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Home My WebLink About724 19TH ST - Building Permits� (7�a) 75a-5273 • Fa�c (�ta) �sa-ae56 • www.ci.costa-mesa.ca.us n rnin unrvt, GUJIA MtJA, GN tlLOLO ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: 724 W 19TH ST 42226221 App�icant PRAUM, STEVE ' Address: 1049 ME�ROSE '-'� � � � /��;-.' � Phone: (714)231-7501 �- /, ,�._�,-_. .,� - PLACEN7IA, CA'; � " . •. - - ` . Zip: 92887 � � , i" r , -' . � . , � �, � ' /�, ;'i� �� . � _ - Owner. � -XU,'YUNGILL � " = � , i, ," . Address �724 W 19TH ST-' ;.,� �. �" � � �/ i;v ; j " Phone: �� " COSTA-MESA, CA Zip: 92627 jf j '� � Convactor. , ORANGE ELECTRICAL CONTRACTORS Address: � 1049 MELROSE - � PLACENTIA, CA � � "Fhone: (714) 980-2300 Zip: 92887 License: 747129 � Stams: ISSUED Applied: O6/05/2003 Issued: O6/O6/2003 �'' . • /%�� SCOPE OF PERMIT CONVERT EXISTING OVERHEAD ELECTRICAI SERVICE TO UNDERGROUND FEED. � FEESUMMARY� - Quantity �� - -� � � . -� � .- � ISSUE FEE � $0.00 .� ' " � � - Temp service test , $0.00 Res. a/c package $0.00 . New Res (1-2 units)., $0.00 New Res (3+uuitsj. � � $0.00 Pool / Spa . ' , � , $0.00 Lightlng Fixts ��; $0.00 ReceptOutlets ��$0.00 Switches��, �� 50.00 • i' NonResAppl�--\ � $0.00�� Res Appl , ,'� � $0.00'�� - Service to 200a . $30.50 � . �, Service to 1000a�� . $0.00 . Service over 1000a `� � � - $0.00 Motors to 1hp �`� � �' - $0.00 ' Motors to 10hp � �- � -$0.00 � Motors to SOhp � _, $0.00 � " Motors to 100hp � $0.00 - Motors over 100hp $0.00� - � . Communicafion drops $0.00 � Sub panel to 200a 50.00 Pole Light Pkg $0.00 Sign Circuits $0.00 0 0 0 0 0 0, 0, 0 1 0 0 0 ' 0� 0 - - 0: 0, 0 �' - � �, _ �� 0 0 � Temp�Dist System / Lighhng Busway /100 ft Standing.Section Misc Electripl Equipmenl , Transformers up to 1 kvalkw " • ......i....,...up to 10 kvalkw ...........:.....up to 50 kva/kw .................up l0'100 kva/kw. ..................over 700 kva/kw : Low Voltage Equipment Low Volt Wiring System / Ckt Misa Conduit Misc. Conductor Ciras ( gen or ride) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other Electrical Fee investigation Fee �. Plan Check Fee �" - . Reinspec6on�Fee Quantiry $0.00 0 ao.00 0 $0.00 0 $18.20 1 ao.00 0 $0.00 , 0 50.00 0 $0.00 ' - 0 $0 00 � 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 .�50.00 , ' 0 � $0.00 , 0 $0.00' � $0.00 $0.00 $0.00 NOTICE: The work aulhorized hy this permit shall compty with all applicable handicap access requiremenis under Calitomia statutes and related regulations. (Ord. No. 92•28, § i, 72-27-g2) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended ar abandoned for a period of 180 days. � ' INSPECTIONS: In order for the Work authorized under this permit [o be considered legal, such work must comply with all applicable codes, and all requlred Inspeetlona and Iinal approval must be obtained. Failure to obtain inspections and final approval will result in the exptra�bn of ihis permlt. FOR INSPECTIONS CALL: (714) 75q-5628 [DECL�A7?TATi1'.QNS7 WORKERS' COMPENSA710N DECLARATON: � �J I hereDy eHirtn under penalry of perjury one oi Ihe fdlowing declaratlons: ❑ I �ave en0 will maintain a cenificete of consent lo sell-Insure lor workers' compensation, es proNtled tor by sectlan 3700 0l the Lebor Code,lor the pedortnence of the J work br which Ihis permil is isSueU. �9 I heve antl wlll meintain workers' compensetlon Insurence. as require0 Cy secUon 3700 of the t�Dor Cotle. fw Iha perfortnarroe ot Ihe vrork tor whkh UJs permit is LssueO. My worke compensatlor)JnsurerAce carder end pollcy number are: 6 caMer: ��5"� �J��J PolityNumber. 2-21'4� (Thls sectlon need irof Oe completed I/ the permlf Is ve/uetl el one �undred ddlers ($100) w less.) ❑ I cenily that In t�e pe ormance of Iho work lor which Ihis permit is Issuetl, I shell nat employ any Oerson in eny menner so es lo becoma wbject to t�e workers' compensetlan lews oi elifo¢�iq,entl egrae thet II I ahould become sub�ect to t�e workers' compensatlon provisions ol Section 3700 of I�e Lebor Cotle, I shell forthwith comply with these pro ions \\ � C, -a-dZ Applicflnt SlgneWre: _��p, Date: WARNINO: FNLURE TO SECURE WORKERS' COMPENSATION CAVERAOE IS UNIAWFLL M!D SHALL SU&IECT AN EMP�OVER TO CRIhUNAL PENALTIES ANDdVIL FlNES UP TOONE HUNDRED T/KRISPND OOLLME (5100.0OO�.IN AUOITION TO THE C0.ST OF COMPENSATION, DMMGES 0.5 PROVIUED WR IN SEGTIIXJ 3'1O60F TNE LABOF CODE.INTEREST, AND ATTORNE'I'S FEES. LICENSED COHTFiACTORS DECLARATON: I hereby eflirm that I em licensed undg{ provi ns oi C pter 9(commendng with Section 7000) oi DMsion 3 of ihe Busine and Professions Code, and my license Is in iull force end enect. uc. a 1�112 `( n� � Cless a �V ConiracroYsSignaWre: Date: 'a—G CONSTRUCTON IENDING AGENCV: ❑ I here6y eNirm that there is a consiruction londinp epency br the peAortnence of t�e work Por which ihis pertnit is issued. (Sec. 3097, Civil Code). Lentlefs NemB: Lender's AOtlre55: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby efllrtn Net untler penelry oi perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW tor Ihe lollowing reeson (Sec. 7Q31.5, Business entl Professlons Cotle: Any dry or counry wNch reqWres e permit lo construct, alter, imprwe, demWish, or repeir any atrucNre, pdor to its Issuence, elso requires the applicam Por such pertnit lo lile e signed stetement Ihat �e or s�e Ls Iicensetl pursuant ro Ne D�slons of the Contreccon License Lew (C�apter 9(commendnq wlth Sectim 7000) of Division 3 oi the Buslness entl Professions Code) or t�at he or ahe Is exempt Uerefrwn a�W Ue ba515 lor t�9 ellegeG eaempUon. My NWailon ot Sectlon 7031.5 by eny applkant for e permlt sub�ects tne app�icam to a civl� pena�ry oi not more tnan fve nunaretl aw�ars (EsoO).): ❑ I, es owner ol ihe property, or my employees with weges es their sole compensation, WILL DO THE WORK, and Ihe strunure is not intended or altered for sale (Sec. 7044, Buslness antl ProFesslons Code: The Coniractors License Lew tloes not appty to en awner ot property who builds or improves Ihereon, and who does suc� work himsetl or herself or Ihrough his or her own employees, provided that such improvements are not intendetl or oHeretl tor sale. If, however, the building or improvement is soltl within one year ot completion, t�e owner-bullder wlll have ihe burden ol proving that �e ar she did not builtl or improve tor purpose of sale.). � ❑ I, es owner of ihe proDerty, am E%CLUSNELY CONTRACTING WITM LICENSED CONTFiACTORS to consiruct ihe pro�ect (Sec. 7044, Business and Protessions Code: The contractors LJcense Lew tloes not epply to an owner ot propeny who builtls ar impmves t�ereon, end who contracis tor such pmject wit� a contrector(s) Ilcense pursuant to the Con�rectors License Lews.). ❑ I em exempt under sec. Business end Professions Code for this reason: Signeture: Data: Owner ID verifletl Dy Crivers license. ❑ Ves ❑ No Drivefs License No. vedllcation of Ownership by �type ot tlocument, I.e. - property tat 6ill or aeetl): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: E�ires: ❑ I hereby certity thet no eacevation tNe (5) or more leet in tlepth into which e person Is required to descend, wlll Ee matle in cannection with work euthorizad by Nis permit, antl thai no builtling structure, sceMolding, telsework, or demolition or dismentling Ihereat, will be more than t�irtysIx (38) leet high. (C�ap. 3.2. Grp 2, Art 2, Sec. 341, Ttle B, Calilamia Adminisiretive CotleJ. ❑ As ownerbuilder, I will not employ enyone to do work which woultl requlre a permit imm the Dlvision ot Intlustrial Setery, as notetl ebave, unless such pewon hes e permit to tlo such work Imm ihe Civision. Signeture: Date: Division of Industrial Safery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AIfT}IORVA710N OF EMAY: I certity under penalry ot perjury thal I heve reed thia eppllcetion end state ihat the intortnetlan givon is wrrect. I egree to comp � with ell stete lews enA city ortlinences relatinp to Ouildinp constmction, and euthodze representetives ol t�e Ciry of Costa Mesa to enter upon the ebove�descrlbetl prope� � or inspec n purposes. I epree not to oauOY a� allow ocCupenq ol eny building authorized by Ihis pertnit unGl final inspection. Sig W O epelOwner(s) � Date c, ..q,.,p � And/Or Authodzed ApD��ant Date COUE �. INSFECTIONTYVE 1676 1266 200 201 202 203 Fized System Final Fire Preventlon Pool Spa Final Finel Re-Root Flnel Bbck/Retaining Well Final Fectory Fire Placa Flnal Sign 204 Finel Demditlon Pd7E VffilELS CODEt INSPEC110NTYPE 206 Final Mechanicel 208 Final Plumbing 210 Final Electricel 212 Finel Fire Prevention 220 Finel Plenning Apprrnel 222 Final Site 250 Final Bullding/Occupenq PAg II�Lfl 1 Q� n�' ♦ I \' Aoolicant to 1III In al1 svacet within heavy bortlur lines ana si9n all aDG�ao�iate Oeclaration CITY "g� COSTA MESA P�g MIT NO. TRACT NO. LOT NO: BLDG. NO. y(5NS1"RUCTIONPERMIT 6E-S2�o% rro�ec� r+aoresz �GY- �v� �`� �� , T,�YP�E OF CONSTRUCTION •� Ownef , ��y,s' � hane �{yryEW ❑_qDD ❑ ALTERATION • Addrp55 Y�- L(/• l %u . C. �L� � ❑ REPAIR ❑ CONVERSION ❑DEMOLISH. Arch/Eng. License No. ❑ O7HER � Addf255 DESCRIPJ ION OF W RK .� • �' � `(LSG.. �!(r '3 " S' . �Contractor .�r C G Phone�.� TVPE OF PERMIT � - .. � Addf255 Ca a • �Y� / i '❑ GRADING 'O FOUNDATION ❑ STRUCTURAL LICENSED CONTRACTOR OECLARATION � � � TENANT �� EIECTRICAL �PLUMBING ❑MECHAI I hereDy atfirm lhat I am Ilcensetl untler provislons ot C�arter 9(tom- . . , mencing- with sectlon 7000) ot Divislon 3 ot the Business ana ❑ O7HER Pro(essions CoCe, an my nsa is in tull torte antl etfett. � pROJECT DESCRIPTION. Lit¢nSeCl s- �� o?y�'�-7� . ' DatelO�i-� .i�Yci�..m��.o �� i . SQ. FT. ` '" .�. "' . . WORKERS' OMPENSATIONDECLARATION - c OCCVPANGF—CONSTRUCTIONTVPE I hereby atfirm that 1 have a certiflcate o( consent to self-insure or a VALUATION C�G� - ZONE tner�eof (Ser�otf{pWr�,.o$rk{e1�rs'��OmpensaUon Iniy�a� or a ca�te0. coPY GRADING CU. VDS. t ACRES ^ 'icY No J S2(Y��'ap�mPanY � � . Certifietl.COpy is h¢r¢by fumi5hetl. ' REMARKS: � ' Certifietl copy is filea with the Uly Builtling Divislon. EX MPTION FROh1 WORKERS' COMPENSATION DECLARATION - � - - ' " - � i A.P. � 9527 10/21/B2 VING REGULATIOKS PLNG.REF.�p ��o��i�v� REAR VARD (TO P/l) GKG. SPACE RE�. � STREET WIDTH ZONING APPROVED BV' SPECIAL CONDITIONS: � (This SecLon neetl not be tomplet¢tl {t the permit 5 tor one huntlretl . ,, . (E100) or leu). � " - ' �" - ' ' - I terLfy that ln tne performance oi l�e work tor which this permil 15 PROVIDED PARK FEE,S DATE issuetl, I shall not emPloy any person In any manner so as to become PLUMBING `- � PLAN CHECK ' ' ' ELECTRICAL ' ' P�AN CHECK' ""' subj¢cl t0 the WorkOrs.Compen5ation Laws Ot GIIfOtOid.' ' Date Signature � BATHTUBS � - �SFiOWERS�� " NOTICE: It after making this tleclaration, you shoultl become subjett TOIlETS URINAlS ' " ' to the Workerz' Compensation provl5ion5 of Ihe Labor Cotle, you'must . forthwith compty with suth provisions or this permit shall be tleemetl LAVATORIES DOUBLE LAVS ' ievoketl. �.. ' . CONSTRUCTION LENDING AGENCV . . KIT. SINKS ' DISHWASHERS ' ''' I hereby affirm that thera is a con5truction lentling agency for lhe per- SERVICE SINKS � SUMPS' " (ormance of the work for which this permit I5 Issuetl (Settion 309] Clv. CJ. -' - ' 1'1 ' A'' - ' FLOOR SINKS FLOOR DRAINS ' Lentler's Name �� rt Lentler'S Atltlress . DRINKING FOUNTAINS ' OWNER BUILDER'OECLARATION INTERCEPTORS CLARIFIERS - � I hereby affirm that 1 am exempt irom tna Contractor'S Licenie Law for tne tollowing rea5on (Sectipn 7031.5 Business antl Prole55ions Cotle: SWIMMING POOL ' P TRAP " -' ' � Any tlry or county which requires a permit to' tons[ruct, alter, improve, tlemolish or repair any stru<ture, prior to its Issuanca, also re- yyqTER SERVICE � ALTERATION quires the ap, Iirznt lor suth pormit to filo a slgnetl statement ihat he is Iicensetl oursuant'to the Orovi5ion5 of the Contractor'S Licenie Law GAS SERV ICE � � UT ETS - � - appurant �or not more than .LJ 1,-as owner o( sole comoensation idt h0 is CxOmpl thero�rom antl lh¢ ry vlotatlon ol $ectlon 7031.5 by s the applicant lo a tivil penalty arz (E500). my employee5 wlth wages a5 thelr , antl IhC stlUCtUfG I5 nol Intentletl lusineis antl Aofeisioni Cotle: The WATER HEATERS SEwER CONNECTIONS SOLARTANK ._ O L BTU OUTPUT COLLECTORS' Contractor'S Ucense Law tloes not apply co an owner of a proDe«Y who builtls or ImDroves thereon, antl who tloes such work himsel/'or ISSUE FEE � � �� through_his own employee5, prOvitlCG t�dt sUcn ImproveTtnli dr0 not intentletl or ofleretl� lor sale. 11, howeveq the bulltlin9 or Improvement MECHANICAL PLAN CHECK is soltl within one year of complelion, tbe awner will haw the burden of proving he tlitl not builtl or imProve for the Durpose ol sale). HEATING SVSTEM �0-300,000 BTU_ ❑ 1,• as ownor. ol-the Property, am exUuilwty contracting with �qND DUCTING' Ilcensetl mntratiors to construcl the project (Secllon 7044. Busineis 300,000'+BTU_ antl Rofasions CoAe: The Con[ractor's Llcense�Law Ooes not apply to an owner ol property who builtls or improves lhereon, ane who con- REFRIGERATION 0-100,000 BTU_ tracis irom�such pro�ecis-with a tontrattor(s) Iicainetl pursuant to SVSTEM- --� •� t�e Gontractor's IJcense Law). 300,000 + BTU _ ❑ I am'ex¢mpt untler Section B. S P. C. for tnls BOILERS BTU reason Date Owner 5�'STEM REPAIR, ALTERATION I herebycertifythat I have reatl this applifation antl state tbat the above EXHAUST SVSTEM MULTIPLE infoimation is corre I a e lo comO�Y w�tn all tity ana <ounly oftlinanc¢5 anE sta aws f U lo co05tfuctiOn, dOtl h¢fGby aUt fiie repre5entatives thi5 ¢nter upon the aDove me Ion •� property for ti u sei � Signdture � Da[e �� 2 � Drivers' License or 55 � �� - ' �SSUE�FEE � - -� - - � - `CMF 0865-46 White-BuilEin9; Unary-iiDP��t; Pink-Accounting; Goldenrotl-ASsessor SO. FL Gn. FT. � GENERATOR ' "04 KW_1-0O.KW�� TRANSFORMER • — �APPLIANCE 30-50 KW_50 � KW _ ,MOTORS 0=1 HP -_1-30 HP _ (INC.SOIAR) 30-SOHP SO+HP= FIXTVRES' OUTLETS SWITCHES -' GAS TVBE SIGNS " ' POLE LIGHTS ' , 37.40 TL � . , � ,� POLES �METERED .SUB ' � PANEL$ ' MAIN ' , SUB - - SERVICE ' ' � " NMP' ,. ... . t� � __. . i ' ISSUE'FEE ' " � ' 'APPIICATION APPROVED BY ' DATFr I/ SUMMARV OF FEES �BUILOING � � PERMIT f� �SMIP � 'E—LL.SZ:- . 7LAN CHECK S �� SSUA'NCE- b, � �� - �LVMBING. S 'GRADING b � PLANCHECK S - '^ '�--� . ,q'. � . ELECTRICAL S�Lfl�L��, � � E .PL"AN CHECK "5 - MICROFILNI E _ ` ' !TOTAL-FEE E. MECHANICAL S . ' - - � � �LE55 AD- .PLANCHECK-E' VANCEPC $_= . . FINAL FEE. $___ • - -• - . _ _ - 37. �o CONSTRUCTION AND PLANNING POOL & SPA '•;, APPROVALS pe�mk � �' �k Date Inspector qppROVALS Permit #� •Date �Inspector'�` 1. Temporary Electrical Service or Pole -- 43. Pool & Equipment Location " . i ipe- n rgrn Steel qeinforcement ' - � 3. lec[riwl Conduit Utility-Undrgrn 45. Forms - 4. Elec[rical Conduit•Undrgrn 46. Elec[rical Bondin .. - . tee ein orce - 47. Rou h Plumbin & ressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNIFE - 7. ootings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pi ❑ Undr rn Test ' .9. Water Pipe-Undrgrn 51. Backwash ines P•Tra-' � " r '' ' ' '" ` 10. Structural Floor System 52. APPROVAL TO DECK � "-" �" � -� � � � ' ' 11.. Property Sewer Line & House Conneaion 53.. Backwash & Rece tor-Final � ' 12. Street Sewer Connection '+ - - 54. -Heater & Vent-Final � - � ' 13. Rough Plumbing ' " - '" " 14. Rough Elec[rioConduit ' � � � - �56.- Electripl-Final � ' 15. Rough Electric-Wiring � - � 57. Solar System-Final ' - - 16. Rough Heating & Air Conditioning � �' .- • encing & Access Approval � 17: Ducts, in Structare APPROVED FOR PLASTERING - � � 18: Ducts, Ventilating . _ __ . .. 19: Gas Pipe-Rough & Test - 60. .POOUSPA SYSTEMS FINAL_ °: , 20. Roof Framing - � • - ' ' � � � 21, Roof Sheathi ' . � 22. � Frame and Flashin �� NOTES: . ' 23. ,.Insulation . � � ' ' - • r - � � 24'. =(athin & Sidin ' � � " ' ' � � � - � � - 25. Drywall Nailing . . " - � ' � � ' 26. Plaster Brown Cpat - ' � 27. Electrical Power Meter-Final - � � 28. � Final Electric � � ' � � � � � ' 29. Final Heating & Air Conditioning - - � � ' - 30. Final Gas Npe•Test . � - 31. Final Plumbing ' ' � -32: rWater Service•Final � - - • ' ' � � � - - ' ' � ' 33.= �Gas $ervice-Final � � ' - � - - ' - • ��' 34. Solar pomestic•Final - � ' • • - � � - ' � 35: �� landsca S rinklin S st�m�'. � � � � ' ' � � - - 36. Sound Attenuatian - • "' � � - � , 37. Handicap Regulations " •� •"• " ' � � 38. FINAL STRUC7URE & BUILDING /- , ' • � � 39. Special;Requirements Completed ° - ' ' 40. Electric Release ro Edison � ' � � I � � � � � • � - - - � - -� --- - "- - 41. Gas Release to Southern California Gas Co. '" � � � . � 42. CERTIFICATE OF OCCUPANCY .- y _ . _ �+ ' { --• '-�No' . �- . Date t -- - - � -- - . _ -� - --- - - -- - -- - - - � ... .._. _. . -- - --- � ..,, • • � J '� Applicant to fill in all SVaces witnin heavy borEer lines anU sign all appropriata tleclarationi. OF COSTA MESA - PERMIT'NO. ' - TRACT NO. � - LOT NO. BLDG. NO.� - � - - • - -- TRUCTION PERMIT Q� S3 ' ' � , ,. ,6105 . 8/.16.(82 ,,- .., 37•85 il rojectAddress Z " +�,j ( .�'/ TVPEOFCONSTRUCTION �� "��_� __, , , ;� ,� � OW�=� I% AQ I [J . �i' " -' PhOne Z-c�7 O NEW � ❑ ADD ❑ ALTERATION � - � - � ' - _ ' . = - . M --- . ---- -- � ' ACdfE55. . - �j�'YLf�� ; . �-REPAIR.00ONVERSION� ODEMOL75H � ZONING REGULATIONS '�� Arch/Eng. -- . LicenseNo.- . . ❑OTHER" �� — ^ . ACdlC55 • - , . . _ DES�I,eT{QN OF WORK A.R �'"� ' .' ' i Concroctof"(�t% � j�,�(r� y-Q��' 7-�� '� I� - IZ �✓SU/L G ZONE' � . .- .PLNG.REF,:�� '" \ Phone YPEOFPERMIT-' ,� � -:. oB � LpWG• , . �SETBACK C 5 . �EOP�RTV'LINE• ' Address� - O�' C j � U � ' S � . ❑ GRADING ❑ FOUNDATION- ❑ STRUCTURAL- - , IDE VARD- - �� -- � LILENSED CONTRACTOR_DECLARATION `' ' "Q.TENANT.O-ELECTRICAL ❑PLUMBWG ❑MECHANICA �EGHY � . �1 h6reby aftirm Ihat I am licensetl untler provisions of Charter 9(com, � .. • � ' meqdn9-wlth� sectloo -7�00) of.l0ivislon 3.ut_the- Busirtesz'aaA ' Q.OTHER �" ' Protezsion5 Lotle, n' my II u� a iz In f'I � forGe � afip�t. � + - REAR VARD (TO P/L) ' -,: - � � License s " ' l'Jce i e' 7 �� PROJECT DE$CRIPTION � ,� _ _ _ _ � _ _ _ _ � �, �-. � 'PKG.SPACEREQ. P OVIDEp � Oate Si9nature - ' SQ. FT.' � _ ' _ ' - STREET WIDTH PARK FEE b- . �, �WpRKERS'COMPENSATION DECLARATI � � OCCUPANCY ONSTRUCTION TVPE � t I hereby a(tirm that I have a certificate of �sen to ulf-insure or a 00 �" ' �- � �� ZONING APPROVED BV- ' DATE � •tifiwte of Work¢r5' CompGnSation Insurance,.or-a Certi/ietl.coPY �'O'LUATION' J _ ONE ^ - � _ _ �i " 'SPECIAL'CONDITIONS: �� ' reo( (Sectiom3800, 12b. C.). ' .GRADINGiCV..V05. ACRESY ' ' JCY No. - " - ComPanY ' "- ' -' ' ' -" ' - ' - ' ' " ' _ . '�pl'Certifietl coPy is hereby furnishetl. _ _, REMARKS:' Q yYCertHI¢tl cOPY Is filad with tha city Builtling Oivislon. �„�� „-z-�. EXEMPTIOMFROM'WORKERS'COMPENSATION-DECLARATION � �� - - - - � � � �� •• (This section neetl not be mmpietetl if the permit is for one huntlretl �• - � � � � _ 'x� t "'�t'.: : (E100) Or I¢55). . . . - _ . " ' ' _ '_ _ _ � I certiry that In tne performance of the work tor which this perrt�it' 15 . .. . f53uCtl,- 1 Shall noi ¢mploy any pe�son In dny mann¢r 50 asYo bacome ' PLUMBING' ' , PLqN CH£GK ' �ELECTRICAL '" PCAN CHECK - � 1� ' Subject to the Worke�s' Compensatlon Laws of Calito�nia. '�= ' ' . '� � � . �... -_ ' BATHTU65 - ' SHOWERS _ "` ' . _ " _ .._ _ .." ._ _' ,_. : � Date � � S�g�ature � � � HpTICE: It after making thls tle<lara0on, you shoWU become subje<t . TOILETS - '.. URINAL•5 -- �- -�^ - - GENERATOR -- py KW '_ 1-lOFKW' ' to the Workers' Compensation provisions o( the Labor Cotle, you must - " ' tTRANSFORMER i... . y . � torthwith tompry wlth 5uch provisioas or this permit ihall be tleemetl �-.QVATORIES � �DOUBLE LHVS' -� - - qPPLIqNCE '- 30-50 KW_50 i KW - -- CONSTRUCTION ENDINGAGENCV ' - " 'KIT.SINKS^ - - "-DISVIWASHERS' - '-^ - -MOTORS ---- �0-1 HP"' '1-30'HP - - i Iherebyaffirmtbattherelsacon5trucHonlentlingagencyfortheper- SERV�CESINKS.• ,SUINPS- -�}- �(INC.SOLAR) .30-SO�HP_-SO+.HP.'�' _��'�_ � torrPance of the�work /or which this permi[ is issuetl (Settion 309� - � 1 Civ: C.). - - - � -. � - - - ' ' " ' -FCOOR SINKS• ' ' � 'FLOOR D0.AIN5 ,� ' �' ' �FIXTURES -�- OVTLETS =SWITCHES - -- � Lentler'S Name ��'• '��' � `T�! �- -' 1�` ` ' " 1' '•--i . ' � • "�"• �� DRINKING FOUN�YAINS '-'• ' • .• � GAS�TUBE SIGNS � � -- - - � LenGer'S,�AAtlress - - "� � - � , � . -_4. r: - i . OWNERBUILDER�DECLAqATION�;�"v��-1-./-''::' ��'`� INTERCEPTORS=""'�'�'CLARIFIERS' �` �'-'' "�� ".POCEL�GHTS ' --""'- ' -- "' - - - � I hereby affirm�that 1 am'exempYtrom.tne Con[2ttoCs License WW.tor �. - . r , s-.- the following�YeaSon (Section 7031.5'�Bu5lnen�antl`Prof¢scioni'COEe: �SWIfNMINGPOOL 1 �-� -PTRAP - � -- -- --- � qpy tity or couniy which requires a p¢rmit to cons[ruct, alter, _ _ POLES -' M TEREO' � SUH - improve, tlemolish�or rapair any structure,prior tO�ilS BSUante, also re-- yyATER'SERVICE ' ALTERATIONi'^ f'� -- ,PANEL4 -'M{i1N�' `� -SUB' - - --+' quiris'the'ap�.liwnt for Such permit to file a signetl�statement that be ' • - - } . , . __� .. .. . .. . _ is liGensetl pursuant-tmlhe provisions of the,Contrac[or's Licente-l.aw" -G/�15 SEftVICE ��' � OUTCETS"' " - SERVICE•-- -- -� - AMP -- � -- i 'ChaPter.9, (commencin9 wlth $ecUon 7000) o[ Dlvlsion�3 of;thC" �- '' ' � usinessantl-Wo(esilons'CdaeJBrtha[�heisexeiript•therefromanG[he �-yyATERHEATERS. "BTUOVTPUT- • � � -� -'— ' - � - '--- - " ••� aslz tor the�allegetl exemption.�Any NolabonioF SettlonV031.5 by - - •� � any�applicanPtbra�•perm�BsJti�ett5-the�appliwrit'toa�ciJil;penalty�-"SEWER'CONNECTIOIJS ��• - -� -- - -j-• � ^--� �- -- ---- �- - - - ^ of not moprtt �an�live huntlr¢d�tloll�rs (y500) • \ �a � - �� ❑-I',:asOwner'otlheproperty,or�myemployeeswltti"wageiastheir��SOI:AR�TANKi--'��^�COCLECTORS��-- - - - �� -�- .� -�'�— 3 OQ'' sole_�ompensation, will:tlo the work, arttl the structure is;not intentletl -- � ' or.of(ere0 for�551e: (SeCHon'7044, Bu5ine55 a0tl R'OfezSioPd Cotle: The" "SOLAR PIPING SVS:'��._..�� '"' ' -- ' � "�SSUE FEE - - - " - '-'- ' ' Q' ' ConCractor's�LicenseLaiv�.tloes_qotapD�Wto�anrowner�oL�aOro�erty�_ -,_ __ _ - _ -qppLICATIONAPPROVEDBV � -DATE � f who builtls or,improves thereon, antl "who tl0e5 such work himself or' ''ISSUE F,�E ' '' '- _ f [hrough hisown emptoyees, providetl Ihat'such'improvement5:are�not interded or oReFetl for sale. Ii,'however, the builtling ot ImproJement - jyjECHANICAL'.^ ;� \ PL•AN CHECK '� SUMMARY OF FEES • is so�tl within.onc year of completion, the owner will hava, lhe burtlen � � .- - - -. � �- � � ' �gUILDING -- I � T � of�"Froving 'he Aitl noY bulltl or improve fOr the purPose of sale). �..�EATING SYSTEM, 0-100,000 8TU . PERMIT ❑ I� as owner �o( 1ne .property,_am. exclusively. contrac[inq_with � ` � r ., , _E `'q • Og�!- r SMIP.� _ E_ ,. �'Jv 7 ( _AND-DVCTI' G� i,.V100.. ' ��PLANCHECK E� PERMIT Iicensetl contractors to construct lhe project Section 7044, Businesz 000 + BTU �� antl-P�otes5ions-Cotler_Tne_Contraetor's:L•icense LAw'does'noPappry to' , _ _ _. _ . _. _ .ISSVFNCE 9�"� �� an o�+ner o( properly who bUiltls Or improve5 thereon,'antl who�con- REFRIGERATION 0-100,000 BTU �PLUMBING .Iracts trom such.projects with a..contractor(s) licesne8� PursuanYto'' SVSTEM- "� - _ - ' • -' • - ' E . __ _._ � �GRADING_'"E� �' � theContrac(or'sl.icen5elaw). ' � �100,000'+gTU - �� -, � ' �iPIANCHECK §�� .-��,� �•.;. ,e,,- S-:� ' 0 1 am-exemptvn�er Section�� - - B. & P.'C: lor this '— � - - - � - " - 'ELECTRICAC E "� ' - " -. `,s � BO�LERS BTV �� reason _ .. . _ _ . ..' _ . . _ � _ _ MICROFILM;S, _ ' ' SYSTEM REPAIR, HLTERATION PL:AN CHECK $-� . ' TOTAC FEE S - � � Date Owner � - � �MECHANICAL- $ ' � - 1 hereby cer[itythat 1 have reatl this application antl state that iha aDove EXHPUST SYSTEM MUITIPIE . ' LE55 AD- '' • informatlon- is correct: I'agree to <ompty with all Uty'antl ounty -'PLAN CHECK E- �VANCE PC S_ '-- - orAinan antl State 1 s r¢lating lo <OnStructlon, dntl �eYeby au hO�iz¢ ' . t ,� � � �f n represe ta -of ths�tity enter upon the above� me ti etl - �- ' '' � � qI7. `/� j p�OpErt e s. ��j FINAL FEE SV / a ' 519n3ture �{iate �G _ ." "' _ .. . . _ _"' ' '_ " _ _ ,' ' _ ""'_. ' . I DrivErs' License o� 55 � �SSUE FEE CMF 0865-46 White-Builtling; Canary-AppliCanq Pink�Accountin9: Goltlenrotl-As5e55o� � ApO��ant to lill in all spatts withln OF�COSTA MESA ' PERMIT NO../ iTRUCTION PERMIT Z- �{-��G • Phone Address � - \ License No. ; Address � Cpntractor I hB�eDy a(fir�n thct 1 atn Ilcen5e0 untler provisions of Charter 9(com- mahcing.with section 7000) of Dlvislon 3 of the Buslness antl Pro�eszions Co(i a tl. my ❑cense is in full torte a� ife Llcense,Cla 5 R � O Oate_ 5�9�atl WpRKERS'COMPENSATION D L RATI N • '1 hi/eby affbm that 1 hava a certificate ot C nSa to Se1f-InSura oi a cartififate o/ Workers' CompensatlOn .Insura cC, r a rertlfi¢tl copy theleot (Sectlon 3800, Leb. C.). '•Iicy Nor Company - Certifletl toPy is herebY furnishetl. _ . Ge�titi¢tl COPY is tileci with th¢ city Bulltling DWisbrt. �7Z�MPTION FROM WORKERS' COMPENSATION DECLARATION �This section neetl not be completetl if Ihe permit I5 to/ one hundretl §300) or le5s). -' Carttly [hat in the perfOrmance O{ the wo�k tor whiGh thi5 pe�rt�it IS IsiuCtl, I zhall not employ any person In any manner so as to become subj9ct to thG Workers' COmpensatb� Laws oF Glffomid. ' ' Dat& 519�ature NOY��E: It a(ter making this tleClaration, you shoultl b¢Come subject to [�e Worker5' Compensatlon prov�sions ot tne Labor Cotle, you must fo�tp`�'ith comply with SUCh provisions Or this Permit Shdll bG tleerYietl revokeQ. CONSTRUGTION LENDING AGENCV I he/eby aftirm that there Is a construcUon lentling agency for the per- forrf�ance ot tne work fOr whlch this permit is 15suetl (Section 309] CIv.�C.I. - . . - . LenOer's Name �..¢�per's Atltlresi � � - OWNER�BUILDER DECLARATION- - I hereby affirm that I am ezempt trom the Contractor's License Law for tha following reason (Section 7031.5 Businezs antl Professions Cotle: qny city o� county which requires a perTit to ConstruGt, alCeq improve,-tlemolish or rep31� any struciure, prio� to its issuanca, also re- qWrBs�the ap; I��'znt for suth permit [o file a s�gnetl statement [ha[ he i5 IlEensetl pUrSuant to Ih! provisio�s 07 th¢ ContfaGtor'S LicenSC Ldw BuSiPess antl ProlMsions Cotle) o� tffa[ hC IS e%enlpt lhe�¢1roT dOtl Lte �asls for the allegetl ezeMPtion. AnY violation o� Section 7031.5 by � appliwnt tor.a perm�t sub�ects the appficaat-to a civU.penalfY iot more tnan (ive huntlretl tlollars (E500). _. I f d5 owne�'of th¢ property, or my employee5'wilh wag¢5 a5 their Sole tompensatlon, wlll �o the work, antl the structure is not Intendetl of 0/f¢retl tOI Shce. ($¢CtlOn 7044, BUSIne55 antl %OfeS5ion5 CotlC: The ConVactorY License Law tloes not appty to an owner of a property who builtls Or im0�oves the�eon, antl Who Ooes SUCh work hlmseN or throq9h his own employees, provitlatl that such improvements are not intentletl or offeretl'(or sale. If, however, the bulltling or Improvement is soltl within one year of completion, the owner will have the burtlen of proving he tlitl not bulltl or improve (or the pur0ose of sale). ❑ I, .d5 Ownef of [h¢ plopefty, af11 ExcluSively COntracting with IicenS¢tl conlraclors to cOnitrucf tlle PfojecL�SECtion 70A4, BuSin¢55 antl.Professions Cotle: .The Contractor's Licenze Law does not apply lo an o�+ner of property who builtls or Improves thereon, antl who co�- trac[5 lrom such project5 wilh a contractor(5) Iicesnetl pursuant to the Con[ractor's Licensc Law). ❑ 1-am exem0� untler Settion B. & P. C. fo� tbi5 reaso� Ihat I have reatl this apPlication antl state tnat the above mrrect. I aqree to eompry with all ciry and countY state law rela ng to construction,antl hereb auth iie ;o( ter upon [n< abovermenj�netl Eo�tler lines antl sign all appropriate tlecla�ati0� TRACT NO. LOT NO. BLDG. NO. TVPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑OEMOl15H ❑ OTHER DESCRIPTION OF WORIf/) q7/PE OF PEflM1T . /� � ❑ GRADING ❑ FOUNDATION TRUCTURAL ❑ TENANT O ELECTRICAL OGLVMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION 50. FT. OCCUPANCV_CONSTRUCTION TVPE VAIUATION ZONE GRADING CU. YDS. ACRES �� -'J L a PLUMBING P�AN CMECK BATHTUBS SHOWERS TOILETS URINALS LAVATORIES DOUBLELAVS KIT.SINKS DISHWASHERS SERVICESINKS • SVMPS FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS- INTERCEPTORS CLARIFIERS' SWIMMINGPOOL PTRAP WATERSERVICE ALTERATION- GASSERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECT10N5 - ' � SOLAR TANK GOIIECTORS� SOLAR PIPING SVS. ISSUE FEE ' MECHANICAL PLAN CHECK HEATING SVSTEM 0-300,000 BTV _ AND DVCTING " �00,000 � BTU�_ 67p9 B/26/B2 ZONING REGULATION�� A.P. $ ' ZONE PLNG. REP. if REAR�VARD (TO PKG. SPACE RE�. STREET WIDTH SPECIAL PROVIDEO PARK FEE E TDATE . � ELECTRICAL v�nN Cr+ECK CCJ_ FT. . � GENERATOR 0-1 KW_ 1-30 KW _ TRANSFORMER - APPLIANCE 30-SOKW_SO+KW_ � MOTORS - 0-1HP_1dOHP�_ ,'QN0.50l.AR) . 30-50 HP�SO+HP _ �FIXTURES OUTLETS - -SWITCHES � - � -GAS TUBE SIGNS - � - - .POLE IIGHTS � - � - � REFRIGERATION 0-300,000 BTU � ' SYSTEM 300,000'+ gTU -n • • ' " BOILERS � -BTU � SVSTEMREPAIR,ALTERATION ' � EXHAUSTSVSTEM MVITIPLE Oriver3' License or 55 � v� �� r ' ISSUE FEE CMF 0865-46 White-Builtlinq; Canary-Applicant; Pink-Accountin9: GolOenrotl-Assessor PANELS SEftV ICE ISSUE FEE MAIN SUB "' AMP 1�1r00 TL APPIICATION-APPROVEOBY�,�,� -OHT SUMMARY OF FEES rBUILDING � �/� ,.,� ' � PERMIT ELY—CCSL SMI7 • E PLAN CHECK E PERMIT . . . ISSUANCE E� � PLUMBING S GRADING S� � PLAN CHECK` S - - � . ' E . ELEGTRICAI S aPIAN CHECK § _ _ MICFOFILM E �MECHANICAL-$ � TOTALFEE�$ ' LESS qD- �PLAN CHECK E VANCE PC §-_ � FINAL FEE § Q � Qb CONSTRUCTION AND PLANNING _ POOL & SPA - - _'. . ' _ T-u'_ Date . Inspector - Date Inspector APPROVALS Permit # ��L� • APPROVALS � � ' Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location "- - --' ��"" - �` 2. _Soil .ipe-Un rgm " ' � 44. Steel Reinforcement ' ` `- " � - � - 3.- Electrical.Conduit Utility-Undrgm _ � 45. Forms' • ' � ' � � - 4. Electrical.Conduit-Undtgrn . 46. �Electrical Bonding, ' � '- �- --- ' � - '� - • . tee ein orce . ' � 47. Rough Plumbin & Pressure Test -- - � - � - - 6. Electrical UFER Grn 48.. APPROVALTO COVEF-GUNITE � - - -- - 7. Footings 49. Electrical Conduit-Undr rn �" ' - �8. - Foundation. � - - - � - 50: � Gas Fipe, � ❑ Undr rn, Test ' ' - ' . 9:�- Water•Fipe-Undrgrn ' 51. Backwash Lines P•Tra � ndr rn � - . -.10. Structural Floor'System � 52. APPROVALTO DECK ' - - � ' -1.7.. Property Sewer Line & House Connection �. � 53. Backwash & Rece tor-Finai ' ' ' - � 12. � Street $ewer_�onnection_ ._ �.. "' ' ' - - - � - - 54. Heater& Vent-Final - � � 13. . Rough Plumbing ' ' - . . _ � .- -- �- -- -- - -' - - � � � 14. Rough Electric-Conduit "- - ' - -- �56. Electrica6Final -----: - � �� " " ' 15. Rough Electric-Wiring " " - - � ' -- - 57. Solar SYstem-FinaF-' . � � ' - ��-' ' � ' - , ',' - ' 16: Rough Neating & Air Cortditioning - -� " `- -' • encing & Access-Approval � - ��.. 17. Ducts in�Structure � --- ' APPROVED FOft P_LASTERING. +. - ' - , 18. � Ducts, Ventilating • _ -.. - � - - . - . - � � ' - ' - ' ' - -- - - ' ' - .- 19. Gas Pipe-Rough_& Test ' � r� � -. � - - '�, 60. - POOUSPA SYST6MS FINAL . _ ,. , . � 20: Roof•Framing - - - -- - - - - - - - - - ' " " - ' � 21. Roof Sheathing - - ,- - - - -'- �- - � -. . . . . - '- . ' . . • . 22. Frame and Flashin �- - • -- . _ NOTES: ' _ _ _ _ � . . "- . . ' 23: Insulation � - � - - � - -- -'� - - - - - � - -- -� � 24. �Lathing & Siding - � - - - ' -. . - - . - . . . - . . - -- ' -- ' ' -' - ' 25. Drywall Nailing � � - - . -- - -.. " ' � • � � ' � � ' � ' 26. Plaster Brown Coat - � ' - - - - - . . .. ' 27. Electrical Power Meter-Final � - �- -� - --- - � ' • � � �• � ' � � 28. Final Electric - � - � � - - - - - � -- �- � � �� ' � � � ° " � 29, Final Heating & Ai� Conditioning - - - - - - - � -- - -- - -- - � � � ' � � � • 30. Final'Gas Pipe-Test -- - - - ' � - - � ---- �- � �-- � � � ' � � ' 31. FinalPlumbing- - --�� _. . _ � . , 32.,rWater Service-Final , - - - - � - - � - - ` �- - - ' - � � � , ' 33.�-� Gas Service-Final � - - �- - � ' � �� . 34. Solar pomesticFina� ' - - - - - ' -,�. . '' .--.. .. . � '•. � , 35. Landsca e S rinklin S stem ' - ' � ' - � � -�� " � ' . 36. Sound Attenuation � � � - • - -- ' ' ' ' � ' � ' 37. Handicap Regutations - . ' . - - -- � , - . ,,. °.' . �." - .. �. ° -,`. , , � 38. FINAL S7RUCTURE & BUILDING �o_//- 8 ' � ' � � "' ' � 39. Special Requirements Completed � � � � ' � • - � 40. Electric Release to Edison ) �• - 41. Gas Release to Southem California Gas Co. ' � � • � �� 42. CERTIFICATE OF OCCUPANCY - - '' ' ' ' ' � i - No. � Date � ' - - - ' -- - - io. ... . .��.. �. � . . , �. ., AOP��cant to fill in all spaeas wit�in �eavy DorGer Iines anE. sign all aDP�oDrlate Eeclaratlons. BJ4� � �� d2 � 0• �U T�- CITV OF COSTA MESA PERMIT NO. TRACT NO. LOT LDG. NO. • ' � • CONSTRUC710N PERMIT % ��r� -• CAnhBCtOf �I hBreby aiflrm that I am Ilcensetl un e menUng wit� seCHon 7000) o( vl AofesElons Coda, ntl Ilcens I �p.1 Llconsa Class ' � 'x Oate�S(9nature � � WOR ERS' COMPENSATION DECLAI � I bareby affirm that I �ave a �ertl/lcat "'��tate of Workers' Compensatlon 'eot (Sectlon 3800, LaE. C.). cyNo.' Wmpany LJ Certitietl copy is bereby turnishetl. ❑ Ger�i(letl topy is 111eC wiM the city 8 � E%EMpTION FROM WORKERS' CO This i¢�(ipn neetl not Oe completetl ' �L/ J TVPE OF CONSTRUCTIO ' PhOn@ L ❑ NEW ❑ ADD ALTERATION - - OREPAIR ❑CONVERSION ❑DEMpLISH License No. � ❑ OTHER DESCRIPTION OF WORK ' - rhone 7ypE OF PERMIT - ' ' -� ❑ GRADING ' ❑ FOUNDATION ' O STRUCTURAL o s of C�arter 9(com- � TENANT O ELECTRICAL �PLUMBING �❑MECHAN o tha Buslnei5 and ❑ OTHER fuu for � .ane / PROJECT DESCRIPTION ' / SQ. FT. ' ' - � . . .. ry OCCUPANCV�CONSTRUCTION 7VPE n� nt to self-Iniure or a VAlVAT10N ' ZONE �. af d CBftltietl cOPY ' - -- - GRADING CU. VOS. ACRES REMARKS:' - • . _ o;w=�o�. N DI i is fc 300) or less). - - \ � cartity (hat in tpe performa0ce of t e wOrk t If rmit is 755ued, � shatl not emPloy any perso n appp n ' Cecome PLUMBiNG� � .�PLANCHECK -' subjoct [ Na Worke s Compensation wg '' i n' ' Date�519�ature ' � BATHTVBS ' SHOWERS ' ' NOTIC : If ai er mak ng lhi5 tle<Iaral on, you 5houl e me subject TOILETS• VRINAl.S " to the Workeri' COmPonSaLon provisloni ot lhe Labo Cotle, you must � fort�W�th Comply wlth Suth prpvision5 or this permi Shall be tleemetl LAVATORIES DOUBLE LAVS revok4tl. � ' ' KIT.SINKS - -DISHWASHERS ' CONSTRUCTION LENDING AGENCV I here6y aflirm that t�ere is a construclion lentling agCncy lor the per- SERVICE SINKS � SUMPS ' " (ormance of t�e work (or whith this permi[ is iuueq (Sectlon 3097 Gv. C,). . ' . - FLOOR SINKS FLOOR ORAIN$ � Lentl¢r'S Name Lentler'S Atltlre55 DRINKING FOUNTAINS - OWNQq BUILDEq DECLARATIpN ' INTERCEPTORS CLARIFIERS ' I hereby a((irm [hat I am exempt irom tne Wn[ractor's �Icense Law (or tne to�Ip�ving-reason' (SecUon 7031.5 BuSiness antl Protesslons COUe: $WIMMING POOL P TRAP Any Nty or munty whicn reqWres a permlt to Conitrutt, alter, improy¢, tlemollsh or repalr any StruC[ure, prlor to its 65uante, also re- WqTER SERVICE ALTERATION qulros the appllrznt tor such permit lo flla a signetl slatement that he {s Iicensetl pursuant to the provislonz ol t�e Contraclor's Utenu Law GAS SERV ICE OUTLETS '^ha0tor 9(tommencing wit� Sectlon 7000) of DlviSion 3 of t�e � '��ess antl ProlMsionS Cotle) or lhat he iz oxompt lheretrom antl the WqTER HEATERS BTU�OUTPOT � is �or ihe atle9ed exemDtion. qny Wolation of 5ectlon 7031.5 by _ y zpp��pt tor a permit suEjecti the appllwnt to a clvll Danalty SEWER CONNECTIONS � � ' Of not mor0 than Ilve hunAretl tlolldr5 (5500�. ' ❑ �, es owner�of ibe O�oper[y, or my employees wlth wagas as thelr SO�.AR TANK ' • COLLECTORS sole cOmpensation, will tlo the work, anC t�e struttur¢ is not Inlentletl or offeretl for sale. ($ection 7044, Buslnezs anG AofeiSions CoEe: The SOLAR PIPING SVS. �� Con�retlor'S Lice05o law tloei not appry to an owner of a prap¢rty who 4uiltl5 or improves thereon, antl who tloes such work himielt or ISSVE FEE ' - ' thfOu9h hi5 own empioyees, provltleE tha[ SUUI improvements are not , inlentletl or oi/eretl /or sale. Ii, however, lhe builtling or Improvement MECHANICAI PLAN CHECK Is solq wi[hin onc year o� completion, the owner will �ave tbebur0en oi Oroving he tliC not Duild or improvo tor the purpose of sale). HEATING SVSTEM 0-300,000 BTV ❑ 4 as owner of lne property, am ezclusively mntracting with qND�DUCTING IlcensCA contractors to construct the pro78ct (Settian 7044, Business 100,000+BTU antl %ofessions Cotle: T�e Contractor's LI<ense Law tloes not apply to an owner ot properly who builtls or improves thereon, antl who con- REFRIGERATION 0-]00.000 BTU lracts (rom suc� projects with a contractor(5� IlceSneC purivant to SVSTEM [ne COntractorY Llcenso Law�. 300,000 � BTV ❑ I am ¢xempt untler Section B. 6 �. C. tor Ihis • BOILERS BTU reason Date Owner� SVSTEM REPAIR, ALTERATION Yhereby ce ify( t 1 ha e reatl thi ap Iiration antl state that tho above EXHAUST SVSTEM MULTIPIE intorrt�ation is`do rect. aq2e(Y co�olv with all tltv antl countv Signa�ure � �e �ZY I ISSVE FEE Drive�s' License or 5 � � CMF 0865-46 White-Builtlinq, Unary-Appliwnl� Pink-Actountin9; GolOenroO-Assesior A.P. � ZONE' REAR VARD (TO P/L) PKG. SPACE REQ. ' STREET WIDTH ZONING APP0.0VEO BY SPECIAL CONDITIONS: e� �� ATIONS tIUEFL. p� PE�RTV LINE PRO V I DED PARK FEE'S � DATE' ' PLAN CHECK' ��' 0-1 KW_I-30 KW _ TRANSFORMER . APPLIANGE 10•50 KW�50 � KW � MOTORS ' 0-1' HP_1-10 HP � QNC. SOIAR) .30-50 HP 50 � HP �y FIXTURES OUTLETS 'SWITCHES' GASTV9ESIG 5 ' POLE LIGHTS' ' ' -' ' POLES METERED - SUB� PANELS MAIN SUB A APPLICATIONAPPROVEDBY — V n'� DATE�O/%/8 SUMMARV OF FEES � BVILDING PERMIT E SMIP E _ PLAN CNECK 5 PERMIT ' ' ISSUAN�E S PLUMBING E GRADING E" ' PLAN GMECK E � ELECTRICAI S • QQ � - � s PLANCHECK E MICROFILM 5 MECHANICAL E � TOTAL FEE S. LE55 AD- PLANCHECK E VANCEPC S� FINALFEE S(1( PO ADP��cant ta (ill in all tpaces wilhin �eavy bortler lines antl sign all apDropriate Aeclarationz. IJN GTY OF COSTA'MESA �� vea IT N� � " TRACT NO. " LOT NO. BLOG. NO. , '^ ' CONSTRUCTION PERMIT ' � � I ' Project Address Z I�T TYPE OF CONSTRUCTION . � �� - t � Owner =� V PhOn2 ❑ NEW ❑ liD� �,ALTERATION � ' ^_ ;'Addres � - - - � - - � _� � - - �REPAIR ❑-CONVERSION ❑DEMOLISH, � `j � Arch/Eng. License No. ❑ OTHER_ �, AddfESS ' DESCRIPTION OF WORK - �%= � . ._ , .. � . . _ :�; ��-., rie/}i �iL ; _ _ \� Contracror - - - •� -� - Phon ' 7_6 ,TYPEOF,PERMIL - � -" " " " " - "r' ' " � Addfe55 � � 'j 2 CN �U 1 � - .., ' ..' ❑ GRADING , O FOpNDAT10N- �❑'STRUCTURAL - \(� �LICENSED-CONTRACTOR DECLARATION . - - . ' . � :Q TENANT ❑ ELECTRICAL �PLUMBING �MECHANICAI �� :I hereby a(firm th:.t 1 am licen58tl untler proW5ion5 ot Charter 9(tom- - . �, . t � menCing' With SeCtiOn 7000)-of �Diviziom 3 0l •the- Bu5lneis�-and� �� OTHER - - � Protezslons Cotle, . tl my ilc use is In (ull force antl �e�tect. � � License C ss ' - -� � � Lic n e O - .PROJECT DESCRIPTION_._ ; _ _ _ y._t . _ f �,. . Se. FT. . ., r Date ` Si9nature ' .„ ' -'- '-��t � -� jWORK RS'COMPENSATIONDEGLARATIO - - 'OCCUVANCV"_� CONSTRUCTIONTVPE �I hereby a/firm that I have a cert(ficate ot co te to selNnsura or a VALUATION- -� a ZONE � tertiTiwte of Workerz' Compensatlon Insura , or a-certl(led copy . - - - � _-� - �_-� . _ _ _� _,�_ . tCa• ot (Saction 3800, Lab. C.). � GRADING�CU`VDS. ' ACRES � "'��.; No. _ ' __" �"_ "' � ComVanY. . ' _ ' "' '_ _ " ' __ _ __ _''' ...i ' _'" __ ' ". . _ __. . �i-�af��" - REMARKS:']'1' rtiti<UCOpy�is,h¢r¢byfurpl5h¢tl._ - _ . _ �__ _. _�" � �" T'��; _ _.1 . , �ertlfletl copy is tiletl with the tlty Builtlin9 DivlSiOn. � EXEMPTION FROM WORKERS' COMPENSATION DECLAqAT10N' ' - ' --'- " ' �' ----' • --r-- �(Thls sectlon neetl.not �e_complatetl if the permif Is for one huntlrea __ __ - _�'_ � SE300) or less�. ' � . .. . , . , u _ r, i . . . _ .�_ . . : certity that n_tne,pe�fo�mance of the work Por which this permi[ Is izsued; I snall not emPloy any person in any manner so as.to become PLUMBING •, a�,"-.� PLAN CHECK "' --'� " subjectiotM1O.WOrkBrs COmpGOSdtlOnLdw50�GIifOTId.__'' ' gATFITVBS � � SHOWERS � � Date Si9nature � � �,NOTICE: It after making this tleclaration, you shoultl �ecoma�subject. �T,OILE ,pV0.1NAL5 - --'i' -' ' ,to the Workers' Compensation provisions ot lhe labor Cotle, you must - � forthwith comply with sucn provisions or this permit shall be tleemetl �VA 5 D - - ' ievoketl.'__'_. i ._- _' ' _1' '._' . ' ' ' "" _ 'KIT:S '..- _DI W R _ - �CONSTRUCTION LENDING AGENCV � �I hereby aftirm that [here is a construction lentling agency for tne per- SERV E �, i '� 5 - "- ��^' ' �tormance of lhe work for wnlch this permit is issued (Section 3097 �CIv.C:). - "- ' —' '-" -- " " "' -FCO SINKS � �F 00 DR N -" " "' FLentler's Name � \ � � `R ILentler's Atltlress Y DRI ING FOVNTAINS"'� "- ---' - '- UWNER'BUILDER'DECLARATION" " ' -'�-"^' - '-�INT � 5- CLARIFIERS � � �' I hereby atfirm that I am exempt from the Contractor's License Law for t�e'following reason.(Section 7031�.5 Buslness antl� Pro(essions Cotle: SWIM - -' "'1-'.' - �Any city Or county whith �tquites a pe�mit to conSlrUt[, alteq Improve, tlemolish'or repair any structure, prbr to its issuance, atso re- -yyqTER SERVICE " � ALT � quires the ap, licant for such permlt to file a signetl statement tnat he I5'�Ilcensetl pursuant to the'provlsions of the Contratlor'sLicense l.aw GAS SERV ICE �- OUTLETS - (Cnapter 9(commencin9 with Section ]000) of Division 3 of tne � B��oess'antl Professions Gotle) or that �he is exempt theretrom antl the �yyqTER HEATERS- "- BTU OUTPUT '- ' 7-"^' ' for the allegetl exemption. Any violatlon ot Section 7031.5 by ippliwnt fora Oermit subjetts� the applicant to a-civil penalty SEWER'CONNECTIONS' �' -" "'" "j ^' ,�. ..ot more lhan five huntlretl tlollars (y500). �� I, as owner of the property, o`r my employees with waqes as lheir "'SOCAR"TANK- " "'COLLECTORS '-�' ""` " -' 501¢_Comp¢n5dtion„will tl0_tM1C.wOfk, antl_the StruGtufe is no[ Intentletl " or otferetl for sale. (Section 7044, Business antl Rofesiions Cotle: Tlie- �p�5>cS=Gf LC E Contractor's License Law tloes not.apply to an owner_of a property_ _ ,_�� ____ __ _ who builtls or improves Ihereon, antl who tloes 5uch work li{mielf or ISSUE FEE j � [hrOu9h_hls own.emplOy¢¢S,.prOvitletl tttal Such improvements a�e not _ _ IntenOetl or otferetl for sale. If, howeveq the builtlin9 or improvement � MECHANICAL PIAN CHECK r is soltl.within one year of completion, (he owner will have the burtlen bf proving he tlitl not builtl or improve foi the purpoSe of sale): HEATING SVSTEM 0-100,000 BTV ' ❑ I,-as-owner of the-property, am exclu5ively cont�acting with- �-�AND'DUCTING-- '' "- --^ licensetl tontractoro to construtt the project (Section ]044, Business 100,000+BTU � Y antl Profe55ion5 Cotle: Tne Contractor'S Llcense Law tloes-not apply to .. an owner of property wno builtls or improves thereon, antl who con- REFRIGERATION 0-300,000 BTU [�aCts�t�oT su<h-project5 with d cont�actor(s) IlceSnetl putsuanl to- SVSTEM--�-- --- � ----- - the Con[rattor's LicenSe Law). 100,000 + gTU � � ❑ I am exempfuntlei Section " B.6 P. C:/or this gOILERS � BTU � reason— --- --- � - - - --- Date Owner SVSTEMREPAIR,ALTERATION � 1_hereb <ertify Ihat 1 nave reaC lhis appliwtion an0 siate Ihat the above EXHAUST SVSTEM MULTIPLE � � inform ' n�is corretL I agree to comply with all city an0 Eo uty ortlinan e tl sta[e la s rela n9 [o mnstruction, antl hereb auln rize represen iv f thi cit en r uoon the' above" mentl netl' � proPertY" � rp ' ' Slqnature te " � Drivers' License or 55 � � � - - -ISSU&FEE - � �- - CMF 0865-46 Whi[e-Buii ng; Canary-Applicant; Pink�Accounting; Golaenrotl-Assessor � � � � ,. ��, 6565 8/23%B2 . ,, 5.00 TL '. ._ .. .. . . . .�� I � - -�:.-� - -- - . _ - . - ,� ' ' - ZONING REGULATIONS - "" - - . A.P. iF . . _ ' " _ ' �ZONE '. -.• - - - -'PLNTGp.�gRVEF. p�'. =" - �' SE�pTEBACK GL ST. vROPE�RTYNLINE. �•�, '•LEF VARD " `__" " . '1 --i �,i i -� � 9IDE V . RIGHT ' . ..' ' ' ' � � _ . �t REAR VARD (TO P/l) � - `PKG.�SPACE REQ. � � PROYIDED .�' - �" � � �' STREET WIDTli �� PARK'FEE 5 - �20NINGAPPROVED'BV ' - � -DATE - "- _ '_ ' _ i �SPEdAL CONDIT(ONS: � - �- - � �. � _ .�_ _-.'__. _ _ � . ' '" __ _ ' _ _ - _ i _ _ _ _ _ ' _ ' _ ' ECECTRICAL' ' - -' ' P�AN'CriECK '- -' ' �50. FT. . _ _ _ _ � _ � fGENERATOR .'0-1-KW_1-lOKW, - - � - ' � �TRANSFORMER � � . ' �,APPCIANCE " '10-50 KW=50�+KW - . 1 �.'MOTORS---- -' 0-1'HP'_3-lOHP' " -' f " (INC.SOLARI.. 30-50.HP_SO.aHP':��ti' �,,.1,._:� _!� . i '�FIXTUi2ES '-"'-OUTL'ETS--'SWITCHES'- - - {GAS'TUBESIGNS-'-�� •-- - - -- - �- - - � �POL'E'L'IGHTS• .'. "- -- '- "-' ' -" " - "� � iPOLES� � ��METERED� .SUB � - � �'PANELS -' - MAIM ' SVB' - - ' '�SERVICE� -- ^ - ""` -"-""AMP - - -� 1' "' _" ". _ ' '-."' " ;__' -ISSVE'FEE —"-'-"' " - ' - '- ' � ' �APPUCATION�APPROVED BV - - - -- --� DATE - • ` SUMMARV OF FEES , � µ ,t� ; �BUILDING-'_..._.' "_ ' ' " _ '�,$. " " _ � rPERMIT $ _ ' �> _-.»�SMIP,�..' . _.. . .. ' PLAN CMECK E �PERMIT ' ,.. • v( ' _ JISSUANCE� 5" r{ i � PLUMBING S � � ' ^ F PLAIV CHECK ��Sr• - _ �GRADING: $ , � I , . .. . �J.. _ . a � ELECTRICAL" S �- ' - - �PLAN CHECK 5--- ,' ._. MIC0.0FILM y" � I '��" "� � TOTAL�FEE 5�� I �,-MECHANICHL.'$ -""'- ' ' - �.} " ..--� � + %' r. � t t9 �, �:'P LE55.'AD�?: %� . "�PLAN-0HECK -§-- ---'VANCEPC' S-- "- � I ` � � � i .„ .� � � _ _ FINAL FEE E� i , . - , . . y . +�� CONSTRUCTION AND PLqNNING � POOL & SPA - � . . �-a . , APPROVALS Permit # Date Inspector qppROVALS ' � Permit # � - "' ' Date � Inspector � 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - --� - -� - Soil ipe-Undrgm �• 44. Steel Reinforcement - - ' �--- � - - ..3.._ Eiectrical Conduit Utility,Un rgm ' 45: � Forms ; �- ' ---- - - � - - - - 4._ Electrical Conduit-Undrgrn � 46. _Elect[ical Bonding. - -- - - - tee ein orce � 47. Rough Plumbing & Preswre TesC `� - -- 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE -� - -- --- _7. _Footings_--•-- . _ ' __ . .. _ � . � � 49. -Electrical Conduit-Undr rn � .: � �.�� • • � . ^ •r �� 8.__Foundation _ ""' ' 50. . Gas Pipe, ❑�Undr rn, Test � " • • - � __9. Water.P.ipe-Undrgrn_. __. - - 51. Backwash Lines P-Tra �❑ ndr m� ` -" ' � ' �' � - 10. _ Structural Floor System " 52. APPROVALTO DECK - • - - - " - ' l 11. _ Property Sewer. Line &..House�('qnnection , 53. Backwash & Rece tor�Final �' - ' '� � 12.. Street Sewec Connection . "_ ' _: ' _� ' " � :�+� _ __54- Heater & Vent-Final - � � 13. Rough Plumbing _ - _. - � - _ " '._ : _,_" _ - _ - - --- -- - , . . - - � 14. Rough ElectricConduit - - - - - � ' -- �56. Electrical•Final - � � � '� 15. Rough Electric-Wiring -- -� � -- - �57. So�arvSystem-Final ' "' ' ` ' � � ' ' ' ' I� ; i6. �Rough Heating & Air Conditioning- � - -- - - -� � -- • encing &�Access�Approval ' ' ' 17. Ducts, in Structure� - ' ' APPROVED FOR PLASTERING � - � - � � 18. - Ducti.-Ventilating . . - - ' - - -- - -. - ---__�. ---' '. ' - 19. Gas Pipe-Rough &Test ' ' ' ._ _ _ _ _ :.60. POO,USPA SYSTEMS FINAL�•, � ' , � - � . . ' 20: - Roof+Frarciing _ . ` . . �j . r � � . , .. . . 21 . Roof Sheathin " - , • � � ' � ' - 22. Frame and Flashin - _ NOTES: ` ." 23. Insulation- '- � - - - � - - _ _ � , 24. lathirtg�& Sidin9 � - - - � - - - - - - . . .- , - . --� - - - ---- -- - - - - , . ,� . - . _ � 25: Drywall�Nailing . __ . .. . �. _ . . . ��. .. r . : �• . . . .. . .• ,.. .... .� 26. Plaster Brown Coat ' � 3 � - ' ' ' � � �- •� � ' ' " 27. � Electrical Power MeterFinal ' ._ '" - • - ' � ' ' - � � � � 28. FinaLElectric - � � - - - ' �• � � - � � ' 29-. �-Final;Heating & Air Conditioning -- - - _ - - ' _ � - • �� . � . 30. Final Gas Pipe-Test _ - . . . - -. - t-- - � - - - - - . . - � , 31. -Final.Plumbing I - '" " i: � "' � - • +' ' � ' ' � ' 32. -Water Service-Final- . .. -� - - - - „ '.-: � • . . . . . . " � . -33.- �GasService-Final __ �- � ' i � - ' • � ^ � - - � � - - - - - - -- - _ ... . ------ � �,.. . . , .. , , , .. � ,. .. i 34. Solar pomesticFinal . "„` � . � .. � .� •., .'n -,�,^ � �: . °�� . ., ••� ,c .:., ,i I 35: Landsca eS rinklin S stem 4 � •� ' ��+ ��' ' ' ' ' "' � "� ' �' ' •- ' ,; � 36. Sound Attenuation �- . • ' - "' : �� , , . . 37. Handicap Regulations - � � ' __ _ � � � , .'-��, � � -� . , , • - � � 38. FINAL STRUCTURE & BUI�DING � � ' - ; � - . 39. Special Requirements Compieted ' � _ � ' � - ' " "' - � ' ' 40. Electric.Release to Edison " " . . , � - .. - --- --" '- ' '-- ' i '� 47. Gas Release to Southern California Gas Co. � �� ' '�.•�. '� 42. -CERTIFICATE OF OCCUPANCY - . _._. _ _ . ` � - �� •- �� - No. Date � "� ' - � .. � . . , , � 39483 , � COSTA MESA BUILDING•SAFETY DEPARTMENT 7.0. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant fo Fill in Completely BUILDING 1/ ADORESS /C� � OWNER • /. C A.P.NO. MA1l ` BUILOING � Z • ADDRESS p_ NL� S% %6o/��q.�. ADDAESS dU CITV �� NOL3%I`/ TRACT ZQ CONSTRVCTION W O N LENOEP a� J � BRANCH J N OWNEP m � ADDFESS � ARCHITECT TEL S J N OR ENGINEER U �( FIqE W a ADORESS ZONE aW W x APPqOVED J O CONTRACTOR BV m � J a ADDRESS p � W TEL. Z�� I P� Z � CITY NO, a Pni� ihIJ13-75cri�,OO 309= ��x�*'''�.5� N FOR BUILDING PERMIT DATE RECEIVED DATE IQSSUE .�7 � ' � PEfiM1T NO. � /� � � . .. Wd STATE . CITV VARDSAPPROVED N p,' LIC. NO. LIC. NO. MAIN BUIL�ING �� SI2E NO.OF BLDG�. (FROM C/L STREET) OF LOT NOW ON LOT RONT F USE OF EXISTING BLDG. F" SI2E OF NO. OF QNEWBLOG. ROOMS STORIES L,SIDE U EXTERIOR WALL ROOF COVERING COVERING REAR F J USE Of BUILDING ANO WORK TO BE PERFORMED OISTANCE BET. n` f MAIN BLDCS. O '�� O C.0 P 3Y+ f' APPROVED y z a U1 hereby acknowlatlBe that I ha�a read this application antl state � thac the above intormatian is correct entl eBree to comply with � ell laws regulatinB builtlinB consbuction, end 1 shell not amploy � enV person in violation of tha workman's compenzetion laws of y tha State of California. Zi �ereby certify that I em properlV licansetl as a conbector untler Sa' iM1a Stata of California Busineu antl Professlons Cotla, Divisfcn 3, THE AMOUN Chapter 9, antl t�at such licanses ere in full force and affect, or I THE PURPO6E am exempt from ffie provtsions of the Staie af California Businesa VALUATION antl Profasstons Cotla ivision 3, ChaDter 9. Si8^at�ra of ` N co Pe�mittee. $ �� — Auffiorizatl AOent VALVE 2 VARDS AFPROVED DATE � � � FT. V �� o �`` TSHOWN UNDER VALUATION IS FOR y OF ESfAeLISHING A PERMR FEE ONLY: ¢ .I �� m � PERMIT FEE $ � � � m PLAN CHECK $ (((�� E � � LL TOTAL FEE _3 ' • '' 319�9 .' , . COSTp MESA BUILDING-SAFETY DEPAF P.O. BOX 1200 COSTA MESA, CAUFORNIP For Applicant to Fill in Completely aooRess /�'7 w, � y J i. OWNER J rt � S �i. F_ � I�c N�4- � ADDRESS � � � W - % � .� / • CITV`QS�� FS��" NOL. CANSTFlUCTION LENDER BRANCI� AODRESS TEL. CONTRACTOR EL M �FC�vN.�r,puc � c o� ADDRES�O Q I S�Tq.�1T0� AUF�.2o CITY�(,f�/jJ�- �� NO��yS LIC. No,;2 a�/9G 2 LICYNO. SIZE NO.OF BLDGS. OF LOT I NOW ON LOT VSEOF �04 s� EXI5TING BLDG. SIZE OF NO. OF :RIOR WALL ROOF ERING COVERING OF BUILDING AND WORK TO BE PER EP�qC� Gui.VDo� �/N i .4LL -p F , iu�a =��-� - �� - o a5a `� � cnsn *>r�'tb APPIICATION FOR BUILDING PERMIT �EI O B DATE RECEIVED DATE ISSVED �-.i o �o'.s'%o No //�'S"' 35�10-,�5� P�/��12Q VALVE FIFE ZONE APPROVED NO.OF USE OF NEW� �/ PL4K5 fj— BUILDJNG a. DSAPPROVED VARDS APPROVED'y IN BUILDING ACCESSORV BUILDING GL STREET), i. � VAP.� I DATE �J QU.P.qJs �� qPPROVED APPROVED i// .s _. / ��7 , - U �� I hereby ecknowletlpe Nat I have raetl this applicetion antl state that the abOve intormation is cOrrBci antl ap�ae to comply with alt tews rBgula[(ng bWltling construcHOn, entl I sheH not amploy eny perton In violatlon of the workmen's compensation lawa of ^ � � � the Steta of Calitornie. � I hereby certity that I am proparly Iicansetl as a contrector untler SQ. FT. o �, the Steta of California Business entl Protessions Cotle, Dlvisicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m� Chapter 9, entl ihat such licanses are In full force antl affect, or I THE PURPO6E OF ESTABLISHING A PERMR FEE ONLV: a� em ezempx from the provisions of Ma 5[ace of Calitornia Businass VALUATION and Profassions CoGa, Division 3, Chepter 9. PERMIT FEE $ B � �� a � �� YY , �� / 0�-- � Si netur¢ o — m Permittge S / ��0 7LAN CHECK $ E / `o LL AuthoriYetl Agent TOTAL FEE $ ��' m Q City of Costa Mesa euilding Safefy Deparfinent P. O. Box 317 Coi�a Mesa, Californio _ .- � CERTIFICATE OF OCCUPANCY NO 2411 C The Building located at '?�t� N":� l'�'t�+ ,'�'.t�!�!: _ has been inspected and fo�nd To comply with the provisions of all Cify of Costa Mesa Ordinances applicable thereto for a Graup � � Occupancy. Use of Building �� `�{�'-I�� Legal Description �'S��'�'� (Sea revarsa side for Matas ond Bounds) /.� Building permit No. ?'.'+�"� Electrical Permit No. �j 2��_ plumbing Permit No. ��C1�;� Floor Load Signs have been installed as Room Capacity Signs have been insfaled as required under Sec. 2308 U. B. C. . required under $ec. 3301 (1) U. B. C. 17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occupied until the owner or operafor has been issued a valid certificate of occupancy by fhe enforcement agency. (b) A new certificate of occupancy shall be obtained whenever the're is a change in: 1) Occupancy classificaTion of a building or portion thereof . '. 2) The number of apartments or guest rooms 3) Ownership If Group H Occupancy, number of apartments and/or guest rooms as required under Sec. 17050.1 (d), California Administrative Code, Title 8, Chapter 9, Article 8. Number of ISSUED TO: d":�!^�',S C. �":P and/or guest rooms Building Officiol / ` _ by D��,�'G` �, ��J112 oafe �r =��/—c7s 7his CeMificate of Occupancy SHALL BE posfed in a conspicuous place on The premises and SHALL NOT BE removed excepf by the Building Official of The City of Costa Mesa UIIfI@f S2C. SOb �8� U.B.C. Form BV9�-IM-11-83—S-B P 1I � _ `,' , 2�'�997 +• CQSTA MESA BUILDING-SAFET7 DEPARTMEM P.O. BO% 1200 COSTA MESA, CALIFORNIA Y2610 For App11mM fo Flll In Complefaly . TYPE OR PRINT BUILDINO ADDRE6Y COSTA MESA, CALIFORNIA nr �F c;;Sr� M�SA � ��5 1965 LICA F PERMR BUILD i� � � 11[C[IR NO. P6 YIT N. _ 2-� -`'i � 7 - " " MPROV[D /.1/�/t i DATB /��a–� � ARCHITECT � T!L er /� J J\ OR ENGINEBR OL'G NO. ZONIN(i wncRese z�[ Ho.or uaaorHrx ��. � �un� OYILOINO CONTRAGTO OLL� tcawt - �� / $ ]� � AD 118Y7 � D�YCRIRION K � K . !o � Y cirr w. r. r+o. — 3 a � 8TAT6 T6L. LOTTO HID6 0 R6AR PHLNO BMALL 08 LH88 TMAN LIC. NO. ' N . BIZH i / �VHB No.oI�LGo�. ALLOWHD (U.B..C..REQUIRH6IHNT) OPLOTS +� Now N � � USEOR YARDHAPPROVHD YARDSMPROVHD � EXI6TINO BLDO. MAIN BUILDINO ACGEY80HY BUILDIN6 �( PROM C/L DTR6LT ) � Y6TlACNLIN[l110Y �OM ✓Z��. p�. e�'fi¢R oP m�[R R[AR YA D � 8106 YARD L[PT R10lfT R.IIID6 . � G' �• DESCRIPTION OF WORK L. DID D rr, rr. NEW T[RATI N AODITI N � RGR �• DIGTANC[ ER. BR. MAIH e REPAIR M IN 6M Llb MAIN BLD AGGHBY. BLD08. y/�,}j DATB BUILDINO � NO.OP BIZE S� � ROOMH I RI G. U. P. MPROVHC EXTERIOR WALL y ROOr MPROV COVERINO //LCU COVHRINO � O� DAT6 � S� UDQ OR BYILDINY ANO WOR ro e PtRFORM �iOLD F�R SPEC L- F.=QUS.^,�MENTS °1 M�v wA �� . �. r� � 1 NlR�Y ACICNOW1.6Dp6 TXI1T 1 HAV6 RQAD TXIB MPL�GTION T16 11MOUM OXOWN UNO[p VALUATION IB fOR TH6 j AND 8TAT8 TNI1T TX6 AGOV6 1� CORR6GT�AND AORB{ TO COY• �YRPo06 OP f6TA0LI8NIN0 A PHPMIT PB8 ONLY. 3 PLY WITN ALL CITY ORDIyl�NCl� AND �TAT{ LAW 'N�OYLATINO ' eu1LolNOCONBirtucn ( YALUATION �—_ � SIGNATURH � Q� PERMITFEB P6RM1TT8 ' s ��/� � / � � � '�s � � (O�y AUTHORI2QD AOQMT v� / y � �. TOTAL FE6 � � CITY OF C05TA MESA, CALIFC �IA November 9, 1966 City of Costa Mesa � Planning Department 695 W. 19th Street Costa Mesa, California 8ubject: Building Permit No. 24997 724 W. 19th Street, Costa Mesa Gentlemer.: I, as ormer, hereby agree to install 5 parking spaces per City Standards, between the existing house and the remodeled . plumbing shop as sfiown on my plot plan within 60 days from this date. I further agree and fully understand that in the event this is not accomplished, that the Planning Department aill issue � Cease and Desist and Stop Work on all business on these�premises. T hereby further agree �o instaii tne z•ea_ fiva �arking spaces as shown on my plot plan in the future if determined to be needed by the Planning Department and upon the demand of the Planning Department of the City of Costa Mesa. ; - � 724 W.r19th Costa Mesa, COtJNI'Y OF ORANGE BUII,DING DEPT. ' 636 No. Broadway s�,� .�, c�uro.,,� pn�e: tci z.�zii Application for Building P¢rmit AND FOR A Certificate of Use and Occupancy Peamit No.�.�. �-F!, 1. OWNER'S NAME-----..�.1-±_.._Li�.__P..._-!..1.......-.l..i�.�-.�....�...�.�.. --._-__.... ................... PHONE:..........- -� -.............: MAILINGADDRESS_._,/...o�.....:5�.......�-.:...L...(....!�......5'� :......................_.._....... CITY.--.e�G..[.P�4.---�:ktL�?iA:....�!:l"{ � Q Name (Archirect or Engineer) Address City. ............. ................._`--..................-- -- - ......................... Stace Lic. No .............�:._.�_[.ti.4,C-__.. Phone.... --.i�Vl-.`:4�.�C... PROPOSED USS: Namc (Contracwr) Address City..............................................................................................:... Statc �.R_..------- Phone......�Y�'r.1'�-c��...... Lic. No.___....----- - 2. IOB LOCATION.......7 �7.--.�......L.Sl.:.... �_.I.�!ic�.:..��•...._..:. (House No.) (Namc of Street) 3. L$GAL DESCRIPTION: Lot.. �...r..} J.-{/. �+.:_�tf..l.�c_/.Y-1DBlock (Metes and Bwnds Dc.criptiofr--Use reversc side of £orm) � (Town or School Diatrict) / � _---------------._ Tract......lCl.....I.�_........._..... 4. . CORNER LOT ( ) INTERIOR LOT ( X ) THROUGH LOT ( ) SLOPE OF LOT ( ) i. SIZE OF BLDG.:..:�..�'J!�..,�_�r.....AREA: OF LOT: �^�..X..... I.9 U AREA:........---.... -- -..._..... G. HEIGHT OF BLDG.:..._._�.3..'.�..� ..............CEILING HEIGHT:.......� OF STORIES. ...�........ -.. 7. NO. FAMILIES........_--.1 .........................Size of Smxllest Bedroom:... �.Q.._!�_.I..�...-..�!.�.. Size of Kitchen....lcZ. x�'� '.'."".-- �....�-,3�r r z� L,; . . ,r,. ��1 S. EXTERIOR WALL CONSTRUCTION:_.._5.�.�:l..s..a�............INTERIORWALLCOVERING........cwv�-�Z:..._...'2� (Fame, Smcco, Etc.) � (PlascerDryuall, Etc.) U 9. SETBACKS: Front Yard From Center Line of Svicet....._._.....L.S_.$ . .. ........�.� ........................... ................................ ............... Yh —i Nearest Sidc Yard.O�.F:f..�..��..Rear Yard...3s.....�.�Distance in Feet Between Bldgs. on Same Loc..L�..7:F.f......Lr......L�._�-_/ • 10. A COMPLETE PLOT PLAN 1S REQUIRED, S�HQWING ALL STRUCTURES ANQ USEIOF EACH. y /� ( �. ]]. For (a) Footing: Width........_. .. Z....er-.........Depth in Ground-_....1.R..`.t:..".^..�....Width of WaII.....Ir!...-�.^....X---L..`�.. Accessory �.,.1 Bldgs. and ........S acin �..aa._"CC �vtaterial of Floor........ ��...:., c('�i..t ........... Similaz (b) Size of S[uds:....�.i,.... _ P g........1..... � � Scruccures: (c) Size of Floor Joists:. ........._---•--:-.....�..._.......Spacing....---.....-- ........................:'CC (d Size of Rafters:......°�.%� ...............•_.-.-.._---5 acin -�`� !� •. "CC ) _�.- P , g .......... :. .... ... ................... ]2. VALUATION OF.PROPOSED• WQtiK:�neludinsm�l, labor, plumbing, electrical �virin�, heatang, fire sprinklers, painting and Z� _ sewage disposal $.:,n3.?...t°.'�"�.......f -�..�� ' G ]3. I HEREBY CERTIFY THA"T TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORREG7 AND THAT THE CONSTRUC7'ION WORK W1LL CONFORM 'TO ALL LAWS OF THE COUNTY O� pRhNGE •AND T.HE STATE OF CALIFORNIA APPLICABLE THERETO. Signed Plans Filed:.......i"��..��.�...------- ................... By FEES: Bldg. Permit Plan Check Total • - Receipt No. Paid to • Date ........... FOR DEPARTMENTAL USE ONLY � GROUP......... ...1.. �'�1....... � �.c..�.U....._.. TYPE.........�...._...__... f _�_ � DIST. � 1�...... �........�-�-��-�- �..... ��'_i.%_ i SHEET NO........ �........... DATE.--� .-��.- Z---•---�---- 5 M-B�S� � (�wner) (Au[horized Agent) ' K1�i(; BY � . APPLICATION. . ... .� /HEALTH ......................._... l/' FIRE ZON ING.....------....-----.... PLANS AND MARSHAL ......................... SPEC'S ................_�/ STATE...----........_......_---�- CORRECTIONS ' ENGINEER � VERIFIED ........................ CAL..... -- _ _ ♦ 1 �^_ , � . `i��I