HomeMy WebLinkAbout1010 17TH ST - Building Permits WEST 17th. STREET. 1010 "
•
42328 - 5-11-77 Ind. Bldg. $86,900.
• -. i 113972 - 6-22-77 Trash Enclostre 500,
. - _ _ . . . . .-S
P19207 E -
S— ® •
- B19150 ALT 25,000/ -ea witanztaiaz
= E19312 amananapisaLirs/dzirS ' •
M19430 REF
•
-7-?0 33..B, 19150
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1
UWNCI< =WIN DZVL''LUYMLIVT UAIC 4-13-77
JOB ADDRESS 1010 West 17th Street, /(2 BUILDING PERMIT NO. 43972
GENERAL CONTRACTOR Owner-Bldr. DESCRIPTION of WORK Trash Enclosure
h4 ?' o. -1 0-1 LOT TRACT FIRE ZONE VALUE $ 500.00
I?, .r°. CTIONS Signature Date TYPE GROUP ZONE )C
SOIL PERMITS ISSI.ED
GAS SUBCONTRACTOR
Data I Number Signature
WATER Plumbing
ROUGH PLUMBING
PROP. SWR. LINE Q HOUSE CON. f
SPRINKLING SYSTEM
MISCELLANEOUS
ROUGH HEATING AND AIR CONDITIONING
TEMPORARY SERVICE OR POLE
UNDERGROUND El POWER L.el
ROUGH WIRING — ' Heating and Vent. .
TR -
'TRENCHES FOMS STEEL REINF. �`
.A S•1,rj77
FLOOR SYSTEM �)�,__ •
BOND BEAM STEEL REINFORCE RIR" 5-31-77
SHEATHING
FRAME AND FLASHING^
LATHING — IN 1 1 OUT n
PLASTER, BROWN COAT
S 'TURAL. FINAL Electric
H. .NG, VENT., REFRIG. AND A.C., FINAL
PLUMBING. FINAL AND GAS TEST n
ELECTRIC, FINAL
BUILDING, FINAL JAI hsz-72
SPECIAL REOUIREMENTS
ADDRESS aBmLmn: MT: CITY OF COSTA. MESA — BUILDING PERMIT
aSNAMEIEKNOWIh 1010 W 17TH ST
i'a"E KEi,Bi7RN ENGINEERING CO PERM NO: » 085126
ADDRESS: %PRIME CONTROLS CO
1010 W 17TH ST PERMIT NO: B 085126 PLAN CHECK NO: N GOVT: N SUPP: N
COS'AMESA,CA 92627650-6600
CONSTRUCTION TYPE: PERMIT TYPE: SIR PURPOSE: OTH
ARCHITECT ORMIKE&: UC.Pa: JOB DESCRIPTION : T/OFF & REROOF W/BUILT—UP SQ FT: 6, 500
ARCA OR ERG'S ADDRESS: UMT:
CLAIM VALUE: 6, 500 . 00 CALC—VALUE: 6, 500. 00 GROUP OCC: B /
ca+mACToaSNAIIE SANTA ANA ROOFING INCORPO ( 714 ) 771-6877
CONTRACTOR'S MAIM 923 N LOGAN ST COMMENTS: REROOF 7000SF COMMERCIAL BUILDING
ADDRESS: SANTA ANA CA uc.NO: 463596 ;raw*;E::**;E**x*;E;Eos;E;E;:*:r•**;EaEtt;e;tAt*;E**;:;E*xx;t'>F;:***;tai'*iss;ixRi:'x*xa:'R;:w;:*;E;e***x;e*'x*x;ER,:x;:x
92702 Uri ZONING REQUIREMENTS
LICENSED CONTRACTORS DECLARATION:I hereby affirm under penally of perdu y the I am licensed under provisions of Chapter S SE TBACKS
(commencing with Section 7003)of Division 3 of the Business and Professions Code.end my faros is in fug form and effect
CITY uc.No.: 03530b LIC.CLASS: C 39 uc.No.: 453596 cps .01 /98 - MAIN BUILDING - - - ACCESSORY BUILDING --- --'- - --
Dale: /U-`)- a --7 crwedm,>.....4gt�ey.' ,C7L.�- 3-J FRNT: FT' IN REAR: FT IN FRNT: Ft IN REAR: FT IN
LEFT: FT IN RGHT: FT IN LEFT: FT IN RGHT: FT iN
OWNER BUILDER DECLARATION:I hereby affirm wider pehejy d patsy the I am exempt hem the co menta Ldcenee Law for the
following
O den.rrepereason($ection aniy.'maim:q-lois .abs rand Professions equires Any�p forsmsuch Penne to Meounty which requires a gane a signed wmesrry alter,impose,
orrw m ansi.G REQ; PROV: PARCEL: 42435110 ZN-r:: REF NO-
' •/t'toned pursuant lo the provisions of the Crmadra License Law(Chapter 9(commixing with Sedan 7030)d. tan d Dation 3 d the PLANNING NOTES?! -e
' "T'usend ProfessionsCode(or he r Nis the eexempt therefrom and the basis lot the alleged expAbt My ratSection e> f'
a Y't7D31.5 by any applicant fora permitrtbpdthe e applicantd were ant to a obi penalty mthan fire(tweed dolled 135OOD. /
is not intended
❑ rofred for sale(Section 7Osa.Business and PMes The 1 im oensr'the Mem&0 my emPloYem with sages es their Me compensation.wil do Ihe LioeseLaw dmndapply toend the�an'sownerdpmgry D E V--E'-L OPMEN I S E R V I C E S tt E Q i1 i R E M b N_.t S
who binds or improves thereon,aid who dos such work tinsee or herself or through he or her own employes,provided the such /I ,- ' f �'
impmemedt ere not seeded r"'id fp'
ale.S,shoose y.Dte build*r build*
inpmwnad"e"Id wulin one yew
d anpleton.the
owner-builder will have the burden d proving he or she did not build or improve for the purpose d tee). `DOMING APPROV'E4�.BY DATE.:
❑ Leo owner of the property am exrimwly commdid with icens.d contractors to ammo the project(Sedan 7044.Business and
Professions Code:The CotlredaLicese Law doer not appylo an owner of property who builds or enigma*'hewn and Who BUILDINL3 APPROVED BY : DATE: / e'.0
contracts for such projects with a contractors)licensed human,to the Contractors License Law). 7.•- �p '- --
❑ Iamexempt uderSection: B.AP.C..frdes reason: APPLICATION ISSUED BY: , _ l\% DAME: '
Dale: Ow+sr. *************************wxf*ww*art****www*www.i-x -* www*wT*wwwm*' *te
'w***Rxx *NW* x%*
I do herebycedity dr I ameware of rn
and requirementse reqrequirementsoafia
Cde Meth and Safety Code Sepias 25505.25533.ad LEGALIZATION:N F E E SUMMARY S'CRUCTUltAin! SEliM7::N'I : Y
35534,and dual I or any Mus building ooc pent wet/wT not(circle w)need to acutely with said rote codes aha the requirements for
a game fix aonsnolenr maddi ruhhewnthe As OnaltyMahegrrru District Residential Cr Milieu appFaketswe exempt from these BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMIP/RES (TRADING
provisions PERMIT 124 . 75
Date: AppfcaN: S M I P/NON--R ES
WORKER'S COMPENSATION DECLARATION:I hereby dem urder penally da
ptsrd r
y e the Mowing dedaars: P LAN 1 . 3.7
❑ Ihave ade. wll msn.Macrvtuud=Win to selLa..fforwmMas'awenss ,.=prwidedlrly Skean 3700d the Labor ISSUE FEE
M
CoIcethewdrnwaadgewiekId*ththePennaelnwd. BUILDING—DIV—> PERMIT ISSUE PLAN--CHECK TOTAL PAID DUE
p Ihave and will m.intsanworkers'ean,am,lennarrm,.ead,drdby---nn 3700 athe(.baCode.tor the pwnaehcedthe TOTALS----> 126. 12 0. 00 0 . 00 126 . 12 126 . 12 . 00
A worm for whirr the permh is hued.My workers'comperestion insurance arienrd poky number are:
Carer: GOLDFM R.At7T.F EXPIRES REVENUE DIVISION 'TOTALS--> COLLECTED: 126 . 12 OVER/SHORT: . 00
Pdry Number: Ourd7.,;L644OT 01 /01 /98 BLDG PMT PLUMBING ELECTRIC MECHANIC FIRE SMTP/TVI GRADING PLAN -CHECK
,This vection need not be completed r came pad is for one htd,ad doles rso00l or we.) 124 . 75 1 . 37
o heady shed in 0he pedmnence of the work for which this permit is Issued,1 Nell net employ any pram in any manner s°s to
become subled tic the waken.CCmoenealen lea d CNlomis, err egos os S 1 null become subpd lo the wdrs' ***************************************ore**********it***************iF*w******if*w*
/0compensationprprovisions of SectionSion 3703 d the Lebo Coda,I shallshalll m i --- pWriw.
aa..
Dalt IU'V1'! -7 Apo. • INDIVIDUAL F E E BREAKDOWN
Warning:FW out to secure worts'compensation coverage is end then ae(Kt an emdoyee to cannel powwow TYPE QTY DESCRIPTIO N UNIT COST TOTAL COST
del fines to to one hundred thousand d tld/es(9100,W3A bur a Itbn to the cwt of compensation damegs a provided for In
Beam 3816 of the Labor Cott Wares(and etmmeyifwa SFC 6500 REROOF BY VALUE COMMERCIAL NOZUNE 1 . 00 6, 500 . 00
CONSTRUCTION LENDING AGENCY:I hereby dame under penalty d patsy that the Is a=Wnoion lenders weer/ler the END OF FEES
performance of the work for which the permit S issued(Sedpn 3087,Cie.C).
LENDERS NAME
LENDER'S ADDRESS:
I chanty that I have read this application and date that the Note Worm/dial is coned.I agree to comply with a0 dry end caddy ordinances
and stale laws reexng to building wnmob°n and hereby tut rare sprswatives el this city to enter spm the eboe-mwired propany
for impedion purposes.
JOHN KIDWELi.
111-0-M97/69:4610/$26.12
Cd/ Name RCPT6:81 8813686
/ _ ode: /d —9- 7 PERMIT:085126
r Signature d Owmr/Apent/AppicantConliadr
(5151-46 WP) White-Buildial A Safety:Green-Fife:Canary-Applicant;Pink-Revenue:Goldenrod-Nose .
• CONSTRUCTION AND PLANNINGPOOL JPA
APPROVALS Permit# 'Date Inspector APPROVALS Permit# Date Inspector
1. TemporaryElectrical Service or Pole 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 53. Steel Reinforcement
.-37-Electrical ConduitUtility-Undrgrnd. 54. Forms
' X73' Electrical Conduit•Undrgrnd. • 55. Electrical Bonding
S• eel Reinforcerrwm: 56. Rough Plumbing & Pressure Test -
•T6:' Electrical UFER'Grnra, 57. APPROVAL TO COVER•GUNITE
ti
-: _]�Fbgtings -� 58. Electrical ConduitUndrgrnd. -
' .814Fouhdation .. 59. Gas Pipe, 0 Undrgrnd., Test
9.,Waier Pipe-Undrgrnd. -, 60. Backwash Lines`P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVALTV2ECK
1.1. Property Sewer Cine & HouseC,onnection62. Backwash & Receptor-Final
12. Seer Cap .• 63. Heater & Vent-Final
13. Roof Drains _ 64• Plumbing System - Final
14, Rough Plumbing. •65. Electrical-Final
• . 15, Rough Electrical-Conduit - J66. Solar System-Final,
16. Rough Electric Wiring' - _ , 67. Fencing& Access-Approval
17. Rough Wiring Sign 68. APPROVED F( R-PLASTERING
C
18. Rough Electrical-7T Bar Ceiling 69. POOL/SPA SYST-JEMS FINAL
19. Rough'Heating-&'Air Conditioning - •.„, FIRE DEPT.REQUIF;EMENT
rr r " r ?
20. RougS Fa4tor Fitod!ace S'i S. t ! -1,APPROVii4.'4 2 Permit# P 'I r
21. Ducts, in StrUCturoi I •• •• 5 a S "z N 70. Underglou Td Hjyjdro 1.
r y
22 Ducts�.r Ventilaimg-; i: .7 c ::; 1 71. Produc •Pip
eing Elias C'Oil
23, Gas Pipe-Rougft& Test i _t -c " . c •• 72. Underground Paso 1 : - _v
24oofi ra 15ing" ^h t ' ••• ., - 73-' Undergrr d.Sto5rLe Tanik0 Gas O Oii
25. RoofSheathing is t II • 74a Overhead Hydro. r
I: `I 1
26, T•BaT'Ceiling (StructyI ral) & Mododoat s .) - ., s 75,Pry Chemical
7 t .-I.. , . r t v - ;, .. •1 a •t :.
27, Erame and Flashing r D r. - t r • r t 76. Dry Standpipe -• .i r ^_
- _ -
r , f -, • 71 •t
28, Lathing &Siding r c ' s ;._, -. +- "I "i ', ,77 FIXEDTE 4 INAL
H ,t• D t _ -I .. .. > t x I 1 iiT . .1
29, Insulation • t. - C •• ( i" 705, FIRE PREY. FIN`QL t
'30, Drywall Nailing `• _k _ 1 � � ''}1EALla,,DEPT.RECU!F1 MENT
K •. I IL
t'
k
31, Plaster Brown Coat. t -v r• i- f K ,• 79.E FINAL INSPECTION e
'. 32, Electrical,-Power MptkrFipal I I ' ' 8q FOOD CERTIFICATE I SjIED. -
FinarEle,tric-. -J o- ... ` '1 ••i
• 33, R _ - tTf _ I Ir Notes: 3. 1 rl ,I i -t - Jt
-' 34, Finat-He ting & Air Conditionirfg S ? ; k + = c T =
:3 , • �--
II « ,� , , .
35, Einar Gas PipeTestj • _ -. t - ...1 :: ' . I. -
' 36. Hood•or Canopy D - ' . .7' t n I.
•?"
, .. a , 71 :. - F r
37. Final:Factory Fireplice' ... .. _ t •3
_ 38. Final Plumbing t 3 _ I - - -
i I I. t =
39. WaterService-Final ' . • -
- 40. Gas Service-Final t - -• -
•
41. Solar Domestic-Final - •' -` _• C-! -
42. Backflow Preventer • •- it •
- 43. Backflow Irrigation t - - _
44. Landscape Irrigation System ' - '
•
45. Sound Attenuation• ;, « t - ,t
46. Handicap.Regulations _ u?• r
47. FINAL STRUCTURE & BUILDING " '-
l�3 7 y 1.4 •
48. FINAL PLANNING - /
_ -y fit_
49, Elecific Release to Edison -
'v
50. Gas Release to Southern California-Gas Co t - ' -
51. CERTIFICATE OF OCCUPANCY « r
No. Date
J4675 6/14/85 13.00 7L
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
•
CITY OF COSTA MESA CMISTR UCTION PERMIT, PERMIT NO. ' TRACT NO. LOT NO. UNIT
Project Address /per f •=*?.1 �Per
- q'4-10
Applicant's Marlin. Address i" - -„ , .' A, TYPE OF CONSTRUCTION' U NEW 0 ADO U ALTERATION U REPAIR
Owner's Name • • •hp , ,3-9y00 0 CONVERSION 0 DEMOLISH 0 OTHER A.P.# - Zone
1l may, rt DESCRIPTION OF WORK/USE OF BLDG. _
Address It '° IN L 74 ' S Main Building: Accessory Building:
EZ
Arch/Eng. - License No. - - TYPE OF PERMIT LI GRADING U FOUNDATION 0 STRUCTURAL T Front 0
Address 0 TENANT 0 ELECTRICAL 0 PLUMBING 0 MECHANICAL B Rear - N
Contractor's Name kkO &-
rV- — hgn/7 -Pill 0 OTHER : A I
Address(mailing) 4 2 a frNi'1 eA a Cc/AA • - PROJECT DESCRIPTION S0. FT. OCCUPANCY K Right • G
''��^s CONSTRUCTION TYPE VALUATION$ $ Left
City License No. 10 C5-4/ _ ZONE GRADING CU.YDS. ACRES R
LICENSED CONTRACTOR DECLARATION n _ Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing Remarks: - .IS I`7 i s0 I Planning'Notes: • 0
. with section 7000) of Division 3•of the Business and Professions Code, and I - ( M .
Livelicense i5 in full forU and,eH�p_� 35 ys T
Utenze Class Cen - $
Date ''" Signature / _ PLUMBING FEES / '
WORKERS'COMPENSATION DECLARATION Bar Sink Showers
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
if Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer Service Sink - - - - - KW. - - -- -
;800, Lab. C,) - - . Automatic Washer Transformer .❑ 15-50
Policy No. Company Backflow Irrigation Sewer Cap - 0 50+ KW
8 Certified copy is hereby furnished. 4 Construction Pole Sub, '
Certified copy is filed with the city Building Division. Bathtubs Sewer Connection • Cooking Unit Meter ❑up to 100 amps
Date • Applicant Clarifiers •
EXEMPTION FROM WORKERS'COMPENSATION DECLARATION Solar Collectors Dishwasher • Meter Clover 100 amps
(This section need--not be completed if the permit Is-for one hundred($100) or -' - - -
less). Dishwasher Solar Piping Dryers ❑Gas ❑Electric I Sub Panel
I certify that in the performance of the work for which this permit is Issued, i - .
shall not employ any Person In any manner So as eco object to the Drinking Fountains Solar Tank •
Fan '
Workers' Com nsa n Laws of California. `O Motors ❑0.1 HP ❑1%-B , ,
• Date',0 '-I + Signature Floor Drains . Swimming Pool w/Spa 'F.A.U.
'NOTICE: If,of er mak; this declaration,you should become subject to the ' Inc.Solar 09.15 HP 018.15+
Workers' Compensation provisions of the Labor Code, you must forthwith FIOOLSinks - . . _ - Urinal - - - -- - - - -
comply with such provisions or this permit' shall be deemed revoked. - Fixt Ures-- -Microwave
CONSTRUCTION LENDING AGENCY - Gas Service Outlets - Water Closet el • Device Boxes
I hereby affirm that there is a Construction lending agency for the performance POIe Light •
of the work for which this permit is issued (Section 3097 Civ. C.) Interceptors - Water Heater _ ' •Outlets Ran e '
Lender's Name 9
Lender's Address - Kitchen Sink I. Water Service '
OWNER BUILDER DECLARATION - Switches _ • Sign
' I hereby,affirm that I am exempt from the Contractor's License Law for the Lavatories,
following reason (Section 7031.5 Business and Professional Code: Any city orI •Auto-Wash - Garbage Disposal , 1 ;Standing Sections
county which requires a permit to construct,alter,improve,demolish or repair P—Trap' -Laundr Tra s
any structure, prior to its issuance,also requires the'applicant for such permit y y Generator 00-5 KW 05-15 KW Trash Compactor
to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains '
the Contractor's License Law(Chapter 9(commencing with Section 7000)of • , •
Division 3 of the Business and Professions Code) or that he/she is exempt •
- _
;:therefrom and the basis for the alleged exemption. Any•violation'of Section - , • • '
-`"031 5 by any applicant for a permit subjects the applicant to a civil -. •:1,,!")031.5
E#1J.penalty of not more than five hundred dollars($500). 9
LJ h'as owner of the Property or my employees with wages as their sole Reinspection Fee 'I $15 Issue Fee $
compensation, will do the work,and the structure Is not intended or offered -
for sale (Section 7044, Business and Professional Code: The Contractor's - - MECHANICAL 'Rainspeetion Fee $15 'Issue'Foe S 3
• License Law does not apply to an owner of a property who builds or improves - FEES
thereon, and who,does such work himself/herself or through his or her own DEVELOPMENT SERVICES REQUIREMENTS:,
employees, provided that such Improvements are not intended or offered for , Boiler Hood or Type I ❑ '
sale. If, however, the building or improvement is sold within one year of com- Canopy Type II 0 - - Zoning Approved By Date
pletion, the owner will have the burden of proving he/she did not build or Im- , Duct-Under-Ground • Building Approved By Date
prove for the purpose of sale). .. - `��''14•f�
❑ I, as owner of the property,am exclusively contracting with licensed con- Duct-Structural --- _ T.,nw�•s�::' , I . Application issued By 7-3--1-- Dat
tractors to construct the project (Section 7044,Business and Professions Code: 4
ger
The Contractor's License Law does not apply to an owner of property who Duct-Ventilating • C-1••"""s '
-builds or improves thereon, and who contracts-for such projects with a con- - -- SUMMARY OF FEES
tractor(sl license pursuant'to the-Contractor's License Law). I am aware that BUILDING PERMIT $ SMIP $
proof off their Workers Compensation insurance should be provided to me. Exhaust System ❑ Multiple ❑ Sys[¢m Repair/Alteration
$ PERMIT
❑ I am exempt under Section - B.$ P.C.for this reason • Firepl/Fact.Bit. PLAN CHECK
ICBG# Fire Dampers $ ISSUANCE $
- PLUMBING
Date — Owner - Heating System& Ducting . Registers ' ry ENERGY P.C. $
I X AO-100,000 BTU ❑100,000BTL _ PLAN CHECK 25% $ •
hereby,cert lfy_ t I e read thisapplication and state that the above - • GRADING $
Information is correct. I agree to comply with all city•and county ordinances ELECTRICAL $ ,
and state laws relating to building construction,and hereby authorize repre- -
sentatives of this ,city:to enteee,,,rrr -upon jhe above-mentioned property for PLAN CHECK 50% $ MICROFILM $
;Inspection purposes. „I - _ v/ I 6�q--g5TOTAL FEE $
Signature ►^(JrnJb'�\ ADate 7 ,! MECHANICAL ' $ t!-00
' Drivers' License or SS I Reinspection Fee $15 Issoe Fee $ 3 PLAN CHECK 25% $, Z-CQ • ' 13-00
CMF 0865-46,rev.10/84 White - Building; Cana- A `` /`
y pplicani; Pink -Accounting; Goldenrod -Assessor ' 4
• - CONSTRUCTION AND PLANNING� POOL _SPA
' APPROVALS Permit#.71 /9930 Date Inspector APPROVALS Permit# Date Inspector
- ) .4 •
' 1. Temporary Electrical Service or Pole - • _ 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd- • '• .i• 53. Steel Reinforcement
,
L
3�YElec{rigal Condyt Utility-Undrgrdd -
.- • 54. Forms -.
4:iElectrical Conduit-Unehgrnd. . I- - 55. Electrical Bonding
5. . ..Reinforceme i„
56. Rough Plumbing & Pressure Test "..
6' Elect-rical UFERZiind. 1 57. APPROVAL TO COVER-GUNITE .1-i,
7••-Foot+rig ~-, 58. Electrical Conduit-Undrgrnd. -
8..Eouriaation ' •' 59. Gas Pipe, 0 Undrgrnd.,Test
9.-Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 Undrgrnd.
10. Structural Floor System 61. APPROVAL TO DECK --'
11^Property Sewer Line& House Connection :•
-;, 62. Backwash & Receptor-Final
12. Sewer„Cap \., 2 '2 - 63. Heater & Vent-Final
13. Roof-Drains ) 64. Plumbing System - Final -
14. Rough Plumbing2 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 0 Gas 0 Oil - -
23. Gas Pipe-Rough & Test - - '72. Underground Flush 'ltd,f,r
24. Roof Framing 73. Undergrnd.StorageTank 0Gas ❑Oil }
25. Roof Sheathing 1 74. Overhead Hydro ,i i
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 r•'
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: y / 71f) nrifine' / , '
34. Final Heating & Air Conditioning q/,Jrr ie T- .yam ,� re ersi ea.cza /
f % /I,,/ yO Xe f a yf //'Alt�!•a/^- G/y T�w�O �a7�aah
35. Final Gas Pipe-Test 1' r t • �►
- .279, en itries-/.�
36. Hood or Canopy -
37. Final Factory Fireplace =
38. Final Plumbing
39. Water Service-Final '
40. Gas Service-Final - ,
41. Solar Domestic-Final - : •
42. Backflow Preventer i
43. Backflow Irrigation
44. .Landscape Irrigation System -
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed .
•
49. Electric Release to Edison
1
•l 50. Gas Release to Southern California Gas Co • -
51. CERTIFICATE OF OCCUPANCY ii )
No, Date .
• A
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTA MESA CONSTRUCTION_'LPERMIT PERMIT NO. TRACT NO. LOT NO. UNIT IR - 3981
Project Address/0/0(/• /7�77 --Sy- • I P i��-0 7 U 6/03/85 I I �8 TI
p
'�^ '� J •TYPE OF CONSTRUCTION LI NEW ADO U ALTERATION U REPAIR f
Applicant's Mailin Address ti�/J i/7/ -1 eY.1y,,/6/J/v
��//Y7!? A)'7/ 214 Phone ❑ CONVERSION ❑ DEMOLISH OTHER A.P.# I Zone
Owner's Name DESCRIPTION OF WORK/USE OF BLDG.
Address F/rnR r I S Main Building: Accessory Building:
Arch/Eng. License No. TYPE OF PERMIT ❑ GRADING y FOUNDATION ❑ STRUCTURAL T Front - - o
Address ❑ TENANT ❑ ELECTRICAL LUMBINGJ�^_� ❑ MECHANICAL B Rear _ N
Contractor's NamatC3/\ Ae/9•C- ld Phone.1`'"4'�� -4/14 ❑ 'OTHER C RightN
Address(mailing) aelle 3 ,T' 4 O7 '//e/r-i✓9.//0 PROJECT DESCRIPTION SQ. FT. OCCUPANCY K ..Left G
- CON ST RUCTION TYPE - VALUATION$ S
City'License No. 1941S" ZONE GRADING CU.YDS. - ACRES R
LICENSED CONTRACTOR DECLARATION //;; _ Ping. Ref.# Parking Req./Provided E
I hereby affirm that I am licensed under provisions of Charter 9 (commencing •Remarks: 3--(�-{ is-0 Planning Notes: - 0
'with section 7000) of Division 3 of the Business and Professions Code,andM
my license is injJl force . d effect. r S
License Clals _TT LI - • N. 47
Dat• -- -— Signature >7•/ 7 . - PLUMBING FEES
WORKERS'COMPENSATION DECLARATION / Bar SinkShowers -
I hereby affirm that I have a certificate of consent to self-insure or a certificate ELECTRICAL FEES
of Workers' Compensation Insurance, or a certified copy thereof (Section Backflow Preventer -
3800, Lab. C.) • - Automatic Washer Transformer 0 15-50 KW
Policy No. Company ' Backflow Irrigation Sewer .• Construction Pole Sub. 0 50+ KW
BCertified copy Is hereby furnished. - - -
Certified copy is filed with the city Building Division. Bathtubs Sewer ConnectionCooking Unit Meter ❑up to 100 amps
date - Applicant
EXEMPTION FROM WORKERS'COMPENSATION'DECLARATION • Clarifiers • Solar Collectors Dishwasher ' Meter Dove? 100 amps
(This section need not be completed If the permit is for-one hundred ($100)or - '-
less). Dishwasher Solar Piping Dryers DGas ❑Electric Sub Panel
• I certify that in the performance of the work for which this permit is iss ed;I
shall not employ any person in any man R{Osp7a$�o be. ome subje o the Drinking Fountains Solar Tank Fan Motors❑0.1 HP ❑1'h-B
Workers' Camp s Win Laws of Calltornjf; f//����j�a
. Dat Signature ,you should Floor Drains I Swimming Pool w/Spa F.A.U. f Inc.Solar 09-15 HP 016-15+
NO CE: If,after making this deciaratio you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith Floor Sinks Urinal - Fixtures - - Microwave
comply with such provisions or this permit shall be deemed revoked. -
CONSTRUCTION LENDING AGENCY - Gas Service Outlets •/ Water Closet '
1 hereby affirm that there is a construction lending agency for the performance Zt� Device Boxes Pole Light
of the work for which this' permit is issued (Section 3097 Civ. C.) Interce tors Water Heater
Lender's Name - p Outlets Range
Lender's Address Kitchen Sink • - Water Service - ' Switches Sign
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the / Lavatories t Auto-Wash- 7 , Garbage Disposal ;Standing Sections
-
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repair - P-Trap - Laundry Trays Z Generator DO-5 KW ❑5-15 KW Trash Compactor
any structure, prior to its issuance, also requires the applicant for such permit
• to file a signed statement that he/she is licensed pursuant to the provisions of Roof Drains
' the Contractor's License Law(Chapter 9 (commencing with'Section,7000) of
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section ,y..A
7031.5 by any applicant for a permit subjects the applicant to a civil �1ct/1--
.
eenalty of not more than five hundred dollars($500). $ 3
U I, as owner of the property or my employees with wages as their sole Reinspection Fee $15 Issue Fee ' ' -
compensation, will do the work,and the structure is not intended or offered -J. Reinspection Fee I $15 Issue Fee $.3
for sale (Section 7044, Business and Professional Code: The Contractor's - MECHANICAL FEES.'
' License Law does not apply to an owner of a property who builds or Improves
thereon, and who does such work himself/herself or through his or her own - DEVELOPMENT SERVICES REQUIREMENTS:
employees, provided that such Improvements are not intended or offered for Boiler Hood or Type I 0
sale. If, however, the buildingor improvement is-sold within one year of tom- •
r. Zoning Approved By Date -
p Canopy Type I ❑
pletlon, the owner will have the burden of proving he/she did not build or im- Duct- Under Ground Building Approved By Date
prove for the purpose of sale). I
D I, as owner of the property, am exclusively contracting with licensed con- Duct-Structural Refrigeration System Application Issued By f Date. _
tractors to construct the project (Section 7044,Business and Professions Code: `�
The Contractor's License Law does not apply to an owner of property who buct-Ventilating • ❑0-100,000 BTU 0100,000 BTU SUMMARY OF FEES
builds'or improves thereon,and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law). I am aware that Exhaust System ❑ Multiple ❑ System Repair/Alteration BUILDING PERMIT $ SMIP • $
proof of their Worker's Compensation insurance should be provided to me. •
PLAN CHECK $ _ PERMIT
• 0 1 am exempt under Section B.& P.C.for this reason Firepl/Fact.Blt. ICBG# Fire Dampers • - PLUMBING $ ' 1 -00 ISSUANCE $ - -
Date Owner Heating System& Ducting Registers PLAN CHECK 25% $ ENERGY P.C. S'
I hereby certify'that I have read this application and state that the-above ❑0-100,000 BTU El 100,000 BTL— - GRADING$ GRADING $
information is correct. I agree to comply with all city and county ordinances
and state laws relating to building construction, •nd hereby authorize repre- PLAN CHECK 50% $ MICROFILM $
sentatives of this t to ter p.n the ;ore-mentioned property for _
inspection purp•• - •• l
-/ i. /� MECHANICAL $ - TOTAL FEE S. I -Cc)
Signature _ " i) �.r Date/- j�<Y.l
Drivers' Lice se or 55,E ry- - %/„ .... Reinspection Fee $15 Issue Fee $ 3 PLAN CHECK 25% $
CMF 0865-46,rev.10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor
CONSTRUCTION AND PLANNING POOL ?A
APPROVALS Permit# Date Inspector APPROVALS Permit# Date Inspector
1. Temporary Electrical Service or Pole • 52. Pool & Equipment Location
2. Soil Pipe-Undrgrnd. 4/4,1-5"'I '4" 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. 7 57. APPROVAL TO COVER-GUNITE '; ,1
7.'Footings L 58. Electrical Conduit-Undrgrnd.
8.,Foundation ,. ,'I 6 59. Gas Pipe, 0 Undrgrnd.,Test
9.`Wate? Pipe-Undrgrnd. ' {
• 60. Backwash Lines,P-Trap, O Undrgrnd. ,
10: Structural Floor System ' ' 61. APPROVAL TO DECK •1
11. Property Sewer Line•& House Connection 62. Backwash & Receptor-Final
12. Sewer Cap -63. Heater & Vent-Final o�
13. Roof Drains / rf 64. Plumbing System - Final J
14. Rough Plumbing ' Ur(/i(Ic ( 7) 65. Electrical-Final '
•
15. Rough Electrical-Conduit 66. Solar System-Final r
•
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 0 Gas 0 Oil
23. Gas Pipe-Rough& Test 72. Underground Flush
24. Roof Framing, 73. Undergrnd.Storage Tank 0 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 PREY. 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:V3/4"- 4"7/�� 4.44.4.-
34. Final Heating & Air Conditioning 7/ /44/ £" „
35. Final Gas Pipe-Test
36. Hood or Canopy
37. Final Factory Fireplace
38..Final Plumbing • 7/,?;f
39. Water Service-Final
40. Gas Service-Final
41. Solar Domestic-Final
•
42. Backflow Preventer
43. Backflow Irrigation
44. Landscape Irrigation System ,
45. Sound Attenuation
46. Handicap Regulations
47. FINAL STRUCTURE & BUILDING
48. Special Requirements Completed
49. Electric Release to Edison
50. Gas Release to Southern California Gas Co
51. CERTIFICATE OF OCCUPANCY
No. Date -
Applicant to fill In all spaces except those within heavy border er lin_es and d sign all appropriate declarations.
CITY OF COSTA MESA I PERMIT NO TRACT NO.
• p LOT NO.. t ,, BLDG NO. 454Q^ ,(/1Q/65 37g60- TL
CONSTRUCTION PERMIT • i a 'I" E. 1 t 3 17i ' • ' •0 '
' Applicant's Mailing Address ' -7 . 'TYPE OF CONSTRUCTION . Li NEW U ADD ALTERATION U REPAIR - 1 • • • I• , ' 'I
Project Address X010 �. �` T - /, ' - ❑ CONVERSION ❑ DEMOLISH ❑'OTHER - - -
Owner's Name /n'i�_ Ivrrd -OSSC) DESCRIPTION OF WORK ' , ZONING REGULATIONS' - -
PiQIG C.L� OL-S Phone _ i
' Addre•ss /0%0 /7 T� L✓STf/ ,v - J - - ..
- - TYPE OF PERMIT • ❑'GRADING I U FOUNDATION U STRUCTURAL A.P.vW' ZONE .
Arch/Eng.` ' - - License No. 0 TENANT %ELECTRICAL 0 PLUMBING 0 MECHANICAL PLNG. REF-'P' • -- BUILDING • ' -
- SFTRAr`le r41 ST
❑ 'OTHER •
Address - ` i - _ _ __ • TO BUILDING ' - .REAR YARD(TO P/L) ' �
'SSD^ PROJECT DESCRIPTION SQ. FT. OCCUPANCY PROPERTY LINE - -
AddrectorsNama /� .- �_��TQ� Phone •
,LEFT SIDE YARD - RIGHT SIDE YARD
C" - ��"j, CONSTRUCTION TYPE ' VALUATION§
Address(mailing)v/S�D a' C�/i✓6G iP • .G...5�,)� v /W4 -
i License No. C /O - 'SOSG S%7 Z_w1Z> f ZONA ' - GRADING CU.YDS. ACRES _ PKG.SPACE,REO. PROVIDED -
LICENSED CONTRACTOR DECLARATION ' I Remarks: �, /9,CSO ' .- STREET WIDTH I PARK FEES
}n • i•hereby•affirm that I-am licensed:under provisions of Charter 9(commencing ' - - ;
with section 7000) of Division 3 of the Business and Professions Code,and ^, SPECIAL CONDITIONS: '-1 [[
(`� my license-Is in full force and effect. , �/�� ' , l
!o • I
j ucensellass ' i _ ' -� ,Ic: se No. + • PLUMBING i • j
Date b�- - Signature ��i�i : : ; Bar Sink . Sewer Cap ELECTRICAL •• '
• WORKERS'COMPENSATION DECLARATION 2 -
1"- '`tpeby affirm that I haven certificate of consent to•self4nsure or a certificate - , Backflow'Preventer-' - - - ^Sewer Connection"----•• - - - - . .- Automatic Washer_. _ _ ,Meter Clover 100 amps. : _ 1
—,Workers' Compensation Insurance,.or a certified copy thereof (Section - _
F,v'430' , Lab. C. //�0 p 9AJ a'(!.-:[r,— - •' Backflow Irrigation - - Solar Collectors Construction Pole I Sub Panel
SP Dl Z,Z7e4.-,, Com _ I _ I
Policy No. pang ' (`re-n1-^i l'I.S : ,l - Cooking Unit . •
Sub Pole i
Certified copy li hereby furnished. ! Bathtubs""-i Solar.Piping I }
LJ Certs ietl tpp tied with the city B I Nisi i DishwasherMotors ❑0 1 HP ❑1 h-8 I I
Date w 'w .AOPlicnt �t 1 _ Clarifiers 1 r. , _ Solar Tank •
- iii:: i'
_ , _ _ _ _EXEMPTION,FROM WORKERS'COMPENSATION DECLARATION , Dishwasher i Swimming Pool w/Spa , - Dryers .OGasDlectric Inc.Solar ❑9-15HP ❑16-15+ 1 i; (This section need not be completed if the permit Is for,one hundred ($100) or -_less),. s f 11i i - i ! ' Fan I �/AMicrowave I. I certify that in the performance of the work for which this permit Is Issuetl 1 ' , Drinking Fountains Urinal 1 i / 1 - i I C
i shall note employ any person In any manner so,as td become subject to the I -T -' '" - I - - F.A.U. i ,Pole Light ,
Workers' Compensatlon•Laws of California. 1 { ' p i Floor Drains - Water Closet - ' I I
Date ! ' I Signature { , Fixtures I I _
{'NOTICE:If,after-sation 'rovisieclaratione you should become'subject to-the -T' -', Floor Sinks •
- r--4,-` - ' - --Water Heater -- -•, - - �� - - P. -_ Y. iRange _, _ _ � / O(-;
Workers'' Compensation provisions.of the Labor Cole be dee ust-forthwith, _ -
I comply with,- such ,provisions:or,this 'permit shall be :deemed; revoked:- Gas Service' . <Outlets . 'Water Service ,. Device Boxes Sign' ,
CONSTRUCTION LENDING AGENCY - I I 1 I i - Outlets , ,
• I hereby affirm that there Is a construction lending agency for the performance, , . 1 Interceptors : t .� - f, ZS Standing Sections SOU i
of the -work for which-this.permit 'Is issued (Section .3097 Civ. C.- - - - Trash Com LJ 00
-Lender's! Name ' - -- - •" Khoisan Sirik - , Switches pactar 1
! Lender's' Address - - _ - ) _ F/
Lavatories_ - I '= - i Garbage Disposal z 3^T/✓ " (,/ /
OWNER BUILDER DECLARATION ' ' a I . •� , , , 1 . i , i • I , r . , /G TS ' �!
I hereby'atfirm that I am exempt from the,Contractoto License Law for'Ihe i Generator,❑o s KW 05-15KW /SNP G- )
oowing reason (Section-7031:5 Business and Professional Code: Any city or, P' T.rep r "t [ - (,
county which requires a permit to construct,alter,Improve,demolish or repair • - .. i - _ Transformer (]15-50 KW i
any structure, prior to Its Issuance, also requires the pursuant
ant:for such permit! ' Roof'Drains I '. . . •. •
i
to file a signed statement-that he/she is licensed pursuant to thelnrovisions of ; - - - • •• . i []5U+KW Reinspection Fee $15
the Contra of t"Li Dense LaW(Chapter 9 ons(commencing:with Section 7000)of ' 1 $15 , i i .
?,vision.3"of the Business and Professions ption"or•that he/she-Is,exempt : Showers ' Reinspection Fee - • ,
Vt.,refrom and the.basis for the alleged exemption:Any,violation of Section •
- � - Meter ❑up to 100 amps : Issue Fee • 'S 3
-'=i1.5 by;any -applicant fora permit'.subjects the applicant to a civil '
deity of not more than five hundred dollars $500 r• • - , a ' Service Sink I • Issue Fee $ 3 - _ _ i I
( I' Zoning Approved By -Date-
co l,•'as;owner of the property army employees with wages as their sole ' I � , i
• compensation will do the work, and'the‘structure,isrofessional-, not intended or.offered ij • - MECHANICAL , - Application Approved By - 'Gate '
, for salesLaw doe 4, oBusiness and Pfa oparoderwho The Contractor's roves
;License Law does not apply to an owner of a property who builds or Improves 'T Refrigeration System , -"ULJ
thereon,rand ,who does such work himself/herself or through his or her own I, 'Boiler • :;, iApplication Issued By ! Oate. +
employees, provided that such'Improvements are not Intended or offered for , ❑0-,100,000 BTU ❑100,000 BTU 1 '( {
sale. If; however,the building or improvement Is sold within one.year of corn- Mkt-Under:Ground I : ' SUMMARY OF FEES i. i'
' elation, the owner'will have the burden of proving he/she did not build or im- , - f
rove for the purpose of sale). - ! Duct-Structural System Repair/Alteration BUILDING •
PERMIT 51 SMIP $ '
LJ I, as owner of the property, am exclusively contracting with,llcensed con- ,
.:tractors to.construct the project (Section.7044,.Business and.Professions Code: - _ . Duct-Ventilating ,�- - . . _ -__, , ,, _.- ' .PLAN CHECK I S,- ' I PERMIT
'The Contractor's License Law does not apply to an owner of Property who - - I ISSUANCE - $
builds or.Improves thereon,and who contracts for such projects with.a con- ' Exhaust System ❑ Multiple❑ PLUMBING 1 $'
tractor(s) license,pursuant to the-Contractor's License Law): }' - - , PLAN •CHECK' $. '.GRADING $
, ❑ I am exempt under Section B.&P.C.for this reason ' Firepl/Fact.BIt. ICBG#
+ I - I ' ' 1 Heatin S ste • I 'ELECTRICAL;:
CONSTRUCTION AND PLANNING POOL A .
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 Utilitv-Undrgrnd. _ 54. Forms ,
4. Electrical Conduit-Undrgrnd. ,• 55. Electrical Bonding -
5. Steel Reinforcement • _ . 56. Rough Plumbing & Pressure Test -
•
6. Electrical UFER Grnd. .: i, . 57. APPROVAL TO COVER-GUNITE ,
7. Footings S ' ' 58. Electrical Conduit-Undrarnd. - •
8. Foundation - 59. Gas Pipe, 0 Undrgrnd.,Test
9. Water Pipe-Undrgrnd.•, - 60. Backwash Lines, P-Trap, 0 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 'r:•;. - 65. Electrical-Final • t
. 15:.Rough Electrical-Conduit ' / . ' . 66. Solar System-Final
-16. Rough Electric Wiring. "_ /p, 4 e, 67. Fencing &Access Approval • -
17. Rough Wiring Sign u.�e�u� / � 68. APPROVED FOR PLASTERING
18. Rough Electrical-T Bar Ceiling 4y, 49 > " 69. POOL/SPA SYSTEMS FINAL
19. Rough Heating& Air Conditioning !!!!ll������ G`' FIRE DEPT. REQUIREMENT
20. Rough Factory Fireplace s- APPROVALS Permit#
21. Ducts, in Structure: - �. 70. Underground Hydro
22. Ducts, Ventilating 71. Product Piping 0 Gas 0 Oil '
.23. Gas Pipe-Rough &Test 72. Underground Flush ,
24. Roof Framing • 4 73. Undergrnd.Storage Tank 0 Gas 0 Oil -
25. Roof Sheathing 74. Overhead Hydro
26. T-Bar Ceiling (Structural(i& Monocoat 75. Dry Chemical
27. Frame and Flashing76. Dry Standpipe
28. Lathing& Siding I 77. FIXED SYSTEM FINAL
29. Insulation 78. FIRE PREV. FINAL
30. Drywall Nailing Notes:
31. Plaster Brown Coat
32. Electrical Power Meter-Final / �y
33. Final Electric 40w
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 Domestic-Final
42. Backflow Preventer ,
43. Backflow Irrigation ,
44. Landscape Irrigation System
45 Sound Attenuation -
46 Handicap Regulations - ,
47, FINAL STRUCTURE& BUILDING
48. Special Requirements Completed •
49. Electric Release.to Edison
50. Gas Release to Southern California Gas Co •
. 51. CERTIFICATE OF OCCUPANCY ,
No _ Date
Applicant to fill in all spaces except those within heavy border lines and sign all appropriate declarations.
CITY OF COSTAhessMESA . CONSTR U��ION PERMIT PERMIT NO.
� 1 cr_ 1'4GTT NO. UNIT NO. • •Project A•ddress /Q/D W, /7 5 r� io'— 3757' 5/2S/Q5 - ' 17E0E5 i!
Applicant's M�;Iing A:d/sess ' 4 ,_4- ao - - TYPE OF CONSTRUCTION W U ADD- GI_ALTERATION U REPAIR - ,
T •Yvj Cp.s,1 AI Co Phone ❑ CONVERSION .❑ DEMOLISH ❑ OTHER FC`X'� OFFIGC A,p.,p,!/!�(�!_ 35�— �� Zone MG.
Owner's Name /77 DESCRIPTION OF WORK/USE OF BLDG-
Address, fl ,v• 7 S-/ j/h'/ 3 1 f I • Ci.D SPT—1-10L � - / S Main Building: ' Accessory Building:
/279/4"‘,/a Go44 J License No. C y&-7D TYPE OF PERMIT U GRADING. U FOUNDATION IJ STRUCTURAL T Fronts 0
Arch/Eng. �/•
�Address - - ❑ TENANT ❑ ELECTRICAL ❑ PLUMBING ❑ MECHANICAL ' B Rear ' N
l,r;\.ontractor's Name ••k• pr)(.- 1 t• �Ut 'V Phone �e ���/ Y ❑ OTHER - P' - I
I I ' y PROJECT DESCRIPTION SQ. FT.-ester 4-ii t(7 /oi1 OCCUUANCY F3-Z C Right . •
N
/Address(mailing) ( 3�! (A it 1 ✓t'� N/_� '11'• C ON STRUCTION TYPE ��M' (VALUATIONS LL/ 0007 K R
/City License No._ - • 3 /T13 ZONE GRADING CU.YDS. ACRES S
•
LICENSED CONTRACTOR DECLARATION - / Ping. Ref.# P. nig Req./Provided - E
/ I hor¢by affirm that I am licensed under provisions of Charter 9(commencing Remarks: • PC.- -1{- 2 5L}-8 _ Planning Notes: dr %P r a _ O
with section 7000) of Division 3 of the Business and Professions Code, and i V M
my license Is in full f e and effect. i ' -, - T
�636r7' Pd � io. e3S .
License s - i n No. , -
Q .Date Signature - PLUMBING FEES
(xv WORK RS' OMP I have N DECof lliconsent
O -Bar Sink Showers . ELECTRICAL FEES
\_]V�
I hereby affirm that I have a certificate of coto self-insure or a certificate j
of Workers' Compensation Insurance,;or a certified copy thereof (Section Automatic Washei - . . Transformer-0-15-50 KW _
\',;lir800 No.Lab. C° -A'-\Le;V - Company ST'AT'E Backflow,:. ' , ■ 1 -
r
Certified copy is hereby furnished. "--
�" --.Itle-c-1,ifll with Applican :oil. ng •' Isla lit--
' �' ■ 11 .Date I ` �M KERS ° Te Solar Piping - .
FR M WeRd•k t- pSATION r onehu :TION ' Cookinyers g
Gas ■ ' Dover, • •1 apt-Pr--
EXEMPTION �'-:
(This section need not be completed it the permit is for one nun• ed($100)or
less).
I certify that in the performance of the work for which this permit Is Issued, I •
shall not employ any person in any manner so as to become subject to theMotors
Workers',Compensation Laws of California, 00-1 ■
..Date Signature - I ::
■. ■
'NOTICE:If,after making this declaration, you should become subject to the
Workers' Compensation provisions of the Labor Code, you must forthwith
comply with such provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY . I Outlets Water Closet
L
I hereby affirm that there is a construction-lending agency for the performance
:7:
of the work for, which this 'permit is issued (Section 3097 Civ. C.) Interceptors Water Heater '
Lender's Name -
Lender's Address - _ _ I '
OWNER BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the - Grbage Disposal .) ;Standing Sections" 7"
following reason (Section 7031.5 Business and Professional Code: Any city or
county which requires a permit to construct,alter,improve,demolish or repairLaundry Trays '
any structure, prior to its issuance, also requires the applicant for such permit • Generator.00-5 KW 05-15 KW Trash Compactor-
to file a signed statement that he/she is licensed pursuant to the provisions of
the Contractor's License Law(Chapter 9-(commencing with Section 7000)of . -
Division 3 of the Business and Professions Code) or that he/she is exempt
therefrom and the basis for the alleged exemption. Any violation of Section !'.
•
7031.5 by any applicant for a. permit subjects the applicant to a civil
penalty of not more than five hundred dollars($500). ,
7 I, as owner of the property'or my employees with wages as their sole -.,
.ompensation, will do the work,and the-structure-Is not Intended or offered Reinspection Fel; „,• I $15 'Issue Fee 5 3
for sale (Section 7044, Business and Professional Code:. The Contractor's
License Law does not apply to an owner of a property who builds or Improves
thereon, and who,does such work himself/herself or through his or her own ■ DEVELOPMENT SERVICES REOUIFiEME TS:p • e_/�
' employees, provided that such improvements are not Intended or offered for Hood or r ,(J J
•
sale, If, however, the building or Improvement is sold within one year of corn- I. ZOning'Approved By_ nate
Welton, the owner win have' the burden of proving he/she did not build or im- 1 , •• I ■, , I W
prove for the purpose of sale). Building Approved By I� I� Date �-29-B"
0 I, as owner of the property, am exclusively contracting with licensed con- • RefrigerationApplication Issued By '- Date
tractors to construct the project (Section 7044,Business and Professions Code:
The Contractor's License Law does not apply to an owner of property who • 00-100,000 : ■ 1'1 111 : SUMMARY O FEES '
builds or Improves thereon, and who contracts for such projects with a con-
tractor(s) license pursuant to the Contractor's License Law), I am awareubjecExhaust Systemt ■ on BUILDING PERMIT $ 1-�0•. 0 SMIP $ 1 p -1 5
proof of their Worker's Compensation insurance should be provided to me.
❑ I am exempt under Section B.Z. P.C.for this reason :• # Fire DampersPLAN CHECK $ PERMIT
PLUMBING. $ ISSUANCE $
Date Owner PLAN CHECK 25% $ ENERGY P.C. $
I herebyat certifyssect I haverread thismapplication and state that the above`•I.1Yfl4hiV½i,i.iatu1 •,
•
Information is correct. I agree toea comply with city and county the
bve ELECTRICAL • $ GRADING $
and'state laws re g to b ',sting onstruction, and hereby authorize repro- PLAN CHECK 50% $ MICROFILM $
sentatives of t s c to , -r, i on the above-mentioned prop rty for
inspection urn ses _ MECHANICAL •
I
Signature I V Date'', •$ TOTAL FEE $ /t?f7�
Drivers' License or 5$yt w $15 . • . Issue Fee $ 3 I PLAN CHECK 25% $ •,
CMF 0865-46,rev. 10/84 White - Building; Canary - Applicant; Pink -Accounting; Goldenrod - Assessor _ - - -'-
! ' •
•
•
CONSTRUCTION AND PLANNING - POOL& A
APPROVALS - • Permit# Date Inspector - APPROVALS Permit# Date Inspector
.I.,Temporary Electrical Service or Pile ' .. 52. Pool & Equipment Location
' c 2. -Stir Pipe-Undrgrnd. - - 53. Steel Reinforcement
3. Electrical,Conduit Utility-Undrgrnd., 54. Forms ••
4. Electr'r al Conduit-Undrgrnd. 55. Electrical Bonding
5. Steel:Reinforcement 56. Rough Plumbing & Pressure Test • .'
6: Elect icalUFER. Grnd. - 57. APPROVAL TO COVER-GUNITE
1. Footings' : . 58. Electrical Conduit-Undrgrnd.
8: Foundation .. ;r 59. Gas Pipe, 0 Undrgrnd.,Test '
9. Water Pipe-Undrgrnd. 60. Backwash Lines, P-Trap, 0 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 0 Gas ❑Oil .
23. Gas Pipe-Rough &Test •
72. Underground Flush
• 24. Roof framing73. Undergrnd.Storage Tank 0 Gas 0 Oil
25. Roof Sheathing - 74. Overhead Hydro
26. T-Bar Ceiling (Structural) & Monocoat - 7///0- / 75. Dry Chemical •
27. FrameandF.lashing - _ �ljR�. y� 5r 76. Dry Standpipe .
28. Lathing & Siding . . �`- 77%, FIXED SYSTEM FINAL
' 29. Insulation . ., y - •- 78. FIRE PREV. FINAL
30_ Drywall Nailing • 1. Of 3/8S 0 S ' HEALTH DEPT-. REQUIREMENT
31. Plaster Brown Coat. . " - . - 79. FINAL INSPECTION
•
32: Electrical Power Meter-Final 80. FOOD CERTIFICATE ISSUED
33. Final electric • Notes: 2 /./.1.Ft
Ca.JSc�Q z�( r ,4..4.(c_
34. Final Heating & Air Conditioningpp � � �r �r�• (e A
35. Final.Gas Pipe-Test .27;-.......
4-/x4 r([tc
36. Hood or . • 78.•
'
•
37. Final Factory Fireplace p cr 5tcir P¢,� . -NS - 8136
38. Final Plumbing ,a241.4-4-a. ,1` f!�/ O�m j-
39. Water Service-Final C
40. Gas Service-Final
41. Solar Domestic-Final -
42. Backflow Preventer
43. Backflow Irrigation -
44. Landscape Irrigation System
45. Sound Attenuation '
46. Handicap Regulations .
47. FINAL STRUCTURE & BUILDING c,1/t !ac nu P 4--
48. Special Requirements Completed
49. Electric Release to Edison - '
50. Gas Release to Southern California Gas Co ,
51. CERTIFICATE OF OCCUPANCY • . -
No. Date
PAiLnO22e5 *175.73
u+ zz �r :a,VV
11 r4". 42328
COSTA MESA BUILDING-SAFETY DEPARTMENT gLD6
Z
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APP I TION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only
PEC B DAE Z=EIVSD D/yT ISSUE
BUILDING /D/D / ,I /7-A__S Jr z 17 G/ 7.- j
ADDRESS rN ^l- (/y /J.//r
OWNER S2o 4•0••••• Da—y to mCNr' &Al. - A"'Na /MI — NU--/ P 23n
BUILDING
ADD �/ ADDRESS O, A / 7 .54_,ADDRESS Imo/ ¢}`r Z. GH4MQoeS,
TEL. I ' - e'AP
CITY $ . NO. 1:4" 120OYam 14 - '-t+' BLOCK
CONSTRUCTION NEWT -OD ALTER REPAIR MOVING DFMOI ISH
LENDER .---
BRANCH
OWNER 0f4..)tJ is d • Carp
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4
ADDRESS / / /' VALUNI*
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OR ENGINEER EC' �6. o'92cS//
•
FIRE IT�
ADDRESS PSS/ 5„ae • /IS ZONE Vjjyy//E GROU)ppp,r!
OWNtf2 yPROV ED J/ //Heti
CONTRACTOR By !! DATE /
ADDRESS •
Zpy�
TEL. Y''1 C7 IPLANSOF,
USE OBUILDIFG d �/
CITY NO. •
1. 9
F• STATE CITY YARDS APPROVED YARDS APPROVED V/
LIC.NO. LIC.NO. I MAIN BUILDING ACCESSORY BUILDING
W SIZE NO.OF BLOGS. (FROM C/L$'[{ ETI '/`
0. OF LOT NOW ON LOT FRONT �r /T /h
. /7F1
Q USE OF
EXISTING BLDG. ^ R SIDE )FT. FT.
Ce) //
H Separate permits are required for L,SIDE (j/6 FT6 FT.
electric,plumbing and heating work. n
WREAR �/ RT. FT.
• f.. USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
Q< MAIN BLOCS. ACCESS.BLOCS.
�t �s����� VAR.* DATE
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tatimEmEN
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FOLD_ FOR SPEci4 — QQ.
0. I hereby acknowledge that I have road this application and state �"'e_L J '^
IY that the above information Is correct and agree to comply with �Q 04 za
Or all laws regulating building construction, and I shall not employ / m
Z any person in violation of the workman's compensation laws of2
m
the State of California.z ,/� m
I hereby certify that I am properly licensed as a contractor under Y SO. FT. ti
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR al
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY: e
am exempt from the provisions of the State of California Business p
VALUATION PERMIT FEE S
and Professions Code,DWI on 3, pter 9.
til
en
Signature of PLAN CHECK S /67„aS 2
Permittee n $ ISCO 906.
47 TAX S 0$ u
Authorized Agent 4(r/GS' 14 /gyro C TOTAL PAID $ /76-77g
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°1' -1-767:;;,"00 00? r.4* *?.61.001
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Corn letel — Use Ink Only
�t RECEIVED BY DATE RECEIVED DATE ISSUED
BUILDING /0�/ is
ADDRESS 4 a1 f //; O� PERMIT NO.
OWNER .
i L , i ' A.P. NO.
ADDRESS ,^
MAIL Au` u) / )I
ADDRESS L
TEL.
CITY NO. TRACT LOT BLOCK
CONSTRUCTION NEW ADD ALTER REPAIR (MOVING DEMOI ISH
LENDER
BRANCH �r
OWNE
ADDRESS Ah VALUE
.$ .49: i
ARCHITECT TEL. US r q- h E
OR ENGINEER NO.
FIRE
ADDRESS ZONE TVP GROUP
O l APPROVED
CONTRACTOR w BY DATE
ADDRESS
TEL. ZONE NO.OF USE OF NEW
CITY NO. PLANS BUILDING
F.. STATE CITY YARDS APPROVED YARDS APPROVED
5 LIC.NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
U SIZE INO.OF BLDGS,
(FROM C/L STREET)
c. OF LOT NOW ON LOT FRONT FT. FT.
a USE OF
EXISTING BLDG. R.SIDE FT. FT.
L.)
FSeparate permits are required for L.SIDE FT. FT. _
Ci
electric,plumbing and heating work. REAR FT. FT.
IQ USE OF BUILDING AND WORK TO BE PERFORMED
4lIGF �� ��//�� DISTANCE BET. BET.MAIN&
O - �����P1 ` / , MAIN BLDGS. ACCESS.V BLDGS.
r(/ //4/'(!/�/_`Narsi•e►I/�/ VAR.# DATE
', C.V.P.qW APPROVED
a
7 APPROVED
ABY DATE
CC
Ri . . • - . ..
C. I hereby acknowledge that I have read this application and state m
a that the above Information is correct and agree to comply with m
a. all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of o
4J the State of California. m
I hereby certify that I am properly licensed as a contractor under SQ. FT. w
the State of California Business and Professions Coda, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR m
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the provisions of the State of California Business / �.00 a
and Professions Code, Division 3,Chapter 9. VALUATION PERMIT FEE S , m
Signature of PLAN CHECK $ 0
0
a.
Permittee $ TAX S f
U
Authorized Agent TOTAL PAID $, `a
, f- 1 •
• . 43972
MAY 13-77PA`u00 625* 1*****5.50
rRSa
COSTA MESA BUILDING-SAFETY DEPARTMENT
P.O.BOX 1200 COSTA MESA,CALIFORNIA 92626
APPLICATION FOR STRUCTURAL PERMIT
For Applicant to Fill in Completely — Use Ink Only RECEI� _ DATE RECEIVED D E I UED
OES
DRSG / , to
t4' I 1 Z-- / ,(��r P __5
v OWNER 3a( Ai � . A.P. NO//(D / / V /X :ER TJjl�.ff
MAIL 4....s--(9._
I,— BUILDING
74
ADDRESS IL,vIJrZ- rf}A 17113cID-.S AD RESS •I/O tV• 1 / 'S
TEL. f ��-=y��r�� Y� ig-07
CITY 1-5 S-n J NO. '`[ - 8.00 411W 1 .��i_ - LOT a !+LOCK
CONSTRUCTION ^^ h(Eyj✓ Aye ALTER -EPAIR MOVING DFMOLISH
LENDER InCae 02U A0)10C-LS
BRANCH 'fkui IT( Ai(tT A) [)'=11'1-(4 In� y/J[ ^/ �$
ADDRESS OWNER Vro���) aeli�(.espen e///
IVIR(AJ o&r'c(- [J /}4ALU?
ARCHITECT /IA
'' /� TEL. USS/�-' I /2,1.-Vr�' $
OR ENGINEER /IA CQ�-1-I- TI SS(JC. NO.
FIRE
�(/ADDRESS n ZONE TYPE GROUP
\ OL(1 AlJ EP- -BL)i /i7t�.
APPROVED
CONTRACTOR j,� BY DATE
ADDRESS /�WIC
k ak� �,
TEL. - Z NO.OF USE OF EW
eiv
CITY nett NO. PLANS BUILD
E^ STATE CITY YARDS APPROVED YARDS APPROVED
gLIC. NO. LIC. NO. MAIN BUILDING ACCESSORY BUILDING
raj SIZE NO.OFBLOG (FROM C/L STREET)
C. OF LOT I S
NOW ON LOT FRONT FT. pir9 FT.
a USE OF
CA EXISTING BLDG. B.SIDE
T.
CA
9 Separate permits are required for L.SIDE T.
Fe
electric,plumbing and heating work.Cc REAR FT.
W
F USE OF BUILDING AND WORK TO BE PERFORMED DISTANCE BET. BET.MAIN&
QQ 1 MAIN BLDGS. ACCESS. BLDGS.
v n .1 VAR.# DATE
_...-1 `7 72-11-S 44 ENC (ow P_C C.V.P.# /� �/ ger-
//
F.YROVED//,b,( / a DATE / 3—il
w HOLD FOR SPECIAL REQUIREMENTS.
0. I hereby acknowledge that I have read this application and state N.
p( that the above Information Is correct and agree to comply with m
4 all laws regulating building construction, and I shall not employ
Z any person in violation of the workman's compensation laws of u
Sthe State of California. N FT.
I hereby certify that I am properly licensed as a contractor under SQ. N
the State of California Business and Professions Code, Division 3, THE AMOUNT SHOWN UNDER VALUATION IS FOR at
Chapter 9, and that such licenses are In full force and effect,or I THE PURPOSE OF ESTABLISHING A PERMIT FEE ONLY:
am exempt from the prov ions of the State of California Business VALUATION PERMIT FEE $ �r0 0 n
and Professions Coda, on 3,Chapter 9. re
r- PLAN CHECK $ "'
0
Signature of �p
Permlttea S J -l�(/1 S CO-0 TAX $ 1 5a u.U
Authors Agent TOTAL PAID $ 575.-0
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