand Flashing=� .� � � � ' >- ;-� a y 76. Dry Standpi�pe tl;^ ' ,� "�`"'--�� '� �,28. Lathing & Siding;' , `� _ � � `" �, �. 77:-;FIXED S.Y.STEM•F.INAL: � _ �� l- 29. Insulation - ` ^ • ' '' 78='�FIRE PREV. FINAL a � � - - � - - r r, �- "' a. - '- r` - � 30. Drywall Nailing �r� ;, � � '� � � HEALTH-DEPT'. REQUIREMENT � �31. Plaster Br'own�Coat ` � "'�T' a i � Ir '' `79•� FINAL INSPECTION' - _ _ " _ :32..Electrical:Power MeterF.inal � � O.�F OD CERTIFIGAT�E ISSUED� �- _ �' ; :33..FinaL Electric'� - • K: �' otes:' -- * " � ' - �' .-r. ��r ' r - '34.:�Final Heating:& Air'Conditioning �` ; j ! ;� ;� ,�'' _;'; ;� ''. c�_ _' � 35.^Final Gas'Pipe-Test�-� •� r -� �.�� ` 'r =� _ -' i - � �- ` i��c . 36. Hoo.d or,CanoPY � � _ - _. : , , .: �. _ •- � � r _ - - - - : _ - - � � - a: ` :,. „ � .6 t� ^ r: -� � i . -37. �Final�Factory Fireplace�� '.�- >.: � � ' � Ft.t, � '. + � � ^� � H'� r 4: - �38. Final�Plumbing ' � - y � � � - _ f ' ' I v � 39. Wa{er Seivice�Final;; _ � ^ .j: tz; • ;: y � �. t - -- - T40. Gas Service-Final `� �� = " • � � ; ' � " � � ` �. - , � [�� ,: : , r . x: � . r. . , .`.41. Solar pomesticFinal'� Y, ;r, `� < .= - -�i � - x. - _ � 42.�Backflow Preventer' ' ^ '� '� ' �' ' � "' , � :-i:- ..� K r �i�^} � ' ' 43. Backflow Irrigation; j` r;; r x;,; � a, _ � _ .. � �44, Landscape Iriipation System� �, �. �� a' r� `� '~ �' `� � x �_ N - .^ 1 - 'i '� " - • - " ' ��._ .:j a, c, •c a: r�r. � E 7' �45.`$ound Attenuation.. � .' �� a - � � ;?i ��. =+ � • "46. •Handicap' Reg�lations O " H + :� ' ". `-� ''•' S ;. ,�. y, r N+' C ir. G ,47.'FINALSTRUCTURE&BUI'LDING �' _ ? ';,.; �� - , - , t - 48.�FINAL PLANNING, � ' - �: ^ � � �;K �. � � s x ;, - r; _; . , .' � : _ � '49. ;Eleccric Relea`se to �dison , y � � �,a -' ,: - _ - 50 �Gas=Release to Southern Calitornia Gas Co " %�� ` "� ` - ' ' �' - - � t m i. _ S W � i� • ' � -� ' ' - •51. CERTIFICATEOF'OCCUPANCY " ' � " ' ' " ` ` ' ' t� x No. Date PR0.1EC7 �UGHES3: ( O 1 W 1 9 TH ST - � . owNea�sH�Me: TRIANGLE SQ, JOID�T VENTUAE aoow¢ss: 33161 CAMINO CAPISTRANO—A SAN JUAN CAPISTRANO ' � CALIFORNIA 92675 714/240-1382 AfltHIENGiNEEfl: REO.NO.: �ooxess: uxrt: uxrt: � JBE ELECTRICAL CONTRACTOR (714)632-9818 PEflMITTEE: �-. nooeess: 1828 TYMPANI CR ANAHEIM CA 92807 110EN5ED COMMCTOR OFCIAMitON: I hereDy amrm Uut 1 am 6ceme0 un0er D�m+sians ol Gwpkr 9(commencin0 �� lon 7000) of Divislon 3 0l the Business anE Prolessions CaUe, aM my Gcense is In fu0 lora anO ettecL ciTruc.:040375 sT.Teuc.:36 3 cuss —10 Oata: y—� $' �' Q� Si r � WOHKEf1E' COMPFNSATION OFCUMTION: 1 � 1 irm ttat I twva a ur�liwte of consent to setl-Insure or a certificate oi Workers' Compensation c cenilieE mpy tn ection 3800, LaO. roucr xo.: �� exv. onn: 6/ O 1/ 9 0 cotnraxr: FAIAMONT ❑ Certi�ied copy is �ereGy Fumis�eE. L� Cenified copy is fileE wR� I�e ciry uil0inp DNision. , Date; �/ � � g � % v MD�iF�1-L—�i �� /"' . � - . IXEMPfION FAOM WORKERS' LOMPENSII710N 0 :(flrs sectim nee0 not De mmpe�e0 if tle pami ¢ fa one MuqreO (570� a less�. I cerlity ihat in the peAormance of t�e xrork lor pemrit ¢ issuetl, I slWl frot empby any person in any manrrer 5o as to bewme waCct m the Workers' Compensation laws ol Calitomia. ` . �ata:� � Sipnatua: NOTILE: If, atter maldnq tNs EMarztion, you ShoWE Eecome subjat ro t�e Workeri Comce�� Drovisions ai tAe LaGor CaOe, you must toMwiN mmpy wiU wcti DraNsbns w Itis permit shall De Eeemetl revokeE. � CON$7pUtilON IFNDING �GENLY: I Mreby aKrm IMt Nem is a consuuctlw IenEi�ry aperrcy lor t�e pertarmance ol l�e work /or wMc� this pertnrt aissued (Section 3097. Crv. C1. . lFNOEq: . . • ' aooxess: , OWNER BUILOEN OECWUITION: I AereOy arcrm Nat I am eaemD� �rom the Convacmri State Licenu Law tor ttu lollowinp reason , (Section 7031.5 Business anE Pmlessional CoCe: - My ciry at munry wNc� reQuires a Dermit ro cronstruc�, alter, improve. Eamolisn, or aDair airy slrupure, prior ro tts issuance. aho repu'ves IAa appfiant loi such permil m file a sipneO statement tlut he/s�e is licerisetl purxuant to tAe Drovisioro at Ne CanVanors' State �itenu Law (Ctupter 9(commencinq xitn Sectbn 70W) ot OMvon 3 0l t�e Business antl Pmhssions Catle) or thal twJSAe Is axempt themlmm anE the basts lor t�a allepeA exempllon. My violatlon of Sectlon 7031:5 hy any applicantfor a permit suhlecls t�e aDD�icant ta a civil penalry al not mom t�an live AunAreO Oollars (5500�. '-' I, u wmer ot tAe D�YenY or rtry e p� wIN wapes az Ndr sple mmperisatlon, xdl Co IM xrork. anU the ❑ structureis notintenCeE orottereAlarsale(Sec�tion�70an, Business mE PmleysipnalCoOe: T�e Con[racrors St�ta License Law Oaes not appN �o an wmer ol a propeM � Oud05 or ImD�s tlrcreon. an0�xln aoes SucA woh nimull/hersel� or tnrou0h . ha or �er ovm empbyees, proviECE Uat suU imywements ue �ro� IntenOW or offere0 to� sale. II, Iwwever t�e GUIIAInp or . impmvement k so10 wltNn ona year ot completlon. t�e awner vrill luve t�e bur0en ai D�oNnp �Ns�e Ci0 noi bui10 ar improve 'lort�0 DurpoSe of sale�.. • � I, as owner ol Ue D�operry, am exGuSNeIy wnVactlnp wlih IlcenseE contractors to construct lhe projecl {Sectlon 7014, Business ❑ anU Prof¢SSions COOe: The Cant2Ctars' $lata LlcenS! Law COM n01 appry to an Owner ol prope�ry vAlo OUAEs or imDroves IherBan and wlro contrzps lor suc� Drojects wit� a �pntnctor�s) Gttnu Dursuant to tM Contratlors' Sta�e Lkense Law). I am aware tlat praol ot Neir Warksr's Compenvtion in5uance slaidE Ce,proNEeE to me. . � I am axamD� un0er Sectbn: B. 8 P. C. � lor this reasore � ' Date: ' Owner. I Oq ImreOy aNry tAat I am aware af an0 uMersWq tM repwemencs of Callfomia HWt� aM Safery CoOe SecGo�a 25505. 25533. an0 2553a anE Ihat I ar any luture bWGinq acupant wiNwlll not (cirUe we) neeE m campty wiN sai0 state coGes an0 Ne repuiremenis far a permil tor conslruIXion or modificatlon from the Air Iny Maupement Oistrict. ResiEentlat cortstructlan appticatlms are e�empt•from inese provi9ons. Daiei AppliCdnl: � n@ahy certity tlwt i nave reaE tA¢ apq'ration antl sum tlut Ne aDove inlormation i� cortect. i aprep m mmDN'MtA a0 d 0(CirtalroPSLMdIdIBIdNStddfllWWblld6l17 IIXRn IX(L'�'aNMI@2P'�GlivGtW�1l6LI(YtOMt&W�tl!@dDL pmp¢rry /fJor inspecuon Dumoses. • ' Date: 7 � �7 O $ignat c oriver's �icenu or Sacia� 5ecunry x: $ 1801.q6 WMte—Buikirq: GrBen�',o0e Enlatcement: Cenarv—Ruplicant: Pink—Revonue: GpWanroE—Ataeasor CITY OF COSTA MESA — BUILDING pERMIT � PERM NO; E 047007 IP,ERMIT NO; E 047007 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE; 5 PERMIT TYPE: ELE , PURPOSE: OTH JOB DESCRIPTION ."WORK WITH" PEAMIT (ELEC UTILITY) SQ FTc • CLAIM VALUE: CALC—VALUE: � GROUP OCC: B-2 /. COMMENTS: B-45493 (B-45339—FOUNDATION ONLY). ***�r***�e�r�e�r��r*�r****r�r***�rx*x�r***�*�r*******�*+r*�r�r**�r*****r**x*�r****+r+t****+��r�*�*�r Z O N Z N G A 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 R$AR: FT IN ERNT; FT IN REAR: FT IN LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: - FT �IN PARKING REQ • PROV: PARC$L: 42421111 ZNE: REF NO; PLANNZNG NZS'PES> . > if iF if iE ff if it �k iE �f 1k ff ik if iF ik iE iF �k 1f if if k!E if if k ik iF ik M 1k if ik ik i!!E ik iF if 1f ff iklf iF iF k k if 1flf iF iF 1f iElf 1k if iE if iF ik iF if k ik M iE iP iE if iF iE ik it iE iE it 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` 20NING APPROVED BY � � DATE: BUILDING APPROVED BY ; � � • ��- DATE: �. - ' . APPLICATION ISSUED BY; • � DATE: ��C� M�FkafitlFMlfffiflEifihiflflflklFikfffflf fflffElE1E1f1EiElEif iFiF �1t1lffiklFihikMikifkikifitMifMM�flFlfilit�fMifififk!!if'ifitlf.ififihMiF�l4!lifllk �iFlFikklflfifikiFMlfififMifikiFikititiEiFitiEiFifikMifikifififiF LEGALIZATION:N , F E�fi 1 S U M M A R Y . STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PEAMIT 15,00 . SOt SMIP/NON—RES PLAN � ISSUE FEE 4,50 . BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL ' PAID •DUE TOTALS—.---> 15.00 4,50 0.00 19.50 19.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 19,50 OVER/SHORT: 00 � BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 19.50 , 'ifMifiFiFiF.MMififikiFKMMitit%lfifitikififiFMlEkifiEiFiEiFiFMiFif1FIFIkiEMK1EM1FfkifMMMKkKiFi4ifMKiFiflEiFifiFififKifKififMifif%KiEiF I N b 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 TEMP•WORKWITH END OF FEES EA. � 15.00 15.00 • � 0 n 0 01 OD058920—D00.58920 TQ Y 6ATE: 04/18/90 TItiE: 03:24 ?9.5Q � CONSTRUCTION AND PLANNING � POOI u�PA APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector r i . 'I. Temporary Electrical Service,or Pol�;,, . . 52. Poot & Equipment Location l, :2�Soil�Pipe-Undrgrnd • � y 53. Steel Reinforcement � � t��3--Elec�[r�ical Conduit Utility-Und'rgrnd,C� ' 54. Forms � i� "�4`EIecJ�jical Cond'uit Undr9rnd!' �" ' 55. Electrical Bonding ; 5`..�Sie61 �Reinforcemen[ >; 56. Rough Plum6ing & Pressure Test rt. " �6!'�E� t'rical UFE��Gmd. � "� � / - 57. APPROVAL TO COVER�GUNITE � � -+: �' +. w . .�. " 7�''F,00iings �;' ,,; '�i �% 56. Electrical Conduit-Undrgrnd. .- ,•� `'}BC Fonndation � ,,,�� : , 59. Gas Pipe, O Undrgrnd., Test . r9�^VJater Pipe-Undrgrnd. � �� 60. Backwash Lines, P•Trap, O Undrgrnd. ^ 10�5tructural Flooi SYstem ,� � r%' 61. APPROVAL TO DECK i'� 1.1.�Property Sewer Line & HouseConnection '�� ,, 62. Backwash & Receptor-Final 1�2.�Sewer Cap x_, c• � f � 63. Heater & Vent�Final 13. Roof Drains „ � ! � 64. Plumbing System � Final � ✓ i 14. Rough Plumbi�g ' 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electri�Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign f>$. APpROVED FOR PLASTERING «� 18. Rough ElectriGal-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - `19. RougFi Heating & Air Conditioning �' FIRE DEPT. REQUIREMENT� M '1 �.] /� ^1i� : T--1 t^ z ct T v a. y �7 ^ G"rim. h`. * t"' C�1 i� n -i -� i I� Rl Q 7 v U 7 +T k rt ! 7 T' '_' I'�� ^� # � 7 20;; Rough F.actory F�r,�place i �„ �� s ti,_,�: y. APPROV�LSHF,Permit # 21� D ms, in� Stc�7Ctar � �'.. �.. �H � n `� nz i,; 70. '.Undergroand HY`dro � .. 22�Ducts,Ventlatingy��, � `�S � '' �#�'07�, ProduciPi in OGas OOiI > -,. n C7 ��: � F# w C 7..P 9 " ,. . .. . � .�. .. 23: •Gas�Pipe,Rough &7Test i ;a5 *?� c� Q rjY t. ��.7z, Underground Flusti � F- r�. 11.r, +r �c t� r i♦ � b 24:'�Roaf Fr'amiri§ a � � E" `•" "� � '' � � ,,, * a ' , 73� j Undergrnd `Smra�Tank�O Gas ❑ Oil 25. Roof Sheathing =�.� � v. r�� p> v�� :. 7q� Overhead Hydro"J� � i �1Y' • r�1 L n ,.♦ _< �+ w o ni a. � --� -i �. �- V�. 26: T-8ar Ceiling (Struttural) &-Mo�ocoat 75` Dry Chemical r �- J * O :n U k a: F. �j �: r7 -J ^ F �� 1. . . ['� `i " �l e. �r .a v� +� 27�Fremeand Flashing ��r !: rn �+ �+ � 76. Dry Standpipe r� x c." �� r. . � e� r, �28. Lathing,& Siding`� �� = � �' `- �"* '� 77 FIXED SY TEM'FINAL n � ��. �:::- o , ..' .. � �: � . 3 . r, H n � �,. � - .. .. � .. �•, , . .. � � 29. Insu�ation S •• W � I �x k 78.'. FIRE PREV. FINAL -� r30. Drywall'Nailing `,Y,,,,,� , i ;_„ � � -*''� " '.HEALTH�DEPj.�RE�UIR,;EMENT �s. > s ,s. , i- 1 ^' (j.�. � f. • . • nrF lt� ' ` ['�W F V l' �r �31. Plaster Biown Coat � �,-m � I �.�.' r' �79. FINAL INSP.ECTtON ';32?"Electrica�IPower'�vl`e�ter�inal '`� '70�FOODCERTIF`CATEISS�JEO� r- ' t» a: � � a. m -; F. ��; . .� �;33„Firial Electric .rx i-1 t .; - '7 "7'7 a�'y C m � '�34�"Final Heating &�Air Co�ditioninlj� � '' � � � �{^''U ,'S Clw �' S C7 n'. F-f ,.� K[�7 [Tt ��• '� � 1* t 1 J H O o N� i-�'� ��. . 35�Final Gas Pipe•Te'st� �� '� . �� `� * ; � �"'� �� tiH :�: ` �' X �-. � S. T ��36. Hdod onCanoPY�:i �` � r.. y �: t� n ; fI '��tc ;; F :.o � �: u i*� '1 C M .iT !�i I y:T7 VI X �{`�'� (l: ): ~ R7 x'.7 i: l:, T [n � � : F; i �.(r c. �:..� � � . -j37JFinal Factory Fireplace� i t.�. �.� * ` � "�� ^ z * cy "�38. Final Plombing y R,�} ' y * ^ j �`''� * S ,�.'', '� � � � _H� '#; � H R �39. Waier Service�Final: � � �" � � � ; j � ; , " v� � * � m ' a r 1.. =n40. Gas Service-Fina� * �r �Q[nm S � m � I ''f� *' Od ^�N a � • +' f1n.[.. m X �Y. X F' • Oi X'� L' �15 �1 •• *!.� � 'A V.'L !-� .F 41. Solar pomestiC�Final � �':' -i lT7 y.' . * �+ "f:� b' M: :C 'J � � 42. Backflow Preventer: � fJ M y � � �4 't� t� %e-� :* d �'+ r'.5 n. �. .. �' t� :*] t'1:J t F r, r,: r F t! r� 43. Backflow Ir�Zjation: j,''S ,,'�. � x x�� i x C'� • ?744. Landscape (friGation System�M'i �- * �1 O � O* �� i; N ;� ^CJ *'' �' � '. r, . -, rr ^� �; a c �c r. s: � ] S_ ti O :' �' � '.- r1 � .�+ �'. t+ C" � L t' i-� F ti K� 1 � r+ CP OJ '2 �1 �45�Sound.AttenUation ,,, �, � ;,*�; -, �. � F.p .. �46�HandicaP Regulations -i O �� *' j � S r � � �� r• r . v � m �"1 !�� ' �47'PINAL STR�'UCTU��iE & BUrLDING * c, � � r` i� � �' S * i � � 48'�FINAL PLANNING i E-.- � 1: ' �/� +':, Ti S w F . y •, n ni Y n �C ?49?�Electric Rele55e [o�Edison , ;' � "" ; ' i ,�, � � .y b y �50:�Gas?Release to Southem Califom�a Gas Co } i .:/�'� +' � r �o �n " O � �51.CERTIFICATEOFOCCUPANCY k -'rx � �� m� '= ' � � No. Date A PX0.IFLT ROOflE83; 6 O I W 1 9 TH ST � owNeesqAMe; TRIANGLE S UARE JNT/VEN ' �ooxess: 33161 A C�INO CAPISTRANO � SAN JUAN CAPISTRANO . CA 92675 (714)240-1382 �qCH/EN01NEEfl: REO,NO.: . IIOOBESS: uxrt: A6B UNIT: r�flMmEE: pACIFIC FIRE SUPP. ( 714 ) 549-9913 nooxess: 3101 W CENTRAL ' SANTA ANA CA 92705 IJCENSEO CONTMCTOB OECUMTION: I hereEy aKrm Ihat I am IicenseE untler pm '' s of Ctwpter 9( enclnp with Sectian � 7000) of Division 3 0l tne Business ana Vrolessions CoEe, ana my licen is in lull lor na ef t. � Icm uc.: 0 3 0 717 a��n uc.: 4 2 3 418 � uss: C L oare: �"�� O Siyiutpuyre: ' Campenutio n��c� ��E� Ilnr1�o� tnerea� (Secu ��00 �aoaG)SrG1O 3/ 9m ro se��insure or a cen�ilcate a� workers• raucrr+o.: FIREMAN'S FUND ' V U fAMP�NY: ❑ CenR'ie0 toDY is he�eDY luircs�ed. � Certifie0 caCYis f ' rtr atY BuiWinO' ...on. Date: � � O Appliynt: IXEM7fI0N M WOpKEp$' COMPENSII110N DECLAflI1TIXIN: (ili5 SecUm reed rot Ee canpkted ii the Vami15 tor are hunprM (f10� w kSt�. I cenity tAat in the pertarmance ol Ne work far wNch itns pemJt ¢ isweE, I stWl not ¢mpby my person in any manner so u to becoma suDject ro tlre Warkers' Compensation !am ol Glifortua. ' Date: � 'Sipnature: NO710E: If, after maNinp t�is aeclaration, yau shoulE hecoma suhlect ro t�e WOMeri ComDensation Orovisions ol tAe Labor CoGa, yau must brthwit� campy wit� 5uU provisions ar tNs pertmt stull Ee UeemeE rewke0. � CUNSiNUCTION LENOINO �GENCY: I AereDy atlirm that Nere is a consWcOon IenUinp apenry lar Ue OeAormanc¢ ol l�a work lar ' whiCh tnis Oermit B issue0 (Section 3097. Civ. C�. ' lENOEfl: aooxess: - OWNEN BUIIDER OECUMTION: I �er¢Oy atlirm Itat I am aem0� trom Iho Com2ctars' Stata License Law far t�e followinp reason (SeCtion 7071.5 Busineu anA Professional COEe: My ciry at counry x1tic� aquires a Oermit ro mnstruct, alter, Imprme, Oemolish, or repair any strucNre, O�or to ia luuanca, also repWres tAe appficant for suU pemnt to lila a signeU stltement tlwt �Us�e is IicensaE pur,uant to I�a D�a�slons ol t�e Contactars' Slate Liunse Law (C�apter 9(crommenNnp wit� Sectlon 7W0) of ONision 3 al I�a Buslness anA Pmfesslons Cotle) urtAat M/s�a is exemD�t�arefmm an0 IAe 6asis lor t�e allapa0 exemD��on. My dolation ol $ectlon 7031.5 Ey any aDD�icant lor a Dermit su�iecLs t�e applicant to a chnl penalry of irot mme Ilun Ihre �undrt0 EaIWrs (5500). I. as awner al Ue o�hY or my empI�yees rAtn wapes as Neir sole compensatbn. wiu ao the woM, ane the ❑ sirucwm is not intenEed or oflere0 br s�le (Section 7DC1. BuBness anE Pmtessional CoOe: T�e Coniradors' Suta License Law Oaes nut appry lo an awner ol a pmpeM � buAOs ar improves l�ereon. an0 wM Goes suc� xrork Aimsell/�ersell ar t�mup� �is or �er own em0loyees, proviOeE that suc� impmvemen�s are not inlenGetl or oHereE lor sale. If, howaver t�e Uuil�in0 or impwvemenl a mIA wlt�in one year ai cumpletion, the awner will have Ne EurEen ol Drovinp Ae/s�a CiE not build or imprme � tor Ine ouryose ol sale�. ' I, as owner of tlre D�aVaM. am exGusiveN contractinp wii� �censeC contractors to construct t�a Drol� (SecUon 70Cd, 6usine35 �❑ aM Professions Cotla: The Cprtraceon' Stata L'ae�na Law Eoes rrot apply lo an wmer ol D�operty wM EuiWs or improves thereon an0 wM conirocis lar sut� pml��5 w1i� � contattor�s) ficen5e Oursuanl to I�e Contractors' State Licei¢a Law�. I am awara tAat prool of t�elr Worker'S CampenSatlEn,insuance sImNU Ee D�4� �o me. � I am anemp� un0er Sectlon: - B. 8 P. C. ' lar tnis reason: ' Da�¢: Ovmer. n I On nea6y canity Ihat I am awam oi and unEerstaiM 1ne repuirements of Califomu Nealtn ana Safety CoGe Sections 25505; 25533, an0 25$y0 and t�at I or any luture WilCinq occupant wilWnll not (tirde ane) neeE lo wmpty with sai0 state co�es anE t�e requimments lar � 0¢rmd tOr conSlNCiion af moGiliWtion hOm �Im Nr UuaNy ManapemenlOisVict. flesidentlal mns(fYNon appliwfions are exempt fmm I�au provisbns. , Dale: MP�� I �ereGy cerliry that I tuve rea0 t�is appfication and state that IM aDove int rmalion isy� rect I a a ro comDh `M�� all ciry an0 counry oro5nancesanOSWtelawSaqMiptoUinMi�pcm¢tructbnaM�ereCyaut " repre�gn�rv �� roertferupontMabove-meniioneE.. DrOPeM Im in50�iion W rposes. '/� f' 7 / �S� / �v Uate: � � �_ S�O�ture: Driver's Liansa or Sacial SewAry M:.�? �� ' — 1BC1J6 W�ite—BuiWifp: Green—CoEa Enlwcemenl: CanarV—ApulicanF, Plnk—Hevenue: Goldanrotl—Fssesaor I' u CITY OF COSTA MESA — BUILDING'PERMIT ' PERM NO: F 046887 PERMIT NO; F 046867 PLAN�CHECK N0: 02992-90 S . GOVT:'N SUPP; N CONSTRUCTION TYPE: 5 1HR SPRINK PERMIT TYPE,; FIA PURPOSE: OTH JOB DESCRIPTZON : INSTALL FIRE_SPRINK SYS (OH) SQ FT: CLAIM VALUE: 4,000.00 CALC—VALUE; � GROUP OCC: B-2 /. COMMENTS: RE: H45493 (ONE SYSTEM FOR A&H) ' �r**�r**********r**�rx*x**x*******rx*xw�r**rr**�**�********x***r«�rr***+r«�r*wwrr*r�**�r 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 ---------- --------- ACCESSORY BUZLDING --------- FRiJT: FT IN REAR: FT IN FANT: FT IN REAR; FT 'IN LEFT: FT IN AGHT; FT IN LEFT: FT IN RGHT: FT IN PARKING REQ• PROV; PARCEL: 42421111 2NE; REF NO: • PLANNING Ni5'fE5> � ik iE 1t M iE �F M 1F iF M iF k if if M ik ik iF iF it if 1k 1k if M!f!t iFlk ik 1F %iF M k if if iE iE iFlflf M 1klklf M MM k iFlf M M M 1FlF M fF if %M ik iE iF it if 1F iFiF k iF 1t M Ik if if M iF 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: HUILDING APPROVED BY ; DATE: ltiFiklFifMiFfFMkifMiFiFM�fitiFMitMikMiFlfkiFikifitiFlFffM1FM� LEGALIZATION:N-' F E E DATE: / 1 I/ * x ** r * �r * *+�1��#��ik'�� ikM14iFMMMMiFMlkkMkMMNifiFiFiFNlFNikiFitiFNM1EltMifMM M'A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRI MECHANIC FIRE SMIP/RES GRADING PEAMIT 63,00 ' ' PLAN � � � 40695 SMIP/NON—RES ISSUE FEE • � BUILDING—DIV—> PERMIT ISSUE PLAN—CHECR �TOTAL PAZD DUE TOTAI,S,----> 63,00 0.00 40.95 103,95 103.95 ,00 REV6NUE DIVISION TOTALSr—> COLLECTED; 63.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK . 63.00 1FifiFitif if.iFlf if iFiFiFiFiFMKifiFitiFiFikiFiFiFif iFMM�FM�Fifif if Mif iFiFiFiFiFit�f if ifiFiFif ifiFiFNKMifiFiFifif iFif i4MMMif MMifiFik±f iFif iFiFiFiF I N D I V I D U A L F E E H R E A K D O W N TYPE FIR 0 8 e QTY D E S C R I P T I O N UNIT COST TOTAL COST 63 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 63.00 • ,END OF,FEES, , � . O1 00053220-0005$220 T O T b3.00. DA7E: 04/I0J90 iIPlf: 10:25 1 � . ' ` . �CONSTRUCTION AND PLANNING ' POOL.. oPA � APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector :i- �.� Temporary� Electrical $ervlce or PoJg� • 52. Pool & Equipment Location ,� E„2�,Soi1�P,ye-Undyprnd.� � �� ' 53. Steel Reinforcement ' �* r+E��ctricaV Condti'rul9tility Undrgrnd>�Q _ 54. Forms "' ��."H�C�r.Tfal Con�iif'�ndrgrnd. pN ,f � 55. Electrical Bonding �c,. Si�JQieinforcemerg y�nX . 56. Rough Plumbing & Pressure Test � ��ec r`�cal UFF�t�rnd. 4 � 57. APPROVAL TO COVER�GUNITE �i � ,S,qotings "� �., , 58. Electrical Conduit�Undrgmd. � � :BnF undation �`� .- � 59. Gas Pipe, � Undrgrnd., Test .-. `D. ter Pi e Undc rnd. � � „r P- 9 .^:-, � ., J 60. Backwash Lines, P�Trap, � Undr9md. .-� }tiOyStructural Floor System y ��/ � 61. APPROVAL TO DECK s~ � ' ��Property,Sewer Lin� & House Conyction � 62. Backwath & Receptor-Final � 12�Sewer Cap c,.. �e � �, . 63. Heater & Vent-Final � ,. 13. Roof Drains �' ' � � � 64. Plumbin S stem � Final ��v p � 9 Y , 74. Rough Plumbiwg � - �� . 65. Electrical�Final �.� 15. Rough Electri�6Conduit 1 ' � 66. So4ar System-Final :� 16. Rough Electris iring � � � � 67. Fencing & Access ApProval 77. Rough Wiring�gn � . 68. APPROVED FOR PLASTERING 18. Rough Electriw�-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19�Rough'eating & Air Conditioning rn� �� C FI��PT.�EQUIR�EMENy �" 2�''R h ct �y� lace �^`'� �� O G* * PPur� V�y �c��Pe.�'"{hit #�� °ic °� � �Y'i'*P � Sm cC�t * S tr�K * '4 �7HF 21NO�ett,Cu St�'SctOtek ��•� ^ r+5 � S H* *' 70. nderg7i�i H�dro M '�-� 7C 1 t� S * rC *� [*" �' I �K 2 �DUc�s, �enc�atin9* � � * 0 � -� F„* � 7�, ProduoF�¢+;ping ��jas !�t0il 23:�Gas.PiperR�gh&aTest i �5 * m c� Q O� ��-72, Undergroand F�US}3 * � � 24:"Roof �r miri �'' � `'E ••F W> O * �K `� +-� * ,.� 9 ..x ;� * � �..{** .7�jUndergrria.Sro;a,p�Tank�OGas ❑dl 25. R�f Sbeathing �.^ � � v s � � O � tux �: 74:J Overhead �iy�dre�7 * ,�� T 28°'T�B'ar Ceiling (St} tural) ''�coat � �"`h* * 7� Dr Che cal ry �~ O m 5 4� �3 x o � v� � Y �+ �� + � 27�FraTe aod �lastiipa ��G * m a�r * 76. Dry Scan V e E-m �� ?! � Zb.t� � �, 28. L�inp�& in§'« `� �'¢'� x * � "* * 77� FIXED �,S El�i�jlNA� '' _�- ��. ... F-� � J x �� f�-� O * ..I ..I .� i* a ^� � c� Oi 29. Insulation •'��'d* S ^ * I I�'•� �� 7� FIRE PREV. FI L *� a"a .w 30. Dr�wa aif%ng�� „� � *�, I I�! �i{� � S .�j�LTF�DEP�.FFtEQY11REMENT 31. Pl�er�rowq Coaa S i trM � I �� jj k 79. FINAL ICd9EECT�N a �:; 32J'Electri �I P er'A1�ter_�inal� *`� � � �� * BO�FOOD CERTIF`1�,`�'ATE I�SUED", :., � rn p+ � �T * � Q` *[*; I I� x , i .. u. 33SFicql r.y�ctr=s O x [*7 i �C * �r Notes: �7 •y[�7 z�? O pn± 34'1Fival F�atiri� & A7" Co"rNition&� n � ^ ( ' � � � S !1.:: :k s O H.. C X:i1 I*1 K? �' �*, M I F. � # W -r, m � . , � �. - � � i � �: 35;:,Fi al Cla} PiM-7e�J� � •. x H � �' *� ^o C7y tt C)r� 36. Hdod d67CanoPY i� � R"7 a z C� 1 [� .# _' E Cle� zc ^;n Q' # n i am N # I� ..�ii * P7 �'U �k iTl ��'7 37_.Firal Fpytory Fire�l c� i�c, y * I * * -;ti 3�Fin�l Ph�mbing y N ' y �^ ' I ��` *. H �W x� a 39yWa't�r Service�Fina� � i ~ x Q 4 I �. x �� -+ w o � � 40.� Gas Service-Finai y:+7 �Si�t*+ S � m I �* O� ol �� -� 41�Solar pomesticFir�2" hs m " *°` � � p.,;� 4, ,.yN P * X 42. 8ackflow Preventei: fu � V i � � W �•� • �F * t7 �-+ � n x�-+ * Y . ONC� [*! x F 43. Backflow Irl�at�o�` �SS * #� �uN r' � r : >+ * q # Mc � J i �R Cl 44. Landscape Irtiqatitl�n Systerfp[�il'J b: � tT1 b D 0► x N N -+ wCJ x� cv o m. w �' . T p .T� �k S i� c. :, F k: x �--i ti C' w x 45.aSound�Ptte�`a,uacioQ .'-'.��F; R *� m m�» s a �• n ti 46:•Handiwp Regulations r- O * �* � S bN S * � I I }l' X >. 47SFI�AL ST�1CTl1�iE & BI�ILDING * I � � n' S M * F G * � U' * 48-iFIt9AL PIANNING � F�* y N � i�' x :*! �2 * F . a < A: E 49?'Ele'Gtric Release to�Edison i * `�� * � .n ` - 2 5�Gas)Release ro 5outhern Califarnie GasCo i � �`�� + G� ot4 �� O o �� rwar�GirnTG n� nrriivnNrv � �* r� mo .. * r^ v Date I �PH0.IECTRODRESS: �U1 W�19TH ST ' ' owNen•srNMe: TRIANGLE SQUARE JNT/VEN ^� p00qE8S: 3 jl(�I A CAMINO CAPISTRANO � SAN JUAN CAPISTRANO �'A 92675 RNCN/ENGINEEP: ( 7 1 n) Z� 0— 1) 8 � � �(1Ep,N0.: �ooeess: ' uxiT: . � CTTY UF COaTP. MESA -. BUILDIPIG PERt4I'C , PERMCT NO: E' OA62G9 ' PLAN CHECK NO: U2563-90 S uxrr: Pppo�s; PACIFIC F IRH SUPP. ( 714 ) 549-9913 3101 W CENT'RAL • SANTA ATJA CA 92705 LICENSED LONTMCfOB DECIAMTION: I hem0y aKrm Itut t am Ac 5A unEer Drwisfans oi CIwD�er 9(commencln0 •+�h Section 7000) ol Oivision 3 at Itre Business anE Prolessims CoEe, aM my I C'a in tWl lora an0 e11tti. citv uc.: p� p 71 7�T"T� uc. 4 2 3 4 18 � B.. - 6 Oate: z ^ �? ^ �� S�pnatura: WOpI(ERS' COMPEN511TION OELLAMTION: I OereOy aKr l I lave a urtificate ol consent to utlimum or a ttrtitiwta ai WOAers' Compensatlon InSuranu, a� a certilietl copy tletea� ( 3800. LdE. C�. roucr xo.: M 7. P 8 0 3 8 9 019 Exe. on�: 0 3/ 9 0 cornr�xr: FIREMAN' S FONI. ❑ Cenitie0 capy is here0y tumiSheU. � CeNfeO copy is fl t q ate: ��1� � L � AppScant: IXEMPf10N FNOM WOIIKEHS' COMPEXSIITION DFCWW ' secGm mN not Ee mmpMM it tAe D�'s ta om AUMreO (5100) w kul. I ceNry Ihat in t�e performance of the work for wtrid� rmit ¢ i55ueE. I stutl not empby any persan in am/ manner so az ro Gecortre � suGle�� o the Warkers' Compenuuon Laws of Caf u. � � '. Oate: ' Siqfuture: N0710E: Ii, afler maldnp ttds Aeclaratmn, you slnul0 Oecome SuEject to Ihe WorMers' Compensatlon pmWsions ol the Lahor CoOe. you must forth�i�� comply wiq� suU O�o�sions or tlis per�t s�all Oe aeeme0 revokeG. CONSTNUCfION IFNDIXG 1GENCY: I tereEy atfirm Wt Nett is a wnsbuclian IeMmp apency lor IM peAormance oi the xrork lor wtuch ttds perMt 5 iswed (��n 3097. Civ. C). , IENOEH: � RODNESS: • - - � OWNEP BUIIDER OECIAMTION: I here6y atlirm WI I am exemD� ��m tM Cantrzctws' Stata Lkense Law lor t�e follovAnO reason (Section 7031.5 Business anE Prohssbnal CoOe: ,My ciry al counry wltic� reqWres a parrtdt ta cansiruct, alter, imprwe, Oemolis�. or repair ziry structure, D� �o its issuana, aLso reqWru Ue app�cant tor wch pemnt to fYe a sipneC statemen� rtat �rlatie b IlunuE pursuant to the Orovklans ol Ne Contrapors' Sute Lluase law (Chapter 9(commexNO atl�� Seclion 7000) at DkLsion 3 0l Ine Businett anG Prolessians CoOe) or tAat �e/sAe is aempt t�eretrom atM t�e Easis Mr Ihe aAeO� exemption. My vblation ol Section 7031.5 Gy any applkant lor a pemdt wDjects tM appGcant lo a cNil penalry oi mt morc Itun five �uMreO'Eotlars (f500�. I, as owner of tM O�PeM or my empIoyees wit� wapes u t�rir sole compensatlon, wlll Eo t�a wark, an0 t�e ❑ 5trucWre Ls �wt ImenGeE or oifereOlor sale (SecUon 70ae. Businea aiM Pmlessional CoEe: TAe Contncton' SWta license Law Eces rrot apDh �o an owner ol a O�OeM � �� or Improves ttcereon, anU wlro Uoes such wark �imull/�ersell or Ihroup� �is or �er mm employees, D�� ti� ��mD�menB are not IntenEeO or otlereE lor sale. II, Aowevar IAa CuilOinp or improvement Ls soltl wiWn one year ol compktian, Ne mmer x101uve Ne GurEen ol pmvin0 ��e Oltl nat buil0 ar Improve lor Ine purya5e ol Sale). . • . I, as owner ol Ue Oroperry� �m e�clusrveIy mnVactlnp wit� IkenSeA contactws to wnsVucl t�e Drqxt (Sectlon 701d, Business ❑ ana Vmteabns COOe: The Comractors Sute Licenu Law Ooa irot apph� ro an wmer ol properry who huilEs or Improves t�ereon S PERM NO: F 0462(9 GQVT: tJ SUPP: il CONSTRUCTION TYPE: 5 1HR SPRINK PERMIT TYPE: FIR PUI2POSC: 0'P13 JOB DE5CRIPTION . INSTALL FIRE SPRINK SYS (UG 6 OH). a� FT: CLATM'VALUE: 20,000.00 . CALC—VALUE: � CROUP OCC: B-2 / COMMGNTS: RE: H45493 PRIMARY Bi.DG. PrRMIT. • **�c��**+c�c*+t� x�****�*rt**�**********x�*��*�r**��r��***�**�c**�c�r��**+��r**�rx*�x��*� �a**r� 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 BUII,DING ----------- ----=---• ACCESSORY DUILDING ---� —��- FRNT: FT CN REAR: FT ' TN FRNT: PT IN REAR: FT �IPI LEFT: FT IN, RGHT: F'T ]:N LEFT: FT IN RGHT: FT Ihl ` PARKING REp,: PROV: PARCEL: 42421111 ZNE: �RGF NO: ` PLANNZ.DIG Nb'TES> . e it it �lk iE �1E i4iE 7f aE jf jE if 3E ?E iC iE iE iE ## 3f k-3E 3t iE jf iE iE iE tt fF iE iE iE ih jE iE?(� iE iE iE iE i! iE iE jE iE iE �1F it iF if # it if if 3F iE iF iE iE it iE 3F fE if # 1Q �E if 3t 3E iF iE lE 1E # iE # U E V E L O P M E hl T S r R V I C E S R E�Q U I R E M E N T S ZONING APPROVED BY . BUILUING APPRUVED BY : APPi,ICATION ISSUED BY: iE?f iE iE # if iE iE fE iE # iE iE iE ii?E k lf d(� iE it 1l3F% f� IE jE i4 # iE iN1E iE iE iE 3E iE iE 1F i4 ?E ik N 3k f( # 1f # 1f ?t L EGAI, I'ZATIUN : N BLAG VM'f PLUMAING nskr�t•r P1�AN TSSUE FEE DATE: � ` DATE: �l O� � a� DATE: 2�.26 �'iF'��F . . .i�sFiFn�iF��*�tx��**�t*K#�".��r. iEiEif3fiEiEik�EiFif�lE�Fif-Ifi( 1t1F1FiEiF3E1F�If1F?ElE�4#iFikiEiEiE�E�)f��iE�FifiFlEtE3'�?EY.#3F# F E E S U M M A R Y STROCTURAL SF.GMEWT:tI ELECTRIC MECHANIC PIRE SMIP/RES GRADING 2]fi.00 GSt SMIP/NON—RE, 140.40 BUILllING-DIV—> 1?GRt4TT ISSUE PLAN—CHEClC TOTAL PAIll . IJUG 'fOTALS----> :7.G:00 0.00 140.40 356.40 355.40 .00 REVENUE DIVISIUN TOTALS--> - COLLECI'ED: 27.6.U0 OVER/SHORT: .00 DLDG PM1' PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-C1iEC1< 1] 6.00 anewnocmVactsforwUOrol�swlt�acantnctwls)IkensepursuanttotMContraclare' nteUcenseLawl.lamaware k�M1ElEjElk3FffkNRMR#3fjEfEiFIFiF1&%iF3f-1k1E1E1E�1F�'afiF+'Fi(-iElf�lEi['!l-iE:'EiEiEiEiElf�i�if�fM�itifif��%i(��%�i(�iFlflfi!�ifdEiF#1f?fi6iEif�fiEif�K�!EfEK inat Droof o1 mNr wonur's ComceRwuon insumnce snoma oe D�� ro me. '[ 1•1 D I� V I D U A I� F' E E B R E A I: D O W DI ' � I am exempt un0er Sectlon: � B. 8 P. C. � mrmisreasan: 'PYPE Q'PY D E S C R I P T I O N UN1T COST TOTAL COST i � � oate: P""« F•j� Z1.G CIRE EQUIP FEF (FROM BLDG VAL� TA}JI�E) 1.00 216.00 I Eo �ereEy cenity tAat I am aware al anE uMersurW tM repuirements ol Glilorma HWt� an0 Salery CoOe Sectiwu 25505. 25533, an0 F ND � i' i� E�$ 2553C an0 Wf I or am� lu[ure WrilUinp acupant vnlVwill mt (tirde one) netd to campy vnth saiE state codes an0 Ne repuirements for a ' . Dermit for consiruction or mo0i/iptlon Imm t�e Fir aliry ManaOement Oistrict. ResiEential conitmction applications am exemD� �rom ' - Ihe58 prOvi5ion5. � . Date: MD�� I nerebY ceniy tlat I tuve rea0 tNs apD�� suL oNinances antl state laws relatinq to EuiINnO ��N�on propeny tor inspectron Ompous. Uate:,"��'�'��L C% Sipnaw� Driver's License ar Social Securiry M: 1861d8 W�ite—BailEinp; Greer nbmama CenW—ApG�icanl; Pink—Revenue; 6olEenroE—Atseswr anE 0100054400-00054900 TdT 216.00 DATE� 02/26/90 TItiE: 15:43 . �CONSTRUCTION AND PLANNING �'APPROVALS l. Permit # Date '{. Temporary Electrical Service or Pole �� . ..� . 2. Soil Pipe�Undrgrnd. � � _ . 3. Electrical Conduit Utility�Undrgmd. 4. Electrical Conduit-Undrgmd... �� . 5. S[eel Reinforcement 6. Electrical UFER Grnd. � i 7.�Footings ' � � ,� 8. Foundation 1�.° 9. Water Pipe-Undrgrnd. i j�� f• . ', 10. Structural Floor SYstem j •� ;� 11. Property Sewer Line & House Connection 12. Sewer Cap , , 13. Roof Drains t \ 14. Rough Plumbing , � 15. Rough Electrical-Conduir' i }, 16. Rough ElectriC Wiring ' 17. Rough Wiring Sign �, � 18. Rough Electrital-T Bar Ceiling � 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure • � 22. Ducts, Ventilating 23. Gas Pipe�Rough & Test 24. Roof Framing 25. Roof Sheathing � 26. T�Bar Ceiling (Structural) & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insulation 30. Drywall Nailing 31. Plas[er Brown Coac 32. Electrical Power MeterFinal 33. Final Electric � 34. Final Heating & Air Conditioning 35. Final Gas Pipe�Test " 36. Hood or CanopY 37. Fina1 Factory Fireptace ' 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46.� Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNING 49. Electric ReleaSe ta Edison 50. Gat Release to Southern California Gas Co ' 51. CERTIFICATE OF OCCUPANCY No. Date Inspector ,' i / ' T ,, ' <�� i J �%�' � . �.' i ry ., n _ POOL 'A APPROVALS Permit # 52. Pool & Equipment Location 53. Steel Reinforcement � 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pres:ure Test 57. APPROVALTOCOVER�GUNITE 58. Electrical Conduit�Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P•Trap, O Undrgrnd 61. APPROVAL TO DECK 62. Backwash & Receptor�Final 63. Heater & Vent�Final 64. Plumbing System - Final 65. Electrical-Final � 66. Solar SYstem-Final 67. Fencing & Access ApProval 68. APPROVED FOR PLASTERING ' 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit# 70. Underground Hydro 3-� 71. ProductPiping�Gas ❑Oil 72. Underground Flush - 73. Undergrnd. Storage Tank O Gas ❑ Oil \ Oate Inspector � .:� '1 �: / . . .� i ` � i � , s-yv Iw..r�.. i5-kD� Iu;O 74. Overhead Hydro � �u�h ��/��%d 75. Dry Chemical . 76. Dry Standpipe 77. FIXED SYSTEM FINAL. ,�rb_t� 78. FIRE PREV. FINAL 7! 4.b- HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED Notes: � �ooncss ov em�wrvo: 6 01 W 19 TH S T o^T'E"'s"""E'°'Q'°"": TRIANGLE SQ JT VENTURE �ooneu: 33161—A CAMINO CAPISTRANO SAN JUAN CAPISTRAN0,92675 r ..'R�rnr,c.i.��;a:�x+a UNT: AXLNRECTOXFNdNFfA: HI HENDY ASSOC. �� 19204 dqCN.ONFNQ'S/iWNE53: � Q 1 S CAMPUS DR uNT: 110 IR CA 92715 ��T�'S� BLAKE AIR COND/SERVICE CO ( 714 ) 630-6412 CQ1fflACTORSYYIIIq 1175 N OSPREY CIR mo�sr ANAHEIM CA ucr+o.: 396109 9280% UNT: LJCENSED COMflACTOP4 DECL�fl�TtON: I Mreby ellim wtls penely d par"ryry Net I em femrd unAx praieqns d Gheqa 9 (mmmencrq wnh Section )000) d Oivbion J d the BuaiMn eM Pmlaeams Code, ud my I'vama n in tull lorro end eXed. cmuc.No.:0/2602/6 uc.cuss: C 20 uc.No.: 3g610 - EXP: 0' /�� Deb: �V ! Z �Y 5 Cowmor OWNER BUILDEfl OECUP�TON: I hereby eHum wtlar peiuly rjury �hm I em e�em0 �� a+ �s �w' �a iM Io0own0 �esaon (Seeion )ro1.5 Buane» eM Prdmvau Gode: � ciY a oam�Y xhidi mCwm a Pormn �o mrewc. etlx. inYow. demolch, or rapei eny el�uclura, pia to m esuerae, ebo rpuiree IM epplimm Iw wc� permn io Rb e egrwd eletemeM Net M ar eM �inmee w�,eru m ine pwubm a u» cmiream lioeme lew ICMa« s(cmun«rina wnn seeon l000) a oi.cia, a d �he .imnsa eM PrWwiom CoCel a tAm he a ehe b uemq tAashom aM IM bmie /or Ne allopotl ssenMian. AnY videtion W Setlion i0�1.5 Ey eny epp4rent la a partnn wbpee tM epplcem to e mN perieliy d nd more �hen Iwe hundreE Adlen �5500�). ❑ �.uowne,a�newwNr«mv�Wa��w.nwepumin.:.deoomv�.d�..,�oro�newix.ene�n.w,xn,reunaw.deA w oNered la eele (�� a�. Bu6iwaeM Pml»riaia CoEe: TM Contreaore Liconae LnwAom m1 eppy loen ovms d qoperry who biid� a inpwee tMreon. eM who don auM wk 1"vnstl u havatl aWou� he a Mr own amWWr. na'� tM wM �mo,wemmus.,. �m mi�,dee «o�ee ia.w. n. no.,.�e,. in. wuimc «mw�am m wa waw� on. rw d mmqau,. m. owrer-0uiMer nill Mve iM DuNen d pwinp M or Me d'd M DuiM a impova lar Ihe W�pwe d eab). � I. ro orrtw d tM PaOMY. em eRWvrdY mniradM v.iih 4cemeA eanimaas ro eonmixf tlr V9� (Seaion AM. Buairms anE Pmfamiwu Cade: TM Conlretlm L'cen+s lew tloe.v iwl epply b en owmr tl p�apeny v.1w buiNa or impw�m Illneon anE who mwecu Ior eud� pqwa xvA e mNroCor(e) 4md punueN to iM ConireCm L'ceius Law�. � I em exemq uMu Seclion: B. 8 P.C.. la Nu raemn: Dme: ��: 1 Eo heraby canEy thet I em ewua dW wMe'sleM ihe �eW'vemaMe d Celiomie IleeEh eM Sefery Cods Setlbro 25505.255]�. vd 25S1f. enE Uei I«vry Muro Wiki�p omipent xill / wll nd (rircM me) rieM �o cwnyy wYh eeid ame oodm eM iM repuiremenle br a Ve�� IaramVucYon a modifraion han IheAi�iieTy .11�+reCemoni D'atiid. Revdepid aMiudian MV�iaa en wmq han Naaa ,.a;�,.. ome: �op�w: WOFKEH'S COYPENSATION DKIAR�TON: 1 hmeby elfimi uMer pa�uM1y d per'ryry wr d iM Idbwinp Eatlereiion: � I heve eM xii meinten e cantlirae d comani ta �apimuro tor waken canpenaeion, e poWM lu by Seaion 3)00 d the lebor Code./a iM1e peAamence d iM xwk Iw wlvch ihia peimil ie iaued. �I heva eM wil meinten wwken' aompenmiion imurerce. m rpuirod by Saim 3)OD d tM laEn Code. br tM pe�ormenoe W �he work In which ihie peimn b ivued. My warkere' mmpenvtion inwrenca cerrier end poliry numbe� va: c�«: RFP�iBT�7r 7NDEMN EXPIRES Poi�Yndmn«: a5n�t�a` 07/01/96 nis aeaian me0 ro� be canpleroJ ] tne permt u/a one hunJrea CdWs R�aol a/w J � I cerltly iM1m in �he perlormema M Ne xroA br wM1c� Ihie peimn ia ueueE, I Mell iwl employ eny penon in ury meruier eo m io became eubjacV io tM xakaY canparomian le�x d Cdilanie. aM apr« Ow il I�Ia Exome wbjea to t compem/et.b�n sion d Sadion 9f00 o11M lebor CoEe, I shell fon�wil� cynpry xii � provisione. � Dme: i�/ � JG1 S ApplkeM: � WeminO� Fallun ro�x�n woM'eri compsnutlan eoverp� ls unl�wful, entl �Iwll r.OJlet employsr fo crlMrul p�nelflu �M clvll flMs up ro om �untlro0 thouuM Jollen (SIOQ000), In etltl/tlon (o M� coaf ol rompxwlbR tlemsps� es prov/dM br In Sxtlon J]O6 0/ ths LeborCOW. Infsnsf, erW �ttornsY i l�ss. CONSTFUCTON LENDMU ACENCY: I �ereEy �rm unEe� penalry d perjury iMl Ihem ie e conqmd'nn biMinp epenry Iw tM �no�a�� d ina .o�x i« wnMn ino re�e �, m.�a tseao� aos�. cr. c). LENPEfl'S NAME: LENDEP'S ADDRE55: I cenRy iM1et I heve reeE Ihis epplcmian end nme ihet ihe ebore intameiion ia mrted. I e0� �o compN �h ell tlly enE munty aEinvwee vM stae lavn rMe�ieq to buikvp conaVudian eM hereby euihwrze �eprewnteliwe d �hia dry �o mter upon iM ebwa.meniioned pope�y faimpeaion Wrpaes. MATTHEW BLAKE � Dme: .__�� _+v-�-+�- f (5t5td6.WP) � Whne-BuiNiq 8 Selely:OreaMFle: Cenery-rlppYranl: Pink-Pawnue; Ookenmd-basa+ar _ITY OF COSTA MESA — BUILDING PERMIT PERMIT NO: M 074401 PLAN CHECK NO: N CONSTRUCTION TYPE: ��—N SP PERMIT TYPE: MEC JOB DESCRIPTION : 2NDS STORY 5294SF T.I./ MECHANICAL CLAIM VALUE: CALC—VALUE: PERM NO: M 074401 GOVT; N SUPP: N PURPOSE: OTH SQ FT: GROUP OCC: B-2 / COMMENTS: " PLANNED PARENTHOOD"/MECHANICAL/ REF B-73981 �****�+�*�*�******�****�x+��****x***��*�r��*******�**��***�r***�rt****�*��**��*�* 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 ------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN PARKING REQ: PROV: PARCEL: 42421118 2NE: REF NO: PLANNING NOTES> �; � iE ik iE 3E iE iE 1ElE 3F iE fElE 9E 3E 3F 1f iE �E fE iE dE i! iE 1E 1E 1ElE 1ElE iE iE �E iE jE �E iE fF.1E IE �E 3E k!E!E iE ie jE 3f if �E 1E iE �E if 3E iF iE iE iE if 1E iF if !F 1E if iE iE �F iE iE �E 3f iE IE iE iE ik jf D E�� 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: HUILDING APPROVED BY : � '/ DATE: APPLICATION ISSUED BY: ,i / 4L%��% DATE: �� —��`� �FiEiE3ElEjf*1ElEifiElfifiEiEif1E9E�E3fiEiE �r +c+c 1F��FiEiflEiEiEik3E3E9Eif�iF7FifaE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N " % ✓ BLDG PMT PLUMBING ELECTRIC MECH'ANIC'' FIRE SMIP/RES GRAU.I*.�, PERMIT 48.00 / _-25$L SMIP/NON—RES � PLAN " ISSUE FEE 15a00' BUILDING—DIV—> PERMIT ISSUE PLAN—CAECK „�,�1'fOTAL PAID DUE TOTALS----> 48.00 15.00 0.00 '�, ^63.00 63.00 ; ,00 REV£NOE DIVISION TOTALS--> COLLECTED: 63.00 OVER/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECAANIC FZRE SMIP/TOT GRADING PLAN—CHECK 63.00 , r1� If iE iF iE iE iE iF iE iE iE iE iE iF if 3E 3f iE 3E �E �% iE iE 3E iF iE 3E jF iE iF jE 1F 1F iE jf iF df if * jE iE iE iE-1E iE iP� 1F iE iF 1E i�' iE iE iE iE 1E iE iE iF 3f iE iE i� 3E iE aE iE if� if if� iE iF aE �E iF 3E iE iE if I N D I V I D U A L F E E=�B•-R,;E A K D O W N TYPE QTY D E S C R I P T I O N '; �� UNIT COST TOTAL CUST , MEC 2 VENTILATION FAN CONN TO SINGli�E DUCT 4,50 9.00 MEC 5 VENTILATION SYS NOT U�IDER PERMIT,EA. 6.50 39.00 END OF FEES. -� '� �!y . . /' 1� �`✓Li i/ �' % 01 07141_��3-�719i�23 ; c�Y 63.�4 � OFlTE: 10�Ji/45 T?i+E; ib:15 M` CONSTRUCTION AND PLANNING POOL 'A APPROVALS Permit# Date Inspector pPPROVALS Permit# Date Inspector. t. Temporary Electric8l Service or P61e 52. Pool & Equipment Location. � . }, 2. $oilPipe-Undrgrnd. "�� . 53. SteelReinforcement ' 3. Efectrical Conduit Utllity-Undrgcntl. 54. Forms ' � 4. Electrical Conduit-Undrgrnd. � 55. E�ectrical Bondin9 ) 5. Steel Reintorcement . 56. Rough Plumbing & Pressure Test ! 6. Electr�cal UFER Grnd. 57. APPROVAL TO COVER-GUNITE '� 7. Footinqs 58. Eiecirical Conduit�Undrgrnd. ' 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test . ' 9. Water Pipe�Undrgrnd. , 60. Backwash Lines, P•Trap, O Undrgmd. � 10. Structural Floor System ,� 61. APPROVAL TO DECK r" 11. Property Sewer Line & HouseCorYnection 62. 6�ckwash & Receptor-Flnal :� 12. Sewer Cap �,? , 63. Heater & Vent-Final '� t 13. Root Drains 64. Plumbing System � Final ' }4, Fough Piombing" �I 65. EfecCrica6Fina1 ' 15. Rough Electrical-Conduit ;.,f 66. Solar System-Pinal ,�"�' � 16. ROugh Electric Wiring :,� 67. Fencing & Access Approval�'O -�.�t 77. Rough Wiring Sign :� � 68. APPftOVED FOR PLASTERI(VG . 18. Rough Electrical�T Bar Ceiling� 69. POOUSPA SYSTEMS FINAL �� 79. Rough Heating & Air Conditioning � 3_. FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 27. Ducts, in Structure 70. Underground Hydro 22. DUcts, Ventilating I1. Product Piping OGas OOiI 23. Gas Pipe•Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas G�OiI 25. Rpof Sheathing 74, Overhead Hydro 26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical _ 27. Prame 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. P�aster Brown Coat 79. FINAL INSPECTION 32. Elecirical Power Meter-Final 80. F000 CERTIFICATE �SSUED 33. Final Electric � Notes: '�`e� � w� ''� , � � �_S[_.�[ 34. Final Heating & Air Conditioning D Z� � ��n '�D D"�'� � 35. FinalGasPipe-Test pLU��/��_�� F 36. Hdod or Canopy 37. Final Factory Fireplace � 0-�� 5 �1�C37�-�%�Z'� -r - - -- 38. Final Plumbing � '�� . 1 � 39. Water Service�Finai � , � - Z'3 � - 40. Gas Service-Final � r 41. So�ar pomestioFinal , � 42. Backflow Preventec 43. Backfiow Irriqation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regu�ations 47. FINAL STRUCTURE & BUILOING � 48. FINAL PLANNING 49. Electric Release to Edison � 50. Gas Release to Southern Cali(ornia Gas Co � 51. CERTIFICATE OP OCCUPANCY No Date City of Costa Mesa Development Services Deparcment Building Safety Division P. O. Box 7200 Coste Mesa, Califomia CERTIFICATE OF OCCUPANCY No.0t7�^�� The Building located at��t�.�� i��r�_� � has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicab�e thereto for a Group R-2 Occupancy. Use of Building Dental Office Legal Description 424-211-11 (See reverse side for Me[es and Boundsl Building Permit No. H96623 Electrical Permit No. Plumbing Permii No._ Mechaniwl Permit No. Number of apartments andlor guest rooms iSSUED70: BuildingOfficial�Tonv C'De Baca Tr�ancrle Sauare Foint Ven e'� �j �l� 331b1 Camino Capistrano (8A) bY San Juan Canistrano. CA 92675 Date AnauRt 17. 1990 This Certifiwte of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by ihe Building Official of the City of Costa Mesa under Sec. 307 1e) U.B.C. � � CMF 3015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File � r i PP0.IELTAEDqESE: 6O1 W 19TH ST � � uxrt: � � OWN6fl'SNAME: 'TRIANGLE SQUAREJOINT VEN �lpDpESS: ;j;j161 CAMINO c'APISTRANO . � • SA, SAN JUAN CAP]:STRANO. . ' � '1.40-2382 , RBCH/ENCINEEB: NONA ASSQC �xeo.xo.:C11588 nooness: ?6901 C�1INU DE ESTRELLA uert: CAPISTRANO HEACH C�1 9?.624 PERMRTEE: j,.A. COUNTY LAND CO � ( 714 ) 240-1382 eooxess: �3161 CAMl'NO CAPTSTRANO A s SAN 7UAN, CAPISTRANO CA 9'2675 UCENSED CONTMCTOB OECIAMTION: I hereEy atlirm Ihat I arti licensed untler D�ovisions ot ChaO�er 9(commencinB wiN Sactlon 7000� aP Oivabn 3 of t�e Basiness and Pratessions CoUe, ana my lioense is in fWl force arM eHect . .. cmuc.:04847I suleuc.: 53200 � ➢ Oate: �' -2 � ' � Sipnamre: �� — � � WOqI(ENS' LOMPENSATION UECUMTION. 1 tieaby a�lbm that I Aave a certibwte ui ransent tu sWFirrsure or a cenifiwte ol Workers' ComDensation Insuance or a cenifie0 trop tAereol (Section 3800. La�. CI. voucr xa.: AY 8 9�- 2 2 7 2 9�i -- ]. 0 EXP. DR�E: L 1 I O 1 I 9 O; cornr�xv: FREMONT , �] Cetlitied copY �s here6y Iumis�e0. � Certilie0 caDY �5 filetl xm� tAe ci BuilEinp DNision. ' :i%!��__� 9 . Oate: J —��' f'6 � � Applican�^ peunrrrox cqan� wonKFnS• mra[HS1nox o[uuunax: (Ros ucmm �eea m� be mmpe�ea a me pmm.'s ror' me nadma g�ml a kssl. � I ttniry ttut iq t�a peAormdnte ot tne Mrolk tor whicn tAis permn is iASued, I shaV not employ any persOn In any manner W as to CeCome ' su�lect to the Wohers' ComDensation Laws of Calilomia. ' � � Date: SiOnaWre: NOTICE: tl, atler makin0 ��is Aeclaration, you shoulU Eecome su6ject, Io the Workers' Compensatian pmvisions of Ne LaDor CoOe, you must lart�wit� comply wit� sucA pravisions or �his.permlt shall be deemetl revokeA. � CONSTNULf10N 1EN01N0 AGENCY: I hereby aHirm that I�ere is�a constmcGon lending aAency lor Ihe peAormance oi Ne vrork lor wAkn ttus pemtit is issuetl (5ection 3W7. Civ. C). . � . LENOER: � , � . enowess: - - OWNEB BUILOEB DECUMTION: I hereby atlirm t�at I am exempt imm the Contractors State License Law for the tollowinp reason (Section 7031.5 Business antl Pmfessional Catle: My ciry of counry which requires a permit to constmc6 alter, improve, Oemollsh, or � repair any structure, pnar to ils issuance, aLso reQuires t�e aDPucant for suc� permlt ro file a si0ne0 statement.t�at hdSAe is IicanseA pursuant to [he D�avisions ol I�e Caitractors' S�ate Licensa Law (Ctupter 9(wmmencinp vnth Sectlon 7000) ot Division 3 oi the Business anE Pmfessians CoAe) or that �e/5Ae is exempt ihereirom and Ne basis for Ihe alle0� exemption. My tiolation ot Secfion 7031.5 Ey any apDlicant far a Dermit su�lects t�e aODlicant to a civil'Denalry oi not more t�an live hunOrea Uollars (5500). I, az owner ol t�e O�DenY or•rtry empIoyees with wapes as Neir sole compeniatlon, MII Oo [he work. anE I�e ❑ strucwm is not imenEea or otterea for saie (Settron 70aa, Business and Pm/essional COCe: IDe Cantacrors' State License Law Uoes not aDUry ro an owner of a pmperry who 6uilOs or improves �Aer¢on, an0 wtio tloes SucA work himself/Aerself or t�rou0h Ais or Aer owmemployees, proviEeU Nat such imprwemenis am not imended or otlered�for sale. Ii, however the buildinp or ImO�avement is sul� within one year oi completion, ��e owner will hava ��e Ourden oi provin0 �e�s�e Ai0 not Eui10 ar impmve for the purposa ol sale�. . . I, as owner of t�e proDerty. am evclusively coMractin0 ��h Iicense0 contracmrs to constmct t�e pmjact (Section )06a, Business ❑ and Protessans COEe: The Contactors' State licensa Law d� nol appy to an owner of properrywAo EuJQs or Improves �hereon anG wlw contracls fo� suc� D�I��s'MN a contractor�s) ticense pursuan� to tha Cantractors' Sute Laenu Law�. I am aware tlut praal oi�t�eir Wahsr's Compertu�on imuranu slroulE Ge D�a�OeU ta me. ' _ � I am exempt arMar Sectiart: B. 8 P. C. tor ihis reason: � Date: �'�'�e�� ' 1 EO Aereby Certiry tAat 1 dm awafe Of an0 ond¢rsYanC Me requirements af Cafibfma Heal(h antl $akry CaOe $ectiom 25505, 25533, arM 2553a an0 that I or any luwre EWIEinp occupant wiNvnll not (cirde ane) neeE m compty with saiG state ca0es anE Ne reQuirtments tor a. permit lor wnstruction oc moEifiwtion fram tha Nr tiry Manaqement Oisinct BesiCential wnstructbn aDDlications ar¢ exempt Irom Iilese provi5ions. ' . Date: NpDIIwnC I �ereUy cenity t�at I hava reaU �his aDPlication and slate Ihat tAe above inlormation is wrrect. I a0ree ro comDly wii� all ciry anE counry ortlinances and state laws relatinq ro bulldinp constmction anU hereby authorize repreuntatives ai t�is ciry to e�r. on iqe ahove�mentlonetl pmpeM �or inspettlon Duryous. / . � � � / � �are; 3 i a�`O � � 517� - — t oriver's �icense or Soda� Security x: 1891�8 White—Buiitli�q: Graen—Cotle Enlorcamenl; Canary—AooNcenk Ponk—Revenue: Go1Cen�W—lv5eesor —"—� CI'CY OF' COSTA MESA' - BOILDING FERMIT � PERM-Nu:.��J PERMIT NU: H. 0�16623 �. 'YLAN C.IiECK NO: 03260--9.O,A GOVT: N SUPP:' N CONSTRUC'PION TYPE: �i�`�� PGRMIT TYPL: STR ;P�jAPOSti: � AL'T vN J JpA �DESCRIPTLOAI : 1583 ENTAL OFFtCE T; I. : � SQ .E'T: � 1, 583 CLAIM VALUG: • 7.0,OOO.UO CAI�C-VALUE: - "10,357..38 GROUP OCC: B-�2�. / COMMFDITS : . ***;�xx�*r�**+e�**x��e***x-�x x��*�e*+�u�**+�*��i'��c*��*��rx��***x**�c*�r�c*x�x�*�'*�**#*x�*�� 'L G N I N GS �R�EIIQ�UCIKRSE M E N T S � _ �------------ MAI�I BUILDIDIG ---------- --------- ACCESSORY BUILDING ---------:-�- FRNT: � F1' IN I2EAR: FT IN FRNT: FT IN REAR: FT IN LEFT: L'T IN. RGHT: FT IN : LEE'T: FT, IN RGFi1': FT ' IN• PARKIDIG RF..Q: PROV: + PARC�L: ;42�2'L'1'11 7.NE: C1 �REP DIO: ,PLADINING NUTES> INT£RIOR ALTGRATION POR A DENTIST. "� . � ' . - . .. .. . : � '.. . . . �. _ � . iE �E iE K If ik �E iE if it 1E iE IE iE iE 3E if �f iE iE iE if if fE ik iElFiF dE iF �f iE dE !f if iE±E iE iE 1E 3f ff i! # it�lk iE iE jE 3E �k 1E ik iE if iflf 1E �E 3Elf ik iE if 1f 1E if 3E iFlF�E iF k iE k�(�F jE iE � . D E V E L O P� M F. N--'T S E R V I C E S R E Q U I R E M F_ N��T ' S I 'LGNl'NG AFPRUVED BY _ ��_ �_��(L . ___ DATE:�j=3;2_�j _ . I BUII,DING APPROVED BY : . nATE: .� �' _' , " � ' � • .,S_'—__' AFPLICATIOtd ISSUED RY: i �j' j�S DATE: =%�j— it 1t it� �1t k** it it �f if i� �1E � i� ic it it it� * it iF'��3F�'iFiFiF'iF'�F3i"iF��#'� iFR'��FiFit�it it it �t it it i� �lE �+FiFiF3FiF3F7Fi� ** iFitIFiElEiEiElPiEiEifjEkiEiEikfkififiElEikiEiEkiE3k�FitiFiEiEikiEiEifiFiEiE ifkiEif3Eik�EiEiEltitlfifiFlEiflEiEiEjtifiFiFiEfFiEiEiEiF3f1E3flfiEifiElf3Eik LEGAI,'I7.ATION:N ' F E E S? U M M A R Y STROCI'iJRAL "SEGMENT:Y BLDG PMT ' PLUMBING F.I,ECTRIC MECHANIC . FIRE� .SMIF/RF.S GRADING PERMI�1 " ?.16�.U0'' � � . � _ }` SMIF/D]ON-RF_S � PLAM 35.10 , � , ' 3.05 iSSUE FE:F.. , , HUILDING-llIV=>. PERMI-T ISSUE PLATI-CIiECK TOTAL � PA'tD ':DUE T02AL5----> 219.05 ,0.00 ; 35..10 7.54.15 254.15 .QO _ _ REVENUE DI��ISIOtJ TOTALS---> - COLLECTEIJ: 254,15: OVER/SHORT: .00 . BLDG PMT FLUMHING F.LECTRIC. MECHANIC FIRE SMIP/TOT GRADING PL�AN-CIiGCK 216.00 . ' � 3.05 j ' 35.10 3F iE if k�k k it it M iE iE iE 3(� M iE if if �E iE k aE 9E �14 jE If !E iE iE if iE iE if iE iE iE iE k iE iE it iF iE ft i( iE 1E iE 3E if 1E iE 3E f! iF iElf k iE �E if if 1f IE iE iE k if iE k if if �f iE iF if 1E it ik ff I Ti D I V I D U A L' F E E B R E A K�D O W N 'CYPI'. QTY D C S C' R.I P T I O N , ,�'ONIT COST ' TOTAL COST SFC 1 583 MED-.T.NT� AI,TER TYPE V-Dt --AVHR 12.86 �'0, 357. 38 . ' ' EDID OF FF.�S 8 � SEG. 330� E�.S O1000Sb596-00056b95 TO'Y" DATE: 03/22/90 ?It[E: f0:35 h 254.15 ` CONSTRUCTION AND PLANNING ' POOL & SPA ,�PPROVALS Permit# Date Inspecto� APPROVALS Permit# Date Inspector 1, Temporary-Electrical Service or Pole - ' . 52. Pool & Equipment Location ,2. Soil Pipe-Undrgmd. 53. Steel Reinforcement 3. Electrical Conduit�Utility-Undrgrnd::.. 54. Forms � -. 4' Electrical Conduit-Undrgrnd. . � 55. Electrical Bonding •5...Steel Reinforcement -- � � _� 56. Rough Plumbing�& Pressure Test ' =�6.'Electrical;UFER Grnd. � 57. APPROVAL TO COVER�GUNITE ,- "'7. Footings ' . - ' � � � 58. Electrical Conduit-Undrgrnd. - 8; Foundatio'n' �� _ � - � 59. Gas Pipe, O Undrgmd., Test ��9.� Water Pipe�Undrgmd. �. � . 60. Backwash Lines, P-Trap, � Undrgrnd. � 10'Structural Floor SYstem � 61. APPROVAL TO DECK j�.�. Property Sewer Line & House Connection 62, Backwash & ReceptorFinal �� 12. Sewer Cap � _ �7 63. Heater & VenbFinal , 13. Roof Drains� •' 64. Plumbing System - Final �' 14. Rough Plumbing 65. E�ectrica�-Final � 15. Rough Electrical-Conduit � 66. Solar System-Final 76. Rough Electric Wiring � _ 67. Fencing & Access Approval 77. Rough Wiring Sign � 68. APPROVED F.OR PLASTERING 1$. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning ,_ '" _ � . FIRE DEPT. REQUIREMENT . 20. �Rough F.actory Fireplace � � -- APPROVALS � . Permit # � 21. pucts, in Structure '" - � 70. Underground Hydro � ^ - M1 22.-pucts, Ventilating '77. Product Piping �Gas ❑Oil , 23. Gas Pipe-Rough & Test _ . - 72, Underground Flush - ",� . 24. Roof Fr;aming � - ' � � � - . . J73::Undergmii.Storage:Tank.OGas ❑Oil 25. Roof Sheathing �. . 74, Overhead Hydro_ _ 26..T-6'ar Ceiling IStructural) &•Monocoat '�- 75r Dry Chemical . . ' �y- 27. Framiand Flathing -_ ' 76. � Dry Standpipe �� 28. LatRirig & Siding _' ` " " 77;; FIXED SY,STEM FINAL ' � �, .. � • 29. Insulation _ � • 76.`- F�RE PREV. FINA'L � 30. Drywall,Nailing � y � �B- - HEALTH�DEPT..�REQOIREMENT 31. Plaster Brown Coat :_ ' �+ ^79. FINAL INSPECTION � 32. �Electrical Power Meter-Final - ' 80'.:FOOD CERTIFICATE ISSUED. � 33. Final Electric ' � �.,: � �+ � Notes: ' �(/ _ .tb�/�.� U f` 34. Final Heating & Air Conditioning - ! , - ' � 35. �Final Gas Pipe�Test _ .� �� __ � -. � = . 36. Hood or Canopy �- � ' - � _ � _' �� , J 37. FinahFaMory Fireplace • -. � , � _ . . _. � ' . 38. Final Plumbing "' � �, _ ' - '39. Water Service�Final - � � � • .- " . � i- � 40. Gas Service-Final " � ' � � ' � - • '41: Solar pomesticFinal � �� . • � � � + 42. 9ackflow Preventer � � ' ' ' . � . 43. Backflow Irrigation � • , � - '44. Landscape Irrigation System - _ � � � . ' - c 45. Sound Attenuation ' . ' ' - , -- � ' . • - '46. Handicap Regulations � . � ., ,s � ' _ ' , , 47. FINAL STRUCTUfiE & BUILDING �- � 46. FINAL PLANNING ' �-? . . ; � . 49. Electric Release to Edison '" . � � ; 50. Gas=Releaie;to Southem California Gas Co • �' _ . : , �� 51. GERTIFICATE OF OCCUPANCY No. Date PfiQ1ECfR00flE53: '(jOS W 19TtI ST � ' ' uxrt: B� owxex�sxune: TRIANGLE SQOAREJOINT VEIJ_ � • "qo"Eu: 33161 CAMINO CAPISTRANO ` � , #A, SAN JUAN CAPISTRANO � 240-1382 .AqGUENGINEEq; NONA ASSOC � � AEO.NO.:CISSBE � �oon¢ss: z69.01' CAM'INO AE ESTRELLA uxR: CAPISTRANO AEACH CA 92624 � ' PENMRTEE: _pROGFiESSI��E DESIGNED PI�MG ( 217 )�437-83G6 RODflEBi: iS4Z SCABRIGHT AV � LONG BEACA CA 90813 11C[NSED LONTMCfON OECLAMTION: I �ere0y attirm that I am I¢ense0 un0er DroNsiaS oi CtuO�er 9(wmmenqnp wit� Sectbn 7Wp) ol ONisim 3 ot Ue BuslneR anE Prohssians CoOe, a�nE'� h�cenu Is in lull lorce ana allect. . � cilr uc.: 0 4 9 S 4 5 aTnre uc.: 3 3 4 7 9 9{� // cuss: oaie:? -23-=�� sronamre�Acd�� .� WOPKEBS' COMPENSIITtON DECUfl11TI0N: I Aer¢ afllrm tlwl l have a ceNfiute ol wnsent ta sel4insum or a �eN/iwta ol WOAers ' Compensation Inwrance, or a cenilieU w roereoi�5ectian 3800, LaE. q. � roucvNo.:73WC00II071�001 exv.o�re: 10/U1/90 cOrnv�mr NA1'IONWIDE ❑ ClrIi9CA Capy i5 MtPAy fumRliEO. � CenifieG mpy is t� IM dry BWEInO �ion. �e:.� '�3 ( � ApPlicant:,� ��f�.", PfION FPON N'OflKER3' COMPEIISITION OEpAMTION: (iFa uNm naC not Ce wmWeteO if Ua D� Li �a ane IaYtl2E 15100) a lar�. i certtry t�af in Me perfortnance af Ma work far whicA [Ais Oermit is'ssued, 1 sAali nof empfoy any person In any manner sa az lo Docome wbjep to tne Wahcrs' Compenution Laxs oi Caltlomia. �� _ wA �— �. ' 4'r g0��'l'o' 4' NOTILE: II. alter maNnO �s tledarallon, you s�ould Eewme suDlect�lo Ne Wo�kers Compensatlon O��sions oi Ne LeOor CaOe. you must IaNmiN mmpty rrit� wc� prmisbns ar Uis permit sliall Oe EeertceO revokpA. CONSTHUCTION LENOIN6 �OENCY: I hereEy attirm tlwt Ihem is a wnsirupion IenAinO apency lor the Detlarmance ol the work lor whiG1 Ih¢ Derrtdt is LSweE (Sallon 3097. CF/. CI. ;' ` lFMOFp: ' �DONE3E: . OWNER 9UILDER OECWUTION: I �ere0y aflirm that I am exempt Irom Ne Cont2ctors' State Llcense Law lor tM lo9wdnp reason (�ction 7031.5 Business aM Profysslonal CoOe: My dry ol caunry wAicA requires a DermA to consiruct. alter, improve, Eemolis0, or repair any sttuciure, prior to its issuana, aLto repuires the appticant tor sucA permil to file a 5ipneE statement that he/slre b IlcenSeE Dur�uant to ttre provisions ol ��e Comactors' SWie License �aw (Chepter 9(commancin0'��h Section 7000) oi Division 3 0l ehe Business an0 Professions CaUe) ar ihat hefshe k eaempt IAeretrom antl ihe Oasis lor the alle0e0 e�emption. My violailon oi Sec[ion 7031.5 by e�Y applicant Por a Oemu[ SUEjectS the aODliwnt to a cNil penalry ol not mora than live �unGretl Oollars (5500). ',, I, as mmer oi tAe D�OeM or my empNyees wkn wapes az their wla campenution, mll Eo t�e work, anE the � structum 6 not imenOetl or ofleretl for sale (Section 704C. Business and Prolessional Cotle: T�e Contrzctors' State Lkenu Lar. Oces not appy ro an owner of a Dmperty who bmlEs or Impmves thereon', an0 wla Ooes suc� work �imsell/�erseB or through �is or Aer own emplayeu, provitled that suc� improvements am not inten0etl or oiferetl for sale. If, hpwever the GUIItlinO or impmvement ¢ so10 wtttin are year oi comdetion, Ihe ovmer vnll have the hurUen of Drpvin9 h�she EiO not �u00 or improve I lar t�e Durpose ol salel. •. . � . I, u ovmer ol Ine properry am excliisiveIy coMraMinp with Ikensetl caniractors la construct Ne Dmle�� (Sectlon 70CC, Business �— an0 Prohssians CoEe: The ConVaclors State Licensa Law Coes not appty ro an owner o� properry who buJ05 or impmves Nereon an0 wAo conVacts lor suc� prol�u �1� a wntractaqsl license pursuant w t�e Contranors' Staro Ucanse Law�. I am aware W( Droof af tlreh Worlxr'S ConW�rtsafian inwance s�ou1G Ee OmviAed to me. I � I am exampt unEer SecUon: B. 6 P. C. � �Or Ih6 r8d5011: • �� Owner. � 40 herehy artiry ttut I am aware ol antl unEersWntl tM repwertrems al Califomia HealtA anA Safery COGe Sectloiu 25505, 255J3, a�M t5S3C an0 ttui I or any tutufe Eulltlmp xCupant vnlVwlil not (tirtlE On0) neea Io Comply wilh SaiA Sla�e Co0¢5 anE t�e rEquifemBn(S IOr a Yer�� or conSWetion or motlilication tmm I�e N''r�u�liry Manapement District. pesi0emial conatmctlan aDW�wtbns are exam0� �rom tAese provisians. , . Date: Appliwnt: I h�reCy cetlity t�at I have reaE �Als apDliwtlon an0 state t�at t�e a6ove infarmation is cormct. I apree to comply wlt� all city, an0 counry wtlifunces an0 st�te laws relatlnp to Mri1Ei�p aristnxtion aM MreEy autturim rmresenuthros al tNs m enter upon the aEove�mentlo�E 7�opeM tor us0�ibn v�moses. � D ��,� oate: �- 23 � QQ Sipnature: d�%{ ( O.i/e� --J oriver's �icensa or Saiv SecuAry M: ' . ��»8 NTiu—Bulki'q: Graan—CoOe Enforcemem; Canary—Applicnnt; Pink—Revenue; GolCanroO—Aapea�or CITY OF COSTA MESA - BOILDING PERMIT , PERM NO: P 04G658 P6RH7T NO: P 046Fi58 • PLAN1CHECK NO: N GOVT:�N'SUPP: N CONSTRUCTION TYF6: V-N PERMIT TYPE: PLU PURPOSE: OTH SOB DESCRIPTION : t.58J5F DENTAL OFFICE T.I. � SQ FT: � CLAIM VALUE: CALC-VALUE: GROOP OCC:_.H,-2 / COMMENTS: RE: D466"L3 PRIMARY $LUG�. PERMIT. . �- ' **�*+t*�rx*�tx******�x**�**�**�c��r�**�-****�t***�r***�r***��r*****x**��+�*�r*�t��t****��t�*�* ' Z O N I N G, LRTEBQAUCIKRSE M E N T S; ------------- MAIN 8U7:LDING —•------- ------- ACCESSORY BUILUING ---�----- FRNT: FT' IN REAR: ET IN FRNT: FT IN RE1�R: £T IT1 L£FT: FT IN,RGHT: FT T.N LEFT: �'T IN RGHT: PT IN PARKIDIG REp: PROV: PARCEL: 424211].7. ZNI'.: REF NO: PLANNING NfSTES> . > � N ik �t iE if iE iE iE iE 3E iE M 1E iF if �E M if ik ik 1E it iE k i( M� IF it iP ik iE If 1E if ik 1E jk ik �E iE k iE if iE 1E iE if if k�lk iE k iE �E iE if if ik iE iF it iE iE iE ik �E iE iE if 1E iF iE k iE ih iE 3( IF iE L E V E L U P td E N T S C R V I C E S";. R EO U I, R E M E N T S . C� ZONING APPROVED BY � • ' _ DATF.: V�!_,_ BUILDING APPROVED BY : _ � DATE: ��• APPLICATION ISSOCD BY: ' f" " DA'CF.: .3/�/�% ' iE3EiEMIhiflEitiElFff�i4*{EiFifiEiEiEitiFdF�7�. . F3F ik� .. iF�� F(•• ��ikifiFifikiElFiFif1E�� aFFiF��fF1E�ifif ik�EifiEiElfiFiFiflElEiFiEiEifiEfFlEifiFiE�FiEiEif-kiEilifitlElEfEfEififiE3t#iEiEk itiEiFiEit1E�1EiliFiflE�E�FlkikiE�flFifiE�lihiFitfF�tiEfEiE1Ei(-iEk3faE LEGALI2ATTON:N F E E, S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELF.CTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 30.00 � -. 25t �;. • SMIP/NON-RES PLAN : � . ISSOE fiEE '.3.00 ' BOILDING-DIV-> PERMIT ISSUE P�AN-CHECK TOTAL� PAID DUF.. TOTAI.S----> 30.00 3.00 ' 0.00 33.00 33.00 .OU REVENUE DIVISIOhI TOTALS-=> COLLECTED: 33.00 OVER/SHORT: 00 BLDG PMT' PLUMBING ELECTRIC`MECHANIC ['IRE SMIP/TOT GRADING PLAD!-CHECK �3.00 , , , � fE M iE i! N iE fF if iE 1f if if 3f i( It 1E jF iE fE i( if iE iE ik iE iF iE k if if 3E-0E iE ik iE iE 3f iF iE iE iE If if if fE iE 3E It iE iE %jE if IE iF if if iE iE iE1F 3E k 1f �E iE 3f aE if iF if ih if iF if if iE k iE I N D I V I D U A L'.'vF E E H R E A K A O W N � • t • TYPE , QTY D E S C R I P T I Q,N. I)NIT COST TOTI�L rOST PLO S WASH BA5IN '-"� 2.00 1.0.00 PLU 1 WATER HEATER ANL�/OR1 i�E�1T 2.00 . 2.00 PLU 1 IdP.'CF.R SERVIC£ 2.00 2.00 PLU 1 GAS PIPING SYS OF -`P TO 4 OUTLGTS �;00 12.00 PLU 6 FLOOR llRAIr1S PLU 1 SIDIKS., COt4MERCIAL OR'�ITIDUSTR.T.AL 2.00 � ' �.Ob rrin• or• FFr:s • � 02 00056855-00056855 T►]T DATE: 0�'23/9D TIFtE� 13:01 ; 33.00 . 'CONSTRUCTION AND PLANNING �- POOL 8 '� ' - Date 1lnspector Date Inspector APPROVALS Permit # �,,,1 � i APPROVALS Permit # �� . 5. Temporery Electrical $ervice or Pole � � +'� 52. Pool & Equipment Locatioa ' ,2.. Soil Vipe-Undrgmd. � w . � ��✓ � 53. Steel Reinforcement ;�� ; �3. Electrical:Conduit•Utility�Un[lrgrnd. . . � ' � 54. Forms .. 4. Electrical Conduit•Undrgmd - �� , 55. Electrical Bonding Vr � 5: Steel Reinfarcement � 56. Rough Plumbing & Pretture Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings -; 58. Elecirical Conduit�Undrgrnd. i �� 8._ Foundation ' _i 'z �� % i 59. Gas Pipe, O Undrgrnd., Test , 9. Water Pipe�Undrgrnd. �' ' /�� ' 60. Backwash Lines, P�Trap, O Undrgrnd. 10.�Structural,Floor System %- � . i' �, � 61. APPROVAI TO DECK �' 1.1.. Property Sewer Line & Hov;e�Connectlon �` 62. Backwash & ReceptorFinal ' . - 12. Sewer Cap . - �'"') �� 63. Heater & Vent-Final � 13. Roof Drains - �_ ; 7,� 64. Plumbing System • Final � 14. Rough Plumbing !� G�% 65. Electrical-Finai 15. Fough Electrical-Conduit � 66. Solar SYstem-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Electriql-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Alr Conditioning � FIRE DEPT. REQUIREMENT . 20. Rough Factory Fireplace . _ � APPROVALS' "Permit # _ � 21. Ducts,in,5tructure - " 70. Underground Hydro 22. Ducts, Ventilating . - � • 77. Product Piping OGas OOiI 23. Gas Pipe•Rough & Test - _ '72. Underground Flush ' 24. Roof Framing - � � 73r�Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing ' � _ 74. Overhead Hydro 26.'T�Bar Ceiling (Structuraq & Monocoat . -�: � 75:_Dry Chemical � � � Z7. Frame and Flashing - 76. Dry Standpipe - � �" � 28. Lathing & Siding " " � 77. FIXED SYSTEM FINAL - � 29. Insulation • /� , 78.. FIRE PREV. FINAL _ _ 30. DrywalPNailing � � `; � - -. _ HEALTH DEP7. REQUIREMENT ', . '�7. Plaster Brown Coat� ^• • 79. FINAL INSPECTION `32..Electrical Power Meter-Final i, �� •� 80. FOOD CERTIF�CATE ISSUED '_33: Final Etectric �% � Notes: y�-yo. ��,yl�(�, �►�,�dp 34. Final Heating & Air Conditioning �!ro �� W��r-m��r �� Kjj, 35. Finai Gas Pipe-Test Lf (� (,�: � • � - - � -36. Hood or Canopy . _ �- �j � ; ' � ' y _ 37. Final Fanory Fireplace� r� �;� - 38. Final Plumbing � $ (J0 (,,� ' _ _ ' 39. Water Service-Final • � � 40. Gas Service-Final ' "' ' � '41. Solar pomesticFinal ' � _ - - .. . - 42. Backflow Preventer - - . � I , 43. Backflow Irrigation . . , ' . . q4. Landscape Irripation System' . - . . � -45..Sound Attenuation � - � � � - . ' _ 46. Handicap Regulations , ' . � j 1 47: FINAL STRUCTURE & BUILDING � �'i 48: FINAL PLANNING �; q9. Electric Release to Edison i,�: ' , n 50. Gas Release to Southern California Gas Co �' 51. CERTIFICATE OF OCCUPANCY No. Date PB0.IECT R�DflESB: �� t. HI Y 9 TH � S T • f '•- �' uxiT: B � owHes•sx►rn¢: TRIADIGLF.'SQUARE�70IPIT VEDI - • eouwess: 93161 CAMINO CAPiSTRANO ' .1tA, SAN JUAN CAPIS'PRANO • 240--7 3Ai RBCN/ENGINEEfl: �`IUNA ASSOC ` qEU.NO.: �-�� 8H nooeess: �6901 CAMINO DE EST'RELI.A � uxR: CAPISTRANO LtEACH CA 92624 PEqMrtr�E: -�VANCED .AII2 COMCEPTS ( 714 ) 380—+3223 �noeesa: �S1U8 MARGUERITE� PKF1Y H1II�3 t�lISSION VIE�70 CA 92fi92 LICENSEO COMMCiON OEClAM710N: I hea69 affirm tlat I am licenutl un0er provisons ot Chapter 9(commencinp wlt� Section �OW� ot Divjfi� U ot tpeyusinea an0 ProfeS :Qn1Cnag, a�na my license is in tC Iorqq Ano enect. cirv uc.: � i 1 gT11TE LIC.: � � V �$$: ! U , ��. Date: �—y — � �— Siqnatura: ��, . WOBNEBS' COMPENSRTION oECLAMTION: I �ere� affirm that I Aave a certitica[e of consent ro sel4insure or a cetlificate ol Workers' Campen;atian �iiiaAc� � qcirc�eg capy inereal �Seaion 38ao, �a�. �1.7 / O 1/ 9 0 raucrxo.: GOLllEN EAGLE �P'0p�` , cornr►xr: }( ❑ CetlifieA coDY �s hera6y furnis�ed. L] Certifietl coDY is filetl with t�h/e ciry BuiltlinA Division. _. �e. � �' �=�� FOPlicanL ��i'LILT LA .`� cXEMPfION FPOM WOBKEBS' fAMPENS�T10N DECIAILITION: Rhis section nee0 not he cam0leteU i the permit is lor one hunOreO (5100) ar less). I certity f�at in the Detlormanca ol ihe work lor which this Dermit is issue0, I s�alt not employ any persan in anY manner so as ro Decome su�lect ro the.WOM1ers ComOensalion Laws of Calilomia. ' OatO: � Sipna�ura: � � � - � - - NOTICE: If, atter maYJnp t�is Oeclaration, you s�oulG hecame su0ject ro the Workers' CamDensation'provisions oi the La�or CaUe, you must tonAwit� comDty with such provisians or Ihis De�mit shall he OeemeO revokeE. CONSTNUCTION 1FN01XC 1GENLY: I hereby atlirm Ihat th¢a is a construc[ion lendinp aOe��Y �or Ne.peAarmance of the waB lor whic� Nis permit is issue0 (Section 3097, Civ. C). � LENDEB: � eooeess: ' OWNER BUIIDEB OEClAMT10N: I Aere�y aflirm that I am exemD� ��om t�e Coniractors' State License Law lor IAe I011owin0 reason (Section 7031.5 Business a� Professional Code: My ciry ol counry whic� requires a permit to canstruct, alter, improve, Eemoli5�. or re0air any siructure. O�or lo R5 issuance, atsa repuiret t�e aDDUcant tar sucM1pemN ro file a sipneE §Wtement Itut he/she ¢ Iicense0 pursuant m the D��ons of tAe Cantractors' State License Law (C�aDter 9(wmmencinq witA Sectian 7000) of DNision 3 of the Busness and Prolessions Co�e�br I�at �e/she is exempt Iherelrom anA t�e Casis for the alleqe0 exemption. Any viola�ion ol Section 7031:5 Oy any applicant lor a Oermit suGi��s ��e applicant to a ciWl penatry oi not moa than iNa hunEreO tlallars (55001. I, as owner oi t�e D�7enY a� mY emplayees wit� wages az Neir mle compensation, wi0 Oo the work, anE the ❑ siruccum is nat intenEeO or oflera0 lor sale (Section 7067, Business anA Proteuional CoUe: ' TAe Contactors' State License Law Ooes not apD�Y �o an owner of a pmPerty wAo builOs ar improves Ihereon, anA wha Ooes such work himselt/�ersell ar ihroug� his ar �¢r own employees, Omvi0e0 Iha� tuch imDrovemenis are not intenGeG or atteretl lar sale. If, however Ne bulltlinp or -impravement is sal0 mt�in one year of comple9on, t�e owner will nave the ouraen of D«n0 ��she EiE not build or imprme for Ihe purpose ol ule1. . , I, as owner ai tha pmperry, am exclusively caniractinp wlth IicenseA cantractars ro constmct I�e pmject (Section 7064, Business .� antl Professions COEe: The Cantracrors' State License law tloes noi aDPN ro an owner o/ Dropefly who EmIEs ar improves Ihereon an0 w�o contracts lar SucA prol�ts wit� a contractor(s) license Oursuant to the Caniractars' $IdiE �IGBf150 L3W). I d111 dWdfB that D�� ol t�eir Woder's Compensation insurance shoula be O�aviOeG m me. � 'I am exemD� unAer Section: ,' i � B. 8 P. C. , ' lor t�is reason: : ' Date: Uwnec I do heahy certily Nat I am aware oi anA untlerstanC tha repuiamenis of Calilomia Health and Salery CoAe Sections 25505, 25533, anA 25534 anG tAat I or any lulum huil0ing cecupant wilUwill not (circla one) nee0 to compN wii� saiE state coGes an0 t�e repuiremmts lor a permit /or conslmctbn or moUilicatbn imm [he Nr Oualiry ManaOement District. Fesitlential consiruction applications are eaemD� �rom these D�avisians. ' ' Date: � Fppliwnt: 1 hereby certiy Itut I Aave reaOlMs applicatian anA state t�at t�e a0ove iniormation is wrmct. I a0ree ro camDN �th all ciry auR'Eounry orainances antl state laws relatln0 �a �uilUinp construdian antl IlereOy aN�o e repres¢ntatives of tlli5 ciry to enter upon I�e aEove�mentioned properiy lar in5ptcipn purpOSCs. /�/%% /� � Daie: L'/ � � �" ( � SiqnaNre: /If ��/ 7` (.e. / � (�i✓ Oriver's License or Saial Secunry x: � � , 16a1-.e W�iro—Buibino: Greeri—CoOe Enlorcemani; Cenery—AOPlkanl: Pink—Revenue; CaolOanroE—hvesmr • CIT'Y OL•' C05TA MESA - BUILDZDIG PERMIT PERMIT NO: t�t 046808 PLADI,CHECK rio: ri CONSTRUCTTON TYPE: V�DI PERMIT TYPE: MEC JOB DESCRIPTION : 1583SF DENTAL UI'FICE T.I. CLAIM�VALOE: � CALC-VALUE: � PEI�M b10: hl. - 09Gi30f3.. GO��T: hl >UPP: N ' -�� PURP05E: OTH 5Q PT: : . CROOP OCC: B-� / � CUMMENTS: RE: B4G623 PRIMARY BLDG. PERMIT: ' x�r�e�*��***�r�c*****�c�-�r*�+�***x ��*x��**��*�**�***�xx**�*z�+��+t+�*�-*rt�*tt�i ��r�*��**�M�� Z O Dl I N G R E Q U I' _ R E M E Dl T S • 5 E T B A C K S � ----------- MAIA1 BOILDING ----�------ ---------- ACCESSORY BUILDIr]G --------- FRN'T: FT IPJ RGAR: PT IN PRNT: PT Irl RF'AR: FT I1�1 � LEFT: FT ; IN RGH1': FT IN � �I,EPT; PT IDl RGHT: ' FT ];IJ . . � PARKI�IG REQ• PROV� PARCEL: 42421111 ZNfi: REF r10: � . PLANNTNC•NOTES? � ' , • > iE M if� IE iE i(� if K 3E iE ik if iE f(� �%�E 9E M ik M k if N if iE if ih iE if if iE �E 14 iE �E iE K iF �E jf %� 3E �E If if 3E iE 1f if dt iE 3E ik dE iE iE 1F ii M IE if iE iE �E iE iE il� dE � iE'�7F iE iE if jE iE ib if iR'••. . D E V E I, O P M E N 1' S� R�,V I C E S R E Q U I R E M E N T; 5 , �' S. . �n�n�nir nounnnrn c�v . �' � r�nTr_ � • UUILUI'.P1G APPROVEL� BY :__ __ � � DATE: _ _ _ sj APPLICATION ISSO�L BY: r , �p*�� DATE: ��'�-_/�'�'d jE iF ih if if 3E iE if if if �E iE iE if ih if ik k iE M M iE �'i t iE��it3 iFi . 1� �!t ��iF�iF iE iE 3(� iE if iF it � 3E iE ' iF3FiF�f 3f3F�& iE iE jk'jf N�%ii�iFifiFiflfiEifikjkifkififiEififlEififif?[�iflflf#1EiElE�IEifiE�FifiEiE�EitiEi(�iE1E��FffiE iEiEiFiE�ltitifitkikiEftlEi!�E9t�kiEiFiFiFjE�(-3EIfiEik?E1f3(� LEGALIZATIUDI:N . F�E E S. U M M A R Y SSRUCTURP_L SEGMEPlT:1�1 BLUG Pt9T PLL�MBING ELECTRIC MECHANIC FIRE SMIP/RES ' �P.ADItdG PERtAI7' 18 . 00 ' 258 SMIF/NON-�RES c�l,Ar� ' ; % ISSUE FEE 15.00 . • BUIi,llID1G-I2TV-> PERMIT ISSUE PLAAI-CIiECK TO'PAL PAID ` ,DUfi TOTAL'a---=.> 18.00 15.00 0.00 33.00 33.00 '.00 RGVENUE LIVIS70N 1'OTALS-->, COLLECTED: "J3.U0 OVER/SIiORT: .00 IILDG Pt4T PLUMBING ELECTRIC MECHAD]Ir FIRL• SMIP/T01' GRADIrIG PLAN-CI3ECK • 33.00 . ' dE i4 ih ih if iF iE iE 3E 3E 3h iE �Jt i! 4 iF 3f iF iE �)f if il� 3f'k iE iE it iF ik 3E iE iE jE iE iF iF if iE iFlF if jk if iP if 3E iE 9f iE iF iE iE iE i! iE if i! i(� iE if if iE # if if �IE iE �1F 3E iE iF �E 3E * i(� iE iE 3f # I: N D I� V'I D U A L F E E B R E A!C D 0 W N ' TYF�E QTY � L E S C R l' P T T O N UNIT CUiT ; TO'TAL COST MEC 7. REPAIR/ALT CQOLING 'Or1IT/SYS W/CNTLS ' 9.00 y,00 MEC 7. kEI'�AIA/ALT HEATING .UMIT/SYS W/CNTLS 9.00 9.0'U END OF FEES 0 tl Q10D057805-OD057845 T�7T 33,00 DATE: 04/04/9D .TIME: 11:21 i � 1 _j 'CONSTRUCTION AND PLANNING' . � ' �- POOL F . - APPROVALS Permit # �Oate lnspector qppROVALS . Permit # Date Inspector _ y . . , 1. Temporary Electrical Service or Pole , `, .' 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. �' � - ' S3. Steel�Reinforcement , 3. Electrical Conduit Utility�U�drgmd. �� . 54. forms � 4. Electrical Conduit-Undrgrnd;.� �- :; 55. Electrical 6ondin9 � ,7 5.-Steel Reinforcement ' . . 56. Rough Ptumbing & Pressure Test � 6. �Electrical UFER Grnd. ' 57. APPROVAL TO COVER�GUNITE • .7. Footings - ' . 58. Electrical Conduit�Undrgmd. � 8, Foundation �� . •, i . 59. Gas Pipe, O Undrgrnd., Test � �.. 9.� Water Pipe-Undrgrnd. �!' � Sl 60. Backwash Lines, P�Trap, O Undrgrnd. ' �10.,Structural Floor System _" 61. APPROVAL TO DECK �%� 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final .-� 12. Sewer Cap � � ' . 63. �Heater & Vent-Final 13. Roof Drains �� ; � 64. Plumbing SYstem - Final i/ 14. Rough Plumbing c 65. Electrical�Final . '" 75. Rough-Electrical-Conduit '� ; 66. Solar System-Final � 16. Rough Electric Wiring � r 67. Fenci�ng & Access ApProval •1 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � / 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79, Rough Heating & Air Conditioning � � � FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace �, APPROVALS . Permit # � 21. Ducts, in Structure � �0. Underground Hydro 22. Ducts, Ventilating . - 71, Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test � 7Z, Underground Flush 24, Roof Framing . 73. Undergrnd. Stora9e Tank O Gas ❑ Oil 25. Roof Sheathing� � 74, Overhead Hydro 26. T-Bar Ceiling (Structurap & Monocoat 75�. Dry Chemical z7, 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 �- 'f . - 79. FINAL INSPECTION - � 32. Electrical Power Meter�Final � ��' - 80. FOOD CERTIFICATE ISSUED 33. Final Electric '� � ' � � Notes: 34. Final Heating & Air Conditioning (� ,j�� ' 35. Final Gas Pipe-Test ' . . �-� �' � � - 36. Hood or Canopy � . , �� • . - _, . i 37. Finai FactorY Fireplace � " ��. � � v. - 38. Final Plum6ing ' �y� ' . � _ � 39. Water Service-Final - � h.�� . 40. Gas Service-Final - � ' � ' �� 41. Solar pomesticFinal . ' �; . • - 42. Backflow Preventer � � - 43. Backflow Irtigation � � � 44. Landscape Irripation System � � • � , . . � � 45. Sound Attenuation . � - � � - • 46. Handicap Regulations ' � 47. FINAL STRUCTURE & BUILDING r� . . i 48. FINALPLANNING 'j• : � 49. Electric Release to Edison � � 50. Gas Release to Southern California Gas Co ai � 51. CERTIFICATE OF OCCUPANCY ` No. Date PpOJFtT ROORESS: (j U 1 W 19 TH 5 T � OWNEB'SX�ME: �'RjF�P��FGLE SQUARESOTNT VEN �ooecss: 33'lEX1CAM:CNO CAPISTRANO Jt�", M�.N,..7UAPt �APISTRANO uxR:B , • ' CITY OF COSTA MGSA - BUILP.ING PERMTT PF.RM`IT N�i; F.' 046536 PLAN CHECK Nn: N CO�ISTRUCTIODI TXPE: V-N • ..- PERMTT TYPE: ELE 2A0-1.382 . pptMIENGINEER: rjUDIA !is i�C BEO.NO.: C L 1 S B B nooxess: �E�g01 CAMIDIO UE ESTRELLA uNR: CAPISTRANO BEACFI CA 92624 • PEm"iTTEE: JBE ELfiCT CONTRACTOR ( 714 ) 632-9818 pUDRESS: • 1�j 2$ TYMPAN I. CL � . � ADIAHEIM CA 92f307 , ❑CENSEO CONTMCfON O�CUMTION: I AereEy affirm ttwt I am licensetl unEer Drovisians ol C�aD�er 9(cammencin0 �� tian 7000) ol Uivision 3 0l t�e Business an0 Pmfessions CoOe, an0 my Ikense is in fu11 farce anU ettecl. . cm uc.: q p 3 7 STRTE 11C.: 3( Q � C1A33: C 1 O � Oate � � � Siqn ' WOBNEBS' COMPEN34TION OECLAMTIO : I hereb i Aat I have a certilicate of consent to sel4insure or a certificate al Workers' Compensatian Ins ance, p certitietl copy there on 380U, Lab. ). voucr xo.: F� O 1 f�l �{p. OqTE: 'G / O I I 9 O • corna�Nv: PAIRMONT ❑ CertilieG copy is �ereby fumishetl. � Certifietl copy Is liletl wif tAe ciry Buildi�ivisian. - 2z - so l ...�:.,S--L�7�l�/ff�� -. i __ qeEMVfION FNOM WONKEPS' �OMPENSITION OEGII (ihis sectlon neeA not 6e completeA if Iha parmit is fa one hunCreO �5700) or less��'T I ceNry ihat in t�e petlormaq�¢ oi [he work for w� is permit is issueE. I shall not employ any permn in any manner'so as to 6ecame : suhlect to t�e Warkers' ComDensatian Laws ai Calilornia. . ,� �, Oate: ' SiO�atum: - ' NO710E: Ii, afler maltinp IMs Oeclaration. you s�oultl becama SUDlect to Ihe Warkers' Compensatlon pmvislons ot ihe LaGor. ' CoEe, yrou must tortirvdt� wmON �� such O��a� or tNs permR stall he Eeemetl revokeA. r; ' CONSTBUCTION IFNDINO �OENCY: I �ere�y aflirm ttut t�ere ¢ a constructlon lendinp a0exy for IDe pedormanu of t�a xrod�tor whic� tAis permii is issueU (Section 3097, Civ. C�. , � ' ' LENOEP: ' � . � . !a� �� ' F�UPESS: . . - . .. OWNER BUIIDEP OECUM710N: I hereby aifirm that I am exemD� fmm tAa Controctars' State License Law for tAe fallowinq reazon (Section 7031.5 Busineu arb p�otessional CaEe: My ciry oi counry whic� requires a Derrtut to caostmct, atter, imD�'e, tlemotis�. or repair am/ s[ructure, O�r Ib its issuance. also apuires tne apqicant im suU permit to file a sipneE statement that he/s�e is IicenseC pursuanl ta t�e D�odsions oi l�e Contrzcmrs; State License Law ICtwpier,9 (wmmendnp xith Section 7000) of Oivizon 3 0l t�e Business and Prufessions Cotle) orihat he/she is'axem0��erelmm anG the basis for ��e alle0etl exemption: Any vblation of Section 7031.5 �y any aDPlicani for a permit SUEjecis ihe apDliwnt ro a ddl penalry ui not mom t�an tNe �untlreC'Aollars (5500). � � I, as owner al the property,or my employees witA wa9es as t�eir sole compensation, will tlo Ihe work, antl the ❑ sirucwre Is not intenaetl ar oflered lar sala (Section 7044. Business an0 Profeuional Code: TAe Contiactors' Sta[e License Law tloes not apDry to an owner ol a pmperty wha OuilEs or Mpmves I�ereon, an0 wAo tloes such work himseli/herselt or �hrouph his or �er awn employees, providM that such imD�ovement5 am nat inienGeE or oifereC for sale. II, haxever Ne Guildinp or imprwement u mltl wit�in ane year of cumpletlon. [he wmer will tuve Ne OurEen of provinp �Nshe EIE not EUJO or improve for the purpose of �le). � . • � I, as owner af Ihe p�oDerty. am exclusNely contractinq wiN Iicense0 contractars to wnstmct the project {Section 7MC, Business anU Professims Coqe: The Contractars' SWte Licrnu Law Does not aDVN �o an owner al propeM who �wl0.s or imD�s Nerean dOd Wh0 COIIipCiS �Of SYCh 0lOqBCIS VAt� d COIIIfdCl�f�S) IIL¢OSB PYt5100t IO I110 �i011�f9LI0f5� 6tate LicenR Law�. I am aWdre �hat proof al Ineir Worker's ComOensation insurance sAaultl �e O�oviEetl.to me. � � I am exempt under Section: B. d P. C. tor Ihis reasan: � ' Date: Owner. � I En �ereby certiry that I am aware oi an0 untlersunA tAe requirements of Califamu Mealt� an0 Salery CoGe Secuons 25505, 25533, anE 2553C and that 1 or any tuture Euiltlinp acupant vnlUwill not (circle one) neeE to wmpry witA ui0 state cotles anG the requirements lor a permil tor consiructbn or moEification hom [�e Air Oualiry ManaOement Disirict. ResiAential construction apDlications are exempt irom t�ese provisinns. ; � , Date: I heahy ceniry tnat I hava reae tnis ap oNinanres anA state Wws relatinp to Eui pmpertny tor inspection Durppus. -Date;= -��! U Uriver's Licenu or Social �cunry N: ApDliunt: �� IM a0ove informatian ¢ co t. I aprea to compry wit� all Uty an0 counry reEyauttwAzereD�esenta' afWscirytoenterupontheabove�mentlonetl � O � 18n�8 W�ite-BuiIEi�So; Green-COCa EnbrcemenL Cenerv-Apo�itan�; Pink-Revenue: GokanraE-Assesmr , � �i � :' PERM NO: E 046G36 GOVT: DI SUI?p; id PURPOSE: P.7�T JOii GESCRIFTIOM : 1583SF' DENTAL OFFICE T.I.' . .. SQ PT: � CLAIM VALUE: CALC-VALU�: GROUP OCC: B-2 /. COMMENTS: REFER TU #D46623 ' . y �lf k k iE iE i(� IE iE iE iE iE iE iE ie N� �IE iE iE �M iF iE if iF M iE iF it iF if iE%# if iEiJ(� it iE if iE �lE-0E iE �lf �If �)E !f N� i4 # iE iE # 3f jE 1E iE If iElE'�E jf 3F if �)F if i4 iE �1t �3(� iE iE �F iE lE dE �lf �IF iE if , 2 n r] I N:G `,; R E Q'U Z R E M F. N'T S � �� S� E T F? A C K S • ' ,�' '----------- MAiPI BUILDING -----=--- -------- ACCESSORY $UILDING --------- FRNT: FT IN REAR: FT = IN FRNT; ET IN RlAR; F'P. IDl LEFT: FT I�I� RGHT: PT f IN . LEF7': F'T IDl RGHT: FT IN ' PARKINC REQ: PROV: PARCEL: 42421111 ZNE; REF MO: PLAiQb1ING NOTES> • ' • > . . .. . . . . ' . .. . _ . �**�*****�,��***��*��*�**��****��+��x��*****�,��*��*+��**�«**,��***,�*�«*��,�� D F. V ti li G P'M G N T�,S�r'B R V I C E S R�`Q U I R E M E N T,S 7.ODIING APFROVBU BY '�-� 1 DATE: , DUILDING APPROVEL D1t : ' ^_,�'•�' _ _ DATti: ' APPLICATION ISSUED' BY: "f � ?�� DATE:�—Z%� iE k iE iE 9f 3f if iE iE if if N� 3E if # i1 if 3E iE �1F if iE ��1F7� 3F ��FiF�iFiE iE iE if iE if'1E it iF iE -i�f i�F}��h b,X it iE iE M�1E iE if iE �X 3f it it iE �fE k�f k k if 1E if iE iE iE if iF jE �IE iE jE k if.lE iF iF iF if if if �lf iE iE 3E if k� iE ik iE if 1F it iE ik if� iE iE if iE iF iF iE if iF 1E iE 1E If 3E iE if fE iF iF-k iE if i! ff iE LEGALIZATION:N � F' L E S.0 M"M A R Y STRUCTURAL SEGh1ENT:�IJ ` � . � , � . BLllG .Pt4T PI�UMBING ELEGTRICkz MECHANIC'. FIRE �SMIP/RF.S GRADItJG PERMIT ' ' 84.1'S„ . ,.,i '' ,�, 502�'� "'� �«. ' ",.`� •SMIP/NODI-RBS ei.Ani • . , ISSUE PEE ' �15:00:'•'� r' �: r ' BUILllIPlG-DIt'-> YERMIT ISSUE .PLAN-CIifiCK��; .• ':�OTAL� PAIU �DUF ti0'TALS----> 84 . 15 .' 1 S_ 00 . �.4 O�i 00' -` �•�99 . 15 99 . 15 , . U� �' (' , t REV£.NUE LIl'ISIUDI TOTA7.,S--� COL'J;ECTfiD:%:� ' 99�.15 OVER/SHOf2T: .00 HLUG PMT PLUMHIDIG ELECTRIC MECIiANIC .` . FIRE ' SMII?/7'OT GRADING PLADI-CHECI: . 99:15 c:-- � :�� . _�� `�. . . aE ik iE if iE k�F k R M it M iE iE iF 3f 1F iE if iE iE iE IE if M iF iF aE iF if 3f iE 1E if jf if i4�i f iE iF iE 1E 3E 1E i� ik iE iE k iE iF IE if iE if N iE 1E iF �� ik �E if 1E i( iE if �1E 3f if if 3� 31 k if if iE #�f 7 N D I V I D U A I,j. r,�•E T•-.B R E A IC�D O L�1 N, ' � : !t. TYPE QTY L B S C R I P T I O-D1�• y- ; UNIT COST TOTAL C051' ELL: 20 FIXTUR£.S, T 7:GHTIrIG �� 1 81' 20 EA. .75 7.S.OU ELF 29 F'IXTURES, LIGHTIDlG-"ADDITIONAL EA. .45 13.45 ELE 2.0 RECEPT/OUTLET i ST -20 '., . EA. .7 i • . 15.00 F.LE 2� RECEP'f/OUTLET .ADDT1'IONAL ;', GA. .45 '�.90 � ELE ' 20 RECEPT/SWITCH , 1� ST 20 •' -; EA. . 75 1S.U0 ELE 16 RECEPT/SWITCIi ' ;ADDI�IONAL :• EA. .4S 7.20 ELL '3 MOTOR/POWR AFPI�RATUS 0�.0� =�'1:0 ;AP �.00 9.00 �� END''OF FEES " ,� m � '� .-> > ` O1 D00`E749-OQOS6749 TOT �9.15 • �,. , ,A , ,,.- L'ATE� 03i2?/90 TIME: 14:16 . � �y� � .. ii .', . , ' " , ' _ i _ CpNSTRUCT10N AND PLANNING . l APPROVALS Permit # �. 1. 7emporary Electriwl Service or Pole - � 2. Soil Pipe-Undrgrnd. �� ,.1 !i; - �3. Electricaf Conduil Utility-Undrqmd. �_ - in 5._Stael Reinforcement - - 6._ �fectricai U�Efl Grnd. �. .7. F�otings - " 1' '� �� 8. Foundation" • " � %� - ,.� 9. Water Pipe�Undrgrnd. � 4',jj _ 10, Structural�Flooi System r - 1 11.� Property Sewer Line & House Connectior 1' 12. Sewer Cap : { : 13. Foof Drains . " � 14. Rough Plumbin9 � � 15. Rough Electriwl-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign -� t$. Rough Electrical-T Bar Ceiling � �19. Rough Heating & Air Conditioning � ' 20. Rough Factory F.ireplace - � , 21r DuCts,in Structure• � _ 22.��Ducts, Ventilatiny , � - .i 23. Gas Pipe-Rough & Test � '_ 24. Roof Framing ' � � - 25. Roof Sheathing •- � � 26:'T�Bar Ceiling (Stiuctural) & Monocoat 27. Frame and Flashing : � � -28: Lathing & Siding_. " � ' - 29. Insulation . � _ � - 3p. Drywall Nailing , 31. Plaster �Biown Coat• ' � � • � 32. E�ectrical Power Meter,Final 33. Final Electric - � 34. Final Heating'& Air Conditioning " ��; 35.'Final Gas Pipe•Tes[ - 36. Hood or Canopy , - ' " -, - r - 37. Final Factory Fireplace ,- � ' 38. Final Plumbing " ' 39. Water Service-Final. . 40. Gss Service-Final � �� q�. $plar pomesticFinal .. 42. Backflow Preventer. � 43. Backflow Irrigation ' 44. Landscape I�riqation System � � 45: SOund.Attenuation . � 46. Hendicap Regulations ' _ 47: FINAL STRUCTURE & BUILDING 48: FINAL P�ANNING - `49. Eiectric Release to Edison �.50. Gas�Release to Southem California Gas C 51. CERTIFICATE OF OCCUPANCY Date Date �� _. • - POO L & � Inspector qppROVALS Permit # � -52. Pool &-Equipment Location . • 53. Steel Reinforcement - � 54. Forms 55. Elecfrical Bonding - • ' 56. Ro�gh Plumbing & Pressure Test 57. APPROVAL TO COVER�GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, � Undrgrnd., Test � 60. Backwash Lines, P-Trap, 0 Undrgrnd. 61. APPROVAL TO DECK - 62. Backwash & Receptor-Final � 63. Heater &'Vent-Finai � 64. P.lumbing SYstem - Final 65. Electrical-final � 66. Solar System-Final � - - 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOIlSPA�SYSTEMS FINAL . .. FIRE DEPT. REQUIREMENT ., -�. APPROVALS Permit# � '70. Underground Hydro - .. 71. Product Piping � Gas O Oil - ' ` ' 72. Underground Flush � � 73. Undergrnd. Storage�Tank�� Gas ❑ Oil 74. Overhead Hydro. � ' �. 75. Dry Chemical � � . - � 76. Dry Standpipe '� - 77. FIXED SYSTEM FIN�L � 78: PIRE PREV. FINALI = HEALTH DEPT. REQUIREM 79. FINAL INSPECTION . � 80._FOOD CERTIFICATE ISSUED : = . . Notes: s ��l� �O��Q ' /�/�.5 P� u�. P r� g ��o - b�t � � - :/1d i A � l�!!�i r i . ` Y . . L /� ��G � � ._ % /l eC.f�C i 7�' 06 . �ie. QiG` /IR� : n.e.t..:-�f s. • > 4 w • r Date � -: Inspettor I `� � 0 COUN'I'Y OF ORANGL� BUII.DING DEPT. 636 No. Broadway Santa Ana, Cali(omia P6one: KI 2fi211 -s___;�.a � - . Permit No.�?.�{...7.�._...... Application for Building Permit AND FOR A Certificate of Use and �ccupancy Date......VJ..VIY_�.!._0. �.._�9 d L-'_--..... 1. OWNER'S NAME......._-_�.I��.�_ .'�,....._�^�..L.H/:.kE�_`L�-' - .................. ...... PHONE:._�':..a..�y6.. - �- ....'..._'.._'-'...'_!�-.-.-/�. �., C. , MAILING ADDRESS.. '�-(, i'J _ - ``". E: /:, t� -- -=-... ---- C1TY..--c.: - -'� = . „•� �� -� ......... ........._:.. . . . Name.... � - -• ... ..................... - .... ..... .._................ (Architect or�ngineer) � Addre=�.----�a..Q �---'--...._/--� -'�----"�--r' ......:................ Ciry -----.. �.S%..�.�.... �.. ft:. State LicNo ................._..._----...---.. t��S� -........ Phone ...................---............... — —""^'�'�-�� Name------- �'.`....`---'---------------...._.----.....-----.......--- .. ...._...... (Contractor�....'...�s. Addre ..____�..�� ........... ----..... . cr..��,�-- ""� . C�ry -- - - ..... ............. -..............._............._- - ......._.... --.. State �_ Lic. No..---- .......................------------- Phone---�..- "_ , " "---'--'--- .-...��__ - ' . ' PROPOSED USE:........ - �� = �-�� L -41..:...-a- - - G . . � 0 M ... .............. . ?. IOBLOCATION........ -..... �Q.�.... - ... �--:..-�.. ..........5-i-� - _ - - -....�..4.S.T_�- �.ESN ............... ........... (HouseNo.) .� (Name of Strret) � (Town or School District) ;. LEGAL DESCRIPTION: Lot- ��--- .............-- Block - - --- - - .............. -........ Tract -.._..... �� - -- ._.- -- (Metes and Bounds De�sc�ript'o[�Use revers� e:ade oi(o�rtr� 4. CORNER LOT ((/ ) NTERIOR LOT ( ) THROUGH LOT ( ) SLOPE OF LOT ( ) .. 4 . . ,� �I �� /� .iI �..!�.AREA:....�.. � / � - % ` i. SIZE OF BLDG.:�%i..-i(.-�--.I.....--AREA:......L...'�.6 ..:.......:..�SIZE OF LOT:..............._--.... ..------.......r::. i � �� G. HEIGHT OF BLDG.:._....I�_--�'.-.----_----........CEILING HEIGHT:---.-..-_�-----_--------------NO. OF STORIES..-__._-.---.._.............. , �/ / 7. NO. FAMILIES..-_-------..� ..................._.Size of Smallest Bedroom:---.��./--%�-��.--/........ Size of Kitchen.......!.../..A...L c�------.- 6. EXTERIOR WALL CONSTRUCTION:...S_% UC...C,...�J_____.__.._.INTERIOR WALLCOVERING..._.n6 NSYE__�� ......--- (Frame, Stuccq EtcJ r �, (Plascer-Drywall, Etc.) 9. SETBACKS: Front Yard From Center Llne of Streec........... J��.1`.._.... �- ... ..........................._-----._.................... �� i Nearest Side Yard....�1...--.r---....--Rear Yard...L.�.._5... �....Distance in Feet Between Bldgs. on Same I.ot_-'--�_�_._----'-.-'-_'---.......-- ]0. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. y // �� ! 11. For (a) Footing: Width....---� .............................Depth in Ground...................-----...---Width of Wall.................._.......---- Accessory p� , � � Bldgs. and a�' �� ii L...5 acin ��1....."CC Material of Floor......----.��.:..'.- ..... �--.� -.-----. Similar �b) Sizc of Stud=_:.......- :.......... p g ...............- -- ... Structures. � l �l ��' � '� � � (c) Size of Floor (d) Size of Rxfter= "CC Ir � _x . �- - ' ......... Spacing......... �:_k�... - ... - -...: 'CC 12. VALUATION OF PROPOSED WORK: Induding all labor, plumbing, electrical wiring, heating, fire sprinkler�, painting and � sewage disposa7 $._..-...�i'..��.�? � � �' . . - - - ----'-...... )3. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION ]N THIS APPLICATION IS CORRECT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. Plans Filed:.......�.�..--�1---�d-----�-.=�..��...'._ Bldg. Permit Plan Check Tota] - - Receipt No. Paid to - Date --.------.. i M-B-it ,� FEES: '/OG " �--... �7. -- .... - $........'..Go ............. - s...%..2 ....................... - ..l.b:.�l.� :............. - ��. .�1.......... ----- ........�a.-. �..��....— S7 Signed:..._.c..>..._'--/t"--�-- � i By:........ a FOR DEPARTMENTAL USE ONLY GRO UP.�...J�'.:).... ...----- TYPE---... ;..1F�.....---._.. _ _... DIST. MAP._G..-..� �-- -...... - SHEET NO......5 ................... DATE.... . �. .. I �.._.......'5�....... � ' . ............. .........-.::...- :-.:--''-'- • f(Owcer) .� - � - - - - ...... (Authorized Agent) �C�_H_pE�CKiING BY APPLICATION.. � X?.,/.!J HEALTH.__ ........................ ZONING.--_---..v_....... FIRE MARSHAL......... - ......... PLANS AND ✓ SPEC'S .............................. STATE.-- •- - .._.............._ CORRECTIONS ENGINEER VERIFIED-------------_......... CAL_- �--._.....-�- -- ---... COUNTY Eli LC'qG ��.�• IN_P_�TOR ��_�J G�C�.. � �. ;. 4. i. 6. 7. S. 9. 70. 11. COUNTY OF ORANGE BUILDING DEPT. 636 No. Broadway Santa Ma, Califomia Phone: KI 2-6211 / _ .:� Application for Building Permit AND FOR A Certificate of Use and Occupancy PeTm�� rro..3.�'' 7 Sd' Dacc — -�.1r�..D� .�.'�...._.�.0...� �0�. �^---- OWNER'S NAME - .....I�S%. /�l.i_......�l.� -.....C�I...��..IQ. �=..�-�"__� �_ -........._......._ - ...... PHONE:....:�,��e _�..H.._�- - MAILING ADDRESS.......w�...�.M... .-/.'"F.ro..N�.J.e.../�..1�../.A_....__�l �� ` .. CITY...�E-�L�,L�� ,S.L�fi.C..C7. -....... . _�. Name.... - - --... . . . ��. - - -�- -... ---- ..__........ Name _..... '- - .... -- - (Architect�� ngineer) ' (Con[ractor) Addre�s - �P..Q.�.........' r_`�- -- -- -S'T'' ` - - ---'-- Address - .. ...-'- ..... -....._- ...._-- ` '-----_.._ -- ..... -- City �.' --- �- '--' -.........__._..._--- ---' �!--` i� '„`�""' ' �—�..�. State Lic. No...... ._:... - __ - ...__..._ Phon '�''.. ...�-�.. _'--- - Ciry..........._C-_b:S..7.. �- ��_E_.S.P....._ ...- - - Scare Lic. No....._..._..-- - -..... -....... Phone.._ - --- ..--.._....__...... 1'ROPOSED USE:...... / 6 � .IOB LOCATION .......... ....- .,CJ.�..`�'_...-.....L.9 �"- s_r,......- - -- ---�-AS.�-'4_ .. �L�_E�.��._............... (House No.) (Name of Street) (Town or Schoo] Distric[) LEGAL DESCRIPTION: Lot- ��. �.._ - -... -..........Block - --- - - - - - -- - --.. Tract�k'EW.�?.�.._.��,�!� (Meres and Bounds Descr,i�p[ion—Use reverse side of form) CORNER LOT (• �/) INTERIOR LOT ( ) THROUGH LOT ( ) SLOPE OF LOT ( ) SIZE OFBLDG.•...1...Q...X.�..O....AREA:--r�..'.Q�....e.P�..o:.b%SIZEOFLO'f.��..A_��^��II.Ir?..v, AREA:._7_�-.iJP�_�,�% � �� (� � HEIGHT OF BLDG.:...._..IO.....�___............CEILING HEIGHT:...._..._.._,4 .................NO. OF STORIES__....I._._._._.._.._...._ . , f/ NO.. FAMILIE5 ..............f.`.-_------:-.........:Size of Smallest Bedroom:-----�-------------...._--_--.--.-_ Size of Ki[chen--.-•�-_----.. ' / 1�,�. EXTERIOR WALL CONSTRUGTION:��.%/L�_.�.l..�..C� ...............INTERIOR WALL COVERING....____O_1'-��.1.1r._._.._......... (Frame, Stucm, Ett.) . ' � / � (PlasrervDryorell, Etc.) SETBACKS: Front Yard From Center Line of Street.......� ,�....._--------------------__-_--.....---_--_........----.........----.---.-_-........_._......---.- _ /� � . . �/ _ / � . Nearest Side Yard_...... �Dt...._...Rear Yard...�........_..Distance in Feet Betwecn Bldgs. on'Same Lot.....__.._�.52......._ ............... A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. ,� �% �i For (a) Footing: Width.......--� �----..-----------Depth in Ground---.....---^.:.------..._.Width of Wall....--.._..._-...----.... Aaessory c7 �/ Bldgs. and .,/J� `�%� �_.S acin �� "CC Material of Floor......��. �� F....... Similar �b) Size of Studc:..__.._ .............. P g-.............._--......... Strucmres: (c) Size of Floor Joists :............------.-------------....Spacing.--------.....___._......------.."CC (d) 5ize of Rafter�:.- - `� %C-�......_ ........... .. .Spacing.......__....J�.[..�._.............:'CC 12. VALUATION OF PR��O..P.OSED.�N _W__ORK: Including all ]abor, plumbing, electrica] wiring, heating, fire sprinklers, painting xnd � sewagc disposal $.._....�;_L�...s.V..:..._.../�lOd 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE' INFORMATION ]N THIS APPLICATION IS CORRECT AND THAT. THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFORNIA APPLICABLE THERETO. � Plans Filed:.....(0.----/o... .s� ................`---............. � v (Owner) Bldg. Permit Plan Check Tota] • - Receipt No. Paid to • Date ........... FEES: OG - $...�:..JO ................. - 5...._... . ........ - - - , � � � ......... �Y....—.! .%...- Sa DATE..S.�...-.�..�...- �Ty_... By:. ..---------._ .... .........------.._' _ �--�-�-� (Authorized Agent) FOR DEPARTMENTAL USE ONLY GROUP..�_.--......-- ....... TYPE......�...._..... - ---....... DIST. �..�:'�.y ............... SHEET NO.__�F ................ APPLICA ZONING._...- v.--.---..... PLANS AND SPEC'S. - - - -�..._........... CORRECTIONS V ERIFIE D ........................ H EALTH.---...._.._ .............. FIRE MAR SH A L------. _ .. .......... .-- STATE--� .. ..... ....... . ENGINEER iN�r�croR 'v M-B.'vl I _� -� - I .__.__.__.._ �_q �