HomeMy WebLinkAbout899 19TH ST - Building PermitsCiry o( Costa Meu
Development Services Department
Buildin9 Sa(ety Division
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCU.PANCY No,
The euilding located at 899 W. 19th St.
has been inspec[ed and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group �z Occupancy.
Use of Buildi
Legal Descriptio
Restaurant
424-I91-02
(See reverse side for Metes and Boundsl
Building Permit No B50159 Electrical Permit No. EP50934 plumbing Permit No. EP50934
Mechanical Permit No. �'750958 Number of apartments and/or guest rooms
ISSUEDTO: BuildingOfficial TonV C'De BaCa
Anita Bishop �' i -
P.O. 80X Z341 by. ' .� _� ." ,'�. `
��rightwood, CA 92397 '
Date January 6, 1992
This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the
Building Official of the City of Costa Mesa under Sec. 307 (e) U.B.C.
CMF 3015-46 rev. 1/83 White - Owner; Canary - Numerical File; Pink � Bldg. Permit File
., - — - .. _.. . . . _ . . . }
WEST 19th.STREET, 899 � �
A
13784 - comp. Malt Shop $ 3,360.
� 14307 -.3-21-63 Grnd. Sign 500.
� 2218 - 8-20-6J Atg. NC (Vencs)
j 42240 - 1-15-64 Plbg. NC (W.H.)
i 42774 - 1-20-78 Elec.Ctmg:of Copy Sign 400.
i�7�30 - 21-12-78 Dcy C:^.e.^. 5y:.. _ 550.
����
i
— B 5 15 PC� 5988-90 S —
' �� 1 'o��J'c^
�
� ` B 50158 PC$ 6936-90 5
� , Ref: PC#5988- 3 �,�ef�:650159—
�
� EP50934 �
� (B50159)� ��9�
1 � �
i — y 50958�3�� ef: B 50159 —
� i
m �
F 51285 PC� 00500-91 �
} --� �1� j �JJ REF� B 00159
�
e
PHOJECT RODflE55: 8 9 9 W 1 9 TH ST
OWNEN'SNAME: BISHOP ANITA L
nooeess: p O BOk 2391
WRIGHTWOOD,CA 92397
UNIT:
(719)
FHCHIENGINEEH: GEORGE PLATES NEG.NO.: Q
aooeess: 11681 CHESTER AV uxir:
GARDEN GROVE CA 92640
PEHMITTEE: THE DOUBLE R COMPANY (719)642-7463
aooness: 2672 CLUB MESA PL
CM CA 92626
UCENSED CONTflALTON OECIAflFTION: I �ere�y ai�irm ��at I am Iicen5e0 unCer pmvisions of Ctupier 9ltommencing wilh Section
7000� ol Drvfsion 3 of t0e Business an0 Prolessions Code, antl my license is in full force anU ellect.
c��ruc.:051494 sraTeuc.:566004n/•_ c�us's: B (� �] ��(�,�,�—
�ale: �.3 —__3=� e7— Signalure: —��1A�4��GC„� Z ` `�^"
�OflRENS' COMPENSATION DECL1BAilON: I here0y affirm IAaI I have a certificale ol consent lo selbinsure or a cenificate ol workers'
�mpen5aiion In5yra�c c�IilieO copy IOereai (Section 3800, �ab. f�1
POLICYNO.: ilS���H E%P.OqTE: I73IOSI9S
,�ncomenxr: STATE
il�' Cenilied copY is hereby furnished. ❑ CertifieE capy is filetl vnih the ciry Building Oivisian.� "� �
Daie: I 2"_3 �rjJ� NPPiicdn�:—��-�� P' .(�✓
E—�
E%EMPTION FBOM WOBflEPS'COMPENSATION OECIANATION: �Thisse��ion neetl nalbe completetlillhe Oermilis brone �undre0�$100�orless).
I cenity ihat in ihe Detlormance of the work lor which this permit is issued. I shall noi employ any oe�son in any manner so as to become
suDlec� to I�e Workers Compensalion Laws o� Calilornia.
Dale: Signature:
NUTICE: II. a��er making Ihis Aetlara�ion. you ShoulO b¢mme Subletl to I�e Workers' Compensation Dmvision5 0� 10e LaUor
COUe. you must fonl�wit� Camply with such pmvisions or t�is permit s�all he tleemeG revoked.
CONSTflUCT10N LENDING PGENCY: I her¢by aHirm Iha� lhere i5 a tonStmcli0n IenOing aAency �or �he pedormance 0� Ihe work for
wMch I�is uermii is issueE �Seciion 3097. Civ. C�.
LENOEfl:
I ADUBE55: '
CITY OF COSTA MESA — BUILDING PERMIT PERM NO; B 0501
PERMIT NO: B 050159 PLAN CHECK NO; 05988-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; STR PURPOSE: ALT
JOH DESCRIPTION : COMMERCIAL T.I, (RESTAURANT) SQ FT: 696
CLAIM VALUE: CALC—VALUE: 8,198.88 GROUP OCC: H-2 /
COMMENTS: +
�e�r*�r*�t����r*��t�t�t*�r*�t�e�r�**�r*�r*�r*�t*�t�t�t**�t��t�e**�t�r�t�t*�t�t�t�r�r�t�r�t�*�r�r�*��t�r*�**�r+r�t�r�rx�**+t�
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
—==--------- MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN AGHT; . FT IN
PARRING REQ • PROV: PARCEL: 42419102 ZNE: C1 REF NO:
PLANNING NdI'ES> TI TO AN EXISTTNG AESTAURANT THAT HAS CHANGED OWNERS.
> TOTAL S� FTG, IS APPROX. 675.
M�FiEiFiFiEiflFlfitiE�fiFitififkkkikMiF3E IFifltifiF�tifiFifiFitkikifititkltikititifiFMlklffEaflE!lifklf)tififlElfiFiFiFitiFMlf�iflFifIF3E�Eififk�E
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: Lz--�:s-�-��
BUILDING APPROVED BY ;?� C� �. DATE: �,3�
APPLICATION ISSUED BY: • C� DATE:
iF 1F iF it fk fF if iE iE M if if iF iF if af if k if it iE iF il� iElE 3f IE iE iE if IE if�iiG�F��'iFit iF
�F �t iFlF iF M iF if If 3F �f if iFlf 1F k M iF if �k IF itlE k k M iF 1f !F If iE �f if �f 3f if iE if 1f iF if M 3E iE if iF iF M M if if M iE 3k if it it 1k k if If k�E fk iE iE if ik iF ik iF it iF iF if �E M ik it
LEGALIZATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:Y
OWNEfl BWL�EB �ECLl�BATION: I hereby at�irm �tla� I am exemp� imm ihe Contracl0rs' Sta�e License Law �or Ihe I011owinB �eason � HLDG pM'r PLUMH ZNG ELECTRIC MECHANIC FIRE $MIP /R$$ GRAD ING
ISection 103t.5 Business anU Pra7essional CaAe: Any ciry ol wun�y wnicn repuires a oermi� m canstma. atter, impmve. tlemolisn, or (1ERM I T .10 b. � 0
r¢pair any Stmtture, Drbr 10 iii issuante. also require5lhe appiitanl for 5uch permi� Io lile a 5igne0 stafemenl Ihal �e/Sl�e a licen5e0
pur5uan11olhe0wvi5ion5ollheConlracio�5'SIa�eLitenSeLaw�C�apler9(commencingwilh$¢ction7000)o�Divi5ion3ait�e9usine55� pLAN 70.20 � SMIP/NON—RES
anU Pwlessions Cotle) or �hat �e/she is exempt �herebom ana ihe Oasis lor ihe alleged exemption. My violation ol Sec�ion 70.37.5 Dy 1, 2 3
� aooiicam mr a oermn subiecis me aPo�iwnt to a civii penauy oi rrot more tnan �rve nunnrea ao��ars �ssoo). ISSUE FEE
i, as owner o� ine wooeny or my empioyees wiih wages as iheir soie compen5aiion, will do me work, and �ne BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL � PAID � DUE
L� simcmre is not imenAetl or aaeree lar sale (Seclian 70da. Business and Pmiessional Cotle: The Coniractors' Siate �icense �aw TOTALS----> 109 . 2 3 0. � � i 0, i 0 17 9: 4 3 179 . 4 3 . 00
Ooes no� apply to an owner of a property who 6uiltls or improves thereon, and who Ooes such work himselflhers¢II or Ihmugh
nis or ner own empioyees, pmvieeo tnat sucn impwvemenis are not intenaed or onerea tor sale. iL nowever tne huiming or REVENUE DIVISION TOTALS--> COLLECTED; 109 , 2 3 OVER/SHORT • �0
impmvemem is sola within one year of completion. Ihe owner will have t�e Euraen of pmving he/she ditl not bui10 or impmve BLDG PMT PLUMB ING ELECTRIC MECHANIC FIRE SMIP /TOT GR�1D ING PLAN—CHECK
lor Ne ouroose ol salel. ,
I, az Owner o� Ihe pmpetly, am extlusively ConttaCling wi�h licen5etl tonVatbrs �a tonSlNt� [he D�oleC� (SeC�ion 7044, Business 1 Q 8, Q � 1, 2 3 '
❑ an0 Prolessims CoOe: T�e Contratwrs' Stare LicenSe Law tices noi apply lo an ovmer ol propeM w� OutlOs of impmveSlhereOn
and who tanlra[IS tor SUth pmle��s vn�h a conlraCiar(S�1i�en5E pursuan� �o IAe COnifac�oR' S�at¢ L¢ense law�. I am awart
��al pmol ol Iheir Warke(5 CnmDensa�ion insuranCe 5houltl be pmvi0etl ro me.
� I am exempi un0er Seclion: 8. 8 P. C.
lor mis reason�,
if if if if k M k if iE aF 3f �F iE if IF k IF 3F iE k IE iE if �f IF iF if if k if IF�f iE 3f M if it �E if if iF k k iE it If If M If if ik iF iE iF �f if k k if iElf iF iE fF iF ik k �t IE IE it if iF k IF iF iFiE if
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
Date: 0x'"ef� I SFC
I tlo �ere�y cenily t�at I am aware ol antl unUers�antl �he reQuirempnis of Califomia Healih antl Salety Code Seclions 25505, 25533, an0
25534 and that I or any fulure Duilding accupant wilUvnll nol (circle one) neetl �o comply with uid slate cotl¢5 an� the requi�ements �or 2
petmit lor tanSlmtii0n Or motlAiWiion Imm Ih¢ Pir Oualily Managlmeni GSVitl. flevdeniial tOnSimt�ion applica�ion5 ar¢ erempi trom
t�ese p�ovisfons.
Oate: Apv�icani:
I here�y rerltlylhai I have read Ihis applicaiion antl S�ale Ihal Ihe abaue in�ormalion is correct. I agreeio comply with all cily ana couniy
oiemances an0 s�ale laws mlaling to builUing conslmction antl hereby aulhorize representalives ol Ihis cily to enter upon ihe above�mentioneU
n�aDerty lor mspeclion purposes. /) e � �/�� ��� �
Dale: ��' �/ 0 S9naiure: /i O L.GaR./��� ` � "� "^" �
od�e�'s Ucense or sociai Secwiiy x:
1641-a6 W�ite—Building: Green—Co�e Enio¢emem: Canary—Applicanl; Pink—Ravenue: GWCenrotl—Assessor
�
RES—INT, ALTER TYPE V—N
END OF FEES
f—�-ct.r .... � 'J
� D E C 0 3 1990 i% �'�`��
cirr oF cosra mi�sa �
—AVER 11,78 8,198.88
CONSTRUCTION AND PLANN„_., "- �OL & SPA
APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole ��,� 52. Pool & Equipment Location ��
2. SoilPipe�Un�gmd. �- `�L 53. SteelReinforcement
�� r_a i'� rv t . .
�'' 54. Forms
.:3_�fle�ctrical�Coriduii,Utiliry-L�ndrgrnd,; , ,
�1 4':�_ElectricalrCori{d�it�Undrgrnd. ' �� 55. Electrical Bonding �
�� 5�St�el Reintor,eement 56. Rough Plumbing & Pressure Test
��6[�ElectricarURER'Gind. �c 57. APPflOVAL TO COVER�GUNITE o-�
_ `...
z7`'Footing;L�"�```}: � 58. Electrical ConduiDUndrgrnd.
. � �. -
'� 8i Foundation� ,_ S ' _` 59. Gas Pipe, O Undrgmd., Test �'
9. Water Pipe-Undag'r`nd. � � 60. Backwash Lines, P-Trap, O Undrgmd.
.�
10. Structural Floor-System �� 61. APPROVALTO DECK
,
11. Pr6perty Se �r Line & Ho�se ConnAction 62. Backwash & Receptor-Final !
12. SeWer Cap - ' �
.- .. . .�. q, 63. Heater & Vent-Final ,
13. Roof Drains �; � � ^� • 64. Plumbing System - Final
14. Rough Plumbi'ng, � , 65. Electrical�Final �
15. Rough Electrical-Conduit . '; 66. Solar System-Final
16. Rough ElectriciWiring � 67. Fencing & Access Approval
17. Rough Wiring $ign � 68. APPROVED FOR PLASTERING
78. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning F1RE DEPT, flEQUIREMENT
- - - - - - -��^ - { - n1
20.?Rough Facto� Fweplace � �:I++ �t � • G _� �"* �. qppROVAL'S%•-%:Permit # �'
.1: \ �I7 S.' �3`rC .� Ci.: ,a U i: D
21.'Duc[s, in•Strpctur'6' � r. �. �`'c.�-, : <; ;j 1:. 70. Underground•,HyAro �F '�
22. Ducts.Vrentilating^� _ �S t ^`: 'Q." �71. Product'P'rPingQCias �Oil `.`�•.
- .� � � . � r^i .a (- i7 ti z c .1 -.-r.:' -
` t � �i T � r� I-�.f' 'c - " .
23: ;Gas`Fipe�Rou�h &`f�est , _,:S �`. r• .= ps 1'.72. Undergrou�nd Flu M`'�r �
24..�Roof: Framing� � � -,� - :�: � " c ��� ? S73 �Undergrnd?Storaq�eTat�k O Gas ❑ Oil • �-`"�, �,
••iv '> �s �r1 a i � 5..� � ,
25. Roof She thin9 � >. "' ` ` �� l t * <- c; • r-, -o a • -
-s ; + � .7 �t;?c .T 74 :;Qverhpad Hydrop .
��
26.i7-Ber Ceiling (Structural) &�Monocoat'• -'� '� - �:'� �!' 75CDr Chemical �4 � � C "�� �� ,. _
- , ��: r 'v Y'�•a S � )Y �, - n � �
27.�-Frame and Fleshin x ��'c .":t. u7 a�- x �� _i5; x S "- i�. �zr.., G;. .
� 9- '�a-.� _.t.R � � �n�� T 76`��Y StandPi�Pe ._co �'1 .
�-28. Lathing'& Siding � . -�SiC -i.;� ��r s', ~ Y � 77 cTFIXED SYSTEM}F�INAL� � � a ti:v ' '
'29. Insulation , �' •�'� �� .'.S�':,-M1 `' �. � * 78:�FIRE PREV. FIN/kL ��. � rr, ,'gtr.•
'30.DrywalPNailing � � �' � � ', i �•�� - HEALTH�DEPT�.REQIiIREIVIENT _ �
n :r r'
�-31. Plaster Brow�,Coat`. S � R.ir �v. ;M �' �� �,� ..�,� a ;79."FINAL IN'SP.ECTION ; J � C, _
r�� - �. a : r: _ ' ,° , _ _ . �
��32.:Electrical�Powter Mete2Final; 5.�:?� N� ��' �a �f r,�80.CF00D CE�RTIFI^ATE IS3UED� = �
i
i 7 l 'c :. :r r �-, T 7:T 'R _
�33.;Final Electric, ' � � Not'es: �
5 6, i �f.^ � . � a - - Q <<.
' C, y U. ' -� tn1:�1 .. .. � � .�.'. �.
,�34.� Finaf Heating & Aic.Conditioning� •i. r�� V ��' �f..:�. c� � ['icx > s �c
� �t ft K
35:'Final Gas Pipe�Test�' T N'¢• � � j` x r '^� '- S ��" �
a!-e� I � 1� ?� �ZG q
' - � x �, � �}: � x i s � y . . � .., �. �
��36." Hood or. CanoPY . ;.� � �, � n.r{ . ^ ! I . i a: F. hv :e' •
� , , ..-.� . n .,�
•,37.'-FinaPFaMory Fireplace^ � r�'+ •1.�";'� �`� � �1 �z �� S n ' �
T. . S- E- 1 n I I rY z ; i' 9
- ir �w 1 •. . :Lt� ') L�� .� ' V � • . -
.-38 �Final; Plumbing r iJ , -+;.- .r i I x :t S �a � �-�
':39.�WaYAiService�finalr � v�' * j i ": .. a� `.�' ?
^� 1 ♦ t�� • 7 ' . . r
'd0.'Gas Service�F'inal �� � a � ��� � u � � �
•-1' 1 v. T `-�.:'Cr S+`. .'r lr, � :i .G. :�
>41::Solar OomestScFinal'; Ci� � � � � � K =� �t^� - * '
Y' tr ;s' 7 _. ' � ': 'j
--42.'�BackflowPreventer ` ;'; ;;� .;�'� I I :`,_;� ,r '��• , .�
�> c. _t
43. Backflow Irrigatione �� «SLC ` '� f � =7Fti � _ �^
�, t I!' Y t' }' � n .
: . Y 6:Q; G a '1. ,' - .> V �
��44. Landscape Irr�ipation Systerq;�r�;,-;; ix x�r J�� .. - v o; -� --�
:45..Sound A'tterivatiom - � + . - � "� . � , � ;; ~'�. ' �
�. r� -: . - nt r• i : �a' • J ?
=46 ;Handicap;Regulatio�s - `_���� _ ` � � �'� j ��. ,. ' ��
`� r, _ � x
47.5fINAL STRIilCTURE & BUItDING � • �3 Z ��"�� �7 '�-` � •
a' t-
48.:FINALPLANNING, � _", '� ,�%� �.t.'ii t:. v, `. �
,
=49.cElec2ric Release to Edison � . ��� �'+� , � = z �i; � � _' . -
d f r rr. •^
'50.tiGas Release t0 Southern Califomia Gas Co 1 ` ��` X'S : _ �;� ; r.
�51. CERTIFICA7E OF;OCCUPANCY . . R �. � ;�.:, `r � : x
No. Date
m
� PPOJECT RUURE55: £{ J J W 19 TH S T - uxiT:
OWNEfl'SNAME: BISHOP!, ANITA L
PODflESS: P O HOh 23�I1
WRIGHTWOOD,CA 92397
(714)
AFCHIENGINEFfl: GEORGE PLATES flEG.NO.: O
AODflESS: 1 i G B 1 CHESTER AV uNiT:
GARDEN GROVE CA 92640
PEXMITTEE: THE DOUBLE R COMPANY f 714 ) 642-7463
nooAess: 2672 CLUB MESA PL
CM CA 92626
LILENSEO CONTIIACTOB oECLABATION: I Aerehy allirm I�at I am Iicense0 unCer pmvisions of ChaD�e� 9 kammendnA ��� �c�ian
7000� af Oivision J ol I�e Business antl Pmtessions Cotle and m license is in full �orce anA ellecl.
ciTruc.: 051494q srnTeuc.:566004 cuss: B ����,/�/� �
Oate: � � � — F� SignaWre: — _ _ ' —�f ����' ' — —
pPNEBS' COMPENSP710N �FCLABATION: I here�y aifirm t�at 1 have a cenilicate ol consenl to setf-insure or a cenifica�e al Workers'
ampensalion lusyrap�a�pc a�cur�ilieU coDY �hereol �Seclion 3800. Lab. G.3 � O 1 I9 S
Iaoucrno.: STATE�� E%P.OATE: �
�fOMPANY:
�� Cerli�ietl copy is hereGy fumishetl. ❑ Certilied coDY is I' 9with t�e ciiy BuiiUinA Oivision. /�
)ate: Z ` lo � pPPliyni: —I�I.N VW"'� �� ��
E%EMPTIONFflOMWONREPS'COdPEN5ATI0NOECtABRT10N: �ThisseclionneeUnolOewmpletedi�IAepermitislorone�untlrM�5100�orless�.
ceniiy ihat in ine pedormance ol the wark tor whicn ihis permil is issue4 I shall not em0�oy any Oe�son in any manner so as la become
>uEje[t �a t�e Workers' ComOensx�ion Laws ol Calilomia.
Jale: - Sign�tuw:
'NOTILE: II. alter making inis declaration, you should become subjeq lo ihe Workert' Compensation provisions of Ihe Labor '
fqde. you musl �orttiwil� comD�Y'�^�� such pmvi5ion5 or �N5 permil S�all be OeemeO revOkeE.
CONSTBOCTION LENOING RGENCY: I Aereby aifirm Itai l�ere is a consiruction lenaing aAency for �he Oehormance ot the wark lar
whicn mis permitis i=suetl �Section 3097. Civ. C1. .
lENOEX:
RODflESS:
OWNEB BIIILDEP OECLAHRTION: I �er¢by ailirm �ha� I am ex¢mpi Imm Ihe Contratlor5' State License Law br Ihe lollowinp rea5on
(Section 7031.5 Business anU Protessional CoGe: -Any ciiy al county w�itll repuires a Oermii to tonsimq, aller, impmve, tlemolish, or
repair any strucmre, priar to its issuance. also reQuires t�e aDDliwnt for suc� permit to lile a vAneO statement Ihat helshe i5license0
pursuant m t�e pmvisions ol the Contractors' State License Law (Chapter 9(commencinq wi�� Section 7000) oi Division 3 0l ��e Business
nA Prolessions Code) or Ihal hehhe is exempt t�erelmm anA Ne �asis lor the alleged exemD�ion. Any violalion ol Seciion 7031.5 6y
�� apD�icant for a permit suDlects tAe aoDliwnt to a civil penally ol not more than hve hunOreO Oollars (35001.
I, as owner af Ihe o�openy or my emVloyees wil� wages as iheir sole comDenSation, WIII Oo ihe work, anJ ifle
❑ s�mcwre is not inrentle0 ar oBerea tar sale (Seclion 7044, Busineu anU Pmlessional COUe: TAe Coniraclors' State License Law
tloe5 no� appty to an owner ai a O�op¢rly wh0 �uiltls or improve5 ihereon. antl who does Suth work OimSelllhersell Dr fhwu0h
�is o� �er own employees. pmvi0e0 that suc� impmvemenis are nm inten0etl ar otferea tor sale. II, �owever I�e buil0inp or
impmvemem is solG within ane year ol completion. the owner will have tAe �ur0en ol proving �e/s0e ditl not OuilA or impmve
lor �ne purpose al sale).
I, as owner ui Ihe pm0etly. am exclusively coniracting vnih IicenseA coniractors m consimct Ihe D�olect (Sedion 7044, Business
❑ ana Pmtesvons Goae: T�e Canlracrors State License Law dces no� apply la an ovmar ol properly who builGs or imprwet Iher¢on
antl w�o comracis for such D�olects wit� a coniracmqs�license pursuant to ihe Coniractors' Siate License Law),I am axare
��at prooi ol Iheir Worker's Compensa�ion insurance s�ou10 De pronGeO to me.
� I am exem0� untler Seclian: 8. 8 P. C.
lar ihis reason:
CITY OF COSTA MESA = BUILDING PERMIT ,
PERMZT NO: EP 050934 PLAN CHECK NO: ,N : N .
CONSTRUCTION TYPE: PERMIT TYPE: ELE PLU . PURPOSE: OTH
JOB DESCRIPTZON : COMMERCIAL T.I. .(FiESTAi.�,RANTa SQ FT:
CLAIM VALUE: � CALC—VALQE: GROUP OCC: B-2 /
COMMENTS: RE: B50159 PRIMARY BLDG. PERMIT.
�x�*�u**�*�x**�**x��*�**x�***+r�r****�**�**��***�r****�rx�x�********�r��r�**��x*x*�r*�**�r�r
, Z O N I N G R E Q U I R E M E N.T S ,
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --=------
FRNT: FT ZN REAR: FT ZN FRNT: FT ZN REAR: , FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT; IN
PARKING REQ• PROV; PARCEL: 42419102 ZNE: REF NO:
PLANNING NfSTES>
.� - 1
1F ib ik iP if iflElElE 1F 1E iklE 1E 1ElE 1E iE iF iF iE iE if iE iE 1E 1f if iE iE iE if if iE 1f �E iE IF iFlE iElE iF iE fE 3E�3E.34lE 3E�E iE !6 !f iE 3E jE 1E fP IF iE 1E iE ik iF IE iE iE iF iE iE �E if if if 1E iE �E iE
D E V E L O P M E N T S E R V•�I, C E S:% A E,Q U I R E�M E N T S,
/ i;
ZONING APPROVED BY � � : DATE:
HUILDING APPROVED BY : DATE:
APPLICATION ISSOED BY: `' DATE: �
ifiF7EififiEiPififiFlfifiEiElElkiEiE��iEifiE � iEiEiEifitifiElkitiF ifk
iPififiEjkiflE�EififlEiFiFlElFkiFiFiEifiEiFiFififiEiEifififiEifiFiE3FiEiFiFiFiEj iE� iEiEif3EiElfifiEfElE�FiEiFiEiEiEiElFlEifiEiP9FiEiPiiiEiEiE*1E�EiEiliF
LEGALZZATION:N F E E S U M M'A R Y. 'STRUCTURAL SEGMENT;N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT B,�SY gSOY SMIP/NON—RES
PLAN ,
ISSUE FEE 3.00 15,00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 16.25 18.00 0,00 34.25 34.25 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 34,25 OVER/SHORT: .00
BLDG PMT PLU1HZN�G� ELE23R25 MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
if it iF iE i! if 1f fE M if iE it �1tiE ik fE ff ik if !f iE if if if �E Ik if iFlFlElk iE iE iE iE 3f fF fE iE ik if iE iE iE iE if iE %�E ik iE iE iE !E iF iklElE iE if ik iE if iF iE �f !f 3E iE if iE i(� fk # �E k iE?E �f
I N D I V I D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Da�e: Owner. E7� E
I do �ereby cenily �hai I am aware of antl untlerstanG �he requiremen�s o� Calilomia Healih an0 Safery Cotle Seclions 25505, 25533, antl ELE
2553a and ihat I or any fum�e builtling occupant wilYvnll not (circle onq neetl ta comply with uiE state coCes anA the repuiremenls lor a I pLp
permii mr cons�mcuon or motlificalion Iwm ihe An Oualny Management Oisirici. FesiUential constmction apvlicaiions are eeemD� �mm pLU
�hese pmvisions. PLU
oa�e: ApO�icant:
I nereby ceritly Ihat I have reaa t�is aDDlicaiion antl siate iha� I�e ahove inlorma�ion is correc�. I aA�ee �o comply wi�� all cily and county
aramances antl s�aie laws relalinp to Duilaing cansimclion antl hnreby aui�orize represen�alives o� Ihis city 10 en�er upon �he above�meniionetl
pmpeny lor inspection pu�poses. Q . ^ )
Dale: ��� SignaWre _ - ` �- µ"�� Y�r`•yY
�
od�ers ucense or sociai Secuniy a:
164ba6 While—Bmltling; GrCpn—CaCe En10rCOmfnL Canarv—APPlicenl: Pink—Revenue: G01�¢nr00—ASSE550�
4 FIXTURES LIGHTING 1 ST 20 EA
7 RECEPT/OGTLET 1 ST 20 EA
1 GAS RE—PIPE
2 SINKS, COMMERCIAL OR INDUSTRIAL
1 WATER RE—PIPE
END OF FEES
z,00 i,00
2.00 4.00
2.00 2.00
c� 000sor��z-ooasoa9� �-+a�- ;.s.?s
DA7E: 82/07/91 TI14E: 15:$j /
V
. CONSTRUCTION AND PLANN�. - OOL,.. �PA
APPROVALS Permit # Date Inspector AppROVALS 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. . 57. APPROVAL TO COVER�GUNITE
�7. Fooiings .,. - � 58. Electrical Conduit-Undrgrnd. �.� �
� 8. Foundation � , - 59. Gas Pipe, � Undrgrnd., Test ' �
9. Water Pipe-Undrgrnd. "� ' 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Structural Floor System �" 61. APPROVAL TO DECK �- �
11. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final '��•
� Z• Se�^'e� CaP .. ;.! � ,�, 63. Heater & Vent-Final
13. Roof Drains � � �
� 64. Plumbing System - Final
14. Rough Plumbing ' 65. Electrical-Final �`
15. Rough Electrical-Conduit �� -j 66. Solar SYstem-Final
16. Rough Electric Wiring � 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
16. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rouqh Heating & Air Conditioning ' FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - : '• APPROVALS Permit #
21;� Ducts, in Stcuctuie .�, � � _., 70. Underground Hydro �
22. OuMs, Ventilating • , ' '• 71. Product Pip�ng � Gas ❑ pi!
23. Gas Piqe-Rouqh &' Test � , � , � � -�' � 72, Underground Flush {
24; Roof Framing i . , � �• i '� � ; � 73. Undergrrid.Storage'Tank OGas ❑Oil ' -
25. Roof Sheathing ' � . � �� '� . ' � 74. Overhead��Hydro : �
26. T-Bar Ceiling �Structural) &:Monocoat '' �, � ' 75. Dry Chemical � • � -
27. FrameandFlashing ��� 76.�DryStandpipe �'�
28. Latbing & Siding � � i� . �� �' � 77. FIXED SYSTEM FINAL' '
. ..� i�
29. Insulation � " „ � � � 78. FIRE PREV. FINAL �
30. Drywall Nailing �. � ' a �� • • HEALTH DEPT. REQUI EMENT
� i. ��:
' `, ,
31. Plaster Biown Coat� � ; I � y I , 79.'FINAL INSPECTION. '
32. Electrical Power MeterFinal �. ; �`) .� S0. FOOD CERTIFICATE ISSUED r
33, Final Electric ' � � ��%;;� � � Notes: ,� � • ,
r �
�34. Final Heating & Air Conditioning , i � . '. .. '
35.�Final Gas Pipe-Test ' 9/ ��
36. Hood cr�Canopy : ,� .�J-' � � � .
I li
I .��. ,.� .
�.,, 1 ;�
37.� Final Faaory Fireplace �;,�',r j .
- 38. Final Pluvn6ing � � �� � ��� � � �
39. Water Service-Final � � I r_� ' .
40. Gas Service-Final , � . I � , � � � , �
41. Solar pomesticFinal �� �• � � ( '• ' - ,
�
42. Backflow Preventer � I I� , e
43. Backflow Irrigation � ,
44. Landscape Irripation SYstem , ' , . . • �
45. Sound Attenuation ' - �
46. ,HandicaP Regulations
4Z FINAL STRUCTURE & BUILDING I � ��
48. F�NALPIANNING , I ���, .
49. Electric Release to Edison � �� j�
50. Gas Release to Southem California Gas Co , � � �, , ' ..
51. CERTIFICATE OF OCCUPANCY . i . . . � . •
No Date �
PItOJECT AUOflESS: 8(3 C3 W 19 TH S T unir:
• OWNEN'SNAME: HISHOP ANITA L
nooxess: P O HO�C 2341
WRIGHTWOOD,CA 92397
RPCH/ENGINEEH: ` 7 1 q' flfG.NO.:
aooeess: GEORGE PLATES � uxiT:
11681 CHESTER AV
PEflminEE: GARDEN GROVE CA 92640
nooRess: RESTAURANT CONNECTION ( 21 3) 996-8556
10527 DALMATION
WHITTIER CA 90609
LICENSED CONiflACIDB oECLAflATION: I hereby allirm t�at I am Iicense0 un0er pmvisions of Chapter 9(commencing wilh Seclion
7000� ol Division 3 0� Ihe Busines9 ana Pmlessions Cotle. an0 my license is in full �o¢e ana eileci.
cirruc.: 052352 ST"TEuc.:53608/'—" cuss: C-20
. ^.;¢; 7. �- $^ � r Signature:_ �--
� BIIEPS' COMPENSp710N �ECLABATION: I �ereoy athrm �hal I have a ceniticate ol consent to sell�insure or a certilicate ol WaMers'
,mpensalion Insurance. or a cenilied coDY Ihereoi (Section 3800, lab. C�.
�POLICY NO.: E%P.OpiE:
COMPANV:
❑ Certifietl coDY is hereby lumis�etl. ❑ CetlilieU topy is IileO wi�h Ihe ciiy Building �ivision.
Da�e: Ao�licanC
ENEMPTION FROM WOflHEHS'COMPENSFTION OECLABATION: (Thi55edi ed na�becomplete0ifthe permi�istaronehundretl�Ellp�otle55).
I cerlity I�a� in Ihe oedormante ol Ihe work lor whit� ��is permil i5 i . I Shall no� employ any per5on in any manner SO a5 i0 Oetome
suGlect io t�e WoC�ker-s�' Compensaiion Laws ol Calilomia. n
pa�e�. 1."— V '— �L_ Signalure: ��—�
NOTICE: II. alier making IOis 4eciaration. you s�oultl become suDlect lo ihe Workers' Compensalion prOvi5ion5 of ��e Labor
COGe. you must fonhxitn camply witn such o��sions or this permit snall De OeemeO revoke0.
CONSTPUCTION LENOING RGENCY: I here�y aflifm lhat I�ere i5 a consiruttion lending agenCy for I�¢ pertOrmanC¢ ol �he work �or
whit� IhiS permii i5 i55uetl �SetliOn 3097. Civ. C�.
LENDEP:
aooness:
IOWNFB BWLOEB OECLABRTION: I �ereUy aitiim i�at I am exempUwm the Contraclors' Siate License Law la� I�e tolloxinp rtasan
(Seciion 7031.5 Business anU Pmfessional Code: Any city o� county w�ich reQuireS a permil Io can5iruct, alt¢r, imp�ove, tlemolish, or
repair any SIrUCWre. Driot l0 ils i55uante, also require5 I�e aOVlicant �or 5uth pefmi� l0 Iile a SigneA 5�a�emen� �ha� h¢/S�e is liCens¢tl
pursuam to t�e Omvisions ol ihe Contracmrs' State License Law �Chapter 9(cammencing with SecGon 7000) of Divi4on 3 oi I�e Business
•ntl Pmfessions CAael orinat ne/sne is eeempl tAerefmm antl tne basis forihe auegea e�emption. My violation ol Sectian 7031.5 by
y applican�for a permil suUjecls I�e applicani Ia a civil p¢nalry of not more I�an hve hunAfed tlollars �ESOU�.
I. as awner of I�e propeny or my employees with wages as iheir sole comDensalion, will do the work, antl Ihe
I'Q s�mciure is nol inlen0e0 or ollereG far sale (Sectian 70aa, Business ana Pwfessional CaOe: ihe Contractors' Siate License Law
tloes not a0oly to an awner of a pmpeny wno ouilds onmpmves ihereoq ane who Joes such work himseti/nersell or IhrouAh
his or her awn employees, provi0etl t�at such impmvemenis are not intentletl or oflereU for sale. If, however ihe Uuilding ar
impmvement is solG wit�in one year ai compleiion. t�e owner will have ihe burtlen oi pmvinp Ae/she tliA not builE or improve
lot Ine purpase ol saie).
I. as owner of �he DmDeny, am e�clusively contractinp with Iicense0 conVactors to consimct Ihe project (Section 70d4, 6usiness
❑ anG Pmiessions COUe: The Comracmrs' Siale License Law does no� apDly �o an owner o� D�apetly who bui105 or improves �hereon
an0 who conlmcis for such pmlects wit� a contractoqs�license pursuanito the Comracrors' State License law�,l am aware
Ihat pmof ol I�cir Workefs Compensalion insumnce shoultl be pmvi0e4 �o me.
� I am exemyt under Suc�iun: B. 8 P. C.
lor Ihis reason:
Oate�. Owner.
I Do �ere�y cenity Iha� I am aware of anC un0erstana ��e requiremenis of Caiifamia Healt� antl Safety Code Sections 25505. 25533, antl
2553a aM ihat I ar any IUWre �uilding occupanl willlwill not (circte one) need to comply with said state codes and tlle requiremenls lor a
permit lor cansimction or motlilica�ion imm ��e Nir �uality Managemen� Oi5lrici. Pesidential con5�mction applications are e�empi �mm
Inese o�ovisions. '
Daie' FpPlicanl:
I AereGy cetlifyl�ail�av¢ tead��is aoG����ion and slatethal the ab -nlorma�ionis Wrreci. lagreelo mmply vrilh allciry antl COunty
orUinancesantlslatelawsrelatingla0uit0ingconsimciionantl�ere au',onzerepresentativeso�INsciry�oenteruponttrea0ove�mmlbnM
pmOetlY �or inspectian purposes. �
Date: � ` �^ L/ SignaWre: _ �
oriver's License oi Sociai Secwity a:
1641 46 Whi�e—Bwlaing: Gre¢n—CoCe Enlorcoment; Ganary—Applicant; Pmk—Revenue; GolCenroE—Assessor
CITY OF, COSTA MESA — BUILDING PERMIT PERM NO: M 05095
PERMIT NO: M 050958 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTZON TYPE: PERMIT TYPE: MEC PURPOSE; OTH
JOB DESCRIPTION : COMMERCIAL T.I. (RESTAURANT), SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: RE: H50159 PRZMARY BLDG. PERMIT.
**���r�r�r*+��+��e*���r******x**��*��rx�*�r***rt�**��+r*�r�x��r�*��*x�*x*x�*�**x****�**��**��r+t*
Z O N I N GS ERTEB�AUCIKRSE N, E N T S
------------ MAIN BUILDING ---------- --------- ACCESSOAY BUILDING ---------
FRNT: FT IN REAR; FT IN FRNT; FT IN REAR: FT IN�
LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN
PARFCING REQ• PROV; PARCEL; 42419102 ZNE: REF NO:
PLANNING NZ7'I'ES>
i
**�*�,�,�*�,�+�,��*�,�*�*���,�K,�***�*x�*�,�*��,�,r��*+��r*,�***�*,�x�+��**���***�**���*,�**��*��r,�
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;
HUILDING APPROVED BY : DATE;
APPLICATION ISSU6D BY: � DATE; ����/
ifiEiPiEiEiEillEiEif�EiEiElEififfEiEltiElFiE . �kfElfiEdEiEltiEiEik - ifif
�EiFiE1EiF1EiEiEikiEiFiFitiflEifiEiEiPiElEifitifiEiElfiEiEikiE�EifikiElEitiEiEif. IkiF 'ftiFiFiklEiElEiflffEiEififitiFif±ElfiFiEifiEiEiEi4iFifiFfliFib3tiEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
PERMIT BLDG PMT PLUMBING ELECTRIC MECH6 50 FIRE SMIP/RES GRADZNG
258 SMIP/NON—RES
PLAN
ISSUE FEE ' 15.00
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 6.50 15.00 0,00 21.50 21,50� ,00
REVENUE DIVISION TOTALS--> COLLECTED: 21.50 OVER/SHORT; 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
?I,rJ� i
iE iF 3FiF if iE iE iE if iE iE iE 3f iE �f ��f jE iE iE iE it iF if �If if if if if if * if �f iF if iE iF if if 3E ik iE if iF iE ff iF �E iE iE iF if if rt 3E ik iF iE 1f If iE if !F!F iE iE it 3E ik if 1E iE if iP iEdE iF dk 3E
I N D I V I•D D 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 ONIT COST TOTAL COST
MEC 1 INST HOOD W/DUCTS FED BY MEC EXHAQST 6,50 6.50
END OF FEES
Y
Ol DOOn,_m40-GPQ3024o r� �-t- 2i,si�
DATf: fl2/03/p1 TIIiE: 1Q:3fi
CONSTRUCTION AND PLAN, S .r?OOL _. SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. 53. Steel Fieinforcement
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 Gmd. . 57. APPROVAL TO COVER�GUNITE
� �7. Footinqs , 58. Electrical ConduirUndrgrnd. '
8. Foundation .� 59. Gas Pipe, O Undrgrnd., Test �, �
9. Water Pipe�Undrgrnd. ' /� 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural F�oor 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 Eleatrical-Conduit 66. Solar SYstem-Final
76. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wifi�g Si9� 68. APPROVED FOfl PLASiERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
�
20. Rough Fattory Fireplace � ` ' APPROVALS Permit #
21. Oucts, in Structure . ... . �- 70. Underground HYdro
22. Ducts, Vencilating � i � ,' 71, Product Piping � Gas ❑ Oil
23. Gas�Pipe-Rpugh & Test . ,. � 7Z, Underground Flush .
24. Roof Framing • •� �- � ` 73. Undergmd.StorageTank �Gas ❑Oil
25. Roof Sheathing �' �� 7q, pverhead Hydro
26.�T�Bar Ceiling (Struct�ral) & Monocoat � 75. �Dry Chemical .
27. Frame and Flashiog . , 76. Dry Standpipe
28. Lathing & Siding � � . � �• �� � � 77. FIXED SYSTEM'FINAL
29. Insulation . � . . � � 78. fIRE PREV. FINAL
30. Drywall�Nailin9 . � �'�'� HEALTH DEPT. REQUIREMENT
.�
� 31. Plaster Brown Coat ' I ' �.!, �, , 79. FINAL INSPECTION
��
�32. Electrical�Power MeterFinal �� j � Y+ 80. FOOD CERTIFICATE ISSUED •
��
33. Final Electric' " . ' � � �, .i'� Notes: ,
34.. Final Heating & Air Conditioning � � � ' � � ` ' �
i
35. Final Gas Pipe-Test � ' ' ' . ' '
� , � ,..I. � .
36. Hood or Canopy ._ - 3�9 :��
37. Finat Facto�V Fireplace - � ��� '
� .
38. Final Plumbing � � `%� ' � �
39. Water Service�Final ' <' -
� � I
40. Gas Service-Final � ' I
i 1
41. Solar pomesticFinal � � • • � ��
I i i
42. Backflow Preventer ' . � � j �, .
43. Backflow Irrigation'
44. Landscape �rrigation SVstem � � � . � �
45. Sound Attenuation
46.' Handicap Regulations �
47. FINAL STRUCTURE & BUILDING �'.�i
48. FINAL PLANNING � �. ; �
49. Electric Release to Edison � � i
50. Gas Release to Southern California Gas Cv I ''"�
� r-�:
5/1. CERTIFICATE OF OCCUPANCY �, ,
Nb Date �
�.
pfl(11ECT ROOHESS: 8 9 9 W i 9 TH JrT UNIT:
OWNEH'SNAME: BISI'IOP, ANITA L�
nooness: P O B�X 2341
WRIC•HTWOOD,CA 92397
(7!4)
FflCHIENGINEEN: GEORGE PLATES flEG.NO.: Q
ADOBESS: '� 1 fjB 1 CHESTER AV uxiT:
GARDEN GROVE CA 9264U
PENMITTEE: EXECUTIVE FIRE PROTECTI013 (213)433-3338
aooeesr. �p GLENUORA AVE 8
L�ONG BEACH CA 90803
LICENSEU CONTFFCIDB OECLAPRTION: I hereby aliirm ��a� I am IicenSeA unCer pmtisions al C�apier 9(commencinp wii� Seciion
7000� ol Oivision 3 0l lhe Business and Pmlessions Cotle. antl license is in tull lorce an0 effecl.
cirruc.:0504 STATELIL.:Jrfq�963 � 16 — �
�ate: L Signalure: _ _ � � �� /
WOBNE�MPENSATIONDECIABAT10N: Ihere�yaHirml�a�l�avi certiliWlBofcon5en�to5e14in5ureo�acerlilicaleaiWOMerS'
Compensa�ion Insurance. or a cenifie0 copy thereoi (Section 3800, L. C).
POLICV NO.: E%P. DFTE:
LOMPANY:
� Cenilie0 copy is hereUy lurnisnetl. ❑ Cenilietl copy is IileO vnlh ihe ciry Building Uivision.
�a�e: /1pplicani:
E%EMPTIONFflOMWOPREPS'COMPENSATIONOECIANRTION: (iliissedionne¢anolLetomDlei¢Uill�epermili5lorOne�unOr¢O�S100�of1u5�.
I ceh�ty Ihai in I�e DeAormance ot Ihe work fo ic� �his p Irmit' suetl, I Shall � ot employ any per50n i y manner 5o as �0 become
subiect ta ine orkers' Cam sa�on Law of Califomia.
Dare: � Signaiure: � - �' �
NOTICE: II, a�ter making I�is tleclaralion, you s�ould become Su�j� Io I�e Warkers' Compenulion D�avisions o� �he La�or
CaOe. you musi farthwiih camply wi�h suc� Drovisions or �hi5 per � shall be Oeem¢d revOk¢A.
CONSTflUCTION LENOING PGENCY: I here�y allirm Ihai lhere is a ConSimtlion IenAing agency lOr lh¢ Dedormance ol �he wOrk lOr
w�ic� I�is permit is i=sueA �Section 3097. Gv. C).
LENDEP:
ROOPESS: . '
OWNEFl BUILUEN oECIAHRTION: I hereUy affirm that I am exem0� Irom t�e Convactors Sla�e License Law lor ihe following reason
(Sec�ion 7031.5 Business antl Pro�esvonal CaAe: Any city of counry which lepuiru a p¢rmii 10 constmet, aliet im0�ove, tlemoliSR or
repair any slructure. o�iar to its iuuance. also repuires ihe ap0���ant for sucA permit ta file a signeE statement that hvJs�e a licenutl
Dursuam to Ine D�ovisions ol ine Coniracmrs' State License Law (C�aO�e� 9(cammencinp vntn Sectian 7000) ol Divivon 3 of Ine Busine55
anE Pmfessions Catle) or inal heR�e is enempt iherefmm an0 Ihe Easis lor t�e alleged e.emplion. My violation of Section 7037.5 by
any appiican� lor a permil suble��s �he applicani lo a civil penally oi nai more IAan live hunAred Gollars (ASIp�.
I, as owner oi i�e D�opetly or my employees wilh waAes as iheir sale campensation, will do ihe wark, antl Ihe
❑ slmcWre a no�imenAeA oralleretl�orsale�Secuon 70a4, Business antl ProteSsionalCoOe: T�e Cantractors' State License Law
Uoes noi apply to an oviner of a pmpe�y who buAds or imD�oves thereon, anG wllo Aoes suctl wark himself/�erself or ihmu0h
�i5 or her Own empl0y¢¢5, pmvi4eA I�a� SUc� impmv¢m¢nI5 are noi inlenUeC Or OflertA laf sale. I( �owever I�e OuilJing or
impmvement is so10 wt�in one yea� ol camplelion, �he owner vnll have �he buraen o� pmvinA Ae/sAe Oitl na� builU or imOrove
lor ihe purpose oi sale�.
I, as owner oi t�e pmperty, am exclusively comraming wiih licensed con�raclors Io conslmc� IAe pwlect (Sectian 7044, Business
❑ and Protessions COAe: T�e Coniradars' State License Law tloes not apply lo an owner ol Dmpetly who bw10s or improves iherean
anG who conlrac�s �or such pmjects vnih a coniracmqs) license pursuanl �o ��e Camracmrs' State License Lawl. I am aware
��at proof of Iheir Worker's CamOensation insurance shoultl �e O�ovitle� to me.
� I am exemp� under Sec�ion: B. 8 P. C.
for t�is reason:
Oa�e: Ownec
I Oa �er¢by t¢nity ��at I am awar¢ oI ana unG¢rslantl Ihe reQUir¢mGniS of CaiilOmia Healt� an0 Sal¢Iy COde Se[Ii0n5 25505, 25533, antl
25534 an0 I�ailor anyluWre DuilUing accu0an�will/willnal (circle one) neeE�o Comply wiih SaiA Slaie cotles antl��erequiremenislor a
permi� �or consimclion or motlilica�ion �mm Ihe Nir Ouahry Managemenl Oislricl. flesidenlial conslmction aDDlicalions are exemp� �mm
inese pmvisions.
Date: pVD�itam:
I hereby ceriily I�ai I have rea0 i�i5 appbcatio ana slale I�at Ihe above iniormalion i5 cort¢c�. 1 aAree lo camply wilh all city antl couniy
ortlmances and staletawsreialingto building nsiruction and her author¢ere0re nlatives ofihis cilyto enteru Ihe,�%"" ' `mentione0
pmperry for inspect///ion'''���purposes.
Oa�e: �� SignaWre'. L
ori�e�'s �ice�se or sociai secudiy s:
16a1-46 Wnne—Bviiding�, Green—Cotle Enbmemem�. Canary—AoolicanC Pink—Revenve�. Goltlanwa—Assassor
CITY OF COSTA MESA — BUILDING PERMiT � ERM NO: F 05128_
PERMIT NO: F 051285 ' FLAN CHECK NO; 00500-91 S COl/T; A1 SUPP: N �
CONSTRUCTION TYPE: PERMIT TYPE: FIR PURPOSE: ALT
JOH DESCRIPTION : COMMERCIAL T.I. '(RESTP.URANT.) SQ FT:
CLAIM VALUE: 800.00 CALC—VALUE: GROUP OCC: B-2 /
COMMENTS; REF H001`i9 _
if if if #f iE i%if 1% if'1f'If iE iF iF IE 1R Y iF iE i%1f 1(' 1f 1h 1% If iE if iI-if if'lf #F af iE M.' �E if Il' IE iF iF if if iE iE IF 1f iF if ii' iE IE ii' #E iF iI-if 1f if jE'Y IE k i4 iE iF iI' Y 1f iF iE'1E ic ii' 1f �F if if
Z O N I N G R E Q 0 Z R E M E N T S
S E T H A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT; FT 3N REAR: FT ZN FRNT; FT ZN REAR; FT IN
LnFT: FT IN RGHT; FT IN LEFT: FT IN RGHT: iT TN
PARKING REQ• PROV; PARCEL: 42419202 ZNE; REF NO;
PLANNING NZSTES>
�
if if if aE �E iC if 1f iE if if �f 3f�% lf �F iF ±k 3E if iE if iE iF if iE iE �F iF if �f ih 1E if iF it IE if 1f if * iF 1E if IE1E if lf if iE# iF �E i41E K iF �E i; iF IE+41f iF Y� iF dF if if 1E �E dF i!� if Y if 9F if iE
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
ZONINCG APPROVED HY DATE:
BUZLDING APPROVED BY : DATE; '
APPLICATION TSSUED BY; �DH S DATE: 'J
**�+�****�*�*�rt**x��**�x u x*�+�*+r���c����*
?t*�**x�rt*�t��*�t+t�t�x�+rx-��t*�t�i��t�t***i�****�*�tat**�t+�x�*�t*i�atx�**�t*��+�*v�*��*�*+��+�i��w***f��t�x�+�*�*+t
LEGALIZATION:N F E E S U M M A R Y STRUCTi.iRAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT
PLAN
ISSUE FEE
HUILDING—DTV—> PERMIT ISSUE PLAN—CHECR
TOTALS----> :1.00 0.00 13,65
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PLUMHZNG ELECTRIC MECHANIC
21.00
13665
TOTAL
34.65
SMIP/NON—RES
34A6p D00
Z1.00 OVER/SHORT: ,00
FIRE SMIP/TOT GRADING PLAN—CHECK
�1,00
i: if iFiE �� iE df �f #E if if �%iE if iE 1EiE i4 i( �%!F 1E 1F �lE �)f if 1f �lf'7f if jf �lf if��1E �IE9E if if �f iE if df �iE if iF #( -)F iEif iE �1f i� 3f 3Fif iF ��E Y. �f #E �7E �%� •lE �If iE-1F iE �If� 1E �N� 9E �lf iE df �IL�If� If �Y-.)f
I N D Z V I D G A L F E E B R E A R'D O W N
TYPE. �TY. A E S C R I P T Z O N UNIT CC)ST TUTAL COST
FIP. 21 FIRE EQUIP FEE (FROM BI.DG VAL iABiE) 1,00 ?1.00
END OF FEES
oi 000az:.�8c-000s?aaa ���r 2t.on
ORTE: 031pE/91 TItiE� 14:35
CONSTRUCTION ANDPL�ANNING POOi SPA
' � Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. 53. Steel Reinforcement
3. EleGtrical Conduit Utility-Undrgrnd. 54. Forms �
4. Electrical ConduibUndrgrnd. 55. Electrical Bonding
5. Steel Reinforcement . 56. Rough Plumbing & Pressure Test
- 6. Electriwl UFER Gmd. 57. APPROVAL TO COVER�GUNITE
� 7. Footings , ' 58. Electrical Conduit-Undrgrnd.
8. Foundation - 59. Gas Pipe, O Undrgrnd., 7est
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structurol Floor System � 61. APPROVAL TO DECK
}}. piopercy Sewer Line & HouseConnection 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Orains _ 64. Plumbing System - Final
14. Rough Piumbin9 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 Ceifing 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20: Rough Factory Fireplace ' ' APPROVALS�, Permit #
21.�Ducts, in Struaure �� 70. Underground Hydro
22. Ducts, Ventilating ' 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test . 72, Underground Flush
24. Roof Framing � - - � 73. Undergrnd. S[orage Tank 0 Gas ❑ Oil -
25. Roof Sheathing �' . 74.-Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - � 75. Dry Chemical . 3,�Z 91 Inf�)
27: Frame and Flashing . , 76. Dry Standpipe "" �
28. Lathing�& Siding .� . � �; �_77;. FIXED SYSTEM F�INAL 3..12�g��-� I;uJJ
29. Insulation � - ' , �76.,�FIRE PREV. FINAL . 3�,i�Z.Sj Wr„�)
30. Drywall�Naiting HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat ., .79:� FINAL INSPECTION � ,
32. Electrical Power Meter-Final - .80. FOOD CERTIFICATE ISSUED
33. Final Electric ' ' ' Noies: ' : -
34. Fina� Heating & Air Conditioning. �
35. �Fina� Gas Pipe-Test ' � . � � � _ �
�.
36. Hood or Canopy � � •
37. Final Factory Fireplace , . � ' ,
38. Final Plumbin9 � � �� • ' . , �
39. Wate� Service�FinaP , " � • �
40. Gas Service-Final ' ' . .
41. Sola� Domes[ic�Finalr � ' '
42. Backflow Preventer , , ,� "
43. Backflow Irrigation � .
44. Landscape Irrigation System� �, - ' � �
45.�Sound Attenuation L � � - . '
46. Handicap Regulations - � � � .
47. FINAL STRUCTURE & BUILDING
46. FINAL PLANNING � �
49. Electric Release to Edison � •
,
50. Gas Release to Southern California Gas Co �
�51. CERTIFICATE OF OCCUPANCY -
No Date
PflOJECT ROOXESS: 8 9 9 W 1 9 TH ST
OWNEfl'SNAME: BISHOP ANITA L
aooness: p O BOSC 2341
WRIGRTWOOD,CA
ANCM/ENGINEEfl:
RODflE55:
UNIT:
92397
flEG.NO.:
UNIT:
PEHMITTEE: THE DOUBLE R COMPANY ( 714 ) 642-7463
aooaess: 2672 CLUB MESA PL .
CM CA 92626
ULENSEO CONTBRCTOfl DECNBATION: I hereGy a�firm �hai I am licensetl under provisions of C�apter 9(commencinp wil� $eclion
7000) of �ivision 3 0� Ihe Business antl Pm�essions Code, and my license is in lull lorce and eHecl.
c�rruc.:051494 s,aTeuc.:566004� cuss: B Q /� ������ �
Oate:..+_Zr '=�Q Signaiure: Q l.Yl'W.Qt.L. `� . V'""^'r.'„-_
OBNEPS' COMPENSRTION OECIAHRTION: I nere0y affirm ina� I nave a certificate al consent m seibinsure ar a cenilicate af Warkers'
impensalian �s�r�cg � 2c��tilietl copy thereof (Section 9800, Lab. L.i 3/ O 1/ 91
POLICY NO.: E%P. OFTE: U
�omrar+v: STATE
Cenilietl caOY is hereby fumished. ❑ CenilieE capy is �iie0 with the city BuilCing Oi/vi�s�ion�.� � � �
2— 3� V AOPliwn�: ,`�"'^ _�. li.c'...�'�^i-Y
oate: _( �
E%EMPTIONFPOMWOflNENS'COMPENSATIONOfCfABATION: (7pi55ectionnee�notbecomplele0i7thepermili5loronehun�reG�3100)arless).
1 cetlily Inai in the �edormance o� t�e work lor whic� this p�rmil is issued. I shall noI employ any person in any manner so a5 io become
sublecllo Ihe VJoiker5' Compensa�ion Laws ol Calilomia.
Da�e: Signature: _
NOTICE: II, alier making I�is declaration. you shoultl hecome su�le�� �o �he Workers' Compen5aiion pmvisions oi Ihe Labor
Cotle, you must fonhwith compty with suc� pwvisions or Ihis Oermit shall Ue 4eeme0 revoked.
CONSTHUCTION LENOING PGENCY: I hereby a�lirm Iha� �here is a cons�mc�ian lentling agency for Ihe performance o� Ihe work �or
�I whith this permil is issued (SetliOn 3097. Civ. C).
LENUEfl:
ROOflESS:
OwNEB BWLOEB OECLABRiION: I hereby affirm that i am eaempl Irom ihe Coniractars' State License Law for tne followinA reason
�Seclion 7031.5 Bu5ine55�anA Pmlessional Code: Any [i�y o� county w�ich repuires a pe�mil to con5tmct, al�er. improve, tlemoli5h, or
repair any slNCWre. O��ot to its issuance. also requires (hN appticant br such permii to file a signetl statement ihat he/she is licensetl
pursuanl lo I�e Omvisions ol Ihe Coniractors' State license Law �Cnapter 9 �commencinA'�+i�h Section 7000) ai Divivon 3 of t�e Busineu
•na Pmlessions Coae) ar lha� �e/s�e is exempl t�ere�mm antl Ihe Ga5i5 for Ihe allegeG eeempiion. My Holatian o� Sec�ion 7031.5 Oy
• aODlican� lor a Dermit 5u01eci5 ��e applicanl Io a tivil pynalty al noi more Itun live hundfetl OWlars (E500).
I, as owner ol ihe O�opehy or my employeeg wil� waAes as t�eir sole compensation, will Do ihe work, antl ��e
� I l� slmcWre is not inlenEea or olleretl tar sale (Section 7044, Busmess and Pmlessional CoOe: The Coniractors' State License Law
Ooes not apply to an owner af a D�openy w�o huiltls ar impwves ihereon, an0 who tlaes such woA himsell/�erself ar t�mu0h
nis or he� own emo�oyees. pmvi0ed �hat such improvemenis are nol inlenAetl ot anerea for sate. tl. trowever Ihe �uilaing or
. impmvemen� is solU wilhin one year oi [omple�ion, �pe awner wiil �ave I�e UurOen of pmvinA helshe Oitl noi GuiIG or imDmve
lor Ihe purpose ol saie).
I, as awner ol �he propeny, am exclusively comrac�ing wi�� licensea conVactors to constmct the pmlect (Sec�ion 7044, Business
' ❑ antl Prniessions Code: The Contracbrs' S�a�e License law Does nol ap01y lo an owner of pw0erty who bwlds or improves thereon
and w�o conVacis lar such pmlects wii� a caniraclor�s) license pursuanl Ia IM1e Comracmr5' S�ate License Law�. I am aware
Ihai pmof ol Iheir Worker'S Compensalion insuraqce 5hou10 �e D�ovided to me.
� I am exemp� untler Semion: B. 8 P. C..
br t�is reason�, .
�ate: Ownec
I tlo here�y cenify Ihal I am aware ai ane unaerslan0 ihe requiremenis of Caltlomia Healin an0 Salety Cotle Settions 25505. 25533, an0
25530 ane I�at I or any fuiwe Guiltling occupant wilUwill not (circle one) need Io camply vri�� saitl siale codes and ihe reQuiremeni5 �or a
permit lor conslmction or motlilica�ion Imm Ihe Air Ouality Managemenl �isVici. Residenlial consimction applicaiions are exempi Irom
Ihes¢ pmvisions.
Date: Rpolicam: _ �
I �ereby cetlily��all�avereatl Ihis appfication antl Sla�e It�yi �pe a00veiniormationi5 carrecl lagreeto comDN`�^�h allci�y anE couniy
orEinancesan0 sialelaas relalinglo building consiNclion antl hereUy au�horize representatives of�his cily�o enter uponthe a�Ove�menlioneG
pmperry l/oi in5�eclion purpases. //
Oate: �1�_�.LL_ Signature'. ! N "r— �' 4��
orivers�icenseo�SociaiSecunty•:
t6ai�a6 Wbite—Builtlin9: Green—Cotle Enlorcemem', Canary—Applicam; Pink—Revenue: Goltlenmtl—Assessor
CITY OF COSTA MESA — BUILDING PERMIT ,
"PERMIT NO: B 050158 PLAN CHECK NO: 06936-90 S G T: ,
CONSTRUCTION TYPE; PERMIT TYPE: STR PURPOSE; OTH
JOB DESCRIPTION : STD BLOCK WAliI, SQ FT; 26
CLAIM VALUE: CALC—VALUE; , 520,00 GROUP OCC: M-1 /
COMMENTS; REF PC# 5988-90S Q� ��� DlS'�
���e**r**�r�t**x�t**�t*x�***rx��***�***** **�*� ******�t**�t***�r*�r�r�t�r�*�e*�**�r�r****�t�t�t+t*
Z O N I N G R E Q U I R E M E N T S
S E T B A C K'S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT: FT IN AEAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: � FT ' IN AGHT: FT IN
PARKING REQ• PROV; PARCEL: 92419102 ZNE: C1 REF NO;
PLANNING N�51'ES> PERMIT FOR EXISTING 3 FT. HIGH BLOCK WALL ALONG SIDE OF
> EXISTING RESTAURANT.
if iF ak iF M iF if iF M!F iE %if M IE if if iF iE iF if iF if M If iE iF if iE if 3E iF K if iE iEiF iF iF IE iF iE if if iF iF 1f if 3f 1E iF iE if 3E iF If iF If if M IF IE iE 1E iF iF if if M iE iF 3F iF if IP 3f if if iF
D E V'E L O P M E N T S IE R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY : J—� � 1�� DATE: � 3
BUILDING APPROVED BY :�-C- •C— DATE: .. ,3
APPLICATZON ISSUED BY; � L�'—C • � DATE•
iF if M it iF it if iF 3k �f 3f �F it itlh �Elf ik N�F iF M k N� iF iE 1Flf if if iF it7Fi��lF it
�f �Elf �F Ik iFiE IF iF 3E iF iE iF �klE k IEif �f iF iF if 3F if IF !E if iF ik k iF if if iF iF M K�F iF K iE 1k if It iF iF if if 3f iF 1F iF IF if iF iF iF iF iE If if iF if iE Ik 3F �E 3f k if If k!F �t If If if iF iE
LEGALIZATION;N F E E S U M M A A Y STRUCTURAL SEGMENT:Y
HLDG„PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 17.00 50
SMIP/NON—RES
ISSUE FEE 11.05
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 17.50 0,00 11.05 28,55 28.55 ,00
REVENUE DIVISION TOTALS--> COLLECTED; 28.55 OVEA/SHORT; 00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
1%.�� ,5� L1,OS
M 3f if �)f M 1f iF M iF 3f ±F k if if ff ff if M If If 1t iF ik M if if k�f IFiE k if �E �F if k iF if !F!f if �F If k�F �k iF if 1f M�F iF iF IF k 1f if if iE It iF k k�E if iF 1E �f �f iE iF iF k k k if ik �t IF
I N D I V I D II 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
SFR ' 26 " RES—CONCRETE BLOCK WALL / FT. 20,00 520.00
END OF FEES
.. •, ._`��. � ol
._. ' .. _.�— C .j��'
DEC 03 1990 ��'��
C►TY OF COSTA MESA
m
0
� CONSTRUC710N AND PLANN�...,
� JO L & SPA
APPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
7. Temporary Electriwl Service or Pole .. � 52. Pool & Equipment Location .
2._Soil Pipe-Undre�r�d. , r �';a -. 53. Sieet Reinforcement
i=' S
._ 3. �Electrical Conduit Utility-Undrgrnd�, i� . 54. Forms
��4:'�lectrical Conduit-Undrqrnd. " .' 55. Electrical Bonding �
Tc ,
"5�Steel Reinforcement 56. Rough Plumbing & Pressure Test ,=,
� 6. Electriwl UPER•Grnd. 57. APPROVAL TO COVER-GUNITE c�
"7. �Footings ' � ' � 58. Electrical Conduit-Undrgrnd. "
8! Foundation _ y 59. Gas Pipe, O Undrgrnd., Test ��
9. Water Pipe-Undrgmd. ., 60. Backwash Lines, P�Trep, O Undrgrnd.
� ,,
10. Structural Floor-System . 61. APPROVAL TO DECK ''�
it. Prdperty Sewer Line & House�Conneaion . 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
rr
i6. Rough Electrie�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 Heatin9 & Air Conditioning FIRE DEPT. REQUIREMENT
- - - ' ' . r.
20.!Roiyh Factory Fireplace ' *� �:" '� "' � • * -pPPROVALS=� �-Per'mit # �' �
.S .:C 3. ., i .�,r rt- � �' \ � ^ a . .�.:': � L: u:
21 30uCts, in_Str�uctur.e�. .. .��� y S 7 �a �� -70. Undergra��d Hydro x � „
22. Oucts, Ventilating ' + ��� i ^ S d` ' �=��, produc[PiAin ❑Ges ❑�Oil ` � -
�� vr -a. � �1 . C' •L . .r . i 9 .n
G . . ^1 i V. 'x ' -' A Y � J: 1 � ' "' L� i ..a _
23 :Gas.�ipe=Rou9h &�Test , ,�S x:�- a; �,� a� 72• Underground Flush^,.� �. __ _
24.�Root Framing � ' .- - ••y < 7 .: � � �Y K �73 _Undergmd'Storag"e,-Tank OGas.O(Jil �. . _
�i. x z ...�•
25. Roof Sheathin � 1' ` "� ".� "''� ;' �� ' ` . ' �
, 9 ; :��r . 74 ,.Overhead Hydro� �r��
26.iT-Bar Ceiling (Structurap &:Monocoat = 'R � '_�'�• � 75;=pty Chemiwl �- 7 '- _ � �� - . ' .
'c• • r �,� v 5. -. � rt.
27..;Frame and Flashi� . �'� � '�" s ^x m ;-^ - --� ,;;�' _ - -_ r- -
9. ,.�� F.;a-- ��Y, a 76. DrySFandP�Pe .c
'-28."Lathing&Sid�ng. -.. ��r�� �p r�, �• • •;M1 y 77� FIXEDSYSTEM�rINAL'« V _ _ ' : �
�
'29. Insulation ���� �" ;S ...• ' �, r{`' �. �' '� y 78. �FIRE PREV. FINAi . �. ~ --
30. Drywall Nailing • � !'• y - -' "; I� -��� � �- HEALTH�DEPT� REQUIREMENT �
,w �_,. I i ' N , r ,�:-, .�
'.31. Plaster Brown Coai: _ ; ,. '`;�; ,--.� , � `� � y ,J9f'FINAL INSPECTION ' ''' ' Q� -
.��32.-ElectricaLPower,Meter:-Final� � ��-?-c; � '�� �� . O:tFppDCERTIFICATEISSUED .i
�
' - !� ^ �a . - , � T:
� CS.a�.ir; . Y n ':i. T
�33.�Find1 Electric, FT; ! � � �Noies: `; ,
r l d,...i� rV :q - y
m � - � . v �
34.-Final Heating & Ai%.Conditioning� ���� '� � �r . ' i. { ,a , ;5 �i'�
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35r�Final Gas Pip`e-Test�Y �D =tT � It i h e] :'t ,�� �-�� T<<� ' �
. ' ir ':1
1 - • a J / � , � ' .y . .� p ' \ �_ \
�36. Hood or CanOPY� �r � i� �-+ � C` .� ' �x �! s : r��7 a •
i .r, ,.. ` �..
'37.-Final Factory Firep;ace,; � �6'� ' _�'� I y ' ' �� �
} � CL' :t. 4C
� - � ".. .. -� .. � . .,�
�38. Final Plumbing t � •- : � - .. - • a7 �
.'39 c:Watei Service-Final� z � I a � �' -•'^- � '*� "
ti� '
„40.��'�Gas Service-F�nal : � � tx �+ [''� � ;, . '
l T' � r � �` �!' ` - -
�41'Solar pomesucFinal a Ci� � �': " � `> w �t^- ^ J.
Y S t � 'q '• ;� -. U ¢ s.
"42 nBackflow Preventer. :;j y - �f `� � p � r ^ -� • �t ,- i-�
43. Backflow Irriyation` ' ` •?�'� - ; ' a� � '�'-� * � �
>. - N i c
t A4. Landscape Ir�igation Syscemx.r� = �-S ;;q - ,�• y� i,' i�; �� �' !: p
...,,, - _. .
�45�:Sound Atterivation • - - •T" , � z - . - ' - �� x�S -
`�46!'Handicap,Regulations ,_. 'S= '"� � t �r- - C� •
�47 �PIN'AL STRWCTURE & BUI�LDING �� l: ��� �C.��A i .uc:s �� -
48:=FINALPLANNING` � � °�.�� • '�"'%i,i '' .i r�` �`. =" '� -
49.=Eleclric ReleOse to Edison � + :: ' � -
_ • /..�' � ;� ' �� 7 5'. .r - - -
�50. Gas.Release to Southem CaliforniaGasCo t r'� ,{; - 5 c' - j y� ' - ':
51. CERSIFICA7EOF;OCCUPANCY ; ; } ,-„ .rp 'r= . o
No Date
� � �EE RECEIU��
-. . - _�z���� �, I�'�`" �1
FEB 6 iS&1
COSTA MESA BUILDING-SAFETY•DEPA MENT �%���Jll FINANCE OEPT.
r. o. eox s+� C08TA MEBA. CALIFORNIA CITY OF COSTA MESA
For Applicanf to Fill In Complefely APPLICATION FOR PERMI7
TYPE OR PRINT BUILDING
Bl11LDING �lJ � /yrh \��
ADDRESS /
COSTA MESA CALIFORNIA For Offite Use Only
rdJ I NECEI D CY DA qEC IVHO OATE �BBl1ED
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Ae rceci ) ��)�S "�` 'i 7E�. , COSTA MESA. CALIFORNIA v
O�",�; INEERI.�O �"�9�1 C . NO.LU� %S ��
ADDR�E6S E. F- ' '%� Z�NE TYPE GROUP �� `1
G'/V�I�,+,�/�p pL{-y{��-� 'O• pppROVED `�` �
CONTRACTOR =C�IaStlGf�.V!UTla�i BV OATE � � ' " �
ADDRESS -/?s�%' ��N'--- � � ONING � � ��
� IONE NO. OF U8H OF NEW /� J �
CITY �� . �� ��/ I PV�N9 BllllDINO�I/T s50 � �
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LHOAL \ �
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OF L07 ��D � IJ d I Now or+ wi D p, p_ NO. a�
UBE OF YARDS EVES V�
EXIHTING BLDG APPROVED ALLOWEO O
/ ILlNTBP LINE BTJ
66TBACK LINE FROM �f �
GENTeR OP 9TPeET REAR YARD ��p FRONT F7. IN, j��
I I RIGHT R. SIDE I FT. IN. t�
SIDE YARD LEFT
• DESCRIPTION OF WORK (/ R�+�' �Y
L SIOE T F7. I� '� • IN. V1 �
I�ALTERATION I II ADDITION I f_ �
� REAR O FT. IN. � �
REPAIR I IIMOVING I IIDEMOL16H I APPROVED K
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BB=IELDING��J X�/I ' ROOMS 9TORIES Bv O / � � � . O }'TE/V _�� � �
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EXTERIOR WALI I ROOF O' �
COVERING 1COVER7NG % L Q 4� a
USE OF BUILDING <.ND WORK TO BE PERFORMED a
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I XER¢BY ACKNOWLEDGe TH�T 1 NAVB RB/�D THI9 APPLIGTION TH6 AMOUM BHOWN UNO¢P VALUATION IB FOR TX! a O
ANO BTATE THAT TXQ ABOVE IB COPRER AND AOP26 TO CON• pURPOBE OP EeT/�Bl18HING A vERMIT FEF ONLY. O
PLY WITN ALL WiY OqDINANC88 ANO BTATE LAWB RGOULATIHG � IL
Bu1LOINa coNeiRu VALUATION
BpIG�MA�NEE O � �� � �'� ERMIT FEE S/� � O
GQ S �l ��� PLAN CHECK S G �I'
AUTHORIZED AGENT � ¢
TOTAL PEE � �
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COSTA MESA BUILDING-SAFETY DEPARTMENT • � � � �
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 •''
A LI TI N FOR STRUCTURAL PERMIT
For Applicant to FHI in Completely — Use Ink Only '
REC I e DATE RECEIVED TE UE
BUILDING � �
ADDRESS
` A.P NO. —O3 — ERMIT N .
OWNER � � /�
MAIL BUILDING 9/ /A// ��
ADDRESS
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CITY � Q
CONSTFUCTION
BRANCH
ADDRESS
ARCHITECT
CONTRACTOR
ADDliESS �/
CITV �
STATE �
LIC. NO.
SIZE
OF LOT
TEL.
NO.
L.
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W A
OWNER
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FIRE
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APPROVED
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LIC. NO.
NO. OF BLOGS.
NOW ON LOT
Separate permits are required fot
electric, plumbing and heating work.
USE OF BUILDING ANO WORK TO BE PERFORMED
ii►�'�uC/ �/�/ �`i,00,-riC�ct/ �
1
/�
I horeby ecknowladpa that I ha�o raad Nle epD��cation enC smte
t�at tha ebove (nlormatlon Is corract entl aprea to comply with
all lawa ropulatinp builtllne con5truction, and I sheli not employ
nny person In vlolatlon of the workmon's componution laws o(
che Stata of Californla.
I hereby certify thet I em prope��Y �tconsad as e conttector under
the State of Callfornie Business antl Professlona Code, Dlvislon 3,
Chepter 9, antl that sueh Ilcens¢s are in tuil foree enE eNeet, or 1
em ezampi ftom the provisiona ot the Scem of California Businasz
anC Professions Cotla, Dlvision 3, Cheptar
Sipnature ot �
Permitteo
AuthOfizetl �
FROM C/L STft
DISTANCE BET
MAIN BLOGS.
VAR. qW
C.U.P.95
APPROVED
LOT BIOCK
= p
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1
VALUE
i $
TVPE � iGROUP�- v
'-/ DATE�/�O �(Y
OF USE OF NEW
NS BUILDING
VED VARDSAPPqOVED
BET. MAIN &
ACCESS. BLd
�ATE
APPROVED
THE AMOUNT SHOWN UNDER VALU
THE PURP�E OF ESTABLISHING A PERP
VALUATION PERMIT FEE E
�O PLAN CHECK E
$ �� �� TAX E
TOTALPAID {
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