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Home My WebLink About758 19TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT Job Address: 758 W 19TH $T Suite: Viciniry: Parcel Number: 42227122 . ' . -� � Applicant: SCOTT, JEREMY Address: 2220 E ORANGEWOOD ANAHEIM,CA Zoning: Phone: 714-3851202 Zip: 92806 Owner: KAMPHAUSEN, BUCK Address °/,NEPTUNE SOCIETY OF OR CO SACRAMENTO, CA Phone: P 0 BOX 246810 Zip: 95824 Contracror: WIN-DOR INC Address: 2220 E ORANGEWOOD ANAHEIM,CA Zip: 92806 Arch : Address: Phone: 714385-1202 License: 545553 Eng: Address: Phone: ISSUED BY: Slatus: ISSUED Applied: 04/15/2004 Issued: 04I15/2004 Phone: Zip: License: License: SCOPE OF PERMIT CHANGE OUT ONE WINDOW. RETRO-FIT SAME SIZE OPENING. ' Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total $17.26 $26.55 $0.00 $0.50 $0.00 $0.00 $44.31 SETBACKS MA�N STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existin : 0 NOTES: Rear 0- 0 Rear 0- 0 Re uired: 0 FEE SUMMARY PLANNING & ZONING LeN 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Righl 0- 0 Right 0. 0 5600.00 asoo.00 NOTICE: The work authorized by ihis permit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced wlthin 1 BO days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considerad legal, such work must compty with all applicable codes, and all required Inspectiona and final epproval musl be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 754-5626 24a&e816'o0) - -- WORKERS'COMVENSAnONDECLARAnON: � I hereby eflirtn under penelry of per�ury one ot the Iallowinp declarations: � I �eVe enE wlll malnieln e Certllicate of consent t0 SBIt-InSura for warkers' compensellon, es OroWded for by SBCtlon 3700 ot t�e Lebar Cotle, for tha peAormence 01 ihe \ viork for whlCh this pertnit Is 155ued. ,[ ��I heve a�W wlll malntein workers' compenaetion InSuranc9. a4 require0 by section 3700 of the Lebor Cotle. for Ne peAormarxa of ihe wOrk fw which this permit U LqweC. �V My workera' compensatlon Insurance cartler aiW polcy numbar ere: Cartier: Poliry NumEer. (Th/s sectlon need not be complete0 i! the permlf /s valued ef one hundred dd/ars ($100) or Iess.J ❑ I cerUfy t�at In Ihe pertormance of Ihe work for which ihis partnit is issued, I shall no� emplq any person In any manner so es to bewme subject to the workers' compen5ation lews at Califamle, entl egrea that It I should become subject lo Ihe warkers' compensetion pmvLsions ot Sectlon 3700 of ihe Lebor I shell torNwiN comply with these provisjoF�s. Applicam Sipneture: �� % Dete: � � r �� WARNINO: FAI�URE TO SECV OR RS' COMPENS ON C9V RAOE IS UNLAW FUl AND SWLLL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO ONE HUNDREO T}IOUSAND DOUARE (f100, ), IN Af�RION TO TN�OST OF G17MPENSATION, DAhNGES AS PRONDED FOR IN SEC110N 3108OF THE UBOR CODE, IMEREST, AND ATTORNE'f5 FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirm thet I em force arW eMect. Lic. # _ contredor� CONSTRUC710N LENI untler AGENCV: Chapter 9(commendng wlth SecUon 7000) ot Dlvision 3 of t�e Buslness end Professlons Code, anA my Ilcsnse Is In tull Class M Date: — i(� ❑ I �ere�y aNrtn that Ihere is a construC�ion Iending egency tor the paAortnance of �he work for w�ich Ihis pertnit is issuetl. (Sec. 3097, Civil Cotle). Lendets Neme: Lendefs Addres9: Signeture: OWNER-BUILDER OECLARATIONS: Dete: I hereby aHirtn thel under penelry of perJury thet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor Ue followinp reeson (Sec. 7031.5, Business entl Prolesslons Catle: My dty or counry which requires e pertnit lo construct, elter, Improve, demdlsh, or re0air any struqure, O�ar to iis Issuflnce, elso redulres Ihe epplicant for such pertnit lo flle a sipnetl statement t�at he or she Is Iicensed pursuent to !he pmNslons of the ContreMoro LJcense Lew (C�apter 9(commendnp wit� Sectlon 7000) ot Dlvision 3 01 Ne Buslness end Professions Cotle) or thet he or she is exempt therelrom and the Casis for Ihe alleged exemption. Any Nolallon of Section 7031.5 by eny epplicent for a permit suD�ects tne applicem ta e civil penelry ol not rtwre then INe hundred dollars (5500).): � t, es owner oi Ihe property, or my employees with weges as their sole Compensetlon, WILL DO 7ME WORK, and the structure is not inlentleO or oNered tor sele (Sec. 7044, Business and Professions Code: The Conlractors License Lew does not apply Io an owner ot property who builds or improvaz Nereon, and who does such watk hlmself or herself or ihrough his or her own emplqrees, provitled Ihat such improvements ere not intended or ottered lor se�e. It, howaver, ihe building or improvement is adtl within one year of completion, Ihe owner-buil0er wlll have ihe burtlen ot Droving that he or she did not build or improve for purpase of sale.). � ❑ I, es owner of ihe properry, em EXCLUSIVELY CONTRACTNG WITH LICENSEU CONTRACTORS to construct the pro�ect (Sec. 7044, Business antl Professions Cotle: The camracmrs License Lew does not eppty to en owner of proDerty who bu1105 or impmves thereon, end who wmrects tor such prolem wit� e contrector(s) license pureuent ta Ihe Contrectors Licenso Lews.). ❑ I em axempt un0er sec. SlgnaWre: Ownar ID verllletl Dy tlrivers Ilcense. ❑ Yes ❑ No Business entl Professions Code lor ihis reason: Vedticetlon o1 Ownership by (rype of daument, i.e. - property tex bill ar deed): Drlvels Llcense No. Date: Expires: DIVISION OF INDUSTAIAL SAFETY VERMR CERTIFlCATON: ❑ 1 �ereDy certify Nal no excavation five (5) or rtrore teet in tlept� into which e person is requireA to tlescentl, will be matle in connectlon with work euihorizetl by thls permit, and ihat no building siruclure, scattdding, talsework, or demoliiion or dismantling ihereoi, will be more than thirry-sI: (38) feet high. (Chap. 32, Grp 2, Art 2, Sec. 341, TIIIe 8, Calitomia AdminlsiratNe CotleJ. ❑ As owneo-builder, I will not employ anyone to do work which would require e permlt trom tha Division ot Industdal Sefery, as nated above, unless such pereon hes e pertnit to do such work irom Ihe diWsion. Signeture: Date: DIvlslon ol Industnel Satery Permil Number: ICEHfIFlCATE OF COMPLJANCE AND AUTHORQATION OF EMAV: I certlty under penalty af per�ury Ihat I have reed ihis ap0��eNon and state thet ihe information given is I cortecl I egree to compty wit� ell stete lews end ciry orUlnances relating ro bulMing con5trunion, and authodze representaUves of lhe Ciry ot Costa Mess to enter upon Ne ebove�descnbed pmperty tor Inspection purposes. I agree not to occupy or allow occupenty ot eny building authonzed by Uis permil until f nel insDection. CODE I, �xsvecTroNnae 1618 Fi.etl System Flnel Fire Preventlon 1268 Pool Spe Finel 200 Flnal Re-Roof 201 FInaI BIocWRetaining Well 202 Final Factory Fire Place 203 Final Sign 204 Final Demditlon Peg 1i�5 � � { v � Date COOEI p15PECTIONTYPE 206 Flnel MechaniCel 20B Final Plumbing 210 Finel Electricel 212 Finel Fire Preveniion 220 Final Planninp Approval 222 Final Siie 250 Final BuildingiOccupanry Pdffi I[�LS (714) 754•5273 • Fax (714) 754-4856 • www.ci.costa-mesa.BUILDING PERMIT n FAIR Df;IVE, COSTA MESA, GA 92626 .lob Address: 758 W 19TH ST Suite: Vicinity: CARPORT ONLY ParcelNumber: 42227122 Zoning: npp�icant ROBERTS, WALT � Address: 1653 SUPERIOR AV - . . - -- � � , . � Phone: (949) 642-7222 COSTA MESA, CA Zip: 92627 Owner: KAMPHAUSEN, BUCK Address %NEPTUNE SOCIETY OF OR CO SACRAMENTO,CA Phone: P 0 BOX 246810 Zip: 95824 Contractor LEE ROOFING OF COSTA MESA Address: 1653 SUPERIOR AV COSTA MESA, CA Zip: 92627 , Arch : Address: Zip: Phone: License: Phone: (949)642-7222 License: 349686 - Eng: Address: ISSUED BY: Status: ISSUED Applied: 04/10/2001 Issued: 04/10/2001 Phone: License: � ; "'' � � � i . ^; SCOPE OF PERMIT-, ' `� '" , REROOF�CARPORT ONLY FOR THE "NEPTUNE�SOCIETY": T/0 CAP SNEET, INSFECT SHTG (OPEN BEAM 1' X 6' T.G.) .� B.U.R. 1/�ROSIN, 1/2$# BASE, 2/11# PLY & 1/72H CAP SHEET - HOT ASPHALL �:,� � � � � 1000 SQ-FT " � .'.� �-, .. � r . - � � '� ., . -_: . _.l . ., _— - -. ---FEE SUMMARY ,;�- � ' , � � Plan Check: � $0 00 ��/ :'' Calc Valuatiorc ' Sz eoo o0 Permit: SMIP Res:. SMIP Com: � � Other:' Inspection: Total: $83.25 $0.00 �."$0.59 $0:00 $0�,00� 583.84 � �� Claim Valuation:.'" � $z,eoo.00 - �,� , , — _` ,;/: i. � , , _,_�i`,";�V�� " ��._, �� . .,r., , - , . ,•�:r,. � < �� - � f ��` �, ! � �i%//>`��/ , ,� , � . � ��., ,./�%��r,, �� =�`�.� � ; PLANNING & ZONING �% / ��;-; j `� /, SETBACKS � ' �. ' . . , . � �,, i �., �. �,(,� . ,-`\ ,\\ �,, i MAINSTRUCTURE Front:�0.0 V� Rear - 0-0 Left 0.0 -," ,;�� Right -�0,0,' ,' - � _ �, :� - . . _ _ . .: �� V . � ' . , ' . . -� � ; j.. . ACCESSORY Front� 0-0 --��. Rear 0-0_ � - Left � 0.0�� Righti ;�0-0 �� ._ , . . - `� - �,,ci. PARKING Ex�sti"a: 0 '�-Requiretl: � o— _ Proposed:� ;�Oi'�"_�' _ -�-�_, _ _:�i�.. _ , NOTES: � NOTICE: The work authorizetl by this permit shall comply with all applicable handicap access requiremants under California statutes and related regulations. (Ord. No. 92•28, § 1, 1241-92) EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for Ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inspeetiona and final epproval must be obtained. Failure to obtain inspections and tinal approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 zaae-ae �eroo� WORKEqS'COMPENSAnON DECLARAnON: � I hereby eflirm under penalry of perjury one oi iha �ollowing declarailons: . ❑ I h�ve and wlll maintain a certificate of wnsent to self-Insure for workers' compensation, es provitled tor by section 3700 0l the Labor Code, tor the peAortnance of the Work lor which t�is permit is issuetl. B�I �ave erid wlll maintain wwkers' compenSallon insurance, a5 required by sectlon 3700 ot the LaDor Code, for the peRormance ol Ihe work for which Nis pertnit is issued. My workers' compensation Insurence cerner antl policy numDer are: Cartier: Policy Number: (lhis section need not be oomp/efed i! Me permif !s vu/ued ef one hvnCreO dd/ers (5100) or less.) ❑ I certiy ihet in ihe peAortnance o1 Ihe work for which Ihls pertnit is issue4 I shell nol employ any person in any manner so as lo becoma subject to Ihe workers' campensetlon laws oi Califamla, and egree Ihat It I should become sub�ect to the workers' compensation proWsions of Sectlon 3700 oi ihe Labor Cade, I shall IORhwith comply wit� these provisions. '//� � ApPlicant SigneWre: `�/ • � /?it/L� S Date: �� WARNINO: FFILUFE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL AND SNALL SOBIECT AN EMPLOYER TO CRIM�NAL PENALTIES AN� CIVIL FINES UP TOONE Hl1NDRED TMOUSAND DOIIARE (E100.000), IN ADDITION TO THE COST OF COMPENSATION, DAM4GES AS PROVIDED FOR IN SECTION 908 OF THE UBOR CODE, INTEREST, AND ATTORNEI^S FEES. IICENSED CONTRACTORS DECLARA710N: �'� I hereby aHirtn t�at I am licensed under pmWsio Chapter 9(commencing with Section 7000j of Division 3 of iha Business and Professions Code, end my license Is In full torce a'W ettect lJc. k Ctass % Contractofs Signeture: .� ^ /l i Date: "%� " CONSTRUCTION LENDING AGENCY: ❑ I hereby aHirm that there is a conslruction lending egency for the peAormance of Ihe work for which this permit is issued. (Sec. 3097, Civil Cale). Lendels Name: Lenders Address: Signeture: Date: OWNER-BUILDER DECLARATIONS: I hereby eftirm Ihat under penalty ol per�ury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW far the tollowing reason (Sec. 7031.5, Busineu and Pratesslons Cotle: Any ciry or counry which requires e permit b construct, elter, improve, tlemolish, or repeir eny siructure, pnor lo its issuance, also requires Ihe epplicant for such permit to Ole a slgneO stetement Ihet he or she is Ilcensed puBuflnt �o Ihe provlsions of Ihe Contradors LJcense Lew (Chapter 9(commencing with Section 7000) ot DlNsion 3 of the Business entl Profeuions Code) or that he or she is exempt iherefrom end the basis for the ellegad exemption. Any violetian of Section 7031.5 by any apP��a�t far e pertnit sub�ects the epplicant to a civil penalry ot not more than live nunaretl aollars ($500).): ❑ I, as owner ot the property, or my employees wlih wages as iheir sole compensation, WILL DO TME WORK, and Ihe siructure Is not intentled or aHered tor sele (Sec. 7044, Business and Professions Coda: The Contrac�ors License Law does no� appty to en owner ot properry who builtls or improves thereon, and who does such work himseli or herselt or ihrough his or her own employees, provitled that such improvements era not Intendetl or oMered lor sele. It, however, the 6uilding or improvement is sold within one year ol completion, the owner-builder will have ihe burden of proving tha� he or she tlid not build or improve for purpose of sale.). ❑ I, es owner oi �he property, em E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS b consWct Ihe project (Sec. 7044, Business ana Protessions Cotle: T�e comractors License Law tloes not eDP�Y �o an owner ol property who Eulltls or Improves Ihereon, antl who contracts lor such project with a comraIXor(s) licanse pursuent to the Contrectors License Laws.). ❑ I em exempt under sec. Slgnature: Owner ID verifietl by tlriver's Ilcense. ❑ Yes ❑ No Business ana Pmtessions Code for this reason: Vedfication ol Ownership by (type ol dacument, i.e. - proDerty tae bill or deed): Drivefs License No. Date: Expires: DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: ❑ 1 �ereby certity that no exwvatlon Me (5) or more feet in depth into which e person is reQuiretl to descend, will be matle in connaction wit� work amhonzetl by this permit, end thet no builtling siructure, scefloltling, telsework, or demolition or dismantling thereof, will be more than thlrry-six (36) feet high. (Ghap. 32, Gry 2, Ah 2, Sec. 341, TWe B, Califomia Adminlstrative Cotle). ❑ As owner-bullder, I will not employ anyone to do work which would require e permii trom the Division ot Indusiriel Sefery, as noted above, unless such person has a permit to do such work irom Ihe division. Signeture: Date: Division o1 Intlustnal Safety Pertnit Number: CERi1FlCATE OF COMPLIANCE AND AUTHORIZATON OF EMRY: I cenify under penelry oi perjury that I have read this appliwtion anC state t�at the Information given is correct I eg�ee to comply with all state laws antl ciry ardinances relating to Gulltling consWctian, and authorize representatives ot Ihe Clry of Coste Mesa to enter upon the ebove-described property tor inspection purposes. I egree not to occupy or allow occuDancy of any building authorized by lhis permit until final inspection. I Owner(s) a . a r An Or AUlhorized Applicanl CQ�E �, INSPECTIONTYPE 1678 Fised System Final Fire Prevention 1268 200 Pool Spa Final Final Re-Roof 201 Final BIaWRetaining Wall 202 Finel Factory Fire Plece 203 Final Siqn 204 Final Demolition QajF� INTITIALS ` �� (�"v� ua�e s�-/D-O/ Date CODE I INSVECTION TYPE 206 Finel Mechanicel 200 Finel Plumbing 210 Final Electncal 212 Finel Fire Preventlon 220 222 250 Final Planning Appro�al Final Site Final Builtling/Oaupancy Q�E INfR1ALS I � 0 PPOJECT RDDNESS: OWNEfl'S NAME: AOONESS: COSTA PNCHIENGINEEP: ADUPESS: rx' sr �N�T: B,UCK �CANTA ST 9`6..7 • � � • flEG.NO.: UNIT: PENMITTEE: MAIO PI,UMBING ( 714 ) 568-1555 aoosess: 1780 E, MCFADDEN SANTA ANA CA 92'704 ' U�:ENSED LONTPRCTOB OECLANFTION; 1 nere0y allirm tlat I am lirenud un0ei provbions ol Ctwpter 9lcommencinB �� Section .7b00� a!�ivision 7 0l lhe Busines5 an0 Pmkuiws CaJe. antl my license is in futl force anG eflect. cirvuc.:pq6527 sTnTEuc.:393597 ��C�sS C-20 � oaie: �^��'4 1 Signature: �� WOPNEB$' LOMPENSATION OECIAXATION: I hereEy allirm lhai I �ave a[eridkat! ot WnSen� lo Sell-insure or a cerii�iwte ai WOrk¢r5' Comce�sz�ion Insy,rancg, o� a c rtilieQ £opy the�eol (Secipn 3800. LaG. ) POLICYNO.:O/91%O�—FS`j E%P.ORTE: 1�OSI92 comeaNv: STATE FU13D r] Cenifiea copy is Aere6y fumishea. � Cenilietl copy is filea with the aty Builainq Division. �ale: �^�ir I � ppplicanL �,�� E%EMPTIONiBOMWOBIIEPS'COMPENSRpONOECIAPRTION: (ihissecuonneeAm�becompkteAilthepermiiisloronehu�hred�E100�orlws). I tenity I�at in ihe Oedarmance of t�e work lor wNch ih5 Oermil is issueA, I shdll not emDloy alry persOn in any manner so as to become SubleCl lo ��e WOrkers' COmpensali0n Laws ol Cali�Omia. Dale: Signamre: NUTICE: If. alte� making t�is Ueclaration, you shoNd Uemm¢ SUGject to t�e Workers fqmpensation prwisions ot ihe la�or � Coae. you mus� forthwith wmpy xi�h such provaions or tNs perrttit sluG be QeemM reroketl. CONSTflUCTION LENDINC RGENCY: I pereGy atlirm Itat Inere is a constmction ImAing a0em.y br t�e pehormance ol ihe work for wMcn inis oermit is iSsuea �Sectian 3097, Civ. C). LENOEfl: aooness: OWNEP BUILOEfl UELtABRTION: I �e1¢Ey allirm I�a� I am eeempi �mm f�e CAntraclar5' S1ate License Law for tne followinp reason (Section 70.71.5 Business and Proles5ional Ca�e: Any city al munty which revuires a permit Io consiNct. alter, impmve, aemolish, or repair any sVucNre. prior to its issuanc¢, also reQuires Ihe aODlicant lor suc� permil to lile a sipned statement ihat �e/she is licensed pursuam Io I�e provision5 0l i�e Coniratiors' State Licenu Law (CtuDter 9(commencin0 vn�h Section 7000) ot Oivision 3 of the Business antl Prolessions Code) ar Ihal he/she is erempl I�e�etrom anE I�e OaSis lof �he all¢qeA exemp�ion. Any viola�ion o� Seciion 7031.5 by any app�icanl lor a pErmil subjecis ihe 0ppliWni to a civil penalty of not moR tlun five �untlRO EotldR (f500). � I. as owner of t�e pm0eny a my empIoy¢es with wa0es as ��eir sde mmpensauon, vrill tlo tAe work. an0 �he ��.1 strucwre is noi inlentl¢a or otler¢� lo� sale (Section 70«. Buvness an0 Pmlesdonal Cotle: T�e Camractors' State License Law aaes not apON �o an ownei al a propeny wlp oWes or im0�wes t�ueon, anG wtn dces suU woA Oimsell/nersell or ihmupn N5 Or �et Own emDloyee5, D�oviE¢G Ilui Suc� imOmv¢m¢ni5 are rwi int¢nOM Or oll¢retl lOr sale. II, �owever IAe bUiltlinp or impmvemenl is solU witllin one year ol completion, ihe owner will have Ne Guraen af ptovin0 ��sne aia not UuilO or impmve lorl�e ourpo5e ol 5ale�. I, as owner o� the O�oOetly. am grclusivelp wnlractin0 wii� IicenSeE cantractors io constmct the D�olecl (Section 704E, Business ❑ antl Pmlessians Coae: 7he Can�racmrs' Slaie Liunse Law aces nol apply to an mvne� 01 prope�ty wtw buAOs or imDmves tAereon and wlro CONratiS �or Suth proj¢�IS Mtii� a Wntratlof(5) lit¢n5e DursVani Io IhB fAnifatlors' Staia License Lawl. I am aware ihat o�oot ol Ineir woder's Compen5ation insurance snoule Ge pwvi0ee to me. � I am exemp� un0er Seclion: B. 8 P. C. lai I�is �eason: Daie: Ovmer. I Do nereGy cenily I�at 1 am aware ol ana unaersunC I�e reQuiremen6 al WGlornu HWIt� antl 5]lety Cotle Seciions 25505. 25533, antl 2553d antl Itlat I or any luture �uilaing Or,�upant wilVwill not (tirUe ane��neeE lo wtnGy wit� Said slate coaes antl the requirements lor a permil lor co�siruction ot moEiliWtion Imm Ilie Air OuaOty ManaAement Oisi(ict. PeskEntial consWction apP��cations are exempt Imm IIIC52 pfOviA0115. Daie: ADO�� I �¢re0y [¢tlity I�ai I �ave reaC rttis applicalion anU state itui i�e above intormation is mueci. I a0�ee �o tompty with ail cily an0 county o�tlmances ana 51a1e laws relaMg to budqing ConSlNction an0 �¢reUy autlqr¢e repre5enla�ives ol I�is [iiy Io enier upon �he a�ove-men�ioned pmpeily lor m50ecimnc pwposes. � � Date:��2—\ ` Signalure: oriver's �icense or Socia� Security a: i641�46 Wlnte—Bmltlinq; Green—Cpde EnlorcemenL Canary—APPlicanl; Pmk—Revenue; GoltlenmE—Assessor CITY OF COSTA MESA — BUILDSNG PERMIT PERM NO; P 052998 PERMIT'NO: P 052998 PLAN CHECK NO; N GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: PLTI PURPOSE; OTH JOb DESCRIPTION ; GAS LINE/OUTLET FOR THE"NEF�TUNE SOCIETY" SQ FT: CLAIM VALUE: CALC—VALUE; GROUP UCC; H-2 / COMMENTS: THE " NEPTUNE SOCIETY" �N-if if -%dE iE �7F�1f �7f If lE if iE �f �f �IE if iE ii-lE # if�iF dE iE iE 1E #� �k iE ie �1F �lF if �t iF if �)F iE �M -1E if-iE �)f iE �It if iF�E #if �3F �%iF -% 3f iE iE iE �IF iE iE dE M dF�iF if jFiE if �lf iE if if K� jE if iEiC Z O N T N GS ERT�B�AUCIKRSE M E N T S ------------ MAIN BUILDSNG ---------- --------- ACCESSORY BUILDING --------- FRNT; FT IN REAR: FT IN FRNT: FT IN REAR: rT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REO• PROV: PARCEL: 42227122 2NE: REF NO: PLANNING N15T'ES> � ie iF if it iE �IE iE �F iFY.� 1F iF if if IE iE 3E #E 3E aFlF iF 3f iF if iF iE if if iF iF iF if iF if 1f ik iF if !F ir iE iE iE 1E iE�ib if'iE IE if iF iP iF if� if?4 3E jE 3E iEjE iF If 1E ah if iE iE if iF if � aF iE �F 3f iE iF D E V E L O P M E N T 5 E R V-I.0 E S,�• R E Q U I R E M E N T S ZONING AFPROVED BY '� — DATE: HUILDING APPROVED BY : ' DATE: �,, APPLICA3ION ISSUED BY; DATE; �2, iF�lfiEiEiErtifiE#EiF7E*jf#IFifk*ifififif . .` r �iFiF1Flf3liFiF4iFiFafiEiF #E# iElfiEieiElflEif�iF3EiFifiFiEif�ifiEih#�iFiilfiEiEiEifiE3fitiFlFlEiFiFiEiElEifiEM�iF .iE 3hif�EiEiFiFN�ififdFif?fiFii�itifiki(�iF�IFifRiikkiE3'rii�if��if3F�lf LEGALIZATION;N F E E S LT M A R Y STRUCTURAL ScGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 2�SY SMIP/NON—RES P],AN ZSSUE FEE 3,00 BDILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DtiE TOTALS----> 2.00 3,00 0.00 5.00 5.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 5,00 OVER/SHOkT; ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHEC}t 5.�� i61E iF iElE iP 1F if af if if # �F if #E iF IF 1F IF 1f iF ff 1F iF IF le iE iE if- If k iE 1F aF if ik if if �lf� if i4 i(� 1E i(� iE 1! �k iF ik �E 3f �E if 1f iE �Y aE �F iF �IF i!� 1P 1t #° 1! iE if jE 7f iFle if IF 3f iE if !b if iE I N D I V S D U A L F E E A R E A R D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST PLU 1 GAS PIPING SYS OF 1 TO 4 OUTI.ETS 2,00 2.00 END OF rEES ii� �:,G5�;37—Gi.��?;37 '� C3T ' . QATE: 1r;22.'S' 'ii:_a 7.':J� r CONSTRUCTION AND�LANNING � �OOL PA ' APPROVQLS PermiE,,# Date Inspector qppROVALS' Permit # Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil PipO-Undrgrnd. , 53. Steel Reinforcement $. Electrica� Conduit UTitity�Undrgrnd. . 54. Forms 4. Electri;al Conduit-Undrgrnd. - 55. Electrical Bonding 5.�Sfjel Reinforcemept ' 56. Rough Plumbing & Pressure Test �. 6. �Electrical UFEF Grnd. 57. APPROVAL TO COVER�GUNITE �- 7. Footings _ 58. Electrical Conduit•Undrgmd. ,8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. . 60. Backwash �ines, P�Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 17. Property Sewer Line & House Connection �� 62. Backwash & Receptor-Final 12. Sewer Cap . 63. Heater & Vent•Final 13. Roof Dra�ns � 64. Plumbing System • Finai l4. Rough Plumbing 65. EfectricaV-Final 15. Rough Electrical-Conduit 66. Solar SYstem•Final � 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Ro�gh Electrical•T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace � • APPROVALS Permit # 21: Ducts, in Structure. ., �- 70. Underground Hydro � . 22. Ducts, Ventilating . 71. Produc[ Piping O Gas � Oil 23. Gas Pipe^Rough & Test � .. . 72. Underground Flusr . 24. Roof Framing � - � 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing � � -� � 74. Overhead Hyclro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27' Frame and Flashing '. . . , 76. Dry Standpipe ' � 28. Lathing�& Siding . • -• 77. FIXED SYSTEM FINAL 29. Insulation - . 78, FIRE PREV. FINAL � 30. Drywall�Nailing / � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat . �.'•-"� 79. FINAL'INSPECTION , 32. Electrical Power Meter-Final I �' 80. FOOD CERTIFICATE ISSUEO 33. Final Electric � � y' Notes: :Y�. � 34. Final HeSting & F,ir Conditionipg �� ` -!�� . , . , � , 35. Finai Gas Pipe�Test � �k{� �,�/f,: . � � 36. Hood or Canopy . � ` � / ,it ' ' � 37: Final Fadory Firepiace . � . �/'l'' . �38. Final Plumbing _ � �`!l (�� - 39. Water Service�Final� �h' � > < 40. Gas Service•Final , , , � 41. Solar pomesticFinal . � �� 42. Backflow Preventer �� ,% 43. Backflow Irrigatian ✓ � 44. �andscape Irrigation System ' " � . 45. Sound Attenuation � ' ' 46. Handicap Regulations 47. FINAL 5TRUCTURE & BU[LDING /• i 48. FINAL PLANNING ,�,� � _ 49. Electric Release ta Edison ��r„ . 50. Gas Release to Southem California Gas Co ' i ��', .. ' 51. CERTIFICATE OF OCCUPANCY � . - � No. Date PB0.IECT RD011�SS: �, �, 1 n r OWNEfl'SNRME: $UC KAMPHAUSEN & " qoqness: PA4'RICR J. HROWN 200 ROOLINGWOOD DR ' VALLEJO CA 94591 707)644-7474 RPCH/ENGINEER: • j ROOflE33: . "I � L�P /.-,1i� IINR: HEO.NO.: uxrt: PERMITTEE: O/ H ' (�T O%� 6 4 4—�J A% 4 nooness: Q00 ROOLINGWOOD - VALLEJO CA 99591 IICEN5E0 CONTMCTOR DFCLAMTION: I hereUy aHirm ��at I am IlcenseA untler provisions oi Chapter 9(commencinA with Section 7000) ot Division 3 oi t�e 6usine55 anA Profeuions Cade, and my license is in full torce and effect. cm uc.: s1nTe uc.: cuss: Daie: Sipnature: "IBREBS' COMPENSRiION OECIAMTION: I hereby aflirm t�at I have a ceNficate oi consent to seli-insure or a certificate of WoAers' npenution Insurance, ar a cerlifie0 coDY thereof (Section 3800, LaD. C). eLICY NO.: E%P. OA7F: COMPRNYi ❑ CeNIieE coDY �s hereby fumis�etl. ❑ Certifie0 wDY a fil¢d vnth the ciry Builainq Division. Oate: oz�c: _.�,[:� NOTICE: If, aiter Coda, you must CONSTHUCTION IFX wAich ihis permit is i Mo�iwm: ' fAMPENSRTtON OECUMtION: (iTis section neetl not he completeE tl Ne pertnA is lor ane huntlreC (E100) a less). nca at the xrork lor which Ihis perm' sue ,�employ any�o� y manner w as to become �ensation Lavrs of Califomia. l �_ SlOnature: T_ !��y — � ip this tleclaation, you shoul0 became sublact to the Wo rsrNE ' Campensatlon Drovisions of ihe Lahar �ith comDly wit� such pmvisions or this Oe�mit shall he tleemed revokatl. �GFNCY: I here0y atlirm that tAere is a constmction Ien0in0 apenry tor the Detlormance ol tha work for (Sectian 3097, Civ. C�. . OWNEB BUILOEP OECLARATION: I �ereby affirm that I am exemOt imm t�e Contacrors' State License Law for t�e fallowing reasan (Section 7031.5 Business an0 Protassional CaUe: Hny ciry oi counry which requires a permit to constmct, alter, improve, demolish, or repair arry siructure, D�or to its issuance, alw repuires iha apDlican[ for such permit to lile a signed stat¢mem that he/she is licensetl pursuantto Ne proNsions althe Contrzctars State License Law(ChaD�er9�commencing with Section 7000)a/0ivision 3 oft�e Business � anA Protessions Cotle) ar tha� �e/she is exempt tAereirom antl iha 6asis for t�e allepetl exemption. My violation of Sec[ian 7031.5 by -�v applicant for a permit su�le�ts tAe apD�� o a ciNl Denalry af not ma2 t�an fve �untlreC tlollars (SSOU). 1, as owner ot t�e pmpeM or my emj1loyees vnih wayes as t�eir sole comDensation, will do the work, an0 Ne 1. � SINC�11fC IS OOf IpI211CCd Of URCfEU �Of Sd10 (Section 70a4, Busmess anA Pro/essianal CoOe 7�e Camractors Sute License Law Eoes not appty ro an owner of a Dmperry who Dullds or imD�aves thereon, anU w0o tloes such waM �imself/herself or tMouph his or �ar own emDloyees, proviae0 that such improvements are notintended or oflere0 for sale. Ii, however��e builEinp or � �� mD�ovement is soltl within ane year of comD�etion, Ihe owner vnll hava the burEen oi D�onnA he/she tli� nat �wltl or improve tor the purpou of ule�. I, as owner af iha D�operiv, am eKclusively contractln0 with licensed caNractors ta consimct tAe Omject (Saction 7044, Business ❑ and Pmlessions CoOe: 7he Cantactors Sfate License Law Eoes not apDN �o an owner ot properry who �uilds or imD� �hereon anA who coniractsior suc� Drojects c�th a conVactor(s)license pursuanito iha Contactors' State �¢ense Law),I am aware that prool of their Worker's Compen5:4ion insurance s�oultl he D�a�i0e0 ta me. - '��, I am exempt unaer Section: B P i � 4 9 B. 8 r. C. �orihisreason: //Z_vLL WORK BY OWNER Date: ��Z'�J�l n Owner. I Eo hereby certiry that I am awam of an0 untlerstanE t�e requiremems of Califamia Healih an0 Safet oEe Sections 2550.5, 25533, and 25534 an0 ihat I or any future Cuiltling occupant wilUwill not (circle one) nred to compry wit� ui0 state catles anOl�e repuirements for a Dermit tor constmction or moditication irom [he Nr �ualiry Manapament DisMct. Resitlential consimction applications are exempt fmm these proNsions. Date: Applicant ' I �ere6y cenity tAat I �ave read this aDPlication an0 state t�at t�e aEove informaGon is carrecl. I apree ro mmpN ��h all ciry antl counry or0inances antl state laws relatinq to �uilCinp conslrucfion antl �ereby ya�onze apresentatives oi this ciry ta enter upan t�e a0ave-mentionetl D�oDeM �a��nsDe bn purpo es. / �ate: Sipmwa: �� Orivets License or Social Secunry x: . 18nJ8 W�ito—BuilEiig; Green—Code Enlo¢amani; Canery—Appllcenp Pink—Revenue: GOltlanroC—Assassor - CITY OF COSTA MESA — BUILDING PERMIT PERM NO; IH 098749 PERMIT NO: IB 048749 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: PERMIT TYPE: OTH STR PURPOSE: ALT JOB DESCRIPTION : LEGALIZE EXPIRED PMT #G39582 SQ FT: CLAIM VALUE; 1,000,00 CALC—VALUE: GROUP OCC; B-2 / COMMENTS: PLANS SUHJECT TO INSPECTOR *******�-**-�**�-�-**��-*�ac-at**-�t**-x�*at*�*-x�**��at�t*-�t�t**��x-*-�rari��t �t**�t�t-�*�-*�r**x-***�x�*-�t**�*�t+e�at 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 ---------- --------- ACCE5SORY HUTLDING --------- � 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; 42417210 ZNE: REF NO: PLANNING NOTES> > . ****�t�t�*�t*�r�t��*�tx�t*x*�t**�t�t*****��t*�t******�t**�t�t�t**�t+��tx****+��t*�t***�t*'*7�*'�ie**+c*� D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T.S 20NING APPROVED BY DATE: � BUILDING APPROVED BY : DATE: "' APPLICATION ISSUED HY•. DATE: O'8c1'r/ D 3fiEiEiFjfifiEitiEkjEiE3Eif�ifif�tifitiEit �e .. . , iti(�iE3Ei(�3E�E3kiEaEi�'��itit iE iE iF jF 1t if it jE ik f! iE i! iE iE iE it iE iE iE �f iE it it iE iF 3F it jE iE iF iE ik iE if !E iE iE 1E iE i4 . sE * iF i6 dE iF iF �f iE ik if if ik 1t iElE iP±k i4 dF if i! dE iE iF ik jt 1E 3E ik.i(� iE 3E �E 3E jE 3E iF LEGALIZATION:N F E E S' M M A R Y STRUCTURAL SEGMENT:Y HLDG PMT PLUMBING ELECTRI.. MECHANIC FIRE SMIP/RES GRADING PERMIT 30.00 PLAN SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ISSUE f�LAN—CHECK TOTAL PAID � DUE TOTALS----> 30,U0 0.00 0.00 30,00 30.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 30,00 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING�PLAN—CHECR 30.00 iE k 1F 1E If iP iE if iE * �F 9E 9F ik jF iF �lk dt iE iE iE �E iE 3E df if iE ik dE iE �t �F if ff 3E 9f iE iE it iF iF iE iElE iE jF iF ik iE 9E iF ik iE iF iF iE iP iE ik iE iE iF iE iF iE �E iE iE 9E 9k 1F iE iF fE 9E iE iE �E 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 NS 1 BUILDING RE—INSPECTZON FEE END OF FEES 30.00 30.00 ok onob�397-�ODbE397 -��,�a =a.uL �r�TE� �8f24t90 TIPlE= 2w:06 � � - � �CO{'JSTRUCTION AND PLANNh.,. - �OL & SPA ; AP�'ROVALS �� Permit # Date Inspector qppROVALS Permit # Date Inspector i � 1.'iemporary Electrical Service or Pole 52. Pool & Equipment Location , 2. Soil Pipe-Undrgrnd. 53. Steet Reinforcement 3.' Electrical �onduit Utility-Undrgrnd. 54. Forms �' 4. Electrical Cond�it•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, O'Undrgrnd., Test ' 9. Water Pipe�Undrgrnd. - . 60. Backwash Lines, P�Trap, O Undrgrnd. 10. Structural Floor System �� 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection . 62. Backwash & Receptor�Final . 12. Sewer Cap - 63. Heater & Vent-Final � � 13. Roof Drains ' 64. Plumbing System � Final i 14. Rough Plumbing . � 65. Electrical-Final � 15. Rough Electrical•Conduit 66. Solar SYstem-Final I 16. Rough Electric Wiring , 67. Fencing & Access Approval ' ' 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling • 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Cqnditioning . FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil - 23. Gas Pipe-Rough & Test . � 72, Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing . 74. Overhead Hydro 26. T�Bar Ceiling (Structuraq & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. � Lathing & Siding �� 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat t , 79. FINAL INSPECTION 32. Electrical Power Meter-Pinal � �� 80. POOD CERTIFICATE ISSUED 33. Final Electric � ;'�! Notes: 34. Final Heating & Air Conditioning �� . i • 35. Final Gas Pipe-Test' � , „ ,' 36. Hood or Canopy � � , ". 37. Final Factory Fireplace • . 38. Final Plumbing . � 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomesticFinal 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation 46. Handicap Regulations � 47. FINAL STRUCTURE & BUILDING ? � 48. FINAL PLANNING y 49. Electric Release to Edison - 50. Gas Release to Southern California Gas Co 51. CERTIPICATE OP OCCUPANCY No. Date ', / �• i : Applicant to fill in all spaces exee0< <�ose wit�in �eavy portler Ilnes anE sign all appropriate Oeelarations. CiTY'OF COSTA MESA CONSTRUCTION PERMIT ProjectAddi�s 7S' Fi' �✓' /i7H �- _ Appl�.an�e-.Clailin�ddre5s �f� W /97N� ST_ Owner's Name Ra ��I� .��T�A S phone �3�• x3`� Address 7S� `%Y. /9TN 1's. CpS��Y<<4ny ArchlEn9. LicenSe No. Address Contractor'sName 9�'T�Q� %• izo0(f�e Phone�;Ax3� Addresslmailing) �j� � %� � Ciry License No. LICENS�D CONTRACTOR DECLARATION I�he�eby eRirm thd[ I aT licensetl untlet provislon5 ot Cha�ter 9(tommenCin9 with section 7000) of DiviSion 3 of the Business antl Professions Cotle, antl my licensp is in full force antl etiect. LICCOSC C�dS � �� • ' �� . �,. .l:v'��7 . � _ KERS' CO PENSATION DECLARATION aby attirm tnat I have a certiiicate ot consent lo selbinsure or a cerNficate �f Worksrs' CompensaliOn Insurante, or d certi(ietl <opy thereof (SeCtiOn „`--d00, �ab. CJ '.'rolicy No. Company eCertifietl copy is hereby turnishetl. Certi(i¢tl copy is Hietl with Me city Builtling Div7sion. Date AppliCant E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This seclion neetl not be comDle[etl if the permit is for one huntlretl (5100) or Iess). I certi/y [nat in Ihe p¢rtO�manca Ot lbe Wo�k for which thi5 p¢rm�t iSlssuetl, I shall not mploy any perzon in any manner so as [o become subjecl to the Worker o pen ation L,awS Of Californi_y—_� p� Date � Si9nature f� NOTICE: If, aft making this tleclaration, you sltoultl become subject to.the Worke�s' COmpensd[iOn provi5ions of the Ldbo� Cotle, you must (orthwlth comply with suGh pwviSiOns o� IhIS p¢rmit shall b¢ tleemetl revoketl. CONSTRUCTION LENDING AGENCV I hereby difirm that Ihere is a tonstruction lentl{ng agencY for the performance of the work for wbich this Oermi[ is issuetl (Secqon 3097 Civ. C.) ltntler's Name Lentler's qtlaress OWNER BUILDER DECLARATION 1 bereby aHirm lhat I am ezempt from the Contraclor's License Law for the /ollowing reason (Sectlon 7031.5 BuSiness antl Professional Cotle: Any city or county Which require5 a Oe�mit to Const�uGt, alter, ITProVe, tlemoli5b o� rGpai� ��y s[ru�[ure, prlor [o its issuance, also requires Ihe apPlicant tor zucn permit ;k;�s'�le a zi9netl statement [hat he/zhe is licensetl purzuant to the provisions oF I�Tt;�-�ontracior4 License law (Cnapter 9.(commencin9 with Section �000) o( .o:.iswn 3 of [he Businezs antl Professions Cotle) or that he/she is exempt ',.the�efroM dntl th< basi5 10/ Ihe allegGtl exemp[ion. AnY violdtlon of Settion +t;,--031.5 by any applicanl for a permit Subjects the applicanl t0 a civil ;'�^Endity bT not more than (ive nantlr¢tl dOilars (§500�. '-❑ I, as owner of Ihe property or my employees with wages as their sole compenSatio�, will tlo t�¢ wo�k, antl lh¢ st�uctu�¢ I5 not Intentletl o� Offe�etl for sale (5¢�tion 7044, Business antl Profezsional Cotle: Tne Con[ractor's License �w tloes nol appty to an owner of a property who �uiltlz or improves the�eon, anC who tloes SUGh work Itimi¢It/her5¢It o� [n�ough hi5 0� hE� own emploYees, providetl Viat such improveeY�entz ara not Intentletl or offeretl �or sale. 11, howevCr, [he builtling or ImprOvement is soltl wi[hin one year of com- ple[ion, the owner will have the burtlen of proving he/zhe ditl not bulltl or im- prove to� �he purpose oi zale). ' ❑ I, as owner oi [he property, am e%clusively contracting with licensetl con- Vactorsto cOnstruGl Ihe prolect (SeCtion 7044, Bu51ne55 dntl Protesslons Cotle: The Contractor's U�ense l2w does not apply to an owner oi property who builtls o� improves tnereon. antl who cOntracts for suth oroiects with a con- trac[or(=� Lcense pur5uan[ to me Confractor•s LiCense LawJ. I am aware tbat proot o(heit Worker's CompenutiOn insurance shOultl be provitletl to m¢. ❑ I am exemol untler 5¢ction B. $ P. C. for [his reason Date _ Owner I hereby cer[iry that I have reatl tnis application antl state that the above Iniormafion is correct. I agree to comoly witn all clty antl county ortlinances antl ztate laws rnla[ing to builtling construction, antl hereby authorize repre- sentativ@s ot lhis city to enter upon the above-mentionetl property for inspe<tio� purcos s.,,_�� N a_�, ,}9 Signature Date Orivers',LI c TYPE OF CONSTRUCTION IJ NEW U ADD L�J .aLTERATION LJ REPAIR ❑ CONVERSION ❑ OEMOLISH ❑ OTHER DESCFiIPTION OF WORK/USE OF BLDG. ��a�a X ?A�TIR�OQ TYPEOFPERMIT U GRA�ING LIFOVNDATION LISTRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ ECH NICAL ❑�OTHER �_nTP�.-��FJr �'�� PROJECT DESCRIP710N SQ. FT, oCCUPANCv� CONSTRUCTION TVPE �� VALUATION 5 I� �0� ZONE GRADING CU. VDS. ACRES_ Remarks: S � I�. .. _ ✓.. .. _ �_ 1 Q Q�i� lA Q i Sink Irrigation king Fountains ir DrainS �r Sinks Service Outlets Kitchen Sink �.dVd[OfIQS P-7rap Roof Drains Rainspaction Fee � $15 Boiler Duc[- UnderGround Duct - Structurel Duct-Ventileting � Exhaust System ❑ Multiple ❑ Firepl/Fact. Bic iC80 # Heating Sysrem & Oucting ❑0�100,000 BTU 0100,OOOBTi Reinspection Fee � . $15 0865-46, tev. 5/88 White - Bulltling; Canary - Ap0licant; Pink - Accounting; Goltlenrptl - A550ssor Showers Serviw Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto-Wash ' Laundry Trays Issue Fee Hood or Typel ❑ Canopy Typell ❑ C�L]-100,OOOBTU ❑100, System Repair/Alteration Fire Dampers Registers Issue Fee A.P. �p �"i' G e S Main Build E T Front B Rear A C Right S Left - Ping. Ref. # Planning Notes: FEES P.ummatic Washer O Construction PoleSub. Cooking Unit � Dishwasher � � . Dryers ❑Gas ❑Elec ' Fan F.A,U. Fixtures Device Boxes OUtleLS Switches Gar6age Dispoul Generator �0.5 KW C $ 3 FEES — - L zooe (� Accessory Building: Z O N I N G R '�jI Parking Req./Provided T�' E Q M ) ,_. T S. ELECTRICAL Transformer ❑ 15-50 KW � ❑ 50+KW Meter ❑up to 100 amps Meter ❑over100amps 5-15 KW � Rainspection Fee � $15 DEVELOPMENT SERVlCES REQI Zoning Approved By Building Approved By ,� . , Sub Panel � Motors�0.1 HP�1X-8 Inc. Solar �9-15 HP 076-15+ Microwave Pole Light Range Sign Standing Sections � Trash CompactOr r Issue Fee � .. SUMMARVbF BUI�pING PERMIT $ � S• 00 �'3 PLAN CHECK $ PLUMBING $ %. �� PLAN CHECK 25% �� ELECTRICAL %-�� $ PLAN CHECK 50% $ MECHANICAL $ � PLAN CHECK 25% $ FEES SMIP .� ' $ . SZ'i PERMIT '- ISSUANCE $ �. ENERGV P.C. $ GRADING 3 MICfiOFI�M $ TOTAL FEE $ � n �i OCO?9�35-C7039e»t? l,'t�-' ';.;,�. �4T�: �.9ii�iis4 �iiiL: 1�:�� . COf:STRUCTION AND PLANNINC P � - �A APj'ROVALS Permit # � Date Inspector AppROVALS �-" Permit # Date Inspector FZ n , 1. ljemporary Electrical Service or Po.le. � 52. Pool & Equipment Location 2�. Soil Pipe-Undrgrnd. � y� �', 53. Steel Reinforcement 3� lectrical Conduit Utility�Undrgrnd: 54. Forms '. 4.'Electrical Conduit-Undrg�nd. � 55. Electrical Bonding / r 5.:Steel Reinforcement , �� 56. Rough Plumbing & Pressure Test .� 6! Electrical UFER Grnd:J 57. APPROVAL TO COVER-GUNITE 7. Footings ', � � 58. Electrical Conduit-Undrgrnd. ' 8. Foundation _ � . 59. Gas Pipe, � Undrgmd., Test ' i�- 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System ;•, �- - 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection � 62. Backwash & Receptor-Final 72. Sewer Cap ' _: i 63. Heater & Vent-Final j 13. Roof Drains � •: � 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit �, 66. Solar System-Final 18. Rough Electric Wiring . �� 67. Fencing & Access Approval I 17�. Rough Wiring Sign 68. APPROVED FOR PLASTERING �i . 1$� Rough Electrical-T Bar Ceiling M � � /.r� 69. POOL/SPASYSTEMSFINAL 19. Rough Heating & Air Conditii riing � FIRE DEPT. REQUIREMENT 20' Rough Factory Fireplace n n� �� APPROVALS Permit # 7 , 21. Ducts, in Structuie j � �� 70. Underground Hydro � 22. Ducts, Ventilatin - r 9 �� j �Q G��% 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test ;� , 72. Underground Flush 24. Roof Framing_�_ '" .-. �` 73. Undergrnd.StorageTank �Gas ❑Oil , 25. Roof,Sheathing� �H �� - 74. Overhead Hydro � 26. T-Bar Ceiling (Structural) & Moy'n�ocoat 75. Dry Chemical 27. Frameand Flas�in9 �..' 76. Dry Standpipe 28. Lathing & Sidirig, ;>� 77. FIXED SYSTEM FINAL 29. Insulation "r � 78. FIRE PREV. FINAL . 30. Drywall Nailing -• � HEALTH DEPT. REQUIRE�MENT 31. Plaster Brown Coat, ` � 79. FINAL INSPECTION __ 32. Electrical Power Meter-Final �'�. S0. POOD CERTIFICATE ISSUED 1).j, �1 �, _ � „ 33. Final Electric . c j'� Notes: r� ,�. �, 34. Final Heating & Air Conditioning �p Zy�q �^ ,� � � " f� � 35. �Final Gas Pipe-Test � 36. Hood or Canopy � 37. Final Factory Fiieplace 38. Final Plumbing a 22 90 � 39. Water Service�Final. r i ��i 40. Gas Service-Final . : i41. Solar pomesticFinal %. in. �_; r: r. ..� 42. Backflow Preventer � `._ � f.� ' _ �} ., 43. Backflow Irrigation � ' ,� • - ~% • % n 44. landscape Irripation System �-';' � 45. Sound Attenuation , � '." 46. Handicap Regulations p� ' � Co 7� i _ ��' 47. FINALSTRUCTURE&BUILDING � 3a•� �" tiUB�� '--- 48. Special Requirements Complete�i 49. Electric Release to Edison ,%^ �i �. � 50. Gas Release to Southem California Gas Co '� ' 'Y,.�;t 51. CERTIfICATE OF OCCUPANCY •�' �• � ' '-' �"�� : . . No. Date ' r � '�� :+ „ r � �� ..i e PN0.IECT�ODRF�38: %SH W 18TH ST OWNER'SNRME: BUC KAMPHAUSEN 6 ' � �ooeEss: pATRICK J. HROWN � 200 ROOLINGWOOD DR VALLEJO CA 94591 707)644-7474 11flCNlEN61NEER: �ODRESS: �.,• IIEO.NO.: uxrt: UNR: � PERMIREE: OIH ( 707 ) 644-7474 �ooeesa: 200 ROOLZNGWOOD VALLEJO CA 94591 LICENSEO CONTMCTOR OECUMTION: I �ea6y aflirm Nat I am IlcenseE unEer Drm+slons ol Clupter 9(commenUnp with Sectlon 7000) oi Divislan 3 of l�e Business anU Pwlessians CaEe, anE rtry license is in tull lorce an0 aHec1. cm uc.: s��n uc.: cuss: Uate: Sipnatua: '�PI(EPS' COMPEN811TION OECURIITION: I AereOy aifirm tlut I have a uniflate ol consent tn ull-insure or a cert�cate ol Warkars' ipensation Insurance. or a ceNfiM copy thereof (�� . LaO. q. AICY NO.: �• �TE� � COMPIINY: ] CertitiM copy is tcereUy IumiS�eE. ❑ Ceni�e0 wpy is fileE vrith Ne tity BuilEinp Division. �i �� Date: M7�� E%EAIPfION FAOM WOIIKFAS' COMPFNSII110M OEIXAH�710N: (tlrs saUm nced not Ee mmppW i e peniil a fa me AutlrtU (5100) w ku�. I certiN ��t in the pertormanca oi tice xrork Iw Mric� tlus pe�mit u asue0. I SAall n empl y persan In anY ��r so az ro become su�lect Io the Warkers' Campenution Laws af Califomu. Oate: ��qT— �7�awre: NOTICE: II, atler maWnp ihis Jeclaation, you slioulE me suGiect ro t orkers' ComOensation provisions o� t�e LaEor CoGe, you must IorIMriN compty vriN sucli provNons w Na pemtit shall �e deemeE revoked. CONSi11UCTI0N IENOINO �GENLY: I �ertby aifirm Ihat there is a wnstructun IenEinp apency lor Ne peAormance ot Ihe work lor � which I�is Dermit is issueE (Section 3097. Civ. q. IENOER: 1DONESS: CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IP 098752 PERMIT NO: lP 048752 PLAN CHECK NO: N GOVT: N SUPP: Y CONSTRUCTION TYPE: PERMIT TYPE: OTH PLU PURPOSE: ALT JOB DESCRIPTZON : LEGALZ2E EXPIRED PMT #G39582 SQ FT: CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: PLANS SUBJECT TO INSPECTOR *�*+r*�r**�+r�*�***�r***�r*****�r*�r*� ar�r**�ir**�**��r****�r �*****a�**x+��e��*�r�t* �*�r�**��r ��* � Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT IN PARKING REQ: PROV: PARCEL: 42417210 ZNE: REF NO: PLANNING NOTES> > iF �F 3E it if jt iE if 3E 1E if if iE iF iE iE if it 3E iF iE iE ik ik if ik iF 3E iF iE iE iE 3f iE ik iE ik it jF if iE 1E iF iF iE iF iF jF S iE ik iE ik if if iE iP 3E iE # iF iE jE 1E 3F iF iF if 1E aE iF iF iE 3F 3E �f 3E if jF D E V E L O P M E N T S E R V I C E S.s' R E Q U I R E M E N T S ZONING APPROVEU BY . � DATE: BUILDING APPROVED BY :_ APPLICATION ISSUED BY;— iE if 1E iE it �F it it 1f if it if if iF iE if if ik iE ik it itiF it iE iE iE ik M If iE 3t ik if �E it iE 1tlf if ik iF ik it iE iE LEGALIZATION:N t' DATE: �— o?l L4J9(� � � �,��-�*�r�r�rD***�*�� * ik iE if iF iF iE if i° .c if if ik iF �E iF it it i4 iF i4 it 9E IE if iF if iF ik i4 it 3R iR 1R ib iF �F iE iF iE iF if k 9E iE iF iF IF iE 3E iE F E E S U M M A R Y STRUCTURAL S£GMENT:N OWNEBBUILOERDECUMTION: IIm2EyamrtntlutlamaempUromtMConUactors'StataLkeinaLawtmlhetotloMnpreason BLDG PMT PLUMBING ELEC1�iZC MECHANIC FIRE SMIP/RES GAADING (Sectlon 7031.5 Business an0 Protessional CoOe: My uty at counry WUUi repWra a permil to wrrsWct, alter, Improve, tlemollsh, or p ERM I T 3 0. � � repair any s�mcture. D�or ta Its issua�e. alm repulres the appkant lor suc� permt to lile a si0�� sWtement that �dsM i5licen5e0 2 r� Z pursuant to me v��s oi ene Camm�ors' Sute �icenu Law (cnapter 9(commencnp w¢n Secuon 7aa0� a� Divisbn a o� tne eusiness SM Z P/ N ON —R E S ana ero�esvons Coael w Wt neane t+ emmpt meretrom ana ene oasis mr tne auepea exemo�im. nny vb�atwn oi Sectlon 7rot.5 by P LAN ^+v ap0�� br a Derml� su�l�s me applkant to a cMl penalry ol �rot mora Ilun INe �unEreE EOAars (35001. I S S U E F E E i, as owner o� tna nraperry or my empbyees witn�es as meir sWe camoenuuon, win eo tne woh, an0 Ihe HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE 'I � siNcture a not inteMeE ar ollereA lor sale (Setlion 7W1, as aM ProlesslaW Co08: Tlm Con[rattor5' State Lkense Law TOTAL S----> 3 0. 0 0 0. 0 0 0. 0 0 3 0. 0 0 3 0. 0 0 . 0 0 Eoes not appry to an owner ol a propeM � �� or Impraves tAereon. aM who Ooes wc� vroM1 himsell/hersell or IAroup� hisar�erovmemployees,DrwiUeOlMtwc�imD�mentsarenotintenOeEorattereOlorSale.If,Irowwert�eEuilEinOor REVENUE DIVISION TOTALS--> COLLECTED• 30.�� OVER/SHORT• 00 ImD�ovement is sol0 wltldn ane year a1 comqetion, Uro owna wili �a�e Ne WrEen ol Drovin0 �Ustre �iE noI build or Improve io�mow�n�seois�e�. BLDG PMT PLUMBING ELECTRIC MECHANIC FIAE SMIP/TOT GRADING PLAN—CHECK I, as awner ot the OropaM. am ezUusNelv mnVUWO �� onVactors to construct Iha projen �Section 70aa, Busineu 30,00 ❑ anU Prolessions Cooe: The Convaclors' SWte lJu�aa Law Gces not appry to an oxner ol propeity who Uu Ids or Irtproves IAereon anEwhocontnclslorSuchOrojeclaw�Uacontactar�s�tiunseDursuanitotMContractors'StataLlcenseLaw�.lamaware iFifititiFifll�il�tjtikihilikitikftililifikiFikifitilititMitik�kikitihilititiliEififikikiFit�ri�lEitiF3kiEiFikiEilikiEik3kkiE3kil�ikif3tiE�kilitik3F3fiFiliE�Ei(� t�al prool ol t�eir Worker'S ComOansaUon insurance should Ee provlAed to ma. I N D I V I D U A L F E E B R E A K D O W N I �� I � I am exemD� unUer Sec�ion: B p'] 0 4 4 B. 6 P. C. mrtnismason: ALL WORK HY OWNER � �� Oate: Q��•� �•� Owner. ��' � v 1 �o MreOy certlry Ihat I am aware ol aM uMerstaM the repuuements ol GlifoMa MWN anG Sa�ery Code Sectians 25505, 25533, anC 25534 an0 tlwt I or any future Uuiltlln0 �Da�� ^o� (arde one) neeE ro mmply w�l� salA sule cotles an0I�8 repuirement5lor a permit lar comt�uction or mo0ificatian Irom ihe Ni� OuaGry Mampement D'sirict. NeSMenUal constn¢tlon apWiatlons are exemDt trom tOeu Drmtions. Date: �DWicant: I AereEy certiN tAa� I taro rea0IN5 apD�� te Nat tlu a0we inlamution'n artM. I apree to wmply wR� atl tlry aM munry OfEIN11ClY3f1E5Idt012W3fCIdWIQtOC111NN0��=�=b1�,��u� �i IOCnICfUD011NE1E0YB-ffIdICMlA property br inspec ion Durpase •�� Y Oate:� Sipfuture: , f E �� Driver's Liunse ar Sodm Secunry x: � �1-48 W�tla—BuilEi�p; Green—COEe Enlorcemam: Canary—ApO��^V P��k—Ravenue: GoltlenroE—Aeaesaor TYPE (JTY `�ijil D E S C R I P T I O N 1 PLUMHING RE—ZNSPECTION FEE END OF FEES UNIT COST TOTAL COST 30.00 30.00 01 QO�b8396—U0058343 Tt7�Zr `s0.00 �ATE: fl8124/9D TIME: 14aDb CONSTRUCTION AND PLANNP,... JOL & SPA ; APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector „ 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-U�drgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undr9rnd. 54. Forms 4. Eiectrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinfprcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footinqs 58. Electrical Conduit-Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe•Undrgrnd. � 60. Backwash LineS,P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection ' 62. Backwash & Receptor�Final l2. Sewer Cap 63. Heater & Vent-Finat 73. Roof Drain4 � 64. Plumbing SYstem - Final � 14. Rough Plumbing 65. Electrical-Final � 75. Rough Elec[riwl-Conduit 66. Solar SYstem•Final . 76. Rough Electric Wiring : � 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOfl PLASTERIPIG 78. Rough Electrical-T Bar Cei�ing 69. POOL/SPA SYSTEMS FINAL 19. Rough Heat�ng & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro 22. Ducts, Vent��ati�g 71. Product Piping C7 Gas ❑ OiV 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathin9 74. Overhead Hydro 26. T•Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & 5iding � 77. FIXED SYSTEM FINAL 29. Insulation .. 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i' 7g, FINAL INSPECTION 32. Electrical POWer Meter�Final �, � 80. FOOD CERTIFICATE ISSUED 33. Finai Electric � ; �j . Notes: 34. Final Heating & Air Condttioning � 35. Final Gas PiPe�Test � -� 36. Hood or Canopy , ' - 37. Finaf Faaory Firepiace i 38. Final PI�m6�ng /0 2 �'� 39. Water Servite�Final 40. Gas Service-Final , 41. Solar pomestic-Final � 42. Backflow Prevencer 43. Backflow Irrigation 44. Landscape Irripation Sysrem 45. Sound Atte�uation 46. Handicap Regulations . . 47. FINAI STRUCTUFE & 8UILDING � � 48. FINAL PLANNING '' 49. Electric Release to Edison " 50. Gas Re�ease to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date rxaecr aooxess: ' ,�, ' ST owxex•s xntr: BUC KAMPHAUSEN S .� IIbDflE3�, pATRICH J. BROWN " VALLEJ�OLCAG90091DR 707)644-7474 ppCHIFNCINEEfl: �OOHESS: xeo.xo.: UXR: UNR: PEIIMI77EE: O/B ( 707 ) 644-7479 nooness: 200 ROOLINGWOOD VALLEJO CA 94591 11CFNSEO fANtMCTON OEClAN1TI0N: I IrereOy aflirm tlut I am tiuMeO unOer DrovNonv ol Gwpter 9(commentinp wit� Section 70W) ol Division 3 oi �M Business an0 Protessio� CaEe, aM my fiume is in lull torce anE eflect. ciTr uc.: sun uc.: cusa: Date: SlpiuNre: 'ANFRS' COMPENSATION OEGAMTION: I hereGy amrm tlut 1 have a uN/kate oi mnsent ro utlJr¢ure or a unifiate oi WorNers' penution Insuance. or a cenlfie0 capy t�ereol (SecGon 3800. LaU. Cl. JCY NO.: EXP. 011TF: � �AMPANY: CeNfieE capy is �ereDy IumisMO. ❑ CerlifieO uVy is i�eE wtt� Ne dry BWdin9 Divivon. • Date: MWU�� IXEMPf10M FIiOM WOHIfFAS' COMPEIIS1ilON DECWW710N: (flis saUm rcW not Ee mmpeRO il tlx D�,S fa ona �uMaE (5100) a kssl. I ceNry that in t�e peAormance ot ihe work for wAkh this pemrit a i SueA, I SIWI not empby arry person m any manner so as ro becoma subject to �ihe W/9rk�ers'/�/P�m,p,ensatian Laws ol Glilomia. - Oare: —11l�.r—�f-+�— Sknature: . MOTICE: If, alter maldnp Iltis OeUaratlon, you 5�w10 Eernma suEjec7 m tp orkers' Comp¢nsatlon D��ons of Ne LaOor CaEe, 7rou muSl IortMvilA comply wil� SucA pmvisions or IN5 permil sha0 Ue OeemeE ramkeE. CONSTPIICTION 1FM01N0 �GENCY: I hereCy atlirm tAat them is a cor¢tructlon IeMinO a0ency lor the pedormance of ihe work lor wAic� tAis Oermil is iuuM (�ron 3097, Civ. CI. LENOER: AOOBESS: � � CITY OF COSTA MESA — BUILDING PERMIT PERM NO: IM 048750 PERMIT NO: ZM 048750 PLAN CHECH_NO; N GOVT: N SUPP: Y CONSTRUCTION TYPE: PERMIT TYPE: MEC OTH PURPOSE: ALT JOB DESCRIPTION ; LEGALIZE EXPIRED PMT #G39582 SQ FT; CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 / COMMENTS: PLANS SUBJECT TO INSPECTOR �r*�r�x��r*****�rx��x-�tat�t�-x-x-�-�**x��r+�*�r�t*�t�t�rx-*�x-�-�*x-*�t-��t�r�-*x�*�t**��r*****at�r+tat�t�r**+t*�t��t�r�r�r* Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN AGHT: FT IN LEFT: FT IN RGHT: FT IN PARKING REQ: PROV: PARCEL; 42417210 ZNE: REF NO: PLANNING NOTES> > it if iE iE fF iE iE jF %ik iE if it iE i!!f �f it 1!!E iE if 1Elf ik if if iE if ff 1E k iE fElE i! �E 1E 3E 3E if if iF if 1E iE fE iE 3E Ik iE iF if iE iE iE iF 36 iE it i! iE iE iE iF iE iF jE ik iF �E iE if ik if iE iE 9E if D E V E L O P M E N T S E R'V.�Z C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : APPLICATION ISSUED BY:� �EihiFitiEiE1E�741kikiEi4iFifiEiEiEiEiklEMifiF'ic iF'iFiF"R"iFiF dFlk *!t 1E iE IF i! 1k i! iE �k iE!! iF 1E jE It 1f 1E �F iE iE ik if iF iE 1F iF iF iE iF ik iF LEGALIZATION;N F E E DATE: DATE: �8%�%D �� if it il� it i(� K IE 3f iF rt�iFiFiFjf i4 ik iE iF iF iF dE 1E iE * iP iF iF iE 1F ik if iF iE ftlElE if ik iE iF fE 1E 1Elf �)t iF iE 1F fF 1f it iF if U M M A R Y STRUCTURAL SEGMENT:N OWNEPBUILOEflOECIAMTION: I�ereOyalllrmtAatlamexamD��romtAeConiractors'Sute�icarise�awiorma�ouwnnpreason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business an0 Pmlesslonal Cade: My ciry oi munry wNch repuires a permit ta consiruc�. alter, ImDmve, Uemolis�, or p ERM I T 3 �. Q � re0air any simctum. pdor to its issuance, also mQulres t�e appliwnt lor sucA Dermlt to lile a 5i0�eE statement Ihat he/she Is Ilcense0 � pursuant io tne provisions ot ine Contractors' Staie Licenm Law (Cneptar 9lwmmencin0 w+�� Secqon 7000� of Oivisian 3 ot tAe Businass 2 S R SM I P/ NON — R E S antl Prolessions Code) ar t�at �els�e Is aRemD� t�erelrom anE Ne �asls lar Iha allepaE exemD�ion. My Wolailon oi Section 7031.5 �y PLAN ^^v appliwnt lar a Darmit sub�ecis t�e apD��l to a cWll penalry of not mom IWn IWe AunAreA �ollars (5500�. I SS UE F EE ' 6 as ow�er o� tne procenv or my em oyees w�m �es u metr w�e wmpenutwn, wi�i ao tne won�. ane tne HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE �, stmcwm b not Intanded ar anered ror sa�e (�ecuan 70aa. B ess and Pmtex4ona� CoOe: ina Comractors' Sute License Law TOTAL 5---> 3 0. 0 0 0, 0 0 0, 0 � 3 0, 0 � 3 �. � 0 , 0 0 Eaes nat apply lo en owner ol a propem/ x1ro huiltls or improvas tAereon, anE wlro Ooes suc� vrork himself/herself ar thraup� M5 or �er awn employees, proWOeO tMI 5uU imprwements are �rot InteMeE or atlere0 far ule. Ii, tqwever the huiltlin0 or R E V ENU E D I V I S I ON TOTAL S--> C OL L EC T ED • 3 �. � 0 O V ER / S HOR T' 0 � ImD�%'ement is 5010 wltNn ana year ol compleUon. Ne owner xill luve tne OurEen at O�a�np Ae/she did not EuilA or ImO�ove �ortneourposao�u�e�. HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK �� B 30.00 I, az awner al t�e D�aperry, am exclusivery conVacWp vAth Ilcense0 coniractars ro construct t�e D�olect �Sectlon , usiness ❑ an0 PraleSsions CaOe: The Conirac[ars' State Lkmse Law Ooes nm apply ro an m�.rer ol D��ty �� or improws tAereon and who contracts tw suc� D�q� �� e convacta(s) Ikense Dursuant to ttie Contaqors' Stale Uceme Law�. I am aware ihat proot ol t�eir WarNer'S Compensatian Insurvxe SMuIE be DrovWaO lo me. � I am eaemo� untler Secuore B p'] Q tj 4 B. 6 P. C. �ormureason: ALL WORK BY OWNER � oate: �� i �9 o Owner. I tlo �ereEy cerlity tlwl I am aware af arM unEerstanC Ua repuiremems ol Calitamia Hwlth anE ery a Sectlons 25505, 25533, an0 25534 anE tlwt 1 ar arry luture OalOinO accupant wllVwiT frot (drde onq neeC to mmply xitn saiG state codes anE tire reQuirements for a per�t lor rnnstruclun or modlficatim trom Ue N'�r u�iry ManaOe�nt OisUict. Ik5lEential rnnsiruction appliwtlons are eaemDt Irom Ihese Drovivms. �ate: �wd�w�i[. I here�y ceNty tAat I taw rea0 t�5 apWiwtlw aM sute orEinances anE state laws rtWiq m ddl0o�0 wmWc6o^: C��M farinSpecYon Durp sc5. Date: � Sipnama� Oriver's ucense or Saciai Security d: 6 CortKt. I apree to COmpty xi[n aA tity uld COunry �ttatives W tlis qtY m emer upon tle a0wo-rtentiaiM ten�J6 Wni�e—Buibirq: GrearCOEe Eniwcemam: Cennry—l�pplican�: Plnk—Ravanue: GdtlanroE—Avesmr iF it i! i! iF it it it k iE if iF it iElE it i! ik it k it if iF 1f it iF k iF iF ik iE fFlk iF iF M �F ik it 1f �t 1k iE 3E i! iE if iE if if IE iF iF iE iFlE i!!F iE ik ik iE iF iF iE fE ik IF i6 iklf iF �F k if iF 1E iF iE I N D Z V I D U A L F E E H R E A K D O W N ` � TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST � MEC 1 MECHANICAL RE—INSPECTION FEE END OF FEES 30.00 30.00 Q1 QQOQ8399—Q00h339S T O"Y _: C'v DATE: 03/24/9D TI�IE: ?4t�5 /; COAVSTRUCTION AND PLANNr. . ,)G� a SPA -f�PP�OVALS Permit# Date Inspector qppROVALS Permit# Date Inspector ,'1. $emporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit UtilityUndrgrnd. 54. Forms 4. Electrical Condui[•Undrgrnd. 55. Electrical Bonding 5. S[eel Reinforcement 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER G�nd. 57. APPROVAL TO COVER�GUNITE ' 7. Footings 56. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, � Undrgrnd., Test � 9. Wate� Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. . 10. Structural Floor System , 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final �Z. Sev"e� CaP 63. Heater & Vent-Final 13. floof Drains 64. Plumbing System � Fina� . 14. Rough Plumbing 65. Electrical�Final � 15. Rough Electrical�Conduit � 66. Sofar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval . 17. Rou9h Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOLISPA SYSTEMS FINAL 19.rRough Heating & Air Conditioning FIRE DEPT, REQUIREMENT 20., Rough Factory Fireplace APPROVACS Permit # 21. DuCt4, in Structure 70. Underground Hydro 22. Ducts, Ventiiating 77. Product Piping OGas ❑Oil 23. Gas PIPe-Rou9h & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structurall & Monocoat � 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. InsulBtion � 78. FIRE PREV. FINA� 30. Drywall Nailing ��' HEAL7H DEPT. REQUIREMENT 31. Plaster Brown Coat ' 79. FINAL INSPECTION 32. Electrical Power MeterFinal i: 80. POOD CERTIFICATE ISSUED 33. Final Electric ; . Notes: 34. Final Heating & Air Conditioning �p 1 9u �� 35. Final Gas Pipe-Test ' �� 36. Hood or Canopy j� � � �i 37. Final Factory Firepiace � ' 38. Final Plumbing � 39. Water Service-Final � 40. Gas Service-Final 41. Solar pomestic•Final 42. Backflow Preventer 43. Backflow Irrigation 44, Landscape Irripation SYstem 45. Sound Attenuation 46. HandicaP Regulations 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNING 49. Electric Release to Edison � 50. Gas Release to Southern California Gas Cn ` 51. CER7IFICATE OF OCCUPANCY No. Date • 7HOJECT ADOflESS: % rj 8 yi 19 TH 5'[' OWNEfl'S NRME: $UC KAM�H[�USEN F. aooeess: �ATRICK J. BROWN 200 ROOLINGWOOD DR VALLEJO CA 94591 707)644-7479 PNCHIENGINEEN: , AOOflESS: NEG.NO.: UNIT: UNIT: PEXMITTEE: NOOR ELECTRICAL SERVZCE ( 714 ) 631-8777 nooness: �gl WEST 17TH ST J-4 COS MESA CA 92627 LILENSEO CONTPRCTOB 0 flA ON: I �e�yby allirm �hat I am licensed untler Dmvisions ol Chapler 9lcommencing wi�h Seclion 7000� ol Division J ol th sines antl Pmlessions CoOe. ana rtry license is in lull foae an0 elteci. CITYLIC.:O3O % TATE��.:�{SL%%4 CLRSS: C-1� Bale: ' �� SignaWie: _'_(,-1L�_� OflR NS'C PENSa OECLANATION: I�er¢byal�irmthallhaveacetliliWleo�tan5enito5el4insur¢oraterli�icateO�WOrkefS' om sa Ns r c rD, rtifie opY �hereol (Section 3800, Lae. �f�. uc� o.:U��g,a�—�� EXP.�RTE: U4IOS�91 �J cen�rea coor � ereby misAed. � g¢nifietl caDY is fileE wi�h the ciry BuildinA Oivision. Daie' � � � Applicant: �— Z 1— ' � I E PTI XOM WOB 5' fAMPEN5RTI0N OECIANRTION: (This sec�ion neeU noi �e compl¢[e0 il ll�e permi� R lo� one hunOree (5100) or less�, }-Eertil at in Ine Dehormance ol t�e work lar Whic� �hi5 Dermit is i55ueA. I shatl no� em0loy airy person in any manner 50 a5lo become s� cl lo IAe Worker5 COmpensatian �ax5 0� Califomia. Oate: 5ignature: NOTILE: II, al�er making Ihis tleclaraliun. you s�oultl Eecome subject lo t�e Workers' Compensation provisions ol Ihe Labar Coae. you must tonnmlh rAmv�Y �� sucn o�avisions or inis permit shall be tleemea revoke0. CONSTPUCTION LEN�ING AGENCY: I hereby a��irm tha� Ihere is a cons�mclion lentling agency for ��e pertormante of �he work tor whicn tnis oermi� is issuetl (5eciion 3097. Civ. C). LFNOEfl: aooe¢ss OWNEB BUILOEP OECIABRTION: I �ereby aliirm that I am exempt imm th¢ ConVactors' State License Law lar the fallowing reason �Seclion 7031.5 Busine55 antl Pmlessional CoOe: qny ci�y ol counry which repuir¢5 a permit �o Constmci. atler, improve, Aemolish, ar repair any s�mciure, D�ior Io ii5 issuanc¢. also re0uire5 Ihe applitant lOr Such Oe�mi� to lile a SiAned Slalemeni I�ai he/she is liC¢nSeA pursuanuo Ihe pmvisions ol Ihe Coniracmrs' S�a�e License Law (ChaD�er 9(commencing wilh Seclion 7000� oi �ivision 3 0l I�e Business ana Pmlessions Code) or ihal he/she is eKemp( lherefmm and ihe Casis for the alle9ea exemplion. My violation ol Section 7Iq1.5 Uy any aOP�icant lor a petmit su�le«s the applicani �o a tivil penalty o� nol more Ihan hve hunOred aollars �5500�. � I. as owner af ihe propetly or my ¢mployees wilh waAes as their sale compen5ali0n, will Jo I�e work, antl Ihe slmaure is nol imenUed or oiferea lor;ale (Seclion 70a4, Busmess antl Pmiessional Cotle: T�e Coniractors' State License Law Gaes nol apDly to an awner ol a property wM �uilds or impmves t�ereon. and wM1a do¢5 such work Aimself/�erself or ihmugil �is or �er own em0loyees, pmvi�eU ihal sucA impmvemenis are not intentlee or otleretl for sale. II, �owever �he huildinp ar impmvemenl is sola vnl�in one year oi wmpletion, t�e ovmer vnll have the OurEen af provinA he/sAe dia not Ouild or impmve lor the purpose o� sale�. I, as owner ol Ihe propeny. am eeclusively coniracting wit� Iicense0 contractors to cans�Nct the D�olect (Section 70da, Business ❑ antl Pmiessions Cotle: The ConiraclorS' State License Law tloes not apply to an owner ol pmpenq who builOs ar impmves thereon anG who COnVatts lor Sut� pr01e��5 Ni(h a conlratia(�S)li[¢n5e Dursuan� Io ��e COnifat�ars' SIafE LicenSe Law�. I am aware Iha� pmol o� Iheir Worke(5 Compensd�ion insurance 5hou10 be pmvide0 �o me. � I am e�empt unaer Sec�io¢ B. 8 P. C. ' lor lhis reason: Da�e: Owner. I do AereGy ceriily ��at I am aware of anA unders�antl Ihe repuiremenis oi Calitomia Healih antl Safery Catle $¢ctians 255Q5, 25533, antl 2553E an0lnat I o� any futute �uilAing acupdnt vnlVwill nol (circle one) neetl ta compry witn SdiA state wEes an0 ihe reauiromenis for a permii im conslmCtion or motlJicalion Imm Ip¢ qir Oualny Management Disirict. BesiOemial consimction applications are exempt Irom IhQSE pfOVIS10�5. , �, Oa�e: ADOlicanl: I hereby cetlity I�a� I have read Ihis applicatioq an� Slale Ihat ihe a�ove ortlinances and s�ale Iaws relating lo builtling coAslmction antl here�y aWM1 prapetly Iarin50eclion purpases. Da�e: I� Z-1 — °I � Si9namre: d privef5 License or Sacial SeCurily k: !} i6nt�a4 '/�'��ie—Builtling: Green—COCe Ehlorcemen�: Canary—A to wmpty wilh all tity antl county �a eni2r upon Ihe a�ove-menlionetl �/ Pink—Revenue; Gobenrotl—Assessor CITY OF COSTA MESA — HUII�DING PERM:CT PERMIT NO: IE 050741 PLAN CHECK NO; N CONSTROCTION TYPE: JOb DESCRIPTION . FEAMIT TYPE: ELE OTH LEGALIZE EHPIRED PMT tkG39582 PERM NO: I6 050741 GOVT: N SUFP: Y �'UkPOSE; ALT SQ FT: CLAIM VALUE: CALC—VALUE: GROliP OCC: B-2 / COMMENTS; PLANS SUHJECT TO INSPECTOR 3E 3(� �� iE �F iF �X� 1E �E if �F iF # iE if iFiF if iE i! af if �k i(� iE if iF jEiFdf •7F�1f iE iF iE3(� df-iE df if �1E iEiF � iE 3E if �lf �f �H� if �Yc iF �k �1(� �7f �)f �E 9F �X� �%-%� 9(� �%� i(�iE i( # i(� # 9E 9E i(� if if dF � dE iE Z N T N GS ERTEHQ�UCIKRSB M E N T S ------------ MAIN HU��LDING ---------- --------- ACCESSORY BJILDING --------- 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 REp • PROV: PARCEL: 97.417210 7NE: REF NO: PLANNING NfSTES> � 1(- 3f� aF if �ik if iE �4 if if� iF iE jf iF if IF �1F iE %iF 3F 3F if 3F iF 3E 1F if 1E 3E �iE if 1f 3F 3f iF iE iE 9f if 1k 1E if 3f if !f 1F if iE iE iE 3f �lf� if K� i(� IPlF if iF ib i!� ii� � iP 3E i(� if #�E if 1f if !F iE iF 1F �16 iE D E V E L O P M E N T S E R V I C E S R E�i U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED HY : F �,/�— DATE: �/� APPLICATION ISSUED HY: �''► "` —• DATE: I^ ZZ�`Z 3Eit�fjf�N3F3f�1t�iE�PY��1(�3(�lEiEiEikifltaEiE�il� �iElEjF3FIFiEiE�IF1f iEif IFi49Eif%1E3E�EiEif�(�iFiEif)fiFi61t�3F�E1h3F3E1k�fifiF-%jEiEiflFif3Flf�EiP3Fifi(�ifiEA� ifx�iF�FiEiFi(�IfIFiFif�iE#K�1EjENjfiElElfiEiEifif3EififlEiEiEjEiEiE LEGALIZATION:N F E E S U M M A A Y STitUC'1'URAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANiC FIRE SMIP/RES GRADING PERMIT 3050� SMIP/NON—RES PLAN � ISSUE FEE BUILDING—DiV—> FERMIT ISSGE 'PLAN—CHECK TOTAL PAID DUE TOTALS----> 30.00 0,00 0.00 30.00 30.00 .00 REVENOE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: 00 BLDG PMT PLUMBING EI,ECTRTC MECHANIC FIRE SMIp/TOT GRADZNG PLAN—CHECK 30.00 iE iE iF if if if if iFiF iE a(� if iE iE iF If if iF iF iE i6 ,�f af iE iF lf �1F-IF iF iF if �lE 1F �1E * If iF 1E i( 3E �N-1E if iE iE iE iF if 1E �lE 3f if if ie �f X� fE lE iFiE IE �lf iF IE i(� IF iF if )F )F iE iE 3f 1f� 9f {. if if iE I N D I V I D U A L F E E B R E A K D O Fi N TYPE QTY D E S C R I F T I O N UNIT COST TOTAL COSi ELF. 1 ELECTRICAL RE—INSPECTIGN FEE 30.00 30,00 END OF FEES v ol oao�as?s-aao�ss?v p ur r�.na OAZE: G!/22/91 TSitE: C9�3d \ � � ' I CONSTRUCTION AND PLANNIIv �' SPA . � APPROVA6S Permit # - Date Inspector pppROVAIS Permit # Date Inspecto. 1. Temporary Electriwl $ervice or Pole, 52. Pool & Equipment Location � 2. Soi� 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. APPflOVAL TO COVER-GUNITE 7. Footings � 58. Electrical Conduit-Undrgrnd. : 8. �Foundation _ 59. Gas Pipe, O Undrgrnd., Test . 9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undigrnd. 10. Structural Floor System ' - 61. APPROVAL TO DECK 11. Property Sewer Line�& House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final � 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit 66. $olar SYstem-Final 16. Rough EleCtric Wiring 67. Fencing & Access Approval 57. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough EleCtrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace - ' APPROVALS ' Permit # 21. Ducts, in Structure, 70. Underground Hydro 22. Ducts, Ventifating � 71. Product Piping OGas ❑Oil 23. Gas Pipe�Rough & Test ' �� 72. Underground Flush � 24. Roof Framing ' 73. Undergrnd: Storage Tank O Gas O Oil 25. Roof Sheathing � - 74. Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing . � 76. Dry Standpipe 28. Lathing & Siding . ' �. 77. FIXED SYSTEM FINAL 29. Insulation � � i � 78. FIRE PREV. FINAL 30. Drywall Nailing � �1 ' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat ' � '_: ( 79. FINAL INSPECTION 32. Electrical Power Meter�Final . � �;`• 80. FOOD CERTIFICATE ISSUED 33. Final Electric -�� Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test ' I' � ,, • 36. Hood or Canopy `� I� 37. Final Factory Flreplace � �-� " 38. Final Plumb��g � 39. Water Service-Final � 40. Gas Service-Final . , , 41. Solar pomesticFinal � � 42. Backflow Preventer ; � 1 , � ' 43. Backflow Irrigation . ' 44. Landscape Irriqation System ' . . � ' 45. Sound Attenuation 46. Handicap Regulations _ , � 47. FINAL STRUCTURE & BUILDING -' 48. FINALPLANNING ��; 49. Elec4ric Release to Edison � i 50. Gas Release to Southern California Gas Co �� ; �� 51. CERTIFICATE OF OCCUPANCY � No Date peaecl�oow�ss: 758 W 18TH ST OWNE9'SN ME: BUC ICAMPHAUSEN 6 nooeess: pATR2CK J. BROWN 200 ROOLZNGWOOD DR VALLEJO CA 94591 707)644-7474 11RCH/ENGINEEfl: �tlDqE3S: . REG.NO.: uNrt: uxrt: PEHMIT7EE: O�B ( �07 ) 694-7474 �oowess: 200 ROOLINGWOOD VALLEJO CA 94591 UCENSEO COIRIUCTOR OECUMTION: I �ereDy aflirm Itwt I am licensetl un0er pravisians ol Chapter 9(cammencinp wit� Section 7000) ol Oivisim 3 0l the Business and Prolessions CaEe, an0 my Ikense is in lull lorce anE effect. cm uc.: srare uc.: cuss: pate: S10nalura: V mpenustioCii InsuranSce,�aN aceN edTcopy t�ereof �Sed o�3800h L�aOa C'Nfiwta ot consent ro utt-insure or a ceroTicate af Workers' .OLICY NO.: EXP. DIITE: � COMP�NY: � ] Cetlifie0 wpy is �erE�y tumistred. ❑ Certilie0 capy is IileE wit� Ne ciry BuilEinO DMsion. J � Oate: MO�� ptEMifION FIIOM WORNEHS' COMPENS1110N OEWMTION: (iNs section nreE not Oe cwnDleleA if tAa pemit,is lor one hurtlreE (f100) or ka�. � cerliry t�at in ihe peAarmance at ihe work Por whicA t�is permit is i 0, I sM1all not empl any person in any manner sa as to became 5u01ect to Ihe �W rkers' Compensation Laws ol Califomia. � � Date: �,� 2.��i n Sl9nanre: NOTICE: ��, atler mabnq Ihis tleclarafion, you S�ould ome su�le�� o Warkere ompensatlon proNsians ol tAe LaDor Cotla, you must lonhwith comply witA suc� pmnsions ar t�is Oermit shall be Eeemetl ravoketl. FONS7HULTION IFMUINO �GENCY: I hereGy aflirm [hat t�ere is a con5iruction IenOing a0ency for �he Derlormance ol Itre work for wluch tnis 9umn is issued (SecUon 3097. Civ. CI. LENDEH: RDDflESS: OWNEB BUR➢ER DECIAMTIOX: I hereby attirm Nat I am exemD� �mm the Cantactars State License Law lor tAe tWlaxin9 reasan (Seciion 7031.5 Business an0 Professional CaUe: My ciry of wunry whic� rsquires a permit �o cons[ruct, alter, improve, Eemolis�, or feDair any sRucNre, prior lo its issuance, also requlras the aDDlicant lor sucn Dermit to file a siqne0 siatement t�a[ he/she is Iicense0 pursuant lo Ne D�oWsions at tAe Contractors' State License Law (ChaD�er 9(commencinA with Sectlon 7000) al Division 3 oi IAa Bus�ness e� Protessions COCe1 a tha� �els�e Is eKempt themtrum aM �Re Oasis Iw ttu aUeqeE exempUun, My Wolation ai SecGon 7031.5 6y any aDUlicant for a Dermit subjects the aDP�� ro a dWl penalry of not mo2 Ihan Me �unEmO tlollars (f500). I, as owner ol t�e praDetly or my emyloyees witM1 wapes as iheir sole compansation. wlll do ihe work, anE Iha J SINLIU�¢ i5 n0i inlGnE¢0 0! OBef¢U IOf 5310 (SEcuon 704a, Busmess an0 Prolessional CoEe: T�e Comractors' Sl2tB LICE050 Ldw � tices �rot appty to an m�mer at a property w�o OuiWs ur imprave: lhe�ean, anE wtn Uces such wark Nmsetl(hersell or throup� Ns or her own emD�'�s, O�OeE itwt suc� impravements am not inten0e0 or attereE lor sale. Ii, Aowxver IAe CuilEinO or Impravemeni is sold vnihin ane year ol wmpletion, t�e owner will hava t�e burden al Drovinq Ae/sAe OiE not huilC or imD�ove for Ihe Durpose ai saie�. � o. I, as mmer ol IAe pmperly, am excluUvely contractinp with Iicense0 caNractors to consiruct iM prole�� (�� 044. Bus�ness ❑ anU PMessians Cotle: The Cantractors' SWte License Law Aaes nat apDN �o an mmer of Droperry wAo Ouilds o� imprwes Uereon anE who coniracts for suc0 D�al��s c{IA a coniractor(s) license pursuant to t�e Contractors Suta License Law�. 1 am aware tlw� Drool ol tnelr Warker's CompenstUon insurance slioul0 Oe provi0f0 to me. �, i am exempt unoer Section: B P% O 4 4 B. a P. C. lar ma reasan: AL WO� RR BY OWNER Date: ��, '� Pxner. I do hereW ce�Y that I am aware ol anU untlerstand the aquirements oi Califomia Mealih anE Safe oEe Sections 25505, 25533, and 2553C antl t�at I or any future �uiltlin0 occupant wilVwfll not (circle one) neeU ro cam0ly with saitl state coEes antl [he �equiremenis �or a permit tor coretrudian or moEilica�lan imm tOa Nr dualiry Manapemen� �istnd. FleeOential consimctlon aDDlicatlons ara exempt fmm these Drwisims. Pate: APDh'cant: I hertEy ceniry ihat I have reaC tNs ap0licatlon an0 state tAat tAe a6ove informatian Is corBet I a0ree to wmpty wRh all ciry anE counry arGnancesanOstateGwsrelatmpmWrilOinOmrSbuctionaMAere tlnr�reprtsentativesaftltlsarytoemeruponNeaDwo-mentianeE propeM �or im ectlon Du ases. � pate: - SIOnaWre: prive,•s �icense or saiaw secumy x: �gaL48 White—BuIItlInO: Graen—COEe Eniorcamem; Cenary—Appllcent: Pink—Aevenua; Go106��oE—Asxaao� CITY OF COSTA MESA — BUILDING PERMIT PERMST NO: IE 048751 PLAN CHECK NO: N CONSTRUCTION TYPEe PERMIT TYPE: ELE OTH JOB DESCRIPTION : LEGAL22E EXPIRED PMT #G39582 CLAIM VALUE: CALC—VALUE; PERM NO: IE 048751 GOVT: N SUPP: Y � PURPOSE: ALT SQ FT: GROUP OCC: b-2 / COMMENTS: PLANS SUBJECT TO ZNSPECTOR �t�ter�t+r�t*�r***at**-�t�rt�r3tar�x-*�-�r�t*�t�t*�x-�t*****��*�r�x�***�*�-**+t�r-x-a�*+t*-�+t�r�r+r�r+r*��-x*�x-�r+c�*�**�t�-�* Z O N I N G R E Q U I R E M E N T S ' sEraAcxs ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT ZN RGHT: FT IN LEFT: FT IN RGHT: FT IN PARXII3G REQ: PROV: PARCEL: 42917210 ZNE: REF NO: PLANNING NOTES> > if �k i4 ik it ib i! iE jE iF iE if �f �k iE iE ik jE iF iE �E iE iF �k iE iE iE fE iE if 3E iE �lE iF iE ik �F 3F fE if it iP iE it 1f iE iF iE IE if i4lF iF �ll�iblt iP iF if iE if iE it iE iE if iE 9E if 9t iF it iE 1E iE ik IF aE 1E D E V E L O P M E N T S E�t V I C E S R E Q U I R E M E N T S ZONING APPROVED HY '" DATS: BUILDING APPROVED HY : DATE: APPLICATION ISSUED HY; DATE: GXZ� �*****�+r+ex��+�****x�*+�* �ss�� x--' — �. *+�**+�****�� * ifiEikifikiFiEiE�kitiE9kiEiE�liEifiEiEiE3E�1EiEififiEiEiFifiEiEiEiElEiFiFiEiFiEiEih' iEikiliEjE*k�1f�1E�ltiEiEiEiEiEiE1EiE3EiEiEjEiEiEiEak�F3faEiF3EiFit9EaFiE9E LEGALIZATION:N F E E S t M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTR7� MECHANIC FIRE SMIP/RES GRADING PERMIT 30. 0 5 3 � SMIP/NON—RES PLAN ISSUE FEE HUILDING—DIV—> PERMIT ISSUE PLAN—CHECX TOTAL . PAID DUE TOTALS----> 30,00 0.00 U.00 30,00 30.00 • .,00 REVENUE DIVISION TOTALS--> COLLECTED: 30.00 OVER/SHORT: 00 BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING'PLAN—CHECK 30.00 it �t ik it iE if iE k i! iF ik iF 3E iE iF if if if 1k iE iElE ik iE iF iF iE ik if 3E iE �t if iE 3E iE iE f! ik iE iE iE dE if i4 3F iF if if iE iE dF if �E if it iE it iE iE iE it iE ik iE it �lE iE ik if it iE iE jt ik ik iF i: iF I N D I V I D U A L F E E B A E A K D O W N TYPE QTY D E 5 C R I P T I O N UNIT COST .TOTAL COST ELE 1 ELECTRICAL RE—INSPECTION FEE 30,00 30..00 END OF FEES D1 06068396-6D06839b Ta�'� 50.U0 OATE: 0�/24/90 TIPtE: 14:Ob CONSTRUCTION AND PLANNING JOL & SPA ' ' Date Inspector Date Inspector ; APPROVALS Permit # APPROVALS Permit # „i. Temporary Electrical Service or Pole 52. Pool & Equipment Location • ' 2. Soil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit�U�drgrnd. 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-Undrgmd. 8, Foundation . 59. Gas Pipe, O Undrgrnd., Test �, 9, Water PIpe�Undrgrnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd. r 10. Structural Floor System 61. APPROVAL TO DECK >>, Property Sewer Line & House Connection . 62. Backwash & Receptor�Final , 12. Sewer Cap " 63. Heater & Vent-Final ' 13. Roof Drains - 64. Plumbing SYstem - Final � 14. Rough Plumbing � 65. Electrical-Final � � 15. Rough Electrical-Conduit ' 66. Solar SYstem-Final 16. Rough Electric Wiring � 67. Fencing & Access Approval 17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOUSPA SYSTEMS F-INAL 1g. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 25, Ducts, in Struaure 70. Undergro�nd Hydro 22. Ducts, Ventilating 77. Product� Piping O Gas ❑ Oil 23. Gas Pipe-Fough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing , 74, Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. .Dry Chemical 27, Frame and Flashing 76. Dry Standpipe 28. Laihing & Siding �� 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat , 79. FINAL INSPECTION 32. Electrical Power Meter-Final t 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: 34. Final Heating $ Air Conditioning :+', � 35. Final Gas Pipe-Test . . � / 36. Hood or Canopy � t� ;� ii 37. Final Factory Fireplace ' ' 38. Final Plumbing � � 39. Water Service-Final � , 4p, Gas Service-Finat ' . ' 41. Solar pomestic-Final _ 42, Backflow Preventer � 43. Backflow Irrigation 44. Landscape Irriqation System 45. Sound Attenuation 46. Handicap Regulations - 47, FINAL STRUCTURE & BUIL�ING 48. FINAL PLANNING �, 4g. Electric Release to Edison 50. Gas Release to Southern California Gas Co 51, CERTIFICATE OF OCCUPANCY No. Date `�. �---- City of Costa Meu Development Services Department Building Safety Division P.O.Box 1200 Costa Mesa, California CERTIFICATE OF OCCUPANCY No. The Building located at!58 W. 19tk1 Street has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B2 Occupancy. Use of Building LOCjdllZfltlOri Legal Description424-172-10 (See reverse side for Metes and Bounds) IE48751 Building Permit No1B48�49 Electrical Permit No.rnc7� � Plumbing Permit No.IP48752 _�7_ Mechanical Permit No.I+''�48750 � Number of apartments � and/or guest rooms ISSUED T0: BuildingOfficial Tony C'De Baca Buc Kamphausen & Patrick J. Brown �c �� 758 W. 19tn 9tr2et by i �.i </. i -� � � is i�v - Costa i�iesa, CA 92G27 " v' T" Date �luqust 9 , 1991 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-a6 rev. 1/B3 White � Owner, Canary - Numerical File; Pink = Bldg. Permit File � - -- 33773 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to F(// (n Completely BUILDING '��P `A/ /� C' �"' ADDRESS I) �� OWNER ��//y-/JE 1 f(s� MAIL ADDRESS 2 . W W TEL. d U CITV NO. ZQ CONSTRUCfION O N LENDER am J � BfiANCH J N m J ADDRESS m ARCHITECT J a OR ENGINEER U � Q w � ADOaESS � aw W Z CONTRACTOR ( J Q m Z r J � ADDRESS J � W W �/' ZFCITV� ��/ w � STATE y Q LIC. NO. _� SIZE 4 OF LOT, J � TEL. � ��LS �� 1� �Pi 6 D CITV ��.Noab�,c L� NO. OF BLOCaS, � I NOW ON LOT � I� SIZE OF NO. OF Z NEW BLDG. ROOMS STORIES U EXTERIOR WALL ROOF COVERING COVERING J USE OF BUILDING AND WORK TO BE PEFFORMED a a X a � 1r � � H y Z O UI hereby acknowleage that 1 hev¢ reatl Mis epplicetion antl state � that tha above intormation is correct anG apree to comply wfth � all laws regulatin8 builtlinB construcNon, entl I shell not employ F any person in violatian of the v.�orkman'z compensation laws of y the State ot California. ZI hereby cart(ty that I am proper�y p�ensatl as a cantrector under the State of Calitomia Business a�d Profesztons Code, Division 3, Chapter 9, antl that such licensas are in full force and ef o� am ezampt from Me p'visions ot tha $tefe 9 Callf a B 0a5 an�tl Prafe55i tl i��Q3, Ch ter'. S��. Si nat ra ot '1ST 29-7iPatr i cri, OQt371 ni.�. `��` ^ APPLICATION FOR BUILDING PERMIT E BV D TE REC IVED DATE ISSUED io �j� /6 �9-7, BUILDING ADDRESS x i � Ea� VALUE $ O� ` • \� VPE GROUP J '1 Z! nerr/1� ^i �}.. %% \ NE _/ INO.OF �I USE OF NEW� G PLAfS BUILDING VARDSAPPqOVED VARDSAPPROVED VAR.# DATE C.U.P.3W /� APPROVED APPROVED /�� T ♦ . m � SQ. FT. � THE AMOUNTSHOWN UNDER VALUATION IS FOR � THE PURP06E OF ESiABLISHING A PERMR FEE ONLV: ¢ VALVATION � �'�"' p� PERMIT FEE $ J '� � � /^/ m $ ��`� PL,AN CHECK $ E 0 ,[� � LL TOTAL FEE $ �� ._____�- `� Applicant to fiil in al1 spams witnln �eavy bortler lines anE sign a��•.�,.... �(iate eeclarations. ` . COSTA MESA •� PERMIT NO. ' TRACT NO. LOT NO. f BLOG. NO. RUCTION PERMIT G_ 39 3� C..P I 2 L� - Projatt Qddress � 7; � TYPE OF CONSTRUC�T,I/ON .'OWnel-- (dy/�� Phone /� O NEW ❑ ADD IG�ALTERATION I � AddleSS O�� Ci /FF �i _ /f/. 8. �.REPAIR ❑ CONVERSION .O,DEMOLISH Afch/Eng. �.["'�(3 •� j¢�(r!J License No. ❑ OTHER � � Addres5 Q �,- �fjn.rg�ra. �j}/L•- � DESCRIPTION OF WORK E'ZG�.J Contractor 6T� - � -- Phone TVPEOFPERMIT, • , "' 4Add�CSS y /7TN• ST• �fI S• ❑ GRADING � FOUNDAT�ON •� STRUCTURAL LIC6YSED CONTRACTOR DECLARATION . �' � ❑ TENANT ��ELECTRICAL�.�PLUMBING��MECHAN 1 hmeby aftirm that I am Iicensetl untler provisions of Charte/ 9(com- � . � �� `� �� 1+ S menNn9-wit� section �-7000) of , Dlvision 3 oi. the Buslnass antl � OTHER Pro(esilons. Cotle, antl my IlcenSe is In fu❑ torca antl .ef(ett. i i License Class �� - lice 3� 7/d S PRO�ECT DESCRIPTION -_ __ .. J. Dale - Signature � ' S4. �T. ' ��9 �� • Pr � � ' WORKERS' COMPENSATION DECLARATION _ OCCUPANCV/�'�T�tIC71_ON TYPE � /V I hereby atfirm that I have a cmHticate o( consent to sel4lnsuro or a VAIUATION Zo�P l% � ! cartifl�ate of Workers' Compensatlon Insurance, or a certHietl copy _ . r. thereof (Section 3800, Lab. C.). ;GRA�ING,CU. VDS. �� ACRES �� Pollcy No. - - ' Company - ' ' 'ertifietl topy is:hereby (urnishetl. _ . REMARKS: ` :ertifietl copy is filetl with tha tlty Bulltling Divislon. M' nnEMPTION FROM'WORKERS' COMPENSATIOMDECLARATION '� - (Thls snction neetl not_be compleCetl It the permit is for one huntlretl � � ',($300) or less). � �I cartlfy_that in the per(OrmanC¢ 01 Ihe work tor whic� this peimit IS I55ueA, I shall not employ any pe�san�in dny manne� 50 a5 [O betom¢ PLUMBING , ' . PLAN CHEGK' - subject to t�e Workers• Compensatlon taws of_ Ulifornia. ` - '' Date � Signature ' THTUBS � SHOWERS � ' ' � �NOTICE: If after makin9 this tleclaratlon, you shoultl become sub)ect ORETS. �. ,�, ' .V RINAL'S -' ' to the Workerz' Compensatlon provislons o( the Labor Cotla, you musl �VATORIES DOVBLE L'AVS " TOrthwith comply with suGh p�ovl510n5 or tnis permit s�all be tleemeE revOketl.""" _ "' "" _'- ^ " . � ' ' CONSTRUCTIONLENDINGAGENGV '� IT.SINKS " "' DISFiWA5HER5" " I hereby affirm that there is a<onstrucfion lentling agency,for;[he per- SERVICE SINKS ��. SUMPS -- -"'"' ' �-' formance ot the work for whlch thls permit is issuetl'(Secllon'3097 � Civ. CJ:--- ` � t� " - "f" " ' ' � FLOOR SINKS's � � FLOOR DRAINS- 'p" ' - '�entler'S Name � ' Lentler'sAtldress �RINKINGFOUNTAINS �, -�-� ,��'� OWNER BUICDER_OECLARATION � `� � "� � IfJTERCEPTORS CLARIFIERS ' I hlreby alfirm [hdt 1 am exempt froin.the'Contractor'S�LIcenSe Law for� .n....u.....�..,..e�<,... im�r�,.�-�nai•z.qusiness zntl Professions'Cotle' � - • • -• - - rt more man nve nunorea aoua� ,�a5 Ownel ofy[h¢ prOPefty, or )T io�e.compensation, will tlo the work, or otferetl for sale. (Section 7044, Bu Contractor's License Law tloes noi a wh0 builtls ot improves the�eon, antl through M1ispwn+employees, provltletl Inlentletl or otte�etl tor sale..lf, howe� Is soltl within one year'of completlon oi prOvin9 .he• diC' nOi owm��or Im ❑.I.-.•as -owner- ot�.the"propeity; 'a a permit [o Cons[ruc[, alteq SWIMMING POOL P TRAP re, priorto its izsuante, also re- yyqTER SERVICE . •P.�TERATION'"- - tile.d.signetl S[d[GTCnt that h¢ 't - ' �� - ' the Gontiactor's Llcense Law GAS SERV ICE /� i. 0U7LET5 � - �.7,000) .of, Divislon, 3 of the he ii�exempftherefrom antl the � yyqTER �HEATERS '. BTU OVTPUT '" -' ' �Iolation,oi.5ettiom.7031.5 by - �� ie-applicant to�a civll' penalty SEWER CONNECTIONS'- ' "` "" ' '- (5500). `' employees wi[h wa9e5 as their 'SOL'AR TANK ' COLL'ECTORS \' . ' itl the structure I5 not In[ontletl �ess antl Protessions Cotle! Tha SOLAR PIPING�SVS. - �� Hy_to an owner ot a property ` ,_ ,._ vho tloes such work hlmself or ISSUE FEE �� 'lat SUCh ITpIOV¢RIBnfS dI8 f101 r fhn-builtlina mdmornvement •..�..... . [ne:GonVactor's L�cens¢ Law). . " :� .�4•. . ❑ I am.exempt untlet Seclion , ' - _ B. S P: C. fOr thi5 } \ ' .' Y• . . 1:..'.. • reason - � - - - '�.i�• "' .} M. �•�) Datn ' � Owner' ' � • � � ' " 1 hereby'tertifytha4l have.reatl.this�applitation antl stat0 [hat [he above Inforrt�ation-is.correct. I aqree [o"comply with�alPUty an0 county o�tllnanceSantl state laws relatingSo'con5t�uction, antl hereby au[hOrize representatives of -this tlty to enter upon_ the above menUonetl ICAL _ PLAN CHECK I SVSTEM' 0-300;000 BTU � :TING . 300,000 a BTU e, „ ;RATION 0•100,000 BTU �J.b' • " ,� -� 100,000 + BTU BTU r REPAI R,'ALTEf3ATION f�5Y5TEM ' .�MUITIPLE properCY-��or � pection pu� ¢s � . � ! � ]'�� . Si9natu�e �� + Date�r�7�+ Drivers',L�cense or 5� � �SSUE FEE � CMF0865-46 l •�White-Builtlin9:,��xry-Appliwnt; Pink�Accounting; Goltlenrotl=Assessor" t\ 8364 6/IB/B2 A.P. � REAR VARD (TO P/L) � 1 PKG. SPACE RE�. SPECIAL CONDITIO G19.62 TL ' PLNTGa. RgUEFL. p�f Z�-''(�1�G' D�� PROPE�RTYNLINE j'T�C _ . . ��-' � � � PROVIDED„ �- - �/l�� PARK FEE S ELECTRICAL "� PLnN CHE -50 F�OPECL�R.� � _ GENERATOR � -0-1 KW_1,30 K ,TRANSFORMER APPLIANCE - 30-50'KW_50'+K �MOTORS" ' 0-1 FIP'_1d0 HP �(INC..SOLHR) � 30-SO�HP_�50+fjp �FIXTURE52o OUTL'ETSSeSWITCH �GHS TVBE SIGNS ' "' ' ' � - POLEILIGHTS "_"-_= -' '{ PANELS " ' ' MAIN SUB ' " - - ' ,SERVICE" ' '�O�.j.' .. AMP' ' ' �- ' " _ ' _ _ ' ' _' ' _"' " _ ',�r � , �. _ . . ' . �, � . J -. � . . � - . ' APPLICATION APPROVED BV - '•- DATE�j. SUMMARV OF FEES. :BUIL'DING '• q � -- ;PERMIT EG��:�SMIP ' ,,b—.Z.+S� i � �PLANCHECK E�.�3 PERMIT�.' � ' ISSUANCE S - �PLUMBING S—.�-� ` � � �, ' PLANCHECK E - , GRADINCo .S ELECTRICAL E�p....�,� � �� E PCAN CHECK $ - MICROFILM�S� ' � �MECHANICAL E '- %, _ -TOTALFEE�$�' ' ' �� LE55 AD- � � ' ' PLAN CHECK S -- VANCE PC $_' " . �i .�: � ' � - . . ' . ` _ - .�� - FINALFEE 5..�{,�- \- . . � . ^ � CONSTRUCTION AND PLANNING ?OOL & SPA �- _ _ .�I '�t � APPROVALS Permit # _i.'L1� Date Inspector _ - . � Date � - Inspector- APPHOVALS Permit # .t� � 1. Temporary �lectrical Service or Pole 43.� Pool & Equipment Location '- �`-� Soil Pipe-Undrgrn • 3'2 4. Steel Reinforcement - - - 3. Electricai Conduit Utility-Undrgm 45. Forms. �� ' '4. .Electrical Conduit-Undrgm � . 46. Electrical,Bonding_; -� � ' - - . tee ein orce � ' 47. Rough Plumbin & Pressure�Test - � 6. Electrical UFER Grn - ,� � 48. APPROVALTO COVER-GUNITE � ' � 7. Footings Y.� ,? � 49. Electrical Conduit-Undr rn ' � B. . foundation 50. Gas Pipe, ❑ Undr tn Test ' � - 9... Water Pipe:Undcgrn � - 51. Backwash Lines P-Tra-'- ❑ ndr m - " - 10. . Structural Floor System ' 52. APPROVALTO DECK "'- '' . 11. Property Sewer.Line &.House Connection._ ', �53. Backwash & Rece tor-Final ' " � � ' ' 12. Street.Sewer Connection � � � 54. �Heater & Vent-Final � . ' 73. Rough=�PluriiHin s+F .��.%�� ;v n`i: �4+v.c - 14. Rough ElectriaConduit W�. GC 41-82- �56�." �Electrical-Final- 15. Rough ElectricWiring = l _ - 57. Solar System-Final - - - ' � ' 16. Rough Heating & Air Conditioning - - � � � _ ' . • encing & Access Approval " 17. Ducts, in.Structure' � � APPROVED FOR PLASTERING � 18. Ducts, Ventilating • . . _ . . 19. Gas Pipe-Rough &Test � � � ' - . 60. POOL/SPA SYSTEMS FINAL � � ' . , � 20. Roof Framing - . � ' - - - � - � 21, Roof Sheathin ' � - � - j � � { - ' NOTES: ' � 'G3 � - a �-�s � `�jb� ' J � 22. Frame and 6lashin 23. - Insulation - ' . ' � -�rp_� � p. . /. 24, lathing & Siding - -(- _ � ` i 25. Drywall Nailing ('�.e C <j`'" S .� - 26. Plaster_Brown Coat ' � ' 27. Electrical Power Meter-Finaf � '" �-9-�a. � Wo-Q.Q l� µte..Q2 0 26. Final Electric � f � 29. Final Heating & Air Conditioning ' ' eL"'� 3 � • 30. Final-Gas Pipe-Test ' - � � 31. Final Plumbing � /� Y3 a 'w� ✓e '4 � ' . 32. Water-Service-Final O e� .d,S-r.0 i „c.a � ' ' � - 33. .Gas Service-Final - � 34. $olar pomestic-Final � � � . 35. Landsca e S rinklin S stem � 36. Sound Attehuation ; - - ' 37. Handicap Regulations � - - � ' 38. FINALSTRUCTURE&BUILDING j . // - � 39. Special Fequirements Completed _.../ 3� /- -S'$ � �,P .D ��'P O �fl- 9- - 40. ' Electric Release to Edison � � � W m �� o it ("o,u.vrc .�t we 41. Gas Relea e to Southern California Gas Co. ' $ � i ( � SK. /CY '� 42. CERTIFICATE OF OCCUPANCY �J'y(''JI �L� �/ CO O- �UK!/�C W� /R( / T� �9� L�/HLL. � ..-. . No ,4d00 � ,� Date! ,� �/ i :oy�, v a � ` • - . _ �� Do /yo7��SsoY � c o�p, UN7�L c1�H�t�c�,'�`L, ✓c Ntr,dTo��-lr-�3 CitV of Costa Mesa Oevelopment Services Department Building Satery Division ' P.O. Box 720� Costa Mesa, Californ'�a CERTIFICATE OF OCCUPANCY No. QCV�I�� The Building located at 7S8 hTP,�t 19Yh StT'2Et has been inspected and found to comply with the provisions ot all City ot Costa Mesa Ordinances applicable thereto for a Group li-2 Occupancy. Use o! Building C�11@Ydl CAtttr2Ct�T�S Off�UE �]Tff� YdLYl Legal Description 115-344-55 1See reverse side for Meces and Bounds) I—¢73Q B-3972 P-44A8 Building Permit No. C+-39�iFi Electrical Permit No. Q63936 Plumbing Permit No. G"3436 Mechanical Permit No. M'�623 Number of apartments `�` a�d/or guest rooms -0 tSSUED TO: Building Official //• 6l l.E�!/�fL �±rF RodaPss �� by �/C1.� !rd ,7,''7 � �se w. �.9rh st. , cosrA r� �e ;�. / - )iL,,�z� 1 �� This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the 8uilding Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. GMF 1015-46 �ev. 7/83 White - Owner, Capary - Numerical File; Pink � Bldg. Permit File � AOGlicant to flll in all sDaees wlthln �eavy porEer lines antl sign all appropriata Ceclarations. � � CITY OF COSTA MESA PERMIT TRACT NO. LOT'tJO. BLOG. NO. � CONSTRUCTION PERMIT I Z ,r�q D , 9093 6/'22/82 Project Address M, TVPE OF CONST UCTION � ' � � o- Own¢tifJ, (� Phane �.� ❑ ryEW ,B,qDD ❑ ALTERATION -- - � _ Addles ,�, � /7 �u' t . A ❑ REPAIR� ❑ CONVERSION ❑DEMOLISH ` Arch/Eng. � - Licenu No. ❑ O7HER ' � ' AddreSs OESCRIPTION OF WORK' _ A'P' �� 3y` 9 I�NE C, Contractar s�- � � PhoneC �� l TVPE OF PERMIT � -•� SETBnC T. Addfe55 // /y. � jT. G.M.. .O GRADING� ❑ FOUNDATION 'Q STRVCTVRAL - 1 � VARO LICENSED CONTRACTOR DECLARATION ❑ TENANT O ELECTRICAL ❑PLUMBING-OMECMANICA 5 p I nereoy aHirm thct I am Ilcensetl untler provislons of Charter 9(cam-� ' � i• „ � E ,_ , menUng' wlth secti0�' 7000)'-ot Divislon -3� oi tha Business -and- � 0 OTHER -- •• J R�GHT .. � Pro(e551on5 Cotle, ��tl my Iicenso is in full force antl effect. . �. �, , REAR VARD (•TO VROJECT DESCRIPTIOM _ License Class -'� 1- � Llcense No. �37�6g . - � �� PKG. SPACE RE�. Oate'/J•.ZI�S:l�Sf9nature .a.Z�A.- 2,.?.,c..: -So.Fr.'•�.. , . -- -• - . WORKERS' COMVENSATION�DECLARATION -- ' OCCVPANCY� CON52RUCTIONTVPE STREET WIDTH I hereby a/Brm tM1at � havo a certtlicate of consent to sel/-Insura�or a Q� � ZONING APPROVF cortitiwto of'fW�orkers''Compensatlon InSuronCe, or a certi/ied'copy- � VALUATION ONE t�ereYNo�c `-3 -��mpany �Ps�NC�M�NS �GRAOINGCU_VDS. ACRES SPECIqLCONDITI :ertifletl COpyAs ber¢by furnl5hatl. . - _. REMARKS:. ' � i:i K� ._ PLNG. REF. $ '." � PROVIDEC PARKFEE . r 29.37 TL� �. � ertlfie0 copy Is t��atl with the clty Bu�ltling D ��s on. EXEMPTION�FROh1 WORKERS'-COMPENSAT�ON�DECIARATION � 0 - - ^ � �� - ' � 1This 5¢Ctlon.n¢etl not.be completetl it the p¢rTil.iS for one_hUntlr¢tl _ - +� SE100) or less). 1 " _ ' _ ' "' " ' - - • - � certiy Nat In the perfo�mance of.the work tor which [his permit Is "� _� ISsueA, I shall not emP�oy any person In any manner so as to become PLUMBING , PLAN CHECK " � - ELECTRICAI -- -' PLAN CHECK,' ' - subject to the Worke�s' Compensation Laws o1_Glifornia. " _ _ _ Oate Signature 6ATHTV85 SHOWERS - � "' � ' - ' - NOTICE: It after m3king this tleclxration, you shoultl bocome subjoct 701L•ETS - �� URINACS "'�"' - ':GENERATOR '0-1'�KW_1-30 KW - to tha Workers' ComPenSaUon provislons of [he Lzbor CoEe, you must -� � TqANSFORMER - . torthwilh comply wi�� such provisions or thii permit shall be tleemetl IAVATORIES DOUBLE LAVS ''' 'APPLIANCE - 10-50'KW_50 ��KW -- -- revokea. . . - -. -- - - � - - -- KIT. SINKS� - '� DISHWASNEHS' - " ' �MOTORS' �CONSTRVCTION LENDING AGENCV -' � OA HP_IQO HP ' - � ' I hereby aHirm•that thero Isa construction londin9 agency for tho per- SERVICESINKS � ';�' SUMPS ''-"- �-' �(�N0.50LA0.) �-10•50 HP_SO+HP �� -_ � formante �fithe,woi K� for_ whic�'thls�per�ml( I5 issuetl (Section, 304] Civ.-C:). _K ' ,(� �, � � � ' FLOOR SINKS FLOOR DRAINS � - � � ' FIXTURES'" - ' OUTL"ETS SWITCHES' - ' - � Lenaer�s, Ndm¢ - ' ' LentleCS�ACtlress �"� ' � `- � DRINi(ING FOUNTAINS'�� ' -- � - - - GAS TVBE SIGNS - - - � - - - }. - .. , _�__. -_... .I', . . � OWNERBUILDEP�OECLARATION�- ' - �-' � WTERCEPTORS � �� CLARIFIERS - � � '�POCECIGHTS' -'-'--' ' -- ' - - --- ---- 1 I herGby a(firrtl lhdt 1 am exempt from [he ContreciOr'S LlcenSe'Law tor - the'f011Owing reason (SecHon 7031:5 Buslnes5 antl'PrafeSzionz CoGo: - SWIMMING POOL - " ' 'P'TRAP ^' ' � - _ _ . _ Any Uly or county �+hith requirei a permil lo tonstrutt, aller, ' POLES METERED �SVB .- Improve, tlemolish or repalr any strutture;'prlor to its lsivance, also rc- �yyqTER SERV ICE � ALTERATION - � - "�PqNECS ' MAIN' - SUB ' ' � qWres thc ap�.IlCan[ ror su<h permil to flle a slgnetl 5[dt0ment that ho ' . is Ilcensetl pursuant ro the provisloni ol the'Contractor's Li<ense Law GASSERVICE OUT�ETS �; SERVICE�' "- �- -AMP' (Cnapter 9(commoAcing with Sectlon 7000) ot Dlvlslon 3 0l lhe � ' � Business antl Professlons Cotlo� o�'tbat n¢ Is exOTPt lherctrom anG'the yyqTER HEATERS' "-BTV OUTPUT � - - �- � - - n•cis for the alle9etl exemption. Any vlolatlon ot Settlon ]031.5 by � � app�ltant'for'a'Permlt su�jects the'apP��ant ro�a civil penalty SEWERCONNECTIONS "' ' ' - "' ' ' - ' � • ' - ot mOr¢ Ihan fiVe huntlretl tlolla�s ($500). .... 1, as owner of �the property, or my employees witti wagei as their SOLAR TANK ` COLLECTORS 1- '' '' - - - .- sole.compensation,.w��l Uo the_work,.antl the structure is not intentletl - or of(eretl for wle. (5e«�on 7044, Businesz antl aotessions Cotle: The SOLAR PIaIrvG SVS. � � —� - -' ' - ISSUE'FEE '"" �- - CO�GdClO['S L1C¢OSB ��V-tlOGS OOL dpply SO.dO Ow�Cf Ot d P�OpB/ty ' -' ( w�o builtls or impro�es tha�eon, antl wno tlocs sucn work himself or ISSVE FEE � � ' � - ' ' APPUCATION APPROVED BV � �• OHTE -- �~ th�ough hls.Own emp�oyres, p�ovitletl.tnat SUCn If�p�Ov¢mCnts drC not Inlendea or otferetl lor sale. It, howeveq the bWltling or Improvemen[ MECHANICAL PLAN CHECK ' ' -� ' 1 ' is 5oltl.withfn onoyoir oi compleHon, lhe owner wlll have the burtlen SUMMARV OF FEES „ - ot proving he tlitl ho[ builtl or improve !or the purpoie o1 sale�. BVILDING - HEATING SVSTEM 0-300,000 BTU ❑ I, �at owner-�of tne p.operry, am exclusivery- contracting wilh qND DUCTING ' ' - - _ �PERMIT , i � � p SMIP ., b '� � ❑<en5etl tontraclors to conslruct tne project (Section ]044, Buslnesz 100,000'� BTV � PLAN CHECK f� PERMIT antl Aofessions Cotle:'The Contractor's Licensa Law tloes not apply to�� - �- ISSVHNCE S � en owner of ptoperly wh0 builtls Or ImprOves lhCreon, antl who con- qEFRIGERATION 0-300,000 BTU � 'PWMBING S - � tract5 irom such -piOlects -with� a �contracto�(5) IlcesnBtl pursuant �o � 5�'STEM � � � ' - - - + � �� • � the Contractor'S Lice05e Law). 100,000 � BTU � �1 �PLAN CHECK E - •� GRADING E ❑1�am�exempCuntle/��ction " -' -" -B.&P.C.forthis BOILERS BTU F .ELECTRICA� 5� � 'y- ' "' 'E' _ /¢ason ' - ' -' ' - � " � MICROFILM E" Oate Owner SYSTEM REPAIR, ALTERATION -- PLAN CHECK S ' - '- MECHANICAL' S TOTAI. FEE E_ I herebycertirythatJ M1ava roatl thiz application antl state lhat [he above EXHAUST SVSTEM MULTIPLE - . ' �E55 AD• - InfOrmallon is coneG�. I agree [o comply witb all Nty antl county �PLANCHECK E - VANCEPC -5,-- ' Ortlinances antl sta[e I?ws rolatlng to construttlon, antl hereby autho�lie ' - � . /CprlSGnta[IveS ol tP�S dty to enter upon Ihe a6ovo m<rltlonetl " PropertY tor�<t�g[� P�ose; �� Signaluro �� '��<<'�^"- Date�-��'�� FINALFEE § Drivers' License or 55 4F--%� < <% � ' �SSUE FEE • --- - . . , _ . CMF 0865-46 Wni[e-Builtling; Unary-Appliranq Pink-Accountlng; GOItl¢nrotl-ASSGSSOr . ., • t CONSTRUCTION AND PLANNING POOL & SPA';� ' � , ., APPROVALS Permit# ��72 Date Inspector qppROVALS Permit# Date Inspector , 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - �- 2. Soil ipe:Un rgrn � � '� 44. Steel Reinforcement � � - - - - - _3. _ Electrical Conduit Utility: Undrgrn: _ _ � � - 45. . Forms . -- - - __4.. Electrical Conduit-Undrgrn • :46. Elec[rical Bonding - � - ' . tee ein orce •� � 1$ ��'' 47. RougFi Plumbin & Pressure Test - � .. 6...ElectricalUFER_Grn 46. APPROVALTOCOVER-GUNITE - - f 7. Footings �' . Q - , g 49. Electrical Conduit-Undr m� � -� .8.. Foundation , ` . (�-�� ...0 � ' 50. Gas�Pipe,-� Undr rn; Test ' ' � � � � .9.. Water.Pipe-Undrgrn '- 51. Backwash Lines P-Tra '❑' ndr rn- - - - 10. Str,uctural.Floor System 52.. APPROVAL TO DECK ' "` - - 11.. Pr�opecty.Sewer Line & House Connection' ' ' 53. -�Backwash & Rece tor-Final - - � � ' � • 12. Street Sewer.Connection . - ' " ' - - • 54. Heater & Vent-Final . � . , ;_ • _ 13. Rough Plumbing_ " - - - ' � - � '` ' - " 14. Rough Electrio-Conduit - - - - � �56.• Electrical-Final - � �- � 15. Rough Electric-Wiring - - � • 57. Solar System-Final ' �' ' � - - ' ' �� 16.- �Rough Heating & Air'Conditioning � ; _ � � encing & Access Approval � - 17: Ducts, in Structure ,� � ' �APPROVED FOR PLASTERING ' - ' 18. Ducts, Ventilating . �- . . ' ' ' . . '. _ _ _ _ . , _ _ 19. Gas Pipe=Rough &Test � � �� 60. _.POOL/SPA SYSTEMS FINAL - , , .� - • - � 20. Roof� Framing� - � - � � � � � • ' ' � � - 21. Roof,Sh�eathin � - � - ' ' . . ' ' • . _ 22; Frameand Flashin ' NOTES: '`�N_ ' �23. Insulation -� � � 24: lathing &�Siding - - � 25. Drywall Nailing - � ' � - � ' � � . � 26. Plaster Brown Coat - � ' - � � � ' " • 27. Electrical.Power Meter-Final ' � � � • - � 28. Final Electric �� - ' ' ' � � 29: Final Heating & Air Conditioning- � - - ' 30. Final Gas Pipe-Test - ' ' • " � � - 31. Final�Plumbing '� ' � � ' 32. Water Service•Final - �� ' � ' ' ' 33. �Gas Service-Final - �� '' ' ' � ' � ' � ' 34. Solar pomestic-Final ' - � • � ' �� ' ' + 35. Landsca e S rinklin S stem' ' � � ` 36. Sound Attenuation � ' • � � 37. Handicap Regulations � � � - - � � � 38. FINALSTRUCTURE&BUILDING ' /-ff ,(J - • � • 39. Special Requirements Completed � ' ' ' � � ' � � ' 40. Electric Release to Edison ' � �"- �� '� - � --- ' 41. Gas Release to Southern California Ga3 Co. � � � �.42. CERTIFICATE OF OCCUPANCY � - - �, . ' � '��No.- Date . � C TYPICAL Cement Coping Optional Channel Block With 13/8 0 Horizontal Top of all Fences For Fences5'.or Less —`=� Vert. Bars 3/8" 0 at 4' -0" O.C.. For Fences Higher Than 5' —� Vert. Bars 3/8" 0at 32" O.C. Fill Cells Solid With Grout WhereSteelOccurs ' Reinforcing Steel Shall S Conform to.Sec.A-1539 •�'�A:S.T.M.� AllSteelto be Lapped . � 24".ortoCode:.' , . . .'. NATURALGRADE 7W0 3/B" OBARS . •� CON7INUOUSTOP & BOTTOM ALL STEEL MUST BE TIED IN PLACE AT TIME Of TRENCH INSPECTION. f, o �r----- � -� �. '� :''�f u ga Y w ¢ _ >; z > i a f N . 6�� CONCRETE BLOCK FENCE a rze� •,o ��+�� '1' �. �:1! ,ll v.�: � �T.' _. __.. 'iG � 1:".41}a%i i4 i •^y-.�:3 e . �. e, e . o. . . . . .� .' . —WIDTH ` SEE CHAR7 BELOW , �L�.. s' 3 10" � D s : ;. I D Z �. GENERAL- NOTES MORTAR : p�e Part Plastic Cement, and Th►ee Parts Sand GROUT : One Port Cement Three and One Half Ports S�and COPING: One Part Cement, Three Parfs Sand CONCRETE: Wetl Mixed 1:2-I/2:3-I/2 � Max. of 7- I/2 Gollons of Water Per Sack of Cement GROUT MAV BE POURED FROM THE TOP �OF THE FENCE IN CELLS WHEHE STEEL _ OCCURS. � . CELL$ AND AREAS OF'HORIZONTAL REIN- �'�FORCEMENT SHALL BE CLEAR, CLEAN & FREE OF�AIL MORTAR DEBRIS, ETC. . � r PROVIDE CLEAN-0UT AND INSPECTION HOLES AT THE BOTTOM OF CELLS CON- TAINING VERTICAL REINFORCEMEN7. BONDS SHALL BE PROVIDED BY LAVING � BLOCKS IN STRETCHER COURSES SO THAT VERTICALJOIN7SALTERNATEIN EACH � . . � , .COURSE. ' DEPTH OF EARTHTCOTH �/3 THE HEIGTH OF FENCE �LOW BOTTOM OF FOOTIN6. SCALE: I/2��= I' FOOTING REQUIRFMENTS CHART WALL HEIGHT . . . . . . . . . . . 6 �. . . . . . . . . . . . 5�. . . . . . . . . . . . 4� . . . . . . . . . . 3� WIDTH . . . . . . . . . . . . . . .14'� . . . . . . . . . . .14�� . . . . . . . . . . . 12��. . . . . . . . . . . 12�� THICKNESS . . . . . . . . . . . .10��. . . . . . . . . . . .10�� . . . . . . . . . . . 8��. . . . . . . . . . . g�� DEPTH OF EARTHTOOTH . . . 24�� . . . . 20�� . . . . . . . . . . . 16��. . . . . . . . . . . 12�� SPACING OF EARTHTOOTH. . 12� . . . . . . . . . . .14� . . . . . . . . . . . 16�. . . . 16� OWNERS NAME: City of Costa Mesa California ��e ADDRESS _%��=�L� _____ � PERMIT NUMBER:_ — Building Department SIGNATURE: _ _ _ _ _ _ _ _ _ _ _ _ _ _ r'oaM euz�-au_n_e+ �9'� '�� jl 4 ` ,'t 1; City of Costa Mc�sc Building Dapl,� THESE PUNS MUST BE ON JOB AT ALL TIMES MAKE NO CNANGEi WITFIOUT PRIOR APPROVAL OF DEPf. THE ISSUANCE OR GRRNTING Of A PERMI7 OR APPROVAL OF PtAyS qN� SPECIFICATfO"�� S;;su 1;0T DE CONSTRUED TO BE A PERMIT FOR, OR ; n 0.PPFCYi l OF, ANY VIOLATION OF ANY pF �HE PRp1"`�; ; pp IHIJ f,O�E. NO PEFM�T PRE• SUMING TO GIVE p.LIHOitiTr 7u v;pIATE OR CANCEL iNE PROVISIONS OF 1;iIL' L'•JOC EHALC cE VA410, E1(EEPT IN 50 FAR p$ TFiE WORK OR USE KHICH IT AUTHORIZES I$ IAWfUI. THE ISSUANCE OF A FERMIT BliSED UPON PLANS AND SPECIFICATIONS SHFII NO( f'REVCNT THE BUtIDINC OFFlCIA� FROM THEREAFTER REQUIRIN THE fARRECTION OF ERRORS IN SAID PLANS AND SPECIFI ATION� OR FROM PREYENTIN6 BUfLDINC OPERATIONS BEING ARRIED ON THyREUNDER WHEN IN VIOLATION OF THIS CODE R OF ANY Oi�IER ORD�ry/�ryCL OF THE CITy, � � RESIDENCE � W W C ti N �,�P.�'ROVED "° �`i"rY'ioP msr,►�`�"�v, , PWJNINO p�T, a13ilZC: 10 �1D0. OBL �!6 FESIOENCE q-Ct'� �� Of 1{I1101qp �q J XESIDENCE -7 58 lq STREfT � _ r; I�RUCTURAL APP pR AL �NLY �EPaRATE pERMITS ARE REQUIRED FOR ELECTRICq�, pLU��g�r�G, HEATING. VENiI(.ATING AND REFRIGERATION WpRK 1-'"__ THI�S� �1d B R „ . �'97�, ALL INSi'ECT�pN � ACCOMpANY �""--- - ___ �EQUESTS 8E EPhPIGYEpJ ��tiLHc I STqTE pF �'E SUG NDUSTRlAL SAFLIFORNIq IDDIT�mm�� .,.-_� BE C REBIDENCE THE FOR d� N W W R � h a � Applicant to llll In all spaces wilnin �eavy CorCer tines antl sign all aDGropriate Ceclarations. 9STq MESA • � P�g MIT NO - TRACT NO.' LOT NO. BLDG. NO'.' '' -' ' " - - ` C U1;ION PERMIT /- ^ �� ' ' � I � � _. ' "5773 �/10%82 � 9.�0 TL� . ProjectQddressr �- G/ � � rN � . ' TYPE OF CONSTRUCTION � � � � __ . , � . ' � � � � �� ' �'�� ' ," •' Owner �/JErER�� " . 'QcmCF�RS Phon t- O/O - ❑ NEVJ � ADD ❑ ALTERATION ' ' � ' ' . - . , . . � ' . ' Address � � - � � - T . . - .� � � 'O REPAIR ❑�CONVERSION ❑DEMOLISH - . - l � �- _ . _ . � O oTF1ER � ° - •- ZONING REGULATIONS -� --Arch/Eng: license No. � ' Addre55� � � . . _ DESCRIPTIONOFWORK _ A'P'� . _ . � � � � ZONE PLNG. REF. � . � � ` ; Contractor �r S� •Qa fl ' Phone�yl•I'o/o . TYPE OF�PERMIT. � ; ' � ,: � ' ' -' - - - -- ' ' B " - ' ' TpaU I LDi ryG J ' I ! Add�¢55 'SET ACK T. PROPERTV LINE ' , .(i.�` -/ J/(. ' ..�., . ' ❑ GRADING 'O- FOUNDATION� ❑�STRUCTURAL � ' •. SIO VARD " ' '" ' - ' '- -" UCENSED CONT�RACTOR.DECLARATION � LE �' ° ' r �I hereb atflrm th:.t I am litenzetl untler � ❑ TENANT ❑ E�ECTRICAL ❑PLUMBING-�MECHANICA �51p E V - - ^- --- - - ' ' ' . . � Y provlslons oi Charter 9 (com- • • � -_ ,� . ; �� ! . RIGHT � ;mencing-with--section ��000) of Division• 3 of� tne �Buziness antl�� :OTHER - - - -- � -- - 'ProfeSsionS Code 'antl my II<eose is In full force antl ef/ect. - � { REAR VAR� (TO P/U .-� . i�%"- - - 337/6� � PROJECT�DESCRIP710N � - �- �� LlcenseCiass LJtense o. � � ' - PKG.SPACE�REQ PROVIDED � - '� .OSte s..�a •i 2 �" 519nature w� -� �4 - -' �- SQ:.FT. ' . " '- _ -- ' ' ' ' - PAPK FEE E ' " , o .. � � y,� � � 'STREETWIDTH '� �WORKERS'�COMPENSATION.DECLARHTION . . . � OCCUPANGV CONSTRUCTIONTVPE _ ...___. . �Z�NINGAPPROVE�.BV - - � 'DATE ' I 1 hereby affirm that I have a certificate ot consent to seli insure,or a VALUATION �� ZONE ' "� � icertifiwte o1-Workers'-Comp¢n5ation-Insurance, or a cerbtlatl�topy _ . . _ . _ _. _ . ___ . _ . . , ___ ._ . . � �SPECIALCONDITIONS: �thereof (Sectlon 3800 Lab. C.). � ,Gp� g GRADING CU. VDS. � ACRES � ^_�icY"No. � [.i•fi �i?"_ ComPanY'-n{' �/�-.-.�.LS.- " ' ' _ _ ' _ _ ' " I _' _ ."' '. . . . ._ ' ' :e�tlfiCtl copy is:her¢by (uml5hetl.___. _ _ _. _ .._ � i �J . REMAHKS:f.. . . _ . _. , _ _. . _ . ... . __ . . - - _ .:erUBetl copy is,filetl with tho dty Builtling Divislon. .,_ , �. � c- � �EXEMPTION"FROM'WORKERS' COMPENSATION DECCARATION - " ' - �' ' - -'�+ ' � - " �(This section.neetl'not be complaletl if tne permit is far one �untlretl --- � � � . (5100) or leu). � . . ' _ ' _ 1 " ".- - - - -. . -u .... _ " ' ' : ' ' _ .. .. _ c " _ - ' 1 certiTy that ln lhe performance ot [he work for whicb this perm0 is - . �� • issuetl, I shall not employ any porson in any manner so�as to-be<ome • PlUM81NG .:��;, -'r..PL'AN CHECK -' ""' -- �ECECTRICAL - - "- PLAN CFIECK ' � �subject to.the Workers:Compensatlon Laws of Californla.� ' ' " ' '- ' ' ' - ' -- _ _ � � ' ` BATHTUB$ ` $HOWERS ' ' " " - -j IDate � Signdture � • ., _ ' " - _ � ,NOTICE: If affer making this tleclaratlon, you shoultl become,;ubject qTOILETS• ,;�.; �.l �,- URINALS'-'" � �GENERATOR--' '0-1 KW_1-lO,KW - ! to the Wo�ke�s' CompGnSdtion provl5ions of the ldbor COtle, yoU'must -- TRANSFORMER � � . . - forthwitM1 comply with zuch provislons or this permit ihall be tleemetl LAVATORIES �OUBLE LHVS'-' '�'" - -�APPL'IANCE-'-'30-50 KW_50 + KW -- -- . " _ , ' .revoketl._. _ :. � . _ �CONSTRUCTION LENDING AGENCV � IT. SINKS"- ""- �ISHWASHERS-� - - � ' � (MOTORS -'-' -'0-1 HP_I'=30 HP '" - ' '-" '. ;I hGreby afflrT that Ihere is a construttion IGntling agency for the per � - -- �}UN0. SOLAR).. -30-50 HP_-50 +�HP- - -- - - .formance of the work for whith this permi[ is issuetl (Section 309 SERVICESINKS � �-Nt5UMP5""- r _ _ }�� Civ. C:):' -- �-- - - - -• - -- �— --- - - --- -� - •FLOOR SINKS' —' -'FLOOR'�RAINS - -' "' ';FIXTURES' -" OUTCETS^'SWITCHES - - "'' {Lentler'S Name _ . . . -'_"`" ' ' '"'_ "" " ' " '" _ ' . - ��__ _ _ " ' ' �Lenaer's Atltlress ' �DRINKING FOVNTAINS'�t """ " ' " ' - aGAS TUBE'SIGNS � - - .. �OWNERBVIL'DER-DECLARATION -'- --• -�- - - ^ -' �NTERCEPTORS � CLARIFIERS - POLELIGHTS' �' � ` -' ' - '� I hereby affirm tha[ I am exemp[ frOm Ihe Gontractor's �icense Law lor t�e following�reason (Se<tion ]03Y.5 Business antl�Prolessionz CoOe:�- SWIMMING'POOL 'PT,RAP '- ' �-' ' ;POLES � � � METERED .SUB Any city or county which r¢quires a permit to const�uct, al�er, improve, tlemolish-or repair any structure,�prior to i[s Issuance, also re-� -yyqTER SERVICE '' ALTERATION " �' 'PANEL'S - -MAtN �' '--' SVB -- - 1 qui�es the ap�.11�n[ tor such p¢rrtlit to file a Signetl statement tnat �e ' is-licensetl pursuant•to•the�provizions�of the Contractor•e License Law� GASSERVICE- �' -OVTLETS` � � ' :SERVICE " -- ' " -- -" AMP- - - �Chapter 9(commencing with Section 7000) ot DiviSion 3 01 t�e . Business antl Grdessions Cotle) or that he isexemp4there(rom antl [he yyqTER"HEATERS"- "BTU'OVTPUT- - " "' -' ' -' "' '-�- "' - ' ' - bazis for the allegetl exemp[lon. Any violation of Sectlon 7031.5 by ' " , _ � appliWn[ 9ov-a-permit Subjects the �applicant-to d� tivil p¢nalty '$EWER CONNECTIONS ' ' " - - ' -- ' ' ' -- '--'" - - -' ' '� �` - ' - � - �t more than rive nundrea tlollars �ysoo�. � - f ., a5 owner ot the-property, or'my emplOy¢e5 with wages ai'their' 'SOLAR TANK "'^-'�"C01LCECTORS, -�-4- � ' - " �' ' ' -' � ' ' '" ' '- - -' � sole.tompensation, will tlo the work, and t�e structure is not intentletl .` _ i ISSUE FEE ' - - " "or offeretl for sale. (Section 7044, Business antl PPofessions COCe: T�e SOLAR PIPING SYS.'- � - ' � -� Contractor's L�cense Law tloes no[ apply to an owner o( a pro0erty -+ :APPLICATION'.4PPROVED�BV -- � � DAT �O � wh0 builtlf or ImProves Ihereon, antl who Goes such wo�k himself Or �SSUE FEE- � ' � � thrOugh his Own_employees, proviCletl [hat Such improvements a�e nol intentletl or offeretl to} sale. It, however, the'Duiltlin§ or improvement- MECHANICAL PLAN CHECK � SUMMARV OF FEES- . �` iz SoIU within one year of completion, the owner will have the burtlen � '-BUILDING �- - -� • - • - -� -- -- - -�-' '-'- - � of proving he Eitl not builtl o�'�Impiove' for tne'purpose of sale).- HEATING SVSTEM 0-100,000 BTV ( i PERMIT E �� SMIP'• �- S i�•1,-as -ownor of-the properiy,. am. exclusively contracting wi[h � AND'OUCTING � ' � ' � ' �`- �- - � - ' '�' '- '• ' ' ''-� ' ' ' "� IicenSetl wntraCtoro to construCt Ibe projeCt (SeGtion �044, Buslness 100,000� BTU ` 4PLAN CHECK § � PERMIT ' .' �antl�Rofessions�Cotle:TheConcractor's-LicensaLaw.tloes.notapptyto - -�i.�-.�-- ISSUANCE S an owner of property who builtls or imOroveS thereon, antl who <on- REFRIGERATION 0-100,000 BTU 1 , PLVMBING E� � Vactt-from such �projects with a contractor(s) licainetl.pursuant to_ .SVSTEM-- � -- � - _ - _ ..� _ GRADING S � tne Contra<tor's License law). 300,000 + BTU � yPLAN CHECK y - � � �� `.. . ❑"I am'eXempl untler'Settion � - -' 8.6'P'C: PorthiS - ' - - "-"' � ' ' ELECTRICAL S � - - a BOILERS BTU " , ' � ieason �� - - - - -- - - ;PLAN'CHECK E' - "MICROFILM E Date Owner SYSTEM REPAIR, ALTERATION � ' TOTAL FEE E , _ �I hereby certit that I hav0 reatl lhi5 a � MECHANICAL.$ - ' y pplication and state that the above EXHAUST SVSTEM MULTIPLE ' pLAN�CHECK- E� r �'- VAN E PC $_ ' - information I5'correcL -I agree"to comply wlth"all-city antl "county � ortlinances antl state laws relatln9 t� construction, antl her¢by authorize , ��, , � fepfe5¢ntatives-of"this"Uty't0'en[er upon [he'aDOve mentlOn¢tl � "'�� ' � property tor sp ction urp�osesy� -�� .� �Tl.es�Lfl... -' - ' S'+•/O••6�' _ FINAL FEE S�— Signa[ure � Data '� Drivers' Licende oi 55 �. _ ` " ' ' - ��SSUE FEE - - - - - � - - - - � � - - - � / CMFO865-�i6 White-Builtlin9:��ary-Applicant:Pink-Accountin9;Goltlenrotl-Assestor CONSTRUCTION AND PLANNIN �7 POOL & SPA • ' • � - � � � APPROVALS Permit # Y�id Date Inspector qppROVALS ., Permit # Date -- In or � 1. Temporary Electrical Service or Pole •-, 43. Pool & Equipmen[ Location � � �� - 2. Soil ipe-Undrgrn � 44. Steel Reinforcement- - � . 3. Electrical Conduit Utility-Undrgrn 45. .Forms � - 4. ElectricaLConduit-Undrgrn 46. Electrical Bonding �- - - tee ein orce � 47. Rough Plumbin & Pressure Test _6. Electrical UFER Grn � - 48. APPROVALTO COVER-GUNITE -- - - 7. Footings 49. Electrical Conduit-Undr rn � � � ` - 8. . Foundation - 50. Gas Pi e, ❑ Undr rn, Test " � .9. Water Pipe-U'ndrgrn.. _ 51. Backwash Lines P-Tra ❑ ndr m'�" '- ' 10. Structural Floor System 52. APPROVALTO DECK -- 11. Property Sewer Line & House Connection � 53. Backwash & Rece tor-Final ' � .12. . Street.Sewer.Connection ' '' _ 54. Heater & Vent-Final ' ' ' 13. Rough Plumbing - � ' - ' � - �' " �- ' , 14. Rough Electric-Conduit • - � �56. Electrical-Final � � ' 15. Rough Electric-Wiring - - - - - - 57. Solar System-Final ' ' ' ' ' ' - '� 76. Rough Heating-& Air Conditioning � - - _ . encing &�Access Approval - 17. Ducts, in Structure � � APPROVED,FOR PLASTERING � �- 18. • Ducts, Ventilating � � + � . _ . - � _ _ � . _ _ _ ,_ _ _ _ 19. Gas Pipe-Rou9h &Test- � • � ' _ _ _ _ _ .."60. POOUSFA,SYSTEMS,FINAL", " � `� . � ' . , , '� 20. - Roof �Framing - - . _ . . _ . . _ ' ' ' � � ' � 21. Roo£Sheathin' --- � - - - . _ .. ], - . �. . � � ' . 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 & Air Conditioning - � . � ' � - ' • � . , � 30. Final Gas Pipe-Test . _ _ � � � �31. . Final Plumbing ' � �� 3_ ' ' � � � ' � " ' • 32z- Water Service-Final - - � � " ' '' � � '� 33. � Gas Service-Final - � - - � __ ' ' ' - � � - 34. Solar pomestioFinal �' � � �� ' �' � • � ' ' � J 35. Landsca e S rinklin S stem � � ' � • ' �� ' ' � - � � 36. Sound Attenuation � . - - 4 � � � � � 37. Handicap,_Regulations ' "� - � � ' _ .. . . • � � � - � 38. FINAL STRUCTURE & BUILDING ' ' ' � - `� � ' � • ' " � ' 39. Special Requirements Completed � � ` � �� 40. Electric Release to Edison �� . " � 41. Gas Release to Southern California Gas Co. � � � � 42. CERTIFICATE OF OCCUPANCY � . ' � ' ' . ' " �No Date � �� AD��icant A MESA ;ON PERMIT all spaces withln heavy borCer lines antl sign all aOPropNate aeclarotions. TRACT NO. - "LOT NO. BLDG. NO.' "�S3D �Project .. - 3 Jt/ /yTN.- - lT. TYPE OF CONSTRUCTION - � � � ' "�w�� TF.Q S• �QdD! RS Phone �ySY /O ❑ NEW O ADD ❑ HITERATION'- AddrCss pp�- ��/f.� .1jQ �8. -- - ❑.REPAIR ❑�CONVERSION ❑DEMOLISH_ J - � ArCh/Eng. - - LicenSe No.- - -- ❑ OTHER � , Addffss - ' - � - - - - -- . DESCRIPTION OF WORK Contrector�t �je S. �,7o,D6F�r -- Phone�yfy�ip TYPEOFPERMIT - " .' �"' - " Addre55' jy �GL%f� �7 "' /,/. ❑_GRA�ING� -❑ FOUNDATION -�STRUCTURAL - - LICENSED CONTRACTOR DECCARATION._ . ' ` '- ' ' � � O TENANT- LECTRICAL��IN�ECHANICA 4 hereby aftirm thzt 1 am IicenseC untler provisiont of Charter 9(com- . f mencing-witn-sacHon� ]000�� o('Divlsion-3 �of the Buzlness antl ��OTHER J � Pro(essions Cotle, antl my Ilcense is In full forte antl eftact. - PRO�ECTDESCRIPTION� �License-Ciass �'/ -� - - ' ' ucen�ie Njj _-331��f . " ,� --' � ""' ' �' �Date -D-• /S. f.L Si9nature"�R7�C �..7Gd�.e+�'.' ' " ' -SQ. FT. ` ' " ' "" '_ v �•OCCUPANCY_CONSTRUCTIONTVPE � �WORKERS'COMPENSATION-0ECLARATION_ . . _�. . .._ �1 hereby affirm that 1 have a certlficdte of consent [O self-Insu�e o� a;, VALUATtON � 20NE 'certNlWtG-of WOrk¢�5' Com0en5dUon Insu�ance, o�.a�ce�tl(Ietl.copy _ . .. . ._ _._ __ lhereof (Section 3800, Lab. C.j. ,�GRADING'CU. VDS. - ACRES � i .. , � ' ,_ �u^iityNo.' - ""Company-- -- --- - - - ._ . _ _��_-- - --- - -- 'ertitieticopy.ish¢rEbyfumi5hetl. __ _„_ ' R ARKSi ". ��. � � . . :ertifie0 rnpy Is filetl with the city Builtling Division. � . �E%EMPTION FROM WORKERS'-COMVEfJ5AT10N DECL'ARATION - - �(This section n¢etl not be completetl if the_permit IS tar one huntlretl (5300) or less). - � ! , . - - � Q ' -1' - - I tert((y_that in,the.performance of [he work for which thfs permit is _� _ ISSuetl, I shall no[ BmplOy any pe�ion In any�mann¢r 50 d5�[O becom¢ "'PLUMBING -_,y, ." PLAN GHECK ' ' ' subject to the Workers_Compensation Laws of Cali(ornia. - " ' '' - ' Date Signatura � BATHTU85 � --SFIOWERS' - ' � -� - NOTICE: I( a(ter making tnls tleclaration, you shoultl become subject ;-TOILETS- ,y �URINALS ' -' '- -^ to the Workers' COTp¢nsation provlsions ot the Labor COtl¢, you'muzt � � � _�f forthwith comply with sucb provisioni or thiz permli shall be tleemetl 'LAVATORIES �OUBLE'LAVS -" - revoketl. . � CONSTRUCTIONLENDINGAGENCV "KIT.SINKS- "-"OISFIWASHERS-^'^" -' •i nereby affirT that there is a cons[rUttlon lentling agency for the per- $ERVICE $INKS. SUMPS ' ''-'- --' ' tOrmdnce o( tne wark tOr whiCh this permi[ is issuetl (Settlon 309] 2� �� CIv-C.1. i ' - � -' - -�" '" FLOOR'SINKS'-- - `FLOOR DRAINS' ' '"`" - ' ' " �l.enCer's Name - Lentler's Atltlress " - DRINKINGFOUNTAINS" ' - ' '� �--'! OWNER'BUIL'DEH OECLARATION • INTERCEPTORS� - CLARIFIERS� -- f`�� - � I hereby affirm lhat I am ezempt from the Contractor's Ucense Law for theiollowin9reason-(Se<tion-]031:5�Business-antl-ProfessionsGotl¢: SWIMMtNGPOOL' " 'PTRAP'- - �---�- -- ?iny City o� counly which rEpuir¢5 a pe�mil to construct, alter, • � improve-tlemolish�orrepairany�structure,prior[oitsissuance,alsore- yyq7ER'SEiiVICE 'ACTERATION - quires the ap�.lifant"for wch permit to tile a signetl statement lhat he is litensetl-pursuant to�the provisions ot [he�Contrac[or'S 6itense law 'GAS SERV ICE - OUTLETS '- -� -'-- more ects [he-applican[-t olla�s (E500). or' my'employees wl ork, antl the_struc[w I,-Buziuezs antl'Aole ot apply to an own antl who tloe5 such �Itletl Ihat suth imorc of provinq he tlitl not � builtl or impn ❑ I,-as-owner of the.properry,.am Iicensetl coniracton to construct the oi LJ I'am"exempt untler reason - Date I h¢rGby [ertifythat I have reatl this dppliWtion antl State tM1al Ihe abOVC In(ormation' is"COrr¢Ct. I-agrCe'to cOmply with all City antl county b�tllnances and sta[e laws relatlng to conSt�uction, antl hereby authOrize representative5 0( tnls' Uty to enter 'upon -the aEove m¢ntioned property for In� t� �urpo}es. ^ 5iqnature ��/' ��''' �ate Drivers' License or 55 � '' " CMF 0865-4fi Whi[e-Builtling; Canary-Appliwnt; af Ihe anU4he WqTER'HEFTERS'- " BTU OUTPUT '- '-" "y - 31.5 by pendlty SEWER CONNECTIONS - "' �' - -- -'- -' �' as'thelr - SOLAR TANK `' - OLL.FCTORS-,' .-" �- itenaea tle:'T�e' SOLAR PIPINCj SVS. - � �'� - roperty nsell'or ISSUE FEE � � ' - -,. - ' �� c cont�acting_with Ifl ]044� BuSil1¢55 tloes not apply to on, antl who con- snetl pursuant ro Bl & P. C. tor t�i5 HEATING SVSTEM 0-100,000 BTU_ ANDDUCTING'- 100,000�+BTU. REFRIGERATION' 0-300,000 BTU_ SVSTEM -- � � 100,000+BTU. BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAUSTSVSTEM MULTIPLE ' - - ISSUE FEE GOIdCfIlOtl-A55¢SSOI :�: v'63b2 � B/ I 8/8� .� 23.0� TL ' ' - - , . ' � '' � '-„ ' "• I " ZONING REGULATIONS .� . � " i 'A.P.iF ._"" _ '_ " ' " ' ' �ZONE � -- . ' - PLNGL�REF.-,$ , „-" , ,' �� IO VARD. _ . "_ .'_ '" _ '_ - ' $Ep � R�IGHT " " • .. � _.- . - . ��REARVARO�ITOP/LI' "- ^- "'� . .. ,'� � "- - ' PKG.SPACEREQ. - � PROVIDED" ` -"� - STREET'WIDTH - � - PARKFEE',E � ;ZONING APPROVED'BV -" - -- DATE � - -" �� .� r �SPECIALCONDITIONS:-" '- - -' - - - , "_ �_'__ ' "' _ - _'_ -_"� ro�",_ ". 1 i . J ' . + i �ECECTRICAL--�' ' - ��P�dtvCtiECK •- - ' t i50_ FT. .- _ _ _ _ 5(]. FT_. __ __ _ - . . �GENERATOR - - - OQ KW'-_ 1=10 KW' ' - -- -� ' (TRANSFORMER : -' t - `2h�' �� jACPCIANCE"'- 30-SO�KW_SO+KW� -- ----- j( {MOTOR$--^- -- 0-1 HP -_1-10 HP - '- �,}" 1 .{INC..SOLAR) _._ .]0-SO�HP 50�t HP � - - , ;FIXTVRES'--�'OVTLETS' 'SW�TCHES"" -- -' � ?GAS TUBE SIGNS -' - " - ' - - 1POLE LIGHTS - -' -' - "-"--' ' " ' 'VOLES ��-'� METERED�� SUB� - I 'PANECS '- - 'MAIN-- '--SUB " � tSERVICE' _ "_." ._' _" _' '.'AN1P- . _ ..'_' _ " i . .�_"' _" ' _ _ _ ��" ' ' _ � t i.'_� _'. "__ __. __�'"`_ __" � ' � ISSUE FEE' ---' '- ^- -- " - `I �APPLICATION APPROV ED BV � - - - - - - DATE - - � � � " "_' . . . _ 1 ` � SUMMARV OF�FEES , , � � • BUILDING - --�-� - �PERMIT Sin • �1;t_ SMIP�,. • S ' ' �PLAN CHECK� $—.�-- PERMIT- � �- " „ � /�/�,/� . ISSUANCE--S� �� PLUMBING S(��./i .� '.GRAD1tJG.: E' .PLP.NCHECK S •.� -yi' , - _a': , � ; .ECECTRICAL.-S - � -� "- . •� MICROFII.M��E ' PCAN CHECK $ - �_ � - ,MECHANICAL- 5 - _' TOTAL FEE E_'. _ . � , �PLANCHECK� $ �- -- � VANCEPC'S_' ...�. : l. : � � _ FINAL FEE S a 3. ea . � CONSTRUCTION AND PLANNING � POOL & SPA' W� . _ � Date Ins ector ' ' ' Date � r •d APPROVALS Permit # � -� V P APPROVALS . . � Permit # ' ' 1. Temporary Electrical Service or Pole �� 43. Pool & Equipment Location � 2. il ipe-Undrgrn, _ -� ' 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn . 45. Forms - - � 4. _Electrical Conduit-Undrgrn_ _ 46.. Electrical Bonding � • tee ein orce' 47. Rough Plumbin & Pressure Test � - . 6._.Electrical UFER Grn - -48. APPROVALTO COVER-GUNITE - - - - - � _ 7. Footings . _ _ _ � 49. Electrical Conduit-Undr rn ' ' 8.� -� Foundation. _ 50. Gas Pipe, � Undr rn, Test � 9. Water Pipe-Undrgm ' ' 51. Backwash Lines P-Tra ❑ niJr rn -- - 70. Structural Floor System . 52. APPROVALTO DECK � ' _i t. Property Sewer Line &.House:Connec[ion � .53. Backwash & Rece tor-Final ' ' ' ' � 12. Street Sewer Connection � ' - • - - � - 54. Heater & Vent-Final 73... Rough Plumbing - � - � - -- - �" � � � ,. 14. Rough ElectrioConduit � � - '�56: � Electriwl-Final •� � - � � � 15. Rough Electric-Wiring • - - - - � - - :.57. Solar.SYstem-Finah ' � ' � � � - � 16. � Rough Heating�& Air Conditioning�_ - -- - - - - . encing &•Access Approval ' 17. Ducts in Structure . � ' - ' ' APPROVED FOR PLASTERING ' � � � � � - �16. - Ducts, Ventilating - - _ ---- _ _ . ' _ � . . 19. Gas Pipe-Rough & Test - � . ' 60. POOL/SFA SYSTEMS FINAL � � . � , ' ' � 20. - Roof Framing � - - - - - - � _ ' � ' - ' - � � 21. Roof Sheathin � - _ - ' -� - �� - �-- - -- - � , � � •� - � ' 22. Frameand Flashin - - � � -i _ . NOTES. ' � � 1 : , . ' � � � � 23. - insulation - - - -- - ' . '.. �.. . , . . � 24. Lathing & Sidin9 - - -- � ' � ' - - - - � - - - - 25.- OrywallNailing - � � !-_ � • � � , 26. Plaster Brown Coat - - ' - � � � • � 27: - Electrical Power Meter-Final - � � - � � � ' ' 28: Final�Electric .. - _... - . _ --� - -- - - -r-� . . .� . . . �,• ' • � . . � 29.- � Final Heating & Air Conditioning- - - - - � - - � ' " � •� " "' 30: �Final Gas�Rpe-Test - . . _ "� . ' • � � � - � ; - 31. � Final Plumbing 3 i . Y3 � � ' � - - �� - ' - 32. -WaterService-Final - � � - - - - - " � ' � � � � � � � 33.- Gas Service-Final - - - - - - � � - �� -- --'_ . _ .., � _� .,. ... - . � 34. Solar pomestic-Firial ' � � • - � - � ` �� • � ' - � � � ` 35. Landsca e S rinklin S"stem � ' ' ' ^ � � � ' �� 36. Sound Attenuation � � F- - - � � - � • " ' • , 37. Handicap Regulations � � � - - - - • - - ' � " � ' � ' � 38. FINALSTRUCTURE&BUILDING - - ' - � " � ' � - � 39. Special,.Requirements Completed � � • - 40. Electric Release to Edison � � �� 41. Gas Release to Southerri California Gas Co. • '� ' � � � 42. CERTIFICATE OF OCCUPANCY � - � � - � ' � � . , ' No � Date � - ' J ob �'/'/t5'-� ApV��ant m ew �n an spaeas wimm neary oeraer nnes ana. agn au appropnace Geela�atlon5. CITY-OF COSTA MESA PERMIT O. TRACT NO. LOT NO. BLDG. NO. �CONS'fRUCTi�N��iMIT � t � 6808 B/26/82 7.OD ' Proje t P.ddress '75 Fj. 1Cj'i�1 $'t• TVPE OF CONSTRUCTION �<OwnerPe{,e RO Bi5 Phon2 1-z S�NEW ❑ADD ❑ALTERATION � Address 11 j'�. 1 {]'1 .S't. Costa Mesa, Ci2, ❑ REPAIR ❑ CONVERSION ❑DEMOLISH - � Arch/Eng. � ' License No. Q oTtiEa � ZONING REGULATIONS D RIPTION OF WORK S�S Ga �� A.P. � Address - - . !� /VC� CO /NMEC � G'A/l4• .�� ZONE PLNTGp. gRE�FL. � co�t�a�co� Graham BTOS. � I11C. PhUneS -1 5 TVPE OF PERMIT PROPE�RTVNIiNE SETBACK C L T. Address 2 2 Centur Pl. Costa Mesa �i3,• ❑ GRADING ❑ FOUNDATION ❑ STRUCTURAL SI�E YARD � LICENSED CONTRACTOR DECLARATION [] TENANT ❑ ELECTRICAL OPLUMBING�,MECHANICA S�IpHTA I h¢reby affirm that I am IlCanietl untler provislons o/ Chdrt¢r 9(com- � R G � mencing wlth sectlon 7000) of Division 3 of tha Buslness antl ❑ OTHER Protesslons CorO/e_ZaOnO my I1ce�3e ls in iulf torta2�n,pLy�;fect. REARVARD�TOP)�) t3�U4 PROJECT DESCRIPTION LicenseGlass Licenze PKG.SPACEREQ. PROVIDED �� Date g�y�g�' Si9nature SQ. FT. . WORKERS' COMPENSATION DECLARATION , ' -OCCUPANCV_CONSTRUCTION TVPE- STREET WIDTH PARK FEE $ �� I hereby affirm that 1 have a certlFl<ate of consent to self-inzure or a VALUATION ZONE ZONING APPROVED BY DATE certifiwte ot Worker5' COTpGnsatlOn Insurance, or a certi(ietl copy thereot (Secllon 00; D. CJ. GRADING CU. VDS. ACRES SPECIAL CONDITIONS: . P�Iicy No. ComPany irT�isai'[� Tnx. , `ertifietl copy is hereby furnlshOtl': ' REMARKS: 6 - :er[Itletl copy iz filetl with the d�Y Builtling Division. �EXEMVTION F(iOM WORKERS' COMPENSATION DECLARATION ' - � - (This tecUon neetl no[ Oe compleCetl if the permit is for one huntlretl _ _ . -�� -_ ,`-� - - _ . �E3001 or Iess1. � --� - - � ' ' ' ' ' � �� cert(fy that ln the performance Oi the work for which this permit�is issuetl, I shall not emPloy any person in any manner so as to become PLUMBING - PLAN CHECK ELECTRICAL PLAN CHECK subject to Ihe Work¢rs CompenzdtiOn LawS Ot Glltornia. � Date Si9nature BATHTUBS SHOWERS ._ . ! NOTICE: �f aTter making this tleclaration, you shoultl become suD7ect TOILETS � .' VRINALS GENERATOR 0-1 KW_1-10 KW to th0 WO�kers' Compen5ation provisions Of the LabOr COtle, you mu5t TRANSFORMER torthwlth comply with such provislons or this permit 5hall be tleemetl LAVATORIES DOUBLE LAVS APPLIANCE 30-50 KW_50 + KW, revok¢tl. � � - CONSTRUCTION IENDING AGENCV.� KIT. SINKS DISHWASHERS MOTORS 0-1 HP_1-30 HP I hereby atfirm thai there is a construction�lentling agency for.the per- •SERVICE�SINKS SUMPS (�NC. SOLAR) �0-50 HP 50 + HP tormance ot [he work for which this'Dermitis i55uetl�(Sectlon�3097, Civ. CJ. - FLOOR SINKS FLOOR DRAINS FIXTURES OUTLETS SWITCHES - �Lentl¢r's Name - ,Lentler'S Atltlress ORINKING FOUNTAINS GASTUBE SIGNS ' OWNER BUILDER DECLARATION INTERCEPTORS CLARIFIERS POLE LIGHTS ' �� 1 hereby atfirm [hat I am exempt from.tlle Contractor'S,UcenSG Law for [he tollowing reason (Se<tion ]031.5 Buslness antl Professions Cotle: SWIMMING POOI PTRAP � Any Gty or county whi<h requ�res a permit to tonztruct, alter, POLES METERED SU8 Imp rove, demolish or repair any StYucture, prlor to its issuance, also re- yyqTER SERV ICE ALTERATION PANELS MAIN SUB quir¢s the appli�nt tor Suth permit t0 filG a SI9nGtl Stdtement thdt,h@ � is Iicensed pursuan[ to [he provisio�s of the Contra<torY License Law GAS SERVICE � OUTLETS SERVICE AMP � (Chapter 9(tommenNn9 wlth SBction 7000) ol Divislon 3 of, the Business antl Prdessions Cotle) or lhat he is exempt tneretrom an0 the yyqTER HEATERS BTU OUTPVT . ' basis for the allegetl exemption. Any violation. of_$ectlon 7031.5 by r vppllwn[ for a permit subje4�s the applicant to a civil penalty SEWER CONNECTIONS t more than five buntlretl tlollars (5500). � , as owner of t�e property, oY my employees witn wages as their SOIAR TANK COLLECTORS sOle compen5dtion, wlll tl0 the work, antl th¢ s[ructurG iT nOt InlCntletl or offeretl for sala. (Section ]044, Business antl Rote55ion5 Cotle: The SOLAR PIPING SVS. ISSUE FEE � Contractor'S License Law-tloes no� apply to an owner of a proper[y ' wh0 bWltlS or imprOv¢5 thereon, 2�tl who tloes Such wo�k nimself or ISSUE FEE ' APPLICATION APPROVED BY DATE � th�ough his Own employees, providea tnat such improvemenlz are not intentletl or ofteretl (or sale. It, hoM'ever, the buil0in9 or improvement MECHANICAL PLAN CHECK is soltl wilhin one year ot completion, the owner will have the burtlen � -- . $UMMAflV OF FEES , , • of proving ho tlitl not �ulltl or improve tor the purpoze of sale). HEATING SYSTEM 0-300,000 BTU O Op0 BUILDING ❑ I, a5 owner ot Ihe property, am exclu5ively contracting with qNDDUCTING y 00 PERMIT b SMIP S Iicensetl contracton to tonstruct the project (Settion ]044, Businois , . 300,000 � BTU PLAN CHECK E PERMIT � antl PrOtessiOns Cotle: The Cont�acto�'S Licen58 Law tl0¢5 nOt apply to ISSUANCE an owner of property who builtls or improves thereon, antl who con- REFRIGERATION 0-100,000 BTU PLVMBING S • Vacts from such projetls with a con[ractor(s) Iicesnetl Oursuant to gySTEM . .-'GRADING S [heContractor'SLicenseLaw). . 100,000+BTU P�ANCHECK E ❑ I am exempt untler Section B. 8 P. C. for this Bp�LERS BTU ELECTRICAL S E reason � PLAN CHECK E MICROFiLM 5 - 5�'STEM REPAIR, ALTERATION � � Date � � Owner � TOTAL FEE $ P hereby certifythat Lhave reatl this appllcation antl state that the above EXHAUST SVSTEM MULTIPI.E MECHANICAL S •�� Information iz correct. I a9ree to �omply with all city antl county PLAN CHECK y LE55 AD- - - ortlinances antl state laws relating to construction, antl hereby authorize VANCE PC $ i representatives of this city to e�[er upon the above mentionetl proparty for ' eCtion pu ose �- � �-f Slgnature. ' Date �-� � FINALFEE $ �/•JD Drivers' Licenze or 55 �%� F CMF OtlbS-4b wnit¢-tlWlOing; CS�ary-HpP��i; nme-saeeounung; �o�aenrou-n»eewe - -� CONSTRUCTION AND PLANNING � I POOL & SPA `�`'� ��.� /y�� 2 ��„ . � . APPROVALS Permit # J L_ZI��L Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service or Poie 43. Pool & Equipment Location . Soil ipe-Undr§rn 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn - 46. Electrical Bonding . tee ein orce 47. Rough Piumbin & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pi e, ❑ Undr rn, Test 9. Water Pipe•Undrgrn � 51. Backwash Lines P-Tre ❑ ndr rn 10. Structural Floor System 52. APPROVALTO DECK it. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final ' 12. Street Sewer Connection - � 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit �56. Electrical-Final 15. Rough Electric-Wiring . 5Z. . Solar System-Final � � - � .16. Rough Heating & Air Conditioning � 2 • encing & Access Approval 17. Ducts in Structure � � 9• APPROVED FOR PLASTERING 16. Ducts, Ventilating ,' 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL � _ 20. Roof Framing - � � 21. Roof Sheathin ' � � . 22. Frame and Flashin NOTES: _ Z 23. Insulation � � - 24. Lathing & Siding ' 25. Drywall Nailing � ' � 26. Plaster Brown Coat 27. Electrical Power Meter-Final � � 28. Final Electric ' � � - � ' 29. Final Heating & Air Conditioning 3 0 :3 ' ' 30. Final Gas Pipe-Test 31. Final Plumbing � � 32. Water Service-Final � � � � 33. Gas Service-Final 34. Solar pomestic-Final � 35. Landsca e S rinklin S stem ,. 36. Sound Attenuation 37. � Handicap Regulations � � 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern GlifoF ia Gas Co. 42. CERTIFICATEOFOCCUPANCY , No Date $u'RvF�/ �UR ��E`-�R L ROS� M AN'Y 120�D�iE.� SURV'E`/ ��58 �-+� �`37F1 S-(SZEE1, COSTF-, MESA�CA. 0 r� W J J � 0 LEC.AL 'I�E.SC RlP j IOI.s . WEST 50F�, oF THE EAST ISoF'T. o'F �-o-rs 39 & 40,'3�_ocK �, -r H s-r�2��T --� z o �'�AC-T N° 612.,M.M.Zo�1-Z � REco�-'us oF OtLAN6E CODUTy, Ca ^ � lu d � 'o 0 0 r r � N � i .� 0 r � so�oo� :A.) ;n ItJ'�'c.:RSEc-f�oN FA��-s ON MAIJNJLE� EST�SS. PER. UTy T1 E5. � — .� �oo. oa� J W �,-� � �, —o c7 ; 0 0 r � � f � 0 � i ,- �� <�-- So. oo' io•�o- -- - -�p.oc . So oo' , — �.. — -- I 6�3�C��V�� ITY OF COSTA MESA ' F3UfLDING DI�/:S!0'd � MAR :L 5 1��3 ?, o � 11 � � Yr..� w�� M1 I � �, o p.SO � � e� �A'S' �I p � ° ° Oi q°/ i � r" ° , M 1 ('� SO.00�j �;1� .� i3o�oo' Y �33o'ee�.) 33�•io;,�-- �o� -fu S i REE � INTERSE�"��O1J F{1L�S ON W Q J J Q 3 � 30' ' MQNi�+O�E�ESrqti, 95,2 c��y 7�f5 � �INDICATES SEi �G� NA�L<�TAG RC'=,304•O� iN7E'25Ec-iU�•� FAt.��S oN _� 1N�1GAiES SET L i-[ RC�. '304G1 MANN��E� . �. i � fiQi � f%�.^v. "O A7E� 2 Z A� Ci-y ��E'S •__ ��/%!1l�� _ LE . c. F� s H E� 2c.r 3p,:o I