HomeMy WebLinkAbout835 19TH ST - Building Permitsr,
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CITY OF iK1STA MESA �
CONSTRUCTION PERMIT
Address
Addr¢ss
(ill in all.sp+
jt61T'NO�
_''''�
; f Phon
Licenu No.
..
!s within heavy Cortler hnes anU sign all apOroOriate Eeclardtions. ,
,-_}- ) � . TRACT NO. LOT�NO. -BLDG:'NO. ;
,,�av
' � • ' TVPE OF CO STRUCTION - � � � - �
!.,3 ��e',l�'J ❑ NEW _�A�D . ❑ ALTERATION
_ ❑ REPAI CONVERSION ODEMOLISH.
❑ OTHER } ~
DESCRIPjION�OF ORK �� �%
. . . a. - �{t: n.!7—�% 7T
Contmctor � . � -L...<JC.: { • k1 rnone�� TC7 %��' ' TVPE OF PE(iMIL ' " , .. � . ,.- . -
, Address ' J j+ ' '�j�,...e �3' � '��GHADING�- ❑ FOUNDHTION ❑STRUCTVRAI
UCENSED CONTRACTOR DECCARATION - .❑ TENANT ELECTRICAL ❑PLUMBING- ❑MECHAN
.I hereby attirm lh:.t I am IlcenseE unaer orovislons ot Ctiarter 9 �com- .�'..
mencing wllh snctlon 7000) of Dlvision 3 ot .the Business antl ❑ OTMER
Prorasslons Coa antl y Iicense is In' (uu torce p^d et ect. � pROJECT DESCRIPTION
Licens Class �• '�� �ense'f�^ '� ��% - ' ' - '� �
�Date �C'� � � 519nature � -f'��-^�-J'�%� 5Q. FT. � . . . , �
WORKERS'COMPENSATIONDECLARATION OCCUPHNCY -_CONSTRVCTIONTVPE
I hereby altirm that I havc a certiflcata of tonsen[ to selfansure or a VqLUATION ' ZONE
�cerHliwte ot Work¢rs' CompSnution Iniurdnce, Or d.CGrtIfleO copy _ � . . . _. . . , .
�^nraol (So< n 800, b �/� n ne GRADINGCU. YDS. ACRES
:Y No.- � L�' ' 'ld�i�C�mDanY i� l ��AZ fL'API '/ /�' � ' _
.:ertifleticopylsherebyfurniihetl. M � � (JA{� , . REMARKS: �
y��y0. Cnrtl/ietl copy is filetl with Ihe city Builtling Divli on.
£XEMPTION FROM WORKER$' COMPENSFTION DECLARATION '- � - � �- ' ' �
(ThiS SCCtion nBltl not Oe cOmpleted It Ihe permit is fOr On! huntlrGtl - � -
S§100) or'lessl. � � .' - ' - - " '
certily that ln the pertormanta of tha work tor which this permit Is
issuetl, I snall not amPloy any perSon in'any manner so as to become ' PLUMBING'-' '' ' PLAN'CHECK �
5ubject to the Workers Compensa[lon Laws o( Cali(omia. '
DdtG SlgndtuR gATHTUB$ $HOWER$'
NOTICE: 1! afler making Inis CaclEration, you sboWa betome zuDject � TOILETS. - URINALS' -
to th¢ WOrk<r5' COmpGnSdtiOn proviilOns o/ th¢ Ldbof COCe, you must �
forthwltRcomply wllh tuch provislonz or tNs permit s�all be tleemetl �VATORIES ' ' DOUBLE LAVS'^ .
�evOketl.
CONST0.UCTIONLENOINGAGENCV - -KIT.SINKS ' D�SHWASHER$ -
1 heroby atfirm Ihat thcrc is a ConStruttion lentling agenCy for the per- SERVIGE SINKS � SUMPS -' '
fo�mance o� tne wo�k t0/ which IhiS p¢rmit i5 IssueU ($eclmn 309]
Civ. C.).. � - � - - . - - • - - - - � FLOOR SINK$ ' 'FLOOR DRAINS ' '
'Lentler's Name
�Lender's Atltlrest � " " -' - " DRINKING FOVNTAINS '� "' '
OWNER BVILOER OECIARATION -- - - - - ' -'WTERCEPTORS "' ' CCARIFIERS � - ' � ' -
I �¢roby af�irm lhat I am ¢z¢mpt from th¢ Con[ractor's License law for
Ihe„iollowin9 reason (Saclion 7031.5 Bvsinezs.an0 Profes5ions.,Cotle: -SWIMMING POOL' --P�TRAP • •
Any dry or county w�ich repuirez a permit fo consVuct, alter, �
Improve, Eemolish or-repair any stru<cure, prior to•ics izsuance, alm.re-. �. WaTER•SERVICE' '"ALTERATION'-' � -
qWres the a0. ����� for such permit to tila a si9netl statement that he
Is Ilcrosetl �pursuant to theqrovisions of the ConVactor's License Law - GAS SERVICE" "" �- -OUTLETS' ." -'s '
(Chapter 9(commencing with Seaion ]000) of Division 3 of the
B��ilnessantlR'o(es5ion5•Cotle�o�that�heis¢xemptth¢r¢iromantltne- -yyqTER'HEATER$- ' 'BTUOUTPUT`
' for the alleqetl exemp[ion. Any violation ot Section 7031.5 by
appliwnt for .a �parmic sublec(s tne� aOP����t to�a-Uvil-ce���Y- -SEWER-CONNECTIONS' ' � ' -- -
.rot more than five nuntlrea tlollars (y500). ��
❑ I, az owner of the�property, or my employees with wages as•their SOL'AR TANK' - � C06CECTORS •
solo compensation, will tlo tne work, antl lhe structure is nol intentletl
or olleretl tor sale. (Section 7�46', Business antl Aofessions'Cotle: The' 'SOLAR PIPING SVS. - "' '" ' ' - -
ConlrattOr'S LlcenSe Law tloez nOt apply to an owne� ot a property
wno��builtls-or improves theraon, anU wno aoes zuch work him5elt or - ISSUE FEE� `'-" �.' -" -" -'-
lhrough nls own employees, provitletl that such improvements are not
Inlentletl or ofleretl' fOr 5ale. Ii, hOwev¢q tne DUI1Cin9 or Improvement' MECHANICAL PLAN CHECK
Is soltl within one year oi completlon, the owner wlll have Ihe burEen
of proving he tlitl �not bulltl or improve'for�the' purpose of sale):' HEATING SVSTEM 0-100,000 BTU
❑. I, as owner ot the .property, am exclusively mn[racling, with qND�DUCTING -� � - -
Iicensetl conlractors to construct the project (Sectlon 7046, Business 100,000+BTU
antl Proteisions Cotle: The Contractor'i Llcense.Law tloep no[ apply to
an owner ol' property who builtli or Improves Ihereon, antl who con- REFRIGERATION 0-300,000 BTU
tracts Irom such Oro�e[ts,with a contractor(s) Ilcesnetl pursuant,[o. SVSTEM-
lhe Contractor4 Ucense Law). 300,000�+ BTU � � �
❑ I'am exompl untler Sectian �- B. S�P. C. (ort�is "BOILERS �� BTV � �
reason
DatC Owner SVSTEMREPAIR,ALTERATION '
I'hBrebyce�Ufy�hJllhaverCatllhlSappliWtionanEstatethallheabove EXHAVSTSYSTEM MVLTIPLE '
inbrmation� is corrott. �1 a9rcc to comply wHn all clty antl� county ,�
ortlinancos antl sta laws r iating to construction, antl hereby authOriEe
rapresentativos � 15 y'to"eN Cr �upon iM1e above� mentioned �
property for ns �i ur0.oses/ .,
519nutura � n�1$�7g'�'�' - Date��� , i� . . - . . ,
Drivers'-Licansn or 55 g^ � ��� � ' - ISSUE FEE� • - - . . . . . _
CMF 0865�46 White-Bulltllnq; Canary-Appllwnh Pink-Attountin9; Goltlenrotl-AsteSsor
' 9649 10/22/62
A.P. � - . . ..-.
ZONE PLNG. REF.;g"
REAR VARD (TO P/L)
PKG.SPACE REQ. � • PROVIDED "
STREET WIDTH PARK FEE b
BV f DATE , _
SPECIALCONDITIONS: - �
. . . . ���
re�a��ui�necrun��R�
GENERATOR - 0•1 KW_ 1-10 KW
TRANSFORMER . ' �
APPLIHNCE 10-50 KW_50�+ KW -
�MOTORS � 0-1'HP_1-lOHP ' '
�(INC.SOLAR�• 30-50HP -50*�HP-� -
•FIXTURES- OVTLETS �SWiTCHES
GAS'TUBE SIGN$" ' � :
VOL'E LIGHT$ -' ' " ' - �
POLES METEREO SUB
�PANELS' ' MAW' SUB - - -
'SERVICE � -^ . AMP---- -
_/' _ ' ' _ ._' _ " �. .. . . ..-. - . _
✓ '" " ` _ `i _ c �
ISSUE FEE - - - - - ✓ ✓ .:
APPLICATION %�PPROVED BV ' DHTFJ 9
G�
P SUMMARV OF FEES � � �
• BUILDING � � -- � - '�
PERMIT 5 SMIP •E
PLAN CHECK E PERMIT' �
- - ISSUANCE- f�
PLUMBING E - '
PLANCHECK E GRAOING_.5.
�ELECTRICAL 5� ' S ,�
PLANCNECK-S � MICROFIlN�S.'
MECNANICHL E'" T�TAL FEE S. - ,
PLAN CMECK �E 'LE55 AD- • � . � ,
'VANC[PC E'_____
.. _r v .' . .,
_ �� FINALFEE 5_[L_�
qvVlicant to till in all soaces within heavy Gortler lines antl sign all apvrovriate aeclaralions.
CITY, C�STA MESA ' ae IT NO. j/ TRACT NO. LOT NO. BLDG. NO.-
CON��RUCTION PERMIT � �o� �y �� _
Project Address y� � � � ' � XJ''. �J�: . - " .TVPE OP C�O/NSTRUCTION.
OWnef Q , �^� `�� J� Phone .,?�-� 'y�j ❑ NEW '[yADD . ❑�ALTERATION'i"
AddfCss �t^� �J � • ❑ REPAIR ❑'CONVERSION..ODEMOLISH
'Arch�Eng. � - - '- License No. ❑ OTHER ' � � �n
DESCf31PTION OF WORK -� �� �� �i
Address - � ' ' -' -- - ' ' '-- ' -
Contrector � /�'r v'-�✓� j ✓ sy Phoner�j�'G�,� TVPE OF PERMIT:' ' . � "-' . . ` .. �
Addresi ' 7� �C�. �, ,;. . '
�n � C• I� ❑ GRADING�,..,r' O FOVNDATION-. O-STRUCTURAC
iICENSED CONTRACTOR OECLARATION O TENANT ��g ELECTRICAL OPLVMBING ❑MECHANI(
1 hErtDy atfirm lhnt I am liGensltl untler provi5ion5 ot Chdrter 9(Com- � -/•�. . •
manting with sectlon � 7000) of Division 3 of the Business antl ❑ OTHER
Professions Cotle antl my Iitense iz in full force a�C effa pROJECT�DESCRIPTION. _ '
Licansgg....��la s r � � ^ Li nse N � 'i `� � � ' -
Date�'Si9nature � -� � �-�!" � -'✓ 54. FT. , _ ,
WORKEFS'-COMPENSATIONDECLARATION OCCUPANCV=CONSTRUCTIONTVPE _
1 nereby affirm that I have a certificate of consent to sel(-insure or a VALUATION - ZONE
certlTlwte of Workers' Compensatlon Ins rance, or. a certitietl coOY �-� - �- �
thereof ($a I�� 38�� C � GRADING CU. VDS. ACRES
• .ry NO(�_� mpany - "
.ertlfietl copy is hareby urnishetl. __ (��'u,/9L� REMARKS: � . . ' _ _ _ .
}n,Certitletl copy is tiletl with the clty Builtling Di �sion. '
EXEMPTION FROM WORKERS' COMPENSATION UECL'ARATION' ' "-' " ' ' ' ' ' ' -
(This sectlon neetl not De comple[etl It the permit Iz for one huntlretl _ � ,
SE100) or lessl. � . ' . _ ., "_ . ' . . . . "': ' "
certify that in [�e per(ormance of the work for which this peimit is
Isivatl, 1 shall not employ any person in any manner so as [o become PLUMBING ��,� �. '_ PCAN'CHECK �'
SuDjGCt f0 thG WOfkGlS' COTpCnsdtiOn Ldws o( UII(oTid.'� ' ' '" '
Date Signature ` BATHTUBS ' � SHOWERS - '
NOTICE: If after making this tleclaration, you shoultl become subject� TOILETS , - URINACS " - "
to the WOrk¢r5' Compinsation proviSiOns of the Labor Cotle, you must � �
forthwith comply wilh such provi5ions or this permit 5hall be tleemetl LAVATORIES DOUBLE L'AVS '� •
f¢vOkttl. � ��
CONSTNUCTION LENDING AGENCY ' ' - --KIT:SINKS' bI5F/WA5HER5 �' ' ' '
I hereby aftirm [hat tnere is a construction lentling aqency tor the per- SERVICE SINKS -- SUMPS '' '' '
formance ot tne work lor which tbis permit.is issuetl (SecHon 3097 '
CIvrCJ. ' ' ' ' ' - ' ' ' FLOOR SINKS � -FLOOR DRAINS �
LenOer's Name
Lentler's AtltlrMs -�DRINKING FOUNTAINS` .- ' = '" -
OWNER BUILDER DECLARATION ' ' INTERCEPTORS �� CLARIFIERS � "
I her0by affirm [hat I am exempt trom the Contractor's license Law for '
the following raason'�Section-]031�.5 Business ana Professions Cotle: � SWIMMING'POOC' "'-PTRAP ^` -"' '"
Any Nty Or COunty whith require5 a permit to const�uct, alt¢�,
improve, demolish or repairany structure, prior to its Issuance, also re- yyqTER SERVICE - 'AL'TERATION '
quir¢s the ap�.licant fOr suGh permit to (ile a signetl statement that he �•
Iz II<ensetl pursuant to th¢ provisions ot the Contractor's License �Law GAS SERV ICE � � -�OUTLETS �- �- '
ICnap(er 9(commentlng with Section 7000) oL.Division 3 ot the -_
Bus��fordthe al�getl exempHon.�Any�violation oP�Se<tioo� �31S�by WATER HEATERS 'BTU�OVTPUT
appllfanDfo� a permit subjetfs the applicant to a-tivil penal[y SEWERCONNECTIONS-'"'.'�' '� '"
ot mor¢ Ihan fivu huntlretl tlollar5 (§500).
LJ I, as owner ol-tbe-property, or my employees witb wages as [heir SOLAft TANK '-" -"COLLECTORS ' � '-
sole tompensalion, will tlo the work, antl the structure is no[ intentletl
or offered tor zale. (Section ]044, Business�antl Professions Cotle: The SOLAR PIPING SVS. � � �- � � -' '
Con[�actOr'S UcCnsC Law-tloes not apply�to an owner of a property
who builtl5 or improve5 thereon, antl who tloes suth work him5elt or - ISSUE FEE � � ' ' �''�
througn his own employees, provitletl tbat such improvemen(s are not
intentletl or ofleretl for sale. If,-however, the builtling or improvemenl MECHANICAL PLAN CHECK
is soltl within one year of completion, the owner will have the burtlen
o( proving he tlitl not builtl or'improve for the purpose of sale). HEATING SVSTEM 0-300,000 BTU
� 1; as- owner ot lhe-property, am exclusivery contracting with AND DVCTING ' '-- '- - -
IICenSetl COn[rdClOrs l0 mnTlruCl Ihe pfOj¢Ct ($eGilOn 7044, Bu51ne55 100,000�+gTU
antl-Professions Cotle: The Contractor's License Law tloes not apply to
an owner of property who builtls or Improves thereon, antl who con- REFRIGERATION 0-100,000 BTU � 1
tracts from such projecls with a contractor(5). licesnetl pursuant to SVSTEM �
Ihe Contractor'S Ucense Law). _ _ . 300,000 � BTU
❑ I am exempt unUer Section ' - ' B. 6 P:'C. (or this BOILERS BTV ��
reason
Ddte Owne� SVSTEMREPAIR,ALTERATION
1 herCbycertifythat I have reatl tbis application antl ztate that l�e above EXHAUST SVSTEM MULTIPIE
InformatiOn'is conecL 1 gree to comply'wi[n-all city antl county'
ortlinance5 antl state lawz lating to nstrucYon, antl hereby authorize
/Opr¢5¢ntatives�Q f hi5/ y� t0 ¢n r up ' th¢ d�Ove mentioned .-
Droperty to�/({b�ti purposes! � '
Slgnature � � � �
/'���' ISSUE�FEE - �. � _ -
CMF 0865-46 Whi[e-Builtling; Canary-Applicant; Pink-Accounting; Goltlenrotl-Assessor '
A.P. $
ZONE
9426 10/2G192"'
VING REGU�ATIOhS..
PLNTGQ. �RUEF. yt
' 7ROPE�RTVN INI
PKG. SPP.CE (3EQ.
STREET WIDTH
ZONING APPqOVED BY
SPECIAL CONDITIONS:
13e50 TL
- '1
�
PROVIDED . '
PARKFEE$ '
DATE . , '
,,.._,... . . I '
VWCLLIIVIi - - -
SO. FT.
GENERATOR 0-1 KW=1-30 KW
TRANSFORMER _ _� .
APPLIANCE 10-50 KW_50+'KW _
.MOTORS- 0-1'H� -I'-IOHP'" -
(INC.SOLAR). �0-SOHP_SO+HP - �-�
FIXTURES OUTLETS" SWITCFIES -
GAS TUBE SIGNS - "' '
'POCE LIGHTS ' - ` ' -' ' -
POI FG MFTFRFII V IR � ' . �
PANELS' �'- - MAIN
SERVICE � ' ,'fjf '�
_ ._ "�_
ISSVE FEE -'
' �SVB,
j�? ��AMP "-
r. � , v� .
'�APPLICATIONAPPROVEDBV- OHTE(�j�
SUMMARYOFFEES � , . �
BUILDING - - � � - --
PERMIT E _ � SMIP,' � : §;_�_ �
'PLAN CHECK $ 'PERMIT� • �� .-
- - --- - � ISSUANCE $ -
PLUMBING E ' ^
' GRADING E. �
PLAN CHECK E ��
;ELECTRICAL Sl+Z:= ' � ' E '
PLAN CHECK'-S - - MICROFlLM b
MECHANICHL'E ' �TOTAL FEE b _ .
PLAN CHECK § ' � L'E55 AD- • �
VANCEPC S_
{ . , �s
_ FINALFEE S..LC�
CONSTRUCTION AND PLANNING( u POOL & SPA, . `''�-
.;�
APPROVALS Permit# 'L�S��I Date Inspector ,ppPROVALS � �� Permit#' � Date� ,Inspector:
1. Temporary Electrical Service or Pole -1-' � - 43. Pool & Equipment Location"'" - ` - - - " - --- " "-'
i ipe- n rgrn � � � 44. Steel Reinforcement � - - ' ' ' '
3. Elec[rical Conduit Utility-Undrgrn .. 45. Forms � - -
4. Electrical Conduit-Undrgm � ' . 46. Elec[rical Bondin - - - - --
. tee em orce 47. Rou h Plumbin & PressureTest -- -� � -`
6. Electrical UFER Gm 48. APRROVALTO COVER-GUNITE - - '- -•
7. Footings - 49. Electrical ConduibUndr m � �'
8. Foundation ' ' 50. Gas Pi ,❑ Undr rn� Test
9.. Water Pipe-Undrgrn ' 51. Backwash Lines P-Tre - � ndr"�n ""-' '-
10. Structurel Floor System � ' 52. APPROVALTO DECK � � -�-- � � ��" `
11. Property Sewer Line & House Connec[ion '- - 53. Backwash & Rece tor-Final �' - '
12. Street Sewer Connection ' - � 54: Heater & Vent-Final ' .
13. Rough Plumbing . .. _ .. . -_-..- .---.._. _ �' _: -.'. . � �'. . .
14. Rough ElectricConduit � - - - �56. Electrical-Final - ' '
15. Rough Electric-Wirin - - - - -- - �- - - - 57. So�ar SYstem-Final - � ' � � �
16. Rough Heating & Air Conditioning - - � - - - - • encing &.Access Approval ' •
17. Ducts in Structure - ' ' APPROVED FOR PLASTERING
18. Ducts, Ventilating .. � ' � � � . _ � . � _ _ •
19. Gas Pipe-Rough &Test 60. POOL/SPA SYSTEMS FINAL'
�20. Roof Framiog . " . ' - " �
21. =Roof Sheaffiin "' ' - - ' , ,
22. Frame and Flashin NOTES: '
23. Insulation � � - . . '
24. Lathin & Siding ' - - - -
25. Drywall Nailing ; �
-26.� Plaster Brown-Coat � ' - - ' � � � � � � �
- 27. � Electrical Power-Meter-Fi�al :' . .•�.. - .. j-.,23- b`� ' � .. . _ . .� . . .
. . .. . .._ ...... .
-28: rFinal�Electric - � � � ' ' � " � -
29: Final Heating&-Ait-Coqditioning - - �� ' � �
30: Final�Gas Rpe-Test - . _ . , ' - � � " � - ' � -
- 31. Final Plumbing -_ . ` " ' '
� 32: -Water Service-Final _ '- ' . - - - - - _ ' . •
' :33:: Gas Service-Fina6� � � - ` �
. 34. Solar pomestic-Final �' � • � - ? ' ' '� " ' ' ' ' � �
. 35. Landsca S rinklin S stem " '' �
36. Sound Attenuation *� i ` ' ' � ' � �' '' , ' . - . - , �
37. Handicap Regulations � • � • ` ' ' '
; 38. FINALSTRUCTURE&BUILDING � ••�• - - � ��
, 39. Special Requirements Completed' - " � �� � �
40. Electric Release to Edison ' " ' ! " � ' � �
' 41. Gas Release to Southern Califomia Gas Co. � � � ' - ' -„
� 42. CERTIFICATEOFOCCUPANCY _ _. ' � ',," ��`.. •
No - Date �i'-' --- -- _ _ ,
��.. , . .. .�
CITV OF COSTA MESA
CONSTRUCTION PERMIT
ADGlieant lo till in all spaeas excevt those within �eary OorCer Iinas anG il9n ail aoorooriate aeelarotlons.
- - . � a50-�. Bi�ai�,:;•
, PERMIT NO._ 1 ' TRACT NO. ^ ! l0T NO. BL . . � �
. .. _ .gyl3 � � ' •�-N��� �,�.7�gy ,.
Applicarit's Mailing Address � � S � � V ri i r P R 1 v A. T _ A_ C a� : TypE OF CONSTRUCTION � rIEW �� ADD ALTERATION REPAI R .�' < < ` �
R S fi ) ' Y �.j, ❑ CONVERSION ❑ DEMOLISH ❑ OTHER � _ _ - . � ,-
Pro�eet Address 3 ti 9-t-t�S , C o s t a e s� . _ - .
Owner'sNama Felipe�Corrado vhone � . DESCRIPTIONOFWORK ,
AddfBSs� g3S W� 1 -9th :St. .Costa M058 ' . n.pEOFPERMIT �' GRAOING - FOVNDATIOpN�' STRUCTURAL .
A�rch/Eng.� � _ LIC2n5BN0.; ' ❑ TENANT ❑ ELECTRICAL ❑•PLUMBINO y� MECNANICAL � .
AddfBu r , , J � ❑ �OTHER ' � ' � - �
Contiector'sNam�efriReration EquipcaRp� C� `PRQIECTDESCRIPTION S�.F7. � ' • , �'- OccuvqNCv �
Addreu�meiling) z251- Venice iBlvd.� - 1�1�-0123 �ONSTRUCTIONTVPE • '� �`VALUATION$' �
1 • % 20N� � GRADINGCU.YDS. ACRES
� eozeNo: 440766� � �
GCENSED CONTRACTOR DECLAHATION � Ramarkt: � ' � . .
I.�ereby affirm thab 1 am II<ense0 untler provlsions ot C�arler 9(commencin9 , � �' ! �
with'sactlon 7000) 01 DlviSion 3 ot the Businass anG Pro/essions Gotla, antl . I�" ' ' �
my Ilcense Is In tull forca antl eftect. ' '
19cense Cleu' ' Ucenm No� ' , � � " PLUMBING ; - i
Date ' ' Si9nature %'� ' )��`'��J��1�+�'� � � I
WORKERS' COMPENSATION DECLARAT OI N" � - Be� SMk '_ �ew�� C�P
�araby:af/irm.thaLl.have a.certiticate of..CAnSenLto SelHnsuie or.a.certiflrate . • �- gackflow Praventer' -�^ �-- � - � �SONRr�ConnECtion- - � - -
Warkars' Compensatlon Insuranca,�ar a cetitiptllco y thereot (Section - "' ,
..ao, uc. c.� . ' R e� r i g e� a L I OII i : g�kflow Irrigation Soler Collectors
POIicY No. '�1 � �4 CampanY Q��� � � ^ " " ' -- ,
❑ Certlfletl coDY �z nereby fumishatl. ' ' �.✓1P� Bathtubs , � $olef Piping � � �
�1 Certl/teC Gopy,iZtlled with she tl.Y Yuiltlin9 D^ o n.. ^ i v� �_ �_, 1 , 7 .
A/ 1?S / 75 S 1..(/ � Clerifiers � So�ar Tenk �
El(EMPTION�FROMWORKERS'COMVENSAT�ON�DECLARATICNI i
(This 5ection neetl not be mmplatetl if ihe parmil iz for�one huntlretl (E100), or �
less)t � .
I tartify that in the per/ormanca ot the work for whi<h this parmk is Iisuetl I�
shalt. not employ any persan in any manner so as to become sub7ect to t{�e
Workers' Companmtlon�Laws of Call/omla.' ', '
Oate� � � � Slqnature I , ' . .
-NOTICE:If,aftermaking [hb�tleUaration; you shoWU become�sub)e<Pto�the -�
Workers'. Compensatlon provi5ions of t�e Lnbor COGe, yau must forthwltlf
comply Iwith� such Orovislons'or N(s-Dermit snall ba �Oeemetl revokatl:( �
CONSTRUCTION IENDING AGENCV ' '
1 hereby aftiren t�at t�era I5 a construetlon IenEing agency lor the�pa rtormance �
of tho work tor Whlt� tNs• permlt -is I55ueE (Sectlon 309T Civ. C.)�
Lentler'S Name � (
Lnntler'S Atltlress , ' ,
OWNER'BUILOER DECLARATION� � `"' �
1 herobv a/flrm thal I am BxamDt ffOT [ha'Conllattor'S lIC8n5! Ldw fOf ltla
U I,�as�owner of tha'pr
tompansatlon wlll.tlothe
� � tor aalol(Sacllon 7044, E
LI<ense Law Ooes not aDD�
thereon, anC who tloes�su
employ ees, provitlotl tnat !
. Sale. I/, hOwever, the bulif
� O�etiOn, t�e Ownar wlll ha�
���ova !o� the purposa oi sa
I, ds owner oi (ha pro{
��tractorsto tonstruct t�e D�
� The Contrattor's Llcenie
bulltls o� improves thereo
tractor(s�license pursuant
❑ I�am exempt untler Sec
Date
�,-I hereby certlly that I h
in(ormation Is mrract. 1 a
antl'itata laws relating lo
sen[atives o/�Ihii!Uty'�t�
,InsOectlon Duiposas.
Signature i� • .
' Drivars' Licenso or.55 � .
CMF 0865-46 rev. 12/B2
a
Dishwdsher �
Drinking Fauntains � {
:
Floor Dreins;
Floar Sinks � - --� - --
Gas Service 'Outlets � -
Interceptor5 '� - ' '
Kitchen Sink; � ' �
L'Bvatories � � i j -'
o _r.:.... . ' � .
; Roof'Drains '' t � , � �
r �
- Showers , o. �" I ' I -
� Service Si"nk � . . � '
' � , i �' r.
r l0 an OWOCf 01 ] property �NTO DUII45 Of ITproVBS gOiIC�, ', � �,
:h work hlmself/herzelf or througb �IS or har own � '`�
uch �Improvements are not Intantlatl or o(laretl tor �� Duct � UndenGround ;
In9 or ImDrovement Is soltl wlthin ono yoar o/ com- � i . .
e t�e burtlan of proving he/sna tlitl not Gulltl or Im- ; , DuCt - S[rUCtUfel
a� , �
erty, am exclusivery conlratting,with Ilcensetl con- Duct - V2ntilatin '�
>ject (Sectlon 7044, Businoss anC.Pra(esslons Gotle:. ' , 9 ._ __
..aw does nOt aPpty to an Owner of Oroperty who , ,
i, and wno contracts for such Oro�acls with a con- ExheuSt System ❑ MWti
o the COnlrattor's LiCenu Law). '
lon ' 8.6P.C.lortnisreason ' Firepl/Fact.Blt.ICBO'#
�
Owner � ' � - � t I H¢Bting SyStCm & Ducting
ve reaA this�applicatloo-antl�state ttiat the aoove� � ❑4100,OOOBTU �100,f
ree [o comply wllh all Uty antl county ortlinanros , i . . . ,
builtling <onstructlon, antl hereby authoriEe re0�e- ' HOOd oi Type I �)
n1er up th� o�v�e-menNonetl Droperty for • 1 �g�a � T� e I I ❑�
�t�r�i i`{� oate �$� 18'/ 8 3 ,
� . � Re9isters � 1
Water C
- -- Water.H
� iWater�S
I �
�•
r
ECHANICAL
Rafrigere
� �a,�,
System R
. 1�
�
1
A
[er - _ _ : ' _ _
iice ' . .. r -
�
i �
C
ReinspectiodFeLe ; §15
Issue Fee � � S 3
�n System ' ' '
osTu o,00,00uaru. 4 0
�air%Alteretion
� . �. . _ � ,. 1 1
Reinspeetion Fee
Iswe Fee � �
$15
S 3
PLNG. HEF. zW
.TO BV ILDING'
PROPERTV LIN
.LEFTSIDE VAF
PKG.SPACE RE
STREET WIDTH
�.ruttion Pole . ' �
ing Unit ' ' � '
uasher � ' '
s �❑Gas'�'�Electiic "
F.A.U. � � � ,
Fixtures � �
Device Boxes .
Ou[IBts
Switches � ' '
Garbage Disposal
Ganerator �0-5 KW OS-15 KW
' `.BUILDING
eFrweCr rn cr- :
PEARVARD�(TOP/L)�". � ��
RIGHTSIDE VARD . �
' PHOVIDED � �
' PARK FEE�$ �
! i ,.
!M2tEr lJov2( 1 W em
Sub Panel i ,
Sub Pole '
Motors DO-i HP ❑
I nc. Solar; � 9-15 FiP �
Microwave
'Pole Light ' �
Renge ; __ � � _
Trash
' 1
�
�
7<0^. T:.
, ❑5U+ KW� ! ,Rainspection Fee $75
Meter ❑up to 100 amps � Jaue Fee ''$ 3
2oning APPmvad BY � � � Date �
' . � � 1
ApPliiation ApOroved BY�f� � � . . . i ^ate . .
APClication Isiwd By �`�� �� ' � Date g_ �'a''�
' � ' ' i � SUMMARV OF FEES � ;
BUILDINGPERMIT $ SMIP . $
PLAN CHECK $ ; PERMIT � �
�PLUMBING � $ � ' ISSUANCE S � .
� � GRADING S ;
'PLAN CHECK� � $ ,
'ELECTRICAL� $ � � ' � �� $ -
� � MICROFILM $ �
'PLAN CHECK , $, p /y�' � - I • i�
MECHANICAL '� $ .1 .% � TOTALfFEE{ . $
'PLAN CHECK• I $ ' ' ' IESS ; $ ; ;
, � � - ' ADVANCEDPC •
I I � � � FINAL FEE, . S, %,d Z%
! '
I
�
�-` .-` �.
.. -- -�'- - - - � --- - � - -
` �CONSTRUCTION AND�PCANNiNG, �� � ' - `- � . ` ' � '-. �OL� `A � . , �� . �
�111�F:13 oate �risvector ' °• : ^ Date � Inspectoi
- ,APPROVALS ;; Permil�#� . APPROVALS� - Permit �1`-
•1. Temporary Electrical Service or Pole � � � .�52: Pool &.Equipment Location � �
�.
� 2: ,Soil Pipe-Undrgrnd:: - , - , `- ' � � 53. �Steel Reinforcement _ . .
. 3. Electrical Conduit Utilitv-Undrgrnd. - , 54.� Forms - , �- �
_� 4: Electrical Conduit-Undrgrnd. - , _ ' ' :; ' 55. Electrical Bonding , � � � �
5. Steel Reinforcement ' � -' 56. Rough �Plumbing'& Pressure Test
6. Elect�ical UFER Grnd.� - ". 57: APPROVALTO COVER-GUNITE.
� ,i
7. Footings ; � : � � � , . 58. Electrical ('qnduit-Undrar�:i. - . _
8. Foundation i �-' � 59. ;Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � � � ' 60. Backwasfi-Lines, P-Trap, O Undrgmd.
10. Structural Floor System ' - ' 61. APPROVALTO DECK �-
11. Property Sewer Line & IHouse Connection " ' � 62. �Backwash & �Receptor-Final � � -
�
12. Sewer Cap - , ' � � _ ' • 63. Heater & Vent-Final . �
13. Roof Drains ., . � 6q. Plumbing System - Final � ��
14. �Rough Plumbing' � � -� � ' � �65. Electrical=Fina1 - " ' �
15.��Rough'Electrical-Conduit'�-� �" - -', -' -. - T" � �66. Solar,System-Final - � � -� , ' � �
16r'Rough�Electric;Wiring, ,� � r ; � ' - : � = - 67. �Fencing & Access dpproval � - �
1+7. �Roug xWiring�Sigm � , � -�� �. 68. APPROVED FOR PLASTERING
�. 18%,Rough�Electrical=T�Bar Ceiling � . i � � 69. POOUSPA SYSTEMS FINAL �
19; Rough Heating & AirConditioning � �;, � � � � FIRE DEPT. REnUIREMENT �
20. Rough Factory Fireplace ' � � � • APPROVALS Permit # ' �
�
21. Duc[s, in Structure '.' ; 70: Underground Hydro ' .
22. Ducts, Ventilating �, � , � � � 71. Product Piping � Gas ❑ Oil
23. �Gas Pipe-Rough & Test ;; � �,- � , , � 72, Underground Flush � . •-
24. Roof Framing� �� ' �� - 73 � Undergrnd. Storage TanK O Gas ❑ Oil
25. Roof Sheathing • � . . � � , � � 74. Oyerhead Hydro . ._
26. T-Bar Ceiling (Structurelb & Monocoat �( �. �� � ' 75: Dry Chemical
27. _Frame and �Fl�shing : ; ' , � � � 76. Dry Standpipe � � ' �
� 28. Lathing & Siding� � � � . 77. FIXED SYSTEM FINAL '
29. Insulation : -' , ' - � � ' ' 78. FIRE PREV. FINAL '
30. �Drywall Nailing � , � � � ' Notes: � �
31. Plaster Brown Coat . � . . � . � , �. . _ . � � .. . . - -
32. .Electrical Power MeterFinal ; � � . � . '
33. Final Electric , • � �
34. ��Aii Conditioning , � � y ^ ' � ' ' .
���'. - �- - i /Z�, 1 '
35. Final Gas Pipe=Test "� � ` � ' ' T " � .
36:1Hood or�CanoPY � . . " . ' � ' • - -.
37; Einal Facio'ry Firepiace' �- •-� - , - � , , :
38.-F',inal Plumbing � ' i �" � ` ; . . � , i ' � ' � � -
39.'Water Se'rvice-Final • � � ' � � ' � �
.
40. Gas Service-Final � , � �
41�:�Solar pomesticFinal � - _ � _, . _ ' _ __ � _
i -- -
42r Backflow Preventer - ' � � ' ' . ' � � � �
�� � - r
43�Backflow Irrigation + 1 � �� . - � . �
44l'�Landscape Irrigation=System • . _ . . � � . -
..,.,
. . �-. . . � i � .. � .
45.�Sound �Attenuation ; �' , � � _ � - �
�-
46. Handicap Regulations I � , ' � ' - � , . . . ' �
47.�FINALSTRUCTURE&BUILDING � � .
: i
48. Special Requirements Completed � � � ' �
49. Elec[ric Release to Edison� � _ _ _ �. ;. ' - .
50. Gas Release to Southern Califorriia Gas Co ; ' '' � . -� •
�
51. CERTIFICATEOF.00CUPANCY + _ � _ `
� � . ' . � -
No � Date
.. . . . Applieant !o fill in all spaces exeept those wit�in haavy DorEar Iines anG sign all appropriata tleelarations. ' '
�: �GTV�OF COSTA MESA � � - .
� CONSTRUCTION PERMIT ' _
`Praject'iiddress � � �
Applicant's Meiling Address ; S!� 7 �- � 9 t� 5 r
Owner'sName L...gQy7Lt/�; 1N r- r t�t pryana�;3—/9�0
Address �y� o Nr_t,.�j or-r ��'/�nT Rcld
Arch/Eng. Licenu No.
Address
Contractor's Nem hone
Address (mailing)
City License No.
LICENSED CONTRACTOR DECLARATION
I hereby aftirm lhat I am Ilcenietl untler provlilons of Charter 9(commencing
wltM1 saction 7000) ot Olvislon 3 of She Business antl Profeszlons Cotle, antl
my Ilcense is in lull force antl efiact.
Licanse Class Licensa No.
Date Si9nature
W00.KER5' COMPENSATION DECL/1RATION
. ' hereby afflrm tna[ I have a tertificate of consent to self-Inzure or a certiticate
1 Workers' Compen5ation �nsurance, or a certifletl <opy Shereof (Settlon
.800, L2b. CJ -
Pollty No. Company
BCertlfietl coOY �s hereby tVrnlshetl. .
Cartlfietl toDY �5 tiletl with the tlty Builtling DIvlSion.
Date .4pplicant .
EXEMPTION FROM WORKERS'�COMPENSATION DECLARATION
(Thls se<tion naetl not be cor�pletetl if tha permi[ Is for one huntlretl (§300) or
less) •
1 certifY'that In the Performence o} the work far_which thls perm�t Is issuetl, I.
'NOTICE: If,iafter'making ihls tleclaratlon;'you shoultl become SulYject to [na
Workers' Compensatlon pro��slons of tna Labor Code, you must Porthwlth
complY w�th such provl5io�5 or this permit�shall be tleemetl revoketl.
CONSTRUCTION LENDING A6ENCV ,
I hareby aftirm tnat thare Is a',�onztructlon lentlln9 agency for the pertorman<e
of the work for which, thls permlt is Issuetl _(Sectlon 309� Civ. C.) ,
LenCer's Name ,
LenCer'S Atldrass " -
OWNER BVILDER UECLAqqTION ' ` I ' �
i herebv affirm tha[ I am Bxemot from the Cont�x[to�'S Llcen58 Law fo� the
to (ile a slgnea itatem�
the Contractor's�Licen:
Dlvislon'3 ai Ihe�Bue
-�eretrom antl tna baf
i31.5 by' any apD���
nalty of not more th
❑ I, as�owne� of thi
Compensation will� tlo
for sale: (Sec�lon •704
u�a�� �aw aoes �oe
thareon,-antl who Goe
employ eas, provltlatl F
sale. I/, however, the I
pletlon, the Ownar wil
�ove for lhe purposa �
LJ I, as owner ot the
trattors to constru<t th
The Contractot's Lice
Euiltlz or Improves th
tractor(s) Ilcensa purn
❑ 1 am axempt unCer
Date
PE T NO. �� TRACT NO. LOT NO. ' BLD . .
�' j 2 �. `�'�-�1�
TVPEOPCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, #
DESCRIPTION OF WORK
- S Main Building:
E
TVPE OF PERMIT GRADING FOUNDATION STRUCTURAL T, Front
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Reaf
❑ OTHER A
PRWECTDESCRIPTION Sq.FT. oCCVPANCV C Right
K Left
CONSTRUG710NTYPE VALUATIONS $
ZONE GRADING GV.YDS. ACRES Ping. Ref. #
Remarks: � �� 3 t Parking Req./Provided
lke of Building:
- PLUMBING - FEES Planning Notes:
Sink ' Showers '
<flow Preventer � � Service Sink
kflow Irrigation • Sewer Cap .
nubs � Sewer Connection '
�ifiers Solar Collectors
iwasher � Solar Piping � '
Drinking Fountains Solar Tank '
Floor Orains . � Swimming Pool w/Spa �
Floor Sinks . •���
Gas SerJice ' Outlets •�
Interceptors
Kitchen Sink
'�B,`also faqul/es t�la appllCdnt f01 Such pafmlt ROO� Ofa1�5� �
�./ihe Is Ilcansed pursuant to tna provizions of' .
aptar 9(commencing with Section 7000) of '
Protasslons Cotle) or thaC ne/she9s exempt . � . � -'
alle9eE exemptlon.-Any violatlomof Sectlon � _. � � .
�tlPretl tlollars (�$500j ha.apP���ant ta a Nvil -�Reinspaction Fee $25
or my 8rt1pI0y885 Wlth wdg05 as thelf SolB �
antl the St/UCtU�e Is nat Inlentletl o� affaietl
s antl� ProteSzional Cotle:' The Contractor'S '
i owner of a property who bulltls or improves gOil2�
rk nimselt/her5@If Or [hrou9h h15 or �er own
iprovements are not Intentletl or otferee for
Improvement I5 SOIE withln one year of com- Duct - Under Ground
burGen of proving he/5he Citl not bulltl or Im- ' Dutt - Structu�al . •
Qwnar
owne� of p�op0rty wh0
uch Orojects with a con-
lawl:
B. 6 P. C. fo� [�Is ieason �
ppllcaUon anC stata t0at the above�
with all CI[y anE county ortlinan<es
ruclion, antl heroby authorize repre-
the above•mentlonetl proparty for �
o c ��
Exhaust System ❑ Multiple
Fi�ep!/Fatt. Blt. ICBO #
Heating System & Ducting
00.100,OOO;BTU �100,000
Signature - a e �
Drivers' L�censa or SS qJ� ' I I PeinspeC[ian FBa
CMF 0865-46 rev. 12/83 Whlte - BuilEln9: Canary - APpliwnt: Plnk • Accounting; Goltlenrotl - Aisessor
$25
Urinal '- "
Water Closet �
Water Heater. . - '
Water Service � ' �
� Issue Fee , ,� $ 3
Hood or Typel ❑
Canopy Type I I � ❑ -
Refrigeration System �.
❑0.100,000 BTU ❑100,000 BT
System Repair/A�teration .
Issue Fee I $ 3
F,�h�,�
Automatic Washer ,
Construction Pole Sub.
Cooking Unit �
Dishwasher
Dryers ❑Gas ❑Elec
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches .
Garliage Disposal
KW
9324 4/26/84
Zone
Accessory Building:
Park,Fees
0
IOa3D Tt,
� ' _ '
ELECTRICAL - FEES
' Transformer ❑ 15�50 KW
❑ 50+KW
� � Meter 'pto700emps . S�
, Meter ❑over100amps �
Sub Panel
Motors�P1 NP'�1%x-8 �
IncSolar �9-15 HP []16-75+
� Microwave '
Pole Light �
nange
Sign
' Standing Sections
�15 KW .Trash Compactor
I Reinspection Fee I$y5 � Issue Fee
PUBLIC SERVICES RE4UIREMENTS:
Zoning APProved By
Buildine'APProved ey � ��
ApplicatiOn laUed By
z
0
N
1
N
G
R
E
�
R
E
N
E
N
T
i
' SUMMARV OF FEES � -
BUILDING PERMIT $ - SMIP ,$ �
PLAN CHECK � $ ' PERMIT .
PLUMBING $ ISSUANCE .$
PLANCHECK 25%'$ ENERGVP.C.'$ '
ELECTRICAL ,$ 0�0� GRADING $ '
PLAN CHECK 50% $ �Z • S� MICROFILM �$ �
MECHANICAL '$ TOTALFEE $ • �n•�
PLAN CHECK 25% $
i
�` C(i�NSTRUCTION AND PLANNING � - � : POOL-Z A � _ , , , . ,: ry _ '
!�� APPROVALS Permit # Date Inspector p�ppROVALS '- Permit�# - ''S� , Date - � Inspecj'or � �.
_ _ ,�
� : • i m
' 1. `f�emporary Electric8l Service or Pole 52., Pool & Equipment Location '� - -
.
3„ -- -
2. Soil Pipe-Undrgrnd. - ' ' � 53.' Steel Reinforcement ' ' . _ " �
37 Electrical Conduit Utility-Undrgrnd. . 54. Forms �- ' �- � . " � ' "�' -
_ 4. Electrical Conduit-Undrgrnd. 55. Electrical�Bonding� `� � � . � � � . j _
5. Steel Reinforcement - 56. Rough Plumbing & Pressu�e Te'st �� • •
6. Electrical UFER Grnd. , 57.• APPROVAL•T.O COVER-GUNITE ; = ; �
• 7. Footings - � � 58. Electrical�ConduirUndrgrnd.... � �. - !' :"
r, -
� 8. Foundatiort 59. Gas Pipe, � Undrgrnd., Test' ' �^
� .
9. Water Pipe-Undrgmd. �60. Backwash� Lines, P;Trap, � Undrgrnd.' -. � '
10. Structural Floor System � 61. APPROVA�CTO DECK �' � � � _ ' � =
11. Property Sewer Line & House Connection � 62. Backwash &_Receptor-Final. - '' ��� ` �' •
12. Sewer Cap �. 63. Heater & Vent-Final � , , - ? � - � . , .. �
13. Roof Drains 64. Plumbing Systein -,Final' . . � � �
� -
14. Rough Plumbing 65. Electrical-Final +� - � •
15. Rough Electrical-Conduit -66. $olar System-Final � ' -, -�" - ""- ^ ' .
��
16. Rough Electric Wiring . 67. Fencing &�Access Approval : � - - � '' ��i r- -
_
17. fiough Wiring Sign ,-.�68.� APPROVED FOR PLASTERI�NG - '
� � '
78. Rough ElectriGal-T Bar Ceiling ' �69. POOUSPA SYSTEMS FINAL - .�
� �
19. Rough Heatin� & Air Conditioning � FIRE DEPT. REQUIREMENT � �' . T, �
� -. i �
20. Rough Faciory Fireplace � APPROVALS� Permit # � '
i 21. Ducts,�in Structure � � � 70. Undergraund HYdro � ' . �
�
22. Ducts, Ventilating � � 71.' Product Piping �Gas'�OOiI � � � ��'. , �. ��
23. Gas Pi e-Rou h & Test � - -�- - --.. _-. - .... - . '
P 9 . 72. Undeiground Flush . �
24. Roof Framing � . 73.� Undergrnd.StorageTank,OGas� �Oil . � ; I
25. Roof Sheathing 74. Overhead Hydro -'`� � �
�
26. T-Bar Ceiling (Structural) & Monocoat ' � 75. Dry Chemical ' � � � ' - � � ' ' -
27. Frame and Flashing 76. Dry Standpipe , �. �_: ' :' � �' �:
28. Lathing & Siding 77. FIXED SYSTEM FINAL � . - , � � , ,
1
29. Insulation ' �78. FIRE PREV. FINAL � ' � ' ' � �
. 30. Drywall Nailing HEALTH DEPT. REQUIREMENT � � �
31. Plaster Brown Coat . 79. FINAL INSPECTION . ' � � �
`32. Electrical�Power Meter-Final � 80. FOOD CERTIFICATE ISSUED � !
�J I i
.� 33. Fin,l Electric � cj y' � �,Notes:, 'y/ .�� �� �� � i
34. Final Heating & Air Conditioning ^ - r� � , � � - - '
35. .Final Gas Pipe•Test , � � - , � ' ' - : , , . _ . s
36. Hood or CanopY � � �. � .��' � r
37: Final Factory Fireplace ' ' � � .. , � - • :{ `
38. Final Plumbing � ' ' ' , , T �
39��Water Service-Final . ; . � � ' " .
40%Gas Service-Final , ' , � � ' ' ' ` '
41. Solar pomesticFinal - - - - - ? : , � '
42. Backflow Prevanter . _ _ . . _ _ _ � � ,
�
; • ��
43. Backflow Irrigation ' ". � . . . � � •
44. .Landscape Irriqation System ' _ ' ' , '
45. Sound Attenuation � , � , - - � ; - -
i =•
A6. Handicap�Regulations - � , � � - � �� - ' �
47. FINALSTRUCTURE&BUILDING , � ', ' ' . j � i . , �
48. Special Requirements Completed' 1 ' ' : ; • � j I � � � ' ° r
49. Electric Release to Edison � � � � � ' � . � � , - " , � , � � ' �
50. Gas Release to Southern Califomia Gas Co � � t ,�. � '
,
51. CERTIFICATE OF OCCUPANCY -, r '- �- , -,- ' '
�
�
No. D`ate� " _ ' . � � . __ � . . � � - � ' -- --- ' - .
`ODflFSgOFBUIIdH�: $3� 1^7 19TH .Ci�:
�.,.> eic/woxN: SUN, JUI LI
aoonEss ^UN, SU-YU
L 9832 VICKSBURG DR
�� TiNGTOtJ BEACH,CA 92646964-4652
ry�. �uuw �oo�ss:
�xcxrtEct on u+ou+�nn:
UNT:
ue ra.:
uxr:
�.M�ru� T0011�ARGOSY�DRCO, (724)846-8625
cam�ecroas�uuxa HUNTINGTON BEACH CA
,�� ��, 625296
92649 uwr: 6
110EN5E0 CONfNACTOP4 DECI.ARATON: I lwaby � uiEer psuly d pwWry Nel I an fi�eneeE indv qwuione d Cheqr 9
1�ma,aou wnn son� �000l d a�� a d m. a�.m....�e aaa..�,. wee. �a mr i�� a i� mn rotie �a mrw.
cmuc.No.: uc.cuss: C-39 <uc.No.: 625296 EXP;
Dme: � Canraaor.v�il /VYQT/1/�
OW NEq BUIL�EN DEC N1TON: I lwaEy dfirtn uMx parWy d porjuy ihm I em eumq han tAe Cmtrtlan liroroe law la tlr
Idbwiq rsa»n (Seaion ]W t.5 Buanw eM PMmceu Code: MY �fi' a mWY whirA nV� a O�i lo m+Wcl. Wx. inPow.
EsmNeh, a reper eiry ewnuro. pior �o na oeuence, deo �u'vea �M applirant tor vuch peimil lo fils e agneE �talameni Mal M m�M
� licenaed W�weM Io Ihe poviaiona tl Ne Comreqae Licarm lew IChaplx B(wmmandnp wi�h Senion'l000) d Owbian 9 d tM
dueimq �A Proleaeione Cada� rn ihd M or Me is ezomq thereM1wn vM �M basie M Ihe dbpeE naamqian. My videtbn d 6aaion
]O�t.s yy any applirail Iw a parmil suhprla IM eppliceni fo a civil penefry d rpl mae �hen fNs hurM�ed ddlen jf500U.
❑ I.goxnerd�MpopMyamyanWvyewx�hwepmmiheiWeoomperoetion.wJldolhswh.mdNaMxtu!eercn'vnandod
v Maed lor aeb (Section 101,.8utlroveM Prdea'vuCOEe: The Comredwslinivve lnwdoes nd WNY �oen ow�wrd V W�Y
who bWAs a inpwm Ihqaon. md xM Eoea euM v�ak hlnaaM a hanN a Ura� he a hm orm anipb/eet. pwided tAel wrA
impove�neMe us M inteMeA a Wsed la sab. X, hows.er. �M buiNi�p a inpmwnaM u sdtl xnhin ona Y� d wmpluion. IM
owror-0uilder wAI heva tM WNen d pev.•i�p he or eho d'd ra1 bdld w impv.a lor tM purpoea d eeb).
❑ I. d ownai d the peopery. em mdiuivMy comrediq wilh IivneeA cnnlreclaa lo canerud iM piojaq (�� ]OU. &niMee eM
Peolszeiau Gode: TM Canreean lieenss lew Eoea na eppy ro en ow'wr d popeM � b�Jda a Imprwm tlwaon enE w1w
cy�p�a ror adi pqeaa wdh e mmreea(�) licenrod qus�e'q m tM Caueauaro Limme lew�.
� I yn uemq under Seaion: ' B. 8 P.G., b Nu iemm:
DNe: Owiw:
1 Eo heMry uniN � I em ewue ol enE u�demvd tlw raquiremmb W Cellomu HWh end Selety Cotle Sactiwn 25505. 255�J, end
25551, yd ihel I u eny Mure WilEirp oaupen� will / will rwl (dre4 me) naed to comoN �h eeirl etme mdw eiM ihe reQuiremenb M
.w�al«mn.wa'vinmoaJicme�han�n.,1i w-OiR�r ��Oia�a.aakruelwnawin,zppktlians.nexemphanuw.
Vowsiqn.
Dae: ADd'cem:
WOHK�p'S COYPENS�TION DECL�RATION: I Mraby elfim� uMm panelly W qrjury ar d IM Idlmvi�q AWutlbru:
❑ I�yaMwilmeintanacenifctladoonrontioeellimurebxwkas'campemalion.opoMadlaby6atlion�)OpAtMlebar
ode, lar IM pMam�erca d IM wk la which I�n pemm u mueE.
�hma eM W meinten worken' wm W�ion irowenm. m iW�mod M Sauion 9100 d tlr laEar Cob. b �M V�m� d tM
wak la xfiidi tl�u P��1 b u�wd. MY waken' com ian ivurencs ortier ad W�' m�mber ero:
�,,,;,,, S7ATE FOND EXPIRES
Pd'xyNumber. i�v �� -7 09/O1/95
(ihis a�ction riesd rwi be crmpbtM i IM perml u M om hunC�eO ddWa �51001 w bv.1
� I aNY �� N^ �°�^�^�a d tM wak far whbh Ihia pmnN u uaueE. I ahell M empby vry pe�son in ury menner o n io
b�pns �ubjW �0 1M wdlws' canpemelfon lewe d Ca(dow�Yqn at d I YpuM becmr rmptl Io iM Mo'ken'
wmo�o �:b a s.a� aroo w in, �.no. cmfr.�wi �onn.un n mo.. pw�.. .
� �
Dde: 2 Appli�eM'
WemLp: F� lun ro� cun woilrr�' nmpeiu�tlon rovwip� 1� unMwNl, �ne �IWI ub/�cf �n emplqw ro MMnI pmeltlu �M
clv/l fl�u up ro ais M1UWiN fMuwd EWI�n (SfOq000A M NJltlon ro M� rost o/ romp�nutron, tlenyp� o pror/dM br In
9�ctlan ]106 0l tln LeborCOJs, InMuS ���msy'� Iwa
CONSTRUCTION LQIOINO ROENCY: I Mnby elfirm uMx perelry d perjury �het tMn u e can9Npion MM'vp epric/ lor IM
ven«mence a �ne wak m, .nw� �w v.�• m ew.d (s«�o� 3os�, cH. q.
LENOEA'S NI1ME:
LENOEH'S RDURESS:
1 carli(y thm 1 heve reed ihis epqiceiion eM tlme ihel ihe ebova inlammian ia mrtad. I epiae to compy wilh all tity eM eouMy ordinenoee
md stms 4vn rNetM ro budEip oonetrwion and haab/ eWv¢a �epaeeniaiiws tl �hie rimYw sNa uD� lM abwa�mwid�eE prapry
Ome:_7[�i�
(515�-ab.WP) �Ms-9uik�q 6 Selay:Onen-Flle: Ceneiy-Appirant: Rnk�Nvanw:Oddpvod-Aaamaor
CITY OF COSTA P1ESA - BUZLLIA]G PERMIT rn i-, r,v;l v; i o
I��RMIT NU; H 071218 PLAN CAECH NO: N vci v nvrr; rv
CONSTRUCTZOF7 TYPE: V-N FEF.MIT TYFE: STR �'//� I�` ���JRPOSE; ALT
JOb UE�CRIFTIt�Pd ; T/OFF P,EROOF W/HOT MOP ���I �` S� FT; S,SQO
1
CLAIM C'ALUE: 5,500.00 CALC-VALUE: S,SOO.OQ GROUP OCC; R-1 /
COMMENTS: • ..... ---..�'" :�-;,_ _ ZOR TO FITlAL
1FdF if-iF if�iE iE'i(�ii��t af 3f iE #�(-Yf i(��1't iM 1f IfjE iF if N iE iEif iE if if 1E�If ?E�lf if if iF�lf 1E�4 if Y�if if'1F i-#if'iF iF Y-i��if iF M if df if 4'N'T'Y'iR if'N'if�1E �4 i' 1k-If�14 iF aF iF�li it Y
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
----------- MAIFI $UILDING ---------- ---- ---- ACCESSOP,Y HUILDING ---------
FRNT: FT IN �EAR: FT IN FRNT; FT IN REAR; FT IAI
LEFT; FT IN RCHT; FT IN LEFT: FT IN RGHT: FT IN
PARRIP7G P.EQ • PP,OC'; PAP.CEL: 42419104 2NE; REF NO;
PLANNZNG Nd'I'ES>
1
?E 1f if�lE 1f�lf 1f"N"k 1E'If')f'1E �Eif 1f if�lf iF iE iF'lf if if iF ih#'Yf if if iE'lE 1E iE 1i*if :h Y�iF iF i4iFM M if iF�X")E+h iF 4 if iFir i�- +f # i1�1f if'IFiF Y'a! if +! if if'�Fif it �f iE-1Eii-'N�'): K Y
D E V E L O P M E N T S E R V Z C E S R E Q U I R E M E CI T S
ZONING AFP�OVED BY _ .�ATg:
BUILDING APPROL'ED BY ; I �
� a DATE;
APPLZCATIOPI ISSUED BY: 'l
iE ff'If 1F'lI' iE iE'K' if'X' il' ir'i%1E'If'M"V A'I! tE 1f if •. � it Y� �F'R • M
if if iF af if'1F 3f if M iE M if jEif iF if �f if # if af if 1F if i�if 1f E i(-if'1f lfaE if if iF M if if �f iF'N'iF iF'X �
LEGALIZATION:�I F E E S 1—
BLDG PMT PLUMBING ELECTRIL MECHAA�IC
PERMIT 81.00 •
PLAr� ,
ISSUE FEE '
BUILDING-DIV-> FERMIT ISSUE PLAN;-CHECK
TOTALS----> S1.SS 0.00 • O.QO
t'� �
DATE: r�=�`% ¢
M f 1f if 'If'If'lE if i4 �F i4'IR if'If `�iTiFiii �c{c
f iF R iF ic if if if iF if af aE iE i4 % iF+F 1a M.4 jf i'r Y �f aF ic iF if iF i4
Y STRUCTURAL;SEGMENT:Y
FZA£ SMIP/RES GRADING
.55�
SMIPINON-RES
TOTAL PAID DUE
81.55 8!,55 ,00
REVENUE DIL'ISZON TOTALS--> COLLECTED: 81.55 OC'EP./S$ORT; -• 00
BLDG PMT PLUMBIAIG ELECTRZC D9ECHANIC FIRE 5MIP/TOT GRADING PLAN-CHECK
81.00 - ,55
if 1f V 1f 1f iF 3f iF 1f if Y+f L af if if tf M� 1f 1f �f'R'1f 1f 1E 1f �Y if if'If'IE #i' iE Y�' �c if if sf iF i41f +E if 4 if iE+E M iE tf'Y Y#` it V 1E if 1f ih if Y�f 4 ik tt il� iF M iF �F'K !�' f �E if If'k?F
I TJ D I V I D U A L `.F E E B R E A H D O Y7 T7
TYPE (JTY D E S C R I P T I O N UNIT COST TOTAL COST
SFR 5500 REROOF HY C'ALUE RESIDENTIAL NOZONE 1.00 S,SOQ,00
END OF FEES
a� �t,i?�a;i-ar,17���2 T u T E1.5e�
�tA7E� p:/21/9S i;IME: i5:F5
�� �c.-n:.�f10N AND PLANNING
7�'APPROVALS Permit �k }
), Temporary Electrical Service or Pole
2. Soil Pipe�Undrgrnd. �)
3. Electrical Conduit UtilitV-Undrgrnii.
4. Electrical Conduit-Undrgrnd.
5. Steel Reiafa�cement �
6. Electricai UFER Grnd.
7, Footings
S. Foundation
9. Water Pipe�Undrgrnd.
10, Structural Floor System 3
t t. Property Sewer Li�e & House Connection
12. Sewer Cap �
13. Roof Drains '
74. Rough Plumbing
� 75. Rough Electrical•ConduR
}6. Rou9hElectricWiring
77, Rough Wiring Sign
18, Rough Electriwl-T Bar Ceiling
79. Rough Heating & Air Conditioning
20. Rough Factory Fireptace
21. Ducts, in Structure
22, pucts, Ventilating
23. Gas Pipe-Rough & Test
24. Roof Framing -
25. Roof Sheathing
26. T�Bar Cefling (Structural) & Monocoat
27. Frame and Fiashing
28. Lathing & Siding
29. Insulation �
30. Drywall Nailing �
31. P�aster Brown Coat
� 32. Etectrical Power Meter�Fina1
33. final Electric
34. finai Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final factory Pireplace
38. Fina� Plumbing
39. 4Nater�Service�Finai
40. Gas Service�F9na�
41. 5olar Obmestic-Final
42. 9ac�t!'ow Preventer
�43. 6a,�kfiJow Irrigation
44. L-e�ndscape Irriqation System �
45. 5ound Attenua[ion ,
� ,, 46:.�Handicap Regulations
47. FINAL STRUCTURE & BUILDING
F'. i '
; 48. FINALPLANNING
49. Electric Release to Edison
50. Gas Release to Southern California Gas Q
Date
Date
1
P06� ,,PA "
1 spector AppqOVAL5 �.Permit #
52. Pool & Equipment Location ,
53. Steel Reinforcement ,
54. Forms . •
55. Electrical �onding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electricai Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Zest
60. Backwash Lines, P-Trap! � Undrgrnd.
61. APPRQVAL TO DECKi
62. Backwash & Receptor-Fit�al
63. Heater & Vent�Finat t �
64. PWmbing SYstem - Final
65. Electrical-Final
66. Solar System�Final
6J. Fencing & Access ApP�oval
68. APPROVED FOR PLASTERING
69. POOUSPA SYSTERrS FINAL
FIRE DEPT. REQUIREMENT
APPHOVALS Permit #
7Q. Underground Hydro
77. Product Pipin� O Gas ❑ Oil
72. �Underground Flush
73. Undergrnd.StorayeTank OGas ❑Oif
74. Overhead Hydro
75. Dry Chemical
J6. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
- HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD �CERTfIFICATE ISSUED
Notes:'�//y/(J� QL�% /f_
� /N /�- S fs/i
Date `Inspector
i
: '
� CITY OF COSTA MESA
' - BI/ILDING DIVISION
► �
� DEVELOPMENT SERVICES DEPARTMENT F9&00126
�y� PERMIT PERMIT NUMBER
'*���m �
(714) 754-5273 • Fau (714) 754-48ss_ FIRE SUPRESSION PERMIT n FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 835"19TH ST Status: ISSUED v/�6
Suite: , Applied: 06I0217998 °
Viciniry: Issued: 06IO2/1998
Parcel Nunmber: 42419109
Applicant: RACANNE, RUFINO
Address:
Owner.
Addrpss
Contractor:
Addr�ss:
Zoning:
Phone:
Zip:
SUN, JUI LI
SUN, SU-YU � .
HUNTINGTON BEACH,CA _ Phoae:
9832 VICKSBURCa DR Zip: 92646
EAGLE SYSTEM FIRE PROTECTION
P.O. BOR 151336 "
S.D. CA.
Phone: 1 800-793-385
Zip: 92715-1336
License: �727558
�
� � �,�
SCOPE OF PERMIT �
INST FIRE SUPPRESSION�SYSTEM FOR KITCHEN HOOD. . �
FEE�SUMMARY
Plan Check: ??
Permit: ??
Other: ??
Inspection: ??
Total: $70.95
Calc Valuation:
Claimed Valuation:
0
So.00
so.00
EXPIRA710N: This pertnit shall automatiwlty expire and become void if work is not commenced within 780 days, or if work is suspended or abandoned
for a period of 18Q days.
INSPECTIONS: In order for the work aulhorized under ihis permit to be considered legal, such work must comply with ell applicable codes, and all
requlred Inapeetlona end flnel app�oval must be obtained. Fallure to obtain inspedions and finel approval will result in the ezpiration ot this permit.
I FOR INSPECTIONS CALL: (714) 7545828 �
�
WORKERS'COMPENSATIONDECLARATION:
I hereEy etfirtn untlar penalry of peQury rne of Ne tdlowing dedaretions:
❑ I heve end will mainteln e ceNtkate of crosent lo seH-Insure for woflcers' compensatlon, as provitled for by sectlon 3700 of the lebor Cotle, for �he pertortnance of Ihe
work for which this permlt is luuetl.
❑ I �ave entl will melntein workers' oompensetian Inwrence, es requireO by section 3700 of Ne Letwr Code. tar the peAortnence oi the work fa which ihis pertrtit is issuetl.
My workars' compensetion Insurence certler entl polic.y number ere:
Certier: Policy Number:
(Thls secUon need nor be aompleted i! the permit /s vslued et one hundreo doqafs (S r00J or /ess.J
� I certily that in the pertormance of the work tor which UL5 pertnit is lssued, I shell not employ eny pereon in eny mflnner so es to Decome subJect to �he wOrkers'
compensatio aw f Calltomia, and agree that I ahould become wb�ecl to the workers' compensetlon proNslons of Sectlon 3700 of the lahor Code, I shell forthwich
compty wlth ese a lans. % �.�-
Applicam Slgnetura: � Dete: � �L ����
WMNIN�: FAILURE TO SEWR WORKERS' COMPE S ON RAOE IS l/NUW FUL AND SNNL SUBJECT AN EMPLOVER TO CRIMINAL PENFLTIES ANO CML FlNES UP TO ONE MUNDRED
TlIOUSPND OOLLFRE (5/00.000) IN AUDfiION TO Tl1E COST OF COMPENSATIIXJ, OAAMOES AS PROVIDED WR IN SECfION 3'!OB OF THE LPBOR CODE, INfERE5f, PND ATTORNEVS FEES.
LICENSED CON7fiACTORS DECLARATION:
1 hereby eHirtn ihet 4.en
force end effect. Lic. p,
ConVectors Signeture:
8(commendng with Sectlon 7000) of Divislon 3 0l tha Buslness er�A�Pr4lg�ions Code, flntl my Iicense is in tull
; � Class p � /�
�� � Dete: _ - % '
CONSTRUCTION LENDINO AP.ENCY:
❑ I hereby efNrtn Net Ihere Is a canstruction lending epenty for the paAormance ot Ihe woAc tor which this permit Is Issued. (Sec. 3097, Civll Code).
Lenders Name: Lendefs Address:
Signeture:
OWNER-BUILDER DECLARATONS:
Date:
1 hereby effirm [hat under penalry ol perJury that i am E%EMPT FROM TXE CONTRACTORS LICENSE LAW for the tollowing reason (Sec. 7031.5, Business antl Professions
Code: Any ciry or counry which reqWres a pertnit to construd, elter, improve, demolish, or repair any strudure. pdor to its Issuance, elso repuires Ihe eppliwnt for such pertnit
to tile a signetl stetement Nat he or she is Iicensetl pursuent lo Ne provisions ot Ne Contractors Llcense Lew (Chapter 9(commenGng with Sectbn 7000) of DiNslon 3 of Ihe
Busine5s end Professions Cade) or �hel he or shB i5 e:empt �hereirom and the Oasis lor Ue fllleged exemptlan. Any vidation oi Section 7037.5 by any epplicant for a pertnit
subJects ihe epplicent to e ciNl penelry of not more Nan Ave huntlreC dollers ($500).):
� I, es owner ot Ihe property, or my employees with weges es their sole compensatlon, WILL DO TNE WORK, end Ihe structure Is not intended or ottereC for sale (Sec.
7044, Buslness antl Professions Code: The Contradors License Lew Coes not appty to en owner of properry who builds or improves thereon, end who Goes such work
himself or �erself or t�rough his or her ov.n employees, provided ihet suc� impravements ere not Intentled or offered for sele. Ii, however, ihe bullding or improvement Is
soltl within one yeer o1 completlon, t�e owner-builder will have ihe burden ol proWng that he or she dld not Oulltl or improve for purpose oi sale.).
❑ I, as owner of the praperry, em El(CLUSIVELY CONTRACTING WfT}i LICENSED CONTAACTOfiS to consiruM the projecl (Sec. 7MJ, Business e� Professions
Code: The conirectors Lkense Lew does not eppty to en owner of praperry who builds ar improves lhereon, end who contrects for such proJect with e conirflctor(s)
Iicense pursuant to the�ConVedors Ucense Laws.).
❑ I am exempt untler sec. Business end Professions Code tor this reason:
Signeture: Date:
Owner ID veritietl by drivefs license. ❑ Yes ❑ No Drivers License No.
Venflcatlon o1 Ownership by (type of dowmem, i.e. - properry tex bill or deed):
Expires:
OIVISION OF INDUSTRIAL SAFETV PERMR CERTiFlCAT10N:
❑ I hereby certity t�at no excevatlon tive (5) or more feet in depih Inio which e person is requiretl to descend, will be made in connection wIN work authorizetl by this
pertnit, end that no building structure, scaHddinp, felsewark, or demalWon or tlbmantling ihereof, will be more t�an Uirty-s�C (38) feet hiph. (Chep. 3.2, Grp 2, Ah 2, Sec.
341, 71t1e e, Calltomie Atlministretive Code).
❑ As owner-bullder, I wlll not employ anyone to tlo work w�ich woultl require e pertnit irom I�e Divislon ot IntlustAal Sefery, es noted ebove, unleu such person has e
pertnit to tlo such work lrom the division.
Signeture: Date:
DlWsion ol intluslrial Sefery Pertnit Number:
CERTIFlCATE OF COMPLUWCE AND AUTHORQ/1TON OF EMRY: I Certity untler penalry W perjury thet I have reatl �his application end stete that the Intortnetion given is
conect. I egree lo compty w�th a0 stete laws end dry ordinences relating to builAing construction, end authorize representetives of the Ciry of Costa Mesa to enter upon the
abave-described properry tor Inspection purposes. l agree not w ocwpy or allow ocwpenq of any building euthoAzetl Dy Nis pertnit untll Mal inspenion.
GOoe �.
1818
1288
zao
201
202
203
Fiaed System Finel Fire Prevenlion
Pool Spe Finel
Finel Re-Roof
Final BIocWReteining Well
Final Feclory Flre Place
Flnal Sipn
204 Flnal DemdlUon
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�ppj MSPECTONME
206 Flnel Mechenicel
20B Final Plumbing
210 _, Final Electdcel
� 212 Final Fire Prevantlon
\.- -- .__ _ ...
220 Finel Plenninp Approvel �
222 Final Slte
250 Finel BuilOing/Occupanry
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