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- S?PAR4TE PERMITS A Q fl D I
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- , __ _ _�. -- -____._ __ __ .. _ . :`. .. m��C���1A1 SAFETy BE COiVSULiED
� ADDl�1�1fq1, REQUIREMENTS.- ___
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City of Costa Meu
Development Services Departmen[
Building Saf¢ty Division
. P. O. Box 7200
Costa Meu, Califomia ,
CERTIFICATE OF OCCUPANCY No. �'j��;,�r��
The euildinq located at 732 West 17th Street. U�it A
has been inspected and found to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group H2 Occupancy. �
Use of Building rndustrial -
Legal Description 424-081-19
(See reverse side for Metes and eoundsl
Building Permit No.R 4Fi37A Electrical Permit No
Plumbing Permit N
Mechanical Permit No. M 48n1 5 Number of apartments and/or guest rooms
Eice Prevention Permit Nl�. F 47879
ISSUEo T0: Building Official Tany C'Da Baca
Peter Rothschild � � /
866 W. 18th Street by -�-'- �., � 7` �` ! i..
Costa t4@sa, CA 92626 , �
Date_Eebruary 27� 1991
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 $ec. 307 (e) U.B.C.
CMF 1015-46 rev. 1/83 White -Owner; Canary - Numerical File' Pink - Bldg. Permit File �
Pfl0.1EC711DOHES�', '�32 W 17TH ST
owpEh�sxune: p�TER ROTHSCHILD
nooeess: 866 W 18TH ST
,-.
650-9466
nxcxrtxoixeex: C. K. ALL EN NEO.NO.: S 1 B Z 3
', eooeEss: 1711 MITCHELL NORTH uxrt: p�
�� IRVINE CA 9'1�14
�r�"^'mEE: BUILDER GROUP . ( 714 ) 969-0169
^oo�� 10190 IMPERIAL AV
GAIiDEN GROVE CA 92643
UCENSED CONTMCTOP OECIAMTION: 1 AereEy atlirm tlut I am IkenseE un0er prwisions ot Ctwpier 9(commendn0 �+�� ���ion
7000) ol ONisbn 3 oi IM Business �nU Profask�u CoOe. uq my fiunse'n in Iu0 force an0 eilecl.
� cirvuc.:050106 $TpTEuc.:583704(/ �� B �
; Q, v. '%'-7 - �ia (�wm: /r'c�'�z ����
IlER3' COMPENSIITION OECUMTION: I MreEy atlum WI I lwve a certitkata of mnsent W uliJnsure or a aNfiw[e ot Workers'
1i h ,�pensation Insurance, or a certifie0 capy I�ereot (SecGon 3800, Lab. q.
J PoLICY NO.: El(P. ORTE: •
� 9 I COMP�NY: - '
; dI ❑ Certiiletl wpy is her¢hy fumishetl. ❑ Certi/led copy is filM wiN Na dry Building OiNsion. '
\ r ,ata: MGficant: • .
� IXEMPf10N FIIOM WOHKERS' LOMPENSITIOM D&IAHATION: RI¢ se�c6ai nxE not Ce wmqeleE if Ihe permn 5 fa one AuMrM (5100) ar kssl.
I certiry tlwt In t�e Dehormance ol the work lor which Vtis perrtut 5 i55ueE, I stWl not employ an/y p/ryon in any manner m az to hecome
� suDlect ro Ne Workars' ComDe���ion Laws ol Calilomia` � ���:ICA�
Q l—!�
� Oate: '�JQ ISipnaiurt: � ��'✓� 2_- ��
NOTICE: , ahar maitinp tAis Ueclaretion, you sMulA 6erome su01� �o t�e Yarkers' Compensairon O��ons ot tAe Lahor
COJe. you must lorthxit� wmpry vnth such Dravi4o�a or Itds perMt shall e Oeemetl rewketl.
CONSTNUCTION LENOINO �CENCY: 1 �er¢Oy attirm Ilut tAere is a construction lentlinq apency lor tAe Derformance ot IAe work lor
wtilch I�is Dermit is issueU (Section 3W7, Civ. C�. , •
IFN�ER: �
ROOBESS: . ' . . . .
OWNEB BUILDER UECIAMTION: I �ereby alfirm that I am exempt Imm t�e Contractars' State Licensa Law for Ihe followinq reason
(Section 7031.5 Business an0 Protassional CaOe: My clry of counry wliic� repuires a Dermit to cansvuct. alter, imprwe, �emolis�, or
re0air any stmcture, D�or to iLs luumce, also re0ulm5 tlro opDliwnt lor 5uU Dermit to file a sipne0 statement (twt hrJsAe B IlcenSeE
pursuant to �Ae Orovislons of t�e Comractari State LicenSe Uw (CAaO�er 9(cammendnp wit� Section 7000) of Division 3 0l t�e Business
�� Pmlessiws CoOe) ar t�at Ae/s�e I5 exempt t�eretmm an0 IM Uasis Por tlro alle0� exemD�iw. My vioWtion ol Sectlon 7031.5 hy
ippliwnt tnr a parmit SUCjecb I�e applicant to a cidl penalry ol nat more tAan /Ne huntlre0 tlollars (5500) � ' .
t
I, as owner ot the property ar rtr/ em loyees M+t� xapes az thelr sale wmpensaUon. wlll Eo t�e xrork, an0 the
1 f� stmctum is not intaMeA or otlem0lor ule (�lon 70Cd, Busness an0 Prolessional Cotla: TAe Caniractore' Slate Ucense Law
I Ooes not apDN �o an ovmer ol a propeM � DuiWs or ImO�s Uereon, md wlq Eoes such work �imull/hersetl or I�muph
�is or Aer awn amployees, D�avi�eA t�at suc� ImDrwements ara not IntenOeO or oflereE for sale. II, however ihe �uildin0 or
improvement ls so1G wltMn ane year al mmpleUon. tAe owner will tuve IM EurEen ol Drouinp �Ustie EIA nat Oui10 or imDrave
br tne ourpose ol sale�. .� � . '
I. u owner ol IOe pmperry. am exUusiveIy contrectln0 ��� �enu0 wntnctars to ronsWct t�e D�olect (SecGon 704A, Business
I❑ an0 Prolessions CoOe: The Caritrutors' State Lfcense law Uou not appN to an mmer ol D�rry ��� or imprmes tAereon
anE wno convacU for sucn Drd�v �+�� a wntraaorls) Ikense W�?�+�� �o tne Contractws' State License Law). I am aware
IAat proof of tAeir WOMer's Compematian insurance sMula Ee pmmOeO ro me.
� I am e�ampt unEer Section: 8. 8 P. C.
lor Inis rwsm:
Date: Oaner:
I Ea hea�y ceniry tnat I am awam ol anO un0erstana �M repuiamems o1 CailtomW Healt� anE $atery CoGe Sectiom 25505, 25533, an0
25534 aM tAat I ar am/ tulure EWEinO �+D�� �+�� �t (drqe one) neeE to mmpy wit� uiO sUte mEes an0 Ne repuirements for a
permil tor wnstmctlon or moEification trom t�e N'— r i� ialiry MmaOement pslAct. HesiOenfial construcuon aDDfications are exemD� �rom
t�eu Drovisiam. �
Date: MD���
I �ereby cerlity tlut I lave reaE Na appfiwGon anE state Ihat the �Oave inlormation is cortect. I apree �o comDN ��� all city an0 wunry
wdiiunces ard State laws mktoip to E�titlm9 caaWclim aM I�ereM amt� apm�mtatiuu ol itrts dtY to eMu uP� t�e aGovcmentionea
Oroperry forinsDection Dpurposes.
Date: �'"7' /� Sip�wWre: �� ���. l
oriver's Licenu or Saiai Securiry M:
1861�a8 W�ite—BuilEirw; Grean—COEe Enlorcamam: Canarv—AoO���enL Flnk—Revenue: GWOenrW—Assessor
CITY OF COSTA MESA - BUILDZMG FERMIT, PERM NO: B 0463'18
PERMII' NO: D 046376 PLAN CHECIC NO: 02593-90 S GOV1': N SUPP; N
,CONSTRUCTION TYPE.: ';. PERMIT TYPE; STR PURPOSE: NF.W
.70B-DESCRIPTION : 900SF INDUS'PRIAL DUILD'ING SQ FT: 949
CLAIM VALUE: 26,000.00 CALC-VALUE: 26,002.60 GROUP OCC: H-2 /-
COMMENTS: ' '
+tx�*��r�t�+t�e*�r�r*�t*��t�*+t�**�t+t*+t+t**ir�t*�t�t��r�r******�t**r**x��tf��t**+t+t�t�t�e*x��r+t******it���t�t�e�e�*
. Z O N I N G R.ti Q U I R E M E N T S -
S E T B A C K S
------------ MAIN BUILDING -------�--- ' ---- ---- ACCESSORY BUILDING -------�--
FRNT: F1' IN REAR: 110 FT IN FRNT: ET IN REAR: PT IN
LEFT: ,].0 FT • IN RGHT: 15 FT IN LEFT: •FT IN RGHT: FT IN
PP.FiKING REQ • 83 PROV: 84 PARCEL: 42408119 ZNE: MG REF NO: DR8954
PLANNING NOTES> 900 SQ FT METAL HLDG TO BE ADDED TO REAR OF AN EX TILT-UP
.> BLDG. RT SIDE STBK IS SEPARATION FROM OTHER, NEW METAL HLDG.
****�e �*+c�*******�e***�r�r�r*+t*+t+t***it**�r******+t*�t+t�-�t******�r�t�t*�r*�**�tir�tr**�r+t*�-�rx���r�r�**
, D E V E L O P'M E N T S E R V I C E S R E Q U I R E M E N T S.= ,
ZONING APFROVED DY� C'o. fc�- � DATE: `�j'-�-�__
BUILDING APPROVED HY : _ , = ' DATF.: ." .
APPLICATION ISSUED BY: ��� DATEi `3,-'�'-•. � , �
if if iE 1E if it iE if 1E if iE IE 1E M iE if iE iE it it M k�FifiFiF�'if'iFiFi 3fiFiF3FiF3F7F'iFiFfk ik k iE iE iE M 1t i! it7F3 i� if k
iE iE it if k If if iF k iE iE if if if iE it 1f k iE iE k iE M if iE iE if �F M�M fE iE if k If k if if if �t jE if iE M iFk iE iE 1E iE it it 1k 3k iE IE k k iF %M iE fE ik iE i4 W.iF ik i! ik ik �k if it it i! k iF
LE<;ALIZATION:N F E'E S U'M M A R�Y STRUCTURAL`SEGMENT:Y
HLDG PM1' PLUMBING ELECTRIC 'MF:CIiANIC FIRE SM'IP/RES. GRADING
PERMIT 265.00 ' . •
' SMIP/NON-RES
PLAN " ]72.25 ' � 3.90 '
ISSUE I'EE
DUILDING-DIV-> PERMIT ISSUE PLAN-CHGCK
TOTAI.S----> 268.90 i.0.00 172.25
REVENUE DIVISION TOTALS--> COLLECTED:
BLDG PMT PI,UMHING ELECTRIC MECHANIC
265.00
TOTAL PAID DUE
441.15 ' 441,15 ,00
268.90 OVER/SHORT: 00
FIRE SMIP/TOT GRADING PLAN-CHLCK
3.90
iE343(�ikikifiliEiE�FitiFkikif3fNkitiEkilkkiFiEiFkiliklfihlFkMiE7fltikifkkiFiFitifiElliFMlEf(�itkkkiEikitiElFlf�liEififitNklEiEikiEiliEiEiEkiF
I N D I V I_ D U A L F E E D R E A K D O W N
TYPE (aTY D E S C R I P T I O Nf � ' UNIT COST TOTAL COST •
SFC 949. IND-TYPE V-N -AVER 27.40 26,002.60
• - END OF FEES
0
Ol �0055573-0�0555]4 T U T
DATE� 03/07/9D TIME: 09:t�
?6$.90
_ , -
. CONSTRUCTVi�NDPLAN� S - . 'OOL, A
,`APPROVALS Permit# � Date Inspector qppROVALS� Permit# Date Inspector
1'Temporary Electrical Service or Pole 52. Pool & Equipment Location
,2._ Soil Pi.pe-Undrgrnd.., _ � 53. Steel Reinforcement
. -3.=Electrical.Conduit UtilityUndrgrnd. 54. Forms ' � ,
- �4.-Electrical Con,duit-Undrqrnd. 55. Electrical Bonding
-.5.�Sreel Reintorcement 56. Rough Plumbing & Presture Test r
��6.=Electrical�UFER:G�nd. - 57. APPROVALTOCOVER�GUNITE �
�7�.:�Footings -• =r� � ~ 58. Electrical Conduit-Undrgrnd. `
�',8. Foundation 59. Gas Pipe, � Undrgrnd., Test r�'
9. Water Pipe�Undrgind. � 60. Backwash Lines, P�Trap, O Undrgrnd. '
10. Structural �Floor System 61. APPROVAL TO DECK '
^ 11. Property Sewer Line:& House,Connection 62. Backwash & Feceptor�Final �
12. Sewer Cap _ • 63. Heater & Vent-Final -.
13. Roof Drains' � �,� ' .
... . 64. Plumbing System - Final
14. Rough Plumbing � 65. Electrical-Final
15. Rough Electrical�Conduit 66. Solar System-Final
16. Rough Electric_Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough ElectriCal-T Bar Ceiling 69. POOL/SPA�SYSTEMS FINAL -
19. Rough Heating &�Air Conditioning �r _- ,T _ �_ FIRE DEPT. REQUIREMENT� . �
20.zRough F.actory F.ireplace _ K� �_� - _ APPROVAL5'="_Permit# �
21rDu"c[s, in Str�uctuPe� - - "- � = : � ^ �70. lJnderg�ound Hydro �
22. Ducts, Ventilating `, _ ^,� { �_. ,� =, ,`', , -�77, product-�Pi"ping O Gas ❑'Oil
23.�Gas-Pipe-Rough & Tesc _ r -: - ' �_•'� • -72, Underground Flush :- -
24. Roof Framing ; y � � � ' T _ , -.73-Undergrnii. Storage:Tank �O Gas ❑ Oil
25. Roof Sheathing -< <' v � + � � _ '.� r F 7q�,-,.Overhead Hydro: , �
- :-� r.. - , s , i
26.�'i-Bar Ceilin Structural) & Monocoat' ' � �` �' '
. 9 ( �,. 751D�y Chemical i �
27 ;�Frame and Rashing: � •.- ��'+ � 76. Dry Stand�ipe '� � -
'28.�Lathin.&Sidin `.: '"�.x -�� ; f .. .��� < r. . . .�,,, ., ^
9, 9 r •_ s:-� -c • 77•-. FIXED SYSTEM�F,.INAL; _
29. Insulation y 5 •� � � 78;FIRE PREV. FINAL ;; � r
�30. Drywal�:Naii ng r � l � �-' � � � ;; �FiEALTH�DEPT. REDUIREMENT
r. , . , _
' 31. Plaster Brown Coat� � �c: s �. �-79.�FINAL INSPECTION >
-32r�Electrical Power Meter-Final, "��; � �. � :r } �80='�FOOD CERTIFICATE ISSUED i
� - . .�. �:� -: n �-� . . � - ..
_ 33�Firtai Elec[ric t T c;G � - * �� �Notes: �:-� -. _ r:
'34. Final H_eatiny�& Ai�Conditioning`� � � � , * �
4. - .-� ri'� '
� � . ..`.� . _•4 .�. e 1 . _.
35,-Final Gas Pipe�Test. _ .. � A�-- i �� c- = t ,
=36.�HoodorCanoPY � ' �•y` � i � '' � � `1 .• ' J .
. • � 4 ' �1: Y �1. V �T�
�37 :Final Factory Firepface� • -,- c�r�+ � . � �v �: - * -
1 (.
'38= Final Plumbing ` � � � � ���' "� ; `- `: k `'�
x .r� --� -1 " F . �
39 .-Water Service-Final, " � ..+ � '� . ' . r
. •� � � c m -
�"40. Gas Service-Final s � `?� ry<��" � � �� ' �!-' �-���� ^
i. ��t- �- _ - - : c,
„4L`Solar pome;ticPinal' ' '`�' � ' • ` R , � - .
. � a ' � .� �. , . a. ;■:
42. Backflow Preventer � ':* :+ • c' ' ' .
i -. �..- - = i v �: �t t -
� C^ T.' i T K�'li .
43. Backflow Irrigations „ > c • , r ; •
T'44._ Landscape I�ii9ation System� c:�� ?;-�- � ' " - ^ �, �, j. :� ` - _ � � , ` �
c f-:.:� r••R�-:; z �-� � r�,�. �: ., - ..�.� _
'-45�=Sound At[enuation. y.... ,r, r r� ,-;� k. _ p ,� c.r '
:46.•HandicapRegulations �� = • - �' • ��'� `� � �
- ' :'a a
_47=FINALSTRIJCTURE&BUILDING-,�:,� j� P� ' ' rn -
A48.-FINA� PLANNING -�- - i � "' " E"
. 21 �1I . Zl.('J�=;, -i �' � .i .
.49� Electric'.Releate to Edison � � � "' � � . • - ' =
.. _ .i♦ . -
• 50.'Gas:Release to Southern Califomia Gas Co 'x ' " - � - ' ' �� - '
s k Y' 7• �' ^_.C� i�� L
-51. CERTIFICATEOF�OCCUPANCY " "'; ^ . „�=. , ' �_ '
No Date
a
I t
rxaeneooeEss-�� • 732 W 17TH ST
OWNEfl'SN�ME: IJ�*TER ROTHSCHILD
�ooaess: (366 W 18TH ST
:,
uNrt: A
✓•
' 650-9466
111CWENGINFEfl: C, K. ALLEN HEO.NO.: S 1 S Z 3
"0°"��� 1711 MZTCHELL NORTH uxrt: A
IRVINE CA 92714
PENMITTEE: BUILDER GROUP ( 714 ) 969-0169
"°o"Ess: 10190 IMPERIAL AV •
GARDEN GROVE CA 92643
ucExSEo LONTMLTOR DEcuMnOx: I nereM affum tlut I am ficensea uneer w�ons al Cnapter s(�mmendnp wltn Settlon
7000) oi Divisian 3 al t�e Busi�rcss anE Protessiau Coee, an0 my Ikenx is in tull torce an0 ettect.
cmuc.:050106 $TpTEUC.:SH3iO4 B /%
Date: �—�- �Q SipnaNra: � -�'��' ,�j.+�C.r �
WONKFRS' COMPEN811TION OECIAMTION: I here0y attirm Ihat I Aave a aNliwte at m t to utldnswe or a certiflpie ol Worken'
Compensatan liuuranc r a nilie0 py IMrmi (Sectlan 3800, �aD. C�.
raucr xo.: 118 ��J 2�— 9� �cv. oere: 0 3/ O 1/ 91
tornr�Hr: STATE FUND
❑ Cer6fieE copy is �ergpy tumis�etl. � CeN/ieE coDY �s fleC with Iha ciry BuilOinp OiWsian.
ete: � � MD���
[xcramox max woxx�xs• eorr[xs�nox oEamuTmx: (ms sea� ceea nw ee �pnee n um� e i« me mudaa (s�ao� a kss1.
i ceniTy tna� in ure ce�ormance o� me work ia wnicn rtia uermn is iswed. i shau wt empby an erson m any manner so u �o eecome
SuEjeci lo ihe Workers' Cpmpe�atbn Laws of Califomia.
Date: Sipnature:
NOTICE: If, atter maltinq Nis UeGaratlan, you 5houlA Cawma su01� �a ��e Workers Comperrsatlon proWsions ol I�a Labor
COOe, you must lonl�t� camDN ��� suc� proNswns or IAis permit s�all Oe EeemM rewke0.
fANSiRUCTION 1EN01NC �GENCY: 1 �eaDy atfirm tAat Ihere 5 a wnsiruction IeMinA apenry tw IAe peAormanre a� Ue work lor
wfucn Mis 7ermif 6 issueE (5ection 3ar7. Crv. C1.
lFNOFR:
auoxcsa:
CITY OF COSTA MESA — BUILDING PERMIT
PERMZT NO: M 048015 PLAN CHECK NO: N
CONSTRUCTION TYPE: 2—N SPRINF PERMIT TYPE: MEC
JOB DESCRIPTION : 900SF INDUSTRIAL BUILDING
CLAIM VALUE: CALC—VALUE:
PERM NO: M 048015
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT;
GROUP OCC: H-2 /
COMMENTS: RE: 846378 PRIMARY BLDG. PERMIT.
*�r�r**�**�e*x#�r+��x*���r��e*�r***�r**�r#�e*�r*�x��+�**���r*�*+r��r*��e+r*�r*�r�r*�x*�e*�t*rx�****�***
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 $UILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKZNG REQ: PROV: PARCEL: 42408129 ZNE: REF tJO:
PLANNING NOTES>
>
-1t ik iE fE �E iE it ik iE if 1f ?f if iE iE �1E?E if iE if if iE if iF iE if !f if if 1E �E iE iE �1(� iE dE iGlE�k`f iE it iE i! it iE iE iF i! 1E 7F 1E iE iE iE if ff iE if if 1F?4 i! fE iE if iE iF iE ik 3(� �E if �f iE fE �f �f 1E
D E V E L O P M E N T S E R"V•Z;.0 E S R E Q U I R E M E N T S
ZONING APPROVED BY � � DATE:
BUILDZNG APPROVED BY ; !� '�1 DATE:
APPLICATION ISSUED BY: B�Gt�.., DATE: %-3 "'"%i
ififiE3fiEifiEifiEififiEiEfEdt�FitiEiEiEiEitifiFiEufE .it `sF •I fE�E�xiEiF3Ft'iFiFifif='iF3F'iFiEiEiE�fifiFifiEifi�?FiFiFiE
df iE iE iE 3f it if if if iE iE dF 7f it iE if i4 iE iE iE if iE iE iF k'E iE 3F i4 iE iE iE if iE iE iE i! iF iF ik iF iE(/ iE iE 1t iF if iE if S iE iF 9f i! iF )E if i(-iE if iE 1E 1k fE if if iE iF iE iE if- if if #t if if if iE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
OWXEPBURDEBOECIAh11TI0N: Ihero6yaKrmWtlameuempttmmiMCantractors'State�iansa�awiarme�000winareasan BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
(Section I037.5 Business an0 Protasianal Cade: My dry ol wunry wtricn requires a permil to cmutruct, alter. Imprwe, Eertansh, m p ERM I T - 2 5. 5 0 � �
rcpair airy struciure, pAar ro its issuanu. �iso rzV�as Ihe aOWican� lor wc� perrtnt to (tla a 5i0�� statement �Aat trJstu is IicenuE
pursuam ro Iha Drovisions oi ttia Cannclors' Sute License Lrx ICImDier 9(commeMfnp wit� Sectlon 7000) ol �NNon 3 0l t�e Business , 2 S i S M I P/ NON — R E S
anE Pmfzutore Co7e) or that MJs�e h ewemD� ��mlrom an0 IM Easis for tM alkpe0 exemptbn. My violaiion ol Sectlan 7031.5 Uy P L AN
any applicant lar a Derm11 subjects I�e appliwm ro a civll DenLry oi not mom ��an five hundreE Eollars (5500�. I S SUE FEE S S. 0 �
� as owner o� tne propeM a� m'/ emWoyees witn waqes as meir swe wmpensation, win do me ww�c, and me BUILDING-DIV-> PERMIT ISSUE PLAN-CHECFt TOTAL PAID DUE
❑ itmcture 6 not inhneea or otteao lor sale (Secibn 7oaa, Businass anU Pmlessionai COEe: 7he Cantractors' Sute Lkense Law TOTAL S---- > 2 S, S 0 1 S. 0 0 �. 0 0 4 �, S 0 4 �. 5 � . � �
Ooes not apDH lo an owner ol � D�D��Y � �u110.5 or Improves I�ereon, aiM wln Ooes 5ucli vrork Mmutt/Mrsdt ar thrwph
Iris a �er ow� empbyees. provWed that wcl� improvemen6 are not inieMeE or oflera0 Ia s�le. It, Aowever Ue builtlln0 or R E V£N U E D I V I S I ON TOTAL S--> COL L EC T ED ; 4 0. 5 0 OI�ER / S HORT : 0 0
improvementlssdOwittdnaieyearoicomdetion,lAemimrxill�avetheCUNenofDroNnyM/slcediGnot0uY0wimprove bLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
for Uie WNOse ol sale).
� I, as owner ol tne properry� am exclusiveN wmracunp wiU fcenua contractors m wnstruct Ne D�oiecf (Seplon 7044, Business 4 0. S �
❑ aM Professions Cotle: Tlro Coniractors SGte Llunsa Law Eros not apDN �o an owner ot praperty wtw Eui1Q5 ar imprwes Nereon
anEwnowntaqsforsucnPml�tswn�acrontactorls)Ike�epursuanitatMContracmrs'�uteUcenselawl.lamaware iE?EiEifiEifiEiEiEiEif#iEifitMiEikifitiEikif�7E�EiEififififiEikifitifftifiEitiEiFiEitiflFiEiEifiFiEitifitakikiElEltlkifikiEdfiE�7kiEikibit.�.kia.�i�iElt+,E.x.iE
tlut prooi ol IAei� Warker'S Compensatbn msumnce sMUM De D��� �o ^'�� j N D I V I D U A L F$ E B R E A K D O W N
� I am exempt unQer Secllon: B. 6 P. C.
?ormisreuon: TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
Date:
Owner.
I Oo here6y artiry lhal 1� aware oi antl unEersnnE W repuiRmeirts af Califomia MeaIN arttl Satery COEe Secfiom 25505, 2557J, and
255J4 anE tlul I or airy i�ua MCIEmO �upam vrilllwNl irot (drUe one) rxM to compy with uiE sWte aOa anE ttre repurements lor a
permit tor conStruUion o� muEituatlm iram Ua tir �ua ily Manapement D'atAq. HeSiEmtial cansirucllon appliwtlmis are examDt trom
thesa Ormtitia5.
Date: � ApDlitant:
I �ereby ceNty that I tave �¢a0 ttus apD�lwtlon en0 stata t�at tAe aEow Inbrmatlon h correcL I apree to comply wli� all ciry anA counry
orEinancg an0 state Wws relatin0 to EuiMinp wmtruclion aiW he2UV a��� reO�taliva oi this ciry to enter upon tire a0ova�mentloned
prapeM �w inspectbn Purposes. /�/7 e
OdIO: �_�~ �O $17n2NR: ,%%%AI�A�G�I���
Oriver's �icense or Soc�a� Secudry x: /I
18�1.48 NTits-BUIIEi�: GrserCoOe Enlacemanl: Cenary-/�pplltant:
�i01�MlO�-A}�!!Wf
MEC
MEC
1 GAS PIPING SYS 1— 4 OUTLETS ' 3.00
1 INST/REL ABS UNZT 501-1000 K BTU 22.50
END OF FEES
�
i
3.00
22.50
/
01 �D0644o7—OQ0644b7 �'O T 40.5(t
�hTE� 07/Q3/90 iIi9c'- 34:35
� COfJSTRUCTION AND PLANNING POOL �._rA
' Date Inspector Date Inspector
APPROVALS Permit # APPROVALS Permit #
7. Temporery Electrical Service or Pole � 52. Pooi & Equipment Location '
t
�� 2. Soi`Pipe•Undrgrnd. "' 53.�Steel fleinforcement �
3. Elecirical Conduit Utility�Undrgrnd. 54. Forms ,�
4. Electriwl Conduit-Undrgrnd. . 55. Electrical Bonding -
5. Steel Reinforcement 56. Rough Plumbin9 & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation �, � 59. Gas Pipe, O Undrgrnd., Test ,_
9. Water Pipe�Undrgrnd. � �:� 60. 8ackwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System - - 61. APPROVAL TO DECK �
17. Property Sewer Line & Hduse Connection .. " � 62. Backwash & Receptor•Final
12. Sewer Cap .. 63. Heater & Vent-Final
13. Roof Drains �-� 64. Plumbing Sysrem � Final '
14. Rough Plumbing • 65. Electrical•Final
75. Rough Electrical�Conduit - .- 66. 'Solar SYstem�Final ��
16. Fough Electric Wiring � =} 67. Fencing & Access Approval (�
17. Rough Wiring Sign �, 68. APPROVED FOR PLASTERING
18. Rough Electricai-T Bar Ceiling 69. POOL/SPA SYSTEMS F INAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIR�EMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Dutts, 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 Chemiwl
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. FINAI INSPECTION
32. Electriwl Power Meter-Final :.� � 80. FOOD CERTIFICATE ISSUED
33. Final Elec[ric I i Notes:
34. Final Heating & Air Conditioning -' 7o O� �j�
� �V
35. Final Gas Pipe-Tes[ 7� ���• �
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 Irriqation SYst¢m
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48. FINAL PLANNING . �,
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co ���
51. CERTIFICATE OF OCCUPANCY
No. Date
�
0
PflQ1Efi �ODflE3&: "] j z W 17 TH $ T
owx�q•$x�Me: THE GAFFOGLZO FAMILY META
' �ooxess: SAME
.it .
650-9466
RflCH�NGINEEP:
�ouxess:
NE6.N0.:
uxrt: p
uxn:
n�"MrtrcE: A.S.A.P. FIRE PROT, (213)327-0160
"0o"E�: 113 E SAVARONA WAY
CARSON CA 90746
110EN5ED COMMCTOfl DECIAMTION: I nereby atlirm tnat I am IicenseE wEer prpvLsions ot Ctupter 9(cammencin0 ��� Sectlon
70001 a� OivLsion 3 of Ne Buslness ana Professlons CoAe, and m Ilcense is in tull lorce anE allact.
cirr uc.: 0 4 I 9 9 8 gTATE UC.��3 �� cuss: C— I 6— /
: —�_�r�F P Sipnatura: � . /��+. �;/��+, �
IKEflS' COMPEN311TION OECIAMTION: I IureO atlirm that I luve a artiticate al conxnt m sGbinsyra pr a uNfirate al Worken'
wmpenSatlon Inwranu a a ceN14E copy thereol �Sectlon 3800, LaE. C�.
roucrNo.: BWC203736 ucr.oAre: 04/01/91
cornr�xr: H I GHLAND S
� CeNtietl mpy's �erMy IumislceA. � Cerlifle0 mDY �s �ileC with Ne ury BuilGinp Uivisiw.
�ete: �O � �'"r_ `� Applicant: " � � ' � `-"�`�
IXEAIPfIOM FliOM WOflKfl6' COMPFNEATION OELUIINTION: (iNs sec6on MeE nd Ea mmyeKO tl IM pertil'a fa ane InMaE (510D) a less�.
�� I ceriiry t�a� in t�e pertarmance oi Ne work for whk� tMs permit is isSueE, I stu� not emqoy arry person in arry manMr so az ro Eemma
� suDject to tne WOM1ns' Compensation Laws of CaHfomu.
Date: - Sipnature:
N07�CE: II. atler maldn0 I�is Eedaration, you 5�ou10 Oecome su6ject to [�e Workers' Campensauon Dravisiom at I�e Lahor
COGe, you must IortAvnU comDN ��h suc� provisions or t�is permil s�all Ee EeemeO rewked.
CONSTqUCTION 1FN01N0 �OENCY: I hereEy aXirm that there Ig a coastmction IeMinp apency lor t�e pertormance al I�a work lor
which IAIs permitis issueE (Sectlon 3097, Gv. C).
lENOER:
� RDD(fESS: �
i ,
OWNER BUIIDER UELUHIITION: I �ereby aflirm Itwt I am exemp� Iram Ne Cont2ctors' S�te Liu�se Ww lo� Ne �oDowinp reason
(Sectian 703t.5 Busine55 aM Professbnal COCe: My dry ol counri �n repuUes a cerrtut to mrsiruct. altu. Improve. eamolisn, or
repair apy struUuro, prior to its isswnce, also repWres t�e aDDticant lor such perMt to lile a slpneE sbtement Itat Ire/sAe Ls IlcenSeE
nursuanl Io ttro 0�� ol tM CantruYors' State License Law (COaD�er 9(commendn0 �� �� ��) ���o� 3 0l the Businass
� Vrol¢ssions COEe) or Ihat nUSM is eaemD� 1�erefmm antl 1�e Dasis for t�a allepe0 ezemD���� �Y'�atlon ol Secdon 7031.5 hy
appliwnt for a permll suEjxis tAe apD���Ent to a civil Denalry of no� mom ttun Ilve �mMreE Eollars (f500�.
I, as armer ol the Droperty or my emyloyees wlt� wapes az ll�eir 5ole compe�ation, will do the woh, anE the
❑ sWcture ¢ �wt inteMeO or offered lor sale (Section 704d, Business anE Prolessbnal COEe: 71ce Contrzqws' Suta L'¢ense Law
tices mt appy ro an armer al a property wM Eullds or imDroves ttcereon, aM wtp dces wcli work NmulUtierseli or tnroup�
1N5 OI 11GI OWl1 GI�pIpyEES, plONOLD I)ld1 SllGI ImD��'��� a%B M1I NIEIIOM OI 011E1E� l0I SdIG. Il, MWpYlI fll! DIl)IGIINJ W
imD�� a��bn me year ot mmDktbn. the owner will tave tM burCen o1 D�9 �1she NE no� EuiM w improva
,� lor Ue Ourpose of yle).
I, as owner oi flu property, am exdusiveN contractinp wltA Gcense0 canvacmrs ro wnswcl Ne project (Sectlon 704/, Business
I❑ antl Prolessims Catle: The Caniracrors' $Wte Ucense Law dces not appry lo an oxner ol D�Oerry � DuiWs or impmves thereon
and who wntrac�s Iw suc� prolats c{ih a contractor(s) Ilcense Dursuant to t�e Cantactors' State �kense Ww�. I am aware
Wt praoi ol Uelr Warksr's Compens,F� insuance s�aultl Oa pro�CeO ro me.
� I am ezempt under $ecfion: B, 8 P. C.
lor this reasm:
Uaro: Ownec
I Co �1CreEq ufliry WI I am awdfe ol a110 u11dErsIaiM tM repuiromenb ol CalifoMa HBaI(n aM $dlery COEB $eCtlonS 25505, 25533, anE
2553e anE ttwt 1 w mry Imua EUWInO accupant �xilVwlll n�t.(cirde one) rrcM ta comply wit� saiE state cotles anE Ne mQulrements lor a
permit lar mnstrudion or mpEitlalion Irom the N'r Oualiry Manapement Gstdct. Fle510enUal constmction applicatlons aro eHemD� �rom
these provhions.
Oate: Nppliwni:
� ncreey certiry ero� � Aaw rcaa tlns appka�im ane sute enat me �oova m�omuuon is mnen. i�pree m compy wrcn au dry ana counry
oNinanas aM siata laws 21atNp ro M�AAuip minin¢Um aM �ert0y amlm� represmhtivp o1 Nta tlry ro mter Wm tte a0we-mentbmE
uroVeM for irispectbn purymes. J� �
DatB: G � �� SiOnatura: � • � � `�
od�ers uunu ar saim sec�r�n x:
18n1�d8 WMto—BUIMinp; Grear�Cotla Enlorcemen�: Canary—Ppplkant: Pink—Revenue: GOltlanro0—Mxswr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 047879
PERMIT NO: F 047879 PLAN CHECK NO: 04272-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE: FIR PURPOSE: ALT
JOH DESCRIPTION : 375SF SPRAY BOOTH SQ FT:
CLAIM VALUE: 700,00 CALC—��ALUE: GROUP OCC: B-2 /
COMMENTS:
�+e�r�r****��r*��r��r��**�r*�*****x�r�r+�+r�**�r*�rx��rx�r�r�r�r*�e�x***�r�e*�r�e**+r�r****�***x+r*****x**
Z O N I N G R E Q U I R E M E N T S
S E T H A C K S
---------=-- MAIN BUILDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR; FT IN . FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; -FT ZN
PARICING RE • PROV: PARCEL: 42408118 ZNE: REF NO:
PLANNING N�TES>
>
ititat�*it�e��ratatit***ititie+r+r+rit�rif**itititatat�*r���r+tatititit��r*atit*�atft�*�at*it�**�r�*****at�at*et�et�t****
D E V E L O P M E N T S E R C� I C E S R E Q U I R E M E N T S
ZONING APPROVED BY .
HUILDING APPROVED BY :
APPLICATION ISSUED BY: � /i
it 1f �k �F iflf ik if k it ik i! i! iE k fF if if if it iF k� F3F3F
it itli iE iE iE ik iF ik j! it it iE iE it if i! it ik it if it iE iF 1E iE �f i! 7E it k iE 1k it it it ik if at it ik if
LEGALIZATION:N F E E S U M
bLDG PMT PLUMBING ELECTRIC
PERMIT
PLAN
ISSUE FEE
DATE:
�_ DATE: � �� G
� DATE: B,��F��
iF'3F3F iFiFiFiF3FiF3kikiEikiFlkfF3fjfitiF iEib
iF iE it it iFlf !E iE 1E k �F iE iE iF if iF ik if iElf jE iE �Elf it if it if iE iE iE iE iE iE
A R Y STRUCTURAL SEGMENT;N
MECHANIC FIRE SMIP/RES GRADING
19.00
652 SMIP/NON—RES
12.35
HUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 19,00 0.00 12.35 31,35 31.35 .00
REVENUE DIVISION TOTALS--> COLLECTED: 19.00 OVER/SHORT: 00
BLDG PMT PLUMBING ELECTRZC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
19.00
iE 9! if iE 3E it iF iF jk it-k IE 3F iE dt it iE jEif iE-lk iE 1E aF iE iF if jt-%iEiE iF iE aE iFik aE jE �lE 3kit ih df �IE iE iF if �F if 9f a! ikif if if kiF iE iE iE if iEiEik iEiF IE 3! it iE iE �)F iF 9E 9E it 3E iE 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 D E S C R I P T I O N UNIT COST TOTAL COST
FIR 19 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1.00 19.00
END OF FEES
01 00063837-00063+337 T�J g Z9.�0
DATE: Q6/25/90 TINE: 12:01
• CC�NSTRUCTION AND PLAI, .G ' POOL .._.PA
' APPROVAL5 Permit� Date Inspector qppROVALS Permit# Date Inspector
�:
i. iemporary Electrical Service or Pole • - 52. Pool & Equipment Location .
2. Soil Pipe-Undrgrnd. � 53. Steel Reinforcement
3: Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit�Undrgrnd... � 55. Electrical Bonding '
5. Steel Reinfarcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. . 57. APPROVAL TO COVER�GUNITE
7. Footings , 58. Electrical Conduit�Undrgrnd.
8. Foundation ,�- .� 59. Gas Pipe, O Undrgrnd.. Test �
9. Water Pipe-Undrgrnd. � - 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
71. Property Sewer Line & House Connection 62. Backwash & Receptor�Final �
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical�Final
15. Rough Electriwl�Conduit � 66. Solar SYstem-Final
16. Rough Electric Wiring 67. Fencing & Access ApP�oval
17. Rough Wiring Sign � 68. APPROVED FOR PLASTERING
18. Rough Electriwi-T Bar Ceiling -� 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace -APPROVALS Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating � 71. Product Piping OGas ❑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 t,��� ��
29. Insulation '� � � .ZQ
��� � 78. FIRE PREV. FINAL I �
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coai ,� �. 79. FINAL INSPECTION
32. Electrical PoWer Meter-Final 'c%, 80. FOOD CERTIFICATE ISSUED
33. Final Electric � ' � Notes:
34. Final Heating & Air Conditioning � ,
35. Final Gas Pipe-Test � • '
�• '
36. Hood or CanopY �� f'�,
37. Final FactorY Fireplace y��'.
i
38. Final Plumb��9 / �
39. Water Service-Final �
40. Gas Service-Final
41. Solar pomestic-Final
42. Backflow Preventer '
43. Batkflow Irrigation
44. Landscape Irriqation System �
45. Sound Attenwtion
46. Handicap Re9uiations ,
47. FINALSTRUCTURE&BUILDING /�;,,,
48. FINAL PLANNING
- !
49. EleMric Release to Edison -� '.
50. Gas Release to Souther� California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date
PXOJELT FOOflESS: % 3� W 1 7 TH ST
OWNEfl'S NAME: METAL CRAFTERS
nooness: SAME
969-0169
AflLHIENGINEEfl:
ADOflE55:
flEG.NO.:
uxir:
UNIT:
PENMITTEE: f'jTIxLDER GAOUP ( 714 ) 969-0169
ROONESS: ).U�9O IMPERIAL AV
GARDEN GROVE CA 9269J
LICENSED CONTflFCTOB DEC�pppTION: I �ere0y ai�irm IM� I am licerttetl untler provisians al ChaD�er 9(commencinp with Setlion
7000� ot Orvision 3 otlhe Business and Professons CoOe. anJ rtry IiRnie is in lulllorce antl eftect. �
cirvuc.: 0'0106 STRTEIIC.:�8370 cuss: B
oaic. — / Sionature: — —�
W08REB5'COMPENSR710NqECLAMTION: I�ereGyaflirmttutltuveacenif eolconsenttoseli�insurearacenilicateotWorkers'
Compensation Insurance, ar a c¢nifiea copy inereof (Section 3800. Lao. C).
POLICY NO.: E%P. O�TE:
COMPANY:
�..� Cenifie0 copY �s �ere�y lumishetl. ❑ Certilietl copy ¢ IileO mtA tAe ury BWding Divivon.
I
le: ApPliwni:
E%EMPTION fPOM WONKEHS' CpMPEN$RTION OEC pTION: Rh¢ settion neeC iwt h� campkte0 i� N¢ pe�ml is ta Me huMretl (5700) Or Ie55�.
I tetlilV I�al in the perlormanc¢ ot lh¢ work Por �hic� t�¢ Oerm� is i55u2a. I shall no� empl Y Oe�son in any manner 5o as fo �ecome
su�lem to t�e Workers' Compensation Laws 1 Calilomia. ry ��
�ate: /�' S/ ~ �� $i9nature: ! /�%i �
NOTICE: If, af�er making ihis aecWration, you sMNU Oewme suCject to e WOAers' CAmOe��ion prOvi5ion5 a7 ��e Labor
Coae. you mus� �orlAvnlA comply vnl� suc� O�ovi5ion5 or l�is perrttit 51 II De OeemeE revokea.
CONSTNUC710N LENUING RCENCY: I nereEy atfirm Ou� t�ere is a construciron Imding aAen�y for �Ae peAormance ol t�e vrork for
wnicn mis Dermit is issueJ �Sectiw 3097. Civ. CI.
LENOEfl:
nooness:
OWNFB BUILOEN DECLAB�tION: I �ereby atlirm tlwt 1 am exemp� tram �he Coniracrors' State License Law lor ��e tolWwinA �eason
(Sec�ion 7037.5 Business an0 Prale55ional COtle: Any cily al counry whkh repuiRs a Oermii Io conSiNcl, aller, imD�ove, tlemolish, or
repair any siruclure. prior to Its issuance, aita requires Ihe ap0licant lor sucA Oermil to lile a siqne0 slatement ihal �elshe is Iicense0
pursuam to ine provisions ol ihe Coniracmrs' Slate license Law (ChaO�er 9(commencin0 ��� Sec�ion 7000) ot DNision 3 0l lhe Business
antl Pmlessians CoOe) or �ha� pe/s�e is exemp� Neretrom ana ��e Oasis for tAe allegeE eremption. Any violatian of Section 7031.5 by
any apDlicant lor a permit suhjecls ine applicanl lo a civil Oenalty ol not more Nan five nunCreO tlollars (55001.
I, as owner ol ine D��oeny or my em loyees vn�n xapes as tneit sde wmoensation. will Oo ine wofn, antl Ihe
❑ stmcmre is noi intena¢u or oueretl lor sale I�tion 70<a, Business anA Pmlessional COUe: Tne Contramors' Stam License Law
does nol aODly lo an p�er af a proDeny wlq �mlGs or imOrw¢5 iheaon, an0 wM Eoes suc� wOrk tlimsell/�ersell or tAmugh
nis a� ner Pxn emplpy¢¢s. o�ovi0¢G tlWt suCn imprwemenls a2 flot intentle0 ar oflere0 Im Sale. II, AOwever lne Euiltlinp ot
' imO�Ov¢menl i5 wIC wl(hin one yeat 01 wmpleli0n, I�e owner wJl tuve Ihe OurOen 01 O�ovinp �c/she Eid n01 6ui10 Or imD�ov¢
lor Ine pw0ose al Sale�.
I. as owner ol tne pmp¢hy, am exclusivery convaninp wit� IicenseC mntracmrs m consimct t�e pmject (Section 70e4. Business
L] ana Pmfessions Code: The Contractors' Siate Licrose Law Gces m� appty to an ovmer ol D�ope�Iy wAo �mWs or imprmu t�ereon
I an0 who tonVatlS lo� Suth projttl5 K71� a CMIIratla1�s) IiCtnyt Our5Wn1 �a IIIB COntrat�ofs $Iai! LitenSe Law). I am awar¢
Inat pmol ol Iheir worker's Campen5ation insurance slwul0 G¢ pmvidetl to me.
� 1 am eeemD� untler $ection: 8. 8 P. C.
lor Ihis rcason:
Ua�e �wner.
I Uo Aereoy ceniry inai I am aware ol anU unEemana i�¢ repuiaments ot California Healt� anA Safery CoGe Sections 25505, 25533, ana
2553< an� Inal I or any fuNre buileing atcupant wilUxill not (drNe One� nee0lo comON `^��� �b slate WAes antl ihe repuiremenis lor a
p¢rmii br canslmction or mppificalion Imm Ihe Air Oualily Manaqement D'¢trki. flesitlenlial construtlion a001icalions are e�empt imm
I�es¢ D�ovisions.
oz�e: M nc
I nereoy cenity iAai I nave reaa tnis aDPlicaY anA Slate Nal I�e aOovE in�ormaliwl 6 corr¢CI. I apree Io tomply Wi�h atl tiiy anU toUn�y
ot0inancM antl state laws reW�inq 10 ONWin iNctqn aM Ilereby aullpfRe repreSCnldlivR of IhiS dt to en�er upOn IhE above-men.tible0
O�oOeiry �or insDec�ion Ourpp5e5. " // �
� ////
�ale: ' SignaWre: '�% ����[.
onver's llcense or Socu� Secu�iiy x: �
1641-46 W��ile—Bmbing: Green—CaCe Enlorcemem: Canary—Applicanl: Pink—Revenue; GOltlenro0—Assesmr
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: B 05487i
PERMIT NO: B 054877 PLAN CHECK NO: 04552-91 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT.TYPE; STR FURPOSE: ALT
JOH DESCRIPTI013 : INSTALL 5 CEZLING FANS, S SUSPENDEA HHAT SQ FT: 5,300
CLAIN, VALUE; 3,500,00 CALC—VALUE: 3,500.00 GAOUP OCC; H-7. /
CUMMENTS: X
*� x �� �r �*x*��+��*+r� �*x�*�� x+��**�**��� **�r*� *�*******�+t+�*xx�*��***+t*��c+�*�c rt*�*�*��t***
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 BUZLDING ---------- --------- ACCESSORY HUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REU• PROV: PARCEL: 00000000 2NE: REF NO:
PLANNING 21(5i'ES>
>
i4 i't if iE i(� iF 3f if iE 3E if 3F af ie 1F if iF iE iE 7F if if iF 3F fE 3f if 3E if it-1P iE iE �)f if if 1f iF if if lf if K if -I6 if 3i� IE i4 if 4f iF 1f IF if if 3E 1f j4 # IF if iF if if if if ii IE 3E i%�e if If if �F if IF if
D E V E L O P M E U T S E R V 1 C'� S R E Q U I R E N E N T S
ZONING APPROVED HY DATE:
BUILDTNG APPROVzD BY : DATE:
APPLICATIOh ISSUED HY; DATE• ���
iEiEiEi(�3E3E�FiFiFtElEit±ti��3(-3c3EiEiElfiFiE FiF�F�iFiFTF�rlF3ciFx��?fiF3fic�kihRuiF3c7F£ 7��1i-3C�
3P �7f if iE if K �ElE fE if iF ii iE iF if�� iF 1E %iE iE if ih iE iE !6 if if iF if iE %iF 3E iE iF it iE �lE af ii fE If iF af #- i'r ie if iE �k af if aF if 3i iE 3F if i41F iE if iE 1E iF �f if �F K ie 3f �lE if s�1F ii� 3F 3E
LEGALIZATIOh:N F E E S U N, N A R Y STRUCTURAL SEGN.ENP:Y
..,
SLDG PMT PLUMHING ELECTRIC MECHAh3IC FIRE SNIP/RES GRADING
PERMZT 63.00
SMIP/NON—RES
PLAN 40,95 ,74
ISSOE FEE � �'�
BUILDING—DIV—> PERMIT ZSSUE PLAN—CHECH TOTAL PAID. �� DUE
TOTALS----> 63.74 0.00 40.95 104.69 1QA;,69�'- .00
REVENUE DIVZSION TOTALS--> COLLcCTED: 104,69 OVER/SHbRT:�'•', .00
BLDG PMT PLUMBING ELECTRIC MECFIANIC rIRE SMIP/TOT GRADING PLAN—CHECK
63.00 ,'79 . . 40, 45
iF if 1M1 if 1(• 1F 1E if 1f 1f )E 1E if' 1E iF IE it 1d 1F if ik ie if iE i(' iE±f 1f ff' 1f #E if +f 1k 1F IE iF if if iF 1(' if 1E iE if If iE if !(�'If �f"1F 1!' 1! if i%1f� �X if iE if if if if -0F.�i(� if i@ iF iE if iF i4 +�iF ii i!� ib if
I N D I V I D U A L F E E B R 6 A K D O W N T
TYPE QTY D E S C R I P T. I O N UNIT COST ��� TOTAL COST
SFC 3500 ALTER BY VALUE �CO�ENDROF�FEES�OZONE 1,00 3,500,00
�' EXPIRE�tion�
��omp�ete Insp�
� $ig Y-�"
t?atE �
�
J
�: CCla`'� =�"���t;_c _.. _. . �;
f.:TL iT/t7i�2 '�:,_ .�� .
CONSTRUCTION ANDPLANNING POOL 1
APPROVALS Permit # Date Inspector qppROVAIS Permit # Date Inspector
1. Temporary Electriwl $ervice or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. ' 53. Steel Reinforcement
3. Electrical Conduit Utility-Untlrgrnd. 54. Forms
� 4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Elec[rical Conduit•Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe-Undrqrnd. 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor SYstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap 63. Heater & Vent-Final
73. 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 ApU�oval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Etectriwl�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning fIRE DEPT. REQUIREMENT
20. Rough Fattory Fireplace APPROVALS Permit #
21. Ducts,in Struc[ure 70. Underground Nydro
22. Ducts, Ventilating 71. Product Piping � Gas ❑ Oil
23. Gas Pipe•Rough & Test 72. Underground Flush .r.i
24. Roof Framing 73. Undergrnd. Storage Tank O Gas O Oil _ �
25. Roof Sheathing � 74. Overhead Hydro � r
26. T�Bar Ceiling (Strucwral) & Monocoat 75. Ory Chemical .-
27. Frame and Flashing 76. Dry Standpipe '
28. Lathing & Siding 77. FIXED SYSTEM FINAL �
29. Insulation � � 76. FIRE PREV. FINAL �
30. Drywall Nailing I HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final . 80. FOOD CERTIFICATE ISSUED '�•�-
33. Final Electric • - Notes:
34. Fina� Heating & F,ir Conditioning
35. Final Gas Pipe-Test ��
� .
36. Hood or Gnopy �
37. Final Factory Fireplace _ � �
38. Final Plumbing ' �
39. Water Service�Final � �
40�. Gas Service�Final '
. 41. Solar pomesticFinal . � �
42. Backflow Preventer � �, , '
43. Backflow �rrigation '
44. Landscape Irriga[ion System .
45. Sound Attenuation E-X-P-1"R-E'D
lncompl te_Inspecllons
46. Handican Regulations
� - '�
47. PINAL STRUCTURE & BUILDING te --,�B�
48. FINALPLANNtNG
49. Electric Release to Edison • �
50. Gas Release to Southern California Gaz Co �
51. CERTIFICATEOFOCCUPANCY
No. Date
Pfl0.1ECT�DOflESS: ']3Z W 17TH $T
OWNEfl'SN�ME: THE GAFFOGLIO FAMILY META
n0URE8S: $�E .
650-9466
RRCNIENGINEEN:
ADOflE3&:
HEO.NO.:
UNI7: B
uxrt:
PEHMIREE: BUILDERS GAOUP ( 714 ) 969-0169
�ooeess: 10190 IMPERIAL HWY
GARDEN GROVE CA 92643
110EN5ED fANTMC70R OECIAMTION: I �ereEy affum Wt I am Ikensc0 unOer pioNsbns of C�apter 9(mmmenUnp wIN Satlan
7000) of Division 3 al t�e Busineu an0 Profestions CoEo. anE my Ikema is in lull lorca anE elleci.
cirr uc.: 0 5 O 10 G $Tp7E IIC.: S H 3�I O 4 �� H
�ate: �0=�.� � Sipnatura:
� �11IENS' COMPENSATION OECLAN1710N: I hereOy ailirm Ihat I have a certilicate of m s t to sett-liuure or a certitiwte o1 Workers'
ptnsali0n InSufance, or a ttrtified coDY ��eteal (S¢cti0n 3800. LaO. C).
.�icr No.: 118 2 3 2 5- 9 0 exv. o�n: 0 3/ O 1/ 1
cornvnxr: STATE FUND
❑ CenilieE copy is nereby fumishe0. � Cenified copy z fdW x8� tlro dry BuilOinp OM1isian.
oate: � - -' MnrManc A 1'?�A�1 .m� .it� /
IXEMPf10N FROM WONKEHS' OMPFN3ATION OEqAMiION: (iFa uctlm neU not Ee ampM � Ne R�� b la are ImMaE (5100) a las).
I ceNty Nat in tne peAormance of W wark fw wNN N¢ permit 515weE. � slull rot empbY NY De� ��y �ner m az to became
suGl� ro iha Workers' Compensation Laws oi Califomu.
Oate: Signatum:
xOileE: 11, aher maVinp NB Cedaralm, you SMNE Eem�ro wqect ro ttro wo�kers' Compemation prmis�ons oi Ne Labor
COEe, you must IarthwiU camON wIN such pravitina or Uus permit stiall Oe Eeemetl rewketl.
CONSTRIICf10N LENOINO IIGENCY: I �ereby affirm tlut thea is a castmction ImOinp apera.y tw tAe pertormance ol tM xrork lor
whic� tAis permit Is iuuM (�� �7. Civ. CI.
IENOFfl:
RDOPESB:
OWNEP BURDER OELUMTION: I �ereCy aKrm ttui I am ezemD� ��om lAe Conirapors' S�ate Licenu Law tor the I011axin0 reason
�(Section 7091.5 Business anE Pmfessional Code: My tiry ol counry wAich reQulres a permit lo consirud, alter, Impmva, Eemolis�, ar
re0air any slmcNre, pdor to Its Iuuance, alm requires ��e aDDlicant lor suc� Dermlt ro lile a s10�� statement I�al �Us�e Is Ilcense0
pursuant to the D�a�ons ol �M Contrndors' SUte License Law (Gupter 9(commeraln0 �N Secflan 7000) oi �Wision 3 at IAa Business
antl Prolesslons COAe) or I�at �Us�a is eeempt t�eretmm antl I�e Easis far Ne allepe0 exemptlon. My vialaiion ol Sedlon 7031.5 Oy
w appliwnt for a Derrtnt suOl�s IAe appficant lo a civil penalry ol mt mom Wn INe �uMreC Edlvs (5500�.
I, aa wmer ot t�e D�operry or my em 4yees wit� xapa u Neir sda compenution, wW do the work, an0 IM
J s�mewm is not intenaeo ar ofleree mr sa�e ��eecuon 7oaa, eusiness mE Profnssional COCe: The Con(racrors' State Licanse �aw
oas not appN �o an wmer ol a o�D�nY � oWOs or imo� �M�eu0. �� C�s suU w^rk N"aenmerself a tnmupn
M5 ar her awn emD�M'�u• W�4� �� suc� Improvements are no� Inten�etl ar offere0 for sale. II, however Ue bull0in0 ar
improvemen� B 5dE wit�in ona year oi competlon, tlre mmer vM lim tlro DurOen oi DrwinO MJslie 0iE not OuilE or Imprave
lo� tAa ourpose ol sale�.
I, az awner of Ne Oroperry, am ezUutivelY m�IraNnp vAN Ircen58C contnctors to corttWct Ne DrojecllSectlon 701A. Businass
❑ anE P�alessimn Ca�: The Contactors �tate Licdoe law Cxs rot aDOh/ m en wmer ol propef1y wM bn7as or impro.es Neaon
dnd WM fAfIV2tI3 IOf SUUI pfOjGCIS \�N i CdIIfdC10f(5) IICLM1Y DUfSUMi lD IM �AlltfdClOR $IdtO LILE1158 ldw�. I 2111 3Wdf0
Inat orool al tneir worker's Compemt� i�sunnce 51puW Ee o�oeU to ma.
� I am exemD� �der Sectim: B. 6 P. C.
lor tnts reasan:
Date: Qwner:
I Oo �ereEy certity that I am aware ol aM uMerswW Na reyuiremenu ol Calilamia Mealih anA Salery CoOe Sections 25505, 25533, an0
2553d an0 t�at I or any NNre Eulltlinp occupant vnlUwill not (drcle ona� neaC to compty xit� saiC Slate co0es an0 t�e raQuirements for a
permit lor consimctian ar mo0itication trom t�e Nr aliry ManaOement Distdct. FeslEential wnslmRion appliwtiom are exempt Irom
tAese provislore.
oaie: Aoar�:
I hereEy ceniry Nat I luve reaE tltis apd�tlon an0 SizU Wt Ne a0ove inlarrtutian I5 cortect. I a0� �o comvN �h all Ury antl wunry
ordinances anA state Wws relatinp to Euiltin0 consVuctim aM MreEy aWp� preumatnts ot N's dry o emer upon t�e a0ove-mamionaE
properry lor in5pection purpous.
Oate: G^ Z7 �! O Sipnamre:�J,j_..�qal.__r� ,
oriver': License or Saial Securitv N:
18/1�8 W�itB-BuiMirp; Green-COAe EnlarcemeN: Canary-AVWKem: Gink-Rwanue; GdCenraE-Assessor
CITY OF COSTA MESA - BUILDING PERMIT
PEAMIT NO: BME 047939 PLAN CHECSC NO: 04270-90 S
CONSTRUCTION TYPE: PERMIT TYPE: ELE MEC STR
J05 DESCRIPTION : 80SF SPRAY BOOTH
PERM NO: BME 047939
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT: 2,500
CLAIM VALUE: 2,500.00 CALC-VALUE: 2,500.00 GROUP OCC: B-2 /
COMMENTS:
�r+�***x�*��r**�e��r��r**�e��r�rx��rx*�r��*�r****x�r**�rxx*�r�r���**x+��r**�*x***�+��r�*���r*x*�x*x�**�
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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT ZN REAR: FT SN
LEFT: FT IN RGHT: FT �,ZN LEFT: FT IN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 92406118 ZNE: MG REF NO:.
PLANNING NOTES> ADU SPRAY HOOTH TO•AN EXZSTING INDUSTRIAL BLDG.
� . .
�rit*jtjti�***�at*ftiti�**�+�x�*+rat**�t�r*atx-*f�**.iF*****f�f��r*�r*�-�-�t�tat***at*�r�t*�*�r�*itieatat***x�******at
D E V E L O P M E N T S E'R,V. I C E S R E Q U I R E M E N T S
ZONING APPROVED HY � CC DATE; �
BUILDING APPROVED HY : DATE: • 3-
APPLICATION ISSUED BY; _.- DATE;' G��
i�iElf'kitlflhlfifiEiFiEiEiElE?f�E'lEihklElf ltft!' 'IEiElhdfifi41Fjf14if rt iFif
iliEikifiEifiEiEiFiFiEifiEiEififiEiEiflkiEifiEit�kifiFiEki!�iEifkifiFifiEifitiEiEjEif .1fiEififikifiEifiE�fkiEiEikiEiEifitffiE%ifiE�IkitiF"ifiEifiEif3EifiEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTUAAL%SEGMENT:Y
BLDG PMT PLUMBING ELECTRIC � MECHANIC FZRE SMIP/RES GRADING
PERMIT 54.00 10.50.�' 6.50
SOX! 25t SMIP/NON-RES
PLAN 35.10 ,�,'; .50
SSSUE FEE 15.00-�, 15.00
HUILDING-DIV-> PERMIT ISSUE PLAN-GHECK TOTAL PAID DUE
TOTALS----> 71.50 30.00 :35.10 136.60 136.60 .00
REVENUE DIVISION TOTALS--> COLLECTEA': 101.50 OVER/SHORT: .00
BLDG PMT PLIIMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADZNG PLAN-CHECK
rJ4.�� 25.rJ0 ?1.�J� .rJO
�.
iE iF if if if� i4iF iE i(' iE iF iFih'lt fE iF ii-if ib iF'!f iE if iFif il' jt ih iF ih'll' iE iI"1(' if i%if il' iFiE'il' 1f iF ih iE'%if if iE if ik ih if iF iFiEik if if iE if iF iF iF i4 ih i6 i! i4 iF if'14 ik if'lE iEiF iEif
I N D I V I D 0 A L F.'�E E H R E A K D O W N
J ,
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
� �.
SFC 2500 ALTER BY VALUE COMMERCIAL NOZONE 1.00 2,500.00
MEC 1 VENTILATION SYS NOT UNDER PERMIT EA, 6.50 6,50
ELE 1 MOTOR/POWR APPARATUS �L:1 - 10,b HP 7.50 7,50
ELE 3 FIXTURES, LIGHTING 1 5T 20 EA. .75 2.25
ELE i RECEPT/SWITCH 1�ST Z0 EA. .75 .75
END OF �'EES
! �;
O1 OQ064132-OOOb4135 T�] T 101.50
DATE: 06/^<7i90 TI�iE: 16:43
r
" CONSTRUCTION AND PLANA JOL & SPA
APPROVA4S Permit # Date Inspeetor qppROVALS Permit # Date Inspector
. ,
1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location '
2. Soil Pipe-Undrgrnd. � - 53. Steel Reinforcement '
3. Electricai Gonduit Utility�Undrgrnd. � 54. Forms
4. Electrical Gonduit�Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7. Footings _ 58. Electrical Conduit�Undrgmd.
8. Foundation � 59. Gas Pipe, � Undrgrnd., Test ,
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, � Undrgrnd. '
10. Structural Floor Svstem 67. APPROVAL TO DECK -
11. Property Sewer Line & House Co�nection 62. Backwash & Receptor-Final
12. Sewer Cap � .. . 63. Heater & Vent-Final �
13. Roof Draihs _ 64. Piumbing System�� Final .
14. Rough Plumbing � _. 65. E�ectrica6Final -
15. Rough Electrica6Conduit 66. Solar SYstem•Final --
16. Rough Electric Wiring ,� 67. Fe�cing & Access Approval j
77. Rough Wiring Sign ` 68. APPROVED FOR PLASTERING
18. Rough EleGtrical�T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough 4eating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in St�ucture 70. Underground Hydro
22. Ducts, Ventilating 77. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Fram�ng 73. Undergrnd.StorageTank �Gas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Struc[urall & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation f, 78. FIRE PREV. FINAL
30. Drywall N2iling �� HEALTH DEPT. RE�UIREMENT
31. Plaster Brown Coat •Y 79. FINAL INSPECTION
32. Electrical Power Meter-Fina� ,. ��'. 80. FOOD CERTIFICATE ISSUED
�
33. Final Eleciric t l� �'�, yQ. � Notes:
34. Final Heatin9 & Air Conditioning � � �
.
35. Fi�al Gas Pipe•Test � •, '
y �
36. Hood or Canopy "�� , /
37. Final Factory Fireplace '� , �
38. Final Plumbin9 �,
39. Water $ervice�Final
40. Gas Service•Final
41. Solar pomestic�Final
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape IrriQation System
45. Sound Attenuation
46. Handiwp pegulations
47. FINALSTRUCTURE&BUILDING � L���
48. FINAL PLANNING � � �
49. Electric Release to Edison �!���,���'
50. Gas Release to Southern Calitornia Gas Co .
51. CERTIFICATE OF OCCUPANCY
No. Date
�I
`•�
� ��
PPDIEC1�E58: '�3z V.j 1']'j'j�] �"j'j'
owx: ipME:-THE GAFFOGLIO FAMILY META
,' ess: SAME
� ,-
� �-
650-9466
RRCHIENGINEER:
nooeess:
flE�.NO.:
uxiT: A
uxrt:
PFflMRTEE: BUILDERS GROUP ( 714 ) 969-0169
aooxEss: 10190 IMPERIAL HWY
GARDEN GROVE CA 92643
LICENSED LON7MCTON DECUMTION: I here6y affirm that I am licensetl unEer pmvisions oi Chapter 9(commencln0 w�t� Section
7000) at Oivision 3 of the Business antl Professians Code, and my Ilcensa is in fullforca and effect.
ciTruc.: 50102 � STnTn ^c.:583704 u�
Oatei� `��__LL Sipnatuaj'� �
r,PIIEB3' COMPENSATION OEClAMT10N: I AereEp atfirm Ihat I luve a certilicata consent to sell-Insum or a ce�ifkate oi Workers'
.ampensatlon Insurance or a certifie0 caDY ����� l5ection 3800. lah. C).
voucr xo.: 118 � 3 2 S— 9 0 ocr. oare: 0 3/ O 1/ 91
cornr�Hr: STATE FUND
❑ Certiiletl copy is hereDy fumiSAeE. � Certifietl copY � fileA wli� t�e Ury BuilUing Oivision.
Oate: �� � 2 7 '� n ADDlicant � A n a Y�. i
F%EMPfION FNOM WOPNFRB' COMPENSIITION OECWWTION: (ihis seNan neeE not be co I te0 il the permit Is lor one nunOreE (E7001 or less�.
I certity ihat in ihe DeAormance ol tAe work for w�ich t�is Dermit is issueU, I shall not amp oy any person in any manner so as lo �ecoma
su6iect m the Woders' Compensation Laws of Califamu.
i Date: S�p�ature: '
NOTICE: II, aher malanq IAis tleclaratlon, you s�auld Gecome suGlen �o the Warkers' Compensa6on Drovislons ot Na LaOor
Code, you must farthxilh campy with suc� D�avurons or this penmt stull Ee 4remeU revoke0.
CONSTBUCTION LFNOING AGENLY: I AeaDy atfirm that Ihere is a cansinKtion ImEinp apency for Ihe pertormance al t�e work for
wttich t�is permi� i5 issued (Settlon 3W7, Civ. q.
lENOEfl:
nooxess:
OWNFR BUIIDEB OEClARl1TI0N: I �ere6y atlirm tAat I am exemD� �rom t�e Contractors' State Licensa Law lor the followin0 reason
(Section 7031.5 Business anE Pmleuional CoOe: My ciry ol counry whic� reQuires a permil ro conswct, alter, imprwe. demolkh, or
reDair any stmcNre. prior ro Rs isswnce, also requiru Ihe apDliunt for sucA perrtut ro file a signetl statament ttat hNshe is ticensed
pursuant ro t�e O�ions ot tAe Contnctors' Staro License Law (Chapter 9(commencinq wit� Secuon 7000) ol Division 9 oi the Business
an0 Prolusions COAe) or ttut IreJs�e 5 ezempt t�eretrom anE Itce Eavs lar IAe allepe0 exempiion. My vioWtion of Section 7031.5 Ey
y applicant lar a pemti[ suEjecls �Ire ap0��� �o a dvil penalry of nat more Nan five �unEmO Oollars (5500). '
CITY OF COSTA MESA — bUILDING PERMIT PERM NO: B 097936
PERMZT NO: B 097936 PLAN CHECK NO: 04269-90 S GOVT: N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; 5TR PURPOSE: ALT
JOb DESCRIPTION : 375SF SPRAY HOOTH SQ FT: 45,000
CLAIM VALUE: 45,000,00 CALC—VALUE: 45,000,00 GROUP OCC: B-2 /
COMMENTS:
*�r****�+r�r***+r���r�r**��r�r�r�r*x��r�r�r�r*+e*�t***x�r�r�r����r*�****x�***x�***����**�x**�***��r��r*
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 5
---------=-- MAIN HUILDING ---------- --------- ACCESSORY BUILDING -----=---
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR: FT ZN
LEFT: FT ZN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 42408118 ZNE: MG REF NO:
PLANNING NOTES> ADD SPRAY BOOTH TO AN EXISTING INDUSTRZAL BLDG.
>
if iE if iE iE iE !E �lElf ftlE� iE iE if iE iE if iElk if !E iE iE if if iF iE if iElE iE iE if if ff i! iklf if if if iE iF iF it itlE if fl� iE iE iE ff iE iF ik iE iE if ±E 1klf iE ik iE ik iE iE if # if 7F iE i!� jE k 1E if i6
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T 5
ZONING APPROVED BY C�L' �,�.!/L'/ DATE: '"G z7�po
f
BUILDZNG APPROVED BY ; DATE: ��
APPLICATION ZSSUED HY: . DATE: �
if?kifltiE?fiEiEifiF''.l�ikiEkitlfifiE�E!!lEiE . iEitiEiEiEitiEkiFiE . jfiE
ifiFiFitiEiEiEiEif�lEltifitiEiFiEitifiEikiEiExifiEitififitikiEififiEitllifiEiFiE fEiEiE3FiEiEkikiEiEiflFffiEififitiEifiE�klEfkiEiEiEitiiiEiEiEitiflEifiE3t
LEGALIZATION;N F E E S U M A R Y STRUCTURAL SEGMENT:Y
bLDG PMT PLUMBING ELECTRIC/�:MECHANIC ' FIRE SMIP/RES GRADING
PERMIT 382.00 /� SMIP/NON—RES
PLAN 248.30 %i 6.75
ISSUE FEE ' �
� as owner oi me v�overty ar my em �oyew wim Maoes as tnetr w�e amperisaGon, w�o da tne woAc, ane me BUILDING—DIV—> PERMIT ZSSUE PLAN—C-�I'ECK TOTAL PAIDi DUE
�❑ iwcwre is �rot interMeo aroHertd Ior sye �SpecGon 7oM, Buvness ma Prolessiona� Cade: Tne Contactors' State License taw TOTAL S--- —> 3 8 8. 7 5 0. 0 0 2 4 8: 3 0 6 3 7. � S 6 3 7. 0 5. . 0 0
Eoes not appN �o an awuer of a DropeM � bmWs or imD�oves t�ereon. and who Oces suc� work �imself/hersell or NrouOh ' � '. ,;, �
�is or her own employees, DmviOed ttat such im0�'ements am not mtenCeE or attereA for ule. II. Aowever the OuilEinp or � " ,i
impravement is wle witnin one year ol compleuon, tne awner vnll have tne bureen ai provinq he/sne did not huile ar improve R E V ENU E D I V Z S I ON TOTAL S--> C OL L EC T$3i : 3 S S. 7 5 O V ER / S HOR T: -� 0 �
�artnepumoseotu�e�. BLDG PMT PLUMBING ELECTRIC MECHANZC FIRE SMIP/TOT GRADING PLAN—CHECK
L ss owner oi the orocertY• am BrUusively coniractlnq wil� Iicense0 contradors to construct tne Drojec� ysectlon 70aa, Business 3 8 2. 0 0 � 6. 7 S ,2 i
❑ an0 Professions CaAe: The Contractors' State lia�ae Law Oces not appty lo an owner oi D�Perry � Du IEs or imDrares Nereon
anGwAocaniract5tarsuc�DrolMscit�acontacfor(s)IicenseDursuant�ottceContrzctars'SUIeLicenSeLaw�.lamawart iF�1tilifiFiF?kitdFit'kit�ltitififlliliFiE'E#itifiEilifiEitilitiFit�kiEiEiEiE�Ejtik�tikiEitikiEiEitiEikitiEiliEikifiEititiEitltifiEiFitififitiEiEiEiEiEiEiEit*
that D��� a� Neir Woder's Campens¢Con insurance sMuld Ee D�tleE ta me. I N D I V I D U A L F E E b R E A K D O W N --
� I am exempt untler Section: 8. 8 P. C.
for �nic reason:
Date: Owner:
I do �ereoy ceniTy IAat I am aware ol an0 unOersiaM the requirements al Calilomia Heattn an0 Satery CoOe Secilons 25505, 25533, an0
25534 antl t�at I or any future Euildinq occupam wilUwill not (cirde one) neeA �o compty xith saitl sWte coAes and t�e reQuiremen[s tor a
permit for consimclian or moEilication imm t�e Nr Oualiry Manapement District. NesiEential wnstruction appliwtions aro eaemD� �mm
�heSB provision5.
Oate: MD��wnL
I hereGy uNfy ttwt I Iwve rea0 Nts apDGwtlon anE state tAat t�e aCove inlormafion 6 cortecl. I aqree �o compy wiN all ury and counry
or6nances and state laxs mJatinO ro CuilEinp mnctn�ctim arN hereEY wlhoAm 2PrumGtives oi Ns dtY w enur u0� Ihe aEo�>rtcentbne0
propeM/ tar inspecfbn puryose5. n � /
Date: i _ 2 � � � � SpnaNre: 1` ��� t �%-� ^�� � '
IDriver's �icense or Socia� Secudry x:
1661<e W�ita-BuilCinp; GreBn—Cotla EnlorcemeM; Canary—ApP��cem; Pink—Revenue; GdOanrotl—Ataesaor
TYPE QTY D E S C R Z P T I O N � UNIT COST TOTAL COST
SFC 45000 ALTER bY VALUE COENDROIAFEESi3OZONE 1.00 �95,000.00
��, . �
�%,
�'�`�/
D1 DOQ64130-00064131 T �'� 3$8.75
DATE� 06/27/90 TiH'c: 16�42
C�NSTRUCTION AND PLANfv„aG POOL & SPA
APPROVALS Permit # � Date Inspector AppROVALS Permit # Date Inspector
.-Temporary Electrical Service or Pole - 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. � � 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgmd. 54. Forms
4. Electrical Conduit�Undrgrnd. , 55. Electrical Bonding
5. Steel Rei�forcement � 56. Rough Plum6i�g & Pressure Test
6. Electrital UFER Grnd. . 57. APPROVAL TO COVER�GUNITE
7. Footings ' 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test .
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. PropertY Sewer Line & House Connection 62. Backwash & Receptor-Final •
12. Sewer Cap 63. Heater & Vent-Final �
� 13. Root Drains � 64. Plumbing System � Final
14. Rough Plumbing � . 65. Electrical-Final
15. Ro�gh Electrical�Conduit . 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling � 69. POOUSPA SYSTEMS�FINAL
19. Rough Neating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. DuCts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rouqh & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storaye Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structuraq & Monocoat 75. �Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation '�' -'�T 78. FIRE PREV. FINAL
30. Drywall Nailing ' � HEALTH DEPT. REQUIREMENT
31. Plaster 9rown Coat i i " �. 79. FINAL INSPECTION
32. Electrical Power Meter-Final ",- j 80. FOOD CERTIFICATE ISSUED
33. Final Eleciric � - Notes:
34. Final HBating & Air Conditioning ,'
35. Final Ges Pipe-Test �''i �"%� !
36. Hood or CanoPY . "'��
37. Final Factory Fireplace [
38. Final Plumbing \ � -
39. Water Service-Final
40. Gas Service-Final
47. Solar pomestic-Final
42. BackffoW Preventer
43. Backflow Irrigation .
44. LandscBPe Irrigation System
45. Sound Attenuation
46. Handicap Regulations �, ��',{�/
47. FINAL STRUCTURE & BUILDING a(� x
48. FINALPLANNING ,;', r'i',�;'
49. Electric Release ta Edison %^ �
�
'L. � �
50. Gas Release to Southern California Gas Co �'
51. CERTIFICATE OF OCCUPANCY
No. Date
iE�T^ Egs: ' 732 W 17TH ST
WNER':�xe: THE GAFFOGLIO FAMILY META
no . �as: SAME
� -
650-9466
ARCNIENCINEER:
RODRESS:
REO.NO.:
uxrt: A
uxrt:
PENMITfEE: BUILDERS GROUP ( 714 ) 969-0169
_, pDOflE38: 1OZ9O IMPERZAL HWY
- GARDEN GROVE CA 92643
LICENSED CONTMCTOB DECUMTION: I here�y aflirm Ihat I am Iicense0 untler D�oNsions af ChaD�er 9(cammendnp with Section
7000) ol Oivisian 3 oi Iha Business an0 Professions Code, anU my license is in fullforce antl eflect.
cinuc.:050106 $*preuc.:�83704 �S B � /
_C �Z%�� Siqnature: �YA'� ( �/�^�
.kEffS' COMPENSATION OFCLAIG710N: 1 hereby attlrm Ihat 1 �ava a ceMficate ot ca t ro seM-insure or a certitiwfe of WOBers'
,,,,mpensation Insurance, or a certifed copy t�ereoi (S¢�tion 3800, LaD. C).
roucr Ho.: 118 2 3 2 5— 9 0 ucv. onh: 0 3/ 01 / 91
WMPANY: STATE FUND
❑ CerlifieE coDY is �eraby hmisAetl. [ Certifietl coDY is fileE with [he ciry BuilEinp Division.
Daie: t o '=r _�� ApplicanF. ����%�i'v" H+ "•.� �rc � �"""�. - —
E%EMPTION FBOM WONNENS' COMPENSOTIOX OEpAMT10N: (ihis section need not he complet Ihe permfl is �or one Au�reA (§7 W) or les5�.
1 certity that in ihe DeAormance of the work far which t�is permit is issueU, I shall not employ any Oerson in any mannar so as to hecome
sublect to Ihe Workers' Compensation Laws oi Califorqla. ,
�ate: � Sipnatur�:
NUTICE: II, alter malting Ihis Aeclaration, you 5hoy10 6ecoma suhlect ta the Warkers' Compensation pravisions of ihe La�or
Cotle, you must larihwith comDry with such proviginns.or tltis permit sAall be deemed revoketl. .
CONSTBUC710N LENOINO RGENCY: I herehy aHirm that IAere is a constmction lentling aAency for Ne pertormance oi tha wark tar
which t�is permit is issued (Section 3097, Civ. C�.
LFNOEfl:
�ooneu:
OWNER BUILUEB OELUIMTION: I �ereby atfirm Ihat I am exemp� from the Contacrors State License Law tor [he PollowinA ��n
(Seclion 7031.5 Businass an0 Protessional COEe: My ciry oi counry which reduires'a De�n �o wnstruct, alttr, improve, dertrolish, or
repair any slmcNre, pnor to its issuance, also reQuiret Ihe aDP��cant for such permit fo file a 5ipneE stalemenl [fwl he/s�e is ficense0
^nrsuant to tAe provi5ions oi ihe Cantrac�ors' State Liceqse Law (C�aD�er 9(cammencinA �h Section 7000) of Division 3 at t�a Busin¢ss
Professlons Cotle) or Ihat he/she is exempt t�ereirom antl [he basis far ihe alle0etl exemption. My viola[ion of 5¢ctian 7031.5 by
apDlicanifor a Dermit subjectsthe applican[ ro a Civll penalry of not more ihan five hunEreC Oallars (5500).
� I, as owner oi Iha pmDeM or my employeas wit� wapes as iheir sole comDensation, will do the woM, antl the
❑ s�mi�ure is na[ in�ended or oflereU tor sala (Section 7044, Business an0 Pmfessional COAe: T�e Coniractors' Stata License Law
Aaes not apDly ta an owner oi a propeM who EuilOs or impmv¢s thereon, antl who does sucA woB himseli/�erulf ar tArouBh
- his or her own emDloyees, pmvided tAat such imDiovemen[s are not intentletl or otlereE for sale. It, �awever t�e 6uiltlin0 or
Mpmvement is saltl within one year oi comDle[ion, the owner vnll Aave ihe �urtlen af pmvinp he/she tlid not bui10 or imprave
Por tAe Durpose ot sale).
I, as owner ot ine proDe�. am exclusively con¢actin0 ��� Iicense0 contractors ro construct ihe Draject (Section 7WC, Business
❑ anU Prohssions CaOe: T e Coniractors' SWte 4icense Law Oces not apDN �a � owner oi Draperty who builGS or improves Nereon
an0 who wntrocts for suc� projects vtt� a controctaqs) licensa Dursuant to [he Con[aqors' State L¢ense Law�. I am awam
tAat Drool ot their Worker's CompensxUon msUrance slwultl be pmnOeA to me.
� I am exempt under Section: B. 8 P. C.
for t�is reason: '
Da�e: - Owner.
I Uo here6y cerlity Ihai I am aware oi and untlerstantl the apuiremen[s of Califomia Healt� anU Safery CoEe Sectians 25505, 25533, antl
25534 an0 [hat I ar any futura builAing occuDant will/will not (circle one) nee0 to comply with sai0 state codes anE the requireman[s for a
permit for consimclion or.mo0itication imm ihe Pir Uualiry ManaOament �istrict Resitlential constmction aDPlications are exemOt irom
ihese O�ovislons.
Date: - ApD��canC
I hereby cetlity that I Aave rea0 [his ap0lication antl sta�¢ t�at the abova infarmation is correct. I a0ree ta comply with all ciry and counry
oNinances anA state laws relaGnp to Uuilding cons[ructioq anA here0y autAarize repraunGtives of Nis ci ro enhr upan tlw a0ovo-mentlone0
prapeM �orinspedian Durposes.
Date: 6 ^ �-� �� S�pnatura;
oriver's �icense or Sada� security x:
1661�48 W�ite—BuIlEing; Gree�CoEe EnlorcemBnt; Canery—Fpplicant: Pink—Revanue; GOIEenrotl—Assauor
m
CZTY OF CUSTA MESA — bUZLDZNG PERMIT PERM NO: EM 047938
PERMIT NO: EM 047938 PLAN CHECK NO: N GOVT: N SUPP: N
CONSTRUCTION TYP,E; S PERMIT TYPE: ELE MEC PURPOSE: OTH
JOB DESCRIPTION : 375SF SPRAY BOOTH (MECH, & ELEC,) SQ FT:
CLAIM VALUE; CALC—ZJALUE: GROUP OCC; B-2 /B-1
COMMENTS: RE: B47936 PRIMARY BLDG. PERMIT.
��**�r�**�*�*��*******+r�**�*�r*�*��r***�����**�*�r**�*��*��***x��*�r**��r+�*�r*��*****x�
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 BUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT; FT ZN.RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING RE�• PROV: PARCEL: 42408118 ZNE; REF NO:
PLANNING N TES>
1 . _� . .
iE iE it iF if ik iF dt it iE iF iE jE iE �E jE jE iE 9E 1E?E 9E if iF it iE �t i! iE iE iE jE iE 9E iE iE jE"# 3F itlE 3f iE if it iE 9F iE jf iE iE iE iE jE iE'lE if iE IF iE �1f iE if ik it iF iE jE �)E if 1E �f 3F dF if if iE iE 3E
D E V E L O P M E N T, S E+,R V�I._ C E S R E Q U I R E M E N T; S
ZONING APPROVED BY '�-� l� � DATE:
HUILDING APPROVED BY : - " DATE;
APPLICATION ISSUED BY: ` �� #�� DATE:
********it*itit�r**�**�*�*� +3F'iF r �,'F 3�' e. iF 3F'iFiFiFx`iFiF3Fg3F�F��F�-it�r***ir�r*x���-*
iEiEjEiEiEiflfifiEiEjliFiFiEiEiE3ElkiEiEiEififiEjEifiEiEl4iEiFiEitif�EfEjEiklEifiE iliflflEiEiFiEjE3EiEiPiEiEiEiEiEjEiP�EiEiFiPibiEiEiFiEiFiEifiEjEiEififiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 25.50 9.50 �
503 25t SMIP/NON—RES
PLAN �
ISSUE FEE ' 15.00 15.00
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 35.00 30.00 0,00 65,00 65.00 .00
REVENUE DIVISION TOTALS--> COLLECTED; 65.00 OVER/SHORT; .00
bLDG PMT PLUMDZNG ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
40.50 24.50
iE iE iE if iF if it iE iE �f iE if iE iF iE jF fE if ik �)E iE iE ik iF iF jf fF iE if iE 3f iE if jE iF ik iF iE iF dE if±E iE iE if 1f it iE if iE iE if iE iE if 1f 1E if iE �E �f iE if 9E if iE iE iE iE iE if iE iF iE iF dt if jE iF
I N D I V I D U A L F E E B R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
ELE 20 FZXTURES, LIGHTING 1 ST 20 EA. .75 15.00
ELE 4 RECEPT/SWITCH 1 ST 20 EA. .75 3.00
ELE 1 MOTUR/POWR APPARATUS 1,1 — 10.0 HP 7.50 7,50
MEC 1 GAS PIPING SYS .1 — 4 OUTLETS ' 3,00 3.00
MEC 1 I�ENTILATION SYS NOT UNDER PERMIT,EA. 6.50 6.50
END OF FEES �
Oi OQ06d13E—DOOd4137 T�a T 65.00
DATE: 05f27/90 TIME: 16:44
- CONSTRUC710N AND PLAI .G POOL & SPA
A�'ROVALS Permit#- Date Inspector AppROVALS Permit# � Date Inspector
�Temporary' Electrical Service or Pole , � - 52. Pool & Equipment Location �
2, Soil Pipe-Undrgrnd. '� �� 53.� Steel Reinforcement '
3. Electrical Conduit Utility-Undrgrnd. . 54. Forms ' '
4. Electrical Conduit-Undrgrnd.;, � � 55. Electrical Bonding .
5. 5teel Reinforcement � - - 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � � � 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd. �
8. Foundation � _ 59. Gas Pipe, O Undr9rnd., Test - �
9. Water Pipe-Undrgrnd. � 60.� Backwash Lines, P-Trap, O Undrgmd. � '
10. 5tructural Floor System � - 61. APPROVAL 70 DECK
11. property Sewer Line & House Connection 62. Backwash & Receptor-Fina1
� Z. 5e�^'e� CaP .� . � 63. Heater & Vent-Final
13. Foof Drains � � 64. Plumbing System � Final
14. Fough Plumbing - 65. Electrical-Final -
75. Flough Electrical-Conduit . 66. Solar System-Final
16. Rough Electric Wiring 67. F.encing & Access Appioval
17, Rough Wiring $ign . , ' 68. APPROVED FOR PLASTERING
18. Ftough Electrical�T Bar Ceiling � - 69. POOL/SPA SYSTEMS FINAL
- 19. Rough 4eating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Pough Factory Fireplace � APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hvdro
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. poof Sheathing 74. Overhead Hydro
26. T�Bar Ceiling (Structurall & Monocoat 75. Dry Chemical
z7, �rame and Flashing ' 76. DrY Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL �
,��
29. Insulation � '�. 78. FIRE PREV. FINAL
30. Drywall Nailing •� HEAL7H DEPT. REQUIREMENT
31. Plaster Brown Coat �/�� 79. FINAL INSPECTION
32. Eiectrical Power Meter-Final �'� 80. FOOD CERTIFICATE ISSUED
33. Final.Electric �� `�J� Notes: ' �
34, Final Heating & Air Conditioning u��(,a .
35. Final Gas Pipe�Test �: (,�.'
36. Nood or CanopY
37. Final Factory Fireplace +
38. Finat Plumbin9 . `�
39. Water Service-Final - •
40. Gas Service�Final -
q7, $olar pomestic-Final
42. Backflow Preventer ,
43. Backflow Irrigation
44. Landscape IrriQation System
45. Sound Attenuation
46. Handicap Regulationt '
47. FINAL STRUCTURE & BUILDING �
j" .
48. FINAL P�ANNING �`„
49. Electric Release to Edison ��/'
50. Gas Release to Southern California Gas Co � ,
51. CERTIFICATE OF OGCUPANCY
No. Date
►i,
/
�OWNEI 4AME: �3Z w 17TH $T
PCTER ROTHSCHILD
�jx� $$` 866 W 18TH ST
RHC WENGINEEfl: 6 5 0— 9 9 6 6
RODNESS:
flEU.NO.:
uxrt: A
UNR:
PENMITTEE: HOILDER GROUP ( 714 ) 969-0169
�oosess: 10q1�90�'}� IM(;�PpERIAL AV q q
110ENSEO CONTMCfO� OiCUWI'OON: l Fere3y a�rm tna� I am IlcenseE unEe OfONs%n�of CfiaD ar 9(cammancin0 ��h Section
7000) ot Division 3 at tha Business an0 Notessons CoEe, an0 my ficense is in NII lorce aM allect.
cmuc.:05�0�7106 ""'��0��58370`t��� � B /�n/
D�e: �ti-7=��— Si9natur0:liL//�e a � ^i�i `R bL(�D^ "
BI(E S' COMPFNSATION OEClAMT10N: I hereGy alfirm Wt I ture a artilicate ot m to utl�inwm a a mrtifkate of WoderS'
mpensalion Insuranu, or a cenifieE coDY ���ea� (��Uon 3800, LaE. C�.
.oucrxo.:1182325-90 �PDA� 03/O1/91
cornrnxr: STATE FUND
❑ Certifietl coVY u Aereq' tumishe0. �{ Ceniliea caDY u Ned wM ttre ci�Y BwIEinO Division. �
Date: ���"'� b ApPlieant: �kt[i1eL w
E%EMPfION FIIOM WOflRNE' COMPEN511TION UECLANI7ION: (11ik uctlm �e0 not Ee compete it e pemit k lar ane �wdreE (f100) a less).
i certiTy tAat in t�e peAormance oi the wmk for wNU th"a permit n issueE. i snatl rot emd ce� in any manner w as to Eecome
sublect ta ihe workers' ComDensatlon laws of Callomu.
Date: Siqnature:
NOTICE: If, alter maMnp I�is Oeclarzlian, you StqulE hemme wOject ro t�e Workers Compensatlon prmdsioris ol tM LaEor
� CaCe, Wu mus� imthwiN cmmVN vriN wN O�mwons w Itds D�mtlt stutl he Aeemetl rewkeE.
. CONSTBUCTIOX LENOING �GENCY: I hereEy aKrm Nat Nero i� a mmiructfon IenENB a0enry lor the peAormance ol tM work lar
i wnic� �his Dermit i5 iaue0 (Settion 3097. Civ. q.
lFNOEfl:
IOOflE33:
OWNEN BUIIDER OECIAMTION: I IcereDy allirm WI I am exempt irom tAe Contrazlari State License Law for tM tallowin0 reason
(Section 7031.5 Business an0 Protessiorel CoAe: My [Iry ol counry whicl� requira a permit ro caisimct. alter, imprwe, demolis�, or
repair am� s(nxlure. D� to iL� issuance. also repWres the applkant Iw wM pemtit to fJe a dpne0 sUtement Wt �Nstre B Ikensetl
purwant to ��e Drovisians ol ina CanUactare' Shte License Law (CMpter 9(mmmencinp vntn Sectron 70W) ai Oivision 3 0l �ne Busirross
ana Prolex4ons CoGe) or Nat IrJshe ¢ exempt Nerefmm uq Uro Oaza tor Ne allepeE exempibn. My violallon ol Section 7031.5 Oy
� applicant lor a Demill wEjects the applicant ta a d�U penalry ol not more Wn Ilve Auntlre0 Eollars (55001.
I, as awner ol Na Oroperty w rtry emp I�yyees wiN xapes u Ne'u sde compe�atlon. xitl Eo Ne waM1, end tAe
�;1 structure is nm inteiMeO ar otlereE lor sale (Sectiw 7064, Business aM ProleSsional CaOe: T�e Controceori State License Law
_ Eoes wt apW to an wmer ot a propeny wM Mtiltls or Imprwes ticreon. a�M wM Eas such woA Nm5N1/hersell a iMoup�
�u ar �er own emO�M'ees, DraviOed tAat mc� Imprwements are no� inten0e0 or oflereA lor sala. II, Iwwaver [�e GUIIEinp on
ImO��mmt u 5dE witNn ane year ol mmpetbn. Ne m�mr will Iwe Ne Wrden Oi D�0 ��� � nol EuilO or improve
Im Ne purpose ol sale�.
I. as owner ol Ue DropeM. am exclu5lveN contruWO �N ticenseA contndon ta comWp Ihe project (Sectlon 76U: 6usiness
❑ aM Professians CaOe: The CanVactas' Suta Lkense Law Eaa nol apply �o an ovmer al properry wno Ein7ds a ImpmRs Iherean
anE who contracLs lor suU D����S wiN a canVactor(s) ke�a Dursuant ro Ure Coninclon' State Lke�se Lawl. I am aware
t�at D��� ol Neir Warker's Campemafian rtaurance SMNE Ce 0�4� �o ma.
� I am exemD� unEer Section: B. 8 P. C.
1 1�' eson'
a
CITY OF COSTA MESA — HUILDING PERMIT
PERMIT NO: M 048195 PLAN CHLCK NO: N
CONSTRUCTION TYPE: 2—N SPRINK PERMIT TYPE: MEC
JOH DESCAIPTION : MAiCE UP AZR FOR SPRAY BOOTH
CLAIM VALUE;
CALC—VALUE:
PERM NO: M 048145
GOVT: N SUPP: N
PURPOSE: OTH
SQ FT:
GROUP OCC; H-2 /
COMMENTS; RE: B47936 PRIMARY PERMIT.
�)t ik iF ik iE * M if iE iEiE it# �F ## iE if if �E # 7F dE �lE �lf #if df �Y.�if 1E 1F1f i(�if iEiF if iE if if iE �7E iE iR it if ikik iE k iE iE �1t itit iF iE iF if if �7F if -ri� # 1E iFik iF-0f fE iE if ilit iF iE#�M
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
------------ MAZN BUILDING ---------- --------- ACCESSOAY BUILDING ---------
FRNT: FT ZN R£AR; FT IN FRNT: FT ZN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT; FT ZN
PARKING REQ: PROV: PARCEL: 92908119 2NE: REF NO:
PLANNING NOTES>
> �-
if iE iE iE iE iE if it it if it iE it iE if if iE if # if iF i! iF'1F ik it it iE iE iE iE iE iE ittF 4 iEif df !E if� if �!-)E iE if iE iE �lE 1t il� iE if iE iE iE if iE iE iE iF iE iF �' it iE if'�E # ik ik 1E iE ik f! iE ik iF #
D E V E L O P M E N T S E R V'Z C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
HUILDING APPROVED BY : - DATE:
APPLICATZON ZSSUED BY, DATE: O�• I3"%/�
itiFfElE9EiEiflE?EfEiflFiEifit�tiEiFiEfF+F1Ea.3iiFxnxx SF�:'- .+c f . iF3F7FiFiflElfifiFif!EiFiF'�ii�if3F'�F'£'£�'�il-tfit
%{:iEifiEifikiFiEif�lFiEifififiM1�lEiEifikiEififiFjFiFiFiFiFiEifiEifa� 1EiEiEifiEi'fkif!liFifiEitifitll�iEftltlEifiFititMi4lFiEiEiEiFif�ElEiFiEiE�f#iFiEiFlFiE
LEGALI2ATION:N F E E S I' M M A R Y STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/RES GRADING
PERMIT 11.00
25$ SMIP/NON—RES
PLAN
ISSUE FEE 15.00
BUILDZNG—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAZD DUE
TOTALS----> 11.00 15,00 0.00 26.00 26.00 .00
REVENUE DZVISION TOTALS--> COLLECTEA: 26.00 OVER/SHORT: .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK
26.00
jE jf iE ih if iE it iE!! iF 1f if �F iE iE 1F 1E ik if if if if iE if iE 1F it k �t it i! iE if it if ft it if M iE iE i4 iF ik iE it iE ik if !f ielf iE iE iF 1f fE iF it iF iF ik iE iE if if iE i4 af if if ik if iE if it %if 1b
I N D I V I D U A L F E E H R E A K D O W N
or a r
TYPE
� Daie: • Owner.
I Eo hel¢Ey tertily Illal I am aw3re af dM uMersWM ttro repuiRml�rtS ot Glitomld HWIII aIM Sal¢Iy COOB SBCiions 25505, 25533, anE N, EC
25530 aM ttut I or a�ry M1nuro DuilEinp ocwpant vnNwll mt (drtle are) neeE to compFj wiN 5aM suta cotles an0 Ne repWremenls tar a
permit tar consiruction a mo0ifiotion irom ihe Ru W Manapement OistrYicL IiesiOential consVucUon appliwtions are eKempt Irom
I�eu Drovisions.
Date: MP��:
I hereby cenity tAat I luve rwE ttus apptication and siate Wt Ne a0ove intormation is mrrect. I a0�ea ro comDh �U y� ury ana counry
orai�unces an0 sUte laws reqfinp Io dn1Em0 ���� ��RM aNhm� reqesenutives ol N5 ciry to ter upon tlre aDove�men6me0
DroDenY �or intpection purpues.
. � $iqnaNR:
Drivei s iClnSC ar $abial $Ewnry
18C1J8 W�ite—BuiM'ug: Grean—COEe Enlwcamenl: Cenery—App�ca�t: Pink—Revanuo: GdEenroC—Asseaea � �
QTY D E S C R Z P T I O N UNIT COST TOTAL COST
1 RELO FORC—AIR/GRAV FURN > 100 K BTU 11.00 11,00
END OF FEES
Oi 00065271-0�06527f 'T O'f 26.00
� DATE: 07/13/90 iIflE: :1:57
- CONSTRUC710N AND PLANN�R.0 )OL & SPA �
APRROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector
1. ertiporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Sgil Pipe�Undrgrnd. 53. S[eel Reinforcement _
3. Elec[rical Cpnduit Utility-Undrgrnd. . 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical U�ER Grnd. 57. APPROVAL TO COVER•GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P�Trap, O Undrgrnd. �
10. Structural Floor System • . 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor•Final
12. Sewer Cap � _ 63. Heater & Vent�Final �
13. Roof Dreins , • 64. Plumbing System - Final
14. Rough Plumb�ng 65. Electrical�Final
15. Fough Electrical-Conduit 66. Solar SYstem-Final . .
16. Rough Electric Wiring , � 67. Fencing & Access Approval
17. Rough Wiring Sign � � 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling 69. POOL/SPA�SYSTEMS FINAL
;.19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Facto�Y Fireplace APPROVALS Permit #
21. DuCts, in StrUcture 70. Underground Hydro
22. Ducts, Ventilating 71. Product Pipin9 OGas OOiI
23. Gas Pipe�Rou9h & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTank OGas ❑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 I 78. FIRE PREV. FINAL
30. Drywall Nailing j�, ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat y�� 79. FINAL INSPECTION
32. Electrical Power Meter�Final � 80. FOOD CERTIFICATE ISSUED �
33. Final Electric . I' Notes:
34. Final Heating & Air Conditioning !/ (S � (�(,�)� ,
35. Final Gas Pipe-Test ��
36. Hood or CanppV � ' %�
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 Irriqation SYstem
45. Sound Attenuation
46. Handicap Regulations ,
47. FINAL STRUCTURE & BUILDING �
48. FINAL PLANNING --
' 49. Electric Release to Edison ,
�0. Gas Release to Southern California Gas Co F
51. CERTIFICA7E OF OCCUPANCY
No. Da[e
PNOJECTAOOflESS: "�3z w 1'�T'x S'1'
OWNEH'SNAME: METAL CRArTERS
AOOHESS: SAML
969-0169
AXCH/ENGINEEN�
PDONESS
wcc.No.:
uxir:
uxir:
PENMITTEE: gUII.DER GROUP ( 714 ) 969-01 69
aooness: 10190 IMPER IAL AV
GARllEN GROVE CA 92643
LICENSED CONTBAGTOB DECLABATION: I hereEy a��irm I�a� I am licensed under pmvisions of C�apter 9(commencin8 with Scction
7000) ol Division 3 0l ��¢ Business anG Pmiessions Cotl¢. and my license is in full forte and efl¢[t.
c�,ruc.:/�%5010C6 STATELIC.://��83704 cuss: H /
Date: —/ ' �� � J � ! GignaWre: ��7T _ — __
WOAItEPS' CDMPENSPTIOfl DECIAAATION: 1 hereby aHiim ihat l �ave a ceniticat ot consenuo seN-iwme o� a certiticate ot WOMe�i
Compensaiion Insurince, ar a certitietl copy Ihereol ISec�ion 3800, Lab. C�.
POl1CV NO.: E%P. URTE:
COMPANY:
❑ Cetlilietl copy is herehy tumishetl. ❑ Ceriilied copy is fileA wii� IAe ciry BuilEing Division.
��
,e: Ap0licani:
i ENEMPTION FXOM WOflREflS' COMPENSATION OFCUflAiION: (TMs sMtion n¢eC no� be complelW ii tM permii a ta one huMr¢C (5f00) or less�.
', I certily Ihat in t�e D¢��orman[e ol the work for whicA Ihis Dermi� is isSueQ I shall not ¢mploy an r n in any manner so as to Cecome
5u�lecl lo iWorke�s' Compe�a�ion Law Califa�nia. !'
vl���
Oa�e: SignaNre: / -
NOTICE: 11. a��C� making Ihis tleclara�ion. you shoula become subjec� lo Ne orkers' Compen5aiion pmvislons ol �he Labor
Code. y0u mu5i �arl�vnth tOmply vrii� 5uc� pmhA0n5 Or tN5 permil S�all be CeemeO tevoketl.
CONSTflUCTION 1EN01NG FGENCY: I hereby affirm I�al ��ere Is a consimc�ion lentling aAency for IOe peAormance of �he work lo
w�ic0 Ihis Oermit is �ssuetl (Section 3097. Civ. C�.
LENOEfl:
R�ONESS:
OWNEfl 9UILOEB OECLAPPTION: I hereby al�irm �hal I am exempt �rom IAe ConiraClors' State Lic¢nse Law for Ihe f011owin8 reason
(Setlion 7Q37.5 Business and Pmiessional Code: Any ciry ol couniy whi[� repuires a permit to con5lmcL ali¢r, im0�ove, tlemolish, or
iepair any 6lmclure. Drior to it6 issoance. atso reONres 1he apD���ant toi Suc� paimfl to iile a SiB�d stal¢ment that helshe is NtOnsed
pursuam to t�e Dmvis�ons ol l�e Comractors State lice�se Law (ChaO�er B(�ommencinp with Section 7000) of Divisian 3 0l ihe Business
antl Pmlessions Code) or i�at he/s�e is exempt �hereVom anG ihe basis lor I�e allepe0 exemption. Any violaiion of Sec�ion 703f.5 Oy
any appliCant for a permil suDiecls the aODlicant to a civil penalry oi not more than live hunOreO Oollars (E500).
I, as owner oi �he pmpeny or my empl0yees wit� wages as Iheir sol¢ compensa�ion, will do Ihe work, antl Ihe
❑ s�mcmre is na� intenOeA or olferea far sale (Section 70a4. Business an0 Professional Code: The Coniracrors' State License Law
aoes noi apply �0 an owner o� a pmpetly who bUiltls or 1m0�ove5 ihereon, anA who does Suc� wOrk �imSelV�enelf ar �hmugh
his or her a�+'n emDloyees. provitle0 ihat sucn improvements are not intenOeA or atterea for Sale. If, however Ihe huildirg or
impmvement is saltl vn��in one year ol completion, ihe owner vnll Aave the OurGen of pmdng �e/s�e Oia not Oui10 or impmve
lor Ine purpose oi sale�.
I, as owner 0� ��e pmperty, am exclusively conVaciing wi�� licensetl conlrac�ors �o cons�mct Ne pmjeci (Sec�ion 7044, Business
J ane Pmtessions Coae: Tne Camranors' Siate Li[ense Law Goes n0� ap01y �o an owner ol pmpetly w0o 6uiitls or impravu t�ereon
antl who coP��acls �or such pmiec�s wilh a cOntracbqs) lic¢nse Oursuant to Ne ConVacloK Slate License law1. I am aware
tlut prool o� �heir Worker's Camp¢nsa�ion insurance shoWG Ge proviDeU �o me.
� I am exempt un0er Seciion: B. 8 P. C.
lor I�is reason:
Ua�e: Owner.
I tlo nereby cenity roai I am aware ol and un0erstantl ihe reauiremems ot Calilomia Heallh and Safery Coae Sectiore 2550.5. 25533. antl
25534 anU Inai I or Jny lulure �uiiding occupan� will/will no� �circle One) neetl Io comply wit� said state co0es and the requirements lor a
permit lor cons�mclion or mOtlilica�ian �rom �he Air O�ali�y Management Dislric�. Fesiden�ial con5tmciion applications are exempt tmm
ihese pmvisions.
�ate: Applican�:
I nere6y cetlAy ihal I nave reae ihis apptication )ntl state inai Ihe abave inlarmation is to�rect. i agree b comoly wilh all Gyy an0 counly
ortlinances antl stalelawsrela�inglo building cpr(s�mc�ion an0 �ere�y authorize represen�a�iues oi�his cilylo enieruponlhe abdve-men[ionea
piope��y/lor inspeclion pwposes. / ''n J
Dale:�(f � ��/ l5ignamre: , �/''�7 ",�+�
Oriver's license or Socia� Secunry a:
16a1-a6 Whne—Bqilaing; Green—Coae Enlorcemanl: Canary—ApPlicanl; Pink—Revenue: Goltlenrod—Assesso�
CITY OF COSTA MESA - BUILDING PERMIT PERM NO; M 054884
PERMIT' NO:.Nr 054880 PLAN CHECK NO; N GOVT: N SUPP; N
CONSTRUCTION TYPE: PERMTT iYPE: N,EC PJRPOSE; ALT
JOB DESCRIFTIOA� : INSTALL 5 CEILING FANS, 6 StiSPENDED HEAT SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: B-2 /
COMMENTS: RE;#B54877
# 8E �k 1EdE iFiF �leih �lf iE iE�1E �1F �lf iE i! �k iE 9E iE iE�lf �I� �F' �k it iE iF iE iEif if -lf iFic #iE �lE i[� �If �If �F �lf iE-1E iEif �k if iE if # if IF )E�k �T` iE-)E �N-#iE�k # if� �lf if �)c9F iE if # ih #�)F -)f�if�iE
7 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 BUILDING ---------- --------- ACCESSORY BUILDTNG ---------
rRNT: FT IN REAR; FT IN FRNT: rT IN REAR: FT ISJ
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKING REp • PROV: PARCEL: 00000000 ZNE: REF NO;
PLANNING N(�1'ES>
i
��***x*�*�***x��� x�-�*�r�ti��**�r���;��t*x**��**�***x w��*�*w+��x���t**�*+��*�c i��e�x�*****x*x�t*
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED 3Y DATE:
BUILDING APPROVED BY ; DATE:
APPLTCATION ISSUED BY: DATE• \�
iFifiFjFlEffiE�IfikifiFiEiFifiEihiEiEifififiF � � , x 3Eifif%ifi6�kfFi6lf �iFic
K�ififif�if*#�Ifif•�1Fif#f�Eif�3FiEle3f�36K�3F1lififiPiE�fiti6iEi(�iF#`�it1Elf�ifif�3EiFifiEiE�F�lF3EiEiFiFiEl4ifdElflE�IEjfif-if�IhlEiEiF�lf�1(��lEiFiF3Ei'rif�E3ERif iE16jF
LEGALIZATION:N F E E S U M M A R Y STR[7CTURAL SEGMENT:N
BLnG PMT PLUMHING ELECTR�C MECHANIC FIRE SKIP/RES GRADING
PERMiT �. 18. 50 •�
-• 25g SMZP/NON-RES
PLAN ,
ISSUB FEE - 15.00 . %:;
BUILDING-DIV-> PERMIT ISSUE PEAN=CHECK TOTAL PAIA-^s DUE
TOTALS----> 18.50 15.00 " • 0.00 33.50 33,40�:,_ .00
REVENUE DIVISION TOTALS--> COL`LEC�'ED: 33.50 OVER/SHORT�cd` 00
BLDG PMT PLUMH.ING ELECTRIC M$C$ANIC FZRE SMIP/TOT GRADING PLAN-CHECR
r:,, 3�8. 50
�. . . ,.
3F 3E 3F aE 7e # i(� iE if iF iE it #�7E it ie 3E%if iP1f iP iF iE i(� 1F IE iE iE i'r it 3t 3E 1E it-3b iF �F 1E i� iF iF iF af iF le ic k it iE 3t if iE-lE+t iE�t lf �E iF it iE 1E t4 �[� 1F i(� iE.7F ic� iE 1E 14 iE if it?Eib �F
I N D I V I D U A I;- '=F E E B R E A K D O W N
TYPE QTY D E S C R T P T I;O. N'.' UNIT COST t TOTAL COST
MEC 1 GAS PIPING SYS f'9 OUTLETS 3.00 3,00
MEC 1 EACH APPL NOT I� OTHER CAT UNDER FEE 6,50 . 6,50
MEC 1 SNST/REL SUSPEN��ED"-HEATER 9,00 • 9,00
E X P 1 R E fl �`�D� OF FEES
e�'tions � �'�
I�comPlete InsP - Vt�,
SI s--�`..— /f�. I tt �QiQ�-.`!',_�US�S:�J —:'�.`'tl ` ... �I
Oate.�._�—�_"- g •,'• �• �'iTc' :iiL��9� lii!Z Z:,J -
.yA '� % ��,
i
CONSTRUCTION ANDPLANNING � POOI� 1 -
APPROVALS Permit# Date Inspector qppROVALS Permir# Date Inspector
t. Temporary Electrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility�Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgmd. � �55. Efectrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAI TO COVER•GUNITE
7. Footings 58. Electrical Conduit•Undrgrnd.
8. Foundation , 59. Gas Pipe, O Undrgrnd., Test �
9. Water Pipe�Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structurol Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor�Final �
12. Sewer Cap 63. Heater & Vent•Final
13. Roof Drai�s , - 64. Plumbing SYstem � Final �
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
' 16. Rou9h Electric Wiring 67. Fencing & Access Approval
17. Reugh Wiring Sign 68. APPROVED FQR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS ' Permit #
21. DuCts, in Struc[ure .. 70. UndergroVnd Hydro
22. Ducts, Ventilating � 77. Product Piping O Gas OOiI _.
23. Gas Pipe-Rough & Test , 72. Underground Flush '
24. RoofFraming . 73. Undergrnd.S[orageTank�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. FINA� '
30. Drywall Nailing � HEALTH DEPT. REQUIREMENT ,- �
37. Plaster Brown Coat� � � 79. FINAL INSPECTION - �
32. Electrical Power Meter-Final . i 80. FO00 CERTIFtCATE ISSUED _
33. finai Electric I Notes:
//�/_�_�/ d�r_ah_�.G�ses g�%(G.�.�ea
34. Final Heating & Air Conditioning
ao_Z_�iaxmiT �w.�r_�icyt_�w,i��U
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 Irriqation System� � `� � � �
- E-X�-I-R-�-D
45. Sound Attenuation � • ' ItKAfTip� fB If1Spf3Ct10�S
46. Handiwp Regulations � r-
47. FINAL STRUCTURE & BUILDING � ���
48. PINAL PI.ANNING � .
49. Elearic Release to Edison
50. Gas Release to Southem Califurnia Gas Co � , � �
51. CERTIFICATE OF OCCUPANCY
No. Date
ppOJEGT AOOHESS: 7 3 Z tiJ 1 7'(`x $'('
OWNEP'S NRME: j✓ETAL CRAFTERS
nooAess: SAME
969-0169
ABCNIENCINEEB:
pODflESS:
AEG.N9.:
UNIT:
UNIT:
PENMITIEF: BITII,DER GROUP ( 714 ) 969-0169
AOURESS: lO1JO iN1PERiAL AV
GARDEN GROVE CA 92693
���ENSED CUNTflRCTOB OELIANFiION: I hereby atlirm thai I am licensetl untler O�ovisions o� Chapter 9lcommencinA wiN Seclion
7000) oi Oirsion 3 at Ihe BUsinEss and Pmie55i0n5 Cotle. and my liCense is in �ull torte anA e�leCt.
cirr uc.: 0 010 6 s,nTE uc. 8 3 7 0 cus/ �%��
�a�e�. /� s _�� Signaiure: �%Z—
WONNEBS' COMPENSRTION DECLANATION: I �¢r¢by aftirm Ihal I have a tenilitale at con5¢nl �a Sell-insUre ar a Certifiwfe 0� Workers'
Com0en5alian Insurance, or a ceniliea caoY ��eteol (Section 3800. �a�. C�.
PO�ICY NO.: E%P. OFTE:
GOMPANY:
❑ C¢tlili¢tl coOY is here�y furni5�e0. Cerliliea copy is �i�etl with �he Cily Buiiaing Oivision.
.�
� e�e: Applicanl:
EKEMP710N FNOM WOPNENS' COMPENSp710N UECLRRFTION: (This seaion nee0 nol be camDleted il ihe cermit is lo� one �untlrea �$7W) or less).
I cetlily Ihai in Ihe pedormance o� the work �or wAich Ihis permii is i ued, I shall no� employ son in any manner so as �o become
5ubl�� �o �f WO�kerY CamDenSalion Laws � Calilor /
Da�e: �� � � SignaWr�
NOTICE: If, afte� makmg this aecla�afion, yon shouPo �ecome sncjest b t Wakers Canpensation pravisions oi the Labo�
COUe. you mus� Iorlhwiih comply wi�h such provisions or �his permii shall be tleemeU revoketl.
CONSTflULTION 1EN01NG RCENCY: I hereby aifirm Ihat I�ere is a ton5�mtiion lending ap¢nty fOr fhe Osdormance ot �be work fOr
wrvcn this permil is issue0 �Sxtion 3097. Gv. CI.
LENOEN:
PDDflESS:
pWNEfl BUILOEP OECIANRT10N: I here6y aflirm Iha1 I am eremp� imm IAe Caniracmrs' S�a�e License Law lor the �ollowinA ��son
(52��ion 70.3t.5 Business ana Pm�essional CoEe: Any city of coumy which requires a De�mit to consvuc�, alter, impmve, aemolish, or
�gpair any stmcWre, prior Io its issuante. also fequire5 ihe applicani lor SutA Permii Io �ile a Signetl S�a�emenl t�at �e/s�e i5liCenSed
pursuant to t�e provisions of Ihe Convacmrs' State license Law (ChaD�e� 9(commencing with Section 7000) ol Division 3 0� Ihe Business
and P�oleSvons Coaq or tha� he/s�e is exempl Nerelmm an� ��e Casis for �he alleged e�emp�ion. Fny violation o� Seclion 7031.5 6y
anY aDo�itant lor a permit sublecls t�0 applicant �a a civil penDliy o� no� more �han live hunGr¢d Gollars (5500).
r1 I. as owner Oi Ihe prOp¢hy or my employees wil� wag¢5 as Ihei� sole campensa�ion, vnll tlo Ihe work, an0 �he
V SVucWte i5 no� int¢ndetl 0� oIi¢�¢tl �IN Sd�e (SeClwa 7064, 9USine55 and Pro�eSSiwal COdet T�e COnlfaCtorS' Stale liten5¢ Ldw
tloes noi apply lo an owner ol a pmpeny who �uiltls or improves Ihereon, and who tloes such work himself/hersell or thmugh
his or hef own employ¢es, D�oviaeA IAai SUC� improvemenl5 are n0� ini¢nGetl or oife�eA lor Sale. II, hOwever �he Uuilding or
imD�Ovemen� ii 5old wilhin one year oi Completl0n, ihe awner wiil haVe Ih¢ burden ol pmving he/S�e Eitl nat Dui10 ar impmve
lor Ine ou�oase ol Saiel.
1. as own¢r ol t�e pmperty, am exclusively cantrnctinq wilh licensetl canVaclars N can5fmct Ne prolecl (Section 7Q44, Busine35
❑ antl Pmtessions Cade: T�e Coniracbrs' S�ate License Law Does no� appry to an owner of D�operry who bwl0s or imprmes tAereon
an0 who conlracis �ar such pmjetis wil� a[oniraclor�sl license purSUant �o �he Conlraclors' S�a�e Lmense Law�. I am aware
ina� O�oo� ol IM1eir Warker's Comoensalion insurance sM1auld �e pmvide0 la me.
� I am e�empi un0er Setlion: B. 8 P. C. ,
fot tnis reasar.
�a�e: Ownec
I Oo hereby [enily Iha� I am awar¢ ol an0 unAerStand Ihe requir¢menls ai CalilOmia,Heal[h antl Safery COAe Settions 25505, 25533, and
255J<antl ��al I or any lulure buil0ing occupan� wilVwill no� (cire�e one) neea lo comply with SaiG slale codes and �he requir¢menR br a
pe�mn IDr constmction oi motlitication tiom t�e Ai� OuaNiy Manag¢ment ilisVict. Residemial cw+simction appiications are exempt trom
I�Ese D�ovisions.
Ua�e: AoO�icam:
I here�y cetldy I�at I �ave reatl Ihis aDO�ica1 n ana slaie Ihai I�e above intorma�ion is correct. 1 agree m comply wi�h all cily anC counry
ordinancesantlstaleiawSreWtingloEui�tling nslmclionan4herebyaulhoritereD�esenta(rveso��toenleruPon��ea6ove-mentiane�
pfOpQ��Y �Of IOSpCL1100 pOfpO5P5. /}—�� ��
Oale: Signalure: /l��/ �
orrve+'s �krnse oi Sociai secwny x:
i6a1�a6 W�ne—Bmldmg; Green—CoEe Enlorcemem; Canary—hp0licam: Pink—Revenue: Goltlenmd—Assessor
CITY OF COSTA MESA - BUILDING Pn^RMIT PERM NO; E 054881
PERMIT NO; E. 054881 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE: PERMIT TYPE; ElE PURPOSE: ALT
SOB DESCRIPTION ; INSTALL 5 CEILING rANS, s SUSPENDED HEAT SQ FT:
CLAIM VALUE: CALC-VALUE: GROUP OCC: H-2 /
COMMF.NT5: RE: fiB54877
�1(� �f iE •7E if ���iE iE �%��K-dE �� jE �k �� If d(-If �)f �%dE if iE df #%'1E �k �)f �N�iF iF df �Yi�1E �lf �IF if �1f 9F iF �N�iE �IF if # df ie dF i( �/F if iF # iE If if i4 �1E �49E iE �If iE �E iF # iEi4 ��E if �lf �1F iC if if �M 3E �1F
2 O N I N GS ERTEB�A�CIKRSE M E N T S
FRNT� ^ ~FT MAIT. BUTLDING ------- --- --------- ACCESSORY BUILDING --- — ----
TN REAR; FT IN FRNT: FT IN REAR: rT IN
LEFT: FT IN RGHT: FT IN iEFT: FT IN RGHT: FT IN
PARKING R&Q• PROV; PARC�L: 00000000 2Nn; REF NO:
Pi,ANN2NG NUT'ES>
i
3E iEli iF # ii• iE ik iF if i(� iF i( 3f iE 3E k 3E if 3E if 1E ii� ie i[� 9E iFlf aF iE iE iE �E iF iE 3E iF iE IE li� if iE iE iF iF iE iF 3f if 3Eif if # 3f > if 7F I( df if 3f if iE iC� �F iP ii 3e �E iE 3e iE if 3e 3E � 1ElE if
D E V E L O P M E N T S E R V I C E S R E(j U i R E M E N T S
ZONING APPROVED BY DATE;
BUILDING APPROVED BY : DATE;
APPLICATION ISSUED BY• DRTE: ll
iFifiElEiEiEiEiFiElEiEfEiEif3f+FiFiFi'riflfiF . . �k�kii�klFifafifiEiFiFiF'�'r��i'riF
iFifiEiFiFi4if-7hiFiFiEiflfN•ifiEiEiEiFihiEiElfiEiFK�iFifiEiPiE3EiEiFiE�1EiE�1fiE3Fi'r3EiFiF-1f��i�RiEifiE�iE3GifN�if•1FiEiE�7(�iF?4iEiFfEiF1'riFik�lf#f3ei'riEi6 �1FiE#
LEGAL�IZATS013:N F E E S U M M A R Y STRi7CTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANiC FIRE SMIP/RES GRADING
P�RMTT 22,50 '
PLAN 50$ SNtIP /NOi�-RES
ISSUE FEE 15.00 '
7liILDING-DIV-> PERMIT ISSUE PLAN-CHECK TOTAL PAID�, DUE
TOTALS----> . 22,50 15,00 0.00 37,50 37.50,.-. .00
REVENUE DIVTSION TOTALS--> COLLECTED; 37.50 OVER/SHORT:��� ,00
BLDG PMT PLUMBING ELECTRIC MECAANIC FZRE SMIP/TOT GRADING PLAN-CHECK
37.50 -, •=
ie aF if iE iE IF �1E-If- 3f 3F ih �E iF iF ie 9E if lE 7f IF ih iE iE 3f if if' ie if iE if� 1f dE iF iF iE 1F if �E %iEj(� iE k iF �f� �F ii i!� iF iF iElf iF 3F iF i(� fi� if jFiE N� �lE �7F�P i4 ii� iF 3F '�lE k iE if� le f�i+1f IE�}4
T N D I V I D U A L F E E B R E A K D O W N �`
i.
TYPE QTY D E 5 C R T P T I O N UNIT COST TOTAL COST
EiE 6 RECEPT/SWITCA 1 ST 20 EA, 75 4,5p
ELE � 6 MO'TOR/POWR APPARA�S 0.0 - 1.0 HP 3.00 .;,18.00
EXPfRED ND OF FEES
Incomplete Inspections ;IO1G':;,�1-_uiII1,=c7o � _ : • .;��
:�'��: =i..,:�i � .. li;.;
Oate �._�- - -- - Sig
CONSTRUCTION ANDPLANNING � POOL A
A�PROVALS Permit # Date Inspector p�ppROVALS Permit # Date Inspector
1. Temporery Electrical 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-Undrgrnd, 55. Eiectrical Bonding
5. Steel Reinforcement _ 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL 70 COVER�GUNITE
7. Footings 58. Electrical Conduit�Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor SYstem 61. APPROVAL 70 DECK
11. Property Sewer Line & HouseConnection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System � Finat
14. Rough Plumbing 65. Electrical-Final
15. flough E�ectrica6Conduit - 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 6$. 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 $tructure 70. Underground HYdro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test _ 72. Underground Flush - '
24. Roof Framing � 73.'Undergrnd.StorageTank OGas ❑Oil �
25. Roof Sheathing 74. Overhead Hydro _ �
26. T-Bar Ceiling (Structural) & Monocoat � 75. Dry Chemical �
27. Frame and FlEshing 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL ..
29. Insulation 78, FIRE PflEV. FINAL �
30. Drywall Nailing � ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power MeterFinal � - 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. �Nater Service�Final
40. Gas Service•Final �
41. Solar pomestic-Final , .
42. Backflow Preventer �
43. Backflow Irrigation �
44. Landscape Irripation System . '
45. Sound Attenuation , E X P I R E D
46. Handicag Regulations • ���p�et¢iTiS
47. FINAL STRUCTURE & BUtLDING te ��' Slg
48. FINAL PLANNING - � �
49. Electric Release to.Edison . .
50. Gas Release to Southern California Gas Co �
51. CERTIFICA7E OF OCCUPANCY �
No Date
Pfl0.1ECT p00flE55: � 3 Z W 1 7TH ST
owxen s xame: METAL CRAFTERS
RDOflESS: $�E
969-0169
AflCM/ENGINEEfl:
RUOflE55:
PEG.NO.:
�N�T: B
UNIT:
PENMITTEE: HUILDER GROUP ( 714 ) 969-0169
aooecss: 10290 IMPERIAL AV
GARDEN GROVE CA 92643
LILENSED CONTBACTOP DECIABRTION: I hereDy aflirm t�at I am licensetl under pmvisions ol CAaprer 9(commenting wit0 Seciian
7000� oi Oivision 3 oi t�e Business antl Pmlessions Cotle. ana my license is in full force ana eflect.
CITY UC.: Q= p � p 6 STpTE LIC.: 3 7 cuss:
�ate: //_ � � � / �aiure:�� . �
WOBRENS' COMPENSATION UECIANATION: I herehy aifirm I�a� I have a cehiliCa�e 0 ConSen� Io Self-insUre or a CetliliCate aI Work¢r5'
Compensation Insurance. or a cenitietl capy thereai 15ection 3800. LaG. C�.
POLICY NO.: E%P. OPTE:
COMPANY:
❑ CenitieA copy is nereby fumisnea. ❑ CertilieE capy fs IileC wit� the city BuilOing Oivision.
.le: ADPlitant:
E%EMPTIONFHOMWONKEPS'COMPENSATIONOEC PTION: (Thi5seclionneeCnotb¢[ompleleCiithepMmiliS�oronehmMreG�S700�ork55�.
I cerlify t�at in t�e Derformanc � Ihe work lor ic� Ihis permit is Issuetl. I s�all� mploy any rs in any manne�
su�le�, �Jhe Warkers' CamDen5ati0n Laws Ca0lomia.,` `j
Oale. �� � � � Signature: ��N
NOTICE: II. ailer malting �his dttlaration. you S�ouIC betame su��ect to ih2 y oMers' Compen5atian O�m'isions ol Ihe La6or
CaEe. yau mus� �ort�wit� mmON'm�� such O�ovisians or IN5 p¢rmit s�all U€ Aeemetl rerok¢G.
LONSTBOCTION LENOING PCENCY: I hereby affirm ��at t�ere i5 a cons�mction lentlinp aAency for �he Oehormance al l�e wark lar
whlch ��is pe�mii is issuetl �Sec�ion 3097. Civ. C).
LENDEN:
ADUPESS:
OWNEH BWLUEP DECUINATION: I hereby allirm I�al I am exempUmm Ihe Coniraclors' State License Law for me following reasan
(Seqion 7031.5 Business anG PmfeAional COtle: Any ciiy ol counry wliich repuires a Oelmi� Io conSlmci, alter, impwve. Oemolish, ar
repair any stmcwre. prior �o ns issuance. also repuires t�e apD�iwnt lor sucA De��� �o lile a siA�eO statem¢nt ttut Ae/she i5licenseU
pursuant to ihe Dmvisions of �he CanUacmrs' Staie License Law (Chapter 9(commencing wi�� Seciion 7000) of Division 3 of i�e Business
and Prolessions Coa¢) or ihat �e/5M1e is exemp� Iher¢imm an0 ��e basi5 for the allegetl ecemD��on. Any vioWtion al Sec�ion 7031.5 by
any applicant far a permit su�jecis the appliWnl to a civil ve�alry of not more tlun live hundre0 aollars (55110�.
I. as owner oi i�e pmpeny ar my employees witA wages as t�eir sole campensation, will tlo I�e work, ana Ihe
�❑ stmcwre ¢ not intenaea or offeretl lor sale (Section 70a4. Business anE Professional Co�e: T�e Contraciors' Siate Licenu Law
' does not aDOty m an owner ol a pmperty wM buil�s or impmves i�ereon, anC wlw does suc� work himself/�ersell or t�roup�
his or her own emD�oyees. D�a�4eU that such imDmvemenis are nat inteneetl ar ofiereA lar sale. If, however I�e Ouiltling or
impmvemem is sold wi�hin one year of completion, tAe owner will have the bur0en of pmving �eh�e 7itl noi bui10 or impmve
lor �he purpose ol sale�.
I, as owner af ihe pmperty. am exclusivety conlractinp witn Iicense0 caniractors to consiNCUhe pmiect (Seclion 7044, Business
J ana Pmiessrons Caae: Tne Caniractors' State License Law tlnes not apDM �o an ovmer of DmpenY who hmlas or improves ttrereon
antl who mnVat�S �or sutll projetl5 with a Conlratior(5) lic¢n5e Oursuan� lo ��e fAntratlars' $laie L¢¢n5e Law). I am aware
Ina� prool oi iheir Warker's Compensation insurance shoulG �e Omvi0e0 ta me.
� I am e�em0� untler Section: B. 8 P. C.
lor t�is reason:
Date: Uvnec
I Do �ere0y cenily t�at I am aware ol antl understan0 �he reQuiremenls of Calilomia Heatl� an0 Safery COAe Sections 25505. 25533, anG
25534 ana Ihai I or any lu�ure builJing accuDant wiNwill nol (circle one) nee4 io compty wi�h sai0 staie cotles antl I�e reQuiremen�s lor a
permit lor cons�mciion or moailica�ion imm ��e Air Oualny Managemen� @strici. Fevden�ial constmction aDPlications are e� mm
��ese pmvisions.
Da�e: APPlicam:
I hereby [er�ify Ihal l have reatl Ihis applicaUo antl Stale �ha� I�e abave in�ormaiion is correcL I agree �o comply with all cily antl counly
ortlinance5antl5iat¢IawSrelaUngloEuilaing n5tmdionanOh¢rebyauitqrizerepres¢nialiveso��his irytoemeruo��neabove�mentioneA
prope�ty lar inSDec�ion pur0oses.
Date-���- ��/ Signature: �
Oriver's license or Social Securiiy M:
�6a1-a6 Wm�e-9uilding: Green—COGe Eniorcemenl: Canary—Applicanl: Pmk—Revenoe; GoltlenroE—Assaswr
CITY OF COSTA MESA - BUILDING PERMIT PcRM NO: B U54874
PERMIT NO: B 054874 PLAN CHECi: NO; 04549-91 S GOVT; N SuPP; N
CONSTRUCTION TYPE; PERMIT TYPE; STR PURPOSc: AL7'
JOH DESCRIPTION : 3NSTALL POWER TABLE FLOOR VENT SQ FT: 1,500
CLAIM VALUE: 1,500.00 CALC-VALUE; 1,500.00 GROUP OCC: B-2 /
COMMENTS: X
+��r*�r****�*�***�*�*��*�*�r�r**�**�**�r**�r*�r��*����*x�x*���±�**��•*�u �*�*�c+����*��k*��**
Z O N I N G R E Q U I R E M E N T S
S E'P B A C K S
------------ MAIN BUILDING ---------- --------- ACCcSSORY BUILDING ---------
FRNT; FT IN REAR; FT IN FRNT; FT IiV REAR: FT IN
LEFT; FT IN RGHT; FT IN LEFT: FT TN RGAT: FT ZN
PARKZNG REp • PROV; FARCEL: OU000000 2AIE: REF NO:
PLANNING NfST'ES>
> •
it� 3F iF 3E N� iE iE iF iF ## ik If if iE iF 3F if �f iE iE IE if iE aF iE iF rt fF IE iF iF if �lk if iF aE i6 �F iE if M� iF iE iF �F lE iE i4 iE# if iF if if iF iE ie �F jf 3E if �lE iE iF IF if if K 1'r fE 3f 3E if iE i6 ii� iF �3E
D E V E L O P M E N T S E R V I C E S R E Q U Z R E M E N T S
ZONING APPROVED BY DATE;
HUILDING APPROVED HY ; � DATE:
APPLICATION ISSUcD BY• DATn• �� '�
if if if if ik iE iF if if iE if if 3f iF IF iF iE iE ie it iE iEiFiFiFiFTr iF iF7F7[ irlfiFiFif7F�FifiFie�7F3F7f � iFle iFTtif�'iF'7F �.. iF if I(�-7f�iF �lf iE� iE iE ia . . . y. i[.
ii1ElEi�iFi(��K�ii�i('iFafiEiF*jhiEiFi6ififiFiFIFiE3EiFiFlEiflFk�ifiFiF#�ifiElFlFiFlfii�ifif�7FiF3FiE1fiflelfiElFiFk�f�EifieiE�E3EitlElfififi�i'tiF3fiEif��E 3Ff!�af
LEGALIZATION:N F E E 5 U M M A R Y STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRSC MECHANIC FIRE SMIP/RES : GRAbING
PERMIT 35.00 '
SM I P/ NON.-Rc. S
PLAN 22.75 .50 _
ISSUE FEE -,
BUILDING-DIV-> PERMIT ISSliE PLAN-CHECK TOTAL PAID- • DUE
TOTALS----> 35,50 O.OU 22.75 58.25 58.25'- ;.� .00
REVENUE DIVISION TOTALS--> COLLECTED: 58.25 OVER/SFIORT: � 00
BLDG PMT PLUMHING ELcCTRIC MECHANZC rIRE SMZP/TOT GRADING RLAN-CHECK
35,00 .5� 22,%j
3F jF iF if iE it it 3E aE if k�7F 3k if �lE if if jF iE iF iF jf 1E Y if if iE it af if iE lt at jf 3F af if ik 3E aE iE iF iE it af iE if if it 1E if jf Ic if �if �iF �3f aE+E3E iE i(� aF at iF �"r jF 3E iF 3E 3f 3F iS 1F if 3F iEiE iF
I iJ D I V I D U A L F E E B R E A K D O W N �r
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL CUST
cvr � snn nr.T�a av VLT.TiF COMN.ERCIAL NOZONE � nn � son nn
!
i
EXPIRED
Incomplete Inspections
l}dI@ .�-- - - - S�8 — - --
n
t
END OF FEES
�
CS •�L:t;151:-CC,I�i.`=�:• 'v"<<: r E;,.:S
"!ATi.t ii/G:it9i F:F:c: i?:5a
CONSTRUCTION ANDPLANNING POOLF .
APPROVALS Permit # ' Date Inspector qppROVALS Permir # Date Inspector
7. Temporary Electrical Service-or Pole 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. , � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms.
� 4. Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Sreel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings 58. Electrica� Conduit�Undrgrnd.
B. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. � 60. Backwash Lines, P�Trap, O U�drgrnd.
10. Structural Floor Svstem , 61. APPROVAL TO DECK �
11. Property Sewer Line & House Connection 62. Backwa:h & Receptor�Final .
12. Sewer Cap � 63. Heater & Vent-Final
13. floof Drains , 64. Plumbing System - Final �
14. Rough Plumbing • � 65. EleCtrical-Final
15. Fough Electrica6Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Appioval
17. Rough Wiring Sign 68. APPROVED FOR PI.ASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS F�NAL
19. Rough Heating & A�r Conditioning -�FIRE DEPT. REQUIREMENT "
20. Rough Factory Fireplace � APPROVALS Permit #
21 . Ducts, in $tructure _ . . 70. Undergro4nd Hydro
22. Ducts, Ventiiating - 71. Product Piping O Gas � Oil
23. Gas Pipe�Rough & Test 72. Underground Flush � �
24. Roof Framing • '�73.' Undergrnd�. Storage Tank O Gas ❑ Oil .
25. ftoof Sheathing 74. Overhead Hydro �
26. T�Bar Ceiling (Siructural) & Monocoat 75. Dry Chemical � �. ,
27. Frame and Flashing 76. Dry Standpipe -
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation . . 78, FIRE PREV. FINqL .
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating & Air Conditioning
35. Final Gas Pipe•Test , �
36. Hood or Canopy �
37. Final FaEtory Fireplace � . ' ^ '
38. Final Plumbing
39. Wacer Service-Final
40. Gas Service�Final � , �
41. Solar pomestic•Final • � . ' �
42. Backfiow Preventer � �
43. Backflow Irrigation ` �
44. Landscape Irrigation System � � � �
45. Sound Attenuation • . ,
46. Handicap Requlations X-P-I-R-E-D
mp t$_ ctions
47. FINAL STRUCTURE & BU�IDING Q ��
� _r�'`_�
48. FINAL PI_ANNING � e '
49. Electric Release to Edison
50. Gas Release to $outhern Califurnia Gas Co � j��
51. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECT ADOflE55: '� 3 2 w 1"� i x $Z'
OWNEN'S NAME: METAL CRAfiTERS
nooxEss: gp�g
969-0169
PflCHIENGINEEP:
pODflE55:
flEG.NO.:
uNiT:� CITY OF COSTA NESA — BUILDING PERMIT PERM NO; N 054876
PERMIT NO; M 054876 PLAN CHECK NO; N GOVT; N SUPP: N
CONSTRUCTION TYPE; PERM•IT TYPE: MEC PURPOSE: ALT
UNIT:
PEPMITTEE: BUZLDER GROUP 1714)969-Oi69
noosess: g0190 ZMPERIAL AV
GARDEN GROVE CA 92643
IICENSEO CONTflFCTON UECIABATION: 1 here6y allirm t�al I am licensetl untler O�ovisions ol Chap�er 9(commencinA wi�� Seciion
7000) 0� Division 3 0l Ihe Business antl Prolessipns Cotle. antl my license is in Iuilforce antl effect.
CITY LIC.: O S 10 6�TE uc.�. �� 3 �P q� cu�ss: p .
Date: ' ISignalUr¢: `y/%��J �
WOBI(E8S' COMPENSATION OECLABFTION: I hereby aifi m tnal I �ave a certificate t consent m sel4insure m a cetlificale al Workers'
Compensation Insurance. ar a ceniliea copy Iher¢oi (Secuon 3800, LaO. C).
POLICY NO.: E%P. OPTE:
COMPRNY:
❑ Cenifie0 copY is here�y furnis�e0. ❑ Cenilietl copy is IileO wit� t�e ciry Buildinq Division.
Ae: PPPlicanC
E%EMPTION FflOM WOflREflS' COMPENSATION�p�TIQN: (iAiS 5tt1iDn neetl iwI GG fAmO�� �� me Parmi� is �a 0ne hutqr¢C �5100) or 1e55).
I ceriify �hat in Ihe pedormance o� the work f r wAich this Oermit is issuetl. I shall noi emDloy any p n in any manner So as to become
subje[t lo Ihe Woders' fAmpensation la o� Calilomi .
Date: �% ' �� `� SignaNre: - /
NOTICE: II, aft¢r making Ihis declaraiion, you should ecome su6ject �o ihe rker5' Compen55tion pmvisions ol Ihe Labor f
Code, yoU mu5� Iorl�wiih comply wi�h Suth p�avi5ion5 ar I�is permil S�ail Ce DeemeO revOketl. �
CONSTHUCTION LENOINC AGENCY: I hereby apirm Ihal �here is a constmction lentling agency for the pedormance oi l�e work �or
w�ic� I�is Oarmil is issuetl (Sec�ion 3097. Civ. C).
IENOEX:
AOUflE55:
OWNEN BUILDEfl OECLAflRTION: 1 hereby allirm Ihat I am ¢xempl Iwm Ihe Coniractors' State License Law for Ihe I011owinA �eason
(Section 70.71.5 Business an0 Pmtes4onal CaOe: qny cily ol counry w�ich reQuireS a permi� to wnstruct, alter, improve, UemalaA, or
rt0av any stmciure. priar to its iuuance. alsa requires t�e apDlicani for suc� De�mit to file a signetl statement ihat �tlshe is IicenseG
pur5uani la Ihe pmvisions ol t�e Conirac�ors' Sia@ License Law (Chap�er 9(cammencinA wit� Sec�ion 7000) ol 0ivision 9 oi �he Business
ann Pmiesvons CoCe) ar ihal �elshe is exempt tp¢�elmm an0 ihe basis lar tAe allegetl exemption. Any violatian ol Seclion 7037.5 hy
any applicanl lor a Dermit su0jects I�e apDlicani to a civd penalry o� noi more �han irve �untlre0 Uollars (55011).
I, as owner of ihe pmpeny or my employees with wages as their sole compensa�ion, wi11 Ao the work, and ihe
❑ simcwre is not intentlee ar ofiere0 for sal¢ �geclion 7074, Bu5inE55 an0 Professional COJe: The fAnlratiors' S�ate LitenSe LaW
aoes no� aoP�Y �o an awner ai a pm0eny wtw builtls or improves thereon, antl wno does such work himsell/Aerseti ar �nrou0h
�is or her own employees, pwvitled ihat such impmvemenls are not inten0e0 or ofteretl for sate. II, however ihe 6uiltling or
impmvemeni is sold wi�hin one year ol Complelion. Ihe owner will have Ihe burtlen oi proving he/she Oitl noi LuiIJ or imD�ove
Iar ine vurpose ol sale).
I, as owner ol IAe pmpetly, am exclusively �onVac�ing with IicenseA coniractars to con5imc� �he prolec� (Sec�ion 7044, Business
L� anA Pmfession5 Code: The Contractors' $la�e License Law tloe5 noi aD01y to an owner ot Omperty who builas or improves Ihereon
an0 who conVacls lor such pmletls wilh a coniractor�s�license pursuantlo the Conirac�ars' S�ale L¢en5e Law),I am aware
��ai Dmol ol �heir Worker'S Compen5a�i0n insurance shoWa be pmvi4e0 �o me.
� I am exem0� untler Sec�ion: B. 8 P. C.
lor Inis reason:
oate: Oxner.
I ao nereey cendy Inal I am aware oi ane unaerstantl Ihe requiremenis of Calilomia Heallh and Safety COAe Seqions 25505. 25533, anE
25534 ane �ha� I or any lumre builaing accupam wilUwill not (tircle one) neeU to comON ��h sai0 state cotles antl ihe repuirtmenis lar a
permi� lor cansimciion or moddication imm Ihe ti� Oua6ry ManaAement Oisirict. Fes�Eential consimc�ion applica�rons are exemp� imm
IMse pravision5.
Oale: ADP��canl:
I neieby cenify thai I nave reaU ihis apPhcaiion 4 s�ale I�al I�e abave inlormalion is correct. 1 agree to comply wi�� all ciry ana Counly
ortlinancesandslatelawsrela�inglobuildingco imctionan rehyau�Irorizere0�esenlativesalt�iscityt enteruponihea0ove�mentionetl
pmpetly 10� i peclion Our�po�sesj.
�a�e: �" � / Signa�ure: �7 '�
oriver's �icense or Sociai Securiry x:
i64i�e6 Wbite-6uilaing; Green—Cotle Enlorcemem; Canary—Applicam: Pink—Revenue: Goltlenro�—Assessor
JOB DESCRIPTION : INSTALL POWER TABLE FLOOR VEtvT SQ FT:
CLAIM VALUE: CALC—VALUE: GROUP OCC: B-2 /
COMMENT5: RE:�tB54874
�k iE �fc iF if �%dE iE �k iE iE ��iFif jF N� if iE �K-�1(�# � jc iE �1F-1E �� iE M if # it �N 3FlE 1E �lE9F �l! if �1(�if iE # iE �3E�1c iE iF ii if if �IFiE9E �If iF �%��# �k 1f �M iE �lF �A� if iE��X � bf iE IEiE if �If iE i[� d(
Z O N Z N G R E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUZLDING ---------
FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN
LEFT; FT ZN RGHT: FT IN LEFT: FT IN RGHT: FT IN
PARKIIdG REO• PROV; PARCEL; 00000000 2NE; REF NO;
PLANN3NG N()'CES>
�
iE IE iE if iF jF if lf iF �f iE �1F 3E iF aE iE If aE iE ff fF iEiE fE iE ff 1f iE iE iF i'r iF iE aE if iE 141f IE * jf 3E �1f if ik i'r ie If iF iE iF 3F if !E �1f IFie iF i/� iF �E jE iF �lF i(� iE3F i!� 3i iF 3(� :i�lE �E 3F �E if if if
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
20NING APPROVED BY DATE:
BUILDZNG APPROVED HY : DATE:
APPLICATION I3SUED BY: DATE:
lFlEitif#FiFiflflf�lFiEif3Pii��fi'tiFif1F1F1E3F x 3Fii�iF�F1EiEiER#��F ��1t�IF
3E fE 3F 3f if i6�k 3F iF aE aF �7E iE iFif ie iF iF iF 3f N� �f if d6 iE if 3f lf if if 9E jF if jf if iE IP 3F af �E iF # if iE ii� 3E iE3E if )E iF �E �f )f if iF IF iF if iejE ie iF If 3f #-iE iF iE 3E aE iF iF 3E 3f iE iF i af
Lr.GALI2ATION:N F E E 5 U M M A R Y STRUCTT.iRAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES' GRADZNG
PERMIT 625i 5N,IP/NON—RE$
YI,AN : �:• �
ISSUE FEE 15. 00 =.�;:, �.
BliZLDING—DYV—> PERMIT ISSUE PLAN—CHECR TOTAL PAID "' DUE
TOTALS----> 6,50 15,00 0,00 7.1.50 21.50"" ,00
REVENUE DIVISION TOTALS--> COLLECTED: 21.50 OVER/SHORT•' �.� 00
BLDG PMT PLUMBING fiLECTRIC MECHANIc�C FIRE SMIP/TOT GRADING PLAN—CHECK
21 . J� 1 • '., rr.; •
if iE if ih iE ik iE iF iE iF if iE iF i61F dE iE iE iF 3E 3f� iF i� iE fF dE iE # if N- 3f� iF 3!� iF iE iE 1F iF>f 3E if iE iF iE iF i[� �lE iF iE i61E iF #F iE iE iF If iE ih ff iF iF jE?e#� if 3f 3(�!f iF �e iF aE If?E iE iE if iE
I N D I V I D U A L r E E B R E A Y. D U i^I N
TYPE QTY D E S C R I P T I O N UNZT COST J',TOTAL COST
MEC j 1 EACH APPL NOT TN OTHER CAT U1�'DER FnE
EXPIRED END OF rEES
Incomplete Inspection5
� �ate .Y - _ _ Sig -
6.50
Cl u�ili�)ZJ."'JG`.�.Dir�� �y . a�T
�nr� i:�t�51:. ZI'tE: lia`.:
��
n : :l':
CONSTRUCTION ANDPLANNING POOL 4
APPROVALS Permit #- Date Inspector pppROVALS Permi+ # Date Inspector
1. Temporary Electrical Serviceor Pole 52.,Pooi & Equipment Location
2. Soil Pipe�Undrgrnd. � 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement ' � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings , 58. Eiectricai Cpnduit•Undrgrnd.
8. Foundation . � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash �ines, P�Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK �
i i. Property Sewer Line & House C4nnection 62. Backwash & Recepmr•Final �
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains , 64. Plumbing System • Final
14. Rough Plumbing 65. Electrical�Final
15. Rough Electrical�Conduit 66. Solar System�Final
76. Rough Electric Wiring 67. Fencing & Access Approval
1�. Reugh Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electridl�T Bar Ceiling 69. POOI(SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace - APPROVALS Permit #
21. Ducts, in Structure - 70. Underground Hydro
22. Ducts, Ventilating , 71. Product Piping � Gas ❑ Oil
23. Gas Pipe�Rouqh & Yest 72. Underground Flush
24. Roof Framing 73. Undergrnd.StorageTankOGas ❑Oil .
25. Roof Sheathing � 74. Overhead Hydro
26. T�Bar Ceiling (Structural) & Monocoat 75. Dry Chemical '
27. Frame and Flashing ' 76. Dry Standpipe .
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL '
30. Drywall Nailing � , HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79.'FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED .
33. Final Electric , Notes:
34. Final Heating & Air Conditioning . '
35. Final Gas Pipe�Test
36. Hood or Canopy
37. Final Factory Fireplacc - �
38. Final Plumbing .
39. Water Service-Final -
40. Gas Service�Final .
�41. Solar pomesticFinal - I �
42. Backflow Preventer �
43. Backflow Irrigation
44. Landscape Irriqation System - .
45. Sound ,Attenuation E X P I R E D
46. Handicap Regulations . �I'It Rl lete Inspections
47. PINALSTRUCTURE&BUILDING ('p: ��' 'qj�s�_r
48. FINAL PI.ANNING
49. Electric Release to Edison �
50. Gas Release to Southern Califurnia Gas Co �. '
51. CERTIFICATE OF OCCUPANCY
No. Date
PflOJECT RDDNESS: '] 3? ti,J 1'�'I`H ST
OWNEB'S NAME: METAL CRAFTER3
aooncss: gpyg
969-0169
AFCHIENGMEEfl:
AOOHE55:
PEG.NO.:
uNir: B
UNIT:
PEPMIT7EE: AUII.AER GROUP ( 714 ) 969—Oi69
aoonEss: 10190 IMPERIAL AV
GARDEN GROVE CA 92643
❑LENSEo LONTBRC70B OECLABFTION: I �e�eby atli�m i�al I am Iicense0 untler proviaions of C�apter 9lcammencing wiN Sectron
7qp) ol Dirsion 3 0l �he Business ane Pr01¢s5ion5 Code. an0 my I¢en50 is in lull torce antl etl¢ct.
ciTvuc.: 05010 STATEL1�583i0�ass: B /
Oate: �� S� �� Signatur¢; _ _ _ �
WONREflS'COMPENSAiIONDECIANATION: IhereDya��iimlhailhaveatertiliCaleO� nsenitasell�insweuracenifiwteoiWorkers'
ComDensation msurance. or a ceniliea copy inereol (Section 3800. Lab. CI.
POLILY NO.: EXP. ORTE:
COMPFNY:
❑ Cenilietl copy is �ere0y lumis�etl. ❑ Cenifiep �oDY �s fileE vnt� t�e city BuilGing Oivision.
,le: Ap0lica�l:
EIIEMPTION FBOM WOBI(EBS' COMPENSATION OE M710N: �fiis senion neea no� Ge compleie0 if �he permit is for one hu�qred (S70D) or less�.
I certity Ihat in I�e OeAormance ol ��e work 10 �ich IAis per ' i5 i55ue0, I shall noi employ any p r �' any manner 50 a5 io become
Su�jeci lo I/�e�/Vp_ rkers' fAmpenSaiion Law of Cali�ornia. �7 j�
Da1e: / / � �r� Signalure: lr%iZ /!' // A . -
NOTILE: If, aller makinA lhis tleclaration. you shoulG be ome subjeci to ihe Ny rkers' Compensation provisions� of the Lahor
CoGe. you must fonliwilh compty witA suc� D�ov�5ion5 or I�is permit Shall 6lOeemeO revok¢A.
CONSTNIlCTION LENUING AGENCY: I hereby allirm ihat Ihere is a consimc�ion lentling aAency lor the Dedormance of the work lo
which Ihis oermit is issuea (Seciion 3097. Civ. C�.
LENOEfl:
aooeess:
OWNEfl BUILUEP DECLABpTION: I here6y allirm Iha� I am exempt Imm Ihe Coniraclors' Sta�e License Law tar �he �ollowinp reason
(Section 7031.5 Business and Pmlessionai Code: Nny ci�y oi county wnich repuires a permil to constmct, alter, improve, eemolish, or
repair arry struciure, prior (o its issumce. aisa requires �h¢ applicant far such permit to (Ae a siB� statemeni 2�at he/she is IkensM
pursuant lo the provisions of Ihe ConVac�ors' $Iale licOnse Law (Chap�er 9(commencing wiih Section 7�00) ol �ivision 3 ot �he Business
and Professions Cotle) oriha� he/s�e is e�empithe�elwm antl Ihe basis lo�lhe allegetl exemp�ion. Fny violation o� Section 7031.5 hy
any apolicant for a permit suhiects �he apP�icanl ta a civil penalty ol nol more Inan live hunOreO tlotlars (SSIq�.
I. as owner al ihe pmDe��Y or my empIOyees with wages as Iheir sole compensation, will ao t�e work, antl ihe
�.� simcmre is not inten0ed or olleretl br sale (Seclion 7044, Business and Pmiessional Cotle: t�e Contracmrs' State License Law
Ooes not aD01y lo an owner of a D�openy wllo Uuiltls or impmves Ihereon, antl w�o does such work himsell/hersell ar Ihrough
nis or �er own employees. pmviUeO ��at sudi imDmvemenis are noi inlentletl or o0ered lor sale. It, �owever �he huilAinB or
improvemem is soltl within ane year of compl¢�ion. Ihe owner will have Ihe burtlen ot pmving he/she Oitl not huild or impmve
• lo� Ihe purpose af sale).
I. as owner of ihe pm0eny, am e�clusively con�mc�ing wiih licensetl contracmrs lo cons�mc� �he pmlect (Sec�ion 7044, Business
'❑ an� Pm�e55i0n5 COde: The Contratiors' State l,icense Law does na� apply to an owner of pmper[y who hmlQs or impmves iherean
antl who coniracis �or suc� pmlecis wiih a cOnlractOr�s) license pur5uani to Ihe COnlraclor5' Slaie LRense Law�. I am aware
Ihat pmol ol Iheir Worker'S Compensalion insurance stlould 6e pmviaetl lo me.
� I am esem0� unaer Setlion: B. 8 P. C.
lor this rea5on: ' �
�a�e: Owner.
I tlo nere�y cenily Inat I am aware ol ane unaerslantl Ine reQuirements ol Calilomia Healih ana Safery Catle Sections 25505, 25533. anU
25534 an4lhatloranylulure builEing occupanlwilVwillnol (circle one�nee0 lo comply with said state todes and ihe reQuirementstor a
permil lor conslmction ar moCilication trom ine Air OUahly Managemenl Oistrict. Pesiaential constmction applications are exempt imm
inese provisiona
Oate: pOD��an�;
I �ereby certify Ihat 1 �ave read Ihis applicali and sldte I�ai Ihe a�ove inlormalion is correct. I agree Io compty vn�h all ci�y antl counry
ortlinawes an0 stale laws rela�ing Io Euiltlmg s�mtlian anC �ere0y a ree represen a�ives o a- to enier upon Ihe ahpve-menlpne0
pmpetly fo� fnspecliun purposes. '
Date: ��___f_�_ S�gna�ure:
od�er's ��cense o� Sociai Securiiv +�
i641-46 Wbite—Budding: Green—CoOe Enlo¢ement: Canary—Applicant; P�nk—Revenue; Goltlenroa—Assessor
CITY UF COSTA MESA — B[3ILDING PERMZT PERM NO: E 05487`_
PERMIT NO; E U548"75 PLAN CHECK NO: N GOVT: N SUPF; N
CONSTRUCTIOtv TYPE: PERMIT TYPE: ELE PURPOSE: ALT
JOB DESCRIPTION : INSTALL POWER TABLE FLOOR VENT SQ FT:
CLAIN. VALUE: CALC—VALUE: GROtJP OCC: B-2 /
COMMENTS: RE:#H5487�
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7. O N I N G R E Q U Z R E M E N T S
, s E T H a c x s
------------ MAIN BUILDING ---------- --------- ACCESSORY 3UILDING ---------
FRNT: FT IN REAR: FT ZN FRNT: FT IN REAR; FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT ZN RGHT; FT IN
PARKING REQ• PROV: PARCEL: 00000000 2NE: REF NO:
PLANNING N(STES>
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D E V E L O P M, E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED bY : llATE:
APPLICATION ISSUED BY: DATE• 1�
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LEGALTZATION;N F E E S U M M A R Y STRUC�,iJRAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES C•RADSNG
PERMIT 9.50 '•
S0± ShIIP/NOiV—RES"
PI,AN
ISSUE FEE 15.OU
BUILDING—AIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID � DI7E
TOTALS----> 4.50 15.00 0,00 19.50 19.50' "" �� ,00
REVENUE DIVISTON TOTAT,S--> COLLECTED: 19.50 OVER/SHORT; ' '; 00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMZP/TOT GRADING PLAN—CHECK
19 . 5 0 s ,.,
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I N D I V 2 D U A L F E E B R E A K D O W N �"
r
TYPE C,�TY D E S C R I P T Z O N UNIT COST �TOTAL COST
ELE 2 RECEPT/SWITCi1 1 ST 20 EA. 75 1.50
ELE 1 MOTOR/POWR APFARATUS 0.0 — 1,0 HP 3.00 3,00
; ENll OF FEES
M
EXPIRED
Incomplete Inspections
Q'dtB .YI _'_. SIg �---""'r"�
S
a
1�i J��Q�_..�S��GI� i�.%J ( ti�7 .4�.i�f1
6NTE� II/LS/91 7T��c: 1j:::
CONSTRUCTION ANOPLANNING POOL A
APPROVALS Permit # � Date Inspector qppROVALS Permit # Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Sdii Pipe-Undrgrnd. 53. Steel Reintorcement �
3. Electrical Conduit Util[ty-Undrgrnd. 54. Forms
4. Electrical Co�duit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement � 56. Rough Plumbing & P�essure. Test
6. Electrical UPER Grnd. 57. APPROVAL TO COVER-GUNITE
7. footings 58. Electrical Conduit-Undrgrnd. '
8. Foundation 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe-Undrgrnd. � � 60.� Backwash Lines, P�Trap, O Undrgrnd.
10. Structural Floor System - 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection � 62. Backwash & Receptor�Final
12. Sewer Cap . 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System � Final � �
74. Rough Plumbing � 65. Electrical-Final
15. Rough Electri�al�Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access ApProval
17. Rough Wiring Sign 6S. APPROVEb FOR PLASTERING
18. Rough Electrical-T Bar Ceiling, 69. POOVSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20.� Rough Factory Fireplace • APPROVALS Permit #
21. Duc[5, in Structure 70. lJnderground Hydro
22. Ducts, Ventilating � � 77. Product Piping OGas ❑Oil
23. Gas Pipe•Rough & Test 72. Underground Flush '
24. Roof Framing 73. Undergrnd. Storage Tank � Gas ❑ Oil
25. Roof Sheathing � 74. Overhead Hydro ��
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashipg � 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 Eleciric ' Notes: • -
34. Final Heating & F',ir 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 pomesticFinal �
42. Backflow Preventer
43. Backflow Irrigation •
44. Landscape Irrigation System � . �
45. Sound Attenuation -
46. Handican Regulations � ,
47. FINAL STRUCTURE & BUILD�NG � �+�
let@ InSp�Y�S
48. FINALPLANNING
49. Electric Release to Edison L�t@ .�
50. Gas Release to Southern California Gas Co � �
51. CERTIPICATE OF OCCUPANCY
No. Date
,\
\
Ciry of Costa Mesa
Development ServiCes Department
Building Safety Division
P. O. Box 1200
Costa Mesa, Califomia
CERTIFICATE OF OCCUPANCY No. Q����¢�
7he Building located at 732 West 17th Stteet. euildinq B
has been inspeCted and found to comply with Ihe provisions of all City of Costa Mesa Ordinances applicable thereto
for a Group_ H2
Use of Buildin�
Legal D
ccupancy.
Induatrial
424�081-19
� (See reverse side for Metes and Bounds)
Building Permit No B 46379 Electrical Permit No. Plumbing Permit.No._
Fire Prevention Permit No. E47880, F47647
Mechanical Permit No. Number of apartments and/or guest rooms
ISSUED T0:
Pater Rothschild
t366 w. 18th street
Costa t•1asa, Cp 92626
Building Official Tonv C'Da Baca
, �
by .. ' �•�
- Date February 27, ,1991
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. 307 (e) U.B.C.
CMF 3015-46 rev. 7/83 White - Owner; Canary - Numerical File; Pink - Bldg. Permit File '
�
PR0.1ECTpODBESS: 7jZ W 17TH ST ' UMIT: "
ownEe•s n�xi: METAL CRAFTEAS ' '
�ooxcss: SAME '
� 969-0169
AflCyIENGII�EEfl: NEO.NO.:
noopess: uxR:
/,
PEXMRTEE: $UILDER GROUP � ( 714 ) 969-0169
. nooeEss: 10190 IMPERIAL AV
� GAADEN GROVE CA 92693
LICENBED CONTMCiOfl DECUMTION: I �ereby aflirm t�a[ I am IicenseU un0er Dmvisians oi Chapter 9(commencing with Section
7000) of Division 3 of [he Business antl Professions Cotle, antl my license is in fuliforce anE ettect -
ci�' uc.: 0 5 O 10 6 sr�re uc.: 8 3 7 Q.7 �. cuss: ��6`���
Siqnature: ��> d �
ENS' C MPEN311TI N DEClAMT10 : I here0y attirm tAat I have a certitiwte ol consent ro self�insure m a cetlificate of Workers'
mDensation Insuranc , r ertihe0 coDY �hereo/ (Section 3800, Lah. C�.
�roucv xo.; 118 ���Z �- 9 0 EXP. DRTE: O 3/ O 1 I 9 1
cornvexv: STATE FUND
❑ Certi/ie0 copy is hereby fumishetl. �/ Ce�ifieE copy is file0 vn[h the ciry Buildinp DiNsio .
Date: �_�_L pPDlicanC �.�� �+_ �
FXFMPTION FNOM WOHKEIIS' COMPEXSATION OECUMTION: (1Ab section need not e wmDlet� ii the permil is for oim hunEred (5100) or Iess .
. I certi/y ihat in ihe De�ormance oi tAa work far w�ich this permit is issued, I s�all not emDloy any person in any manner sa as to Uecome
, su�lect to the Workers' Campensation Laws of Ca�itornia. ' _
Date: ' SiAnature:
NOTICE: tl, atler making ihis Oeclaation, you s�ou10 Uttome suhlect to tAe Workers Compensation pmvisions of Ihe LaUor
Code, you must fonhwith camply with such pmNsions or tAis De�mit shall be EeemeE revoked.
CON37NUCTION 1EN01NG �GENCY: I hereGy aHirm Ihat thea is a construction IenCinp aqency far Ihe perlarmance of the work for
w�icRNis permit is issued (Section 3097, Civ. C�.
LENOEN:
" "`" 'FOONESS:- .
OWNER BOILOEN OECUM710N: I Aereby affirm that I am eaempt from the Contractors State Licensa Law lor IDe tollowinp reazon
(Section 7031 S 9usiness ana Professional Catle: My dry oi counry which reQuims a permit [o construct, alter, improve, Aemolis�, ar
� repair any struclure, pnor ro Rs issuance, also reQuires tAe aDPlicant /or such permit to fle a signeE statement ihat he/s�e is IicenseE
oursuant to Ihe Oravisians at the Con[racrors' S[ate License �aw (Chapter 9(commencinp wilh Section 7000) oi �ivision 3 oi the Businea
, U Professions Code) ortha[ he/she Is exempt Iher¢Imm anE ihe basis Port�e allepeE exemption. Any violation of Section 7031.5 by
. � aDDlicant lar a Oermi[ su�lects t�e applicant to a civil Oenalty of nat more ihan five hundred dollars (5500)..
I, as owner of ihe proOeM ar my emGloyees witA waAes as their sole compensation, will tla ihe work, antl the
O stmcmre is not intentletl or oflereG for sale (Secimn 7044, Business and Pmfessional Coda: The Coniractors' S[ate License Law
- does noi aODN �o an owner of a DropeM �o Uuiltls or impmves IAereon, an0 who tices suc� woA �imsett/Oersell or t�muph
�is ar her awn emD�oyees, D�odtletl that such imD�ovements are not intenOeC or oHeretl lor sale. II, �owever tAe EuilOinp ar
. improvement is solC vnihin one year of completian, tAe owner vnll have ihe buraen oi praWnq �e/s�e Ai0 not hui10 ar im0�ove
fort�e Ourpase oi ule�.
I, as owner oi the proDerly, am exclusively contractinp vrith licensatl contractors ro consiruct the D�ole�� (Sedion 70A4, Business
❑ an0 Pmfesslons Code: The Contracrors' State Licenu Law Ooes not apply lo an owner oi pmperty who 6mI0s oi impraves t�ereon
an0 who con[racis for such projects wit� a coniracror�s)license Oursuant tothe Contractors' S�ale Licenu Law�. I am aware
IAat D�oof of their Worker's Compenution insurance shoultl be proviAeA ro ma. '
� I am exempi unEer Seciion: � B. 8 P. C.
IOr IhiS reason:
�ate: Owner.
I da hereby certity Ihat I am aware o� and understantl Ihe requirements of Calitomia HealtA and Safery Coae Sections 25505, 25533, and
25537'anA that I or any fumre buildinp occupant will/will not (circle one) neeA to compy with saitl sWte coAes anE the requirements for a
permit for constmdian or mo0ification irom Ne Air �ualiry ManaAement District. Hesitlential consiruction apDlica[ions are exempt Iram
t�ese pmvisions. ' _
Date: Applicant:
I �ereGy certiry Ihat I have reaE [his a00�icatian an0 state Ihat the above iniormation is cor2ct I aqree to compN �h all ciry anU coun .
or0inances anE state laws relatin0 �o Cuildinp nstmction antl Aereby authonze representatives of thi�iry to enter upon Ihe abova-mantion
pmDerty tor insDectian purposes.
r /
Date: SignaNre:
Dnver's license ar Social Secunry x: �
1641-Ofi W�it�BuilAing; Graen—Cotle Enforcemanp Canary—Applkant; Pink—Rev¢nue; GoltlanroE—Aqsessor
CITY OF COSTA MESA - BUILDZNG PERMIT
PERMIT NO: HME 048675 PLAN CHECK NO; 05397-90 S
CONSTRUCTION TYPE; PERMIT TYPE: ELE MEC STk
JOB DESCRIPTION ; INSTALL ROOF VENT
PERM NO: BME 048675
GOVT: N SUPP: N
PURPOSE:.ALT
SQ FT;� 2,500
CLAIM VALUE: 2,500.00 CALC-VALUE: 2,500.00 GROUP OCC: B-2 /
COMMENTS: VENT FOR ELIMINATED WINDOWS '
**�**n��*�����tx *-x�*��******�����***�r*��*�r*****��**�**��r**�****��+r*�r**��*�r**��**
Z O N I N G R' E Q U I R E M E N T S
S E T H A C K S �
------------ MAIN BUILDING ---------- --------- ACCESSORY BIJILDING ---------
FRNT; FT ZN REAR; FT IN FRNT: FT IN REAR: FT IN
LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: F,T �IN
PAAKING REQ• PROV: PARCEL: 00000000 ZNE: REF NO:
PLANNING NtS'I'ES>
) �
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D E V E L O P M E N T S EyR V I C E S R E Q U I R E M E N T�>S
ZONING APPROVED BY !"i � DATE: ':�
HUILDING APPROVED BY ; c� DATE: �
7�
APPLICATION ISSUED BY: �� ' �— DATE: �— � �
jFiFifiEjEiEifiEjEiEitifiEjFikiF3fifiF�tifil3f�3F3f3FiF3f�iFiFifiF�F3F3f3F�3f3F� iFiF���3FiFiFiFiF�3f�ik�t3E�E1EilikiEjE�F3FiF itiE
3t it it iF iE iE it iE 3E 3E iE iF iE 3f iF iE 3E �E if �k jt it iE iE iE ik if it ik jE iF 3F �E �E 9E�IE it iE 3F 1t 3E it �E �E iF iE 1E iE iE iF 9E aE 3t 3E iE iE iE 1E iE �F �k it iF iF iF iE if ik iF iE iE iE ik 3E if if iE iE 3E
LEGALIZATION:N F E E 5 U`M M A R Y' STRUCTURAL SEGMENT:Y
BLDG PMT PLUMHING ELECTRIC;;;MECHANIC FIRE SMIP/RES GRADING
PERMIT 54.00 � 7.50="} 6.50
SOR�'. 25$ SMIP/NON-RES
PLAN 35,10 ' ';• . .50
ISSUE FEE 15.00,..5 15.00
BUILDING-DIV-> PERMIT ISSUE PLAN-�CHECK TOTAL PAID DUE
TOTALS----> 68.50 30.00 35•:10 133.60 133.60 .00
REVENUE DIVISION TOTALS--> COLLECTED: ' 133.60 OVER/SHORT; .00
HLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK
54.00 22.50 21,50 .50 35.10
�
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I N D I V I D U A L F,�E E B R E A K D O W N
. i
TYPE QTY D E S C R I P T I O N�'�f UNIT COST TOTAL COST
SFC 2500 ALTER HY VALUE COMMEACIAL NOZONE 1.00 2,500.00
ELE 1 MOTOR/POWR APPARATUS �1+.1 - 10.0 HP 7.50 7.50
MEC 1 INST/REL AIR HANDL UNIT'� 0-10000 CFM 6.50 6.50
END OF 'FEES
F•
(i.
�7
0� OOOh3043-Oa06E047 T O T i33.5C
6ATE� �3I21/90 TIME� ?6�28
/ -
CONSTRUCTION AND PLk G _, POOL & SPA
• APPROVPtLS Permit # � Daie Inspector qppROVALS Permit # Date Inspector
1. Temperary Electrical Service or Pole . 52. Pool & Equipment Location
2. Soil Pipe�Undrgrnd. ' � 53. Steel Reinforcement
3. Electrical Conduit UtilitV-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrg�nd. . � 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test -
6. Electrical UFER Grnd. 57. APPROVAL TO COVER�GUNITE
7. Footings ' � 58. Electrical Conduit�Undrgrnd.
8. Foundation . � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. - ' 60. Backwash Lines, P-Trap, O Undrgrnd. �
10. Structural Floor Sysiem 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 Plumbing 65. Electrical-Final �
15. Rough Electrical-Conduit 66., So�ar 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. ��POOUSPA SYSTEMS FINAL
� 19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace . APPROVALS �Permit #
21. Ducts,in Structure 70. Underground Hydro
22. Ducts, Ventilating 77. 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 IStructural) & Monocoat 75. Dry Chemical
27. Frame and Flashing � 76. Dry Siandpipe
28. Lathing & Siding . 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing � � HEAITH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION' .
32. Electrical Power Meter�Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric r0-�� ��d��,Y'i Notes: � .
34. Final Heating & Air Conditioning /��qp L�
35. Final Gas Pipe-Test ,�/ C�
36. Hood or Canopy �
37. Final Factory Fireplace .
38. Final Plumbing � .. . ,
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFinal
42. Backflow Preventer '
43. Backflow Irrigatio� �
44. Landscape Irriqation System �. .
45. Sound Attenuation
46. Handicap'Regulations
47. FINAL STRUCTURE & BUILDING e��� 6.yr �
48. FINAL PLANNING � .
49. Electric Release to Edison
� 50. Gas Release to Southem California Gas Co � '
51. CERTIFICATE OF OCCUPANCY
No. Date
. ���
Pfl0.1ECTAOONE$S: �,F„� W 1'1TH ST
owxee�sxnMe: pETER ROTHSCHILD
AUDRE83: 8( 6 W 18 TH ST �, ' .
� �. . . '
UXIT: B
650-9466� '
''RNCHIENGINEEP: C. K, ALL F.N HEO.XO.: S 1 3
}� noox¢ss: 17711 MITCH�LL NORTH ��` A
' IRVINE C� 92714
♦ , PENMIITEE: BUILDER GROUP ' ( 714 ) 969-0169
: RDDPESB: 10190 IMPERIAL AV
GARDEN GROVF ' CA 92643
LICENSFO CONTMCTOB OECLAMTION: I �ere0y affirm tha[ I am licensetl untler DroWsions ot C�apter 9(commencinp vnth Section
70W) ol DiNsion 3 0l tAe Business anA Prolessions Cbae, anJ my license is in tulbforca an0 effect.
cm uc.: 0 0106 $rnTe uc./:5� g 370 cuss�:/�/]�/� .
Uate: � � —� . ` SlOnature: " � . ��
' 'KERS'LOMPENSATIOXOECUWt�ION: I�erebyaffirmihai�acerti0�olconsentrosett-insuraoraceMNcateofWoders' �
iensation Insurance, or a certilieU copY �hereof (Section 3800, LaC. C�. .
I..,JCY NO.: ' � EXP. D�TE:
COMPIINY:
r] Cenife0 copy is AereEy fumisne0. ❑ CeNfeq �ppy IS fJeA xit� �I1e city BuilEinp OlVlsiOn. 1 �
..ate: Applicant -
F%EMPTION FBOM WOPNEBS' COMPENSATION OECIAiWTION: (This sactlon neetl not Oe comDleteO il ihe permit is for ane hundreA (5100) or less�,
I certlry Ihat In Ne pertormance of the woB lor which Ihis Oermit Is IssueU, I shall not employ any person in any manner so as ro Oecome
suble�t to IAe Woders' Campensation Law/s oi Califamia.
Oate: � � � �� F SlOnature: - . . . ' -. _ �
NOTICE: IL aher maknp tAis declaration, you shpultl Demma suUject to t�e orkers' CampensatPon provisions oi the LaOor
COAe, you must larthxit� compy wit� wch pmvUims or tltis pemnt 50a11 Ee UeemeE rewke0.
CONSTPUCTION 1FN01NG 1GENCY: I AemOy aflirm that them is a wnstruction lendinp aOe��Y �or t�e performance of Ne work for
wnic� inis permit is iuue0 (SecGon 3097. Gv. C). , ,
IFNUEfl: - ' . '
ROOflESS: . ' ' ' ( , ' '
OWNEB BUIIDER OECIAMitON: I Aereby alfirm t�at I am evemD� «om t�a Contractors' State License Law lor the followin0 �easan
�Sepion 7031.5 Businew anE Professional CoOe: My ciry ot counry which reQuires a permit ro wnstruct, alter, improve, Eemolis�, ar
aDair any structure, D�or ta its issuance, also reQuires [he applicant lar tuch. permit ro file a sipneU slatement ihaf he/she is IicenseA
pursuant ro IAe pmvisions ot t�e Contractors' Slate Licgnu Law (ChaDter 9(commencln0 witA Section 7000) af �ivislon 3 oi the Business
an0 Prolesvons CoAe) or I�at he/she is exempt therefrom antl ihe basis for t�e allepe0 exemD�ian. My Wolation ol Seciion 7031.5 hy
�pplicant for a permit suojecis the appllunt to a GNI penairy of noi more than five nunEreO tlallars (`3.A0). �
� I. a5 mmer of [ne OropeM or my empI�y¢¢5 Njt� x2pes a5 tlleir Sa1e�fAmpensalian, will Oo t�e Work, anA itle
i� struclure h notintenEeE oroHereOlorsale�5e�pon 7044. Buvness anE PmlessionalCoOe: T�e Contactars Slate Licenu Law
I Oces not apDN��a an avmer at a pmperry wlw OuilOs or impmves t�ereon. anE wlw Eoes such work �imull/Aerselt or tArouph
��is or �er own employees, OmviOed ttut sucA imprwements are not iniendeU or offe2E Por sale. It, twwever t�e EuilEinp or
imD�ovement is solE vnthin one year ol compl¢�ion, [he owner will �ave Ne DurUen oi OmNnO he/she OiE not huiltl o� imprave
, lor the Ourpose ot sale�. � �, �
I, as owner ot Ihe pmDe�T/. am e�clusively con�racting with IlcanSeU contractors ro constmct the prolect (Secllon 7044, Business
I❑ � antl Protessions Coda: The Cont2ctors' State �icenu Law tloes not apDry ro an owner ol pmDerty who EmIAs ar impmves thereon
anE wlw wntracts for SucA Drolecis wlt� a cOn[racror(5) license Dursuant ta t�e Condactors' $W[B LiCE�50 L3WJ. I dm awa�0
tlwt proof ol Neir Worker's Compensation inyurance snoul0 oe prmnOeE Io me.
� I am exempt unOer Sectiw: B. d P. C.
lar tNs reasan: �
Oate: � Owner. �
I Oo nereEy ceniy t�at I am aware of antl unEerstantl tne requiaments ol Calitomia Mealin an0 Satery Code Sections 25505, 25533, an0
2553d an0 t�at I oGany tuture EuilEinA �cupant wil 11 not (circle one) nee0 to comDly vntA saiE state catles anC ��e aquirements tor a
permit lar wnstructian or modilication Irom the Nr UUaliry Manapement OiStncL Res�aential constmction applications are exempt iram
t�ese Dravislons. '
Date: ApDlicani:
I Aereby certiry ihat I have reatl this application and stdte iha[ the above information is correct. I aAree ta comply with all ciry an0 counry
or0inances anG state Wws relatinp ro huil0inp conslmcti0n anE he2�y aut�odze aD�esentatives ol t�is ciry ro enter upon IAe a0ove-mentlonetl
pmDerty Por inSpeciion purpases. �/
Date: �� ��O LSiOnature: �� (1 �
Driver's �icense or Socia� Security x: ' �
1841�ae W�ite—Bu1lEing; Green—Cotla Enlorcerpen�; Canary—Applicam; Pink—Revenue; Goltlenro0—Avessor
CITY ,OF COSTA MESA' -- HUILDING PERMII'
PERMIT NO: B 046379. „ PLAN'CHECK N0: 02592-90 S
CONSTRUCTION TYFF_: �" PEItMIT TYPE: STR
JOB llESCRZPTION : 1200SF STEEL INDUSTRIAL BUILDING
CLAIM VALUE: "19,000.00 CALC—VALUE: 28,989.20
PERM NO; B, 046379
GOVT:
SQ E'T:
GROUP OCC:
N SUP-P: N „
PURPOSE: NEW
1,058
H �z �
COMMENTS:' ' � ' ' '
�tx+t*ar+t**�t�ei�*it�t**+t�rx+�**�t�r�t�t�tit*+t�rir***�r�r*�r�t�tat�tit+t�t*i�r�rfr*�tititir�e�t�t�t�rft*�t�t�r xit�t�tx��t�rt�r***�tit
, Z O N I N G R E. c,� U I R E M E N T S �
, S�•T� B A C K'S '
------------ MAIN BUILDTNG —•--=----== '-- ------- ACCESSORY BUILDING ------,--
FRNT: FT IN REAR: 110•FT IN FRNT: FT IN REAR;' FT TN
LEFT: 15 FT IN RGFIT: 52'FT IN ,LEfiT:, FT; IN RGHT: FT . IN
FARKING REQ: 83 PROV: 84 PFIRCEL:�42408119 ZNE: MG REF NO: DR8954
PLANNING NOTES> 1200 SQ FT METAL BLDG TO BE ATT TO REAR OF EX TILT—UP BLDG, �
> SIDE STBKS ARE.SEPARATION FR EX BLDG OR OTHER NFW METAL-.BLDG
�e* �r ��r+�***�*��r*� �ex �+t**���r�r�x **�r�r� ��e�r+r** **+r�*�r* *x�x *et*+t*�r*�x�r�+r�����r� *it+t't��tat*�r�r�r�c ��
D F. V E I; O P M F. N T� S E R V I•C E S R E Q U I R E M E N T S�� ,
'LONING, APPI20VEA BY. C��. E. _ DATEd ��__ ,
BUILDING APPROVED HY : � UATE: ��i .
T_.__
APPLICATION ISSUED BY: ��A�� . DATEi �i =:r� o
ikiEMitiFitititiflFiF3kiE1ElFMkifiEiFiEiE�i�FiF�iFi �iF7FiFillEiE3fiEifiEiEM3F�ii� if3E
if iE �11� ik iE if it it it 1F i! �k i! iE i! %it il� iE ik �1E if 1E if ik �1F iE Ik 7k iE �%�)f 1(� 1(� iE iE �E fE k iE if iP if iF i4 dE IF if k iE ik ik if iF iE iE if �1f jk if if 3E if� 3EiE it #�if ik iE if �E iF �F if� 1! i! iE iF
LEGALIZATION:N F E E�,S:U'M M A R Y � STRUCTURAL',`SEGMENT:Y
� BLDG PMT_ PLUMBING ELECTRIC MECHANIC FIRE �SMTP/RES , GRADING
PERMIT 278.'00 . • �; ; '
„ � � , SMTP/NON—RfiS
PLAN 1.80.70'. ' ' 4.35
ISSUE FEE
HUILDING—DIV-> PERMIT' ISSUE PLAN—CHECK
TOTALS----> 282.35, 0.00 . 180.70
REVENUE DIVISION TOTALS--> �' COLLECTED:
.HLDG PMT PI.UMBING EI,ECTRIC MECHANIC
��ii3.00
TOTAL PAID DUG
463.05 ' 463.05 .00
282.35 OVER/SHORT: .00
FIRE SMIP/1'OT GRADING.PLAN—CHECK
4.35 �
iEiEkififiE9kififiElfaflfkK�MifNifiEiEififlEiEifk�ltKiEK�lfikiE1f1f3f�kfE�Ei4MlEifiEiEiF�fiEiE3kiFiFifiEiEikifiEiElEitlEiE7Elf�fiFiflEiFiEiEjFititififiE �
I N D I C� I.D U A'L F E E B R E A K U O W N
TYPE QTY - P E S C R I P 1' I O N ' UNIT COST TOTAL COST
SFC � 1058.�.
IND—TYPE V-N
�. . _
� —AVER 27.40 '18,989.20
EDIll'OF FEES
� � ,
n
� 01 00055571—OD055572 T UT 282.35
• DATE� 03/07l90 TIflE: 09:46
ACCOUHT :: 8117<02002
oi oo2i ooa ODOSSS71—QpOS5572 �
a�io�i90 or cx r��a ��� 25�
r+
CONS7RlI�.dION AND PLAN� � � )OL �A
APPROVALS ��ermit# - Date Inspector qppROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole 52. Pool & Equipment Location �
,2,NSoi1 Pipe-.Undrgqnd.- . - " , . 53. Steel Reinforcement . _ ,
� 1-3!'ElectricaGConduit�U(ility-Undrgrnd. 54. Forms
_ .j ` .
<'r'.- T
� '" 4.'Electrical.,CoAtluit=Undrgrnd� ' 55. Electrical Bonding .
��5.cSreel Reinforcem�nY� � � 56. Rough Plumbing & Pressure Test =
��.� - -
:':��`Electrical 11FER Gr�nd. "� � 57. APPROVAL TO COVER�GUNITE
�,Z�.=Footings � ���� - 58. Electrical ConduirUndrgrnd.
^�8�. Foundation ,' � � 59. Gas Pipe, O Undrgrnd., Test �
9. Wa[er Pipe;Undrgind. - 60. Backwash Cines, P-Trap, O Undrgmd. �
10. Structural�Floor System 61. APPROVAL TO DECK .
11. Property Sewer Line'& Hou'se Connection 62. Backwash & Receptor�Final �
12. Sewer Cap =. � 63. Heater & Vent-Final '
,, '� '
13. Roof Drains'=�,. ,: � ' - 64. Plumbing System - Final
14. Rough Plumbing 65. E�ectrical-Final �
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric_Wiring � � . 67. Fencing & Access Approval
r17. Rough Wiring Sign 68. APPROVED FOR PLASTERING .
18. Rough Electrical�T Bar Ceiling ' . 69. POOL/SPA SYSTEMS FINAL
19._Rou9h Jeating-& A`r Conditioning __ � �, s _pIRE DEPT. REQUIREMENT
20. Rough FactoFy Fireplace r� r: z,;; , '`' ',` : APPROVAL'5;,-,FPerrriit # � - �
21.�Ducts, in Structure', "" `''-� ; : �'� 70. Underg'round�Hyiiro
�
22._Duc(s, Ventilatin � , , �' ' �
. 9' � '• � -- x c�77. Product�Piping O�Gas O�OiI
23.•Gas_Pipe.Rough & Test �� t��:G � rt ' ;�� ; �7p, Underground FlusFi 4 ' " ��
24. Roof Framing k ��-, ,� "� = _, t':73.'Undergmd. Storage Tank O Gas ❑ pil
25. Roof 5heathing � � i _� - ' _•�� * 74.�-0verhead Hydro_� {
26:'T�Bar Ceiling �Struciural) &�Mo�ocoat �;,; ;- y p �� 75.�D..ry Chemical -�� - � -
27.,Frame and FtashingT _ a,� : c' � i C :� -y' �' - 76. Dry Standpipe h� _ .
ti28r Lathing.& Siding z ��� �H ��-'� ;', "� "� ",'�. ;' 77,.'�.�FIXED SYSTEMiFINAL• :.�. - ?
29. Insulation � k - ' ; � 'T ` 78�FIRE PREV. PINAL x ' -
1 ' 4 '1 "
��30. Drywall:�lailing ,; _ ' �.-; ^ � �;� ._ HEALTH=DEPT; REQUIREMENT
431. Plaster Brown CoatF'S � T^ i--t'� � �-'7g, iFINAL INSRECTION ��
_ �. - ,
32:Electrical Power Meter�Fi,nal
F "��;}�'`� � � 'SO�FOODCERTIFICATEISSUED_
... .. . . . ,., . -. .
z,33'_�Final Electric :� - � �-�- ; K � � �� a� Notes: '-'T� �� � . � �
. r- _i;�� � . - ..
�34:.Final He'ating & AirFConditioning= _ � K v I i � •; • �� � .
35''Final Gas Pipe�Test%.� V �� Y �+ ! :z: - � � �..: C'�ti •� -
..�.
T36_Hood Or CanoPY ' - -r ' ' -' - � ' � � '� . ..
� .� . �_� -t. f'7 ':J .
--37 `Final Factory Fireplacex � - c�<: �: � ' F? r. � !r. !'
- . r I .,.
'r38: ,Final Plumbirig .• , "`''i: ' � �`: - � �.:� :; ` .
��
; . . .. . � _ - . -. , � .
"39:�Water Service;Final' ,�., � c �-- �-
' - ' � m e r.
!'"40. Gas Service�Final :"� ',��r' = = :: x r: . . >� -
s: -i�- :t _. , -"�• ,: M�
'2'41."Solar pomesticPinal - - ,��„� ; �r. ' � -. � -i i � � - ,
�:. -
42. Backflow Preventerx _' '� ;-,; ? * ^ a' '� �' ' - � -
� c_ ; �r..-. t: �. ,. :7 ;r.�� , .
c �.� � , . .r. - � r-~ .
43. Backflow IrrigationF >. C;. : K^ e, ' '
�T"44, Landscape IFripation System^�':- ^y 'x'-: �� � .. n� •�: _ -:�^ � c`
I J C �. i;'^ _} 'G Y Y. - T S -[
;45�Sound Attenuation: :r �l - ;z, �: - -, .•y. -.�i -
:�
_46.•Handicap Regulations �'' =�� - ` � ' + $� ' - -' - '�
- � s r•; ' ' ,�
-,47-FINAL STRUCTURE & BUILDING�- ' � ` � -'� ...
- D/� -
48.-FINALPLANNING �" Z �C�,( �f.��'t�, _ .4 ' ""
n �
�:'49.`:,ElectricyRelease to Edison ' �� ., i �, � , � ,� � -`r� �, . - �� '
-50=-Gas=Release to Southem Calif mia Gas Co } 'P � :. `' r � , � ,
=51. CERTIFICATEOF''OCCUPANCY " � " - •
No. Date '
PHOIECf RDOflE38: �I3 Z l'i i�%Tii ST
OWNER'SN�ME: TNE GAFFOGLIO FAMILY META
ROOPEBSi $�E
.
ApCI11ENGINEER: 6 S �— 9 4 6 6
nooeess:
IiE0.N0.:
UNR: B
uxrt:
°E"MiTTEE: A.S.A.P. FIRE PROT. (213)327-0160
�ooeess: 313 E SAVARONA WAY
CARSON CA 90746
LICENSED CONTflRCfOR OECIAMT10N: I AereEy atflrm tlut I am GceirseE wMer D�wrs of Chapter 9(commexinp wit� Secllon
70pp) al OiNsion 3 of tne Business ane Protessions CoOoZ, an0 rtry Iittnse 6 in Iu0 lorty anU etlect.
cirr uc.: 0 419 9 8 STRTE LIC.: �I J�� cuss: C-16 ,% �
�a�-(P'��-a�—�� Si9naNr8: '%�7� %Lor�it� NT✓�`
ip1IEpS' fAMPENSITIOX OECUMiIUN: I hwe0y atl'vm itwt I tava a ceNfrata ol consent ta ull-irtsure or a certiticate ol Workers'
.bm0ensa[ion Insuranca, ar a ceNfieE copy t�ereot (Section 3800. LaE. C1.
IroucrNo.: F3WlC203736 �.o��: 04/01/91
COMPRNY: Hl�Ht'�y I�'�§ n
� CertifieE coDY �slie2SyYuma .�.;y CeNfieE copy is NM wiN IM tity BWOmp Oivision.
�ate: % �i�,^ � � � ppylicant: - / / • � � ' �
E%EMPf10N FROM WORIIEHS' COMPEXLITION OECIAii►TIOM: (iFis sx6m �eE not Ee conpleLLtl H IM pertit'a fa ore huqrW (5100) ar kss�.
I certify that in the pertormance oi IM vrork far wNch tNs 7ermit is IssueE. I shall not employ any person in any manner so as to become
supject ro t�e WOMers' Compensation Laws oi Califortua.
Ddte: Sipnature:
NOTICE: II, alter maldnp ttus EecWation, you s�ould 6ewme wGject tu Ne Worters Compertsation Ormivons of Ne L�Cor
Code. you must tortAwiN wmpty wlth 5uc0 provisqns a Uis pemtit s�all be tleemed rowkctl.
CONSTPIICTION 1EN01N0 11GENLY: I �ereby affirm W� there is a cansinKtron IenEinp apem.y fw Ne OeAormarice of the work lor
whkR tMs permlt is issuM 1�� �7. Civ. G�.
LENDEP:
RDOflEBE:
OWNEB BUILOER OECIANITION: I hereUy atfirm Itw� I am exempt Imm t�e Caniractors' State Licenu Law lor tAe tallawinp mason
(Saction 7031.5 Business anO Professional CoOe: My dry of counry wNCli reQWres a pprmlt �o construct, alter, imprw4 Eemalish, or
apair any stmcWm, D�or to its iswance, also reqWres tM aDW�� �w suc� permit to lile a dOnM statement IAaI �e/sM Is IlcenseC
oursuant to t�e proNSWns ol IAe Cantraceori State llceme Law (�Dter 9(mmmentinp rriU Sectlan 7ppU) ol DNislon 3 0l Ne Business
1O Prolessions CoOe) or Itul twJSM h exempt Itrertfrom arq Ihe Wsts tw ttre allepeG eaempUon. My doWUon ol Section 7031.5 by
Y+Od�U�t la a O��rtti! s+�lecU t�e aPC�� fu a dW Oe�b ol not mae than fnro Iu�EreD OdW�s 13500).
I, as owner at t�a Droperty or my employeu wiN wapes az their sola comDensatlon, will do tha work, anE I�e
I� simcturBis notlnten0e0 orotlereElorsale(Section 7044, Buvness anA ProlessipnalCoAe: The Conlraclors' State License Law
Oaes not apDly Io an vwner of a Dmperry w�o Guiltls or imDrmas t�areon. anU wM does suc� �rork Mmsall/�erself or t�roupA
' �is or Oar own emd%�s. OrwfECC Itut suc� improvements ara not intenEeE w ottereE lor sale. II, however Ihe builtlinp or
improvemmt u sdE witfon om year o1 competion, tM wmer vn11 luve IM SuNen at 0�0 ��e dIA noi DuiW or improw
for IM Duryose at sale).
I, as owner oi Ne Drope�ty am axUudveN convactin0 with ticensM contnctws �o cansVuct the Draject (Section 7MC. Business
❑ ana Profesvons Cotle: TM ConinctOrs State Lkmse Law Ooes rrot apON �o an ovmar nl O�DBrty wAo Gullds or ImD�'es IAereon
anA who coniracis lorsuc� pmjects with a coniractor{s�license Oursuantto t�a Comnctors' State Licensa Law�. I am awam
t�at D��� ol Iheir Worker's ComDensatlon insurance s�oWO he proviOeE ta ma.
� I am exem7t uMer Sectbn: B. 8 P. C.
lo� IMs reason:
4ata; Q«ner.
I Oa here0y carliry t�at 1 am aware of and untlersunA Ue repuirtmen6 0l falifomia Health and Safety CoEe Sectlons 25505, 25539, and
25S7C anG ttut I or any tuture builEinO acupant xilUwlll not (drda one) nee0 ro campty wit� saiE stata coCes anE t�e aquirements for a
Permit tor GOM14lNctian or m00ifiCatlOn trom Ne N�t�uall�y Manapement UisVict. HesiOenGal tanSlruCtlon appliCation5 are eaempt from
tneu provi4ons.
Date: MO����
I nareEy ttniry inat I Aave rea0 t�is apD��tion and state that Ue aCave IntormaUon is cortec�. I a0rea ta wmDh ��� all ctty an0 counry
Ortlinantes anE s�die laws 2W6np lo OIriWNq coltSVu[IiOn arq he2Dy aNtlotiie rlpfCSdi�ztive5 al Ud5 tiIy N enter upOn tlro aCrne-menllpnEO
prOperty for inspecfbn puryoses. ��� �
Oate: �� � �—�" ( V Siqnatura: � ` � 'ti'—+- �
Driver's License or Saial Secmity e: �
Whlte—BuiWi�g: GreerCoEa Enfo�cement; Ceiary—Applkant: Pink—Ravenue: GOIEenroO—Atsessor
CITY OF COSTA MESA — HUZLDING PERMIT
PERMIT NO: F 097880 PLAN CHECK NO: 04271-90 S
CONSTRUCTION TYPE: PERMIT TYPE: FIR
JOB DESCRIPTION : 80SF SPRAY BOOTH
CLAIM VALUE: 300.00 CALC—VALUE:
PERM NO: F 047880
GOVT: N SUPP: N
PURPOSE: ALT
SQ FT:
GROUP OCC: B-2 /
COMMENTS:
�t*�txi�x+r**�,r*+r�r*�r�e*�rx��r�e�r�r�rx�r**�r�tx��*xx�r�ririt�x�i�f�ir�t�r�x�itfrir+r**��r****x��tx�rxit+t�ei�x�*�t****+�rt
Z O N I N G A E Q U I R E M E N T S
S E T B A C K S
------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDING•---------
FRNT: FT IN REAR: FT IN FANT: FT IN REAR; FT IN
LEFT: FT IN FtGHT: FT IN LEFT: FT IN RGHT: FT IN
PAAYCINr AEQ� PROV: PARCEL: 42408118 ZNE: AEF NO;
PLANNING NbTES> �
>
3E jE if iE iF iF iE 3E jF if iE iE iF 3F iE iE jE iE if iE �E if if jE 3F iE �f 3F if �E iF iF if iE ff iF?f if iElE iE 3k if iE if iE iE iE if it ff iF iE iE if �IE k!E if 3E if ik if iE dE if if 3E iE iE IE iE if iE ik iElF iE jE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONZNG APPROVED BY DATE:
BUILDING APPROVED HY : � DATE: 6 S S�
APPLICATION ISSUED BY: � �� DATE: �/�k���F�€
#iEN-iFiEiEiE�EiEiFiEif�7EaK-+�EA'�iE�lEifiEiEiE E F iF �iFiFiF�iFi�i�lfiEifififlE7f1F1fiE e ifif
itititiEi:ikiEiFitiEiEikffiE%aEikiFiEiEiFiEiEKitiElEiElEifiEiFiFififiEifitifit% EiE9fiEiEiEiFitifititiFaEiEifiEikiEiEiEiFifiEiFitiEiEifffiEiFifiEiFrtlEiE
LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;N
BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/RES GRADING
PERMIT 1565Y SMIP/NON—RES
ZSSUE FEE 9.75
BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE
TOTALS----> 15.00 0,00 9.75 29,75 24,75 .00
REVENUE DZVISZON TOTALS--> COLLECTED: 15.00 OVER/SHORT: .00
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECR
15.00
iF i6 iP iF if ik iE 1E-1E il� iF iF 3F if iE iE iFiE * iF 1E it ik if it iE i(� iE i! if ik k ik iF jE iE if iF it iFiE �%� iE it it iF it iE iF it 9Fdt it ihjF it iF jf jE iE i43E if �f iE 1F iE �)E iE* ik iFiF it if �)F iF ik if
I N D I V I D U A L P E E H R E A K D O W N
TYPE QTY D E S C R T P T I O N UNIT COST TOTAL COST
FIR 15 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00 15.00
END OF FEES
01 0006383E-OOOb3838 T 4 T L5.�0
DATE: Q6/25l90 TIttE: I2:Oi
CONSTRUCTION AND PLAh,.n4G � POOL ,PA
- APPROVALS Permit# Date Inspector AppROVALS Permit# Date Inspector
1. TemPorary Electrical Service or Pole � 52. Pool & Equipment Location •
2.� Soil Pipe�Undrgrnd. 53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgmd. ' 54. Forms �
4. Electrical Conduit�Undrgmd.' � 55. Electrical Bonding �
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. � 57. APPROVAL TO COVER�GUNITE
7. Foot�ngs � 58. Elec[rical Conduit�Undrgrnd.
8. Foundation j 59. Gas Pipe, � Undrgrnd., Test
9. Water Pipe�Undrgrnd. . 60. Backwash Lines, P�Trap, O Undrgrnd.
70. Structural Floor SYstem 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection . 62. Backwash & Receptor�Final
12. Sewer Cap 63. Heater & Vent•Final
73. Roof Drains � 64. Plumbing System - Finai
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit � 66. Solar SYstem-Final .
16. Rough Electric Wiring - ' 67. Fencing & Access ApProval
17. Rouqh Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical•T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMEN7
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 & 7est ` 72. Underground Flush
24. Roof Framing . 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro �24,��
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL �,,� � �y.
� 29. Insulation 1 78, FIRE PREV. FINAL 13y�
30. Drywall-Nailing i� HEAL7H DEPT. RE�UIREMENT
31. Plaster Brown Coat l / 79. FINAL INSPECTION
32. ElecUical Power Meter�Final ���� � 80. FOOD CERTIFICATE ISSUED
33. Final Electric -! Notes: �
34, Final Heating & Air Conditioning � �
35. Final Gas Pipe-Test , •
36. Hood or Canopy ' �
37. Final Factory Fireplace I
38. Final Plumbing ' � .
39. Waier Service�Final � �
40. Gas Service-Final � ' �
41. Solar pomesticFinal
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irriqation SYstem
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING , ,'
48. FINAL PLANNING
49..Electric Release to Edison �/' ', �
50. Gas Felease to Southern California Gas Cn
51. CER7IFICATE OF OCCUPANCY
No. Date
YP0.IECT RDOflE53: -� 3 2 w 1 7 T H $ T
owxex�sxnrne: g�TER ROTHSCHILD
�oon�ss g66 W 18TH ST
uxR: A & B
650-9466
aecx�excixeee: C. R. ALLEN REG.NO.: S S j
ROONESS: 1']11 MITCHELL NORTH �"�� A
PEaMmEE: IRVINE CA 9Z714
aooxess: A.S.A.P. FIRE PROTECTION (213)327-0160
113 E. SAVARONA WAY
CARSON CA 90746
UCENSFD CONTMCfOR DECIAMiION: I �ere�y aflirm that 1 am IicanseE under D�odsions oi Chapter 9(mmmencinp wit� Section
7000) al Divition 3 0l tM Business an0 Prafessions CoOe, an0 my license'a In tull torce aM ellect.
cm uc.: 0 419 9 8 ST"T� �� 5 41 319 �u�� 16 r
Y: � � � 9� Sipnature: ��
31IEBS' fAMPEN311Ti0N OELUMTION: I �ereb aKrm t�at I tuve a urli0ute oi wnsem ro sett-insure or a certifiwte of Workers'
mpensation Insurance, or a certifieU wDY ihereol �SecGon 3800, La6. C).
Iroucrxo.: BWC 203736 exr.o�h: 04/O1/91
coMrpxr: HIGHLANDS
r] Certifie0 copy is hereby hmisheE. [$ Certifietl capy is IdeO w,it� AIhe ciry uil0inp ONisian. /
Oate: L � % — Y� ` pppliwnt: �J�
E%EMPTION FBOM VIOBNEfl3' COMPEXSIITIOX DECUFWTION: Rlns sac6on naed noI 0e mmplMeE tl the permt is br oiw huntlreO (510� ar lar�.
I cetliry tlut in tAe Oe�armance af IAe work for w�ich this permit Is iSsueA. I shall not employ any Oermn in any manner m as ta 6ecome
sublect m tAe Warkers' Compensaiion Laws ol Califomla. _
Wte: Slpnature:
NOTICE: Ii, atler makinp Ihis tleclaration, you S�ouIE Eecome su�l� �a tAe WOMers' Compensatian provisians oi Ihe La�ar
COAe, you must tort�with compty with suc� provisions or Ihis permit shall Oa tleemeA revoketl.
CUN%TBUCTION 1FN01NG �6ENCY: I here0y alfirm ��at [here I5 a constmctlon IenAlnp apency for tAe petlarmance of tAe wod lor
wAichlhis permit is issueU (Seclion 3W7, Civ. C).
LEN�EN:
�UGHESS: '
OWNFB BUIIDEB OELUMTION: 1 AereGy allirm ihat 1 am exemD� �rom tAe Contrzctors' State License Law tor Ihe I011owin0 R�n
(5¢ction 7031.5 Business anA Prolessional Catle: My ciry oi counry which repuires a Dermit to canstruct, alter, imD�ove. EemoIISA. or
repair any rtructure, D�or to iLs issuance, also requires Ne apDlicant for such permit ta file a sipne0 siatement Ihat he/s�e is tiunuE
pursuant to ttre O�+sions oi tAe Coninclors' State Licensa Law (Ctupter 9(commenpnp vnN Section 7000) of Divition 3 0l the Business
�E Pmfessions Cotle) or that �e/5Ae is aMemD� ��eafmm an0 Ihe basis far t�e alleOeA exemplion. My dolation oi Section 7031.5 Oy
Y appliwm for a Dermil w�l� ine apptirant to a civll penalry al not more ttun /ive AUMrM Uollars (55001.
' I, as �owner of the property or my employees vnth wa0es as t�eir sola compensation. xill Uo Ne xrork, antl [�e
I❑ sWcture is not intenOeE or aHered tor ule (Sectlon 7011, Business anE ProlesUonal CaEe: The Comrzctors' Sfate liceiae Law
tices �rot appty to an awner at a proDerry who Ouilds or imDroves IMreon, anE who Oces such work Nmulf/herselt ar thrau0h
Ns or her own amployees, D�a�ed that such Impmvemenis ara not inten0e0 or otlereE tar sale. Ii, Aawever t�e huilEinA or
imD�ement a SOIE vntNn ona year at complatlon. ttre owner wlll Mve t�e WrEen ai O�a��O hNshe NC rrot EUJE or imDmve
lor tice purposa oi salel.
I, az owner af the property, am excluslveN contractinp witn ticenseE wntractors ro conswct 11re prole« (��on 70C4, Business
❑ aM Professims CaOe: The COMrzpors State Lkrnse Law Oces ml appN ro an mmer ol Dmperrywtp Ew1Es or improues Ihereon
anU wAo contracts for such Drajects wit� a crontractor(s) license Dursuant to IAe Contactors' State License Law). I am aware
that D��� oi t�eir Worker's Compenulion insurance shoul0 Ue D�'i0etl lo me.
� I am exempt unCer Sectbn: B. d P. C.
tor ihis reasOn:
Date: Owner.
I Oo �ere�y cetliy Nat I am aware al an0 un0erstantl I�a reQuiremenis of Calitamla Heah� anC Safery CoAe Sections 25505. 25533. anC
25534 an0 inat I or any luture buil0inp acupant wilVwill not (crcle one) neeE ro camDly wit� sai0 sWta coEes and t�e reQuimmen6 lar a
permit for consimction or mo0lfication imm ihe Pir Oua6ry ManaOemenl Distdct. Rasitlential consimction appliwtions are exempt Irom
these D�avisions.
Oa[e: ADD�icant:
I here0y certiry t�at I luva 2aE tAis application anE state ihat Ihe a�ove information is correct I apree ta compy wiih all ciry anA unry
ardinanus ana state Wws reWiinp ro Gulltlinp�`onslmcilon and here6y aulhanze 2D�s tives oi ihis cily to enter upon the aDove-me oneU
pmpeM forinspectlon Durposes. Y
Oate: �� �— � Sipnature: _P
oriver's �icenu or Socia� Secudry x:
1861i8 W�ite—BuiMi�g: Graen—CoOa Enlorcement: Cenery—Applicant: Pink—Revenue: GdEanraE—hsm�or
CITY OF COSTA MESA — BUILDING PERMIT PERM NO: F 047647
PEAMIT NO: F 047647 PLAN CHECK NO: 04054-90 S GOVT: N SUPP: N '
CONSTRUCTION TYPE: PERMIT TYPE; FIR ' PURPOSE: OTH
JOH DESCAIPTION ; INSTALL FIRE SPRINKLER SYSTHM Sg FT:
CLAIM VALUE; 1,500.00 CALC—VALUE; GROUP OCC: H-2 /
COMMENTS: RE: B46378 PRIMARY BLDG. PERMIT.
�r***�r*���t�rx�e�r�*�t�t�t�t*�r*�*�****�r�t�t�r*x�r�r***�t�r*�r**x�r�*��r�r****�t**�r�r+t***x�+t�t*�t*�r+t�t�t�t�t�
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 BUILDING ---------- --------- ACCESSORY BUILDING ---------
FRNT: FT IN REAR: FT IN FRNT: FT IN REAR: FT IN
LEFT; FT IN RGHT: FT IN LEFT: FT ZN RGHT: FT IN
PARKING REQ: PROV; PARCEL: 42408119 ZNE: REF NO:
PLANNING NOTES>
�
M if if ik iF iF it iF it it ik it �k iE i! it iE iE it if if iF if it if �! i! if i! if iP * it iE it if if i! iE ik it it i6 it it i! iF iE it iE if it if iE it if iE iE 3t it it ik it iE iE iE %it it iF it it if if iE if iE iE iE
D E V E L O P M E N T S E R V I C E S R E Q U I R E M E N T S
ZONING APPROVED BY DATE:
BUILDING APPROVED BY : (� � DATE:
APPLICATION ISSUED BY: Y4— DATE: — r l�
if it iE iE iF if� it if if if iF �t if iF if ik iE it 3F iE iE ifiF�F#3fiF�f7F iF7F'iF'�iF3F'iF3F3F3F3FiF'iF7f7f3F�F'ifiF3F3FiFiF7F3f3FiF iE iE it it if if if it iE %ie
if ik iE if if iE 1E if ik it it if if it it k�1E if iE if if iE iE if �E ik it iE it it it ib ik ik if iE i! ik iE iE iE if ik iE iE it if iE it iE iF ik if ik iE iF �k iP iF iE iE if if iF iF it it iE if iE iE if iE it iE iE iE if iF
LEGALIZATION:N � F E E S U M M A R Y ,STRUCTURAL SEGMENT:N
BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADZNG
PERMIT 3565t .SMIP/NON—RES
PLAN 22.75
ISSUE FEE
BUILDING—DIV—> PERMZT ISSUE PLAN—CHECK
TOTALS----> 35,00 0.00 22,75
REVENUE DIVISION TOTALS--> COLLECTED;
BLDG PMT PLUMBING ELECTRIC MECHANIC
TOTAL PAID DUE
57.75 57.75 ,00
35.00 OVER/SHORT: ;,00
FIRE SMIP/TOT GRADING PLAN—CHECK
35.00
i!� 1E iE iE iE 3E iE iE iM1iE jF if ik iF if if iE iF iFiFiE 3F iFif if if iE iF iE if it iE iEiFjk iFjE iP ik it ik iFiE ik iF iE ik if iE iEiF iE jE iliE iE iE if iFiE if iF iF if if dE �7l� i! iEiF it if if df iFiF i! iEiF
I N D I V Z D U A L F E E H R E A K D O W N
TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST
FIA 35 FIRE EQUIP FEE (FROM HLDG VAL TABLE) 1.00 35.00 �
END OF FEES
C ;
a iJ
�?�
^1 � rd
_ � _ �:
��
� ..
v J �
CONSTRUCTION AND PLAA ,G POOL .PA .
. APPROVALS Permit # Date Inspector APPROVALS Permit # Date Inspector
, 1, Temporary Electrical Service.or Pole . 52. Pool & Equipment Location ��'
� Z: Soil Pipe-Undrgrnd. " � 53. Steel fleinforcement •
�3. Electrical �Conduit Utility�UnHrgrnd. = - 54. Forms
4. Electrical Condui[-Undrgrnd. 55. Electrical Bonding �
5."Steel Reinforcement � � 56. Rough Pfumbing & Pressure Test �
� 6. Electrica� UFER Grnd. 57. APPROVAL TO COVER�GUNITE
� 7. Footings 5$. Electrical Conduit-Undrgrnd.
g, Foundation � 59. Gas Pipe, O Undrgrnd., Test
P
9. Water Pipe�Undrgrnd. �� 60. Backwash Lines, P�Trap, O Undrgrnd. /r.'•
10. Structural�Ploor System �"% ;f� 61. APPROVAL TO DECK �'
17. Property Sewer Line & House'Connection i, - 62. Backwash & Receptor-Final ��
12. Sewer Cap I �, 63. Heater & Vent�Final
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final -
15. Rough Electrical-Conduit 66. Solar System-Final
16. Ftough ElectrirWiring _ 67.� Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical�T Bar Ceiling ' 69. POOIfSPA SYSTEMS FINA�
79. Rough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20.. Rough Factory Fireplace '- �' - .? APPROVALS Permit # "
21. Ducts, in Structure • . � ' 70. Underground Hydro
22. Ducts, Ventilating; _ , , .71. Product Piping �Gas OOiI
23. Gas Pipe�Rough &�Test � , 72. Undergro�nd Flush J
24, Roof Framing ' �� , _ i, 73. �Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing - 7q. Overhead Hydro � L,�-yv (1.t�7
26. T�Bai Ceiling ($tructuraq & Monocoat ' 75. Dry Chemical '
27, Frame and Flashingi � _ 76. Dry Standpipe - y �
-28. Lathing & Siding". • - • ', '• 77: FIXED SYSTEM:FINAL . ' � Q�y'V �„�,
29. Insulation � _ 7g, FIRE PREV. FINAL � ' lo Ss-C-�y Iyi�
30. Drywall Nailing �" � HEALTH.DEPT. flEQUIREMENT
31, Plaster Brown Coat � J�-79. FINAL INSPECTION
�32. Electrical Power Meter-Final - ' - SO..FOOD CERTIFICATE ISSUED ._
33. Final Electric , -• � Notes: � - •- _ , �
34. Flnal Heating'& Air Conditloning � " ,
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: SolarpomesticFinal � . ' . -
42. Backflow Preventer ' • � :
,
43. Backflow Irrigation, " , . �
44. Landscape Irrigation System-� � : _ , _
45. Sound Attenuation ; ' . -
46.�Handicap Regulations � - � �
47; FINAL STRUCTURE & BUILDING , ' .
46. FINALPLANNING � � �
�49.� Eleciric Release to Edison ' , .
.50. Gas Release to Southern California Gas Co � ' • '
51.,CERTIFICATEOFOCCUPANCY ' � � •� ' �
No. Date
\
Gty ot Cotta Mesa
Development Serv�ces Department
' Building Safety Oivision
P. O. Box 1200
Costa Meu, California
CERTIFICATE OF OCCUPANCY No. ��02�'�;.`�
The Building located at 732 West I7th Street
has been inspected and tound to comply with the provisions of all City of Costa Mesa Ordinances applicable thereto
for a G�oup 82 Occupancy.
Use of Buiiding
Legal pescription 424-081-19
(See reverse side tor Metes and Boundsl
Building Permit No a 22813 Electrical Permit No. E 23675 Plumbing Permit No. D 99R43
Mechanical Permit No.
Fire Preverition Permit I�o. P 23276
ISSUE6 TO: "'�"—
Alanar Corpocatfon
732 W. 17th Street
Ca�.ta M`sa, CA 92627
Number of apartments and/or guest rooms
Building Official William Howard
by I.:, � � ! !'..-,�_
Juno 13. 1986
This Certiticate of Occupancy SHALL BE posted in a conspicuous piace on the premises and SHALL NOT BE removed except by the
Building OHicial ot the City oT Costa Mesa u�der Sec. 307 (e) U.B.C. ,
CMF 3015-46 rev. I/83 White - Owner, Canary � Numerical File; Pink - Bldg. Permit File '
\ Ci
ADo���ant to /ill in all spaces ezceot inosa wltnin heavy DorOer lines ana sl9n all avProDriate Geclarations.
CITV OF COSTA MEg�Jp C`O_N1STR CTION PERMIT ' PE${�AIT NO. TjtACT N� LOT O. UN�IT NO.
Prolect Address, �` Vv � ���1f}4 ��' . �. M
Applicant's M6iling� Apd,d�rP7s/s�,�
Owne,'s Name Q✓r""^T Gi1eQ. ' Phone ' � � I
Address� �� �► . � ��" ��' . c-n � cA q�
Addreu —)-'��l'� I�IJI� -V N-� ++v . v� -�J�p�
Convoctor'sNam ' Y Phone�4b•9567
Addresslmailingl� ��%�j���.��-� Ue. �'-✓1br�QE['-�Li�
City License No. �'� �� / '
LICENSED CONTRACTOq pECLARATION
1 hereby affirm that I am Ilcensetl untle� p�ovlSionS of�hartet 9(commencing
witb section ]000) of Oivisfon 3 0( the siness a Protezslons Cotle, anA
my Ilcense is in t I for e an efte q �
u�a�� ��a�� �•-a.� o.s i�y
Dalc ' Slgnature ' / �
WORKERS' COMPENSATIpry DECyn FI N
1 nereby affirm [hat I bave a�ertificaYe o t to selbinsure or a certlticate
of Workers' Comp¢nsation InsurarvEe; or ertlfietl copy thereot (Section
3800, Lab. ) (� • t-
olicY No���W ComPanY�n'�K�0.� �mlQj�
�Certifietl copy is hereby turnishetl..
Certifi tl cap I5 tlletl wi[h the city B ilgyry Oivisiq n.
oatel—�—�` apoiicant�ttKVU. GY
EXEMPTION FROM WORKERS' COMPENSA ON DECLARqiION
(This seciion neetl not be completetl if the perm�t is for one huntlretl (5300) or
less).
I certity that in Me porformance of tne work tor whlch tnis oerm�t iz Issuetl, I
shall nol employ any per50n in any mann¢r 50 as to becom¢ Subject to the
Workers' ComPensation LaWs of California.
Dale Si9nature
'NOTIGE: If, atlet makinq this tleClaratlon, you shoultl become subj¢M to the
Workers' Compensa[iOn provi5ion5 of Ihe LabOr Cotle, you TuSt iorlhwith
comply wlln suc� provi5ions or th15 pOrmit shall be tl¢emetl revoketl.
CONSTRUCTION LENDING AGENCV
, I nereby aflirm that there Is a constructlon lentling agency for the parbrmance
ol tna work tor wn�cn tnis permit is issuetl (Section 3097 Civ. C.)
Lentler's Name
Lantler's Atldress
OWNER BUILOER DEGLpRATION
I heraby alfirm lhat 1 am exemp[ from lho Contractor's Licensu Law for the
lollowin9 reason (Soctlon 7031.5 Business antl Professional Cotle: Any city or
counly which �equires a pqrml[ to ConStruct, altCr, Improva, demoli5h O/ repair
any sVUClute, prlo� to It5 Issuancl, also �¢qWres Ihe appllcant for Tuch parmit
to lile a signetl statement that he/she 15 Ilcansetl purivant ro Ihe ProviSions of
the ConlraCtor'S License Ldw (Chap[er 9(commoncing with Sectlon 7000) ot
DIvISiOn 3 Of the BuSlnasS antl Prof¢551on5 COGO) o� lhat It¢/z�o is exempt
therClrom antl IhG basi5 �Or Ine dlleqetl ax¢mPtion. Any vlolatiOn o1 Settlon
]031.5 by any apO��Gant tor a permil subjects [he appllGant (O a civil
�enalty o1 nol more than tiye huntlreG tlo11ar5 (f500).
1, as owner ot tne prpportv or my employees with wages as thetr sole
compan5ation, will Co Ihe work, antl tho structure is not IntentleC or otferetl
tor sa10 (Section 7044, 6u5iness antl Profe55ional Cotl¢: Thp COn[ractor'S
i i�,.o�a i,w nnns not aoolv tn an owncr ot a oroperry who builtls or improves
CmPloyues, provltletl that 9u[h in
SaIC. If, howeveq tne bulltling or
pletion, the owner wlll haye the I
�rove fortne purpote olsal¢),
1, ai owne� of lha D/operty, e
VaGtors lo Cons(ruGt tha PrOject (
Tho ConVactor's Liconse �w tl
builtls or Improves tnereoh, ana
tractor(t1 license pursuant'�o rne
prooi o! [heir Worker'S Compe�
❑ I am exempt un0er 5ection—
Date '
1 IterCby certify tnat hd
Information is <orrect I ag
antl state laws ralati t
sentatives of Nis c to
in5pection purposep'
Si9nature �
Drivers' Licen O
AF 0865-46, rev / C
Owner
va reatl
re¢ to c
'�Olt or thrOu9h his or hOr own
�e not Intendetl or oHeretl for
Is soltl within ono Yoar oi com-
ing he/sne tlitl not bulltl•aLim-
\
contracting with Iicensetl con-
Busine5z antl ProfeSsions CoOe:
to an owner oi proparty who
�, for such projects wlth a con-
License Law). 1 am awara that
ma shoultl be proviGed [o me.
— B. & P. C. for Ihis reason
tlon-antl sta[e that [he above
dll dtY antl <ounty ortlinances
i,an� he�eby aythoNxe tep�e-
bove-mentionetl orooertv tor
P� ;� �' _
TVPE OF CONSTRUCTION I.J NEW U ADD L'�J ALTERATION LJ REPAIR
❑ CONVERSION ❑ DEMOLISH ❑ OTHER .
DESCFIPTION OF WORK/USE OF BLDG. �—
TVPEOFPERMIT GRADING FOUNDATION STRVCTURAL
❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL
❑ OTHER
PRQIECT DESCRIPTION SQ. FT 1-� oCCVPANCv �)
C O N STR VCTI ON TVPE��i�ALUATION §��_1i6,�/ _
ZONE GR I U. D ��Em ACRES
Remarks: �D /� � q`� � �. el '
low Preventer
lOw irrigation
Drinking F�e
Floor Drains
Floor Sinks
Gas Service
Interceptors
Kitchen Sink
Roof Drains'
Reinspection Fee $15
Boiler
Duct - Under Ground
Exhaust System LJ 1V1n1
FirepVFact. Blt. ICBO �W
Heating System ctin
❑0.100 TU �100.
Reinspaction Fee
Builtling; Canary - Applicanp Plnk - Accounting; Goltlenrotl - Assessor
Showers
Service Sink -
Sewer Cap . .:' -
Sewer Connection
Solar Collec s
Solar P' ing
ar Tank
Swimming Pool w/Spa
Urinal
1y@ter Closet
Water Servi
Aum-Wash
Isue Fee
Hood or Type I ❑
Canopy Typell ❑
Re(rigeretion System
Oaioo,o ❑�oo,000
�m Repair/Alteration
Dampers
$15 I I � Izwe Fee
�� ���
FEES
5 3
3
A.P. # G
S Main Buildi
E
T Front
8 Rear
A
C Righ[
K Lett �
S
Ping. Ref. #�
Planning Notes:
Automatic W:
Construction
Cooking Unit
Dishwasher
Dryers �Ga!
Fan
F.A.U.
Fixtures
Device Boxes"
Outlets
Switches
Garbage 9is�
Fee
9629 2/�0/95
Zone
Accessory Building:
Parking Req./Provitled
G��
f i. n r l�.i^!� �
ELECTRICAL . .
Transtormer ❑-15-50KW
�O SO+,KW
Meter �uptol00�amps
Meter �over 100 amps
Electric
KW LJ5-75 KW
DEVELOPMENT SER
ZoninB APOroved BY_
Building AOProvad By
Appliptian Ittued By_
$15
• -..�r TL
Z
O
N
I
N
G
R
E
�
M
T
s
FEES
Sub Panel
Motors❑ HP�1h-$
Inc. ar 09-15 HP 076-75+
icrowave
ole Light
Fiang
Sign
; Standing Sectio
Trash Compacror
Issue Fee $ 3
y�TS: ...I—IO—O�
SUMMARV OF FEES
BUILDING PERMIT $ .'�CaN'..00 SMIP $ 5.39
PLAN CHECK $ PERMIT
PLUMBING $ �SSUANCE $ �
PLAN CHECK 25% $ ENERGY P.C: $ /
EI.ECTRICAL $ GRADiNG $ - �
MICROFILM $ �
PLAN CHECK 50% $ �—���
MECHANICAL $ TOTAL fEE �$�1 J I
PLAN CHECK 25% $ ' ' �
J
CONSTRUCTION AND PLANNING POOL ,PA
APPROVALS Permit � Date Inspector qppROVALS Permit # Date Inspector
.p
1. Temporary Electrical Seruice or Pole , ��. 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. ,, �. 53. Steel Reinforcement
3-Electrical Conduit,Utility-Undrgrnd: - � � 54. Forms -
4.�Electrical Conduit,-Undrgrnd. • 55. Electrical Bonding . •
5. Steel•Reinforcement. 56. Rough Plumbing & Pressure Test
,
6.� Electrical UFER Grnd. '. 57. APPROVAL TO COVER-GUNITE '
7. footings �- . . 58. Electrical Cqnduit-Undrgrnd. '
8. Foundatioq � . - 59. Gas Pipe, O Undrgrnd., Test .
9. � Water Pipe-Undrgrnd. - ��. � 60. Backwash Lines, P-Trap, O Undrgmd.
10. Structural Floor Sy"stem " ". t�� ,�. 61. APPROVAL TO DECK
11. �Property Sewer Line;& House Connection ., _ 62. Backwash & Receptor-Final
12: Sewer Cap�% . : '' � 63. Heater & Vent-Final '
-,..
13. � Roof'Drains �, ��, � `;' 64. Plumbing System - Final � �
14 "'Rough Plumliirig ; �� � 65. Electrical-Final �
15. Rougli Electrical-Conduit 66. Solar System-Final '
16. Rough Elec[ric Wiring 67. Fencing & Access Approval ,
17. Ftough 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. Duc[s, in Structure ' 70. Underground Hydro
22. Ducts, Ventilating ' � 71. Product Piping OGas ❑Oil �. '
23. Gas Pipe-Rough & Test ,. 72. Underground Flush �
24. Roof Fremin9 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing .+�.y,.��.�,L � 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monacoat 75. Dry Chemical
27t �Frame and Plashing � y kS` c 76. Dry Standpipe
26. �Lathing &�Siding � 77. FIXED SYSTEM FINAL '
29. Insulation /y� G 78. FIRE PREV. FINAL �
30. Drywall Nailing � � � � HEALTH DEPT. REQUIREMENT
314 Plaster Brown Coat � 79. FINAL INSPECTION �
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
M C-
35. Final Gas Pipe-Test �. � �Q
36. Hood or Canopy
37. Final Factory Fireplace % �
38. Final Plumbing .
39. Water Service-Final �
40. Gas Service-Final '
41. Solarv Domestic-Final .
i,
42. Bacliflow.Preventer �
43. Backflow Irrigation • � �
44. -Landscape Irrigation System , , , �
45. Sound Attenuation
46. Hand'+cap Regulatio�s � y � ` �
47. FINAL STRUCTURE & BUILDING �
48. Special Requiremen[s ComPleted
49. Electrie Release to Edison � . .
50. Gas�Release to Southem California GasCo �.
51. CERTIFICATE OF OCCUPANCY
No. DatB
_� .
acancam to ri�� in au swce: excePt tnose w�tnin neavr eoraer nnes a�a s�yn au avcrooriate aeemretions. O I O3 '2/cij/:)G c�'. oC'. TL.
CITY OF COSTA MESA CONSTRUCTION P�MIT � " PERM NO. TRACT NO. LOT NO. UNIT NO. ' - , ��
. Projv�tAddress �-�/'Z � f% /-%L� s � �$93 � � - � � '
r TVPE OFCONSTRUCTION NEW ADD �ALTERATION REPAIR
.-Y��plicanYs Mailing Addreu �-S�O � u r„JL'-f.<Fn--l�-.-�-tt .
/7 / ❑ CONVERSION ❑ DEMOLISH O OTHER
Owfier's Name �%v��� ��� �'""g � Phone A•P• # -- ; Zone
DESCRIPTION OF WORK/USE OF BLDG. ---F'�
Address 7 � �T- ��� � 7 � � - - � S Main Building: Accessory Building: .
E - Z
Afch/Eng. _ LicEnseNo. TVPEOFPERMIT GRADING FOUNDHTION STRUCTVRAL T Front � p
Addre55 ' � . . ❑ TENANT ❑ ELECTRICAL PLUMBING ❑. MECHANICAL . . �A Rear ' . , ' . N
Contfactor'S Nam �= Phone -'��-� � � 'OTHER � � -' ^ , , .
' PROJECT DESCRIPTION 561. FT. 'oCCUPaNCv C Right . N
Addresslmailingl ' � q v� � �*-p ' . K Left '� ' � � � G
OC�i �O / � CONSTRUCTIONTVPE ' VALUATION$ $ .
CityLicenSeNo. _ , � • ZONE GRADINGCU.YDS. ACRES - . E
LICENSED CONT0.ACTOR DECLARATION � - Ping. R¢f.'(k P3fkin9 R¢q./P�avid¢d .
1-M1ereGy alfirm [hat I am licensetl untl¢r provisions o(�Charte� 9(cominentlng qema�ks: � � � Planning�Notes: ' M
with section ]000) o/ Division 3 of the Business ana Profe55ions COtle, antl . T
my license is In full force antl effect. ' ' , � . '
License C ss _ ' LI �se rvo.�`�� �1 L % • � � , � S
Date�� Signa�ture � ' " ' PLUMBING FEES � ' ' ; , � � ' �
WORK RS' C MPENSATION C ARATION
.� g ' BarSink Showers ' ELECTRICAL FEES
� I hereDy atilrm that I have a cer ifl te of consent to salLinzure or a certifitate
of Worken' Compenzation InSLr nce, or a certlfietl�c py thereot (Section, gackflowPreventer �SeNiceSink� � � ��
` �j �/ p p /� Automatic Washer- Transformer ❑ 15-50 KW
� po��yN�!L)�T��A�%(/�ompany �` �� � �l' Backflowlrrigation SewerCap � � ConstructionPoleSub. � ❑50+KW
O�Certifietl mpy I5 her¢by fumishetl. . �. -
� Certitietl cop y• Is fllep witM1 the city B ing olvu i� ' � ;�''' Bathtubs . � ' Sewer Connection Cooking Unit .,; ,- . Meter ❑up to 100 amps �
Date'L''% .`l—SC� APPlicant�!/.. ^ . /' . � . � .
EXEMPTION FROM WORKERS',COMP NSA ION DECLAFATION� �- Cl3rifiClS . _ r .. _ $olaf ColleCtorS _ DiShwashef .. . Me[er ❑over 100 amps ._ _
(Thissection neetl nat be com0�atetl it e p<rmit IS for on¢ huntlr¢tl (E300) or
iess) ' � Dishwasher - Solar Piping � � ' Dryers ❑Gas' OElectric Sub Panel .
I C¢rtity Ihat'in [he perto�mance of [be wo�k tor whith this perm�t iz issuetl; 1,� . - �
shall' not employ any person in any manner so as to become subject to the • Drinkin9 Fountains Solar Tank ' � Fan � ,Motors �0-i HP 01'/: - 6 (
Wo(ke�s' Compensation Laws of CalitOmia.� � �„��/' - . �
, Oato - Signature ' ' Floor Dreins� , Swimming Pool w/Spa � ' F.A�U. �
'NOTICE: It, a(ter making this tleclarallon, you shoultl become subject to the Inc. Sola� �9-15 HP �i6-15+
Workers' Compensatlon provisions ot the Labor Cotle, you must fort�with Floo� Sinks " � Urinal � � Fixtures Microwave 1
comply with sucit provisions or -thi5 �p¢rmit shall be tleemetl revoketl. _
CONSTRUCTION LENDING AGENCV � � � � GBSSEtviC¢ -0ut12t5 Wdt¢�CIOS¢[ �
I hereby atfi�m that there iz a mnztruction lentlfng agency for the p¢rformance �� Device Boxes POIC Light '
of the work for whicn this permit is issuetl_(Sectton 3097 qv. CJ Interceptors . - Water Heater Outlets Range �
Lentler'S Name
Lenaer•s Atlare:s ' � � Kitchen Sink , - Water Service _ ' Switches � ' '
OWNER BUILDER �BCLARATION � � Sign
I hereby atflim that I am exemot trom the Conlractor's� License Law torthe Lavatories ' 'Auto-Wash � Garbage Disposal ; Standing Sections
following rCason (Settion 7031.5' Business antl ProfeSSional Cotle: Any city or . � �
county whlcFl 1¢quires a Oermit f0 COnStNct, alter, ITprove, tlemOlizh of tepair P-Tf2p L3undf�/ Tfdys ' '
any Structure, prio� to it5 issuance, also �equirei Ihe aOP��cant fo� such permit G¢O¢/et0� �0.5 KW 05-15 KW T�dSh COmp3Ct0�
t0 lile a si9n<U statement�[hat he/she is licensetl pur5udnt lo the PrOvisions ot Roof Drains
the Contractor's License Law (Chap[er 9(commencing with Section ]000) of ,
Division 3 of the Business antl Protessions CoOe) or lhat ne/she is ezempt __ - �
the�efrOm and Ihe basis for the allegetl exemption. Any- vlolation oT Section , ' -
7031:5 by any applicant for a permit subjects tM1e aOP�icant [o �a civil
��enalty o( not more than five huntlretl Gollars (g500). � ' � - -
1, as owner of IM1e property.or mY emploYeeS with wages as thei� sole � F7einspection Fe0 ' .$15 � Issue Fee - $? �
compensatlon, will tlo the work, antl the structure Is not intenaetl or o(teretl � qeinspection Fee $15 Issue Fee t$ 3
tor sale (Section 7044, Business antl Professlonal Cotle: The Contractor's . � MECHANICAL FEES
LlcenSe Ldw tloes not apply to an,own¢r of a propnrty who builtls or improves '
thereon, antl who tloes such work himselt/hersoH or througn his or her own , • Hood or Type I� ❑ � ' DEVELOPMENT SERVICES REQUIREMENTS: - -
¢m01oy¢es, p�ovitletl tltat such improvements are not9ntentletl or off¢retl.tor Boiler .- 2onin A roved B �
sale. If, nowever, lhe builtling or improvement is soltl within one year of com- Canopy Type I I ❑ . g PP Y Date
pletion, the owner wlll'have the burtlen oi provin9 ne/she Oitl not buila or im- Dutt - Under Ground ' I Building Approved By Date �
prova tor the purpose of sale). ' � . � . � , ���
❑ I, as owner of the prooerty, am exclusivety contracting wim Iicensetl wn- Duct -Structural , Refrigeration System ., � Application Issued By Date
t�aCto�5l6 construct the projecf (Section 7044, Business antl Pwtesslon5 COtle:
The Contractor's License Law does not apply to an owner oi property who Duct - Ventilatin9 � • ❑0-100,000 BTU ❑100,000 BTU _ � SUMMARV OF FEES ' �
builds o� ImOroves [hereon, antl _wbo cont�acts to� such projects with a con- ' �
tractor(s1 Ilcense pursuant to tne contractor's Licanse Law). 1 am aware tnat Exhaust System ❑ Multiple ❑ System Repair/Alteration ' BUILDING PERMIT $ SMIP $
prOot o( their Worker's Compensation insurance shoultl De pwvitletl to me. PLAN CHECK $ PERMIT
❑ I am exempt untler Section B. & P. C. tor this reason Firepl/FacL Blt. ICBO # Fire Dempers PLUMBING $ �SSUANCE $
Date ' Owner ' Heating' System & Ducting � Registers � pLAN CHECK 25% $� ENERGV P.C. $' ,
I hereby certiry that i have read this appiication and state Nat the above ❑4100,000 BTU �100,OOOBT �- ELECTRICAL �$ GRADING `$ �
in/ormation is mrrect. I agree to comply with a11 city anA county ortlinances • i � '
antl state laws relatin9 to builtlinq consVucNon, antl hereby authorize reore- � � ' • � � P�AN CHECK 50%' $� � MICROFILM $ -
zen[a[ives of Ihis cit - to ¢nte�� pon the abOvo-mentionetl proper[y fo� � � , i , • , %�
inspection ourposes. � ' � MECHANICAL � $ � �, � �/
Slgnature ' ' oate.<-Z��Q`�' � � ' � � . TOTALFEE ' $
Drivers' Licens or 5 � �-' � ' Reinzpeetion Fee $�5 lu�ue Fea � $ 3 PLAN CHECK 25%� $ - � ' ' - � '
CMF 0865-46, rev. 10/84 White - Bullding; Canary - Appllcant; Pink - Accounting; Goltlonrotl - Assessor
C014STRUCTION AND PLANNING � � ' POOL & SPA %' ' ` ' ' '
A�ROVALS Permit# ' Date Inspector qppROVALS Permit# Date Inspector
/
��1. Te,mporary Electrical Service or Pole 52. Pool & Equipment Location �
�� 2. Soil Pipe-Undrgmd. ' .Sj�i��� � 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. � 54. Forms . �
' 4. Electrical"Conduit-Undrgrnd. • 55. Electrical Bonding .
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test •
6. Elecirical UFER Grnd: � 57. APPROVAL TO COVER-GUNITE .
7. Footings � 58. Electrical Conduit-Undrgrnd. _
8. Foundation • � 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. ' " 60. Backwash Lines, P-Trap, � Undrgrnd.
10._ Structural Floor System 61. APPROVAL TO DECK � �
11. Property Sewer Line�& House Connection . 62. Backwash & Receptor-Final
12. Sewer Cap . ' • 63. Heater & Vent-Final �
13. Roof Drains . 64. Plumbing.System - Final ��
14. Rough Plumbing'� ��'�f� � 65. Electrical-Final . ,
15. Rough Electrical-Conduit ' 66. Solar System-Final
16. Rough Electric Wiring . 67' Fencing & Access Approval -
,-]7. Rough Wiring Slgn , 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning . FIRE DEPT. REQUIREMENT
20. Rough Factory Fir�place � APPROVALS Permit #
21. Ducts, in Structure � 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
�
23. Gas Pipe-Rough & Test 72.j Underground Flush
24. RoofFraming ' 73. Undergrnd.StorageTankOGas ❑Oil �
� 25. floof Sheathing � 74. Overhead Hydro - -
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical ,
27. Frame and Flashing 76. Dry Standpipe
28�. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final � 80.; FOOD CERTIFICATE ISSUED
33. Final Electric Notes: �
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test G�� �` �
36. Hood or Canopy
37. Final Factory Fireplace . � �
38. Final Plumbing � ��/�. .
39. Water Service-Final
40. Gas Service-Final
41. Solar pomesticFin21 � , ,�
42. Backflow Preventer '
�
43. Backflow Irrigation '
44. ,Landscape Irrigation System �
45. Sound Attenuation ,
46. Handicap Regulations
�. 47. FINALSTRUCTURE & BUILDING �
48. Special�RequirementsCompleted � �
49. Electric Release to Edison � ,
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY � - . _
.
No. ' � Date , � .
AOGlicant to fill in al1 svatts exeeo< <hose within heavy Eoraer lines antl sign all aoProoriate tletlarations. .
CITY OP COSTA MESA , � -- -- - � - pE IT NO. ' TRACT NQ � LOT NO�. , BLD . . - • I O31 �/ I ll/8E ,
�,CONSTRUCSIONPERMIT — � ���'. �%t � ; - '.. ' � . ; �' ; � _ . I�;�oi'fi ;�L.
PrUject Add�ess ' Z � TYPE OF CONSTRUCTION�� ; 'NEW �ADD . , LTEftATION � REPAIR " �
ApplicanYs Malling Addr¢55 � -/ ' , : � ❑ CONVERSION ❑ DEMOLISH ❑ O1HER � ' � � q;p, �4 ' - Zone � 1 . � � ' '
� I� I TIN6 EIVDEhIeMEMs • DESCRIPTIONOFWORK �` �
Owner's Name "�i� Phone � , ! - � S� Main Building: - . � , - Accessory�Building:. Z
AddIe55 - � - TVPE OF PERMIT GftADING: ❑ FOUNDATION �^STRUCTURAL ' . T Front � � ' � - � pJ :
Arch(Eng.. - ' ' LlCense No. . ❑ TENANT � ELECTR�CAL' ❑ PLUA781NG- ❑,MECHANICAL ' � B Reaf �- • � ' � " _ ' . . �
Address� : . , .' - ': � : � � . � , .� �OTHER � � ' ' � � � �� A� , . . _ . . . , N a
B�PSCOE �LE IG �+�� ' PROJECT DESCRIPTION � St�. FT. • °- � �oCCUPArvCV � � K Right � � - . . � ' G
Contrector's.Name- C� Phone , _ . , . ,
Addresslmailing) z 4' S. I�.�il��� � N 1%O� CONSTRUCTIONTYPE �� ; � ' VALUATION$ ;S ,L2ft � � � � � . ' - � i R
E
� - . � . ' „ � � , � ZONE ` GRAOINGCU.YDS. �AGRES PIng.Ref.# ' - Park.Fees $ , - � ` �
City License No. a 7� , ' � �� V t
LICENSED CONTRACTOR DECLARATION � ' ' ' Remarks: � �� a-}- 13. � . V Pafking Req./ProVided ' ' ' ` �
"' I hereby;aitirm thzt I:am licensetl untler provisions oi�Charter 9(commencln9 , � � � _ - R
� with Sectlon 7000) ot DiviSion 3 of the Busine55 antl ProtesSions Cotle, antl � ' � � , � � � ' � ' USe Of Building: �
my license is in tutl force antl�eftect. ' . ' ' - - � - � E �
License Class � Licen ' '�A3�'=3 ' � • , PLUMBING ' � FEES ' Planning Notes: � � ' ' , - M •
. Date ��Z 7' g� Si9nature � � � - ' , � � � E
, WORKERS'COMPENSATIONOECLARATION' � g2lSink Showers N �
I hE�eby atfl�m that 1 hav¢ d C¢rtiflcafe of consent to self-Insure o� a certificate ' � ' � - • � � T
�; o( Workers" Compensatio � In5ur5nce, or a-certifietl,-copy �theieof-(SacUom � gackflow Prevente� ; Service Sink � . ' �.. S
1 � 3800, Lab. C.) � � , . � Backfloov Irr:gation . . � � Sewer Cap • � �_ � � � � ;
, Policy No.N�(.%H�Ni'?�O�H�{'I ' Company_Q-RI�DNAVr ' ELECTRICAL FEES
[] _certnietl copy is nereoy`furnishea. �� + ` ' " -,; . . � Bathtubs - Sewer Connectiom - � ...- Automatic Washer , � ' a .Transformer ❑ 15-50 KW : ,
L�_I'Cer[il ietl cy py tiletl with the city BA�I mg D v� i , r� ❑$0 + KW •
oate L�%-I�� ' APplicantT'���/%���i^�-�'L� � _~Clarifiers � SolarCollectors � *- ConstructionPoleSub. ' � i ,
EXEMPTION FROM WORKERS' COMPENSATIOKDECLARATION - ' Di5hr4dsh¢! '"-' - ' -'- ' " " - � � - '
,(This section neea not be comoletetl it the permit is tor one huntlrea (E100j or ; � . ! -Solar Piping ' Cooking'UniT � Meter �up to;.t00�amps -� + - -•
less). . . .-, - . 1 . , : ' - _ . � � . ,
� I certity that in the pertoiTanca oi the work for which thl5 pe�m�t is issuetl, I� I D�IOkipg FOUntein5 5012� T3nk � Oishwasher . `Meter ❑over 100 amps ; i Qj ,
shalb noY employ any person in any manner so:as to become subject to the . , . � . � - - � ' ' '
Workers'. Compenwtion Laws of Califomia.� . . ' r Floor Drains� : � Swimming Pool w/Spa , �; ��Dryers ❑Gas ❑Electric ,Sub Pane6 ' ; Q� I
Date t ' Signatur¢ ' ' ' , . , ' �.
� NOTICE: If,'after making this tleclaration, you shoultl become Subjeci to [he ' E Floor Sinks ' �. Urinal � � � Fan � 3 MOiors �0-1 HP �'/z- 8 � �
Workers' Compensation provisions'oT the'Labor Cotle,'you mus[ forthwith"' , � � , - - -�- - - - � � � �
compty wich� such provisions or .this-,permit,shall be tleemetl, revoketl_ GasService, ; 'Outlets� . WaterCloset _ ' � •�F,A,U. � � � � .InaSolar�09-75 HP �76-15+ �
CONSTRUCTION LENDING AGENCV�' � � �' i ' � ' � '. � � c � ' . ' ' ' - ' � � r _ _ _ _ � , , � �
I hereby afflrm that there Is a:Construction lentling agency tor the perforrtiance Int¢Yc¢ptOfS ; I ' �`_ W2te! H¢Bt2� . � � % FixtulCS ! t ' ' . � ��MIC�OWav2 ' � � ' 1
of Ihe :wbrk "tor which. thlr permit is,issuetl. (SecNon �3097 Civ: Cq. ' ' � - ' ' - - � � � • ✓�✓ � �
Lender's. rvame - - � _ - . � Kitchen Smk -� � ' �� = Water SerJice :,. - i - � Device Boxes ' � ' •
e .. . � � , . � -.- ; , - . ; e Pole Light i . � i.
Lentler's Atltlress - ' - -- - � � Lavamnes� - � ' ; � _ • , i ' ! �
OWNER BUILDER OECLARATION � � .- �. � � ` � . � - . ° I - _ � Outlets . � � ; Range ' • � � -� �
I hereby aftirm that I am�exempt Trom the Contractor's License l.aw Tor the � _. � , � . �� . ,
following reason (Section 7031.S�Businessantl Protesslonal'Cotle:.Any city or � P-Trap- �� � ! - -� �'g �Switches , Si9n � Q '
COunty which �equi�es a pe�mit to constiuct, alteq imp�ove; demolish�o� �eDai� . y+ � y _ - , ' ' ' � � �
any structure, prwr to its issuance, also requires the applicant tor such permit : � Roof Drains• ' �. � _ � ` . � '; � w �. Garba9e Disposal ' . A . Standing Sections i � ��
to tile a signetl statem¢nt thdt �he/Sh¢ is licensetl pu�suant to the provisions o� � - , ., �- � � � •
fhe Contractor's.License Law (ChaO�er 9 (commencing with�5ection-]000) bf . ' - � � � �� ^� ( ' � • �
Division� 3,-of the'Business and Protessions Cotle).or that he/she is exempt � �� ' f� -.� � � ' ' �.. �. ' Generetor �0-5 KW �5-15 KW ,I Tresh Compacto� � � ///tJ ;
. therebom antl the basis fonthe allegetl exemption: Any violation� of Section ' _ . " � . _ . . - . � � �
. 7031'S by,; any applicant tor a permiL sub�ects'the, applicant to �a, civil , - Reins ction Fee . ' �-i '� � ' '� �' E'� ' D!
'�nalty of not more than five hunareG tlouars (E500).' : : � � Pe ' $25� , Issue�Fee : j � ^ � $ ,3 ;
LJ I, as owner of the�propecty oi my'employees�.witti wa9es�as their iola . . � �MECHANICAL j Reinspaction Fee $25 �luue Fee� �$ 3
compensation will tlo tM1e work, antl [he-st�ucture I5 nOt intentletl oi ofter¢tl � -, � ' FEE$ ',
for sale' (Secfion 7044, Business antlt Professional� Cotle:, The Contractor's j � , � , � � , PUBLIC�SERVICES REUUIREMENTS: � � ' � ' - . � '
LicenSe Law tlaes not apply to an:owner of a property'who builtls or improves Boiler - ' HpOd or � Type I� ❑, - t ' • '
th¢reon,' antl who'tloe5 such wo�k himself/he�sel( o� thtOu9h his or h¢r ow❑ ' �- ' ' i "� Zbning Approved By � Date
employee5, provitletl that such improv¢ments are nOt Intentletl o� otteietl,to� �2nOpy TypE I I ❑ L; � _ � � 1
ule. If, however, the builtlin or im rovement is soltl wifhin one ear, of com- � Duct� Under GFound i , ;
9 p v . . Application Approved By Date
pletion, the ownen will have the burtlen of proving he/she tlitl not builtl or im- ' . � .
�rove tor the purpose o( sale). , � Duct - Structural ! � Refrigeration System � �'' . -{ Applimtion Issued By � - ' �at�
I, az owner of the property, am exclusively contracting' with licensetl con- � ❑0-100,000 BTU ❑100,000 BTU ' '
trattors to construct me project (Section 7044, Business anG Professions Cotle: ' Duct - Ventilating � , � �SUMMARV OF FEES ' � �
The� Contracfor's� License Law does not appry to an owner oL property-who . . . , _ . _ . . . - _ . . : - . , ' ' � � $
builtls or improves thereon,'antl who contracts for such projects with a con- Exhaust System ❑ Multiple ❑ System Repair/Alteretion � ���� f BUI LD WG �PERMIT $� SMIP � ' �
Vactor(s) license pmsuant to.the Contractor's �.icense Law), , � PLAN CHECK $� PERMIT
� I am exempt untler Section . B. & P. C. �or this reason ' Firepl/Fact. Blt. ICBO #' I� � � T� PLUMBING $ ISSUANCE .$ , �
Dafe � � ' • Ownen � ' � ' �' � Heating System & Ducting • ' ''� PLAN CHECK � $ ' ENERGY P.C. � $ '
I hereby cerHfy that I have reaG this application antl state tFat the above � ❑4100,OOOBTU.�100,000BT ' � •` GRA�ING $�
information is correct. I agree to comply witn all dty antl county"ortlinances �,' ' - -' ' - - - . � r�.; ELECTRICAL $� -
anA"state laws relating"to builtlin9 construttion, antl hereby authorize repre- � � . , � , 90 _ MICROFILM $ '
5en[atives of this city to'enter; upon the above-mentionetl property for ', 7LAN CHECK , $ �• �
inspection purpo . - � 'Z 1./�86 . ' ' ' ' MECHANICAL ' $ ' %S. 0
Signature � Date � � •• TOTAL FEE ,$ � 7 .
Drivers"License or.55 � - Heinspection Fee $25� ' � laue Fee � $ 3 � PLAN CHECK : � $ � '
�
'CMFO865-46rev:7/83 W�ite-Building;Canary-APplicant;Pink-Accounting;Goltlenrotl-'Assessor � - � - - ' - - . _ � .. _ .., -_ _ _ __ _ �
CONSTRUCTION AND PLANNING � POOL & SPA
� APPRbVALS -Permit #- Date Inspector qppROVALS Permit # Date Inspector
� 1. Temporary Electrical Service or Pole� ' S2. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. :J � 53. Steel Reinforcement � ,
3.,;ElectriCal Conduit Utility-Undrgrnd. � 54. Forms . �-�
�4.:Electrical Conduit-Undrgrnd. � ��� 55. Electrical 8onding ;,
5. Steel Reinforcement . . 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grntl. .' � 57. APPROVAL TO COVER-GUNITE %! �
7.�Footings • � � � , 58. Electrical Conduit-Undrgrnd. � �.
8. Foundation .� '. 59. Gas Pipe, O Undrgrnd., Test ...
9.'Water�Pipe-Undrgmd. •� ' 60. Backwash Lines, P-Trap, O Undrgrnd.
10. �Structural Floor System � ' 't' 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 Plumbing'' " 65. Electrical-Final �
-. 15. Rough Electrical-Conduit y� 66. Solar System-Final
16. Fough Electric Wiring , h/ �L �� � 67. Fencing & Access Approval �
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
- 18. Rough Electrical-T Bar Ceiling y� � 69. POOUSPA SYSTEMS FINAL
19. Fough Heating & Air Conditioning � FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace;'';^ � APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating ��, 77. Product Piping O Gas ❑ Oil
� 23. Gas�Pipe-Rough & Test ' 72. Underground Flush
24. Roof•Framing 73. Undergrnd.StorageTank �Gas ❑Oil
'T` � 25� Roof�She`atfiing � i • - � 74. Overhead Hydro
� 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry.Chemical
27:`Prame and Flashing . 76. Dry Standpipe
28. Lathing & Siding � 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PfiEV. FINAL
30. Drywall Nailing .� ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electriral Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric . (p (� � CI� U� Notes: �� � � �
34. Final Heating & Air Conditioning � - ^ ` � '
� C
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 ' � ' � �
:7
42. Backflow Preventer '�� � =� �� � � `
=�:, i
43. Backflow Irrigation �•�' � . � ' '
1"1
44. ,Landscape Irrigation SYstem:'• • ��
,
45. Sound Attenuation . � c� ,
46. Handirap Regulations ' ,
.�_ r
47. FINAL'STRUCTURE & BUI�DING � . • � in
48. Special�Requirements ComplPted ' , � `� �
49. Electric Release to Edison - .;y
50. Gas Release to Southern California Gas Co � � " '
� 51. CERTIFICATE OF OCCUPANCY ` ' ' ' J� " ' .
'-�
;�. No Date �j . `.�j ' j, . , i
..,
�
CI
AOG���ant to fi�l in all spaeas except those wttMn heavy GorGer lines anE sign all aov�ovriata aeelarations.
CITY OF COSTA MESA,� /CONSTR U�Cs�T-ION PERMIT PEQ�tQIT NO. , TRACT NO. LOT NO. UNIT NO.
Project Address �732 u[. �7 � `� �•
Applicant's Mail/�r�� Address 732 G!, /7?u ST
Owner's Name /T�a��2 2p• Pho�e
Address 732 G( �7� `sr �.STR L�HRS'A
ArchlEng. License No.
Address
Contractor's Name SNdL� /�'+'/Ge /�r • Phone �-���
Addresslmailing) �6�/ �����N �h, �e� �v�V$
CityLicenseNo. �mG�4'L
LICENSED CONTRACTOR DECLARATION
I hereby affirm [hat I am ticensetl untler proWilons oi Charter 9(commencing
with sectlon 7000) of oivision 3 ot lha BuSinezs antl Protesslons Cotle, antl
my Iicense is In (ull fo� aR�J Effect. .y��� /
Llcense Class ��/'� - Licen o. ��
oete -3- 27- BL 5ienatureY �,,.� �� +�7-! o
WORKERS' COMPENSATION DECIARATION. .
hereby aftirm that I nave a certificate of <onsent [o self-insure or a certlfiCale
Workers' Compensation Insurance, or a certlfietl copy thereof (Section
.d00, L2b. G. �y.��
Poiicy rvo ��%� Comoany�+/n�/� �d"'��
� Certifietl mpy is hereby fumishetl. .
�ate�tifj$� cp4y Is tiletl wAPPI c nI�Y Builtlipg Div�sio�-e��
C O K .��
EXEMPTION FROM WORKERS' COMPENSATION DECLARFTION
(ThiS S¢ction neetl �ot be completetl if the pOrmil is fo� one hunUretl ($300) o�
less).
I certlfy Ihat In the perlo�mance of the work fOr which �his perm�t i5Is5Uetl I
shall not employ any person In any manner so as to become subject to the
Workers' Compensatlon Lawz o( Calitornia.
Date Si9natura
'NOTIGE:Ii,aiter making this tleclaration, you shoultl become sub7ect to tne
Workers' Compenwtion provisions ot the Labor COCe, you must forthwltn
comply wll� Such provlsion5 or thiz pOrmit snall be tleemetl revoke0.
CONSTRVCTION LENDING AGENCV
I hnreby aHlrm tnat tnere is a constructlan lentling agency for the performance
OI the work for whic� this permit IS i55ultl (Section 3097 Civ. CJ
Lentler's Name
�enGer's ACdress ,
OWN2R BUIL�ER OECLAFATION
1 hereby affiim that I am exempt irom tM1e Contractor's Llcense Law for lhe
following reason (Sactlon �031.5 Busineis antl Prafesslonal Cotle: Any city or
counry whlch requires a permit lo construct, altar, improva, tlemolish or rapatr
dny StNG[ur0, pIIO! t0 Ils I55udnt¢, also feqWl85 tbe applicant fOr such pelmit
to file a slgnaC statament that he/she Is Iicpnsatl pursuanl to the provisions ot
�the Conlractor's License Law (Chapter 9(commencing wiln Sectlon 7000) ot
OIvi5lan 7 ot the Buiiness antl Professions Cotlo) or tltat tte/she is exempl
�Crofrom ane tne DaSis tor th¢ allegetl axompUOn. Any v101atlOn of Settion
031.5 by any applitant for a parmit subjacti lbe applicant to a civil
�Entlly ol nol more than live huntlr¢tl tlollars (5500�.
1, as owner of [he property or my omployees with wagas as thelr sale
compensaUon, will tlo the work, antl the structure Is not IntenOetl or oHeretl
for sale (SacUon 7044, Business anC Profei5ional Cotle: The Con[ractor's
Licenm Law OOes not applY t0 dn Owner ot a p�operry who builtls o� ImprOves
thcreon, and who tloes such work himzelf/norsalf or Nrougn nis onher own
employeos, provltletl that such improvoments are not Intentletl or offeretl tor
sale. I1, hOwavaq lhe Euiltlinq or imp�ovaTent IS Soltl withln one year 07 com-
pletlon, lho OwnO/ will have [he burtl¢n o1 prOving ne/sne tlia nol builtl o� Im-
�rovB Ia�the purpo5¢ Otsale).
1, ds ownet o1 the property, am eaclu5ivery cOntraClin9 with lic¢n5e0 COn-
Vactors td cons[ruct tne project (Sectlon 7044, Business antl Professions Cotle:
The ConVactor'S license Law does nOt apply to an Owntr ot property who
builGs or improves thereon, antl who contracts tor such o�ojects witn a con-
[ractm�sl Ilcanse pursuant to tne Contractor'S Liconse Law). I am aware lhat
prool of their Worker'S Compenzatlon insuranco ihoultl bo provitletl to me.
❑ P am oxempt under Section B. & P. C. for this reason
Dato owner
1-hereby cmtify that I have'reai
IMormaliOn is CorrecL I agree to
antl stat¢ laws ralating to builOm
sentatives of thls ciry to enfep
InsPection purpa5 /� y
5" t re /•i���
Y7
TVPE OF CONSTRUCTION LI NEW LI ADD � ALTEftATION U REPAIR
❑ CONVERSION ❑ OEMOLISM ❑ OTHER
DESCRIPTIONOF WORK/USEOF BLDG. AOd PH.VO. .�!/LR S/�(�/1,S
TYPE OF PERMIT LJ GRADING LJ FOVNDATION LJ $TRUCTURAL
❑ TENANT ❑ ELECTRICAL � PLUMBING ❑ MECHANICAL
❑ OTHER
PROJECT DESCRIPTION Sq. FT. S�m OCCUPANCV �r�G'
CONSTRUCTIONTYPE ' VALUATIONS 6O�' ��
20NE GRADINGGU.YDS. ACRES
Remarks: .
Ber Sink
Backflow Preventer
Backflow Irrigation
Bathtubs
Clarifiers � .
Dishwasher . �
Drinking Fountains
Floor Dreins '
Floor Sinks
Gas Service �Outlets
Intertepmrs '
Kitchen Sink �
Lavatories
P-Trap
Roof Drains �
ReinspeMion,Fee $15
Boiler � � �.
Duct� Under Ground
DUCI - $tNCtuf81
Duct - Ventileting
Exheust System ❑ MWtiple ❑
Firepl/Fact. Blt. ICBO #
Heating System & Ducting
❑ o-i oo,000 eru O i oo,000 ar
�gna u - -- - -
Drivers' License or 55 $ I I Reinspeetion Fee � I $15
AF 0865�<6, �ev. ]0/84 Wnite - guiltling; Canary - Appliwnt; Pink - Accounting; Goltlenrotl • Assessor
Showen
Service Sink
Sewer Cap
Sewer Connection
Solar Collecrors �
Solar Pipin9
Solar Tank
Swimming Pool wlSpa
Urinal
Water•Closet
Wa[er Heater
Weter Service
Auto-Waih �
Laundry Trays ' .
J '
Isue Fee � 3
IANICAL FEES
Hood or Typel ❑ _
Canopy Typell �
Re(rigeration System
❑P100,OOOBTU ❑100,000
System Repair/Alterotion
Fire Dampers � '
Registers . � �
Issue Pee _ "
5 3
A.P. qW
S Main Buildi
E
T Front
8 Fear
A
C Right
K Left
S
Ping. Ref. #
Planning Notes:
Automatic Washer
Construction Pole Sub. .
Cooking Unit
Dishwasher
Oryers OGas ❑Electri
F.A.U.
Fixlures
Device eoxes
Outlen
Switches
Garbage Disposal �
Generaror �45 KW
Fee
2208 4/QI/H6
2ona
Accessory Building:
Parking Req./Provided
ELECTHICAL '
� Transformer ❑ 15-50 KW
❑ 50+KW
Meter ❑up to 100amps
Meter-Dover 100amps'
Sub Panel
Motors OPi HP 01'h - 6
Inc. Solar �9�15 HP 016�75+
Microwave
, Pole Light .
�.i o l .
' Standing Sections
5 KW Trash Compector �
515 Issue Fee $ 3
DEVELOPMENT SERVICES REQUIREMENTS:
Zoning Approved By
Building Approved 8y - �
Z
O
N
1
N
G
R
E
Q
M
T
$
� SUMMARV OF FEES �
BUILDING PERMIT $ ��/ ♦ ����2 SMIP ' , $
PLAN CHECK $ S��.i PERMIT . ;
PLUMBING � $ • ISSUANCE $
P�AN CHECK 25% $' ENERGV P.C.' S
ELECTRICAL $ GPADING 5
PLANCHECK 50% $ MICROFILM 5 �
MECHANICAL S TOTAL FEE S��
PLANCHECK 25%� $
CONSTRUCTION ANDPLANNING P00. SPA
APPROVALS Permit # Date Inspector AppROVALS Permit # Date Inspector
1. Temporary E�ectrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
3.'�Electrical�Conduit Utility-Undrgrnd. 54. Forms
4:'Electrical Conduit-Undrgrnd. � 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test
6� Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings 58. Electrical Conduit-Undrgrnd.
8. Foundation ' 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, O Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Finaf
14. Rough Plumbing 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit #
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping OGas ❑Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing 73. Undergrnd. Storage Tank O Gas ❑ Oil
25. Roof Sheathing 74. Overhead Hydro 2�
26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical
27. Frame and Flashing 76. Dry Standpipe
28. Lathing & Siding 77. FIXED SYSTEM FINAL �� �
29. Insulation 78, FIRE PREV. FINAL
30. Drywall Nailing ' HEALTH DEPT. REQUIREMENT
31. Plaster Brown Coat 79. FINAL INSPECTION
32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final Electric Notes:
34. Final Heating & Air Conditioning
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace �
38. Final Plumbing
39. Water Service-Final
40. Gas Service-Final
41. Solar pomestic-Final .
42. Backflow Preventer •
43. Backflow Irrigacion
44. Landscape Irrigation System
45. Sound Attenuation
46. Handicap Regulations
47. FINALSTRUCTURE&BUILDING
48l Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co .
51. CERTIFICATE OF OCCUPANCY '
No. Date
AODlicant to fill in all spaces excev� thoza wltnin neavy Dortler Ilnes ana sign all avVroorlate declarations.
CiTY OF�COSTA M��$JA/� CONSTRUCTIO P -fM'IT ''`""' ' '"" ' ""`'' '"" "" '"`" "'"" ""
Praject Address C ✓ Z � • /7 � �/ ' � � ��
TYPE OFCONSTRUCTION NEW ADD ALTERATION REPAIR
AppliCant'S MdilingAddr¢ ❑ CONVERSION ❑ DEMOLISH OTHER
Owner's Name ����J���/'f �.�/5/��+.../� Phone/� /�� DESCRIPTION OF WOPK/USE OF BLDG.
Address � 3 0 - �'✓ � � ` —��.—�-4 .LJ '
Arch/Eng. License No. TVPE OF PERMI� GRA�ING FOUNDATION ❑ STRVCTURAL
Add�Ess ❑ TENANT EIECTRICAL ❑ PLUMBING ❑ MECHANICAL
Contractor's Nam � OC � W Phone y� 2Dj ❑ oTMER
Address (m=�i���l ��.S �%i n C���': PROJECT DESCRIPTION � 5q. FT. ocCUPANCv
g p CONSTRUCTION TVPE VALUATION $
City License No. � 7/ IONE GRADING CU. VDS. ACRES
LICENSED CONTRAqTOR OECLARATION -
I hereby aHl�m that I am licensetl untle� provi5i0ns of Gharter 9(commencing
with section 7000Lot Division 3 of the Buslness antl Professions Coae, antl
my license is in i fRar�e��effect. 2 7 9/� �J
License I s cense No. '� � �
Date Z Signature
WORK RS' OMPENSATION DEC RATION
I hereby aftirm that I nave a certificate ol consent to selt-insure or a certiticate
it Workerz' Compens8tion Insurance, or a cartlfietl copY thereof (Sectlon
J800, Lab. C.)
Policy No. Company
❑ Cer[itietl copy Is nerebv tumishetl. �_ n i /
E%EMPTYON FROM WORKERS' COMVENSATION DECLARATION
(This seclion neetl not be completetl If the permlt Is tor one huntlretl ($300) or
less).
I certify that in lM1e pBrtormance o( the w < � w ich this pL{'mit is i55uetl I
shall rW{ ploy ny person in any ma o o beco E subject to t�e
Work215' e t Lzws ot Califor .
Date� Si9nature
NOi E: 11, a er makjn9 this tleclaration, you sno Itl become subject to the
Workers' Co pen5atio� provisions ot the I�bo� COtle, y0u must torthwith
comply with sucn provisions or thiz pe�mit Shall be tleemetl �evoketl.
CONSTRUCTION LENDING AGENCV
f hereby altirm that there is a construc[ion lentlin9 agency ior the performance
of the work tOr which this permit i5 ISSued (5¢Ction 3097 Civ. C.)
Lentle�'s Name
Lentler'i Atltlress
OWNEP BUILDER OECLARATION
1 herebv atflrT tllat 1 am ezemOt from the Conlydttof's LlcenSe Ldw tOf the
Icounty whicn reqwreE a permit to construcq alter, improve, aemousn or repan
any sVucture, pNor to its issuanw, also requlres the applicant tor such permit
to file a signetl statement that he/she is Ilcensetl pursuant to the provisions oi
tne Conlractor's License Law (Chapter 9(commencing wltM1 SecNon 7000) of
Division 3 of the Business antl Profeszions Cotle) or that he/she is exempt
-�M1eretrom antl lhC bd5i5 fo� the alleged ¢xemption. Any vlolation o( Section
S:g1031.5 by any applicant for a perrnit subjects the applicant to a�civll
-�w enalty nf not more than five huntlrotl tlollars (5500).
� 1, as owne� of the p�operty or my employoes with wages as thei� Sole
compan5ation, will tlo the work, antl the structura iz not intentletl or ofteretl
tor sale (Section 70d4, Business antl Protessional Cotle: The Contractor'S
License ldw tloes not apply to an owner of a properry who builtls or improves
thereon, antl wno tloez such work himselt/herzelf or throu9h nis or her own
employees, Orovltletl tM1a[ such improvements are not incentletl or offeretl for
sale. It nowever, [he builtlin9 or improvement IS Toltl wlthin one year of com-
pletion, the owner wi�� have the burtlen of proving he/Sh¢ tlitl not builtl o� im-
prove fortno purpose otsale).
❑ I, as own¢r O7 lhe properiy, aT exclusively Contracting with IicenSetl con-
IfdCLOlS IO COOSIlUC� �h2 p(OjCCl ($CCt100 ��44� BOSIpQ55 dfld PlOiE5510lIS COdB:
Tne COnt�actor's Llc¢n5e Law tloes nOt apply lo dn owner of pro0erty who
bullUs or imOroves t�¢reon, antl who contracts for such projects wilh a con-
tractor(s ucense puryuant ro the Convacmr's License Law). 1 am aware that
proof o� thlir Wo�k@�'s Compensation InSuranco shoultl be provitletl to Te.
❑ I am exempt under 5¢ction B. & P. C. far this reason
Date - Owner
I nereby certify that � nave reatl tnis applicatlon antl sta[e chat the above
information IS co�r¢c[. � aaree to Comolv with dll dty antl counlY o�tllnances
Signature ffY /9//
Drivers'�License or 55 � �
Remarks:
Bar Sink
Backtlow Preventer
. Backflow Irrigation =
Bathtubs
Clarifiers
Dishwdsher
Drinking Fountains
Floor Drains
Floor Sinks '
iid5$EIVICC - �Ut12L3
Kitc`hen Sink
lavatories
P—Trap �
Roof:Drains
Reinspection Fee '$15
Boiler
Duct - Under Ground
Duct - Structural
Duct - Ventilating
Exhaust System ❑ Multiple
FirepUFact Blt. IC80 #
Heating System & Ducting
❑6100,000 BTU �700,000
Reinspeetion Fee � $15
GMF 0865-46, rev. 30/84 White - - Accounting; GOltlenrOtl - ASsessor
Showers
Service Sink
Sewer Cap
Sewer Connection
Solar Collectors
Solar Pipin9
Solar Tank
Swimming Pool w/Spa
Urinal
Water Closet
Water Heater
Water Service
Issue Fee
Hood or Type I ❑
Canopy Type 11 ❑
Refrigeration Sysiem
Oo��oo,000eru ❑ioo,000sru
System Repair/Alteration
Fire Dampers
Registers �
Iswe Fee
FEES
$ 3
FEES
$ 3
A.P. �
S Main Buildi
E
T Front
e Rear
A
C Ri9ht
K Left
S
�Ping. Ref. #
Plannin9 Notes:
Automatic Washer
�Construction Pole Sub.
Cookin9 Unit
Dishwasher
Dryers.�Gas ❑Elec
Fan
F.A.U."
Fixtures
Device Boxes
Outlets
Switches
Garbage Disposal
Generator �0-5 KW C
Fee
6180 9/28/87
. Zone
Accessary Building:
Parking Req./Provided
4050 TL
ELECTRICAL FEES
Transformer ❑ 15-50 KW -
Q 50+KW
Meter ❑up to 100 amps
Meter ❑over700amps -
Sub Panel
Moto 1 HP 1`/h-6
Inc.Solar 09-15 HP �i6-15+
Microwave
� Pole Light
Range
Sign
Standing Sections
5 KW �Trash Compactor
$15 � � laue Fee
DEVELOPMENT SERVICES RE�UIREMENTS:
Zoning Approved By
Building Approved By Y�
$ 3
SUMMARV OF FEES
BUILDING PERMIT $ SMIP $
PLAN CHECK $ PERMIT
PLUMBING $ ISSUANCE $
PLAN CHECK- 25% $ ENERGV P.C. $
ELECTfi1CAL $ � GRADING $
PLANCHECK 50% $ ' MICROFILM $
MECHANICAL $ TOTqLFEE $ `�
PLAN CHECK 25% $
Z
O
N
I
N
G
R
E
Q
M
T
S
CONSTRUCTION AND!PLANNING nt POOL & SPA '
h`� Date Inspector Date Inspector
A�PQROVALS Permit�# •-APPROVALS Permit#
�
1�.Temporary Electrical Service or Pole 52, Pool & Equipment Location �
'l
2.� Soil Pipe-Undrgrnd. ' `53. Steel Reinforcement
3. Electrical Conduit Utility-Undrgmd. ' ' 54.� Forms � .
4. Electrical Conduit-Undrgrnd. � 55:' Electrical Bonding
5. Steel Reinforcement � 56. Rough Plumbing & Pressure Test
6. Electrical UFER Grnd. .' 57';iAPPROVAL TO COVER-GUNITE
7. Footings ' � 58. Electrical Conduit-Undrgrnd. '
8. Foundation i 59. Gas Pipe, � Undrgrnd., Test
9. Watei Pipe-Undrgrnd. '' 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor Sys�2rri 61. APPROVAL TO DECK �
1 7. PropertY Sewer Line'& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final
13. Roof Drains 64. Plumbing System - Final '
14. fiough PWmbing � � 65. Electrical-Final
15. Rough Electrical-Conduit 66. Solar System�Final
16. Rough Electric�Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace APPROVALS Permit#
21. Ducts, in Structure 70. Underground Hydro
22. Ducts, Ventilating , 71. Product Piping O Gas ❑ Oil
23. Gas Pipe-Rough & Test 72. Underground Flush
24. Roof Framing � 73. Undergrnd.StorageTank OGas ❑Oil
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (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 8rown Coat 79. FINAL INSPECTION ""�
i ','.
/
32. Electrical Power Meter-Final � 80. FOOD CERTIFICATE ISSUED ;�
33. Final Electric 8 Notes: . ���
34. Final Heating & Air Conditioning , � . ; i �
35. Final Gas_Pipe-Test
36. Hood or Canopy
37� Final Factory Fireplace
38�:�.Final Plumbing � ,
�
' ..� 39 �Water Service-Final � � � � � � `� ' '
�'
�' 40. Gas Service-Final ; � ' ` '
41. Solar pomestio-Final � �> �
�, 42. Backflow Preven[er , j, :� • '
� , .
43.;8ackflow Irrigation ' ���J�� � �- • ,
i �: �' '
;�44� Landscape Irrigation System � . . . .
. ,
��45.,Sound Attenuation I ,
q6. Handicap Regulations � ' � - • �
47.fF�NALSTRUCTURE&BUILDING � i ; �'� �
48:`Special Requirements Completed � , . . � � � ,
, ,
49. Electric Release to Edison � '' '
fl .
50. Gas Release to Southem California Gas Co „ �, � -
51. CERTIFICATE OF OCCUPANCY �i.. • �
:'`-
No. Date . .
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� ADD���ant to ii11 in all spatts exceot tnose witnin heavy borOer Ilnes antl sign all aporapHate tleclantions.
CI I V�06 COSTA MESA CONSTRUCTION.PERMI� PERMIT NO. ' TRACT NO. LOT NO. UNIT NU.
Project Address ���'T i� �' S '
Applicant's Mailing�.` �b35 �� � � �i�"'t1�'�S w�A
Owner's Name ✓�L'�N�Q C-"R `� ' Phone �
Address �3� �"3eiyr �'�� $�'
Arch/Eng. License No.
Address
Contractor's NamP -� � � '�—<—'� � �� � Phone b`'��b�-�
Address (mailingl � L�5 �� M ���"�s �"�� L'� ~• 4 Z'�"
City License No. �" � � � �
LICENSED CONTRACTOR DECLARATION
I nereby aftirm that 1 am licensetl untler provisions of Charter 9(commencing
with uction �000) ot �ivision 3 ot the Business antl Protessions Cotle, antl
my Iicense is in tul� torce an eifect. -�f
License Class L� Li nse No. 2-� ��2 1
Date�R..�T zs Si9nature
WORKERS' COMPENSATION DECL ON
1 hereDy atfirm that I have a certi/icate of .o sent to seli-insure or a certificate
i Workers' Compensation Insurance, or 'certlfletl copy thereot (Section
800, Lab. G ' n
PoliCy rvo. �� � � yq �• Com any '"tQhSt�✓ 11-1tY
8 Cmt letl copY is he� y fumishetl. �
C. fietl c py's iil ith the clty, II i v io '
Oate � Applicant
E%EMPTIO FROMWORKERS'COMPEN,A IONDECLARATION
(Thi55ettion neetl not be completetl if [he p¢ it i5 for On¢ huntlretl ($300) or
less).
I certity lhat in the per(Ormance of the wo�k for whith this p¢rm�t is issuetl, I
shall not employ any person in any manner so as to Decome subject lo the
Worke�i' Compensation LawS ot CdlifOrnia.
Date • Si9nature
.NOTICE: H, afle� making thii tl¢cla�ation, you Shoultl become subject to the
Workers' Comp¢nsation provlsions of lhe Ldbor Cotle, you musl forthwilh
<omply with such D/ovisions or this pe�mit shall be tleem¢tl revoke0.
CONSTRUCTION LENDING AGENCV :,i
1 he�eby afflrm that there is a constructlon lentling a9enCy for the peitormance
of lhe work � for whicb this permit is issued (Section 3097%Civ. CJ
Lender's Name
, Lender's.Atltlres5 � �
� OWNER BUILDEH OECLARATION
I hereby atfirm that I am exempt bom the Contractor's License "Law for the
tollowing reason (Section 7031.5 Busine55 antl Protessional Cotle: Any city or
county which requires a permit to construct, alter, improve, tlemolish or reoair
any structure, pdor to itz izsuance, alzo requires the aoP���ant for such permit
'to file a signed statement that he/She Is II[enzetl OurSudnt to tha p�oviSiOns of
tho Contractor's License Law (Chapter 9(comm¢ncing with Se<tion']000) ot
Division 3 of the Business antl Protessions Cotle) or Ihat ne/she is ezempt
•herc�rom antl [he basis for the allegetl ezemption. Any violation of Section
'031.5' by any applicant Tor a permit subjects the applicant to a<Ivil
ienalty of not more than five nuntlretl tlollars (5500).
❑ I, as owne� ot the property Ot my ¢mploye¢s wi[h wa9e5 �a5 thei� sole
compensa[ion, will tlo the work, and the st�uctu�e is not intentletl o� ott¢r¢tl
br 5ale (Section ]044, Buslness antl Professional Cotle: The.ConVactor's
LicenSe Law tloes not apply [O an owner ot a p�operty wM10 builtls or improves
ther¢on, antl who tloes su<h work himself/hetself or [hrough his or h¢r own
employCes, provitletl that such improvements are not Intentletl or offer¢tl to�
Tale. If, now¢ver, the builtlin9 or imprOvemeni Is soltl within one year of com-
OletlOn, the owne� will have tbe burtlen Of Proving M1e/s�e tlitl nat builtl or Im-
prOve 10r the purpo5e of sale).
❑ I, as owner ot the property, am ezclusivery contrac[ing with licensetl con-
t�a<[O/5[o con5truttthe project (Section ]044, Business antl Profession5 COtle:
The Contracror's License law tloes nol apply to an owner ot property who
builtls o� improves thereon, antl wno conVacts for such prOj¢cts witn a Con-
tractor(s1 ucense pursuant to me Contractor's License Law). I am aware that
proof Of (h¢ir Worke�'s Compensation Insurance shoultl be provitleC to me.
❑ I am exempt untler Section B. & P. C. for [his reason
Date
I hereby certify thal
IOiOlTdi1011 �5 COIlCCI
antl stale law Iatir
5¢Ofd[iv85 Of lh S i
Inspectlon pu p e
SlgnaWre
Drivers' License a
CMF 0865�46, rev. 30/84
Owner
have reatl this applicatlon dntl state that th¢ dbove
agrae to com0ly with dll <ity and county Ortlinances
o builtling cons[ruction, antl hereby aut rize repre-
enter upon the above-mentionetl roper y �fo�rJ
Datz 4r�
� � �
White - Bulltling; Canary - Applicanh Pink - Accountin9: Goltlenrotl - Assessor
$15
ES
Iwue Fee $ 3
iANICAL FEE
Hood or Typel ❑
CanoPY TYPe 11 ❑
Refrigeration System
❑0-100,000 ❑700,OOOBTU
Sys Repair/Alteration
Fire Dampers
Fiegisters • �
Iwue Fae � � � $ 3
Auromatic Washer
Construction Pole
Cooking�Unit
Dishwashe� '
Dryers �Gas ❑
Fan
F.A.U.
Fixtures
Device Boxes
Outlets
Switches
Garbage Dispoul
Generator ❑ K
Fee
6038 9/25/87 •
�
2one
Accessory Building:
Parking Req./Provided •
ELECTRICAL
Transformer ❑ 15�50 KW
❑ SO+KW
Meter ❑up to 100 amps
Merer ❑over 100 am
Sub Panel
Motors❑ HP�1'h-8
Inc. ar �9�15 HP �16-15+
mrowave
Pole Light
Range
Standing Sections
5-15 KW Trash Compactor
$15 luue Fee
7000 TL
FEES
$ 3
Z
O
N
I
N
G
R
E
�
M
T
S
DEVELOPMENT SERVICES REQUIREMENTS:. �
Zoning Approved By Date �
Building Approved By ~��� /• Date
Appliwtian Issued By Dat�
. SUMMARV OF FEES
BUILDING PERMIT $ SMIP 5
PLAN CHECK $ PERMIT -
. PLUMBING $ Z DD ISSUANCE $,
PLAN-CHECK 25% $ ENERG� P.C. $
ELECTRICAL $ ' GRADING $
PLANCHECK 50% $ MICROFI�M $
MECHANICAL $ TOTALFEE $ 7' ��
PLAN CHECK 25% $
CONSTRUCTION AND�PLANNING . POOL & SPA '
APPROVALS Permit-# Date Inspector AppROVALS Permit# �' Date Inspector
1..Temporary Electrical Service or Pole 52. Pool & Equipment Location �
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement �
3. Electrical Conduit Utility-Undrgrnd. 54. Forms
4. Electrical Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel Reinforcement 56. Rough Plumbing & Pressure Test �
6. Electrical UFER Grnd. 57. APPROVAL TO COVER-GUNITE
7. Footings �, ' 58. Electrical Conduit-Undrgrnd.
8. Foundation 59. Gas Pipe, O Undrgrnd., Test
9. Water Pipe-Undrgrnd. - 60. Backwash Lines, P-Trap, � Undrgrnd. �
10. Structurel Floor System 61. APPROVAL TO DECK
11. Property Sewer Line & House Connection 62. Backwash & Receptor-Final
12. Sewer Cap 63. Heater & Vent-Final �
13. Roof Drains 64. Plumbing System - Final
14. Rough Plumbing 65. Electrical-Final .
15. Rough Electriral-Conduit � 66. Solar System-Final
16. Rough Electric Wiring 67. Fencing & Access Approval
17. Rough Wiring Sign 68. APPROVED FOR PLASTERING
18: Rough Electriral-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.StorageTank OGas OOiI
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat . 75. Dry Chemical • '
27. FrameandFlashing . - � •i 76. DryStandpipe - '
28. Lathing & Siding 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing HEALTH DEPT. REQUIREMENT
37. Plaster Brown Coat ' 79. FINAL INSPECTION �
32. Electrical Power Meter-Final � � 80.� FOOD CERTIFICATE ISSUED
33. Final Electric Notes: " ' �� `
34. Final Heating & Air Conditioning
35..Final Gas Pipe-Test f�`�
•�r.
36. �Hood or Canopy � � �
37.'Final Factory Fireplace - � . ,.
� ' � ': `...
38' Final Plumbing ���_yv , � , _ ! -�
39. Water Service-Final � � �
40. GasService-Final - ' •-
41. Solar pomesticFinal � - �
+42. Backflow Preventer `� ' . ; . '
�43. Backflow Irrigation . "_ , . ;
t
�, ` � . .
•44: Landscape Irrigation System •
45� Sound Attenuation ` �
� ., .
46. Handicap Regulations • �� . � .
,i.
47. FINAL STRUCTURE & BUILDING . ' ' -I
. �. ._ .. . �,.
48. Special Requirements Completed '. ,
49� Electric Release to Edison � . - �
50. Gas Release to Southern California Gas Co � � '
51. CERTIFICATE OF OCCUPANCY
No. Date e