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Home My WebLink About985 18TH ST - Building PermitsCITY OF COSTA MESA BUILDING DIVISION DEVELOPMENT SERVICES DEPARTMENT PERMIT C_S_/ V PERMIT NUMBER E98-00812 � (714) 754-5273 • fax (714) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: Owner: Address 985 W 1 STH ST 42436105 SMITH, GARY ELECTRICAL PERMIT ;�"s� Phone: � r � /� " , Zip: ,n << �� ' l � =N'T TR ✓i 1 ; , ,_ ` _ � -�' PhOne. Zip: SWtus: ISSUED Applled: 07/31/1998 Issued: 07/31/1996 714-642-1500• -- - ; �/ �j�,'� �� i �`�l\:\ - �-' `_ / � �"�` � \ w��,�```�r"�C� \ \~\��\\ ��_�� ./ ./� �\\� � 92663 ��A��;ti , i / / ��\��`� `�� A�� V ' ��V" / �� .�A�� \�\�./ �;\�\ �� ',� `�� .":•`\ .\ \��\ �1 % Phone�; � �� '� � � - �.� _ •i•�Z��'� � �� ' 1 ��r.. .� ��.;�� .., i, � !t .rLicense . ! . , . _ � -.��1 ! � -r`��c ��'� - - ��,�,: �' `; ' ��' /',.. �:,; ` �� '`.. . . �� - ! ;.' � �r= ��"�� SCOPE OF PERMIT � �� ` ��. _, �^REF'B98-01293;�WST 27 FIXTURES, 65 OUTLETS, 8 SWITCHES, 2 SUBPANELS, 6 MOTORS TO'1.0 % ��`� HP, �7 MOTORS TO 10 O�HP,3 MISC APPARATUS�(WELDERS)�� — ,�i-� ��i i r�i .J �� {, :,�-1., � i�,'�.�� . , 1:= � � ,� � ...� - ..�� J�,.. . . .. - ti� � �, �,, FEE �=i �`' , . ervicetest ��<< New Res,(t-2�units) � New Res �(3+units) " Pool / Spa� `� �� Lighting Fi�cts VV� � Recept Outlets \ / Switches �',��'� Non Res Ap'pl��A Res Appl '��.-��, Service to 200a��`� Service to t000a `� Service over 1000a Motors to 1 hp Motors to 10hp Motors to SOhp Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuits Temp Pwr Pole Intermed Pole `7 $22.00 $0.00 $0.00 $0.00 so.00 $0.00 --- --------- �� FEE SUMMARY -`7 , � , ,� , ' J, � h �Qaantity-�, �"1^.,r-. �_� �-. � c,',/`�.�.:, � Quantity� . , � — � _-_ ,—Temp Dist System'/�Lighting $0.00 0- � - ' - �'; -� � "- � -- -- Busway%700ft� � $0.00 0' � . �� '� � Standing�Sect.ion � $0.00 0 � ��' � � 0 Misc Electrical Equipment ' , $48.75 �3 � �� ti' � 0 Trensformers�up'.to 1 kva/kw $0.00 -��0 � � '-�- ' 0 ................up to 70 kva/kw � $0.00 %S;: 0 , /�� / ' 27 ' . -� -"- � .' . ....:............up to 50 kva/kw $0.00! %% 0 ` . , ,; ,� � 65 . �� - �• .....up to 100 kvalkw $0.00,"��% 0 �" " ' ' � 8 � �� - :,:fover 100 kva/kw $0:00;- 0 � �� 0 . � ,.= ��Low Voltage Equipment � $0:00 0 � ' ` ' __ �,�i ,�� 0 _'� � � -', �Low Volt Winng System / Ckt - = $0.00 . 0 � ' �'' � ��$0.00��A� 0� � � 'Misq: Condw{; �� - ;� $0.00� 0 �� ' " $0.00 �0�� = ; ' � � � = Misc.� Conductor � � � � � ' � ' - $0.00� -, 0.,�./ - � `� $0.00V ��Oc�^_�V � � ''� � � � �Circus ( gen o_r� ride) � � $0.00' `� 0'. - � `�`� $25.`50 �� 6 � �=ti �,� �- " , Cirous (mech ride or lights) . . - $0.00 �� 0 �, � \ �\ � _� $77.00 i� � � 7�_ _ - Christmas Tree Stand ' �$0.00,-- - A� � �;'$0.00 ��J//0� �� FireworksStand�. - ,�- $0.00� ; � 0 �`�$0:00� � (JO �'� - J ; , � . Other�Electrical Fee ?`, .-,$0.00' $0.00 �� Oi �, l , - � � _ � . ,' - _i . ; $0.00 `� �->_-0�- �� - � � ��'�`�,Investigation Fee � �$0.00 $54.50 --,2_ � _ : Plan Check Fee_ �; � � - $0.00 - $0.00 0-, � . � � ... , >,Reinspection'Fee- `- $0.00 $0.00 0 $0.00 0 TOTAI CALCULATED FEES 5309.55 $0.00 0 COMMENTS I SPECIAL CONDITIONS EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or it work is suspended or abandoned for a period of 780 days. INSPECTIONS: In order for the work authorized under this pertnit to be considered legal, such work must comply with all applicable codes, and all requlred inapeetlons and finel approval must be obtained. Failure to obtain Inspections and final approval will result in the expiration of this permit. FOR INSPECTIONS CALL: (714) 7545628 WORKERS' COMPENSA710N DECLARATION: ' I hereby eKrtn under penelry oi per�ury one oi Ihe following deGaretions: � ❑ I heve enA wlll malntein e certificete of consent ta self-Insure for workers' compensetion, es providetl for Cy section 3700 0l the Lebor Catle, for the pertortnence of the work for which this permit is Issuetl. ❑ I �eve entl wlll malntain workero' campensatlon insurence, es required by seqion 3700 of Ne Lebor Code, for the pedormance ot the work for whic� t�is pertnit is issuetl. My workers' compensetlon Insurance certier end policy number ere: Cerrier. Policy Number. (lhls section need not be compleletl i! the perml! ls ve/uetl af one hundred dollers (5100) or less.) ❑ I certify Ihat in the peAormence of �he work for whlch Ihis permit is iuued, I shell not employ eny Derson In any mennar so es to become sub�ect to ihe warkers' compensetlan laws at Celltamie, and egree that If I shaultl become su6ject to the workers' compensetian provisions of Sectlon 3700 of Ihe Lebor Code, I shell torthwith COmply with ihese provl91on9. Applicent Signeture: Dete: WARNINO: FAILUFE TO SECURE WOHKERS' COMPENSATION COVERAGE IS UNLAWFUL PND SHNLL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES AND CIVIL FlNES UP TOONE HUN�RED THOUSAND DOLLARE (5100,000), IN A�DITION TO TME COST OF COMPENSATION, DAMAGES AS PROVI�ED FOR IN SECfION 31080F THE UBOR CODE, IPREREST, AND ATfORNE1^S FEES. LICENSED COHTRACTORS DECLARATION: I hereby etFirtn ihet I em Ilcensetl untler provisions ot Chapier 9(commencin9 with Sadion 7000) of Divlsion 3 of the Buslness end Professions Coda, end my Iicense is In Full force and ettecL Lic. p � Cless N Contrectors Signature: Date: CONSTRUCTION �ENDING AGENCV: ,❑ I hereby affirm that Ihere is e construcGon lending egency tor Ihe performance of Ihe work for which this Dertnit Is issued. (Sec. 3097, Clvil Cotle). � Lender's Name: Lender's Atltlress: I Signature: Deta: OWNER•BUILDER DECLARATIONS: I �ereDy eftirtn ihat under penelry af per�ury Ihat I am EXEMM FROM TiE CONTRACTOHS LICENSE LAW tor Ihe tollowing reewn (Sec. 7037.5, Business end Professions Cotle: Any ciry or counry which requlres a permlt to construd, alter, Improve, demolish, or repalr any structura, prior to its Issuance, elso requires the epplicant for such pertnit to file e signe0 statement that he or sha Ls licensetl pursuant to �he O�aNsions of iha Contractors License Lew (Chapter 9(commencing with Seqlon 7000) of Division 3 of Ihe Business anO Professions Code) or Ihet he or she Is ezempt therefrom and the basis for the alleged exemption. Any violetion of Section 7031.5 by any applicant for e pertnit sub�ects the epplicent ro e ciNl penelry ot not more than flve huntlretl tlollars ($500) J: ❑ I, es owner of the property, or my employees with wages as Iheir sole compansatlon, WILL DO THE WORK, end Ihe structure Is not intentletl or otteretl 1or sale (Sec. 7044, Business entl Protesslons Cotla: The Contractars License Lew does not apply to en owner ot properry who builds or improves thereon, end who tloes such work hlmseli or heroelf or through his or her own employees, provitletl that such improvemems ere not intentletl ar afleretl 1or sele. 11, hawever, the buildinp or improvament is sol ' n one year ol completion, t�e owner-Duiltler wlll �ava the burden ot proving ihat he or she did not bulid or Imprwe lor purpose of sele.). I, es owner ot Ihe Droperty, em E7(CLUSIVELY CONTRACTING WfTH LICENSED CONTRACTORS to construcl the project (Sec. 7044, Business entl Professions Code: The contrectors Ucense Law does not epply to en owner of property who Guilds or impmves thereon, end who wntrects for such proJect with e contractor(s) Ilcense Dursuent to the Contredors License LewsJ. ❑ �n e:�dt under �er ID vedfled Vedficatlan of Ow Business en0 Professions Cotle for this reason: license. �B'9es ❑ No Dy (type of document, i.e. - properry ta+c DIII or deed): DIVISION OF INDUSTRIAL SAFEN PERMR CERTIFICATON: Driver's License No. Expires: ❑ I hereby cenity Ihet no eacavetion iive (5) or more feet in depth Into which a person is redulretl to tlescen0, wlll be metle in cnnnedlon with work authorized by this pertnit, enA ihet no building structure, scattoltling, telsework, or demolition or dismentling Ihereof, wlll be more Ihen thirty-six (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 3A1, 71t1e B, Celtlomla Atlminlstretive Code). ❑ As owner-bulitler, I will not employ enyone to tlo work which would requira a pertnit irom the Divlsion of Intlusirlal Safery, es notetl ebove, unless such person hes e pertnit ro do such work imm the division. Signature: Date: Division of Industnel Satery Pertnit Number: CEHTIFlCATE OF COMPLIANCE AND AIJTHOR¢ATION OF ENTRY: I certify under penelry ot perjury Ihet I have reetl this application end stete thet the information given is wrtect. egr e to wmply with ell state I end ciry ordinances relating to building construclion, end euthoAze representetives of the City ot Coste Mesa to enter upon the above- d property�=eclion ses. 1 agree not to occupy or allow occupancy of eny building authorized b ihis pertnit until I ection. , � �-�/• �i � Sin'innt��ir (N Ownerfsl Data $�j,y INSPFCTONTYPE 1616 Fized System Final Fire Preven6on 1288 Pool Spa Final 200 Fnal Re-Roof 201 Final Block/Reteining Wall 202 Flnel Fectory Flre Plece 203 Final Sign 204 Finel Demolltlon iZEi•S!! psg ��$ jflpFj INSPECl10NTYPE 206 Finel Mechenical 20B Finel Plumbing 210 Final Electricel 212 Finel Fre Preventlon 220 Finel Planning Approvel 222 Finel Si�e 250 Final Bullding/Occupancy 4.\�� II�IDELS -� . _ CIN OF COSTA MESA _. ; � BUILDING DIVISION � DEVELOPMENT SERVICES DEPARTMENT �•�� PERMIT �P RMITNU ER Y E99-00210 (714) 754-5273 • Fex (774) 754-4856 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Atldress: Suite No Vicinity: Parcel Nunmber. APPlicant: Address: Owner: Address Contractor: Address: ISSUE FEE Temp service test Res. alc package New Res (7-2 units) New Res (3+units) Pool / Spa Lighting Fixts Recept Outlels Switches Non Res Appl Res Appl Service l0 200a Service to 7000a Service over t000a Motore to 7hp Motors to tOhp Motore to SOhp Motors to 100hp Motors over 700hp Communicgtion drops Sub panel to 200a Pole Light Pkg Sign Cirtuits Temp Pwr pole Intermed Pole 985 W 18TH ST 42436105 GARY SMITH SMITH, GARY 985 W iBTH ST C.M� ELECTRICAL PERMIT Phone: 949-642-1500 Zip: Phone: Zip: 92663 Phone: Zip: License: SCOPE OF PERMIT INSTALL 2 OUTLETS, 3 SWITCHES AND 3FIXTURES FOR OFFICE TI, RE;Bgg-00350. S22.00 $0.00 $0.00 $0.00 $0.00 $0.00 $3.00 $2.00 $3.00 $0.00 $0.00 50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 so.00 so.00 $0.00 $0.00 $0.00 50.00 Quantity FEE SUMMARY Temp Dist System I Lighting Busway /700 ft - Standing Sedion Misc Electrical Equipment Transformers up to 1 kva/kw ................uP to 10 kva/kw .................uP to 50 kvalkw .................up to 100 kvalkw ..................over 100 kvalkw Low Voltage Equipment Low Volt Wiring System I Ckt Misc. Conduit Misa Conductor Circus ( gen or rida) Circus (mech ride or lights) Christmas Tree Stand Fireworks Stand Other E�ectrical Fee Investigation Fee Plan Check Fee Reinspection Fee status: ISSUED Applied: 03/12/1999 Issued: 03/12/1999 Quantity 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 50.00 0 50.00 0 50.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 0 $0.00 $0.00 50.00 50.00 TOTAL CALCULATED FEES E30.00 COMMENTS I SPECIAL CONDITIONS EXPIRATION: This permit shall automatically axpire antl become void it work is not commenced within 180 days, or if work is suspanded or abandoned for a period of 180 days. INSPECTIONS: In order tor the work autMrized urMer this pe+mit to be consldered �egal, such work musi comply with all applicable codes, end atl requlred Inepectlona entl flnel approvel must be obtained. Feilure to obtain Inspections and final approval will result in the expiretion of this permit. FOR INSP�CTIONS CALL: (714) 7545828 � WORKERS'COMPENSATON DECLARATION: . I hereby eHirtn unAer penalry of perjury one oi the idlowing tleclaretlons: ❑ I have end will malnteln e certilicate of consent m setl-Insure for workers' cwnpensetlon, es provitletl tor by sectlon 3700 0l Ue Lebor Code, for Ihe pertarmance of �he xrork for whlch ihis pertnit Is issued. ❑ 1 �ave antl will malntein workers' campensetlon InSurance. es repulretl by section 3700 oi the tabor Cade, for ihe perlormence ot the wwk fw wNch Ws pertnit Is IssueA. My vrorkera' compensetlon Insurence cartier end policy number ere: Carriar: Pollcy NumOer. (Thls secUon neetl not be comp/efed!! Me perm7l /s ve/ued ef one hundred dollers (S100J or less.) - ❑ I certlty that In Ihe peAormence ol the work for which this permit is Issued, I shall not employ eny person in eny manner eo as to become subJact to the workera' compensetlon lawa of Califomia, end epree Ihel II I ahould become sub�ect to Ihe workers' crompensetion proNslons of Sectlan 3700 of Iha LeDor Code, I shell forthwith comply with these provislons. Applicant SlgneWre: Date: WARNIN(3: FAILUNE TO SECURE WORKERS' COMPENSATIIXJ COVERAQE IS UMAWFUL AND SHALL SUBJECT AN EMPLOVER TO CRIMINAL PENALTIES PND CML FlNES UP TO IXJE HUNDRED T}10USAND DOLLFRE (5100.000),IN ADDITIIXJ TO THE COST OF COMPENSATION, DPAN�ES AS PROVI�ED FOR IN SECTION 3/080F TME LABOR CODE, INTEREST, AND ATTORNEI^S GEES. LICENSED CONTRACTORS DECLARATION: I hereby efflrtn tha� I em licensetl under provisions oi Chepter 9(commencing with Section 7000) oi Division 3 of ihe Business end Professions Cade, end my license is in full torce and eflen. Lla x Cless a Contrectors SlpneWre: Date: CONSTRUCTION LENDING AGENCV: ❑ I hereby eftirtn Na� there is e construction lending egen�y lor Ihe peAortnance ol the wark br whith Ihis permlt is Issued. (Sec. 3097, CMI Code). Lentlers Neme: Lendefs AdEress: Sipneture: Date: OWNER•BUILDER DECLARATIONS: I hereby eXirm thet under penalry oi perjury that I em EXEMPT FROM TME CON7RACTORS LICENSE LAW lar the following reason (Sec. 7031.5, Busineu entl Pmfesslons Code: Any ciry or counry whic� requlres e permit to construd, alter, Improve, demolish, or repeir eny sirucNre, pdor to Its Issuence, elso reduires Ihe epplicant for such permlt to file e slpne0 statement t�at he or she is Ilcensad pureuent to the provisions of Iha Cantrectors License Lew (Chapter 9(commencing wlih Sectlon 7000) of Divislon 3 of the Buslness anO Professions Code) or thet he or she is exempt therelrom end the basls tor Ne ellegetl exemptlon. Any violatlon of SecUon 7031.5 by any applicant for e permlt sub�ects the epplicent to e civil Denelty ot not more then five hundred tlollars ($500).): ❑ 1, es owner ot the property. or my employees with weges es Ihelr sole wmpensatlon, WILL DO TF1E WORK, enG tha structure is not intended or ottered for sale (Sec. 7044, Business end Pratessions Cade: The Contrectors Llcense Lew does nat eppty to en owner of property who builCs or Improves t�ereon, entl who tloes suc� work �Imselt w hersell or ihrough hls or her own employees, proNCetl Ihet such Improvements ere not Intentletl or ottered tor sale. If, however, the building or improvement is sdd wlthin one year oi complefion, the owner-bullder will have ihe burden of pmving ihet he or she tlitl not builtl or Imprwa tor purpose ot sale.). ❑ I, e9 owner of the properry, am El(CLUSIVELV CONTRACTING WfTM LICENSED COHTRACTORS to consiruct the project (Sec. 7044, Business antl Professions Cade: The contrectore License Lew does not eppy to an owner of properry who builds or improves thereon, anA w�o contrects tor such proJecl with a contrador(s) Iicense purxuant to the ConVactors J�snse Lews.). _,� ❑ I am exe der sec. Business and Prolesslons Cotle for Uis reason: �� SignaNre: Dete: Uvner ID verllleC by d rs Ilcense. ❑ Yes ❑ No DrHels Llcense No. Vedllcetlon of Owne p by (type of Eocument, i.e. - D�operty tex bill or deed): DIVISION OF INDUSTRIAL SAFEN PERMR CERTIFICATION: ❑ I hereby certlly that no excevetlon five (5) or more leet In dept� Into w�lch a person is requlred to descentl, will Oe maOe In connectlon wlth work authorizad by thls pertnit, end thet no bulldlnp aWcture, scettolding,lelsework, or demoliHon or dismantling thereof, wlll be mare then ihirry-elx (38) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Tltle B, Celllamle Administretive Cotle). ❑ Aa owner-bulider, I wlll nat employ enyone to tlo work which would requlre e pertnil trom Ihe Divislon of IndusMel Sefery, es nated ebove, unless such person hes e permit to tlo such work trom the division. Signeture: Date: Division of IMustrial Safery Pertnit Number: CERTIFlCATE OF COMPWWCE AND AUTHOR ON OF EHTfiV: I certily under penelry of perjury ihet I �eve read this epplication end stete thet ihe intortnetion given is corred. gree to compty with all state lews e ci ordinances releting to building wnsWction, end authodze representetives ot the Clry of Cosla Mesa to enter upon t�e ebove orooeMlelp�sDection purpo s egrsa�n6(I�occupy or ellow occupancy of eny buit�ng euthodze,�A by Ihls pertnft until ffnal (nspecibn. Md�Or Authorized Applicant COOE �. dSPECTIONTYVE 7818 Fxed System Finel Fire PrevenGon 1288 Pool Spe Final 200 Flnel Re�Roof 201 Finfll &ocWReteining Wall 202 Flnel Fectory Flre Plece 203 Flnel Slpn 20A Finel DemollUon 2H8�8 �.�IIIIJR+, �j IxSVECTIONTYPE 206 Flnel Mechenlcal 208 Finel Plumbing 210 Flnel Electrlcal 212 Rnel Flre Preventlo0 220 Flnel Planning Approval :s� 250 Flnal Site Flnal Bullding/Occupancy � �� -: ., . y�� :.:.,.::�;: �. CITY OF COSTA MESA BI/ILDING p1VIS10N DEVELOPMENT SERVICES DEPARTMENT PERMIT � PERMIT NUMBEfi � 698-01293 (714) 754-5273 • Fax (714) 754-4856 . 77 FAIR DRIVE, COSTA MESA, CA 92626 Job Address: 985 W 18TH ST Suite: Vicinity: Parcel Nunmber: 42436145 npplicant: SMITH, GARY Address: 2869 TOBAGO PLACE Owner: Address BUILDING PERMIT Zoning: – � �r.Phone.. (7.1A) 979-5386 . COSTA MESA, CA �.��X -- ; " Zip ' 92827 - � - � -. � i�/ -�• � � . , , , � t - i� � � �MPBEL"L`�ALLEN T TR � � - � /� � � � � i ri t �� '-, l i � / r . I.VIA CIDO NORD .. ' ,. � ` - / ( ' � � � � � ,A < //� \\`�_, ��l � l � ! �� -- P4Aone v–�-: :�� .-. ��.. t < �%-\ � ., �� ` � ORT� CH CA.i�,.� _ - .. Zip 92663 �'\ �� . \ \ i j:, �\�\ % � \ �/%,��` �1��.� � �\��\\.. ��l" `��i �A�'�� \A \ �,�:: v� �\V`. , �� Phone: �- . �,�.. �� Zip: � � �.\ r�� Licenae: _ _ _ � ,' �� , � � � � � �, � , � .,. . �i -� �` �, � ;, ; — � iC ' � i t e; �, � � / � `-�- A i `�`�� i �� y'_�� .P,hone_ _� .°�.,e,�{t�� r \ ,.r`%" i �, 1 �! 1��,��_ - 2ip. .<R ;ii �� .. � , J.. r �..•� �� f" .' License. � r, �, *� ii / r ' �,� \ i. .- . A /"�/� v- ,�� f `, � J Arch �Eng �' jJ�I- Address � 1 t�� `�.....// /!i ) �j i )�y �''�'� '� I .. �,� �, � Status: ISSUED Applied: 07/17It998 Issued: 07/30/1998 �� INTERIORAL >; � !ANDAFIREE I i��, ^ ,{.'i,i ��,`t� �i - i i^,*�� '� � _... ��1.�., ;�Plan Check �� '$81.09 l�� tPermit ��124.75 �ISMIPRes ��;'$0.00 �SMIP Com>� ��\$1.32 SF7@GllOfl: j �\�\ �/ � �� SCOPE OF PERMIT �V � , !R4TIONS TO AN EXISTING INDUSTRIAL BUILDING>TO�INS7ALL PARTITION WALLS IT DOO , � C��,. - — � � ., u _ ;: . ` �: ��'. ; ..A� . � .. . � ' . , / .��4xk� y.^, –. ., �.�,.... J � � � - a�.,�. - _, �� / � , ��` / �` — — � � r� %t� �� . l. �� ' �'� � ,� � � ,:..A . �. . r: �� .� � �� V � �I .. , i . � ��\ ; /% � �`;� �" r PL4NNING'& ZONING � � �� /�..� � �,.��..� '- , ., r,n �` � � � ,`� _.r �% r � '- \ ' //'� , � ;\ - SETBACKS �.�:A ��%�`' �� `": �' ��` � _ .-, , ,_, MAIN STRUCTURE Fionf ; 0�0� %` /� Rear 0- 0 .Left - 0- 0� ��-A ��,'��- ' - � \ �J,/.�-' � �, ACCESSORY Front�0 0•A � Reai,-..0-0 ` `;LeR,' �0-0 ��'�` �''�� \ ... , PARKING Existinq: 0�� `- quired: 0 l��- Proposed: 0 NOTES: � � _ � . � . ` � , - . • =Calc Valuation � Claim Valuation i � '� ; �, $6,300.00 -$6,300.00 , �� - %' � ',1!. � , �; ; i%i,j �� .�� i � � . \� � � t� /. "- ' / .e;. i%. , i� . � '��i �� <� i(-/ ` � i. - . � ,, / /,, Right . 0- 0 '.� � � Right -„ 0; 0 �. .�. - EXPIRATION: This permit shall automatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. INSPECTIONS: In order for the Work authorized under this permit.to be considered legal, such work must comply with all applicable codes, and all required inapectlons end flnal epprovaf must be obtained. Failure to obfain inspections and final approval will result in ihe expiration of this permit. FOR INSPECTIONS CALL: (714) 7545626 WORKERS' COMPENSATION DECLARATION: , I hereby effirtn under penalty of perjury one ot the following declarations: ❑ I heve anO will meintain a certificate of consent to sett-Insure for workars' compensation, as proviAed 1or by section 3700 of the Lebor Code, for the perlormanca of ihe work for which this pertnit is issuetl. ❑ I have and wlll maintain workers' compensation insurance, es required by section 3700 of ihe Lebor Code. for ihe perlortnance of Ihe work for which this pertnit is issued. My workers' compense�ion Insurance carder and policy number ere: � Cartier: Policy Number: (71rls secUon need nof be comp/eted i/ fhe permit is va/ued af one hunCred dollers ($100) or less.) - ❑ I certify Ihat in the perfortnance of the work for which this pertnit is issued, I shell not employ eny person in any menner so as to become sub�ect to the workers' compensatlon laws of Califomia, end egree that if I shoultl become subject to Ihe workere' compensetlon provisions of Section 3700 of Ihe LeEor Cotle, I shall forlhwith comply wlih ihese pravisians. Applicent SigneW re: Dete: WARNING: FNLURE TO SECURE WORKERS' COMPENSATION COVERAOE IS UNLAWFUL AND SHALL SU&IECi AN EMPLOVER TO CRIMINAL PENP.LTIES AND CIVIL FINES UP TOONE HUNDRED TqUSAND DOILARE (5100,OW), M ADOITION TO THE COST OF COMPENSATIIXJ, DAM4GE5 A$ PROVIDED f-0R IN SECTION 3]Ofi OF THE LABOR CODE, IMEREST, AND ATTORNE`fS FEES. LICENSED CONTRAC70R5 DECLARATION: I hereby aHirtn ihet I em licensetl under provisions of Chaptar 9(commencing with Sadlon 7000) ot Division 3 of ihe Business antl Professions Cotle, and my license is In tull force end eHect. Lic. # Class # Contracror's Signature: Date: CONSTRUCTION LENDING AGENCY: � ❑ I hereby affirtn that Ihare is a construc�ion lending agency for ihe peAortnance of ihe work tor which Ihis permit is issuad. (Sec. 3097, Civil Cotle). Lentlefs Name: Lendefs Address: Signeture: Date: OWNER-BUILDER DECLAHATIONS: I hereby aKrtn that under penalry of perjury �hat I am EXEMM FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Businass and Profeulons Code: Any ciry or counry which requires e pertnit to consiruct, alter, improve, demolish, or repair any structure, pnor to its issuance, elso requires iha applicant for such permi� to Tile a signeO statement Ihat he or she is licansed pursuant to Ihe provisions ot ihe Cantrectors License Lew (Chepter 9(commencing with Section 7000) of Division 3 0l ihe Busines Professions Code) or ihet he or she is exempt iherefrom and Ihe basis for the alleged exemption. Any violation of Section 7031.5 by eny applicant for e pertnit sub ihe applicant to e civil penalry of not more ihan fve hundred tlollars ($500).): I, as owner of the property, or my employees with weges as iheir sole compensailon, WILL DO TME WORK, antl ihe structure is no� intended or oHered for sele (Sec. 7044, Business and Professions Code: The Contractors Llcense Lew does not epply to an owner of properry who 6uiltls or improves ihereon, and who does such work himself or hereelf or through his or her own employees, provitled Ihat such Improvemenis are not Intended or oflered for sele. If, however, the hullding or improvement is soltl within one year of completion, the owner-builder will have Ihe 6urtlen of provinq ihet he or she did not bulltl or improve for purpose of sale.). ❑ I, as owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED CONTRACTORS to construct the project (Sec. 7044, Busineu antl Professions Code: The contrectors License Lew does not apply to an owner of propeM1y who builds or improves ihereon, and who conirects for such project with e contractor(s) license pur�uant to ihe Coniractors lje�nse Laws.). i Business and Protassions Cotle for ihis reeson: � �L �-� oace J— license. ❑ Ves ❑ No vers Licen �. Expires: Vedticetlon of Own�rsj(p by (rype of tlocument, i.e. - properry ten bill or deed): DIVISION OF INDUSTRIAL SAFETV PERMR CERTIFICATION: ❑ I hereby cerlity Ihat no excavation five (5) or mare taet in tlepth Into which a person is required to tlescend, will be made in connection wit� work authonzed by this permit, entl ihat no builtling simcture, scefrolding, falsework, or demolition or dismenHing thereoi, will be more then ihirty-six (36) feet high. (Chap. 32, Gry 2, An 2, Sec. 341, Title 8, Celifomle Adminisirative Cotle). ❑ As owner-bulltler, I will not employ anyone to do work whlch would require e pertnit from iha Division of Intlustrial Safery, es noted above, unless such person hes e pertnit to da such work from the division. Signatura: Date: Division of Indusiriel Setery Permit Number: CERTIFlCATE OF COMPLJANCE AND AUTMORVA710N OF ENfAY: I certity under penalty of perjury thet I have reatl this epplication and state lhat the intormation given is correct. 1 egree to comply with all state laws and city ordinences releting to building construdion, and authorize represente�lves of the City of Costa Mesa to enter upon the above-dascribed property for inspection Durposes. I agree not to occupy or allow occupancy ot any building euthonzed by this ermit until tinal inspedi � '�- �� - �� Signature Of Legal ner(s) ' Date And�Or Authorized Applicant Date CODE t INSPELt10NTYPE 1616 1288 200 201 202 203 Fixed System Final Fire Prevention Pool Spe Final Finel Re-Rooi Finel BIocWRetaining Wall Finel Fectory Fire Plece Final Sign 204 Final Demolition �g I�� LQOEt INSPECTIONTYiE 206 Finel Mechanical 208 Flnel Plum�ing 210 Flnel Electncal 212 Final Fire Prevention 220 Finel Plenning Appravel 222 Final Site 250 Finel Building/Occupency QA7E UIi�EL3 Form No. DA-10 - 95 CITY OF COSTA MESA BUII.DING SAFETY DNISION 77 FAIR DRIVE, P.O. BOX 1200 COSTA MESA, CA 92628-1200 (714)754-5273 APPLICATION FOR UNREASONABLE HARDSHIP EXCEPTION Date Received: 30 � g Accepted by: � ��-� DOCUMENTAI'ION OF UNREASONABLE HARDSHIP / Project � gs �/ g L�i S%� Address: Owner: Gany L. Smi,th Applicanr Same Plan Review # D / (�— �!� z�%3 Telephone: 949-642-1500 Telephone: S��e s*ss�sstssi+ra#wsassssss►sssttssssss►ttr►sst*sts*rs►►sas*s*x*sst►rt►�#ssas►ss►s►trts■ I FIEREBY REQLTEST AN� ASONABL HARDSHIP EXCEP'I70N for ihe public accommodation identified as follows: /1/IQ C�1 / rf .e $�j o� -- _ I DECLARE that an unreasonable hardship exists and that compliance wi[h the building standard would make the specific work of the project affected by [he building standard unfeasible. In support of the application, the following informauon establishes the grounds Cor a hardship exception under 1995 CBC § 222.4: 1. State the wst of providing access. 2. State ihe cost of all consrrucuon contemplated 3. The access feature increases the cos[ of construcuon by: $ SOOc�'od $ 6 0 � g_;�dUO � �o o � �a�3 = �/3,7�7a 4. State the impact of proposed improvements on financial feasibiliry ol'the project. wvc� /A� .•�r u/�.v Di-v i'.P c �`- i'n {�' o s.'`i /2 • � 5. State the nature of the accessibiliry which would be gained or IosC ' Cle.:nB�n�i �!i%n •- /Yp0/ /].i//�irle fnii.o iz.�� 1/� ��w /-eva_r havzic�tihQ oy, r-esTrb•�n daors , _ 6. Sta[e the nature of the use of the faciliry under wnstrucGon and its availability to handicapped persons: • . . . ' �. 4 � �ss d �r 61�� .� a �r��,��.,: �� -r�e¢z�s r .�i cc u�-� o dQ 7�-e .e /o{/ .e � s. 7. State the faciGties to be provided that are uivafent to the access fcature requested to nbe waived. , Attac�hments provided for the abqve (if necessary): �mu i/,��P 20�i OT� e ONs7L [ further acknowledge that if the excepGon being requested is for improvements along the route of vavel for an alterarion project of minor valuauon (<$55,000) or to alter an area previously exempt from accessibiliry requiremen[s under California law, [hat I will expend no less Ihan 20% of the valuauon of the projec[ (not induding cos[s for requirements along access route) to improve access along the route of travel as reyuired by 1995 CBC § 1134B.2.1 exceptions I through 6. '[he following individuals provided infortnation listed in the above secuon: i�, i ✓ i! �� GARV L. �MITH Owncr(s) 985 w. 18.th S.theet Cab.ta Me�sc., CA 926?7 Address Address , 7-30-9& SignaNre Date Signamre Da[e Iwsws.wr� �o�o �r\ � � -y�� 7�3o/Q$ � U`��._:' `/ � � City of Costa Mesa �y� Building Safety/Code Enforcement Division 77 Fair Drive, P.O. Box 1200, � Costa Mesa, CA 92628-1200 (714)754-5273 Form No. DA-I I-95 Notice of Action By Building Official of Unreasonable Hardship Application Owner enant/Manager: Address: `1� S � Dear Sir: Date: $'�7�Qg An application for a hazdship excep[ion has been filed with [his office. The following action was [aken: Date of Action: '7�30�48 Permit Number. �6,� � O%� 9.� Project Name: Project Address: %A�S Cf/• �S � � ❑ The above-named project has been denied an unreasonable hardship exception under 1995 CBC § 222.4 [j�The above-named project has been gran[ed an unreasonable hardship excepUon from [he requirements of the State of Califomia CCR-Tide 24 (Regulations for the Accommodations of the Disabled) pursuant to 1995 CBC § 222.4 �The following findings aze made: 1. The type of facility is: 2. The�fa,c`�i�ytis used by the general public for: Ylh I 0�e�ne v'0.l � v ��75L T��1 �� 3. The cost of providing access is: �S �C70' �� 4. The total cost of construction of the facility is: lt �,�,�9 � 5. Tt�e acc ss fea re s� �at would be ained or lost is/are: -e �S �O �� b u�y..e� �`fbJ' P''�n j•e c.t• Lo�s v1Qc., •eti. r` � n Y-�.-� bld,y• 6. The Tide 24 Accessibility Improvement would impac[ o�ithe financial feasibili y of the p ject as follows: n...� n � i,I.,I� . �_f_._.�_� u --- v— � a�t wu r-� p-r� o :nt facilita[ion is providefl as fol _ ,. � .�� /• Two �i'� :r� res7`rc�o�cs. � - --�� [�The following person provided information for the above-referenced project: Name: ITGIY'Y �� S„'l � TYl Phone: �q I �oTZ'—��7d Firm: 1 �'�GfiC1 /T Address: �JgS W • � O � � / • The determina[ion of an unreasonable hazdship exceplion by this office and this document do not allow for blanket exception from 1995 CBC access requirements. The exception provided for on this form applies only to the following items of the idendfied project. PLEASE TAKE NOTICE that if you disagree with the determina[ion of the Building Official, or believe [hat grounds for a hardship exception exist, you may seek an appea] to the Access Appeals Board. The Applica[ion For An Appea] to the Access Appeals Board (Form DA-6) is at[ached. An application for an appeal shall be filed with the Building Official within seven (7) days from the date of the Notice & Order. The Building Official's office is located on the 2nd floor of City Hall, 77 Fair Drive, Costa Mesa, CA 92626. If you have any question, please contact the Building Of5cial. 2104d8MW O/'7�� Date �_ � CITY OF COSTA MESA . � evao�N� oms�oN > _ � � DEVELOPMENT SERVICES DEPARTMENT � �� PERMIT PERMIT NUMBER �899-00350 (714) 754•5273 • Fax (714) 754-4856 77 FAIR ORIVE, COSTA MESA, CA 92626 Job Address: 985 W 1 STH $T Suile: Vicinity: Parcel Nunmber: 42436105 Appliwnt: SMITH, GARY Address: 985 W 18TH ST C.M. Owner. SMITH, GARY Address 985 W 18TH ST , C ,M. , � Contractor. Address: � BUILDING PERMIT 2oning: Phone: . Zip: 92663 Phone: Zip: 92663 Phone: License: Arch : Address: . '� Phone: Zip License: . ENLARGE EXIT OFFICE AREA. Plan Check: Permit: SMIP Res: SMIP Com: ' Other: Inspection: Total: $26.16 $4025 $0.00 $0.50 $0.00 $0.00 $66.91 SETBACKS MAIN STRUCTURE Front 0- 0 ACCESSORY Front 0-0 PARKING Existinq: o NOTES: Rear 0- 0 Rear 0- 0 Required: 0 Eng: Address: Zip: SCOPE OF PERMIT FEE SUMMARY ' r' _ %/ PLANNING 8 ZONING Left 0- 0 Left 0- 0 Pr000sed: 0 Calc Valuation: Claim Valuation: Right 0-0 Righl 0- 0 Status: ISSUED Applied: 03/11/1999 Issued: 03/12/1999 Phone: License: $7,130.00 $1,130.00 EXPIRATION: This permit shall aulomatically expire and become void if work is not commenced wfthin 180 days, or if work is suspended or abandoned for a penod of 180 days. INSPECT10N5: In order for the work authorized under this permit to be considered legal, such work must comply with all applicable codes, and all requlred Inepeetlona end finel epp�ovel must be obteined. Failure to obtain inspections and final approvel wlll result In the ezpiration of this permit. FOR INSPECTIONS CALL: (774) 7545828 � `� � WORKERS' COMPENSATON DECLARATION: - � I hereby eifirtn untler penalry of perjury one of Ihe following declarations: •' ❑ I heve and will meintein e certiticate of consent to selt•Insure for workers' compensation, es provitled for by section 3700 of the Lebor Code, for ihe peAormance of the work for which ihis permit is Issued. � ❑ I have antl wlll meintain workers' compensation insurance, es requireA by sectlon 3700 oi the Lebor Code, tor Ihe peAormence of Ihe work for which this pertnit Is issued. My workers' compensetion Insurance cerrler end policy number are: Cartier. Policy Number. (1h15 sectlon need not be comp/eted /l the permit !s velued af one hundred dollers ($100J or less.) ❑ I certly that in the peAormence of the wark tor which this partnil is issued, I s�ell not employ eny person in any mennar sa es to become subject to the workers' compensetlon laws of Celifomla, and egree Ihet If I should �ecome subJect to che warkers' compensetion provisions of Section 3700 of the Lebor Code, I shell tort�with comply wlth these provisions. Applicant Signature: Date: WARNINO: FAILURE TO SECURE WORKERS' COMPENSATION COVEMOE IS UNIAW FUL AND SHALL SUflIECT AN EMPLOYER TO CRIMINAL PEWILTIES AND CIVIL FMES UP TO ONE HUNDRED hqUSAND DOLLARE (E/00,000), IN FDDITION i0 THE COST OF COfdPENSATIIXJ, �AMAGES AS PROVIDED F017IN SECTION 3108OF TME LABOR CODE, IN�EflE5T, AND AITORNEV'S FEES. LICENSED CONTRACTORS DECLAPATION: I hereby eflirm Ihei I am licensetl untler provisions of Chapter 9(commencing wlth Section 7000) of Division 3 of Ihe Business end Professions CoOe, and my license is In full force antl eHect. lJa p Class k Caniractofs Signeture: Date: CONSTRUCTION LENDING AGENCY: ❑ I hereby effirm ihet ihere is a construction lending egency Por ihe peAortnence of the wark far which this permit is iuued. (Sec. 3097, Civil Cotle). Lender's Name: Lentlefs Atltlress: Slgnature: Date: OWNER-BUILDER DECLARATIONS: I hereby aHirtn thet under penelry ol perjury that I em EXEMP7 FROM THE CONTRACTOHS LICENSE LAW for ihe following reeson (Sec. 7031.5, Business end Professians Gode: Any clry or counry which raquires a permit to construd, alter, Improve, demolish, or repeir any swcture, pnor to its Issuence, elso requires Ihe epplicant for such permit to file e signed statement thet he or she is licensed pursuant to ihe Drovlslons of Ne Conirectors Licensa Lew (Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code) or ihet he or she Is exempt therelrom end the besis for the alleged exemption. Any violatlon of Sectlon 7031.5 by eny epplicent for a pertnit sub�ects the epplicant to e ciNl penalry of not more Nen five hundred dollers ($500).): ❑ I, as owner of the property, or my employees with weges es thair sole compensetion, WILL DO THE WORK, end tha struqure is not Intendad or offeretl for sale (Sec. 7044, Business entl Professlons Code: The ConlreMors Licensa Lew does not appy to en owner of property who builds or Improves ihereon, entl who tloes such work hlmself or hersell or Ihrough his or her ov.n employees, proNOetl thet such improvements ere nat intentleC or otteretl tor sale. If, however, the building or Improvement Is sold within one yeer o1 completlon, the owner-builder wlll have the 6urtlen ot proving that he or she did not bulld or Impmve tor purpose of sele.). ❑ I, es owner of the property, am EXCLUSIVELV CONTRACTING WITH LICENSED COMAACTORS to construd the project (Sec. 7044, Business and Professions CoCe: 7Te contrectors License Lew does not epply ro en owner of property who builds or Improves thereon, end who contrects for such project with e contracror(s) Ilcense pursuent lo the Contrectors License Lews.). ❑ I em esemF Signature: � Owner ID verified VeAticetlon of Ox Businew antl Pmtessions Cotle tor this irs license. ' � Yes ❑ No Drivefs Ucense No. by (rype of documenL i.e. - property tex blll or deed): DIVISION OF INDUSTRIAL SAFETY PERMR CERTIFICATION: Dete: b9^/it^ �Expires: ❑ I hereby certlty t�at no excevatlon tive (5) or more feet In Gept� into which e person is requlratl to descend, wlll be mede in cannectlon with work aufhorized Dy this pertnit, end that no building structure, scaHolding, ielsework, or demolition or dismentling thereof, will be mare then Ihirry-siz (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Title B, Celliomle Administretive Code). ❑ As owner-builtler, I will not employ anyone to Oo work wNch woulU requlre a permit from the Division of Industrlel Safery, as noted above, unless such person has e pertnit to do such work from the divisian. Slgnature: Date: DiWsion of IndusMel Safery Pertnit Number: CEHTIFlCATE OF COMPW WCE AND AUTlIORQATION OF EHTRY: I certity under penelry of perjury ihat I have read this epplicatlon end stete thet the intormalion given is correc� I eQree to comply with all state s end ciry ordinences relating to Dulltling wnstruction, entl authorize representetives o1 the Ciry of Caste Mesa to enter upon the ebove�a�ribed praperry for Insped�rposes. I egree not ta occupy or allow acupancyyF any Duilding euthorized by Ihi�=rtnl� a)til fl`nel I� � ion. / � i➢ _ _ `� // i�- � LO�E I. INSpECTON TYVE 1818 Flxetl System Flnel Fire Prevention 1266 Pool Spe Final 200 Flnel Re-Roof 201 Final BIxWRetaining Well 202 Finel Feclory Fire Plece 203 Final Sign 204 Flnel Demolitlon 20dBd8 ps¢ �64 sqpfj INSVEClIONTYPE 206 Finel Mechenical 20B • Final Plumbinp 210 Finel Electricel 212 Fnel Fire Preventlon 220 Finel Plenninp Approvel 222 Final Site 250 Flnel Building/Occupflnq Ciry of Costa Meu euilding Safety Department P.O. Box 1200 Costa Mesa, Califomia CERTIFICATE OF OCCUPANCY .!`-' �'t^�,"�� The Building located at 9R� i�aat 1R+h Gt�'at � � has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B-2 Occupancy. use of Building CaTMenerial Offices and S4arehouse - Interior Alterations Legal Description a.P.{$42h-361-OS (See reverse side for Metes and Bounds) Building Permit No �-73� Electrical Permii No. E—II29/1263 Plumbing Permit No.P^1.4351�9t7 '' Number of apartments —D— and/or guest rooms —Q— ISSUED T0: Building Official bY�� Ji.�� C'U571�Z4 tFE.'Ppi, F'ARR2C'A`tt1RS ViCtOY C. ?�—DisectdY BUildirig lliviSiT Date �tobex' � 1931 This Certificate of Occupancy SHALL BE posted in a conspicuous place on the premises and SHALL NOT BE removed except by the Building Official of the City of Costa Mesa under Sec. 306 le) U.B.C. � � Form BU 34 Rev. i City of Costa Mesa Building Safety Department P.O. Box 1200 Costa Mesa, California CERTIFICATE DF OCCUPANCY !..= ,$��'A The Building located at 985 [1TeSt lBtl'1 StSe2t -• SIir3.�T, ONLY — has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto for a Group B—?_ Occupancy. � Use of Building Industrial Bui�tilinct Legal Description A.P.#424-361—OS . (See reverse side for Metes and Bounds) Building Permit No S141d Electrical Permit No. aQ��S Plumbing Permit No. �Q�F� - Number of apartments —�-- and/or guest rooms —(1— ISSUED 70: BuildingOtficial b„`'"�i'�'��, ��'1�.�.�. :i�1c'tT,r�d r',i'+'1'ERPRISES Victor C. Newton — Director Buildinc� Divi:.. Date OctoL�'r 27, 1981 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 Rll id Rav 11 /9n GTy OF COSTA MESA CONSTRUCTION PERMIT Address Arch/Eng. to fill in all s0aees within heavy EorGer Iines anE si9n all apOropriate tleclantions. �ERG61T NO. TRACT NO. LpT NO. �BLDG. NO. Phone License No. TVPE OF CONSTRUC,T,,I/ON ❑ NEW �ADD 18 ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER Addless . DESC TIO QF ORK „f j�TP/!� q/' � ' Contractor �W� R - Phone �-� TVP OF PERMIT '. Addre55 ❑ GRADING ❑ FOVNDATION ❑ STRUCTURAL LICENSED� CONTRACTOR DECIARATION �fENANT ❑ ELECTRICAL OPLUMBING ❑MECH/iN 1 hereby affirm that I am Itcensetl untler provislont of Charter 9(com- mancln9 wltn section 7000) of Divislon 3 ot the Buslness antl ❑ OTHER Professions Coae, antl my Iitense Is In full force antl etfece. pROJECTDESCRIPTION .�� _ . ' Llcense Clasz License No. .Date Si9nature ' - SQ. FT. p � . �, WORKERS• COMPENSATION �ECLARATION � OCCUPANCV o--CONSTRUCTION TV.PE x" LV I hereby afflrm that 1 have a rertificate o( con5ent to selt-insure or a VALUATION2�, .sov ZONE tertlfiwte of Workers' Compenzatlon �Insuranca, or a certifietl <opy� - �- - 'nereot (Section 3800, Lab. C.). - GRADING CU. VDS. ACRES licy No. Company - - J Cer[ifietl copy is hereby fumishetl. . . ._ � REMARKS: � ❑ Certifietl copy i5 filetl with the tity Builtling Divislon. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION - (This section neetl not be completetl iLthe permit I5 tar one huntlretl . , � , _ _ 55100) or less). • c¢rtlry that In the p¢rforTance Ot the work for which this perTit is issuetl, I shall not emPloy any person in any manner so as to become PLUMBING PLAN CHECK � subject to the Worker5 .Compensation Laws of Calitornla. _ . Date Si9nature BATHTUBS -SHOWERS � NOTICE: It after making thi5 tleclaratlon, you shoultl become subject TOILETS VRINALS " ' to [he Workers' Compensation provisions ot tne LaDor CoAe, you must - forthwlth comply wi[� 5utn provisions or this permit zhall be tleemetl �VATORIES DOUBLE LAVS " �¢voketl. ' ' . _ CONST0.UCTIONLENDINGAGENCV KIT.SINKS � DISHWASHERS - 1 hereby a(firm tnat t�ere is a constructlon lentling agency lor'the per- SERV ICE SINKS SUMPS� formance of the work.for, whlch, thiz permit is iszuetl (Sectlon.�3097. - •� ` • '`�' Civ. CJ. " �,� � �� FLOOR SINKS FLOOR DRAINS- � �entlei's'Name � - U I,-as owner of th¢ p�Operty, Or my omployees with wag¢5 25 their sole tompensz[ion, will tlo tne work, and the structura is not intentlea nr nf/erea �or s5le. lSectlon 7044. Buslness antl Professlons Code: Tho as owner ❑ I am exempt untler SecUon reason Date z owne� 1 h2rGby[8rtifythat,l hdv¢ informatlon is correct. I ortlinances antl state laws r representatives of this c property for s tio Signature � INTERCEPTORS '.CLARIFIERS(� c� SWIMMINGPOOL �PTRAP ` � � WATERSERVICE. �2 ALTERATION GASSERyICE � _ OUT�ETS WATER�HEATERS BTU OUTPUT SEWER CONNECTIONS ' ' SOLAR TANK COI.LECTORS ' SOLAR PIPING SVS., � � a oroocrtr ' _ . __ ' or improv¢ tOr t�e pu�pose ot Sale). �.rty, drtt exGluSiv¢ly�contraGting wlth ct the project (Sectlon 7044; Buslness t�acto�'s LICGnS¢ Law does no[ apply to Itls or improves thareon, antl who con� i a Wnt�actor(s) Iiceznetl pursuant t • .. .B.& P. . r i : is appliwtion antl state that [he above to comply witn all city antl couniy g to construction, antl.hereby au[horize o¢ntEr upon the above mentiop ed ��i�i / �--- 7��-i /B! MECHANICAL" P�AN CHECK HEATING SVSTEMi.O-300,000 BTU_ AND�DUCTING. ,y 300,000 + BTU _ REFRIGERATION 0-300,000 BTU_ SYSTEM' ' ' - � 300,000.+ gTU _ BOILERS BTV SVSTEM REPAIR,ALTEfiATION EXHAUSTSVSTEM MULTIPLE � - / '' ' ISSUE FEE - � Orivers' License or 55 � — CMF 0865-46 Whife-Builtling; Canary-Appliwnt; Pink-Accoun[ing; Goltlenrotl-Assessor � ZONE REAR VARD (TO P/I PKG. SPACE REQ. STREET WIDTH ZONING APPROVED SPECIAL CONDITIO� i 4�743 B/=7/EI NING REGULATIONS PLNTGp. RUEF�. p� �� — PROPE�RTVNLINE � .) PROVIDED / PARK FEE $ ELECTRICAL � aLAN C GENERATOR 0-1 KW_1-10 KW 'TRANSFORMER APPLIANCE 10-SOKW_SO+KW MOTORS ��` 0-1 HP_1d0 HP ....v� •w'..! (INC. SOLAq) 30-SO HP �� SO + HP SIGNS ' POLE PANELS-- MAIN SVB SERVICE ' - AMP 283oC4 TL APPLICATION P.PPROVED 8Y ' DATE - SUMMARV OF FEES PERMITVG b f O•n� O- SMIP E�. 7 2 PLHNCHECK S_�/.�a._D�" PERMIT � � ISSUANCE 8 ,C.'�r: PLVMBING b ,-��. � PLANCHECK $ GRADING S ELECTRICAL 5 S � PLHNCHECK g MICROFILM y MECHANICAL S ' TOTAL FEE $'��.� PLHN CHECK E LES$ AO- � VANCEPC S_ � � '� FINAL FEE. S _�Q.i •DY ADV��anl to fill in all Ci7Y OF COSTA MESA �' CONSTRUCTION PERMIT License No: witnln heavy Eortler lines antl sign all apo�opriate eeclantions. TRACT NO: LOT NO. � BLDG. NO. `Address ' " ' -' 'Contractor $Y1SCO2 Electric � Pno�b49- Address Zggg Baker St�.. Costa Mesa I.ICENSEO CONTRACTOR DECLARATION I hGreby ditirm thdt I am IlcarySetl untlBr provi5ion5 Of Charter 9 mencing wlth section 7000) of Olvislon 3 ot the' Busines! Professlons Cotle, antl my Iicenze is In tull forte apQ e Data y--Z5-251 Sl9natUre� � ' wi'�1. WORKERS'COMPENSATIOryDECLARATION � I hereby alfirm Ihat I have d certl(IwtO Of con5ent to selt-insure or d certlficate of Workers' CompensaHon Insurance, or a<ertifletl copy !icy No. Company �Certifietl copy is here0y furnl5hetl. - � � � Certifietl copy is filee with the city Builtling Division. EXEMPTION FROM WORK�RS' COMPENSATION DECLARATION (Thls se<tion neetl not be cOrhpletetl il [ne permit IS for one huntlretl S$3001 or less). tert(ry lhdt in [ne pertormaryce of lhe work tor which_thi5 p¢rTit is Issuatl, I shall not employ any p¢rson in any manner zo as to become SUDject to the Workers' Compensation Laws oi CalHornia. . Date Sl9natUre ` NOTICE: It after making this tleclaration, you shoultl become subjec[ to the Workers' Compensatioq provlsions of [he Labor Cotle, you must forthwith comply with such provisions or this permli shall be tleemetl �OVOketl. - . - CONSTRUCTION LENDING qGENCV 1 hereby aiBrm that there is a�onstructlon lentlin9 agency for the per� formance ot the work for w��ry thl5 permit is Issuetl (Section 3097 Civ. C.1. . � . �enEer's Name� '°` �� 'i�� Lentler's Atltlress OWNER BUILDER DECLARqTION I nereby aftlrm lhat I am ezeeript from the Contractor'S Licenze law tor tM1e followina rea5on (Se<tion �031.5 9uiiness antl Professions Cotl¢: tlemolish o� tepair aqy strvctu�e, p� e aPpllCant tor suth permit lo file a � QU51lIB55 antl PrM¢ssions Cotle) or that he IS ex¢mpt [heref�om antl th¢ sis for the allegeE exempli0n. Any violation of Section ]031.5 Dy y aOP��nl for a pe�mit subjeGts the applicdnt to a civil panaliy � not more lhan five huntlrgtl tlollars (5500). � ❑ I, as owner of Ihe property, or my employ¢es with wa9e5 as thel� sole compenm�ion, will�tlo thp wo�k, antl the structure is not intebtletl or otferetl for sale. (Section ]044, Businass antl Aofessions Cotle: Tbe Contractor's License Law tloas not appty to an owner of a property wh0 builtls or improves therBon, antl who tloe5 zuch work himself or NrOu9h hI5 Own em0loyees, provitletl tltat Such impwvement5 ar¢ not intendetl or oHe�etl for sal¢. I�� howeveq th¢ bulltlin9 0� imprOvement is�soltl withln onayear of completion, the owner will have the burtlen bf proving he tlitl not builtl or imProve tor the purpose of 5ale). ❑ I, as owner of tne property, am exclusively contracting with licensetl contractors to wnztruct the oroject (5¢ction 7044, Business antl Professions Cotle: The Contractor'i Llcenze Law tloes nat apply to an owner O7 P�operty who builtl5 or Improv¢s Ihereon, an� who con- Vacts from suth Projects wi�p a con[ractor(s) Ilcesnetl Oursuant to the Contractor's License Law), ❑ I am ¢xempt untler SeCtion B. & P. C. (or ibi5 reason ' ,Date -� ' Owner I hereby <ertity tnat I have reatl.rois applitation antl state that the above informalion is correct. I a9ree to comply with all City antl county ortlinances antl State laws relat�pg to COnstruction, antl hereby authOriie rcpresenW[Ives of tM1iS city to nter upon lhe aCove entlon¢tl property .tor J{�spfction . pys¢ , 519naWre �lTs��.:h �1. Date Drivers' License or 55 �F /� �. CMFO865-46 White-Builtling;Canary-AppliWnt: TVPE OF CONSTRUCTION � NEW ❑ ADD ❑ ALTERATION � ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK TVPE OF PERMIT ❑ GHADING ❑ FOUNDATION ❑ STRUCTURAL ❑ TENANT � EL'ECTRICAL ❑PWM6ING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION . ) . SQ. FT. � - OCCVPANCY_CONSTRUCTION TVPE VALVATION ZONE GRADING CU.�VOS. ACRES � REMARKS: �{/ � PLUMBING PLANCHECK �-- BATHTVBS SHOWERS TOILETS � ' . U0.1NAL5 ' LAVATORIES DOUBLE LAVS ' � KIT. SINKS DISHWASHERS � -- SERVICESINKS �SVMPS ' FLOORSINKS^'�� \ FLOORDRAINS DRINKING�FOUNTAINS �� INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP - WATER SERVICE . ALTERATION GASSERVICE OUTLETS WATER HEATERS BTU OUTPUT SEWER CONNECTIONS � SOLARTANK COLLECTORS SOLAR PIVING SVS. ISSUE FEE MECHANICAL PLArv CHECK HEATING SYSTEM 0-300,000 BTU AND DUCTING 100,000 * BTU REFRIGERATION 0-100,000 BTU SVSTEM 100,000+BTU BOILERS BTU SYSTEM REPAIR,HLTERATION EXHAUSTSVSTEM MULTIPLE ISSUE FEE r— GOIEenrotl-Aszessor 5eeb si�Kie� 5�a. 7t A.P. � 20NE 0 SETBACK IDErvARD EF �C 5�p E YA RIGHT REHR VARD (TO P/L) PKG. SPACE REQ. STREET WIDTH 'ZONING APPROVED B\ •SPECIAL CONDITIONS: ELECTRICAL � REGULATIONS PLNTGp. RgUEFL. p� ' PROPE�RTY LINE PROVIDED PARK FEE E DATE PLAN CHECK �GENERATOR p.l KW_ 1-30 KW _ TRHNSFORMER � APPLIANCE 10-SOKW_SO+KW_ MOTORS 0-1 FIP_1-30 HP _ � (INC.SOLAR) ]0-50HP�SO+HP_ - FI%TURES 55 �UTLET52(�jSWITCHES - - �GAS TUBE SIGNS ' POLELIGHTS "" PANELS MAIN SVB 1 , SERVICE " 400� AMP� APGLICATION APPROV ED BV DATE SUMMARV OF FEES BVILDING ' PERMIT $ SMIP E_ PLAN CHECK S PERMIT� - ISSUANCE E_ PLUMBING b GRADING b_ PLAN CHECK S ELECTRICAL S� E PLANCHECK $ . MICROFILM E_ MECHANICAL $ TOTAL FEE E _ PLAN CHECK S �-ESS AD� VANCEPC E_ FINAI FEE S � � � CONSTRUCTION AND PLANNING FOOL & SPA . � �'� , APPROVALS Permit # Date �nspector qppROVALS � �Permit # � Date Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location � � � � Soi ipe-Undrgrn � 44. Steel Reinforcement - - • 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. .Electrical.Bonding . tee ein orce 47. Rough Plumbin & Pressure Test � 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation - �-- 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tre ❑ ndr rn � 10. Structural Floor System 52. � APPROVAL TO DECK - 11. Property Sewer Line & House Connection 53. Backwash�& Rece tor-Final 12. Street Sewer Connection � 54. Heater & Vent-Final 13. Rough Plumbing � - 14. Rough ElectricConduit - � - - • " ` -56. 'Electrical-Final 15. Rough Electric-Wiring ' � 57. Solar System-Final � - � 16. Rough Heating & Air Conditioning- • encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING � 18. Ducts, Ventilating ' � - . 19. Gas Pipe-Rough &Test ' - • 6U. POOL/SPA SYSTEMS FINAL � - 20. Roof Framing � � 21. � Roof Sheathin ' 22. Frame and Flashin NOTES: . 23. Insulation -,?o-S! 24.�- Lathing & Siding ' ' 25. Drywal� Nailing � - 26. Plaster Brown Coat � 27. Electrical Power Meter-Final ' 28. Final Electric -1/-8 Gr 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. . Final Plumbing ' 32. Water Service-Final 33.� Gas Service-Final - � 34. Solar pomestic-Final � 35. landsca e S rinklin S stem 36. Sound Attenuation 37. Handicap Regutations ' 36. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed � 40. Electric Release to Edison - 41. Gas Release to Southern California Gas Co. � 42. CERTIFICATE OF OCCUPANCY . No Date AOP��Unt to fill In all spaces witnin �aavy boraer Ilnes ana sign ali approvriate aecla�ations. � CITY. OF COSTA MESA PERMIT NO. TRACT NO. LOT NO. �BLDG. NO. •CONSTRUCTIONPERMIT � IoZ�oaZ, Arch/Eng. ' � �License No. Address Contractor , � '� Phone Address � - - � - I hereby aftlrm tha[ I am Ilcensetl untler provl5ion5 Ot Chdrt¢r 9(<Om- men<in9 "/��h section 7000) of Dlvision 3 of the Business antl Professions Cotle, antl my Iicense is in full (orce antl effect. Llcense Class License No. Date Si9nature WORKERS'COMPENSATION DECLARATION - I hereby affirm that I �ave a<ertiticate of wnsent to ulLinsure or a certlflfzte of Workers' Compenzatlon Insurance; or a tertifiea copy '•reof (Section 3800, Lab. C.). icy No. Company � Certifietl <opy is hereby furniSheC. � --� - � � ❑ Certifietl mpy Is filetl with the city Builtling Division. EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This section neetl not be completetl if the permit.is for one huntlretl ($300) or leu). I<¢rtify Ihat in the pertormance ot [h! work tor which thi5 permii i5 Issuetl, 1 shall not employ any person In any mdnner so as to.become subject to the Workers' Compensation Laws of Glifornia. Date Si9nature NOTICE: I( attar making this tle<laration, you snoultl become sub�ect to tha Workers' Compensatlon provlsions of tM1e Labor Cotle, you must forthwith comply with such provislons or [his permit shall be tleemeE �evoketl. - � � CONSTRUCTION LENDING AGENCV 1 hereby aifirm that there is a constructlon lentlin9 aqency for the per- formance of the work for wnlch this permit it Issuetl (Sectlon 3097 Civ. C.). ' Lentler's Name Lentlef'S AtldIe55 OWNER BUILDER DECLARATION � 1 hereby affirm tha[ I am exempt from Me ConVatlor'S LicenSe Law for the following reason (Sectlon 7031.5 Business antl Professions Cotle: Any city Or County which requires a permit to mn5truct, all¢q improve, tlemolish or repair any structure. Prior to its issuance, also re- quirts tne ap011cant IOr such permit [o file a Signetl Statemenl [hat h¢ is Iicensetl pursuan[ to the provisions ot th< COntraGtor'S LI<Gnse Law �Chapler 9(commencing wlth Sectlon 7000) of Dlvision 3 of [he rsiness antl P�o1e55ion5 Cotle) or that h0 is exompt thereirom antl the 'is /or the alle9etl exempNon. Any violation of Settlon ]031.5 by / appliwnt for a permit sub)etls thG appliGant to a tivil penal[y nol TOr¢ than fiv¢ huntlr¢tl t1011ars (5500). ❑ 1, a5 Own¢� ot lha prOperty, Or my amployee5 with wagl5 as th¢Ir sole compensation, wlll tlo the wo�k,�antl� tha structure Is not Intentle0 or offeretl for sale. (Section 7044. Buslness antl Protessions Cotle: The Contractor's Llcense Law tloes not applY to an owner of a property wh0 bWltls Or improves tltereon, antl who tloes such wOrk himselt Or throu9h his own employ¢e5, prOvitletl Inai Such ImprOvemen[s are not IntentleC or oHer¢tl lor sale. If, boweveq th¢ builtling or Improv¢m¢nt I5 501tl within ona yea� ot completiOn, IM1e owner wJl have the bu�tlen f provin9 he tlitl not builtl o� Improv¢ for th¢ Pu�poSe of sale). 1,'as owner of the property, am extlusively contracting with I SCtl COOIfdCLOR l0 COOSIlUC( IhC plOj2CI ($CC[�00 i044. BUSIOQ55 �antl Professions Cotle: The Contractor•5 License Law does not apply to an owner of property who builtls or improves thereon, anU who con- ` �raCtS flOm such O�oleCtS with d contrattOr(s) Iitesnetl pur5udnt to mthe Contrac[or's License Law). `1 ❑ I am Cxempt untle� Section B. 8 P. C. tor thi5 \`,,, reason ` Date ' Owner O I herebycertifythal I have reatl tnis aOPlication.antl Stal¢ [hat tne abOve �Informdtion is correG[. I agree to comply witlt all city antl county ortlinances antl state laws rela g to construction, antl nereby authorize representatives of [his it o ente� upon the above mentionetl property .'nspec[ion. es.. '^ / �� Slqnature Date �� Drivers' License or 5 � � TVPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER DESCRIPTION OF WORK ❑ GRADING ❑ FOUNDATION ❑ $TRUCTVRAL ❑ TENANT �`ELECTRICAL ❑PLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION � SQ. FT. - OCCUPANCY_CONSTRUCTION TVPE VALUATION ZONE GRADING CU. YDS. ACRES REMARKS: PLUMBING BATHTUBS TOILETS LAVATORIES KIT. SINKS SERVICESINKS PLAN CHECK SHOWERS URINALS �OUBLE lAVS DISHWASHERS SUMPS 6205 lu/Cl/ej ZONING REGULATIONS A.P. � ZONE REAR VARD (TO PKG. SGACE REQ. 20NING APPROVEO B` SPECIAL CONDITIONS: ELECTRICAL PLNG. REF. � PROVIDED PARK FEE $ PLAN CHECK GENERATOR � 0-1 KW_1-10 KW _ TRANSFORMER � APPLIANCE 10-SOKW_SO+KW_ �� MOTORS - 0-1 HP_1�30 HP _ —�� (INC. SOLAR) 30-50 HP 50 + HP _ FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS � INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP � WATER SERVICE ALTERATION �t GASSERVICE OUTLETS WATER HEATERS � BTU OUTPVT SEWER CONNECTIONS SOLAR TANK COL:LECTORS SOLAR PIPING SYS. ISSUE FEE MECHANICAL PLAN CHECK HEATING SYSTEM 0-300,000 BTV _ AND DUCTING 300,000 + BTU _ REFRIGERATION 0-100,000 BTU_ SVSTEM 300,000 + BTV _ BOILERS BTV SVSTEM REPAIR,ALTERATION EXHAVSTSVSTEM MULTIPLE ISSUE FEE CMF 0865-46 Wni[e-Builtling; Canary-Applicant; Pink-Accountin9: Goltlenrotl-Assessor FI%TURES OUTLETS SWITCHES" GAS TUBE SIGNS ' POLE UGHTS ' PANELS MAIN SUB SERVICE ' F ISSUE FEE AGPLICATION Z 28aC" 'Cl. �ATE SUMMARV OF FEES � BUILDING ' ' ' � • PERMIT S SMIP S PLAN CHECK § PERMIT ' ISSUANCE $ PLVMBING E GRADING $ PLAN CHECK $� ELECTRICAL E IXv — S , PLAN CHECK $ MICROFILM E MECHANICAL $ � TOTAL FEE $ PLAN'CHECK g LE55 AD� VANCEPC $_ FINAL FEE S �� CONSTRUCTION AND PLANNING � . FOOL & SPA � -' APPROVALS Permit # Date Inspector qppROVALS Permit # Date - Inspector 1. Temporary Electrical Service or Pole 43. Pool & Equipment Location '• . Soil ipe-Undrgrn 44. Steel Reinforcement � 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce 47. Rough Plumbin & Pressure�Test 6. Electrical UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit•Undr rn - 6. Foundation 50. Gas Pi e, ❑ Undr rn, Test 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn � 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer Line & House Connection 53. Backwash & Rece tor-Final 12. Street Sewer Connection � 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough ElectricConduit �56. Electrical-Final 15. Rou h Electric-Wiring � 57. Solar System-Final 16. Rough Heating & Air Conditioning � • encing & Access Approval 17. Oucts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating ' 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS FINAL 20. Roof Framing 21. Roof Sheathin 22. Frame and Flashin NOTES: 23. Insulation 24. Lathing & Siding � 25. Drywall Nailing � 26. Plaster Brown Coat 27. Electrical Power MeterFinal �.�'� L 28. Final Electric 29. Final Heating & Air Conditioning - 30. Final Gas Pipe-Test 31. Final Plumbing 32. Water Service-Final • 33. Gas Service-Final 34. Solar pomestic-Final 35. Landsca e S rinklin S stem 36. Sound A[tenuation T 37. Handicap Regulations � 38. FINAL STRUCTURE & BUILDING 39. Special Requirements Completed 40. Electric Release to Edison . 41. Gas Release to Southern California Gas Co. 42. CERTIFICATEOFOCCUPANCY No Date AOVi��ant to fill In all ipaces wit�ln heavy borEer Iines anE slgn all apOroprlate tleclarations. GTY OF COSTA MESA PERM�T N% �� I TRACT NO. LOT NO. •BLDG. NO. CONSTRUCTION PERMIT M sy Addrea (�pQ'�! SUD�/i/Qti A/!P - Arch/Eng. � - License No: • Address - - � � � - � Contractor � � - Phone � � eww.�� . . . .. LICENSED CONTRACTOR DECLARATION. ' ' - 1 hereby a(firm that 1 am Ilcensetl untler p�ovisions of C�arter 9(com- manUn9-with section 7000) of Divlsion 3�0/ the Business'antl Protessions Cotle, lantl my Iitense Is in full (or<e antl e(fect. Date ��L'—^' Si9nature ' WORKERS' COMPENSATION DECLAR ION . I hereby afilrm that I have a certlficale ot tonttnl to selt-insura or a certiilfate of Workers' Compensatlon dnsurante, or a tertit{etl copy '�ereot (Section 3800, Lab. C.). Icy No. � Company' � . CartifieA copy is heraby (umishetl. - ' ❑ Certifietl copy Is filetl with the city Builtling Divlzion. EXEMPTION FROM WORKERS'�COMPENSATION DECLARATION (Thls )5ection neetl not be completetl ii the permit 15 for one huntlretl Sater�(fy.thats�n the pertormance of the work tor which.this permit is issuetl, I shall not employ any person In any manner so asfto; bacome SUDjett io the Workers' Compenzation Laws of Californla.. . ._ Date Signature NOTICE: If after making lhis tleclaration, you shoultl become subjett t0 th¢ WOIk0I5' CompGllsdtl00 plOVlSions Of [h< Ldbor COtle, yoU must forthwith tomply with such provislons or thls permlt shall be tleemetl rOVOk¢tl. _. . _ CONSTRUCTION LENDING AGENCV 1 hereby a(firm that t�ere Is a con5truttion lentling agency for the per- formante of [�e work for which thls Oermii is Iisuetl (Section 309� Clv.'CJ. ' ' '- - ' L¢ntle�'s Name Lentler•5 Atltlress OWNER BUILDER DECLARATION ' - ' - � I hereby affirm that I am ezempt from the Contractor'S License Law for i Me' followin9 reason (Sectlon 7031.5 Business antl Professions Cotle: � Any city or county which requires a permit to tons(ruct, alter, Iimprove, tlemolish or repair any structure, prior to its Issuance, also re- OUi�CS LYI¢ dp011Cdnt }01 SIICh pe�mit to tile a SignGtl StdtBm¢nt that h¢ ^usiness anE Professions Coae) Ot tnat ne IS-exempt Ine�¢t�om antl tne :is for the alle9etl exemption. Any violation of Section ]031.5 by / appliwn[ for a permit sublects tne applicant'to a tivll penalty . not mOr¢ than tive huntlr¢tl C011ars (5500). ❑ I, as owner ot the property, or my em0loyees with wages as their sole compen5atlon,.will tlo ttte work, antl:fhe sVucturc is not in[ontletl or ofteretl for sale. (Section 7044, Business antl Profezsions CoCe: The Contractof'S Llcen5e�L2w tlOes not apply to an Ownef ot.a pfoperty wh0 builtl5 or improves the�eon, antl wh0 does sUch work hiTself Or N�ough his Own employee5, provitl¢tl [hdt such Imp�Ov¢Tents a�e nOi Intentletl or offeretl (or sale. If, however, the builtlin9 or improvament Is.sola within one year of completion, lhe.owner wlll have the burCen of proving he tlitl not build or improve for the Ourpose of sale). � I, as 'owner Of the p�ope�ty, am ¢xCluslvely contraCtin9 with Iicensetl con[ractors to construct the Oroject (Section ]044, BuSiness ana Protessions Gotle: The Contractor'S�Licenza Law tloes not apply to an owner of ptope�ty wh0 builtls o� Imp�oves th¢rGOn, antl who COn- trdct5 trom Such prO�ects with a'contfactor(5) II[esnetl pursuant [O the Contractor'S License Law). ❑ I am exempt untler Settion � B. & P. C. (or [his reason Date Owner � - - I hereby ttrtify Ihat I nave reatl this applifa[lon antl state that the above information is correct. I a9ree to comply with all city antl <ounty oftlinances anU state IawS relaUn9 to COMtNCtion, dntl hereby dutholize rep�e5entdtive5 of this city to enter upon tne above mentlonetl properiy for inspection purposes. . . Signature Date Driverz' Licenz¢ or 55 � TVPE OF CONSTRUC�T/IO�N � ❑ NEW �O ADD �a.I�LTERATION ❑ REPAIR ❑ CONVERSION ❑�EMOLISH � OTHER DESCRIPTION OF WORK ra,J s [ Ti TVPE OF PERMIT - " ❑ GRADING ❑ FOVNDATION ❑ STR ❑�TENANT ❑ ELECTRICAL OPLUMBING ❑ OTHER PROJECT.DESCRIPTION _ . SQ. FT. OCCUPANCY_CONSTRVCTION TVPE . VALVATION ZONE GRADING CU. VDS. ACRES _ REMARKS: PLUMBING . PLAN CHECK BATHTVBS SHOWERS ,TOILETS URINALS LAVATORIES DOUBI.E'LAVS' - KIT.SINKS ' ' DISHWASHERS" SERVICESINKS� SUMPS FLOOR SINKS � FLOOR DRAINS DRINKING FOUNTAINS- - ` IfVTERCEPTORS CLARIFIERS �SWIMMINGPOOI PTRAP ' WATER SEfiVICE HLTERATION GASSERVICE OVTlETS BTV OUTPUT,i- • • SEWERCONNECTIONS ` SOLAR TANK COLLECTORS-' SOLAR PIPING SVS. ISSUE FEE MECHANICAL aLArv CHECK HEATING SVSTEM 0-300,000 8TU_ AND �UCTING 300,000 t BTU _ REFRIGERATION 0-100,000 BTU_ SVSTEM 100,000+BTV_ BOILERS BTU SVSTEM REPAIR, ALTERATION EXHAUSTSVSTEM . MULTIPLE ISSUE FEE CMF 0865-46 Wnite-Builtlin9; Canary-Appliwnt: Plnk-Accounting; GoltlenroG-Assessor %�0� � �ZO REGULATIONS ' ' � -� A.P. �` _ _ . . . � �ZONE � ` PLNG. REF. � ' ' ' "' REAR VARD (TO P/L) PKG. SPACE REQ. � STREET WIDTH� � ZONING APPflOVE� BV SPECIAI CONOITIONS: PROVIDED PARK FEE b OATE ' ELECTRICAL - " ' 'PCAN CHECK ' GENERATOR 0-1 KW_ 1-30 KW _ TRANSFORMER ' ' APPLIANCE 30-SOKW_50+KW_ MOTORS 0-1 FIP_1-30 HP _ . (INC. SOLAR) 30-50 HP 50 + HP _ 'FIXTURES OUTLETS SWITCHES ' ' GAS TUBE SIGNS ' " ' ,POLE LIGHTS' - " ' PANELS MAIN SVB " SERVICE " ' � AMP ISSVEFEE ' ' - � APPLICATION APPROVEO BV - DATE� SUMMARV OF FEES - BUILDING — PERMIT y SMIP S PLAN CHECK 5 7ERMIT ,. ISSUANCE 5 PLVMBING E PLANCHECK S GRADING § ELECTRICAL 'S S PLANCHECK b ` MICROFILM §� - MECHANICAL E—(_ � TOTAL,FEES PLANCHECK §' VANCEPC S_ FINAL FEE S—! CONSTRUCTION AND PLANNING POOL & SPA ' � ' . • • � . APPROVALS Permit� Date Inspector qppROVAtS . Permit# , Date Inspector ;1�„eTemporary Electr�ical�Service,or, Pole ' 43. Pool�& Equipment Location � ' Soi ipe-Undrgm - 44. Steel Reinforcement -� ' -� 3. Electrical �onduit Utility-Undrgrn 45. Forms � 4. Electrical Conduit-Undrgrn 46. Electrical Bonding , � � �- tee ein orce 47. Rough Plumbin & Pressure Test 6. Electrical UFER Grn ' 46. APPROVALTO COVER-GUNITE � ' 7. Footings 49. Electrical Conduit-Undr rn � . B. Foundatibn ., �- 50. Gas Pipe, ❑ Undr rn, Test � � - 9. Water Pipe-Undrgrn 51. Backwash Lines P-Tra ❑ ndr rn ' - 10. Structural Fioor System ' 52. APPROVALTO DECK .' '" . 1.1.. Property Sewer_Line & House,Cqnnection . 53. Backwash & Rece tor-Final . 12. Street Sewer_Connection " 54. Heater & Vent-Final 13. Rough Plumbing 14. Rough Electric-Conduit �56. Electrical-Final 15. Rough Electric-Wiring 57. Solar SYstem-Final � - - i6. Rough Heating & Air Conditioning � � • encing & Access Approval 17. �Ducts in Structure � APPROVED FOR PLASTERING 18. Ducts, Ventilating , 19. Gas Pipe-Rough & Test " 60. POOL/SPA SYSTEMS FINAL - 20. Roof,Framing - 21. Roof Sheathin � - 22. Frame and Flashin NOTES: 23. Insulation � 24. Lathing & Siding 25. Drywall Nailing � 26. Plaster Brown Coat 27. Electrical Power MeterFina� - � 28. Final.Eleciric ' 29. Final Heating & Air Conditioning / 30. Final Gas Pipe-Test 31. Final Plumhing 32. Water Service-Final � • 33. Gas Service-Final 34. Solar pomestic-Final 35. Landsca e S rinklin S stem 36. Sound Attenuation 37. Handicap Regulations 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed � 40. Electric Release to Edison 47. Gas Release to Southern CalifoFnia Gas Co. 42. CERTIFICATE OF OCCUPANCY No Date in allspaces witMin CITY, OF COSTA MESA � aeaM�ir�ryo. ,;CONSTRUCTIONPERMIT %`" Address � � � - - � � License No. Addiess Address I hereby affirm tnat I am Ilcansetl unCer provislons of Charter 9(com- mencing wltn �section 7000) ot• Dlvision 3- ot tha � Business antl Professions Cotle, tl y Iicense is In full (orce a tl eifect. LitenSe CIasS �' �L° , License N � oat,�o-�y�•R� Signature �•� WORKERS COMPENSATION DE RATION - - . I hereby atiirm that I have a ce ate o( con5ent to selbinsure or a certiflczte of Workers` Compens lon Insurance, �or a certifletl copy ' ereat( tior7�3�00,ib�C.). �^./r_i // 'cy Ne ��y �" Company !7�Z�(� �h+� �rtifietl copy IS h¢r¢by furnishetl. tifletl copy IS filetl with th¢ City Builtlin9 DivisiOn. EXEMPTION� FROM WORKERS' COMPENSATION DECLARATION (This secUon neetl not.be completeA it_tha permit is for one �untlretl (g100) or Iess). I rertlfy that in the�per(ormance of the work for which this permit Is izsuetl, I shall no[ employ any person in any manner so as lo become zub)ect to.the Workers' Compensation Laws.ot California. ' Date � Si9nature NOTICE: It after making thls tleclaration, you shoultl become subject to tne Workers' Compensation provlsions of the Labor Cotle, you must forthwith comply with such provislons or this permit shall be tleemetl revOkCtl. � .. CONSTRVCTION LENDING AGENCV I hereby affirm Ihat there is a constructlon Ientling agency for the per- (orman<e of the work tor whicn this permit Is issuetl (Sectlon 309] Giv.-C.). . _ . . . ' " Lentler's Name Lentler'S Atltlress OWNER BUILDER �ECLARATION ' I hereby atfirm [hat I am exempt from.the Contractor's License Law for the following reason (Section 7031.5 Business antl ProfesSions Cotle: Any city Or munty wM1ich requires a permit to consVuct, alter, improve, tlemoli5h or repair any structure, prior to its issuance, also re- qWres the appliwnt for such permit to file a signetl statement that he is'Iicensetl Dursuant to tM1e provi5ion5 ot th¢ Contrdctor'S CicenSe Caw (Chapter 9(commencing with Settion 7000) of Division 3 of the �^v51ne55 antl Ad¢ssiOns Cotl¢) Ot that'M12 Is ¢xeRlpt th¢r¢troT antl th0' 'Is tor the allegetl exemption. Any violation of Sectlon 7031.5 by � applifvnt for a permit subjetts the appli<ant to a civil penalty . not mO�e Ihan five hUntl�etl O011ars (E500). ❑ I, az owner of [he property, or my employees with wages as their sole compensation,.will tlo the work, anG [he structure is not intentletl Or Off¢r¢tl for sale. (Sectlon J044, Busin¢55 antl Profe55iOns Gotle: The Cont�acto�'s License Law tlo¢5 not apply to an Owne� of a p�operty wno builtl5 or Improves thereon, ana who tloes such work himselt Or tnrough N5 own employees, provltletl [hat such imorovements are not intentletl Or otfe�etl fo� sale. If, howeve�, the builtling Or imp�ovement is saltl within one year of completion, the owner will have the burtlen of proving he tlitl not builtl or improve tor the purpose of sale). ❑ I, as owner of the property, am exclusively tontracting with lic¢nSetl <Ontra<tOrs to construct the project (Settion 7044, Business antl Professions Cotle: Tbe�Contractor's License ldw Coes not apply to an owner of property who builds or improves thereon, antl who con- tracts'trom such proj¢Cts wi[h a COntractor(5) IICeSnGtl pursuant to the Contractor'S Li<ense Law). ❑ I am ezempt untler'Section 8. & P. C. tor Nis reason Date Owner 1 he�¢by c¢�tify [hdt I hav¢ reatl this application antl state tha[ [h¢ above intormation is mrrect. I aqree to comply with all tity antl county ortlinance5 antl Slate laws relaHng to Construttion, antl hereby authoNze representatives of this city to enter upon the above nti netl O�opert pec E purpo ES: ,' Signature �- Dat� ZC bortlerlinesantl.signallapproV'� tetleelarations. TRACT NO. LQT NO. i I�BLDG. NO. TVPfjOF CONSTRUCTION ['��NEW ❑ ADD ' O ALTERATION-- ❑ REPAIR ❑ CONVERSION ❑DEMOLISH ❑ OTHER' DESCRIPTION OF WORK .7YPE OF PERMIT ' '�GRADING ❑ FOUNDATION O'STRVCTURAL- ❑ TENANT ❑ ELECTRICAL ❑PLVMBING ❑MECHAN ❑�OTHER � PROJECT DESCRIPTION . _ SQ. FT. OCCUPANCV_CONSTRVCTIONTVPE VALVATION ZONE GRAOING CU. YOS. ACRES �i �-t�1� PLUMBING . . :PLANCHECK TOILETS �. , VRINALS' LAVATORIES DOUBLE LAVS ' 'KIT. SINKS " ' � DISHWASHERS SERVICESINKS ,SUMPS ' FLOOR SINKS FLOOR DRAINS DRINKING FOUNTAINS ' '- INTERCEPTORS CLARIFIERS SWIMMINGPOOL PTRAP' WATERSERVICE ALTERATION GASSERVICE � OUTLETS � WATER HEATERS "BTU OUTPUT' SEWERCONNECTIONS SOLARTANK COLLECTORS SOLAR PIPING SYS. � ISSUE FEE � MECHANICAL PLAN CHECK HEATING SVSTEM 0-300,000 BTU AND DUCTING 100,000 + BTU REFRIGERATION 0-300,000 BTU SYSTEM ' 300,000 + BTU BOILERS BTU SVSTEM REPAIR,ALTERATION EXHAVSTSVSTEM MULTIPLE Drlver Li nse or SS � � """" " CMF 0865-46 White-Builtling; Canary-Applicant; Pink-Accounting; Goltlenrotl-Assessor 7111 10/20/81. 5.00. TLi ZONE REHR VARD (TO P/L) PKG. SPACE REQ. STREET WIDTH ZONINGAPPROVEDBV � SPECIAL CONDITIONS: PLNGp.gR�EJFL.� -- �ROPE�RTVNLINE � . PROVIDED PARK FEE S ' DATE ELECTRICAL P�.crv CHECK - GENERATOR•- 04 KW_1d0 KW_ TRANSFORMER ' APPLIANCE 10-SOKW_SO+KW_ MOTORS 0-1 HP_1-10 HP _ • . QNC. SOLAR) 30-SO HP SO + HP _ FIXTURES " OVTLETS SWITCHES�" ' ' GAS TUBE SIGNS - - " POLE LIGHTS' - PANELS MAIN SUB SERVICE ' AMP ISSUE FEE ' ' APPLICATION'APPROV ED BY SUMMARV OF FEES BUILDING PERMIT § SMIP S PLAN CHECK 5 PERMIT PLVMBING g� �SSUANCE E G0.A�ING E PLAN CHECK b ELECTRICAL b S PLANCHECK S MICROFILM § MECHANICAL E- TOTAL FEE S PLAN CHECK 'E _ LESS AD- VANCE PC S FINALFEE E� 0 t , �..-._ .. CONSTRUCTION AND PLANNING " POOL & SPA'`�� •-\,a '' . AP.PROVALS Permit-�# Date . Inspector qppROVALS ' Permit# Date Inspector .It I:��'IR\f�l 11 Temporary Electrical Service or Pole 43. Pool & Equipment Location - Soil ipe-Un rgrn 44. Steel Reinforcement � � 3. . Electrical Conduit Utility-Undrgrn - 45. Forms � - � 4. . Electrical Conduit-Undrgrn 46. Electrical Bonding tee ein orce 47. Rough Plumbin & Pressure Test � 6. Electrical UFER Grn �� 48. APPROVALTO COVER-GUNITE � - � 7. Footings__ 49. Electrical Conduit-Undr m - � 6. Foundation 50. Gas Pipe, ❑ Undr rn, Test 9. Water Pipe-Undrgrn - 51. Backwash Lines P-Tra � ndr rn - 10. Structura� Floor System 52. APPROVAL TO DECK ii. Property Sewer Line & House Connection 53. Backwash &�Rece torFinal � .12. Street Sewer Connection � 54. Heater & Vent-Final 73. Rough Plumbing . � 14. Rough ElectricConduit - - ��56: , Elecirical-Final 15. Rough Electric-Wiring �� - � - � - �57. � Solar System-Final 16. Rough Heating & Air Conditioning - • encing & Access Approval 17. Ducts in Structure '�' • APPROVED FOR PLASTERING 18. Ducts, Ventilating ' ,_ 79. Gas Pipe-Rough & Test - - 60. POOL/SPA SYSTEMS FINAL � 20. Roof Framing � - 21. Roof Sheathin , 22. Frameand Flashin NOTES: ' 23. Insulation � - � 24. Lathin & Siding ' � 25. Drywall Nailing � - 26. Plaster Brown Coat 27. Electrical Power Meter-Final 28. Final Electric � � � 29: Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing _ /b � 32. Water Service-Final � 33. Gas Service-Final ' 34. Solar pomestic-Final � � 35. Landsca e S rinklin S stem - ' 36. Sound Attenuation � 37. Handicap Regulations � 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed 40. Electric Release to Edison 41. Gas Release to Southern California Gas Co. 42. CERTIFICATE OF OCCUPANCY ^ No� Date � - . APY��cant to flll in all f CITV. OF COSTA MESA P RMIT NO. . CONSTRUCTION PERMIT 1 - Addrea License No. Address Contracror wit�in neavy EorEer IlnesanE.slgn all I hareby effirm thal I am IlCenflC Untla� provliloni O/ C�arter 9(com- mencing wlth sectlon 7000) af Dlvision 3 oi the Bu5ine55 anG PrOfB551on5 COtle, anE my Iltenie IS In full forte entl elfe Llcensa Clais C�� Licensa o. 0 Date�� L'�� Slgnature ��`� ��Q� WORKERS' COMVENSATION DEC ARATION I hereby affirm that I have a certlfica[e of consent to self-insure or a certitl�ate ot Workers' Compan5ation Insurante, or a certifietl copy "'+reof (Saction 3800, Lab. C.). cy No. - Compariy - Certltlatl copy Is hereby fumisnetl. � - . �, Certi(latl copy Is /iletl wlth the city Buil0ing Division. EXEMPTION FROM WORKERS' COMPENSATION OECLARATION �Thls sectlon neetl not be completetl if the permit is /or one huntlretl 83001 or Ieu1. � cert(fy that in the per(ormance Ot.the work }Or whit� thls permit IS Izsuetl, I zhall not emPloy any person In any manner so as to becoma sub�ect to tha Workeri Compansatlon Laws of Ulifornla. Date Sl9na[ure NOTICE: I/ after making this tleclaratlon, you shoultl be<ome sub�ect t0 th0 WOfkefs' CompGnsatlOn plovl5lOn5 O( th! Ldbor Code, you mutt forthwith com0ly wlth suth provlsions or this permit shall be tleemeC revoketl. CONSTRUCTION LENDING AGENCV ' I hereby altirm that t�ere.ls a con5truction lentling agency (or the per- (ormance ot-[he work for which tnis permit is iuuetl (Settlon 3097 Civ. C.1. - . ' LBntler'S NdmO Lender'S AtlUress OWNER BUILDER DECLARATION I heraby aHirm that t am exompt from tne Contractor'S License Law (or the (ollowing reason (Settlon 7031.5 Business antl Professlonz Cotle: Any dty or county whith roqUlres a perTit t0 Construct, dlt¢r, Improve, tlemollsh or repalr any struc[ure, prior to Iis Issuance, also re- quires lhe appliwnl tor 5uth pormlt to file a 5I9ne0 ztatement tnal he is Ilcensetl pursuant to tho provislons of the Con[ractor's License Law �Chaplor 9(commentin9 with Sectlon 7000) ot Division 3 of the isiness antl Professions Cotle) or that he is exempt therefrom anO Iho 'Is for tne allegetl exemptlon. Any vlolation of 5ection ]031.5 by r appliwnt'for'a Oermil su0�ects the applltant to a Civll panalty nOt more than fiva huntlretl tlolldr5 (5500). ❑ I, as owner oi the property, or my employees witn wages as tneir sole compen5ation, wlll tlo tho work, ana the structure is no[ inientletl or offeretl for sale. (Sattlon 7044, Business antl Rofesslons Cotle: Tna Coniractor's Llconsa Law tloes not apply to an owner of a proPerty wh0 bullds ol ImprOVBi [hGfeOn, dntl wh0 OOeS Such work M1imselt or throu9M1 hls own ampl0yBU5, pfovltlOtl lhat sucll ImprovGmentS afa nOt Intontletl or otferetl for sale. 1�, however, tna builCing or Improvemen[ Is soltl witnin one year ol completlon, tha owner wlll have t�o burtlen bf proving he tlitl not builtl or Improva for the purpose of sale). ❑ I, as owner of the property, am exclusively contracting wilh Iicensetl conlractort to tonstruct tne Droject (Section 7044, Business antl ProfeSsions Coae: Tne Contraclor'S Licensa Law tloes noi apply to an owner ot property who builtls or improves [hareon, antl who ton- tracts from sucn pro�etti with a conVac[or(s) Ilcezned pursuant to Ihe Contractor'S Litenso Law). ❑ I am exempt untler Sacllon B. d P. C. for thls reason Date Owner 1 hereGy certity Ihal I have roaC this ap0��t1on antl state inat the above Informatlon is corrett. I agrea to mmply with all Uty antl county ortllnances antl state laws relatin9 to constructlon, antl M1ereby authorize r¢pr¢5¢ntatives Of 1h15 Uty la anlGr upon fhG above mentlonetl orooertv-�Scr�y�yypa�uwdulp66Pi // . . ,i� i/_ Q, NO. "��BLDG.NO. TVPE OF CONSTRUCTION ❑ NEW ❑ ADD � ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEMOLISH. � OTHER DESCRIPTION OF WORK TYPE OF PERMIT � ❑ GRAOING ❑ FOUNDATION ❑ STqUCTURAL ❑ TENAIVT ❑ ELECTRICAL �PWMBING �ECHFV ❑ OTHER PROJECT DESCRIPTION 5�. FT. ' . _ . OCCVPANCV�CONSTRUCTION TVPE VALUATION ZONE GRADING CU. VDS. ACRES 0.EMARKS: � - PLUMBING�. _ PLANCHECK BATHTVBS SHOWERS � TOILETS VRINALS ' LAVATORIES DOUBLELAVS"- KIT.SINKS � DISHWASHERS SERV�CESINKS SUMPS FLOOR SINKS 1 FL000. DRAINS DRINKING FOUNTAINS � INTERCEPTORS SWIMMING POOL WATERSERVICE GAS SERV ICE WATER HEATEFS SEWERCONNECTIONS SOLAR TANK SOLAR PIPING SVS. ISSUE FEE MECHANICAL CLARIFIERS PTRAP ALTERATION OUTLETS COLLECTORS PLANCHECK HEATING SVSTEM 0-300,000 BTU_ ANDDVCTING 100,000+BTU. REFRIGERATION 0•100,000 BTU_ SVSTEM 100,000+BTU_ BOILERS BTU� SVSTEM REPAIR,AITERATION EXHAUSTSVSTEM MULTIPLE ISSUE FEE CMF 0865-46 Whlte-Bulltling; Gnary-ApPliwnt: Rnk-Accounfing; Goltlenrotl-Assessor �oag I,0%16/BI A.P. $ ZONE REAR YARD (TO PKG. SPACE REQ. STREET WIDTH SPECIAL CONDITIONS: ELECTRICAL LNTGp. gRUEF�. p� GROPE�RTVNLINE � � PROVI�ED - PARK FEE $ � DATE PLAN CHECK-� RAU�� GENERATOR 0-1 KW_1-lO KW _ TRANSFORMER APPLIANCE 30-50 KW_50 + KW _ MOTOR$ 0-1 HP=1-30 HP _ (INC.SOLAR� 10-SOHP SO+HP_ FIJ(TURES OVTLETS"' SWITCHES �GAS TVBE SIGNS POLE LIGHTS MAIN SERviCE APPL�CATION APPROVED BY AMP SUMMARV OF FEES BUILDING PERMIT E PLAN CHECK S PLUMBING E PLAN CHECK 5 ELECTRICAL S PLAN CHECK E � MECHANICAL E PLAN CHECK S ;�� Il,O� TU DATE SMIP E PERMIT ISSUANCE E GRADING 'E E ' MICROFILM S TOTAI_ FEE E LE55 AD- VANCEPC §_ 1 FINAL FEE 4 .,- . i�Uol l CONSTRUCTION;AND'yP„LANNING � � POOL�&SPA � ., � ' APPROVALS Permit# Date Inspector pppROVALS � Permit# `�� Date Inspector. i. Temporary Electrical Service or Pole 43: Pool & Equipment Location � - - 2. Soil ipe-Un rgrn 44. Steel Reinforcement - 3. Electrical Conduit Utility-Undrgrn • 45. Forms 4. Electrical Conduit-Undrgrn 46. Electrical Bonding . tee ein orce 47. Rou h Plumbin & Pressure Test 6. Electricai UFER Grn 48. APPROVALTO COVER-GUNITE 7. Footings 49. Electrical Conduit-Undr rn 8. Foundation 50. Gas Pipe, � Undr rn, Test 9. Water Pipe-Undrgrn ' 51 . Backwash Lines P-Tra ❑ ndr r 10. Structural Floor System 52. APPROVALTO DECK 11. Property Sewer �ine & House Connection 53. Backwash & Rece tor-Final 12. Street Sewer Connection � 54. Heater & Vent-Final . 13. Rough Plumbing 14. Rough E�ectric-Conduit �56. Electrical-Final , �. 15. Rough Electric-Wiring 57. Solar SYstem-Final� 16. Rough Heating & Air Conditioning • encing & Access Approval 17. Ducts in Structure APPROVED FOR PLASTERING 18. Ducts, Ventilating 19. Gas Pipe-Rough & Test 60. POOL/SPA SYSTEMS F,INAL � 20. Roof Framing 21. Roof Sheathin '� � 22. Frame and Flashin NOTES: �,�, �„i, / V-�„ 23. Insulation „� (J �� 24. Lathing & Siding 25. Drywal� Nailing � 26. Plaster Brown Coat - 27. Electrical Power Meter�Final . 28. Final Electric � 29. Final Heating & Air Conditioning 30. Final Gas Pipe-Test 31. Final Plumbing � 32. Water Service-Final 33. Gas Service-Final 34. Solar pomestic-Final 35. Landsca e S rinklin S stem � 36. Sound Attenuation '� 37. Handicap Regulations ', • 38. FINALSTRUCTURE&BUILDING 1 39. Special Requirements �ompleted 40. Electric Release to Edison , � 41. Gas Release to Southern Califor'nia Gas Co. 42. CERTIFICATEOFOCCUPANCY � �� No Date � AVP��ant to fill in all spaces wilnin CITY, OF COSTA MESA � aeg�nir 9 GO , CONSTRUCTION PERMIT Y � Address � , ArchlEng. License No. � Address � , Contrector C/,�� yG Phone � Address P.e7-. f3r�.t ii,r_CR �r'nSrnu/F.Se 1 hereby afllrm that 1 am Iicensed unEer provlslons of Charter 9�(com- mencin9 wit� section 7000) of Division 3 of the BuSiness antl Pra(e5sion5 Cotle, antl my Iltense I5 In full forca antl effect. ucenuCiass G- se '25�741 Date 9�—«'�� Si9nature WORKENS' COMPENSATION DECLARATION 1 hereDy af/irm that I have a certificate of consent to self-insure or a carHiitate of Workers' Compensation Insurance, or a cerH(IeA copY "�reo/ (Sectlon 3800, Lab. CJ. <y No. Company Certl/ietl <OPy IS'hereby furnl5hetl. � Certlfletl copy Is filetl with the City Bulltlln9 DlviSion. EXEMVTION FROM WORKERS' COMPENSATION OECLARATION (§100)5BOriles5�eetl not be completatl�if th0 pGrTlt IS fOr on¢ huntlratl 4 cer[ffy that �n the per(ormance of [he work for which this permit is Issuatl 1 sna11 not emPloy any parson In any manner so as to become SUGjBC� to the Workeri COTpensdtlOn Laws ohCallfornia. - Date Signatura NOTICE: I/ aiter making this tleclaratlon, you snoultl become sub)ect to t�e Workers' Compensatlon prorislons of the Labar Cotle, you muit (OlthwiN comply with Suth plovl5iOn5 Or this plrTit Shall be tl¢¢T¢tl revokatl. CONSTRUCTION LENDING AGENCV . I heroby affirm lhat lhere is a tonztrucNon lentling a9ency tor the per- formance of the work tor which thls"permit Is issuetl: (Sectibn 3097 Civ. C.1. . _ � I..entler's Name � � � �` Lentler'S ACtlress Any. city. or counry wnirn reqwres a permrt ro cons[rucq arter, improve, tlemolish or repair any structure, prior to its issuance, also re- quires the appliwnt for such permit to tile a signetl statement that he is Iicensetl pursuant to the provisfons of the Contractor's License Law `Chapter 9(commencing with Sectlon 7000) of Division 3 of the �" �S��ess antl Professionz Cotle) or that he Is ezempt therelrom antl the ��+,=„15 for the allegetl exemptlon. Any WolaUon of Section 7031.5 by s.::,.' apD��nt (o� a permit subj¢Cts the ap0licdnt lo a civil penalty -Fnot more [han five huntlretl tlollars (§500). ❑ I, a5 owO¢r ot the property, or my employees wilh wa9es as Meir sol¢ <OTp¢nsation, wlll tlo Ihe wo�k, antl th¢ sl�uctu�e is not�inlentletl or otferea ior sale. (Section 7044, Business ana R'ofessions Code: The Contractor'S Litenze Law tlaes not appry to an owner of a proper[y who bulltlT O� Im0/oves thereon, antl who tl0¢5 SUGh work himself O� tnrough his Own employee5, proviCetl thal Suth ITprOvements are not int¢nded or of/erltl fOr sale. If, however, the builtling or Improvemin[ is soltl within one year of completion, the owner will have the buraen ot OrOving he tlitl not builtl or improve fOr Ihe purpose of sale). ❑ I, as owner of� the property, am ezclusively contracting with IlcenS¢tl COntractor5 to conStrUct the proj¢Ct (58CtlOn 7044, Busin¢55 antl PrOfC551on5 COtle: The Contlactor'S lIC8n50 Ldw tloe5 not apply l0 an owner ot property who builtls or improves tM1ereon, antl who con- traCts tfom such pfoject5 with a COntfactol(5) IlceSn¢tl pulsUant to the Contrattor's Ucense Law). , ❑ I dm ¢xempt untle� 5¢ctlon B. & P. C. f0/ thi5 reawn � Date � Owner - 1 hereby tertity that Phave reaU this applifation antl sta[e tha[ the above in(ormation iz correct. I aqree to comply with all tlty antl county Ortlinant¢s an0'state laws relatin9 to construttlon, dntl hereby authorize representatives of lhli <ity [o enter upon [he abOve mentionetl property f r spe� tl ur Signature �-�'' _ _ _ oate q��'�a� Drlvers' License or 55 � �" / �- CMF0865-46 Whlte-BUIlaing;G Dortler lines anE.sign all appraarl�! Ceclarotior TRACT NO� , LpT NO. � BLDG. NO. TVPE OF CONSTRUCTION ❑ NEW ❑ ADD ❑ ALTERATION ❑ REPAIR ❑ CONVERSION ❑DEM( � OTHER TG.%EA7 � �NAO2n-% DESCRIPTION OF WORK Q0� N'�� ❑ GRADING ❑ FOUNDAT.�IjO�N ❑ STRUCTURAL ❑ TENANT ❑ ELECTRICAL µyPLUMBING ❑MECHAI ❑ OTHER PROJECT DESCRIPTION� ' - SQ. FT. � ' " ' OCCUPANCV_CONSTRVCTION TVPE VALVATION ZONE GRADING.CU. VDS. ACRES PLUMBING � . BATHTUBS TOILETS .�%ji LAVATORIES /(� KIT. SINKS SERVICE'SINKS- - FLOOR•SINKS DRINKING+FOUNTAINS INTERCEPTORS SWIMMING POOL WATERSERVICE GASSERVICE WATER HEATERS SEWERCONNECTIONS PIAN CHECK SHOWERS VRINALS DOUBLE lAVS DISHWASHERS SUMPS FLOOR DRAIN$ CLARIFIERS P TRAP ALTERATION OUTLETS COLLECTORS SOLAR PIPING SVS. ISSUE FEE MECMANICAL PLAN CHECK HEATING SVSTEM 0-300,000 BTV _ AND DUCTING 100,000 + BTV _ REFRIGERATION 0-100,000 BTU_ SVSTEM 100,000+BTV_ BOILERS BTV SVSTEM REPAIR,ALTERATION EXHAUSTSVSTEM _ MULTIPLE ISSUE FEE Pink-Accountin9: Goltlenrotl-Assessor ZONING.REGU4ATIOjUS A.P. ii .. � �... .-. � ... .. � , �_ .. _ 20NE PLNG. REF. $ REAR VARD (TO P/L) PKG. SPACE REQ. P0.0VIDED STREET WIDTH ' PARK FEE 5 ZONING APPROVED BV DATE SPECIALCONDITIONS: � ELECTRICAL PLAN CHECK ci��nr�.i�rn 0-1KW_1-lOKW_ TRANSFORMER APPLIANCE 30-SOKW�SO+KW_ MOTORS 0-1 HP_1-10 HP _ (INC. SOLAR) 30-50 HP_50 � HP _ FI%TURES OUTLETS SWITCHES GAS TUBE SIGNS � POIE IIGHTS PANELS MAIN SVB SERVICE qMP ISSUE FEE APPLICATION . _ SUMMARV OF FEES ' � BUILDING PERMIT S SMIP § PIAN CHECK $ PERMIT ' ' '/'— ' ' ISSUANCE 5 � PLUMBING y� - • • PLAN CHECK E GRADING' E' ELECTRICAL $ - s PLAN CHECK E MICROFILM E MECHANICAL E TOTAL FEE E PLAN CHECK S , VA CE PC. .b ' FINALFEE E a�� I � �. � CONSTRUCTIONANDPLANNING �� " POOL&SPA . � � . ' APPROVALS Permit # Date Inspector qppROVALS Permit # � Date ^ � Inspecior 1. Temporary Electrical Service or Pole � 43. Pool & Equipment Location . Soil ipe-Undrgrn �. -� 44. Steel Reinforcement 3. Electrical Conduit Utility-Undrgrn 45. Forms 4. Electrical Co�duit-Undrgrn 46. Electrical Bonding . tee ein orce 47. Rough Plumbin & Pressure Test ' 6. Elec[rical UFER Grn • 46. APPROVALTO COVER-GUNITE � 7. Footings � " 49. Electrical Conduit-Undr rn - - �� 8. Fouridation - • '- -' ' '50. Gas Pipe, ❑ Undr rn, Test � � 9. Water Pipe-Undrgrn � 51.� Backwash Lines P-Tra ❑� ndr rn 10. Structural Floor System 52. APPROVALTO DECK - it. Property Sewer Line & House Connection � � - - 53. Backwash & Rece torFinal � � � � � - - 12. �Street Sewer Connection -- 54. Heater & Vent-Final � ` 13. Rough Plumbing [ ) � -- - - - � � 14. Rough ElectricConduit � - -:56. _ �Electrical-Final � 15. �Rough Electric-Wiring- - - - - - � 57. Solar System-Final � • • • �-� • ' " ' - 16.- Rough Heating & Air Conditioning encing & Accen Approval � 17. Ducts in Structure APPROVED.FOR PLASTERING � �� 18. Ducts, Ventilating • � . 19. Gas Pipe-Rough &Test • � � � 60. POOL/SPA SYSTEMS FINAL . � , 20. Roof Framing� � - � ' ' 21. Roof Sheathin ' - ' . NOTES: �� ' Q.hs O � � �w,+� , � 22: Frame and Flashing' � � �' � ' 23. Insulation ' ' ' .¢,w o�2fl�P 24. Lathing & Siding � - � � � 25. Drywall Nailing � ' � 26. Plaster Brown Coat � 27. Electrical Power Meter-Final 28. Final�Elearic - � 29. Final Heating'& Air Conditioning � -' ' 30. Final Gas Pipe-Test ' � � � ' 31. Final Plumbing 32. Water Service-Final � � � 33. Gas�Service-Final ' ' � � - � � ' . 34. Solar pomesticFinal •� � � - � 35. Landsca e S rinklin S stem � - � 36. Sound Attenuation ' � �' ' ' 37. Handicap Regulations � � � � � � � � � 38. FINALSTRUCTURE&BUILDING 39. Special Requirements Completed � � ' 40. Electric Release to Edison � - � - � ' - 41. Gas Release to Southem California Gas Co. - - � ' `� - �- � -� - - - , 42. CERTIFICATE OF OCCUPANCY : _ _ _ . � � � � . � - •No Date - - � - - f � F � a Q N h T F G W F < J 6 > } � C W a 0 C G. Z W s 3 .'� COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use [nk Only BVILDING �! C— � � �_ ADDRESS O J OWNER OR TENANT MAILING � / D ��D � ADDRESS ` -/T� TEL./ CITV /1/S� �rL /S[ {{ NO. p %�—/ LENDER �' BRANCH � ADDRESS — ARCHITECT � , „ _ ADDRESS CONTFlACTOH ADDRESS CITV STATE LI0. NO. SIZE GO OF LOT O TEL. NO. CITY LIC. NO. NO.OF BIDGS NOW ON LOT Separa[e permits are required for eleMric, plumbing and heating work. USE OF BUILDING ANO WORK TO 8E PERFOFMED � I haraby aeknowlatlpe that I heva reatl this eppllcetiOn antl stata that t�e ebova Informetion if correct entl epree to comply with ell laws reguletinp building consvuction, antl I choll not employ any parson in violetlon ot the workmen'a compansation laws of Me State of Celifarnla. I heraby cartify thai 1 em proparly Ilcenutl as a contractor �ntler Me State of Calitornla Busines� antl Profeaions Code, Division 3, Chnpter 9, antl thet suc� lieensez ara In fuil forca nntl effect, or � am oxempt from tho provisions of tha Stata of Cnlifornfa Businasa antl Profassipny Cotle, Oivi 3, Chapter 9. mP�� i Slgnotura of Parmittee or Authorizetl Agent Date 3 O / J��10 3/10/81 l�.50 TL APPLICATION FOR STRUCTURAL PERMI'f R A.P. NO. BUI LDI NG ADDRE55 UNIT OR SPACE NO. NEW � ADD APP DA APPROVEDSETBACKS E a C i m m SQ. FT. �`+ 7 THE AMOUNT SHOWN UNDER VALUATION I$ FOR m THE PUqPOSE OF ESTABLISHING A PERMR FEE ONLV: � VALUATION PERMI7FEE S q n m 0(j PLAN CHECK E ^ ^^'� 0 SlD('/�/�— TAX § G T � J (/ U TOTALPAID b //1 c 11 , � . . . COSTA MESA BUILDING-SAFETY DEPARTMENT � P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only \ BUILDING ^ c'� ' .v AOORESS J OWNER OR TENANT MAI LI NG ADDRE55 ' CITV � BRANCH �� ADDRESS — ARCHITECT � . . _ . ADDRE55 -�- CONTRACTON �R/�[ � AODRESS "��3 �, CITV � � STATE IIC. NO. . S12E � OF lOT '��q ��yp TEL. NO. TE � � TEL. NO• I CITV LIC. NO. NO.OF E Sepazate permits are required for electric, plumbing and heating work: USE OF BUII�ING AND WORK TO BE PERFORMED /L l�ii fT121�li � in� . _ . —. `�'" a' \ t APPLICATTON FOR'$TRUCTURAL PERMIT RECEIVED�V PERMIT �/ /J /� r.� 7 � A.P.NO.��--V�/�. �I 35E BVILDING ��s �� J /�/� � . ADORE55 / VNIT OR SPACE NO. TR.NO. BLK. WEW ADD LTER REPAIR MOVING DEMOLISH OWNER USE ' TL � yao- zl � L �� Y . �O / / �u% 1e .C. �/� v Y> 6(�. 5` � � APPRO E SET CK � \ � (FROM /LSTREE ) � o • oM F� ,L. - � � - �. I !/ �. i �/ � L. SIDE FT. � / �% REAR FT. � PLiiNN G ACTION ' 'I /Y , %Q � � �ocanvcn .n�� /N I hareby ecknoWledBe ihat I have reatl thls applicntion entl stnte � Mat iha eGova ��formatlon if eorreet antl epree to comply wlth .�. ell laws reyulet�np buiitlinB conrtruction, antl I s�ell not employ HOLD FOR SPECIAL REQu1REMENTS ' eny person In vlolaUon of Ma workman's cOmpenmtion lews ot � Me State of Celifornle. . m I hareby cartify that I am proporly Iicensetl es a contractor untlar SQ. FT. �`+ the Stete of Cellfornle Businesa entl Professions Cotla, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, antl ihat such licenfes ere in full force entl effact, or I THE PURPOSE OF ESTABL6HING A PERMR FEE ONLV: " em exempt from Ma pr vi ns of Calitornia Businesa a VALVATION PERMIT FEE S anA ProfeulOro C � ' s n, C 9 ' S v m PLAN CHECK y -�-c�� ^ Signatura of f� $/ Q YQ TAX E f Permitta G � � �3 � AuthOrized Age�t Date � a� TOTAL PAID E ��.��Z . , COSTA MESA BUILDING-SAFETY DEPARTMEN� P.O. BOX 1200 COSTA MESA, CALIFORNIA 92fi26 For Applicant to Fill in Completely — Use Ink Only BUILDING (;�(y� � � � „ ADDRESS ! O OWNER OR TENANT �,N /lp� MAIL�NG � .�� ADORE55 �3 O 4R c�Tv /.� /�w*� �cr+ No` 6�/2 - CONSTRUCTION LENDER �'.✓/`� BRANCN �— ADDRESS '� APPLICA ON FOR STRUCTURAL PERMIT REGEIVED PERMIT " � "� o v A.P. NO. —L'� --• 3 L ^ � ADDRE55 98� �_ /�j� S� UNIT OR SPACE NO. !�p`��. I� �,rt,o� lto5 a� NEW ADD LTER REPAIR MOVING DEMOL OWNER �� -�Qy.� G'/vl�^ VALUE USERO�...""._" n G/.�.I/I $ 12 Ti. ADDRESS / /_ � /L curve �v - ivrt i� tinuur APPROVED /_/� / � CONTRACTOR ��+ BV �G DATE (� � ADDRESS �—� ^ TEL.1 ` CITV NO. `�D F STATE � CITV APPROVEDSETBACKS � LIC. NO. IIC. NO. � SIZE NO.OF BLOGS. (FROM C�TREET) � o. OF LOT 2 G( o Q NOW ON LOT RONT FT. `` , a USE OF O � � E%ISTING BLDG. .N. �/�Q� FSeparate permits are required for L SIDE L✓ FT. o electric, plumbing and heating work: REAR � FT. FVSE OF BUILDING AND WORK TO BE PERFORMED PLP,NNING ACTION Q i � DATE d M�L '/ �(D [ %n� �ROVED ' �� v 7 , � r � = i w � I hereby acknowledga that I have reatl this applicatian antl state � (y� that the ebove information is correci and agree io comply with � a ell laws reguleting building conscruction, and I shell not employ � 7, eny pe�wn In violaiion of the workman's compensetion laws of - m � the Staie of California. L ' 3 I hereby cartify that I am prope�ly Ilcensetl as a contrector untler /� �' FT' p00 �� N the State of Califo�nia Business antl Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chapter 9, and that such licenses are in full forc d eftect, or I THE PURPO6E OF ESTABLISHING A PERMIT FEE ONLV: � am exempt from the provisionsof theStat f alif rnia B�siness VA�VATION PERMIT FEE a 32, j v a antl Protessions Cotle, Divisi , Cha t r . m m PLANCHECK S !� I, / 2 0 Signature o Parm�ftte $2Q��' TAX S �� f Authorizatl Agent Date �5 � U TOTALPAID § �� % 7