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Home My WebLink About983 18TH ST - Building PermitsApPlicant to /ill in all CiTY oF coSTA ME�S�A .CONSTRUCTION PERMIT Projr�CAddress - �'n� ln�. ��i�T� � � � Applicant'sMailingAddress :ZZ�(� S6 �^:1Z�[�iiiT ST C/�NiNA1J, � Owner'sName MINEP_IC'.�.- T'hSL�-. Phone Address ��. B� �"Z�7 �CNM�NIi�. �PN�CKy� —� Arch/Eng. License No. ` � Address � Contractor'sNamP M��TLI�E�F T�Y/(' _ phone S� 3P%5 Addresslmailing) �2C(e i0 VJ2fGNTST iv.'7�4 f7 /a- Ciry License No. � �3��0 � LICENSED CONTRACTOR DECLARATION . 1 her¢by affi�m ihat I am licensetl untler'provlslon5 of Chdrte� 9(commencing wltn section ]000) ot Oivision 3 of the Business antl Professions Cotle, antl .�my license is in full force antl etfect. ' License pass � �ic nse tvo.y32S/�J Datell�-29-�G signature ` WORKERS' COMPENSATION DECLARATION I hcreby affirm that t nave a certiOcate of consent to self-Insure or a certiticate � of Workers' Compensation Insurance, or a certi(Ie0 <opy thereof (Section \ ' 3800, Lab. C.) �/ � Policy No. S�U 7+i� Company 7�.QL Certifletl copy is nereby fumishetl. CertifiCtl copy is filetl with t�e city Bull nq p 5io Date �Q��4-6G APPlicant � EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (Thissection neetl not be campletetl if the permit is for one huntlretl ($300) or less). I certity tnat in tne pe�fo�mance of Ih¢ work /o� which this perm�t is i55uetl, I shall mt employ any person in any mann¢r So as to become Subject [o the Workers' Compensation Laws of California. � Date " Si9nature �- • NOTIGE: If, after-mdking'this tleclaration, youshoultl become suEject to tne � Work¢r5' COmpensatiOn provi5lons o( thG Ldbo1 Cotle, you mu5t forthwitb comply with suth p�ovisiOnS o� this perTil Shall pe tleeme0 �evoketl. CONSTRUCTION LENDING AGENCY 1 nereby affirm that tnere is a construction lentling a9en<y for tne Oerformante of lhe work tor which tM1is permit is issuetl (Section 309� Civ. C.) Lentl¢r'S Name 4antler's Atltlre55 OWNER BUILDER DECLARATIOfJ I hereby af/irm that I am exempt from the Contractor's Litense Law tor the followin9 reason (Section ]031.5 Business antl Professional Cotle: Any city or counry which requires a oermit to construct, alter, imorove, tlemolish or repair any sttuGtwe, prior [o its is5uance, alm �equire5 tlt¢ appliCant (or zuch p¢rmit to (ile a stgnetl statement that he/she is Iicensea pursuant to the provisions of Ihe Contraclor'S LiCenSe Law (Chapter 9(COmmenNn9 with Sec[ion ]000) of Division 3 of the Business antl Profes5ions Cotle) or that �e/sne is exempY meretrom antl'.the basis for the allegetl exemplion. Any violation ot Section 7031.5 by any ap0��cant Tor a permit subjec[s lhe appliCant to a civil �enalty,ol not more Ihan five huntlretl tlollars (5500�. I,'a5�owner of Ihe prop¢r[y or, my employeas wilh wages as th¢i� Sole � Compensation, will tlo the wo�k, an0 the structure is not intentleE or Otfer¢tl for sale (Section ]044, Business and Professional Cotle: Tne Contractor's License law tloes not apply to an owner of a properfy who builtls or improves ' thmeon, antl who doessuch work nimself/herself or throu9h his or her own employeas, provitletl that such Imorovements are not intentletl or oitered tor Sale. If, however, the builtlin9 or improvament i5 soltl within one year of com- pletioq the owner will have the burtlen of proving he/she tlitl no[ bulltl or im- �row fortho purposo of sale). I„�a5 owner of�the property, am exCluSlvery cont�aCting with Ilcensetl cOn- t�attOrs to const�uct the project (Section 7044, BuSin¢ss antl P�ofeszion5 Cotle: T�e Contractor'S Llcense L,aw does not apply to an own¢r of property who builtls or Improves thereon, antl who contracts (or zuch projects with a con- tractor(sl bcenie pursuant to the Contracror'z Litense Law). 1 am aware tnat proot of t�eir Worker•s Compensation insurance shoultl be proviaetl to me., ❑ I am exempt untler Section g. & P. C. (or thiz reason � Date I nei infor Si9nature � Driver5' Licens CMF 0865-46, rev. or Own¢r have reatl this appliwtion ane state t�at the above a9/ee to comply wlth all dty antl county ortlinances o builtling construction, antl hereby authorize repre- t� ent�pon the aDOve-m¢ntion¢tl -P_ro/D ert to� Date,,/O/Z� /' ��— � exeeo�tnose within heavy bortlerlines i TYPE OF CONSTRUCTION •LJ raEW LJ ADD LJ AL� ❑ CONVERSION ❑ DEMOLISH O OTHER _ DESCFiIPTION OF WOFiK/USE OF BLOG. iG ti9n all appropriate tleclarations. �� , UN1T NO.• � � � fERATION REPAIR' � , TVPE OF PERMIT GRADING � FOUNDATION STRVCTURAL ❑ TENANT ❑ ELECTRICAL '❑ PLUMBING ❑ MECHANICAL 'Q OTHER _ � � ' � PROJECT•DESCRIPTION' Sq.FT. ' OCCUPANCv— CONSTRUCTION TYPE �,�� VALUATION 5 ZONE�_ GR/�uipGCU.VDS. ' ACRES_ / i �7 Remarks. � Q/]/�a lS '� S(��Z Sink Floor Orains• , " Floor Sinks � � Gas Service Outlets Interceptors Kitchen Sink � Lavatories . P-Trap - • Roof Drains Reinspection Fee Boiler Duct - Under Ground - PLUMBING . • Showers Service Sink � � 'SewerCap - � •Sewer Connection � Solar Collecmrs � Solar Piping � � ' ' Solar Tank Swimming Pool w/Spa ' Urinal I Water Closet Water Heater - . Water Service - � � Auto-Waih Laundry Trays $15 Duct - Ventilating Exhause SVstem ❑ Multiple O, Firepl/FacL�BIt.ICBO�p . Heating System & Ducting .- ❑ ai oo,000 sTu O i oo,000 sri Reinspection Fee S75 White - Builtlin9: Canary - Applicant; Plnk - Accounting; Goltlenrotl • Assessor Isue Fea Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑aioo,000sru ❑ioo,000sr System Repair/Alteration FireDampers � Registers laue Fae ES A.P. o__. S Main Bu - E T Front 8 C Right' K Lett S Ping. Ref. # Planning Notes: Automatic Washer Construction Pole Sub. Cooking Unit Dishwasher � ' Dryers ❑Gas ❑Elec Fan � P.A.U. Fixtures ; , �6263 10/29/86 B � - { � '. 24..75 � TL Zone . _ EIECTRICAL , Transformer ❑ 15-50 KW . . .❑ 50+,KW . Meter ❑up to 100 amps Meter �(over 100.amps ' Sub Panel ' . Motors O0.1 NP 1 h'- BI Inc.Solar �9-15 HP �16- Microwave' ' . Pole Light . � Fiange + . Garbage Disposal Standing Sections Generator �0.5 KW �5�15 KW Trash Compactor . 5 3 _ Reinspectian Fee $15 Issue Fee FEES DEVELOPMENTSERVICESREQUIREMENTS: � Zoning Approved By � Building Approved By � � Application laued By $ 3 FEES 3 2 O N I N G R E Q M T S FN 9 SUMMARY OF FEES . BUILDING PERMIT $ SMIP S PLAN CHECK $ �PERMIT - PLUMBING $ ISSUANCE $ � PLAN CHECK 25% $ ENERG�' P.C. $ ELECTRICAL $ I I.IS\ii GRADING $ � PLANCHECK 50% $ 7..J�C- MICROFI�M $ L, - MECHANICAL S TOTAIFEE $a7. 7S 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-Undrqrnd. 53. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrnd. 54. Forms � � 4. Electrical Conduit-Undrgrnd. 55:'Electrical Bonding 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test � 6. Electrical UFER Grnd. 57. �APPROVAL TO COVER-GUNITE ' 7. Footings . 58. Electrical Conduit-Undrgrnd. 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. � � ' - 60� Backwash Lines, P-Trep, 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 Wiring �� (� � 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. Rough FactorY Fireplace APPROVALS Permit # � � 21. Ducts, in Structure 70. Underground Hydro �� 22. Ducts, Ventilating 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test 72. Underground Flush 24. Roof Framing 73. Undergrnd.StorageTank'OGas ❑Oil 25. Roof Sheathing 74. Overhead Hydro � 26. T-Bar Ceiling (Structurap & Monocoat 75. Dry Chemical � 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FIIVAL 29. Insulation 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical;Power Meter-Final /��1��(y R(� 80. FOOD CERTIFICATE ISSUED 33. Final Electric .� �' Notes: /�.38• �i/ N ti 34. Final Heating & Air Conditioning NTF 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Factory Fireplace • ' 38. Final Plumbing � -. ' . 39. Water Service-Final 40. Gas Service-Fina� - 41. Solar pomestic-Final - 42. Backflow Preventer � 43. Backflow Irrigation . _ _ . � 44. Landscape Irrigation System ''"'�� ,��" � �,�,` \ -- 45. Sound Attenuation ��' 46. Handicap Reguletions , � � 47. FINALSTRUC7URE & BUILDING � � 48. Special Requirements Completed � 49. Electric Release to Edison � . 50. Gas Release to Southern California Gas Co • 57. CERTIFICATE OF OCCUPANCY No. Date -9�-� CITY OF CQS=A,M�SA _�CI MIT AOPlicant to fill in all spaces except those within heavY boraer lines antl sign all aoo/opriate tleclarations. � ApplicanYsMailin,��AAddress �S]� i'bx �QCX�lO �f- ��Kib�ley�' �, � Owner's Name {11 N F��"r� �� N C Phone7.L��2�/� � Address 73C% �S WC$ b 1 '�rJA4{E( M Arch/Eng. License No. Address ' ��,�n�n Contractor's Name Phon/e ws2c-1-�+ `�^� Address Imailingl�Ci• � �� Vs-�� Ciry License No. ��9 �LICENSED CONTRACTOR DECLARATION ' , � I hereby aftirm that I am licensetl unde� provision5 ot Cha�te� 9(commencing � with sectlon ]000) of Division 3 of the Business antl Professlons Cotle, antl my license is in full jorce�ntlteffect. , � �� ' � UCEOSC CId55 L - � � C.' e i '�ens o. I Date L �- 1_� �i-�_� c�,.�a. i�1/� � �WORKERS'COMPENSATION/DECLARATION � - : 1 hereby affirm that I have a certificate of consent co self-insure or a<ertificate ot Workevs' Compensation Insurante, or a certitietl <opy thereot (Section ` 3800, Lab. C t1 ��` ,� N� Policy No. � � �l� Company�d �� Certitietl copy is hereDy furnizhetl. Cerlif'etl co qi�Sfiletl witb the city B'I'y�/ ng [)Ml�o� � Date� �l �+�`��,— APPlicant�/!- �� EXEMP ONT1 FROM WORKERS' COMPENSATION DECLARATION ' (Thissection n¢¢tl not be complet¢tl if the pe�mit is for One huntlretl (E300) or Iess). 1 certify that in the per(ormance of the work for which rois perm�t is issuetl, I shall not employ any person in any manner so as to become subject to the Worker5' Compansation Laws of California. ' Date Si9nature ' - � . NOTICE: If, aiter making thiz.tleclaration, you.shoultl become subject to.the. Workers' Compensation provisions ot the Labor Cotle, you must torthwith comply with such provislons o� this permit shall be tleemetl revok¢tl. CONSTRUCTION LENDING AGENCV I herety affirm tha[ there is a construction lentling agency �or the �pertormance of the work� for which this permit is Issuetl (Section 3097 Clv. C.) Lentler's Name , LenGer's Atltlress ' OWNER BUIIOEN �ECLARATION I he�eby affirm that I dm exempt from the Contracto�'s LiCense L.aw for the following reason (Section 7031.5 Business antl Professional Cotle: Any city or county whlch requires a permit to construct, alter, improve, tlemolish or repair any structure, prbr to itz issuance, also requires the ap0�icant for such permit to file a signetl statement that he/sne is licensetl pursuant to ihe'provisions of 'the Contractor's License Law'(Chapter 9(commencing witn Section 7000) of Division 3 of-the Busine25'antl Prote55ion5 Cotle) or that he/Sh2 is ezempt tneretrom antl the ba5iz for the alleqetl exemption. AnY violation of Settlon 7031.5 tiy any applicant for a permit subjects the applicant to a civil �e0dlty o( not more than five huntlretl tlollars ($500). I, as owner oi the �property or my emo�oyeez with wa9es�as their sole compensation, will Oo the work, antl the structure is not intentletl or offeretl for�salc (Section %044. BUSir1855 and Profeszional Code: The ConM1actor'S License l2w tloes not ap01y to an owner of a property who builtls or improves thereon, and wno tloes such work himseli/herself or tnrougn hls or her own employees, provitlea that such improvements are not intentletl or offeretl tor � sale. If; however, the builtling or improvement is soltl within one yearb� com- ' -' Oletion, tne owner wlll have the burden of proving he/she dltl not builtl or im- prove forShe purpose of sale). . ❑ I', as owner of the property, am exclusively mnGactin9 with�licensetl con- tractorsto constructthe oroject (Section ]Oa4, Business antl Protesslons Cotle:' The�Contra<tor's License Law tloes not apply to an owner of property'who builtls�oq improves thereon, antl who contracts for such Oroj¢cts wlth a con- ' tractor(sl ucense pursuant to the Contractor's �icense. Law). I am aware that proof of thei� Worke�'S'Compensation insu�ance Shoultl"be provitletl to me. ❑ I am exempt untler Section , B: & P. C. tor this reason Date - ' Owner I nereby certify that I have reatl this apo�ication antl state that the above iniormation is correct I agree to comply with all city antl county ortlinancez antl state laws relatin9 to b}� iltling construction, antl hereby authorize repre- . sentatives ot yae51<ity �'�eq�er y(Qn Jpy above-mentioned property _foy � " (o � . e �llo.S ' � , : TYPE OF CONSTRUCTION� NEW ADD ALTERATION REPAIR .❑ CONVERSION ❑� DEMOLISH ❑ OTHER A p, # 2 � DESCRIPTION OF WORK/USE OF BLDG. � � � . ' - S Main Building: � E TVPE OF PERMIT GRADING ❑ FOUNDATION • STRUCTURAL I T Front ' � ' ❑ TENANT � ELECTRICAL ❑ PLUMBING ❑ MECHANICAL , �A Rear . ❑ OTHER � � ' ' . � PROJECT DESCRIPTION Sq..Fr. oCcuPANCv � C RighY " - K Left CONSTRUCTIONTVPE VALUATION$ � � � !S ZONE 'GRADINGCU.V�S. ACRES PIng.Ref.�# � � . Remarkr. � � ' ; , 'Planning Notes: � . ' ' �� , � PLUMBING ' -�FEES. � - � � I Bar Sink Backflow Preventer Backflow Irrigation Bathtubs . � Clarifiers Dishv✓asher � Drinking Fountains Floor Drains Floor Sinks � � 3as Service ' Outlets Interceptors � Kitchen Sink - Lavamries � P-Tiap; ' Roof Drains Reinspaction Fee $15 Boiler ' Duct - Under Ground ' Duct-Strucmral ' Duct - Ventilating Exhaust System � ' Multiple ❑ �Firepl/Fact. Bit. ICBO # Heating System & Ducting �- ❑ ai oo;000 sTu O i oo,000 aT� Signature� �� - I I .Drivers' License or SS - Reinspec[ion Fea CMF o865-46, rev. l0/84 White - Builtling; Ganary - Appllcant: Pink - Acmuntln9: Goltlenrotl - Assessor Showero Service Sink . Sewer Cap Sewer Connection Solar Collectors Solar Piping Solar Tank Swimming Pool w/Spa ' � Urinal � Water Closet � f Water Heater Water Service - - - Aum-Wash ' Isue Fee 0 Hood or Typel ❑ � Canopy Typell ❑ Refrigeration System ❑0-1,00,000 BTU ❑ 100,000 ! System Repair/Alteration Fire Dampers , ' Registers � � $15 � i laue Fee $ 3 FEES' $ 3 I _ e Automatic Washer Construction Pole Sub.. Cooking Unit Dishwasher � . Dryers ��Gas ❑Electr Fan � F.A.U. Fixtures , � ,72p6l�II/13/66 ,. . 3 6% - ' S� - zo^a ' Accessory Building: � . ; � - i r , � Parking Req./Provided ' Outlets Switches ' - - - - Garbage Disposal � Generator �0.5 KW �545 K ELECTRICAL � � . � � ' Transformer�.� 75-50KW . � •._050+KW�; Meter ❑up to 700 amps, Meter ❑overf00amps Sub Panel Momrr�0-1 HP�1'f.-8 . Inc:�Solar �9-15 HP 016-15+ Microwave ! - Pole Light Range �r Sign ' - " - Standing Sections . C W � Trash Compacmr I Reinspection Fee � I$15 I I luue Fee • ' DEVEIOPMENTSERVICESREQUIREMENTS: Zoning Approved By Building Approved By � � � Application Issued By te 8.m T 1 ' .G. } Z : O N I ' N , G R E Q M T � FEES $ 3 ' � . SUMMARV OF FEES ' ' ' � BUILDING PERMIT $ SMIP '$ � � ' . RLAN CHECK $- PERMIT � � � PLUMBING� $- � - ISSUANCE $� ' PLAMCHECK . 25% $ � ENERGV P.C. �$� � ELECTFICA'L � � -$ � - GRADING $ ` � -" ` PLAN CHECK 50% $ MICROFILM $ ' MECHANICAL $ TOTALFEE �$ � PLAN CHECK � 25% $ ' ' , . CONSTRUCTION AND PLANNING POOL & SPA APPROVALS Permit# Date Inspector qppROVALS " Permit# � Date Inspector 1. Temporary Electrical Service or Pole- �� 52. Pool & Equipment Location � , 2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement ' 3. Electrical Conduit Utility-Undrgrnd. � 54. Forms� � • � � 4. Electrical Conduit-Undrgrnd. ' 55. Electrical Bonding . 5. Steel Reinforcement 56. Rough Plumbing & Pressure Test , 6. Electrical UFER Grnd. � 57. APPROVAL TO COVER-GUNITE , : 7. Footings ' ' 58. Electrical Conduit-Undrgrnd. � i . � 8. Foundation 59. Gas Pipe, O Undrgrnd., Test ' 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-7rap, 0 Unilrgrnd. ' 10. Structural Floor System 61. APPROVAL TO DECK i t. 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 Electiical-Conduit . ' 66. Solar System-Final . ' i 6. Rough Electric Wiring 67. Fencing & Access Approval . . 17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL � 19. Rough Heating & Air Conditioning , FIRE DEPT. REQUIREMENT � 20. Rough Factory Fireplace APPROVALS Permit # _ � 21. Ducts, in Structure � 70. Underground Hydro - - 22. Ducts, Ventilating 71. Product Piping �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 37. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final // 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: - 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy ' ' � .. 37.. Final Factory Fireplace . � �� , �. � 38: Final Plumbing . � � :. 39. Water Service-Final � `� � �� ' " i. r40. Gas-Service-Final ' li . ; . ' � ii,• "41. Solar pomesticFinal - - 7 � :/ '� � . c. _ , 42.- Backflow Preventer � � � "' y� ; � .-. _ � ' � 43.' 8ackflow Irrigation � � , � i •" ..' �44�.� Landscape Irrigation System � ' ��j � � � 45:,�Sound Attenuation ..� ;;, �� `.�,. �" 46. Handicap Regulations " . „ ;' � � �'47:? FINAL STRUCTURE & BUILDING ' � � � 48. Special Requirements Completed • . • - , • � . ,^�. 49.'Electria Release to Edison , t;' �- � ' 50. Gas Release to Southern California Gas Co �� . 51. CERTIFICATE OF OCCUPANCY � � . No. Date • � � � PflOJECT ADDNESS: c) 8 j W 18 TH $T OWNEP'SNAME: DOROTHY WESLER aooness: gg1 W 18TH ST JtA COSTA MESA CA 92627 (714)642-6642 PflCM/ENGINEFfl: AODRESS: neo.xo.: UNIT: UNIT: PEflm'TTEE: MODULAR PROTECTION ( 714 ) 675-3437 aoosess: 2 2 z z COCO PALM TUSTIN CA 92680 LICENSEo CONTHALTOB DECIANAiION: I nere�y aHirm tnat 1 am IicenseJ unEer Orovisions ol CAapter 9(commencinp wit� Sec�ian 7000� ol Division J oi i�e Business an0 Prolessions CaOe. anG my license ¢ in lullfoue an0 ettect. CITYLIC.:O 19 srareuc.:65542 euss:C-16 EXP: 04/95 ' oa�e: _� 1 Siqnamre. _ _� ' IWOHHEN COMP 7 TIONOECIAPATION: I�ereOyatfumtlu�InaveacertilicateolconsenitoselNnsureoracertificateolWorker5' Compen5alion Insurance. or a ceriilie0 cooY �nerto115ecQon 3800. Lao. C�. Paucvxo.:13154339-39 E%P.ORTE: OS/OL/9S comvaxr: STATE FUND ❑ Cenilied c pY is her Oy furnis�etl. � CenifieE copy yis f��eC wit� t�e dry BuilEing Divaion. Dale: `r APOliwni: �Y�//�^�� E%EMP710N FpOM Y PIIEflS' COMPENSIITION OECLRMTION: (iNs uCUm nMG roi Ee mm(tlete0 i� pE permil i5 �M dle hunAreO �5100) or I¢55�. I cenity Ihat in ine peAormdnce al ihe wOrk for whitn ihis perrttit is iSsuea. I StWtl nol employ any per5on in any manner so as to hecome 5u0�ep lo ihe Worker5' Compen5alion Laxs o� Caldomia. Date: Signamre: N�TILE: II. aller maMinp I�is d¢tlaraUon. you SOou10 Eemme SuOietl Io 1�¢ WOrkers' ComOensation pmvisions of the La6or CoGe. yrou musl fantrmtn campty wi�� suc� prmd5iort5 or INS p¢rmit StuA he CeemeE rewke0. LONSTBIlLTION 1EN01NG RGENCY: I �ere0y atlirm itut Nere ¢ a mmtructian IenGing apency fw I�e peAwmance of ��e vrork for w�ich t�is permiiis issued (Section 3097. Gv. C�. LENOEfl: AODPESS: /I OWNEP BUILDEB DECLAIUTION: I �ereUy allirm tlut I am exemp� imm ihe Contractor3' State License Law lar I�e followin0 reason (Sectian 703t.5 Business anA Pmfessional COEe: Any ciry ol counry wliic� reQuirts a pemrit ro construci, alttr, imD�%'e, Uemolis�, ar re0air am) stmnure, prio� to its issuance, also repuires Ue a0d�� ar suc� permii Io ide a SiB�� sutement that he/s�a i5 IicenSeE pursuanl to t�e D�ovisions ol i�e Coniractors' State License Law (Ctupter 9(commmcinp wit� Section 7000) ol Divisian 3 of lhe Business anG Pmfessions Ca�e) or t�a� �e/s0e is eaempt I�erefrom an0 �ne Oasis lar t�e allepeE eKemD��on. My violation of Section 7037.5 hy any applitant far a perrtul weiects ine appiWni to a uvil penaity of not rtqre tAan live huntlre0 Odlars (5500). I. as awner of ��e pmpeny or my emWoyees wit� wayes as meir sole wmpenution, wlll do t�e wad, antl t�e ❑ strucmm rs not intendea or olferetl lar sale (Sectian 70M. Buvness an0 Prolessimal CaOe: The Conlractors' S�ate Liunsa Law aoes not aooly to an owner ol a D�aDeny wh0 Guilas or imD�aves Inereon, an0 wno aoes such woM himselllnBrseil or InroupA �is or Aer own employees. OrovitleE ttwt suc� imDrovemena are nol inten0e0 or oflereE for ule. If, Mxever t�e OUIl01np or impwvement 6 5010 vnlNn ale y¢ar ol cartqleibn, t�e ownef will have lhe OurCen ol prOvinO ��e Oi0 nol bui10 or impwva " lorine purpase ol salel. I, as owner oi me proDeny, am exdusively contractinp wiN Ikense0 wntracmrs m constmtl t�e project (Seciion 70aa. Business ❑ anU Pmlessiws CaEe: TAe Cantactors' S�ate Lkmu Law Uces mt appry ro an ovmer al D�Perty � OmIEs ar imprwes therean an0 w�o convacis lar suc� O�q��s with a wniractor(5) ��cense pursuant to t�e Contractors' SWta Licenm Law). I am awam Ihal prooi ol 1�¢ir WOrkei 5 Com0en5aiion insurante S�ON4 De OmviUeA Io me. � I am e�empi untler Section: 6. 8 P. C. tor Ihis reason: Da�e: �e� i ao here�y cendy �nat I am avrare of anC uMerstanE �ne repuirzmenR of Ca4lornia HWt� anE Satery Code Sections 25505, 25533, antl 2559d antl Ihat I or any lutWe Ouiltlmq acupant vnIV=11 not (drGe one) nee0 io wmpry wit� Saia state cotles antl ihe repuiremenis for a permii lor conslmction or modilica�ion from IOe Air Ouahiy Managemeni DiSMti. Re5i0eniial COnSimclion applicalions ate exempi Irom �hese pmvi9ons. Daie: �W�ticam: I hereGy cerii�y Ihai I have reatl Ihis appliWtion an0 Slaie Ihal I�2 a ve mlOrmalion is fArrttL I aqrte l0 fAmD�Y �� all Ciiy an0 COuniy or0inancesanOSlalelawsrelatingla�uil0ingconslmaiananUnere�y tMrizerepresentatWesollMsdrytoenterupontheaEme-mentionetl pmoeny lar insp �tian pur Oses. Date: 2 Sigialme: A � � Uriver's �icense or 'al Securiry e: ,.� �6ai-a6 Whne—Building: Green—CaEe Enlo¢ement; Canary—ApO�� Pink—Revenue; GobenroE—Asseswr CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F Q70905 PEAMIT NO; F 070905 FLAN CHECK NO: 00036-95 L GOVT; N SUPP: N COA]STRUCTZON TYPE: PERMIT TYPE: FZR PURPOSE: OTH JOB DESCRIPTZON : FIRE SUPPRESSION FOR CELL SITE SQ FT: CLAIM VALUE; 5,000,00 CALC—VALUE; GROUP OCC; B-2 / COMMENTS: FIRE SUPPRESSION FOR CELLULAR PHONE EQUIPMENT BUILDING it***+�r**�t�t*itirit***ir*�trtit�tt**�r�tra�r*+*r*ir�*r+r�t�t**itirr�tit�r*rrr�rx�ir�t�rr�r�*i�***�xrr+F*�**x** Z O N I N G R E Q U I R E M E N T S S E T H A C K S ------------ MAZN BUILDIPIG ---------- --------- ACCESSOP.Y BUILDING --------- FRNT: FT ZN AEAR; FT IN FRNT; FT IN REA.R; FT IN LEFT; FT IN P.GHT; FT IN LEFT; FT IN RGHT; FT Itl PARKING REQ: PROV; PARCEL; 00000000 ZNE; REF NO: PLANNING NOTES> i **w*�*�***�r+r***�rr*,r�*�r*+t�r**rir*****+r�r»****w*r***r**,�u**r*��r*x�**+�*+t*+�*�***x�r*x�*�- D E L' E L O P M E N T S E R V I C E S A E Q U I P. E M E N T S ZONING APPROVED BY , DATE: BUILDING APPROVED HY : DATE: APPLICATION ISSOED BY: �NL DATE: � 2(o ctlr M if 1f if if iFM iFif afit 1f if ifM 1f 1Eif�F �f M iE . if jM if �f �E if �F iR if iF iE iE iE if 1E f if 1f M if if if if if'lf if 1! ik if� if if if Y if iF if ii 1f if i(� 1F if if if iF if ik af iF i! if ii af iR 1f iF'1!� +i ii iR 1E M iF 1F 1F �4 �! i� if if �f iE iE iE M�f if if if i� iR if af 1f jf iE if �If� if 1f iE LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMEPIT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING AERMIT 72,00 PLAN 466go SMIP/NON—RES ISSUE FEE BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 72,00 0.00 46.80 118.80 118,80 .00 REVENOE DIVISION TOTALS--> COLLECTED: 72.00 OVER/SHORT: .00 SLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK %2,�� itiEiFilM�M�kiFiEifitifritMitififitilriElfifi�ritiflf�Ilif��FMriei!ifatrkif#Fif-lfltkifiliFifi'i'1fkltififMifiti'1tiFil4itllritYi!if�fitifiraf* I PJ D I V I D 0 A L F E E B R E A K D O W N TYPE QTY D E S C R Z P T I O N UNIT COST TOTAL COST FIR 72 FZRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 72,00 END OF FEES Q2 �7017S6c0-00175ft6U Ti_tY '2,�17 D�7E: G1/2Els" TI�fE: 15:?0 CONSTRUCTION ANDPIANNING POOL,��PA APPROVALS Permit # � Date Inspector APpROVALS Permit # Date Inspector 1. Temporary Electrical Service or Poie 52. Pool & Equipment Location 2. Soii Pipe-llndrgrnd. 53. Stcel Reinforcement 3. Elec2rical Conduit Utiiity-Undrgrnd. 54. Forms 4, Electricai CondUit•Undrgrnd. 55. Electrical Bonding 5. Steel Reinforcement 56. Rough Plum6ing & Pressure Test 6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE 7, Footings 58. Electrical Conduit�Undrgrnd. B, Foundation � 59. Gas Pipe, O UnUrgmd., Test 9. Water Pipe•Undrgrnd. 60. Backwash Lines, RTrap, O Undrgmd. 10. Structural Floor System 61. APPROVAL TO DECK 11. Property Sewer Line & House Connettion 62. Backwash & Receptor•Final 12. Sewer Cap . 63. Heater & Vent-Final 13. Roof Drains 64. Plumbing System - Final 14, Rough Plumbing 65. Etectrical�Final 15. Rough Electrical-Condu�t '� 66. Solar SYstem�Final 16. Rough Electric Wiring 67. Fencing & Accets A�Proval 17. Rough Wiring Sign 68. APPROVED FOR PLqSTERING 78, Rough Electrical•T Bar Ceiling 69. POOI/SPA SYSTEMS FINAI 19. Rough Heating & Air Cortditioning FIRE DEPT. REQUtREMElVT 20. Rough Factory Fireplace • - � � - AppROVALS � � Permit # 21, Ducts, in Structure • ' � 70. Underqround HYBro 22. Ducts, Ventilating- )1. Product Piping O Gas � Oii 23. Gas Pipe�Rough & Test � . _ 72. Under9round Flush 24, Root Framing ' ; � ' 73. Undergrnd.StorageTank OGas DOiI 25. Roof Sheathing � 74. Overhead Hydro 26. T�Bar Ceiling IStructural) & Monocoat . , . ' 75. Dry Chemical 27. Frame and flashinB . 76. Dry Standpipe • - 28. Laihing & Siding '• 77. FIXED SYSTEhA.FtNAL' 29. Insulation � 78. FIRE PREV. FINAL ' /�y�9� � 30. Drywall Nailing „ HEAITH DEPT. REQUfREMENT 37. P�aster Brown Coat , 79. FINAI INSPECTION 32. Electrical Power Me[er-Final B0. FOOD CERTIFICATE ISSUED 33. Final Electric ' �Notes: � 34. Final Heatin9 & Air Conditioning 35. Final Gas Pipe-Test � 36. Nood or Canopy . � - � ' 37. finai Factory Pireplace .' . ,, � � 38. Fina6Piumbing ' � 39. Water Service�Final ' . � � 40. Gas Service-Final . � - 4t. So�ar OomesticFinal ' - _ • . 42, 9ackflow Preventer � • � � 43. dackflow Irrigation ' � 44. Landscape Irri9ation System � _ � ' 45. 5ound Attenuation ' . 46. Handicap Aegulations " 47. FINAL STRUCTURE & BUILDING 46. FINAL PLANNING 49, Electric Release to Edison 50. Gas Release to Southem California Gas Co 57. CERTIFICATE OF OCCUPANCY No. Date