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Home My WebLink About841 19TH ST - Building Permits� .. Y � y' 4.�? r -�, z; h 1 a�..� . . . �� - r`��ciT��7�+ 'i^.:; i' =�+r synd �?^ ` � ..I� y. •�'` .t 1 4—' .F ' � �� t rY '`v "r . .. A �� a V e�in.i - . , i9 x � �'.l ?! .. . . . . h • - t . „ � : � k. . - 5 G ` , ' ,� t . . r �:�!9•;�,.:` . . .. '_,�';v , .i . , . � �,,��', , .•y��I,�.,.Fj'ri , j.: � � 'i j, . : �!. , ' �. - .5�.'.. .. . .' '' ., �y • .'i � t . � . f. i i , y '1 M .'� t, ; .I � ! l�l ti . f il � +.,: j, } I G . r" / . �i',� v . . . � , .. - .� . . ,.-t� .:. . , .. �._. , . �. .4 � . �. .. . . ,. . ,.... � ' � ' , . . �. . -.. ' � y,, ' ' � . .. , � . .. t .._.i.4 iJ� .-al'.;/V iFFl�TZ i). Fl.a r.__ . . �...,_ .�...�---�---___..-.:-�______ ._ =-�.-�.. _.-_...--, •.l--__ _ --._ ._ .. . _._ ' �it�p o f,, �o5ta 2�Y� e�a � , Development Services, Division of Building and Safety �` CERTIFICATE OF OCCIJPANCY ' This certlficate is issued pursuant to the�r q m rits�f he Uniform Building Code, Section 308 � /:-�. � i � ,�� adopted by the Ciry of Costa Mesa cer•hfies;that.at�tlie rime of�its'issuance the building structure herein , � � below described was inspected �� pp��o occupancy.�as'�f�'ovllJj^\�� Building Address 841�W/ Use RESTAURANT �� f�5� ^ ._ i Group n Type of Cc i ti�, / Owner of Building Paul ,Traut �� Address 1F17 WaatPliff.Di�.i BUII.DING OFFICL41:31$�,� xic� ssa�, cBo lI .�_'✓ �i � o: r..: .. I.X `�Y-�+,-�`^�=A I��..0 . i � Ii117�Nncmnl't'H AC}1 Pd ��, � !�� . I� ,� „�,r,` B; r �� y ku � ��'� �� Date s �„� � :;�. _ - = .� ; \'�;,�`_, . , ;a\� �, , a � -!�...... -�,� REQUIRED TO BE � _ . ,� ,.. , � ��B dg. Permit No. B98-01102 �`��U�� t. . � ��;,1, �. = , �`, ', �! �e��" ` Use Zone � j, � �, ,� n�,�$ ��Sn ,f I ! �J ' �l C -� �� 1�. >j' - ti � ,r�� - !brua y 25, 1999 , ` � - . _� [COUS PLACE � � . , , CITY OF COSTA MESA F _ � BYILDIN6 D/VISION DEVELOPMENT SERVICES DEPAFTMENT J PERMIT PER ITN MBER / �� 698-01102 � (714) 754•5273 • Fax (714) 754-4856 77 FA{R DRIVE, CASTA MESA, CA 92626 Job Address: $4^1 W 19TH $T Suite: /S Vicinity: Parcel Nunmber: 42419107 Applicant: JEFF JONSON Atldress: / �/ owner: TRAUTWEIN�PAU � i i.� Address °foL&M�PROPERTY�M NEWPORT BEACH,CA �� ESTOLIFF�DR � '/'��i \ ✓/%i Contrector: % THE JONSSON-G( r.s,'� � i ; �ii�/ Address: fiMORGAN�#700� � / �i % BUILDING PERMIT Status: ISSUED Applied: 06/22/1998 Issued: 08/28/1998 Zoning: �i .Phone:,'-,'"-' - '-� - �, � -t :Z�P - �: _ � �'.�:. \� �� , � ��;�� -R � /7 /`� '' � _ _ ''��1 � _� l . - �l �� f / �`: r ! .-; Phane:.>�r � - � _ _� � / � � /. A . . . _�ti`�-; ` �.,, /�\>` \ 2!.%'t—_�-" FZ�p: 92660 "'�\�\''^��\\j�\ `� `\ � PANY \\�\ �l\� �! U� \ �/\ .-,;!/ ;'? ../�� Phone:�949-581-1896 \��\\ ��. \�\ /,-IRVINE,CA/ Zi i � �� / P�.,92618 \:�A � ^,� ��',A ,',�� , �/!r� Licenset'"�'691288 ��V A�-� �, nrcntenq � JEF�JONSSON K, . � r �.. � ; � ",}� ( , l \ �� Address „' � � r � � '� . r_ I i� �: , � i 4 �. ' , ,� � � � �� _ i�Pho e�4_ , r��`'. "t,�i � � { '�, �' . �C j i �- � i ' 1 , �j,�%s Zip. _ --� � `�, �✓ � � �� i F��` ; ��' f � - ,��,,,, �-� � License C27314 � �-_ �� \� �.Ar ' , � _ ' � � � ` ' � � �' SCOPE OF PERMIT V � � �� ' . INTERIOR ALTERATION TO CONVERT A VACANT SUITE TO A MEXICAN.RESTAURANT WITH PUBLIC �� , �AREA NOT TO EXCEED 300 SQSFT ;i"� t � �--•, .'K � � ��[ � i . �� n � ' t � i.. �.") i� i,.�-e..J iL� U r�IJ� �,u'.. � � L_ � � � 'HOURS OF OPER \TIONt OPEN FOR LUNCH, CLOSE NO LATER � % � �� RA ? - ' THAN 11 P.M. � , , _ � � _ . „ r� �n .'��I �1?��^"' ��' r,� L.�f+�� 31� �n� .. �, i � .�� i �_. .i' '� __ _ _ �l` % Plan Check; �� ? Permit: " SMIP Res:, ; � SMIP�Corri' � � Other: � Inspection. � , 25 �� 0 � ' .r `' �� <, � � f �� , , � „i+,� ,,�,ri ; � � `r�,. rr f \ � �V� t i .,: �� . t G Teta1- � $338.13.; �� ` �� ' .< � , f� � � � l � // � � V� \. �� { �io � �;:� �� _. ,-_�� - _ �,�. � / � �- �,` . �%,_ � SETBACKS � � � � , MAINSTRUCTURE Front 0•0.; Reari 0-0" ACCESSORY FroN .0-0 ' -Rear .,.0-0 PARKING Existinq: o NOTES: Re uired: 0 \`, _. �, Calc Valuation:i '( i '= g2o,000.00 �iii � , � Claim Vaivation:- / �\"' S2o;oo0.00 �,� � i t / j// f � .: f ' ��!l .,// % � � f, �� ,i� = �� :� i/'�; � � �>` 1 _�A �/.,A � � � '�U\NNING & ZONING� � \ ��A G� ; � � - _ . _ _ � - \ � / %,. , i _ - „ i � . Lefl - 0- 0��`�� J Right 0= 0 i �A \ - . . � -- _ , i . � ., ,._ -. .%�"�_ •-^ � � �Left--�A�'0='0 -- '��Right 0-0 , . � _ Pr000sed: 0 �• � EXPIRATION: This permit shall automaticelly expire and become void if work is not commenced within 780 days, or it work is suspended or abandoned I for a period ot 180 days. INSPECTIONS: In orcler for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inapeetlona end flnal epprovel must be obteined. Failure to obtain Inspections and final approval will result in the expiration of this permR. FOR INSPECTIONS CALL: (714) 7545628 � � : ' WORKERS' COMPENSATION DECLARA710N: I hereby eifirtn under penalry af perjury one of the follavAng deGarations: � ❑ I �eve end will maintein e certiTicete of consent to self-Insure for workers' campensetion, as provided tor by sacilon 37W oi the Lebor Code, for the peAortnenCe of Ihe work tor which this pertnit Is iuuetl. � ❑ � have enO will me�me�n workers' campenselion insurence, es required by seciion 3700 ot the Le6or Cotle, for ihe perto�mence of Ne work for w�ich Nlv permit Lv issued. My workers' compensatlon Insurence carrler end policy number ere: � Carrier. Pdiry Number. � (Ihls section need nof be complefed!/ the peimlf is velued et one hundred dollers (5700) a IessJ ❑ I certify Ihat in �he pertortnanca of Ihe work for which ihis permit is iuued, I shall not employ eny person in eny manner so as to become subject to the workers' compensetlon I�ws of Califo la entl apree thet Ii I shoultl became subject to the workers'-wmpenselion prodslons oi Sectlon 3700 of ihe Lebar Code, I shell torthwith comply wit� these provisions // � ApPlicant SlgneNre: �� A�1 �� / Date: ��Y^'� �"'� WARNINCa: FAILURE TO SELUREWORKER9'COMPENSA CWERAGE IS UNLFWFUL AND SHALL SUBIECT PN EMPLOYER TO CRIMINAL PENALTIES AND GVIL FlNES UP TO IXJE HUNDRED TFKKISAND DOl1ARE ($��). IN ADORIIXJ TO THE COST OF �MPENSATION, DAMAGES AS PROVIDED WR IN SECTIIXJ 3708OF TME LABOR COOE, INTEREST, AN� ATiORNEYS FEES. LICENSED CONTRACTORS DECLARATION: I I hereby eftirm t�et I em forca antl eXect Lic. A_ � Contractofs Signeture: of h pter 9(commencing with SecU�i 7000) ot DlWsion 3 of the Business��nd Protessions Code, and my Ilcense is In tull � Cless p �/•o Date; �_ 7 CONSTRUCTION LENDING AGENCY: ❑ I hereby aifirtn thet �here is e consiructlon lending egenq for the pedortnance of the vrork for wNch this permit Is issuea. (Sec. 3097, Givil Code). LentleYs Name: Lentlefs AAdress: Signature: Data: OWNER-BUILDER DECLARATIONS: I hereby eftirm ihat untler penalry of perJury ihet I em EXEMPT FROM 7HE CONTFiACTORS LICENSE LAW far Ihe lallowing reeson (Sec. 7037.5, Business entl Proteulons Code: Any ciry or counry which repuires a pertnit to consimct, alter, improve, demolish, or repelr eny atrucNre, prior to its issuance, also requires Ihe epplicant for such perm0 to Ole a signetl statement thet he or she Is Ilcensed pureuant to Ihe provislons of ihe Coniractars License Lew (CheD�er 9(commenGng with Saqlon 7000) of DlWslan 3 of ihe Business and Professions Cade) or that he or she is exempt therefrom and tha basis for tha elleged exemptlon. Any Wolation of Sedion 7031.5 by eny eppllcant tor e pertnit subjects the epplicant ro e civil penalry of not more Nan five huntlretl tlollars ($500).): ❑ I, es owner of Ihe properry, or my employees with wages as iheir sala compensation, WILL DO THE WORK, end the siructure Is not Intended or ol�eretl tor sele (Sec. 7044, Business and Protessions Cotle: The Con�rectors License Lew does nol epply to an owner of property who builds or improves thereon, end who tloes such work himself or herself or lhrough his or her own employees, providetl thet auch improvements era not Intendetl oi offered for sale. If, however, the bullding or improvement Is sold wi�hin one yeer o1 completion, �he owner-Oulltler wlll have Ihe burden oi proving that he or she tlld not build or improve for purpase of sele.). ❑ I, as owner of Ihe D�operry, em E%CLUSIVELY CONTRACTING WI7H LICENSED CONTRACTORS to wnstruct Ihe projact (Sec. 7044, Business end Professions Cotle: The conttactors Llcense Lew tloes not apply to an owner of property who bullds or Improves thereon, end who contracts tor such prqect with e wntractor(s) license pursuant ro the Contrectors License Laws.). . ❑ V em ezempt u�er sec. Busioess aad Protesslons CoCe tor this reason: Signature: Date: Owner ID venTied by dmefs licensa. ❑ Ves ❑ No Drivefs License No. Espires: Verifiwtlon of Ownershlp by (rype ot dacument, i.e. - property ta�c bill or deed): DIVISION OF INDUSYA�AL SAFETY PERMR CERTIFICATION: O i nereey ceNy Nat no eacavation 1Ne (5) ar more feet in depth Imo which e person Is requlred to tlescenq wlll be made In connection with worK euthodzed by this pertnit, end ihet �o builtling siructure, scaHoltling, felsework, or demdition or tlismantling thereoi, wlll be more then thirty-six (36) feet high. (Chap• 32. Carp 2, Art 2, Sec. 341, lltle 8, Cali�omia AdminlstretNe Cotle). ❑ As owner-builtle�, I wlll not employ anyone to tlo work which would raquire a partnit irom the Dlvision of Indusirlel Sefery, es noted above, unless such person has e permit to tlo such woM Uom ihe divsion. Signamre: Date: Division of Indusiriel Sefery Permit Numter; pt4) 754-5273 • Fex p14) 754-4856 • www.ci.coste-mesa.ca.us _ 77 PAIR DRIVE, CASTA MESA, CA 92626 SIGN PERMIT JobAddress: 841 W 197H ST Suite: C Viciniry: Parcel Nunmber: 42419107 npplicant: PAUL ARTMYER Address: Zoning: ISSUED BV: ..-Phone: -714-894-2011 i- : iG.i'.�i:iZ�p; � , _ �._ -' /�.-_�,_. �i - -� - �- �t.-`� owner BOECKMAN, CAROLY.N-SUE TR V� � � ' �� I , � f�; , '= , Address PAUL TRAUTWEIN TRUST . . � - � r / �� \ ,� \ REDDING;CA �' � �� Phone �. � �/ � �� . 536 AURORA PL � � � � r ' � � �'' -� =� � / , � -= / �- : � Zip --.96001 0100--_, � � - -� � /�// �,?;�i�t\ � \ .. .�y�tc_. ��. � -�.�\\�'�\.., �I( Contrador: ; GONTINENTAL�SIGNS INC' , � �� . Addiess:� �7541 SANTARITACIRCLE � `� �� .'� \� �' ��/ \ SUITE�D��.`!� Phone: 714-694-2011 �� ..� �� i\�� . . ' STANTON; CA � Zlp: 90880 � �' ��.�_ .. ' / � ��`� A �Arch/�En�� ,i'�� Licensej,664525 � .. _ �.A:� ��'., . 9 � ,., �:A, A� (� �. �. �i� � r-� Address:� �.�� = ��. .� . . � � � „ . � �;,A�� •.��, . \, A ' , i "/n' _ ' Phone:� , , _ . , � '� '�-, - , ��. � � , . ,. . - , . - Zip:� - .- .. ' , � . , �� ' , � �. . � � ! ; �� _ _�L'icense: ,� ; � S , � � , � ` -. � . . i/ , �' . . :, . . � ' ` - SCOPE OF PERMIT� �,!/` � . _70 SQ F2�CFWNNEL LETTER SIGN. � � - � � A� ` � - � '� � ILLUMINATED WACL• SIGN FOR DENTISTRY UNIT C � � �� - . , . �`� � �, �' , � - `: i�, � fEE SUMMARY -- � , � ` � P�8f1 C.hBCk:� � $35.�� -tr��`� �',�� '-/,' i�� f � .�1�1VA�C.S�C�/8�U8T1�f1. It. i $1,50000 � �,�� , : � $�.d� --_ _ _ _ _ _ '_ _ _ _ __ _� � / � A_ / I �' I ��. � Permit� $54.00 ' , � Claimed Valuation �� S,i,s0000 ; � �� SMIP Corri:. �� $0.50 , ..� ' ;. ��;��. ,, , _ , �„� ��r� 't';i; ; � � , �',� 1 � Other'� $0.00 .----- -- � :� � /�.='c� �"� ,��. -, , ', � - — , � $0.00 �- � ' _- - � - < _ ` �� " �, �;'� ' � � � ; j� � ,�Inspection:��. $0.00 i �� i,. � � � � ��% , , . ` � $0.00 1 � = _,• , � , • /i �/ � � `, ��, . $0.00 ` __ - � � ��j/ / � y r� . ; i r` � j�� ; , Total: $89.60 ' - �> � � � ' �� - -� - .., : �, �,-�/ ��i �' � �i Status: ISSUED Applied: OBI10R006 - - . Issued: 08/10/2006 ' � — '� �� j PLANNING & ZONING.� '�� s=-,:� , j% Z r '� ! , . . �" ��/ � i-, \ i � � , „_ � �.i/�/� //�� . A� " � � �'" � i% ,.�//, ,. .. .�.- _ � � �, i i j� �, . , . <., v �/ / � , , , , ; � ., �.�, / �� _ ;--- '� � . �';\� G�, �� /' ,��- � -� �,<:� ��/ �; ' - � � ,� ,_`-� � n _�, ��,� �� . _ +'� . %,. j � �� _ , -;; '�/ /, ,�._ -- .:�\_, �_ -- -� . . /j �� - - _ � �, � . .. _ _. �'�� . O�/ � , ;� � _ �j NOTICE: The work aulhorized by this permit shall compty with all applicable handicap access requirements under Califomla statutes and related regulations. (OM. No. 92-28, § 1, 12-21•92) , �. EXPIRATION: This permit shall automalically ezpire and become vold if work Is not commenced within 180 days, or if work is suspended or ebandoned for a period ot 780 days. � � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all appllcable codes, antl ell i required Inspeetlona end flnel approvel must be obtained. Feilure to obtaln Inspections end tinal epproval will result In the expiration of this pertnit. FOR INSPECTIONS CALL: (714) 7545826 , ' ' zsao+a lerwl . WORKERS'COMPENSAnON DECLARAPON: � I hereDy ettirtn untler penelry ot perjury one of ihe following deGaretions: - ❑ I have end Will melntaln e cartiflcate of consent to self-Insure for workers' compensation, es proNtletl tor by secUon 3700 of Ihe Lebor CoOe, tor Ihe pertortnence ot the work for w�lph this pertnit is IssueC. � ve end wi11 meintein workers' compensetlan insurance, es required by sectlon 3700 of Ne Le6or Catle, for ihe peAormance of iha work for whiM MLs permit L9 Lssuetl. warken' compensetion Insurence carrier and poliq number ere: �m . , s�'AT � P � � /G �'.f�� s sectlar neeq nat be oompleted ll the pertriit is valueO et one huntlretl dollars ($100J or less.) �� "' � i certly ihet in Ihe peAarmance of the work far which ihis pertnit is Issued, I shall not employ any person in eny manner so as to become sub�ect to Ne workers' wmpen n laws of Celifomie, antl egrea t�at tl I shoultl b come sub�ecl to the workers' campensatlon praNsions of Sectlon 3700 of the LeDor Cade, I ahell forthwlth ith pro sions. cant Signet . 5��£ _ A O Dete' �` �� ` �� LURE TO SEWRE WORKERS' COMPENSATION COVEM�E IS U WFUL AND �SU61ECf AN EMPLOYER.TO CRIAUNAL PENALTIES AND CML FlNES UP TO ONE HUNDRED TYqUSAND DOLLARE (E100,000),IN ADOfTION TO TNE WST OF OOMPENSATION�GES AS PRWIDED FOR IN SECfION 37080F THE LABOR CODE, IMEPE5f, AND ATTORNEY'S FEE9. LICENSED CO TORS DECLAHATION: 1 her rm t� nsetl un r rovis�lo sof Chepter 9(commendng wiN Section 7000) af D 3 of the Business anC Prof ons COOe, an0 my license Is In ful� fo . � (�i ��,� S _ -Cless M - G` � � ��. � -i,n- / o gnetu� _(�eL �-+ f' CONSTRUCTION LENDINO AGENCV: �� 1 hereby aflirm that �here is a construclbn lending egency for the peRormance of ��e work tor wNch INs pertnit Is Issued. (Sec. 3097, Civil Coda). Lentlers Neme: LentleYs Adtlress: SlgneWre: Data: OWNER•BUILDER DECLARATIONS: I hereby eHirm th�� untler penelry of per�ury I�at I em E%EMPT FROM THE CON7RACTORS LICENSE LAW for the following raeson (Sec. 7037.5, Business entl Professlona Cotle: Any ciry or counry which requires e permit to construct, elter, Improva, demolish, or repair any etrucWre, pdor to Ita Issuance, elso requires the epplicant for such pertnit to flle e signetl statement ihet he or she Is Iicensed Dursuent to ihe provisions of ihe Conirectors LJcense Lew (Chepter B(commenclnp wlth Sectlon 7000) of Dlvlsion 3 of the Buslness end Professions Cade) or Ihel he or she is ezempt Neretrom entl Ne besis for Ne alleped exemption. Any Noletion of Secllon 7031.5 by eny appllcant for e permit sub)ecLs the eppllcanc to a dvil penaly ot not more then five hundred dWlare (5500).): 0 1, es owner of lhe property, or my employees with wagas es Meir sde campensallon, WILL DO THE WORK, arM t�e atructure is rrot intenGed or oHered tor sale (Sec. 7044, Business entl Professions Code: The Contrectors License Lew does not epply lo an owner o1 property who builAs or improves thereon, end who doea such woAc himself or herself or ihrough his or �er own employees, providetl Ihat such improvemenis ere not Intended or aflered tor sale. Ii, howeve�, the bullding or Improvement le eold within One yeer of completlon, the owner-bullder will heve t�e Curden of provinp that he or she did not build or Improve for purpose ot sele.). ' ❑ I, es ov.•ner o1 the Oroperty, em El(CLUSIVELY CONTfiACT1NG WITH LICENSED CONTHACTORS to wnstruct the pro�act (Sec. 7044, Busineas eiM Professlone Code: The eontrectors LJcense Lew Ao9s not eppty to en owner of property who builds or impraves ihereon, flntl w�o contracts for such prolect w�th e contredor(e) liCense puBuent to the Contrectore IJcense Lews.). ❑ I em exempt under sec. s�0oawre: Owner ID verified by tldvers Ilcense. ❑ Ves ❑ Na Business end Professions Code for this reason: Vadflce0on of OWnership by (rype of tlocument. I.e. - property tex bill or tleetl): Drivels lJcense No. Date: Expires: DIVISION OF INbUSTRIAL SAFETY PERMIT CERTIFICATION: ❑ I hereby cetlify thet no excavatlon Bve (5) or more leet In depth Into which a person is requiretl to descend, wlll be metle in connecllon wlth work euthohzed by Nb pertnit, end ihat no building siructure, scattoltlinp, felsework, or demolllion or dismantling ihereof, will be mora than thlrty-six (38) faet high. (C�ap. 3.2, Grp 2, !ut 2, Sec. 341, Title B, Calitomia Administretive Cotle). ❑ As owner-hulider, I will not employ enyone ro do work which would requlre a permit irom ihe Dlvlslon of Intlusidel Sefety, es noted ebove, unless such peraon hae a pertnit ro tl0 suCh work from the dlvislon. Signature: Date: Dlvision of Intlustriel Sefery Permit Number: CERTIFlCATE OF COMPLJMICE AND AUTHORVJITON OF EMAY: I certity under penelry of per�ury thet I �ave read Ihis applicatlon end stete thet the Informetlon gHen is correct. I egree to comply wllh ell state lews end ciry ortlinences relating to building constructlon, enC euthorize represenletives ol the Ciry of Coste Mesa to enter upan the ebove-described property tor inspection purposes. I agree not to occupy or allow occuDancy of eny huilding euthorizetl by Ihis pertnit untll finel inspectlon. COOE 1, �xsveeneNnve — 1616 F�Cetl System Flnal Fire Preventlon 1266 Pool Spe Final 200 Final Rg-qooi 201 FIneI BIp�WRetelning Well 202 • FInalFacto,.�e,Plece____--� 203 Finel S18n ; _ 204 Final Dgmolitlon . . • Q�¢ �{a fQQf�( IN4PECTIONTYPE 206 Finfll Mechanical 208 Finel Plumbing 210 Finel Electdcel 212 Finel Flre Preventlon /- ' 220 Flnel Plenning Approval �0 —� —0!� `� � /,,� 222 Flnel Slte � / N 250 . Finel Building/Occupency } 4.d� u� �f1`� i � /� �T:: QA�F. �{� �� I (714) 754-5273 • Fax (714) 754-4856 • www.ci.casta-mesa.cELECTRICAL PERMIT n FAIR DflIVE, COSTA MESA, CA 92626 ,lob Address: 841 W 19TH ST saite No G Vicinity: � ' � - - :- Parcel Nunmber: 42419107 npplicant: PAUL ARTINGER Address: 7541 SANTA RITA CIRCLE ISSUED BY: SUITE D _ Phone: 714-894-2011 - STANTON, CA ' � =Zip:'� "90680" -".__ _ i ..i -'�'%��--�5`/�' �'�� . i , 1� � �`�� \~\. � , Ownar. BOECKMAN; CAROLYN SUE TR � � �\ �: ��'� . „ . r, I� j � �� `-' 4 AddreBs PAULTRAUNIEMTRU9T � � '� - � - � I'L , � " �' � � �� i ��v _--_- '�-�� iREDDING; CA • � � % i - - �"-Phone=- -_ -�� - , ' , � . f��;,536AURORAPL � �`` " =- --Zip:- 96001-0100_�� ,'/ � , .,�,'�� ,;, . .\ ,`\ . % /%%�/i �� /^� i % j,;� � / � ��\:��\�°::... /j Contractar. �.CONTINENTAL'SIGNS INC � � � �' Address: 7541_SANTA RITA CIRCLE '� �� -�� %� � �";� �� SUITED ,�� Phone:,.714-894-2011 �. �� " � � � STANTON,CA Zip: �90680 ��,�� ' �� ;i, � License:684525 � � ' _� ' i i � �; - - .,'\ . , � -��.`., .- �' . � � .. � , �� 1 , , - � - . tii' � � � .. � � Status: ISSUED Applied: 08/102006 Issued: 08/102006 . - '� ," . -' �'REF SBOB-00081 �FOR MUNIT.0 ' 1 CIRCUIT FOR SIGN -" RMIT'' � ' � ��- _" � i-- ��.� , � _ � � _.�.n� �� _ , , , ` � , � " �� ; > FEE SUMMARY � A' � ` ` ' `� ' � - 7' � J �. . � �uantiry ' - - - . '-. -- . . ._ . Quantiry � t� ' r� `. � ' � ISSUE FEE � � � ' $23.50 � 'r' T'!' / ''� ,; ;' ` �Temp Dist System�/ Lighting `�� $0.00 0 , �� : ' . . � \- Temp service test $0.00 , � � - - - - - - Busway�/100 fb - �- �' �-- � $0.00 0 , , , � _ � ' ' Res: a/c package - , $0.00 � -' "- - - - Standing Sedion „r; $0.00 0 ' � �, �, ; r- - ' �� f �New Res-(14 units),' , ; $0.00 . 0 , Misc Electncal Equipment '� $0.00 0 �. �'; ) ,,, ,' i ;� � New Res (3+units) - $0.00 , 0- -� � , „ - -Transformers up to 1 kva/gw $0.00 0 .. �� i Pool/Spa , � $0.00 �-" 0 � %� i ` ' uptol0'kvalkw `"�I $0.00 0 �'�� -� ' � � Lighting�FiMs � $0.00 .,�0 - - up'to50kva/liw� -', $0.00 0 /!!� 1 f�'� Recept Outlels . ��. $0.00 � 0 '� . '. up to 100 kva/kw � � � $0.00 0 ��r� � -� � Switches _ � � $0.00 0 .... . �::�over700kvalk�J ' $0.00 0�%� -� ) /f�: � Non Res Appl � � � � � $0.00 � 0 Low Vollage�Equipment � - $0.00 0 �� / `� ; f, � Res Appl . � - ''-'� : $0.00 � 0 Low Volt VJiring.System / Ckt � $0.00 /0�� / � � ;�' � ,�� Service to 200a . , $0.00 0 Misa Conduit . ; $0.00 /�0�% � % L, � Service to t000a $0.00 0 .,'--7' ` Misc.�Conductor . $0.00 i� , � j �/ i Service over t000a ` - $0.00 0 " � ' Circus (.gen or ride) • ', $0.00; ,�; 0 � .! /� � i Motorefolhp , `�`,�$0.00 ' 0 - - Circus(mech�rideorlights) - �$0.00,%� 0 l, ��^' � MotorstotOhp � '$0.00 �, � 0�••�_ . � ' �CfiristmasTree�Stand .� ;_-„$0.00.� Or > ��.�/ Motors fo SOhp' � , �$0.00 "" 0� - � ' Fireworks Stand� � � $0.:00 0 `�' /� �� Motors to t00hp � � $0.00 , ` 0 - - �� Olher Electrical Fee ; _ �$0.00 � , �� Motors over t00tip , , $0.00� ' � � 0� � � � . , .. - . - /. �: ' ' i �, Communication drops � $0.00� � � ; z 0' � - � ��Investigation Fee� • ' $0.00 �� ,i � �; Sub panel to 200a �� '- , ,$0.00 . - - � 0 �, ��, , � � Plan Check Fee � �_ . ; �; , 80.00 ', '/ PoleLi htPk � ;� �$D.00� 0 � �- �-`��'`��Reins ectionF.ee�' ' � �$0.00' �� Sign C�cuits � �` ��.$24:60, �� :11.�, � '`". _-----'�-� �..--"� .�� r ;,� � � Temp Pwr Pole �-.$0.00 �� ., O�i i.� �- � _ TOTAL CALCULATED F,EES�•., 548.10; �/ .� Intermed Pole � -$0.00 " �0' . , _ � � , � ,- � � COMMENTS7 SPI ' , _ . :, ,�:� „ AL CONDITIONS�" %'' . -- � ': NOTICE: The work authorized by this permit shall comply with all applicable handicap access requlrements under Calllomla stalules and related regulations. (Ord. No. 9248, § 1, 12-21•92) . - EXPIRATION: Thig permit shall automaticelty expire and become void if work is not commpnced within 780 days, or if work is suspended or abandoned for e pedod of 180 tfays. , INSPECTIONS: In order for the work authorized under thls pertnit to be consldered legal, such xrork must comply with all applicable codes, and a�l requlred Inspeetlone end finel approvel must be oblained. Failure to obtain Inspections and final approyal will result in the expiration ol this partnll. . FOR INSPECTIONS CALL: (714) 7545828 , zua+s (erool -- � WORKERS' COMPENSA710N DECLARATION: . ' 1 hereby elfirm under penalry of Per�ury one of Ihe tollowing declaretions: ❑ I.heve end will maint8�n e cerllficete ot consent to self-Insure far workers' compensetlon, es provideO for by sectlon 3700 0l the Lebor COAe, tor ihe pertormence of the ,., �work for which this pertnit Is issued. ❑�I heve enC will mainte�n workers' compensatlon Insurence, as required Cy secUon 3700 ot Ne Lebor Cotle, ta Ne pertoimence ol the wo�k tw whkh this pertnit Ls Issuetl. ' My workere' co%� nse o Insurence ceMer enC pollcy number ere: !2 �i Cartier. �// �� PdiryNumber. �L. � T O s�� (Thts secl/on neeC not be C�We(ed I/ fhe pertnit ls velued ef one hundred tldlers (S100J oi less.� �; � � ❑ I certify thet in tha pe�o�ence of Ihe work for which thls pertni[ is IssueE, 1 s�etl not employ eny paraon In eny mennar so es to becane suDjed to Ne workers' compensation laws o� Cellfornle, end agree thet if I ahoulA 6ecoma auD�ect to Ihe workers' compensetlon provlslons of Sedlon 3700 of the LeDor CoOe, I shell fonhwHh comDly wlth ihese prod lons. n � �y / � ApPlicant Sipnature:.__ C Dete: -- J1i� � 0`� � 5� WARNIN(3: FNLURE TO SEW RE WORKERS' COMPENSATION WVERAQE IS WFUL AND SM�LL SU9IECT AN EMPLAYER TO CRIMINAL PEN�LTIES AND CML FlNES UP TO pJE HUNDRED TIIOUSPND DOLLr1RE (E10D,OWI. �N ADDRIIXJ TO TME COST OF CqAPENSATIq , DAM40ES AS PROVIDED FOR IN SECTION 37080F7ME LABIXi CODE, INfEREST, AND ATfORNE1"S FEES. LICENSED CONTRACTORS DECLAPATION: I hereby aHlrm ihat I am torce end elfect. Lic. A_ ConlrectoYs Signemre: 01 Ch er 9(commencing with Sectlon 7000) ot DlWslon 3 of t�e Bi � Class p De1e: Code, end my Iicense is In full CONSTRUCTION LENDING AGENCY: ' ❑ I hereby effirtn Nat it�ere is e constnution lentling epency for Ne peAofmance ot the work for which �his permit is issued. (Sec. 3097, Civil Code). Lendef5 Name: Lender's Address: Signelure: OWNER-BUILDER DECLMAT�ONS: Dete: I hereby efllrtn thet under penelry of pe�jury thet I em EXEMPT FNOM 7HE CON7RAG70R5 LICENSE LAW tor the following reason (Sec. 7031.5, Buslness entl Protessions Cade: My dry or counry whic� requires a pertnit to consiruct elter, improve, Gemolish, or repair eny slmIXure, O�or to its issuance, elso requires tlie appllcant for such permit to flle a sipnetl stetement Ne1 he or ahe is Ikensed punuant to the provlslons of Ne Contraclors Lkense Lew (Chapter 8(commendnp wiN Sectlon 7000) of Dlvision 3 oi the Business anE Professions Coda) or Ihet he or She Is exemp� iherehom end �he besls for the elleped ezemptbn. My Wdallon ol Secllon 7031.5 by eiry epplkant fa e permit suo�eccv cne eppncem �o a dw peneiry o� no� more man nve hundred awiers (Ssoo).�: ❑ I, es owner W the proGerty, or my employees wlth wapes es iheir sole compensatlon, WILL DO THE WORK, and tha strucWre Is not intended or ofleretl lor sele (SeC. 7044, Bualness end Protasslons Code: The Coniractora License Lew does not epply to an owner of properry who bullds or Improves thereon, end who does such work himseN or hersaM or through his or her ov.n employees, proNded ihet such imprwemenis ere not intentled or aHered tor sele. Ii, �owever, the buildinp or Improvement Is soltl wit�ln one yeflr 01 completlon, the owner-builder will heve ihe Durtlen of proving that he or she diA not Duild or Improve for purpose of 9ale.). ' ❑ I, ee owner of Ihe D�oPerty, em EXCWSIVELV CONTFiACnNG WIiTI UCENSED CONTRACTORS to construct t�e pro�ect (Sec. 7044, Business entl Pmfesslona Cotle: The wntredoYs License Lew does not epply to an owner of Droperry who builds or Improves t�ereon, and who contrads br such pro�acl wi�h e coniractor(s) Ilcenae pursuant to tde Contractore License Lews.). ❑ I em eaempt under sec. Business end Professions Code tor this reason: Slgnature: Dete: Owner ID verified by tlriver's Ilcense. ❑ Yes ❑ No Driver's License No. Vedflcation ol Ownership by (rype of documem, I.e. - property ten bill or deed): DIVISION OF INOUSTRIAL SAFE7Y PEAMR CERTIflCATON: Expiras: ❑ I hereby certity that no excavation frve (5) or more feet In depth into which a person is required lo tlescenQ will be mede in connection with vrork euthodxed by Nis pertnit, enA that no bV�ltlinp sWMura, sceMdding, falsewofk, or demditlon or tlismantling theraoi, will Oe more than thlrty-six (38) feet high. (Chep. 32, Gry 2, Atl 2, Sec. 341, Tltle 8, Celifomlw Atlminlstretive Code). ❑ Ae owner-Duilder, I W��I not employ anyone to tlo work which would requlre e pertnil from the Dlvislon of Industrial Safery, es noted ebove, un189s auch person hea e permit to do such wofk irom the division. . SigneWre: Date: DMsion of industrial Safey Pertnit Number: CERTIFlCATE OF COMPLIANCE AND AUfNOR¢A110N OF EHfRV: I certity under penalty ot per�ury Net I heve read t�is epplicetlon and stete Ihet the Infortnation glven Is correcc I egree to compty W��h all stete laws entl ciry ordinences releting to builAing construction, end euthodze representatNes ol the Cily ot Coste Mesa to enter upon Ihe ebove-described property to� Inspection purposes. I agree not lo accupy or ellow xwpancy M any builtlinp euthorizetl by Ihis pertnit until final inspection. CODE �. INSVELTIONTYVE 1618 Fi:ed System Finel Flre PrevenGon 1288 Pool Spa Final 200 Finel Re-Roof 201 Finel BIocWRetaInl�B Well 202 Flnal Factary Fire P�ace 203 Final Sign 204. � Final DemWitlon . � PAIE 11f�ALi /J � I �V' � �� Date � �,j INSPELTONTYiE 208 Final Mechanical 20B Finel Plumbing , 210 . . Finel Electricel 212 Finel Flre Preventlon 220 Final Planning Approvel 222 Final Slte 250 , Finel Building/Occupenq . _"`--l--.� "`.� I %��17 �� a � CITY COSTA MESA, 8171LDING SAFETIi JISION POST 11� CONSPICUOUS PLACE ON THE JOB NOTICE Schedule inspection one workday in advance. To schedule inspections, call (714) 754-5626. Provide the following iniormation: 1) Permit number, 2) Job address, 3) Inspection item number. PERMITS EXPIRE 180 DAYS (6 MONTHS) FROM ISSUANCE OR LAST INSPECTION . . •. Item e STRUCTURAL Date Inspeetor Item e POOL &"SPA Uate Inspeetor 3 Job Site Consult 94 Pool & Equipment Location 4 Footings 1 Uter Ground 96 Steel Rein(orcement � 6 Slab 100 Electrical Bonding 8 Structural Floor 102 Rough Plumb & Pressure Test 11 Pre-Inspect Rooi 104 Approval to Cover - Gunite 12 Roof Sheathing / Building Height 106 Elec Conduit - Underground 14 T•Bar Ceiling-Structural 108 Gas Pipe � Underground Test 16 Shear Panel 110 Backwash Lines, P-Trap, 18 Frame & Flashing Underground 20 Lathing 8 Siding 112 Approval to Deck 22 Insulation 116 Pool Plumbing System - Final 24 Drywall Nailing 118 Pool Electrical - Final 26 Plaster Brown Coat 122 Fencing 1 Access I Alarms Approval ' 30 Pre-Graut 124 Approval Sor Plastering 31 NPDESIBMP 126 Pool � Spa Systems - Final 33 Disabled Access - � -• 1610 Overhd Hydro l Overhd Rough 1612 Dry Chemical ELECTRICAL 1614 Dry Standpipe 36 Ufer Ground 1616 Final - Fixed System 38 Elec Canduit - Underground 44 Rough Elec - Wiring . 46 Rough Elec. Conduit ' • • ' • 48 Elec T-Bar Ceifing Call'(714) 754-5626 tot the tollowi�g: nate inapeetor 50 Elec Power Final I Meter Release 200 Final Re-Roof 51 Temp Power Final 201 Final Block I ReSaining Wa{I ' 203 Final Sign 204 Final Demolition 206 Final Mechanical PLUMBING & MECHANICAL 208; Final Plumbing 52 Soil Pipe - Underground 210j Final Electrical 53 Shower Pan � ' Call (714) 327•740010r the following: " oate mspecior 54 Water Pipe - Underground 212: Final Fire Prevention 55 Underground Gas Call (714) 754-5671 two (2) working days 62 Rough Plumbing prior to final. oa�e Engineer 63 Prewrap 216 Final Public Svs. Dept. Approval 64 Raugh Mechanicai Call (714� 754•5245 fur the tollowing: ua�e Inapector 66 Rough - Factory Fireplace 220 Final Planning Approval 68 Sewer Sysfem Cal1(T14ti 754-5626 for the tollowing: �ate tnspec�or 72 �as Pipe - Rough 222 Final Site 90 Gas Pipe Test - Final 250 Final Building � Occupancy 92 Water Service - Final v �, NOTES: SEE REVERSE 0559-46 pev. y06) � � CITY OF COSTA MESA �F� __ ' � BUILDING DIYISION ��li � � DEVELOPMENT SERVICES DEPARTMENT l� '�� PEfiMIT .. PERMITNUMBER P98-00864 (714) 754-5273 • Fax (774) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job qddress: Suite No Vleinity: 841 W 19TH ST ,1 ^'� �� Parcel Nunmber. 4Z419107 Applicant: JONSSON, JEFF Address: 6 MORGAN IRVINE Owner: TRAUTWEIN, PAUL TR Address %L & M PROPERTY MGNT NEWPORT BEACH,CA . , 1617 WESTCLIFF DR #112 Contractor: THE JONSSON COMPANY Address: 6 MORGAN #100 ArChlEng: Address: IRVINE,CA PLUMBING PERMIT Phone: 949-581-1896 Zip: 92618 , Phone: Zip: 92660 Phone: 949-581•1896 Zip: 92678 License: - 691288 Phone: Zip: License: Status: ISSUED Applied: 1 111 9/1 9 9 8 Issued: 1111 g/1 gg8 SCOPE OF PERMIT SUPP�EMENT TO : P98-00674 AND REF: 898-01102. WORK SHAIL BE: INSTALL GRESE TRAP INTERCEPTOR. .' ; ISSUE FEE Backflow irrigation Backflow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwashgr Drein, Floor Drein, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Inlerceptors (Sand Auto ) AMT $6.50 $0.00 $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 80.00 $0.00 $0.00 $17.75 $0.00 Qrr FEE SUMMARY AMT Laundry Tub / Washer ' $0.00 Landscape Irrigation $0.00 P-Trap . �- $0.00 Pressure Regulator $0.00 Process Piping (per 10 R) $0.00 Receptors $0.00 Septic Tank $0.00 Sewer Cap for Demo $0.00 Sewer Connect 80.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, wmmercial $0.00 Sink, Floor $0.00 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 nrv 0 0 0 0 0 0 0 0 0 0 0 0 . 0 0 0 0 0 0 COMMENTS I SPECIAL CONDITIONS SumpPump Swimming Pool Trep Pnmer � � Urinal Vacuum Brkr Bkflow(1-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (foileQ Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe Water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT 50.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 70TAL CALCULATED FEES: $24.25 Qn 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 1 BO days, or if work is suspentled or abandoned tor a period of 180 days. � INSPECTIONS: In order tor ihe work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all required Inapeetione and (Inel approval must be obtained. Failure to obtain inspections antl final approvaf will resuit in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSATION DECLARATION: �• I hereEy aHirm under penalry oi perjury one of t�e lollowing declaretions: � I heve end will melntain e certlllcate oi consent to self-Insure tor workers' com0ensetion, es prm�detl for by saction 3700 oi t�e Lebor Code, for ihe peAormence o1 the work for whith tNs pertnit Is Issuetl. ❑ 1 heve flnd wlll melntain workera' compensetion insurence, es required by sectlon 3700 ot Ihe LeOor Code, for the paAamance ol Ne work for which thLq pertnit Is IssueA. My workers' compensetlon Insurance certler end policy number ere: � Cartfor. Poli�y Number. (TTIs secfion neetl nat be complefed!! the permlf Is velued et one hundred dollaro (S 100) or leu.) �I cenify that In the peAo nce ol tha work for which this pormit Is Issued, I shall not employ eny person in eny mennor eo es lo become sub�ect to the workers' compensetlan lews ol ell mla, entl epr e thet II I should become subject to the warkers' wmpensaqon proNslons ol SeIXlon 3700 ot t�e Lebor Code, I shell forihwith comPh' with t�ese Dro s I-1 �O, ` r �_ ApDlicem Signature: Date: V � 1 ��— WAqNIN6: FAILURE TO RE O PS' CO/AF NSATION WVERAGE IS UNIAWFUL AND SHAll.SU&IECT Ml EMPLOYER TO CRIMINAL PENALTIES AND CML F1AES UP TO ONE HUNDRED TFIOUSMID DOLURE (510D,000), IN ADDfTION TOiHE OOST OF COMPENSATION, DAMAGES AS PRONOED WR IN SECfION 37080F TME IABOR CODE.INTEREST. AND ATTORNEV'S FEES. LICENSED CONTfiALTORS DECLARATION: I hereDy effirtn thet I am licensetl uqtler provisions o� C�epJ�[�f(�qmmencing wi�h Section 7000) ot Division 3 of the Business en Professiors Code, end my Ilcense is in full torce end eHect. Lic. a � A _ .�� I�/.11i class a �� Contrector's Signature: � Date: � CONSTRUCTION LENDING AGENCY: ❑ I hereby effirtn that ihere Is a construction lending agency for the peAortnance ot the work tor which this pertnit is issued. (Sec. 3097, Civll Cotle). Lentlers Name: Lendefs Address: Slgneture: OWNER-BUILDER DECLARATIONS: Date: I �ereby eKrtn Net untler penelry ol pa�ury thet I am EXEMPT FROM THE CONTRACTORS LICENSE LAW fof Ihe idlowing ree50n (SBC. 7031.5, BUSinesS entl PfOfB5310n9 Cotle: Any dry or counry which requires e pertnit to consiruct, alter, improve, Cemolis�, or repair any siructure, prior to Its issuance, also requires the applicant tor such permit to file a si0netl sietement ihat he or she is Ilcensed pursuent ro the provisians ol t�e Goniractors License Law (Chapter 9(commendng with Section 7000) of DiNsion 3 01 the Business end Professions Code) or thet he or she Is exempt iherefrom end the besis tor the alleged e:emption. Any Wolation o1 Section 7031.5 by any appliwnt for e permil sub�ects Ne epplicent to e civl penelry of not more then five hundretl tldlaro ($500).): � p I, es owner of the property, or my employees with weges es thelr sole compensatlon, WILL DO T1E WORK, entl the structure Is not Intentled or otferetl for sele (Sec. 7044, Business end Professions Code: 7Te Contrectors License Lew does not eppty to an owner of properry who builds or Improves thereon, and who does suc� work hlmsetl a� hersell or through his or her own employees, proviaed thet such Improvements ere not InienAetl or offered tor sale. II, however, ihe bullding or Improvement Is sold within one yeer ol completlon, the owner-bulltler will have the burden ot proving ihat he or she did not bulld or improve lor purpose of sale.). ❑ I, es owner of the property, am El(CLUSIVELY CON7RALTING WfTH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Buslness anA Prolesslon9 Catle: TTe conlreUors License Lew does nol apply to an owner af property who hullds or improves thereon, end who wniracts tor such project with e contractor(s) Iicense pursuant to the Contractors License Lews.). ❑ I em exempt under sec. Business end Professions Code for this reason: Signature: Date: Owner ID verifled by drivers licenso. ❑ Ves ❑ Na Drivers License No. Ve�ificetlon ot Ownerehip by (type ol dacument, I.e. - property tex bill or tleetl): Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I �ereby certify that no escavetlon Ove (5) or more leet in tlept� into wNch a person Is required to descend, wlll be metle in connectlon wlth work authodzed by this pertnit, end tha� no builtling structure, sceflolding, lelsework, or tlemolitlon or tlismantling ihereat, will be more then thirty-six (38) teet high. (Chap. 32, Grp 2, An 2, Sec. 341, T1tle B, Gellfomla ACminlstretiva Cade). ❑ As owner-bulitler, I will not emplay enyona to do work which would requlre e pertnit Iram Ihe Dlvision of Intlusirlal Sefery, es noted ebwe, unless such person has a pertnii Io do such work from ihe Civision, Slgnature: Dete: DlNslon o1 IndusMal Satery Permil Number: CEHTIFlCATE OF CAMPLIANCE AND AIffHORVA710N OF ENTAV: I certily untler penalry of perjury that I heve read Ihis epplica�lon antl state that Ihe Inlormation given Is cortect. 1 egrae ro comply with ell siete laws enC clry oNinences relating to builCing conslruMion, flnd authorize represenletives ol lhe Ciry ot Costa Mese to enter upon the ebOve-desCribed properly tOr inspecUon purposes. I agree not to occupy or allow occupenty of any building authodzetl Dy Nis permi� wtil flnal Inspection. COOE �. ixsveenoxrrve 1676 Fized System Finel Fire Preventlon 1266 Pool Spe Final 200 Flnel Re-Rooi 201 Finel BIocWReteining Wall 202 Finel Factory Fire Plece 203 Fnal Sign 204 Fnal Demolition 7dIE II�ALS COOE� INSPECTIONTYPE 206 Final Mechanical 208 Finel Plumbing 270 Finfll Electdcel 212 Final Fire PrevenUon 220 222 250 Flnel Plenning Approvel Final Site Final Builtling/Occupanty �:: . �. � � �: : — �. I .1111. . ' m1y � (714) 754-5273 • Fex (714) 754-4856 � Job Address: 841 W 19TH ST s�ne No P` Vicinity: Parcel Nunmber: 42419107 npp�icant: JEFF JONSSON Address: Owner: Address CIN OF COSTA MESA B11►LDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT ELECTRICAL PERMIT �� / PERMIT NUMBER / � E98-00922 r 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OB12817998 Issued: 08/28/1998 �- �- --::,-:i�c_.� - -_ --�,a�i:'i'P6one: _ .-- '_ _ . _'-- �_ � � / :_ "- Z�p: i � '� �/� �� / % \ � � � . �;` ', � 1' / � TR\ `.,� �_:� ._' �� /�/\�\�� NT �/: - ' -- =`� �.� �" =\�� \�I ��\ y � --� �- - - �\,�\��\I �\ �` �- � Phone: ��, � � �� , , � 112' Zlp: 92660 \��A,/ / A �/ � � \ \ �j%s �\;�� -�� , ,,iii � Contrector:�� THE JONSSON COMPANY �� ;'1 � 'Address�-i\6MORGAN�#100 � \�� `��` /';�/ �-��-�/' i�%:,% Phone'.y 949-587-1896 • ,��. - �� `�/ i �":' � . IRVINE,CA -- .� ' :: �Z�p� 92618 � i �� ( - � 1�� "'�� \ � %�- ' i �� iCicense 69�2 8 � - � j - � ' �`�\ � � , . . � - �� /Ar:� �' _ -- =��y ' i � `i` , �, C: ti . � 1 , ��r _ - -- _ .�� _y �,. � �' - c � � - � �'' � SCOPE OF PERMIT � �� .. RESTAURANT TI,�INSTALL 45 FIXTURES, 19 OUTLETS, 20 SWITCHES, SERVICE & SUBPANEL. ." ,` j � rRE:B98-01702. - . - - _ - - -__ - -� � " � ; � � , ��/, , "�� .., 1i ��"nl`� � �) . �' ��A !'.'. ,� _-�_ ..._- -..�U�S�i-�� .�A �I�.. � r i - _. - - - - a �� , FEESUMMARY -�� % ; ' ' � ^ ;, � , _ Quantib �.r �r��2,�� '�-. i �*�_�� - --�. QuanGty � ; � , ISSUE FEE . _ 522.00 " ` - �Temp�Dist System / Ughting � � $0.00 0 , � �� Temp service test � � $0.00 �- �� - _�- - Bu`sway.l100 8 � � - � $0.00 0� l �� i� � � � Res)�a/c package 50.00 Standing Section . $0.00 0�-! , ', New Res (1-2 units) $0.00 0 Misc ElectricalrEquipment `� $0.00 ,0 ��%�� " NewRes�(3+units) ., $0.00 � 0 Transformers�uptotkvalkw $0.00 i0�1 -��-�� iU� � �' � ' _ . Pool / Spa, � ' , � ��, �, $0.00 . 0 ................up to 10 kva/kw � $0.00 ��0' -'i _ �" /.�! ' Lighting Fixts. ; , A �\ $3fi25 ' 45 � ......:..........up to 50 kva/kw �� $0.00 ��-0 `-� ,� „! ReceplOuqets �, � ��519.00 19 �"'��'�� ....upto100kva/kw �$0.00��%�0 � � -; Switches �. - ` $20.00 20 '�� ;' } ' ... :'-...^.over 100 kva/kw �$0.00 % � 0 i � � � i Non Res Appl�,� ^- $0.00�. 0 �° � Low.Volta e E'ui ment �' �$0.00� 0% � /��%� . . . J,: i��{� .9 Q P / � � „ ResAppl .. . $0.00��,� , -0� _� � -,_, v ;-Low�VoltWrtmgSystem/Ckt„-,$0.00 -� 0 Service to 200a , 7 , . $0.00 -. � � 0 , � ' -� � Misc;,Condud �� ' 1 . ��i $0 00!> � 0 Service to 1000a � $55.50 At -- � �'�� MisaaConductor ' `/� $0.00 C� 0 � Service over t000a � � � $0.00,; 0 ,� � �F ! � Grcus ( gen oi ride) ; j $0�00 �� O�i Motorstolhp ' `;� �$0.00 � 0 � � �-�`-_.,� �Circus(mech_ride;or-lights)��>$0.00� i0�� Motors to 10hp � �,$O.OD- `� 0� --�' - Christmae 7ree Stand '� `"$0 00 j i�0 Motorsto50hp �'--_$0.00�� 0'.:;�r- FireworksStand�r" � ��$O,OO;ij�O Motors to t00hp `-$0:00� � �: 0� , ;�.�� ; - -'� � __ Other Electrical_Fee� ` � � ,$0.00/ Motors over 100hp $0.00 � 0 ` � _, � � � - _ � _ > ,' .�-i Communication drops $0.00 � � " � 0 -, � � � ,� `Investigation Fee . -�.; ��" � $0.00 Sub panel to 200a $2725 ��- 1`- � .- Plan Check•Fee_-i✓��- ` $0.00 ...��.,..�... Pole light Pkg $0.00 0 � �- - - - - �: � :- �Reinspedion.Fee - � � $0.00 SignCircuits $0.00 0 � ' - -- - - Temp Pwr Pole $0.00 0 TOTAL CALCULATED FEES 5160.00 Intermed Pole $0.00 0 COMMENTS / SPECIAL CONDITIONS EXPIRATION: This permit shell automatically expire and become void if work is not commenced within 1 BO days, or If work is suspended or abandoned for a perlod of 180 days. ' � INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlone and finel epprovel must be obtained. Failure to obtain inspeclions and fina� approval will result in the expiration of this perrttit. FOR INSPECTIONS CALL: (714) 7545828 � WONKERS' COM7ENSATION DECLARATION: � � i hereby attirtn untler penelty ot perjury arre M the fdlowing decla�atwns: ❑ 1 have and will melnfein a ceNficate of consent to setl-Insure tor workers' compensetlon, as provketl for 6y section 3700 ot the labor Code, tor ihe peAortnance ot the xrork tor which tMs permit Is issuetl. ❑ 1 heve and wiil inte workers' comp iseGo� insurence, es required 6y sectlon 3700 of �the labo� Cade� fw ihe pertormance of ��e work for which thi9 pertnit IS issued. My warkers' _ antl poifcy number ere: / Camer. — � j/ Poiicy Number. ` (Thls secHon rteed not ��d �� Me p�rmlt rs vslued a! one huntlreUCWJea I$J00j w Jess.j ❑ i ceeiy tna� in tne pedar ie ce oF f0e vrork tor which this percnit Is issued, 1 Shall not employ any person fn eny manner so as tu bscome Sub�ect to the worksrs' compensetion Iflw9 of Cal"r fa, ntl agree hal If 1 shou�d becom9 subject M Me wotk ' campensetlon Pruvisions of Secllon 3700 of the le6or Catle, 1 shall fwthwith compiy vnM these proHsia . • �/ n Applipnt SI9neWre: � Date: � 7i� �? "'""7 Wf�flNiN6: FAILURE TO SEGURE WORK PS' COhIPEN �ATION GWERAGE IS UNIAWFUT AND SVIAL� SUBIECT AN ENPLOYER TO CRIMINAL PENALiIES ANO CIVIL FlNES UP TO ONE MUNDRED THOUSAND �OI.UIRE �5100,000), IN nDDIT10N T4 THE ODST OF COMPENS0.TiON, OAMAGES AS PqpViDEO FOR IN SECTION 3708OF THE IABOR CODE, iMEREST, AND ATfORNE!"S FEES. UCENSED CONTRACTORS DECLARATION: I hereby e�Nrtn that I am �censetl untlet D� sk foft9 entl BMec[. Lit, k_'..� Contractors S�qnatu�e: 9(commencing wtlA Seci 7000) ot Division 3 of the 8usiness and Pmtesslons Cotle, antl my Iicense Is ir�ll > � Class q /�� Data: � CONSTRUCTION LENDMG AGENCY: ❑ I hereby affirm that Ihere is a wnstmctlan lending agency for ttre pertortnance of the work 1or which this permit is (s5uetl. (Sec. 309�, Civll Code). Leoders Neme: lentler's Adtlress: Slgnelure: Data: OWNER•BUILDER DECIARAT10N5: 1 nereby eHirm thac under penelty ot perjury that I em E7(EMPT FROM TME CONTR0.CTORS LICENSE lAW for the folbwing reason (Sec. 7631.5, Busfness and Professions Code: Any c(ry a counry whlch requires a pertnfi to consiruct, aller, imprrne, demdish, or repair eny strucNre, p�Sor to its Issuance, e�so requires the appliCant for such p8rtnii ro ftle e slgned statement that Re ar she is liaensed pursuant to the proWsions oi tha Contracfors LJcense lsw (C�apfer 9(commenWng with SecOon 7000) of Division 3 af ths Business ana Professions Code) ar that he or sAe is ezempt therefmm and the hasis tar Ne allegetl exemption, Any violation ot Sectiat 703L5 by any appliCant tor a pertnit subjecta the applicant to e civil penalry of not mwe than five hundre0 tloliars ($500).): ❑ i, es owner ot t�e pmperty, ar my employees vrith weges es thelr sole compensaGon, WILL DO TME WORK, aM the structure is rrof inteMed w oHaretl for sale (Sec. 7044, Businass antl Professions Code: 77+e Contraclws LJcense lew tloes nol eppiy ta en owner ot property who Guilds ar improves thereon, flnd who tloes such wark himselt ar herself or through his or her own employees, p�ovitlad thet such impmvamanis are not intendetl or oHeretl for saie. I1, however, the Guilding or improvemeM is sold within one year M compleGon, ihe ovmer-builder wlil have the buMen a1 proving thet he or she tlid not builC or Improve to� pu'pose of sale.). ❑ 1, as owner of the pioperty, am EXCLUSIYELY CONTf7ACTiNG WITN LICENSED COMRACTOFS to conswcl the pro)ect (Sec. 7044, 8usiness entl Pro�essions Cotle: The contrecrors License Law does �t apply ro an owner of praperty who builtls or Improves thereon, and who contracfs fa such projecl wlth a conVador(s) license pursuanf to the Coniractors License laws.). � 1 am exempt under sec. Business antl Professions Cade for this reason: Signature: Dete: Owne� ID verified Cy tlrivers license. ❑ Yes ❑ No Orivar's Ucense No. Expires: Verificetlon of Ownership by (rype of document, i.e. - property te�c bill or dseC): DIVISION OF INDUSTRIAI SAFETY PERMR CER17fiCATtON: . ❑ I Aereby certify that no excavatlon five (Sj or mora iee� in depth (nto which a person is required to tlescend, wili be matle in conneqion with work euthodzed Cy tNs p0rmit, end thet no building strucNre, sceftolding, talsework, or tlemolition or tlismantlirg thereof, will be more then Ihirty-siz (36) feet high. (CheQ. 32, Gry 2, Art 2, Sec. 347, Ttle B, Califomla Atlmin(stratNe Code). ❑ As owner-builder. I will not employ enyone lo do wo�k which would require e pe�mit irom ihe Oivlsion M Intlustrial Satey, as noted ebove, unless such person hes e pemnt to do such work from the tlivfsion. Signature: Dete: Dlvision of intlustrial Safery Pertnll Number. CEHTIFICATE OF COMMIANCE AND AUTHORI7ATION OF EMAY: 1 certity under penalry o1 perjury thet 1 have read this epplicetion and state that the information given is correct. 1 egree o comply with e11 stete Iaws and crry ortlinances reieting ro bu�ltling construction, end authadzs represgntatives of the Gity of Cos[a Mesa to snter upon the above-de � property for inspe bn puryoses, I ag�e n to accupy oi allow occupancy of any 6uilding auihorize0 by Ih(s pe if unG1 flnal tns clion. �' l� ��7 J —� gnatwe Ot L e�(s) / Date ceoE+ ItlSPECTONiYVE 7816 Fixetl SyslOm Final Fire Preveniion 1266 Pooi SPa Flnal 200 Flnel Re-Foof ' 201 Finet Block/Remini�g Wflll 202 Finai Pactory Ptre Place 203 flnalStgn 204 Ff�alOemoli6on [a+aaa PASE I�dlS �Qp� INSPEC110NttPE 208 Finai Mechan(cai 208 Final Plumbir�g 210 Finel Electticel 212 Finai Flre PrevenNon 220 Finei Plenninq Approvel 222 F(nal Site 250 F(nal6uilCing/pccupancy CIN OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT �� : PE�T� ER � P98-00674 (714) 754-5273 • Fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: PLUMBING PERMIT �C.P � Gt� . «'d'h � �� Parcel Nunmber: 42419707 i 1� nppl�cant: JEFF JONSSON _ __. _ Address: % �,�";e--��-..;'--�-=" --- ="-\ oW�er �� /� /,4// Contrector: ' ( /� Address:��... . . "�i ,"- , - . � IRVINE,CA . /� (' ^ � I � i ��/ \�H* 1 . f, � % , -C _ _ �-- hi� ; �: 16171 � Status: ISSUED Applied: 08/28/1998 Issued: 0812 8/1 9 9 8 -;/i'� - - - .__ � /�iiY%;: -_�iPhone: . -_.�-,_�-;- ,,, ,.;�, � ��- �\ ,,, _ > >� z�p , ' � � � �� A� � �, � � i ��'�/ �\� �'�� . A` '` � - 7 - - _' � L, �� N; PAUL';TR�-; -, :` =�.`=\� ��Y \�,\ \ -�-=- J-` - --\v\�� \: 'ERTY�MGNT� »' _� '��. �/ \ ///i= �� :��. � i iACH;CA:.-j' Phone: .�� ;,_ i �IF,EDR #112 Zip: 92660 �` � � i� % / ��1��, #100 COMPANY � i ! ArchlEng: ` Address: � � � � i 949=58`1896 92618 691288 � .`''�Y .�.�,,,. ,, � j� ��. �' � �/ -/� �/ � � 'Phone � ,�n� p T - i�.l.A / - ;� e,' _ _� ap �'' ''�,L �cl�� ir �� ,�.. ' -� --- ---------..._._--_--=', . - . , _ _ __-__ License: _. _ _-- . _ __. _ . . � - � r �. � ,. �.� u;�r'SCOPE C i - RESTAURANT TI, INSTAEI 3 SINKS-2 WATER GAS OUTLETS, 1 GAS SERVICE, 7 FLOOR DR SINI(S, 1 SERVICE SINK. RE:B98-01102. i >�"'� , . � � ,. ;,) EATER, 1 WATERSERVICE��B�� 1� � 4 COMM SINKS 2 FLOOR� %��- �� ., � r_-. - , � � i /ii, �� nl� %( 1��; '. U % �\� � ��\�� ' FEE SUMMARY � % �� 1 i �� . � AMT� QTY � � � AMT QTY /�� .`/ ISSUEFEE,.�' $2200 � � LaundryTub/�Washer., ��$0'00 0 Sum Pum �� :� ,. ,-' P,. P � �. BackFlow vnyation $0 00 �-0 �andscapelrrigallon � t,.. $0 00- , 0 Swimmin Pool . BackFlow Preventer� �' a$0 00 ��0� a P Trap ,J' ;�� iC ��$0 00;� i�0\, ,. Trap Pri er � ��' Bathtub �� , $000., �0 � � - ,PressureRegu�ator %�� $000 ',0 '' . �Urinal / � %"� ClarifierSystem �� $000 � 0��"�� Process�Piping(per10H)��.$000 � 0 ��%�VacuumBrkrBkFlow(1�4) Connect (Ice,Soda etc) � ;, $0.00 '/�0 \ � Receptors, � - f �� , � $0 00 ,' _ 0 _- � Vacuuiri Bikr Bkflo�'v(5+) Dental Units �-- �$0 00/,�'0 '-Sephc Tank _� ' ' - $0 00 �c0 � Wa'sh Basin � �� Dishwasher �� $OAO � � 0 ,.. Sewer Cap for Demo � $0.00 �0 � � �- VJash Basin Set Drein, Floor $61,25�� 7� ��_ ',' ' -�Sewer Connect � $22.00 . �1," \ V��. Waste and Vent System Drain, Rainwater $0.00 `��0 � "`� 1 Sewer Pnvate�Line . , _ :_$0.00�.��0� ��, � �� Water:Closet (Toileq Drain, Roof $0.00 �'0 , �Shower� � � � �� j', $0.00 �-_=0_�% �.��VJaterHeater/vent Drinking Fountain $0.00 �6-, '�� . Sink, bar�. -, � \� , i � $0.00- "0 /.//�,Water Piping (Inst or Rep.) _ �,-, ExpansionTank $0.00 0 � �'_Sink,�commercial� �� ,$35.00-��4'�ii�,� WaterRe-pipe Gas Earthquake Valve $0.00 0 -Sink, Floor - � . ,� ' �. ��,. -$17:50"� 2 �'` � Water Service Gas (1-4 outlets) $5.50 1 Sink, kitchen -� �--- $2625 3 Water Softener Gas (Over 4 outlets) $4.00 4 Sink, service/mop $8.75 1 OTHER Gas Repipe $0.00 0 Spa (private) $0.00 0 VIOLATION Gas Service $8.75 1 Spa (public) $0.00 0 PLAN CHECK Interceptors (Grease, Oil) $0.00 0 REINSPECTION Interceptors (Sand Aulo ) $0.00 0 COMMENTS I SPECIAL CONDITIONS �' $0.00 $0.00 $0.00 $0.00 so.00 $0.00 $0.00 $17.50 $11.00 $0.00 $0.00 $8.75 $0.00 $0.00 $0.00 50.00 $0.00 TOTAL CALCULATED FEES: $248.25 QTY , 0 0 0 ' 0 0 0 0 0 0 2 1 0 0 1 0 7 EXPIRATION: This permit shall automatically expire end become void if work is not commenced wlihin 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and ell requlred Inapeetlona end flnal epproval must be obtained. Failure to obtain inspeaions and final approval will resutt in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545828 � WORKERS' COMPENSATION DEC�AAnON: 1 hereby aKrm under penalry af perjUry one o1 Ue fdlowing Oeclflrations: ❑ I have end wlll meinlaln e certi��eie W consen� to self-Insure for warkers' compensetion, es provideA tor by aecllon 3700 of t�e Lebor Cotle, for the peAortnence oi the work for which this pertnit Is I54ueC. ❑ I heve end will maln�eln workers� compensetion insurence, as requiretl by sectlon 3700 oi Ne Lebor CoCe, far Ihe pertortnence of the work lor which ihis permit Lv issued. My workero' compensation Insurance caMer end policy number ere: � Cartier: Policy Number. � (rnls seceon neea nor ne comp�erea i� tAe penNrls vewed er one nunerea ao��ars (sroo) or �ess./ ❑ I certify thet In the peAortnanGe oi the work tor which ihis pertnit is issued, I shall noLemploy eny person in any manner so es to become subject to Ihe workers' compensetion lews of C ifo ia, and egree th� If I shoultl become sub�ect to Ihe w rs' compensfltion provlsions af Secllon 3700 ot the Lebor Code, I shell fonhwith comply vAtfi these provisi � �`�, � ,,, � �Applicent Signature: c Date: �� b� WARNING: FAILUflE TO SECURE WOR RS' CpAPEN$ATION COVEMGE IS UNUWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND pNL FlNES UP TO ONE MUNDRED TIqUSAND DOLIARE (5100,000�, IN ADDfn�'7 TOTHE COST OF COMPENSATION, DFMAOES PS PROVIOED FOR IN SECTION 3/08OF THE IABOR �DE:INfEREST, AND ATTORNEYS FEES. I LJCENSED CONTRACTORS DECLARAnON: I hereby ettirtn Iha� I em Ilcensed undar provlslons of �force and eMact. LJc. x Coniractors Signeture: wiih Sect�7000) ot DiNsion 3 of ihe Business end / Class q / Dete: _ Cotle, entl my Iicense Is CONSTRUCTION LENDING AGENGY: ❑ I hereby affirm Ihat t�ere is e constructlon lentling egency for the pertortnence of ihe work for which this permit is issued. (Sec. 3097, Civll Code). Lender's Neme: � Lender's Address: Signature: Date: OWNER-BUILDER DECIARATIONS: I hareby eflirtn thet under penelry ot per�ury that I em EICEMPT FROM THE CONTRACTOHS LICENSE LAW lor t�e lollawing reason (Sec. 7031.5, Business end Prolessions Code: My ciry or counry which requires a pertnit to consWcl, alter, improve, demolish, or repair any structure, prior to its issuence, also requlres the applicant tor such permit to flle e signetl stetemen� ihet he or She Is Ilcensetl pureuent to the provislons of the Coniwdow License Lew (Chepter 9(commencing with Sectlon 7000) of Division 3 01 the Business end Professions Codepor Met he or she Is exempt thereirom end the Gasis for the alleged ezemptlon. Any violatlon ot Sectlon 7031.5 by any epplicant for e pertnit subJecls ihe eppllcant to e clWl penelry o� not more ihen five huntlretl tlollars ($500).): ❑ I, es owner of the properry, or my employees with wages as their sole compensation, WILL DO THE WORK, en0 �he siructure Is no� Intended or oflered tar sele (Sec. 7044, Businass end Protessions Code: The Contractors License Law does not apply to an owner of property who bullds or Improves Ihereon, entl who tloes such work himself or heraelt or Ihrough hl9 or her own employees, proNded thet such Improvements are nat Intentletl or otteretl for sale. II, however, ihe bullding or Improvement Is so10 within one year of comple9on, the owner-bulltler will have t�e burtlen of proving that he or sha ditl not bulld or improve tor purpose ol sele.). ❑ 1, es owner of Ihe property, aRi E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to consiruct Ihe pmject (Sec. 7044, Business antl Professlons Code: The contrectors LlcensB L.ew does not apply to fln owner of property who builtls or improves Ihereon, and who wntreds for such pro�ect wlth e contrector(s) license pursuant lo t�e Conirac�ors License Lews.). ❑ I em eaem0� untler sec. Signatura: Owner ID venfieA by tldveYs license. ❑ Ves Veritice0on of Ownership Dy (rype oi tlocumenl, l.e. Business and Professions Code for this reason: ❑ No Drivers License No. pmperty tac bill or deed): Date: Expires: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby certly thet no encavatlon ilve (5) or more feet in depih Into which e person is requiretl to tlescend, will be mede in connectlon wlth wark aut�odzetl Oy thls permit, antl that no bullCing stn+�ure, sceffoltling, falsework, or demalition or tlismantling thereof, will be more ihen thirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title 8, Celifomie AtlminlsiraWe Cade). ❑ As owner-bullOer, I wlll not employ enyone to do work which woultl require a pertnit irom ihe DMsion of Intlusirial Safery, as noted ebove, unless such person hes e pertnit to do such work from Ih@ division. Signature: Date: Division of Indusirial Safery Pertnit Number: CERTIFlCATE OF CAMPLIANCE ANO AUfXOROATON OF EMAY: I certify under penalry of perjury that I have read this application end stete Ihat tha informetion given is correcl. I agree to comply wlth all sta�e laws end ciry ordinances relating lo building construction, and authorize representatives of the Ciry of Costa Meu to enter upon Ihe ebovadexribetl property for inspectio� purposes. I egree not to occupy or ellow occupancy of any builtlinp authorized by ihis partnit until finel Inspedion. COOE t VISPECTIONTYVE 1616 Fixed System Final Fire Prevantian 1266 Pool Spe Finel 200 Flnel Re-Roof 201 Flnel BIocWReteining Wall 202 Flnel Feqory Flre Plece 203 Flnel Slgn 204 Finel Demolitlon �SJ �mi � QAIE IIi�LS CQpEj INSYECTIONTYPE 206 Final Mechenical 20B Final Plumbing � . 21a Finel Electdcal 272 Flnal Fire Preventlon 220 Finel Plenninp Approval 222 Final Site � 250 Finel BuIlding/Occupency �. 1 .IIII. . f�J� /.�� a,��' �'��; • ¢'�..� � � •�:.;; � � � ��ia� �sa-sz�a • Fax (�ia� �sa-aess Job Address: s��:0 No Vicinity: 841 W 19TH ST A Parcel Nunmber. 42419107 CITY OF COSTA MESA BUILDIN6 DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT MECHANICAL PERMIT �7YV 1 PERMIT NUMBER M98-00397 77 FAIR DRIVE, COSTA MESA, CA 92626 Status: ISSUED Applied: OB/28I1998 Issued: OBY28I1998 Applicant: JEFF JONSSON _ Address: �i��,2_"'.----=-�".m- _� � . ,'` - - � , - '� _ .\� l�rf i�� -..'.Bhone ' � � � �� '� �. Z�p � � � �� i %�1.�. � = � '� �� - ` '` =_ �� !� � r� r ��` ` , Owner. TRAUTWEIN, PAUL'TR � �� , : —,__ Address: °hL'&�M PROPERTY MGN� - , , - "t�`_^�\.,��-��^� ��`J\� �l�.i i� � � � /� NEWPORT.BEACH CA i ; � Phone: \�\�.� \ �' � j �\ � �\ � ;'16L7 WESTCLIFF DR #.112 Zi 92660 � �� / � � � � P' �� < � > V1 � �� /, �/ � `/� � ontr�tor ,� THE JONSSON COMPANY �� iioi� �h � \ Addressi, � i 6 MORGAN j#100 ,/- ` � �ti� �� `�� ' � �;�� Phone:'s,949-581-1896 __ -_��.A� ��%�'� � �' � C � � ��-IRVINECA Zip��92618 ' %'� �� ""�� . � i _ � .A,rch I Eng � Address: . e , ,/ ' � � ;� ,� � � �� . � � Licen e 697288^� :� i ' `,�� / . �� .F . -'y,-i�"I � � . A,� � - C t � ,.. l � � � � i� �� „ __ - =_ - ��r.� , � , � � 1 � ,� r•. - __ - �, _�, /� , . � � ti. . _�} .,, ,� Phone: � --il� � � ..� , . � , �-- \, �. r ; � / �t / j Zip: , . _ _ � , " i License: � ' � �� "' � , , -- � _ -_ -_ - - --- - � - -- -- - � - -" i .. � oi��nr'i�r n�r�iii f TI, ��INSTALL 3-HOODS, 2�FANS$-4 AIR �tti:i`A�`�L:. �� ' fi � � i DLIND UNITS. RE:B98-01102.; / i i el , . � �' , _.� �,:� '�.�J`j F.EE'SUMMARY.�_'�- 11i � -•q �\', �� ,.; ��Quantity- - _ _,� —i �. -� � � _�I ISSUE FEE -� ; • $22.00 � Repair / Alt Absorbtion Unit Inst FAU�<700 k BTU `�..;��'��. $0.00� Repair /�Alt Refngeration Unit Inst FAU.>100 k BTU', �.`:� �, $0.00 Ventillation:System � Repair / Alt QoolinglHeat �\��`�, �, $0.00 0 Evaporetive Cooler � Inst / Rep.�Recess Wall Htr A`'r�,A $0.00 0 „p Commercial Incinerator � �� Refrig Sys 2100 k BTU � �,� °. $0.00 0 � �"' ro'-Domestic Incinerator Refrig Sys >.100 k BTU , A� ��$0.00 0 r;'�� '��^',;>_ Comoressors I Absorption Sv Gas Piping �` ��- �� $0 00 0 i:� �; �a=;��'�',c Up to 3 hp / 100 k BTU � Facto Fire lace' � �$000 0-�� `-"��° -4� �� 3T`15ti /SOOkBTU� ��` ry P . _. . r _ � o p ,.�.�i � Hood wlMech Exhaust � � � 528:50� �.3 _ (.' ' � � � ' ;15 To,30,hp7 1;OOO,k BTU ij' f � VAV Box �� "� ,�,$Q00 0�� r�� ;' 30 To 50 hp /4 750�k��BTU l � �// Vent Fan / Single Ducl� � - ,�$13;00 2 ��V �' � � � � � ; Over SO:hp.FOver-�7;750 BTU�� Appliance ��:�� 'i'.50.00�� 0 � � ,� �� <Balers c%i �, �i,A � � FireDampers . �$0.00 0;�� -�� - - Upto9hp�� '��' /%r� Smoke Dampers - , $0.00 0 '� 3 To 15_hp. " �� ,. , � Inst or Relocate Appl Vent � �� $0.00 � 0%' � - ' - �, � " ,_ �, �15 to 30, hp _ � �`, _� �.�j, � � Air Handlers < 10000cfm �' $38.00: - 4 - , . � � ` � ' 30 to 50'hp ,� �-- - ;�, j Air Handlers > t0000cfm $0.00- �0� ' � . , , Over 50 hp ij ��,,� FloorFurnace $0.00 -' 0,.�� - . � , , ... �, , v.OtherMechanicafEee� Floor or Suspend Heater � I $0.00 0 ' �- - � �- , _ .�investigation-Fee� Plan Check Fee Reinspection Fee TOTAL CALCULATED FEES COMMENTS I SPECIAL CONDITIONS , _ � r„ , . �v � ,� �' Quantity �_ , )0 r �p� �J i3O �; i�Q/ �i 0 $0.00 j 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 $0.00 EtOt.50 EXPIRATION: This pertnit shell eulomatically expire and become vold if work is not commenced wlthin 180 days, or if work is suspended or abandoned for a perlod of 180 days. INSPECTIONS: In order for the work authorized under thls permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepaetlona end flnal approval must be obtained. Failure to obtein Inspections end final epprovel will result in the expiration of this permit. FOR INSPECTIONS CALL: (774) 754-5626 WORKERS'COMPENSATIONDECLARATON: _ I hereby effirtn untler penalty of perjury one ot the following declarations: � ❑ I heve and will ma�nteln e certlficate ot consent to sell-Insura far workers' compensation, es proNded for by sectlon 3700 of tha Lebor CoOe, for the peAortnance of the woAc tor which Ihis pertnit is Issued. ❑ I have and vnll maintaln workere' compensallon Insurd�ce, es requireA by sectbn 3700 the Labor Coae, ta the peAortnance of Ne work for which Nis pertnit Is issued. My workers' wmpensatian Insurflnce carrler flnA pollcy numDer ere: • -Cartiar. � PolicyNumber. � ((his section need not ba �P�ereC if the permit Is valued ai one hundred dollars ($f 00) or IeuJ I certify that in the paAortn ce ot the work for which this permlt is issued, I shall not employ eny person in any manner so es to become sub�ect to Ihe workers' compensation laws ot C ifo la, entl e ree t�at I I 5�oultl Decome suhJect lo Ihe warkers' compensatlon provisions of Sectlon 3700 of the Lflbor Cotle. 1 shall forthwit� compy wiM these proNsi � �g ' ,y� �utn � --i Appllwnt Slgnature: Dete: " �C=J �� ""1 WMNINO: FAILURE TO SECURE WORI RS' COMPENS IXJ CO�ERAGE IS UNLAW FUL AND SHFLL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND GML FlNES UP TO ONE HUNDRED TFIOUSAND DOILARE ($100.�). IN A�DRION TO THE COST OF GOMPENSATION, DAMAOES AS PROVI�ED FOR IN SECTION 31060P THE IABOR CODE, INTEREST, AND ATTORNEI^S FEES. LICENSED CONTRACYORS DECLARATION: I hereby ettirtn that I em licens un pr v ic force and ettecl. Lic. x � Caniractor's Signeture:r- of Chapter 9(commencing with S t on 7000) of Divisian 3 at the Business and Protesslons Cade, end my license Is in full 7 � Class # oa�a: _ — 69 CONSTRUCTION LEND�NG AGENCY: ❑ I hereby a(firtn thet Ihere Is a constructlon lending egenry far Iha pertortnence of the work for which this permit is issued. (Sec. 3097, qvil Code). Lender'S Neme: Lenders Address: Signature: OWNER-BUILDER DEGL�AATIONS: Date: I hereby eflirtn that unde� penelry of perjury that I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW for the follaxing reeson (Sec. 7031.5, Business end Professions Cotla: My ciry or counry w�ich requires a pertnit to construct, elter, Improve, aemolish, or repair any siructure, prior to its issuance, elso requires ihe epplicant for such permit to flle e signad statemen[ thet he or she is Ilcensed pureuam to the provisfons of Ihe CoMractors Llcense Lew (Chepiar 9(commencing wlth Sectlon 7000) oi Dlvlsfon 3 of tlie Business and Protesslons Cotle)�or t�at he or she is exempt theretrom and the basis for the ellegetl exemption. Any violetion of SecUon 7031.5 by any epplicant for a pertnit sub�ecfs the epplicant ro e ciWl penelry oF not more Nan five hundred dollars (E500).): ❑ I, as owner of t�e ProDeity, or my employees with wages es thelr sole wmpensatlon, WILL DO TNE WORK, and the siructure Is not intended ar oHeretl tor sele (Sac. 7044, Business and Professions Code: The Contractore LJcense Lew tloes not eppty to en ownar ot properry who huilds or improves theraon, end who does such work himsetl ar herself o� through his or her own employees, proNded that such Improvements ere not intendetl or oflered for sele. If, however, t�e building or Improvement is sold within one ye0� 01 complation, the owner-6ulltler wlll have ihe burden of proving that he or she tlid not build or Improve for purposa of sele.). ❑ I, as owner of Ihe D�aPeM. em E7CCLUSIVELY CONTRACTING WITH LICENSED CONTFiACTORS to wnstrud Ne project (Sec. 7044, Business antl Pmfessions Cotle: The contreGtors Llcense Lew tloes not eppty to en owner of property who builds or improves thereon, entl who conirecls for such proJect with e comradoqs) license pursuant ta the Conirectors License Lews.). ❑ I am exempt under sec. SignaNre: Owner ID verified by drivefs licertse. Q Yes VeATicatlon of Ownerehip by (rype o1 dacument, I.e. Business and Professions Code tor Ihis reason: ❑ No Driver's licanse No. prope�ty te�c bill or deed): Date: Explres: DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ' ❑ I hareby cenify iha� �o excevatlon five (5) or more teet In depth Into which a pereon is required to descend, wlll be matle In connectlon with work euthodzetl b� `'� permlt, end Ihet no bullding siructure, sceftoldinp, falsework, or demolition or tlismentling thereof, will be more then thirry-six (36) feet hiph. (Chep. 32, Grp 2, Art 2, Se:. 341, Title 8, CalifoRde Adminlstrativa CaCe). ❑ As owner-builder, I will not employ anyone to tlo work whlch would requlre e permit from ihe Division of Indusirial Setety, es notetl ebove, unless such person hes a pertnit to do such Wo�k fram the division. , SlgnaNre: _ _ Date: Division of Industrial SafBry Pertnit Number: CERTIFlCATE OF COMPIJANCE AND AUiHORIZA710N OF ENTAY: I cenify untler penalry of perjury that I have read this epplication and state that ihe iniormation given is correct. I agree to comply with all state laws entl ciry ordinences relating to builtling construction, end authonze representatives ot the Ciry of Caste Mesa to enter upon the abova-Uescrib properry for Ins/pe�qiy�p �purp.�oses. I apree t to oaup or ellow occupancy ot any building amhodzed by this permit until finel Inspection. L ' _ _ C'`�'% _ _ ' '_.�!� � gneture OI Legel Owneqs) / . Dete ��(, IN�?ECTONT'PE QS¢ ��$ 7676 Fized System FiPel Fire Prevention 7286 200 201 202 203 Pool SOa Final Flnel Re-Roof Finel Block/Retaining Well Finel Feqory FirB Plece Final Sign 204 Final Demolition 2d46i6 j�y�j INSDELTONTYPE 206 Final Mechenical 20B 210 272 220 Finel Plumbing Final Eleclricel Final Fre PrevenUon Final Planning Approvel 222 Final Sita 250 Final Builtling/Occupancy Z��S (714) 754•5273 • Fax (774) 754-4858 Job Address: Suite No Vicinity: 84'! W 19TH ST A Parcel Nunmber: 42419107 npp�icant: RAPIA, Address: 841 W 1£ CITY OF COSTA MESA � 9UILDING DIVIS/ON DEVELOPMENT SERVICES DEPARTMENT PERMIT PLUMBING PERMIT �-" ' =N�i� �--, �'� � #A / C�� I I` I I �� Phone: �. 1 - � �- Zip. � G-`�/�-�": ` �'- = ,l/� `NEWPORTBEACH,CA Phone: � 1677 WESTCLIFF DR #112 Zip: 92660 �,�/�2 ��f/ ' ' , � �� Contractor� � � `'>k I � ..� �Address �� -/ '' •. ` j''!/ �� /i%� �1�� `''�S� -Phone: �•% c� �r�, _/ 1,��' � ;� r!;�j�'�_ - � z�p ._' _ I ��I �(�i� � %yd��-�%''� License: �\ '� `;` �i \ `�� , � A�chlEng:f�-� ` I ��jAddressi-� � �� i � ��. , �. . � � � 7� �(�i�' �r ✓ �� ,�f, 1� L�Phone. . ��'� U/�.;0 � '� �� r �� ' __' _ ---. _: Zip. �- - - '= 1 ' �� - �' � � n � License �� , ' - � _ l��_'1 f�'7} ,l.vlr i�'� ..{s:�.�',(� i� 1 `�' , , - � SCOPEOF'.PERMIT� 1 �i � -'" `. � � ..NEW GAS METER AND GAS LINE. � � i �A � / ��.,_. , - � 1� � \ ��, �� n. �� ,A��. \\V'�, .`�' �� `� ISSUE FEE � � �9 BackFlow•Pieventer �7 $0�00 Bathtub ��\ ~/'' 50.00 Clarifier System, SO 00 U PERMIT NUMBER l/..,.,. .... _ - - 77 FAIR ORIVE, COSTA MESA, CA 92628 Status: ISSUED Applied: 09/23/1999 Issued: Og/23/1999 ISSUED BY: � _�. -- -' l�li; �� f ,,r � , � �/�l � �� i r��' iUMMARY- -�- � � j, �� -•.:� , AMT QTY �, t //�� sher ',,,� $0.00 0 Sump Pump on �, � i$0.00 0 .,i.Swimming:Pool f � G�jJ �� $0 OO�t, 0. .� Trap P�iiner �r��'r,�0 $000��.--0�,�, +�f .,S�Unnal! � � r 10 ftl. �$0 00 �a �. 0<P.' iVacuum�Brkr Bkflow(1•41� Connect (Ice,Soda;elc) �30:00�� 0��`� y�Receplors, �� ` '- h'��"$0:00�;<�0� �'' DentalUnits V�� $000 0�� T�k� i � � 5 Dishwasher � �\ Drein, Floor �� Drein, Rainwater C� Drain, Roo( Drinking Fountain Ezpansion Tank Gas Earthquake Valve Gas (1-4 ouUets) Gas (Over 4 outlets) Gas Repipe Gas Service Interceptors (Grease, Oip Interceptors (Sand Auto ) � � ��Sephc ,an ; � � , 5000 �� 0 ./- 50.00%�0 �� Sewer�Capf,orDemo- �� -500trr�0� 50�00 �, 0� \ �Sewer Connectt � ��"��.�50.00�� 0 50.00�� .0�>///�� Sewer Private�Cine = � �$0:00 0- . $0.00� �0� J/ �� Shower ,_$OA0��0�\ $0.00- �-�0 �/ � `�Sink� ba�r' �, , � -� '. '; SOAO �0� �� $0.00�'?�0V � Sink,commercial-� � �, $0.00`�"0� $0.00 �0.� � - �� _Sink, Floor-J � � �� ;; '• � $0.00 � 0, !/ 56.15 1 \\ �Sink,kitcheq__ $O.00jyO�� 50.00 0 ---Sink,.service/mop��i .r"�50.00-�- 0� 50.00 0 Spa (private) -- - - - - --50.00 0 59.80 1 Spa (public) 50.00 0 50.00 0 50.00 0 COMMENTS / SPECIAL CONDITIONS / vent (Inst or Rep.) Water Service Water Sokener OTHER VIOLATION PLAN CHECK REINSPECTION $0.00 $0.00 $0.00 $0.00 50.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 50.00 $0.00 so.o0 TOTAL CALCULATED FEES: $39.45 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 0 a7 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia stetutes and related regulations. (Ord. No. 9248, § t, 12-21•92) EXPIRATION: This pertnit shall eutomatically expire and become void if work is not commenced within 180 days, or if work is suspentled or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permlt to be considered legal, such work must comply with all applicabla codes, and all requlred Inepeetlone end final epprovel must be obtained. Failure to obtain inspections and final epproval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSA710N DECLARATON: I hereby elfirm untler penelry ot perJury one o1 Ihe tollowing declaretlons: � ' ' ❑ I heve entl wlll maintein e certilicate ot consent to sell-Insure for workers' compensetion,.es provltletl for Dy secilon 3700 of ihe LeDor Cotle, for the pertortnance of Ihe work for which this Dermit Is issued. ❑ I heve entl wlll mainteln workers' compensetlon Insurance, as redulred by soctlon 3700 of Ihe Lebor Cotle, for Ihe peAortnance of Ne woB for which this pertnit Is Issued. My workers' compensetion Insurenca carAer end pollcy number ere: Certier. Pdicy Number. (This sect/on need not be completed 0 Me perml( !s velued ef one huntlred dWlersy$100) or less.) ❑ I certity thet In Ue peAortnance of the work lor which this pertnit Is issue4 I s�all not empby any person in eny manner so es ro become sub�ect to the workere' compensetlon laws of Celifomla, and egrae t�et tl I should became subJect to t�e workers' compenseHon provisions of Sectlon 3700 0l t�e Lebor Cotle, i shan lonhwitn wmply wlth these provisions. Applicant SlgnaWre: Date: WARNIN(3: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNIAWFUL AND SHRLL SUBJECT AN EMPLOVER TO CRIMINAL PENFLTIES AND CIVI� FlNES UP TOONE NUNDRED T}70USAND DOLLARE (5100,000), IN PDDfiION TO TME COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTIIXJ 31060F TNE LABOR CODE, IMFAEST, AND ATTORNEYS FEES. LICENSED CONTRACTORS DECLARATION: � 1 hereby eflirm that 1 em Ilcensed under provislons ol Chapter 9(commencing with Sectlon 7000) of Dlvision 3 of the Business and ProfesslOns CoEe, antl my license is In tull force arM eHect tJC. M Class !F Contrattofs Slgnaiure: Date: CONSTAUCTION LENDING AGENCY: ❑ I here6y attirtn ihat thera is a construction lentling egency tor ihe pertormance of the work for which this pertnit Is issued. (Sec. 3097, Civil Cotle). Lentler's Neme: Lendefs Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby eftirtn the� undBr penal�y of perjury Ihat I em E%EMPT FROM TME CONTRACTOHS LICENSE LAW br lhe tWlowing rea5on (Sec. 7031.5, Business and Prolessions Code: My dry or counry which requires e pertnit to consWct, alter, improve, demolish, or repair any suucmre, pdor lo its issuance, also requires t�e applicant for such permil to file a signetl stetement thet he ar she Is Iicer.sed pursuem to the pmvisions ol tha Cantrectors License Lew (Chapter 9(commendng wIN Sectlon 7000) of Dlvislon 3 of the Business antl Prolessions Code) or thet he or she Is ezempt Iherelrom end the basis for Ne alleged exempLon. My ddaGon of SecOon 7031.5 by eny applicflnt for e permit subjects the applicant to e clvil penalry ot not more Ihen Ilve hundred dollars ($500).): ❑ I, es owner af Ihe property, or my employees wlih weges as iheir sole compensetion, WILL DO TME WORK, antl ihe structure is not Intentled or oHeretl for sele (Sec. 7044, Business entl Professlons Cotle: The Contractors License Law tloes not epply to en owner of property wha builds ar improves therean, end who daes such wark himsell or herselt or ihrough his or her own emplayees, provitled that such ImpmvemeNs are not Imendad or oMered tor sale. II, hor.ever, Ihe building or Improvement Is sold within one yaer ol completion, the owner-bullder wlll have the burden ol proving that he or she did not huild or Improve tor purpase ol sele.). � I, es owner oi the property, em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS ta wnstruct ihe proJect (Sec. 7044, eusiness ana Professlons Code: The�a�7 actors Llcense Lew does not apply to en owner ol property wha builds or impmves Ihereon, end who contrects tor such proJect wii� e contrecior(s) license puryGepl to the Contrectors License laws.). ❑ I�m ax�fi untle � Business entl Prolesslons Cade for this reason: i� re: Own ID v nlied by drivefs licen . Yes ❑ No Drivefs ' nse Verilication of Ownership by (type of documem, I.e. - prapeny taz bili or deed): DIVISION OF INDUSTRIAL SAFETY VERMIT CERTIFICATION: ❑ I hereby certity thet no excavetlon Ilve (5) or more teet In depth Into which e person Is raquired to descend, will be matle in connectlon with work euthorized by this pertnit, entl t�at no builtling structure, sceNoltling, felsework, or tlemoll�lon or tllsmantling Ihereot, will be mora than thirry-six (38) teei high. (Chep. 32, Grp 2, Art 2, Sec. 3A1, Title B, Callfomia Atlministretive Cotle). ❑ As ov.ner-bulltler, I will not employ enyone to tlo work which would requlra e pertnit iram the Division of Intlustrial Safery, es noted flbove, unless such person has e pertnit to tlo such work trom Ihe division. - Signeture: Date: Division of Indusirial Sefety Permit Number: CERTIFlLATE OF COMPLJANCE AND AIJTHORIL1710N OF EMRY: I certify under penalry ol per�ury that I heve read this eppliceUon end stete ihat Ihe informetion given is correc�. I agrea to wmply with ell stete lews entl ciry ortlinences relating to bullAlnp conslruction, end euthoAze represen�etives oi the Ciry ol Costa Mesa to enter upon the above-tlescribe�roperty for inspec�ion purpases. I egrea not to accupy or ellow occupency ot eny buliding euthoAzeO by lhis pertnit untll Ilnal Inspection. 40oE r. INSPECTIONME � 1676 Flxed System Finel Fire Prevention 126fi Pool Spa Flnal 200 Finel Re-Raot 201 Final BIocWReteining Wall 202 Final Fectory Fire Placa 203 Finel Sign 204 Final Demditlon 24/6<6 PAIF. II��$ �Q7�j INSVECTIONME 206 Final Mechanical 208 Final Plumbing 210 Finel Elecirical 212 Final Flre Prevention 220 Flnal Planning Approval 222 Flnal Site 250 Final Building/Occupanry Qd1E ItIIID�Li /D -5-95� � � . j . � � - CITY OF COSTA MESA . ; _ � BUILDING DIVISION ' : DEVELOPMENT SERVICES DEPARTMENT J ' y� �. PERMIT PERMITNUMBER •trom+m F98-00277 (714) 754-5273 • Fax (714) 754•4856 77 FAIR DRIVE, COSTA MESA, CA 92626 FIRE SUPRESSION PERMIT Job Atldress: 841 19TH ST Suite: Vicinity: Parcel Nunmber: 42419107 Apptiwnt: STARCHER, JAMEY Atldress: OF/ EXECUTIVE FIRE PROTECTION owner. TRAUTWEIN, PAUL TR Address %L 8 M PROPERTY MGNT NEWPORT BEACH,CA 1617 WESTCLIFF DR #112 Zoning: Phone: 56242&5211 Zip: Phone: Zip: 92660 Contraaor: EXECUTIVE FIRE PROTECTION Atldress: 5133 CONANT ST LONG BEACH Phone: 562-429-5211 Zip: 90808 . Licensa: 547963 StaWs: ISSUED 1' I�V" Applied: 12/08/1998 Issued: 12I3011998 SCOPE OF PERMIT INSTALL CHEMICAL FIRE SUPRESSION SYSTEM IN A COMMERCIAL KITCHEN HOOD. WORK IS FOR "LOS RANCHEROS MARKET' - SEE T.I. # 898-01102 QSSUED). � FEE SUMMARY Plan Check: $38.68 i Permit $59.50 Other: $0.00 Total: $98.18 Calc Valuation: 50.00 Claimed Valuation: Si,soo.00 EXPIRATION: This permit shall automatically expire and become void ii work is not commenced within 180 days, or if work is suspended or abandoned for a period bf 180 days. � INSPECTIONS: In order tor the work authorized under ihis permit to be considered Iegai, such work must comply with all applicable codes, and all required inapections and (Inel approvel must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 � WORKERS' COMPENSATION DECLARATION: 1 hereby aKrm untler penalry ol per�ury one ot the following decleretions: ❑ I have antl wiil melnlaln e certifcate of consenl to se&Insure br warkers' campenution, as pmvitled for by sectlon 3700 of the Lebor Cotle, lor the peAartnence ol the work tor wl�ich ihis pertnit Is issued. ❑ I heve enC will maintein vroAcers' oompensetlon insurance, as reqWretl 6y section 3700 ot the Lebor Cotlo, for the peAormence ot lhe work tw which this permit is IssueO. My workers' crompensetlon Insurance certier end pollcy number are: Cartier. Pdky NumDer. (Thls 5ectlon neetl not Ee comp/efed I! Me perm/t !s ve/ued af one /hy red dol/e S I00J or less.) ❑ I certify Ihet In Ihe pertorqfarce of Ihe work far �ch t1�16 ortnit is � ed, I shall not employ eny person in eny manner so es to bewma sublec� �o tho workors' compensation lews of - Cod I h II f h I � comply wlih Ihesepro� Appllcant Signetura: � 7lqUS4ND DOl1ARE (5100.OW). end egree THE COST OF to Ihe workers compensellon provlslons oi Secllon 3700 o he Labor e, s e ort w t / _ Date: 1� � � � WD $jIKL SUBIECf PN EMPLOYER TO CRIMINAL PENr1LT1ES AND GVIL FlNES UP TO ONE HUNDRED S A�'ROVIDED FOR IN SEGTON 31080F THE LABOR ODDE, INiEfiEST, AND ATTORNEV'S FEES. LICENSED CONTAACTORS DEC A710N: I �ereby attirm Ihet I em Ilcensed u e provisians oi Cha r 9(c Ith ection 7000) of Division 3 ot Ihe Busi'�ess and Proteuior/g Cade, an0 my Ilcense is In lull force end aflect. lJc. N Class p�-�/-� �j�7 /��- � -- Contractors Signetura: Date: V �/ ol / J �/T'7,� CONSTRUCTION LENOING AGENCY: ❑ I hereby effirtn that there is e construcGon lentling agenry lor the peRortnance ot ihe work tar which Mis permit is issued. (Sec. 3097, Civil Code). LenOers Name: Lenders Atldress: SignaNre: Date: OWNER-BUILDER DECLARATIONS: 1 hereby effirtn Ihat under penelry ot perjury thet I em E%EMPT FROM TME CONTRAC70RS LICENSE LAW tor the tollowing reason (Sec. 7031.5, Business end Professions Code: Any dry or wunty which requires e pertnit to construct, elter, Improve, demolish, or repair eny siruMure, pdor to its issuance, also requires the applicent for such permit to tile e signed stetemem tha� he or she is licensed pureuem ro the provlslons ol ihe Camractors License Lew (Chapter 9(commencing with Section 7000) of Divisian 3 0l lhe Business entl Prolessions Cotle) or that he or she is exempt �herefrom end tha Dasis tor iha allegetl exemption. My violatlon of SecUon 7037.5 by eny eppllcant tor e pertni� suD�ec7s the epplicant to e civ�l panalry of not more Nen five hundred ddlars ($500).): ❑ I, es owner of t�e property, or my employees wlth weges es �helr sola compensatlon, WILL DO THE WORK, end ihe structure is not intendad or oHered tor sale (Sec. 7044, Business end Professions Cade: The Contractors License Lew does not appy to an owner of properry who CuilCs w improves thereon, and who does suc� work himselt w herself or Ihrough fds or �er own employees, proNdetl t�at such Imprwemen4s are not IntenCed w oXered for sale. tl, hor.aver, t�e building or Improvement Is solA within ane year of wmplellon, the ownervbuiltler wlll have Iha Durtlen oi proving ihat he or she tlltl not Duiltl ar imprwe lor purpase of sele.). ❑ I, as owner of Ihe properry, em EXCLUSIVELY COMRACTING WITH LICENSED CONTRACTORS to construd Ihe project (Sec. 7044, Busineu anO Protessions CoCe: TTe contrecrors License Lew does not epply to an owner at praperry who Duiltls or imprwes Ihereon, entl w�o contrects for such proJect with e contractor(s) Iicense pursuent to the Coniractors License Lews.). ❑ I am evempi under sec. Business and Professions Cotle lor this reason: Signature: Date: Owner ID verltied by driver's license. ❑ Ves ❑ No Dnver's License No. Expires: Verilicatlon ot Ownership by (rype oi tlocument, I.e. - properry tex bill or deeC): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIPICATION: ❑ I hereby coNty thet no excavetlon tive (5) or more teet In de0�h Into which e person Is requlred ta descend, wlll be metle in connedlon with work euthodzed by this permit, entl thet no bullding strucNre, scallolding, telsework, or demolition or dismentlinp thereoi, will be more Ihen thlrty-six (38j feet high. (Chep. 32, Grp 2, An 2, Sec. 341, Title 8, Celtlomle AdministralNe Cotle). ❑ As owner-builtler, I will not employ enyone to do work which woulA require e Oertnit trom Ne Dlvision ol Industriel Selery, es noted above, unless such Derson has e permit Io do such work from the division. Signeture: Date: Division af IntlusMal Safery Pertnil Number: HA2ARDOUS MATERIALS AND EMISSIONS CERTIFICATION: 1 Will the eppllcant or presem or future builtling occupent nead Io file and certity a Business Plan tor emergency respunse to release or threaiened release ot e hazardous meterlal? ❑ Yes ❑ No (Section 25505 ot ihe Celifomia Healih end Salery Code requires, with some e:cepiions, Ihat e Business Plen be tiled with the Costa Mesa Fire Depertment by every business whlch �as et eny me time during e repo�etl year e quentity of harardous materiels equel to or greater ihan e weight of 500 pounds, or e volume of 55 gallons, or 200 cubic teet oi wmpressatl gas al stendard tempereNro end pressure). ..................................................................................................................................................................................................................... ......................................................... 2 Does or will Ihe epplicant or present or tuture building occupent neetl to fle e re8istra�ion tortn tor acutely hezardous materiels7 ❑ Yes ❑ No (Seclion 25533 at the Califomia Health and Sefery Code, with some eaceptions, raquires registretion wlth t�e Coste Mesa Fire Department by eech bu5ine55 whlch at any one tlme has on hantl e quantlry of ecutely hazartlous meterials equal to or greeter then e weight of 500 pounds, or a volume of 55 gallons, or 200 cubic feet of compresse0 gas at stendarU tempereture antl pressure). ... _ ............................................................................................................................................................................................................................................................................ 3 Does or will the epplicant or present or future building occupant neetl to prepare an RMPP (Risk Management end Pravention Program for acutey ha=ardous materials)7 ❑ Yes ❑ No (Section 25534 of the Califamia Health an0 Safery Cotle provitles thet t�e Costa Mesa Fire Depanmant mey require the preparetion, cenifiwtion end filing wlih Ihe Fire Depertmam of en RMPP by businesses which are reQuired Io register acutely hazardaus materiels with the Flre Depertment. ................................................................................................................................................................................................................................................................................. . 4 It an RMPP is pre58n[ly requireQ �as Section 25534 of the Califomia Health and Safery Code been tully complietl wIIh1 ❑ Yes ❑ No .................................................................................................................................................................................................................................................................................. 5 Does Or will �he epplicant or present or future building occupant require for the work which is Ihe sub�ect ol �his a plication ape rtnit for such ConSWcUon or modlfiwllon Irom ihe South Coest Air Oualiry Menagement Dlstrict or from any other air pallution control district or agenc�? � Yes ❑ No (Section 658502 of the Califomia Govemment Code requires thet the raquested infortnation be lumished an applicatlons tor non-residential building pertnils). ................................................................................................................................................................................................................................................................................. 8 WIII eny Deh of t�e feciliry ro be canstructatl untler I�Is permlt be within 1000 teet trom the auter boundadan ot e school9 ❑ Yes ❑ No (It Yes'. the facilltv must meet the reouiremem of Seclions 25534 end 42303 ot tha Calitomla Heatlh end SaleN Cada). u e Permlt irom tne Soutn Goest Alr ouellry Menegement Uislncl or otner atr pqiution coniroi aislnc� or egency IS reGWretl tor lhe work wnfclt is Ine SUD�eC� ot Ihis eppliCetlon, heve ell of �he disclosures prescrl6etl 6y Celllornie Heellh end Sefery Code Section 42303 been matle7 ❑ Ves ❑ No .......................................................................................................................................................................................................................................................................... (It yes'. enech cenificete at complience irom tha appropdele eir pollutlon control oHicer�. CERTIFICATE OF COMPLIANCE: 1 certiN that under penalry af perjury tha infortnetion given ebove Is correct. I apree to wmpy with all state laws and clry ordinenCes reperdinp HeiErdou9 Me�erlel5 end Eml95fons. Slgneture: Date: CERfiFlCATE OF COMPLIANCE AND AyTHOR �ION OF�Y: 1 certity under penelry of perjury Ihet I heve reed thi9 epplicalion end stete that t�e Intormatlon given is mrtect. I egree lo comply with ell slate.faws dry orCina es releting to building constructlan, entl euihodze representetives ot the Ciry o1 Coste Mese to emer upon �he aDove-0esc tl property for inspectl rSpu p . I agree to occupy or allow ocwpancy of any building euthorized by this pertnit unUl final inspection. / J �� ,, ✓_r-� 309��- NO Authodz Applicant ate COOE I. 1818 7288 200 201 202 203 204 2N6-66 INSVECTONTYiE Fixed System Final Fire Prevention Pool SDe Finel Finel RaRool Finel BIocWReteining Wall Finel Factory Fire Plece Flnal Sign Fnal Demdition 06B It�15 GO�EI INSPECTONTYPE 206 Finel Mechenical 20B Finel Plumbing 210 Final ElectAcel 212 Final Fire Preventlon 220 Finel Planning Approval 222 Final Siie 250 Flnal Building/Occupanry � � 'Job Address: 841 W 19TH ST Suite: A Vidniry: Parcel Nunmber: 42419107 Applicant: UNKNOWN Address: ' SIGN PERMIT Zoning: Phone: ZiP: Owner. . �BOECKMAN, CAROLYN SUE TR � Address . PAUL TRAUTWEIN 7RUST � -REDDING, CA - Phone: ,536 AURORA PL � Zip: 96001-0100 ConVaclor: " " Address: � . Phone: Zip: ' � License: � Stalus: ISSUED Applied: 05It7/2004 Issued: OSN 7/2004 ISSUED BY: � �� V Arch / Eng : . , � � Address: ' " � - . Phone: Zip: � License: � � � SCOPE OF PERMIT 19.5 S�.Ff. CHANNEL LETTER SIGN FOR'LA COCINA DE ISABEL MEXICAN RESTAURANT'. ILIUMINATED WALL SIGN - Plan Check: $54.11 $0.00 Permit: $83.25 SMIP Com: $0.53 Other. $0.00 $0.00 Inspection: $0.00 $0.00 $0.00 Total:.�� , $137.89 NOTES: _ . - _ _ _ FEE SUMMARY � PLANNING 8 ZONING Calc Valuation: Claimed Valuation: � a2.soo.00 sz,soo.00 NOTICE: Tha work authorized by ihis pertnit shall comply with all applicable handicap access requirements under Calitornia statutes and related regulations. (Ord. No. 92-28, § 1, 12•21-92) EXPIRATION: This pertnit shall automatically axpire and become vold if work is not commenced within 180 tlays, or If work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlona and finel epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration ot this parmit. FOR INSPECTIONS CALL: (774) 7545828 aas-ae (aroo) � i WORKERS' COMPGNSATION DECLARATION: . , 1�heraCy e�flrtn untler penalty ot perfury one ot the tWlowing declera�ions: - ❑ I heve end will maintein e certllicate ol consent to self-Insure lor warkers' compensatlon, es provided for by secilon 3700 ot che Lebor Code, for the pertomiance of Iha work for which this pertnil I5 issued. ❑ I heva entl wN meiniain woflcers' campensatbn �nsurence, fls reQulred by SeCtbn 3700 0l the Lebor Code, lor ihe peAortnance af the work for which this pertnit is iswetl. My worker/s' compe�ns/ation Insure cerrler end policy number ere: // Ce�rtier. J �/T 7—� �c. .NurMBr. I ��ZJ� �� (Thls sect/ar need nat be complefed!! the pertnil ls valued et one h�ndred dollars (5100) or less.) V ❑ I certity thet in the peAortnance of the work for whlch Ihis permit Is Issue4 I shall not employ eny person in eny manner ao es to 6owme suD�en lo the workers' compensation laws o1 Celitomia, end epree t�at if I shoul come sub�ect to the workers' compenseiion provislons ot Sectlon 3700 01 Ihe Labor Cotle, I shall lonhwlth comply�it�these p� sion. _ s. �� A � [� Applicent:SigneNre: �'�—�i �De'B�` / - �� r � ~ D I i WARNINO: FWLURE TO SEGURE WORNERS' COh/FENSATION COVERAGE UNUWFUL AND SHALL SUBIECT PN EMPIOYER TO CRIMINAL PENr11TiES AND GVIL FlNES UP TOONE HUN�RED TFIOUSAND �OLLARE (5100.000�. IN AODITION TO TNE COST OF WMPENSAiIIXJ, DAMAOES AS PROVIDED FOR IN SECfION 37080F THE LABOR CODE, INTEREST, ANO ATTORNEI"S FEES. LICENSED CONTRACTORS DECLARATON: (commenGng with Section 7000) of Division 3 0l ihe Business and Prafessions Cotl�. enC my license Is in full uo. a CONSTRUC710N LENDING ACENCY: ' ❑ I hereby emrtn that ihere is a construction lending agen�y for the DeAortnence of the wark far which this permit Is issuetl. (Sec. 3097, Civil Code). Lenders Neme: Lenders Addreu: s�goawre: Date: I hereby eflirtn that unAer penalry ot perjury t�et I em EICEMPT PROM THE CONTRACTORS LICENSE LAW tor the lollowing reason (Sec. 7031.5, Business entl Professlons Cade: Any dy or caunry whic� reQuires a pertnit to constmcl, alter, Improve, tlemolis�, or repair eny atructure, pdor to Its Issuance, elso requlres the epplicem tor such portnit to flle e signetl sietement Ihet he or she Is Ikensatl�y rsuent to the proNslons of Ne Contrectore License Lew (Chepter 8(commencinp wlih Secllon 7000) of Dlvision 3 at Ihe Business end Pmtessions CoCe) or thet he or afie CTexempt Ihereirom end the basb br Ue elleged exemption. My dole0on of Secllon 7031.5 by eny epplicant tor e pertnil sub�ects the eppllcant ro e dWl penelry of not more Ihen Me huntlred tlollars (5500)J: ❑ I, es owner of Ihe property, or my employees with wages es t�eir sole compensa�on, WILL DO THE WORK, antl ihe structure Is not Intendetl or oHereA for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Lew does not appty to an owner of propeRy who builtls or ImD�oves thereon, and who does such work himself or hersetl or through his or her own employees, praWded that such Imprmements ere not Intended or ottered lor sale. tl, however, Ne builtling or improvement Is soltl within one year of completlon, the owner-builtler will have the burden of proving that he or she did not Duild or impmve for purpose of uleJ. ' ❑ I, es owner ot Ihe propetty, Bm E%CLUSIVELY CONTRACTING WITH LIGENSED CONTRACTORS �o conStruCt Ihe pro�ett (SeC. 7044, Bu5ine55 end PrOfessions Catle: The contractoro LJcense Lew tlaes not eppy lo an owner ol property who Dullds or Impmves t�ereon, enA who coNracts for such pro�ed wit� e contractor(s) license pursuant to Iha Cantrectors License Lews.). ❑ I em azempt untler sec. Business antl Profouions CoOe lor this reason: Slpneiure: Dete: Owner ID venfied by drivefs Ilcense. ❑ Yes ❑ No Drivefs lJcense No. Vedilcetlon at Ownership by (rype ol documem, I.e. � properry tax blll or Ceetl): Expires: DIVISION OF INDUS7RIAL SAFETV PERMR CERTIFlCATION: ❑ I hereby certify ihat no excevetion tive (5J or more teet in depth Into which e person Is requlred ta descend, will be mede in connection with xrork authonzed by t�ls permit, entl Nat no bui�dinp sWcture, scaflolding, telsework, a demoli6on or Cismanfling thereof, will be more then ihlrty-six (36) feet high. (Chap. 32, Gry 2, Art 2, Sec. 341, 71t1e B, Califomie AAministretive Coda). ❑ As owner-builtler, I will not employ enyona to tlo wark whic� woulA require e permit irwn t�e DlWsion of Intlustriel Selery, es notetl eDove, unless such person hes a pertnit to do such work trom Ihe dlWsion. SignaWre: Dete: Divislon oi Industrial Satery Permit Number: CERIIFlCATE OF COMPLIANCE AND AUIHOR¢A710N OF ENTRY: I cenity under penalry of perjury that I have read this epplication and state that the information given Is wrrect. I agree to comply with all siate laws an0 dry ordinances releting to 6uiltling wnsiruction, antl authonze representatives oi ihe Ciry ot Costa Mesa to enter upon t�e ebove4escribed pmperty tor inspection purposes. I agree not to ocapy or allow occupency of eny building aufhorized by �his permit until final inspaction. COUE �• INSPECTIONTYVE 7616 Fixed Sysrem Final Fire Preventlon 1266 Pool Spa Final 200 Flnel fiaRool 201 Final BIacWReleininp Well ,202 Final Fectory Fira Place 203 �Flnal Sign 204 FlnelOemolition COUE 1 INSPECIION TYGE 206 Final Mechaniwl 208 Finel PlumDing 210 Final Electdcal 212 Finel Flre Preventlon 220 Finel Plenning Approval 222 Final Slte 250 Final Bulltling/Occupenry Da1a (714) 754-5273 • Fex (714) 754•4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Viciniry: Parcel Nunmber: 841 W 19TH ST A A 42220214 Applicant: PAUL ARTINGER Address: 7541 SANTA RITA CIRCLE SUITE D STANTON,CA - Owner. � DANG,LISA Address '9581 BOCSAAVE WESTMINISTER,CA Contractor. CONTINENTAL SIGNS INC Address: 7541� SAN7A RI7A�CIRCLE SUITE D . STANTON, CA . ' � � ELECTRICAL PERMIT Phone: (714)894-2011 Zip: 90680 Phone: 774-531-0284 Zip: 92683 � " _-Phone: (714) 894-2011 Zip: 90680 License: 664525 SCOPE OF PERMIT ILLUMINATED WALL SIGN MEXICAN RESTURANT ` ISSUE FEE Temp service test Res. a/c pacicage New Res (1-2 units) New Res (3+units) � Pool I Spa Lighting Fixts Recept Outlets swi�ones Non Res Appl � Res Appl Service to 200a � Service to 1000a ,� Service over 1000a �- , Motors to 7hp �� Motors lo �Ohp � Motors to SOhp Motors to 100hp Motors over t 00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits $23.50 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 ao.00 ao.00 ao.00 ao.00 ao.00 ao.00 . ao.00 $0.00 ao.00 �� so.00 $0.00 $0.00 ao.00 50.00 $24.60 Quantity 0 0 0 0 0 0 0 0 0 o, , 0- 0 0 0 0 0 0 0 0 1 Status: ISSUED Applied: OS/17/2004 Issued: OS/17/2004 ISSUED BY: �// / �� FEE SUMMARY. Temp Disl System hLighting Busway /100 R Standing Section Misc Electrical 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 EquipmenC �- - Cow Volt Wiring System / Ckt . Misc. Conduit _ -. Misa Conductor ;. , _ Circus ( 9en or dde) � . � ' Circus (mech dde or lighis) � � Chnstmas Tree Stand �, . Fireworks Sfand . Other Electncal Fee , Investlgatlon Fee Plan Check Fee Reinspection-Fee �uantity $0.00 0 $0.00 0 so.00 0 30.00 0 $0.00 0 $0.00 0 $0.00 , 0 $0.00 . 0 so.00 0 ao.00 0 so.00 0 $0.00 " 0 so.00 . o .30.00' 0 �. � so:oa o , $0.00 � 0 � so.00 ; o ao.00 � $0.00 30.00 $0.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Califomia statutes and related regulations. (Ord. No. 9248, § 1, 12-21-92) EXPIRA710N: This permit shall automatically explre and become vold 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 permlt to be considerad legal, such work must comply with ell epplicable codes, end ell required Inspeetlons and finel approval must be obtained. Fallure to obtain inspectlons and tinal approval will result in the ezpiretion ol this pertnit. FOR INSPECTIONS CALL: (714) 7545626 �». o idu,� i WORKERS'COMPENSAnON DECLARAPON: _ I hereby aHirm untler penalry of perjury one ot the following dedarations: - ❑ 1 have end will maiNain a certifiwte of consem to selt-Insure for workers' compensetian, es provided lor 6y section 3700 of ihe Labor Code, for the peAortnence of the work for which this pertnii is Issuetl. ��"'�I heva end will malntain wofkers' compensatlon insu2nce, as requiratl by section 3700 af the Lshor Code, lor ihe peAortnanca ot ihe work for wNch Ihis permit Is IssueC. ��My workers' compensation In cerder end policy number era: 7 �Certier. . �.' "f � i�� Policy Nu� / f� / ��oz � (fifs sect/ar need nof be completed I7 the perm/f As ve/ued et one huntlred dollers ($100) or less.) ❑ I certify t�et in the pertortnance af the work lor which thls pertnit is issued, I ahell not employ any person in eny menner so as to become suh�ect lo Ihe workers' compensetlon laws of Califomia, erW egree t�at if I s�oul0 becomasub�ect to t�e workers' campensetlon provlslons of Section 3700 of the Lebor Code, I s�ali torihwlih comPly with these Provisions. � �,�1:��a: �a-wPi � Q��-�--c.oQ � �; ; � - �7-oy WARNINO: FFILURE TO SECURE WORKERS' WMPENSATION COVEMGE IS UMA AND S/W.L SUBIECT AN EMPLW ER TO CRIMINAL PENA�TIES AND dVIL FlNES UP TO ONE HUNDRED TMOUSAND DOLLARE (5100,000), IN ADDfiION TO TNE ODST OF COMPENSITION, OMNGES AS PROVIDED FOR IN SECfION 3]OB OF TNE Lr1BOR COOE.INTEREST, rWD ATTORNEI^$ FEES. LICENSED CONTRACTORS DECLARATION: I hereby eHirtn thetl.am�licensetl under provlslons of Chepter 9(cammencinp wl�h Section 7000) of Oivislon 3 of Ihe Business en Pryf�essiqpsLode, end my Iicense Is In full force end�eflec�L.Lie"N'� �� Class�p'—� � Y'� F"""'_ v � CoNr� Ls S�gneture: .9�c �� Dete^ �S � 7� (J CONSTRUCTION LENDING AGENCY: ❑ I hereby eHirtn thet there Is e construMion lending egency for the peAormance of the work for which ihis pertnii is IssueC. (Sec. 3097, Civil Code). Lentlela Name: Lendefs AOtlreu: SigneWre: Date: OWNER-BUILDER DECLARATONS: I hereby eillrtn t�et under penelry ol per�ury Ihet I em EXEMPT FROM TME CONTRACTORS LICENSE LAW for tha tollowing reason (Sec. 7031.5, Buslness ena Professions Cotle: Any ciry orposnry which reQulres e permit lo construct, alter, improve, tlemolish, or repair eny strucWre, pdor to Its issuance, elso requires the appllcaM Por such pertnit to file e signetl stelbment that �e or she Is Ilcensed Dureuant to the proWsions al the Conirectors License Lew (Chepter 9(commencing with Sectlan 7000) of Divlslon 3 of the Business end�rofeuions Code)�or Nat he or she is e:empt therefmm end !he besls tor tha elleped exemption. Any vlalatlon of Section 7031.5 by eny eppllceN for e pertnit subjects the epplicent to e civil penalry at not more ihen five huntlretl tlollers ($500)J: . ❑ I, es owner of ihe property, or my employees wlth weges as Nelr sole compensation, WILL DO 7HE WORK, end the slructure Is not intendetl or oNered tor ssle (Sec. 7044, Business and Professions Code: The Contrerdpg License Lew does not apply to an owner of property who builtls or improves thereon, antl who does such work himselt or herself or through his or her own emplpy9Bsf�rovided Ihat such improvements ere nat intended or oNeretl for sale. If, however, Ihe Duilding or improvement is sdd within one year of comDletion, the owner-bulder will hava the burden of proving ihat he or she did not build or imprwe for purpose ot sale.). • ❑ I, es owner at the praperry, em EJ(CLUSIVELV CONTFiACTING WRH LICENSED CONTHACTORS to consWct Ihe D�olect (Sec. 7044, Business antl Professions Cade �The comradors License Lew doas not epplytD an owner of property who bullds or imprwes ihereon, entl who conirecls tor such project wlih e contrectoqsj IiCBnSe pur5uant to Ule r.On�rflttOfS LIC8fI5e L2w5.). ❑ I em asempt under sec. Business entl Professions Code for this reason: Slgnature: Date: Owner ID vertlietl by driver's Ilcense. ❑ Ves ❑ No Drivefs License No. Expires: Verillcetion at Ownership by (type of tlocument, I.e. - property tax bill or deed): OIVISION OF INDUSTRIAL SAFETY VERMR CERTiFICATION: ❑ I hereby certity ihat no excavetion Iive (5) or more teet in depth into which e person is required to tlescend, wlll be mede in connection wit� work euthorizetl by t�ls pertnit, end that no building structure, sceMdding, talsework, or demditlon or dismantling Ihereot, will be more ihan thirty-six (38) teet �igh. (Chep. 3.2, Gry 2, Art 2, Sec. 341, Ttle 8, Celifomla AdminislretNe Co�e). ❑ As ownerDuiltler, I will not employ enyone to tlo work which would require e permil Irom ihe Divislon ol Industriel Sefery, es noteA ebove, unless such person hes e permll Io do such work Irom Ihe tlivision. Signeture: Date: Divislon ol Industnel Safery Permil Number: CERTIFlCATE OF COMPLIANCE AND AIJiHOROA710N OF EMAV: I certiy unEer penalty of perjury thet I have reatl t�ls applicetion end siete Ihet the Intormation given is cortect. I agree to compty wit� all state laws end dry oMinances relatlng to bullding construdion, antl euthodze representetives at Ihe Ciry of Coste Mese to enter upon the ebove-dexribed property tor Inspec0on purposes. I agree not to ocapy or ellow occupanry of eny building euthorized by this permit until finel inspectlon. COUE A, IHSiECTONTYPE 1818 Plxed System Final Fire Preventlon 1288 Pool Spe Final 200 Finel Re-Roof 201 Finel Block/Retelning Well 202 Final Fectory Fire Plece 203 Flnel Sign 204 Final Demolition �jg �$ �j INSPECTIONTYPE . 206 Final MOCheniCel 208 210 \212 220 Finel Plumbing Final Elec�rlcel fine(Fire Preventlon Flnal Planning Approvel 222 Finel Slte 250 Final Building/Oaupanty Date PAIE Ui�LS / m ' ` Ciry of Costa Mesa Development Services Deparcment Building Safety Division P.O. 8ox 1200 � Costa Mesa, Califomia CERTIFICATE OF OCCUPANCY No. The Building located at 841 W. 19TH STREET UNIT C has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. Use of euildinq MEDICAL OFFICE "DR. HUONG DAVIDSON�' Legal Description 424-191-07 (See reuerse side tor Metes and Bounds) Building Permit No B67350 Electrical Permit No. E(7351 Mechanical Permit No. M68167,M68289 Number of apartments mbing Permit No. p67352 and/or guest rooms a ISSUEDTO: BuildingOfticial TONY C'DE BACA PAUL TRAUTWEIN � /� !�, _ f lbl/ WC5'fl.L1t'L+ llKl i111L bY , ✓/�.� �y%�,r NEWPORT BEACH, CA 92660 p � Date O — ��'' ' 9 �� This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the CitV of Costa Mesa under Sec. 307 (e) U.B.C. CMF 1015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink � Bldg. Permit File �� Pfl0.1EC�A0�AES5: 841 W 19TH JrT � �N�T. �. Otl/NEH'SNAME: PAUL TRAUTWIEN anoxess: 161� WESTCLIFF DR # 112 N.B. 92660 i APCM/ENGINEEA: DONALD I NMAN flEC.NO.: Q O n n O � ROOflE55: 1SiSS BROOKHURST AV dNrr Z21 W.M. 714) $39-5022 CA 92683 PEHMITTEE: LONG CONSTRUCTION (300)723-0543 AODflESS: 1 O B 3 Z CAP ITAL AV SA G.G. CA 92643 LICENSEU CONTNACTON DECIAflATION: I hereUy allirm t�at 1 am licensed untler provisions ol C�apt¢r 9(cammenting vni� Sec�ion 7000) of �wision 3 0l ihe Business antl Pm�essions Cotle. ana my license is in full brce antl el�ect. ciTr u: sraT uc.: 3 g q g 1 g cuss: H Oate: Signatu�e: WOflHEBS'COMPE ATIONOECIA RTION: Ih¢r¢Eyallirmi�a�l�aveacerlil aleo�mn5enito5e14in5urearacerliliw�ealWorker5' Compensation insura ce. or a certiliee copy inereol ISection 3800, LaD. q. voucvNo.: 1105003-93 E%P.ORTE: SO/OS/99 COMPPNY: STATE FUND r] Cenifie0 copy is �ereDy Iumisne0. � Cenifiea coOY �s IiieC wiin �Ae ci�y BuilGing Oivision. Jate: Pppliwni: _ E%EMPIION FB M WOPI ffl ' C0 7PENSATION OECLAPRTION: (i�is s¢clion neeG noI I: complete0 if tAe p¢rmil i51or one huMreC �$t00) or 1e55�. I teNty Ihal in �e peAormante 0� Ihe�wOrk br w�i�h ��is permil ii iSSUeG. I shall I employ any person in any manner So as la �ecome 5ubjeci to ihe Workers Compen5aliomLavrs a� Califomia. Dare- Sigwture: NOTICE: 11, afler making I�iS OeClaraiion. you S�oUIE become Su�le�� o I�e Workers' �ompensation provisions ol ��e LaEor COtl¢, y00 RIUS� IOfiflwllh C011lply wiill S�t11 plOVI51005 Of IhiS pCfrtl�i Slldll UQ OCCIIICA evokeG. CONSTNUCTION LEN�ING AGENCY: I �ereby allirm Ihat t�ere i5 a canslmc�ion lenaing agency br I�e p¢dormance oi lhe work lor which this permit is i=sue0 (Section 9W7. Civ. C�. � LENOEN: aoueess: OWNEP BWLOEB OECLABRTION: I hereby allirm Ihat I am exempl imm tAe Coniractors' State License Law for ihe following reason (Secuon 70.31.5 8usiness anJ Pmiessianal CODe: Any [i�y ol caunry whic� repuires a De�mil Io con5imcl. alier, impmve. Eemoli5h, or iepair any simclure. Drior ta its issuance, atsa repuires Ihe apWicant lor such oermil to lile a sipne0 stalemenl lhal he/she is licensea Dursuanl m ine provisians Oi Ihe CanlraCmrs' Slafe Litense Law (ChaD�ei 9(commentinA wilh S¢Clion 7000� ot Divisi0n 3 01 I�e BuSineu and Prolesvons CoOe) ar thal �e/s�e is eKemO� ��e�elrom anE I�e Dasis for the all¢peG ezemption. Any Wolation ai 5¢pion 7031.5 Ey any applicant lor a permii subjetls Ihe aDPlicanl �o a civil penalty ol noi rtwre t�an five huntlre0 Gollar5 (55110�. I. a5 owner ol ��e O�aPeriy ar my employees wilh waBes as I�eir 5ole compensation, will Ao �he work, and Ihe ❑ s�mcwre is nat imen0etl or aifered lor sale (Section 70a4, Busmess ana Pmiessional CaOe: The Comractors' S�aie license Law daes nm aoDly to an owne� ol a pmperty who Ouilds or imD�oves thereon, ana who Aoes sucn xrork nimsell/nerself or thmuqh �is or �er ovm employees, pwvi4eA ��al such impmvemenis are not inlendeE or oifere0 lor ule. I�, hOw¢ve� Ihe 6uiltling or improvemenl is sola wil�in one year of camplelion. I�e owner wiil have I�e OurGen ol O�ovinq �e/s�e Eitl noi huiltl or improve Ior ine purpose of sale�. I, as owner oi Ihe propetly. am exclusively comracting with licensea conlmcbrs to cansimct the prolect (Sec�ion 7044, Business ❑ an0 Pmfessions CoOe: T�e ConVaclors' S�a�e License Law Ooes nol apDly �o an owner a� D�oDe�Y w�o bmlCs or impmve5 ihereon ana who contracts lor such O�olect5 wi�h a conVacior�s)license pur5uani lo �he Contraclors' Slale Li[ense Law�.l am aware Ihat p�ooi oi Iheu Warker's Campensabon in5urance sMu10 �e O�om0e4 lo me. � I am eeempi under Section: 9. 8 P. C. , lor ihis reason. / oa�e: Ownec I Qo hereby ceriily that I am aware ol antl un4erslanA ��e reQUir¢menis oi Cali�ornia Heallh and Safeiy Cotl¢ $¢LIi0n5 25505, 25533, and 2553d an� I�al I o� any fuiur¢ builtling occupant will/will nal (circle one) neea Io comply with SaiC 51a1e co0e5 an0 the repuiremen�s for a permi� �ar con5lmclion or modilicalion imm Ihe Nu Ouah�y Management �i5Vic1. FeSidenliai conslmclion a0�licaiion5 are exempl lmm �hese provisions. Oa�e: ApDlicanL I here0y ceriily Ihal I have rea01�i5 aOPlica�ion anU Slaie iha� 1�¢ aUove ordinances antl stale laws relaling lo buildmg conSlmciion and hereby ay,l� pmperiy loi ins ection purposes. � �a�e'. Signatura �- Oriver's License or Social Securiry ": mation is correct. I aA�eeto comply wilh atl cily antl counly reD�esenlalives ol lhis cily to enter uDon ihe abWe�mentioned 1641-46 Wbite—Builtling: Green—Cotle Enlorcemenl Canary—Appli<anf. Plnk—Ravenue; GolOenroO—Assessor r"�'v � v'✓ J� CITY OF COSTA MESA - BOILDING PERMIT PERMIT NO: H 067350 PLAN CHECK NO: 01575-94 A CONSTRUCTION TYPE: V-5 PEAMIT TYPE: STR PERM NO: B 067350 GOt,�T: N SUPP; N PURPOSE; OTH JOB DESCRIPTION ; INTERIOR idALL PARTIONS " 1700 SF " SQ FT: 1,700 CLAIM VALUE: 25,000.00 CALC-VALUE: 18,448.00 GROUP OCC: B-2 / COMMENTS: INTERIOR 1700SF FOR " DR HUONG DAVIDSON " **�****as**�****�c�*x*��*x�**�*�c*�c-+�****��****+��****�*�c***�***+r**�+��r***�**+c�c*�*�r** 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 ------------ MAZN BUILDING ---------- --------- ACCESSORY BUILDZNG --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT ZN LEFT: FT IN RGAT: FT IN LEFT: FT IN RGHT; FT IN PARKING REp• PROV; PARCEL; 42419107 2NE: C1 REF NO; PLANNING NdTES> T.I. TO CONVERT LAUNDRY TO DENTAL OFFICE, 1 584 SF.,.SHARED > PARKIAIG STUDY CONDUCTED; ADE�UATE PKING AVAfL FOR THI� USE.� aEiPiFifiEiEMiEiEfE1E1F1ffEifif-1FifilKiE�YiF3f1EiE�fjEitlEffiEitiE#iFifiEiEififiFiEi: iEiEifitiFiElfiEifiEififMiElEiEi:fFkiElEif� ffiEiFifif itifaf 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 l�� DATE: �I1-� ��1 HUILDING APPROVED BY : DATE: +��C ��` ```��, T� APPLICATION ISSUED BY: �'Y ��l � DATE; ' Z (�L� iEiEiEiEiF1F%iEfEiEiEiEiE1F1EiE1f�f9EiF1E'1Ei�3F�t'�Tt�E3'E�'3F1F�iFi��FiF�fi��iE�E�3f� iM1 'K' ��F�i��iFiEiFifiFlfiflEiEif !1 1E itiF*ifltiElFififlEiFifiFiFiEiEiflFiEiEjEiFiEk+fiEiEiEiEjtifiEikiEiGaE1E�EiE�FiEiEifiliEiFifif3EiP1ElEififiEl��EiE�+�,iEiEiEiEifiti!#°i(-1FiF�fifiFifiEifikiE�f LEGALIZATION:N F E E S U M M A R:.Y ! STROCTURAI. SEGMENT:Y �� BLDG PMT PLUMBING ELECTR'IC ME�HANIC` /FIAE \ MIP/RES GRADING PERMIT 198,00 ' . � •� y %, � - � �'•"r MZP/NON-RES PLAN 32.18 ' " • : . 3.87 ISSUE FEE ' - ,_ � i , i BUILDING-DIV-> PERMIT ISSUE �PLAN=CHECK . TOTAL � PAID DUE TOTALS----> 201 , 87 0. 00 _ � 32 , 1'8 234?�QS :^�� 23�4 . OS , 00 f' � REVENUE DIVISION TOTALS--> COLLECTED: '� 201.8;7 OVER/SHOAT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC ��FIRE�J9MIP/TOP� GR�ADING PLAN-CHECK isa.00 : �y .., 1 3.87� 1 ik 1E 1E if if if fE iF * 1E 1f iE 1E it if M if if 1E 1E iE iE if if iF iE iE 1E iE iF iF jf if iE {F 1E if iE iE iE iE 3E iE 1E if,jE 1E 1E if if 1f 1f fE if if fF i(�,lf iE 1E if iE iF 1k 1E if aE iE if IE 1F iE iE?E iE iE if 1E 1E I N D I V I D U A L F E E , B R E A K D.. O' W N� ,i TYPE QTY D E S C R I P T I O N' �� '/�� UNIT �'COST TOTAL COST . l : , n SFC 1600 OFF-INT. ALTER TYP.E V-N i-AVERa'� _10��84 17,344,00 SFC 1600 EQU-ALT COMM. AIR ENDDOF FEES -AVERG, ,i69 ' 1,104.00 �,� �� ' �`' : /:l . h ,J / '` " � _. . : , ��.� D .� . 1 . . r � � '. MQ 'f , i f.. , c�rr o�c�:�,11 MESA I CONSTRLi;T10N AND PLANNING ' j � APPROVALS Permit � ♦ - ; t. Temporary Ele[trical $ervice pr Poie 2. Soil Pipe-Undrgrnd. �� 3. Elect�ica� COrdWt U"�ih'-Undrgrnd. 4. Elettr�cai Condu:t•Undrg�^d. . 5. Steel Re�nforcement __ 6 E!ectr,a� UFE9 G �d 7 Foonngs �'�. 8. Foundat�on 9. INater Pipe�Untlrgmd. 10. Structural Floor Svstem �I i i. Praperry Sewer Line & Ho�se Connection 72. Sewer Cap 13. Roof Drains �� 14. Rough Pl�mhmq I 15. Rough Electrical�Condu�c 16. Rou9h E'eetric Wiring 17. Rough!"JiricgS�gn 18. Rough ElectriwbT B�r Ceil��ng 13 ftou�h Heaun3 & A�r Cocdrt�an�.ng 2C. Rough Factory Firep;ace I� 21. Dutts, in Structur. ;��22. Duets,Venrlaung ��. �23. Gas Pipe�Rough & 7est � �24 RoOf Fra:nin-y �G'`'__ ��25. Roof Shcathing 26. T-Bar Ce�hng IS[�ueturall & �Vlonocoat 27, Frameand Flashing 28. Lathing & Siding 29. Insuiut�vn 30. D�Y::a!� f4aJm9 lD � 3� 7. ?��;Ir- &or+n Coat i 3?. E�eetr�wl Poc.e� ",Setc•-F-a-- 33. rin.i ElectnC i 34 P��: :.�Hc�tin; � A'r Conc.ron�ng 35. Fina� Gas Pipe�Te;t 3u". Hood or Canopy I3.7 r,� al Faemry F�repi�ce 38. Final Plumbing 39. VVater Scrvice�Fin.i 40. Gas Service-Final 41. Sola� Domestic-Final 42. Backfiow Preventer 43. Bacicflow Irrigation 44. Landscape Irnqa[io� System 45. Sound Attenuation 46. Hand�cap Regulations 47. fINAL STftUCTUfiE & BUILDING � 48. FINAL PLANNING 49. Elect�ic Release to Edison 50. Gas Release to Southern California Gas Co Date Date �� Inspector �� POOI PA - - --. APPROVAIS Permit � Dace Inspector � 52. Pool & Equ;pment LocaT.on . , 53. Stecl Reinforcement � � � 5d. Facns ' � i 5b. Fte�t��wl Bord�ng ' 56. Rour{h P�urt,hirg & P�essure Test ' 57. APPFOVA!_ TO CO��A�GU�'I�E , � 58. Eiecincdi Cordmr Undigmd. I � i 59. Ga5 Pipe, �7 Uru'qrrd., Tcs! � � --- T - 60. Baelc�vesh Li�,c:, P�Tran. C_' U^clrgrnd. � 61. APPROVAI TO UECK � � -E-�-- 62. Bade:::.shlL ReeeNtc� `ina' � � - , ' 63. Hoater & Vent•Final ! 64. Plumbing SYstem � Final � 65, Electrical�Fina1 � 66. Solar System�Fin�i -� _J fi7 Fencing & Acc�<s qppru:al _� 68. APPROVED FORPLASTERING -- - -: 69. POOUSPASYSTE��ASPINAL ' FIRE DEPT. REQUIREf�IEtJT ! � � APPROVALS Pernn(;`- � 70. L'adcry�o�r� H�a�o 71. ProciuCt P�Pin� ' . Ga5 .� �il , . � -� � 72. Underground Fluc�• ' %3. Ur+dcrgmd.5ror;.ic7.:�k,"Gas _.:i�.l _ _ - �- 74. Ov��rFcad Hytlrn ' J5. D�y Chemieal-- � _ � -�- 76. Dry Standp:pe - - -- i 77. FIXED SYSI EM FINAL � 78. FIRE PREL�. FINAL , NEALTN DEPT. REQUIREP��'cNT I 79. F��ALIRS^fCTiON _ , � � . 0�. FOGU CEk � IFICATE ISSUED � - � --�- - 1-- - - Not�S: � - 3- �' �(�- ,�r=�o -�z`- s-=-� � . --5 �-� ` �v-�m c�- � �[.c"�` , ��_i �i�i l'�`l" K.�C�S� � /��_��'� _( �3a �(� _ �f��- w��tCs_ s�-�� , � 7-L7-`l�i`� �_Bs,.� m•� fc�- _'�_J- 'I � _ i_ i _ I � I PflOJECi AOONESS: 8 q S W 1 9 TH 5T � " ' OWNEfl'SNAME: PAUL TRAUTWIEN aooxess: 1617 WESTCLIFF DR 1i 112 N.B, � 92&'00 uxir: C v/r'Ad'tvt'(_ AflCNIENGINEEH: DONALD INMAN REG.NO.: OOn�O � aoonEss: 15355 BROOKHURST AV ti' 221 W,M. 714) 839-5022 CA 42683 PERMITTEE: LONG CONSTRUCTION (f300)723-0543 ADDPESS: 1Ojj32 CAPITAL AV SA G.G, CA 32643 LICENSED CONTHACTOB OECIAPRTION: I hereby affirm �hat I am IicenSeA under pmvisions oi Chapter 9(cammencing with Sec�ion 7000� o� Division 3 of Ihe Business anA Pmfessions Code, an my license is in lull brce and e��ecl. ciTv uc.: sTaTe uc.: 3 8 4 818 cuss: � Daie: �� i�� Sigremre: — _ WOHNEBS' C PENSpTION OECIABATION: I here�y aflirm that I �ave a c ificate ol consent to selhinsure or a cenilicale ot workers' ComOensalion Insumnce or a cer�ilietl copy Ihereot (Sec�ion 38W. La� C). voucrr+o.: 1105003-93 E%P.OATE: SOIOSI9�I camraxr: STATE FUND r] Cerlified copy is hereby Wmis�ea. � Cenifietl copy is 1 ea with �he ciiy BuilOing �ivision. ,- 1 - � pa�e: ' Npplicant EXEMPTION F OM WOfl ERS' COMPENSpTION OECIANpTION: (ihis secii n nee0 na� ¢ completea if �he permiti5 for ane hUnAretl (8100) or less�. I cetlily �hat in Ihe pedormance ol Ihe work lor which this permit is issue4 I shall oi employ any person in any manner so a5 to become sublac� �a Ihe Workers'"Compensaiion Laws ol Califomia. y- � oate: � Signature. I' � NOTICE: II. af�eymaking Ihis Oeclaration, you 5hou10 become subjep ta Ihe Workers' Compensation�pmvisions oi �he Labor CoOe. you mus� idrihwil� compry wil� such O�ovisions or t�i5,pe�mi��s�all be Deemed revoked. �`.1 CONSTflUCTION LENOING RGENCY: I �ereby a�firm Iha� there is a,con5lmqion lentling agency for.Ihe�peAormance oi the work �ar which this permit is i=sue0 �Secnon 3097. Ci¢ C�. -�� ` J LENOEX: AODflESS: OWNEB BUILOEN OECLABPTION: I hereby a��irm Iha� I am exemp� Imm the Coniractors' Sta�e License Law �or �he following reason (Seciion 703L5 Business and Pm�essional Code: Any ary of counry which requires a permi� ta conS�mcL al�er, impmve, demalish, ar r¢pair any S�mcWre. prior Io iis issuance, also requires Ihe applican� for such permi� to lile a 5igneG statement ��al �e/s�e is licensetl pur5uani �o Ihe pmvisions af Ihe Conlraciors' State License Law (Chap�er 9(commencing wiih Sec�ion 7000) ot OiviSion 3 0l �he Business an� Pmlessions Catle) or Iha� he/s�e i5 ecemp� iherefmm and Ihe basis lor I�e alleged exemption. Any viola�ion o� $ection 7031.5 by any applicantlor a Dermi� subjecis t�e aDPlican� to a civil penally ot no� mor¢ ihan five hundred dollars (E500). I, as owner o� I�e pmpetly or my employees wiih wages as Iheir sole compensa�ion. wiil tlo Ihe wofrc, and the ❑ slmcmre is noi inlentletl or olfereJ for sale (Section 70a4. Business ana Professional Code: The Conlrac�ors' S�ate License Law Ooes no� appty lo an owner o1 a prope�y who bwltls or impmves Ihereon, antl who tloes suc� work himselflherselt or ��mugh his or her own employees. provitletl IM1ai such impmvemen�s are noi in�entlee or otteretl �or sale. Ii, however ��e builtling or imOrovemen� is sola wiihin one year o� comple�ion, Ihe owner will have Ihe bur0en of proving helshe OiJ nol Duild or improve lor ��e purpose o� sale). I, as owner o� �he propehy, am exclusively conVac�ing wiih licensetl conVaciors to constmc� Ihe pmlect (Sec�ian 7044, Business ❑ antl Pmlessions Cotle: The ConUac�ors' State License Law does not apPly lo an owner oi properiy who builds or improves Ihereon and who conVacts fo� such pr01eC�5 wi�� a conVac�or(s)license pu�suan� to Ih¢ Contrac�ots' S�a�e License law�.l am aware Ihal proo� at �heir Worker'S Compensa�ion in5urance shoultl be pmvidetl lo me. � I am exemp� under Section: B. 8 P. C. tor Ihis reason: Date: Ownec I Oo hereby cerli�y that I am aware oi anU untlerstanA �he requiremenis o� Calilomia Heatlh and Sa�e�y Code Seclions 25505, 25533, antl 25534 ana Ihal I or any fuiure bwlding occupanl will/will not (circle one) neetl �o compty with said s�a�e cotles and the requirement5 for a permit br canstmciion or modilicalion �mm �he Air Ouality Managemenl �iSVicL Pesiden�ial constmclion apDlications are exemp� fmm Ihese prOvisions. �ale'. QOPlicam. I �ereby cer�ily��a� I have read �M1is app6ca�ion antl Slate Iha� ordinances and 5�a�elaw5reiatinglo Ouilding conslmc�ion antl h pmpe�ly far ij'spetlion rposes. Oate'. �L1M�_�� _ Signature: _ l ' Oriver's License or Sociai Securi�y a: I agree b compty wi�h all ciry and coun�y his city Io en�er u0on Ihe above�mentionea 16aL46 W�i�e-9wltlmq, Green—Cotle Enlorcemenp Canary—Applicanf. Pink—Revenue; Goltlenrotl—Assessor PERAIIT ND; P CITY OF COSTA MESA - BUILDING PERMIT PERM NO: P 067352 . 057352 -� FLAN CHECK NO: N GOVT: N SUPP: N CONSTRUCTION TYPE: V-5 PERMIT TYPE; PLU r/�/� PURPOSE: OTH JOH DESCRIPTION , INTERIOR WALL FARTIONS " 1700 SF " _ c'�a'� �//\\ CLAIM C�ALUE: CALC-VALUE: GROUP OC�. -"✓/ COMMENTa: INTERIOR 17nOSF FOA " UR HUONG DAVIDSON " RE:#H57350 -N� �1F iE iE iE �1F K iE aE iE it+E iF iF iF iE iE iE iE ik � iF iF iF iF jF iF iF iF jf if� iF i� �N- iE ir� i: iF * lf �lf �t 9f 1E iE iE #�If * iF �f �it Yr IE 9F iE-K �lE iE iE �1f �IE jc 3( i(-1E jE if�>f it� �1F ?E 3E it . t iE u aF iE Z O N I N G R E Q U I R E M E N T S S E T B A C K S ------------ MAIN BUILUING ---------- --------= ACCESSORY BUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGAT: FT IN LEFT: FT IN RGI-IT; FT IN PARKING REQ; PROV: PARCEL: 42419107 ZNE: REF NO: PLANNING NOTES> > at*irit�*jt**+��****��r�r*�ir**�+�***+�*�r*�*xatx�rir*it***��t***��r�t+��r+r*��+�*��+�+t�t*�rae+r+e�-ar�r+�*+e*at D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: 1� iEiE�tiEiEiEitiEjEfEiF*iriEit�tiE%i(�iEiFlti��F3FiFiF'iFiFiF�if�TF�t�FTiFi'r�t�F"i"riF3F #��F�iziFiFiF��F*iEiE-%�DiAEiTaiEEirit� . , �� y�.+t 9f iE aE iE iE if +E if if if iP iF 1f if iE iE iE 9F iE if aE 3E 9E 3f iE iF jE iE * iF iE fE iE iE 1E iE iE if iE iE jF if iE iE af iF iE iElf iE iF ik iF iF if if it �1F {F iE if �E aE iE iE * if iE aE iE iF �?E if iF iE iE 1E 1E LEGALIZATION: N F.E E S,U', M- M A`R fY� STRUCTURAL 5EGMENT; N BLDG PMT PLUMBING 'ELECTRIC�, MECHANIG, FIRE SMIP/RES GRADING PERMIT . —49':00 , ,�. (L ,�, ' � PLAN 25R - � ' '� �_ � SMIP/NON-RES ISSUE FEE 20.00 -' �` ' " I" � BUILDING-DIV-> PERMIT ISSUE PLAN-C-HECI< %' TOTAL PAID DUE TOTALS----> 49,00 20,00 � 0,00 �' �69.00 69.00 ,00 REVENUE PIVISION TOTALS--> COLLECTED,: ��",69:.00, OVEP.;SAORT; ,00 BLPG PMT PLUMBING ELECTRIC MECKANIC ,-^FIRE',^,�MIP/TOT GRADING PLAN-CHECK 69.00 : � ,.. .. ,n` ^' � iE it iE iE iE ik iE if jf 3E±f if iF iF iF iF If iE 9f i: �E iF #Y� f� �E iF �E �f iF IE iE if iE iE fE iE if if �iE �)E iF #� iE 1E iElf if �1E if if iE if * iF 9E 3E iF if� iF iE !f iE iF if iE -)f if 1E jE iE * fE iE fE jF df I N D I V I D U A L ;✓F�E E.,B R'E A K D O W N TYPE QTY D E S C R I P T I O N. j� ��! r UNIT COST TOTAL COST FLU 4 SINK, BAR ,,.� i� - ,/ t� 7,00 28,00 PLU 1 WASH BASIN `J- i. � � 7 00 PLU 1 WASH BASIN (SETJ PLU 1 WATER CLOSET (TOILET). -� ; `.i, , END,:OF� FEES?� �!�;�;,� ' : r\.. r, � � �, Y1 � `�j ' /� � . , , � � � ._ r! � ,.I�,7.1 � '�. � .I `� � '�7i, 1� 1� ' 1� ..-s� � � n, � e _ . �.� ., 1::•� -j '�. I .t"; �� ,/� '_ � _, CONSTRUCTION AND PIA�NING APPROVALS Permit ik i. Temporary Electrical Service�rr Pole 2. Sotl Pipa-Undrgrnd. • � 3. Electricai Condmt Utihty�Uncrgrrtd. 4. Electrical Conduit�Undrgrnd. 5. S+,eel Reinforeement . 6 Eizct��cal UFER Gmd 7. F��;tings 8. Po�ndat;on , � 9. Water Pipe-Undrgmd. �, i .10. Structural Flooi SYstem ��---1 11. Properry Sewer Line & House Connection 12. Sewer Cap ' 73. Roof Drains 14. Rough Plumbing � I 15. Rough 6ectrical-Cor.dwt 76. Rvugh Eieciric Wiring '�� 17: Rough Wiring Siyn II, 18 Rough Electrical•T Bar Ceihng � 19. Raugh Hzating & A�r Cocdit�oning ZD. Rouqh Factory Fireplace '�,, 21. DuctS, in Structure ''�, 22. Ducts, Ventilating �i 23. Gas PiPe�Rough & Test 24. Roof Framing � 25. Roof Sheathing ��. 26. T•Bar Ceiiing IStructurall d� iFonocoat �', 27. Frame and Flashing 28. Laihing � Sidin9 '�., 29. Insulation 30. D-y�;reil Naihng 31. ?Iaste' B'orrn Coat 32. E ectncal Power f4ieterFinal 33. F�.nal Electr�c 34. F.ncl Heatiny & Air Conditionirza ��.. 35. F nal Gas P�Ge�Teat ----i 3G. Hood or Cannpy I 37. F nai Pactory Firepiace 38. Final Plumbing � 39. tiVater Service•Final � �. Gas Serwce-Final �. 47. Soiar pomestio-P.na� '��. 42. Backflow Preventer 43. Backflqw Irrigation � � 44 �,�i�scaGe Irngatir- Gvstem---� �� i-h5. f:aurfd .Attenuation ' L6. Handi�aP, Re�ulatons _ 47. FINAL S7'.?UCTURE & 6UIlDING 48. FINALb4FYVNI�JG � 49. Electric Re el ase to Edison e 50. Gas Release to Southem California Gas Co 5t. C�R7IFICATE OF OCCUPANCY P�p. __ _ Date _ J Date � POOI PA ' Inspector qpPROVALS Permit � 52. Pool & Ey�ipment Location "p./�(1 53. Steel Reinforcement I i� 5A. Forms 55. ElecVical Bonding G6. Rough Piumbing &- Press-ure Test-� 57. .4PPRO�fALTOCOVFR•GUr:i'E I - I 56. Electrical Condwt�Und�q•nd. _ � 59. Gas P�pe, L7 UnU�grnci., Te;t i -� --------i 60. Backwash Lines, P�Trap. O Und�o,r�d. 61. AFPROVAL TO UECK . _ 62. Backc.ash�& Reea1��'-f��a� � 63. Heatei & VenbFinai ��, � 64. P�umbing Svstem � F�nal � 65. Electriral�Flnal 66. Solar System�Fina� 67. Fencing & Acces+ Apnroval 68. APPROVED FOR PLASTEflING 69. POOL/SPASYSTEAiSFINAL F�RE DEPT. ftEQI.'IREMEtuT APPROVALS P,:r.�.i�l �: 70. UndergroUnd Hy;.o 71. Product P;piny :7 C,ds J Oii 72. Undergrou��d FRis�� 3. Undcrgm+'.. S±i �,� ' , _ - r_.. - , .. 74. Ow�head Hydro 15. Dry Chemicai 76. Dry Standpioe 77. FIXED SYSTE\! Date � Insp� � 78. FIRE PREV. FINAL _� L___ HEAL7H �EPT. REQUIRE��7ErvT 79. FIi.;AL ID!5°cC?�(;': --^- �- ' � ---- � 30. FOUJ CER-iiFICPJE ISSUED I t ' --- --- � ------�-- - ^ Nates: � � 6=�� k�,t�c�s �T �'�r� - : � -%�i-=-cG'4= - GOYL2£s�.'Cl07�!-./`!!i t_/ _ _ �-=ls=�i_¢-w�6-r_ .wtt-rF=_so>v B�_oawrrs7~ � . ' f; -- ------ -------T--- ---a �'- � � ---'t� -- --� � I 1:' �- -- / � ly PH0.IECTROUflESS: B4I W 19TH ST � OWNffl'SNPME: pAUL TAAUTWIEN aooxess: 1617 WESTCLIFF DR it 112 N.B, 92660 AflLH/ENGINEEH: DONALD INMAN PEG.NO.: OO��O noosess: 15355 BROOKHURST AV 221 W,M. 714) 839-5022 CA 92683 PEflMITTEE: LONG CONSTRUCTION (800)723-0543 aooaess: 10832 CAPITAL AV SA G.G. CA 92643 LILENSEU LONTBRCTOB UECIAMT10N: � �ere0y atlirm Ilwi I am tic¢nsed uMer prwi5bn5 0l Gupte� 9(commencinq vnt� $ection 7000) of Drvision J o� Ihe Business an0 Pmlessfons COde. an0 my license is in lull torce antl eflect. ciTvuc.: 062032 srareuc.:384818 cuss: B EXP; 04/95 Oa�e: �—� � Signawre: _ — WOBREHS'COMPENSRTIOND LLABATION; Iher¢Gyaflirmt�atl�avea ifiWt fmn5enitoull-insureoracertilicatpO�WOM1erS' COmpensation Insurana. o� a cerlifie0 cODY I�ereot (Se[Ibn 78W, lab. roucrxo.: 1105003-93 E%P.URTE: SO�OS�94 comrnxr: STATE FUND ❑ Cenifietl copy is nere�y fumisneA. � Cenifie0 w0y �s I�tl with the ciry BWding DNisian. �ale: �` � ApDlicanC E%EMP110NfNOMWOPKEPS' MPENSIITIONOECIAMTION: (f1i55etAM notUe mplMMi�UepGRil'R�aanelwnUreU(37ql�Otkss�. 1 cenify inat in ine petlormance ai tlie woA �ar wh¢h rttis Dermt 6 isw . I 5hd0 twt emplq any person in any mdnner So as to Oecome subject lo the Woiker5 ComDensation LawS Of Califomia. Oale: — SignaWre: NOTICE: II. a�ler making lhis E¢[Iarali0n, you S�ouIE E¢tome SUDI�� o I�E Wafkers' Compensaiion pmvisions ol tAe La�or CoOe. you must lon�with comO�Y'^'�� such provRions or Iks permit Stull be CeemeU avoketl. CONSTflUCTION LENOING FGENCY: I Aer¢py aflirm I�at t�ere is a Consimction lentlinp aqency lor I�e pedormanca o� lhe work for wnicn inis oermn is ¢sue0 (�tion 3097. �. C�. LENOEfl: AD�flE35: OWNFfl BWLOEfl DECIAflATION: I �erthq allirm ihat I am exempt Imm t�e Contractors' State Lic¢nse Law lar t�e Iollowin0 reason (Setlion 7031.5 Business antl Prolessional fp�e: Nny city ol wunty wNch reduires a permit to wnstmct, alter, im0�ove, OemolisA, or rtDair airy 9ruclure. O��or to ils �ssuarKe. dlso requirts t�e aDO��:n1 br sutl� perrtut to lile a SigneA siatement Ihat h¢/s�e �s IicenseG pursuam ro i�e O�oHsians af the Comracm�3' State li¢nse Law (CIuO�er 9(commennnq vnN Sectlon 7W0) of Oivision 3 al t�e Business and Pro�essions Code� or t�at neh�e is ex�mpi ��erelmm ana ine Oasis for I�e alleqeE eRemption. Any violation af Seclion 7031.5 Cy any apDlitant �Or a Oermii SUDIeCis I�e aDPlicani IO a Civil penaliy 01 nol rtqr! Itun live �undreE UOIIaR (5500). I, as owner ol t�e D�oDeny ar my emyloyees vntn wapes as t�eir sole wmDensa�ion, wlll Ua the work, antl I�e ❑ slmclure i5 no1 inlentled or ollere0loi sale (Section 70<4, Business anC Prolessional Cotle: T�o Camractors' Siata License law Coes no� appry to an owner ot a O�aDeriy wln �WEs ar imprwes �hereon, aM wM Oces suU work himself/hersell or t�mup� his Or het awn emDloy¢¢5. 0��4lG Ilwl Su[� ImprOv¢menB arE noi in�¢nOeE or atfer¢E fOr sale. I�, �Oweve� Ihe �uiltlinp Or imprOvemeni 6 sold vninin One yCar al completion, ine owner vriil twve Ine eur0en ol prOvinp ne/slie Eid not Ouila ar imDrme for ine Durpose of satel. I, as owner at the pm0erty, am e�clusively contractinp mtn Iicrose0 contractors to constmct �he pmiect (Section 7044, Business ❑ and Pmlessians CoEe: IDe ContraCtors' Stare License Law Ooes noi aOVN �o an avmer ol pmpenp wha 6mI0s or im0�%'es �hemon antl wha comracts lor suc0 pwleqs witn a tomractoqs) license oursuant to me Comractors' Siam Licnnse Law). I am aware Ihat prool ol illtif Waiker 5 CUmDEnSdIiW inSufdOtE SIIOuIG �E pfOVIGld IO mE. � I am eKempl un0er Senion: B. 6 P. C. lar inis rta5on: Oate� Owner. I Oo nerehy cenity tnai I am awa�e ol ana pn0erstan0lne reQuirements ol Calilomia Healin and Safety Cotle Sections 25505, 25539, antl 2553d antl Inal I or any INure Guilainp acupant wilVwill not (cirUe one) neeA lo cam0ly wilA sai0 state codes an0 I�e repuiremenls for a� permil for WnsVuctqn or mo0dicalion Imm ine Air Oualily Manapement Ustrict. fleFeentidl ConStrudion apDliWtions are eMempt Irom inese prmtions. Date: ApO�ant: I �ere�y cettity I�al I �ave rea0t�is applicdtion an0 stalei�att�e aboveinfarmationi5 correct. I aA�eeta wmply with ail city antl county orainances antl slatelaws relatingto �uilDin9 panslmc�ion and hereGy lhOraere0�e5enlaiives o�ihi5 ci�yio en�eiuponthe ahave�mentioned pmperiy loi � 50et�ion purposes. �a�e: $ignature: o�i�ersucenseo�5ociaisecu�ity+: ifi<Lab WM1ne-8uiltling: Green—Cotle En�orcemenC Canary—Appliwnl: Pink—Revenue: GOICenmE—Assessor CITY OE COSTA MESA — BUILDING PERMIT PERM NO; M 06828 PERMIT NO: M 068284 PLAN CHECK NO: , N GOVT; N SUPP: N CONSTRUCTION TYPE; V-5 pERMIT TYPE; MEC PURPOSE: OTH JOB DESCRIPTION : INTERIOR WALL PARTIONS " 1700 SF " SQ FT: CLAIM VALUE: CALC—VALUE� GROUP OCC: 8-2 / COMMENTS: INTERIOR 1700SF FOR " DR HUONG DAVIDSON ", RE;�667350 +r�r��rx�+r*+rwx�rw�r�rxw+r�r�r+rr�r+r�wx�r�r�r�e�rx�x�r�wxr�c*r*�*:r�rwx�+r�r�r�r�r�r�r�rw�rx��r�r*+��rx �rw**�r�r�r*�r Z O N I N G R E Q U T A E M E N T S sETeacxs ------------ MAIN HUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: ET IN LEFT; FT IN RGHT; FT IN LEFT: FT IN RGHT; FT IN PARKING REQ• PROV; PAACEL: 42419107 ZNE: REF NO; PLANNING Nd'PfiS> > 1klt if 1tlflElE iElF fk 1t iElk!!!E ftlt 1F M if fE 1F 1f if it ft iF 1k iF 4 if 1t 1t M 1f it 1F ik 1f 1t 1E iE if M ik if 1F M 1! 1E iE 1F iE %1t 1k 1k 1f 1Flt 7F iF M if 1f fF iFlE iklF 1F M 1F 1k if 1f 1F 1! 1E D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE; _BUILDING APPROVED BY : DATE: APPLICATION ISSUED BY: DATE: � Mif7FMiE1EMMMiE1tMiFiFMM1lilMiFilM klliElklFiEMitiF% MM fE1kkM1ElEfFfE1kMMM7F1tMMM1EltlFkifif MMMIEMlFM1Fff iF1f 1F1fMMMlkikMMIFMiFMMiENMMMMM1f 1fk1E1f 1kM1EMMKitfFlkMlFlEfFMiF4!!1lif LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GAADING pERNIT 18z5t SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 18,00 15.00 0.00 33.00 33.00 .00 REVENOE DIVISION TOTALS--> COLLECTED: 33.00 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33.00 1tlfikkkkifihilifkMltiF/fkMMMM1FiFfffkMMMMk1liflkMMMMififltitflMM7kifikMMMIFMit4ikitikNMlt1l1k1tM1k1tMftMMitMifitifififiklti! I N D I V I D U A L F E E B R E A K D O W N TYPE .QTY MEC 1 MEC 1 D E S C R I P T I O N REPAIA/ALT COOLING UNIT/SYS W/CNTLS REFRIGERATION SYSTEM <= 100 K BTU/H END OF FEES UNIT COST 9,00 9,00 TOTAL COST 9,00 9.00 V O1 OO1d5096-00165�]96 T�3 T 33.QU DA7E: U3/Q2/94 TItfE: 1b:29 CONSTRUCTION AND PLANNING POO. SPA APPROVALS Permit # Date Inspector APpROVALS Permit # Date Inspector 1, Temporary Electrical ServiD: or Pole . 52. Poo� & Equipment Location � 2. Soii Pipe�Undrgmd. o p� 53. Ste¢i Reinforcement �. S t�•� - ,��'�L�v�ca�gd��Jxiiity�ff'ndrgrndo"� 54. Forms �r- � � w� � .,4.'�Iectrica+�nduit;Y)�drgmd. i _, 55. EleCtrical Bonding �-?---z 6 �l a�- �"�teel Reinf��ep e'dt ��x 56. Rough Plumbing & Pressure Test S y��_ 1,4�;�+Lctric��,�E�C;nd. � 57. APPflOVALTOCOVER�GUNITE ', ��=}64--'Q"'`„ �i'[-.-6 =:i�7�6)tingsr�y�� ' 58. EleclncalConduit�UndrgmU. ��aundatiot�yFF'„� `" 59. Gas Pipu, O Undrgrnd., Test �� 9.:LYater PipeftJ'intiFt�rnd. 60. Backwash Lines, P�Trap, C7 Undrgrnd. �� 10.-Strucwral ;�o'�r SYstem � 61. APPROVAL TO DECK i t. �roperty Sewer Lin�$ Hopfe Conn�tion � 62. Backwash & Receptor•Final ._n t 12. Sewer Cap W � `� 63, Heater & Vent�Final 13. Roof Drains � � ;e� � 64. Plumbing System - Final 14, Rough Plumtif!r� � 65. Electrical-Fina� 15. Rough �ctrica>Condurt � 66. Solar System-final 76. Rough EQEctric�9ring J 67. Fencing & Access Approval � 7. Rough Wir��,ng S�& '� 68. APPROVED FOR PLAS7ERING 18. Rough ElectricaFT Bar Ceiling 69. POOLlSPA SYSTEA1S FINAL 19, Rough Heatiog & Air Canditioning FIRE DEPT. REQUIREMENT 20, tiiough F�torq F��lace i�^;*� K'7 i O� ^'t �' 7�etPPROVAtSu��Y+err,�sit # � -'*��"�.1 c - a < < :- m r. �� '� x :� ;� � c.� � n l�: 2j. �uC�i, if�StfLL�TVf� ` 1 F F =CS .•' � J '7� +� '.z. :S:i'-7 C7 ! : i �- r i ^+S r O ..k � 0. Uajer9�Pl�*cd�'�YCSo �K 22. �DuC3, V3Y�til3tiny-.a� I :�S + � � S �* � {1. ProduCt,Fni �fig a'ii'� OOiI 23. 6as ^ pe�ougi� &"t�st ' '�.. � �" • � "�' ' : � ` " r `.� � „., � , ;�� , ,� P S �.. , �2. Undergro�{�*3c1;Fl�r �; �_ J�J •• 24. �oo�Frarning• Sa i�F ••F �� v x`� cJ3.� nderyrncCStorar!�a'ank QGaz ❑Qt"' �-�T r. 25. Roo7'Sh�thin �� ` � '� � :1�� '� S --+F� > �y 9 z' ,Z �• �� ,; ;' : :7* � i4.;�verhead 1-�ydro � 26. �i�BaryCeiling (Str�puraq & p�osoat � ei c� mx ♦ 75. �ry Chemical '� ''� 7 �' -. c..� "1_.F .'r1 27, yrerqe anFd Flashin �* � ` � °J #� 76. iDr Stand6tpv �t 7' '� �'=� � i :� H F i� D:F R: Y .a - CO fi K.,^ . � t y�, � v . .. :�"i� i�8. �atking �' Siding �*' n �-] G- x t: £ . ..w � 77. cFIXED Sl`�FE(vf��lA� 1. �n -29. 4nsulati� �Y G �^' •. '' i m �; 78.�IRE PREV. FIN�}}� �� 7� i � v . -7 J . r30. Drywall �ailing �r y r y � 'x r �-+ HEA�LTH�EPT.ri�6QUFREMB�T , , �, •31. Platter B"wn..Coa�t 5 i .�t� x ' �'�9. `FINAL IN��CTIU�'I .* � °� `j � �-'__r+"_x :.i i�7. , ��2, clectrica�owJr Me�r;final i r� t N � tC70. ,{i00D CEfiTIF16XYIsE IS9UED _ r±� K ! �':� �3. �in2*''�EI ri � � x � i � x z1 : t i�JotG: y �� ' ; O 'J'C�,7- z34. T;inasFle�in A��o�rdi.tior�i�s i1 _',•` e a:g.-"�� '1^_: � ��-! . _ I35. Ftina3-Ga�PiP�Te : � -� >: h: - nn� t' � m A/rt�/'/��'� r+� � _7___t .. a: i. .. �� '] Y=Y�� r,`�, i i 3�'"_��.__.�, ,^. ,�?6. Hoo�;or'C'anoPY � Y� C i tP'7 c x!� � F. T_ ;�o .' n, �.;n f. t R• 'S7.6inal'FactoryFire'al�ctr'_ �Sc' � zm . g -- Nr�a% 4-y .� P� -1 [ .��. H '1 Y � J � .. .. i ,r � � .. .. y L R i 4 , �_ i. ... _ �38. Fina�fll�pbin9 .Jt N i "� I �•�� • r �•.� ip '� �3g. Water.Service-Finaii:�� t� r i1oe. ,. ..,t-: a:G Sr n� x" r Q ?� �. .s r• 9D, Gas Service•Final `,r; �., ,.�;..; S t_ � Y ^" �;�; i' �� r�7z gl. $olarpomesticFitcal-S C�� ^ +:;s f� `�^ ^`" �� ma '`� r - K :. D (._, t �-+ :l / ' ' `CZ. Backflow Preventeu'r' R `y :� � � �;, � F a=' -; �. 43. Backflow Irrig2tioP�* . �=S +' ,`�. '^`' r r �l.'' x -r r,; x n h+ 'J l� 7'. h c i; ' .. ♦ . A .� �' " 4�4. landscapg Ir(J�'.at'p�SYstem�,mr g T;- � J i�� ^ ^j ,_. --� e� :a o0 p.5, �und Atten�tionx �-+�F T ��= F �- F�r ��l ti r� �u a;Q `� � m i� � L� Y. o' CT G• t-� C: # $S. FT�ndicaA.RechQation� d • ry .. •. + : _ -•,. � ,-+ � a •. * c, �r, O � S t 47. E�N3i STqLtBTURE & BUICDING k`'"� �'� � a� .� • �. �!'. . 1 C 8 i-n 46. E,- NFiL P�ANf�ING i � �� _., Y �; � : ;y ;*i Q � A9. Electric Release to Eiiison i = i `� ��T. � � ': R ' 'r] rf • � � � 9p. Gas �igiease to $outljem CatifdrnyaS�'ias Co r � t. .' =� :� � � J o.� J Si. CER_FtCATEOF CCUPANC x r n -._' �: � E-� = a Vo. Date VPOJECTRDUPE$$: B41 W 19TH S"i OWNEfl'SNFME: FAUL :RAUTWIEN nooeess: 1617 ?�fEfiTCLTFF DR ti 112 N.B. 92660 u"it: C ` CI:Y OF CU5TA MESA — BUILDING FERI1IT PERM NO: M 06E1b7 PERMIT NO: M 06Ui67 PLAN CHECK NO; PI GOVT: N SUPn: N CONSTRUCTION TYPE; V-5 PER?tIT TYPE: itEC PlitiFOSE: GTH pPCH/ENGINEEN: DOiIALD INtdAN HEG.NO.: UOOOO ' nooeess: i535� HRCOI:HURS': AV uxn: 221 [d,:;. 714) 539-5022 CA 926E3 PFflMITTEE: LONII CONSTF.UCTION ( 800 ) 723-054 3 nooness: 10832 CAPITAL AV SA G,G. CA 92643 ❑LENSEo CaNrPRQOP oFCUPpr10N: I nertoy alhtm tlWt I am 4ttrttt0 utNer o�w5ion5 0l CAdDter 9lwmmenGnp wi01 Seciion 70001 0l Oivision 3 0l the Busineu an0 Profess�wu Catle. anG my licenu is in lull Iwce anE eflect. cir c.:062032 sT�reuc.:304�13 �s��EXP: 09/95 ate' ��2d��y Siqnawre: � HEPS' CUMPENSRTION UECIANRTION: I hereEy allum tlwt I have a cenilkate ol consent to ulNnsure or a ceniircate of Workers' � CompCnSaiion Il 1 V J°S J�i�iey �ov mermi ISectron 3¢00. Lao. 1�O / O 1/ 9 4 roucvno.: STP.TE FUND E%P.ORTE: COMPpNY: ❑ CenifieG coDY �s �ereGy tumaAetl. � CMAieG eopy is IileO w/i�y�£ ury BuilEinp DiviSion. (��/I/e/� � ' �e: � ! `T ApVliwnt: �L / — v [IIFMPT�ON FNOM WOflKEBS' COMPENSIITION OELIAN�TION: (tlut se[Iion neetl no� Ge car�nM il Ne pemni is �ar mB AwUteA �5700) or kss�. I ceriily I�ai in t�e Oedormar¢e oi t�e work tor wNch 1�i5 permii is i55ueE. I s�all nol employ airy person in any manner so as to Cecome su0iect to tne Warkers' Comoensation Laws of Calitomia. Oaie: Spnamm: NOTICE: II, al�er making t�is Eeclaration, you NOWd Eecome suEjttt m the Waders Compensation D��ons al e�e LaEor Cotle. you musl lanittx�� tAmpy wit� sut� O�ovi9on5 w tti5 permil 5tW0 OC GeemeE revokeE. LONSTHUC710N LENDING RCENCY: I �ere0y allirm tlwt t�ere is a ton5truction IenEinp a9enty for the pertarmance af the work lor which iNs Dermit is i55uM (SCciion 3097. Gv. C�. LENOEfl: noonEss: JOB DE5CRIPTION . I;�TEkiOR WALL FiiRTIONS " 1700 SF " ��J FT: CLAIM VALUE: CALC—VALUE: GP.OUP OCC: b-2 / COMMENTS; REF: B-67350 iF#�if1EiE#iE##iFiFif#K�i�lEiE##1F#X�iflYiElFiEifiFi4iQ1F1F'N ii� if####Kii1F')Fif#iFiFY.�#il#ie#M�MY�#t #i iii: Yr#ifi:+tii- W i:�K�i%4'.##i.'�:? Z O N I N C R E Q U I R E 11 E N T S S E T B A C K S ------------ MAIN HUILDING ---------- --- ---- ACCESSORY BUZLDI;VG --------- FRNT: FT IN REAR: FT IN FRNT: FT IU REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RCHT; FT IP7 PARKING REQ • PROV; PAACEL; 42419107 2NE; REF :10: PLANNING NbTES> � #IE�F#3E#�EiFfE9EiE#jFiFifiF######iF3F##iFifiF#if#��Y3e3F#�:ifiFiFYr#i6iF####�1F##ii#-#?EiFiE#iF[�k-K�3Gii�#ti�#�Kx..Y+Yr#iF#iEiF#ieit 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 v T S 20NING APPROVED BY DATE: BUILDING APPROVED BY : DATE: APFLICATION ISSUED BY; I fli%U—� DATE: 2� ql �+��*�r**��*x��r�x*�?�ir�rir�x�� SF��rxx�+.#xu»x�u`xt`��x'�ru��r�n#��r#;t#um,:x� �u.r �=ri*� ##ltif#if#iEiE1E#lfii-##iE�E#ft#1FfEjEiE#ifiEilili4fEfF##%•##7F##3iX�1P#iEfE###12#iE#i}#IE#Y##b%14#rii:it##lEf.� F##i ff### LEGALIZATION;N F E E 5 U M M ra R Y STRliCT[JRAL S'ChIENT:N OWNEBBUIL�EHOECIAP�tION: Iherebyallirmttutlamexemptlmm��eCaniractors'StareLicenseLawlorthefollowinpreason HLDG PMT PLUMHING ELECTRIC MECHANIC FIftE SMYP/RES GRADING ISection 70.31.5 Business ana Pmleuional Cade: nny ury of wuniy wnich reVuires a Oermit Io construct, alier, imD�ove, Oemolish, or P ERM I T 9. 0 0 re0air any Stmtlure. O��o� �o i�5 i55uanCe. also rBpuire51�8 aOPlitanl lOr SutA Oefmil (O lile a 5ipneE Slaiemen� ihal �0/S�B i5litense4 pursua�uo me orovisions ot me Comracmri State License Law �CAaO�er 9(cammencinp vnt� 5ection 7000) oI Division 3 o11he Business pLAN 2 S o SM I P/� 70�1—RES . an0 Pwlessions Cotle) ar that �e/s�e is exempt i�emlmm an0 t�e Oasis for tAe a11e0� eKemption. pny violation of Section 7031.5 Cy ' � any appfcan� ror a permit suoiects me appiiam to a crvii penatty ot no� more man iroe nuneree aoilars �5500�. I S SUE F E E 1 S. � � I, as awner of ine orooeny or my emptoyeu wim waoes as ineir wie compensation, will Ao Iha work, ana ihe BUILDING—DI��—> PERMIT IS..�'.rUE FLAN—CHECK TOTAL PAID DUE ❑ stmcwre is not inrendetl ar olleree lor sale (seclion 76ad, Busine5s an0 Piolessional COEe: The ConVac�ors' S�a�e Licanse Law TOTAL S----> 9, 0 0 1 S. 0 0 0, 0 0 2 4, 00 2 4, 0 0 , 0 0 Does nol aD01y to an owner of a O�openy wtlo UvilOs ar improves 111ereon, and w�a Uoes suc� woM Aimsell/�erself or t�mupA �isorherownemployee5.provi0e0t�atsuc�imprmement5arenountentle0oro11ere0br5ale.Il,haweverlhe0uiltlinpor REVENUE DI��ISION TOTALS--> COLLECTED; 24,00 OVER/SHORT; 00 impmvememissdtivnthinaneyearolcomDletion,iheownerwillhavet�eOurCenolpmvinqhUS�eAltlnot6ulldorlmDmve $LDC FMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAAJ—CHECP' lOr I�e purpose al sale�. � i, as owner ol me Dmoeny, am axclusivety caniractinq wit� Iicense0 contractors to consiruct I�a pmlect (Sectlon 7041, Business 2 4. 0 0 ❑ an4ProlessionsCode: TheCanlractor5'StateLkenSelawEoesnotapptytoanownerofpraperry w�oEwlOsarlmOrovesihereon �,*,X,#ftlf#ifitit�kif#itif�lE1F#itit#it#iE#i!##�kifiEiF##K#itiElt#iF##K�#ifiEiP#lkltiEl.'�1c.K.�(.�-q*-�•y.*.{;########9fl;�X•s;#it#s. antl wM10 contratls br sucA D��e�is vrit� a comracloqs�licrose pursuant lo I�e Contractors' State License Law�. I am awara thai prool ol Iheii WaBer'S Compensalian insurance shoulG be pmvla¢0 lo me. I N D I V I D U A I.1 . E' E E $ R E A K j) O W N � I am eAempt un0ei Section: B. 6 P. C. ior tnis reason: TYF�E QTY Date: Q^'^e1: I MEC i ao nere�y ceruly Ihat I am aware of an0 unaers�antl Ihe mauiremenis of Cablomia Heali� an0 Safery Coae Sectians 25505, 25533, antl 2553< ana ��at i or any fuWre �uiiainA occupant vnNwitl noi (circle one) nee0lo camON �� saiA stata co0es an0 t�e mpuirements for a permit lor cons�mciion or motltlication imm t�e A�r�uality Manaqement Ustnct. FesiAenlial constmc�ian apD�ications are exempt Irom ihese pmvisions. Oal¢: Ap0liCani: I M1ereOy certity Iha� I �ave rea01hi5 appliCatiOn anU Sla�e I�al l�e a0ave in�Ormalion i5 rorr¢ci. I apr¢e la Com01y wil� all ciry anC touniy orainances ana stale laws relating lo �uil0ing tonstmclion antl �ere0y aulMrize repr¢Sentatives ol tllis ciry to enter upon ttle above�mentionea �y for inspectian OurOoses. 7� G- S L� s�9�am�e: �`� � od�ers ��cense a� Sariai secudty �: 16a1-a6 Wmie—Bwioing; Green—GOCa Enio¢emeni: Canary—Appiica�C Pmk—Revenue: GolOanrotl—Assessor 1 D E S C R I P T Z O N UNIT COST RELO FORC—AIR/CRAV FtJRN c= 100 K BTU 9,00 ENA OF 'FEES ' TOTAL CO5T 9.00 01 OO1b4440-00164440 TOT 24. DATE: 07/2D/44 TIME: 14:1` CONSTRUCTION ANDPLANNING POOL 1PA ' APPROVALS Permit #'� Date Inspector APPRpVALS Permit # �ate Inspector 1. Temporary Electrical Service or Poie 52. Pool & Equipment Location 2. Soi� PIPe�Und.grnd. 53. Steel Reinforcement 3. E�ectrical Conduit Utility-Undrgmd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcemenc 56. Rough Plumbing & Pressure Test 6. E�ectrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation 59. Gas Pipe, � Undigrnd., Tesi 9. Water Rpe�Undrgrnd. 60. Backwash I.ines, P�Trep, O Undrgmd. 10. Structural Floor System � 61. APPROVAL TO DECK � t t. Property Sewer line & House Conaectio� 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent�Finai 73. Roof Drains 64. Plumbin� System � Fina� 74. Rough Plumbing 65. ElectricaLFinal 15. Rough Electrital�Condu�t 66. Solar SVstem-Final 16. Rough E�ectric Wiring 67. Fencinc� & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. ROugh Electrical�T Bar Ceiling 69. POOL/SPA SYSTEPAS FINAI. 19. ROuyh Heating & Air Conditioning FIRE DEPT. REQUIREMER�T 20. RDugh Factory Firepiace APPROVALS Permit # 21. Oucts, in Structure 70. Underground Hydro 22. Ducts, Ventilaiing 71. Product Piping GGas ❑Oil 23. Gas Pipe•Rouqh & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. ftoof Sheathing 74. Overhead Hydro ' 26. T•Bar Ceiling (Structurel� & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. f�NAL 30. DrYWaII Nailing HEALTH DEPT. REQUIREMENT 31. Plzster Brown Coat 79. FINAL INSPECTION 32. Electriral Power Meter�Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: 34. Final Heating & Air Cond(tioning �p �+ ��d ��1 -L S 35. Final Gas Pipe-Test 36. Hood or CanopY 37. Final Factory Fireplace 38. Final Plumbing 39. Water Service-Finat � 40. Gas Service-Final qt, So1ar OomestirFinal 42. Backfiow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation 46. Handicap {iegulations 47. FINAL STRUCTURE & BUILDING 48. FINALPLANNING 49. Electric Release to Edison 5�. Gas Release to Southem Cafifomia Gas Co , 51. CERTIFICATE OF OCCUPANCY No. Date � I � I � I� �aicrnooness: gql W 19TH ST .�:lNEfl'SNFME: PAUL TRAUTWIEN RDOflESS: 161'� WESTCLIFF DR # 112 N.H. 92660 AflCM/ENGINEEfl: DONALD INMAN XEG.NO.: OOQ�O • aooacss: 15355 BROOKHURST AV 221 PEXMITTEE: W,M, %14� 839-5022 CA 92683 aooness: LONG CONSTRUCTION ( 800 ) 723-0543 10832 CAPITAL AV SA G.G. CA.92643 LICENSEO CONTPACTON OEClA8RT10N: I �ere0y allirm �pat I am I¢en5e0 unaer O�o��sions ol Chap�er 9(commencing wilh $eciion 7000� ol Division 9 0l I�e Business an0 Prolessions COae. ana my license is in tNl foue anE ellecl. cirr uc.: q� srnTe uc.: 3 g q g 18 cuss: H Date: y "12 f �� Signature: � _ WOPICENS' CO PENSRTION OECIABATION: I �ertLy a�li�m I�a� l Aave a C¢rli6 ate 01 fAns¢ni lO sell�insure ar a t¢�iliCai¢ O� Watk¢rs' Comoensation Insurance. or a cenifiea copy tnereof (Section 3800. LaO. CI. roucrHo.:�105003-93 E%P.00iE: SO.QI/94 comrar+r: STATE FUND ❑ Ceniliea coOY is �ereby furnishe0. � CertilieE copy is li E wit� ��e city Builaing Oivision. Dare: Appl¢ant: - ' E%EMPfION Ffl M WOflK 5' COMPENSITION OFCLAMTION: (m¢ �p,yqn neeG mi completeE il ihe permt b la oire hwqieG (S70%w I¢Ss). I Cerii�y ��at in Ne peAormdnte ai Ihe wOrk lOr w�it� I�iS p¢rmii i5 iiwe�. I S�all o� emDloy any person in any manner so as lo becom¢ Suble�� 10 Ih¢ WOfk¢r5 COmp¢n5dii0n LaWS 01 CdlifOfllid. " � �a�e: Signaturt: NOTICE: If. aller making I�iS Ueclaralion, you 5�ou10 Decome SuOjtti �o I�e Workers' Compensalion Omvisions al �t�e LaGor , CaOe. you mus� IonlmiiA compN xit� such pmvitions ar tNs Oermit stull he AeemeO revoketl. � CONSTflUCTION LENDING RGENLY: I �ereGy allirm t�a� inere is a tonstruclion lentling a0ency �or I�e Oerlarmance al ��e wark �or , wnicn inis oermii is issuee (Section 3097. Civ. CI. ; LENDEN: ' �� RDOflESS: OWNEB BWLUEN oECUNR710N: I nert0y allirm inat I am exempt Irom tne Contrac�ori Slate License law Ior the lollowinp reason �Seclion 7031.5 Business antl PmlessiMal CAOe: My cily ol counry w�it� reQuires a permi� to mnstNct, alter, improve, Cemolish, or ' re0air any simcture. prior ta its issuance, also repuirest�¢ apDlicant for 5uU Dermit to file a siOneE statement I�at �e/stle is licensed pursuanl io I�e pioviUons Of ine Comratmri State Lkerrse �aw (CtuO�er 9(commenung vnN Sectbn 7000) ol Oivivon 9 al t�e Busineu an0 Pm�essions Co�el or Ihat �e/sne is e.em0� t�etetrom an� t�e Oasis tor t�e allepeE evemp�ion. Any violation ol Section 7031.5 by any applicant for a verrtm suejecis ine appliunt lo a Civil penalty ot �MI mOre than five Iluntlre0 aollars (5500). I, as owner ol I�e propeny or my empIayeCS wilh wages as t�eir sole compensation, will tlo I�a woik, antl I�e ❑ stmcmre is noi imenAee or ottere0 lor ule (secbon 70aa, Business antl Pmleuional Cotle: T�e Contractors' State License Law does not aoD�Y �o an awner ol a propeny who Ouilds or impmves Inereon, an0 who tloes such work nimself/heRelf or inrough �is ar her own empl0yee5, pmviG¢A Ihai 5ut� imp�w¢m¢nI5 are nol inlenGeE Of all¢reE lor sale. II, how2v¢r I�e UUilainp Or impmv¢m¢ni is so10 w%�in one year al complGiiory. Ihe ownet vn�� dve �he EurGen of pmvinq Adshe tliE n01 huiltl or impmve �or I�e purpOse ol sale�. I, as owner ot i�e pmDeriy, am eeclusively comraqing xit0license0 contracmrs to constmn I�e pmlect (Seclion 70aa, Business O an0 Professians Coae: 7ne Comractors' S�are Lice�¢e Law aaa wt appN m an wmer ol pmpe,rry wlro Emlas ar improves �herron S CITY OF COSTA MESA — BUILDING PERMIT PERM NO: E 067351 PERMIT NO; E 067351 PLAN CHECK NO: N GOVT: N SUPP; N CONSTRUCTION TYPE: V-5 PERMIT TYPE: ELE FURPOSE: OTH JOB DESCRIPTION : INTERIOR WALL PARTIONS " 1700 SF " SQ FT: CLAIM VALUE: CALC—VALUE; GROUP OCC: B-2 / *�*+Mr*+Nr******�***�R�**��***��R�r**D*+c�**�*�*D***D*�N+r�t��r***�H***+�r�**ir�r*+�+�**�r***�r*�r Z O N Z N G R E Q U I R E M E N T S S E T H A C K S ------------ MAIN HUILDING ---------- --------- ACCESSORY BUZLDING --------- FRNT: FT IN REAR: FT IN FRNT; FT ZN REAR; FT IN LEFT; FT ZN RGHT: FT IN LEFT: FT ZN RGHT: FT IN PARPCING REQ: PROV: FARCEL: 42419107 ZNE: REF NO; PLANNING NOTES> > ,.- if M iF iF if fE if jf iF 1F fE i: #k 4 iE iE 1f iF iE 4 iE 1f af iF �E iE iE fF if iF iE a� *{E if 3E if if if 1E �E iE iE 1t i! iE 1F if if %�f iElE 1E if if iE 1c 1E k aE 1E 1k!F ik if 1E iE iE 1E if 1E iF iR if jE if 3E 1F D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ZONING APPROVED BY DATE: BUILDING APPROVED BY ; DATE: / APPLICATION ISSUED BY: '� DATE: �tl � iF if i:1F iE jE iE 3F ff iF if jE if if iE iE iF K iE if iF 1F8"I�iF�'i�;f iFiFiFif±F�FiF3lif3f3f�FifiFiF±F�F iFiFi:��FiF k 1E ih if� iF ih iF iE if ic iE #f iF iE it �E iE if iE 1F iE if if if it iF iE iE 1E jF iF iE iE M 1f- if iE iE 1f iE iF iE iE it �iE ic * 1k iF iE M 1E i4 it iE iE M if 1t if if iF iE iE it if iF if if iE 1E iF iE it iF 1E iE 1E �E iE if if if i6 if iE if if iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 44.40 SOt SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 44.40 15.00 0.00 59.40 59.90 .00 REVENUE DIVISION TOTALS--> COLLECTED: 59.40 OVEA/SHORT: .00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 59.40 anaw�ocomraclslorsuchpralect5wit�acontqctorlsllicenuDurwanttot�eContracmrs tateLicenseLawl.lamaware .�,*,*,*,�,*,�,*,�,**,.x,.It.M,*.lf*it,lt,*,�,K,1(.*******�.if.%**.x.,K.it,i�..lEif..x.M,*iE�f.K.iE*N,i(,ff,if„�***M„x,iE#*�t,*,�i(,*�(„Mi(,-M,*,kit,�tc�(,*,** I�al D�ool o� I�eir Worker'S Gompen5aiion insunnce s�au10 Ce pmviOeG Io me. � I am exemD� unaer Sec�ion: B. d P. C. I N D I V I D U A'L F E E H R E A K D O W N rormisreason: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST Dale: Owner. I tla �ereoy cenify t�a� I am aware of anU unOersiantl I�e r¢Quiremen6 al Cahlarnia Meali� an0 Safety COEe Sectians 25505, 25533, an0 E L E 1 4 F I X T UR ES , L I GH T I NG 1 S T 2 � EA . . 7 5 1 0. 5 0 2553a and inai I or any lumre Guiiaing occupant xiAM^i�� n0i (urde one) neeG �o compry vnth uiG su�e a0es an0 t�e �eQuirements lor a EL E 2 0 R EC E P T/ 00 T L ET � 1 S T 2 0 EA , , 7 S 1 S. 0 0 permillor[onSlmctianarrtq0i�i[ationirOml�eArtOuatilyManagemen10i5tnc1.Ne5i0enlialrAnSlmc�ianaDUlica�ion5areexemp�irom ELE 22 FiECEPT/OUTLET ADDITI�NAL EA, ,45 9,90 mescom�isions. ELE 12 RECEPT/SWITCH ' 1 ST 20 EA, .75 9.00 oate: noo�icant: � END OF FEES � �' w1 I hereey certify mat I nave reatl mis apd��an ano state that tne aUwe information 6 correa. I aA�ee to wmpty vritn a0 uly antl coumy t�• � '� tl ordinances antl state wws relating ia buneing cons�mctian ana h¢re • awnorrze rev��nutives ol tNs dty �o enrer upon ine above�memionetl � � � �� pmpetly for in50ec�ion purposes. �p �ate'. Signaiure: IYIAY � i� Orrver's Lic se or So ial Secunry M: t6<646 W�ne—Buileing: Green—CoEe Enlorcemen�; Canary—ApplicaN: Pink—Revenue: GolOenroO—Asseswr CITY OF C�STA MESA 1 , CONSTRUCTION A(HD PLslNNING � APPROVALS Permir� 1, Temper^ory EIeC,rical Sarmc;�iPole Date 2, $oJ Pioe�Undrgrnd. �`�. �_EI�.C-�f�ci_Ci,r�_,•'t Ut:q!Y�UMi:arnll. _ - ' 4. Electnca�� Canau4�Undrmrd. I � 5 S. .I R,::�+c�c�ment -- G. E:�cV�ca: � :R G;�id 7. Fuot�ng,f----- ---' r-----'--- � 6. F�.�-��t,a�� - I9. 1'.�ter Pipv.Vnd�c nd, ' �10 Structural Fluur System -=- --- -- ----_ 11. �' oDe�:y ;.;.�• �,r.�, d Hou�r. Conarct�on - � � 12. S�,:r:ar Cnn �13 r•,un'7ra�n5 I '�4. Ro�qh Pl�r�i��n3 - rt5 Rn�_igh E�cctr;c��•Con6.�t � '6. Po..�h:lee'•�el':�"•3 I 17. R�u;h 1^,'�ri�� S�gr � Inspector P00 L ,PA APPROVALS Permit ;� 52. Pool & Equipment Locatron 53. Steel Reintorcement 54. Forms � I 55. Eleclrical Bond•ng ��-�� SG Roc9h Plurt,bing !b Pr,;sswo T�.r;t -I ' 57 APPROVAI. TO CO\�ER�GU��TE 50. Electricai Cor.duirUrdrgrnd. 59. G�5 PipU. C7 UnJrEn�u., Teat Datu I Impec� _.�� _--+� I i --�_, �- � E0. Eae!;wash l�nes, P�Trcp, C7 Undrn•^d ,_ �61. APPROVAL TO �ECK � 62_ El,;t:coidah & HCLB�Pur�Fi�,31 � i ! 63. Haatcr �i Vent-Fin;.i � 6i. Plumbing System � F�nal 65. El�ctrical•Final 66. Solar SVstem-Final 67. Feneing & Accdss APP�oual C8. APPROVED FOR PLRSTEFIt:,; � � 18. iiouyh Electrica6T Bar Ceding B��Qi/ `�e' \ 69. POOL(.`iPA SYSTEM1BS fINAL 1 � � �� -�' I- ^^.,_-� H�ati�.g & Ai '(�^r�';.Or.irg 7 � fIRE DtPT. REQUIRE.YEN"i I �1 :', � . F_�.a�y. F:•m,'acz � � � APPROVALS Prrm�t =` -_-_ ' r� -- -- ----- - -- - --%-- ' i '. � v��s, �n Stn ctc'� � '0. Underg�pund Hyd�o ' i � �7. i;.�.'�, V, nt,l�tui i � -4----I _-- -- - b - - � /i. Product P�ping [ i Ga. �J Oil _ �','L . n p,.�p�..ah c: T^sc � 4� /2. Underground Flut � � �- - - - -- - - -� - ----I -- -+---- � - -- -�--- -�--- ; I7i� ."�±�^.,»�'�9 � � 73. Urtdergmd.Storao._�ia�lc('G;+� -.0�. , � I-_ _, _r __ _ _ � _ _ -_ __ _ _ _�. _ -_" �� '-iu-.�.>>._t'"1 --__ _ __' I 74. �eerheadHYciru _-_-_ __ li � L- ---- -------- � - - -r-- �-- � ?R. ; �t:�r C^�linr� �Structu•ail E ii n �ocoat � ��5. Dry Chemicdl _ -- _ _ -- 1 - ._ .__- _-�-- 'Ij � 7;. ��arc:in�� F:u n�ng _- __ _'_- ____-_ 'I ___ _ , 7h. Dry StandpiPe � -_ I_--_.� . ____ __ __ _ -._____ _ _ _ -I- _ _, _ _._ '__ ' _.-- -- -__ _ _ _ 1. ____ , �%F. .�tm-.; ;�.:� d-.a - I --- - r--- i 1i. FI::ED SVSTEt:' F;`.A�. - T- � � -- ------- �-----�- ------------------�-----� i�..^ �...�:• c� � � � 78. FIRE PRCV. F��'AL . � i -- �--'- --- -------- ---- ---i----- -�-- -- -- ). �;yv�aL' .2a�lmq I I HGALTH DEP'i. RtOUIHEiv�ENt i �J,-_ _-=-�-_-- -�----- - -- --- -- - -- - -- .. -�------ 3i, r� :. B.�:� ��,�t r 79. FIfCAL INSPECTIC': I - }-- -- . I-- � ." . � _� -, P, • �^ ': �te� F.ra' - - - � 'i n0. FOOD CEHTiF ICt.' F �5_i,.'� J I r____ -___ -__ __ .+'_ *_ _ p n�p-� 'l L_'-_ , � 73. �:i�lEio�(riG i �.��.f�(!_/��"`�-�! - _ -� `/�� J ---_ - -- - .� - , � i , ot�5: < < �LL - �- 6 r�4. F •�.�t Ifect�n� "'� A�. Ca^ilrt�o��"g� . -( -- --- - ----- - -- -- � 35. F��s! Ga: P�Pe�Tc;: 36. t�ood or Canopy 37. F,nal Factory Flr.piace 38. F�r.al Plumb�ng 39. �Jater &nrvica�Finzl 4Q Gaz Serv�ce.Final 41. Soiar pomcsticFinal 42. Bacictl;,m� Prevanter •i3. a: c::f,c:. Irr:�a?:�n I 4:. Lardsczpe I�riqation System L�-- -- d5. Sound Attonuation 46. Nandicap R�gulationt __ 47. FIRAL STRUCTURE & oUILDIMG 42 f-INALP�_ANiVI\G 49. �lec-rc R:!.ase to Etlieon 50. Ge: R:•te.,sc to Southern Califomia Gas 51: CERTIFIC.� � E Of- QCCUPAiVCY t�o _ Date _ � ------------ -- ------- �� ____ _ ._ _ _____- _ _ _ _-_-_ _ _ _ '. _ _ -_._.__-___._-_ _ ____- . • ----------- --c ------ + ----- - - - ;---^--,J ----- -- - -- - - ----=---r- t -------- . `.--:: 1 � � ------ !.` � � I� PflOJELT ADOHESS: B!� 1 w 1[� TH $7` -'OWNE'MS NAME: TRAIII W�N PAUL A nooRess: 536 AURO{7A FL REDD'ING, CA. 96001 646-3679 FflCHIENGINEEP: ADDXESS: flEG.NO.: u"iT: CITY OF COSTA MESA - B[lILDING PERMIT PERMIT NO; B 057267 PLAN CHECX NO: N CONSTRUCTSON TYPE; PERMIT TYPE: STR UNIT: PEPMITTEE: ROSS t; BARRUWS INC. ( 71 4) 557-7440 aooness: Z60 B, ALTOIJ AV --- SANTA ANA CA 92707 UCENSEO CONTNACTOB OECtAflATION: I hereby afhrm that I am licensed un�er Omvisions o� ChaO�er 9(commencing wilh Sec�ion 7000� ol �ivision 3 of t�e Business and Pm�essions Code, and my license is in full �orce and ettec�. CITYLIC.:OZO92g4 STATELIC.:3z'j,ROZ cuss: C--39 -' o1 ��. Date: �—G �` /�-' Signa�ure: �I /�" " _ _ �� WOBKEBS' COMPENSPTION DECLAIIATION: I here�y aflirm thal I have a cehibcaie oi consent �o seli-insure or a certi�icate o/ Workers' Compensation Insurance. or a ceniliea copy t�ereot (Seciion 3800. Lab. C). POLICYN0.:6O6S3S.'yI. EXP.DRTE: O%�Q1�92 COMPFNY: STATE FUND ❑ Cenilietl copY �s herehy WmisheA. � Certi�ietl copy is tiled wi�� Ihe ciry BuilOing Division. ` oz�e: :� -G '%2 noorcznc `�-�j-•-_�-e.e�s-�-� . E%EMPTION FflOM WOPREflS' COMPENSATION oECIANRTION: Qhis section need no� 6e campletetl if �he permit is �or ane hunOreA �$1 W� or less�. I cetli�y Iha� in I�e pertormance oi ��e woB �ar which this permi� is issuetl, I shall not em0loy any person in any mannet so as b became sublec� lo �he Workers Compensation Laws ol Calitornia. Date: Sipnamre: NOTICE: If. afler making tnis aeclaration, you shoultl become su6iect b the Workers' ComDensalion pmvisions of tAe Lahar Cotle, you must �orthwi�h com0ly with such pmvisions or �his permi� shall be tleeme0 revoked. CONSTBUCTION LENOING 11GENCY: I hereby aliirm ihat there is a constmction lentling aAency lor Ihe pertormance ol ihe work br w�ic� �his permit is issuetl (Sec�ion 3097, Civ. C). tENDEN: FOONE55: OWNER BUIIUEB �ECIAflATION: I hereby affirm ihat I am exempt imm the Conttactors' State License Law for the following reason (Seclion 7031.5 Business anU Pmlessional Cotle'. Any city oi coun�y which requires a permit �o conslmc4 alter, impmve, demolish, o� repair any 51mcWre. prior lo its issuance. also requires �he applicant �or 5uch Dermi� �o lile a signed 51a�emen� thal he/she is licensed pursuant �o Ihe D�ovisions ol 1he Contractors' Stale License Law (Chapter 9 �commencing wiih Section 7000) a� Division 3 0� ��e Busineu antl Pmiessions Code) or Iha� �e/she is exempi ��ere�mm an4 i�e �asis for the allegetl exemption. Any viola�ion of Seciion 703L5 by any applicam �or a De�mil suble��s Ne applican� to a civil penaliy ol not more �han Irve �unJreO Oallars (5500). I, as owner a� Ihe pmperty or my employees wit� wages as their sole compensation, will tlo ��e work, and the ❑ simc�ure is not in�enaetl orofleretl tor sale (Section 7044, Business and Pmlessional Cotle: The Contracrors' State License Law does no� apply �o an owner ot a pmperiy w�o 6uiltls or improves Ihereon, an0 who tloes such work himSelOhersetl or �hrough his or �er awn emptoyees, pmvidetl ihat such impmvements are not inten0etl or ofiere0 br sate. Ii, however Ihe builtling or impmvement is sola within one year of completion. ihe owner will have Ihe Uurtlen of pmvinp he/she di0 not bui10 ar improve �or Ihe purpose ol sale). I, as owner of the pwperty, am exclusively canVac�ing wi�h licensetl conlrac�ors to constmcl Ihe prolect ($ection 7044, Business ❑ antl Pm�essions CoOe'. The CanUacbrs' State License Law does nof aOPly �o an owner o� pmpe�y who builtls or impmves thereon an0 w�o contracts for such pmlecis wi�� a contraclor�s) lic¢nse Oursuan� �o ihe Contractor5' S�a�e License Law�. I am aware ihat proof of their warker's Compensation insurance shoultl be pmvitlea to me. � I am exempt unaer Semiort B. 8 P. C. �or Ihis reason: Da�e: Owner I tlo hereby cerlity ihat I am aware ai antl untlerstand �he requi�¢ments of Cali�ornia Heal�h ane Satery Code Sec�ions 25505, 25533, an0 25534 antllhatl or anytulure builtling occupaniwill/will not�circle one) nee0 lo wmply with said state coEes and the reQuiremenisior a permit lor conslmc�ion or modifica�ion fmm �he Pir Oualily Managemen� Dis�nc�. FeSideniial cons�mclion applicaiions are exempt imm ihese pmvisions. Oale: Applicant: I hereby cerlilytha� I Aavereatl Ihis applicaiion antl 5ta�elhai Ihe abeveintormalion is correcL lagr¢e lo comply with alltily anA counry ordinances antl slatelawsrelatingta builaing wnslmciion and here�y aWhorize reDresen�aiives o��his ciryio enler upon�he a�ove-men�ionetl pmpeny far inspec�ion purposes. n �'�(�' O` - , � +Oa�e'. � �G -�2 Signature:�/Q{��-'nX(�/"`"�^�'� 'i oriver's License or Social Secu�iiy p: 1641-a6 Whne-Buildino', Green-Cotle Enlorcement: Canary-Aoolicant: Pink-Revenue; GOldenw0-Assessor JOB DESCRIPTION CLAIM VALUE; T/OFF CANOPY ONLY 7,000.00 CALC-VALUE: PERM PdO; H 05726 i GOVT: N SUPP; N PURPqSE: ALT SQ.FT; 7,000 7,000,00 GRC�UP OCC: B-2 / COMMENTS; REROOF ENTIRE BLDG W/ BTJILT UP *��*�**��r�-**�*��*�+r+��r***+e �x �***x u*�***�**�#�x**�***�v��*�r ��c�x-�***��x� ��-��+�r�x�� Z O N I N G R E Q li Z R E M E N T S . sErBacxs ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT; FT : FN REAR: FT IN FRNT: FT IN REAR; FT IN LErT; FT - IN RGHT; FT IN LEFT; FT ZN RGHT; rT IN PARKING RE • FROV: PARCEL: 42419107 ZNE; REF NO: PLANNING N 'FE5> ? l' • 3f if� i4 �lE if It 3E �lk if iE if jF iF iF # 3E iE if iE �1E ih 3E iE # iF iF-1e jF if� 1F iF iF 36 �lf iF �F jh it� M IF iE iE if li� i!� iF iE-lF#- if iE iE 3E # ii� 3f if fE �lE 3F iE if iE 1E 1E 1f if if if )E # 3F iFif if jF IE 3E �k 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 n'N��' S _- . � `LONING AFPROVED BY DATE: 1 BUILDING APPROVED BY ;_ __ APPLICATION I3SUED BY• ifjFjEiE�Eif3fif�iE�lE�Eifif�)fiEif#`1FiE3E�l(� ... , rc r ..�r ... iE iE IE jt if it fE iFit iE jf # 3F iE iE t� iE iE iE 3EiE if iE it iF �E # 3F ih * jf �F 3f if 1f !E iE iklf� LEGALIZATION;t3 F E E ,S� r BLDG FNT PLt7MBING EL PERN;IT 40,00 ��_ _ DATE: �• .• DATE: �O:S��'7� �r fe r x �lE iE k#?F if a(-a( 3f *'iFlF�i7�ir 1E �lf iE �f ih it iE iE iflh 3t if jE if ii�-%if� le If �1f 14 iE i'r !f N� !F i 3(-�i(•,iF,�f dE �f 3E if 3E �(- ik 3C� �}t� M M A R Y STRUCTU�AL ScGN,ENT:Y �� MECHANIC FIRE SMIF'✓,RES GRADING U Pi.AN �'. �r SMTPINON-RES ISSUE FF..E ✓ fi `_ 1. 47 BUILDING-DIV-> PERMIT ISSUE PLAN�CHECK TOTAL PAID DIJE TOTALS----> 91,47 O.UO !.= `;� 0.00 91,97 91.47 .00 7. ✓ �1 REVENUE DZVISION TOTALS--> COLLEC�rED; 91.47 OVER/SHORT: 00 $LD9oPO�T FLUMBiNG ELECIRIC MECHANIC FZRE SMIPiTOi GRADiNG PLAN-CHECK i+�, iE iE 3E* 1F if IF �F �E ie if fF iE iF 3E iE �F ie iF iE iE 3E 3E�� lE 3F iPiF dE 3f �E iE if ii� 34�E �F i6 iE iF iE iE %� jt if ie iF iE 3tiF # ie iE j't iE iF 7F iF if iE iE-IE 1E 3F iE 1F !i iE � 3e j'r 3?� 3i?f i� �F if?E iE I N D I V I D U A I, �F E E H R E A K D O W N TYPF.. QTY D E S C R I P T S Q� N�� UNIT CUST TOTAL COST /N SFC 7000 REROOF BY VALUE CU�ERCI,AL hU20NE 1.00 7,000.00 'E, D'�OF/'r'EES i'' •' ''! i � L. : t,S r1 �r �'�/`'�h� ,a� f 1 �"�� °I JG�.74',.m-C�1lY�0-'. -- --'- � / ��:' . ', . . + = , _, _ � : . � � POOL & SPA , CONSTRUCTION AND PLANNING i APPROVALS Permit # Date Inspector qppROVALS Permit # Date I�spector �• �1. Temporary EleCtrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement . 3. Electrical Conduit Utiliiy-Undrgrnd. 54. Forms 4. Electrical Conduit�Undrgrnd. 55. Electricai Bonding 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test 6. Electricat UFER Grnd. 57. APPROVAI TO COVER�GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation � 59. Gas Pipe, � Undigrnd., Test � 9. Water Pipe-Undrgrnd. � , 60. Backwash Lines, P-Trap, O Undrgrnd. � 10. Structural Floor System 61. APPROVAL TO DECK � 11. Property Sewer Line & House Conneaion 62. Backwash & Receptor�Final 12. Sewer Cap - 63. Heater & Vent-Final . 13. Roof Dreins 64. Plumbing SYstem - Final 14. Rough Plumbing 65. Electrical-Final - 75. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wirin9 Si9^ 68. APPROVED FOR PLASTERING 18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAI 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Facto�y Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil 23. Gas Pipe�Rough & Test 72. Underground Flush � 24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof $heathing 7v � C�l Q �IRy �y/F% 74, Overhead Hydro 26. T�Bar Ceiiing (Scructural} & Monocoat 75. Dry Chemical 27. Freme and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAI 30. Drywall Nailing � , HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION , 32. Electriwl Powet Meter�Final � 80. FOOD CERTIFICA7E ISSUED 33. Final Electric Notes: /% /f �A�� ,,/ .�G i /! � O� o°!=Q✓ �' �LW? Y! �J_� AI_il J/� 34. Final Heating & Air Condiiioning StG �J � Cw�t.� B�- /_�a � F.� 35. Final Gas Pipe-7est � . � �/7_�p-L 36. Hood or CanopV ''� : 37, Final FattorY Fireplace . ' 38. Final Plumbing 39. Water Service�F�nal 40. Gas Service-Final 41. Solar pomesticFinal - . - 42. Batkflow Preventer 43. 8ackilow Irrigation 44. Landscape Irriqation SYstem 45. Sound Attenuation 46. Handicap Regulations 47. fINALSTRUCTURE&BUILDING �.� q� /�/ 48. FINAL PLANNING 49. Electric Release to Edison 50. Gas Re�ease to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY �lo, Date PNOIELT RDDNESS: S Q S W 1 9 TH rJ T OWNEH'SNRME: VERA HUGHES nooness: 1617 WESTCLIFF DR N.B. CA 92663 714) 646-3679 ABCN/ENGINEEfl: AODflESS: PEG.NO.: uNiT: � UNIT: PEflMITTEE: STURE DAVIDSSON (719)645-2390 aooncss: 1821 KINGS RD N,B, CA 92663 LILENSEO CONTBRCTOB UEGtAMT10N: I IcereOy alllrm Iliai I am ticertu0 unCer D«ons 01 ChaO�er 9(commencinp wilh Seciion 7000) ol Drvision 3 of �he Bus�ness arM Pm�euions CoOe. an0 my license is in full torce anC efiect. CITY LIC.: STATE LIC.: CUSS: . Oate: Signature: i WOBKEBS' COMPENSpiION OEClABlIitON: I nereUy aflirm tAat I nave a cenificate af cansent to sell�insure or a cenilicate oi Workers' ComOansaiion Insurance. or a cetlilied Copy �hereo� (Section 380p, �aG. C�. POLICY NO.: E%P. OqTE: COMPANY: ❑ Ce�ifieE coOY �5 hereGy fum$�ea. ❑ Certitied copy a fif�d mt� fAe dry Building Division. � Date: Ap0licanl: EXFIAPTION FFOM WOPlERS' COMPENSIITION OEClAMT10N: (itis E¢ctpn Me0 not Ee mmp te0 ii tAe ' w huMreO (5700) a less�. 1 certity thal in ��e pedorman[e ot Ih¢ wOrk Por wNCh INS p¢rmii rs�ue0. I 5 ¢mp ry any perso in any nner 50 a5 i0 0¢cOme 5u0iecl �o I�e Workers fAmpensation LaxS of Califarnia. Daie: _ " SiAnature: NO71C : II, aftei making t�is Geclaration, you s�oultl Eewmp suCject m t�e rs' Ca pwvision5 0� lhe Lahor Code. you must lonnwiln compty wi�h such provisinns ar this permil shall be aeemetl revokea. CONSTHUCTION LENDING FGENCY: I her¢Oy aflirm Ihal ��ere i5 a tonSlmtii0n IenUing aAenCy for Ihe Oeharmante a� ��e work �or wnich Ihis O¢rmii is i5sued (Setlion 3W7, Gv. C�. LENOEfl: RODflESS: OWNEB BUILOEB UECLAPRTION: I �ert�y aflum tlut 1 am eKempt Imm t�e Condactors' State License Law lar tM idlovnnq reason �Section 703L5 Business an0 Pro�essianal Cotle: My city ol county w�icn repuires a Dermil ta wnslruci. alter. impmve. Oemolish, ar r¢pait any Slmtiur¢, pnor to ii5 issuante. also rcpuireSlhe applirjni Iot SuU Dermi IO lile a vOneO Slatemeni (Iui �alSAe is li[¢nsed pursuanl to Ihe pmWsians ol l�e Cantratlors' State License Law 1Cnapter 91�mmencinp vnm Sec�ian 7000� oi �ivisian 3 ot ine Business anE Pm�essi0n5 Cotl¢) or I�al he/5�e i5 eeempi I�ereirom antl Ihe Oasis �or I�e alllqeG exemplion. Any vi01ali0n 01 Setiion 9031.5 Oy any aoolicant for a permi� su0ietls Ine applicam to a civil penatty ol no� more �han live nunCrea dollars 13500�. I. as owner al Ihe pm0eny ar my employees �t� wa➢es as t�eir sole cam0en5atian, wi0 Ea Ihe work. antl itle ❑ s�mcmre is no� intende0 or offered for sate (SecUon 7UA4. Busmess anA PmlesSionai Cade: T�e Conlractors' State Licensa law aoes noi aooM lo an owne� al a D�openy wla �WIUs or im0�aves iherton, an0 wM Eoes such work himselflherull or tAroupn �� his or her own emploVeeS, ptOvided l�al Su[A impwvemenl5 ar¢ n0i inlentle0 or O��ereA lor Saie. I�, AowOver Ihe CuilAinA Or improvement is soltl vntltin one year of rAmpleti0n. tirc Ovmer wiu luve the Euttlen of O�a�nO ��e ai0 nat buile or imD�ove lor Ine purpose ol Sale�. ❑ I. as owner oi ine D�openy, am eMtlusiveN cantraninA �� licensea cantractors m wnstmct t�e pmlect (Sec�lon 70C4, Business aiM Prolessions CaOe: T�e CmUactors Sute Lice�e Law pces npt appry to an owner ol properry who OW0.5 ar improves lnereon anE who tonlracl5lor SUCh O�oletls vnfh a tonlraCloqS) liunsc pur5uani Io Ihe Conirat�ars' Slaie L¢CnSe Law). I am aware I�al pmol ol I�eir WOAer'x CompeMation insurance stqul0 Ge provitleG to me. �f i am e.empt untler Sec6on: BP704 4 B. d P. C. ror inis r/easoo: OWN.ELR—bUILDEA Oa�e: _D "'� � S T Uxner. I ao nereLy cenAy Rul I am aware ol ana untlerstana tne requirements ol Calibmu H¢alih ana f ' S505. 25533, an0 25534 antl I�al I or any IuWre OuilGing occupant wilVvnll not (nrcle ane) neeG to com0�/ ��h SaiA staie cOGes antl Ihe reQuiRmenis br a perm�l lor conslmction or rtpOdicali0n imm t�e Nrauabiy Manaqement OiStrict. fleSiUentul constru[tion apDliWtims are eMempt imm IMse provisions. Date: MD�a�� I h¢reGy tt�lily I�ai I have teaE ��is a0�litdGon an0 Sla�e Ilui I�e aCove inlotmali0n i5 C rret�. I a HP'Coq�D�Y w��h all Ciiy an0 COun�y orAinancesanas�atelaw5relatingtobuildmgconstmctionanOher m�oriter resentai+esoitni irytoenA uponlOeaUave�menlioneE pmpetly for in50re��b^ Du�poses. �alel _ti/ �u � � �— Signaiure: _ �rivefsLicen5eor5ocialSecuriryx: 16a1�E6 W�ne—BuilEing: Grea�—COde EnlorcemenL Cdnary—AOPIiWnL GolOenroE—Asseswr CITY OF COSTA MESA — SIGN PERMIT , PERM NO: SB •067632 PERMIT NO: SB 067632 PLAN CHECK NO: 02196-94 S GOVT: N SUPP: N CONSTRUCTION TYPE: V—N PERMIT TYPE: STR SIG PURPOSE: ALT JOB DESCRIPTION : CHANGE SIGN PANEL E CHANGE NAME SQ FT: CLAIM VALUE: 75.00 CALC—VALUE: 75.00 GROUP OCC: B-2 / COMMENTS: ONLY CANGE OF SIGN PANEL +t��t�u*+r�ttF*at*�racx.*�rw*�taE**�--�+r***+�+r�c�rr�ar+t�-��t�at�r*ar�t��wait�t��t �tit�t+E�r�tx�af�+t�c�tiraF+r#n+ea�*+t-�t�it*�**** S I G N I N F O R M A T I O N DISTRICT; 1 TYPE; WALL ILLUMINATION: INT CATEGORY: CHA DZMENSIONS: 2FT OOIN X 6FT OOZN AREA; 12.00SQFT LETTER HT: 14 IN STREET FRONTAGE 1; 472,50 STREET 1: W 19TH ST STREET FRONTAGE 2; 0.00 STREET 2; PARCEL: 42419111 ZONE: S1 LOCATION > FRONT: 3t REAR; HUSINESS NAME: HOUNG DAVIDSSON DDS > LEFT; RZGHT; O T H E R T O T A L S G R O U N D S I G N THIS ACTZVITY . 12.00SQFT OVERALL HEIGHT; OFT,.OIN THIS SITE . O,lOSQFT GROUND CLEARANCE: OF'I'. OIN ITEMS OF INFO 1 PLANTEA AAEA: O:OOSQFT ITEMS FOR ACTIVITY: 1 HLDG SET BACH; 20FT , COPY VERBZAGE ; DENTISTRY PLANNING NOTES: PSP ZE-81-27 INCLUDES COLOR RESTRITIONS— � if if ik iE if iE iF iF if iE if ?F iE 1f i! iE jE �t 1E �f if �R �E iE iF k 1E ik i! iE ic it 1E if if iE 1E if k 1F iE iF iE iE 1t if if if iE iE M iE if iE if aF jF jf 1E iF 9E jF iR if �lf �t iE iF jF,�M? iE if IF iF if 1F df 1f M D E V E L O P M E N T S E R V I C E 5 R E Q 0 I R E M E N T S ZONING APPROVED BY :��/�r� DATE: _6 �� HUILDING APPROVED BY : V/M',+y`�� DATE: �_ � APPLICATION ISSUED BY; C./V�� DATE: / %S� ��I-- itit*iF+t*it****it*��tit;tia**if*i�F�'i�iF3'FiF�FSF7F�F;'FS�3F�r'*�F�r:FiFiF'�FTr�Tt�FTc+r��tiF'i}lF*it***�r*+rfc(J�r* � �i�� LEGALI2ATION;N F E E S U M M A R Y STRUCTUR�L SEGMENT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC PERMIT 15.00 PLAN ISSOE FEE 9,75 SIGN SMIP/12ES GRADING 10.00 SMIP/NON—RES .50 HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 25.50 0.00 9.75 35.25 35.25 .00 REVENUE DIVISION iOTALS--> COLLECTED; 35.25 OVEA/SHORT: 00 SLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMZP/TOT GRADING PLAN—CHECK 15.00 10.00 .50 9.75 �it#�*�r�r*��itir�**�**�r�r+r+t*�**+t*�r*+��r�rxx*�r�eir�r�r**�**+r�r+�*****�r*�r*�r*+r*�x*�r?r*ir*+txrtx*r�iF# Z N D I V Z D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST NO FEES WERE SELECTED FOR THZS PERMZT O1 D016?336-00162389 T O T 35.25 DATE: 06/16/94 TI11E: 15:22 CONS7RUCTION ANDPLANNING - POOL PA APPROVALS Permit �€ Date Inspector qppROVALS Permit # Date Inspector 1. TemPorary Electrical Service or Pole 52. Pool & Equipme�t Location 2, $pil Pipe�Undrgrnd. 53. Steel Reinforcement 3. Electrical Condu�t Utility�Undrgrnd. 54. Forms 4. Electrical Conduit�Undrgrr.d. 55. Electrical Bonding 5. Steel Reinforcemenc 56. Rough Plumbing & Pressure Test 6• Electrfcal UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7. Footings 58. Eloctrical Conduit•Undrgmd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Tes[ 9. Water Pipe•Undrgrnd. 60. Backwash Lines, P�Trap, O Unclrgrnd. 10. Structural Floor Svstem 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final 12. Sewer Cap 63. Heater & Vent�Final � 13. RoOt Drains � 64. Plumb�ng System - Final 14. Rough Plumbing 65. Electrical�Final • 15. flough Eiectrical-Condu;t 66. Solar System-Final t6. Rough Etectric W1rt�g 67. Fencing & Access Approvat 17. RoUgh Wiring Sign 68. APPROVED FOR P�qSTERING 18. RoUgh Electrical�7 Bar Ceiling fi9. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. 17EQUIREMENT 20. fiough Factory Fireplace APPROVALS Permit # 21. DuGts, in Structure 70. Underground Hydro 22. DuGts,Ventitating 71. ProductPipingOGas ❑Oil 23. Gas P�ae�Rough & Test 72. Underground Flush 24. RoOf Framing � ' 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar CeAing (Structurap � Monocoat 75. Drv Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 76. FIflE PREV. FINAL 30. Drywali Nailing HEALTH DEPT, REQUIREMENT 31. Piaster Brown Coat 79. FINAL INSPECTION 32. EleCtrical Po�ver MeterFinal 80. FOOD CERTIfICATE ISSUED 33. Fin2� Electric �� Notes: 34. Final Heating & Air Conditioning . �� 35. Fina� Gas Pipe-Test ' ' ." � � � 36. Hood or Canopy ' 37. Fine� Factory Fireplace 38: Fioal�Plum6ing 39, Watar Service-Final . 40. Gas Service-Final 41. Soiar pomestic-final 42. Batkflow Preventer 43. Backflow Irrigation � 44. Landscape IrriGation System 45. Sound Attenuation 46. Handicap Regulatio�s .� � � 47. FINAL STFUCTURE & BUILDiNG Q�yIZ _/�/i/� � �� V f Vs w 46, FINAL PLANNING 49. Electric Release to Edison ., �� 50. Gas Release to Southern California Gas Co 51. CERTtF4CATE OF OCCUPANCY , . . No. Date y, \ _,. � _� F� � �-�p �� _,, �'. �E'a�,`_a � FI� �a`] v�� C.0 � COSTA MESA BUILDING DEPARTMENT �'- �� "` FE8 1a �g�� P. O. BO% 31] COSTA MESA, CALIFORNIA ¢��fANCE DEPT. FOR APPLICANT TO FILL IN �APP FIC�ATION�FOR PERMIT ADDRESSc� , � S? • BUILDING . COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY S RECEIPT NO. PERMIT Nq� OWNER , uG 'c ci � o S MAIL RECEIVlO BV�� 04TE RECEIVED 01TE ISSUEO nooRess I>G �'r -��... ��.., /-i�a^ . ./��Z"a� �_/�-\� �-i/_ -S � LEGRL LOT OESCRIPTION N�, � � A.P. NO. �� {� — Q 3Q `� SIZE / 1--7 r / TEL. BUILDING NO. ApDRE55 LIC. No. COSTA MESA, CALIFORNIA FIRE ZONE CITV LIC. � S^ �ONe / pOq�os TYPE �(� NO. G • �TNO�/- • 2 B�PROVED DATE �4G�4' M� L CORRECTIONS � � INO.OF BLOGS. NOW ON LOt SETBACK f.INE FflOM ^ � ccNlen or sin[[i e� 6 a REAR YARO SIDE YARD�S RIGHT.Z.��! LEFT � DESCRIPTION OF WORK Laa/v�:- o� NEV ALTERATION qOOITION REPAIR MOVING IDEMOLISH BUILDING NO.OF SIZE � ROOMS STORIES E%TERIOR W L AOOF /�/ COVERING ��U GL L) COVERING� rJP USE OF NE'� � � �i � � CI7Y Q�'<:':'TA n�tJ�H 6`E€'T' SUBJ"tC7 TU � G. DEV'T. REG. r I HEREBY 4CKNOWLEOGE THiT I MAVE RE/�O THIS RPPLICl�TION <Np %��`JI!�'/`ci�� " STnTE THqT THE I��OVE IS CORRECT ANO PGXEE TO COMPLT WITX PlL � jj , . CITY OR�INPNCES �1ND STRTE AWS FEGULATING BUILDING CONSTHUC� L/ T�o�, ypLUATION �.� SIGNA OF PERMIT FEE S�3� � PERMITTE '�' e_�� JPLAN CHECK S 5 �J? AUTHORIZED AGENT TOTAL FEE $�JJ ��tQ �� y . . . ' :" �' -. _ i�ixr�„ `T� � ��'r; _..a i;. �i��LEI� �oSTA Q , _ . l "fiVZ9-57i�uesa'1AZa �***59.�� COSTA MESA BUILDING DEPARTMENT � '�i �S� P. O. BO% 31] COSTA MESA. CALIFORNIA � FOR APPLICANT TO FILL IN APPLICATION FOR PERMIT ADDREI55 �Y J ,�� BUILDING COSTA MESA. CALIFORNIA FOR OFFICE USE ONLY ' . �. . l . _�_ _ _ . _ RECEiPT NO. � EMMrt/N� OWNER MAIL nooRess �AFCHITECT IOR E�" VEER CONTRACTOR ADDRE55 �� ece� LOT �[ DESCItIPT10N NO. A.P. NO. I J�+ Q30 SIZE OF L /z � TNO. � �- y( ^ BDD EI55 / � � r9 �� LIC� �� COSTA MESA. CALIFORNIA FIRE � i ZONE NO.OF BLOGS. NOW ON LOT $ETB4CN LINE FROM c[rvi[A oF srn[[r �«� REAR YARD j p SIDE YAFD L f RIGHT �/ G LEFT DESCRIPTION OF WORK NEW/ �if/ ALTERATION IADDITION REPAIR 1�OVING I DEMOLISH BUILDING / ,s, � NO.OF SIZE (O � v U ROOMS � STORIES I COVERIINGWALL,._ L- ROOF "j�� /% (.yrr�� COVERING /!/- �OY�� USE OF NEW � TR %� .-I% iU n L.. .� '/ I � PL1N5 �� ` APPRO E T• / BY dJier. , OATE CORRECTIONS C1TY OF '` �( -� . / tl�C/� � " . 5 �t � ` � • -/+/ uw� ti.�� '% I HEREBV ACNNOWLE�GE TM�T I M/�VE READ TMIS 1PPLIC�TION �NO STATE TN1T TME ABOVE IS CORRECT 4ND AGREE i0 COMPLY WITM 1LL CITV ONOINANCES AN� STGTE L<WS HEGIlL4TING BUILUING CONSTFVC� �� iloN. � VALUATION SIGNATURE OF RMiT FEE S PERMITTEE �/ �J�7� PLAN CHECK 5 5 (i, � �c� AUTHORIZED AGENT TOTAL FEE $ � � . �od.