HomeMy WebLinkAbout885 18TH ST - Building Permits/'' ��(� ��L2. / . _;i`c �'G
' �O �. ��T� ST ^ov�ica�t m rui ii'bll Oaeef eNeQyt t�ose wl��in heavy Eorder Ilnes anC sign all approprlate GeUantlons. .
CITYUF,COSTA MESA -� PERMIT NO. TRACT NO. LOT NO. BLD . .
, CONwTRUCTIONPERMI t�' �—/4pq(o LOT `70 CUeS/Cv(1i l��' ' 42�1 7/17/n�_ �r-,
ProiectAd�4gss TVPEOFCONSTRUCTION r7Ew noo ALTERATION REPHIR
AppliCant'SNlailinBAddf¢S5� � � '/ - N/� � ❑ CONVERSION ❑ DE OLISH THER q,p, q�, (,, /O � Zone � -
� ' ^,7�31 ' aOD DESCRIPTION OF WORK � � - �� ^
Owner's Name ���1.� one /�,� � , .� S Main Building: Accessory Building: Z
Address�%�S%/ /11fk r�.' ue. /uJ �/0 /�f '— . - E O
/ TVPEOFPENMIT GRADiNG FOUND iorl 57RUCTVRAL T Fron[�3I� m, CU•{S ry
ArChlEng. Litense NOr�'�5�� [o. ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL B Rear O� � �
Addreu � ❑ �oTHER A N
Contractor's Nam m hone PRQIECT DESCRIPTION �5/q/.�Fr. oCCUPA,N`c�C g�, K Right �/ ��,�p��p�,�. G
AJdresslmailing) GONSTRUCTIONTVPE/y0�� VALUATIONST5��60 S �ef� D E
. 20NE GRADING CU. VDS. ACRES ping. Ref. q� � � � Perk.Fees $ _� �
Ciry License No.
LICENSED CONTRACTOR DECLARATION Remarks: � �j� � p� � �� S� g' Parking Req./Provided � U
I h¢r¢by a(firm [hat I am Iicensetl untler provisions o! Chart¢r 9(coTT¢ncing R
with sectlon ]000) o/ Dlvision 3 of the Business antl Protessions Cotle, antl 9 _ S Use of Building: �_��, � E
my Ilcense is In full force ana effecL �
License Clazs License No. PLUMBING FEES Planning Notes: M
E
oate Slgnature , . . Bar Sink Showers M Il (1 S F. AL R�OUTAEr1.?NS9
.N
N•'�RKERS' COMPENSATION DECLARATION .T
eby affirm tnat I have a certificate of consent to sel(-insure or a<ertificate gackflow Prevenier Service Sink -' -
lorkers' Compensatlon Insurance, or a cerilfietl copY thareol (Sectlon � " S
3000, Lab. CJ • Backflow Irrigation $ewer Cap � �- . ELECTRICAL " FEES
Policy No. Company � "
Bathtubs Sewer Connec[ion
e Certlfietl copy Is hereby turNshetl. _- � �' AutOmatic WaSher TransfOrmer ❑ 15-50 KW
Certifletl copy Is filetl with Ihe city Builtling Division.
❑ 50+KW .
Date Appllcant Clarifiers $plar Callettors Construction Pole Sub.
EXEMPTION FROM WORKERS'•COMVENSATION DECLARATION DiShuYdShef SOlef Piping ' -i Cooking Unit Meter ❑up to 1008mpi
(Th15 soc[lon neetl not be compleletl if the pafm is tor one huntlretl (E300) or
less). � Orinkin Fountains , �
I certlfy t at in ne rtormance ot the wor r. Ich this perm� .is issuea, I 9 Solar Tank ' Dishwasher Meter ❑over 100 amps
shall not mplo DerzOn in any man r beco bjeCt t0 lh¢ -
Work a n Laws ot Calltorni . ' Floor Dr2in5 Swimmin Pool w�S a�
Date Signature 9 P Dryers ❑Gas ❑Electric Sub Panel
NOTICE: t,ia(t m king this Ceclaratlon, ShoulC become subject to lhe Floor Sinks U�inal Fan � �. MOtOrs 00�1 HP �1Ya- B '
Workeri' Componsallon provisions of the La or Code, you must forthwith , -
comply wi[h zuc� provisions or this Oermit , shall be GeemeO ruvoketl. Gas S¢rvicE . Oullet5 We[er Closet � F.A.U. . • . �'- ' IncSOla� �9-15 HP �16-75+ �-�
CONSTRUCTION LENDING AGENCV
I h¢roby at(IrT Ihal tbefe IS a<Onstfuctlon lentling agBncy 1of Ihe p0rforTdntO Int¢fC¢ptOfS WB[¢I H¢BLCf ;.} Fi%tUf25, � .
� Microwave
Of the wOrk ior whiclt thls p¢rmit is issuetl (SaCtion 3097 Civ. CJ � '
.V O.v )s—
Londer's Name � Kitchen Sink Water Service � Device Boxes �� -' Pole Light
Lentler's Aeaross Lavatories � -
OWNER BUILDER DECLARATION ' � - ' OUll2t5, Range �
1 hereby afflrm lhal 1 am oxnmpt Irom the�Contractor's Liconsa �aw for the p_Tra ' � ' '
following reason (Sectlon 7031.5 Buziness antl Professlonal Cotla: Any Nty or P " ' � SwitChes � �� � gi9�
counry which roquiros a permit to construct, alter, improve, tlemolish or rapair � , .
any structuro, prior lo its issuance, also requlres the appllcant for suth parmil ' ROOf D�ains ' ' Garbage:Dispo521 � _ Standing Set[iOns
to /ilo a 5ignatl StatOment thal h0/Sh¢ I5 Ilcensetl Oursuant to the prOvlSiOns o7
, tlte Contractor's LICenSe Law (enaoter 9(tommencing witn Section 7000) of • Generolor OO-5 KW �5�15 KW
C �on 3 of Ihe Buslna55 dntl Protas5lons COUu) o� Ihal ho/ihe IS axempt � T�25h COmpeGtO�
t �om antl the basis for tha allogetl exemptlon. Any vlolatlon of.5oction .. , � ,,.
7 5 by dny applicanl tOr a permit suDjects tna applicant to a clvll ReinSpection Fee $25 IssuB FeB ' $ 3 "
�enalty o/ not mora lhan five huntlrotl tlollars (E500j. � ,
lJ 1, as owner o/ the property or my employeez with wages as tnair sole i ReinspeCtion Fee ` §� Issue Fee S 3
compensation will ao the work, anE the structure Is not InlenEetl or offerntl MECHANICAL FEES '
tor salo (Sec�lon 7044, Business antl a.ofozsional Gotle: Tna Contractor's - PUBLICSERVICESR�O�IIHEJYI NTS:
LlcenSB Lew tloBS nOt apply l0 an ownaf ot a pfop8fty Who bu11Cs o1 ITprOMs BOiI¢f HOOd Ol TypQ 1 ❑
ther¢on, anU wno Eaet SUGh work himsalf/h¢r581f Or through h15 or her own ���� �'
em0loy eas, provitlotl that sucn improvoments are not intentlea or o/fare0 for Canopy Type I I ❑ 2oning ApOroved By__b��:s._� ate �
sale. I/, nowover, [he bulltlin9 or Improvement Iz soltl within one yoar of com- Duct - Undei Ground 9uild�nB Approved By �" ' DatO —
pl tlon, the owner wlll navo [he burtlen of proving ha/sna tlitl not bulltl or Im- - .. , .
ve tor tno purpose o/ sale). Duct - Structural Refrigeretion System _ Appliption Issued By ate '%—�%=��
as owner of lha property, am exUuSiveiy contracting with Ilcansetl con- ❑p�100,000 BTU ❑100,000 BTU � �4
rat O/5 to co05trutt t�e pro�act 1Saclion 7044, eustnass antl Professlons Coae: Dutt - Ventilating � `S� ��' -$UMMARY OF FEES
he Contractar'S Uconse Law doez not apply ta an owner of pro0erly who , .
p antl w contracts tor such ro Exhaust System ❑ Multiple ❑ System Repair/Alteration �.BUILDING PERMIT "$C ���� S � SMIP ��S
Uuiltls or im roves tnareon, P lects wlth a con• ' ,� $
tracmr(s) �Itensa O�rsuant to the C t ctor•s Ucense Law). 'PLAN.CHECK,' �.$ �- PERMIT
❑ I am eze pt na r Sactlon � P. . or t Is r ason Firepl/Fect. Bit. ICBO # ;�PLUMBING � $� ' ISSUANCE $
oate ! Owner " Heatin95ystem&Ducting .' P�P,N�CNECK 25% $-� ENERGVP.C. $
1 hereb <ertM tnat I hava reae this appliwtion ana state tnat tne abova ❑6100,OOOBTU�700.0008T %• ' $•
Informafion rrecL I a9rea to como�Y wlth all tlty ana county qrtlinances � :ELECTRICAL � GRADING $
antl state law dting lo bulltlin9 constructlo antl heroby auth Izo repr - � i , , pLAN CHECK 50°6„$..�' MICROFILM �$
sentatives o/ i ty to enter up the v enHonetl per y f r , .. ..
Inspectlon D sa � U Date � � `MECHANICAC� . : $• % TOTAL FEE $ ���' ('�
Slgnatura , Reinspection Fee� $25 �swe Fee - -$ 3 PLAN CHECK 25% $ . �
Drivers' Licen or �#
CMF 0865�46 rev. 32/83 White - Builtling; Canary - APOlicant; Pink - Atcounting; Goltlenrotl - Assessor -
,-CONSTRUCTION AND-PLANNING � � POOL R SPA - : . _ _
Date - Inspector � - �Date ' Inspector _
. •�APPROVALS Permit# APPROVALS- Pe. _.# _ . _ -
,,�1; Temporary Electrical Serviceor Pole - 52. Pool & Equipment Location - - . . . �� .
� 2;� So�l pipe-Undrgrnd. 53. Steel Reinforcement � - - � ''- _ �
3. Electrical Conduit Utility-Undrgrnd. 54. Foims . � �
"4.- Electrical Conduit-Undrgmd. _ 55: Electrical Bonding � � �
5'. Steel Reinforcement , 56.. Rough Plumbing & Pressure Test = ' . -
� i �
- 6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE . ' -
� 7i. Footings � 58. Electrical Conduit-Undrgrnd. - '
; 8�. Foundation �� � �y �/c� �59. Gas Pipe, O Undrgmd., Test � ' � -
I9� Water Pipe-Undrgmd. �� 60. Backwash Lines,�P-Trap, O Undrgrnd. � ��
� 10'. Structural Floor System 61. APPROVAL TO-0ECK _ .
11: Proper[y Sewer Line & House Connection 62. Backwash & Receptor-Final �
�. 12; Sewer Cap . 63. Heater & Vent-Final ' �
i - -�
13i' Roof Drains 64. Plumbing SYstem - Final ' , �
�
14. Rough Plumbing � 65. Electrical-Final - ' � � _
75. Rough Electrical-Conduit � ; 66. Solar System-Final � - ' " - " -
' 1.6. Rough Electric Wiring � . ' 67. Fencing & Access App�oyal. ' - �� - -' ' -
i
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING � �-
. 18. Rough Electrical _T Bar Ceiling 69. POOUSPA SYSTEMS FINAL • �_
19.,Rough Heating & Air Conditioning - FIRE DEPT. REQUIREMENT� - �'- -
r. '
20. Rough Factory Fireplace � � APPROVALS Permit�# � , '
21. Ducts, in Structure 70. Underground Hydro ' �
22. Ducts, Ventilating 71 . Product Piping O Gas _ 0 Oil � , � � q.
23. Gas Pipe-Rough & Test 72. � Underground Flush � ��
24. Roof Framing ` - . 73. Undergrnd.StorageTank OGas ��Oil•-, •
25. Roof Sheathing / 3 � � 74. Overhead Hydro � � � ' . '
� 26. T-Bar Ceiling (Structural) & Monocoat 75.� Dry Chemical , ' � .
i
27. Frame and Flashing � � �L 76. Dry Standpipe , ��
28. Lathing & Siding � 77. FIXED SYSTEM FINAL ' �
�29. �Insulation 78. FIRE PREV. FINAL � '
30. Drywall Nailing � / /O � , . HEALTH DEPT. REQUIREMENT ; '
31. Plaster Brown Coat � 79. FINAL INSPECTION .'
32. Electrical Power Meter-Finaf 80. FOOD CERTIFICATE ISSUED '�
33. Final Electric Notes: �// � J'��%.6'vC]'� LJ/ql�-S !�S �fr
34. Final Heating & Aii Conditioning ��js"]' C��i/ '-�' �
35. Final Gas Pipe-Test .! � �c.� ,oK �%C1 ��Q�Zh.(O� -
36. Hood or CanoPY . I . L/ �j� ���� �,� �� .. r
37. Final Factory Fireplace � � L (, � � � �,n.p� � �Q �
38. FinalPlumbing � ,Zg � �N4c..('ii,[L£�4-, rU�f E�O
39. Wa4er Service-Final , � ' d�6 �'L £CT m.+2 ��`�1/�'Jl �.$�i � af� �C�
40. GasService-Final � � 'I'a � SJh. �y�(`��� %!St
41. Solar pomesticFinal � �,��� . � �� 85- -
42. Backflow Preventer � , � '
43. Backflow Irrigation � � '
44. Landscape Irrigation System � - ' �
45. Sound Attenuation � � - ' 4
46. Handicap Regula[ions � � � � ' - '
47. FINALSTRUCTURE&BUILDING �� � (�L '
49. Special Requirements Completed � � ''
49. Electric Release to Edison
i
50. Gas Release to Southern California Gas Co ' '
' ' 51. CERTIFICATEOF OCCUPANCY O � �/` � _ - . �
No.` � Date � � �(p �I Y . � . . _ �- - �
• City of Costa MEsa
Development Services Department
Building Safety Div�sion
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No. ��G1s�.��
The Building located at �5 hTEst 19th StL�Et
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group �z Occupancy.
Use of Building ���� StDTdcJE
Legal
Building Permit No
Mechanical Permit No.
424-061-01
B14096
(Sea reverse side for Metes and Bounds)
lectrical Permit No.E15863�E15969 p�umbing Permit No. P�778�p16669
Number ot apartments Q and/or guest rooms �
ISSUED70: BuildingOfficial �� � '
Mo�xovia Av2nue Pam,przh;l `�- / /t �--
by �V , ( �I 0� i.lAA� V
4141 MacA,z'thur Blvd. #101, Newport Beadi, CA '
oace l % /,��A,n i � l � �i�
This Cenificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed exeept by the
Building Official of the City of Corta Mesa under Sec. 307 (e) U.B.C.
CMF 3015-46 rev. 1/83 Whi[e - Owner; Canary - Numerical File; Pink - Bldg. Permit File
�
Apolieant to fill in all soaces exeeot those wit�in �eavv Gortler lines antl si9n all aOP�opriata GeClarations.
_�.
CIrY OF cOSTa MESA CONSTRUCTION PERMIT
Project Address � S �� • � Q+�h 5'f �tdZ _� -
Applicant's Mailing qddreu �
Owner's Name Phone - �� 8,
Addrew i 7� q�-� o K Y�elc—s• '�Q��
Arch/Eng. License No.
Address (� �� �
Contractor's Nam.��:�[_.[pC�s� ��' Phone $�.Z�v�
Addreu (mailing) gyo� Oo� �v�...e �A1 � c�_ �
Ciry License No. .—,3 3 G` �/
LICENSED CONTRqCTOR DECLARATION
I bereby aftirm that � am licensed un0er provisions ot Cbarter 9(commencin9
with section ]000) of Division 3 of the Business antl Professions Cotle, antl
my Iicense is in fun force antl efiect. ' �2 u� O f
License Class � Licensa IVo.
Dale �0- I I- X �� Signature
WORKERS' COMPENSATION DECLARATION � ' �
I he�eby af�i�m lhat � have a cerliflcate o/ consent to self-Insure,oi a Ce�tificate
of Workers' Gompepyytion Insurance, or a certitietl copy thereot (Section
3800, lab. CJ '� --
Polity No. -� ' Company �
8 C¢rtifietl copy is hereby lurniSh¢tl. .
Certifletl coOY �z �iletl with the city Builtling Divizion.
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thi55¢ction ne¢tl nqt be tompleletl it Ine permit is for one huntlr¢0 (E100) or
lessl. .• . . �
I c¢r[ify that in, tlte p¢r(ormance Of the work tOr which thi5 Oe�m�t is Issuetl, I
shall not emploY any person in any manneS so as to be<omu subjett to the
Wo�ke�5' Compensation LawS of CalifOrniy/ /� � � � p �
Date I n - /'�- �iOS�_Si9nature �t-� � �L1C%S.L�o..�X9a�—
NOTICE: If, aft¢r m8king this tleclardtlon, you shoultl become subj¢Cf to the
Workers' Compenwfion'provislons ot the Labor Cotle,-you must forthwith
comply -with' such provisions or this Oermlt snall be-tleemetl revoketl. '
CONSTRUCTION LENDING AGENCV
I h¢reoy at(irm tnat there is a'construction lentlin9 agency for Ihe performance
of [he work for which this permit iz issuetl (Settion 3097 Civ. CJ
Lentler's Name �
Lenae�'S Atltlress
OWNER BUILDER DECLARATION ' �
I horeby affirm [hat I am exempt irom the Gontractor's Licenie Law for tM1e
followin9 reason (5¢ction 7031.5 Business antl Professional Cotla: Any city or
county which requires a permit to construct, alter, improve, tlemolisn or repalr
any 5[ructure, prlo� to ifs issuance, also requires the applicant 10r SUCh pe�mit
to fi�e a slgnetl sta[Qment tnat he/sbe iz licensetl pursuant to the provisions of
lhe Contractor's License Law (Chapter 9(commencing with Section 7000) of
DiviSion 3 of the �usiness antl Professions Cotle) or Ihat he/she is exempt
therefrom antl the basis tor tha allegetl exemption. Any violatiomof Secfion
7031.5 by any applican[ for d Oermit SUGjectS' the ap0lican["[o d civil
�endlty of not more than five huntlretl t1011ars ($500j. '
I, a5 owner ot �he property�o� my employ¢¢5 with wd9¢5 as thei� sole
compensation, will tlo the work, antl the structure is noe intentletl or of(eretl
for sale (Section,7044, Busine55 antl Profeszional Cotle: The Con[ractor's
LlcenS¢ Law tloes npt apply l0 un owne� ot a proparty who builtl5 Or improves
therGOn, antl who tlaes such wo�k himsel(/herself Or through hiz o� her own
employ¢ez, provitletl that Suth ImprOvements are not Inlentletl or 071eretl tor
Sale. I�, however, t�¢ builaing Gr Imp�ovement is soltl within on0 year o( com-
pletlon, th¢ owner wiil have tho burtlen of provinq he/sM1e ditl not builtl or im-
�ove for [he,purpose of sale).
I, as ownet of the p�operty, am exclusively contracting wltlt licensetl Con-
tractors to construct the Oroject ($CCIIOII 7044, B�siness antl Pro/esslons Cotle:
The Contra<tor's �icense Law does nof apply to an owner of property who
builtls or Imowves tnereon, antl wno contracts for such projects with a mn-
t�act0/(5 Ocense PUrsuant to the ConVaCtor'S License Law). I dm aware that
proot o� their Worker's Compensalion insurance zhoultl be provitletl to me.
❑ I am exempt unq¢r $ection B. & P. C. �or this reason
Date
I hereby certity fhat I
iniormation is corrsct.
antl State IawS rela�ing
5<ntativa5 ot this c'���}}}y
Inspection purpas�
Si9nature n
Drivers' License or $5 q
CMF OB65-46, rev. 4/B4
Owner
Inls applicatiOn dntl stat¢ that the above
�mply with all city antl coun[y ortllnances
con5truction, and hereby authorize re0re-
Date le��-) S�.'� 7
' C�7? v I I I _
�E OF CONSTRUCTION NEW ADD ALTERATION REOAI R
� CONVERSION ❑ DEMOLISH ❑ OTHER
DESCRIPTION OF WORK/USE OF BLDG.
TVPE OF PERMIT LJ GRADING L'JFOUNDATION LJ STRUCTURAL
❑ TENANT ❑ ELECTRICAL v}PLVMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION 5Q. FT. oCCUaANCv_
CONSTRUCTION TVPE VALUATION $
ZONE GRADINGCU.VDS. ACRES_
Remarks: r� 4�r.,
�.
Sink
Preventer
Irrigation
Dishwasher
Drinking Fountains
Floor Drains '
Floor Sinks ' .
GasService Outlets
Interceptars �
Kirchen Sink
Lavatories
P-Trap
Roof Drains .
Reinspection.Fee ' I $15
Boiler
Duct - Under Ground
Duct - Structural �
Duct - Ventilating
Ezhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO #
Heating SVstem & Ducting
❑ a� oo,000 eTu O i oo,000
Reinspection Fee � $15
White - Builtling; Canary - qpplicant; Pink - Accounting; Goltlen�otl - AssesSor
Showers
Service Sink
Sewer Cap
Sewer Cannection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Goset �
-Water Heater
Water Service
Issue Fee
Hood or Typel ❑
Canopy Typell ❑
Refiigeration System
❑o=ioo,000eTu ❑ioo,000eTu
System Repair/Alteration
Isue Fee
A.P. #
S Main Buildi
E
T Front
B Rear
A
C Right
SLeft
Ping. Ref. #
Planning Notes:
FEES
� Automatic Washer
Construciior Pole Si
� Cooking Unit �
Dishwasher
Dryers: �Gas ❑EI
Fan
F.A.U.
� Fixtures" - ' �
� Device Boxes
Outlets
� Switches
Gaibage Dispoul
Generator 00.5 KW
�� 1
$ 3 � Reinspectian Fee.
0224 10/15/84 23.00 iL
Zone
Accessory Building:
Z
O
N
1
N
G
R
Parking Req./Provided E
Q
M
S.
i
ELECTRICAL
7ransformer � 75-SOKW �
❑ 50+KW
5KW
$15
Meter LJup m 100amps
Meter ❑over100amps
Sub Panel ' �
Motors OO-1 HP � 1'/, - 6
Inc.Solar 09-15 HP �16-15+
Microwave - " '
Pole Light
Range
Sign
' Standing Sections
Trash Compactor �
FEES luue Fee
DEVELOPMENT SERVICES REDUIREMENTS:
� ZoninB APProved By
Builtling Appraved By —�
, Appliration Issued By ( !'���
0
$ 3
FEES
$ 3
SOMMARV OF FEES
BUILDING PERMIT $ SMIP $
— � PLAN CHECK � $ PERMIT
PLUMBING $ ���� ��UANCE $
* PLAN CHECK 25% $ �•�� ENERGV P.C. $
ELECTRICAL $ GRADING $
� PLANCHECK 50% $ MICROFILM $
MECHANICAL $ TOTALFEE $ 23'C�Q
PLAN CHECK 25% $
. CONSTRUCTION AND PLANNING POOL & SPA
-;� APPROVALS Permit #� Date Inspector AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool'& Equipment Location
• 2. Soil Pipe-Undrgrnd. � �� f�fy l� �53. Steel Reinforcement � �
3. Electrical Conduit�Utility-Undrgmd. � 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-Undrgmd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. . 60. Backwash Lines, P-Trap, � Undrgrnd.
i 10. Structural Floor System 61. APPROVAL TO DECK •
11. Property Sewer Line & House Connecf ��f � 62. Backwash & ReceptorFinal_ �
12. Sewer Cap „' 63. Heater & Vent-Final
. 13. Roof Drains � • ( �� 64. Plumbing System - Final� � . �
14. Rough.Plumbing ' . ' 65. Electrical-Final • • �
I 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 ' APPROVAIS Permit#
21. Ducts, in Structure ' � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush � �
24. Roof Framing � ,r , � � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80.. FOOD CERTIFICATE ISSUED
33. Final Electric • Notes:� �b �� �ruf(�,Ay�D W14�7'F!L 3EQVtGZ O�
34. Final-Heating & Air Conditioning ., IK DiTC� RutyKt��f� �ASTTO W�T E��nO ON
35. Final Gas Pipe-Test ��lcr( RiJV1A, C.EJ - 1'"7) gf CohTirw�EO
36. Hood or Canopy �
37. Final Factory Fireplace . _
38. Final Plumbing ' z � (,f/,�'f .
39. Water Service-Final • ' '
40. Gas Service-Final �
41. Solar pomestic-Final •
42. Backflow Preventer '
43. Backflow.lrrigation , . . '
44. .Landscape Irrigation System
45. Sound Attenuation ' '
46. Handicap Regulations �
47. FINALSTRUCTURE&BUILDING '
48. Special Requirements Completed � '
49. Electric Release to Edison ' -•
50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY . � '
� No. Date
`\,
�
ADo���ant to fill in all spaces exceo� those witnin heavY OorEer lines ana si9n a11 aDVropriate aeclarations.
Ci7v-oFCOS7aMEsn_CONSTRUCTION PERMIT r`"""�'�"" bG� ��`'� "" """�`" "'"" ""
Project Address ��l � w � �A � vS� :�° .ti� ti:/: ' ,
',f.;: ;:; J., ^ ' i ,�VPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR A P#
Applicant's Mailing Address, • ✓;+ �•7-�-�' ✓ � �„� c /= ] n... /� ' '
� . •. :� H ie'. i �< Phone '� G I -!'� S;i � CONVERSION ❑ OEMOLISH ❑ OTHER ' .
Owner's Name T, .J' DESCRIPTION OF'WORK/USE OF BLDG.'
Address �I`{`%G �C�/��i!��FC:c G���'�. _ � i 5 MainBuilding:
' E
Arch/Eng. � - License No. ' TYPE OF CERMIT � GRnoI�vG FOUNDATION STRUCTURa� T Front
' ' ❑ TENANT �O ELECTRICAL -❑ PLUMBING ❑ MEGHANICAL 6 Reaf
Address - - � � - • , '
� �'_A:�:G� �'{'ii��C_�4 ' Ph ei.'.2'CS"y ' ❑�OTHER . . � . . . � A 9
Contracmr'sNama i � C Ri h[ ;
�•• - r ! PROJECT DESCRIPTION SQ.FT: OCCUPANCV K
Address Imailingl7��ri j � � �'-'^ ✓ !.� �°j'n �� � S Left .+
'CONSTRUCTION TYPE VALUATION $
City License NO. ,",.�� ��' �` � - ZONE � GRADWG CU. VOS. . ACRES
LICENSED CONTRACTOR DECLARATION Ping. R¢f. #
I hereby at(irm tnat I am licensetl untler provislons of.Charter 9(commencing Remarks: . �� Planning Notes:
with 5ection ]000) of DiviSion 3 of the Bu5ine55 antl Prote55ions Cotle, antl . , , -
my ucense is in tW1 �orce ana eHect. ' G' '� G ' � ' ^ ' �
Licen CI s ��-�? � �—(� � kenze rvo. .��.Ui
Date � �� '�—'�(1�J5'g �t � �'�-%'Y� ^TSjo' a PLUMBING FEES
WORKERS' COMPENSATION �ECLARATION ' ' ' BarSink � ' � Showers . , .
I hereby affirm that I M1ave a certificale of conient [o s¢If-iniure o� a ce�Uficat¢
oi Workers' Compensation Insurance, or a cortifietl, cooY thereof (Section - Backflow'Preventer - - ServiceSink� � ' - ' � � '-
3800, Lab.�CJ ' ' ' � AutOmaticWeSh¢r
Policy No. ' - ' Company � ' � Backflow Irrigation . , Sewer Cap ConSVuctiOn Pole I
eCertifietl copy is hereby turni5hetl. � ' �
Cettifietl Copy I5 filetl with Ihe city Builtling Dlvizlon. B2thtUbS ' S¢wE� COnn¢ctiOn Cooking Unit �
Date Applicant ' i
EXEMPTION FROM WORKERS' COMPENSATION DECLARATION Clarifief5 SOlar Collectors Di5hwa5her °
(Thi55ection neetl not be compl¢tetl if tne permi[ 15 for one huntlretl (5300) or � - •
less). . Dishwasher ; $olar Pipin9 Dryers ❑Gas �I
I certity Ihat in the perto�manGe of Ine wo�k for�which this pe�mR is issuetl I . . - . �-
shall not employ any person in Sny manner s'as tp�eco e�subject to t�e Dfinking Fountains • Solar Tank Fan � �
Worker �Ompe�nsation'ldwSotCalibmia.�' ( �.� r' r . .
. Date j/�—�� ,�.'��i.--��'' Si9nawre �- ��J '��'✓� •n� Floor Drains i Swimmin9 Pool w/Spa� � F.A.U.
'NOTICE: If, after makin9 tnis tleclaration, you shoultl become subject to the
Workers' Compensation provisionz of.tlte.Labor Cotle, you must tor[hwith FloorSinks ' - Urinal - � ' - Fixtures - -
comply with such O�oviSions o� Ihis permit shall Ce tleemetl r¢voketl. .
CONSTRUCT.ION LENDING AGENCV'' � GaSService � �OutlEts � WaterCloset' � � DeviCeBOxei
I hereby aftirm that Ihere is a const�uction lentling agency to� the perto�mance
Of the 'work tor whicn this permlt is . issuetl (Section 309Z Civ. C.) Int¢rCeptOrS Wdtef Hedt¢/ � '.2 Outl¢[5
Lentl'eYs'� Name _ , ' , '
Lentler's�Atltlresz _ Kitchen Sink � Water Service ' Switches
OWNER BUILDEN DECLARATION - � '
�' 4208 12/18G84
'. Zone '
Accessory Building:
Parkin9 Req./Provided
I
ELECTRICAL �, �
I hereby afflrm that I am exempt irom the Cont�actor'S License Law /o� the Lavatones . ' . Auto�Wash . � Garbage Disposal
following reason (Section 7031.5 Businass anC Professlonal Cotle: Any clty or � ' . .
county which requires a permit to conztrucq alter, improve, tlemolish or repair P-Trap � Laundry Trays � Generator �0-5 KW 05-15 KW
any structure, prio� to it5 issuance, also �equires tM1e applicant to� such pe�mit ' _
lo file a-signetl stalement thaChe/zhe (5 IiG¢n5e0 OurSuant to Ihe prOvisions o( ROOf D�3in5 � �
the Contmctor's License Law (Cnao�er 9(commencin9 witn Section 7000) of
Division 3' ot the, Business antl Pwfessions Cotle) or that he/she ii exempt � . � . - �
th¢rel�om antl the basis for the alle9etl exemplion. Any violation of Section � ,
7031.5 by any ap0���ant for a' Permll subjects [he applican[-to a civil ��
��dlty of not more than five huntl�etl tlollars (ESoo). , $ 3 �
}[he� m�eily o� my employe¢5 with wa9e5 a5 Ihel� sole ReinSpectlOn.F¢e' $15, 14Ue Fee �
� Transformer ❑ 15-50 KW '
� i O SO+KW
� Meter ❑up ro 100 amps '
� Meter ❑over 100 amps � _
� Sub Panel .
Motors �41 HP �1 h- 8
Inc. Solar� �9-15 HP � 16-15+
Pole Light
Sign
; Stariding Sections '
Trash Compac[or
i 1_ az owner o^ p p 4��N rna cr.��cru.e is nnt intentlea or ofteretl Reinspection Fee $15 Issue Fee S 3
aw aoes noi app�y io an u
antl whdtloes Such work
�s. orovi�ed tha[ such imp
U I, as owne� of the property, a
t�aCtorS t0 const�uci the project (!
The Contractor's License Law tl�
bulltls or imp/oves thereon, antl
Iractor(s) license puisuant to the
proof o1 [heir Worker'z Compen
� I am exempt un0er Section—
Oate Owner
I hereDy certity that I have reai
IMormation is mrrect. I a9ree to
ana ztate laws relating.to builain
zentatives of this city ent
IfISDeC��0f1 pUlp05¢5.
I `�AS
elf/herself or throu9b his or her own
ients are mt intentlea or ofieretl for
ement is.soltl within one year of com-
01 oroving he/she tlitl not builtl or Im-
�slvely contra<ting with licensotl don-
7044, Business antl Protessions Cotle:
appty to an owner oi property who
mlracts tor such p�olecls wlth a Con-
ctoi'S License Law). I dm aware that
inzurance shoultl be provitletl to me.
B. & P. C. to� thi5 rea5an
J
Date t -i ��'�� �
Boiler '
Duct- Under Ground
Duct - Ventilating �
Ezhaust System ❑ Multi
FirepVFact. Blt. ICBO �
Heating System & Ducting
❑0.100,OOO�BTU �100,C
1 5 gnature ' I I
� �" ��`'�•+� Reinspection Fee
� �rivers' License or 55 �
CMF 0865-46, rev. SO/84 White - Builtling; Canary - Appiicant; aink - Accounting; Goltlenrotl - Assessor
J
$15
Hood or Type l � ��
Canopy Typell ❑
Refrigeration System
❑0-t00,0006TU ❑10(
System Repair/Alteratio
Fire Dampers �
Regizters
Issue Fea
.i
FEES
DEVELOPMENTSERVICESREQUIREMENTS: ' � �
� � Zoning Approved By Date �
' euilding Approved By ' ' Date '
Application Issued By ��� � Dat -I L
SUMMARV OF FEES � � .
BUILDING PERMIT $ SMIP � $ '
PLAN CHECK $ PERMIT � �
PLUMBING $ _'S�O ISSUANCE $ �
' PLAN CHECK 25% S . SO ENERGV P.C. �$
�� ELECTRICAL $ GRADING $ �
. PLAN CHECK 50% $ � MICROFILM $
� � MECHANICAL $ TOTALFEE $ •S• SC)
$ 3 PLAN CHECK 25% $ �
. . . . , :. -v .- .,. . _ . . . � � .
CONSTRUCTION AND PIANNING POOL h �PA
.
kPPROVALS Permit # Date * Inspector APpROVALS Permit # Date Insper.t�r
, �L ..
' 7. Temporary Electrical Service or Pole 52. Pool & Equipment Location
I��2. Soil Pipe-Undrgrnd. .. , 53. Steel Reinforcement
' 3. Electrical Condui[ Utility-Undrgmd: �. � " 54. Forms ' �
I �4. Electrical ConduibUndrgmd. , � 55. Electrical Bonding '
I� 5. Steel Reinforcement � - - . 56. Rough Plumbing & Pressure Test �
6. ElectricAl UFER Grnd�. � 57. APPROVAL TO.COVER-GUNITE �
' 7. Footings ��. 58. Electrical Conduit�Undrgrnd.
I 8. Foundation � ' 59. Gas Pipe, O Undrgrnd., Test� �
9. Water Pipe�Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgrnd.
' 10. Structural Floor System . 67. APPROVAL TO DECK �
i
I�11.: Prope}ty Sewer Line & House Connection 62. Backwash & Receptor-Final
.12. Sewer Cap � 63. Heater & Vent-Final
� 13. RooYDrains � 64. Plumbing System - Final
14. Rough Plumbing _ ' • 65. Electrical-Final ' -
� -15. Rough Electrical-Conduit- � 66. Solar System-Final
i6. Rough Electric Wiring 67. Fencing &�Access Approval ' �
� 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING � '
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL - �
19. Rough Heafing & Air Conditioning � , FIRE DEPT. REQUIREMENT � -
20. Rough Factory Fireplace, ' APPROVALS Permit #
21. 'Duc[s, in Structure , • 70. Underground Hydro
22. Ducts; Ventilating „ 71. Product Piping O Gas ❑ Oil '
23. Gas Pipe-Rough & Test 72. Underground Flush �
24. Roof Framing � 73 � Undergrnd. Storage Tank O Gas ❑ Oil �
25. Roof Sheathing , 74. Overhead Hydro
26. .T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe .
28. �Lathing & Siding 77. FIXED SYSTEM FINAL
. 29. Insulation �. � 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
� 31. Plaster Brown Coat � 79. FINAL INSPECTION �
�
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
� 33. Final Electric � Notes: � ,
34. Final Heating & Air.Conditioning . _
35. Final Gas'Pipe-Test .
36. Hood or Canopy � - , ,
37. Final Factory Fireplace � i ' �
38. Final Plumbing . � (,�jilJ � �
39. Water Service-Final . �
40. Gas Service-Final . ;
41. Solar pomestic-Final _ � _ ,
42. Backflow Preventer � � � ' ' .
43. Backflow Irrigation � . � ' �
44. .Landscape Irriqation System .
45. Sound Attenuation, , � . � . ' ' � ' �
46. Handicap Regulations . . �
47. FINAL• STRUCTURE & BUILDING � � - . ,
48. Special Requirements Completed � � - � � � . '
49. Electric Release 4o Edison , - - - - -- - . ,
50. Gas Relea'se to Southem California Gas Co � ' , �. � . .
57. CERTIF,ICATEOF.00CUPANCY � _. ' � _. . �_ . '
_ '. � , .
Nn. ' Date , . _
`"1 - � - - - - '
Aoo���ant to fill in a11 soaces aicep�those•witnin neavy Gortler Iinas antl sign ali aooro6r+ate.aeClaratlons.
- CITY OF COSTAM A CON S7RUCTION PERMIT -
' PiojectAddress 8�� W• iBth Street, Costa�Tiesa
(, ApplicanYsMailin �Address — �, aS ' 'inger�____ :l�
Owner'sName -�onrovia Ave., _ar . phone 9
Address --- - �
Arch/Eng. License No.
Aildress
Contractor'sNameJ�,.C' Electric.IriC. �pho�e 43-5044
Address(mailingli-L4`F• F'+8S't Edin�er,_ Santa Ana
City License No. �J 33
LICENSED CONTRACTOR DECLARATION � �
I h¢reby a(fi�m that 1 am Ilcensetl unUe� p�ovi510ns of Cna�l¢r 9(Commencin9
with section ]000) oi Dl�islon 3 of the Business an0 Professions Cotle, antl
my Iicense is in tun force dntl effect.„ _ n �[y q KO� t�
Date tv/ J�� "�Signature �
'ORKERS' COMPENSA710N D RAT ON .
hereDy affirm tba01 havg a certit a of consent to self-Insure a certiflcate
of Workers' Compensation Insura ce„or a certlfletl copy thareo( (Sectlon
3800, Lab.J[G9JC 629192840 � Aetna Casualty
Policy No.�� Comoany
�Certitietl copy is hereby turnishetl.
c`llti f3°y��+iea w�rn rne ��cr eJ+�aL � otL'"1.°@etTic InC ;
ata Appllcant �
-EXEMPTION FROM WORKERS' COMPENSATION DECIqRAT10N .
fThissectian neeG not be Como�etetl if the perml[ is for one huntlretl ($300) or
that in the perfo�mance of tqqqeee���work for which thls
employ any per5on in any(mpnner s�as(�ybGco
qompqpsa({aryEawz of Calit�i�nJa�„ y � �
compry with such� provi5ionz or t$ja' permR snan oe tleemea revokea.
CONSTRUCTION LEN��NG AGENCV y' - �
I h¢reby afflim that thar¢ I5 a construction le�tling agenty fo� the perTormance
��of the wark: for'which .this permit I5 Issuetl.(Section 30B7 Clv. C.)-
Lyntler's Name � , , ,
' Lentler'S Atltlress" ' � __
� OWNEfi BUILUEN UECLARATION ' ' ' �
I hereby a(iirm that 1 arq exempt from [he Cantractor's License Law for the'
following reason'(Sectlo� 7031.5 Business antl Profe55ional Cotle: AnY city or
county which requires a permit.to construct, alter, improve, tlamolish or reDair
• any structure; prior to It5 Izsuanw, also r¢qWreS the aOG�icant (or Such permit
' to fll¢ a si9n2tl sta[ement that he/she Is IlcenS¢tl pur5uant to th8 Provi5iOn5 of'
thcrotrom antl tne bas�s for tne allegea exempimn.�r�ny vio�ao�n � x�uon
]031.5 by-any applicant for a permit sub)ects..[ne applicant �ro a civii
„�enalty o( not more than five huntlretl tlollars ($500).
LJ I, as �owner of�tha'property or my employees with wages as their sole
compensation; will tlo the work, antl the siructure is not IntenOatl or oiferetl
� for sale (Section 7044, Business anC Professional COEe:.Tha Contra<tor's
License 12w tloes not apply to an owner ot a Orooerty who builtls or improves
[heteon, antl wno �oe5 such work hims¢If/her5¢I( o� thrOugh hI5 0� her own
' employe¢s, provi0etl [hat such Improvement5 are �not Intentletl o� offe�etl fo�
sale. It, nowever, the bu�itling or improvement Is soltl wlthin one year'oi com-
ple[IOn, the owner wlll tlave the bu�tl¢n of prOving h¢/She tlitl nOt builtl o� Im-
. p�Ova for the purposa Of sal¢). .
❑ I, az owner ot the property, am exclusively contracting with Ilcensetl con-
�[�actOrs to conSt�uCt the.prole<t (Section 7044, Business antl' Profes5ions Cotle:
� The Contractor's Licens¢ �aw does not apply to an owner ot property who
�builtls or iTproves lhereon, antl who contraGts tor su<h pro)ec[5 with a con-
t�ac[or(sl license pursuaryt�to�the ContraGtoi's Litense Law). 1 am awdre that
o�oot of their worker•s Compensation Insurance shoultl be provltletl to me.
❑ I am exempt untler SRction B. & P: C. for [his reason
• Date Owner
�I hereby certifY tbaf 1 have reatl fhis appliwtlon antl state tha[ the above
intormation Is correct. I�a9re to comply with all city antl county orGinances
`Signahre
� Drlvers'
`
CMF 0865- E
TVPE OF CONSTRUCTION LJ NEW LJ ADD LJ ALTERATION IJ REPAIR
❑ CONVERSION ❑ �EMOLISH ❑ OTHER
. DESCRIPTIONOFWORK/USEOFB�DG. '
TVPEOFPERMIT LJGRADING LJFOUNDATION LJ'STRVCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTfON 54. FT. oCCciPANCv
CONSTRVCTION TVPE VAWATION $
ZONE GRADING CU. VDS. ACRES
Remarks: ��.7� ^ �A.� y � ,
Preyenter
Irrigation
er ,
Fountains
Floor Drains
FloorSinks � - �
�i25 $ENIC2 � �U[IEtS
In[erceptors � . r:
Kitchen Sink �
Lavatories ' , -
P-Trap
Roof Drains •
i
ReinSpeMion Fae � $15
Boiler' � - '
Duct- Under Ground'
Duct-Structurel - �
Duct- Ventilating � . � .
Exhaust System ❑ Multiple ❑
Firepl/Fact. Bit. ICBO #
Heating System & Ducting
�P700,000 BTU �O 100,000 BT'
relating lo b�I mg constructlo , antl hereby authonze repre- ,
bis tlt1 [o er upon•�tTl¢' bove-mentionetl /property for
oses. ` Date/D��'� � '
55 � - .. � Reinspection Fee
10/84 Whit¢ - Builtling; Candry - Applicdnt; Pink - Accounting; Goltlenrod - A558550r
Showers
ServiteSink' -
Sewer Cap� '
Sewer Connection ,
Solar Collectors
Solar Piping '
Solar Tank ,
Swimming Pool w/Spa
Urinal
Water Closet ' � �
Water Heater � �
Water Service - � �
Auto-Wash ' .
Laundry Trays �
..
Issue Fae
1ANICAL
�Hood or ' Type I ❑ �
.CanoPY TYPeII•❑ .
Refrigeration System � ' '
OO-t00,0006TU ❑700,000,BT1
System fiepair/Alteration '
� Fire Dampers ; �
Registers •
, i �
I � !
i
, , laue Fee ' •
A.P. �p •
S Main Buildi
E ,
T Front '
e Rear
A
C Right
K �ett
S
Ping. Ref. #
Planning Notes:
1172 10/3�/e4
� Accessory Building:
Parking Req./Provided
o5eQ� TL
2one ,
ELECTRICAL � � .
Automatic Washei �� Transformer � 15-50 KW
ConstructionPoleSub. . � ❑ 50+KW
Cooking Unit Meter �up to 100 amps
Dishwasheb Meter ❑over.100 amps _ _
Dryers ❑Gas,DElectric SubPanel I �
Fan � ' MotorsO67 HP�1:4-8 '
F.A.U. � InaSolar �9�15 HP �1645+
' FixNres ' " " Microwave
,Device Boxes Pole Light -
Outlets � Fange � .
� ' Switches -
$ign
� �' �Garbage Disposal � '3 ; Standing Sections ,
�''Generator �0.5 KW �5-15 KW Trash Compactor .
$ 3'
FEES
$ 3
_ 'ReinspeMion Fee $15 Issue Fee
DEVELOPMENT SEfiVICES REQUIREMENTS:
� 2onin8 APProved By , �
� Building Approved By �
Aootication Issued Bv �'�� ' .
$ 3
e
2
O
N
1
N
c
R
E
Q
M
T
S
- � � , � SUMMARV OF FEES .
� � BUILDING P.ERMIT $ SMIP � $
P�P.N CHECK �$ ' PERMIT
' PLUMBING ,S � ISSUANCE '$ , 1 .
� PLAN CHECK 25% j$ } • ' ENERGV P.C. $ �
� ELECTRICAL • '$ ICo O GRADING� �$ �
� PLANCHECK 50% �$ MICROFILM $ � �
� ; MECHANICAL $ ' , TOTAL FEE i$ JC1�
� � PLAN CHECK 25% $ � • � � �
� CONSTRUCTION AND PLANNING �' � POU� & SPA .
� ' Date. Ins ector 'APPROVALS Permit#
'APFROVALS Perm�t # ,� P Date Inspector
� 1. Temporary Electrical Service or Pole - '._, - �52. Pool & Equipment Loca[ion ,.
2. Soil P,ipe-Undrgrnd. � -�j ��,, '� 53. Steel Reinforcement . �`
3�-ElectricalConduitUr�lity-Undrgrnd: �� �i - � 54. Forms _,'
4. Electrical Conduif-l{ndrgmd. .! �, . 55. Electrical Bonding � '
5.�Steel�Reinforcement � 56. Rough Plumbing &.Pressure Test •�i
6� Electrical UFER'Gmd" � • J.� �`� , •57. APPROVAL TO COVER-GUNITE :`
� 7.�Footings •i� .' i,_ � , '- � - 58.. Electrical Conduit-Undrgmd. •
�
�� 8C�Foundation ,i .�. � ' 59. Gas Pipe, O Undrgrnd., Test - �'
9:.: Water, Pipe-Undrgrnd-' G' - •� 60. Backwash Lines, P-Trap, � Undrgrnd. �
tO.�Structural Floor Sys`�Cm '_ � y � ' 61. APPROVAL TO DECK
11:= Property Sewer line�& House Connection" ;; .y •� �- 62. Backwash & Receptor-Final �
.� �
12:`: SeWe"r Cap � .^ ' � ;? " �- ' 63. Heater & Vent-Final
t. i - O
13.'Roo �Drains ;•� � � _. . '--�- �.;
y 64. Plumbing System - Final
14:;RQugh Plumbing� � " � "' 65. Electrical-Final - �
15 Rough Electrical-Conduit 66. Solar System-Final � �
16. Rough Electric Wiring ��' i �� �
wAL� �;2 �' �(� 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � G. 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 � 7J. Product Piping �Gas ❑Oil
23. Gas Pipe-Rough & Test _ 72. Underground Flush
24. Roof Framing • 73. Undergrnd. Storage Tank � Gas O Oil
25. Roof Sheathing� • 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat '� 75. Dry Chemical ' .
27. Frame and Flashing. � � 76. Dry Standpipe �
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION �
32. Electrical Power Meter-Final ��q 80. FOOD CERTIFICATE ISSUED
33. Final Electric �� ()., Notes: �/ �
Y,
34. Final�Heating & AirTConditioning � ' 1' G � �� '��y'�'a � ��
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 -- � .
i
42. Backflow Preventer _' � , ''�''f � � � '
43. Backflow Irrigation - � �
44. Landscape Irrigation SYstem -
45. Sound� Attenuation � �
46. Handicap Regulations � � �
47. FINAL STRUCTURE & Bl11LDING
48. Special Requirements Completed
� •
49. Electric Release to Edison �� ', " : �
50. Gas Release to Southem California Gas Co • , ' ' �
51. CERTIFICATE OF OCCUPANCY � - ^ -• �
No. � Date ' . _ ` , .
Applicant to fill in all spaees exce0< <�osa wit�in heavy GorEer Ilnas an0 sign all approDriate Geelarations.
CITY OF COSTA MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO. .
ProjectAddress 895 W• 18th Street, Costa Diesa
Applicant'sMuilingAddreu 1514—F�East E in�er S.A.
Owner'sName Tionrovia .�iVB. Part. phone8 3— 9 9
Addreu
Arch/Eng. License No.
Addreu -
Contractor'sName J.r+. Electric,I11C•phOne�43_5041!
nddresslmai�i�y��.5!114—F East Edin�er Ave. Santa
Ciry License No, p���38�
LICENSED CONTRACTOR DECLARATION
1 neraby aftirm that I am ticensetl untlar provislons o/ Charter 9(commencing
with zection 7000) of Divislon 3 of tne Business an rofessloni Cotle, antl
my license Is In fu forc antl etfec �
LicenieClj� �ib ens o. 4 �
Date � Si9nature
' WORKERS' COMPENSATION D RA ION
hereby aifirm that 1 have a cerli it e of c nsent to seif-Ins or a certi/icate
t WOrkers' CompenSaliOn Insu ca, Or a rtl etl wpy t re f($e
saoo. ub.,f�9JC 6291928�pp,P,,,v
PolicY No.��.
S�yl Certifietl copy IS her¢by tumisneA.
tJ Certifi cy p Is flletl wlth the city Bulltling Dlvlsion.
� oate 1�1 h�$S qppp��( J r. Fl Prtri r_ Tnr _
EXEMPTION FROM WORKERS' COMPENSATION OECLARATION '
(This section neetl nOl b¢ cOmple[etl if th¢ Oermit is tOr One untlrBtl (5300) or
Iess).
I cCrtity [hat in thC perfOrmance ot the. rk /0� whJch N s Grm�l Is ISSuetl,
.shall not employ any person' in any m n er so as t bec e sub�ect to t e
Dateers'+Fofr+o�59hVP �?59naturelfo I
/1 /OJ
'NOTICE: I(, after makinq this tleclarat ou 51 oultl ac me s ect to lhe
Workers' COmp¢nSatlOn provislons o lhe ldbor Cotle, you m forlhwilh
'complY �+�th such provlsloni or t s p rmit ihall � be tleemetl_ �evoketl.
�CONSTRUCTION LENDING AGEN -+` ' ' •
:1 nereby affirm that tbere is a wnstruttion tentlin9 agoncy for tne pe�/ormance
of [h¢ work for which -tni5 .Oermit is Iszuetl (Sectlon 3087 Clv.- CJ
tanEer's Name -
Lantler's Aatlrost
. OWNER BUILDER DECLA0.ATIOfJ � -
I he�¢by aHl�m that I am BxGmpl 7�oT NO Conl�attOr'S'LICOnse Lnw t0� the
following reason^(Section 7031.5 Businoss antl Proiessional Cotle: Any cily or
..,.�....., ntrn .a ��i.�c a nn•mlt tn censtrucl. alter. Imnrove. tlomolish or repalr
rom antl the bazls�tOr the alle
i Dy any applican[ tor a p�
y ot not more [han five buntlre
as ownor of'lha'�proporW or
r — /' o� Q � � � .
TYPEOFCONSTRUCTION NEW ADD ALTERATION REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTMER Ap .�y
DESCRIPTION OF WORK/USE OF BLDG.
S Main BuilJing:
TVPEOFPERMIT GRA�wG FOUNDATION �STRUCTVRAL T Front
❑ TENANT O ELECTRICAL ❑ PCUMBING ❑ MECHANICAL B ReD�
❑ OTHER A
� RWECT DESCRIPTION 5q. F7. oCCUPArvCv K Right
CONSTRUCTIONTVPE VALUATION§ 'S L2f1
ZONE ' GRADING CU.YDS. � ACRES Ping. Ref. #
Remarks: Planning Notes:
Sink
Preventer
I rrigation
ing Fountains
Drains
Sinks - ,
Ki[chen Sink
Lavatories �
P-Trap - � i �
� Roof Drains '
as Iheir Sole ,I I Reinspettion Fee
1 License I.aw tloes not appty to an owner o� a property wno ouuas or improves
i tnereon, anC who tloes.such�work nimself/horself or tnrou9h his or hnr own
, employ ee5, provitletl that suGh ImOrOvnments aro nol Int¢ntletl O/ oIIBrCtl for
� snle. It, nowever, thu bulltling or improvument ii soltl wilhin one yoar ot com-
' pletlon, tho ownor wlll havo [he burtlen of proving he/sho tlIG not builtl or Im-
�rova for tne purpose oPsale).
LJ I, as owne'r of tne proPerty, am oxclusively tontra�tlng with Iiconsetl con-
�[ractors to construct [he project (Sectlon �044, Businoss antl Profasslons Cotle:
� The Con[ractor's L'I<ense Law doe5 n0l apply to dn owne� Of ProPe�ty who
builtls or, ImO�oveS [heraon, antl wh0 contracts lor'such pro�eGls wlth a mn-
' trac[or(51 Ilcense purzuant to t�e Contractor's Licanse Law). I am aware that
proo/ ol lhei� Wotker'S COTpenSallon InSurdnCO ihoWtl ba OrOvitletl t0 me,
: L7 I am exempt unC¢r Section B. 6 P. C. �or this reason
Date Owner
cros
aoove
Boiler
Service Sink
Sewer Cap
Sewer Connection •
Solar Collectors '
Salar Piping
Solar Tank
Swimming Pool w/Spa
Urinal '
Outlets : � Wa;er Closet ' �
� � ' Water_Heater'
- Water Service
' n�m�we:ri
Duct-UnderGround
Duct-Structural ,
Duct- Ventilating .
ExhaustSys[em ❑ MWtiple
Firepl/Fact.8lt. ICBO #
Heating System & Ducting
❑4100,000 BTU 0100,000
Signature // �'�/ _ Oate � '�
Drivers' c�nse or gf - '%? � ' Reinspection Fee $15
CMF 0865-4 r. 10/84 White - BUlltling; Canary - ppllwnt; Pink - Accountin9: Goltlenrotl - A5se55or
� Issue Fee '
iANICAL '
Hood or Typel �� �
Canopy ' Typell � ' �
Refrigeration System , .
Oo-i oo,000 eru_ O i oo,000 ei
.System Repair/Alteration •
Fire Dampers
' Registers ' �
i
I Iswe Fee • '
Auromatic Washer
Construction Pole Sub.
Cook�in9 Uni[ ' �
Dishwasher �
Dryers ❑Gas �Electric
Fan
F.A.U.
�:......_. -- . - �
Device Boxes
Outl¢t5
Switches
Garbage Dlsposol
Generetor �0�5 KW
5660 I/16/35
Zone
Accessory Building:
' Parking Req./Provided
ELECTRICAL �
Transformer ❑ 75-50 KW
❑ $O+KW
Meter �up ro 100 amps'
Meter ❑over100amps.
� SubPanel'
Motors � 0.1 HP � 1 h- 8
' InaSolar �9-15 HP 01615+
Microwave -
Pole Light� � �
� Range � • � �
! Standing Sections
5 KW Trash Compactor
�o;,J TL
FEES
2
O
N
I
N
G
R
E
�
M
T
S
$ 3 , . �
Reinipection Fee $15 Issue Fee , 5 3'
FEES
� DEVELOPMENTSERVICESREQUIREMENTS: ' �
2oning Approved By � Date
Buildin8 APP�oved By Date
Application luued By �/ � Dat�
� SUMMARV OF FEES ' � �
� BUILDING PERMIT �$ SMIP �$ � +
PLAN CHECK $ � PERMIT � .
PLUMBING ,$ ISSUANCE ,S
� PLAN CHECK 25% $ � . ENERGV P.C. �$
� ELECTRICA'L 5 ' � IS t GRADING� 5
PLAN CHECK 509G $ �. / O � MICROFILM 5�
MECHANICAL � �S ; TOTAL FEE $ �-�
$ 3 PL'AN CHECK 25% $ ' �
w �_ -
CbNSTRUCTION AND PLANNING - - POO� a SYA '_
..APPROVALS . Permit # - Date Inspectoi , qppROVALS Permit # Date Inspector
1. Temporary Electric8l Service or Pole '. .� 52. Pool & Equipment Location
2. Soil Pipe-Undryrnd: �. �•� ' �� 53. Steel Reinforcement �
'� 3..Electrical Conduit•lltilitY-Undrgrnd. -�� � 54. Forms - � .
-4: �Elect;ical Conduit-U'n.drgrnd. �- 55. Electrical Bonding � �
5. �Steel;Reinforcement .. . 56. Rough Plumbing & Pressure Test �
6:'ElectricalUFER�Grnd. _ 57. APPROVALTOCOVER-GUNITE
. .:
7.,Footi�gs �+ �; ' 58. Electrical Conduit-Undrgrnd. �
8~Fouridation �'� • 59. Gas Pipe, O Undrgrnd., Test �
.
9:,Wate'r�Pipe�Undrgr,nd�. • C �: • 60. Backwash Lines, P-Trap, O Undrgrnd.
10.�Striuctural Floor System C ' �61. APPROVAL TO DECK
11._ Property Sewer Line,•& House Connection :; : 62. Backwash & Receptor-Final
.�
12:�Se�e� Cap " . 63. Heater & Vent-Final -
13;�Roof_Drains i� � � !, �.i � ' 64. Plumbing SYsrem • Final •
14��fRough Plumbing � � � • 65. Electrical-Final �
15. Rough Electrical-Conduit 66. Solar SYstem-Final �
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 � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace , APPROVAIS Permit #
21. Ducts, in Structure 70. Underground Hydro �
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Fiashing . 76. Dry Standpipe
28. Lathing & Sidinq � � 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 ��1 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. $otar pomestio-Final ,- - • - �
42. Backflow Preventer .
43. Backflow Irrigation �
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations � '
47. FINALSTRUCTURE & BUILDING
48. Special Requirements Completed , ,
49. Electric Release 4o Edison � � � � �
50.,Gas Release to Southern California GasCo
51. CERTIFICATE OF OCCUPANCY � '
No. Date
� ' .
Applicant to fiil in all sDaees exeeD� tnoso wilnin heavy OarOer Iines anG sign a11 approDrlale eeclarations.
CITY OF COSTq MESA CONSTRUCTION PERMIT PERMIT NO. TRACT NO. LOT NO. UNIT NO.
ProjeEt Address � �• y��''�n
Applicant'sMailingAddRress . ,�'j t��N�G�-�r� 4��a��L��G�6
Owner's Name P t�s �C�J j T.2i..<T/cYldhone _L..L./�V7 �
Addreu �16•(' $. �AAT�wIaD/�
Arch/Eng. License No.
Address • � �� ���
Contractor's Name Phone _1Q��' Lr1y
Addresslmailingl � �n}� �% OQ.AAIGE gZ(o(o�
City_License No. %�a� 3 f
LICENSED CON7RACTOR DECLARATION
I hareby,atfirm that 1 am licensetl untler provisions of Charter 9(wmmencin9
with section 7000) of Division 3 of tha Buslnezs antl Profe55ionz Gotl"e1, a/ntl
my Iicense iz in tpll brce antl eifect. �,C� b U y b
License Class � – Licenze No.
Date �n�• (r—_a.;�� Signature
WORKERS' COMPENSATION DECLARATION
I hereby a(tirm tqal 1 nave a certiflcate o1 consent to seli-insure or a certiticate
ot Workers' COmpansation InSurance, Or a certitietl copy thereof (Section
3800, �b.-� t=a cruo,., r
amicy rao. ��`�2Z.S1 �j 1 Company
�rtitietl covY Is hereby turnishe0.
rti(iea copY is filetl with tne city Buil� Division.
Dato ��' �� L� APPlicdnt 4' ����'U � .
EXEMPTION FROM WORKERS' COMPENSATION ECLARATION
(Tnis sec[ion neetl nol b¢ com0leletl i1 the Oermit is�(or One huntlretl (5100) or
Iess). .
� I ce�iity,[hat in ihe p¢rtO�mSnce Of Ihe wO�k fo� which this pe�mit is i55uetl I
shall mt employ any pe�son in any mannlr so as fo becom¢ Subjec[ to t�e .
Workers' Compeq�tion Lawz of Calitornia.
. Date Signature
' NOTICE: If, atteY making this Oectaration, you should become subject to the
Worker5' Gomp¢nsatlon prOvisionl Of [he Labor CoCe, y0u must torthwiN
comply with such provisions or this permit shall bo aeemetl revoketl.
CONSTRUCTION LENDING AGENCV '
1 hereby atflrm tqal thtre is a'conz[rucHon lentling a9ency lor the pertormanca
Of th0 work tor which thii Oermil is Issu¢tl (Sectlon 3097 Civ. CJ
l.Cntler's Name � . . -
Lentler's Atltlress � _. , .
OWNER BUILDER DEGLARIITION ' - '
I hereDy afflrm thal 1 am exempt 7�oT l�e COM�actOr'S Licenie Law (or tbe
tollowing'reason ($¢cBon 7031.5 BuSiness antl' Profe55ional Cotle: A�y city or
counly which rqqU�r85 a p¢rmit [o COnstr4Gl, aller, ITprava, tltmaliih or repair
any sVUGture, pYlar to Il5-iisuanc¢, als0 r¢qWreS the applitanl 1or such parmlt
to �I10 a signetl Elatemenl [hat hc/she IS IlcenS¢tl Oursudnt lo [h0 ProviSions ot
, Iha Contractor's Licenso law (Cnapter 9(commenc(n9 with Section 7000) of
DiviSion 3 ot tho Business antl Profezsions Cotle) or tnat ho/ihe is exempt
therefrom antl the baiis forthe ailo9etl exempcion. AnY violaUon ot Sectlon
7031.5 by any aOGllwnt tor a parmlt SubjeGts thn aDP�����< <o a clvil
,eennlly oi no[ rt�oro than tive huntlretl tlollars (y500).
LJ I, as owner ol the proverty ormy umploveez wlth wa9os as thoi. solo
compensation, Win tlo tne work, ana the structure is nol intentletl or oHerotl
lor sale (Soction 7044, Business antl Protessional Cotlo: Tho Contractor'S
�icanse Law tloes nol apPIY to nn owner ol a property who bulltlz or improvas
Ihe�eOn, antl who dots su<� work �ImS¢It/�eri¢It or IhrOugh his ot he� own
employees, proritletl that such improvaments are not Intentletl or afferetl 1or
sale. It, �owevar, the builtlin9 cr improvnment is zoltl within One yedr Of com-
pletion, the ownm wlll have the burtlen of proving he/sna tlitl mt buiitl or im-
�rove 1or the pur0oso 01 Sale).
I, a5 own¢r Oi Ihe p/operly, aT oztluslvely <ont�acting wlth IicenSltl con-
tractorsto construct the project (Section �044, Busine5s antl Professions Cotlo:
Tho ConVactor's License Ldw do¢s not apply to an owner o� pmperty who
bulltls or impro�es thereon, antl wno contracts for zuch projects with a con-
trdctor(S1licen5p purivan[�to th¢�ContfaCloi's Licanze Ldw). 1 am dware Ihat
prooi of th¢ir Worke�'s COmpensaUon InsuranGe zhoultl Oe OrOvIE¢tl to me.
❑'I am exempl untler $ection B. & P. G. tor this r¢ason
Date Owner
I hereby certity tnat I nave reatl this appliwtion ana stata that the above
iniormation is correct. I agree to comply witn all city ana county ordinances
antl stata laws �elating to builtling tonstructlon, antl heraby au[horize repre-
sen[atives o( this dty to en[er upon the above-mentione0 property for
Inspection pur set. � � �/ �c--�
Si n t re �/ wh :'/T� Date C�'2Z-6
TYPE OF CONSTRUCTION � NEW U ADD LJ ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOL•ISH ❑ OTHER , q,p,.A6
DESCRIPTION OF WORK/USE OF BLDG.
� . S Main Building:
TVPEOFPERMIT�b GRADING ' FOUNDATION STRUCTVRAL � T FIOnt
❑ TENANT Jd.ELECTRICAL ❑ PLUMBING' ❑ MECHANICAL B Reaf
❑ �OTHER � p'
PROJECT OESCRIPTION SO. FT. OCCVPANCY C Right
K Left
CONSTRVCTIONTVPE VAIUATION$ $ '
ZONE GRADING CU. VDS. 'ACRES p�ng. Ref. #
Remarks: �r „� � n��_.,, � ti, /� , - Planning Noies:
Sink
Irrigation
Drinking Foun�ains
Floor Drains '
Floor Sinks �
Gas Service Outlets
Interceptors. ' �
Kitchen Sink
Lavatories �
P–Trap
Roof Dreins ��
Roinspection-Fee � $15
Duct� Under Ground
Duct - Strucmrol
Duct-Ventilating �
Exhaust System � Multiple �
Firepl/FacL BIt. IC80 dh
Heating System & Ducting
❑0.100,000 BTU 0100,0008T
9 a u �
Drivers' License or SS ��'� � I I Rainspection Fee I S75
CMF 0865-46, rev. 4/84 White - Builtlin9; Canary - ApOi�wnL Pink - Accounting: Goltlenrotl - Assessor �
Showers
Servite.Sink
Sewer Cap
Sewer Connectian
Solar Collecmrs .
Solar Pipin9
Solar Tank •
Swimming Pool w/Spa
Urinal
Water Clout
Water Heater
Water Service
Issue Fae
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
❑0.100,OOOBTU d100,000
System Repair/Alterotion
Issue Fee
FEES
0
Automatic Washer __
Constructior Pole Sub.
Cooking Unit '
Dryers IJGas
Fan
F.A.U.
Fixtures '
Device Boxes
Outlets
Switches
Garbage Dis
Generato� �C
lectric
0737 10/2:'/64
Zone
Accessory Building:
i Parking Req./Provided
ELECTHICAL ,
Transformer ❑ 15-SO KW
❑ 50+ KW
KW U5-15 KW
Meter ❑up to 100amps
Meter ❑over100amps
Suh Panel
Motors �0.1 HP 01 :4 - 8
Inc.Solar'�9-15 HP 016-15+
Microwave
Pole Light
Range
Sign
Slandin9 Seciions
Trash Compactor
tl.� ��
FEES
Z
O
N
I
N
G
R
E
�
M
T
S.
$ 3 � -
le. Reinspection Fee $15 luue Fee $ 3
FEES
DEVELOPMENT SERVICES REOUIREMENTS:
Zoning Approved By Date
Building Approved By Date
Application luued By Dat�
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK 3 PERMIT
PLUMBING S �SSUANCE $
PtAN CHECK 25% $ ENERGV P.C. 3
- EIECTRICAI $ F�G�i GRADING 5
PLAN CHECK 50% $ MICPOFILM $ p �,�
MECHANICAL $ TOTALFEE 5 �
S 3 PLAN CHECK 25% $
CCJNSTRUCTION AND PLANNING POOL _ �PA
APPROVALS Permit # Date Inspector • AppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. . 53. Steel Reinforcement
3. Elec[rical Conduit Utility�Undrgmd,l 54. Forms '
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
3
5. Steel Reinforcement � � ' S6. Rough Plumbing & Pressure Test :
6. Electrical UFER Gmd: 57. APPROVAL TO COVER�GUNITE •
7. Footings � 58. Electrical Conduit-Undrgrnd. �
8. Foundation _ ' 59. Gas Pipe, O Undrgrnd., Test ,
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd. ,
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 Wirin9 � � 67.' Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18.. Rough Electrical-T.Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace ' APPROVALS Permit #
21. Ducts, in Struc[ure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
23.� Gas Pipe-Rough & Test � . 72. Underground Flush .
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing , 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation ' ' 78. FIRE PREV. FINAL
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric � Notes; �� - 1
34. Final Heating & Air Conditioning w� u� .� / � i
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 i .
43. Backflow Irrigation . .
44. .Landscape Irrigation System
45. Sound Attenuation . •
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY . �
No. � Date
City of Costa Mesa
Building Safety DepaMment
P. O. Box 317
Costo Mem, California
CERTIFICATE OF OCCUPANCY N� 1743 C
The Building located at � y� W,�'ST � u T� S%�
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicabl= thereto
for a Group � 2 Occupancy. -
Use of Buildina � � �� u% ��l/�fJ �/9 C_Ti/.LA1� �k" /�
Legal Description /'�n �t. �G v i y o� NPT A/IiGA %.0 /l l� /Vo. jf G- i �.V 'O
(See raver�e iide for Mete� and Bounds)
� f
Building Permit No. � K�� �� Elecfrical Permif No. ' Plumbing Permif No—� � � 2
Floor Load Signs have been installed as Room Capacity Signs havo been instaled as
required under Sec. 2308 U. B. C. . requ�red under Sec. 3301 (1) U. B. C. —
17050. CERTIFICATE OF OCCUPANCY. (a) No apartment house, hotel, or lodging house shall be used or occ�pied
until the owner or operafor has been issued a valid certificate of occupancy by the enforcemenf agency.
(b) A new cerfifitate of occupancy shall be obfained whenever there is a change in:
1) Occupancy classification of a building or portion thereof
2) The number of aparTmenfs or guest rooms
3) Ownership
If Group H Occupancy, number of apartments and/or guesf rooms as required under $ec. 17050.1 (d), California
Administrative Code, Tifle 8, Chapter 9, Article 8.
Number of apariments— and/or guest rooms
ISSUED TO: Building Official //�
� ti' � S- a L � 9�c I!' �t I u,C I�, by i C�•,,.w._ ; i� o-V�r� �
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This Certificate of Occupancy SHALL BE posted in a conspicuous place on fhe premises and SHALL NOT BE removed
excepT by fhe Buitding Official of the City of Cosfa Mesa under Sec. 306 (e) U.B.C. Fo,,,, sv�—�M—ii-ea—s-s r
I 39445
COSTA MESA BUIIDING-SAFETV DEPARTMENT
P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626
For Applicant to Fill in Completely
PA17
��C 77-7�t��;—�; 0� i 785" _`* `*10.50
TION FOR BUILDItdG PERMIT
sui�oiN� gifs (.lJi / g �T `
ADDRESS jj
OWNER ,( � U f`. A.P. NO. `lp
MAII r`� ,' 1 BUILDING �gC �
AODRESS �J lI�/� �— p ADDRESS �
d U CIT � s �j' � NOL �+T�v� �RACT��C
~ Z CANSTRUCTION W A
O N LENDEP
am
J � BRANCH
JN OWNEfl C
� w ADDPESS
ARCWTECT TEL. �L
' OR ENGINEEfi N
V Q FIFE
w � ADDRE55 ZaNE T
a w APPROVED
w Z CONTRACTOR � BY
J Q
m Z
J ¢ ADDflE55
w W TEL. Z N NO.OF �
z� CITV NO. P�� �
wO STATE CITV VARDSAPPROVED
y� LIC. NO. LIC. NO. MAIN BUILDING
�� SIZE NO.OF BL ^. (FROM C/L STREET)
OF LOT NOW ON LOT pOM FT.
USE OF
EXISTING BLDG. g
� SIZE OF NO. OF
Z NEW BLDG. ROOMS STORIES L SIDE
�! COVEEROINGAL� COV�ERING REAR FT.
J USE OF BUILDING AND WORK TO BE PERFORMED OISTANCE BET.
a MAIN BLDGS.
VAR. �
� a s G �.�.P. #
� � / APPROVEDu �
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Z
O
U1 heraby ecknOwlatlOe that { have reed this epp�icatlo� antl s<ete
� tha[ tM1e above InformaHon ic corract antl eprea to comply wlth
� all lews repuleting builtlinp consttuetion, antl 1 shell not amploy
� any person In violaSion of the workmen's compansation laws oi
;y tha State ot Californie.
z1 hereb4 certify that I em properly Iicensetl as e eantrector untler SQ. FT.
the State o� California Businass antl Protess(ons Cotle, Divisicn 3, THE AMOUNT SHO�
Chapie� 9, and that s�ch licensas ere in full force entl effect, or I THE PURPpSE OF ES
am ex¢mpt from the provisions of the Steta of CalNornla Business VALUATION
entl Prolaszions Cptle, D visfon 3, Ch ptar . �
SIB�atura �/ � �
Permltte S /�
Auffioitzatl Apant
BLOCK
VALUE
J
USE OF NEW ` C7�
BUILDING 1��
VAROSAPPRpVED
BET. MAIN &
�'�--27----
STr ATE \
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VALVATION IS fOR �
A PERMIT FEE ONLV: m �
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,,._,J.CDST'A�MESA^BUI��DING-5aFETY�DEPARTMENT�b 8y �L�d,�� � MA 4 'n�� )j,���, �,�
'. P.O. BO%91] C08TA MHBA� CA{.IFORNIA
INNiV�E DrPT. "' �
� r.irv nF r.r�ern �rFce -
For Applican� to Fill In Completely APPLICATION FOR PERMIT
TYPE OR PRINT '� ' FOf OffiCBDU58 Only
au��oiNa 8 9�� "�d ��
AOORESS �
.. PHGEIM NO. ' P P�fI�T Q.
COSTA MESA, CALIFORNIA o S
4 N(C VBDBY DA=EPQC81;6D� �iA�J,19=11EO�
OWNER N �� (7 Y �� K
MAIL �' z D 3 d • �h�/ �f�{�� BUILDIN6 � � / � �
ADORE59 ry'T ���� ADDRE59 •'
CITY ���+ d� ��+ / NO. F+ (JI �ONE TYPB � V�OUP � �
ARCHITECT � TEL . /J �a APPROVEO ,
ORENGINEER •� NO L BY DATB \
ZONING �� • y�
AC i9 �D `
zo e no. or uee op new
� ' �+ nune auuwno
CONTR CI'OR r J � \
` P'3 o��w�.,�o� o s
ADDRESS T�
(i— ��v0— � ` •
w�...Y,Nrr A. P. NO. I�
qTY ILN/o vw \
NOiE: NO EAVE OVERHANG BHALL BE LESS HAN• `
6TATE �� �j -_ TEL. 90' TO SIDE 8 REAR P. L. --
LIC. NO. /--NO. �
EAVES
SIZE � I rvo. oR eLDoe. ALLOWED ( U. B. C. REQUIREMENT)
OF LOT� NOW ON LAi
YAROSAPPROVED YARDSAPPROVED
USEOF MAINBUILDINO ACCESSORYBUILDIN6
EXISTING BLDO.�
( FROM C/L SfREET ) �]
aeTaACK urve PxoM GO / REAR YAR Z� FRONT 3 U FT � ��� Ff v
CENTER OR eTRE6T J
SIDE YARD LEFT Y Z, I RIaHT O' R. SIDE /� FT. � �-
DESCRIPTION OF WORK L.81DE �a �. �� Fr.
7 a o0
NEW _ ALTERATION AODITION REAR (�S'FT. �'�
DISfANCB BEL � BET. MAIN Q
RE MOVIN6 DEMOLI6N MAIN BLDGS. ACCE55. BLDG��
BIIILDIN6'7 /� //�T NO.OP � VAR.SC DATE
SIZE /C ✓ V�+ ROOMH 6TORIEB C.U.P. APPROVED
COVERINGWALL�Q• I CO�ERIN6 LV�`• BPPROVE DATE� �P
USE OF BUILDING AND WORK TO BE P6RFORM�D CI L Q F.MENTS
�� ,Q�
. ✓ �q // . % ��r
0 B-� sc. Fr.
0
� HEREBY ACKNOWLEDOE TXAT I HAVB- D THIB APPLIGTION 8 AMOUNT 9HOWN UNOEH VALU�TION 19 POR TX8 �
AND BTATE THAT TH8 VE IB COqpECT N� AOREE TO COM- PURPO88 OI BBTABLIBNINO A PBRM�T P68 ONLY. 0
PLY W�TH ALL G�T FUI NCBB A BT/�T LAW9 PHaULATINO ypLUAT10N ///���
BOILOINO CON9T GT � /�� � H
SIGNATURE , PERMITFEE $ a, �
, \ - ,1"`�'E /D� � A E� ! �+ �O ¢
\ZED A6ENT $`� 0�� � ri:l uCv a
� TOTALFEE U C/
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" " IUL 28-66 001G06o�****°5.00'
� - ' 25957
' COSTA MESA BUILDINGSAFETV DEPARTMENf
P.O. BOX 1200 � COSTA MESA� CALIFORNIA BMI!
For ApplJcant to FI►1 In Completa�y APPLICATION POR PERMR
TYPE OR PRINT BUILDINi3
e�i�oiHo � . far Offlce Use Only
wooResa �
11�C[IR NO. NCf1M1}
COSTA MESA, CALIFORNIA G7.i��
nusincer -�Je ■ �esueo
' r / -
OWNER I �
MAIL � � � � BUILDINO �
ADURBBf ! ADDREBY
T6L ' PIRB � y �
CITY NO ZON6 TYPH � OROUP
ARCHITECT T6L b'� BY'ROV[D DATH /-��K7
OR ENOINE6R NO. �
� � ZONIN(i • � .
iRESB S ' SON[ NO.O� UY[OIN[W _ e�
C��� J �uru suuoina �S/LU/iNI//I
COMMGTO i , �
y L[oAL
AO R[Y! l ^CC�V D�aCRITON ` O�
CITYCb "tSii A.P.NO. �- � '
NOTQ: NO 6AVH OV[RHANO SHALL B8 LH88 THAN
STATH THL / /� /� 20' TO 81D6 a RQAR P. L.
LIC. NO. N b U '
e�vea
81Z6 � � No.ol�tDaa. ALLOWBD .(U.B.C.RCQUIRHMHNTI
OF LOT Mow N '
YARDBMPROVHD YARDBMPROVHD
USE OP MAIN BVILDINO AGCEYSORY BUILDINO
EXISTIN6 BLDO.
<PROM C/lBTR[[T)
a¢rewerc una �nor ` � �RONT Pi.
ceNnR o� /TR[[i RiAR YA D I
e1DiYARD 1.[PT /J ��' RIOFIT V!. R.61Dt FT.
DESCRIPTION OF WORK �. oi rr. rr.
TtllATl AODITI N RUR PT. F�.
OIHTANC[ O[T. BlT. MAIN Q
RerAIR �ryp gM �g MAIN BLD ACCH88. BLD69.
BUIlDIN6 p� NO.Or VAR.# DATH
812E 6/Oa ROOMB 1 / G. U. P. MPROVHD
E%TCRIOR W / �//-��- IIOOr �b � MP �
COVERINO /��`� � COVHRINO Ci0 i� er OAT! -
UHC OF s LDIIVY AND 1lK TO D6 PB PORMtD d
{y0
`f_ � d
�
BO. Rf. '�
1 HPAmY IICKMOMM1dOO{ TNI1T 1 MAV[ 11HAD TNIO APPLICATON iXl I�YOUlR OXOWM UNOBR VALUATON I8 !OH TH6 j
AHO 9TAT8 TNAT TH6 AlOV6 1� CORR[R�AHD AORe[ TO COY. �YNPGe6 O! [RAOLI9HIN0 A PBRMIT I[6 ONLY, �J�.
PLY WITM ALL CITY OROINANCY AND YTAT{ L11WY R[OYLATINO
BWLO�NOCONDTpOCT10N. VALUATION � �
PERMITT6 e�' PERMIT FE8 LI �� O
�J s ..7�1�� — �
AUTHORI2iD AOQ /' � / , �
TOTAL FEE