HomeMy WebLinkAbout620 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa��DING PERMIT 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 620 W 19TH ST
suite:
Viciniry:
Primary Occ: B Eat<50/ OKce/ Bar<50
Parcel Number: 42214221
App�icant: DOWNING,�FRANK
Address: 1220 S WRIGHT STREET
SANTA ANA, CA
0
Type of Construction:
Zoning:
Phone: 714-973-6233
Zip: 92705
Owner: GOODWILL INDUSTRIES OF ORANGE COUNTY
Address %MARTIN, ANN
SANTA ANA,CA Phone: '
410 N FAIRVIEW ST � Zip: 92703-3412
Contracror: LAVEY ROOFING SERVICES INC
Address: 1220 S WRIGHT STREET �
� SANTA ANA, CA
Zip: 92705 -
Arch :
Address:
Zip:
Phone:
License:
Phone: 714-973-6233
LicenSe: 811111
Eng:
Address:
ISSUED BY:
Status: ISSUED
Applied: 03/27/2006
Issued: 03/27/2006
Phone:
License:
REROOF FOR "GOODWILL INDUSTRIES". TEAR OFF EXISTING ROOF MATERIALS, REROOF WITH CARUSLE TPO SINGLE PLY ROOF SYSTEM,
APFORX 7500SF. REPAIR AND REPLACE SHEATHING AS NEEDED. "ROOF SHALL COMPLY WITH T-24 COOL ROOF STANDARDS FOR
COMMERCIAL BUILDINGS".
FEE SUMMARY
Plan Check: $0.00 �
Permit: $251.25
SMIP Res: $0.00
SMIP Com: $3.00
Other: $0.00
Inspection: $0.00
Calc Valuation: Sia,zas.00
Claim Valuation: S�a,zss.00
Total: $254.25
• PLANNING & ZONING
SETBACKS �
MAINSTRUCTURE Front 0-0 ,. - Rear 0-0 Left 0-0 Right 0-0
ACCESSORY Front 0-0 �' � Rear 0-0 Left 0-0 Right 0-0 .
PARKING , Existin :� 0 Reouired: . 0 Pronosed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned
for a period of 780 days.
INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepeetions end final approval must be obtained. Failure to obtain inspections and final approval will result in Ihe expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545626
WORKERS'COMPENSAnON DECLARATON: '
I hereby aflirm under penalry ol perjury one of the following dedarations: �y
n
❑ I have and will meimain e cenifiwte of consent to self-Insure tor worka�' borr�ynsation, as pmvitletl for by section 3700 of ihe Labor Code, tor the peAormance of the
work lor which lhis permlt Is issuetl.
� I have antl vnll maintain workers' compensatlon insurance, as require0 Dy section 3700 of Iha Labor Code, for the pertortnance ol the work tor which Ihis pertnit is Issued.
�Mywaqcers^comPensation Insuranncne wrrier and policy num6er ere:
Ca[ner:L��SP�iT�/ �MS. W�%. PWjC Numtier.Wii�-G4D-�/�if�7�0/f.
�('`Ais.sect(on need not be com0�eted il (he permit is �alued a( one hundred dollare ($100) or /ess.) �---�
❑ I certify that in ihe performanca of ihe wor< for which Ihis permit is issued, I shall not employ any person in eny manner so as to become subject to the workers'
compensetion laws ot Celllornla, entl e e that if I should bacome subject to Ihe workers' compensetion provisions of Sectlon 3700 of the Labor Code, I shall forthwith
camply with thes�� isions. � O
Applicaat SigneWre: �Datei; '�-e7 `a�%— O (�
WARNING: FALLLRE'TP ECURE WORKERS' COMPENSATION RAGE IS UNUWFIIL AND SHALL SUBIECT AN EAlPLOVER TO CRIMINAL PENALTIES AND GVIL FMES UP TOONE HUNDRED
TI�OUSPND DOLL.ARE (5100,000), IN ADDITION TO THE WST OF PENSATIIXJ, DAM4GES AS PROVIOED FOR IN SECiION 31W OF THE LABOR CODE, IMEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECIARATION:
I hereby aHirm ihat I am licensed under provisions of Chapter 9(commencing with Section 7000) ol Division 3 0l ihe Busing5=a�.ntl�rolessions Code, and my license is in full
torceerwenecG.�ic.0 ���/� C�assa G
Oontracmrs5ignature: �j ( 'u�,.�� FD`a4e:;' �_'� T�l7/
CONSTRUCTION LENDING AGENCV:
❑ I hereby aHirm that there is e construction lending egency for the peAormance of t�e work tor which this permit is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lendafs Atltlress:
Signeture:
OWNER-BUILDER PECLARATIONS:
Dete:
I hereby aftirm that under penalty of perjury Ihat I am EXEMPT FROM THE CONTRACTORS LICENSE lAW tor the following reason (Sec. 7031.5, Business end Professions
Cotla: Any ciry or counry which requires e permit m consimc6 elter, improve, demolish, or repair eny siructure, prior to its issuance, elso requires ihe applicant for such parmit
b file e signetl statement ihat he or she is Ilcensed pursuant to the Drovisions of the Coniractors License Law (Chapter 9(commencing wit� Section 7000) of DlNslon 3 of the
eusiness and Professions Code) or thet he or she is ezempt Iherelrom end tha �asis for the aileged axemption. Any violation of Section 7031.5 by any epplicant for a permit
subjects the aDPlicant to a civil penalty of not more than tiva huntlretl tlollars ($500).):
❑ I, as owner ot the property, or my employees wi�h wages es their sole compensation, WILL DO THE WORK, antl �he siructure Is not intentled or oMered lor sale (Sec.
7044, Business and Professions Cotle: Tha Coniractors License Lew does not apply to an owner of property who builds or improves Ihetaon, and who does such work
himself ar hersell or through his or her awn employees, provided ihat such improvements are not intentled or offeretl for sale. If, howaver, the building or improvement is
soltl wi�hin one Year of completion, the owner-builder will have the burden ol provinq ihat he or she ditl not build or improve lor purpose of sale.).
❑ I, as owner ot (he property, em EXCLUSIVELV CONTRACTINC WITH LICENSED COMRACTORS to consVuct the project (Sec. 7044, Business and Pwlessions
Cotle: 1Te conlradors license law tloes not appYy to an owner oY propertyw�o bailtls or impmves Ihereon, an0 who coniracis br such proled with a coniractor(s)
license pursuaPl to the Contractors License Laws.).
❑ I Bm exemp� under sec. Businass antl Profe55ions Cotle for IhiS reason:
SigneWre: Date:
Owner ID verlflad by driver's license. ❑ Yes ❑ No Driver's License No. Expires:
Vedfication ol Ownership hy (typa of dwument, i.e. � pmperty tax bill or tleed):
DIVISION OF INDU5TRIAL SAFETV PERMIT CERTIFICATION:
❑ I hereby cehify lha� no excavetion tive (5) or more feet in deplh in�o which a parson is required to descend, will be made in wnnaciion wi�h work authorized by ihis
pertnit, and that no builtling siructure, scaHolding, talsework, or tlemoli�ion or dismantling Ihereol, will be more than thiny-six (36� lae� �iqh. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title B, California Administrativa Cotle).
� As owner-builder, I will not employ anyone to do work which would require a permit fwm the Division ol Industnal Sefety, as noted above, unless such person has e
permit to do such work irom ihe division.
SignaWre: Date:
Division ot Intlustrial Safety Permit Number:
CERTIFlCATE OF COMPLIANCE AND AI7T}IORVATION OF ENTHY: I cenily untler penalty of perjury ihat I have read ihis epplication end state ihat tha infortnalion given is
correct. I agree to comply with all stete lews and ciry ordinances relating to buiiding consimction, antl auihonze representatives ol l�e Ciry oi Costa Mesa to entar upon ihe
ebove-described propehy for inspection puryoses. I egree not to occupy or allow occupency of eny builtling authorized by this permil umil final inspection.
CODE t. INSPECTIONTYCE
1616 Fixed System Final Fire Prevention
1266
200
207
202
203
204
Pool Spa Fihel
Final Re-Rooi
Final BIocWPetalning well
Final Factory Fire Place
Final Sign
Finel Demoli�ion
f7.�i�Ci�n7.��-]
� ((�/ oT��
CpDE� INSPECTIONTYVE
206 Final Mechanical
20B Final Plumbing
210 Final Eleqrical
212 Finel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Otcupancy
PdIE It�LS
(714) 754-5273 • Fex (714) 754-4856 • www.cl.costa-mesa.BUILDING PERMIT n FAIR DFiIVE, COSTA MESA, CA 92626
Job Address: 620 W 19TH ST
Suite:
Vitinity: REAR OF BLDG FOR GOODWILL
Parcel Number: 42214221
Applicant: TAYLOR, RANDY
Address:
Zoning:
Phone: 714-547-6308X250
Zip:
owner: GOODWILL INDUSTRIES OF
Address ORANGE COUNTY
410 N FAIRVIEW ST Phone:
%MARTIN, ANN Zip: 92703
Contractor.
Address:
Phone:
ISSUED BY:
Status: ISSUED
Applied: 09/28/2000
Issued: 11/17/2000
Zip: License:
nrch : Eng: BONALDO ENGINEERING
Address: Address: 10970 ARROW ROUTE
Phone: STE 201 Phone: 909-944-9992
RANCHO CUCAMONGA. CA
Zip: License: 91730 License:
SCOPE OF PERMIT
NEW 450 SQ Ff CANOPY AT REAR OF AN EXISTING BUILDING FOR "GOODWILL STORE." ALSO, CHANGE IN TYPE OF
CONSTRUCTION TO TYPE VN FROM TYPE V1HR �
Plan Check: $63.21
Permit: $97.25
SMIP Res: $0.00
SMIP Com: $0.74
Other: $0.00
Inspection: $0.00
Totai: $161.20
SETBACKS
MAIN STRUCTURE Front 0- 0
ACCESSORY Front 0. 0
PARKING
NOTES:
Existinq: 0
Rear 0-0
Rear 0- 0
Required: 0
FEESUMMARY
Calc Valuation: g3,soo.00
Claim Valuation: Ss,soo.00
PLANNING & ZONING
Lek 0-0 Right
Left 0- 0 Right
Proposed: 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 9248, § 1. 12-27-92)
EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days. .
INSPECTIONS: In order for the work authorized under this permit to be considered �egal, such work must comply with all applicable codes, and all
required inepectlons end finel approval must be obtained. Failure to obtain inspections and final approval will result in lhe expiration of this pertnit.
FOR INSPECTIONS CALL: (774) 7545628
2aaaas Is�oo)
WORKERS'COMPENSATONDECLARAnON:
I �ereGy aHirtn under penelry of pU�jury one of lha following tleclaretions:
❑ I heve flnd will meinWln e ceNf�ce�e oi consent to self-Insure lor workers' compense0on, es Orovitled tor by sectlon 3700 0l the Lebor Cotle, for the peAormflnce of t�e
work br which Nis Pertnit Is issuetl.
❑ I heve arW will mflintaln worKera' wmpensetlon Insurance, as reQuiretl by sectlon 3700 al Ne Lebor Code, for iho peAormence at t�e work tw whkh Ws pertnit Is Issuetl.
My workere' compensetion I�surence carrier end pollcy number ere:
Carder. Poliry Number:
(7hls section need nor be cromplefed 1! fhe permif Is valued et one huntlred dollere (5100) or IeuJ
❑ I cenity that in Ihe peAortnence oi lhe work for which t�ls Oermit is Issued, I shell not omploy any person in eny manner so as to become subjoct to the workers'
componsetion laws ol Celilomla, end agree that il I s�oulA become sub�ect to Ihe workers' compensallon Drovisions 0� SecOon 3700 oi t�e Lflbor Cotle, I shell tort�wit�
comply with ihese provislons.
Appltcanl 5lgnature: Date:
WARMNO: FAILURE TO SECURE WO�E0.5 OOMPENSATION COVEMOE IS UMAWFL� M1D SMALL SU91EGf Ml EMPIOYEP TO CPoMINK PENALTES AND CML FlNES UP TOIXJE HUNDRED
T/iOUSAND DOLURE (5100.000),IN �DDfiION TO THE C0.5T OF COMPENSRTION, DAMAGES 0.5 PROVIUED FOR IN SEGfION 31080F TNE IABOfi COOE, INfEREST, PND ATTOHNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eHirtn that I am IlcenseC untler D�ovisions of Chepter 9(commencing with Secllon 7000) of DlNsion 3 of the Business end Protessions Code, and my license Is �� �ull
brce end eflect. Lia p Class p
Contractors Slgnature: �ate:
CONSTRUC710N LENDING AGkNCY:
❑ I �ereby eflirtn that Ihere is d��stmction lending agency for ihe peAormance of t�e work tor which Ihis permit i9 iuued. (Sec. 3097, Civil Coda).
Lentlefs Name: Lenders Address:
Signature: Date:
OWNER•BUILDEFi DECLARATIONS:
I hereby ettirm that mMer penelry of perjury t�et I em EXEMPT FROM THE CONinnC70aS uCENSe �nW tor che Ioilowin8 reason (Sec. 7031.5, Business entl Professlons
Cotle: Any dry or counry which requirea e pertnit to construc4 alter, improve, demdish, or repalr eny sWcture, prior to Its luuance, alw requires the eppliwnt for such pertnit
to lile e signetl statement thet he or she is IlcenseG pursuant to Ihe provisions of Ihe Coniractors lJcense Law (Chapter 9(commendng with Section 7000) 01 DMslon 3 0l the
Business end Proteuions Coda) or that he or she is exempt Iherefrom and ihe basis for the elleped exempUon. My vldelion of Sectian 7031.5 by any eppliwnt tor e pertnit
sub�ecis Ihe appllcant to e Gvll penelry ot not more Ihan tive huntlretl dollars (5500) J:
�I, as owner of the properry, or my employees with weges es their sole wmpensatlon, WILL DO THE WORK, entl the structure Is not Intentled or otlerea tor sele (Sec.
7044, Buslness and Profesa�ons Code: The Contrectors Liconse Law does not apply to en owner ot properry who builds or improves thereon, end who does such work
himsetl or herself ar through his ar her own employees, provlGetl ihet such improvements ere not Intentletl or oNeretl lor sale. If, however, the bullding or improvement Is
soltl within one year ol comp�etion, the ownervbuiltler wlll heve the burden of proWng that he ar she did not Duiltl or improve tor puryose ot sele.).
� I. as owner ol Ne properry, am EXCLUSIVELY CON7RAC71NG WI7H LICENSED CONTRACTORS to conswct t�e D�qeci (Sec. 704d, Business enC Professlons
Cotle: The contrectors lJcense L.ew does nm eppty lo en owner ol proparty who builAs or Imprwes theraon, end w�o coniracts lor such pro�ect wlth e conireaor(s)
Ilcensa pursuant m the Cant�ecbrs Llcense Lews.�.
❑ 1 a e: ec. Business end Prolessions Cade tor this reason:
� SurO. � � r - — _ _ _ Date:
-0wner ID vadfied by tlrive s Iic e. ❑ Yes ❑ No Dtiv re e eicense No� . �-� �E�Ite '
Verlflcation oi Ownership Dy (type of documenL I.e. - property las blll or tleetl):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby cerUfy that no ezca�etlon fWe (5) or more teet in Cept� into whlch e person b requiretl to descerM, will be made In connectlon with work euthoAzetl by t�ls
pertnit, end lhat no builCing siructure, Scattdding, talsework, or demolition or tllsmanUing Ihereot, will be mora than thlrty-slz (36) fee� hiph. (Chep. 32, Grp 2, A� 2, Sec.
3a1, Title B, CaOfomia AtlminlSlratNe Code).
❑ As owner-builtler, I wlll nol employ enyane to tlo work which would require e permlt Irom the Divislon ol Industrial Sefety, as noted ebove, unless such person has e
permit to do such work tmm ��e tlivislon.
Sipnature: Date:
Division ol Industrial Setety Permil Number:
ICERi1FlCATE OF COMPLIANCE AND AIfTTiORVJ1710N OF EMRV: I cehity under penelty ot perjury ihat I have read thi9 epplicaUon end stete Uat the Inlormation given Is I
cortecc I egree to comply wlth ell stete laws and ciry ordlnances releting ro �ulltling constructlon, enA euthodze represenlaUves ot the Clty at Coste Mese to enter upon the
a4ove-described properry for insptl�Uw purposes. I egree noi to occopy or ellow occupancy of eny building aulhorized by Ihis permit until final inspection.
CODE �. INSFECTONTYPE
1616 Fi:atl System Finel Fire Prevention
1268 Pool Spa Final
200 Final RaRaot
201 Final BIocWRetaining Well
202 Finel Factory Fire Place
203 Final Sign
204 Final Demolitlon
PAiE It�4$
COOE� INSiECTqNTVPE
206 Final Mec.haniCei
20B Finel PIumDing
210 Final ElecMcal
212 Final Fire Prevention
220 Final Planning Approval
222
250
FinalSite
Final Building/Occupanty
Pdg
�
wnntssaemim�a 620 W 19TH ST ��+T�
o�asru�EiF�'x: GOODWILL INDUSTRIES OF
�oopEss ORANGE COUNTY
EMARTIN, ANN
•.,,410 N FAIRVIEW ST SANTA ANA,CA 9270_
,vv�. �u�mo �oo�ss:
�
ARCNRELT OR FNOMEER:
UNT:
cor�m�marsruuE: SIGNS AND SERVICES (714)751-3982
COMfl�tTOR3YNlW6 10980 BOATMAN
�oon�ss STANTON CA ucrn.: 439828
90680 uxr:
110ENSED COMNACTONS DECLAPATION: I hereby eRim uMm penetly d po�ury Nm I em Ikenead uMar po-ria'vro d Chuqx B
(wmma�d^Y �uh Seclion ]aa0) d Onuion 3 d Me Bueimv ud Pminsim� Cods. end mY icaw o in lup lam and aMw.
emuc.No.:032528 uc.cuss: C q5 uc.No.: q39gzg
om. � �«�« '(rjQ SiTa n S r�.rvir_aa
OWNER BUILO OEC PATION: I Iweby elf wdx pmely W perjury iAp 1 mn fxemq Imm �M CaVrtlm Liwma Lew la IM
IcOowip nnwn (�� ]W1.5 Buaness enE Rdeatiw Cade: Afry ciy a oumty whid� nqu"ve� e perma to oduwn. eEx. m�prow.
wd'oh, w rpv eiry eVuciwe, priw b b'vauence, ebo redu'vav iM eppl'rent for wch pxmC lo fib e vipned tltlame�X tlW M a�he
canwd wmwu io �M Prw+ebm a tle CaLLreaas limma law I��Pm e(mvnavq wn Senion 1000) d Oii'sion 9 d Ns
awn W Rdmeioro CaEel a thm Ae a ehe o uemq thereM1an erW IM bce M tM elepW me�Wion. AnY violu'vn d 6edion
1W t.5 by ury apqiu�u Iw e pmmtl wbpas iM xpq' ant to e tivd peruEy d rw1 man ihen Ma hund�eE EaWn �SSO011.
❑ I.mowwdtMpweNYamYemM�+wihwepesmtheiedemmpensstim.WIEOIM'.w�kuMlMM�tlunenolutlrdM
a Mered I« eeb (Section )oa. Bud�e vd Pmlesama CaEe: The Com�raae li�ua lewdoss m� nwNto m owiwM nwMY
wM W1ds W inpvwe Ihaaan. aM Wq Eom suN r.aklinaetl a hrsN a Waq� M a!w own amGbla�. pa'� tIW osA
im0�maqs ms nal imxtled a allaeE la sab. O.Iarrawr. �M bWdiip a in V�mW u wtl xillun ane Yw d mnpaun. tM
owrorbuitlm xill heva iM burden G Vb'�M M or eM d'q nol buitl or imKa+la �M MW�e d vebl.
❑ �. u mme. a �n. nw.m..m uaimrdv �vred'no wOh &emaa mno-.pn. ro cann�e m. o� (s.eion ro... euinw. w
Prdsniom Code: The CanVedon License law Eoes nd eppy io en ow'wr d papeRy w1ro Euilde a impwm �Iwaon enE who
wnVecu M atli yqetls r.vh a ouormor(e) lica�d quewiu b tM Catlrmas liosma lew�.
� I em azemp uMx Section: B. 8 P.C., br Nb iae�m:
Dtls: Owier:
I do Miaby calily NN I em ewere d ard undentenE iM reQuimnams d Callwnie IbMh erd Sebty CaAs &aUbu?5'AS, �SV, entl
TSS�. uM tlw I a M' Mure W�d'vq u�peni wJl / wil m� (ticb ane) ewA m mroly wlh uid pYs avdss and tM �pW�emab Iw
epe�mulacomvuc�ionamodifralionhomlMAi u3eT .�y aiepemaniDimric.PeeitleMielmMrudianeppfutiomenuamqlmmNau
pwisiom.
Dats: Appl"can1:
WOPNEP'S COYPENSATION DECL�F�710N: I herspy e1Nm iuMer par�eAy d pa'ryry ons oI1M Idbwi�p ExLrtliom:
� I heva end wil mdnlein e cerlXcele d mneenl lo eell�inaure for w�ken' compsmetion, m poviEeE fa by Setlion 3100 d th� lebor
coda, ln the perlwmem;s d Ne xak frc wNch mie pemiB ia iaeued.
n I hava vM xil meinlen waken' oompenmtion inurenw. sv �ayui�ed by Sepion �]UO d tM Lebor COEa. br tM perbrmeiws W IM
�e work la wfiieh ihie prmX u ivued. MY waken' eanpanWion ineureMe uerix md pdiry r�umbw era:
c�« GOLDEN EAGLE EXPIRES
Pakr N�mn,= — 0 2/ O 1/ 9 7
n..a;o„�,.e,w e. �amae, m. vo�. a m. o,e nw�mee ewe,. rs�oo/ o.�..�
❑ � mn'N �ne� in tM Ve�ormenee d �n. w«k fw whcn �Me i°emN ie muad, I e1Wl mi .meM �v w� F any manMr n n w
Escaro e�bjW to IM xaMen' mmpenmlion lewe d Calianu, uM yreq Ntl i I Mauk beoone wAj�tl toVM Ma�w�'
canpevetian �rwieiom d Seabn a)00 d tM lebar Code. I ehap Iwlh�' fi�pfy x' IM�
Dtls: Appfcam: �
Wimlip: F�Uun f�seuro rtsri mmpawtlon cwwep� Is u M1rl, �n Mtll �ub/�ct n� loyr roWMml pr�Wq xM
dM� nn.s �y m m. nu�d�.d mouuw ew�.n lsraqooaA a �n ro m. cm� o� m uon a.�...+w.� roi �n
S�ctlm Jlo6 0l tl�� GaDor COW, Infem4 � ermmsyY Irow
CONSTitUCT10N LENDINO AOENCY: I Meby elfum untlx pmxEy tl pvjuy �M rtwn u e amn'uCian Mndvp qprcy br IM
pMamvw d tM wk br wnidi t!m pumY 6 ceued (�� �. C'v. CI.
LENDEN'S NAYE:
LENDEfl'S MUPESS:
1 cenily the� I hm nad ihb appl' � end vne �het iM ebwe iMpmetion e oonetl.l epaetocanply wuh ap ury wd owroy adbwior
eM Ms Nw Mtliq ro buYdip oonmWion utl heraby vMvrta mpnwVatiwa dtAn ayw eMx upon IM ebw��mwXiontl p�apxy
�«���0��°�� LINDA SMITH
Dms: � !/ � —/ .
(5151�16.WP) Whna-BuiYlip 6 Sdery: DieamFb: Cuwy-Appiratl: Pink-Rwmue: pdEenmJ-Awm
CITY OF COSTA MESA — SIGN PERMIT
PERMIT NO: SB 078694 PLAN CHECK NO: 02934-96 S
CONSTRUCTION TYPE: . PERMIT TYPE: STR SIG
JOB DESCRIPTION : ILLUM. WALL & LOGO SIGNS,MON FACECHANG
PERM NO: SB 078694
GOVT; N SUPP: N
PURPOSE: OTH
SQ FT:
CLAIM VALUE: 2,000.00 CALC—VALUE: 2,000.00 GROUP OCC: H /
COMMENTS: "GOODWILL STORE" SIGNS
��r�*�r�r�**�r�r**��*�rx �*�r�e***��r��r�r*�r�r��r�r*�r�r�r�r�r**�r*�r**� x **�r*���r*ar*�r���r��*x��r�r�r�***�rx
S I G N I N F O R M A T I O N
DISTRICT: 1 TYPE: FS SIGN (CH/COPY)+ 2 WALL ILLUMINATION: NON CATEGORY: CHA
DIMENSIONS: 9FT OOIN X 6FT OOIN AREA: 46.00SOFT LETTER HT: 18"
STREET FRONTAGE 1: 150.00 STREET 1; G7 19TH ST
STREET FRONTAGE 2: 0.00 STREET 2:
PARCEL: 42214221 ZONE: C1 LOCATION > FRONT: X REAR:
BUSINESS NAME: GOODWILL STORE > LEFT: RIGHT;
O T H E R T O T A L S G R O U N D S I G N
THIS ACTIVITY . 86.00SQFT OVERALL HEIGHT: OFT OIN
THIS SITE , 86.00SQFT GROUND CLEARANCE: OFT OIN
ITEMS OF INFO : 1 PLANTER AREA: O,OOSQFT
ITEMS FOR ACTIVITY: 1 HLDG SET BACK: 20FT
COPY VERHIAGE ; GOODWILL STORE, DONATIONS (DIRECTIONAL) ON FS SIGN CH/COPY;
GOODWILL + LOGO—WALL CAHINET; GOODWILL STORE—CHNL LTR WALL
PLANNING NOTES: 1 CH/COPY—FS SIGN; 2 NEW WALL SIGNS
iP 1E 1E i%ii'!! iE'1f if iF if')E'lf �F if jf ik iF'IE ih ih iF iF iF'lf il' if if i4 i6 ih iP 1E iE i! if i%1! iE �E'�h'IE iF i! iE ih iEiQ1k iE'�f if 1F 1E if iE'N' 1E'IE'lE ih iI' il"If iF if iF if li' ii' iF if i%K i6 ih'M' 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 T S
ZONING APPROVED HY �1J � t— DATE:��22��[
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
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LEGALIZATION:N F E E S U M M A R Y
BLDG PMT PLUMHING ELECTRIC MECHANIC
PERMIT 62.25
PLAN 40.46
ISSUE FEE
_ DATE:
DATE:
iFiFiFlfifiE�kikifk'kifk � iF'iF'iFiF�FiF
STRUCTURAL SEGMENT:Y
SIGN SMIP/RES GRADING
SMIP/NON—RES
.5�
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 62.75 0.00 40.46 103.21 103.21 .00
REVENUE DIVISION TOTALS--> COLLECTED: 103.21 OVER/SHORT: 00
HLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK
62.25 .50 90.46
ifiElflklFiElFiElfiEiflEiflE1ElkiEiflEiEiEiElFiklFlkffikiF'1E1E1EflfEfE141kif1Eif1E1FiE1f1EiE7E�lEiEfFiE1EiF1F ilfflElEiE1E1E1E1EikifiEiEkiEiElElFiflflE
I N D I V I D U A L F E E B R�� ii N
��y�
TYPE QTY D E S C R I P T I O N �j�,� Uy OST TOTAL COST
NO FEES WERE SELECTED FOIi '�f�iI� RMIT
R �
CONSTRUCTION AND PLANNING , POO� �PA
APPROVALS Permit # Date Inspector qppROVALS . Fermit # � Date Inspectoc
/
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. � ' 53. Steei Reinforcement -� '
�3 Electrical Co�duit UtilitvUndrgrntl. 54. Forms � � �
r- .
� 4. �lectrical Conduii=Undrgrnd. � 55. Electrical Bo�ding •
�5 �Steel Reinforcement, 56. Rough Plumbing & Preszure Tesi �
. r
"6. Electrica� UFER G�nd. 57. APPROVAL TO COVER GUNITE _ �
' - :
� "Z: -Footings � �- 58. Electrical ConduiT;Undrgmd. "- '
..8: Foundat�on . '�� 59. Gas Pipe, O Undrgrnd., TeSt '
� 9. Water Pipe-Undrgrnd. 60. Backwash Linef; P•Trap, � Undrgrnd.
'�40. St�uctural Floor System ' 61. APPROVAL TQ�dECK �
-1.1. Property Sewer line & House:Conhection 62. Backwash & Receptor�Pinal ;
12. Sewer Cap - -- � , 63. Heater & VenbFinal
73. Roof Drains ' � 64. Plumbing System - Final ;
14. Rough Plumbing � -' 65. Electrical-Fina� .
15. Rough EleciriwFConduit ' 66. Solar System-Final ' •
16. Rough E�ectric Wiring - ' � 67. Fencing & Access�ApProval
iJ. Rough Wiring Sign 68. APFftOVED F09:PLASTEflING
18. Rough Etectrical•T Bar Ceiling 69. POOL/SPA SYSPEMS FINAL �
79. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace �- -- - -� _ =� : APPROV.i\LS •Permit# � `
�.�
21. {iuccs, in S2ruiture - ' - . � T ' ! 4 ` ` T •
z . - - r70._Und�rground-Hydio- � i
22. Duas, Ventilating _ . _,- ;r�- �� '�71.eProdNct Pipin�"O"Gas O�,OiI k
23.'Gas PipeRoU9h & Test '. - - - _ �72.�l�Pderground Flush _ - �� _
24. Roof Praming . �� __'. -- � . C �73. UndErgmd. Storage Tantrfl Gas O Oil
25. Roof Shaathing - - ' '-� . ' _ jq.,,Qyei-head Hydro ' - ,�
26. T-Bar Ceiling (Struc'turalL& Monocoat �. '75. Dry Chernical• -� « r. _
' - --- � . . ; _ , _
27. Freme and Plashing • ' _ _ _ - •� - � 'w 7, ��6.,:DjV S�andpip'e �1 .'�. �;.�
28. iathing & Siding �. �� . . - � � z _ ; • , _ .77, �FlXE'8 SYSTEM��F.INAL= +•
29. Insulation ` � __ - '- . _ __ - ` r 78. F,IRE�REV. FINAL _ �
30. Drywall Nailipg . - _ � . - - _ - �� '- HEALTN DEPT;�REQUIR-EMENT-�
31. Plasrer BCown Coar' •- ' " �` 79. F4�NQt INSPECTJQN �
t -
� 32.�Electrical Powier Meter-Firtal _ �� ="; ���� �� 8D. FOOD�CERTIFICA'fE ISSUED t' �s
. 33. Final Electric - - � �� � Notes� �` "� '-
� - ' d �- r - ' U
� 34..Fina1 Heeting & Air Conditioning'- `'- � ` r. T� ' _ _
�r � ' _
- 35.:final GaS�Pipe-Test - _' � • � * " :' �.. r _ , + '
36. Hood or Canopy - �. � ' '. �` ' �- " • . "'
,i • i - . �L � . T �' �
37.�F.inai Factory Pirepiace. -� , . ' ',� s". _
_ - _ _ - � Y ~ ' v. _
` 38. Final Piumbing . 4.'� rv� � ' : ' 1 _ . . '
� 39. Water Seavice•Final r � ' - ��, . � _ � � -
V" , -
� � 40. 6as �Service-Final � ' �� " - - ' �� x- , ' - - � • � �
- � � �_•�: . �
� 41. $olar pomesticFinal � _ - -- � - . � ` v �
- - -•� ' � -
42. Backfiow Preventer - - - • � s� � ' '� - � -
� - r .n ,.F . .- _
43. Backflow Irrigation - - - - - � ' , -. x - �, x � - '
- - " - - - > � i .
�44. Landscape Im.igatioq System - -, - � '� r a • _ ,
C �? ! +
45. Sound Attenuation .� -��:. - - -� - � _: ' -� =i � "
� r - r -
�46. Handicap Regulaiiocls � ` . _ - '' � ' ' ' - � � - �
47,. FINAL STRUCTURE & BUILDWG ' ��' �, r: , '� � . ' �
- . c. • �� �.
48.,fiNALPLANNING _ : � - ^ �_ � � �
49. ,Electric Fielease to Ediso� � - ' �, ti -' -" _� �-
50. Gas Release m Sou[hem Califoroia Gas Co ' � � - - _ - -, ' �.
51. CERTIFICATE OF OCCUPANCY ., _ ; _� _ _
No Date
� �o0N650FBNlqNO: fjzO W 19TH .ST �M�
�m�xs""yEffa�vr� GOODWILL INDUSTRIES OF
�o� ORANGE COUNTY
�MARTIN, ANN
10 N FAIRVIEW ST SANTA ANA,CA 9270
�vv�. wuuxo wo�ss:
���opE++m+�+ MDR + A �c�= C20731
�xa+�++aY�oo�s: 28822 ALOMA AV unr:
LAGUNA NIGUEL CA 92677
�+�T�� HURST AND SZEBERT ( 714 ) 361-0111
cwrn�crons�,uiwa 2377 SO EL CAMINO REAL
�oo�ss SAN CLEMENTE CA ucao: 622681
92672 wn: 103
IJCEN3EU COMAACTONS DECLAHATON: I hmeby Mim ivder penely d�wj�wy Nm I mn firo�ued wder pomiom d Cheqr D
I��ro .an ssn:,n �000l a aw� a a ms a,v�.n .�d Pm�eaoue cme. and mr �ne e m nm raw ene dtw.
cmuc.no.:054075 uc.cuss: g uc.No.: 622681 EXP: 08/96
�/., �- �ti ___ . / d_ // —
EP UILOEF DECIAq�TON: I MnEy etNm wder per�ely d pxjuy IhlTI em wmq'�ipn IM Catl�eaan liwa lew la IM
raum (SeUion ]0]1.5 Bueiwa� W Praleatiorm Cods: MY cty a cvuMY xM1irh �eNro e D�e to mnstrutl. etlar.'vnpow.
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wmew vM Rdw'vu Codal a IIW M a ehe b asemq �haelrom ud �M Mm br IM al�Ned ssemNbn. My vidu'rin d Seqion
MJ1.5 by any eppliunt /a e permu wbpps �M oppl'rsM to e rnil {wnely d m� mws ihen fxe huMred doAaia �SSOpj).
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«at«ee br wa Isx+ion �ou.6udno ene rrd.,dona coes: me comreaan Laems ler.mm iw roWr�oen o.iwd popany
who WiM w impmvee IMroon, end who doee euch wk IimaeM or henN a Nrouph hu a Mr own empoyees, povideC that euch
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� 1. ea owror d tM PmP<M. em evtluehah roniradin0 wilh limnwd wMrxtae to conqiutl iM V�I� (Beqion 90H. Busima� enE
Pmlauiwu Code: TM Conlroeae Licenm lew doa ml WWY ro en owner d popMy wlw buildv a imWuves �herean W who
eantracts M wN propaa wnh e cwqreGa(e) Ikemed WnueM to iM CaMreprca Limnea lew�.
� I em eaemq undar Sac�ion: B. S PA..Ia Nia reeson:
Oeie: p�y
I do hemM wniN Ihet I em ewere d ark �Men1eM IM mVuiromonb d Celf«rca Heetlh mM Se1NY Code Setliam 25.505. P5533. end
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eparmillaoonevunionamodi(KetbnhaniheAi u�iie y�enepemeniDietritl.Ravidmlielcanet�ud'oneppireliomanuemqliomlhna
paripaa.
Dtla: qpplcaril:
WOPKER'8 COMPENS�TON DECLM�TION: I lweby dfi�m uMr prieryy d pe�yvy wa d IM b0onfrq Mdebivq:
� I hevs eM wiq meiMen e centliceta d mnaeni ia veM.ineuro br xmken' cpnpeneetbn. m pewidad for by Sxtion �10p d tM tabar
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n work Ia xfiid� ihia pamil u Mued. MY ��� �pe�ian ieauruce fart'w eM pdiry number ma:
c.�,: GOLDEN EAGLE EXPIRES
Pdiry Numbr. O 1/ O 1/ 9 7
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CDeie: ` ' !.b �Ddiwq: /�ii �� r e
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9�ctlon 91(A6 0/ tlHla6or COW. Infr�st ��Momsy'� I�u.
CONSTIIIIC710N LENOINU AOENCY: I Iwapy elfvm uqy pmeryy d perj�ey Ilu� �Irs o e omq�utlbn bndvp q�rw.y br tly
psAamviw W iM xak la which Ini pxmi e esued (�1ion �OB). Cw. CI.
IENDEN'S NAYE
LblOEP'S �ODPE39:
I unilytha I heva netl Nu eppGcqion end qW INt Na ebv.e iNon�inn u conea.l yps b comply wEh N rdy rd odray advwce�
end aWa Iew� mWM �o buJdM mnwwion md h«obyeuiAaas mpeemteuws dihe fYY ro ems uP� tM abvn-menlionatl papeny
la"vupadion pvpoaea.
WAYNE JUSTICE
n
�51511B.WP) W�Ne-BuINipB
Dme: f� � � � ��
FN�-iieuenue; Ookenmtl-rlewea
PERMIT NO: B
CZTY OF COSTA MESA - BUILDING PERMIT
PERM NO: B 078480
078480 PLAN CAECK NO: 01794-96 A GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMZT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : 70545F STORE TI SQ FT: 100,000
CLAIM VALUE: 100,000.00 CALC-VALUE: 100,000.00 GROUP OCC: B /
COMMENTS: "GOODWILL" 6524SF_RETAIL, 5305F STORAGE TI.
� *�x �x�**�****��*���***x **�x�****� *+�**x ***+�x � *x ��**+r********+�+�**x����***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 --------- -------- 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: 42214221 ZNE: C1 REF NO:
PLANNING NOTES> INTERIOR ALTERATIONS ONLY FOR GOODWILL INDUSTRIES BUILDING
> (EXISTING•OCCUPANT).
iE 1E 1! 1E iE if iE iF 1t if 1E iE 7E 1E 1E if f! fE 1E 1E iE 1E 1f 1E iE iE fE 1E iE 1E iE i!� 1E'lE iE 1E if iE iElE'IE �IElE k iE 1E'IE i! 1E 1E 1f 1E iE �E fE 1E iE �E iE'lE if 1k 1t 1E iElk 1E ib iE iF iE iF 1E 1E itlklE �)E �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 APPROVED BY CTL� DATE: `
BUILDING APPROVED BY : � �,. H DATE: U
APPLICATION ISSUED BY; '? ��\i� DATE:
1F1E1Eif'161E1Fifi!lE1EiEiE�EfFiEiEiE�EiEiEiEiFiF�i�'jf����F�F�F�if�� �F3F3F3F3F3F3F7F3F3f�F�iFif7FiF7F1f1EiEiFlEiEiEiflEiF iEif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/RES GRADING
PERMIT 887.25 `
t �. SMIP/NON-RES
PLAN 144. 18 "--� _ �� • 21 .00 .
ISSUE FEE " '"
BUILDING-DIV-> PERMIT ISSUE �PliAN-CHECjC TOTAL PAID DUE
TOTALS----> 908.25 0.00 � 144.18 1052.43 1052.43' .00
REVENUE DIVISION TOTALS--> COLLECTED: 908.25 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
si;%.2s � zi.00
IE 1E 1E 1E if 1k 1E ik 1f 1E 1E 1E iF 1f it if if if if 1f ik iF iE 1E if iE 1F 1E if iF 1E iE if lf.if 1k if 9E 1E 1E 1E iE iE iE 1F 1E 1E'If iE 1E 3F jE iE iE 1E 1E iE iE iE 1E iE iE �E 1E 1k iE 1E fE 1t ik 1f !E iE IE iE 1F iE 1E 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 COST
�; .
SFC 100000 T,I. STORE " BY VALUE/$1 1.00 100,000.00
END^OF FEES
J.
, � . '1
•� /
�� �7
Y
EX� � _.�.
DATE ✓ � '� /
j CONSTRUCTION AND PLANNING ., � P�� 'PA �
APVROVALS Permit #-�.- Date lospector qpPROVALS Permit #T- pate Inspector
i. Temporary Eiectrical Service or Pole � 52. Pool & Equipment Location
2. $oit Pipe-Undrgrnd. 53. Steel Reinforcement �
_ �
3. Electrical Conduit Utiliry�Undrgrnd. 54. Forms
4. Elec[rical�Conduit-Undrgrnd. � 55. Electrical Bonding . �
5.� Sieel Reinforcement 56. Rough Plumbing & Pressure 7est
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNtTE
7. Footinqs 58. Electrical Conduit•Undrgrnd. 1
� 8. Foundatian �, 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pip¢�Undrgmd. � � 60. Backwash Lines, P•Trap, O U�drgmd.
70. Structural Floor Svstem � 67. APPROVAL TO DECK
1 t. Proper[y Sewer Line & House Connection 62. Backwash & Receptor�Fina� ••
12. Sewer Cap ' • 63. Heater & Vent�Fina� �
73. Roof Drains . � � 64. Plumbing System - Final
�
� 14. Rough Pl�mbing � 65. E�ectrical�Final "�
75. Rough Elsctricat-Condurt � 66. Solar System-Final '1 �
76. Rough ElectricN'�ring � 67. Fencing & Access ApProval �,
77. Rough Wiring Sign 68. APPROVED FOR PLASTEfiJNG ��
18. Rough Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Fa�tory Fireplace �. � APPROVALS Permit #
21. Ducts, in Structure , ' 70. Underground Hydro �
22. Duc[5, Ventilating . 77. Product Piping OGas OOiI
23. Gas Pipe-Rough & Test � , 7z, Underground Fiush
24. Roof Framing , � � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof SheHthing - � 74. Overhead Hydro
26. T-Bar Ceiling (Struciurap & Monocoat 75. Dry Chemical -
27. Frame and Flashing . 76. Dry Standpipe '
28. Lathing & Siding 77. FIXED SYSTEM FINA•L
29. Insulation ' � � 7g, FIRE PREV. FINAL �
30. Drywall Nailinq �'t, t'�,�� -��y3 �� HEALTH DEPT, REQUIBEMENT
�)�
37. Plaster Bro�Yn Coa+ � 79: FINAL INSPECTION �
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Fina� Electric - - Note� � G �/J/� �, �
34. Final Heating & Rir Conditioning , �} � � ��-� / � ,n/%
35. Final Gas P�pe-Test � p ,p
�� � �-�
p/.�G/ �NNL �/p)- �C. Lo�I���y�
36. Hood or GanopY ` � � _
r
37. Final Factory Firepl�ce : A ,
38. Final Plumbing � � � -
39. Water Service�Final � �
40. Gas Service-Finai _ _ �-
41. Solar pomestfo-Final � _ . � � _,
42. Backflow Preventer '
43. Backflow Irrigation . �
44. LandscapC Irripation System -
45. Sound Attenuation - -
46. Handicap Regulatioris ' .
47. FINAL STRUCTURE & BUILDING
48. FINAL PLANNING'
49. Electric Re�ease to Edison
50. Gas Re{ease to Southem CaGfomia Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Ji
�
�oncs� ewiano: 6 2 O W 1 9 TH S T �NT�_
sra�Eii�u+oxN: GOODWILL INDUSTRIES OF
�+� ORANGE COUNTY
tMARTIN, ANN
4f'0 N` FAIRVIEW ST SANTA ANA,CA 9270:
�PVI. WJlNO �1DDPE55:
;,,. ��,�^r �rm'.'Ta:a
uc w_
uxr:
cwm�aanwu� SIGNS AND SERVICES (714)751-3982
canm�crars�uiwo 10980 BOATMAN
�sx STANTON CA ��: 439828
90680 ,,,,i;
LICFNSED CONfq�CTOp4 DECLAF�TION: I Iw�by � uMr pe�Wy d pe'ryry iM I am Ivmsetl uMx pwievq d GAspx 9
(rmimand�0 wtl� Seetim )000) tl Onoion 3 d Ihe Buvnen eM Prdmffioru Cods. end mY Gceroe u m Iu01au rd aflW.
cmue.xo.: 3'y2 28 uc.cuss: C 45 uc.xo.: 43 (8' E) : 07 96
Dtle: O � Cammeaor: q �
OWNEN BUIL EN OEClAfl1TION: 1 hneby d! unEu peealy het I em ase q m iM CaNmfm liorms LSY Ip Ihs
Idbv.�0 nemn (Seaion 1W I.5 &reiron eM PMeno�u Code: cYY a courM/ whidi u"um s D�� lo wn�4ucY. Mr. impw+.
Wnd"nh, w repei eny el�ucturo, p'v �o ne iwvKe, ebo repuiree the applimr,t la a�ch permil to fYs e opneE qnameM OW M a�M
4w�ed W��� lo IM powione d tlq Canlrepon Lioenaa law �Cheqa 9(mmmandip wp� $etlion ]Opp) tl Divebn � d Ils
iwinero end PrWenune Code� or Ihet he or ehe ie uemq iherehom arM �ha bsire Iw tM Nlepad mmmq'nn. My videlion d Seacn
]031.5 by enY Wdimnt lar e parm� ahjeqa �M eppliraM to a tlnl penally d noi mas �hen IMe huntliatl AOAn� �SFOp�I.
� I,uowiwrdlMpropany«myemO�ewVhwapeamiheieolemmpenwqn,willdotMMwk,uMtM�vuclwaerwlmlaMed
«dlemd b eala (Sed'wn 1oN.6utlron uM PNesaionaCOEe: The Canlreeae Lioerae Lawdoes mt eGOM loen oan�erd popeny
who W Wa a inpovee theman, end xfio doea euM work himsaM or MnaA w throuph he a her own amployae�, qwWad �hel wch
Imqmemem� ma rot imuMed rc oHxed la eeb. tl. lawaver. tM buJdirq a inpmnmsX b wtl wil�in aw ysr y ampblun, Ihs
ownu�Wilder will here �M WNen W pvriip M or sM d'd nd brild a impwe fa tM puryroe d sab).
� I. n owror d iM D�W�Y. em ssd�ay' wMretliq x'nh 4rensod eonVenoee �o m�ffiW IM pG� (Swion 1D�I. Bw'nws and
PMaabn� CoEe: TM Comreem L'cenw Lew dow � eppty b an o�mer N propity x1w W� or impovn thpeon a�q wlw
cmtmrn In wrh prqspe wM e aoNretlor(a) licenaed quvuaN �o tM CaNratlp� L'pems ler�.
� I em eaanq uMx Senion: B. 8 P.C., br this raeson:
Da�s: Ormer
i m iwsbv �N ma i.m ....re a ena �.b..iene m. Aa�«�e�m a cwo�:. �eedn .na sduv coa. s.a�. uws. uva. w
25SL. uM thet I a enV Muro Euikuq oavG�t xill / W M(drtb me) neeE b candY wY� seid pate aode� enE tM ieWvamru b
.o.�!aro.�.wn�,o�moecmo��in.u'�r �.w�nomM,.a�e.rr�n�,wa,.00��......�anomn..
Dete: Apqkaru_
WOXKEN'8 COMVQI4ATION DECLARATON: I Iwaby e1(um uMr pyiepy M psjvy ay a pa byv,vp yyvey�q:
❑ IhewenEWmdnleinepNfcaledwmenlloeMim'caMxoM1da'mnpamqjp�.mryo.iJMtWby6emon3]OOdtMleEv
Gode. la iM pMamenca tl tM work la wlich Nu peimu u'vsustl.
r-7 �n.v..nEMilmsimen.o�Men�wmo����.mnpu'vaAMs.aianalaode�.l.eorcod..a.�Mo�«mmn.wui.
7C wak 1« r.hRh tlin ro�� u ivueC. Mv wa4as' ion imure�m ramar eid Vd'h' mvnbsr ra:
c.m..: G�LDEN EAGLE EXPIRES
PaKr N�me.. 0 2/ O 1/ 9 7
, Thia swian mM �ar M mnak(M � tlr o�� b ror a» nund.sd mlav Rtanl a bw.l
❑ I caNY � in IM pe�formerice d �M wak for wfiich Ihu parmn u iaweE. I eheA m� empby ury psnon In eiry menner n u to
bscaro w4a to �M xvrkars' camV�e�ian lewe d CelEanie. end y�es ihtl tl I kwk beconr wEW io �M xpYen'
compene ion p' ion� W SaUbn 3'!00 d tha lebor Code. I&WI lon dlh cam wiN Imes qoNelwa..
ome: Andsem:
w�m/np: F�Ilun ro�� n wortr�'rnnpwwtlon eov�rep Mu/ ena �lull HC/� t xlplqw ro eNMnsl p�n�ftlu e�H
NNI 11� w ro on� hunOrM Nq�wrM tla/Nn (SIIX{OW), Itlon ro tlro eoat ol eonpxwfbR dsmsp�� �� pnrlMC br In
S�ctlon ])OB ol IM LeEor Cob. Int�nsl, eM �ttomsyY f
CON9THUCTfON LENDINO AOENCY: I Iwaby a1Nm uMer pmetly d pejury tIW iM�e b e mruUUC'nn Widup qpwy br iM
psn«mercs a �ns wak �a wnidi m: v+�� u ew,ee (seeun s»l. cM. cl.
LENDEP'S NAME:
LDIDER'8 �OUHESS:
I cMJy �Mt I heva imd ihu epplicalian enE tlme IIW Ne ebovs'v�tumetbn u wnetl. l qpw t000mpy wdh �A eryanE muNy ddmyaw
e�d cWe lawa �ele�ip to Wikip conmuc�ion ud Mreby aulhor¢a re{reventpHas d thu tay m amx upon IM ebo�smmtiwrd popMy
���D�°�D�"' LINDA SMITH
vnm � � n
1 `��
ome:
SqneluroaY r/RpenUAppfu�W'Cav2en
(5f51J6.WP) �1s-BWEiq85eMy:Greee�Fb:Cewy-Appfeyp:Pink�iwanus:pdErxpy�e�a�or
.. _, CITY OF COSTA.MESA — BUILDING PERMIT
. . _ . _ _ . _ PERM NO: E 078695
PEftMIT NO: E 078695 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
JOH DESCRIPTION : ILLUM, WALL 6 LOGO SIGNS,MON FACECHANG SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: H /
COMMENTS: "GOODWILL STORE" SIGNS, RE:#SB78694
�r�r*x�+�x�+r�x*�r*x**�r**x�x x�x�x����**��*�*x*�**x�*��r*+r**x�*�*�**x�**���*�*�**��****+�*****+��
Z O N I N G R E(] U I R E M E N T S
S E T H A C K S
------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 42214221 ZNE: REF NO:
PLANNING NOTES>
i
1E iE if 1f 161E �lE iE if iE iI� iE ik iF iF 141E 1k 1k 1f 1E 1f 1E 1E 1E �E IE 1E 1E 1E IE'll' fF iE fE'IE ff� ih 1E'N' 1ElE'14 iE 1f 1E iE 1E 1E fE'lE 1f 41E i41E 1f iE 1E iE 1E iE fE i(� iE IE �f' IE 1E 3E 1f iE 1ElE iE iE IE 1E 1!
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:
APPLICATION ISSUED BY: DATE: ��F#��'iF'iF
iEiE1E1F'kiF'IE1EififiFiFiEiflEk1E1E1fk1k1kif�F3Fif�iFiF3F7FiFiFiF7FiFif3F3f 3f�iFiFiFfkiFiFlklF�klFlElklf 1liE
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 4450t
PLAN
ISSUE FEE 22.00
HUILDING—DIV—> PEAMIT ISSUE PLAN—CHECK
TOTALS----> 44,00 22,00 0,00
REVENQE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
66.00
FYSMi7t�.Lil�G.i�9
TOTAL PAID DUE
66.00 66.00 .00
66.00 OVER/SHORT: .00
FIRE SMIP/TOT GRADING PLAN—CHECK
iF ik iF 1f 1E 1E 1E 1k 1E 1E 1E iE iE 1E i!'ll� 1F 1k k 1E 1E 1E 1E 141E 1F ff 1F 1E 1t 1E 1E 1E it 1E 1E 1f 1E'IE 1E i! �! 1F'IF 1E'IE 1E 1E 1! fF 1E fE 1E 1F 1E iE 1E iE 1E 1E 1f iE iE iE ff 1F 1k fE 1E 1E k'1F 1E 1E 1ElE 141E 1f
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
ELE 2 SIGN/ OUTLINE LIGHT SYS ON 1 HR CIRC 22.00 44.00
END OF EEES
EX IRf�_D
DATE � �/ — � � L��
9
CONSTRUCTION AND PIANNING
APPROVALS Permit # Date
t. TOmporary Electrical Service or Pole
2. Soil Pipe•Undrgmd. � -;
4'. El2ctrical Condidlt�ndrgrnd.
POO �PA
I�spector qppROVAIS � Permit #
52. Pool & Equipment Location �•
53. Steet Reinforcement i
54. Forms �
' 55. Electrical Bonding � '
-�`s: �Steel Reinforcement= 56. Rough Plumbing & Pressure Test
y6. Electrical UFER;Ornd. 57. APPROVALTO COVER•GUNITE
- 7� �Kootings : Z, 58. Electrical Conduit-Undrgrnd.
:- 8' Foundation x� _ 59. Gas Pipe, O Untlrgrnd., Test -
: 9. Water Pipe•Undrgrnd. � �' 60. Backwash Lines: P Trap, � U�ndrgrnd.
10. St,uctural Floo� System . 67. APPROVAL T%DECK �
-t t. Pro"perty Sewer Line & Hous'e"ConPection 62. Backwash & Receptor�Final ;
72. S�nver Cap a ti 63. Heater & Vent�Final � •
a: -
13. Ropf Drains � � 64. Plumbing System - Flnal �
14. Rough Plumbing � � 65. Electrical-Final .
15. Rough Electric�`i�-Cortduit 66. So�ar System-Finai �
16. Rough Electric Wiring ' 67. Fencing & Access�Approval .,
77. Rougb Wiring Sign � - 68. APPROVED F�,R.PLASTERING
18. Rflugh Electricai•T Bar Ceilirrg ' . 69. POO�7SPA SYSTEMS FINAI
79. Rough Heating & Air Conditioning F{RE DEPT. FEQUIREMENT -
Y �
20. -Pough Factory Fireptace . � =_ � - -, + APPRO�FALS_ `- Permit # •�
' _ �
21.:Dutts, in Str['i'aur� � ",- �_ � x ~' : 70.=Und2Cground H.'ydro . '
22. Ducts. Ventilating', ,. : � q�: ^ 7L�ProdUct=PiPing.QGas OOiI
23. Gas�Pipe=Rough &Tesc ;; ,� �,a, nx � 7y, Undetgraund Fiush .�
24. Roof Framin4 ��- -• � •. �' � x: 73. Unde�grnd. Staage Tank O Gas LJ 0�1
25. Roof Sheathing _ y �� tr�"� �'; C n��^ ` 7q' OverheaQ Hydro,' y
26. T-Bac Celing (Str,��cturap & Manocoat .R ��: ;' ,`: �. 75�. Dry Chemical "�- �-. +- _ ..
27. Frame and Flashitty� � a.t i Y r* 7g, pry Star�d�ipe�.� - '
�+� - • r. + � .
28. Lathing&Siding_.; - - ;,-: ..* 77.. FIXED$YSTEAt�FINA'L
29. Insulatian '' � � ' ' > * ' ' 7$, FIRE PREV. F'INAL � -
�� i 'a
30. Drywall�Nailing : - � � " � �r r ;_HEALT,+j DEPT._RE�UIREMENT
31. Plaste� 6ibwr�Codt'' '' �' 79. FINAL ij+l�PEC7,:(OfV �-� � �
m c � t
32.,Electrica4Power Nle�ef-Final �� � ' ,t ., 80: FOOD �ERTIF�tCA7E ISSUED
33. Final'Ele�tric_ .. . ' ` � ' ^ Not�s; =.' - _ `
� '� n �y �
�' 34..final He�ting`�.'& �r;Co'nditionlrig.= _ � ' ' t � � �� � x . _
35. Fina4Ga5�Pipe-TeSt'� � - »: � �T . -.� ' cc_� � � �
36. Hood or'Canopy " ; ` ' ~ _ ' l. -
?' � .. .+ i. i . G
37. Finat Faccory FirepWce : .- • � " ` � � '
.
38. Fina! PlOmbing . ' - , �. � l„ � _ -
39. Watar Service•Finai • � - i � � � � �- rr - ,
40. Gaz Servise-Final ' _ � ' � _' `
` : r i: ' z
41. Solar Damestic•Fina1 > � .� y�. _ � •
� ! �, t -
42. Backflow Preventer� �' _ ' - _ �� y� � -
43. Backflow �rrigation+ �� - � • + " .- + ,�. -
44. Landscape Irrigatioq System_ � _ � „ _ _ - _ _ _ .. -
45. Sound AttenDation. -. - _ , w �, �- r = � ' ` . - - - � �
T. � �
:46. Handicap Regulations - � ' "fi � _ •• - �`
r _ _
47, FIN�� STRUCTURE & BUILDING r' , �_ '
48.'EINAL PLANNtNGb . . ' .
�49. Elecvic Release to Edison � � r-
50. Gas 9elease to Southern Califor�ia Gas Co �
.51. CEflSIFICATE OF OCCUPANEY ;
Date
�
�
�
m
.
Date • Inspector
_ �
`_ _
6
��l� 620 W 19TH S7 u�:
wrswmeuaax�c GOODWILL INDUSTRIES OF
�ss ORANGE COUNTY
iMARTIN, ANN
1�0 N FAIRVIEW ST SANTA ANA,CA 9270
�vr�. �u�aa �no�ss:
urcxrtEcronwm�ffn: MDR + A uexo, C20731
w�xonwaa,�ss: 28822 ALOMA AV u,n:
LAGUNA NIGUEL CA 92677
cwmacroxsrw� COUNTY HEATING AND A/C IN ( 714 ) 639-9981
������u� 1948 WEST COLLINS
�� ORANGE CA �� 396569
92667 �,rt,
LICENSED CONTfl�CiOH9 DECWIATION: I Amsby � uw pe�wy a p.rt.y uw i.m icemea uw. pod.ou d cneqr a
(oaxnantin0 wN� frtlion )OW) d Oi�"vion J d Ns &�aw uM Pmlaatlun Code. W mY 6wnw b in hA bu and aMatl.
cmuc.No.:031409 uc.cuss: C 20 uc.xo.: 396569 EXP: 00/00
om.: 1 ��% ��1 � c�a«: �.���
OWNEP BUILDER DECLAN�TON: I Iweby el�um undee prWy d pxjwy Ihel 1 em wmq Imm tM �rfm lkwes lar Ip IM
lomwiq rse�on (SMion ]W t.5 &niins md Prdaaia�� CoEe: AM JY a aounM which nMm e Germil to carhuG. eMr. inVa+.
Wnd'eh. a rpv my �vunva, p'v m b ev�enn. dm �wpmw IM eppluea Ia euc� penM to Rb e tl�ppisd Mamrq tlW M a�M
GcameE qmuent lo IM provwb�u d tM Caurraoes lJem�s law jCheqr B(�mantlnp wM1h 8eabn 100p) d DMbbn � d IN
!w'viau eM Rdaeim Codsl a Ihm M a dw u usmq IherNmn eik �M Wue Iw tM NbpeE aaemqion. My vulmion d Baqon .
)Wl.s W eny e00� la � Oa� � Ns eVWceN �o e wi P�+�M1 W na mwe ihen fHa hu�dnd EaAen �SSOOd. .
� I.mowwrdlMpWMYnmY�GbJ�wYhwqp�niMi�aMmmM�lron.wi0dothexak.andNeMctun'snolWrWE
v MarH lar ub ISecUon 1M�. Buvinaa vM Prdaeiora Cods: The CaMretlae limme lewdoee na evGNto en ow�wrW pwMY
Mw buiM a inP� �Mrean. vd who dow vuc� xvk IJmwM n hereall a �hrouph h's a Mr ovm mmWoM�. pw� thtl ww�
'unPp+�meN� ue roi Weded a dlaad lor ub. Y. hows.er. tM dWdiiq a inpv.aneM w�dd xilhin wYw d comPMbn. Ua
owrorWiNv xiA hwe iM dnden d pro+irp M or Me AN not buiN a imD�'e lor iM WTae d mN).
❑ I. u owror d �M pnyerry. em utluwaly mnirmip xiU IicaneeE conuectwa to wnWud iM pmptl (9atlion'lON. &ninss eM
Gmlmioro CoEe: TM Caprsum liwiw lew doa ml wdY ro en owew M PwMY wla build� a �mV�'a Ilw��an md wfc
caurem Iv �uM pWsq+ Wh a auLLmdv(�) IicanmE O�uem to ihe Ca4mdas Licen�s Lew).
❑ I am ssemq undar Sectbn: B.8 P.C.. lor Nu reum:
Dw: Ormar:
� m n«+M �r u�n �.m ....e a w wa..iw me nQuiiem.m. a c.oanr H..nn end smetr cm. s.uo�. asws. zs5a�. ene
?35.'M. md Nel I a M' Mwa Eiukin0 �D� �i0 / wil m� (ticb ane) nestl ro mMN wih uid ewa mdw ad iM npLwn�b Iw
•MmmlammtwionamodJmiontramiMAi ue�'i�ty enpememD'mrie.RrdaNelmMrutlian�WVfutiaroenu�nWhanNw
aa++�».
om.: n,p�v:
WOPKEN'S COYVFNS�TON DECLAiIATON: I hrehy elGm ivMer paroby d pwjiry wr d Ns fdbw'ep bAuetbm:
❑ I heva md wil me'vaen e cen'dms d amwu lo Winnvs br wdken' ampamYion. sVw� fa M Satl"n� 3'!W d IM leEa
COEs. la tM pMm�urca d tM wvk tor wlidi Yva pe�mE u ia�ued.
p in.,..�e.u��.«�.•�w����.m�.me�.ews.a�s�aoame�m«coe..�u.o.�«�.wu.
.a.�«w:nwo.mmm�.e.wr�+'�"i���n•,�•: EXPIRES
c�.
r,r� w,,,n., 0 7/ 0 5/ 9 7
(ilvw ucicn roM rat M mnpixeC % tM 0�'m1 e b ons MuNeJOOVen /S10D/ a ImJ
� I unN Ne� b ths DMamenca d IM work M v.fiitl� Nb Pd� e'vaueE. 1 Ne0 M amWW eM' Dd� �+ �Y m�nw n n m
bscama �ubjW W tM wMas' mnqrmtion ivw� d CWamie, enE eprr Ntl i l ehaM bemns abjW Io IM walu�'
mryis�Wion pa+aiom d SWion J]00 d IM lebar COJe. I IpMrqhmn�\p�y wVh �Ilp/��sG�q�(\��
Oma: ,�� 1/q � App&a�u: �� K� .11W�fd �� _
w•�+nro:vw�o.ro..�.��.wrt..�rnmo«waonee..nw�,�wm..�e.rm�ml«�.�.�nm ro�,aN,wawro...na
rlrY rt� W m arw Iru�M MouaW JWlus lftMrooA N tl9tbn ro M ca�r ol mrtpwu�tbn �W a P+o�� br M
s.enan arw er m. i.ao, eoe., oe.�..e w.mM,.r'. n.a
CONSTAUC110N LENqtq �OENCY: I lrebY Nfiim vdr P�M M C^�WY �ha thra h e mutwbn MMW prMry br Or
v.�+��. a m..o�t w wiw� w o�i e�a �s.a� �on, cw. c�.
IENDEN'3 N/JIE
LOlOER'4 ADONES4:
I ertJy ihtl I lur� n�E Ihu �pp4Wm rd nm� thn tlN e0ow itlomwbn b mnW. I qwlo canqy wYh �0 rIy �tl m�v�y ad4uicr
vM �tms I�xs reletnv b bddn0 mmueion aM heraby euilwix� nw��eGvm d �hu arym amx uv� tM eEw��mMiard pnwM
1Orutlpatl10np`D°�°'' HOWARD GLASKY
� I ■ lkw. Sq' }�+�•Y1•��OG�'•werfa Dme: ! I
f
,\� (SIStJp WP) '/�M1A��p 8 Sefey; aneirFb: Cuwy-Appirmt: Rnk-Iievenue:OOWwad-Nwua
CITY OE COSTA MESA — HUILDING PERMIT
PERMIT NO: M 078651 PLAN CHECK NO: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC
JOB DESCRIPTION : 7054SF STORE TI
CLAIM VALUE:
CALC—VALUE:
PERM NO: M 078651
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: B /
*��***�*i��r�r�00D**��*�r�*�***********��**���**�****�**4x�**i�*B�****�r�r+�x�x�*x��rx�x��r**�r*
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG ---------
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: 42214221 ZNE: REF NO:
PLANNING N6TES>
� •�
if1ElEiEri'1!il1E1E14ik1E1FiE1F1EiFiklklf1E141fIFik1k1E1Ek1F1FkiEiEklfil1E1F1kikikiflElkkiEiEkiliFkitik1k1k14iE1E1FikiElkikfkfE14if1E1FiE1FfElFikiFiflEif
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:
RRTT.f)TNC; APPRAVRn RY � ! .1 . DATE:
APPLICATION ISS
ik iF 1F 1E ik 1F 16 iF i! if 1E iE 1E iE iF
LEGALIZATION;N
F E E S U M M A R Y
DATE: �
41E1k1t1f1Elklk 1E1F
STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRTC� MECHANIC FIRE SMIP/RES GRADING
PERMIT f"� 79 25
v � � ' 25t SMIP/NON—RES
PLAN �. ,; J� �, �
ISSUE FEE •%' �' 22.00
BUILDING—DIV—> PERMIT ISSUE PLAN=CHEGK TOTAL PAID DUE
TOTALS----> 79.25 22.00 " 0,00 101.25 101.25 .00
�� ��
REVENUE DIVISION TOTALS--> COLI;ECTED: 101.25 OVEA/SHORT: 00
BLDG PMT PLUMBING ELECTRIC MECHANPC.� '�'FIRE SMIP/TOT GRADING PLAN—CHECK
101.25 � :
✓ �
1E 1k iF 1k 1f 1F 1E 1f 1E iflk 1E 1k 1F 1E Ik 1E 1f k �F k 1f IE iE i! 1! 1! iF 1E ft fE 1E iE 7! 1f' if 1E 1E fE.iE iE ik'1k fE iE 1E 1E ff 1F 1f 1E 1E 1F i! 1E 1k ik 1F 1E iE 1k IE k 1E 1E 1E 1E 1f Ik 1E 1f 1E 1t i! 1E �k 1E 1E 1F
I N D I V I D U A L % F'lE ,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
, � ��
MEC 4 REFRIGERATION SYSTEM+' <= 100^K BTU/H 13.25 53.00
MEC 2 VENTILATION FAN CONN'TO`SINGLE DUCT 6.50 13.00
MEC 1 INST/REL SUSPENDED HEATER ' 13.25 13.25
'�END OF FEES
-' � ,'-
tiJ �, � ���II
i � �J�� J�� ��
� � ✓
'.S:'F. � . � � _ . _ r
, , 'f
\ `,
�CnNSTflUCTION AND PLANNING P00 SPA
. Date Inspector � Date Inspoctor
• �, APPROVALS Permit # APPROVALS Permit #
� . .
i. Temporary Electrical Service or Pole 52. Pool & Equipment Locat�on :� �
Y
2. Soil Pipe•Undrqrnd. .� • 53. Steel Reinforcement ,� .�.
3.'ElectriwLCoqduit IFS���ry�Undrqrrid. • 54. Forms �
:. . . _ ._ `
� 4�. �4ectrical Condvi(.Undrgrnd:' � 55. Electrical Bonding ,
'�8:'Sreel ReinforeemeCY 56. Rough Plumbing & Pressure Test -
' ;.__._, �
^6. Electricall�F,ER'Cmd. 57. APPROVALTOCOVER�GUNITE
'>Z,`Footings � " : 58. Electricaf Conduit-Undrgrnd. -
�: -
-$. Foundatiorr -,. �, - 59. Gas Pipe, O Urid�rnd., Test ?�
-'9. Water Pipe-Undtgrndr� 60. Backwash Lines, B-Trap, O Undrgrnd.
��
' 10. S[Yuctural Floot SYstem _� 61. APPROVAL TO DECK i
11. Property Sewer Line & Houie Coryiection 62. Backwash & Receptor�Finat
12. Sawer Cap �_ � � 63. Heater & Vent-Finai !
13. Roof Drains �, - � - 64, Plumbing SYstem - Final
14. Rough Plumtring -� ! 65. Elec[rical�Fina� '!_.
15. Rough Elec2rica6Candui[ 66. Solar SYstem�Final i ,
16. Rough Electric Wiring ' 67. Fencing & Ac egs�ApProval '
17. Rough Wiring Sign ' 68. APPROVED FQR� PLASTERING
78. Rough Electripi-7 Bar Ceilirtg , � gg, POOL/SPA SYS�fEMS FINAL
79. flough Heating & A�r Conditioning 'r^S, FIRE DEPT. RE�UIREMENT
/ L _
20rRough Factory �'ireplace . ' - APPROVALS `: Permit # � -
_ - .� r
21. Ducts, in 5tructui3' 'F" T�= '. '
v . - _ 70: Und'erground Hydro ._
22. Ducts, Ventilating - , _ , - ¢+ � 7�, Produ�t�iping'QGas ❑Oil
,
23. Gas'Pipe-Rough & �esc _ Y ,� �� � ^_ r �l" 7z, Underground Ffush -
24: RoQt Framing �. . �••� �� - a�. 73. Undergmd. Storer�,e Tank O Gas C1II�1-
- r �
25. Ro�f Sheathing �' • • � ��� �� 74. Overhead H dvo" '� �
Y K C�
26. '(�Bar Ce�ling (Strycwral) &lvlonocoat �� � - 7.5. Dry Chemical �� - r� �- _ - � _ � !
27.'Frame and FlashlR9'. _ . r.,, "_ I6. Dry StaodpiPe,_, i ,_.-. - '. E.,.` �
28. �Lathing-& Siding-,. - -� _ . . L.jc 73, FIXED$Y.STEM.FINAL � : i
29. In:ulatiR� ,�� ' �� '� ` n� 7�. FIRE PREV. FINAL y� C� i
�
�
30. DrywaUNailin9 . � - - . ,:, -NEALFHDE&T.�RE�UIRENIENT ���J
31. Piaster Browo CoeF; ., ' r_ 79. FINAL 1tJSPECI]ON x� =��
32. -Electrical Power �e,terFinal, � ;;; � ,- 86. FOOD CEkTIFIQATE lSSUED 1- �
33. �Final Electric ' � � ' '" ' I� t��c { �n� �,�q (,(
. . , _ 4 ' #. fdntes: C-1 L_L;H� .V`IJ �/Z�$�'�,.�� - --
34._ Final Heating& Ajr�Cortditioning - $;,_,q�C�,6 �_� �q� � j/�2 CZ'���
- 4 . �` ' (/
35.-Finai Gas Piae-Te'�t• �_ ':� ;� � -� -`-K n�s��-- ����
- . �_ .c - ± - �i�� a�n�s_=:
36:_Hood or Canopy _ _ -, ,� . �.��� ' � ' _
37._Fina4Faccory Fireptace � " ' • , - �G� �
f: ,/r`!� '�
• K •� ( 4� , � ���� �«� �
38. FinaFPlumbing � ; .. .. .� � ' � �. . r x.
39. Watei Service-Firial - � �4 -, . _ r Y �; :~ ^
,. .
^ . � a .
40. Gas Service-Final` . . - �, - � F � , "
41. Solar pomesticFinal . .. r - , • :. �
r -
42. �ackflow Preventer; - ' ' : � •' � y
43. Backflow Irrtgation• . - _ ._. _
.� o- -
..44. Landscape IrripaYoP System' . _. _ * ` _, } � '_ . �'' `
' �. r. . � �. .. . ^1 •JC".
:45 �5ound Atrenuation r . - _ c, , ; ' - s � . "
' �r' m �.- f
-4fi.`Handicap,Regpiati0ns � - � :'. . ..; - _ � �;.,-; ' '. •:
n, �:
47,.. FINAL STRIJCTURE & BUFLDING � � '- - ' '
s ' � _ - y
48.:FIMAL PLANNING _.,_, ; � ; : y _.
-49. Electric Release to Edison : - .. -,
�50. Gas Release to Sou(hern California Gas Co ' � -. _ = `� �_ ,• -
51. CERTIFICATE 0�-OCCUPANCY , „ _ - i ' _
.. � r _. �.. . .- .
Vo Date
�ooxFss oc eu�wK+: 6 2 0 W 1
oxxesa±wev�awrtc GOODWILL
.ow�ss ORANGE CO
kMARTIN,
3.10 N 'FAIRVIEW ST
�vvi. r,wn+o.n�ss:
H ST
DUSTRIES OF
TY �_ .
N
SANTA ANA,CA
uwr:
�r�►n
�xcxrrEcroneimr�n: MDR + A uc.rw.: C20731
,wcx. on �o.•s �oonEss: 2 8 8 2 2 AL OMA AV uxr:
LAGUNA NIGUEL CA 92677
cawm�erarsxu�: FLYNN, D S PLUMHING ( 714 ) 770-6194
CWIN�CTOR4YN1➢l0 z8051 LUCERO
,�p�; MISSION VIEJO CA ��, 381489
92692 u�:
IICENSED CONfPACTOPS �ECLAN►r10N: I hmeby �fim �vWs pvJy d pa�wy Mee 1 em IbaneeE �vdr pd'mbm d CYuqr 9
(canmentln0 w4h Seciion )Ooo) tl Oirmsion 9 al Ne Bw'vwa aM Pmlxivu Cods. end mY Goema o in hA Iwu end altatl.
cmuc. .. 9�.cuss: C 36 uc.No.: 381489 EXP: O1 /97
e: Ganredar � � �Z�/ �
OW BUILOEN DECUfl ON: I herdN dfirm uMer pauly W perjry ihel I un asemq hpn iM CWeeaan L'weme lew Im ths
� ' 0�se�an (Seuion )W S&ninaa ad Prdwiom Coda: /�nY c�Y a owvaY WiirA ie�era+ a 0�^^i to mnmw. eEa. hnwoh.
daA. p ea{ri mry BI�ucWro. pe'v m lf en�a. eho nCmat IM eppli�'M td ach ppm6lo Rb e erypd qebmM Ciel M G 4e
u 6osmed w�.m lo �ne n�+ d nr comreeae Lica,.e law ICAeq« 9(mmm.�q wan seau� �mw) a a.ubn a a �ns
Bu�inev uM Prdeaiom Codsl a ihel M a dn o e�emN tlsehwn W �M bmu lor tM e0eiad �mmqion. NH vcW ion d Sad'v�
]OJ1.5 by eiry eppl'ranl la e permn nbpG+ IM eppliunl to � dvil per�My d nal mon Ihen fve huMAA do0tn �SS00�.
❑ I.mownardiMqopenY�mYemdW^^a�hwepeam��eiwlemmpwmbn.wJlEotMwk.udiMeWtlunbnainlaMd
adleraE br eeb (Seclion )ae. Buaima eM Pmlmbona Cotla: TheCamreGae liowa law dom rc1 eDPNtoan wnw d paparly
who Wids a in0�* therean: end who Eme eutl� xwk Ivmsetl a henN u Nrwqh he a her am�^mPb�wn. V�d �Ar wM
impwwnsNa ere nd irue�ded a dIMeE Iv eeb. tl. hvxawr. iM buiqinp n Ynppynpy u add rNAn one yev d camplubn. lAs
owMr-0uikx wiil hm tM WNen W p��q M a eM d'd �M buiM or impo.a lor �M pnpma d�eb). ,
❑ I. n oxiwe d Ihe MWaM. em exduaMMY aoMreaM Milh IironeeA eaNrMon m eanebutl tlw MMea (beqion ION. Bwinee� ud
Pmhuims Code: TM Contreaas licenae Lew Eaee rot epply io en owinr d propeM � build0�ur,imqovm ihmaon end wAo
conlrecla Iw euM prqwe wnh e mMretlor(e) I'ranaeE punuenl b �he Camrapors Lironae lew),�/ �
CITY OF COSTA MESA — HUILDING PERMIT
PERM NO: P 078547
PERMIT NO: P 078547 PLAN CHECK NO: N GOVT: N SUPP; N
CONSTRUCTION TYPE: V—N PERMIT TYPE: PLU PURPOSE: ALT
JOB DESCRIPTION : 7054SF STORE TI SQ FT:
CLAIM VALUE; CALC—VALUE: GROUP OCC: B /
COMMENTS: "GOODWILL" 6524SF RETAIL, 530SF STORAGE TI. REF;B-78480
x*�*********�+t�*it*��**�r*x*x�***+t�*�**+r�**�r�+r�rtx**�*�**��r*x+cx***�*��*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: 42214221 ZNE: REF NO;
PLANNING NOTES>
I % . *'
�if fE iE 1k 1f �k 1E iE iE iElE 1ElE iE iE 1t 1E 1E iF 1f 1k �E 1E 1E 1! 1f 1E �E 1E �E 1E iE 1F iE iF if 1E iF 1E �F iE iF if 1E 1E iE iE iE 1E iF iE 1E iE iE 1F 3E fE fE fE 1E iE fE fE i! f!� 1E 1E fE f! iE �f iE fE �E 1E iE 1k ik 1f
D E V E L O P M E N T S E R V I C E S' R E Q U.I A E M E N T S
ZONING APPROVED BY �> �`�DATE:
��
BUILDING APPROVED BY : M i DATE: /
❑ i.m�mp��e..s,a��: e.aa.c.,m,mA�: 1 APPLICATION ISSUED BY: �`/I/�--- r%� DATE: �
+�� iEiEjF�k'lEiEiFiE3EiFikltiFiEiEikiFifiEifiEiF3f��F3F3F�F�F3F�3fif3f3FSf�iF1FiF�F�Fit�kiF3Fi�SFiFi�F3FSFiFi�$�ikikjljf�Fi4jFakiE�F iE9E
ome: � LEGALIZATION:N F E E S U M M�A R Y STRUCTURAL ENT:N
i a, i»�,w «n�r uw i� e..,.e d�e we«+i�e m. �,w��.M. a cd�o�. w.nn .m seron ea. s.a�. aws. zssa�. w
25Sa',eMthmlauryMureDuikinpamipemxill/Wl�w(d�cbme)nsedrocanpytiheeidstmemEeserd�herpu4amamsbr BLDG PMT PLUMBING ELECT�RZC ME
e��oonWc�bnamoEifmionhaniMAr3wity�i.-arupenisnDivriy,qesbyylyoonqruypiappfrybyyewmpryp�yyw pERMZT C.HANIC FIRE SMIP/RES GRADING
DW: MOGwv:
WONKER'S COYPd4�AON DECLMAiON: I Mreby elfmm ivMr prupy d prpry ms d iM bppwmp detlermcm:
� IhewaMNmeintenecenSrated����oeaXtinaunlarv.arken'oompaiyqip�,npoviEediaby3eCimJ]OpdtMleEw
Gods, la iM pufwmerice d Ne work fa wlich thia permil u ivued,
�] �n....�dwm�menwaka.•mmo�o�inWence.mny�mwMscaa�aoam.unorcod..b.u»v«�ammbeau.
..m�ia.n�w.v�mm.�e.Mr�k.�.•����l�wwu.r�n...�.: EXPIRES
c.m.,:
a,r�.N�mn,, — O1'/O1 /97
71ris aectian neM nd be complMed'/ Ure pwmrt n br one �undredCdkn /Sf00/ w bm.J
❑ ' ihet in Ne pMormeMe d �M �M � wfiich Ihie prmil b iaeued, I Mell rwl empby ury penm in ury men�nr �o n lo
Wt4 o t wn lewe d Cdilanie. uM pna Nn ! I ehwtl lemnr m�EjeG,�o iM xwlmn'
,� W� D� ie'wn e�i 3'!� d tM lebor CoAe. 1 NWI fpNwe� epnpl� x5hQIhoee pv�mpi�.
Dms: Mdium: Z�i' / � '
�
W /np: F�Nun ro sxu�r wo xa' eomywetlon eov�np� l� unliwlul, �MaNll wbJsef en rrplqw ro erVMiul pn�ltlr �ntl
Mi nnu � ro ms n�.rer.e rno�sw dwYn (ito4aoA m.ee�uon ro m� eo.r o� ron�orwtbn wmep.. u proMeM ror In
S�ctlon ]lOB ol tlw Le4o� Cods. /Naes4 uW �rtonMY'a /w.
corurnucnoN �arnra aeErur: � n«eM ��.. w�v d pe�,.y mm m.. e. mw�unc� imero wwy a. u»
perlormenoe d �M xak br r.hitl� thi Da�ml o ueued (Seeun 3oal. C'v. CI.
LENUER'S NAYE
LENOEfl'S ADONE55:
I cMity IM I!uw neE No appficetbn end alms thet tlp ebo.s iNariWion e oonW.l ppesb canqy vNh eG ayeM matly ord'nm�ce
eM f W! Isws NtlM b buk'rq mmvWiM eM h✓abV eWwza npawtlativm d �h'v alal�/ b aYs Wn^ IM ebwsmslinieA papwry
�°`°'°°'�"'"'°°"'jIIQN FLYNN
Oms: � / � ��
(5151-M.WP) While-Buildiq d SdM': ���-Fb: Cenery-AppFceM: Pink-Aevenue; potlen�oE-.bemeor
PLAN
ISSUE FEE
46.00
25�
22,00
' v �.
✓ � .
- �� n
SMIP/NON—RES
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK � TOTAL PAID DUE
TOTALS----> 46.00 22.00 - 0.,00 68,00 68,00 .00
�'.il i v
REVENUE DZVISION TOTALS--> COLLECTEp �� 68.00 OVER/SHORT; 00
BLDG PMT PLUMBING ELECTRIC MEGHANIC�!' •FIRE SMIP/TOT GRADING PLAN—CHECK
. 68.00 n �'F�,�`� ;
� 1 �{, 't
1F fE fE i! 1E 1E iF'1F'IF 1E i(� ik 1f �E iE iElE 1E 1f if'k 1f 1E 1ElE fE 1E iE fE 1E 1E 1E 1E iE iEiElf ik iElFiE ih 1(-jE fk
I N D I V I D U A L' E� F�i� E�E
TYPE QTY D E S C R I P T I O, N �,'- ';
PLU 2 WASH BASIN � � •^r!' �'
PLU 2 WATER CLOSET (TOILET�)„ �'�'^',�
PLU 1 WATER HEATER AND/OR'V�ENT
END ,OF F�HES
i /\ `
Y� ��'� � .
♦ I
� •��
�, ^
� r
��� � :I�n{i� i
� i� i �-
'! 'r":t� : _ 1 � i i
i
� � ��
:� � � � ",
iE�EiE1E�E1F1ElF�ElEfkfE�iE1E�EiE1lfEfE�EfE1EiEiEiEfE�E�EfEfEfEiEiE
H R E A K D O W N
UNIT COST
8.75
8.75
11.00
TOTAL COST
1�,5�
17.50
11.00
%
\
' COFJSTRUCTION AND PLANNING/ � POOL 'A '�-�"''
� APPROVALS Permit # ` 1 Date Inspector qppROVAIS Permit #� i� Oate Inspector
; i. Tamporary Electrical Serviceor'P e. � 52. Pooi & Equipment Loc2t�pn,` ' ,�
2. Soil Pipe�Undrgrnd. . { 53. Steel Reinforcement ( . ��`� j
, �
3. Electrical Conduit Utiliry�Undrgrnd. 54. Porms � ��� '
4. Elecirical ConduibUndrgmd. �,j:' ~ 55. Electrical Bonding ' y�, �.
5. Steel Reinforcement ° � 56. Rough Plumbing & Pressure,Test ' ��
6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNtTE ��
7. Footings 58. E�ectrical Conduit-Undrgrnc�. � �
8. Foundation 59. Gas Pipe, � Undrgrnd., Test '� �
�!. Water Pipe�Undrgrnd. . 60. Backwash Lines, P�Trap, O Undrgmd. �,
10. Structura� Floor Svstem � Qi. APPROVAL TO:DECK % � `
i'
11 F PropertY Sewer Line & House Connection 62. Backwash & RecePtor�FinaL �
12. Sewer CaP � . ,63. Heater & Vant-Final � '
13. Roof Dra�ns •'� � 64. Plumbing System � Final ��:
74. Rough Plumbing -f/��P� � 65. Electrical-Final
15. Rough Electrical•Conduit •66. Solar System-Final � .
16. Rough EtectricWiring 67. Fencing & Rccess ApProval ' '"
17. Rough Wiring Sign 68. APPROVED FOR� PLASTERING � �
� i%'
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS PINAL
74. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT--
20. Rough Factory Fireplace - APPROVALS . Permit #
21. Ducts, in Structure � .. � 70: Underground Hydro
22. Dutts, Ventilating � 71. Product_Piping OGas ❑Oil
23. Gas Pipe-Rough & Test � . 72. Underground Fiush ,
24. Roof Freming - 73. Undergmd.StorageTank �Gas OOiI ,�
25. Roof Sheathing - � 74. Overhead Hydro ~� r
26. T-Bar Ceilin9 (Svuauraq & Monocoat 75. Dry Chemicat - - �i'� j
27. Frame aod Flashing 76. Dry Standpipe � ., j.
�
28. Lathing & Siding � . 77. FIXED SYSTEM FINAL �`��i� �)
29. Insulation 78, FIRE PREV. FINAL � .J �
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT � �
31. Plaster Btown Coat _ 79. FINAL INSPECTION
32. Electrical Power Meter�Final � 80. FOOD CERTIFICATE ISSUED
33. Final Electric � • � � Notes:/ �/
. . ? � Gb�d%�.2./_ZL`��l.l�X/ .
34. Final Heeting & Air Conditioning , ���� "
�h'� ���--'
35: final Gas P�oe•Test � �1 �',_ 2_�L C, E7r�� __
36. Hood or Canopy . .. � ! - ���p3-� � �
tP��F'�e
37. Final Pactory Fireplace ' �' � �7
�� .�T ��l St,�a �--�V+Ez_
38. Final Plumbing �y�j .
�-h- 6 ,�_w_
39. Water Service-Final
40. Gas Service-F(nal .
41. 5olar pon'�estio-Pinal � • , -
42. Backflow Preventer - � . -
43.�Backflow irrigation
44. Landscape Irripation System �
45. Sound Attenuation
46. Handicap Regulations . '
47. FINAL STRUCTURE & BUILDING ',
48. FINAIPLANNING �
49. Electric flelease ro Edison ' ��
50. Gas Release to Southern California Gat Co ;:i`-' �
51. CERTIPICATE Of OCCUPANCY �
No� Date
%
\.
�
aeunowc: 620 W 19TH ST mn:
s'wweiva,wm: GOODWILL INDUSTRIES OF
.00�ss:ORANGE COUNTY
BMARTIN, ANN
3-10 N�FAIRVIEW ST SANTA ANA,CA 9270
ux. �uimo �oox�ss:
urcxrtccron��nn: MDR + A ucxo, C20731
u�a.onwan�oox¢ss: 28822 ALOMA AV �;
LAGUNA NIGUEL CA 92677
�,��ru� S AND S ELECTRIC (714)788-1411
cwm�croxs�uinu 393 W LA CADENA DR
,�o� RIVERSIDE CA ��, 498711
92501 �, 16
IJCENSEO COMNACTOFS DECIAFATION: I he�eby dlim wEx pa�y�y d pnjury Nn i vn Ipnsed uMr pro.i�'vu d Cheps Y
Immn,«r v wun san�m �000l d ohou� a a ue a�ineo ene r�dovme coe.. e�d mv �me u:, rw evc. w.me.
emuc.No.:047873 uc.cuss: C 10 uyyq: 498711 EXP: O1/97
a-<// �� �
om.: �` / / b com.m-orT1�% � �
OWNEN BWLDEN DECIAN�TION: I hmsby dfiem wdx penely d perMsy IhN I em mmp hvm iM Caq�etlm L'raua lew la IM
�olov.+q rwm (Seaian lW 1.5 &nn»� enE Rataime CoCe: Np' cYY a wvny Niih iNwm s v�d �o mmwa. eMr.'vnpo.a.
Mmd"eh, a repei mry ebuciun, pnor b b'swnce, abo npu"vu iM appkranl In acA pwm[ to fle e eprieE Yatnrm Nn M p�ha
e I'vned qvwent to tM qov�ns d Ihs CWretla� Lioema law �CMqs e(mmmxaiip wt� 9atlnn'lUW) d Oiiubn � tl IM
Bumwv aM Prdonione Cotle� a thet M n eM u womq �hselrom eM iM b�e la IM elbpeE eaemplion. Nry vnletion d Sadion
)W 1.5 by ury epptlrenl for e pmmil MpGt IM eppl'raM to e tiril pwWly d nd mon Ilw� fm himdietl EaOen �5.500U.
� I.mo�.nerdlMpopsnyartryamplv�ae�MhwpesntheidemmpemeYm.wypullywvrk.pdpyemcyrsunp'vyysdM
«oflend b aeb (Seuion'lou.6ue'vwveM PMmdon CaEe: TM GoMreumlioeiw lawdon na1 eVM/lo n oww d propany
rM diE� a inGr� �M�san. enE who Eme evh wak h'vnaetl a henN a Nraqh he a Mr ovm amGbl+e4 Pa'�d �hY ad
impaaneNs ma rol imrded a dlsed la Wa. tl. hows.w.IM WiNvq a inppqnqtl u wtl wil�in dp Y� d mmplalian. IM
owmrbuJda xi9 heve IM EUNen M proviiq M w eM Eid ml buiW a impow lar IM puryme W uk).
� 1. m o�wrr d Ihe PWeM. am utludrdY mNmenO MtA fanmd caWMus b wnMq Ns pqetl (Safion mM. Bus'vwa rd
eia.mwu cme: m. comima, lic«,» l.w m« nd ewh ro.n own. a wwem •ro euw «'vnpm« m..m .ne .ro
wur+aa ror wdi pqqe xtlh e mnmMq Iheeesd wnuw m tM CoMrae«� L'vse ler).
❑ I em eumq unEer Sxlion: B. 8 P.C.. br �hu reeaon:
Dme: Owriar:
I do IwWI canJV Nm I em ewxa W end �vAenwd Ns mVw�aW d CaOmiw H�eM end SelaV Code 9raiam RS005. 255J�. eM
25.fiM, uM Nq I a+nY Muro dukuq oopmmi WI / wA nal (acb an) roM b mmp�Y �Nh nid qets aoda� eM iM �ap�emmwro br
eP��taaaulruction«modifimionhamiM�i ��iy eroY�MDieliitl.Meidmlielamp�uaionWW�ioromae�emqhom�hne
pmbione.
Dete: Appfcw:
WOflKER'S C04PENS�TON DECWi�TION: I Mreby e1Nm �vdy �w�epy d prjuy wa d iM Idbw'vp Eedebum:
� I Mw eM Mil meinten e cMXictle d oonseM to eaXirwn tor r.oikeri wnpenWbn, n pwitlaE fa by Swim J]OD d �M lebor
COM. ia lM pMm�wica M Ihs xpk Iv wFich Nn peniw u baustl.
� �] ine.�..�ew�m.�.aw«.•oomo.�:M��.�o..onma.eMs.e4,a�aoam.�morcoe..wnrw�am.
I ..akea.nd�w.v«mmA�.e.Mv.d,wd.'�'��p�{�.�,;«wwkr�e.,.,.: EXPIRES
c.m..:
rd� M,mn� 0 7/ O 1/ 9 7
(inia esaim mae Iwr as rondwaa r w n«mt b kr ans wnmed exan R�m/ nWa.l
❑ I Miy tIW m iM partormuca d ths woek tor r.fiie� ihw pemie b'wauaE. I tlW � siWrry e�ry pxeon n eiry meiuw n s �o
Eecana wbjeU m iM wM1we' mmpmWion Iew d CdAmiie eM eprw py� 1 I kiaM becane waen m iM Makan'
�w��, wa+scn. a s«aion a)oo a �n. lenn, code. � n.nn � /p�w}Awn �/
Dtle: � � f� ��� ADd'seN: �G:.///t0lJT
Wamlrrp: F�Bu� ro ueun wilrw�'rorrp.ruetlon eov�rp� b �m4W�q uqWII ub/�c! ur 1r�plqw ro almiiW puvltlr �nC
GHI l/nu �p ro om hurtlrW fhouuM EWYn (SIPq000A b��� �� ro�t o/ ror�o�ru�tbM1 Wn�� n provMW M In
9ctlon �RK ol M� Lelo� Code, lirtre�( uM etfom�Y�� �1u.
CONSTIIUCfION LENOINO AOENCY: I Iweby elflrm under perWry d par'�vy ihtl Ihan u e oanurwion 4M"vp s�pnry lor IM
n.d,�,z. a m..�+� i« � me v.�i m o.»a csae:.,� �. c�.. q.
LENOEN'8 N�IIE
LENOEN'S AODPESS:
I ceniN tha� I heva read Nia WMicetion and uma ihm tM ebovs iNamdbn b conaa. I eYres IocanG�Y rril� e0 dly eM cauMY aNirorcu
erd efere leMs reletM W buYdaq canatrutlion antl hereM ewlw¢e npueNetiw G ihe d1Yro emx upon tM eEwe�mMiarod p�opa�ry
�°"nspe°�°"`°°'°'' BAAD SCHMIDT
Dms: —�
(5151.M.WP) W�na-Buildiq 8 Sdery: O�eeMFk; Cvury-AppiraN; Rnkaiwanw; Ootlan�ob-Masmr
CITY OF COSTA MESA - BUILDING FERMIT
PERM NO: E 07854£i
PERMIT NO: E 078548 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V-N PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : 7054SF STORE TI / ELECTRICAL SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: H /
COMMENTS: "GOODWILL" 6524SF RETAIL, 530SF STORAGE TI.
*�rx�**u�x�*�x��tx�***x�x�**�t***�r*x�rt+r*x�x�x-x-i�-**i��r**�r*x-�-x-***x-***x�*��tx��ti�*x�**x�*�-****�x��rx�*�-+�+t�-
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- 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: 42219221 ZNE: REF NO:
PLANNING NOTES>
i �)
1E 1E fE iE 1E 7k iE 1E iE iE iE fE 1E IE i! 1t 1E iE IE iE fE iE fE 1f 1E 1E 1E if iE 1E'lE �E 1F 1f !E 1E 1E iElE 1E if 1E 1F if if if k!E 7E 1E 1ElE iE �E'lE iE 3E iE 3E if iE iE ik 1E if iE 1k iE 1f 1E �E'lE �E 1E 1E jE ik iklf
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:
i _
APPLICATION ISSUED BY: "�/��f:J DATE: /' IG-7So
*+r+�x�iF*+�ifiEit+�f�f�*f�x�it�iFiE*�t3f3F3FiF'iFiFTFiFiFiF'iF3F'�fiFiFTFid�t-3F3F�3F�iFiFiF7FiF 3F'iFiFi�iF�tf�it*iF+�it*it��F'iFit�r
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 204•,-50
SOk SMIP/NON—RES
PLAN .
ISSUE FEE �22`,-00
BUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 204.50 22.00 �', 0.00 226.50 226.50 .00
�
REVENUE DIVISION TOTALS--> COLLECTED: 226.50 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC' FIRE SMIP/TOT GRADING PLAN-CHECK
226,50 •
iE'1E if �klElF'k if iE iE iE ff k iE iE iE ik iE iElflE 1E if 1E iE iE 1f 1E 1klE iE 1! it 1ElE 1FlE ik 1E if !E iE 1t iE iE ik If itlF iE 1E 1E iE 1E iE �E fE �E iE fE jE iE 1k if 1f iE 1E if �E'lE �E iE �E fE iE 1E iE iE 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
/
ELE 20 FIXTORES, LIGHTING�' .1 ST 20 EA, 1.00 20.00
ELE 75 FIXTURES LIGHTING' ADDITIONAL EA. .65 48.75
ELE 6 RECEPT/OUTLET 1 ST.20 EA. 1,00 • 6.00
ELE 14 RECEPT/SWZTCH 1 ST 20 EA. 1.00.,_. ; 1-4.00
ELE 1 SERVICES BELOW 600�'V & 201- 1000 AMP 55,50 �55.50'
ELE 1 SUB-PANEL 16.25 16.25
ELE 4 MOTOft/POWR APPARATUS 1.1 - 10.0 HP 11.00 44,00
END OF FEES
�,�^� „�n7! q , - -- - - - -
. , - ^ l' . ' - ' ' ' ' __' ' '. _
' _ ' • ' ' , � ' � - •. �t�'.. .. .
�3NSTRUCTION AND PLANNING
qppROVALS Permit #
+ :
t. Tsmporary Elearirai Service or Pole �
2. $dil Pipe-Undrgrnd. �
3. Electrical Conduit Ufiliry•UndrBi�'
4. Efectricat Conduit-Undrgrnd. �� -
5. Steel Reinforcement
6. Electrical UFE,R Grnd.
7. Faotings
8. Foundation .
9. Wacer Pipe�Undrgrnd. -.�1
70. Suuctural Floor Svscem '� �
17. ProPerty Sewer line & House Conr�ection
12. Sewer Cap -• - (}
73. Roof Drains � �
%
14. Rough Plumbing '
15. Rough Electrical-Conduit '�
,
16. Rough Electric Wiring � : �
17. Rough Wiring Si9n -
78. Rough Electripl-T Bar Ceiling
79. ROugh Heating & Air Conditioning
20. Rough Factory Fireplace �
2l. �ucts,i� Structure ,
22. Ouas, Ventilating
23. Gas Pipe-Rou9h &'Test
24. Roof Framing � -
25. Roof Sheathing ,
26. T-Bar Ceiling (Strucmral) & Monocoat
27. Frame and Flashing
28. Lathing�& Siding -
29. Insulation
30. Drywall Nailing -
31. Pl2ster 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 Firepiace '
38. Finat Plumbing � �
39. Water Service-Final
40. Ga6 Service�Final
41. Solar pomestic•Final
42. Backflow Preventer
43. BaGkflow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDtNG
48. F4NALPLANNItJG
49. Electrie Release to Edison
50. Gas Release to Southem California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Date � Inspector
POOL ?A
APPROVAIS Permit # Date
� 52. Pooi & Equipmenc Locatio�✓
53. Steel Reiniorcement ��
i
54. Forms
55. Electrical8onding �
.�+~'''•
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER�GUN�TE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
,
60. Backwash Lines, P-Trap, EQ ndrqrnd.
67. APPROVAI. TO DECK �" '�
62. Backwash & Receptor�Final
63. Heater & Vent-Final
64. Plumbing System - Finai � �
/
65. Etectrical-Finat ,' '
66. Solar System-Finai °
67. Fencing & Access ApProva��,•
68. APPROVEDFOR'PLASTERING
69. POOL/SPASYSTEMSFINAL
FIRE DEPT. REQUIREMENT
APPROVALS Permit #
- 70. Underground Hydro
71. Product-PipingOGas ❑Oil
_ 72. Underground Flush . _
" 73. Undergrnd.StorageTank OGas 00�1
74. Overhead Hydro
75. Dry Chemical �
76. Dry Standpipe � '
7�. FIXED�SYSTEM FINAL
78. FIRE PREV. FINAL - .
- NEAITH DEPT. REQUIREMENT
79. FiNAL INSPECTION ' .
`80. FOOD CERTIFICATE ISSUED
�' Notes: �/� p � /�n er ./.� //G
.7=17^46 �rf �a
7 - Z 6 -�L6 �: f•a,(
`(!/ -L�. �. '�?rll�ir �
Insp�
. �1
--�•-
r n,
�
i : �
i
.
6 .
��Ei � 620 W 19TH ST "�'
GOODWILL INDUSTRIES OF
"D°'�� ORANGE COUNTY
iMARTIN, ANN
l0 N FAIRVIEW ST SANTA ANA,CA 9270_
w�. wqma �oonEsx
������ MDR + A �� C20731
��ari�� 28822 ALOMA AV �M:
LAGUNA NIGUEL CA 92677
�+��"� S AND S ELECTRIC (714)788-1411
�+��� 393 W LA CADENA DR
�� RIVERSIDE CA ucao: 498711
92501 uxr: 16
UCENSED COMq�CTOpS OKL�P�TION: I Aereby aLim uNr prWy d psjury Ntl I em IEerueA �vds prwhiwn d CNqr Y
(wmmman0 wilA 6xtion ]000) d Oiwion ] N Ns Bua'vww uN Pmlmtions Code. uM mY luvus e in hdl laca end a%W.
cm ue. xo.:,� q � uc. cuss: C 10 uc. No.: q 9 8 71 1 EXP : O 1/ 9 7
�J�,� 73
o..� 1�.l� c«mwa:
OWNEN BN�DFJI OECtAR�TON: I hsWy Wum �vMr psuly N px�ry ��p � em ewnp ryyn ��p f.pX�ayp� licww Lew �p pp
IaOow+q raum (SWian ]W I.S &unms md Rde�+ions Cods: MV c�Y a muniY xfi4A n0am a V�a �o mmeua. Mm. hnpaw.
bnwls�, rc np�i my �wcN�a. p'v b b sauercw. Nm n'pirr tM eppfoK la vch pa�mY lo Ns e ripnd pelameN tlW M a Nr
o r..w�..e w�,� �o in. ao+�. a u,. com�.a«. ���.. �. �cnw« e(oomme�d� ..en s.aoo �awl a o:e� a a�ro
Bu�anws sN Ndanum COMI a Nr he a tlr 6 a�amq IMalmn eM tM bem la IM eAepeE mrMian. �m'v4Nion d Baacn
iW I.5 by e�ry eppN�V tp � pwmil qipj�R� �M eppliuN lo e tihl penehy W np mpr� Ilun Ma huM2tl EoOen �SSOOU.
❑ I.00wwd�MPWMYamYn��rY�reu+o�ISWammO�+�.WEo1MMvk.eMNemwvs'smFordeE
a aI1eM br We (6ecibn roM. B�wu eM PralmdmaCode: Ths CaNreeas llorna tawdoee ml eDvN loan owrw d papany
wM Wie� a inpw�� �Mnm. W Mn Eom �urh wk h'vnaetl a MnN a tivwph he a Mr wm wndWw. p�d Or v�M
impwemW� ma nal iMerMeE a dlareA ta eeb, tl, howawr, IM buJJi�q a inqo.arnenl ie eold wi�Nn ms yavW mmpMbn, tlw
ownmduiltlr WI heva �M dvdsi d pwirq ha a Ma Nd nd bulld a impo.a fa tM pvpwe d Ws).
� I. u owrw d iM MWa�Y. am uCu�A'W mnt�adYq wnh fiwnntl wnvecbn ro conelnM iM Wol� (Satlon )OLI. &s'uws eM
aid«.o, ca.: ni. caw.na. Lvn. �.n. m.. m.,p� ro,� ow,., d c�w.m ww wua. « v�p�w.. m..d, .oe .iro
wMmcb la odi pajea� wuh e omamrior(s) IkamM Wnuem to the Conlredae Liceme lex�.
� I em eiemp udar Ssclion: B. 8 P.C.. M Nu rsaaon:
o,�.: a.�«:
i m n..M,»wr uw i.m e.... d.m ��w�.w�e �n. �.aw�ew d c.uo�. r�nn �a smarv coa. s.ao�. zssos. nsaa..�a
]SSJ�. W tlw I a M' Nun WJEvq oawrW�� xi0 / wil na (ereb me) �wed ro eanWY wIh veid qele codee enE tM n0wmnanb br
eM�4lvwnet�uclianamoEGretionhantM/v ue�iy enapemeniDiet�.RmidanlWmnY�udionai0�vioroeneTMnWlmnNw
poWaion+.
om.: �oa�.: ..
WORKER'S COMPOlSATION DK WIATION: 1 Mralry ellum wdx ps�epy d perp�y one d IM Idbw'vp AWuel'vn:
❑ I Mw eM W meimen e und'rata d ouuent io eatlinavs br waiken' cwnpenalbn. m provided la by Saeqn J)00 d �M lebor
Cods, ta IM ou�f�w�c� a tlr wrk 1« wl'rh Nu wM u iaueA.
rl in.V.,�ew�,u�wa+d.•oomc��,w��...Aw���ws.a�,aroowm.i.e«cee..w.m.w�«�am.
j� .oM �o..n:d� mo v.��a a ow.a. wr•��• �o� i�n.nce wi�..�d cour ry,me« em:
c.�..: rnr, rnMa EXPIRES
�'Nioi°°" rg��126Sd� 07/O1/97
RN+s«Sur n..e nar m m�N� r rn. o�+�+e m� m. �wnsw eomr� �S�anl a rv.)
❑ I unA' 7� in Ns pMpm n�e d �M wak 1« wlich ihu pomN b iaued. I WII �wl ampby airy pseon N e�ry mww p n �o
bcams adaP w �he ur: mnprvmion Mw a C�fdmo. enE Wns tlw J I�hadA becam aibiw �o tM x�Mw�•
nwio pm'vion SMion 3lW q IM Lebar COM. I duE falhwGh mmyy wN� Noea prar�u.
� •: Mph.m:
Wunbq: F�9u� b we�n wort�n' conpwu�tlon rorrp� I� wlm'M xM �l WI.uDi� �n Nn➢Iqw ro cM�llalYwbr oM
dvN Ilnu ap ro om huWntl thouuM dolpn lffOqOppA N Mfltlon ro M� cwt ol ronpr�ufbn � d pA��W M In
Sctlm ]]tl8 0l 1M L�Eor COM. Intrst uM �rtom�y� Iwa
CONST11lICT10N LENp/q �6ENL�: I Iwab� elfum �vdw psWy tl psjuy tM1e iMa's e mmtwion Iw�p ypcy b tlp
DMwmam d ur wM b.Tidi Ri pam� e swnE (Sedion JOBI. CH. CI.
IENDFJI'S N41E
LENDEN'S ADORE99:
I unAy ihq I Ma nad No appGcqion end tlW Ihel Pw eEow iNwmNbn u mnw. I prea Io oomyy xilh e0 dry end mury Whw�or
eM Wt� bMf tie1n0 m dutli�0 mmNr4m ad IwabV aWvc� 2PMan�tlMt al lhe tilYb Wa uV� IM ebwamsY'ved POMb
IR impstlion pepor�.
� �TQTCE SANCES
Oele:
(St51�l.WP) Wlwe-Bu0dry8Sdely;Omen-Fb:Cenery-AppiraN:Pink-Rewnw:OdEmiaA-Msee�n
_ CITY OF COSTA MESA — HUILDZNG PERMIT �-PERM NO: E 07879
PERMIT NO: E 078793 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: V—N PERMIT TYPE: ELE PURPOSE: ALT
JOH DESCRIPTION : 70545F STORE TI / ELECTRICAL SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: "GOODWILL" 6524SF RETAIL, 5305F STORAGE TI. / REF B-78480
���*x����***�r�r+r��*��rx*���**�r�r*�r+�+r�**��+�*+���**x�*�*��**�*�r���**x�r�r�***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 ---------- --------- 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: 42214221 ZNE: REF NO:
PLANNING NOTES>
i J �
1E iE 1f fE 1E 3E it 1! iE iE 1E iE 1E 1k if if iElf iE 1f 1E i(� 1E iE iE IE li if 1E iE IE �)E 1P 1E iE 1E if� 1E 1E IF iF 1f 1E 1E 1k 1E 1E 1E �Ih 1E 1k IE 1E fE 1E ik ih iE if IE 1E iE ik iE 1E If iE iF 1E IE k 1E 1E iF ik if It if IE
D E V E L O P M E N T S Ei 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 :
APPLICATION ISSUED BY
*��*�r*x �r��r*****rt�t***�
LEGALIZATZON:N
BLDG PMT PLUMBING
PERMIT
PLAN
ISSUE FEE
HUILDING—DIV—>
TOTALS---->
�
F E.'E�. S U M M A R Y
ELECTRIC MECHANIC
22.��
50�
22 , �Q
PERMIT ISSUE PLAN—CHECK
22.00 22.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
44.00
FIRE
DATE:
DATE: ^ 4
*�*****x� **
STRUCTURAL SEGMENT;N
SMIP/RES GRADING
SMIP/NON—RES
TOTAL PAID DUE
44.00 44.00 .00
44.00 OVER/SHORT; .00
FIRE SMIP/TOT GAADING PLAN—CHECK
�E IE 1E 1E 1E iE iE 1f 1k 1E IE ff 1! 1E iE 1E iE f! If i! i! iE 1E 1E iE 1! 1E iF iE ib iF 1F iF k 1E �F 1E 1E iE 1E iE iE iE il� 1f if iF 1E 1E iElf 1f 1E 1E fE iE iE iF 1F iE 1E 1F ik 1E 1E 1E iE IE i! 1F fE �E jF ik 1E iE k 1ElE
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
ELE 1 TEMP SERV PWR POLE W/OUTLETS EA. 22.00 22.00
END OF FEES
! POOL PA ` ` - �
CONSTRUCTION AND PLANNING
� Date Inspec[or Date Insp,eiror
APPROVALS Permit �h APPROVALS Permit # / •
: �
t. T:mporary Electrical Service o��Pole 52. Pool & Equipment Locatioii:l
2. Soil Pipe-Undrgrnd. � � � 53. Steel Reinforcement •'
� 3. �IectriwkConduit Utfiity•Undrgrnd. 54, forms % -
4:�ElectricalCor?duit_Undrgrnd. � 55. ElectricalBonding � "
� 5. Steel Reinlo�cement�' 56. Rough Plumbing & Pressure Test ' �
6. Electrical UFFRGrnd. 57. APPROVAL TO COVER�GUNITE
7. Footings - 58. Eloctrical Conduit-Undrgmd.
..8: Foundation� . ` 59. Gas Pipe, O Undr,grnd., Test
� 9. Water Pipe-Undrgr,tid. �_ 60. Backwash Lines,�P�Trap, � Undrgmd.
'70. Stiyctural Ploor Svsterri 61. APPROVAL TO�QECK
�1. Property Sewer line & Hous;':Connection 62. Backwash & Receptor�Final
�12. Se7er Cap � ' 63. Heater & Vent-Final
r �
13. Roof Drain5 � � 64. Pl�mbing System - Final
14. Rough Plumbin§ 65. Electrical�Final �
15. Rough Electricai•Coqduii J; 66. Solar System-Final
16. Rough Etectriclkiripg 67. Fencing & Access Approvai
17. Rough Wiring $j�n -- - 68. APPROVED FOR P�ASTERING
18. Rough Electrical-T Bar Ceilirtg- 69: ROOUSPA SYSTEMS FINAL
19. Rough Heat�ng & Air Conditioning FIRE DEPT�. REQUIREMENT
20. Rouqh Facroiy Fireplace ���r� - , - n�-; , APP�OVA.�C Permit# j
21. Ductr', ir�Structure , •' `_' '-; ` ���' `. 70.:�Jndergtound F�ydro �
22. Ducts. Vqntilatin� ,f� �� = � i�.� � 71. ProductPiping�E7fias OOiI
'23. Gas Pipe�Rvu§li & Test : ?� ; 72• Undergrourhd Ftvsh -
24.RoorFriming. �, � � �_.-. `.� � - "r< 7� �ndergrod.3toiageTankOGas OOiI
i25. RoofSheathing :�* `_ '`� :'T ��� `���+ 7Fk OverheaifHydr,o �
w
2B. `f'�Bai.Ceiling (Strptjural) & R4qq�oat - ' m �-+ i,jt: 75:r Dry Chemical y - � -. -
eT, Grame and Flashihlj;: �-' - - o - t .+ .- ' c
� _ � r, r. ,.�z. 7fS. Dry Sta �Cpe _, -
� 28. tathi� & 5idin ,: � �'•.° -'. :- �_ .i�x � .
9 9.z.� � _ , .. ..,. 77S fIXED�STEitiI.fINAL
• 2y. Insulatide •� - •' ' - � ` � ' .. 7�: FIRE PREV. F�NAL , � -
� 30. Dr H�all ilin �`y '' r � i " � �-IfiALT1jDEPT.REnUIREMENT
Y {�6� 9-:r� i j^. H r._.
_ 31. Plaster 6wwn.,CoA'f.;' ' ;:.�.- �• ' ' �'` 79? FINAL ��PECTtON r -
�. 32. ElectricalPo�a'2r fqletec�final � F� -. ;� / ('/.f�� �� � 367 FOOD G�EFiTIFICA�E ISSUED �
33. fsinaL�lectric _* i t ''26/ � //// �/- _ - � _ _ -
� C . � � -� l(\ y� � IY�2$: T
. . ' � V. .
- -. � Hfn :� � _ "
� - 34. FinaL'�featin9� ?!i'.�onditioniQ9y ., .. � 1 �: � .n� i :. - _ �
35. Fina}GarPipa�Teeax ��.* -� { � �,o-: �n °-�-7 - _
36. Hoo3'or�Canopy "'�... _�; ; I ; � r • . + r _,
_ � �. o
• 37. E'ina^fattorv FirepNdar �;n� 1 a:'n � �; '
i
: 38. FinaJ,Plu'�bing '�^ "�. .. .. ` n r� k � ` ,y ` .
- r
�� 39. Water Service•Fine�c� " � � , r�.�'z ;, „; r a.
,
i �. a
40. Gas Service-Final r ; ,! � G" [O- � ,
H'� �T a' T : ' 1 � � : C . • � .
�__' ..
- 41. Solar pome4ticFinat ;; , ;, . ,d� ,
� 42. 6ackflow Prevent¢� �' ' . - , - : � . •
43. Backflow Irr�ga[ion � - , � . _
44. Landscape Irripation System � ` '•
45. Sound Attenuation � . � -
46. Handicap Rsgulations
47. FINALSTflUCTUf2E&BUILDING � � '
46. FINAL PLANNING' �
49, Electric Release to Edison . . � '
50. Gas Release to Southern California Gas Co ` - -
,`
51. CERTIFICATE OF OCCUPANCY
No. Date
PBOJECTAUDBESS: 62O W 19TH J`��; -,
OWNEfl�SNIIME: GOODWILL INDUSTR`IES
�• aooeess: 6z0 W. 14TH STREET
COSTA MESA
uxir:
646-0034
ANCN/ENGINEEfl: flEG.NO.:
FDUPE55: UNIT:
PEXMITfEE: SAUNDERS CONSTRUCTION ( 714 ) 646-0034
aooxess: 1760 MONROVIA AV A-1
CM CA 92627
UCENSEO WNTBRCTOfl DECL11flATI0N: I hereby aifirm Ihat I am Iicense0 un0er D�ovisions o� C�aO�er 9(commencing with Sec�ion
7000) ol Division 3 0l �he usiness and Pmfessions Cotle, ana my license is in full�orce an0 ettec�.
cirr uc.: 9 sTnre uc.: 3 8 2 7 4� c ss B
�- � Zg�qv�9�a���e:
WOXKEflS' COMPENSATION OECIANATION: I her¢�y aflir al I ha a nAi e ol c nt to seu�insure or a certilicate oI Workers'
Compensa�ian Nsyr�nc� ry a r,er�ired copy inereo� (secti n 3soo. �ab. Iz � O 1/ J Z
roucrr+o.: STA'PE1� E%P.OATE:
COMPPNY:
❑ Cerlifie0 coDY is here�y �umishea. � Certilie� capy rs �6b i�A �Ae ciry BuildinA Oivi '.
at'D e: ��_�� v Applicant: �7(/�'�,
EXEMPTION fflOM WOBKERS' fAMPEN5FTI0N DECIAMTION: �IMfs sec�i ne irot b amp@ � Ihe pemui is for one huntlre0 (5100) or less�.
I cerlity �hai in Ihe pedormance o� the wo�k tor which Ihis perFni� is issue4 I strall n � emplo any person in any manner so as �o become
su��ec� to ihe workers' Compensation Laws of Calilornia.
Date: SignaNre:
NOTICE: II, atler malung Ihis Declaralion, you shoWA become sublecl to �Ae Workers' Compensa�ion provisions of I�e Labor
Cotle. you mus� fohhwiih Comply wilh such provisions or Ihis permi� 5hall be OeemeO revoked.
CONSTflUCTION LENOINC FGENCY: I hereby aHitm �ha� �Aere is a Cons�mCtion lentling agency for �he petlormance o� ihe work �or
which ��is permil is issuetl (Seclion 3097. Civ. C).
LENDEB:
II�UPESS:
OWNEfl BUILOEfl OECLAPATION: I hereby atlirm Na1 I am exempt fmm �he Coniractors' Sta�e License Law for Ihe following reason
(Seciion 703L5 Business ana Pmfessional Code: Any ciry af county w�ich requires a permi[ to constmcL alter, improve, demolish, or
repair any slmclure. Orior lo iis issuance, also requires �he aD0lican� lor suc� Dermit to �ile a signeJ s�aiement �ha� he/she is licensetl
pursuam to Me D�ovisions oi Ne Contraciors' Stale License Law (Chapter 9(commencing with Section 7000� of Oivision 3 01 Ne Business
an0 Pmlessions Cotle) or Nal �e/she is exempt therefram antl Ihe basis for t�e allegetl exemption. Any violation ol Section 7031.5 by
any applican� �or a permi� subjecis the apD�ican� �o a civil penalty of not more �han five hunOreO Aolla�s (5500�.
I. as owner oi the D�oDeny or my employees with wages as their sole comDensatian, will tlo ihe work, and the
❑ simcWre is nat in�entletl ar oftereJ lor sale �Section 7004, 0usine55 antl Pm�essional Code: Th¢ Contracmrs' S�ate License Law
" tloes not appry to an owner o� a pmperty w�o bui105 or impmves Ihereon, anA who does suc� woM himsell/hersel� or �hmugh
his or her awn emDloyees, pmvitletl �hat such impwuemen�s are nol in�enAed or ofleretl �or sale. If, however the builtling or
improvement is so10 wi�hin one year o� completion, ��e owner will have the 6urden of pmving he/she tliU not builtl or improve
far ihe ouroose ol salel.
I, as owner ol Ihe pmpeny, am exclusively comracting wiih IicenseG comractars to cons�mci �he pmjec� (Sec�ion 7044, Business
� and Pmlessions Cotle: The Con�ractors' Sta�e License Law tloes no� appry �o an owner ot pmperry who hwlds or impmves �hereon
and who coNrac�s lor such projecls wiih a conVactor(s�license Oursuan�to �he Con�racmrs' Siate License Law),I am aware
Iha� pmo� of Iheir Worker'S Compensation insurance shoultl be provitle0 �o me.
� I am eeempt untler Sec�ion: B. 8 P. C.
�or Ihis leason:
Oale: Owner.
I tlo hereby cenily ��at I am aware of antl untler5iantl Ihe requirements ot Califomia Heal�h antl Sa�ery COAe Sections 25505, 25533, antl
25534 antl �hat I or anV �uWre builtling occupan� will/will no� (circle one) nee0 Io comply wi�h saitl sta�e cotles antl fhe requiremenfs for a
permil for constmclion or motlilication �mm Ihe Fir Oualiry ManaAemen� �islric�. flesitlenfial cansimction applications are e�empt from
t�ese pmvismns.
Daie: ppplicanC
1 �ereGy cerlity Ihat I have reatl ihis application an0 51a�e �hal ihe a�ove inbrmaiion is cOrrect I agree b comply ith all city an0 coun�y
ordinances ana slalelawsrelalinglo building consimctian anU here0y aN�p nxerepresenlativesoflhi 'ryto eni u ihe above-meniioned
pmpetly lor inspection purposes. � /� �
iL.�� d �6n �
oriver's License or Social Security a:
1641-n6 While—Builtlinp'. Green—Code Enior<emenC Canarv—Aoolicanl: Pink—Revenue: Goltlenrotl—Assecsor
CITY OF COSTA MESA - BUILDING PERMIT PERM NO; B 058814
PERMIT NO; B 058814 PLAN CHECK NO; N GOVT; N SUPP;
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: RaP
JOB DESCRIPTION ; REPAIR STUCCO SQ FT; 1,750
CLAIM VALUE; 1,175,00 CALC-VALOE: 1,750,00 GROUP OCC: B-2 /
COMMENTS: REPAIR WOAK ONLY
***��*�*��*�***��**�**�*�*�*�**x�****�***�*�****+�x�***��*��**�*�*��c-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 ---------- --------- ACCESSOAY 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
PARRING REQ • PROV; PARCEL; 00000000 ZNE: REF NO:
PLANNING Nt5'TES>
� r. � � `.^'
iF iFlt iF iE iE iE iE k iE iE i6 it iF IF ff iE iF iE if i! iE.k �IE itit iE if ik iEiE 3k iF iE il� iE �t it iFiE if iE iEiF it it if iE iE iE it i(� ik 1E iE �E iF if �k iFiF �E ik iF 3E iF iE iEiF iE if iE iE i! # 3E iF ib jF
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
BUILDING APPROVED BY
APPLICATION ISSUED
ik iFlf iklE iE if i! ik iF if iE IFiE iE iE iE if iP
iF iF if iE �E if iE ik iE if iE if iFiE it iF iE iE �E
LEGALIZATION;N
BLDG PMT
PERMIT 41,00
PLAN
ISSUE FEE
HUILDING-DIV->
TOTALS---->
F E E S U
DATE;
� DATE; � � �Z Z-
DATE; 2-� L.
iliEfEiEiEiE1E3EiEiE ifiE
if iF ik iF �f if if if jE iE iE iE iE iF iFiE iE 3E �E ik iF iF 3k �f if if ik iFiE iE iE ik af iE iE iF
M A R Y STRUCTURAL SEGMENT;Y
PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
r
PERMIT ISSUE PI,AN-CHEC
41.50 0.00 0.00
SMZP /NO�N-RE$---
.1
K TOTAL PAID \ DUE
41.50 41.50 .00
REVENUE DIVISION TOTALS--> COI.LECTED: 41,50 OVER/SHORT; 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
41.00 .50
iE # it ik iF 1f if 3f �E iF �E if iF iE iE �F �E IE 1E iE 3E if iE if iE iE iFiF iFlF if if iE iE �lf �F if if iE if aFlE �E if 3f IF i! 3F jE 1F it iE iF 1f 1E ik iE if iElE �1F If iE if iE iE iF �1f 1E iE 1f 1t 3F aE if �1f 3f iF iE
I N D I V I D U A I. •�F E E B R E A K D O W N
TYPE QT'Y D E 5 C R I P T I�O N.' UNIT COST TOTAL COST
SFC �750 ,ALTER BY VALUE C�ENDROFAFEESNOZONE 1.00 1,750.00
: J.
���
EXPIRED
� p e2e IrrspeCYionS
t?�tQ�� y��i� �� .
.�'
OS Cule""�i 7'.": _' "
4."-;TE: ;.%_�. .. ' ..= 1..2_
� r f
.._'�- - -- j POOL � oPA ,
CONSTRUCTION AND PLAfYNING, r �
- � Date Inspector Date Inspe�tor
i.PPROVALS Permit # APPROVALS Permit #
i
- l. Temporary Electrical Serviie Oc Pole " 52. Pool & Equipment Location
2, Soil Pipe-Undrgrnd. � r -' �- 53. Steel Reinforcement '
...
3. �EfEct�ical Conduit Utilit�•Urµlrgmd: � � 54. Forms �
4. E12ctrical Conduit-Undrgmd • • 55. Electrical Bonding __
5. Steel Reinforcement -% . � 56. Rough Pfumbing & Pressure Test � f'�
6• Etectrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE .
7. Footi�gs - �_ . 58. EleciricAl Cqnduit�Undrgrnd.
. 8. Foundation . .- � 59. Gas Pipe, D Undrgrnd., Test
9. Water Pipe-Undrgrnd. �� �� '„ 60. Backwash Lines, P�Trap, O Undrgmd. .
10. Structura� Floor System '�� R. ��� - 67. APPROVAL TO DECK .�,/•' �
11. Prope�ty Sewer Line & House{�fnnectiori 62. Backwash & Receptor-Final �
12. Sewer Cap :�,_ - 63. Heater & Vent-Final -
13. Roof Dreins � � 64. Plumbing System - Final ',1 �
14. Rough Plumbin9 - 65. Electrical�Final �
15. Rough ElectricabConduit ; ��� 66. Solar System-Fioal �)
16. Rough Electric Wiring � � 67. Fencing & Access Approval
77. Rouqh Wiring Sjgn , ; 68. APPROVED FOR PLASTERING �
i
18. Rough Electrical-T Bar Ceiling � 69. POOUSPA SYSTEM$ FINAL '
19. Rough Heating & Air Conditioning FIRE DEPT. REQUfREMENT
20.�Rough Factory F,ireplace �_ 4 7 ". � APPROVALS ',-Permit#
21:`Ducts, in St:uctuce, . '� . ��70. Underground Hydro
22. Ducts, Ventilating � ' 71. Product P$�ing OGas ❑Oil
23.;Gas P�Pe-Rough &�Test . . � , . 7y, Undergrovnd Flush� , ,
24. Roof Framing � �� - ' �: 1 � s�73.�Undergmd.Stora�eTank OGas OOiI
25. Roof Sheathing ' ' , 74. Overhead Hydro_ � t� ' �
26. T�Ba� Ceiling (Structurall & Monocoat - 75. Dry Chemlcal � - �
27. Frame and fiashing � ' 76. Dry Standpipe ' � . -' ', �/ �
28. Lathing & Siding � -, __ � J/y'L � 77. FIXED SYSTEM F�INAL' �
�
29. Insulation . , ` � / � '`� 78.. FIRE PREV. FINAL � . ' '�t
�30. Drywall Nailing _�I _ �I � HEALTH DEPT. REQUIREMENT ' �
31. Plaster Brooyn Coat .:ZS . 79'.�FINAL INSPECTION �� - - �
�
32. Electrical Power Meter�Final _ ��, �-� < 80. �FOOD CERTIFICATE ISSUED
33, Final Electric ' � � G�-� f�._/ � ` , �
'� . Note:: { ��' ` �� T //�Y _
34. Final Heatinq& Air, Conditionipg�, - ' ,t' , � ,/`. � _-, �� • � _ �u
��✓
35.`Final Gas Pipe-Test rj\ �- �, : � '
36. Hood or Canopy - � � � , ' _
' � � �
37. Finai Factory Fireplace •" - � . j'
"38. Final Plumbing � � � �' , _
.39. Water Service=Final � . .
i
40. Gas Service-F.inal . . ' j I ' -
41. Solar pomestic-Final � s � �
i
42. 8ackflow Preventer " � � - '
1 .
43. Backflow Irrigatiorr - � ,
44. Landscape fr'sigation SVstem . . , �, -
45. Sound Attenuation ' ;
46. Handicap Regulations � � � ' �
47. FINAL STRUCTURE & BUI'LDING ' ' -
..1 �,
48, FINALPLANNING j.: '";, .
49. Electric Release to Edison :.(�" � .
50. Gas Release to Southern California Gas Co �'� '� -
51. CER7IFICATE Of OCCUPANCY .
No. pate
� �
Pfl0.1EtT ROOflESS: G Z U W 19 TH S T
OWNER'SNFME: ATARI CORP
"aoosess: 1196 BORREGAS AV
SUNNYVALE
CA
UNIT:
AflCMIENGINEEN: HEG.NO.:
p0�flE5S: UNIT:
PEflMITTEE: HEATH AND COMPANY ( 21 3) 223-4141
aooxess: 3225 I�ACY ST
LOS ANGEI�ES CA 90031
IICENSEO CONTNRCTOB UECIABATION: I hereby alfirm Iha� I am licensetl unaer pmvisions oi ChaD�er 9(commencing wi�� S¢ction
70f10) ol �irsion 7 al �he Business antl Professions Code an� my IicenSe is in �ull lorce ana e�fec�.
ciTx uc.: 012 5 7 srnre uc.: 414 3 51 cus� —4 5
oale: 2 Signature: //
WOflKEflS' LOMPENSATION DECIAflATION: I �ereby ir � at I have a cenifkate ol consent to ull-insure or a cetlilicate of Workers'
CompensaGon ���alr alce�ti�ie� .�ap� +�iereo� (Sec6an 3800, tab. �1�4 / O I/ 9 3
roucv xo.: NATL UNION E%P. ORTE:
comvnxr: ,�{
❑ Certihetl coOY �s hereby fumisAeA. L'1 Cenif LIeG wit� the ciry BuilEing Division.
�� �`°`� � -
Da�e: 1 2 - Aoolcant' �
E%EMPTION FqOM WOBHEflS' fAMFFNSpTION OECLAMTIO . R�i tion n¢etl na� 6e complete0 il Ihe permi� is lor one hunare0 (5100� or less�.
I cenily ihat in ihe DeAormance ol ihe work lor which ihis oermil is issue0, I snall not employ any person in any manner so as to become
SUblet� lo IAe Work¢rs' COmOensalion Laws Ot Calilomia.
Oate: Signa�ure:
NOTICE: II. after making t�is Oeclaratinn. you shoula bewme SuEjttt to ihe Workers Compensation pmvisions ol tAe Lahor
CoOe, you must ton�wit� comply with such provisions a� ihis permit shall be AeemeO revaked.
CONSTHUCTION LENOING IGENCY: I herthy aitirm Ihat there is a[on5trutii0n 1¢nGing apency �or t�e peAormance ol t�e work �or
w�ic� �hi5 Oermii is i<sued (Section 3097. Gv. C�.
lFNOEFl:
AODflESS:
' OWNEB BUILOEB OECUFRTION: I hereby allirm Ihat I am exemD� ��om tAe ContracmK State License Law br ihe following reason
�Section 7031.5 Business antl Pmfessional Code: Any city ol counry which reQuires a permil �o conslmct, al�er, improve, tlemoliSR or
repair any simcture. prior m its issuance, also reQuires the apD�icant lor sucA permit to file a siAneO statemem that he/she is Iicense0
pursuanl�olhe prowsions al�he Canlraciars' Slaie Liwnse Law�Chapter9(commencing vnih Sec[ion 7000) of�ivision 3 o�[he Business
ana PmleSsionS Code) ar IM1ai he/Sh¢ is e�¢mpt �her¢irom antl �he basis tof IAe allegeA exemption. Any violaii0n al SeCtion 7037.5 by
any applicanlfor a permil su0lects ihe appliWnt to a civil penalty ol not moa f�an five AunUreO Uallars (5500�.
I. as owner ol ine pmperty or my emVloyees with wa0es as IAeir sale campensaGon, vnll Oo tAe work, an0 ihe
❑ sirucmre is not imenaee or oflere0 for sale (Section 7044, Busineu anA Pmiessiaiul Cade: The Controctori State License Law
Goes not apply ta an owner ol a pmpeny who builOs ar impmves I�e2on, and who tloe5 suc� wOM himsell/herselt ar I�rouAh
�is or her own employees, proviDeA t�at suc� improvemenis are not intenaetl or ofierea for ule. II, �owever the EvilOinA or
impmvemen� is 5a14 wii�in one year o� complelion. I�e owner will �ave ��e 6urden ol pmvinp he/s�e Gi0 nOt �uild or impmve
lor ine purpose ot salel.
❑ I, as owner of ihe prope�y, am exclusively coniractinA w��h licensetl coniractors to wnsiNct II1e pmtecl (Section 704M1, Business
an0 Professions COUe: The Contraciors' Sia[e License Law tloes no� apPly lo an owner o( propehy wlio 6mI0s or impmves ��ereon
antl wAo conirams lor such pmiects witn a contrac�or(s) license Dursuant to the Contractors' State License Law�. I am aware
IAai pmof oi IAeir Workei s Compensation insurance shoultl be pmvide0 to me.
� I am exempi under Section: B. d P. C.
lor IhiS reason:
Da�e: Owner.
I do nereGy cenily Ina1 I am aware ol ana uneerstane the reQuirements al Calilornia MealtO an0 Shcery CoOe Seclbns 2`S.AS, 25533, antl
2553A antl ��al I or any fuiure Guil4inB occupan� will/will noi �circle one) ne¢tl Io wmpty wi�h uiC state c00e5 antl IAe repuiremenis for a
permi� lor cansimc�ion or modilicalion Irom Ihe Air Oualiry Management OistricL PesiOential con5imclion aDP��cations are exempi Imm
III¢50 prOvisions.
Oale: ApPlicanl:
I here�y cetlity @at I have reatl Ihis a0�licalion ana s�ate ��al ��e abave inlorma�ion is wrreci. I agree Io comply with all ciry anU county
orEinancesan4s�alelawSrtlatinA�o ' erebyaulMrizerepreseniativeso�IhiscilyloenleruDonlheabove-men�ione0
pmpetly lo� ins clian purposes. �
C �
�ate: <f��/_� Signai ���
ori�er's license or Socia� Sew�i�y x: �
i6nt�a6 White—BwlOina; Green—Cotle EnbrcemenC Canary—Aoolicanl; Pink—Revenue: GOIEenrad—Assnsanr
CITY OF COSTA MESA - SIGN PERMIT Nzx Nc�; Sci�; V]�la�
PERMIT NO: SBE 059183 PLAN CHECK NO: 03679-92 S ,cr i: suYN:
CONSTRUCTION TYPE; PERMIT TYPE; ELE STR SIG PUAPOSE; OTH
JOH DESCRIPTION ; 2-LUMINATED WALL SIGNS SQ FT:
CLAIM VALUE; 3,500,00 CALC-VALUE: 3,500.00 GROUP OCC: B-2 /
COMMENTS: THE "STAPLES" WALL SIGNS ��{-v� �L/Cr�� 2E �It `�B��I�iSZ—
iklfiF�k�%iP%ifiE�%it1F�1(�j(#�1FiEif�)EiF#iF��iFiEiEifiE�1E�1ElF-1(-iFiEiE lEifiE 1EiE -X�%���E�IEiEK�iE�E�(�if--1F�1f�1F�k��iFif��ifikjE�lFiEiflF�lF�EiF�IE-kiEiP�EiE�!
S I G N T N F O R M A T I O N
DISTRICT: 1'1'YPE:-WALL (2) ILLUMINATION: INT CATEGORY; NEW
DIMENSIONS; 4FT OOIN X 17FT 02IN AREA: 117.00SQFT LETTER HT: 28
59'REET FRON1'AC,E i: 331 , 50 STREET 1; ti� 17TH ST
STREET FRONTAGE 2: 260.50 STRBET 2; ANAHE7M/SUPERIUR
PARCEL: 42428117 7.ONE: C2 LOCATION > FRONT; REAR:
AUSINESS NAMF.: STAPLES-THE OFFICE SPRST > LEFT: X RIGHT:
O T H E R T O T A L S G R O U N D 5 I G N
TEiIS ACTSVITY : 117.00SQFT OVERALL HEIGHT: OFT OZN
THIS SITE : 217,OOSQFT GRUUND CI.EARANCE: OFT OIN
ITEMS UF INE'U : 8 PLANTER AREA: O.00S�FT
ITEMS FOR AC1'IVITY: 9 BLDG SE'P $ACK: 81FT'
COPY VF.RHIAGE : STAPLES - TEIE UFFICE SIIPBRSTORE
PLANNING NOTES: INFO ITEMS OVER 2 FRONTS
�E K--041E�%� %dF 9E�lE iF iF�%� iFiE��1F iE �iF k�lE �lF if dF iE �%� k iE 3E �lE # iE 1f� �lE # 9F�7! if iE �1F �lE il-�N-�IE iF iE iE �IEiF# �1FiEdF �lE-0C� iE i( df 3f df -%�E-N� ik �lE �1F if -1FiC�iFiF3E-jE �)f �iF-IF �lf if iEiE iF
D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY W(SI�- DATE: � 21 t
HUILDING XaPPROVED HY : DATE;
APPLICATION ISSUEI) BY: DATE: L1, �j L
lFfF7f-lEif�%%��If1Fi(�9tiFiFiF�1EKi(-�I('itiE%iF . . . .. .. . . . . #�7f�1E#iEiE.�.IE.If..K. .. ... .RiF��SFH•�lE
LEGALIZATION;N F E E S U M M A R Y STRfJCTURAL SEGMENT:Y
BLllG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING
PERMIT fi3.00 30,00 117.00
503 SMIP/NON-RES
PLAN 40.95 .74
ISSUE FEE 15.00
BOII,DING-DSV-> PEkMIT ISSUE PI,AN-CHECR TOTAL PAID DUE
TOTALS----> 210,74 15.00 40.95 266.69 266,69 .00
RE;VENUE llIVISIpN TOTALS--> COLLECTED: 266,69 OV�R/SHUR1': 00
AI,DG YMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN-CHECK
63.00 45.00 7.17.00 .74 40,95
lf�lFiFiEiEitiE9(�iEiEifi(-iFiF#iE3EiE�7PikiF�EiFif-3EiEiEif1E �If�X�9E�J(�aE9FikdFjE-%ifiEiFdh-%�3E�%�iEdl3tiF�%#if�lEi6iEX'3f�fEi(-iFifiE#�iE9F�1i-iE�Jf#�IFiEdEif�N�lf�1f1E
I N D I V I D�U A L E E E H R E A K D O W N
TYPE� QTY D E S C R T P�T I O N ONIT COST TOTAL COST
ELE 7. E X P kR'i��iQ�
� �m latelr�isw"� L
�t���� � S�g �
�
INE LIGHT SYS ON 1 BR CIRC 15.00
END OF E'FES
f�
r5 f��� : •1� �.J ' '" _ _'
LkIG: .t`�. _a . �. i . � a..
30.00
! POo� � �va
CONSTRUCT�ON AND PLANNING ' _
Date Inspector APpROVALS Permit # Date Inspector
%aPPROVALS Permit # •
�
1. Temporary Electrical Serviceor Pole �52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. - 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation , 59. Gas Pipe, Q Untlrgrnd., Test
9. Water Pipe-Undrgmd. 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Flaor System � 61. APPROVAL TO DECK . �
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Oreins 64. P�umbing System - Final
14. Rough Plumb�ng 65. Efectrical�Finai
15. Rough E�ectrical-Conduit 66. Solar System-Final
76. Rough Electr�c Wiring 67. Fencing & Access Approval
17. Rough Wiring Si9� 68. APPROVED FOfi PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Contlitioning 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�Aou9h & Test . 7Z, Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O'Gas ❑Oil
25. Roof Shea[hing 74. Overhead Hydro .
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
27. Freme and Flashing 76. Dry Standpipe �
28. Lathing & Siding 77. FIXED SYSTEM PINAL y
29. Insulation 76. FIRE PREV. FINAL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
t
35. Final Gas Pipe-Test �
36. Hood or CanoPY ; I �
37. Final Pactory Fireplace ' '
38. Final P�umbing �
39. Water Service-Final
40. Gas Service-Final
t
41. Solar pomesticFinal
42. Backflow Preventer ' � '
43. Backflow Irrigation
44. Landscape Irripation System
45. Sound Attenuation �
46. Handicap Regulations
4Z FINAL STRUCTURE & BUILDING r
48. FINA�PLANNING ; ; �
49. Electric Refease to Edison ,
50. Gas Release to Southern California Gas Co
51. CERTIFICA7E OF OCCUPANCY
No. Date
t - � � . -
� �26'70 � - - —
' .,• . —
CdSTA MESA BUILDING-SAFETY DEPARTMENT � t%'�� 101969
\ ,r
� P. O. 60X i17 COBTA MEBA. CAI.�FORNIA \ �'{I I�� .i� � �.
7 For Applicanf fo Fill ln Comple+ely APPLICATION FOR� �PERMIT�S1:1 iu�_SA
TYPE OR PRINT
�,y, BUILDING
BUILDING ���`
ADDRE65 O Z (i (/V . I '
COSTA MESA CALIFORNIA For Offite Use Only
- - / RECEIM NO. PH MIT Np.
OWNER I �YVY(/r-/ d
✓
Mq�� �' RE D TE pQCEIy Ep ATE 188UBD
ADDRESS �LIUI ` I.� � I,��/O^GU I alc�-60
� ,_ / TEL. '� BULL� G % /�
CI C.A�/� V NO. •-30 �Y Y pDORESb fs� �- V' �/ � '
ARCHITBCT TEL. K��^ COSTA MESA. CALIFORNIA
OR ENGINEER NO. �.�.3 �{
� '�"� FIRE //�J
A iS5 �-O � ZONE TYPE : GRO/U�.F r
CONTRAGTO APPROYED X % �`
BY DATE U �
aooaess' U - �F ' ZONING b
' 20NB NO. OP U88 OP N8W �
CITY . n � / I PI.�N9 I BUILDINO J
(j i �
STATE !V ' l� .� N L d•�3 a�> >� �ea�� 'LJ � .
LIC. NO. / oeacx�rriox t �/ ♦ � .<{ )'
SIZE I / 'I No. OR BIDOB. 2
OF LOT (i NOW ON LOT �n'� p, p, NO. J �� �
U6E OF - - YARDS EVES
EXI8TIN6 BLDG APPROVED ALLOWED �
l ' \
BBTBACK LINB PROM / �� «N�R LINB 8T.)
CBNTeR OP BTRaeT S REAR YARD FRONT ��FT. IN.
SIDE YARD I LEFT �� I RIGHT SO r R. SIDE J'.�FT. / IN. \\_•'
DESCRIPTION OF WORK
L. SIDE FT. IN.
NEW I II ALTERATION I II ADDITION I REAR '�"/ . F7. IN.
AIR I IIMOVING I IIDEMOLI6H I PRO � I *w�
O
UILDING NO. Oa / . S '�•
SIZE � ROOMS 6TORIE6 �
vvtrv�ne uiei � � e..n� /.�a..:X"w.M !�'♦ rY d1 4• ? f1 T R1/J
�2 — - — .,� �-� ---" �a .S7'
� ." N+�;�vF.o _ r_
1 HEREBY ACKNOWLEDGB TH�T I XAVB RGD THI9 APPLIGTION {HE AMOUNT SHOWN UNDEN VALUATION I9 POR THH
ANO BTATH THAT TH6 A00V8 IS GOPAfi� ANO IIGREE TO COM- p�ppOBE OP, EBTABLIBHINp A PERMIT PEE ONLY.
PLY WITX ALL CITY OPDINANCHB AND BTATE LAWB REOULATINO
9uLLotNa coNBTRUCT1oN. VALUATION ��
BIGNATURE OF � PERMIT FEE $ ��� a
PERMITTE � �f , o
%'�.GJ . S�JIj 7D�� LAN CHECK S� 1 6 O
U V �O 0
AUTHORIZED AG NT
TOTAL FEE y
c.: a � �� (+ -�-�uo-+�l-�-..�(,
i$UII,DING SAFETY DEPARTMENT NA 1430 �
P, )1. Bos No. 317
Costa Mesa, California /
Date �� — .Z �f � .l. Q
CITY OF COSTA MESA ,
CERTIFICATE OF OCCUPANCY
Building Permit
Use of Building.
Electrical Permit No Plumbing Permit No
_ n �— _
The building located ar b i O /�/d �9�Q �.e.f
Legal Descrlptio�
(See reverse side for Metes and Bounds)
: been iaspected aud found to comply with the provisions of all City of Costa �Mesa Ordin-
aaces applicable thereto for a Group �- � Occupancy.
ISSUED TO: , City Bu�Qici���
•��,.,,.,�. c�c. _ ����.,
(Owner of Building By
CC: ❑ Original—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edison Co. ❑ 3rd copy—File
Form 206 SB P 1M 1-60
4
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P. O. BOX 917 C08TA M�A. ��-�RORNIA
For Applicant fo Fill In Completely
TYPE OR PRINT
BUILDING � '1 /i / � _ � T
A�DRESS vCF�
COSTA MESA, CALIFORNIA
� A"'NITECT
TEL.
_�
FIRE
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r . � �-c� �- 9�'�,
�'�jl���l� ^ ��PT.
f��� i-�� �nCT�� f.".C('11
APPLICATIOIV FOR PERMIT
BUILDING
For O#iee Use Only
COSTA MESA.
—i,r"t ST ZONING
�T Mb�N ZO NO.OF U66 OP �
a /" � PI.ANB � BUIIDINO
T6L. �a� /�
— B" No.�/B �.�02Z DEBCRIPTION 1/ �� L-Gi �-�
OF LOT /O 0 X I Now ON Loie Z p, p, NO. —/ �� �� D
USE OF C�� � G.E YARDS EVES
E%ISTING BLDG. �/�SE l� --------- ---------
SHTBACN LINE FROM
CENTeR oF 9TNEHr REAR YARI
SIDE YARD I LEFf I RIGHT
DESCRIPTION OF WORK
��X J� NO. 03 �
ROOMS 5T05
WALL ROOF
COVER�NG
IILDING AND WORK TO 6E PERFORMEO
1 XBRHBY AGKNOWLEDOB THAT 1 XAVE
AND BiATE TXAT THE OVE IB �
PLY WITH ALL CI RD N� P
BUItDINO CON9 �
, AUTNORIZED AGENT
-
(CCNTlR LIN6 BTJ
APPROVED
�
'YX19 MPLIGTION T�{E ANOUM BXOWN UNDER VALUATION 18 POR THH
D AGPE�- PURP08E OF E9TABLIBXING A P¢RMIT FEE ONLY.
lAWB fiHGU NG
VALUATION �
QU PERMIT FEE $ /�
$/�/ PLAN CHECK 5
0-V
TOTAL FEE
�_�,
� � :-
; � �..3265
COSTA MESA BUILDINGSAFETY DEPARTMENT
P. O. BOX H17 G06TA MEBA. CALIFORNIA
For Applleanf fo Fill In Complefely
TYPE OR PRINT
BUILDING ��ao z�1
ADDRE88
COSTA MESA, CALIFORNIA
OWNER
:'�:,e«<Gr,n �-,n� ¢ /I A Li.w
FEE RECEIVED
�,� � cr(oCl �"-'\
�PPLI
�� C�D���A
BUILDING
For Office Use Only
TRfiCe1M NO. P qMIT NO.
� / ��2 Es
�r' I � %� nec�ve�La I:.�%� a���n
CONTRAROR � ABYPROVED • DATE///� 9/�✓ �
ADDRE ! � NING � �� �
• ZONE� NO. OI U88 OP N!W �f
GTY I ILANe � I BUILD�NO..�C
S�ATE . I �y TEL. ( '/ (� /'� � �. A'/� ��L C,i�
LIC. NO. -T��I � df NO. �1. 3� '7 6 L60AL ///y� y�i %�_ � �.CL.dU
DHBCPI'TION ✓ �l' �( �/ �
61ZE / /� / I NO. OP YlD6�. ^� ^ '�A� �
OF LOT y NOW oN tAT q, p, Np, / �-��/� • C� \
U6H OP p YARDS EVES 1'
EXISTING BLDG pPPROVED ALLOWEO
88TBACN LJNB PROM �• �� IC6NTeR ��N[ 6T.1 ,
CeNTeN 01 BTRCHT .�JQ -Q REAR YARD FRONT 5� FT. � IN. �
SIDE YARD I LEFf I RIGHT R. SIDE C� FT. IN. \'-`�
DESCRIPTION OF WORK
L. SIDE FT. IN.
N I II ALTERATION I II ADDITION I REAR ,.�-� FT. IN.
REPAIR I II MOVING I II DEMOLI6H I BYPROVED •� �, DATE I- «C
BUILDING NO. OF ' G(/J�/7
SIZE ROOMS 6TORIES . '
EICTERIOP WALL ROOF ' -
GOVERING COVERING � �
U8E OF BUILDING AND WORK TO BE PERPORMBD � • -
�
� i (/ � `-'
1 H8R6BY AGRNOWL8D08 TNAT I X�VB ns�n rx�s wnuunox ' TMs AMOUNT 9HOWN UNOlR VALUATION IB FON TM8
M1D 9TATC TNAT TX8 ABOVB 18 CORRBCT AND AOR88 TO COY• pURP088 OF 88TABL19HIN0 ♦ vHRMIT GE6 ONLY.
PLY WITH �LL CITY ORDINANC86 /�N AT8 UW6 R80ULATNO
BUILOINO CONelRUCiION. , VALUATION � '
81GNATURE OP � PERMIT FEE S .� �� H
PERMITTE � !'
S � OO � PLAN CHECK $
K
I AUTHORIZED AGENT TOTAL FEE �� �
6
�. �
.,
`%. �
- COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
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ADDqE:
OWNER
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ADDRE:
CITV �
BFlANCH
ADDRESS
ARCHITECT
OR ENGINEER
ADDRESS
CON7RACTOR
ADDqESS
CITY
STA7E
LIC. NO.
SI2E
bF LOT �(�%
LSE OF
'E%ISr�NG BLDG.
SIZE pF
TEL.
NO. ,
qTV
LIC. NO.
� � NOAF BLDGS.
X � I NOW ON LOT
COIl�r»c?LC/AL F-
NO. OF
:RIOR WALL ROOF
ERING COVERING
OF BVILDING ANO WORK TO BE PERFOFMEO
-O � ac,� Zv���
VAID
AUC, 24-77.cMSF001736+� ��*+�*10.0�
PPLI ATION FOR BUILDING PERMIT
R C E BY E CE1VED 7E IS ED
� a�
� � PERMI'f'"f1Q�
A.P. NO. J �1
AD'ORE S W. I� S
fQirviCG✓ /pl S /t�!'__� � _. _....
FIRE
�' � �SJ717
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NE NO.OF USE OF NEW ��,;�
� l PLANS� 6UILDING � _ /u//
Qf
VARDSAPPROVEO VARDSAPPROVED
DISTANCE BET. BET. MAIN
MAIN BLOGS. ACCESS. BL
VAR.# DATE
C.U.P.# APPROVED
V
I hereby acknowledpe thet I have read this application antl state
t�+ai the abova intormetion is correct antl agree to comply with
a11 laws regulatinp building construciian, antl 1 shall not employ O, �
any person in violation ot the workmen's compensation laws of
the Stare of Calitornia. T� �
I hereb certif that I em SQ. FT. o
y y properly Ilcensetl as a convactor untler
the Stata of Celitornie Businass antl Protessions Code, Divisicn 3, THE AMOUNT SHOWN UNOER VALUATION IS FOR �
Chapter 9, and tha[ such licenses ere In full force antl effect, or I THE PURPpgE OF FSTABLISMING A PERMI EE ONLV: m
am exompt from [he provisions of the State ot Calitornia Business VALUATION
antl P�ofessio s Cotla, Division 3, Chaptar 9. N
. ERMIT FEE 5 ]
SIB�ature ot ./ m
Perm�ttee S/�`/D P�AN CHECK $' E
V
D �� LL
Authorizad ABant TOTAL FEE $
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COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING /_//O I / ���/'�1 G�S�M�/�%
ADDRESS «�G H� '
OWNER OR �OQ.OL✓/L-L- /NDUS7/2/�'`�
TENANT
MAIUNG 5�h � FA/ V/Gw �iNT N
ADDRE55
TEL.
��T� SANr� a��' No. s4�6:
COKSTRUCfION A i n_. P
BRANCH
AODRESS 7/(/J �I S/ 5���
, ,..),S�
APPLICATION FOR STRUCTURH L PERMIT ��_ 85 TL
RECEIVEO PERMIT � �„ - � ;� � � �
A. P. N O. � .Z �. — � � eZ � % /
ADDRESS�ZQ �?/ � �h �O<�7/� mESii
UNIT OR
$PACE NO.
iR.NO. LOT) 8LK
-vw FmS ( v ie �Z �a
NEW ADD LTER REPAIR MOVING DEMOLIS
OWNER ) � �' I T,�"�-�
%.t-�s/'9/'J USE Co�lyliYlZcre�u-1 VAWEs'�/
ADDFiESS
CITY /,/�..LJIOJ U�C�� `'�� . NOL 77�
STATE CITV
LIC. NO. LIC. NO.
SIZE �� pS� NOWONL��
OF LOT � C�
use oF gLv� GNi SrArnQS
EXISTING BLOG.
Separate permits are required for
electric, plumbing and heating work:
VSE OF BUILDING AND WORK TO BE PERFORMED
I3
I hereby ncknowled0e that I have reatl Mis epplicetion and state
Mat tha ebove Information Ie corract and aBree to comply wlih
oll law� rep�loNng builtllnB conrtruction, antl 1 zhall noi amploy
eny permn In violetlon of ma workman's compensallon laws of
Me Steta of Cnlifornle.
I heraby cartify that I am properly Iicansetl as a contrector under
ihe Stam ot California Business entl Profeulons Cotle, Oivision 3,
Chapmr 9, antl that sueh licansas ere in full torce antl effect, or I
am axampt fram provlaions of the e of Calffornia Businass
entl Protossio o, Dlvision 3, Che ter . a
SIO�atura of �
Parmittea
or , �i
Authorized ABont Date
ZONE �
APPROVED
APPROVEDSETBACKS
�
PLANNING ACTION
�O
�
DnTE �
APPROVED �
APPROVED e��- s , ��
U
� ��
>
m _ I,
.: ��
SQ. FT. ISO� O cmv �
J
THE AMOVNTSHOWN UNDEF VALVATION IS FOF nl
THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
VALUATION PERMIT FEE E q
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PLAN CHECK E � v o
g/SOO�. TAX E / 1 O U�
TOTALPAID S �.
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QOSTA MESA BUILDINGSAFETY DEPARTMENT APPLICATION FOR STRUCTURAL PERMIT
r.v.o�.. ��..o �.w�n�.���..,.,..� vniv�na�vc� RECE B PERMIT // (^�
For Applicant to Fill in Comple[ely — Use Ink Only `'"r" J
ADDRESS �(J • / � ��. A•P•NO.
OWNEROR ( BUIL�ING �J� / �ID 1
� ADDRE55 LT/ /'GL�
TENANT
UNIT OR
MAILING �/ SPACE NO.
ADDRE55 �(� sU • �I�/ S / �
/� /�� TR.NO. LOT BLK.
CITV QN�Q /JI+Q `T�• NOL�.'�3�I
NEW ADD ALTER REPA�R MOVING DEMOLISH
COPLS'fRUCTION
LENDER G �
BRANCH /
OWNER •
ADDRESS VALUE
ARCHITECT TEL. USE �, �P� . y
OR ENGINEER M ��'�'��
ADDRESS ZONE � TVPE � GROUP F� Z
APPROVED S � �O
CONTRACTOR BV DATE
ADDRESS
TEL.
CITV NO.
STATE CITV APPROVEDSETBACKS
IIC. NO. �IC. NO.
SIZE NO.OF BLDGS (FROM C/L STREET)
OF LOT NOW ON LOT NT FT.
USE OF
EXISTING BLDG. F
Separate permits are required for L. SIDE FT.
electric, plumbing and heating work.
REAR FT.
USE OF BUILDING AND WORK TO BE PERFORMED PLANNING NCTION
DATE
APPROVED
APPFOVED
1 �areby acknowletlBa thot I have reatl this eppllcetion entl stata
that tha above Infotmetlon ia correct anG aprea to comply with
ell lows roB�latinp b�ildlnB <onstructlon, and I shell not amploy
any parcon in violetlon ot Mo workmen's componaation lews of
Me Scete of Californie.
I heraby certify that 1 sm properly Iicensetl as a contractor untler SQ. FT.
che Stata ot Calitornia Businass entl Professions Cotla, Oivision 3, THE AMOVNTSHOWN UNDER VALVATION IS FOR
Chapter 9, antl thet cuch licens¢Y are in full force nntl eftect, ar I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exampt from t pravlsions of tha Stnta of California Business VALUATION PERMIT FEE E 2� Q�j
entl Professions C , Divtslo , Chagter 9.
� PLAN CHECK 5
Sipnatura of
Permittae j� $ TAX S
or
Authorizetl nt Date TOTALPAID S �QQ
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N
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GOSTA MESA BUILDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completety — Use Ink Only
IILDING /� �1 _ W . I / ?}� �•T.
)DAF.SSJie /f'O `7
CIYV"5�1•1'',ffj .,
CON5TRUCTION
LENDER
BRANCH
ADDFESS
�/riYYl s� �L�L�
6 3l S� �7.
ADDRESS
TEL.
CITY NO.��U
STATE qTY
IIC. NO. IIC. NO.
SIZE NO.OF BIOGS.
OF LOT NOW ON �OT
USE OF
EXISTING BLDG.
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WORK TO BE PERFORMED
'�6
0 I hereby acknowletlga thet 1 have reetl this epplicatlon end ztete
y� that She BbOva infOrmeilon Is corract entl agree t0 comply with
a atl laws reBulating builtling constructlon, and 1 shall noi employ
Z any person In vlolation of the workmen's compensation lews of
Tthe State o1 Celifornle.
3 I hereby certify thai 1 am properly IlcenseG as a contrector untlar
the State of Celifornia eusiness enC Protessions Coda, Dlvision 3,
Chapter 9, antl that sueh licences are In full force and etfaci, or I
am exempt irom th provisions of the S<ate of Celitornia Businass
and Professions Co , Divis' 3, Chepter 9.
� / SiBnature of ,
IX Parmittae >t i
� \or � O
Autharized nt Date
APP ATION FQR! STRUCTURAL PERMIT 8 0 50 TL
:E E PERMIT *TO C!1 f� n O
IV JlllleJO
A.P. NO. ZZ- Z- Z
6UILDING / !9� i. , /� �i �
ADDRESS (OG.(J (n� ��ii
BLK.
R REPA71
��--.���
OWNER ` �
�w�^ �n VALUE
USE /'1 L� . LJG �.-_"_'
20NE C/ ypE � GROUP
APPROVED �
Rv OATE S /
APPROVEDSETBACKS �
(FFOM C/L STREET) �
ROM FT. �
L. SIDE FT. �
GLANNING ACTION �
DATE
APGROVED
APPROVED (
n �./
i
a
SQ. FT. �
J
THE AMOUNT SHOWN UNDER VALUATION IS FOR m
THE PURPOSE OF ESTABLISMING A PERMIT FEE ONLV: �
VALUATION PERMIT FEE $ , / N
n
PLAN CMECK E "�
0
'� LL
g �� � TAX E f
V
TOTALPAID y � ��