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Home My WebLink About746 17TH ST - Building PermitsDATE I SUBCO � � � P Gas Test /'-/S YYjCS p•9-5% " c ,%' ac� � '`'�'`'�'L � OWNER MARKEL, GEORGE � nA're � JOB ADDRESS 7�y6 W. 17th Street. UIIl�_B BUILDING PERMIT NO. S36O GENERAL CONTRACTOR VALUE § AP. No. LOT TRACT PIRE ZONE � DESCRIPT(ON OF WORR � GROUP TYPE ZONE . PLAN NO. ?ECTIONS � DATE I 3UBCONTRACTOR coat i Gas Test - /S""' � vr. � S Ila- � PERMIT313SUED IRJTT A r.'tFi(1 ._ , DATE BUILDING VALUE E AP. No. LOT TRAC1' PIRE ZONE DESCRIP'I'ION OP WORK ?ECTIONS I DATE I BUBCONTRACTOR I DATE I NUM coat Gas Tut U[dIT C . _ . . .� . .. Pr�7,.� . oWNER MARKRi,. GEORGB DATE ]OB ADDRESS 7t�6 Zd. 17th Street, UIIlt Ii BllILDING PERMIT NO. 5j60 GENERALCONTRACTOR VALUEf � AP. No. LOT TRAC'1' P[RE ZONE DESCRIPT[ON OF WORK GROIIP TYPE ZONE PLAN NO. , �ECTIONS DATE SUBCONTRACTOR I DATE NU Trcnches Forms Stcel UNIT D : ..r _• __ „_ . . OWNER MARKEI., GEORCE DATE � � )os �nDRess 7L�6 W. 17th Street, Unit E BIDLDING PERMIT NO. 5360 GENERAL CONTRACTOR VALIIE S AP. No. LOT TRACT FIRE ZONE DESCRIPTION OF WORR GRO[IP TYPE ZONE PLAN NO. �!ECTIONS I DATE I BUBGONTRACTOR I DATE NUMBER browa TTISTT Y C�Ln . . .,. . , . '� .. �.. . a .. -r � ,.,1..�r .. .... �. • s.r... . . . . .. . .... ... .r r� ' ... OWNER MARKEL � GL'X�TiGE ' DATE _ JOB ADDRESS %�ib W. 17th Street, URl.t BUQ.DING PERMIT NO. SjC�O GENERAL CONTRACTOR VAL[IE $ AP. I�o. LOT TRACT PIRE ZONE DESCRIPTION OF WORK GROUP TYPE ZONE PLAN NO. ?ECTIONS I DATE I SUBCONTRACTOR I DATE coat PERMITSISSUED - 'A ,. _ _ _ � UNIT F �-�-- DATE � ]OB ADDRESS 'j�y() W. 17th Street. L1]�t G BUILDING PERMIT NO. 5360 GENERt1L CONTRACTOR VALUE $ AP. No. LOT TRACT F�RE ZONE DESCRIPTION OF WORK GROUP TYPE ZONE PLAN NO. �ECTIONS I DATE I I ___ PERMITSISSUED SUBCONTRACTOR � coat Gas Test iiA1TT r. Kz�,n �OWNER g] JOB ADDRESS ��y 'ERAL C0� �\ti. No.�- � � INSPECTIONS j��J sm� � \ GAS W ATEp ROUGH PLUMBING PROP, $WF. �INE SPRINKLING SYST Normazi L. ROUGH HEATING AND AIR CONDITIONING TEMPORAp� SERVICE OfV POLE UNDE0.GROUN� � POWER � ROUGM N'IRING TRENCHES � FORMS � STEEL REINF FLOOR SVSTEM BONO 9EAM � STEEL REINFORCE [7 SHEATN�NG FRAME ANO FLASNING LO" 'VG - IN r] OUT r] P. :R, BROWN COAT STRUCTURAL, FINAL HEATING, VENT., REFFIG. AND A.C., FINAL PLUMBING, FINAL AND GAS TEST n ELECTflIC, FINAL TRACT DATE BUIL[ SUBCONTRACTOR UAIt 7 BUILDING PE ��CRIPTION of WORK Add Fir E ZONE VALUE bl O ROUP � TYPE III—. SUBCONTRACTOR ROUGM PLUMBING PROP. $WR. LINE Q HOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEHTING ANU AIR CON�ITIONING TEMPORARV SERVICE OR POLE UNDERGROUN� � PpWER � ROUGH WIRING TRENCHES � FONMS STEEL flEINF. FLOOp SYSTEM BONO BEAM n STEEL PEINFORCE n SNEATHING FRAME ANO FLASHIN LATHING - IN OUT ❑ PLASTER, BROWN COAT ST' URAL, FINAL NE�. .�. VENT., REFRIG. ANO A.C., FINAL PLUMBING FINAL AN� GAS T�T n ELECTRIC, FINAL BUILDING, FINAL OWNER DYNA-PLEx, INC. DATE 1-13-70 JOB ADDRE55 746 W. 17th Street BUILDING PERMIT N0. 31245 G -RAL CONTRACTOR pWner-Builder DESCRIPTION oF WORK paint Spray Booth � Ar ,ro.116-211-41 LOT (Por) 608TRACTN {D ,Mesy FIRE ZONE VALUE $ 1 600 00 � INSPECTIONS Siqnoture Date GROUP F� TYPE TV ZONE M� � SUBCONTRACTOR GAS WATER Plum6in ROUGH PLUM9ING PROP. $WR. LINE Q HOUSE CON. � SPRINKLING SYSTEM MISCELLANEOUS ROUGH HEATING ANO AIR CONDITIONING TEMPORAftY SERVICE OR POLE UNDERGROUND � POWER � ROUGH WIRING i�eatin and Ven}. TRENCMES � FORMS � STEEL REINF. � FLOOR SYSTEM BOND BEAM STEEL REINFOR�E SHEATHING FRAME AND FLASHING ' LO` 'YG — IN OUT P� !R, BROWN COAT STRUCTURAL, FINAL MEATING, VENT., REFRIG. AN� A.C., FINAL PLUMBING, FINnL ANO GAS TEST ELECTRIC, FINAL �I � � wnu niur. c�uni /i��.�—o �-///il� COBTA MESA BUILDING GEPARTMENT 111 East 20th Street Costa Mesa, Call}ornia , •�J �•� _ � � y�y� �`'`a•r,v,� C E�Z� I�� A T'E Building Permit NO�y`_�.. ux oT Building..._�...:....":._f. The building locatsd at...._� (ilf,t tI i�-_ �� . _: N° 208 C oase...---.../�...�..../`4�-- ......�__! . /�33'� �OSTA T1E8A �� O•F�OCCUPANCY �/�,5� :v�ca� rermlt No.._'__.......lPlum}�In9 PG�mIL'•,�� y' �i"r^.�„�� —r �''�/�vse.� � _ iDf - ��- T-� �ri:� Lot ..................'.......................... Bloek............................................ Traety�:��,".1�l�Y'� /�.Z (8ee rcverse side tor Metes and Bounds) has been inspected and found to comply�tb tLe provlsions of all Clty of Costa Mesa Or- dinances applicable thereW for a Group ............... ��..._Ottvpancy, 189UEDT0: .�/ Ji ` � � A. J. VOL2 � , •h� C �. �/ i I /� �•l f.. ....... C��%l�ng ;�al ..... . ........._.........._...... .........._................--- �:. �.. � t.f� i aC� _.. (OwneroiBulldinp) By ..............................._...""�"..............."""........ ❑ Originnal—Owner ❑ lst copy—Gas Co. ❑ 2nd copy—Edlson C��p 3rd mpy—File Form 206 GH IM I&68 ,.._,._.__._ ._.,...,_ --- - _ ELECTRICAL PERMIT Job Address: Suite No Vicinity: Parcel Nunmber: Applicant: Address: 746 W 77TH ST D D 42408118 ZEYNEP MISIR �i-�y�;.,�-,;r-�"�=*__ _ � if ,i'�,..-- ` � - _ __ f�,• �, �`- -� �_ (-_� - � ��, ( �'Yi�� / Owner. q ;ROI '/d� a',� Address� ' /oDA; ��.;'7 �NEW i. , � ISSUED BY: � � / . � � � � �• � � -s`S � Phone�94&679-0926 �, � �) � ��. �� / ��. � z.Z�P�} L f 1� ' � � ' " /% f / �\� _ `. �� ^'� � / �� /.� /. '�_-_"__�==�_��-,-'i �%/'�� \�� /�`'-'�G-�'��vA�. . '�'� /� A �� j' � \ I /`,1' ..--.��"."�_' _� V \?a. � � \ � �.i SGHILD.:PETER?B?.TR'� �`��\��> , / Phone: tr^1'� i^% 1420 BRISTOL'ST NORTH#100 Zip: 92660-2914 6��^,`� � � j' %% %':/ /:`i �7'�/ �j ' ��• , /J'�� I I�iL � l'+'Contractor: OWNER-BUILDER ��• , • ' � ;' P � � ; / i -' ,:;% p p '�,. � � � i Address: � �,�` 'i � '� „t+�"'� r ' ; ` � � r/ � ' � �fil�q � � �, �� .�� P e. . - ,' �11 - -% - `�i?J � , !' _ -�,l , , Zi 1 � '1 '�1 �I �', i �,:. ..- , �- P ,; ' �� n o'� /�i A „� License: 000000 i '�i � p��I�, � .� - --- -- -- ,ii � :-' :,. . ,. ---" -'___�. .----. ; ; � INSTALL A � New Re's�(31u\`s)� � � Pool /'Spa;� Lighting Fixts -1�� Recept Outlets 1 switches �''y�� 5�� .� i Nr, �, � Quantiry,;-_=- $23.50. (�' �`--._: $0.00° � $0.00 � $0.00 1 0 so.00 ' o � $0.00 �� 0 ��so.00 � o ,, \$0.00 � 0 Non Res Appl �\ ResAppl '�� - Service to 200a \ Service to 1000a � ' �� Service over 1000a `�-�'�`.'� Motors to 1hp �� Motors to 10hp � Motors to SOhp � Motors to 100hp Motors over t00hp Communication drops Sub panel to 200a Pole Light Pkg Sign Circuils Temp Pwr Pole $0.00 ao.00 $0.00 $0.00 $0.00 �r--�� i ' �� ( / „� � � �' �= �� '\ _ �� T i '%; ';/�,� , �c � — � ::'. :. �� Busway /100 ft „° � SWnding.Section Misc Electrical Equipment Transformers-up�to 1 kva/kw � "�`�'�- u to 10 kva/kw �': ................ p �� . :... :! .`..�:� .yup to 50 kva/kw .............`nuD•to 400 kva/kw C . 0 \��S.^a�MO�`r �� .' 0 � \\ea�.o Q�, ��t0o J � \0�°�� o, ��O %-• 0�\`\��1'�y='-a /�jQ� `ti_ �. ��. OJ � i/0 I ('J� � r— \ 6�(,r- /�,[ o � �� 4,_ �'J�� iA` O`l l�„'��.J� � 0 0 Status: ISSUED Applied: OS/13/2005 Issued: 05/13/2005 Quantity %' $o.00 0 ' $0.00 0 �� $0.00 �0� u0.00 0� $o.00 - y�"o'� $0.00. �y,0� Misc VConductor `� �� $0.00 Cqas ( 9en-or nde)� !$0.00; Circus_(mech"ride or lights) <\�"$0:00 Christmas Tree Stand� , �, �$0:00 .Fireworks�Stand�1 C \� �-% 30.00, Other ElecMcal:FeeU � $0:00. �� ; � �� 1�� 1nvesti9ationFee_..--j/�'%i $0.00 PIan,Check:Fee%�� $0.00 Reinsp,ection�Fee' $0.00 TOTAL CALCULATED FEES E54.00 ��'� l;_';�, �L, � � � ` —i �,\� � 1 NOTICE: The work aulhorized by this permit shall comply with all applicab�e handicap access requirements under Caiilomia statutea and related regulations. (Ord. No. 92-28, § 1, 12-21-92) EXPIRATION: This permit shall automatically expire and become void if work Is nol commenced within 180 days, or if work is suspanded or abandoned for a period of 180 days. INSPECTIONS: In order for the work authorized undei this permit to be considered legal, such work must comply with all epplicable codes, and all required Inapectlone and final epprovel must be obtained. Failure to obtain inspections and final approval will result in the expiration ol this pertnit. FOR INSPECTIONS CALL: (714) 7545828 zae�ae (a�oo� WORKERS' COMPENSA710N DECLARATION: ' � � ' w „ ' I here'Iy eqirm upder penalry oi perjury one ol the following declarations: � . � , � - . ❑ I heve end will maintain a cenificate ot consent to self-Insure for workers' compensatlon, as provided for by sectlon 3700 of iha Labor Coae, lor'ihe pertormance of the. work tor whicfi t�is permlt Is issued. ve end will maintain workers' compensation insurance, es requiretl by section 3700 ol Ne LaDor Cotle, for Ne pertortnance of the work tar wh1U thts permit is IssueC. y workers' compensation Insurenca carrier end policy number are: � � Gemer. PWicyNumber. (This section need not be comp/eletl if the permit is velued et ane huntlretl dollers ($f 00) or less.) ❑ I cenity Ihat in the perfortnence of ttia worli tor which this pertnit is iuued; 1 shall riot employ eny person�in eny manner so as to become suD�ect to Ihe workers' compensation laws of Celifomia, end egree t�et it I should become sub�ect b t�e workers' compensation provisions of Section 3700 oi Ihe LaDor Code, I shall forthwith comply with ihese provisions. Applicant Signature: Date: WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERA�E IS UNLAWFUL AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVI� FlNES UP TOONE MUNDRED THOUSAND DOLLARE (5100,000�, IN ADDITION TO THE C0.ST OF CAMPENSATION, DAMnOES AS PROVIDED FOR IN $ECTION 31O60F THE IABOR CODE, IMEREST, AND ATTORNEY'S FEES. LICENSED CONTRACTORS DECLARATION: I hereby attirm that I am Ilcensetl untler proNsions of Chapter 9(commencing with Section 7000) of Divisian 3 0l the Business end Professians Catle, anC my license is in tull lorce end eflect. Lic. a Cless p Comrectors Signature: Date: CONSTRUCTION LENDING AGENCV: ' � ❑ I hereby aflirm ihat ihere is e construction lentling agency br the pedormence ot Ihe work for which this permi� is Issued. (Sec. 3097, Civil Cotle). Lenders Name: Lender's Address: Signeture: Date: OWNER•BUILDER DECLARATIONS: I hereby aflirm that under penalry of perjury that I em EXEMPT FROM THE CONTRACTORS LICENSE LAW for the following reason (Sec. 7031.5, Business entl Protessions Cotle: My ciry or counry w�ich requires e permit to construct, alter, improve, demolish, or repair any strudura, prior to its issuance, elso requires the epplicant for such permit to Poe a signetl statement t�at he or she Is Iicensetl pursuent ro the prodsions of Ihe Contractors LJcense Law (Chepter 9(cammendng with Sectlon 7000) of Division 3 of the Business end Prolessions Cotle) or Ihet he or sha Is exempt therefrom entl Ihe �asis br I�e alleged axemption. Any violation of Section 7031.5 by eny epplicant for e permil sublec�s the epplicant to e civil penalry of nol more than five hundred dollars ($500).): ❑ I, es owner of Ihe properry, or my employees with wages as thelr sole compenselion, WILL DO THE WORK, entl t�e structure Is not IntentleC or oflered lor sale (Sec. 7044, Business and Professions Code: The Contractors License Lew does not epply to an ownar of property who builds or improves thereon, entl who does such work himself or hereelf or ihrough his or her own employees, Pmvided lhet such improvements are not Intended or oMeretl for sale. If, however, ihe building or improvement Is �old within one yeer ot completion, the owner-builder will heve the burden of proving that �e or she tlitl not DuiIC or Improve for purpose of sele.). � I, as owner of the property, am El(CLUSIVELV CONTRACTING WITH LICENSED CONTBACTORS to construct the project (Sec. 7044, Businass and Professions Cotle: The comractors License Lew does no� eppty to an owner oi property who builds or improves thereon, end who contracts for such pm�ed wit� e conirador(s) license pursuent to the Coniractors Licen,qe'Laws.). �� Business end Professions Code for this reason: 9W1`er ID varilied by�ef�ffRnse. n'�� ❑ No Verilicatian of Owne ship by (type oi tlocument, i.e. - properry �a�c GIII or Oeetl): DIVISION OF INDUS7RIAL SAFETV PERMIT CERTIFICATION: ❑ I hereby certity that no ezcavetion five (5) or more taet in depth into which e person is required to tlescend wlll be mede in connection with work euthonzed by ihis permii, and ihat no building s�rucWre, sCaHolding, falsework, or demolitlon or dismantling Ihereot, will be more ihen thirry-six (36) feet high. (Chep. 32, Gry 2, Art 2, Sec. 341, Title e, Califomia Atlministrative Code). ❑ As owner-Duiltler, I will not emplay enyane ta do work which would require e Dermit irom the Division of Intlustrial Sefery, es noted ebove, unless such pereon �as e pertnit ta do such work irom t�e tlivision. Signature: Date: Division of Industnal Safery Permit Numbec ICERTIFlCATE OF COMPIIANCE AND AUTHORIZA110N OF EMAY: I certily under penalry of perjury iha� I heve read Ihis epplication end state ihat tha information given is I correct. I egree to comply with ell stele lews and city ortlinances relating to buil0ing consimction, antl euthodze representatives ol the Clty ot Costa Mesa lo enter upon �he ebove-descnbed properry for inspection purpases. I ayree not to occupy or ellow occupancy of any building authonzed by this permit until tinal inspection. CODE t. INSPECTIONTYPE """ " ' • ' ' - 'PAIE 1616 Fizetl System Final Fire Prevention 1266 Pool Spa Finel 200 Final Re-Rooi � ' 201 Final Block/Retaining Well 202 Final Factory Fire Placa �� 203 Final Siqn 204 Final Demolition '�IMRI�Lg • - - � QQpf�( INSPECTIONTYVE - � 208 FinafMechanical 20B Finel Plumbing ' 210 � Finel Electricel. �. 272 Finel Fire Prevention 220 Finel Planning Approval 222 �Final Site � � 250 Final Building/Occupency March 20. 2007 CITY OF COSTA MESA P.O. BOX 1200 • 77 FAIR DRIVE • CALIFORNIA 92628-1200 DEVELOPMENT SERVICES DEPARTMEN7 BUILDING DIVISION COURTESY NOTICE OF PERMIT EXPIRATION West Seventeenth Associates LLC 3189 B Airnray Av Costa Mesa CA 92626 PERMIT NUMBERS: FOR: PROJECT ADDRESS: E05-00459 New Electrical Service 746 W 17th St., D, Costa Mesa Our records indicate the above listed permits were obtained for property improvements or alterations at the above address. Per the 1997 Uniform Building Code, Section 106.4.4 Expiration, permits are valid for 180 days from the date of such permit, or the date of your last inspection for the project. Our records do not show an inspection for these permits within the last 180 days nor have they had an approved final inspection. If you have a signed inspection card showing that an inspection was made within 180 days, or that the final inspection was approved, please contact this office so we may correct our records. If you do not have an approved final inspection, your permits wiil expire on April 3, 2007. Additional fees will be required to finalize expired permits. Requestina an inspection—If you need to request an inspection please call our Inspection Request Line at 714-754-5626. Requestina an extension—If you wish to request an extension, requests must be made in writing addressed to Ed Petros, Chief of Inspection, at the above address, detailing circumstances and listing an estimated date of completion. If you have any questions, please contact the Building Division at 714-754-5273, between 8:00 a.m. and 4:30 p.m., and a staff member will be happy to assist you. The accuracy of records affecting your property is our goal and we appreciate your working with us to resolve this matter. Sincerely, �� M Jane Weidenkeller Office Specialist II Building Division (774) 754-5273 • Code Entorcement (714) 75G-5623 • Planning Div'�sian (774) 754-5245 FAX(714)754�4856 • TDD(714)754-5240 • www.ci.costa-mesa.ca.us (714) 754-5273 • Fax (714) 754-4856 • w�vw.ci.costa-mesa.ca.us 77 FAIR DRIVE, COSTA MESA, CA 92626 • BUILDING PERMIT • JobAddress: 746 W 17TH ST Suite: Vicinity: Parcel Number: 42408118 ` Zoning: Status: ISSUED Applied: 12/07/2001 Issued: 12/07I2001 Applicane ROSS & BARROWS INC. �_ - ISSUED BY: �i�� Address: 260 E. ALTON AVE " � � � %-�� " "" -' . � - ,� : - - - - - ' /, � �� l �-� �• '. Pfione: (714) 557-7440 � � .:: ,'< � SANTA ANA CA �� ; ��, � Zip: 92707 ; , `' ''� / ;^,% � , • � �� i , �\� Owner. ROTHSCHICD,�PETER B TR ' � � � j'� �� " �� _ - , �\,,\ Address ,/oNEWPORTCOASTMGNT_CO - _- _ ; _ - _. � ,, �A� � � % .151.KALMUS DR SUITE D= ., - _ __Phone: �� - �, A `� � �� ,'iINC� : �� - Zp_ 92626 --`..� ,��_ � �� ;// � .� j/'� -:,,A ��A /% �-' �,� � � ' ��:��A Contiactor. �ROSS 8 BARROWS INC. A� � �,. �� % � _�. �. ; � /Address:; 266E.-ALTONAVE \, ��'��,�, � ' � , � , � , � -. � / Phone:�`(714j 557-7440 � � ; �`- . � ` , - ' -- SANTA ANA, CA ' ' � � � � � � � Zip:�.;"�92707�� License: 327802 � .. . - _ , ,�:.,. � . � �� _ � • l, - � , , � � Arch.: , '-'' _ ., . �� , .. ; � � _ ,�, . % •- Address: � " • � � � ,�" . , _ Address:`—�� - � , . . , l � _ _' - . � . ' � . �' � � Phone: - ' ' ' , , ., . — . A : j � `� Phone: ��' ', � � . /� �� . �, �Zip: , : / \ ` �� License: \ "� . . . - -� `License: � A %� � "' �,ti ,, _-.. 'y � SCOPE OF P.ERMIi _, r �,n; '� � . � TEAR OFF E%IST BUR AND REPLACE WITH SAME "'1 '� �- `� �, . . _ . _ .. ._..___ f,'.�._._ �. Plan Check: $0.00 Permit: $349.25 � SMIP Res ', $0.00 SMIP Com: $4.62 Other. �� $0.00 `, Inspection: . $0.00 � �. Total: $353:87 ��, �,, A� � FEE SUMMARY � � �� ' r , - _ �'r - i; -. .�'; �� .. - —- - - ii , _ . _ � � , i ��.'<� , ' % \\_ . � SETBACKS- � "'- ' � � � / -_� � A� MAIN STRUCTURE�Front„ O�D� � � Reai ��0-0 �\ i . ACCESSORY �Front�- 0- 0,� �� Rear � 0- 0 � �� ; PARKING Existin :, �0_. � _, �"Requlred: ' �0 NOTES: PLANNING & ZONING LeR 0- 0 Left 0- 0 � - � Proposed: i , �, - i Calc Valuation Claim Valuation: , , \i � ' , � �� Szz,000.00� szz;000.00 i - - �� , - - � �i � ' � ' / <. i,�;., �'� i, 'Right -, ` 0- 0, \ �: �, %" Ri9ht � � 0- 0 �" �� . � .,, �.-�, II NOTICE: The work autho�zed by ihis permit shall comply with all applirable handicap access requirements under Calitomia�statutes and related regulations. (Ord. No. 92-20, § 1, 12-21•92) EXPIRA710N: This permit shall eutomatically expire and become void if work is not commenced within 180 days, or if work is suspended or abandoned for a period of 180 days. ' ' ' INSPECTIONS: In order for the work authorized under ihis permit to be considered legal, such work must comply with all applicable codes, and all required Inspections and final approval must be obtained. Failure to obtain inspections and final approval will result in the expiration of this pertnit. FOR INSPECTIONS CALL' (714) 754-5626 zaawa �auo� WORKERS' COMPENSATION DECLAHA710N: . I hereby aKrm under penelry of perjury one of tne lollowing declarations: �� ❑ I have and will maintein e cenificate of consent to setl-Insure far workers' compensation, es proWded for by section 3700 oi the Lebor Code, fortY�,pertortnance ot the work tor whiCh ��i5 pertnil IS i55uetl. I heve and will maintain workers' compensation insurance, as required by section 3700 0l Ihe Lebor Code, for Ne peAortnance of the work for which Ihis pertnit is issued. y workers' compe�lsatlon Insurance car�ar entl policy number are: Cerrier: Policy Number: (This section need not be campleted il fhe pemlit Is velued af one hundred dollars ($100) or less.) ❑ I certify Ihat i rtn ce of the work for which Ihis pertnit is Issued, I shall not employ eny person in any manner so as to become subject to the workere' compep ion laws of o nia, end e that It I should become subjact to the wo ' rovisions of Sactian 3700 ot Iha LeDor Code, I shall forthwit� �Iy� t�fi [rt05B r on . �J I�APPlicant S' . �b _��-- Dat . � z ` � / —� / E TO SECURE WORKERS' WMPENSATION COVERAGE IS UNLNWFUL AND SMALL SUBIE E R TO CRIMINAL PENALTIES AND CM� FlNES UP TO ONE HIINDRED THOUSANODOLLARE($t00,000�,INADDfTIONTOTHkWSTOFCOMPENSATION,DAMNGES0.SPROVIDEDF-0RI CTIIXJ3]OfiOFiHELABOHCOOE,IMEREST,ANDATTORNEY'SFEES. i6y aflir at I am lic ed under provisions of Chapter 9(commencing with Section 7000) of end ect. Lic. a / Cotle, end my license Is in full C9NSiHQCT10N LENDING AGENCY: ❑ I hereby affirtn that there is e consiruction lending a9ency for ihe performance of the work for which this permit is issued. (Sec. 3097, Civil Cotle). Lentler'S Neme: Signature: OWNER-BUILDER DECLARATIONS: Lender's Atldress: Date: I hereby ettirtn Ihat under penelry of perjury ihat � am EXEMPT FROM TIiE CONTRACTORS LICENSE LAW tor the following reason (Sec. 7031.5, Business end Professlons Code: Any ciry or counry which requires a pertnit b consiruct, elter, improve, tlemUish, or repair eny siructure, prior to Its issuance, also requires Ihe epplicant for such permit ta tile a signetl statement that he or she is licensetl pursuent to the provisions of the Conirectors LJcense Law (Chapter 9(commencing with Section 7000) of Division 3 of Ihe Business end Professians Cotle) or that he or she is e:empt therelrom and the 6asis for Ihe elleged exemption. Any vialation of Section 7031.5 by eny epplicant for e permlt sub�ecis ihe epplicant to e civil panalry of not more Ihan five huntlretl dollars ($500).): ❑ I. as owner ot t�e property, or my employees with wages es iheir sole compensation, WILL DO THE WORK, entl Ihe siructure is not intentletl or oHeretl tor sale (Sec. 7044, Business end Professions Code: The Coniractors Licanse Law tloes not apply to an owner of proparty who builds or improves Ihereon, end who does such work himself or herself or through his or her owr� employees, provitled ihat such improvemenis ere not intended or oNered for sale. H, however, iha builtling or improvement is sWd within one year of completion, the ow�r-builtlar will have the burden ot provi�g thet he w she tlitl not build or improve tor puryose ot sale.). ❑ 1, as owner of ihe D�aPany, em EXCLUSIVELV CONTRACTNG WI7H LICENSED CONTRACTORS to construct t�e project (Sec. 7044, Business entl Profeuions Code: The cromrectors License Lew does not epply to an owner ol property who builds or Impmves thereon, and who contrects tor such project wtlh e contreaor(s) license pursuant to the Coniractors License Lews.). ❑ I am ezempt untler sec. Business end Protessions Code tor this reason: Slgnature: Date: Owner ID veritied by dnvefs license. ❑ Yes ❑ No Dnvefs License No. Expiras: Vedtication ot Ownership by (rype of tlaument, I.e. - pmperry t� bill or tleed): DIVISION OF INDUSTRIAL SAFETY PERMIT GERTIFICA710N: ❑ I hereby certify t�at no excavetion five (5) 0� more teet in depth Into which a person Is required to descend, will be mede in connection wit� work euthorized by this permit, antl that no building siructure, scalloltling, falsework, or demolition or dismantling theraol, will be more ihan ihirry-six (36) feet high. (Chep. 32, Grp 2, Art 2, Sec. 341, Ttle B, Califomia Administrative Cotle). ❑ As owner-builder, I will nat employ enyona �o tlo work which would require a permit Irom Ihe Division ot Industnel Safery, as noted ebove, unless such person hes a pertnit to do such work from ihe division. Signature: Date: Division of Indusirial Safery Permit Number: CERTIFlCATE OF COMPLIANCE AND AUTTIORW710N OF ENTRY: I certity under penalry of per�ury that I have rea0 tNs applicetion antl state that the Intormetion give� is conect I agree to comply wlth all s;ate laws end ciry ordinances releting to bulltling consWctlon, entl authorize representetives ot Ihe Ciry ol Costa Mesa to enter upon Ihe above-descnbed properry tor inspection purposes. I egree not to occupy or allow occupency al eny 6uilding euthorized by this pertnit until finel inspection. COpE �. IXSPECIIONTYVE �� 1616 Fixed System Final Fire Preventlon 1266 200 zoi 202 203 204 Pool Spa Finel Finel Fie-Rooi Finel BIocWReteining Wall Final Factory Fire Place Final Sign Final Demolition � II�LS -aL �Z� / Z -� ��''l Date S CODEI INSPECTIONTYPE �¢, � 206 Final Mechanical 20B Finel Plumbing _ 210 Final Electncal 212 Final Fire Preventlon 220 Final Planning Approval 222 Final Site 250 Final Building/Occupanry PBOJECT FDOBE55: '� Q( jnJ ��y�� S'j' OWNEfl'SNPME: FIETER ROTHSCHILD aoosEss: 866 W 18TH C,M 92626 NFCHIENGINEEP: FDONESS: PENMITTEE: NOOR ELECTRICAL SERVZCE E aooness: 711 W 17TH ST COSTA MESA CA 9 UCENSEO CONTPpCTOH OECLAHATION: I hereoy aifirm I�ai I am licensetl untlei pmvis 7000) of �Ivlsian 3 of the Business and Pmtessions Code, an0 my license is in full to m cirruc.: 030877 srnreuc.:45277A cuss: _ 1 ate: ��Zs�l Signature: NEHS' COMPENSATION OECLAPATION: Iherebyanirm � certilicat �consen Comoensation Irlsu[ante_o[a t¢tlihe4cpDv �hereol (Secti ab. C). _ UNIT: �7 Y nec.xo.: uxrt: (714)631-8777 � J009 i C (commencing wi�h Section r�; 03/95 o self-yKure or a cenificate of woMers' POLICY NO.: v o v< o<�— v�+ �7{p,rppTE: v Y i v i i v: comraNr: STATE FUNP j j � Cetli�ied copY is here�y lumished. � Cert4ieGcoDY �5 filed wi�h e city Bui Oi ' n. � �� f � � Applicant: MPTION FNOM WONREFS' COMPENSATION DECLpFpTION: C�i e0 no� b t0 ple�ed i� the permi� i5 �of one huntlretl ($100) or less�. I cetlify Ihal in �he pedormance oi Ihe work for which t�is p i� is' e4 I s�all not employ any person in any manner so as �o become sublect Io Ihe Workers' Compensation Laws ol Califomi . Date: Signam : NOTICE: II, aller making Ihis �eclaralian. you should become suGlen Io Ihe Warkers' Compensation pmvision5 0� �he Labor Caae. you must fonhwith comply with such pmvisions or ihis permit shall be Aeemetl revoketl. CONSTflUCTION LEN�ING PGENCY: I hereby a�lirm Iha� Ihere is a cons�mction lending agency /or Ihe petlorman[e of Ihe work �or whictl �his permit is i=sue0 (Section 3097. Cir. C�. LENOEfl: aooxess: OWNEH BUILOEH UECLAHRTION: I hereby a��irm Ihat I am exempt Uom ��e Contrac�ors S�ale License Law tor �he following reason �Seciion 7031.5 Business antl Pm�essional Code'. Any ciry o� counry which reQuires a permit m constmci, al�er, imD�o�e. tlemolish, or repair any stmciure. prior �o i1s issuance. also requires ihe applican� lor such permi� �o iile a signed statemen� Ihat �e/she is licensed pursuan� lo Ihe pmvisions o� �he Conlraclors' Slaie License Law (Chap�er 9(commencing with Section 7000) of Division 3 0l lhe Business antl Pmlessions Cotle) or �hai he/she is exempt I�ereimm an0 the basis lor Ihe allege0 exemption. Fny violation o� Section 7031.5 by any applican�for a permii SuDjec�S Ihe applicant to a civil penalry o� noi more �han live �undre0 tlollars (5500�. I, as owner oi the pwpeny or my employees with wages as their sole com0ensation, will do tAe work, antl Ihe ❑ stmcture is not inten0etl or otferetl lor sale (Section 7044, Business and Pmtessional Coae: 7he Contractors' Stare �icense Law � does n0� apply �o an ownef oi a proDerty wha huild5 Of impwve5 lhereon, antl wha doe5 SUCh wofk himsell/�ers¢It Or Ihmugh � his Or her own employee5. provi0e0 ��al Such impmvemen�s are n0� in�enA¢tl or oflered �or Sale. II, howev¢r �he bUiltling or impmvemen� is sold wiihin one year of completion, �he owner will �ave Ihe �urtlen of pmving Aelshe Oid nol build or impmve lor �ne purpose of sale�. I. as owner of �he pmperty, am excNsively coniracling wi�h licensed coniraciors to constmct I�e pmlecl (Seciion 7044, Business ❑ anA Pmiessions Cotle: The Conirac�ors' Slate License Law tloes noi appty Io an owner o� pmpeny who builAs or imDmves �hereon antl who conirac�s tar such projec�s wi�h a contracloqs)license pursuanl Io Ihe Contractors' $fate License Law�. I am aware Ihal pmo� o� their WOBer'S Compen5aiion insurance shoultl be pwvitled to me. � I am exemp� under Sectmn: B. 8 P. C. � lor ihi5 reasort Oale: Owner. I tlo �ereby cenily Ihat I am aware ol an0 under51an01he requirements o� Cali�omia Heal�� an0 Safery Cotle Sec�ions 25505, 25533, antl 2553a antl �ha� I or any fuiure OuilOing occupant will/will noi (circle one) neetl �o comDly wi�h said s�a�e codes and �he requiremen�s �or a permil for conslmction or mo0ilication Irom t�e Nir Oualily Managemen� �isirict. Resitlemial consimc ion apDlica�ions are exempt fmm �hese pmmsions. Oate: Npplicanl: I hereby certify�hal I haveread ��is apPlica�ion antl s�a�e tha��he above inbrma�ion i� L I comply with all ciry and coun�y ortlinancesandstatetawsrelatingtobuiltlmgconsimctionandherebyauthorizereD�ese esai oemeruDontheabove-mentionetl pwpeny lor inspection purposes. n �¢: Signaiure: _ onver's �icense or Saciai Securi�y n: � 16a1-a6 wni�e—Builamg�, Green—Cotle Pink—Revenue', Goldenrod—Assessor CITY OF COSTA MESA — BUILDING-PERMIT PERMIT NO:� E .067729 PLAN CHECK NO: D] CONSTRUCTION TYPE: 5—N PERDIIT TYPE: ELE JOB DESCRIPTION ; ELECTRICAL UPGRADE CLAIM VALUE: CALC—VALUE: PERM NO; E 06772� GOC�T: N SUFP: N PURPOSE: OTH SQ FT: GROUP OCC: R-3 / COMMENTS:. ONLY ELECTAICAL WORK #+r�rar-�#��*****+r+r�x--x*�x�ar�+r�r�t�r*�r�x*#�r-�*-z�-�c��-**� *****�-x-�jt*-�*��r+�+t� ��-**+r��t�t��*��-�t*�*i!�-�t**;r+t�r Z O N I N G R E Q O I R E M E N T 5 S E T H A C K S ------------ MAIN EUILDING ---------- --------- ACCESSOP,Y HUILDING --------- FRNT: FT IN REAR; FT IN FRNT: FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN FARKING REQ: PROC�: FARCEL: 42408118 ZNE: REF NO: PLANNING NOTES> > �f it �!f'1F iE if 1E iE .v.'.t if �If if 1f �E 1f �lE �f if #E iE it iE if if !f if f.* �1(� if if it iF�iF iF1E�ik !E iE iF 1Flf iElE ih'R� K� if if jf?E if if iF iF iF 1E # iE iF 4 iE �)f iF iE i! if �F �F 9E 3� �F ic iE iE if # 7f iP D E V E L O P M E N T S-'"E � R V I C E S R E Q 0 I R E M E N T S r��. ZONING APPROVED BY - DATE: BUILDING APPROVED BY ; " DATE: APPLSCATION IS5UED BY; �. /°/,� ,� Z S iEit*if*i�i�***iE�Eit�i�i�*iti[-�t** � � � 'V�VTh�?��3FiF3F's€3FiF3F3F�i�ic*i�*p*�%�iE*�",F��*�iti� iEifififif�ifjFitifiEiE9EiflEifiEiEifiM1aE��kiEiFiE9EifiEiflEiEiEjf,if�lEiEiE�lfiEifif#ifiEifiF�l:iE�1E�lEitiEiElf�lf�lfiFifiElE�lfiEifiEif�14�1fif�1E' jE�lciFi6ifj'iEi4if LEGALIZATION;N F E�E S U M M A A Y STRUCTURAL SEGMENT:N BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES GP.ADING PERMIT 29.50 50� SMIP/NON—RES PLAN ISSUE FEE 15.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 29,50 15.00 0.00 49.50 44.50 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 44,50 OVER/SHORT: .UO BLDG PMT PLUMHING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAP7—CHECK 44.50 iF iF i.` iE iE iE # iE iF iE iE iF i! jE if if af iElf iE ic # iE if iE iE �t at iE if if iE if 1E iE jE iE if iE ih iE iflE iE jF iE 9f jF iE iE jE if if 1f !F!E iF if if iE 3F iE if if if iElt ik iE iE iE jF if if if i4 if �F iE _ I N D I V I D U A L F E E B R E A K P O W N TYPE QTY D E S C R 2 P T 2 O N UNIT COST ELE 1 SEP.VICE5 BELOW 600 V 6 BELOW 201 AMP 18,50 ELE 1 MISC CONDUIT NOT LISTED REQ PERMIT 11.00 � ' END OF FEES TOTAL COST 18.50 11.00 tli fl�ib133b-00162336 T C�T 44.SD DATE: Q6/:4/94 TI11E: OS:07 CONSTRUCTION ANDPLANNING qPPROVALS Permit # � 1. Temporary Electriral Service or Pole 2. Soif Pipe-Undrgrnd. 3. Electrical Conduit Utility-Undrgrnd. 4. Eiectrical Conduit-Undrgrnd. 5. S[eel Reinforcement 6. Electr�cal UFER Grnd. . 7. Footings 8. Foundation 9. Water Pipe-Undrgrnd. 10. Structural Floor Sys[em 11, property Sewer Line & House Connec.ion 12, $ewer Cap 73. Roof Drains 14. Rough Plumbing 15. Rough Electrical�Conduit 16. Rough Electric Wiring .� }'7. flouqh Wiring Sign 78. Rough Electrical�T Bar Ceiling 19, Rough Heating & Air Conditioning 20. Rou9h Faceory Fireplace 21, pucts, in Structure 22. Ducts, Ventitating 23. Gas Pipe�Rough & Test 24. Roof Framing 2�. Roof Sheathing 26. 7-Bar Ceiling (Structura�) & Monocoat 27. Frame and Elashing 28. Lathing & S�ding 29. Insulation 3Q. Orywall Nailing 37. P�aster BroH�n Coat 32. Electrical Power MeterFinal 33. Final Electric 3q, Final Heating & Air Conditioning 35. F�na� Gas Pipe-Tes[ 36. Hood or Canopy 37. Final Factorv Fireplace 38. Final Plumbing - 39. Water Service-Final 40. Gas Service-Final 41. So�ar �omesticFinal 42, 8ackflow Preventer 43. 6ackflow Irrigation 44. Landscape Irripation System 45. Sound Attenvation 46. Handicap Regulations 47. FINAL STRUCTURE & BUILDING 48. FINAL P�ANNING 49. Electric Release to Edison 50. Gas Release to Souchern California Gas Q 51. CERTIFICATE OF OCCUPANCY Date Date � Inspector �' POOI PA AVPROVALS Permit # 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrica� Bonding , 56. Rough Plumbing & Pressure Test 57. APPROVALTOCOVER�GUNITE '. 58. Electrical ConduibUndrgrnd. 59. Gas Pipe, O Undrgrntl., Test 60. Backwash Lines, P�Trap, � Undrgrnd. �i 67. APPROVAL TO DECK ''� 62. Backwash & Recepior�Final �I 63. Heater & Vent-Final , 64, Plumbing System � Finai ' 65. ElectricabFinal 66. So�ar SVstem-Final � 67. Fencing & Access Apqrovai 68. APPROVED FOR PLASTER�NG 69, POOL/SPASYSTEMSFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 70. Underground Hydro 71. Product Piping C> Gas ❑ Oil 72. Underground Fiush 73. Undergrnd. Storage Tank O Gas ❑ Oil 74. Overhead Hydro 75. Dry Chemicai 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH OEPT. REQUIREMENT 79. FINAL INSPECTION � B0. FOOD CERTIFICATE ISSUED Notes: Date � Inspector �� APPLICATION ;FOR A BUILDING P�^MIT ,` �� -� � 1 � BUIIDING PERMIT NO. E�ectr�ca� ao Trac[ Block Lot Pormlt No. �, BuilEln9 � I { t'h � �O 7 3 3 pe�mb1No. � Atltlress `n 1 I Y " Cross .� E P �� 3 g 6 Mechanical a Area Street . r-„ 1 Permit No. LU.1 'm Owner � Type of R'oject: ❑ New ❑ Alter ❑ Atltlition # ,aaa,ass '%'{� ❑ aeoa�� ❑ conVe.< ❑ cemo ❑ Occupancy Vmt. CItY ZIP PhOne � A.P. $uP. DiSt./ Insp. A�ea Arc�itecy Zona $p�. Pmt. NO. D�19ner Licenu No. Setba<ks P/L Front G/l SL Street Witlth Atltlress VarAs Le t 9 ear CItY ZIP P�ona ave o�. e g . . En9lneer Ucense No. � rk ng SpaceT equ re �ov B overe a Atlaress m Clty ZiP Pnone Struct No, of No. of Height Stories Famiry � LICENSED CONTRACTOR'S DECLARATION Park Fees Yes Fee � ReqWrea' ryo GT. Receipt m I hareby atfirm [hat 1 am Iicensed under provisions of Chepter 9 t (commencin8 wich Sectlon 7D00 of Division 3 ot tha Busineu entl Zonin9 A�ProveE By: Date Professions Cod/e1 and�[^y license is in full force and eHactl. 3 LlcenseClas `'�" — LicenteNumber �+%'�Yn�n P oateJ�—y connector LfnYY1kS-ri u5/1 r'IsltRir� Misc. E Atltlress ��^4� n/��Al�i I'fii�• R'oposetlUse LL City antl Zip n Q�� r_^ Phone of $t�uc[u�e N CONSTRUCTION LENDING AGENCV d I hareby affirm that there is a construciion lantling agency for tha a parformanca of the work for which this permit is issuad (Sac. 3097, Occ. TyO� CoAe ' Civ. CJ. Class Const. Year C LandeYa Nema �i�� n USE/OCCUPANCV SI2E SQ. FT. J Lender'a Addret. OWNER-BUILDER DECLARATION 1 r I heraby nffirm thot I am oxempt from the Conttactor's licanse Law 1O fa� the followin0 �eason: � ❑ I, as owner of the propertV, or my employeas with waBes es their 2• sale compensa[ion, will do the work, antl tha svucwro is no[ L intentlotl or otfxretl tor sale, f' 3. � ❑ I, as ownor of tha proparty, am exclusively conrractin8 with Ileensed cOn[ractors to cans��ct the project. � ❑ I am ezompt under Sac. . B&PC for this reason 4• y Date pwnar E WORKERS' COMPENSATION DECLARATION Total Valuation � I hereby offirm that I have a certiticete of consent ro self-insure, EnRoa<bment P¢rmit Repulretl ❑ Ves ❑ No or a certlficate of Workars' Gompensation Insurance, or a certifieC C copy thereot. G�aGinq Pmt. Gratling Q Policy No Company Requiretl ❑ Vei ❑ No Pmt. No. y ❑ Certifiatl topy is heroby furnished. a� Certiti co yisfilatlwith � ge1' .�)� O C,M• RoughGratling � Q %- Approvetl by: Date Data I /o � qPPlican 3 CERTIFICAT F EXE TIOP — FROM WOFiKERS COMPENSATIONINSURANCE Z (This section naetl not be compieted if permit is for $100 or less). � I certity tM1et in ihe pertormanca ot the work for which thie permit is 3 195uetl, I Shell nOt BmplOy any p8f50n in any TdllnBr 50 as t0 �BCOmB ry sub�act to tho Wor4.ars' Compensation Laws af Calitornio. PERMIT FEES Uata qpplitant � NOTICE TO APPLICANT: If, aftar making this Certificata ot Structural E Plan Check $ Enemptlon, you ahoultl become. aubject to ihe Workeri Compansation provisions of the Labor Code, Vou must forthwith <omply with such Electriwl Special provisions or thfs pnrmit shall be deemetl revoked. $ Invest, s I CERTIFY THAT I HAVE READ THIS APPLICATION AND STATE THAT TME ABOVE INFORMATION IS CORRECT. I AGREE TO �umbing E COMPLV WITH ALL COUNT�' ORDINANCES AND STATE LAWS RELATING TO BUILDING CONSTRUCTION, AND HEREBV AUTH- Mechaniwl E OR12E REPRESENTATIVES OF THIS COUNTY TO ENTER UPON THE ABOVE M NTI NED PAOPERTV FOR INSPECTION PUR- Re-GraCe ES. � � � �;� f� InsDection S 1 I 1 1 1""X/ 1 ura o �—L'�—" � � %e-Gratle Permil p lican or qen� Dem Rec. No. E Issua s Plan Iiivance All spaees within this dax must he complMed to procex+ Check By: Approvetl: CMF 0335-66 (BV-28) rav. 6/8P � 0 �� I 1��_,'�_J�� ; I i ' �--��_l_ I i � . , _L-t _ "1` ' ^-'-t-�_i--�--ri I . j �� i � ��. � � �. ��i_�._I 4 i 1 I I i I_j ` I ': i� ;� � � � _i j i� ��, � I I � I � !� - I 'II �'II ��' �� I I I _1t � I ,�' �.— ' �. 1 I r �_l _� _ � t , �- �---t� ?- , ; � rt `_�i—f + . �� 1 � I ! i Ilr.-i_ � -+ } t � ' - +- l �- i - --�- ^-- 1 �-'�_ . � ....1.�._' t I i � '�( � t� 1-` � �1 _ _� .�._��i-��-{-�� -+-+�- � - -� '` ..� �� 1 � r) � - - - - � _ � � . 1 I_ �- - _ =� �-_ _�=-�_�i_ --�_I-; i � � � i . -�-'- r ��I�fi TT i_tY 1_I` -� N%r� I'�91�'�?�' � �Zy -�-L-, � -•_-:-� ._ 1 ��_,�� t� ' -��_y-r_�J,_j � � 1 --� .-h � '1"_�- I { I _�-._I_'t � �'t'.. r� .-, � . y -1 --r �--�- '-��---� '-r-'r--+--�--� + i �-+ '- t � +.�_. . _ � � } i- t , rt ��-i i ,—"_. -, � . 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Pf. � 0 TH[ AYOUHi GNOWN YNO6R VALUATION IB IOX TM6 j �URPOO[ OI �BiAlLIBNINO A PHRMIT P[[ ONLY. 1 VALUATION �. �Q � prj PERMITP6E � f � /3(70 w` TOTAL FEH S '+� r �/'/ ��.� [�VVV` .. C097A MESA BUILDINCrSAFETY DEPARTMEPff P.O, BOX 7200 COSTA MESA, CALIFORNIA 9262E For AppUcan� to FIII In ComplNdy TYPE OR PRINT • ADORHDp 'r�6 west i� th st. COSTA MESA, CALIFORNIA 1 x 3(iCI 1 I No _or e�oas. I BETBACK uN6 �PON GO � R6AR c8Ni8ROPel118R � No e Clo YAR LBFr qIQ/fT DESCRIPTION OF WORK i Exl9ting Bti.11ding t HBRSDY ACkNOWl[DO� T�(AT.1 NAVd AIAD YXI/ A►/LIGnOM ANO lTAT[ TMAT iNt ApOV�,I! CORR[C} AMO A011[� TO tAY. �LY WITN ALL CITY�p�� I1J1 fT� {AYY� 11[OUtATINO GV�LDINpCONRiIU // AUiFfOh�z{D AQ6H7 � 21�CMSAOO �I7O'n ****13.50 A►PLICATION FOR PERMR BUILDINa for OH1n Uw Only ��i— /" 1- teo�� E�- 3 'L 3 -(o �.NO. u� //' �5 i( f8: NOPAVEOVBNNAN08MALLBQLHBBTHAH ' TO HIDH a RHAR P. L 'E6 .OWHD (U.B.C.REQUIN6MHNT YARDiMPROVED YARDBAPPROVHD MAIN BUILDINO ACGE880RY BUILDINO v�n.lt owre A �v �li.,,ts�i owrc a m � s . rr. � 'Jp{ AMOUM 1HOWM YHDEA YALUATION IB POA TX6 n ►YRPoG[ OI iRApL16NIN0 A PCPWT ![8 ONLY. VALUATION �' aQ � PBRMIT P86 sa o ° 1500.00 `` TOTRLPEE 13�5� • . � ��! PA3U e ,�*e* JAN 13-7G�nsAOO 268 z4.00 ' COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIfORNIA 92626 forApplicant to Fill in Completely APPLICATiON FOR BUILDING PERMIT RECEI V � B DATE RECEIVED DATE IS�jSUED ADDRESS — OS � / � ' .J— D OWNER / L—� A.P. NO. — L�LI l T I P IT N.� MAIL 2 BU�LDING ^� f7 ��* UNiT Z . ADDRESS Jr G CO� /� P.DDRESS ��f � 1— S�T T TRACT LOT BLOCK a U CITY �!`�• ��C NO. L' �Ti 2 Z Q CqNSTflUCfION W A O � LENDEF± P �/ d m /\ J � BRANCH �— J tn OWNER E i —L t J ADDRESS VAWE �(� m ARCHITECT /" TEL. S �� J a OR ENGINEER �� P1 V Q FI E � W Q ADDRESS �- ZONE TVPE GROUP d W n `_ APPROVED / J O CONTRAGTO �'V u�'+� (� BY DATE ��' Q m Z J � ADDRESS'�� W w TEL. ZONE NO.OF '1 VSE OF NEW A�AIT �= CITV NO. —� PV+� V BUILDING � Z �- w� STATE _� CITV YARDSAPPROVED VARDSAPPROVED y� LIC. NO. LIC. NO. MAIN BUILDING ACCESSORV BUILDING � O (FFOM GL STFEET) SI2E NO.OF BLDGo. OF LOT ^ NOW ON LOT qOM FT. ��X FT. USE OF /QiLV EXISTING BLOG. /i ✓ G � %�'1 � �� p � SIZE OF NO. Z NEWBLDG. :�OOMS STORIES L.SIOE �� FT. U EXTERIOR WALL ROOF COVERING COVERING REAR FT. FT. J USE OF BUILDING AND WORK TO BE PERFOflMED DISfANCE BET. BET. MAIN & a MAIN BLDGS. ACCESS. BLDGS. a Q �In� S J� ��0�� VAR. � DATE O C.U.P.� APPROVED F APPROVED y � �. — 0 z 0 V1 hereby aek�owletlBe that I heve reetl this eppllcallon antl ctata � [he[ t�e ebo+a Informallon Is cOrreet antl aprao to comply wi[h � all lews raguletlnB builtlinB �onstruction, antl I ahall not amploy � ony person In ��oletlon ol tho workmnds compansaUon lews of y the Stam of Californle. m ? I �ereby cerdfY thet I am proparly Iicensatl as a con[rncror untlar SQ. FT. o the S[ate of CalifOrnie Business entl Profecs(ons Code, Dlviaicn 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chaptar 9, antl Mat fueh Iitonsas ara In full (orca entl affact, or 1 THE PURPOSE OF ESTABLISNING A PERMIT FEE ONLV: Q am exempt t/om the provlsiona of the $tato of Celifornla Business VALUATION / antl Professio�s Code, Dlvision 3, �fiaotYc9. PERMIT FEE 5 ((/ / 0� j /)j � Sipnature ot / � �/n��_ / d� /i Oa °� Permlttee �� 5 J[f1 DO PLAN CHECK $ J E � `o LL Auffiorizetl AOent TOTAI FEE 5 / 9D : � 3451 ' " COSTA MESA BUILDINGSAFETY DEPARTMENT ' " �^-7?�r��OO1310�' ��* :��8.06 P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 APPLICATION FOR BUILDING PERMIT For Applicant to Fill in Completely RECE VED �ATEDRE`CEIV D D/iTE IS��' BUILDING ^� 3 � , AO�RESS OWNER A.P. NO. � a P ,�10/ % MA I L BUIL�ING ADDFESS T ADORESS � a� TEL. TRACT LOT j�O BLOCK CITY ' NO. F Z Z Q CONSTRVCTION A O � LENDER 6. m J � BRANCH � -� N OWNER � J ADDRESS VALU p m ARCHITECT TEL S. S a M� J a OR EN INEER V Q FIRE C w 2 AODRESS ZONE TYPE GROUP/` _/ d w APPROVED J � CONTRACTOR BY DATE m Z J � ADDRESS w w TEL. ZONE NO.OF USE OF NEW � = CITY NO. P BUILDING Z H �0 STATE -CITY YARDSAPPROVEO VARDSAPPROVED y CL LIC. NO. LIC. NO. MAIN BUILDING ACCESSOFV BUILDING �� SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT flONi FT. FT. USE OF EXI5TING BLDG. F F SIZE OF NO. OF Z NEWBIDG. ROOMS STORIES L.SIDE FT. FT. U EXTERIOR WALL ROOF . COVERfNG COVERING REAR FT. FT. = USE OF BUILDING AND WORK TO BE PERFOFMED pl$7ANCE BET. BET. MAIN & a MAIN BLOGS. ACCESS. BLOGv. a Q VAR.9W DATE 0.U.P.qp qPPROVED � F" APPROVED � Z � VI hereby acknowletlpo Mat I heve reatl this application antl ztate � Ihat [he abova informetion is correct antl apree to comply wi[h � oll lows rep�lotinp build(nB consttucc(on, entl I shell not employ F eny p0rmn in violatlon Of tho workmBn's cOmpenmtion lews ot y the Stata ot Californie. m m ? I hara6y cartify that I em proparly Ilcansed as a conttacior un0er . FT. o She Sta[e ot Californie Bus(nass end Profassfons Cotla, Dlvlsion 3, THE AMpUNT SNOWN UNDEF VALUATION IS FOR � Chepter 9, and that such licanses are in full force Bntl eftact, or I THE PURPp6E Of ESTABLISHING A PERMIT FEE ONLV: m am ezempt from the provisions Of the Stete Ot CalilOrnia Businass ¢ VALUATION m antl Professlona Cotle, Division 3, Chapter 9. PEflMR FEE $ � � � Sipnetura of m I Parmittee g Oi(/h� PV1N CHECK 5 E v (/ [� �o`� Authorizetl ABont TOTAL PEE $ '� /� l �' r . 2�136 11�03/80 40.10 Tl,� ' COSTA MESA BUILDING-SAFETY DEPARTMENT APPLICATION FOR�STRUCTURAL PERMIT '� �� y � P.O. BOx 1200 COSTA MESA, CALIFORNIA 92626 RECEIV BV PERMIT For Applicant to Fill in Completely — Use [nk Only BUILDING �7�� w � y� �y�. 1 A.P. NO Zi� �'O8 -. ADORE55 / � � BUILDING / OwNER OR �/ ' •' /+ wC� ADDRE55 (0 TENANT R, �f� v VNIT OR ADD0.E55 �� J Z �� { . SPACE NO. . O. LOT BLK. TE L. - CITV COS�� s�C NO.(:KZ'a�Z1 NEW , ADD LTE REPAIR MOVING DEMOlISH CONSTRUCTION A� p�L LENDER IV BRANCH OWNER ADDRESS VALUE b ARCMITECT TEL. VSE S ` OR ENOINEE ^ ADDRESS 20NE 1 TVGE GROUP 'Z . CONTRACTOR ��fR C� ByPROVED DATE �I 3�O ADDRESS _i�L W l `_~ S� CITV �ps� Yh.dS C NO.L�{Z'9,1T.I F STATE CITV APPROVED SETBA KS � LIC. NO. LIC. NO. . - (,a� SIZE NO.OF BLOGS. (FROM C/L STREET) L OF LOT NOW ON LOT NT FT. a USE OF � EXISTING BLDG. y FSeparate permits are required for L. SIDE FT. � electric, plumbing and heating work: qEAR FT. [.�.� USE OF BUILDING AND �'�'ORK TO BE PERFOFMED PLqNNING ACTION a c DATE a' � APPROVED 7 APP OV � �, v� ..1 � k] �� I haraby ncknowlotlpa i�nt I heva reatl thie epplicatlon antl steta � thet t�a ebova Informetio� is correci an0 aprae to comply wIM � all lawf repuletinp bulltlinB �onrtruction, antl I shall not employ � Z any peraon in vlolatlon o} �e workman's compensetion laws of m � Me Stece af Cal7tornia. ' 3 x SQ. FT, m I haraCy cartify that 1 am ProPerly Iiccnsatl nse eonttector untler � Ma Smte of Californle Bu4��esa and Profasalonz Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m Chepta� 9, anC that such I�cBnces nre In full forca enC afiaei, ar I THE FVRPOSE OF ESTABLISHING A PERMIT FEE ONLV: � am ¢xempt from the p�ovisiona af Ne Siata of California Buziness anC Profassione Cotle, Divis�on 3, Chapter 9. VALUATION PERMIT FEE S � d�( N O T m Sipnetura Of �/_ �/ � � P CHECK E! V o Permittoe lf'� 7iC/ �'K�- $ TAX E f AuthorizaCA:er.t ^a!� 1O`3O '_`� TOTALPAID S u I . • / COSTA MESA BUILDING•SAFETY DEPARTMENT nv �onn �ononun ooeoc �i2135 II/D3%80 �3.50 APPLICAT[O�FOR STRUCTURAL PERMIT � ' .._' __"' '_" __'......""' _"._.. _..._... _ RECEIVE V PERMIT ATO 50934 For Applicant to Fill in Completely — Use [nk Only i`� ADDRESS �� W. l��y S`� A.P. NO. �O� `�" BUILDING OWNEROR �. /� �,��,r ADORE55 TENANT t90 UNIT OR ADDRE55 V '�'� st" SGACE NO. ` � W `� .N . LOT � � BLK. /�y�� TEL. CITV 1�� J�1 NO.I�{Z��Z� NEW • ADD HL E REGAIR MOVING DEMOLISH CANSTRUCTION `' LENDEF YO`1�� BRANCH . OWNE0. ADDRESS USE (�N.�.4.� S � /!C�/C�UEE L� AftCHITECT TEL. OR ENGINEER � ADDRE55 ZONE TVPE � GROUP �� CONTRACTOR !'�•W. �^�O�C�G� B�PROVED DATE /I p CIQ ADDRE55 �4� W �� S � CITV �0�� -a C NOL�+�Z+q�� STATE CITV ' APPROVEDSETBAC LIC. NO. LIC. NO. �A� SIZE NO.OF BLDGS. (FROM C/L STREET) OF LOT NOW ON LOT ONT FT. USE OF EXISTING BLDG. Separate permits are required for L. SIDE FT. electric, plumbing and heating work: flEAR FT. USE OF BUILDING AND WORK TO BE PERFORMED PWNNING ACTION T DATE APPROVED APP OV t /y'y� 1 a�J I hereby aeknowletlga that I have read this application antl rtam that ihe abova Intormallon is correct antl aprae to comply with ell lews reBuletinp builtling construction, antl 1 shall not employ eny person in violetlon of Ma workmen'a compensation laws of the State of Celifornie. I hereby certify ihet I am properly Iicansetl as e conbactor undar SQ. FT. t�e State ot Callfornla Bu�iness entl Professiona Cotla, Divlaton 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR C�epter 9, antl thet such licen6es ere In tull force end effect, or I TNE PVRPOSE OF ESTABLISHING A PERMIT FEE ONLV: am exempt trom the provizlona of the State of Califarnia Business VALUATION PERMIT FEE § D end Profeseions Cotle, Oivision 3, Cheptar 9. . 00 (�� PLANCHECK S �3� Ob Sipnet�re of y �QQ� Permittee " $ TAX S �O or Authorizatl Agant Date � TOTAL PAID 5�3 • O Tl. • 'COSTA MESA BUILOING—SpFETY DEPARTMENT � ;. . P.O. 84X 1200 � Costa Mesa, Calitornia ADDRE55 ��r ITV LICENSE NO. NO. ITtM Dwallinp. Sq. Ff. Gorage, Sq. Ft. First 20 OutleU, eoch Oullats, Addilional Firsl �0 Fixtures, eoch Fiafures, Addilional Dryer Fon Heater Oven, Domastic Pole, Consnuction� Range, Domeiti� � Maron �See Schedvle) HP GCN �llf S _. -- \, 6306 7/30/80 13�.00 IT4' --•- - _. _. _ .. ��.. —� PERMIT NO. TRACE NO. REC'D BY � 7' / 2 lOT NO DATE ISSUED O BUILDING USE '%-�O'FO � BNLDING -� �G w � �,� e E � ADDRE55 COSTA MESA, CAtIFORNIA _ !� NEAREST �� D NA _ KC �. V�� ceoss sr_ [ITYFcy ."'i \: \�Y� TFL NO. �[J�aD_5�00 r 1 HEREBY ACKNOWIFDGE TMAT I HAVE READ TMIS �VPII• CATION AND �STATE TNAT TNE ABOVE IS COR0.ECf AND AGREE TOZCOMYIY�WITH ALL CITY ORDINANCES AND STATE LAW$ REG- (((\\UGTING EIKTNIUI WIRING. `��I CERTI% TNAT I POSSF55 TNE ABOVE VAIID STATE OF ULIFORNIA CLASSIFIG ON OR 1 AM THE IEGAt OWNER OF TNE SINGIE fAMItY E IDENTIAI PROPERTY DESCRIlED ABOVE. i 5lpmwr. of � v PFRMITiEF NO. 17[M GCM flES Sipn 3 1 Tron�. 2.00 Tran�/ormen KW Genamton � KW Sub-Total Fee� HP o�,°� O'a APPROVALS Iitl1[Cia Melen, aa. TEMP. GOtE � Varmil Fae UNDERGROUND CONDUIT � 3 00 Ro� I .`V Sub�Total FNs FIMURES � — /� POWER � Tofal Fea� / ^ � UTIIIIY CO. NOTIFIED � � FINAI CMF 0313-46, rev. 7/75 For items not listed refer to Fee Sthed�le B�DG. PERMIT NC