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Home My WebLink About252 19TH ST - Building Permits Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. /1.14d 12" ".Jr u 03yG 6 Q °R70I 2.67 I 0 00 f?- c 61 P MIT O. TRACT O. LOT NO. UNIT NO. ) "ll CITY OF COSTA MESA CoN TRUCTIO ERMIT _. A,P,# 4.24) -,:ag/ —/9 Zone ,e, Project Address toi'-CZ: S Main Building: Accessory Building: J /� �rft// YPE OF CONSTRUCTION U NEW ' ADD ALTERATION U R P R Applicant's Mailing Address ��.�n/ ?� �f/�,/.1.7- •/ 9 ..-�- 'fel" 9y7/- III CONVERSION El ❑ OTHER /XJ ��J ..f T Front. � a Owner's Nae £P/G / ,//t Phone/Ltt q- / u / A 3 3 /Q_/i N �yGQ DESCRIPTION OF WOR /USE OF BLDG. �� ./ .Fe l[CY�.ceS B Rear �J Address Cage/ �/2✓//✓� 927/41 4r..4 /d' ,z a g 5 / . cit. TVPE OF PERMIT N GRADINe I■ FOUNDATION STRUCTURAL C Right N Arch/E m-' License No. K G Address• _ 1.11 TENANT El ELECTRICAL El PLUMBING ❑ MECHANICAL s - Left R /�. .Y€.L� ❑ OTHER 6JC Z@.a. ./u 6- LGL a, Ping. Ref. # � -(p(p Parking Req./Provided Z$ E Contractor's Name_ C�//.�✓S� �c...,2"•W Phone-7/y-n« 7 Address(mailing) S/fi'�/' PROJECT DESCRIPTION SQ. FT- OCCUPANCY :3_ /st s �j� .� ea O �/ • CONSTRUCTION TYPE �T� VALUATION $ ./97 a Planning Notes:v/�'3� .� ,F/� t^�p�-cK-C.OY1 �iLY M City License No. (Jr .076� ZONE GRADING CU.YDS ACRES J ' 0 /ee • Dst. � &Y. t�es,o wee- S.T LICENSED CONTRACTOR DECLARATION PQ✓J.rC �..i.m�6 !S N�-r /� �• z �iLs• I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: %7l• y4J ` „;,z7; f�L - *,:s•-- • /�f etue 4/ /^• with section 7000) of Division 3 of the Business and Professions Code, and i' my license is in fu rce a d effect. _ 1. ELECTRICAL FEES ,� License CI s Lice se N ••- 700.E .lei 6: �/ Date /0 el, 1/ Signature .' 9 ...1 V PLUMBING I FEESAutomaticTransformer 0 15-50 KW , WORK ERS'LO MPENSATION DECLARATION Bar Sink Showers • • ❑ 50+ KW 1 hereby affirm that I have a certificate of consent to self-insure or a certificate 'Starkers' Compensation Insurance, or a certified copy thereof (Section - Cooking Unit •. . Meter ❑up to 100 amps ■ ), Lab- C.) ;- •_ckflow Preventer - Service Sink - /n1�9�6 �d�,cG -- _. ® . Dover ,-'4W No. Company Backf • rrigation` Sewer Cap _ Certified copy is hereby furnished.: _ • ■ ■ _ Certified opy flied with the city BuiJGzri9_Divisi _ / ( j " - Bathtubs - Sewer Connection Date / o/ Applicant �/� I' G�J•r - - EXEMPT ON ROM WORKERS'COMPENSATION DECLARATION - Clarifiers r Solar Collector3 _ . s (This section need not be completed if the permit is for one hundred($100) or Motors• ■• ■ - less). - , _ Dishwasher _ Solar Piping - , I certify that in the performance of.the work for which this permit is issued;"I' - .. II. shall shall not employ,-any,person in any-manner so as to become subject to the Drinking Fountains- olar- - - - Micro ."e Workers' Compensation Laws of California. - + Device' ,� Date a Signature ' - - Floor Drains - ri '-tiny Pool w/Spa • ight NOTICE: If,aftei,making this declaration, you should become subject to the' • Outlets Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. - I I CONSTRUCTION LENDING AGENCY Gas Service 3 Outl- Water Closet -- Switches Sign I hereby affirm that there is a construction lending agency for the performance of the work for wnicn/�tpi5 permit Is issued (Section 3097 Civ. C,) Interceptors Water Heater - Garbage It:::!!1' Standing Sections I Lender's Name /l' Li/L - Lender's Address Kitchen Sink Water Service • ' Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION - I hereby affirm that I am exempt from the Contractor's License Law for the Lavator. Auto-Washt following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P- ap Laundry Trays any structure, prior to its Issuance, also requires the applicant for such permit , to file a signed statement that he/she Is licensed pursuant to the provisions of Roof Drains the Contractor's License Law(Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $ 3 'fj.{efrom and the basis for the alleged exemption. Any violation of Section ::%i";L.S by any applicant for a permit subjects the applicant to a civil k'�'ie:;;,,?;illy of not more than five hundred dollars ($500). $ 3 DEVELOPMENT SERVICES REQUIREMENT• sS / co I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee Zoning Approved By -r Cr Dates�,`` JL � compensation, will do the work,and the structure is not intended or offered �`+ 9 for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL IL. FEES . 'Building Approved By , Date erese Law does not apply to owner if a property or who builds s or improves _ thereon, and who does such work himself/herself or through his or her own 'Application Issued By {rs ' Dat employees, provided that such improvements are not intended or offered for Boiler Hood or Type I 0 • 'R sale. If, however, the building or Improvement is sold within one year of com- Canopy Type II 0 - SUMMARY OF FEE prove , the owner will have the burden of proving he/she did not build or im- Duct-Under Ground f ss I prove for the purpose of sale). BUILDING PERMIT $ `1 0 Z — SMIP $ ZS -- ❑ I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System 1p LAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating -• 100,000 BTU 0100,000 BTU • "• PLUMBING $ ISSUANCE $ builds or improves thereon,and who contracts for such oroiects with a con- - tractor(s1 license pursuantrk 'sto the a License be aware that III Exhaust System 0 Multiple ' System Repair/Alteration PLAN CHECK 25% $ ENERGY P.C. $ proof o their Worker's Compensation insurance should be provided to me. -ELECTRICAL $ GRADING $ ❑ 1 am exempt under Section B.& P.C.for this reason . Firepl/Fact.Bit. ICBG*a. a •. MICROFILM $ • PLAN CHECK 50% $ Date owner Heating System& Ducting MECHANICAL $ �7�2 !/ • .7 I hereby certify that I have read this application and state that the above ❑0-100,000 BTU ❑100,000 ST TOTAL FEE $ ( information is correct. I agree to comply with all city and county ordinances PLAN CHECK 25% $ and state laws relating to building-construction, and hereby authorize repre- sentatives of this city to to upq he above-Mentioned property f Inspection purp99aaaass /��n >/ y Signature .�/1�.�K ` ¢ Date z // Drivers' License or SS 9s '/22; Fee $15 0t 60044665-00.04/. 7 :07 ,1.• DATE: 16/11/44 TRE 11+ ; I) 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor - CONSTRUCTION AND PLANNING ..' - POOI 'PA APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector F' r .. 1. Temporar9Tlectrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. ' / , I_CQ 53. Steel Reinforcement : r 3, Electrical Conduit Utility-Undrgfnd. ad, 4 54. Forms 4. Electrical Conduit-Undrgrnd. _ 55. Electrical Bonding 5., Steel-Reinforcement . •, . // 56. Rough Plumbing & Pressure Test . .I 6. Electti/.ical UFER Grnd' -. ', r / 57. APPROVAL TO COVER-GUNITE • ( i ,., 7. Footings - 4,r qit «l 58. Electrical Conduit-Undrgrnd. 1 8.' Foundation r 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. 61.2610 L. •D 60. Backwash Lines,P-Trap, ❑ Undrgrnd. 10. Structural Floor System ., 61. APPROVAL TO DECK 11. Property Sewer Line & House Connection 'r • 62. Backwash & Receptor-Final • 12. Sewer Capp 63. Heater & Vent-Final ''* 13: Roof Drains i 64. Plumbing System - Final • 14. Rough Plumbing' (2-t7-`� LEd 65. Electrical-Final 15. Rough Electrical-Conduit - 66. Solar.System-F inal X1'6. Rough Electric Wiring , L_ '3. 9 be L4 67. Fencing & Access Approval • 17. Rough Wiring Sign v 68. APPROVED FOR PLASTERING �r 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL '19'. Rough Heating & Air Conditioning (2r27-4e Len r FIRE DEPT. REQUIREMENT . '-20. Rough Factory'Fireplace 2-2)-20 `co APPROVALS Permit# . 21. Ducts, in Structure * 70. Underground Hydro• 22. Ducts, Ventilating 14 71. Product Piping 0 Gas 0 Oil i 23. Gas Pipe;Rough &Fest , , -r- _ - 72. Underground Flush 1'24. Roof Flaming UV 73. Undergrnd.Storage Tank 0 Gas 0 Oil ,' 25.-Roof Sheathingr- - '.'i X00? 74. Overhead Hydro ' 26. T-Bar Ceiling (Structural) 8i Monocoat !. 75. Dry Chemical 27.-Frarneand Flashing .2_'0 / rr , 6. Dry Standpipe 28,lethal.&YSiding - %' `// z/70 77. FIXED SYSTEM FINAL 29. Insulation ' 1-10-70 cf,sct( 78: FIRE PREY. FINAL 30. Drywall Nailing ' ;. * /-)9.2-10 c p HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 'I 79. FINAL INSPECTION 32. Electrical Power Meter-Final' /17117.-10/ R Oat! 80. FOOD CERTIFICATE ISSUED . 33. Final Electric y-� 0 R. R�/� Notes: /t, PL. si..... a/o !/ a.- /21-ft-et/ye 34. Final Heating & Air Conditioning u�_7m L FC 151, „ )8r OK `e � Si: /�-N• /`' 35. Final Gas Pipe-Test l_ -tie cep ( --'''S'q7 -CCr�. - tii5 40-1 N.1./� V/Ef' 36. Hood or Canopy V-' '90 - . �j) to Or ':37. Final Factory Fireplace yam* 1-Em Y $8. Final'Plumbing'- ' , K_g-7o LEp .39. Water Service-Final,, , r 40. Gas Service-Final / V Yy :41. Solar Domestic-Final '...iir r •--) 42. Backflow Preventer' -, / i> t - 43. Backflow Irrigation - ,i .-, 'l ti? 44. Landscape Irrigation System , : " o .. I , ' 45. Sound Attenuation, h' / 71M 46. Handicap Regulationsl; _, 47. FINAL STRUCTURE& BUILDING *pip 614- 1. 48. Special Requirements Cornpleted , 49. Electric Release to Edis`on'l p ,r. -50.,.Gas Release to Southern California Gas Co - - '0 ' n f. 51. CERTIFICATEOF'OCCUPANCY - r, - `% r No. Dates fir . PROJECT ADDRESS: 252 E 19TH ST UNIT: ' CITY OF COSTA: MESA —. BUILDING PERMIT PERM NO: P 044633 4 OWNER'S NAME: ERIC TYLER • ADDRESS: 252 E. 19TH • PERMIT NO: P 044633 PLAN ,CHECK NO: N GOUT: N SUPP: N • . • CONSTRUCTION TYPE: PERMIT TYPE: PLU • :PURPOSE : ALT . ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION : PLUMBING ' SQ FT: . ADDRESS: . UNIT: ' CLAIM VALUE: CALC—VALUE: GROUP OCC: / PERMITTEE: COL MAR PLBG ( 714 ) 548-9125 ADDRESS: 376 SUNRISE CL . COMMENTS: 13 Lt0 *SS - .- • C .M. CA 92627 ******************* *****N******** ***ieit***itu•st+eitot*et*******atm*aeat IE ***srx***x+c*3E LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section - Z ON ING R E Q U I R E M E N T S, 2 . 7000)of Division 3 of the Business and Professions Code,and my license is in lull force and effect. SETBACKS • CITY tic.:044483 STATE uc.:N/A '2 cissa: �G�L4 r Date: /D 'o't 8� /signature: //.G � �•• FR MAIN BUILDING • ACCESSORY BUILDING WORKERS'COMPENSATION DECLANIITIO I hereby affirm that I have a certificate of consent to sell-insure or a certificate of Workers' FAIT; FT I N R EAR: F T I N 'FAIT: FT I N REAR: `FT I N Compensation Insurance.or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT; FT IN RGHT: FT IN POLICY NO.: • EXP.DATE: • • COMPANY: PARKING REQUIRED: PARKING PROVIDED : PARCEL: 42628119 ZONE: , ❑ Certified copy is hereby furnished. 0 Certified copy is filed with the city Building Division. PLANNING NOTES> ' Date: • Applicant: • ************************************it***it**********it*************************** • EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (Ra secfioh q • heed lot be completed the perm)is for one hundred(3100)or less). 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 , I certify that in the performance of the work for which this permit is issued.[shall not employ any person in manner so as to become - • subject to the Workers'Compensation La f California. ZONING APPROVED BY • ,. .DATE: Date: /p —?' —S1 (Signature: ,e7--.1Z ,C? -veeeS/ I NOTICE:If.after making this declaration,you should become subject to the Workers'Compensation provisions of the Labor BUILDING APPROVED BY : .4 DATE: N Code,you must forthwith comply with such provisions or this permit shall be deemed revoked.. .• • t ' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a censtruction lending agency for the performance of the work for APPLICATION =ISSUED B Y: • '' DATE: l D 23 which this permit is issued(Section 3097,Civ.C). *******************************************3*******,************************* ** L LENDER: *********************************it********************************************* ADDRESS: - - ' LEGALIZATION:N 'F .E E — S ' U M M A R . Y STRUCTURAL SEGMENT:N • x • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC , MECHANIC FIRE SMIP/RES • GRADING ' (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT2 2 . 00 i repair any structure,prior to its Issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed 2 5$ SMIP/NON—RES • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN ' • and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031:5 by '• any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 3 . 06 I, • as owner of the property or my em loyees with wages as their sole.compensation, wit do the work, and the BUILDING—DIV—> PERMIT ISSUE . PLAN2.CHECK TOTAL PAID DUE ❑ tructure Is not Intended w offered for sale(tectiai 7044.Business and Professional Code: The Contractors State License Law TOTALS————> 22 . 00 3 . 00 0 . 00 25 . 00 25 . 00 . 00 • does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through . p .-4 hisor her o�sold�mhn pmvidedtne year hacomcsuch Ip,00vveentsrare e11 not ihave theded or offered for of salestedweerid not tie or building REVENUE DIVISION TOTALS--> COLLECTED: 25 . 00' OVER/SHORT: 00 for the purpose of sale). . BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT 'GRADING PLAN—CHECK • 1,as owner of the properly,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 25 . 00 ' ❑ and Profession Code: The Contractors'State License Law does not apply to an owner of properly who builds or improves Merman Ir ' and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State license Law).l am aware ************************** 'N' *********** ***************************************** That proal of tires:Worker's Compensation.Insurance should be provided t0 me. i . IND IV I D U A L; F'E E BR EAKDOWN .. ❑lam exempt under Section: B.8 P.C. . • �rmis reason: TYPE QTY• D E S C R I P T I , O�N UNIT COST TOTAL COST Date: Owner: PLU 2 BATHTUB 2 . 00 4 . 00 I do hefty certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533,and PLU 1 ' LAUNDRY •TUB OR WASHER 2 . 00 2 . 00 25534 and that I or any future building occupant will/will not(circle one)need to comply with said state codes and the requirements for a PLU 2 SHOWER • 2 . 00 4 . 00 permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from PLU 4 - WASH BASIN ' ' 2 . 00 4 . 00 • these provisions. PLU 2 WATER CLOSET (TOILET) -1. 2 . 00 4 . 00 . ' . - Date: Appruant: • END OF: ,FEES I hereby certify that I have read this application and state that the above Information is correct.I agree to comply with all city and county r ' ordinances and state laws relating to building constructionauthorize and hereby representatives of this city to enter upon the above-mentioned •. - . '! , r property for inspection purposes. / /�� ///J�� • •-f / Date: /t —93'$2 !Signature: 71%C�ed lec2dC —`.tea— 1. %t at ��.v`�.r'��J,r5 J ' • Driver's License or Social security x: . %- Wail f 1::23:>9 11.. ' (-I t 1641.46' White—BulWlno:Green—Code Enforcement:'Cenarv—Aoolicanq Pink—Revenue;Goldenrod—Assessor - - .. . . . _ ' CONSTRUCTION AND PLANNING POOL& SPA APPROVALS , Permit# Date Inspector APPROVALS Permit# lipDate Inspector •1, Temporary Electrical Service or Pole 52. Pool & Equipment Location • .2. Soil Pipe-Undrgrnd: - Jt/2469 CACP 53. Steel Reinforcement - 3/Electrical Conduit Utility-Undrgrnd. 54. Forms i 4!"Electrical Conduit-Undrgrnd. 55. Electrical Bonding _ 5.-Steel Reinforcement - • " 56. Rough Plumbing & Pressure Test _ 6.: Electrical LIFER Grnd- "j. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. F' 8. Foundation _ . 59. Gas Pipe,0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. dolt? (neo 60. Backwash Lines, P-Trap, 0 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 - I 64. Plumbing System - Final 14. Rough Plumbing I /a/L7/)� GOP 65. Electrical-Final - 15. Rough Electrical-Conduit 1 - 66. Solar System-Final 1 16. Rough Electric.Wiring .I 67. Fencing & Access Approval 17. Rough Wiring •Sign 68. APPROVED FO,R PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning2. _ . FIRE,DEPT.REQUIREMENT - . - _ 20. 'Rough Factory Fireplace -_:r..: - _• - - , t APPROVALS .- Permit # • - - 21: Ducts,in Structure' - - I. - ' I:70. Underground Hydro 22_•Ducts, Ventilating _ - - _ 71. Product'PTping 0 Gas OOil 23.Gas Pipe-Rough & Test - . . 72. Underground FlOsh - 24. Roof Framing Z. - • - •-• . 73. Undergrnd.Storage Tank-0 Gas 0 Oil 25.- Roof Sheathing. 741'Overhead Hydro' 26::.T-Bar Ceiling (Structural) & Monocoat . - 75. Dry Chemical - . - 27. Frame and Flashing ' T 76. Dry Standpipe - - - 28. Lathing& Siding 77: FIXED SYSTEM,FINAL- 29. Insulation ,_ 78. FIRE PREV. FINAL 30. Drywall'Nailing i „ • HEALTH DEPT. REQUIREMENT;. 31. Plaster Brown Coat • M -' . 79. FINAL INSPECTION 4 _ - 32. Electrical Power Meter-Final ., . 80. FOOD CERTIFICATE ISSUED a - 33..Final Electric Notes:, ,i sp itzt 7 2/Li-etwef •.'34-.Final Heating & Air Coriditioning � Y ns slat sit -. S 35._Final Gas Pipe-Test I� . 4FtO •' (f - ,', care Locte�f� p _ 36. Hood or Canopy r - - -.37rFinal Factory Fireplace- ' :38. Final Plumbing tf1/,3`4b L,ap '' .. - :' c c 39. Water Service-Final. 77_. ;40. Gas Service-Final " - • ; -41. Solarpomestic-Final" -: 42. Backflow Preventer - -- 43. Backflow Irrigation - '-" - - - 44. Landscape Irrigation System ' - , • _r 45.Sound,Attenuation _ - 46. Handicap Regulations '- - 47"FINAL STRUCTURE & BUILDING? i - - .- 48.-FINAL PLANNING - _ L.� . s , 49. Electric Release to Edison - - X••i. - / '50. Gas•Release to Southern California Gas Co - 1-• 1 • - 51. CERTIFICATE OF OCCUPANCY - - No. Date PROJECT ADDRESS: 252 E 19TH ST UNIT: - CITY OI' COSTA MESA — BUILDING PERMIT • PERM NO: M 045378 ' OWNER'S NAME:•ERIC TYLER .•ADORERS: SAME , PERMIT NO: M 045378 PLAN CHECK NO: N GOVT: N SUPP: N • CONSTRUCTION TYPE: • PERMIT TYPE: ,MEC • PURPOSE: NEW ARCH/ENGINEER: ' NEO.ND.: JOB DESCRIPTION : NEW HEATING SYSTEM • SQ FT: ADDRESS: UNIT: - , CLAIM- VALUE: CALC—VALUE: GROUP OCC : . / • PERMITTEE: NEWPORT AIRE SYSTEMS ( 714 ) 642-8575 ADDRESS: 1539 MONROVIA AV ' • G - COMMENTS : REFER TO 4940488 - N. B . CA 92663 ********EeyE*+rrEE****yE*********aE*********.e*******x** sara :***se*****>F **+TTI,+E*N***sr** * LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N .I N G REQUIREMENTS - 7000)of Division 3 of the Badness and Professions Code,and my license is in full force and effect SETBACKS • CITY LIG.:n„9904 1 STATE LJC.(044: C20 ' Date: / 2�I� f Signature: c' • MAID) BUILDING • FRNT: ACCESSORY BUILDING FRNT; FT IN REAR: FT IN FT IN REAR: FT' • IN WORIcERS'COMPENSATION DECLARATION: thereby affirm .t I have.certificate of consent to sell-insure or a certificate of Workers' r` Compensation Insurance or certified copy thereof(Section 3801).Lab.D) LEFT: FT IN• RGHT: FT IN LEFT: FT IN RGHT : FT IN . , PDUCYNo,: 113 /581-89 EXP.DATE: 07/01 /90 . COMPANY: STA'TEPARKING REQ: ' PRQV: PARCEL : 43927123 ZNE: REF NO: 1 Certified copy Is hereby furnished. Certified copy is filed with the city Building Divisi PLANNING NOTES> i l ZzCd Date: Applicant: ************* ********************iE*•.***4***************************** ******** EXEMPTION FROM VICKERS'COMPENSATIONDECARATrON: (This ta n need not be=peed Num permits far one hundred(sio0)orl . D E 'V E L O P M E N T S E R.-"V I .0 E S R E Q U I R E M E N T,S •I certify that in the performance of the work for which Mil permit is issued,I shall not employ any person m any manner so as to become - . subject to the workers'Compensation Laws of California. ZONING APPROVED BY '--+ • •DATE: , Date: Signature:-_ BUILDING APPROVED BY • -' r • NOTICE:If.atter making this declaration,you should become subject to the Workers'Compensation provisions of the Labor _ - I DATE:: • Code,you must forthwith comply with such provisions or this permit shall be deemed revoked. , r ' CONSTRUCTION LENDING AGENCY: I hereby affirm that there is a construction lending agency for the performance of the work for APPLICATION ISSUED BY: . I' - , DATE: Z' which this permit is issued(Section 3097,Civ.C). ********************** �� *********a(: —* ** LENDER: . ******************************************************************************* ADDRESS: • LEGALIZATION:N F E E " S' U M M A R .Y STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'Slate License Law for the fallowing reason • BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING . (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT ' 9,00 repair any structure.prior to Is issuance,also requires the applicant for such permit to file a signed statement that he/she Is licensed • '• • pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN AN . • 25* S M I P/NON—RES and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars(1500). ISSUE FEE . . , 15 . 00 I, as owner of the property or my employees with wages as their sole compensation, caul do the work, and the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID .DUE ❑ structures not Intended or offered for sale(Section 7044.Business and Professional Code: The Contractors'State License Law 'BUILDING —--—> 9 . 00 15 . 00 0 . 00 24 . 00 24 . 00 .00 does net apply to an owner of a properly who builds or Improves thereon,and who does such work ifmself/herseli or through • his or her own employees,provided that such Improvements are not intended or offered for sale.If.however the building or REVENUE DIVISION TOTALS-->- COLLECTED: 24 . 00 OVER/SHORT' , 00 improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SNIP/TOT GRADING PLAN—CHECK I,as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 2 4 . O O ' '❑ and Professions Code: The Contractors'State License Law does not apply to an owner of properly who builds or Improves thereon ' and who contracts ler Such projects with acontractor(s)license pursuant to the Contractors'State License Law).l am aware **************************************************************.I(-**************** that proof of their Worker's Compensation insurance should be provided to me. I N D I • V I D U A L F E E 13 R E A K D O W N ❑ I am exempt under Section: B.8 P.C. . for this reason: • TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST • Dat Owner MEC 1 INSTALL FORC/AIR FURN c= .100 K DTU/H ' 9 . 00 9 .00 ' I do hereby certify that I am aware of and understand the requirements of Catfomia Health and Safety Code Sections 25505,25533,and END OF FEES 25534 and that I or any future building occupant wilt/will not(circle one)need to comply with said state codes and the requirements for a • permit for construction or modification from the Air Quality Management District.Residential construction applications are exempt from these provisions. • . Date: Applicant: • I hereby certify that I have read this appication and state that the above information is correct.I agree to comply with all city and county -ordinancesppand in state on purpose to bsMmq and hereby �� fixes of t' to enter upon the above-mention . property for scection purposes. I • ,• • 9 a/--�• • Date: I �� / Signature: . • Driver's License or Social Security A: - ' 01 00049577-00049577 TOT 24.00 1641-48 White—Building;Green—Code Enforcement;Gamily—Applicant;Pink—Revenue;Goldenrod—Assessor DATE: 12/12/89 TIdE1 15:59 CONSTRUCTION AND PLANNING POOL _ SPA A• PPROVALS Permit# Date Inspector APPROVALS Permit # Date Inspector • '1. Temporary Electrical Service or Pole ` 52. Pool & Equipment Location - • 2. Soil Pipe-Undrgrnd. ' i 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 UF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings • 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, 0 Undrgrnd.,Test 9. Water Pipe-Undrgrnd. e , 60. Backwash Lines,P-Trap, 0 Undrgrnd. 10. Structural Floor System r / 61. APPROVAL TO DECK 11. Property Sewer Line & HouseConnection 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 22. Ducts, Ventilating ; - 71. Product Piping 0 Gas 0 Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing - • 73.•Undergrnd.Storage Tank 0 Gas 0 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 PREY. 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 V3/0 (•,�j� • - 35. Final Gas Pipe-Test �''ll • - 36. Hood or Canopy • • 37. Final Factory Fireplace 38. Final Plumbing _ - • 39. Water Service-Final 40. Gas Service-Final - - - • 41. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation -' 44. Landscape Irrigation System - 45. Sound Attenuation 46. Handicap Regulations 47: FINAL STRUCTURE & BUILDING .. - - 48. FINAL PLANNING . 49. Electric Release to Edison ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Date . 1 • PROJECT ADDRESS: 252 E 19TH ST , UNIT: 0 ' . CITY -OF COSTA MESA - BUILDING PERMIT ' PERM NO: E 044665 OWNER•s NAME: ERIC TYLER - - AODJIESS: 252 E 19TH ST , , PERMIT NO: E 0A4665 ' PLAN CHECK NO: • N . GOVT: N SUPP : N • COSTA MESA • CA • CONSTRUCTION TYPE: V--‘14 PERMIT TYPE: ELF. ':PURPOSE: ADD' ' ' 92627 j , •ARCH/ENI/LEER: - REGNO.: JOB DESCRIPTION : ADD TO EXISTING- ' • „ r SQ FT: ADDRESS: . UNR: x - . _ CLAIM VALUE: CALC VALUE: GROUP OCC:. .R--3 / ' • • •PERMITTEE: SUNRISE BUILDERS, INC. • ( 714 ) 474-0661 . . . - ' ADDRESs: 17801 MAIN ST. D COMMENTS: REFERENCE BLDG. PERMIT B40488 IRVINE CA 92714 .********eE****>EaF**>E********x*******+t**IF F* **se**eFIL tkxafar****its*x****x**** *.x**tFae>c* LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Section Z 0 N I N G R EQUIR E M E N T $ ' - • 7000)of Division 3 of the Business and Professions Code,and my license is in full force and effect. S E T B A C K S - . •cm uc.:0 4 8$6) STATE uc.:5 7 0 0 8 4 cuss: B Date: I/0h-� g9 signature: /�l� /�—/' MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSATION DECLARA71ON: Ihereb affirm that have a certificate of consent to self-insure or a certificate of Workers' FRNT: FT IN REAR: FT IN FRNT: FT • IN REAR: • FT IN 1 Compensation Insurance,or a certified copy thereof(Section 3800,Lab.C). LEFT: FT IN RGHT: FT IN LEFT: :FT IN RGHT: FT : IN POucYN0.: 1066946-89 Ewan: 04 /01 /90 COMPANY: STATE FUND PARKING REQUIRED : PARKING PROVIDED: PARCEL: 42628119 ZONE: ' r •• ❑ Certified copy is hereby furnished. ® Certified copy is filed with the city Building 0''' n. / PLANNING NOTES> i • ' >,--faE > Date: /d 7., �'� Applicant: t .._� ******************************* *aF******************************aE************** EXEMPTION FROM WORKERS'COMPEN TION DECLARATION: (This section need not be completed if the permit is for one hundred(5100)or less). • D E V EL O P M E N 'T S.-.E,-R V' I C E S R :E Q U I f R E M E N, T S I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become . '.• subject to the Workers'Compensation Laws of California. - ZONING APPROVED BY - DATE: Date: youSignatureshul BUILDING APPROVED BY DATE: NOTICE:If,after making this with on, should become subject to the Workers'Compensation provisions 011ie Labor , Code,you must forthwith complywith such provisions or this permit shall be deemed revoked. x CONSTRUCTION LENDING AGENCY: I hereby affirm that there Is a construction lending agency for the performance of the work for APPLICATION ISSUED D Y: ' ':a4414,124,411112!6, o,' - - DATE: 4. Z- �' • which this permit is issued(Section 3097,Civ.C). **************************• - ********** � LENDER: ' *******************************'**W************ . ******************************* . ADDRESS: • - LEGALIZATION:N - ' F E E S- 1.19,1 M A R -Y STRUCTURAL' -SEGMENT :N • OWNER BUILDER DECLARATION: I hereby affirm that l am exempt from the Contractors'State License Law for the following reason. BLDG PMT PLUMBING ELECTRIC 'MECHANIC , FIRE' SMIP/RES GRADING ' (Section 7031.5 Business and Professional Code:-My city of county which requires a permit to construct,alter,improve,demolish,or PERMIT . - . 98„25 repair any structure,prior to its issuance,also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencingwith Section 7000)of Division 3 of the Business _licensed /-•5 0-t • 1 SMIP/NON-RES , 'and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.My violation of Section 7031.5 by PLAN • -, ' ' , - any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500): ISSUE FEE . :415 . 00 I. as owner of the property or my employees with wages as.their sole compensation, will do the work, and the BUILDING-DIV-> •PERMIT' ISSUE " PLAN-CHECK TOTAL PAID • DUE ' ❑ structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTALS----> 98 . 25 45 . 00 ' 0 . 00 113 . 25 '1 1 3 . 2 5 . . 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through ; his or her own employees.provided that such improvements are not intended or offered for sale.If.however the building or REVENUE 'DIVISION TOTALS--> COLLECTED: 113 . 25 OVER/ HORT• OO • improvement is sold within one year of completion,the owner will have the burden of proving he/she did not build or improve ; CONSTRUCTION AND PLANNING POOL & SPA 'APPROVALS . Permit# rDate . Inspector APPROVALS Permit# Date Inspector 1.'Temporary Electrical Service or Pole t r 52. Pool & Equipment Location /. , 2. ,Soil Pipe•Undrgrnd.- "•, • - - 53: Steel Reinforcement .J • • 3::Electrical Conduit Utility-Undrgrnd: 54. Forms ' 4. Electrical Conduit-Undrgrnd. I 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electrical UF ER Grnd. 57. APPROVAL TO COVER-GUNITE - • 7: Footings -. - 58. Electrical Conduit-Undrgrnd. i - - 8. Foundation • r 59. Gas Pipe, 0 Undrgrnd., Test f/ 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, ❑ Undrgrnd. :� l 10. Structural Floe?System `E. - , 61. APPROVAL TO DECK . 11. Property Sewer•Line & House Connection If 62. Backwash & Receptor-Final 12. Sewer Cap - - / -� 63. Heater & Vent-Final 13. Roof Drains _ _ '' 64. Plumbing System - Final A / 14. Rough Plumbing • 4 . . 65. Electrical-Final 15. Rough Electrical-Conduit 7. 6.'6.'Solar System-Final I 16. Rough Electric.Wiring I 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 • , y FIRE DEPT. REQUIREMENT - .20. Rough Factory Fireplace - - _ - • APPROVALS _ -*Permit# 21. Ducts,in Structure - - • ,70. Underground Hydro - 22. Duets, Ventilating • . - - - . . 71 . Product Piping O Gas 0 Oil 23. Gas Pipe-Rough &Test - -", * "72. Underground Flush "' 24', Roof Framing - - "73.•Undergrnil.Storage Tank'O Gas 0 Oil • 25. Roof Sheathing - 74. Overhead Hydro 26._T-ger Ceiling (Structural) &"Monocoet ‘ • • _ - - 75r,Dry Chemical c - 27: Frame and Flashing - - - - 76. Dry Standpipe _ _ - 28. Lathing & Siding ` " , , : 77,• FIXED SYSTEM•FINAL --, 29. Insulation - ' 78.- FIRE PREV. FINAL - 30. Drywall_Nailing 7 . , • HEALTH DEPT.'REQUIREMENT- '31. Plaster Brown Coat"- ^ -' �'��T.. 79. FINAL INSPECTION - i -' .:32..Electrical Power Meter Final u/i Set `- '80. FOOD CERTIFICATE ISSUED_ 33.• Final Electric -- • 7////�` r i�a • Notes: ' ��y'�� ' Pato/V ,J- 34. Final Heating&'Air Conditioning ' r /a 35.'Final Gas Pipe-Test. • • (' - -. --36. Hood or Canopy - ' '• 1�:�; • _• 37. Final Factory Fireplace 1. ' r l -, .138. Final Plumbing _ "L' _ _ 39. Water Service-Final �- : !i�� i •-- • - •'40. Gas Service-Final - - ' ` ` _ .. ' 41. Solar Domestic-Final-- • i - - w 42. Backflow Preventer' i' - - 43. Backflow Irrigation . c.. ,‘ '44. Landscape ITrigation System tr... -, 45. Sound Attenuation • - -, - I'a - - - 46. Handicap Regulations _ • - - - 47. FINAL STRUCTURE & BUILDING - ,,a -- - r 48. FINAL PLANNING _ - 't',• + ` . 49. Electric Release to Edison 'v-` • 50:-Gas Release to Southern California Gas Co _•; ' 51. CERTIFICATE OF OCCUPANCY ' - No. Date ' • Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations. . PERMIT NO. TRACT NO. LOT NO. UNIT NO. CIT,OF COSTA MESA CONSTR CTION PER ITA.P.# • I zone ZS7 F_.ASIA< -St o /t/BSA . 6-4-03-1 Proleca Address �/ t t S Main Building: Accessory Building: .-Applicant's Mailing Address 3 e0,!P e NA 1lWl✓e, ii7,/y TYPE OF CONSTRUCTION UNEW rr--IiU��ADD U ALTERATION UREPAIR E Front Z Owner's Name .-tic ll w— 6y6—en9 ❑ CONVERSION ❑ DEMOLISH LWOTHER ?aay �'�v - j TB N // Phone DESCRIPTION OF WORK/USE OF BLDG. fl A Rear I Address 9 entr;et �hYrk'&— C-i ' 9.Z 2/Y -- --- Arch/Eng. r n�$N _ TYPE OF PERMIT ❑ GRADING ❑ FOUNDATION U STRUCTURAL I C Right N Z f L/ /_�pQ'`p� ❑ TENANT LECTRICAL ❑ PLUMBING ❑ MECHANICAL $ • Left G • Address 2 �� t 1• . Bi"VD� q R Contractor's Name. aSwce 1 '- =��p1'one ❑ OTHER I Ping. Ref.# Parking Req./Provided E -� , PROJECT DESCRIPTION 5G. FT. - -.- OCCUPANCY Planning Notes: Q Address(mailing) —rT / CON ST RUCTION TYPE VALUATION$• T City License Ng --- ZONE GRADING CU.YDS --ACRES - S. LICENSED CONTRACTOR DECLARATION I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: a'JYa - r'YJ — • - with section 7000) of Division 3 of the Business and Professions Code, and F t' . t_ my license is in full force and effect. /J FF �¢, i1`TC/ �J 1-1E58 ELECTRICAL FEES License Class License No. r K1 Date Signature PLUMBING I FEES Automatic Washer Transformer 0 15-50 KW WORKERS' COMPENSATION DECLARATION ' Construction Po le Sub. 0 50+ KW / ' •eby affirm that I have a certificate of consent to self-insure or a certificate • Bar Sink $hOW¢rS 1 'orkers' Compensation Insurance, or a certified copy thereof (SectionBackflow Preventer Service Sink Cooking Unit Meter ❑up to 100 amps J, Lab. C.) Dishwasher Meter ❑over 100 amps Policy No. .' • Company Backflow Irrigation Sewer Cap __ _ 8 Certified copy is hereby furnished. Dryers ❑Gas ❑Electric - Sub Panel Certified copy Is filed with the city Building Division. Bathtubs Sewer Connection _ • Date Applicant • i•—•-•i•—•-• EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Clarifiers Solar Collecto _ Fan Motors 00-1 HP 01%.8 (This section need not be completed if the permit is for one hundred ($100)orDishwasher Solar Pip' F.A.U. less). Inc.Solar 09-15 HP 016-15+ I certify that in the performance of the work for which this permit Is Issued I Fixtures shall not employ any person in any manner so as to oma to the Drinking Fountains Sol ank • Microwave Workers' Co lata? Laws a Californias J!�g af'ck9kj C �IA._� /q/� Device Boxes Pole Light DateO /Of, ft $ Signature a'C• ject t---- Floor Drains imming Pool w/Spa 9 NOTICE: If,aft r m ing this declaration,you should become to the Outlets Range Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal comply with such provisions or this permit shall be deemed revoked. --r-CONSTRUCTION LENDING AGENCYGas Service ' Outlets Water Closet Switches Sign I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name Lender's Address Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION ' I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P—Trap Laundry Trays ' any structure, prior to its issuance; also requires the applicant for such permit to file a signed statement that he/she is licensed pursuant to the provisions of Roof Dra' C et the Contractor's License Law(Chapter 9(commencing with Section 7000)of / —'•'inion 3 of the Business and Professions Code) or that he/she is exempt Reinspection Fee $15 Issue Fee $A efrom and the basis for the alleged exemption. Any violation of Section 1.5 by any applicant for a permit subjects the applicant to a civil • natty of not more than five hundred dollars($500). $ 3 DEVELOPMENT SERVICES REQUIREMENTS: LJ I, as owner of the property or my employees with wages as their sole Reinspection Fee I $15 Issue Fee • compensation, will do the work, and the structure Isnot intended or-offered _ Zoning Approved By Date for sale (Section 7044, Business and Professional Code: The Contractor's MECHANICAL FEES Building Approved By Date License Law does not apply to an owner of a property who builds or improves _.. tt thereon, and who does such work himself/herself or through his or her own Boiler . ' Application Issued By �_� Date /0�I� employees, provided that such improvements are not Intended or offered for . sale. If, however, the building or Improvement Is sold within one year of com- •e I I ❑ SUMMA- OF FEES pletion, the owner will have the burden of proving he/she did not build or im- Duet-Under Ground ✓ p�rya for the purpose of sale). •- BUILDING PERMIT $ SMIP $ /l IIS I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural fetation System PLAN CHECK $ PERMIT tractors to construct the project (Section 7044,Business and Professions Code: The Contractor's License Law does not apply to an owner of property who Duct-Ventilating ■0-100,000 BTU ❑100,000 BTU PLUMBING $ ISSUANCE $ builds or Improves thereon. and who contracts for such Projects with a con- ENERGY P.C. $ tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System 0 Multipl: il System Repair/Alteration I PLAN CHECK 25% $ proof o their Worker's Compensation Insurance should be provided to me. ELECTRICAL $ ...;V�•� � GRADING $ 0 I am exempt under �Section B.& P.C.for this reason Firepl/Fact.BIt. ICBG Fire Dampers PLAN CHECK 50% $ MICROFILM $ ate ;{. _ Owner _ . _ / ,�. Heating System _ ducting Registers MECHANICAL ,r1 QO -I hereby certify that I have-read this application and state .t the above ❑0.100,001 : U 0100,0008 $ TOTAL FEE $ SCJ information is correct. I agree to comply with all city and co my ordinances PLAN CHECK 25% $ and state laws relating to building construction,and hereby authorize repre- sentatives of this t6o antl upO <9above-menfionetl pro art for • Inspection purpose �,1'', ,7)- /� DateiO 01 DaQ44854—!] 04:25{• TOT �p,UL' nature / / ��- Reinspection Fee $15 _ Issue Fee $ 3 DATE: 10/13/89 TINE: 1221;. 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor . CONSTRUCTION AND PLANNING . POO. SPA v Date -Inspector Date Inspector APPROVALS Permit# APPROVALS Permit# s 1. Temporary Electrical Service or Pole . /&Lief 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 T. Footings - 58. Electrical Conduit-Undrgrnd. - • 8. Foundation 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 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 Electrical-Conduit 66. Solar System-Final •16. Rough Electric Wiring 67. Fencing & Access Approval 1.7! Rough Wiring Sign 1� 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 'i .4- APPROVALS Permit#- . / 21. Ducts, in Structure r 70. Underground Hydro / • 22. Ducts, Ventilating ':,j; 71. Product Piping 0 Gas 0 Oil ,/ 23. Gas Pipe-Rough & Test .4t. . •'72. Underground Flush �/ 24. Roof Framing ,' 73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing / 74. Overhead Hydro / ' 26. T-Bar Ceiling (Structural) $t1Monocoat 75. Dry Chemical ,t 27. Frame and Flashing 76. Dry Standpipe ' 28. Lathing & Siding 77. FIXED SYSTEM FINAL / 29. Insulation • 78. FIRE PREV. FINAL ti 1 30. Drywall Nailing / HEALTH DEPT. REQUIREMENT 31. Plater Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final , „..„, -4 80. FOOD CERTIFICATE ISSUED 33. Final Electric ierforfil 67,4, 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. Solar Domestic-Final 42. Backflow Preventer 43. Backflow Irrigation ' �' •� 44. Landscape Irrigation System I ' 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING ' • 48. Special Requirements Completed 49. Electric Release to Edison Irt; 50. Gas Release to Southern California Gas.Cor_() 51. CERTIFICATE OF OCCUPANCY (" _ :.5 No. Date ;, I PROJECT ADDRESS: 252 E 19TH ST UNIT: CITY OF COSTA MESA — BUILDING PERMIT PERM NO; M 058821 GINNER'S NAME: IVY, JOHN P JR ADDRESS: IVY,,; JOHN P JR TR PERMIT NO: M 058821 PLAN CHECK NO: N GOVT: N SUPP: N 2 25E 19TH ST 'COSTA MESA, CA 92627 CONSTRUCTION TYPE: V—N PERMIT TYPE: MEC PURPOSE: OTH 642-4286 ARCH/ENGINEER: REG.NO.: JOB DESCRIPTION ; 5 TON A/C UNIT W/ELEC, HOOK UP SQ FT: ADDRESS: UNIT: CLAIM VALUE: 1 , 500 . 00 CALL—VALUE: GROUP OCC: R-3 / PERMITTEE: CALIBER HEATING & AIR ( 714 ) 669-9320 ADDRESS: 195 SOUTH "C" STREET 250 COMMENTS; SMOKE DETECTOR REQUIRED TUSTIN CA 92680 **�E+ESE*>E*4*** **�E**** ***�r* Dc-IE**>E***kE*** -*+E*DF******+F****DE+E***DE**x-*DE**DF+E**EE*DEIE** LICENSED CONTRACTOR DECLARATION: I hereby affirm that I am licensed under provisions of Chapter 9(commencing with Secfion Z ONING REQUIREMENTS 7000)of Division 3 of the Business and Professions Code.and my license is in full force and effect. SETBACKS CITY LIC.: 0 2671 STATE uc.:589544—T cuss: C20 n r CC bzs lcf"_ Signature: l`� �e X4 59MAIN BUILDING ACCESSORY BUILDING WORKERS'COMPENSA710N DECLARATION: (hereby affirm that lhave a Certificate of consent to sed-insure or aeertifKate of Workers' FRNT; FT IN REAR: FT IN FRNT; FT IN REAR; FT IN Compensation lysyrappel y q.Wtifielegpy thereof(Section 3800.Lab.R1 /01 /93 LEFT; FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN •• POLICY NO.: l 1 7 l O 6 7 L EXP.DATE: I COMPANY: STATE FUND PARKING REQ. PROV: PARCEL: 42628119 ZNE: REF NO: ti 7 Certified copy is hereby furnished. 1-11 Certified copy is filed with the city Building Division. PLANNING NOTES> > ale' `P S /5 Z Applicant: �, ^\ qe ( Jn_ *************** **************************************************************** EXEMPTION FROM WORKERS'COMPENSATION DECLARATION: (TMs section need not be completed if the permit is for one hundred(5100)or less). DEVELOPMENT SER VICES REQUIREMENTS I certify that in the performance of the work for which this permit is issued,I shall not employ any person in any manner so as to become subject to the Workers'Compensation Laws of California. ZONING APPROVED BY DATE: Date: Signature: BUILDING APPROVED BY NOTICE:If.after making this declaration.you should become subject to the Workers Compensation provisions of the Labor v DATE: _____J____!* ill Code.you must forthwith comply with such provisions or this permit shall be d revoked. APPLICATION ISSUED B Y: � � - DATE: 1' / �� CONSTRUCTION LENDING AGENCY: hereby affirm that there is a construction lending agency for the performance of the work for 4 which this permit is issued(Section 3097.Civ.C). ************************* ** ' **** ,�***************************** He *l4 LENDER: ************************ ************3e**' ************************************* ADDRESS: LEGALIZATION:N F E E SUMMARY STRUCTURAL SEGMENT:N OWNER BUILDER DECLARATION: I hereby affirm that lam exempt from the Contractors'State License Law for the following reason BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING (Section 7031.5 Business and Professional Code: Any city of county which requires a permit to construct,alter,improve,demolish,or PERMIT 9 00 repair any structure.prior to its issuance.also requires the applicant for such permit to file a signed statement that he/she is licensed5 2 SM I P/NON—RES pursuant to the provisions of the Contractors'State License Law(Chapter 9(commencing with Section 7000)of Division 3 of the Business PLAN and Professions Code)or that he/she is exempt therefrom and the basis for the alleged exemption.Any violation of Section 7031.5 by 'T and any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars($500). ISSUE FEE 15 , 00 I, as owner of the properly or my employees with wages as their safe compensation, will tlo me work, ane the BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE U structure is not intended or offered for sale(Section 7044,Business and Professional Code: The Contractors'State License Law TOTAL S————> 9 , 0 0 1 5, 0 0 0 . 00 24 . 00 24 , 00 , 00 does not apply to an owner of a property who builds or improves thereon,and who does such work himself/herself or through • his or her own employees.provided that such improvements are not intended or offered for sale.If,however the building or REVENUE DIVISION TOTALS--> COLLECTED• 24 . 00 OVER/SHORT• ,00 improvement is sold within one year of completion.the owner will have the burden of proving he/she did not build or improve for the purpose of sale). BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK I.as owner of the property,am exclusively contracting with licensed contractors to construct the project(Section 7044,Business 24 . 00 LI and Professions Code: The Contractors'State License Law does enol apply to an owner of property who builds or improves thereon l and who contracts for such projects with a contractor(s)license pursuant to the Contractors'State License Law).I am aware ******************************************************************************* i that proof of their Worker's Compensation insurance should be provided to me. INDIVIDUA L F E E BREAKDOWN O I am exempt under Section: B.&P.C. 4._ for this reason: TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST Date: Owner: MEC 1 INST FORC—AIR/GRAV .FURN <= 100 K BTU 9 . 00 9 . 00 I do hereby certify that I am aware of and understand the requirements of California Health and Safety Code Sections 25505,25533.and END OF FEES t, 25534 and that I or any future building occupant wilUwill not(circle one)need to comply with said state codes and the requirements for a Permit for construction or modification from the Airuality Management District.Residential construction applications are exempt from these provisions. , , j Date: Applicant: I hereby certify that I have read this application and state that the above information is correct.I agree to comply with all city and county Ordinances and slate laws relating to building construction and hereby authorize representatives of this city to enter upon the above-mentioned property for inspection purposes. /� e 72 Signature: f \ 61- Cala 4 fir I. Drivers License or social security x. . . • 164146 White—Buildina:Green—Code Enforcement:Canary—Applicant:Pink—Revenue:Goldenrod—Assessor CONSTRUCTION AND PLANNING • POO. SPA 1 APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Servile or Pole - 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement 3.E ctrical Conduit Utility-Undrgrnd, • 54. Forms 4. Electrical Conduit-Undrgrnd. • 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. 'Electrical OF ER Grnd. 57. APPROVAL TO COVER-GUNITE 7.. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation . 59. Gas Pipe, 0 Undrgrnd., Test 9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, 0 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 Electrical-Conduit 66. Solar System-Final 16. Rough Electric-Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign - 68. APPROVED FOR PLASTERING 18. Rough Electrilal-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough Factory FTeplace ^ > APPROVALS - lPerthit# - 21. Ducts,in-Strii.ctue: .. _ _ f . _70. Underground Hydro 22. Ducts, Ventilating . _ i -47 ' '4 =71. Product.Piping 0 Gas 0 Oil 23.-Gas Pipe Rough &Test Y . , ,- 72. Underground Flush. 24.•Roof Framing • - ' .73. Undergrnd.Storage Tank 0 Gas 0 Oil 25. Roof Sheathing : • "74. Overhead Hydro_ 26. T-Bar Ceiling (Structural) & Monocoat • ' v 75.-Dry Chemical 27. Frame and Flashing, - . - 76. Dry Standpipe 28. Lathing& Siding I t • > 77: FIXED SYSTEM FINAL -29. Insulation - I� 78. FIRE PREY. FINAL 30. Drywall-Nailing - I 1 �: HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat_ _ II (, ' 79. FINAL INSPECTION - 32.-Electrical Pov,er Meter-Final I -80.• FOOD CERTIFICATE ISSUED 33. Final Electric - i Notes: 9f/a/JQL /`(cr 2e461- cC-O ' 34. Final Heating& Air:Conditioning; 1 35. Final Gas Pipe-Test' ,r`• 1' ' _ 36. Hood or Canopy - . - 37.-Final Factory Fireplace" - ! ' 1 -38. Final Plumbing . I - , • -39. Water Service-Final • - I° - . 40. Gas Service-Final - . I I I• - _ 41. Solar Domestic-FinalI i 42. Backflow Preventer - I I I 43. Backflow Irrigation - -44. Landscape Irrigation System;' _ _ - 45. Sound Attenuation- - • ' 46. Handicap Regulations - .. - , 47. FINAL STRUCTURE & BUI'LDING - ' I 4. 48: FINAL PLANNING ._ i . ' -49_'Electric Release to Edison -50. Gas Release to Southern California Gas Co I _.%I, - 51. CERTIFICATE OF OCCUPANCY No. Date Illi ' Applicant to fill In all spaces within heavy',order lines and sign all appropriate declarations. OF COSTA MESA P MIT NO )TRACT O. ROT NO •BLDG.NO. NSTRUCTION PERMIT Aj- N. (O j L�c5L: WI' `� 7237 9/03/82 123.51 TL Project Address _ - • • ., -, �J''a Z7�2/• .E�al„ Sr:S . TVP OF CONSTRUCTION // ' Owner' fl, -cA 9 ,4/ __ q� Phone NEW 0 ADD 0 ALTERATION • �Q�� %-er . --te t 1 Address ,:,.7 c",;?.. %l` �� ❑ REPAIR 0 CONVERSION ODEMOLISH ZONING REGULATIONS ' Arch/Eng. /�/� �///!x$icenze No. 0 OTHER A.P. Z(Z — Z lot' Address DESCRIPTION OF WORK 5'�7 1 — I_I , �.A' l ZONE PLNG. REF.Sfe • Contractor .i - - Phan L • PERMIT ti - Av/�///� BUILDING 1 v I I I G • , q 4 ltj/ TYPE OF y� y= 2' 7'p gV i p SETBACK 6Ft9'r'; �e PROPE RT�LINE Address �� '- - ❑ GRADING Lfj FOUNDATION XSTRUCTURAL' ,SIYARD if 4s_,U f/ - , LICENSED CONTRACTOR DECLARATION4-- l I hereby affirm that I am licensed under piovislons of Charter 9(tom- TENANT 0ELECTRICAL PLUMBING ❑MECHANICAL SIID YARD .y1(—LP is - mencing with section 7000) of Division 3 of the.Business and 0 OTHER' - '` RIG T I 3l_O rl Professions Code, and my license Is In full force and effect. PROJECT DESCryRIPTION •fie .REAR YARD(TO P/L) . '. • License Class- license No. 7I� PKC.SPACE REQ. '(� PROVIDED Z •50e .FT. WORKERS'COMPENSATION Date rDECLARATION 'OCCUPANCY �p(��pN{6(�a F,app,VV(11CTION TYPEyCal STREET WIDTH ((JO PARK FEE 5 I' hereby affirm that I have a certificate of consent to self-Insure or a VALUATION "-ZONE Or ZONING APPROVED BY bk. W,tJez_' DATE q f� 1,3I Zi certificate-of Workers' Compensation Insurance, or a certified copy T� / thereof(Section 3800,Lab.C.). GRADING CU.YDS. • ACRES SPECIAL CONDITIONS: . P'•Iicy No. Company - - ',ertlfied copy is hereby furnished. REMARKS: • ,_ ;ertifietl copy is filed with the city Building Division. - _ _ • , EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - - _ ((This section need not be completed if the permit is for one hundred($100) or less). - - - - certify that In the performance of the work for which this permit is ___ / Issued,-I shall-not employ any person in manner so as to become PLUMBING - •PLAN CHECK - - ELECTRICAL PLAN CHEC Kr t e subject th Wo 5 Compensation I fornia. _ - UWtLLING GH HHtat • Date � Signature L.' BATHTUBS SHOWERS _ SO.FT. SO FT NOTICE: If after making this declarati n, you should become subject TOILETS URINALS - - - - GENERATOR 0-1 KW_1-10 KW • to the Workers' Compensation provisions of the Labor Code,you must TRANSFORMER . forthwith comply with such provisions or this permit shall be deemed LAVATORIES DOUBLE'LAVS- 'APPLIANCE 10-50 KW SO+ KW revoked. CONSTRUCTION LENDING-AGENCY - - KIT.SINKS - DISHWASHERS . MOTORS t0-1 HP_1.10 HP I hereby affirm that there is a construction lending agency for the per- SERVICE SINKS SUMPS— r• - -. (INC.SOLAR) 10-50 HP 56+ HP formance of the work for which this permit Is issued (Section 3097 - - - - _ - _ Civ. C.): N. FLOOR SINKS FS.QOR DRAINS FIXTURES OUTLETS SWITCHES Lender's Name ins _ . Lender's Address -s-� ` -� - - ❑RINKING'FOU NTAINS �, . - GAS TUBE SIGNS / -T _ . -OWNER BUILDER DECLARATION " r> -'-'^. 1 •.,-" `0 • • POLE LIGHTS I.hereby'affirm that I am exempt from'the Contractor's License Law for I• NTE RCEPTO RS,(s� 'CLARIFIERS the folloyAnlireason-jSection.7031.5 BusIness and Professlons'Code: SWIMMING POOL l ; P TRAP ' -+ ' POLES KUL I WIN METERED SUB • Any city-or county which requires aysermlt-to construct, 'alter, t• • - _ _ improve,demolish or repair any structure,.prior to its issuance,'also re- WATER'SERVICE --' ALTERATION .- PANELS MAIN . .SUB i quires the applicant for such permit to file a signed statement that he - •, is licensed pursuant to the provisions of the Contractor's License Law GAS SERVICE OUTLETS - SERVICE AMP . (Chapter 9 (commencing with Section 7000) of Division.3 of the __ _ Business and Professions Code) or-that he is exempt therefrom and the- -'WATER)-IEp-ERS' • .•' BTU OUTPUT • - - - basis for the alleged exemptiont Any violation of.-Section 7091.5 by.. __ zpplicant .for a permit subjects the'applicant to`a r}yll'penalty• ; SEWER CONNECTIONS-) _ _ of more than five hundred dollars WOO). , ' ., as owner of the-property; -SOLAR TANK COLLECTORS - •; , will do the work,and the structure Is not Intended _ or offered for sale. (Section 7044, Business and Professions Code: The' SOLAR PIPING SYS. - , ISSUE FEE ,y�/ • Contractor's License Law does not apply to an owner of a property .- - - APPLICATION APPROVED BY -/ /.�+ DATE who builds or Improves thereon; and who does such work himself or ISSUE FEEV 1 through his own employees, provided that such improvements are not Intended or offered for sale. If, however, the building or Improvement MECHANICAL PLAN CHECK 7e1 roSUMMARY OF FEES "0 is sold within one year of completion, the owner will have the burden 7• • , of proving he did not build or Improve for the purpose o/ sale). HEATING SYSTEM 0-100,000 BTU PERMIT G nt'flli .SMTP _. E • • S • ❑ -I, as owner of the property, am exclusively contracting with AND DUCTING ' - - • licensed contractors to construct the project (Section 7044, Business 100,000+BTU PLAN CHEC E _T't PERMIT and Professions Code: The Contractor's License Law does not apply to „ISSUANCE S• • an owner of property who builds or improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ tracts from such projects with a contractor(s) licesned pursuant,to SYSTEM - - GRADING $ - the Contractor.'s License Law). / . 100,000+BTU PLAN CHECK $ - ❑ 1 am exempeurider Section ' ' I B.8-P.C.for thisBOILERS BTU ELECTRICAL S $ reason - PLAN CHECK $ -'MICROFILM $ SYSTEM REPAIR,ALTERATION Date Owner TOTAL FEE E I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE MECHANICAL $ LESS AO- ' Information is correct. I agree to comply with all city and county PLAN CHECK E - VANCE PC S ordinances and state laws relating to construction,and hereby authorize ' / representatives of this city to,enter upon the above mentioned S� property for inspect 3A 'Z" FINAL FEE E !��• Signature � •Date Drivers'License or SS -- -'ISSUE FEE - CMF 0865-46 White-Building;Canary-Applicant;Pink-Accounting:Goldenrod-Assessor 11111J CONSTRUCTION AND PLANNING POOL&SPA _ Date Inspector " " Date - Inspector APPROVALS Permit# APPROVALS Permit# - - -. - - - 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location - 2. Soil Pipe-Undrgrn _ 44. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrn _ 45. Forms - -_. 4. Electrical Conduit-Undrgrn __ _ _ . .-.- - . 46. :Electrical Bonding , - - - 5. Steel Reinforce - 47. Rough Plumbing& Pressure Test 6. Electrical UFER Grn 48. APPROVAL TO COVER-GUNITE 7. Footings a. (A---CP'+- f) 49. Electrical Conduit-Undrgrn 8. Foundation - 50. Gas Pipe; ❑Undrgrn,Test • 9. Water Pipe-Undrgrn -- • - 51. Backwash Lines,P-Trap. ❑Undrgrn • 10. Structural Floor System . ,5Z,_APPROVAL TO DECK 11. • Property Sewer Line & House Connection _ ._ • .'a3::"_'backwash & Receptor-Final 12. Street Sewer Connection _ 54. Heater & Vent-Final 13. Rough Plumbing _ 55. PWmbina System• Final ' 14. Rough Electric-Conduit -56.• Electrical-Final 15. Rough Electric-Wiring 57. Solar System-Final . 16. Rough Heating & Air Conditioning - . . 58. Fencing & Access Approval 17. Ducts,in Structure - - . 59. -APPROVED FOR PLASTERING '-. _ 18. Ducts, Ventilating _ .- . - _ -.-- -- �:` -• • - - 19. Gas Pipe-Rough &Test . - • - _60. POOL/SPA SYSTEMS FINAL • 20. Roof Framing - _ - - - 21. Roof Sheathing (-wt./4. ,,,,-,. ,-r!-s) _ - - - • 22. Frame and Flashing )4, ._51,5 -.1- ,,`, _c , _ NOTES: r4_s .6-9.,__. ' ��'� "_zrare ,,._per �, VB27 23. Insulation • t\ LT- .3-s-a - •_4.4.1.tjj- ..-1.......,--- .24. Lathing &Siding (can n.r�.•) .!-'S ) • 1'x•41 - A 4044 4 .... -c - p. 4..J. . .1 -..�w-04 e.rim E.c.¢.«. Z an . 25. Drywall Nailing _ / m-err ��. �y�c Lam!/�' 26. Plaster Brown Coat 31 -�°_ 4 z..JS3 � ' y�G �ff 2.1 27. Electrical Power Meter-Final _ _ -. _ 28. Final Electric - _ ,4 nearrit 0it- oa OA-.\s ALA PArPA _V A)..'�1/../9;Y= a� a,rl,o, 29. Final Heating & Air Conditioning _ _&v-t. �b aSA•'i2- p•1 _ C1 ...b5 /-/9-)? 30. Final Gas Pipe-Test _ _ - _ . .- - f , 31. Final Plumbing -_ .. _. .._-.._ • 32. Water Service-Final 33.. Gas Service=Final • . . 4. 3 ;- Solar Domestic-Final - .. 35.-' Landscape SprinklingSyitem . - . . - - 36. Sound Attenuation - - - 37. Handicap Regulations 38. FINAL STRUCTURE& BUI LDING - `J"/ 1`_l^76 c�11,taQ rffZ&, QQ,&,i C; k C`Lzoee- 39. Special Requirements Completed �r ((( IJ 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY .No Date . - - - •, _ - Applicant to fill In all spaces except those within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA CONS RUCTION P AIL? T PERMIT NO. TRACT NO. O UNIT NO. A.P. _ ' Zone 2sz E. UC 94> ` + y 4 -2, Ig Project Address • S Main Building. 'Accessory Building: Applicant's Mailing Ad rens TYPE OF CONSTRUCTION ❑ NEW ADD U ALTERATION U REPAIR E Front 77 t n Z rd ��Y}� ❑ CONVERSION ❑ DEMOLISH OTHE• T � ) O O Owner's Name kola' y Phone •S" r+(a / D SCRIPTIrN • ORK/USE OF BLDG. Siif • A Rear 3 Y N Address i ,de dee/ / ' f'r - , �/ _ er g I K Right G Arch/En . • _ ,_1'�w Licen • No. a: TYPE OF PE•MIT GRADING FOUNDATION �' VRALi Address - .e .a, i 99- / _ :f C RFT'. 0 TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL $ 7..;1,--3 I a- R Contractor's Name ' - rm./,s(a•,- 77#1{one S?f/OL / 3Z❑.OTHER D� Ping. Ref.# Parking Req./Provided Q �? G� G �,A/� PROJECT DESCRIPTION SQ. F7. o$ OCCUPANCY /C // L Address(mailing) S'7" o Planning Notes: N f ttie - r'- �/, k Q(c#d M CONSTRUCTION TYPE VALUATION$ 2,'Z S. "R 1 (/e- City License No. ZONE GRADING CU.YDS. ACRES [}Or nne4 cca- T LICENSED CONTRACTOR DECLARATION .,./� n_ ! - $' I hero• affirm that I am licensed under • • - • ar er • (commencing Remarks: IC U .-7U/„ ` /Q with sec • 600) of Dlvislo - e Business and Professions Code,and, ,` V c.a /�' ' my license is in fu -•• if• O6g[ r ' -An ELECTRICAL License :�2u �ai� O. - pn��( ! -�L FEES 4.,• • PLUMBING I FEES Automatic Washer Transformer 0 15.50 KW Date x/ ,� Signature / / • - WORK--5' OM•ENSAT ION DECLARATIONConstruction Pole Sub. 0 50+ KW I hereby affirm that i have a certificate of consent to self-insure or a certificate Bar Sink Showers ' Workers' Compensation Insurance, or a certified copy thereof (Sect7 Cooking Unit Meter pup to 100 amps )0, Lab. C. G fi(� •T r Backflow Preventer . Service Sink .one No. /UFA7 v 'O ! Company ._C .1 ".. Backflow Irrigation Sewer Cap Dishwasher Meter Dover 100 amps Certified copy is hereby furnished. Ofy¢fs ❑Gas ❑Electric Sub Panel Certified op ,{$,fi tl with the city Build Division Bathtubs Sewer Connection Date ./.// A' Applicant �"c0, ' EXEMP ON ROM WORKERS'COMPENSATION DECLARATION Clarifiers •;••;f,Coll ,;.....('cite_. less). tor Fan Motors 00-1 HP O'h-B (This section need not be completed if the permit Is for one hundred ($100)Or Dishwash '�' a.•;_ 0 _ F.A.U. Inc.Solar 09-15 HP 016-15+ _ - I certify that in the performance of the work for which this permit is Issued 1 - " shall not employ any person in any manner so as to become subject to ,a,; Drinking L- tai•-- ' � .yFixtureslar Tank Microwave Workers' Compensation Laws of California. ,'- Date • SignatureIE. Device Boxes g 1 i ;C;'.. E a Swimming POOI w/Spa Pole Light NOTICE: If,after making this declaration, you should become s •jro to the �-comply Workers' Compensation provisionsrionsor of the Labor Code, youd ..• Or[hWl uI,- ' FIO•�n nl _� Urinal Outlets Range comply with such provisions or this permit shall be di fi • rev.-,y CONSTRUCTION LENDING AGENCY " �— Switches A��` Service Outlets Water Closet Sign I hereby affirm that there is a is permit lending (Section for the lar i ante of the work for which this ermit is issued (Section 30• I;I Civ. C ~ Interceptors Water Heater Garbage Disposal Standing Sections Lender's Name ...--1151,---1- _ Lender's Address - • Kitchen Sink Water Service Generator 00-5 KW 05-15 KW Trash Compactor OWNER BUILDER DECLARATION - _j - I hereby affirm that I am exempt from the Contractor's License Law for the Lavatories Auto-Wash following reason (Section 7031.5 Business and Professional Code: Any city or county which requires a permit to construct,alter,improve,demolish or repair P-Trap It;undry Trays . - any structure, prior to Its Issuance, also requires the applicant for such permit' _ } ,r to file a signed statement that he/she is licensed pursuant to the provisions o� 'Oo1'Drains the Contractor's License Law(Chapter 9(commencing with Section 7000)Of { Division 3 of the Businessaand Professionsd Code) or that aexe '• �� Reinspection Fee $15 Issue Fed $ 3 x'+631.5 and the basis for the alleged exemption.subjectsAny violation of Sec T +" ,� I - _ f`.i31.5 by any applicant for a permit subjects the applicant to elf/ ! - ) - -'malty of not more than five hundred dollars($500). �\ `� •1T r i -EVELOPMENT SERVICES REQUIREMENTS: _i I as owner of the property or my employees with wages as their soh* I 'j. R 1'' a $15 Issue Fee J(�^� `�•• compensation, will do the work,and the structure is not intended or of fere• - Zoning Approved By �r Date " ✓ ' • for sale (Section 7044, Business and Professional Code: The Contractor' 7I MECHANICAL l /'/ License Law does not apply to an owner of a property who builds Or improves [, -ES Building Approved By �� /, iare �� bate i thereon, and who does such work himself/herself Or through his or her own - Af �� Application Issued By �G� �dfflrar Dat- employees, provided that such improvements are not intended or offered for C7 Boiler Hood 0 • ype __ sale, If, however, the buildingor Improvement is sold within one year of tom- n' pletion, the owner will have the burden of proving he/she did not build or Im- Duct. Under Ground ;''1:° ype ,. Y' SUMMARY OF FEES prove for the purpose of sale). •• BUILDING PERMIT $ 5-9'-00 SMTP •$ • S� ❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural -efriger. system tractors to construct the project (Section 7044,Business and Professions Code: .e PLAN CHECK $ PERMIT The Contractor's License Law does not apply to an owner of property who •, ^�4.stilatin. ,1100,000 BTU 0100,000 BTU builds or improves thereon, and who contracts for such oroiects with a con- j' PLUMBING S ISSUANCE $ tractor(s) license pursuant to me Contractor's License Law). I am aware that Exhaust S -t2 •' ' ul I ':•I ��4 System Repair/Alteration I PLAN CHECK 25% 5 ENERGY P.C. $ proof of their Worker's Compensation insurance should be provided to me. _ -_ /.. 0 I am exempt under Section B.& P.C.for this reason '\ Fire l/F: _BI• T.S:! ELECTRICAL $ GRADING $ p Fire Dampers PLAN CHECK 50% $ MICROFILM $ Date Owner •ati.,iSYstem& Ducting Registers MECHANICAL $ I hereby certify that I have read this application and state that the above • .i-100,000 BTU 0100,000 BTL— TOTAL FEE $ Information is correct. I agree to comply with all city and county ordinances 6:- PLAN CHECK 25% $ and state laws relating to building constr tion, and hereby authorize repre- sentatives of this • y to enta( upo a ab entioned proper y r inspection pure / B),/� , Signature j / /!/_ Date �/ Drivers' License or 55# Reinspection Fee I $15 Issue Fee $ 3 0865-46,rev. 5/88 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor ICONSTRUCTION AND PLANNING POOL 'A APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector 1. Temporary Electrical Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. I � 53. Steel Reinforcement , 3. Electrical Conduit Utility-Undrgrnd. 54. Forms ' ., . 4. Electrical CoridaitUndrgrnd. 1 ,t 55. Electrical Bonding 5..Steel Reinforcement : 56. Rough Plumbing & Pressure Test , 6..,ElectricalUFEIIGrnd. ',' ' 57. APPROVAL TO COVER-GUNITE . 7; Footings % r 58. Electrical Conduit-Undrgrnd. i 118.-.Foundation ?; i 59. Gas Pipe, O Undrgrnd., Test •, 9� Water Pipe-Undrgrnd. i . . 60. Backwash Lines, P-Trap, 0 Undrgrnd. 101:Structural Floor System i ( . 61. APPROVAL TO DECK 11'Property Sewer Line & House Connection 62. Backwash & Receptor-Final i 12.,Sewer,Cap;i" • ,', r' 63. Heater& Vent-Final ' . . 13. Roof Drains. %r 64. Plumbing System - Final . , r 14: Rough Plumbing: 65. Electrical-Final ' 15. Rough Electrical-Conduit 66. Solar System-Final meq,, r - , 16. Rough Electric Wiring 67. Fencing & Access Approval - 17. RoughWiring Sign • , 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceili^g -- ` 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating& Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough..Factory Fireplace r r'q� APPROVALS Pe`r`rnit# -, i _ 21. Ducts, 42:Structure '' 70. Underground Hydro w i _ 22. Ducts, Ventilating F171. Product Piping O Gas OOil 23. Gas Pipe, Ten Rough & Tet :.j - 72. Underground Flush 24. Roof Framin � ' ' 9 � N, 73.73. Undergrnd.Storage Tank 0 Gas •❑Oil � . 25. 'Roof Sheathing • r: 74. Overhead Hydro 26. T•Barreefing (Structural) &Monocoat 75. Dry Chemical • ._. lit-9 I / - 1 ,27: Frame and Flashing f 76. Dry Standpipe -28' Lath( &•.Siding • r' 77. FIXED SYSTEM FINAL ' 29. Insulation �'" i 78. FIRE PREV. FINAL 30. Drywall=Nailing t- .N. . HEALTH DEPT,. REQUIREMENT 31. Plaster drown Coat V n "^ 79• . FINAL INSPECTION-., 32. Electrical Power Meter-Final Y 80. FOOD CERTIFICATE ISSUED 33. Final Electric it Notes: 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test - -36. Hood or Canopy 37. Final-Factory Fireplace_ 138. Final Plumbing . '-39. Water Service-Final-: Z r.) �r _40. Gas Service-Final - " • J • I `-41- Solar Domestic-Final' 1 ._ 42. Backflow Preventer 43. Backflow Irrigation._ ' 7 r 44. Landscape Irrigation System !..•i ) 45. Sound Attenuation,. I-" 46. Handicap Regulations 1 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed •49. Electric Release to Edison . - f 50: Gas Release to Southern California Gas Co e Vi .- . - .i 51. CERTIFICATE OF OCCUPANCY No. Date - �� - Applicant to fill In all spaces within heavy border lines and sign all appropriate declarations. CITY OF COSTA MESA PER IT N'Qq. TRACT NO. LOT NO. BLDG.NO. 7415 9/08/82 13.00 TL CONSTRUCTION PERMIT Pc., 4148 - Project Address UrZ e. /yTN Cr - . TVP F CONSTRUCTION - .. - •• '• - Owner .,�petc.4./1! Gt/ nitPhonet`Z/j/ - NEW • 0 ADD - 0 ALTERATION O , •Address ..2.52' �, ,/1 The s-„-.. .. - 0 REPAIR ❑CONVERSION ❑DEMOLISH ,t - Arch/Eng. �7 • - - cense No. 0 OTHER ZONING REGULATIONS • - Address le/A/ erda-Pe��(� DESCRIPTION OF WORK A.P. ' r'l ZONE PLNG. REF.9 • •Contractor . . Phone ' • _ - -- BUILDING TTppgg(t�JI�pIs.IG TYPE OF PERMIT SETBACK C/L ST PROPS RTV LINE Address - _ • ❑ GRADING,- FOUNDATIOt`I/ 0 STRUCTURAL § SI YARD ' • LIGENSEW-CONTRACTOR DECLARATION 0 TENANT ELECTRICAL .•LL._77,•PP!/LUMBING ❑MECHANICAl1 lL99(DE YAWL/ I hereby affirm that I am`Iicensed under provisions of Charter 9(com- RI HT mencing with section 7000) of Division 3 of the Business and . .❑OTHER - - .- .. Professions Code, and my license is in full force and effect. REAR YARD(TO P/L) PROJECT DEMON LI<onse Class License NO._ f"��fO , PKG.SPACE REO. PROVIDED'' • Dat^ Signature 50.FT., 'n , WORKERS'COMPENSATION DECLARATION - OCCUPANCY�CONSTRUCTION TYPE �/74l� STREET WIDTH PARK FEE S ' • . I'hereby affirm that I have a certificate of consent to self-insure or a VALUATION ZONE ZONING APPROVED BY .. I DATE, , certificate , theeof(Sects n 3800Lab.Compensation) Insurance, or a certified copy GRADING CU.YDS: - ACRES SPECIAL CONDITIONS: ..`• •, ' PolicY.No. Company. - - - , -.waffled copy is Withthe iy Building Division. brtREMARKS: "7/Z) i1 - - -' ;entified copy is filed txEMPTION.,F.ROM WORKERS' COMPENSATION DECLARATION - - _ - - -7 - . (This section need not be completed if the permit is for one hundred - • . _ - • . . - . . . . - - ($100) or less). - . . - - I certify that in the performance of the work for which this permit is _ _ _ Issued.. I shall.not employ any person in any manner so as to become PLUMBING ,,PLAN CHECK ELECTRICAL PLAN CHECK subject to the Workers Compensation Laws of California. - — BATHTUBS -- ' - SHOWERS UWhLUNU U AHAUt . . Date Signature 50 FT SO FT NOTICE: if after making this declaration, you should become subject TOILETS URINALS - • 'I " GENERATOR 0-1 KW_1-10 KW ' to the Workers' Compensation provisions of the Labor Code,you must - TRANSFORMER . ._ _ - . forthwith comply with such provisions or this permit Shall be deemed LAVATORIES DOUBLE LAVS APPLIANCE 10-50 KW 50+KW - revOkeCONStl. -_..- -- - KIT.SINKS •- - . DISHWASHER,/ - MOTORS CONSTRUCTION LENDING AGENCY 0-1 MP_1-30 HP „ I hereby affirm that there Is a construction lending agency for the per- SERVICE SINKS • r ' .SUMPS - , " "' "' '(INC.SOLAR) 10-50 HP_50+HP formance of the work for which this permit Is issued (Section 3097 p(� Civ, CJ.. _ .. . - - _ .- _ FLOOR SINKS - - t9•FL AIMS• - FIXTURES OUTLETS SWITCHES . • s Lender's Name - ((�7. . - _ ___ Lender's Address - - - " -" DRINKI,NC:aJaF. 14WA g , -' - GAS TUBE SIGNS ' OWNER BUILDER DECLARATION ^ - ` /NTE ROW TO s CLARIFIERS POLE LIGHTS 1 hereby'affirm that 1 am exempt from.tne Contractor's•License Law for the following reason.(Sectlon.7031.5'Business and Professions Code: SWIMMIPI� PTRAP - WKSl Hut.noN t✓ • , , Any city or county which requires a permit to. construct, alter, 2R • POLES METERED SUB I improve,demolish or repair any structure, prior.to its issuance,also re ;WATER'S VICE' ALTERATION • - PANELS MAIN , , SUB quires the applicant for such permit to file a signed statement that he - _ I ' , Is licensed pursuant to the provisions of.the Contractor's License Law GAS SERVICE-- OUTLETS .' SERVICE /BD AMP. (Chapter 9 (commencing with Section 7000) of Division 3 of the - •. Business and Professions.Cotle).or-that he is exempt therefrom and the WATER HEATERS "• BTU OUTPUT- / • - I baslf for the alleged exemption. Any violation of Section 7031.5 by ✓/ •' - r - applicant for a permit subjects the applicant to.a civil penalty SEWER-CONNECTIONS " - c - - t more than fico hundred dollars ($500). - _ . • • as owner of. the property;Of-my employees with wages as their SOLAR TANK - ' COLLECTORS "' .. Sole compensation, will do the work,and the structure Is not intended _ I 1 or offered for sale;(Section 7044, Business and Professions Code:'The SOLAR PIPING SYS: . ISSUE FEE , ' �J •1"-"Cont rector's License Law tloes not apply to an owner OI a property _ _ _ who builds-or Improves thereon,and who does such work himself or ISSUE FEE - — APPLICATION APPROVED BY DATE r: ) through his own employees, provided that such improvements are not intended or offered for sale. if. however, the building or Improvement" MECHANICAL PLAN CHECK '/ is solo within ono year of completion,the owner will have the burden _SUMMARY OF FEES_ - - .roving he did not. build or improve for the purpose of sale). BUILDING , • j'.i/ as owner of the property, am exclusively contracting with HEATING SYSTEM 0-100,000 BTU . PERMIT . $ - SMIP' .. -' $ ' _c:rsec contractors to construct the project_ (Section 7044, Business AND DUCTING 100,000 +BTU PLAN CHECK $ PERMIT ' fan an; Professions Code: The Contractor's License Law does not apply to ISSUANCE• $ an owner of property who builds or Improves thereon, and who con- REFRIGERATION 0-100,000 BTU PLUMBING $ - • - . _ / tracts from such projects with a contractor(s) Ilcesned pursuant.to SYSTEM - - - . :GRADING S. '• the Contractor's License Law). 100,000+.BTU PLAN CHECK S ' ❑.1 am exempttinder Section B.&P.C.for this BOILERS BTU ELECTRICAL E a s reason PLAN CHECK E MICROFILM $ - Date Owner SYSTEM REPAIR,ALTERATION - TOTAL FEE S MECHANICAL S • I hereby certify that I have read this application and state that the above EXHAUST SYSTEM MULTIPLE I .- - LESS AD- information is correct. I agree to comply with all city and county PLAN CHECK $ VANCE PC $ ordinances and state laws relating to construction and hereby authorize - r . representatives of ci t0 enter upon the above mentioned res --- Signature property for in �.j . '1 Signature - • Date O FINAL FEE § Drivers' License o SS Br - ISSUE FEE .CMF 0865-46 White-Building;Canary-Applicant: Pink-Accounting:Goldenrod-Assessor CONSTRUCTION AND PLANNING POOL'_&SPA . .. Date Inspector k '" - Date ' - Inspector APPROVALS Permit# - - - n APPROVALS _ • Permit# _ _ _ - 1. Temporary Electrical Service or Pole _ 43. Pool & Equipment Location - - -2. - Soil-Pipe•Undrgrd . , 44. Steel Reinforcement - - - - . - - -_ 3. Electrical Conduit Utility-Undrgrn 45. Forms • ' • ' • - - -- , 4. Electrical ConduitUndrgrn • - _ _ , -_ _ . 46. Electrical Bonding ` . --" - - ' - , 5. Steel Reinforce • . . 47. Rough Plumbing& Pressure Test - - ' -• - - - 6. Electrical UFER Grn -48. APPROVALTOCOVER-GUNITE" - . - ` 7. Footings • 49. Electrical Conduit-Undrgrn 8. Foundation • 50.. Gas Pipe; 0 Undrgrn.Test 9. • Water Pipe-Undrgrn ' 51. Backwash Lines;P-Trap, _❑Undrgrn 1, 10. Structural Floor System LI 52. APPROVAL TO DECK . • _ ' 11. Property'Sewer Line & House Connection • _ . _ 53. Backwash& Receptor-Final • . 12.- Street Sewer'Connection • . ., . . 54. Heater & Vent-Final . 13. Rough Plumbing - • - ' 55. Plumbina System -Final ' 14. Rough Electric-Conduit - - - -56. -Electrical-Final - . . . , 15. Rough Electric-Wiring /-/55--oo3 CC . - - . .57.- Solar System-Final . . • 16. Rough Heating & Air Conditioning - . 58. . Fencing &Access Approval 17. Ducts, in Structure • 59.. APPROVED FOR PLASTERING • 18. Ducts, Ventilating _ . - . - . . . . 19. Gas Pipe-Rough &Test - . . 60.. POOL/SPA SYSTEMS FINAL . 20. Roof Framing - _ • _ - - .-- _ _ _. - _ - - . - - - : 21. , Roof Sheathing •• I _ _ ._. ... �• - - -- - -- - - - ,. ' 22. Frame and Flashing - _ _ _ 'NOTES: ': • 4 r` - _ 23. Insulation )- _. .. .' . - .. _ - ' - '`• .1 J7o T yogic( ' %-/ p-t7--M7C- - - 24. ' Lathing & Siding - _. . . y _ ._ � . _ _ .. _ 25. Drywall Nailing _ - c _-P ? 1 •W ///�, iL . •26. Plaster;Brown Coat . . . �p ' 27. Electrical Power Meter-Final - - - _ - _,'Q, y_. - l./, U • Plage_ �� _„ •28. i Final Electric __ . ... _ _ _ -. _ - ._ f- - _ 29. Final Heating & Air Conditioning „1. - ._ • _ ___ . - -. ----. - . . • •30. Final Gas Pipe-Test ' . _ ' _ __ _ - J . -=- - . ' 31. Final Plumbing - _ • . - _ _ - _ . ' _ " _ " • 132. , Water Service-Final _ _ _ .. . . _ - _ . . - . • . .. .. 33. Gas Service-Final _ "_ _ _I _ -. • ' ' • 34. Solar Domestic-Final _ • '35. Landscape Sprinkling System - - • - . _y 136. Sound Attenuation. ' - • i37. Handicap Regulations • - - • . _ 38. FINAL STRUCTURE & BUILDING - • ' . 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. - - - • 42. CERTIFICATE OF OCCUPANCY - • . . NodDate _ , / Applicant to fill in all spaces within heavy border lines and sign all appropriate declarations. - - CITY OF COSTA MESA -r PER�M^JT NO. TRACT NO. LOT NO: ' BLDG.NO'. CONSTRUCTION PERMIT =Y^ il� ' 7790 9/1.6/82 16.50 TL ' Project-Address7 670 ' / C TYPE OF CONSTRUCTION .: '__ , _ - •f T�,' Owner ' car,-;-.7 „re: f ��. Phone ❑ NEW Ill ADD 0 ALTERATION .5 . " 1. 6%.‘‘.....Z0/L90 AddressREPAIR_0CONVERSION ❑DEMOLISH _ I - •;_. , ZONING REGULATIONS •.: • = • Arch/gin. -7�G UG:�/fd ��i�i Lf ense No. ❑OTHER „ A.P. Address- - , _ ��ff -DESC DESCRIPTION O F'WORK - Q�/-/t,�1 �k.,--TIIe 1 ZONE • PLNG.REF. Contractor /d e G TYPE'OF PERMIT ' -- "'- •BUILDING --- - Tp Bti L,RIrvG SETBACK GL 5T. PROP R •Y LINE Address- -- - --- ' 0 GRADING 0 FOUNDATION ,❑ STRUCTURAL -"' ',SID YARD -- - -- -- - - - " LICENSED-CONTRACTOR DECLARATION �" " ' b1.0 •LEFT - - '[I I hereby affirm that I am licensed under provisions of Charter 9(corn- � ❑ TENANT ❑ E.LE9CTRICAL ❑P�LU•MBI ❑-�M'E+CH-AN/I�CAV•510E- AkU - - - mencing•with-section- 7000) of'-Division--3. of the Business and. ..0-OTHER. tel/E2 al TG C /t/C RIGHT - - Professions Code, and my license is In full force and effect. - ; L ; REAR YARD(TO P/L) _ __ .PROJECT-0ESCRIPTION I _ _ _ - _ - _ ' License Class License No. - s. PKG.-SPACE REQ. PROVIDE--- WORKERS!COMPENSATIONrDECLARATION - __ OCCUPANCY CO I I __ ' e ., 50. FT. •• _ _ _ . _ _ • Na UCTION TYPE • .STREET WIDTH _ , PARK FEE,S, ,I hereby affirm that I have a certificate of consent to self-insure or a VAL'UATIONs�DQ' NE • .1 - P. 7ZONING'APPROVED BY - - '"DATE certificate of-Workers' Compensation. Insurance, or a certified copy - - . -- ___ -. _ . _ --__ _ - _ - thereof(Section 3800, Lab.C.)- GRADING CU.-YDS. - .• ACRES - (SPECIAL CONDITIONS: Icy No-- _ _ . - --- - _ 'Company _ _ _ . ._ _ ._. _ - _ __ . _ __ _ _.-_ � ___ _ _ _ ___ -. a certifietl,copy-is hereby turniihetl.- _ '_:REMARKS:.. :'... .......1..—.-.....• 1 ` - — — --•- -_ J Certified Copy is filed with the city Building Division. . _ ) . . i. it-EXEMPTION'FROM WORKERS' COMPENSATION DECLARATION -' . - • .6..r.72-11/16.)-j- a sz-i - - -- ---- - - `-- '---' - "' ' -'• ••' ..j - CONSTRUCTION AND PLANNING POOL& SPA. . - - I APPROVALS Permit# ADate Inspector PPROVALS • Permit# DatInspector 1. _Temporary Electrical Service or Pole 43. Pool & Equipment Location' - ' - - - .. - . .-- ' 2, Soil Pipe-Undrgrn- ' - 44. Steel Reinforcement - - 3.._ Electrical Conduit Utility-Undrgrn . _ - __ . . - 45. Forms .. ' - - -- I. 4. Electrical Conduit Undrgrn :__ • _ -- 46. .. Electrical.Bonding -c - - - ._ 5. Steel Reinforce _ •- - N, 47. Rough'Plumbirig & Pressure Test -- -- •• - - 6. - _Ele_ctrical_UFER G n . •_ 48. APPROVAL TO COVER-GUNITE- H. - - - 7. _Footings _ - _ __- - 49. Electrical Conduit-Undrgrn - - ' 8. _ Foundation . _ _ _ • 50. • Gas-Pipe, LI Undrgrn,Test • ' .9. Water_Fipe-Undr.rn -, .__ . _ 51. Backwash Lines, P-Trap. Undrarn • ' 10.. Structural Floor System - __ ' - 52. APPROVAL TO DECK- ' -- - - - - - _ ' '._11. Property.Sewer Line & House_Conriection _ _ f-/9..,Y3_ r_ • ._53..-Backwash•& Receptor-Final -. 12.__Street Sewer Connection - -- '_ - __'_-___ - _ .. _ -- 54.- Heater & Vent-Final - 13. _ Rough Plumbing - - 1- /f- F3 � J�? '� - -- - - . . _ . �/" -55 - Plumbing System-- Final - 14. Rough Electric-Conduit r • •• - --• - - •- '56. . Electrical-Final - - - • - - - ' 15. Rough Electric-Wiring - -- - ` - -- - 57. 'Solar System-Final , . - - '• ' ' 16. - Rough Heating& Air Conditioning - - - - - -_ 58• .Fencing & Access Approval . 1.7. Duct , in Structure:'. _ . _.,.._ . .. . _. . ' . 1 . . _ ' .. ._ .- - ' 59,_- APPROVED-FOR PLASTERING - - - ' ' 18. --Ducts, Ventilating- _ - _ - - . . _ _ 19. Gas Pipe-Rough &Test - - _ _ . 60. POOL/SPA SYSTEMS FINAL 20. - Roof Framing _ _ . . --- -. .- _ - - • • ' 21: Roof Sheathing - : -- '- - _- - ._ - - - - - •t. ti i 22. Frame and.Flashing . - - r -_ . . _ _ NOTES: 23. Insulation - - - - - - _ _ _ _ _ ___- -. " 24. Lathing&-Siding -- - !--- ' _ • - ---- - - - A 25: Drywall Nailing - 26'. Plaster Brown.Coat . - . _ .. _ _ - _ __ _ .. _ _ _ - - - - _ _ 27. . Electrical Power Meter-Final:' - ' . _ ' -._. .. _ ' ' ' _ - -. - - 28: - -Final Electric - -- - - • - - - - • _ 29. Final Heating & Air Conditioning __ - - I -. . -- . - - - , 30. Final'Gas Pipe-Test. - _ _ . _ ' - - . _ . - . - - . - • . - ,31:. - Final;Plumbing _ _ _ _r . _ ... .- _ 32: Water Service-Final _ _ _ , - - 33. .Gas Service-Final . --f-/9-.83 .97?r 34. Solar Domestic-Final '•"' C . ; ' - EXPIRFf35. Landscape Sprinkling System 36. Sound Attenuation '• IncOm lets - - Jnsnertion� - ._ . - . 37. Handicap Regulations 1 ; - - - '- , `- , 7 - - - , . , - - _ 38. FINAL STRUCTURE & BUILDING ' ' > - 1 _ Date / a-L�Y/Sib4)4 39. Special Requirements Completed - . ' 40. Electric Release to Edison - ' - - i - 41. Gas Release to Southern California Gas Co. - ' ' 42. CERTIFICATE OF OCCUPANCY ._ -. - • No • Date -- .-