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Home My WebLink About921 18TH ST - Building Permits(714) 754-5273 • Fax (714) 754d856 • Wvnv.Cl.COste-me58.ca.us 77 FAIR DFiNE, GOSTA MESA, GA 92626 ELECTRICAL PERMIT Job Address: Suite No Viciniry: Parcel Nunmber: Applicant: Address: Owner: 921 W 18TH ST ROOF MOUNTED SOLAR PANELS 42436115 CARSON,THOMAS 921 W 18TH ST COSTA MESA, CA CARSON. THOMAS TR Address 921 W 1BTH ST COSTA MESA, CA Contrector: OWN ER-BU I LDE R Address: INSTALL SOLAR PANELS ON ROO OUTLET, 1 SWITCH, & 1 NON RES ISSUE FEE Temp service test Res. a/c package New Res (1-2 units) New Res (3+units). Pool I Spa Lighting Fixts Recept Outlets Switches Non Res Appl �'�� ', i Res Appl � �, Service to 200a � Service to 1000a Service over 1000a Motors to 1hp Molors to 10hp Motors to 50hp Motors to 100hp Motors over 100hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits 7emp Pwr Pole Intermed Pole Quantity $23.50 50.00 50.00 50.00 0 $0.00 0 $0.00 0 $0.00 0 81.10 ' 1 $1.70 1 $475� ;�� .J - 5000, �; c0��; ' 80.00�> �0�= �� $0.00, �� 0\ $0.00 , 0 $0.00��. :� 0 so.00 0 so.00 _ . o $0.00 0 $0.00 0 50.00 0 $0.00 0 so.00 0 $0.00 0 $0.00 0 $0.00 0 status: ISSUED Applied: 05/22/2001 Issued: 05/22/2001 ISSUED BY: Phone: (949) 6451334 2ip: 92627 Phone: (949)645-1334 Zip: 92627 Phone: Zip: License: 0 INSTALLI RECEPTACLE " FEE SUMMARY Quantity Temp Dist System / Lighting . $0.00 0 Busway /700 ft� , - 50.00 0 .' Standing Section � 50.00 0 , . � Misc Electriwl Equipment 50.00 �� 0 � � Transformers up to 1 kva/kw $0.00 �. 0 ................up l0 10 kva/kw $0.00' 0 .................up to SO�kvalkw 50.00 ' 0 � .:...............up to 100 kvalkw � 50.00 " 0 , � , ..................over 100 kva/kw „ $0.00 0 , Low Voltage Equipment =: 50.00 =, 0 - Low Volt Wiring System I Cki-' $0.00 'i 0 Misc. Conduit - . - = $0;00 ; ' � � 0 ; � Misc. Conductor � �� ,, ��$0.00- � , 0 � Circus ( gen or ride) � ��$0.00 0, , Cirws (mech ride or lights) � $0.00 , 0 �Christmas Tree Stand s $0.00 0 Fireworks Stand ; --, 50.00 0 ' ' � 'Other Electrical Fee " ' ' . So.00 � Mvestigation Fee - 50.00 � Plan Check Fee 50.00 Reinspection Fee $0.00 TOTAL CALCULATED FEES E30.45 COMMENTS / SPECIAL CONDITIONS / ', � NOTICE: The work authorized by this permit shall comply with all applicable handicap access requiremenis under California statutes and ralated regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void it work is not commenced within 1B0 days, or if work is suspended or abandoned for a period of 180 days. INSPEC710NS: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, end all requlred inspactlons and finel epproval must be obtalnad. Failure to obtain inspections and final approval will result in the expiration of ihis permit. FOR INSPECTIONS CALL: (714) 7545626 zmase �eroo� WOHKERS' COMPENSATION DECLARATION: I �ereDy eHirtn under penely ot perjury one af ihe following tleGeratlons: ❑ I heve end wlll meinteln e`5rtllicate pf consent to self-Insure tw workers' compensetlon, as proWded for by section 3700 0l Iha Labor Cade, tor the pertortnence of the y, work for wNc� thls pertnit is Issuetl. u I �ave end will maintein workers' compensetlon Insurance, as requiretl by sectlon 3700 0l the Lebor Cotle, for the peAortnance ol t�e work tor which lhis permit Lv Issued. My workers' wmpensation Insurance carder end policy number ere: - Cerde� PdlCy Number�-_ _. _ one or Iess.) � I cenity thet in the peAormence oi the work for w�ich Ihis pertnit Is issued, I shall not employ eny peraon In eny manner so as to becwne sub�ect to the woAcers' compensation laws of Celltomia, g� e el II I should become sub�ect to Ihe workers' campenselion proNslons ot Sectlon 3700 af Ihe Lobor Catle, I shall fort�with comply wiU Uese Drovisions. �/ .AppIICeM�SIgnaNre:� Dete: � �(J� O� ' WARNIN(3: FNL � FE TO SECURE WORKE COMPEy AT} 1 COVEMUE IS UNUWFUL uJD SHALL SUBIECT rW EMP�OVER TO CRIMINAL PENALTIES PND CNIL FlNES UP TOONE MUNDRED TiK1U$PNO OOl1ARE (E100,000), IN ADDRipJ TO THE�ST OF CqMPENSATION, DNMGES AS PROVIDED FOR IN SECTION 31080F THE LABOR OOOE, INTEREST, M1D ATTORNEY'S FEES. LICENSED CONTAACTORS DECLARATION: I hereGy aHirtn Ihal I am Iicensed under provisions ot Chapier 9(commencing with Section 7000) of Division 3 ot the Business and Professions Cotle, and my license is in full torce end ettecL LJc. a Class a Cantrectors SlgneNre: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby eNirm t�at t�ere Is e consiruction lendlnp apency lor Ihe peAortnance oi the work tor which this permit is issued. (Sec. 3097, Civil CoOe). Lenders Name: Lendefs Address: SlpnaNre: Date: OWNER-BUILDER DECLAiiATONS: I hereby eMirtn Ihet under penelry ol per�ury Ihet I em EXEMPT FROM 7HE CONTRACTORS LICENSE LAW tor the lollowing reason (Sec. 7031.5, Business entl Professions Cotle: Any ciry or counry w�lch requires e permit to construct, elter, imprwe, tlemWisn, or repair any siructure, pdor to Its issuance, elso requires lhe applicant far such pertnit to Iile e slgnetl stetement that he w ahe is Ilcensetl pureuent to the provisions ol the Conirectors Ucense Lew (Chepter 8(commendng with Sectlon 7000j of DMslan 3 of the Business end Professions Cotle) or t�et �e or s�e Is exempt t�erefrom end the basls tor t�e ellegetl e:emption. Any violation af Sectlon 7031.5 by any applicant far a pertnit sublecis ihe epD��e�� b e Gvil Denalry of not more than tive hundred dallars (5500).): ❑ I, es awner ot Ne property, or my employees wlth wages es I�eir sole compensa0on, WILL DO TME WORK, end the siructure is not imendea or oNeretl for sele (Sec. 7044, Business entl Protessions Catle: The Contractors License Lew does not appty to an owner of properry who builds or improves thereon, and w�o tloes such work himsetl or herself or through his or her awn employees, provi0etl Ihat such improvements are not Intended ar oHeretl for sele. lt, however, the builtling ar improvement is soltl wit�in one year of wmpletion, the ov.ner-builder will hava t�e burtlen of proWng ihat he or sha ditl not build or improve for Duryose of sale.). ❑ I, es owner ot t�e DropeM. em EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS m construct ihe pro�ect (Sec. 7044, Business and Professions COCe: 7he wntrectore Llcense Lew does not aOPh to an owner of properry who Dulltls or Impmves thereon, end wha contracis tor such projed with a conirador(s) Ilcense pursuant to thefjontrectors License Lews.). ❑ lem Owner ID verlfle� dif6� Vediicetlon ol Ownership Business antl Professions Cotle for ihis reason: Date: ❑ Ves ❑ No DnveYs Ucense No. Expires: of daument, I.e. - property tex bill or deed): DIVISION OF INDUS7RIAL SAFETY PERMR CERTIFICAiION: ❑ I hereby certity thet no excavetion Ilve (5) or more feet in Oept� into which e person lv requireA lo descend, will �e made in connectlon with work euthorized by t�is pertnit, anE ihat no bullding siructure, scaHoltling, felsework, or demolillon or dlsmentling thereof, will be more than ihirty-six (36) teat higR (ChaD� 32, Grp 2, Atl 2, Sec. 341, Title 8, Celltomia Administra0ve Code). ❑ As ov.ner-DuilEer, I vrill nol employ enyone to tlo work which woultl require e permlt trom tha DlWsion of Indusirial Salery, as noted above, unless such persan hes e permit to do such work tmm �e tlivision. Signature: Date: Division of InEusirial Salery Pertnit Number: CERTIFlCATE OF COMPLIANCE /WD AIfTHORVA710N OF ENTRV: I ceM1ih/ under penalry ol perjury Ihat I have read t�ls flpplicetion entl siate Ihat the Intortnation given is correct. 1 egree to co ty v.ith el�.stete lews end Ciry orClnences reletinp to buil0ing cOnstruction, end euthorize representetives ol t�e Ciry of Costa Mese ta enter upon tha eDove-described prope� ci ,Qaotb,� oses. I egree not to accupy or ellow occupency ol eny building eu�horized 6y thi ertnit until linel inspection. i��-��- - � /Dl Lgn OfiegelOwner(s).� ° Date AnNOr Authonzed Ap0llcant Data CODE �. �HsrccnonTrve 18�6 Fixed System Firial fire Preventlan 1286 Pool Spa Final 200 Flnel Re-Roof PAIE ��d15 COOE I INSPECTION TYPE 206 Finel Mec�anical 208 Finel Plumbing 210 Final Electrical 201 Final BIxWRetaining Wall 272 Finel Fire Prevention 202 Final Feciory Fire Place 220 Finel Planninp Approvel 203 Finel Sipn 222 Finel Site 20C Final Damolitlon 250 Flnal Bullding/Octupency P� ; - ! 1tlI�4i (714) 754-5273 • Fax (714) 754-4856 • www.ci.costa-mesa.ca.us 77 FAIR ORIVE, COSTA MESA. CA 92626 Job Address: 921 W 18TH ST Suite No Vicinity: Parcel Nunmber: 42436115 Applicant: CARSON, THOMAS TR Address: 921 W 18TH ST COSTA MESA, CA Owner: CARSON, THOMAS TR Address 921 W 18TH ST �- COSTA MESA, CA Contractor: OWNER BUILDER Address: Arch / Eng : Address: ISSUE FEE BackOow irrigation BackFlow Preventer Bathtub Clarifier System � Connect (Ice,Soda,etc) Dental Uni45 � Dishwasher , Drain, Floor D2in, Rainwater Drain. Roof Drinking Fountain Expansion Tank Gas EaMquake Valve PLUMBING PERMIT ISSUED BY: Phone: 949-645-1334 Zip: 92627 Phone: Zip: 92627 Phone: Zip: License: 000000 Phone: Zip: License: SCOPE OF PERMIT ADD GAS SERVICE FOR INDUSTRIAL BUILDING. INSTALL NEW GAS WATER HEATER. FEE SUMMARY AMT QTY AMT $23.50 Laundry Tub / Washer �$0:00 $0.00� 0 Landscape Irrigation $0.00� $0.00 � 0 P-Trap � $0.00 $0.00 ' 0 �' Pressure Regulalor $0.00 50.00 ' 0.,,� ;, Process Piping (per 10 ft) � $0.00 $0.00 . . 0 ��' � Receptors $0.00 $0.00 0 , . Septic Tank $0.00 $0.00 � �0 � - „ � Sewer Cap for Demo $0.00 $0.00 0 � Sewer Connect _ $0.00 $0.00 0 � . � � Sewer Private Line - $0.00 $0.00 �- 0 � . Shower . , $0.00 $0.00 , 0 , . Sink, bar j0.00 $0.00 �0 � Sink, commercial � $0.00 $0.00 0 � Sink, Floor � $0.00 QTY 0 0 0 0 0 0 0 0 0 0 0 0 0 0 Status: ISSUED Applied: 10/04I2002 Issued: 10/04/2002 AMT Sump Pump $0.00 Swimming Pool $0.00 Trap Primer 50.00 Urinal 50.00 Vacuum Brkr Bkflow(1-0) 50.00 Vacuum Brkr Bktlow(5+) 50.00 Wash Basin 50.00 -Wash Basin Set 50.00 Waste and Vent System $0.00 Water Closet (Toilet) $0.00 Water Heater I vent 512.30 Water Piping Qnst or Rep.) 50.00 Water Re-pipe 30.00 Water Service $0.00 QTY 0 0 0 0 0 0 0 0 0 0 1 0 0 0 NOTICE: The work authorized by this permit shall comply with all applicable handicap access requirements under Calilornia statutes and related regulations. (OM. No. 92•28, § 1, 1241•92) EXPIRATION: This permit shall automatically expire and become void if work Is not commenced vnthin 180 days, or it work is suspended or abandoned for a period of 1 BO days. INSPECTIONS: In order for ihe work authorized under ihis permit to be considered legel, such work mus� comply with all applicable codes, and all requlred Inspectlons and flnal epproval must be obtained. Failure to obtain inspections and final approval will result in the ezpiralion of ihis permit. FOR INSPECTIONS CALL: (714) 754-5626 zaasan �e�ao� WORKERS' COMPENSATION DECLARATON: � I hereCy eillrtn under penalry of perjury one of Ihe tWlowing tledaretions: ❑ I �ava end will maintein e cenificete oi wnsent lo sell-Insure tor workere' compensation, s pmvidetl tor by section 3700 of tha Labor Coda, br Ne pertormance of the work lor which Ihis pertnil is issued. ��. ❑ I �ave end wlll maintaln workers' campense ion insurance, es reQuired 6y sectlon 3700 ot Ihe LeOor Code, lor t�e peAortnance ol ihe �e iich Nis pertnit is issuetl. My workers' comqensatipr�,lnsurence ' r d pollty number ere: Carder. \ i) /�l 11 Policy Number. hls sec0on need not�c�mplefed Il the imif /s relued a( one huntlred dollers ($100) or IeuJ I cenity that In Ihe peAormance ol lhe wark tor which Ihis pertnil is Issued, I shell not employ eny person In eny menner so es to become sub�ect lo t�e workere' mpensatlon lews ol Calilomia, entl egree the� il I should become suD�ed to Ihe workers' compensation provlsions ot Sectipn a700 0l t�qt.gppr� I a�all forthwilh comply with these provislons. '`) I �"r/ " AppliCem Slgnature: Date: l V WMNINO: FNLUHE TO SECURE WORKERS' COMPENSATION CpVERAOE IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CiiIMiNAL PE TES M1D CML FlNES UP TOONE HUNDRED T/qUS4ND Dp.LARE (5100,000�, IN ADDfTION TO TME ODST OF COfdPEN$ATION, OMi4GE5 A$ PROVIDED FIXi IN SECiION 9]OB OF TME UBOR ODDE, IMEREST, AND FTTORNEV'$ FEES. LICENSED CONTRACTORS DECLARATION: I hereby eMlrm ihat I am Ilcensed under provislons ol Chepter 9(cammencinp wlth Section 7000) of Dlvlslon 3 oi the Business antl Piolessions CoCe, and my license is In tull lorce end aHact. Llc. N Class p Contwctofs Signature: Dete: CONSTRUCTION LENDING AGENCY: ❑ I hereby eXirtn that there is a wnsiruction lending egency lor the pertortnance of the work for whic� ihis permlt is issued. (Sec. 3097, Civil Cotle). Lentler's Name: Lentler's Address: Signature: Date: OWNER-BUILDER DECLARATIONS: I hereby effirm t�et under penalry of per�ury that I am EXEMPT FROM THE CONTRACTORS LICENSE LAW lar the following reason (Sec. 7031.5, Buslness and Professions Cotle: Any ciry or counry which requires e pertnit to construct, elter, Improve, tlemolish, or repair any sWCWre, Pnor to its issuence, also requires the applicant for such permil ro flle e signetl statemenl thet he or she Is Ilcensed pursuant to the provisions of the Cantrectore License Lew (Chapter 9(commencing with Sectlon 7000) ot DMsion 3 of the Business entl Professions Code) ar thet he or she is e:empt therelrwn entl t�e basls for the ellegetl exemption. Any vialation o1 Sectlon 7031.5 by eny epplicenl for e pertnit suhjects the epplicant to a civil penalry of not mare than five hundred dollars (5500).): as owner of ihe property, or my employees with wages as their sole compensatlon, WILL DO TME WORK, and the structure is not intendetl or ottered for sele (Sec. 7044, Business and Professions Code: The Coniractars License Lew tloes not appty to en owner of property who builds or Improves Ihareon, end who does Such work himself or hersetl or ihrough his or her own employees, 0«deA that such improvements are not Intendad or otteretl tor u!e. II, however, Ihe bulMing or improvement is solG wiihin one year ol wmpletion, the owner-builtler vrill �ave ihe burden of proving that ha or she did not builtl or imprwe tor purpose of ule J. ❑ I, es owner ot Ihe proparry, am El(CLUSIVELY CONTRACTNG WITH LICENSED CONTRACTORS m consiruct Ihe prqect (Sec. 7044, Business antl Professbns Code: The contractors Licen Law tloes not apply to an owner ot property who �uiltls or Improves thereon, end who contrects lor such pro�ect wiih a contrector(s) Iicens�e.pursuan6to.N�Co rectors License Laws.). , ❑ I em e:empt under �i SlpnaNre: `�� /� Owner ID venfied cy �nveYs Vedficetlon ot Ownership by ol Business end Professions Code for ihis reason: s ❑ No Drivefs License No. i.e. - properry t� 6III or dead): Date: DIVISION OF INDUSTRIAL SAFETV PERMR CER7IFlCATON: ❑ I hereby cenity Ihat no ezcavatlon Me (5) or more feet in tlepth into which e person is require0 to descend, will be mede in connection wilh work avUodzed Dy thts pertnit, end that no building siruIXure, sceNoltling, lalsework, or demolition or dismanlling �hereof, wlll be mora then ihirty-slx (36) feet �Ig�. (Chap. 32, Grp 2, Art 2, Sec. 341, Title 8, Celitomla Adminlstrative Code). ❑ As owner-tuilder, I wlll not employ enyone to tlo work w�lch wou10 requlra e permit from the Divislon ot Industnel Satery, es noted ebove, unless such person has e permil lo tlo such work trom the dlvislon. Sipneture: Date: DlWslon oi Industdal Setery Pertnit Number. CERTIFlCATE OF COMPLIANCE qND AUIHORVATON OF ENRiV: I certify under penalry of perjury that I have read this epplication and slate Ihat the infartnatlon given is correct I agree to mply wit�� I�lawerond dry ortlinences releting to building cnnstrucNon, end authodza represeNatives yI the Clry ot CosW Mesa lo enier upon Iha eDove-descnD / spection ifrposes. I agree not to occupy or ellov.• occupancy ot eny building authorized by thig,pyrrfiil uPtjNi�al in,_ sygcuon. IU/ T�U01 � SI ature Of Legal Owner(s) Date AnNOr Authodzetl Applicam Date COOE 1. INSYECf10NTYFE 1818 Fixed System Finel Flre Prevention 7288 Pool Spe Finel 200 Finel Re�Roof 201 Flnel BIocWReteining well 202 Final Factory Fire Place 203 Finel Sign 20C Finel Demolltion �g Q�Q fQyf,� INSPECfIONTYPE 208 Finel Mec�anical 208 Finel PlumDing 210 Flnel Elecirical 212 220 Flnel Flre Prevention Finel Plannlnp Approvel 222 Final Site 250 Finel Building/Occupancy PAIE I[�IA �tl rv ioin �a PN0.IECTRUOflESS: CARSON THOMAS TR OWNEN'SNRME: P 0 BOk z173 nooxess: NEWPORT BEACH,CA 92660 645-1334 UNIT: RflCHIENGINEEN: flEG.NO.: �ooeess: uXiT: TOM CARSON (714)645-1334 PEPMITTEE: 41Q SAN BERNARDINO AVE auoxess: NEWPORT BEACH CA 92663 LICENSEU CONTMCTOP UECUIMTION: I hereEy allirm tlwt I am licenutl untler O�ovisions ol C�aD�er 9(commencin0 ��h Section 7000) ol Uivtsiun 3 oi I�e Busineu antl Pmlestions CoOe. an0 rtr/ licenu is in full force anE eflect. CITY IIC.: S7R7F L1C.: C1A53: Oale: Signature: WOBNEPS' COMPENSRTION OECIAMTION: I AereOy affirm t�at I have a cenificate al consent lo sell�msure or a certiliwte ot Workers' Campensa�ion Insurance, ar a certiliea capy I�ereo� (Seciion 3800, LaG. C�. POLICY NO.: E%P. D�TE: COMPIINY: � C¢rti�iM copy is hereGy IumisheU. ❑ Cenifie0 mpy is filetl wii� Ihe ary BuilGinp Divaion. ,ie: MWicant: E%QAPtION FflOM WOXKEflS' f�PEN5RT10X OECIAMTION: (ilia sectian ireN �wI he mmpkle0 iI Ilie perml's �ar one �unOreO (5100) or lea�. I ceni�y 1 etlorm e of I�e work I ' IAis Dermit is issue0, I s�all noi employ any person in any manner so as lo become suhjec� �o t�e ion al Cdlifomia. � Dare: NOTICP afte bnA � E raiion. yau stwultl Decome wDject m lhe Workers' Compertation prwisons ol t�e laEor Catle mus� IarlMnl ty wii� wU Drovaro�a w tlds perrtdt shall be GeemM rewkM. CONST ION 1EN01NG � NCY: I �¢reby atlirm tha� �here 6 a rA�alnKiial IenOinp apeM.y lor Iice peAormante o� Ihe work lor wNcO this permii is issue0 �Section 3097. Gv. C�. IFNDEB: RODflESS: OWNEfl BUIILEB OECUMTION: I hereby atlum ttut I am exempt imm Ilce ConVanors Slah Lkense law lor the IdbxinB reason (Section 7¢i1.5 Business aM Prolesdonal CaOe: My dry of munry wNch reqares a pefmit �o consvuct, atter, improve. tlertwfal�, or repair a�ry strucWre. prior to its isswnw. also repuires t�e ap0�� or wU perrttii to lile a vgnetl statement Ihat �Nslre is GcertuO pursuam m I�e pmv¢ions of Itce Cantracmri S�ate License Law (Chapier 9(cammencmg wii� $eciion 7000) ol 0ivaion 3 0l I�e Buaness antl Pmiessions Cotle) or IAat �e/she is exempt l�ere�mm antl �he basis �or t�e allegeJ exemplion. My Halation al Section 7031.5 Oy any applicant lar a permil suGl��s tice applirant Io a civil penaliy ol nol more Ihan live huMretl Oollars (55110�. I. ds owner ol the OropehY or rtry employees wit� waqes az their Sole cOmpeiaation. wi� Co ihe wofk, antl Ihe ❑ sWCWre s not inteMeO or onereG for sale (Setlion 7D44. Busness and Professioiul Cotle: Tlie Convactors' State License Law dces �wt aoDN to an mmer a1 a propeM � �uOM1s or imwwa ttrereon. and who Eces wch xo�k Nmutl/lrersell ar INaph ins or Irer wm employeec. D�4� �� suU� imprwemenB are not intenGeG or atlereA for sale. II, hvxever ttce drildifp or imprwement is Sdtl wil�in ane year ol wmpletian, Ihe axner wi0 hav¢ tlre GurGen al prDvinO �� nol �IrilO or impmve lar t�e Durpose al sale�. I, as owner o� I�e Omperty, am excluvveN coniroctinq vn�� licensed contracfors lo wnswct tAe D�� (�� • Busineu ❑ an0 R'ofesdms COUe: The CamractaK $tate Liceree Law tices rwi appty ro an owner ol propeny who UWOs m improues Ihereai an0 w0o coniratls tor wc� prqects vnl� a mntracior(s) license pursuant m lhe Canlnciors' S�ate Lice�e Law�. I am avrzre �{ �nat w�� o� ineir worker's ��ivp ¢wance snowo be wwi0ea �o me. p I am exemp� unOer ,q�iyli WORK B� aOWN lor ihis reasan: oate: /i+aa, 2L !'./ Owner: .,T----T �/ I Uo hereby cetlity Itut I am aware ot anU untler5lanU �he repuiremenis al C� mO�Healih anE Sa�ery Coae Seciions 25505, 25533, anG 2553e an0 ihat I ar any Imure buil0ing occupnnt xilVwill not (drele one) n d to comph/ wilh sai0 state coGes anE IAe re0uirements lor a permii �or cpulruction or moGilicatron irom Ihe Air OuaGry Maregertrent Oislricl. NesiOeniial canstruc�bn apptiwtbrrs are exempi trom mese pra��ns. Oate: ApPlicani: I �ere6y ceriity IAa� I have read I�is applitaii0n an0 Slaie Ihat Ihe a�ov¢ inlorma�ion is torreCi. I agree lo wmON ��h all tiry an0 caUnry orCinances antl slale laws relaling �a builtling croslmciion and here0y aultwdie repr en�aliv¢s ol �h¢ city �o enier upon 1�e a0ove�mentione0 pmpehY �or insDection pmposes. oae- �� / Om�er's LKense or Socul ecurity A: t6n1-46 W�ile—Builai�g:Green— e Pink—Rovonue; GdtlenroE—Pssesmr CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; E 058764 PLAN CHECK NO: N rOVT- N SI1PP. U CONSTkUCTION TYPE: PERMIT TYPE; ELE PURPOSE; OTH JOB DESCRIPTION ; ELE METER —EXISTING ONE WAS REMOVED SQ FT: CLAIM VALUE; CALC—VALUE; GROUP OCC; B-2 / COMMEN'I'S: INSTALL METER �r*�tx �r�r*�r****� **x*�ex�rx�*�rx�*�r��*��r�*+r*� **�t**�r�t�t�tx�*�r�r��r*x�*�r�e� x*�r�t*�x �**x**�**��*x�* Z O N I N GS ERTEB�AUCit(RSE M E N T S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING --------- FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN LEFT: FT IN RGAT: FT IN LEFT: FT IN AGHT: FT IN PARKING REQ• PROV; PARCEL; 42436115 ZNE: REF NO: PLANNING NiS'i'ES> � it ik k �f 1f if if iF �F k 1k �E it iE if If IE ik If 1E iF if M ik 1E1E ik iE iE IE iE �F k k�F k �E iE iE iE 1E k if iF iF iF iF if k 1E if iklt fFlE iE�1f�iEiE iE iFiF iFik �E ik iE iE it iE iE iFlF iE �f iF it K� i!( D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S ,�-i 20NING APPROVED BY DATE: � BUILDING APPROVED BY : DATE: � APPLICATZON ISSUED BY• � DATE; � Z�¢ MikifiFifiFiEltitiElElEjEiEiFIFIFk1EiF1Ek ikiFiflEiEl6�EiFiF�E it 1f if it iEit iFiE iE k ik iE iF �f iE 1F If IE iF 1f 1E iE 1F 1E �E 1E iE i! iF iEiF it iF M iF iF iF M iF iF iE if ik iE fFiE iE iE iE if iF k iF 1f 1E 1FiElE if IFiF 1E iE iE iE 1F i! iE iFlF if IE �F �1FlF iE If 1F iE iE LEGALIZATION;N F E,E/ S U M M A R Y STRUCTURAL SEGMENT;N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMSP/RES GRADING PERMIT 18.50 SOY SMIP/NON—RES PLAN ISSUE FEE 15,00 BUILDING—DIV—> PERMIT ISSOE PLAN—CHECK TOTAL PAID DUE TOTALS----> 18,50 15,00 0.00 33,50 33,50 ,00 REVENUE DIVISION TOTALS--> COLLECTED; 33,50 OVER/SHORT: ,00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 33,50 1f iflt 1f 1f �! if it IE �E iF iF �f if i! ik Ik iflE �! ff �F iF iE iF If if 1k It 1f iF 3f it �E �E �f �E IE i!!F IF �f lkif iF 1E iF if k if k �k 1E iF iE iE �! iEiE�E iF iF �f iE if 3E k if ik 3f iE iF iE iF iF 1F k iE 3F I N D I V I D U A L F E E B R E A K D O W N TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V 6 BELOW 201 AMP 18.50 18,50 END OF FEES �1 U�'�7^tr.'�r��.a" _ ._ L,�T�''r�,'�:I�7 ".. – .1�".. f � � CONSTRUCTION AND PLANNING: „ . POOL A � APPROVAIS Permit # � Date Inspector qppROVALS Permit # Date . Inspector 7. TerriPorary Electriwl Service or Pole , 52. Pool & Equipment Location - ' 2, Soil Pipe�Undrgrnd. . � 53. Steel Rei�forcement ` 3. Efectrical Copduii.Utility-Undr9md. � � . 54. Forms �:4. Electrical Conduif:Undrgmd. � � % " 55. Electrical Bonding �5. $teel Reinforcement '' 56. Rough Plumbing & Pressure Test .� �� Eteccricat UFER Grnd. � 57. APPROVAL TO COVER�GUNITE . � 7�. Footings � 58. Electrical Conduit-Undrgrnd. � 8. �Eoundation . � - 59. Gas Pipe, 0 Undrgrnd., Test � � `� 4. Water Pipe-Und:gmd. 60. Backwash tines, P-Trap, d U�drgrnd. 70. Structural Floor System 61. APPROVAL TO DECK � ' 11. �Property Sewer Lihe & House Connection 62. Backwash & Receptor-Final , � � �_ �2._�eWe� CaP �.. fi3. Heater & Vent�Final � � 13. Roof Dr�ins 64. Plumbing System • Final 14. Rough Plumbing' 65. Electrical�Finat , 15. Fou9h Electrica6Conduit � 66. Solar System•Final ' - i6. Rough Electfic Wiring 67. Fencing & Access Approval 77. FoUgh Wiring Sign 68. APPROVED FOR PLASTERING 18. Rou9h Electr�cal-T Bar Ceiling - 69. POOUSPA SYSTEMS FtNAL 19. Rough Heating & Air Contlitioning FIRE DEPT. REQU�REMENT 20. Rough:Factory_Fireplace '; Y C.t *'' APPROVAIS�•� Rermit # . , 21. DuCts�,,in Structure .-.. �'- ..�� 70.-L�dergr,ou�d NYdro i� 22. Dotts, Veritilating - • � 71! Product.Piping`[aGas ❑Oil 23, Gas Pi�pe�Rough�& Test :.� , ' .'� 7z, Underground flujh - 24. Roof Framing , � - °- �- - • �� `; � -J J�. Undergrnd.SroY�qe Tank O Gas OOii 25. Roof $heatbin9. - ' . � '�' • ' 7a. Overhead Hydro �- 26. T•Bar Ceiling (Structural) & Monocoat ^ T=" 75. Dry Chemical - ' - Z�. Frame and Flashipg - _ _ �� 76. Dry Staqdpipe "� � 28. Lathing&Siding--. � t�: 77. FIXED�SYSTEM,FINAL .. � 29. Insulaiion - - �� .. 78. PIRE PREV. FINAL - � � � , ' ! 30. DrY�Yall Nailing � - HEALTI-I DEPT. REQUIREMENT 31. Plasier Brown Cq2t ;, 79. � AL'I��NSPECTIO'N �� g 32. Electrical Power Meter�Final �/ ^ t � OD CER7IFICA"i'E ISSUED +- 6 ' 33. Fjnal Elect�ic 17 � ' otes: - ' t � , �4. F n31 Heating & Air Conditioning � � �-=� . • ` � � -� _ : � 35. Fina� Gas Pipe�Teit , _ - ' "� ' - ' ' � � � i 2 ' :O � 36. Hood or CanopY . - , �' .s � ` ., . . ., �I - - 37. Fin3i Factory Firepla�e ' -' ' � � �''' � � , � 38. Final Plum6ing . � •' � . � - _ , I" 39. WeterService�Final � �� ' ' ' t i_ t 40. Gas Service-Final� ,- L - r ; . i � . -._ .. � 41. Soler pomestioFinal ' - " 42. Backtlow Preventer " " �. - - 43. Backflow Irrigation � ' ' .. , � 44. Landscape'Irripation System - , r : �� . � � .. '> 45. Sound Attenuation • _ • r 2 _`• ' - 46. Handicap'Regulafions � . , , 47. FtNALSTRUCTURE&BUILDING � i�?�=-� � �� 48. FINE+LPLANNING ��r'�, > � � • 49. Eleccric Release to Edison � ��,.r� � �. ' 5p. Gas Release to Southem California Gas Co � � ��t - � 51. CER7IFICATE OF OCCUPANCY � ; ' No. Oate _ -- - _..-!_ City of Costa Mesa Building Safety Department r.o. eox izoo Costa Mesa, Califomia CERTIFIC'ATE OF OCCUPANCY `O `�°�6� �. i : - The Building located at )21 '::c:.•t l�;th ,'�;:rc--i- � has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group �-2 Occupancy. � Use of Building i•Is.rnhnnr,r [N`t�t�., u,,,iat.,m Legal Description �].h••�.51-09 (See �everse side for Metes and Bounds) Building Permit No 3301.=:+ Electrical Permit No. ��a� Plumbing Permit No. � Number of apartments and/or guest rooms iSSUED T0: Building Official ' , . - ,� by f'�' !J p-7,�ir ,.. �' ':' _ _[=-Y .:. ;-.-- R. F_ A:C. CAT.TdM � Dffie n..,,-....+ ti , no, This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 (e) U.B.C. ' Form BU 34 Rev. 11p0 � � �. ' �R � ' �3^u I 5 Pnco COSTAMESABUILDINGSAFETYDEPARTMENT F�bY-3-71�y„OO 047, o�'�=�'wS�.�C P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILD�NG PERMIT % z� Fo� Applicant to Fil! in Completely FECE � D ��'�/ jlT I e U 7) BUILDING �/"J, (�J , ADORESS (y d PEBMIT N L OWNER �r � C� V A.P. NO. - s- D I7 (}^� � �( BVILDING l �• � AODRE55 -(/�J W. (� pQ �HKJ� E+DDRESS �� Qp� %YLC«L� � n s ` W W TE . qqCT �LOT BLOCK aU CITV /'!JG(ewp�o0 N ��p�� ZZ Q CONSTFUCTION W A D ALTER P F- LENDER . a m � C GC U J � BRANCH J N OWNE Q "� AODRESS I/ /I,��. C ARCNITECT ^ T"e V NEL. 3.1�S1Fi "/(•',l'" yyPA� I V LUg �� - OR ENGINEER I U N � '�� Q FIRE w� ADDRESS � /� eC� S�'�� AaH ZONE TVPE GROUP a w BVPROVED qTE �—/ O� / J O CONTRACTQR � m Z \ J � ADORESS O �� w W TEL. i- ZONE NO.OF USE OF NEVj� z� CITV NO(�, �5 � / P�� BUILDING \ _ � STATE CITV YAFOSAPPFOVED VAFDSAPPftOVED �� y� �IC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILOING '� 7O - (FROMGLS REET) 512E /. NO.OF BLOGS. Q OF LOT ap� X,� Q� NOW ON LOT FONT OFT. FT. ` USE OF �� \� EXISTING BI.qG. U O�� FT. FT. H SIZE OF iI' NO. OF .I� Z NEWBLDG.yi��iX�77�� ROOMS STORIES L.SIDE /•�S. FT. EXTERIOR WA�� ROOF pN V COVERING COVERING FEAR I FT. p FT. J VSE OF BUILDING ANO WORK TO BE PERFORMEO DISTANCE BET. BET. MAIN & MAIN BLOGS. ACCESS. BLDGS. _ �- VAF.qW DATE O ��iLIC. Ii,}^ �'L� �/ I Cti �IQE�O��. C.U.P.qW APPROVED F �, � _C� t� � APPROVED y �' z FyO�,H a�OR S�< TAL REQUIREMENTS O UI horeby ack�owletlBe chet I have reaa this applicotion antl state 5, � a �`.�,,.��,o �. � chat the above information is correct antl agrae to tomply with � ull laws regulatinp builtlinB consvuction, and 1 shell not employ F eny person ih violation ot the workman's compensation laws of y tho State of Califomia. �.3.11 � CJ ZI hereby certify that I am properly licensetl as a conSractor under SQ. FT. o cha State ot California Business antl Protessions Code, Divisicn 3, THE AMOUNTSHOWN UNDER VALVATION IS FOR � Chnpier 9, aqd that such licenses are in full torce entl etfect, or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLV: ¢ am enempt from ihe provisions ot Ne State ot Celltornie Business VALUATION entl Professions Cotle, DivisiOn 3, Chapter 9. - m PERMIT FEE $ � � Sipnntura of !' T m Permlttee - �- $ 3�vv� PLAN CHECK $ V E / LL Authorizetl Agent � TOTAL FEE 5 � Z d U Z 2Q O� am � � J � U N Za W � aw W Z J Q m Z J � W w O ZH w � N � � � F z Q U ! Q � y Z 0 F= U � � r N Z 35866 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely BUILDINGI, oi i,. ��s� �� OWNEFi R�/ /1� MAIL �._ _ Clrv ( (f J CONSTRUCTION BRANCH ADDRESS ARCHITECT CONTRACTOR ADDRESS CITV STATE UC. NO. SIZE � OF LOT � [� TEL. NO. CITY LIC. NO. INO.O BF L�OG. NOW ON LOT EXI5TING BLDG. ()�F�=�� 1f klf/RE C uSa SI2E OF �� NO.OF NEW BLDG. '/O FOOMS STOF EXTERIOR WALL ROOF COVERING ,(J,LOCK COVERINGRU{AT�A USE OF BUILDING AND WORK TO BE PERFORMED I hereby acknowletlge ffio[ I have reatl ffiis applicaiion antl state that che above information is mrrect antl agree to comply wiffi all lews regulatinp builtlinB consttuction, antl I shall not employ any person in violation ot the workman's compensation laws of the Siate of Calitornia. I heraby certi(y that I am properly licensetl as a contracior unGar the State of Calitornia Business antl Professions Code, Divisicn 3, Chapter 9, antl thet such licenses ere in full forca antl attect, or I em exempt trom the provlsions of the State ot Californie Businass antl Professions C e, DiviSion 3, Ch¢pier 9. Slgnature of Permittee ��-�� Auffiorizetl Agent A.P. NO. � I BUILDING ADDRESS a FIRE ZONE APPqOVE PRi� c '•��.: - T_"_ iAf!-57.,c�,;•�0 3.,1:% ^- TION FOR BUILDING PERMIT � D^T�i^C V � � E I SUED � i J , � `A f S }_O� P�`�, �„� � � CA LL � VALUE �O e\�� 5 GfiOUP � DATE � � � ZONE NO.OF USE OF NEW \ M PLA1.7$ � BUILDING (N{}�?��{.aLS � � U VARDSAPPFOVED VARDSAPPROVED � MAIN BUILDING ACCESSORV BUILDING (FROM G.L STREET) // R. SIDE � FT // L. SIDE FT / REAR � FT. DISTANCE BET. /�� MAIN BLDGS. / VAR. #t �.,,.P.#Zc-•7a• �l6 THEAMOUNTSH( THE PUFP06E OF E VALUATION 5 �� FT. � FT. FT. FT. BET. MAIN & ACCESS. BLOGS. DATE ' / � APPROVED / 7 C"� L � � �� W 0 NDER VALVATION IS FOR ' SHING A PERMIT FEE ONLV: � ¢ - m r11T FEE 5 �' �.-/ J ! CHECK $ / J� E O - LL �L FEE 5 � � ' �I�t r_FL�JQfi lti COSTA MESA BUI�DING-SAFETY DEPARTMENT P.O. BOX 1200 C4STA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely ADIDRESS 9.2/ wesT �a � s/ OWNER PaTr�/�\ ��c .T,ea,us ��R QooREss 9.� � u��rr �8 �'sl CITVC QST/'/ /�/r � NOL. CANSTRUCTION BFANCH ADDRESS CONTRACTOR Pi. /n�, ADDFESS/�9�� y�`, ciTvFULNT7/N Vf STATE � �; O � D LIC. NO. SIZE OF LOT USE OF EXISTING BLDG. SIZE OF WALL AN �. N OL �3�'I CITY LIC. NO. � INO.OF BLOGS. NOW ON LOT NO. OF ROOMS STOF ROOF COVERING K TO BE PERFORMED . �- �- i,vG 6a.r �.ilr, 13-75�a"00 729'r �**�*5.50 f.MSP APPLICATION FOR BUILDING PERMIT REC�IV� BV ATE -CE V TE I�ED / �/ - A.P. NO. /NJ�ISI� PE I � BUIIDING � � nooaess � TRACT LOT BLOCK W A D A OWNER UE 5 S O�' \ FIRE C� ZONE TVP GROVP APPROVED BV / �J DAT � � ZONE NO.OF PIAN$ VAROSAPPROVED DISTANCE BET MAIN BLOGS. VAR. � C.U.P.aW USE OF NEW YQQ P/�i BUILDING .?�f/�. VARDSAPPROVED ACCESSORV BUILDIN BET. MAIN & -/3-7J � o Fo�f T?uc%S• � I huraby acknowledga that I have reatl this applicetion antl stete , STATE � that ffie above informeqon is carrect entl aproe to comply wl[h. � all luws reguletln8 builtlinp ronstrvction, entl I shall nat employ' � O � nny Oerson in violetion of the workman's compnnsatian lews ot y th¢ Stere ot Californio. � zI hereby certify that I am properly licensetl as a contracior untler_ S�. FT. o tha State of Californie 9usiness and Professions Cotle, Oivisicn 3, THE AMOUNT SHOWN UNDER VA�UATIO R � Chapter 9, anC chac such Iicenus are in full force antl affect, or I THE PURPOSE OF ESTABL4SHING A PERMIT FEE ONLV: m am exempt irom tPe prov(sions of the Stete ot California Business ¢ ontl Professians Code, Oivision 3, Chepter 9. VALUA710N � PERMIT FEE $ • � � �� Signature ot �. ,q� i� m Permittee -�� -J $� O^ PLAN CHECK $ E `a . AUNorixetl ABant � /� LL TOTAI FEE S • w /