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Home My WebLink About753 20TH ST - Building PermitsP.FD�icant to /ill in all spaces except those within neavy boreer Iines antl sign all apvrooriata tlaclarations. �9�5 , CIT COSTA MESAc C1,nV)N Rl�TlO PERMIT PERM� N%c /O TRACT NO. LOT NO. UNIT NO. ' • � �" " 9� � 2�e4 , a•OO . TL Project Address � �J "" � ��/� ��' �� ' �J /✓ • . ' . , � ' . , - � AppliC2nt�5Mdili��A��racc �7�TZ , O.SPh!) �,L� TYPEOFCONSTRUCTION rvEw ADD ALTERATION REPAIR �'y� ❑ CONVERSION ❑ DEMOLISH ,❑ OTHER q,p, # - 2one OwneriNa(�{neQ t v/ � �Phone "",I`��y DESCRIPTIONOFWORK/USEOFBL•DG. Address �/ 3 V � �r I�` � V' r�� P�Ym(/f' ' S Main Building: Accessory Building: Arch/Eng. !- ' M� � LiCense No.' TVPE OF PERMIT . GRADING FOUNDATION STRUCTURAL T� Ffont 0 Addreu � ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL B Rear N Conlracmr'sNam H%F P _Phone�62-5'�/a3 �'OTHER A � 2 v PROJECT DESCRIPTION Sq. FT. oCCUPANCV K Ri9ht . G / Addreu (mailing) - OmQ O CONSTRUCTION TYPE VA�UATION 5 g Left . R Ciry License No. L� � ZONE GRADING CV. VDS: ACRES - LICENSED CONTRACTOR DECLARATION ' PI�g. R¢l. # Pdfkiny R¢q./P�Ovid¢d E I'hereby a/firm that 1 am licensetl untler provisions ot C�arter 9(commenNng Remarks: Planning Notes: , . � witn secllon �000) of Division 3 of the Buslne55 antl PrOteSSions Cotle, anA M my Ilcense is in tull torce antl efiect. yy�� - � T LicenSe Clazs -r(.�(3.lpQ�License No. . S' Date � � Si nature �� PLUMBING FEES WORKERS' COMPENSATION DECLARATION � Bar Sink ' ShoWefS I hereby af(irm that I have a certificate of consent to self-insure oi a cerUficate ELECTRICAL FEES ��Y.,y:f Workers' Compensation Insurance, or a certitied tooY �hereof (Sectlon . BackflowPreventer ServiceSink �= p,�3oo,-Lab. CJ �- ' ' ' - Automatic Washer Transformer ❑ 15-50 KW 1 Policy No. Company Backflow Irrigaiion Sewer Ca / � 50+ KW ! P Construcuon Pole Sub. �1 e Certifietl mpy is hereby furni5hetl. , � Certifietl copy is (ilea with the city euiltling Division. � ;� Ba[htubs Sewer Connection Cookin9 Unit ' Meter ❑up to 100 amps . Date � APPlicant - EXEMPTION FROM WORKERS' COMPENSATION OEGLARATION Cldrifi¢r5 , $Olar COII¢ctOrS Di5hWd5her Met¢r ❑Ov¢r 100 dmp5 (Tbis section neetl not be completetl if the p¢rmit is to� One huntlretl (5300) or - iess). , Dishwasher � Solar Piping Dryers OGas ❑Electric Sub Panel � I ce�tify that. in Ihe pe�formance Of the work tor which this permit is issuetl I snall not employ any person in any manner so'as to become subject to t�e Drinking Fountains Solar Tank Fan Motors �0.1 HP 01'h- 8 �Worker5' Compensation Laws of Calitornia. Date Si9nature Floor Drains Swimming Pool w/Spa F,A.U. NOTICE: If, afie� making this tle[la�ation, you Shoultl becoTe subject t0 the Inc.501d� 09-15 HP 016-15+ Workers' Compen5ation provisions of the Labor Cotle, you must forihwi[b FIoolSinks Urinal Fixtures comply with such O�oviSions or tM1is pe�mit shall be tleemetl revoketl'. Microwave � CONST0.UCTION LENDING�,AGENCV" GasSefviCe Outlet5 WaterCl05¢t � DeviceBOxeS POIeLi ht I hereby afllrm that there is a mnstructlon lentling agency tor the performance - , 9 ot th¢ wo�k (or which this pe�mil is Issuetl (SeCtion 3097 Civ. CJ Intercep[ors Water Heater �utlEts � � Lentler's Name � - Range Lentler4 AEtlress � - _ Kitchen Sink � Water Service Switches ' Sign OWNER BUIL�ER DECIARATION �- I hefeby aftirm lhat I am exempt flom the ContractOl's Llconse Law for the LavatOfi25 - . � (�idfbd ¢ Di5 OSdI - following reason (SecUon ]031.5 Business antl Professional Cotle: Any city or _ 9 P "Standing Sections county which �equires a pe�mit to mnStruct, alter, imprOve, tlemollsn o� repair P—Tf2p any structure, prior to its issuance, also repuires the applicant for such permit Generator �0-5 KW �5-15 KW ' Trash Compactor [o file a Si9netl s[atement that he/she Is licensetl pursuant f0lh¢ Provi5ion5 of ROOf D�ains ' tne Contractor's LicenS¢ Law (Chdpter 9(commencin9 wi[h Seclion 7000) of DivlSion 3 ot the Bu5ine55 antl Profe55ion5 Cotle) or Ihat he/she is exempt -`.i�erefrom antl the basis for the alle9etl exemption. Any violation ot Seclion ��.`�731.5 by any appliwnt far a permit subjects tne apD��ant to a civil "-��nalty of not more than tive hunAretl tlollarz (E500). • ��L� I, as owner of lhe property or my employees with wa9ei as tneir sole Reinspection Fee $15 Issue Fee $ 3 ComOensa[ion, will tlo the work, antl [he st�ucture i5 nOt intentletl o� ofteretl RBinSpec[ion F88 $1$ ISSuO Fee $ 3 tor wle (Section 7044, eusiness antl Protessional Cotle: The Contractor's MECHANICAL FEES License Law tloes not apply to nn owne� of a prop¢rty who builtls or imp�ove5 � thereon, antl who aoes such work hlmself/hertelt or through his or her own - � DEVELOPMENTSERVICES REQUIREMENTS: � employ¢ez, provitle0 lhat Such improvements are not intentlatl or offered for BOII¢r HOOd Or Type I ❑ Shce. If, however, the builaing cr improvement is soltl within one year oi com- Cdnopy Typy I I ❑ Zoning Approved By Data pletion, the owner will have ihe �urtlen ot proving ne/she tlitl not builtl or im- Duct - Under G�ound Building Approved By Date �rove (or the pur0ose of sale). �(� I, as owner of tne oroperty, am exciusivery contracUng wltn Ilcansea con- Duct -Structural Refrigeration System Appliption 15sued 6y ' Dat8L1� tractors to mnstruct the project ($ectiOn 7044, Business and Profession5 COtle: The Contractor's License Law does not apply to an owner of property who Duct - Ventilating ❑a100,000 BTU ❑100,000 BTU SUMMARV OF FEES I - builtlz or improves Ihereon, antl who coptracts for such projects with a con- tractor(sl license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP $ proOf o( lheir Worker's Compensation insurance shoultl be provitletl to me. PLAN CHECK $ PERMIT ❑�I am exempt untler 5ection B. & P. 0.(or this reason Firepl/FacL Blt. ICBO # PLUMBING $� I$$UANCE $ Date Owner - - Heating System & Ducting . ENERGY P.C. $ PLAN CHECK 25% $ I hereby certi(y that I have eaa mis piication and state that the above ❑6100,OOOBTU �100,0008T ELECTRICAL �� GRADING $ information is <o L 1 a9re to co I with all clty antl county ortlinances - $ antl state laws lati tQ b i" s uction, ana'hereby authorize repre- PLAN CHECK 5096 MICROFILM $ Q' � � sentatHes ot i cit td r -mentionetl ro rty i r MECHANICAL , $ TOTAL FEE $�_t/ // InSpection Our synaeure oate � peinspeetion Pee $15 Iszue Fee $ 3 PLAN CHECK 25% $ Drivars• License or 55 � CMr unoo-vo, rev. a�av Wpi{e - Bullalnq; Canary -'appncant; NinH - taccounung; moiaenroa -iassesso� CONSTRUCTION AND PLANNING ' ' � � P��' '�A � � � �� - APPROVALS . Permit# - Date Inspector pppROVALS - Permit# Date Inspector -1. Temporary Electrical Service,or Pole �� 9� /, 52. Pool & Equipment Location ' v 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement � . 3.'Electnical Conduit �Utility-,Undrgrnd. � . 54. Forms � � . � ,4. Electrical Conduit-Undrgrnd. ' � _ . - 55. Electrical Bonding , ��5.- Steel Reinfoicement ' ' . 56. Rough Plumbing & Pressure Test � - � • 6.� Electrical'UFER Grnd. _. '- - ' 57. APPROVAL TO COVER-GUNITE . � . . 7. Footings •� 1- • '; 58. Electrical Conduit-Undrgmd. - 8. Foundation ' 59. Gas Pipe, � Undrgrnd:, Test 9. Water Pipe-Undrgrnd. - ' - 60. Backwash Lines, P-Trap, O Undrgmd. ?.9. Structural Floor System - � � �, 67. -APPROVAL TO DECK , �' � . 11. Property Sewer Line & House Connection 62�. Backwash & Receptor-Final ' �: � 1,2. 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. POOUSPA 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. ProductPiping'OGas ❑Oil � 23. Gas Pipe-Rough & Test '' 72. Underground Flush � ' . ' 24. Roof Framing , . � 73. Undergmd. Storage Tank � Gas ❑ 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: � � 34. Final,Heating & Air. Conditioning / . � ., 35. Final Gas Pipe-Test ' , . , � - 36. Hood or Canopy , � . 37. Final Factory Fireplace � , . . 38. Final Plumbing ' ' , �I 39. N/ater Service-Final � � � � ' 40. Gas Service-Final , ` . � 41. Solar pomesticFinal . . ' . � . � 42. Backflow Preventer " , ' , 43. Backflow Irrigation . . ' . � i • . . ' ' 44. ,Landscape Irrigation System , � . . 45. Sound_.Attenuation � � � , . 46. Handicap Regulations � . ' � 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed � � � ' . 49. Electric Release to Edison . � - � ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATEOFOCCUPANCY No. Date �' ,.•. 963'� . COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 31� COSTA MESA, CALIFORNIA fOR APPC/CANT TO f/LL /N COMPLETELY '�Y,P,E OR PRINT BUIIDING • � ✓ J a� ADORESS - �� ti � 'S T COSTA ME5.4, CALIFORNIA OWNER • �i �L U C (� O rJ� MAIL /s !i � � _// n � ` ADDRESCaI 7" Y �.y L CITYV(./ �I I Y��l NO./��Z' ARCi -GT OR' NEER LEGAL DESCF A.P. M1 iR (7"' F/`N LCTNO./%JZ.J2 ByPF '�-!� ,'�/C!/EsT/M�iY�-r�=� - INOT�� f� �I BLOGK ` I TRA�T" ZONE I S � - � APPF B� n�J � y /� � I I NO. OF 9LDG8. Q yqq� V � NOW ON LOT REQI USE OF O 0 (cE�� E%ISTING BLOG �� FRO� i'ipFf7ti" � SETBACK IINE FROM �✓ � CENTEfl OF 6TREET ��/ REAR YAR� R. SII SIDE VARD I LEFf IO' I RIGHT /D� v, L. SII DESCRIPTION OF WORK � __ BUILDING��DO A� SIZE E,%1TE�R�IOR WAL r %OP 4 I HENEBV ACKN L [ •NO STATE TH T E PLY WITH ALL IT O BUIIO�NG CO 9 CT SIGNATU PERMIl7 AUTHORI2ED AGENT IJ � P�t'l�v9 /f-��9 !� � : THAT 1 HAVE READ THIS APPLICATION l0 E IB COflflECT • AGHEE TO COM- 8 ANO ST/�TE AW9 REGUTATING I % ( � ��:t�. ��r�� b - FINANCE DEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING Fo,e officF usF aNcy I PEC¢IPT NO. I P�.pM�T y� IYE� BT I D�TE RECENED I DATEd9', Y /_ � i !_' /'"Y � _/ N COSTA MESA, CALIFORNIA N ZONING NO. OF __ I U6E OF NEW PLANB �UILDING 'dl1�, ho. �-��FlPPROVED IN_I � IN. PERMIT FEE S � �;- �- g/[/ G// \ PLAN CHECK $ / 7• — %- �� O [� TOTAL FEE $ cJ �• '� / , J, q �Qt� � 3_".�tl�� .; COSTA MESA BUILbIN6-SAFETY DEPARTMENT . . • P. O. BOl( 917 COBTA M6HA. CALIRORNIA For Appl)canf fo Fill In Completely TYP� OR PRINT BUILDING � T ADORE68 COSTA MESA CALIFORNIA OWNER �/ � h�` � MAIL 9lJ. AeY L�7 ■ ARCF'" 'Cf A//fMc ffi�. ' 8T^ Tv� U8E OF E%ISTING BLDG 8H'�BACK LIN6 VROM I� USE OP r ra � �oL ' ' �-a7 _ � /� i� I ut�wanu9lD*8. / i LEFT �'S / RIGHT � S DESCRIPTION OF WORK ROOF / i xar+eer wc1wowteooa rHwr i xwve rsuo nais wrruur�oH �r+o er�ra n'�* n�s �ebve is mnrsecr u�o AOR88 ro cod• PLY WITX ALL LIIY OPDINAN�9 AND HTATB L.AW9 R8611LATN0 6UIlDINO CONBTRURION 81GNATURE OF PERMITTEF - AUTHORIZED AGENT � FE� RECEIVED � �uazztssi FINANCE OEPT. CITY OF COSTA MESA APPLICATION FOR PERMIT BUILDING For OHiee Use Only . /� / f16CE1PT NO. / RqQ � J o� rvm ev I owTe wecuvsc I o�rc �eai CO3TA MESA. GC�� /9s��ONING ZONH /,%/�IpuHB �.BBlDINO� n �1 L80AL ��' � �I � O86CRIPTION A.P.NO. l�� VARDS EVES APPROVED ALLOWED (C6M8R LINB 9T.) r,/ _ . � 00 6oa 5 S i� '� ApPli ! OF COSTA MESA JSTRUCTION PERMIT Addrea AddreSs CA�trdclor in all toacas withln haavy borEer Ilnes anE sign al1 appropriate ae�laration T NO. TRACT NO. LOT NO. BLDG. NO. � cST � TVPE OF CONS7RUCTION (1 Phone . �] � NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION�DEMOLISH LICenSC NO. ❑ OTHER DESCRIPTIpN OF WORK L� 1 hereby affirm that I am Iicansetl untler provl5ions of Charter 9(com- menNng witb SecHon-7000j at Olvision 3 of tM1e'Buslness antl Aofeisfons Cotle, anC my Ilcanse I5 in full to� a antl eftect. License �lass ' � I so N Z Date �'�'� $ � Si9nature WORKERS' COMPENSATION DECLARATION I M1orBOy alfirm Ihat I hdve d cartifiwte Of COnsent lo se -iniur0 or a CerttlfWta of Workers' Com0an5dtion Insuranca, or a certllfeQ copY thereot (5� tqon 3800, Lab. C.�. /� � ✓ n c—rA t P' ' Nc (t�:�7 ��%� ��'/ CAmPanY L4 r�vf !Lr v�/" ��J � tltl� topy Is hereby fumisnatl. �_art�{�¢tl topy is filatl witn tha dty Builtling Divislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (TNs s¢�fion neetl noC be <omple[ed if the parmit is �or one huntlreC SS100) or leul. certl(y �hat ln the performance of the work for whlch fhis permit is Isivatl, I shall nol emPloy any par5on in any manner so as to become Subject tOIhG Work¢r5 Compe�5dtion LdwS Ot Callfofnia. DatO $i9nature NOTICE: It after making thls tletlaration, you snoultl become subjact co [he Workers' CompenSaUon provlsions o! tne Ldbor COCe, you muzt fOrt�w�(h COmply wil� sUch prOWsionS or thlz purmlt Shdll be tleem¢tl revoketl. � • CONSTRUCTION LEN�ING AGENCV I heraby affirm that t�ore I5 a coostructlon lending agency tor the per- torman�e Ot the wOtk �Or whicn thl5 pCrmit i5 ISSUCG ($ecllon 3097 Civ. C.�, Lentler•s Name Lontlar'S ACtlre55 OWNER BUILDER OECLARATION I hereby aHirm [hat I am exempt irom the Contractor's Llcense Law for tho following reason ($ectlon 7031.5 Businass antl Protesslons Cotle: AnY �Ity or county which reQWrez a permlt to construcq altar, im rove, tlemolish or repair any s[ructure, prior to itz Issuance, alsa re- quPes Ibe aOG��= for suth permit to tile a ti9�etl statement Ihat he ii IlcenSeE pursuant to the provislons of (he Contrattor's Ucense l.aw (Chapter 9(commenting with Sectlon �000) of Dlvislon 3 of the Busineis antl F'deszions Cotle) or that he is exampt therefrom anC the ba•" 'br t�e alle9eA exemption. qny vlolation ol Settion 7031.5 by a� plitdnt fo� a p¢�mit sub�ect5 th¢ applicdnt to a civil penalty m more lhan, five hunEretl tlollars (g500�. ❑ i, a5 Owner of t�e property, or my employees wltn wages as their sole COmpenSdtion, will tlo tna work, antl the st�uCturC is not in[entle0 or ofteretl lor sale. (Sectlon ]044, BuSiness antl Protesslons Cotle: The Contra�tor's License Law tloes noi apply to an owner ol a proper[y wno builtls or Imp�Ov¢5 [he�eon, antl who tlOes SUCh wotk himsel� o� t��ough hi5 Own employees, provi0etl that such Improvemfnts are no[ IntentleC or otferetl tor sale. Ii, however, [ne builtlin9 or improvement iz zoltl within one year ot compleNon, the owner wlll hava the bura¢n of prp��pg he tlitl not builtl or imProve for thc PurpOse of Sal¢). ❑ I, as owncr of Ute property, am eXtlusively mnVetting wi[h Ilcensetl contractors to consVuct the project (Section 7044, Businezs antl P101t55I003 COtla: T119 COntfdCtOr's LIc8nS0 Ldvv tloei Oot dpPly to an owher ol'prOpe/ty wh0 bUiltlS o� imprOvez thereon, dntl who COn- traCls flom Such projlCti with a contracto!(5) IIc8500tl puf5udnt [O the Contractor's Licenso Law�. ❑ I afn Gxampt untlBr SC<tlOn B. & P. C. fOr Ihii reason Dato Owner I nerBby certify tnal 1 hdve r0atl tni5 dpplicatlon a�tl stale lhdt the above inforrqation is wrrecL I agree to comply with all Uty antl counly ortlinances antl state law r9� tlng [o construction, antl nereby authorize repr¢zpntdtives of t I FiJy l Bn1Gr Upan thC above mention¢tl p�Opa�ry 1�(� ry�pur Q,�'7 Q% Sl9na[ure �l((f �r � Da[e,� Drivers' License or 55 �_ CMFb865-46 W�ite-BUIltling; TVPE OF PERMIT ❑ GRAOING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PLVMBING ❑MECHAI ❑ OTHEF VROJECT DESCRIPTION' . S�. FT. OCCUPANCV{�_CONSTRUCTION TYPE VALVATION`�'j�a� ZONE GRADING CU. VOS. ACRES PLUMBING PLAN CIIECK BATHTUBS SHOWERS TOILETS URINALS � LAVATOftIES DOUBLElAVS KIT.SINKS DISHWASHERS SE0.VICESINKS SUMPS � FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS � SWIMMING POOL PTRAP WATERSERVICE ALTERHTION GASSERVICE OVTLETS � WATER HEATERS BTU OUTPUT SOLAR TANK COLI_ECTORS � ' SOLAR PIPING SVS. � ISSV E FEE MECHANICAL PLAN CHECK h1EATING SVSTEM 0-100,000 BTU AND DUCTING 100,000 + BTU REFRIGERFTION 0-300,000 BTU SYSTEM �00,000 * BTU BO�LERS BTU 5�'STEM REPAIR, ALTERATION E%HAUSTSVSTEM MULTIPLE ISSUE FEE ; Ponk-Atcoun[ing; Goltlenrotl-Assessor A.P. � ZONE REAR VARD (TO i PKG. SPACE RE�. STREET WIDTH SPECIAL ELECTRICAL 3002 B/07/81 IING REGULA710NS � f PLNTGp. RUEFL. $�ry PROPE�RTV LIN PROVIDED PARK FEE PLAN'CHECK ��^ 0-1Kw_1-lOKW_ TRANSFORMER qPPLIANCE 10-50 KW_50 a KW _ MOTORS 0�1 HP_1-10 HP _ (INC. SOIAR) 10•SO HP 50 + HP _ FIXTURES OVTLETS SWITCNES GAS TUBE SIGNS ' ' ' ' POLE LIGHTS ' POLES METERED SUB PANELS MAIN SUB $ERVICE ' qMP ISSUE FEE FFFLICATION DATE 31a37 T6 SUMMARV OF FEES BUILDING PERMIT b �7'S� SMIP 5 ' $ PLANCNECK 5 ��' 3 PERMIT PLVMBING § a •a�y �SSUANCE S GRADING E PLAN CMEGK E � ELEC7RICAL S E PLAN CHECK S MICROFILM y MECHANICAL S TOTAL FEE y PLAN CHECK E _ LE55 AD- VANCEPC S_ FINALFEE § 31.37 CONSTRUCTION AND PLANNING POOL & SPA . , _� �; APPROVALS Permit# Date Inspecto� qppROVALS -. Permit# � Date Inspector 1. Temporary Electrical Service or Poie - 43. Pool & Equipment �ocation i ipe-Un rgrn - 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgr� � 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce � 47. Rough Plumbin & Pressure Test 6. Electrical UF�R Grn 46. APPROVAL TO COVER-GUNITE 7. ootings 49. Electrical Conduit-Undr rn 8. Foundation � 50. Gas Pipe, ❑ Undr rn, Test 9. . Water Pipe-Undrgrn 51. Backwash Lines P- ra ❑ ndr rn 10. Structural Floor System � 52. APPROVALTO DECK • � �11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final � 12. Street Sewer Connection � - �� 54. Heater & Vent-Pinal 13. Rough Plumbing 14. Rough Electric-Conduit � � �56. Electrical-Final 15. RoughElectric-Wirin �� - 57. SolarSYstem-Final • 16. Rough Heating &� Air Conditioning • encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough &Test - 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathin 22. Frameand Flashin NOTES: 23. Insulation - 24. Lathin & Siding 25. Drywall Nailing 26. Plaster Brown �oat � 27. Electrical Power Meter-Final � 28. Final Electric � 29. Final Heating & Air Conditioning 30. Final Gas Pipe•Test 31. Final Plumbing � 32. Water Service-Final - 33. Gas Service-Final 34. Solar pomestic-Final 35. �Landsca eS rinklin S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison ' 41. Gas Release to Southem Califomia Gas Co. 42. CERTIFICA7E OF OCCUPANCV ' No Date ApPlieant lo fill in all C!TY OF COSTA MESA PERMIT NC CONSTRUCTION PERMIT �j,s, Addres Address (�,OntfBCtol wi(�in neavy bor0er Iines anE sign all approD��ate aeclarotian / TRACT NO. LOT NO. � BLDG. NO. ST TVPE OF CONSTRUCTION PhOnB . � ❑ NEW ❑ ADD ❑ ALTERpA�TION ❑ REPAIR ❑ CONVERSION p�DEMOL15H LiC¢n5¢ NO. ❑ OTNER DESCRIP710N OF WORK OL IS 1 hereby affirm that I am IlcanseE unEer provl5ions of Charter 9(com- mendn9 with sectlon 7000) ot Dlvlsion 3 of lhe Bu5ina55 antl Profeislons COCe, anG my Iltensa is In (ull torte antl affect. ucense Ciass '2' nse e�c+ 2Z.r oate A` 7 $ � Signature WORKERS• COMPENSATION DECIARATION .1 horeby aftirm thal 1 have a tertifiwte ot <onsent to s Ibinsure or a COrtlflwte o1 WorkGrS' ComcpenSatiOn InSurance, or a Certifietl cOpy tnereot(se�G07/'C�b�/.). .QI�i� G�`G� r � NO. Company � rti({¢d topy is hereby furnishetl. . �.,ertif�etl copy I5 filatl wtth the city BUlltltn9 �iviston. EMPT�ON FROM WORKERS' COMPENSATION DECLARATION (Thls section neetl not be comple[etl if the permit I5 tor one hunOretl caioo> or ies:�. � � 1 certify that In the performante ot Ihe work tor which this permit is 155uetl, I shall not amPloy any person In any manner so as to become sub�ecl t0 the Workers CompensaUon Laws of Glilornla. Data $I9naturG NOTICEi If atte� makirlg th15 tl¢Cldratlon, you Shoultl becom¢ subject to the Worker5' COmpensation prOvi5ion5 0/ the Labor COtle, you mu5t fOrthwlth <OTply wlth Such proviSlOns or IhiS p<rTit shall b¢ tl!¢metl revoketl. . - CONSTqUGTION LENDING AGENCV I hereby aftirm that there Is a construction lantling agency tor the pur- formant4 of [h0 work for whiG� this permit is issu@tl (S¢CtlOn 3097 Civ. C.1. ' - Lentler's Name LenEer's qtltlress OWNER BUILDE0. DECLARATION - I hereby affirm that I am exempt irom tne Contractor's Lltense Law lo� [ha followin9 roason (Sectlon ]031.5 gusiness antl Protesslons Cotln: Any City or COuntY whith requirei d plrmlt t0 COnstruct, alter, improve, Gamolish or repair any ztructura, prior to its Issuance, also ra- qWtes the a0011cant 10� SUCh pCrmit to tile a signetl Stalement lhdt h0 Business antl Prdezslons Gotla) or that be is exempt theretrom antl the b' 1or the allegetl exemptlon. Any violation of Sectlon 7031.5 by t DPtlwnt for a permit SUE�octs tne aDP�� to a dvil ponalty o c more than tive huntlretl tlollar5 (5500). ❑ I, as p�yner ol lne property, or my employeet with wa9es as thalr Sole Compen5d[Ion, will tlo tM1e work, an� the StruCtwO i5 not IntCnd¢U or olieretl for sala. (Section 7044, Busina55 antl Aotesilons Cotle: The COntfactor's Llce0s8 Ldw tlo¢5 n0[ applY to an owpef O( a pfoper{y who builtls o� Imp/oves therBOn, antl wh0 tloe5 Suth wo�k himsell O/ tnrOugh hi5 own nmplOy¢es, provitl¢tl Ihdt su<h improvem¢nts are not Int¢ntletl or oHetetl fOr sale. If, hOwevN�, thG bulltling or ImO�ov¢T¢nl Iz soltl wi[hin on0 year ot COTPIelIoO, the owr18/ will hava th¢ bu�tlen oi prOving he tlitl nOt builtl ar iTp�ove ror lbe purpose o1 Sd10). ❑ I, as owner ol tha Oroperty, am uxclusively conVaclin9 with Ilcensatl conVactors to construct lhe prolect ($ection ]044, Buslness antl Protessions Cotle: The Contractor'S Licenx Law tloes not apply to an Owne� of p/operty who builtls o� Improve5 Iha�eOn, antl who con- bdtts tfOrtl such pfoject5 with a conlractor�5) IIC04n8tl pursuant to lhe Cantractor's Llcense Law). ❑ I am ¢xempt untler Sectlon B. & P. C. �or thiz reason Dato Owner ! hereby �ertifY that 1 have reatl this application anG state that tne aboye informd[ion is Cortect. I agree t0 comply with all City antl munty ortllnan i s antl state��Yting ro co05truction, antl hereby authorize rOpresen atives of t c tonepter upon lhe dbov¢ mentlonetl Slgnature Date ra � Drivers' License or 55 # � ` CMF 0865-46 Wnite-Bu'iltlin9; Canary-AppNrant: Pink-Ac< TVPE OF PERMI7 ❑ GFADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL ❑PWMBING ❑MECHN ❑ OTHER PROJECT DESCRIP710N SQ. F7. . OCCUPANCV_CONSTRUCTION TVPE VAWATION �n�� ZONE GRA�ING CV. YDS. ACRES PLUM6ING BATHTU95 LAVATORIES KIT. SINKS � SE0.VICE SINKS PLAN CHECK SHOWERS URINAL$ DOUBLE LAVS DISHWASHERS SUMPS � ' FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS INTERCEPTORS CLARIFIERS SWIMMING POOL �P TRAP - ' WATER SGRVICE ALTERATION GASSERVICE WATER HEATERS SEW ER CONNECTIONS SOLARTANK SOLAq PIPING SVS. ISSVE FEE MECHANICAL 8TU COLLECTORS. CHECK HEATING SVSTEM 0-]00,000 BTU_ AND DUCTING 100,000 + gTU _ REFRIGERATION 0-300,000 BTU_ $YSTEM 300,000 t BTV _ BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAVSTSYSTEM MULTIPLE ISSU� FEE Goltlenrotl-Assessor A.P. $ ZONE PKG.SPACE REp. STREET WIDTH 3003. 8/07/81 20NING REGULATIONS " � �— f � PLNTGp. 8R�E1F�. p��y PqpPE�RTY LINI P/L) PROVIDED PARK FEE SPECIAL CONDITIONS: ELECTRICAL G MOTORS ,(IN0. SOLAR) PLAN CHECK � 0-1 KW_ 1-30 KW _ 30-50 KW_50 + KW _ 0-I HP�1-30 HP _ 30-50 HP 50 + HP _ FIXTVRES OUTLETS SWITCHES GAS TUBE SIGNS - POLE UGHTS ' ' PANELS MAIN SVB SERVICE' qMP ISSUE FEE 'LICATION HPPROVED 8V 31a37 TL SUMMARV OF FEES . BVILDING PERMIT E ��J��•S�O SMIP S •� PLANCHECK E1.Z� PERMIT PIVMBING 5� �SSUANCE b PLANCHECK S GRADING S EIECTRICAL S b PIANCHECK g MICROFILM S MECHANICAI S TOTAL FEE $ PIAN CHECK E LE55 AO- � VANCEPC S_ FINAL FEE S 3/. 3 7 CONSTRUCTION AND PLANNING • FOOL & SPA . _ • � �' �` Date Inspector - Date Inspector APPROVALS Permit # �APPROVALS � Permit # 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location Soil ipe-Undrgm . 44. Steel Reinforcement - 3. lectrical Conduit Utility-Undrgm - . 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce • 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 6. Foundation -� 50.. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51.� Backwash Lines P•Tra ❑ ndr rn � 10. Structural Floor_System 52. APPROVALTO DECK . 11t Property Sewer.Line & House Connection 53. Backwash & Rece tor-Finab � 12. Street Sewer Connection ' 54. Heater & Vent-Final � 13. Rough Plumbing - � � 14. Rough Electrio-Conduit - �56. Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final 16. Rough Heating & Air Conditioning • encing & Access Approval 17. Ducts' in Structure APPROVEO FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL � 20. Roof Freming 21. Roof Sheathin 22. Frame and Flashin NOTES: 23. Insulation 24.- Lathing & Siding 25. Drywall Nailing - 26. Plaster Brown Coat ' 27. Electrical Power Meter-Final � 28. Final Electric 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final 33. Gas Service-Final 34. Solar pomesticFinal � 35. Landsca e S rinklin S stem • 36. Sound Attenuation 37. Handicap Regulations 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. . 42. CERTIFICATE OF OCCUPANCY � No Date