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Home My WebLink About680 18TH ST - Building Permits(714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 ELECTRICAL PERMIT Job Address: 680 W 18TH $T Suite No B Vicinity: UNIT B Parcel Nunmber: 42424132 Applicant: Address: Owner: Address Contractoc Address: ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units) Pool / Spa Lighting Fixts , Recept Outlets Switches Non Res Appl � Res Appl Service to 200a _ , Senice to 1000a Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Morors to 100hp Motors over 700hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole VERBURG, BRIAN T 680 W 18TH ST �' : ��.-� -'�''� ' - UNITB -� y-�� -Phone: COSTA MESA, CA�� - 2ip: 92627 / � � � " , � VERBURG, BRIAN T � � 680 W 18TH ST - . UNIT B Phone: COSTA MESA, Cq Zip: 92627 � � . . . .-.Pfione: , . . . Zip: - - . � �� - License: � Stams: ISSUED Applied: 10/04/2001 Issued: 70/04/2007 ISSUED BY: ' /' - - _ ��.. Y i _ �� / � . . •��! � .. ��' � �� `:; . � _ �� SCOPE OF PERMIT RELOCATE AND UPGRADE ELECTRICAC SERVICE TO 200 AMP. ' . $23.50 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 so.oa so.00 50.00 $0.00 $30.50 $0.00 $0.00 - $0.00 $0.00 $0.00 � $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 �, _ FEE SUMMARY „ Quantity . _ � � _ � , ' _ . � . � � � - Temp Dist System FLighting 0 0 0 0 0 0 0 0 � 0 0 0 0 0 0 0 0 0 0 0 0 0 t i. Busway A00 fl � Standing Section Misc Eiearical Equipment Transformers up to 1 kva/kw ..:.............up to 70 kva/kw ...........:.....up to 50 kva/kw .............:...up to 100 kvalkw ..................over 100 kva/kw - Low Voltage Equipment � Low VOIt Wiring System / Ckt Misa Conduit , Misc. Condudor . Circus ( gen or ride) � Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand - �Other Electrical Fee . Quantity � , $0.00 0 50.00 0 -- , � $0.00 0 50.00 0 30.00 0 50.00 0 $0.00 � ��.0 so.00 .; � o _ $o.00 ,' o $0.00 0' $0.00 � 0 $0;00 �', D � $0.00 ; " ' 0 � � $0.00 0 $0.00 0 $0.00 � 0= 50.00��'/0 $0.00 - �� Investigation Fee , � � $0.00 Plan Check Fee � � 50.00 Reinspection Fee - $0.00 TOTAL CALCULATED FEES E54.00 COMMENTS / SPECIAL CONDITIONS NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under California statutes and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically ezpire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, antl all required inspectlona end final epproval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 244&CB (8�00) WORKERS'COMPENSAnON DECLARATON: I �ereby ettirtn under penalry oi perjury one of ihe tollow�ng tleclarations: ❑ I �ave end will maintain a certificate ot consent to setl-Insure tar workers' campensetion, es pmWtletl for �y seMion 3700 ot Ihe Lebor Cotle, for the peAormence of Ihe work tor which this pertnit is issued. ❑ I have aritl will mainWin workers' campensatlon insurerxe, es requlretl Dy section 3700 ot the Lebor Catle, for Ihe peAamence of Ne woAc for whith ihis permit Is iswed. My workers' compensaCnIan I urence cartler end olicy number are: Cerrier. ( Y�_�� Poliry Number: CTh/s sec0on neetl no� be comp/e�ed i/ fhe permiV velued ef one hundred dallers ($100) or IessJ nity thet in �he pertortnance oi the work wmpensetlon lews at C�amia, end egree comply with ihese pg� i ons. Applicant Signeture: � WARNINO: FAILURE TO SECURE WORKERS' COMPE� UCENSED CONTRACTORS DECLARATION: ilt is issued, I shall not employ eny person in eny menner so es to become subject to the workers' ;o�D�ect to the workers' compensetion provislons ot Sectlon 3700 o the Lebor Catle, I shell farthwlih Dete: I t� �-{�' r— IS UNLAWFUL AND SHALI SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CI L FlNES UP TO ONE HUNDRED 1TION. DAMAGES PS PROVIDED WR IN SECTIqJ 3708 OF THE UBOR CODE, IMEREST, AND ATTORNEY'S FEES. 1 hereby aflirtn thet I em licensetl undar provlsions ot Chapter 9(commencing with Section 7000) of Divislon 3 of Ihe Business antl Professions Cotle, entl my Ilcense Is In full force e� eHect. lic. a Class x Contrenofs SlgnaNre: Date: CONSTRUC710N LENDING AGENCY: ❑ I hereby attirm thai there is e construction lending epency for the peAormance ot the work for which Ihis pertnit is issued. (Sec. 3097, Civil Cotle). Lentlefs Neme: Lentlers AOtlreu: Signeture: Dete: OWNER-BUILDER DECLARA710NS: ' _ I hereby eltirm thet untler penelty at per�ury ihel l em E%EMPT FROM THE CONTRACTORS LICENSE LAW lor ihe tollowing reeson (Sec. 7031.5, Business entl Professlons Code: Any city or counry which reQuires e pertnii to construct, elter, improve, demolish, or repair any strucWre, pnor to Its luuance, also reduires the appllcant br such permlt to ille e signetl stetament ihet he or she is Ilcensed pursuent to the provislons of ihe Conhactors License Lew (Chepter 9(commencing wit� Section 7000) oi Dlvision 3 oi the Buslness entl Professions Code) or thet he or she Is exempt Ihereirom end the Gasis for the ellegetl exempllon. Any violatlon af Section 7031.5 6y eny eppllcant tor a pem+' suD�ects the applicant to a civil penalry oi not more then five hunAretl Aollars ($500).): ❑ I, es owner af ihe proparry, or my employees with weges es their sole compensatlon, WILL DO THE WORK, anA the slructure Is not intended or oHeretl for sale (Sec. 7044, Business and Professions Cotle: The Coniraclors Llcense Law dces not appty to an owner o1 properry w�o bullCs or Improves thereon, and who tloes such work himself or herself or ihrough his or her own employees, providetl ihat such improvements ere not Intentled or oMered lor sele. If, however, the builtling or improvement Is soltl within ane year of completion, ihe owner-builder will �ave t�e burtlen ot OmWng iha� he or she tlid not build ar improve tor purpose ot salaJ. ❑ I, es owner ot the property, am E%CLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct Ihe project (Sec. 7044, Business end Professions Cade: Tha coNrectors License Lew tloes not eppty ro an ownar oi property who bulltls ar improves thereon, antl who comrects tor such project with a comractar(sj license Dursuant ro the Contractors License LewsJ. ❑ I em exem nder se Business anA Professions Code for this reason: Signeture: �� J.. \ _ _ Date: Owner ID veritietl by drivers licensryg/ �s � No Dnvefs License No. Expir : Vedflcetlon ot Ownership Dy (typ4of dacumem, I.e. - pmperty tez blll ar deed): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTFICATION: ❑ I hereby certiry that no excavetion five (5) or more teet In tlepth Into which a person is required to descend, wlll be made In connection with work authodzed by thls pertnit, and that no building siructura, sceHoltling, talsework, or demolition or dismantling ihereof, will ba more than thlrry-six (38) feet hiph. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle B, Calitomia Atlminis�rative Cotle). ❑ As owner-builder, I will not employ enyone to do work which would require e pertnil from the Divislon of Indusirial Sefery, as noted above, unless such peraon hea a pefmit to tlo such work from the tlivision. Signature: Oate: Division of Industrial Sefery Permil Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZATION OF EMRY: I cenify under penelry ot perjury thet I have read this application and state thal ihe information given is correct. I e ree to comply gwrit7hn all sta e lews end city ordinances rela�ing to building constructioq end authodze representaiives of Ihe City of Cosle Mesa to anter upon iha ebove- ribedympery t' sp ion� es. I�nat to accupy or atlow occupency ot eny building euthorized by Ihl�pftrtryt ury'i�n�nspection. %� � c� V� T d Signeture Of I.pga Owner(s) Date � COpE �. INSPELRIONTYPE �jF 1fi16 Fixetl System Final Fire Prevention 1266 200 2oi 202 203 Pool Spe Finel Final RaRoof Final BIocWRetaining Well Final Fectory Fira Place Final Sign 204 Final Demolition IMii1FL5 �f,d INSFECTIONTYPE 206 Final Mechaniwl 208 Finel Plumbing 270 Finel Electrical 212 220 Final Fire Preventlon Finel Plenning Approval 222 Final Site 250 Final Building/Occupency i It�� ti s (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 BUILDING PERMIT JobAddress: 680 W 1$TH $T Suite: Vicinity: RESIDENCE & ATTAHCED GAR4GE FOR UNIT B Parcel Number: 42424132 npp�icant: BOULGER, SHAWN Address: 2851 E LA CRESTA AVE. ANAHEIM, CA Owner: HSIEH, SHIOW KUANG Address 752 W 19TH ST COSTA MESA, CA Contracroc LINNERT ROOFWG, INC. Address: 2851 E LA CRESTA AVE. ANAHEIM,CA Zip: 92806 Atch : Address: Zoning: Phone: (714) 632-1900 Zip: 92806 Phone: Zip: 92627 Phone: (714)632-7900 License: 664319 Eng: Address: Phone: ISSUED BY: Status: ISSUED Applied: 11/30/2000 Issued: 11I30I2000 Phone: Zip: License: License: SCOPE OF PERMIT REROOF: TIO EXISTING ASPHALT SHINGLES, REPAIR/REPLACE SHTG AS NEEDED, 1 LAYER OF 3Q# FELT, APPLY 20-YEAR "GAF ASPHALT SHINGLES" ALL NEW FLASHINGS. 17.93 SQUARES. . . . _ n Plan Check: $0.00 Permit: $83.25 SMIP Res: $0.50 SMIP Com: $0.00 Other: $0.00 Inspection: $0.00 Total: $83.75 SETBACKS MAINSTRUCTURE Front 0-0 ACCESSORY Front 0- 0 PARKING Existina: o NOTES: Rear 0- 0 Rear 0- 0 Reauired: 0 FEE SUMMARY PLANNING & ZONING Left 0- 0 LeR 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0- 0 Right 0- 0 s $2,900.00 82,900.00 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements untler Calitornia statutes and related regulations. (Ord. No. 92-28, § 7, 12-27-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 180 days, or it work is suspended or abandoned for a period of 180 days. . INSPECTIONS: In order tor the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred inspectlons and tinel approval must be obtainad. Failure to obtain inspections and final approval will result in the expiratlon of this permit. FOR INSPECTIONS CALL: (714) 7545626 z+ee�ae �aroo� �J WORKERS' COMPENSATION DECLARA710N: I hereby aNirm under penalry ol perjury one of Ihe lollowing tleclarations: 0 I have antl will maintain e cehiticate of consent to setl-Insure tor workers' compensetion, es pmvided tor by section 3700 at Ihe Lebor Cotle, for the peAormence of �he �1 work tor which this permit is issuad. �I have and will malMain workers' compensetlon insurence, as raquiretl by section 3700 of the Labor Code, for ihe peAormance of the work tor which this pertnit is issuetl. My work8/ �/ mpensatlon Insurance cartler antl policy number are: (^JC ��a? �I �O %S C¢rtier. �/ /�q.�1�1/4- PolicyNumber: (This sectlon need not be comp/etetl il the permit is velued et one hunOred tlW/ers (3100) or IessJ ❑ I cetlify that in the pedortnance oi �he work for which this permll Is issued, I shall not employ any person in eny manner so es to Cecome subJect lo tha workers' compensation laws of Califomle, end agree thet It I s�ould become sub�ect to Ne workers' compensation proNsions of Sectlon 3700 ot t�e Lebar Catle, I shell torthwilh comply with thesa provisl sp �7 ?PP�can�gi-- natu_e:_�i�—�._ �SG�..�-^^ fDate� %�' 3Ci • �Q WARNINO: FAILURE TO SECURE WORKERS' C0IAPENSATION COVEMOE IS UNUWFUL M1D SiU115UBJECT AN EMPIOVEiiTO CRIMINAL PENALTIES AND GVIL FlNES UP TOONE MUNDRED T/qUSW D DOILARE (5/00,000), IN ADORION TO TME W5T OF ODMPENSATION, DAMAGES 0.S PROVIDED FOR IN SECTION 3108 OF THE UBOR CODE, IMEREST, M1D ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby aKrm that I am licenserd� r provisions of Chepter 9(commencing with Section 7000) of Division 3 of the Busineu and Professlons Cotle, antl my license Is In full force and etted. LJc. a %n�0"�� Gless a C"��/ CONS7RUCTION LENDING AGENCV: ❑ I hereby aflirtn thet there is e consiruction lentling agancy for t�e pedormance ot the work tor which this permit is issued. (Sec. 3097, Civil Code). Lentlels Name: Lentler's AOtlress: Signeture: Dete: OWNER-BUILUER DECLAqATIONS: I hereby aHirm thet under penalty of per�ury Ihe� I em EXEMPT FROM THE CON7RAC70RS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Prolessions Code: Any ciry or county which requires e Oermit to constiuct. alter, improve, demolish, or repair eny strucWre, pnor to its issuence, elso reQuires the epplicant for such permit ro file a signeE stetement thet he or she is Ilcensetl pursuem to the provisions af the Contrecrors License Lew (Chepter 9(cammencing wlth Sectlon 7000) of Dlvision 3 of the Busineu and Prolessions Cade) or that he or she is ezem0� therelrom end the basis tor ihe elleged exemptlon. Any vloletion oi Sectlon 7031.5 by eny eDPlicant for e permit subjects the applicant to e civil penalty oi not more ihen Nve huntlreC tlollers ($500).): ❑ I, as owner of ihe proper�y, or my employees with weges as thelr sole compensatlon, WILL DO THE WORK, antl the structure Is noi InlentleC or otteretl for sal9 (Sec. 7044, Business and Prolessions Code: The Contractors License Law does not apply Io an owner of propeny who builtls or improves thereon, entl w�o Ooes such work himself or hersetl or Ihrough his or her own employees, proNded that such improvements are not intended or oHeretl �or sele. It, however, the builtling or improvement Is so10 wiihin one year ol completion, ihe owner-builder will heva the burden of proNng thai he or she did not build or improve for purpose ol sele.). ❑ I, as owner oi the property, em EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS to canstruct the prolect (Sec. 70d4, Business end Prolessions Cotle: ThB tontrettor5 LlcenSe Lew AoeS no� epply to en owner ot pmperty who builds or Improve5lhereon, end who Con�retl5lor 5uth O�o�etl wlih e con(rector(s) license pursuant to tha Camractars License Laws.). ❑ I am exempt untler sec. Signature: Owner ID verified by drivefs license. ❑ Ves ❑ No 8usiness and Pmfessions Cotle tor this reeson: Veriticetlon ol Ownership by (rype of documenL I.e. - properry tax bill or tleetl): DIVISION OF INDUSTRIAL SAFETY PERMIT CERTIFICATION: Drivefs License No. Date: Expires: ❑ I hereby ceNfy tha� no exceve�ion five (5) or more feet In depih into which e person Is required ta descend, will be made in connection wilh work euthorizeC by Ihls permlt, antl ihat no builtling structure, scalloltling, lalsework, or demolition or dismantling thereoi, will be more lhan thirty-six (36) tee� high. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Califomia Administrative Code). ❑ Ps owner-builtler, I will not employ enyone to da work which would require a pertnit iram ihe Division of Industriel Sefery, es noted ebove, unless such pereon hes e permit �o do such work trom the tlivision, Signatura: Data: Division of Industnal Satety Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTHORIZA710N OF ENTRY: I certify under penalry of perjury that I heve read this epplicalion and stete thet the infortnation given is correci. I agree to wmply with ell stete laws entl ciry ortlinances rela�ing ro building consWction, and euthodze representallves of the City of Coste Mese to enter upon Ihe ebove-descnbad property tor inspection purposes. I agree not to occupy or allow occupancy of any building au�honzed by this permit until finel inspection. COOE 1. INSPECTONiYFE 1616 Fixetl Sys�em Flnal Fire Prevention 1266 Pool Spe Finfll 200 Final Re-Root 201 Finel BIocWReteining Well 202 Final Fattory Fire Plete 203 Finel Sign 204 Final Demalition PAIE 1[�E6i � � i�-?o •�a Date COQE� �xsvernoNrrre 206 Final Mechanical 208 Final Plumbing 210 Finel Elecirical 212 Final Fire Preventlon 220 Final Planning Approvel 222 250 Final Site Finel BuiltlingiOccupanry � lt� Applicanl lo /ill in all SOaces except iM1ose wit�in �eavy Dortler lines antl Tign all app�op�lale Oecldrations. COSTA MESA .CONSTRUCTION PERMIT J�APPIicanYs Mailing Addregs � ��/ / J� -Owner's Name LT�'PS �% / / -e- hone � Address � Arth/Eng. License No. Address Contractor's Nam Phone � Address (ma I'ngl � � Ciry License No. LICENSEO CONTRACTOk DECLARATION 1 heieDy al/irm that I am qcensetl untlar provi5iOn5 of ChartOr 9(Commencing with 5oction 7000) of Division 3 of [ha BuSiness antl Protesslons Cotle, antl my Iicense is In f W I brco aqtl el�ect. Licensu Class Llcense No. Date � S�9nature VORKERS' COMPENSATION DECLARATION � nereby aHlrm tna[ I nave e cer[itltate ol consent to solf-insure or a certificate of Worker5' Compnnsatioq Insuranco, or a cerlltietl copY tM1ereOf ($octlon. 3800, Lab. C.) Policy No. Company eCo��ilietl copY is horeby turnisM1eU. Certi/ied copy Is /iled w�th fhe city Bulltling Dlvislon. Date APPlicant EXEMPTION FROM WORKERS' COMPENSATIDN DECLARATION ' (Tnis secdon naetl not be completetl if tbe rmtt Is (or onn nuntlretl (5100) or less). • I cerlify lhat in ttle perfortnance o( [h w rk fOr whlCh this perm�t is Issuetl, I shall not emplOy any pOr50n in any a e� so as t ecom subject [o the Work�/ �Co pen LI n-taWs ot Cali or � Date/�99�ature � �NOTSCE: 1, atter making this tlecla o, y0u Shoultl becOm ' ct o the Worke�s' CompensaUon oro�ision q the tabor Cotl¢, you must forthwith comply with such prOvi5ion5 �this pe�mit shall Oe tleemetl �evokeU. CONSTRUCTION LENDING ABENCV . 1 hereby dfflrm that thGre is a WnStruc[ion lentling agency fo� tlte Derto�mance ot the wOrk lor which this permit i5 ISiu¢tl (Settion 309] Civ. CJ lenaer's Name Lentle�'z Atltl�e55 OWNER BUILDER pECLqRFTIOfJ I hereby affirm that I am ¢xemp[ from [be ConVacto�'S License Law for the f011Owifl9 f¢d50n ($2CfIo0 �/031.5 Bu510B55 dOtl PIOt¢5510lIdl COtlE: AOy Clty_01 tounty whith rtquires a p@�mit to conStruCQ alter, Improve, tlemolish o� �epair any sVUC[ure, prior to it5 isSuanCe, also requires IM1e applicant fp� such'permit to (ile a siqnetl statem¢nt ihat he/she is Iicensetl pursuant to the provisions o� [he Contrattor's License La�y (Chapter 9(tommencinq wi[h Section 7000) 01 Division 3 ot Ihe Busines; antl Profe55ion5 COtl¢) or that he/she is exemp[ therefrom dntl the ba5i5 �Or th¢ alleg¢tl exemption. Any riolation o( Sectlon 7031.5 by any applican[ (pr a permit subjects Ihe applicant to a civil �nalty ot not more than fi�e huntlretl tlollars (E500). I, az owner Oi the orooe.cy or my amploy¢es wiln wage5 as their zole mmpen5dtion, will tlo the work, ana the structure is nol intentletl or ofteretl for ule (Section 7064, 9usiness antl Profe551ona1 Catle: The Con(ractor's License Lax^Uoes not apply to an owner of a prop¢rty who builtls o� imp�oves lhereon, anU wno tlOes zuch wo�k �Imselt/h¢r5¢If or Ihrough hfs o� ner own Gmptoy ea5, �proNGeU Ihat iuch improvements are not Int¢nAed o� oft¢retl tor sale. If, howeveq tne b W Itlinq or improvement is soltl wlthin one year of com- pletioq Ihe owner will M1ave Ihe bu�tlen ot prOvin9 be/s�e tlid not builtl or Im- prove ior tp¢ purpose oi Sa�e). ❑ I, as owner of tne o�op¢r[y, am excluslvery conVacUng wlth licensea con- tractorsloconsVuct the project (Section ]044, Butinesiantl Protessions Cotla: The ConVattor's Llcense �w tloes not apply to an owner o( property wno bWltls or Improva5 thOruory� antl who contract5 lor Suth prolotts with a Con- tractor(s) llconse pu�suant�(o [ne GonV eee�� or's Licanso Law). I am aware tnat proof o( th¢ir WOrk¢r'S Compen5ati 1{{Suranca Shoultl be provldetl to me. ❑ 1 am exempt under Sect(pn�,0.,d➢.`Q1or thfs reason Date Owner TVPE OF CONSTRUCTION L.J NEW IJ ADD LI ALTERATION V�. REPAIR ' ❑�CONVERSION ❑ DEMOLISH ❑ OT R - DESCRIPTION OF WORKIUSE OF BLDG. �P ,T,QnGiw i ,�� -- TVPEOFPERMIT GRADING FOUNDATION STRUCTURAL • ❑ TENANT ❑ ELECTRICAL ❑ VLUMBING ❑ MECHANICAL O OTHER PROJECT DESCRIPTION SO.F7. oCCUaAN v CONSTRUCTIOlYTYPE VAWA710N$ � �' ZONE GRA�INGCU.VDS. ACRES Ramarks: Bar Sink Backflow Preventer BaCktlow Irrigation Bathtubs Clarifiers Dish�.vdsher Drinking Fountains Floor Drains Floor Sinks GasService Outlets Interceptors Kitchen Sink Lavatories � � P—Trap Roof Drains ReinspeRion Fee � $15 Boiler Duct - Under Ground Duct - Structural Dutt - Ven[ilating Exhaust System � Multiple PirepVFact. Blt. ICBO � iieeting System & Ducting ❑0�100,000 BTU 0100,000 LSi9natura _ � Date/(�%Y—Sn Drivers' l nso or 55 � Rainspection Fee CMF OBfiS-46, rev. ]0/84 Wh�te - Builtling; Canary - Applican(; Pink - AC<ounling; Goltlanrotl - Assessor $15 Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Water Closet Water Heater Water Service Auto�Wash Laundrv Travs Isue Fee Hood or Typel ❑ Canapy Type II � Refrigeration System ❑aioo,000eru ❑ioo,000 System Repair/Alteration � Fire Dampers , , Iswe Fae FEES S 3. $ 3 A.P. # S Main Building: E T Front 8 Rear .A C fiight K Lett S. Ping. Fief. qiE Planning Notes: Automatic Washer - Construction Pole Sub. CoOking Unit Dishwasher . Dryers ❑Gus ❑Electric F.A.U. Fixtures Device BOxes Outlets Swi[thes Garbage Disposal Generator �0.5 Fea 2127 10/14/85 Accessory Building: Parking Req./Provided �L,@U TL ZonB ELECTRICAL Transformer � 15�50 KW ❑ 50+KW Mecer U� Meter � Sub Panel MOIOR ❑ Inc.Solar to 100amps �r 100 amps HPO1`/a-6 �75 HP �16-15+ Pole Light Range Si9n , ; Standing Sections ❑5-15 KW Tresh Compactor $15 laue Fee DEVELOPMENT SERVICES NEQUIREMENTS: Zoninp Approved By Building APProved By � FEES S3 2 O N I N G R E Q M T $ SUM A�/p V�p/�� FEES BUILDING PERMIT $� �y._fL SMIP $ • S� PLANCHECK $� PERMIT PWMBING $ ' ISSUANCE $ PLAN CHECK 25% $ ENERGY P,C. $ ELECTRICAL $ GRADING $ PLANCHECK 5096 $ MICROFILM $ " MECHANICAL S TOTALFEE � $ � •� PLAN CHECK 25% $ � ;'CONSTRUCTION AND PLANNING P� & SPA - ' ' •, � Date Inspector qppROVALS Permit # Date Inspector - . pPPROVALS Permit # Y� �� 1! Temporary Electrical $ervice or Pole 52. Pool & Equipment Location ' . 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms �4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE 7. Footings 58. Electrical Conduit-Undrgrnd. . . ' . 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test . . 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, � Undrgrnd: 10. Structural Floor System .� 61. APPROVAL TO DECK � 17. 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-Fina� � , 15. Rougfi Electrical-Conduit 66. Solar System-FinaV - � 16. Rough Electric Wiring 67. Fencing & Access Approval .. . . 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING , 18. Rough Electrical-T Ba� 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 77. Product Piping OGas ❑Oil � . � 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd. S[orage Tank � Gas ❑ Oil � 25. Roof Sheathing 74. Overhead Hydro � - 26. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical � '� i 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 . � 39. Water Service-Final ' • , 40. Gas Service-Final ' 41. Solar pomestic-Final ' - 42. Backflow Preventer 43. Backflow Irrigation � � 44. Landscape Irrigation System _ 45. Sound Attenuation � 46. Handicap Regulations � . 47. FINAL STRUCTURE & BUI4DING �, - ' 48. Special Requirements Completed 49. Electric Release to Edison 50. Gas Release to Southern Califprnia Gas Co ' , � 57. CERTIFICATE OF OCCUPANCY , - No. Date �� Avo�icant to fill In a11 spaces exceot tnose wltnin IlearY eoreer lines ana sign ali aovropriate tleclarations. /.op� 'COSTA MESA CONSTRUCTION PERMIT � � Project Address ��n i�/es r i�sT �rWir� E+ppT'�.2nt's Mailing qddress irI �/j ia/aSTl.ri�./p Gri��_ Owner's Name (��OS %j/� F✓/l �.. ohone . ' Address �2i1 y /il/15 T//✓/�.f /.i�%' ✓�", .9 %1�/ Arqh/En . - 7 'f� 9 License No. Address Contractor's Nam � Phone Addresi (matlingl� City Litense No. ' LICENSED CONTRACTOR DECLARATION � hareby altirm thal I am Ilcensetl untler provislons of Chartor 9(commoncing with section 7000) of Division 3 01 the Business antl Prafessions Cotlo, antl my Iicense is in full forco antl elfect. Licensc Class Llconso No. Da�c Si9nalure 'ORKERS' COMPENSATION DECLARATION ��Ereby aHirm that I have a ce�Uficata of consent to SClbinsu/e or a cartlflCate �� Workers' CompanwUon Insurance, or a certlflotl copy thereof (Soctlon 3800, LaD. C.) . - � Pol��y No. Company 8 Cerlitietl copy Is �oraDy furNsbetl. C¢rtifietl copy i5 filetl with the city Builtling DIvlSion. Da�o qpplicant EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thi55ection neetl nol bu cOmplete0 ii the permil is ior one huntlretl (§100) or �ess�, I cyrti/y that in the performance of th ork for wnlcn tnis o �t Is Issuetl I shall no� employ any pa�son In an�nner so as}e-b�co e subjett [% t{�C WO�keysAf�o�P�nS)tiqq4aWs o1 Ca}rro 1i i�i . ! woru¢rs' Comp¢nsabon p�Ovlsio f the Labo� Cotle, yoh mUsi fortM1with Corryply wit� Such provi5ion5 [hf5 permlt Shall ba tle¢Tetl revoke0. CONSTRUCTION LENDING A ENCV 1 hQreby aHirm that th<re i1 d<Ons[ructiOn IenOing agency (or the performance ot ibe wOrk tOr whic� Ihis permit is Bsuetl (5ectlon 3097 Civ. CJ LHntler's Name �eqtler's Atltlress - ' OWNER BUILDER bECLARATION I hereby affirm that I am exempt from the ContraCtor's License Law for tne foliowin9 reason (Section 7031.5 Busine5s antl Professional Cotla: Any city or coUnty w�icn requirez a permlt to construct, al[e�, Improve, tlem0lisb o� �epaii any structure, prior to Its issuan<e, also requires the applicant tor such permit auegea exemption. Any violatlon ot a pe�Tit Subjects the applicant to ' fal I, az owner of the prooerty or my employees with wa9es as thair sole . compensation, will tlo [he work, antl t0e structura is no[ intentled or oHeretl for �le (Section ]044, Busineis antl Pmfessional Cotle: The Contrattor's LiCense Law tloes not apply to an owoer ot a prope�ty wno builtls or Improve5 tb@�eon, antl who tloe5 SUCh wo�k himzelf/he�Selt O� through hiz or M1e� own emplOyees, provitletl tnat sUctt improvemenls are n0t In[entletl o� ofte�etl fOr saie. 11, however, the bulltling or ImO�ovement Is soltl within one year of'com- P�Otlon, the owner will havf tne burtlen of p�oving he/she tlitl n0[ builtl or IT- prpye for tne purpose of sale). ❑ I, as own¢r of Ihe prop¢rty, am exclu5ively Conl�acting wit0 licensed con- ba��ors to construct the prqect ($ecGon ]004, Buslne5f dntl Proteszlon5 COtle: Th0 ConVactor'S License lsw dOes not apply to an ownet of property wh0 bu�ltls or Improvas tncroon, antl wno contracts lor such projects with a<on- tra«or(51 Ilcense pu�sUanl to tne ConV qror's Liconso Law) I am aware that p/po1 0( Ibeir WOrker'S GOmpensaHo hsurance shoultl be /p{,6"vltletl [o me. ❑ I am oxempt untler�tlon g, F„�,'or [his roasop� / ��—�� / Dale /�� >"'�--+ _...._. A ---� _ ___ �� __ TYPE OFCONSTRUCTION LINEW LI.ADD LIALTERATION InJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OT R N�,,G . DESCRIPTION OF WORK/USE OF BLDG..��l�{ TVPE OF PERMIT LJ GRaoIrvG ❑ TENANT ❑ ELECTRICAI ❑ OTHER PROJECT DESCRIPTION Sp.F7.1 1FOUNDATION /�'STRUCTURAL PLUMBING ❑ MECHANICAL . CONSTRUCTION TYPE VALUATION 5� 20NE GRADINGCU.VDS. ACR Remarks: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks - Gas Service Outlets Interceptors - Kitchen Si�k Lavatories P—Trap , Roof Drains . Reinspection Fee � 515 Boiler Duct - Under Ground � Dutt - Struttural D�ct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # � Heating System & Ducting .00-700,000 BTU 0100,000BT ay�nn �a:umyry w�en au c�ry ana tounry ora�nantoi anq state law relating to bullAl g con5trucNon, antl heraby authorize repre• sen�atives o �is dty t nt upon Ibe abovo-mantionetl pro0orry fo� insbectlon o sas. Slgna[ure Oa[e�o �y-� Diimrs' ense or SS�qF — Rainspection Fee $15 CMF 0865-46, /ev. ]0/84 WhitO - BUiltlinq; �yndry - Appliwnt; Pink - ACCounting; Goltlenrotl - ASsesSor Showers Service Sink Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa Urinal Wacer Closet Water Heater Water Service Auto-Wash Isue Fee Hood or Typel � Canopy Type II ❑ FEES Refrigeration System ❑aioo,000eru ❑ioo,000sru System Repair/Alteration Fire Dampers Registers ' � Issue Fee ' $ 3 A.P. # S Main 8uildin9: T Front 8 Rear A C Right g Left Ping. Ref, iW Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher Dryers ❑Gas �Elec Fan F.A.U. Fiztures - - Device Boxes Outlets Switches Garbage Disposal Generetor Oa5 KW C Fee 2126 I�/14/85 Zone . I Parking Heq.�Provided ELECTRICAL � Transtormer ❑ 15�50 KW - � 50+KW SKW $75 Meter lJup to 100 amps Merer ❑over 100 amps . Sub Panel Motors �0.7 HP �1 h� 8 Inc. Solar 09-15 HP �1&15+ Microwave - - Pole Light Range Sign ; Standing Sections Trash Compactor Izsue Fee DEVELOPMENT SERVICES HEUUIREMENTS: Zoning Approved By Building Approved By �� 15e:.0 TL FEES 0 $ 3 SUMI�AAY�Qf FEES � S � BUILDING PERMIT $ �b �� SMIP $ PLAN CHECK $ PERMIT . PLUM8ING $ ISSUANCE � $ PLAN CHECK 25% $ � ENERGV P.C. $ ELECTRICAL $ . GRADING $, PLAN CHECK 50% $ MICROFILM $� � � MECHANICAL $ TOTAL FEE $ S+S P�AN CHECK' 25% $ � Z O N 1 N G R E U M T S I� GONSTRUCTION AND PLANNING P� & SPA It Date Inspector qppROVALS Permit # Date Inspector APf�ROVALS Permit # . ', 1. Temporary Electrical Service or Pole . 52. Pool & Equipment Location � � 2. Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement ' • � 3. Electrical Conduit Utility�Undrgrnd. ' 54. Forms � "� � 4. Electrical ConduirUndrgrnd. 55. Electrical Bonding � 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test . 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE �• � 7. Footings 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O 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. SolarSystem-Final .- -i6. Rough Electric Wiring 67. Fencing & Access Approval .. 97. �Rough Wiring Sign � 68. APPROVED FOR PLASTERING ' � 18. �Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducts, in Structure 70. Underground Hydro • 22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil ' 23. Gas Pipe-Rough & Test . 72. Underground Flush � - � 24. Roof Framing 73. Undergmd.StorageTank OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structurat) & 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 � � . � . � 39. Water Service-Final 40. Gas Service-Final � . 41. Solar pomesticFinal , 42. Backflow Preventer � ' ' 43. Backflow Irrigation � ` � ' 44. Landscape Irrigation System � ' ' 45. Sound Attenuation 46. Handicap Regulations � . . ' . 47. FINALSTRUCTURE&BUILDING , � � .. - 48. Special Requirements Completed� � , 49. Electric Re�ease to Edison � ' � 50. Gas Release to Southern California Gas Co , 51. CERTIFICATE OF OCCUPANCY � No. �� . Date � � � - �