HomeMy WebLinkAbout839 19TH ST - Building Permits; ' ; Gf�,.�T 192� s�c, 339 � . __ .. -. .
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4056 - 4-]2-57 store buildin�; $31,625•
8756 - 3-�7-57 Plb�. I�C (se�:er)
6i63 - 12-19-57 Si�,r 200.
k976 - 12-26-57 �1Gn CAI'CELLED
15$72 _ u-27-61 elec 1:w11 sigr, 101.
2p351 _ g_i5_6g elec Sacia si�;n 39�•
53295 - u-u-� Pltib. tac (�zs) \
,{{,q2.a �I..E_O.►SC�.�1`c��rf�.)
54131- Elec.4lall Sign (83t� 300. 1
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Costa 117esa Bwiding vepar merit ' APPLICATION d�'OR PERMIT
�� ,�! 111 EAST 20th STREET m���_ _ g U I! D ��'�N_G. _
� � COSTA MESA, CALIFORNIA -- '
�i ' �.
•.�FOR APELICANT TO F'dLL IN ; �OR OFY+'%CE gJSE ONLY ;
i Receipt No. ,Pe/rmit;No. ;
Adilding 8� w 19 th 1 �' '7`��3 �
T Reoetved'by Date Rec'd. Date Issued �
osta b.esa, California �� , � . -
N arest placentia ' ' � '' � �-'� /a��b -J
Cro9s St. Buildin i �
. Address � I
ow�er Tr utwien Brothers ! Costa CSR�, C&lifOTTlia � '
Mail zq10 Newport Blvd. �
Addrcss Nearest � - t
Tel Cross St. .
cityNewport No11�6 Zone ; No.oi Type I Group
Architect or Lic. . 1� i I P�ans I �
Engineer E.Yi. Springe rv,. 4635 Approved � � -
b i Date :
Address ' ' , ` �
_ , ��
3y e. '
trectorB.L. h4etcalf t�o, Sc��� � ,F r� y
nddress y,q60 N.Glassell Oranae Cali � .�,_e; �gv�L+ -A _
, • i
De er Ption � No. 801 I Block I TraciNPM � '' "'� ENT' .
� � , ECT 7U BL'JG. UEPT. RE .
(Attach Metesand Bounds) ��� � �,3Q—
No. oi Bldgs. � �
� Size ot Lot r}r� �n I Now on Lot - '----- DAT� a' O
Useof I No.of I No.of ' �-P�ry T.CH. f.. A
Existing Bldg. Familles Rooms �
Setback Line from Rear Vard � �'o �- - - �- - -� -' - -- ' - - - `" � � ' - "' � 'Z
� Center of Street �19 Side Vard L. rs '� �� D
DESCRIPTION OF WORHN,S,�7 i ��'� �"" `�' '� r
New x � I Alteration I I Addition I �
Repair I I Moving_ � I Demolish I �
'_ —
.t Eluilding 55x100 No. ot �
4jze Rooms � StorfesOIle
� -ior Wa❑ RooT
���9 �pg�retel CoveringCOlqpO. I
APPROVAL.S
�Use cf New Foundation Location Inspector D.ate
Buildin4 Besuty SalOn & Dry�'ood8 � Forms,Materlals,
�r.�i Under-Pinning
Frame: Fire Stops,
Bracing, Bolts
i
Lath.�nt. :�
I hereby acknowledP,e that I have read this Application �. ,
�nd state that [he above is coirect and agree to comply Lath. Ext.
with al] City Ordinances and State Laws regulating
building construction. '
Signature of "� Plaster, Int
Permittee ✓' �- •� n CT C a �-F q
Plaster, Ext.
Authorized Agt. � � - ��
Maeonry Reinforced n
Valuation / Permit Fee $ ,� � �
G� S� Plan Check $ � Bond Beam
s 3/ � Total o
Fee $ � FINAL
� ��.,..., zne r..x iNt i2fix •i . '
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�, � I ' . � Stroet . . ' ,
- PLO� PLAN ' ' '
Show Iowtion and distances irom
c-. property Ifne and between 6uildings. �
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rxaECT �ooness: TRAUT
OWNEN'S NAME: ,I,R
aooaess: 3 3 5 31
646-3
AflLH/ENGINEEH:
9TH ST uxir:
, RAYMOND FRANK
NIDA CALITA
CAPZSTRAN0,92675
flEG.NO.:
RDOflESS: " UNIT:
PENMITTEE: ROSS 6 HARROWS, INC. ( 714 ) 557-7440
pUDflESS: Z6O E. ALTON AV ---
SANTA ANA CA 92707
LICENSEO CONTPACTON DECIABRTION: 1 �ere0y alfirm that 1 am IicenseE un0er pmvisions ol C�apte� 9(commencinA w��� Section
70pp) ol Di��u+Ar�� pusiness antl Pmlert.�q��Mp� ap� my license is in IWLforrq ppd effecL .
�v �� �c avc t. ��
CITy LIC.: qSTRTE LIC.: �f]� C�LA�SS: , � � � �
Ddte: �� � � ' / � Siqnature'. ` i�� /-�� —�-% �uu--L'K1T'Lt.t�+`�(
WONKENS' LaMP(N p LION O•ECt,�Rp�TION: 1 Aere6y aftirm Inat I nave a certiriyte of tons nt ta selFinsure ar a ceniticate of warkers'
COIfIpQO5di1011 �('�;�i'b�.yCB��y.y coov mereoi Isecuo� 3soo. �ae. Q.7 / O 1/� 1
roucr xo.: STATE FUND E%P. OpTE:
'� LOMPRNY:
� Cenilien copy is �ereoy Iumane0. � CertilieG copY is IileE vnl� t�e ciry Builtlinp Division.
�ale: % '-�e - 9/ AOOlic3nl: � /F�t���rr"�Zi�-s�'
E%EMPiION FBOM WONI(EBS' COMPENSpTION OECIAflRTION: QhiS 5edim nCM iwt be cOmple�e0 i� Ihe perml i5 �Or me 1wnOreG �3100) ar leu).
, I c¢N�y I�ai in �he pptlormance of tht work �or which Ihis permil is i55ueE. I s�all not employ any Derson in any manner so as to become
subl�� la t�e Work¢r5' Com0en5alion lavrs 0� Califomia.
Oa�e: SiqnaWre:
NOTICE: II, aller making I�ii 4CCWraiion. y0u Slloultl OeCOme SUGjeCi Io I�e Workers' Compensatron O�a+�ons of the La�ar
Coae. you must ronhwitn compry wim sucn pmvisions or ihis permi� snan be Eeemee revakeC.
CONSTPUCTION LENOINC pGENtY: I �ereUy aifirm tAa� Ihere is a constmciion lentlinp aAency lor t�e pedormance ol t�e work lor
wfu�n IhiS Oermit is issue0 �Section 3W7. Gv. C�. _
LENDEN:
�ooxess:
OWNEP BUILOEP OECLAflRTION: I hereby aflirm I�at I am exempi Imm the Contractors' Stale License Law br U�e following reason
(Section 7031.5 8usine55 antl PmIeSSfonai Code: Any Cily of Counry whit� requires a permi� lo ronstmct, alt¢r, impmve, aemolis�. ar
�epair any stmcture, prior lo its issuance. also repuires I�e ap0�icant lor suc� permlt lo lile a signe0 statement ihat �e/she is IicenseA
pursuant to t�e provisions ol th¢ Cantracmri State Licenu Law �C�aDhr 9(wmmencinq wi�h Section 7000� al Oivisian 3 oi the Buvneu
an0 Pmtesvons CoUe� or �ha� �e/s�e is exempt the�etmm and I�e Dasis lar the alle0etl eKemO��an. My doWUan of Section 70J7.5 by
any apPlicanl lor a permil subl��s I�e app�iWnt to a civil penalty ol nat mOre tilan iNa huntlreC tlollal$ �5500�.
I, as owner� o� Ine ompeny or my employees with wapes as Ineir sale compensation, will eo t0e work, and ine
� stmcwre is not intentletl or oltere0 1or sale (Section 70<a, Buvneu anE Pmiessional Catle: T�e Contractors' Siate License Law
does nol aOD�Y �o an owner ot a D�openy w�o Ouilas or imprOves t�er¢an, antl wM1a Ooes such WOA MmSeINAelself or fhmug�
nis or �er own em0ioyees, provNeG t�at suc� impmvemems are not intentleG or oifereU tor ule. If. howeve� t�e 6uilEinp or
imD�ovement is sole witNn one year ol campletion. tAe ovmer win Mve tne ��rEen ot D�avinq n¢/5Ae OiU noi Oui10 or improve
ta� �h¢ purpOse ot sale�.
I. as mvner of the property, am exclusively comracting vnth licensetl contractars to constmct the projep (Section 704d, Business
❑ and Pmlessions CaCe: Tt�e f,pnVactors' Slaf¢ LiCense Law d0e5 nal appty IO an owner ol properiy wA0 EWIGS or impmv85 ihereon
anG who comracis lor such O�olects wi�h a comractar(s) license pursuam to Ihe Contraciors' State License Law�. I am aware
tlut pmol of iheir Worker's fqmpensation insurance stwula he D���tletl to me.
❑ 1 am ¢hemp� unGer Section: B. 8 P. C.
lor Inis �eason:
Oate: Owner.
� uo nereby cenily thai I am aware ol an0 unEerstanG ihe requirements ol Califomu Healt� and Safety Caae Seclions 25505, 25533. anJ
2553E anA Ihat l 0i any IUWie OuilOing octupan� vrill/wiA n0i (tirtle one� nee0 io crompty wi�h Said Stale m0e5 anE Ihe t¢Quirtmeni5 for a
Vermil �or consirutiion or moGJicalion trom Ihe Air uali�y Managem¢ni DiStfit�. Besitl¢niial tonSlmciian applif2li0n5 are ex2m0� ��om
�Oese pmvisions.
Oate: ADPlicant:
� �ere0y tetlity I�ai I �ave reatl Ihis aO�Ikaiion anA Slal¢ Na� ��e aGOv¢ intOrmalion is COrr¢CI. I aA�e¢ �o ComON ��h aA ci�y antl Counry
araindn[M antl state laws reWlinp lo DwlCng tonsimction anE �ereUy autiqriZe reyesenialives of iNs dry to enter upon Ihe a0ove�mentbnetl
Oropetly fot in50eclion pwposes. / \
Oale: ��' � Siqretme ��� %���-'�'
Oriver's License or Social Secwiry �:
�6aLa6 WM1��2—Butlding: GrCCn—COEe EniOrCCm¢nl; Canary—qppl¢an�; Pink�qavenue; GOIOpmOtl—ASSBSSo�
CITY OF COSTA MESA — BUILDING PERMIT
PERMIT NO: B 051862 PLAN CHECK NO; N � 6 V3�'�li�ior; :—;:=
CONSTRUCTION TYPE: PERMIT TYPE: STR PURPOSE: ALT
JOB DESCRIPTION : T/OFF REROOF W/ BUILT UP SQ FT: 7,900
CLAIM VALUE; 7,400.00 CALC—VALUE: 7,400.00 GROUP OCC: B-2 /
COMMENTS: T/OFF REROOF W/ BUILT UP
�trx�r*�t�t�t�t*x****x��e�*�tx��t�r**�e*�t�***r***�r�t*�t**�+��**��e*�e�r��r�r***�e*�rx*+�*�t*�tr+t�tr**�t*+t�t*
Z O N I N GS ERTEBgAUCIKRSE M E N T S
------------ MAIN HUILDING ----------
FRNT; FT IN REAR; FT IN
LEFT; FT IN RGHT; FT IN
— ACCESSORY BUILDING — —
FRNT: FT IN AEAR: FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ• PROV: PARCEL: 42419108 ZNE; REF NO:
PLANNING NZSTES>
�
If �f M M!f 1f IF iF 3f �E if IF 1E iF K If M If �F �f M if 3! k iE iflflf if If if k iF 1f �f if IF IF if k M M IF 1f )E iF If M IE iF �f if if iF�F�F iFiFiF1t if if if iF iF �f �E �F �f �f if If K�f 1F 1f if iflf
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;
BUSLDING APPROT/ED BY : DATE;
APPLICATION ISSUED DATE• C��F���
IEifMM1FlEMitiEiE�lFiflPiFlfiFiFif iElEiF ififiFiflflFlflflfM af
1EifififiElFifiElFMifii�fMlfMlflEitlFlfMMififiFM1F1f1E1fiFKif�F1 �fIf1ElE�fMiE3FMiEiflflFiE%IfififlFMiflEifMiFMiFikifklfatlfKMlfifMkififiEif
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y
BLDG PMT PLUMBING E CTRIC MECHANIC FIRE SMIP/RES GRADING
PEAMIT 99.00
SMIP/NON—RES
ISSUE FEE I.SS
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DOE
TOTALS----> 100,55 0,00 0.00 500,55 100.55 .00
REVENUE DIVISION TOTALS--> COLLECTED: 100.55 OVEA/SHORT; 00
BLD99PM�� PLUMBING ELECTRIC MECHANIC FIRE SMIPiT55 GRADTNG PLAN—CHECK
If if �F IF IF iF 1f M iF jFiF �f IE iFM M if i1iF if If IF If If if ii K iE if �f �F �FiF if if if if 1F if if iF �F M if iF 1F K iF M iF if it iF 1F if if �f iE iF 1F IF if M iF K 1Fii if iE 1F �f iE K iF iE if 1f iF iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE (jTY D E S C R I P T I O N UNIT COST TOTAL COST
SFC 7400 REROOF BY VALUE COMMERCIAL NOZONE 1,00 7,400.00
END OF FEES
01 OOOEb137—ClIOEd1S$ lS'l9 'I l_�'. �_
DATE: (14/3D/91 7ItiC: 12:4�
�--�
CONSTRUCTION AND PLANNING P00.. d SPA
APPROVALS Permit # Date Inspeetor AppROVALS Permit # Date Inspector
i. Temporary Electrical $e�ce or Po�lev 52. Pool & Equipment Location
^2. Soil Pipe-Undryrnd �+ zQ 53. Steel Reinforcement
�-,�3.'�ElectricalCon'guiz�ltility-Undrgrn`d.`�' 54. Forms
. z4. Hectcical Condiiii-Undrgrnd. w'� 55. Electrical Bonding
��5. Srj'��el�,Reinforc,emeht ` x 56. Rough Plumbing & Pressure Test �
�� �Electrical UFER�Grnd. a 57. APPROVAL TO COVER�GUNITE
-�z7.'�ooting5 TC c 58. Electrical Conduit-Undrgrnd. �•�
i�58. ,Fqundation �.'� �' 59. Gas Pipe, O Undrgrnd., Tes[ � r
=9. Wd"fer Pipe�U �tlr`grnd. ' ' 60. Backwash Lines, P-Trap, O Undrgrnd.
,10. Stivctural Floor SYstem t 61. APPROVAL TO DECK
\7. Pr �perty Sewer Li� & Hbuse ConAection 62. Backwash & Receptor-Final
'12. Sew`er Cap y y y 63. Heater & Vent-Final
13. Roof Drains V 64. Plumbing Sys[em - Final
14. Rough Plumhing " 65. Electrical-Final
15. Rough Electrical-Conduit ' 66. Solar System-Final
16. Rough Electr�c Wiring 67. Fencing & Access Approval
17. Rough Wiring�Sign 68. APPROVED FOR PLASTERING
18. Rough Electr�al-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
- - - - c� C�r�W:. �� ft:
20: Rough_Factory'Eireplace � aT q`7 ' O I ^x''� i� APPR�OVACS�" Peimit #�+ %' �T'
cc ., �n 5:•. � r.,• �:� s Ta x C, Q�¢[u�:= > 1 ;r i�
^ � r:- :� � r. - . .. . „� � � �.; :r ��i
21'.' D'ucts„p SVucfure ••• '.,S S ,.x x� 70.�Under,graurtd Ffydro M
22.Ducts�Gentilating' � ��`� � ^ ,� �i��� 77,produ�t�Piping-[YGas �l0il
c d n�: � .^ S' t- : s.
1 S. .. . � '. Nx'd. i- f:�� I' �-i �
23:, Gas Pip.re-Ro�gh�&;Test .,�s .�� ,. � n;� x: 72. Undergro_upd F.7u��. v � a
24: Roof Fram�ing iY . Ff- v D J�" ~�� e�'� 73% UndergrnZl.Std�'ageTank �Gas D�Oii
.it ••st t i :tii� ti . I .J�.3
25. Roof S eathin ` ` z' f' ' �� � '�"�'` ' ' � � � �
� 9r.< d v v� p;> �)< * 7;��Overheaa Hydr�o' �
26! T=6ar Ceiling (Sttuctural) BCMococoat � � u7 � 7 ;*:n < 7y', Dry Chemical �� t•� V z
v r- re . .-. �. r �, n
2y Frame.and.Flastiin`8 'n �" u � 76.'Dr ���� `�5' ' S `�r �
�L - :� Dtr,cc ��� ,.Y� �x � Y StarlP_�Pe..trJ U
' 2 . Lathir�q&Sidingxa� ��t^' ^ <� •- �•+a 77; FIXED�S�STE ��INA'l� V �"
rt. -. �;.t ` ��� .�•.. i � lTl ' . I � L .t. A - �.
29. Insuiation'. �;K y- ,. �� � � �� �, 7�, FIRE PREV. F�INAL .� � p� T
� 30. OrywalPNatling�-• � y � ! , �� � •-+ HEALTHDEP.TFREQUIRfMENT
,� rr
�. 31. Plaster$rown Coei .S � ;.r,,,. : � ' � A ;: 79: FINAL �NSPECTI,ON ; �' � �
�. 32: Electncal Po`wei RAecerFina� � a i•s I � i< x, 80� FOOD CERTIF.ICYITE ISSUED �
_ -�� -, �.,�
. 33� Final Electt�c '' rt ,� '. � # � I �'� rt �' � Notes: � ��� .F _ ` �T
�; 3,4: Final Heating & Air�ConditioA+�g ;` � � � � r �. �:, j ,��� � 5 �'
�r iry
35 Final Gas Pipe•Te3i _ W '% K^ I �t� •s r :� :� cn,s v lr f%C�
:ti I [�':K'._ :1:0 li.' s r+i��
� 36t Hood or CanoPY n " i ;� n. � � I ' � ,. 5 � :.o � ' n. � � '��r
' ' - a -� :y n
� 37� Final Factory Fire�larte ' j.'� �' `r`' ; �"'*" `� ' ``�
.t : F�:•• --� K P? x l- a�:
z . . .. .. .0 .. �u i .. .� .. n.
= 38. Final Plumbing -+ r � �:r � S + �� �7 O
� J 39. Water Service-Finai J � � - ��� l� •'� �t*+ A x O
-�. ., �: t t[ �
' C 'K ' 1'. ; ' IR �. � y . .. . � .
40. Gas Service_Final., ;
' y ,y!r r s cn I E- a cc r.��u �
: 41. Sotar Oomestic-FinaG :1 " F n � I '�'� �v • -
r. n ��k z^ : v �J + T. ;.7
42'. Backflow Preventei' - " '� � I K° y j�, .+ �' '�
43. Backflow Ir�.igation � �S � � � R ` � � �''!'v ' � .,
. tt . .r . i .
� . '- •�T.�T. • • . . IV `N J �
� y 44. Landscape"liripation SYstem �^ s r n� .Jv� 'r: c 0' N �� .J D
45� Sound Attenuation ' y'z�' "' ' F �� ';�:,�' �` � C. �;�. E-J rt
�
; 46. Handic�p Regulations ;" '� +' � �� �� �r ` � - � p�. � ;.
� � �
47:: FINAL STRUCTIiRE & BUILDING �_ " n, S�: ` x
_ x
48': FINAL PLANNI�G r` ' � E� �`� ' �
; lJ i i ra �a .= w
: � 49r ElectrirRelease to Edison . I � �: R % � ^ % �'�
. .. . �. v .cM� � o» . u
'. 50� Gas Reiease to Soothem Ca;lifornia Gas Co ,K I ,+: ,.� :�,*� - •
� i 51. CERTIFICATE OF OCCUP,AIVCY ; ;. ; ;-,� j:y�, ;Y � ,- G
No. - " Date
,.,_,.�.__._ .w,.._,._..--- .... ----
u
MECHANICAL PERMIT
dob Address: 839 W 19TH ST
Suite No
Vicinity: COIN LESS LAUNDRY
Parcel Number; 42419108
npplicant: PHILLIPS, SEAN ' � ;'� _.
ISSUED BY:
Status: ISSUED
Applied: 09I15/2003
Issued: 09/1&2003
�, i
Address: 11816 WESTERN AW. " � �. � - ' � � ; - - -
�, .
� /; ' - �' , � . Phone:� 714-721-4959 CELL .� I ���_ ��
�
�' �� .'�
STANTON, CA � ` , ' . � Zip: - -90680 -� � - ' i _ \ / �� � � ��
// j. ;�' ' '" ' ��l A�VAA
� � � .
�" � ' � " �
Owner �iTRAUTWEIN;RAYMOND�FRANK � �� �� `/ ���_A.
� %' \ � ' ' � , ; � i . ��:�`�
Address- TR, �� "�, � .�- �
, i i � � ; � .' � '� �. ; .' . �� _ .
����� `NEWPORTBEACH,�CA Phone: ����t,�� � � -'�
, • 1617 WESTCLIFF DR #206 Zip: 92660.5526 � � ' ' �` �
,` i:- ��. _ . � - ' �` , -
Co`ntractor. ; OWNER-BUILDER " _ � �. � � �' �,
Address:-. , , ', � � - � �
, . - . , � Phone. �
� � ' � . � � . . , - �Zip:� _, .
i �
' - '� � ' ,�" � - " License:000000
�' „
� : � . .� . - ,
���- � ' ��" � SCOPE OF PERMIT �� ��
�, ! ; 5,000 S.F. INTERIOR TENANT IMPROVEMENT FOR'COW LESS IAUNDRX' BY�STERLING
, �' ' EQUIPMENT FOR A SELFSERVICE�LAUNDRY. 2 VENT�FANS/SINGLE DUCT, 6 EVAPORATIVE
� - COOLER, 2 3 TO 15 HP�BOILERS. � ' � � , , -
� - - - REF: B03-01240� . _ - _ -
� � � � � � FEE SUMMARY ' .
� - Quantity_' - _ � � ' .- ' ,"
ISSUE FEE.- - . 523.50 ' � � ' Repair / Alt Absorbtion Unit �
Inst FAU <700 k BTU 50.00 0 Repair I Alt Refrigeration Unit ,
Inst FAU >100 k BTU , 50.00 0 Ventillation System � ,��
Repair/,Alt Cooling/Heat 50.00 0 EvaporativeCooler � '
Inst / Rep. Recess Wall Htr� $0.00 0 � Commercial Incinerator ,� �
Refrig`Sys <700 k BTU �� �� ' $0.00 0 �-' Domeslic Incineralor , < ; �
Refrig Sys >100 k BTU � � �' $0.00 0 ., ti �"'�� Compressors / Absorolion Svslems �� � �
GasPiping':�� $0.00 0 ,� ' - ����
Factory Fireplace , �� ����50.00 . 0 �
Hood wlMech Exhaust � $0.00 0
VAV Box �V � ; . � ' � $0.00 , 0
Venl Fan I Single Duct � -,$14.50, �,. 2 �
Appliance � � " , ; 50.00 � 0 �
FireDampers V`;��, ' , $0.00 . 0 _
Smoke Dampers \ -�� -� $0.00 , �0 -
Inst or Relocate Appl Vent �� , � 50.00 ; 0', ��
Air Handlers < 10000cfm " $0.00' ,� 0. � � .
Air Handlers > 10000cfm .. 50.00 0 - - ' - '
Floor Pumace � 50.00_ 0 � `
Floor or Suspentl Heater 50.00� 0' -.. �,-
Up to 3 hp /400 k BTU ,
'3To15hp/SOO�kBTU�•� � �
75 To 30 hp / 1,000 k BTU - ,
" 30 To 50 hp / 1,750 k BTU " '. �.
Over 50 hp I Over 1,750 BTU .
Boilers ". � ' � -
-. . _Up�to�3hp " - ,�,�-'.
3To15hp'� � � �- � �
15to30hp � , � , � '
' . . - '30 to 50 hp _' ` � � ' %
Over 50 hp , � �
_ - -Other Mechanical Fee � " j" �
� InvestigationFee �'�.-'
, �Plan Gheck Fee �'
._ �. � ,Reinspeclion Fee
� Quantity
50.00 0
30.00 0 � '
50.00 0 . �� '
$63.80, "8 ;
i $000, 0
\$0.00' 0'��
' $0.00 �� 0'
' $0.00 � 0
$0.00 - 0
$0.00� 0
$0.00 0
'$0.00 0
$54.30 2
$0.00 0
50.00 0
$0.00 0
50.00
$0.00
$0.00
NO710E: 7he work authorized by this permit shall comply with all applicable handicap accass requirements under Caiifomla statutes and retated
regulations. (Ord. No. 92-28, § 7, 12-21-92)
EXPIRATION: This permlt shall automatirally ezpire arM become void II work Is not commenced within 780 days, or it work Is suspended or abandoned
for e period of 180 days.
INSPECTIONS: In ortler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end ell
requlred Inepectlons and (inal approvel must ba obtained. Failure to obtain Inspectlons and final approval will result in the expiration of this pertnit.
FOR INSPECTIONS CALL: (7/4) 754-5628 , �
WORKERS' COMPENSATION DECLARATION: _ �
I hereby eHirm under penelty of per�ury one o1 Ue following AeGeretlons:
❑ I have end will maintein e certlllwte of cansent to self-Insure lor workers' compensetlon, es provided for by sectlon 3700 oi the Lebar Code, lor ihe peAormance of Ihe
work far Wh�h thls permll Is Issuetl.
❑ 1 heve ena wlll melntaln workeB' compense0m insurar�ce, es required by sectbn 3700 ot Ne Lebor Cotle, for the pertortnence oi the xrork tw whMl� Ws pemtil is Lswed.
My workers' cwnpensallon Insurence cartier erW pdky number ere:
Certfer. Pollcy Number.
(Th/s sectlon nBed not be complefed lllhe pemUf ls veluetl et one hurMred dollars (5100) or less.)
���I ceNfy IM1at In the pertormance of Ine work tor which t�is permit is Issued, l ehell not employ eny person in eny menner so es to become aubJecl lo �he workers'
canpensat� �� s af�ia, end egre)�� If I shoulA Decorne suDJect to Ne workers' compensation provisions of Sec�n 3700 0l lhe Labor Code, I shell forthwlth
comply wi�h t�ese O�oW ' /
newica��sia�w,a: coa�e? `I J,� 03
.�
WARNINO: FAILURE TO SECURE WORKEH$' OOMPENS4TION COVEMOE IS UNUWRIL AND SWLLL SUBJECT AN EMPLOYER TO CRIMIIUL PENALTIES AND CML FlNES UP TOONE HUNDRED
TMOUSAND DOL1�E (5100,000). IN ADDfT10N TO TME COST OF COMPENS�TION, OAMAOES AS FROVIDED FOR IN SELTION 3708 OF THE UBOR CODE, INTEREST, AND ATTOqNEYS FEE$,
LICENSED CONTAACTORS DECLARATION: '
I here0y eNirtn lhat I em Ifcensed under proNslons of Chepter 9(canmend�q with Sectlon 7000) of DMsion 3 ot the Business and Professions CoAe, erM my license Is In full
torce enO eNecl. Lic. a Cless a
CanlrectoYs SIQnaNre: Date:
CONSTRUCTION LENDING AGENCY:
❑ � nereny emm, u,at u,ere Is a consin,c+ion �ena�op apemy ta ihe penormanca m fna work tor wnicn m�s perrrdlls lssuea. �sec. 30�n, civ➢ coae).
Lentlers Neme: Lentler'9 Atltlress:
SlgneWre: Date:
OWNER-BUILDER DECIARATIONS:
I here6y eHirtn that under penelry of perjury Ihet I em EXEMPT FROM THE CONTRACTORS LICENSE LAW lor Ihe tollowinp reawn (Sec. 7031.5, Buslness entl Professiwu
Code: Any city o� counry whlch requires e pertnit lo conslruct, elter, Improve, demalish, or repair eny atructure, Prlor to Its issuance, elso requires Ihe epplicant lor such pertnit
to flle e sipned stetement thet he or ahe Is IicenseE pursuant to the p�ovislons af the Contractors llcense Lew (Chapter 9(commencing with Section 7000) of Dlvision 3 of the
Buslness entl P�ofessions Codej or Ihat he or she is exempt Iherefran and Ihe besb for the alleged e:emptlon. My v1olNtlon of SecUon 7031.5 Oy eny epplicartt far a permlt
sub�ects Ihe epplicent lo a civil penalry ot not more Nan five hundred dWlers ($500).):
❑ I, as owne� o11he properry, or my employees wiN wages as the�r sole compensatlon, WILL DO THE WORK, flntl Iha structure Is not IntenAetl w ottereE for sale (Sec.
7044, Busi�ess end Professions Code: The Contrectors Llcense Law does not appty to en owner of proper�y w�o build9 or improves thereon, and who tloes such work
himself or herself or throuph his or her own employees, prwided thet such improvements ere not intended or otterad fw sale. If, however, �he builtling w improvement b
sold within one year of completion, the owner-builder will have ihe burden ot Oroving ihet he oi she did no� bulld or improve for purpose of sele.). '
eT7 I, es owner of ihe properry, em El(CLUSIVELV CONTRACTING WRH LICENSED CONTRACTORS lo wnsiruct the project (Sec. 76M14, Buslness and Pmtessbns
Code: The �«actors License tew does not appty ta en owner at property w�o builds or Imprwes therean, antl who conVac�s tor such pro�ect wlth a conireccor(s)
license Dursuant ta the Contractors License Lews.).
❑ 1 em exemp�//hder sec. //i /, Business and Prolessions Code for this reeson:
Owner ID verifietl Dy tlrivefs license. 7(( Ves ❑ No
Veriflcation of Ownership by (type ot document, i.e. - properry tex bi0 or dee�:
�'Oete:� % /.r'��
e�`raa:• `l— �t�a�
DIVISION OF INDUSTiiIAL SAFETY PERMR CEHTIFlCATION:
❑ I hereby cBrtity thet no excavatbn Me (5) or more teet in Cepth into whkh e person U requlred to Aescend, wlll be metle In connectlon with work euthorized by NU
pertnit, end t�at no Duilding struqure, scettoltling, telsevrork, or tlemditlon or tlismentling t�ereof, wlll be more t�en Ihirly-siz (38) leet high, (C�ap. 3.2, Grp 2, Ar12, Sec.
341, Ttle 8, Celifomla AdminislretNe Cotle).
❑ As ownar-builder, I wlll not employ flnyone to do work w�lch would requlre e pertnit trom the Dlvislon ot IndusMel Setery, es notetl ebove, unless such peraon hes e
permit to do such work Irom tho diWslon.
Signature: Dete:
Dlvislon of Indu5lAal Safery Pertni� Number:
(CERTIFlCATE OF C�MPLUWCE AND AUTMORVJITON OF EMiiY: I cenify under penelry of perjury thet I �eve reatl Nis eppllcation end stele Ihet the informetion piven lv I
correCt. I Bgree ro campry wilh ell stete laws erM dry ordinances releting ro bullding construdion, flnd euthodze representatNes of t�e City ot Coste Mesa ro enter upon Ihe
ebove-described Property tor inspection purposes. l agree no� to awpy or atbw occupanq oi eny buildinp euthorize0 by Nis parmit unlil finel inspectlon.
cooe �.
1818
1268
200
201
202
203
204
FUcetl System Flnel Fire Praventlon
Pod Spe Flnal
Flnel R9-Rool
Flnal BIfxWReleininp Well
Flnal Factory Fire Placo
Finel Sign
Finel DBmolition
PAIE P�1dL5
� wsvernoxme .
208 Finel Mechenical �
' .208 Finel Plumbinp ,
210 Flnel Elecidcal
212 Flnal Flre Preventlon �
220 Final Plenning Apprrnal
222 Finel SIIe
250 Finel Bullding/Occupanry
L i
(774) 754-5273 • Fex (714) 754-4856 • www.ci.coste•mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626
Job Address: 839 W 19TH ST
Suite No
Vicinity: COIN LESS LAUNDRY
Parcel Nunmber: 42419108
PLUMBING PERMIT
- Stafus: . ISSUED
Applied: 09/15/2003
Issued: 09116/2003
- - � � ISSUED BY:
,�- , .. � . _ -- . - _ . _
Applicant PHILLIPS, SEAN��'�`;' � � � � ��= _ -
Address: 11816 WESTERN AV - � - ' ` �' � ' _ �' � � � ' . � .
� � '• � � � � � Phone 714-721-4959 CELL ' . �� .
��
. STANTON CA � - . - - Zip'. -90680 � ,_ � �, " � �
�;-� � -. -_ �- .. _ � . � - � �
� \ � . � _� �
/ / j� / �, �. � , __, � -- � �
i
�
Owner �'TRAUTWEIN,.RAYMOND FRANK ` ���` / / j ��� �
� Address 'TR �� � ��� ����� �' � �
, .C���' . / '�\
, , �, / . NEWPORT BEACH, CA Phone: , ' �, �
� ' � /; 1617 WESTCLIFF DR #206 Zip: � 92660-5526 ` �
, � , , . �
i� . " - �. . � �
� _ _ , ' �.' - � � , -� - � \
Contractor: OWNER-BUILDER . _
�� � Address: _' .� f 1 , � •• - - _ � , ' • ,
, � . . ;� < � " - �Phone: - _ .. .., . . � �,
.. .. _ . . �� � . ,. . �,'�
� . . . , . Zip: . _. � � - ,
� A �. � � � - _.. .
, , License: 000000 � . , ,
i �
� ,Aich / Eng;.
Address:
i. .' • '. � • � � _, '- . . �
� - . Phone. , .
V� . . ,�,'�t• rZi - � =A_. �-�---- . � � � ,
P ^_ ;
, `� - � . : �License: - " _ . . � _ • . _ _ , . .
� `.� � ,- � ,� ' - ' ��
�, ��� � � - � � SCOPE OF PERMIT`_'�, . � �%,� � � � � �
`� 5;000 S.F. INTERIOR TENANT IMPROVEMENT FOR'COIN.LESS LAUNDRY" BY STERLING EQUIPMENT- ,� �
\�\ ��: \� FOR A SELF-SERVICE LAUNDRY. 1 BACKFLOW FREVENTER, 8 FLOOR DRAINS, 1 GAS OUTLET �� �� �/ .
��,� \`" ,�(1-4);,35 GAS OUTLETS OVER 4, 1 GAS,SERVICE'73 LAUNDRY TUB/WASHERS, t SEWER CONNECT, / �; .
\`_' `= " 1 COMMERCIAL SINK, 2 FLOOR SINKS; 1 SERVICE/MO?�SINK, 2 WASH BASINS, 2 WATER� -' ' ��, �"
�� 'CLOSETS, 2 WATER HEATERSNENT, 7 WATER REPIPE, 1 WATER SERVICE. -���� �
� >, i
� ,�� c REF:803-01240 �:-.: .. . .. � , - .7 . ' . � '�'� � - .�,� • .
V'�� . �-�; , - - - " i ., - i �
��,� ; �: , ' FEE SUMMARY ,
� ���. `AMT - �. QTY �� - AMT QTY � - - '
ISSUE FEE � �� $23.50 ' � �Laundry Tub / Washer, $775A0 73- " Sump Purrip .'
BackBow irtigation �� -$0.00� �� ] � i - Landscape Irtigation 50.00 � 0 ' �Swimming Pool ,��
Backflow Preventer �$9:80-, 0; -���- � ���P-Trap, $0.00 - � 0 �'� �, `Trap Pnriier %
Bathtub $0.00 �� -0 - . '� , Pressure Regulator �� � $0.00 0 � � �Urinal�,�'� �
Clanfier System $0.00"�_ � -0��'-- �` Process Piping (per�10 k) $0.00 �0.. � ' -Vacuum Brkr Bkflow(1-4)
Connect Qce,Soda,etc) $0.00 0 � -- � �Receptors � -„��'., � , 50.00 - 0 � "Vacuum Brkr BkBow(5+)
Dental Uni[s $0.00 0�� -. Septic Tank 30.00-- 0-, -/ j�Wash Basin
Dishwasher $0.00 0 �"Sewer Cap for Demo ,��: 50.00 `�. 0-�� Wash Basin Set
Drain, Floor $78.40 B Sewer Connect - $24:65 � 1 Waste and Vent System
AMT
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$19.60
$0.00
$0.00
an
0
0
0
0
0
0
2
0
0
NOTICE: The work aulhorized by this permit shall comply with all applicable handicap access requirements under Californla statutes and related
regulations. (Ord: No. 92-28, § 1, 12•21-92) ,
EXPIRATION: This pertnit shall automatically expire end become void if work is not commenced within 780 days, or If work is suspended or abandoned
for e perlotl of 780 days.
INSPEC710NS: In ordar for the work eulhorized under this permit to be considered legal, such work must comply with all applicable codes, end ell
required inapeetlons and flnal epprovel must be obtained. Failure to obtain inspections and final approval will result in ihe axpiratlon of this pertnit.
FOR INSPECTIONS CALL: (714) 7545628 .
c«o.0 �vw�
WOHKERS'COMPENSAnONDECLARAnON: � �
I nereby efflrm uneer penalry ot pe7ury one of the followinp tledaratlons:
❑ I heve enG wlll meintai� e certificete of consent to aelf-Insure for workers' compenseilon, es provided tor by section 3700 of the Lebor Code, for the peAortnance oi iha
work for whkh Nls pertNt is Issued.
❑. I.heve arM wlll melntain workers' compensatbn insurenw. es rqquired by sectlpn 97pp p� pie Lebor Code. for Ne peRormance of Ihe work for whkh this pertNt Is iswed.
��� My worketa' compensatlon Insurence cartler anA policy number are:
Certler.- � `" PdicyNumber.
(Tirls secNon nee0 nof be comp�ete0!/ fhe permltls ve/ued et one hundred dollers (S100J or lesg.)
��I ceN1y t�at In the peAortnance oi iha work for which t�is pertnit is issued, I shell not employ any person in any manner ao es to Decome subject to the workers'
compensatlon laws oi C ifomia, entll ee � t if I shaultl beCome sub�act to the warkera' campensatlon pravislons ol Section 3700 0l the Labor Coda, l shall lorthwUh
compy with these Prrn ons.
`A,wi�mab�an,re: ..,o. oet—,-a� 9–/S–G3
WARNINO: FNLURE TO SEWRE WORKERS' CpAPE TON COVERAGE IS UNLAW FUL M!D SHl�LL SU&IECT rW EMPLOVER TO CRIMINr1L PENALTIES AND CML FlNES UP TO IXJE HUNDRED
TFqUSAND DOLURE (5100,000). IN ADDITION TO THE COST OF COMPEN$ATION, DMM�ES AS PROVIDED FOR IN SECTION 3')OB OF THE LABOR CODE, INTERE5T, AND ATTORNEI^5 FEES.
LICENSED CONTRACTORS DECLAfiATON: �
I hereby effirtn Ihet 1 em Iicensed untler proNslons ot Chepter 9(commenGng wlih Section 7000) ot Division 3 of the Business and Professions Code, antl my license Is In full
force end eflect. Lic. x Class x
Contractofs Signature: Dete:
CONSTRUCTION LENDIN6 AGENCV:
❑ I nereby atflmi thst there ts e constniaion lenalnq epen�y tor the peAoimance ot tne wotK tor wnich tnis permit is issued. (sec. 3os7, crvll Code).
Lendera Neme: LendeYs Atldress:
SlpneWre: Date:
OWNER-BUILDER DECLApAnONS:
� hereby efArtn Net under penelry of perJury Ihet I em EXEMPT FROM THE CONTiiACTORS LICENSE LAW for the tollowing reeson (Sec. 7037.5, Business entl Professions
Code: My clry or counry whi�h raquires e permit lo construct, alter, improve, demolish, or repair any structure, prior ro its Issuance, elso requires Ibe epplicant tor sueh pertnit
to Ole e signed ata[ement that he or she Is Ilcensed pursuent to ihe pmWslons of Ne Contrectors lJcense Lew (C�apter 9(commendng wi�h Seclion 7000) of DNlslon 3 of the
8usiness end Professions COGe) or Ihat he or sha is e:empt Iherefrom arW 1he basLs lor Ne ellegetl eaemptlon. My violetlon of Section 7031.5 by eny appllcant tor e pertnN
sub�ectn the epplkant ro e clVl� pe�alry ol not more then Me hundred tlWlers (5500).):
❑ 1, es owner ol ihe praplrty or my employees wlth weges es their sole compensetlon, WILL DO Tl1E WORK, end the structure is not Intended or offereO lor sele (Sec.
7044, Business end Pro�ess�wis Code: The Contredors License Lew does nat appty to en owner at property who builds or improves thereon, and who tloes such work
hlmsetl or herseH or Mrough Ms or her own employees, provided thet such Improvemanis are not imentletl or oXered tor sale. II, however, ihe buildinp or Impmvement is
eolO wit�ln ona year at �mpletion, tha owneo-builtler will heve the burden of pmving that �e or she did not hudd or impmve tor puryose of sale.). '
�I, es owner ol ihe prapehy am EXCWSIVELY CONTRACTING WITH LICENSED CONTpAC70BS to construct Ihe pmlect (Sec. 70a4, Business and Professians
Code: TTe cantractors L��ense Lew does no� eppty to an owner oi pm0erry who �ulltls or impraves Iheraon, and wha cantrects br such proJect with e contrector(s)
Iicense pureuent to the Conir�ore license Lews.).
❑ I em exempt u¢ber sec, ,/�,R/ Buslness end Prafessions Code for Ihis reeson:
Owner ID vedfled by drivers I��ense. �Ves ❑ No �-Drivere�Llcenee;No.
Vedflcetlon ol Ownership by (rype of Gocument, I,e. - property terz bill or deetl):
DIVISION OF INDUS7filAL SAFETY PERMR CERTIFICATION:
❑ I hereDy certNy that no bxcavetlon flve (5) or more feet in tlept� into which e pereon Is required to tlescend, will be made in connection with work authorized by this
pertnit, end that no building siructure, scaHolding, lalsework, or demolition or dlvmantling thereof, wlll be more than thlrty-slx (38) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title 8, Calitomia AdminblretNe Cotle).
❑ As owner-builder, I will not employ enyone ta do work which would require e peimil from the Divislon of Industriel Sefery, es noted ebove, unless such pereon hes a
permlt to tlo such work from ihe division.
Signeture: Dete:
Dlvlsion of Intlusinel Salery Permit Numbar:
CEHTIFlCATE OF COMPLIANCE AND AUfF10RIZAiION OF EMRY: I certify untler penelry o1 perjury that I have read this epplicatlon and state thet the Informetlon given is
correct. I agree to compty vrith ell stete laws entl ciry ortlinences relating to bulltlinp consiructlan, entl euNOAze representeWes of the Ciry of Costa Mese to enter upon tne
ebove-descdbed property br inspectlon purposes. I egree not to occupy or allax occupancy oi eny building euthonzed by Ihis pertnit uNil flnel inspection.
OI Legel Owner(s)
i, : m � , u y
1818 Flaed System Flnal F�re Preventlon
1268 Pool Spe Final
2W Finel RaRoof
201 Flnal Block/Re�einirp Wall
202 Final Fectory Flre Pla�e
203 Finel Sign
204 FlnalOemoliliort
�ff. I��
CO�E I INSPECTION TYPE
206 Final Mechanical ,
208 Finel Plumbing
210 Final Electdcal
212 Finel Fire Preventlon
220 Final Planning Approval
222 Final Site
250 Final Building/Occupancy
� �LL
(�ta� �sa-sz�s • Faz (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIFi �RIVE, WS7A MESA, GA 92626
Job Address: 839 W 19TH ST
Suite:
Viciniry:
Parcel Nunmber: 42419108
SIGN PERMIT
Zoning:
Applicant: ARTINGER, PAUL, - '
Address: 7541 SANTA RITA , , � .
SUITE D � ' Phone: 714-894-2011
STANTON, CA � - � � Zip: 90680
Owner. , TRAUTWEIN, RAYMOND FRANK
Address TR ' �
, � NEWPORT BEACH, CA - Phone:
� �, 1617 WESTCLIFF DR #206 Zip: 92660-5526
Contractor.- CONTINENTAL SIGNS INC
Address: 7541 SANTA RITA CIRCLE �
SUITE D Phone: (714) 894-2011
STANTON, CA . , Zip: 90680
, License: 664525
Arch / Eng : . - �' - �
Address: � - � " �
Plan Check:
Permit:
SMIP Com:
Other:
Inspection:
Total:
Phone:
2ip:
- � License:
Status: ISSUED
Applied: O1/13/2004
Issued: 01113/2004
ISSUED BY:
`
" SCOPE OF PERMIT
INSTALL A NEW 49.5 SQ.FT: BUILDING SIGN FOR A NEW LAUNDRY. - . -
'COINLESS LAUNDRY".
FEE SUMMARY
$63.21
$0.00
$97.25
$0.84
$0.00
$0.00
$0.00
$0.00
$0.00
$161.30
PLANNING & ZONING
NOTES: �
Calc Valuation: Sa,000.00
Claimed Valuation: Sa,000.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automatically expire and become void if work Is not commenced within 180 days, or it work is suspended or abandoned
for a period of 180 days.
INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
required Inepeetions and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the explration of this permit.
FOR INSPECTIONS CALL: (714) 754-5626
2aa�ae �amo�
WORKERS' COMPENSA710N DECLARA710N:
I hereby eHlrm under penalty of perjury one of the following declarations: � •
❑ I have and will meintein a certificete ol consent b self-Insure tor workers' compensatlon, as O�o��ded tor by section 3700 of the Lebor Cotle, lor Ihe pertortnance of the
1 w��ork lor whlch this permlt Is issuetl.
p��nave end wlll maintain workers' wmpensation Insurence, as requiretl by section 3700n1 the LeDor Code, Por Ihe peAortnance of Iha work br whlc� ihis pertnit is issued,
J� My workers' compensation Insurence cerrier end policy number ere: p�
Certier: S �� _� PolicyNumber: ��� /J.� I�
(Thls secNon ne ne�pompleted i/ the permiNs valued et one hundred dollers ($ f 00) or less.) —�
❑ I certify that in the F
compensetlon laws
comply with Ihese �
Applicant Signature: _
of ihe work br whic� this permit is issue4 I shell not employ any person In any manner so as to become subiect to tha workers'
, antl egree that If I shoultl �ecome subject to Ihe workers' compensetion Dmvisions o Sectlon 3700 oi the Lebor Code, I shall forihwlth
Dete: �� � —I?� � 0`�
WARNING: FAILURE TO SECURE WORKER$' CqAPENSATION COVEMG I UNLAWFUL PNO SHHLL SU9IECT PN EMPLOVER TO CPIA4NAL PENALTIES AND CML FlNES UP TO IXJE HUNDRED
TFKKISANOOOILAqE(5100,OW),INADDITIONTOTNEWSTOFCQNPENS ON,DNMGESASPROVIDEDFORINSECTION31060FTHEUBOR�DE,IMEREST,FNOATTORNENSFEES.
LICENSED CONTRACTORS DECLARATION:
I hereby aMirm Ihat I am licensetl under rovisions of
force end eHect. Lic. N <
ConlrectoYs Signeture: r
(commencing with Section 7000) of Divlsion 3 0l Ihe Business and Professions Cotle, end my license Is In tull
Cless q �l�6J�
^�^-�—�� Date: � I � /1 �/_
CONSTRUCTION LENDING AGENCY:
❑ I hereby aNirtn ihat Ihere is a construction lentling egency for the pedormance of ihe work br which t�is permit is issued. (Sec. 3097, Civil Code).
Lentlels Name: Lendefs Atldress:
Signeture:
Date:
OWNER-BUILDER DECLARATIONS:
I hereby eHirm t�al under penalry of perjury that I am E7(EMPT FROM THE CON7RAC70RS IICENSE LAW for the following reason (Sec. 7031.5, 8usineu end Professions
Code: Any ciry or counry which requires e pertnit to consiruct, elter, improve, demolish, or repair any structura, prior to its iuuance, elso requires the spplicant for such permit
lo file e signed stetement that he or she Is Iicensed pursuent to Ihe pmvlsions ot ihe Contrectors License Lew (Chapter 9(commencing with Sedion 7000) 01 Division 3 ot �he
Business end Protessions Code) or ihel he or sha is exempt iherefrom and the basis for t�e alleged exemption. Any violation of Seclion 7031.5 by eny applicant tor e pertnit
subJects Ihe epplicant to a civil penalry oi not more Ihan five huntlretl dollars ($500).):
❑ I, es owner of iha properry, or my employaes wlth weges as iheir sole compensetion, WILL DO THE WORK, antl ihe stmcWre is not Intended a otteretl for sale (Sec.
7044, Business and Professions Code: The CoNrectors Licensa Law does not apply lo an owner of property who builds or improves Ihereon, and who does such work
himselt or herself or through his or her own employees, provided thet such impravements ere not Intended or aHered for sele. If, however, the building ar improvement Is
sold wiihin one year of completion, the owner-builder will have ihe burden of proving that he or she did not build or improve for purpose ol sele.). '
❑ 1, es owner ot t�e D�aDerry, am E%CLUSIVELY CONTRACTING WITH UCENSED CONTRAC70RS to construct the projecl (Sec. 7064, Business and Professions
Cotle: The coniradors License Lew does not epply to an owner of propeny who builAs or Improves ihereon, and who contrecis br such pro�act wlth a contractor(s)
license pursuant to the GONractors License Lews.).
❑ I am exempt under sec. Business and Protessions CaGe for this reeson:
Signature: Data:
Owner ID verifietl by tlrivers license. ❑ Ves ❑ No Dnvefs License No. Expires:
Vertlicetion ol Ownership by (rype of documenL i.e. - properry tax hill or tleed):
DIVISION OF INDUSTRIAL SAFETY VERMR CERTIFICATION:
❑ I hereby certify ihet no excavatlon five (5) or more feet in Uepth into which e person is required ro descend, will be made in connection with work euthorized by this
pertnit, and that no building sirudure, scaHolding, lelsework, or demolition or tlismantling thereof, will be more ihan thirty-six (36) feet high. (Chap. 32, Grp 2, Art 2, Sec.
341, Title B, Califomia ACminis�reUve Code).
❑ As owner-Duiltler, 1 will not employ enyone to do work w�ich would require e pertnit Irom the Division of Intlus�nal Safery, es noted ebove, unless such person hea e
permit to tlo such work irom the tlivision.
Signature: Date:
Divislon of Industrial Safery Pertnit Number:
CEHTIFlCATE OF COMPLIANCE AND AUTHORIZATON OF EMAY: I cenity under penalry of perjury that I have read this application and state that the infortnatlon given is
correct. I egree to compty with ell stele laws enC city ordinances relating to builGing construction, and authodze representativas ot Ihe Cly oi Costa Mesa ro enter upon Ihe
ebove-described praperty tor inspection purpases. 1 egree not to accupy ar ellow occupancy of eny building authorizetl by Ihis permit until finel inspection.
COOE 1. INSGECTIONTYPE
7616 Flned System Flnel Fire Prevention
1268 Pool Spa Final
200 Flnel Re-Roof
201 Finel BIocWRetaining Well
202 Final Factory Fire Placa
203 FInelSign
204 Final Damolition
�g ��$ �QQFj INSYECTIONTVPE
206 Final Mechanical
208 Final Plumbing
210 Final Electrical
212 Final Fire Prevention
220 Final Planning Approval
222 Pinel Site
250 Final Building/Occupency
PAIE It�EL�
�/61 �j,��
�i w� iar•�ua - ran�i .�.a+-. ...... . .........�............�.. ......,...
ELECTRICAL PERMIT
Job Address:
Suite No
Viciniry:
Parcel Nunmber:
839 W 19TH ST
COIN LESS LAUNDRY
42419108
Status: ISSUED
Applied: 09/15/2003
Issued: 09/16/2003
Applicant: PHILLIPS, SEAN _ -- ISSUED BY:
Address: 11816 WESTERN AV � ,ii''-'�� ��� � _ - _ , ,�
� � ��� � �� � � � Phone: 714-721-4959 CELL� - �
r�.5- _ '�
STANTON. CA; �' � -. � � - Zip: 90680 ; , ' � ; ���
_.. � - . - - , . �
�
` -' �`� �
��;/% . � �- "., , _ ' �_ ; _ . -,- . � . �� �-��A,
Owner: %TRAUTWEIN, RAY.MOND�FRANK. ' - �� � � � ' � ��� � �\
�`�/'i'� , " ��. ��, ����� .�� �
Address.� �'TR. ' �� _ _ - , � � ` . � :�� �.
/ . .� � � � ' � \v�, '
/ - � � NEWPORT BEACH,-CA" Phone: � /
i i � . , , A'.:'.�� � � -` �
/� ��/ �1617 N%ESTCLIFF�DR #206 Zip: 92860-5526 `' `�� � � � �� �� A
� ". , -� i% �� � , �,. _�� �: _ � ;' �
; �- ..: . � � � .,
. . . , . ..�',
' Conuactor: � OWNER-BUILDER . ` ' �,' � � `
� � Address: ' - , '- . , . � ' `
, ,- . , , , _. �Phonei . , - . � . - . . - ,
, _ . -; ,. , , �
' � ' .� ' . . , . _ - ZiP, -.. . ; . .
' . License: 000000 � _ - � ' � �
I , ,/,:,
� .- � �
' SCOPE OF PERMIT , �
��. ,�% ' 5,000 S.F. INTERIOR TENANT�IMPROVEMENT FOR "COIN LESS LAUNDRY" BY STERLING EQUIPMENT �
'� FOR A SELF-SERVICE LAUNDRY. 43'UGHT FIXTURES, 19 OUTLETS (INCLUDES 2 VENDING � � ,
i� . MACHWES AND 2 COIN MACHINES), 12 SWITCHES, 73 NON RES APPL, 1 SERVICE TO 1000A, 1 Y'
� SUB PANELS TO 200A. . � � ,
�' ,
�� � , ,REF:B03-01240 „ �,,.% :��\ _, , . _ _. � �
' `� - - �- - - ' � ' �� � , � .
FEE SUMMARY �
�,
- r Quantity - - _ - , Quantily"� � � ,`
ISSUE FEE � , � `;�.. $23.50 Temp Dist System % Lighting $0.00 -0. � �
Temp service test ^ , $0.00 . ;-^:Busway /100 ft $0.00 � 0. �,� `
Res.a/cpackage ��`� $0.00 -�`:'�� �� SfandingSeclion $0.00 '� -0 �
New Res�(1,2 unils) _ ���$0.00 '� 0 � �`?�" ' ' Misc Electrical Equipment $0.00 �-%� �0 � i �, �,�
New Res (3+unlLs) , � ��$0.00 , 0 , , _ . Transfortners up jo 1_kJa/kw.= _ _, $0.00 � � 0 '� � �
' _..; '� . . �
Pool / SPa � � �,� - $0.00 . - 0 � ................uP to 10 kvalkw $0.00' 0 .. , , .
Lighting Fizls�� � ' `. ', $3879� � ` , 43 - " :................up to 50 kva/kw " E0.00 / � 0 � ,
Recept OuUets - ` -' . . $20.90 _ ; 19 � � � ' .................uP to �100 kva/kw - ;'- $0.00; , � 0 - " �
Switches � � � . � . $1930 , � � `12 � � . , ..................over 100 kva/kw � $0.00 -� 'p � ,",
Non Res Appl ��� $34675 � � 73. � � Low Voltage Equipment � . ' $OAO 0 - i �
ResAppl �' -V ��$0.00 �� 0 � � - �LowVOItWlringSystem/Ckt - $0.00�� ,-Oy �i
Service to 200a �� � ` $0.00 ' i '0 � � � Misa CondWt � , �$0.00 � 0 � �
Service to 1000a �� $82:15 � _ �. �� ,1-" � �- Misa Conductor � � , � � $0.00 �-/0
Service over 1000a �$0.00 �-_ - 0� � ; , � , Circus ( gen or riile) ' � $0.00� - 0
Motors to 1 hp $0.00. � � ` -� 0 -" ` � � . � Circus (mech ride.or lights) . . ,,'�$0.00 0
nnotors to 70hp $0.00 �-�" 0 �-'� �-� �� �Christmas Tree Stand " ` �/$0.00 0
Motors to 50hp $0.00 �� 0 _, - Fireworks Stand- i���%�� 50.00 0
Motors to 100hp 50.00 0 � __" �' Other ElecVical Fee 50.00
Motors over 100hp $0.00 0 - - � -�
,
NOTICE: The work authorized by this pertnit shall comply with all applicable handlcap access requiremenis under Califomia statutes and reiated
regulations. (Ord. No. 92-28, § 1, 12-21-92)
' EXPIRATION: Thls 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 ot 180 days.
INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with ell applicable codes, and all
required Inapectiona end final epproval must be obtalned. Failure to obtain inspactions and final approval will result in tha ezpiralion of this pertnit.
FOR INSPECTIONS CALL: (714) 7545626 ,
2aae-ae Iarool .
WORKERS'COMPENSAnON DECLARAnON: �
I �ereby aKrm untler penalty of peryury one of Iha tWlowing tledaratians:
❑ 1 have and will malntain e certiTicate of consent to setl-Insure for workers' compenutlon, es proNdad for by sedlon 3700 ot Ihe Lebor Cade, for the DeAormance of the
work tof which ihis,pertnit 15 I55ueA.
❑ I have a�tl will maintaln workers' compensaGon Insurence, es requlred by seclion 3700 of tha Lebor Cotle, tar the perlortnance ol Ne wwk for whtch Nls pertntt Is Issued,
My workere' compe�eatlon Insurence cerrier end policy number ere:
Cerrler: policy Number:
(rn/s secfion �eed not be oompleted ll fhe permlf Is velued ef one hundred dWlero ($100) or less.)
�`I certi�y �het In ihe peAormance of Ihe work br whlch �his pertnit is lssued, I shell not employ eny person in eny manner so es to become subject to the workers'
compense�lon laws of Cel' le, antl apraq99��tffI11}yyt If� ahoulA become sub�ect to the workers' compensetion pmvisions ol Sectlon 3700 of the Lebor Cotle, I shell fort�with
comply with these provis' . /� ///%
n�pW_karn�s�gneture:= � ✓�ii!�. �p�__Y._ q_��-a 3
WARNING: FAILURE TO SECURE WORKERS' WMPENSATON COVEMGE IS UNUW FUL AND $HqLL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIFS eW0 CMl FlNES UP TOONE MUNDREO
T10USAND IX%URE (5100,000), IN ADDITION T07ME CQST OF COMPENSATION, DM1qGE5 AS PROVIDED FOq IN SECfION 3708OF THE L4BOA CODE, INTEREST, AND ATTORNEVS FEES.
LICENSED CONTRACTORS DECLARATON:
I hereby aftirtn ihet I em Ilcensed under provlslons ot Chepter 9(commenGng wlih Section 7000J of Divislon 3 of ihe 8uslness and Professions Code, entl my Ilcense is in full
larce entl ette��. Uc. p Cless M
Contraaafs 5g�aNre: � Date:
CONSTRUC7�ON LENDING AGENCV:
❑ I hereby affirm thet there is e construction lentling egency tor the performence of the work for which t�ls permit Is Issued. (Sec. 3097, Clvll Code).
Lentler's Neme: Lentlels AaAress:
Signeture: . Date:
OWNER-BUI4DER DECLARATIONS:
1 here6y fltttrtn ihet under penalry ot per�ury thet I am EXEMPT FHOM THE CONTRACTORS LICENSE LAW iw the tollowtng reason (Sec. 7a31.5, Business and Professtons
Cade: Any ciry or county which �equires e permit to construct, alter, improve, demolish, or repair any structure, prior to Ils issuance, also requires t�e epplicent tor such pertnil
to 111e e signed s�etement that he or she Is Ilcensed pursuent to ihe provislons ot t�e Conirectors Llcense Lew (Chapter 9(commencing wl�h Sectlon 7000) of Dlvision 3 of the
Business end Proteulons Code) or ihet he or she is ezempt Iherefrom and ihe besls for the alleped esemOtion. Any vloletlon of Section 7031.5 by eny epplicant for e pertnit
sub�ects the app���ent to a cMl penalry oi not more Ihen fiva hundretl tlollers (SSW).):
❑ I, as owner ot Ihe praperry, or my employees with weges fls iheir sole compensatian, WILL DO THE WORK, enA Ne struqure is nat IntentleE ar oHered for Sele (Sec.
7044, Business entl Pratassions Code: The Contrectors License Lew does not eppty to an owner of property wha builds or improve9lhereon, end who Goas such woAc
himself o� hersetl or through his or her own employees, provitled ihat such Improvements ere not intended or oftered for sele. If, however, the building or Improvement is
sold witni� one yeer of wmpletion, Ihe owner-bullder will �ave ihe Durden ol proving that he or she tlitl not build or improve for purpOse of sale.J. •
$r 1, as owner of the properry, em EXCLUSIVELV CONTRACTNG WITH LICENSED CON7RACTORS to consiruct the pro�ed (SeCJ044. BuSiness entl Pmfession5
�Code: The conirectors Llcense Lew tloes not apply to en owner ot property who builds or Improves Ihereon, and who contrects for such pro�act with e conirector(s)
license pursuent to the Contreclors License LewsJ.
C
ID venfetl by dMerS license. �VeS ❑ No
Business end Professions Code ior this reason:
Vedflcation ot Ownership by (type oi documeN, i.e. - property tex bill
`Ezpires:�
DIVISION OF INDUSTRIAL SAfETY VERMR CERTIFICAT{ON:
❑ I hereby �ertity that no ezcevatlon five (5) or more feet in depth into which e person is requiretl to descend, will De made in connectlo� with work euthodzed by t�is
pertnit, antl that no building strudure, sceHolding, falsework, or demolitlon or dismantling Ihereof, will be more than thlrty-six (38) feet high. (Chap. 3.2, Grp 2, Art 2, Sec.
341, Ttl� 8, Celltomia Administrative Code).
❑ As owne�-bullder, I will nol employ enyane to tlo work which woulA requlre e permit from Ihe Dlvlsion of Indusiriel Sefey, as noted ebove, unless such person hes e
permit to tlo such work from the divislon.
Sipnature: Date:
DiWsion of IndusMel Safery Permi� Number:
CERTiFlCATE OF COMPLIANCE AND AI7T}i0ROA710N OF EMAY: I Certily under penalty oi per�ury that I �ave reatl Ihls epplica�ion entl s�ete thet t�e Infortnellon given Is
conect. I agree to compy with ell stete laws end dry ordlnences relating lo bulltlinp consiructlon, anO euthonze representetives of the Clry of Costa Mese to enler upon Ihe
ebove-described property tor inspection purposes. I agree not to omupy or ellow occupancy oi eny bullding euNorized by this pertnit until final inspeclion.
Legel
COOE �. INSPECTIONTYPE
1816 Fixetl System Final Fire Prevention
1288 Pool 5pe Final
200 Finel Pe-Roof
207 Fine1 61ocWRelelnlnp Wall
202 Final Factory Fire Place
203
204
Final 51gn
Final Demolition
PAIE 1N�LS
GOOE� INSPECiIONTYPE
208 Finel Mechanical
20B Final Plumbinp
° 210 Finel Electricel
212� Flnel Fire Prevenilon
220 Final Planning Approval
222 Flnal Site
250 Final Building/Occupency
�.1 JILL""
�i .+�' �r��3�
,,,.,,.,_.._,.. - .....,.._,._. .--- --- ---._...---EDILDING PERMIT
Job Address: 839 W 19TH ST
Suite:
Viciniry: COIN LESS LAUNDRY
Parcel Number: 42419108
Zoning:
Applicant: PHILLIPS, SEAN -
Address: 11816 WESTERN AV . � � - — ' ' ' - - .
- "� . - - -. _ - Phone: 714-721-0959 CELL -
STANTON, CA, � �� . � � � � Zip: 90680 • �
,
Owner. TRAUTWEIN, RAYMOND FRANK
Address TR � i ' � - ' �
i i � �
l NEWFORT BEACH,'CA - Phone: - - �
� �i1617WESTCLIFFDR#206�. " Zip: 92660.5526 \ '
�� ��' , � "
Convac'tor: �OWNER=6UILDER
�Address: � :��j-',°i�
� - � . � � Phone: �
�� ,
�-Zip: ' ', License:� 000000
. � Amh.:_ � �, _
Address: , . , �
� �. ,
.
I , r� Zip: . . . " �
. �
, ., Phone: �. .
� � License:
', 5,000 �S.F. INTERIOR TENANT IMPROVEMENT FOR °COIN
Eng:
Address:-� �
Stalus: ISSUED
Applied: 07I22I2003
Issued: 09/12/2003
ISSUED BY:
� A
�\
' . . � ' �
� � :����
�i
� � � � ��,�A
� �.:. � .
, � ;� , �
�� '
- , � ' � Phone: � �
%
� License:
\
rro vr r�rtrvn � �
LAUNDRY" BY.STERLING,E�UIFMENT FOR A SELF-SERVICE LAUNDRY.
" - . `
FEE SUMMARY ,
, Plan Check: -$545.84 ' � "' Calc Valuation: Sn,soioo
��
Permit: � $839.75 — - - � �� _ i "- � �' C�aim Valuation: ; � � Sn,eoi.00:
� : SMIP-Res:�, $0.00 � � . _ -" /,/ �
`SMIPCom: $16.34 , -
� � Other.-, '�: $0.00 ' �� •� ;
,, ,
Inspectiorr � � ' $0.00 ` -
� �� , �.� ��, . :,z. _ � ;/ i � �� .
� , TotaL _ $1,401:93 -` �> � � % " . �.'
�
� ., � � �
�� ��, , � �� PLANNING 8 ZONING � � �' - �
SETBACKS_ � � . ' � ��
MAIN STRUCTURE Front 0- 0' �� Rear - 0- 0 - Left 0- 0 �, Right, ;0- 0� �� � i�
�. �� .. ii ; � , - -_ ; - � , .i - � ,
•- C : � i
ACCESSORY �Front�; 0= 0- � � � , / Rear � 0- 0 _ _ Left 0- 0 � � Right' 0. 0 � , � �
� - ,
PARKING Existin : -'0 , -Re uired:,..0 - � Pr000sed: 0. , � �� �
V � A , � � � . . _
NOTES: �� � � � � � � � �
� �, ��
NOTICE: The work authorized by this permit shall comply with all applicable handlcsp access requiremenis under Callfomia slatutes and related
regulations. (Ord. No. 92-28, § 1, 12-21-92)
EXPIRATION: This permit shall automaticelly expire and become vold if vrork Is not commenced within 180 days, or if work is suspended or ebandoned
tor a period of 780 days.
INSPECTIONS: In order for ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all
requlred Inapeetlona end flnal epproval must be obtalnetl. Failure to obtain inspecllons and final approval will result in the expiralion ol this permit.
FOR INSPECTIONS CALL: .(774) 7545626 ,
�.,o-w 1�1
a
WORKERS' �COMVENBA710N DECLARATION: .
1 �ereby eHirtn undo� penelry of per�ury one of Ne iWlowinp deUaretions:
❑ I have end will mainteln e ceNiicete of consent lo aell-Insure for xrorkers' compensatlon, es provided for by section 3700 0l ihe Lebor Cotle, lor t�e performence of the
WOrk f0! which Ihl9 permii 19 IssuBd.
❑ I heve arM wI0 meintein workers' wmpeft5ation Nsurence. es require0 Dy section 3700 0l the LeEor Cotle. iw Ne OeAortnance ot Me vrork fa wlibh Ihis Oertnit b Ls.wetl.
My workera' compensatlon Insurence tartler arM pdiq number are:
Certier. � Policy Numher.
(!hk secfbn need iwt be ownpleted!l Me pertntt 4s vel�ed et one hunOred doHars (S I00) or less.)
["�'I certiy that in the peAormence of ihe work for w�lch this pertnll Is Issue0,1 shall not employ any person In eny menner so es la become sub�ect to t�e waAcers'
compensetion laws o1 Ca mie, entl egr at tl �I should become sub�ect ro ihe workers' wmpensetion proWslons ot Sectlon 3700 of the Lebor Cade, I shall fotlhwlth
compty wiN these provi . � ///J
Applkant Sipneture; / �-+ oaia: �'I! 2-�o �
WARMNO: FM.URE TO SEWRE WOPo(ER5 COMPENSATON COVEMQE IS UNLAWFUL M!D SHNL SU9IECT AN EMPLpVER TO CRIA9NAL PENALTES AND qVIL FlNES UP TOONE HUNDRED
THOUSWD OOLLAHE (f100.000),IN ADDRION TOTME Cd6T OF WMPENSATION, DAANGES AS PROVIDED FOR IN SECIION 31080F TME UBOR pppE, INfERE5T, AND ATTIXiNEY'$ iE65.
UCENSED CONTRACTORS DECLARATION:
I herehy eHlrtn Ihat I em IlcenseC under proNsbns of Chepter B(cnmmencing wlth Secllon 7000) ot DlNsion 3 011he Buslness antl Pratesslons CoOe, entl my Ikanse Lq in full
f0lL9 end BflBtL LIC, M CI939 M
Contrectofs Signenl�e: � Dete:
CONS7RUCTION LENDING AOENCV:
❑ I hereby flifirtn Nat Ihere Is e constructim lentlirp epenry tor Ne pertormance of Ue work tor which this permit Is issued. (Sec. 30g7, Civil Cotle).
Lentlefs Narne: Lenders AAtlress:
Slgneture: Dete:
OWNER-BUILDER PECLARATIONS:
I hereby efllrtn Net Untler penelry ol per�ury Net I em EXEMPT FROM TNE CONTFiACTORS LICENSE LAW for the following reflson (Sec. 7031.5, Business entl Prolessions
Cotlo: My Gy or county whlch reQulres e pertnrt to consWct, eltor, improve, tlemolish, or repeir eny struqure, pdor to Ita lawance, eLso requiros the applicent for such pertnit
to flle a sipned stetement Ihet he or ahe Is Ikense0 pursuent to the provlslans at Ne Contrectorn lJcense lew (Chapter 9(commendng wlih SecUon 7000) ol DMslon 3 of Ne
Business arW Profess�ons Code) or thet �e w she �v exempt therefrwn end the besls fw the ellepetl ezemptlon. Any Wdetbn of Sectbn 7031.5 Dy eny eppllcent for a pertnN
su6Jects the appliceni to e cMl penelry of rrot rtrore than Me hundred dollars (5500).):
❑ I, es owner of Ihe properry, or my employees wiN weges es Neir sole campensetlon, WILL DO THE WORK, enA Ihe strucNra is not Intendetl or ottered tor saie (Sec.
7044, BusinesS and Professions Code: The Contradors Lkense Lew does not apph to an owner of properry w�o builds or improves thereon, and who does such worlc
NmseH or herseli or �hrough his or her own employees, provltletl that such improvements ere nat intended or oMered tw sale. If, �owever, ihe buildlnp or Improvemeni is
sold within one year of completion, t�e owne�-Duilder wlll heve the burden of proNng that he or she did no� build or improve far purpose at sale.). '
� 1, as ov.•ner of the proparly, em EXCLUSIVELY COMRAC7ING WRH LICENSED COMRACTOHS to construct Me Droject (Sec. 704a, Business enC Professlons
Cade: The con«ectors LJcense Lew does not eppy lo en owner o1 proparty who bullds or Improves Ihereon, antl who contreqs for such pro�ect wlih e contractor(s)
Iicense oursuaG: lo Ihe Contrectary License Lews.).
❑ I em exempt u r sec. �
signature:
Owner ID verlfleE by drivefa Ilcensa.
Yes ❑ No
Buslness end Protessions Code for Uis reason:
oate: � �I---1 `L —a
DriverslJcenseNo. Ezplres: �3^b 'd
Vedfketion ot Ownership by (type ol dowmenL I.e. - propeM �ex blll or OeeO): �
DIVISION OF INDUS���L gAFE7Y PERMR CERTIFICA710N:
❑ I �ereby certify that'ro excavetbn five (5) or more teet In tlepth Into which s person is req�iretl to descand, will be made in connaclion wft� work eul�orized by t1�is
permit, end Iha� �o bullding siructure, scaXOlding, felsework, or demditlon a tlismantling thereof, will be more t�an thirly-siz (36) feet high. (C�ap. 32, Grp 2, Art 2, Sec.
341, Ttle B, Ca�Ifomia Adminisiretive Cotle).
❑ As owner-builder, I will not employ enyone to do work whlch would require e pertnit irom Ne Division o1 InOustAel Sefery, es noted ebove, unless such person ha9 e
pertnit to do suFh work Irom Ihe d'Msion.
Slpnature: Date:
DIWSIon o1lnOustrial Sefery Pertnit Number.
CEHTIFlCATE OF COMPLIANCE AND AUIHOR¢ATION OF EMIiY: I ceNty under penelry ol per�ury Nat I heve read this epplicetlon and stete Ihet Ihe intortnatlon pNen Is
cortect. I epree to compN wilh ell stete lews end dry ordinances relating to bulltling constructlon, end authorize representetives of Ihe Clry of Coste Mesa to enter upon the
e0ove-described property for inspectlon purposes. I epree not to occupy or allow occupenq ot eny building euthorized Dy Nis pertnit until Tinel Inspection.
�
Slgna I OWner(s) � _!2 a��
. P AndOr Authorized App�icant Date \
COOE �. INSVECi1DNTYFi QAIF. I�Le�
7878 FUceC Sysiem Finel Fire Preventlon
�zse
200
201
202
203
Pod Spa Finel
Flnel Ra-RaO�
Flnal 91ock/Hetalning Well
Final FeMory Fire Plece
Final Sign
204 Final Demdil�on
� MSPEC110N iNE
208 Finel Mec�anicel
20B Finel Plumbinp
210 Finel EleCtrlcel
212 Final Fire Prevantlon
220 Final Plenning Approval
712 Final Site _
250 Final Bullding�Oxupenq
�g ��
(�t4) �54-52�3 • Fax p�a) 75a-aB56 • www.ci.costa-mesa��SCTRICAL PERMIT �� hA1H UMIVt, (;p51A MtSA, GA yZtl26
Job Address:
Suite No
Vicinity:
Parcel Nunmber:
839 W 19TH ST
42419108
App�icant: ARTINGER, PAUL
Address: 7541 SANTA RITA CIRCLE ,-- �
SUITE D
STANTON,CA
Phone: (714)894-2011
Zip: 90680
Owner. ' TRAUTWEIN, RAYMOND FRANK
Address �TR . -
Conlractor:
Address:
ISSUE FEE
Temp service test
It Res. alc patkage
New�Res (1-2 units)
`New Res (3+unils)
Pool / Spa
Lighting Fixts
Recept OuUets
Switches
Non Res Appl
Res Appl
Service to 200a
Service to 1000a
�� Service over 1000a
Motors to 1 hp
� Motors l0 10hp
Motors to SOhp
Motors to t00hp
Motors over 100hp
Communication drops
Sub panel to 2QOa
Pole Light Pkg
NEWPORTBEACH,CA-
1617 WESTCLIFF DR #206
CONTINENTAL SIGNS INC
7541 SANTA RITA CIRCLE
SUITE D
STANTON,CA
Phone:
Zip: 92660-5526
�Phone: (714)894-2011
Zip: 90680
License: 664525
Stams: ISSUED
Applied: Ot/13/2004
Issued: 01/13I2004
ISSUED BY:
.A
�
��
SCOPE OF PERMIT
REF: SB04-00005. SIGN CIRCUIT FOR ILLUMINATED SIGN. "COINI.ESS LAUNDRY'.
$23.50
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
' $0.00
$1.10
$0.00
$0.00
50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
Quantiry
0
0
0
0
0
1
0
0
0
0
0
0
0
0
0
0
0
0
0
FEE SUMMARY.
Temp Dist System / Lighting
Busway /100 R
Standing Seclion
Misc ElecVical 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 Voltage Equipmenl
Low Volt W ring System / Ckt
Misa Conduit ,
Misa Conductor
Circus ( gen or ride)
Circus (mech ride or lights)
ChrisVnas Tree Stand
Fireworks Stand
Other Electrical Fee
lnves6gation Fea
Plan Check Fee � �
Reinspectlon Fee
Quantity
$0.00 0
$0.00 0 ,'
50.00 0
50.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
$0.00 0
50.00 0
50.00 0
50.00 0
$0.00 0
$0.00 0
50.00 0 " ,
$0.00 � , 0 "
50.00 0
30.00
ao.00
50.00
ao.00
NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related
regulations. (Ord. No. 92•28, § 1, 12-21-92)
EXPIRATION: 7his pertnit shall automatiCally axpire and become void if work is not commenced within 180 days, or it work Is suspended or abandoned
tor a period o! 180 days.
INSPECTIONS: In order for lhe work authorized under this permit to be consitleretl legal, such work must comply with all applicable codes, antl all
requlred Inapections and tinel approval must be obtalned. Failure to obtain inspections and final approval will rasult in �he expiration of this permit.
FOR INSPECTIONS CALL: (714) 7545828
zuaae �a�oo�
WORKERS'COMPENSATION DECLARATON:
I �ereby efllrtn under penelry of per�ury one of ihe tdlowing dedara6ons:
❑ ve entl will maintein e cenificete of consaN to selbinsure fw workers' compensetlon, es pmvided for by sectlon 3700 ot the Lebor Code, fw the peAormence of ihe
ork for whlch this pertnit is issuetl.
I have end wlll melntain workero' compensellon InSurance, es repulred by sectbn 3700 0l Ne Lebor Cotle, for the perto�ance of t�e work ta wNch thLa permit is issued,
My workers' compensation fpsurence carder antl pollcy number ere: �i�v
Cartier: .S ��r� POIIcy Number. �� 7� !7 /X �
(Thls section need nof be comp/efed 1! fhe permit Is valued af one hundred dW/ers ($ f00) or less.)
� 1 ceNly Nat In Ihe pertortnence ol ihe work tor w�lch Nis pertnit is Issued, I s�all nat employ eny person In eny manner so as to become subjec� to tha workers'
compensatlon Iaw�Calllomie, enA agree tha� I� I shoulE become sub�ect to the workers' compensa0on proNslon � t$e �tion 37� of the Lebor CoOe, I shell lorihwith
comply vrit� t�ese p�s�ion�s�.�% � / 3 D�F
ApPliwnt Signature: Ci"f,'G/ � � , Date: ��
WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEM IS UMAWFUL AND 5lU11 SU8IECT AN EMPLOVER TO CRIMIFAL PENAL ES AND CML FlNES UP TO ONE MUNDRED
TNOUSAND DOl1ARE (5100,000), IN ADDRIIXJ TO TME COST OF COMPENSITION, OAMAGES AS PROVIDED FOR IN SEGTON 31080F THE UBOR OODE, IMEflEST, AND FTTORNEYS FEES.
LICENSED CONTRACTORS DECLARATION:
I hereby ettirm ihat I am licensed under provisic
torce and e8ect. Ua N_-�/�
Con[rectors Signature: �
CheD�ar 9(commencing wiN Section 7000) of Division 3 of the B
Class q
�— e �SL—� Date: _
Cade, antl my license is in full
CONSTRUCTION LENDING AGENCY:
❑ I hereby ettirtn Ihat thera Is a constructlon lending agenq tor Ihe paAortnance of ihe work lor which this permit Is issued. (Sec. 3097, Civil Cotle).
Lendef9 Nama: Lendefs Address:
Signeture:
Date:
OWNER-BUILDEH DECLAFiATONS:
1 hereby aHirtn ihat unEer penelry ol perjury that 1 am E%EMPT FHOM TME CONTRACTORS LICENSE LAW tor the followinp reason (Sec. 7031.5, Business end Prolesslons
Cotle: Any ciry or counry which requires e pertnit to construct, elter, imprme, tlemolis�, or repair eny sirucNre, prior to Its �uuance, elso raquires t�e aDDlicant tor such pertnit
to tile a slgne0 statement thet he or she is Ilcensea pursuant to ihe provlsions ot ihe Contrectors License Lew (Chapter 9(wmmendng with Sectlon 7000) ol DWlsion 3 of the
Business erM Professions Cade) or that he or she is exempt Nerefrom and the besls for Ihe elleped eaemptlon. Any Woletlan of Section 7031.5 by any epplicant for e pertnit
sub�ects Ihe epplicant to e clvll penalry of noI more than five hundred dallars (5500).):
❑ I, es owner ol t�e property, or my employees with wages as I�eir sole compenution, WILL DO iHE WORK, and the structura Is not intended or oHeretl far sale (Sec.
7044, Business anC Professlons Code: Tha Contractors License Law does not appty to an owner ol property who builds or improves thereon, and w�o does such work
�imselt or hersetl or ihrough his or her awn employees, Drovided thet such improvements ere not Imentletl or oNered tor sale. If, however, ihe building or Improvement is
soltl within one year of completion, the owner-builder will �ave iha burden ot proving Uat he or she did not builtl or ImOmve tor purpose of sale.). '
❑ I, es owner ot Ihe property, em EXCLUSIVELV CON7RACTING WITH LICENSED CONTRACTORS to construct ihe proJeci (Sec. 7044, Business entl Professions
Code: The cronirectors License Law tloes not apply to en owner at pmperry wfw �uiltls or Improves therean, entl who contracts for such project with e contractoqs)
licensa pursuam to tha Contrectors License LawsJ.
❑ I em exempt unAer sec.
Slgnature:
Owner ID verifled by drivefs Ilcense. ❑ Yes ❑ No
Business and Professians Code for this reason:
Vedllcatlon ol Ownership by (type ol documem, I.a. - property tex blll or deed):
DIVISION OF INDUSTRIAL SAFETV PERMIT CERTIFICATION:
Drivers Ucense No.
Date:
Eupires:
❑ I hereby certity that no e:cavetlon five (5) or more leet In depth Into which e person is required to descend, wlll be made In wnnectlon with work authodzed by thls
permlt, entl ihat no bullding siructure, scaflolding, falsework, or demolition or dismanlling t�ereol, will be more Ihan thlrty-slz (38) leet high. (Chep. 32, Grp 2, Ar12, Sec.
341, 71t1e B, Callfomla Administretiva Cotle).
❑ As owner-6uilder, I will not employ anyone to do wark which woultl require a pertnit Imm the Dhrision oi InGus�dal Selery, es nated ebove, unless such person hes e
p8rtnit to do such work Irom Ihe tlivision.
Signatura: Date:
Division of Industnal Safery Permit Number:
CERTIFlCATE OF COMPLIANCE AND AUTHORVATION Of ENTRY: I certily untler penalty oi perjury ihat I �eve reed Ihis epplicetion and steta thet Ihe Inlartnetlon given is
correct I egree to comply wit� ell stete lews and ciry ortllnances relaNng to building constructlon, entl euthodze representetives of the Ciry ot Caste Mesa to enter upon the
ebove-desr,�ibed property lor Inspection purposes. I egree not to acupy or ellow occupancy oi eny builtling euthonzed by ihis pertnil until final inspecilon.
CpUE /. MSVECiqNME
1616 Fixed System Finfll Flre Preventlon
1268 Pool Spa Final
200 Final Re-floof
201 Final Block/Reteining Wall
202 Final Factory Fire Place
203
204
Finel Sign
Final Demolitlon
PdIE L�A64
1 � �/ b �ate
Date
COOE 1 INSPECTION T'PE
206 Final Mechanlcal
208
210
212
220
222
250
,Final Plumbing
Final EleclnCal
Final Flre Prevention
Final Planning ApprO�al
Final Site
Final Building�Occupency
PAiF. L�EL�
��ILi �1i
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ti