HomeMy WebLinkAbout999 18TH ST - Building Permits[�\
Aoo�icant lo Ii1l In all spacas axceo� �nose witnin neavy bortler Ilnes ane slgn all aooraoriata Ceclarations.
�i7v oF COSTA M�EyS�A CONST� UC� IO1N PERMIT
Project Address �`7H � Si/H /.AS/A G'�ii . '
Applicant's Mailing Adtl eu �/.,,35 �LSl
�Owner's Name �rD�iwi �. /�A.P71 ��,..J. P�hon/� �1%`//,Z7_
Address y,3.���a ��/P A� �uu.r/ FScl.f
'Arch/Eng. Licenu No.
�Address
Cootracror's Nam ' hone
Address (mailing) �
City License No. '
LICpNSED CONTRACiOR OECLAR TION �
I hereby. af(irm that I am Iicensetl untler provitions of Cnarter 9(commencing
with section ]000) ot DlviSion 3 ot the Bu51ne55 antl Pro(e55ions Cotle, antl
my Ilcense is in tuil force antl etiect.
LI<ense Clazs en58 No.
Data Si9nature
WOi=KERS' COMPENSATION DECLARATION
I hereby affirm tnat I have a certificate of conzent to self-insure or a certiflcate
of Wprkers' Compensation Insurance, or a certitietl copy thereof (Sectlon
3800, Lab. C.) � , �
PoliQy No. � Company �-'
eCertiffetl copy iz M1e�eby (utni5he�. ;
Certifi¢tl copy is filetl with the City Builtling Dlvlsion. ��
Datg AOO�icant
E%QMPTION FROM WORKERS' COMPENSATION DECLARATION
(Thiz section neetl not be comple[etl it th¢ permll i5 fOr One huntlretl (5300) or �
less). • - .
I Cer(jty Ihat in the pe�lo�mante ot th¢ work }or,whlcM1 thls perm�t'is'�Iss�etl, I
shall not employ any per5on in any Tar� e� 50 as o peco e 5 61ac1 to [he
Worke�CZorpDer�saUnn Laws o( Galiforpf0, p \ '� �
Dat@ -5 �S Si9nature ���L'� � •
'NO710E: It, after making thts tlactar ' n, you s oultl become subject to lhe
Wo�keri' Comp¢n5atlon pwviSions ot Ih¢ Labo� COtlO, you muit tortpwith
comply wlth SUCn p�ovlSiOns or [nls petmlt Shall be tle¢metl �avOketl.
CONSTRVCTION�LENDING AGENCV
1 hereby afffrm thal thero is a conztruction lentlin9 agency for the perbrmance
of tno work tor whlch th13 permit i5 issuetl (SeCtlOn 3097 Civ. C.)
ln�der'i Name�
Lentler's Atldress
OWNER BUIL�EN DECLARATIOfi
I h0�eby atfirm that 1 am exempt iroT the COnt�actOr's �icense 1..aw tor tne
�o��owin9 reason (Sectlon-7031.5 Businesi anU Professlonal Cotle: Any clty or
coUnry which r¢quires a parmit t0 con5trucl, alter, ImOrOvn, tlemolish o� rOpai�
nny sV ucture, prior to its isivance, also requires the apPi��ant for such permil
to iile a 5ignetl statament thdt ne/she Is IlCensetl purivant to th0 provl5iOn5 Of
the Contractor's Llcense L. w(Chapte� 9(<ommoncin9 with SecUon 7000) o�
�Div�sion 3 of the Buslnass antl Prolessions Cotla) or that he/she is exampl
the�etrom antl t�e ba515 tor l�0 allegetl exemptlon. Any violaliOn oi Suctlon
70�1.5 Dy any applican[ IOr a permit SubjecK lhe apP��Gant [O d Clvil
��alty o1 not more tban fivn nuntlred tloltars (E500).
LJ I, as, owner of the properry or my employaes with wa9es as their solo
componsation, will tlo thu work, antl [he itructuro is nol intenaetl or oiferaC
lor sale (Soction �044, Business antl ProteSsional Cotlo: Tha Contraclor's
License Law tloes not app1Y to an owner o� a proporty who bullas or Imoroves
theroon, antl wno tloes such work himselt/hersell or through nis or hor own
employees, provitletl tnat suth Improvements are not Intentletl or oHeretl for
sel0. 11, however, the builtlin9 or imorovement is soltl wlt�in one year o� com-
pletion, the owner will have t0o burtlen of proving he/zhe ela not builtl or Im-
�� ve for the pur0ose oi 5ala).
I, as own¢� oi th¢ P�ope�ly, am exclusively Cont�acting with Iicensetl <On-
[ra�{orsto consVuct tha project (Sec[ion 7044, Businoss antl Professlons Cotle:
Tne COnlracto�'S Licensa Law OoeS not apply to an owtiet Of proPerty whp
bulltls or Imo�oves th¢reon, antl wno conVaGts for such pro7ects with a con-
tra�tor(S1 Ilcens¢ pu�suant to the Con[�acto�'s Litense L.aw�. I am aware lhat �
p/pof o1 Ihei� WorkeCs ComDensation insUranco shoultl be provi�etl [o� me.
❑ 1 am exempt untler SecHon 8. & P. C. �or this reason '
Dato � Owner
I hereby certify that P bave reatl this applicatlon'antl state tbat the above
• intbrmation is <orrect. I agree to comply with all city antl county or0inances
antl state laws relating to builtling consiru<tlon, antl �ereby au(horize repre-
sen(atives oi � this City [O en r u n t a abOva-menHOnetl properly for
InSpettion pur0 ¢s. /
Signature �� DateS¢-�- '�
TYPE OF CONSTRUCTION LJ NEW U ADD LJ ALTERATION U REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER A p#, .
DESCFIPTION OF WORK/USE OF BLD .
� (�n/Y(A S Main Building:
— E
TVPEOFPERMIT GRAOING FOUNDATION STRUCTURAL T Ffon[
❑ TENANT ❑ ELECTRICAL Q PLUMBING Q MECHANICAL B Rear
❑ OTHER A
PROJECT DESCRIPTION 5�. FT. ' OCCUPAN�Y C Right
K
CONSTRUCTIONTYPE VALUATIONS _F��Q g Left
20NE GRADING CV. VDS. ACRES Ping. Ref. #
aemark:: � Planning Notes:
' PLUMBING . FEES
Bar Sink
Backflow Preventer
Backflow Irriaation
Clarifiers
Dishwdsher ;
Drinking Fot,
Floor Drains
Floor Sinks
Gas Service
Lavamries
P-Trap
Root Drains
Ou[lets
Reinspection Fae' !� $15
Boiler . I
Duct- Unde. Ground
Duct-StrucWral '
Ouct - Ventilating
Exhaust System ❑ Multiple ❑
FirepVFacL BIL ICBO #
Heacing System & Ducting
❑ai oo,000 eru O i oo,000 an
Reinspection Fee
`� Dr{�ers' LicEFse or 55 $«�/� �/ �� � �
CMF 0865-46, rev. 30/84 Wnite - guileing: Canary - Appllynt; Pink - Accountin9; Goltlenrotl - Asseisor
$15
Showers
Service'Sink '
Sewer Cap
Sewer Connection
Solar Collecmrs
Solar Pipin9
Solar Tank �
Swimming Pool w/Spa
Urinal
Water Closet
Water Heacer
Water Service
Auto-Wash
Leundry Trays
laue Fae
Hood or Typel ❑
Canopy Type I I ❑
Refrigeration System
�aioo,000eru oioo,000
System Repair/Alteratian
Fire Dampers
Registers ' -
Iswe Fee
Z
5 3
FEES
3 3
Automatic Washer
Construction Pole S
Cooking Unit
Dishwasher �
Drye:s ❑GasK,�E
Fan
F.A.U. .
Fix[ures
Device Boxes
Switches ',� -
Garbage Disposal
Generator �0.5 KW �5-15
$15
5485 6/25/85
2one
Accessory Building:
Parking Req./Provided .
ELECTRICAL
� Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100 amps
Mecer ❑over700amps
Sub Panel
Motors OP1 HP �iX--6
Inc. Solar �9-15 HP 016-15+
Microwave �
Pole Light
Range
; Standing Sections
Trash Compactor
Issue Foe
DEVELOPMENT SERVICES REQUIREMENTS:
2oning Approved Qy
Buittling Approved By �_
2.:o�C Tl
FEES
$ 3
S�{MMARY OF FEES ' �
BUILDINGPERMIT $ 1��SO SMIP $ •��
PLAN CHECK � $ pERMIT
PLUMBING $ S-�O ISSUANCE � $
PLAN CHECK 25% $ ' ENERGY P.C. $
ELECTRICAL $ GRADING S
PLAN CHECK 50% $ MICROFILM $
MECHANICAL S TOTALFEE 5 23•�C�
P�AN CHECK 25% $ ' _ _ _ _
Z
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N
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'�- CONSTRUCTION AND PLANNING POOL & SPA ,.
,� . APVROVALS Permit # Date Inspector qppROVALS Permit # � Date Inspector
1. Temporar,y Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. .� 53. Steel Reinforcement �, �
3. Electrical�Conduit Utility-Undrgrnd. � 54. Forms -
4. ElectricaliCondui[-Undrgrnd. �-= 55. Electrical Bonding �
5. Steel Reiriforcement , 56. Rough Plum6ing & Pressure Test •
6. Electricaf UFER Gmd. 57. APPROVAL TO COVER-GUNITE i
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation � _• 59. Gas Pipe, O Undrgrnd., Test
- 9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System � , 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection ' ' 62. Backwash & Receptor-Final
12. Sewer Cap /�` �S �� 63. Heater & Vent-Final
13. floof Drains 64. Plumbing System - Final ,
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar SYstem-Final
i 6. Rough Electric Wiring � 67. Fencing & Access Approval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil
� 23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30..Drywall Nailing '. HEALTH DEPT. REQUIREMENT
31.'Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Condi[ioning
35. Final Gas Pipe-Test
36. Hood or Canopy '
37. Final Factory Fireplace l
38. Final Plumbing (�
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer
43. Backflow Irrigation
44. .Landscape Irrigation System '
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. Special Requirements Completed
49. Electric Release [o Edison ,.,
' 50. Gas Release to Southern California Gas Co �
51. CERTIFICATE OF OCCUPANCY
No. Date
V
�
�
Aoolicant to fllt in all soaces exceot those within heavv bortler Ilnes ana slan all aooroorlate tleclarations.
PER NO. TRACT NO. LOT NO. . UNIT NG. , � ~
'CITY�F COSTA MESA` ONST UCTI ��PER�IT � � ( 3 i . � ' � : ' -, � _ , 1 ' � ; - � - t ; � "
ioject Address � � � . , . � . � �
� z L s- �.'� TYPE OF CONSTRUCTION NEW ADD � ALTERATION � REPAIR� '
°Applicant's Mailing Address � '
` "�� >�� �. . Ph^nP • , ❑ CONVERSION ❑'OEM�LISH ❑ OTHER q.p. # , , . Zone . '_
Owner'sName .h�Y f' DESCRIPTIONOFWORK/USEOFBLDG. � ' - ���� -
, Address ' ' � � - % S MainBuilding: y>;':;�'y,,/aocessory vi� in : (iTt�q�
. Arch/Eng. License No. ' TVPE OF PERMI7�{ � GRADirvG ❑ FOUNDATiON $TRVCTURAL T F�ant - ' �, ��' -l- � �
� ❑ TENANT LCIELECTRICAI:�❑ PLUMBING 0 MECHANICAL '
f 'Addres's ' /�+ /� )�( ' � � / . . .B Rear • . � �,• � I�.', N
' �D � � 1 /GO�/��/ � PhOn ❑ �OTHER' � - %� �
� Contracmr'sName ���' . � � C' Right . -+ - N
� , � PROJECT DESCRIPTION 54. FT.� ' oCCUParvCv K � . - , . � � G
1 Address (mailin9) " � � ' f .
� r�� CONSTRUCTIONTVPE -VALUATION$� g Lef[ �
City LicenSe No. , 20NE GRADING CU.YDS. ACRES • ' ' � '
LICENSED CONTRACTOR DECLA0.ATION � � '' 4 Ping. Ref. # arking e. �. .E
'I hereby�atfirm tha[ 1 am licensetl untle� provislon5 of Charte� 9(commencing Remarks: . � i � ' Planning NOtES: � � � ' ' '' ' M
I �vith section 7000) of Division 3 of the Busine5s antl Professions Cotle; antl � �
' my license is in full t rc¢ an eff¢ct. ��2� / O iO ' ' � T�
� License CI ss � �Icens�y No. �S � . ` S
�.C' ' /�. �� - PLUMBING ^ ' � FEES
Date _ Sia�t //L X/h� /,Z�\� I • _ �
WORKERS' OMPENSATIONOECLARATION � BarSink � ShoWe�s . ' '
I hereby aftirm that I have a certificate of consent to selt-Insure or a certlflcate . ELECTRICAL :FEES
05 Workers'.Compen5ation_InSuronce, oi a ce�tifletl coDY_the�eof (SecHon, gackflowPreventer - � ServiceSink- ! - , ' -
i_ .
AutomaticWasher� � Trensformer ❑-75-50KW .
3800, lab: 1GVi I '
Policy,No."'"����� Company ' ��s ��� Backflow Irrigation Sewer Ca - . �0 50+ KW �
P Cons[ruction Pole Sub.
�Certifietl copy is hereby fumishetl. ' � , , , � ,
Certifie c py is (iletl with the city euiltlj.pm� on. Bathtu6s Sewer Connection Cooking Unit Merer ❑up to 700 amps
Date_�' Applicant L'� - -
EXEMPTI N FROM WORKERS' COMPEN ION DECLARATION Clafifiefs Solaf ColleCtOrs � � _ Dishwasher � � Meter ❑ovel 100 amps
(Thissection neetl na[ be completetl if the permit is for one huntlretl ($300) or Dishwdsher
less). � ' . � Solar Piping � Dryers ❑Gas ❑Electric $u6 Panel
I certify tnat in the performance of the work for �+hich tM1is permk Is Issuetl I . _
shall not employ any person in any manner so as to become subject to t�e Drinkin9 Fountains � Solar Tank Pan . � •
Workers' Compensation Laws of Califomia. , Motors �0-1 HP �1 %� 8
Date � Signature Floor Drains Swimming Pool w/Spa F.A.U. � -
'NOTICE: If, after making this tleclaratiOn, y0U sPOultl become subject to the InC.$012f �J-15 HP �76-75+
Workers' Compensation p�ovisions of the Labof Cotle, you must fortM1with � FIOO�SinkS Urinal - Fixtures - � ' -
compry wilM1 such provi5ions or this permlt Shall be tleemetl revoketl. Micwwave
CONST�RUCTION LENDING AGENCV ' G35S¢rvic2 ' Out12tS WaterCloset - DeviceBoxes ' �
1 hereby affi�m Ihat th¢r¢ is a construttion IentlinQ agency tor tne pe�fo�mance P012 Light
of the work .for,. which �tnis permit_ is issu9tl (Section 309� Civ: C.), �nterceptors Water Heater Outlets
�enaer's rvame Range �
�entler's Atltlress � . . , Kitchen Sink � Water Service ' Switches Sign ' �
OWNER BUILDEN �ECIARATION . �
I hereby affirm that I am exemp[ trom the Con<ractor's License Law for the Lavato�ies , Auto-Wash' . Gar6a e Dis osal �
following reason (Section ],031.5 Business antl Professional Cotle: Any city or ' 9 P Standing Sections ,
county whlcM1 requires a pe�mit to con5truct, aIt64 improve, tl¢molish o� repai� P—Tf3p LeuOd� ,T�a 5 t
. any sVucture, prior to its issuance, also requires the applicant forsuch permit Y Y Generator O0.5 KW �5-15 KW Trash Compactor
-[o file a signetl statement that M1e/sne Is licen5etl Pursuant to the provisions ot ' ROOf Drains � i �
the Contractor's License Law (Chapter 9(commencing with Sec[ion 7000) of ,
Division 3 of the Business antl- Profe55ions CoPe) o� that he/She is exempt . -
Iherefrom antl the basi5 for the alleqetl exemption. Any violation ot SectiOn �-
.7031.5 by any applicant for a permit subjeG�s the applicant [o a civil - �� '
�enalty of nof more tM1an tive huntlretl tlollars ($50�)- ' � , 3 '
LI I, as owner ot tne property�or my employees with waqes as their sole Reinipection.Fee $15 Issue Fee $
wmpensation, will Co the work, ana the structore is not intentletl or oiteretl� Reinspection Fee � $75 Issue Fee . $ 3
for sale (Section '1044, Business antl Professional Cotle: Tne Contractor's ., � . MECHANICAL FEES
License Law tloes not ap01y to an owner o( a prvPerty who builtls or improves • ,
thereon, anC who tloas such work hlmself/nerse�f or through his or her own , DEVELOPMENTSERVICESREQUIREMENTS: '
employee5, prOvitletl Ihat such Improvements a�b not intendea o� offe�etl fo�� BOiIC� _ � HOOd O� Typ¢ I ❑ . . �
Zonin A roved B
sale. If, however, the builtling or improvement i5 soltl within one year of <om- Canopy Type II ❑ - ' 9 PP Y Date
pl¢tlon, the owner will hdve [he burtlen ot p�oving he/she tlitl not bulltl o� Im- DUCt - Undff i�irou0d ' � ' BUilding ApplOv¢d By Ddte
��Ove for [he purpo5e of sale).
I, as owner oi the,Property, am exclusively Contractln9 with licensetl con- Duct - Strutmrel . � Refrigeration System � Applieation Issued By Date�
tractorsto construct tne oroject (Section 7044, 6usiness antl Professlons Cotle: • �
The Contractor's License Law does not appry ro an owner ot property who Duct_ Ventila[ing, ❑0�100,000 BTU ❑100,000 BTU . � '
builds or improves tnereon, antl who conVacts for such projects wlth a con- - - -- _ . SUMMARY OF FEES , ,
tractor(sllicense purivant�to the Contractor's Llcense Law). I am aware thac ExhaustSystem ❑ Multiple ❑ System RepaidAltera[ion �� BUILDING PERMIT' $, ' SMIP $
proof of tneir Worker's Compensation insuranGe shoWtl be provitletl to me. , . P�AN CHECK $ PERMIT �
❑ I am exempt untler�5ection �B. 6 P. C. for this reason- Firepl/FacL Blt. ICBO # Fire Dampers PLUMBING $ ISSUANCE $ ,
Date owner Heating System & Ducting, � Registers � . PLqN CHECK � 25% $' ENERGV P.C. $'�
I- hereby certify that I have reatl tnis application antl state tnat tne above ❑6100,OOOBTU �100,0008T �--- - - /� �/� � GRADING $.
intormation is correcL' I a9ree to comply with a�l city antl wunty ortlinances ELECTRICAL $ •z] w_ .
antl sta[e laws relatin9 to builtlinq ton5truction� antl hereby authorize repre-� i � , . MICROFILM � $ � �
sentatives ot lhis ty� to/� nter u n the above-mentionetl=ro ty tor� � ' PLAN CHECK 50% $ ,
ins9pection purpos�L/ //� I � � . . , , TOTAL FEE $ �'�
�Si nature ��� 6�/1.�Y Y Date MECHANICAL $
peinspection Fee ,$15 Issue Fee ' $ 3 PLAN CHECK 25% $' .
Drivers' License or 55 �
CMF 0865-46, rev. 30/84 White - Builtling; Canary - Applicant: Pink - Accountin9: Goltlenrotl - Assessor
' �NSTRUCTION ANb PLANNING , POOL & SPA
��PPROVALS Permit# Date Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical $ervice or Pole 7� C� 52. Pool & Eguipment Location
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement -
3. Electrical Conduit Utility-Undrgrnd � , 54. Forms �:��
4. Electrical Conduit-Untlrgrnd. • ' 55. Electrical Bonding ��
5. Steel�Reinforcemeni ,� 56. Rough Plumbing & Pressure Test . �
6. Electrical UFER Grnd. 57. APPROVALTO COVER-GUNITE 'I
„
7:' Footings y` �� 58. Electrical Conduit-Undrgrnd. `' ��
�
8. FoLndation •' �.� , 59. Gas Pipe, O Undrgrnd., Test ,1'
9:^Water Pipe-Undrgrnd! . 60. Backwash Lines, P-Trap, O Undrgrnd. '
10�Structural Floor Sy'stem ' 61. APPROVALTO DECK �
11. Property Sewer Line & House Conne'ction � 62. Backwash & Receptor-Final
12.. Sewer Cap � 63. Heater & Vent-Final ,
13. Roof Drains '' ' 64. Plumbing System - Final ' �.
14. Rough Plumbing� t � 65. Electrical-Final
75. Rough Electrical-Contluit 66. Solar System-Final _
76. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 6$. APPROVED FOR PLASTERING
18.•Rough Electrica�-T,Bar Ceiling 69. POOL/SPASYSTEMS FINAL � .
19. Rough Heating & Air �onditioning FIRE DEPT. REQUIREMENT '
i .
20. Rough Factor`y Fireplace APPROVALS Permit # .
21. Ducts, in Structure 70. Underground Hydro
22. Duc[s, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Fiush �
.24. RoofFraming 73. Undergrnd.StorageTankOGas ❑Oil
- 25. Roof $heathing • • 74. Overhead Hydro �
26. T-Bar Geiling (Structuralj & Monocoat 75. Dry Chemical
� 27. Frame and Flashing 76. Dry Standpipe � .
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation � 78. FIRE PREV. FINAL �
30. Drywall Nailing _ HEALTH DEPT. REQUIREMENT .
31. Plaster Brown Coat . 79. FINAL INSPECTION -
32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning ,
35. Final Gas_Pipe-Test
36. Hood or Canopy , -
37. Final Factory Fireplace .
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final •
42. Backflow Preventer. ' �
43. Backflow Irrigation �
44. �Landscape Irrigation 5ystem � �
45. Sound Attenuation �
46. Handicap Regulations
47. FINAL STRUCTUR� &�BUILDING � '
48. Special Requirements Completed �
49. Electrie Release to Edison '
�
50. Gas Release to Southem Califomia Gas Co � � ^ �
51. CERTIFICATE OF OCCUPANCY -
�\ No Date _ ' � '
1
ADplieant to fill in all spaees exeeDt ihose witnin heavy eartler Iines anO.si9n a1l aoPropriate Geclantions.
GTY,G'�.COSTA MESA CbNSTRUC>TION
xProject A'ddress � ^� h � !
Applicant's Mailing Address .�" 5 R�
Owner's Name. A% � Phone
Address ,rj�,� ' ��(
Arch/Eng. � -f-lls:-1 �Ee1fSe�lVo. �-/�� Z'
.Address �� L' -
�Contractor's Nam Phone '
�Address (mailing) �
City �icense No.
LICENSE� CONTRAC70R DECLARATION
I hereby aftirm that I am licensetl untler provisibns of Charter 9(commencinq
with section �000) ot Division 3 of the Business antl Professions Cotle, antl
�my license is in (u1l torce antl effact. '
License Clasz License No.
�a[e Si9nature
WORKERS' COMPENSATION DECLARATION
I hereby atfirm that I have a certiticate of consent to selt-insure�or a certificate'
of Workers' Compensation Insurance, or a certi(ietl _copy thereot (Section
3800, Lab. C.)
Policy No. Company
BCertifietl copy is hereby tumigryetl. � - .
Certifletl copy is filetl with th@ �ity Builtlinq �ivision.
Date AppliCant .
EXEMPTION FROM WORKERS' COMPENSATION DECIARATION
(Thissection neetl not be completetl if the permit i5 for one huntlretl ($100) ar
less).
I c¢rtity that in the pe�formance of the work Por which this permi{ is issu¢tl, I
shall not employ any petson in any manne� So as t beco e su �eCt the
Workers' Co�np=nsati$�n Laws ot Calitomi3/
Date �—._� �J� $�9�ature _ '�
-NOTICE: If, after making [his tlBcla�ati , y0u s tl become Subject to the
Workers' Compensation provisions ot e l�bo Cotle, you must (orthwifh .
comply wilh such ptovi5ion5 or this pe�mit shall be tleemetl revoketl.
CONSTRUCTION LENDING AGENCV . .
I nereby affirm that there is a consVuction Ientling agency for the performance
ot the work for which this permit is ,issuetl (Section 3097 Civ. C.)
Centler's Name
Lentler's Atltlress
OWNER BUILOER �ECLARATION -
I hereby a(firm that I am exempt irom the Contractor's License Law for the
followin9 reason (Section ]031.5 Business antl Professional CoOe: Any city or
tounty which requires a permit to tonst�uct, alteq improve, Oemolish o� tepair
any strutture, prior to its issuance, also requires the applicant for such permit
to file a signetl statement that qe/she is IicenSetl pu�suant to [he provi5ions of
the ConVactor's License Law (Chapter 9(commencing with Section�7000) of
Division 3 of Ihe Business antl Professions Cotle) or fhat M1e/she is ezEmpt
Iherefrom antl the basi5�for the allegetl ezemption.'Any violation ot SeCtion
7031.5 by any �applicant for ,a -permit subjects the applicant to. a civil
�enalty of nat more tnan five hundretl tlollars ($500).
1, as owner of the property or my employees with� wages as thelr sole
compensation, will tlo ttte work antl tM1e structure is not intentletl or ofFeretl
tor zale (Section 7044, Business and Professional Cotle: �The Con[ractor's
�icense Law tloes not appty [o dn owner of a properry who builtls o� improves
thereon, antl who tloes sucn wbrk himself/herself or tnrough his or her own
employees, provitletl that such improvements are not intentletl or offe�etl tor
Sale. If, however, the bulltling or imp/ovement Is soltl witM1in one yea� of com-
pletion, the owner will have th@ burden of proving he/she tlitl not builtl or im{
prove for the purpose of sale). ' - '
� I, as owner of the pro0erty, am exclusively contracting with Iicensetl con-
IractoR to consYrutt the pro�ect (Section �044. Business antl PrOfession5 Cotle:
The ConVactor's License Law does not apPly,to an owner of Oroperty who
builtls or improveSthereon, antl who contracts tor such projects with a con-
tractor(s) license pursuant to the ConVactor's License Law). I am aware tM1at
proof ol their Wo�ker'S Comp@nsation insu�ance Shoultl� be Provitletl t0 me.
❑ I a{n exempt untler Section B. &�P. C. for thi5 reason
ure
I have
I aare�
itl�f/is a(fp1 aation antl scate t�at the-abave
compry wi[h all tlty antl munty ortlinances
ng construction, and hereby authorize repre-
r�upqn the above-mentibnetl property for
✓S � 8 .i�te5a !!OS
TVPE OFCONSTHUCTION EW ADD TER TI N REPAIR
. ❑ CONVERSION ❑ DEM LISH ❑ diG�� �� 'A•p• # [„� ��
DESCRIPTION OF WORK/USE OF BLDq,i ' ���� ��� -�� �� �
S Main Buildi
TVPE OF PERMIT GRADING ❑ F �i'I, `F�5 ku T Front �<
F�� m� a�..,. �{:,.:
❑ TENANT ❑ ELEGTRICAL ❑ PLUMBIIWI w+' hIEG AN1�6 L B Rear y
❑ �OTHER � p' `
PROJECT DESCRIPTION Sa. Fr'/ oCCUaa/NlCY ' C Right L
CONSTRUCTION TVPE y- VALUATION $"�1'S OD�� O Q S Left �S
ZONE GRAOING CU. VDS. � ACRES p�ng. Ref. #%�
Remarks:' , � �.(,J(i_(%� G PlanningNotes:
0
Sink
�Preventer
Irrigation
Drinking Fountains ,
Floor Drains
Floor Sinks
Gas Service Outiets
Interceptors
Kitchen Sink
Lavatories _ A %
Reinspection Fee
Under Ground
Structural
r
$f10W2f5
Service Sink ' ' "
Sewer Cap
Sewer Connection
Solar Collecror
Solar Pipin ,
Swi m' 9 Pool w/Spa
Urinal -
Water Closet .
Water Heater
Water Service '
Auto-Wash
Laundry Trays
$15 Issue Fee . $ 3
� MECHANICAL FEE
� Hood or Typel ❑
Canopy Type I I ❑
Exhaust System ❑ Multiple
Firepl/Fact. Blt. ICBO # �
Heating System & Ducting
❑ ai oo,000 eru O i oo,000
Fee � $75
CMF 0865-46, �ev. 10/84 White - Builtling; Canary - Applicanq Pink - Accounting; Goltlenrod - Assassor
`
Refrigeretion System
❑aioo,000eru ❑ioo,000
System Repair/Alteration
Fire Damoers
Issue Fee
N
$ 3
-ss-r
Automatic Washer
Construction PoleSub.�
Cooking Unit
D ishwasher
Dryers ❑Gas ❑Elect
Fan
F.A.U.
Fiztures - '
Device Boxes
Outlets
Switches
Garbage DiSposal
Generetor �0.5 KW ❑
DEVELOPMENTSER
Zoning Approved By �
Buildin9 APProvad By
6944 I/�8/ti6 ?�::,SE TL
2one
ry Building:
2
' O
N
I
N
G
`' R
Req./Provided S E
� Q
M
T
S
ELECTRICAL � �
Trenstormer ❑ 15-50 KW
❑ 50+KW
Meter ❑up ro 100amps
. Meter ❑over100amps
Sub Panel
Mocors�0-iHP�iy�-S '
fnc5olar �9-15 HP �7645+
Miirowave ' '
Pole Light •
Range
; Standing Sections
5 KW Trash Compactor
$15 Issue Fee
tEQUIREMENTS:
FEES
$ 3
1-,'�-
SUMMARV OF FEES
BUILDING PERMIT $ 2�: S!� SMIP � $ '3.IS
PLAN CHECK $ PERMIT'
PLUMBING ; $ � �SSUANCE $
PLAN CHECK 25% $ ENERGV P.C. $�
ELECTRICAL • $ GRADING $' �.
PLANCHECK 50% $- MICROFILM' $
MECHANICAL $ TOTAL FEE $ � �
PLAN CHECK 25% $ �
,'1£ONSTRUCTION AND PLANNING
�APPROVALS Permit #
�1. Temporary Electrical Service or Pole
� :�2. Soil Pipe-Undrgrnd.
.3. Electrical Conduit Utilhy-Undrgmd.
4. Electrical Cor�duit-Undrgrnd.
5. Steel Reinforcement .
6. Electrical UFER Grnd. �
. 7. Footings
8. Foundation
. 9. Water Pipe-Undrgrnd. �
10. Structural Floor System
11. Property Sewer Line & Hause Connection
12. Sewer Cap
13. Roof Drains �
14. Rough Plumbing
• 15. Rough Electrical-Conduit
16. Rough Electric Wiring '
�17. Rough Wiring Sign ,
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning
20. Rough FactorY Fireplace . , , "
� 21. DuCts„in Structure
. 22. �Ducts, Ventilating • �
, i
23. Gas Pipe-Rough & Test •-
�- 24. Roof Framing �., f �
�- 25. Roof Sheathing ' , '
26. T-Bar Ceiling (Structural) & Monocoat
27. Frameand Fl�shing
"28. Lathing & Siding .
29. Insulation �
' 30�.Drywall Nailing "
31. Plaster Brown Coat �
32. Electrical Power Meter-Final
33. Final Electric . �
34: Final Heating & Air Conditioning
35. Final Gas Pipe-Test -
36. Hood or CanoPY �
37. Final Factory Fireplace ,
38. Final Plumbing �
39. Water�Service-Final , '
40. Gas Service-Final ' - �
, 41. Solar pomestic-Final
��•42. Backflow Preventer ,.
�43. Backflow Irrigation -'
44. Landscape Irrigation System �
45. Sound AttenUation �
46. Handicap Regulations ,
47. FINAL STRUCTURE & BUILDING
48'. Special Requirements Completed '
49. Electric Release to Edison j
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
Date
POt, � & SPA �
I�spector pppROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVALTOCOVER-GUNITE "
58. Electrical Conduit-Undrgrnd.
� 59. Gas Pipe, � Undrgrnd,, Test
� 60. Backwash Lines, P-Trap, O Undrgrnd.
61. APPROVAL TO DECK
62. Backwash & Receptor-Final
� 63. Heater & Vent-Final
. ' 64. Plumbing System - Final
65. Electrical-Final
66. Solar System-Final
67. Fencing & Access Approval
68. APPROVED FOR PLASTERING
69. POOL/SPASYSTEMSFINAL
FIREDEPT.REQUIREMENT
APPROVALS Permit # _
70. Underground Hydro
71. Product Piping O Gas ❑ Oil
72. Underground Flush
73. Undergrnd. Storage Tank � Gas ❑ Oil .
. 74. Overhead Hydro
' 75. Dry Chemical
76. Dry Standpipe
77. FIXED SYSTEM FINAL
78. FIRE PREV. FINAL
HEALTH DEPT. REQUIREMENT
79. FINAL INSPECTION
80. FOOD CERTIFICATE ISSUED
Notes:
u
i
':
Date I Inspector
s
0
�
<.
\
Ciiy of Costa Mesa
Development Services Department
Building Safety Division
P. O. Box 1200
Costa Mesa, California
CERTIFICATE OF OCCUPANCY No. OG.7SG�
The Building located at 999 West 18th Street
has been inspected and fountl to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group R2 Occupancy.
Use of Building Office
Legal Description 424-361-01
� (See reverse side for Metes and Bounds)
Building Permit No Ad aR�. 99 Electrical Permit No.��6�.E46533 plumbing Permit No. '
Mechanical Permit No. Number of apartments and/or guest rooms
ISSUED TO:
Robert J. Chapman
1602 Placentia Avenue
Costa Mesa, CA 92627
Building Official 2bnv C'� Baca
by
Date .Tiina il. 1990
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 Cona Mesa under Sec. 307 (e) U.B.C.
CMF 1015-46 rev. 1/83 White -OWner; Ca�>.y - Numerical File; Pink - Bldg. Permit File
.j
1
� •,
rxaecr �oonesy. y cJ y W 18 TH ST �
awxew�sxerne: ROBERT J CHAPMAN .
ADOHESS: 1(OZ PLACENTIA AV
; COSTA MESA 926'17
� uxir:
RflCNIEN01NEEfl: TI'IOMAS HAMILTON � . ' ,pEa.No.:C-7�39
aoonEss: 2043 WEST CLIFE' L'R. °• 113
NEWPORT BEACH CA 92660
°Em"mEE: RRAUS CONSTRUCTION � ( 714 ) 536-1429
eooxess: 11542 SURVEYOR CL
FI.F3. CA 92646 '
LILENSEU fANTRACTOP OECUMTION: I �ereDy aifirm I�at I am licrnsed under provhions af CAaDter 9(cortunendnp vnth Sxtion
7000) of Division 3 af t�e B siness anA Prolesslons Cotle, anG my Ilcensa is in full tarce antl eltecl.
cirr uc.: 3 9 8 0 3� 3TATE 11C.: 3 7 7 S 1 q �s ykts:.y�
Date:_�=%��__ Sipnatua: �Cj� '
WOBNEpS' COMPENSRTION OECIAMTION: I �ereDy attirm tAat I have a cenificate ol cunsent to selbinsure or a ceniliwte a/ Workeri
Compeqsation InSurance ar a c¢rtifietl copy IAereo� (Section 3800, LaO. C).
roucvxo.:101�587-89 exr.oare: 07/O1/90
roManxr: STAT£ FUND
) CertifreG coPY n�re0y Iumished. � Cer7ifieE copY n fitetl wittr crty Bu�tlinp �ivision. _
' r. '
oate: � — '7= R.O `� qppueanr. �estiY /�.--�r��' 'e
F%Fl1Fry0N FAOM VlOPKERS' COMPENSATION DECIdMT10N:� (ihis seciion neeE irot �a completM i� Ne permil b lor one �wdr� (5100) or kss).
I ceniry (hat in t�e petlormance al [6e work for wtnch Ihis Dermit �s i55ue0, I shatl not employ any person in any manner sa as to Gecome
6u�IEti Ip [AB WUB¢�5 CAInp8�5dtlM Ld'(IS 01 C2�ifomia. L" :�
�ate: � - ' � $ipnature: � • � - � �
NOTICE: tl, atler makinp INrtleGaratiml, you�shoWE hecome auGlect to the Workers' Compensatbn provisions ot Ne Lahor
CoEe, yau muSDtarthwit� compty witti suc� Orovicbns or ttris-permit shall be deemetl revokeE. ' '�'
� CONSTqUCT10N LENDING �GENLY: I her¢Oy alHrm tAxt there is a wnstmction lendinp apency lar t�e petlormance n/ t�e woM lor
wAich �nis permit is issueE (Sectlon 3097. Gv. C):• r�
LENDEP: � � � + '
' AOPRE83:' ' - - - - -
OWNEq BUIlOEB UECIAMt10N: I �ere�y aHirm that� I am exempt �mm IAe Caniracrors' State Licanse Law far tAe fallovnnp reason
(Section 7037.5 Busineu and Prafessional CaOe: My cRy oi caunty w�icn requires a permit ro wnsimct, alter, improve. Aemolis�, ar
repair dny sirucmro. D�or to its Lssuance, also r¢Quixs t�e appfiwnt for suN,permit to lile a signeE statemem that �e/she is fcenSeE
pursuant ro the proNslons M me Ca�Naqors: SWte License Law (Cl�pter 9(commendn0 ��� Section 7000) 0/ pvision 3 at Ne Business
anE Prpiesvons CoOe) or thal trrJs�e is e�empt tAereimm an0'the basis for the alleqeG eKemptian. My Nolation of Section 7Q91'.5 Ey
any aDplicant for a permit subjects �he apDlicant Io a civil penatly ot not more ihan fiva �unared Uollars (5500).
I, as owner ol tM property�ar my employees witn wapes az Neir wle compensatian, will Oo the wark. anE tha
� siructure is not intentleC or ollerea tor sale (Secuan 70a4. 9us�nes5 an0 Pmfessional Caae: Tne Contractori Suta License Law
Eoes not apDN ro an awner oi a propetty wlw huOUs ar improves t�ereon, anA wAo'Eoes such work �im5etl/0erself or �hrouph
' his or Aer awn empkyees, DroviEeO that such improvemenis are not intenOeU or offerea tor sale. 11, however Ne buil0inp or
impmvement is so10 witAin one year af complation, tAe owner will Aave the Uurden oi DraNnO he/she Eid not bui10 or imDrove �
-1w tAe purpose oi sak). � � �
i
I, az owner of Ihe proDeM, am exduSiveN wniractln0 wrth IicenseO wntactors to cons[ruct Ihe Dmjed (Section 7044, Business
❑ antl Profesiwns Catle: The Coniraclors' SGte License Law tices nol appy ro an owner oi 0�rry �'�ho bwl6s or improves therean
ana who contacts for suc� prol��s wltA a crontractaqs) license pursuant to IAa Contradars' State License Law). I am aware
that Droof al t�eir Worker's Compensation insurance s�oultl 6a D�ovitletl ro me.
� I am exemD� untler $ectbn: B. 8 P. C. � . '
!w tna aawn: � � ,
Date:. ' � ' . ' Pxner.
I Eo AereEy cartiry tAat I am awam of antl unEerstanU the reQWremems ol Calilomia Healt� an0 Satery CoOe Sections 25505, 25533, and
2553C and tlwt I or any tNbre buiMinO �upant wiNwin not (cirUe one) neM to compty witn uia sute catles antl ttw repuirements tor a
permil tor constructwn or moEifiotian hom Ue Nr Waliry Manapement District Pesidential mnstmction appliwtiws are exempt Imm
thesa provisions. � '
Oate: . . App4cant: �
1 heapy �ertiy that I hare read tAis appfiw[ion an0 st�te Ilwi tAe a6ove information is correct. I aqree lo compty wilh all ury aM counry
orEinances anE state laws rClaWp ro buiMinp consfrucnon anE hereby auttnAm present tivw oi Nis ciry to enter upon Me ahovementione0
. PmDerry /or inspection purppse5. ; :
�Oare:3 � % � JO Sipnamre:� �;--'� � � .
Dnvers License oi Social Securiry x:
180b4B WMIe—Builtlin0: Green—Cotle EnlorwmenCCenerv—PpD�icenl: Pink—Rgvenue; GolOenrotl—Aveffor
CITY..OF COS'fA MESA - HUILDSNG PERMII' PEF2M NO:, I3 ,096382
PERMI'f NO: B 046382 � PLAN CHECK NU: 03026-90 A GOVT: N SUPP; N_
�CONSTRUCtION TYPE: V-N PERMIT TYPE: S"fR ' , PORPO$E;,NEW
JOD DESCRIPTION : NEW INDUSTRIAL HLDG.,T2EFER TO�PC.1056-89 S(? FT: 1,830 '
CLAIM VALUE: 63,119.00 CALC-VALOE: 64,340,.90 GROUP OCC{ H-1. /,
COMMENTS: CONST 612SE' OF'FICE,1218SF MOLDING SHOP �av �.�. � 2��/� �O/� ds.f�
it**��e���e*k�ititae��-*�r*��xr+tx**�e�r**�e*�r*x**�e�r**itx����r+r x�** ****rt�r*�rx �� � �t*+t+t**�r
Z O N I N GS ERT.EB�A CIKRSE M F. N T S ., • ,_.
=------------ MAIN BUTLDING ----------- --------- ACCESSORY BUILDING ------=--
FRNT: FT IN REAR: FT IN FRNT: FT IN R£.AR: FT. IN, :
LEFT: , F1' IN RGHT: , FT IN LEFT: :FT IN RGHT: . FT' 'IN- `
PARKING REQ: PROV: FARCEL: 42436101 ZNE: REP NO: ' � �
PLANNING NOTES> , . ' �.
>' • -
' *�t*�r*�****�e�rfr��e,*'�t**atatat*��**��x��-**ffiF**irftet�r���r��rr**et***�r�r�***if'i�it***�r�xit*�r�r�itatat�-ir+rit+��tet
-. D E V-E=L O P M F: N�T E'R�V I,•C E S-, R E Q 0 I. R E M� N T'S �
. i' : 4 e�, F `-! — .
'7.ONING APPROVED;BY �%, :,_�� . ''"�j i DATE: ,`3- ]�Q ,
.; : li
.BUILDING APPROVED BX, : i___ DATE: 1_^p_�G
'APPLICATION •ISSUED BY: � '�+ DA1'E: 3'--7 O
;:il� �lf iE it iF �lE'1f 1E 1F iE iE If if i4 iE iE k if iE.if �lE k iE iF iE �1h 3F ik ik it iE iF��F.'iF����� 3E �f
iEifif14�I4iE'1f4iF�liFkkklf�EiEikiPififlFiF1E*ifiElkiFiFikrt�fiFikiFltltiEififiF iE�fifiFifk�EitifiFifiEiElf-k3f3E9EiliFlEiElfi6iE�fiEikif�lkiEiEfEiEiE
LEGALIZATION:N F E E S U M M,A R.Y ,, STRUC'TURA7, SF.GMENT:Y
BLDG PMT PLUMBING ELECTRZG�MECHANIC ,EIRE SMTP/RF.S GRADING
PERMI�L 482.00 •� � _
• !" � � SMIP/NON-RF.S
PLAN ' 78.33.. .. �' ' ,. %` 9.G5
ISSUE PEF. ', ' ':� . '�
HUILDING-DIV-> PERMIT ISSUE PLAN=CHF.CK =%rTOTAL '• PAID ' DUE
TOTALS--=-> 491.65 0.00. .• ��7g;33 569,98. � 569.98 .00
.. �. ,
"REVENUE DIVISION TOTALS-->. COLI:EG,TED;e �'. 569.98 ^�OVER/SHUHT: 00
' BLDG PMT PLUMBING ELECTRIC MECHANIC �'FIRE� SMIP/TOT GRADING PLAN-CHECK
482.00 , . . ... _ ';9.65 78.J3
1E if if iF iF if if !F k!E �f if if 1! k 1E iE iE 1E iE iE iF iElE iE 3f ik iE ik ik �t fF ik it �E iE N�'if 1E fE if M iE iE iE iE ik iF if 1f IE 1! if ik 1E �F it if M rt 3f i! iF IE iE jF iE Ik ff iklf iF iF 4 iE iE iF iE iE
I N D I,V I� D U A L �FrE E 1�B A���ti A K'D O W N
r
1'YPE QTY D F. S C" R I P T I" O N� � q� �•, . UNIT COST TOTAL COST
SFC 1218 ' IND-TYPE V-N i, �''"y �?'-AVGR "' -37,40 33,�373.20
SFC 612 OFP-TYPE V-N =' � --AVER 'S0.60 ' 30,967.20
" END lOF FEES+, .
�� i
. '� � �' 1 . I, ' t
' ' ' .%f �� • �
. ' . A" � . ' , . ' �� ,
h %
;� ,y .
m
'a� aoossssi-noosssaa -r�r
" ?AT�? �J�U7/90 TIhE: 10:51
�'
� �T � .
i' ,
.569.98
9
0
CONSTRUCTION AND PLANNING - PO 9 SPA �
APPROVALS Vermit# Date Inspector qppROVALS Permit# Date Inspector
;
1. Temporary Electrical $ervice or�Pole. �; 52.� Pool & Equipment Location �
� .2._Soil Pipe_Undrgrnd._ ` '�� ��`Qp �� 53. Steel Reinforcement
�_ '3:rElectrical Conduit� Utility-Undrgrnd� ' 54. Forms V
';4.,Electriczl�Conduit-Undrgrnd.J - _ g�-+2Q�y agfq �� 55. Electrical Bonding �
� 5:�Steel Reinforcement � r J�� L�r-0�O �(,.i� 56. Rough Plumbing & Pressure Test
'" �6._ElectricaP UFER Grnd. " 1,`.� �' (� 57. APPROVAL TO COVER-GUNITE -
- i. �
�' 7:_Footings..- --�;�_' _ _ � 0 �'w 56. Electrical Conduit-Undrgrimd. , ;
�B.cFoundation �. �� � 59. Gas Pipe, O Undrgrnd., Test �
J'
9:'Water Pipe-Undrgrnd. •��� ��� 60. Backwash Lines, P�Trap, O Undrgmd. '
10. Structural Floor System v' 61. APPROVAL TO DECK �, n
11. Property Sewer Line & House'Connection' 3��Z_t� L,Ep 62. Backwash & Receptor�Final %�:`;
f
12. Sewer CaP ' ' j _ !q � � � 'I;
63. �Heater'& Vent�Final
13. Roof Drains ��.' , � �� � 64. Plumbing SYstem � Final �j
14. Rough Plumbing � � 65. Electrical-Final ,
15. Rough Electrical-Conduit 66: Solar System-Final -
16. Rough Electric�Wiring G�j'- a� G 67. Fencing & Access Approval
17. Rough Wiring Sign . 68. APPROVED FOR PLASTERING
18. RoughElectrical-TBarCeiling 69. POOL/SPASYSTEMS'FINAL
19. Rough Heating &.Air Conditioning� �� s�_� 1L��� , _ FIRE DEPT. REQUIREMENT . �
20.'-Rough Fictory Fireplace -T N -� - '..' � �APPROVALS � �Permit # �
21. �Ducts, in Structure� '• •' = `-' t' �-'* * 770. Undergiounsi Hydro °
- r -.:. n .. - ,: � �
22:-Duc{s, Ventilating. �"" '` -� � S �;X x�77. ProductPiping OGas O;OiI
23.�Gas_Pipe-Rough & Test `}= '+� �* " C � + -+72. Underground Flush- - '' - • "
24. Roof Fra'ming _ �'" "`; i�%1,7�y rpGJ,'� �;;73�-Undergrnd�:Storpge>Ta�nk,OGas OOilu
25. Roof Sheathing �- � � ��_:{'' ^�"};� �7q"�Overhead Hydro"�„� � 't
26._T�Ber Cei�ing (Structural) &-Monocoat ,`. , , � c r 757Dry Chemical ,.. � y� ~ � �
27 ��Frame and F.lashing� = o , SrL-� '�' �;�= 76. Dry Stand"pipe -� � J
~ r. i �_
_28. Lafhing & Siding�_"^, " .:� 2:,� � � - " ' "y"�, .;, 77;: FIXED SYSTEM F�INAL; �, r; i -y
29. Insulation • 1'-. �� S � ` �?� 78EFIRE PREV. FINAL �-> C ,
%%' %
'30. Drywall-Nailing �-y � ��j 1� �� � NEALTH=DEPT'.` R�EQUIREMENT
_ 31. Plaster Brown Coata � >*, • � �x e:�79.� FINAL INSP.ECTION t� �
/ �. ..., .
-:32��Electrical Power'Metei'�,F,�nal , ��f �q0 �`G k "SO���FOOD CERTIFICATE ISSUED�;.
' _. - ` �� .., �;, .. . IL!!`"J�'�7T�
_,33�-Fina.l Electric �*+ . � a; ; � q� �a �, x �Notes: C-� Il?l c7.'^
34._Final Heatin'& AirConditionin > ` �� / p,� � � /� ec�.
.,. � 9 � c -� 9 -i G �S"�� � 4 •Y�� t' 0 � � `=' �P� � rs4� L�"'
35'-Final Gas Pipe�Test;� �� � .: ����[� ( �,� � ` �' ^'� ,.,,,G,�,.� Q%�=
�36�Hood or'�CanoPY; i ;� , �.. _ c � C'� /j,G '!-}' r .:u, u �j %�i., . ^ ri
r v h 1._
37.�Final Fectory Fireplacep, � y�- � z_� j� %`�V n-N�-lZ.� a� B� �2 ._/,[,
d �'�`-2-
�-�38�-Final Plombing -��� .r;3 ' � �j ��!{/ (�Rt�� - � '"' '� `,� , (�ct��
' '39.; Water Service;Final,� � u � ,,,� 4 �: fl , /7�. D ,� 0 � � .r � � ��
"40. Gas Service-Final-+� ^. c,?-�i� � +: ; . � �k : Ce� ticj =• /,�
� n �� - - x t. [�. m �. +: a �✓04`-'
_47 �Solar pomesfirFin`al� � j �� -' � ,r "�� 1p.r �� �m�=�.�,y' �,; - �as ,���
42. Backflow Preventer. � . ''� ' _ :. � "�Y�� � 'r * Q� Q�..v�
_ , �,
43. Backflow Irrigation� _"' R: F y, .- � - •
,^� _. A.' - ": •.. - :: ^.- x . ..D '
�•44. LandscSpelrrigationSystem� • , k " Y,h;a _ £ � :r�: K= -
�(4 _.1�+� �- i -, f� ��: � - FI i�..v ::G� .
'-45^Sound Attenuation . .. x, ` . .-; ;�+: �: � - r^ F+"
' 46.•Handicap Regulations •- . �r �K ' � �. ' -- ;, �
� �.,. ,
.47r'FINALSTRUCTURE&BUILDING G%lC�� �66i/�� � �� �
48._FINALPLANNING � �. '` � V , �'; -: ` ' _ `
:
49: �Electric:Releaseto�Edison �y" r � �;."�,. ` ;i - - " ; _
. ,
-y50�Gas_Release to Southem Califom�a Gas Co + ��' C� r ° ' "� ' •--�T � • ' ;
51. CERTIFICATE.OFOCCUPANCY ' . " ' ,- . ._-' . - - '
No. Date
rnaecr nooness: ; g g y W 18 T� S T' ,. oxrt:
OWNEWS N�ME: �jOB CHAPMAN • . . �
eooness: SAME . � .
IIflG1/ENGINEER:. ' • flEG.NO.: -
eooxEss: �,. . uxrt:
� PEHMITTEE: �KRAUS CONS'PRUCTION ( 714 ) 536-14'l9
, RODflESS: z��4Z SURVEYOR CL �
H.H. '- CA 92646 �
110EN5E0 fANTMCTOB OECIAMTION: I �ereby aifirm�ihat I am IicenseO unGer pmNslons of CAapter 9 �commencinq wi[� Section
70W) ol Oivision 3 oi tha Businas an0 Professions CoOe, antl my license a in tull force an0 eifect.
cm uc.: 3 4 8 0 g' STRTE LlC.: 3%% H S���O�
Date: � — � U SiO�aNa: � �
WONKE85' W MPENSFTION DEClAMT10 : I �erehy aHlim t�at I Aave a cenitiwte ol consant to selbinsure ar a certflicate ai WOMers'
Compensation Insurance, or a cenilieE coDY �hereof (Section 3800, La�. C). ' '
roucrxa.: 1016587-89 exr.onTe: 07/O1/40
cornrnxr: STATE FUND ,
❑ Cenified copy is �ereby Iumishe0. /� Certifie0 caOY is filetl vnih e ciry iltlinp Division. �
�7a ` l
Uate: v �' p �� � ` Applicanl:'
IXEMPf10N FXOM VIOflIIEPS' fAMPFN&TION OECIAMTI0IN (�Ais secuon med not be completeU tt Ne ce�t z for one AwNrM (5100) a less).
I ceNy that in [�e pertormance ol tAe work ior whic� t�is �permit is issue0, I shall not emptoy any De«� in any manner so as to become
su61eC �o the Workers' Compensation Laws ol Calitomia'.. , �
Date: ' SiOnature:
NOTICE: If, att¢r maltin0 this OecWration, you s�ou10'Oecome suCle�� �a ��e Workers' Compensatian Orovivons ol [Ae Labor
CoOe, you must �artAvnih camply with sucA D�ovisions ar I�is DermR shall Aa CeemeA revaketl.
CONSTBUCf10N LEN�INO �GEXCY: I �ere0y aHirm tAat`I�ere Is a consiruciiou IenOinp apency lor the peAormance of tha work lar
wlnch tnis permit Is IssueE (Sectlon 3097. Civ. CI. ' -
LENDEN: �� . �
nooeess: . �
OWNEN BUILDEB OECIAMTION: I I�ertEy attirm t�at 1 am exempt imm t�e Con[ractars' State licenu law for t�e followinp reasan
(Sectian 7037.5 Busineu antl Pm(essianal CaOe: My ciry ol county which reQuires a DermR to construct, alter, improve, Oemolish, ar
repair any rtructure, O�or ro iis issuance, also requires t�e aDPlicant lor SucA Dermit to file a si0netl statement tAat hUSAe is licensed
pursuant to t�e pmvisians ol Ihe Contactors' State License Law (C�apter 9(cammencinp vnth Section 7000) of Division 3 0/ Ne Busines
an0 Prolessions Catle) or tlwt he/she is exempt tAerelmm antl the Easis tor t�e a11e0e4 exemD��an; Any dolation ol Section 7031.5 �y
any applicam lor a De�mit su�lects Ihe appliwnt ro a civil penalry of nat more tlun live huntlretl Oollars (550�. �
I, as owner ol t�e praperty or my employees witA wayes u tAeir mle campensa6on. will Ga t�e xrork, an0 t�e
❑� structure is not intentle0 or allereE lor sale (Section 7004; Busmess anE Prafeuional Coda: T�e Canactori State Llcense Law
dces nat aDPh �o an owner ot a DropeM �o bulltls or imOmves therron, anA who Ooes such xrork Aimuli/herself or throug�
his or her awn employeu. pmvi0ed ttat suc� impmvements ara not inten0etl or oflereE far sale. If. however tAe 6uilUinp or
imOmvement is so10 within one year oi completion, IAe owner will �ave the �urtlen a/ Drovin0 ��s�e EIG not Eui10 or improve
for tlu Durpose oi sale). '. _
I, as ovmer ot �ne pmperry, am exUusively contractin0 wittl licensetl cantractors ro construct ine proieci (Section 70d4. Business
❑ an0 Professians COGe: The Cantrdctors' State License Law Goes not apDN �o an awner al pioperty wlq GuilEs or improves therean
anE who caniracis for such D�I�� �Ih a cantractor(s) license pursuant to t�e Coniracrors' Stata Liceme Law�. I am awam
that praol ol I�eir.Worker's Campensa6w insurance s�oultl Oe pronEeG to me. .
� I am evemD� untler Section: � B. 8 P. C. �
lor this reasan: , � '
Date: � ' - Owner.
I Eo Aereby certity that I am aware of anU un0erstanE t0e requirements oi Calibmia Healt� and Safery CaUe Sectbns 25505, 25533, an0
25534 anE that I or any future building occupant wllUwill not (circle one) neeE ro comply with saitl state caEes an0 t�e repuirements lor a
permit for construction or mo0ifiwtion imm tAe Nr Oualiry Manaqement District. HesiOentiai coretmctian aDP�����ans are exempt lram
iheu D�ovisbns. ' , ' ,
�ate: ' ApDlicant:
I �er¢Ey certity that I have rea0 t�is appliwtion an0 state tAat tha ahove information is rnrrect. I apree ro camply wlt� all ciry and counry
ordinairces anA state laws relatinp to 6uildn0 ���+��b� and hereCy auttnnze represe uures of t�is ciry ro enter upon tM aUave�mentione0
propeM �or insDecti(on� Ourpoms. �
Oate:_� �X��Q �Si9nature: / �
oriver's �icense or saia� Secunry x:
1891J8 W�ite—BuilEing; Grean—COEa Enlorcemen�; Canary—Applicant; Pink—Revenue; GoltlenraE—Assessor
� CITY OF COSTA MESA' —.��BUILDING PERMIT
PERMIT NO: B 096399 ' PLAN CFIBCR NO: 03040-90 S�
CONSTROCTION TYFE:'
JOB DESCRIPTION .
CI.AIM VALUE:
, , .PERMIT�TYPE: 51'R
55LF PROPERTY I.INfi BLOCK WALL
PERM,NU: B �'046399
GOVT:_ fN SUPP; N
�.
, PURPOSE: OTFI
SQ FT: �.. � . �55'
1,000,00 CALC—VALUE: 1,100.00 GROUP OCC: M-1 %,
CUMMENTS:
iEat3titiEielt**ititit**at*at***k+r�at*+t�rit�ritiEitititir�rititit�itatx�itit*��titit�rx*�e��**atatit**�tit*��it��itiflt�itatiEit
2 O N I N G R E Q U I R E M E N T S,_ �
, S E T H A C K S � .
-------�------- MAIN BUILDING ---------- ---------- ACCESSORY BUILDING ---------- -
PRNT: FT IN REAR: .FT IN FRNT; 110 FT TN REAR: FT IN
LEF1': E'T TN, RGHT: FT IN LEFT: FT IN RGHT: FT ; IN
PARKING RGQ• PROV: PARCEL: 42436101 ZNE: MG ' RF.F NO:
PLANNING N(7TLS> 3?." MAXIMUM IiE:IGHT BLOCK WALL UN' THE REAR PROPERTY L'!NE �;
� .
%�iE iE iE 1t ik iE IE 1f if iE iF iE if iE if it 3E 1E iE iE if it iE ik ik iF iF iF 1E iE iE k ik iE if i! it iE fE 3E if !F 1F iF iE 1ElE if -0f iE iE iE iE iP ff ih if it�3k i! ik ik ik iE iE i! ik iE iF 1E i! 4 �f iE iF ik 1k �f fE
L E V E L O�P M E N T S E R V I C E S R E Q U I R E M E N,T S
i
ZONTNG APPROVED BY __ � ____� ��� DATE: � g—�i� _
DUILDING APFROVED RY ':__ � ` �DATE: � '. ___
APPLICATIQN LSSUED BY: � . nATE; ��'��
i4iEIEiEIEIEiElEiEiE3fifltiFifiE141FiEiE3flf�-3F7F7F'�i€�#-"�iF�iF�Fi��'�'iFi f�iF3FiF14ififihiEiEilikiEk 3F � iFTFifiE
if iE iF if it it if if 3k it iE iE if if iF it if iE iF iF iF k 3E M IF iF dE if iE 3f if If )f �t iE if it it Ik iE if �t i! 1E iP �1E iF it k it it iE it iE 1E ik k iF a! IE fF i! iE iE k IE iE it iElh It iE 16�N� 3E iF if If �1f
LEGALIZATION:N "' ' . '' f' E G �S U M M A R Y' " `• STRUCTURAL SEGMEMTeY
'�BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE �SMIPLRES GRADIDIG
PERMI-T 27.00 " � ,i, � . ' . SO :
PLAN � 17.55 ' 4 ' ' 'SMIP/NON—RES,
ISSUE FEE , ',�? .
AI)ILDSNG--DIV—> FERMST ISSOE PLAN-CHECK TOTAI, PAID ' DUE
TOTALS----> 27.50 0.00 �17<55 45.05; 45.05 .00
�,.
REVENU� DIVISIUN TOTALS--> COLLECTED: " 45,OS OVER/SlIORT: .00
BLDG FMT PLUMBING �LECTRIC MECHANIC � F.IRE $MIP/TOT GRADING PLAN—CHECK
27.�� , � . ,5� i).55
1ElF IE iE it iF iE iF 1f * fF iE 1E if �E iE IE iE if if iE ik if iE ik if 1E iE iF iE iE if if dE ik iE IE 1F'IE 3F�if if 1E iE iF 1ElE IE 3E ik it iE iE ik iF ff iE if 3f-if iE �If 1E if �f iE iE if �f iF IF �f �E iF iE iF if �%ff
� . ' I N D 7 V I D U A L';� F, ;E H B R E A K•D O W N
�/
TYPr QTY D E S C R I P 1' I O N;%" � , UNI1' COST T01'AL COST
SFR, SS RES—CONCRETE HLUCK'WALL '• / FT. , 20.00 1,100.00
. END �OF: FFES .
� � ,
. ^ .
y 7 ,
. i . ., i � . - ,
. � r�: (3%� : . � .
. .:��,; � ' � � � . ' i . .
i • '
�1 Q0�556b`-D0055667 TOT
DATE:,03lO8/9D TIPIE: 16:4f
i
��
45.05
P
CbNSTRUCTION AND PLANNING
APPROVALS Permit # Date
� 1' Temporary Electrical Service or Pole -.,
2., Soil Pipe�Undrgrnd_ ; ,
= �'3 �Electrical Conduit-Utility-Undrgrnd.'
r-
j ;4. Electrical Conduit-Undrgrnd. �.';
��5. Steel Reinforcement �
: ,6. Electrical UFER,Grnd.
� 7. Footings _ � L� �«p�(� �-7rG�$
-' 8. Founda[ion '
_-
9. Water Pipe-Und�grnd.
10. Structural Floor System .
17. Property Sewer Line:& House Connection .
12. Sewer Cap _ , :✓
13. Roof Drains � "�
14. Rough Plumbing
15. Rough Electrical•Conduit
16. Rough Electric,Wiring
17. Rough Wiring Sign
18. Rough Electrical-T Bar Ceiling
19. Rough Heating & Air Conditioning _
� � - --
20:-�Rough F.actooy Fiiieplace =�-' " � �
21 -Ducts, ir'Structu�e' ' " = �
' k
22._Ducts, Ventilating "- _ ° �
23.�GasPipe�Rough & Test " _ ' °T, '
24:'Roof Framing ` J`� �, '
25. Roof Sheathing •' •� ''
�
26.'T-Bar Ceiling (Structurap &-Moriocoat" ',.
27._Frameand Flashin9� : c'c � �
_28. Lathing & Sidinq ^ .. "; ,' - `� - ••
� 29. Insulati0n • ' '
��30. Drywall_Nailing t � .� ;,,
`_�31. Plaster Brown Coat, S - s
�'32:_Electrical Power Meter'-Final � �''
t
r, : .
i33.:Final Electric . � � }•
�;34.�Final Heating & Ai� Co�ditioning� ;1, ' i
35: Final Gas Pipe-Testc •� • r.-
= 36. Hood or'Canopy � -� '^��
� - � z�.
-37: �Final Fdctory Fireplace.-, -. _ r �
=38rFinal Plumbing r� ,,,�r'' ' �y �
� �39. ,Water Service�Final� � ; � _ -
':40.• Gat Service-Final � T -'- = ' '�'
r ✓ c
;41. �Solar pomefticFinal" .-. � ' ''
s
42. Backtlow Preventer -� '�
4+ X
43. Backflow Irrigatioq' ' - .,
T44. La�dscape Irtipation System`�"'� ; �:'� " r -
45..Sound ,Atten�uation - .. . ' ` ; :
_ 46: •Handicep Regulations _ +
_.47 �FINAL STRUCTURE & BUILDING _ �';c�2-[t
48. FINAL PLANNING -`-
x
; 49 ; Electric'Release ta;Edison ' �.
50.':Gas Release to $outhern California Gas Co *
. 51. CERTIFICATE OF OCCUPANCY
No. Date
Inspector
0
PO� _ & SPA
APPROVALS Permit #
52. Pool & Equipment Location
53. Steel Reinforcement
54. Forms
55. Electrical Bonding
56. Rough Plumbing & Pressure Test
57. APPROVAL TO COVER-GUNITE
58. Electrical Conduit-Undrgrnd.
59. Gas Pipe, O Undrgrnd., Test
60. Backwash� Lines, P-Trap, O Undrgrnd.
67. APPROVAL TO DECK
62. Backwash & Receptor-Final
63. Heater &,Vent-Finai .
64. Plumbing System � Final
65. Electrical-Final �
66. Solar System•Final
67. Fencing & Access ApProval
68. APPROVED FOR PLASTERING
69. POOL/SPA SYSTEMS FINAL
�FIRE DEPT. REQUIREMENT �
aPPR�OVALS� y<�Permit # ^
Date � Inspector
"•' � ,70. Underground Hydro `
� �71. Product P.iping � Gas �.Oil
� "72. Underground Flush ' � " .
.' �J3lUndergmd.Storage_T,ank�Gas ❑Oil
• 74. Overhead Hydro ,_ '
' 75r Dry Chemical � � -•
'- � 76. DryStandpipe �� '� .
� ' 77:- FIXED SYS7EM FINAL. _ �
78.,PIRE PREV. FINAL ' ' �
. _ NEALTH�DEPT.FiEQUIREMENT
' 79. FINAL IfVSPECTION -
S0:'_FOOD CERTIFICATE IS�SUED_, ~ I
+ •• . � � �� a ��,
• f Notes: "7 ^r .�,
s ' � =Z'� "Q�^' ibG<oe Lfi�
� • ' eG - _ ' �+Gt4iNG
�:: _ -7"c��"ElAI� Q�� Pl'i"-� �✓r.a«t%"-i
�. _ r �.
a - � --
, ., i- � •
.: - �
A 1
6
C]
�
Pfl0.i@�7 p00flE38: C3 (j 9 W� 1 B TFI $T �
OWNEP'SNIIME: RODERT J CHAPMADI
, �DpAE� 1602 PI�ACENTTA AV_
• ,C_OSTA MESA 92627
uxrt:
�RGUEXGINEEH:'i'HOMAS HAMILTUN � � "E0•N0•�C-7139
�ooxess: z043 WEST CLIFF DR, u"rt:113
� NF.WFOAT BEACH CA 92660 i
PEflMITTEE:AZ D6J�PROFfiS,IONAL PLMB. (714)67"7�-6072
enoeEss: }8043 VIA DEL 1,ARG0 �
MURRIETA GA 92362
11LEN5F0 COMTMGTOA DfCUMTION: 1 Uereby allirm I am ' nSeE un0er provhions ot Cdupter 9(commendn0 ��h Sectlon
7000) 01 Oivision 3 al IAe Business antl Rofessions Ca0 an y' is in fun Iorce and eilect.
cmuc.:050234 ST��uc.:50F37 2 � .-- 6
Dap:�^2��� Siqnature:
,
WONkEBS' COMPENSATION DECIAMDON: I �ereb allir tut I ve a certifipte al con nt to 5e14in r or a certitiwte ot Warkers'
Compensation Msuranca, or a cerYdieU copy t�eaaf'ISe ' 3800. LaD. C),
PoIICY NO.: ' E%P. OATE: �
COMPINY: �
� Ceninea copy is neaey tumtsnee. ❑ CertifieE wpy is fileA witn tlre tlry BuilCinO �ivision.
� . . .. . . . . .
Date: Applicant: '
I [eN�y Wt in
su0jm to ttre
arp'rtunnef W
Dale: �. � ^ �-! � r- lJ Slpnature: c'i _ " ' . � . . — ,
HOTICE: II, alter makinp Inu eeclaratinn, you slro d ecame subject to t�e'wor�ers' omyensatlon pravisbns ol the Lahor
CoEe, you must �ortliwit� comply wit� such D�a�s s or ihis permit stull be Otemetl revokeE. �
LON$1pUCTIOX LENUIpO RGENCY: I hemUy atfirm ��at Ihero h a amtnxtian IeiiCinp apency lor IM pertormmce ol tM woM lor
wnicA tNs Garmit is is4ueE ISection 309). Gv. cl. .
IFNOER:
� AOOflE33: • • -. . . .
� • - - ' � , .
OWNEB BUIIDFR OECIAMTION: I �ereEy affirm ttut I am exempt /rom the Caniractors' State Liiense Law br the followin0 �eason
(Sectian 7037.5 Business antl.Profe55ional CaOe:' My ciry ai wunry wNch qquires a permit ro constmct. alter, imD�a�e. Oemolis�, or
repait any siruceure. priar to i6 LSsumca. �LSo reqWres tAe applicant lor wcl� permit ro file�a siqneG statement tlut he/she is IlcenSeE
pursyyit to Ne Drovitions ol Ne Contactwi SWte License Law (Ctupter 9(cpmmencinp wnh Section 70W) ol 0ivision 3 oi tAe Business
a�N P�iessions CaOa) or tAat twlstro is�exemp� Ilrereirom and IAe Easis lor Ihe atlepeE exemptbn. My vioWtqn of Sectbn 7031.5 Dy
am/ dppdcant iw a Dermit 5u0jecu Itro applkant to � dNl penatry of �qt more Itun Iive AuntlreO OWars (SSW�.
I, as owner oi me o�oami or my employaes wit� wapes as their wle camDensatlon, will Oo llie work, antl tAe
O strucWm Is nat intenAed or anere0lor sale (Section 7044, Buvness anE Pmlessional CoOe: .T�a Contactors' Siate License Law
Eces not aPDN to an mmer ol a properry wlio huiltls ar ImOroves t�creon, anU wlro tloes suc� work Mmul1/�ersell or tAmuph
tua or her own emDbY?es. D�� ��� wch Impmvemen6 aa noI intenGeO or aBereE lor sale. II, tqwever t�e OuilOinO or
improvement IS wiA wrtNn one year ol mmD�etian, t�e ovmer xill Aave tM EuNen ot Drwinq �e/stro diE not �uiM or Improve
tor I�e purtrose ol saleL . . ' .
I, as Ovmer oi the propeM. am exduSWeN contractinp Witn IICenSeE COntnCtors to toIIStNCt Uk projEtt ($eclion 7014, Busine55
❑ anU Prolessions CaOe: TAe Can4actars' �Gte License Law Gow not appty �o an awne� ol prapeM �o OWAs ar improves theraon
an0 wtio contracts lor sucn O�i�ts witn a contractoqs) Iicensa WMuant ro ihe Cantraqors' State Licenu Law). I am awara
that D��� of iheir Woder's ComDensaGon insurance s�oulE �e D�avi0e0 to me.
� I am esempt undar SeUlon: � B. 8 G. C.
, lor I�is reason:
6dI0; � �Nfltf:
I Eo nereEy cenly inat I am aware ol antl unOerstanA tM reauiremenis ol Calilornu Health anA Salety CoOe Sectbns 25505. 25533, and
25531 an0 tlut I or any future EuilUinp occupant wiNmll not (circle ane) neeE to compty with saiA state cotles and Ne repuiremenis for a
Derrtih for wnstructwn ar mo0iliatian Irom the Nr ualiry ManaOement D(stncl. NesidenGal constructlon apD�iqllons am anemp� Imm
cnese prwisions. ' . . ,
Date: AVM��� �
I �errpy �Ny I�at I Aave rea0 th¢ apD��� antl nate tAat Ue aGove informatlon Ls correct. I ayree to
aainances arie sute wws reiatino to oWbino �Nc� narze rmresent oi s to
D�op�hy Iorinspetllon purpo5e5.
Uate: �3 —2� --�C� Sipnacure:
��(
Drroer's licerrse or Socwi Securiry x:
with aA ciiy an0 counry
m IM a7mo-mantlme0
CITY OF COSTA MESA – DUILllIt•IG �ERMI'C PERM A10: P 04667.1.
PERMIT NO: P 046611 PLAN CHECK t�10: � � N • GOVT: 1�1 SIIPPi hl
CONSTRUCTION TYFE: V-N PERMIT_TYPF.i PLIJ PURPOSG: OTI3
JOA DESCRTPTIOTI : NEW INDUSTRIAL BLDG.,REFER '1'O PC.1056–fi9 SQ FT:
CLAIM VALOE: CALC–VALUE: � GROUP• OCC: B-2 !
COMMENTS; RE: B463E32 PRIMARY BLDG. PERMIT. '�
*��r�r*��e��**********�*�****��r***�r�r���r��***�*�e�e**�r�r�***�e*+�**+�*��r*�*�*�**�r+e��e*��,+��
Z O N I N G R E Q U I R E M E N T S � .
S E T B A C'K •S ,
— --------- MAIAI L•UILDING -----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN
– ACCESSORY BOTLliING – -
FRNT:�� FT • IN REAR: FT IN
LI:P1': FT, ItJ RGHT: l•T IN
PARKING REp • PROV: PARCEL: 424J6101 2NE: REF' NO:. '
PLANNING'NdTES>
> . �. .
�cicifjt*+t�t�*�r*xar*�e**itat*it*�*�tit�*�t�eitititifat�*��etatitit�rft�it4�-�*�*itit�r*ititititit�it**itie�iFx*ifitit�t*�*ft
D E•V E L O F M G tJ T S E R V=I� C E.5�: R E Q U I R E M E N T a
�
ZONING ?�PPROVED IIY _ � DATE:
AUILDING APPROVED B1[ �: ' _ _ .' � • � DA'PF':
APPI,ICATTON ISSUED DY: � •" %un DATE: �/��,
**itiriEk"�E*>tifitiE�tiF��-ititikif-kit � . iF"iF t t �iF"{F 1FiF'lFiFiF�Fx-�r*******w�r� -**
3!iliEkiEiFiliEltitM-1EItiEitkifkiEitiElEiEikflitikiliklfftiElFkifiEititifiElflF�FiE �kfFlfiEk�tifikikillkkklEifikkikiElfiEit'iEiFiEffiElk�tkifiE'k
LEGALIZATION:N F F E S U M M A'R Y. STRUCTURAI:'SEGMENT:N'
BI�DG PMT PLUMBING� ELECTRIC ` MECHANIC _, FIRE SMIP/RES . GRADZNG
PERMIT : 16.00 �' " x .� �
. 25t- , '�' .. r, - •
PLAN � , * ' r`' � • � . SMIP/NON–RF.S
ISSUE FEE - 3. 00 , ! '�' , ��
BUTLDING–DIV–> PERMZT ISSUE PLAN.CgECK� • TOTAL � PAID ; DUE
TOTALS----> . 16.,00 3.00 ' '-':0,=.00� 19:,00 19.00 .00
. � - !�� r, ' % � '
REVENUE DIVISIGN TOTALS--> COLLECTED: "!19:00• OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC -.PIRE 'SMIP/TOT GRADIDIG PLADI–CHECK
19.00 ,'. . .. . ... i . .
;�� :, ; , � .'
iE if iE 1E iE iE if iE 3! 3k 3f 3k iE if 3E iF it M k i(� if�M if !f if iE if k iF fE k if�i! �k if iE!! M.iE 1f i4 iEjif'if iE'it if�l4lf i! if k df {f iE iE iE iF if if if # iE Ik it ik 1P ik iFlF �F if iF ik if if !f� fE if
I N D I V I D U A L �';E' E�� �aB r' E A K.11 0 W N
TYPE QTY � D E S C R I P T I O N�'� �, , UNIT COST TOTAL GOST
PLU � 1 WASH BASIN .� .. %`: ,•;' " r.�. 2.00 2.00
PLU 1 WATER CLOSET (TOZLET) •• � t., 2,00 2,00
PLU 2 WATER HEATER AND/OR.VENT,•• :�t: ' . 2,00 ` 2.00
PLU 1 WATER SERVICE • ,,i !„ '`�' 2,00 2.00
PLU 1' GAS SERVICE `.� �: ;-"�� 2.00 • 2.00
PLU 1 BACKFLOW IRRIGATION , ,,�, • el 2.00 2,00
PLU 1 BACKFLOW PR$VENTF.R •- • < + „ . � ` . 2,00 2.00
PI.0 ' 1 RAIIJWATER SYSTEM – FER DRAIN � F. �� 2. 00 ?.. 00
� ENDt,OF FEES� �w �
, : r.�-
�� `.
r
m
teatw wnite—eui�ainc:Graercoaeemorromem:Canerv—nnoiicam:Pine—aevanve;Goroenrod—�nessor - � - �� DI OOQi66YS-OQOS6GZS TUT ' 19.Q�
' _ ___ . _ _ _. DATE: 03/21/90 TInE� 13�34
0
CUNSTRUCTION AND PLANNING - PO� d SPA
APVROVALS Permit # •' � Date ,Inspector pppROVALS Permit # Date Inspector
�
1.'Temporary Electrica� Service or Pole �� 52. Pool & Equipment Location
2. Soil Pipe•Undrgrnd. _-' 0.(r(� 53. Steel Reinforcement �
-� 3. Electrical Conduit Uti�ity�Undrgrnd. � 54. Forms ,.,
' 4. Electriwl Conduit�Undrgrnd.n � 55. Electrica� Bonding ,
.
� 5..Stee1 Reinforcement � 56. Rough Plumbing & Pressure Test
6:�Electritat UFER Grnd. ' 57. APPROVAL TO COVER�GUNITE _
�7:-Footinqs� �,- •� c o 58. Eiectrical ConduirUndrgrnd.
.8. Foundation '- _ . � 59. Gas Pipe, O Undrgmd., Test '
9:' Water Pipe-Und�grnd. �" 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor Svstem 61. APPROVAL TO DECK
17. Property Sewer`-Line & House Connection 2 �� 4� 62. Backwash & ReceptorFinal
12. Sewer Cap _ � 63. Heater & Vent-Final
13. Roof Drains,� , - 64. Plumbing SYstem � Final � •
14. Rough Plumbing 65. Electrical-Final �
15. Rough Electrical�Conduit ' - 66. Solar System-Final � '
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
77. Rough Wiring Sign �68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS�FINAL �
79. Rough Heatin9 & Air Conditioning � FIRE DEPT. REQUIREMENT _ �.
20.-�Rough Factory Fiieplace ;_ �- - , APPROVALS _ Permit # - �
21: Ducts, in:Struc[ure' '' . � � '' � 7p, Underground Hydro
22. Ducts, Ventilating � ' �� .. :;71. Product Piping OGas ❑Oil
23. Gas-Pipe•Rough & Test , � _ ' � •72, Under9round Flush� �
24. Roof Framing . ' ' � . 73. Undergrnii. Storoge Tank O Gas ❑ Oil
25. Roof Sheathing � � 74. Overhead Hydro
26.'T�Bar Ceiling (Structural� & Monocoat . � • 75:_ Dry Chemical � , . , '-
27.-Frame and Flashing . ' � • " � ' 76. Dry Standpipe - , " � "
28. Lathing�& Siding. '_. ' ., 77: FIXED SVSTEM FINAL .. . :^ �_
29. Insulation �' 78.� FIRE PREV. FINAL : ' f
+'.,. -
30. Drywall Nailing . � �� r . . -- HEALTH DEPT. REQUIREMENT � - -
31. Plaster Brown Coat �_ ' �' 79. FINAL INSPECTION '
.32. Electriwl Power Meter-Final �i _., S0. FOOD CERTIFICATE ISSUED ,. .-
. 33. Final Electric � .. . � Notes: �
,•� pD , - .
34._.Final Heating & Air Contlitioning ' �
�� ` t R!
35.� Final Gas Pipe�Test � • Qv � -� � •-
� �
�. 36. Hood or Canopy '�� � � �"/�f ^ ��,L
� "�
37.�Final Factory Fireplace'. �- . t � �; �: �
38. Final Piumbing _ � , � ' � �/ ' ' - `
x �
39. Water Service-Final � � - ';
r
40. Gas Service-Final � " � -
'�41. SolarpomesticFinal-' �� � � . �
42. Backflow Preventer ' ' ' '
, . . _.
43. Backflow Irrigation. - . � � • • • • �
44. Landscape Irrigation Sys[em _ . � _ ' ' _. �- �
45. Sound Attenuation ��. � . � . � � •
46. Handicap Regulations � � i � ;
47: FINAL STRUCTURE & BUILDING _. � ,', .
.. � . .-
48.'FINAL PLANNING � � .
49, Electric Release to Edison � . � . � . .
50. Gas Release to Southern California Gas Co �� I` j . ' ' ' ' ; ' ' � .' '
57. CERTIFICATE OF OCCUPANCY - '
No. Date
reaecr �ooxess: 9 9 9 W 18 T H S T
owHee�sxune: ROBERT J CHAPMAN
noosess: 1602 PLACENTIA AV
• COSTA MESA 92627
uNrt:
RNCNIENGINEER: THOMAS HAMILTON REO.XO.: C—�II 39
eonness: 2043 WEST CLIFF DR, uxrt: 113
NEWPORT BEACH CA 92660
PEIIMITTEE: THE ZIMMER COMPANY ( 714 ) 895-2788
RDONE&8: S 3 Z H 1 ANAWOOD WY
� WESTMINISTER CA 92683
LICENSEO CONTMLTOR DFIXAMTION: I trcreEy amrm W� I am GcenseE un0er D� a� �D�e� 9(amrtcendnp wIN Section
7000) af Division 3 al IAe Business ana Professions CaEe, my Gceiae b in IUA lorce anE eflect.
cmuc:03636�2` sreleuc.:0438'7�� 1_cu�ss: C—
_Daie:�-3�� `� SiOnaWrei..�1���
WORKEPS' LOMPENLITION OECIAMTION: I trere allirm Itut I Aaw a ce- cauent to setlJfsua w a cenifmate al Workers'
CAmvenSation liaur2nte, ar a UNtieC Copy ttlere0l�SCttlOn 38W, l]b. C�.
� PoLICY NO.: �P� ��TE�
COMP�NY:
, � Certilie0 copy ¢ hereW �umislieE. ❑ CeN�ieO copy I5 fileE wiN Ne city BuilEinO �on.
Date: MDr���
IXEMFfION FlIOM VIOBKFAS' COMPEN&TION DEClA1W710N: (Tha sectim reN mt be completeA il Uie pemii b for one AunEreA (5100) or less�.
I certiry that in I�e pertarmance ol ihe work for whk� thisppyy��ssiibb ueE. I StWI rrol emD �Y De�n m any manner m as to become
SIIOIBC/I Io1 IM Workers' CaAmpensation Wws ol Calilomia� �
. Oate: �l' " 3� — —1 � Sipnatura: "`��
NOTICE: II, atler maAinp tNs Eeclarztlw, you s0ou1E Eemme wGl� �o �e Wo rs CompeiSaGon prmisions ol tAe LaOor
Cotle, yrou mus� loM1�wit� camDly wit� 5ut� provisiont or INs permi� slu eeme0 ravoked.
COMSTNUCTION LENDINO �GENCY: I here0y allirm t�a� there Is � canstruqion IenEinp aBency lor IDe peAormance ol ihe wark far
wAic� Ihis Dermit is iuued �Sectlon 3097. Gv. q.
lFNOFR:
nooxesa:
OWNEN BUIIDEP DECWUTIOX: I �ertOy allirm ttut I�m exempt Imm Ilm ConUapars' Sute Licenu Law lor t�e Io11o�Nn0 reason
(Section 7031.5 Buslness an0 Prolessioiul CoAa: My cly ol caunry wNcn rzpNres a Dermit to consiruct, alter. improve, tlertwlish, or
re0air any siructure, prlor to fls iuuantt, also reyul2s t�e appfrcant for wU permit ta file a SiqnW sutement ttut �NSLe is IlcensaU
pursuant to Ne provlsiau at IM Contactars' Svte lkense law (Gupter 9(cammericinp rriN Sectlan 7000) ol Oivtslon 3 0l t�e Busineu
anE Pmhssions CaOe) or tAat ANsOe is e�empt t�emlmm aiN Ne Oasis for Ne allepeA exemption. My NolaGon al Section 7031.5 Ey
any apDlkant lor a Dertrdt wE�uts Ne applicant lo a dW pemlry al rot mort than iNe MmOrM Oollars (5500�.
I, az mmer at Ue D��Y � m'/ e� wiN Mapet az NNr sole mmpensation. wa Eo Ne work. an0 Uro
❑ structure ¢ irot inten0e0 ar ollereE lor sale ( wn 70an. Business and ProfesUonal CaEa: TAe Convaciors' State License Law
aces imt appN ro m wmer o� a propeM ��s a �mpmves tnerean. aM who mes sucn xark mmulfinerseu or mraupn
�I5 ar he� own employees, proNEeE Wt suc� imprwements am not IntenOeE or otlerM lor sale. II, �owaver t�e EuilUlnO or
improvemem is sd0 wittdn pn ytar a1 comprtan. tM owner .i0 luw Ilrc WNen ol 0�0 �� 4� not Ouild or ImO�'e
lar IAa Wrpose ol salel.
I, az awuer ol Ne D�� am exd convacWp xiN IicenseG wntractors ro mnstrurcotpNerery D�ol�0 �15e5ction 7011, Business
❑ a� w�Ipt�w�i�Vac�lO�r 5o�ch 7�q��aoV dor(� �e�Wrs�wnt�io �C.oamraitors Sta�Licenu� artw . I�amuaw�are
tAat proot of Nur Workar's Compeinatbn iwarce sinNd De D��� ta me. �
� I am exempt u�Mer Sectlon: B. 6 P. C.
lor tNs reason:
Data: Oxner.
I Oo AeaEy mrtiry Nat I am aware al anE wderswM W reVuirements ol Calitamia HWN anE Satery COEe Sections 25505, 25533, anE
2553C an0 tlut I or any fNura GUIICinp occupant wilUxill not (crde one) neeE �o comvN �N �4 state a0a anOlna rapuirtments for a
permn tar wnsirud'mn or moEilkation Irom tM N'r�o liry MaiuOement District. NesOeniial mrmruction applicatlons are exempt trom
tAeso provisions.
Oate: MD����
I here0y ce�iry ttut I luve reaE tttis apD�� �O suta W� IM aEova inlarmalion 6 cortect. I apree ro mmpy with all ciry and counry
ordinances an0 state Wws relatinp to OWWinp corrstNClWn anG tceaby au[Iwr'vn aD�ntatWes of tMs dry ro enter upon t�e ahove�mantbneE
P��MnY �or inspecli0n Wryoses. ��
Oate:�—ZO—S� Siqnature: —�-- /"=� ""'��' �
uriver's �irense ar Sociai Secunry x:
166td6 W�Ite—BullEing; Grean—CaEe Enlorcamanf, Cenery—Applicent; Pink—Revenue; GOIEenroA—AIDaesaor
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: M 047123
PERMIT NO: M 047123 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYPE; V—N PERMIT TYPE: MEC PURPOSE: OTH
JOH DESCRIPTION : NEW INDUSTRIAL BLDG.,REFER TO PC.1056-89 SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENTS: REF BP46382
!f if if �k k f! k ik k ik if M k if ik iF �t ik if ik if if k it ik iE if if iE if if iF if if if it it k if !f �f !f fklh iE if if ik ik k if if if ik k it �f 1k ik if if if i! if it it it 1k if iE iE if if ik it it iE 1F i!
Z O N I N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN HUILDING ----------
FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN
--------- ACCESSORY BUILDING ---------
FRNT: FT IN FEAR; FT IN
LEFT: FT IN RGHT: FT IN
PARKING REQ • PROV: PARCEL: 42436101 ZNE: AEF NO:
PLANNING Nt)TES>
>
iklE if it if ik iF ik itlt ik if if iE iE iE iE iF iE iE if if if if iE iE iE i! 3E iE iE ff if it iE ik ik it �f itlf 1t iF 1t 1t iE iE iE if IE Mk 3E iF if it if if �k iE iE iE 1E if iE iE if iE iE 3f iF if if iF it if M 1f iE
D E V E L O P M E N T S E R 17�I C E S R E Q U I R E M E N T S
ZONING APPROVED HY DATE:
BL)ILDING APPROVED BY : DATE:
ni
APPLICATION ISSUED BY; ' DATE: �i n
�tititit�r+rititit�ritititititatitiF*ititit3F'iF E3F'iF3Fit�tit*atitafiEiFit��iF'i �� *�r
ifikitMikildl�tiFifiklfifiklFiEifiFiFMkltitiFiFiEititiEitiEiEikiFifiEdt' ilifif i6ifififiEifikltikiEiElflfit�lFlfifkiEkitiEltiEiF3fiEikitiEitiEititiEit
LEGALIZATION:N F E E �S U M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC (MECHANIC FIRE SMIP/RES GRADING
PERMIT 13.50
252 SMIP/NON—RES
PLAN •
ISSUE FEE 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 13.50 15.00 0.00 28.50 28.50 .00
REVENUE DIVISION TOTALS--> COLLECTED: 28.50 OVER/SHORT; 00
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
28.50
if iF ik ik ik iF iF if ik ik k ik if 1tlF iF it ik ik M ik ik k k i! i! ik it i! ik if fk ik ik 1h ik it if iF it if iF it 1t i! if if 1E if if it if N 1f !f it if it ik it ik itlf it if it if if ik i! iE iE it ik iE if it ik i!
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY
MEC 1
MEC 1
f���^fy:�if�lii�i»
INST/RELOC RECESSED WALL HEATER
VENTILATZON FAN CONN TO SINGLE DUCT
END OF FEES
UNIT COST TOTAL COST
4.50 9,50
01 00059719—OQ059719 T 4 l" 23.50
DATE: 04/30/90 TIME: ?0:41
CONSTRUC7�ON AND PLANNING P��� & SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1� Temporary �lectrical Service�or Pole 52. Pool & Equipment Location
_ 2._ Soil Pipe-Undrgrnd.; 53. Steel Reinforcement
-•-�3. Electrical Conduit Utility-Undrgrnd, 54. Forms '
4; Electrical Co�duit-Undrgmd. 55. Electrical Bonding
.�5�.'.Steel Reinforcement 56. Rough Plumbing & Pressure Test '
. 6: � Electrical UFER Gmd. 57. APPROVAL TO COVER�GUNITE -
7„ Footings . - 58. Electrical ConduirUndrgmd. _�
.8. Foundation � 59. Gas Pipe, O Undrgrnd., Test �
9: Water Pipe-U�drgrnd. ' 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Finai
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Draint �- •� _ 64. Plumbing System - Final �
14. Rough Plumbing � 65. Electrical-Final
15. Rough.Electrical-Conduii 66.,SolarSystem-Final
16. Rough Electric.Wiring' 67.- Fencing & Access Approval
17. Rough Wiring Sign 6$. APpROVED FOR PLASTERING
18. Rough Electricat-T Bar Ceiting 69. POOL/SPA SYSTEMS F1NAL
79. Rough Heating & Air Conditioning , FIRE.DEPT. REQUIREMENT
`.
20. Rough �Facm�y Fireplace "' �= � � ' � ` ' � �
;.y � . # APPROVALS.. ;:Permit#
21 . Ducts, in Structyre " " "'= � - ;' ; , � 70. Underground Hydro .
22. Ducts, Ventilating� '� - _ - -7�, Product Piping �Gas OOiI
23. Gar Pipe�Ro�7gh & Test � ` � • _ � ' 7z, Underground Flush '
24. Roof Framing . . '� � - � � �73..Undergrnd.StorageTank�OGas ❑Oil
25. Roof Sheathing � ' '' �y ; 74.'Overhead Hydro�_
26..T�Bar Ceiling (S[ruotural) & Monocoat � r� �>; - , 75:-Dry Chemical � � �
27. Frame and Flashing i' A 76. Dry Standpipe �;, � " �
28. Lathing�& Siding '' y`'�_ . ' �' j � 77.- FIXED SYSTEM FINAL y - y
_29. Insulation " x _ ' ,.,; � 78.•FIREPREV.FINAL , �' �
30. Drywall Nailing � � , ' �� �HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat '- " � � �'79. FINAL INSPECTION �^
i
� 32. Electrical Power Mecer�F.inal �' A, '80. �FOOD CERTIFICiaTE ISSUED
'33.'Final Electric • ' ' ' Notes: ` • '
n � ,i' -
� 34. Final Heating & Aii Conditioniny� _ _ � � - , , -
35. Final Gas Pipe�Test � •• � � � ; � o � �
� ,
'36. Hood o,CanoPY =' -. . -_ . . ' '� + - � -
37. Final Factory Fireplace �� - � � � _ �-:� �_� y"'
.38. Final Plumbing ` -tl , �' � � s �' �
y
39. Water Service-Finak ' ' - . � � _ � � � '
40. Gas Service�Final � "" _ " •-
�.41. Solar pomesticFinal ' � � � . -- � _ . �
r
42. Backflow Pre�enter � * � ^ . � - "
� .-�-.. •.i :�,� • -
43. Backflow Irrigation .. ' -� ,,. . _ �- • •
. . -
44. �andscape IrripatiqnSystem���•� ' ' ' ' . ' "
- sr �
45: Sound At[enuation � .: . � �:; �-> - . ' � �� �
46: Handicap Regulations - - ' - �'� ;
47. FINAL STRUCTURE & BUILDING „ - , ,
48. FINALPLANNING � � ' ' .. ;
49: Electric Release to Edison •. . .
•SO..Gas Release to Southem California Gas Co '� • � � ' - � ' '
��, s
51. CERTIFICATE OF OCCUPANCY ' ' - -
No. Date
Pfl0.1ECf �OUflE33: �j 9 9 W 18 TH S T
OWNEfl'8 N�ME:�AOB CHAPMAN
�ooxess: SAME
IIqCM/ENGINEEP:
�DDflESS:'
REO.NO.:
uxrt:
UNIT:
PEAMmEE:TUNNICLZFPF. EI,�CT (7f4175A-0847;
�ooxess: 3 2 L 4 ORF.GON ST � •
C.M, CA 92626
LILENSFU CONTMCTOB OECIANITION: I hereby atlirm tlwt I am IiunseU untlar pmNsions al Ctwpter 9(commencinp wit� Section
70001 0l Division 3,01 Iha Business anJ Professiaa CaEe, and my Ilcmu is in tuP lora antl ettect.
cm uc.: 014 8 9 3 s�nn uc.: 3 3 8 G 0 cuss: C 10
Date: ' Sipnature: �r� - - � /
WOBNFRS' CO PENSA710N OECUMTIOX: I her t I Aave a ceNtkata al cauent ta self- su or a cetlificate oi WOMers'
Compensatian Insuranca. or a artitie0 coPY Uereol (5ection . Lab. C). '
PoLICY NO.: FXP. U�TE: ' �
COMPRNY:
.] CeNlied coDY � hereGy fumisheA. ❑ CertifieE copy ls fileA wit� the dry Builtlinp Divisbn.
Oate: MD����
El(EMPIION FlIOM WOPI�AS' COtWENS1TpM OEUAP�TION: (� section rcN not De mnqlefe0 il IAe D� B la one AUMieE (5700) a lessl.
I certity ttut in flre pertormaxe ot Ne work lor wtuc� tltis pemdt a iuueQ I stWl wt empby arry persan in any ma ner m az to 6ewma
- suEject to tne Wo cers' Compensatim Lavrs of Catifamia.
oaro: � L�J -Siqnatum: � � � 1
NOTICE: If, aher malan0 �� tledaratim, you � e wEjM lo t�e Workers' Comperisatbn Dr '' { of Ne Labor
COAe, yau must tonMuiN mmpy xit� wch provitions permt shall Oe OeemM revokeE. � {
LONSTRUCftON 1EN01NG �GENLY: I hereDy atlum Wt Nea o a comtruction ImOinp apemy tor [�e peAorrtance ot tlu woM for
wNcn Inu permit is issueE (Sectian 3097. Civ. C�. , , f{
LEXDEN: . , / � �
�DOPE8E:
OWNFR BI11lDEH DECIAMTION: I tcert0y amrm W� 1 am ezemD� ��m Ne Contractors' State Lkeme law iw tlre lollowinp reason
(Section 7031.5 Business an0 Profzs4anal CoOe: ' My dry ol coumy wttiU repuires a permil m construct, al�er, improve, tlemolish, or
repair any SlrucNre. prior ro tts isuuxe, alw rtquues W eDW�� lor wch perMt to lile a 5ipne0 sGtement llut �Nshe ¢ Iiunse0
pursuant to tAa pmNsions o1 tne Comnaors' Sute License Law (Ctupter 91�mmeiuin0 ��� �tlon 7W0) ot OMsion 7 0l IAe Business
an0 Professians CoCe) or 1Aat he/stie'a eRempt tMrefrom �n0 �M has'¢ tm Ne allepeE eaemD���� �Y �u�� ol Sectbn 7037.5 Oy
anY appium lor a perrrvt whjects t�e appllcant to a NvY penalry oi not more Wn Me huMreE Eotlars (SSW�. - :
�I, az avmer ol t�e pmperty or my employees wit� wapes as ineir sole, cnmpewtlon, win Eo tlro wark, en0 Ine
❑ structure ¢ irot intenEeE or aHered tor sale (Sectan 7011, Business �n0 Professimal COEe: 7Ae Coniactars Sute licenu Law
tices rwt apDN m an v«ner of a proceM wM ddl6s w improves tnerean. an0 wno Eom sucli work �imull/hersell or Inroup�
hL5 Or lier own empbyees, pmNOed Wt wcn imprwements are irot mtenEeO w offereE lor sale. It, hpwever tM CUIlOinp ar
imOrOvemen� LS SOIE vAtNn one year al mmpleti0n. lIR Owner mT Ilava t�e OurOen ot 0�0 �¢�a AIC no� CuilA or imOrOve
lor ttrc ouryose ol sale).
I, az owner af Ne properry am exGuSiveN conVactlnp wlt� Ikenutl wntrutan to construct tne O�Wect (Sectlon 70C1, Business
❑ an0 Professions CaOe: The Contractors' Stata license Ww Ooes rot apply ta an owoer ot properry wlp GwWs or Improres tMreon
aiM wtp contncu Im sucn Drojeccs wIN a conenctarls) 6case pursuant to rtn Canv�aors Sute lkense Law�..l am aware
Wt Droof ol tlieir Worker's Compemaflon Nsua�xe 5hoW0 Oe DrovqeU ro me. �
� I am ezempt un0er SecUon: B. 8 P. C.
Iw tMs reaun: ' � .
oate: Umer:
I Oo �erehy certiry that I am awaa ol antl uMemantl tlre reparement5 oi CalttorMa Meatt� arW Safery Code Sectbi5 25505, 25533, an0
2553a anC Nat i or arry Mure CuilONq occupan� wilUwitl irot (drtle one) mN ro comqy v.itn said siate mUes an0 tna repuirements lar a
permii for construction w riwtlifiutlm iran Ne Nr �uaLry ManaOement OLstrict. HesWential constructbn appliwtions are exempt fram
these Dravisiwa. �
Oate: MP��1:
I nere0y ttniry ttut 1 Aave rea0 ttus appGcaOon antl state Wt Ue a0ove inlorma6m 5 correC. I a0�� to camDM ��� �� ciry an0 counry
oNiwicesanOSWtelawsreWunptoCUBOmq� ' a�MnheaOyautlar¢erepresenfaUuesottld5arytoemerupont�eaDovo-ment�one0
Pr°DeM tu� DttGon OmWus' 1��y('i � I .
Date: Spna[ ' � �^�
oriver's �icenu or Soua� securiry a:
1661�4fi � Wl�ite—B�riW'vg: Green—CaOe Enlortamont: C%nary—Applirant: Pink—Revenue: GdEenraE—Asaeswr
, CITY UF COSTI� ML•SA. — B[I.T.LDING PF.RMI7 � PERM NO: E 046586
YERMIT iJO: E 0466�6 PI,AN CHi;Cit NO: � N GOVT: N SUPP: N
CONSTRUCTION 'CYPE: PERMIT '['YPE: BLE PORPUSE: OT[3
JOH DF.SCRIPTION . L SQ FT:
CLAIM VALUE: ' CALC—VALUF: GROUP OCC: M=1 /
COMMEMT'S : 1 +�{�, �O �. Rj ��� �� ' � .
+��*�x�r�x�*�t�e+��rt�rx��*�* *��� �r * +e***��x*��-***��r�r*«*�****�r�r+r*.�*�r**�r***�*****�
, Z O N I N GS ERTEBQ�UCIxRSE M r N T S , �
------------ MAIDI BUT,LDING -----�------ ------�--- ACCESSORY BUILDIMG -----------
FRNT: FT IN RF.AR: FT IN FRNT: FT IN RF.AR: PT IN
LEFT: FT IN RGHT: FT IN I�EFT; FT IN RGHT: FT IN '
PARKING REQ: PROV: PARCCL: 424J6101 ZDifi: REF NO: �
PI,ANNING NOTES> �
> ' _ '
iE k 1E iF aE if if 1E if iE iE iE it iE 1E 3f 3f 3E �E iE IE 3E �1E 3E 3E iF �F �f M 1E 1f 3E ik ik ik �( iE if if if if dE if %if iF iE it If fE 3E iF iE if IE �)F iP iF �%Ikit if M� K i(� iE IE iE 9f if iF �E iE dF if iE 3E iE iE
D E V E L O P M E N T S:E R V I C G> R E Q U I R E M E N T S' '
ZONING AFPROVED BY � DATE:
DUILllING APPROVED BY :_ _ ' . DATE:� �
APPLICATZON ISSUED DY: �� r. DATE: '����j ��Q.__
�7kitiElEifiEiklfililMiEiEiEik�ikifffitiEiE . iFiF�}Fk3FkiEiFiEiEiEifiF N�fF �1E*M#
M� i(� �E iF iE iE if 1E ii iE iE it iE iE iE i! iE fE iE it iE it iE ik fE iE iE * iF iE If 1i• ik 1t if�iP iF iE if it if 1E it it iF it i! iki! i41E 1F if iE if �k if iF it ik fF f(� ff if iE k iE iE ik iF 1E k if -If 3E i� 1f K� jE
GEGALIZATION:N f'lE-£ :S U M M A R Y STROCTURAL SL'GMEN1':Al '
BLDG PMT PLUMBINC, ELECTRIC MECHANIC FIRE SMIP/RF.S GRADING
PHRMIT . 74.35
: �'• S O S SM I P/ NON—RE'.i
PLAN ' �
ISSUE FEE 1-5.00
BUILDING—D7V--> PERMII' ISSOE PL"AN—CFIECK TOTAL PAID DUE
TOTALS----> 74.35 15.00 0.00 89.35 89.35 .00
REVENUE llSVISION 'tOTALS--> COLLGCTF.D: 89.35 OVER/SHORT: .00
. HLDG PMT FLUMBING ELGCTRIC MECIiANIC F'IRE SMIP/TOT GRADIDIG PLAN—CIIECK
_ 89.35 a,— ,
1f iE If If N�k iE �E M 9f iF N If fF M if IE M if 1t if 3k M if 3FK-K iEjE �f lEiF iEifif M iE iF IE 74 i! iE if M�k iF iF i( iF iF M if 1E IE M ifif If iflf if iE 1E iE iFif if �f 1E if !f iFiF k if if M If if
I N A I[' I D U A' L� F E E B R F. A K D O W N'
TY[?E QTY D E S C R I P T I O'DI
ELE 15 FIX7'URES, LIGHTl'AIG ,� ] ST. 20 EA.
ELC 20 RECEPT/OUTLET ' 7. FiT 20 EA.
GL�F. "l3 RECEPT/OUTLET .� ZiDDiTIONAL fiA.
ELG ].1 RECEPT/SW7TCH �'1 ST 20 GA.
ELE ]. SFRVICES BEI,OW G00. C� 6 BELOW 701 AMF
ELL•' 1 SOB—PANEL
Ei+1D OF FCES
UDIIT COST TOTAL COST
.'75 11 . 25
.75 15.00
.AS 10.35
.75 � 6.25
1$.50 18.50
11.00 11.00
01 OQQ57013-00�57013 TO T 89.'s5
DATE: 03/26/90 TIIfE: 14:3?
CJNSTRUCTION AND PLANNING . PO� b SPA �
APPROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector
1.' Temporary Electrical Servic�r�Pole �� • 52. Pool & Equipment Loca[ion ,�
�2. •.Soil Pipe-Undrgmd. . "� 53. Steel Reinforcement ' �+.
" ,3.`-Electrical Conduit Ut�lity-Undrgmd. . Formt ' �
--4. Electrical ConduibUndrgrnd. - � . 55. Electrical Bonding
5. Steel Reinforcement '� � 56. Rough Plumbing & Pressure Test -
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7. Footings _ �, � A 56. Electrical Conduit�Undrgrnd. ��
8. Foundation y�' �°\, 59. Gas Pipe, O Undrgrnd., Test ' � �
1
9. Water Pipe-Undrgmd. -'� 60. Backwash Lines, P-Trep, O Undrgrnd. i�
r�
10. Structural Floor System i 7 � 61. APPROVAL TO DECK
11. Property Sewer Line & HouseSConnection ��: 62. Backwash & Receptor-Final ; Y
)
12. Sewer Cap _ � 63. Heater & Vent-Final � ��
13. Roof Drains �' � 64. Plumbing System - Final � n
' �
74. floughPlumbing ,��` 65. Electrical-Final �'
15. Rough Electrical�Conduit �� ,-�r 66. Solar SYstem-Final .
16. Rough Electric Wiring ' 67. Fencing & Access ApProval .
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING �
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning _ FIRE,DEPT. REQUIREMENT _ _.
20.,�Rough Factory Pireplace , - ' APPROVALS . _ Permit # -
21. DuCts, in Structure, - - 70. Underground Hydro
22. Ducts, Ventilating . � - , -71. ProducrPiping OGas OOiI
23. Gas Pipe-Rough & Test � � , 72. Underground Flush
24. Roof Framing � . 73. � Undergrnd. Storage Tank O Gas ❑ Oil
25. RoofSheathing^"� � ' 74,�OverheadHydro
26. T-Bar Ceilin9 IStroctura{1 & Monocoat , 75. Dry Chemical
27. Frame and Flashing - ' ' 76. Dry Standpipe �
28. Lathing,& Siding; ' --- _ � � 77.• FIXED SYSTEM FINAL
29. Insulation i'. - ' 78. FIRE PREV. FINAL
30. Drywall:Nailing_:. . - HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat . . FINAL INSPECTION
„
� 32. Electrical Power Meter�Final (L FOOD CERTIFICATE ISSUEO
33. Pinal Electric ��_ ' otes: Q
34. Final Heating & Air Conditioning .' ' � . �
- 35. Final Gas Pipe-Test � - " .
36. Hood or.Canopy , '- . � ' .
37. Final Fd�tory Fireplace- � . .. � '
�
38. Final PFumbing -- ' -, .
� 39. Water Service-Final .. - '
40. Gas Service-Final _ • ' .
41. Solar pomestio-Final � - � � � � �
42. Backflow Preventer _. -' �
43. Backflow Irrigation • � .
44. Landscape Irripation System , � , . . - -
� 45. Sound Attenuation �- • • � • �
�46. Handicap Regulations . ' � � - ,
47. FINALSTFUCTURE&BUILDING
s
48: �FINAL PLANNING„ � � �.' ' . � �
49..Electric Release ta.Edison --
.^
50:'Gas Release to Southern California Gas Co ;. -
51. CERTIFICATE OF OCCUPANCY
No. Date
PN0.IECT RODNESS: rj 9 C.� W 18 TH S T'
IowNen�senMe:.R091iRT J CHAPMAN
, . ^QD�g�� 1602 PLACENTIA,AV
" �COSTA MESA 926?.7
uxrt:
�RCHIENGINEER: THOMAS HAMILTON ' pEa.No.:C—"7139
RDOBES&: ZO43 WEST CLIFF DR. °NR`.113
. � NEWPURT BEACH• CA 92660
- PEIIMI7TEE: KRAUS CONSTRUCTIUN ( 714 ) 536-1419
' RUOflE38: Z1S9Z SORVEYOR CL
H.B. - CA 92646 ' '
LICENSED CONTMCTOR DECUMTtON: 1 lrereEy attirm that I am licertsed wiAer provfsimu al Cluptn 9(commenUnp with Section
7000) ol Oivision 3�of IM Buvness antl Pmlessions CoGe, and my license is in tull torcE an0 effect. .
cmuc.:0�73�4.,8�0r3 $7^����377814 �Iy�6655,,��{{ / •
Oate;_yy_(�7.�7_./_ SiqnaNre:!�=3C{ ��i�, -
WOflKERS' COMPEN8pTI0N OECLAMTIdN: I AereCy affirm t�t I have a certiBcate of consen� ta sell-insure or a certilicate Oi Workers' �
Camp¢nsation Insuran�e or a cehifieA caOY thereal (Section 3800, La6. C�. .
roucrxo.:10L�5B7—B9 exr.oa�: 07/0.1/90
carnrnxv: STATC FUND ,
� CetlifeE coDY �5 here0y tumisheC. � CehifieE copy is ttleA mih Iha M �inp Di 'sian. , /
Datq: . S� / \�� j'�� qpplicant: � ��
E%EMPTION FflOM WOXNFNS' fAMPFN&TIOX OFCUMTION: Rhis seNon neeA irot be complpteU if Ihe Dermtt is tor'one AunOreO �$1 W) or less�.
I cettiTy that in IAe petlormanca ot the wo�k br which this permit is issueQ I shall not employ any person in any manner so as to hecome
Isu0lect ro Ihe Ylorkers' Compensatian Laws al Calilomia.
oate: - � ' signamrc: _ . . . -
NOTILE: B,_ailer maqnp Nis declara6on. you slwulE hecome suEject ro Ne Workers' ComDensatbn prm�isions al Uk LaEor
� Ca�e, you must IortAwitA comDN �+�� such D�a�sions or tNs permit shall 6e UeemeC mvoketl.
CONSTBUCf10N'LENOINO �GENCY: I here0y atlirm tAat there is a consiruction lendinp a0enry lor Ihe pedormance al Ihe work for
wAi�p IAis permit is iSSueC (Seclion 3W7, Civ. C�. ,
lFNOEfl:
FOOflESS: ' � ' .
• � . .
OWNEfl BUILOEB OECLAIUT�ON: I AereEy amrm tlut I am exemD< «am t�e Coirtrat1ors State Lkense Law tor IM iWlowinp rezwn
(Section 7031.5 Business an0 Professional CaOe: My dry ol counry wNcn requires a pemut ro rnnstmct, atter, imprave, Cemalish, or
repair any sWCWre, prior to its iwuance, also repuires the aDDh�nt lor such permil to �le a 5i0�etl sWtement ltwt �e/s�e i5 Gunutl
purSuanl to tAa proNsions of the Contraztors' Stata Licenu Law (ChaD�er 9(commencinq witA Section 7000) of Divislon 3 of Ihe Business
an0 Pmfessions CoOe) or that hUshe is eKemO� Ihereimm anU ihe Casis for Ihe alleqeA axemptian. My violation ol Sactlon 7031.5 by
any applicant lor a permit suUlects the epDliwnl ta a civil penalry of not mare [han hva �unEreO tlollars (f500�' ' �
I, az owner ol tAe Draperty or my employees wit� wapes as t�eir sole comDensatian, will tlo t�e wan, ana me
'❑ sirupum ¢ not inten0e0 or ottere0 for sale (Section 7674. Business antl Professlonal CaEe: T�e Contractors' Sine Ucenx Law
. dces not aDDN to an mmer of a D�p�M �o GuIIEs or improves thereon, an0 wlro does such work �imselt/Oersell or IAroup�
, his or her ovm employees, DrpvitleU t�at suc� imD�'emenis aa not inten0ed or a/1ereL for sale. Il, �owever tha builtlinq or
improvement is sold vnthin one year ai compleiion, the owner will have ihe �urtlen ol provinp he/she Oi0 not DuiIJ or improva,
for tAe puryose of salel.. � • : �
I, az owner al t�a pmperty. am axclusively cantractinA with licensetl wntracrors to constmct the Drolect (Sectlon 7014, Business
❑ and PmleSsions Catle: Tha Gontractors' Stata license Law does nat apply ro an owner of Droperty who 6mttls or Improves [har¢on .
ana wlw coniracts for suc� projects wit� a caniractor(s) licens¢ Dursuant to the Contractors' Stata License Law). I am awara
Nat D�aof al their Worker's Compenution insurance shoul0 Oe pmWOetl to me:
Q I am e�empt un0er Sedion: B. 8 P. C. � �
lor I�is reason: ,
Oata: Ownec
� I ao hereEy certity tAat I am aware al an0 unJerstand the requirements ot Calilomia Healih and Salery COEe Sectians 25505, 25533, anE
25534 an0 tlut I ar arry IUNa builEinp acuD�� �Nwill nat (cirde ane) nee0lo compty vnih saiE state cotles anE t�e aQuirements tor a
certnit for consimction o(moEiticaGon tmm t�e tir Ovaliry Manapement D'a1Act. PeaOenUal wnstmdion apDtications are uempt Imm
IhEu pmvi5ion5. . . .
Ddte: Applicant
I heaby Ceriity It1al I �ave fea0 illi5 applitatlon an0 Siate Ihat lh¢ aDov¢ informaiion is WR¢ci. I apree to cOmply vni� all ti�y anG c0unry �
Ofdj���5 y1E Sid10IdW5 2I2IIIIQ IO �YIIERIO COfLS�Nt(IOtI ]IIA IICfl� 3UIIIOfIZC fCD25Q11f2�rvE5 OI IMS Clly �0 Cf1�Ef IIp011 ��8 d00VB�I11EIlOMBd
DfOptfl)' �Of i115pECIqf1 DUfpOSES. //�N' �
Oate: —��� �� � /Spnamre: v "�"� � �
Driver's �icenu ar Sadm Security x: ' '
18<t�d6 Wnita—BUIl01ng; Groen—CqEe Enlorcemenl: Cenery—Appliwnt; Pink—Revenue: GOIEenroE—Asseuor ' -
CITY qF COSTA MESA —�BUILDING PERMTT, PERM NO: �: 046533
PERMII�` NO.� L, 04E533 . PLAN CHECH NO: � rl GOVT: A1 SUPP: N'
, .. � ..
CUNSTRUCTION TYPE: V—N PERMIT TYPE: ELE � PURPOSL•:: NEW
JOB DESCRIPTION : MEW INDUSTRIAL BLDG.,REfiER TO PC.1056-89 SQ FT: � �•
CLAIM VALUE: � � CALC—VALUE': _ GROUP UCC: D-2 /,
COMMENTS: 'CONST 6'1"lSP OFFI�CE,1218SF MOLDING SHOP�.(LCFERc .CD �j��3k�2' '
,3(�ikkiEifiElEiFiEiEifkif�fiENNlfklE�klEkifiliEififfFiEifiElkikiElEiEiFiEiEiElEiEkklEfElf iEMiFilfflfiElffkibkk ikiFiFjEifiEiEiEl6ifdE3EiEkiliEif
, 2 O N I N G R.F. Q U I R E M E N T S '
•5 E T H A C K S �
------------ t9AI.1�l BUILDING —'---------- - --�-----:-- ACCESSORY AUILDSNG-
FT2T1T: FT IN RF.AR: � FT IN FRNT: F'T IN REAR: FTl IN
LEFT: FT IN RGHT: � FT IN LE1T': ' G1' IDI RGHT; IT IN.
PARKING RE • PROV; PARCF.L:'42436101 ZrIE: REF NO:
PLANNING N�TES> ., �
�. . . ? .. ' ' . . . - , o
1f iE if 1E K iE iE iE 1f if if if if iE iE if if if if iF 1f i(� if iP iE IE 1E iE if 3f lE iE If if iF 1F If iF IE if iE iE k fE 1E if if if lE if iEff �t iF k 1E ik if it i(� IE it itr iF iF if k�! 1F if i! iF �E 1E iE i(� iE 3FiF
. D E V F. L O P M E Dl T S E R V I C E S R E Q U I R.E M E �l T S
ZONING APPROVEll AY ___ �� DATE: '
HUILDING APPROVED BY,:i ' _ DATE: ` �
APPI.ICATTON ISSUED BY.: UATE: ���
*x�+�f���-x�**�r*�cx�itif�r�t**x�**�r"iF"RlF�F3F�F�'iFiF'� � �iA�F3F�F'iF�F'iF3F�ex�***��r*�r�*��iF'k���t�t
df iF iE 3E iE iE 3E �E iE if� 7f ik 1E k iE iE 1F iE iF it i6 iP ik ik if ik iE iE i! iE iE �E -0E 1E%iE if �� k iflf if if !E iE iE 1E iE iF if !E k M k!f if it ik it 1k IE if iE iE ik iE ik iF iE 3k fE fE 1F iE IE iE if fE.-k
LEGALIZATION:N" '" F E E S U M M'A R Y STRUCTURAL'SEGMENT:N
BLDG PMT PLUMHING ELECTRIC MECHANIC fiIRE SMIP/RES GRADING
PERMST " , 15,00 �
� " S08 SMIP/D1qN—RES
pLar� ,
ISSUE FEE 15,00 � �
BUILDING--DIV—> FEAMIT' ISSUE PLAN—CHECK TOTAI, PAIll ` DUE
TOTALS=—=�-> �_ 15.00 15.00 0.00 30,00 30.00 ! .00
REVENUE DIVISION TOTAI.S-->' COLLECTED: 30.00 OVER/SHORT: 00
BLDG FM'C PLUMAIDIG ELECTRIC MECIiANIC FIRE SMIP/TO'P GRADING PLADI—CHECK
: , 30:�00 ,
iE 9E 3E iE 3E iF�fE iE k iFlE,iE IE iE iE iE 1E iF iF if 1E iF �k It fE it if iE iE 3f 1k if iE iE if iE K if 3E iE iF 3f iE iE if if iE 3E �f-iF �4 i4 %fF ** if if iP if if if if 3f if i(� if 1f 3( �F iE fE aF )E iE �f fE lE �E
I AI D I V I_ D U A' L P£. E Q R E A. K D O W N
TYPE Q1'Y D E S C R I Y T I O N U�IIT COST TOTAL COST
� ,
ELE- ].. TEMP SERV PWR POI,E id/OUT.LF't5 EA. 15.00 25.00
GND OF 'FEES
9
0
,�
O1 Q0056148—OQO`6148 TCtT 30.00
DATE� 03/15/90 TTttE: 12:36
0
CANSTRUCTION AND PLANNING � � P� & SPA
APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector �
1.. Temporary Electrical Serviceor�Pole� �; "� 52. Pool & Equipment Location - �
.2._Soil PipB-Undrgrnd.,• - ' - _ � 53. Steel Reinforcement
= "3.`Electriwl Conduit Utility-Undrgrnd: 54. Forms - .
" �4._Electrical'Conduit-Undrgrnd. � � __ - 55. Electrical Bonding ,
5: �Steel Reiriforcement � � 56. Rouqh Plumbing & Pressure Test
6.�Electrical.UFER�Grnd. " 57. APPROVALTOCOVER-GUNITE -
7.-Footingr'-:'[ � - - 58. Electrical Conduit-Undrgrnd. -
" 8.. Foundation ' 59. Gas Pipe, O Undrgrnd., Test
9. Water PiOe Undigrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Struttural Floor SYstem ' � 61. APPROVAL TO DECK
11. Property Sewer Line�& House Connection � 62. Backwash & ReceptorFinal --
12. Sewer Cap - �. ' � � 63. Heater & Vent-Final
13. Roof Drains: _ _ , . 64. Plumbing System � Final �
14. Rough Plum6ing 65. Electrical-Final �'
15. Rough Electrical•Conduit , , 66. Solar SYstem-F.inal ,
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign ' 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling � ' 69. POOL/SPP, SYSTEMS FINAL
19. _Rough Heating & Air Conditioning _,t � _ �FIRE DEPT. REQUIREMENT
20.-Rough Fdctory Fire`place _� : - , _ . �� , �AppROVALS -'..Permit #
21: DuCts, in�Str`ucture � � " " : - - - � '� _70. Onderground Hydro '
.-
22. Ducts, Ventilating � � - � � . 71. Product Piping O Gas ❑Oil
27 Gas-Pipe;Rough & Test _ '_ �' ' , 72. Underground Flush
24. Roof Framing _ a ' � � -73: Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing - ' 74: Overhead Hydro-. �
26.-T-Bar Ceiling (Structural) &'Monocoat , . , ' , i 75rDry Chemical . - _ � .
27. Frame and Flashing .. - � 'r �� � 76. Dry Standpipe -' ' '
-28. Lathing-& Siding .-� �� � _ ° ; � �� 77.� FIXED SYSTEM F,INAL �.-. -
29. Insulation �'3 = � °:` 78� FIRE PREV. FINQ�L
130. Drywall:Nailing , y _ _ . - �HEALTH�DEPT. REQUIREMENT
37. Plaster Brown Coar ' .-" 79. FINAL INSRECTION •F
�32. Electrical Power Meter-Final ' _ `'80._FOOD CERTIFICATE ISSUED .-
'33. Final Electric � � • , . � 1 Notes: - - . � '
34.,,Final He3ting�& Air�Conditioning- _ : , - .
`35.� Final Gas Pipe�Test.- .� �� -� � , r ' � � - � � -'
"36. Hood or Canopy- ` � : '- ; . • ; ' , ' �..
.
�37.� Final Factory Fireplace:. --- . +
"38. Final Plumbing :, ` ' � '
- u'
39. Water Service�Finah� - . � : ' , � +-�
- 40. Gas Service�Finaf � � - • " - ' - ' ' ' „,
'.�41. Solar pomesticFinal" � ^ �� ' � �. � = , � -
42. Backflow Preventer- ' ^ � " ' - �
- i � v �C .
43. Backflow Irrigation . '-' � , . �r _
� 44. Landscape Irripation System' - ' � ' ' . ' ' �
.'i S ' � s '
'45�.� Sound Attenuation � .�.. ' �� _ � , ,-, ., -• , � � ��'
�46. Handicap Regulations - ' • - ��
, _ .
,,,47.�FINALSTRUCTURE&BUILD�NG �, ; '� � � .
48.'FINAL PLANNING - -' " •� � - " "
,, v
�49.;;Electric Release to Edison ' , - -�
'59: Gas-Release to Southem California Gas Co � ' ` ' - - •- � � �
� -
51. CERTIFICATE OF OCCUPANCY ° ' '
No. Date
. 234a,
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O. BO%at] C08TA M6BA, CALIFORNIA
For Applicant to Fill In Completely
TYPE OR PRINT
i�oiNa yq9 �W�sr TH J]`.
JRE59
COSTA MESA. CALIFORNIA
NER /�I� I � P�CS.�4 � �_ .
ADDRH88 � W QI
THL. C�.
CITY C D C r(� �S�' � NO. �p
A 1^EC�fCe . — TFL. ��
� STATE
f
USE OF
EXISTINO BLO6.
9BTBACK LINE PNOM r ^ (
uE,L �'
EP7 S �( ( I R16HT
DESCRIPTION OF WORK
BUILDINO � � NO.OP
SIZE ROOMB
EXTERIOR WALL..O Q I COV�ER
COVERING W
U&8 OF BUIL�If�p AND WORK TO BH
I NEHEBY /�CRNOWLHDOB TXAT�1 NAVB flBAO TMIB APPLICATION
AND 9TAT8 TXAT TH6 �BOV[ I8 COHqHCT �NO AOR86 M COM-
PLY WITM �LL CITY ORDINANCQB ANO YTI1T� IAWB H[OULATINY
BUILOINOCONBT0.UCT N.
SIGNqTURE OP
PERMITTE
AUTHORIZ6DA6HNT
BUI
FEE RECEIVED
JAN 21 1965
FINANCE DEPT:
CITY OF COSTA MfSA
APPLICATION FOR PERMR
BUILDING
For Offlca Use Only
P[C[IM! NO. I jFJl�ILT N�
� ; l "
BYPR nQA� � r b/ lal /�� � DATE L) ZI ( G�
3'a' P!J_ ' ZONING �
ZON[ NO.OI UYQOPN[W
�✓1// / �IANf � OUILDINO e,/�
/ /!
/��/�)}� �y/I ��I
LlOAL f� / V / ' {� ( � 0 'S �J�➢�`
06GCRIRIO /
A.P.NO. II V� I SI —1
NOTE: NO EAVE OVERHAN6 SHALL BE LE88 TNAN
90' TO SIDE @ REAR P. L.
EAVES
ALLOWED <U.B.G.REOUIREM6NT1
YARO8APPROVED � YAR08APPROVED
MAIN BUILDING ACGESSORY BUILDIN6
DISTANCB BET. BET. MAIN Q
MAIN BLDpB. ACGE55. BLI
VAR.# DATB
+'/!��
��
THH AMOIINT 9HOWN UNDHR VALLATION IB POR TH8
PUHPOB[ OP [BTABL�9HIN0 • P6RMIT PE8 ONLY.
VALUATION p�
PERMIT FEE S �
s /.5 oa �
/3 �
TOTAL FEH