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Home My WebLink About887 19TH ST - Building Permits.. _ =+.p_: , . ?�: :�'n:: - .. __ _ . - � ,. . :;�,;;�: ,r � � . . �, <7 '.v:� c:� r`o � �t Syi ,i�i ..3 �pT^tiMR'�A � ��A 'S'" rr�'�.^�u " iz ;��; � � �='", - - - - ��`� �"=�`,y} . . . . ". . . _ .:. .4Ti4�104 .�� - .x ,,� `J � �r= :°�iv �^n��,.�:� w :F '� f r.' .;u;p A � 4( K 'yy�.n - �4k'r� ��/.�+i'� Z��R. f�[y"\ ti iS `C . . . . �.Y'� J+:.:S�'i .. '�` +,�'�k '."i".'�s� . . - -'`' ::ii:s-: . . .. '�:J.;. M1. , , Y4::` r�j . ' . ' . "' q_i `F _ : �,�`r;': ,; �d7 >J IqTa s�. I` i :� � s ' � 's� —B24 6 Trash Encl. & Blod: Wal ' � ��/a� s3zzo.00 _J � ��-. B/2�425 PC fl106-86a $80,000.00 — �I/��9na11 Camercial Shell __ _� �� —E24449 Te� Constr.. Pole — .. �7�//��i' �a j � ��_ ', P24538 82425� — i � I//zs/�� ; � �� f E25�3� B24255 �{' — �>/ ' �� 'd - � � 549�r & A/—� ,��,'� _... . _ // /B-3'd ; �� _ ._ , E a7r39 ��a1�7 � SBE 449 unit--_ � PC#15 - $ Wa 1 ign — :� � _ � � _SB45444 PC#2006-895 Sign of posts ��c�'� — �� 1 �' `��e��.,. �.��Y � - . . �' 4:.4-�v � . :i':r..�':'. .. ' .. � f.S:}'•'� . .' . i".,: (714) 754-5273 • Fax (714) 754-4856 � Job Address: 887 W 19TH ST Suite No C Vicinity: Parcel Nunmber: 42419103 Applicant: MACIAS, FELIPE Address: CITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Owner: BISHOP, ANITA LYDIA TR Address P O BOX 2341 WRIGHN/00D, CA Contractor: Address: ArchlEng: Address:. ISSUE FEE Backflow irrigation BackFlow Preventer Bathtub Clarifier System Connect Qce,Soda,etc) Dental Units Dishwasher Drain, Floor Drain, Rainwater Drain, Roof Drinking Fountain Expansion Tank Gas Earthquake Valve Gas (1-4 outlets) Gas (Over 4 outlet5) Gas Repipe Gas Service Interceptors (Grease, Oil) Interceptors (Sand Auto ) 4 PLUMBING PERMIT Phone: 949-fi42-2638 Zip: Phone: 2ip: 92397 Phone: Zip: Licanse: Phone: Zip: License: PERMIT NUMBER 11. 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: SCOPE OF PERMIT 1 FLOOR SINK, REF B99-01527. UNIT C, ARCOIRIS WATER. 1 WATER PIPING. AMT $23.50 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 QTY FEE SUMMARY AMT Laundry Tub / Washer $0.00 Landscape Irrigation $0.00 P-Trap $0.00 Pressure Regulator $0.00 Process Piping (per 10 ft) $0.00 Receptors $0.00 Septic Tank $0.00 SewerCaptorDemo $0.00 Sewer Connect $0.00 Sewer Private Line $0.00 Shower $0.00 Sink, bar $0.00 Sink, commercial $0.00 Sink, Floor $9.80 Sink, kitchen $0.00 Sink, service/mop $0.00 Spa (private) $0.00 Spa (public) $0.00 an 0 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 0 COMMENTS / SPECIAL CONDITIONS Status: ISSUED Applied: 11/1011999 Issued: 11/70/1999 SumpPump Swimming Pool Trap Primer Urinal Vacuum Brkr BkFlow(i-4) Vacuum Brkr Bkflow(5+) Wash Basin Wash Basin Set Waste and Vent System Water Closet (Toilet) Water Heater / vent Water Piping (Inst or Rep.) Water Re-pipe water Service Water Softener OTHER VIOLATION PLAN CHECK REINSPECTION AMT $0.00 50.00 $0.00 $0.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $9.80 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 TOTAL CALCULATED FEES: $43.10 orr 0 0 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorized by this permit shall comply with ell applicable handicap access requirements under California stetutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire end become void if work is not commenced within 180 days, or if work is suspended or ebandoned for a period of 180 days. ,.. L,K INSPECTIONS: In order for the work authorized under this permit to be considered lagal, such work must comply with all applicable codes, and ell �. requlred Inspectlona a�d flnal approval must be obtained. Failure to obtain inspections end final approval will result in the expiration of this permit. ' FOR INSPECTIONS CALL: (714) 7545626 � WORKERS' COMPENSATION DECLARATiON: - I hereby aflirm under penelry of perjury ane oi the tollowinq daclarations: 0 ave end will malntain a cenifiGe�e of consam m self-Insure for workers' compensation, as provitled for by sectlon 3700 of the Labor Code, for �ha peAortnance of Ihe wark lor which this permit is issued. I have antl will maintain workers' �pensaUon insurenca, as required by section 3700 of the Labor Code, for the peAortnance oi �he work tor which this permit is iuuetl. My workers' Compensation Insurance cartier and policy number ere: Cerner: Polity Num�er: (lhis section neetl not be comp/etetl i/ tbe permit Is va/uetl ef one hundred dollars ($100) oNess.J ❑ I cenify that in the paAortnance of the work for which this permit is issued, I shall not employ any person in eny manner so es to become subjact to the workers' compensation laws ot Calitomia, antl agree thet if I should become subject to the workers' cnmpensation pmvislons of Section 3700 ot the Labor Code, I shall fonhwith comply wiih these provisians. Applicant Signature: Date: WAFNING'. FAILURE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNLAW FUL AND SHALL SU&IECT AN EMP�OVER TO CRIMINA� PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOILARE �St00,000), IN ADDITIOr1 TO THE GJST OF CAMPENSATION, DAMAGES A$ PROVIDED FOR IN SECTION 37W OF THE IABOR CADE, INTEREST, AND A7TORNEY'S FEES. LICENSED CONTRACTORS DECLAqATION: I hereby eHirm thet I am Ilcensed untlel provisions ol Chaptar 9(commencing with Section 7000) of Division 3 of Ihe Busineu and Professions Code, antl my licanse is In full force antl eNect Lic. # Class # Contrector'S Signeture: Date: CONS7RUCTION LENDING AGENCY: ❑ I hereby ettirtn Ihat there is a constmction lending agenty tor the pertortnflnce of the work for which ihis pertnit is iuuetl. (5ec. 3097, Civil Code). Lentlers Name: Lendets Adtlress: Signawre: Date: OWNER-BUILDER DECLARATIONS: I hereby aflirm thet under penalry of petjury that I am EXEMPT PiiOM TME CONTFiACTORS LICENSE LAW for the fUlowing reason (SecJ031.5, Business and Pmfeuions Code: Any city or counry which requires a parmit to consiruct, alter, improve, tlemolish, or repair any sirucNre, prior to its issuence, elso requires the applicant for such permit to tile a signed stetement Ihat he or she is licensed pursuent to the provislons of the Contractors License Law (Chapter 9(commencing with Section 7000) of Division 3 ot the Business antl Professions Code) or the� he or sha Is exempt theretrom entl the basis for tha allegeA exemption. Any violation of Section 7031.5 by any epplicent for a permit sub�ects ihe applicant to e civil panelry of not more Ihan tive huntlretl dollars ($500).): ❑ I, es owner of the property, or my employaes with weges as iheir sole compensetion, WILL DO THE WORK, end the swcture Is not intandetl or offerad for sale (Sec. 7044, Business and Professions Cotle: The Contractors License Law tloes nol apply to an owner of property who Gulltls or improves thereon, and who does such work himself or herselt or ihrough his o� �er own employees, provitled that such improvements ere not intended or oHeretl tor sale. If, however, ihe building or improvement is 1 sold wi�hin one year of completion, the owner-builtler wlll heve Ihe 6urden of proving ihet he or she tlitl not build or improve tor purpose of sale.). LA I, es owner of ihe property, am EXCLUSIVELV CONTRACTING WITM LICENSED CONTRACTORS to consiruct the pro�ect (Sec. 7044, Business and Professlons � Cotle: Ttie contrectors License Law does not epply to en ownar of property who builds or improves �hereon, end who contrac�s for 5uch projact with a coniractor(s) license pursuent to the Coniracbrs License Lews.). ❑ I em mpi untler sec. Business and Professions Code for this reason: at� Da Owner ID veritied by driver's license. es ❑ No s licen No. ' s: Verifiwtion of Ownership by (type of ocumeni, i. .- properry tez bill or tlee . DIVISION OF INDUSTRIAL SAFETV PERMIT CERTFICATON: ❑ I hereby certify thai no excavatioP five (5) or more feet In depih into which e person Is requiretl to tlescend, will ba made in connection with work aut�onzetl by this permit, antl ihat no building structure, scaHoltling, falsawork, or demolition or tlismantling ihereof, will be more than t�irty-slx (36) leet high. (Chap. 32, Grp 2, An 2, Sec. 341, Ttle B, Califomia Administrative Code). ❑ As owner-bulltler, I wlll not employ anyone to do work whlch woultl requlre a permit irom ihe Division of Industnal Safety, es notad above, unless such person has a permi� �o do such work irom the division. Signature: Data: DiviSion of Indusirial Safery Pertnit Number: CERTFlCA7E OF COMPLIANCE AND A�ORQATION OF ENTRY: I cehify under penalry of perjury that I heve read Ihis application and state Ihat the intormation given is correct I egree to comply with all state laws end city ortlinences relating to builtling construction, and euthorize representatives ot tha Ciry of Costa Mesa to enter upon ihe above-tlescn�ed propeny for inspection purposes. I agrea not to occupy or allow occupancy of eny huildinq authonzatl Dy this pertnit until final inspection. Signature Pf Lagal Ownar(s) Date CODE t, INSGELTIONTYVE 1616 Fized SySiem Finel Fira Praver��ion 1266 200 201 202 203 Pool Spa Final Final Re-Raof Final BIxWRateining Wall Final Factory Fire Place Final Sign 204 Finel Demolition 2446-4fi QAjg fyjQ��j 4Qp� INSPECTIONTYPE 206 Finel Mechanicel 208 Final Plumbing 210 Final Electdcal 212 Finel Fire Preventlon 22� Final Planning Approval 222 Final Site 250 Finel Bullding/Occupancy � . 1 .1111: '. / � •�� (714)754-5273 • Fax(714)754-4856 .� CITY OF COSTA MESA � BI/ILDING DIYISION DEVELOPMENT SERVICES DEPARTMENT PERMIT Job Address: 887 W 19TH ST Suite: C Vicinity: Parcel Number: 42419103 npplicant: PHILIPPE MACIAS Address: BUILDING PERMIT Zoning: Phone: 949-642-2638 Zip: Owner: BISHOP, ANITA LYDIA TR Address P O BOX 2341 Phone: WRIGHTWOOD, CA � Zip: 92397 Contractor: Atldress: 2ip: Arch : Address: Zip: STORE TI FOR WATER RETAIL. Plan Check: Permit: SMIP Res: SMIP Com: Other: Inspection: Total: $81.41 $125.25 $0.00 $126 $0.00 $0.00 5207.92 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0.0 PARKING Existinq: o NOTES; Phone: License: Rear 0- 0 Rear 0-0 Required: 0 Phone: License: i Eng: Address: SCOPE OF PERMIT FEESUMMARY PLANNING & ZONING LeN 0. 0 LeR 0. 0 Proposed: 0 PERMIT NUMBER / V I 699-01527 77 FAIR DRIVE, COSTA MESA, CA 92626 ISSUED BY: Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 StaWs: ISSUED Applied: 9122/1999 lssued: 71/10/1999 Phone: License: Ss,000.00 ss,000.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under Califomia sletutes and related regulations. (qrd. No. 92-28, § 1, 12-21-92) EXPIRATION; This permit shall automatically expire end become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPEC710N$; In order tor the work aufhorized under this permit to be cansidered legal, such work must Comply with all applicable codes, and ell required Inapectlona end final epproval must be obtained. Failure to obtain inspections end final approvel will result in the ezpiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS'COMPENSATON DECLAqATON: I hereby aHirtn under penalry of perJury one at t�e lollowing tleGeretions: •, ❑ I heve antl will malntain a ceM1lllcate of consent to selt-Insure tor workers' compensetlon, as provided for by section 3700 of ihe Lebor Cotle, br Ihe peAortnance of the work for which this permit Is Issuetl. � ❑ I have end will maintaln workers' compensatbn insurance, as requlred by section 3700 of ihe Labor Cotle, for ihe peAortnance af the work for which Ihis permit is issued. My workers' compensa0on Insurence carder and poliry number are: Cerder. Policy Number. (Th/s sec(ion need not be camplefed!! the perm/f is velued a( one hundred dallars ($f 00J or Iess.J ❑ I certify Ihet in Iha pertormance ol Ihe wark for which Ihis partnit I5 issuetl, 1 shall not employ eny person In eny manner so es to become subJecl lo Ihe workers' compensetion laws ol Califomia, and agree t�at if I should become sub�ect to the workers' compensatlon proWsions of Section 3700 0l Ihe Lebor Cotle, I shall fonhwlih comply with ihesa provi5ions. Applicant Signatura: Date: WARNINO: FAILUFE TO SECURE WORKERS' COAIPENSATIIXJ COVERAGE IS UNIAWFUL AND SHALL SUBIECT AN EMPLOVER TO CqIMINAL PENALTIES AND GVIL FlNES UP TOONE HUNDRED THOUSAND DOLLAFE (5100.0OO�.IN ADDITION TO THE COST OF COMPENSATIIXJ, DNAAGES AS PROVIDED FOq IN SECTION 3'!OB OF THE LABOR CODE, IMEREST, AND ATTOpNEV'S FEES. LICENSED CON7RACTORS DECLARATION: I hereby attlrm ihai I am licensetl untler provisions ot Chapter 9(commencing wi�h Section 7000) ol Divislon 3 of ihe Bu5lness an0 Professlons Cotle, entl my license Is In lull tarce and eflect. Lic. N Class a Comractals Signatuie: Date: CONS7RUCTION LENDING AGENCY: ❑ I hereDy eMirtn ihat thera is a cons�ruc�ian lending agency lor the pertormence of tha work for which Ihis permit Is Issuad. (Sec. 3097, Civll Coae). Lendefs Name: Lendels Address: Signature: Date: OWNER-BUIIDER DECLARATIONS: I hereby aHirm that untler penelry of perjury that I em E%EMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business and Protessions Cotle: Any city or counry which requires e pertnit to construcL alter, improve, demNish, or repair any structure, pdor to its issuance, fllso requires Ue applicant for such permit to lile a signed statement that he or she is Ilcensetl pursuani to the provislons ot the Contractors License Lew (Chepter 9(wmmencing with SecUon 7000) of Division 3 ot the Business entl Professions Code) or that �e or she is exempt thereiram entl ihe besis tor t�e allegeE exemption. Any vlolation oi Section 7031.5 by any epplicant tor e pertnii sub�ects t�e applicant to e dvll penelry af nm more than five hundreC tldlars (5500)J: ❑ I, as owner oi the property, or my employees with wages as iheir sole compensation, WILL DO 7HE WORK, end the structure is nat intentletl or oHered for sale (Sec. 7044, Busineu and Professions CoOe: The Contrectors License Lew does not appy to an owner of property who builds or improves thereon, end who does such work himself or herself or ihrough his or her own employees, provlded Ihat such improvements are not imended or oNered for sale. If, havever, ihe builtling or impmvement is �sold within one year of completion, the ownerbuiltler will have the burden of provinq that he or she did not build or improve for purpose af sale.). I, es owner of Ihe property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRAC70RS to consiruct the prolect (Sec. 7044, eusineu and Professions � Cotle: The conirectors License Lew tloes not appty to en owner of property who builds or improves ihereon, and who coniracis for such pmject with a cnntracror(s) license pursuant to the CoNrectors License Laws.). ❑ I exempt under ec. Business antl Professions Code tor Ihis reeson: ture: � a S \ venlied by tlrivefs license. es ❑ No Drivefs Licen o. Venfication oi Ownership by (rype of dxumeN, i.e. - property tax Gill or dee . DIVISION OF INDUSTRIAL SAFEfY PERMIT CERTIFICATION: Date: ❑ I hereby certity t�at no e:cevatlon live (5) or more teet In depth Inm which a person Is requlred to descend, wlll be metle In connecNon wl�h work authodzetl by thls permit, entl that no bulltling slructure, scettolding, felsework, or demolition or dismantlinq thereof, wlll be more than thirry-siz (36) feet �Iph. (Chep. 3.2, Grp 2, Art 2, Sec. 341, Title B, Calitomia AtlministretHe Cotle). ❑ As owner-builtler, I will not employ enyone to do work which woultl requlre a permit from the Division of Indusirlel Sefaty, as noted above, unless such person has e permit ta do such work irom Ihe tlNislon. SlgnaWre: Date: Divislon ol Intlustrial Safety Permit Number; CERTIFlCATE OF COMPLIANCE AND AIJTHORIZAl10N OF EMRV: I certity under penalry of perjury t�at I have reatl this eppliwtion end stale that the information given Is correct. I eg�ee to comply with all state laws end ciry oNinances relatlng to bulltlinq construction, entl euthodze representatives of the Clry of Cwta Mesa to entar upon the abova-descdbed D�aPerry for Inspection purposes. I agree not to occupy or allow occupancy ol eny 6ulltling euthodzad by Ihis pertntl unNl Ilnel InspecHon. COOE �. INSPECiIONTYPE 1616 Fixetl System Final Fire Prevenlion 1268 Pool Spa Finel 200 Final Ra-Raof 201 Flnel BIocWRetelning Well 202 Finel Factory Fire Plece 203 Flnal Sign 204 Final Demdi�ion zaea-ea Q9IE �� Dete / � — � �b "�f�i ��$ £QQ� INSPECTIONTYPE 206 Final MeChanlCel 208 Final PlumGing 210 Final Elecitical 212 Flnel Fire Preventlon 220 Final Planning Approval 222 Finel Site 250 Finel Building/Ocwpancy aeg u�s AOUXESS OF BUILqNG: 0 0/ rv i� i n axxEasruweiv�aavx: AN I TA B I SHOP � AOONE53: PO B�}t 2 3 4 1 � WRIGTHWOOD CA 619) 249-6222 1VPL.Y4lII10 AUDNES4: ANCNRECT OREINYNEEfl: ANCX.Ofl EN6.'S ADOPE55: cartn�craraNua: R0101 RNPHENGL I SH CONiPACTOR9 MYlINO S. A. CA ADo"� 92703 LICEN9ED CONfRACTOfl4 DECL�p�TION: I heroby eA4m unEm peneXy d pe�ury thel (oommaritlrp wi�h fieclbn ]000) d Onwion a d tha Buaiwn aM Prdeaeions COEe. ud r .cmuic. No.: uc, cuss: uc. No„y5 5 3 9� UNT: uc. xo.: UNT: (714)978-2612 uc.ra.: 553456 UNT: I em Icemed uMer O��ione d Cheptm 9 y liceiue 6 in hll bres uM eMad. >6 /o�e: C� " ` + ` 8 co�veao�: ' \p1Ef N BUIlOEN OEClAN1T10N: I M�eby dfirm uMm penaly d perjiry ih em axemq ham IM Cmtredm Licema lew la IM Idbw'vq rsuon 1�1an )031.5 &roiws� eM Pmiptlona Cods: AnY W a oounry which repuim e psmm to caawa. Mer. improve. Eemoli�, or repair eiry elmclum, pnor �o Ne beuerwe, eleo requii» Ihe epplirsnl lor euc� peimil to file e epneE etebment Ihtl he m cM i� IicanaaE Wm+e^� �o Ihe prmvionv W Ihs Caniretloro Lironee Lew �Cheplar e(mmmendnp vrilh Sed'on l0ao) d Diveion e of �he BueiMw eM Prdmiwu Gode� a Ow M a ehe b usmq Ihrshom vM iM bnia la Uw elbpM aemqion. Nry vNmun d 6W qn JW 1.5 by ury eppGuN Ip e parmil wbjetls the appl'ram �o a cil panelry at M maa Ihen fMa �uMnE Edlen �5500�). � I,esownaroflhaproprfyamysmpbyesexv�wepaaulMieolsmmpemelion,willEotMMak,endiheNiucluree�wllnteMW a Mered for eele (Sec�ion ]Oa, Buunm enE PrdnaionaCode: Tha Comrepon Liasnae Lewdwe m� appty Ioan bwnar d qopeny who W id� a inqwa� iMrean, uM xM doee auM Mwk Nmroll a hene� or Nraqh h6 or Mr mm empbyas�, provideE ihet wc� impovammN vs nd imaMed a cMxsd la sab. tl. howawr. IM buitlirq or inpwsneM u wtl wilhin ona Ymr af mmplMion. Ne ownerbuiMr will heve Ihe WNen d pwiip M a eM did M briN a imprws la tM puryaa d aeb). � I, u mmer W �ha properly, em eaduerveN ��redirp xil� IioeneaE contmcton ro canelrud iM pm�etl (Setlbn 100<, Bwirrose arM Prole��bm GoCe: Ths Convedon L'cenae Lew doee na epply to en ownar W propeny wlw Wilds a'unprv.•p iMnan end who convecu la arh pqMe with e mmrepa(s) IicameC punuem m �M Gamreaon Uoenae lewl. � I em emmq ueMa Section: B. 8 P.C.. Iur Ihb reeaon: Dms: ��TM� I Eo MiabJ ��N YW I am awere at W ivdenlard Ns �eVuiremaua d Geldmue HaMh end SafMY Cods Sedlau 25505. 25533. enA Y55�1, uM Nm I a eny hnun Wibvp arupenl wi0 / wa no1(d�c4 aw) rrod to wmpy wih �eid ptls codw uM tM repuinmsma M •prmntncansirutlionamoCilmtionhwn�heAi w�iy �epamaMOutntl.ReeiEemielaonMiutlioneppf�utiomuaexsmptlmmtMea Deia: MW�: WOHKEfl'S COMPENS�TION DECLARATION: I Mroby dfirm uMer penalry d pe�ury me d Me MbvAip dedereliom: � I hm aM Mil me'viten a ceMkme d mwnt Io �etlimun br wwken' camperoetbn, n prwkad la by SaCion �)00 d Ihe lebor Cods. la tM perlmvrca M ths xak la wNch Nu permil u bswd. � I hew vd wll meiMen xaken' compenwion imurenos. n rpuieW by Seian 3MU d tM leEor COM. br tM pMamerce d IM wak la whic� �hie parmil is usued. My wnksn canpemetion inwrwa urtisr and poliry number ara: c�«: Pd'ry Numbr: eMian rieM iat 6s cand+�� I tM 0�l'u /a one hwMred CNbn 131001 a Iw.) I certh' � in IM peAmmence d IM work /a which ��is prmil w uawd. 1 e1Wl iwl employ erry qnon in ury mennar �o n lo n.�om, wq� �o m..�x«.� �w�.m� mw. d CeNmiie. W pne thn ! I Mouk becoim �ubptl lo IM xvMn' pn�on qwiaiom d Seeion 310U d IM Lebor Coda. I d��eShxnh wmpH�pm.ieiau. / e: � nodicem: 7/ p: F�flun ro ucun walrx�'ronqrwtlon roverap� l� vnlnrN ntl �N/I ubJcf �n wmployx to crlMml pwltlu aiW dH� nros w ro ar. nu�ar.e mou,.ne edr.. (s�m.aooA m.eeinon ro m. eose o� roim«u.rhn a+�a++ o aAvbw ror in 9�ctlon 31P6 0l IM L�bor Cod, InNnaL ��msys Mu. CONSTfiUCT10N LENDINO RGENCT: I Mreby elfi�m under penelly d peryry �hat IMn o e aon9ruqion bMi�p apoMy tor Ne �no�,��. a m. won� i« ..n�a� m: o�� A�.a �saao� aoe�. c:. c�. LENDEN'S NIJIE: LENOEP'S ADORESS: i�.wv �nm i n�. �om ma evd�m�,.oe am. mm � eeore wo�m� m w�.a. i w� m wmdr wun �o mr.�e oamv o�a�. eM s�e 4we rMetip Io buildiq cmabWion eM Mrsby eWv¢s �epreseNelnef d Iho dy b sMw upan IM ebws-meMiqad poperly '°""'0'°'°"°"'D°`°'ROYD FROST D�te: �� (5151�6.WP) ��ikiq 8 Sd&y.OnaMFb: Cwry-AppireN: puik_{imwmu:OdEenmd-Aeamor CITY OF COSTA MESA — SIGN PERMIT PERM NO: SB _077989 PEAMIT NO: SB 077989 PLAN CHECK NO: 02219-96 L GOL'T: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR SIG PURPOSE: OTH JOH DESCRZPTION : INSTALL ROOF SIGN SQ FT: CLAIM VALUE: 800.00 CALC—VALUE: 800,00 GROUP OCC: B / ICOMMENTS: •"LUIS HAIR SALON" iF 1E iE if iE if if �F if iE if if 1E iE if iF iE if iF �Ih dE af jE *�lE iE af if iF 1E i(� iE iF 1E iF if * iE iF ih 1E iF 1E iF if if it �E If �f iF iF if 1E If if it iE �E �f if iE i6 iE if 3F * iF fE �F-IE-1F iF IF iE IE iE aE if S I G N I N F O R M A T I O N DISTRICT: 1 TYPE: BUILDING ILLOMINATION: NON CATEGORY: NEW DIMENSIONS: 3FT OOIN X lOFT OOIN AREA: 30.00SQFT LETTER HT: 12 STREET FRONTAGE 1: 84.00 STREET 1: W 19TIi ST STREET FRONTAGE 2; 0.00 STREET 2: PARCEL: 42419103 ZONE: C1 LOCATION > FRONT: REAR: HUSINESS NAME; LUIS HAIR SALON > LEFT: RIGHT: X O T H E R T O T A L S G R O U N D S I G N THIS ACTIVITY . 30.00SQFT OVERALL HEIGHT: OPT,�'OIN THIS SITE . 47.SOSQFT GROUND CLEARANCE: OFT rOIN ITEMS OF ZNFO 1 PLANTER AREA: O.00SQFT ITEMS FOR ACTIVITY: 1 HLDG SET BACK: 20FT � COPY VERBIAGE : LUIS HAIR SALON — MEN — WOMEN — NAILS PLANNING NOTES: ' iE 1E 1E 1f 1E iE ik 1F iE 1E if iE 1E 1E 1E iF IE if 1f If iE iE ik jE if iE jE iE if if �f !E ik if iF 1k iE iE iE 1E If 1E iE 1E 1E 1E iE �E if iF i! 1F jE 1E 1ElE iE 1E 1E iE iElF if 1E iE iE iE 1E 1F�1E 1F iF iE 1ElE iE �E 1E ik 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 : ��Q DATE: G APPLICATION ISSUED BY: DATE: �*+�****��***+�*****�*x� ��***�r�**� ** LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGM NT:Y BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RE GRADING PERMIT 29.25 SMIP/NON—RES PLAN 19.01 .50 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTALS----> 29.75 0.00 19.01 REVENUE DIVISION TOTALS--> COLLECTED: BLDG PMT PLUMBING ELECTRIC MECHANIC 29.25 TOTAL PAID DUE 48.76 48.76 ,00 48,76 OVER/SHORT: .00 SIGN SMIP/TOT GRADING PLAN—CHECK ,50 19.01 iE �4 K if a4 �E if IE iE iE iE iF iE iF iF iF IE iE if iE iE 3E 9E iE iF iE K iE iE iE iE if 1E 1F 1f iF iE if iE iE iF iF iF i(� iF 1E if �E �1(� af i61f iF iE 1E iF 1f iF 1F 1E iE 1E iE 1E �F iE iE 3E IF if iF 1F if iElE iE iF iE 3E I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST NO FEES WERE SELECTED FOR THIS PERMIT ��.. i�.l�:'" _'Il��•��^(i7� TTr^�T Yl•e/C .:TL. C: "�. . I�._v 1.9:J. r CONSTRUCTION AND PLANNING i POOL « SPA ' qPPROVALS Permit # �� Date lnspector AppROVAL$ Permit #� Date Inspector 1. 7emporary Electrical Service or Pole 52. Pool & Equipment Loca[ion � 2, Soil Pipe•Undrgrnd. 53. Steel Reinforcement - , 3. Electriw� Conduit Utility-Undrgrnd. 54. Forms � � 4. Electrical Conduit�-Undrgrnd. � 55. Electrical Bonding � � 5. Steel Reinforcement 56, flough Piumbing & Pressure Test 6. �IectricalUFERGrnd. 57. APPROVALTOCOVER�GUNITE ' 7. Footings 58. Electrical Conduit-Undrgrnd. 8. �oundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd. ' 60. 6ackwash Lines, P-Trap, C� Undrgrnd. � 70. StruMural Fioor SYstem � . " 61. APPROVAL TO DECK � t t. Property Sewer Line & House Connection . 62. Backwash & Receptor•Final � 72. Sewer Cap � � 63. Heater & Vent-Final 13. Roof Drains SII. Pfvmbing System ��ina{ 14. Rough Plumbing • 65. Electrical-Final 15. Fiough Eiectrical•Conduit 66. Solar SYstem-Final 16. Fough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 66. APPROVED FOR PLASTEfliNG 18. Rough Electrical�T 8ar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning , FIRE.DERT. ftEQUIREMENT r- 20. Rough Factory Fireplace ` � � - "" - APPROVALS �Permit # . 21. Oucu, ia Structure , . - - - _ � - -70. Underground Hydro � 22, pucts, Ventilating - _ , � • 7�,� p,roduct Piping G�'Gas ,�Oil 23. Gas Pipe�Rough & 'rest .. _„ - _ . 72. Underground Flush _ 24. Foof Framing '�' ' 73. UndOrgrnd. Storage Tank CI Gas ❑ 0�� 25. Roof Sheaibi�g . � . - - 7q, pverhead Hydro . 26. T-Bar Ceiling (Structurap & Monocoat - 75. DiY Chemical � 27. Frame and Fiashing . r 76. Dry Standpipe _ 29. Lathing & Siding � 77. FIXED SYSTEM FINAL 29. Insulation .�� 7g. FIRE PREV. FINA� 30. D�Y�vall Nailing � • HEALTH DEPT. REQUIREMENT 31. Plaster Brown,Coat . - , 79. FlNAL INSPECTION 32. E�ectrical Powar MeterFinal 80. FOOD CERTIFICATE ISSUED ' 33. Pinal Electric - Notes: 34. Final Heating & Air Conditioning � _ 35. Fina� Gas Pipe-Test - � . 36. Hood or Canopy ' - 37. F�aal FactorY Firepiace � � , � 38.�PinalPlumbfng �� 39. Water Scrvice-Finai � -� ' . 40. Gas Service-Final � 41. Solar pomesticFinai � 42. Backflow Preventer . � . 43. Backflow Irrigation � � � - 44. Landscape Irripation System � • " • � 45. Sound Attenuation ' �, 46. Handicap Regulations • .`47. FINAL STRUCTURE & BUIIOWG �;LYy 9 �'(�j/ �' � � . - G 48. FINALPLANNING 49. E�ectric Release to Edison .� � 50. Gas Release to Southern California Gas Co - • 57. CERTIFICATE OP OCCUPANCY No. Date /— PP0.IECTRI�011ESS: 8(J'J W 19TH ST ' �owx¢x�sSrleMe: ANITA L PUANT AI5HnP . ADOflC33: I�O 2 3 4 1 • .WRIGHTWCI011 CA 92397 714)5?.5-12.".3 11flCHlENGINEEP: , �aoxess: ' uxii: x�o.xo.: uxrt: PENMITTEE: TRAVIS UL1'RAVISTONS ZNC (71A)650-7446 �ooness: 760 W 1%TH ' � • CM ' CP. 92627 LICENSED CONTMCfOP OECIAMTIDN: I �eiaby aKrtn that I am Iicense0 unCer pmvisions of Clwpter 9(commencinp vntA Seclion 70W) oi Division 3 af t�e Business and Professions Code, antl rtry license,is.in�full;hrce�and e¢ct� cm uc.: 0 4 J 9 4 4 ST�r� uc.: 5 2 2 9�� V � Da�e: _ 'Z � SlOnawre. �T� � L /— WONNERS' COM ENSRTION �ECLAMTION: I AereOy attirm Ihat I have a c¢rtificate oi consent to selbinsure or a cenitica�e ol Workers' ComDensation Insurance, ar a mnilieO coOY thereal (Sectian 38W, LaE. q. roucr xo.: P 7, 0 G 7. H exr. onr�: 0 5/ 0 9,/ 9 0 , coMr�xr: CAL I F. I ND . ' � Certifle0 caDY is hereby IurnisAed. � Certitied c�.iFfileO w�t� t� '� ivi '.� , Odt¢: � � r '� �T� Annl� Qy� ��1��' IXEMVfION FXOM WONNEBS' COMPENSATION OECUMTION: (iha union neeE not he campletetl il the permil is iw ane AunErea (f100) a less�. I certiry t�at in the periormance of tne work lor whlc� t�is permlt is issueU, I shail not employ any person in any manner so as to become su�ject to the WOBers' Compensation Laws ol Calilomia. - Oate: ' ' SlOnaturo: - - � NOTICE: If, aiter makinp Ihk Aeclaration, yau SAouIU become subjeci ta the Workers' Campensatian Orovisions ai t�a LaEor COEe, yau must fonlrxitA camply wit� suc� proWsions or Ihis permit shall he �eemetl revoketl. ` CONSTBUCTION tEN01N0 �OENCY: I hereGy affirm tAat there is a cons[ruction Iendin0 agency for tlre Oetlormance ol I�a work lor which t�is permii I5 i5Sue4 (Section 3097, Clv. C). LENOEN: � � . nooxess: . OWNEB BURDEP OEClAMT10N: I �ere0y attirm that I am exempt trom Ihe Contactars' Stah License Law lor Itre fUlowinp reason (Sectian 7031.5 Business an0 Pmfessional CoOe: �'My ciry of caunry wliic� requires a permil ta consimct, alter, improve, Aemalish, ar reDair any structure. prior to i6 issuance, also'requires I�e appliwnt for sucA permit to lile a apneE statement tAat AxJSAe ¢ Ilcensetl pursuant ta t�e D�sions of tAe Contractors' State License Law (ChaD�e� 9(cammendnp wit� Sectian 7000) ai Division 3 al Itre Business and Professions CoOe) or Nat he/sAe a eaempt Iheretrom and t�e Casis for the allegetl exempqon. My Wolation al Sectian 7031.5 6y a�ry apqicant iw a Dermit suhjects Ihe appliwnt ta a dvd penalry ol not more than five huntlreE ddWrs (5500�. �. I, as awner ol Ihe Draperly or�my em Iryses vAth wapes az Neir sole campensalion, will Eo t�e wark, and tlre ❑ structua is not intenaeE or atlere0 for sale (�tion 70Cd, Busmess and Professianal CoOe: The Cantracrors' Suta License Law Uoes not apDN �o an owner ot a D�opeM w� �utlas or ImDroves [�ereon, and wlro aces suc� work himsell/�ersell or throu0� his or Mr own emDbYtts, proviEetl [hat sucA improvemen6 are not imentle0 or oflereE ta sale. If, tnwever ttrc Cuiltlinp or imprwement Is sold wilnin one year at wmpletion, tAe owner will Aave the Ourtlen oi provinp Aeh�e di0 not Uuiltl or improve �for tne purpOSe ot ule�. � _ . I, af owner ol Ihe pmDerN. am extlusivel cantractinp with IicenseC contactors to consiruq t�e prole�� (��tion 7044, Business ❑.ane arotessians Coee: ihe Contractors' S�ute Lkense Law Oces no� apply ro an owner of Draperry wiw owws or impraves tnereon anG wtw con[racls tar sucA pmle«5 vAt� a coniractor(5) licenu Dursuant to tAe Cantactars' Stata License law1. I am aware Rwi D�� oi t�eir Worker's Campensatlon insurance sMultl �e provitled t0 me. - � I am exempt unUer Section: 8. 8 P. C. . � • for tnis aason: � , i Date: Umec I tlo �erehy certiry t�at I am aware ol antl un0erstanA the requirements of California Healih antl Safery Catle Sectians 25505, 25533, anU � 2553d anE I�at I or any futura buil0in0 occu0ant wilVwlll not (circle one) neetl m comDty with ui0 state wdes and the repulrements for a permit tor construction or moUiliwtion Imm Ne NTBuaiiry ManaOement Oisinct NesiOential constmction aDP�ications ara exempt Irom these pmvisions. � � - � Oate:� AppllcanC I here0y cenity Ihat I �ave rea0 t�is aDPlication antl state I�at tha a0ove orElnances antl sWte laws relatinp to builEinp canstrvction an0 �eah h pmDenY �or inspection purp`o5e5. Date: �2 �`'�1 " D 7 SiOnature: � oriver's License or sada� Secunry x: -t841�e W�iro--BuilEiiq; Green—CoOa EntorcemenL Cflnarv—Aoolicent: Pink—Revenue; GOIEenroO—Assessor anE P�RMT'I' NO: SB 095444 CONS'TRUCTTON TYPE: JO`B DF.SCRIP7'ION . CLAIM VALUE: , �� CI.TY OF COSTA MESA — SIGN PERMIT PLAN CHECK NO: 02006—II9 S PERMIT TYPE: STR SIG ' " ' - PERM NO: GOVT: - -� SB 045444 N SUPY: 1?URPOSE: SIGN ON POSTS . SQ FT: 600.00 CALC�—VALUE: 600.00 GROOP OCC: B-2 / N N�W COMMF.NTS: .�,IGN ON POSTS 6 FT HIGEI MAX ' • �r*��**�r****rt***�c��*�*�***�*�*at***+�*#*at�**�r*��**�*+�*�r*��x �*r��e+e*�r��c�c��*��rxx�*+��* S. I G N I N F C) R M A T' i O N� , DISTRICT: 7_ TYFE: GROUND TLLUMINATION: NON CATEGORY; NEW DIMENSIONS:' 3FT 06IN X 5FT OOIN ARfiA: 1"I.SOSCJFT LETTIiR HT: 14 IN STREET FRONTAGFi 1:' 81.00 STkF,ET 1: 1�1 19TH � S9'REET FRONTAG� 2: 0.00 STREF.'P. 2: ' � ' PARCEL: 424191U3 `LONE: C1 LOCATION > FRONT: GROUND �� 12P•.AR: � BUSINF.S�i NAME: HAPPY NAILS, ANN'S DE.AUTY> LGFT: RIGHT: O T FI E R T U'1' A L S G R O U N D S I. G N � TTTIS AC1'IVITY. . 3.00SQF'4 OVERALL IiEIG1IT: OFT OIN TH:LS SITE . : 3.00SqFT •� GROUND CLEARANCE: 4FT 6IN. TTEMS OF' INFO : 3 � � PLAN1'ER AREA: 3S.00SQi.�T I'PEMS FOR AC'I'IVITY: 3 BLDG SET' BACK: � OFT COPY VI:RBIAGE . HAPPY �1ATLf"i, AN�I' S BEAUTY SALON, WE:STLDID ART ' • PLADINING DIOTES: � ' ' ' � 1F it iE iE it iF if iE iE �E 3C-3E if iE 3E iE iE'�E 1F i' iF iE 1E iE jE i:� iE fE 9E iE iE 3E 1E if if # ib if iF 3' iE ik 1E �F �E i! i(� iE if �E !F 3E iF 3' iE ih # ff �F �1f �f iE if iE iF iF ##E �)E 1E 3E it dk�iF k k K iE iF D E V E L U, P M E N T S� R V I C E S • R E(� U I R'E M E N T S 20N'iNG APPRUVED �DY : �'1T—/C_P �� ' �'" DATE: ��_S�'�> �IUILDI�NG APPROVED IIY : __ __ __ ___ DATE: ��Z•_�P� APPLICA'CION ISSOEll BY: � DATE: �Z� I�i'B� i'kkitiF�flEiEiEkiEiFiEifiEiEiE)E�iF16iEiFiFif&i�jE) � � itiFiF��"iF . ��iF��f�1E�YEiki�iEiEdE�lF3fiE3t�if�F�g �!y LEGALI2ATION:N F�E�E S U M M A R STRUCTURAL�SEGMENT:Y BLDG'PMT PLUMHING EL�CTRIC ME PERMIT. 17.00 ' PI;AN 1]..US • tss��r•. I'EE • �IUILDING—DIV-> PEkMIT IS'SUE� PLAN—CIiECK TOTALS,----> 35.00 0.00 ' 11._OS RE��ENUG D]:VISICiN TOTALS—� COLLF.(_TrD: ➢T,DG PMT PLUMBING'F_LECTRIC MECHANIC 1%.UD � �HANTC SIGN SMIP/R£S GRAllING 17.50 ' SMIP/NON—RES . � .50 TOTAL � PAID DUE , 46.05 • 46.05 .00 46.05 OVER/SHORT: .OU SIGN SMIP/'POT GRADING PLAN—CHECK 1��,5�' _5� � 11.�5 iE �E iE •{,..if iE if iF 3E �E X� ie �1(-�f iP jF �f iF If �f 3E iE 3F K, # iE K� 3E iF if ### iE iF it iE if if iE iE �k iE if iF ih 1E iE iE iE iE #a( if i4 #',F if ik i(� •%iE i( dE if if iE iE k d6 iE iE # K� k# if # iE ' I. N D I V I D U A. I, F E E 'B R E A K ll O W N i TYPE QTY D E S C R I P T' I�O.N • UNIT COST TOTAL COST � NO FEES WERE SEI,ECTEll FOR THIS PEkMIT , , ". O1 000500�1—OQ050004 T O T 56.05 DATE: 12/19/89 TIME: 08:21 -- ��i " f 1� U, � �ONSTRUCTION AND PLANNING _- POG SPA �APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspecto,r i �%.'i'emporary_ Electrical Service or Pole 52. Poot & Equipment Locaiion � . � 2. Soil Pipe�Undrgrnd. , -� 53. Steel Reinforcement � 3..Electricaf Conduit Utility�Undrgrnd. . 54. Forms � ' , 4. Electrical Conduit-Unclrgrnd. 55. Electrical Bonding 5. Stee! Reinfo�cement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. -, 57. APPROVAI TO COVER�GUNITE 7. Pootings 58. Electtical Cqnduil-Undtgrnd. 8. Foundation . � , 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe�Undrgrnd, 60."Backwash Lines, P�Trap, � Undrgrnd. 10. Structural Floor System 67. APPROVAL TO DECK , 11. Propertv Sewer Line.& House Connection - 62. Backwash & Recepto�-Fina4 ' 12. Sewer Cap � � 63. Heater & Vent-Final ' 13. Roof Dreins _ . 64. Plumbing Sy:tem - Finah � 14. Rough Plumbing ' 65. Electrical-Final � - I 15. Rough Electrical-Conduit , 66. Solar System-Final . � - 16. Rou9h Electric Wiring � . 67. Fencing & Access ApProval 17. Rough Wiring Si9n � 68. APPROVED FOR PLASTERING I 18. Rough Electrical�T Bar Ceiling ' 69. POOL/SPA SYSTEMS FINAL � 79. Rough Heating & Air Conditioning' ` FIRE DEPT. REQUIREMENT I 20. Rough Factory Fireplace APPROVALS Permit # 21: Ducts, in Structure � - � 70. Underground Hvdro � 22. Ducts, Ventilating 71. Product Piping OGas OOiI 23. Gas Pipe-Rough & Test 72. Underground Flush I QA. Roof Framing . � 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing � 74. Overhead Hydro I 26. T-Bar Ceiling (StrucWraq & Monocoat -� 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding - 77. FIXED SYSTEM FINAL 29. Insulation -- -78:+ FIRE PREV. FINAL 30. Drywall Nailing , .� ��'' HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat i�� j79. tFINAL INSPECTION 32. Electrical Power MeterFinal - �80.��fOOD CERTIFICATE ISSUED 33. Final Electric ' ��Note's:� 3A. Final Heating & Air Conditioning . V �� ' �� 35. Final Gas Pipe�Test ' 36. Hood or Canopy , � ; �{ 37. Final Factory Fireplace � �� 38. Final Plumbing ' ' ' � j 39. Water Service-Final � ' � '��' / • 40� Gas Service-Final ' �� , � 41. Solar pomestic-Final . � � , . ,: , 42. Backflow Preventer �q - ' 43. Backflow Irrigation " 44. Landscape Irrigation System � � - ' 45. Sound Attenuation . � � � 46. Handicap Regulations � � � � 47. FINALSTRUCTURE&,BUILDING � f10 ^,� � 48.. FINAL PLANNING ' �. �� T `� � , � ' 49. Electric Release to Edison �• - ' C•� 50. Gas Release to Southern California Gas Cn ��' �-• �' 51. CERTIFICATEOFOCCUPANCY No. Date i � l � CI'�v.OF�CUSrAMESA CONSTRUCTIONPERMIT ProlectAddre3s �7 �•lrf� `�T Applican�:s'MailingAddress �� BLX 2?�� [jf%�/�ns�n�_V; Own@r;_^.ame' -�/L/} f�'�//c�!'L Phone��2 Address f�� c'�k c Z�4 /—��/' G•sT—�Ejcz ••� l�11. . Arc� � �.t��;?�+� =�--License No.n.�� Z/ti` Address lu/�� Rii FN L� G��r Contractor's Nam �+ � Phone 99F9�� Addresslmailingl�8y� O� Wh• •" A+`�- City License No. LICENSED CONTRACTOR �ECLARATION 1 hereby aftirm that 1 am Iicensetl untler prn��sions o/ Charter 9(Wmmencin9 wilh section ]000) ot DiviSiOn 3 0l the Bu5ine55 antl PrOfe551on5 Cotle, antl my Iicense is in rw� torce ana ettact. �Fy6.�� License CIysz� � ens�jJo. Date�„`�6 , � WORKERS' COMPENSATION DE LAR �ON ' Itereby.atti�m fhat I have a certificate of co�sent to 581f-Insure o� a certificate / Worken' Compensation Insurance, or-a certitietl copy thereot (Sectlon aB00. Lab. C.1i�9�L� � 7�Sle� �ra � P Ilcy No. Y � Company� Certi/ietl copy I5 hereby /umishetl. � Certi/ietl mpy is filetl with the city 6uildng Dlvlsion./ Date APplitant_ � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thi55CGtion neetl not be completetl it the pF�mit is (or one huntlretl (§300J or less). !' � ' 'F I certi/y that in the Oe�fo�mance o7lhe wo�k tor whicn Ihis pCrm�t is issuetl, I shall mt employ any person In any manner so, as to become subject to the WO/kere' ComOensation l.dws of Cali(Omia. - �� DatB $I9nalure - 'NOTICE: If, after making this tlaGlara[ion, you shoultl become Subject to the Workers' Compensation provlsions of�tne Lzbor Cotle, you mus[ fortM1with comply with such provisions or thi5 permi[ Shall be tleemed rewketl. LONSTRUCTION LENDING AGENCV. " • � I hereby af(I�m that [her¢ ii a construction lentling agenCy tor the pertormance of the work tor�y hicn hls pe�n it is� issuetl (Sectlon 3097 Civ. C:) • Lentler's Name «�+/-�� % �1�-�K ' LentlCr's AOEress�� C� OWNER BUILOER OECLARATION ' '- I hereby attirm that 1 am ¢xompl from Ne Contractor'S Lic¢nse Law for the /ollowing reason (Section 7031.5 Business 3ntl Professional Cotle: Any city or counly which requires a permit to conztruct, al[er, improva, Cemolish or repair any structure, prior to its iszuance, also requires the applicant for such permit to lile a si9netl SLdICRIClII Lhdl FIC/SI1C is licdnsetl pu�suant to the provisions of � the Contractor's License Law (Chapter 9(cemmenting with Sec[ion �000) ot ']ivislon 3 of the Business antl Profession5 Cotle) or tha[ ne/she is exempt ierefrom antl the basis for tho allegetl exdmpNon. Any violation of Section � J31.5 by any� applicant for a permib Subjects tM1e applicant'to a civll . enalty o(.not more than five bundretl tlollars($500). � - ' � I, as owner of the property, or my emPloyees wlth wages as their sole , COmpenSation, will tlo ttte work, antl the structwe is not inlentletl o� offeretl tor sale (Section']oa4, Business antl Protessional Cotle: The Coniractor's' � LJtense Law tloes not apply lo an owner of a property wbo bUiltls or im0/oves � thereon, antl who tloes such wOrk himzelf/he�selt o� In�ough his ot he� own Iemployees, proviaetl inat such Improvements arE not IntenEed or o(feretl fo� sal¢. It, however, the bullUing or improvement Is soltl wllbin one year of com- pletion, the owner will have the burtlen of Proving he/she Oltl not builtl or im- p�ove to� the pu�pose ot zale). ❑ I, as owner of the p�operty, am exclusivery mntraclin9 with Iicensetl con- Iraclor5 to consfruct the projecl ($ectiOn ]044, Business antl Pr0(e55ion5 Cotle: The ConVac[o�'S License Law tloes not apPb �o an owner ot property who bulltls or improves lhereon, antl who.conVacts (or such projects with a con- tractor(511icense pursuant [o tM1e ConVactOrY �icense Law�. I am aware that proot o1 [M1eir Worker's CompenSaUon insurance shoultl bv provltletl to me. ❑'I am exempt untler SectiOn B. & P. C. fo� this reason Dale Owne[ _ 1 hereby certify that I have ieatl this information is wrrect. a9/ee to compl antl state laws relati to builtling cons Sen[dtivez ot this c' to ente� upon Inspection p s. Signalure � ' Driver5' LicenSe 55 � abave iances repre- Y for Icant to fill In all s0aee5 except thosa wit�in heavy bortler lines antl si9n all apPropriate tleclarations. P�$M� NQ. ^ u� AC NO ��O�T Ni.r UNIT NO. IJ T� G J �NL LO TYPE OFC�NSTRUCTION NEW- ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DECSCRI�O; OF WORK/USE OF BLDG. S�!}rr CU.sI��Ci�-- LJ 1 TVPEOPPERMIT LY�GRADING LIFOVNDATION IK(STRVCTURAL ❑'TENA�IT O ELECTRICAL ❑ PLVMBING ❑ MECHANICAI ❑ OTNER / PROJECT DESCRIPTION S�.FT oCCUaA Cv1�q") CONSTRUCTION TVPE_ ^ VALUATION $�r�n ZONE _ GRADING CU. VDS. ACRES_ Remarks: Irrigation Drinking Fountains Floor Droins Floor Sinks - - GasService Outlets I nterceprors Kitchen Sink � Lavatories Roof Drains PLUM814VG � FEES Showers Service Sink ' ' • - Sewer Cap� - . Sewer Connection � ' . Solar Collectors Solar Piping . - Solai Tank � � Swimming Pool w/Spa Water Closet ' Water Heater Water Service -Auto-Wash . 9 Reinspection Fee � .$15 I I� Iwue Fee ' I $ 3 I • • ,MECHANICAL ,,, FEES Duct- UnderGround Duct-Structural , Duct - Ventilating Exhaust System ❑ �Multiple Firepl/Fact. Ble ICBO # Heating System & Ducting ❑0.100 000 BTU � 100,000 Reinspection Fee I $15 � CMF 0865�46, rev. 10/84 White - Builtling; Canary - Applicant: Plnk - Accounting; Goltlanrotl - Assessor Hood or Typel ❑ Canopy Type I I ❑ Re(rigeration System , � ❑0-700,OOOBTU ❑100,OOOBTI System Repair/Alteration Fire Dampers Registers Issue Fee � $ 3 !t A.P. dk L-I L S Main Buildin9: E 2 T Front B Rear '. A C Right g Left ' Ping. ReL # �Q� Planning Notes: � Aummatic Washer Construction PoleSub. Cooking Unit Dishwasher - Dryers ❑Gas �Eler Fan F.A,U. 7957 6/20/86 � Zone Accessory Building: —aa . Parking Req./Provided T7'il/� LLK �lK.t,C_/G�. � ii..'f _ /7 — Outlets - . ' Swicehes• • � ,. Garbage Disposal � Generator �65 KW �5-15 K i Reinspectian.Fee � $1 ELECTRICAL • , Transformer ❑ 15,50 KW' ❑ SO+KW Meter ❑up to 100 amps Meter ❑over 100amps - Sub Panel ' . Motors �0.1 HP �1'rS- 8'� Inc.Solar �9-15 HP �16-15+ Microwave ; � Pole Light . Range Standing Sections Trash Compactor luue Fee � \ 439.21�; FEES I $ 3 Z O N I N G R E Q M T S DEVELOVMENTSERVICES EQUIREMENTS: Zoning Approved By �R.�7 �ate S� �Building Approved By • � Date Applifation Issued By' Dam � - SUM V QF FEES BUILDING PERnMCI� $ ' �� SMIP ; $ s�o PLANCHECKL✓O$ � PEFiMIT � ' . PLUMBING �� ,$ ISSUANCE � $ PLAN CHECK` 25% $��.�' ENERGV'P.C. $ � ELECTRiCAL $ r GRADING $ PLANCHECK 509G 5. MICROFILM � S'� MECHANICAL S TOTAL FEE S PLAN CHECK 25% $, � r � CONSTRUCTION AND PLANNING � HPPROUA4S Permit # � 1. Temp rary Electrical Service or Pole r 2. S�oil Pipe-Undrgrnd. � 3. Electrical Conduit Utility-Undrgrnd. 4. Electrical Conduit-Undrgrnd. 5. Steel Reinforcement 6� Electrical UFER Grnd' , 7. Footings S�£/C P ' 8. Foundation - 9. Water Pipe-Undrgrnd. � 10. Structural Floor System 71. Property Sewer Line & House Cannection 12. Sewer Cap � �, 13. Roof Drains � 14. Rough Plumbing 15. Rough Electrical-Conduit - 16. ,Rough EleCtric Wiring 17. .Rough Wiring Sign 18r Rough Elect�ical-T Bar Ceiling 19. �Rough Heating & Air Conditioning 20.�Rough Factory Fireplace 21. Ducts,in Structure ' 22. Ducts, Ventilating 23. Gas Pipe-Rough & Test 24. Roof Framing � 25. Roof Sheathing 26. T-Bar Ceiling (Structural) & Monocoat , 27. Frame and Flashing � 28. Lathing & Siding . 29. Insulation ' 30. Drywall Nailing � 31. Plaster Brown Coat . 32. Electrical Power Meter-Final 33. Final Electric � 34. Final Heating & Air Conditioning 35. Final Gas PiPe-Test 36. Hood or Canopy 37. Final Faaory Fireplace � 38. Final Plum6ing ' 39. Water Service-Final , • 40. Gas Service•Final 41. Solar pomestic-Final , 42. Backflow Preventer 43r Backflow Irrigation 44'= Landscape Irrigation System • 45. Sound Attenuation � , 46� Handicap Regulations ` . 47,; FINAL STRUCTURE & BUILDING 48. Special Requirements Completed 49. Electrie Release to Edison� 50: Gas Release to Southern California Gas Co 57i CERTIFICATE OF OCCUPANCY Vo _. . _ Date Date POO, ;PA Inspector AppROVALS Permit # 52. Pool & Equipment Location 53. Steel Relnforcement 54. Forms 55. Electrical Bonding 56. Rough Plumbing & Pressure Test � 57. APPROVAL TO COVER�GUNITE 58. Electrical Conduit-Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test 60. Backwash Lines, P-Trap, O Undrgrnd. 61. APPROVAL TO DECK 62. Backwash & Receptor-Final � . 63. Heater & Vent-Final 64. Plumbing System - Final ' 65. Electrical-Final 66. Solar System-Final - 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING 69. POOL/SPASYSTEMSFINAL . FIRE DEPT. REQUIREMENT APPROVALS Permit # 1 70. Underground Hydro 71. Product Piping O Gas ❑ Oil 72. Underground Flush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe . 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTION 80. FOOD CERTIFICATE ISSUED No�t„e� « � A-;� Date Ilnspector 0 0 AVClicant to fill in all spaces except those within heavY bortler lines antl sign all appropriate tleclarations. CiTY OF COST�A MQES+7aI 'CONSTRUCTION'PERMIT ProjectAddre`ss[�CL/ w �� -�� ApplicanYs Mailing Address � - � Owner's Name Ah/tY. � �.f%cja Phone s�. / 11 J Address �yio �_cPc �i�'c�.o42- F/��r/+�' Arch/Eng. � license No. Address Con4ractor'sNam �P3f� �� - t Phone 99l`)1'1� Address (mailing) y `�� h' f�t�"� �'r City License No. �2 LICENSED CONTRACTOR DECLARATION 1 nereby af(irm titat I am licensetl untler provisions ot Charter 9(commencing with section �000) of Division 3 of the Business antl Professions COCe, and my license is in fu force antl efiect. �icen��l�y ` � 'cense No.a��967'7 � Date � 5'9 t WORKERS'COMPENSATION DE LA ION I hereby aftirm that I have a certificate o consent to seli-insure or a certiticate f Workers' Compensation Insurance, or a certifietl copy thereot (Section 800, �ab. C.) � � o��YNo. siE9�ly companySTa{G�y.d Certifietl copy is hereby fumishetl. wPJt ��,4� Certitie copy/ is filetl with the city Builtling Divi on Date 1£�f�J�` Applicant �g/R-�+ � r�%1�- �q��, EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be completetl if the permit is for one huntlretl ($100) ar less). I[er[ify that in the pertormance ot the wo�k tor which this perm�i is Issuetl, I shall not employ any pe�son in any manne� so as to become subject to the Workers' Campensation Laws of Califomia. Date Signature � NOTICE: If, after making this tlecla�ation, you Shoultl become subject to the Workers' Comp¢nsation provisions ot the Labor Cotle, you must forthwith comply with such p�ovision5 or this pe�mit shall Ge tleemetl revoketl. CONSTRUCTION LENDING AGENCY ' I nereby aifirm that there is a mnstruction lentling agency tor the pertormance ot the work tor wM1i4h this permit is issuetl (Seciion 309� Civ. CJ Lentler's Name'��+�r../ 1rfi�K -Lentler'S AOGress �+��7 OWNER BUIL�ER DECLARATION � V 1 hereby affirm that 1 am exempt trom the Contractor's License Law for the foilowing reasod (Section 7031.5 Business antl Professional Cotle: Any city or munty which requires a permit to construct, alter, improve, tlemolish or revair any structure, prior to'its issuance; also requires the apo�icant for such permit to tile a signetl.statement that he/she is licensetl pursuant to the provisions ot the Contractor's Li<ense Law (Chapter 9(commencing with Section ]000) of pivision 3 oT4ne'BuSinesS antl-Professrons CotleJ-or that he/she i5 exempt 'heretrom antl'the:basis for the allegetl exempfion. Any violation of Section 731.5 by any applicanf for a�permit Subjects the applicant to a civil analty of not more than five huntlretl tlollars ($500). ❑ I; as ownei ot the property or my employees with wages as their sole campensation; will tlo ihe work, antl the structure is not intentletl or ofleretl for sale (Section 7044, Business antl Protessional Cotle: The Cantractor's License Law tloes not apply [o an owner of a p�operty who builtls or improves thereon; antl who tloes such work himself/nerselt or through his or her own employees, provitletl that such imp�ovement5 are not intentletl o� ofte�etl for sale. I(, however, the.builtling or improvement is soltl within one year of com- pletion, the owner will have the burtlen of proving he/she tlitl not builtl or im- . prove tor the purpose of sale). ❑-I, az owner of the property, am exclusively contracting with licensetl mn- Iractors to canstruct the Droject (Section ]044, Business antl Pro(ezsions Cotle: � The Cont�actor's LicenSe law does not apply�to an owner of prope�ty who �i builtls or improves [hereon, antl who mnt�acts to� such projCctS wifh a mn- Itractor(5) iicense pursuant to ttie Contracior's License L.aw). I am aware that proof ot tM1eir Worker'S.Compensation insurance shoultl be provi0etl to me. ❑'I am exempt untler Section ,_ B. & P. C. for this reason Date I hereby certify tha' iniormacion is correc' antl state laws relatir sentatives of tni ci inspection pur Signahre Drivers' License CMF 0865-46, rev. 10/84 _ owner I have reatl tnis application antl state .that the above I agree to comoly with all city antl county ortlinances �to builtling construction, antl hereby authorize repre- � to enter upon the above-mentionetl property for 7 %�_-,., � � Date t/i.i�%!� x .� TYPE OFCONSTRUCTION '�S NEW IJ ADD LJ ALTERATION LJ REVAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TYPEOFPERMIT GRADING FOUNDATION STRVCTURAL . ❑ TENANT ❑ ELECTRICAL ❑.+ PLUMBING ❑ MECHANICAL ❑ OTHER T/�S� incl �F I_3IOCK 4.sIIS �'.s/1I IL/C•F PROJECT DESCRIPTION SQ. FT. OCCUPAN .y,� CON STRUCTION TVPE VALUATION $ �� ZONE GRADINGCU.V�S. ACRES Remarks: , . ' ' Bar Sink Backflow Preventer Backflow Irrigation Bathtubs Clarifiers Drinking Foc Floor Drains Floor Sinks Gas Service Interceptors Kitchen Sink Lavatories Outlets ' Roof Drains � Reinspection Fee $15 � Boiler � Duct - Under Ground - Duct - Structural Duct-Ventilating� . Exhaust System ❑ Multiple Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑6700,000 BTU 0100,000 Reinspection Fee � '$15 White - Builtling; Cana/y - Applicdnt: Plnk - Accounting; Goltlenrotl - Assesso� Showers Service Sink Sewer Cap Sewer Cannection - Solar Collecmrs $olar Piping Solar Tank Swimming Pool w/Spa Urinal ' Water Closet Water Heater Water Service - Auto-Wash laue Fee Hood or Typel ❑ Canopy Type I I ❑ Refrigeration Sysiem ❑0-100,000 BTU ❑100,000 BT System Repair/Alteration . Fire Dampers = Registers Issue Fee FEES A.P. �k �oC � ^ S Main Building: ' E T Front A Rear C Right, K . _ Ping. Ref. � ' Planning Notes: m Aummatic Washer Construction PoleSu6. � Cooking Unit Dishwasher � � Dryers ❑Gas ❑Electric .' ' Fan F.A.U. Fixtures Device Boxes Outlets Switches Garbage Dispoul Generaror �0.5 KW 0545 KW $ 3 I � Reinspection Fae $15 FEES DEVELOPMENT SERVICES RFQI Zoning APProved BY— �"� � Building Approved By —L�E Aaoliqtion luued Bv $ 3 ' i959 ;6Y20%86 Zone Accessory Building: Parkinp Req./Provided � 78.93�.,r, ... ,-- . , 21CAL FEES Trensformer ❑ 15-50 KW ❑ 50+KW Mecer ❑up�to 100amps Meter ❑over100amps Sub Panel ' Motors �0-1 HP O1 % :8 Inc.Solar �9-15 HP �16-75+ � Microwave � ' ' Pole Light, � � Range � Sign ' i Standing Sections .Trash Compactor ' � luue Fee . $ 3 NTS: � - '/ ZO� �—Date �o�� Date ��_'_� Z O N I N G R E Q M T S � SUM V FEES � BUILDING PERMI7 '$ ===-L7� SMIP � . : $ s �O PLAN CHECK , $ . PERMIT � ' �' PLUMBING $ ISSUANCE �$ . PWN CHECK 25% $ ENERGV P.C. $_ ELECTRICAL $ _ GRADING $ PLANCHECK 50% $ - MICROFILM $ - /� MECHANICAL $ TOTALFEE $ �7i� PLAN CHECK 25% $ ' � 1 CONSTRUCTION AND PLANNING POOL & SPn r APPROVALS Permit #' Date Inspector AppROVALS Permit # Date Inspector; v 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location ' 2. Soil Pipe-Undrgrnd. • 53. Steel Reinforcement ' 3. Electrical Conduit U[ility-Undrgrnd. 54. Forms a 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test Q 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE ❑, 7. Footings �� P��` . �0 6 Q�- 58. Electrical Conduit-Undrg;nd. �, 8. Foundation '�� . 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. ,. 60. Backwash Lines, P-Trap,�� Undrgrnd. 10. Structural Floor System ' 61. APPROVAL TO DECK � 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electri�al-Conduit 66. Solar System-Final i6. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL • � 19: Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # _ 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush , 24. Roof Framing . 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro , , 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical . 27. Frame and Flashing 76. Dry Standpipe ' 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 7S. FIRE PREV. FINAL 30. Drywall'Nailing ; HEALTH DEPT. REQUIREMENT ' , � 31. Plaster Brown Coat 79. FINAL INSPECTION � �. 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: (� g P(o �� ,��-'��{�- , 34. Final Heating & Air Conditioning � 35. Final Gas Pipe-Test . 36. Hood or Canopy � � 37. Final Factory Fireplace . � 36. Final Plumbing . ' 39. Water Service-Final - 40. Gas Service-Final � � ' 41. Solar pomestic-Final . 42. Backflow Preventer � 43. Backflow Irrigation - 44. Landscape Irrigation SYstem . ' • 45.. Sound Attenuation !�` ' • ' •46. Handicap Regulations �. � �. 47. FINALSTRUCTURE&BUILDING �� . ' ,- , 48.'Special Requirements Completed � �q �� M � , ;' , � 49. Electric Release to Edison � ' 50. Gas Release to Southern California Gas Co � . 51. CERTIFICATE OF OCCUPANCY No. Date \ 1 APD�icant to /ill In all spaces exeeo< <�osa within heavy Doraer Iines ana.sign all avv�aGriate Gaelaratlons. ciT`OOFCOSTA ESa CONSTRU TION ERMIT • � Project Address �7 [.v i9 � S�a �° f' Applicant's Mailing Address Owner's NIa-�me ��Cy�`g �S� ��,�.�e �Pghoi�ne —�— Address J'�TL{ � -�` �� iR7 Address �� u r �'�%d 0 0 „"�, Contracmr's Nam - S�N$ Y„ �� ' Phon�� 'S �� Addresslma"I' gl� o�� G%VSQ'%" �I- �- � �" Ciry License No. �� LICENSE� CONTRFCTOR DECLARATION I hereby affirm that 1 am licensetl untler provislons ot Charter 9(commencin9 W�lh SCCS�00 JOQO) O( �IVISIOfI 3 o(,the Business antl Grofessions Cotle, antl my license is m II f ntl effect. � �-� � r� � r- Lice�f Cf�s Licen�a No:<<�s�r»t�? Oate%�� 5"9 t C-`�0�� WORKERS'COMPENSATION DECLAR ION � I hereby aifirm that I nave a certi(itate of consent to 5¢I1-insure or a certificate' f Workers' Compen5a[ion Insu'ance, or a certifie.d Lopy thereOf 5 Cti n� d00, Lab. :G()Ley¢� (� T¢.. 1.,,.,�_9�a PolicY No. ✓iT'YlJ 3�— (J 1O ComPanl �"fiuG� ftl�li -• ,(ny Cerlifietl mpy I5 hereby fumishetl. p.�C ' I � i A with the city iltlin9 iviSioNn,.``Al'� Dale ApplicaM,.� � �� EXEMPTION FROM WORKERS' COMPENS ION DECLARATION (TM1is section neetl not be completetl if the per It is for one huntlretl ($100) or less). ' ' 1 certity that in the P¢rformance of th¢ wOrk fo� whicn thl5,0e�m�l i5 issuetl I' shall nOt employ any pe�son in any manne� so as to become Subject to�the Workers' Compensatlon Laws of Calitornia. - . Date Si9nature �NOTICE: If, af[e� making Ihis tlecla�ation, y0u shOultl become subject to thB Workers' Compensation-provislons of. the Labor Cotle, you must forthwith comply wilh such provislons or this pe�mit shall be tle¢metl �evoketl.� �, CONSTRVCTION IENDING AGENCV ' � I nereby aHirm that tnere is a construction Ientling agency for the parformance of the work for which [his permit i5 iz5uetl (Section 309] Civ. C.) Lentler's Name � LenOer's Atltlress . OWNER BUILDEN DECLARATION I hereby dtfi�m that I am ex¢mpt �rom tbe ConVaCtOr'S Licensa C�w tot th0 � following reason.(Section ]031.5 Businessantl Professional Cotle: AnY city�or, <ounty which requires a pe�mlt t0'const�uCt, alte�, Improve, tlemolish or �epai� any struclure, prlor to Its issuanca, also reqWras the applicant for such permit lo tile a Signetl sta[ement Ihat he/5hE is Ilcenzetl pursuant to Ihe provi5ion5 ot the Contracror's License Law (Chapter 9(commencing with Section ]00o) of Division 3 oi the Busin2z5 antl Professlon5 COtle) o� lhat he/she i5 ¢xempt 'herefrom antl tne ba5iz tor the allegetl exemp[ion. Any vlolation ot Sectlon 731.5 by any applicant fOr .a permit 5ubject5 the applicant [o a civil analty of not more tnan five nuntlretl aollars (5500). ❑ I, as owner of the property�or my amployees with wages as their sole <ompensatlon, will tlo Ihe work, antl the structure is not IntenCetl or oiteretl fof Sale (52ction ]044, Bu5ine55 antl PrOfesslonal Cotl¢: Th8 Conttacto!'S License law tloes nol app�Y to an owner ot a property who builtls or improves [hereon, antl who tloe5 sucn wo�k hIT5211/112�SCIf OI NroO9l1 h15 O! hB� OWfI employees, provitletl [hat such improvemen[5 ate not Intentletl Or Ot(eretl fo� sdl¢. If, hOwever, [he builtling or ImprOvement i5 Soltl within one yea� ot com- pletion, the ownar will nave the burtlen of provin9 he/sne tliG not builtl or Im- prova for the purpose oi sale). ' ❑ I, as owner ot the property, am ezUusively mntractin9 with Ilcensetl con- traclors lo construct lhe Project (Section ]044, Business antl Professions Cotle: The ConVactor's License law dOes no[ applY to dn owne� of pro0erty wh0 builas'br improves ihereon, antl who mntracts for such projects with a con- tractor(51 license pU�suanf�to�the Contrac[oi'i License Law). I am awa�e that pwof o� IM1ei� Worker's Compen5ation in5urdnce shoultl be. Provltletl to me. ❑ I am axemp[ untler Section ' B. & P. C. tOr this reason Date ` Owner I hereby certity that I have reatl this application antl state�[hat the above intormatlon is correct. I agree to comply witn all tlty antl county ortlinancas antl state laws relating to builtling construction, antl here�y authorize repre- sentatives of iiz city to enter upon e above-mer�tionea property for �inspectlon p oses. _ _ � � " ! G Signaluro �dreL� � Date' � TVPE OF CONSTRUCTION LJ NEW U ADD LJ ALTERATION U RE7AIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, # � DESCRIPTION OF WORK/USE OF BLDG. S Main Buildi E TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL T Front ❑ TENANT ❑ EIECTRICAI � PLVMBING ❑ MECHANICAL 8 Rear ❑ OTHER A PROJECT DESCRIPTION Sq.P7. oCCUPANCv C Right K Left CONSTRUCTIONTYPE VALUATION$ $ ZONE - GRADING CU. VDS. ACRES p�ng. Ref. # Remarks: � 2 l �� Planning Notes: Irri9ation Clarifiers Dishwasher Drinking Fountains Floor,Drains Floor Sinks Gas Service Intercepmrs Kitchen Sink Lavatories Roof Drains Reinspeetion Fee Outlets $15 Boiler Duct- UnderGround Duct � Structural Duc[ � Ventilating Exhaust System ❑ Multiple Firepl/Fact.8lt. ICBO # Heatin9 System & Ductin9 ❑0100,000 BTU �0100,000 '`D�r vers' License or 5� � � Reinspeetion Fea � $15 CMF 0865-46, rev. 30/84 White - Bulltlin9; Canary - Applicant: Pink - Accounting; Goltlenrotl - Assessor ShoWers Service Sink Sewer Cap Sewer Connection Solar Collecrors Solar Piping Solar Tank ' Swimming Pool w/Spa Urinal Warer Closet Water Heater Water Service Auto-Wash laue Fee Hood or Typel ❑ Canopy Type 11 ❑ Refrigeration System ❑aioo,000eru Oioo,000 System RepaidAlteration � Fire Dampers Registers Issue Fee FEES tl Automatic Washer - Construction Pole'Sub. Cooking Unit ` Dishwasher � Dryers ❑Gas ❑Electric Fan F.A.U. Fixtures Device Boxes Outlets _9319. 7/I4%86 ��°"� „ �c..t.(.y�,-5'Sn• ,- ..- - - : 50.5D - TL 2one Accessory Building: ' Z O - N I N G . R ' Perking Req./Provided E M T s ELECTRICAL � Transformer ❑ 15-50KW ❑ 50+KW Meter ❑up to 100 amps Meter ❑over 100amps Garbage Dispoul Generator 00.5 KW 05-15 KW Sub Panel Motors OO-i HP O1'/: - 8 InaSolar �9-15 HP �16-75+ Microwave Pole Light Range Si9n ; Standing $ections Trash Compactor � $ 3 I �- Reinspection Fee $15 luue Fee FEES DEVELOPMENT SER VICES REQUIREMENTS: ZoninB APProved By euilding Approved By Aaoli1ationdssued Bv � $ 3 FEES $ 3 � . SUMMARVOFFEES BUILDING PERMIT $� SMIP $ PLAN CHECK $ ��(�/�� PERMIT PLUMBING $ ��{!},�_ ��UANCE $ PLAN CHECK 25% $ �j 4U ENERGV P.C. $ —�'�_ ELECTRICAL $� � ' GRADING $ PLANCHECK 50% $' MICROFILM, $ (�- � �� MECHANICAL $ TOTAL FEE $ _a2Y'.Lv PLAN CHECK, 25% $ , /'CONSTRUCTION AND PLANNING F � PUOL �A � Date� Inspector Date Inspector' i�APPROVAL� Permit# APPROVALS Permit# I ,i • 1. 7emporar.y Electrical Service or Pole - ;�� 52. Pool & Equipment Location � .: . � i � 2. Soif Pip�-Undrgrnd. � . ' " y,� �l� 53. Steel Reinforcement f � 3: �lectrical Conduit,Utility-Undrgrndl � ��' 54. Forms , �4. �Iectrical�Conduit-Undrgrnd. , � _ 55. Electrical Bonding ' / 5� Steel ;Reinforcement �� . � .. •.� 56. Rough Plumbing & Pressure Test 6� Electrical UFER'Gmd. �, 57. APPROVAL TO COVER-GUNITE . 7..Footings � - � 58. Electrical ConduirUndrgrnd. �� "� � 8.. Foundation ��-'� i. 59. Gas Pipe, � Undrgmd., Test - l^��., � 9� Water Pipe-Undrgrnd. � k� , 60. Backwash Lines, P-Trap, O Undrgrnd. �� f 10. �Structural Floor System � .`, 67. APPROVAL TO DECK 11; Property,Sewer Line & House Connection �- �/� G� 62. Backwash & ReceptorvFinal // 12. Sewer Cap i'! ' ��' ' 63. Heater & Vent-Final � }. � � � 13. Roof Drains ~ ��' � 64. Plumbing System - Final % � ' 14. Rough Plumbing=' �' ��L fG 65. Electrical-Final • ., 15. Rough Electrical-Conduit 66. Solar System-Final ��16. Rough Electric Wiring . _ 67. Fencing & Access Approval _ . �17. Raugh Wiring Sign 68. APPROVED FOR PLqSTERING - 18. Rough Electrical-T Bar Ceiling� 69. POOL/SPA SYSTEMS FINAL �; � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. qough Factory Fireplace �� APPROVALS Permit # 21. qucts, in Structure �., 70. Underground Hydro 22. Ducts, Ventilating ,� 71. Product Piping �Gas ❑Oil -23. Gas Pipe-Rough & Test ,� Z2.,Underground Flush � �� - �-24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. 7-Bar Ceiling (Structural) & Monocoat 75. Dry Chemfcal �-27. Frameand Flashing 76. Dry Standpipe 28• Lathing & Siding � � 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT � 37. Plaster Brown Coat 79. FINAL INSPECTION -- �. 32. Electrical Power Meter-Final , 80. FOOD CERTIFICATE ISSUED 33. Final Electric � � ' - Notes: � � � 34.' Final Heating & Air Conditioning ' � ' ' 35. Kinal Gas Pipe-Test - - 36. Hood or Canopy � � � 37. Final Factory Fireplace . 38. Final Plumbing � / 39. Water Service-Final 40. Gas Service-Final � 41 . Solar pomestic-Final � , 42. Backflow Preventer � i 43. Backflow Irrigation a ` 44. Landscape Irrigation System - 45. Sound �Attenuation i ' 46. Handicap Regulations ; 47. FINAL STRUCTURE & BUILDING ' � 48. Special Requirements Completed . 49. Electric Release to Edison . �, 50. Gas Release �to Southem California Gas Co � : 51. CERTIFICATE'OF OCCUPANCY �:No. Date � � :� � Appllcant to fill in all SDaees exceD< <�ose wlt�in �eavY Dortler Iines anE sign all apOropriale tlaclarations. . CITY OF, COSTA MESA CONSTRUCTION PERMIT � PE T Na s yg TRACT NO. LOT NO. UNIT NO. - � Project Address 8%�7 � a� S� ��r � 3�� Applicant'SMailingAddfe55 TYPEOFCONSTRUCTION EW 'HDD ALTERATION REPAIR • ❑ CONVER510N ❑ DEMOLISH O OTHER ' A.P. # . ' Owner's Name Phone DESCRIPTION OF WORK/USE OF BLDG. , , Addreu Arch/Eng. License No. Address Coniracwr'sNam • � � � �T� Phone y3��!�� Addreu (mailing) 2YL0 �. C TSS, f/.✓.¢f/Giil./ _3� �!�' ` Ciry Licenu No. I.ICENSED CONTRACTOR DECLARATION ' I hereby affl�m Inal I um IlCensetl untle� O�ovislons of Charter 9(commencin9 with 5ection 7000) oi Dlviz�on 3 0l the Bu5Ine55 antl ProfeS5iOn5 Cotle, anE my Iicense is in full torce anq etfect. IJcanse C a5s — 0 LiGe Oate g Sl9nature WORKERS' COMPENSATION DECLARATION I hereby atiirm that I have a certiticate of consent to seli-insure or a certlticate ' Workers' Compensation Insurance, or a certified copy thereof (Sectton :oo, �ao. c 1 - E. . N../i� . voiicv rvo. ��'�x2RR��comPanY 8 Certifietl copY �s hereby fumfshetl. ' CepIn fietl c py iz ii ea witn the city Builtlin aion. Dalci ^� � ' ADP��ant �� - - EXEMPTION FROM WORKERS' COMP SATION DECLARATION (Thissection neetl not be cor�pletetl it tne parmit is for one huntlratl (E300) or IC55). I certiiy lhdt in tne pertOrfTance of the work tor which this perm�l IS issuetl, 1 shall not employ any Oerson in any manner so as to becomo suoject to th¢ Workerz' Gompensalion Laws of Californla. Dato Signature .NOTICE: If, atter making thls Ueclaration, You shoul0 becoma zubject to the Workers' Compensation prqvisions ot the Labor Cotle, you murt fortnwith <omply with suth p�ovlsibn5 O/ Ihii p¢rmlt shall be tleafhptl revOked. CONSTRUCTION LENDING AGENCV 1 hareby afflrm�that tnare is a constructioa lentling agen<y /or the pertormance Ot Ih0 work 10r whith this Oermlt Is issu¢tl (Section 3097 Civ. C.) L¢ntler's Name Lantler's AtlOress OWNER BUILDER OECLARATION � I heraby etfirT thal 1 dm oxempt'froT the Con[ractor'S Licenie L.aw tor the tollowing reaso� (Soction 7031.5 Buslness anC Protossional CoOe: Any ci[yior county which reqWres d peYmit to conStruCt, alter iMprove, tlemoli5h or reDair ��.��c�u.e_ oNor to Its issuance. a1m reauirus t�e aeplicant tor zuch permit �T r�`�e�elrOm antl Ihe baih lor (he alleged exaTpllon. AOy violatlon of Sectlon '�e;i:31.5 by any applicant lor a Permit sub�ects the apD��ant to a tivll ,'nalty oi not moro tnan Iiye huntlr¢tl t1011a�S (5500). �'L� I, as ownet of lhe prqpGrty or Ty emplOyees with wdgaS as [�eir SOIe tompensation, will tlo tho Work, antl Ine structure is not Intentlatl or offeretl for sale (Section 7044, Busine55 antl Professional Coae: Tho Con[rac[or's Liconse Law tloes not apply to an owner ot a property who Duiltls or improves tha�eOn, antl who tloes suth work blm5el(/baRelf Or Ihrough pis o� hOr own employoes, pwvitloa tnal such improvements are not IntenGetl or oHeretl lor salo. If, howaver, the bulltling or imProvemont is soltl within one year ot com- 'plctiOn, [ho owncr wlll hpve the bu�tlan of prOving he/sne tlIC nOt builtl o� im- �rova 10� the pu/DoSa Oi salp), I, as owner ot the property, am exclusivelY contractin9 with Ilcense0 con- tra<tors to mnsV uc[ the vroject (Section 7044, Business antl Professionz Cotle: The Conlrac[or's Li<onso l2w does nol dpPty to dn owne� 01 property wh0 bullas or Imoroves tnereon, antl who contratts tor such projacts with a con- traclor(s1 licens¢ pursuant to lhe Con[rat[O�'s License Law). i am aware lhat prool o( [bel� Workar'S Cbmpensation Insu�anc¢ sltoultl be ptovltlatl to me. ❑ I am exemp[ unEar Seclion B. & P. G. for this reason Date Owner _ I herCby certify thdt I �aye reatl [nls InforTation is cotrett. 1 agY¢e [o wmp antl slata laws relallng to bWltling con Drivers' License or SY TVPE OF PERMIT LJ GRnDING ❑ TENAIVT ❑ E.L/E!CTRICAL� ❑ OTHER . FYlG/F'TTn PROJECT DESCRIPTION S�.FT._ CONSTRUCTION TYPE Sink Preventer Irriqation . Floor Dreins Floor Sinks . GasService Outlets Interceprors Kitchen Sink ' �8V8LOfICS P—Trep Roof Drains Reinspaction Fee $15 M Boiler Duct - Under Ground Duct - Structural �uct - Ventilating Exhaust System � Multiple ❑ FirepUFact. Blt. IC80 � Heating System & Ducting t jiSb100,000 BTU 0100,OOOBT � -C-��- Reinspaction Fee � $15 CMF 0865-46, rev. 10/84 White - Builtling; Canary - Appli<ant; Pink - Atcounting: Goltlenrotl - Asse55or S Main Bwldmg. E FOUNDATION $TRUCTURAL T FlOnt PIVMBING MECMANICAL 8 Rear � �' C_ A OCCUaANCv C Righ4 K Lett VALVA710NS $ NG CU. VDS. ACRES Ping.'Ref. � � � � Planning Notes: Showers Service Sink � Sewer Cap �� Sewer Connection Solar Collectors Solar Piping � Solar Tank Swimming Pool w/Spa Urinal Water Closet . Warer Hearer Water Service Auto-Wash � Laundry Trays laue Fae Hoodor Typel ❑ Canopy Type II ❑ Refrigeretion System �4700,OOOBTU ❑100,000 SVstem Repair/Alteration Fire Dampers Issue Fea Zl FEES Automatic Washer � • Construction Pole Sub. Cooking Unit - Dishwasher Dryers ❑Gas ❑Electric 3751 9/25/86 - e ZOne Accessory Building: ELECTRICAL . . Trensformer ❑ 15-50 KW ❑ 50+KW F.A.U. � Fixtures Device Baxes ' Outlets Switche5 ' Gar6age Disposal Generator 00.5 KW �5�15 KW Meter LJup to 100 amps Meter ❑over'100amps � Sub Panet Motors �P7 HP � i X- 8 I nc. Solar 09-15 HP �d 16-7 5+ Microwave Pole Light Range Standing Sections Trash Compactor 53I �e. Reinspection Fee $15 laue Fee FEES DEVELOPMENT SERVICES REQUIREMENTS: Zoning APProved By Building Approved By Anoliption Issued Bv � ' 3 56.75 TL FEES $ � SUMMARV OF FEES - ' BUILDING PERMIT $ SMIP $. PLAN CHECK $ PERMIT � ' -�^" PLUMBING $ �SSUANCE $ PLAN CHECK 25% $- ENERGV P.C. $ ELECTRICAL $ GRADING S � PLAN CHECK MICROFILM MECHANICAL�'� TOTAL FEE �S � 7'S PLANCHECK z5°6 $ �d• 73 Z O N I N G R E � M T S CY�`� CONSTRUCTION AND PLANNING POOL & SPa. : APPROVALS Permit# Date Inspector qppROVALS Permit# � Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgmd. . 55. Electrical Bonding �� 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit-UndrgrndW 8. Foundation 59. Gas Pipe, O Undrgrnd., Test;�� 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 'U .� 11. Property Sewer Line & House ConneMion 62. Backwash & Receptor-FinaY� 12. Sewer Cap 63. Heater & Vent�Final 73. Roof Drains � � 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Fiough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring 67. Fencing & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING • 18. Rough Electrical-T Bar Ceilin9 69. POOUSPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning q�_� (�W FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts,in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush . 24. Roof Framing ' 73. Undergrnd. Storage Tank O Gas ❑ Oil � 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar�Ceiling (Structurel) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Ory Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. RE�UIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION � 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric Notes: � 34. Final'F.leating & Air Conditioning �j-/d"�6 �� 35.- Final�Gas Pipe-Test 36. Hood or Canopy ' � 37. Final Factory Fireplace . ' 38. Final Plumbing ' . 39.�Water Service-Final ` 40. Gas Service-Final . � 41. Solar pomestic-Final . ' 42. Backflow Preventer 43. Backflow Irrigation . � 44. Landscape Irrigation System � 45. Sound Attenuation � - � 46. Handicap Regulations � 47. FINALSTRUCTURE&BUILDING • • 48. Special Requirements Completed � , 49. Electric Release to Edison , 50. Gas Release to Southern Calitornia Gas Co . 51. CERTIFICATE OF OCCUPANCY No Date . AOP��ant to flil in all spaces except tnose within neavy OorOer Ilnes antl sign a11 aoD/opriate aeclarations. CI7vO�F-cosT,a;MESA CONSTRUCTION PERMIT „ProjeCt A'ydress � ``�7 w �� f� 'r%� � ' Frpplicani'sMailin9Address ��` �'"�� b��' Owner'sName� �^�� '��`�� Phone �2l'�LtJ Address ��y�4'�+ pCl4n vr..a� �%b�f..w Arch/Eng.T _ License No. � Address Contractor's Nam %✓�� C:r r� .-,ai vhon^e 99H� � Addreulmailingl��y� L� �"�`��5�4� U.%�<.1�'-� City License No, d ��dd8 LICENSED CONTRACTOR DECLARATION 1 hereby attirm [M1at I am lic¢nsetl untle� provislon5 of Charte� 9(COmmencing with 5ection 7000) of DlviSion 3 a! the Buslness antl Prolessions Cotle, antl my Iicense is in rwi torce a a errece. �� `�� Llcens�C � — kiCensCNo Da[e > Si9nature WORKERS' COMPENSATION DECLAR ION � nereoy affirm that I nave a<ertlficate oi consent to selftinsure or a certifi<ate Work¢rs' Compensation Insurance, or a certifie0 copy roereof (Sectlon �o. �b. �, S'c�.s,.Y ' S'f�.L �: � Yolicy No. Company � CertifiCtl copy i5 heroby tu�niSh¢tl. ' Gertifietl c %p�is tiletl with the city ' ' ision. � Da[e.�L.�S'- APPlican[ ' ✓"� E%EM7TION FROM WORKERS' COMPE TION DECLARATION (Thissection neetl not be completetl if the p rmR is for one huntlreC (5100) or less). 1 certify tnat in Ihe pertormanCe ot the wo�k for which this pe�mR I5 iSSuetl I shall'not employ any person in any manner so as to become subjett to t�e workers' Compensation Laws ot California. � Date ' Si9nature . NOTICE: It, aftar making this�tletlaration, you Shoultl become subject to the Workers' Compensation provi5ions of tne Labor Coee, you must fortnwith comply wi[h such prOv�5iOn5 or thi5 permit snall be tleemetl r¢vokee. CONSTRUCTION LENDING AGENCV I hereby af(irm that there is a construction lentling agency for che performance of the wo�k for wmcn this permit, is issuetl (Section 3097 Civ. CJ Lentler's Name . LantleYS�Atltlress - - OWNER BUILOER OECLARATION � . I hereby a(tirm that I am ezempt trom the Contractor's License l.aw for the '. following reason (Section 7031.5 Business antl Pro(essional Cotle: Any city or �� County whicn �equi�es a p¢rmlt to construct, alter, ImD/ove, tlemolish o� �epair any 5trucWre,-prior to i[s issuance; also requirez the a00��ant for such permit to tile a Si9netl stafement thal he/she is licensetl purSudnt to the provizions of [he Contractor's License Law (Chapter 9(commencin9 with Section 7000) of ' DlviSion 3 of th¢ Bu51ne55 antl Professions COtl¢) or that h¢/she is exempt' =refrom antl [he'basis for the alleqetl exemption. Any violation ot Section 31.5 by any appli<an[ Por a pe�mit Subjects th! applicant fo a tivll .�alty ot not more tnan five huntlreG tlollars ($500). L� I, as Owne� ot tho prOp¢rty or my employe¢5 wlth wa9es �as their sole Comp¢nsation, will tlo th¢ wo�k, antl tne struCture is not intentled o� offe�etl for sale (Section ]044, Business antl Professional Cotle: The Contractor's License Law tloes not apply [o an owner o( a property wtto bW Itl5 or Improves [boreon, antl who tloe5 Such wOrk himselt/herselt or Ihrou9b hi5 or het own employeez, provitletl [ha[ SUCh ImOrov¢ments arG mt Intentletl o� oHe�etl IOt sala. If, nowever, the builtling or improvement Is soltl wlthin one year ot com- o�ellon, the owner wi11 nave the burtlen of proving he/she altl not bulltl or Im- prove for the purpose af sale). , � ❑ I, a5 owner o� the prOOerty, am exclusively con[�acting wi[h IicenseC cOn- t�att0/s t0 conrt�uct the Oroj¢<t ($ection 7044, Busin¢55 antl Protes5ion5 COtle: The ConVactor's License Law does not apply to an owner ot Property who builtls or improvez thereon, antl who contracts for such'prolects with a con- tractor(s1 license'pursuant to the Gontractor's License Law). I am awaro tnat, proof of their Wotke�'s CompensatiOn insu�ant¢ shoultl be provltletl to me. ❑ I am exempt untler Section � B. & P. C. �or tnis reason Date antl state iaws reiaur SEOIdI1VC5 Of (�I� CI Inspection ourp . Si9^ature , �rivers' License or � CMF 0865-46, rev. 30/84 . owner have reatl this application antl state that the above agree to compty with all Uty antl county ortllnance5 o builtling construction, antl hereby authorize repre- to enlet upon the above-mentiOneO PrOperrty, 10r �Date �/1//" .. �—_ TVPE OF CONSTRUCTION IJ NEW LJ ADD LJ ALTERATION LJ REPAI R ❑ GONVERSION ❑ DEMOLISH ❑ OTHER � DESCRIPTION OF WORK/USE OF BLDG. TVPE OFPERMIT LJ GRADING LJ FOUNDATION IJ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL O OTHER _ PROJECT DESCRIPTION SQ. FT. OCCUPANCY— G O N ST R V CTI ON TV PE V ALUATION $ 20NE GRADINGCU.VOS. ACRES_ ___-__.._ � � _ � - ' . � � i . _ . ar Sink ackflow Preventer ackflow Irrigation athtubs Drinking Fouritains Floor Drains � Floar Sinks GasService Outlets InterceptOrs Kitchen Sink , Lavatories P-Trap Roof Drains . i , � PLUMBING Shower5 Service Sink Sewer Cap Sewer Connection - Solar Collectors Solar Pipin9 Solar Tank Swimming Pool w/Spe Urinal Water Closet Water Heatei Water Service� Auto-Wash Laundry Trays FEES Feinspection Fee, � $15 I I . Issuo Fee � I $ 3 Boiler Duct - Under Ground Duct - Struttural . Duct - Ventilating Exhaust System ❑ Multiple Firepl/Fact. BIt. ICBO # Heating System & Ducting ❑0.100.000 BTU 0700.000 Reinspection Fee � $15 Whit¢ - Builtlin9: Canary - Appliwnt; Pink - Accountin9; Goltlenrotl - Aszessor Hoodor Typel ❑ �Canopy Type II � Refrigeration System ❑aioo,000sTu ❑ioo,000 System Repair/Alteration Fire Dampers _ _ Registers , Iwue Fee � A.P. # S Main Building: E T Fron[ 8 Rear A C Right S Left Ping. Ref. # � Planning Notes: Automatic Washer Construction PoleSub. Cooking Unit , Dishwasher Dryers ❑Gas ❑Electric Fan � F.A.U. FixWres ' Device Boxes � Outlets , Switches - • ' Garbage Dispoul . Generator O65 KW 05-15 KW Reinspection Fee FEES DEVELOPMENTSER 'Zoning Approved By- Buildine APProved By Appliwtion luued BV_ $ 3 , 8863 .7/b3%86 Accessory Building: ICAL Transformer ❑ 15-50 KW ❑ 50 + KW Meter LJup to 100 amps Meter ❑over 100 amps Sub Panel . Motors 041 HP 01 Yh - S IncSola'r �9�15 HP�0,16=15+ Microwave l Pole Light` o........ � ' Sign Standing Sections Trash Compactor 0 0 $15 ' I luue Fee � REQUIREMENTS: 9.00 Tl. $ 3 Z O N I N G R E Q M T S � SUMMARV OF FEES � � BUILDING PERMIT '$' SMIP . $ PLAN CHECK $ PERMIT � PLUMBING $ ISSUANCE � ;$ PLAN CHECK 25% $ �¢�� ENERGV P,C. $ ELECTRICAL . 5 �y.VJ1— GRADING . $ � PLANCHECK 50% $ ' MICROFILM $� MECHANICAL $ TOTALFEE $ 8�� PLAN CHECK 25% $ . • , � ` y CONSTRUCTION AND PLANNING POOL & SPA ' ,^ � Date Inspector � Date Inspector APPROVALS Permit # , APPROVALS Permit # , L�Temporary Electrical Service or Pole '�� ). '� � 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms . ;� � 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding � � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE � 7. Footings 58. Electrical Conduit-Undrgrnd. y - 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains , 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electrical-Conduit . 66. Solar System-Final 16. Rough Electric Wiring - - 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � 18. Rough Electrical-T Bar Ceiling ' ' 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure . 70. Underground Hydro y� 22. Ducts, Ventilating 71. Product Piping OGas OOiG i 23. Gas Pipe-Rough & Test 72. Under9round Flush o 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil ., 25. Roof Sheathing • 74. Overhead Hydro . '; 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe �� 28. Lathing & Siding . 77. FIXED SYSTEM FINAL � 29. Insulation 78. FIRE PREV. FINAL �- 30. Drywall Nailing HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat 79. FINAL INSPECTION �; 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .� 33. Final Electric ' Notes: r . , 34. Final Heating & Air Conditioning ' 35. Final Gas Pipe-Test ' 36. Hood or Canopy . 37:'Final Factory Fireplace - ` 38�Final Plumbing - ; 39�Water Service-Final � � 40. Gas Service-Final. � � ' 41. Solar pomestic-Final ' � � 42. Backflow Preventer ' �'� � " t+ c ;43. Backflow Irrigation . ' {�"�� S,' �� ' ' > - �44. Landscape Irrigation System ` �y .' r " • • - .45�Sound Attenuation ' ' . . �� , �, r . �46:�Handicap Regulations "' -e- ,.� .r 47r FINAL STRUCTURE & BUILDING � " s•' � ,� �r . � . , 48��,Special Requirements Completed �r t' V'!u ,,. ' 49. Electrie Release to Edison � � � � �i > :.i 50. Gas Release to Southern California Gas Cv /� � � `' ' r 57. CERTIFICATE OF OCCUPANCY • ; � No. Date � 4 � . _ ��/S G_C� � AOO��eant to (ill in all spaces excepl those witpin �eavY �oraer Iines antl sign all aporoDriate Geclarotions. CITY OF COSTA MESQA CONST�CTION PERMIT ' �-PERMf=,NO. '" '� -'_' TRACT NO. LOT NO. UNIT NO. Project Address � (�,7 � � T Applicant'sMbilingAddress ��5 �� ,LyC1N A Owner'sName �SNdQ Phone Address Arch/Eng. License No. Address �� .,�.h Contractor'sName Mlrf, i�'fO�,i e1S��j� Phone�lL' L9..C� Address (mailingl •r1 e� City License No. ' aA / UCENSED CONTRACTOR DECIARATION � � 1 hereby aHirm tha[ I am licensetl untler provisions of Charter 9(commencing witM1 section �000) of Divislon 3 ot the Business antl Professionz Cotle, antl � my Ilcense is in tu torce antl etfect. , ' n Licen�Cla'z ��O � QLicey�No,3y�T� Date ti `S �--- � WORKERS' COMPENSATION DECLARATION I hereby aifirm that I have a ceriiticate oi consent to selLinsure or a terti(I<ate � ` Wo�ke�s' Comp¢nzation Insurance, ot a certifietl copy the�eot (Section .00, �ab. CJ . �olicy No. Company eCertifietl cooY is hereby turnishetl. Certitietl copy is,filetl with the city Builtling Division. Date Applicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION ' (This section neetl not be completetl it the permit is for one huntlretl (5700) or less). I te�[ify that in the p¢rformance ot the wo�k tor which this pe�m�t i5 iSSuetl, I snall not employ any pe�son in any manner So a5 to become subject to the Worker Co ens� t.}'O n LawS of Calitqr9y� n Date ��2LY Si9nature —/��r� � / NOSICE: It, atter making this tleclaration, you shoultl bec e subject to tha Workers' Compensation provisions of tM1e Labor Cotle, you muzt forthwifh comply witn such p�ovisions or thi5 permit Shall b¢ tl¢lmetl �evoketl. CONSTRUCTION LENDING AGENCV � i ' I hereby af/irm that there is a tonstruc[ion lentlin9 agency tor the performance o� the work tor which fhls permit is issuea (Section 309� Civ. C.) Lentler'S Name Lfntler's.AtlOre55 � e OWNER BUILDER �ECLARATION ' I hereby aftlrm that I am examp[ from the ContraHor's License Law tor the following reasOn (Section 7031.5 Bu5ine55 antl PrOfe55ional Cotle: Any city or county whlch reqWres a permit to construct, afler, improve, aemolish or repalr any struclure, prio� to it5 i55uance, aiso reqWreS the applicanl for SUCh pa�mit to fiie a signetl statement tnat ne/she is IlcenseG pursuant to the provisions of ihe Contractor'S UGenze Law (Chapt<r 9(comm0ncin9 wilh Sectlon 7000) Ot Dlvision 3 ot tha Business antl Prolesslon5 Gotle) or that he/she•is exempl- "�er¢trom antl the basis for the allegetl exemption. Any violatlon of SeCtiOn 31.5'by any applican[ for a permit subjects tne aoo��ant to a civll nalty of not more than five huntlretl t1011ars (§500j. ' J I, as owner ot lhe property or my employees with wa9es as their sola I compensatlon, will tlo tbe work, antl tne structure is not Intentletl or ofteretl for sale (Sec[ion 7044, Business antl Professional Cotle:.The Con[ractor's LiCenSe Ldw tloe5 not apply t0 an owne� of a property who bulltls o� Improves [hC�eon, dntl wh0 tloes such wo�k M1imself/herselt ot th�ough his or h¢r own employees, ptovitletl lhat such imprOv¢ments are not intentletl or o(te�etl fo� sala.' If, howevGr, the bulltling or improvemont is soltl within one year o( com- pletlon, tho owner will have the burden of proving he/sne tlitl not builtl or im- �rove for the purposa ot sale). ' I, 55 owner of the prOPerty, am exclusivery Con[ratting with IlcenSetl COn- ' tractors to construct the Oroject (Section ]044, Business antl P/ofesiionz CoOe: The Contractor's License Law does not apply to dn owne/ of P�oOerty who builtls or improves thereon, antl who contracts for sucn projects with a Con- tractor(s'bcense oursuant to the Contractor's Liwnse L.aw).•I am aware that proot o��[heir Worker'S CompensatiOn inSurance shoultl be provitletl t0 m!. ❑ I am exempt untler 5ection B. & P. 0.�or this reason Oate ' � Owner 1 hareby certify that I have reatl this�apolication antl state tnat the above Intormation is mrrecL I aqree to comply wi[h all city antl county ortlinances antl state laws reldfin9 to builtlm9 conSlruCtion, antl her¢by autho�iie r¢p�e- sentatives of thls city to enter upon tne above-menHoned property tor inspection u ses' �.�y� - Signdture -Date�� TVPE OF CONSTRUCTION �.NEW IJ ADD U ALTERATION LI REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER p� p�6 DESCRIPTION OF WORK/USE OF BLDG. • ' S Main Buildi TVPE OF PERMIT GRADWG FOUNDATION STRVCTURAL ' T Front ❑ TENANT � ELECTRICAL� ❑ PLUMBING ❑ MECHANICAL B Reaf ❑ OTHER R PROJECT DESCRIPTION S�.,FT. � OCCUaANCv �K Right • CONSTRUCTIONTVPE VALUATION$ g Left ]_ONE GRADING CU. VDS. ACRES' p��9.'R¢f. # Remarks: � y,� ,rj � �(QM� �/ � {� �{; Planning Notes: Backflow Pieventer Backflow Irrigation � Bathtubs Clarifiers ' Dishwasher Drinking�Fountains Floor Drains ' Floor Sinks � GasService Outlets Interceptars Kitchen Sink Lovatories;: P-Trep ' Roof Drains � Reinspaction Fee , Service Sink Sewer Cap Sewer Connection � Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal - Water Closet � Water Heater � Water Service Auto-Wash Lsundry Trays Automatic - ConstructionPoleSub. Cooking Unit � - Dishwasher ' Dryers ❑Gas ❑Electric Fan � ' F.A.U.'` Fiz[ures � , Device Boxes : $15 I I: d laue Fea I $ 3 I MECHANICAL � FEES Boiler � Duct - Under Ground Duct - S{ructural Duct - Ventilating Exhaust System ❑ Multiple ❑ �Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ o-i oo,000 sru O i oo,000 er ,Drivers' �icense or 55 � ' - �� , I neinspea�on ree `MF 0865-46, rev, 10/84 White - Builtling: Canary - Applitanh Pink - Accounting; Goltlenrotl - Assassor •$15 Hood or Typel ❑ Canopy Type I I ❑ Refrigeration System ❑aioo.000aTu ❑ioo,000 System Repair/Alteretion ' Fire Dempers Registers _ laue Fee � $ 3 R Qp(l0 9/ I 2/.86 c Zone Parking Req./Provided 0 ELECTRICAL i ' � Transformer ❑ 15-50 KW O50+KW Meter �up to 100 amps ; Meter �over100amps � Sub Panel � . � . Mo[ors �0.1 HP �1 h- 8 ' Inc.Solar 09-15 HP��1675+ v Microwave ' Pole Light � Range c:.... - Garbage Disposal Standirig Sections Geneiator 00.5 KW �5-15 KW Trash Compactor Fee . � $15 �. � Issue Fee DEVE�OPMENT SERVICES REQUIREMENTS: 2oninB APProved By � Building Approved By � — � �� . 124.65 Ti 2 O N I N G R E Q M T S FEES � '� ' � S 3 _Date � � SUMMARV OF FEES ' ' BUILDING PERMIT $ � SMIP $ PLAN CHECK � $ _PERMIT PLUMBING � $ ISSUANCE S . PLAN CHECK 25% $ ' ' ENERGV P.C. $ � ELECTRICAL �$ µ .5 GRADING $ � ' PLANCHECK 50� $ S MICROFILM S�(� /� MECHANICAL $ TOTALPEE $ �/ 7• �OS PLAN CHECK 25% $ � � �� CONSTRUCTION AND PLANNING ' POOL $ SPA �� APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility�Undrgrnd. 54. Forms 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UFER Grnd. �,6,� 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. - 8. Foundation 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final 12. Sewer Cap � , 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 74. Rough Plumbing - 65. Electrical-Final 15. Rough Electrical-Conduit G_`,� 66. Solar System-Final 16. Rough E�ectric Wiring �"'p�� s"'� %' �-4-5�. Y� f, 67. Fencing & Access Approval � 17. Rough Wiring Sign �" 68. APPROVED FOR PLASTERING 78. Rough Electrical-T Bar Ceiling � � 69: POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning �� FIRE DEPT. FEQUIREMENT � 20. Rough Factory Fireplace APPFOVALS Permit # 21. Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush '24. RonLFraming � 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro • 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing . � 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT , 31. Plaster Brown Coat 79. FINAL INSPECTION . � ' 32. Electrical�Power Meter-Final •(p. � 80. FOOD CERTIFICATE ISSUED 33. Final Electric �7') t� Notes: 34: Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy . 37. Final Factory Fireplace , - 38. Final Plumbing • - 39. Water Service-Final 40. Gas Service•Final ' 41. $olar pomesticFinal , ' ,42. BackflowPreventer � 43. Backftow Irrigation . � ' 44. Landscape Irrigation System . � . _ _ � .45. Sound Attenuation . 46. Handicap Regulations ' ,- r 47. FINALSTRUCTURE&BUILDING , �� 48. Special Requirements Completed • 49. Electric Release to Edison � • 50. Gas Release to Southern California Gas Co � i 51. CERTIFICATE OF OCCUPANCY No. Date ` ' - l � CITv oF COSrA MESA CONSTRUCTION PERMIT � Project Addres� �S� �� 9� Applic9nt's Maili g Addiess Owner'sName � "� � Phone Addrets��G!r%�� /� Arch/Eng. License No. Address Contractor's Name— Phone Addreulm��g� � � City License No. IICENSED CONTRACTOR DECLA0.ATION I hereby aHirm thae I am licensetl untler provislons o1 Charter 9(commencin9 with section 7000� of Division 3 0l [he Business antl Professionz Cotle, antl my license is In (ull /orce antl eflect. License Clazs License No. Oate SlgnaWre �ORKER$' COMPENSATION DECLARATION hereby attirm that I nave a certiticala ot tonsent to selNnsure or a certiilcale ot Workers' Compensation Inmrance, or a,certitietl cooY thereof (Section 3800, Lab. C.) Policy No. Company 8 Certifiecl copy is hereby (urnished. Certifietl copy is fileU with Ine <ity Builtlin9 Dlvision. Date APPIiCdnt EXEMPT�ON FROM WORKERS' COMPENSATION DECLARATION' (Tnis se<tion neetl not be completetl if the permit is tor one huntlretl (E100) or less). I certify Ihat in lbe pe�fo�mdnce O1 In w k fo � permR IS is5ue I stlall noi employ any persOn in any ¢r 5(1 Te subject [ a Worker Compenzation Laws of Cali nla. � Oate i_��Si9natu e NOTICE: t, atter aking [his tleUa tlon, you shoultl Decom �ect to the Workers' Compensatlon provisions oi the Lebor Cotle, you st forthwi[h comply with such prOVI5iOn5 0�' tM1is permil Shall be tl metl revoketl. GONSTRUCTION LENDING AGENCV I ��eroby a/firm that [here is a construction lentling a9en<y lor lho per/ormance of the work for wnich tnis permit is 15zuetl (Sectlon 309] Civ. C.) Lentler's Name LFntler'S AtltlfeSs OWNER BUILDEH OECLARATION I hereby aHlrm lhal 1 aT exampt IrOm th0 Contractor'S License Law fOr Ihe lollowing reason (Saction 7031.5 Bu5lness antl Protessional Cotlo: Any city or County which �equirai a Oermit t0 cOnstruGt, dltCr, Improv0, tl¢molish or r¢pah any sVucturo, prior to its iszuance, also requires tha applicant for suth permi[ .., ..�e ,.�,.�en aa�a,..en� rnar noizne Is Iicensetl owsuant to lhe orovisions ot d5 antl the bazis tor the allegetl exomption. Any vlolation of � any appllcant 1or a perTll SUDjecls th0 applicant lo not more l�an fivn nuntlretl tlollars (5500). w tloes nol apply to an owner o1 a prooerty wno DWias or ntl who tloes Suth wo�k hiTselt/nar281f or through hi5 0� ...,�nun ma� c�on Lnerovnmonts ara not in[enGeO or ol saie.� ii, nowe�e�, ma bullAing or improvemont is soltl within one year o� mm- pletion, tne ownor will navo the burtl¢n ot ptoving he/Shc tlitl nOt build or.iT- p�Ov! tor tho purpOse ot Saln). ❑ I, as owner ot [he property, am axclu5ivoty contractin9 wilb licenzetl can- tractors to conzbuct the pro�ect (Seclion 7044. Businesi antl Professlons Cotle: Th¢ Contractor's License 12w does not apply to an owner of Droperty who builtls or Imoroves tnereon, antl wno contracts lor such projetls with a con- ' tractOr(51 liceni¢ pursuant [o thC ConlractOYi Licanse Law). I dm aware thdt p�oof o( thelr Wotker's COmpansatio insu�ance ihould b0 P�ovitl¢tl to me. ❑ I am exempt unOer Section .& P. C. �or lhis r son oate � owner � 1 hereby certity'that 1 have reaa thls applicatlon antl stat hai Ihe above information is co�rec[. I a9ree to comply with all dty antl un[y ortlinances antl ztate lavye'iela ' bullAing construpflon, antl hereby authorize repre- sentativas o/ t�z nlar upon j�I§ above-mentionetl property for or55� AF 0865-4fi, rev. 30/B4 White - Bulltlin9: Canary - ApO��anh. to flll in all spaces exceot those witnln heavy Eortler Iinas an0 sign all approoriate Ge<Iaratlons. ,_:,�.�.a� ��, �, ..._. ..... �__. .._. � �,Y,� TVPEOFCONSTRUCTION NEW ADD ALTERATION �❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCRIPTION OF WORK/USE OF BLDG. TVP^E OFPEfiMiT GRADING FOUNDATION STRUCTURAI 'LJ TENANT ❑ ELECTRICAL ❑ PLVM6ING ❑ MECHANICAL ❑ OTHER PROJECT DESCRIPTION SO.F7. OCCVaAriCV_ •CONSTRUCTIONTVPE ' VALUATIONS ZONE � GRADINGCV.VDS. ACRES— Bar Si'nk Backflow Preventer Backflow Irrigation Bathtubs Drinking Fountains Floor Drains Floor Sinks Gas Service�, � OuUets InterCeptor5 ' Kitchen Sink Lavatories'� P—Trep Root Drains Reinspection Fee $15 Boiler Duct-UnderGround Duct - Strucwral Duct - Ventilating ExhaustSystem ❑ MWtiple Firepl/Fact. Blt. IC80 � Heating System & Ducting ❑a i oo,000 sru O i oo,000 I I Reinspection Fae -- I 575 Accounting; Goltlenrotl - Assessor $hOw¢f5 Service Sink Sewer Connection . Solar Collectors Solar Piping • Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater ' Water Service Auto-Wash laue Fee Hood or Typel ❑ CanonV Typell ❑ Refrigeration System ❑O�100,0006TU ❑100,000 System Repair/Alteration Fire Dampers Registus Issua Fee „ REPAIR FEES A.P. qW S Main Building: E T Front 8 Rear A C Right g Left Ping. Ref. # Planning Notes: Auromatic Washer Construction Pole Sub. Cooking Unit � Dishwasher Fan F.A.U. • Fixtures Device Boxes Outlets Switches Garbage Disposal Generaror �0.5 KW 1469 I/30/87 Zone Accessory Building: Parkin9 Req.IProvided ELECTRICAL _- . Transformer ❑ 15-50 KW ❑ 50+KW , i Meter � to 100 amps Meter ❑over 100 amps - Sub Panel Motors �0.1 HP � i X� 8 Inc.Solar �9�15 HP �16-15+ Microwave Pole Light Range $1911 Standing Settions 15 KW Trash Compactor 5 3 Rainspection Fee 515 luue Fee FEES �DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approved By � Appliption luued By- $ 3 ge00 TL Z O N I N G R E U M T S FEES S 3 0 SUMMARV OF FEES BUILDING PERMIT S SMIP S PLAN CHECK $ PERMIT PLUMBING' $ �SSUANCE $ . , PV�,N CHECK 25% $� ENEFGY P,C. 5 ELECTRICAI S GRADING 5 PLAN CHECK' 50% $ MICROFILM $ � MECHANICAL S TOTALFEE $ � PLAN CHECK Z5% $ � CONSTRUCTION AND PLANNING _ POOL & SPA APPROVALS Permit # Date ' Inspector qPPROVALS Permit # Date � Inspector 1. Temporary Electrical �Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement � . . 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � 4. Electrical Condui[�Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test ' 6. Electrical UFER Grnii. 57. APPROVAL TO COVER�GUNITE 7. Footings �� , 58. Electrical Conduit-Undrgrnd. . 8. Foundation' 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, O Undrgrnd. 70. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final � 12. Sewer Cap 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final . " 15. Rough Electrical-Conduit 66. Solar System-Final 16. Rough Electric Wiring � 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Elearical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT • � 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro 22. Ducts, Ventilating 71. Produc[ Piping O Gas ❑ Oil 23. Gas Pipe-Rough & Test 72. Underground Flush • 24. Roof Framing 73. Undergrnd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT �� 31. Plaster Brown Coat 79.� FINAL INSPECTION �� 32.. Electrical Power Meter-Final �_ _F� 80. FOOD CERTIFICATE ISSUED 33. FinalElectric Notes:�_��7 T� �3 6t]A� T) S ^ � ' 34. Final Heating & Air Conditioning R ��p5 a y/�1w S �+ h 35. Final Gas Pipe-Test . 36. Hood or Canopy 37. Final Factory Fireplace . � � ' 38. Final Plumbing ; ,39. Water Service�Final . . 40. Gas Service-Final ' 41. Solar pomestic-Final ' • , 42. Backtlow Preventer ; 43. Backflow Irrigation . �,44. Landscape Irrigation System � • . � 45. Sound Attenuation �'� 46. Handicap Regulations � J 47. FINAL STRUCTURE & BUILDING 48. Special,Requirements Completed � , 49.:Electric Release to Edison 50. Gas Release to Southern California Gas Co � � � 51. CERTIFICATE OF OCCUPANCY '�� No. Date � , ��,.