HomeMy WebLinkAbout799 19TH ST - Building PermitsCITY OF COSTA MESA
BUILDING DIVISION
77 FAIR ORIVE, COSTA MESA, CA 92626 •(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us�
PERMIT TYPE
APN: 42420101
Zoning: ,
FOR INSPECTIONS CALL: (714) 754-5626
PERMIT NUMBER:
B_MISC STATUS:
DATE ISSUED:
ISSUED BY:
V BX08-00103
ISSUED
07/31/2008
RMD
JOB ADDRESS: 799 W 19TH ST CM ,- -�- _'� .SuitelUnit:
Vicinity: ARCO STATION � ��'r:'; Primary Occ: � � ' `'_'•-` Const Type :?? � � ' ,
SQ. FT: 30 ,.',;"�, . Valuation: . E12,000.00' `� ? � ' �
�'>
SCOPE OF WORK: f�; , , < " - :.
INSTALLATION OF NEW HEALY CLEAN AIRSEPAR,4TOR UNIT (NEW VEEDER ROOT MANIFOLD TO EXISTING VENT RISERS
TO . �iz�r" i, i; �. o f' ;; `,\s., .
CONNECT TO NEW TANK); U�SE OF,THE THE'EXISTING 30SF PAD WITH A NEW MEfAL�ENCLOSURE WITH BUMPER POSTS,
��• �•t ;�
AND {?J� ir .:�„�-y.,� :P� _ :�.. .
ASSOCIATED EVR PHASE II�FUELING�UPGRADES AT THE EXISTING "ARCO STATION.'l�';t, '-,'`�r, �-'�.
OWNER:
City/State:
Phone:
APPLICANT:
City/State:
Phone:
�,, J, ,. , ; r-. .. : . , . �„��.� .
� �' . .. i ' `i � �, '� 1 � � : �.
THRIFTY OIL CO � , { ` Address:: PO BOX 2128 -.. � "' � � Unit .
SANTA FE�SPRINGS; CA ,.- �,- :. • , ' Zip Code: 90670-0738 : �
. �
. � ti �' , ,Y, i,i� r _ _ - - , :A, _ , r.�.�;��,1 _ �:, � � .
' �11 , � s'x' - : � c �_ f � 't ;
MC COMA5 CHRIS Address: ,� `� '•� Unit:
„
,� �.. r,;#rl : , . �. �.T.._ . _ i - �t�`l
. � ..., ._.._�...... , ZipCode: � �, (,..,.i� ,,
I {;�, � ,
7891X123`�. '':_-,� ` : y �; -.' ,,i
213381-. ...r .
CONTRACTOR: CHARL'E5 E THOMAS COMPANY INC — - License No.` 302015' : . �
Address: 13701�;S:ALMAAVENUE - -�- - • � :'r ^ ' � � Unit:
City/State: GARpENACA'����, _ �'''� ' '..
Zip Code: 90249' Phone 213321-8420 Cell: .. �
ARCHITECT:
Phone
ENGINEER:
Phone
� r-
- License No.
� �; �. , . � . , . . .
PATRICK FI�EDLER , ";
213-381-7891':� . � ; '
"li=.
Building Plan Check: �
Building Permit:
Electrical Permit:
SMIP Residential
SMIP Commercial
�.. ' ; License No. C38123 ��
. _ : FEE SUMMARY �. : j �
-- `' � '$52.31
- t$209.25 : .
� _ . . � $O.OQ
$0.00
$2.52
NOTICE: The work authorized by this permit shall wmply with all applicable handicap access requirements under Califomia statules and relaled
regulations. (Ord. No. 92-28, § 1, 12-21-92) � �
EXPIRATION: PERMIT EXpIRES 160 DAYS FROM DATE OF ISSUE OR DATE OF LAST INSPECTION. - .
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply wilh a�l applicable codes, and ali
required inspectlons and flnal approval must be obtained. Failure to obfain inspecGons and final approval will result in itie expiration of fhis permit:
COOE t• INSPECTION TYPE
1816 Fized System Final Fire Prevention
1268 Pool Spa Final .
200 Final Re-Roof
207' Final Block/Relaining Wall
202 Final Fadory Fire Place
203 FinalSign
204 Final Demo ition
DA� IN11ML
CWE/ ixsrecnoxirre �
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Pravention
220 Final Planning Approval
222 Final Site
250 Final Builtling/Octupancy
DRTE INTM45
. '� �L ...r
WORKERS' COMPENSATION DECLARATION:
I hereby aKrm untler penalty of perjury one of lhe following declarations:
❑ I have and will maintain a ceAi(cate of wnsent to sel�-Insure for workers'
compensation, as providatl for by section 3700 of the Labor Code, !or the
peRortnance o( the xork for which this pertnit is issued.
❑ I have aiM will maintain Morkers' compensatbn insurance, as required by
section 3700 of lhe Labor Code. fa the peAartnance of tlre work fa which this
pertnit is issuetl. My Norkers' compensation Insurance carrier and policy
number are:
tcame�r wA�s at�t �nc�tC�Wv� �rs
r(T�iflOCf4nn!ltlrafOB�Z-1 I� ei�'ICI�� V I�rf100)aless)
1�1
Policy NumDer: W G
❑ I certify that In the peRormance ot the work for which this permit is
lasuetl, I ehall not amploy any pereon in any manner so es to become subject
to lhe workere' tAmpansation lawe of Callfomla, antl agree that if I should
beco subject to e rkers' compensalion provfsions of Section 3700 of
the or Cotle, II (� hwith wmply wiM Nese provi ions
1's IpnsWrc Dat��
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVER4GE
IS UNLAWFUL AND SHALL SU&IECT AN EMPLOYER TO CRIMINAL
PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLAF2S
($100,000�, IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS
PROVIDED FOR IN SECTION 37W OF THE LABOR CODE, INTEREST, AND
ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm that I am licensetl unCer provisions of Chapter 9(commencing
with Section 7000) of Division 3 of the Business and Professions Cotle, and
my license is in full force and effect.
Lic: ' O b ��Class# ��� ��� O
� D ,�
�Cant s ipnaWre `_ Date
CONSTRUCTION IENDING AGENCY:
❑ I hereby affum [hat ihere is a canstruction lerxfing agency fa the
peAortriance of the xork fv wfiich tNs pertnit is issued. (Sec. 3097, Civil Code�.
Lentler's Name:
Lender's Address:
Siqnature Date
OWNER-BUILDER DECLARATIONS:
I hereby aRrm that under penalry of perjury ihat I am El(EMPT FROM THE
CON7RACTORS LICENSE LAW for the following reason (Sec. 7031.5,
Business antl Professions Code: Any city or counry which requires a permit to
wnsWct, alter, improve, tlemolish, or repair any structure, prior to its
issuance, also requires Ne applicant for such permit to file a signed statement
that he or she is licensed pursuant to the provisions of the Contrectors
License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the
Business and Professions Code) or lhat he or she is exempt lherefrom antl
the basis for the alleged exemption. Any violation of Section 7031.5 by any
applicant lor a permit subjects the applicant to a civil penalty of not more than
five hundred dollars ($500).):
❑ I, as ovmer of Ihe property, or my employees with �rages as their sole
compensation, WILL DO 7NE WORK, and the slructure is not intended or
oflered for sale (Sec. 7044, Business and Professions Code: The Contrectore
License Law tloes not apply to an ovmer of property who GuilCs or improves
thereon, and who dces such work himself or herself or lhrough his or her ovm
employees, provided ihat such improvemenis are not intended or oHered for
sale. II, however, the building or improvement is sold within one year of
completion, the ovmer-builder will have ihe burden of proving that he or she
did not build or improve for purpose of sale.�.
❑ I, as ovmer of the property, am EXCLUSIVELY CONTRACTING WI7H
LICENSED CON7RAC70RS to construct Ihe project (Sec. 7044, Business and
Professions Code: The contractqs License Law does not apply to an owner of
property who builds or improves thereon, and who contracts for such project wilh
a contractor(s) license pursuant to the Contractors License Laws.).
❑ I am exempt untler sec. �
Business and Professions Code for this reason:
Sie�aWre pa�e
305]AB (3I0])
Owner ID verifed by driver's licer, , Ves ❑ No
Dnver's License No. Expires:
Verifiwtion of Ownership by (rype of document, i.e. - properry tax bill or deed):
DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION:
❑ I hereby certify that rro excavation frve (5) or more fcet m depth into wfiich a
person is required to descend, will be made in connection with work autMrized
by this permit, and that no building s[ructure, scaffddinq, falsework, a demolition
or tlismantling ihereof, will be more than Ihirty-six (36) feet high. (Chap. 3.2, Grp
2, Fvt 2, Sec, 341, Title 8, Califomia Adminislrative CoAe).
❑ As owner-builder, I will not employ anyone to do work which would
require a pertnit from the Division of Intluslrial Safety, as noted above, unless
such person has a permit to do such vrork from the division.
Applicenfs SignaWm
Division of Industrial Safery Permit Number: _
HAZARDOUS MATERIALS AND EMISSIONS CERTIFICATION:
t. Will the applicant or present or future building accupant need to file antl
certify a Business Plan for emergency response to release or threatened
reiease of a hazardous material7 � Yes ❑ No
(Sec[ion 25505 ot the Califomia Healt� antl Safery Code requires, wilh some
exceptions, that a Business Plan be filed wiN the Cosla Mesa Fire
Depanment by every business whic� has at any one time tlunnq a reporteC
year a quantiry of hazardous materials equal to or greater than a weight of
500 pounds, or a volume of 55 gallons, or 200 cuDic feet of comprassetl qas
at standard temperature and pressure).
2. Does or will the applicant or present or future 6uilding occupant neeC to file
a regisiration form for awtely hazardous materials? ❑ Yes ❑ No
(Section 25533 ot the Califomia Health and Satery Code, with some
exceptions, requires registration wit� the Costa Mesa Fire Depanment by
each Eusiness which at any one time has on hand a quantity of aculely
hazardous materials equal to or grealer than a weight of 500 pounds, or a
volume of 55 gallons, or 200 cubic feet of compressed gas at stanAard
temperature and pressure).
3. Does or will the applicant or piesent or future building occupan[ need to
prepare an RMPP (Risk Managemen[ and Prevention Program tor acutely
hazardous matenals)? ❑ Yes ❑ No
(Section 25534 of the Califomia Health anC Safety Code provides that t�e
Costa Mesa Fire Department may require the preparation, certifiwtion and
filing vri[h the Fire Department of an RMPP by businesses vRiich are requireE
to register acutely hazardous matenals with lhe Fire Department.
4. II an RMPP is presently required, has Section 25534 ot ihe Califomia
Healih antl Safety Code been lully wmplietl with7 ❑ Yes ❑ No
5. Does or will the applicant or present or future buildinq occupant require tor
[he v.vrk which is Ne subject of lhis application a pertnit for such wnsWction
or modification from the South Coast Air Qualiry Management District oi from
any other air pollutlon wntrol Gistrict or agency? ❑ Yes ❑ No
(Section 65850.2 of lhe Califomia Govemment Code requi2s lhat the requested
infortnation be fumished on applications la ran-residental building pertnits�.
6. Will any part of the facility to be constructed under this permil be within
7000 feet from the outer boundaries of a school7 ❑ Yes ❑ No
(If yes", the facility must meet the requirement of Sections 25534 and 42303
of the Califomia Health antl Safety Code).
7. If a permit from the South Coast Air �ualiry Management District or other
air pollution conVol distnct or a9ency is required (or ihe vrork vrtiich is the
subject of this appliwtion, have all of lhe disclosures prescribetl by Califomia
Health and Safery Code Section 42303 been made? ❑ Yes ❑ No
8. (If'yes", attach certificate of compliance from the appropriate air pollution
control offcer).
CERTIFICA7E OF COMPLIANCE: I certi(y that under penalry of perjury the
infortnation given above is correct. I agree to compty with all sWte lavrs and
city ordinances regarding Hazardous Ma[erials and Emissions.
SignaWre
CERTIFICATE OF COMPLIANCE AND AUTHORVATION OF ENTRY: I
certify under penalty of perjury lhat I have read this application anA state that
lhe information given is cortecl. I agree to comply with all state lavrs and city
ortlinances relaUng to builtling construction, and authorize represenWtives of
the City of Costa Mesa to enter upon ihe above-0escriGed property for
inspection purposes. I agree not to occupY or allow occupancy of any building
authorizetl by this pertnit until final inspection.
SignaWreofl er Dale
, ( og
_ OlorAut n A pliCdN (�.- Ddle
(714) 754-5273 • Fax (77a) 754-4856 • www.ci.cos�a•masa.�L�CTRICAL PERMIT �� FAIR DRIVE, COSTA MESA. CA 9262fi
Job Address: 799 W 19TH ST
Suite No
Viciniry:
Parcel Nunmber: 42420101
Applicant: ARANNA, GERARDO
Address: 14118 S INGLEWOOD AV
HAWTHORE,CA
Owner: THRIFIY OIL CO
Address PO BOX 2128
SANTA FE SPRINGS, CA
Phone: 310.679-9991
Zip 90250
Phone:
Zip: 90670-0138
Comractor: PETCON TECHNOLOGIES INC
Address: 14118 S INGLEWOOD AV
Phone: 310.6�
HAWTHORNE, CA 2ip: 90250
License: 67599
' S60PE OF PI
UNDERGROUND UPGR/A _ E1f,,l_Ll SUMPS T�INCLUD
REPLACE OVERFILL AIAFiAAlREF: B03-0221 i.
�
ELECTRICALTOIN'L'UDE:9,,OUTLETAND'O �ALA
AUTHORIZED BY TH�S PER � 7. a., ,
�r.�`��NOTE: ELECTR! AL+WORK IS SUBJ GT TO �IELD IN
..f&.i14�'GP.RQVIDE ANYAQQITIONAL DOCUMfyNTATIQN,AS RI
Appl
200a
1000a
Pole llgfifPkg
Sign Circuits
Temp Pwr Pole
S1.
50.00 �
50.00
$0.00 ••
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
so.00
$0.00
$0.00
$0.00
0
0
0
0
0
0
0
a
0
0
0
S�atus: ISSUED
Applied: 03I18R004
Issued: 03I182004
ISSUED BY:
EXPI�D
DA'PE ��
�
EMS� -TTHEFILLBOXAND `�,;
r
5 '�
)�4 LECTRICALWORK �-� ����H.�
I �
, .a,.
Y'
PPROVAL. APPLICANT WILli+4 "M'��.
INSPECTOR. Fs::��,�%/
/ Lighting
Misc &IectFical Equipment
7ransto�miers?up.lo 1 kvalkw
...... �'-�"u"p�to' 10 kvalkw
..........
.........%Fyup to 50 kva/kw
.................up to 100 kva/kw
..................over 100 kvalkw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misc. Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
Chrislmas Tree Stand
Fireworks Sland
Other Electrical Fee
Investigation Fee
Plan Check Fee
Reinspection Fee
4uanllty
$0.00 0
$0.00 0
$0.00 0
$1820 1
so.00 0
$0.00 0
$0.00 0
so.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00
$0.00
$0.00
$0.00
TOTAL CALCULATED FEES 542.80
�I NOTICE: The work authorized by this permit shall comply with all applicable handicap acwss reQuiremenls unde� Califomia stalutes and related
' regulations. (Ord. No. 92-28, § 1, 12-21-92)
'�, E%PIRATION: This permit shall automatically expire and become void il work is not commenced within 100 days, or if work Is suspendetl or abandoned
lor a period ol 1 BO days. �
INSPECTIONS: In order lor the work authorized under Ihis peimit to be considered legal, such work must comply with all applicable codes, and all
requlred Inepectlona end Ilnal approval musl be obtained. Failure lo obtain inspections and tinal apP�oval will result in the expiralion oi this permit.
��, FOR INSPECTIONS CALL: (714) 75M5626
e«o�+o �o�w�
WONKERS'COMPENSATION DECLARATION: w� w
I haroby atlirm untler Oenalry ol pe��ury one ol the �dlowing decWrations:
❑ 1 beve entl will mainlain a cenihcate ol consent to sell-Inw�a for workors' componsalion, as pmvitlatl lu� Dy section 37J0 0l Ihe Lebnr Cafe, lor Ihe petlormanca ot Ihe
work br wnic� I�is permn is fssuetl.
� I ndva and will maintafn worke�5' compOnsation insurance. as requiretl by section 3700 0l lhe L2bor COtle, �or Ino pUtlormanca of Ine work lor w�¢h Rlis pennit is issuotl.
My worMers' Compensation Insurancu Carrier antl poLcy numoer are: -'
Ca�aJ�'. POlicy Numb.�r'.
(T Ns .ecnnn neuu noi De campielntl �1 me pernuf is valuea at one nunarnd dolld�s /S 100) or less.)
❑ i cendy ihat m me pedormance ot �ne wod lar w�icn i�is permii is issuod, I snall noi em0�oy eny porson in any manner so as to bemme subjact io ine workers'
compensaiion laws o� Calnomia, antl eg�ee I��a� i� 1 snoula �ecome sub�en lo Ine worhers' compensation pmvisions oi Secuon 370p ol Ihe L'eDor Cotle, 1 5�a11 IOMwith
comply witn Inese provisions.
App6Gum Signatuia�. Dam�.
W�FN�r1G' FAR URE TO SECURE WORKERS' COMPENSAi�ON CAVEMGE IS UNUWFUL �ND SHALL SUBIECT AN EMPLOYER TO CRIMiN�1 PF.N�LTiES AND CNII FINES UP 10 ONF. HUNDRED
��p��$AN� WI,URE �E100,(Q01. Irv ADDI fIUN TO iHE WST OF COMPENS�I 1p1, D�MA4E5 �5 PROVIOE� FOR IN SEC11pJ ]!C6 OF i11E V BOR CO�E, IMEREST, MID AT70HNEY5 FEES.
, r
LICENSED CONTRACTORS DECLARATIOH: fI ' � �
I hnroDy atlirm I�a� I am liten5etl untlor Orovi5ion5 0l Cnapier 9(CommonCing wilh SecbOn 7000) ol Dnision 3 0l Ihe Businoss antl PmIB55i0n5 Cotle, nntl my license is in Iull
lorte entl etlecl. LC. • Class • i" -� � I
Conlrqctur'S Signalurn: Ualx: � \ /
CUN5TAUf.TION LENOING AGENCY: '�� \ � "
❑ I Il�n:by AHinn Ibai I�18rb is a Lon5ltuCliOn lentling aq�nCy IOr Ihe pCtlOrmaOte ol Ihe work br wniClldhi3'PBfRIi� i5 i55uAd. ,
Lvnaer'S Nama: Lantler's Atldross: ��*" }'�- � � �_'.
SignaNru: �l . �, � ., - .. � fr ... ..n�'d��b.� �..�, I Date
OWNER-BUILDEP OECLAPnTIONS � ' ' �
I �ero�Y eflirm t�al untler Denalry ol perlury I�at I am E%EMPT PROM TTIE CONTRACTO
Cono: Any aty or cowiry wNcn reqwres a ponnit to crostmct, al�er, improvu, tlomohsn, or
Io I�Ic a signetl stelnm6nl Inai ho or sntl is licensea pursuant to Ine prpViSiOne'of'ihe Conp
Businass antl Piaesswns Cotle) or mat no or s�e is exempt tneretrom an6 Ne hesis foi t
suo�ecis tne aDDI¢am to a civil penalty W noi more than tive huntlr6C Odlaro (SS00).�:
❑ I, as owner oi Ine pmpeny, or my employees wilh wages ea Melr wla compeniation,
7U44, Businnss antl Proiessions Cotlo: 1 he Contranors License lew Eoee no1 epply
pimsult or herse�t or Nmugh his or �er own employees; ptovitleE Ihai sucl� k�rovem
goW witOm one Vear ol wmple�ion, Ihe ownei-Duiltler will have [h0 bur0en W D���ng
❑ I, as owner nl me p�openy, am E%CLUSIVELY CONTiiACT1NG WITH LICENSED (
Code: 7he conuaziuro license Lan ooes no� apP�Y a���er ol propeny who builc
iicense pwsuanl to ine Coniracto�s UCense LewsJ?..;' '`� 1�.. ', '
❑ I am o•ompl untler sec. f�� ' '� r Business anC Protggaions
$ignaiure: l ' �• � �` . • ( ��- � t
Ownoi ID ventiea �y tlriver's'Ikenae � " � Veal � No �� ' Driver s Lict
!- 7 t
Venncaiion ol Ownership Dy (ly{�e ol tlocilmeN, I.e. - properiy tea �ill or Ceetlj: E
! . _ . ...-. . l 1 .. � _ .
DIVISION OF INDUSTMAL SAFETY PERMIT CER'
n. �
❑ i noreby cenity tnai no escavaiion �ive (5) or m
permn, ano mal no huiltling strucwre, scaBWdi
3d I, lnlo B, WldOmia Atlminis��euve Cotle�.
r. �.�,
❑ As ownar-bui�tler, I will not employ anyone io
permn to tlo sucl�,work ham me arvision.
1 � 1� -,
„4������,.: �. , -.;_
�� � , �
Divisin� ��� Intluslrial.5a}ery Permit Number.'
CA710N: f. . : f
feetin'tlepin inlo wh'ich p p9rson
feUewoik, or demdition a tlisma
, ..,� � _ .!
wwk'whic��woula repuire a pan
"- � �1
$BC: 3097, Clvil
�� .
.. ... �,...: , ' �,
: UCENSE LAW Ior�Me lollawing reaf
p0ir eny slmtWre, p�ia,lo i1s issuancE
:tord License Luw (Cbepler 9 (commei
i ellepetl axomption. Arcty viula�ion ol ;
I � f
IILL DO�THE WORK, entl me svuctur
an Ownei of property�who DwltlS or im
in ere-rwl INentleAbr oneretl lur sal6.
3111e w she did�n04builtl or improve �c
�
NTRACTOP9 to'constmct Ihe projuc�
Df ITprove! thereon, antl wfiu CONrac
. , � /,..
,�do'lor I�is raeson:
� Da�o: _
ie No. �
�
+ t.''�
�Sec. 7031.5, Businass and ProloSsions
w reqmre5 Ine applicanl tor sucn Oermit
p riltb Section 7000� ol Uivison 3 oi Ina
�on 70�1.5 Uy any app�icant tor a oermn
nd int� ntletl or ofleretl tor sale (SeC.
res thereon, entl wno tlnes such work
10WevEr. Ihe �uiltlmg or improvnmeni is
rpuse ol sala.).
�
c. 70dd, 6usiness antl Prolessions
P Sticn,projeq wiN a coniractoqs�
E.pire5:
tles[entl, will bo ma�IB in connaction wiih work authorizntl by I�is
will be more Ihan initly-si. (36) leet Mgh. (Cnap. 3.2, Grp 2, An 2, Soc.
IM1e Division ol Indusirial Satety, as noletl a0ove, unless sur.h pxrson nas e
Dala:
� WAI Iho applitarii or�Oresonl or,Nture DuOCing occupani nead to lile entl tenity a Business Plan lor omergnncy response lo release or I�realenetl releaso ol a �azeitlous
maturiul7 ❑ Vea' `� .: � No - � . � /
ISeCliOn 25505 011fi0 CBldwf�iB HBBItt1�Bntl Sa�ely COtle rBquif05, wilh Some oxCeO�ions, I�al 9 BUSino45 Plen be lilod wii� Ihe Costa Mesa Fire Dupariment Dy e�ury
UVSiness whicn hee'al�eny pq Gme tluiing a roponetl year e quantity ot hazartlous malenals oquul to or giealor inan a weight of 50o pound5, or a valmno 01 55 gaUons,
rn 2G0 cuoic teel 01'compresseE qas el stunaa�tl temoerawre antl prossure).
.........................................._..�_.._..___...�._-........................................................._....................................................................................................................._.............,.... .._.............. .. .....__.....................__.................
..... . ....
2 Ue�ea ur wiil tnr. app&ent a praseni'or luture buileing occupa�t neotl m lile a regisvaiion lorm lor acumly nazartlous materials7 ❑ Ves ❑ No
�$ection 25533 nl Ina Celilomia Healih antl Sa�ery Cotle, wnn some e.coptions, reqwres regislrauon wnn tnu Cosia Mesa Fire Depanmem by eucn busimass which et nny
unn ume nas on nariC.a_punnuiy ot aculety nazamous mxinnals oqual to or greater Uian e weigin ol 500 puun�s, or a wlume ol 55 gallons, or 200 cubic luel ot
cnmpressea gas ai sianaarU Iemoerature antl pressure�.
................._. _................................................................................_.._........................_..........._.__.............................._........_....................................................................................................,.........._.............._....,........................._........_...
9 DOes or will tha apolicant nr preseni ar luture builtling cecupant neetl io prepare an RMPP (Risk Managemenl antl Prevenlion Program lar ecutoly hazartlous materialsl7
� Ycs ❑ Flo
iSnciinn 255:rt ol t�e Cahlornia Meatln and Satery Cotle pro�tles tnat Ihe Costa Masa Fire Depanmem may require me pre0ara�ian, cenilicaGon and liling wi�� Ine Pire
UVP%��munl ol nn RMPP uy bus��osses wnich are requlretl lo �egister atuiely hazartlous malbrials wiVl ihe Fu9 Depanmenl.
................_........................_..........................._.....__........ _..._..... .._....._....._._.._........._.._..__......................................_............._................................................_.. . ........_.......... ................_._........ _...._......"'_"_"......."
4 It an IRdPP is pmsently requrted, nas Seciion 25534 0l i�e Calilomia Healih and Salety CoOe beon tulty complied witM ❑ Ves ❑ No
........................................... _....................._......._....._....................r. __........_............._.................._....._........................._..............................................................._........_............................._................_....._....:.............._......_.........._..
y i�pns ur wilt �na apphcam or presnm or luwre builmng occupam requirx lor ine wo�k whic� is 1ne 5ubjor.l ol rtiis aeplicaiion a�ermii lor such [anslrur,uon or motltlicauon
�rpm Ihn Sawti Guas1 nu Uualny Managamam Oisu�u or �mm any oll+n� air pollulion conlml tliStriCi or agunCy? L.l 1'ao No
�ynction 65Ati02 nl Iho Ca6lomia Govemrtleni CodE fCquires Ihal IIIB requC510tl mtormaii0n be tumislietl on appliCalions br non-rnsitlentiul builtling p¢rmns).
............................................... ....._..._........_.........._......._.._........_...._._......__......_.............................._...............................................................................................,..............._........._.. ._..._.._.._._...._.._._.._.......__.....�............
,� Witl uny pert ot Ihe facility Io 6e consimctetl under Inis permil Ee within 1000 teat tmm I�e oulur bountlaries of a sc�ool'? ❑ Ves ❑ No
pi'yes', tne taahry must meei ipe reqmremem of Secbons 25534 antl,42303 0l tne Calitomia Healtn antl Satery Code).
............................................_..._..._................,........._....................__........................................._................................................................................................_......._.........................................._.............._.__........._._...._......_._......
7 d a parmil Imm Inn Souih Coasi Air Ouality Management pisinti or other air polluiion conVd tlislrici or agency is requvetl lor Ihe work whith �s Iha subject ol Ihis
'�yWmatwn, nev� all o1 tnn a�scbwws pwuuhea by Calilomla Nealth antl Safety COUe Section <23�3 bexn matle? [] Yns ❑ No
.......... . ...._._ ..........................__..__......._.._..........:....._...........__._.....___..___._......._.__.._.._.._._.....__......._.......;..........._""'_'._............_..............._........_............_.._..........._.._..__...__._......_.__......___.._._._...�._.......
d lit yEs', aitacn ceh�hcate ot compliance tmm Inn a00�aP��aie air polluuon conlml ofl¢er�.
��R fIFlCATIi Of COMPLIANGE: I Cetlity Inai unaer pennlry of perjury Ne infOrmalion giVen eDovB i5 COrreC�. I agree IO COmply wilh all Slaie laws 2ntl City Ominanr.05
iegar(ling Ha[ertlou5 Matunal5 tlnd Emi55iun5.
Signawre: Uata:
CERTF�CA7E OF COMPLtANCE AND ALJTTIORIIATON OP ENTRY: I cenity untler penatly ol porjury Ihet I have reaA ihis epPlicalion and slate t�a� t�e mtormatinn given is
correcl. I agrea lo comO�Y'�'��h all state laws entl city orUinances relating to builtling consimction, and aulhotiTe �aprnsonlallvos ot Ihe Clty ol Cosla Mesa to entor unon Ihe
aowe�oescribetl prope�y �or inspection purposes. I agree not to occupy or allow occuoancy ol any buildinq eutnoriiotl by i�is permii unlil bnal inspociion.
�QpE • INSPECTI�HTVPf;
1616 FixeC SY3tem I
Fira
203
2oa
SignalWe OI Lngnl (hvneqs)
AUlnonzBtl ADD�i[ant Deie
Q1i( i �
re Prevemion �'"�""�
�J� �'n .':i�.i"�,1�. ;'.�. '�\
�; .�� r '-�
Wall �1 �� �'
:..' ..;} I,7„�.
�.'� < �
;��� •`.a�,.;�'. .��.'j.Y
COOE � INSYECTION T1'Vt
?OB'^"Flnel Moclienleal��
t , ; �, , . „
20B Flnal PlumWnp "- _ f,' +
� ..� ,
2t0 FmelEloUrical � '
I + ' l �,
2� 2 .Finet�Firo,Prav_entlan;�
1.:.. . . .�... .�
220�' -FkwlPlennin9�ApProval
22i � ' :.FinBI Sile
k - ,
250_ _ �• Finel Builtlin<yOccupency
(7�a) 754-52�3 • Fex (714) 75a-a856 • www.ci.costa-mesa.ca.us 77 FAIH Uh11Vt, GVJ I A MtJA, GA `JZbLO
ELECTRICAL PERMIT
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
799 W 19TH ST
42420101
Applicant: ARANNA, GERARDO
Address: 14118 S INGLEWOOD AV ,
HAWiHORE,CA-
owner. THRIFIY OIL CO
Address PO BOX 2128 . -
SANTA FE SPRINGS, CA
Contractor: PETCON TECHNOLOGIES INC
Add�055: 14718 S INGLEWOOD AV
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 unils)
New Res (3+units)
Pool / Spa
Lighling Fixts '
Recept Outlels
Switches
Non Res Appl
Res Appl
Service to 200a
Service to t000a
Service over 7000a
Motors to thp
HAWTHORNE,CA
Phone: 310-679-9991
Zip: 90250
Phone:
2ip: 90670-0138
Phone: 310-679-9991
Zip: 90250
License: 675998
ISSUED BY:
Status: ISSUED
Applied: 03/18/2004
Issued: 03I18I2004
SCOPE OF PERMIT
UNDERGROUND UPGRADE FILI: SUMPS TO INCLUDE�NEW EVR SYSTEMS AT THE FILL BOX AND
REPLACE OVERFILC AIARM. REF: 803-02215. �
ELECTRICAL TO INCLUDE: 1 OUTLET AND ONE ALARM SWITCH. NO OTHER ELECTRICAL WORK
AUTHORIZED BY THIS PERMIT.
NOTE: ELECTRICAL WORK IS SUBJECT TO FIELD INSPECTION AND APPROVAL. APPLICANT WILL
PROVIDE ANY ADDITIONAL DOCUMENTATION AS REQUIRED BY THE INSPECTOR.
523.50
$0.00
$0.00
$0.00
$0.00
$0.00
50.00
$1.10
$0.00
$0.00
$0.00
$0.00
50.00
$0.00
$0.00
�uantity
0
0
0
0
1
0
0
0
0
0
0
0
m
FEE SUMMARY
Temp Dist System / Lighling
Busway /100 ft .
Standing Sectlon � �
Misc ElecVical Equipment
Transfortners up to 1 kva/kw
................up to 10 kvalkw
.................up to 50 kva/kw
.................up to 100 kva/kw '
..................over 100 kva/kw
Low Voltage Equipment
Low Volt Wiring System / Ckt
Misc. Conduit
Misa Conductor -
Circus ( gen or ride) � -
Cirws (mech ride or lights)
Quantiry
$0.00 0
$0.00 0
$0.00 0
518.20 1
50.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulatlons. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: Thls permlt shall automatically expire and become void if work Is not commenced withln 180 days, or if work Is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the xrork authorized under this permit to be considered legal, such work must comply with all applicable codes, and alI
requlrad Inspaetlons and finel approval must be obtained. Failure to obtain inspeclions and final approvel will result in the eKpiration of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5828
zu�ae �a�ao�
WORKEHS'COMPENSAnON DECLARAnON:
I hereby atlirtn under penelry of perjury one af Ihe following dedaretions:
❑ 1 �eve entl will melntein e certificate of consem to se&Insure for warkers' compensation, es provitled for by sectlon 3700 at the Le6or Code, for the pertormence ot ihe
wo tOr whlCh thi9 pertnit IS Issuetl.
ave and wlll maintain workers' compensa�pn Insurance, es required by sectlon 3700 of Ne Lehor Cotle, for the peAortnance Of the work tor whicli Gtis psrtnit is Iswetl.
My workers' compensation Insurance carrier antl policy numDer ere:
Certler: � Policy Number.
(Thls secUar need not be completed if the perrrvf is ve/ued et one hundre0 ddlers (5100) or less:) ,�
❑ I certity that in the pertarmance of Iha Work tor which this permit is issued, I s�all not employ eny person In eny manner so es to hecome subject to Ihe workers'
compensetlon laws of Califomia, and egree that tl I ahould become sub�ect to the workers' campensetlon provisions ot Seee���tlon 3700 t t�e Lebor Cotle, I s�ali foMwith
comptywiththeseprovisiwu. �I � �, /
AppllcantSigneture: lerar���yrjrJp Dete: � ���
W ARNINp: FAILURE TO $ECUfiE WOPNERS' COMPEf�1$AT1pN CpVERAGE IS UNUW Fl1L rW� $MAIL SUBJEC� AN EMPLOYEF TO CRI I PENALTI S AND p L FlNES UP Tp pNE MUNDRED
TTIOUSAND OOLLARE (E100,000), IN ADDITION TO T}� �T OF COMPENSATION, OMUGES AS PFOVIDED FOF IN SECiION 908OF TME LABOR CO�E, INTEPEST. AN� AITORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereDy eflirm Ihat I am licensed under provisions of Chapter 8(commencing wilh Sectlon 7000) of Dlvislon 3 oi t�e Business ond Professlons Code, antl my Iicense Is in full
brce entl eflect. Lic. M Class A
Contrecmr's Signature: �r�'O7� rana Dete: `� ( � ( �e
CONSTRUCTON LENDING AGENCY:
❑ I hereby aMirm Ihat there is e wnstruction lending epenry lor tha peAortnence of lhe work for which Ihis permit is issuetl. (Sec. 3097, Civil Catle).
Lentlefs Name: Lentler's AtlEress:
Signeture:
OWNER-BUILDER DECLARATIONS:
Date:
1 hereby aHirtn thet under penalry ol pe�ury Uat I am E%EMPT FROM THE CONTHACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professlons
Cotle: Any city or counry which requires e permit to construq, alter, improve, tlemolish, or repair any strucWre, pnor to its issuance, elso reduires Ne applicant tor sucli pertnit
to lile a signetl statement Ihat he ar she Is Ilcensed pureuant to t�e D�ovlslons of Uie Contraqore License Lew (Chepter 9(wmmencing wiih Section 7000) oi Divlsion 3 of the
Business en0 Protessions Cade) ar thet he or she Is exempt Uerefrom entl Ihe basis for ihe alleged exemption. Any vialation af Sedion 7031.5 by any epplicant far e pertn0
subjects the epplicam lo e civil penalry of not more than five hunEretl tlollars ($500).):
❑ I, es owner ol ihe property, or my employees with weges es iheir sole compensetion, WILL DO THE WORK, antl t�e siructure Is not intendetl or oflered for sale (Sec.
7044, Business entl Professions Cotle: The Contractors lJcense Lew tloes not apply to an owner of properly who builtls or Improves thereon, antl who tloes such work
himself ar herself or ihrough his or �er Own employees, D�aWdeA thet such improvements are not Intended or oflered for sale. It, however, ihe building or improvement Is
sold within one year ot completion, the bwner-builtler will heve the burtlen ot proving that he or she did not build or improve lor purpose of sale.). '
� I, as owner o1 the properry, am E%CLUSIVELY CONTRAC7ING WITH LICENSED CONTRACTORS to wnstruct the project (SecJ044, Business antl Professions
Code: The contractors License Law does not epply to en owner ot property who �uiltls or improves iheraon, and who contracts for such project with a con[raaor(s)
license pursuant to ihe Contractars License Laws.).
� I em exempt untler sec.
Slgnature:
Ownaf ID veAfied by drivers Ilcense. ❑ Yes ❑ No
Bu5in855 end Prote55ion5 Cotle for this reeson:
Verillcallon oi Ownership Dy (rype of tlowmeht, i.e. - praperty tax bill or deetl):
DIVISION OF INDUSTAIAL SAFE7Y PERMIT CERTFICATION:
Drivers Ucense No.
Date:
Fxpires:
❑ I hereGy cenity ihat no exwvation tive (fi) or more leet In tlepth Into which a person Is required to descend, wlll be mede In connection wlth work authorized by Nls
pertnit, and that no bulltling structure, scaHolding, lalsework, or tlemollUon or dismantling thereof, will 6e more �hen Ihirty-six (36) feet high. (Chep. 32, Grp 2, Ah 2, Sec.
341, Title 8, Callfomie AAministreUve Cbde).
❑ As owner-bullder, I will not employ anyona to tlo work w�lch would require e permit irom t�e Division ol Industriel Setery, as noted ebove, unless such person has e
permit to do suc� work hom 7he Gvisioq,
Signeture: Date:
Dlvision oi IndusMel Satery Permii Number:
CERTIFlCATE OF COMPLWJCE AND AUfHOH¢ATON OF ENTHY: I cenify under penalry ot perjury that I �ave read this application end state that the infarmatlon gNen is
carrect I agree la compty with ell slete lews antl ciry orOlnences relatinp to building construction, entl authodze representatives of the Ciry ot Coste Mesa to enter upon t�e
ebove-tlescribed property for inspection purypses. I egree not to accupy or ellaw occupency ot eny building euthonzed by this permit until final inspection.
� ignature Ot Legel Owner(s)
Grroy.lo �i'ad�
AnNOr Authodzetl Applicant
cooe r. INSPECTONTYGE
1818 Fl.ed Sysiem Final Fire Preventlon
1288 Pool Spe Finel �
200 Finel Re-Rool
201 Finel Block/Retalninp Wall
202 Final FeCtory Flre Plece
203 Final Sign
20a Finel Demoll0on
PdIE I[�l5
COOEI INSPECTONTYFE
208 Finel Mechenical
208 Flnel Plumbing
210 Flnel ElecVical �
212
220
222
250
Flnal fire Preventlon
Final Plenning Appraval
Flnal Slte
Finel 8ullding/Occupency
PAg ItII�L$
(714) 754-5273 • Fax (714) 754d856 • www.cl.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
. ELECTRICAL PERMIT
Job Address: 799 W 19TH ST
Suite No
Vicinity:
Parcel Nunmber: 42420101
Applicant: IRVING TERRY
Address: 13701 S. ALMA AVENUE "� .
. - Phone: 213-321-8420
GARDENA CA � � � Zip: 90249
Owner. THRIFTY OIL CO ' '
Address � PO BOX 2128 , � - � '
� . ' . � - Phone:
SANTA FESPRINGS, CA Zip: 90670-0138
Convactor: CHARLES E THOMAS COMPANY INC
Address: 13701�S.ALMAAVENUE � ��
GARDENACA
Phone: 213-327-8420
-. Zip: 90249
License: 302015
Status: ISSUED
Applied: 11/17/2004
Issued: 11/17/2004
SCOPE OF PERMIT
ADD SENSORS FOR UNDER DISPENSER PANS FOR "ARCO" �. _
' - ' � - . i. . . -.
ELECTRICAL TO INCCUDE: 1 MISC: ELECTRICAC EQUIPMENT. �" '
FEE SUMMARY �,
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res (3+units)
Pool / Spa. � � -
Lighting Fixts
Recept Oullets
Switches
Non Res Appl � � �, �
Res Appl
Service to 200a � �, ,,
Service to 1000a ,
Service over 1000a
Molors to 1hp �
Motors to 10hp
Motors to 50hp
Motors to 100hp
Motors over 100hp
Communication drops
Sub panel to 200a
Quantity
$23.50
$0.00
$0.00
$0.00 0
� $0.00 0
, � $0.00 0 i�,�� �
50.00 0
' $0.00 0 .. � �
$0.00 � - �0 -
-".'-$0:00��-. 0 ' _ '
' " $0.00 ' . . . Q - .
� $0,00 , ' � 0�' ,
..$0.00 ' . 0�- . . .-
$0.00 0
$0.00 0
$0.00 0
..$0:00 ` � 0. .
$0.00-�' ; 0 � -- .
$0.00 0
$0.00 � 0 � ..
$0.00 0
� - Quantity
Temp DistSystem / Lighting � $0.00 0 ,
Busway'/100 k - $0.00 0 '
Standing Section � $0.00 0'
Misc Electrical Equipment $1820 -1 � �
Traris(ormers up to 1 kva/kw $0.00 �0 -
...........:....up to 10 kva/kw $0.00 .:.'0
.................up to 50 kva/kw $0.00..: . � 0
......:..........upto100kva/kw-,;,. $0.00',� 0
..................over 100 kva/kw - $0.00" 0
Low Voltage Equlpment �- �$0.00 /- 0
Low Volt Wiring System / Ckt. �� .$0.00��' �� 0
Misc. Conduit " $0.00- -. %0
Misc. Conductor � : � i $0.00'� 0
Circus ( gen or ride) �� $0.00 ' - 0
Cirws (mech ride or lights) $0.00 �0 �
ChristmasTree Stand , $0.00 � 0
Fireworks Stand � . 50.00 �� 0
Other,ElectricalFee- '�$0.00
Investigation Fee - � $0.00
Plan Clieck Fee $0.00
;
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire end become void if work Is not commanced within 180 days, or if work Is suspended or abandoned
tor a period of 180 days.
INSPECTIONS: In order tor the work authorized untler this permlt to be considered legal, such work must comply with all applicable codes, and all
required Inapectione end final approval must be obtflined. Failure to obtain Inspections and final approval will result in the expiratlon o1 this permit.
I FOR INSPECTIONS CALL: (714) 7545628
�..� �aN„
WORKERS'COMPENSA710NDECLARATON: . •� ---.,
I hereby eHirm under penalty ot perjury one o1 ihe tollowing tleclaratlons: - �
❑ I heve end wlll maintein e certiflcete of consent to self-Insure tor workers' compensatlon, es provided tor by section 3700 of t�e Lebor Cotle, for the peAormance of Ihe
work lar which ihis permit is IssueO.
—�
����have flnd will melntaln workers' compensation insurance, es requiretl by SecGon 3700 of ihe Labor Cotle, for Ne perfonnanca oi Ne work tor which this pertnit is issued.
My workere' compensation Insurrenca carrier antl policy numb ere: —7/
CerABr: � �%T TVK� (.��Orxt�/�f �Pd�Nu`mberu �/ fO�G/9 %03
ecHon need not be compleretl il the peimit is valued af one huntlred dallars ($100) or Iess.J �""—�- �
❑ I cenify that in the pertormance oi the work for which ihis pertnit is issued, I shall not employ eny person in any manner so es Io become subject to tha workers'
compansetion laws oi Celtlornl entl agree if I sho � Gecome subject to Ihe workere' compensetion proWslons of Section 3700 of the Lebor Code, I shall forthwith
comply with thesa provisions � -
��%Slgnatuie:x�C�T= �- .Daie� U� �� � � O `�
'p'ARNINOrFAICURE TO SECURE ORKERS' PENSATION COV IS UNLAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENPLTIES PND CIVIL FlNES UP TOONE HUNDRED
TMOUSAND OOLLARE (5100,000), IN ADDITI O THE COST OF PENSqiION, DAMAGES AS PROVIDED FOR IN SECTION �OB OF THE LABOR COOE, INrEREST, AND ATTORNEI"S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby eXirm Ihat I em licensed untler provisic
CONSTRUCTION LENDING AGENCV:
9(commencin9 with Section 7000) ot Division e.8usiness antl Professions Cad and my license Is In tull
�- �;x. �%2yo .ffsf 2 .�l-
❑ I herehy aHirtn tha� ihere is a construction lentling egency for t�e performance ot the work tor which this pertnii is issued. (Sec. 3097, Civil Code).
Lendefs Name: Lendefs Address:
Signeture:
OWNER-BUILDER DECLAfiATiONS:
Dete:
I here6y eHirtn thal under penalry of perjury that I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Busineu end Professions
Cotle: Any ciry or county wttich raquires e permit to construct, elter, improve, demdish, or repeir any swcture, pnor to its issuance, elso requires ihe epplicant for such pertnii
b file a signetl statement Ihet he or she Is licensed pursuent to the provisions oi the CoNrectors License Law (Chapter B(commencing with Sectlon 7000) ot Divislon 3 oi the
Business and Professions Code) or t�at he or she is exempt theretrom and the 6asis for ihe elleged exemption. Any violetion o1 Section 7031.5 by eny epplicant for a pertnit
subjecis the epplicant to e civil penelry of not more than five hundred dollers ($500).):
❑ I, as owner of ihe properry, or my employees with wages as Ueir sola compensation, WILL DO THE WORK, and t�e siructure Is not intentletl or oNered tor sale (Sec.
7044, Business and Professions Code: The Coniractors Llcense Law does not apDly to an owner of propeny who builds or improves thereon, end who does such work
himself ar herself or through his or har own employees, pravided that such impravements ere not intended or oHered lor sale. If, however, Ihe building or Improvement is
sold within one year ol completion, ihe owner-builder will heve the burden of proving ihet he or she did not build or improve for puryose of sele.). •
❑ I, es owner of the property, em EXCLUSIVELV CONTRACTING WI7H LICENSED CONTRACTORS to consiruct Ihe praject (Sec. 7044, eusiness and Professions
Code: T�e contractors Llcense Lew does not apply to en owner of property who bullds or Improves thereon, antl who contrecis tor such project wlth e contractor(s)
license pursuent to the Contrectors License lews.).
❑ I em exempt under sec. Business and Professions Code for this reason:
Signature: Data:
Owner ID venfied by drivefs license. ❑ Yes 0 No Drivefs License No. Explres:
Vedticatlon of Ownership by (type oi tlaument, i.e. - pmpeny tax blll or deed):
DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATON:
❑ I hereby certiy thet no excavetlon Ilve (5) or more teet In tlepih into which a person Is required to descend, wlll be mede in connection with work euthonzetl by thls
permit, antl ihat no building siructure, scaffoltling, lelsework, or demolition or dismantling thereof, will be more then Ihirry-six (36) teet high. (Chep. 32, Grp 2, Art 2, Sec.
341, Titla 8, Calitomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which woultl require e permit trom the Division ol Intlustnel Sefery, es noted above, unless such person hes e
permit to do such work trom the division.
Signature: Date:
Division oi Indusinal Satery Permit Number.
CERTIFlCATE OF COMPLIANCE AND AIJf}iORIZA710N OF ENTAY: I cenify under penalry of perjury that I �ave read this application and state that the intortnation given is
correct. I egree to comply with ell stele laws end city ordinances relating to building construction, end euthorize represenletives of Me Ciry of Costa Mesa to enter upon the
ebove-described property tor inspection purposes. I egree not lo occupy or allow occupancy ol eny building authorized by ihis permit until final inspection.
cooe �. n+srecnoNrrve'
1616 Fizetl System Final Fire Prevenlion
1266 Pool Spa Final
200 Finel Re-Roof
201 Flnal Block/Reteining Wall
202 Final Factory Fire Plece
203 Finel Sign
204 Final Demolition .
QAg 1[�9Li
eooe� iNsrecnoxrrve
206 Finel Mechanical
208 Final Plumbing
210 Final Electncal
212 Final Fire PrevenUon
� • 220 Final Plenning Approval
222
250
Final Site
Final Buildinq/Occupency .
PAIE
�. G.?"ILf!
1t�L$
(714) 754-5273 • Fax (774) 754-4856 • www.ci.costa-mesa.ELECTRICAL PERMIT �� FAIR DRIVE, COSTA MESA, CA 92626
�ob Address: 799 W 19TH S7
Suite No
Vicinity:
Parcel Nunmber: 42420101
Applicant: DIAZ, JOE
Address: 2627 S MAIN ST
SANTAANA,CA �"
Owner:
Address
i
THRIFTY�OIL,CO ; .
PO BOX 2128 � -' .
SANTA FE SPRINGS, CA
Status: ISSUED
Applied: 10/09/2003
Issued: 10/09/2003
ISSUED BY: �
Phone: 714-754-6440
Zip: 92707
Phone:
Zip: 90670-0138
Contractor. J C PALOMAR CONSTRUCTION INC
Address: 2627 S MAIN ST
SANTA ANA, CA
.
ISSUE FEE
Temp service test
Res. a/c package
New Res (7-2 units)
New Res (3+units)
Pool I Spa
Lighting Fixts
Recept OutleLs
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
Service over 1000a
Motors t0 1hp
MOtors to 10hp
Motors to SOhp
MOtorS to 700hp
Motors over 100hp
Communication drops
Phone: 714-754-6440
� Zip: 92707
License: 781040
SCOPE OF PERMIT
RELOCATE 400 AMP SEF�l�CE UNDERGROUND: ON-SITE WORK ONLY. NO OTHER WORK AUTHORIZED BY
THIS PERMIT. "ICRf 1
�'802- - bl l 1� C S n� � tZA�, � c(�' a--E-� �>
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
so.00
$0.00
$0.00�:
% $0.00
$0.00
$0.00
$62.15
$0.00
$0.00 "
$0.00
$0.00
$0.00
$0.00
$0.00
Quantity
0
0
0
0
0
0
0 ,
�. p .
0
1
0
0
0
0
0
0
0
FEE SUMMARY
Temp Dist System / lighting
Busway I100 ft
SWnding Seclion
� Misc Elechical Equipment
�� Transformers up to 1 kva/kw
................up to 10 kva/kw
.................uP to 50 kva/kw
.................up to 100 kva/kw
. . ..................over 100 kva/kw
" � Low VOIWge Equipment
Low Volt Wiring Syslem / Ckt
Misc. Conduit
Misa Conductor
Circus ( gen or ride)
Circus (mech nde or lights)
� Chrislmas Tree Stand
Fireworks Stand
� Other ElecVical Fee
Investigation Fee
Quantity
$0.00 0
$0.00 0
50.00 0
$0.00 0
50.00 0
so.00 0
50.00 0
so.00 0
30.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00
$0.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California 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 within 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 considered legal, such work must comply with all applicable codes, and all
required Inepeetiona end final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration oi this permit.
FOR INSPECTIONS CALL: (714) 7545626
2A46-66 (NW)
WORKERS'COMPENSATON DECLARAnON:
I �ereDy eNirm under penalry oi perjury one of ihe tollo g declarations:
�� I have entl will meintain e certificate oi consent to sell•Insure for workers' compensation, es provided tor by section 3700 01 ihe Labor Cotle, for the performence of the
wark or which this Dermit Is issued. ^
ve and will maintain w rkelr,' compep5ationi�SOtsnce, es requlrAP by section 3700 of the Labor Code, for Ihe pedortnance of ihe work lor which this permit Ig Issuetl.
My workers' compen i{ra e darri r entl Ool�6y number are
1
Cerrier: 1 t./� '---� J/r �. Pollcy Number:
(This sectlon need naf be completed i the peimif is velued et one hunOred dola�0) oi less.)
❑ I certity �het in Ihe peAormance of the work for which t�ls permit is issued, I shall not employ any person in any manner so as to becoma subject to Ihe workers'
compensalion lews ot Callfo 'a, entl egr e Ihet Ii should become sub�ect to Ihe workere' compensetion provisions of Saction 3700 ot the Labor Cotle, 1 shell fotlhwlth
comply wiM these Drovisio . �
' (l �
Applican� Signature: �� Date: .. %� r ���
WARNING: FAILURE TO SECURE WORI FS' COR1PEpl ATIqJ C IS UNUWFlIL PND SHALL SU6IELT M' EMPIOVER TO CRIMINAL PENALTIES AND NES UP TOONE MUNDRED
THOUSAND OOLURE (E100,000), IN FDDRION TO TNE WST OF COMP $ATION, DMMGESlS PROVIDED FOR IN SECTION �]OB OF THE LABOR OD�E, IMEREST, AND ATTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirtn that I am licensed under proNsions of Chapter 8(commencing with Section 7000) of Division 3 at the Busineu and Proleuions Code, and my license is in full
torce antl eNea. Lic. p Class»
Comrector's Signature: (r� ��— Oete: < <._ . _ J/\�
CONSTRUCTION LENDING AGENCY:
❑ I hereby eNirm thet ihere is a constmction lentling agency for the peAormance of ihe work tor which Mis permit Is issued. (Sec. 3097, Civil Cotle).
Lenders Name: Lendefs Address:
SlgnaNre:
Date:
OWNER-BUILDER OECLARA710NS:
I hereby eHirtn Ihat under penalry of peryury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, Business and Professlons
CoOe: Any ciry or county w�ic� reQuires a permi� to consiruct, elter, im0�ove, demWish, or repair any strucWre, prior to its issuance, also requires the epplicant tor such permit
ro lile e signetl statement that he or she Is Iicensatl pursuant lo the proWsions ol ihe Contractors License Lew (Chepter e(commendng with Sectlon 7000) ot Dlvision 3 oi the
Business end Professions Coda) or that he or she is exempt therefrom end the besis tor the alleged ezemption. My violation of Seaion 7031.5 by eny applicant for e permit
sublecis Ihe eDD���en� �o e civil penalry of not more than tive hundred dallers ($500).):
❑ I, as owner of t�e property, or my employees wlth wages es t�elr sole wmpensation, WILL DO TME WORK, end the structure is not intended or offered for sele (Sec.
7044, Busineu and Professions Code: The ContraMors License Law dces nm appty to en owner of property who builds or imprwes thereon, antl who does such work
himsell or herself or thraugh his ar her own employees, provided thet such improvemanis ara noI Iniendetl or oHeretl tor sale. II, however, ihe building ar improvemenl is
sold within one yea� of completion, ihe owner-builder will hava the burdan ot proving ihat he or she ditl not bulld or improve for purpose of sele.). �
❑ I, as owner of the pmpeM• am EXCLUSIVELV CONTRACTiNG WITH LICENSED LONTRAC70RS to wns�ruct the Orolect (Sec.1044, Business and Professions
Code: The coNrectors Licensa Ww does no� epply lo en owner ol property who builds or improves Ihereon, and who comracis far such project with e contrector(s)
license pursuent to the Contractors License Laws.).
❑ I am e.empt under sec. Business and Professions Code for this reason:
Signeture: Date:
Owner ID verllletl Dy tlrivefs license. ❑ Ves ❑ No DAver's License No.
Venflcation ol Ownership by (rype oi daumenL i.e. - pro0erry tez bill or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATION:
Expires:
� 1 hareby certiry thet no excavation five (5) or more feet In depth into which e person is requiretl to descentl, will De made in connection wiih work euthoAzetl by this
pertnit, end that no building strudure, swNoltling, falsework, or tlemolition or tlismantling thereot, will be more than thirty-six (36) teet high. (Chap. 32, Gry 2, Art 2, Sec.
341, Title 8, Celitomia Administrative Code).
❑ As owner-builder, I will not employ anyone to do work which would require e pertni� trom the Division ot Industrial Sefery, es noted above, unless such Derson hes e
pertnit to do such work irom the division.
Signeture: � � ' Date: �
Division of Industnel Safery Permil Number:
ICERTIFlCATE OF COMPLIANCE AND AUTHOHQATON OF ENTRV: I cenify untler penalry of perjury �hat I have reatl this epplica�ion and stata that Iha infortnetion given is I
carrecl I egree to wmpN with ell state laws end ciry artlinances relating to bullding construction, entl euthorize represematives of the Ciry ot Costa Mesa to entar upon t�e
ebove-descnbetl property for inspec�ion purposes. I egree not to occupy or ellow occupancy of any building authanzed by this pertnit until final inspection.
CODE t. INSPECTIONTYPE
1618 FIxeO System Final Fire Prevention
1266 Paol Spa Finel
200 Finel Re-Rooi
201 Fine181ocWRetaining Well
202 Finel Feciory Fira Place
203 Finel Sign
204 Final Demolition
PAIE INTITIRLS
� � � —l�e
ate
cooer ixsvecnoNrvre
206 Final Mechenical
208 Final Plumbinq
270 Final Eleclrical
212 Final Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupency
PA7i It�BL6
� rj�►
f,
(774) 754-5273
• Fax (774) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
ELECTRICAL PERMIT
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
799 W 19TH ST
42420101
Applicant: STULTZ, RICHARD
Address:
Owner: THRIFTY OIL CO
Address PO BOX 2128 ��
� � SANTA FE SPRINGS, CA
Phone: 81&722-0965 X102
Zip:
.' Phone:
Zip: 90670-0138
Convactor. _ TRC ALTON GEOSCIENCE INC
Address: 21 TECHNOLOGY DR
IRVINE, CA
Phone: 949-753-0101
Zip: 92618
License: 409606
ISSUED BY:
Status: ISSUED
Applietl: 10/24/2002
Issued: 11/OB/2002
SCOPE OF PERMIT
, ELECTRICAL TO INCLUDE: 1 OUTLET, 3 SWITCHES, 1 SERVICE TO 200A, 1 MOTOR TO 1 HP, t
.�� MOTOR TO 10 HP, 1 MOTOR TO 50 HP, 1 SUB PANEL TO 200A AND 1 TEMP POWER POLE.
' REF.: 802-0111 "THRIFTY OIL COMPANY" • , .
ISSUE FEE
Temp service test
Res. a/c package
New Res (1-2 units)
New Res.(3+unitsj �
Pool / Spa ' �
Lighting Fixls
Recept OutleLs �
Switches
Non Res Appl . '
Res Appl
Service to 200a ,
Service to 1000a � �
Service over t000a. �
Motors to 1hp
Motars to tOhp �
Motors to SOhp
Motors to t00hp
Motors over 100hp
Communication drops
Sub panel to 200a
Quantity -
$23.50
$0.00 '
$0.00
$0.00 0
$0.00 0
$0.00 � 0
$0.00 0
$1.10 1
��$3:30 � 3 -.,�
�$0.00 �i_.-.0,-'- .
.-� $0.00�� � 0 � ,
� ; ,$30.50 `_= � 1 �
�;�� $0:00 � -;�\0, � - .
. $0.00.; ��.�0 .:
. � $4.75 - 1 � -
,��.$12.30 � - ,1�.
`� $0.00 �. �'0-�� �
�� ao.00. ' o
50.00-' 0���: ',
$0.00 - 0
$30.50 � ��1". -
FEE SUMMARY
� � . Temp Dist System / Lighting
' Busway /100 k
Standing Sec6on
Misc Electrical Equipment
Transfortners up to 1 kva/kw
................up to 10 kva/kw
_ . � : .................up to 50 kva/kw
� � .............:...up to 100 kva/kw
' . ' ..................over 100 kva/kw
, Low Volfage Equipment � �
Low Volt Wiring System / Ckt
� � Misc.�Conduit .
.. � � Misc. Conductor
� Circus ( gen or nde) �
- Cirws (mech ride o� Iights)
- Chnstmas Tree Stand
Fireworks Stand �
' , ONer ElecViwl Fee � �
Quantiry
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
so.00 0
$0:00'
', Investigation Fee $0.00
Plan Check Fee $0.00
NOTICE: The work authorized by this permit shall comply with all applicable hantlicap access requiremenis under California 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 within 180 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 considered legal, such work must comply with all applicable codes, and all
required Inspectlons and tinal epproval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626 ,
2C6&48(8/00)
WOqKERS' COMPENSATION DECLARATION: � -
I hereby aNirtn under penalry ol perjury one of the following declaretions:
❑ I have and will maintain e cenificata of rnnsent to selt-Insura tor workers' compensation, es provltled Por by section 3700 01 ihe Lebor Code, tor the pertortnence at the
work for which Ihis permil is issuetl.
� I have entl will maintain workers' Compensation insurence, es requiretl by section 3700 of t�e Lehor Cotle, tor the pertormance of t�a work Por which this pertnit Is issued.
MyLL'Worke mpe InBurence carner antl/p�olicy number ere: ^ u �I' {Ay ?
Cerrier: ]�L������jJe.�L:�� `�'INTL�.%i PoliCyNumber: O�l �V �/ M FS"/ tJ�_
(This sectlon neetl ot be complete0l( tbe pelmit w va��et on undred dollers ($700) ar less.)
❑ I cenify thet in the performance of Iha work for which this permll is issuaq I shall not employ eny person in any manner so es to become subject to the workera'
wmpensetlon laws af Celllomla, end agr that'f I sJ}��ould �ecome sub�ecl ro the workers' wmpensation provisions o1 Sectlon 3700 0l the Lebor Cotle, I shell forihwlth
comply with ih��r io �� /] �� „ � /, . n � � /�C /� � O �
b /A�1M(
AppllcenlSignelure: _�� � �-r—•� ���� Date:
WFRNINO:FAILURETOSECUFEWO S'COMPENSA ON ERA�EISUNUWFlKANDSWILLSUBIECTANEMPLOVERTOCRIMINALPENALTIESANDCMLFlNESUPTOONEHUNDRED
TFKKISMlO DOILARE (5100.000), IN ADDIiION TO THE COST OF COMPENSATION, DAAMGES PS PROVIDED FOR IN SECTION 31060F THE UBOR WDE, IMEPEST, AND nTTORNEV'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby atlirm that I am li ensetl und r rovisions of C�apter 9(commencing with Sec�ion 7000) of Divl�slon 3 ot the 8u iness en ro sslons Cotle, end my li nse I in full
ro�ce e�a enaa. uo. x (�{-/�/�(% � ciess a�_��$ Gl� �IC+�
Comrector's SignaNre: `7t'-Y-"'� Dete: � �%.
e � u_yv�r
CONSTRUC710N LENDING AGENCV:
❑ I hereby attirm Ihat Ihere is e conslruction lending agency for ihe peAortnance oF ihe work for which ihis pertnit is issued. (Sec. 3097, Civil Cotle).
Lender's Neme: Lender's Atltlress:
SigneNre:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby aflirm ihat under penelty of per�ury ihat I em El(EMPT FROM THE CONTRACTORS LICENSE LAW for the tollowing reeson (Sec. 7031.5, Business flnd Professions
Code: Any city or counry which requires e permit to consWct alter, Impmve, demolish, or repair any strucWre, pnor lo its issuance, elso requires the applicant for such permlt
lo lile e slgnetl statement Ihet he or she is Ilcensed pursuant to ihe provisions o1 the Comrectors License Lew (Cheptar 9(commencing with Sectlon 7000) of Divislon 3 of t�e
Business and Profeuions Code) or that he or she is exempt therefrom and the basis tor the alleged azemptlon. Any violation of Sectlon 7031.5 Dy eny epplicent for e permtl
subjeds the epplicent to a civll penalry o� �a� more ihan live hundretl tlollers ($500).):
❑ I, es owner ol Ihe property, or iny employees with wages as their sole compensation, WILL DO THE WORK, and the structure Is not Intentle0 or ottered for sele (SeC.
7044, Business and Professions Cade: The Coniractors License Law tloes not apply to en owner of pmperry who builds or impmves ihereon, and who tloes such work
himselt or hersetl or Ihmugh his ar her own employees, pmvideU Ihat such improvemenis are not Intended or oHeretl for sale. It, however, Iha building or Improvemen� Is
soltl wiihin one year oi compleUon, the owner-builder will have Ihe burden of proving thei he or sha did not �uild or improve tor purpose ol sele.).
❑ I, es owner of Ihe property, am E%CLUSIVELV CONTflACTING WITH LICENSED CONTRACTORS to canstrucl lhe prol�� (Sec. 7044, Business end Profe55ion5
Cotle: The coNrectors Llcense Lew tloas no� apply to en owner at pmperty who bullds or Improves ihereon, antl who coniraas br such project wlih e conVector(s)
license pursuant to iha ContraG�ore Licanse Laws.).
❑ I em exempt under sec. Business end Professions Cotle for ihis reeson:
SlgnaNre: Date:
Owner ID veritietl by drivers Ilcense. ❑ Yes ❑ Na Drivers Licensa No.
Vedficetlon of Ownership by (rype ot document, i.e. - properry taa blll or deed�:
DIVISION OF INDUSTiiIAL SAFETV PERMR CERTIFICATON:
Expires:
0 I hereGy certify thal no excavelion tive (5) or more feet in depth into w�ich e person is required to descend, will be made in wnnection wit� work euthorized by thls
permit, and that no building structure, scaHolding, felsework, or tlemolitlon or Oismantling thareol, will be more than thirty-si: (36) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Title 8, Celifomla Adminisl�etive Cotle).
❑ As awner-builtler, I will not employ enyane ta do work which would require e permit fram t�e DlWsion of Intlustnal Sefery, es noted ebove, unless such person has e
permit to tlo such work from the division.
Signature: Date:
Division ot Industnal Safery Permlt Number:
CERTIFlCATE OF COMPLIANCE AND AIITHORIZA710N OF ENTRY: I cehify under penelry of perjury �he� I have read ihis epplication and sta�e �het the iniormatlon given Is
correct. I egree to wmply wllh ell sta�e lews and ciry ortlinances releting to builtling conslruction, and euthonza represantetives of Ihe Clty of Costa Mesa to en[er upon the
ebove-descnbed property tor inspection purpases. I agree nat to accupy or ellow accupancy of any building authorized by this parmil until finel inspectian.
COOE �. INSPECTONTYPE
1618 Fixetl System Finel Fire Pre�ention
1286 Pool Spe Final
200 Final Re-Roof
201 Final BIocWRetaining Well
202 Final Factory Fire Place
203 Final Sign
204 Final Demolition
� ��� vu�e
Date
QdjE Jy��$ GODEI INSPECTIONTYPE
� 206 Final Mechaniwl
208 Finel Plumbing
210 Final Eletldcal
212 Finel Fira Prevention
220 Final Planning ADP�oval
222 FInelSite
250 Final Builtling/Occupancy
PA7E II4IDEL5
(714) 754-5273 • Fax (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, GOSTA MESA, GA 92626
�ob Address: 799 W 19TH ST
Suite No
Vicinity: THRIFTYOIL
Parcel Nunmber: 42420101
Applicant: STULTZ, RICHARD
Address:
Owner: THRIFTY OIL CO
Address .. FO BOX 2128
�SANTA FE SPRINGS, CA
PLUMBING PERMIT
Contractor: ' TRC�ALTON GEOSCIENCE INC
Address: 21 TECHNOLOGY DR . :
Arch / Eng :
Address:
IRVINE, CA
Phone: 87 &722-0965 X102
Zip:.
Phone:
Zip: 90670-0138
Phone: 94&753-0101
Zip: 92618
LicenSe: 409606
Phone:
Zip:
License:
ISSUED BY:
SCOPE OF PERMIT
PLUMBING TO INCLUDE: 1 GAS SERVICE, 1 P-TRAP, 41 PROCESS PIPING (PER 10'), AND 1
SEWER CONNECTION.
REF.: 802-0111 "THRIFTY OIL COMPANY"
ISSUE FEE
BackOow irrigation
Backflow Prevenler
Bathtub
Clanfier System
Connect pce,Soda,ety.
DenWl Units
Dishwasher
Drain, Floor
Drain, Rainwater
D2in, Roof
Drinking Fountain
�.as sr..�vice
FEE SUMMARY.
AMT QTY , AMT
$23.50 � . Laundry �Tub / Washer ` $0.00
$0.00 ` � �0� ��� � '` t' Landscape IrrigaUon . $0.00
$0.00 ' 0�:>. ' P-Trap $9.80
' $0.00 , � 0 -� ����,� Pressure Regulator $0.00
$0.00 � - 0 � � Process Piping (per 10 ft) $401.80
,$0.00- - 0 ' '�-.Receptors $0.00
$0.00 0, , Septic Tank � � $0.00
$0.00 0 > � � � � , Sewer Cap for Demo � - $0.00
$0.00 �� -� 0 � �. � Sewer'Connect $24.65
$0.00 ' 0 �._ 'Sewer Private Line � $0.00
$0.00 � �0, = � Shower � ' $0.00
$0.00Q�, 0 �� - - � Sink, bar - ' $0.00
CJ • P,+ � � - - � _ , . -
QTY
0
0
1
U
41
0
0
0
1
0
0
0
Status: ISSUED
Applied: 10/24/2002
Issued: 11/OBI2002
SumpPump
'� � Swimming Pool
. Trap Primer ,
Urinal
' Vacuum Brkr BkFlow(t-4)
Vacuum Brkr Bkflow(5+)
Wash Basin
Wash Basin Set
� Waste and Vent System
Water Closet (Toilet)
- Water Heater / vent
Water Piping (Inst or Rep.)
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Qn
0
0
0
0
0
0
0
0
0
0
0
0
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
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 o1 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlona and final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiretion of ihis permit.
FOR INSPECTIONS CALL: (714) 7545626
2dd&46 (NW)
WORKERS'COMPENSATIONDECLAAAnON: � -
I �ereby aHirm under penalry of perjury ona of the following daclarations:
❑ I have and will maintain a certifice�e oi consent to setl-Insure br woBers' compensetion, es provitled for by sectlon 3700 of the Lebor Cotle, for t�e peAormence of ihe
work for which this pertnit is luued.
� 1 have entl wlll maintain workers' ca�pe�sa0on insurence, as required by sectlon 3700 of ihe LeDor Code, for Ne peAortnanca ot ihe work ior which this permil is lswed
M wo,rLkere1'�' —m. s�(ion Insurence cartif�an�d � �l�i numher are: 1I I (�,
Carriar:Y TL�tV'ITDV� 1:1QIA�iI�(p�, �MIUTA.(�/� Policy NumDer. �� �'V ��� l c.�_
(TAis section neetl o! be comp/ete0 i/ Ihe permit i va/u et one hunOred dWlers (5100) oi less.)
❑ I cenify ihat In ihe peAormance of Ihe work for which ihis parmit is issued, I shell not employ any person in eny menner so as to become sublect to �he workera'
compensetlon laws of Calitornle, P�d egree that if I should b come subject lo the workers' compensation provislons of Saction 3700 ot the Lebor Cotle, I shell forthwlth
comply with the p ov i 5 � I�I-`��� ��; (� / �������(f1 t �,,e"r L
ApplicaniSigneture: � �� f �� ���`���/""t" ' Date: I I—S—D%.
WARNING: FAILURE TO SECURE WO 5' ��P SATIqJ WVEMG �IS AW FUL AND $MALL SUBIECT AN EMPLOYER TO CRIMINAL PENALTIES AND GVII FlNES UP i0 ONE HUNDRED
THOUSMID OOLLARE (5100.000), IN AD O�'1 TO THE COST OF COMPENSATION, DAAUGES A$ PROVIDED FOR IN SECTIIXJ 3]OB OF THE UBOR CODE. INTEPEST, AND ATTORNEY'S FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aHirm ihat I am lic� sedrlun er � visions of Chapter 9(commencinp wlih Section 7000) of Di 'sion 3 oi I�e Business aFd1 P ofe,{� s�lons Cade nC my Ilcens s in ull
torce antl eHecL Lic. a '•� ��'� Class a g G�P 1�� Tf / G` � C, �� ���
Contrectors SigneNre: Date: ��S — �'
CONSTRUCTION LENDING AGENCV:
❑ I hereby aNirm that Ihere is e constmctlon lending egency for Ihe peAormanco of ihe work far which ihis permit is Issued. (Sec. 3097, Civil Coda).
Lendefs Name: _ .. Lendefs Address:
Signature: _
OWNER-BUILDER DECLARATIONS:
oace:
I hereby flNirm ihat under penalry of perjury Ihet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lor the following reason (Sec. 7031.5, BuSiness antl Professions
Cade�. Any ciry w counry which rec}uires a parmit lo constmct, alte�, improve, demdish, or repair any structure, pAor lo its issuance, also requires the applicam tor such parmit
to file a slgne0 statement that he or she �s Ilcensed pursuant to Ihe O�ahsions of Ihe Coniractors License Law (C�epter 9(commencing with SecUon 7000) of Dlvlsion 3 of the
Business entl Professions Code) or Ihe� he or she is eaempt therefrom antl iha besis tor the alleged azemption. Any violetian ot Sedion 7031.5 Dy any epplicant for a pertnit
subjects the applicant to a civil penelty a� �ot more ihan five hundred tlollars ($500)J:
❑ I, es ownar ol the property, or my Bmployees with wages as iheir sole compensetlon, WILL DO THE WORK, and the structure Is not Intentletl or offared for sale (Sec.
7004, Business end Professions Code: The Contractors License Law does not apply to en owner of property who builds or improves thereon, end who tloes such work
hlmself or herself or ihrough his or her own employees, provided thet such Improvements ere noi inlentled or oflered for sele. If, hawever, ihe buliding or Improvement is
soltl within one year of completion, Ihe owner-builder will heve the burden ol Droving that ha or she did not build or Improve tor purpose of sele.).
❑ I, as owner ot the property, em EXCLUSIVELV CONTRACTING WI7N LICENSED CONTRACTORS to wns�ruct ihe projact (Sec. 7044, Business entl Professions
Catle: The con(ractors License LeW tloes not epply to en owner ot property wfw builtls or improves thereon, entl who contracis lor such project wlth e cnntractor(s)
license pursuant to the Contrectors �cense laws.).
❑ I am eaempt under sac. Busineu antl Prolessions Code for �his reason:
SlgnaWra: Date:
Owner ID verllied by dnvefs license. ❑ �es ❑ No Drlvefs License No. Expires:
Verlficetlon of Ownership by (type of Cocument, I.e. - property ta�c bill or tleed):
DIVISION OF INDUSTRIAL SAFE7Y PkNM1T CERTIFICA710N:
❑ I hereby certify ihat no excavallon }��e (5) or more teet in depth into whicfi a person Is raquired to descend, will be mede in connedion wNh woAc eWhodzad by this
permit, end that no building structure, scatfolding, falsework, or demolitlon or dismantling t�ereof, will be more �hen ihirty-six (36) teet high. (Chep. 32, Ory 2, Art 2, Sec.
341, Title B, Califomie Atlminlstratl�e Coda).
❑ As owner-builder, I will not employ anyone to do work which would requlre e partnit tram the Division of Intlustriel Sefery, as notetl flbove, unless such person hes e
permit to tlo such work trom t�e divi5ion.
SignaWre: Date:
Division o1 Industrial Safery Permit Number:
CERi1FlCATE OF COMPLIANCE AND AU�MORVATON OF ENTRY: I certity under penalry of perjury that I have read this application enC state thet the informetion given Is
wrtect. I agree to comply with all state laws antl ciry ordinances relating to builtling consiruction, and aut�orize representatives ot ihe Ciry of Costa Mesa ta enter upon the
eDove-descnbed property for insDecGon purposes. I agree not lo occupy or ellow occupanty of any builtling authorized 6y this permit until finel inspection.
COOE�. INSPECTIONTYPE PdIE Ii�LS
1818 FIxeG System Final Fire Preventlon
1268 Pool Spa Final
200 Final Re-Roof
201 Final BIocWRetaining Wall
202 Final Factory Fire Place
203 Finel Sign
204 Finel Demolition
COOEt INSVECTIONTYPE
206 Finel Mec�anical
208 Finel Plumbing
210 Finel Electdcal
212 Flnel Fire Prevention
220 Final Planning Approval
222 Final Site
250 Final Building/Occupanry
� ��
�
, f
(714) 754-5273 • Fa�c (714) 754-4856 • www.ci.costa-mesa.ca.us
BUILDING PERMIT
Job Address: 799 W 19TH ST
Suite:
Vicinity: ARCO STATION
Parcel Number: 42420101
2oning:
Applicant: DIKICIOGLU, D1LEK TURUMTAY
Address:
Owner. THRIFTY OIL CO
Address PO BOX 2128
SANTA FE SPRINGS, CA
Contractor: PETCON TECHNOLOGIES INC
Address: 14118 S INGLEWOOD AV
HAWTHORNE,CA
Zip: 90250
Arch :
Address:
Phone: 310-679-9991
Zip:
Phone:
Zip: 90670-0138
Phone: 310-679-9991
License: 675998
Eng:
Address:
Phone:
// rAln unlvC, VVJIN mcJ/1, l.N a<oco
ISSUED BY:
Status: ISSUED
Applied: 12I30I2003
Issued: 01/21/2004
Phone:
, Zip: License: License:
SCOPE OF PERMIT
UNDERGROUND UPGRADE FILL SUMPS TO INCLUDE NEW EVR SYSTEMS AT THE FILL BOX AND REPLACE OVERFILL ALARM.
Plan Check: $72.31
Permit: $111.25
SMIP Res: $0.00
SMIp Com: $1.05
Other: $0.00
Inspection: $0.00
Total: $184.61
SETBACKS
MAIN STRUCTURE Front 0- 0 Rear 0. 0
ACCESSORY Front 0- D Rear 0- 0
PARKING Existin : 0 Required: 0
NOTES:
FEE SUMMARY
Calc Valuation:
Claim Valuation:
PLANNING 8 ZONING
Lefl 0- 0 Right 0- 0
Left 0- 0 Right 0• 0
Proposed: 0
$5,000.00
as,o0o.00
NOTICE: The work authorized by this permit shall comply with all applicabla handicap access requirements under Califomia statutes and related
regulatlons. (Drd. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void it work Is not commenced wl�hin 180 days, or If work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work euthorized under this permit to be considered legal, such work must comply with all applicable codes, and ali
requlred Inapectiona end finel approval must be obtainBd. Failure to obtain Inspections and tinal epproval will result in the expiratlon of this pertnit.
FOR INSPECTIONS CALL: (714) 754-5626
!yegyg Igipp�
WORNERS' COMPENSATION DECLARATION: � � �
I hereby ettirtn under penalry of perjury one ot the Ioliowing dedarations;
❑ I heve and will maintaln a ceNficate ot conseN to sell-�nsure far workers' compensetlon, es provided for by sedian 3700 oi Ue Lebar Cade, for Ihe pertortnflnce ot the
work for whlch this pertnit Is issueA.
,� I heva entl will melritain workere' compensaUon insuranca, es requiretl 6y seqlon 3700 of the Lebor Code, for tha perfortnance of Ihe work tor w�ich ihis pertnit Is issued.
My worke compa a�lon Insurence carrier entl Iicy number ere:
CaMer. ��7� ��M �MS��"n �n �7r�f9-��+� pollcyNumber. �uo b`35 q- Zooy
(Th/s section need not be comp/efe0 i/ fhe ermif /s va/ued et one huntlred tlWlers ($100) oNess.)
❑ I cenily thet in t�e DeAormance of Iha work for which this permit Is issued, I shell not employ any person in any menner so es to became subject to the workers'
compensetlon laws of Calllomia, and apree thet II I shoultl Decome sub�ecl ro Ihe warkers' compensation proNsions of Section 3700 ot the Lebor CoOe, I shall Iw1hwIN
comply with these provisio � I /� o"
Applicant Signelure: � Date: � ' 6 �
W ARNINd: FAILURE TO SECURE WORKERS' COMPENSATION CO �RAGE IS UNLAW FUL AND SW1LL SU6IECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FlNES UP TO IXJE HUNDRED
TFIOUSMIO DOl1ARE (E100,000), IN ADDRION TO THE WST OF C rAPEN$ATION, DAhMCaES AS PROVIDED FOR IN SECTION 3708OF THE IABOR WOE.IMEREST, AND FTTORNEI"S FEES.
LICENSED CONTRACTORS DECLAHATION:
I hereby aHirm that I em Ilcensed unde/ pyvL�i[
lorce end eflect. Lic. x� b�
Contraaors Signawre: -VS /i
CONSTRUCTION LENDING AGENCY:
e(wmmenGng with Section 7000) ot Division 3 oi the Business and Prolessions Code, entl my Ilcense Is in full
Class p A, C 10 . I-1 A Z }1-r�
� Dete: O� 1 b � Z.-.o�-
� I hereby aHirtn t�al t�ere is a constructlon lending agenq for �he pedormance ot the work tor which this permit Is Issued. (Sec. 3097, Civil Code).
Lendefs Name: LendeYs Atltlress:
Signeiure:
OWNER-BUILDER DECIARATIONS:
Date:
I hereby effirtn Ihat under penalry oi perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for Ihe Iollowing reason (Sec. 7031.5, Business entl Professlons
Code: Any city or counry which requires e permit to consiruct, elter, Improve, demolish, ar repair eny structure, prlor to Ifs Issuance, also redulres Ihe applicanl lar such permil
to lile e signed stetement Ihet he or she Is Iicensad pursuent lo the pmNsions oi the Cantrectors LJcense Lew (Chepter 9(commencing with Sectlon 7000) ol DMslon 3 oi the
Business and Professions Code) or that he or she is ezempt iherefrom en0 the Dasis for the elleped eaemptlon. Any vloletlon ot SecUon 7031.5 by any appllcant for e pertnit
sub�ects the applicant ta e civil penalry of not more than Five hundretl dollars (5500).):
❑ I, fls owner of the property, or my employees with wages es their sde compensaiion, WILL DO TME WORK, en0 the sWcture is not intentled or ofleretl for sflle (Sec.
�044, Busineu and Protessions Code: The Contractors license Lew Cces not flpply to an owner of properry who builds or improves thereon, and who does such work
himseN or herself or through his or her own employees, provided that such improvements ere not intendetl or oNeretl tor sale. If, however, ihe building or improvement is
soltl wit�in one year of wmpletioq Ihe ownar-builder will have the burden ot provinp ihat he or she did not build or impmve tor purpose o1 sale.). '
❑ I, as ownar of the properry. am E%CLUSIVELV CONTRACTING WI7H LICENSED CONTRACTOHS lo construct the project (Sec. 7044, Business antl Prolesslons
Cotle: The contrectors License law tloes not appty to an owner ot pmperry who bullds or improves ihereon, entl who coniracts for such project with a cantracror(s)
license pursuant to the Coniractors License LawsJ.
❑ I am exempt under sec. _
Signeture: �
Owner ID verifietl by Cnvefs license.
Verlticetlon of Ownership by (rype of
Business entl Proteuions Code br this reason:
Ves ❑ No
i.e. - properry tax bill or deetl):
DIVISION OF INDUSTRIAL SAFETY VERMR CERTFICATION:
Drivers License No.
Expires:
❑ I hereby cenily thet no excevatlon IWe (5) or more teet in depih into which a person is required to descend, wlll be made in connecilon wlih work auNoAzetl Dy this
pertnit, and that no building siruqure, scattolding, talsework, or demolition or tlismaniling Ihereof, will be more ihan thirty-six (36) feet �ig�. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Calitomia Adminisiretive Code).
❑ As owner-bulltler, I will not employ anyone to do work which would require e permll Irom the D'Msion of Industrial Selery, es notetl ebove, unless such person hes e
permit lo tlo such work from the division.
Signeture: Date:
Division of Industrial Selery Pertnit Number:
CERTIFICATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRV: I certity under penelty ot perjury ihai I have read thls flpplication end steta thet the intortnation glven is
cortect I agree Io comply with ell stete laws enO dry ordinances relatlng ta building wnstructlon, end emhodze represematives of t�e Clty ot Costa Mese to enter upon the
above-descnbetl D�oper�y lar inspection pury05es. I egree not to occupy or allow accupenty of eny building aulhorized by this permil until finel inspection.
COpE I, INSPECTIONTYPE PAIE II�ELS
i616 Fi:ed System Final Fire Preventlon
1288 Paol Spe Finel
200 Finel Re-Roof
201 Flnel BIxWRetelning Well
202 Final Feclory Fira Plete
203 Finel Sign
204 Finel Demollilon
COUE� INSVECTIONTYPE
208 Finel Mechenical
20B Finel Plumbinp
210 Finel Elecirical
212 Flnel Flre Preven�ion
220
222
250
Finel Planning Approval
Finel Slte
Finel Builtling/Occupenq
�3�ib%o�- .
Da e
PdiE II�LS
v
4
AUDPESSOFBUIIWq: 799 W 19TH ST '
OYMER8NA11EIFIQlOWN: THRIFTY OIL CO
�ss:10000 LAICEWOOD HLVD
DOWNEY,CA 90240
�vc�. Yuura �oo�
uwxrtccr ox ��nn:
�xcx an u+a�s �no�s:
uc w:
CONIX1CTpf8 W11�:
LONf111CTOR4YYlII10
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UNT:
urar:
uxt:
UCENSEU COMF�C70N4 DECIAN�TION: l lweby a11im �ader prmly tl prjey Net I em licaneed uider paidme d CAaqx 9
(mmmanen0 xnh 6eciion 1000) d Oivuun 3 d tlr � ad PNw'vu COAs. eM mY 6mss u'vn hID bma eM aflW.
CRY 11C. NO.: IJQ QA54: UC. NO.:
ome: camwa:
OWNEN BUILOEN DECIAN�TiON: I hsab� dfi�m uMx psWy tl perjey tlw I em eremq han IM Cartraqon L.i'�ne lew lor tln
IaWw+q �wm (Seaion 1W13 &vnes� md Rolmtioro Cab: Mf' dY a mWY Wid� npvs� e D�a to muWd. eCer.'vnY�.
Mmd'eh, a repei em/ et�uctwe: p'n b n u�uence, abo �ep�urr tM eppl'vaa Im wrli pemW lo fib a eqmE slelemanl tlW he a cM
m r�,,.d w� �o ��» w�� d m. com�,m. uw�. t... wtia� s coo�+m�o .an s«.o� �000� d aw� s a n+
eus'vrae end vrdwiom coeel «�mm �s a dn u a.emp �nerarmm .na ins me �« ur •Aeped e�anwc�. �nr vidmon a seeia,
]W 1.5 by my eppNranl la a panN vd�w �M eppfcW to e a.i ps�eQy af mi mas then fxe MaWed EaCue �S.AOD.
❑ �..soxmW�n.ww.nr«nn.nwur...••nw*Ye+.��n.:w.mmwmetim..aaum.xak..nani..wm,num�imeMee
«MereE br eeb (Sectian 10u. B�ruend PNwams Gode: TAa Caqreaa+l'odus lewEom nd eGW to en ox+rord pw�Y
,.ro nuiC. «inn�+. �nw.u,. w.ro eoe..w,.cn� limsen «n.w «tlraph h'e w ns c..o «npb�w. a� �nel .ucn
impw«neMs ve nd ieueided a aflead la eeb. tl, Mrever. Na dukinp or inpowenoN o sotl xilhm ms yaer d mmpbtion, Ns
v ow�nr-0u�der xa Mro IM WNen d pwinp M a eM dd nd ddd a'vnpv.a la tM p�vpaea d aebl.
`�J I.aowirrdiMV�WdH.emm'iim�dYmmmeiqwNlcnnodamtracbnbmWi�dUrV4blSwion]W4.&minmsaM
Prdaubns Code: The COMreem liwius Lew Eom no1 ropY ro an w�wr d pwMY x1a buitls a imG�'a �Iw�eon eM wlw
wMracb M aM� p9�e wvh e mNretlaU) fiwusA P�umtl to tM Cau'etla� Liwme Laul.
� 1 em exanp ,^�`/ B. 8 P.C.. far nunon: //'�"/��}��/ /�1 L
Dets: / �U�/ � Onir. � �[ /2%i t /.G✓LGCY ' ��l/
i eo n.eer �N um i.m ..,a.. a.oa „�w..u�e m. nm�.m a cw�. �.en.m s.iw cod. s.ao�. zssaa. �a
Y55J1. arW tIW I a ury Mun bultliiq mvpant xill / wil �(�b one) � m canply wY� wJ pela oodee uM iM raqulromante M
e D�� taooruUuctbnn maEifimtianhan iMAi3iuTly I%nepanwM Diqild. RmidNisl amv�uaion WP�'vn en eumP� Imm Ihms
ywi.lon..
Deta: MV�cuu:
WORKEP'S COYVENS�TION DECUR�TION: 1 MrWy W'vm uMr pautly W paWy ar al tlr bYov.inp AxLrat've:
� I heva eM W meimen e carllicW M m�wni to �ap�nM W wkai mmpeemlbn, m provNW ta by &edion 3100 M IM LeCa
coe.. �« m. w��. a m..aw i> �.i:a, w. w�a a a.�,ed.
❑ i n..�..�e w m.mi.:�.w�w.• mma�� �..+m�+b.a W sw:., aroo a m. �.eor coe.. ro� m. o«iornw�ae a in.
wak fa xiiM IM D�� h fuiwC. MY wakm' cwnDn+dbn mwrenn mrriar W Ddk�' nwnCx us:
c.�w:
Po4y Numbr.
(Ttia eed'pn �aM rol M carV�Md / NSV/��I u b aro IwNd dJtlert �=100)Or 4q.)
� I omlN � in N� pMamenca al �M wak 1« xAkA thb perme b ImwE. I tlu0 m� mipb� erty psmn n ury menna m n io
e.�«�. aei� �o �n. �n«.• �v.�� r». d CeNmie. W eW� YW i I�hadd bmmr nbpa �o �n. »m�.�
oomw�+m� awmu�. d swon a�oo a in. �.bo. cod.. i.n.o ronnwn eomoN wn un.. pwmo�o.
W�rn/n0: FWun ro wcu� wilevi eoniM�tlon covp�P Is uWwfW, uW �Atll WC/�cl �n �rrV�� roWMmlV�tlu uN
c�M� nnu w ro om n�.ro.w moww euawn ltiatamA a��n ro m. co.� or co�«u•uon �w� u povmw ror m
s�ctlon ]]OB erlM l�6or Cotlr. INrpc ��m1Y'• rws.
LONSTPUCTON LENqNO �OEHCY: I Ir�Wy mNm udv prutly d pajuy Ntl �Mn n a conqMian bM'vq epsy.y br IM
pmfarmencs d IM wrk M whiN �h's W�mi u'sasE (Sepian ]OB1. Cv. C�.
IENDEN'S NMIE
LOlOER'S MOPE59:
i unar �nm i nma n.e mo.cvrwcn.,a.m. mr m. mor.:,tamacn e omw. i.a.. m canMr•en eo ar.oa m.+r �av�e�cw
vd nnte lawe �Nmeq m bwk^G muo-ueion vd hrW eWnres npupuetn+� d Nu �YY b oNs uv� tM ebove�membrd popeny
�°`"'°"'�"�"'D'"'SUSAN CABRAL
///J� ^^ Pm/ay���rtr`H/� ���h �
LLf.ilG/�% 1 //PJLL.I��fLJGSe/(/ Dtls:
sq�wreao«wi w �u«
(5t51-48.WP) WAns&nldnO85e1My.0�w�-Fb:GuivY-�VP�M:Pink-Mwnw:[iddri�o�Namw
PERMIT NO: SB 086613
CONSTRUCTION TYPE:
CITY OF COSTA MESA - SIGN PERMIT
PLAN CHECK NO: U0208-98 S
PERMIT TYPE; STR SIG
5 Q -D l
PERM NO: SB 086613
GOVT: N SUPP: N
PURPOSE: OTH
JOS DESCRIPTION : REPLACE 2 ILLUMINATED LOGO SIGNS SQ FT:
CLAIM VALUE: 1,000.00 CALC-VALUE: 1,000.00 GROUP OCC: B /
COMMENTS: REPLACE ZLLUMINATED LOGO SIGNS
iE iF if iF±F iE iF iF iE iF aF fF iE iE �F if iF aF if K if iF iE 1f iF iF iE 1E �f if iE IF 3E iF iE iR if iE 1E �f aE 1E iF ik if ik iF if 1f if'1F K iF iE iE iE iE iF 1E 1F if 1E iE iF iE iE iF if if iE iF if iF 3F 1k i(' iE ik 3k
S I G N I N F O R M A T I O N
DISTRICT: 1 TYPE: ILLUMINATED LOGOS ILLUMINATION: INT CATEGORY: NEW
DIMENSIONS: 1FT 08IN X 1FT OSZN AREA; 5.605QFT LETTER HT: 12 INCH
STREET FRONTAGE 1: 130.00 STREET i: 19TH STREET
STREET FRONTAGE 2: 110.00 STREET 2: PLACENTIA
PARCEL: 42420101 20NE: C1 LOCATION > FRONT: X REAR:
BUSINESS NAME: ARCO > LEFT: RIGHT:
O T H E A T O T A L S G R O U N D S I G N
THIS ACTIVITY . 5,60SQFT OVERALL HEIGHT: OFT OIN
THIS SITE . 185.00SQFT GROUND CLEARANCE: OFT OIN
ITEMS OF INFO 1 PLANTER AREA: O.00SQFT
ITEMS FOR ACTIVITY: 1 BLDG SET BAC](: 20FT
COPY VERHIAGE : LOGO
PLANNING NOTES: '
if i!!E 1E 1E 1E iE iE iE k!! iE ik jE 1E if k fE 1E Ik if iE iE 1E 1F'1F if 1f !E 1Elf 1f if 1f iE iE if iE 1E �k ik iE'k iklk ik ik iE fE �E 3f iElE if iE ik iF iE iE �E IE iE ik if ik iE 1E iF iF'N� %ih iF iE ik iE 1F �f �f
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY �� DATE; I II�t�`Ld
BUILDING APPROVED BY : DATE: "
APPLICATION ISSUED BY: DATE; � (� �l
1kiE'1F'k'IbiElEi6iEiflfifikiEififiFi4iEiFiE1E ifikiFiEiE1Eil3Fik1E iPiF
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING
PERMIT 34.75
SMIP/NON-RES
PLAN 22.59 .50
ISSUE FEE
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 35.25 0.00 22.59 57 84 57 84 00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMBING ELECTRIC MECHANIC
34.75
57.84 OVER/SHORT: .00
SIGN SMIP/TOT GRADING PLAN-CHECK
.SO 22.59
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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
NO FEES WERE SELECTED FOR THIS PERMIT
_'�� ;. ? , � � ; �
;`
' ; _ . ,
81-16-1998/&i:81 PIVf57.8�
RCDTB:81-88182%
PERMIT:986613
�--
CQNSTRUC710N AND PLANNING POO� e SPA
APPROVALS Permit # Date Inspector pppROVALS Permit # Date Vnspector
1, Temporary Electrical Service or Pole 52. Pool & Equipment Location
2, Soil Pipe-Undrgrnd. � " 53. S[eel Rei�forcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. $tee� Reinfarcement 56. RoUgh Plum6ing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7'. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgr�d., Test
9. Water Pipe�Undrgrnd. 60. Batkwash l.ines, P-Trap, O Undrgrnd.
70. $tructural.F�oor System 61. APPROVAL TO DECK
11. property Sewer Line & House Connection ��, gatkwash & Receptor-Final
12. 5ewer Cap 63. Heater & Vent�Final
13. Foof Orains 64. Plumbing Systom - Final
14. fiough Plumbing 65. Eiectrical-Final
15. Fough Electricai-Conduic 66. Solar System-Final
16. Rough Elearic Wiring 67. Fencing & Access ApProval '
77. Rough Wiring.Sign , � 68. APPROVED FOR PLASTERING
18. Rough-Electrical-T Bar Ceiling -" 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning ._. �� FIRE DEPT. REQUlREMENT
20. Rough Factory Fireplace -� ' � APPROVALS , Permit #
21, Ducts, in Structure. ,� , 70. Underground Hydro
22. Ducts, Ventif2ting' � i �� � � 71.,product Piping OGas OOiI
23. �Gas Pipe-Rough & Test . " . _. 7p, Underground Flush
24. poof Framing ' ' . 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Foof. Sheathing , . , .. � � . 74. Overhead Hydro � �
26. ?-Ba. Ceiling (Structuraq & Monocoat • ' 75. Ory Chemical � p
27. Frame and Flashing 76. � Dry Standpipe �,°j
28. Lathing & Siding ' . � 77. FIXED SYSTEM FINAL� - j
29. Insulation � 78. FIFE PREV. FINAL '
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION - i
32. Electrica� Power Meter-Fioai 80. FOOD CERTIFICATE ISSUED '-
33. Pinal Electric ' � Notes: , '
34. Final Heating�& Ajr Conditioning �
35. Fnal Gas Pipe-Test '
36. Nood or Canopy ' �
37. Final Factory Fireplace , . ,
38. Fina� Plumbing � � � �
39. Water Service-Finai � , ,
. 40. Gas Service-Finai . �
41. Solar pomestic•Final .
42. Backflow Preventer �
43. Backflow Irrigation
44, �andscape Irrigacion System ' �
45. Sound Attenuation .. ' o ?�
46. Handicap Regulations � � �
47. HNAL STRUCTURE & BUILDING l�„j �� ��,., °-'- '
L�, �.
�
48. FINAL PLANNING • �= �+�
:� ,
49. Electric Release to Edison ' � . „^, ��
50. Gas Release to Southern Califotnia Gas Co ��� F�
51. CERTIFICATEOFOCCUPANCY
No. Da�e
/I
}
�
�oonEss a emima: 7 g g W 19 TH S T
owr+�rsru�EiF�rr�: THRIFTY OIL CO
�o� 10000 LAKEWOOD BLVD
DOWNEY,CA 90240
APPL. IWIWfi IDDPESA
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CONfPACTqf6 WIIE:
COff11�CTORSYAM1➢q
1WRE49:
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IJCENSED COMP�CTORS DECLAfl�l10N: I M�eby eRrm iuder pmaly d pajury Nm I em 4caneE under prwuima d Cluqa 9
(aommenmq wE� Seclian )OW) d Oweion ] d Ne &�was and Pmlasdma Coda. ud mY 4anm u in IW lan end ellatl.
cm uc. no.: uc. cuss: uc. No.: EX P;
ome: comree«:
OW NEN BUILDEN DECIAN�TION: I M�eby elfi�m untler pruly d prjwy �hat I em ecamq hom IM Cmtroem Liwme Law la rtw
�jllpwiq �anm (SMion ]W I.5 Buaros� vM PMw'vu Code: MY vY n mun7 w1uN iW��� e VwmG lo mubucl. eEb. "unYda.
demdeh. a ropei eiry N�udiva: pv b 1s'swenoe. eho npidm iM epplimM tar wch peniw to fib a aqnaE MtenrM Nel M a ehe
o �::en.w wmiw m ine nw�au w d» comma«a licenu taw IcheN« 9(mmmendro .un s.aon �aaa) w oivuion a a ��r
Buaineee eM Prdmu�s COEeI a ihel he u ehe u exemp ihaahan vM �he baaa la tM NbpeC exempion. My videtion d Swion
lW 1.5 by enY aGV�^^t Iw e permi wbpua IM applicem to e wY per�elly d nd mae ihen fxe huMred dollen �55WI).
� 1. ea oxner d Ihe vropaM or my empbyem wih wepea ee thei vob oompenaetion. will Eo IM1e MOA, and tM etru.lun w M imenAaJ
or Mered br veb (Soclbn ]016. Bueimn erd Prdmeione Code: Tlie Conlrapan Licenas lew doee mt epplyto en ownerd pmpe�ly
wM10 WdEe a Mnpovn Ihereon, and who Ems euch xwk himmtl a heneC or Ihrapl� hb a hm awn employeea, pwided �hm wch
imqwemenM ve �M Imended a dleieE lor eab. H, howwar, lhe buiNieq a inpovemeM u eald wilhin me yeer d complMun, the
�owrer-0uiNw xill Mw IM burdan M prwiiq M a ehe NE �wl buik or impova lor iM qiryose d ada).
I. ea mme� M IM pWaH. am udimvey mnlrepiq x�lh liomasd conVaclan ro cmffiW �ha pol� (5etlion ]OM. Bwiross vd
Pralmbns Code: TM CaNretlm Liceve law Aoea iM apply b an owmr d papr�y wfio buiks ar "unpwm �lieison and wM
coMrecb la aiN prqeda wuh e conlredm(e) leen�ed Wnuw to IM CaNratlore Lioenae Lew).
� I em memq/ )uMer $/eC�tion: B. d P.C.. la reevan: //�� d
One: l//� � I`i 8 Ownx: e 1�%�i-� l Gl/n - •a� S�
� do hnreby cerlEy tlW I em ewms d vd unCenbM Ihe m�uimnam d Cdlwnie HeMh eM Seiety Code Sed' S. Y5533, eM
255�a. vk thet I a enY Mwa dukAO �W^^�. will / wil �wl (wcb ons) need b comWY wih seiE mte oodm enE IM npuinmaMs b
a pxmu lawawnion or mo4ifr�ionM1an IMAr3wFy .l�enepemra Oatriia. Reatlmtol mmtMian appimtiwneressemq hdn Neu
„«roms.
Dete: �ON��
WOPKEfl'S COMPEN9ATION OECLANITION: I Mraby etfimi undar pe�ully d pajuy ane d iM Idbwi�p dedumidn:
� I heve eM xil mmMen a<Mi�iceta d omwit lo oMimuia lur wkas' wnWereetion. m proMed la by Setlion J)00 d �M lebor
Code. irc tM pMortneza d Ns wM1 la wlich thu prmu u 6eued.
I❑ 1 heva eM xil me'vXew r.v�M�e' mmD��un 4uueuo. m nW'ved M SW'v� 3)UO d tln lebor CaEe. For IM GMa�� d IM
wak la wfiidi Mu G�n u iwued. MY war4sn' wmPe�ion nwrence mrt'w end W4Y rvvnber are:
c.m«
Pol'ry Numbr.
(T�IY SBffN» nled MI bI CYMnC�� IIMCM�1l! b MO hYld/OE Od/BI9 �1W� p IXD.)
� I arlh Nm M Ne O�ameew.< d IM work lar xfikh �Itia M�G b iwleJ. I Mutl ml mWm/ anY Pd� in +M Tmmr p tl t0
pxane subpa to iM Mohas' mmpaiWion lar.* al CefAamu, vM xp�ae Ntl A I NwM bacome mbpq �o tM MMen'
canpa�uelion pwie'va d SWcn 3�U0 d iM LeEor COEe. I NeY taNwLLh mmp�y Mdh thma p�oris'vu.
om.: Mvr�um:
W�mlip: FNun ro Ncw woAw�'ronpr�utlon eovrp� Is un4vNl. �M �1WI WtlJcI �n wnolonr ro alrNml qn�ltls uM
dv�� nira �p ro on. nuWrM tlrouub tlMl�n (sttqP00A b�d^n ro tla mr ol rompwu�tan �/+ P+o��� ror In
s«non 9ros or rn. twso. coa, �nr.n,e..ne.rco.my�, r....
CONSTFUCAON LENOINO ROENCY: I Miaby alfirm uMm pendry d psj�ry tha �Mn u e m�meuqion bMiip epency M iM
perlormeMe W IM wark ia wAidi �hu W^^i n uweE (6adion 308). CM. CI.
LENDER'4 NAME:
LENUEP'S �DOflESS:
1 conity Ihm I hr+e �aed thh epqcqon uq aW iMl Ne eEo�'e iMwmetiu� u canad.l qpm lo canply wil� all ay erd mumy aE'vwwu
vM B�! IBWe AIO�M �O driW�ly CIXWYtlIpI Gnd M!!�' BNhMR� �lWCMnIMNtl d �hp P11' b MNlf uD� IMlbOVG.TM1�UnOd pOpMY
�°`�°�0a`0onp°P"" SUSAN CABRAL
��7/� yP�nm /Nq���y��./
l �.U/l,lf/ l liC.I/C�0 Dme: ��
sioneNrc a o.m�romv�GnYra+ucaNretl«
(S15tde.WP) Whils-Bwldip d Sdary; OreemFk; Canery-AppF:eni; Fnk-Revenue; (3oldemo�Nxev
� _ .�o
CZTY OF COSTA MESA — BUILDING PERMIT
PERM NO: E 086614
PERMIT NO: E 086619 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
JOB DESCRIPTION : REPLACE 2 ILLUMINATED LOGO SZGNS SQ FT:
CLAZM VALUE: CALC—VALUE: GROUP OCC: B /
COMMENTS: REPLACE ILLUMINATED LOGO SIGNS, RE:SH86613
1F')E iE iE'lF iF if �f iF IE iF 1f if iE iE aE jE iE fE 3f 1f ik'1E iE if if ik 1E if iF �E iE iE iE if �E 1E �E �E 1E iE iE ik i{'M-iF iE iE if if iF fE i(� ik i! iF if iE �E iE if iE'IE �E 3E �1f-�iF ik if 1E iE 1E if ik 3E jf iE iF
Z O N I N G R E Q U Z R E M E N T S
S E T B A C IC S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE • PROV: PARCEL: 42420101 2NE: REF NO:
PLANNING N TES>
%
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D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: U« l�
1F iF i! iE * iE it ik 1k iF iF ik if i(� if� 1E if i! 1E �E i! iE iE �f ib 3E !E iF iE iE 3E �E��'�iF af
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 49,00
SOt SMIP/NON—RES
PLAN
ISSUE FEE 22,00
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 99.00 22.00 0.00 66.00 66.00 .00
REVENUE DZVISION TOTALS--> COLLECTED: 66.00 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
66.00
iE iE if �f iF �1E �k 1E ik iF 1f �F k iE �F k iE 1E iE �E �)F iF aF iklE iE iE �k 1E �E fE if iE 1E 1E ff 7ElF if iE iE �E it 1E iE i!!E if if j! iE �1f if iF iE 3E ik if iE�iE 1E 3E iE 1E ik �E if if ik iE iF 1f iE iF iE if it 1E iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNZT COST TOTAL COST
ELE 2 SIGN/ OUTLINE LIGHT SYS ON 1 HR CIRC 22.00 44.00
END OF FEES
ti � i��i
L+�I �� I
D�_
81-16-1998/83:58 PM/f66.88
RCDTt:81-6818298
PERNIT: f�86614
0
CONSTRUCTION ANO PLANNING POU� & SPA
APPROVALS Permit #� Date Inspector AppROVAI.S- Permit # Date Inspector
_ �. Temporary Electrical Service or Pole 52. Pool & Equipme�t Location
2. Soi� Fipe-Undrgrnd. 53. Stee� Reinforcement .
3. Electrical Conduit Utility-Undrgrnd. - 54. Forms
'�4. Electrical Conduit-Undrgrnd. ' S5. Electrical Bonding -
5. Steel Reinfarcement 56. Rough Plumbing & Pressure Test
6. Electriwl UFER Gmd. 57. APPROVAI TO COVER�GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation . 1 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor Svstem 61. APPROVAL TO DECK
i 1 t. Property Sewer Line & House Connection - 62. Backwash & Receptor-Finai
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System � Final
14, Rough Plum6ing � � � 65. Electrical-Final '
15, Rough Electrical-Conduit 66. Sofar SYstem-Finaf
16. Rough Electric Wiring 67. Fencing & Access Approvai ,
1), 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, Rou9h Factory' Fi�eplace "' 7' . APPR�OVALS � Permit #
21, Ducte, in Structure� � � . 70. Undergrourtd Hydro
22, Ducts, Ventilating •' � � '� 71. Product Piping D Gas � Oil
23. Gas Pipe-Rough & Test . � � � 7p, Underground Flush
24, Roof Framing , '_ � - 73.' Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof SheSthing . - . 74. Overhead Hydro . �
26. T-BarCeiling (Structural) & Monocoat ' . ' 75. Dry Chemical _ . � '
27. Frame and Flashing , . 76. Dry Standpipe
28. Laihing & Siding � � � 77. FIXED 5YSTEM �INAL
29. Insulation ' . . 78: FIRE PREV. FINAL �
30. Drywall Nailing � • HEALTH DEPT. REQUIREMENT
31. Plasie� Brown Coat � . 79. FINAL fNSPECTION
32. Elearical Power MeterFinal �80. FOOD CERTIFICATE ISSUED
33. Finai Electric . - '� , �: . , Notes: �
34. F.inal Heating & Air Conditioning . (�j
35. Final Gas Pipe�Test' �, . , ' �,y'
36. Hood or Canopy - • . � - " �� - I
37. Pinal Factory Fireplace . - ' � �.;
� 38. Finat Ptumbing ' ' 1
39. Water Service-Final' � _ _ �
40. Gas Service-Fina� � �
41. Solar pomesticFinal . - -
42. Backflow Preventer � � � •
43. Backflow Irrigation � � � � �
44. Landscape Irr,igation System , . .
45. Sound Attenuation , ' � ' F'
� �
46. Handicap Regulations - i,' �
r
47, FINALSTRUCTURE&BUI��ING ' ' � � „x°�
rnry..
48. FINALPLANNING . �G�.y�
49. Electric Release to Edison �'� ��
50. Gas Release to Southern Calitornia Gas Co Ts, '�
51. CERTIFICATE OF OCCUPANCY "" �
No Date
/"r`
�I
0
1DDPE54OF BNLWq:
qMFRBIULE IF pqWN:
�oo�n
�vr�. � rmart�ss:
W 19TH ST
Y OIL CO
LCK�EWOOD BLVD 90240
wre
urcxrcc�onu+omern:TAIT ASSOCIATES �� C17342
,wcw.on�++a�swo�a: 1100 TOWN 6 COUNTRY RD uNr; 1200
ORANGE CA 92686
rnan�crarax�:
CQRFACTORB MY19Yi
� �pppEgq 11C NO.:
I ' uMt:
LICENSEO COMfP�CTON4 DECL�N�TION: I Iw�eby elrrm �kv pwWy d pajuy tlW 1 mn Ii�nwA unEs pro�ri�ipu d Cheqw 9
(canmacnY wiM Sec(v� ](p0) af fMon 3 d tla Buaw W Pmfadoeu Ca4. erd rm' Gcmw b M IW bro mN oRact.
cm uc. no.: uc. cuss: uc. wo.: EXP ;
OWNEp B111LOEN DECIAPATON: I Asaby tlNm uMx prWy d pmjiey Ihe� 1 em awnpl M1qn IM Can'eeas liaenea lnw la tlr
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a allretl br ub (Se4ion ]OM. B�eu eM PmloriwCode: TM CadrWm licmua Low Oou m� WDN�o an ownerd VbOeM
who buitle ar inV�� tMroon. vd xfa doee auCi wak hhnM n MnN a rt+aph he a ha own r^M�r*M. Va'� Ihel ach
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" ownerbu� wi0 heve Ne WNm M pw'vq M w ehe ditl nd ddd a imPa+tar the MDae d�elel.
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.oeimnlmm�etnictianaM1qd�ifiwi0nhanlMAi�Y ��4Aiiq.RMidNWOwWMionaVDKmiomane�MnqlmmNeN
oma: �+
W ORKFP'S C04PE114ATIX1 DK'WI�TIOM: I lr�hry elfnn utlr prutly af p�ej�vy ar d tlp btlow'aq doduelus:
❑ IMaudriimein�euecsofcwd�aue�vroWFmw�ebwken•mnpa�tbn.oP'a�dbrbY9�eian9)aOatMLebor
eae.. �« in. c+n«menc. d m..An �a M:N, me o«me's A,uee.
p in.».�ew�m.w.:��n�.•�v.�+:+,�,.�+�...+�.m+�ews.�,�a�mam.�.eo,ua.n.m.o«i«�.am.
wak ru nhid� mu a«me u b.wi. Yr.ntr.' oanw�.�im imrw.cs urrix erd w�v rolmbe. u.:
c.�:,:
Policy NumEr:
(fiia swlion neeJ mtW canWaroC / NsW�! e b aa huiCrW Ctl4n �Sl WI d Isn.l
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perpne wE�ed to IM xo'Im�s' mm9rmaion �e'n d Cefdamis, aM pns Ntl Y 1�houW Exaro wb�ec to tM MwMis'
<pnpeva(ion qwiabm d 9aeian a1oD tl tM lebor CoEe. i dull IMnxnh aompFy xitl+ Now pmvima.
oms: �ow�
W�mNq: FWun lo �K,u+wo�kM conq�udon wv�rp� b unlwqd. �nC NWI �u6hc� �n �rrplqw ro alMn�l p�n�ltlu �ne
dvrc rtna w ro am nure'.e rnouwr aww. f7rOGIanA a tllldm m m. nw awim«�oxiwt �++rod n PTrm.a /or �n
S�etlon ]7f1A el M l�Do� Cob. IN�n+t md �tbrrN✓� hn.
CONSTHUCTION IENDIN� A6ENGY: I Irrab/ dG�m ivMr pwupy d psj,ry �Mt tMn's e m�wiueqn biWip yhrcy M Iha
prlpmwa d �M rM la wtitl� tha pami e uarE (3equn �l. C'x, CI.
LEllDEfl'S NAME
LENUEq'S AODNE54:
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CITY OF COSTA MESA - BUILDING PERMIT
�PERM NO: B 086662
P$RMIT NO; H 086662 PLAN CHECK NO: 00236-98 S GOVT; N SUPP; N
CONSTRUCTION TYPE: � PERMIT TYPE: STR PURPOSE: OTH
JOB DESCRIPTION : REALACE EXISTING FACIA W/NEW AT CANOPY SQ FT: 8,000
CLAIM VALUE: 8,000.00 CALC-VALUE: 8,000.00 GROUP OCC: B /
COMMENTS: REPLACE FACIA AT CAiVOPY
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Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42920101 ZNE; C1 REF NO;
PLANNING NOTES> REPLACE EXISTING FASCIA WZTH NEW FASCIA ON EXISTING CANOPY
%
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D E V E L O P M E N T 5 E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY `'ZT�'- DATE:
BUILDING APPROVED BY : ���-aI� bATE: ��j
APPLICATZON ISSUED BY: DATE;
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LEGALI2ATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRTC MECHANZC FIRE SMZP/RES GRADING
PERMZT 137.25
SMIP/NON-RES
PLAN 89.21 1.68
ZSSUE FEE
BUILDZtJG-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 138,93 0,00 89.22 228.29 228.14 ,00
REVENUE DIVISION TOTALS--> COliLfiCTED: 228.14 OVBR/SHORT; ,00
t�Lt�3d� T'h1'� T�LUM�iRiti EL�t"t`F�i� l�fE�'�lRS�i� �3fF� 3M1t'!T�'± �ft��2f1� h'tP�fJ—�'+�E�'H
37.z5 1.6� 8�1.21
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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 S C R I P T I O N UNIT COST TOTAL COST
SFC B000 ALTER BY VALUB COMMERCZAL NOZONE 1.00 B4O00.00
END OF FEES
EX��,����� � �� ,
p�reJ=-�-�'" �JA N
v 2 01998 �
CITY OF COSTA MES,4
CQNSTRUCTION AND PLANNING FO� _& SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspeccor
1. Temporary Eiectrical �Service or Pole �' 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3, Electrical Conduit Utility-Undrgrnd. 54. Forms
' 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel 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 Ploor SYstem 67. APPROVAL Tp DECK
15. PropertY Sewer Line & House Connection - 62. Backwash & Receptor�Final
12. Sewer Cap �
63. Heater & Vent-Final
13. Roof Dtains 64. Piumbing System • Finai
14. flough Ptumbing 65. Electrical•Final
15, Rough Electrfcal•Conduit 66, Solar System-final
16. Rough Electtic Wiring � 67. Fencing & Access ApProval
tl. Rough Wiring Sign � 68. APPROVED FOR PLASTERIt�fG
18. Rougfi Eiectrical-T Sar Ceiling 69. POOLlSPA SYSTEMS FINAL
19. Rough Heatin9 & Air Condittioning F1RE DEPT. REQUIREMEN7
20. Rough Factory Fireplace � � APPROVALS Permit #
21. Ducts, in Struaure 70. Underground Hydro
22.Ducts,Ventilating � 7}. ProductPipingOGas ❑Oil
23. Gas Pfpe•Rough & Test � 72. Underground Ffush
24. Roof Framing 73. Undergrnd. Storaye Tank O Gas ❑ Oil
25. Root Sheathi�g � 74. Overhead Hydro
26. T-Bar Ceili�g (Structurall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Scandpipe p4,
28. Lathing & Siding 77. FIXED SYSTEM FfNAL
29, I�sulaiion 7$. FIRE PREV. FINAL i
�..
30. Drywall Nailing NEAITH DEPT, RE�UIREM
31. Pla4ter Brown-Coat 79. FINAL �NSPEC?!ON •
32. E4ectrical Power Mecer-finai 80. FOOD CERTiFtCATE lSSUED
33. Final Electric . Notes:
34. Fin21 Heating & Air Conditioning
35. Fi�al Gas Pipe-Test ' „ . '
36. Hood o� Canopy '
37. Flnai Factory Fireplace
38. Final Plumbing �
39. Water Service-Final � '
40. Gas Service-Final � .
41. Solar pomestic•�inal �
42. Backflow Preventer -
' 43. Backflow Irrig2tion '
44, landscape Irrigation Syscem ,
45. Sound Attenuation • '
46. Handicap Regulations �
47. FINA�STRUCTURE&BUILDING ,.
48. FINA� PLANNING �
49. Electric Release to Edison -
50. Gas Release ta Southern Califomia GasCn
51. CERTIFICATE OF OCCUPANCY
No. Date .
eu�mx+ 799 W 19TH ST ura:
v�arw THRIFTY OIL CO
,�nonEss: 10000 LAKEWOOD HLC�D
DOWNEY,CA 90240
�oo�z%
oe E+x�+N�n: uc ra_
UICII Oq Elq: S A0011E59: UNT:
wxm�crarswu� PETCON TECHNOLOGY ( 310 ) 782-7848
owm�croxs �aiwo 18 7 2 D EL AMO B L
��; TORRANCE CA �G�,; 675998
90501 �M, A
110EN4ED CONfRA�TON4 DECL�NATION: I hereby ellim uMx perely d pe�pvy OW I em Ifwnetl undx pprielonc d GMqr B
(mmmenen0 xilh Sea� )000) d Divuion 3 d Ihe &miron end PMesaiau Code. W mY lioenee e m Iu01au and afletl.
cmuc.No.: uc.cuss: A,B uc.No.: 67599 EXP:
..�f Data: �1 CJ1 �/`� `� �? Comrear.
/ OWNEP BUILDEN OEClAP1TI0N: I Mmby e/fiem uMer penety d per�ury ihel I em axemq Imm IM ComreCon nea lew Ip Ns
�Rlbwiq reenon (SeApn n1315 Bueroae md Rdamoiu Code: MY uY a Ooun�Y xfiidi �e0ui2� e 0�� lo muhucl. Mx.'unVo.e.
•': emd'eh. a rM� MY sl�uctwe. 0� ro Ea baenro, ebo �aVw�ae �Iw eGqimm lor wM v�^� to file e apned Mtemen Nei M a 4e
'�;; i�.ee w�m io me no+�.�. a me cwreao�. uo.ti. �. Icn,a« e lo�m.�aro .an saa� �000) a a.e� s a n.
"Bumime aM Prdoseva Cadel a thm h a eM e vemq Iherehom erd IM basa fa iM eAepeA memqion. My viobtbn W Swion
'loJl.s yy eny epp;w�� r« e permil wbieaa ine epp:sm io e ew panMy d na mae �nen rve hundrea aWen �ssmp.
� I. e� owner a11M MOPe�Y a mY emdq'esa v.Yh we0m m ths ade com0�aeum. MiA do Us �wrk eM the Mvaun'v m1 iMaMed
a oRaad M sab (Seciim'lOM. Buarcn eM Pmleseiom Code: The Caniradas Limeba lewdou ml �plYloen oxnerd qapMy
' wlw Euide a inP�++a Ihaeon. erW Ma Eom euM Mwk limdl rc henM or �hu+9h he a Mr own empb�w. pa+dad thel wc�
improwinmb Ne nal'uqeMeE a afMeE ta eeb. tl. lnrever, tM buiqirp a inpmwnM u wd xilNn ons yw d complelion. tM
owrrrLuiNer W�I hara iM buNen d Va+�e he a ohe tlid na WYE a'unpa* la Ne W�e d eabl.
[] I, n wror d iM nwaN, am utlueiwN ooniretln0 Mit� I'v.amed contrxtan ro m�m�w tla wol� i5ed'on'lou. &a'vm� mM
cra.aaron. code: nb comrecon ucense �ew eoe. na eppv m a� o.�w a ww�r .no waaa « imo�'.. �n.,.m .�a wno
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❑ I un wmq wdm Seclia+: B. d P.C., tor Ms rmeon:
Dete: �'�Ta�
�� ry�yy �ryy Wt I em ewere d eM urdwateM tM �p�imneme W Callanu Naellh eM Selely COAe baqiwu 25505, 25.539, W
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aW��lawmNciinnamoddralianhaniMAt u3�R�iy enepamemDiAAtl.RukaaielmWrWioneOGN'dioroenamnWM1anYw�
a�.
Dete: ApplicanL
W OflKEH'S CONVENg�T�ON OECIAR�TION: I Mroby dfi�m uMer penMy W pe�jury one N ihs b9owiip Eetluelnns:
� I hma ad wJ m��en a cMAktla d aonwil Io �all+mwa br wakeri mmpanmion. n provNaE la by Sauion 3]00 d tM leCn
coe.. i« m. oM�• d u» w�x io..n:d, iw o«�a e��.a.
❑ in....�e.ame:a.:�.c.k«rmmv�onv�wr.�,o...s�.mm.eMscmrrooam.�enarcoe..a.m.v.�n.�an,.
��«���'������'•S'�ATE� FUND �P���� EXPIRES
c�, 07/O1/97
Polry Numbr. —
(Jlria wian rrd M� 6s amqefM l iMO�M u br ms huMied ddW (Si001 a Iw.)
� I CN��Y 1�1tl If11�10 �lf�MNIKG d I�N WOf�[ �Of M�IIJI 1�10 pM11W IM 1tl11M�. � B�1B� M1 Y�IpOY NY Vd�� N MY T8lYW �O Y 10
b«mn w4��o �M wn n mmpsemion le.n a CeNaNe, a wns cw ' 1 dvm bsm. .i m N. wrimr.•
�pauq� 'eum d sqion �100 d IM leUar COEe. I 1 �' mmpl� ' N m pwiacm.
Dats: O AOd���
W�mMp: Fa9un ro�un wroik�ri rompwwtlon rovxp� la unbwNl, uM�IWI �upJ.ef �n xiployr ro Jtil pw�WtluW
dNi n�.. �y ro o�w m.w�.e rro�.w ewm. (tiataooa a.mw� ro m. �o.r o� �o�ro.�..wn e.nrw .. n�.+e.e m. �n
Sctlm a)!16 oI M/w6or Codr. IIrtw4 uM �etomq'� �Ma
CONSTtiUCTION L§MqN� A�ENCY: I M1mery effirm uMer penMy d par'�vy ihet iM e e ouutrudion Wd'vp e�sicy br tlr
pmlormeMe d �M v.� br whiM ��e prmi b naueE (Seaion 3091. CM. C�.
�ENDEF'S NAME:
LENUER'S �DDNE94:
� CMIh' �� ��IBV! IlP41�111lVGrGbJI Nld M810 ��W �10 PbN! III�MIWCf14 CIXIM]. ��N IOCqllp'/ FS�1 GO @/41d WIp11% OIdC141CY
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L Pnm N.me �j, ������
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p u�e 1 e1//�peN/Ap ZnLCON2tltt
(5151�A6.WP) WhnsBuikvp85dery:OrterrFls:Carieiy-Appicen�:Rnk�levenue:Oddmrod-Mw��or
CITY OF COSTA MESA — BUILDING PERMIT
PERM NO: B 079166
PERMIT NO: B U79166 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE; OTH
JOH DESCRIPTION : REMOVE PETROLEUM STORAGE TANKS SQ FT: 25,OOQ
CLAIM VALUE: 25,000.00 CALC—VALUE: 25,000.00 GROUP OCC: S-3 /
COMMENTS: REMOVE STORAGE TANKS, COMPACT 6 GRADE SITE
�*�t�**x*****+��t******�*******+�**�r***x**+t**�*�t*�***�**�*******x*****�**+��t*�**�*x*
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 IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV: PARCEL: 42420101 2NE: REF NO:
PLANNING NOTES>
>
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A E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : DATE:
APPLICATION ISSUED BY: DATE: $ � "W
iE1E16ikiE*ih�E�1E�1E�EiEiEikiE9fiElEiFiE1EiE iEiEiE3EfE�FiEiE1EiF iEjE
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC MECHANIC FIFtE SMIP/RES GRADING
PERMIT 349.75
PLAN
ISSUE FEE
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK
TOTALS----> 355.00 0.00 0.00
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLOMHING ELECTRIC MECHANIC
349.75
TOTAL
355.00
SMIP/NON—RES
5.25
PAID
355.00
D00
355.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
5.25
* iE af'�f ie *'� * if ie * if * * *'�f * if x' * x� �r'� * iE * �' �' *'x�'� af x- x� * * * ie'� x' * * *'x� *+�'�'x�+t iE iE'� �'x� * * * * *'� iE ie'� �x- *'� * x- * �' *'�+�'� * * * rt'x�
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 25000 ALTER BY VALUE COMMERCIAL NOZONE 1,00 25,000,00
END OF FEES
EXPI�ED�/
DATE �` ( ` b
�CTION AND PIANNWG _ P0� SPA
i,�. _S Permit # Date 'Inspector APPROVALS Permit # Date. inspector
'•%i. Temp� ary Electrical Service or'Pqle � 52. Pool & Equipment Location ) �
1� ` -�
2. $oil Pipe-Undrgrnd. ' • 53. Steel qeinforcement , �
3. Electrical Conduit Utility-Undrgr'nd. 54. Forms � '
4. Electricai Conduit�Undrgr�d. • 55. Electrical Bondiny . -- � �,
5. Steel Reinforcement 56. Rough Plumbing & Pressure •l�est _' '
:
6. Electrical UFER Grnd. ' 57. APPROVAL TO COVER�GUNITE ,: •"
7. Footings 58. Electrical Cond�it-Undrgrnd. --:��
8. Foundation 59. Gas Pipe, O Undrgrnd., 7est •
9. Wa2er Pipe-Undrgmd. _ .� 60. Backwash Lines, P-Trap, � Undrqrnd.
10. Structura� Floor Svstem -� 61. APPROVAL TO DECK
17. Property Sewer Line & House Gonflection 62. Backwash & Receptor�Final '
72. Sewer Cap 63. Heater & Vent�Final �" j
13. Roof Drains � � 64. Plumbing System � Final -'. ;
74. Rough Plumbing �_i 65. Electrical-Final
15. Rough Electrical-Condurt `� 66. Solar SYsiem-Final �'�
� � 1
76. Rough Electric Wving _� : 67. Fencin9 & Access ApPrbval- �
17. Rough Wiring Sign ' � 68. APPROVED FOR PLASTERING `�
78. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL "
� Z.
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Duas, in Structure 70. Underground Hydro
22. Ducts, Ventitating 71. Product Piping O Gas Q Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank � Gas O Oil
25. Roof Sheathi�g 74, Overhead Hydro
26. T�Bar Ceiling (Structvral} & 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. Drywail Nailing HEALTH DEPT. REQUIREMENT
31. Plasrer Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTiFICATE ISSUED
33. Final Electric Notes: -
34. Final Heatin9 & %��� Conditioning - . _
35. Fina� Gas Pipe-Test ' -
36. Hood or Canopy �' .
37. Final FactorY Fireplace � - -
3S. Final Piumbing �
39. Water Service-Finai
40. Gas Service-Final
41. Solar pomestic-F�nal
42. Backf�ow Preventer
43. Backflow Irrigat�on
44. Landscape Irrigation System
45. Sound Attenuation
46. Handiwp Regulations
47. FINAL STRUCTUfiE & BUILDING
48. FINAL PLANNING .
49. Eiectric Release to Edison ,
50. Gas Release to 5outhern Caiifornia Gas Co �
51. CERTIFICATE Of OCCUPANCY
No. Date
�
�I
��
i,00pessawnm+a 799 W 19TII ST
raxsr,u1Eivaaax: THRIFTY OIL CO
�ooxEss: 10000 LAKEWOOD BLVD
� DOWNEY,CA 90240
uHr:
lxcxrtecTowexar�an: uc.xo.:
wcx oe u+a�s �oonEss: �:
caxm�craraw�: PETCON TECHNOLOGY ( 310 ) 782-7846
cartn�crars�uina 1 8 7 2 D EL AMO B L
��, TORRANCE CA ��,; 675998
90501 �M, A
110ENSEU CONfflACTORS OECLAFATION: I Mreby aRim ivdu qnNy d pe�jury Mu I em IicerueE uMs prarieion� d CMqx B
(mmmmtln0 xil� Seclion )0o0) M Oivieion 9 d tlie Buwmw ud Pralwvions Coda, and im' 4oeroe is m lull lacs enE Mlae.
cmuc.r+o.: uc.cuss: A,B uc.N'o.': '6'7A599�8n,I EXP• �
ome: � b Camreaw: VW�_ !�W�C���
�WNEF BUILDEP OECIANATI � 1; I hereby elfim� wiEer peWy d perjury tMt I am vemp M1an IM Caqfadon Lcws law la Na
Ibwiq reawn (SeUion lW t S&niwf eM Pmlesa'vr Code: A^Y W a aowYY xAid� �aQu4e� a V�a lo mrotrW. etler. MYow.
.emd'oh, a rpeir eny aVutlun. pn lo ts evarae. edo nQiu�m iM epplirent ta rrJi pa�m! W fib e eipnetl simameM tlW M a cM
ie licenaed pureuenl to iM prwnian d Iha Cwurmaa lioeroe lew ICheqs 9(mmmanenp Milh Sedion 1000) d Oiieion 3 d the
9udnan eM Prdevuro coeal «�nn ne «ane o uema �nsd.an and �he bmo I« ne eAsped Qe�Mo�. an vuWion d seeun
)031.5 by anY eDW� la e pemm +ubpCa the epWirm�t to e tivi penetly M nol maa then Ma IuuMnE EaOen �f500p.
❑ i.a,o..�.�ainenoro�ra�n�oM�+wnw�+s,m.:.daoomw�+�..�eou»won�.m,em..wa�o.e�a�m�a
«dlmeE far veb (5ecuon ]ou. Bm�nu end PNeaima Code: TM CaNmem liwros lewdoa+ml eDvN�o en owrrd poprty
wno huide n inpan+�haean. W Wn droe aurh wak Nmrtl a henN a Wuq� !ie n Mr own amWuMsa. p�� ihel euch
impmvemeMe ere nd imerded u alleied f« eeb. tl, however, �he buitliip a inpro�ameN ie edd xil�in aro ymr d oompletion. IM
owmrbuitler will heve �M Wrdsn d qvn�p M w aM EiE nal bWd a'vnpv.e la �M Wryws d vb).
� I. a� ow*wr d tM popery. em e.�MrvdY ���eq � ficenaeE canbac�on ro mguutl IM pmjetl (SeUion'lOM. Bueirree eM
P�a.�«o�. cea.: m. comauo�. ��.. m.s m�dr ro m, o...� a o�ro�r wno ao'b. « mv�« nw.o� .�a.no
eaniMa M.udi v�M�^ xvn e mN�edMal4md we.wu �e �hs Cavetlm L'vsro.lew�.
� I em exanq unda Seclian: B. 8 P.G.. M Iho �eeaon:
Daia: �++�:
I tlo heraby cenM �het I am awera d enE uMeia�vM the rayuimn«an d Cdiortiu IkNh W Selety COAe Sediam?5505, 25539, eM
255�1. eM Ihm I a enY Mu'e WYdnO � rri9 / W M(mc4 ano) nsod ro camW Mh uid eWe aods� end �M nqid�wnems M
e W�0 taaonsVuclion n �mdi(ratbnhamlMA'r�enepenwa DiCntl. RmksY W omt��urlion WOk'diaroan wmWhanthNa
ww���..
W OflKER'S COYPENSATION OECIAii�TION: I herW/ tlfi�m uMr psiMy W pajuy ar d Na Idbwiiq detluetbm:
❑ in.w.mw�w.:,.�nu�w.aoo�,..v�o.w:�.�«.on�.:�w�...n�r«wsm�arooam.i.eo�
coee. �« in. wnam.nc. a w.w �« wNd, mu w�a o b.wd.
❑ � her. e�w x�� m.�ven nawn� aomo.�� �n.noe... nPdne W swwn aroo a m. �.e« coa.. a �n. o.���. a m.
.�ia�.n�,w.w�nmm.�e.Mr.�x«*'�i°��.°�Y�JJ�.mwu.r��ne,a.: EXPIRES
`°�'°` 07/O1/97
Pdiy Numbar.
(ihia roction rod mtW mnWMe] / IMG�l'u b ms hwd�s0 ddlus IS1P01 a NnJ
� I cMly �hn in Ne peAamerce N tM MaM br v.fiich ihu pamG b imntl. I NeY nd anpby vry pw�on n art/ menror w q lo
becoms wbjea �o �M woNan' mrtpenmion lew� d Celtlomin enE pir tlw Y 1 Nwk bsemr aEjW to 111��� waken'
cpnpenaNbn 0�viabru I Saaion �)00 d iM lebor Code. l ehell lo vn M� Nrl ob ��. �
DYe: O /�pplv'aN:
WemMa: FiNun ro uc�n wo «�'rnmpruetlon covwap� l� unNwlul, uW ilWl �uD/ct �n rrplqw ro cNm arltlu eM
elv/I flnu up ro ons �InGIM flaua�nd aoll�n (S1Pq000A M aAd/Wn ro V�� ew! ol eomp�wtbR O+�W N PAM� br In
S�ctlon �]06 0/ IM LMor Cod, IMwt aM �rtomy� ha. ..
CONSTRUCTION LENDINO AOENCY: I Areby efFrtn unCer peneny d perjwy �hel IMn u e m'wiuraion MnNrp ypnry M IM
perlormava d tM w�k br whirh the permi u cawd (�� �. C'v. C).
LENOER'S N�IIE:
LENOEF'S �UDRE59:
I cerlily Ihe I heve raad thia epplice�ian eM nn� �hel tlr ebwe iMamLLbn b oonw. I ep�e �ocqnply w�ilh M cey mq wu�xy wd'menou
erdatalsbwerMeliqbMi iqmWudion+MlwebyeiMar¢e�ep�ew�tetivbd�huelybatderupanlMebv.e�metLioneEpiaperly
�IX inHVatlpn puWm'
PnN Nema �\Q
Dme: �+V Q' .
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(5151e6.WP) Whna�B�itivp 8 Se1ey; Geean-Fb: Cvury-Appiais: Pink�is.enue: Oddxxob-Asveemr
CITY OF COSTA MESA — DUILDING PERMIT
PERM NO: P 079167
PERMIT NO: P 079167 PLAN CHECK NO: 03440-96 S GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: PLU PURPOSE: OTH
SOB DESCRIPTION : INSTALL 3 PETROLEUM STOAAGE TANKS SQ FT:
CLAIM VALUE: ' � CALC—VALUE: ' GROUP OCC: S-3 /
COMMENTS: INSTALL STORAGE TANKS
**�*��*�x**���**��****��*�*x**���rx***�***�r���*******+��**�+��*x*�r*��*+r�*�*��*�*�*
Z O N I N GS ERTEBQAUCIKRSE M E N T S
------------ MAIN HUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR• FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARXING REQ: PROV: PARCEL: 42420101 ZNE; REF NO:
PLANNING NOTES> ,
i
ik if iElE 1E 1E iF if if i6 iE if iE iE 1E iE iE iE iE �E 3E iElE iF iE iE iF iE 1E iE if 1f if iF 1F ik if 3E iE 3E 9E jE 9E jE iE 3f iE iE iE 3E if if iE iE iE �E iE iE iE jE 3f ik-)E if 3f �E iE 1E 3E 3E iF if iF 3E IE jf jE iE 1E
D E V E L O P M E N T S E R V I C E S'• R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY :
APPLICATION ISSUED BY:
7E 1E iE if iE iE if if ik ik 1! 1E iE iE if iF 1E iF if iE iE N
LEGALIZATION:N
BLDG PMT
PERMIT
PLAN
ISSUE FEE
F E E S U M M A R Y
PLUMBING ELECTRIC MECHANIC
131.25
25$
32.81
22.00
DATE:
DATE: � �
�E�E�iEif3f3k*3E�EjE3ElE ifiE
STROCTURAL SEGMENT;N
FIRE SMIP/RES GRADING
SMIP/NON—RES
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 131,25 22,00 32.81 186,06 186.06 .00
REVENUE DIVISION TOTALS--> COLLECTED: 186,06 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
153,25 32,f31
1E if !F 1E iE 1E if !E ib i6 iE iE �f iF �F fF �ElE fk iE iE if jf ib if:f iE 1f !F * dk iE 1E 1E fE 9E iE fE �f �E aE iE IE �)E iE 1E fE i(� iF i616 iF iE iE iE iE �E 1E iE IE if af ik if ib iF iE iE 1E 1E 1f iE if 1E iE iE fE iE iE
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
PLU 15 . PRODUCT/PROCESS PIPING PER lOLF EA 8.75
END OF FEES
EXPIREpD�
DATE 'l� b
131.25
� •' . CTION AND PLANNING
. >LS Permit #
1. � �rary Electrical Service or?o�e
2. Soil Pipe�Undrgrnd. ; - �- �l,
3. Electrical Conduit Utiljry-UndrgMd.
4. Electrical Canduit�Undrgrnd. �
5. Steel Reinforcement � y �
6. Electrical UFER G��d.
7. Footings
8. Foundation
9. Water Pipe�Undrgrnd.
10. Struaural Floor Svstem "
1 t. Property Sewer tine & House Cd[�ection
12. $ewer Cap �
13. Roof Drains
14. Rough Plumbing _i
15. Rough Electriral-Gonduit •�
16. Rough Electric lNiring • �-
17. Rough Wiring Sign �
78. Rough Electrical-T Bar Ceiiing
19. Rough Heating & Air Conditioning
20. Rough Factory Fireplace
21. Ouc[s, in Structure
22. Ducts, Ventilating
23. Gas Pipe-Rough & Tese
24. Roof Framing
25. Roof Sheathing
, 26. T�Bar Celing (Structurap & Monocoat
27. Frame and Flashing
28. Lathing & Siding
29. Insulation
30. Drywall Nailing
' 37. Plaster Brown Coat
32. Electrical Power Meter-Finai
' 33. final Electric
34. Final Heating & Air Conditioning
35. Final Gas Pipe�Test
36. Hood or Canopy �
37. Final Factory Fireplace
38. Final Plumbing ,
39. Water Service-Final
40. Gas Service-Finai
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigati0n System
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING
49. Electric Release to Edison
50. Gas Release to Southern Calitornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
Date
P & SPA
Inspector qppROWAIS , Permit #
52. Pool & Equipment Locat�oa
53. Steel Reinforcement '�'
54. Forms `'
ii
55. Etectrical Bonding '
.
56. Rough Plumbing & Prassurrjest
57. APPROVAL TO COVER•GUNITE
58, Electrical Condyit-Undrgrnd,
59. Gas Pipe, � 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
APPROVAIS Permit #
70. Underground Hydro
77. Product Piping OGas �Oil
72. Underground Flush
73. Undergrnd. Storage Tank O Gas ❑ Oil
74. Overhead Hydro
75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTN DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
' L� �
Date Inspector
}
.
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r,�oon[ssaeuwwo: 799 W 19TH ST
oxxensruYeivaawr+: THRIFTY OIL CO
� �oon�ss: 10000 LAKEWOOD BLVD
DOWNEY,CA 90240
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woness:
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utn:
c«�m�crareru� PETCON TECHNOLOGY ( 310 ) 782-7848
CWIII�CTOR9YN1➢10 1872 DEL AMO BL
�ooness: TORRANCE CA ucwo.: 675998
9 0 5 O S ,,,,,: A
IJCOlSED COMNACTOfl3 DECLARATiON: I hwsb� Nim uMr paWy d pspry tlW I mn OcumE wdx prwubv al Cheqr Y
(cammenrirq wdh Sacrion ]000) d Diwun � d tlw B�mirv W Wda��'vu CoEs. end mY Goww e n tu0 bm end aMw.
cmuc.Ho.: uc.cuss: A,D uc.xo.: 67599 EXP:
Q .
om.: O 6 A comean: Ar-
OWNER BUILOEN UECIANATON: I M�eby alfi�m u�der pmNy d psµy �AY 1 am eaanp imm IM CMieCan l+ sroa lew 1a Qr
ullo.nq immn (5wion 1wt.5 Bw:a.. rd Rdwam+ Code: MYW n aduuY MdC� �apu'vs e v�d w mmwn. eds.'cnVrw+.
lemafeh. a rapei M' �mcMe. a� m u'vww�oe. e6o ip�nm Ne eoP� tar aM Da�+to 9a e mP� pYemaV tlW M w sM
'w Ikarusd W�+� �o IM pow'vv al IM Caweeon liu'ue lay' �CM1eNx 9(aommendmq wa� Setlion 1000) d Dirvebn 3 d IM
eumso w Ndmons coeel «�ne� ns>.ns u m«np �Ivaewn em �ro bnu �ar me ebped mi.mq'v�. Nn vio�uo� a&wun
]W 1.5 b/ eiry epp4nnl la e pmmY niEjslf IM eppiv'sN to a dN pe'Wy d nol mm �As�! Iuv�eE doYus �5500p.
❑ �.rooxnma�n.ww�r>�^r�MmM•�nw�qp+.�0,.:.o�.mn,ro�..adom..alc�dm..m�mu.um:a«ked
a e/lxed br Ws (Seetion lou. Bw'vrn eM P�almdwu Cotle: TM Cav�aCaslimew lnvEawnol eoNYtoanownxd puprtl
Ma Mdd� a in0�+�lw�am. md Mn dom arh rM 1"vn�eE a henN n Wvqh lie a her own e�b�w. pwitlM ihm aich
imP��a�b ve nal "vuardod aWeaE la ub. tl. howaver. Ne bulGN a inpwa�ml u roN xnh'vn oro Y� d mmpMbn. iM
ormar-0uiNer �w0 hew tM MVEm d pw'vq M a Yr dd rcl Wdd a'unpwa fa th p�vpue al �e1el.
� I. o anw d �M pWMY. em arimWY aomrtl�q wi� Frusd mmedu� b canbud ths G�A� (5eaun Nu. Bubie� md
Pmlwim� Gode: TM Caqream Lirnn lnw dou nd eGWI b en oww d V�W�Y wl+o ddds a uiPo+� tls�an xd Ma
coweei b wrA p4x++MN e mmraM�) fcm�od w�� m �M Camma� liowa l+W.
� 1 em uanp wMer Seclbre B. 8 P.C.. la Ne neam:
Date: a^w
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T5SL. eM tlw I a eT' M1Pu� dJMnO � wi0 / wA na (mcb ane) roeE b canPM w�iA oid mts mEu md tM �epuvan�nb la
aC��lacan�iu�ionamod�ionhomtMAi e�iy anqpme�uDiprid.RmitlamielaorW�udioneGGG'midaenwmNfmmNa�
n�..
WONKER'S COYPENSATION UECLARATION: I lwsby dMn �ndr pmNy d pr�vy w d IM b0ox'vq deduelbro:
� � nm,..ne wu meim.w. cennwe a oon..m io.wa�n. ro, wixaY cona«umion... a� �a M s.a�m amo a m. �.nv
CaM, la IM prlmnucs d IM wah la Mich NN pamb b WuaA.
❑ i nw..�e wi� me�m.:i won.n� m�v�on inw�.a.. m�.w:.d M eww� nm d u,e �.n« code. r« m. vu�m.�o. a m.
waMlwxhiMMepemmbinusE.Myworken'oom�ss_mmNE FUND �'�'����� EXPIRES
c.,ri,,: S 1�P.1
Pdicy Numbr. - � 7� � 1� 9 7
(This esdian mW mt M ear�ystM / Jw pmri u M ms ha�eC dn0en RI001 n Nu.)
� 1 caliy Nm in Ne porlmnerca d iM wk la �hhl� ihu pvnW u umE, I NeY nal wnpby xry pason N ury merurr o n to
pecoms ��bjea to iM xwVws' comper�wion Nw d Ca4lamie. eM apiw tlW tl 1 Na�M bacmis wEjs o iM MMs�'
cpnpn�etun misbm d•'on 00 d iM lebar CaM. I WY tM wEh mpf� ' iho� p�M+ioir.
DNs: � Md�
w�rri/rp: F•xun ro ueun rortwi romvw�wtlon tovwp� b W�rM �rW Ntll r!/st �n �ntplayv ro e Ypw�i�ltl« urC
elvd nrw w ro ax n�nend rMusW aolov� !it W uooA In �tlNtlon ro un mt el n�qnrGon d�� a P+�vMw ror In
9.eaon sro6 or m. l�eo, coa. �ne.i..e .w.mn»r'. �«..
CONSTHUCl10N LENDINO �OENC1': I Iweb/ efRem uM�r pu�eR/ d p�rjuy ihet iMn u e mutwion IWvq apa�x.Y �a R+
psn«m.me d �n. wa.k ror MiA �ne v�� u uwsd (swb� �041. cir. cl.
LENDEfl'8 N�11E
LENDER'S AOOHE44:
I cMdy i�n I luw rseE Nu appGm'ni aM tlab ihel tlr eEove "vdamnion e mnw. I qr lo comply Nh e0 auy W odvtly a�dvwcw
W etate lew� nlelni ro dutliq canatrurbm md Mrab/ eWvaa �m�m� d No iIf'ro emr upm Ne ebwamatliwrd PWMY
Ia irmGeab^ V'^pp°�� � 1
(5151J6.WP) Whua-BuiNi�p8Selef:a'w�-Fb:Cuwy-ACP�d:Pv�k-Mmue:OddavoA-A+aeev
CITY OF COSTA MESA - BUILDING PERMIT
PERM NO: E 079168
PERMZT NO: E 079168 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: ELE PURPOSE: OTH
JOH DESCRIPTION : INSTALL 3 PETROLEUM STORAGE TANKS SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: S-3 /
COMMENTS: INSTALL STORAGE TANKS, RE:#P79167
iE 1F f! 1E iF 1E iE fE iF if fElE 1! iE fE 1E if iE ik iE 1k ik 1E fElE �f iE iE iE 1Elf 1E iE iE iE 1E if 1E �E 1k k 3E if fE �E if iE iE iF iflb if� 1f iF iF iE iE iF �)F 3E 1k iE ik 1E iE iE iE �E 3E 1E iE 1E �f �f 1f iE if 161E
Z O N Z 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 IN
LEFT; FT IN RGHT: FT IN LEFT: FT IN RGAT: FT IN
PARKING REQ: PROV: PARCEL: 42420101 ZNE: REF NO:
PLANNING NOTES>
i
1EfElfiEikjFlEiEiEiElEiE�EiFlE�EiEfbififiFlEiEifiFiElEiE�F1EfE�FjEipiEiEfElE�FaEiElffEfE1f1E1EiElE1EiE1EiEfEaE1f1E1E1EiEfEiEiEjEiEiE3EiEifiEaE3E�E3E�EiE1E1EiE
D E V E L O P M E N T S E'R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY r DATE:
BCIILDING APPROVED BY : - DATE:
APPLICATION ISSUED BY: ` DATE: l� ��
1ffEfEiFiEiklfiE�EfElEjE1E�1E�E3EiEiPiEififiF iflEifiEiflEikiE�E3E iEif
LEGALIZATION:N F E.•E S U M M A R Y STRUCTORAL SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECAANIC FZRE SMIP/RES GRADING
PERMIT 71.50
50� SMIP/NON-RES
PLAN
ISSOE FEE 22.00
HUILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID DUE
TOTALS----> 71.50 22.00 0.00 93.50 93.50 .00
REC�ENUE DIVISION TOTALS--> COLLECTED: 93.50 OVER/SHORT: .00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
93.50
iE 1E 1E'1E fh iE ik iFlf iE 1E 1E if 1E aE iE IE 1E iE iE iF iE 3E 3f iE 1f !E df if iE iE iF if 1E if iElE iE 1E 1F IE 3E if iE if 1E if fE k iE fE iE 3E 1E 1E 1E if iE 1E IF if iF 1E 1E iF ik iE if if 3F iE jE df iF 3k i8 3E �F iE
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TO'LAL COST
ELE
ELE
ELE
ELE
6 FIXTURES LIGHTING 1 ST 20 EA. 1.00
1 SUB-PANE{� 16.25
3 MOTOR/POWR APPARATUS 1.1 - 10.0 HP 11.00
1 MISC CONDUIT NOT LISTED REQ PERMZT 16.25
E�PI� ��
DATE _ `� (�
G.00
16.25
33.00
16.25
10N ANO PLANNWG _ PC 4� SPA
i Permit # Date Inspectoi qppROVALS Permit # Oate Inspector
1. Tev. .rary Eiectricaf Service or Qole 52. Pool & Equipment Locatiorf ;� ��
� 2. Soil Pipe-Undrgrnd. ' 53. Steel Reinforcement �-- - � ,�
3. Electrical Conduit Utility-Undrglnd. 54. Forms
4. Electrical Co�duit-Undrgmd. G� to�� Q� _ 55. Electrical Bonding .._ , ��
5. Steel Reinforcemen[ � I 56. Rough Plumbing & Pressure �est ,
i
6. Electrical UFER Gmd. 57. APPROVAL TO COVER�GUMTE �
7. Footings 58. Eloctrical COnduibUndrgrnd. �
8. foundation 59. Gas Pipe, O Undrgrnd., Test '
�=.
9: Water Pipe•Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. '
10. Structural Floor System _�� 61. APPFOVAI. TO DECK
i t. Property Sewer Line & House Conpection 62. Backwash & Recepror�Final 7
72. Sewer Cap 63. Heater & Vent-Final •'��
, 73. Roof Drains - 64. Plumbing SYstem • Final ^
14. Rough Piumbing - 65. Electrlcal�Final ��
15. Rough Electrica6Conduit -.� 66. Solar System�Final •� �
16. Rough Electric Wiring - �= 67. Fencing & Access Approval ��
17. Rough Wiring Sign 68. APPROVED FOR PLASTEPING '
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUfREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventiiating 71. Product Piping O Gas O Oil
23. Gas Pipe•Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Shea[hing 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. Drywail Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. F000 CERTIFICATE ISSUED ,
33. Final Eleccric �IIa�Iq /R � Notes: �
Y`
34. Finai Heating & Air Conditioning
35. final Gas Pipe-Test �
36. Hood or Canopy . �
37. Finai Factory Fireplace " '
38. Finai Plumbing � .
39. Water Service-Pinal �
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backtlow Irrigation
44. Landscape Irrigation System
45. Sound Attenuation
46. Handiwp Regulations
47. FINAL STRUCTURE & BUILDING
48. FINAL P�ANNING
49. Electrie Release to Edison ,
50. Gas Release to Sou[hern Calitornia Gas Co
51. CERTIFICATE OF OCCUPANCY
No Date
_\
, Costa Mesa Building Depa�i t,i,.�,it —' e�Yr;.ICA'i10N FOR PERMIT
' �, �� 711 EAST 20th STREET �' � g U I L D.� N G '
'' �!OSTA MESA, CALIFORNIA
'�'FOR APPLICANT Td FILL IN FOR OFk'ICE USE ONLY
eceipt No. Permit No.
Building /� . �
Addreas � C / i . �f �`G � �
Costa Mesa, California Rece/'fved Date Rq 'd./ DaM Issy�d
Nearest �u Z' 1� ��''1 - �' 3`�
Crosa St. _ uilding �„ {�
Owner ��j '',;!.`�/! :�� /1 ��EJ �%c.)C: �� Address CiOSta, MC38�� Cifl.�liOl'lll& '
Mafl /�f n
Address ��� .�l K 4��L+E-� Nearest / � �` �
-� � Tel. Cross St. ` � � � /�q '
City �. Cl!��:a- l,l:i �-,.. .'� _- No. 2one `! I No. oi I Type �! Grou�
Architect or Lic. Plans �
Engineer No. Approved�
b Date •
+dress CORRE ONS �
City Lic.
�ontractor .a� �� No. i� �.eG .Ce'+
e'
Address 'Q �� A�
Lega'I Lot /Y+-w Yo>r � I �� � �— r
Descrfption I No. �O � I B�ock I Traet F,s,[F+ � -� �
�"/ ., � '
(Attach Metes and BoundeyQP /�6 � �.�0 � � , � �' � ,
No. of Bldgs �
Size of Lotl/n Y/?7 I Now on Lot IjJ/;'�C
Useof ' " I No,ot I No.of _,�
Existing Bldg. Famillea Roo e. �
Setback Line from j. Rear Vard 3 �P Z
Center of Street O L Side Vard �. •� y
DESCRIPTION OF WORH � ,
I/ ,...
New p I I Alteratlon I I Addition I ����;pCG .' �
ii d
Repair I I Moving I I Demolish I
Building No. of
'+.e io+7� 2f.'J � Rooms Stories
.erior Wall Rooi
�ver�ng cover�ny APPROVALS
Use oT New �' - ,-
BUIlding eJG,+ <sr�� 6 �' ����� Fau:idation Location Inapeetor D a
� ' " Forms, Materials,
Q .�.t/r yp-Leif .� CrL/� UnderPinnfng
' - Frame: Fire Stops,
Bracing, Bolta
I hereby acknowledge that I have r¢ad this Application Lath. Int. �
and state that the above is rnrrect and agree to comply Lath. Ext.
with all City Ordinances and State Laws regulating
building constructlon. -
Signatureoi :r � j �"�') � . Plaster,lnt.
Permittee � • �`� � `� �/i.� ; �i
, � � � • Plaster, Ext
Authorized Agt. Masonry Reintorced
Valuation �/� � ' Permit Fee $ � O � Bond Beam
60 P�an Check $
$/,� Gi8 8� Total � L� �Q FINAL
Fee O
. . �
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� Show locatlon`and• distances from . .'.b' _ . ' , � � �" ,
, property line and between buildings. , , ., _; ., ..
. _ , .. � i' .� . �
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CASTA' MESA BUILDING DEPARTMENT
^ _ ____" P.0-80X 31�.___"""
FOR APPLICANT TO FILL IN
...
�ss �%�,�.I�� �r� i� ��..
COSTP. MESA. CALIFORNIA
OWNER
YN
CIT�
iH EL
OR IP
�DRE55
TEL.
NO.
LIC.
NO.
i�
CITY LIC.
NO.
�-
�eca� �or r_K�-..�.
OESCRIPTION NO. C% BLOCK /TRACT
A.P. NO. � Q�' ���� jrJ
SIZE MO.OF BL�GB.O
OF LOT Q MOw ON LOT
USE OF
E%ISTING BLDG.
SETBNCK LINE FFOM �
CENiEA OF sieEEi O REAR YARD
SIDE YARD RIGHT � LEFT
DESCR�PTION OF WORK
NE ` A4TERATION ADDITION
REPAIR MOVING DEMOLISH
BUIIDING n NO.OF j
SIZE ` ROOMS � STORIES
E%TERIOR WALL C � ROOP � /
COVERING `.J COVERING
USE OF NEW 1�� __ J. .. ___ lr"�_.. � _
FEE j ECEI �ED
FINANCE DEPT. �
CITY OF COSTA MESA
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
- -. __.- -- - --'-'----- �
� � � r(�-zz -�
A��RE55 -/ / y ( ��� s-
COSTA MESA. CALIFORNIA
FIRE
ZONE
20N�1 / PL�NS /� tYPE � GROUPY - /
L� Lf� !
BYrG V V'l(i����' DATE / O �L
CORRECTIONS
CiTY O� �TA M�.��+
CL
. ' BLDG. DEPt. REG.
ECT "
. n _ ,. . �,
q�
STTTEEiHI.T TNEOABOVOE ESTCORRECT•FNDRAGNEE TIO COMPLY WIOiH ��� , U�)���f I
CITY ORDINFNCES RNO STPTE LAWS REGULATING BIIILUING CONSTPUC� �.�..�. .� � �-�� J�'f �/A �/ �'✓
iioN. VALUATION D
SIGNATURE OF �%�, --PERMIT FEE $ � O `
PERMITTEE `���� • t
� � 5 /� �OO " PLAN CHECK $ � � �
AUTMORIZED AGENT iL� TOTAL FEE $ �j � �iM�
. ' _,
CO$ E8A BUILDING DEPARTMENT
1H ,�2bth Street
6oata Mesa. CaliTornla
N° 472 c
` �.` . _
.
Date.........1'_6"""""•../ ..�'.•..�..._�_�...
CITV OF COSTA �ME9A
CER�IFICATE OF�OCCUPANCY % �
. ,, .
Building Permit No. ��.._..�'..Elec� �I ,P�rmiyNo........�!....JPIumbing``ermlt yo./�f�,.. �
�'" ' � � ' � ' ' . � � / p'%a. / � / � .
Use oi Buildina--._- ................:........................�........'..."'...:.................':r.'_'.�..r..... .
......."""""" """
The byl(dfng loc�ted
G- C r-,, 1 Q
. f y [' .
c
!See reverse side for Metes and Bounds) o
s been inspected and found to comply with t/he provlsions of all Ctty of Costa Mesa O�
dinances applicable thereto for a Group..__...�...f...........Occvpanc .
� � �^ )
ISSbED_yO : . ,/ • / / .
A. J. VOLZ
� x � J. ' ��� - f� ,(� � Gt Bulldin WFlCIaI �
� y g' .
...:.... _...... _.l ..."... _ ::........................:"'.'...... �.........
Owner of Buildin B '` y//!"` �_/l r"'_�lL:..
i . 9) Y:'r"'...._.........'.._.
CC: ❑ Original—Owner ❑�Sst copy—Gas Co. ❑ 2na copy�—Eaison Co. ❑ 3rd mpy—Flle
Form 206 GA 1M 14-68 �
�... .t
:�.✓.4 62`�9
COSTA MESA BUILDING DEPARTMENT
P.O. BOX 31�
COS7A MESA, CALIFORNIA
FOR APPLICANT TO FILL IN
BUILDING ' (� /,/ '� 'r'1' ,
ADDRE55 � UV
C05TA MESA. CALIFORNIA
MAIL
ADDRESS I L /J'��i
iI� ... TEL.
CITv �.ifi L NDi
A TEGT LIC.
O� �GINEER NO.
LEGfL LOT
OESCRIPiIo�u NO. O BLOCK T A
A.P. NO. � �/ d�
SIZE / �Jj NO.OF BLOGS. •
OF LOT ��(/ X% ��ow o�v �oi
USE OF , I
EXISTING BLDG. / 'L� T / /v
SETBRCK IINE FflOM
CENTEN OF STFEET REA RD
SIDE YARD EFT '
DESCRIPTION OF WORK
h_ .. ALTERATION qDDITION
REPAiR M�`/ING DEMOLISH
BUILDING NO.OF
SIZE ROOMS STORIES
E%TERIOR WALL AOOF
COVERING COVE
USE OF NEW.. _ ��� � �-�� n
ST�TE TH/�T
CITV OROINi
TION.
AUTHORIZED I
���
�F�.3 �j� �
� tlESA �
�Ec zo-s-rPD�ESA" 25a *�*�*Z.(1�
APPLICATION FOR PERMIT
BUILDING
FOR OFFICE USE ONLY
RECEIPT NO. PERMIT NO
�a a 9
RECEIVED BV D�TE MECE�vEO O�IE ISSUE
�,, Yu . /� �� _� � � a —a � -�
BUI lpl NG �
ADDFE55
COSTA MESA. CALIFORNIA
FIRE
G.—
APPROVED
CORRECTIONS
ciT•�� C.� CCSTA �„esn
L:ii:�',�!��l�l
` �
\�
CORRECT �NO AGXEE TO COMPLY WITM �LL
fE L�WS RECt� NG B IDING COrvSTRVC-
� VALUATION ��.-s�
,� PERMiT FEE �• V +�
5 _n wM.L� PLAN CHECK 5
�i!/(I i _
TOTAL FEE 8 _�J /� `9M`
��� : � i os�
♦
� .
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILOING
ADDRESS
OWNER %H�I/-T O/L CO,
MAIL _ _ _ _
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CITV UJwN�y
CONSTRUCTION
LENDER
BFANCH
ADDFESS
ARCHITECT . _
ADORESS /d-�
CONTHACTOR
ADDRESS (,yi
CITV�,✓p..�j
STATE
LIC. NO. ,2 �f�
SIZE
OF lOT
USE OF
LJ ��/j
TEL
NO.
TEL.
No.28'3 �
CITY i
LIC. NO. �
NO. OF BLDGS.
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
' �✓ ��/.9�,5•`l.2 u
�.CT. GAN e�„
u
o.0 Oi,�
1 heraby ecknowletlBe thet I hava reatl this eppliceHon antl state
that the above info�matlon Is correct entl agrae to comply with
all lews reguletinp bulldlnp conctructlon, entl I shell not employ
eny parson in vlolation of the workman's companmtion lews of
Me Sta<e of Californle.
1 heraby certify that 1 am properly Iicensatl as a conKactor under
the Smte ot Californie Business and Profass(ons Cotle, Dlvision 3,
Chaptar 9, antl that such Ileenses ere In full forca end effeci, or 1
am exempt from the DrOvisiy ns of the S� f Ce oani Busi
end Professione Co e; Div 5n 3, Ch��
SlBnature of G
Permlttee
Authorizetl Agant
JAN -9-76P�InOO ?_b6� ****4Fi.id
ca��
FORSTRUCTURALPERMIT
DATE R EIVED qTE I55 O
� � - fo '%�_ �
A.P. N /
BUILDING
ADDRESS
OWNER.Y.�i�
S
FIRE
ZONE T
APPROVED
ev
Z E NO.OF
� PLANS �
VAROS APPROVED
MAIN BUILDING
(FROM C/L STREET)
VAR.
BLOCK
VAROSAPPROVED
FT
&
�
�
n
m
o'
m
SQ. FT. a
THE AMOUNT SHOWN UNDER VALUATION IS FOR m
THE PURPOSE OF ESTABLISHING A PEFMIT FEE ONLV: �
VALUATION PERMIT FEE $ d
/^—�� � N
—a�/�/V m
PLAN CHECK E ^
0
$ TAX S �D LL
f
U
TOTALPAID E Q
�
` ' _ �1�62
� COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. 80X 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
BUILDING � � _)/
ADDRESS (/��
OWNER 7N���r ���- C(�'
MAIL
ADDpESS (ijD �O/2/-�'��C
TEL.
CITY DO�✓�v�_ NO. Z3 �J
CANSTRUC710N
LENDER
BRANCH --
ADDRESS ���
ORENGINEEFl N• � SOh'NFG'A NEL��j yJ
ADDRESS � 3 ,L� P—���a�n''q� T•�D✓,
CONTRACTOR [�CS'i��L
ADDRESS fp�3 j i� �/4/L�OdQ ,S'J�
TEL.
F CITV 1Nl>✓.$i/L'- NO. gj�s"7
� STATE CITV �
LIC.NO. �.�� 3� LIC.NO.
{a7 SI2E NO.OF BLOGS.
0. OF LOT NOW ON LOT Z
a USE OF
^ ExI5iING BLDG.
�
FSeparate permits are requ'ved for
,� electric, plumbing and heating work.
: USE OF BUIIDING AND WORK YO BE PERFOF7MED
Q
G
-� l�Ew c.9srt Roorr� o.e
¢
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� I heraby acknowled8a that I hava reatl ihis application antl state �
y� Mat the ebova Infarmallon is corYeei and eBree to eomply with m
a ell lews reBuleting builtling conftr�ction, and I ahell not employ
i
Z eny perwn In violatlon of Me wo�kman's compenaallon laws of v
� tha State of Californla. m
3 I hereby carilfy that 1 am proparly licancetl as a contractor untler S�. FT. �v
tha State of Celifornia Businau ond P�ofeulons Cotle, Divislon 3, THE AMOUNT SMOWN UNDEF VALUATION IS FOR m
Chepter 9, entl that such licenus era in full forca end effact, or I TME PURPO6E OF ESTABLISHING A PERMIT FEE ONLV: �
em azempt from th .provisians of the Stete of Callfornia Buslnass a
end PrOfasslan�C tle,�s� 3,i�ar 9�.-""�/� VALUATION PERMIT FEE $ N
� �� � m
1 ^ _ PLAN CHECK E ^�
Sipneturaof ` / I��^O o
Parmlttee � � $ � �y../v Tqx g '� LL
�
U
Authorized ABent TOTAL PAI D § �
�nN -�-�r,P"-1000 2s5 33.5D
LM$f 7 A*4ir
FORSTRUCTURALPERMIT
BUILDING
ADORESS
ROVE
�E NO.OF
� PLAKS
VARDS APPROVED
DISTANCE BET
MAIN BLDCS.
VAR. �9`..� i
LOT70� BLOCK
L
, t VAW$
R
i �
GROUP /,
DATE � 1 � L �
USE OF NEW �/
BUILDING
VARDSAPPROVED I ` •
ACCESSORV BVILDING
"��'"
FT.
F . �Ct
FT.
l��r.
BET. MAIN &
ACCFSS. BLOGS.
�o°'oTen�.�,. �il � 'J/ �
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COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORN�A 92626
For Applicant to Fill in Completely — Use Ink Only
ADDRESS �q'� �j(J' 1 � � ��
OWNER �rf,�jQ�F'rY �IL �
�-
MAII.
ADDRESS
TEL.
CITV NO.
BRANCH
ARCHITECT
OR ENGINEER
ADDRESS
CONTRACTOR � C
ADDRESS
CITV
STATE
�I0. NO.
SIZE
OF LOT
TEL.
TEL.
NO.
CITV /
LIC. NO.
NO.OF BLDG4
NOW ON LOT
Separate permits are required for
electric, plumbing and heating work.
USE OF BUILDING AND WOPK TO BE PERFORMED
I hereby acknowladge that I hova raetl this applicetion antl stete
thet tha ebave Informetlon Ia corract entl egrae ta comply with
all lews reguleting builtlinp eonatruetlon, and I shall not employ
eny person In violeSion Ot Ma workman'e compansatlon lewe of
Me Stata Of California.
1 haraby certify thei I am propo�ly Ilcanaetl as a contracior untler
tha Siate of Celifornla Businass antl Profeaslons Cotla, Dlvialon 3,
Chapier 9, entl that sueh Iicansos aro In tult forca ontl affect, or I
em exampt from tha prpv7aio of tha S alHornP � elness
entl Pratassions Cod �Divi 3, Ch tor 9.
SIB�etura o�
Parmittee �
Authorized ABant
JAH-9-76PatuOO 264,� ****.+
CHSL 6.51
FORSTRUCTURALPERMIT
DATE RECENED D�TEJ�SUE9�� �
G/ %
—ri���
9UILDING
ADDRESS
�
ED
�T N�. �
, �
BLOCK
1E � IPLANS�fI BUILDIN�� �'� �
� f�
VARDSAPPqOVED VARDSAPPROVED
REAR FT
DISTANCE BET.
&
�[
N
m
i
V
m
SQ. FT. N
THE AMOUNTSHOWN UNDEF VALUATION IS FOR m
THE GURPOSE OF ES'fABLISHING A �ERMIT FEE ONLV: �
VALUATION PERMIT FEE S a
u�
I m
�(r pL,qN CHECK E "�
0
5 � � LL
TAX E � f
U
TOTAL PAI D . E
� .
. • .� � 131.`�
� ' COSTA MESA BUILDING•SAFETY DEPARTMENT
P.O. BOX 12� COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completegly�— Usc Ink Only
BUILDING � �� /�/i /C}'���
ADDRESS ui ! r
OWNER r � ,, �i � '
ADDRESS �6d S^L� Ft ( �/( �yL �
y�� TEI.
CITV !/A/�f1/A'P l/ NO.�Li
BRANCN j �—
ADDRESS I
7EL.
G G/Z � � f �i'I � S
"ov:.-, a. L�z �
fF.819-76P�i�OO 760�+ �`**rt30.50
CMSF
APPLICATION FOR STRUCTURAL PERMIT
REC VE 8Y O TE R CEIV DATE I55 E�
� �/
PE 1 �
A.P. NO. I I � O
BUILDING N/� /� c /
ADDRESS •/r/� �� � % � (]� j
^_
�/Y�
"� �
��
M
�
p^�- /p�� ZON NO.OF SE OF NEW
CITV IL� ��T O r .f�/' � N� �GO/ GYI PLA BUI DING
F STATE: qTY �'ARD APPROV ARDS OVED
� LIC. N�O. 3 �(� G• ��C. NO. MAIN BUILDI CES50 BUILDING
W 512E � NO.OF BLDGS (FROM C/L S
d OF LQT NOW ON LOT M FT.
a USE �OG
.,y. EXIS,fINt3 BLDG.
y —
� ' Separate permits aro required for � s FT ' F
Q electric, plumbing and heating work.
REA F .
VS:E OF BUILDING AND WORK TO BE PERFORMED DISTANCE B BEf. MA1 � I
� MAIN eLDGS. ACCES�. BLOGS.
a !� /7 ST ` /��L,!/� P� l��L C I VAR. qw DATE
�� �
I
; � n �.�.P.* APPROVED
} l� �� �i v� ���o��� ,:�� APPROVED a _
a I �'b cQ efs , e � ��
� "
Q1 ha�aby neknowletlps that 1 hnvo raed thlt nOV���atlan antl Rafe . C
4 Mat the ebova Informetlon b eorroet entl epree W comply wk� m
ell lawe repulailnp bullCinO eonqaueUoq anC 1 s�ell not �mplov . �
z any person In vlolatlOn of MO viorkmen't eampen+etiOn lews of
ZMa Snte of Celifornle, m
3 1 haraby certify shat I am properly IlcansaA e� e cnntrectar �ntlar SQ. FT. ti
Me Stete ot Calitornla Buain�o antl Prolmion� CaCa, Dlvislon 3, TME AMOUNT SMOWN UNDER VALUATION IS FOR p�p
ChapMr 9, anE thet aueh Iieanraf are in full forea anE 9Heet, or I TNE NRPOSE OF ESTABLISHING A PERMIT FEE ONLV: �
em axampt from the provi�lons c�f tha Stem af Cellfornle Bu�lnau ' O e
antl Profeulon� Cotla, Dlvislon 3, Chap r 9. VALUATION PERMIT FEE E ,�
Slpneture of �� PLAN CHECK S � D a o
Permlrtee � $ 2oOO TAX 3 O f
� U
Aut�orizad Apant TO7AL PAID 5 � 0
s
� � ' 4132a
COSTA MESA BUILDING-SAFETV DEPARTMEN
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92826
Fox Applicant to Fill in Completely — Use Ink Only
ADDqESS / / �� / / S' 1
OWNBR �� ^ � O �L ( Q .
MA I L b6 7�' G', �/ Z�./iC C
ADORESS p ( ��
TEL.q/� �
CITY ��/ /i}/ {�J � (% NO. //�.
P
ADDRESS
ARCMITECT
PAi� 30.50
rE819-76cHsr�O 761++ **'�*
APPLICATION FOR STRUCTURAL PERMIT ^�
REC�IYEDBV OATE9ECEIYED nnrcwcimn 1 �
A.P. NO.I I i�� F�� �
BUILDING �/]/j I/�.
ADDFESS f./'•�
ADDRESS �O ���� � •
TEL. ,y� ZO t NO.OF USE OF NE
aTv' [ r' ' p N� No. L6/ai/ ` FI.AKS BUILDIN
�-F. STATE / CITV VAHDSAPPROVED VAFDSAG OVi
� IIC.NO. �$ �j(� IIC.NO. MAINBUILDING ACCESSOFVBUIL
{p 512E NO.OF BLD6S, (FROM C1lSTREET)
�. OF LOT NOW pN LOT FT. T. /
a USE OF r//
,N., ExISTING 6LDG. F •I
y
FSeparate permiu aro requ'ued for 5 FT.
Q electric, plumbing and heating work. REAA FT. T.
� USE OF BVILDING AND WOAK TO BE PERFORMED
� DISTANCE BET. BEf. MAIN 8i
` Q MAIN BLDGS. ACC6S BLDGS.
Qy I '� F O� � Gr1'J CURP.� �ROVED
� APPROVED
r—
.a
a
w
QI herabV ecknowl�tlpa thet 1 heva �aetl this eppllcetlon entl stats
a Met tho ebove Informetion Is torrect entl epra� to comply wIM
a all law� reowetioa e�ueinp <oos�r��tioo, a�a i.n,u not amDloy
z eny parwn In violetlon of Me workmen'� companption lewi of
�T Me Stata of Celifomle.
3 1 nereevi certit t�at 1 am 54. FT.
y prapa�ly Iicantetl es s contractor unCv
the Sute of Celifornle Bu�in�n entl Profwsiona Cotla, Divlslon 3, THE AMOUNT SHOWN UNDER VAIUATION
C�apta� g, entl thet weh Ilcenm� ars In full forea enE aNact, or I THE PURPOSE Of ESTABLSHING A PERMR FEE
em saampt from tha proritlo�s of Ma Stete ot Celifornia Bu�inan VALUATION PERMIT FEE S
antl PrOfouion/s C}otla, Divi�lon 3, Chepn 9.
Slpnetu�a of/� �- PLAN CHECK S
Parmlttaa /N'�!%���Pa���6t� S 2 Q�(� TAX 3
Aut�orizatl Apant TOTAL PAID { Q
�
C
m
i
m
N
IR m
/: "
e
N
m
n
0
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,� ' � ' 4133{�
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely — Use Ink Only
, BUILDING � �.��. ,_ _ . �, _ . �
OWNER
MAIL
ADDRE
CITV
BRANCH
ADDRESS
ARCHITECT
CONTRACTOR
ADDRESS
CITV
F STATE
LIC. NO. �
� SIZE
C� OF LOT
a USE OF
i.�. EXI5TING BLDG.
N
TEL.
NO.
TE L.
NO. �
CITY �
LIC. N
NO.O BLDG
NOW ON LOT
F Separa[e permits are required for
0 electric, plumbing and heating work.
� VSE OF BUILOING AND WORK TO BE PERFORMED
�_ F
a
a ��--
Q
' � �
.r-1
PL
W
P.
�EB 24-76cnsa0� 893= *'�*wt�J.Sf
APPLICATION FOR STRUCTURAL PERMIT
FECE ,B DATE RECEIVED pq��SS` �
�y PERMI NO.
A.P. NO. �O-1 I� Z
BUIIDING �19 - � '�' J �
ADORESS � � �,.
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() I hereby acknowletlBe that I hpva reatl this appllcotion end stata �
(�' that the ebove Informatlon ia correct end aprea to comply wlth m
0. all lews reBuletlnB builtling conrtruetion, antl I�hall not employ
i
WanV perwn In violatlon of Me workman's compensetion lews of m
,� the Stata of Celifornia. m
� I hareby certify ihai 1 am prope�ly Ilcensetl es a contrecmr untler SQ. FT. �+
the Siate af Californle Business antl Professionz Cotle, Dlvislon 3, THE AMOVNT SHOWN UNDER VALUATION IS FOF m
Chapter 9, antl that suc� Iicanses era In f�ll force end efteet, or I THE PURPOSE OF ESiABLISHING A PERMIT E ONLV: e
am axempt from the ovisions the Stat of Callfornie Buclness a
antlProtessiOnsCo Olvislo ,Chapt VAlUAT10N PERMITFEE $ �Q N
Sipnature of PLAN CHECK $ �� ^
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Permlttee ' S�� � TAX $ LJ Q �
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Authorized Agent TOTAL PAID E ��