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Home My WebLink About789 19TH ST - Building PermitsCOUN'I'Y OF ORANGE BUILDING DEPT. 636 No. Broadway Santa Ma, CaGfoenia Phone: KI 2fi211 Application for Building Perm�� AND FOR A Certificate of Use and Occupancy ]. OWNER'S NAME.-----.�.<.SA.'..N...(i1.---....�..__Q.EI_ST...... ' Permit No..�.. ,(7, .. �.l.� Date.S.�_..�.5(.'.... /�----'-1...l...�/....--"'-.. PHON E :.................................. MAILING ADDRESS.----....9.�f-----...G.�Ce`'------.--Sr......_ ...............------......,.._.. CITY1r�AL77!�....�i!,�'�...G'iAIA./.F Numc .... ..........ti�.0��.._- ..... - - .. - -�� -....._. (Architec[ or Enginecr) Addrees... ....... �-" --' ........... ....._._....- ---...._--" -"---- City State Lic. ] PROPOSED 2. JOB LOCATION_._.....�...�..� �' , � (House No.) -- -...._- 3. LEGAL DESCRIPTION: Lot......._._? (Me.es and Bounds Description—Use reverse Name - �� ..�.1��'�!lY�.�_."".t_.._ Le'�:�,5`- r"- -.._ ---.. (Contrac[or) Address - .....�.�.%.._......�-.i%.Sr.�'--......_�.i.' ................... City -�'/�.�Y..T�'..--...�eY.l: �......�tt¢1.1-. .F...---- State Lic�No.....- ... ... -�--"------- Phone�^'�..!,�_..^'.�Or� or %^d Tracrd/I�.°'.Pd�f.7'..._/.j1+�3'•� 4. CORNER LOT ( ) INTERIOR LOP ( v) THROUGH LOT ( L}' SLOPE OF LOT ( ) i. SI2EOFBLDG.:..�.!l..8�_....AREA:_.L:��7�i'�oiSIZEOFLOT:r7.7.Fq.��..AREA:.��I.)�.I..a_b..-...... i' p/ 6. HEIGHT OF BLDG.:.....IR' .............................CEILING HEIGHT:.._.W:...__........__..........NO. OF STORIES........._�....._........... ,' �' �. /�'/ 7. NO. FAMILIES ..............�..................._.Size of Smallest Bedroom:.......!..�X.�.��.......... Size of Kitchen... ��..K�FQ...+.._. S. EXTERIOR WALL CONSTRUC'I'ION:..__.Y.CD..f..N�-____..,____INTERIOR WALL COVERING.._�A�CI�d!L._......... (Frame, Stutto, Etc.) � O i ' /' ' (Plaster/Drywall, Ete.) - 9. SLTBACKS: Front Yard From Center Line of Street.......(Q..�...._.....��'.f7.eGi.z_....,l.a._.7'�--...�Lh_P ............................. / � p� Nearest Side Yard.._�.(��._____.____Rear Yard..IBs�.__..__..Distance in Feet Bctween Bldgs. on Same Lot..�C.C.!.Q.�!�_._____.._._. 10. A COMPLETE PLOT PLAN IS REQUIRED, SHOWING ALL STRUCTURES AND USE OF EACH. / // // // ]]. For (a) Footing: Width--------I._�:------._ .............Depth in Ground..-_��--...............Width of Wall------...f°....--•--_...---.•--. Accessory ' � �' y/�/� q Bld s, and �b) Size of Swds:sCX..T ............._Spacing._L� ��._...___...:'CC Material of Floor__...a�.............._._......... Similar Struccures: .r „ �, (c) Size of Floor Joists:._....�r.ik-¢z ..................._--.Spacing--.......Sit------....._............:'CC N () ' " �- P g-........�.�','_ii "CC d Size of Rafters:....----'�'i�.------....----...._ S acin ...................... . 12. VALUATION OF PROPOSED WORK: Including all labor, plumbing, elecvical wiring, heating, fire sprinklers, painting and sewage disposal $---"---9L��-x--'.-----'---.---..... ' 13. I HEREBY CERTIFY THAT TO THE BEST OF MY KNOWLEDGE AND BELIEF THE INFORMATION IN THIS APPLICATION IS CORREGT AND THAT THE CONSTRUCTION WORK WILL CONFORM TO ALL LAWS OF THE COUNTY OF ORANGE AND THE STATE OF CALIFOR�IA APPLICABLE THERETO. „ J/ Signed: J Plans Filed:._- .... ��.��../.....- ----... --By: FEES: Bldg. Permit - Plan Check • Tota1 - - �� Reccipc No. Paid to - Date..---...------------- (Authorized Agent) FOR DEPARTMENTAL USE ONLY � --I CHECKING BY �` GROUP ................ v..-_. APPLICATI ..... .- EALTH...--_......_............,. .. � . . ;�.....__. TYPE_.. -�- � -� ... - - ZONIN FIRE • � DIST. �/% / ...._ — - MARSHAL ...............-- �- �:�-�""' PLANS AND MAP -� � -��--./!/.._ .:........... � ��T- -..... ... - SPEG'S. � ........ ...... . _. .. ..... SHEET NO.._.� . .._ . STATE...__... ...--------- ..... � CORRECTIONS ENGINEER g.',iTI.- -- --� ...------- --- ... --........ VERIFIED------------------.. CAL.- ---- - DATE.. r.�g��-f. . SM-2-51 urtiri� eu �c.rsc I\'��.;'na � AVD��ant to /ill in all sD+�es within �aavy borCar Ilnas antl Jgn all approD��ate Eeclaralion CITY QF COSTA MESA � PERMIT NO. TRACT NO. LOT NO. BLDG. NO. CONSTRUCTION pERMIT C.-/Z.Z.._�f Addrea Address Address 61f7 �/�=/�I d iT– D TVPE OF CONSTRUCTION PhOne ❑ NEW ❑ ADD �ALTERATION . . r ❑ REPAIR ❑ CONVERSION ❑DEMOLISH � � LiCEnSB No. ❑ OTHE0. DESCRIPTION OF WORK A'P' � ZONE Phone �� I horaby affirm lhdt I am Ilcenzee untler p�OvI5IOn5 OI C�e�ta� 9 �COT• - J menCing wltM1 Settlon 7000) of Dlvislon 3 of the � Business anA Profezslons Cotla, antl my Iltensa IS In full forte antl eftect. til Liconse Class Licensa No. Date � Slgnatura � WORKERS•COMPENSATION DECLARATION � �I hereby afflrm Ihat I ha� a cartiticate ol consent to sel/-Insure or a certltitate of Workers' Compensatlon Inzuranta, or a certlfie0 copy thaYeof (SeCtlon 3800, La4, C.). Polity No. � Company - r' ^arHfletl copy is hereby furnlihetl. ertifletl topy i5 tiletl Witn the city Builtlin9 Div151on. _'MPTION FROM WORKERS' COMPENSATION DECLA0.ATION (Thli section neetl not be Completetl if the Oermit is /or one huntltetl � �53001 or lessl. cert(ty t�at ln the performan[e of the work (or which tnis permit is � Issuetl, I zhall not emPloy any person In any manner so ds to b¢co e .`�, subJeciEo th �° �� s Anature tlqyLa_v}s nf GY✓oAla�� Date `T f' .-G3�iv L �NOTIC : If a/ter makin9 thls tlaclaratlon, you sho Itl beto e subject [o the Workeri' Compensdtion provislons o( the Labor Code, you must forthwith tomply wilh such provislont or this permit snall be tleametl "�(' ravokotl. .. . . . _ CONSTRUCTION LENDING AGENCY 4 1 hereby altlrm that there is a constructlon lentllnq agency tor the per- �formance ot the work for wnic� thls Oermlt Is Issuetl (Settlon 3097 Civ. CJ. ' .,F LenCer'S Nama � Lentler's Atltlrez5 OWNEF BUILOER DECLqRAT10N � I hereby aftlrm that I am exempt Irom.the Con[ractor'S LlCense Law tor tne following rea5on (Section 7031.5 Buslneis antl Profe551on5 Cotle: � Any city or county which reqWres a permit to conSiruct, alter, Improve, tlemolish or repa�r any structura, prior to Its issuance, alzo re- qWres tha appllwnt for sych Oermit to file a slgnetl statemenl tbat he � Is Iiteniotl pursuant to th6 provislons of the Contractor'S Llcanse Law � (Chapter 9(tommencing �yith Sectlon 7000) of Divislon 3 ot tlm Buslnezs antl Prde551on5 Cotle) or lhat'he is exempt therefrom antl tha basls for tho allegetl exe�Tptlon. Any violatlon of 5ectlon 7031.5 by ar•• aDP��nt for a perrt�it sub�ects lne appllwnt to a tivll penalry n more than tive huntlrotl tlolldrs (E500�. D5 owll¢r Ot lha prODtltY. of mY GTPloyee5 with wagei ai th¢I! Contractor'i License Law tloes not apply to an ownar of a proDer[y wh0 bulltli Or ITp/ovei thOreon, antl who tloes such wOrk nlm5eli Or through hls own employap5, p/ovltl8tl [hdt zuch ImprOveT0015 8r0 not In[ontletl or offeretl for sale. If, however, the Duiltling or Improvemen[ Is soltl withln ono year ot complotion, the owner wlll have the bur0en of proving he tlltl not hulltl or improve for [he purpose ot sale). ❑ I, as owner of the property, am exclu5lvely contracting with IlCensetl contracto�s to <OnSVUCt the project (5lCtion 7044, BuSIn955 antl Prolessions Cotle: T�0 Contrattor'i Lltense Law tloei not apply to an owncr of property who builtls or ImOroves tneraon, antl who ton- tlatls tlortl such plo�6<t2 wlth a COntlactof(s) IIC@Sn¢tl pur5udnt to iha ConVactor's LJtense Law�. ❑ I am axempt untler Sattion B. & P. G. lor this reason Date Owner - 1 hereby cartiry that I have reatl this appliwtion anG stata that the abova InforTatlon IS CO/rect. I dgreG [O comply witn all city dntl county ortllnances antl state.laws relating to con5trucHon, antl herpby authO�liB mnrwcentatives of this citv to owler uoun the etloviL�entlonetl LICanS¢ or 55 TVPE OF PERMIT ❑ GRADING ❑ FOUNDATION ❑ STRVCTURAL �TENANT �ELECTRICAL OPLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION SQ. FT. �1 . OCCVPANCV�qCONSTRUCTIONTVPE FP.AYNE VALUATION��•t%O ZONE G � GRADING CU. VDS. ACRES REMARKS: PLUMBING BATHTUBS fOILETS LAVATORIES KIT. SINKS SERV ICE SINKS FLOOR SINKS DRINKING FOVNTAINS INTERCEPTORS SWIMMING POOL WATER SERVICE GASSERVICE WATER HEATERS SEwERCONNECTIONS SOLARTANK SOLAR PIPING SVS. ISSUE FEE 'PLAN CHECK SHOWERS URINALS DOUBLE LAVS OISHWASHE0.5 SUMPS FLOOR DRAINS CLARIFIERS P TRAP ALTERATION OVT�ETS BTU OUTPUT COLLECTORS MECHANICAL PLAN CHECK HEATING SVSTEM 0-]00,000 BTU_ AND DUCTING 300,000 * BTU _ REFRIGERATION 0-300,000 BTU_ SVSTEM 100,000 a BTU_ BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAVST SVSTEM MULTIPLE - � ISSUE FEE CMF 0865-46 White-B��Itling; Canary-Appllwnt; Pink-Accounting: Goltlenrotl-Assessor REAR VARD PKG.SPACE STREET WIO CONDITIONS: PLNG.REF. PARK FEE ELECTHICAL aLAN CHECK GENERATOR p-1 KW_ 1-30 KW _� TRANSFORMER APPLIANCE 70-SOKW_SO+KW� MOTORS ' 0-1 HP_1�30 HP _ (INC. SOLAR) �0-50 HP=50 + HP ,� FIXTURES OUTl.ETS SWITCHES GAS TUBE SIGNS POLE LIGHTS PANELS MAIN SVB SERVIGE 1 .rR9�L"O I/V1 AMP APPLICATION %�PPROVED BV SUMMARV OF FEES BUILDING PERMIT § PIANCHECK S PLUMBING S PLANCHECK S ELECTRICAL S� PLANCHECK E MECHANICAL E PLAN CHECK S SMIP PERMIT ISSVANCE GRADING DATE E _ E _ E — S MICROFILM E TOTAI FEE 5 LESS AD- � VANCEPC E_ FINAL FEE E `� oL- „ CONSTRUCTION AND PLANNING POOL & SPA � APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1. Temporary Electrical Service ct�' �;� 43. Pool & Equipment Location �' •-' - . Soi ipe-Un rgrn - 44. Steel Reinforcement � ' 3. Electrical Conduit Utiiity-Undrgrn � 45. Forms ' 4. Electrical Conduit-Undrgrn 46. Electrical Bonding - -- . tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE - 7. oo[ings - 49. Electrical Conduit-Undr m � 8. Foundation 50. Gas Pipe, .❑ Undr m, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn � 70. Structural Floor System 52. APPROVALTO DECK i t. Property Sewer Line & House Connection i 53. Backwash & Rece tor-Final 12. Street Sewer Connection � 54. Heater & Vent-Finat 13. Rough Plumbing ' 14. Rough Electric-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 Sheathin ' - � 22. Frame and Flashin NOTES: 23. Insulation 24. lathin & Siding 25. Drywall Nailing 26. Plaster Brown Coat - 27. Electrical Power Meter-Finai G 26. Final Electric �-�� - � ' 29. Final Heating & Air Conditioning - 30. Final Gas Pipe-Test „ 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Fi�al 34. $olar pomestic-Final 35. Landsca e S rinklin S stem 36. Sound Attenuation 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 . .i :, COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING `�Q ' �, / �1 ADDRESS /Q � 'r OWNER OR R' M TENANT MAILING //' 'J j l qODRE55 �(p 7 J CITV '/%�1�� IVOL. BPANCH , ADORESS ARCHITECT ' l OX85 6/I�/EC "c4:oCG TL APPLICATION FOR STRUCTURAL PERMIT A.P. NO. � ADDRE55 ��j/� /� , `/ � s ��`T_ ""�T °R !� lD D SPACE NO. TR.NO. LOT NEW ADD ALTER REPAIR MOVING DEM( WNER �. .�. USE�, �y'{,�yrD WWES�� APPROVED ADDRESS g�L �`(• /—�,�fJ(� � (�/ TEL�33�2 CITV NO. � STATE CITY APPROVED SETBi �I0. NO. Z LIC. NO. W SIZE ' NO.OF BLOGS. IFFOM C/L STR�F G OF LOT �C � U NOW ON LOT OM F- `� USE OF � � EXIS7ING BLDG. - � � � Separate permits are required for L. SIDE Fi a elec[ric, plumbing and heating wmk. qEAR ' Fi W USE OF BU�LDING �+ND WORK TO BE PERFORMED [.w PLANNING ACTIC a ,/ '7 .� �-e Or CGs q �' APPRO J � W 0 1 hereby aeknowlatlge cha� 1 hove ieetl thls eppllcaHon entl stete � that the ebove info�matian Is correct antl eprea to comply with a ell laws reOuleNnp building conatrucNon, antl I zhall nOt employ �eny perwn in v(olation of the workmen's compenmtion lewe of �„ t1�e State ot Calitomla. � I hereby mrtlfy that I am proper�y IlcensaC es a eontraGtor under 54. F the State of Calitornle Busineza and Profeuions Code, Dlvlsion 3, THE AMOUNT Chapter 9, and that wch� licanzes are In tull tofce entl effact, or 1 THE PURPOSE C am exempt from the Provisiona of the Smte o Callfornia eusiness VALUATION antl Professlona Cotle, DWiyen 3, apter 9. / � Signemra af / �� G• /�� Permittee g y/) p�,.� �� 30 8 �IV Vvai Authorixetl ABent Da[e r �/ r � . �� .__ / DATE r APPROVE � 7 nnT� 1i �Y/�� h i m m N JN UNDEfl VALUATION IS FOR m ABLISHING A PERMIT FEE ONLY: e PERMIT FEE E� �� q n n PLAN CMECK "� 0 LL TAX S �� F u TOTAIPAID w _ i � �J . ' F C a a � � x F C W F� Q O Y i' .� x w a O a Z W S 3 COSTA MESA BUILbING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Usc Ink Only ADDRESS �� V�• I `�� T�ENANT�R �� G.G. �.y,� CC�.O!'� MAILING �� `O I � ADDRE55 b GTV `�ECA.i�v'�' � NOL��G��—� BRANCN ADDRESS ADDRESS �c.s /'r• Uv+�. CONTRACTOR c? �� ADDRESS ✓{UZ N � CITV Q � LIC. NO. ZZ ��Z SIZE OF LOT TEL. No. (33- CITV LIC. NO. INO.OF LB�DGS NOW ON LOT Separate permits are required for electric, plumbing and heating work: USE OF BUILDING AND WOflK TO BE PERFORMED I hareby acknowledpe ihat I heva reatl this applicetion antl rtete thot the above informetian is corract antl apree to comply wlth all laws regulatinB builtlina eonstrucNon, entl 1 s�all noi employ eny persan in vlolation of Me workman's compensation laws ot Mo Stete of Celifornla. I hereby certffy that 1 am properly Iicanaed as a conttactor untlar tha Stata of Celifornie Bug��eu end Professions Code, Dlvlsion 3, Chnpror 9, and t�at suc�,l{ee c� are In full force and effect, or I am exompt fr0 �e pr<v�iio s of�(he tate of Californla Business untl Profes onz C e, DI tlo , Ch1Wt r 9. Sipnncura o � � Permlttee or (� Au[horized Ageni Date � TION FOR STRUCTURpL PERMIT Eo 5� TL A.P.NO. �� BUILDING �� AODRE55 UNIT OR SPACE NO. TR.NO. LOT NEW � ADD LTER �+ USE I?'I APPROVED APPROVEDSETBACKS (FROM C/L STFEET) NG ACTION THEAMOUNT TNE PURPOSE ( VALUATION $ �� C/ '7- ( - vv ✓V • ��y �+� • BlK REPAIR MOVING DEMOUS Vq�UE � E — ��„� �T- 3 DATE / /�3/ rjO APPROVEDf� O i :� a n > m m � VN UNDER VALUATION I$ FOR m 'ABLSHING A PERMR F ONLV: � PERMIT FEE y � AO a n m PLAN CHECK 5 � "� O TAX S O LL , D f U TOTALPAID E .� ='�t'. �iesa Building Departtrien� —' AZ r� L�u�'riUN r,;n-�,,,�iivur '— ��:;,'# .d�c °:.. � 111 EAST 20th STREET ' �jQ __ B U.I L D,I�..N G___.' '. �,,. � �'+�T�`COSTA MESA, CALIFORNIA •- � Y'- jAPPLICANT TO � , �OR OFFICE US� ONLY Receipt No. Permlt�No. I Bullding �i /// ! ' /! j� '7 � j7 � AddrGss ��_/ W�� - ° — � : J-d / �p . Costa b�esa, California Received bx Date Rec'd. Date Isaued ' „__—�-, ' � ° ��-9�s� Owner � Mail �� Address City—�r(1'.�'.�/� Architector �� Engineer Address �- 'i��(r Aei„� Add ress e� � � � Legal ' Lot Description � No. TTI� ity Lic. ounumy � Address � � Costa Mesa, Califomia Cross St. • ZoneG, � I No.of I Type Plans Approved bY CORRECTIONS No. of Bldgs. �- Size of Lot Now on Lot .� .- - -- - —•- � -- � Useof I No.of No.of r;L. 1 A ExistingBldg. r Families �I Room9� � 1�� Setback Line from ��1 � Rear Vard - - � � � ^"" - --" "' � Z Center of Street �p�� Side Vard � DESCRIPTION OF WORIi FiITY OFC'��T�iIES� Nevi � I Alteration Repair I I Moving Bufldi � � No.of Size �� Room: �xterlor Wallr R verina -'7 %i I C Addition Stories 7 hereby acknowledge �that I have read this Application and:state that the above is mrrect and agree to comply �xith all City Ordinances and State Laws regulating building w ruction. Signature of /// Permittee _ ��- (..�+ �E /Zi� � __.—+sv Authorized Aut. .:./' $ �'�1 � Total �c Fee $ APPROVALS Foundation Lxation • Inspecto Forms, Materlals, Under-Pinning Frame: Fire Stops, Int. Date — '_" _... i V ' ' � n . ..' :..Q.a , � . . .. �.. . 1 : • f 8how Iocation and dfstancea from property line and hetween buildinga . :�Sy�,-�lr`'? T�+�(,.-��:.'lqP'�i'J .��•'f:�. i'. �'.l�Y.'Y�s��^�� ` �. a <� COSTA MESA BUILDING•SAFETV DEPARTMENT EY j P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING � � ADDRESS OWNER OR � ,/ � TENANT .;,AL.F /�� /�U ADDR'E 5/S ..iu �i�I TA [io✓ I� r CITV �r I�. L/�A N�L�� G � y � F WG F� � � i� � W 0. 0 LL' O� Z{y S 3 BRANCN �� CONTRACTOR .// /� / ADDFESS CITV STATE LIC. NO. OF LOT �j �7 r� ��[ �� USE OF CITV IIC. NO. NO.OF BLDGS. NOW ON LOT Separate permits are required Cor electric, plumbing and heating work: UILDINO AND WOFK TO BE PERFORMED ) / �^�� P yn ,. �/ � !v C�r .. . � •� . . .J '� 1� / ��_� I h�raby eeknowlWpe thet I Aeva r�etl thls ePplleetlon entl rteta thet Ma ebov� Informetlon I� corr�ct end e0raa to comply wIM ell lewt /spuleTlnp bulltllnp <onrtfuttlOn, end 1 Mell not employ eny p�rwn In vloletlon of ths workmen'� companuNon lews o1 Ma Steta of CelHornle. I �ar�by e�rtlfy that I em plOpa�ly IIC�IIMO e� e contlector undm Ms Stete of Celifornle Bu�lnm entl Vrofndoro COE�, Dlvl�lon 7, Cheptv 9, end ffiet �ueh Iie�nwt ero In full force enE �Hact, or I 'em aw�mpt irom Me Orovitlons o1 tho Stet� ot Celifornla Bualnau en0 Prolralon� Cod�, Dlvidon 3. Cheptar 9. Slpnetw� aQ f '��^ ��(�/ i` Parmltto �y ^.�'. ; / �./- �: �r� .� �.� \ o, , AUNorli�tl Apant ��e APPLICATION FOR SfRUC7VRAC PERMIT ��, ; I RECEIVED BY PERMIT w n/�� I �r8�r A.P. NO. BUILDING AD�RESS UNIT OR SPACE NO. TR.NO. LOT tlL�c. I NEW ADD LTER REPAIR MOVING DEMOLISH � �� OWNER �.f, N Il� �� VALUE \ 'r � l t: 3 . (1 1J-r7 •�_` ^/ � "y � — — APPROVED p BV DATE v r � APPROVEDSETBACKS (FROM GlSTREET) FT � J PWNNING ACTION OJ�TE APPROVED � �-r �� P I C i 0 � . FT. n THE AMOUNT SHOWN UNDEP VAIUATION IS FOR m THE PURPOSE OF ESTABLISHING A PERMR FEE ON�V: � VALUATION VERMIT FEE f � N � I n IPLAN CMECK S �i � �� p ,. S C�0 �/J•� Zi 7Ax 5 .G,/" u�� '� . l . ._ _— TOTALPAIO f �,-•7(�� / � _'I ADP��cant lo fill in all spaees within �eavy bortler lines antl si9n all aoV�opriate tleclarations. CITV OP �STA MESA ' PERMIT NO. . ,-. .TRACT NO. LOT NO. BLDG. NO. coNSTRUCTION PERMIT /� G �� Prolect Address T�8' /.V 1 G�/J 0. TYPE OF CONSTRUCTION Ownef /j.Ryy[( �iQ/t , Pr�one 6 3r-S? 8 ❑ NEW ❑ ADD ❑ ALTERATION Address- � � �"�� ' - O REPAIR.O CONVERSION �❑DEMOLISH ArchlEng. ' ' ' Licenie NO. � ❑ OTHER Addres5' - � DESCRIPTION OF WORK Contractor - - Phone� TVPE OF PERMIT � '. , � , - Add�¢55 ' - - ' - � - , O GRADIN ❑ FOVNDATION ❑ STRVCTURAL .LICENSED CONTRACSOR DECLARATION . ' � � 7ENANT�LECTRICAL ❑PWMBWG OMECHANI 1 hereby afOrm th:.t 1 am Iicensetl untler provlsions ot Charter 9(com- ,/— - mencing with� section 7000) of Dlvlsion 3 of the 'Busine5s antl ❑ OTHER - Protessions Cotle,' antl my ❑cense Is In full forca antl eifect: •,pROJECT DESCRIPTION • - . Llcense tlasz � Llcense No. � - ' . . 'Date Si9nature ' �� ' SQ. FT. _ WORKERS'COMPENSATION�DECLARATION ' - OCCVPANCV=CONSTRUCTIONTVPE � � I hereby afflrm thzt I have a certlficata o( consen[ to sel�-insure or a VAWATION �ZONE �cer[iTiwte- o( �Workers' Compensation Insurance,- or a certilietl copy' - --� [hereof (Section 3800, Lab. C.). � GRADING CV. VDS. ACRES `Policy No. ' Company - " ❑.Certifietl topy is'hereby furNshetl. � . . _ � . "'REMARKS: � . . ' .._ . . - . ❑ Certifietl <opy Is.tileA wlth Ihe city 8uiltlinq Division. _ 'EXEMPTION'FROM WORKERS"COMPENSATION DECLARATION - " ' " ' " '(This sectlOn n¢etl nOt De.compl¢[¢tl.if the permit is fo �one huntlretl -' - -- , . _ (E3�0) Of �B55�. . . _ '. , • .' :I certity that in t pert mance ot the work for which this pe�mit IS , issuetl, I s II n empl any per'son In any manner so as [o�become . PCUMBING � + PLAN CHECK Datject t C W ers' om�ure tlon f..pyl� j��IZ r/ a -... . �� BATHTUBS SMOWERS .NOTI E: If (ter making this tlecl5rat on you shoultl become subjeci �.' TOILETS ' VRINALS [o the Workerz' Compensation pro'visions of tne LaOor Cotle, you muzt LAVATORIES DOUBLE LAVS ' fo�thwi[h comply with suth p�ovi5ion5 0� thiz permit shall be tleemetl revoketl. . . - . - -' � ' �� 'KIT.SINKS DISHWASHERS'- ' CONSTRUCTION LENDING AGENCV • I her¢by atfl�m that th¢re is a conStruCtiOn I¢ntling ag¢nty to� the per- SERV ICE $INKS SUMPS �� formance ot the work for whi<h this permi[ is issuea ($eclion 309] Civ: C.). ' ' ' � ' � ' " FLOOR SINKS � FLOOR DRAINS� � Lentler's Name Lentle�'S Atltlress DRINKING FOUNTAIN$ - � ECLARATION am exempt from the (Section 7031.5-Bu or any to : Law for �NTERCEPTORS CLARIFIERS nsCotle: 'SWIMMINGPOOL ' PTRAP '- "' ' :t, alter, :, also re- yyqTER SERVICE ALTERATION that be mse Law GASSERVICE'�� OVT�ETS . 'Business antl �Professions Cotle) or [hat he Is exempt tM1eretrom ana me� yyqTER HEATERS BTU OUTPUT �' ba5i5 for the allegetl ex¢mp[lon. Any vlola[iOn of SeCtion 7031.5 by , my applicanl�tor-a�permit subjects [he applicant to a civibpenalty SEWEftCONNECTIONS �� f not more than five huntlretl tlollars ($500�. � ' ,I, as�owner ot the propmty - � ' ' SOLAR TANK " COLLECTORS ' will tlo tM1e brk, antl the struclure is not inientletl or otferetl for 5al .(Section 7044, Busine55 antl Professions Code: The SOLAR PIPING SVS. Contractor'S LI<ense 12w tloes not, apply to an owner of a property who builtls or Improves Ihereon, antl who tloes such work himself or ISSUE FEE [hrough his Own employees, provitletl thal SUCh imprOvements a�e not Intentletl o� oHeretl for sale. I/, howeveq [hC builtling or improvement MECHANICAL P�AN CHECK is sold within one year of COmpletion, tho ownEr will have the bu�tlen ' of- provin9 he did not bulltl or improvC lor tM1e purpose of sale). HEATING $VSTEM 0-300,000 BTU_ ❑ I, as. owner �of the pro0arty, am axclusivety mnVattin9�with qNDDCICTING licensetl COn[raclor5 lo conSVuct [ne prOjecl (Section ]044, Business 300,000 + BTV _ �antl� Professions-Gotle:?ne Contractor's Llcense law does notapply to - an owner of properiy wM10 builtls or improvez tnereon, antl who con- REFRIGERATION 0-100,000 BTU_ (racts-f�om such projects�with�a contra<to�(s) IicBsnatl- pursuant t0� SVSTEM- ' p the Coniractor's License Law�. 300,000 + BTU _ + ❑ I am exempt untler Sectlon - B. 6 P. C. for this BOILERS BTV J rea5on - SVSTEM REVAIR, ALTERATION � Date Owner I hereby certilythat I have reatl lhis applitation antl sta[e that the above EXHAUST SVSTEM • MULTIPLE ' Intorma[ion'is mrreci.'I agree to comply w all dty antl munty ortlinances antl state laws rela}ing to c struct" antl here0y authorize rep�esentative5 0( "th15 y lo e r up [he above [ionetl property tor insp¢cli pulpose . . / � � Si9nature C ( D t � � Drivers' License or 55 ac � /� 'ISSUE FEE !\�"MF 0865-4fi White-Builtling; Canary-Applicant; Pink-Accounting; Goltlenrotl-Assessor � 012i1 I I /03/�72 -+• A.P. � ZONE � REAR YARD (TO P/L) . PKG. SPACE RE�. STREET WIDTH� � ' ' ZONING APPROVED BV SPECIqL CONDVTIONS: ELECTRICAL •� � REGULATIONS - �" PLNTGp. RUEFL. �g � PROPE�RTYNL NE � PROVIDED PARK FEE 5' T VLAN CHECK`� - , � GENERATOR 0-1 KW_ 1�10 KW '_ �TRHNSFORMER APPLIHNCE 30�50 KW_50 + KW _ MOTORS 0-1 HP_3-10 HP = �(INC. SOLAR) ' 10�50 HP 50�+ HP _ FIXTURES�- � OUTLETS SWITCHES .GAS TUBE,SIGNS �-. � .- POLE LIGHT$ � .. ' . � . PAN�lS MAIN = -, �SUB � SERVICE -�.qMP � . �� = � 1 � :� APPLICATIONAPPROVEDBV, . , ' '. DHTE . . � ' - " SUMMARV OF'PEES " � � BUILDING ' , � � , ' ' PERMIT E SMIP � - $-__ PLAN CHECK S � PERMIT , . ISSUANCE- S PLUMBING E ' ' G0.ADING -$_ PLAN CHECK E '• ' ELECTRICAL E •B� � $ , PLANCHECK S ' MICROFIIN §' MECHANICHL b � TOTAL FEE S PLAN CHECK E LE55 AD- ' . ' VANCEPC $_�___ . . FINAL FEE. $ _D_�+ CONSTRUCTION AND PLANNING �� , POOL & SPA ' APPROVALS Permit #�� D8�` �� AFPROVALS: �� Permit # '� Date Inspector 1. Temparary Electrical Service or Pole -.., � ��' 43. Pool & Equipment Location � • �� i ipe- ndrgm Steel Reinforcement � - - 3. lec[rical Conduit Utility: Undrgrn 45. Forms -� -- 4. ElectriCyl Conduit-Undrgin �+' 46. Electrical Bondin � � � . ee ein orce ' 47. Rou h Plumbin & Pressure Test - ' 6. Electrical UFER Grn 48. APP.ROVALTO COVER-GUNITE 7. ootings - 49. Electrical Conduit-Undr m � - 8. Foundation 50. . Gas Pipe ❑ Undr rn Test 9. Water pipe-Undrgrn ' 51. Backwash Lines P- ra '❑ n r 10. Structural Floor System 52. APPROVAL TO DECK 11. R'operiy Sewer Line & House Connec[ion 53. Backwash & Rece tor-Final 12. Street Sewer Connection 54. Heater & Vent-Final � 13. Rough plumbing � � ' 14. Rough Electric-Conduit '56. Electripl-Final 15. Rou h Electric-Wirin 57. Solar System-Final ' ' 16. Rough Heating & Air Conditioning • e�cing & Access Approval 17. Duc[s in Structure - • APPROVED FOR PLASTERING 18. Duc[s, Ventilating . ' _ , .. „ __ 19. Gas Pip¢•Rough & Test 60. POOL/SPA SYSTEMS FINAL - 20. Roof Framing 21. Roof gheathin � � 22. Frame and Fiashin NOTES: 23. Insulation � 24. Lathin & Siding � 25. Drywall Nailing - � 26. Plaster, Brown Coat � 27. Elec[rical Power Meter-Final /�� ' 28: -Final Electric . ' 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test � 31. Final piumbing � ' ' ' 32i -Water gervice-Final 33. Gas Service-Final•• ' � 34. Solar pomestic-Final � � � 35. Landsra S rinklin S stem � 36. Sountl Attenuation � 37. Handicap Regulations 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. � - �� 42. CER7IFICATE OF OCCUPANCY - No Date � � , . . � — Applieant to fill in a11 spaces excev< <hose within neavy borGe Iines ana sign all ayN�vr••.•......-.��..._ __ y ' ' F=cosTannesA-- CONSTRUCTIONPERMIT � PERMITNO. T c7�vo LOTNO. ITNO. ' 2413 5/06/85 G3vo"r:. .TL CITYc /T ._ 7 Sr `79 .C/ ��Yl.� 7�I ' � A � - •- , ��ddress �7�� :a.� ��i� $r #� ; pplicantsMailingAddress' ��Z �p�✓�GYC.� �� S�'. . Owner's Name E 1% 01 � �9 G t� � � Phone �3'�'SZ�I .� �Address �� N�ndlerCr� Dr �.c�nCl�o �a�ot VQr�PS Arch/Eng. License No. � Address �, c Contractor'sName�.iy HAQ�� hd Phoneb�l�-4i�(��o Address Imailing) sy 2� Y� 5+. '-' �' City License No. -� fi Z � S ' � CICENSED CONTRACTQR DECLARATION I•hereby�aHirm that I a�m licenzetl untler provislons of Charter,9 (commencing with sectlon ]000) of Dlvlsion 3 of the Bu5ine55 antl Professions Cotle, antl my Iicense is In (ull force antl ettect. ' ; License Class � � Lice sa No. �' � Z �'1 ' Date 4'-ZI-$S �• Signature WORKERS' COMPENSA710N DECLARATION I heieby alti�m [hat I hav@ a certifitate ot con5¢nt to selt-insut¢ o� a Ce�tlficate of Workers' Compensation Insurante, o� a certlfietl`copy thereo/ (Section 3800, Lab. CJ - " " - � Policy No. Company 8 Certitietl copy i5 h¢reby tumishetl. Certifietl copy is filetl with the city Builtling Division. Date ' Applicant • EXEMPTION FROM WOqKERS' COMPENSATION DECLARATION (Thissection neetl not be Gom0leted if the permit Is tor one huntlretl (5300) or less .. ) rk (o� which [his e�m�t is issuetl I I certify that in the perfarmance of the wo P zhall� not ¢mploy any person in any mdnner so a5 lo bec me suCject to t�e Workers' Compensa(ion Ly�vs of Calitomia. N ^ G),[�.�,� .Date' 4-Z-1-0.5- Si9na[ure JCZ� '-""-' AnnT� . . 'NOTICE: If, after making this tleclaration, you snoultl�b ome subject to tha Workers" Compensatlon brovisions of the Labor Cotle, you must forthwith compty with such p�ovjsion5 0� thi5 pe�mil Shall ba� tl¢emetl revoketl. , ,CONSTRUCTION'LEN�INC. AGENCV " I ltereby aifirm tbat there is a const�uttion lentlin9 ag¢ncy fo� the pe�tormance , of Ihe work for which Ihis permit is ISSueO (Section 309] Civ. CJ LenOer's�: Name � �' Lentler's AGtlress � � OWNER BUILOER �ECLARATION i nerebv atflrm�tnat I am exempt irom tne Conlraclor's License Law (or the to lile a slgnea slait the Contractor's Lic Divlsion�3 01 the',E theret�om antl the, 7031'.5 by any ap �enalty of no[ more I, as owner of� compensation will�� tor saie (secfion � License Law tloes n thereon, antl wno � emploYees, piovi0e� sale. If, howeveq t� o�etlon, tne ownerr �rove 10� the purpa. I. as owner o1 il builtls o� Improves [r � fldCtO!(5) IiC¢OS¢ puf5 proof o( lheir Worke ❑ I am exempt unifer �]031.5 Business antl Professional Cotle: Any city or permit to construct, alter, improve, tlemolish or repair s issuance, also requlres tne avP��cant for such permil � t that he/she Is Ilcensetl pursuant to the provisions of Law (Chapter 9 (commencing'with-.Section 7000) of ess anq Protessionz Cotle) or that he/she is,exempt for the allegetl exemPtiOn. AnY ��iolatiOn ot $ection nt �or a permit subjeGts the aOP��ant to a civil five huntlretl Oollars (g500). � ' '. D�operty or my employ¢¢i' with wdge5 as their sole ie work, and the structure is not intentletl or offeretl Business and Professional Cotle: The Contractor's ply to an owne� ot a p�ope�ty wno builtls or improves such wo�k hlm5elf/herselt or tbrou9n his or her own t such improvnmenls are�not inteneetl or ofteretl for Ilainq or imo�a�ement is soltl wiNin one year of wm- : �ave the burtlen 01 provin9 he/she tlitl not bulltl or im- sale). operty,-am exclusively cOntrattinq with lic¢nsetl con- pIOjBCI ($CCIIOO %04Q. BUSIOE55 dOd PIOfE55�005 COtlE: ' e Law tloes not apply to an owner of property who xon; an0 wno <ontracts (or such projects wlth a con- nt to Ibe Cont�actor'S License Law). I am aware that 'Compeniatlon insurance shoWtl be orovitletl to me. :ction 8. & P. G/or thi5 reason TVPE OF CONSTRUCTION LI NEW - LI ADD L7' ALTERATION LJ REPAIR � ❑ COIVVERSION ❑ DEMOLISH ❑ OT�R O � A.P. dp p�;� R�y OF WORK/USE OF BLD�� -Yr � � E Main euilding:, « TYPE OF PERMIT GRADING .FOUNDATION •STRUCTVRAL T Ffont ❑ TENANT ❑ ELECTRICAL ❑ PLUM6WG ❑ MECHANICAL ,' , A Rear ❑ OTHER PROJECT DESCRIPTION SQ: P�/7�. � OCCUPArvCv B"� C Right , CON57RVCTIONTVPE '• � VALUATION$ L�%OO� S left � � ZONE GRADING CV. YDS. AC1iE5 Pl�y. R¢f. �' Remarks: -- �s � 2 Planning Notes: <'Vc �fG-� SS'ii Drinking Fountains Floor Drains Floor Sinks � � Gas Service �OuUets ' Interceptor Kitchen Sin , - Lavatories. , P-Trap� � ��. Roof Drains , r � _ ,. � ReinzpeMion Fee� $15 Boiler Duct- UnderGround Duct-Structural � Duct - Ventilating Exhaust System ❑ Multiple ❑ � Firepl/Fact. Blt. ICBO �H Data - OWner , Heating System & Ducting ' ' 1 hereby��certlfy.that.,l�have rea0 IhiS application antl state fbat Ihe above ❑P700,000 BTU �100,0008T intormatlon Is correcL 1'agree to comply wlth all city an0 county ortlinances ana,5tat¢ IawS relatin9.t0 builtling conStruCtion, and hereby authoriie r¢pre- ' r sentatives �oi this 'city to enter pon tM1e above-mentionetl property tor i in5pectlon purposes.' q - Signature • � �' Date 4'Z�'85 DriverY Ucense or 55 � � ' Reinspection Pee $�5 -.0865-46, rev. ]0/84 Whit¢ - Builtling; Canary - Appljcant; Pink - Accountin9; GOltlenrotl - ASsessor Sewer Connection Solar Collectors •� Solar Piping Solar Tank Swimmin P I�w 9 Urinal � er Service uto-Wash Laundry Tra� v � Issue Fee � $ 3� FEE Hood or Typel � ❑ . CanoPY TYPe II ❑ , . Refrigeration System � � ❑aioo,000eru ❑ioo,000eru System Repair/Alteration Fire Oampers Registers ' n Issue Fee 3 Auromatic Waiher Construction Pole S� Cooking Unit Dishwasher Dryers ❑Gas ❑E Fan F.A.U. Fixtures ' Device Baxes OuUets Switches Garbage Dispoul Generator �65 KN lectric , . Zon� Accessory Building: ig Req.fRrovided � , Z O N I N G E. Q M r S � ELECTRICAL , � FEES Trensformer ❑ 15-50 KW � � � ❑ SO+KW Meter ❑up to 700 amps Merer ❑over 100 amps ' � $ub Panel Momrs�0-1 HP �1yh-8 � Inc.Solar �9-15 HP �16-15+ -Microwave ' • ' r ' �Pole Light Range ' Sign ; Standing Sections 5-15 KW Trash Compactor ' i � Reinspection Fee �$75 I I luue Fee DEVELOPMENTSERV E R UIREMENTS: Zoning Approved By Building Approved By _ Ae..1:�eH.... I.<�.sA Rv . i / $ 3 S-6 �85. r _r� SUM ARV OF FEES � � �7� � BUILDING PERMIT $ ��0. 'rJ0 SMIP $ �-� PLAN CHECK $ � �-. 3 � pERM1T PLUMBING $ ISSUANCE $ PLAN CHECK 2596 $ � ENERGV P.C. $ ELECTRICAL $ GRADING $ PLANCHECK 50% $ MICROFILM �$ T MECHANICAL $ � TOTAL FEE $ �•��,�i PLAN CHECK 25% $ C , �' ` /NSTRUCTION AND PLANNING � POOL & SPA � �� Date Ins ector PPRUVALS Permit # P APPROVALS Permit # Date Inspectnr . Temporary Electrical Service or Pole. . 52. Pool & Equipment Location - 7. Soil Pipe-Undrgrnd. , � 53. Steel Reinforcement 3.. Electrical Conduit UtilitY-Undrgrnd. 54. Forms f4.�Electrical Conduit-Uniirgrnd. � � 55. Electrical Bonding . 5.- Steel Reinforcement 56. Rough Plum6ing & Pressure Test � ' 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE : 7.: Footings �' S8. Electrical Conduit-Undrgrnd. ' 8. Foundation . -� 59. Gas Pipe, O Undrgrnd., Test - 9.� Water Pipe-Undrgmd. -, � � � 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System 61. APPROVAL TO DECK ^ 71. Proper[y S¢wer Line�& House Connection 62. Backwash & Receptor-Final 72. Sewer Cap .� - 63. Heater & Vent-Final i 13. Roof Drains �� . 64. Plumbing System - Final � � � 14. Rough Plumbing�. � .. 65. Electrical•Final - 15. Rough Electrical-Conduit - 66. Solar SYstem-Final � 16. Rough Electric Wir.ing �" 67. Fencing & Access Approval 17. Rough Wiring Sign � � 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling . 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMHNT 20. Rough Factory Fireplace • � APPROVALS Permit # i 27. Ducts, in Structure , 70. Underground Hydra .��. Ducts, Ventilating . 71. Product Piping � Gas ❑ Oil 23r Ga5 Pipe�Rough & Test ' � 72. Underground Flush �4:-'Roof Framing ; 73. Undergrnd. Storage Tank � Gas ❑ Oil 25. Roof Sheathing ^ 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 7�7; Frame and Flashing � �S , 76. Dry Standpipe , 2$. Lathing & 5iding 77. FIXED SYSTEM FINAL 29. Insulation . � 78. FIRE PREV. FINAL 30�:'-Drywall Nailing t� y � HEALTH DEPT. REQUIREMENT 31�.Plaster Brown Coat � 79. FINAL INSPECTION 32.'Electrical Po`�'ier MeterFinal 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning� ' ' 35. Final Gas.PiPe-Test � ' � � 36. Ho / or Canopy : � . v 37. Firw�actorY Fireplace i 38. Final Plumbing,��l�� ! . 39. Wa SerGice-Final '�1 �". . ' ' � " . . ,� _ , , 40. Gai�ervice-Final '' , ' � 41. Sol�pomesticFinal - • 42. Ba � ow Preventer ' � . � 43. Backflow Irrigation ' �' ' � � �r.� 44. .Landscape Irrigation System�� 45. Sound Attenuation ��; �. � 46. Handicap RCgulations �� ' . . - 47. FINAL STRUCTURE & BUILDI�NG • � 48. Special Requirements Completed � 49. Electric Release to Edison , " - � " " � � 50. Gas Release to Southem Califomia Gas Co � � � � 51: CERTIFICATE OF OCCUPANCY - - - . - �� Nn. - " Date , .-- � - � ' �'.. CITY OF COSTA MESA : CONSTRUCTION PERMIT Aoolleant to f111 in al1 soaces eneaD� lhose uli�hin neavy baraer Ilnes ane slgn all aoorovriate tleclaratlons. -� PERMITNO: 7RA., NO.� LOTNO. BLD . . . Project Address i�� /I • � �/ � S�L �=CT ' u ApplicanYsMailingA/dd�reu /63� .�1i<-y�/J-2i� l�ie Owner'sName`- �^ � �cT�M Pne�e E3i.�7�Yi Address. �E�3 �'I�C/"� L�{/VD Ci2 ' � � . � � Arch/Eng: License No. � i Address, - Contractor's Nam � Phone Address (mailingl , City LicPnse No. � � LICENSED CONTRACTOR DECLARATION • I hereby, affirm that I am licenzetl untler provi5ions of Cnarter 9�(commancing • with section 7000) of Dlvision 3 of the Busineu antl Profesiions Cotle, antl my Ilcense is In full /or<e antl etfect. � � � � . License Class � license No.� Dzte � ' � Signature � WORKERS' COMPENSATION DECLARATION ' I hereby ai(irm that 1 have a certificate oi mnsent to self-insure or a certiticate � o(_W orkers' _Compensation. Insurance,,.or_a_certifietl .copy thereot .(Section. , 380Q Ldb. CJ � . . , � ' Policy No. ' � Company 8 Certifietl copy is �ereby fumishetl. ', ! , , . , , Certitiea copy is filetl with the tlty Builtling Division. � � Date Applicant , E%EMPTION'FROM WORKERS"COMPENSATION DECLARATION _ (This section neetl not be completetl if the permiYis tor ane huntlretl (5100) oi � less). . . • � . . , • 'I certify tltat in lhe performance of the work fonwhlch IhiS pe�m�t I5 i55uetl, I shall not employ any pe�son in any manne so a to b¢c0 subjett to the Workers'�pmpeAsatiomLawz of Californ�_ �_, . . , comply �wlth such p�ovlsion5 or thls ,pe�mlt snall De tle¢metl �evoNea. GONSTRVCTION IENDING [16ENCV' � - ' I heteby aftirm that [he�e IS a Wnstructlon Ientlin9 d9Bncy f0� Ihe pe�/o�mance� of tM1e �work for which. tbis permtt. is issuetl. (SecHon 30B7 Civ. 'C.) , Lentl¢r'z Name� ' IJCpE@!'S AtlEIE55 � ' OWNER BUILDER �ECCARATION ' ' ' 1 hereby, aftirm that I am�exempt. from tne Gdntractor's License law tor the � following reason (Saction'7031.5 Buslness antl ProTesslonal Cotle: Any city or wunty which �equir¢5 d petmit'to con5truct, alt¢r, iTprove, tlemolish o� repalr . ,any structure', pNor to Its.issuance, also reqWres [he applicant (or 5uth permit to (ile a,signetl Statement [hat he/she is Iicensetl pu�suant to lh¢ prOviSiOns o} the Contractor's Llcense law (Ghapter 9(commencin9 with Section 7000) o( 71vi51on 3�oi tne BusinBss antl Professions Cotle) Or tnat hu/zne is axempt . ierefrom antl the basls for tha allegetl examption. Any vlalation of Section 031:5 by any applicant for.a permit sub�ect5. lhe. applicant to a� civll . .¢e�nalty of nol mora than five nunaretl tlollars (E500). ' ..p(J I, as' owner of Ihe property �.or my employees with wages as thelr sole � tompensation, will tlo tne work, antl tne-structure is not Intentlotl or oHeretl i for ule� (Sec[ion 7044, Business and Profezzional Cotle: The Contractor'S LlcenSe Ldw tloes not apply to an owne� of d prOperty�who builtls or improvos � theraon, antl who tloci such work hlmself/hersClf or tltrOuqh hls o� he� own employees, provitletl that such improvements are not intentletl or offeretl.for sale. If, hOwever, the �Ulltlin9 or improvement is soltl within One year ot com- pletion, ine owner, will �have tha burtlen of oroving ha/sne tlitl not builtl or im- �rove�forthe purpo5e ot sale). I, dz own¢r of the p�operty, am exclu5ively <ont�acting� with IlcenseA con- � traccorsto construct tne project (Section 7044, Business anC Profession5 Cotle: , The ContractorY License Law Does no[ apply to an owner of property who -builtls or' Improves thereon, antl who contracts for such projects with a con- tra<tor(s) Iicense pursuant to the Contractor'S License Law). ' , ❑ 1 am exempt unaer Settion B. P. C. for this reason � Dte Z nwn _ ___—___ _ _ I hereby ce ify tnat I have reatl this application antl state that the above Intormation Is cor�ect. �1 agr¢e to comply with all city antl county Ordinan<¢s , antl sta[e laws relating to builtling const(� ction; antl hereby au[hoNze repre- sentatives of thls citY. to' en(e/. uporyithe above-mentionetl proDerty �ipr � � S �� • TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR, O CONVERSION ❑ OEMOLISH ❑ OTHER DESCRIPTION OF WORK � TVPEOFPERMIT.�� GRADING FOVNDATION STRUCTURAL - ''❑ TENANT IIG ELEGT,RICAL ❑ PLVMBING ❑ MECHANICAL ❑ �OTHER . ' � PROJECT DESCRIPTION 54.F7. ,oCCUVArvCv CONSTRVCTION T'VPE � � VALUATION 5 . ZONE � � ' GRA�INGCV.YDS. .ACRES Remarks: � � ' ' � . • , I: ., . ' . � � ', Sink cflow Preventer <flow Irrigation � rtuhs . � i ifiers iwasher� � = - ' iking Fountairis t . �r Dreinr � � �r Sinks ' ' i �nes- _ . �P .� . Drains• �; ' - spectionl�Fee � � • I $25� . . � Boiler � . . � � Duct - Under Ground � � Duct - Structural ' Duct-Ventilating . i ' Exhaust System ❑ Multiple �• firepl/Fact Bit. ICBO # Heating System & Ducting � ❑0.100,OOOBTU�100,OOOBTI Si9na[ure �./ "� �- uace i � Drivers' License or 55 � Reinspection Fee $25 CMF OB65-46 rev. ]/83 . White - Builtling; Canary.- Appliw�t: Pink - Accounting; GOltlenroA - Assessor ,_ 0 Showers Service Sink Sewer Cap � Sewer Connec Solar Collect< Solar Pipin9 ..� Swimming Pool wlSpx Urinal Water Closet Water Heater � Water Service ° r. � . Issue Pee � / -- $ 3 iANICAL � Hoad or � Type I ❑ ' Canopy Typell ❑ Refrigeration System . . ' ❑0700,000 BTU ❑100,000 BTU 1 laue Fee � $ 3 A.P. �W S Main Building:� E T Front B Rear , I > A C Right S Left Ping. Ref. # Parking Req./Provided Use of Building: ; — Automatic Washer � ConS[ruction Pole & Cookino Unit-i - Dryersa�Gas� �EI� Fan � � F.A'U. ' � Fixiures Device Boxes � i ODUetS i i Swiiches Garbage Oisposal . Generetor �0.5 KW Zoning Approved By_ Application Approved By 6159 9/2�/93 I2one ' . Accessory Building:_ B.u... Ti Z O N ' N � G Park.Fees $ . J - � ELECTRICAL � ' Transformei ❑ 15-50 KW � � 50+KW ./ - 'Meter �]up to 100 amps iMeter ❑over t00amps � ic � 'Sub Panel � 'Motors�0.1 HP�1'h-8 Inc.Solar•�9-15 HP �16-' - Microwave � � 15 KW P �� Range Sign Standing Sections,� � Trash Compactor , � Issue Fee ' . $ 3 � • � �ete ation Isuad'By w� "� ' Dat � �SUMMARV OF FEES � BUILDWG PERMIT . $ SMIP � $ PLAN CHECK ' � $ PERMIT � PWMBING �, $ 'ISSUANCE $ PLAN CHECK � $ ENERGV P.C. $ � ELECTRICA� � $ O O GRADING $ PLANCHECK � $ � MICROFILM $ p /�� MECHANICAL $ � . TOTAL FEE $ �'�`�" PLAN CHECK , ' $ . � � - � �CONSTRUCTIONANDPL'ANNING ; - �' � � -- - ^' ' ._ POO._ SPA-� , . - k' APPROVALS, Permit#� -', Oate -.�Inspector � AppROVALS Permit#: Date Inspector� i - ", , �, . il Temporary Electric8l Service or Pole �� _ - •, .52. Pool & Equipmenf Location � � `2. Soil Pipe-Undrgrnd. ' � : � 53. Steel:Reinforcemen4 - - �3. Electrical Conduit Utility=Undrgrnd.� � ' ' � - 54. FormS � . � -` - �, 4i Electrical Conduit-Undrgrnd. . , � - : � .' 55: Electiical Bonding ' ' � � ' '5. Steel Reinforcement . ' " � � ' -�56. Rough Plumbing & Pre'ssure.Test " 6. Electrical UF,ER Grnd. , � - _ 57. APPROVAL TO COVER-GUNITE - , 7-. Footin s ' � . � � � • g . � " 58. Electrical Conduit-Undrgrnd. . 8. Foundation , � - � ' 59. GasPipe,'O�Undrgrnd:;Test � � ' ' - 9. Water Pipe-Undrgrnd. � � - �_' 60. Backwash Lines, P-Trap, O Undrgmd. 10. Structure�l Floor $ystem �- ,' 61. APPROVAL TO DECK � 11. Property Sewer l,{ne & House Connection �, � 62. Backwash & Receptor-FinaP - 12. Sewer Cap � . = 63. Heater & Vent-Final 13. Roof Drains . , , � � ,64. Plumbing Sy,stem: Final • � 74.'Rough Plumbing - - 65. Electrical-Final - '- - ' - � 15. Rough Electrical-Conduit -,- -� - ' � 66. Solar�Syster»-Pinal - - ' � 16.. Rou h Electric,Wirin ` - - -- - - . . 9 9 . , 67. �Fencing &'Acbess Approva! . - 17.. Rouyh Wiring Sign ' ' �' - ; �.. 88. APPROVED; FOR PLASTERING 18.� Rough Electrical�7 Bar Ceiling ,�_ . �69.� POOC/SPA SYSTEMS FINAL ' � � 19. Rough Heating & Air Conditioning. � ' . i . �FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace ' � ; APPROVAL,S � Permit #' i i .. ' 21. Ducts, in`Structure � • � .�70. Underground.Hydro � :a • 22. Ducts, Ventilating � ' ,' , 7�1. Product Piping O Gas ❑ Oil % , 23. Gas Pipe-fiough & Test � �� . 72. Underground'Flush � ' 24. Roof Framing �� '. � , � 73. Undergrnd. Storage Tank O Gas ❑ Oil - 25. Roof Sheathing . � 74. Overhead Hydro ' 26. T-Bar Ceiling (Structuraq &'Monocoat . " • , 75. Dry Chemical . 27. Frame and Flashing , ,� ', ' 76. Dry Stendpipe - 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 � �, : 80. FOOD CERTIFICATE ISSUED ' 33. Final Electric �� ' � Notes: � � 34. Final �Heating�& Air Conditioning � � . � �� , � � - .. 35. Fina! Gas Pipe=Te'st _. ' � ' . - . � - _. . . � 36. Hood�or Canopy ' � � � �� - � '- � _ 37. Final Factory Fireplace ' , ; � � . , : _� � ' � � 38. Final Plumbing � , � � � • � 39. Water Service-Final ' � ' - • � � � ' � - 40. Gas'Service-Finali ' � • � � � � - � 41. Solar pomestic-Final , _ _ �. ' _ . . _ . � � 42. Backflow Preventer � , � �M=i� � ' - 43. Backflow Irrigation , , ' � i - . � 44. �Landscape Irrigation System � ' � � , ' � � 45. Sound Attenuation , � � • �, � i � ' � 46. Handicap Regulations , - � � � � ' 47.,FINALSTRUCTURE&BUILDING �� ' . , 48. Special Requirements Completed • � -' '� � , � ' 49. Electrie Release to Edison . � • - � • - - �- -+� � ' ��. - - • � , � , 50. Gas �Release to Southem� Ca�ifornia Gas Co ' ' , � � ' . 51. CERTIFICATE OF OCGUPANCY. � _1 - . _ .. . � _ • - i ' � No. � � �Date - � �. - � � - ' . ADDlicant to fill in all soaees exceot tnose witnin neavy Doraer Ilnes ane sign all avVroO��ate Ueclarations. � CiTY oF coS7A MESA CONSTFi�CTION PERMIT . Projec� Ad�ss � ��9 �L% � � ' � Applicant's�.^AailingAtldreu p-�/�'T� �� — Owner's Name �A• �� v�` 2 Phone -Adtlress '7 8� W �4 �� "'r� �Arch/Eng. License No. Address Contractor's Nam M_J/ E�i9CNf�PiiJ Phone �9J-g9Gf Addreulmailin9l P'o. ��n�a L�D�C`siG' G�Q— 2e Ciry License No: � � 0.3� LICENSED CONTRACTOR DECLARATION 1 nerCby at(irm thal i am IiGensetl untlBr provislons O1 Charta� 9(commCn<Ing with sectlon �000) ot Divlsion 3 ot the Businoss antl Profezsions Coda, and .my Iicense is in (ull torc antl ofiect. ' .Licanse Class /� r'�� Lic se N �!�9L G_ 'DatAi��.A�C 519natura . _ WORKE�25' OMPENSATION DECLARATION • ' hereby affirm that I have a cerUtiwta ot consent to sel/-insure or a<ortHicate Workers' Compen=ytion, Insurance, or a certiiletl copY thereof (Sectlon d00, Lab. C.),_, Polity No. ' Company 8 Certifietl.copy is hereby furnishe�. Certifietl copy is fi�etl with th¢ city Bulltling Divlsion. ,' . Date � Applicant . E%EMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl if tha permit 15 for one huntlretl (5300) or I¢55). I Certify Ihat �in the pe�formance af the wOrk to� whiCh this pe�m�t Is ISSu¢tl; I snall not employ any person in any manner so as [o become subject to the Worke Com ensa �Laws o( Cali a. •• � Date Si9nalure -� � � R - � 'NOTICE� t, Stter making thit tlnclaration, you sn tl be<ome �D�act ro Ihe Workers' Comp¢nsaliOn prOvisions of lhe' Labot Cotla, y0u must forthwitn comply with sucn provislons or this permlt shall be tleemetl revoketl. GONSTRUCTION L@NOING AGENCV ' I nereby afHrm tnat there is a consfructlon lentling agency for Me performance of the work fOr Whlch [hi5,0ermit IS ISsuetl (SeCtiOn 3097 Clv. C.) Lentler's Name - Lentl¢r'S Adtlress OWNER BUIL�ER OECLARATIOIJ I nereby a�fltm [hal I am exemOt f/om tho Contrdclor's LIcenSC Law tor tlte followin9 reason (SeStion 7031.5 Business antl Protessional Coee: Any citY or county which requir05 a pormlt lo wn5truct, alt¢r, Improve, tlemolish o� rapair any str�cture, prior to Its issuance; also raquires tho applicant for such pnrmit to file a signetl stateMent Ihdt he/she is Ilcensetl pUlsudnt to tlle prOvi51on5 Of the Confractor'S Liceqsa Law (Chapter 9'(commenUng witb'Sectlon�7000) of � •]ivision 3 of the BUsinuss antl Protes5ion5�Cotle) Or t�at h¢/She is axempl , iere(rom antl tM1e ba5is tor [he allegetl ezempliOn..Any violation ot Sectlon J31.5 by �any app��cant for a�. permit subjects tha applicant to a civll Znalty of not more than five nuntlrea tlollars (5500). LJ I, a2 owner of tha property or my employe85 with wag<5 as their zole i tomoensation, wi�l Go the work, antl the structure is not intenaetl or ofteretl fo� sale (Section 70q4, Bu5ine55 dntl ProfeSTiondl Cotle: Tha Con[rattOr'S LlcenSG Law tloes nOt'apply l0 an own¢r 01 a prOperty who bulltls ar Improvez tnereon, ana who aoes such work hlmself/hersell or through his or nar own employees, providetl �hat such improvements ara not intentletl or o((eretl for sale. If, now¢ver; [he builtling or ImprOvemenl IS sOltl within ona year ot com- pletlon, lhe owner w�ll have tne buraen of proving he/s�e tlitl not bulltl or im- �rove �or tne purpose of sale). I, ai owner ot th0 Oroperty, am exclusivoly contracUng witlt Iic¢nsntl con- lfac[o6 to consV uct tl�o Project ISectlOn 7044, Bu5Ino55 dntl Pfofe55ions COtlO: Tha Con(ractor'S LiCenSo Law does nOt appty to an owner of OropCrly who' bulltls or Improvos lhereon, antl who contrac[s for such projects wltn a con- tra<tor(51 Ilcense pursuant to the Contractor's Liconse Law). I am awara tbat prool o( lheir Wo�ker'S CompenSatlon InSurance shoultl be P�ovitlo0 t0 me. ❑ I am exempt untler Sectlon B. 6 P. C. �or thls reason Date Owner 1 hereby certiry t�at I have rea� Inlormation is carrec(. I agrea to antl slate laws relatiqg to bulltlin SantdtivGi of [hls Uty�� inspectlon �UJlJ�985� Siqnature �.Z,�_ �Drivers' License or 55 � atlon an0 state tnat me aoove i all clty antl county ortlinances an.anG hereby authorize repre- above-menliOnetl Property, iOr TVPE OF CONSTRUCTION LJ NEW LJ ADD U ALTERATION LJ REPAIR ❑ CONVERS�ON ❑ DEMOLISH ❑ OTHER - q,p, # DESCRIPTION OF WORK/USE OF BLDG. �� • . ' S Main Building: E TVPE OF PERMIT ' GRADING UNDATION STRVCTURAL T Front ' ❑ TENANT ❑ ELECTRICAL 'PLUMBING ❑ MECHANICAL ' B Rear ❑ OTHER �= PRWECT DESCRIPTION 5�. F7. oCCUaANCv - C� Right K Left CONSTRVCTION TVPE VALUATION S S ZONE GRADING CU.YDS. ACRES p�ng. Ref. # Rvmarkr � � Planning Notes: 3ackflow Preventer 3ackflow Irrigation 3athtubs Clarifiers �ishwasher Drinking Fountains Floor Drains Floor Sinks ' Ges Service OuUets . Interceptors Kitchen Sink � Lavatories ' P—Trap Roof Drains ' Reinspection Fee' $15 Boiler Duct - Under Ground Duct - Svuccural Duct - Ventilating � Exhaust System ❑ Multiple Firepl/PacL Blt. ICBO �/h Heating Sysrem & Ducting� ❑P70Q,000 BTU � 100,000 Reinspection Fee � $15 CMF 0865-46, rev. 30/B4 Wnite - Builtlin9: Canary - Applicant; Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink � Sewer Cap Sewer Connection Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spa Urinal . Water Closet Water Henter WaterServica ` Auto-Wash laue Fee Hood or Typel ❑ Canopy Type II ❑ Refrigeretion System • ❑0.100,OOOBTU ❑100,0001 System Repair/Alteration F ire Dampers Registers Issue Fee $ 3 $ 3 Automatic W� Construction Cooking Unit Dishwasher Dryers ❑Ga�. Fan F.A.U. ' Fixtures Device Boxes - .'Bl1%% y�iG�B�J ..Jo: 4 2one Accessory Building: ' Parking ELECTRICAL er " Transformer ❑ 15-50 KW �• � ' IeSub. � " � 50+KW Meter ❑up to 700 amps ' Meter ❑ov¢r700amps ❑Electric Su6 Panel Motars O0.1 HP 07:5 - 8 � ' Inc.Solar �g-15 HP �16-15+ Switches Garbage Disposal Generator �0.5 KW J Pole Light . . Range $i9n ; Standing Sections � 5 KW Trash Compactor ' ' Reinspeaion�Fee - $75 Iwue Fea i DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By BuildinB APProved By � i �n....r.....:.... �....ew c., , f / FEES $ 3 Z O N I N G R E Q M T S ' . SUMMARV OF FEES BUILDING PERMIT $ SMIP � $ PLAN CHECK • $ PERMIT � PLUMBING $ � ��UANCE $ PLAN CHECK 25% § ENERGV P.C. $ � � ELECTRICAL , $ � GRADING $ 'PLAN CHECK 50% $ � MICROFILM � $ ' ' 'MECHANICAL $ � TOTAL FEE 5 �� PLAN CHECK 25% $ • , � CONSTRUCTION AND PLANNING POO SPA AP�ROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector 1�Temporary Electrical Service or Pole 52. Pool & Equipment Location �� 2. Soil Pipe-Undrgrnd. .� VCnT S' /i�� 53. Steel Reinforcement � � '' 3�. ElectricalConduit Utility-Undrgmd: 54. Forms i' 4. Electrical Conduit•Undrgrnd. � 55. Electrical Bonding � , 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. ,Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 9. Footings " 58. Electrical Conduit-Undrgrnd. g. 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 14. Rough Plumbing �'� �r ��"� 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 Elec[rical-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. Product Piping O Gas ❑ 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 (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 - 37. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 3 S- �-OG 34. Final Heating & Air Condi[ioning / 'r �i 35. Final Gas Pipe-Test � a` 36. Hood or Canopy 37. Final Factory Fireplace 38. FinalPlumbing q(s�' G2/� ' 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backfiow Irrigation 44. ,Landscape Irrigation System 45. Sound Attenuation � ' 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed � � 49. Electrie Release to Edison ' � � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No Date � ' Aoolicant to till in all soaces excePt thase wilnin heavY boraer Iines ana si9n a11 aPProoriate Ceclarations. GITYy�F COSTA MESA CONSTRUCTION PERMIT , "ProjectAddress 7A� 4%• �9�j St, �' A ' S5a �ernard SF. C.M, �/�pticant's Mailing Address ` Owner's Name F D O��e� Phone 533-�e5Z 1 Address �' � Nec.c��anci d�. Qc.nc�o �alos Vr�c(r < Arch/Eng. License No. Address Contractor'sNam��•S. NU��uv�c� Phone bl3'BiOb Addreulmailingl 552 Bcfnpr� 5�' C•M• Ciry License No. � 5205 LICENSED CONTRACTOR DECLARATION 1 hereby aifirm that I am licensetl untler provisions ot Charter 9(commencing with section ]000) of Division 3 of the Bu51ne55 antl Professions Cotle, antl my Ilcense is in f II torce antl eHect. �icense ciass �- ice e No.4i L56 Date :+'Z4'�S Signature WORKERS' COMPENSATION DECLARATION ' nereby affirm that I have a certificate of consent to zelf-insure or a certlficate f Workers' Compensation Insurance, or a certitietl copy thereof (Section 1800, lnb. CJ Policy No. Company eCCrti/i¢tl copy is he�eby furni5hetl. CerHtietl mpy Is flletl with the city Builtling Divizion. Date Applicant EXEMPTION FROM WORKE0.5' COMPENSATION DECLARATION (This section neetl no[ b¢ mmpletetl it the pGrmit i5 tor One huntlr¢tl (EI00) or Ie55). I certity that in [hG Performance of the work to� whith (hi5 p¢rm�t i5 issuetl, I shall not employ any person in any mann¢r so as to Decome suGject to the Workers' Co (jenwt n LawS of Califomi .Date 6—�`—�� $ignature �� 'NOTICE: It, after makin9 this tleclaration, you shoultl ecome subject to the Workers' Compensalion provl5ions of the Labor Cotle, you mu5t fOrthwith comply wi[h such O�ovision5 or IhiS pCrrnit shall be tleemetl �evoketl. CONSTRUCTION LENDING AGENCV 1 hereby affirm that tM1ere is a construction lentling agency for the Oer(ormance of the work tor which this permit is issuetl (Section 309� Civ. C.) Lentler'S Name Lentler's Atltlress OWNER BUILDEN DECLARATION I nereby af�irm that I am exem0� from the Cont�acto�'S License Law fo� the following reason (Section 7031.5 Business antl Protessional Cotle: Any city or coun[y wM1ich requiros a permit t0 consbuct, alter, improve, Gemolish o� re0ai� any structure, prior lo Its isSUance, also require5 the applicant for such permit to file a si9netl statement tnat he/she is Iicensetl pursuant to tne Orovisions of ihe Contractor'S License Law (Chapter 9(commencing wi[n Section 7000) o( 7ivi5ion 3 ot Ihe Business antl Protessions Cotl¢) Or Inat he/she IS ¢xempt ier¢f�Om antl the basis for the allegetl ex¢mption. Any violdtiOn o1 $ection J31.5 by any. applicant fo� a permlt subjects th¢ applicant lo a Civil �enalty of not more than five nuntlretl tlollars (E500). LJ I, as owner of the oroperty or my employees with wages as thelr sole compensation, will tlo the wo�k, antl the st�ucture is not Intentletl or offe�etl fo� sale (Section ]044, Bu5ine55 antl PrOfeZsional CoCe: The COnt�actor'S Li[ense Law tloes not apply [o an owner of a property wM10 builtls or improves thereon, antl who tloes such work himseli/herself or through his or har own employ ees, prOvitletl that su<h improvements are not intentletl or ofteretl for sale. It, however, tne builtlin9 or improvement is soltl within one year of rom- pletlon, the owner wili have the bu�tlen O( provinq he/she tlitl not bulitl o� im- p�ove totthe pu�pose of zale). ❑ I, as ownE/ ot the property, am exGusively cont�acting with IlcenS¢tl con- tractors to mn5truct the project (Section ]044, Business an0 Professlons Cotle: The Contracto�'S License law tlOes not apply to an owner of property who 'builtls or improves tnerean, antl who mntracts for such projects with a con- tractor(sI license punuant�to the Contractor's License �aw). I am aware that proof of [hei� Worker'S Compensation insurance shoultl be provitl0tl to me. ❑ I am exempt untler $ection , 8. & P. C. for this reason Date Owner P hereby certify that I have reatl this application antl state that the above intormation is correct. I agree to compty wlth all city antl county ortlinances antl sta[e laws relating to building construction, antl hereby authorize repre- sentatives of this city fo e ter u n the above-mentionetl properiy tor insPect�on ouroq,�e�. 6-24-85 Si9na[ure K � Date Drivers' License or SS � TYPE OF CONSTRUCTION LI NEW LJ ADD LI ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER Ap # DESCRIPTION OF WORK/USE OF BLDG. S Main Building: E TYPE OF PERMIT�, GRA�ING FOVNDATION STRUCTURAL T Front ❑ TENANT ISJ ELECTRICAL�-PLVMBING ❑ MECHANICAL 6 Reaf ❑ �OTHER � \ A PROJECTDESCRIPTION Sc;.FT. oCCVaaNCv C Right CONSTRUCTION TVPE VALUATION 3 S Left ZONE GRA�ING CU. VDS. ACRES Ping. Ref. # Remarks: � �� 7L� (� �� u�(�^ Planning Notes: Sink Preventer I rrigatiOn rinking Fountains loor Drains loor Sinks asService DUfIC[5 Kitchen Sink Lavatories P—Trap Roof Drains Reinspection Fee � $15 Duct - Under Ground Duct - Strucmral Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact elt. IC80 # Heating System & Ducting ❑ ai oo,000 aru O i oo,000 er Reinspection Fee � $15 CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor Showers Service Sink Sewer Cap Sewer Connection Solar Collecmrs Solar Pipi� Solar Tank p��j Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service AUfO�W85I1 laue Fee Hood or Typel ❑ Canopy Type I I ❑ Re(rigeration System ❑o�ioo,000eru ❑ioo,000 Sysrem Repair/Alteration Fire Dampers Registers Issue Fee S 3 $ 3 Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher . Fan . 5402 6/24/85 2Bo50 TL Zone Accessory Building: Req./Provided ELECTRICAL Transformer ❑ 15�50 KW ❑ 50+KW Fixtures Device eoxes 0 utlets Switches Garbage Dispoul Generator �65 KW 05�15 KW Meter LJup to 100 amps Meter �ov¢r 100 amps Sub Panel Motors�61 HP�1'h-B Inc.Solar�9-15 HP 016-15+ Microwave Pole Li9ht Range � Sign ; Standing Sections Trash Compactor � FEES � Reinspection Fee �$15 � �,Issue Fee I $ 3 � DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Date Building Approved ey Date Appliwtion Issued By Date �O Z SUMMARV OF FEES BUILDING PERMIT $ SMIP $ PLAN CHECK $ PERMIT , PLUMBING $ I ��OO �SSUANCE $ PLAN CHECK 25% S 2•�O ENERGV P.C. $ E�ECTRICAL $ II•(n0 GRADING S PLANCHECK 50% $ �� SO MICROFILM $ MECHANICAL $ TOTALPEE $ _ 2S. PLAN CHECK 25% $ Z O N I N G R E U M T S � �� ; �COI�STRUCTION AND PLANNING YAPF�ROVALS Permit# i. Temporary Electric8l Service or Pole 2. Soil Pipe�Undrgrnd. 3. Electrical Conduit UtilityrUndrgrnd. , 4. Electrical Conduit-Undrgrnd. . 5. Steel Reirlforcement 6.. Electrical UFER Grnd. 7. Footings ' . 8. Foundation � 9. Water Pipe-Undrgrnd. . � 10. Structural Floor System 11. Property Sewer Line & Hause Connection � 12. Sewer CaQ 13. Roof'Drains � 14. Rough Plumbing 15. Rough Electrical-Conduit 16. Rough Electric Wiring 17. Rough Wiring Sign 18. Rough Electrical-T Bar Ceiling 19. Rough Heating & Air Conditioning 20. Rough Factory Fireplace 21. Ducts, in Structure 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing ' 25:"floof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat � 27. Frame and Flashing 28. Lathing & Siding � 29. Insulation 30. Drywall Nailing 31. •Plaster Brown Coat 32. Electrical Power Meter-Final' � 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Faaory Fireplace 38. Final Plumbing 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. -Landscape Irrigation System . 45. Sound Attenuation 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed 49. Electric Release to Edison � , •� 50. Gas Release to Southern California Gas Co �'Si. CERTIPICATE OF OCCUPANCY � Date i Date POO SPA Inspector AppROVALS Permit# 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test 57. APPROVAL TO COVER-GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. � 61. APPROVAL TO DECK 62. Backwash & Receptor-Final 63. Heater & Vent-Final 64. Plumbing System - Final 65. Electrical-Final 66. Solar System-Final � 67. Fencing &"Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # T� 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank � Gas ❑ Oil 74. Overhead Hydro � 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CER`iIFICATE ISSUED Notes: � Date �Inspector A r AOP��cant to fill in all spaees exceot those within heavy bortler Iines antl sl9n all apvropriate tleclarations. CIT,Y oF COSTn napESA CONSTRUCTION PERMIT _ �PiDject Address �QQ �. `� � st # A /1]'py�cant'sMa�i�ngAddress 53Z"$ernerc.l ST� G./h• �owner's Name E' D Ol�vr �" Pj,'�,e 83a-6s2� Address � I hieLc�larr� D� Ranc�no �Yw�uz �/e��[ 5. 'Arch/Eng. . _ LicenseNo.. - � Address " m Comracror'SNamP.�L�.S. NCwUI�Anf� . Phone�.Q�D Address�lma��ng) 5 �✓hP G�^CI S+� C� . M City Licens¢ No. � - ' 3T�d'Di � LICENSED CONTRACTOR DECLARATION 1�he�eDy atf��m'that 1 am Vtcensetl untlet ptovisionl of Chartet 9(commencing with se<tion �000) of DlvisiOn 3 Ot [he Bu5ine55 and ProfeSsions Cotle, a�tl my Iicense is �� full force antl e(fect. LJcense Class C' nPTf, � n�(}/G �'(p�1� Licens}� No. ��'j'.'��G,��(`�� Date 4-2�'-i•S 5iqnature ��[��/'�[idda('A � ' WORKERS' LaMPEN5AT10N DECLARAT,ION � � 1 here�y afflrm that I have a lertiflcate of ConSent to sel(-inSWe or a certiticdte �� workers' Compensation Insurance,� or a certltiea copy thereof (Sectlon _ 1800, Lab. C.) ' r � Policy No. ' � ' Company � � 8 Certifiea �ooY Is hereby furnishea. ' Certliletl copy is filGtl with the City Builtling DlviSion. Date � APplicant - � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sectioM neetl not be completetl if [M1e permit is Tor, one huntlretl (EI00)'or less). I cer[iTy [hat in the performance of ttte wo�k for whictt tnis pCrT�t i5 i55uetl, I snall not emPloy any person in any manner so as to become subject to the ' Workers'�Co -^q;]�on�Laws of California� a n/_ _ n�� Date 4' � Signature o lROC� 'NOTICE: If, after makirig this tleclaratlon, you should� be me subject to the Workers' COmpenzation prpylsions ot the LabOr Cotle, you mu5t forthwith. _ comply 'witn; such provisions or this permlt shall be tleemetl revoketl. CONSTRUCTION!LENDING NGENCV _ ' '. � I nereby affirm that there is a<onstruction lentling agency tor the'pertormance _ of thC work (or, which this Permit fs issuetl (Section 3097 Civ. C.) Lentler's' Name' • � ' � � _ Lentler's�atlaress ' - �- • � � � ' OWNER BUILDER OECLARA710tJ •' � 1 hareby atfi�m,that I am e%emp[ trom lhe Cont�acto�'S License I..aw fo� tbe following �rCason (Section 7031.5 Businesz antl Protess�onal Cotle: Any city or county whi�h require5 d p¢rmibto const�uct, alt2r, improv¢, tl¢mOlish or repair any structure�, pnor to its'issuance, also requires tM1e apPlicant tor sucn permit to file a si9netl statement'that he/she iz II<ensetl pursuanl to the provisions o( the Contractor's LicenSe Law (Cnapter 9(commencing with Sectlon �000) ot Division 3 ot the�Busine55 dntl Profe55ion5 Cotle) or thaf h0/She is exemPt � 'herefrom Tntl the ba5is forthe allegetl exemption: Any vlolatlon' ot Sectlon D31.5 by any "applicant for `a permit subjects the applicant, .to d civil enalty of Not more than five hu�tlretl tlollars ($500).. , � _ ❑ I, as oWner ot the property or: rtiy �employees witn wages as their sole compensalio�. w�� tlo the work, antl the structure is not intentletl or otteretl � for sale. (Se�tion 7044, Business antl. Protessional Cotle: Tne Contractor's LitenS¢ Law tloes nol apply [o an owner of a property who buildz or improves thereon, antl who tloes sucn work'himzeli/herselt or tnrougn nis or ner own employees, P�ovitletl that such imProvements are not intentlea or otferetl tor sale. Ii, hoWever, the �uUding u( improveT¢nf iz solC withln ane year ot com- pl¢tiOn, tlte owner will have the bu�tlen of p�oving he/sh¢ tlitl nOt builtl or im- �rova tor ttle purpose of sale). ' - U I, as owner oi the property, ain exclusively contracting with licensetl con- tractors to tonstruct tha project (Sectlon 7044, Business antl Protessions Code: The Con[tactor4 License Law does not appty to an bwne� of property Who bulltls or irnproves thereon, antl y+ho contracts for sUch projGtts with a cOn- Vatlor(5) O�ense pursuanl�[o th¢ Contractor's License Law). 1 am awa�e tttat proot of tpei� Wo�ker's Compe�wtion insu�ance shoultl be provitletl to me. ❑ I am exempt untler Section B. & P. C. for this �eason Date I hareby. csrtify that I� information is correcL I antl state la�+s relating t sentatives of this city insoectlon purooses, p � 5' t 1 Owner � �ve reatl this application and state that the above ��ree to comply wiih all city antl county ordinances building const�uction, antl nereby autno�ize rep�e- e te� on the above-mentionatl property for oate 4 -2�-SZ`�i TVPE OF CONSTRUCTION LI NEW -LJ ADD LJ ALTERATION U REPAIR ❑ CONVERSION O DEMOLISH ❑ OTHER DESCRIPTION OF WORKN 1�0�9�G. - � TVPE OF PERMIT GRAD�NG FOUNDATION STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL� � � ❑ �OTH@R � ` ' ' ' - ' PROJECT DESCRIPTION 5Q. F7. OCCVPANCV� CONSTRUCTIONTYPE VALVATION $ 20NE GRADINGCU.VDS. ACRES Remarks: ��l�g� Sink <flow Preventer - - � . ' <flow Irri9ation nubs ' itiers � iwasher iking Fountains �r Drains a Sinks � . . - Service 'Outlets Kirehen Sink ' � Lavatories � ` � . P-Trap Roof Drains �. . � � Reinspaction Fee $15 Dutt - Under Ground - Duct - SVuctural Duct - Ventilating Exhaust SVstem ❑ Multiple ❑ Fiiepl/Fact. BIt. ICBO # Heating System & Ducting , ❑ 0.100,000 BTU O 100;000 BTi Iigna u�e Drlvers' �icense or 55 � I I Reinspection Fee I 515 CMF 0865-46, �ev. 30/84 White - Builtling; Canary - qppllCdnt; Pink - Accou�tin9; Goltlenrotl - ASSGSSor Sf10WC15 Sewer Cap Sewer Connection Solar Collectors Solar Piping (�Q'y Solar Tank Swimming Po w � Urinal Water CIOSei ' Water Heater • ' Water Service ' Auto-Wash � Issue Fee . Hood or Type I ❑ CanoPV TVPe 11 ❑ Refrigeration System �o-�oo,00aeTu Dioo,000 System Repair/Alteration Fire Dampers Registers A.P. # S N1ain Buildi E T Front B Rear /1 C Righ[ K Left S Ping. Ref. # Planning Notes: 1600 4/2C/85 L3.7o , Zone - Accessory Building'.. . Z Q , N , . 1 N - G " p 1 Parking Req./Provided E � Q � i M .. � ._ 7 � • , S ELECTRICAL Consnuction Pale Sub. Cooking Unit �- . � Dishwasher _ � Dryers ❑Gas` R Ele�tric Fan. ; QI F.A.U. . . � � Flxtures ' - O DeJice Boxes '� OUtI¢LS ' - ' (� Switches Garbage Dispoul � Generator �a5 KW 05-15 KW i $ 3 FEES laue Fee � .� `� Reinspection Fee � $15 � �EVELOPMENTSERVICESREQUIR Building Approved By � FEES ❑ 15�50 KW � � i ,. . ❑ 50,+KW . Merer ❑up ro 100�amps Meter ❑over 100 amps_ .. , Sub Panel . . - : ' � . Motors 690-1 HP �1'F. - 8 ; � � , Inc.Solar,09-15 HP 01�6-15+ � � � Micr`owave �� - � • � � ' .Pole Light Range Sign • � ; Stending Sections Tresh Compactor � luue Fea � �� , SUMMARV OF FEES ' � � BUILDING PERMIT $ SMIP $ ' � �PLAN CHECK $ ' PERMIT � . � PLUMBING $ f 7. 6O �SSUANCE '$ PLAN CHECK 25% $ � � �.�NERGY P.C. � $ ' ,ELECTRICAL $ �',.�� tGRADING $ � PLAN CHECK 50% � $ �zOV'°'ICROFILM $ � � MECHANICAL $ TOTAL FEE $ PLAN CHECK 25% $ 71-¢�' (f., �.p , � r � COS,�STRUCTION AND PLANNING POOL, ;PA � ' Date Inspector Date Inspec*or "•'4PP.ROVALS Permit# APPROVALS Permit# i. Temporary Electrical Service or Pole 52. Pool & Equipment Location � 2. Soil Pipe-Undrgmd. .• 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5: Steel-Reinforcement. � 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE ' 7..Footing's ; � 58. Electrical Conduit�Undrgrnd. g, Foundation � ' 59. Gas Pipe, O Undrgrnd., Test �, 9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor Systerrm ' 61. APPROVAL TO DECK 11. Property'Sewer Line &. House Connection " 62. Backwash & Receptor-Fioal � 12. Sewei 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 � 1 LO 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL , 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21, Ducts, in Structure 70. Underground HYdro 22. Ducts, Ventilating � 71. Product Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test .� ;� 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing �� 74. Overhead Hydro 26. T-Bar Ceiling (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. Prywall Nailing !, i HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric �' Notes: '3`" / o,�'c� '- Yl!) C� e' 34. Final Heating & Air Conditioning - - t' � t'' -, .,. � 7�/ � J' • o ri a�L � i � o 35. Final Gas Pipe-Test "� T r9r �,C� �i,+✓cX v. 36. Hood or Canopy 37. Final Factory Fireplace 38. Final Plumbing C�� C�l�,{J 39. Water Service-Final 40. Gas Service-Final � 41. Solar pomestic-Final 42. 6ackflow Preventer . '- � ' 43. Backflow Irrigation . � � \ 44. .Landscape Irrigation System � Y ' 45. 5ound Attenuation 46. Handicap Regulations � •� 47, FINALSTRUCTURE & BU�LDING ' ; 48. SPecial Requirements Gompleted �' qg. �lectric Release to Edison � �,y I 50. Gas Release to Southern Celifornia Gas Co �,�� ` �7. CERTIFICATE OF OCCUPANCY � . � � i-r � Date i � i ' �, � �i I Pfl0.1ELT RDOflE33: '� 8 9 j.j 1 9'j'x $'I` OWNEN'SN11ME: SARNISC AVETOOM ��DDflESSr $ J�..lE RPCM/ENOINEEN: ROOflES3: PEO.NO.: uxR: D UNR: ' PERMIREE: DAVID ENDERLE ( 714 ) 646-9947 nooeess: 1835 NEWPORT BL C.M. CA 92627 UCENSED CONTMCTOB OECIAMTION: I �ereby aflirm that I am ficense0 un0er DroNsionS of C�aphr 9(commencin0 vnth SetliOn 7000) ol Divislon 3 of Iha Business anE Professions CoUe. anE my license is in tulliorce anC ettect. CITY LIC.: ST�TE IIC.: LUSB: � 'Ute: SiOnature: �pKEOS' COMYENSRTION DELlAM710N: I �ere�y atlirm tlut I �ave a certifca[e ol consent �o self-insua or a certificate al Workers' ,mpensa�ion Insurance, ar a certifie0 copy thereo/ (Sectim 3800, LaE. C). IPoLICY NO.: EXP. D11TE: COMPANY: � Certifietl copy is here0y fumishe0. ❑ Certified copy is fileE wrth the ciry BulOinq DNision. Oate: ApPlicanC `' IXEMPIION FliOM VAHKEIIE' COMPENSIITION OECIAM710N: (1Fis seclim neeG not h mmpleteE il the permt'a for ane hundred (5100� or less�. I certity that in the performance ot the xroM for wNch ttus pemtit k issue0. I StWI not empby airy person in any manner so as lo became subiect to t�e Warkers' Campensatbn Laws�Oi Caltlomu. /�� - �/ c�� Date: }l � �� V � SiOnature: �/ �..�+ — � NOTICE: It, atter makinq this tleclaraGon, you shoul� Eecome subjep m the WaBers' ComDensation pmvi5ions of the La6ar CoOe, you must faMvnih compry witA suc� D�ovisions or ihis Dermit shall be OeemeE revokeO. CONSTBUCTION 1EN01NG RGENCY: I Aereby aHirtn that there a a rnnsWction IendinA aAe��Y �or t�e pertormanca oi�t�a xrork for whic� tAis permit is iuued (Section 3097, CN. L). � � lENOEH: , nooxess: IOWNEP BUILDEP OECUM710N: I �ereEy aflirm Itwt I am eKempt Irom Ne Coniractors' State License Law tor the I011owin0 �easan (Section 7031.5 Business an0 Pmlession9 CaOe: My dry of counry which requires a permit to canstruct, alter, Improve, Eemolish, or reDalr any structure, D�a� �a ns issuanca, aLSo requias the applicant lor such permit ta tile a sipned statem¢nt itat he/she is Iicenu0 pursuant to the D�a�sions ol the Contnctors Sta[a License Law (Clupter 9(commenUnp wit� Sectlon 7000) of OlviSion 3 at the Business �nA Professians Code) ar ihat hds�e I5 eaemD< <heretmm an0 Ne Easis for t�e a11e0eE exempfion. My Wolatian ol Sectian 7031.5 by y applicant for a permit sublects t�e apD�icant to a cidl penalry ol not mam t�an Me hunAmO Gollars (5500�. I�I, as owner oi tAe pmperry or my em loyeu vritn wapes az thei� sole wmpensatlon, will �o t�e work, and tha strucWm is not imenOeE or oflere0lor ule (�uon 70aa; Business anE Pmlessianal Cotla: The Condactoro' State License Law Eces nol apDA' �o an owner ol a properry who EUIWs or imDrovu t�ereon, anE wlro Eces suc� vrork �imsell/herselt or throuAh � his or her own em0loyees, providetl tlut suc� imDrovements am not intenEeO or otteaE lor sale. II, howaver �ha GuilAinp or ImD�ovement is sold within one year af compleGon, the owner wi0 have I�e OurOen ol pmNnp he/she Ui0 not Duild or Improve IOf IIIB POfp050 01 5318). I, as owner ot the Dmperty. am excluSiveN wntractlnp wiN li¢nseU wnVactors to wnstmct Ihe Dmlect ISection 7044, Businass ❑ an0 Profasslore COAe: The Cantrac[ors' State license Law Eces nat apDh �o an awner oi properry wlio Dulltls m improves ��e2on anE wAa conlracis for suc� Dml��s wi[� a comactar�s) license pursuant to the Cantactars' Stata Licanse law). I am awam IAaI pra0� al Iheir Worker's fAmpensatlon insurance sMuIG Ce provi080 to me. � I am axBmD� un0er Section: B. 8 P. C. 1or thls reason: // Date: a — o7—q ' QO /9vmer (��—� �--✓4'+ / I Ao �ere0y ceNry Ihat I am awaa ol aM un0erstanE t�e repuiaments af Califomu Mwtth and Salery Coda Sections 25505, 25533, and 25531 antl that I or arry future buil0inp occupam vnlVwill not (cude ona) neeE to wmply wit� sai0 state co0a antl Ne reQulrements lor a permit for canstructbn or moUitication tmm tM Nr Oualiry Manapement asMct Nesi�entul constmction applications ara exempt Imm Ihese Drovisions. Oate: �1pDlicant: I here0y ceNry tnat I tave reaE thR applicatian antl state that Ne ahove inbrmation ¢ correct I a0ree ro comD�Y wRn a0 ciry and counry orEinances an0 state Wxs relatinp ro bWlEinq cons�uction aM tcereby auttnnre representatives of Nis tiry to enter upon Ihe abwe�mentlone0 propeM for inspecllon Durposes. / ^ G_� _ / / i l — C / t Oate: � �9� �v Siqnatua: �U"�� Dnver's License or Sceial Secunry x: 1841-06 W�ite—Builtli�; Green—CaEa Enlorcement: Canary—ApO��^�� P�^k—Revenue: Goltlanrad—Asaassor CITY OF COSTA MESA - HUILDING PERMIT PERM NO: E 048798 PERMZT NO: E 048798 PLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTZON TYPE; PERMIT TYPE: ELE PURPOSE: ALT JOB DE5CRIPTION : 800SF TANNING SALON T.2. SQ FT: CLAIM VALUE: CALC-VALUE: GROUP OCC: H-2 / COMMENTS: REFER TO #B48797 **��r�r�r�r*�r�r�r��x��r�*��**��*��*�***��*�r**��****�*��«�**#��r*��**�**��**�* Z O N 2 N G R E Q U I R E M E N T 5 s E T s A c x s ------------ MAIN BUILDING — -------- --------- ACCES50RY BUILDING --------- FEtNT: FT IN REAR• FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGIiT: FT IN PARKING REQ: PROV: PARCEL: 424201U2 ZNE: REF NO: • PLANNING NOTES> � (" iE iE �E it if ik �F 1E iE ik it iE i(� iE it iE iE �If iE iE �lE ik if 3E if iE iElE iE jf 3E jF iE 3E yc iE iE iE iE iE 1F iE iF if 1f ib iF i4 iE iE if iF iE it iE iF 1E iF iE iE iE iF jE it iE iF i6 3f iF 3k fE �E iF iE if iElE if �E D E V E L O P M E N T S E;R V I C E S ft E(,� U I R E M E N T S v ZONING APPROVED BY . _____'_ DATE• BUILDING APPROVED BY : DATE; *�*******�*******D�tB** �� ' *�**D***�t*�F�'�#�** iE iE �E �F iP it k�F �F iE ik iE jk �F 1! if �E iE 9E �E iE 1E if �F if iE 9E iE 9E if iE iF iF i6 if iF iE iE �E iE iE �k iF iE if iE dE ik iF dE �1E 3E ak if iF iE iF if iE iF iF it iF iE iF jfr 3F iF iE iE iE iE jE iF iF 3E �f 3E iE LEGALIZATION:N F E E "S U M M A R Y STRLICTURAL SEGt4ENT:N BLDG PMT PLUMHING ELECTRIC MECHANIC SMZP/RES GRADING PERMIT 35 . 0•U _� SOi$ S /NON—R PLAN • ISSUE FEE 15.0'0 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID UE TOTALS----> 35.00 15.00 .-,0.00 50.00 50.00 . 0 AEVENUE DZVZSION TOTALS--> COLLECTED: 50.00 OVER/SHORT: 00 HLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 50.�� d! i! if if 7F it if i! i! iF if !f i! jE 1E if it if iE �f jf ik it iF ib iF iF k iE iF iE iE iF �F 1! df iE iElf iP ik iE ik it ik it �t if-iE if if iF it it iE 3k if if iF 7F iF ik %!F iF if it iE it jE IF iE jE 1F if iE i6'if iF I N D I V I D U A L F E E B ii E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COS� ELE 12 RECEPT/OUTLET 1 ST 20 EA. .75 9,00 ELE 1 SUB-PANEL 11.00 11.00 ELE 1 SIGN/ OUTLINE LIGHT SYS ON 1 BR CIRC 15.00 15.00 END OF FEES Ol 00065599-ODOd'3594 '�Q'y j�" =�j, (�� ?ATE: 08/Z4/9Q TIfiE: Q3�43 r. CONS7RUCTION AND PLANh.,.G POG. SPA Date Inspector Date Inspector APPROVALS Permit # � APPROVALS Permit # __._ 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2� Soil Pipe-Undrgrnd. 53. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgmd. - 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electrical Bonding 5. Steel Relnforcement 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 prains � 64. Plumbing System - Final 14. Rough Plumbing - 65. Electrical�Final ' �' 15. Rough Electrical-Condui; r� 66. Solar System-Final :� 76. Rough Electric Wiring �'�� 67. Fencing & Access'Approval 17. Rough Wirinq Sign 68. APPROVED FOR PLASTERING� i 18. Rough Electrical�T 8ar Ceiling - 69. POOUSPA-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, Ventilating 71. Producl Piping O Gas OOiI 23. Gas Pipe�Rough & Test 72. Underground Flush . 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 76. FIRE PREV. FINAL 30. Drywall Nailing . HEALTH DEPT. REDUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric �-�m.4'� �¢w.(� Notes: 34. Final Heating & Air Conditioning � �m / �+ C7 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 domestic•Final 42. Backflow Preventer 43. Backfl0�' Irrigation 44. Landscape Irriaation SYstem 45. Sound Attenuation 46. Handicap Re9ulationt 47. FINAL STfiUCTURE & BUILDING 48. FINAI,PIANNING • 49. Electric Release to Edison , 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date rxaecr c RRCH/ENCINEEN: ROOIIESB: 789 W 19TH ST JARNZSC AVETOOM SAME NEO.NO.: uxrt: D UNR: PEflMITTEE: DAVID ENDERLE ( 714 ) 646-9947 RDOflESS: 1$ 3 S NEWPORT BL C.M. CA 92627 110ENSED CONTMCTOR OECIAMTION: I herehy affirm Nat I am IlcenSeA unEer Dmvisions of CtuDter 9(commancin0 ��h Sectlon 7000) of Division 3 0l tAe Business and Pralesslans Cotle, antl my licensa I5 In full lorce an0 ellect. cm uc.: � sTaTe uc.: cuss: , ^•+e: sipnature: IKEflS'COMPENSRTIONOELlAMT10N: IAerehp affirmt�allhaveacertlflwteolcanuntlaself�insuraoracertilicateoiWorkers' .ipensation Insuranca. or a certifieA wDY thereoi (Section 3800, LaO. C). IPoLICY NO.: E%P. ORTE: COMPRNY: —] Cerlifi¢E copy is hereby IumishaE. ❑ Ceril�l¢E cOpy Is tileU wit� �Ae ciry Bul101np OIN51on. _ � �ate: pODlicant: E%EMPfION FROM VlORKEPB' COMPENSIITION OECUPATION: (Th¢ 5ection neea not Ge camplated if Ue permii is lor one AunCreA (5100) or less). I ceNty that in Ihe peAormanca of t�e work far w�ich this permlt Is issueA, I shatl not employ any person In anY manner so as ro hecoma suEiect ta Ine Workers/' Campensation Laws i CaliPomia. Oate: �^�7 — �(� �SlpnaNre: �.� — � - / NOTICE: II, aher makinq tAis Geclaration, yau sAoulE e suhle� �a �he Workers' Compansation pmvisions of Na LaEor � CoUe, yau must fonhvntA com0ly with such Drovisions ar this permit s�all be OeemeO revokeE. CONSTBUCTION IENDINO �GENCY: I hereUy attlrm Ihat thare is a constmctian Ien0in0 a0ency for Ihe pedormance ol the vrork tor w�ic� Nis permiiis LsSueU (Sedion 3097, Civ. C). LENOEP: ' ��URESS: OWNEB BOILOFB OECIAlUT10N: I heaGy aHirm that I am exempt imm [�e Coniractors Slate Lkense Law lor tha lollovnnp reason (Section 7031.5 Business and Pmfesslonal Cotla: My ciry ol counry wNc� reyWres a Deimit lo canstruct, alter, ImD�'e. OamdlsA, or repair any strucwre, prior to R5 issuance, also repuims the apD��nt lor suc� Dermit to lile a sipned 5laiement Itat �dshe Is Ilcensetl pursuant ro the provisions ol iha Contacrors' State Licenu Law (C�aptar 9(commenqn0 �� bn 7000) of Division 3 at Ihe Business ^+E Professians COEe) or that he/she is exemp� I�erefrom anU the Easis lor t�e allepe0 exemption. My Molation ol Sectlan 7031.5 Ey applicant tor a Dermil suojecis Ne applican� ro a uvil penatty ol not moa than iNe hunCreO Eollars (55001. - I, as awner of the OropeM or my e�p IoyMs wit� wa0es as I�eir sole wmpensatlon, wlll tlo I�e work, an0 IM I� L� siructureis notintendeE orotterMlorssle�5ecuon 70A4, Business an0 PralessionalCoEe: The Convactors State License Law Eces not appy to an owner of a D�operty wM builOs or imD�aves thereon, and wtro Oces such woAc �imself/herself or throupA his or �er own employees, D�4eE that suc� imprwements am nol intenUeO ar otlere0 lor ule. II, however the DuilUinO or ` Imprmement is SaIA wilNn one year af completion, the owner will luve ihe UUNen oi Drovinp �e/s�e OiO no� EuiIC ar ImDmve for tAe purposa of sale�. - I, as owner of Ihe Droperry, am exclusivety contactin0 �+t� Iicense0 conVactors to construct t�e Drojecl(Section 706C, Business ❑ an0 Protestioiu CoAe: m0 Cartraclors' Sute Lice Ww tices �rot appy to an wmer oi properryvRro 6W4s a ImD� �ereon antl who contracfs for such projects ��i� a con �5) Gcense pursuant ro IM ConVaclars' Slate LiuMe law�. I am axaa tAat praof al t�eir Worker's Compenselian msu ShoulE 6e D�ahded �a me. ' � I��am exemp� under Section: . 8 P. C. for this rwson: / �aro: � ��U ( Owner: �� / I Oa �erehY �e�iry that I am aware ot and understanE Ihe requirzmenls oi Glifomia Health an0 Salery CoOe Sectbre 25505. 25533, an0 25534 anE itut I ar any fuma builEinB �Da�� II not (drGe ane) neeE to compty wit� SaiE state coUu anOl�e reyuiremenis for a permit lar construction or modifiwtion trom tlw N�uality Manapement 0¢tncL Iie5i0entlal wrewction apDliwuons are exempt trom IAese Drovitims. Da[e: MP��: 1 nere6y ceniry iha� I twve reaOlNs apDliwuon anE sule that tha aCove inlormatlon ¢ correct I apree ro compy w1tA all ciry anO caunry ordinances ana stata laws reWtlnp to EWtlinp caatruNon a�U MreEy auttw� reD��s of tlds crtY ro enter upon tM aCovtrmeMionM P�DeM lor i�¢Deqbn Duryases. / �� / / Oate: ��/^�� `S�pnature:��"`�—" � Z—J "�— � . odver's License ar Socia� Secunry x: 1841d8 White--BuilEhg; OrBBn—COEe Enlommant; Cenery—Applicant; Pink—Rovenue: GoltlenraE—Aveawr � CITY UF COSTA MESA – BUILDING PERMZT PERM NO; B 04879'1 PERMIT NO: B 098797 PLAN CHECK NO: 05520-90 S GOVT: t�l SUPP: N CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE; ALT JOB DESCRIPTION : 800SF TANNING SALON T.I, SQ FT: 6,000 CLAIM VALUE: 6,000.00 CALC–VALUE: 6,000.00 GROUP OCC; B-2 / COMMENTS: X - *�t�r***x�*�t**�r�t**�t**�t**�t****+t*�r*it*�t�***u-*+r�+r**x�*�r�***�r*�t�r*x�*i�*�t**�t�r**+�*��*x-**�t*�t* Z O N I N G R E Q U Z R E M E N T S ' S E T B A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING ,-------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR:' FT IN LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT ZN PARKZNG REp• PROV; PARCEL: 42420102 ZNE: C1 REF NO: PLANNING N(�TES> INTERIOR ALTERATION FOR A TANNING SALON IN AN EXISTING > COMMERCIAL HUILDING (USE IS CONSIDERED A BEAUTY SHOP � PERM) *�t�r+�*�t*��r*********�*�r+t�t*it�>r�r**�*�t��tf�**+t�tit*�r*x�i�*****�t+t****�t��t-****+�**�t�{*i��ti�+ri�*** 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 W��– DATE: 2—Z�� BUILDING APPROVED BY ; DATE; �' APPLICATION ISSUED HY: �, P�� DATE: 4,_ [`� ��'jc7 iFiEiEiEiEjEiflfifiEdEi6iflE�kitiEiEititiE3E '�iFiF9FilikifdElElfdFiF �iFR'3�1fiE iE �lE IE iE iE !f iE �F ik iF �t ik iE dF i6 dt iE iE if iElE jElE iE �f if ik iE 3! iE iE k!t iE iF iF jF �E 1E fklE 1E iE i! ik if it iF iE ik fF if !f aF iE �E iE if ik it K fE iElE it iE jE dE �1E ik iF 1E fE fE * i6 i1 �k IE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 81.00 SMIP/NON—RES PLAN 52.65 t. �' .90 ISSUE FEE ;;* BUZLDING—DIV—> PERMIT ISSUE PLAN—CHECI( % TOTAL PAID DUE TOTALS----> 81,90 0.00 52,65 i 134.55 139.55 .00 REVENUE DIVISION TOTALS--> COLLECTED; / 134.55 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC �E'IRE SMIP/TOT GRADING PLAN—CHECK 81.00 .90 52.65 iF iE jE 1E �f iE iE jE iE iF jE if ff iF iE iF ik df if iE iE * iE �E jE iE 3E k iE if if it i! iF iEll-iF iE iF'iE if it it ik iE iFlE iE �lF iF if ik 1E M iE �f if 3k 3E iE if it if iF aF iF if iE �E 9f iF ik 1E dF jE if iF 3F iE . I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E 5 C R I P T I O•N �, UNIT COST TOTAL COST SFC 6000 ALTER BY VALUE COMMERCIAL �NOZONE END OF FEE�S'. �i / � c�� 1.00 6,000.00 D1 00068600–OOO6E6�]2 i"�] T 13¢.55 DA1E: �2/29/90 Ti11E: OS:�` I CONSTRUCTION AND PLANi_ ,; ' ' 100�.,. SPA PPROVALS Permit# Date Inspector qppROVALS Permit# � � Date Inspector ' .�emporary Electrical $ervice or Pole _ 52. Pool & Equipment Location 2. =Soil Pipe�Undrgrnd. �- 53. Steel Reinforcement '� , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms -• - 4. Electrical Conduit�Undrgrnd. � � 55. Electrical Bonding ` " 5. $teel Reinforcement 56. Rough Plumbing & Pressure Test '�� 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings • 58. Electrical ConduibUndrgmd�. , 8. Foundation '� i' 59. Gas Pipe, O Undrgrnd., Test � 9. Water Pipe�Undrgmd. . �� 60. Backwash Lines, P-Trap, O Undrgmd. ' 10. Structural Floor System 67. �APPROVAL TO DECK � � � 11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final ' �' 12. Sewer Cap ' � 63. Heater & Vent•Final • 73. Roof Droins � 64. Plumbing System • Final ;� 14. Rough Plumbing 65. Electrical-Final �/ � 15. Rough Electrical-Conduit � 66. Solar SYstem-Final �� 16. Rough Elettric Wiring . 67. 'Fencing & Access ApProval / =. 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �. 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - ' 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 77. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74, Overhead Hydro 26. T-Bar Ceiling (Structural� & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electriwl Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test _ 36. Hood or Canopy 37. Final Factory Fireplace �-(d^ �a R��( ��t„�� 38. Final Plumbing - � 39. Water Service-Final 40. Gas Service-Final 41. Solar pomestic-Final ' 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ��p.-� �'pw� 48. FINAL PLANNING ( 49. Electric Release to Edison '� 50. Gas Release to Southem Califomia Gas Co I 51. CEFTIFICATE OF OCCUPANCY No. Date � City of Cos�a Mesa Development $ervices Department Building Safety Division P. O. Box 7200 Costa Mesa, Califomia CERTIFICATE OF OCCUPANCY No. The Building located at 7tt4 ru�Rr 7onc �r�o�r. n..;r.,n has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group Occupancy. Use of Building Legal Description Salon A24-201-02 Building Permit No H 4$�9% Mechanical Permit No. ISee reverse side for Metes and Bounds) lectrical Permit No. E�8�98 Plumbing Permii No Number of apar[ments and/or guest rooms ISSUED TO: BuildingOfficial Tonv C'De Baca Jarnisc Avetoom � ' � ��' 789 W. 19th $t., Unit D - by �� J.-1 i i,� -, �,._ C�sta Mesa, CA 92626 Date Mav 24. 1991 s Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the ilding Official of the City of Costa Mesa under Sec. 307 (e) U.B.C. C�vtF 1o15�a6 rav. 1/83 White -Owner, Canary - Nurtrerical File; Pink � Bldg. Permit File