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Home My WebLink About750 17TH ST - Building Permits. � -�.��.,�- OWNER Edna Pope \ DATE 3-16-5t� JOBADDRESS ?CO 41. 1%},Y! St,. BUILDINGPERMITNO. ljl! G�"ERAICONTRACTOR J.R. Pope VALUE $ 3�090.00 LOT i1P# 1�.6-21�—�.1 BLOCK TRACT Ihrelling /�e+ju-rC�� ` GROUP I TVPE V ZONE M—�- FIRE DISTHICT 139 c -' �� I PERMITSISSUED INSPECTIONS T SUBCONTRACTOR DATE I NUMBER Foundation Forms and Grade to Garage Rough Framing �r„�� ' v ' — Plumbing, Rough to Slab Plumbing, Rough Complete � Temporary Pole Wiring, Rough Gli Meating, Rough � Heating, Final LG Sewer i S 7ank or Cesspool � La_..�n9 A < Plastering / Plumhing, Final, Fixtures Complete — , Plumbing,FinalGasTe5tJ5'� _/- Wiring,Final LG ' OCcupanCy — Ga�m Y10 6-H IM 12-69 �� ... «.gs a esa �u,,.� epan,.�e,..,— `_ �r�ICn'�� 'RMli�� ` 117 EAST 20th STREET ' A ` � �' `�,', N G..l._._. _ �� _� OCOSTA�MESA,•CALIFORNIA� {� ��7"- -' � ",�OR APPLICANT TO � ' FOR OFFICE USE ONLY, : j �ceipt No. permit�No. ' Building � � : �i �I•� i f ' � Address % ��_ � i � - . . Costa Mesa, Ca 'fornia /R'e�c, %yf'')d'6y D /e Re d. � Date Is`yued ? Nearest �LVr.t! .a i � ( � J � ~� � �� 1 CrossSt. Building ��b I, . — /� �; _: R � Address W Owner ' Costa Mesa, California , � City � � No. Zone,�,/ No. of �- r�T.ype�' I Group.� ,Arohkector Lia ��/ � Plaris'�� I -�' � : �. Engineer No. b�p�oved �, �o�D�e . I Addreas �np�, � � I . - • �---- atYu�. .�_.'�COItRECTIONS� y�is ConVactor .No. � � • , Address � � 4`K ' Legal ot y/i�-� / O^ .� DesCription I No. �Q�81ock T t � � .� � ' � (Attach Metes a�tl Bounds) CSJ�CC.J► . 1 � No. of BldgaQ c�� ~ - �� Size af Lot ��300 I Now on Lot r _-. -' - ---- ---' � "' - p Use 0� .I No. of I No. oi ' ,.;. i, 77 Existtng Bldg. Families goojny� C Setback Linetrom q� Rear Vard - —�"-'—� ---- "'— " — � Center of Street // Side Vard f� S� � D DESC PTION OF WORK '` �`' ''� �� New I I.4�teration I I Addition � —�- - X �.�.;..� .,. Repair I I Moving I!� I Demolish I ' f� Building No. of � Size '� Rooms Stories Exterior Wall � , , Rooi 9�p ' � � Covering �/ . �✓ � Coverin 66x Usc oi New Foundatio� Location 8�;��s Dc.�.�� .�.' Forms, Materials, Under-Pinning Frame: Fire Stops, Bracing, Bolts I heteby acknow]edge that I have read this Application Lath. Int. and State thnt the above is-correct and agree to rnmpl}• Lath. Ext. with all City Ordinances and State I.aws regulaCing bnilding construction. Signature of '��J 1 Plaster, Int. Pern�ittee _ \ /\n D / —\-d"N'\" Plaster, ExL Authorized Agt. - � v " Masonry Reiniorced Valuation q�( `1 plan Check $ % O Bond Beam O/ S ` � Total ^ O Fee 5 . r F�NAL , ...._ _ 9ile !:_ 1M 1').f:l . i �-� � -�I. - � a` ��- 8trcet � � PLOT PLAN Show�lowtion and distances irom property line and between buildings. � . .. . _ `, _ . . . . � . � ... � . . . _ . ,�.� '` :�2 /o ' // -. ?c.,?.. /} P —%%G . .. . �i r; � � � � ... - �. . . ,, .1'.�.�;:�.�: c �� 'f,r ��.c �� ;... - '> - . � . . . . �. . . . �i1�/M'_'/!✓+n��_ . - . . -. �z � _,Y.y� , � . . .. .f . -N'+�� ^N�� "� �� '._ . ' �- -• / fy � `•7E., s--� _ : _ ,� �,�'� _, _ ' �' _ <<�� .�..... _ - - : t�.S.Z,r._� .-o�.�:c.s�� . . �;�� ' � . `6oJ:_ _ _. - . �' .,:• � ;��ij( 6�1 � , � . � :t . ,,, , • ' ' .i.�. ' ' ' .. . i _ . . _ • l. , . , - - - . . 0 • � ( .� ��'. ' -.t u .... _�... ..� .nw�ca .1 . . . . . � � . .0 • .,. . . - i , . ' . i � . -,{ ' . ' � . . .'r . � - � i. .. . ' \ - , . � . ,. .. � �.. _ _ _ _ ' ' . . . � • ., �; ��,. . . � '....'. - ." "_ ' ' "" '_' _ �ly •`'i. . . , _ _. _ _ " '__ ' . _ - " . __ - , � . � . � . I I OWNER SHE47ARD & SON 'JOB AODRESS- 750 W. 17tt C�'�ERAL CONTRACTOR ; � o.ii6-2u-3i �oT �NSPECTIONS SOIL � .-_ pW1TER ROUGH PLUMBING GROP. $WR. LINE �_ � NOf15E CON. SPRINKLING SVSTEM MiSCELLnNE0U5 ROUGM HEPTING RND �IR CONDITIONING TEMPORnRV SERVICE OR POLE UNOERGROUN� [] POWER � ROUGM WIRING TRENCHES IJ FORMS STEEI RE FLOOR SYSTEM BOND BEAM �1 STEEL PEINFORCE � SNEATHING FR4ME r1N0 FLr15NING ^ LGTNING — IN1 � OUT ` � P 'ER. BROWN CO�T 5 .TUR4L, FINAL MERTING, VENT., REFRIG. AN� A.C., FI PLUMBING. FIN>L 4ND GA$ TEST n ELECTRIC, F�N4L 9WLOING FIN1L DATE SUBCONTRACTOR PERMIT N0. F � L < .N. � F C F Q C .d 6 > r � a � d � � L z{ij 'S' 3 ' ` i(J��a� COSTA MESA BUILOING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BVILDING �r/1 I„ '�tu �+'� ADORESS J(J �N J OWNER S��wQ MAIL --��n .. � CITV ( �'.tY1 /ALLz`� C�/.� • NOL. BRANCH ADDRESS ARCNITECT TEL. CONTRACTOR ADDRESS;�`�� WW� LJ�( � 1 /�� CITV.�� l�� (,..(.]. NOL�'�! STATE ^ O�� CITV IIC. NO. 'L LIC. NO. SIZE NO.OF BLDGS OF LOT NOW ON LOT 1 USE OF ` EXISTING BLDG /�` �� SeFarate perntits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFOFMED I heraby acknowledpe t�at I �eva reatl thls application end �mte Met Mo obove Informallon 1� eorract end aprea to comply wit� all lew� repuletlnp bulltlinp eon�truetlon, entl I ahnll not amploy any parwn In violetlan ot Ma warkman'� compenmtlon low� of Me Suta of Celifornle. 1 hereEy eertify t�nt I em properly Iicanaetl ea a contrector unAar Mo Suta of Cellfornla Budnau and Profaulona Cotla, Dlvialon 3, Cheptar 9, antl t�et suc� Ilcente� are In full forea enE Mfxt, or I em ezempt from the provl s of tha Stete of California eusinass nntl Profasslo Cotl , Dlvlf o 3, Ch pt� Sipneturs of Parmlttes Aumorl:s0 nt 1660 5%26/78 �__. �2 :60 T� APPLICA170N FOR STRUCCURAL PERMIT RECEIVEO BV DATE RECEIVED neT� �ecimn ADDRESS ZON VAR $ C.U.P. # APGROVED OF /1 I USE OF �h APPROVED THE AMOUNTSHOWN UNDER VALUATION IS FOR THE PVFiPOSE OF ESTABLISHING A PERMIT FEE ONLV: VALUATION PERMIT FEE S � �Q � PLAN CMECK S � s /�/�' �� TAX 3 � (J TOTALPAID S � n m i m m � m b � m 0 LL i u _ . ; ��'*u:�26 - COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 �� For Applicant to Fill in Completely — Use Ink Only BUILDING ^ '�`• _I• ADDflE55 J'{' W �1 OWNER '.,/rII�rN S�LZZNL CITV TEL. NO. A.P.NO. IIO� <`I '—�I BUIIAING � �{� �l ADDRE55 1f J /78 ;�'J . iMIT NO. LOT IL,Y]I BLOC 66.50 .TL'' 6b.5�a�K,T6 �'- LENOEFi �/ v� BRANCH OWNER ADDRESS VALUE ARCNITECT TEL. � E R EN NE FIRE '�f ADDRESS ZONE VPE GROUP �!�` APPROV CONTRACTOR W BV DATE ADDRESS TEL. ZON NO.OF USE OF NEW CITY NO. PLAfS BUILdNG � � r � STATE CITV YAA0.SO.PFROVED VARDSAPVROVED � LIC. NO. �IC. NO. MAIN BUILDING ACCESSOFV BUILD {y SIZE NO.OF BLDGS (FROM C/L STRE �. OFLOT NOVJONLOT F . 6 USE OF � EXISTING BLbC y FSeparate permits are required for �. si FT. T. o electric, plumbing and heating work. REAR FT. F. .�. USE OF BUILDING AND WOHK TO BE PERPORMED DISTANCE BEf. BEf. I Q MAIN BLDGS. ACCESS. LDGS. ; VAR # DAl'E Q, p� � C.U.P. j� APPRpVED �/ ' / t !/f/ "P° —L } � � k W � I �oraDy aeknowlatlpa t�et 1 havs reatl thb epplieeHon end tinte � p: thet t�b above Information Is corract enA aprea to eompiy wlth m d ell lews repulatlnp bulltlinB eanrtructlon, entl I shall not amploy / / � eny perwn in violatlan of Ma workmen'� compenmtlon lawt ot 0 � the Stnte of Cell O/ m 3 I �aroDy ce y that I propotly Ilcensatl aa a contrectar untler � the Stete Calffornle usineas and Profevione Cotla, Dlvbion 3, THE AMOUNT SMOWN UNDER VALVATION IS FOR m Chepter 9 end that a h Iicanees In full forca entl affoct, ar I THE GURPO6E OF 6TABLISHING A PEHMIT F ON � am axem t from tha rovlalons o t e Stete of Callfornle Businafa y entl Profe lona Cod Dlvlsio 3 p r 9. VALUATION ERMIT FEE S N m PLAN CHECK S o Sipnetur� o LL Pbmltts S TAX . S � U AuthorizWApent � TOTALPAIO S OWNER gFg JOB ADDRESS G� 'ORAL C01 �A o. ��(,_ INSPECTION$ SOIL �G r15 WATER AOUGH P�UMBIN� PROP. SWR. LINI SPRINK�ING $YS MISCELLRNEOUS POUGM NESTING AND nIR CONOITIONING UN�ERGROUNO � I POwER ROUGM WIRING FLOOR SYSTEM BON� BEAM I,� STEEL REINFORCE SHE?THING FRAME RNO FLRSHING LATHING — IN_L� Pi lR. BNOWN C04 DATE 7_20_7g BUILDING PERMIT N0. Iil[�P.i FIRE 20NE VALUE SUBCONTRACTOR . , - '� _: ��424 COSTA MESA BUILDING-SAFETY DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only ADDRESS r� KI• I �N OWNER �WQ�Z'J MAII / ��. 1 -ii, ADDRESS W � �R TEI. CITV �,. NO. CANSTRUCiION LENDER BRANCH ARCHITECT TEL. CONT �+SOQ64 7/20778 APPLICATION FOR STRUCTURAL PERMIT ECEIVED BV DATE RECEIVED ❑qTE ISSl1E❑ BUILDING ADDRESS OWNER FIRE ZONE APPROVED /'� ZONE NO.OF CITV Vl�a, . NOL . a,�. PLANS .�. STATE /� CITY �ARDSAPPROVED � LIC. NO. �'�-Q lg LIC. NO. MAIN BVILDING {a7 SIZE NO.OF BLDGS (FROM C/LSTREET) �. OF LOT NOW ON LOT qONT FT. a USE OF A � EXISTING BLDG. / � 7 � FSeparate permits are required for L. SIDE F-r. � electric, plumbing and heating work. REAR FT. F USE OF BUILDING AND WORK TO BE PERFORMEO DISTANCE BET. OMAIN BLDGS. j VAR. # d 161. = N 1 c.u.P. �h } �� C� APPROVED ..l 6S W 0 I hereby acknowlatlge that I have reatl this eppllcation enA stata y� that the ebova Information is correet antl agrea to comply with a all lews regulating buil0ing construeNon, and I shall not amplay z any parmn in violation oi the workman's compensation laws at x ffie Stata of Celifornie. 3 I hereby cenify that I am properly Iicensed as a contrecior untler SQ. FT. the State oi California Businau entl Profeaiona Code, Divislon 3, THE AMOUNT SHOI Chapter 9, entl thai suc� Iic es ara In full force tl eftect, or I THE PUFPOSE OF ES em exempt fram i�e provisl� oi tha teta of Call ornie Business VALUATION antl Pfof8551 f CO 8, Divisi n, he r 9. staneture of / � y/'� Permltta $ IL � /f1 Authoriza nt � /v' BLOCK OATE �' �I � USE OF NEW BUILDING VARDSAPPROVED ACCESSORV BUILDING BET. MAIN & 5:50 TU � n m i m m N VN UNDER VALUATION IS FOF m 'ABLISHING A PERMIT FEE ONLV: � PERMIT FEE S � a N m PLAN CHECK y �� TAX E LL f `U TOTALPAID E OWNER r �ROUGH PLUMBING �/ PROP. $WR. LINE MOUSE CON. SGRINKLIMG SVSTEM ' MISCELLANEOUS FOUGN ME�TING ANU �IR C NDITIONI UNDERGROUN� U GOWEN NOUGN WIRING FLOON SYSTEM BONO BE�M �] STEEL NEINFORCE SMEATHING iR�ME �ND FL�SMING L�TMING - IN n I PI CR. BROWN CO�T 51 fURRI. FINAL ., REFRIG. �Mp A.C., FINAL �L AND GA$ TEST I-I BUILDING, FIN�L DATE fU6CONTRACTOR PERMIT N0. . _ � ` -- .. • '. . 4�`�9's3 � �- • v . COSTA MESA BUILDING-SAFETV DEPARTMENT P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use Ink Only BUILDING %�J �,�� n,J,. ADDRE55 � W � CJ OWNER po tir ///��sLSR N�CS N MAIL i i. i.. . I� . . Y � ' "" " AL _" � Fc 5 W M a � � x F C� w F a c .] 7 .rd C W .,r O C�. L z 'S' 3 � 1 CITV /y�,(�(f CONSTRUCTION C LENDER BRANCH �O I ADDFESS ,C'v �� h7 �l� ��J NO. RU:DD L`', S� D n.0 A� �" � r� �- � � TEL. /� fi'J/i � NG. Nn ADDRESS /� /5��p(,�r U/L/�9�GA CONTFACTORs �Q/L•T''/j�l[ ��/j,O�tJTJD1i �� ADDRESS /�p �,r� �t�/�f'flj,(�C7ZON C(/L TEL. r7 CITV /� /i! /j( (l� NO. �L STATE +7 � � �� / CITY LIC. NO. L LIC. NO. SI2E NO.OF BLDGS. OF LOT NOW ON LOT Separate permits are required for electric, plumbing and heating work. VILDING AN� WORK T� BE PERFOR� I �ereby acknowledge that I hava reatl ihis eppllcetion and stete that the above (nformaiian iz correct end eprea to comply wlth all lews reB�latinp buildinp construction, entl I shall not amploy any pereon in vlolatfon of Me workman's compenmtion laws of Ma State of Californla. I hereby cenify ihat I am properly Ilcenzed as a conirecSor under the State of California Business and Professions Code, Dlvlzion 3, Chapter 9, and thet sueh Iieenses are in full force end effect, or I am exempi from Me provisions of thpep Stata of Callfornia Buslness antl Professions ode, �Ivision 3, Ch/'�' —�\ SIB�ature of � Permittee —� Autho�ized Apent \' 51b7 /21l78 159.19 TL L� APPLICATION ['OR STRUCTURAL PERMIT BUILDING ADDRESS TRF FIRE `30'/�p �%s�� DATE 0 VARDSAPPROVED I V![RC�APPROVED VAq.# DATE C.U.P. # APPFOVED APPROVED n m i : ( SQ. FT. c�0v ,v , THE AMOUNT SHOWN UNDER VA�VATION IS FOR m h THE PURGOSE OF ESTABLISHING A PERMIT FEE ONLV: V� e VALUATION PERMIT FEE $ Z� vV m \ $//Ba0 TAX CHECK $ lB�. o� � l.3q � TO?ALPAID El53• OWNER MISCELL�NEOUS ROUGH ME�TING AND �IR CONbITIOMING TEMPOR�RY SERVICE OR VOLE UNOERGROUNO � POWER � ' ROUGM WIFING TRENCHES FORMS STEEL RE FLOOR SVSTEM BONO BE�M � STEEL REINFORCE � SNEATMING FR�ME �ND FLASMING L�TMING — IN n OUT PL - 'ER, BROM'N CO�T 5. :UR�L, FIN�L DATE FIRE ZONE VALUE TVPE V OROUI SUSCOMTRACTOR ;;r..►rr.�� ,'> - . �� i� ' ' COSTA MESA BUIIDING•SAFETY OEPARTMENT F � kl a 4 � H T F A{y Q Q � a > .r.l C W W 0 a a z W S � PAIP ::^,��i� �Ec , z-,��SAao sb�� s.s� r.v,ovn �<w I.yJINmcJH,4/aL�rVnrvlNDeo<o APPLICA7'ION FOR STRUCTURAL PERMIT � For Applicant to Fill in Comple[ely — Use Ink Qnly RECEIVED6Y DATERECEIVEO DATEISSUED ADDHESS �(J � � OWNEfl J� � C � J �' A.P. NO. �' g/ PER IT NO. MA�� y }- BUILOING �� J �} (� AOORESS / G �� SI ADORESS Y�/ �! j CITY CGS I N(tr oio`.' /t%�pi�2t/7E'�` �oT a�ocK CON5fRUCf10N W A D IENDEfl O BRANCH /� OWNER (.v %�� ADDRE55 /J„�� US c ARCHITECT TEI. S •��r OF ENGINE 4i FIRE ADDRESS ZONE T PE GFlOUnP APPRi?VED % � CONTRACTOR � s BY OATE �"' AODRESS f�'3 6 S S L f/ ZON NO.OF USE OF NEW p TEL.� PIANS BUILDING CI7Y /�q �(/�� NO. 30' rj $TATE /� �/r��'� �ICYNO�` YMA NSBUIIDiNG ACC SSORY BUIIOiNG LIC. NO. 7 SIZE NO.OF BLOGS. (FROM C1l5TREET) OF LQT NOW ON LOT P(i FT. FT. USE OF EXIS7ING BIOG. FT Separate permits are required for �, si FT. FT. etectric, plumbing and heating work. REAR FT. FT. USE OF BUILDING ANO WORK TO BE PERFORMED ��A� 8� � p,rq�N$ MAIN BlD(�5. ACCE55. BLOGS. /NS1A1/ Ca � SIl� � c.ur�"'.r.vW APPFOVEO APPROVEO 1 hereby ecknow1e0p0 thet 1 heva raatl thia applicetion end s[ete Met tha abova Info�meti0n is w�rect antl eyrae ta <ompiy wlth ell lews requleting building conrtrucdon, end 1 ahali not emDioy any penon in vlotatiOn of Ma wO�kman'f compensat(O� laws of Me Steta ot Celitornle. 1 �embY certlfy that 1 am properiY ��censetl m a cont�actor untler St], fT. tha Stete of Calitornle 8uatnass and Profeaslons Cotla, Divlcion 3, THE AMOVNT SHOWN UNDER VALUATION IS fOR Chapter 9, entl that wch Iicenaea are ln full force end effect, or � THE PUFlPO6E OF ESTABLISHiNG A PERMR FEE ONIY: am exempi from ffia rovisiona of the State oi CalHomia Bualneas VAlUAT10N VERMIT GEE S �� entl Frofaulona Cotl , Dlvlsion 3, C pier . SiOneture o ' c`.� � P�N CHECK i ^� Parmlttea /� $_ l r R, TAX 5 «.�� AuthnrizadApant TOTALCAID S � C� N n m i m m J m u N m m 0 LL i u i F � {r] a Q N y S F C F Q � ..1 Q 7 J C W 0 � 6� Z W S 3 r� � - � �..40g5 COSTA MESA BUILDING-SAFETY DEPARTMENT 'P.O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant [o Fill in Com te Use Ink Only BUILDING.- . � ' ADDRE55 • �� 57��tT—�s�"b�'SP OWNER LP1QR� E. /V4f-S1�i� MAIL ADDRESS Z�JS'U�. �%�'.�s�iQ [3L{I�� -�^ TE L. Ct7V3�ht�1TA l+�l� GA� r�0.35�"I CANSTRUCiION BRANCM ADDFESS :' " � r ADORESSI�J a� Mhir1—S.t.Tct�—�• d ��' CONTRACTOF R�f�b�I�IS GUK�T�- NF/�`�I�G• ADORESS 'L79� NG4i'c(Y� aVE.; SJ�Tc"'G` CITY NO�, jLFI{�'� LCa i11�Ti1� Gb. STATE y CITV LI0.N0. 3JS' LU UC.NO. SI2E NO.OF BLDGS. OFLOT I�Oj[3�'G f^T. NOWONLOT � USE OF EXISTING BLDG. � Separate permits are required for electric, plumbing and heating work. USE OF BUILDING AND WORK TO BE PERFORMED / /f ROVED �L'IJ-j'77PAIUOO 204� A��300.1� «�; FORSTRUCTURALPERMIT �ATE RECEIVED D TE ISSUEC � � � �I DATEC/ —C/ � % 7 ZONE NO.OF USE OF NEW T. FlANS BUIIDING ARDSAPPROVE VARDSAPf MqIN BUILDING ACCESSORV (FROM C STREET) , RONT FT. / F � !/ F / L. SIDE FT. F n .,. i � VAR. ,� � G . C.U.P. qJ R c rtv , oo.rwaov I hereby acknowledBe thet i have �aetl 2his appllcetion antl nate that the ebove Information la correct nntl agree to comply with all lews r>puleNnp bulltlinB �onsvuctlon, end I ahall not omploy any parson In vloletlon of Me workmen's eompeneatlon laws of Ma Stata of Celifotnie. 1 fiareby cartffy thai 1 em proporty lieunsatl es e controctor �nder the Stata of Calitornia Businea and Profauions Code, Divislon 3, Chapter 9, and thot sueh Iicenws a�o in full forca entl affact, or I am axampt irom the provisions ol th9 Stete of Californla Buslness end Profaaslo�ns Co/tle, Dlvislon 3, Chap arn 9. Sipneture af � �-/j//',� � (' Permittea �r° '�"�- Authorizatl ABent BET. I BET. MAIN & a'S. ACCESS. BLU DATE t. � o( > O e � � 5a. FT. — ..�. - �� THE AMOUNT SHOWN UNDER VALUATION IS•FOR m� TME PURPO6E OF ESTABLISHING A PERMIT FEE ONLY: e � VALUATION PERMIT FEE E d I �� m _n PLAN CHECK' S �QO � � v g V 1� ��Or-� TAX E / rI u� �VI �� O TOTALPAID _� 4_ � . ' ' , �� S COSTA MESA BUILDING-SAFETY DEPARTMENT 'Pn RnXt200 COSTAMESA_CALIFORNIA92626 auc i2-��PA1000�2�5 �***440.00 [tl5q APPLICATION FOR STRUCTURAL PERMIT For Applicant [o Fill in Completely — se Ink Only qECEI V DATE RECEIVED DA E ISSUED BUILDING 'So / ADDRESS �� S � ��Q� PERMITNO. OWNER , � A.P. NO. G.. % 1 fl.� (� MAIL ADORIESS 7�/O /,�' �J� ADDRESS TEI. TRACT LOT BLOCK GTV N� CANSTRUCTION W '4 '4 LENDER N N BFANCH /J �./ OWNER „� EG dN ADDRESS y �G,� � VALUE ARCHITECT TEL. USE ��u� 5 OR ENGINEEF N FIRE ADDRESS ZONE TYPE GROUP • APPROVED CONTRACTOR BV DATE ADDRESS TEL. ZONE NO.OF USE OF NEW CITV NO. P�� BUILDING STATE CITV �'ARDSAPPROVED VAflDSAVPROVED LIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING SIZE NO.OF BLOGS. IFROM C/L STREET) OF LOT NOW ON LOT RONT FT. FT. USE OF EXISTING BLDG. FT Separate permits are required for � �. sioe FT. FT. electric, plumbing and heating work. REAR FT. FT. USE OF BUILDING AND WORK TO BE PEFFOflMED DISTANCE BET. BET. MAIN & MAIN BLDGS. ACCESS. BIDGS. VAq.#` DATE ' C.U.P.qy'+ qPPROVED APPROVED I hereby acknowledBe that I have raetl ihis application and siate ihet ihe abOve info�metlon is cOr�aci antl egree t0 comply with all lewc rapulatinp bulldinB conetrucHan, entl I shell noi employ anY Oereon in violatlon of the workman's compensation lews of the State of Celifornle. � hereby certlfy that 1 am properly Itcensetl as e conirector untler SQ, FT. the Stata of Californla B�siness entl Prafesslons Cotle, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR Chapter 9, entl that a�eh Ilcensos era in full iorea entl effact, or I TNE PURPOSE OF ESTABLISHING A PERMIT FE LV: am exampt irom the provislons of the Staie ot Callfornla Businesa VALUATION PERMIT FEE E entl Professlone Cotle, Dlvlsion 3, Chapter 9. / i� PLAN CHECK E SIB�aiura of Permlttee $ TAX E Authorizetl ABant TOTAL PAID S � O(� .. - � . ��55 ' COSTA MESA BUILDING•SAFETY DEPARTMENT P,O. BOX 1200 COSTA MESA, CALIFORNIA 92626 For Applicant to Fill in Completely — Use lnk Only BUILDING �-jl � /� ADDRESS L)G/ OWNER Q � k MAIL R.�/ �. �/� l� 4IlORF55 rtti v�tJ CITY ADDRESS ARCHITECT NO. TEI. 852i 4/03/78 B6o5Q, TL AI// APPLICATION FOR STRUCTU2AL PERMIT N�V RECEIVED BY DATE RECEIVED nnrc �ca�cn BUIIOING ADDRESS FIRE '�L//� e 7 so �v. TEL. ZO NO.OF - CITY NO. v� .F.. STATE CITY VAROSAPPROVED � LIC. NO. LIC. NO. MAIN BUILDINO {a7, SIZE NO.Of BLOG^.a. (FqOM C/L STREET) , �. OF LpT NOW ON LOT FT a USE OF .�.� E%I51lNG BLOG. y � Separate permits ere required for � s�o F q electric, plumbing and heating work. qEqa FT. � USE OF BUILDING AN� WORK TO BE PERFORME� p�,qN B Q MAIN B � VAF, vh Q i(!7`. io.� a��rte.c!-�' �.�.P.,,Y . � E �, %'� .d a w Q1 hota4Y aeknowle0ys thnt 1 hm�e rentl t�Is applleatlOn antl steta p� thac tha obo�a Iniormeilon la correct antl a0�eo to compiy with d all law� rpulatlnp builtliny contnucUon, entl 1 shall not employ �eny parwn (n vloletfon o4 tha workman's compansetfon laws of 5 Me Stets ot Callfornle. 3 I �arnby certHy thot 1 em proparly Iicensed os o contractor untlar S�, FT. Ma Stsm of Califarnie Businen anE Ptafeulona Coda, Dlvislon 3, TME AMOUNT SMOt Cheptar 9, entl thet wch Iicansai era lo tull torca end effaci, or I THE PURPO6E OF E5 em examD< trom,Ma provisionf of the Stete of Celifornia Businea yqLUAT10N nntl Professlona CoEe, slon 3, Chaptef 9. B� s�fl�a��.� �,�� $ � p� o0 0 Permlttea AutfiorizeA Apant VALVS /Q'� 7� USE OF NEW onrE APPROVED n m i m m N YN UNOER VALUATION IS FOR m 'ABLISHING A PERMR FEE ONLV : � PERMIT FEE S .00 m PLAN CHECK S � O o TAX S I O v TOTALVAID g n15Q � Pfl0.1ECTRODflE55: �ISO W 17TH ST OWNEX'SNAME:SHEWARD, TERRY A noosess:SHEWARD, VERONZCA P O HOX 7.789 NEWPORT BEACH,CA I�I J 92663 uxiT: APCN/ENGINEEB: HANNS U, BAUMANN BEG.NO.: S 1 i A nooness: 567 SAN NICHOLAS uNiT:104 NEWPORT BEACH CA 92660 r¢xminEc: TERRY SHEWARD ( 714 ) 673-0760 aooness: 222 21ST ST NEWPORT BEACH CA 92660 LICENSEO CONTflACT08 OECUMTION: I �ert0y allirm Itut I am IicenSeJ un0er provisions ol Ctupi¢r 9(commencinq with Section 700�� ol �ivision 3 0l I�e Business antl Professions CoGe. anG my license is �� Wllloqe ana efleci. CITY LIC.: STATE LIC.: C1A55: Daie: - Signamre: WOflKENS' COMPENSA710N OECLABpTION: 1 �ere�y alfirm t�at 1 �ave a cenifitate ol cpn5ent to seli-insure ar a cettilicate oi WOMers' Comp¢nsalion Inm�ance, or a[ertdi9a �ppy �hereol (Sectpn �800. Lab. C�. 7LILY NO.: E%P. O�TE: COMPANY: �] CerlitieE mpy is �¢r¢Gy �umiS�Nd. ❑ Cenified'wDY ¢ IileG vnih t�e ciry BuilOinq �ivisian. �al¢: Applicani: � E%EMPTION FFOM WOflREBS' COMPEN$pT10N DECUILITION: , �iAis seclion need not De compkt[d il �he permi is �a one hunOreC �S1IXq ar less�. I cenily �hat in ��e peAormance ol I�e work lor wMc� th¢ p�rrttil is issu¢tl. 1 shall no� employ any De«� �n any mann o as to Uecome Su�leCt lo Ihe Workers' ComOCnsali0n Laws ol CaBI � //�� " e• Date: �� 9�t e� ' �� L:a(a« NOTICE: II, alier making INS Oeplaratial, you SMWd Eecam¢ WGI�� to lhe WOrkCls' Compensation D�ovisions ol tne Lahor Cotle, you musl IOrt�wil� tomply wi�� 5uth prOH5wn5 or lN5 permii Shall Ee Geemetl revOkeE. CONSTPUCTION LENOING AGENCY: I hereGy aifirm Ihat I�ere is a con5tmciion IenOinp aAency lor I�e DeAormance ol I�e work for w�ic� Ihis Oermn is issueC �Seclion �pg7, Civ. C�/ �EN�EX: ADOflESS: �� OwNEfl BWLOEfl OECtABA7lON: I nereby aflirm Inat I am exempt Irom tAe fAniraciors' Stale Licetrse Law lar Ihe tollowing reason (Seclion 7077.5 Business ana PmI6Ei0nal Ca�e: Arry pIY ol COunry whitli reQuireS a perrtnt Io COnSirutt, alter, imprwe, Oertwlish, or iepai� any siructure. prior to its iRuance. a150 repuita the apd�^� �w Sucll Mrmil to lile a sipnetl statement tAat �Nshe is Iicense0 pursuanl Io I�e O�avivan5 0� Ihe Con¢attars' Stale Lianse Law (ChaD�er 9(wmmencinq vritn Section 7000) ol Division 9 al �he Business antl Pmlessions Code� ar Nat �e/sng is e�empl tnerelrom anE Ine basis lor I�e alle0e4 eeem0lion. Any violalion ol Section 7031.5 hy any apD�icant lor a Dermit su�lects ��e applicanl la a civil Oenalty ol ilot mort t�an five �unEred Uollars (55110�. ❑ I, a5 owner oi Ihe D�oDeqy or my ¢mploy¢e5 wil� waqes a5 Iheir SOIe wmDensalion, will 4o Ih¢ work, and Ihe stmcWre is noi imentlee or alleree lor sale 15ection 70a<. Business anG Pmlessional COCe: TAe Contractors' Slate License Law aoes noi appty m an awner oi a O�openy wln OWCs or imDrwes Ihereon, aM who Uces such wark �imsell/Aersell ar t�mu0h nis or her own emoloyees, prOviOeC that wctl imptovemenis are not intenaGE or alfere0 lor Shce. �l �wwever tAe �uiltlinp or improvemeN is soltl vnt�in qpe year of camDletion, t�e owner will lave Ihe OurGen ol pwvinp �e/sAe AiU nat Gui10 or imD�ove tor ��e purpose ot sale�. v-. I, as owner af t�e pmpenp. am erUusivery canVatlinp wil� IkenseG rnnVactars to cOnsimcl I�e D�aleci (Seclion 7044, Business 4J anU Prolessions CoOe: The fAntraclas' State Licmu Law Gces not appry m an pvmer ol property wlio Omlds or imD�wes t�ereon an0 w�o wntraas toi suc� projecls wit� a wnuactaqs) license Wrsuam to ihe Contracrors' Sta�e Lkense Law�. I am aware Ihal O�oo� o�t�¢ir Worker's ComOensation insurance should Oe D�ovitletl lo m¢. � I am e�emo� under Section: B. a P. C. � lar Inis reason: Oaie: �-7 � Pe+i ' I Oo �ereCy cenity Iliai I am aware ol an0 unCers�anG Ihe tepuiremenis ol Catilomu Heali� anA $dfe�y fAOe SeciiOns 25505, 25537, and 2557< an0 Inal I ar any tuture Euil�inq occupanl wilVwiO nai (drele one� ne¢E Io compy wilh SaiE state to0es anU I�e repuiremenls lar a pCrmii lor mn5lmtlian or rtroEiliCatibn Irom t�e Art abiy Manaqemmt qs�rict. ReS�Cemul wnstruction appliutions are eKempt imm Inese orovisions. �ate: Npplicanl: _ I �et¢by ce�tily I�al Ihaverea01hi5 dpplication ana Stal¢ itul ordinances an0 staielaws�elalinglo GuilOing conslmction an0 � O�opetly torinspection OQur�poses. paie: _� � $ �—/si__ Signaiu ' ori�ers t�cense o� sodai securitv n: I agree Ia comp h all cily antl IAisciNloenle theabove�me i64F46 Wbne—BuilEmg; Grean�.�e EnbmemenL Canary—ApP��can�; Pink—qevenue: Gol4enroE—Assessor CITY OF COSTA MESA — HUILDING PERMIT PERMIT NO; B 061287 PLAN CHECK NO; 00774-93 S CONSTRUCTION TYPE; PERMIT TYPE: ST'R JOB DESCRIPTION : 250LIN FT OF 'PRE CAST' PANEL WALL CLAIM VALUE: CALC—VALUE; 15,000.00 PERM NO: B bll / GOVT; N SUP ; N PURPOSE; OTH SQ FT'; 250 GROUP OCC: B-2 / COMMENTS: RETAINING WALL �r��r***x�**�r*��r�r�**x**��r�r�x��x x�ex-��***�r+e**�**�x� x�e**x�z�•*�t�r�***�*�*x��r�rx r*�*�-�e�***� Z O N I N GS ERTEBQAUCIxRSE M E N T 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 IN RGHT; FT IN PARKING REQ• � PROV; PAACEL; 42408117 ZNE; MG REF NO; PLANNING NUT'ES> REPLACE EXISTING WALL > !k 1E it iE jF it iE iE if 1! iE k ik 1f iE iE if iF i! iE iE iE i! �E k* k if iElE iE if it �E %�-IF i4 iE 3k iF iE 1E1E !h iF iF * it iF 3E 3E 3F iE ff if jElklE iE 3f iF ib iE if if �lt iE ib iE�i('If ih jE i4 ik M� IP �1f� 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�]`� S ZONING APPROVED BY •�C2� DATE; �/�/� BUILDING APPROVED HY DATE; APPLICATION ISSUED HY• /��,//l// DATE; �S�•� ilakiEififlEiFifkikiEffiEfFiElf�E�1E1lilkifiF7Fx z-,�i'F/T�iFiFiFIFiF£iFi'r�T�'iF7F7F7FitiF3F3f'itiFiFiF3t7FiF7f3FTtkiEiElFiEi(�i6iEiF1E � x tx icx �iEiE iF it 1t if 1F 1f it 1E iE i! M� 7F if iF 3f iE k 1t it iF iElFlt iE!! 1�iE 1f IE !E iE if iE k 1ElF 1! iE it iE it iF ih if� IE ik iElf if iF iF k lFlf 3f� ik!! iF iE 1ElElEif k iEif X� 1E iFik iE dF 1F )t �f If iE iE if LEGALI2ATION;N F E E 5,U/M M A R Y STRUCTURAL SEGMENT;Y �r t.,. BLDG PMT PLUMBING ELECTR�ZC.;,N�fHAN�C- FIRE SMIP/RES GRADING PERMIT 162,00 ' .� c. :-^ 1.50 .,. ,; •- - SMIP/NON—RES PLAN 105. 30 `• ' .' � �i � ISSUE E'EE , k '>' BUILDING—DIV—> PERMIT ISSUE P�AN�CH�EC�C� "% TOTAL PAZD DUE TOTALS----> 163.50 0.00 ''., 505.30 " 268.80 268.80 ,00 t � � i �.l� REVENIIE DIVISION TOTALS--> COLLECTED� ��" 268.80 OVER/SHORT• 00 BLDG PMT PLUMBING ELECTRIC MEeHA7J�� "�FIRE SMIP/TOT GRADING PLAN—CHECK � 162 . 00 •• ,� J' �';i�: 1, 50 305. 30 k ik iE iF iF 1F!!�! 1f iE It if 3f iF �F iE if iF ik ik !f 1E if fE ff if iF it if iE if 1F it M� 1f i! ik i�,iF iFiE iF 3f 7E i(� 3f ik iFiE i! ik iF iF ik �ri� 3F if it 3E iF iF iE f4 iE iE if if !t iF �F K 1F 3F K� #�IE IE �E �1F I N D I V I D U A L� � F;� E '<B �.R E A I( D O W N TYPE QTY D E S C R I P T I 0•,�N---. �,' .�f UNIT COST TOTAL COST SFR 250 RES—RETAIN WALLS (7V$R'f,6_ FT 1'FT, 60,00 15,000,00 END-OF�•FEES .r ' 1 � � � �/ ;� . ."y. // �l /.� �. . r �!_ , /' �� CONSTRUCTION AND PLANNING-- � APPROVAIS Permit-,xr t. Temporary Elec�ncal Service or Pole 2, SOiI Pipe�Undrgrnd. 3. Efectricat Conduit Uti4ity-Undrgtnd. 4. Electrical Conduit-Undrqrnd. 5. Steel Reintorcement 6. Electrlcal UPER Gmd 7. Footings 8, Foundation 9. Water Pipe-Undrgrnd. 70. Structural Floor System 11. Property Sewer Line & House Connection 72. Sewer Cap 13. Roof Orains 14. Rough Plumbing 15. Rough Electrical-Conduit 16. Rough Electric 4"/iring 77. Rough Wiring Sign 18. Rough Electrical-T Bar Ceibng 19. Rough Heating & Air Conditioning 20. Rough Pattory Fireplace 21. Ducts, in StruaUre 22. Ducts, Ventilating 23. Gas Pipe•Rough & Test 24. Roof Framing 25. Roof Sheathing 26. T•Bar Ceiling ISvucturall & Monocoat 27. Frame and Flashing 28. Lathing & Siding 29. Insula[ion 30. Drywall Nailing 31. Plaster Brown CAat 32. Electrical Power Neter�final 33. Final Electric 34. Final Heating & Air Conditioning 35. Final Gas Pipe-Test 36. Hood or Canopy 37. Final Fac:ory Fireplace 38. Final Piumbing 39. Water Service-Final 40. Gas Service•Fina� 41. Solar pomestic•Final 42. Backfiow Preventer 43. Backflow Irrigation 44. Landscape Irripation System 45. Sound Attenuation 46. Handicap Regulations 47. FINAL STRUC7URE & BUILDING 48. FINALPLANNING 49, Electric Release to Edison 50. Gas Release to Southern California Gas 51. CERTIFICATE OF OCCUPANCY Date Date i'vJl _ oPA Inspector p�ppROVALS Permit � 52. Pool & Equipment Location 53. Steel Reinforcement 54. Forms 55. Electrical6onding 56. Rough Plumbing & Pressure Test /J 57, APPROVAL TO COVER�GUNITE � 56. Electrical Conduit•Undrgrnd. 59. Gas Pipe, O Undrgrnd., Test fi�. Backwash Lines, P-Trap, � Undrgrod. 61. APPROVALTODECK 62. Backwash & Receptor•Final 63. Heater & Vent-Final . 64. Plumbing System � Final . �� ,- 65. Electrical•Final • 66. Solar SYstem-Final - 67. Fencing & Access Approval 68. APPROVED FOR PLASTERING'i � 69. POOL/SPASYSTEPASFINAL FIRE DEPT. REQUIREMENT APPROVALS Permit # 3 u 70. Underground Hydro 77. Product Piping O Gas C Oil 72. Underground Flush 73. Undergrnd. Storage Tank � Gas ❑ Qil 74. Overhead Hydro 75. Dry Chemical 76. Dry Standpipe 77. FIXED SYSTEM FINAL 78. FIRE PREV. FINAL HEALTH DEPT. REQUIREMENT 79. FINAL INSPECTfON 80. FOOD CERTIFICATE ISSUED Notes: ? .4� �/-_ "-.--,� i w e._�t%! G �'� � Date � Inspector � ' BAUMANN EfVGINEERING c.ms�m�r� sm,aursi E�p�ers ' 68] Sen Nmlef d. � S!b 108 � IMwCvI Bsr1l Cw USA • 028fi0 Teleplqrr71VM62BBp.FA%7/�91LL�M[ 1s'{p ' A drYbn d Bauwn Re�mrtt� W M�IOpAr� Goporeiyi � . �f � � I !%t7 �E'!" a-K. �, , � 970 ,9. / /oF/ Nvr3 3I�9 /q �� ' � 1 -�b,.VIS� �c�AT1��.1 -oF I I I .. . ._ _. _ ____ __. . G.�N . - . _ . - -- a � �---- . � _.. - -_._. _._._---•---.... -- - �,��,� �� w�a. e P ro � I�wl., � �FA 6G: :G.G_..�iE113 -'.--�.C. '�t�N�l►� � �� 't2+t�E c� Ex �'��r4 . G M�I �� R�c: W J.t.�- "T►� S�E fLt�oJEO—�) � I � � ------ r i � --- . --:_ I r-' ,. �. / � / � � ��\ // / � �• � �_ , � '� I �� i , `. i ^� i, ,:: i � .'v/I� �- -� ,} �c-va 'P,C, �aatz � l�''7'�a�: .��.z s7 .�__=G — -- - . .... }, ; :�: APPRUVED ;� �a Mesa Bui��repi.�� BY _ lL.EF- • -L��1(�� -`� THE5E PLA7CSQ''"�j�--� -�",�' .,.�.4el�Tl7.1cS'..1.:`';_ NO CNANGES-P� `FTbtA--`,1�`��91y+-f�-�6�:� 7HE 155UFNCE OH 7M: :L' fA+� .{I7 O ii A'Pi�'�.•;'AT,�OF PLANSANUSPL�'r� aS�'-'�,�•/.-.,,Q"MF:4'^'70'UC'/- PER!AIT��OR. ORJ.,�,��ao{r, ti��:�� ;�� xrtv OF ,,ir:rnowsioushr. ri;cor,: - -:'s::.: ��c;ve AUifiOFITY TO y1�,y�,�j�' M� �,'C��.'�:' PtUS CODG SNALL BE Cx?:iG CTG�c^! ��t �� ..:��•.. ✓, r.:. JR USE WI IICH IT AU7HpRIZF"S I.'.IN:CFI"n. 1HE ISSUANCE Of P fF.�:f%li GAS'cG +:�'..+: `��ii A.tiU SPEQFIGATIOIJS SFAII I:OT i::�:'t:7 7: r: '- C:: i�tAl FqOf.t THERBAFTEF+ HE'vUlA:td:d :-F:: CC::?�:::'e'^::: o i.iii�AS ��: sti�o r�tins nNn �s�ec�cr;: �;;r.:: �•a � ;=;.::. : ;��veN�ir:c 6UI�DINGOPENA71GNSnF.ftYCFrFi;i� U':7r.F�i'.i�::�`fR'iA1EN kJ VIOIAT�ON OF TH!5'CCCE Gn (!: wn'i CiHE 4 G�iL:t:hNCE O� 7!1E CiTY. Pl- �tik�- ��_-q3s �' � ��\ IVI lRl l vYtU Nf � 1 2�� '�.�11 �NC'E:-::_---- � �'�7 �EQ�O �D2 I� - — �7�r►'17 �� -- r- � �� r � 1--� �) Pq0.15CTA00flE55: ']SO W 17TH ST i(WNEN'SNFME: SHEWARD, TERRY A nooness: SHEWARD, VERONICA J P O BOX 2789 NEWPORT HEACH,CA 92663 UNIT: � AflCHIENGINEEX: HANNS U, BAUMANN REC.NO.: S 1 �� aooness: 567 SAN NICHOLAS � 104 NEWPORT BEACH CA 92660 � PEflMITTEE: CANVIN ELECTRIC ( 714 ) 54%-4929 � AODflE55: 9Q1 t•.r BI$H�P ' S,A. CA 92703 UCENSEU CONTflACTON OECIAflATION: I hereby allirm ��ai I am licensetl unaer pmvisions oi Chapter 9(commencinp wii� Seciion 7000� ol �ivision ] ol I�e 9usiness antl Pmiessions CoGe. an0 my license is in fullfarce an0 el�eci. c c.: j��T9TE LIC.. 3 8 5 9 3 9 C/%�� Oate' ��/ � Signature: _ . . — _ NEBS' COMPENSATION OECLABATION: I hereby alfirm t I have a ceriificate oi wnsen� to sel4insure or a cetlificaie oi Workers' ampensation Insurance. or a certifie0 copy Ihereol �Seciion 3800. LaG. C). POLICY NO.: EXP. ORTE: COMPANY: � � Certi�ietl coDY is hereUy Iumis�e0. ❑ Cenifie0 capy is tileE with t�e ciry BuilOinA ��ion. 7ate: Appliwnt: :%EMPfIONFflOMWOXI(EXS'fAMPENSlITIONOECIAflATION: (lttissectionnreGrotDecanplelediithepermrtatatonehuntlre0�5100�orle5s�. certi�y ��at in �he Detlorman[e ol the work lor whic� I�is De�mit is issu� � employ any person in an er so as Io become I �o Ihe Workers' ComDens ion Laws ol Calibmia. at �� Signalure: NOTICE: II, a��er making I�is deciaration, you slioultl ecome suUjec� Io t�e Workers' ComOensa�ion pmvisions o� Ihe Labor Cotle. yau must torlAwith comply vnth such provisians or Nis permii shall Ee aeeme0 revoketl. ;ONSTflUCTION LENOING AGENCY: I hereGy aifirm ��a� Ihere is a conSVuc�ion 1¢ntling agency fo� �he p¢tlormance Ot Ihe wark �or xhich Ihis Oe�mi� is i:suetl (Sec�ion 3097. Civ. C). LENOEfl: A�ONESS: OWNEF BWLOEB oELUPR710N: I hereLy atlirm ihat I am eKemO� ��om ine Contracmrs' State License law for tne followin0 �eason �Section 7Q31.5 Business antl Pmlessional CoOe: Any ury al wunty wNc� repuires a Dermit �o wnstmct, alter, impmve, 4emolisR or repair any simc�we. prior lo its issuance, also rtpuires Ihe applicani lor such permi� to lile a siAneO sta�¢meni ihai he/she is Iicen5e0 pursuam �o I�e pmvisions of Ihe ConVaclors' Staie License Law IChapter 9lcommencinA ��h Section 70001 ai DiWsion 3 a1 the eusiness antl Pmlessions Code) or iha� �e/she 4 exempl iherefrom anU Ihe Uasi5lar I�e alleped eeem0�ion. My violation ol Section 7031.5 by any aD�licant lor a Dermil sublaCls Ihe aDPlicant �o a civil Denaliy o� noi more t�an live hunAreO tlollars (SSOIp. I, as owner al IAe propeny or my emplayees vnN waAes as Neir sole compensalion, will do �he work, antl �ne ❑ simcture is nm intenaetl or otieretl lor sale (Section 70aa, Business an0 Pmfessional Code: T�e Coniractars' Slale License Law tloes not apply lo an owner ot a o�openy wno OuilOs or improvEs tAerean, anU who eoes such woM himsell/herself or IhmugA �is ar �er own emD��'ees. O�ovitleG thai suc� impmvements are nol inlentletl or ollereE lor sale. II, however ihe Ouildinp or impmvemen� is so10 wil�in one year of Compleiion, ��e owner vnit have I�e burtlen o� pmvinp he/she Oi0 nol bui10 or impmve lor Ihe purpose ol sale�. I, as owner ol Ihe pmperty, am exclusively ConlraclinA wiih Iicense0 coniraclaa ta constmc� Ihe pmlect (Seclion 70d4, Business ❑ and Pmfessions Cotle: T�e Coniractors' State License Law Oces not appty to an owner ol pm0erty vrtio OmIJs ar impmves the�eon and who rontrac�s �or such projetls vn�h a Conlraciar�5) litenu pUrsuan� to I�e CAniraC�ors' Sta1e License Law). I am aware ��at pmol al �heir Worker'S Compen5aiion insurance s�oulU �e proviUetl ta me. � I am e�emp� wder Secliont B. 8 P. C. lar Ihis reason: oate: Owner. I Do nereby certily t�al I am aware of an0 un0erstana Ihe requirements oi Califamia Heallh anA Saleiy CoOe Sections 25505, 25533, an0 2553a antl t�ai 1 or any Iwure Uuilaing acupam mlWnll not (cirGe one) nee0 to compty with uiG state codes and the repuiremenis br a permitloi consimction or motlili[ation Imm t�e Pir Oualiiy Manag¢ment DiSUici. NesidentulconSVuction appli[ations ar¢ exem0� �mm �hese pmvisions. Dale: Applitani: I �ereby certily IhaU �ave reaA IhiS ap0litaiion antl S�at¢ t�al IAe aUwe inbrmaiion i5 turreci. I agree lo Camply wi�h ail ciry and tounry ordinanws antl Slalelavrs rela�inglo buidingcan5iruttion anU �ereb/aulMrize r¢pr¢5en�aMwai�NS utyto¢nter upon�he ahove-men�ione0 piopetly forinspection purpo�s]es. �le: �J�� 7 Signaiure: v �t vets �icense ar Socia� Securi�y x: % 1641�46 W�ite-6wlainq; Green—Cotle Enbrcemem; Canary—ApplicanC Pink—Revenue; GOIEenrotl—Assessor � - CITY OF COSTA MESA — BUILDING PEAMIT PERMIT NO: E OG6068 PLAN CHECK NO: N CONSTRUCTION TYPE; PERMIT TYPE: ELE JOB DESCRIPTION ; NEW SERVICE CLAIM VALUE: CALC—VALUE: PERM NO; E 066068 GOVT: N SUPP: N PURPOSE; OTH SQ FT: GROUP OCC: B-2 / COMMENTS: ONLY ELECTRICAL WORK *�r*�r+�*��r�r**�r**�+r+�*x��rt�+r*+r**�r�x�r�r�r�r��r*�*�+r**�r�r�r�e**x�***�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 BCTILDING --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN LEFT: FT IN RGHT; FT IN LEFT; FT IN RGHT: FT IN PARKING REQ: PROV: PAEiCEL: 42408117 ZNE; REF NO: PLANNING NOTES> > �r�r��+t***�r�t�t ��t�tx��rx ***�t*�r+�+�*��r�r�r�'�t:**+r+�*x *******�r�t�**+�*****�r***x *�***�r*��*x � ****� D E C� 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 HY : � DATE: APPLICATION ISSQED BY: DATE: ififiEklliElEiElEiEififlE7EiflfififiElflEjk .. . ififif1f1f1fklFiE1E 1f1f i! if aE if iE iE if iE ik if iE if if �1f iE iF it iE iE iE 1E iE iE it iE if iE ik it ik iE if iE if iE iE ik iE i(-iE M iE if iF iE it iE if i! iF f! iE it 1E if it i[� if iE if iE iE i(� if iE iE 1F-k if iE iE if aE iE k if iE ik iE LEGALI2ATION;N F E E S U M M A R Y STRUCTURAL SEGMENT:N BLDG PMT PLOMBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT 29 50 PLAN ISSUE FEE BUILDING—DIV—> TOTALS----> 'sox 15.00 PERMIT ISSUE PLAN—CHECY. TOTAL 29,50 15,00 0,00 44.50 SMIP/NON—RES PAID DUE 44.50 .00 REVENUE DIVISION TOTALS--> COLLECTED: 44.50 OVER/SHORT: ,00 HLDG PMT PLUMBING ELECTRIC MECHANIC FZRE SMIP/TOT GRADING PLAN—CHECK 44,50 �f ik i! i! it ff iflt if 1E iE 1t it ft 1f 1E 1f iE iE 1E i! �f if f! if !f!E ff !k �! 1t It iE ff �E 1E ff if �lE ik iElf fk it 1E iF �f if if it if fE fE iE iE !F if it if !E if iE 1E if if 1f 1E ik fE 7f 1k it 1E iElf if 1E 1E 1E 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 ITNIT COST TOTAL COST ELE 1 SERVICES BELOW 600 V S BELOW 201 AMP 18.50 18.50 ELE 1 SUB—PANEL 11.00 11.00 END OF FEES 01 oDiP5s48-0025.�,548 T GT 4<,5p OATE= 02/15/94 TINE: 11:16 � �i � r :.-, - CONSTftUCTION AND PLANNING % POOL .,PA � J APPROVALS Permit #� Date �_ Inspector qppROVALS Permit # Date Inspector I .� 1. Temvorary Electrical Service'or Pole 52. Pool & Equipment Location • 2. Soil Pipe�U�drgrnd. � 53. Steet Reiniorcement 3. Electrical Conduit Utility�Ur�, grnd. 54. Forms � 4. Elettrical ConduiFUntlrgrnd:'� 55. Electrical Bonding 5. Steel Re'mforcement 56. Rough Plum6ing & Pressure Test 6. Electr�cal UFER Grnd. 57. APPROVAL TO COVER•GUNITE 7. Footings 58. Electrical Conduit�Undrgrnd. 8. Foundation � 59. Gas Pipe, O Undrgrnd., Test 9. Water Pipe-Undigrnd. 60. Backwash Lines, P�Trap, � Undrgrnd. 10. Strucwral Floor SYstem '� 61. APPROVAL TO DECK 17. Property Sewer Line & Houge Connection �: 62. Backwash & Receptor•Final 12. Sewer Cap � i 63. Heater & Vent•Final - 73. Roof Drains 64. Plumbing System • Final 14. Rough Plumbing i! , 65. Elettrical�Final 75. Rough Electrical-Conduit � 66. Solar System•Final � 16. Rough Electric Wiring �� 67. Fencin9 & Access Approval 77. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Electrical�T Bar Ceiting 69. POOUSPA SYSTEPAS FINAL ( 79. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT I 20. Rough Factory Fireplace APPROVALS Permit # 21. Ducis,in St�ucture 70. Undergro�nd Hyd�o 22. Ducts, VeM�lating 77. Product Piping OGas ❑Oii 23. Gas Pipe•Rough & Test 72. Underground Flush 24. Foof Framing 73. Undergrnd. Stora9e Tank O Gas ❑ Oil `�5. Rooi Sheathing 74. Overhead Flydro �' 26. T�Bar Ceiling (S[ructuraq & Monocoat 75. Dry Chemical 37. Frame and Flashing 76. Dry Standpipe 28. Lathing & 5iding 77. FIXED SYSTEh1 FINAL 29. Insulation 78. FIflE PREV. FINAL 30. Drywall Nailing HEALTH OEPT. REQUIREMENT 31. P�aster Brown Coat 79. FiNAL INSPECTION 32. Electnca� Power Meter�Final _� 80. FOOD CERTIFICATE I$SUED 33. Final Eleciric � �� Notes: 34. Final Heating & Air Conditioning 35. Final Gas PiPe•Test . 36. Hood or Canopy 37. Final Facto�Y F�replace � ; 38. Final Piumbing 39. Wa[er Serviae�Final 40. Gas Service�Final � 41. Solar pomestioFinal �- 42. Backflow Preventer �"� 43. Backflow Irrigation - 44. Landscape Irripation System 45. Sound Attenuation • 46. Handicap Regulations ; ' 47. FINAL STFUCTURE & BUILDING � 46. FINAL PIANNING - 49. Electric Release to Edison 50. Gas Release to Southern California Gas Cn 51. CERTIFICATE OF OCCUPANCY - No. Date CANVIN ELECTRIC z-2� 941 W. Bishop • Santa Ana, CA 92703 •(714) 547•4924 y'��,�a�„ �'�l ��. ..� p �wu�JO -.��iNO(J+i _.�-�-- 2��o Amp �'L �g TN/N�✓CL�-a � i z��,� — !?-G�7./U ✓o �' Sw3 r'��eL�"� Mq,n/ C,U G onll/ r .; a � ' `t (Lic. No. 385439) 2DOAm��3o,-rW�,�,' �'Hd►� �c�w�� 1er��zs'�n�i�k ;200� {vs�� _ yy�,�i C �itTriJ6 2 00 ��rnP ''�✓Q� y tJ� R r Sw3 �Au1BL � � /)'IA�nJ LVG ONLY , ��',Z �rl-I�+nl CU. Z,� �;,�nu� � S�3�aKet2 �2r s rac� Arr�p �v�I a0J< T�a<Tu.+� c�� /oTT']'F{h1 C'(J. Z��C'On/D(I f L �00 Am J�+�� S'� �R�L-�8 3�yw,a� ' $ ritq�nl LU6o�� . � Jv� �7��zess �'7. °S� cJ / %�h � �s; � /ilcs� �'A _ v�Ji � #�' � �C�i� i �� PPPIECTAOUflE55: 7SO W 1%T]'i JCT OWNEN'S NRME: SHEWARD, TERRY A noonEss:SHEWARD, VERONICA J P O BOX 2�89 NEWPORT B$ACH,CA 92663 ANLN/ENGINEEN: RODPE55: NEG.NO.: UNIT: UNIT: PEflMITTEE: FIRE STOP ( 714 ) 569-0016 aooxess: 1253 S, WRIGHT 0 SANTA ANA CA 92705 UCENSEO CONTPFCTOB OECLAflATION: I here�y alfirm Iha� I am licensetl under provisions o� C�aD�er 9(commencing with Sec�ion 7000) ol Orvision 3 0l ��e Business an0 Pmlessions Cotle. antl my license is in WII lorce and ef�ec�. cirv u/c.:042116 srare uc.g01419 S— 6 Dale: .{y ` 9'� Signamre: — _ ^'�j /�� — - WOHNEPS' COMPENSATION DECLABRTION: I pereUy aliirm IIWI I �ave a cetlilicaie ai COnseni lo Seli-i� ce�i�itaie o� Worker5' Campensation Insurance. or a cenified coDY �nereaf (�ction 3800, LaG. CI. voucrxo.:NWC18264301 EXP.ORTE:OS�SS�94 comraxr:GOLDEN EAGLE ❑ Certiliea coOY is �ere6y Iumis�e0. � C¢rtiliea coDY �s IileU vnlh t�e ciry BuilUing �ihsion. / Oaie: O �' `�� Applicant: � �(/ �r V -- E%EMPTION fBOM WOBKEPS' COMPENSATION UEC�ppAT10N: (ihis section need no16e comple�eU if Ihe p¢rmit is �or One hunOreO (5100) or less�. I cerlity ��at in �he perlormance ol lhe work �or which Ihis permil is issued. I shall not employ any Derson in any manner so as �o �ecome sublecl lo Ihe Workers' Compensation Laws of Calilomia. Date'. Signamre: NOTILE: II, a�ter makinp Ihis declaraiioq you shoul0 become suUlecl b �he Workers' Compensation pwvisions o� Ihe Labor Cotle, you must forthwilA comply with sucp Drovisions or Ihis Oermi� shall he tleemetl revoke0, CONSTPUCTION LENUING RGENCV: I hereby allirm �hat �here is a coretmc�ion IenAing agency lor �he perlormance ol I�e work lor which ihis Oermi� is issued �Seciion 3097. Civ. C�. IENOEN: ADUflE55: OWNEP 9UILOFfl DECIABRTION: I hereby ai�irm I�al I am exempt Imm Ihe Caniractars' Siate License Law for �he followinp reasan (Setlion 7Q31.5 Busine55 an0 Pmte55ional CoOe: Any ti�y of counly w�ith repuires a Dermi� to cOnSimt�. all¢r. impmve. Oemolis�, ar reDair any Slmclure, prior lo ils issuance. also t¢puires I�e appliwni lor such p¢rmii Io file a 5igneE 5lalemeni �twt he/s�e i5licen5e0 pursuam io Ine Omvisions ol t�e Contracmrs SId1e Litense Law �Cnap�er 9(wmmencing m�� Seciian 7000) ol Divivon 3 0l t�e Business an0 P�ole55ions Catle) or Ihal he/s�e is ecem0� �herelmm anG t�e Dasis for �he allege0 eKemption. My vialalion ol 5¢[Iion 703L5 by any apP�icani br a permil 5ubjeci5 ihe aOPlicapi to a civil penally oi not more lhan live huntlreG 4oilars (5500). I. as owner ol Ihe pmpetly or my employees with waAes as �heir sole compensaiion, will Oo ihe work, antl the � slmclure is not inlenaetl or offered lor sale (Sec�ion 70aa, Business antl Pmfessional Cotle: The Coniractors' State License Law does no� appty to an owner ot a propeqy w�o builtls or impmves Ihereon, and who tloes such wofk himsell/�ersell of throuph his or �er awn employees. providetl ��al suc� improvement5 are noi intenaeA or offeretl �or 5ale. II, howev¢r IM1e Ouiltling or impmvement is sold wilhin one year ol [ompleiion, Ihe owner will have ��e GurAen ol pwvinp �e/5Ae Oid nol GuilA or impmve , lor Ihe purpose ol salel. I, as owner ol the pmpeM1y, am eeclusiv¢Iy comracting wilh licensetl con�ractors m cons�mcl lhe pmlecl (Sec�ion 7094, Business ❑ antl Prolessions COCe: The Comracmrs' g�ale License Law tloes no� apply to an owner o� D�openy w�o huilAs or impmves thereon an0 w�0 mniratis br 5ut� pmjeCis with a tonVa[IoqS�litense pursuan� 10 Ihe ConiraCtOrs' Staie Lic¢nse Law�.l am aware inat 0�� ol ineir Worker's Comp¢nsa�ion insurance s�ould Ee pmvi4e0 la me. � I am eKemD� under Section: B. 8 P. C. lar Inis ieason: �a�e'. Ownec I Ua �ereoy cenily i�ai 1 am aware of and unUerstanA ihe reQuiremems af Caiibmia HealtA an0 Safery CoGe Seciions 25505. 25533, and 2553C and Ihal I or any lulw¢ �uilding occupanl will/will not (circle one) neea �o comply wit� saiG Slale coUes an0 ihe repuiremen�s br a peimi� loi consimc�ion or mo4ilicaiion imm NP Nir �uabty ManaAement �is�ricl. Resi4eniial consimclion apDlica�ions are eremD� ��om IhPSC pf�vi5i0ni �ate: ADD�icant: I �er¢Ey certily�hal I �avereatlt�is apPlication antl 5lalelAal Ihe a�ov¢inlorma�ion is correcL lagr¢e�o comply vnl� allci�y antl counry ardinancesanastalelawsrelalinglobuiltlingcan5imctionanUhere6yau��or¢ereD�esenia�iveso��hisdxt IoenleruD heabOve�menlione0 prOperry ior inSpCClion purposes. // �ate'. � —� — � SignaWre:��i ' oriver's Licenu oi Sociai Seaii�y e: 164t-a6 W�ne—Builtling; Graen—Gade EnlorcemenL Canary—Appliw^C Pink—Fevenue: GolOenroG—qssassar CITY OF COSTA MESA — BUILDING PEAMIT PERMIT NO: F 062427 PLAN CHECK NO; 01570-93 S CONSTRUCTION TYPE: PERMIT TYPE: FIR PERM NO: F 062427 GOVT; N SUPP: N PURPOSE: OTH JOB DESCRIPTION ; BACRFLOW RETROfiIT SQ FT; CLAIM VALUE: 5,600,00 CALC—VALUE: GROUP OCC: / COMMENTS: THE "PARAWAY GROUP" *****�+�***�r�r*****��r*******�rx��rr *x�*+�*****+r*****�r�r**�r***x *� ***x *�r�r�r�r**�r�*�r*� *�e�x *�r � Z O N I N G R E g D I R E M E N T S S E T H A C K S ------------ MAIN BUILDING ---------- --------- ACCESSORY BUILDZNG --------- FRNT: FT IN REAR: FT IN FRNT; FT IN REAR; FT IN LEFT; FT IN RGHT; FT IN LEFT; FT IN RGHT; FT IN PARRING REQ• PROV: PARCEL; 13965201 ZNE; REF NO; PLANNING NiSTES> i �e*■******+��e■■�e********�r*«.,r�r�rr�r,e�e+r*********r�e***�r**�r*�r�r***�r*�r*�r*�r*«�*�r�e*�r�***** D E V E L O P M E N T S$ R V I C E 5 R E Q U I R E M E N T S ��ZONING APPROVED BY DATE; BUILDING APPROVED BY APPLICATION ISSUED H DATE; S ifkitifititMlflkMMkiFiFMifMif ikMkMlf�flfMkkkikitklflFMiFikiFMkkiFififkRilkftltklfiFiF3kiFkkitkikkikklfitif�kif 1Fk�FiEikiFiFiFltiF LEGALIZATION:N F E 6 S U M M A R Y STRUCTURAL SEGMENT;N HLDG PMT PLUNBING ELECTRIC MECHANIC FIRE SMIP/RES GRADING PERMIT B1552 SMZP/NON—RES ISSUE FEE 52.65 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECX TOTAL PAID DUE TOTALS----> 81,00 0.00 52.65 133,65 133.65 .00 REVfiNUE DIVISION TOTALS--> COLLECTED; 81.00 OVER/SHORT• 00 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 81.00 1tMitltltif if iFif iFiF 1kIkM 1f iElk 1Fk k iflkk 1E il� il� If Ik1f M 1kIk1F#f ikiFiFlkM IklElf �1F1k1f if iflf ik 1f k 1f iF1F if IFikkiklElf 3f 1Eit 1tiFif iE1E 1E1klF iEiE iF�IF1! if �Ik I N D I V I D U A L F E E B A 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 81 FIRE EQUIP FEE (FROM BLDG VAL TABLE) 1,00 81,00 END OF FEBS t D1 0014D249-0�140249 T G T OATE: Ob/02/93 iIME: 10:33 31.OD / CONSTRUCTION AND PLANNING POOL _ cPA APPROVALS Permit¢p Date Inspector qppROVALS Permit;b Date lnspector � 1. Temporary Elettrical ServiYe or Po:g,- ', 52. Pool & Equipment Locat�on ,• ' 2�,rci�Pipe-Undr�nd. ;; � . 53. Steel Reinforcement � '- � ti�;JYical Cond.:i Ut:htY�Und�'gmdi'�s � 54. Forms _ " � �t�C�rical Cond�.i.rt-Undrgrnd. �,� 55. Electrical Bondmg ��r Steel Reinforce�e�t � v�= < 56. Rough Ptumbing & Pressure Test a "8-,�1"C�rical UFER $md. c 5J. APPROVAL TO COVER-GUNITE i- n,.�- - ��. �.,�ooFjngs - �� 58. Electncai ConduirUndrgrnd. � ' E' 8' foJn,dation ' 59. Gas Rpe, O Undrgrnd., Test � o. � 9. ater Pipe�Undrgmd. !' ' 6p. Backwash Line;, RTrap, �1 Ur.drgrnd. � 10. Struitural Floor System ' - ' 61. APPROVAI TO DECK ! 11. Pro�erry Sewer Lirte & House nrie,ction 62. Backr:ash & RrceptcrFnal ' 12. Sew�r CaP _ . ., / ' 63. Heater & Vent•Finai '. I 13. Roof Orains � '� 64. Piumbing SYstem � Flnal � 14. Rough Plumbi;ag ' � 65. Electrical�Final - � --t 15. Rough Electricat-Condu�t .,' 66. Solar SYstem-Final %, ' � 76. Rough Electric_Wiring % � 67. Fencing & Access Approwl y 1 _a 17. Rough Wiring Sign ;'; 68. APPROVED FOR PLASTERING � 18. Rough Electrical�T Bar Ceilir.� 69. POOL/SPA SYSTEMS FINAL � J! 19 �Rc�qh Heati�g & Ai� Conditioring K r � _, �FI�rQ,�F�T. �QUIREMEN� � � 20T o h tt0u1' �+v lace '�"�'mT'. G�' r u-�"'` ,4PPR�V�,$;,y`-'F.pefs�it,��;� .c� '� � � S. x�G S sx ,. . rS . �=-�-3¢ - � ��3 21.-0uCts, i nStrBctW'L=� ' •• •• `-+y � S � - % � =70. tfidergiven�i Hy'�ro " ' 22.yn uds, 'nY ti � . : S � , ��'� =77. Pr T � �' s � �`i � ^.4: - C'J < � � f. -.: > oduc€:�rpi�9 :3'�+jis �i7�1 , 23.�6a..-Pipe�iotuah&T:est i :7S ?:7 a K Ox« 72. Undergroi�tlFimr ' = i • ,_„ � .. > 7 (o�Y�i3 tu.ijJ_, 24�'�ioo'. fr min'g' �r ;` � �'�' "F' ` � G �' "' ,73rUnder m0 Stor'-�T:.nk � Gas :� 0�1 , i'1 •,c 7 ,�M x 9 ,'`��._ . �--:"T . - � 25. Roo` SFr�thing -.* K v� r� i7 ? i= � 7q{;pverhead Nydro�� " � _ •. � ^ ' �s 26: °f��y Ceilin (Stt�c`turail & � Ocoat " `'fl t'' �`��' ` C " �" ' � �� v 9 �S �" r C r x �5gDry ChemJcal . ., _ 27�ramey�l F{�shia,g.. �xx x 7 �- S�. � 76. Dry StanC�Sipe 'J�> � � t+� � l> F - ' !-28PLathing� S13i^9':'� p�r � x� ..* x 77ry FIXED �'el'Ef��INAL,� �'� �� I : .� -"1 ;29. Insulaticn _� :r. <'- ^> .... r� . x * 78EFIRE PREV. FINfi.i y > ''' .,: I�' L'�� ..__ ., �'30. Dryvrall-�dai(ing �.' � ;t:_ ''' s �tEALTF-�3JEPT'xR'EQQIRF,.fviENT .,, = : i -1e u �: -:�-� � �31. Plaster gro�vrtCoat: S � T�:T A I I� ��^79. PINAL if'�S€ECTtG.N a� J r I , - ic ^� - --� - -', -32. �Electnc�Porver Nete:�Eznal� � �'� •" ` ^� `$0�`FOOD CERTIFf�b'i'E IS��IED,_„ T � � � _ - . , i � < .� , . _ '�- a >33.�-�iRi� El'occr�a . �- i q . �-` w� Ncttes: - � r, t:.. CC7 �3---Fr i--'F, `. ._ , . ... .. .c_ - . .. : -T.0 � „ �[ _ -� � 4�ina7 HeaUn�& Air'Conditidrui,y5 �� %,� ' � � . � - � �s ' S i ,.. - ,- r �} -� i( x Y y 35f-Fin31 Gas Pipe-Test.; �z � : r., <;� � �„i. � - � ,_�= -1 ` .. . _..c�t---.-.�C=-='i-=n--- --� -'�36 � Hodd or Canopy " = � C*' -' �+ �* tl � k � _ � : vc �•: � '" . a � � , 1 r w -: •' n] x . ,. .� >!- rr 1 ' 1 _I.'� 't__� ., _„_ _ ' i �7.`.�inal Factory Fvepjace� � �-" -c �+ �K .-+: y < ':a� - : - . • :y_ . . .. � -' . -- - I ^�8:�inJ1 Plumbing ' ti i �% � .' � s •-�� fi� - -I .r � o .. mx �-s Q�-� K .� V 'A' �' y\��• r-39;}Vater Service-Fina(. .: � <, �_ !, x � � - I ,�AO.'Gas Service-Final •. •� Si*'C- n � [. ; � L�: ?? % � '� j ;- ., k Ct -. x � - 1 ��1.�Solai Domestio-Fin�l ' tt . � m� -,� - - , _ .� , h2. Backflow Preventer '� < � � Z •'� • %'- " � ,. � - r'7�- .c <x ^C.-2 T.0 r - __� x S .S 1 .. " _ � 43. Backflow Irr�ation` ,_ M,r , x • y�� i' _ � ^ - . . ,y ._ � � �. . ??�4. Landscape Irfigatian SvsterfoCq,7 x � ?7 = C Js.c x. :v ;L �- �tC.' • '' _� .LLL.` 4.• < --� - -n :� �. � t < ,r S �.- n z ic S - z i-� lr �y: � F-+ ;. _�c 7c i - r �J �. < ?45�ound @tte'rqiacior� ... x TJ t*7 cn;_, � � " � • -� * _ J �6 �Handicap Regulatio�s y Q w t 4�- n;� �-'� ,� � '� �.47.�'IN�L STRUCTUf�E & 6UILDING r._ � 1 '"�-- ro;' ' r r I � 48.fINY+�L PLANNING �:'�' x t " � T N S K ' ��49r�levKric ReleSse to �Edison i x � : x � ^ s " „ � x .r. , i50 �S.�as Nelease to Southern Cali4orrtia Gas Co * � - -•�.a " • 31. CEfLTIPICATEOFaCCUPANCY ' �' ' t=• �� .� " .- �- No. Date �, PROJ��T ROOflESS: 7 S O W 1 7 TH ST OWNEfl'S NRME: TERRY SHEWARD aooxess: p0 5'78y NB CA 98663 pflLH1ENGINEEX: RDOXESS: flEG.NO.: u"�T CITY OF COSTA MESA — BUILDING PERMIT PERMIT NO; P 051190 PLAN CHECK NO; N CONSTRUCTION TYPE: PERMZT TYPE; PLU � JOH DESCRTPTION ; REPLACE P—TRAP ON FLOOR SINK UNIT: CLAIM VALUE: CALC—VALUE: PEflMITTEE:- THE EARLS PI.OMBING ( 714 ) 772-3470 � aooness: 1533 W, I.INCOLN ' ANANHEIM CA 92801 LICENSEO LONTIIALTOP OECIABATION: I �eteby aliirm �tut 1 am lic¢nseG unCer ➢�avi5ian5 0l Cnapler 9{commencinp wi�h Secilon 7000) al Divison J oi In! B�meu anC PmIt55ian5 Cotle, anA rtry Ikenu i5 in Iu0 farGe and Bl�ecl. ' , cirruc.:005938 STpTEIIC.:Z176S'� ��III��/ cu��,ss: 36 �ne: �/ SipnaN�e: _i3�� i . /OPREHS' COMPE SATION OEClANl1710N: I �ereGyalfirm th � ave a mhcale at consent to sel4insure or a cenificate of Workers !ComOensali�n Insurance. or a ceridletl Copy Iher¢Ol �Section Lae. I, voucr xo.: U 4 8 4 0 EXP. �RTE: O 3� O 1 91 � caMraxv: BEAVER ❑ Certifietl copy is hereUy lumis�ed. � CendieU capy is fileG vni� ItR dty uJOing UviSian. Daie; Applicanl: E%EMPTIONFflOMW NREPS'COMPENSATIONOECIAPRTION: Ipnn iro��ecompletCdiflhepermiti5foronehun4reA�5100�o�1es5�. I tenify ihat in Ine pedormance of ihe work lor whicn tAis pe� . is issuea, I SAall not employ any per5on in any manner so as to hecome sublec� to the Worker4' Compensalion Laws o1 Califomia. Oaie; Siqnature: NOi1LE; II, alter ma4ing iNs Oeclatati0n, you S�oNC 0¢Came su0j¢Ct to ��e Workers' CAmpMtation pmvKions al I�e LaE4r Cade. you musl foMwil� camply vnih suc� D�a��ons or iNs D¢rmii Slull Oe Geemetl revoke0. CONSTPULTION LENOING pGENLY: 1 �ereEy allirm t�at t�ere is a co�atruction IenOmg apemy br tAe perlormarke of I�e work for wAic� Ihis permit is issueG (Seciion 3097. Civ. C�. j LENDEP: ROOHESS: ' OWNEB BIIILOEB OECUBRTION: I �ereEy alii�m �hat I am exempt Imm I�e Comractors' State Li¢nse Law lor ihe followinp reason �Se¢tion 70.3t.5 Business anG Prolessional CoOe: Any tiry ol wunty w�� repuires a permit to canSWct. alter, imprave. Cemolish, or �¢pdif dny S�Ntiuf¢. pti01 10 i15 �SSudntl, aL50 flQuifCS IA¢ dpDliCdni 10� SUC11 pBflNi b iil8 d Sipn¢� SIdiERI¢flt IIWI IIPJSAB i5 IiC¢nSEtl pmguanl lo I�e pmvisian5 0l l�e Lomranori Siate License Law �Chapter 9(mmmencing wit� Section 7000) of Oivision 3 of i�e Business anG p�ofessions Ca7e1 or tha� hUs�e is eKempt t�erelmm anOl�e Gas�s for Ne alteAeO exem0�ion. Rny viaWtion ol Sectian 7031.5 6y anY aDPlicant lor a Dermil su�jems ihe a071icant to a ciWl penaliy oi nol moa ihan live �unAreO Oollars (SSW). I, as owner ol Ihe property or my em loyees vnth waAes as t�eir sale comDenuiion, will Oo t�e wark, and t�e I❑ SimcWre is nat imendetl or o�hreE for sale (�ctwn 70a4. Business �n0 Professimal C,�e: IDe Caniractars' State License Law Goes noi aD�W lo an awner ol a D�aDeny wtp Ovil05 ar im0��'es ��ereon, anG who does suc� work himseli/hersell or ihmu0h N5 ar h¢r Ovm emplayees. pmvitle0 IMI 5ut� imprOVEmen6 2r¢ tql inlenG¢E or olfere0 �Ot sale. II, Mwevet I�e buildinq Of impmvemenl is solE witAin one yEar ot cam0�elion, t�e Mmer wi0 hdve t�e OurGen of Dmvinp �PJs�e UiE nol UuilU or impmve lor ine purpose af v�e). I, as owner ol ine prooeny. am e[clusively coniractin0 ��h Iicense0 coniractors to consimcl Ine pmiect (Seclion 7Ma, Business ❑ antlPmtessionsCoae: T�eComractars'�SiaieLicenuLawtloesnotaOPlymanwmerolOroperty wTOCuildsorimpmves�hereon antl w�o taniratls �or suth pr01eci5 wi�� a contrdctor(s�licen5e pur5uani�o Ihe ConVattors' Siate License Law�. i am aware I�al pmol ol I�eir Worket'S ComDenuti0n iniurante SAoulO Oe Orovi0e0 IO me. � I am erempi utbe+ Settion: B. 8 P_ C. lor mis reawn: Oaie: O+mer. I tl0 nereby cendy Inat I am awaB ol ane unaerslantl tne reQuiremenis al Califomia Healih ana Salety fAee Sections 25505, 25533, antl 25574 and Inat I or any future huiltlmg occu0ant willlwitl nol (circle one) neetl lo wmply wilh sai0 slale cotles antl the reQuiremenls tor a permil lar conslmclion or mo0ilication.imm ��e Air Ouahty ManaBemem Oislricl. flesidential canslmction appficaiion5 are exempt (mm Ihese pmvisions, Dale: Applicanl: I hQ�¢py �eilAy I�atl Aav¢ ieaDihiS applita�i0n antl Slal¢�Aali�e aGWein�Ormaiionis COrr¢Ci.lapr¢¢Ia tOmply wi1M1 alltiiy an0 Caun�y orpuWncw and state laws reUtinq to euiWing ronstmclnn arq nereUy autMr¢e reD�esenu ¢5 ot �lus d�y to enter upOn Ine abOve�mentioned prOperly lor inspeclian DurOoses. - Da�¢: ��(2[ q� Signat e: � � I on�er s ucense a� Sociai secmny »: i646a6 Whne—Buibvg: Geeen—COEe Enio¢emenl Canarv—/OD��CanC Pinh—Fevenue: Goltlenro0—Assessor PERM NO: P 05119 GOVT: N SUPP: N PI7RPOSfi: OTH SQ FT: GROUP OCC: B-2 / COMMENTS; REPLACE P—TRAP IN FLOOR SINK �t�t�t�*�r**�tx�* ��t�t***�*�t�t+�*�t�r**�e***�e�t**�t�***��*�e+e�r**+�*�e* �*�t**+r«��*�e�r+� ��x�+��**� *+�**�* Z O N I N G R E Q IJ 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 IN RGHT; FT IN PARKING REQ• PROV: PARCEL: 00000000 ZNE: REF NO; PLANNING NiSTES> � " . iE %� k if If iE iF aE iF k if iE ik iE k if iF if 1F i� iF iE If iE Ik IF iF If � iF iE iE if iF IF iF iF 1F iF i! )f if 1FiF 3F iF iE iE iFif iE 1F if iF 1E iE if ±E iE iE i!� )f if iE iE If if 1E 3f iF aE iF 1E i� aE a4 if if 1E 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 DATE; BUILDING APPROVED BY.: _ DATE; APPLICATION ISSUED BY; DATE; GZz � 3EiklfltkjtiFififjf)EififiEiFiEihkiFiElfiE��iF£iiif �'iFiF'��F�flEif{F*kiEih�ik i4 itiflEififdfiE7f4�f1EfFjEifiEiEiPNiFiFiE�fiEiElfiEiFififiF�ltIFlEiEiEiEiflFlfifkiFifM iEiF#iElfifiF�IFiFibiFifiEiFiE1EM�1EikIflElFiE�ElFiE1i��EiE�fiElE1F LEGALI2ATION;N F E E S U A R Y STRUCTURAL SEGMENT;N PERMIT HLDG PMT PLUMBIoo ELECTRI MECHANIC FIRE SMIP/RES GRADING ' '15Y SMIP/NON—RES PLAN ISSUE FEE 3.00 BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID DUE TOTALS----> 2.00 3.00 0,00 5,00 5.00 ,00 REVENUE DIVISION TOTALS--> COLLECTED: 5.00 OVER/SHORT; 00 BLDG PMT PLUMBINC- ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN—CHECK 5,�� ik iF k 3t M jf� if iF if if if ik 1E M 1f IF if if iF if if iE IE af lE if �f lE k 1F 3E iE If 1F if iE N� iE iFif it ik iE iE 9F iF If 1f iE if iF iE fE if �E If k iE iF iE iF iE IF 1E iE 1!� if iE !F k iE if i! 7t if 141� if 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 PLU 1 c D E S C R I P T I O N FLOOR DRAINS END OF FEES UNIT COST 2.00 TOTAL COS'C 2.00 O100031v.ifi—OCO'Si530 T�'C:T ' S.G: OArE: R?!?7I92 TT17E: i�i�0 CONSTRUCTION AND PLAiv�.,iJG 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 Utiliry-Undrgmd. 54. Forms 4. EleCtrical Condui[-Undrgrnd. 55. Electrical Bonding - 5. �Steel Reinforcement 56. Rough Plumbing & Pressure Test 6. Electriwl 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 j�` � 61. APPROVAL TO OECK 71. Property Sewer Line & House Connection 62. Backwash & Receptor�Final 12. Sewer Cap 2 63. Heater & Vent-Final ' 73. RoOf Drains 64. Plumbing System - Final 14. Rough Plumbing 65. Electrical-Final 15. Rough Electriwl-Conduit 66. Solar System-Final i 6. Rough Elettric Wiring 67. Fencing & Access ApProval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 78. Rough Elearical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT - S. 20.�Rough Factocy Fifeplace ; • � a �APPROVALS"' _Permit # , 21.� Ducts, in Structuce � , , '' � ' , - - _ � . � � 170. Underground Hydro 22. Ducts, Ventilating � . �+ 71. Produc('Piping O�Gas ❑ Oil 23.;Gas P�Pe'Rough & Tesc ' � . = � ' .72, Underground Flush _ 24. Roof Framing ', -� � � � - 73.• Undergrnd. Slorage�Tank O Gas ❑ Oil - 25. Roof Sheathing N, ' ' �74: Overhead Hydro • . 26.�T-89r Ceiling (Strucwral) & Monocoat � a� . 75..:Dry Chemical - � ' . 27. Frame and Flashin9 1 .. � 76. Dry Standpipe �� ; � - .28.� Lathing & Siding'r - -. � � , . � � 77.: FIXED SYSTEM'FINAL� 0 29. Insulation - � " " ' � � ' 78; FIRE PREV. FINAL . �30. Drywall�Nailing ,-'� 7 �'� • �� • HEALTHDEPT.REQUIREMENT 31. Plaster Brown Coat ' - " 79. FINAL`INSPECTION - 32. Electrical Power MeterFinal' � �. .:80..FOOD CERTIFICATE ISSUED 33. FinalElectric _ � � " ' . `�,yi� 'Notes: � - ; ; - `34. Fin01 Heating & Air Conditioning� - ' � �, �; �i. � _ „ ' , ', 35..Fintl Gas Pipe-Test' + :Y�� / �_ ` , ' �36. Hoad or�CanoPY , - ' . ' Il:!'. "/,• _ .., . _ 37._Final Factory Fireplace �' •- � ' I � "' '� .� c -38. Final Plumbing �, - . .- _. 3,�( /�( (��jrjf' • ' . '39. Wat¢� Service-Final � _ " � �^ - .40. Gas Service-Final ' , � 1 �� -� - I. • �41. Solar pomesticFinal -, - � •� � � � .f - �'. 'F 42.'BackflowPreventer; - � �'.; i. , �; . 43. Batkflow Irrigation �^ - ' ' - . � .. �44. Landscape IYripation System ' � � ,�� . . • . -' .A5._Sound Attenuation r • . .. � , � 46 Handicap Regalations � - '� � ' . . • ' . �47: FINAL STRUCTURE & BUILDING � . • � . � 48. FINALPLANNING : '� � ' , 49.` Electric Release to Edison . 50. Gas-Release to Southem California Gas Co ' � �` � ' - � � • . i /- - _51. CERTIFICATE OF OCCUPANCY �" � ' No Date Pfl0.1ECT.400BE$$: %SO C,7 �.%TH ST .. yOWNEfl�SNAME: SHGWARD,�TERRY A aooeess: gHEWARD, VERONICA J P O BOX 2786 NEWPORT BEACH,CA 92663 PflCN/ENGINEEfl: FDONESS: PEG,NO.: UNIT: UNIT: PEflMITTEE: O, C, FLAG AND BANNER ( 714 ) 777-7777 nooness: 10].27. ACCACIA GARDEN GAOVE CA 92705 LICENSEO CONTBACTOP DECLRPFTION: I he.re�y aliirm Ihat I am licensed unGer pmvisions of ChaV�er 9(cammencing with Section 7000� o� DiviSion 3 0l the Business antl Pm�essions Cotle, an0 my license is in lull brce antl efleti. ciTruc.:03A1979 srnreuc.:446585 uss: —61 � Date: �� 8' � f Signamre: __ _ _—�� WOflNEPS' COMPENSATION OECIAflRTION: I �ere�y alfirm t have enificate ol consem m selbinsure or a tertilicate oi Warkers' � fpmpensation Insurance. or a certilietl copy �hereaf (Section 0. La . �. 7LICY NO.: E% OATE. ' COMPANY: �] Cetliiietl COOY is hereby lumis�etl. ❑ CenifieU copy is litetl wit� the city BuilOing �idsion. I � I Dale: F071icant: EXEMPTIONFROMWOflNEflS'LOMPENSRTIONOELUflATION: (T�issetlionneeAnolbecompleteaill�epermilisloronehunOreC(5100�Orless). 1 cetlily I�at in Ihe p¢dormanre ol Ihe work tor wAic� Ihis Oermit i5 i . I shall noi employ ny Derson in any manner w 3510 OCcome Su�lecl �o t�e Workers' Compensation Laws oi Calibmia. � Daie: _j=l� � S� Signaw�e: - NOTICE: II. afler making ihis tleclaralion, you snoultl becom u e to e orkers' Compensation provisions ol tne Lahor Cotle. y0u musl lort�with comDty vrith suc� provi5ions or �N5 rmi� sh I a¢eme0 revake0. CONSTPUCTIDN LENOING AGENCY: I �ereby allirm Ihat Ihere i a con5du ,io IenOing agency tor ��e pe�ormance o� Ihe work �or wnich ihis permit is issue0 (Sec�ion 3097. Civ. CI. � LENOEX: AOOflESS: OWNEB BWLOEB OECLAMTION: I hereEy aflirm itui I am exempt Imm tAe Comractors' State License Law for the followinq reason (Section 7031.5 Business antl.Pmlessionat CoOe: Nny city oi coumy which reQuires a permit to consimct, alter, impmve, Aemolish, or r¢pair any SlmtWre. prior �0 ils issuante. a15o r¢quires ��e applitanl �Or Suth Dermii lo �ile a SigneG Slalemenl �Aai �e/S�e is liC¢n5e0 pursuant to Ihe Drovisions ol ��e Coniracrors' Sia�e License Law (Chapler 9(commencine wilh Sec�ion 7000) o� Division 3 0� Ihe Business an0 Pmlessions Cotle) or Ihat he/s�e is eKempt Iherefmm antl Ihe �asis lor the alleAed exemption. Any violation of Seclion 7031.5 Gy any applitdnl Ior a permit su�lecis ine apvlicant lo a civil oanalry ol nal more Inan live hunered dolla6 (5500�. I, as owner af tne pmDeny ar my emplayees vnih waAes as their mle compensation, will tlo ine wark, antl ihe � simdure is no� inten0ea or ollere0 tor sale (Seciion 7044, Business and Pmiessional Cotle: The Convactors' State License Law , tloes no� apply to an owner ol a D�opetly who bmlds or impmves ihereon, and who Ooes such work himsel�/hersel� or IAmugA his or Aer own employees. O�oviUeO ihat such impmvements are not intendetl.or oifered for sale. II, �owever the building or improvemenl is soltl wiihin one year o� completion, �h¢ owner will have ��e burtlen o� pmvinA he/s�e tlitl not builtl ar impmve lor tAe pur0ose ol sale). I, as owner o1 ine vmpeny, am excrosPoelp Conlrat�ing wilh lic¢nsed cOnlraClorS io wnslmtl Ihe pmletl (SeClion 7044, Business ❑ an0 PrO�ession5 Code: The Conlrat�ors' Sla�e Litense Law tice5 n0i apply Io an awn¢roi pmpeM who �mlJs or imDmves lher¢on antl who conirat�s �or Suth pmjet�s wilh a coniradOr(5) litense pursuan� Io Ihe Conflat�ors' Slate LicenSe Law), I am awaf¢ Ihai pmo� ol Iheir Worker'S Compensation insurance 5�oulU be Omvitled �o me. � I am eaempt untler Section: B. 8 P. C. �.. lor I�is �eason: Dale'. Ownec I tlo hereby cetlify Ihat I am aware ol an0 underslana �he requiremenls of Cali�omia Heal�h and Safery CoOe Sec�ions 25505, 25533, ana 2553G and Ihat I or any lulure �uilaing occupanl will/will not (circle one) neea to comply wilh saitl state coEes and ihe requirtmenls lar a permit lo� cons�mc�ion or modilicalion �mm I�e Air Ovaliiy Managemen� OiStrict. flesiUeniial conslmciion aOPlicatians are exempi �mm t�ese pmvisions. �ate'. Applicanl'. I h¢i¢by t¢tliiy I�ai I luve rea0 I�iS appliCaliOn and Slaie ��at I�e a0ove intOrma(ion i5 wrrecL I agree IO comOty wilA all City an0 Coun�y ortlinancesanaslalelawsrela�ing�o�uiltlingconslmctionanOhereby Whonzerepre5en�ali�esofthisciryroen�eru0onlheabove�menlionetl DmDerly loi inspection purposes. Oale: '�.I Signalur¢: � oriver's ucense or socia� securi�y a: � �6ALafi W�na—Builtling; Green—Cotle Enlorcemenl: Canarv—Applican�; Pink—Revenue: GOltlonroG—Assessor CITY OF COSTA MESA - HUILDZNG PcRMIT PERN� NO; B 05072 PERMIT NO: B 050724 PLAN CHECK N0: 00315-91 S GOVT: N SUPP: N CONSTRUCTION TYPE: PERMIT TYPE: STR FURFOSE: OTH JOB DESCRIPTION ; FLAG POLE SQ FT:' 1,500 CLAIM VALUE: 1,500.00 CAi,C-VAL[iE: 1,500.00 GROUP OCC: H-2 / COMMENTS: 25" FLAC POLE �F v( 9(� if #* If �%K df aE i(� 3F If iE iE #� �F �!E 16 if le �� k �lf if A� �lF �(-.1E.I6.K. i6.N �%�%-X i4 �� iE ib i( i(�# �7F �k i(� 3f if �% lE �X %..1:. #.%.I(.,x..%.K .x .?; .}(..K..X �% % ii� i(� 7f 4f �IE dE �X� �%# �% N � Z O N I N G R E Q U I R F. M E N T S S E i A A C K S ------------ MAIN BUILDING ---------- --------- ACCESSC�RY HUILDING --------- FRNT; FT IN REAR: ' FT IN FRNT; 17 FT 6 IN REAR: 266 rT 9 IN LEFT: FT IN RGHT; FT IN LEFT: FT IN RGH'T: 48 FT IN PARP:ZNG REO• PROV: PAACEL: 92408117 ZNE; MG� REF NO: PLANNING NiSTES> PROPOSED TWO ZS' HZGH FLAG POLES LOCATED WITHIN THE FRONT > SETBACK. - �� xx-**x�-x********�*�***�*�+�*x***�**�**�+�**x�**��***��****�**��*-�******ve;�*�x�x*�** 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 _ Hi7ILUING AFPRUVED BY :_ APPLZCATION ISSUED B� )fi(�3E3E�)(fFdbf(�df�FlflFfFlf�lE3FiEi(�IE. xiE+r �Edf3F3f%��(�-1Fif*3f�%ififlFiF�E�iEN� iE iF I�EGALIZATION;N BLDG PMT PLUMBING PERMIT 35,00 PLAN 22.75 ISSUE FEE DATE: + DATE: � DATE • -O� � .n . . . iE1EiFiFaflElEff�k#�Tr 3F iFiE )F ' -1F%If�1f�IF)EIEj4KffiFiFjF�E143EiF1EN�#3FIE�E3hihiER�lFifif3E�lfif ' U M M P: R Y ' STRGCTURAL SEGMENT: Y IC MECHANIC FIRE SMIP/RES + GRADING .50 SMIP/NON-RES BUILDIVG-DIV-> PERMTT IS'SU� PLAN-CHECK TOTAL FA3D DIIE TOTALS----> 35.50 0,0 22,75 58.25' S8.25 .00 REVENUE DIVISION TOTALS--> COLLECTED; 58,25 OVER/SHORT; .00 BLDG PMT FLUMBING ELECTRIC MECHANIC FIRE SMIP/TOT GRADING PLAN-CHECK 35.00 .50 22.75 iF 3E iP iF iE ih iP�%� iF jF iE 3E If �iE 3F� tE k 3F IF #�14 3h aE 3t jf� aF iE # 3E �%�f IF iF if if if iE 3t K� 4E iE iF if 1E iE if� if # fh �lf iE iE iE jE iE If 3E N�ii� 7F If 9h iE 1E iE 3F �iE �lE if i(� fE if 3F �If %iE K� ie �t I N D I V I D U A L F E E B R E A R D O W iv ' TYPE QTY D E S C R I P T I O N UNIT COST TOTAL COST SFR 1500 STRUCTURAL BY VALUE, PER 51.00 1.00 1,500,00 END OF FEES ru ..! i 4Z Oa�78'&9-CQD?8;,9i Y�3'� DATE: U.l15/i�i 7lf�t: ;1:36 �- � 1 �. CONSTFiUCTION ANO PLANNIN6 - - �PA APPROVALS Permit# Date Inspector pppROVALS Permit# Date Inspector 1. Temporary Electrical 5ervice 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 Condui[-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. Hea[er & 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 CAnditioning 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 Nailinq ; �� f I^ HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat � �� 79. FINAL INSPECTION 32. Electrical Power MeterFinal � !, t� �/ 80. FOOD CEflTIFICATE ISSUED 33. Final Electric � '� �� Notes: . 34. Final Heating & Air Conditioning � �t�� ; � 35. Final Gas Pipe�Test �� i; , 36. Hood or Canopy � t j ! � . 37. Final Factory Fireplace �� ' i,�: 38. Final Plumbing � � 39. Water Service-Final i i - � 40. Gas Service-Final `� � 41. Solar pomesticFinal � � -� i. . - 42. Backflow Preventer. � t� � � 43. Backflow Irrigation ' �� i � 44. L.andscape Irripation SYstem 45. Sound Attenuation ' 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING �� 6(i 48. FINAL PLANNING 49. Electric Release to Edison I l;'!%� 50. Gas Release to Southern California Gas Co � I � � 51. CERTIFICATE OF OCCUPANCY , , No. pate ' Pfl0.1ECT ADOXESS: % S O W 1 7 TH $T . UNIT: OWNEP'S NRME: TERRY A SHEWARD �" aooxess: p.O.BOX 2786, N.B. �CHIENGINEEfl: BEANARD %{D%i�"is NEG.NO.: C S O S 8 3 noosess: 11022 ACACIA PKWY uwr: E G,G. CA 92640 1 PEflMITTEE: SIGNS TODAY ( 714 ) 250-7120 nooeess: 17851 SKYPARR CI A IRVINE CA 92714 UCENSED CONTflFCTOP OECIAflATION: I �ere0y atlirm Ilui I am lic¢n5etl untler pwvisions ol Chapter 9 �commencing wii� Section 70001 0� Oivl9o� 3 of t�e Busiri¢ss an0 Pm�essions Cotle, an0 rtry laenu fs in lull �orce antl el�eti. c�Truc.:0�1933 sTeTeuc.: 861� cwss:�A ^ /� / o,i�: /� �I � 9 O , � Signaiur � _ Q.r-� /_ , �� WOPNEB$' COMPENSpTION DECIABATION; I �ere0ya��um Inal l �ave a cenihcate o� cOnSenl �0 5el6insure or a ceni�ital¢ ol Workers' Compensalion Insurance. oi a ceriilie� capy I�ereof (Sec�ion 38W. LaG. C). POLICY NO.: EXP. OATE: Cenitied copy o �ere0y tumi5lred. CJ Cenifietl mpy a fileE witA the dty euiltling Divisbn. Date: ApDfiwm: EMEMPTION iBOM WOflKEPS' COMPENSATION OECIABRtION: Q�is saiion nee0 �roi Ee completetl il t�e perml is lor one hu�re0 (St00) or 1¢ss)/ I cenify Ihat in ihe perlormance ol ihe work �o +Nch ihi5 pe�mit is issue0, I snall not employ any DerSOn in any manner o as to becoffy! Subletl lo Ihe Workers' Campensalion Law^ ol Caiifomia. � , � ii � Oaie: 1 � q � Signamre: � NOiICE: If, aiter matting t�a tleclaration, yuu slwNa bewme suEl�� o the Workers' Campensat n rovisions of lhe LaUor COCe. yau mus� tonhwit� comply xiN suc� provi5ion5 or tNs Derrttit 51NII he 0¢¢meE revake0. CONSTBUC710N LENUING AGENLY: 1 �erepy allirm tta� t�ere rs a cahtlmction IenOing agency for t�e petlormance of the worN for wnicn ihis permn is issuea (Senion 3d97. Gv. CI. IENOEP: noonEss: OWNEfl BUIlOEfl OECLANRTION: I he�eEq alfirm ihat I am eeempt Imm lhe Contracmrs S�a�a License Law br the lollowinp reason �Section 7031.5 Business and Pmlessional CoAe: Any cily ol coumy w�ic� requires a permit to constmc�, alier, improve, aemolish, or repair any slmclure. prior to i15 issuance. al5o requires t�e aODlicani lor suc� permit Io file a si0ned slalemenl ��ai helshe is licensetl pursuam io t�e Omvisions ol tne Contranors' State License Law �CIUD�er 9(camme�nq vnt� Sectron 7000) ol Division 3 of ��e Business anC Pro�e55ians fAael ot tlWl �PJs�e is exemD� ��eRtrom an0 Uie GaS�s for Ihe allegM exemplion. My violalion ol Setlion 70375 Gy any ap0licant lor a Oermil su0jecis ihe aD0liWnt �o a civil Denalty of nol more tllan Irve �unOred Eotlars (5500). I. as owner ol ttre D�openy o� my employees with r.apes as In¢'u sole wmpensatipn, vnll tlo t�e wark, antl iAe ❑ SImCWr¢i5 nolinlenC¢0 orol�ereC IQrSdie�SeCbon 70d4.8uvnE55 an0 Pro�e55i0ndlCaOe: T�e COnira[�ors' Sute License Law eoes no� ao7N �o an owne� o� a property who Ouilas or im0��=s inereon, an0 wno aoes such work nimsell/nersell or tAmugn fnis or ner awn emo�oYees, provi0ed t�at sucn imD�wemenls are not inlen0etl or allereA �or Shce. It. Auwever the �uiltlinp oi ' improvement R sold wilhin one year af completion, �he owne� edll fuve rtle hurtlen ol pmviqp �¢/s�e CiA not builE or improve lor ihe purpose o� salel. I, as owner of t�e D�op¢ny, am eMclusively contrat�inA �� licensea conlracmrs m conslmp lhe prolect (SetliOn 704A. Business ❑ an0 Pmlessions CaOe: ihe Contraqors Slaie LicenSe Law Oaes nol aDDly to an owner oi Dmpeny w�o Outlds or impmves �Aereon an� who Conlratis br Suttl O�oletts wii� a tonlratl0r�5)�KenSe pur5uan� IO t�¢ ConlraCiarg' $lale Lit¢n5e Law�.l am awafe Ilui pr0oi ol ineir Wotker's Compensation insuranCe stroulA be provi0e0 to me. � I am e.empi u�er Seciian: B. 8 P. C. br I�is r¢a5on: Date: Uvn¢r. 100 �eie�y tetlity t�ai I am awaie oi and UM¢rSlanE IOe r¢Quirementt ol Cah�omu Heal�h an0 Sa1Biy CoOe Sec�ions 25505, 25533, anA 255� antlihal I or any�Wure OuilOing occup3n�wilVwillnol �circle one) neetlio wmply wiih SaiU slale caEes and��e repuiremen�sior a Vermil lor conslmclion or modi6ca�ion Imm I�e Air Ouah�y ManaAemeni Oi5lric�. Re5i0¢nlial [onSlNclion applications are eHempl Irom I�ese provisions. Oate: Ap0liwnt: I �ereDy cerUty t�at 1 nave reaE Inis apphW�ion an0 slale ihat t�e aEove information 6 carreti. I agteC to wmpty vrith all ciry anE fAunty orainancesaiM s�atelaws�eWtingla G�IrUtiion arb herebyau�lpr@er¢pre5enlatives0�ihi5 GIyiO enlerupon�he above- enliOnEA O�op¢rly fai inspe[Iion pu�W5e5. Oale: � a' �� SignaWre: � a---'�-' � � od�er's ucense or Sociai seadiy e: i6A1��6 WM1ne—BuilOing; Grean—CoOa EntorcemenC Canarv—Applrtant: Pink—Revenve: GolOenrotl—Assessor CITY OF COSTA MESA — SIGN PERMIT I��E , PERMIT NO: SB 050173 PLAN CHECK NO: 069B7-90 S �'6VT�SUI�hi CONSTRUCTION TYPE; PERMIT TYPE: STR SIG PURPOSE: NEW JOB DESCRIPTION ; CONSTRUCT 285F CONCRETE MONUMENT SIGN SQ FT: CLAIM VALUE: 7,600.00 CALC—VALUE: 7,600,00 GROUP OCC: B-2 / COMMENTS: NONELECTRIC SIGN �****+t�t*�r�rr�r�rr*�*��r�r**�e**�e�t�r**+e***r*�r�r�e�r�r�r�r+r*�tr*�t�t*�r*�r*�r��r*�*�r***�r�r** �r***�**** S I G N 2 N F O R M A T I O N DISTRICT: 2 TYPE: GROUND ILLUMINATION: NON CATEGORY: NEW DIMENSIONS• 8FT OOIN X 3FT 06IN AREA: 28,OOSQFT LETTER HT; 6 STREET FRONTAGE 1; 150.00 STREET 1; W 17TH ST STREET FRONTAGE 2: 0.00 STREET 2; -- PARCEL: 42408117 ZONE: MG LOCATION > FRONT; X REAR: BUSINESS NAME: PAR—WAY GROUP > LEFT; RIGHT; O T H E A T O T A L S G R O U N D S I G N THIS ACTIVITY 28.00SQFT OVERALL HEIGHT; SFT OIN TAIS SITE 28.00SS?FT GROUND CLEARANCE: 1FT 6IN ITEMS OF INFO c 1 PLANTER AREA: 56':bOSQFT ITEMS FOR ACTIVITY: 1 BLDG SET BACK; 33FT;, COPY VERBIAGE : PAR—WAY GROUP a PLANNING NOTES: �"'� if 1tlE if iF iF M M aE it iF If 1t If if iE 3f IE ik if �f if M iF k iF iF kik �f IF �k Ik it k It if iF ik ik 3f if iE ik iE �F �f if iFlf 1F If iFif If IF if iF If iF It 1tlF If �F iF �E if iF it iE iF k aE IE k M iF i! 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 �9�1 _ DATE: 1� � BUILDING APPAOVED HY : DATE: APPLICATION ISSUED BY: c DATE:�v � J kMk1ElEkkiElfifkififlElElfiFiEfEififiE ifitiEiFlFikiFiEiEif iEiF LEGALIZATION:N F E E S U M M A R Y STRUCTURAL SEGMENT;Y BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/RES GRADING PERMIT 99.00 28.00 SMIP/NON—RES PLAN 64,35 1.14 ISSUE FEE BUILDING—DIV—> PERMIT ISSUE PLAN—CHECK TOTAL PAID , DUE TOTALS----> 128.19 0.00 64,35 192,49 192,49 .00 REVENUE DIVISZON TOTALS--> COLLECTED; 192,49 OVER/SHORT: 00 BLDG PMT PLUMBING ELECTRIC MECHANIC SIGN SMIP/TOT GRADING PLAN—CHECK 99.00 28,00 1.14 69.35 ilMlf9fk�fkMkifkiFiFlfkififMif)FkkklFlfMltkik�flflt�f%kif�tlfiFiFiFifkklFklflfiflFlfkMiElf3f�F�flfiElFiFMlEiflFkMlEkifklEifiElFiFifiE I N D I V I D O 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 NO FEES WERE SELECTED FOA THIS PERMIT CI G007;;�•;b—:.G�J7554i T�� PA7E: 12/04�40 iZ��: La�:.s V i�Zey4 CONSTRUCTIOii AND PLANNING P� ` A APPROV.`(LS Permit# Date Inspector AppROVALS Permit# Date Inspector t. Temporary Electriwl Service or Pole 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. -� 53. Steel Reinforcement ;, 3.:Electrical��Conduit.Utility-Undrgrnd. 54. Forms -�;4.�Electrical Cond'uit�Undrgrnd. 55. Electrical Bonding z •z �y 5"Steel Reinforceme�t 56. Rough Plumbing & Pressure Test `; �-,6.,.Electricaf UFER'Grnd. 57. APPROVAL TO COVER�GUNITE • . i' �r,7�. �Footings': '� ` y � 58. Electrical Conduit-Undrgrnd. - � B.�Poundation; �� 59. Gas Pipe, O Undrgrnd., Test 9FWater Pipe-Undrgmd. 60. Backwash Lines, RTrap, O Undrgmd. 10. Structural Floor SYstem 67. APPROVAL TO DECK 11. Property Sewer Lint& House Connection 62. Backwash & Receptor�Final 12. Sewer Cap L . 63. Heater & Vent-Final 13. Roof Drains = � 64. Plumbing System - Final 14. Rough Plumbi�g ` 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 ElectriEal-7 Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQIiIREMENT - -__ ' . - - - �_�. - � � 20.�Rough F.actory Fireplace �--�+' � rG S -qPPFiOVALS �j; PyfmiY� :? : �.v ,uSU; rrzn• •��. ; .� 21.;_DuBts, in StructuF2: ,�, �c�-; yr;�C'� ,i01 } _ -K S _ 70. �Underground Hydr� = � . � 22. Ducts, Ventilating�4 � �� : '"-^ - + =71�Product Piping O.Gss O`bll ' �. r , • . t, ��1j1 _' ` - .y �-. 23';Gas PiPe-Rou h &�:+ est�"� � ``. '_ �, i ''�r �' '? . r � ,-�� . '"c ' 9 I �: _ � .- � - . r 7 - 72.,Underground Flush• i ,_ ,,,,�� ,. 24.iRoof Framing :� -�'r =�'��'� .T." • 7 G :73. l7ntlergrnd.StorageTank O�Gas �Oil - c't _c r�i> '�: �. : � r � ��}:� 25. Roof Sheathing '';; ' " "'� � � �Y ` :74�jOve'rhead,Hyd�o � �` � ..: i�7•f'•- . 26 � T-Bar Ceiling (SIrU�turaq��&-Monocoat '- �� i �75P'Dry Ch,emital " � ' � v .. r- 7 . , r- ^r... 27:'Frame and Flashin �"� - ; . •• � a � � ,�`': f �� .. . - -.� xc � t a; s� , 76,; Dry Standpipe' �X,- '. ,. 28.`Lathing & Siding a _J ••> ��-�3 = � •• ••77' FIXED'SYSTEM FINAL S ' � r .. -, 29. Insulation � : ��c'"` �F'�r.��,;'�� ''� ' � 7g. FIRE PREV. FINAL � r . ��30. Drywall'Naitlng �� -� �•^ .�'� =:c � �� -� ' � •-, HEALTH DEPT REQUIREMENT o� r .-� •`31. Plaster Brown Coaf; `'- �'� �'�� j. � 79. �INACtNSPECTION� � �' - �;32.-Electricdl Power Meter-Pinal -_ , a!t: 80. �ROOD CERTIFICATE ISSUED . i '33 `Final ElectriC .� _ - •.f ``� �lot s: '� '3,� � _�- � . �34rFin�1 Heating:& Air,Conditioning. � K ' `. 'c, t - .. ,� � - � �35'"Final Gas Pipe•Test� � '� � +��` I � n "� ' c ^„� y ;r tl Y p .� . . .6 � = J ! �a � 1 f '• . t�. �36'Hoodor;CanoPY .. - .2" 3. C'�'� � C. ,. ± s; . � 37;�Fin51 Factory FirePlace,� ,�i�� 1 k � ` . . �. � ;38,-Final Pl,u_mbing z er �_:t*.�r�_ ` � •� � . -, -rc .r m � 'r39aWaterService=Final�'-> �� 7': �n * ' ' '' Y !% �'Sp }:r � _ - T. -C...c•r. 1';r • ♦ �S; � � ' SAO.`-�Gas Service�Einal - �,� . .. "� , " - ; _ � ',' : . „�, .. 41%Solai DomesticFinal -.�� .� �c. � ? � �f-- - -� ' ' c.^� ��n n Y ' t�i.r .a �r 'T r,. 42"�Backflow Preventer .� " .��` : �F' � I 'r- J �i'' � ' . � 43. Backflow Iriigation' s r �� ';�:r � �� '� '� ^• � -' _ _ , .44. LandscaFe Irripatiqn SYs[em � ,; , ' � t ,: , -,- - i_ r X p; . '�.; � S • a_45 :Sound Attenuation �.: ` z ' - :' • ' - `^ f ,r.r.. i. � r �n n rr, � ' �_i '_46. Handicap Regulations 'T • , "�•, `• ,`y ' �" � ; �, r • �u' - r �47. FINALSTRUCTURE&�BUILDING � " ��W� � ,+ �. i�� :�� ' �. , > !; ''46.'FINALPLANNING ' `';� r � :�, ;7 � . _ -49.-Ele'ciricReleaseto:Edison �; . � ' .>' Y� �� _ � . .n � m r =50._Gas Release to SouShern California Gas Co I I �i � - _ ^`.` : - �_ ,. ' 51. CERTIFICATE OFOCCUPANCY x ; y ;;; ., .� . _, ;' No. Date AoO��ant to flll in all sDaces except tnose withln heavy eorEar Iinas antl sign al1 approorlata tleclaratlons. CI7Y OF COS7A MESA CONSTRUCTION PERMIT Project Address ��T'7 !U, 1 �� S�k:l Z Applicant's Mailing qddress S�^'� L Owner's Name �� •Zw��-�/ Co x+cf phoneG'�D Address Sn —� Arch/Eng. License No g Address Contrac[or's Nem ��f1G ''� 7�+ti l6�i�'�'Fsn Phone ��.�SI? 7 Addreu (mailin9) _YC/ %�O 1C �Ci �+ i'.Q/LilYl CL'� jl %I x Ciry License Na �n07(� LICENSED CONTRqCTOR DECLA0.ATION ,I hC/eby atfi�m [hal � am Iicensetl�untler prOvisiOnsof Cna�te� 9(Commencin9 wilh.5ection ]000) of Division 3 ot the Business antl Professions Cotle; antl my Iicense is in full force antl eltect. � License Class C'� L�cense No � Date S� � S �� Y Slqnature WORKERS' COMPENSATION DECLARATION 1 nereby aHirm that � nava a certiticate oi consent to solt-Insure or a cartlfltate' of Workers' Compeh�tion Insurance, or a certHletl coOY thereof (Sectlon 3800, Lab. G.) Policy No. Company eCo/ti(ietl capy is hereby furni5hetl. , Certifietl mpy is tilatl with [ne city Builtling DiviSion. Date Applican[ EXEMPTION FROM WORKERS' COMPENSATION DECLARATION (This sacfion neetl nqt be completetl i( the permil I5 for one huntlretl (E100) Or Iess). I Cartlfy [hat in the p¢rfo�manCe of [be work tOt which thi5 permR is Issuatl, I shall not emv�oy any person in any manner so as to beco �e subjpel�lO tna Worke,G;��JmP@qs'j`y� Laws ot CalifOrtt4l( � Dale � d Si9naWre �ry�<� ' 'NOTICE: If, atter making tnis tlaUarati n, you s�oultl become subject to [ha Wo�ke�s' Comp¢nSaUon provi5ions of lhe Labo� Cotle, you must to�tbwith comply with such orovisions or this permit snall be aeemetl ravokea, CONSTRVCTION LENDING AGENCV � I nereby aftirm that there is a constructlon lentlin9 a9ency tor tne performanca of Ihe work tor whlcn lhi5 permit is i55u0tl ($ection 3097 Civ. C.j LenGer's Name ' Lontler'S Atltl�es5 OWNER BUILDEN pECLARATION 1 hereby afflrm that I am ezempt irom tha Contractor's License L.aw tor tho following reason (Sqction 7031.5 Business antl Professional Cotle: Any cllY or county which requires a permit to construct, altor, improve, tlemollih or ropalr any structure, prior to Its Izsuance, also requlres the aoP�icant 1or such permlt to lile d Si9netl 5tat0mOnl thdt hR/ztle IS Ilcen58tl pUlsuant t0 the ploviiiOns ot Ihe Contrac(or's Ucense Law (ChaD�er 9(commontlng wlth Section 7000) ol DlWsion 3 ot lbe quzlnes5 and. Professions Cotle) or lhat ne�sno it uxempt therofrom antl [he basis for the alle9ea examptlon. Any violalion ol Saction 7031.5 by any appllcant 1or d pe�mlt subjetti tlm applitant [o d civil' ,�enHlty of not more (han ilve huntlretl�tlollars (5500). LJ I, as owner of tho oroperry or my amployees with wages as ineir sola tompensalion, will tlo tha work, antl the structura Is not InlentleC or olterotl lor ulo (SecNon 7044, Business antl Prolessional Cotle: The Contractor:s Liconse ldw tloes not apply to an owner of a proporry wM10 builtls or Improves IheteOn, antl who tlae5 SUGb w0/k himzelt/horSpB or thrOu9h nis or hur own employeas, provlaetl that such improvements aro not intentlotl or ofieretl tor 5HI0. It, howevGr, t�¢ bullding o� impraveTent IS SOIE wI[hln one yea� ot COT- pl0llon, the Ownar �y��l hav0 the burtlen Of proving he/ih¢ tlitl not bulltl o� IT- ��rova tor the ourpose ot zala�. I, as owner ot the property, am ezclusivery tontractlng wifh Iicensetl con- tractors to mnstruq tho project (Section ]044, 9uslnass antl Professions Cotle: Tne Contractor's �Icenso l.aw does no[ apPly to dn ownet ot properly wh0 builtls or Improves thor¢on, ane wno contracts tor such projects with a con- tlaclor(5) llcenze pUrSuant to lhC ConlractOr's LICBnS¢ Law). I artl awale lhdt proo( of Iheir Worker's CompensaliOn InsuranCe shoultl be provl0atl to me. ,❑ I am exempt unUer Section B. 3,P. C. for this rea5on Date Owner , I her¢by ttr[ify tryat I have �eatl Ihis application antl state that tbe dbova Information is mrrg��. � agree to comply with all Uty antl county ortlinances antl state laws reia�ing to builtlinq conSVutHon, and hereby authorize repre- sen[ative5 0( th'y� ��ty l0 ent up n the abova-mGnUonetl Otop¢rty IOr� InsPectionyy�yses. . � � ' � _ _ � e Driver5' L�nse or SS �ao3�� i _. TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER DESCFiIPTION OF WORK/USE OF BLDG. _�ZF.•+ �'��'z-• d� �L 4 TVPE OF PERMIT LJ GRADING LJ FOUNDATION LJ STRVCTURAL ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING � MECHANICAL ❑ OTHER PRQIECT DESCRIPTION 5a. FT. OCCuvANcv CONSTRUCTION TYPE VALUATION $ ZONE GRADINGCU.VDS. ACRES Rema�ks: Sink Preventer Irrigation Drinking Fountains Floor Drains Floor Sinks Gas Service OuUets Kitchen Sink Lavatories P—Trap Roof Drains Reinspaction Fee NG Service Sink Sewer Cap Sewer Connection � $olar Collectors Solar Pipin9 Solar Tank Swimming Pool wlSpa Water Closec � Water Heater Water Service Auto-Wash Laundry Trays $15 Isue Fao Boiler �� p Duct - Under Ground Duct � Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ' ❑ ai oo,000 eru � i oo,000 en Heinspection Fee � $15 CMF 0865-46, rev. 30/8a White - Builtling: Canary - qpplicant; Pink - Accounting; Goltlenrotl - Assessor Hood or Typel ❑ Canopy Typell ❑ Refrigeration System ❑0.700,OOOBTU ❑100,000 System Repair/Alteration Fire Dampers Registers laue Fee FEES A.P. �W - S Main Buildin9: T Front B Aear A C Right g Left Ping. Ref. # � Planning Notes: Automatic Washer Sub. 6 Accessory eui Zone ELEC7RICAL � Transformer ❑ 15-50 KW ❑ 50+KW Cookin9 Unit .�_. ' Meter �up to 100 amps Dishwasher � Meter �over100amps Dryers ❑Gas ❑Electric Sub Panel Fan !�%� Motors OGi HP �1 X- 8 F.A.U. Inc.Solar �9-15 HP �i6-15+ Fixtures - Mittowave ' Device Boxes Pole Light � Outlets Range Switche5 . Sign . Garbage Disposal ; S[anding Sectians Generatar �0.5 KW OS-15 KW Trash Compactor FEES Z O N I N G R E � M T S S 3 Rainspeetion Feo 515 Issue Fee S 3 FEES DEVELOPMENT SERVICES REQUIREMENTS: 2oning ApProved BY �ate Building Approved By Date � � Appliption laued By �� Dat SUMMARV OF FEES ' BUILDING PERMIT $ SMIP $ PLAN CHECK , $ PEHMIT � � PLUMBING � $ . ISSUANCE $ PLAN CHECK 25% $' ENERGV P.C. $ ELECTRICAL $� GRADING $ PLANCHECK 50% $ —�7 M�CROFILM $ , MECHANICAL $ � / �"' TOTAL FEE � $ 7� $ 3 PLAN CHECK Z5% $ . � � I . �CONSTRUCTION ANDPLANNING POOLo,�PA - - - ,� APPROVALS Permit # Date Inspector qppROVALS Permit # Date Inspector • 1. Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2. �Soil Pipe-Undrgrnd. . � 53. Steel Reinforcement - 3. Electrical Condui['Utility�Undrgrnd. 54. Forms ' 4. Electrical'Conduit-Undrgrnd. � 55. Electrical Bonding - I 5. Steel ReinforcemenY 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. Wa[er Pipe-Undrgrnd. � 60. Backwash Lines, P-Trap, 0 Undrgrnd. � 10. StrOctural Floor System 61. APPROVAL TO DECK 11. �Property Sewer Line�& House Connection " 62. Backwash & Receptor-Final 12. Sewer�Cap � •* 63. Heater & Vent-Final 13. Roof Drains • " 64. Plumbing System - Final 14. Rough�Plumbing • 65. Electrical-Final � 15. Rough Electrical-Conduit 66. Solar System-final - 16. Rough Electric Wiring 67. Fencing & Access Approval � 17. Rough Wiring Sign , 68. APPROVED FOR PLASTERING 18: Rough Electrical-T Bar Ceiling 69. POOUSPA SYSTEMSFINAL 19. Rough Heating & Air Conditioning FIRE DEPT. REQUIREMENT 20. �Rough Faaory 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.StoregeTank OGas ❑Oil � 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Ftaihing 76. Dry Standpipe 28. .Lathing & Siding � 77. FIXED SYSTEM FINAL 29. In'sulation 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 Faaory Fireplace . � 38. Final Plumbing i��r �'�,(� 39. Water Service-Final 40. Gas Service-Final 41 . Solar pomestic-Final 42. Backflow Preventer 43. Backflow Irrigation 44. Landscape Irrigation System 45. Sound Attenuation � ' ' 46. Handicap Regu�ationt - 47. FINALSTRUCTURE&BUILDING � 48. Special Requirements Completed 49. Electric Re�ease to Edison � ' 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY No. Da[e �_ ' AVP��ant to �III In all spacas excevt those within neavY OarCer linas ana sign all aoPrao��ate tlaelaratlons. ^ CITV OF COSTA MESA CONSTRUCTION PERMIT ?ERMIT NO. TRACT Ntl. .LOT NO. UNIT NO. f � � 3-� � 2612 6/21 /84 I �3:�Q TI PiojectAddress SO �'+.. I �"'L+�,riY. Applicani's Mailing Addr¢Ss ' p TYPE OF CONSTRUCTION NEW ADD ALTERATION REPAIR G ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q,p, y�6 Zo�e Owner's Name C ��LY '--U �ar'^^�' bLphone � � DESCRIPTION OF WORK/USE OF BLDG. 0(� S.� � S Main Building: Accessory Building: Addreu � S �"'� ��-.. E Z Arch/Eng. LicenSeNo. TVPEOFPERMIT GRADING FOVNDATION STRUCTURAL T Front '- . � 0 � Addf255 _ . ' ` ❑ TENANT ❑ ELECTRICAL ❑ PLVMBING ❑ MECHANICAL A Reer - � N Contractor's Nam RGj�j.�, �' (* i�A_h 11APhon�µ— ti��a7 �'OTHER C Rlght N I 1 e PROJECT DESCRIPTION Sq. FT. oCCUCANCv Addreu Imailin I �'�" � � S ��' • c�i-� � Si' ._ C. A_ �IJ 9 CONSTRUCTIONTVPE VALUATIONS g Left G ;CityLicen52No. . ZONE GRADINGLU.VDS. ACRES ' R LICENSED CONTRACTOR OECIARATION i Ping. RCf. �f Purking Req./Provided E l.� I bereby aiiirm that I am liconsetl untler provisions ot Charter 9(cominencing Remarks: ' ' C 3 � b � Planning Notes: � � �d with section 7000) ot Divislon 3 of the BuSiness ana Professions Cotle, antl M my Iicense Is in tull lorce antl aflect. ��Q 5�39 � T LJcense Class ' Licen No. S' 05te 1=y1'74Q Signature PLUMBING FEES � • • WORKERS' COM7ENSATION DECLARATION Bdr Sink ShOw¢rs . ' ' I hereoy ailirm tnat I nave a certlficate ot consenC to selNnsure or a certlilcate ' ELECTRICAL FEES -01 Worke�s' Compansatlon InSurance, or a certifi¢tl COpy the�eof (Section r �- � BackflowPrevencer - � -- ServiceSink '� - � - - � . _ 3800, �ao. ,C,.` � � • Automatic Washer Transformer � 15-50 KW aoiicv No. `�'� �� Company Cn-C+ � � Backflow Irrigatio,n Sewer Cap Construction Pole Sub. ' ' ❑ 50 + KW �Certifietl copY �s hereby furnishetl. � - � � . Certltietl copy IS flled with the city B Itlinq Oivisip1n. Bdthtu65 Sewer Connection COOklfly UOit M¢t2� ❑up t0 10� dTpS Oate )^�l I�gQ APPlicani �.. B .` n .Llo�. � . . � ' � E%EMPTION FROM WORKERS' COMPENSATION DECLARATION ClBrifief5 Solar CqlleCtors Dl5hwa5hef � _ Meter ❑Ov2r 1000mp5 (Thissection neetl not be completetl if the permlt iz for one huntlretl ($100) or Di5hwd5hEr ' • � - iess). i ' ' Solar Piping Dryers ❑Gas ❑Electric Suh Panel , • I certity'that In Ihe periormance of the work tor which this perm�t is issuetl, I � . shalb not employ any person in any manner so az to become suoject to the Drinking Fountains Solar Tank Fan workers' Compensation' Laws oi California. . Motors �0.1 HP �1 �- 6 Date Signature � Floor Drains Swimming Pool w/Spa , F.A,U. NOTICE: II, atter makln9 this tlaclaratlon, you shoultl become subject to the Ina $olar �9-15 HP 076-75+ Workers' Compensation O�ovislons ot lhe Labor Cotle, you musl forthwltn Floo� Sinks • Uririal Fixtur25 'Microwave compty with suCh proN5iOn5 or this permit Shall be tleemltl revoketl. _ , CONSTRUCTION LENDING AGENCV GdSSefviCe OuU¢l5 - Wdt¢rCI05et . ' . 1 hereby altlrm that t�ere is a construclion lentlin9 agency for the performance Devite BoxCS Pole Light ot tne work lor whicn tnis permit Is issued (Se<tion 3097� Civ. CJ �nterceptoro -' Water Heater ' Outlets � Lantler•s Name ' Aange Lenaer's AEtlress Kitchen Sink Weter Service � Switches OWNER BUIIDER DECLARATION .. 5�9� 1 hereby atflrm tnal I am ezempt trom the ContractorY Ucense Law tor the Lavarories Garbage Disposal • Standing Sections following reason (SecHon ]031.5 Business and Pro(¢55ional Cotle: Auy ciry or , , _ tounry wN<h raqWms a permit to construct, alteq improve, tlemoli5h or re0a1r P-T�ap any ztructuro, prlor to Its issuance, also requires tne avG��cant tor zucn oermit Generator �0.5 KW �5-15 KW Trash Compactor to tile a sl9netl statamont that he/sne is Iicensetl pursuant to the provisions of Roof Drains the Contractor's License Law (CnaD�er 9(commencin9 wilb Sectlon ]000� of � 2 DIvlSion 3 of Ihe Bu5ina55 dnd Prolession5 Code) or that hC/S�e is exlmpt [heretrOm antl lnG ba515 fOr Iba allegaE OxOmpliOn. Any v101ation of SecHon 7031.5 by any apD��cant for a Oermit subjects tna apOlicanl to�a civil - � � Gntlty ot not more Ihan flve huntl�eU tlollar5 (5500). � S 3 e3 � 1, as owner ol thc oroperb or my employcez with wages as tnetr sola ReinspBLtion Fea , $15 Iitue Fee S componwtion, w�ll tlo tho work, antl the structure is not InlnnCeA or offeretl Reinipection Fea $15 ISSue FBB $ 3 tor sale (Section 7044, euzlness ana Pro(ezslonal Cotle: The Contractor's - MECHANICAL - FEES Licen58 l.nw tl005 nol dpP�Y [O tln owner Ot a prop0rty wllo builtls of impfove5 tneraon, anG wno tloes sutn work nimseli/nerseli or through his or her own HoOd or T e 1 ❑ ' DEVELOPMENT SERVICES REQUIREMENTS: . Boiler employ¢as, 0/oviGad tha[ such Imp�ovOmentS ara not intenaea or olterea for YU Sale. Il, nowBve�, th0 bulltlin9 c� ImptoveTent Is Sold wi[hin one year ol com- - Cd�OPy Typ¢ I I ❑ Zaning App�OVed By DatB D�el�On, the owncr will hdve lha bu�den 01 PrOving he/slte tlitl not builtl or im- DUtt - Und¢� G�Ound Buildin8 />PP�a�ad By � Dete �lOva tOr ttle putpo58 Ot salo). - Z I, as owner ol tha Oroperty, am azclusively contracting witn licensetl con- Duct - Structural Refrigeration System Application Issued By ��j � Dat IractOrsto const�utt the prOject ISecllon 7044, Busin855 antl Prof¢Ssions Cotle: _ The Contractor'i Licanse Law does not apply to an owner of property who Duct - Ventilating ❑0.100,000 BTU '� 100,000 BTU SUMMARV OF FEES . bui105 or Improve5 Ihereon, antl who contracls for SUGh projecl5 with a con- . tractor�sl licanse pursuant to the Contractor4 License Law). I am aware lhat Exhaust System ❑ Multiple ❑ System Repair/AI[erati0n BUILDING PERMIT $ SMIP $ proOf Of tnelr Worker's Compensatlon insurance snoultl be provitletl to me. . P�AN CHECK $ PERMIT ❑.I am exempt unGer 5ectlon e. S P. C. (or this reason Firepl/Fact. BIL ICBO # ISSUANCE $ PLUMBING � $ Date Owner Heatin9 System & Ducting PLAN CHECK 25% $ ENERGV P.C. $ i hereby certiry that I have reatl this appiication antl state that tne above � ❑0.100,000 BTU �100,0008T ' ' ELECTRICAL $� ��3.�(� GRADING S intormation is correct. I a9ree to comply with all city antl county ortlinances antl'.state laws relatlng to builtling wnstruction, antl hereby authorire repre- � • PLAN CHECK 50% MICROFILM $ sentatives o� thi5 c tY t0 ente� upOn the dDOve-mention¢0 Property for . $ - Inspectlonpurposes. MECHANICAL $ �� Si9nature � �C� ��-� Date�_ TOTAL FEE $ _� � oriverz' ucense or 55 � !'� �-? }? �!- Reinspection Fee $75 laue Fee $ 3 PLAN CHECK 25% $ CMF 0865-46, rev. 4/84 Whit¢ - Bulltling; Canary - Appliwnt; Pink - Accountin9: GOltlenro0 - ASse55or " ' � CONSTRUCTION AND PLANNING � `; . POOL & SPA . � APPROVALS Permit# Date Inspector AppROVAI,S Permit# Date Inspector 7. Temporary Electrical Service or.Pole , 52. Pool & Equipment Location . 2. Soil Pipe-Undrgrnd. �� . ' � � 53. Steel Reinforcement '3. El�ctrical Conduit Utiliiy-Undrgrr�d. , 54. Forms ' 4. Electrical Conduit-Untirgmd. 55. Electrical Bonding � 5. Steel Reinforcemem ' . 56. Rough Plumbing & Pressure Test 6. Elpctrical 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. Proper[y Sewer Line & House Connection �62. Backwash & Receptor-Final 12. SeWer Cap ! � . -- . 63. Heater & Vent-Final 13. Roof Drains .• 64. Plumbing System - Final �� 14. Rough Plumbing •' � 65. Electrical-Final • 15. Rough Electrical-Conduit - � 66. Solar SYstem-Final � 16. Rough Elec[ric Wiring , 67. Fencing & Access Approval - . 17. Rough Wiring Sign . � 68. APPROVED FOR PLASTERING _ 18. Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL . 19. Rough Heating & Air Conditioning �� - . ' FIRE DEPT. REQUIREMENT ' 20. Rough Factory Fireplace APPROVALS Permit # 21. DuCts, in Structure 70. Underground Hydro •22. Ducts, Ventilating 71. Product Piping O Gas ❑ Oil � .23. Gas Pipe-Rough & Test � � 72. Underground Flush � `24. Roof Framing . 73. Undergrnd. Storage Tank O Gas ❑ Oil 25. Roof Sheathing 74. Overhead Hydro 26. T:Bar Ceiling (Structural) & Monocoat 75. DrY Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation �78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION - 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric 7(o Notes: 34. Final Heating & Air Cqnditioning 35. Final Gas Pipe-Test � 36. HOod or Canopy � � . 37. Final Factory Fireplace ' ' 4'�' 38. Final Plumbing � � 39. Water Service-Final . � � . 40. Gas Service-Final - � ' 41. Solar pomestic-Final �a 42. Backflow Preventer � 43. Backflow Irriqation . . . ' 44. .Landscape Irrigation System . . 45. Sound Attenuation , 46. Handicap Regulations . 47. FINAL STRUCTURE & BUILDING 48. Special Requirements Completed � • 49. Electrie Release to Edison � - 50. Gas Release to Southern California Gas Co � 51. CERTIFICATE OF OCCUPANCY ' . �� No. Date ' a Aop��ant to /ill in all spaces excev� lhosa witnin heavy eortler Ilnes anG slgn all appropriate aeclarations. CI7'voE�OSTAMESA CONSTRUCTIONPERMIT ' Pi�jec[ Address , � � � ,L� �• `�� S �• � ApplicanYs Mailing Address Q y' � ��• �� $� ��r+o S.'Q, Owner's Name �• r u �� h+A Ll.e_phon�—'�-e a- � 0 Address � S'� � •'+- { ��'�+ S� ' Arch/Eng. License No. Address Contractor's Nam � I � Phone �c4 Address (mailing) � � � '� � � hm� ��" �--�i �� City License No. � � �' g $ � LICENSED CONTi2ACTOR DECLARATION 1 hereby aftirm that 1 am licensetl untler provislons of Charter 9(commencing with section ]000) of Olvision 3 of the Business antl Profeszions Cotle, antl - my license is in full torce antl etiect. License dass ' �1 License No. �g 5�� 9 oate �� ' ' S"9 t �i�� i.ef C`�. .1.�� \WORKERS' COMPENSATION DECLARATION , 'p;;'-`ygreoy affirm that 1 nave a certiticate ot consent lo sal�-insure oi a certlficate -.Workers' Compensztion Insurance, or a certitietl'copY ther¢of (Section -��`-00� Lab. ) p�� / z/ (� �� Policy No.%�p--� Company�,�.?_lL � BCeriiti¢tl copy is hereby furnisneC. , Certiiletl copy is ti etl with the city Bu'Itling DivJ�ion. Oate -S� �� APPlicant._.I(�� • ` �^�•9-�-�' ) EXEMPTION FROM WORKERS' COMPENSATIOfJ OEGLARATION (Tnissection neetl not be completetl if the permit is for one huntlretl (b100) or less). � I certity lhat in the perlormance ot the wG�k fOr which thi{pe�m�t Is Issuetl, I shall not ¢mploy any person in any ,ma'N�er zo,as to become subject to the Workers' Compensation Laws of Cali(dm'S /1 ' , Da[e Si9nature�� T ; NOTICE: If, after making this tlecla�ati n, you shoultl become subject to t�e Workers'� Comp¢nsation provi5iOn5 of the Labor Cotla, y0u must forthwith comply with suctt provisions o�- thi5 permit shall be deemetl �evok¢tl. � 'CONSTRUCTION'CENDING AGENCV � 1 bereby af(irm ihat there is a construction�lentling agency for the pertormance of (he work for which this per it is issuetl (Section 309] Civ. C.) Lentler's Name. , Lender2Address _ OWNER BUILDER DECLAR TI N� - I hereby aftirm [hat I am ezempC irom t�e ContractOr'S License Law for tne (ollowing reason (Section ]031.5 BuSiness antl Professional Cotle: Any city or county which requires a permit to construct, alter, Improve, tlemolisn or repair any scructure, orlor to its issuance, also requires tne applicant for such permit to fiie a signetl ztatement that ne/she is licensetl pursuant to the provisions of the Contractor's �icense Law (Chapter 9(commehcing with 5ection 7000) ot "�IviSion 3 of tM1e Business antl Professions COtle) o� that he/She is exempl ^refrom antl the ba5is for th¢ allegetl ex¢mp[ion. Any viOlation of SecliOn i31.5 by any applicant for a permit suDjects the ap0licant to a civil �+e,nalry of not more than tive nuntlretl tlollars (E500). ' U I, as owner ot tne property ar my employees wlth wages as their sole comoensation, will tlo the work, antl the structure is nof intentletl or oiferea . for wle (Section ]oa4, Business ane Pro(essional Cotle: The Contractor's License Law tloes not apply to en owner of a properly who builtls or improves the�eon, antl who does such work himsel!/herself or throu9h his or ner own emploYees, provitlea tnat such improvemenis are not intentletl or ofteretl tor sale. If, however, lne bulltling or imp�ovement is soltl within one yea� ot com- Oletion, the owner will have the burtl¢n Ot p/oving he/she tlitl not builtl or im- �rove tor the purpose oi zale). I, as owner 01 tM1e prOpe�ty, am exclusively cont�acting with Ilcensetl con- tractors to construct the project (Section �044, Business antl Professions Cotle: The Con[ractor'S LicenSe Law does no[ apply to an owne� of prOPe/ry who GuiltlS or improv¢5 thereon, antl who contracts tor zuch prOj¢cts with a con- tractor(s1 Ocense pursuant�to the Contractor4 License Law). I am aware that ptoof o� thei� WOrker'S Compensation in5urance s�0ultl be provitleC to me. ❑ I am exempt untler Section 8. & P. C. for this reason Date Owner 1 heretiy certify that I have reatl tni apo�� tion antl state that the above information is <orrect. I agree to com ly with all cily antl county ortlinances antl state laws relating to builtlin9 �o StruCtiOn, antl he�eby authorize re0re- zentatives of thi city, to enter upon the above-mentionetl'property tor inspectlon purp05 /-� � Signature . e .l ' {, Oateyr]�_�� TYPE OF CONSTRUCTION LJ NEW L1 ADD 1-J ALTERATION LJ REPAIR ❑ CONVERSION ❑ DEMOLISH ❑ OTHER q.p.# DESCRIPTION OF WOfiK/USE OF BLDG. Cli.�% S Main Buildi E TVPE OF PERMITp� GRADING FOUNDATION STRUCTURAL � T Ffont ❑ TENANT 1'�` ELECTRICAL ❑ PLUMBING ❑ MECHANICAL A Reaf ❑ �OTHER -. C Rlght PROJECTDESCRIPTION 5O.F7. oCCVvnNCV K. CONSTRUCTIONTVPE VALUATION$ S Left ZONE GRADING CV. VDS. ACRES Ping. Ref. � qemarks: � Planninq Notes: Sink Preventer Irrigation DiShwasher • Drinking Fountains Floor Orains � ' Floor Sinks ' Gas Service � Outlets Interceptors . Kitchen Sink " Lavatories P-Trap Root Drains Reinspection Fee � � S75 Duct- Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple ❑ Firepl/Fact. Blt. ICBO # Heating System & Ducting ❑ 0-100,000 BTU � 100,000 BT I I Reinspeetion Fee Drivers' Licenze or 55 # � �] CMF 0865-46, rev. 4/84 Whi[e - Builtling: Canary - AOP�icant; Pink - Accounting; Goltlenrotl - Assessor $15 Showers Service Sink Sewer Cap Sewer Connection Solar Collecrors , Solar Tank Swimming Pool w/Spa Urinal Water Closet• ' Water Heater Water Service � Issue Fee Hoad or Type I � Canopy Typell ❑ Re(rigeration System OPi00,000BTU ❑100,000 System Repair/Alteration laue Fee FEES 0 $ 3 FE $ 3 ,Auromatic Washer Construction Pole Si Cooking Unit � Dishwasher Dryers �Gas ❑EI Fan F.A.U. Fixtures Device Boxes OulIeLS Switches � Garbage Dispoul Generator �P5 KW Fee 0334 5/14/84 � Zone Accessory Building: Parking Req./Provided � ICAL Transformer ❑ 15-50 KW 0 50 + Kw Meter LJup ro 100amps Merer ❑over 100amps� Sub Panel 'a,qm �� 1p Motors O0.1 HP O1 :4 - 6 Inc.Solar 09-15 HP 016-75+ Microwave Pole Light � Range ' Standing Sections 15 KW Trash Compactor $15 Isue Fee DEVELOPMENT SERVICES REQUIREMENTS: Zoning Approved By Building Approvad By SUMMARV OF FEES BUILDING PERMIT $ SMIP PLAN CHECK $ PERMIT PLUMBING $ �SSUANCE PLAN CHECK 25% $ ENERGV P.C. ELECTRICAL $ � GRADING PLAN CHECK 50% $ MICROFILM MECHANICAL $ � TOTAL FEE PLAN CHECK Z5% $ $ � 15.00 TL FEES S3 Z O N I N G R E � M T S. �ONSTRUCTION ANDPLANNING - POC SPA , APPROVALS Permit# ' Datel Inspector p�ppROVALS Permit# Date Inspector , Temporary Electrical Service or Pole � 52. Pool & Equipment Location 2. Soil Pipe-Undrgrnd. � � . 1 53. Steel Reinforcement , 3. Electriral Conduit UtilitY-Undrgmd. �� 54. Forms � � i 4. �Electrical Conduit, Undrgrnd. � ' 55. Electrical Bonding i 5! Steel Reinforcementi , 56. Rough Plumbing & Pressure Test . 6. �Electrica,l UFER Grrid.' � _ 57. ,APPROVAL TO COVER-GUNITE . i, 7. Footings ' i�� - i .. 58. Electrical ConduirUndrgmd. •" 8. Foundation . �� , � 59. Gas Pipe, O Undrgmd., Test 9. �Water Pipe-Undrgrnd. I ' I 60. Backwash Lines, P-Trap, � Undrgrnd. 10. Structural Floor System i . � . 61. APPROVAL TO DECK 11: Property Sewer Line�& House Connection � ' 62. Backwash & Receptor-Final - i . 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 i 6. Rough Electric Wiring 67. Fencing & Access Approval 17. Rough Wiring Sign 68. APPROVED FOR PLASTERING 18: Rough Electrical-T Bar Ceiling � 69. POOL/SPA SYSTEMS FINAL 19. Rough Heatirg & Air Conditioning � ' FIRE DEPT. REQUIREMENT 20' Rough Factory Fireplace APPROVALS Permit # 21., Ducts, in Structure 70. Underground Hydro 22. Ducts, Ventilating � � 71. Product Piping OGas ❑Oil 23. Gas Pipe-Rough & Test _ � 72. Underground Flush . 24. Roof Framing 73. Undergrnd.StorageTank �Gas ❑Oil 25. Roof Sheathing 74. Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and Flashing 76. Dry Standpipe 28. Lathing & Siding � 77. FIXED,SYSTEM FINAL 29. Insulation . 78. FIRE PREV. FINAL 30. Drywall Nailing HEALTH DEPT. REQUIREMENT 31. Plaster Brown Coat 79. FINAL INSPECTION 32. Electrical Power Meter-Final �o � 80. FOOD CERTIFICATE ISSUED 33. Final Electric (o 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 � � • _ . i 42. Backflow Preventer 43. Backflow Irrigation _ � C' 44. .Landscape Irrigation System 45. Sound Attenuation � _ 46. Handicap Regulations 47. FINALSTRUCTURE&BUILDING �- ' 48. Special Requirements Completed � 49. Electrie Release to Edison � 50. Gas Release to Southern California Gas Co � ' . �.� 57. CERT.IFICATE OF OCCUPANCY No. � Date ' , Applieant !o fiil in all svaces except those within heavY Oortler Iines antl sign all approoriate tleclarations. CITY OF COSTA MESA , , JO B,#10737 - �^�^�•�T ^�^ _ re..�r..i.. � r�T r.i� _wi n. . CONSTRUCTION PERMIT Project Addfess ' ' TYPE OF CONSTRUCTION- LJ NEW Y�l ADD LJ ALTERATION LJ AppliCant'S Maliing � d e� • ANAHEIM .BLVU. ANH.. ❑ corvveaswrv ❑ DEMOLISH O OTHER TERRY SFIEWAkD � 673-0760 DESCRIPTION OF WORK Owner's Name Phone Addfe55 ZZZ Z1SC ST, P.O. BOX 2786� N,P.B, TYPE OF PERMIT GRADING FOUNDATIO STRUCTURAI Arch/Eng. License No. 'O TENANT ❑ ELECTRICAL ❑ PLUMBING �MECHANICAL Addr¢55 ❑ �OTHER Contrector'sNam KINNEY AIC � Phone� ��Z—�44i Addresslmailing) 1441 S ANAHEIM BLVD__ ANAHFIM City �icPnse No. 006218 LICENSED CONTRACTOR DECLARATION � 4h¢r¢by af(itT Ihat I am IlceqseE untle� provi5iOn5 of Chart<r 9(coTm¢nCing wlth sec[lon 7000) of Divlslo� 3 of tha Busineis antl Professlons Cotle, antl mY Iicense is in tull ip�GG }nQe}jECto LJcenso Class _ t1 V t11. (,2 L��ense o.� Date �-9$_Rtl SignatUre , WORKERS' COMPENSATIOry DEC RATION lereby aftirm tha[ I �ave a ce�lificate of consent to Self-insure or a CBrtificate . Workers' Compensatlon Iqsurance, or a certifietl., copy thereoi (Settion .eoo, �ab. c.� C19970425 Policy No. Company J�A �Certifietl copy Is hereby furNshetl. Cer ti <o Is flletl with the city Itll g Divisi�9l Ddte �—�—�4 AOblicdnt��Q�C.101I0�. EXEMVTION FROM WORKERS' COMPENSATION DECLARATIONT— (Thissection neetl not be completetl i( the permit is tor one huntlretl (E300) or less) I certi(y that in the oertormance of the work for wh(ch this perm+t is Issuatl I shall' not employ any persOn �p any manne� so a5 t0 becoma wGje<t [o t�e Workers' Compensation Laws af California. Da[e Si9nature NOTICE: If,'after making lhis tleclaration, you shoultl become subject to the Work¢rs' CompGnSation provisions ot �the Labor Cotle, y0u Tust forthwl[h comply with such p�Ovizlons o� IhiS pe�mit Shall be tleemetl �Bvoketl. CONSTRUCTION LENDING AGENCV I hereby alfirm tM1at Ihere is a Construction lentlin9 agency for the performance of the �work �or which, thit permit is 6sueE (SecHon 3097. Clv. ,CJ I..entler's Namo Lentler's Atltlress OWNER BUILDER DECLARq710N I hereby affirm that I am ezempt trom [ne Cdntractor'S Licenze Law tor the tollowing rea5on (Section 7031.5 Business antl Professional Cotle: Any city or county which requires a permit [o construct, alter, improve, Gemolish or repalr �any struCture, prbr to It5 issyance, al5o requires the ap011cant tor such permit to tile a signetl statement that he/she is licensetl pursuant to the provisions of the Contractor's License Law (Cnapter 9(commencing with Section ]000) of �Ivision 3 ot the Business arytl Protessions Cotle) or that ne/she is exempt erefrom anG t�o basis �or the allegetl exemption. Any violation ot Section J31.5 by any applicant for a permit subjects the appllcant to a civil �enalty of not more than five huntlretl tlollars ($500). I, as.owner of the proparty or my employees with wages as their sole compenSatiOn, wlll tl0 the wo/k, antl the stluctur¢ is not intentletl Or offer¢tl for sale (Sectlon ]044, Business antl Professional Cotle: The ConfraCtO/'S �� License Law tloes not apply tp an owner ot a property who builtls or improves • theraon, antl wM10 tloes such �york himself/nerself or tnrough his or har own employees, provltletl tnat such Improvements are not intentletl or offeretl for wle. It, however, the bulltling or improvement iz soltl wit�in one year ot com- pletion, tne owner will nave the burtlen of proving he/she tlitl not builtl or im- �rova for the purpose ot sale). I, as owner of tne property, am exclusively contractin9 with Iicensetl <on- tractors to construtt Ihe projecl ISe<tlon 7044. Business anA Professions Cotle: The Contractor•s Llcense, Law does not app1Y to an owner of properly who bulltls oi improves [hereon, antl who contracts for 5uch projects with a con- tractor(5) Iicense pursuant to the Contractor'z Licenze Law). . ❑ I am exemp[ untler Sectbq B. & P. C. Por Ihls rea5on Date Owner . I hereby certify tnat I have r¢atl iniormation Is conect. I agre� to c antl ttate laws relatin9 to bWltling zentapves of lhis ci�Y to en[er. PROJECT DESCRIPTION $�.FT. OCCUPAf CON STRVCTION TVPE VALUATION § _ 20NE � GRADINGCV.VDS. ACR Remarks: Bar Sink Preventer Irrigation rinking Fouraains . loor D�ains loor Sinks � as Service Outlets Ki[chen Sink , Lavatories P—Trap ' Roof Drains Reinspection Fee � $25 Boiler Duct - Under Ground Duct - Structural Duct - Ventilating Exhaust System ❑ Multiple � Firepl/Fact.Blt.ICBO# ' 2 Heating System & Ducting � ai oo,oao sTu O i oo,000 sr � Signature Date t77'7l'Y' ' Drivers' ��Llcense or 5� � ReinSpection Fee $$5. CMF08G5-46rev..7/83. White-Builtlin9:Canary.-APPliwnt;Pink-Accounting;Goltlenrotl-Assessor. . Snowers Service Sink Sewer Cap Sewer Connection Solar Collectors -Solar Pipin9 Solar Tank . Swimming Poo� w/Spa Urinal Water Closet Water Heater Water Service laue Fee Hood or Typel ❑ Canopy Type I1, ❑ Refrigeration System �aioo,000sTu ❑ioo,000sTi System�RepaidAlteration � 11 SUPPL[ES 7 RETUkNS REPAIR A.P. qW S Main Bu E T Front B Rear A C Right K Left S Plrtg. Ref. # Use of Building: fEES P�anning Notes: r � E � Automatic Washer ; ' ConstructionPoleSub. Cooking Unit , - • $ 3 24. Iss�e Fee $ 3 Dryers L1Gas LJEIec[ric Fan F.A.U. � Fixtures Device Boxes ' Outlets Switches Garbage Dispoul Generator O65 KW �5�15 KW 238u 6/10/'4 Zone Accessory Park.Fees $ Transtormer LJ 15-50 KW ❑ 50+ KW Meter ❑up [0 100 amps � Me[er �over 700amps Sub Panel Motors�0.1 HP �1X-8 Inc.Solar �9-15 HP 016-15+ Microwave ' Pole Li9ht Sign Standing Sections Trash Compactor �7.. a L' � z O N 1 N G . R E Q U f R E M E N T S FEES I Rainspection Fee I$25 � Issue Fee I $' 3 I PUBLIC SERVICES REUUIREMENTS: ' Zoning Approved 8y Date Application Approved 8y Date Appliqtion Issued By ' �1� nat � � SUMMARVOFFEES BUILDING PERMIT $ � SMIP , $ PLAN CHECK $ ' PERMIT PLUMBING $ � �ISSUANCE $ PLAN CHECK $ ENERGY P.C. $ ELECTRICAL $ � GRADING $ PLANCHECK $ � M�CROFILM $ MECHANICAL � $ � SS.00 � TOTALFEE ' $ SS:OO PLAN CHECK . $ � ' � CONSTRUCTION ANDPLANNING � POG SPA APPROVALS Permit# � � Date Inspector qppROVALS Permit# � Date Inspect6r • 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 ''S�. 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 - Final � 14. Rough Plumbing 65. Electrical-Final . --• 15. Rough Electrical-Conduit ' - 66. Solar System-Final ' 16: Rough Electric Wiring ' 67. Fencing & Access Approval 17�. Rough Wiring Sign . � � 68. APPROVED FOR�PLASTERING 18. Rough Electrical-T Bar Ceiling 69. POOL/SPA SYSTEMS FINAL 19. Rough Heating &�Air Conditioning - FIRE DEPT. REQUIREMENT 20. Rough Factory fireplace ' APPROVALS Permit # 21. Ducts, in Structure - 70. Underground Hydro 22. Ducts, Ventilating 71. Product Piping �Gas ❑Oil 23..Gas Pipe�Rough & Test �� ' 72. Underground Flush • 24.;Roof Framing � - � � 73. Undergrnd.StorageTank �Gas ❑Oil . � 25. Roof Sheathing' •' � 74, Overhead Hydro 26. T-Bar Ceiling (Structural) & Monocoat 75. Dry Chemical 27. Frame and�Flashing � 76. Dry Standpipe 28. Lathing & Siding 77. FIXED SYSTEM FINAL 29. Insulation � 78. FIRE PREV. FINAL 30. Drywall Nailing � HEALTH DEPT. REQUIREMENT � 31. Plaster Brown Coat � ' 79. FINAL INSPECTION 32. Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED 33. Final Electric � Notes: 34. Final Heating & Air Conditioning �q�,�- �V 35. Final Gas Pipe;Test � 36. Hood or Canopy 37. Final Factory Fireplace . . 3$ Final Plumbing ' ' . 39. Water Service-Final � 40. Gas Service-Final � � � 41. Solar pomestic-Final .' � 42. Backflow Preventer � 43. Backflow Irrigation � � � 44. ,Landscape Irrigation System � , - 45. Sound Attenuation ' 46. Handicap Regulations ' 47. FINALSTRUCTURE&BUILDING 48. Special Requirements Completed . 49. Electric Release to Edison � - � 50. Gas Release to Southern California Gas Co 51. CERTIFICATE OF OCCUPANCY - _ - _ No. Date